bluuebunny/crossref_metadata_2025 huggingface dataset:
Diet-induced changes in functional disability are mediated by fatigue in relapsing-remitting multiple sclerosis: A secondary analysis of the WAVES randomized parallel-arm trial
Authors: Crippes Landon J , Saxby Solange M , Shemirani Farnoosh , Bisht Babita , Gill Christine , Rubenstein Linda M , Ten Eyck Patrick , Carr Lucas J , Darling Warren G , Hoth Karin F , Kamholz John , Snetselaar Linda G , Titcomb Tyler J , Wahls Terry L
Published: October 2023

Background

People with multiple sclerosis (MS) often report dietary modifications; however, evidence on functional outcomes remains sparse.

Objective

Evaluate the impact of the low-saturated fat (Swank) and modified Paleolithic elimination (Wahls) diets on functional disability among people with relapsing-remitting MS.

Methods

Baseline-referenced MS functional composite (MSFC) scores were calculated from nine-hole peg-test (NHPT), timed 25-foot walk, and oral symbol digit modalities test (SDMT-O) collected at four study visits: (a) run-in, (b) baseline, (c) 12 weeks, and (d) 24 weeks. Participants were observed at run-in and then randomized at baseline to either the Swank ( n = 44) or Wahls ( n = 43) diets.

Results

Among the Swank group, MSFC scores significantly increased from −0.13 ± 0.14 at baseline to 0.10 ± 0.11 at 12 weeks ( p = 0.04) and 0.14 ± 0.11 at 24 weeks ( p = 0.02). Among the Wahls group, no change in MSFC scores was observed at 12 weeks from 0.10 ± 0.11 at baseline but increased to 0.28 ± 0.13 at 24 weeks ( p = 0.002). In both groups, NHPT and SDMT-O z-scores increased at 24 weeks. Changes in MSFC and NHPT were mediated by fatigue.

Discussion

Both diets reduced functional disability as mediated by fatigue.

Trial Registration

Clinicaltrials.gov Identifier: NCT02914964
The Power of Live-Streaming in Consumers’ Purchasing Decision
Authors: Hossain Md. Alamgir , Kalam Abul , Nuruzzaman Md. , Kim Minho
Published: October 2023

Livestreaming has gained popularity as a new e-commerce platform, communication tool, social network, and source of entertainment for millions of users. It is important to examine the nature and history of this developing area of e-commerce since it has the potential to be exploited to overcome the COVID-19 pandemic’s challenges. Therefore, this study critically explores the consumer livestreaming purchasing behavior and proposes a model, which composed of stimulus, organism, and response as the extension of stimuli-organism-organism model. The structural equation modeling approach applies for analyzing 434 survey responses from a convenience sample. The results suggest that the stimulus variable (source credibility, response capability, platform interactivity) significantly affects the organism variables (customer engagement, swift guanxi), which in turn significantly contribute to creating responses (purchase intentions, actual purchase behavior). Customer engagement and swift guanxi also have potent mediating effects in the model. We offer novel insights into new consumer behaviors in livestream commerce that can underpin future research to promote businesses and services even under challenging conditions.
PHEISQUAL: A Scale to Measure Service Quality of Professional Higher Educational Institute From Faculty Perspective
Authors: Kamakoty Juhi , Singh Sandeep
Published: October 2023

This paper studies the service quality (SQ) of higher education institutes (HEI), offering professional courses from the perspective of faculty as they are the service providers as well as a major stakeholder in the educational arena. PHEISQUAL (Professional higher education institute service quality) scale has been developed to measure the service quality of HEI offering professional course using mixed methodology. Four factors namely—Training & Placement, Faculty Resource, Learning Infrastructure, and Assessment & Evaluation have been extracted. The scale has been subjected to rigorous analysis of scale development process and has complied with same. Thus this study accrues a new instrument to measure service quality of professional institutes offering higher education by taking into account the technical as well as operational factors.
A Randomized Controlled Pilot Study on Home-Based Expressive Writing Intervention for Community-Dwelling Japanese Older Adults Who Care About Their Forgetfulness
Authors: Ogawa Susumu , Suzuki Hiroyuki , Kobayashi-Cuya Kimi Estela , Murayama Sachiko , Iizuka Ai , Takahashi Tomoya , Yamauchi Misako , Fujiwara Yoshinori
Published: October 2023

Stress management activities that older adults can efficiently perform at home are needed. We therefore created a home-based expressive writing for older adults focusing on habituation and conducted a randomized controlled trial. Participants were randomly assigned to the expressive writing group ( n = 42) and the active control group ( n = 40). The expressive writing group wrote about stressful events for 15 to 30 minutes 3 times each day at home. The active control group wrote about what they bought the previous day on three different days. Twenty six participants were included in the final analysis. The results showed that rumination, a risk factor for depression, decreased in the active control group compared to the expressive writing group. Our findings suggest that older adults can efficiently perform writing sessions at home. Also, a task such as cognitive training, rather than writing about stressful events, decreased rumination in older adults concerned about their forgetfulness.
A Framework for Examining the Relationship and Classifying Instructional Strategies, Methods, and Techniques
Authors: Lowell Victoria L. , Ureña-Rodríguez Lucía
Published: October 2023

