bluuebunny/crossref_metadata_2025 huggingface dataset:
The Outcome of a Caregiver Potential Support Program on Anemia Prevention Among Children Six Months to Two Years in Thasala District, Nakhon Si Thammarat Province, Thailand
Authors: Saipaen Suphaphorn , Kusol Kiatkamjorn , Eksirinimit Thidarat
Published: March 2023

Children under two years old are at risk for anemia because young children have an increased need for iron for their physical growth and brain development. The purpose of this study was designed to evaluate the effects of a caregiver potential support program on anemia prevention in children six months to two years old attending the subdistrict health-promoting hospital in Thasala District, Nakhon Si Thammarat Province. This study was quasi-experimental. The sample included children aged six months to two years old and their caregivers, who were selected by random sampling and allocated to either the experimental or control group, with 40 pairs per group. The experimental group received a potential support program, while the control group received regular care. Both groups were followed for 12 weeks. The instruments used were the potential caregiver assessment, children’s anemia assessment, and a program to support the potential of primary caregivers. Descriptive statistics, chi-square, and t-tests were used to analyze the data. The results revealed that 11.4% of the children had anemia, and a hematocrit count of less than 33% (range = 30-40, M = 34.89, SD = 1.97). The mean scores of knowledge about anemia and iron supplementation after using the program in the experimental group and control group were significantly different (p < 0.001). The mean scores of knowledge about anemia in the experimental and control group were 15.75, SD = 0.54, and 13.28, SD = 1.43 respectively. The mean scores of knowledge about iron supplementation in the experimental and control group were 10.75, SD = 0.49, and 8.15, SD = 1.54 respectively. It was found that the experimental group had a higher mean score on food care behaviors than the control group for 6-11 months and 1-2 years, with statistical significance. The experimental group also had a higher mean score of care behaviors concerning children’s consumption of medicine than the control group (M = 58.20, SD = 4.05; M = 45.78, SD = 9.66, respectively), (p < 0.001). The mean score of the hematocrit level for the experimental group was found to be higher than the control group after receiving the program (M = 35.80, SD = 1.55; M = 34.83, SD = 2.14, respectively), (p < 0.05). Therefore, healthcare providers should support caregivers' capacity to provide continued care for children to prevent anemia.
Incidence and Severity of Acute Myocardial Injury after Thoracic Surgery: Effects of Nicorandil
Authors: Protasov K. V. , Barahtenko O. A. , Batunova E. V. , Rasputina E. A.
Published: March 2023

Aim. To study the perioperative dynamics of myocardial injury biomarkers high-sensitivity cardiac troponin I (hs-cTnI), ischemia-modified albumin (IMA) and soluble ST2 (sST2) when taking nicorandil in lung cancer patients with concomitant coronary heart disease (CHD) undergoing surgical lung resection.

Material and methods. The study included 54 patients (11 women and 43 men) with non-small cell lung cancer and concomitant stable CHD who underwent lung resection in the volume of lobectomy or pneumonectomy. Patients were randomly assigned to the nicorandil group (oral administration 10 mg BID for 7 days before and 3 days after surgery; n=27) and the control group (n=27). In the study groups, the perioperative dynamics of hscTnI, IMA and sST2, determined in the blood before and 24 and 48h after surgery, were compared. We calculated the incidence of acute myocardial injury in the groups, which was diagnosed in cases of postoperative hs-cTnI increase of more than one 99th percentile of the upper reference limit. The associations of nicorandil intake and acute myocardial injury were evaluated.

Results. The groups were comparable in gender, age, basic clinical characteristics, as well as baseline levels of myocardial injury biomarkers. After the intervention, both samples showed an increase in the hs-cTnI and sST2 levels and a decrease in IMA concentration (all p<0.02 for related group differences). In the nicorandil group, in comparison with the control one, 48h after surgery, we found lower mean levels of hs-cTnI [16.7 (11.9;39.7) vs 44.3 (15.0;130.7) ng/l; p<0.05) and sST2 [62.8 (43.6;70.1) vs 76.5 (50.2;87.1) ng/ml; p<0.05), concentration increase rates of hs-cTnI [14.8 (0.7;42.2) vs 32.5 (14.0;125.0) ng/l; p<0.01) and sST2 [24.4 (10.3;42.4) vs 47.4 (17.5;65.3) ng/ml; p<0.05), as well as highest concentrations for the entire postoperative period of hs-cTnI [30.7 (12.0;53.7) vs 79.0 (20.3;203.3) ng/L, p<0.01] and sST2 [99.8 (73.6;162.5) vs 147.8 (87.8;207.7) ng/mL; p<0.05]. The serum IMA decreased when taking nicorandil to a greater extent [-8.0 (-12.6; -2.0) vs -2.7 (-6.0; +5.5) ng/ ml; p<0.01] 24h after surgery. Acute myocardial injury was diagnosed in 7 people in the nicorandil group (25.9%) and in 15 in the control one (55.6%; pχ2=0.027). The adjusted odds ratio of acute myocardial injury when taking nicorandil was 0.35 (95% confidence interval 0.15-0.83, p=0.017).

Conclusion. Taking  nicorandil  in patients with lung cancer and concomitant CHD  who underwent  surgical  lung resection is associated  with a lower postoperative  increase in hs-cTnI  and sST2  and a reduced risk of acute myocardial  injury, which may indicate the cardioprotective effect of nicorandil under acute surgical stress conditions.
Loopholes for Underage Access in E-Cigarette Delivery Sales Laws, United States, 2022
Authors: Azagba Sunday , Ebling Todd , Adekeye Olayemi Timothy , Hall Mark , Jensen Jessica King
Published: March 2023

Objectives. To comprehensively catalog and review state e-cigarette delivery sales laws as well as capture their scope and dimensions.

