bluuebunny/crossref_metadata_2025 huggingface dataset:
The outsider: Outsider rhetoric and truth-seeking in The Profession of Faith
Authors: Warner John
Published: February 2024

Efforts to identify oneself as an “outsider” are an increasingly visible feature of the democratic political environment, and perhaps no political thinker has utilized outsider rhetoric to greater effect than Jean-Jacques Rousseau. That said, virtually no attention has been paid to the important role that such rhetoric plays in a work that Rousseau believed to be the “best and most useful” of the Eighteenth Century— The Profession of Faith of the Savoyard Vicar. In this article I attend to the vicar's use of outsider tropes, focusing in particular on how they serve to legitimate an account of truth-seeking which would otherwise be rejected by the vicar's skeptical audience. I also show how the vicar's understanding of the conditions necessary to proper truth-seeking are different from Rousseau's own. This argument, if successful, illustrates the intrinsically rhetorical character of The Profession as well as calling attention to the presence of an important though neglected rhetorical strategy. In achieving these dual aims, this essay contributes both to the growing literature on The Profession and highlights neglected aspects of Rousseau's own rhetorical strategies.
Social Media Posts About Carpal Tunnel Release: A Cross-Sectional Analysis of Patient and Surgeon Perspectives
Authors: Reynolds Christopher A. , Mehta Manish P. , Wu Scott , Neuville Alexander J. , Ho Alisha , Shah Chirag M.
Published: February 2024

Background:

Social media provides an increasingly popular, unfiltered source of perspectives on healthcare. The objective of this study is to characterize the landscape of social media posts regarding carpal tunnel release (CTR).

Methods:

Content was queried from Instagram between February 2, 2019 to August 12, 2021 using the hashtags #carpaltunnelrelease and #carpaltunnelsurgery. The 1500 most-liked posts were analyzed. Poster demographics including age, gender, region, and symptom qualities and post characteristics including type, number, timing relative to surgery, tone, and satisfaction were collected. Categorical variables were compared utilizing chi-squared test. Univariate and multivariate regression were performed.

Results:

The most popular post types included single photo (55.2%), multiple photos (18.8%), or single video (18.2%). Of all, 70.6% posts had fewer than 50 “likes.” Patients accounted for 51.8% of posts, followed by surgeons (13.3%), other health care providers (11.7%), and physical therapists (8.8%). Women (66.7%) outnumbered men (33.3%). Fifty-five percent of posts were domestic. Posts mostly depicted postoperative care (85.6%). The most frequently mentioned symptoms were pain, burning, numbness, and tingling. Of all posts, 45.1% had a positive tone, 49.1% neutral, and 5.7% negative. Univariate analysis revealed that posters who were patients, underwent open CTR, and were female were more likely to post negative sentiments.

Conclusions:

Most posts regarding CTR are from patients, are postoperative, and are positive or neutral. Although rare, negative posts were more likely to originate from posters who are patients, female, or underwent open CTR. With this information, surgeons will be better prepared to address patient concerns, set patient expectations, and enter the social media themselves.
“This Is a Look Into My Life”: Enhancing Qualitative Inquiry Into Communication Through Arts-Based Research Methods
Authors: Harasym Jessica A. , Gross Douglas P. , MacLeod Andrea A. N. , Phelan Shanon K.
Published: February 2024

As researchers in communication sciences and related disciplines continue to embrace qualitative research methodologies, there will be a corresponding need for innovative methods and strategies for data collection and generation, reflexivity and knowledge translation to make qualitative research methods more inclusive. Historically, those who communicate differently from the status quo have been excluded from or spoken for in qualitative research. The resulting omission of these perspectives in the literature constitutes a critical research-to-practice gap as clinicians seek to deliver client-focused communication care. Arts-Based Research (ABR) offers researchers a means of augmenting potentially linguistically and cognitively demanding verbal interviews while inviting participants to share a window into their daily lives with researchers and knowledge users. Additionally, ABR offers participants alternative forms of expression and creates avenues for researcher reflexivity and participant-researcher reflexive dialogue. To illustrate how ABR can enhance communication research, we present reflections on a study that incorporated multi-media artistic materials in a reflexive arts-based collective case study design. Working with young people experiencing post-concussion communication changes, we used arts-based materials collected and created by participants to support and enhance data collection. These materials were analyzed as part of each case, across cases, and played a central role in sharing our findings. Additionally, arts-based materials facilitated participant-researcher reflexive dialogue and researcher reflexivity. The goals of this paper are to: 1) provide a brief overview of ABR as a method for researchers interested in communication; 2) discuss four ways to incorporate ABR in the research process; 3) provide a case example illustrating different types of creative works to illustrate the four ways ABR can enhance communication research; and 4) discuss benefits, considerations and implications of using ABR to support inclusive research design.
Russian LGBT activism and the memory politics of sexual citizenship
Authors: Stoltz Pauline , Khlusova Anna
Published: February 2024