Globally, educators and researchers use different terms to describe instructors’ approaches when presenting instructional material in formal and informal settings. Terms commonly used to describe instructional approaches include teaching/instructional strategy, teaching/instructional method, and teaching/instructional technique. Although practicing educators and researchers use these words interchangeably, they have different meanings, leading to confusion regarding the relationship between these approaches and their proper usage when describing instructional practices. The research-to-practice gap in all fields exacerbates the issue, as practitioners and researchers may use different terms. As a result, there is a need for consistency in the terms used to describe instructional approaches across all fields and a shared understanding of the correct meaning of the terms and the relation between the terms. Practitioners and researchers need a resource that includes the correct terms and provides information on instructional approaches for classroom application and research purposes. This paper presents a framework consisting of the definitions, the relationship, and the taxonomy for the terms: instructional strategies, methods, and techniques. This framework can help educators and researchers locate information about instructional approaches for classroom application and can serve as a catalog presenting the most common instructional strategies, instructional methods, and instructional techniques used in formal instruction.
Quality Assurance in Higher Educational Institutions: Empirical Evidence in Indonesia
Authors: Nugraha Nugraha , Prasetyo Yogi Tri , Sugiharti Harpa , Lhutfi Iqbal , Widyaningsih Aristanti , Triantoro Arvian , Ong Ardvin Kester S. , Young Michael N. , Persada Satria Fadil , Kristamtomo Putra Raden Aditya , Nadlifatin Reny
Published: October 2023

The purpose of this study is to look into the importance of educational processes, practices, and research activities in predicting knowledge skills and competences (KSC) and employability in Indonesian higher education. A survey was used in the quantitative research approach. Respondents to this study selected 500 instructors and students from 31 universities in Indonesia that offer outstanding approved study programs. The Indonesian Ministry of Education, Culture, Research, and Technology oversees all universities. Scoring and structural equation modeling were used to evaluate the data. The educational process is significantly influenced by facilities. Significant relationships have been discovered between facilities and practicum activities, facilities and research activities, practical activities and employability, research activities and employability, research activities and KSC, and practical activities to KSC. There is no significant relationship between the educational process and employability, nor between the educational process and KSC. This study’s findings also show that the educational process does not mediate the effect of facilities on employability but does mediate the effect of facilities on KSC, that the effect of facilities on employability was mediated by the practical activity variable, that practical activity variables mediated the effect of facilities on KSC, and that research activity variables mediated the effect of facilities on employability. Variables related to research activity influenced the effect of facilities on KSC. This research’s contribution can become literature for future research and can be used by education stakeholders to identify applicable policies to assist KSC and its graduates’ employability.
Generativity and Subjective Wellbeing of Malaysian Old Adults: The Role of Gender and Living Arrangement
Authors: Nainee Sarvarubini , Mohd Hashim Intan Hashimah , Mohamad Yusof Masarah
Published: October 2023

This study examined the moderating role of gender and living arrangements in the relationship between generativity and subjective well-being among Malaysian old adults. The descriptive survey research design was utilized for this study. The target population was healthy old adults aged 60 and above in Ipoh, Malaysia with healthy cognitive ability. Using a purposive sampling technique, 441 old adults were recruited from public places to participate in the study. They responded to a validated questionnaire administered via structured interviews. Instruments include measure of generativity and subjective well-being. The study employed an independent sample t-test and Pearson correlation to find the differences and associations between understudied variables. Hayes Process was used to test the moderation effect of gender and living arrangement. The main results of the analysis show significant correlation between all variables. Specifically, the study suggests that gender and living arrangement moderate the association of generativity and old adults’ SWB. However, gender as a single variable does not moderate the association. Hence, this paper concludes that by contributing to others, the subjective well-being of older adults could be improved. The findings are useful for all relevant parties to develop necessary actions for promoting successful aging among senior citizens.
Impact of Surgical Resection Without Spinal Fusion for Thoracic Dumbbell Tumors on Postoperative Global Spinal Sagittal Alignment and Clinical Outcomes
Authors: Okubo Toshiki , Nagoshi Narihito , Tsuji Osahiko , Ozaki Masahiro , Suzuki Satoshi , Takahashi Yohei , Matsumoto Morio , Nakamura Masaya , Watanabe Kota
Published: October 2023

Study Design

A retrospective comparative study.

Objectives

This study investigated radiographical changes in global spinal sagittal alignment (GSSA) and clinical outcomes after tumor resection without spinal fusion in patients with thoracic dumbbell tumors.

Methods

Thirty patients with thoracic dumbbell tumors who were followed up for at least 3 years were included in this study. Variations in the outcome variables were analyzed using individual GSSA parameters measured on radiography. Clinical outcomes were assessed using the modified McCormick scale (MMCS), Japan Orthopaedic Association (JOA) score, and visual analog scale (VAS). To assess the impact of the affected levels on these outcomes, we divided the patients into three groups according to the location of the tumor (upper [T1-4], middle [T5-8], or lower [T9-12] thoracic spine).

Results

The GSSA parameters (cervical lordosis, T1 slope, thoracic kyphosis [global, upper, middle, and lower], thoracolumbar kyphosis, lumbar lordosis, sacral slope, pelvic incidence, and pelvic tilt) of all the patients did not change significantly after surgery. Eleven of thirty patients had preoperative gait disturbances but they could walk without support (MMCS grade I or II) at the final follow-up. The JOA score and VAS showed significant postoperative improvements. No statistically significant differences were observed in each postoperative sagittal profile or clinical outcome between the upper, middle, and lower groups.

