bluuebunny/crossref_metadata_2025 huggingface dataset:
Playing with open-ended material as experiences of democracy: The Waldorf case
Authors: Nome Dag Øystein
Published: April 2024

Using participatory observations accompanied by video and audio recordings, this article investigates how negotiations about play scripts evolve during play in two Waldorf kindergartens. In particular, this study aims to examine how child-initiated play can contribute to the development of basic democratic skills in early childhood. The concept of resistance proposed by Gert Biesta has been a theoretical starting point for analysis. Hence, this article investigates how and what kinds of resistance are offered through play negotiations with unprocessed, open-ended play materials typical of Waldorf kindergartens. The analysis reveals that resistance is offered by the play materials, previous play scripts, and play partners. In addition, open-ended play materials seemed to add more complexity to negotiations than industrially processed toys. Consequently, the risk of failure in such negotiations becomes more intrusive.
A short history of the British Urology Researchers in Surgical Training (BURST): The power of collaborative research
Authors: Mak Quentin , Byrnes Kevin Gerard , Nathan Arjun , Kerdegari Nikki , Khadhouri Sinan , Bhatt Nikita , Kasivisvanathan Veeru
Published: April 2024

The British Urology Researchers in Surgical Training (BURST) is a UK-based, trainee-led urology research collaborative. Since inception in 2014, BURST has led projects in several urological subspecialties with the aim of improving urological practice for patient benefit. Key innovations we have used include an emphasis on social media communications and developing innovative technology solutions to improve collaboration. In this review article, we summarise our recent studies and highlight important strategies for performing collaborative research.

Level of evidence: Not applicable.
ICT, Supply Chain Digital Integration Capability, and Firm Financial Performance: The Antagonistic Effects of Perceived Government Support and Cognitive Constraints on Digital Transformation
Authors: Zhao Jun , Liu Xiao-yan
Published: April 2024

While awareness among managers regarding the benefits of digital transformation in supply chain management has grown, many Chinese SMEs have not fully embraced this shift due to ineffective ICT investments, a lack of effective government support, and the presence of related cognitive challenges. Leveraging a sample of 302 SMEs in China, the study employs SEM techniques to validate the direct effect of ICTs on the digital integration capability, and the relationship between the digital integration capability and firm financial performance. Furthermore, the LMS technique is applied to investigate the moderating role of government support and cognitive constraints within these relationships. Result shows that: (1) ICTs positively affect firm’s supply chain digital integration capability; (2) firm’s supply chain digital integration capability positively affects firm financial performance; (3) perceived government support exhibits an antagonistic effect, hindering the promotion of supply chain digital integration capabilities through ICT infrastructures; (4) Certain cognitive constraints related to digital transformation act as negative moderators within the digital transformation process. Through the exploration of two previously overlooked factors, namely perceived government support and cognitive constraints related to digital transformation, our research contributes to a deepened understanding of dynamic capability theory, social cognitive theory, and organizational inertia theory. Our findings suggest that government policymakers must reassess the effectiveness and objectives of policies in the digital transformation journey. Furthermore, firms are urged to acknowledge and address the potential adverse effects of cognitive constraints within their organizations and among their supply chain partners. Emphasizing the importance of digital integration capability is also crucial.
Knowledge, attitude and preventive practice toward Covid-19 and associated factors among outpatients in a rural hospital in Vietnam
Authors: Hai Ha Vu , Hoang Duc Nguyen , Thi Anh Van Doan , Viet Lac Thu Nguyen , Minh Son Nguyen , Thi Xuan Hien Nguyen , Huu Le Nguyen , Tien Hung Duong , Thi Bich Ngoc Nguyen , Thanh Hung Le , Tien Huy Nguyen
Published: April 2024

Background:

The COVID-19 pandemic has emphasized the critical role of public knowledge, attitudes, and practices (KAP) in disease containment. Understanding these aspects can guide health promotion initiatives and policy decisions.

Design and methods:

This cross-sectional study examined the KAP concerning COVID-19 prevention in Vietnam. Participants’ sociodemographic data, along with KAP toward COVID-19, were collected in a survey utilizing a standardized questionnaire. Uni- and multivariable logistic regression were used to identify factors associated with poor level of KAP.

Results:

Of 335 participants, 97 (28.9%) had poor knowledge, 52 (15.5%) poor attitude, and 48 (14.3%) poor practices. Older age (OR = 2.23; p = 0.024), minority non-Kinh ethnicity (OR = 3.05; p = 0.03), education below high school (OR = 8.80; p < 0.001), limited social media access (OR = 2.86; p = 0.002), and limited mobile phone usage (OR = 3.08; p = 0.001) increased poor knowledge risks. Non-Kinh ethnicity (OR = 5.00; p = 0.005) and lower education (OR = 14.79; p < 0.001) were linked to poor attitude. Older age (OR = 2.26; p = 0.035), lower education (OR = 5.74; p = 0.003), and poor knowledge (OR = 3.33; p = 0.005) were associated with poor practices.

