bluuebunny/crossref_metadata_2025 huggingface dataset:
Botrytis cinerea tolerates phytoalexins produced by Solanaceae and Fabaceae plants through an efflux transporter BcatrB and metabolizing enzymes
Authors: Bulasag Abriel Salaria , Camagna Maurizio , Kuroyanagi Teruhiko , Ashida Akira , Ito Kento , Tanaka Aiko , Sato Ikuo , Chiba Sotaro , Ojika Makoto , Takemoto Daigo
Published: June 2023

Botrytis cinerea, a plant pathogenic fungus with a wide host range, has reduced sensitivity to fungicides as well as phytoalexins, threatening cultivation of economically important fruits and vegetable crops worldwide. B. cinerea tolerates a wide array of phytoalexins, through efflux and/or enzymatic detoxification. Previously, we provided evidence that a distinctive set of genes were induced in B. cinerea when treated with different phytoalexins such as rishitin (produced by tomato and potato), capsidiol (tobacco and bell pepper) and resveratrol (grape and blueberry). In this study, we focused on the functional analyses of B. cinerea genes implicated in rishitin tolerance. LC/MS profiling revealed that B. cinerea can metabolize/detoxify rishitin into at least 4 oxidized forms. Heterologous expression of Bcin08g04910 and Bcin16g01490, two B. cinerea oxidoreductases upregulated by rishitin, in a plant symbiotic fungus Epichloë festucae revealed that these rishitin-induced enzymes are involved in the oxidation of rishitin. Expression of BcatrB, encoding an exporter of structurally unrelated phytoalexins and fungicides, was significantly upregulated by rishitin but not by capsidiol and was thus expected to be involved in the rishitin tolerance. Conidia of BcatrB KO (ΔbcatrB) showed enhanced sensitivity to rishitin, but not to capsidiol, despite their structural similarity. ΔbcatrB showed reduced virulence on tomato, but maintained full virulence on bell pepper, indicating that B. cinerea activates BcatrB by recognizing appropriate phytoalexins to utilize it in tolerance. Surveying 26 plant species across 13 families revealed that the BcatrB promoter is mainly activated during the infection of B. cinerea in plants belonging to the Solanaceae, Fabaceae and Brassicaceae. The BcatrB promoter was also activated by in vitro treatments of phytoalexins produced by members of these plant families, namely rishitin (Solanaceae), medicarpin and glyceollin (Fabaceae), as well as camalexin and brassinin (Brassicaceae). Consistently, ΔbcatrB showed reduced virulence on red clover, which produces medicarpin. These results suggest that B. cinerea distinguishes phytoalexins and induces differential expression of appropriate genes during the infection. Likewise, BcatrB plays a critical role in the strategy employed by B. cinerea to bypass the plant innate immune responses in a wide variety of important crops belonging to the Solanaceae, Brassicaceae and Fabaceae.
Transcriptomics reveal the genetic coordination of early defense to Armillaria root rot (ARR) in Prunus spp
Authors: Cai Lichun , Adelberg Jeffrey , Naylor-Adelberg Jacqueline , Schnabel Guido , Calle Alejandro , Li Zhigang , Reighard Gregory , Gasic Ksenija , Saski Christopher A.
Published: June 2023

Armillaria root rot (ARR) poses a significant threat to the long-term productivity of stone-fruit and nut crops in the predominant production area of the United States. To mitigate this issue, the development of ARR-resistant and horticulturally-acceptable rootstocks is a crucial step towards the maintenance of production sustainability. To date, genetic resistance to ARR has been found in exotic plum germplasm and a peach/plum hybrid rootstock, ’MP-29‘. However, the widely-used peach rootstock Guardian® is susceptible to the pathogen. To understand the molecular defense mechanisms involved in ARR resistance in Prunus rootstocks, transcriptomic analyses of one susceptible and two resistant Prunus spp. were performed using two causal agents of ARR, including Armillaria mellea and Desarmillaria tabescens. The results of in vitro co-culture experiments revealed that the two resistant genotypes showed different temporal response dynamics and fungus-specific responses, as seen in the genetic response. Gene expression analysis over time indicated an enrichment of defense-related ontologies, including glucosyltransferase activity, monooxygenase activity, glutathione transferase activity, and peroxidase activity. Differential gene expression and co-expression network analysis highlighted key hub genes involved in the sensing and enzymatic degradation of chitin, GSTs, oxidoreductases, transcription factors, and biochemical pathways likely involved in Armillaria resistance. These data provide valuable resources for the improvement of ARR resistance in Prunus rootstocks through breeding.
Transcriptomic analysis reveals the functions of H2S as a gasotransmitter independently of Cys in Arabidopsis
Authors: Fang Huihui , Yu Zhenyuan , Xing Kehong , Zhou Lingyi , Shao Yuke , Zhang Xiaofang , Pei Yanxi , Zhang Lu
Published: June 2023