Conclusions

Tumor resection without spinal fusion did not affect the various GSSA parameters and resulted in satisfactory clinical outcomes, indicating that spinal fusion may not always be necessary when resecting thoracic dumbbell tumors.
The Racializing Work of Cultural Narratives: An Analysis of Colorblind Frames of Puerto Rican Climate Migrants
Authors: Aranda Elizabeth , Blackwell Rebecca
Published: October 2023

Using narrative analysis, this article examines the relationship between coloniality and racializing characterizations of Puerto Ricans, on the one hand, and taken-for-granted formula stories about U.S. national identity and morality, on the other. Our analysis draws from two data sets: 21 newspaper articles published in a Florida newspaper in the aftermath of Hurricane Maria about the needs and conditions of climate migrants from Puerto Rico and 54 interviews with Puerto Rican climate migrants who relocated to Florida after the hurricane struck the archipelago in 2017. This multilevel analysis explores prevailing colorblind racism frames that circulate across levels of social life embedded in stories that appeal to cultural ways of thinking and feeling about the world. Our findings show how colorblind frames in broadly shared narratives can reinforce racial scripts and perpetuate ethnoracial inequality. They also show that the broad circulation of such narratives at cultural, institutional, and interpersonal levels renders the racialization process less discernible.
Seeking Direct Accountability for Disproportionate Discipline and Dis/ability Classification
Authors: Bornstein Joshua , Lustick Hilary , Hannon LaChan V. , Shallish Lauren , Okilwa Nathern
Published: October 2023

Accountability for racially disproportionate discipline and dis/ability classification has conventionally spotlighted the disparate impact on students. Typically, findings such as “x% of African American students were suspended” or “y% of Latinx students were misidentified as having learning dis/abilities” reinforce this pattern. Our qualitative study sought the outlines of a different framing that locates accountability in practices, policies, and patterns of adult actors that produce those unjust outcomes. Practitioners, policy makers, researchers, and activists participated in this interview study by giving their perspectives on that reframing. Although their analyses fell short of directly holding the educational system accountable, they did highlight reforms such as increasing student agency in discipline and classification processes, expanding those processes to include a holistic analysis of students’ lives, and acknowledging that current accountability measures evade and obscure structural racism in discipline and dis/ability classification.
Development and Implementation of a Medical School Course Integrating Basic, Clinical, and Health Systems Sciences
Authors: Miller Kathryn E. , Qua Kelli , Croniger Colleen M. , Mann Donald , Mulloy Karen B. , Painter Elizabeth , Rowland-Seymour Anastasia , Schirokauer Oliver , Singh Mamta K. , Wilson-Delfosse Amy L.
Published: October 2023

OBJECTIVE

In recent years, significant steps have been made in integrating basic science and clinical medicine. There remains a gap in adding the third pillar of education: health systems science (HSS). Core clerkships represent an ideal learning venue to integrate all three. Students can experience the value of integrating basic science as they learn clinical medicine in environments where HSS is occurring all around them.

METHODS

We outline the creation of Sciences and Art of Medicine Integrated (SAMI), a course that runs parallel with the clerkship year and integrates basic science and HSS with clinical medicine. A complete description of the planning and implementation of SAMI is provided. We include the participants and educational setting, the goals and objectives, and the structure of each session. To encourage the integration of basic science, HSS, and clinical medicine, students utilize a series of tools, described in detail. Examples of each tool are provided utilizing a case of a patient presenting with obstructive sleep apnea.

RESULTS

We successfully implemented this course with positive reception from students.

CONCLUSION

This course represents a step not only toward the integration of HSS with basic science and clinical medicine but also an advancement in training future clinicians to provide high-value care. Future curricular development must consider the validation of a measure of clinical reasoning that assesses a student's ability to think in a cognitively integrated fashion about basic science, HSS, and clinical medicine demonstrated by enhanced justification of clinical reasoning and a more holistic approach to planning patient care.
Numbers Matter: Raji Tribe and Their (Limited) Interaction(s) with State Institutions
Authors: Pant Bhawesh
Published: October 2023

With ethnographic documentation, the present study aims to portray the everyday life and social concerns of the Raji tribe, one of the particularly vulnerable tribal groups residing in Uttarakhand, India. The Raji community with their unique historicity, peculiar spatiality and uncommon understanding of their identity makes them very offbeat compared to other tribal communities. The narrations were documented from six villages ( Bhagichaura, Altadi, Kimkhola, Ganagaon, Bhagtiwara and Kutakumaonchaurani) in the Pithoragarh district, Uttarakhand. The immersive fieldwork in the Central Himalayas, Kumaon, was conducted from April 2021 to August 2022. The results of the study uncovered the structure of proxy politics, which hinders the efficient involvement of Rajis in the larger political sphere. This article also documents the narratives around changes in cultural landscapes due to forest management regulations. This article ends with a critical gaze on tribal policies, considering the precarious situation of the Raji community as its mainstay. The constraining lived worlds of the Raji community are the result of intersections of discrete presuppositions, institutions and social factors. In order to mitigate the existing challenges, Raji’s are continuously adjusting their social in accordance with the capitals they hold.
Coercive geographies: Biopower, spatial politics, and the tourist
Authors: Iaquinto Benjamin Lucca , Cheer Joseph M , Roelofsen Maartje , Minca Claudio , Ong Chin-Ee , Wong Cora , Lapointe Dominic , Qu Meng , McCormick AD , Lin Chih-Chen Trista
Published: October 2023