This article discusses barriers to the citizen practices of Russian lesbian, gay, bisexual and transgender activists in the memory politics of Russian sexual citizenship. Based on memories of activism, as told in interviews with Russian lesbian, gay, bisexual and transgender activists, we focus on how these memories play a role in their national and transnational struggles for sexual rights and recognition, and how intersectional inequalities may create barriers to their queer and memory space-making practices. The interviews were conducted in 2021 ( before the war between Russia and Ukraine, which started in 2022) and focus on the period between 2010 and 2020. Our findings highlight how intersectional inequalities of power influence Russian sexual citizenship and queer (memory) space-making, both at home and abroad. Theoretically, the results reveal the need to situate Russian lesbian, gay, bisexual and transgender activism in time, place and space in research on narratives of progress and social change in studies of queer global politics and transnational solidarities.
A history of the European Medical Society for Psycholytic Therapy (EPT) 1964–1974
Authors: Passie Torsten
Published: February 2024

The emergence of a so-called psychedelic renaissance has been proposed to characterize the revival of research into (psycho-)therapies using psychedelic drugs. In Europe, the most widespread approach employed in the 1960s and 1970s that involved the use of drugs like LSD and psilocybin as an adjunct to psychotherapy was named according to its main theoretical framework, that is, psychoanalysis as psycholytic therapy (psycholysis). Psycholytic therapy involves the use of serial low-dose sessions embedded in conventional long-term psychotherapy. However, this approach seems to be neglected today in favor of the psychedelic peak therapy paradigm with the use of just one or two high dose sessions to induce symptom reduction and personality transformation with a minimum time of psychotherapy. A review of the history and activities of the European Medical Society for Psycholytic Therapy (EPT) shows that it was a significant institution at the time. The EPT was founded as a professional society in 1965 aiming to coordinate European efforts of LSD therapists and enable professional exchange to further the development of psycholytic therapy. It also aimed to disseminate psycholytic therapy as an innovative treatment, and encourage international cooperation to develop standards of therapy and training. Up to now, there is virtually nothing available in the literature about the EPT and its activities. The author reconstructs the history and activities of the EPT based on unique archival resources to learn from past experiences and to help inspire the development of standards for treatment and training in the future.
Incidence of acute and delayed rectal toxicities following hydrogel spacer insertion in men receiving dose-escalated radiotherapy for prostate cancer
Authors: Anton Sagayanathan Prasanth , Loganathan Ajanthan , Tharakan Ninan , Kalapara Arveen , Antoniou Stefan , McGhee Luke , Pridgeon Simon
Published: February 2024

Objectives:

The objective of this study was to evaluate the effectiveness of a hydrogel spacer in reducing acute and delayed rectal toxicities.

Materials and Methods:

Patients undergoing definitive radiotherapy between January 2015 and March 2018 were retrospectively identified from our institutional cancer registry. Planning data were collected on dose-volume histograms (DVH) for V65, V70 and V75 Gy. All patients underwent definitive volumetric modulated arc therapy (VMAT) of 78 Gy over 39 fractions in a single centre. Toxicity reporting and definitions were in accordance with Common Terminology Criteria for Adverse Events (CTCAE) guidelines.

Results:

A total of 162 patients received radiotherapy during the study period (spacer n = 80; no spacer n = 82). Baseline characteristics between groups were comparable. Acute rectal toxicity was documented in 19 men (24%) with spacer versus 36 men (44%) without spacer devices ( p = 0.007). Over a median post-treatment follow-up period of 17 months (range = 3–38 months), there was a significant reduction in delayed toxicity in men with spacers compared to men without (17 men 21% vs. 31 men 39%, p = 0.021).

Conclusion:

Hydrogel spacer devices reduce rectal radiation exposure in prostate cancer patients undergoing radiotherapy. This translates into a clinical benefit in terms of acute and delayed rectal toxicities.

Level of evidence:

cohort study
Menopause and the role of physical activity – The views and knowledge of women aged 40–65
Authors: Wasley David , Gailey Samantha
Published: February 2024

Menopause marks the end of female reproductive capacity. It is defined as the point after cessation of the menstrual cycle for 12 months (Nursat et al., 2008). Awareness about menopause has increased over the last decade, yet studies have shown that women still lack knowledge regarding the subject. Likewise, awareness of women between the age of 40–65 on the potential role of physical activity prior to and during menopause in women is unclear. Women ( n = 162) aged 40–65 years completed a survey rating their knowledge, answered fact-based questions and reported their experiences of menopause. Their levels of, and beliefs on, the role physical activity on symptoms and menopause associated disease risk were also collected. Women reported their confidence in their current knowledge level at 67% reflecting 37% higher rating than an estimate of their knowledge 10 years ago. Their factual knowledge score was 56%. Knowledge was primarily gained through friends and family and almost half (46%) had not spoken to a healthcare professional. Frustration was expressed with lack of knowledge and support of healthcare and others. Women using HRT (44%) had mixed attitudes towards its role. A high proportion were active and felt that physical activity can help manage symptoms and impact long-term health consequences of menopause. Menopause education strategies for women, healthcare professionals and others need to be improved. Lack of education may be causing women to struggle and feel negatively towards this life stage. Physical activity was viewed positively for the symptoms and a treatment during menopause and long-term health.
Comparing Spinal Cord Drift, Clinical Outcomes and C5 Palsy in Degenerative Cervical Myelopathy: A Study of Cervical Laminoplasty Versus Laminectomy/Fusion
Authors: Basu Saumyajit , Gohil Kushal
Published: February 2024

Study design

Retrospective comparative study.

