bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Mind Mapping on Jamboard in Tenth-Grade Students Past Tense Mastery
Authors: Badriyah Desy Qomariyatil , Devanti Yeni Mardiyana , Laeli Anita Fatimatul
Published: December 2024

The purpose of this study to investigates the impact of mind mapping in google Jamboard on students' Simple past tense mastery. The instrument used in this research is a multiple-choice test. Quasi-experimental design is a method in this research with a sample of 60 class X MA Darullughah Wal Karomah students who were divided into control and experimental groups. The experimental group received teaching using mind mapping on google Jamboard, while the control group followed traditional teaching methods. The data shows that the average value obtained in the experimental class was 73.07, while in the control class it was 64.69. The research results show that the use of mind mapping in google Jamboard can improve students' simple past tense mastery. Mind mapping is an effective way or method for teaching grammar. Additionally, combining mind mapping with a digital platform like google Jamboard can create a more interactive, fun, and engaging learning environment. research should explore the impact of mind mapping through jamboard on other areas or skills of language learning. This study did not have much time. If the time were longer enough, the finding would be more effective. So, in the future, researchers should have more time to do it and ensure the internet connection is good because if it is bad, it will also take a lot of time
Türk özel güvenlik sektöründe uzmanlaşma
Authors: Demirci Uğur , Uçkun Ceylan Gazi , Konak Orkun , Karakurt Bayram
Published: December 2024

21.Yüzyıl’da, mesleklerin gelişmesi ve bu alanlardaki bilgi birikiminin artmasıyla birlikte mikro uzmanlaşma eğilimi ortaya çıkmıştır. Bu tür uzmanlaşmanın sektörler açısından etkinlik, verimlilik ve ekonomik büyüme gibi birçok pozitif sonuçları bulunmaktadır. Türkiye'de ise, özel güvenlik sektörü önemli büyüklüğe erişmesine rağmen sektörel uzmanlık alanları hakkında bilgi bulunmamaktadır. Bu bağlamda araştırma, Türk özel güvenlik sektöründeki uzmanlık alanlarını tespit etmek üzere gerçekleştirilmiştir. Araştırma keşfedici bir tekli durum çalışmasıdır. Araştırma verisi, şirket kurucusu, şirket yöneticisi, kuruluş yetkilisi, güvenlik sorumlusu, uzman eğitici ve özel güvenlik görevlisinden oluşan 3.230 kişiden toplanmıştır. Veri içerik analizine tabi tutulmuş ve elde edilen 41 kodun yedi tema altında toplandığı tespit edilmiştir. Ayrıca araştırmanın geçerliliğini artırmak amacıyla, elde edilen sonuçlar ayrı bir katılımcı grupla paylaşılarak odak grup görüşmesi gerçekleştirilmiştir.
Digitala verktyg i förskolan - vad, hur och varför?
Authors: Del Gaiso Tove
Published: December 2024

Artikeln beskriver delar av resultat från en praktiknära studie om digitala verktyg i förskolan. I studien har förskollärare prövat olika sätt att undervisa med digitala verktyg med barn mellan 2-5 år. Studien visar bland annat att digitala verktyg är komplexa och att förskollärare behöver möjligheter att föra diskussioner om didaktiska frågor rörande undervisning med digitala teknologier.
Construction and validation of a readmission risk prediction model for elderly patients with coronary heart disease
Authors: Luo Hanyu , Wang Benlong , Cao Rui , Feng Jun
Published: December 2024

Background

To investigate the risk factors for readmission of elderly patients with coronary artery disease, and to construct and validate a predictive model for readmission risk of elderly patients with coronary artery disease within 3 years by applying machine learning method.

Methods

We selected 575 elderly patients with CHD admitted to the Affiliated Lu’an Hospital of Anhui Medical University from January 2020 to January 2023. Based on whether patients were readmitted within 3 years, they were divided into two groups: those readmitted within 3 years (215 patients) and those not readmitted within 3 years (360 patients). Lasso regression and multivariate logistic regression were used to compare the predictive value of these models. XGBoost, LR, RF, KNN and DT algorithms were used to build prediction models for readmission risk. ROC curves and calibration plots were used to evaluate the prediction performance of the model. For external validation, 143 patients who were admitted between February and June 2023 from a different associated hospital in Lu'an City were also used.

Results

The XGBoost model demonstrated the most accurate prediction performance out of the five machine learning techniques. Diabetes, Red blood cell distribution width (RDW), and Triglyceride glucose-body mass index (TyG-BMI), as determined by Lasso regression and multivariate logistic regression. Calibration plot analysis demonstrated that the XGBoost model maintained strong calibration performance across both training and testing datasets, with calibration curves closely aligning with the ideal curve. This alignment signifies a high level of concordance between predicted probabilities and observed event rates. Additionally, decision curve analysis highlighted that both decision trees and XGBoost models achieved higher net benefits within the majority of threshold ranges, emphasizing their significant potential in clinical decision-making processes. The XGBoost model's area under the ROC curve (AUC) reached 0.903, while the external validation dataset yielded an AUC of 0.891, further validating the model's predictive accuracy and its ability to generalize across different datasets.

