bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of a blended learning approach on stratified care for physiotherapy bachelor students
Authors: Adje Mishael , Steinhäuser Jost , Laekeman Marjan , Rogan Slavko , Karstens Sven
Published: July 2023

Background

Stratified models of care are valuable for addressing psychosocial factors which influence the outcome of patients with musculoskeletal disorders. Introducing such models in undergraduate training has the potential to propagate this knowledge with evidence and foster its implementation. The objective of this paper is to explore the perception and changes in the fear-avoidance beliefs of physiotherapy students participating in a developed blended learning course on stratified care.

Methodology

A mixed-methods with a convenient sample of two consecutive cohorts were given a blended learning course on stratified care for patients with low back pain. The blended learning course comprised scientific rudiments and application of stratified care in clinical practice conceptualised using the KERN’ 6-step approach. The exam scores, perceptions, performance on self-reflection-tests and pre- and post-scores on The Tampa Scale for Kinesiophobia for Physiotherapists’ (TSK-PT) were obtained. After gaining clinical experience, participants were invited to discuss their clinical experiences and perceptions in workshops. The quantitative data was analysed explorative-descriptively. The qualitative data was analysed following an inductive coding system with constant comparisons.

Results

Ninety-one participants consented to the evaluation (mean age = 22.9 ± 1.6 years), 66% were female. Exam scores correlated with time spent in training (r = 0.30) and scores on self-reflection-tests 1 and 2 (r = 0.40 and r = 0.41). Participants in both cohorts described the learning resources as promoting their interest in the subject (72% and 94%), up-to-date (91% and 93%) and helpful (91% and 97%). The fear-avoidance scores for participants decreased from 53.5 (± 9.96) to 40.1 (± 12.4) with a large effect size (d = 1.18). The regression model [F (2, 49) = 1151.2, p < 0.001] suggests that pre-TSK-PT and the interest of participants in the training predicted post-TSK-PT. The workshop participants (n = 62) all worked in clinical practice. Emerging from the analysis were 4 categories (evolving to maturity in practice, perceiving determinants of stratified care, strategising for implementation and adopting an outlook for future practice).

Conclusion

The quality of engagement in learning, training strategy and interest in the subject contributes immensely to learning outcomes. This blended learning course was successful in reducing kinesiophobia and influencing the participants’ attitude towards care with the potential of being translated into long-term practice.
In search of an international multidimensional action plan for second victim support: a narrative review
Authors: Seys Deborah , Panella Massimiliano , Russotto Sophia , Strametz Reinhard , Joaquín Mira José , Van Wilder Astrid , Godderis Lode , Vanhaecht Kris
Published: July 2023

Background

Insights around second victims (SV) and patient safety has been growing over time. An overview of the available evidence is lacking. This review aims to describe (i) the impact a patient safety incident can have and (ii) how healthcare professionals can be supported in the aftermath of a patient safety incident.

Methods

A literature search in Medline, EMBASE and CINAHL was performed between 1 and 2010 and 26 November 2020 with studies on SV as inclusion criteria. To be included in this review the studies must include healthcare professionals involved in the aftermath of a patient safety incident.

Results

In total 104 studies were included. SVs can suffer from both psychosocial (negative and positive), professional and physical reactions. Support can be provided at five levels. The first level is prevention (on individual and organizational level) referring to measures taken before a patient safety incident happens. The other four levels focus on providing support in the aftermath of a patient safety incident, such as self-care of individuals and/or team, support by peers and triage, structured support by an expert in the field (professional support) and structured clinical support.

Conclusion

The impact of a patient safety incident on healthcare professionals is broad and diverse. Support programs should be organized at five levels, starting with preventive actions followed by self-care, support by peers, structured professional support and clinical support. This multilevel approach can now be translated in different countries, networks and organizations based on their own culture, support history, structure and legal context. Next to this, they should also include the stage of recovery in which the healthcare professional is located in.
Barriers and facilitators to integrating depression care in tuberculosis services in South Asia: a multi-country qualitative study
Authors: Todowede Olamide , Afaq Saima , Adhikary Anoshmita , Kanan Sushama , Shree Vidhya , Jennings Hannah Maria , Faisal Mehreen Riaz , Nisar Zara , Khan Ikram , Desai Geetha , Huque Rumana , Siddiqi Najma
Published: July 2023

Background

Depression is common among people with tuberculosis (TB). The condition is typically unrecognised or untreated despite available and effective treatments in most low- and middle-income countries. TB services in these countries are relatively well established, offering a potential opportunity to deliver integrated depression screening and care. However, there is limited evidence on how such integration could be achieved. This study aimed to understand the barriers and facilitators to integrate depression care in TB services.

Methods

We conducted nine workshops with 76 study participants, including people with TB, their carers, and health service providers in Bangladesh, India, and Pakistan, seeking views on integrating depression care into TB clinics. We used a deductive thematic approach to analyse the translated transcripts of audio recordings, contemporaneous notes made during workshops for Bangladesh and India and workshop reports for Pakistan. Using the SURE (Supporting the Use of Research Evidence) thematic framework, we extracted and categorised barriers and facilitators into various domains.