Objectives

(i)to compare spinal cord drift between laminectomy and fusion(LF) and cervical laminoplasty(LP) for degenerative cervical myelopathy(DCM) treatment,(ii)to study relationship between preoperative cervical alignment, postoperative spinal cord drift, functional outcome, and C5 palsy.

Methods

A cohort of 114 patients who underwent LP or LF for DCM were identified. After propensity-score matching, both groups included 30 patients each.Cobb angle(C2-C7) was used to assess pre-and postoperative cervical spine alignment(at 2-year follow-up).Based on alignment, there were lordotic(L) and straight(S) subgroups.Spinal cord position was measured on sagittal-and axial-T2W MRI of cervical spine pre-and postoperatively at 2-year follow-up and cord drift was measured by subtracting preoperative values from postoperative values.Functional recovery(mJOA score, mJOA recovery rate),and C5 palsy in patients were recorded and compared.

Results

LF had higher mean spinal cord drift than LP(2.66 ± .77 vs 2.16 ± .80 mm, P = .049).Lordotic subgroups exhibited greater cord drift than straight subgroups within LP and LF groups.Both groups significantly improved mJOA scores at 2-year follow-up, with no LP-LF difference in mJOA recovery rate(mJOA-RR).Lordotic subgroups had significantly higher mJOA-RR(LP-L vs LP-S, P = .048; LF-L vs LF-S, P = .045).Preoperative cervical alignment, cord drift, and mJOA-RR correlated well(Spearman’s ρ .7143 and .6053 respectively).Patients with >2.5 mm cord drift(n = 24) had significantly higher mJOA-RR as compared to <2.5 mm cord drift(n = 18). Substantial clinical difference was seen in C5 palsy risk between LP-S and LF-L, with the LF-L group having 3-fold higher risk.

Conclusion

LF had a biomechanical advantage in maximizing spinal cord drift in severe DCM cases, while both LP and LF showed significant improvements in neurological function. However, variability in C5 palsy rates highlights the need for individualized patient assessment.
Prediction of Toddlers Acute Respiratory Infection (ARI) to Become Pneumonia in Martapura Catchment Area, Banjar District, Indonesia
Authors: Lutpiatina Leka , Sulistyorini Lilis , Yudhastuti Ririh , Notobroto Hari Basuki
Published: February 2024

Introduction. The pneumonia pattern in young children may vary across different catchment areas. Therefore, this study aims to analyze the predictive factors for toddlers with an Acute Respiratory Infection (ARI) developing into pneumonia in the catchment area of Banjar Regency, Indonesia. Methods. A case-control design, with 300 respondents, consisting of 106 cases and 194 controls. A questionnaire of interviews with mothers/caregivers of toddlers. Forty-one indicators data were analyzed using multiple logistic regression with backward stepwise regression to arrive at the final model. Results. The predictive factors for toddlers with pneumonia were the child’s age ( P-value .070), child development ( P-value .007), breastfeeding ( P-value .051), family income ( P-value .026), and location of houses along the river ( P-value .025). Conclusion. A prediction index for toddler pneumonia has been compiled, which can be applied to improve the health of lower middle-class toddlers requiring more government attention.
Employee Support for Unionization at Starbucks? A Peer-Influence Negotiation
Authors: O’Neill Regina M. , Levesque Laurie L.
Published: February 2024

Workers’ personal perspectives on situations and the actions they take are shaped by their own experiences and preferences and through negotiated agreements with others. Employee Support for Unionization at Starbucks is a four-person negotiation exercise that reinforces skills of perspective-taking and listening within the context of peer influence with others who may or may not agree with them. Students review a scenario about a familiar context (a Starbucks store) and craft individualized perspectives based on assigned roles as a barista or shift leader. Students prepare negotiation plans to influence each other regarding whether to support unionizing efforts at their store. This small group exercise simulates how personal perspectives (priorities, positions, and goals) and peer relationships affect one’s approach and negotiation of key issues. The debrief explores relevant concepts and the impact of shared perspectives, emotions, and workplace relationships.
Navigating the AI frontier: Should we fear ChatGPT use in higher education and scientific research? Finding a middle ground through guiding principles and practical applications
Authors: Saccenti Daniele , Buattini Matilde , Grazioli Silvia , Torres Dalila
Published: February 2024

