bluuebunny/crossref_metadata_2025 huggingface dataset:
Ethics knowledge, attitudes, and experiences of tertiary care pediatricians in Ethiopia
Authors: Tekleab Atnafu Mekonnen , Lantos John D.
Published: July 2022

Background

Pediatricians in developing countries face different ethical dilemmas than do doctors working in settings with more resources. There are very few studies from developing countries analyzing pediatricians’ knowledge and attitudes regarding the ethical dilemmas that arise in such settings. To address this gap, we explored the clinical ethical knowledge, attitude and experience of physicians who are working in the Department of Pediatrics and Child Health (DPCH) of St Paul’s Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia.

Study population

All pediatric resident doctors and pediatric consultants who were working in the DPCH of SPHMMC in December, 2020.

Method

A structured pretested self-administered questionnaire was distributed to all 79 of the residents and consultants in the department during the period December 15–27, 2020. The questionnaire assessed the knowledge (23 questions), attitude (9 questions) and experiences (9 questions) of the study participants regarding a variety of bioethical issues. Data were analyzed using SPSS version 20.0 for windows. The mean, median, standard deviation, and interquartile range of respondents’ scores were determined and compared using Fisher’s exact test.

Result

A total of 59/79 (75%) physicians completed the questionnaire. The mean age of the participants was 30.7 ± 4.1 years. Thirty six (61.0%) were female. At the time of data collection, more than half (57.6%) served < 5 years as a physician. The mean ethics knowledge score of the respondents was 12.3 ± 2.34 out of 23 knowledge questions. The lowest and highest knowledge scores were 8 and 19 respectively. Scores were highest on questions about confidentiality (94.9% correct) and lowest on questions about genetic testing and diagnosis (13.6% correct). Only 13 (22.4%) physicians agreed with the practice of children should never be treated without consent of the parent.

Conclusion

Tertiary care pediatricians at one hospital in Ethiopia lack knowledge about current standards in bioethics. There is a need for more ethics education in this setting.
A competence improvement programme for the systematic observation of frail older patients in homecare: qualitative outcome analysis
Authors: Strømme Torunn , Tjoflåt Ingrid , Aase Karina
Published: July 2022

Background

The growth of frail older patients with extensive care needs in homecare creates a need for competence development. Improvement programmes are essential to fill this knowledge gap. However, the outcomes of such programmes remain unknown. Therefore, the aim of this study is to describe the outcomes of a competence improvement programme for the systematic observation of frail older patients in homecare.

Methods

This study applied a qualitative mixed-method design. Data were collected in two homecare districts using participant observation, focus group interviews, and individual interviews.

Results

The analysis revealed five concepts characterising the outcomes of the competence improvement programme: 1) frequency of vital sign measurements, 2) situational awareness, 3) expectations and coping level, 4) activities for sustained improvement, and 5) organisational issues affecting CIP focus. Substantial differences were revealed across the two homecare districts in how homecare professionals enacted new knowledge and routines resulting from the competence improvement programme. The differences were related to the frequency of vital sign measurements, coping levels, and situational awareness, in which successful outcomes were shaped by implementation issues and contextual setting. This involved whether routines and planned activities were set to follow up the improvement programme, or whether organisational issues such as leadership focus, resources, and workforce stability supported the programme.

Conclusions

This study documents the differences entailed in creating sustainable outcomes of an improvement programme for homecare professionals’ competence in recognising and responding to deteriorating frail older patients. Depending on the implementation process and the homecare context, professionals enact the activities of the improvement programme differently.
Identification of human mitochondrial RNA cleavage sites and candidate RNA processing factors
Authors: Carbajosa Guillermo , Ali Aminah T. , Hodgkinson Alan
Published: July 2022

Background

The human mitochondrial genome is transcribed as long strands of RNA containing multiple genes, which require post-transcriptional cleavage and processing to release functional gene products that play vital roles in cellular energy production. Despite knowledge implicating mitochondrial post-transcriptional processes in pathologies such as cancer, cardiovascular disease and diabetes, very little is known about the way their function varies on a human population level and what drives changes in these processes to ultimately influence disease risk. Here, we develop a method to detect and quantify mitochondrial RNA cleavage events from standard RNA sequencing data and apply this approach to human whole blood data from > 1000 samples across independent cohorts.

Results

We detect 54 putative mitochondrial RNA cleavage sites that not only map to known gene boundaries, short RNA ends and RNA modification sites, but also occur at internal gene positions, suggesting novel mitochondrial RNA cleavage junctions. Inferred RNA cleavage rates correlate with mitochondrial-encoded gene expression across individuals, suggesting an impact on downstream processes. Furthermore, by comparing inferred cleavage rates to nuclear genetic variation and gene expression, we implicate multiple genes in modulating mitochondrial RNA cleavage (e.g. MRPP3, TBRG4 and FASTKD5), including a potentially novel role for RPS19 in influencing cleavage rates at a site near to the MTATP6-COX3 junction that we validate using shRNA knock down data.