Results

Reported barriers to integrating depression care in TB services included lack of knowledge about depression amongst patients and the staff, financial burden, and associated stigma for people with TB and their carers. Government buy-in and understanding of how to identify and screen for depression screening were potential facilitators reported. Additionally, breaking through mental health stigma and providing the additional resources required to deliver this service (human resources and consultation time) were essential for integrating depression and TB care.

Conclusions

Depression is a common condition found among people with TB, requiring early identification among people with TB. Integrating depression care into Tb services by health workers requires the availability of political support and the provision of resources.
Incidence of postoperative administration of opioids in dogs undergoing a tibial plateau leveling osteotomy after intra-operative liposomal bupivacaine administration with or without morphine epidural
Authors: Scaglione Jessie , Carver Jacqueline
Published: July 2023

Objective

To determine the influence of two intraoperative pain management protocols on the need for additional opioids in patients receiving an epidural and periarticular liposomal bupivacaine (PLB) vs. PLB alone in the 12–24 h period after undergoing a TPLO.

Study design

Retrospective study.

Animals

One hundred seventy-four dogs with cranial cruciate ligament tears presenting for TPLO.

Methods

Medical records of dogs presenting for a unilateral or bilateral cranial cruciate ligament tear who had a TPLO performed were reviewed for signalment, weight, body condition score, and peri-operative pain management protocol. Dogs were divided into two groups: those who received an epidural and PLB, and those who received only PLB. Post-operative opioid administration was recorded for each group.

Results

Patients who received an epidural and PLB received fewer postoperative opioids. There were 36% fewer opioid injections administered to dogs who received epidurals compared to dogs who did not receive epidurals (IRR) (95% CI) = 0.64 (0.45–0.92), P = 0.02). BCS was not a significant predictor of the post-operative opioid requirement (IRR (95% CI) = 1.3 (0.75–2.4), P = 0.38). When adjusting for BCS as a possible confounder, there were 39% fewer opioid injections in dogs who received epidurals than dogs without (IRR (95% CI) = 0.61 (0.42–0.88), P = 0.009).

Conclusions

The incidence of postoperative opioid administration was significantly diminished in patients receiving both an epidural and PLB.

Clinical significance

Administration of an epidural in addition to infiltration of PLB significantly decreased the incidence of postoperative opioid administration in dogs undergoing a TPLO.
Use of thiols and implications for the use of inhaled corticosteroids in the presence of oxidative stress in COPD
Authors: Cazzola Mario , Page Clive P. , Wedzicha Jadwiga A. , Celli Bartolome R. , Anzueto Antonio , Matera Maria Gabriella
Published: July 2023

Background

Oxidative stress and persistent airway inflammation are thought to be important contributors to the development of chronic obstructive pulmonary disease (COPD). This review summarizes the evidence for targeting oxidative stress and inflammation in patients with COPD with mucolytic/antioxidant thiols and inhaled corticosteroids (ICS), either alone or in combination.

Main body

Oxidative stress is increased in COPD, particularly during acute exacerbations. It can be triggered by oxidant air pollutants and cigarette smoke and/or by endogenous reactive oxygen species (ROS) released from mitochondria and activated inflammatory, immune and epithelial cells in the airways, together with a reduction in endogenous antioxidants such as glutathione (GSH). Oxidative stress also drives chronic inflammation and disease progression in the airways by activating intracellular signalling pathways and the release of further inflammatory mediators. ICS are anti-inflammatory agents currently recommended for use with long-acting bronchodilators to prevent exacerbations in patients with moderate-to-severe COPD, especially those with eosinophilic airway inflammation. However, corticosteroids can also increase oxidative stress, which may in turn reduce corticosteroid sensitivity in patients by several mechanisms. Thiol-based agents such as erdosteine, N-acetyl L-cysteine (NAC) and S-carboxymethylcysteine (S-CMC) are mucolytic agents that also act as antioxidants. These agents may reduce oxidative stress directly through the free sulfhydryl groups, serving as a source of reducing equivalents and indirectly though intracellular GSH replenishment. Few studies have compared the effects of corticosteroids and thiol agents on oxidative stress, but there is some evidence for greater antioxidant effects when they are administered together. The current Global Initiative for Chronic Obstructive Lung Disease (GOLD) report supports treatment with antioxidants (erdosteine, NAC, S-CMC) in addition to standard-of-care therapy as they have been demonstrated to reduce COPD exacerbations. However, such studies have demonstrated that NAC and S-CMC reduced the exacerbation risk only in patients not treated with ICS, whereas erdosteine reduced COPD exacerbations irrespective of concomitant ICS use suggesting that erdosteine has additional pharmacological actions to ICS.

Conclusions

Further clinical trials of antioxidant agents with and without ICS are needed to better understand the place of thiol-based drugs in the treatment of patients with COPD.
Association between inflammatory biomarkers and venous thromboembolism: a systematic review and meta-analysis
Authors: Ding Jiayue , Yue Xuanye , Tian Xiaobing , Liao Zhangyuan , Meng Ran , Zou Ming
Published: July 2023

Background

Venous thromboembolism (VTE) is a common thrombotic vascular disease that has a significant impact on people’s well-being and quality of life. A plethora of clinical studies explore the relationship between inflammatory biomarkers and VTE but yield conflicting results. This article proposed to pool these studies to draw a more convincing conclusion.