The adoption of Artificial Intelligence-based chatbots, including ChatGPT, in various sectors has raised concerns about their implications in higher education and scientific research. While the academic world aims to foster critical thinking and produce reliable research, the use of chatbots has elicited resistance from some academics due to fears of inaccuracies. In this paper, we extensively examine this phenomenon in higher education and scientific research, seeking to understand its practical applications, limitations, and potential risks. We investigated how ChatGPT is currently being used by academia, young researchers, and students. We also identified its areas of application and conducted trials by engaging ChatGPT, with transcripts included in the paper. Based on our findings, we discuss the results in the context of the needs in higher education and scientific research, presenting guidelines for responsible adoption. We distinguish positive use cases, areas requiring caution, explicit limitations of ChatGPT, and cases of unethical use. Importantly, we view ChatGPT as a valuable technological innovation but emphasize the necessity for thoughtful and responsible implementation. While we do not consider its use inherently deceitful, consistent, and shared guidelines are essential to ensure its ethical and effective application.
Role of UPI Application Usage and Mitigation of Payment Transaction Frauds: An Empirical Study
Authors: Edburg B. Franklin , Umadevi K. , Vidya M. , Kumar P. M. Ramesh
Published: February 2024

The objective of this investigation is to analyze the intention behind user behavior toward employing Unified Payment Interface (UPI) apps and pinpointing successful solutions for mitigating frauds linked to them. This will increase safety measures, which would lead to an escalation in usage among consumers, ultimately resulting in higher financial inclusion across India through cashless transactions. The Indian digital payment system has been transformed by these platforms, including Google Pay, PhonePe, and Paytm, which together account for over 90% of all online payments made. Users are attracted primarily due to its convenience as well as ease-of-use factors along with influence from their peers who have turned into avid users themselves. Largely, due to COVID-19 lockdown disruptions many people shifted away from traditional monetary exchanges toward Internet Banking options leading to a surge-related crime involving transactional fraudulent practices costing up to 346%. The popularity itself throughout time due again mainly because it’s easy access capabilities UPI payment app development on fraudulent activities continued. A structured questionnaire was adopted during the collection phase within Chennai City among active UPI payment apps users whose data were analyzed using multivariate statistical techniques. The result proves that predictors such as perceived security, safety, risk consistent advantageous represents key inferences, supplying impetus towards utilizing technology and providing cautionary advice where deficiencies subsist. Info dissemination, emphasizing feature/benefit analysis targeting core customer groups, delivered periodically supplemented defensive protocols, incorporating trial process adaptations can mitigate further risk associated with application utilization. Reader response, demonstrating accommodative response based on familiarity, empowering generational social structure, and enabling transformation gained momentum, demonstrates structural readjustment and solidifies the benefits borne out by increased adaption ratified effective outcomes accruing overall benefits, favourably impacting a variety of demographic profiles, and guaranteeing continued use.
A CD38-directed, single-chain T-cell engager targets leukemia stem cells through IFN-γ–induced CD38 expression
Authors: Murtadha Mariam , Park Miso , Zhu Yinghui , Caserta Enrico , Napolitano Ottavio , Tandoh Theophilus , Moloudizargari Milad , Pozhitkov Alex , Singer Mahmoud , Dona Ada Alice , Vahed Hawa , Gonzalez Asaul , Ly Kevin , Ouyang Ching , Sanchez James F. , Nigam Lokesh , Duplan Amanda , Chowdhury Arnab , Ghoda Lucy , Li Ling , Zhang Bin , Krishnan Amrita , Marcucci Guido , Williams John C. , Pichiorri Flavia
Published: February 2024

Treatment resistance of leukemia stem cells (LSCs) and suppression of the autologous immune system represent major challenges to achieve a cure in acute myeloid leukemia (AML). Although AML blasts generally retain high levels of surface CD38 (CD38pos), LSCs are frequently enriched in the CD34posCD38neg blast fraction. Here, we report that interferon gamma (IFN-γ) reduces LSCs clonogenic activity and induces CD38 upregulation in both CD38pos and CD38neg LSC-enriched blasts. IFN-γ–induced CD38 upregulation depends on interferon regulatory factor 1 transcriptional activation of the CD38 promoter. To leverage this observation, we created a novel compact, single-chain CD38-CD3 T-cell engager (BN-CD38) designed to promote an effective immunological synapse between CD38pos AML cells and both CD8pos and CD4pos T cells. We demonstrate that BN-CD38 engages autologous CD4pos and CD8pos T cells and CD38pos AML blasts, leading to T-cell activation and expansion and to the elimination of leukemia cells in an autologous setting. Importantly, BN-CD38 engagement induces the release of high levels of IFN-γ, driving the expression of CD38 on CD34posCD38neg LSC-enriched blasts and their subsequent elimination. Critically, although BN-CD38 showed significant in vivo efficacy across multiple disseminated AML cell lines and patient-derived xenograft models, it did not affect normal hematopoietic stem cell clonogenicity and the development of multilineage human immune cells in CD34pos humanized mice. Taken together, this study provides important insights to target and eliminate AML LSCs.
WSB1, as an E3 ligase, restrains myocardial ischemia–reperfusion injury by activating β-catenin signaling via promoting GSK3β ubiquitination
Authors: Fang Lini , Tao Yang , Che Guoying , Yun Yongzi , Ren Min , Liu Yujie
Published: February 2024

Background

Reperfusion is the most effective strategy for myocardial infarct, but induces additional injury. WD repeat and SOCS box containing protein 1 (WSB1) plays a protective role in ischemic cells. This study aims to investigate the effects of WSB1 on myocardial ischemia–reperfusion (IR) injury.