Methods. We conducted an in-depth review to determine whether states had at least 1 form of e-cigarette delivery sales law. We coded laws for 5 key policy domains: (1) delivery terminology used in laws, (2) age verification requirements, (3) packaging label requirements, (4) permit or registration requirements, and (5) fines and penalties for violations.

Results. Overall, 34 states had e-cigarette delivery sales laws with varying scopes and dimensions. In 27 states, these laws required at least 1 form of age verification requirements. We identified mandatory packaging labels in 12 states, and 7 states where permits were required. There were considerable differences among states on the scale of fines and penalties for violations.

Conclusions. Our findings reveal extensive heterogeneity in e-cigarette delivery sales laws among states, particularly regarding the scope and dimensions of these laws.

Public Health Implications. The mapping of e-cigarette delivery sales policies showed several potential loopholes that may diminish their effectiveness. (Am J Public Health. 2023;113(5):568–576. https://doi.org/10.2105/AJPH.2023.307228 )
Building working relationships with peers: an induction activity for students
Authors:   University of Greenwich, Yan Lili , Reilly Dawn ,   University of Greenwich
Published: March 2023

The initial period of transition to university (‘induction’) is important as this is when students first meet university staff and are introduced to university systems. Students also meet each other for the first time and start to form friendship groups which will provide a source of peer support throughout their programmes. This case study sets out an activity which we use with the new students on our extended accounting- and finance- related programmes to introduce students to library resources and enable them to start to build working relationships with their peers. The activity begins with information about the library from an Academic Services Librarian, delivered using an interactive quiz format. Students then work in small groups using the library PCs straight away which enables students to start to build friendships and work independently. The final part of the activity includes group presentations to the whole class.
ombining words and drawings, the better to understand students’ lived experiences
Authors:   Anglia Ruskin University, Gibson Poppy
Published: March 2023

This case study presents and interprets two data sets – interviews and line drawings – about barriers to learning in the HE context, as seen from the student perspective. Eleven undergraduate students participated in this exploratory study, which took place at a United Kingdom higher education (HE) institution. The findings help reveal to the reader the lived experiences of students and present opportunities to consider intervention practices that can be used to support student transition from further education (FE) into HE. This case study also discusses how to collect and use this mixed data set and highlights how employing this method promotes student voice. Researchers may find that the approach may be applicable to their own project design.
Teaching introductory economics: an interdisciplinary approach
Authors:   North South University, Iqbal Nabeel
Published: March 2023

Using three examples, this opinion piece argues that introductory economics can provide an effective context in which to introduce university students to interdisciplinary learning and thinking. The first example illustrates how input-process-output diagrams can be used to stimulate interdisciplinary thinking in classrooms when teaching the concept of production. The second and third examples illustrate how elasticity and the concept of circular economies, respectively, can be introduced using an interdisciplinary approach. These examples are suitable for introductory economics classrooms in which students gain a foundation of basic scientific and mathematical concepts.
INTIMATE PARTNER VIOLENCE AMONG ADOLESCENT LATINA MOTHERS AND THEIR REPRODUCTIVE OUTCOMES: A SYSTEMATIC REVIEW
Authors: Khan Sara , Dongarwar Deepa , Salihu Hamisu
Published: March 2023

Objective: Approximately 1 in 3 women worldwide has experienced intimate partner violence (IPV), with the region of the North, Central, and South Americas reporting a prevalence of 29.8%. The health impact of IPV on women’s reproductive outcomes has been well-documented, but the intersection of IPV and reproductive outcomes in the adolescent population in Latin America has not been explored. The purpose of this systematic review is to synthesize the existing literature on reproductive outcomes associated with IPV in adolescent mothers in Latin America. Methods: A systematic review of the literature using the PubMed database was conducted using a search term including key phrases pertaining to our topics of interest: Latin America, adolescent mothers, IPV, and reproductive outcomes. Articles published between 2010-2020 exploring at least two of the four major topics were included in our review. Articles were divided according to relevance to four categories: (1) Pregnancy and motherhood in Latina teens, (2) IPV in Latin America, (3) Reproductive outcomes associated with IPV, and (4) IPV among teen Latina mothers and their reproductive outcomes. PRISMA reporting guidelines were utilized, and flowcharts were created to demonstrate the study findings. Results: Of 288 initial articles, 0 articles explored the intersection of IPV and reproductive outcomes, specifically in teenage Latinas. However, 9, 16, and 22 were found to match the first three categories listed in the methods section. IPV was associated with adverse reproductive outcomes, both directly and indirectly, such as unintended pregnancy and preterm birth. Our results also showed that adolescent Latina women were at a significantly higher risk of both pregnancy and IPV than most women in other age groups globally. Conclusion and Implications for Translation: IPV represents a significant threat to the health of Latina women as well as their reproductive functions. Although Latinas represent an important proportion of the global adolescent population, current literature is scarce, and more research on the impact of IPV on adolescent Latinas is warranted.
Prevalence and Associated Risk Factors of Postpartum Depression among Mothers in Pennsylvania, United States: An Analysis of the Pregnancy Risk Assessment Monitoring System (PRAMS) Data, 2012-2015
Authors: Luong Nhiem , Thuma Sara , Santore Angelo , Ma Zhen-qiang , Watkins Sharon , McCarty Erin
Published: March 2023