Methods

We searched several databases for studies before April 2023. Available data was processed using Stata software (version 15.0 SE) and R (version 4.1.2). This meta-analysis has been registered in PROSPERO (CRD42022321815). The VTE in this review encompassed pulmonary embolism, deep vein thrombosis, and cerebral venous thrombosis.

Results

A total of 25 articles were finally involved in this study. Our results revealed that higher levels of high-sensitivity C-reactive protein (hs-CRP, MD, 0.63, 95%CI, 0.21—1.05) and C-reactive protein (CRP)> 3ug/ml (OR, 1.52, 95%CI, 1.18—1.96) might be regarded as risk factors for future VTE occurrence. The elevated levels of monocyte (MD, 0.03, 95%CI, 0.00—0.05), hs-CRP (0.85, 0.61—1.08), CRP (0.66, 0.20—1.13) and IL-6 (0.47, 0.25—0.70) might represent the previous VTE; a series of markers such as white blood cell (1.43, 0.88—1.98), neutrophil (1.79, 1.02—2.56), monocyte (0.17, 0.14—0.21), hs-CRP (3.72, 1.45—5.99), IL−6 (5.99, 4.52—7.46), platelet-lymphocyte ratio (33.1, 24.45—41.78) and neutrophil-lymphocyte ratio (1.34, 0.95—1.73) increased during the acute phase of VTE.

Conclusions

In general, activated inflammatory biomarkers might not only be correlated with an increased risk of VTE, but may also give a hint of the occurrence of VTE in clinical settings.
Adamantinoma-like ewing sarcoma arising in the pancreatic tail: a case report of a rare entity and review of the literature
Authors: Wang Zhe , Wen Xiaobo , Zhang Yingchun , Zhang Xinke
Published: July 2023

ALES is a rare subtype that demonstrates the EWSR1-FLI1 translocation characteristic of ES and demonstrates complex epithelial differentiation including diffuse cytokeratin and p40 expression. It has predominantly recognized in the head and neck and is common in middle-aged population. This case is the first case of ALES reported in the pancreatic tail, sharing some morphological characteristics with ALES in the head and neck, including monotonous cytology, infiltrative growth pattern, and complex epithelioid differentiation, but ALES in the head and neck often has high-grade histological features (e.g., necrosis, high mitotic rate, etc.), and sudden keratinization can also occur, but these features were not reflected in this primary pancreatic tail ALES. Although ALES arising in the pancreatic tail and in the head and neck sites share the immunohistochemical and molecular profile, our case can provide new ideas in differential diagnosis of ALES arising in pancreatic tail and promote increased recognition and understanding of ALES.
Disc degeneration is easily occurred at the same and adjacent cephalad level in cervical spine when Modic changes are present
Authors: Liu Junhui , Chen Binhui , Hao Lu , Shan Zhi , Chen Yilei , Zhao Fengdong
Published: July 2023

Objective

This research aimed to evaluate the influence of Modic changes (MCs) on disc degeneration at the same and adjacent cephalad levels in the cervical spine.

Methods

This research retrospectively reviewed 1036 patients with neck pain, upper limb pain, or numbness who were treated at our out-patient clinic and underwent cervical MRI and cervical anteroposterior/lateral radiography from Jan, 2016 to Jan, 2021. MCs and disc degeneration parameters at same and nearby cephalad levels of MCs were evaluated. Discs were divided into the MCs, adjacent, and control groups, and the association between MCs and disc degeneration at the same and adjacent cephalad levels was investigated.

Results

Of the 1036 patients whose MRI scans were reviewed, 986 met the inclusion criteria (503 women and 483 men; average age, 62.8 years; scope of 35–79 years). The prevalence of MCs in the cervical spine was 13.0% (128/986). Type I, II, III changes were observed in 38 (29.69%), 82 (64.06%), and 8 (6.25%) patients, respectively. MCs were most frequently identified at the C5–6 (59/986; 5.98%) and C6–7 (38/986; 3.85%) levels. Disc with MCs showed worse outcomes with regard to disc degeneration grade, anterior osteophyte formation than the adjacent and control groups (p < 0.05), whereas they were more severe in the adjacent group compared to normal group.

Conclusion

Our findings indicate that MCs increased disc degeneration at the same and nearby cephalad levels in cervical spine, and the severity of degeneration at the same segment was more serious than that at the cephalad level.
The CAR-HEMATOTOX score as a prognostic model of toxicity and response in patients receiving BCMA-directed CAR-T for relapsed/refractory multiple myeloma
Authors: Rejeski Kai , Hansen Doris K. , Bansal Radhika , Sesques Pierre , Ailawadhi Sikander , Logue Jennifer M. , Bräunlein Eva , Cordas dos Santos David M. , Freeman Ciara L. , Alsina Melissa , Theurich Sebastian , Wang Yucai , Krackhardt Angela M. , Locke Frederick L. , Bachy Emmanuel , Jain Michael D. , Lin Yi , Subklewe Marion
Published: July 2023

Background

BCMA-directed CAR T-cell therapy (CAR-T) has altered the treatment landscape of relapsed/refractory (r/r) multiple myeloma, but is hampered by unique side effects that can lengthen hospital stays and increase morbidity. Hematological toxicity (e.g. profound and prolonged cytopenias) represents the most common grade ≥ 3 toxicity and can predispose for severe infectious complications. Here, we examined the utility of the CAR-HEMATOTOX (HT) score to predict toxicity and survival outcomes in patients receiving standard-of-care idecabtagene vicleucel and ciltacabtagene autoleucel.