Conclusion

TyG-BMI, RDW, and diabetes mellitus at the time of admission are the factors affecting readmission of elderly patients with coronary artery disease, and the model constructed based on the XGBoost algorithm for readmission risk prediction has good predictive efficacy, which can provide guidance for identifying high-risk patients and timely intervention strategies.
Cardiovascular risk profile with SCORE2 and SCORE2-OP: comparing Portugal, Spain, Italy, and France using the new European predictive models
Authors: Fontainhas Mariana , Gavina Cristina , Miranda Joana , Pereira-Silva Raquel , Guichard João , Seixas Daniela , Araújo Francisco
Published: December 2024

Introduction

This study aims to characterize the cardiovascular risk profile in countries with low-to-moderate cardiovascular mortality risk (Italy, Portugal, France, and Spain) using the SCORE2 and SCORE2-OP models. It also examines regional variations and the involvement of healthcare professionals in performing risk assessments.

Methods

A retrospective observational study was conducted using data from 24,434 cardiovascular risk assessments performed between December 2022 and July 2023 through a digital application used by physicians. The assessments used the SCORE2 model for individuals aged 40–69 and the SCORE2-OP model for those aged 70 and older. Risk stratification into “low-to-moderate,” “high,” and “very high” categories was analyzed based on individual risk factors such as age, smoking habits, systolic blood pressure, and cholesterol levels.

Results

Approximately 50%–60% of individuals in these countries were classified as having “high” or “very high” cardiovascular risk. The highest proportions were observed in Portugal (62.44%) and Italy (64.05%), while lower proportions were found in Spain (46.65%) and France (52.74%). Regional analysis identified areas with the highest cardiovascular risk, such as Portalegre in Portugal and Apulia in Italy. Key risk factors included older age, smoking, high systolic blood pressure, and high non-HDL cholesterol. General practitioners were the primary healthcare professionals conducting these assessments.

Discussion

The study highlights a significant proportion of individuals with “high” or “very high” cardiovascular risk in countries with low-to-moderate mortality risk. These findings underscore the need for targeted cardiovascular disease prevention strategies and the crucial role of general practitioners in managing cardiovascular risk.
Exploring lower secondary school teachers' perceptions of integrating simulations into chemistry instruction
Authors: Batamuliza Jane , Habinshuti Gonzague , Nkurunziza Jean Baptiste
Published: December 2024

Introduction

Teachers play a crucial role in guiding students to enhance their learning and achieve academic goals. Understanding their perspectives on educational technology is essential to fostering effective integration into classroom instruction. This study investigates the perceptions of lower secondary school chemistry teachers regarding the ease of use and usefulness of integrating ICBLS into teaching.

Methods

A multiple case study design was employed, involving eight chemistry teachers from four schools where ICBLS had been implemented. Data were collected through semi-structured interviews, group discussions, professional workshops, and classroom observation. The data were transcribed and analyzed thematically using NVivo 14 software.

Results

The findings indicate that teachers hold positive perceptions of ICBLS, citing benefits such as enhanced safety, collaboration learning, and hands-on activities. However, challenges were identified, including limited access to computers and insufficient professional training.

Discussion

The study underscores the importance of addressing technical and training barriers to optimize the use of ICBLS. Recommendations include strengthening professional development, fostering peer collaboration, aligning curricula with ICBLS, and ensuring administrative support and provision of adequate resources.
Development and validation of a risk score to predict adverse birth outcomes using maternal characteristics in northwest Ethiopia: a retrospective follow-up study
Authors: Anteneh Rahel Mulatie , Tesema Getayeneh Antehunegn , Lakew Ayenew Molla , Feleke Sefineh Fenta
Published: December 2024

Background

Adverse birth outcomes are unfavorable outcomes of pregnancy that are particularly common in low- and middle-income countries. At least one ultrasound is recommended to predict adverse birth outcomes in early pregnancy. However, in low-income countries, imaging equipment and trained manpower are scarce. According to our search of the literature, there is no validated risk prediction model for predicting adverse birth outcomes in Ethiopia. Hence, we developed and validated a model and risk score to predict adverse birth outcomes using maternal characteristics during pregnancy for use in resource-limited settings.

Methods

A retrospective follow-up study was conducted from 1 January 2016 to 31 May 2021, and a total of 910 pregnant women were included in this study. Participants were selected using a simple random sampling technique. Stepwise, backward multivariable analysis was conducted. The model's accuracy was assessed using density plots, discrimination, and calibration. The developed model was assessed for internal validity using bootstrapping techniques and evaluated for clinical utility using decision curve analysis across various threshold probabilities.

Results

Premature rupture of Membrane, number of fetuses, residence, pregnancy-induced hypertension, antepartum hemorrhage, hemoglobin level, and labor onset remained in the final multivariable prediction model. The area under the curve of the model was 0.77 (95% confidence interval: 0.73–0.812). The developed risk prediction model had a good performance and was well-calibrated and valid. The decision curve analysis indicated the model provides a higher net benefit across the ranges of threshold probabilities.

