bluuebunny/crossref_metadata_2025 huggingface dataset:
Iterative learning control for switched singular time-delay systems
Authors: Gu Panpan , Tian Senping , Liu Qian
Published: September 2024

This paper deals with the problem of iterative learning control for a class of switched singular time-delay systems. The considered switched singular time-delay systems with arbitrary switching rules are operated during a finite time interval repetitively. According to the characteristics of the systems, a closed-loop D-type learning algorithm is proposed. Using the contraction mapping method, we show that the algorithm can guarantee that the system output converges uniformly to the corresponding desired trajectory on the whole time interval. Finally, simulation examples are given to illustrate the effectiveness of the proposed algorithm.
Operating modal parameter identification of railway vehicle bogie based on k-value optimization variational mode decomposition and second-order blind identification method
Authors: Wang Xianghong , Fu Yaqi , Tan Xiaohui , Liu Fulong , Xu Xiaoqiang , Hu Hongwei
Published: September 2024

Due to the variable operating conditions and strong background noise, the accuracy of modal parameter identification of the railway vehicle bogie is low. This paper proposes a method for identifying operational modal parameters by combining the K-value optimization variational mode decomposition (KVMD) and second-order blind identification (SOBI) method (KVMD–SOBI method). Firstly, the variational mode decomposition (VMD) algorithm is used to adaptively decompose a single-channel vibration signal into intrinsic mode function (IMF) components with different scale characteristics. The feature IMF components are selected through the K-value optimization method based on energy ratio and stability graph. Then, the SOBI algorithm is used to separate the matrix composed of the feature IMF components. And the mode shape and single-mode signal are obtained. Finally, the natural frequency and damping ratio of each order mode are extracted by the single-mode parameter recognition method. Through simulation and experimental verification, it is shown that the proposed method has good noise robustness and can effectively identify the first three modal parameters of railway vehicle bogies in variable-speed operation. At the same time, the feature IMF components extracted by KVMD algorithm eliminate the sensitivity of sensor installation positions and operating conditions to detection results. Therefore, this method is an excellent operational mode identification method based on a single-channel signal with good noise and working condition robustness.
Study on vibration fatigue of lifeguard in a metro bogie and methodology for damage estimation based on the measured acceleration
Authors: Zhang Zhenxian , Wu Xingwen , Zheng Yuhao , Liu Yang , Jin Xuesong , Zhou Jinming , Chi Maoru , Wen Zefeng
Published: September 2024

The lifeguard is more like a cantilever beam installed on the end of bogie frame, used to remove foreign body on the rail. Due to severe vibration condition, the lifeguard has been reported to be subjected to fatigue failure by railway operators. This paper thus studied on fatigue failure mechanisms of lifeguard through both the field test and numerical simulation. In the field test, the vibration acceleration and dynamic stress developed on the lifeguard were measured to identify main contributors to the fatigue failure. The test results showed that the structural resonance arising from the rail corrugation-induced high frequency impact serves as the main causal factor. To better understanding the failure mechanism, a numerical model considering the flexibility of lifeguard was established to determine the stress field of lifeguard based on the modal method, which was further used to estimate the residual fatigue lifetime for given loading conditions. The results showed that the obtained dynamic stress for given position on lifeguard is quite comparable with those obtained through the field test. Based on the obtained dynamic stress, the fatigue damage was further estimated and concluded that the fatigue lifetime of lifeguard is much less than the designed lifetime under the considered loading condition. The rail grinding and the structural improvement are thus suggested to mitigate the vibration fatigue of lifeguard.
Qualitative Inquiry, Ontology, and the Question of Being: “We Are Not Yet Thinking”
Authors: Hein Serge F.
Published: September 2024

Mainstream/conventional qualitative research is fundamentally an epistemological activity, with the result that methodological issues are largely dealt with epistemologically rather than ontologically. For continental philosophy, however, epistemology has its basis in ontology. The continental approach to ontology has its origins in Heidegger’s reopening of the question of Being in Being and Time, which is viewed as having permanently altered the epistemological program that guides modern philosophy and modern science. Heidegger asks: What is the meaning of Being? Being is what determines beings as beings, but it is not itself a being. Heidegger conceives of Being as a question but because Being is not a being, the Being-question is unanswerable and always remains open. Being cannot be an object of knowledge but, instead, is an issue for thought. Heidegger’s examination of the Being-question also has a number of important implications for mainstream qualitative inquiry.
A Psychometric Evaluation of the Revised Version of the Adult ADHD Self-Report Scale in Chinese Adolescents
Authors: Xiao Ling-Rong , Zhao Gang , Zhang Pei , Tian Xian , Wu Xiao-Xue , Li Jun-Ru , Liu Si-Yan , Wu Hong-Mei
Published: September 2024

Background:

Adolescent-specific ADHD self-report screening measures can greatly increase the likelihood of correct diagnosis and timely treatment of ADHD in adolescents. This study provides preliminary evidence for evaluating the reliability and validity of the Adult ADHD Self-Report Scale-Revised (ASRS-R) in a school-based sample of Chinese adolescents.