Methods

Data were retrospectively collected from 113 r/r multiple myeloma patients treated between April 2021 and July 2022 across six international CAR-T centers. The HT score—composed of factors related to hematopoietic reserve and baseline inflammatory state—was determined prior to lymphodepleting chemotherapy.

Results

At lymphodepletion, 63 patients were HTlow (score 0–1) and 50 patients were HThigh (score ≥ 2). Compared to their HTlow counterparts, HThigh patients displayed prolonged severe neutropenia (median 9 vs. 3 days, p < 0.001), an increased severe infection rate (40% vs. 5%, p < 0.001), and more severe ICANS (grade ≥ 3: 16% vs. 0%, p < 0.001). One-year non-relapse mortality was higher in the HThigh group (13% vs. 2%, p = 0.019) and was predominantly attributable to fatal infections. Response rates according to IMWG criteria were higher in HTlow patients (≥ VGPR: 70% vs. 44%, p = 0.01). Conversely, HThigh patients exhibited inferior progression-free (median 5 vs. 15 months, p < 0.001) and overall survival (median 10.5 months vs. not reached, p < 0.001).

Conclusions

These data highlight the prognostic utility of the CAR-HEMATOTOX score for both toxicity and treatment response in multiple myeloma patients receiving BCMA-directed CAR-T. The score may guide toxicity management (e.g. anti-infective prophylaxis, early G-CSF, stem cell boost) and help to identify suitable CAR-T candidates.
Targeting NEDD8-activating enzyme for cancer therapy: developments, clinical trials, challenges and future research directions
Authors: Fu Dong-Jun , Wang Ting
Published: July 2023

NEDDylation, a post-translational modification through three-step enzymatic cascades, plays crucial roles in the regulation of diverse biological processes. NEDD8-activating enzyme (NAE) as the only activation enzyme in the NEDDylation modification has become an attractive target to develop anticancer drugs. To date, numerous inhibitors or agonists targeting NAE have been developed. Among them, covalent NAE inhibitors such as MLN4924 and TAS4464 currently entered into clinical trials for cancer therapy, particularly for hematological tumors. This review explains the relationships between NEDDylation and cancers, structural characteristics of NAE and multistep mechanisms of NEDD8 activation by NAE. In addition, the potential approaches to discover NAE inhibitors and detailed pharmacological mechanisms of NAE inhibitors in the clinical stage are explored in depth. Importantly, we reasonably investigate the challenges of NAE inhibitors for cancer therapy and possible development directions of NAE-targeting drugs in the future.
Neutrophils extracellular traps formation may serve as a biomarker for disease activity in oligoarticular juvenile idiopathic arthritis: a pilot study
Authors: Heshin-Bekenstein Merav , Baron Szilvia , Schulert Grant , Shusterman Anna , Fidel Victoria , Ben-Shahar Yoav , Shukrun Rachel , Binenbaum Yoav , Elhasid Ronit
Published: July 2023

Background

Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in children, causing significant morbidity. Despite the dramatic improvement in treatment, many patients do not achieve complete remission, and biomarkers for subclinical disease, flares, and response to treatment are lacking. Neutrophils and neutrophil extracellular traps (NETs) play key roles in the pathogenesis of autoimmune and inflammatory conditions. In this study, we characterized neutrophil enzyme activity and NETs formation in oligoarticular and polyarticular JIA and explored their association with disease activity.

Methods

Neutrophils from 6 healthy controls and 7 patients with oligoarticular and polyarticular JIA were freshly isolated at time of diagnosis and after glucocorticoid intra-articular injection. Enzymatic activity of neutrophil granular enzymes was monitored by colorimetry and PMA-activated NETs formation was assessed using fluorescent microscopy.

Results

In this pilot and feasibility study, we revealed that NETs were significantly increased in oligoarticular JIA patients at time of diagnosis compared to healthy controls. Anti-inflammatory treatment using intra-articular steroid injection normalized NETs formation in these patients. Correlation between NETs formation and clinical Juvenile Activity Disease Activity Score-10 (cJADAS-10) was linear and significant (P = 0.007) in oligo but not in poly JIA patients.

Conclusions

This is the first study exploring the link of NETs formation with oligo and poly JIA activity. We demonstrated a statistically significant linear correlation between cJADAS-10 and NETs formation in oligo but not in poly JIA patients. Hence, we suggest that NETs may reflect clinical disease activity in JIA, and may serve as a putative biomarker. Further work is needed to validate these initial results and determine the dynamics of NETs formation in JIA.
The impact of CFTR modulator triple therapy on type 2 inflammatory response in patients with cystic fibrosis
Authors: Mehta A. M. , Lee I. , Li G. , Jones M. K. , Hanson L. , Lonabaugh K. , List R. , Borish L. , Albon D. P.
Published: July 2023

Background

Treatment of cystic fibrosis (CF) has been revolutionized by the use of cystic fibrosis transmembrane conductance regulator (CFTR) protein modulators such as elexacaftor/tezacaftor/ivacaftor (ETI) triple therapy. Prior studies support a role for type 2 (T2) inflammation in many people with CF (PwCF) and CF-asthma overlap syndrome (CFAOS) is considered a separate clinical entity. It is unknown whether initiation of ETI therapy impacts T2 inflammation in PwCF. We hypothesized that ETI initiation decreases T2 inflammation in PwCF.