Numerous studies have revealed the gasotransmitter functions of hydrogen sulfide (H2S) in various biological processes. However, the involvement of H2S in sulfur metabolism and/or Cys synthesis makes its role as a signaling molecule ambiguous. The generation of endogenous H2S in plants is closely related to the metabolism of Cys, which play roles in a variety of signaling pathway occurring in various cellular processes. Here, we found that exogenous H2S fumigation and Cys treatment modulated the production rate and content of endogenous H2S and Cys to various degrees. Furthermore, we provided comprehensive transcriptomic analysis to support the gasotransmitter role of H2S besides as a substrate for Cys synthesis. Comparison of the differentially expressed genes (DEGs) between H2S and Cys treated seedlings indicated that H2S fumigation and Cys treatment caused different influences on gene profiles during seedlings development. A total of 261 genes were identified to respond to H2S fumigation, among which 72 genes were co-regulated by Cys treatment. GO and KEGG enrichment analysis of the 189 genes, H2S but not Cys regulated DEGs, indicated that these genes mainly involved in plant hormone signal transduction, plant-pathogen interaction, phenylpropanoid biosynthesis, and MAPK signaling pathway. Most of these genes encoded proteins having DNA binding and transcription factor activities that play roles in a variety of plant developmental and environmental responses. Many stress-responsive genes and some Ca2+ signal associated genes were also included. Consequently, H2S regulated gene expression through its role as a gasotransmitter, rather than just as a substrate for Cys biogenesis, and these 189 genes were far more likely to function in H2S signal transduction independently of Cys. Our data will provide insights for revealing and enriching H2S signaling networks.
Amino acid permease RcAAP1 increases the uptake and phloem translocation of an L-valine-phenazine-1-carboxylic acid conjugate
Authors: Xiao Yongxin , Hu Ciyin , Hsiang Tom , Li Junkai
Published: June 2023

Amino acid conjugates of pesticides can promote the phloem translocation of parent ingredients, allowing for the reduction of usage, and decreased environmental pollution. Plant transporters play important roles in the uptake and phloem translocation of such amino acid-pesticide conjugates such as L-Val-PCA (L-valine-phenazine-1-carboxylic acid conjugate). However, the effects of an amino acid permease, RcAAP1, on the uptake and phloem mobility of L-Val-PCA are still unclear. Here, the relative expression levels of RcAAP1 were found to be up-regulated 2.7-fold and 2.2-fold by the qRT-PCR after L-Val-PCA treatments of Ricinus cotyledons for 1 h and 3 h, respectively. Subsequently, expression of RcAAP1 in yeast cells increased the L-Val-PCA uptake (0.36 μmol/107 cells), which was 2.1-fold higher than the control (0.17 μmol/107 cells). Pfam analysis suggested RcAAP1 with its 11 transmembrane domains belongs to the amino acid transporter family. Phylogenetic analysis found RcAAP1 to be strongly similar to AAP3 in nine other species. Subcellular localization showed that fusion RcAAP1-eGFP proteins were observed in the plasma membrane of mesophyll cells and phloem cells. Furthermore, overexpression of RcAAP1 for 72 h significantly increased the phloem mobility of L-Val-PCA in Ricinus seedlings, and phloem sap concentration of the conjugate was 1.8-fold higher than the control. Our study suggested that RcAAP1 as carrier was involved in the uptake and phloem translocation of L-Val-PCA, which could lay foundation for the utilization of amino acids and further development of vectorized agrochemicals.
Commercial exergames for rehabilitation of physical health and quality of life: a systematic review of randomized controlled trials with adults in unsupervised home environments
Authors: Rüth Marco , Schmelzer Mona , Burtniak Kateryna , Kaspar Kai
Published: June 2023

Background

Commercial exergames are widely available tools that can support physical rehabilitation at home. However, the effects of the unsupervised use of commercial exergames in home environments are not yet clear. Hence, we provide a systematic review on the effects of unsupervised commercial exergaming at home on adults' physical health (RQ1) and quality of life (RQ2). We also scrutinize adults' experiences with exergaming at home regarding participant support, adherence, and adverse outcomes (RQ3).

Methods

We searched Web of Science, PsycINFO, PubMed, Embase, and CINAHL for peer-reviewed randomized controlled trials with adults in need of rehabilitation. Overall, 20 studies (1,558 participants, 1,368 analyzed) met our inclusion criteria. The quality of evidence was assessed with the Cochrane risk of bias tool.

Results

Effects of unsupervised commercial exergaming at home on physical health were higher in seven studies and similar in five studies regarding the respective comparison or control conditions; eight studies reported non-significant findings. Of the 15 studies that also examined effects on quality of life, improvements were higher in seven studies and similar in two studies regarding the respective comparison or control conditions; results were non-significant in six studies. Participant support consisted of setup of the exergaming system, instructions, training, and contact with participants. Adherence was high in eight studies, moderate in six studies, and low in one study. Adverse outcomes related to exergaming were found in four studies and were at most moderate. Concerning the quality of evidence, six studies were related to a high risk of bias due to outcome reporting bias or ceiling effects in the primary outcome. Additionally, 10 studies yielded some concerns, and four studies were related to a low risk of bias.

