bluuebunny/crossref_metadata_2025 huggingface dataset:
Mixed Convection of Cu–H2O Nanofluid in a Darcy–Forchheimer Porous Medium Microchannel with Thermal Radiation and Convective Heating
Authors: Rikitu Ebba Hindebu , Makinde Oluwole Daniel
Published: November 2023

Heat transfer and convective flow of Cu–H2O nanofluid in a microchannel with thermal radiation has many attributes in engineering, industries, and biomedical sciences including cooling of electronics, drug delivery, cancer therapy, optics, missiles, satellites, and
lubricants. Therefore, this paper aims to investigate the hydrodynamical behaviors and heat transfer characteristics of Cu–H2O nanofluid through a porous medium microchannel with thermal radiation and convective heating. The highly non-linear partial differential equations
that govern the momentum and energy equations are formulated, non-dimensionalized, transformed into ordinary differential equations and solved numerically via the fourth order Runge-Kutta integration scheme. Consequently, the numerical simulation reveals that the nanofluid velocity and temperature
profiles show a rising pattern with increasing values of the pressure gradient parameter, variable viscosity parameter, Darcy number, thermal Grashof number and Eckert number. The temperature profile escalates with the Prandtl number however it diminishes with the Biot number, Forchheimer
number, suction/injection Reynolds number and nanoparticles volume fraction. Furthermore, the thermal radiation parameter indicates a retarding effect on the temperature profile and hence, radiation quite effectively controls the microchannel temperature distribution which plays a significant
role in cooling the flow transport system. The skin friction coefficient at both microchannel walls indicates a rising pattern with the suction/injection Reynolds number, thermal Grashof number, Eckert number and Darcy number. Moreover, at both microchannel walls the heat transfer rate enhances
for large values of the suction/injection Reynolds number, thermal Grashof number, Eckert number, variable viscosity parameter and Darcy number whereas it decreases with the thermal radiation parameter, Forchheimer number and nanoparticles volume fraction. The Biot number reveals an opposite
effect on the heat transfer rate at the left and right walls of the microvhannel.
A Local Thermal Non-Equilibrium Approach to an Electromagnetic Hybrid Nanofluid Flow in a Non-Parallel Riga Plate Channel
Authors: Sharma Tanya , Kumar Rakesh , Chamkha Ali J.
Published: November 2023

The fluid flow in a non-parallel configuration exists in the electronic heat removal devices, microchannel heat sinks, and angled confusers/diffusers. The fluids in these applications are prone to flow separation and bifurcations. To deal with such type of problems, a novel idea of
a converging or diverging type Riga plate channel is introduced in this study. The Riga plates are utilised to produce the cross-flow magnetic and electric fields which give rise to an exponentially decaying Lorentz force. Also, a porous matrix with variable permeability is considered to fill
the Riga plate channel. The thermal equilibrium state between the hybrid nanofluid and porous media is ignored i.e., a local thermal non-equilibrium (LTNE) approach is adopted to model the energy balance equations. The dimension-free form of the guiding equations is tackled by using the Chebyshev
pseudospectral quasi-linearization method. The heat transfer rate is respectively incremented by 21.42% and 63.12% in the converging and diverging flow regimes, with the inclusion of a Riga Sheet. The skin friction coefficient is depressed with modified Hartmann number (Ha*) and porosity
(ε) for the converging/diverging flow regime. The LTNE state alters to the LTE with Nield number (Ni), thermal conductivity ratio (γ) and ε.
The Siberian Storm Track Weakens the Warm Arctic–Cold Eurasia Pattern
Authors: Yang Minghao , Li Yi , Dong Wei , Shi Weilai , Yu Peilong , Chen Xiong
Published: November 2023

With a particular focus on the Siberian storm track, this study provides new insights into variations in the warm Arctic–cold Eurasia (WACE) temperature anomaly pattern by using reanalysis data. The results show that the Siberian storm track has a significant out-of-phase relationship with both the WACE pattern and Ural blocking on the interannual time scale. The strengthened WACE pattern can weaken the Siberian storm track through a suppression of the low-level atmospheric baroclinicity over midlatitude Eurasia. The weakened Siberian storm track can contribute to the WACE pattern through feedback forcing from synoptic-scale eddies, which can also create favorable conditions for the development of Ural blocking. Composite temporal evolution reveals that the strongest cold Arctic–warm Eurasia pattern is preceded by the peak of the Siberian storm track. The Ural cyclonic circulation reaches its maximum amplitude on the peak day of the Siberian storm track strength and continues to persist for one day with the maximum amplitude due to the feedback forcing resulting from the Siberian storm track. On the intraseasonal time scale, the occurrence of the Siberian storm track activity can serve as an early indication of the diminished Ural blocking and WACE pattern.