Conclusion

In general, this study showed the possibility of predicting adverse birth outcomes using maternal characteristics during pregnancy. The risk prediction model using a simplified risk score helps identify high-risk pregnant women for specific interventions. A feasible score would reduce neonatal morbidity and mortality and improve maternal and child health in low-resource settings.
Using microbes to suppress overwintering inoculum of Monilinia laxa on mummified fruits and to protect cherry blossoms and fruit from infection
Authors: Bellamy Sophia , Shaw Michael , Xu Xiangming
Published: December 2024

Cherry brown rot, primarily caused by Monilinia laxa, poses a significant threat to cherry production in the UK. Traditional control methods are labour-intensive or environmentally damaging, favouring alternative solutions such as using biological control agents (BCAs). This study investigated the survival and efficacy of two BCAs, Bacillus subtilis (B91) and Aureobasidium pullulans (Y126), in reducing M. laxa populations on mummified fruits and cherry blossoms. Field experiments were conducted to assess the survival of B91 and Y126 on mummified fruits over winter and their effect on M. laxa sporulation in spring. Additionally, the efficacy of the two BCAs when applied to cherry blossoms was evaluated, at different times of application relative to M. laxa inoculation. Y126 could persist on blossoms and throughout the growing season. B91 population level declined rapidly on blossoms but recovered once fruits appeared. Neither BCA usefully reduced the concentration of M. laxa. Y126 was marginally more effective at long-term reduction. On mummified fruits, Y126 population size declined rapidly within the first two weeks after inoculation before stabilising. B91 survived slightly longer. Longer interaction times between M. laxa and the BCAs in the late winter resulted in lower spore counts of M. laxa from mummified fruits. While both BCAs reduced M. laxa populations when applied close to M. laxa inoculation, BCA populations were not maintained at effective levels throughout the growing season. These results suggest that multiple applications targeting critical periods (blossom and pre-harvest) are necessary for effective control of M. laxa by either of these BCAs.
Myeloid-specific deletion of autotaxin inhibits rheumatoid arthritis and osteoclastogenesis
Authors: Heo Gwangbeom , Jeong Sihyun , Park Soyeong , Kim Su Jin , Lee Yunna , Woo Seong Ji , Kim Kyunghwan , Park Byung-Hyun , Rhee Sang Hoon , Im Eunok
Published: December 2024

Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by joint swelling, pain, and bone remodeling. We previously reported that autotaxin (ATX) deficiency disrupts lipid rafts in macrophages. Lipid raft disruption results in the dysregulation of RANK signaling, which is crucial for osteoclastogenesis and the pathogenesis of RA. Therefore, we evaluated the effect of ATX deficiency on joint inflammation and osteoclast differentiation. A collagen-induced arthritis mouse model was used with myeloid lineage-restricted Atx-knockout (AtxΔME/ΔME) mice and DBA/1 mice treated with the ATX inhibitor PF-8380. Joint inflammation and bone erosion were visualized using hematoxylin and eosin staining and micro-computed tomography. Osteoclast differentiation was assessed by tartrate-resistant acid phosphatase staining. ATX deficiency suppressed joint inflammation, bone resorption, osteoclast differentiation, and pro-inflammatory protein expression in both AtxΔME/ΔME mice and PF-8380-treated mice compared to controls. Mean disease score of Atx+/+ mice at the end of experiment was 3.813, but that of AtxΔME/ΔME was 0.185 (p < 0.05). The differentiation of bone marrow-derived macrophages into osteoclasts was reduced in AtxΔME/ΔME cells compared to Atx+/+ cells. ATX deficiency suppressed RANKL-induced phosphorylation of ERK and Akt and the interaction between RANK and TRAF6. ATX deficiency disrupted lipid rafts and dysregulated RANK distribution in RAW264.7 cells. Actin ring formation was also inhibited in AtxΔME/ΔME osteoclasts. ATX deficiency suppressed RA and osteoclast differentiation by disrupting lipid rafts and altering the RANK signaling pathway. This suggests that ATX inhibition may be an effective strategy for developing new disease-modifying antirheumatic drugs.
Stigma related to podoconiosis in Ethiopia: a systematic review
Authors: Abiso Temesgen Lera , Kerbo Amene Abebe , Woticha Eskinder Wolka , Koyira Mengistu Meskele
Published: December 2024

Background

Podoconiosis, one of the neglected tropical diseases (NTDs), affects barefoot people in impoverished regions and contributes to poverty by having negative impacts on economic output, education, and disability. Podoconiosis has enormous social, psychological, and economic implications for the affected individuals. Social stigmatization of people with the disease is widespread, and patients are restricted from schools, local meetings, mosques, and churches and not allowed to marry into unaffected families. Therefore, this study aimed to systematically review the stigma related to podoconiosis in Ethiopia.

Methods

The Preferred Items for Systematic Reviews and Meta-analysis (PRISMA-2020) guidelines were followed. PubMed/Medline, Scopus, Web of Science, Google Scholar, and Google databases were searched. Articles published in the English language from inception to 2023 were included. Data were extracted by using a pre-prepared Excel sheet, and a narrative synthesis of the findings was done. This review was registered in the PROSPERO International Prospective Register of Systematic Reviews with registration number CRD42024510091.

Results

A total of 19 studies were included in this systematic review. This systematic review identified different types of stigmas reported from individuals with podoconiosis. The types of stigmas identified were enacted, felt, and internalized stigma and social stigmas, including exclusion from different social occurrences such as idir, meetings, funerals, and churches/mosques. Stigma also prevented patients with podoconiosis from visiting health institutions for the treatment of the disease and using health services for other cases.

Conclusions

Stigma among podoconiosis patients is widely distributed in Ethiopia. Different types of stigmas were identified among the patients. Extensive work needs to be done to prevent the disease and stigma. Strengthening works on community awareness about the disease help to ensure that it does not get transmitted from affected individuals to others.