Background: Postpartum depression (PPD) is the most common morbidity among new mothers. With an estimated 140,000 resident births annually in the state of Pennsylvania, United States, no publication is available about the prevalence and risk factors associated with PPD specifically for Pennsylvania. This study aims to estimate the self-reported prevalence and risk factors associated with PPD. Methods: Weighted Pregnancy Risk Assessment Monitoring System (PRAMS) surveillance data of 4,022 Pennsylvania mothers with live birth(s) during 2012-2015 were analyzed. Descriptive statistics were used for mothers’ characteristics. Between-group differences were evaluated using the Chi-square test. Risk factors associated with PPD were analyzed by logistic regression models. All analyses were performed using Stata version 13 (STATA Corp., College Station, TX), taking into account the complex survey design, and P-values <0.05 (2-tailed) were considered statistically significant. Results: Of the 4,022 mothers, the overall prevalence of PPD was 12.1% (515 mothers); the prevalence was 12.4% (108) in 2012, spiked to 14.8% (156) in 2013, then significantly declined to 10.9% (127) in 2014 and 10.1% (124) in 2015 (p=0.03). In a multivariable logistic model, significant risk factors included depression before pregnancy (adjusted odds ratio [aOR]: 3.7, 95% CI: 2.3-6.0), abuse before or during pregnancy (aOR: 3.5, 95% CI: 1.6-7.3), the mother’s job loss (aOR: 2.1, 95% CI: 1.3-3.4), extended time away from husband/partner due to military deployment or work-related travel (aOR: 2.3, 95% CI: 1.1-4.5), a husband/partner not wanting the pregnancy (aOR: 1.7, 95% CI: 1.1-2.9), and arguing more than usual with a husband/partner (aOR: 1.6, 95% CI: 1.4-2.4). Conclusion and Implication for Translation: PPD is relatively common in Pennsylvania; however, the prevalence declined significantly during the study period. Depression before pregnancy, abuse before or during pregnancy, job loss, extended time away from husband/partner due to military deployment or workrelated travel, husband/partner not wanting the pregnancy, or arguing more than usual with a husband/partner increased the odds of experiencing PPD. Further studies should be conducted on approaches to prevent PPD among new mothers.
Uptake, Translocation and Metabolization of Tramadol, Amitriptyline, Orphenadrine and Lidocaine by Garden Cress, Pea and Water Hyacinth
Authors: Detzlhofer Anna , Gerchhamer Christian , Madikizela Lawrence , Himmelsbach Markus , Mlynek Franz , Buchberger Wolfgang , Klampfl Christian W.
Published: March 2023

In the present work water hyacinth plants (Eichhornia crassipes) collected from two South African rivers were analyzed with respect to the presence of pharmaceuticals and their major metabolites. Thereby a number of drugs including amitriptyline, orphenadrine, lidocaine, and tramadol could be detected. Particularly for the latter substance relatively high concentrations (more than 5000 ng g− 1 dry plant material) were detected in the water plants. Subsequently the uptake, translocation and metabolization of these four substances was investigated in a laboratory study employing plant garden cress (Lepidium sativum) and pea (Pisum sativum). These model plants were grown hydroponically using a growing medium containing the selected pharmaceuticals at concentrations ranging from 10 µg L− 1 -10 mg L− 1. Time-resolved uptake studies revealed that all four pharmaceuticals were taken up by the roots and further relocated to plant stem and leaves. Investigations on the metabolization of the parent drugs within the plant led to the detection of a series of (mainly) phase I metabolites.
The Nuclear Equation of State from Experiments and Astrophysical Observations
Authors: Tsang Chun Yuen , Tsang ManYee Betty , Lynch William , Kumar Rohit , Horowitz Charles
Published: March 2023

With recent advances in astronomical observations, major progress has been made in determining the pressure of neutron star matter at high density. This pressure is constrained by the neutron star deformability, determined from gravitational waves emitted in a neutron-star merger, and the mass-radii relation of two neutron stars, determined from a new X-ray observatory on the International Space Station. Previous studies have relied on nuclear theory calculations to constrain the equation of state at low density. Here we use a combination of constraints composed of three astronomical observations and twelve nuclear experimental constraints that extend over a wide range of densities. A Bayesian inference framework is then used to obtain a comprehensive nuclear equation of state. This data-centric result provides benchmarks for theoretical calculations and modeling of nuclear matter and neutron stars. Furthermore, it provides insights into the microscopic degrees of freedom of the nuclear matter equation of state and on the composition of neutron stars and their cooling via neutrino radiation.
Research on the Impact of Air Pollution on the Cost of Living of Residents
Authors: Wu Xuepin , Ma Yongjun
Published: March 2023

