bluuebunny/crossref_metadata_2025 huggingface dataset:
Utilization of technology-enhance learning tools among vocational and technical education teachers in Nigerian tertiary institutions
Authors: Benedict Ohanu Ifeanyi , Chukwugozie Osinem Emmanuel , Ekpereka Ibezim Nnenna , Adaobi Chukwuone Chiamaka , Eleazar Ejiofor Toochukwu , Tobias Orji Chibueze , Ojang Okadi Ashagwu , Ogechi Nwandu Lilian
Published: April 2024

The study determined training needs of teachers and issues in the utilization of Technology-enhanced Learning tools in Vocational and Technical Education in Nigerian tertiary institutions. Five research questions and one hypothesis guided the study. The sample for the study is 318 teachers from six tertiary institutions that offer majority of Vocational and Technical Education programmes in Nigeria. Instrument for data collection was developed by the researchers and was validated by five experts in Vocational and Technical Education. The overall reliability index of the instrument is 0.81. Results from collected data revealed that the teachers require training to enable them use Technology-enhanced Learning tools for instructional delivery; the current mode of instructional delivery in institutions is face-to-face approach; many institutions have Information and Communication Technology center and institution wide internet which are not effectively utilized for instructional delivery, among numerous other findings. Among the recommendations is that teachers should be given access to the available Technology-enhanced Learning facilities in their institutions to enable them learn how to use them at their own free times. It was concluded that most VTE teachers are eager to deploy Technology-enhanced Learning tools for instructional delivery but some institutional supports they need, especially trainings are inadequate.
The future’s impossible disciplines
Authors: Allahyari Keyvan
Published: April 2024

In this commentary, I want to stay with three questions: where exactly are we talking about when we are talking about the geographies of the impossible? Is speculative method necessarily transformative? What happens when we base our vision for future research on seeking new territory rather than examining regimes of production of our own geographical knowledge?
Self-directed Learning Ability and Shadow Education Expenditures: A Comparison of Impact on Student Achievement in Korea During COVID-19
Authors: Yoo Jisung
Published: April 2024

This study examines the impact of students’ self-directed learning (SDL) ability and parental expenditures for shadow education, and other factors, on academic achievement in South Korea during the pandemic. Busan Education Longitudinal Study panel data for 2019 (pre-COVID) and 2020–2021 (COVID) were utilized. National exam scores of middle and high school students in Korean, English, and math subject areas were analyzed using multiple regression, random effects, and two-way random effects models. The analysis revealed that, during the pandemic, parents’ high expenditures to provide shadow education to complement their children’s public education did not significantly influence academic achievement. In contrast, SDL ability was found to have a significant impact on achievement in all three subject areas during the pandemic. The findings underscore the importance of programs, policies, and teaching strategies that develop students’ SDL skills to enable them to learn on their own when a crisis restricts traditional teacher-guided classroom instruction.
Not All Emissions Are Created Equal: Multidimensionality in Nations’ Greenhouse Gas Emissions and the Affluence/Emissions Nexus
Authors: Huang Xiaorui
Published: April 2024

This study proposes a multidimensional emissions profile (MEP) framework, aiming to analyze how a broad social force systematically and heterogeneously affects four emission components of nations: (1) emissions generated by domestic-oriented supply chain activities, (2) emissions embodied in imports, (3) emissions embodied in exports, and (4) direct emissions of end-user activities. I implement a multiregional input-output approach to operationalize these emission components. Using the MEP framework and dynamic fixed-effects models with the seemingly unrelated regression estimator, I find these four emission components are heterogeneously related to national affluence in high-income nations. As these nations become even wealthier, affluence is gradually decoupled from emissions generated by domestic-oriented supply chain activities and direct end-user emissions, yet it remains strongly coupled with the other two emission components in distinct ways. The findings demonstrate the MEP framework’s utility and contribute a multidimensional perspective to the debate on the economic development–climate change relationship.
A Novel Curriculum for Internal Medicine Residents to Care for High-Need, High-Cost Patients
Authors: Khalili Joshua , Jeong Jiyeon , Tibbe Tristan D , Sim Myung-Shin , Yoo Sun M
Published: April 2024

OBJECTIVES

High-need, high-cost (HNHC) patients represent a small proportion of patients in the US, but result in disproportionately higher healthcare utilization. Teaching Internal Medicine (IM) resident trainees to provide high value care for HNHC patients is critical. We sought to improve resident attitudes and increase clinical skills associated with treating HNHC patients by creating a curriculum that leveraged the UCLA Extensivist Program, a patient-centered medical home for HNHC patients.

METHODS

We developed a curriculum for PGY-2 and PGY-3 IM residents centered on caring for HNHC patients over the course of 6, 4h sessions during 1 academic year. Participants completed pre- and post-intervention surveys assessing self-rated attitudes and skills associated with caring for an HNHC patient population.

RESULTS

Twenty-one IM residents completed the curriculum and 41 were in the control group. There were no statistically significant differences in assessed attitudes and skills, but there were trends of improvement, including a decrease in participants who agreed or strongly agreed they felt overwhelmed when seeing patients for posthospital discharge follow up (45.0% pre- to 41.7% post-intervention) and an increase in participants who agreed or strongly agreed they have the skills to successfully transition HNHC patients between inpatient and ambulatory settings (20.0% pre- to 33.3% post-intervention). Participants reported better understanding of resources available to HNHC patients, effective coordination of transitions of care, and comprehensive assessment of social determinants of health.