Conclusions

We identify novel cleavage junctions associated with mitochondrial RNA processing, as well as genes newly implicated in these processes, and detect the potential impact of variation in cleavage rates on downstream phenotypes and disease processes. These results highlight the complexity of the mitochondrial transcriptome and point to novel mechanisms through which nuclear-encoded genes can potentially influence key mitochondrial processes.
Improvement of several stress response and sleep quality hormones in men and women after sleeping in a bed that protects against electromagnetic fields
Authors: Díaz-Del Cerro E , Félix J , Tresguerres JAF , De la Fuente M
Published: July 2022

Background

The electromagnetic fields (EMFs) emitted by the technologies affect the homeostatic systems (nervous, endocrine, and immune systems) and consequently the health. In a previous work, we observed that men and women, after 2 months of using a bed with a registered HOGO system, that prevents and drain EMFs, improved their immunity, redox and inflammatory states and rejuvenated their rate of aging or biological age. Since, EMFs can act as a chronic stressor stimulus, and affect the sleep quality. The objective of this work was to study in men and women (23–73 years old) the effect of sleeping for 2 months on that bed in the blood concentrations of several hormones related to stress response and sleep quality as well as to corroborate the rejuvenation of their biological age.

Methods

In 18 men and women, plasma concentration of cortisol, dehydroepiandrosterone (DHEA), catecholamines (epinephrine, norepinephrine and dopamine), serotonin, oxytocin and melatonin were analyzed before and after 2 months of using the HOGO beds. A group of 10 people was used as placebo control. In another cohort of 25 men (20 experimental and 5 placebo), the effects of rest on the HOGO system on the concentration of cortisol and testosterone in plasma were studied. In all these volunteers, the biological age was analyzed using the Immunity Clock model.

Results

There is a significant increase in plasma concentration of DHEA, norepinephrine, serotonin, oxytocin, and melatonin as well as in testosterone, after resting for 2 months in that bed with the EMFs avoiding system. In addition, decreases in Cortisol/DHEA and Testosterone/cortisol ratio and plasma dopamine concentration were observed. No differences were found in placebo groups. In all participants that slept on HOGO beds, the biological age was reduced.

Conclusions

Sleeping in a bed that isolates from EMFs and drain them can be a possible strategy to improve the secretion of hormones related to a better response to stress and sleep quality, which means a better endocrine system, and consequently better homeostasis and maintenance of health. This fact was confirmed with the slowdown in the rate of aging checked with a rejuvenation of the biological age.
E3 ubiquitin ligase MAGI3 degrades c-Myc and acts as a predictor for chemotherapy response in colorectal cancer
Authors: Wang Haibo , Yang Wenjing , Qin Qiong , Yang Xiaomei , Yang Ying , Liu Hua , Lu Wenxiu , Gu Siyu , Cao Xuedi , Feng Duiping , Zhang Zhongtao , He Junqi
Published: July 2022

Background

Recurrence and chemoresistance constitute the leading cause of death in colorectal cancer (CRC). Thus, it is of great significance to clarify the underlying mechanisms and identify predictors for tailoring adjuvant chemotherapy to improve the outcome of CRC.

Methods

By screening differentially expressed genes (DEGs), constructing random forest classification and ranking the importance of DEGs, we identified membrane associated guanylate kinase, WW and PDZ domain containing 3 (MAGI3) as an important gene in CRC recurrence. Immunohistochemical and western blot assays were employed to further detect MAGI3 expression in CRC tissues and cell lines. Cell counting kit-8, plate colony formation, flow cytometry, sub-cutaneous injection and azoxymethane plus dextran sulfate sodium induced mice CRC assays were employed to explore the effects of MAGI3 on proliferation, growth, cell cycle, apoptosis, xenograft formation and chemotherapy resistance of CRC. The underlying molecular mechanisms were further investigated through gene set enrichment analysis, quantitative real-time PCR, western blot, co-immunoprecipitation, ubiquitination, GST fusion protein pull-down and immunohistochemical staining assays.

Results

Our results showed that dysregulated low level of MAGI3 was correlated with recurrence and poor prognosis of CRC. MAGI3 was identified as a novel substrate-binding subunit of SKP1-Cullin E3 ligase to recognize c-Myc, and process c-Myc ubiquitination and degradation. Expression of MAGI3 in CRC cells inhibited cell growth, promoted apoptosis and chemosensitivity to fluoropyrimidine-based chemotherapy by suppressing activation of c-Myc in vitro and in vivo. In clinic, the stage II/III CRC patients with MAGI3-high had a significantly good recurrence-free survival (~ 80%, 5-year), and were not necessary for further adjuvant chemotherapy. The patients with MAGI3-medium had a robustly good response rate or recurrence-free survival with fluoropyrimidine-based chemotherapy, and were recommended to undergo fluoropyrimidine-based adjuvant chemotherapy.

Conclusions

MAGI3 is a novel E3 ubiquitin ligase by degradation of c-Myc to regulate CRC development and may act as a potential predictor of adjuvant chemotherapy for CRC patients.

Graphical Abstract
The impact of the COVID-19 pandemic on people who inject drugs accessing harm reduction services in a rural American state
Authors: Thakarar Kinna , Kohut Michael , Hutchinson Rebecca , Bell Rebecca , Loeb Hannah E. , Burris Debra , Fairfield Kathleen M.
Published: July 2022

Background

The impact of public health policies during the COVID-19 pandemic on people who inject drugs (PWID) has varied across regions. In other countries, recent research has shown that PWID access to harm reduction services, despite rapid adaptations, has been negatively impacted. Our study describes these impacts in a rural state.

