bluuebunny/crossref_metadata_2025 huggingface dataset:
Process of adhesion of the Adequate Childbirth Program to improve obstetric care in private hospitals in Brazil
Authors: de Oliveira Débora Cecília Chaves , Rodrigues Andreza , de Azevedo Nicida Lucia Regina , Gomes Maysa Luduvice , Torres Jacqueline Alves , Engstrom Elyne Montenegro
Published: January 2023

Background

In 2015, a quality improvement project called “Projeto Parto Adequado-PPA” was implemented in Brazilian private hospitals to reduce unnecessary high rates of cesarean sections. This study aimed to analyze the decision-making process of managers and care leaders to adhere to the PPA.

Methods

The Healthy Birth study is evaluative research that used mixed methods to evaluate the implementation and effects of the Adequate Childbirth Program in 12 hospitals that participated in the program. Eight out of 12 hospitals were selected for a qualitative approach. We interviewed ten managers and 24 care leaders from July to October 2017. The interviews were transcripted, and data was systematized using the MaxQda software, with Thematic Content Analysis, to identify the facilitators and barriers for adherence to the Adequate Childbirth Program. We used the conceptions of the Diffusion of Innovation as an analytical reference.

Results

The main reasons to adhere to the Adequate Childbirth Program were the absence of other quality improvements programs in Brazilian private services using multifaceted interventions, social and market status for participating; commitment to quality of care; and the possibility of structural reforms related to the Adequate Childbirth Program implementation. In addition, inviting hospital influencers to learn about the objectives and intentions of the project before joining was considered an important strategy to motivate hospitals.

Conclusion

Social, cultural, and economic constructs motivated adherence. The invitation strategy used by the Adequate Childbirth Program coordination, through socially respected members in Brazil, such as doctors, was highly valued by the leaders of the hospital team and encouraged adherence to the Program.
Scale-up of a novel vital signs alert device to improve maternity care in Sierra Leone: a mixed methods evaluation of adoption
Authors: Bright Sophie , Moses Francis , Ridout Alex , Sam Betty , Momoh Mariama , Goodhart Venetia , Smart Francis , Mannah Margaret , Issa Sattu , Herm-Singh Simren , Reid Fiona , Seed Paul T. , Bunn James , Shennan Andrew , Augustin Katrin , Sandall Jane
Published: January 2023

Background

The CRADLE (Community blood pressure monitoring in Rural Africa: Detection of underLying pre-Eclampsia) Vital Signs Alert device—designed specifically to improve maternity care in low resource settings—had varying impact when trialled in different countries. To better understand the contextual factors that may contribute to this variation, this study retrospectively evaluated the adoption of CRADLE, during scale-up in Sierra Leone.

Methods

This was a mixed methods study. A quantitative indicator of adoption (the proportion of facilities trained per district) was calculated from existing training records, then focus groups were held with ‘CRADLE Champions’ in each district (n = 32), to explore adoption qualitatively. Template Analysis was used to deductively interpret qualitative data, guided by the NASSS (non-adoption, abandonment, scale-up, spread, sustainability) Framework.

Findings

Substantial but non-significant variation was found in the proportion of facilities trained in each district (range 59–90%) [X2 (7, N = 8) = 10.419, p = 0.166]. Qualitative data identified complexity in two NASSS domains that may have contributed to this variation: ‘the technology’ (for example, charging issues, difficulty interpreting device output and concerns about ongoing procurement) and ‘the organisation’ (for example, logistical barriers to implementing training, infighting and high staff turnover). Key strategies mentioned to mitigate against these issues included: transparent communication at all levels; encouraging localised adaptations during implementation (including the involvement of community leaders); and selecting Champions with strong soft skills (particularly conflict resolution and problem solving).

Conclusions

Complexity related to the technology and the organisational context were found to influence the adoption of CRADLE in Sierra Leone, with substantial inter-district variation. These findings emphasise the importance of gaining an in-depth understanding of the specific system and context in which a new healthcare technology is being implemented. This study has implications for the ongoing scale-up of CRADLE, and for those implementing or evaluating other health technologies in similar contexts.
Parent-young communication on sexual and reproductive health issues and its associated factors: experience of students in Agaro Town, Ethiopia
Authors: Abdissa Daba , Sileshi Workitu
Published: January 2023

Background

Sexual and reproductive health (SRH) is at the base of young people's living and wellbeing. A significant number of young peoples are affected by avoidable SRH problems due to a lack of appropriate knowledge regarding SRH. Parent-young communication on SRH is critical in informing them about risk and protective behaviors which in turn decrease the likelihood of involvement in risky sexual behaviors. Therefore, the purpose of this study was to evaluate the parent-young communication on SRH issues and associated factors among secondary and preparatory school students at Agaro town, Southwestern Ethiopia.

Methods

School based cross-sectional study was conducted from April 13 to April 20, 2019 using stratified random sampling technique. A total of 315 students were included to the study. Data were collected using pretested interviewer-administered structured questionnaire entered into Epi data version 3.1; and analyzed using SPSS version 20. A variable having a p-value of < 0.25 in the bivariable logistic regression model was subjected to multivariable logistic regression analysis to avoid the confounding variable’s effect. Adjusted odds ratios were calculated at the 95% confidence interval and considered significant with a p-value of < 0.05.