CONCLUSION

A curriculum to improve resident attitudes and skills associated with caring for HNHC patients was successfully implemented in an IM program at a large academic medical center. The curriculum may be adapted for other training programs; long-term training woven throughout training may be important to significantly improve resident education on how to care for HNHC patients.
Morphosyntactic skills in Arabic-speaking children with autism spectrum disorder: Evidence from error patterns in the sentence repetition task
Authors: Abd El-Raziq Muna , Meir Natalia , Saiegh-Haddad Elinor
Published: April 2024

Background and aims

Although autism spectrum disorder (ASD) has not traditionally been associated with morphosyntactic impairments, some children with ASD manifest significant difficulties in this domain. Sentence Repetition (SRep) tasks are highly reliable tools for detecting morphosyntactic impairment in different languages and across various populations, including children with ASD. This study is among the first to evaluate morphosyntactic abilities of Palestinian-Arabic (PA) speaking children using a PA SRep task.

Methods

A total of 142 PA-speaking children, aged 5-11, participated in the study: 75 children with typical language development (TLD) and 67 children with ASD. The PA SRep task targeted morphosyntactic structures of varying complexity (simple subject-verb-object [SVO] sentences, biclausal sentences, wh -questions, relative clauses). Children’s accuracy scores were assessed across these structures and error patterns encompassing morphosyntactic and pragmatic aspects were analyzed.

Results

Two subgroups of ASD emerged: 43% showed age-appropriate language skills (ASD  +  NL) pairing up with TLD peers, while 57% showed signs of morphosyntactic impairment (ASD  +  LI). Children in both groups exhibited a higher frequency of morphosyntactic errors than pragmatic ones. Children with ASD  +  LI showed difficulties with producing complex morphosyntactic structures, such as relative clauses and object wh-questions. Error analysis revealed that children in the ASD  +  LI group produced sentence fragments and simplified constructions when complex structures were targeted.

Conclusions

The current study extends the cross-linguistic evidence of the heterogeneity of morphosyntactic profiles in children with ASD to Arabic-speaking children. Error analysis indicates that poor morphosyntax, rather than pragmatics, challenges children's performance on the SRep task.

Implications

Our results emphasize the importance of comprehensive language assessment in children with ASD and underscore the need for tailored intervention plans targeting impaired morphosyntactic structures in some children with ASD.
High-order simulation of geological domains and effects on stochastic long-term planning of mining complexes
Authors: Morales Daniel , Dimitrakopoulos Roussos
Published: April 2024

Stochastic long-term mine planning has evolved to account for different sources of uncertainty. Typically, the uncertainty and local variability of boundaries in geological domains have been overlooked by experts through their deterministic interpretation of available data. Categorical attributes are used to model geological domains, and their stochastic simulation accounts for the mentioned issues. The ability of two-points simulation methods to reproduce complex patterns or the requirement of a training image in multiple-points simulation methods has limited their implementation in mining environments. The high-order simulation of categorical attributes presents a mathematically consistent framework that overcomes these limitations by using high-order spatial statistics from sample data. The case study at a gold mining complex shows two stochastic mine plans based on two sets of geological realisations: geological domains in the first set are modelled using conventional wireframes, while, in the second, they are simulated through the high-order method. The resulting mine plans are substantially different; while both plans present a similar quantity of metal recovered and lifespan, risk profiles are up to 40% wider, and the expected NPV is 20% higher for the case of simulated geological domains, given the decrease of waste handling costs and the corresponding reduction in environmental footprint.
Joint stochastic optimisation of stope layout, production scheduling and access network
Authors: Penadillo Cristina , Dimitrakopoulos Roussos , Kumral Mustafa
Published: April 2024

The three main optimisation components of sublevel stoping methods are stope layout, production schedule (or stope sequencing) and access networks. The joint optimisation of these components could further add value to an underground mining project. This potential has not been considered in the literature due to computational difficulties, and the problem was solved sequentially. This paper proposes a new joint optimisation model to integrate these components. In addition, the proposed optimisation model incorporates stochastic simulations to capture uncertainty and variability associated with the grades of the related mineral deposits mined. The optimisation model is based on a two-stage stochastic integer programming (SIP) formulation that maximises the project's net present value (NPV) and minimises the planned dilution. Applying the proposed method at a small copper deposit shows that the SIP outperforms the results obtained from mixed integer programming. For a seven-year mine life, the SIP model generated ∼20% more NPV, demonstrating the importance of developing a joint optimisation formulation and accounting for grade uncertainty and variability.
Association between pathological positivity rate of endometriosis, demographics, and concomitant gynecological conditions
Authors: Moiño Daniela , Sarkar Papri , Al Jumaily Maha , Malak Samantha , Tanner Jean Paul , Mikhail Emad
Published: April 2024

Background:

To date, there remains a paucity of present-day literature on the topic of demographics and the biopsy-proven pathological positivity rate of endometriosis.

Objective:

The goal of this study was to explore the association between patients’ demographics and other concomitant gynecological conditions or procedures and the pathological positivity rate of excision of endometriosis.

Design:

Retrospective cohort study.