Conclusions:

Elderly individuals, those with low education, and limited media access had elevated risks of poor KAP. Emphasizing public health media and targeted education, especially for underserved groups, is vital for effective epidemic management and future strategy planning.
Participation Levels of Scheduled Castes in Gram Panchayat and Gram Sabha: A Sociological Study in Rural Telangana
Authors: Harinath Silveru
Published: April 2024

The constitutional protections in India have a moderately good effect on the lives of Scheduled Castes (SCs). Additionally, the social movements helped marginalized communities’ voices to some extent by empowering them to assert their rights and participate in the decision-making process. The Constitution has opened up political entry to underprivileged groups as a part of the decentralization movement at the grassroots level. Given an opportunity on par with other social groups, the SCs are showing more interest and are ahead in contesting in the elections with the support of their respective political parties. An effort has been made in this context to emphasize the problems and difficulties experienced by the elected SC members in local bodies in rural Telangana. The main objectives of the study are to examine the participation rates of SC representatives in Gram Sabha, analyse experiences in the political system in terms of gender and examine the discriminatory practices that elected officials have to deal with. The findings show that the SC representatives’ participation in Gram Sabha is weak and lacking in the decision-making process because of a lack of official backing and covert discrimination by the officials. Additionally, the SC representatives experience covert prejudice on the part of other castes. Since the bulk of the representatives are new to the election process, they are unaware of the duties that they are expected to carry out. According to the findings, the Gram Sabha should plan and finalize the village development plans in front of the people without the involvement of the local MLAs.
Arthroscopic-Assisted Core Decompression of Humeral Head Osteonecrosis With Bone Marrow Aspirate Concentrate Augmentation
Authors: Brusalis Christopher M. , Weissman Alexander C. , Yazdi Allen A. , Muth Sarah A. , Allahabadi Sachin , Cole Brian J.
Published: April 2024

Background:

The proximal humerus is the second-most common anatomic site for osteonecrosis, a condition of disrupted blood supply leading to death of bone tissue, with resultant shoulder pain and dysfunction. Core decompression is a viable joint-preserving surgical intervention that aims to improve local blood supply and restore bone health prior to bony collapse.

Indications:

Humeral head osteonecrosis has numerous underlying causes, most commonly the sequelae of prior trauma, chronic use of systemic corticosteroids, sickle cell disease, and alcohol abuse. Core decompression may be indicated in the early, pre-collapse stages of osteonecrosis, whereas more advanced stages of disease are commonly indicated for joint reconstruction procedures, such as bone grafting or arthroplasty.

Technique Description:

With the patient in the beach chair position, bone marrow aspirate concentrate (BMAC) is harvested through a percutaneous incision along the anterolateral proximal humerus. While viewing through a standard posterior portal, a transtibial anterior cruciate ligament (ACL) guide is placed through an anterior portal at a site on the humeral head surface, centered at the area of greatest humeral head bone edema as identified on preoperative magnetic resonance imaging. A guide pin is placed through a lateral portal within the ACL guide, to the subchondral bone. A 7.0-mm reamer is applied over the guidewire, followed by administration of demineralized bone matrix soaked in BMAC into the reamed channel within the proximal humerus.

Results:

In patients with early stages of humeral head osteonecrosis, core decompression confers superior clinical outcomes with reduced rates of subsequent surgical procedures compared with nonoperative treatment. Core decompression has shown to reduce the radiographic progression of osteonecrosis. Further research is necessary to determine the additional clinical benefits of augmentation with orthobiologic agents, such as BMAC.

Conclusion:

Arthroscopic-assisted core decompression is a valuable, minimally invasive surgical treatment for early-stage proximal humerus osteonecrosis. Adjunctive treatment with BMAC and demineralized bone matrix may enhance clinical outcomes.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Tetrahedrite-(Cu), Cu12Sb4S13, from Bankov near Košice, Slovak Republic: a new member of the tetrahedrite group
Authors: Sejkora Jiří , Biagioni Cristian , Števko Martin , Musetti Silvia , Peterec Dušan
Published: April 2024

Tetrahedrite-(Cu), Cu12Sb4S13, has been approved as a new mineral species (IMA2022–078) from the Bankov magnesite deposit near Košice, Slovak Republic where it occurs as anhedral grains, up to 0.4 mm across, associated with skinnerite, chalcostibite, famatinite, tetrahedrite-(Fe) and zoned aggregates of tennantite-(Cu) to tennantite-(Fe). Tetrahedrite-(Cu) is steel-grey, with a metallic lustre. Mohs hardness is ca. 3½–4 and calculated density is 5.029 g.cm–3. In reflected light, tetrahedrite-(Cu) is isotropic and grey with a bluish shade. Reflectance data for the four COM wavelengths in air are [λ (nm): R (%)]: 470: 31.1; 546: 30.1; 589: 29.9; and 650: 28.1. The empirical formula, based on electron-microprobe data (mean of 17 spot analyses), is Cu11.42Zn0.26Fe0.19(Sb4.06As0.08)Σ4.14S12.99. The ideal formula is Cu6(Cu4Cu2)Sb4S13, which requires (in wt.%) Cu 45.76, Sb 29.23 and S 25.01, total 100.00. Tetrahedrite-(Cu) is cubic, I$\bar{4}$3m, with unit-cell parameters a = 10.3296(15) Å, V = 1102.2(5) Å3 and Z = 2. Its crystal structure was refined by single-crystal X-ray diffraction data to a final R1 = 0.0347 on the basis of 261 unique reflections with Fo > 4σ(Fo) and 22 refined parameters. Tetrahedrite-(Cu) is isotypic with other tetrahedrite-group minerals. Previous findings of tetrahedrite-(Cu) are reported and some nomenclature issues, related to the Fe and Cu oxidation states, are discussed. At the Bankov deposit, tetrahedrite-(Cu) is related to hydrothermal, most probably Alpine, solutions strongly enriched in Cu, Sb and S.
Applicability of enzymatic and phenol–sulfuric acid methods for determination of cellulose nanofibers in ecotoxicity testing
Authors: Matsuzawa Tomohiko , Tai Rie , Mano Hiroyuki , Ogura Isamu
Published: April 2024