Systematic review registration

PROSPERO, identifier CRD42024510091.
When to use a metaphor: metaphors in dialogical explanations with addressees of different expertise
Authors: Scharlau Ingrid , Körber Miriam , Sengupta Meghdut , Wachsmuth Henning
Published: December 2024

The present study aims to understand how metaphors are used in explanations. According to many current theories, metaphors have a conceptual function for the understanding of abstract objects. From this theoretical assumption, we derived the hypothesis that the lower the expertise of the addressee of an explanation, the more metaphors should be used. We tested this hypothesis on a relatively natural data set of 24 published videos with close to 100,000 words overall in which experts explain abstract, mostly scientific concepts to persons of different expertise, varying from minimal (children) to profound (expert). Contrary to our expectations, the frequency of metaphors did not decrease with expertise, but actually increased. This increase could be statistically substantiated with higher differences in expertise. The study contributes to a better understanding of the use of metaphors in actual explanatory processes and how metaphor use depends on contextual factors. It thus supports the expansion of the conceptual and linguistic perspective on metaphors to include the aspect of how metaphors are used by speakers.
Morphological evolution of the Qingshuigou subaqueous delta of the Yellow River before and after the operation of the Xiaolangdi Reservoir (1997-2007)
Authors: Zhang Jiarui , Wang Qing , Zhan Chao , Li Zilu , Cao Yin , Wang Haojian , Liu Zeyang , Yu Limeng , Song Qiuyu , Li Yan , Su Teng , Zhu Jun , Shi Hongyuan
Published: December 2024

The Modern Yellow River Delta has a rich history of geomorphological transformations shaped by frequent avulsions and rapid progradation. However, the delta entered a phase of altered morphodynamics following the construction of the Xiaolangdi Reservoir, which fundamentally restructured sediment transport regimes and seasonal hydrological patterns. These changes have amplified challenges in predicting long-term deltaic evolution under evolving boundary conditions. The Qingshuigou Subaqueous Delta, as a major depositional zone, provides a compelling lens to examine these morphodynamic processes. However, seasonal variations in riverine sand transport fluxes driven by the water-sand regulation scheme that accompanied the construction of the Xiaolangdi Reservoir and its impact on the evolution of the delta front are particularly understudied. This study developed a simplified long-term morphodynamic model of the Qingshuigou Subaqueous Delta to investigate its response to riverine water and sediment discharges from 1997 to 2007. The findings are as follows: (1) The morphological evolution of the Qingshuigou Subaqueous delta has gradually changed from the pattern of “leading edge deposition and localized near-shore erosion” before the construction of the Xiaolangdi Reservoir to the pattern of “enhanced leading edge deposition and increased near-shore erosion” after the construction. (2) The construction of Xiaolangdi Reservoir has weakened the spatial distribution of the erosion process to a certain extent, changing the spatial distribution dominated by the erosion process (63.8% of area) before the construction to the spatial distribution dominated by the accretion process (More than 50% of area) after the construction. (3) The spatial and temporal variability of the incoming sediments leads to a significant coarsening of the grain size of the tidal flats in the southern part of the abandoned delta, which in turn maintains a relatively steady state of the shoreline variability. In contrast, the abandoned sand spit experiences severe erosion and depositional fluctuations due to intensified wave action. (4) The study emphasizes the importance of considering seasonal variations in unsteady discharge in modeling the long-term evolution of the delta. It provides new insights into the spatial and temporal differentiation of the geomorphic equilibrium of the Yellow River Delta and contributes to a broader understanding of delta evolution.
Phosphate addition intensifies the increase in N2O emission under nitrogen deposition in wet meadows of the Qinghai-Tibet Plateau
Authors: Wu Jiangqi , Wang Haiyan , Li Guang
Published: December 2024

Alpine wet meadows are known as N2O sinks due to nitrogen (N) limitation. However, phosphate addition and N deposition can modulate this limitation, and little is known about their combinative effects on N2O emission from the Qinghai-Tibet Plateau in wet meadows. This study used natural wet meadow as the control treatment (CK) and conducted experiments with N (CON2H4 addition, N15), P (NaH2PO4 addition, P15), and their combinations (CON2H4 and NaH2PO4 addition, N15P15) to investigate how N and P supplementation affected soil N2O emissions in wet meadow of QTP. Contrary to previous studies on grasslands, the effect of phosphate addition treatment on soil N2O flux was not detectable during the growing seasons of 2019 and 2020. Over a span of two years, the N addition treatment significantly increased the N2O flux by 3.45 μg⋅m–2⋅h–1 due to increased soil N availability. Noticeably, phosphate addition intensified the effect of N deposition treatment on soil N2O flux with high significance in the early growth season of 2020. This augmentation can be attributed to the alleviation of limiting factors imposed by plants and microorganisms on soil N and P, fostering the mineralization and decomposition of litter and soil nutrients by microorganisms. Consequently, the results showed that total nitrogen and nitrate nitrogen were the main controls on soil N2O emission under N and P addition. In addition, redundancy analysis showed that the relative abundance of NirK genes in soil microorganisms (Bradyrhizobium, Devosia, Ochrobactrum, Alcaligenes, Rhizobium) is the main factor affecting N2O flux and available nitrogen. We project that if nutrient input continues to increase, the main limiting factor of soil will change from N restriction to P restriction due to the unique microbial nitrogen conversion process in the alpine meadow, significantly increasing N2O emissions. Consequently, the heightened contribution of alpine wet meadows to global warming and ozone depletion hinges on the dynamics of nutrient input regimes, spotlighting the urgent need for informed environmental management strategies.
Brain organoid methodologies to explore mechanisms of disease in progressive multiple sclerosis
Authors: Simões-Abade Madalena B. C. , Patterer Marlene , Nicaise Alexandra M. , Pluchino Stefano
Published: December 2024