Methods

A single center retrospective chart review was conducted for adult PwCF. As markers of T2 inflammation, absolute eosinophil count (AEC) and total immunoglobulin E (IgE) data were collected longitudinally 12 months prior to ETI therapy initiation and 12 months following therapy initiation. Multivariable analyses adjusted for the age, gender, CFTR mutation, disease severity, inhaled steroid use, and microbiological colonization.

Results

There was a statistically significant reduction (20.10%, p < 0.001) in 12-month mean total IgE following ETI initiation; this change remained statistically significant in the multivariate model. The longitudinal analysis demonstrated no change in AEC following therapy initiation.

Conclusion

This study demonstrates that there is a statistically significant percent reduction in mean total IgE but no change in AEC following ETI initiation. ETI may lead to decreased antigen and superantigen load in the airway as a result of improved mucociliary clearance and these changes may drive the decline in total IgE, without influencing the epigenetic drivers of eosinophilic inflammation. Further studies are warranted to determine the underlying mechanism of ETI impact on T2 inflammation and possible role for asthma immunomodulator therapy post ETI initiation in CFAOS.
An improved multi-source information fusion method for IMU compensation of missile
Authors: Shi Chunfeng , Chen Xiyuan , Wang Junwei
Published: July 2023

The conventional SINS/CNS integrated navigation system equipped on ballistic missiles is typically equipped with attitude measurement, which can only estimate the gyro drift and has no effect on accelerometer bias. To address the issue, an improved multi-source information fusion method containing a new nonlinear framework called SINS/RKCNS with the indirect horizon reference and kinematic constraint is proposed, and a MAP-based modified iterated CKF is involved to increase positioning accuracy and system robustness. Furthermore, to reduce the influence of correlated noise, state augmentation is employed in the iterative process. Eventually, experiments are conducted, and the results confirm the effectiveness of the proposed approach.
Clinical utility of overviews on adverse events of pharmacological interventions
Authors: Sachse Thilo , Kanji Salmaan , Thabet Pierre , Schmiedl Sven , Thürmann Petra , Guirguis Fadi , Sajwani Shellyza , Gauthier Marie-France , Lunny Carole , Mathes Tim , Pieper Dawid
Published: July 2023

Background

Overviews (i.e., systematic reviews of systematic reviews, meta-reviews, umbrella reviews) are a relatively new type of evidence synthesis. Among others, one reason to conduct an overview is to investigate adverse events (AEs) associated with a healthcare intervention. Overviews aim to provide easily accessible information for healthcare decision-makers including clinicians. We aimed to evaluate the clinical utility of overviews investigating AEs.

Methods

We used a sample of 27 overviews exclusively investigating drug-related adverse events published until 2021 identified in a prior project. We defined clinical utility as the extent to which overviews are perceived to be useful in clinical practice. Each included overview was assigned to one of seven pharmacological experts with expertise on the topic of the overview. The clinical utility and value of these overviews were determined using a self-developed assessment tool. This included four open-ended questions and a ranking of three clinical utility statements completed by clinicians. We calculated frequencies for the ranked clinical utility statements and coded the answers to the open-ended questions using an inductive approach.

Results

The overall agreement with the provided statements was high. According to the assessments, 67% of the included overviews generated new knowledge. In 93% of the assessments, the overviews were found to add value to the existing literature. The overviews were rated as more useful than the individual included systematic reviews (SRs) in 85% of the assessments. The answers to the open-ended questions revealed two key aspects of clinical utility in the included overviews. Firstly, it was considered useful that they provide a summary of available evidence (e.g., along with additional assessments, or across different populations, or in different settings that have not been evaluated together in the included SRs). Secondly, it was found useful if overviews conducted a new meta-analysis to answer specific research questions that had not been answered previously.

Conclusions

Overviews on drug-related AEs are considered valuable for clinical practice by clinicians. They can make available evidence on AEs more accessible and provide a comprehensive view of available evidence. As the role of overviews evolves, investigations such as this can identify areas of value.
Can blockchain technology strengthen consumer preferences for credence attributes?
Authors: Contini Caterina , Boncinelli Fabio , Piracci Giovanna , Scozzafava Gabriele , Casini Leonardo
Published: July 2023

Consumers’ interest in product information, such as nutrition, environment, and social aspects, is increasing in the food market. Blockchain technology can enhance credibility of quality signals on labels through transparency and accountability in the supply chain. This study examines the impact of blockchain technology on reducing consumer uncertainty about credence attributes and facilitating informed choices. It is particularly relevant for food policies, as greater consumer awareness promotes proactive involvement in sustainability and public health. We conducted a choice experiment with 300 Italian consumers, focusing on craft beer and analysing how blockchain technology in strengthens organic and DOP certification. The results provide valuable insights for producers and policymakers to develop voluntary approaches that engage society in objectives that concern the collective well-being. They highlight the potential of blockchain technology in communicating credence attributes and empowering consumers. However, our study reveals that the impact of blockchain technology on choices is influenced by a different level of trust, likely due to the complexity of understanding its functioning.
Sodium levels and grazing pressure shape natural communities of the intracellular pathogen Legionella
Authors: Bergman Oded , Be’eri-Shlevin Yaron , Ninio Shira
Published: July 2023