Results

The mean age of the respondents was 20.2 ± 2.6 years. The study finding showed that 61.3% of the participants were discussed on SRH issues with their parents. According to multivariate analysis; educational status of mother [primary education (AOR = 3.67; 95%CI = 1.93, 6.97),secondary education(AOR:2.86; 95%CI = 1.20, 6.80)],educational status of father[primary education (AOR = 5.8;95%CI = 2.8, 12.3,secondary education (AOR = 3.21; 95%CI = 1.55, 6.59)],having family size of < 5 (AOR = 6.4; 95%CI = 3.36, 12.37) and having boy/girlfriend(AOR = 1.99; 95%CI = 1.0, 3.8) were significantly associated with parent-young people communication.

Conclusion

About two third of the participants communicate with their parents about SRH issues and parents’ educational status, family size of < 5 and having boy/girlfriend were significantly associated with it. The main reasons for not communicated was cultural taboos, shame and parents lack of knowledge. Therefore, it is necessary to educate and equip students and parents to address the identified problems.
Chromosome-level genome assembly of a high-altitude-adapted frog (Rana kukunoris) from the Tibetan plateau provides insight into amphibian genome evolution and adaptation
Authors: Chen Wei , Chen Hongzhou , Liao Jiahong , Tang Min , Qin Haifen , Zhao Zhenkun , Liu Xueyan , Wu Yanfang , Jiang Lichun , Zhang Lixia , Fang Bohao , Feng Xueyun , Zhang Baowei , Reid Kerry , Merilä Juha
Published: January 2023

Background

The high-altitude-adapted frogRana kukunoris, occurring on the Tibetan plateau, is an excellent model to study life history evolution and adaptation to harsh high-altitude environments. However, genomic resources for this species are still underdeveloped constraining attempts to investigate the underpinnings of adaptation.

Results

TheR. kukunorisgenome was assembled to a size of 4.83 Gb and the contig N50 was 1.80 Mb. The 6555 contigs were clustered and ordered into 12 pseudo-chromosomes covering ~ 93.07% of the assembled genome. In total, 32,304 genes were functionally annotated. Synteny analysis between the genomes ofR. kukunorisand a low latitude speciesRana temporariashowed a high degree of chromosome level synteny with one fusion event between chr11 and chr13 forming pseudo-chromosome 11 inR. kukunoris. Characterization of features of theR. kukunorisgenome identified that 61.5% consisted of transposable elements and expansions of gene families related to cell nucleus structure and taste sense were identified. Ninety-five single-copy orthologous genes were identified as being under positive selection and had functions associated with the positive regulation of proteins in the catabolic process and negative regulation of developmental growth. These gene family expansions and positively selected genes indicate regions for further interrogation to understand adaptation to high altitude.

Conclusions

Here, we reported a high-quality chromosome-level genome assembly of a high-altitude amphibian species using a combination of Illumina, PacBio and Hi-C sequencing technologies. This genome assembly provides a valuable resource for subsequent research onR. kukunorisgenomics and amphibian genome evolution in general.
Mesorectal motion evaluation in rectal cancer MR-guided radiotherapy: an exploratory study to quantify treatment margins
Authors: Boldrini Luca , Chiloiro Giuditta , Cusumano Davide , Romano Angela , Placidi Lorenzo , Turco Gabriele , Antonelli Marco Valerio , Nardini Matteo , Galetto Matteo , Indovina Luca , Gambacorta Maria Antonietta
Published: January 2023

Background

Mesorectal motion (MM) is a source of uncertainty during neoadjuvant chemoradiotherapy (nCRT) delivery for locally advanced rectal cancer (LARC). Previously published experiences using cone-beam computed tomography imaging have already described significant movement. Aim of this analysis is to assess inter-fraction MM using the higher tissue contrast provided by hybrid magnetic resonance imaging (MRI) in LARC patients (pts) treated with MRI guided radiation therapy (MRgRT).

Methods

The total mesorectum, its superior (Msup), middle (Mmid) and lower (Mlow) regions were contoured on the positioning MRIs acquired on simulation day and on each treatment day. Six PTVs were obtained adding 0.5, 0.7, 1, 1.3, 1.5 and 2 cm margin to the whole mesorectum, starting from the simulation MRI. Margins including 95% of the mesorectal structures during whole treatment in 95% of patients (pts) were considered adequate.

Results

A total number of 312 fractions of 12 consecutive pts was retrospectively analyzed. The different mesorectum regions show specific motion variability. In particular, Msup shows larger variability in left, right and anterior directions, while the Mlow in caudal and posterior ones. The anterior margin is significantly larger in the Msup than in the other regions.

Conclusion

Different mesorectal regions move differently throughout the radiotherapy treatment, with the largest MM in the Msup anterior direction. Asymmetrical margins are recommended.
Codelivery of TGF-β1 and anti-miR-141 by PLGA microspheres inhibits progression of intervertebral disc degeneration
Authors: Xiao Liang , Gao Daokuan , Zhang Yu , Liu Chen , Yin Zongsheng
Published: January 2023

Background

Cervical and lumbar pain is usually caused by degeneration of the nucleus pulposus (NP). As a powerful therapeutic strategy, tissue engineering can effectively restore the normal biological properties of the spinal unit. Previous studies suggested that poly(lactic-co-glycolic acid) (PLGA) microspheres are effective carriers of cells and biomolecules in NP tissue engineering. This study aims to explore the therapeutic effect of PLGA microspheres coloaded with transforming growth factor-β1 (TGF-β1) and anti-miR-141 on intervertebral disc degeneration (IDD).