Multiple sclerosis (MS), a debilitating autoimmune disorder targeting the central nervous system (CNS), is marked by relentless demyelination and inflammation. Clinically, it presents in three distinct forms: relapsing–remitting MS (RRMS), primary progressive MS (PPMS), and secondary progressive MS (SPMS). While disease-modifying therapies (DMTs) offer some relief to people with RRMS, treatment options for progressive MS (pMS) remain frustratingly inadequate. This gap highlights an urgent need for advanced disease modeling techniques to unravel the intricate pathology of pMS. Human induced pluripotent stem cell (iPSC) technologies and brain organoids are emerging as promising tools for disease modeling in both 2D and 3D in vitro environments. These innovative approaches enable the study of disease mechanisms that closely mimic human pathophysiology and offer new platforms for screening therapeutic compounds, surpassing the limitations of traditional animal models. However, deploying brain organoids in disease modeling presents challenges, especially in the context of non-monogenic disorders. This review delves into cutting-edge brain organoid techniques that hold the potential to revolutionize our understanding of pMS, offering a pathway to disentangle its underlying mechanisms and drive transformative discoveries.
Circulating miR-134 in mesial temporal lobe epilepsy: implications in hippocampal sclerosis development and drug resistance
Authors: Guerra Leal Bárbara , Carvalho Cláudia , Santos Cristina , Samões Raquel , Martins-Ferreira Ricardo , Teixeira Catarina , Rodrigues Diana , Freitas Joel , Lemos Carolina , Chorão Rui , Ramalheira João , Lopes João , Martins da Silva António , Pinho e Costa Paulo , Chaves João
Published: December 2024

Aim

miR-134 has been widely reported as upregulated in experimental and human studies of Mesial Temporal Lobe Epilepsy the most common drug-resistant epilepsy (DRE). Studies have shown that the use of antagomirs, anti-miR-134, may be a promising therapeutic approach to these epilepsies. However, data on miR-134 in other epileptic syndromes is scarce. In this study, we aimed to quantify serum levels of miR-134 in a cohort of patients with Mesial Temporal Lobe Epilepsy-Hippocampal Sclerosis (MTLE-HS) and with Genetic Generalized Epilepsies (GGE). Additionally, we explored the correlation between miR-134 serum levels and clinical parameters, such as age at onset or febrile seizures antecedents, to evaluate its potential as a biomarker and therapeutic target in epilepsy.

Methods

miR-134 levels were evaluated in cell-free serum of 131 patients with epilepsy (75 women, 56 men; age 41.10 ± 13.12 years; 72 with DRE) and 42 healthy individuals (25 women, 17 men; age 42.40 ± 9.80 years). The epilepsy cohort included 77 MTLE-HS patients and 54 GGE patients.

Results

Patients with elevated miR-134 circulating levels were at higher risk of drug-resistant epilepsy (OR [95% CI] = 2.246 [1.111–4.539], p = 0.021). Other risk factors included an older age (OR [95% CI] = 1.032 [1.004–1.061], p = 0.025), history of febrile seizures (OR [95% CI] = 2.994 [1.385–6.471], p = 0.005) and higher disease duration (OR [95% CI] = 1.038 [1.011–1.066], p = 0.006). The strongest predictor of DRE was hippocampal sclerosis (OR [95% CI] = 10.338 [4.566–23.404], p < 0.001). Circulating miR-134 levels were significantly higher in MTLE-HS patients compared to controls (p < 0.05) and GGE patients (p < 0.05). However, the clinical utility of miR-134 in discriminating MTLE-HS patients from controls was only moderated (AUC = 0.651 ± 0.051 95% CI 0.551–0.751, p = 0.007).

Conclusion

We show that miR-134 circulating levels are associated with DRE, especially in MTLE-HS, a syndrome characterized by severe hippocampal damage, consistent with activity-regulated miR-134 expression. This overexpression likely contributes to disease progression and our results support the potential of targeting miR-134 as a novel therapeutic approach for refractory epilepsy.
Neuroethical considerations and attitudes about neurostimulation as a fatigue countermeasure among emergency responders
Authors: Cabrera Laura Y. , Munoz Alejandro , Mehta Ranjana K.
Published: December 2024

Introduction

First responders play a pivotal role in ensuring the wellbeing of individuals during critical situations. The demanding nature of their work exposes them to prolonged shifts and unpredictable situations, leading to elevated fatigue levels. Modern countermeasures to fatigue do not provide the best results. This study evaluates the acceptance and ethical considerations of a novel fatigue countermeasure using transcranial Direct Current Stimulation (tDCS) for fire and emergency medical services (EMS) personnel.

Methods

To better understand first responders' perceptions and ethical concerns about this novel fatigue countermeasure in their work, we conducted semi-structured interviews with first responders (N = 20). Interviews were transcribed into text and analyzed using qualitative content analysis.