In parallel with the development of novel materials, such as cellulose nanofibers (CNFs), their effects on aquatic organisms should be evaluated. In ecotoxicity testing, concentration measurements are important to obtain accurate exposure concentrations; however, few studies have measured the concentration and dispersion state of CNFs in test solutions. Therefore, we evaluated the applicability of enzymatic and phenol–sulfuric acid methods for CNF quantification in ecotoxicity testing. In the enzymatic method, CNF content was determined by quantifying the d-glucose produced from the CNFs using cellulase with a glucose assay kit. Three types of cellulases were purchased, and impurities such as d-glucose were identified and removed. The differences in CNF degradation efficiency among the cellulases were evaluated, and a cellulase suitable for CNF degradation was selected. In the phenol–sulfuric acid method, a microplate-based method was employed to handle a large number of samples. We demonstrated that both the enzymatic and phenol–sulfuric acid methods could quantify CNFs in media for ecotoxicity testing. The enzymatic method was able to measure lower CNF concentrations (~ 1 mg/L) than the phenol–sulfuric acid method (~ 10 mg/L) and had less interference with CNF quantification by algae and non-cellulosic polysaccharides.
Integrated bioinformatics analysis of retinal ischemia/reperfusion injury in rats with potential key genes
Authors: Qing Kai-Xiong , Lo Amy C. Y. , Lu Siduo , Zhou You , Yang Dan , Yang Di
Published: April 2024

The tissue damage caused by transient ischemic injury is an essential component of the pathogenesis of retinal ischemia, which mainly hinges on the degree and duration of interruption of the blood supply and the subsequent damage caused by tissue reperfusion. Some research indicated that the retinal injury induced by ischemia-reperfusion (I/R) was related to reperfusion time.

In this study, we screened the differentially expressed circRNAs, lncRNAs, and mRNAs between the control and model group and at different reperfusion time (24h, 72h, and 7d) with the aid of whole transcriptome sequencing technology, and the trend changes in time-varying mRNA, lncRNA, circRNA were obtained by chronological analysis. Then, candidate circRNAs, lncRNAs, and mRNAs were obtained as the intersection of differentially expression genes and trend change genes. Importance scores of the genes selected the key genes whose expression changed with the increase of reperfusion time. Also, the characteristic differentially expressed genes specific to the reperfusion time were analyzed, key genes specific to reperfusion time were selected to show the change in biological process with the increase of reperfusion time.

As a result, 316 candidate mRNAs, 137 candidate lncRNAs, and 31 candidate circRNAs were obtained by the intersection of differentially expressed mRNAs, lncRNAs, and circRNAs with trend mRNAs, trend lncRNAs and trend circRNAs, 5 key genes (Cd74, RT1-Da, RT1-CE5, RT1-Bb, RT1-DOa) were selected by importance scores of the genes. The result of GSEA showed that key genes were found to play vital roles in antigen processing and presentation, regulation of the actin cytoskeleton, and the ribosome. A network included 4 key genes (Cd74, RT1-Da, RT1-Bb, RT1-DOa), 34 miRNAs and 48 lncRNAs, and 81 regulatory relationship axes, and a network included 4 key genes (Cd74, RT1-Da, RT1-Bb, RT1-DOa), 9 miRNAs and 3 circRNAs (circRNA_10572, circRNA_03219, circRNA_11359) and 12 regulatory relationship axes were constructed, the subcellular location, transcription factors, signaling network, targeted drugs and relationship to eye diseases of key genes were predicted. 1370 characteristic differentially expressed mRNAs (spec_24h mRNA), 558 characteristic differentially expressed mRNAs (spec_72h mRNA), and 92 characteristic differentially expressed mRNAs (spec_7d mRNA) were found, and their key genes and regulation networks were analyzed.

In summary, we screened the differentially expressed circRNAs, lncRNAs, and mRNAs between the control and model groups and at different reperfusion time (24h, 72h, and 7d). 5 key genes, Cd74, RT1-Da, RT1-CE5, RT1-Bb, RT1-DOa, were selected. Key genes specific to reperfusion time were selected to show the change in biological process with the increased reperfusion time. These results provided theoretical support and a reference basis for the clinical treatment.
Characterization of genital chlamydia trachomatis infection among women attending infertility and gynecology clinics in Hunan, China
Authors: Zhou Qianting , Li Jiayan , Luo Lipei , Min Shuling , Wang Li , Peng Lixiu , Hou Yinglan , He Ping , He Song , Tang Shixing , Chen Hongliang
Published: April 2024

Background

Genital infection with Chlamydia trachomatis (C. trachomatis) is a major public health issue worldwide. It can lead to cervicitis, urethritis, and infertility. This study was conducted to determine the characteristics of genital C. trachomatis infection among women attending to the infertility and gynecology clinics.

Methods

Endocervical swabs were collected from 8,221 women for C. trachomatis nucleotide screening and genotyping, while serum samples were collected for C. trachomatis pgp3 antibody determination using luciferase immunosorbent assays.

