bluuebunny/crossref_metadata_2025 huggingface dataset:
Purine nucleosidase (PNase) activity, probiotics potential, and food applicability of a newly-isolated Levilactobacillus brevis LAB42
Authors: Ferdiansyah Mokhammad Khoiron , Kang Hai-Seong , Kim Ga Yeong , Park Beomseok , Kularathna Ramesha M.R.E. , Abraha Haftom Baraki , Kim Kwang-Pyo
Published: December 2023

Hyperuricemia, a condition characterized by elevated levels of uric acid in the blood, is known as a risk factor for gout disease. In this study, we isolated a total of 72 MRS-grown colonies and evaluated their purine nucleosidase (PNase) activity. Among the isolated bacteria, Levilactobacillus (L.) brevis LAB42 displayed the highest PNase activity. Our findings also indicate that PNase activity can vary among lactic acid bacterial strains and during different growth phases. Based on the kinetics study, LAB42 consistently exhibits the highest PNase activity. Due to its ability to attach to Caco-2 cells and its resistance to acidic environments and bile exposure, L. brevis LAB42 was chosen for further studies and showed that with the right combination of additives, it has the potential to be an appropriate starter for milk fermentation.
Bayesian-optimized unsupervised semantic segmentation model for structural crack detection
Authors: Sun Qixin , Zheng Ruiping , Xu Boqiang
Published: December 2023

To reduce the reliance of existing mainstream vision-based crack detection algorithms on annotated datasets, this paper presents an unsupervised semantic segmentation-based approach. The proposed method first employs the Felzenszwalb-Huttenlocher algorithm for pre-segmenting the image, generating superpixels. Subsequently, a with an autoencoder model is designed to progressively approximate the superpixel segmentation results, and the optimal model is obtained by Bayesian optimization. Through comparative experiments with existing algorithms, it has been demonstrated that the proposed method performance comparable to supervised algorithms, even without the need for labeled data. As a result, the deployment complexity of the algorithm is significantly reduced, while expanding its applicability.
The impact of taking up care tasks on pensions: Results of typical-case simulations for several European countries
Authors: van den Bosch Karel , Kirn Tanja , Kump Nataša , Liégeois Philippe , Moreira Amílcar , Stropnik Nada , Barslund Mikkel , Vergnat Vincent , Dekkers Gijs
Published: December 2023

Informal care is often accompanied by a reduction or abandonment of professional activity by the caregiver. Therefore, caregiving may be associated with a lower pension for the former caregiver than for people without care obligations. There is a large gender difference in informal care responsibilities, and this may contribute to the gender pension gap. As the impact of care-related labour market decisions depends on the design of the pension system, we carry out a cross-country comparison, in which we analyse the impact of care obligations in countries with high (Luxembourg), middle (Liechtenstein, Belgium, Portugal) and low (Slovenia) gender pension gaps. Using typical-case simulation models, we examine how the impact of care-related events is mediated by pension rules, given women's labour market decisions. To what extent does working part time or interrupting one’s career at the age of 30 or 54 reduce the later pension benefit? How are these losses mitigated by pension credits that are conditional on caregiving? We find that the mitigating effects are generally strongest in Belgium, followed by Luxembourg and Slovenia. Such credits hardly exist in Portugal, while in Liechtenstein they have only a small impact. However, the consequences of either working part time or interrupting work can also be mitigated via general rules in the system that are unrelated to caregiving (such as in Portugal and Liechtenstein). They can, on the other hand, be aggravated by the existence of higher accrual rates for individuals who extend their careers, as in Luxembourg and Slovenia.
Predicting climate change and occupants’ behaviour impact on thermal-energy performance of global south housing: Case study in Brazil
Authors: Cruz Alexandre Santana , Bastos Leopoldo Eurico Gonçalves
Published: December 2023

Due to climate change conditions, natural ventilation potential may reduce over the years and increase dependence on HVAC systems. Moreover, occupants’ behaviour regarding natural ventilation is a significant parameter affecting the thermal-energy performance of residential buildings as people tend to occupy their homes differently depending on their life, work and cultural routines. Therefore, in this study, the thermal-energy performance of a Global South (GS) housing case study located in Brazil was assessed in a future weather context. This paper included two major steps: (1) Optimization procedure to create optimized models based on different occupancy patterns; and (2) Parametric analysis to explore the building’s thermal-energy performance for a given constructive design option, occupant behaviour and weather data. The optimization procedure included a multi-objective optimization based on the Non-dominated Sorting Genetic Algorithm II (NSGA-II) to minimize discomfort hours and cooling energy demand, while parametric analysis explored the occupants’ behaviour varieties derived from alternative occupancy patterns, ventilation availabilities and HVAC operation modes. The obtained future context simulation results indicated an increase in discomfort hours and cooling energy demand, while the most appropriate architecture design might vary depending on the occupancy behaviour.
Is There a Main Effect? Improving Data Literacy Using Practice Examples and Peer Collaboration
Authors: Cross Victoria L. , Imundo Megan N. , Clark Courtney M. , Paquette-Smith Melissa
Published: December 2023