Methods:

The ASRS-R and the Strengths and Difficulties Questionnaire (SDQ) were administered to 867 adolescents aged 12 to 16 years ( Mage = 13.08 years). Construct validity was assessed using correlation analysis of the ASRS-R with the SDQ. Moreover, confirmatory factor analysis (CFA), internal consistency, retest reliability, and measurement invariance of the scales were examined by gender.

Results:

CFA showed a two-dimensional factor structure of the ASRS-R, and the model fitted the data well (χ2/ df = 4.370, RMSEA = 0.062, TLI = 0.932, CFI = 0.940, GFI = 0.927, AGFI = 0.907, and SRMR = 0.038). The ASRS-R scale was invariant across gender and had satisfactory internal consistency (Cronbach’s alpha = .934) and test-retest reliability (intraclass correlation coefficient = .874). The construct validity, as calculated using the SDQ, was also acceptable.

Conclusion:

The ASRS-R can be a psychometrically reliable self-report instrument and provide preliminary support as a simple tool for identifying ADHD symptoms in Chinese adolescents. The findings provide evidence for extending the application of the ASRS, previously limited to adults, to the adolescent populations.
Use of the subcutaneous ureteral bypass device and urethral stenting for treatment of malignant urinary outflow tract obstructions in cats
Authors: Covo Mariel S , Berent Allyson C , Weisse Chick W
Published: September 2024

Objectives

The aim of this study was to describe the technical success and outcomes of ureteral and urethral decompression using the subcutaneous ureteral bypass (SUB) device and transurethral self-expanding metallic stents (SEMS) as a palliative treatment option for feline malignant urinary outflow tract obstructions.

Methods

A retrospective study was conducted of 14 cats with ureteral and/or urethral obstructions secondary to diagnosed or suspected transitional cell carcinoma (TCC). In all cats, a SUB device and/or a SEMS was placed to relieve the obstruction(s). Group 1 consisted of cats with ureteral obstructions, with or without concurrent urethral obstructions, and group 2 consisted of cats with only urethral obstructions.

Results

Eight cats were included in group 1 (seven with concurrent urethral obstructions) and six cats were included in group 2. TCC was confirmed in 8/14 cats. Repeat urethral obstruction due to tumor in growth occurred in 6/13 (46%) cats with a SEMS, and no cats developed recurrent ureteral obstructions after placement of the SUB device. Three cats had additional covered stents placed after urethral re-obstruction. The median survival time (MST) from the time of device placement was 52 days in group 1 (mean 92; range 14–349) and 80 days in group 2 (mean 96; range 7–209). The MST from the time of mass identification of the cats that did and did not receive adjunctive therapy was 349 days (mean 358; range 124–602) and 43 days (mean 113; range 14–423), respectively.

Conclusions and relevance

The use of bypass devices for feline malignant urinary outflow tract obstructions is a viable option to provide immediate renal and urinary bladder decompression. TCC in cats is locally aggressive and can result in urethral re-obstruction, prompting consideration for placing a covered urethral stent. The use of adjunctive therapies for malignant neoplasia should be considered to improve overall survival once the obstruction has been relieved.
Uveitis: A snapshot in the MOG antibody spectrum
Authors: Fabiani Claudia , Tosi Gian Marco , Damato Valentina , Ulivelli Monica , Rufa Alessandra , Cerase Alfonso , De Stefano Nicola , Cortese Rosa
Published: September 2024

Despite the commonly observed association of anti-myelin oligodendrocyte glycoprotein (MOG) antibodies with bilateral optic neuritis, their connection to uveitis is largely unexplored. The presented case involves a 41-year-old male with uveitis and bilateral optic neuritis, subsequently diagnosed with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). This case, characterized by bilateral optic neuritis associated to anti-MOG antibodies and the concurrent onset of unilateral anterior uveitis, provides further evidence concerning the features of intraocular inflammation in MOGAD. The patient’s treatment response, including the use of rituximab due to contraindications to oral steroids, emphasizes the importance of personalized management strategies in MOGAD-associated ocular manifestations.
Is occlusal contact re-established within 6 months after bonding of a fixed anterior bite plane in adolescents with a Class II division 2 incisor relationship? A randomised controlled trial
Authors: Dunbar Evelyn , Chalmers Elinor , Sivamurthy Gautham , Revie Gavin , McIntyre Grant T , Mossey Peter A
Published: September 2024

Objective:

To determine if re-establishment of occlusal contact was achieved within 6 months after insertion of a fixed anterior bite plane in individuals with Class II division 2 incisor relationship, and to evaluate the occlusal and vertical skeletal changes and acceptance of the intra-oral scanner and bite plane.