This symposium examines the relations between biopower, destination governance and tourism. Biopower, a Foucauldian concept, refers to political strategies based on humanity’s biological features. In the simplest of terms, it is applied via biopolitical mandates that govern life of a given population. Contemporary tourism exemplifies the exertion of biopower over the mobility of travellers, as was evidenced during the COVID-19 pandemic, and to a lesser degree, continues to do so. The role that tourism plays in enabling authorities to enact spatial transformations reinforcing state power, while also indicating potential means of resistance, is foregrounded in this symposium. The four empirical contributions extend biopolitical thought by demonstrating that biopower is instrumental in the practices and regimes of mobility, security, in/exclusion of tourism. In Europe, the Dutch government experimented with enclosed “COVID-safe” tourist spaces. In Macao, China’s border regime screened tourists based on their viral threat capacities. On Naoshima Island in Japan, museums have transformed into infrastructures of bodily control. In Taiwan, flight attendants are grappling with newly emerging forms of biopower shaping the sociality of air travel and their own practices of hospitality. These empirically informed contributions interrogate how tourism figures in attempts to govern bodies at the population level, while uncovering the modes of coercion applied to govern tourists and the spaces they inhabit.
Efficacy of pneumatic retinopexy in young adults with rhegmatogenous retinal detachment
Authors: İpekli Zeynep , Pehlivanoğlu Seren , Artunay Özgür
Published: October 2023

Background:

In young adults with rhegmatogenous retinal detachment, pneumatic retinopexy can be a cost-effective and minimally invasive highly effective method in suitable cases.

Objectives:

To evaluate the role of pneumatic retinopexy in the treatment of young adults with rhegmatogenous retinal detachment (RRD) and the factors that may affect the success of pneumatic retinopexy.

Design:

Retrospective study.

Methods:

The study included 67 eyes of 67 patients aged between 21 and 40 who underwent pneumatic retinopexy (PR) between January 2015 and June 2021 for primary RRD. We retrospectively analyzed the prognostic factors that may affect the success of PR, such as preoperative age, best corrected visual acuity, tear site, lens condition, and axial length.

Results:

PR was successful in 61.2% of the patients, whereas 38.8% required secondary surgery. Between the group that had a single surgery (Group 1) and the group that required secondary surgery (Group 2) the tear location, axial length, and volumes of gases used were statistically different ( p = 0.04, p < 0.001, and p = 0.02, respectively). There was a significant difference in visual acuity before and after surgery in the group that was successful with a single surgery (Friedman χ2 = 40.051, p < 0.001). There was no significant difference between the two groups in terms of intraocular pressure ( p > 0.05), and glaucoma was not observed in the postoperative period.

Conclusion:

Since it is a minimally invasive and cost-effective method that provides rapid visual rehabilitation, it can be considered as first-line therapy in young adults who are suitable for PR.
Impact of a reimbursement policy change on treatment with erenumab in migraine – a real-world experience from Germany
Authors: Hong Ja Bin , Lange Kristin Sophie , Fitzek Mira , Overeem Lucas Hendrik , Triller Paul , Siebert Anke , Reuter Uwe , Raffaelli Bianca
Published: October 2023

Background

Monoclonal antibodies (mAbs) targeting the Calcitonin Gene-Related Peptide (CGRP) pathway are safe and effective treatments for migraine prevention. However, the high cost of these novel therapies has led to reimbursement policies requiring patients to try multiple traditional preventives before access. In Germany, a recent change in insurance policy significantly expanded coverage for the CGRP receptor mAb erenumab, enabling migraine patients who failed just one prior prophylactic medication to receive this mAb. Here, we compare the clinical response to treatment with erenumab in migraine patients treated using the old and new coverage policy.

Methods

In this retrospective cohort study, we included CGRP-mAb naïve patients with episodic or chronic migraine, who started erenumab at our headache center according to either the old or the new insurance policy and received at least 3 consecutive injections. Headache diaries and electronic documentation were used to evaluate reductions in monthly headache and migraine days (MHD and MMD) and ≥ 50% and ≥ 30% responder rates at month 3 (weeks 9–12) of treatment.

Results

We included 146 patients who received erenumab according to the old policy and 63 patients that were treated using the new policy. At weeks 9–12 of treatment, 37.7% of the old policy group had a 50% or greater reduction in MHD, compared to 63.5% of the new policy group (P < 0.001). Mean reduction in MHD was 5.02 days (SD = 5.46) and 6.67 days (SD = 5.32, P = 0.045) in the old and new policy cohort, respectively. After propensity score matching, the marginal effect of the new policy on treatment outcome was 2.29 days (standard error, SE: 0.715, P = 0.001) more reduction in MHD, and 30.1% (SE: 10.6%, P = 0.005) increase in ≥ 50% response rate for MHD.