Background

Legionella are parasites of freshwater protozoa, responsible for Legionellosis. Legionella can be found in a variety of aquatic environments, including rivers, lakes, and springs, as well as in engineered water systems where they can potentially lead to human disease outbreaks. Legionella are considered to be predominantly freshwater organisms with a limited ability to proliferate in saline environments. Exposure of Legionella to high sodium concentrations inhibits growth and virulence of laboratory strains, particularly under elevated temperatures. Nonetheless, Legionella have been identified in some saline environments where they likely interact with various protozoan hosts. In this work, we examine how these selection pressures, sodium and grazing, help shape Legionella ecology within natural environments. Utilizing Legionella-specific primers targeting a variable region of the Legionella 16S rRNA gene, we characterized Legionella abundance, diversity, and community composition in natural spring clusters of varying sodium concentrations, focusing on high sodium concentrations and elevated temperatures.

Results

We observed the highest abundance of Legionella in spring clusters of high salinity, particularly in combination with elevated temperatures. Legionella abundance was strongly related to sodium concentrations. The Legionella community structure in saline environments was characterized by relatively low diversity, compared to spring clusters of lower salinity. The community composition in high salinity was characterized by few dominant Legionella genotypes, not related to previously described species. Protozoan microbial community structure and composition patterns resembled those of Legionella, suggesting a common response to similar selection pressures. We examined Legionella co-occurrence with potential protozoan hosts and found associations with Ciliophora and Amoebozoa representatives.

Conclusions

Our results indicate that selection forces in saline environments favor a small yet dominant group of Legionella species that are not closely related to known species. These novel environmental genotypes interact with various protozoan hosts, under environmental conditions of high salinity. Our findings suggest that alternative survival mechanisms are utilized by these species, representing mechanisms distinct from those of well-studied laboratory strains. Our study demonstrate how salinity can shape communities of opportunistic pathogens and their hosts, in natural environments, shedding light on evolutionary forces acting within these complex environments.
Using a drifting GPS-Argos satellite buoy as a method for detecting acoustic-tagged fish offshore in an ancient lake
Authors: Yoshida Makoto A. , Mabuchi Kohji
Published: July 2023

Background

Telemetry methods that allow low-cost, offshore tracking are required for the effective conservation and sustainable use of migratory fish in large lakes with vast and deep offshore areas. Surface drifting buoys, or drifters, are promising platforms for acoustic receiver attachment that have few operational constraints. However, the low recovery rate of drifters in the open ocean presents a challenge. In contrast, closed waters, such as lakes, are more suitable for operating drifters since drifting objects eventually strand on the shore. In this study, we examined the effectiveness of a single GPS-tracked drifter for telemetry surveys of the common carp Cyprinus carpio, which migrates throughout the large offshore area of a large lake, Lake Biwa, in Japan. Its performance was assessed regarding the success rate of drifter recovery, detection frequency of tagged individuals, search area of the drifter, and accuracy of detection locations.

Results

We successfully recovered the drifter during all eight deployments. In 6 deployments, tagged individuals were detected 777 times. The drifter successfully detected 48% (10 of 21) of the tagged individuals, exhibiting higher performance (10–33%) than fixed receivers used in other telemetry studies conducted on highly migratory fish species in the lake. The drifter scanned an area of 5.5–8.0 km2 per day. Based on the data obtained from the field trials, the horizontal location accuracy of detected individuals was estimated to be approximately 400 m in shallow coastal areas and 600 m in deep offshore areas. Furthermore, the horizontal distance of tagged individuals traveled was estimated to be between 2 and 9 km within a day.

Conclusion

Our newly developed method deploys and retrieves a single GPS drifter that allows low-cost, wide-ranging telemetry surveys in offshore areas of large lakes. The lack of boat noise, moderate moving speed, and continuity of observation range of the drifter seemingly enabled the efficient detection of tagged individuals. Thus, the drifter method offers a promising novel approach for acoustic telemetry in offshore waters that can operate in combination with large receiver arrays and other mobile platforms.
Mental illness stigma among indigenous communities in Bangladesh: a cross-sectional study
Authors: Faruk Md. Omar , Rosenbaum Simon
Published: July 2023

Background

Mental illnesses stigma is a universal and transcultural phenomenon. While mental illnesses stigma is pervasive in Bangladesh, very little research exists on stigma toward mental illnesses among indigenous communities. This study aimed to investigate the prevailing stigma and the risk factors among different indigenous communities in the Chattogram Hill Tracts (CHT) in Bangladesh.

Methods

A cross-sectional survey was carried out and participants were recruited purposively from Rangamati, a South-Eastern district of Bangladesh in the CHT. Participants from various indigenous communities including Chakma, Marma, Rakhine, Tripura, and Pangkhua were recruited. The 28- item Bangla translated version of the Mental Illnesses Stigma Scale was used. Independent-samples t-test, ANOVA, and multiple regression were performed.