Significance Statement

Because of the high impacts of the warm Arctic–cold Eurasia (WACE) pattern on public safety, socioeconomic development, and the economy, it is crucial to enhance our understanding of variations in the WACE pattern. This paper specifically investigates the impact of internal atmospheric variability on the WACE pattern, focusing on a pronounced negative correlation between the Siberian storm track and the WACE pattern. Daily composites also reveal that Siberian storm track activities can promote a strong cold Arctic–warm Eurasia pattern by maintaining the strength of the quasi-stationary Ural cyclonic circulation. As such, paying close attention to Siberian storm track activities may hold the promise to improve the prediction of the strength of the WACE pattern.
ABL1 kinase plays an important role in spontaneous and chemotherapy-induced genomic instability in multiple myeloma
Authors: Kumar Subodh , Talluri Srikanth , Zhao Jiangning , Liao Chengcheng , Potluri Lakshmi B. , Buon Leutz , Mu Shidai , Shi Jialan , Chakraborty Chandraditya , Tai Yu-Tzu , Samur Mehmet K. , Munshi Nikhil C. , Shammas Masood A.
Published: November 2023

Genomic instability contributes to cancer progression and is at least partly due to dysregulated homologous recombination (HR). Here, we show that an elevated level of ABL1 kinase overactivates the HR pathway and causes genomic instability in multiple myeloma (MM) cells. Inhibiting ABL1 with either short hairpin RNA or a pharmacological inhibitor (nilotinib) inhibits HR activity, reduces genomic instability, and slows MM cell growth. Moreover, inhibiting ABL1 reduces the HR activity and genomic instability caused by melphalan, a chemotherapeutic agent used in MM treatment, and increases melphalan’s efficacy and cytotoxicity in vivo in a subcutaneous tumor model. In these tumors, nilotinib inhibits endogenous as well as melphalan-induced HR activity. These data demonstrate that inhibiting ABL1 using the clinically approved drug nilotinib reduces MM cell growth, reduces genomic instability in live cell fraction, increases the cytotoxicity of melphalan (and similar chemotherapeutic agents), and can potentially prevent or delay progression in patients with MM.
Improved production of lactiplantibacillus plantarum RO30 exopolysaccharide (REPS) by optimization of process parameters through statistical experimental designs
Authors: Elmansy Eman Ahmed , Elkady Ebtsam M. , Asker Mohsen S. , Abdallah Nagwa A. , Khalil Bigad E. , Amer Shaimaa k.
Published: November 2023

Background

In investigating of (exopolysaccharide) EPS from unconventional sources, lactic acid bacteria have a vital role due to their generally recognized as safe (GRAS) status. EPSs have diverse applications such as drug delivery, antimicrobial activity, surgical implants, and many more in many sectors. Despite being important, the main hindrance to the commercial application of these significant biopolymers is low productivity. Therefore, this study primarily focuses on optimizing physio-chemical conditions to maximize the previously produced EPS from probiotic Lactiplantibacillus plantarum RO30 (L. plantarum RO30) using one factor at a time (OFAT) and method Response Surface Methodology (RSM).

Results

The EPS obtained from L. plantarum RO30 named REPS. The medium formulation for REPS production using the OFAT method revealed that sucrose (20 g/L, beef extract (25 g/L), and ammonium sulfate at 4 g/L concentration were the optimum carbon, organic and inorganic nitrogen sources, and REPS yield was increased up to 9.11 ± 0.51 g/L. RSM experiments revealed that, a greatly significant quadratic polynomial attained from the Central Composite Design (CCD) model was fruitful for specifying the most favorable cultural conditions that have significant consequences on REPS yield. The maximal amount of REPS (10.32 g/L) was formed by: sucrose (40 g/L), beef extract (25 g/L), pH (5.5), incubation temperature (30 °C), and incubation period (72 h). A high closeness was obtained between the predicted and experimental values and it displayed the efficiency of the RSM.

Conclusion

This study was conducted to reinforce REPS production in the probiotic LAB L. plantarum RO30 by utilizing various experimental parameters. The maximum REPS yield of 10.32 g/L was attained under the circumstances optimized in the study.
DNA methylation and lipid metabolism are involved in GA-induced maize aleurone layers PCD as revealed by transcriptome analysis
Authors: Wu Yequn , Hou Jiaqi , Ren Ruifei , Chen Zhenfei , Yue Mengxia , Li Le , Hou Haoli , Zheng Xueke , Li Lijia
Published: November 2023

Background

The aleurone layer is a part of many plant seeds, and during seed germination, aleurone cells undergo PCD, which is promoted by GA from the embryo. However, the numerous components of the GA signaling pathway that mediate PCD of the aleurone layers remain to be identified. Few genes and transcriptomes have been studied thus far in aleurone layers to improve our understanding of how PCD occurs and how the regulatory mechanism functions during PCD. Our previous studies have shown that histone deacetylases (HDACs) are required in GA-induced PCD of aleurone layer. To further explore the molecular mechanisms by which epigenetic modifications regulate aleurone PCD, we performed a global comparative transcriptome analysis of embryoless aleurones treated with GA or histone acetylase (HAT) inhibitors.

Results

In this study, a total of 7,919 differentially expressed genes (DEGs) were analyzed, 2,554 DEGs of which were found to be common under two treatments. These identified DEGs were involved in various biological processes, including DNA methylation, lipid metabolism and ROS signaling. Further investigations revealed that inhibition of DNA methyltransferases prevented aleurone PCD, suggesting that active DNA methylation plays a role in regulating aleurone PCD. GA or HAT inhibitor induced lipoxygenase gene expression, leading to lipid degradation, but this process was not affected by DNA methylation. However, DNA methylation inhibitor could regulate ROS-related gene expression and inhibit GA-induced production of hydrogen peroxide (H2O2).