Conclusions

Starting erenumab earlier in the course of migraine progression in a real-world setting may lead to a better response than starting after multiple failed prophylactic attempts. Continually gathering real-world evidence may help policymakers in deciding how readily to cover CGRP-targeted therapies in migraine prevention.
Relationship between myopia control and amount of corneal refractive change after orthokeratology lens treatment
Authors: Sun Lu , Song Hong-Xin , Li Zheng-Xuan , Chen Yun , He Zhi-Qiang
Published: October 2023

Background

To evaluate the relationship between amount of corneal refractive change (CRC) after wearing orthokeratology (Ortho-K) lenses and axial length (AL) growth.

Methods

We retrospectively enrolled 77 patients (77 eyes) aged 8–14 years who wore Ortho-K lenses more than 12 months. We divided the patients into 2 subgroups: spherical equivalent (SE) ≤ -3.0 D and SE > -3.0 D subgroup. The sagittal and tangential curvature maps and corneal topographic data within the 8-mm diameter ring at the baseline and during follow-up visits after wearing Ortho-K lens were recorded in addition to the area, height, and volume of the CRC region. The AL data were recorded at the baseline and during follow-up visits. Multivariate linear regression was conducted to analyze associations between the area, height, and volume of the CRC region, AL elongation, and SE.

Results

The average change in the CRC region was 9.77 ± 0.60 D in height, 16.66 ± 3.61 mm2 in area, and 87.47 ± 8.96 D*mm2 in volume on the tangential diagram after wearing Ortho-K lenses for 3 months. The AL showed a change of 0.19 ± 0.14 mm after 1 year of Ortho-K lens wear (P < 0.05). At 1 year, AL elongation was negatively correlated with the area (P = 0.019) and volume (P < 0.001) of the CRC region. At 1 year, for every 1-mm2 increase in the area and every 1-D*mm2 increase in the volume of the CRC region, the average AL elongation decreased by 0.01 mm and 0.002 mm, respectively, in the multivariate analysis. In patients with SE ≤ -3.0 D, AL elongation was negatively correlated with the CRC-region volume (β = -0.002, P = 0.018), and in patients with SE > -3.0 D, AL elongation was negatively correlated with the CRC-region area (β = -0.017, P = 0.016).

Conclusions

The AL elongation-control efficacy of Ortho-K lenses may be related to the area and volume of the CRC region.
Determinants of early discharge after birth among mothers delivered vaginally at health facilities: further analysis of the Ethiopian demographic health survey
Authors: Bitew Desalegn Anmut , Diress Mengistie , Gela Yibeltal Yismaw , Belay Daniel Gashaneh , Kibret Anteneh Ayelign , Chilot Dagmawi , Sinamaw Deresse , Seid Mohammed Abdu , Seid Abdulwase Mohammed , Simegn Wudneh , Eshetu Habitu Birhan , Andualem Amare Agmas
Published: October 2023

Introduction

The majority of maternal and newborn deaths take place during the first few hours and days after birth and thus postnatal contacts should begin as early as possible, especially within the first 24 h, then again within two to three days after delivery. Globally, early postnatal discharge has increased over the past 50 years and currently too. Even if Ethiopia has very low PNC coverage, there is no evidence on who is discharged early. Hence, the aim of this study was to determine the magnitude and the predictors for early postnatal discharge in Ethiopia.

Methods

This study was based on the secondary data analysis using the Ethiopian Demographic and Health survey (EDHS) 2016 data set. The weighted sample of 2,225 delivered mothers were included for the final analysis. The model was best fitted as assessed by Hosmer-Lemeshow test (p value = 0.1988). The variables with P-value ≤ 0.2 in the bi- variable binary logistic regression analysis were included in to the multi-variable binary logistic regression analysis. The Adjusted Odds Ratio (AOR) with 95% confidence interval (95% CI) was computed to assess the strength of association between the outcome and independent variables. The variables with a P-value of less than 0.05 in the multi-variable binary logistic regression analysis were declared as statistically significant predictors of the outcome variable.

Result

The overall magnitude of early discharge was 70.41% (CI: 68.48, 72.30). Residence (rural; AOR: 0.61, 95% CI: 0.46, 0.80), educational status (No education; AOR: 1.87, 95% CI: 1.19, 2.94), religion (Muslim; AOR: 0.69, 95% CI: 0.55, 0.87, Others; AOR: 0.24, 95% CI: 0.10, 0.57), wealth index (Poor; AOR: 0.77; 95% CI: 0.59, 0.99), marital status (Not married; AOR: 0.29; 95% CI: 0.13, 0.67), ANC visits (No ANC visits; AOR: 0.63; 95% CI: 0.46,0.86), parity (3rd parity; AOR: 1.48; 95% CI: 1.03, 2.11), and size of the child (larger size; AOR: 0.63;95% CI: 0.50,0.79, (smaller size; AOR: 0.72; 95% CI: 0.56,0.92) were independent determinants of early discharge.