Methods

The myocardial IR was induced by left anterior descending (LAD) ligation for 45 min and subsequent reperfusion. The overexpression of WSB1 was mediated by tail vein injection of AAV9 loaded with WSB1 encoding sequence two weeks before IR surgery. H9c2 myocardial cells underwent oxygen-sugar deprivation/reperfusion (OGD/R) to mimic IR, and transfected with WSB1 overexpression or silencing plasmid to alter the expression of WSB1.

Results

WSB1 was found highly expressed in penumbra of myocardial IR rats, and the WSB1 overexpression relieved IR-induced cardio dysfunction, myocardial infarct and pathological damage, and cardiomyocyte death in penumbra. The ectopic expression of WSB1 in H9c2 myocardial cells mitigated OGD/R-caused apoptosis, and silencing of WSB1 exacerbated the apoptosis. In addition, WSB1 activated β-catenin signaling, which was deactivated under the ischemic condition. The co-immunoprecipitation results revealed that WSB1 mediated ubiquitination and degradation of glycogen synthase kinase 3 beta (GSK3β) as an E3 ligase in myocardial cells. The effects of WSB1 on myocardial cells under ischemic conditions were abolished by an inhibitor of β-catenin signaling.

Conclusion

WSB1 activated β-catenin pathway by promoting the ubiquitination of GSK3β, and restrained IR-induced myocardial injury. These findings might provide novel insights for clinical treatment of myocardial ischemic patients.
Alternative blood transfusion triggers: a narrative review
Authors: Arynov Ardak , Kaidarova Dilyara , Kabon Barbara
Published: February 2024

Background

Anemia, characterized by low hemoglobin levels, is a global public health concern. Anemia is an independent factor worsening outcomes in various patient groups. Blood transfusion has been the traditional treatment for anemia; its triggers, primarily based on hemoglobin levels; however, hemoglobin level is not always an ideal trigger for blood transfusion. Additionally, blood transfusion worsens clinical outcomes in certain patient groups. This narrative review explores alternative triggers for red blood cell transfusion and their physiological basis.

Main Text

The review delves into the physiology of oxygen transport and highlights the limitations of using hemoglobin levels alone as transfusion trigger. The main aim of blood transfusion is to optimize oxygen delivery, necessitating an individualized approach based on clinical signs of anemia and the balance between oxygen delivery and consumption, reflected by the oxygen extraction rate. The narrative review covers different alternative triggers. It presents insights into their diagnostic value and clinical applications, emphasizing the need for personalized transfusion strategies.

Conclusion

Anemia and blood transfusion are significant factors affecting patient outcomes. While restrictive transfusion strategies are widely recommended, they may not account for the nuances of specific patient populations. The search for alternative transfusion triggers is essential to tailor transfusion therapy effectively, especially in patients with comorbidities or unique clinical profiles. Investigating alternative triggers not only enhances patient care by identifying more precise indicators but also minimizes transfusion-related risks, optimizes blood product utilization, and ensures availability when needed. Personalized transfusion strategies based on alternative triggers hold the potential to improve outcomes in various clinical scenarios, addressing anemia’s complex challenges in healthcare. Further research and evidence are needed to refine these alternative triggers and guide their implementation in clinical practice.
The role of dexmedetomidine administered via intravenous infusion as adjunctive therapy to mitigate postoperative delirium and postoperative cognitive dysfunction in elderly patients undergoing regional anesthesia: a meta-analysis of randomized controlled trials
Authors: Wang Di , He Xiao , Li Zicen , Tao He , Bi Congjie
Published: February 2024

Study objective

This meta-analysis aimed to assess whether continuous intravenous administration of DEX during surgery can be part of the measures to prevent the onset of postoperative delirium and postoperative cognitive dysfunction in elderly individuals following regional anesthesia.

Methods

We searched the databases of PubMed, Embase, the Cochrane Library and China National Knowledge Infrastructure (by June 1, 2023) for all available randomized controlled trials assessing whether intravenous application of dexmedetomidine can help with postoperative delirium and postoperative cognitive dysfunction in the elderly with regional anesthesia. Subsequently, we carried out statistical analysis and graphing using Review Manager software (RevMan version 5.4.1) and STATA software (Version 12.0).

Main results

Within the scope of this meta-analysis, a total of 18 randomized controlled trials were included. Among them, 10 trials aimed to assess the incidence of postoperative delirium as the primary outcome, while the primary focus of the other 8 trials was on the incidence of postoperative cognitive dysfunction. The collective evidence from these 10 studies consistently supports a positive relationship between the intravenous administration of dexmedetomidine and a decreased risk of postoperative delirium (RR: 0.48; 95%CI: 0.37 to 0.63, p < 0.00001, I2 = 0%). The 8 literature articles and experiments evaluating postoperative cognitive dysfunction showed that continuous intravenous infusion of dexmedetomidine during the entire surgical procedure exhibited a positive preventive effect on cognitive dysfunction among the elderly population with no obvious heterogeneity (RR: 0.35; 95%CI: 0.25 to 0.49,p < 0.00001, I2 = 0%).