Conclusion

Overall, linking of lipoxygenase, DNA methylation, and H2O2 may indicate that GA-induced higher HDAC activity in aleurones causes breakdown of lipids via regulating lipoxygenase gene expression, and increased DNA methylation positively mediates H2O2 production; thus, DNA methylation and lipid metabolism pathways may represent an important and complex signaling network in maize aleurone PCD.
H2A.X promotes endosperm-specific DNA methylation in Arabidopsis thaliana
Authors: Frost Jennifer M. , Lee Jaehoon , Hsieh Ping-Hung , Lin Samuel J. H. , Min Yunsook , Bauer Matthew , Runkel Anne M. , Cho Hyung-Taeg , Hsieh Tzung-Fu , Fischer Robert L. , Choi Yeonhee
Published: November 2023

Background

H2A.X is an H2A variant histone in eukaryotes, unique for its ability to respond to DNA damage, initiating the DNA repair pathway. H2A.X replacement within the histone octamer is mediated by the FAcilitates Chromatin Transactions (FACT) complex, a key chromatin remodeler. FACT is required for DEMETER (DME)-mediated DNA demethylation at certain loci in Arabidopsis thaliana female gametophytes during reproduction. Here, we sought to investigate whether H2A.X is involved in DME- and FACT-mediated DNA demethylation during reproduction.

Results

H2A.X is encoded by two genes in Arabidopsis genome, HTA3 and HTA5. We generated h2a.x double mutants, which displayed a normal growth profile, whereby flowering time, seed development, and root tip organization, S-phase progression and proliferation were all normal. However, h2a.x mutants were more sensitive to genotoxic stress, consistent with previous reports. H2A.X fused to Green Fluorescent Protein (GFP) under the H2A.X promoter was highly expressed especially in newly developing Arabidopsis tissues, including in male and female gametophytes, where DME is also expressed. We examined DNA methylation in h2a.x developing seeds and seedlings using whole genome bisulfite sequencing, and found that CG DNA methylation is decreased genome-wide in h2a.x mutant endosperm. Hypomethylation was most striking in transposon bodies, and occurred on both parental alleles in the developing endosperm, but not the embryo or seedling. h2a.x-mediated hypomethylated sites overlapped DME targets, but also included other loci, predominately located in heterochromatic transposons and intergenic DNA.

Conclusions

Our genome-wide methylation analyses suggest that H2A.X could function in preventing access of the DME demethylase to non-canonical sites. Overall, our data suggest that H2A.X is required to maintain DNA methylation homeostasis in the unique chromatin environment of the Arabidopsis endosperm.
Cost consequence analysis of transcutaneous tibial nerve stimulation (TTNS) for urinary incontinence in care home residents alongside a randomised controlled trial
Authors: Fenocchi Linda , Mason Helen , Macaulay Lisa , O’Dolan Catriona , Treweek Shaun , Booth Joanne
Published: November 2023

Background

Urinary incontinence (UI) is prevalent in more than half of residents of nursing and residential care homes and can have a detrimental impact on dignity and quality of life. Care homes predominantly use absorbent pads to contain UI rather than actively treat the condition. Transcutaneous tibial nerve stimulation (TTNS) is a non-invasive, safe, low-cost intervention with demonstrated effectiveness for reducing UI in adults. We examined the costs and consequences of delivering TTNS to care home residents in comparison to sham (inactive) electrical stimulation.

Methods

A cost consequence analysis approach was used to assemble and present the resource use and outcome data for the ELECTRIC trial which randomised 406 residents with UI from 37 care homes in the United Kingdom to receive 12 sessions of 30 min of either TTNS or sham (inactive) TTNS. TTNS was administered by care home staff over 6 weeks. Health state utility was measured using DEMQOL-U and DEMQOL-PROXY-U at baseline, 6 weeks and 18 weeks follow-up. Staff completed a resource use questionnaire at baseline, 6 weeks and 18 weeks follow-up, which also assessed use of absorbent pads.

Results

HRQoL did not change significantly in either randomised group. Delivery of TTNS was estimated to cost £81.20 per participant, plus training and support costs of £121.03 per staff member. 85% of participants needed toilet assistance as routine, on average requiring one or two staff members to be involved 4 or 5 times in each 24 h. Daily use of mobility aids and other assistive devices to use the toilet were reported. The value of staff time to assist residents to use the toilet (assuming an average of 5 min per resident per visit) was estimated as £19.17 (SD 13.22) for TTNS and £17.30 (SD 13.33) for sham (per resident in a 24-hour period).

Conclusions

Use of TTNS to treat UI in care home residents did not lead to changes in resource use, particularly any reduction in the use of absorbent pads and no cost benefits for TTNS were shown. Managing continence in care homes is labour intensive, requiring both high levels of staff time and use of equipment aids.

Trial registration

ISRCTN98415244, registered 25/04/2018. NCT03248362 (Clinical trial.gov number), registered 14/08//2017.
A consensus statement on minimum operational standards for geriatric emergency care in Belgium: a modified Delphi study
Authors: Heeren Pieter , Islam Farah , Desruelles Didier , Flamaing Johan , Sabbe Marc , Milisen Koen ,   the Belgian URGENT Delphi Group, Heerinckx Philippe , Hubloue Ives , Tran Tuan Long , Wynants Stefan , Ghekière Veronique , De Brauwer Isabelle , Beernaert Laetitia , Cristelbach Sophie , Guldemont Sven , Lumen Dieter , Sohet Sebastien , Bogaerts Emilie , Himschoot Nadja , Michaux Nicole , Dath Mayelise , Biets Robin , Piron Cecile , Van den Heede Koen , Vande Voorde Carine , Ricour Celine
Published: November 2023

Background

As emergency department (ED) leaders started integrating geriatric emergency guidelines on a facultative basis, important variations have emerged between EDs in care for older patients. The aim of this study was to establish a consensus on minimum operational standards for Geriatric ED care in Belgium.