Methods:

All women >18 years old who underwent laparoscopic surgery for endometriosis at a tertiary care hospital from October 2011 to October 2020. Women were classified into two groups: (1) Study group: women with >80% pathological positivity rate of endometriosis and (2) Control group: women with <80% pathological positivity rate.

Results:

A total of 401 women were included in the analysis. No difference was noted in the 80% pathological positivity rate based on body mass index [BMI; 68.7% in normal BMI versus 80% in underweight, versus 74.5% in overweight, and 74.1% in obese patients ( p = 0.72)]. The percentage of patients reaching 80% pathological positivity of endometriosis was lower in women who had undergone previous laparoscopy for endometriosis compared to surgery naïve women (66.5% versus 76.5%, p = 0.03). In addition, a higher percentage of women who underwent concomitant hysterectomy (83.5% versus 68.8% for non-hysterectomy, p = 0.005) or bilateral oophorectomy (92.7% versus 70.0% for non-oophorectomy, p = 0.002) reached 80% pathological positivity. Women with an associated diagnosis of fibroids (79.7% versus 70.5%) or adenomyosis (76.4% versus 71.7%) were more likely to reach 80% pathological positivity compared to women without any other coexisting pathology; however, the observed differences were not statistically significant. After applying a log-binomial regression model, compared to White non-Hispanics, Hispanic patients were 30% less likely to reach 80% positivity (RR: 0.70, 95% CI: 0.49–1.02), although not statistically significant.

Conclusion:

No significant racial difference was found when comparing the rates of 80% pathological positivity of suspected endometriosis lesions among groups. Endometriosis pathological positivity rate was unaffected by patients’ BMI and the presence of concomitant pathologies. In addition, prior laparoscopic surgery for endometriosis might cause tissue changes that result in a decrease in the observed pathological positivity rate of endometriosis lesions during subsequent surgeries.
Project Governance and Governance of Interorganizational Project Networks: Toward Understanding Their Relationships and Future Research Agenda
Authors: Wang Linzhuo , Wang Xinnan , Liu Xuemei
Published: April 2024

This article considers and reflects upon the mark that Ralf Müller made through his published research on project governance. From project governance to governance of interorganizational project networks, Müller, along with his coauthors, has made significant contributions to project governance literature. In light of these two decades of theoretical development, we compare and synthesize the key elements of project governance and network governance. We provide a model that integrates project governance and network governance and propose several main themes for future research, including investigation of network governors, network governance design, mechanisms and principles, and its impact on improved project performance.
Interlocking intramedullary nail for forearm diaphyseal fractures in adults—A systematic review and meta-analysis of outcomes and complications
Authors: Lari Ali , Hassan Yousef , Altammar Abdulwahab , Esmaeil Ali , Altammar Abdulaziz , Prada Carlos , Jarragh Ali
Published: April 2024

Purpose

The purpose of this systematic review is to examine the outcomes, complications, and potential advantages of using anatomical interlocking intramedullary nails (IMN) in the treatment of radius and ulnar shaft diaphyseal fractures in adults.

Methods

Medline, Embase, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched between January 2000 and January 2023. Studies meeting criteria were observational or randomized controlled trials evaluating outcomes in IMN for adult diaphyseal forearm fractures. Standardized data extraction was performed and a quality assessment tool was used to evaluate individual study methodology. Descriptive statistics for interventions, functional outcomes, and complications were reported. Meta-analysis was performed for patient-reported outcome measures and operative time.

Results

A total of 29 studies involving 1268 patients were included with 764 (60%) undergoing IMN, 21% open reduction and internal fixation (ORIF), and 9% hybrid fixation. There was no significant difference between groups in DASH and Grace–Eversmann scores. Operative time was significantly shorter in IMN compared with ORIF. The DASH scores were: 13.1 ± 6.04 for IMN, 10.17 ± 3.98 for ORIF, and 15.5 ± 0.63 in hybrids. Mean operative time was 65.3 ± 28.7 in ORIF and 50.8 ± 17.7 in IMN. Complication rates were 16.7% in the IMN group, 14.9% in ORIF, and 6.3% in hybrid constructs. There were 11 cases of extensor pollicis rupture in the IMN group. Average IMN pronation and supination were 78.3° ± 7.9° and 73° ± 5.0°, respectively. Average ORIF pronation and supination was 82.15° ± 1.9° and 79.7° ± 4.5°, respectively.

Conclusions

Similar functional outcomes and complication rates along with shorter operative times can be achieved with IMN compared with ORIF. The use of IMN is promising, however, higher quality evidence is required to assess appropriate indications, subtle differences in range of motion, implant-related complications, and cost-effectiveness.

Trail Registration PROSPERO (International Prospective Register of Systematic Reviews) (ID: CRD42022362353).