Conclusion

Administering dexmedetomidine intravenously during surgery can potentially play a significant role in preventing postoperative delirium and postoperative cognitive dysfunction in patients older than 60 years with regional anesthesia according to this meta-analysis.
Sex differences in the frailty phenotype and mortality in the I-Lan longitudinal aging study cohort
Authors: Lu Ya-Wen , Chang Chun-Chin , Chou Ruey-Hsing , Lee Wei-Ju , Chen Liang-Kung , Huang Po-Hsun , Lin Shing-Jong
Published: February 2024

Background

Frailty is a common geriatric syndrome related to multiple adverse outcomes. Sex differences in its prevalence and impact on mortality remain incompletely understood.

Methods

This study was conducted with data from the I-Lan Longitudinal Aging Study, in which community-dwelling subjects aged > 50 years without coronary artery disease or diabetes were enrolled. Sex disparities in phenotypically defined frailty and sex–morality predictor interactions were evaluated. Sex- and frailty-stratified analyses of mortality were performed.

Results

The sample comprised 1371 subjects (51.4% women, median age 61 years). The median follow-up period was 6.3 (interquartile range, 5.8–7.0) years. The frailty prevalence did not differ between men (5.3%) and women (5.8%). Frail individuals were older and less educated and had poorer renal function than did non-frail individuals. Body composition trends differed between sexes, regardless of frailty. Relative to non-frail men, frail men had significantly lower body mass indices (BMIs; 24.5 vs. 23.4 kg/m2, p = 0.04) and relative appendicular skeletal muscle masses (7.87 vs. 7.05 kg/m2, p < 0.001). Frail women had significantly higher BMIs (25.2 vs. 23.9 kg/m2, p = 0.02) and waist circumferences (88 vs. 80 cm, p < 0.001) than did non-frail women. Frailty was an independent mortality predictor for men only [hazard ratio (95% confidence interval) = 3.395 (1.809–6.371), psex–frailty interaction = 0.03].

Conclusion

Frailty reflected poorer health in men than in women in the present cohort. This study revealed sex disparities in the impact of frailty on mortality among relatively healthy community-dwelling older adults.
Blood neutrophil to lymphocyte ratio is associated with 90-day mortality and 60-day readmission in Gram negative bacteremia: a multi-center cohort study
Authors: Roldgaard Marcus , Benfield Thomas , Tingsgård Sandra
Published: February 2024

Introduction

The Neutrophil-Lymphocyte Ratio (NLR) in blood has demonstrated its capability to predict bacteremia in emergency departments, and its association with mortality has been established in patients with sepsis in intensive care units. However, its potential concerning mortality and readmission in patients with Gram-negative bacteremia (GNB) is unexplored.

Methods

This retrospective cohort study included patients with GNB between 2018 and 2022 from six hospitals in the Capital Region of Denmark. Patients who were immunosuppressed or had missing NLR values on the day of blood culture were excluded. Logistic regression models were used to analyze the association between NLR levels and 90-day all-cause mortality, while the logit link interpretation of the cumulative incidence function was used to assess the association between NLR levels and 60-day readmission. Associations were quantified as odds ratios (OR) with corresponding 95% confidence intervals (CI).

Results

The study included 1763 patients with a median age was 76.8 years and 51.3% were female. The median NLR was 17.3 and 15.8% of patients had a quick sequential organ failure assessment score of two or three. Urinary tract infection (UTI) was the most frequent focus and Escherichia coli the most frequent pathogen. Statistically significant differences in median NLR were found by age group and pathogen, and for patients with or without hypertension, liver disease, chronic obstructive pulmonary disease, dementia, and alcohol abuse. 378 patients (21.4%) died before 90 days. 526 (29.8%) patients were readmitted to the hospital within 60 days. For each doubling of the NLR, the OR for all-cause 90-day mortality was 1.15 (95% CI, 1.04–1.27) and 1.12 (95% CI, 1.02–1.24) for 60-day readmission. Analysis of subgroups did not show statistically significant differences between groups in relation to the association between NLR and mortality. The discriminatory ability of NLR for mortality was limited and comparable to blood neutrophil or lymphocyte count, producing receiver operating characteristic curves with an area under the curve of 0.59 (95% CI, 0.56–0.63), 0.60 (95% CI, 0.56–0.65) and 0.53 (95% CI, 0.49–0.56), respectively.

Conclusion

Blood neutrophil-lymphocyte ratio was associated with 90-day all-cause mortality and 60-day readmission in patients with GNB. However, the ratio has limited ability in predicting mortality or readmission.
Assessing the effects of tempol on renal fibrosis, inflammation, and oxidative stress in a high-salt diet combined with 5/6 nephrectomy rat model: utilizing oxidized albumin as a biomarker
Authors: Liu Beibei , Hu Yanling , Tian Danyang , Dong Jianlong , Li Bing-Feng
Published: February 2024

Background

Oxidative stress has been implicated in the pathogenesis of chronic kidney disease (CKD), prompting the exploration of antioxidants as a potential therapeutic avenue for mitigating disease progression. This study aims to investigate the beneficial impact of Tempol on the progression of CKD in a rat model utilizing oxidized albumin as a biomarker.