Learning to interpret visual representations of data is an important step towards becoming an informed consumer of research. The current study assesses the effectiveness of two versions of a scaffolded online module in improving students’ ability to identify main effects and interactions in 2 × 2 factorial designs. Across two experiments ( N = 313), we compared exam performance between sections of a lower-division conceptual statistics course that completed the module (in addition to other course activities) to a section that did not complete the module ( n = 91). The first iteration of the module (used in Experiment 1, n = 96) was completed once individually and once with peers and did not enhance students’ individual performance on conceptually-related exam questions. However, performance on the module was low, indicating that students may have needed more support to benefit from this experience. In Experiment 2 ( n = 126), we made three empirically-driven changes to better scaffold student learning: we added a worked example, offered a greater variety of examples, and instructed students to complete the whole activity with peers. Under these conditions, performance increased on related exam questions. We conclude that this freely available module is a promising intervention to strengthen students’ ability to understand factorial designs.
An Introduction to the James Quirk Special Issue and the Economics of Combat Sport
Authors: Butler Robert
Published: December 2023

The purpose of this special issue is two-fold. Firstly, it is a celebration of the contributions and life of James (Jim) Patrick Quirk. Jim's contributions to the field of economics and sub-discipline of sports economics span almost half a century, and he can rightly be considered one of the forefathers of the subject. The second is to consider an area that, to date, has received little attention in sports economics and is deserving of greater exploration – combat sport. Appropriately, two of the earliest working papers considering combat sport were co-authored by Jim Quirk, and therefore, it is fitting that this area is explored in the realization of this special issue.
James Patrick Quirk: An Academic Obituary
Authors: Fort Rodney
Published: December 2023

The work summarizes the contributions of James (Jim) Patrick Quirk to the field of economics, and sub-discipline of sports economics. It also provides a personal account of Jim Quirk as both a mentor and friend.
The Switch Up: BlackCrit, The Heritage, and the Wave of Athletic Racial Capitalism
Authors: Williams A. Lamont , Schweinbenz Amanda , Pegoraro Ann
Published: December 2023

In this article, the authors examine the period of time between Edwards’ third and fourth waves of athlete activism, featuring a lapse in The Heritage of Black athlete activism efforts. By applying a Black Critical Theory lens and analyzing athletes like Michael Jordan in the apolitical era of Black athletes, this study provides contextual understandings in addressing the gap in Black athlete activism and advancement from the 1980s to the late 2000s. The BlackCrit lens allows for the exposure of the problematic nature of racial capitalism, and how it caused athletes to go against The Heritage of Black athlete activism.
Machine learning and deep learning for brain tumor MRI image segmentation
Authors: Khan Md Kamrul Hasan , Guo Wenjing , Liu Jie , Dong Fan , Li Zoe , Patterson Tucker A , Hong Huixiao
Published: December 2023

Brain tumors are often fatal. Therefore, accurate brain tumor image segmentation is critical for the diagnosis, treatment, and monitoring of patients with these tumors. Magnetic resonance imaging (MRI) is a commonly used imaging technique for capturing brain images. Both machine learning and deep learning techniques are popular in analyzing MRI images. This article reviews some commonly used machine learning and deep learning techniques for brain tumor MRI image segmentation. The limitations and advantages of the reviewed machine learning and deep learning methods are discussed. Even though each of these methods has a well-established status in their individual domains, the combination of two or more techniques is currently an emerging trend.
Peacebuilding and Social Change Through Soap Opera: The Two Elements of Moral Authority of ‘Team Kenya’
Authors: Pukallus Stefanie , Brouwers Laura A. C. M.
Published: December 2023

Thus far, the success of soap operas in peacebuilding and their contribution to social change have been attributed to the edutainment format they usually take. The edutainment format is indeed an essential element of success, but it alone does not reveal the basis for soap operas’ influence on audiences and societies. We therefore argue that for soap operas to have a transformative peacebuilding effect, to contribute to the learning of non-violent engagement with conflict and thereby to enable social change and resilience to violent conflict within societies, they need to do more than educate and entertain: they need to acquire moral authority. This moral authority can only be derived from the combination of two elements: first, edutainment and second, civil norm building. The second element, though indispensable, has thus far not formed part of our understanding of the success of soap operas. To illustrate our argument, we take the soap opera Team Kenya which was created following the 2007–2008 post-election violence to help Kenyans overcome their ethnic-tribal identity conflicts in non-violent ways as a case study.
The Rise of a “Fudan Goddess”: Cultural Entrepreneurship in China Between Moral Education and Popular Culture
Authors: Fumian Marco
Published: December 2023

This article investigates the trajectory of Chen Guo, a successful moral educator who became an internet celebrity and bestselling author of self-help books thanks to the originality of her teaching methods. The article reveals that Chen Guo's contributions as a state teacher and as a popular cultural producer, rather than being at odds with each other, are to a very large extent unified, as she has managed to create a moralising but depoliticised approach to teaching which encourages personal self-improvement and social awareness by drawing from the principles and practices of self-help literature. Chen Guo's career and work thus offer a unique case to investigate the interactions and the intersections between official and popular culture in contemporary China, in particular, by observing how the current party-state's ideological apparatuses incorporate the creative use of popular cultural forms in their message with the aim of enhancing the efficacy of the official ideological education.
Human Capital Development and Performance in Garment Industries in Nigeria: Business Owners and Employees Simultaneous Development Perspectives
Authors: Abolarinwa Samson Ige , Asogwa Cosmas Ikechukwu , Ugwu Osmund Chinweoda , Adedoyin Samuel , Uzuagu Anthonia Uju , Ndu Vitalis Chinedu
Published: December 2023