Level of evidence III.
New investigation of encoding secondary metabolites gene by genome mining of a marine bacterium, Pseudoalteromonas viridis BBR56
Authors: Handayani Desy Putri , Isnansetyo Alim , Istiqomah Indah
Published: April 2024

Pseudoalteromonas viridis strain BBR56 was isolated from seawater at Dutungan Island, South Sulawesi, Indonesia. Bacterial DNA was isolated using Promega Genomic DNA TM050. DNA purity and quantity were assessed using NanoDrop spectrophotometers and Qubit fluorometers. The DNA library and sequencing were prepared using Oxford Nanopore Technology GridION MinKNOW 20.06.9 with long read, direct, and comprehensive analysis. High accuracy base calling was assessed with Guppy version 4.0.11. Filtlong and NanoPlot were used for filtering and visualizing the FASTQ data. Flye (2.8.1) was used for de novo assembly analysis. Variant calls and consensus sequences were created using Medaka. The annotation of the genome was elaborated by DFAST. The assembled genome and annotation were tested using Busco and CheckM. Herein, we found that the highest similarity of the BBR56 isolate was 98.37% with the 16 S rRNA gene sequence of P. viridis G-1387. The genome size was 5.5 Mb and included chromosome 1 (4.2 Mbp) and chromosome 2 (1.3 Mbp), which encoded 61 pseudogenes, 4 noncoding RNAs, 113 tRNAs, 31 rRNAs, 4,505 coding DNA sequences, 4 clustered regularly interspaced short palindromic repeats, 4,444 coding genes, and a GC content of 49.5%. The sequence of the whole genome of P. viridis BBR56 was uploaded to GenBank under the accession numbers CP072425–CP072426, biosample number SAMN18435505, and bioproject number PRJNA716373. The sequence read archive (SRR14179986) was successfully obtained from NCBI for BBR56 raw sequencing reads. Digital DNA–DNA hybridization results showed that the genome of BBR56 had the potential to be a new species because no other bacterial genomes were similar to the sample. Biosynthetic gene clusters (BGCs) were assessed using BAGEL4 and the antiSMASH bacterial version. The genome harbored diverse BGCs, including genes that encoded polyketide synthase, nonribosomal peptide synthase, RiPP-like, NRP-metallophore, hydrogen cyanide, betalactone, thioamide-NRP, Lant class I, sactipeptide, and prodigiosin. Thus, BBR56 has considerable potential for further exploration regarding the use of its secondary metabolite products in the human and fisheries sectors.
Optimizing nutrient solution for vegetative growth of Dendrobium Tubtim Siam and Phalaenopsis Taisuco Swan through plant tissue nutrient balance estimation
Authors: Costa Milton G. , Mantovani Cibele , de Mello Prado Renato
Published: April 2024

Background

Orchids are grown without soil in many regions of the world, but there is a lack of studies to define the balanced and adequate nutrient solution for their cultivation, mainly in the vegetative growth phase. Therefore, this paper aims to evaluate the optimal concentration of the nutrient solution based on the proposal by Hoagland and Arnon (1950) in the vegetative growth phase capable of increasing the nutrient contents, growth, and dry matter production of Dendrobium Tubtim Siam and Phalaenopsis Taisuco Swan. In addition, this paper aims to estimate a new nutrient solution from the optimal nutrient contents in the dry matter of these orchid species to be used in the vegetative growth phase.

Results

Nutrient contents, growth, and dry matter production increased as the nutrient solution concentration increased up to an average concentration of 62 and 77% for D. Tubtim Siam and P. Taisuco Swan, respectively. We found that the Hoagland and Arnon solution presented a group of nutrients with concentrations above the requirement for P. Taisuco Swan (nitrogen, phosphor, calcium, and sulfur) and D. Tubtim Siam (phosphor, calcium, magnesium, and sulfur), while other nutrients in the solution did not meet the nutritional demand of these orchid species, inducing nutritional imbalance in the vegetative growth phase.

Conclusion

We conclude that using a balanced nutrient solution created specifically for each orchid species in vegetative growth might favor their sustainable cultivation by optimizing the use of nutrients in the growing medium.
Foliar-applied silicate potassium modulates growth, phytochemical, and physiological traits in Cichorium intybus L. under salinity stress
Authors: Mohammadi Hamid , Abdollahi-Bastam Soraya , Aghaee Ahmad , Ghorbanpour Mansour
Published: April 2024

One of the major problems endangering plant growth and productivity worldwide is salt stress. This study aimed to assess the effects of potassium silicate (K2O3Si) on the physical, biochemical, and morphological characteristics of chicory (Cichorium intybus L.) under various levels of salinity stress. The plants were treated with K2O3Si at concentrations of 0, 1, 2, and 3 mM and cultivated under different salt stress conditions (0, 80, 160, and 240 mM NaCl). The findings revealed that salt stress led to decreased root and shoot dry weights, Fv/Fm ratio, chlorophyll a, b, and total chlorophyll, as well as inulin contents. However, foliar exposure to K2O3Si at all salinity levels resulted in improvements in the measured traits. As salinity levels increased, there was a corresponding increase in the accumulation of sodium ions (Na+) and a sharp reduction in potassium ions (K +) in the shoot. Nonetheless, treatment with K2O3Si caused a decrease in Na + accumulation and an improvement in K+ content under all salinity levels. Carotenoid content increased under 80 mM salinity stress, but decreased with higher salinity levels. Application of K2O3Si at all levels resulted in increased carotenoid content under salinity stress conditions. The content of MDA increased significantly with increasing salinity stress, particularly at 240 mM. However, foliar spraying with K2O3Si significantly decreased MDA content at all salinity levels. Salinity stress up to 160 mM increased the total phenol, flavonoid, and anthocyanin contents, while 240 mM NaCl decreased the biosynthesis of phytochemicals. Additionally, the use of K2O3Si increased the content of total phenol, flavonoid, and anthocyanin at all salt levels. Foliar application of K2O3Si increased the tolerance of chicory plants to salinity stress by reducing MDA and increasing phenolic compounds and potassium content. These results suggest that exogenous K2O3Si can be a practical strategy to improve the growth and yield of chicory plants exposed to saline environments.
Anesthesia management for a child with the Koolen-de Vries syndrome: a case report
Authors: Zhao Yuyi , Zuo Yunxia
Published: April 2024