To explore the impact of air pollution on residents' cost of living, this study selected balanced panel data from 161 prefecture-level cities for 2010–2020 and conducted a related study using fixed effects, 2SLS, and threshold models. The study found that, firstly, air pollution significantly raises the cost of living and has a short-term cumulative effect on the cost of living, i.e., the impression of past air pollution continues to affect residents' current cost of living. Secondly, air pollution itself and the level of the digital economy will make a threshold effect of air pollution on residents' cost of living, i.e., the higher the level of air pollution, the higher the cost of living of residents. However, as cities develop a higher level of the digital economy, the effect of air pollution on residents' cost of living will diminish. This reflects that cities with high levels of air pollution cause an increase in the cost of living for residents. However, the digital economy improves urban air quality by promoting industrial upgrading, technological innovation, and optimal resource allocation, thereby reducing the additional costs incurred by residents in dealing with air pollution. This study also reveals the intrinsic link between air pollution and the cost of living for residents, which has implications for cities coping with air pollution.
Both tectonic activity and CO2 variability affect temperature gradients in the Cretaceous
Authors: Gianchandani Kaushal , Maor Sagi , Adam Ori , Farnsworth Alexander , Gildor Hezi , Lunt Daniel , Paldor Nathan
Published: March 2023

The Cretaceous ‘greenhouse’ period (~145 to ~65 million years ago, Ma) in Earth’s history is relatively well documented by multiple paleo proxy records, which indicate that the meridional sea surface temperature (SST) gradient increased (non-monotonically) from the Valanginian (~135 Ma) to the Maastrichtian (~68 Ma). Changes in atmospheric CO2 concentration, solar constant, and paleogeography are the primary drivers of variations in the spatiotemporal distribution of SST, which plays a key role in the evolution of the rich biodiversity that persisted during the Cretaceous. However, the particular contribution of each of these drivers (and their underlying mechanisms) to changes in the SST distribution remains poorly understood. Here we use data from a suite of paleoclimate simulations to show that atmospheric CO2 fluctuations and paleogeographic changes have a comparable effect on mid-latitudinal SST gradient through the Cretaceous. Further, we use a fundamental model of wind-driven ocean gyres to quantify how changes in the northern hemisphere paleogeography drive a reduction in the meridional oceanic heat transport, leading to an increase in extratropical SSTs. This reduction in heat transport results from a weakening of the subtropical ocean gyres, caused by a decrease in the ratio of meridional to zonal extent of the ‘gyral basin’.
Timely expression of PGAM5 and its cleavage control mitochondrial homeostasis during neurite re-growth after traumatic brain injury
Authors: Liang Min-Zong , Lu Ting-Hsuan , Chen Linyi
Published: March 2023

Background:
Patients suffered from severe traumatic brain injury (TBI) have twice the risk of developing into neurodegenerative diseases later in their life. Thus, early intervention is needed not only to treat TBI but also to reduce neurodegenerative diseases in the future. Physiological functions of neurons highly depend on mitochondria. Thus, when mitochondrial integrity is compromised by injury, neurons would initiate a cascade of events to maintain homeostasis of mitochondria. However, what protein senses mitochondrial dysfunction and how mitochondrial homeostasis is maintained during regeneration remains unclear.
Results:
We found that TBI-increased transcription of a mitochondrial protein, phosphoglycerate mutase 5 (PGAM5), during acute phase was via topological remodeling of a novel enhancer-promoter interaction. This up-regulated PGAM5 correlated with mitophagy, whereas presenilins-associated rhomboid-like protein (PARL)-dependent PGAM5 cleavage at a later stage of TBI enhanced mitochondrial transcription factor A (TFAM) expression and mitochondrial mass. To test whether PGAM5 cleavage and TFAM expression were sufficient for functional recovery, mitochondrial oxidative phosphorylation uncoupler carbonyl cyanide 4-(trifluoromethoxy) phenylhydrazone (FCCP) was used to uncouple electron transport chain and reduce mitochondrial function. As a result, FCCP triggered PGAM5 cleavage, TFAM expression and recovery of motor function deficits of CCI mice.
Conclusions:
Findings from this study implicate that PGAM5 may serve as a mitochondrial sensor for brain injury to activate its own transcription at acute phase, serving to remove damaged mitochondria through mitophagy. Subsequently, PGAM5 is cleaved by PARL, TFAM expression is increased for mitochondrial biogenesis at a later stage after TBI. Taken together, this study concludes that timely regulation of PGAM5 expression and its own cleavage are required for neurite re-growth and functional recovery.
Evaluation of the transmissibility of norovirus and the effectiveness of prevention and control measures for school in Jiangsu Province
Authors: Wang Jing , Rui Jia , Zhu Yuanzhao , Guo Xiaohao , Abudunaibi Buasiyamu , Zhao Benhua , Su Yanhua , Chen Tianmu
Published: March 2023

Objective：This study aims to estimate the transmissibility of norovirus outbreaks in schools by different transmission routes, evaluate the prevention and control effects of quarantine, school-closure and disinfection measures under different intervention intensities, and finally propose scientific and effective prevention and control suggestions.
Method: We selected 23 outbreaks of norovirus infectious diarrhea in Jiangsu Province’s school from 2012-2018, a SEIAQRW model was established, the effective reproduction number (Reff) was used to assess the transmissibility of the outbreaks, the total attack rate (TAR) and peak incidence (PI) were calculated to evaluate the prevention and control effects of different intervention measures.
Results: The reproduction number of norovirus outbreaks in human-to-human route was 8.92 and in water or food-to-human route was 2.19, without intervention. When quarantine was implemented, the effect of reducing the total attack rate was average and the effect of reducing the peak incidence was better; When it took measures of school-closure or disinfection, the scale of the norovirus outbreaks decreased gradually as the intensity of intervention increased, and when the school-closure intensity or disinfection intensity reaches 90% or more, the total attack rate and the peak incidence reduced significantly.
Conclusion: Norovirus outbreaks are highly transmissible from human to human in schools. When a norovirus outbreak occurs, quarantine need to be supplemented with other interventions, and the implementation of high-intensity school-closure or disinfection of the external environment could effectively reduce the spread of the virus.
Tumor attached to major intrahepatic vascular for colorectal liver metastases after preoperative chemotherapy
Authors: Liu Wei , Cui Yong , Wu Xiao-Gang , Chen Feng-Lin , Wang Kun , Sun Ying-Shi , Xing Bao-Cai
Published: March 2023