Methods

We conducted semi-structured interviews with PWID, community partners, and healthcare providers in the rural state of Maine (USA). We explored how changes made during the pandemic impacted access to harm reduction services, including basic services (i.e., shelter), syringe service programs, safe drug supply, low barrier treatment, and peer support. Interviews were analyzed using the framework method to apply Penchansky’s model of access, with Saurman’s modification, which includes six dimensions of access—accessibility, availability, acceptability, affordability, accommodation, awareness.

Results

We interviewed thirty-six stakeholders (N = 9 community partners, N = 9 healthcare providers, N = 18 PWID). Policies such as mobile outreach expansion, mail delivery of equipment, and relaxed telemedicine regulations facilitated accessibility to syringe service programs and low barrier buprenorphine treatment. Public health policies, such as social distancing and screening policies, reduced contact, which subsequently reduced acceptability and awareness of many services. Elimination of the one-for-one needle exchange in some areas increased, acceptability (i.e., perception of service), and affordability for PWID. However, some areas actually began enforcing a one-for-one needle exchange policy, which reduced affordability, acceptability, and awareness of services.

Conclusions

Changes resulting from the COVID-19 pandemic have impacted all dimensions of access to harm reduction services among PWID. While some barriers to harm reduction services were unavoidable during the pandemic, we found that specific policy decisions mitigated service barriers, while other policies exacerbated them. Relaxing needle exchange policies were particularly helpful in facilitating access to harm reduction services by giving community organizations flexibility to adapt to the evolving needs of PWID. These results can inform policies and service delivery to optimally mitigate the negative impacts on PWID during, and beyond, the pandemic.
Validity and reliability of the Persian version of the short-form child perceptions questionnaire 11–14-year-old children (CPQ11–14)
Authors: Baherimoghadam Tahereh , Hamedani Shahram , Naseri Navid , Ghafoori Alireza
Published: July 2022

Background

The Child Perception questionnaire 11–14 (CPQ 11–14) is an efficient tool for assessment of oral health-related quality of life (OHRQoL). This questionnaire has been briefed to 16 items (CPQ11–14 ISF-16) to facilitate its employment. The purpose the present study was to translate CPQ11–14 ISF-16 to Persian language, culturally adapt, and initially evaluate its among adolescent population.

Material and method

The questionnaire has been translated to Persian, then back-translated to English, and finally underwent cultural adaptation and pretesting assessment. It was then filled out by 318 participents (175 grils and 143 boys), with the age of 11 to 14 years resident in Shiraz, Iran. The Persian version of CPQ11–14 ISF-16 along with the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) and two suggested global questions were administered among participants to assess its criterion validity.

Results

The factor analysis extracted two domains and the factor loading of domains ranged from 0.423 to 0.837. Persian version of CPQ11–14 ISF-16 presented high internal consistency (Cronbach’s alpha = 0.854), and showed excellent criterion validity with PIDAQ (rho = 0.731, p < 0.001). There was a statistically significant positive moderate correlation between CPQ11–14 ISF-16 and its factors 1 and 2 and two global questions (first global question: rho = 0.439, p < 0.001; second global question: rho = 0.457, p = 0.035).

Conclusion

The Persian version of CPQ11–14 ISF-16 has optimal validity and reliability in a general population of 11–14-year-old Persian children.
Aboriginal and Torres Strait Islander Peoples' perceptions of foot and lower limb health: a systematic review
Authors: Sadler Sean , Gerrard James , West Matthew , Lanting Sean , Charles James , Searle Angela , Chuter Vivienne
Published: July 2022

Background

Ongoing colonisation produces inequity in healthcare delivery and inequality in healthcare outcomes for Aboriginal and Torres Strait Islander Peoples. As a consequence, within the domain of lower limb health, foot disease has severe impacts for First Nations Peoples. Central to developing culturally safe healthcare and driving positive foot health change for First Nations Peoples, is the need for health professionals to develop understanding of First Nations perspectives of foot health. The aim of this systematic review was to evaluate studies investigating Aboriginal and Torres Strait Islander Peoples' perceptions of foot and lower limb health.

Methods

PubMeD, Ovid (Embase, Emcare, Medline), CINAHL, Informit Indigenous collection, and grey literature sources were searched to 23rd July 2021. We included any published reports or studies that examined Aboriginal and Torres Strait Islander Peoples' perceptions of foot and lower limb health, or meanings of, or attitudes to, foot and lower limb health.

Results

Four studies with a total of 1515 participants were included. Studies found that Aboriginal and Torres Strait Islander people self‐assessed foot health with a demonstrated ability to perceive their feet as healthy relative to Western clinical measures of peripheral blood supply and neurological function. Footwear, including ill‐fitting or lack of footwear was considered a contributing factor to reduced foot and lower limb health. Foot pain affected up to 60% of participants with up to 70% of foot pain untreated. Lack of access to culturally safe health care delivered by culturally capable health professionals was perceived to contribute to worse foot and lower limb health outcomes.