Discussion

This systematic review summarizes promising evidence that the unsupervised use of commercial exergames can support and complement rehabilitation measures in home environments. Still, future studies based on larger samples and using more recent commercial exergames are needed to obtain more high-quality evidence on the effects of different exercise prescriptions. Overall, considering the necessary precautions, the unsupervised use of commercial exergames at home can improve the physical health and quality of life in adults with needs for physical rehabilitation.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022341189, identifier: PROSPERO, Registration number: CRD42022341189.
Do toddlers’ levels of cortisol and the perceptions of parents and professional caregivers tell the same story about transition from home to childcare? A mixed method study
Authors: Drugli May Britt , Nystad Kathrin , Lydersen Stian , Brenne Anne Synnøve
Published: June 2023

Introduction

Enrolling in childcare represents the first transition in toddlers’ lives and lays the foundation for their well-being in childcare centers going forward. Child cortisol levels may be an indicator of how toddlers themselves experience their introduction to childcare. In the present study, we explored changes in toddler cortisol levels during their first month in childcare and at a 3-month follow-up, as well as the perceptions of parents and professional caregivers regarding the toddlers’ settling-in process during the same period.

Method

This study used a mixed-method design. Saliva samples were collected from 113 toddlers and their cortisol levels analyzed. Qualitative notes were collected from parents (n = 87) and professional caregivers (n = 101). The data were analyzed using linear mixed model and thematic analyses, respectively.

Results

Changes in toddler cortisol levels and their parents’ and professional caregivers’ perceptions of the transition process fit well. Both data sources indicated an easy start in childcare when parents were present, while the first weeks separated from parents seemed quite demanding. After 3 months, the cortisol levels returned to a low level, while child well-being was perceived as high.

Discussion

Toddlers need time to adapt to childcare settings. Even if they are well taken care of by their keyworkers during the day, many toddlers are tired and exhausted in the evenings at home, particularly in the first weeks of separation from their parents. Both professional caregivers and parents should be aware of toddlers’ need for emotional support during their transition to childcare.
The impact of COVID-19 (Coronavirus) on children and young people with Down syndrome in the United Kingdom
Authors: Pagnamenta Emma , Hodgkinson Penny , Davidson Rosemary , Joffe Victoria L.
Published: June 2023

The COVID-19 pandemic had a profound impact across the globe. Evidence suggests children with Special Educational Needs and Disabilities and their families experienced impacts on well-being and disruptions in support from education and health services. This study investigated the impact of measures associated with the COVID-19 pandemic on children and young people (CYP) with Down syndrome in the United Kingdom, specifically changes in speech, language and communication abilities, behavior, social, emotional and mental health and access to education and healthcare services. Forty-six parents/carers of CYP with Down Syndrome (aged 2–25 years) completed an online survey between June and September 2020. Parents/carers frequently reported deterioration in speech, language and communication, literacy and attention skills since the onset of the pandemic. Deterioration in social and emotional wellbeing and behavior, including greater reliance on adults were also reported for some CYP with Down syndrome. Parents reported challenges with home-schooling and reductions in support from education and community services. Preferences for support during COVID-19 were for professional support or from other parents. These findings have implications for the support that is now needed for CYP with Down syndrome and their families and for periods of social restrictions in the future.
Cost-effectiveness of peer-supported self-management for people discharged from a mental health crisis team: methodological challenges and recommendations
Authors: Le Novere Marie , Johnson Sonia , Lloyd-Evans Brynmor , Marston Louise , Ambler Gareth , Clarke Caroline S. , Osborn David , Lamb Danielle , Hunter Rachael Maree
Published: June 2023

Background

Mental health acute crisis episodes are associated with high inpatient costs. Self-management interventions may reduce readmission by enabling individuals to manage their condition. Delivery of such interventions by Peer Support Workers (PSWs) may be cost-effective. CORE, a randomized control trial of a PSW self-management intervention compared to usual care, found a significant reduction in admissions to acute mental healthcare for participants receiving the intervention. This paper aims to evaluate the cost-effectiveness of the intervention over 12 months from a mental health service perspective. Analysis methods of increasing complexity were used to account for data missingness and distribution.

Methods

Participants were recruited from six crisis resolution teams in England from 12 March 2014 to 3 July 2015 (trial registration ISRCTN: 01027104). Resource use was collected from patient records at baseline and 12 months. The EQ-5D-3L was collected at baseline and 4 and 18 months, and linear interpolation was used to calculate 12-month values for quality-adjusted life-years (QALYs). The primary analysis of adjusted mean incremental costs and QALYs for complete cases are calculated separately using OLS regression. Secondly, a complete-case non-parametric two-stage bootstrap (TSB) was performed. The impacts of missing data and skewed cost data were explored using multiple imputation using chained equations and general linear models, respectively.

Results

Four hundred and forty-one participants were recruited to CORE; 221 randomized to the PSW intervention and 220 to usual care plus workbook. The probability that the PSW intervention was cost-effective compared with the workbook plus usual care control at 12 months varied with the method used, and ranged from 57% to 96% at a cost-effectiveness threshold of £20,000 per QALY gained.