Methods

PLGA microspheres were characterized by scanning electron microscopy, a laser particle size analyzer, and laser confocal microscopy. The in vitro release rate of biomolecules from the microspheres was analyzed by reversed-phase high-performance liquid chromatography and agarose gel electrophoresis. The rat NP cells (NPCs) treated with the solutions released from microspheres for different lengths of time were assigned to a control group (Ctrl), an empty PLGA microsphere group (Mock microsphere, MS), a TGF-β1-loaded PLGA microsphere group (TMS), an anti-miR-141-loaded PLGA microsphere group (AMS), and an anti-miR-141 + TGF-β1-loaded PLGA microsphere group (ATMS). The proliferation and apoptosis of NPCs were observed by alamar blue and flow cytometry. The gene and protein expression of cartilage markers COL2A1 and ACAN were observed by RT-qPCR and Western blot. The rat model of IDD was established by tail puncture. Rats were divided into a control group (Ctrl), a mock operation group (Mock), a TGF-β1 microsphere group (TMS), an anti-miR-141 microsphere group (AMS), and an anti-miR-141 + TGF-β1 microsphere group (ATMS). The degree of rat tail IDD was assessed in each group through magnetic resonance imaging (MRI), safranin O-fast green staining, immunohistochemistry, and Western blotting.

Results

PLGA microspheres were stably coloaded and could sustainably release TGF-β1 and anti-miR-141. The results of in vitro cell experiments showed that the release solution of PLGA microspheres significantly enhanced the proliferation of NPCs without inducing their apoptosis and significantly upregulated cartilage markers in NPCs. The effect of microspheres was greater in the ATMS group than that in the TMS group and AMS group. In vivo experiments showed that IDD could be effectively inhibited and reversed by adding microspheres coloaded with TGF-β1 and/or anti-miR-141, and the effect was greatest in the ATMS group.

Conclusion

PLGA microspheres coloaded with TGF-β1 and anti-miR-141 can reverse IDD by inhibiting the degeneration of NPCs.
Ultrasound-guided serratus anterior plane block for transapical transcatheter aortic valve implantation
Authors: Peng Ling , Ding Meng , Wei Wei
Published: January 2023

Background

Reducing postoperative pain due to the thoracotomy incisions in patients undergoing transapical transcatheter aortic valve implantation remains a challenge.

Methods

We introduced ultrasound-guided serratus anterior plane block (SAPB) in a patient with severe aortic insufficiency and chronic obstructive pulmonary disease before surgical intervention.

Results

The patient’s postoperative 1 h, 4 h, and 12 h resting visual analogue scale scores were 3, 1, and 1 without single injection of morphine or dezocine for rescue analgesia.

Conclusions

Ultrasound-guided SAPB could improve analgesia after transapical transcatheter aortic valve implantation.
Helicobacter pylori-induced NAT10 stabilizes MDM2 mRNA via RNA acetylation to facilitate gastric cancer progression
Authors: Deng Min , Zhang Long , Zheng Wenying , Chen Jiale , Du Nan , Li Meiqi , Chen Weiqing , Huang Yonghong , Zeng Ning , Song Yuanbin , Chen Yongming
Published: January 2023

Background

N4-acetylcytidine (ac4C), a widespread modification in human mRNAs that is catalyzed by the N-acetyltransferase 10 (NAT10) enzyme, plays an important role in promoting mRNA stability and translation. However, the biological functions and regulatory mechanisms of NAT10-mediated ac4C were poorly defined.

Methods

ac4C mRNA modification status and NAT10 expression levels were analyzed in gastric cancer (GC) samples and compared with the corresponding normal tissues. The biological role of NAT10-mediated ac4C and its upstream and downstream regulatory mechanisms were determined in vitro and in vivo. The therapeutic potential of targeting NAT10 in GC was further explored.

Results

Here, we demonstrated that both ac4C mRNA modification and its acetyltransferase NAT10 were increased in GC, and increased NAT10 expression was associated with disease progression and poor patient prognosis. Functionally, we found that NAT10 promoted cellular G2/M phase progression, proliferation and tumorigenicity of GC in an ac4C-depedent manner. Mechanistic analyses demonstrated that NAT10 mediated ac4C acetylation of MDM2 transcript and subsequently stabilized MDM2 mRNA, leading to its upregulation and p53 downregulation and thereby facilitating gastric carcinogenesis. In addition, Helicobacter pylori (Hp) infection contributed to NAT10 induction, causing MDM2 overexpression and subsequent p53 degradation. Further investigations revealed that targeting NAT10 with Remodelin showed anti-cancer activity in GC and augmented the anti-tumor activity of MDM2 inhibitors in p53 wild-type GC.

Conclusions

These results suggest the critical role of NAT10-mediated ac4C modification in GC oncogenesis and reveal a previously unrecognized signaling cascade involving the Hp-NAT10-MDM2-p53 axis during GC development.
Esketamine-based opioid-free anaesthesia alleviates postoperative nausea and vomiting in patients who underwent laparoscopic surgery: study protocol for a randomized, double-blinded, multicentre trial
Authors: Chen Hai-yan , Meng Xiao-yan , Gao Hao , Liu Hui , Qiu Hai-Bo , Lu Jun , Song Jin-Chao
Published: January 2023

Background

Although opioids are commonly prescribed in clinical anaesthesia, the significant side effects attributed to their overuse are raising increasing concerns. One way to reduce perioperative opioid consumption is to apply opioid-reduced anaesthesia (ORA) and even opioid-free anaesthesia (OFA), which involves regional techniques, neuraxial anaesthesia, nonopioid analgesics or combined use. The aim of this study was to investigate whether the application of OFA by using esketamine in intraoperative analgesia could minimize the side effects of postoperative nausea and vomiting (PONV), as well as other short-term side effects related to anaesthesia.