Background: Colorectal liver metastases attached major intrahepatic vessels has been considered to be risk factor for survival outcome after liver resection. The present study aimed to clarify the outcomes of R1 surgery (margin<1mm) in CRLM patients, distinguishing parenchymal margin R1 and attached to major intrahepatic vessels R1.
Methods: In the present study, 283 CRLM patients who evaluated to be attached to major intrahepatic vessels initially, underwent liver resection following preoperative chemotherapy. They were assigned to one of the following groups: R0 (n=167), R1 parenchymal (n=58) and R1 vascular (n=58). We analyzed the survival outcomes and local recurrence rates in each group.
Results: Overall, 3- and 5-year OS rates after liver resection were 53.0% and 38.2% (median OS 37 months). Five-year OS was higher in patients with R0 than R1p (44.9%% vs. 26.3%, p=0.009), whereas there was no significant difference from patients with R1v (34.3%, p=0.752). In the multivariable analysis, preoperative chemotherapy>4 cycles, CRS 3-5, RAS mutation, R1p and CA199>100IU/ml were identified as independent predictive factors of OS (p<0.05). There was no significant difference for local recurrence among three groups.
Conclusion: R1 parenchymal resection was independent risk factor for CRLM. R1 vascular surgery achieves outcomes equivalent to R0 resection. Non-anatomic liver resection for CRLM attached to intrahepatic vessels can be pursued to increase patient resectability by preoperative chemotherapy.
RETRACTED: Unveiling the Diagn: RCR and SPIO contrast-enhanced DWI MRI for Distinguishing Benign Liver from Malignant Liver Lesions
Authors: Mehar Muhammad Abdullah , John Akash , Ali Abid , Ahmad Aiman Aftab
Published: March 2023

The authors have requested that this preprint be removed from Research Square.
Long-term outcome of definitive radiotherapy for locally advanced non-small cell lung cancer: a real-world single-center study
Authors: Zhu Hong , Xu Yi , Gao Huiquan , Fan Xingwen , Fan Ming , Zhao Kuaile , Yang Huanjun , Zhu Zhengfei , Wu Kailiang
Published: March 2023

Background
Locally advanced non-small cell lung cancer (NSCLC) is a heterogeneous disease with poor long-term survival. This study examined overall survival (OS), progression-free survival (PFS), treatment effectiveness, and toxicity in patients with locally advanced NSCLC treated with definitive radiotherapy.
Methods
A retrospective analysis of demographic information, clinical characteristics, treatment patterns, and clinical outcomes of 789 patients with locally advanced NSCLC who underwent radical radiotherapy at our center between January 2005 and December 2015 was performed. The Kaplan–Meier method and log-rank test were used for survival comparisons, and Cox regression was used for multivariate analysis.
Results
There were 328 patients with stage IIIA disease and 461 with stage IIIB disease. By the last follow-up, there were 365 overall deaths and 576 cases of recurrence, metastasis, or death. The median survival time was 31 months. The OS rates at 1-, 2-, 5-, and 10 years were 83.7%, 59.5%, 28.8%, and 18.9%, respectively. PFS rates at 1, 2, 5, and 10 years were 48%, 24.5%, 11.9%, and 5.5%, respectively. Rates of ≥ grade 3 acute radiation pneumonitis or esophagitis were 7.6% and 1.9%, respectively. Rates of ≥ grade 3 chronic radiation pneumonitis and esophagitis were 11% and 0.4%, respectively. Multivariate analysis showed that the Karnofsky Performance Status (KPS) score, smoking status, and combined chemotherapy were independent prognostic factors for OS (P < 0.05). Multivariate analysis revealed that combined chemotherapy and radiation dose were independent prognostic factors for PFS (P < 0.05).
Conclusion
Patients with stage III NSCLC treated with definitive radiotherapy had a median survival time of 31 months and a two-year OS rate of 59.5%. Patients with a KPS score of 80 or higher, who had never smoked, or underwent combination treatment had a considerably longer OS.
Protective Effect of Bacteroides fragilis on TNF-α- Induced Inflammatory Changes in Human Colon Epithelial Cells and in Inflammatory Bowel Disease Mouse Model
Authors: He Qiuyue , Niu Min , Bi Jiandie , Du Na , Liu Shumin , Yang Kai , Li Huanqin , Yao Jin , Du Yan , Duan Yong
Published: March 2023