Conclusion

A substantial proportions of mothers in Ethiopia had been discharged early (before 24 h). Residence, education, wealth index, religion, marital status, ANC follow up, parity and size of the child were predictors of early discharge. Adequate hospital stay should be promoted. Since the early discharge in Ethiopia is very high, home based postnatal visit should be strengthened focusing the identified predictors.
Synthesis and characterization of hydroxyapatite nanoparticles and their effects on remineralization of demineralized enamel in the presence of Er,Cr: YSGG laser irradiation
Authors: Maddah Fatemeh , Shirinzad Mehdi , Khalafi Zahra , Rezaei-Soufi Loghman , Mohammadi Younes , Eskandarloo Fatemeh , Farmany Abbas
Published: October 2023

Background

This study aims to synthesize and characterize hydroxyapatite nanoparticles (nano-HA) and evaluate their effects on the remineralization of demineralized enamel in the presence to Er,CR: YSGG laser irradiation.

Materials and methods

Enamel specimens from 44 human molars were divided into four groups: control, demineralized enamel, demineralized enamel treated with nano-HA, and demineralized enamel treated with nano-HA followed by Er,Cr:YSGG laser irradiation (0.5, 20 Hz, 60 µs, 20 s). Vickers microhardness test was used to evaluate the enamel surface hardness. The morphology and chemistry of enamel surfaces were assessed using scanning electron microscopy (SEM) and Raman spectroscopy, respectively.

Result

The result of this study showed that the application of Er,CR: YSGG laser irradiation to demineralized enamel treated with nano-HA had the highest impact on its microhardness.

Conclusion

ER,CR: YSGG laser irradiation promotes enamel remineralization after treatment with nano HA.
Using a novel virtual-reality simulator to assess performance in lumbar puncture: a validation study
Authors: Xie Sujun , Grimstrup Søren , Nayahangan Leizl Joy , Wang Zheng , Wan Xing , Konge Lars
Published: October 2023

Background

A lumbar puncture procedure’s success depends on a competent physician minimizing the risk of failing to get a sample and avoiding complications such as post-dural headache. A new virtual-reality simulator might be helpful in deciding when a physician is competent to perform lumbar puncture. We aimed to investigate validity evidence for a simulator-based test in lumbar puncture and establish a pass/fail standard to allow a mastery learning training program.

Methods

Validity evidence was investigated using Messick’s framework by including participants who were novices, intermediates, or experienced in lumbar puncture. Each participant performed two lumbar puncture procedures on the simulator, and fifty-nine predefined simulator metrics were automatically recorded. Cronbach’s alpha was used to explore internal consistency reliability. Intergroup comparisons were made using independent sample t-tests with Tukey’s correction for multiple comparisons. The learning effect was explored using paired sample t-test analysis, and a pass/fail standard was established using the contrasting groups’ method.

Results

73 novices, 18 intermediates, and 19 physicians performed the test resulting in a total of 220 procedures. 25 metrics (42.4%) had good discriminatory ability, and the reliability of these metrics was good, Cronbach’s α = 0.81. The experienced physicians were significantly better than the novices (18.3 vs. 13.3, p < 0.001), and the pass/fail standard was established at 16 points. This standard resulted in 22 (30.1%) novices passing (i.e., false positives) and 5 (26.3%) physicians failing (i.e., false negatives).

Conclusion

This study provides validity evidence for a simulator-based test of lumbar puncture competence. The test can help ensure basic competence at the end of a simulation-based training program for trainees, i.e., a mastery learning training program.
“Nurses and health professionals facing female genital mutilation: a qualitative study “
Authors: Ugarte-Gurrutxaga MIdoia , Mazoteras-Pardo Victoria- , de Corral Gonzalo Melgar , Molina-Gallego Brígida , Mordillo-Mateos Laura , Gómez-Cantarino Sagrario
Published: October 2023

Background

Transnational migratory movements make Spain a country with a very diverse population, including women and girls from countries where Female Genital Mutilation (FGM) is practiced. Given this reality, we set out to carry out a qualitative study to identify the knowledge, attitudes and skills of health professionals regarding FGM.

Method

Qualitative study with a content analysis approach. Forty-seven health professionals with the profiles of Nursing, Family Medicine, Pediatrics, Midwifery and Gynecology and Obstetrics were purposively selected. Data were collected through semi-structured in-depth interviews and focus groups. The qualitative content analysis approach was used for data analysis. The study was conducted in the years 2019 and 2022.

Results

Although most professionals are aware of the current legislation on FGM in Spain, only a few of them are aware of the existence of the FGM prevention protocol in Castilla-La Mancha. This lack of knowledge together with the perception that FGM belongs to the private sphere of women, contributes to the loss of opportunities to identify and prevent FGM.

Conclusion

Health professionals’ training, especially midwives and pediatricians, is essential to the identification and action against Female Genital Mutilation.
Application of whole-cell biosensors for analysis and improvement of L- and D-lactic acid fermentation by Lactobacillus spp. from the waste of glucose syrup production
Authors: Augustiniene Ernesta , Jonuskiene Ilona , Kailiuviene Jurgita , Mazoniene Edita , Baltakys Kestutis , Malys Naglis
Published: October 2023

Background

Lactic acid is one of the most important organic acids, with various applications in the food, beverage, pharmaceutical, cosmetic, and chemical industries. Optically pure forms of L- and D-lactic acid produced via microbial fermentation play an important role in the synthesis of biodegradable polylactic acid. Alternative substrates, including by-products and residues from the agro-food industry, provide a cost-effective solution for lactic acid production and are a promising avenue for the circular economy.