Methods

A two-stage modified Delphi study was conducted. Twenty panellists were recruited from Dutch and French speaking regions in Belgium to join an interdisciplinary expert panel. In the first stage, an online survey was conducted to identify and define all possible elements of geriatric emergency care. In the second stage, an online survey and online expert panel meeting were organized consecutively to determine which elements should be recognized as minimum operational standards.

Results

Between March 2020 and February 2021, the expert panel developed a broad consensus including ten statements focusing on the target population, specific goals, availability of geriatric practitioners and quality assurance. Additionally, the expert panel also determined which protocols, materials and accommodation criteria should be available in conventional EDs (39 standards) and in observational EDs (57 standards).

Conclusions

This study presents a consensus on minimum operational standards for geriatric emergency care in two ED types: the conventional ED and the observational ED. These findings may serve as a starting point towards broadly supported minimum standards of care stipulated by legislation in Belgium or other countries.
Plasma acylcarnitine in elderly Taiwanese: as biomarkers of possible sarcopenia and sarcopenia
Authors: Lo Chi-Jen , Lin Chih-Ming , Fan Chun-Ming , Tang Hsiang-Yu , Liu Han-Fang , Ho Hung-Yao , Cheng Mei-Ling
Published: November 2023

Background

Sarcopenia is defined as the disease of muscle loss and dysfunction. The prevalence of sarcopenia is strongly age-dependent. It could bring about disability, hospitalization, and mortality. The purpose of this study was to identify plasma metabolites associated with possible sarcopenia and muscle function to improve disease monitoring and understand the mechanism of muscle strength and function decline.

Methods

The participants were a group of healthy older adult who live in retirement homes in Asia (Taiwan) and can manage their daily lives without assistance. The participants were enrolled and divided into four groups: control (Con, n = 57); low physical function (LPF, n = 104); sarcopenia (S, n = 63); and severe sarcopenia (SS, n = 65) according to Asian countries that used Asian Working Group for Sarcopenia (AWGS) criteria. The plasma metabolites were used and the results were calculated as the difference between the control and other groups.

Results

Clinical parameters, age, gender, body mass index (BMI), hand grip strength (HGS), gait speed (GS), blood urea nitrogen (BUN), hemoglobin, and hematocrit were significantly different between the control and LPF groups. Metabolite patterns of LPF, S, and SS were explored in our study. Plasma kynurenine (KYN) and acylcarnitines (C0, C4, C6, and C18:1-OH) were identified with higher concentrations in older Taiwanese adults with possible sarcopenia and S compared to the Con group. After multivariable adjustment, the data indicate that age, BMI, and butyrylcarnitine (C4) are more important factors to identify individuals with low physical function and sarcopenia.

Conclusion

This metabolomic study raises the importance of acylcarnitines on muscle mass and function. It suggests that age, BMI, BUN, KYN, and C4/Cr can be important evaluation markers for LPF (AUC: 0.766), S (AUC: 0.787), and SS (AUC: 0.919).
Feasibility of Symptom monitoring WIth Feedback Trial (SWIFT) for adults on hemodialysis: a registry-based cluster randomized pilot trial
Authors: Agarwal Neeru , Shah Karan K. , Dansie Kathryn , Bennett Paul N. , Greenham Lavern , Brown Chris , Smyth Brendan , McDonald Stephen , Jesudason Shilpanjali , Viecelli Andrea K. , Morton Rachael L. ,   on behalf of the Symptom monitoring With Feedback Trial (SWIFT) Investigators, Hawley Carmel , Johnson David W. , Harris David , Laranjo Lilliana , Couchoud Cecile , Caskey Fergus J. , Palmer Suetonia , Jose Matthew , Simes R. John , Manns Braden , Handke William , Coiera Enrico , Mister Rebecca , Westall Portia
Published: November 2023

Background

Patients with kidney failure on hemodialysis (HD) experience considerable symptom burden and poor health-related quality of life (HRQoL). There is limited use of patient reported outcome measures (PROMs) in facility HD units to direct immediate care, with response rates in other studies between 36 to 70%. The aim of this pilot study was to evaluate feasibility of electronic PROMs (e-PROMs) in HD participants, with feedback 3-monthly to the participants’ treating team, for severe or worsening symptoms as identified by the Integrated Palliative Outcome Scale (IPOS-Renal), with linkage to the Australian and New Zealand Dialysis and Transplant (ANZDATA) registry, compared with usual care.

Methods

This is a registry-based cluster-randomized controlled pilot trial involving all adults receiving HD in 4 satellite units in Australia over a 6-month period. HD units were cluster randomized 1:1 to the control (HRQoL data collection only) or intervention arm (symptom monitoring with feedback to treating team every 3 months). Feasibility was assessed by participant response rate (percentage of eligible HD participants, including new incident participants, who completed the questionnaire at each time point); retention rate (percentage of participants who completed the baseline questionnaire and all subsequent measures); and completion time. HRQoL and symptom burden scores are described.

Results

There were 226 unique participants who completed the e-PROMs (mean age 62 years, 69% males, 78% White-European, median dialysis vintage 1.62 years). At 6 months, response rate and retention rate for the intervention arm were 54% and 68%, respectively, and 89% and 97% in the control arm. Median time to complete IPOS-Renal was 6.6 min (5.3, 10.1) at 3 months, and when combined with the outcome measure (EQ-5D-5L), the median time was 9.4 min (6.9, 13.6) at 6 months.