Conclusions

Aboriginal and Torres Strait Islander Peoples' perceptions of foot and lower limb health are influenced by multiple complex interrelated factors. The limited number of studies in this area indicates ongoing failings to consult First Nations Peoples regarding their own lower limb and foot health. It is therefore essential that healthcare service and cultural capability implementation is led by Aboriginal and Torres Strait Islander Peoples in co‐design. Urgent need for further research that exemplifies design and delivery of culturally safe care is required.
NeuroSAFE PROOF: study protocol for a single-blinded, IDEAL stage 3, multi-centre, randomised controlled trial of NeuroSAFE robotic-assisted radical prostatectomy versus standard robotic-assisted radical prostatectomy in men with localized prostate cancer
Authors: Dinneen Eoin , Grierson Jack , Almeida-Magana Ricardo , Clow Rosie , Haider Aiman , Allen Clare , Heffernan-Ho Daniel , Freeman Alex , Briggs Tim , Nathan Senthil , Mallett Susan , Brew-Graves Chris , Muirhead Nicola , Williams Norman R. , Pizzo Elena , Persad Raj , Aning Jon , Johnson Lyndsey , Oxley Jon , Oakley Neil , Morgan Susan , Tahir Fawzia , Ahmad Imran , Dutto Lorenzo , Salmond Jonathan M. , Kelkar Anand , Kelly John , Shaw Greg
Published: July 2022

Background

Robotic radical prostatectomy (RARP) is a first-line curative treatment option for localized prostate cancer. Postoperative erectile dysfunction and urinary incontinence are common associated adverse side effects that can negatively impact patients’ quality of life. Preserving the lateral neurovascular bundles (NS) during RARP improves functional outcomes. However, selecting men for NS may be difficult when there is concern about incurring in positive surgical margin (PSM) which in turn risks adverse oncological outcomes. The NeuroSAFE technique (intra-operative frozen section examination of the neurovascular structure adjacent prostate margin) can provide real-time pathological consult to promote optimal NS whilst avoiding PSM.

Methods

NeuroSAFE PROOF is a single-blinded, multi-centre, randomised controlled trial (RCT) in which men are randomly allocated 1:1 to either NeuroSAFE RARP or standard RARP. Men electing for RARP as primary treatment, who are continent and have good baseline erectile function (EF), defined by International Index of Erectile Function (IIEF-5) score > 21, are eligible. NS in the intervention arm is guided by the NeuroSAFE technique. NS in the standard arm is based on standard of care, i.e. a pre-operative image-based planning meeting, patient-specific clinical information, and digital rectal examination. The primary outcome is assessment of EF at 12 months. The primary endpoint is the proportion of men who achieve IIEF-5 score ≥ 21. A sample size of 404 was calculated to give a power of 90% to detect a difference of 14% between groups based on a feasibility study. Oncological outcomes are continuously monitored by an independent Data Monitoring Committee. Key secondary outcomes include urinary continence at 3 months assessed by the international consultation on incontinence questionnaire, rate of biochemical recurrence, EF recovery at 24 months, and difference in quality of life.

Discussion

NeuroSAFE PROOF is the first RCT of intra-operative frozen section during radical prostatectomy in the world. It is properly powered to evaluate a difference in the recovery of EF for men undergoing RARP assessed by patient-reported outcome measures. It will provide evidence to guide the use of the NeuroSAFE technique around the world.

Trial registration

NCT03317990 (23 October 2017). Regional Ethics Committee; reference 17/LO/1978.
Myometrial oxidative stress drives MED12 mutations in leiomyoma
Authors: Li Yinuo , Xu Xiuhua , Asif Huma , Feng Yue , Kohrn Brendan F. , Kennedy Scott R. , Kim J. Julie , Wei Jian-Jun
Published: July 2022

Background

More than 70% of leiomyomas (LM) harbor MED12 mutations, primarily in exon 2 at c.130-131(GG). The cause of MED12 mutations in myometrial cells remains largely unknown. We hypothesized that increased ROS promotes MED12 mutations in myometrial cells through the oxidation of guanine nucleotides followed by misrepair.

Methods

Genomic oxidative burden (8-OHdG) was evaluated in vitro and in vivo by immunohistochemistry. MED12 mutations were examined by Sanger sequencing and deep sequencing. Transcriptome examined by RNA-seq was performed in myometrium with and without LM, in primary myometrial cells treated with ROS. 8-OHdG mediated misrepair was analyzed by CRISPR/Cas9.

Results

Uteri with high LM burden had a significantly higher rate of MED12 mutations than uteri with low LM burden. Compelling data suggest that the uterus normally produces reactive oxidative species (ROS) in response to stress, and ROS levels in LM are elevated due to metabolic defects. We demonstrated that genomic oxidized guanine (8-OHdG) was found at a significantly higher level in the myometrium of uteri that had multiple LM compared to myometrium without LM. Transcriptome and pathway analyses detected ROS stress in myometrium with LM. Targeted replacement of guanine with 8-OHdG at MED12 c.130 by CRISPR/Cas9 significantly increased the misrepair of G>T. Exposure of primary myometrial cells to oxidative stress in vitro increased misrepair/mutations as detected by duplex sequencing.