Bacteroides fragilis, one of the potential next-generation probiotics, but its protective mechanism is not yet known. We aimed to characterize the anti-inflammatory effect of B. fragilis and to elucidate its mechanism through in vivo and in vitro experiments. An in vitro model of inflammation by induction of colonic cells with TNF-a, and co-cultured with B. fragilis to detect cell viability, apoptosis and invasive capacity. Furthermore, critical proteins of the TLR/NF-κB pathway and the inflammatory cytokines were measured. For animal trials, C57BL/6J male mice were orally administered B. fragilis or PBS once daily for 21 days. Colitis was induced by drinking 2.5% DSS from days 0 to 7. The mice were weighed daily and rectal bleeding, stool condition and blood in the stool were recorded. We found that B. fragilis treatment alone was harmless and had no effect on cell viability or apoptosis. While predictably TNF-α decreased cell viability and increased apoptosis, B. fragilis attenuated this deterioration. The NF-κB pathway and inflammatory cytokines IL-6, IL-8 and IL-1β activated by TNF-α were also blocked by B. fragilis, which was likely mediated by TLR2. Animal studies showed that B. fragilis ameliorated DSS-induced colitis, as evidenced by weight loss, shortened colon length and enhanced barrier function. The colonic tissue levels of inflammatory cytokines (TNF-α, IL1β, IL6) were decreased and IL-10 was increased as a result of B. fragilisadministration. In conclusion, B. fragilisexhibited anti-inflammatory effects whether in vivo or in vitro, and it may be a potential probiotic agent for improving colitis.
Distribution Discrepancies Between Male and Female Physicians in Urban and Rural Japan: A Twenty-Year Longitudinal Study from 1994 to 2014
Authors: Kimura Kazuki , Inoue Kazuo , Ando Takahito , Ito Masanori
Published: March 2023

Background
The Japanese medical education system produces 9,000 graduates per year, but the government still struggles with a shortage of physicians in rural areas, despite the implementation of several strategies. Our study examines this problem in detail during the period 1994–2014, comparing data on gender, years of medical experience, and demographic and geographic factors.
Methods
We analyzed the Physician Census from 1994, 2004, and 2014, examining data on physicians’ gender and the number of years since licensure. To correct the impact of municipal mergers, the analysis was aligned with the number of municipalities in 2014 (1741). We examined data from each physician (gender and years of medical experience) and analyzed the demographic and geographic distribution trend using Spearman correlation coefficients. We then used the Gini coefficient to evaluate the distribution change of physicians based on gender and years of experience.
Results
The number of physicians increased 1.29-fold over the 20-year observation period (1.23-fold for male physicians and 2.17-fold for female physicians), and the percentage of female physicians increased from 13.4–20.4%. The top one-third of the most populous municipalities were served by 79.4% of the physicians, and 87.7% of all physicians work in the top 1/3 municipalities in terms of population in 2014. The number of female physicians was higher at 91.8% compared to 86.8% for male physicians. The Spearman correlation coefficient examining the relationship between “ratio of physicians to total population” and “distance from prefectural capital” was 0.194–0.222–0.270. The Gini coefficient for all physicians was 0.315–0.298–0.298 (male physicians: 0.311–0.289–0.283, female physicians: 0.394–0.385–0.395). The Gini coefficients were lower for veteran physicians of both sexes than for younger physicians. The Gini coefficients for female compared to male physicians were higher in all age groups, showing that females had a denser population in urban areas.
Conclusion
The distribution of female physicians was lower in rural areas compared to their male counterparts. An improvement in policies to improve work–life balance for female physicians might encourage them to move to rural areas and alleviate the chronic shortage of medical care in these locations.
Qualitative study of factors for the use of serving chopsticks and separate dining in Sichuan and Chongqing, China
Authors: Wen Yaqi , Jiang Ke , Zhao Wen , Dai Ronghua , Zeng Huang , Yuan Jun , ZHAO YONG
Published: March 2023

Objectives To conduct a qualitative phenomenological study exploring factors for using serving chopsticks and separate dining.
Methods Qualitative phenomenological research was conducted via face-to-face, semi-structured interviews. All interview transcripts were analyzed using the seven steps of Colaizzi phenomenological data analysis and were input into the Nvivo12 (qualitative research analysis software) through sentence-by-sentence, word-by-word coding and formed themes.
Results Two main themes and fifteen sub-themes were found. The barriers in implementing serving chopsticks and separate dining include consumers bearing the cost of serving chopsticks and separate dining in the end; long-established dietary habits and culture background of willingness to share food with others by using own chopsticks or eating in one pot; the difficulty for low-end catering to implement the serving chopsticks and separate dining; separate dining bringing challenges to grasping the quantity of meals given each person’s varying preferences; weak public awareness of serving chopsticks and separate dining; their perception that troublesome and embarrassing, separate dining destroys the overall aesthetic of the food; and no sophisticated design of serving chopsticks and separate dining. Suggestions to implement serving chopsticks and separate dining include pioneering the implementation and training of communal chopsticks sharing in the restaurant industry, the collective units implementing the serving chopsticks system, producing highly recognizable serving chopsticks, creating a living atmosphere of serving chopsticks, promoting the comprehensive government system to form a new "food" fashion, conducting serving chopsticks experience activities, guarantee through government mandatory policies starting with teenagers, prioritizing the implementation of serving chopsticks, and gradually promoting the serving chopsticks system.
Conclusions Mandatory government policies and measures, public education on serving chopsticks, creating a good atmosphere for serving chopsticks, the production and sale of recognizable chopsticks and reasonable separate dining design, and the initiative of the catering industry and unit canteens to assume the responsibility of chopsticks sharing are required.
Impact of menopause on relapse rate and disability level in patients with multiple sclerosis (MS): A systematic review and meta-analysis
Authors: Shahraki Zahra , Rastkar Mohsen , Rastkar Elnaz , Mohammadifar Mehdi , Mohamadi Aida , Ghajarzadeh Mahsa
Published: March 2023