Discussion

There was a minimum 57% chance that the intervention was cost-effective compared to the control using 12-month costs and QALYs. The probability varied by 40% when methods were employed to account for the relationship between costs and QALYs, but which restricted the sample to those who provided both complete cost and utility data. Caution should therefore be applied when selecting methods for the evaluation of healthcare interventions that aim to increase precision but may introduce bias if missing data are heavily unbalanced between costs and outcomes.
Aberrant brain entropy in posttraumatic stress disorder comorbid with major depressive disorder during the coronavirus disease 2019 pandemic
Authors: Fu Shishun , Liang Sipei , Lin Chulan , Wu Yunfan , Xie Shuangcong , Li Meng , Lei Qiang , Li Jianneng , Yu Kanghui , Yin Yi , Hua Kelei , Li Wuming , Wu Caojun , Ma Xiaofen , Jiang Guihua
Published: June 2023

Aim

Previously, neuroimaging studies on comorbid Posttraumatic-Major depression disorder (PTSD-MDD) comorbidity found abnormalities in multiple brain regions among patients. Recent neuroimaging studies have revealed dynamic nature on human brain activity during resting state, and entropy as an indicator of dynamic regularity may provide a new perspective for studying abnormalities of brain function among PTSD-MDD patients. During the COVID-19 pandemic, there has been a significant increase in the number of patients with PTSD-MDD. We have decided to conduct research on resting-state brain functional activity of patients who developed PTSD-MDD during this period using entropy.

Methods

Thirty three patients with PTSD-MDD and 36 matched TCs were recruited. PTSD and depression symptoms were assessed using multiple clinical scales. All subjects underwent functional magnetic resonance imaging (fMRI) scans. And the brain entropy (BEN) maps were calculated using the BEN mapping toolbox. A two-sample t-test was used to compare the differences in the brain entropy between the PTSD-MDD comorbidity group and TC group. Furthermore, correlation analysis was conducted between the BEN changes in patients with PTSD-MDD and clinical scales.

Results

Compared to the TCs, PTSD-MDD patients had a reduced BEN in the right middle frontal orbital gyrus (R_MFOG), left putamen, and right inferior frontal gyrus, opercular part (R_IFOG). Furthermore, a higher BEN in the R_MFOG was related to higher CAPS and HAMD-24 scores in the patients with PTSD-MDD.

Conclusion

The results showed that the R_MFOG is a potential marker for showing the symptom severity of PTSD-MDD comorbidity. Consequently, PTSD-MDD may have reduced BEN in frontal and basal ganglia regions which are related to emotional dysregulation and cognitive deficits.
Epistemic citizenship under structural siege: a meta-analysis drawing on 544 voices of service user experiences in Nordic mental health services
Authors: Nouf Faten , Ineland Jens
Published: June 2023

This paper presents a meta-analysis, drawing exclusively on qualitative research (n = 38), which contributes to findings on mental health service user experiences of received provisions and/or encounters in contemporary social and mental health services in the Nordic countries. The main objective is to identify facilitators of, and barriers to, various notions of service user involvement. Our findings provide empirical evidence regarding service users’ experiences of participation in their encounters with mental health services. We identified two overarching themes, professional relations and the regulative framework and current rule and norm system, in the reviewed literature concerning facilitators and hindrances of user involvement in mental health services. By including the interrelated policy concept of ‘active citizenship’ and theoretical concept of ‘epistemic (in)justice’ in the analyses, the results provide foundations for broader exploration and problematization of the policy ideals of what we call ‘epistemic citizenship’ and contemporary practices in Nordic mental health organizations. Our conclusions include suggestions that linking micro-level experiences to organizational macro-level circumstances opens up avenues for further research on service user involvement.
Bundle management strategy in reducing hospital-acquired pneumonia in hospitalized patients with mental disorders
Authors: Han Jingjing , Li Dan , Rao Yan , Wang Gaohua
Published: June 2023

Introduction

The incidence of hospital-acquired pneumonia (HAP) is high in the medical setting for mental disorders. To date, effective measurements for preventing HAP in hospitalized mental disorder patients are unavailable.

Methods

This study was conducted at the Large-Scale Mental Health Center of Renmin Hospital of Wuhan University (Wuhan, China) in two phases: baseline phase (January 2017–December 2019) and intervention phase (May 2020–April 2022). In the intervention phase, the HAP bundle management strategy was implemented in the Mental Health Center, and the data on HAP were collected continuously for analysis.

Results

A total of 18,795 and 9,618 patients were included in the baseline and intervention phases, respectively. The age, gender, ward admitted to, type of mental disorder, and Charlson comorbidity index did not differ significantly. After intervention, the rate of HAP occurrence decreased from 0.95 to 0.52% (P < 0.001). Specifically, the HAP rate decreased from 1.70 to 0.95% (P = 0.007) in the closed ward and from 0.63 to 0.35% (P = 0.009) in the open ward. The HAP rate in the subgroups was higher in patients with schizophrenia spectrum disorders (1.66 vs. 0.74%) and organic mental disorders (4.92 vs. 1.41%), and in those ≥65 years old (2.82 vs. 1.11%) but decreased significantly after intervention (all P < 0.05).

Conclusion

The implementation of the HAP bundle management strategy reduced the occurrence of HAP in hospitalized patients with mental disorders.
Non-suicidal self-injury function: prevalence in adolescents with depression and its associations with non-suicidal self-injury severity, duration and suicide
Authors: Shen Ying , Hu Yingzi , Zhou Yongjie , Fan Xiwang
Published: June 2023

Background

Given that adolescents with depression are at the highest risk for non-suicidal self-injury (NSSI), a thorough understanding of their NSSI functions, as well as associations between functions and severe behavioral consequences, is essential for risk assessment and invention development.