Methods/design

The study was designed as a prospective, randomized, controlled, multicentre trial. A total of 278 patients were enrolled; participants were nonsmoking female patients aged 18–50 years and scheduled for laparoscopic appendectomy or cholecystectomy, ASA at I–III, with no serious physical or mental diseases. Both groups received usual perioperative care except for the analgesic medication of either esketamine or sufentanil. The primary outcome was the incidence of PONV 3 days after surgery. Secondary outcomes included recovery status, pain, sedation level and overall recovery, delirium and cognition, anxiety and depression and total consumption of analgesic agents.

Discussion

This trial may show that the synergy of esketamine and propofol anaesthesia reduces PONV as well as other short-term adverse events, thereby providing a better safety and satisfaction profile of ERAS for laparoscopic appendectomy and cholecystectomy.

Trial registration

Chinese Clinical Trial Registry ChiCTR2100047169. Registered on June 9, 2021
The CALM trial protocol: a randomised controlled trial of a guided self-help cognitive behavioural therapy intervention to reduce dental anxiety in children
Authors: Marshman Zoe , Rodd Helen , Fairhurst Caroline , Porritt Jenny , Dawett Bhupinder , Day Peter , Innes Nicola , Vernazza Christopher , Newton Tim , Ronaldson Sarah , Cross Liz , Ross Jennie , Baker Sarah R. , Hewitt Catherine , Torgerson David , Ainsworth Hannah
Published: January 2023

Background

Globally, around 13% of children experience dental anxiety (DA). This group of patients frequently miss dental appointments, have greater reliance on treatment under general anaesthesia (GA) and have poorer oral health-related quality of life (OHRQoL) than their non-dentally anxious peers. Recently, a low-intensity cognitive behavioural therapy (CBT)-based, self-help approach has been recommended for management of childhood anxiety disorders. A feasibility study conducted in secondary care found this guided self-help CBT resource reduced DA and a randomised controlled trial was recommended. The present study aims to establish the clinical and cost-effectiveness of a guided self-help CBT intervention to reduce DA in children attending primary dental care sites compared to usual care.

Methods

This 4-year randomised controlled trial will involve 600 children (aged 9–16 years) and their parent/carers in 30 UK primary dental care sites. At least two dental professionals will participate in each site. They will be assigned, using random allocation, to receive the CBT training and deliver the intervention or to deliver usual care. Children with DA attending these sites, in need of treatment, will be randomly allocated to be treated either by the intervention (CBT) or control (usual care) dental professional. Children will complete questionnaires relating to DA, OHRQoL and HRQoL before treatment, immediately after treatment completion and 12 months post-randomisation. Attendance, need for sedation/GA and costs of the two different approaches will be compared. The primary outcome, DA, will be measured using the Modified Child Dental Anxiety Scale. Scores will be compared between groups using a linear mixed model.

Discussion

Treating dentally anxious patients can be challenging and costly. Consequently, these children are frequently referred to specialist services for pharmacological interventions. Longer waiting times and greater travel distances may then compound existing healthcare inequalities. This research will investigate whether the intervention has the potential to reduce DA and improve oral health outcomes in children over their life-course, as well as upskilling primary dental healthcare professionals to better manage this patient group.

Trial registration

This clinical trial has been registered with an international registry and has been allocated an International Standard Randomised Controlled Trial Number (ISRCTN27579420).
Risk factors of occupational skin diseases among traditional batik manufacturing workers in Yogyakarta, Indonesia
Authors: Febriana Sri Awalia , Erdina  , Dewi Kusuma , Ridora Yohanes , Anggraeni Agustina , Indrastuti Niken , Waskito Fajar , Oginawati Katharina , Tanziha Ikeu , Prakoeswa Cita Rosita Sigit
Published: January 2023

Objective

Batik is one of the Indonesian traditional arts made by decorating fabric using the resist dyeing technique. Currently, batik manufacturing serves as an important source of livelihood in Indonesia. However, the production process of traditional batik involves a range of chemicals and some repetitive physical movements, making batik production inseparable from physical and chemical hazards which increase the risk of developing occupational skin diseases (OSD). This study aimed to identify the risk factors related to OSD, including occupational contact dermatitis (OCD), among traditional batik manufacturing workers in Yogyakarta, Indonesia.