Conclusions

Electronic symptom monitoring among HD participants with feedback to clinicians is feasible. Variations in response and retention rates could be potentially explained by the lengthier questionnaire, and higher frequency of data collection time points for participants in the intervention arm. A definitive national RCT is underway.

Trial registration

ACTRN12618001976279 (07/12/2018).
Impairments in sleep and brain molecular clearance in people with cognitive deterioration and biological evidence of AD: a report of four cases
Authors: Buongiorno Mariateresa , Granell Esther , Caruana Giovanni , Sansa Gemma , Vives-Gilabert Yolanda , Cullell Natalia , Molina-Seguin Jessica , Almeria Marta , Artero Cristina , Sánchez-Benavides Gonzalo , Ray Nicola J , Correa Sonia A.L. , Krupinski Jerzy
Published: November 2023

Background

Recent evidence suggests that the failure of the glymphatic system – the brain’s waste clearance system, which is active during sleep – plays a key role in the pathophysiology of Alzheimer’s Disease (AD). Glymphatic function can be investigated using serial MRIs after intrathecal gadobutrol injection. This technique can reveal the health of the glymphatic system, but has not yet been used in participants with cognitive impairment due to AD.

Case report

This report describes the sleep and gadobutrol tracer clearance patterns of four participants diagnosed with mild to moderate cognitive impairment with evidence of AD pathology (pathological levels of Ab and p-tau in cerebrospinal fluid). We performed polysomnography and MRI studies before tracer injection and MRI scans at 1.5-2 h, 5–6 h, and 48 h after injection. Despite participants reporting no sleep problems, polysomnography revealed that all participants had moderate to severe sleep disturbances, including reduced sleep efficiency during the study and obstructive sleep apnea. Severe side-effects related to tracer administration were observed, impeding the completion of the protocol in two participants. Participants who finished the protocol displayed delayed and persistent tracer enrichment in the cortex and white matter, even 48 h after injection. These outcomes have not been observed in previous studies in participants without AD.

Conclusion

The findings suggest that brains with sleep impairment and AD pathology have poor glymphatic function, and therefore cannot clear the contrast tracer efficiently. This is likely to have caused the severe side effects in our participants, that have not been reported in healthy individuals. Our results may therefore represent the only available data acquired with this technique in participants with AD pathology.
Do disempowered childbearing women give birth at home in Sierra Leone? A secondary analysis of the 2019 Sierra Leone demographic health survey
Authors: James Peter Bai , Yendewa George A , Bah Abdulai Jawo , Osborne Augustus , Kpagoi Satta Sylvia , Margao Emmanuel Kamanda , Kangbai Jia , Wardle Jon
Published: November 2023

Background

A nationwide assessment of the link between women’s empowerment and homebirth has not been fully examined in Sierra Leone. Our study examined the association between women’s empowerment and homebirth among childbearing women in Sierra Leone using the 2019 Sierra Leone Demographic Health Survey (2019 SLDHS) data.

Method

We used the individual file (IR) of the 2019 SLDHS dataset for our analysis. A total of 7377 women aged 15–49 years who gave birth in the five years preceding the survey were included. Outcome variable was “home birth of their last child among women in the five years preceding the 2019 SLDHS. Women’s empowerment parameters include women’s knowledge level, economic participation, decision-making ability and power to refuse the idea of intimate partner violence. We used the complex sample command on SPSS version 28 to conduct descriptive and multivariate logistic regression analyses.

Results

Three in every 20 women had home childbirth (n = 1177; 15.3%). Women with low [aOR 2.04; 95% CI 1.43–2.92] and medium [aOR 1.44; 95%CI 1.05–1.97] levels of knowledge had higher odds of giving birth at home compared to those with high levels of knowledge. Women who did not have power to refuse the idea of intimate partner violence against women were more likely to had given birth at home [aOR 1.38; 95% CI1.09-1.74]. In addition, women with no [aOR 2.71; 95% CI1.34-5.46) and less than four antenatal care visits [aOR 2.08; 95% CI:1.51–2.88] and for whom distance to a health facility was a major problem [aOR 1.95; 95% CI1.49-2.56] were more likely to have had a homebirth. However, no statistically significant association was observed between a women’s decision-making power and home birth [aOR 1.11; 95% CI 0.86–1.41].

Conclusion

Despite improvements in maternal health indicators, homebirth by unskilled birth attendants is still a public health concern in Sierra Leone. Women with low knowledge levels, who did not have power to refuse the idea of intimate partner violence against women, had less than four ANC visits and considered distance to a health facility as a major problem had higher odds of giving birth at home. Our findings reflect the need to empower women by improving their knowledge level through girl child and adult education, increasing media exposure, changing societal norms and unequal power relations that promote gender-based violence against women, and improving roads and transport infrastructure.
MicroRNA-21 promotes head and neck squamous cell carcinoma (HNSCC) induced transition of bone marrow mesenchymal stem cells to cancer-associated fibroblasts
Authors: Wang Hao , Zhou Zhengyu , Lin Wenchao , Qian Yechun , He Shifang , Wang Jun
Published: November 2023

Background

Most patients diagnosed with head and neck tumor will present with locally advanced disease, requiring multimodality therapy. Bone marrow-derived mesenchymal stromal cells (BMSCs) respond to a variety of tumor cell-derived signals, such as inflammatory cytokines and growth factors. As a result, the inflammatory tumor microenvironment may lead to the recruitment of BMSCs. Whether BMSCs in the tumor environment are more likely to promote tumor growth or tumor suppression is still controversial. We aimed to determine whether microRNA-21(miR-21) would play a vital role in HNSCC induced transition of human bone marrow mesenchymal stem cells (hBMSCs) to cancer-associated fibroblasts (CAFs).