The development of firm employees may not be sufficient without simultaneous development of business founders’ intellectual capital because of the role business founders play in business strategy decisions and their increasing involvement in business operations. Prior studies seem to have ignored this important role of business founders in ascertaining the effects of human capital development in corporate performance by focusing solely on firm’s employees. This study proposed and tested human capital development from both business founders’ and employees’ perspective and determined how such simultaneous intellectual development can enhance firms’ productivity in garment industry in Nigeria. A survey research design method was employed and the data collected from 100 individuals who either owned or belonged to the top management team of Garment Industries in Nigeria was empirically tested using regression analysis. The result indicated that human capital development of business founders and employees positively affect firms’ productivity suggesting that firms that engage in simultaneous training of employees and founders performed better than those focusing solely on employees. Simultaneous training, educating, mentoring and learning capacity of both business founders and their employees can generate substantial returns to garment firms that can revitalize the industry while making them internationally competitive. The positive effect associated with simultaneous human capital development of founders and employees depends on good management efficiency as training the founders requires effective human development strategy. Generally, this effect suggests that human capital development should be given adequate attention and may not be value adding if business owners are not connected in the model of organizational human capital development.
Treatment Outcomes After Switching to Second-Line Anti-Retroviral Therapy: Results From the Thai National Treatment Program
Authors: Sudsila Pupe , Teeraananchai Sirinya , Kiertiburanakul Sasisopin , Lertpiriyasuwat Cheewanan , Triamwichanon Rattaphon , Gatechompol Sivaporn , Putcharoen Opass , Chetchotisakd Ploenchan , Avihingsanon Anchalee , Kerr Stephen J , Ruxrungtham Kiat
Published: December 2023

This study aimed to assess second-line antiretroviral therapy (ART) outcomes in a National HIV Treatment program. People living with HIV aged ≥18 years initiating first-line ART who switched to second-line protease inhibitor-based regimens from January 2008 to May 2019, with a minimum of 1-year follow-up were studied. The primary outcome was second-line treatment failure (two consecutive virological failure episodes (viral load ≥1000 copies/mL)). Of 318,506 PLH initiating ART, 29,015 (9.1%) switched to second-line regimens after a median (IQR) ART duration of 1.63 (0.60-3.59) years. Lost to follow-up (LTFU) occurred in 5316 (18.3%) of whom 1376 (5%) remained LTFU and alive; 4606 (15.9%) died. Cumulative second-line failure incidence was 9.8% at 6 years, more common in females, younger PLH those with lower switch CD4 cell counts. Multidisciplinary, innovative support systems are needed to improve second-line treatment outcomes, particularly those relating to modifiable risk factors.
Dietary Consumption on Glycemic Control Among Prediabetes: A Review of the Literature
Authors: Thipsawat Sopida
Published: December 2023

Introduction

Prediabetes is a condition that, if left unaddressed, can lead to various complications, such as neuropathy, retinopathy, and nephropathy. Among the critical factors contributing to the development of type 2 diabetes mellitus, dietary choices stand out as particularly significant.

Objective

Consequently, our objective is to examine the latest research findings concerning dietary consumption and its impact on glycemic control in individuals with prediabetes.

Methods

A literature review of randomized controlled trials was performed using databases such as PubMed, Scopus, and ScienceDirect with searches conducted from January 2019 to 2023. The primary reviewer assessed the quality of the selected studies for bias risk using the Joanna Briggs Institute critical appraisal method for randomized controlled trials. Initially, 975 articles were identified through the search, but after applying the inclusion criteria, only 9 articles were ultimately selected.

Results

The review found that a carrageenan-free diet, yogurt with Lactobacillus plantarum OLL2712, Allium hookeri extract (AHE), and delta-tocotrienol improve HbA1C levels. However, salmon, zinc supplement, and balanced deep-sea water were not effective on HbA1C. In addition, studies on the effectiveness of vitamin D in controlling blood glucose levels are inconsistent.

Conclusion

Nurses can enhance patient outcomes through collaborative efforts to create individualized dietary strategies. These strategies may encompass the adoption of a carrageenan-free diet, the inclusion of L plantarum OLL2712-enriched yogurt, the utilization of AHE, and the integration of delta-tocotrienol into the dietary plan. This approach is particularly applicable to ambulatory care nurses, health supervisors, and primary care providers.
Physiological responses of coriander (Coriandrum sativum L.) to exogenous 2,4-epibrassinolide at different concentrations
Authors: Xu Zhiqi , Huang Shuchao , Xie Yandong , Wang Shuya , Jin Ning , Jin Li , Tie Jianzhong , Meng Xin , Li Zhaozhuang , Lyu Jian , Yu Jihua
Published: December 2023

Background

Brassinolide, known as the seventh plant hormone, can improve the photosynthetic capacity of plants, promote plant growth and development, promote the formation of horticultural crop yield, improve the quality of horticultural crops, and also improve the ability of plants to resist biological and abiotic stresses.

Results

The effects of different concentrations of exogenously sprayed 2,4-epibrassinolide (EBR) on growth, physiological and photosynthetic characteristics of ‘All-round large leaf coriander’ were studied in substrate culture. The results showed that 0.05, 0.1, and 0.5 mg.L− 1 EBR promoted the growth of coriander and increased the aboveground fresh and dry weights, with 0.5 mg.L− 1 EBR having the most significant effect. Spraying 0.1 mg.L− 1 EBR increased the content of soluble sugars and protein of coriander leaves. Spraying 0.1 and 0.5 mg.L− 1 EBR significantly increased the chlorophyll content and photosynthetic parameters of coriander leaves, and 0.5 mg.L− 1 EBR also significantly increased the chlorophyll fluorescence parameters of coriander leaves. Spraying 0.5 mg.L− 1 EBR upregulated the expression of CsRbcS, CsFBPase, and CsAld. Correlation analysis showed that aboveground fresh weight under exogenous EBR treatment was significantly positively correlated with aboveground dry weight, plant height, Pn, Gs, Ci, and CsAld (P < 0.05), and soluble sugar content was significantly positively correlated with the number of leaves, Y(II), qP, and CsRbcS. The results of the principal component analysis (PCA) showed that there was a significant separation between the treatment and the control groups. Spraying 0.5 mg.L− 1 EBR can promote the growth of coriander, improve the quality of coriander leaves, and strengthen coriander leaf photosynthetic capacity. This study provides new insights into the promotion of coriander growth and development following the application of exogenous EBR.