Results

High C. trachomatis DNA prevalence (3.76%) and seroprevalence (47.46%) rates were found, with genotype E (27.5%) being the most prevalent. C. trachomatis omp1 sense mutation was associated with cervical intraepithelial neoplasia (CIN) (odds ratio [OR] = 6.033, 95% confidence interval [CI] = 1.219–39.185, p = 0.045). No significant differences in C. trachomatis seroprevalence rates were observed between women with detectable C. trachomatis DNA in the infertility and routine physical examination groups (86.67% vs. 95%, p > 0.05); however, among women with negative C. trachomatis DNA, the former group had a markedly higher seroprevalence than the latter group (56.74% vs. 20.17%, p < 0.001). C. trachomatis DNA, but not pgp3 antibody, was significantly associated with CIN (OR = 4.087, 95% CI = 2.284–7.315, p < 0.001).

Conclusion

Our results revealed a high prevalence, particularly seroprevalence, of C. trachomatis among women with infertility. Furthermore, we found an association between C. trachomatis omp1 sense mutations and CIN. Therefore, C. trachomatis serves as a risk factor for CIN.
Increased risk of hypocalcemia with decreased kidney function in patients prescribed bisphosphonates based on real-world data from the MID-NET® in Japan: a new-user cohort study
Authors: Hasegawa Tomoaki , Komamine Maki , Ishiguro Chieko , Motomura Haruka , Kajiyama Kazuhiro , Nonaka Takahiro , Nakazato Yuki , Kimura Ryota , Maniwa Harumi , Iguchi Toyotaka , Horiuchi Naoya , Uyama Yoshiaki
Published: April 2024

Background

In the post-marketing stage, cases of hypocalcemia associated with bisphosphonate preparations (BPs) have been reported in patients with decreased kidney function, despite warning against use of BPs in such patients in the package insert (PI) of Japan. The purpose of this study was to investigate the safety of BPs in patients with decreased kidney function.

Methods

The cohort study was conducted in patients with osteoporosis and newly prescribed bisphosphonate utilizing real-world data from MID-NET® in Japan. The adjusted hazard ratios (aHRs) for hypocalcemia (a corrected serum Ca level < 8.00 mg/dL) relative to the normal group were calculated in each decreased kidney function group (mild, moderate or severe group).

Results

A total of 14,551 patients were included in the analysis, comprising 2,601 (17.88%) with normal (eGFR ≥ 90 mL/min/1.73m2), 7,613 (52.32%) with mild (60 ≤ eGFR < 90 mL/min/1.73m2), 3,919 (26.93%) with moderate (30 ≤ eGFR < 60 mL/min/1.73m2), and 418 (2.87%) with severe kidney function (eGFR < 30 mL/min/1.73m2). The aHRs (95% confidence interval) for hypocalcemia were 1.85 (0.75–4.57), 2.30 (0.86–6.21), and 22.74 (8.37–61.78) in the mild, moderate, and severe groups, respectively. The increased risk of hypocalcemia depending on kidney function was also observed even when calculating the aHR for each specific BP such as alendronate sodium hydrate, minodronic acid hydrate, and sodium risedronate hydrate. Furthermore, similar results were obtained in the sensitivity analysis by altering the outcome definition to a 20% or more reduction in corrected serum Ca level from the baseline, as well as when focusing on patients with more than one laboratory test result per 30 days during the follow-up period.

Conclusions

These findings suggest that the risk of hypocalcemia during BP prescription is higher in patients with decreased kidney function, particularly those with severely decreased kidney function. The quantitative real-world evidence on the safety risk of BPs obtained in this study has led to the PI revision describing a relationship between hypocalcemia risk and decreased kidney function as a regulatory action in Japan and will contribute to promoting the proper use of BPs with appropriate risk management in clinical practice.
Atypical anti-glomerular basement membrane disease with membranous hyperplasia: diagnostic challenges and treatment variability
Authors: Tong Ruoyu , Luo Zhengmao , Zhong Xianyang , Fan Liming , Lai Huangwen , Shen Meng , Huang Yuanhang
Published: April 2024

This case report presents a detailed analysis of a 31-year-old male patient who presented with a complex array of clinical symptoms, including proteinuria, hematuria, edema, and kidney insufficiency. Despite undergoing multiple tests, the results for anti-glomerular basement membrane antibodies yielded negative findings. Subsequently, kidney biopsy pathology revealed a distinct diagnosis of atypical anti-glomerular basement membrane (anti-GBM) disease with membrane hyperplasia. Treatment was initiated with a comprehensive approach involving high doses of corticosteroids therapy and cyclophosphamide (CTX). However, contrary to expectations, the patient’s kidney function exhibited rapid deterioration following this therapeutic regimen. The culmination of these complications necessitated a pivotal transition to maintenance hemodialysis. This case underscores the intricate challenges associated with diagnosing and managing rare and atypical presentations of kidney disorders. The negative anti-GBM antibody results and subsequent identification of atypical anti-GBM nephropathy highlight the need for tailored diagnostic strategies to discern subtle nuances within complex clinical scenarios. Additionally, the unexpected response to the treatment regimen emphasizes the potential variability in individual patient responses, underlining the necessity for vigilant monitoring and adaptable treatment strategies. This case report contributes to the evolving understanding of atypical kidney pathologies and the complexities involved in their management.
Multi-organ involvement caused by Scedosporium apiospermum infection after near drowning: a case report and literature review
Authors: Yao Yao , Xu Qian , Liang Wenwen , Ji Suqiong , Kosari Mohammadreza , Xu Shabei , Zhu Zhou , Mao Zhijuan
Published: April 2024

Background

Scedosporium apiospermum (S. apiospermum) is a rare fungal pathogen that causes disseminated infections. It rarely affects immunocompetent individuals and has a poor prognosis.