Methods

Adolescents with depression from 16 hospitals across China, for whom data was available regarding their NSSI function, frequency, number of methods used, time characteristics, and suicide history were included. Descriptive statistical analyses were performed to determine the prevalence of NSSI functions. Regression analyses were conducted to explore the relationship between NSSI functions and behavioral characteristics of NSSI and suicide attempts.

Results

Affect regulation was the primary function of NSSI and followed by anti-dissociation in adolescents with depression. Females recognized automatic reinforcement functions more frequently than males, while males had a higher prevalence of social positive reinforcement functions. Automatic reinforce functions played the prominent role in associations between NSSI functions and all the severe behavioral consequences. Specifically, functions of anti-dissociation, affect regulation, and self-punishment were all associated with NSSI frequency, while higher levels of endorsements for anti-dissociation and self-punishment were linked to more NSSI methods, and greater level of endorsement for anti-dissociation was related to longer NSSI duration. Only the increase in endorsement of self-punishment was associated with a greater hazard of suicide attempts.

Conclusion

The dominant functions of NSSI in adolescents with depression was automatic reinforcement, specifically affect regulation. And prevalence of NSSI function differed between males and females. Anti-dissociation and self-punishment seemed to be the most risky factors as they were linked to severe NSSI or suicide behaviors. More attention should be given to these functions in risk evaluation, and the targeted interventions should be developed accordingly in a timely manner.
Historical developments, hotspots, and trends in tardive dyskinesia research: a scientometric analysis of 54 years of publications
Authors: Baminiwatta Anuradha , Correll Christoph U.
Published: June 2023

Background

Since being recognized as an important drug-induced clinical entity during the 1960s, tardive dyskinesia (TD) has generated an extensive body of research seeking to understand its clinical characteristics, epidemiology, pathophysiology and management. Modern scientometric approaches allow interactive visualization of large bodies of literature to identify trends and hotspots within knowledge domains. This study thus aimed to provide a comprehensive scientometric review of the TD literature.

Methods

Web of Science was searched for articles, reviews, editorials and letters with the term “tardive dyskinesia” in the title, abstract, or keywords through 12/31/2021. A total of 5,228 publications and 182,052 citations were included. Annual research output, prominent research areas, authors, affiliations and countries were summarized. VOSViewer and CiteSpace were used for bibliometric mapping and co-citation analysis. Structural and temporal metrics were used to identify key publications in the network.

Results

TD-related publications peaked in the 1990s, gradually declined after 2004, and showed a further small increase after 2015. The most prolific authors were Kane JM, Lieberman JA, and Jeste DV overall (1968–2021), and Zhang XY, Correll CU and Remington G in the last decade (2012–2021). The most prolific journal was the Journal of Clinical Psychiatry overall, and the Journal of Psychopharmacology in the last decade. Knowledge clusters in the 1960–1970s dealt with clinical and pharmacological characterization of TD. In the 1980s, epidemiology, clinical TD assessment, cognitive dysfunction and animal models predominated. During the 1990s, research diverged into pathophysiological studies, especially oxidative stress, and clinical trials on atypical antipsychotics, with a focus on clozapine and bipolar disorder. In the 1990–2000s, pharmacogenetics emerged. More recent clusters include serotonergic receptors, dopamine-supersensitivity psychosis, primary motor abnormalities of schizophrenia, epidemiology/meta-analyses, and advances in TD treatment, particularly vesicular monoamine transporter-2 inhibitors since 2017.

Conclusion

This scientometric review visualized the evolution of scientific knowledge on TD over more than five decades. These findings will be useful for researchers to find relevant literature when writing scientific articles, choosing appropriate journals, finding collaborators or mentors for research, and to understand the historical developments and emerging trends in TD research.
Gender differences in the relationship between loneliness and health-related behavioral risk factors among the Hakka elderly in Fujian, China
Authors: Chang Huajing , Ruan Wenqian , Chen Yating , Cai Longhua , Liu Xiaojun
Published: June 2023

Introduction

To explore gender differences in the relationship between loneliness and health-related behavioral risk factors (BRFs) among the Hakka elderly.

Methods

Loneliness was measured by the UCLA Loneliness Scale Short-form (ULS-8). Seven BRFs were examined. Mann–Whitney U, Kruskal-Wallis, and post hoc tests were conducted to compare the differences in ULS-8 scores among the Hakka elderly with different BRFs. Generalized linear regression models were employed to examine the associations of specific BRF and its number with the ULS-8 scores among the Hakka elderly in male, female, and total samples.

Results

Physical inactivity (B = 1.96, p < 0.001), insufficient leisure activities participation (B = 1.44, p < 0.001), unhealthy dietary behavior (B = 1.02, p < 0.001), and irregular sleep (B = 2.45, p < 0.001) were positively correlated with the ULS-8 scores, whereas drinking (B = −0.71, p < 0.01) was negatively associated with the ULS-8 scores in the total sample. In males, insufficient leisure activities participation (B = 2.35, p < 0.001), unhealthy dietary behavior (B = 1.39, p < 0.001), and irregular sleep (B = 2.07, p < 0.001) were positively associated with the ULS-8 scores. In females, physical inactivity (B = 2.69, p < 0.001) and irregular sleep (B = 2.91, p < 0.001) was positively correlated with the scores of ULS-8, while drinking (B = −0.98, p < 0.05) was negatively associated with the ULS-8 scores. More BRFs were significantly related to greater loneliness (p < 0.001).