Results

Over half of responders (59%) were interested, but over a third had a cautionary stand. Half of the participants seemed to have positive views regarding acceptability; a few were more cautionary or hesitant. A main area of consideration was user control (75%), with the majority wanting to retain some control over when or whether to accept the stimulation. Just above half of the participants (64%) mentioned privacy concerns. Another relevant consideration, raised by 50% of participants, was safety and the potential impact of stimulation (e.g., side effects, long-term effects). Overall, participants thought they needed to understand the system better and agreed that more education and training would be required to make people more willing to use it.

Discussion

Our exploration into combating fatigue among first responders through tDCS has revealed promising initial reactions from the responder community. Findings from this study lay the groundwork for a promising solution, while still in a nascent design stage, to improve the effectiveness and resilience of first responders in fatiguing shifts and critical situations.
Acid-assisted polysaccharides extracted from Asparagus cochinchinensis protect against Alzheimer’s disease by regulating the microbiota-gut-brain axis
Authors: Li Ruixue , Wang Hui , Wang Qinjian , Zhang Zhiqiang , Wang Li
Published: December 2024

In this study, an acid-assisted extraction strategy was used to extract a novel polysaccharide (ACP) from Asparagus cochinchinensis, after which this polysaccharide was purified and subjected to extensive characterization. ACP was determined to have an average molecular weight of 15,580 Da in structural characterization studies, and it was found to primarily consist of glucose, galactose, L-fucose, and fructose at an 82.14:12.23:2.61:2.49 ratio. Trace amounts of xylose, arabinose, and rhamnose were also detected in ACP preparations at a 0.48:0.04:0.02 ratio. GC–MS analyses identified eight different sugar linkages within ACP, including Glcp-(1→, →2)-Glcp-(1→, →6)-Glcp-(1→, →4)-Glcp-(1→, →3, 4)-Glcp-(1→, →2,4) -Galp-(1→, →4,6)-Galp-(1→, and →3,4,6)-Galp-(1 → linkages present at 23.70:1.30:3.55:50.77:6.91:1.10:11.50:1.18 molar percent ratios. One-dimensional NMR, two-dimensional NMR, and methylation analyses ultimately revealed that the polysaccharide is mainly composed of →4)-β-D-Glcp-(1 → and a small amount→4,6)-α-D-Galp-(1 → and →3,4)-α-D-Glcp-(1 → and so on. Branched chain is mainly composed of α-D-Glcp-(1 → 4)-β-D-Glcp-(1 → connected to the sugar residues α-D-Glcp-(1 → 4)-β-D-Glcp-(1 → O-4 position or sugar residues of α-D-Glcp-(1 → 4)-β-D-Glcp-(1 → O-3 position. ACP treatment in SAMP8 mice was associated with reductions in oxidative stress and brain pathology together with enhanced cognitive function. ACP treated SAMP8 mice also presented with increases in Bacteroidota abundance and reduced Firmicutes, Patescibacteria, Actinobacteriota, and Campilobacterota abundance. Thus, ACP can prevent Alzheimer’s disease by modulating the microbe-gut-brain axis.
Drug-induced coagulopathies: a real-world pharmacovigilance study using the FDA adverse event reporting system
Authors: Lu Yanjun , Xu Qian , Zhu Shita
Published: December 2024

Background

This study aims to investigate adverse drug reaction signals associated with coagulopathies through data mining using the Adverse Event Reporting System (FAERS) of the US Food and Drug Administration. Prompt identification of high-risk drugs provides a valuable basis for enhancing clinical drug safety.

Methods

The adverse event reports related to coagulopathies from Q1 2004 to Q2 2024 were extracted from the ASCII data packages in FAERS. The reporting odds ratio (ROR), proportional reporting ratio (PRR), and Bayesian confidence propagation neural network (BCPNN) were used to identify adverse drug reaction signals associated with coagulopathies.

Results

During the reporting period, 40,545 reports were retrieved, with a slightly higher proportion of females than males. Among the top 30 drugs associated with the occurrence of coagulopathies, 24 drugs exhibited positive signals in risk analysis. Based on the individual drug reporting odds ratio (95% confidence interval) as a measure of risk signal strength, the top five drugs are as follows: gemcitabine [ROR (95% CI):16.87 (15.83–17.98)], busulfan [ROR (95% CI):15.51 (13.69–17.58)], anti-thymocyte globulin [ROR (95% CI):15.49 (13.49–17.78)], tacrolimus [ROR (95% CI):12.7 (11.57–13.95)], etonogestrel and ethinylestradiol vaginal ring [ROR (95% CI):11.88 (10.95–12.89)]. After categorizing the drugs, the strongest risk signal is sex hormones and modulators of the genital system [ROR (95% CI):11.88 (10.95–12.89)], followed by analgesics [ROR (95%CI): 6.73 (6.38–7.1)], immunosuppressants [ROR (95% CI):3.91 (3.76–4.05)], antineoplastic agents [ROR (95% CI):3.33 (3.22–3.45)], corticosteroids for systemic use [ROR (95% CI): 2.94 (2.73–3.18)], antiepileptics [ROR (95% CI):1.93 (1.71–2.18)], drugs used in diabetes [ROR (95% CI):1.5 (1.34–1.67)], antibacterials for systemic use [ROR (95% CI):1.46 (1.28–1.68)].