Methods

In this study, we used electron microscope to observed exosomes collected from human tissue and two cell lines. We co-cultured hBMSCs with exosomes from FaDu and Cal-27 cells with miR-21 inhibited or not, then assessed cell cycle changes of hBMSCs with flow cytometry and determined expression level of α-SMA and FAP through qRT-PCR and Western blot.

Results

We observed an up-regulation of miR-21 expression in HNSCC tissue and FaDu and Cal-27 cells. Importantly, the exosomes derived from both cells induced CAFs-like characteristics in hBMSCs. while treatment with a miR-21 inhibitor effectively suppressed the transition of hBMSCs to CAFs and reversed the changes in the cell cycle distribution. This suggests that miR-21 plays a crucial role in facilitating the transition of hBMSCs to CAFs and modulating the cell cycle dynamics.

Conclusion

Our findings highlight the significance of miR-21 in mediating the communication between HNSCC cells and hBMSCs through exosomes, leading to the promotion of CAFs-like features and alterations in the cell cycle of hBMSCs.
Lactate receptor GPR81 drives breast cancer growth and invasiveness through regulation of ECM properties and Notch ligand DLL4
Authors: Lundø Kathrine , Dmytriyeva Oksana , Spøhr Louise , Goncalves-Alves Eliana , Yao Jiayi , Blasco Laia P. , Trauelsen Mette , Ponniah Muthulakshmi , Severin Marc , Sandelin Albin , Kveiborg Marie , Schwartz Thue W. , Pedersen Stine F.
Published: November 2023

Background

The lactate receptor GPR81 contributes to cancer development through unclear mechanisms. Here, we investigate the roles of GPR81 in three-dimensional (3D) and in vivo growth of breast cancer cells and study the molecular mechanisms involved.

Methods

GPR81 was stably knocked down (KD) in MCF-7 human breast cancer cells which were subjected to RNA-seq analysis, 3D growth, in situ- and immunofluorescence analyses, and cell viability- and motility assays, combined with KD of key GPR81-regulated genes. Key findings were additionally studied in other breast cancer cell lines and in mammary epithelial cells.

Results

GPR81 was upregulated in multiple human cancer types and further upregulated by extracellular lactate and 3D growth in breast cancer spheroids. GPR81 KD increased spheroid necrosis, reduced invasion and in vivo tumor growth, and altered expression of genes related to GO/KEGG terms extracellular matrix, cell adhesion, and Notch signaling. Single cell in situ analysis of MCF-7 cells revealed that several GPR81-regulated genes were upregulated in the same cell clusters. Notch signaling, particularly the Notch ligand Delta-like-4 (DLL4), was strikingly downregulated upon GPR81 KD, and DLL4 KD elicited spheroid necrosis and inhibited invasion in a manner similar to GPR81 KD.

Conclusions

GPR81 supports breast cancer aggressiveness, and in MCF-7 cells, this occurs at least in part via DLL4. Our findings reveal a new GPR81-driven mechanism in breast cancer and substantiate GPR81 as a promising treatment target.
A case report of pituitary neuroendocrine tumor manifesting as severe conjunctival chemosis
Authors: Yamamuro Shun , Yoshino Atsuo , Nishide Takuma , Negishi Hiroshi , Kumagawa Takahiro
Published: November 2023

Background

Conjunctival chemosis (CC) is an extremely rare symptom of pituitary neuroendocrine tumor (PitNET). We report an extremely rare case of PitNET manifesting as severe CC.

Case presentation

A 48-year-old male was admitted to our hospital with severe CC, proptosis, and ptosis of the right eye. Magnetic resonance imaging demonstrated the tumor mass invading the cavernous sinus (CS) with cystic lesion. The patient underwent emergent endoscopic transsphenoidal surgery, and the pathological diagnosis was PitNET. CC of the right eye remarkably improved after the surgery. Glucocorticoid therapy was performed for right oculomotor nerve palsy, which rapidly improved. The postoperative course was uneventful and the patient was discharged from our hospital without hormone replacement.

Conclusions

CC caused by CS invasion of PitNET can be cured by early surgical treatment. Therefore, PitNET is important to consider in the differential diagnosis of CC.
Epidemiology of asthma exacerbation in children before and after the COVID-19 pandemic: a retrospective study in Chengdu, China
Authors: Zhang Lei , Liu Hanmin , Ai Tao , Chen Zijin , Tang Wei , Hu Shuai , Hu Jie
Published: November 2023

Purpose

To examine the numbers and characteristics of children affected by asthma exacerbation in Chengdu, China, before and after the COVID-19 pandemic to inform efforts to manage childhood asthma in the post epidemic era.

Methods

Data were retrospectively collected from children admitted for asthma exacerbation to Chengdu Women and Children’s Central Hospital between January 2017 and December 2022. Rates of hospitalization, ages of the affected children, comorbidities and infections, and relationships between hospitalization and seasonal or environmental factors were examined before and after the epidemic.