Design:

Single-centre two-arm parallel group randomised controlled trial with 1:1 allocation to intervention and control groups.

Setting:

Dundee Dental Hospital and Research School, UK.

Participants:

A total of 38 participants aged 9–16 years (11 males, 27 females) with Class II division 2 incisor relationship and increased overbite (greater than one-third incisor overlap).

Methods:

Participants were randomised to intervention (n = 19) and control (n = 19) groups using block randomisation. The intervention group had a fixed anterior bite plane, and the occlusion and vertical facial dimensions were monitored with intra-oral scans, lateral cephalograms and photographs. The control group received no treatment and occlusal and vertical facial dimensions were monitored with scans and photographs. Questionnaires were completed by participants and parents/carers. An intention-to-treat analysis was planned.

Results:

The overbite reduced in all participants in the intervention group (mean initial overbite: 5.07 mm, 95% confidence interval [CI] = 4.15–6.00; mean overbite after 6 months: 2.45 mm, 95% CI = 1.93–2.96). There was a mean incisor intrusion of 0.29 mm (95% CI = 0.17–0.42) and mean eruption of the first molars of 0.23 mm (95% CI = 0.09–0.37). There was no significant change in incisor inclination or vertical skeletal change. Feedback from participants and their parents/carers were generally positive.

Conclusion:

Fixed anterior bite planes effectively reduce an increased overbite in adolescents with a Class II division 2 incisor relationship, due to a combination of incisor intrusion and molar eruption with no change in incisor inclination or vertical skeletal change. Intra-oral scanning and fixed anterior bite planes are acceptable in adolescents.
Are mobile phones predominant in dual-frame computer assisted telephone interviewing surveys?
Authors: Vicente Paula
Published: September 2024

The effectiveness of Computer Assisted Telephone Interviewing (CATI) surveys relying on fixed telephone numbers has been eroded by the rise in mobile phone usage and the growing population reachable exclusively through mobile phones. As a result, telephone survey methodologists have had to come up with research designs capable of dealing with the coverage bias in CATI surveys caused by incomplete fixed phone directories. The methodological and operational issues of dual-frame surveys, namely those combining fixed phones and mobile phones, have been extensively investigated, but a comprehensive overview of the magnitude of mobile phone use in CATI surveys is lacking. The present study explores this research gap by analysing data from 675 CATI surveys conducted in European countries. Although a generalised scenario of single frame mobile phone designs is not yet visible, the predominance of mobile phone units over fixed phone units in dual-frame CATI surveys is evident. The sampling method and the target population are the survey-related features most strongly associated to the percentage of mobile phone units in the sample. Survey organisations in countries which continue to have a high number of fixed phone subscriptions tend to give less weight to mobile phone frames in their dual-frame designs.
Clinical Efficacy and Mechanistic Insights of Anshen Dingzhi Prescription on Breast Cancer-Related PTSD Through Network Pharmacology and Molecular Docking
Authors: Zhang Hao , Zhu Yongfu , Zhu Guoqi , Yang Shaojie
Published: September 2024

Anshen Dingzhi prescription (ADP) is a classic prescription of traditional Chinese medicine, which has been used in the treatment of neuropsychiatric diseases. However, its treatment of breast cancer-related post-traumatic stress disorder (BC-PTSD) lacks clinical research evidence and its mechanism is not clear. The present study investigated the efficacy and action mechanism of ADP against BC-PTSD. The results of the clinical trial showed that after 4 weeks of treatment, both groups showed reduced post-traumatic stress disorder checklist-civilian version (PCL-C), Pittsburgh sleep quality index (PSQI), self-rating depression scale (SDS) and self-rating anxiety scale (SAS) scores, and increased functional assessment of cancer therapy-breast (FACT-B) scores. The serum cortisol (CORT), tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β) levels were decreased and brain-derived neurotrophic factor (BDNF) level were increased, and the improvement of serum TNF-α, IL-1β, and BDNF in treatment group was better than that of the control group. The overall treatment efficacy in the treatment group (43.90%) was superior to that in the control group (23.81%), and the overall incidence of adverse effects was lower than that in the control group. The results of network analysis and molecular docking showed that ADP blood components could act on IL1B, TNF, and BDNF. ADP contributes to the treatment of BC-PTSD symptoms, with a mechanism possibly related to its regulatory effect on TNF-α, IL-1β, and BDNF levels.