Conclusions

Together, our data identified a clear connection between increased myometrial oxidative stress and a high rate of MED12 mutations that may underlie the risk of LM development and severity in women of reproductive age.

Graphical Abstract
R&D of a low-complexity OFDM acoustic communication payload for Micro-AUV in confined space
Authors: Jiang Weihua , Tao Qiuyang , Yao Junhui , Tong Feng , Zhang Fumin
Published: July 2022

With small size, high flexibility, low cost, and deployment convenience, Micro-sized autonomous underwater vehicle (Micro-AUV) is capable of performing diverse underwater missions efficiently in confined underwater space, for the extensive purpose of rescue, sightseeing, pipeline engineering and so on. The underwater acoustic (UWA) communication technique provides an effective way to support this types of underwater mission for telemetry and remote control of Micro-AUV. However, while the adverse multipath caused by confined space poses significant challenge to the classic coherent acoustic communication schemes that need channel estimation and equalization processing, the employment of non-coherent communication scheme is generally limited by low data rate. By utilizing time-domain and frequency-domain differential modulation to suppress the influence of multipath, a low-complexity UWA communication payload is designed to provide an effective solution to make a tradeoff between data rate and implementation complexity. Based on a STM32 series processor, this paper introduced the software and hardware implementation of a time-frequency differential OFDM UWA communication payload for Micro-AUV and presented the performance evaluation of the system in confined underwater space. The experimental results achieved in a confined lake show that the proposed system has the potential of being used for Micro-AUV to achieve a data rate of 1.96 kbps at a distance of 200m with acceptable implementation overhead.
Development of uniform food information –the case of front of package nutrition labels in the EU
Authors: Bottari Federico , Mark-Herbert Cecilia
Published: July 2022

The current malnutrition epidemic calls for actions. Current practices in the EU show a variety of communication efforts but the international character of food markets call for a harmonized language. The aim of the project is to identify the themes in the on-going debate regarding the development of a single front-of-package nutrition label in the European Union. A case study approach was used, focusing on the positions of different key stakeholders in Sweden and Italy. Overarching EU-perspectives, European Commission and European Council of Ministries were also included. Collected data from semi-structured interviews and strategic documents were used in a thematic content analysis. The results show that the stakeholders are influencing the process towards contradicting outcomes. Different stakeholders argue for opposing ideal labelling schemes, while still agreeing on the need for a harmonization. Major disagreements arise on whether the label should be voluntary or not, based on portion or 100 g and on the ideal label design. Stakeholders’ positions depend on food system role and previous experience of this type of labelling. The internal political debate in the European Union is still at an early stage and consensus has not been reached due to diverging views. The patterns that emerge from the analysis of the different point of views can facilitate the cooperation between stakeholders and policy-makers.
Identification of phenylketonuria patient genotypes using single-gene full-length sequencing
Authors: Gao Jinshuang , Li Xiaole , Guo Yaqing , Yu Haiyang , Song Liying , Fang Yang , Yuan Erfeng , Shi Qianqian , Zhao Dehua , Yuan Enwu , Zhang Linlin
Published: July 2022

Background

Phenylketonuria (PKU) is a common, autosomal recessive inborn error of metabolism caused by PAH gene variants. After routine genetic analysis methods were applied, approximately 5% of PKU patients were still not diagnosed with a definite genotype.

Methods

In this study, for the first time, we identified PKU patients with unknown genotypes via single-gene full-length sequencing.

Results

The detection rate of PKU genotype increased from 94.6 to 99.4%, an increase of approximately 5%. The variants c.1199 + 502A > T and 1065 + 241C > A were found at a high frequency in Chinese PKU patients.

Conclusion

Our study suggest that single-gene full-length sequencing is a rapid, efficient and cost-effective tool to improve the genotype detection rate of PKU patients. Moreover, we provides additional case data to support pathogenicity of deep intronic variants in PAH.
Disulfiram inhibits liver fibrosis in rats by suppressing hepatic stellate cell activation and viability
Authors: Yang Xiao-Mei , Wu Zheng , Wang Xiaoqi , Zhou Yaoqi , Zhu Lei , Li Dongxue , Nie Hui-Zhen , Wang Ya-Hui , Li Jun , Ma Xueyun
Published: July 2022

Background

Liver fibrosis is a wound-healing response to chronic injury, featuring with excess accumulation of extracellular matrix secreted by the activated hepatic stellate cells (HSC). Disulfiram (DSF), also known as Antabuse, has been used for the treatment of alcohol addiction and substance abuse. Recently, overwhelming studies had revealed anti-cancer effects of DSF in multiple cancers, including liver cancer. But the actual effects of DSF on liver fibrosis and liver function remain unknown.

Methods

In this study, we evaluated the effects of low-dose DSF in CCl4- and Bile Duct Ligation (BDL)—induced hepatic fibrosis rat models. Cell proliferation was detected by using the Cell-Light™ EdU Apollo®567 Cell Tracking Kit. Cell apoptosis was analyzed using a TdT-mediated dUTP nick end labeling (TUNEL) kit, viability was measured with Cell Counting Kit-8(CCK8). Relative mRNA expression of pro-fibrogenic was assessed using quantitative RT-PCR. The degree of liver fibrosis, activated HSCs, were separately evaluated through Sirius Red-staining, immunohistochemistry and immunofluorescence. Serum alanine aminotransferase (ALT) and asparagine aminotransferase (AST) activities were detected with ALT and AST detecting kits using an automated analyzer.