Results

The study demonstrated that working duration (≥ 8 h daily) and type of work (wet process only) were statistically significant as risk factors for developing OSD. While for OCD, our results found that gender (male), history of atopy, and type of work (all and wet phase only) were risk factors for OCD development among traditional batik manufacturing workers.
Production, characterization and techno-economic evaluation of Aspergillus fusant l-asparaginase
Authors: Asitok Atim , Ekpenyong Maurice , Amenaghawon Andrew , Akwagiobe Ernest , Asuquo Marcus , Rao Anitha , Ubi David , Iheanacho Juliet , Etiosa Joyce , Antai Agnes , Essien Joseph , Antai Sylvester
Published: January 2023

Protoplast fusion is one of the most reliable methods of introducing desirable traits into industrially-promising fungal strains. It harnesses the entire genomic repertoire of fusing microorganisms by routing the natural barrier and genetic incompatibility between them. In the present study, the axenic culture of a thermo-halotolerant strain of Aspergillus candidus (Asp-C) produced an anti-leukemic l-asparaginase (l-ASNase) while a xylan-degrading strain of Aspergillus sydowii (Asp-S) produced the acrylamide-reduction type. Protoplast fusion of the wild strains generated Fusant-06 with improved anti-leukemic and acrylamide reduction potentials. Submerged fed-batch fermentation was preferred to batch and continuous modes on the basis of impressive techno-economics. Fusant-06 l-ASNase was purified by PEG/Na+ citrate aqueous two-phase system (ATPS) to 146.21-fold and global sensitivity analysis report revealed polymer molecular weight and citrate concentration as major determinants of yield and purification factor, respectively. The enzyme was characterized by molecular weight, amino acid profile, activity and stability to chemical agents. Michaelis–Menten kinetics, evaluated under optimum conditions gave Km, Vmax, Kcat, and Kcat/Km as 6.67 × 10–5 M, 1666.67 µmolmin−1 mg−1 protein, 3.88 × 104 min−1 and 5.81 × 108 M−1.min−1 respectively. In-vitro cytotoxicity of HL-60 cell lines by Fusant-06 l-ASNase improved significantly from their respective wild strains. Stability of Fusant-06 l-ASNase over a wide range of pH, temperature and NaCl concentration, coupled with its micromolar Km value, confers commercial and therapeutic value on the product. Free-radical scavenging and acrylamide reduction activities were intermediate and the conferred thermo-halo-stability could be exploited for sustainable clinical and food industry applications.
History of the Development of Analytical Models of Cracking of Restrained Walls on a Given Edge Since 1968
Authors: Zych Mariusz
Published: January 2023

This research paper presents and comments on analytical models for calculating the widths of cracks formed as a result of imposed deformations generating tensile stresses in reinforced concrete base-restrained members. This issue regarding the mechanics of concrete structures has been presented on the basis of calculation models since 1968. In accordance with the current regulations of the European standard, the mechanics of the cracking of base-restrained members have been presented in a very simplified way, which was justified by a limited number of research studies performed on such members as well as in a few subject publications. The main purpose of this work was to present especially those models that had the greatest practical significance within a specific period of time or formed the basis for further studies of other authors. In addition, future trends in the development of computational tools are presented. The chronologically presented development of design ideas, which takes into account varying degrees of advancement of the mechanics of cracking due to the distinctly different design consequences, is a valuable source of information and an inspiration for subsequent researchers. In the second part of the paper, a few of the most important issues connected with the calculation of the crack width in base-restrained walls are presented. It is shown that currently, on the basis of the up-to-date knowledge, there are possibilities to create more complementary standard guidelines, which is already taking place in the case of European guidelines.
Bacteroides-derived isovaleric acid enhances mucosal immunity by facilitating intestinal IgA response in broilers
Authors: Wang Xinkai , Hu Yifan , Zhu Xiaoyan , Cai Liyuan , Farooq Muhammad Zahid , Yan Xianghua
Published: January 2023

Background

The interaction between nutrition and immunity plays a vital role in nutrient digestion, absorption, and metabolism during poultry production. Recent studies showed that the gut microbiota contributes to the development of intestinal mucosal immunity. However, the mechanisms by which gut microbes regulate this process remain unclear.

Methods

We compared the intestinal mucosal immunity and gut microbiota of Arbor Acre broilers (AA (lower mucosal immunity) and Chinese native Wuliang Mountain Black-bone chickens (WLMB) (higher mucosal immunity) using 16S rDNA sequencing, transcriptomic analysis, and immunoglobulin A (IgA) antibody repertoire sequencing. We then combined 16S rDNA sequencing with transcriptomics to identify the key microbes and found that they were positively correlated with IgA production. Next, we transplanted candidate microbes into 1-day-old broiler to explore their role in intestinal mucosal immunity. Finally, we verified the function of candidate microbial metabolites in regulating the immune function of macrophages and the intestinal-epithelial cells (IECs) using in vitro experiments.

Results

WLMB performs stronger mucosal immunity than AA, including higher IgA levels, more diverse IgA antibody repertoire, and higher bacterial affinity. Bacteroides was identified as the key microbes related to the intestinal IgA response. Bacteroides transplantation could increase IgA concentration in the duodenal contents by enhancing the expression of IgA, polymeric immunoglobin receptor (PIgR), B cell-activating factor of the TNF family (BAFF), and activation-induced cytidine deaminase (AID) in the duodenum. Additionally, Bacteroides-derived isovaleric acid promoted M2 macrophage polarization of macrophage via mTOR/PPAR-γ/STAT3 signaling pathways and regulated the immunologic function of IECs to produce cytokines, including interleukin (IL)-10, IL-4, BAFF, and transforming growth factor-beta (TGF-β), thus promoting IgA production in B cells by facilitating AID expression.