Trial registration: Chinese Clinical Trial Registry, http://www.chictr.org.cn,ChiCTR2300077801
Pathophysiology of adhesive capsulitis of shoulder and the physiological effects of hyaluronan
Authors: Yuan Xiangnan , Zhang Zhiqiang , Li Jianjun
Published: September 2024

Adhesive capsulitis, commonly described as “frozen shoulder,” is experienced as chronic soreness and discomfort accompanied by an increasing inability to use and manipulate the joint, which can cause disability and interfere with normal activities. The onset of the condition is sudden and the origins obscure. The more we know about how this condition arises and evolves in the human body, the better the medical profession can provide effective management and amelioration. In examining the pathology and pathophysiology of adhesive capsulitis, we found recent evidence that intra-articular use of hyaluronan can provide effective relief. In this letter, we summarized this research to obtain a better understanding of the pathophysiology of adhesive capsulitis and the effects of hyaluronan.
Advances in the mechanism of CDK4/6 inhibitor resistance in HR+/HER2− breast cancer
Authors: Wu Sijia , Xu Junnan , Ma Yiwen , Liang Guilian , Wang Jiaxing , Sun Tao
Published: September 2024

Among women, breast cancer is the most prevalent form of a malignant tumour. Among the subtypes of breast cancer, hormone receptor (HR) positive and human epidermal growth factor receptor (HER2) negative kinds make up the biggest proportion. The advent of cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors, which are dependent on cell cycle proteins, has greatly enhanced the prognosis of patients with advanced HR+/HER2− breast cancer. This is a specific treatment that stops the growth of cancer cells by preventing them from dividing. Nevertheless, the drug resistance of the disease unavoidably impacts the effectiveness of treatment and the prognosis of patients. This report provides a thorough analysis of the current research advancements about the resistance mechanism of CDK4/6 inhibitors in HR+/HER2− breast cancer. It presents an in-depth discussion from numerous viewpoints, such as aberrant cell cycle regulation and changes in signalling pathways. In response to the drug resistance problem, subsequent treatment strategies are also being explored, including switching to other CDK4/6 inhibitor drugs, a combination of novel endocrine therapeutic agents, an optimal combination of targeted therapies and switching to chemotherapy. An in-depth study of the resistance mechanism can assist in identifying creative tactics that can overcome or postpone drug resistance, alleviate the problem of restricted treatment strategies following drug resistance and enhance the prognosis of patients.
Navigating self-regulated online teaching: Educators’ response to the COVID-19 pandemic
Authors: Tang Joni Tzuchen , Hong Jon-Chao
Published: September 2024

Amidst the unprecedented challenges brought on by the COVID-19 pandemic, the landscape of education has undergone profound transformations. One of the most notable shifts has been the rapid transition to online teaching methodologies. This transition has highlighted the critical role of teachers in self-regulating their instructional approaches while actively engaging in the realm of online learning. In this study, we delve into this dynamic environment, closely examining the practices of different age groups of educators: 177 teachers aged 20-30, 217 teachers aged 31-40, 68 teachers aged 41-50, and 15 teachers aged 51 and above. Our research takes a comprehensive approach, organizing the investigation into three distinct phases, each comprising six essential elements. Through this structured analysis, intriguing patterns emerge, particularly within the Performance and Appraisal Phase, where notable disparities among age groups within the Self-regulated Teaching Model become evident. In response to the multifaceted challenges posed by online teaching, our study proposes a compelling solution. We advocate for a strategic alignment of instructors from diverse age groups to collaboratively guide online courses. By harnessing the collective strengths and perspectives of educators across generations, this collaborative pedagogical approach has the potential to significantly enhance the efficacy of online teaching endeavors.
Samir Amin: A Short Intellectual Portrait
Authors: Bagchi Amiya Kumar
Published: September 2024

This article begins with Samir Amin’s family background to understand his development as a fiercely committed Marxist who throughout his life was dedicated to changing the world. All the disappointments and defeats of the cause he espoused only sharpened his determination. The article reviews Amin’s professional career in economic planning and some of the key concepts that he elaborated in the interest of social change—including eurocentrism, the law of worldwide value, and maldevelopment—before turning to his concern with political Islam, which he saw as an accessory to imperialism.
Informal caregivers compared with users and health workers on well-being and respect for human rights in mental health care services
Authors: Atzeni Michela , Primavera Diego , Aviles Gonzales Cesar Ivan , Galletta Maura , Marchegiani Sonia , La Torre Giuseppe , Sancassiani Federica , Nonnis Marcello , Urban Antonio , Cantone Elisa , Romano Ferdinando , Nardi Antonio E , Carta Mauro G
Published: September 2024

Background:

This study aimed to measure differences among informal caregivers, users, and mental healthcare workers (MHW) regarding job/organizational satisfaction and perceptions of respect for rights in the mental health services of one region of Italy.