Results

Liver fibrosis was distinctly attenuated while liver functions were moderately ameliorated in the DSF-treated group. Activation and proliferation of primary rat HSCs isolated from rat livers were significantly suppressed by low-dose DSF. DSF also inhibited the viability of in vitro cultured rat or human HSC cells dose-dependently but had no repressive role on human immortalized hepatocyte THLE-2 cells. Interestingly, upon DSF treatment, the viability of LX-2 cells co-cultured with THLE-2 was significantly inhibited, while that of THLE-2 co-cultured with LX-2 was increased. Further study indicated that HSCs apoptosis was increased in DSF/CCl4-treated liver samples. These data indicated that DSF has potent anti-fibrosis effects and protective effects toward hepatocytes and could possibly be repurposed as an anti-fibrosis drug in the clinic.

Conclusions

DSF attenuated ECM remodeling through suppressing the transformation of quiet HSCs into proliferative, fibrogenic myofibroblasts in hepatic fibrosis rat models. DSF provides a novel approach for the treatment of liver fibrosis.
Measuring learning that is hard to measure: using the PECSL model to evaluate implicit smart learning
Authors: Lister Pen
Published: July 2022

This paper explores potential ways of evaluating the implicit learning that may be present in autonomous smart learning activities and environments, reflecting on prior phenomenographic research into smart learning activities positioned as local journeys in urban connected public spaces. Implicit learning is considered as intrinsic motivation, value and richer engagement by participants, demonstrating levels of experience complexity, interpreted as levels of implicit learning. The paper reflects on ideas for evaluating implicit smart learning through planning for experience complexity in the context of a pedagogical model, the Pedagogy of Experience Complexity for Smart Learning (PECSL), developed from the research. By supplementing this model with further conceptual mechanisms to describe experience complexity as surface to deep learning alongside cognitive domain taxonomy equivalences, implicit smart learning might be evaluated in broad flexible ways to support the design of more effective and engaging activities. Examples are outlined placing emphasis on learner generated content, learner-directed creative learning and supporting dialogue and reflection, attempting to illustrate how implicit learning might manifest and be evaluated.
Rational coordination regulation in carbon-based single-metal-atom catalysts for electrocatalytic oxygen reduction reaction
Authors: Cui Xun , Gao Likun , Lu Cheng-Hsin , Ma Rui , Yang Yingkui , Lin Zhiqun
Published: July 2022

Single-metal-atom catalysts (SMACs) have garnered extensive attention for various electrocatalytic applications, owing to their maximum atom-utilization efficiency, tunable electronic structure, and remarkable catalytic performance. In particular, carbon-based SMACs exhibit optimal electrocatalytic activity for the oxygen reduction reaction (ORR) which is of paramount importance for several sustainable energy conversion and generation technologies, such as fuel cells and metal-air batteries. Despite continuous endeavors in developing various advanced carbon-based SMACs for electrocatalytic ORR, the rational regulation of coordination structure and thus the electronic structure of carbon-based SMACs remains challenging. In this review, we critically examine the role of coordination structure, including local coordination structure (i.e., metal atomic centers and the first coordination shell) and extended local coordination structure (i.e., the second and higher coordination shells), on the rational design of carbon-based SMACs for high-efficiency electrocatalytic ORR. Insights into the relevance between coordination structures and their intrinsic ORR activities are emphatically exemplified and discussed. Finally, we also propose the major challenges and future perspectives in the rational design of advanced carbon-based SMACs for electrocatalytic ORR. This review aims to emphasize the significance of coordination structure and deepen the insightful understanding of structure-performance relationships.
Solar and geomagnetic activity dependence of 150-km echoes observed by the Equatorial Atmosphere Radar in Indonesia
Authors: Yokoyama Tatsuhiro , Takagi Rieko , Yamamoto Mamoru
Published: July 2022

The occurrence characteristics of 150-km echoes in low-latitude regions are studied using the Equatorial Atmosphere Radar (EAR) in Indonesia. The long-term observation of the 150-km echoes by the EAR enables us to study the occurrence characteristics of 150-km echoes statistically. It is shown that the occurrence rate of the 150-km echoes observed by the EAR shows a semiannual variation with two peaks in solstices and a negative correlation with both the EUV flux and $$\Sigma$$
Σ
Kp index, that is, the solar and the geomagnetic activity. Geomagnetic activity correlates with the occurrence rate of 150-km echoes observed one day after when the $$\Sigma$$
Σ
Kp was measured. However, the occurrence rate is always low during the high solar activity period regardless of the geomagnetic activity. While the seasonal variation and the solar activity dependence of the occurrence of 150-km echoes are consistent with previous studies, this is the first time a negative correlation with geomagnetic activity is reported.