Results

The results indicate evidence of a gender difference with females reporting more stigma than their male counterparts. Age, gender, socioeconomic status, and monthly income are associated with stigma among indigenous people. Further analyses of the subscales indicated significant differences among sociodemographic variables.

Conclusions

The results provide an insight into the prevailing stigma and associate risk factors among indigenous communities. The results may help inform anti-stigma interventions targeting indigenous communities in Bangladesh.
The marriage of immunomodulatory, angiogenic, and osteogenic capabilities in a piezoelectric hydrogel tissue engineering scaffold for military medicine
Authors: Wu Ping , Shen Lin , Liu Hui-Fan , Zou Xiang-Hui , Zhao Juan , Huang Yu , Zhu Yu-Fan , Li Zhao-Yu , Xu Chao , Luo Li-Hua , Luo Zhi-Qiang , Wu Min-Hao , Cai Lin , Li Xiao-Kun , Wang Zhou-Guang
Published: July 2023

Background

Most bone-related injuries to grassroots troops are caused by training or accidental injuries. To establish preventive measures to reduce all kinds of trauma and improve the combat effectiveness of grassroots troops, it is imperative to develop new strategies and scaffolds to promote bone regeneration.

Methods

In this study, a porous piezoelectric hydrogel bone scaffold was fabricated by incorporating polydopamine (PDA)-modified ceramic hydroxyapatite (PDA-hydroxyapatite, PHA) and PDA-modified barium titanate (PDA-BaTiO3, PBT) nanoparticles into a chitosan/gelatin (Cs/Gel) matrix. The physical and chemical properties of the Cs/Gel/PHA scaffold with 0–10 wt% PBT were analyzed. Cell and animal experiments were performed to characterize the immunomodulatory, angiogenic, and osteogenic capabilities of the piezoelectric hydrogel scaffold in vitro and in vivo.

Results

The incorporation of BaTiO3 into the scaffold improved its mechanical properties and increased self-generated electricity. Due to their endogenous piezoelectric stimulation and bioactive constituents, the as-prepared Cs/Gel/PHA/PBT hydrogels exhibited cytocompatibility as well as immunomodulatory, angiogenic, and osteogenic capabilities; they not only effectively induced macrophage polarization to M2 phenotype but also promoted the migration, tube formation, and angiogenic differentiation of human umbilical vein endothelial cells (HUVECs) and facilitated the migration, osteo-differentiation, and extracellular matrix (ECM) mineralization of MC3T3-E1 cells. The in vivo evaluations showed that these piezoelectric hydrogels with versatile capabilities significantly facilitated new bone formation in a rat large-sized cranial injury model. The underlying molecular mechanism can be partly attributed to the immunomodulation of the Cs/Gel/PHA/PBT hydrogels as shown via transcriptome sequencing analysis, and the PI3K/Akt signaling axis plays an important role in regulating macrophage M2 polarization.

Conclusion

The piezoelectric Cs/Gel/PHA/PBT hydrogels developed here with favorable immunomodulation, angiogenesis, and osteogenesis functions may be used as a substitute in periosteum injuries, thereby offering the novel strategy of applying piezoelectric stimulation in bone tissue engineering for the enhancement of combat effectiveness in grassroots troops.
A symbiotic footprint in the plant root microbiome
Authors: Hartman Kyle , Schmid Marc W. , Bodenhausen Natacha , Bender S. Franz , Valzano-Held Alain Y. , Schlaeppi Klaus , van der Heijden Marcel G.A.
Published: July 2023

Background

A major aim in plant microbiome research is determining the drivers of plant-associated microbial communities. While soil characteristics and host plant identity present key drivers of root microbiome composition, it is still unresolved whether the presence or absence of important plant root symbionts also determines overall microbiome composition. Arbuscular mycorrhizal fungi (AMF) and N-fixing rhizobia bacteria are widespread, beneficial root symbionts that significantly enhance plant nutrition, plant health, and root structure. Thus, we hypothesized that symbiont types define the root microbiome structure.

Results

We grew 17 plant species from five families differing in their symbiotic associations (no symbioses, AMF only, rhizobia only, or AMF and rhizobia) in a greenhouse and used bacterial and fungal amplicon sequencing to characterize their root microbiomes. Although plant phylogeny and species identity were the most important factors determining root microbiome composition, we discovered that the type of symbioses also presented a significant driver of diversity and community composition. We found consistent responses of bacterial phyla, including members of the Acidobacteria, Chlamydiae, Firmicutes, and Verrucomicrobia, to the presence or absence of AMF and rhizobia and identified communities of OTUs specifically enriched in the different symbiotic groups. A total of 80, 75 and 57 bacterial OTUs were specific for plant species without symbiosis, plant species forming associations with AMF or plant species associating with both AMF and rhizobia, respectively. Similarly, 9, 14 and 4 fungal OTUs were specific for these plant symbiont groups. Importantly, these generic symbiosis footprints in microbial community composition were also apparent in absence of the primary symbionts.