Methods:

A sample of 100 caregivers, 240 MHW, and 200 users completed the “Well-Being at Work and Respect for Human Rights Questionnaire” (WWRR) in community mental health centers in Sardinia.

Results:

Caregivers reported higher satisfaction toward MHW on perceiving respect for human rights among users (5.2 ± 1.0 vs 5.1 ± 1.1, p < 0.0001) and health professionals (5.3 ± 0.8 vs 4.5 ± 1.3, p < 0.0001) and organization well-being (5.1 ± 1.2 vs 3.9 ± 1.3, p < 0.0001); toward users about respect of rights of MHW (5.3 ± 0.8 vs 4.9 ± 1.2, p < 0.0001) and both toward users and MHW on dissatisfaction on resources ( p < 0.0001). Caregivers strongly highlighted insufficient resources for services.

Conclusion:

Despite caregiver satisfaction, resource deficiencies signal a critical juncture in Italian mental health care. Continued cuts in healthcare spending, especially in mental health, raise concerns for future outcomes.
Is the Diagnosis of fifth Metatarsal Fracture Type Consistent? An Interobserver Reliability Study
Authors: Chapman James , Gupta Shubhi , Choudhary Zain , Davies Thomas , Airey Grace , Mason Lyndon
Published: September 2024

Background:

Treatment pathways of fifth metatarsal fractures are commonly directed based on fracture classification, with particular proximal fractures typically requiring closer observation and possibly more aggressive management. Our aim is to investigate the interobserver reliability of assessment of subtypes of fifth metatarsal fractures.

Methods:

We included all patients referred to our virtual fracture clinic with a suspected or confirmed fifth metatarsal fracture. Plain anteroposterior radiographs were reviewed by 2 novice observers, initially trained on the fifth metatarsal classification identification. Eight different zones were defined based on anatomical location. Patients were excluded from analysis if neither observer could identify a fracture. An interobserver reliability analysis using Cohen κ coefficient was carried out, and degree of observer agreement described using Landis and Koch’s description. All data were analyzed using IBM SPSS, version 27.

Results:

A total of 1360 patients who met the inclusion criteria were identified. The 2 observers had moderate agreement when identifying fractures in all zones, apart from zone 1.2 and distal metaphysis (DM) fractures, which only achieved fair agreement (κ = 0.308 and 0.381 respectively). Zone 3 has slight agreement with zone 2 proximally, and there is an apparent difficulty with distal diaphyseal shaft (DS) fractures, resulting in a lot of crossover with DM, achieving a fair level of agreement (DS 312 vs 196; DM 120 vs 237; κ = .398, P < .001).

Conclusion:

Reliability of subcategorizing fifth metatarsal fractures using standardized instructions conveys moderate agreement in most cases. If the region of the fracture is going to be used in an algorithm to guide a management plan and clinical follow-up during a virtual clinic review, defining fractures of zones 1-3 needs careful consideration.

Level of Evidence:

Level III, retrospective cohort study.
Reflections of Chinese character culture in nomenclature: A quantitative linguistic and geolinguistic examination of five-star hotel names in China
Authors: Synn Asa
Published: September 2024

This study investigates the names of 801 five-star hotels across the Chinese mainland, quantitatively analyzing syllable length, geographical names (city and province names), and common terms within six regions and thirty-one provinces. The research aims to elucidate the lexical characteristics evident in the names of these luxury hotels from a geolinguistic perspective, thus offering insights into China’s linguistic culture. The analysis revealed that the prevalence of five-star hotels correlates significantly with economic size and geographical location. Notable regional differences were observed in the usage of syllable counts and geographical names, with marked distinctions between the north and south, and more subtle variations between the east and west. The employment of city names was particularly prominent. The term jiudian 酒店 emerged as the most frequently used common term, especially in the Central South and Northwest, while fandian 飯店 was more commonly used in the Southwest, North China, and Northeast. Additionally, a diverse array of common terms characterized the nomenclature in the East China region.
Drama-based pedagogy as a pedagogy of the possible for preservice teacher education
Authors: Yoon Sae Saem
Published: September 2024

This conceptual paper responds to Glăveanu’s call for scholarly dialogues on possibility studies, contextualizing it within the field of education, specifically preservice teacher education. The primary objective of this article is to propose drama-based pedagogy as a pedagogy of the possible. Drawing from anecdotal data of using drama to teach preservice teachers, the paper demonstrates how drama-based pedagogy aligns with the eight possibilities of the pedagogies of the possible.
Cytological analysis of flower development, insights into suitable growth area and genomic background: implications for Glehnia littoralis conservation and sustainable utilization
Authors: An Chang , Ye Kangzhuo , Jiang Runfa , Chen Jiayi , Yao Yixin , Lu Lin , Cheng Yan , Liu Ruoyu , Liu Xiaofen , Zhao Heming , Qin Yuan , Zheng Ping
Published: September 2024

Background

Glehnia littoralis F. Schmidt ex Miq., an endangered plant species with significant medicinal, edible, and ecological value, is now a central concern for conservation and sustainable utilization. Investigating the physiological and ecological mechanisms leading to its endangerment and elucidating its genetic background constitutes the foundation for conducting in-depth research on G. littoralis.