Graphical Abstract
Long head of the biceps intra-articular tenotomy using needle arthroscopy under local anesthesia: preliminary results and technical note
Authors: Rosso Claudio , Grezda Kushtrim , Heuberer Philipp R.
Published: July 2022

Purpose

Arthroscopic isolated biceps tenotomy is a procedure successfully performed in patients with degenerative rotator cuff tears which offers good clinical results. With this article, we describe the technique of biceps tenotomy with needle arthroscopy in local anesthesia and the results of first patients treated from 2018.

Methods

Thirteen patients with irreparable rotator cuff tear treated with arthroscopic needle biceps tenotomy under local anesthesia were included. Constant score and active/passive flexion were recorded preoperatively and at 3 months postoperatively.

Results

The average age of the patients was 71 ± 7 year old. All the patients were available for the follow-up. The Constant score significantly improved from pre- to postoperatively (44 ± 8.9 to 63.1 ± 14.2, p < 0.05). Active flexion improved from preoperatively 115 ± 24° to 145 ± 31° postoperatively (p < 0.05), while passive flexion did not significantly improve.

Conclusion

This technique can be safely performed in the elderly patient with irreparable rotator cuff tears and pain refractory to conservative measures.
Clinical and radiographic outcomes following transcrestal maxillary sinus floor elevation with injectable xenogenous bone substitute in gel form: a prospective multicenter study
Authors: Lombardi Teresa , Lamazza Luca , Bernardello Fabio , Ziętek Grzegorz , Stacchi Claudio , Troiano Giuseppe
Published: July 2022

Purpose

To investigate clinical and radiographic outcomes of transcrestal maxillary sinus floor elevation performed with an injectable xenograft in gel form, analyzing general, local and surgical variables possibly influencing the results.

Methods

Patients with residual crestal height < 5 mm underwent transcrestal sinus floor elevation with xenograft in gel form to allow the placement of a single implant. Simultaneous implant placement was performed when primary stability was ≥ 15 Ncm. Graft height was measured immediately after surgery (T0) and after 6 months of healing (T1). Univariate and multivariate regression models were built to assess associations between clinical variables with implant survival and graft height at T1.

Results

71 patients underwent transcrestal sinus floor elevation and 54 implants were simultaneously placed. Delayed implant placement (at T1) was possible in 5 cases out of 17 (29.4%), whereas in 12 patients (70.6%) implant insertion was not possible or required additional sinus grafting. Implant survival rate, with a follow-up varying from 12 to 32 months after loading, was 100%. Mean pre-operative bone height was 3.8 ± 1.0 mm, at T0 was 13.9 ± 2.2 mm and at T1 was 9.9 ± 2.8 mm. Bone height at T1 was negatively influenced by membrane perforation at surgery (p = 0.004) and positively influenced by immediate implant insertion (p < 0.001).

Conclusions

Transcrestal sinus floor elevation performed with injectable xenograft gel resulted in 100% implant survival rate. However, immediate implant insertion seems a crucial factor to preserve vertical bone gain: one-stage technique seems to be the most predictable approach to optimize clinical outcomes with this approach.

Trial registration clinicaltrials.gov, NCT05305521. Registered 31 March 2022—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT05305521.
Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as risk factors for mortality in Peruvian adults with chronic kidney disease
Authors: Umeres-Francia Gianfranco Eddú , Rojas-Fernández María Valentina , Herrera-Añazco Percy , Benites-Zapata Vicente Aleixandre
Published: July 2022

Objective

To assess the association between the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with all-cause mortality in Peruvian patients with chronic kidney disease (CKD) attending a tertiary hospital.

Methods

We conducted a retrospective cohort study in adults with CKD in stages 1–5. The outcome variable was mortality and as variables of exposure to NLR and PLR. Both ratios were categorized as high with a cutoff point of 3.5 and 232.5, respectively. We carried out a Cox regression model and calculated crude and adjusted hazard ratios (HR) with their 95% confidence interval (95% CI).

Results

We analyzed 343 participants with a mean age of 78.3 (± 11.9) years and 62.9% (n = 216) men. The median follow-up time was 2.45 years (2.08–3.08), and the frequency of deaths was 17.5% (n = 60). The mortality of patients with high NLR was 28% compared to 15.7% of the group with normal NLR, and the mortality was 35.7% in those with high PLR and 15.6% in those with normal PLR. In the crude analysis, the high NLR and PLR were significantly associated with all-cause mortality (HR = 2.01; 95% CI 1.11–3.66) and (HR = 2.58; 95% CI 1.31–5.20). In the multivariate model, after adjusting for age, sex, serum creatinine, albumin and hemoglobin, the high NLR and PLR remained as independent risk factors for all-cause mortality (aHR = 1.97; 95% CI 1.05–3.69) and (aHR = 2.62; 95% CI 1.25–5.51), respectively.

Conclusion

Our study suggests the relationship between high NLR and PLR with all-cause mortality in patients with CKD.
Cannabis-only use in the USA: prevalence, demographics, use patterns, and health indicators
Authors: Carlini Beatriz H. , Schauer Gillian L.
Published: July 2022

Background

The prevalence of adults who consume cannabis while abstaining from other substances is not known in the USA. This study used nationally representative data to estimate the prevalence and explore the demographic characteristics, cannabis use behaviors, and self-reported health of US adults with past 30-day cannabis-only use, as compared with adults who used cannabis as well as other substances.