Case presentation

A 37-year-old woman presented with multiple lesions in the lungs, brain, and eyes, shortly after near drowning in a car accident. The primary symptoms were chest tightness, limb weakness, headache, and poor vision in the left eye. S. apiospermum infection was confirmed by metagenomic next-generation sequencing (mNGS) of intracranial abscess drainage fluid, although intracranial metastases were initially considered. After systemic treatment with voriconazole, her symptoms improved significantly; however, she lost vision in her left eye due to delayed diagnosis.

Conclusion

While S. apiospermum infection is rare, it should be considered even in immunocompetent patients. Prompt diagnosis and treatment are essential. Voriconazole may be an effective treatment option.
Reduced fetal cerebral blood flow predicts perinatal mortality in a mouse model of prenatal alcohol and cannabinoid exposure
Authors: Rouzer Siara Kate , Sreeram Anirudh , Miranda Rajesh C.
Published: April 2024

Background

Children exposed prenatally to alcohol or cannabinoids individually can exhibit growth deficits and increased risk for adverse birth outcomes. However, these drugs are often co-consumed and their combined effects on early brain development are virtually unknown. The blood vessels of the fetal brain emerge and mature during the neurogenic period to support nutritional needs of the rapidly growing brain, and teratogenic exposure during this gestational window may therefore impair fetal cerebrovascular development.

Study Design

To determine whether prenatal polysubstance exposure confers additional risk for impaired fetal-directed blood flow, we performed high resolution in vivo ultrasound imaging in C57Bl/6J pregnant mice. After pregnancy confirmation, dams were randomly assigned to one of four groups: drug-free control, alcohol-exposed, cannabinoid-exposed or alcohol-and-cannabinoid-exposed. Drug exposure occurred daily between Gestational Days 12–15, equivalent to the transition between the first and second trimesters in humans. Dams first received an intraperitoneal injection of either cannabinoid agonist CP-55,940 (750 µg/kg) or volume-equivalent vehicle. Then, dams were placed in vapor chambers for 30 min of inhalation of either ethanol or room air. Dams underwent ultrasound imaging on three days of pregnancy: Gestational Day 11 (pre-exposure), Gestational Day 13.5 (peri-exposure) and Gestational Day 16 (post-exposure).

Results

All drug exposures decreased fetal cranial blood flow 24-hours after the final exposure episode, though combined alcohol and cannabinoid co-exposure reduced internal carotid artery blood flow relative to all other exposures. Umbilical artery metrics were not affected by drug exposure, indicating a specific vulnerability of fetal cranial circulation. Cannabinoid exposure significantly reduced cerebroplacental ratios, mirroring prior findings in cannabis-exposed human fetuses. Post-exposure cerebroplacental ratios significantly predicted subsequent perinatal mortality (p = 0.019, area under the curve, 0.772; sensitivity, 81%; specificity, 85.70%) and retroactively diagnosed prior drug exposure (p = 0.005; AUC, 0.861; sensitivity, 86.40%; specificity, 66.7%).

Conclusions

Fetal cerebrovasculature is significantly impaired by exposure to alcohol or cannabinoids, and co-exposure confers additional risk for adverse birth outcomes. Considering the rising potency and global availability of cannabis products, there is an imperative for research to explore translational models of prenatal drug exposure, including polysubstance models, to inform appropriate strategies for treatment and care in pregnancies affected by drug exposure.
The sedentary behavior reduction in pregnancy intervention (SPRING) pilot and feasibility randomized trial
Authors: Gibbs Bethany Barone , Kozai Andrea C. , McAdoo Shannon N. , Davis Kelliann D. , Savidge Meghan B. , Paley Joshua L. , Hauspurg Alisse , Catov Janet M.
Published: April 2024

Pregnant individuals rarely achieve moderate-to-vigorous intensity physical activity recommendations.

Purpose The sedentary behavior reduction in pregnancy intervention (SPRING) pilot and feasibility randomized trial aimed to demonstrate feasibility, acceptability, and initial efficacy of a lower intensity intervention targeting reduced sedentary behavior and increased standing and steps.

Methods First trimester pregnant individuals at risk for high sedentary behavior and adverse pregnancy outcomes (APO) were randomized 2:1 to a multi-component sedentary behavior reduction intervention or no-contact control. Intervention components included biweekly remote health coaching, wearable activity monitor, height-adjustable workstation, and a private Facebook group. Evidence-based behavioral targets included sedentary time < 9 h/day, increasing standing by 2–3 h/day, and ≥ 7500 steps/day. Participants completed all-remote assessments (baseline, second trimester, third trimester) of sedentary behavior and activity (thigh-worn activPAL) along with exploratory pregnancy health outcomes abstracted from medical records. Intervention effects vs. control were evaluated using generalized mixed models and an intention-to-treat approach. Intervention participants also provided feedback on perceived benefits and acceptability.