Results

Our observations have revealed a significant degree of floral sterility in wild populations of G. littoralis. The inflorescences of G. littoralis are classified into three types: completely fertile, completely sterile, and partially fertile compound umbels. Moreover, the flowers of G. littoralis can be categorized into fertile and sterile types. Sterile flowers exhibited abnormalities in the stigma, ovary, and ovules. This study is the first to discover that the presence or absence of a giant cell at the funiculus during the initiation of ovule primordium determines whether the flower can develop normally, providing cytological evidence for female sterility in G. littoralis. Conversely, both fertile and sterile flowers produced normally developed pollen. Field observations have suggested that robust plants bear more fertile umbels, while weaker ones have fewer or even no fertile umbels, indicating a close relationship between flower fertility and plant nutritional status. Our model correctly predicted that the eastern coastal regions of China, as well as prospective areas in Neimenggu and Sichuan, are suitable environments for its cultivation. Additionally, Using flow cytometry and genome survey, we estimated the genome size of G. littoralis to be 3.06 Gb and the heterozygosity to be 4.58%.

Conclusion

The observations and findings presented in this study were expected to provide valuable insights for further conserving its genetic resources and sustainable utilization of G. littoralis.
Sorafenib plus memory-like natural killer cell immunochemotherapy boosts treatment response in liver cancer
Authors: Eresen Aydin , Zhang Zigeng , Yu Guangbo , Hou Qiaoming , Chen Zhilin , Yu Zeyang , Yaghmai Vahid , Zhang Zhuoli
Published: September 2024

Background

Heterogeneity of hepatocellular carcinoma (HCC) presents significant challenges for therapeutic strategies and necessitates combinatorial treatment approaches to counteract suppressive behavior of tumor microenvironment and achieve improved outcomes. Here, we employed cytokines to induce memory-like behavior in natural killer (NK) cells, thereby enhancing their cytotoxicity against HCC. Additionally, we evaluated the potential benefits of combining sorafenib with this newly developed memory-like NK cell (pNK) immunochemotherapy in a preclinical model.

Methods

HCC tumors were grown in SD rats using subcapsular implantation. Interleukin 12/18 cytokines were supplemented to NK cells to enhance cytotoxicity through memory activation. Tumors were diagnosed using MRI, and animals were randomly assigned to control, pNK immunotherapy, sorafenib chemotherapy, or combination therapy groups. NK cells were delivered locally via the gastrointestinal tract, while sorafenib was administered systemically. Therapeutic responses were monitored with weekly multi-parametric MRI scans over three weeks. Afterward, tumor tissues were harvested for histopathological analysis. Structural and functional changes in tumors were evaluated by analyzing MRI and histopathology data using ANOVA and pairwise T-test analyses.

Results

The tumors were allowed to grow for six days post-cell implantation before treatment commenced. At baseline, tumor diameter averaged 5.27 mm without significant difference between groups (p = 0.16). Both sorafenib and combination therapy imposed greater burden on tumor dimensions compared to immunotherapy alone in the first week. By the second week of treatment, combination therapy had markedly expanded its therapeutic efficacy, resulting in the most significant tumor regression observed (6.05 ± 1.99 vs. 13.99 ± 8.01 mm). Histological analysis demonstrated significantly improved cell destruction in the tumor microenvironment associated with combination treatment (63.79%). Interestingly, we observed fewer viable tumor regions in the sorafenib group (38.9%) compared to the immunotherapy group (45.6%). Notably, there was a significantly higher presence of NK cells in the tumor microenvironment with combination therapy (34.79%) compared to other groups (ranging from 2.21 to 26.50%). Although the tumor sizes in the monotherapy groups were similar, histological analysis revealed a stronger response in pNK cell immunotherapy group compared to the sorafenib group.