Results

In this study, the transcription factor (TF)-based whole-cell biosensor strategy was developed for the L- and D-lactic acid determination. It was cross validated with commonly used high-performance liquid chromatography and enzymatic methods. The utility of biosensors as an efficient analytical tool was demonstrated by their application for the lactic acid determination and fermentation improvement. We explored the ability of Lacticaseibacillus paracasei subsp. paracasei, Lactobacillus delbrueckii subsp. lactis, and Lactobacillus amylovorus to biosynthesize optically pure L-lactic acid, D-lactic acid or mixture of both from organic-rich residual fraction (ORRF), a waste of glucose syrup production from wheat starch. The fermentation of this complex industrial waste allowed the production of lactic acid without additional pretreatment obtaining yields from 0.5 to 0.9 Cmol/Cmol glucose.

Conclusions

This study highlights the utility of whole cell biosensors for the determination of L- and D-forms of lactic acid. The fermentation of L-lactic acid, D-lactic acid and mixture of both by L. paracasei, L. lactis, and L. amylovorus, respectively, was demonstrated using waste of glucose syrup production, the ORRF.
GAD1 contributes to the progression and drug resistance in castration resistant prostate cancer
Authors: Wan Lilin , Liu Yifan , Liu Ruiji , Mao Weipu
Published: October 2023

Background

Prostate cancer is currently the second most lethal malignancy in men worldwide due to metastasis and invasion in advanced stages. Studies have revealed that androgen deprivation therapy can induce stable remission in patients with advanced prostate cancer, although most patients will develop castration-resistant prostate cancer (CRPC) in 1–2 years. Docetaxel and enzalutamide improve survival in patients with CRPC, although only for a short time, eventually patients develop primary or secondary resistance, causing disease progression or biochemical relapse.

Methods

The gene expression profiles of docetaxel-sensitive or -resistant prostate cancer cell lines, namely GSE33455, GSE36135, GSE78201, GSE104935, and GSE143408, were sequentially analyzed for differentially expressed genes and progress-free interval significance. Subsequently, the overall survival significance and clinic-pathological features were analyzed by the R package. The implications of hub genes mutations, methylation in prostate cancer and the relationship with the tumor immune cell infiltration microenvironment were assessed with the help of cBioPortal, UALCAN and TISIDB web resources. Finally, effects of the hub genes on the progression and drug resistance in prostate cancer were explored using reverse transcription-polymerase chain reaction (RT-PCR), immunohistochemistry, cell phenotype, and drug sensitivity.

Result

Glutamate decarboxylase 1 (GAD1) was tentatively identified by bioinformatic analysis as an hub gene for the development of drug resistance, including docetaxel and enzalutamide, in prostate cancer. Additionally, GAD1 expression, mutation and methylation were significantly correlated with the clinicopathological features and the tumor immune microenvironment. RT-PCR, immunohistochemistry, cell phenotype and drug sensitivity experiments further demonstrated that GAD1 promoted prostate cancer progression and decreased the therapeutic effect of docetaxel or enzalutamide.

Conclusion

This research confirmed that GAD1 was a hub gene in the progression and development of drug resistance in prostate cancer. This helped to explain prostate cancer drug resistance and provides new immune-related therapeutic targets and biomarkers for it.
Rapid Mycobacterium abscessus antimicrobial susceptibility testing based on antibiotic treatment response mapping via Raman Microspectroscopy
Authors: Ren Weicong , Mao Yuli , Li Shanshan , Gao Bo , Fu Xiaoting , Liu Xiaolu , Zhu Pengfei , Shang Yuanyuan , Li Yuandong , Ma Bo , Sun Luyang , Xu Jian , Pang Yu
Published: October 2023

Objectives

Antimicrobial susceptibility tests (ASTs) are pivotal tools for detecting and combating infections caused by multidrug-resistant rapidly growing mycobacteria (RGM) but are time-consuming and labor-intensive.

Design

We used a Mycobacterium abscessus-based RGM model to develop a rapid (24-h) AST from the beginning of the strain culture, the Clinical Antimicrobials Susceptibility Test Ramanometry for RGM (CAST-R-RGM). The ASTs obtained for 21 clarithromycin (CLA)-treated and 18 linezolid (LZD)-treated RGM isolates.

Results

CAST-R-RGM employs D2O-probed Raman microspectroscopy to monitor RGM metabolic activity, while also revealing bacterial antimicrobial drug resistance mechanisms. The results of clarithromycin (CLA)-treated and linezolid (LZD)-treated RGM isolates exhibited 90% and 83% categorical agreement, respectively, with conventional AST results of the same isolates. Furthermore, comparisons of time- and concentration-dependent Raman results between CLA- and LZD-treated RGM strains revealed distinct metabolic profiles after 48-h and 72-h drug treatments, despite similar profiles obtained for both drugs after 24-h treatments.