Background

The Koolen-de Vries syndrome (KdVS) is a relatively new rare disease caused by micro-deletion of 17q21.31 which was first reported by Koolen in 2006. Typical phenotypes for KdVS include hypotonia, developmental delay, moderate intellectual disability, and characteristic facial dysmorphism. Up to now, there was only one case report about anesthesia management of patient diagnosed KdVS. It was a 2-year-old girl who experienced an MRI exam under anesthesia.

Case presentation

We described a 21-month-old boy who planned to undergo an orchidopexy under general anesthesia diagnosed with KdVS. He had an intellectual disability, characteristic facial dysmorphism, tracheo/laryngomalacia, patent foramen ovale, and cryptorchidism related to KdVS. Due to the complex condition especially the presence of tracheo/laryngomalacia, we took some special measures, including reducing the amount of long-acting opioid, keeping the spontaneous breath, performing a caudal block, and applying the laryngeal mask. But the laryngeal mask was changed to an endotracheal tube because it failed to provide adequate ventilation. The boy experienced mild laryngeal spasm and hypoxia after extubation, but lateral position and etomidate eased his breathing problem and re-intubation was avoided. It is indicated that anesthesia management for patients with orphan disease is a real challenge for all anesthesia providers.

Conclusions

The Koolen-de Vries syndrome is a relatively new orphan disease involving multiple systems. Keeping spontaneous breath, evaluating airway potency to anesthetics, applying endotracheal tube, and post-extubation lateral or prone position may be helpful for airway management for patient with hypotonia and tracheo/laryngomalacia. KdVS patient needs prolonged post-anesthesia monitoring and/or medication for airway complications.
Serum PM20D1 levels in patients with idiopathic pulmonary arterial hypertension and its clinical significance
Authors: Wang Lin , Liu Jiaxiang , Zhou Liufang , Fu Qingmei
Published: April 2024

Objective

This study aimed to investigate the serum levels of Peptidase M20 domain containing 1 (PM20D1) in idiopathic pulmonary arterial hypertension (IPAH) patients and examine its association with lipid metabolism, echocardiography, and hemodynamic parameters.

Methods

This prospective observational research enrolled 103 IPAH patients from January 2018 to January 2022. Enzyme-linked immunosorbent assay (ELISA) was used to measure the serum PM20D1 levels in all patients before treatment within 24 h of admission. Demographic data, echocardiography, hemodynamic parameters and serum biomarkers were also collected.

Results

The IPAH patients in the deceased group had significantly elevated age, right atrial (RA), mean pulmonary arterial pressure (mPAP), mean right atrial pressure (mRAP), pulmonary capillary wedge pressure (PCWP), pulmonary vascular resistance (PVR) and significantly decreased 6 min walking distance (6MWD) and tricuspid annulus peak systolic velocity (TASPV). IPAH patients showed significant decreases in serum PM20D1, low-density lipoprotein cholesterol (LDL-C), and albumin (ALB). Additionally, PM20D1 was negatively correlated with RA, NT-proBNP and positively correlated with PVR, ALB, 6MWD, and TAPSV. Moreover, PM20D1 has the potential as a biomarker for predicting IPAH patients’ prognosis. Finally, logistic regression analysis indicated that PM20D1, ALB, NT-proBNP, PVR, TASPV, RA and 6MWD were identified as risk factors for mortality in IPAH patients.

Conclusion

Our findings indicated that the serum levels of PM20D1 were significantly decreased in IPAH patients with poor prognosis. Moreover, PM20D1 was identified as a risk factor associated with mortality in IPAH patients.
Beneficial effects of time-restricted fasting on cardiovascular disease risk factors: a meta-analysis
Authors: Qiu Zhengqi , Huang Emma Yun Zhi , Li Yufei , Xiao Ying , Fu Yancheng , Du Jun , Kan Juntao
Published: April 2024

Background

Cardiovascular disease continues to be a leading cause of mortality worldwide, highlighting the need to explore innovative approaches to improve cardiovascular health outcomes. Time-restricted fasting (TRF) is a dietary intervention that involves limiting the time window for food consumption. It has gained attention for its potential benefits on metabolic health and weight management. This study aims to investigate the impact of TRF on key risk factors, including body weight, glucose metabolism, blood pressure, and lipid profile.

Methods

We conducted a systematic search in five databases (Scopus, Embase, PubMed, Cochrane, and Web of Science) for relevant studies up to January 2023. After applying inclusion criteria, 12 studies were eligible for analysis. Quality assessment was conducted using the ROB-2.0 tool and ROBINS-I. Risk of bias was mapped using Revman 5.3, and data analysis included Hartung-Knapp adjustment using R 4.2.2.