Conclusions

Experimental results indicated that combination therapy significantly enhanced treatment response, resulting in substantial tumor growth reduction in alignment with histological analysis.
Determining direct, indirect healthcare and social costs for diabetic retinopathy management: a systematic review
Authors: Benhamza Mawdda , Dahlui Maznah , Said Mas Ayu
Published: September 2024

Introduction

Diabetic retinopathy (DR) is a rapidly growing global public health threat; it affects 1 in 3 people with diabetes and is still the leading cause of blindness among the working-age population. The management of diabetic retinopathy is becoming more advanced and effective but is highly expensive compared to other ocular diseases.

Aim

To report direct medical, indirect medical, and nonmedical costs of diabetic retinopathy in developed and developing countries through a systematic review.

Methods

Related articles published in the PubMed, Google Scholar, and EMBASE electronic databases from 1985 to 2022 were identified using the keywords direct medical and indirect medical and social costs of diabetic retinopathy. However, previous systematic reviews, abstracts, and case reports were excluded.

Results

Thirteen articles were eligible for assessing the economic burden of diabetes management and its complications. Our analysis revealed that increasing prevalence and severity of diabetic retinopathy (DR) are associated with higher direct and indirect healthcare expenditures. The impact of DR on working-age adults, leading to irreversible blindness in advanced stages, underscores the urgent need for cost-effective prevention and management strategies.

Discussion

This study systematically reviewed the direct medical, indirect medical, and nonmedical costs of DR in developed and developing countries. Our findings highlight the significant economic burden of DR, emphasizing the importance of implementing effective prevention and management measures to alleviate costs and enhance patient outcomes.

Conclusion

The substantial financial burden of DR necessitates a re-evaluation of current screening and management programs. Revision of these programs is crucial to improve quality of care, reduce costs, and ultimately achieve Sustainable Development Goal 3, which aims to ensure good health and well-being for all.
Suicidal behaviors among refugee women in Jordan: post-traumatic stress disorder, social support and post-displacement stressors
Authors: Brooks Mohamad Adam , Dasgupta Anindita , Khadra Maysa’ , Bawaneh Ahmad , Kaushal Neeraj , El-Bassel Nabila
Published: September 2024

Background

This paper examines the frequency of suicidal behaviors (suicidal ideation or attempt) among a sample of Syrian refugee women living in non-camp settings in Jordan. We asked several questions surrounding suicide and examined the associations between post-traumatic stress disorder (PTSD), social connectedness, post-displacement stressors and suicidal behaviors.

Methods

Participants (n = 507) were recruited using a clinic-based systematic sampling from four health clinics throughout Jordan in 2018. We used a multivariable logistic regression to examine the hypothesis of whether positive screening for PTSD (PCL-5), social isolation (have no friends or family members available to help), and greater number of post-displacement stressors (PMLD Checklist) is associated with suicidal behaviors.

Results

Approximately one-tenth (9.86%) of participants surveyed reported suicidal behaviors (suicidal ideation or attempt) in the past six months. Our hypothesis was partially supported. In the adjusted multivariable analyses, screening positive for PTSD [OR:4.02 (95% CI:1.33, 12.15)] increased odds of suicidal behaviors, while having one friend or family member available to help when in need [OR:0.31 (95% CI:0.13, 0.78)] decreased odds of suicidal behaviors. We did not find any associations between the number of post-displacement stressors and suicidal behaviors in the multivariable model.

Conclusion

Agencies and practitioners addressing suicidal behaviors among Syrian refugee women should provide interventions that aim to reduce PTSD symptoms and social isolation. Potential intervention includes screening for mental health symptoms and suicidal behaviors during routine visits with service providers, as well as providing proper mental health and psychosocial support services according to the mapping of available services.
Undergraduate dental sleep medicine teaching at German university dental schools - a questionnaire-based survey
Authors: Sambale Janine , Jablonski-Momeni Anahita , Korbmacher-Steiner Heike Maria
Published: September 2024

Purpose

Diagnosing and treating obstructive sleep apnea (OSA) requires fundamental understanding of sleep medicine, including training and clinical experience. So far, dental sleep medicine (DSM) has not yet become a mandatory part of dental education in Germany. This questionnaire-based survey for both lecturers and students aimed to evaluate DSM education among undergraduate students.

Methods

A structured questionnaire was sent to the managing directors and student councils of all 30 German university dental schools. The questionnaire contained 13 questions on teaching quantity and content, lecturers’ knowledge, and future interest in DSM. For each university dental school, only one questionnaire should be completed by the student council and the managing director. A scoring system assessed lecturers’ knowledge based on clinical experience and qualifications. Descriptive data and correlation coefficients were calculated (P < 0.05).

Results

The responses of 24 lecturers (80%) and 28 students (93.3%) could be evaluated. DSM was reported to be included in the curriculum by 14 lecturers (58.3%) and 4 students (14.3%). Mean teaching hours per semester were 1.4 ± 1.4 h (lecturers) and 0.2 ± 0.6 h (students) accordingly. Greater knowledge of lecturers in DSM was positively correlated with the inclusion of DSM in the curriculum (P = 0.022) and with the number of teaching hours per semester (P = 0.001).