Conclusion

Exogenous EBR treatment increased coriander plant height, leaf growth and aboveground dry weight, and enhanced photosynthesis. Exogenous spraying of 0.5 mg.L− 1 EBR had the most significant effect.
Mean platelet volume and total white blood cells as diagnostic biomarkers for acute appendicitis at Omdurman military hospital: a cross-sectional study − 2021
Authors: Basher Mohamed Osman Suliman , Ahmed Ahmed Abdelfattah , Hamza Aamir Abdullahi
Published: December 2023

Background

Acute appendicitis (AA) is among the most common nontraumatic indications for emergent abdominal surgical procedures. However, accurately diagnosing all cases can be challenging, physical examination, biochemical markers, and imaging techniques can sometimes be insufficient. This study aimed to (a) compare the mean platelet volume (MPV) and total white blood cell count (TWBCs) in patients with or without histological evidence of an inflamed appendix and (b) determine the positive predictive value, negative predictive value, sensitivity, and specificity of both MPV and TWBCs as diagnostic biomarkers in the diagnosis of AA. We conducted this research at Omdurman Military Hospital, focusing on patients who presented with symptoms suggestive of AA.

Materials and methods

An analytical cross-sectional study conducted at Omdurman Military Hospital from December 2020 - December 2021. The study population was patients who presented to our emergency department with symptoms and signs suggestive of AA. Participants were patients operated on as cases of AA. Data variables included sociodemographic characteristics, clinical presentations, intraoperative appendix macroscopic findings, preoperative MPV and total white blood cell count (TWBCs), and postoperative histopathological findings.

Results

A total of 106 patients were included in this study, with 75 (68.2%) males; half were 10–19 years old. Sixty-three patients (57.3%) had low (< 7.5 fL) MPV, whereas 47 (42.7%) had normal values. Comparing MPV to total white blood cells (TWBCs) revealed that MPV was more sensitive (84.6%) and specific (90%) than TWBCs during the first 24 h of inflammation. However, the TWBCs were more sensitive (97.2%) but less specific (94.7% vs. 100%) after 24 h of onset.

Conclusion

In this study, MPV was lower in patients with AA, while there was an increase in TWBCs. The high sensitivity and specificity of TWBCs and MPV indicated that they form a promising diagnostic marker for AA.
The association between sedentary behaviour and sarcopenia in older adults: a systematic review and meta-analysis
Authors: Mo Yihan , Zhou Yuxin , Chan Helen , Evans Catherine , Maddocks Matthew
Published: December 2023

Background

Sedentary behaviour is considered to contribute to sarcopenia when combined with physical inactivity. Whether sedentary behaviour is independently associated with sarcopenia remains controversial. The aim of this study is to explore the association between sedentary behaviour and sarcopenia in older adults in community and long-term care facility settings.

Methods

Eight electronic databases including MEDLINE, PsycINFO, Wanfang were searched from inception until August 2023. The review included cross-sectional and longitudinal studies concerning the association between sedentary behaviour and sarcopenia among participants over 60 years old. Evidence was pooled by both random-effects meta-analysis and narrative synthesis. Subgroup analyses explored variation according to adjustment of physical activity, settings, and measurements of sedentary behaviour and sarcopenia. Quality assessment for individual studies was performed with the Joanna Briggs Institute (JBI) Critical Appraisal Checklist.

Results

Seventeen articles (16 cross-sectional studies and 1 longitudinal study) of 25,788 participants from community or long-term care facility settings were included. The overall quality of the included studies was rated high. Meta-analysis of 14 cross-sectional studies showed that sedentary behaviour was independently positively associated with sarcopenia: pooled odd ratio 1.36 (95% confidence interval, 1.18–1.58). The independent positive association remained in subgroup analyses by adjustment of physical activity, settings, and measurements of sedentary behaviour and sarcopenia. The narrative analysis corroborated the findings of the meta-analysis and provided additional evidence suggesting that interruptions in sedentary periods were linked to a decreased likelihood of developing sarcopenia.

Conclusions

The findings support the hypothesis that sedentary behaviour is independently positively associated with sarcopenia in older adults, providing vital indications for the development of strategies to prevent sarcopenia.

Systematic review registration

The systematic review protocol has been registered with the PROSPERO database (CRD42022311399).
Efficacy and safety of glucocorticoids use in patients with COVID-19: a systematic review and network meta‑analysis
Authors: He Qiaolan , Wang Chen , Wang Yingqin , Chen Guannan , Zhou Yue , Wu Yuanyuan , Zhong Ming
Published: December 2023

Background

Currently, some meta-analyses on COVID-19 have suggested that glucocorticoids use can reduce the mortality rate of COVID-19 patients, utilization rate of invasive ventilation, and improve the prognosis of patients. However, optimal regimen and dosages of glucocorticoid remain unclear. Therefore, the purpose of this network meta-analysis is to analyze the efficacy and safety of glucocorticoids in treating COVID-19 at regimens.