Conclusion

Our study revealed that Bacteroides modulate the intestinal IgA response and maintain gut health in broilers. Bacteroides may be a promising alternative as an immunomodulatory microbial agent for developing next-generation probiotics for broiler production.
Psychological challenges and related factors of ordinary residents after “7.20” heavy rainstorm disaster in Zhengzhou: a cross-sectional survey and study
Authors: Wang Zhifeng , Jiang Bing , Wang Xingtong , Wang Dongxu , Xue Haihong
Published: January 2023

Background

In 2021, a once-in-a-century heavy rainstorm suddenly attacked Zhengzhou, an important inland city in northern China. However, there have been no studies on the psychological health of disaster-stricken residents. This study is the first to comprehensively report on the mental health status and related factors of local ordinary residents after the heavy rainstorm.

Objective

The purpose of this study is to investigate the mental health status and related influencing factors of local ordinary residents after the flood disaster, and to provide reference for government departments to formulate disaster psychological intervention countermeasures based on evidence-driven strategies.

Methods

The snowball sampling technique was used in this study, and measurement tools of Rainstorm Exposure Questionnaire, Subjective Perception of Rainstorm, Post-Traumatic Stress Disorder Checklist-Civilian version (PCL-C), Depression, Anxiety and Stress Scale-21 (DAS-21) and Chinese version of Social Support Rating Scale (SSRS) were used to evaluate the rainstorm exposure, subjective perception of the rainstorm, psychological symptoms and social support of the disaster-stricken residents within a week after the rainstorm. Logistic regression analysis was used to examine the psychological status and related factors of local residents after the rainstorm disaster.

Results

A total of 469 valid samples were obtained in this study. All the subjects were in the disaster area and experienced the rainstorm personally, with normal intelligence. The statistical results showed that 25.37% people had experienced at least three rainstorm-related stresses, nearly 20.26% people had post-traumatic stress disorder (PTSD) symptoms, and 39.3%, 53.92% and 65.83% people had depression, anxiety and stress symptoms, respectively. Multivariable logistic regression analyses indicated that female (all p < 0.05), the divorced, agricultural workers/farmers (all p < 0.05), students (all p < 0.05), people experiencing at least three rainstorm-related stresses (p < 0.05 or p < 0.01), people with lower satisfaction at the social flood fighting measures (p < 0.05 or p < 0.01) and people with low social support (p < 0.05 or p < 0.01) were all independent risk factors for poor psychological health, and college education or above (p < 0.05 or p < 0.01), the lower degree of worrying about themselves (all p < 0.01), family members (all p < 0.01) and family property (all p < 0.01) were all related to higher psychological health among flood survivors after the disaster.

Conclusions

Rainstorm could cause local residents to have various degrees of psychological symptoms. This study identified factors associated with the psychological health of disaster-stricken residents, which could be used to develop psychological interventions in improving psychological health of local residents.
From pilot knowledge via integrated reservoir characterization to utilization perspectives of deep geothermal reservoirs: the 3D model of Groß Schönebeck (North German Basin)
Authors: Norden Ben , Bauer Klaus , Krawczyk Charlotte M.
Published: January 2023

The Groß Schönebeck site in the North German Basin serves as research platform to study the geothermal potential of deeply buried Permian reservoir rocks and the technical feasibility of heat extraction. The structural setting of the site was investigated in more detail by a newly acquired 3D-seismic survey to improve the former conceptual model that was based on several old 2D seismic lines. The new data allow a revision of the geological interpretation, enabling the setup of a new reservoir model and providing base information for a possible further site development of Permo-Carboniferous targets. The 3D seismic allows for the first time a consistent geological interpretation and model parameterization of the well-studied geothermal site. Main reflector horizons and the corresponding stratigraphic units were mapped and the structural pattern of the subsurface presented in the 8 km × 8 km × 4 km large seismic volume. Attribute analysis revealed some fracture and fault patterns in the upper Zechstein and post-Permian units, while formerly hypothesized large offset faults are not present in the Rotliegend reservoir. However, a well-established graben-like structure at the top of the Zechstein succession is most likely related to broken anhydritic brittle intra-salt layers of some meter of thickness. Most reflectors above the salt show a rather undisturbed pattern. The main reservoir sandstone of the Dethlingen Formation (Rotliegend) was mapped and characterized. The base of the underlying Permo-Carboniferous volcanic rock sequence and hence its thickness could not be depicted reliably from the geophysical data. Based on the seismic data and the available reconnaissance drilling, logging, and laboratory data of the Groß Schönebeck research site, the thickness and distribution of the sedimentary Rotliegend (with emphasis of the sandy reservoir section) and of the volcanic rock sequence was modelled and stochastically parameterized with petrophysical properties guided by seismic facies pattern correlation, providing a more realistic reservoir description. Properties include total and effective porosity, permeability, bulk density, thermal conductivity, thermal diffusivity, and specific heat capacity. The data and interpretation constitute the basis for a better understanding of the thermo and hydromechanical processes at the site and for future measures. Further site development could include a deepening of one well to provide evidence on the volcanic rock sequence and consider deviated wells into favourable zones and the design of a fracture-dominated utilization approach.
Inclusion in practice: a systematic review of diversity-focused STEM programming in the United States
Authors: Palid Olivia , Cashdollar Sarah , Deangelo Sarah , Chu Chu , Bates Meg
Published: January 2023