Results Participants (34 intervention; 17 control) had mean age 32 years, were 83% White, with mean pre-pregnancy BMI 28 kg/m2. Retention was high (90% and 83% at second and third trimester follow-up visits). Intervention participants decreased sedentary time (-0.84 h/day, p = 0.019) and increased standing (+0.77 h/day, p = 0.003), but did not increase steps/day (+710, p = 0.257) compared to controls. Intervention participants reported many perceived benefits and identified the wearable, height-adjustable workstation, and behavioral lessons as most useful.

Conclusion For pregnant individuals at risk for high sedentary behavior and APOs, a sedentary behavior reduction intervention is feasible, acceptable, and may offer a viable alternative to more intense physical activity recommendations during pregnancy. Further testing in a fully powered clinical trial is warranted.

Trial registration NCT05093842 on clinicaltrials.gov
Integrating trans-omics, cellular experiments and clinical validation to identify ILF2 as a diagnostic serum biomarker and therapeutic target in gastric cancer
Authors: Liu Shao-Song , Wan Qin-Si , Lv Cong , Wang Jin-Ke , Jiang Song , Cai Dan , Liu Mao-Sheng , Wang Ting , Zhang Kun-He
Published: April 2024

Background

Gastric cancer (GC) lacks serum biomarkers with clinical diagnostic value. Multi-omics analysis is an important approach to discovering cancer biomarkers. This study aimed to identify and validate serum biomarkers for GC diagnosis by cross-analysis of proteomics and transcriptomics datasets.

Methods

A cross-omics analysis was performed to identify overlapping differentially expressed genes (DEGs) between our previous aptamer-based GC serum proteomics dataset and the GC tissue RNA-Seq dataset in The Cancer Genome Atlas (TCGA) database, followed by lasso regression and random forest analysis to select key overlapping DEGs as candidate biomarkers for GC. The mRNA levels and diagnostic performance of these candidate biomarkers were analyzed in the original and independent GC datasets to select valuable candidate biomarkers. The valuable candidate biomarkers were subjected to bioinformatics analysis to select those closely associated with the biological behaviors of GC as potential biomarkers. The clinical diagnostic value of the potential biomarkers was validated using serum samples, and their expression levels and functions in GC cells were validated using in vitro cell experiments.

Results

Four candidate biomarkers (ILF2, PGM2L1, CHD7, and JCHAIN) were selected. Their mRNA levels differed significantly between tumor and normal tissues and showed different diagnostic performances for GC, with areas under the receiver operating characteristic curve (AUROCs) of 0.629–0.950 in the TCGA dataset and 0.736–0.840 in the Gene Expression Omnibus (GEO) dataset. In the bioinformatics analysis, only ILF2 (interleukin enhancer-binding factor 2) gene levels were associated with immune cell infiltration, some checkpoint gene expression, chemotherapy sensitivity, and immunotherapy response. Serum levels of ILF2 were higher in GC patients than in controls, with an AUROC of 0.944 for the diagnosis of GC, and it was also detected in the supernatants of GC cells. Knockdown of ILF2 by siRNA significantly reduced the proliferation and colony formation of GC cells. Overexpression of ILF2 significantly promotes the proliferation and colony formation of gastric cancer cells.

Conclusions

Trans-omics analysis of proteomics and transcriptomics is an efficient approach for discovering serum biomarkers, and ILF2 is a potential diagnostic biomarker and therapeutic target of gastric cancer.
Changes in corneal biomechanics in patients with glaucoma: a systematic review and meta-analysis
Authors: Li Xinru
Published: April 2024

Introduction

Corneal biomechanics has been implicated in a variety of ocular diseases. The purpose of this study was to evaluate the relationship between the glaucoma and corneal biomechanical properties, and exploring the value of corneal biomechanics in the diagnosis and follow-up of glaucoma diseases.

Methods

We searched studies in PubMed, EMBASE, Web of Science and clinicaltrials.gov., as of October 8, 2022. Only English studies were included, without publication time limit. We also searched the reference lists of published reviews. This meta-analysis was conducted with random-effects models, we used mean difference(MD) to evaluate the outcome, and the heterogeneity was assessed with the I2 statistic. Subgroup analyses were performed under the appearance of high heterogeneity. We used 11 items to describe the characteristics of included studies, publication bias was performed through the Egger’s test. The quality assessment were evaluated by Newcastle–Ottawa Scale(NOS) items.

Results

A total of 27 eligible studies were identified for data synthesis and assessment. The result of meta-analysis showed that in the comparison of included indicators, the corneal biomechanics values of glaucoma patients were statistically lower than those of normal subjects in a similar age range. The covered indicators included central corneal thickness(CCT) (MD = -8.34, 95% CI: [-11.74, -4.94]; P < 0.001), corneal hysteresis(CH)(MD = -1.54, 95% CI: [-1.88, -1.20]; P < 0.001), corneal resistance factor(CRF)( MD = -0.82, 95% CI: [-1.21, -0.44]; P < 0.001), and intraocular pressure(IOP)( corneal-compensated intraocular pressure (IOPcc): MD = 2.45, 95% CI: [1.51, 3.38]; P < 0.001); Goldmann-correlated intraocular pressure (IOPg): MD = 1.30, 95% CI: [0.41, 2.20]; P = 0.004), they all showed statistical difference. While the value of axial length(AL) did not show statistically different(MD = 0.13, 95% CI: [-0.24, 0.50]; P = 0.48).