Methods

This meta-analysis retrieved randomized controlled trials from the earliest records to December 30, 2022, published in PubMed, Embase, Cochrane Library, CNKI Database and Wanfang Database, which compared glucocorticoids with placebos for their efficacy and safety in the treatment of COVID-19, Effects of different treatment regimens, types and dosages (high-dose methylprednisolone, very high-dose methylprednisolone, Pulse therapy methylprednisolone, medium-dose hydrocortisone, high-dose hydrocortisone, high-dose dexamethasone, very high-dose dexamethasone and placebo) on 28-day all-caused hospitalization mortality, hospitalization duration, mechanical ventilation requirement, ICU admission and safety outcome were compared.

Results

In this network meta-analysis, a total of 10,544 patients from 19 randomized controlled trials were finally included, involving a total of 9 glucocorticoid treatment regimens of different types and dosages. According to the analysis results, the 28-day all-cause mortality rate was the lowest in the treatment with pulse therapy methylprednisolone (OR 0.08, 95% CI 0.02, 0.42), but the use of high-dose methylprednisolone (OR 0.85, 95% CI 0.59, 1.22), very high-dose dexamethasone (OR 0.95, 95% CI 0.67, 1.35), high-dose hydrocortisone (OR 0.64, 95% CI 0.34, 1.22), medium-dose hydrocortisone (OR 0.80, 95% CI 0.49, 1.31) showed no benefit in prolonging the 28-day survival of patient. Compared with placebo, the treatment with very high-dose methylprednisolone (MD = -3.09;95%CI: -4.10, -2.08) had the shortest length of hospital stay, while high-dose dexamethasone (MD = -1.55;95%CI: -3.13,0.03) and very high-dose dexamethasone (MD = -1.06;95%CI: -2.78,0.67) did not benefit patients in terms of length of stay.

Conclusions

Considering the available evidence, this network meta‑analysis suggests that the prognostic impact of glucocorticoids in patients with COVID-19 may depend on the regimens of glucocorticoids. It is suggested that pulse therapy methylprednisolone is associated with lower 28-day all-cause mortality, very high-dose methylprednisolone had the shortest length of hospital stay in patients with COVID-19.

Trial registration

PROSPERO CRD42022350407 (22/08/2022).
The functions of long non-coding RNA (lncRNA)-MALAT-1 in the pathogenesis of renal cell carcinoma
Authors: Anbiyaee Omid , Moalemnia Arash , Ghaedrahmati Farhoodeh , Shooshtari Maryam Khombi , Khoshnam Seyed Esmaeil , Kempisty Bartosz , Halili Shahla Ahmadi , Farzaneh Maryam , Morenikeji Olanrewaju B.
Published: December 2023

Renal cell carcinoma (RCC), a prevalent form of renal malignancy, is distinguished by its proclivity for robust tumor proliferation and metastatic dissemination. Long non-coding RNAs (lncRNAs) have emerged as pivotal modulators of gene expression, exerting substantial influence over diverse biological processes, encompassing the intricate landscape of cancer development. Metastasis-associated lung adenocarcinoma transcript 1 (MALAT-1), an exemplar among lncRNAs, has been discovered to assume functional responsibilities within the context of RCC. The conspicuous expression of MALAT-1 in RCC cells has been closely linked to the advancement of tumors and an unfavorable prognosis. Experimental evidence has demonstrated the pronounced ability of MALAT-1 to stimulate RCC cell proliferation, migration, and invasion, thereby underscoring its active participation in facilitating the metastatic cascade. Furthermore, MALAT-1 has been implicated in orchestrating angiogenesis, an indispensable process for tumor expansion and metastatic dissemination, through its regulatory influence on pro-angiogenic factor expression. MALAT-1 has also been linked to the evasion of immune surveillance in RCC, as it can regulate the expression of immune checkpoint molecules and modulate the tumor microenvironment. Hence, the potential utility of MALAT-1 as a diagnostic and prognostic biomarker in RCC emerges, warranting further investigation and validation of its clinical significance. This comprehensive review provides an overview of the diverse functional roles exhibited by MALAT-1 in RCC.
High SNHG expression may predict a poor lung cancer prognosis based on a meta-analysis
Authors: Shen Guo-yi , Huang Rong-zhi , Yang Shao-bin , Shen Rong-qiang , Gao Jian-li , Zhang Yi
Published: December 2023

Background

An increasing number of small nucleolar RNA host genes (SNHGs) have been revealed to be dysregulated in lung cancer tissues, and abnormal expression of SNHGs is significantly correlated with the prognosis of lung cancer. The purpose of this study was to conduct a meta-analysis to explore the correlation between the expression level of SNHGs and the prognosis of lung cancer.

Methods

A comprehensive search of six related databases was conducted to obtain relevant literature. Relevant information, such as overall survival (OS), progression-free survival (PFS), TNM stage, lymph node metastasis (LNM), and tumor size, was extracted. Hazard ratios (HRs) and 95% confidence intervals (CIs) were pooled to evaluate the relationship between SNHG expression and the survival outcome of lung cancers. Sensitivity and publication bias analyses were performed to explore the stability and reliability of the overall results.