Colleges across the United States have shown a commitment to advancing diversity in the STEM fields by creating programs aimed at improving outcomes of women and/or racially and ethnically minoritized students. However, most existing literature focuses on the successes of singular college programs rather than comparing these STEM interventions across the higher education landscape. This systematic review investigates the literature on diversity-focused “STEM intervention programs” (SIPs) at the postsecondary level. We categorize key features of these programs and their outcomes, and we look at which program components have the most empirical support. We examine 82 articles that reported on SIPs with disaggregated outcomes, coding each initiative’s features and outcomes. Across these articles, we found six common program components, with most programs including more than one component, and five common program outcomes. Just 53 articles tested differences in outcomes of participants relative to a comparison group. This subset of research found support for the effectiveness of all coded components for improving student outcomes, though studies of multi-component programs did not parse the relative contributions of each component. Based on these findings, we conclude multi-component interventions that create a welcoming environment and focus on the successes of minoritized students help redress existing institutional shortcomings and are a promising step towards diversity, equity, and inclusion in STEM. However, more rigorous quantitative studies are needed to empirically assess the effectiveness of individual SIP program components.
Ventilation during continuous compressions or at 30:2 compression-to-ventilation ratio results in similar arterial oxygen and carbon dioxide levels in an experimental model of prolonged cardiac arrest
Authors: Kopra Jukka , Litonius Erik , Pekkarinen Pirkka T. , Laitinen Merja , Heinonen Juho A. , Fontanelli Luca , Mäkiaho Tomi P. , Skrifvars Markus B.
Published: January 2023

Background

In refractory out-of-hospital cardiac arrest, transportation to hospital with continuous chest compressions (CCC) from a chest compression device and ventilation with 100% oxygen through an advanced airway is common practice. Despite this, many patients are hypoxic and hypercapnic on arrival, possibly related to suboptimal ventilation due to the counterpressure caused by the CCC. We hypothesized that a compression/ventilation ratio of 30:2 would provide better ventilation and gas exchange compared to asynchronous CCC during prolonged experimental cardiopulmonary resuscitation (CPR).

Methods

We randomized 30 anaesthetized domestic swine (weight approximately 50 kg) with electrically induced ventricular fibrillation to the CCC or 30:2 group and bag-valve ventilation with a fraction of inspired oxygen (FiO2) of 100%. We started CPR after a 5-min no-flow period and continued until 40 min from the induction of ventricular fibrillation. Chest compressions were performed with a Stryker Medical LUCAS® 2 mechanical chest compression device. We collected arterial blood gas samples every 5 min during the CPR, measured ventilation distribution during the CPR using electrical impedance tomography (EIT) and analysed post-mortem computed tomography (CT) scans for differences in lung aeration status.

Results

The median (interquartile range [IQR]) partial pressure of oxygen (PaO2) at 30 min was 110 (52–117) mmHg for the 30:2 group and 70 (40–171) mmHg for the CCC group. The median (IQR) partial pressure of carbon dioxide (PaCO2) at 30 min was 70 (45–85) mmHg for the 30:2 group and 68 (42–84) mmHg for the CCC group. No statistically significant differences between the groups in PaO2 (p = 0.40), PaCO2 (p = 0.79), lactate (p = 0.37), mean arterial pressure (MAP) (p = 0.47) or EtCO2 (p = 0.19) analysed with a linear mixed model were found. We found a deteriorating trend in PaO2, EtCO2 and MAP and rising PaCO2 and lactate levels through the intervention. There were no differences between the groups in the distribution of ventilation in the EIT data or the post-mortem CT findings.

Conclusions

The 30:2 and CCC protocols resulted in similar gas exchange and lung pathology in an experimental prolonged mechanical CPR model.
COVID-19 and tourism sector stock price in Spain: medium-term relationship through dynamic regression models
Authors: Carrillo-Hidalgo Isabel , Pulido-Fernández Juan Ignacio , Durán-Román José Luis , Casado-Montilla Jairo
Published: January 2023

The global pandemic, coronavirus disease 2019 (COVID-19), has significantly affected tourism, especially in Spain, as it was among the first countries to be affected by the pandemic and is among the world’s biggest tourist destinations. Stock market values are responding to the evolution of the pandemic, especially in the case of tourist companies. Therefore, being able to quantify this relationship allows us to predict the effect of the pandemic on shares in the tourism sector, thereby improving the response to the crisis by policymakers and investors. Accordingly, a dynamic regression model was developed to predict the behavior of shares in the Spanish tourism sector according to the evolution of the COVID-19 pandemic in the medium term. It has been confirmed that both the number of deaths and cases are good predictors of abnormal stock prices in the tourism sector.
Isolated surgical vs. transcatheter aortic valve replacement: a propensity score analysis
Authors: Almedimigh Abdulmalik A. , Albabtain Monirah A. , Alfayez Latifa A. , Alsubaie Faisal F. , Almoghairi Abdulrahman , Alotaiby Mohammad , Alkhushail Abdullah , Ismail Huda , Pragliola Claudio , Adam Adam I. , Arafat Amr A.
Published: January 2023

Background

The debate about the optimal approach for aortic valve replacement continues. We compared the hospital and long-term outcomes (survival, aortic valve reintervention, heart failure readmissions, and stroke) between transcatheter vs. surgical (TAVR vs. SAVR) aortic valve replacement. The study included 789 patients; 293 had isolated SAVR, and 496 had isolated TAVR. Patients with concomitant procedures were excluded. Propensity score matching identified 53 matched pairs.