Methods

After four weeks of treatment, metabolic parameters, including body weight, left ventricle residual weight, kidney weight, urine volume, and water and food intake, were measured. Systolic blood pressure, urinary protein, oxidized albumin level, serum creatinine (Scr), blood urea nitrogen (BUN), 8-OHdG, TGF-β1, and micro-albumin were also assessed. Renal fibrosis was evaluated through histological and biochemical assays. P65-NF-κB was quantified using an immunofluorescence test, while Smad3, P65-NF-κB, and Collagen I were measured using western blot. TNF-α, IL-6, MCP-1, TGF-β1, Smad3, and P65-NF-κB were analyzed by RT-qPCR.

Results

Rats in the high-salt diet group exhibited impaired renal function, characterized by elevated levels of blood urea nitrogen, serum creatinine, 8-OHdG, urine albumin, and tubulointerstitial damage, along with reduced body weight. However, these effects were significantly ameliorated by Tempol administration. In the high-salt diet group, blood pressure, urinary protein, and oxidized albumin levels were notably higher compared to the normal diet group, but Tempol administration in the treatment group reversed these effects. Rats in the high-salt diet group also displayed increased levels of proinflammatory factors (TNF-α, IL-6, MCP1) and profibrotic factors (NF-κB activation, Collagen I), elevated expression of NADPH oxidation-related subunits (P65), and activation of the TGF-β1/Smad3 signaling pathway. Tempol treatment inhibited NF-κB-mediated inflammation and TGF-β1/Smad3-induced renal fibrosis signaling pathway activation.

Conclusion

These findings suggest that Tempol may hold therapeutic potential for preventing and treating rats undergoing 5/6 nephrectomy. Further research is warranted to elucidate the mechanisms underlying Tempol’s protective effects and its potential clinical applications. Besides, there is a discernible positive relationship between oxidized albumin and other biomarkers, such as 8-OHG, urinary protein levels, mALB, Scr, BUN, and TGF-β1 in a High-salt diet combined with 5/6 nephrectomy rat model. These findings suggest the potential utility of oxidized albumin as a sensitive indicator for oxidative stress assessment.
Early choroidal and retinal changes detected by swept-source oct in type 2 diabetes and their association with diabetic kidney disease: a longitudinal prospective study
Authors: da Silva Monica Oliveira , do Carmo Chaves Anne Elise Cruz , Gobbato Glauber Corrêa , Lavinsky Fabio , Lavinsky Daniel
Published: February 2024

Background

To evaluate structural changes in retina and choroid in patients with type 2 diabetes (T2D) and their association with diabetic kidney disease (DKD).

Methods

T2D patients with mild or no diabetic retinopathy (DR) were followed for 3 years using structural SS-OCT and OCT angiography (OCT-A) taken every 6 months. Parameters were compared longitudinally and according to the DKD status on baseline.

Results

One hundred and sixty eyes from 80 patients were followed for 3 years, 72 with no DKD (nDKD) at baseline and 88 with DKD. Trend analysis of T2D showed significant thinning in GCL + and circumpapillary retinal fiber neural layer (cRFNL), choroid, and decreased vascular density (VD) in superficial plexus and central choriocapillaris with foveal avascular zone (FAZ) enlargement. Patients with no DKD on baseline presented more significant declines in retinal center and choroidal thickness, increased FAZ and loss of nasal and temporal choriocapillaris volume. In addition, the nDKD group had worse glycemic control and renal parameters at the end of the study.

Conclusion

Our data suggests the potential existence of early and progressive neurovascular damage in the retina and choroid of patients with Type 2 Diabetes (T2D) who have either no or mild Diabetic Retinopathy (DR). The progression of neurovascular damage appears to be correlated with parameters related to glycemic control and renal damage.
1 km of living area: age differences in the association between neighborhood environment perception and self-rated health among Chinese people
Authors: Mu Yuexuan , Ge Shu , Du Benfeng
Published: February 2024

Objectives

This study aimed to explore the age differences in the relationship between neighborhood environment perception and self-rated health among Chinese people.

Study design

This is cross-sectional study.

Methods

The participants were 2,631 residents aged 18 and above from 2021 Chinese General Social Survey (CGSS). Self-rated health was reported by residents. Neighborhood environment was measured by respondents’ subjective perception of 1 km living area. Ordered logit regression models were used to examine the relationship between neighborhood environment perception and self-rated health.

Results

In summary, 42.08% were classified as young adults, and 57.92% were classified as middle-aged and older adults. Young adults with higher perception of neighborhood social environment were more likely to perceive good health. Neighborhood built environment was significantly associated with self-rated health among middle-aged and older adults.