Results

The group that underwent the TRF intervention exhibited a significant decrease in body weight (SMD: -0.22; 95%CI: -0.41, -0.04; P < 0.05) and fat mass (SMD: -0.19; 95%CI: -0.36, -0.02; P < 0.05), while maintaining lean mass (SMD: -0.09; 95%CI: -0.08, 0.26; P > 0.05).

Conclusion

TRF has shown potential as a treatment strategy for reducing total body weight by targeting adipose tissue, with potential improvements in cardiometabolic function.
Reevaluating Adiponectin’s impact on obesity hypertension: a Chinese case-control study
Authors: Wu Ou , Lu Xi , Leng Jianhang , Zhang Xingyu , Liu Wei , Yang Fenfang , Zhang Hu , Li Jiajia , Khederzadeh Saber , Liu Xiaodong , Yuan Chengda
Published: April 2024

Background

Obesity and hypertension are major risk factors for cardiovascular diseases that affect millions of people worldwide. Both conditions are associated with chronic low-grade inflammation, which is mediated by adipokines such as adiponectin. Adiponectin is the most abundant adipokine that has a beneficial impact on metabolic and vascular biology, while high serum concentrations are associated with some syndromes. This “adiponectin paradox” still needs to be clarified in obesity-associated hypertension. The aim of this study was to investigate how adiponectin affects blood pressure, inflammation, and metabolic function in obesity hypertension using a Chinese adult case-control study.

Methods

A case-control study that had finished recruiting 153 subjects divided as four characteristic groups. Adiponectin serum levels were tested by ELISA in these subjects among these four characteristic Chinese adult physical examination groups. Waist circumference (WC), body mass index (BMI), systolic blood pressure (SB), diastolic blood pressure (DB), and other clinical laboratory data were collected. Analyzation of correlations between the research index and differences between groups was done by SPSS.

Results

Serum adiponectin levels in the| normal healthy group (NH group) were significantly higher than those in the newly diagnosed untreated just-obesity group (JO group), and negatively correlated with the visceral adiposity index. With multiple linear egression analysis, it was found that, for serum adiponectin, gender, serum albumin (ALB), alanine aminotransferase (ALT) and high-density lipoprotein cholesterol (HDLC) were the significant independent correlates, and for SB, age and HDLC were the significant independent correlates, and for DB, alkaline phosphatase (ALP) was the significant independent correlate. The other variables did not reach significance in the model.

Conclusions

Our study reveals that adiponectin’s role in obesity-hypertension is multifaceted and is influenced by the systemic metabolic homeostasis signaling axis. In obesity-related hypertension, compensatory effects, adiponectin resistance, and reduced adiponectin clearance from impaired kidneys and liver all contribute to the “adiponectin paradox”.
Inflammatory bowel disease patients’ perspectives of non-medical needs
Authors: Norouzkhani Narges , Faramarzi Mahbobeh , Bahari Ali , Shirvani Javad Shokri , Eslami Saeid , Tabesh Hamed
Published: April 2024

Background

Inflammatory bowel disease (IBD) imposes a huge burden on the healthcare systems and greatly declines the patient’s quality of life. However, there is a paucity of detailed data regarding information and supportive needs as well as sources and methods of obtaining information to control different aspects of the disease from the perspectives of the patients themselves. This study aimed to establish the IBD patients’ preferences of informational and supportive needs through Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA).

Methods

IBD patients were recruited from different centers. Considering inclusion and exclusion criteria, 521 participants were filled a predefined questionnaire. This questionnaire was prepared through literature review of the recent well-known guidelines on the needs of IBD patients, which was further approved by the experts of IBD area in three rounds of Delphi consensus. It includes 56 items in four sections of informational needs (25), supportive needs (15), sources of information (7), and methods of obtaining information (9).

Results

In particular, EFA was used to apply data reduction and structure detection. Given that this study tries to identify patterns, structures as well as inter-relationships and classification of the variables, EFA was utilized to simplify presentation of the variables in a way that large amounts of observations transform into fewer ones. Accordingly, the EFA identified five factors out of 25 items in the information needs section, three factors out of 15 items in the supportive needs section, two factors out of 7 items in the information sources section, and two factors out of 9 items in the information presentation methods. Through the CFA, all 4 models were supported by Root Mean Squared Error of Approximation (RMSEA); Incremental Fit Index (IFI); Comparative Fit Index (CFI); Tucker-Lewis Index (TLI); and SRMR. These values were within acceptable ranges, indicating that the twelve factors achieved from EFA were validated.

Conclusions

This study introduced a reliable 12-factor model as an efficient tool to comprehensively identify preferences of IBD patients in informational and supportive needs along with sources and methods of obtaining information. An in-depth understanding of the needs of IBD patients facilitates informing and supporting health service provision. It also assists patients in a fundamental way to improve adaptation and increase the quality of life. We suggest that health care providers consider the use of this tool in clinical settings in order to precisely assess its efficacy.
The feasibility of half-dose contrast-enhanced scanning of brain tumours at 5.0 T: a preliminary study
Authors: Jiang Zhiyong , Sun Wenbo , Xu Dan , Mei Hao , Yuan Jianmin , Song Xiaopeng , Ma Chao , Xu Haibo
Published: April 2024

Purpose

This study investigated and compared the effects of Gd enhancement on brain tumours with a half-dose of contrast medium at 5.0 T and with a full dose at 3.0 T.