Results

Patients who had TAVR were significantly older (P ˂ 0.001) and had significantly higher EuroSCORE II (P ˂ 0.001), NYHA class (P ˂ 0.001), and more prevalence of diabetes mellitus (P ˂ 0.001), hypertension (P ˂ 0.001), chronic lung disease (P = 0.001), recent myocardial infarction (P = 0.002), and heart failure (P ˂ 0.001), stroke (P = 0.02), atrial fibrillation (P = 0.004), and previous percutaneous coronary interventions (P ˂ 0.001) than SAVR patients. In the matched cohort, atrial fibrillation occurred more frequently after SAVR (P = 0.01), and hospital stay was significantly longer in SAVR patients (P ˂ 0.001). There were no differences in hospital mortality between groups (P ˃ 0.99). Survival at 1, 3, and 5 years was 97%, 95%, and 94% for SAVR and 91%, 79%, and 58% for TAVR patients. Survival was lower in TAVR patients before matching (P ˂ 0.001) and after matching (P = 0.045). Freedom from the composite endpoint of stroke, aortic valve reintervention, and heart failure readmission at 1, 3, and 5 years was 98.9%, 96%, and 94% for SAVR and 94%, 86%, and 75% for TAVR. The composite endpoint was significantly higher in the TAVR group than in SVR before matching (P ˂ 0.001), while there was no difference after matching (P = 0.07). There was no significant difference in the change in ejection fraction between groups (β: −0.88 (95% CI: −2.20–0.43), P = 0.19), and the reduction of the aortic valve peak gradient was significantly higher with TAVR (β: −7.80 (95% CI: −10.70 to −4.91); P ˂ 0.001).

Conclusions

TAVR could reduce postoperative atrial fibrillation and hospital stay. SAVR could have long-term survival benefits over TAVR with comparable long-term stroke, heart failure readmission, and aortic valve reinterventions between SAVR and TAVR.
Association between pelvic inclination and balance in children with spastic diplegia
Authors: Allah Naglaa Ezzat Abd , Kamal Hebatallah Mohamed , El-Nabie Walaa Abd El-Hakiem Abd
Published: January 2023

Background

Children with spastic diplegia experience gait abnormalities and problems caused by deficits in balance, motor control, and spasticity. Abnormal pelvic inclination is common in patients with diplegia which may result in poor pelvic balance.

Purpose

This study was conducted to investigate the relation between pelvic inclination and standing balance in children with spastic diplegia.

Subjects and methods

Thirty children with spastic diplegic cerebral palsy from both sexes, aged from 5 to 14 years participated in this study. Their degree of spasticity ranged from 1 to 1+ according to Modified Ashworth Scale and they were on level I or II on Gross Motor Function Classification System. Pelvic inclination angle was measured by using the formetric instrumentation system during standing position while standing balance was assessed by the Biodex Balance System.

Results

There was a statistically significant relation between pelvic inclination and the overall, anteroposterior, and mediolateral stability indices of standing balance (P < 0.05).

Conclusion

The obtained results suggested that there was significant correlation between balance and pelvic inclination in children with diplegic cerebral palsy.
A Call to Assess the Impacts of Course-Based Undergraduate Research Experiences for Career and Technical Education, Allied Health, and Underrepresented Students at Community Colleges
Authors: Leonetti Cori T. , Lindberg Heather , Schwake David Otto , Cotter Robin L.
Published: January 2023

Limited data are available on the differential impacts course-based undergraduate research experiences (CUREs) have on subpopulations of community college (CC) students, including those in allied health, career and technical education, and nursing pathways (workforce). This essay addresses CC demographics, student success, and assessment practices for CUREs.
A Phase Ib/II Study of Lenvatinib and Pembrolizumab in Advanced Endometrial Carcinoma (Study 111/KEYNOTE-146): Long-Term Efficacy and Safety Update
Authors: Makker Vicky , Aghajanian Carol , Cohn Allen L. , Romeo Margarita , Bratos Raquel , Brose Marcia S. , Messing Mark , Dutta Lea , Dutcus Corina E. , Huang Jie , Schmidt Emmett V. , Orlowski Robert , Taylor Matthew H.
Published: January 2023

Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported.

The open-label phase Ib/II Study 111/KEYNOTE-146 of daily lenvatinib 20 mg plus pembrolizumab 200 mg once every 3 weeks showed promising efficacy and tolerable safety in patients with previously treated advanced endometrial carcinoma (EC; primary data cutoff date: January 10, 2019). This updated analysis reports long-term follow-up efficacy and safety data from 108 patients with previously treated EC included in the primary analysis. End points included objective response rate, duration of response, progression-free survival, overall survival, and safety. Investigators performed tumor assessments per immune-related RECIST. At the updated data cutoff date (August 18, 2020), the median study follow-up duration was 34.7 months (95% CI, 30.9 to 41.2), the objective response rate was 39.8% (95% CI, 30.5 to 49.7), and the median duration of response was 22.9 months (95% CI, 10.2 to not estimable). The median progression-free survival and overall survival were 7.4 months (95% CI, 5.2 to 8.7) and 17.7 months (95% CI, 15.5 to 25.8), respectively. Treatment-related treatment-emergent adverse events of any grade occurred in 104 (96.3%) patients. The most common grade ≥ 3 treatment-related treatment-emergent adverse events were hypertension (33.3%), elevated lipase (9.3%), fatigue (8.3%), and diarrhea (7.4%). The results demonstrate extended efficacy and tolerability of lenvatinib plus pembrolizumab in this cohort of patients with previously treated advanced EC.