Conclusion

Corneal biomechanics are associated with glaucoma. The findings can be useful for the design of glaucoma screening, treatment and prognosis.
A pathway study of factors influencing quality of fertility life
Authors: Maierhaba Abulizi , Jiang Ming , Zhi Lihuan , Wei Xueyu , He Lijuan , Wang Li
Published: April 2024

Backgroud

To investigate the factors influencing fertility quality of life in infertile men, constructing a structural equation model of the factors influencing fertility quality of life in infertile men, and to provide suggested measures for improving fertility quality of life in infertile men.

Methods

It is a Observational study. Infertile men (n = 250) attending a fertility centre in a hospital in Xinjiang, matched 1:2 men with no obvious male factor in the control group (n = 500).The Quality of Fertility Life Scale, the Social Support Scale, the Fertility Stress Scale and the Positive Attention Awareness Scale were used to conduct the survey. The model was constructed by applying the maximum likelihood estimation method in Mplus 8.3 software, to explore the factors influencing the quality of reproductive life of infertile men through path analyses. Differences between the case and control groups were statistically significant (P < 0.05) in terms of total fertility quality of life scores, core entry dimensions, affective responses, physical and mental relationships, selective treatment dimensions, and treatment tolerance.

Results

Past medical history, history of exposure to hazardous environments, health insurance reimbursement, social support, fertility stress, and mindfulness are important factors affecting the quality of fertility life of infertile men.

Conclusion

The quality of fertility life of infertile men is not optimistic. By improving the level of mindfulness, fertility stress, and social support, we propose appropriate measures to improve the quality of fertility life of infertile men. These measures can improve their confidence in clinical diagnosis and infertility treatment, enabling them to cope positively with these challenges.
Financial-related discrimination and socioeconomic inequalities in psychological well-being related measures: a longitudinal study
Authors: Bridson Lucy , Robinson Eric , Putra I Gusti Ngurah Edi
Published: April 2024

Background

This study examined the prospective association between financial-related discrimination and psychological well-being related measures and assessed the role of financial-related discrimination in explaining socioeconomic inequalities in psychological well-being related measures.

Methods

Data of UK older adults (≥ 50 years) from the English Longitudinal Study of Ageing were used (baseline: Wave 5, 2010/2011; n = 8,988). The baseline total non-pension wealth (in tertiles: poorest, middle, richest) was used as a socioeconomic status (SES) measure. Financial-related discrimination at baseline was defined as participants who reported they had been discriminated against due to their financial status. Five psychological well-being related measures (depressive symptoms, enjoyment of life, eudemonic well-being, life satisfaction and loneliness) were examined prospectively across different follow-up periods (Waves 6, 2012/2013, 2-year follow-up; and 7, 2014/2015, 4-year follow-up). Regression models assessed associations between wealth, financial-related discrimination, and follow-up psychological measures, controlling for sociodemographic covariates and baseline psychological measures (for longitudinal associations). Mediation analysis informed how much (%) the association between wealth and psychological well-being related measures was explained by financial-related discrimination.

Results

Participants from the poorest, but not middle, (vs. richest) wealth groups were more likely to experience financial-related discrimination (OR = 1.97; 95%CI = 1.49, 2.59). The poorest (vs. richest) wealth was also longitudinally associated with increased depressive symptoms and decreased enjoyment of life, eudemonic well-being and life satisfaction in both 2-year and 4-year follow-ups, and increased loneliness at 4-year follow-up. Experiencing financial-related discrimination was longitudinally associated with greater depressive symptoms and loneliness, and lower enjoyment of life across follow-up periods. Findings from mediation analysis indicated that financial-related discrimination explained 3–8% of the longitudinal associations between wealth (poorest vs. richest) and psychological well-being related measures.

Conclusions

Financial-related discrimination is associated with worse psychological well-being and explains a small proportion of socioeconomic inequalities in psychological well-being.
Significant insights from a National survey in China: PrEP awareness, willingness, uptake, and adherence among YMSM students
Authors: Liu Yuanyuan , Xian Yidan , Liu Xuan , Cheng Zhaoyu , Wei Siyue , Wang Jianping , Chen Jiageng , Li Changping , Ma Jun , Yang Jie , Liu Fengli , Yu Maohe , Chen Zhongdan , Cui Zhuang
Published: April 2024

Introduction

Few studies focused on the Pre-Exposure Prophylaxis (PrEP) -related aspects, and the applicability of prior evidence to young men who have sex with men (YMSM) students was unknown. This study aimed to assess the awareness, willingness, uptake, and adherence (AWUA) to PrEP among YMSM students in China and to explore the associated factors with these stages.

Methods

A cross-sectional survey with a sizable sample of 1151 was conducted among YMSM students aged 16 and above, who self-identified as men who have sex with men(MSM) and resided in mainland China between October 20 and December 20, 2021. The chi-square test and Fisher’s exact test were used for univariate analysis, followed by multivariable logistic regression analysis of influencing factors at all levels.

Results

According to the cascade analysis approach, 88.71% of the participants were aware of PrEP, among which 66.7% expressed willingness to use it. Among those who were willing to use PrEP, only 13.80% took it, and of those who took it, 44.68% adhered to it. The students taking PrEP were those with higher education (OR = 4.239, 95% CI: 1.334–13.467), residence in pilot cities (OR = 2.791, 95% CI: 1.498–5.198), residence in high-risk areas (OR = 5.082, 95% CI: 2.224–11.612), engagement in multi-person sexual behavior (OR = 2.186, 95% CI: 1.236–3.867), and substance use (OR = 1.908, 95% CI: 1.167–3.118). Furtherly, students with higher adherence to PrEP were likely to have receptive sexual behaviors (OR = 8.702, 95% CI: 2.070-36.592), absence of substance use (OR = 4.468, 95% CI: 1.371–14.561), and uptake of PrEP through daily oral route. (OR = 7.065, 95% CI: 1.699–29.371).