Results

Fewer children were hospitalized for asthma exacerbation, yet more hospitalized children had severe exacerbation after the epidemic than before. Rates of hospitalization varied considerably with time of year, and the timing of peak hospitalizations differed before and after the epidemic. Only before the epidemic, rates of hospitalization for asthma exacerbation were positively correlated with humidity. Infants made up a smaller proportion of hospitalized children after the epidemic than before, with preschool children accounting for most hospitalizations after the epidemic. The proportion of children hospitalized for asthma exacerbation who also had pneumonia was significantly smaller after the epidemic than before. Conversely, the proportion of children hospitalized for asthma exacerbation who also had allergic diseases was significantly greater after the epidemic than before.

Conclusion

The epidemiology of asthma exacerbation in children changed after the epidemic. Future efforts to manage the condition in the paediatric population should focus on severe asthma exacerbation, prevention and management of allergic diseases, and the influence of meteorological and environmental factors.
Psychometric performance of EQ-5D-5L and SF-6DV2 in measuring health status of populations in Chinese university staff and students
Authors: Zhou Hui Jun , Zhang Aixue , Wei Jie , Wu Jing , Luo Nan , Wang Pei
Published: November 2023

Aims

To compare measurement properties of EQ-5D-5L and SF-6DV2 in university staff and students in China.

Methods

A total of 291 staff and 183 undergraduates or postgraduates completed the two instruments assigned in a random order. The health utility scores (HUS) of EQ-5D-5L and SF-6DV2 were calculated using the respective value sets for Chinese populations. The agreement of HUSs was examined using intraclass correlation coefficients (ICC) and Bland-Altman plot. Convergent validity of their HUSs and similar dimensions were assessed using Spearman’s correlation coefficient. Known-group validity of the HUSs and EQ-VAS score was assessed by comparing the scores of participants with and without three conditions (i.e., disease, symptom or discomfort, and injury), as well as number of any of the three conditions; their sensitivity was also compared.

Results

The ICCs between the two HUSs were 0.567 (staff) and 0.553 (students). Bland-Altman plot found that EQ-5D-5L HUSs were generally higher. Strong correlation was detected for two similar dimensions (pain/discomfort of EQ-5D-5L and pain of SF-6DV2; anxiety/depression of EQ-5D-5L and mental health of SF-6DV2) in both samples. The correlation between the two HUSs were strong (0.692 for staff and 0.703 for students), and were stronger than their correlations with EQ-VAS score. All the three scores could discriminate the difference in three known-groups (disease, symptom or discomfort, number of any of the three conditions). The two HUSs were more sensitive than EQ-VAS score; and either of them was not superior than the other.

Conclusions

Both EQ-5D-5L and SF-6DV2 HUSs have acceptable measurement properties (convergent validity, known-groups validity, sensitivity) in Chinese university staff and students. Nevetheless, only EQ-5D-5L (PD and AD) and SF-6DV2 (PN and MH) showed indicated good convergent validity as expected. Two types of HUSs cannot be used interchangeably, and each has its own advantages in sensitivity.
Survey the effectiveness of education based on message framing through mobile phone on women’s physical activity
Authors: Shakerinejad Ghodratollah , Baji Zahra , Tehrani Masoumeh , Jarvandi Farzaneh , Cheraghi Maria , Hatamzadeh Nasser
Published: November 2023

Background

Physical activity in female employees is a healthy behavior and increases strength, endurance, improves flexibility, improves the feeling of vitality and freshness, improves health, and ultimately increases life expectancy. Health messages are one of the most effective ways to engage people and motivate them to perform healthy behaviors. The purpose of this study was to the study of the effectiveness of education based on message framing through mobile phone (whatsapp) on the physical activity of women employees of universities and higher education institutions in Ahvaz city.

Method

In this interventional study, 90 of female employees of three universities and higher education institutions of Ahvaz city were selected by random sampling and randomly divided into three groups (30 participants) receiving gain framed messages, receiving loss framed messages and the control group. The tools of data collection were demographic information questionnaire and international physical activity questionnaire (IPAQ). The participants of the intervention groups received educational messages about physical activity behavior in two different gain and loss framed messages through whatsapp for one month. Data were collected from three groups at the beginning of the study, immediately and two months after the intervention, and were analyzed using SPSS version 26.

Results

The results showed that there was a significant increase in the average physical activity score after the intervention in two interventional groups. by comparing the increase of this score, 53% improvement in physical activity is observed in the gain message group and 15% in loss massage group but there was no significant increase in the control group.

Conclusion

The results of this study showed that the design and implementation of education programs based on message framing, especially gain framed messages through online education (Whatsapp) can improve and promote physical activity behavior in women employees.
Medical resource utilization and the associated costs of asthma in China: a 1-year retrospective study
Authors: Yang Xueer , Zhang Tiantian , Yang Xuanyi , Jiang Jie , He Yuwen , Wang Pei
Published: November 2023

Background

Despite evidence that severe and poorly controlled asthma are associated with more clinical unmet needs and intensive utilization of healthcare resources, limited data is available on severe asthma expenditure in China. The study aimed to assess Medical Resource Utilization (MRU) costs of asthma and explore the cost drivers in order to better understand the economic burden of the Chinese population suffered from asthma.