Background: Menopause is a physiologic phase in women’s lives. Finding regarding MS course through menopause is diverse and we designed this systematic review and meta-analysis to estimate impact of menopause on relapse rate, and disability status.
Methods: PubMed, Scopus, EMBASE, Web of Science, google scholar were systematically searched by two independent researchers on January 1st 2023. They also evaluated conference abstracts and references of the references. Data regarding the total number of participants, first author, publication year, country of origin, disease duration, disease type, annual relapse rate, and Expanded Disability Status Scale (EDSS) before and after menopause were recorded.
Results: A literature search revealed 1024 records, after deleting duplicates we had 660 records. Twenty-one full texts were evaluated, and finally four studies remained for meta-analysis. Mean ARR before menopause ranged between 0.21 and 0.37, and after menopause ranged between 0.13 and 0.08.
The SMD of menopause ranged between -1.04, and -0.29, while the pooled SMD was estimated as -0.52(95% CI: -0.88, -0.15)(I2=73.6%, P=0.02). Mean EDSS before menopause ranged between 1.5 and 2, and after menopause ranged between 2 and 3.1. the SMD of EDSS ranged between 0.46, and 0.71. The pooled SMD of EDSS change estimated as 0.56(95% CI: 0.38, 0.73)(I2=0, P=0.4).
Conclusion: The result of this systematic review and meta-analysis show that menopause cause a decrease in relapse rate, unlike an increase in disability status.
Changes of Severe Maternal Clinical Features
Authors: Suo Ye , Tan Guoliang , Wang Jianbao , Zheng Yuxin , Luo Fenbin , Fan Jialin , Sun Xuri , Liu Yuqi
Published: March 2023

Purpose
To observe and compare the dynamic data changes of the severe maternal in ICU, so as to provide experience for increasingly complicated maternity cure.
Materials and Methods
Observational study was adopted. The characteristics of severe maternal in ICU during the periods from January 1, 2009 to December 31, 2016 (stage 1) and from January 1, 2017 to June 30, 2022 (stage 2) was collected for review.
Results
Compared with stage 1, the ratios of comorbidities (67.1%), irregular antenatal care (44.7%), vaginal (10.6%), and hysterectomy (17.7%) among the severe maternal in stage 2 were increased; Among the main reason for the patient admitted to the ICU, the ratio of nonobstetric factors rose (40.2%), including pancreatitis (14.1%) and pulmonary arterial hypertension (4.0%), the ratios of which increased; In obstetric factors, the ratio of postpartum hemorrhage (47.6%) rose, including placenta previa (32.9%) ; the ratio of pregnancy-induced hypertension (39.5%) dropped, while that of HEELP syndrome (58.6%) rose; The ratios of patients combined scarred uterus (52.1%).
Conclusion
Clinical features of the severe maternal are more complex, diverse and serious. It is required to strengthen the management of the multidisciplinary team dominated by the ICU to improve the level of severe maternal cure.
Clinical features and images of malignant lymphoma localized in the pancreatic head to differentiate from pancreatic ductal adenocarcinoma
Authors: Kato Naohiro , Yamaguchi Atsushi , Sugata Syuhei , Hamada Takuro , Furuya Nao , Mizumoto Takeshi , Tamaru Yuzuru , Kusunoki Ryusaku , Kuwai Toshio , Kouno Hirotaka , Tazuma Sho , Sudo Takeshi , Kido Miki , Ito Takuo , Kuraoka Kazuya , Kohno Hiroshi
Published: March 2023

Background
Pathological examination by endoscopic ultrasonography–guided fine-needle aspiration (EUS-FNA) has been reported to be useful in diagnosing pancreatic malignant lymphoma (ML), but some ML cases are difficult to be differentiated from pancreatic ductal adenocarcinoma (PDAC).
Methods
This retrospective study included 8 patients diagnosed with ML that had a pancreatic-head lesion at initial diagnosis and 46 patients with resected PDAC in the pancreatic head between April 2006 and October 2021 at our institute. ML and PDAC were compared in terms of patients’ clinical features and imaging examinations.
Results
The median tumor size was larger in ML than in PDAC (45.8 [24–64] vs. 23.9 [8–44] mm), but the median diameter of the caudal main pancreatic duct (MPD) was larger in PDAC (2.5 [1.0–3.5] vs. 7.1 [2.5–11.8] mm), both showing significant differences between these malignancies (both, P < 0.001). In the analysis of covariance, MLs showed a smaller caudal MPD per tumor size than PDACs, with a statistical difference. Sensitivity and specificity using sIL-2R ≥ 658 U/mL plus CA19-9 < 37 U/mL for the differentiation of ML from PDAC were 80.0% and 95.6%, respectively (P < 0.001).
Conclusions
Diagnosing pancreatic ML using cytohistological examination through EUS-FNA can be difficult in some cases. Thus, ML should be suspected if a patient with a pancreatic tumor has a small MPD diameter per tumor size, high serum sIL-2R level, normal CA19-9 level. If the abovementioned features are absent and still cannot be confirmed as PDAC, re-examination should be considered.
Initiating Dose of hMG in Clomiphene plus hMG regimen in aged patients with poor ovarian response: More is better?
Authors: SUN NINGYU , Yin Ping , Yan Hua
Published: March 2023