Conclusion

There are gender differences in the relationship between loneliness and BRFs among the Hakka elderly, and individuals with more BRFs were more likely to feel loneliness. Therefore, the co-occurrence of multiple BRFs requires more attention, and integrated behavioral intervention strategies should be adopted to reduce the loneliness of the elderly.
In silico clinical trial evaluating lisdexamfetamine’s and methylphenidate’s mechanism of action computational models in an attention-deficit/hyperactivity disorder virtual patients’ population
Authors: Gutiérrez-Casares José Ramón , Quintero Javier , Segú-Vergés Cristina , Rodríguez Monterde Pilar , Pozo-Rubio Tamara , Coma Mireia , Montoto Carmen
Published: June 2023

Introduction

Attention-deficit/hyperactivity disorder (ADHD) is an impairing psychiatric condition with the stimulants, lisdexamfetamine (LDX), and methylphenidate (MPH), as the first lines pharmacological treatment.

Methods

Herein, we applied a novel in silico method to evaluate virtual LDX (vLDX) and vMPH as treatments for ADHD applying quantitative systems pharmacology (QSP) models. The objectives were to evaluate the model’s output, considering the model characteristics and the information used to build them, to compare both virtual drugs’ efficacy mechanisms, and to assess how demographic (age, body mass index, and sex) and clinical characteristics may affect vLDX’s and vMPH’s relative efficacies.

Results and Discussion

We molecularly characterized the drugs and pathologies based on a bibliographic search, and generated virtual populations of adults and children-adolescents totaling 2,600 individuals. For each virtual patient and virtual drug, we created physiologically based pharmacokinetic and QSP models applying the systems biology-based Therapeutic Performance Mapping System technology. The resulting models’ predicted protein activity indicated that both virtual drugs modulated ADHD through similar mechanisms, albeit with some differences. vMPH induced several general synaptic, neurotransmitter, and nerve impulse-related processes, whereas vLDX seemed to modulate neural processes more specific to ADHD, such as GABAergic inhibitory synapses and regulation of the reward system. While both drugs’ models were linked to an effect over neuroinflammation and altered neural viability, vLDX had a significant impact on neurotransmitter imbalance and vMPH on circadian system deregulation. Among demographic characteristics, age and body mass index affected the efficacy of both virtual treatments, although the effect was more marked for vLDX. Regarding comorbidities, only depression negatively impacted both virtual drugs’ efficacy mechanisms and, while that of vLDX were more affected by the co-treatment of tic disorders, the efficacy mechanisms of vMPH were disturbed by wide-spectrum psychiatric drugs. Our in silico results suggested that both drugs could have similar efficacy mechanisms as ADHD treatment in adult and pediatric populations and allowed raising hypotheses for their differential impact in specific patient groups, although these results require prospective validation for clinical translatability.
Promoting and supporting breastfeeding in a protracted emergency setting—Caregivers' and health workers' perceptions from North-East Nigeria
Authors: Amat Camacho Nieves , Chara Abdullahi , Briskin Emily , Pellecchia Umberto , Kyi Htet Aung , de Rubeis Maria Livia , Hussain Faisal , Ahmed Tasneem , Ogundipe Oluwakemi F. , Burzio Chiara , Kamis Uba , Bukar Lawan M. , Von Schreeb Johan , Kolokotroni Ourania , Della Corte Francesco , Sunyoto Temmy
Published: June 2023

Background

Breastfeeding (BF) should be protected, promoted, and supported for all infants in humanitarian settings. The re-establishment of exclusive BF is also a central part of the management of acutely malnourished infants under 6 months (<6 m). Médecins Sans Frontières (MSF) runs a nutrition project in Maiduguri, a protracted emergency setting in North-East Nigeria. This study aimed to explore caregivers' (CGs) and health workers' (HWs) perceptions of BF practice, promotion, and support among CGs with infants <6 m in this setting.

Methods

We conducted a qualitative study using in-depth interviews and focus group discussions combined with non-participant observations. Participants included CGs of young infants enrolled in MSF nutritional programs or who attended health promotion activities in a displacement camp. MSF HWs were involved at different levels in BF promotion and support. Data were collected involving a local translator and analyzed using reflexive thematic analysis directly from audio recordings.

Results

Participants described how feeding practices are shaped by family, community, and traditional beliefs. The perception of breastmilk insufficiency was common and led to early supplementary feeding with inexpensive but unsuitable products. Participants often linked insufficient breastmilk production with poor maternal nutrition and stress, in a context shaped by conflict and food insecurity. BF promotion was generally well received but could be improved if tailored to address specific barriers to exclusive BF. Interviewed CGs positively valued BF support received as part of the comprehensive treatment for infant malnutrition. One of the main challenges identified was the length of stay at the facility. Some participants perceived that improvements in BF were at risk of being lost after discharge if CGs lacked an enabling environment for BF.