Conclusions

Ultimately, the rapid, accurate, and low-cost CAST-R-RGM assay offers advantages over conventional culture-based ASTs that warrant its use as a tool for improving patient treatment outcomes and revealing bacterial drug resistance mechanisms.
Regulation of the integrin αVβ3- actin filaments axis in early osteogenic differentiation of human mesenchymal stem cells under cyclic tensile stress
Authors: Peng Yan , Qu Rongmei , Yang Yuchao , Fan Tingyu , Sun Bing , Khan Asmat Ullah , Wu Shutong , Liu Wenqing , Zhu Jinhui , Chen Junxin , Li Xiaoqing , Dai Jingxing , Ouyang Jun
Published: October 2023

Background

Integrins are closely related to mechanical conduction and play a crucial role in the osteogenesis of human mesenchymal stem cells. Here we wondered whether tensile stress could influence cell differentiation through integrin αVβ3.

Methods

We inhibited the function of integrin αVβ3 of human mesenchymal stem cells by treating with c(RGDyk). Using cytochalasin D and verteporfin to inhibit polymerization of microfilament and function of nuclear Yes-associated protein (YAP), respectively. For each application, mesenchymal stem cells were loaded by cyclic tensile stress of 10% at 0.5 Hz for 2 h daily. Mesenchymal stem cells were harvested on day 7 post-treatment. Western blotting and quantitative RT-PCR were used to detect the expression of alkaline phosphatase (ALP), RUNX2, β-actin, integrin αVβ3, talin-1, vinculin, FAK, and nuclear YAP. Immunofluorescence staining detected vinculin, actin filaments, and YAP nuclear localization.

Results

Cyclic tensile stress could increase the expression of ALP and RUNX2. Inhibition of integrin αVβ3 activation led to rearrangement of actin filaments and downregulated the expression of ALP, RUNX2 and promoted YAP nuclear localization. When microfilament polymerization was inhibited, ALP, RUNX2, and nuclear YAP nuclear localization decreased. Inhibition of YAP nuclear localization could reduce the expression of ALP and RUNX2.

Conclusions

Cyclic tensile stress promotes early osteogenesis of human mesenchymal stem cells via the integrin αVβ3-actin filaments axis. YAP nuclear localization participates in this process of human mesenchymal stem cells.
Indacaterol inhibits collective cell migration and IGDQ-mediated single cell migration in metastatic breast cancer MDA-MB-231 cells
Authors: Ayama-Canden Sophie , Tondo Rodolfo , Pineros Leyton Martha Liliana , Ninane Noëlle , Demazy Catherine , Dieu Marc , Fattaccioli Antoine , Sauvage Aude , Tabarrant Tijani , Lucas Stéphane , Bonifazi Davide , Michiels Carine
Published: October 2023

Metastasis is the main cause of deaths related to breast cancer. This is particular the case for triple negative breast cancer. No targeted therapies are reported as efficient until now. The extracellular matrix, in particular the fibronectin type I motif IGDQ, plays a major role in regulating cell migration prior metastasis formation. This motif interacts with specific integrins inducing their activation and the migratory signal transduction.Here, we characterized the migratory phenotype of MDA-MB-231 cells, using functionalized IGDQ-exposing surfaces, and compared it to integrin A5 and integrin B3 knock-down cells. A multiomic analysis was developed that highlighted the splicing factor SRSF6 as a putative master regulator of cell migration and of integrin intracellular trafficking. Indacaterol-induced inhibition of SRSF6 provoked: i) the inhibition of collective and IGDQ-mediated cell migration and ii) ITGA5 sequestration into endosomes and lysosomes. Upon further studies, indacaterol may be a potential therapy to prevent cell migration and reduce metastasis formation in breast cancer.
The association of serum betaine concentrations with the risk of new-onset cancers: results from two independent nested case-control studies
Authors: Xie Hailun , Zhang Kangping , Wei Yaping , Ruan Guotian , Zhang Heyang , Li Shuqun , Song Yun , Chen Ping , Liu Lishun , Wang Binyan , Shi Hanping
Published: October 2023

Evidence from epidemiologic studies on the association of circulating betaine levels with the incident risk of cancer has been inconsistent. We aimed to investigate the prospective association of serum betaine concentrations with the risk of cancer. We performed two, nested, case-control studies utilizing data from the “H-type Hypertension Prevention and Control Public Service Project” (HHPCP) and the China Stroke Primary Prevention Trial (CSPPT), with 2782 participants (1391 cancer cases and 1391 matched controls) in the discovery cohort, and 228 participants (114 cancer cases and 114 matched controls) in the validation cohort. Odds ratios (OR) of the association between betaine and cancer were calculated using conditional logistic regression models. There was an association between serum betaine as a continuous variable and total cancer (OR = 1.03, 95%CI = 0.99–1.07, p = 0.097). Among cancer subtypes, a positive association was found between serum betaine and the risk of lung cancer, and an inverse association was found with other cancers. Interestingly, a U-shaped association was observed between serum betaine and digestive cancers, with a turning point of 5.01 mmol/L for betaine (betaine < 5.01 mmol/L, OR = 0.82, 95%CI = 0.59–1.14, p = 0.228; betaine ≥ 5.01 mmol/L, OR = 1.08, 95%CI = 1.01–1.17, p = 0.036). In the validation cohort, a significant association between serum betaine as a continuous variable and total cancer (OR = 1.48, 95%CI = 1.06–2.05, P = 0.020) was also found. High serum betaine was associated with increased risk of total cancer and lung cancer, and a U-shaped association was found with the risk of digestive cancers, with a turning point at about 5.01 mmol/L.