Conclusion

The neighborhood environment is an important predictor of the health of its residents. Neighborhood environmental modifications should be tailored to meet the needs of different age groups, promoting health equity.
Prediction of individual, community and societal resilience in the Czech Republic compared to Slovakia during the war in Ukraine
Authors: Koubová Alice , Kimhi Shaul
Published: February 2024

The present study examines, as research questions, which and to what extent psychological and demographic variables significantly predict individual, community, and societal resilience among a sample of Czech Republic adults (N = 1,100) six months after the Russian invasion of Ukraine. The research tools included the following scales: Societal, community, and individual resilience; hope, well-being; morale; distress symptoms; a sense of danger; and perceived threats. The results indicated the following: (a) Correlation analysis shows that resilience is significantly and positively correlated with supporting coping factors and significantly and negatively correlated with suppressing coping factors. (b) A comparison of supporting coping indicators (hope, well-being, and morale) and suppressing coping indicators (distress symptoms, sense of danger, and perceived threats) in the Czech Republic with those variables in Slovakia and Israel indicated that Israel reported higher resilience, higher supporting coping indicators, and lower suppressing coping factors. Three-path analysis among the Czech sample indicated that the best predictor of SR was the level of hope, the best predictor of CR was morale, and the best predictor of IR was the sense of danger. In an attempt to explain these findings in the discussion section, we refer to the background of Czech society and a possible connection to the findings.
Short-term effectiveness of the national German quitline for smoking cessation: results of a randomized controlled trial
Authors: Maspero Simona , Delle Simone , Kraus Ludwig , Pogarell Oliver , Hoch Eva , Bachner Joachim , Lochbühler Kirsten
Published: February 2024

Background

The objective of the present study was to examine the short-term effectiveness of the national German quitline for smoking cessation.

Methods

A parallel-group, two-arm, superiority, randomized controlled trial with data collection at baseline and post-intervention (three months from baseline) was conducted. Individuals were randomized to either the intervention group, receiving up to six telephone counselling calls, or the control group, receiving an active control intervention (self-help brochure). The primary outcome was the seven-day point prevalence abstinence at post-assessment. Secondary outcomes included changes in smoking-related cognitions and coping strategies from pre- to post-assessment, the perceived effectiveness of intervention components, and the satisfaction with the intervention.

Results

A total ofn = 905 adult daily smokers were assigned to either the intervention group (n = 477) or the control group (n = 428). Intention-to-treat analyses demonstrated that individuals allocated to the telephone counselling condition were more likely to achieve seven-day point prevalence abstinence at post-assessment compared to those allocated to the self-help brochure condition (41.1% vs. 23.1%;OR = 2.3, 95% CI [1.7, 3.1]). Participants who received the allocated intervention in both study groups displayed significant improvements in smoking-related cognitions and coping strategies with the intervention group showing greater enhancements than the control group. This pattern was also found regarding the perceived effectiveness of intervention components and the satisfaction with the intervention.

Conclusion

The present study provides first empirical evidence on the short-term effectiveness of the national German quitline for smoking cessation, highlighting its potential as an effective public health intervention to reduce the burden of disease associated with smoking.

Trial registration

This study is registered in the German Clinical Trials Register (DRKS00025343). Date of registration: 2021/06/07.
Physical activity during pregnancy and the risk of gestational diabetes mellitus: a systematic review and dose–response meta-analysis
Authors: Xie Wanting , Zhang Liuwei , Cheng Jiaoying , Wang Yirui , Kang Haixin , Gao Yi
Published: February 2024

Background

Previous research has indicated the inverse association between physical activity (PA) and gestational diabetes mellitus (GDM). However, the dose–response relationship currently remains undetermined. This study aims to explore the dose–response relationship between PA during the first and second trimesters of pregnancy and GDM risk.

Methods

Studies on the relationship between PA during pregnancy and GDM risk published before April 25, 2023, were searched for in six databases. According to the inclusion and exclusion criteria, all literature was screened for eligibility. The Newcastle-Ottawa Scale (NOS) was used to assess risk of bias. Publication bias was examined using funnel plots, Begg’s and Egger’s tests, as well as trim-and-fill analysis. We harmonized exposure estimates of PA during pregnancy to the common unit of the metabolic equivalent of task (MET)-h/week. Restricted cubic splines were used to model the dose–response relationship. The criteria from the World Cancer Research Fund were used to assess the certainty of evidence across outcomes. All analyses were performed using Stata 15.1.

Results

The results indicated that in contrast with the lowest level of PA, promoting the highest PA level lowers the risk of GDM by 36% (RR = 0.64, 95%CI: 0.53 ~ 0.78). We found a curvilinear dose–response association between PA during the first trimester and incident GDM (Pnonlinearity = 0.012). Compared to inactive pregnant women, for those who achieved the guidelines-suggested minimum level (10 MET-h/week) of PA during the first trimester, the GDM risk was decreased by 13% (RR = 0.87, 95%CI: 0.79 ~ 0.96). A linear relationship was found between PA during the second trimester and the GDM risk (Pnonlinearity = 0.276). The results with a restricted cubic spline model suggested that pregnant women who accumulate 10 MET-h/week have a 1% reduced risk of GDM compared to completely inactive individuals. Twice (20 MET-h/week) or a higher amount of PA (50 MET-h/week) contributed to further reductions in GDM risk.

Conclusion

There is a dose–response relationship between higher levels of PA in both the first and second trimesters and reduced risk of GDM; the relationship is stronger in the first trimester. Increasing PA during pregnancy can prevent the development of GDM.

PROSPERO registration number

CRD42023420564.