Results

Forty publications involving 2205 lung cancer patients were included in this meta-analysis. The pooled HR and 95% CI values indicated a significant positive association between high SNHG expression and poor OS (HR: 1.890, 95% CI: 1.595–2.185), disease-free survival (DFS) (HR: 2.31, 95% CI: 1.57–3.39) and progression-free survival (PFS) (HR: 2.01, 95% CI: 0.66–6.07). The pooled odds ratio (OR) and 95% CI values indicated that increased SNHG expression may be correlated with advanced TNM stage (OR: 1.509, 95% CI: 1.267–1.799), increase risk of distant lymph node metastasis (OR: 1.540, 95% CI: 1.298–1.828), and large tumor size (OR: 1.509, 95% CI: 1.245–1.829). Sensitivity analysis and publication bias results showed that each result had strong reliability and robustness, and there was no significant publication bias or other bias.

Conclusion

Most SNHGs are upregulated in lung cancer tissues, and high expression of SNHGs predicts poor survival outcomes in lung cancer. SNHGs may be potential prognostic markers and promising therapeutic targets.
Baseline C-reactive protein predicts efficacy of the first-line immune checkpoint inhibitors plus chemotherapy in advanced lung squamous cell carcinoma: a retrospective, multicenter study
Authors: Zheng Xinlong , Zhang Longfeng , Wu Lin , Zhao Jun , Sun Jianguo , Fang Yong , Zhou Jin , Chu Qian , Shen Yihong , Yang Zhenzhou , Chen Lijin , Huang Meijuan , Lin Xiaoyan , Liu Zhenhua , Shen Peng , Wang Zhijie , Wang Xin , Wang Huijuan , Han Zhengbo , Liu Anwen , Zhang Hongmei , Ye Feng , Gao Wen , Wu Fang , Song Zhengbo , Chen Shengchi , Zhou Chenzhi , Wang Qian , Xu Chunwei , Huang Dingzhi , Zheng Xiaobin , Miao Qian , Jiang Kan , Xu Yiquan , Wu Shiwen , Wang Haibo , Zhang Qiuyu , Yang Shanshan , Li Yujing , Chen Sihui , Lin Gen
Published: December 2023

Aims

To investigate the predictive value of baseline C-reactive protein (CRP) levels on the efficacy of chemotherapy plus immune checkpoint inhibitors (ICI) in patients with advanced lung squamous cell carcinoma (LSCC).

Materials and methods

In this retrospective multicenter study spanning from January 2016 to December 2020, advanced LSCC patients initially treated with chemotherapy or a combination of chemotherapy and ICI were categorized into normal and elevated CRP subgroups. The relationship between CRP levels and treatment outcomes was analyzed using multivariate Cox proportional hazards models and multivariate logistic regression, focusing primarily on the progression-free survival (PFS) endpoint, and secondarily on overall survival (OS) and objective response rate (ORR) endpoints. Survival curves were generated using the Kaplan-Meier method, with the log-rank test used for comparison between groups.

Results

Of the 245 patients evaluated, the 105 who received a combination of chemotherapy and ICI with elevated baseline CRP levels exhibited a significant reduction in PFS (median 6.5 months vs. 11.8 months, HR, 1.78; 95% CI: 1.12–2.81; p = 0.013) compared to those with normal CRP levels. Elevated CRP was identified as an independent risk factor for poor PFS through multivariate-adjusted analysis. However, among the 140 patients receiving chemotherapy alone, baseline CRP levels did not significantly influence PFS. Furthermore, within the combination therapy group, there was a notable decrease in the ORR (51% vs. 71%, p = 0.035), coupled with a significantly shorter OS (median 20.9 months vs. 31.5 months, HR, 2.24; 95% CI: 1.13–4.44; p = 0.033).

Conclusion

In patients with advanced LSCC, elevated baseline CRP levels were identified as an independent predictive factor for the efficacy of combination therapy with chemotherapy and ICI, but not in chemotherapy alone. This suggests that CRP may be a valuable biomarker for guiding treatment strategies.
Urban residents’ self-rescue in response to public health emergencies in China: a qualitative study
Authors: Gao Yazhuo , Chen Ying , Lin Yin , Zhong Fangfang , Zhu Xuehua
Published: December 2023

Background

The abject uncertainty and unpredictability of public health emergencies have plagued various countries. Global health governance and international communities are facing long-term and arduous challenges. The self-rescue ability of individuals in a public emergency may be the most powerful trait to improve the survival rate outside the hospital. The study explores the cognitive ability and attitudes of urban residents in China towards self-rescue in response to public health emergencies. It provides appropriate evidence for improving the self-rescue ability of urban residents in China.

Methods

Sixteen urban residents were selected using the purposive sampling method for semi-structured interviews. Theme analysis was used to collate and analyse the interview data.

Results

Two themes and five sub-themes were analysed. The two themes included cognition and attitude of Chinese urban residents for self-rescue in an emergency. Urban residents believed that their knowledge and skills for self-rescue in an emergency were low. The ability for emergency self-rescue is affected by multiple factors, with relatively limited options for improvement. Nonetheless, the respondents expressed a desire to accept interventions under psychological crisis and a strong willingness to acquire knowledge and skills required for emergency self-rescue.

Conclusion

This study investigated the perceptions and attitudes of Chinese urban residents towards emergency self-rescue. The results support enhanced ability of urban residents to respond to public health emergencies, thereby diminishing the negative outcomes. The findings suggest the need for strategies to address the factors affecting emergency self-rescue.
Comparison of the effect of combined administration of intravenous and intra-articular tranexamic acid versus their administration alone in the management of blood loss in total knee arthroplasty: a prospective, multicenter study in Iran
Authors: Fakharian Mohammadali , Fakharian Arman , Keshmiri Zahra , Khorrami Amir Mohsen
Published: December 2023

Background

Total knee arthroplasty (TKA) is associated with significant blood loss. Antifibrinolytic agents such as tranexamic acid (TXA) are widely used to manage blood loss during TKA. This study aimed to compare the efficacy of three different administration approaches of TXA in TKA.