Conclusion

This study corroborates the strong influence of household and contextual factors on the practice, promotion, and support of BF. Despite identified challenges, the provision of BF support contributes to improvements in BF practice and was positively perceived by CGs in the studied setting. Greater attention should be directed toward providing support and follow-up for infants <6 m and their CGs in the community.
Global hotspots and trends in research on preschool children’s motor development from 2012 to 2022: a bibliometric analysis
Authors: Wang Jun-Wei , Qu Sha , Zhu Zhi-Cheng , Zhao Xing , Song Wen-Jing , Li Xue , Chen Wan-Di , Luo Dong-Mei
Published: June 2023

Background

Motor development plays an important role in human development throughout the lifespans, from conception to death, and has received increasing scholarly attention in recent years. However, valuable comprehensive reviews and literature analysis on this topic are still lacking. Here, this bibliometric study aimed to identify global motor development research hotspots and trends on preschool children’s motor development from 2012 to 2022.

Methods

CiteSpace 6.1.R4 was used to visualize and analyze general bibliometric characteristics, research hotspots, and trends through a review of 2,583 articles on the motor development of preschool children, which were published from 2012 to 2022 and included in the Web of Science Core Collection.

Results

Research on motor development in preschool children has been carried out into a phase of rapid development. The top five frequently occurring keywords were physical activity (n = 489), performance (n = 319), intervention (n = 222), health (n = 196), and executive function (n = 165); The top five keywords in terms of centrality are academic achievement (0.22), low birth weight (0.16), association (0.14), brain (0.13), and cerebral palsy (0.13). Thirteen keyword clusters were produced from the log-likelihood ratio (Q = 0.74, S = 0.88), and five research topics has been received focused attention in recent years. The keywords with the strongest citation bursts in the last 5 years are developing country (S = 5.92), school-aged children (S = 5.86), middle-income country (S = 3.46), efficacy (S = 5.41), readiness (S = 3.21), motor proficiency (S = 3.6), and screen time (S = 3.3), indicating newly emerging research trends.

Conclusion

The results indicated that interventions involving fundamental movement skills, cognitive function, 24-h movement behaviors, neurodevelopmental disorders, and health-related fitness were hot topics in the field of motor development over the last decade. Emerging research trends generally center on school readiness, socioeconomic status, motor proficiency, and screen time.
Multidimensional background examination of young underweight Japanese women: focusing on their dieting experiences
Authors: Murofushi Yuka , Yamaguchi Shinji , Kadoya Haruka , Otsuka Hikaru , Ogura Kasane , Kaga Hideyoshi , Yoshizawa Yasuyo , Tamura Yoshifumi
Published: June 2023

Introduction

This study examines the background of underweight young women in Japan from multiple perspectives, focusing on whether they have ever dieted.

Methods

A screening survey was administered to 5,905 underweight (BMI < 18.5 kg/m2) women aged 18–29 years, who could report their birth weight recorded in their mother-child handbook. Valid responses were obtained from 400 underweight and 189 normal-weight women. The survey collected data regarding height, weight (BMI), body image and perception of weight, dieting experience, exercise habits from elementary school age onwards, and current eating habits. Additionally, five standardized questionnaires were used (EAT-26, eHEALTH, SATAQ-3 JS, TIPI-J, and RSES). The primary analysis was a comparative analysis (t-test/χ2)—with the presence or absence of underweight and diet experience as independent variables, and each questionnaire as a dependent variable.

Results

The screening survey revealed that approximately 24% of the total population was underweight, with a low mean BMI. Of the respondents, more than half reported their body image as skinny and a small percentage as obese. Compared with the non-diet-experienced group (NDG), the diet-experienced group (DG) had a significantly higher proportion of past to current exercise habits. There was a significantly higher percentage of disagreement responses from the DG for weight and food gain than for the NDG. The NDG weighed significantly less than the DG in terms of birth weight, and lost weight easier than the DG. Additionally, the NDG was significantly more likely to agree with increasing weight and food intake. The NDG’s exercise habits were below 40% from elementary school age to the present, predominantly owing to a dislike for exercise and a lack of opportunity to implement it. In the standardized questionnaire, the DG was significantly higher for EAT-26, eHEALTH, SATAQ-3 JS, and Conscientiousness (TIPI-J), whereas the NDG was only significantly higher for Openness (TIPI-J).

Discussion

The results suggest the need for different health education programs for underweight women who desire to lose weight and experience dieting and for those who do not. This study’s results are reflected in the development of sports opportunities optimized for each individual, and in the development of measures to ensure adequate nutritional intake.
Development and validation of the health literacy environment scale for Chinese hospitals from patients’ perspective
Authors: Tong Yingge , Wu Yixue , Han Zhiqing , Xue Zihao , Wei Yeling , Lai Shanyuan , Chen Ziyi , Wang Miaoling , Chen Siyi
Published: June 2023

Introduction

While the research on improving individual health literacy by promoting individual skills and abilities is increasing, less attention has been paid to the complexities of the healthcare environment that may influence patients’ ability to access, understand, and apply health information and health services to make health decisions. This study aimed to develop and validate a Health Literacy Environment Scale (HLES) that is suitable for Chinese culture.