Conclusion

YMSM students exhibit distinct patterns of “high awareness, low willingness, low uptake, and low adherence” to PrEP. Strategies for reduction in the acquisition of HIV prioritizing the current features of utilizing PrEP were urgently warranted.
Promoting children’s health through community-led street interventions: analyzing sustained voluntarism in Canadian School Streets
Authors: Thompson Carise M. , Collins Patricia A. , Frohlich Katherine L.
Published: April 2024

Background

Active School Travel (AST) initiatives align with the Ottawa Charter for Health Promotion, which calls for ‘creating supportive environments’ and ‘strengthening community action.’ However, their reliance on volunteers poses sustainability challenges. The main objectives of this study were to document the motivations, satisfaction, and experiences of volunteers involved in sustaining two AST initiatives in Ontario for an entire school year.

Methods

Two volunteer-led School Street initiatives in Kingston, Ontario successfully operated during pick-up and drop-off times of each school day. The first initiative operated for the entire 2021-2022 school year, and the second operated for the entire 2022-2023 school year. These initiatives were the first of their kind in the province of Ontario, Canada. Volunteers from both sites (n = 56) participated in online surveys and their motivations, satisfaction, and experiences of their role were compared using the 2-sided Fisher’s Exact Test.

Results

Over 80% of volunteers were highly motivated to promote safety and over 70% of volunteers were highly motivated to disrupt the status quo of unsupportive, car-centric urban environments by reimagining how streets can be used. By taking collective action to re-shape the environment around these public schools to support healthy, active living, our findings reveal that over 90% of volunteers were highly satisfied. Of the volunteers, 87% felt they contributed to child safety and 85% felt they had developed stronger community connections. They appreciated the short (i.e., 40 minute) time commitment of each shift, weekly email communications by the community organization leading the initiative, and the volunteer schedule. They also appreciated the positive social interactions during volunteer shifts, which they felt outweighed the minimal resistance they experienced.

Conclusions

This research demonstrates the importance of logistical, motivational, and social factors in recruiting and retaining volunteers for community-led School Streets. Our findings support appealing to prospective volunteers’ influence in achieving School Street objectives (e.g., improved safety) in recruitment efforts, as well as highlighting School Streets’ innovative approach. Communicating with volunteers throughout School Street planning and implementation processes and limiting traffic in the closed street zone (i.e., by excluding the school staff parking lot and private driveways from the scope) are additional recommendations based on the findings of this study.
The Fractional exhaled Nitric Oxide (FeNO)- test as add-on test in the diagnostic work-up of asthma: a study protocol
Authors: Kaya T. , Braunstahl G.J. , Veen J.C.C.M. in ’t , Kappen J.H. , Valk J.P.M. van der
Published: April 2024

Background

Asthma is a common disease characterized by chronic inflammation of the lower airways, bronchial hyperactivity, and (reversible) airway obstruction. The Global Initiative of Asthma Guideline recommends a flowchart to diagnose asthma with first-step spirometry with reversibility and a bronchial challenge test (BPT) with histamine or methacholine as a second step [1]. The BPT is considered burdensome, time-consuming for patients and staff, can cause side effects, and is expensive. In addition, this test strongly encumbers lung function capacity. Elevated Nitric Oxide (NO) is associated with airway eosinophilic inflammation in asthma patients and can be measured in exhaled air with the Fractional exhaled (Fe) NO-test. This low-burden FeNO-test could be used as an ‘add-on’ test in asthma diagnostics [2, 3].

Methods and analysis

This multi-center prospective study (Trial number: NCT06230458) compares the ‘standard asthma diagnostic work-up’ (spirometry with reversibility and BPT) to the ‘new asthma diagnostics work-up’ (FeNO-test as an intermediate step between the spirometry with reversibility and the BPT), intending to determine the impact of the FeNO-based strategy, in terms of the number of avoided BPTs, cost-effectiveness and reduced burden to the patient and health care. The cost reduction of incorporating the FeNO-test in the new diagnostic algorithm will be established by the number of theoretically avoided BPT. The decrease in burden will be studied by calculating differences in the Visual Analogue Scale (VAS) -score and Asthma Quality of Life Questionnaire (AQLQ) -score after the BPT and FeNO-test with an independent T-test. The accuracy of the FeNO-test will be calculated by comparing the FeNO-test outcomes to the (gold standard) BPTs outcomes in terms of sensitivity and specificity. The intention is to include 171 patients.

Ethics and dissemination

The local medical ethics committee approved the proposed study and is considered a low-burden and risk-low study. The local medical ethics committee registration number: R23.005.

Strengths and limitations of this study

Strengths: This is the first study that investigates the value of the FeNO-test (cut off ≥ 50 ppb) as an add-on test, to determine the impact of the FeNO-based strategy, in terms of the number of avoided BPTs, cost-effectiveness, and reduced burden on the patient and health care. Limitations: High FeNO levels may also be observed in other diseases such as eosinophilic chronic bronchitis and allergic rhinitis. The FeNO-test can be used to rule in a diagnosis of asthma with confidence, however, due to the poor sensitivity it is not suitable to rule out asthma.