Object: This study was to investigate the effect of different human Menotrophin (hMG) initiation doses on in vitro fertilization (IVF) outcomes in aged poor ovarian response(POR) patients undergoing ovulation induction with Clomiphene Citrate (CC) combined with hMG; Method: The clinical data of 142 POR patients more than 40 years old were collected and were divided into 3 groups according to the initiation dose of hMG (Group A=75IU, Group B=150IU, Group C=225IU). The baseline characteristics and IVF outcomes were compared; Results: We found that with the increase of hMG initiation dose, the average number of oocytes retrieved increased, pair-to-pair comparison showed that the the average number of oocytes retrieved in Group Awas significantly lower than that in the Group B and Group C(P<0.05). Compared with Group B, the fertilization rate and oocyte utilization rate of patients in Group C were significantly lower (P<0.05). There was no significant difference in MII oocyte rate, Cleavage rate, embryo formation rate, high-quality embryo rate and pregnancy outcomes among the three groups(P>0.05). Conclusions: For aged POR patients receiving CC combined with hMG, increasing hMG cannot improve patients' IVF outcomes and Pregnancy outcomes. 150IU of hMG initiation dose may be the better choice for aged POR patients.
Evaluation of an HIV Homecare Program for Lost-to-Follow-Up Populations: A Mixed Methods Study in Detroit, Michigan
Authors: Bonadonna Lily , Guerrero Esther , McClendon Tammie , Union Sheronda , Kabbani Dana , Wittmann Daniela , Cohn Jonathan , Veltman Jennifer
Published: March 2023

Background
Maintaining people living with HIV (PLWHIV) in clinical care is a global priority. In the Metro Detroit area of Michigan, approximately 30% of PLWHIV are out of care. To re-engage lost-to-follow-up patients, Wayne Health Infectious Disease clinic launched an innovative Homecare program in 2017. In addition to home healthcare delivery, the program included links to community resources and quarterly community meetings. We aimed to evaluate Homecare’s impact on participants’ ability to stay engaged in HIV care and reach viral suppression. We included data from PLWHIV and their healthcare workers.
Methods
We used a convergent mixed-methods design, including first year program record review, semi-structured interviews, and a validated Likert scale questionnaire rating illness perception before and after Homecare. Interview data were collected from 15 PLWHIV in Metro Detroit and two healthcare workers responsible for program delivery. Semi-structured interviews focused on obstacles to clinic-based care, support networks, and illness perceptions. Interview data were transcribed and analyzed using a thematic approach. A fully coded analysis was used to create a conceptual framework of factors contributing to Homecare’s success. Means in eight categories of the Brief Illness Perception (IPQ) were compared using paired T-tests.
Results
In the first year of Homecare, 28 of 34 participants (82%) became virally suppressed at least once. The program offered (1) social support and stigma reduction through strong relationships with healthcare workers, (2) removal of physical and resource barriers such as transportation, and (3) positive changes in illness perceptions. PLWHIV worked towards functional coping strategies, including improvements in emotional regulation, acceptance of their diagnosis, and more positive perspectives of control. Brief-IPQ showed significant changes in six domains before and after Homecare.
Conclusion
Homecare offers an innovative system for successfully re-engaging and maintaining lost-to-follow-up PLWHIV in care. These findings have implications for HIV control efforts and could inform the development of future programs for difficult to reach populations.
A comparative analysis of lipoprotein transport proteins – LolA and LolB from Vibro cholerae and LolA from Porphyromonas gingivalis
Authors: Jaiman Deepika , Nagampalli Raghavendra , Persson Karina
Published: March 2023

In Gram-negative bacteria, N-terminal lipidation is a signal for protein trafficking from the inner membrane (IM) to the outer membrane (OM). The IM complex LolCDE extracts lipoproteins from the membrane and moves them to the chaperone LolA. The LolA-lipoprotein complex crosses the periplasm after which the lipoprotein is anchored to the OM. In g-proteobacteria anchoring is assisted by the receptor LolB, while a corresponding protein has not been identified in other phyla. In light of the low sequence similarity between Lol-systems from different phyla and that they may use different Lol components, it is crucial to compare representative proteins from several species.
Here we present a structure-function study of LolA and LolB from two phyla: LolA from Porphyromonas gingivalis(phylum bacteroidota), and LolA and LolB from Vibiro cholerae (phylum proteobacteria). Despite large sequence differences, the LolA structures are very similar, hence structure and function have been conserved throughout evolution. However, an Arg-Pro motif crucial for function in g-proteobacteria has no counterpart in bacteriodota. We also show that LolA from both phyla bind the antibiotic polymyxin B whereas LolB does not. Collectively, these studies will facilitate the development of antibiotics as they provide awareness of both differences and similarities across phyla.
Transcriptome analysis of neurotransmitters and related molecules in gastric cancer tissue
Authors: Wang Shengwan , Hu Jingqing , Yang Sunhu , Li Feng , Zhang Ying , Zhang Youcheng , Yin Xiaodan , Chen Juan , Wang Kexie , Li Dong , Zhang Yanjie
Published: March 2023

Objective To investigate whether the differential expression of neurotransmitters, their receptors, and synthetases is related to the occurrence and progression of gastric cancer.
Methods Gastric cancer tissue samples from 5 patients and 2 adjacent normal tissue samples were collected, the transcriptome detection of relevant molecules was performed, and the results were compared with the whole proteome data of gastric tissue from normal HPA subjects.
Results HPA showed that highly expressed classic neurotransmitters and neuropeptides were not expressed or very low expressed in 5 gastric cancer tissue samples.
Conclusion We believe that the main cause of gastric cancer may be the extremely low expression or no expression of neurotransmitters, neuropeptides and other genes that should be highly expressed in normal gastric tissue, resulting in out-of-control management of gastric tissue cells and then gastric cancer.