Methods

Data came from adults 18 years and older who responded to the 2017 or 2018 National Survey on Drug Use and Health and reported past 30-day cannabis use (n = 12,143). Cannabis-only use was defined as past 30-day cannabis use with no past 30-day use of other substances (alcohol, tobacco, other illicit substances, non-prescribed controlled medications). Weighted frequencies and 95% confidence intervals (CI) were computed for all sociodemographic and cannabis-related variables, overall, and across the two categories of cannabis consumers, stratified by age.

Results

The prevalence of past 30-day cannabis-only use among US adults was 0.9% (95% CI: 0.8, 1.0) and varied by age (2.0% of 18–25 years old; 0.7% of 26–49 year olds, and 0.6% of those ≥ 50 years). Among adults with any past 30-day cannabis use, 8.4% (95% CI: 7.6, 9.2; n = 980) reported cannabis-only use. Age was significantly associated with past 30-day cannabis-only use, with adults 18–25 years and 26–49 years having higher odds of cannabis-only use compared with older adults. Past year cannabis dependence was lowest among cannabis-only consumers aged ≥ 50 years (0.2%; 95% CI: 0.1, 0.5) and highest among young adult cannabis and other substance consumers (16.7%; 95% CI: 15.3, 18.2). Past year prevalence of any mental illness was generally similar across cannabis use groups and by age.

Conclusions

The prevalence of adult cannabis-only use in the US is low — most cannabis consumers report using other substances in the past 30 days as well. While cannabis-only use among older adults is rare, it does not appear to be accompanied by a high prevalence of dependence. These findings should guide future research and policymaking.
Ventilator-induced lung injury results in oxidative stress response and mitochondrial swelling in a mouse model
Authors: Joelsson Jon Petur , Asbjarnarson Arni , Sigurdsson Snaevar , Kricker Jennifer , Valdimarsdottir Bryndis , Thorarinsdottir Holmfridur , Starradottir Eir , Gudjonsson Thorarinn , Ingthorsson Saevar , Karason Sigurbergur
Published: July 2022

Background

Mechanical ventilation is a life-saving therapy for critically ill patients, providing rest to the respiratory muscles and facilitating gas exchange in the lungs. Ventilator-induced lung injury (VILI) is an unfortunate side effect of mechanical ventilation that may lead to serious consequences for the patient and increase mortality. The four main injury mechanisms associated with VILI are: baro/volutrauma caused by overstretching the lung tissues; atelectrauma, caused by repeated opening and closing of the alveoli resulting in shear stress; oxygen toxicity due to use of high ratio of oxygen in inspired air, causing formation of free radicals; and biotrauma, the resulting biological response to tissue injury, that leads to a cascade of events due to excessive inflammatory reactions and may cause multi-organ failure. An often-overlooked part of the inflammatory reaction is oxidative stress. In this research, a mouse model of VILI was set up with three tidal volume settings (10, 20 and 30 mL/kg) at atmospheric oxygen level. Airway pressures and heart rate were monitored and bronchoalveolar lavage fluid (BALF) and lung tissue samples were taken.

Results

We show a correlation between increased inflammation and barrier failure, and higher tidal volumes, evidenced by increased IL-6 expression, high concentration of proteins in BALF along with changes in expression of adhesion molecules. Furthermore, swelling of mitochondria in alveolar type II cells was seen indicating their dysfunction and senescence-like state. RNA sequencing data present clear increases in inflammation, mitochondrial biogenesis and oxidative stress as tidal volume is increased, supported by degradation of Keap1, a redox-regulated substrate adaptor protein.

Conclusions

Oxidative stress seems to be a more prominent mechanism of VILI than previously considered, indicating that possible treatment methods against VILI might be identified by impeding oxidative pathways.
The consequence of the credit risk on the financial performance in light of COVID-19: Evidence from Islamic versus conventional banks across MEA region
Authors: Ahmed Hussien Mohsen , El-Halaby Sherif Ismail , Soliman Hebatallah Ahmed
Published: July 2022

Purpose

The increased number of nonperforming loans (NPLs) during COVID-19 pandemic has interrogated the robustness of banks and stability of the whole banking segment. We examine the impact of credit risk (CR) on financial performance (FP) by comparing Islamic banks (IBs) to conventional banks (CBs). We also investigate the influence of COVID-19 on this association.

Design/methodology/approach

Our sample includes the largest 200 banks across 15 countries from the Middle East and the Africa (MEA) region over a four-year period (2018–2021). Panel ordinary least squares (OLS) with fixed and random effects were used.

Findings

We find a negative association between NPLs and FP for IBs and CBs. We reveal that COVID-19 is partially mediated the association between NPLs and FP in case of the whole sample and separated sample of CBs while not in case of IBs.

Originality

The evidence of CR and FP on samples of financial sector across MEA region has not been studied in the era of COVID-19 as far as we know.

Research limitations/implications

This study contributes to the knowledge of the risk and financial performance during the crisis nexus and provides information that is valued to bankers, academics, managers and regulators for policy formulation.