Methods

A retrospective analysis was conducted using Chinese sampled national claim database. Patients aged 6 years and above with primary diagnosis of asthma and asthma-related medical visit/hospitalization during 2015 were included. Medication was used as a proxy per the GINA and China guideline to identify asthma severity (i.e. mild, moderate, and severe). multiple linear regression model was conducted to identify MRU costs drivers.

Results

7,254 patients diagnosed with asthma were included: 4,529 (62.4%), 2,200 (30.3%), and 525 (7.2%) had mild, moderate, and severe asthma, respectively. On average, each severe patient spent 6,782 Chinese Yuan (CNY) on asthma treatment and had 57.0% hospitalization rate during the year, 3.9- and 4.4-fold of the average of overall population (P < 0.001 for both). The proportion of patients experiencing exacerbation significantly higher in the severe asthma population (66.5%; P < 0.001) compared to mild (30.0%) and moderate (16.8%) groups. In subgroup with 1,660 samples had annual consecutive data, severe patients had annual cost of CNY 8,314 and 52.2% hospitalization rate. 13% of severe patients who had frequent severe exacerbation (≥ 2 events) experienced the highest annual average cost CNY 23,037, P < 0.001) whereas children aged from 6 to 14 with a lower annual cost of CNY 1,094.2, 1,660.2 and 3,020.2 for mild, moderate, and severe patients respectively. The multiple model identified degree of severity, control status, complications, age, and live region as independent drivers of MRU costs.

Conclusions

Chinese asthma patients bear heavy economic burden. Severe asthma associated with higher MRU (mainly from hospitalization) and costs compared with mild to moderate asthma in China. More efforts should be devoted to the control of the disease severity and complication as the main drivers of asthma cost.
Successful rehabilitation after multiple severe complications following orthognathic surgery: a case report
Authors: Holm Cecilia Koskinen , Johansson Lena C. , Brundin Malin , Sjöström Mats
Published: November 2023

Background

Complications of orthognathic surgery are quite rare, but they cause suffering in affected individuals. The range of complications is broad and includes both hard and soft tissue.

Case presentation

We here present a case of a fully healthy woman without signs of impaired healing capacity. The patient underwent bimaxillary orthognathic surgery and experienced multiple complications both peri- and post-operatively. During the post operative period, the patient also suffered from soft tissue complications after an orthopaedic injury. Therefore, we referred the patient to her general practitioner for further medical investigation. We also present the result after restorative surgery and endodontic and prosthodontic treatment resulting in a successful rehabilitation.

Conclusion

This case report clearly shows the need for a good collaboration between different odontological and medical fields to achieve a good and predictable result. In situations where normal healing processes do not occur, in-depth analysis must be carried out.

Highlights

Orthognathic surgery affects soft and hard tissue which can result in adverse healing and complications. It is of great importance to follow up performed surgery to see late complications. Be restrictive with early re-operations when there are signs of necrosis. Always use a multidisciplinary approach when handling complications after surgery.
Economic evaluations of immunization programs as an indispensable tool for policymakers
Authors: den Boon Saskia , Ahmed Sayem , Sarker Abdur Razzaque
Published: November 2023

Introducing new vaccines within national immunization programs requires careful consideration of disease- and vaccine-related issues as well as of the strength of the program and the affected health system. Economic evaluations play an essential role in this process. In this editorial, we set the context and invite contributions for a BMC Health Services Research Collection of articles titled ‘Economic Evaluations of Vaccine Programs’.
Local anesthesia versus saddle block for open hemorrhoidectomy: cost-analysis from a randomized, double blind controlled trial
Authors: Sikakulya Franck Katembo , Ssebuufu Robinson , Okedi Xaviour Francis , Baluku Moris , Lule Herman , Kiyaka Sonye Magugu , Muhumuza Joshua , Molen Selamo Fabrice , Bassara Godefroy Nyenke , Waziri Musa Abbas , Kithinji Stephen Mbae , Leocadie Mugisho Munyerenkana , Kagenderezo Byamungu Pahari , Munihire Jeannot Baanitse , Vahwere Bienfait Mumbere , Kiswezi Ahmed , Kyamanywa Patrick
Published: November 2023

Background

Despite the benefits attributed to the use of local anesthesia (LA) for open hemorrhoidectomy (OH) in developed countries, this technique is still not considered as the first line technique in low-income countries such as Uganda; therefore, we aimed at comparing the cost of OH under LA versus Saddle block among patients with 3rd or 4th degree hemorrhoids.

Methods

This trial was conducted from December 2021 to May 2022 among patients with primary uncomplicated 3rd or 4th degree hemorrhoids. The operating time, and direct costs in (US$) including medical and non-medical were recorded. We analysed the cost in the two groups (local anesthesia versus saddle block) using SPSS version 23.0.

Results

Findings of fifty-eight patients were analysed including 29 participants per group. There was a significant difference in operating time and cost among the two groups (p < 0.05). The mean operating time was 15.52 ± 5.34(SD) minutes versus 33.72 ± 11.54 min for OH under LA and SB respectively. The mean cost of OH under LA was 57.42 ± 8.90 US$ compared to 63.38 ± 12.77US$ in SB group.

Conclusion

The use of local anesthesia for OH was found to have less operating time with high-cost effectiveness. Being affordable, local anesthesia can help to increase the turnover of patients who would otherwise wait for the availability of anesthesia provider. Policy makers should emphasize its applicability in low-income settings to help in the achievement of 2030 global surgery goals.

Trial registration

Pan African Clinical Trials Registry, PACTR202110667430356. Registered on 08/10/2021.