Methods

In a prospective, multicenter study, 285 patients with end-stage osteoarthritis who underwent TKA between 2020 and 2022 in three orthopedic surgery centers were included in the study. To manage bleeding during TKA, one of the three methods of intravenous administration (IV), intra-articular injection (IA), and combination administration of TXA was performed for the patients. Postoperative blood loss was calculated using blood volume and change in hemoglobin level from preoperative measurement to postoperative day 3.

Results

The mean baseline Hemoglobin (Hb) was not significantly different between the three study groups (p > 0.05). The mean postoperative Hb of 12 h, 24 h, and 48 h after the surgery was not significantly different between the three stud groups (p > 0.05). The mean intraoperative blood loss in the combined TXA group was significantly lower compared to the IV and IA groups (0.025). The number of blood transfusions in the three study groups was not statistically significant (p > 0.05). No side effect was recorded in any group, as well.

Conclusion

Blood loss in the combination TXA group was significantly less than in the other two groups. Combination TXA can help reduce blood loss after TKA surgery.
Correlation between secondary metabolites of Iris confusa Sealy and Iris pseudacorus L. and their newly explored antiprotozoal potentials
Authors: Abdel-Baki Passent M. , El-Sherei Moshera M. , Khaleel Amal E. , Abdel-Sattar Essam , Salem Mohamed A. , Okba Mona M.
Published: December 2023

Background

In the last few decades, the use of plant extracts and their phytochemicals as candidates for the management of parasitic diseases has increased tremendously. Irises are aromatic and medicinal plants that have long been employed in the treatment of different infectious diseases by traditional healers in many cultures. This study aims to explore the potential of three common Iris species (I. confusa Sealy, I. pseudacorus L. and I. germanica L.) against infectious diseases. Their in vitro antiprotozoal potency against Plasmodium falciparum, Trypanosoma brucei brucei, T. b. rhodesiense, T. cruzi and Leishmania infantum beside their cytotoxicity on MRC-5 fibroblasts and primary peritoneal murine macrophages were examined.

Methods

The secondary metabolites of the tested extracts were characterized by UPLC-HRMS/MS and Pearsons correlation was used to correlate them with the antiprotozoal activity.

Results

Overall, the non-polar fractions (NPF) showed a significant antiprotozoal activity (score: sc 2 to 5) in contrast to the polar fractions (PF). I. confusa NPF was the most active extract against P. falciparum [IC50 of 1.08 μg/mL, selectivity index (S.I. 26.11) and sc 5] and L. infantum (IC50 of 12.7 μg/mL, S.I. 2.22 and sc 2). I. pseudacorus NPF was the most potent fraction against T. b. rhodesiense (IC50 of 8.17 μg/mL, S.I. 3.67 and sc 3). Monogalactosyldiacylglycerol glycolipid (18:3/18:3), triaceylglycerol (18:2/18:2/18:3), oleic acid, and triterpenoid irridals (spirioiridoconfal C and iso-iridobelamal A) were the top positively correlated metabolites with antiplasmodium and antileishmanial activities of I. confusa NPF. Tumulosic acid, ceramide sphingolipids, corosolic, maslinic, moreollic acids, pheophytin a, triaceylglycerols, mono- and digalactosyldiacylglycerols, phosphatidylglycerol (22:6/18:3), phosphatidylcholines (18:1/18:2), and triterpenoid irridal iso-iridobelamal A, were highly correlated to I. pseudacorus NPF anti- T. b. rhodesiense activity. The ADME study revealed proper drug likeness properties for certain highly corelated secondary metabolites.

Conclusion

This study is the sole map correlating I. confusa and I. pseudacorus secondary metabolites to their newly explored antiprotozoal activity.
Underlying motivations hampering Flemish primary care physicians from overcoming the barriers in osteoporosis care: an EMR-facilitated clinical reasoning study
Authors: Verdonck Caroline , Van Daele Ellis , Willems Ruben , Borgermans Liesbeth , Boeckxstaens Pauline
Published: December 2023

Background

Over half of the European population aged minimum 65 years presents with at least two chronic diseases. Attention towards these diseases exhibits disparities, with limited primary care physician (PCP) attention for osteoporosis. This was confirmed in a previous integrated osteoporosis care (IOC) project in which notable difficulties to enlist PCPs arose. Consequently, this study was initiated in Flemish PCPs for in-depth analysis of underlying mechanisms hampering PCPs to fully commit to osteoporosis care.

Methods

A qualitative Electronic Medical Record (EMR)-facilitated clinical reasoning study was conducted. A semi-structured interview guide was employed to guide PCPs from reflections on their own patients to broader views regarding osteoporosis care. An inductive thematic analysis was performed using NVivo 12.

Results

Thirteen PCPs were interviewed. They stated that osteoporosis patients often had complex (medical) profiles. PCPs emphasised the ongoing necessity for prioritisation within this context. This leads to a competition for PCP attention during consultations at three levels: i. between acute versus preventive care; ii. between primary fracture prevention and other preventive services and iii. between secondary fracture prevention and other preventive services; spanning eight areas of competition: disease significance, perceived impact, PCP awareness, the patient agenda, PCP competence, PCP support, perceived patient burden, and efficiency of care provision. Applicability of these areas of competition differed between levels.