Methods

Twelve subjects diagnosed with brain tumours were included in this study and underwent MRI after contrast agent injection at 3.0 T (full dose) or 5.0 T (half dose) with a 3D T1-weighted gradient echo sequence. The postcontrast images were compared by two independent neuroradiologists in terms of the signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and subjective image quality score on a ten-point Likert scale. Quantitative indices and subjective quality ratings were compared with paired Student's t tests, and interreader agreement was assessed with the intraclass correlation coefficient (ICC).

Results

A total of 16 enhanced tumour lesions were detected. The SNR was significantly greater at 5.0 T than at 3.0 T in grey matter, white matter and enhanced lesions (p < 0.001). The CNR was also significantly greater at 5.0 T than at 3.0 T for grey matter/tumour lesions, white matter/tumour lesions, and grey matter/white matter (p < 0.001). Subjective evaluation revealed that the internal structure and outline of the tumour lesions were more clearly displayed with a half-dose at 5.0 T (Likert scale 8.1 ± 0.3 at 3.0 T, 8.9 ± 0.3 at 5.0 T, p < 0.001), and the effects of enhancement in the lesions were comparable to those with a full dose at 3.0 T (7.8 ± 0.3 at 3.0 T, 8.7 ± 0.4 at 5.0 T, p < 0.001). All subjective scores were good to excellent at both 5.0 T and 3.0 T.

Conclusion

Both quantitative and subjective evaluation parameters suggested that half-dose enhanced scanning via 5.0 T MRI might be feasible for meeting clinical diagnostic requirements, as the image quality remains optimal. Enhanced scanning at 5.0 T with a half-dose of contrast agents might benefit patients with conditions that require less intravenous contrast agent, such as renal dysfunction.
Childhood and adolescence factors and multiple sclerosis: results from the German National Cohort (NAKO)
Authors: Holz Anja , Obi Nadia , Ahrens Wolfgang , Berger Klaus , Bohn Barbara , Brenner Hermann , Fischer Beate , Fricke Julia , Führer Amand , Gastell Sylvia , Greiser Karin Halina , Harth Volker , Heise Jana-Kristin , Holleczek Bernd , Keil Thomas , Klett-Tammen Carolina J. , Leitzmann Michael , Lieb Wolfgang , Meinke-Franze Claudia , Michels Karin B. , Mikolajczyk Rafael , Nimptsch Katharina , Peters Annette , Pischon Tobias , Riedel Oliver , Schikowski Tamara , Schipf Sabine , Schmidt Börge , Schulze Matthias B. , Stang Andreas , Hellwig Kerstin , Riemann-Lorenz Karin , Heesen Christoph , Becher Heiko
Published: April 2024

Background

Multiple Sclerosis (MS) represents the most common inflammatory neurological disease causing disability in early adulthood. Childhood and adolescence factors might be of relevance in the development of MS. We aimed to investigate the association between various factors (e.g., prematurity, breastfeeding, daycare attendance, weight history) and MS risk.

Methods

Data from the baseline assessment of the German National Cohort (NAKO) were used to calculate adjusted hazard ratios (HR) and 95% confidence intervals (CI) for the association between childhood and adolescence factors and risk of MS. Analyses stratified by sex were conducted.

Results

Among a total of 204,273 participants, 858 reported an MS diagnosis. Male sex was associated with a decreased MS risk (HR 0.48; 95% CI 0.41–0.56), while overweight (HR 2.03; 95% CI 1.41–2.94) and obesity (HR 1.89; 95% CI 1.02–3.48) at 18 years of age compared to normal weight were associated with increased MS risk. Having been breastfed for ≤ 4 months was associated with a decreased MS risk in men (HR 0.59; 95% CI 0.40–0.86) compared to no breastfeeding. No association with MS risk was observed for the remaining factors.

Conclusions

Apart from overweight and obesity at the age of 18 years, we did not observe considerable associations with MS risk. The proportion of cases that can be explained by childhood and adolescence factors examined in this study was low. Further investigations of the association between the onset of overweight and obesity in childhood and adolescence and its interaction with physical activity and MS risk seem worthwhile.
PSAT1 enhances the efficacy of the prognosis estimation nomogram model in stage-based clear cell renal cell carcinoma
Authors: Wang Jun , He Xiaoming , Mi Yuanyuan , Chen Yong Q. , Li Jie , Wang Rong
Published: April 2024

Background

Clear cell renal cell carcinoma (ccRCC) is associated with a high prevalence of cancer-related deaths. The survival rates of patients are significantly lower in late-stage ccRCC than in early-stage ccRCC, due to the spread and metastasis of late-stage ccRCC, surgery has not reached the goal of radical cure, and the effect of traditional radiotherapy and chemotherapy is poor. Thus, it is crucial to accurately assess the prognosis and provide personalized treatment at an early stage in ccRCC. This study aims to develop an efficient nomogram model for stratifying and predicting the survival of ccRCC patients based on tumor stage.