Conclusion

Our findings indicate that multiple drugs are associated with an increased risk of coagulopathies. From the pharmacovigilance perspective, proactive analysis of these drugs aids in clinical monitoring and enhances risk identification of coagulopathies.
PM2.5-induced oxidative stress upregulates PLA2R expression in the lung and is involved in the pathogenesis of membranous nephropathy through extracellular vesicles
Authors: Zhang Wang , Chen Jiating , Yuan Ye , Luo Jiao , Zhou Zhanmei , Wang Guobao
Published: December 2024

Background

Particulate matter (PM2.5) has been implicated in the development of membranous nephropathy (MN), but the underlying mechanism has yet to be fully understood. Oxidative stress is an essential factor of PM2.5-related toxicity and plays a significant role in the exposure of target antigenic epitopes in MN. This study aims to explore the pathogenic effects of PM2.5 in facilitating the crosstalk between the lung and kidney in MN.

Method

We examined oxidative stress indicators and the circulating levels of extracellular vesicles (EVs) in patients diagnosed with MN. Additionally, we assessed the expression of M-type phospholipase A2 receptor (PLA2R) in human lung tissue ex vivo. To verify the impact of PM2.5 on PLA2R expression in the lung and the kidney, we stimulated human bronchial epithelial cells (Beas-2B) with lipopolysaccharide (LPS) or PM2.5. We then treated podocytes in vitro with the supernatants from PM2.5-exposed Beas-2B cells, intervening with GW4869, an inhibitor of EV release, to explore the role of EV-mediated cell-cell interactions.

Results

We found that elevated serum markers of oxidative stress and increased levels of PLA2R + EVs correlated positively with anti-PLA2R antibody levels in the serum of patients with idiopathic MN (IMN). Notably, PLA2R expression was significantly higher in the lung tissue of smokers, suggesting a possible link between PLA2R and oxidative stress. In vitro experiments demonstrated that PLA2R expression in Beas-2B cells was upregulated upon stimulation with LPS and PM2.5, an effect that could be reversed by the antioxidant glutathione (GSH). Furthermore, the supernatants from PM2.5-exposed Beas-2B cells were found to induce PLA2R overexpression and injury in podocytes, with this effect being mitigated by GW4869, an inhibitor of EVs release.

Conclusion

Our study contributes new knowledge to the understanding of how environmental pollutants, such as PM2.5, cause kidney damage through oxidative stress and EV-mediated signaling. The findings pave the way for further research into therapeutic strategies targeting oxidative stress and EVs, which could potentially improve patient outcomes of MN, particularly in high-risk populations like smokers and those exposed to air pollution.
Monitoring of the trough concentration of valproic acid in pediatric epilepsy patients: a machine learning-based ensemble model
Authors: Chen Yue-Wen , Lin Xi-Kai , Chen Si , Zhang Ya-Lan , Wu Wei , Huang Chen , Rao Xin , Lu Zong-Xing , Liu Zhou-Jie
Published: December 2024

Aims

Few personalized monitoring models for valproic acid (VPA) in pediatric epilepsy patients (PEPs) incorporate machine learning (ML) algorithms. This study aimed to develop an ensemble ML model for VPA monitoring to enhance clinical precision of VPA usage.

Methods

A dataset comprising 366 VPA trough concentrations from 252 PEPs, along with 19 covariates and the target variable (VPA trough concentration), was refined by Spearman correlation and multicollinearity testing (366 × 11). The dataset was split into a training set (292) and testing set (74) at a ratio of 8:2. An ensemble model was formulated by Gradient Boosting Regression Trees (GBRT), Random Forest Regression (RFR), and Support Vector Regression (SVR), and assessed by SHapley Additive exPlanations (SHAP) analysis for covariate importance. The model was optimized for R2, relative accuracy, and absolute accuracy, and validated against two independent external datasets (32 in-hospital and 28 out-of-hospital dataset).

Results

Using the R2 weight ratio of GBRT, RFR and SVR optimized at 5:2:3, the ensemble model demonstrated superior performance in terms of relative accuracy (87.8%), absolute accuracy (78.4%), and R2 (0.50), while also exhibiting a lower Mean Absolute Error (9.87) and Root Mean Squared Error (12.24), as validated by the external datasets. Platelet count (PLT) and VPA daily dose were identified as pivotal covariates.

Conclusion

The proposed ensemble model effectively monitors VPA trough concentrations in PEPs. By integrating covariates across various ML algorithms, it delivers results closely aligned with clinical practice, offering substantial clinical value for the guided use of VPA.
Interrogating peace in a violent democracy: a global south critique
Authors: Buer Ingri Bøe , Villenave Sabrina
Published: December 2024