Methods

This study was conducted in two phases. First, using the Person-Centered Care (PCC) framework as a theoretical framework, initial items were developed by using the existing health literacy environment (HLE) related measurement tools, literature review, qualitative interviews, and the researcher’s clinical experience. Second, scale development was based on two rounds of Delphi expert consultation and a pre-test conducted with 20 hospitalized patients. Using 697 hospitalized patients from three sample hospitals, the initial scale was developed after item screening and its reliability and validity were evaluated.

Results

The HLES comprised 30 items classified into three dimensions as follows: interpersonal (11 items), clinical (9 items), and structural (10 items) dimensions. The Cronbach’s α coefficient of the HLES was 0.960 and the intra-class correlation coefficient was 0.844. The confirmatory factor analysis verified the three-factor model after allowing for the correlation of five pairs of error terms. The goodness-of-fit indices signified a good fit for the model (χ2/df = 2.766, RMSEA = 0.069, RMR = 0.053, CFI = 0.902, IFI = 0.903, TLI = 0.893, GFI = 0.826, PNFI = 0.781, PCFI = 0.823, PGFI = 0.705). The item-content validity index ranged from 0.91 to 1.00, and the scale-content validity index was 0.90.

Conclusion

The HLES had good reliability and validity and provides a patient perspective tool for evaluating HLE and a new perspective for improving health literacy in China. That is, healthcare organizations make it easier for patients to access, understand, and use health information and service. Further studies about the validity and reliability of HLE should include other districts and different tiers or types of healthcare organizations.
Low uptake of hepatitis B vaccination among healthcare workers in primary health facilities in Mwanza region, North-Western Tanzania
Authors: Ndunguru Bernada , Wilfred Diana , Kapesa Anthony , Kilonzo Semvua D. , Mirambo Mariam , Hyera Fred , Massaga Fabian
Published: June 2023

Background

Despite the availability of hepatitis B vaccines (HBV) in Tanzania, their uptake among healthcare workers (HCWs) in high-level facilities, such as tertiary hospitals where the vaccines are available, is low. However, their uptake among HCWs in primary health facilities remains understudied. The lack of this information limits the scaling up of HBV vaccination programs.

Methodology

A cross-sectional analytical study was conducted between June and July 2022 among HCWs in the Misungwi and Ilemela districts, which were purposefully selected. The sample size was calculated using the Taro Yamane formula, and data were collected using a self-administered questionnaire and analyzed using IBM SPSS® version 25.

Results

A total of 402 HCWs were recruited, their mean age was 34.9 ± 7.77 years, and only 18% (76/402) reported being fully vaccinated. HCWs in Ilemela showed higher uptake (χ2 = 23.64, df = 1, p = 0.00) of the vaccine than HCWs in Misungwi. Being male (aOR = 2.38, 95% CI 1.28–4.45, p = 0.006), working in an urban setting (aOR = 5.75, 95% CI 2.91–11.35, p = 0.00), and having an employment duration of more than 2 years (aOR = 3.58, 95%CI 1.19–10.74, p = 0.023) were significantly associated with higher odds of vaccination. Moreover, high perceived susceptibility to HBV infection (aOR = 2.20, 95% CI1.02–4.75, p = 0.044) and history of needle prick injuries (aOR = 6.87, 95%CI 3.55–13.26, p = 0.00) were significantly associated with higher odds of HBV vaccination.

Conclusion

Low uptake of HBV vaccine among HCWs in primary health facilities was observed with a noteworthy difference between rural and urban settings. Therefore, advocacy campaigns and resource mobilization toward the promotion of HBV vaccination in primary health facilities are pivotal.
COVID-19 challenges, responses, and resilience among rural Black women: a study protocol
Authors: Qiao Shan , Wilcox Sara , Olatosi Bankole , Li Xiaoming
Published: June 2023

Despite the aggregated burdens and challenges experienced by rural Black women during the COVID-19 pandemic, many likely also demonstrated strength and resilience to overcome challenges. A mixed methodology and a community-based participatory approach will be used to collect multilevel data on challenges, responses, resilience, and lessons during the pandemic from Black women, community health workers, and community leaders in rural areas in South Carolina (SC). Specifically, the unique circumstances and lived experiences of rural Black women during the COVID-19 pandemic will be documented to understand their needs regarding effective management of social, physical, and mental health challenges through focus group discussions and in-depth interviews with Black women, community health workers, and local community leaders recruited from rural SC communities. Barriers, facilitators, and potential impacts of multilevel resilience development will be identified through a survey administered among rural Black women recruited from 11 rural counties (with one as site for a pilot testing of the questionnaire). A report for public health practice will be developed, including recommended strategies to optimize health systems' emergency preparedness and responses through triangulation of qualitative and quantitative data from multiple sources. Findings in the proposed study will provide valuable references in terms of addressing social determinants of health factor challenges during the pandemic, fostering resilience, and informing evidence-based decision-making for policymakers. The study will contribute to the development of public health emergency preparedness plans, which can promote the resilience of women, their families, and local communities as well as optimize effective preparedness and response of health systems for rural Black women and their families during infectious disease outbreaks and other public health emergencies.