Methods

We first analyzed the microarray expression data of ccRCC patients from the Gene Expression Omnibus (GEO) database and categorized them into two groups based on the disease stage (early and late stage). Subsequently, the GEO2R tool was applied to screen out the genes that were highly expressed in all GEO datasets. Finally, the clinicopathological data of the two patient groups were obtained from The Cancer Genome Atlas (TCGA) database, and the differences were compared between groups. Survival analysis was performed to evaluate the prognostic value of candidate genes (PSAT1, PRAME, and KDELR3) in ccRCC patients. Based on the screened gene PSAT1 and clinical parameters that were significantly associated with patient prognosis, we established a new nomogram model, which was further optimized to a single clinical variable-based model. The expression level of PSAT1 in ccRCC tissues was further verified by qRT-PCR, Western blotting, and immunohistochemical analysis.

Results

The datasets GSE73731, GSE89563, and GSE150404 identified a total of 22, 89, and 120 over-expressed differentially expressed genes (DEGs), respectively. Among these profiles, there were three genes that appeared in all three datasets based on different stage groups. The overall survival (OS) of late-stage patients was significantly shorter than that of early-stage patients. Among the three candidate genes (PSAT1, PRAME, and KDELR3), PSAT1 was shown to be associated with the OS of patients with late-stage ccRCC. Multivariate Cox regression analysis showed that age, tumor grade, neoadjuvant therapy, and PSAT1 level were significantly associated with patient prognosis. The concordance indices were 0.758 and 0.725 for the 3-year and 5-year OS, respectively. The new model demonstrated superior discrimination and calibration compared with the single clinical variable model. The enhancer PSAT1 used in the new model was shown to be significantly overexpressed in tissues from patients with late-stage ccRCC, as demonstrated by the mRNA level, protein level, and pathological evaluation.

Conclusion

The new prognostic prediction nomogram model of PSAT1 and clinicopathological variables combined was thus established, which may provide a new direction for individualized treatment for different-stage ccRCC patients.
Real-world evidence of treatment patterns and survival of metastatic gastric cancer patients in Germany
Authors: Luna Jaime , Picker Nils , Wilke Thomas , Lutz Magnus , Hess Jürgen , Mörtl Bernhard , Xiong Yan , Götze Thorsten Oliver
Published: April 2024

Background

Patients with metastatic gastric cancer (mGC) have poor prognosis. This real-world study aimed to describe treatment regimens and survival of mGC patients.

Methods

A retrospective analysis was conducted using anonymized German claims data (AOK PLUS) covering a period from 2010 to 2021. The study population included newly diagnosed mGC cases identified from 2011 to 2020. The index date was defined as the first diagnosis of metastasis on or after gastric cancer diagnosis. Therapy regimens were identified based on inpatient and outpatient data, and subsequently stratified by line of treatment. Survival analyses were conducted using the Kaplan–Meier method.

Results

The cohort consisted of 5,278 mGC incident cases (mean age: 72.7 years; male: 61.9%). Nearly half of the incident cases received mGC-related treatment (49.8%). Treated patients were more often male, younger, and had fewer comorbidities compared to untreated patients. Of the 2,629 mGC patients who started the first line of treatment (1LOT), 32.8% switched to 2LOT, and 10.2% reached 3LOT. Longer survival time was observed among disease-specific treated cases compared with untreated cases (median real-world overall survival (rwOS): 12.7 months [95%CI 12.1 – 13.3 months] vs. 3.7 months [95%CI 3.4 – 4.0 months]).

Conclusion

Systemic therapy was not received in almost half of the mGC patients. In those patients, a very short median rwOS was observed. Treatment patterns were generally in line with the guideline recommendations, however, therapy switching rates and poor prognosis indicate high unmet needs also in the treated population.
Spatial-temporal drivers and incidence heterogeneity of hemorrhagic fever with renal syndrome transmission in Shandong Province, China, 2016–2022
Authors: Duan Qing , Wang Yao , Jiang Xiaolin , Ding Shujun , Zhang Yuwei , Yao Mingxiao , Pang Bo , Tian Xueying , Ma Wei , Kou Zengqiang , Wen Hongling
Published: April 2024

Background

Hemorrhagic fever with renal syndrome (HFRS) signals a recurring risk in Eurasia in recent years owing to its continued rise in case notifications and the extension of geographical distribution. This study was undertaken to investigate the spatiotemporal drivers and incidence heterogeneity of HFRS transmission in Shandong Province.

Methods

The epidemiological data for HFRS, meteorological data and socioeconomic data were obtained from China Information System for Disease Control and Prevention, China Meteorological Data Sharing Service System, and Shandong Statistical Yearbook, respectively. The spatial-temporal multicomponent model was employed to analyze the values of spatial-temporal components and the heterogeneity of HFRS transmission across distinct regions.

Results

The total effect values of the autoregressive, epidemic, and endemic components were 0.451, 0.187, and 0.033, respectively, exhibiting significant heterogeneity across various cities. This suggested a pivotal role of the autoregressive component in propelling HFRS transmission in Shandong Province. The epidemic component of Qingdao, Weifang, Yantai, Weihai, and Jining declined sharply at the onset of 2020. The random effect identified distinct incidence levels associated with Qingdao and Weifang, signifying regional variations in HFRS occurrence.

Conclusions

The autoregressive component emerged as a significant driver in the transmission of HFRS in Shandong Province. Targeted preventive measures should be strategically implemented across various regions, taking into account the predominant component influencing the epidemic.