Conclusion

Our results reveal that symbiotic associations of the host plant leaves an imprint on the wider root microbiome – which we term the symbiotype. These findings suggest the existence of a fundamental assembly principle of root microbiomes, dependent on the symbiotic associations of the host plant.
Relationship between disability and psychiatric outcome in multiple sclerosis patients and its determinants
Authors: Hassan Shady Safwat , Darwish Esam S. , Ahmed Gellan K. , Azmy Samah R. , Haridy Nourelhoda A.
Published: July 2023

Background

Multiple sclerosis (MS) is an inflammatory demyelinating central nervous system disease with diverse clinical manifestations. The present study aimed to compare the psychiatric outcomes of MS patients with full ambulatory versus impaired ambulatory function and identify the potential risk factors for disability in MS. Seventy MS patients were classified into two groups based on their Expanded Disability Status Scale (EDSS) scores, Group A: full ambulatory (EDSS ≤ 4.5) (N = 48), Group B: impaired ambulatory (EDSS ≥ 5) (N = 22). All participants were evaluated by the Socioeconomic Scale, Hamilton Anxiety Scale, Hamilton Depression Scale, Brief Psychiatric Rating Scale, and The Pittsburgh Sleep Quality Index.

Results

In the total cohort (N = 70), females represented (77.1%). The mean age was 31.16 ± 6.46, the mean age of onset was 26 ± 6.083, and the mean disease duration was 5.33 ± 3.653 years which was less in Group A than in Group B. Relapsing–remitting multiple sclerosis (RRMS) was the most common presentation (80%), representing 93.6% of Group A. Group A reported more severe depression and anxiety, while Group B had more poor sleep quality. Correlation analysis showed increased relapses, progressive-relapsing multiple sclerosis (PRMS), cervical or dorsal plaques, sensory or motor manifestations, and precipitancy increased disability, while RRMS type decreased disability.

Conclusions

Full ambulatory MS patients had high anxiety and depression, while impaired ambulatory MS patients had poor sleep quality. Associated factors for disability were frequent relapses, plaque location, MS subtype, sphincter, and sensory symptoms.

Trial registration clinicaltrials.gov, NCT05029830. Registered: September 01, 2021, https://clinicaltrials.gov/ct2/show/NCT05029830
Willingness to receive COVID-19 vaccine in relation to psychological wellbeing among a sample of university students in Vietnam
Authors: Bui Nhat-Le , Thi Hue Vu , Suong Mai Vu Ngoc , Thi Yen Vy Nguyen , Le Thuy-Tien , Thi Lan-Anh Nguyen , Tang Thuy-Linh , Sharma Rajesh , Chu Dinh-Toi
Published: July 2023

Background and aims

Nowadays, there are contradicting opinions about the benefits and risks of COVID-19 vaccine, which lead to the hesitance among recipients to receive the vaccine. This study aims to evaluate the university student’s attitude toward COVID-19 vaccine, preventative measure, and status of their psychological wellbeing.

Methods

This was a cross-sectional study among Vietnamese students aged ≥ 18 years to evaluate their willingness to receive COVID-19 vaccine, psychological wellbeing status, and preventive measure compliance. The participants were asked to fill in a questionnaire via Google Form. Descriptive and analytical statistics were performed with p < 0.05 being considered as statistically significant.

Results

A total of 2998 randomly selected participants in Vietnam completed the questionnaire with participants’ mean age of 20.26 $$\pm$$
±
1.84. The mean score for the willingness to receive COVID-19 vaccination was 46.13 $$\pm$$
±
19.03 (the highest point was 54). Regarding preventative measures, the mean score of compliance was 7.15 $$\pm$$
±
1.98 over a 10 points scale and “being vaccinated or not” did not affect their compliance. 56.94% participants were having normal psychological wellbeing at the time of survey and rest 43.06% reported to have experienced stress, varying from slight to severe level. There might be a trend that those studying medicine or those with higher educational level had higher rate of stress than others.

Conclusion

The study showed a positive result of Vietnamese students’ willingness to receive COVID-19 vaccine and compliance towards preventive measures. Besides, we also reported that almost half participants had experienced stress during the pandemic. Developing proper interventions to deal with factors contributing to psychological wellbeing and related problems are essential to deal  with and overcome the pandemic or post-pandemic struggles.
Propionic acidaemia crisis: a specific DWI finding—case report
Authors: Abdella Khairy
Published: July 2023

Background

Propionic acidaemia is among the rarest metabolic disorders described in the literatures. It has resulted from an inborn error in the catabolism of amino acids with an accumulation of organic acids as a consequence of this error. This illness was especially manifested and discovered in early postnatal life with other forms seen later in the childhood period.

It has different clinical presentations with poor feeding, hypotonia, and lethargy described in the early neonatal period, while mental retardation, global developmental delay, and seizures are seen in childhood.

Case presentation

We present a case of a 4-month-old child already diagnosed in his early neonatal period with propionic acidaemia currently presented with propionic acidaemic crisis in the form of frequent attack of seizures and severe hyperammonemia with unique DWI features which shows bilateral symmetrical restricted diffusion in the subcortical and subinsular white matter that are specific to propionic acidaemia crisis and does not relate to any vascular territory.

Conclusion

Propionic acidaemia is one of the rarest metabolic disorders reported in both early neonatal life and the childhood period. Understanding the clinical presentation and MRI findings with specific DWI changes reported in this case assists the health care provider in making the appropriate clinical management and metabolic screening decisions. This case with these rare and specific DWI changes seems to be unique to the propionic acidaemia crisis which reinforces MRI findings and changes mentioned previously in the literatures.