Conclusion

The intricate context in which PCPs operate, creates a competition for PCP attention leading to a lack of attention for fracture prevention. To preserve efforts in fracture prevention, areas of competition should be systematically addressed.

Trial registration

Approval for the study has been provided by the Ghent University Hospital Ethics Committee (BC-09797).
Neutrophil extracellular trap-induced intermediate monocytes trigger macrophage activation syndrome in adult-onset Still’s disease
Authors: Jia Jinchao , Wang Mengyan , Ma Yuning , Meng Jianfen , Zhu Dehao , Chen Xia , Shi Hui , Sun Yue , Liu Honglei , Cheng Xiaobing , Su Yutong , Ye Junna , Chi Huihui , Liu Tingting , Zhou Zhuochao , Wang Fan , Chen Longfang , Yi Da , Xiao Yu , Yang Chengde , Teng Jialin , Hu Qiongyi
Published: December 2023

Background

Adult-onset Still’s disease (AOSD) is a systemic autoinflammatory disease characterized by innate immune system activation, with a high risk for macrophage activation syndrome (MAS). MAS development is associated with monocyte/macrophage activation and cytokine storm. Monocytes consist of three different subsets, classical monocytes (CMs, CD14brightCD16 −), intermediate monocytes (IMs, CD14brightCD16 +), and non-classical monocytes (NCMs, CD14dimCD16 +), each has distinct roles in inflammatory regulation. However, the frequencies and regulatory mechanism of monocyte subsets in AOSD patients have not been identified.

Methods

We performed flow cytometry, RNA sequencing, phagocytosis analysis, and enzyme-linked immunosorbent assay to evaluate monocyte subsets, cell functions, and potential biomarkers. The effect of neutrophil extracellular traps (NETs) on monocytes was determined by evaluating mRNA levels of DNA sensors, surface CD16 expression, and inflammasome pathway activation.

Results

Higher proportions of intermediate monocytes (IMs) were identified in active AOSD patients. IMs displayed higher expression of CD80, CD86, HLA-DR, and CD163 than CMs and NCMs. CD163 upregulation was noted on AOSD IMs, accompanied by increased phagocytic activity and elevated cytokine/chemokine production, including IL-1β, IL-6, CCL8, and CXCL10. The frequencies of IMs were correlated with disease activity and higher in AOSD patients with MAS (AOSD-MAS). CCL8 and CXCL10 were highly expressed in RNA sequencing of monocytes from AOSD-MAS patients and plasma CXCL10 level could serve as a potential biomarker for AOSD-MAS. Moreover, DNA-sensing pathway was activated in monocytes from AOSD-MAS patients. Stimulation with NETs derived from AOSD induced DNA sensor expression, the expansion of IMs, and inflammasome pathway activation. These effects can be abrogated by DNase I treatment.

Conclusions

Our results demonstrated that the proportions of IMs were elevated in AOSD and associated with MAS. The DNA component in NETs from AOSD plays an important role in the formation of IMs, shedding new light for the therapeutic target.
Circadian dependency of microglial heme oxygenase-1 expression and inflammation determine neuronal injury in hemorrhagic stroke
Authors: Henrich Luise , Kiessling Iva , Steimer Matti , Frase Sibylle , Kaiser Sandra , Schallner Nils
Published: December 2023

Background

The heme oxygenase-1 (HO-1) enzyme pathway is of crucial importance in the removal of toxic blood components and regulation of neuroinflammation following hemorrhagic stroke. Although a circadian pattern dependency in the incidence and severity of hemorrhagic stroke exists, it is unknown whether the activity of the HO-1 system in the context of hemorrhagic injury also exhibits circadian dependency. We hypothesized that the circadian regulation of microglial HO-1 would determine the extent of neuroinflammation and neuronal injury in a murine model of subarachnoid hemorrhage (SAH).

Methods

In vitro expression patterns of HO-1 and circadian rhythm genes were analyzed in the microglial BV-2 cell line and primary microglia (PMG) using Western blot and qPCR. PMG isolated from Hmox1fl/fl and LyzM-Cre-Hmox1fl/fl mice were used to evaluate the role of microglial HO-1. We further investigated the in vivo relevance in a murine subarachnoid hemorrhage (SAH) model using Hmox1fl/fl and LyzM-Cre-Hmox1fl/fl mice with myeloid cell HO-1 deficiency, inducing SAH at different zeitgeber (ZT) times and analyzing the expression of HO-1 and the circadian control gene Period-2 (Per-2), respectively. Furthermore, we measured the inflammatory cytokine Monocyte Chemoattractant Protein-1 (MCP-1) in the cerebrospinal fluid of SAH patients in correlation with clinical outcome.

Results

HO-1 baseline expression and response to CO with blood exposure depended on ZT. In vitro expression of circadian control genes was de-synchronized in LyzM-Cre-Hmox1fl/fl PMG and did not respond to exogenous CO exposure. We found that circadian rhythm plays a crucial role in brain damage after SAH. At ZT2, we observed less phagocytic function, more vasospasm and increased microglial activation. CO reduced mortality at ZT12 in HO-1 deficient mice and reduced the difference between ZT2 and ZT12 in the inflammatory response. Induction of MCP-1 in the CSF from SAH patients was time-dependent and correlated with the expression of circadian control genes, SAH severity, functional impairment and delirium.

Conclusions

Our data point towards a crucial role for the HO-1 enzyme system and circadian control in neuronal injury after a hemorrhagic stroke.