This article examines the complex and often conflicting forms of ‘peace’ in Rio de Janeiro’s favelas, using a postcolonial critique to challenge the state’s top-down imposition of realist and neoliberal peace models. It begins by interrogating the concept of ‘peace’ in the context of the Brazilian State’s historical racialization and criminalization of favelas. The article develops four key arguments. First, it considers how militarized public security policies in the “War on Drugs” translate into ‘peace as war’ in the favelas. Second, it considers criminal governance as ‘peace as order’. Third, it critiques the Pacifying Police Program (UPP) as part of a neoliberal ‘tourist peace,’ prioritizing the safety of international visitors during significant events in 2014 and 2016. Finally, it highlights non-violent peace processes within the favelas, which aim to achieve a ‘positive peace.’ The article argues that different actors, including organized criminal groups, can produce various forms of peace, raising critical questions about whose peace is being pursued and at what cost.
Scale-based screening and assessment of age-related frailty
Authors: Wang Xiao-Ming , Zhang Yuan-Hui , Meng Chen-Chen , Fan Lu , Wei Lei , Li Yan-Yang , Liu Xue-Zheng , Lv Shi-Chao
Published: December 2024

As the population ages, the prevalence of age-related frailty increases sharply, which increases the risk of poor health status of older adults, such as disability, falls, hospitalization, and death. Across the globe, frailty is moving toward the forefront of health and medical research. Currently, frailty is believed to be preventable and reversible, so the early identification of frailty is critical. However, there are neither precise biomarkers of frailty nor definitive laboratory tests and corresponding clinical testing techniques and equipment in clinical practice. As a result, the clinical identification of frailty is mainly achieved through the widely used frailty scale, which is an objective, simple, time-saving, effective, economical, and feasible measurement tool. In this narrative review, we summarized and analyzed the various existing frailty scales from different perspectives of screening and evaluation, aiming to provide a reference for clinical researchers and practitioners to judge and manage frail older people accurately.
Long-term impact of Diabetes Prevention Program interventions on walking endurance
Authors: Munshi Medha N. , Venditti Elizabeth M. , Tjaden Ashley H. , Knowler William C. , Boyko Edward J. , Middelbeek Roeland J. W. , Luchsinger José A. , Lee Christine G. , Hazuda Helen P. , Salive Marcel E. , Edelstein Sharon L. , Storer Thomas W.
Published: December 2024

Objectives

Type 2 diabetes (T2D) and prediabetes are associated with poor walking endurance, a marker of physical function. We aimed to examine the long-term effects of metformin or intensive lifestyle intervention in adults at high risk of T2D on their 6-min walk test (6MWT) performance.

Methods

Participants were randomized in the 3-year Diabetes Prevention Program (DPP) to one of the three groups: lifestyle intervention, metformin, or placebo, and were subsequently followed in the DPP Outcomes Study. A 6MWT was conducted 20 years after randomization. Associations between DPP interventions and 6MWT completion (achieving a distance ≥200 m) were assessed using logistic regression. Among the test completers, differences in distance walked (6MWD) were evaluated using multivariable linear regression. Additional variables of interest included concomitant measures of body mass index (BMI) and grip strength along with mean measures of HbA1c and self-reported physical activity (PA).

Results

Data on 1830 participants were analyzed. The interventions were not associated with test completion or the 6MWD among test completers (362, 364, and 360 m in the lifestyle, metformin, and placebo groups, respectively, p = 0.8). Age, education, grip strength, and PA were each significantly associated with the 6MWT completion and the 6MWD after adjustment. Grip strength, PA, and education were positively associated with the 6MWD, while age, BMI, and HbA1c were negatively associated with the 6MWD.

Conclusion

We confirmed that the 6MWT is related to other measures of physical ability such as PA and grip strength in persons at risk for and with T2D, suggesting potential long-term benefits of maintaining a healthy lifestyle. However, we did not observe a sustained effect of the original randomized interventions.

Clinical trial registration

http://www.clinicaltrials.gov/ct/show/NCT00004992, identifier DPP NCT00004992; http://www.clinicaltrials.gov/ct/show/NCT00038727, identifier DPPOS NCT00038727
The prevalence of burnout and coping strategies among Palestinian health professionals: a cross sectional study
Authors: Ahmead Muna , El Sharif Nuha , Alwawi Abdallah , Hemeid Asma , Ziqan Motasem
Published: December 2024

Introduction

During times of conflict, healthcare personnel face a heightened vulnerability to experiencing psychological problems such as burnout. The impact of conflict or wars on mental health professionals in Palestine and their strategies for managing these problems are currently not recognized. This study sought to assess the prevalence of burnout symptoms and coping strategies among healthcare workers in Palestine, in the context of the ongoing conflict and political violence.

Methods

The study utilized a cross-sectional research design. Self-reported questionnaires, including the shortened version (9 items) of The Maslach Burnout Questionnaire and Brief COPE scales, were used to gather data. The relationship between the research variables and burn symptoms was investigated using Chi-squared test, Student’s t-test, Mann–Whitney, and Analysis of variance and multi-regression.

Results

A total of 713 participants were recruited. The prevalence rates were as follows: burnout—(72.9%), emotional exhaustion (44.2%), depersonalization (9.8%), and low personal accomplishment (72.2%). The multivariate analysis found that those who worked more than 16 h per day and those who had 1–15 years of job experience were more likely to had emotional exhaustion. Active coping, substance use, informational support, and emotional support all reduced the likelihood of burnout while behavioral disengagement and self-blame increased the possibility of experiencing burnout. Finally, substance use decreased emotional exhaustion, increased depersonalization and enhanced personal accomplishment.

Conclusion

The findings revealed a high prevalence of burnout among health professionals during wartime and political violence. As a result, health professionals are vulnerable to mental problems during political violence and they need immediate assistance in enhancing their mental wellbeing through psychological support, and comprehensive training in stress management.