Conclusion

Postgraduate education and incorporating DSM knowledge into undergraduate education (“Teach the Teacher”) seems to play a key role in fundamentally training future dentists in this field.
Patient and professional perspectives on physical activity promotion in routine cancer care: a qualitative study
Authors: Saint-Onge Kadia , St-Cyr Jany , Doré Isabelle , Gauvin Lise
Published: September 2024

Backgrounds

Physical activity is associated with many benefits in reducing cancer symptoms and treatments side effects. Yet, studies consistently show that knowledge about physical activity is under-promoted among people diagnosed with cancer. Therefore, we aimed to contribute to filling this gap by ascertaining patient and professional perspectives regarding physical activity promotion.

Methods

This study took place in Montreal, Canada. We conducted individual, semi-structured interviews with cancer patients who participated in a physical activity program and professionals working in the healthcare system. Participants had to be aged over 18 years, be able to communicate verbally in either English or French, and consent to an audio-recorded interview. A hybrid deductive-inductive approach to content analysis was applied to analyze interview transcripts using Dedoose and Microsoft Excel software.

Results

Our sample comprised 21 patients (76.2% women) and 20 professionals (80% women). We identified 24 factors (barriers, facilitators, and improvement suggestions) influencing physical activity promotion across organizational, community, and social levels. Results suggest that to improve physical activity promotion in cancer care, it is necessary to showcase exercise specialists as a healthcare resource, to champion for this change within health organizations, to develop partnerships between public and private sectors of the health and fitness industries, and to reassess social norms concerning cancer survivorship and treatment.

Conclusion

These findings shed light on the gaps and the bright lights in physical activity promotion for people diagnosed with cancer across numerous levels.
Identification of interventions to improve patient experienced quality of care in transitions between healthcare settings: a scoping review
Authors: Hindsbak Natasia , Morsø Lars , Hvidtjørn Dorte , Walløe Sisse
Published: September 2024

Background

Transitions in healthcare settings can be a challenge for patients and they express a need for guidance and support to cope with these transitions. The aim of this scoping review was to investigate if interventions can improve patients’ experiences when transitioning between healthcare settings.

Methods

This review was conducted following the Johanna Briggs Institute’s methods and reported according to the PRISMA-ScR Checklist. Included articles were published and peer-reviewed, and reported qualitative and quantitative findings on patient experiences with interventions when transitioning between healthcare settings. The search was conducted in May 2024 in Medline Ovid, Embase Ovid, and Cinahl.

Results

Twenty-three studies were included. Factors extracted from the studies were: author(s), year of publication, country of origin, study design, theoretical methods, population description, intervention, phenomena of interest(s), and key findings. There has been an increase in published studies on the subject in the last few years, and most of the included studies originated from Western countries. Most studies were quantitative, primarily RCTs, and the theoretical methods were thus mainly statistical analysis. The study populations were found to be heterogeneous. The interventions were categorized: care coordinator, program, integrated care, online communication platform, coaching, discharge care plan, and miscellaneous interventions.

Conclusions

Overall, interventions were found to improve the patient experience. Centralization of healthcare has increased the number of transitions, and patients express that the coordination of healthcare transitions can be improved. This review’s findings should be used alongside other research on interventions’ effect on factors like hospital readmissions and mortality to determine the optimal intervention to implement.
Grb7, Grb10 and Grb14, encoding the growth factor receptor-bound 7 family of signalling adaptor proteins have overlapping functions in the regulation of fetal growth and post-natal glucose metabolism
Authors: Moorwood Kim , Smith Florentia M. , Garfield Alastair S. , Cowley Michael , Holt Lowenna J. , Daly Roger J. , Ward Andrew
Published: September 2024

Background

The growth factor receptor bound protein 7 (Grb7) family of signalling adaptor proteins comprises Grb7, Grb10 and Grb14. Each can interact with the insulin receptor and other receptor tyrosine kinases, where Grb10 and Grb14 inhibit insulin receptor activity. In cell culture studies they mediate functions including cell survival, proliferation, and migration. Mouse knockout (KO) studies have revealed physiological roles for Grb10 and Grb14 in glucose-regulated energy homeostasis. Both Grb10 KO and Grb14 KO mice exhibit increased insulin signalling in peripheral tissues, with increased glucose and insulin sensitivity and a modestly increased ability to clear a glucose load. In addition, Grb10 strongly inhibits fetal growth such that at birth Grb10 KO mice are 30% larger by weight than wild type littermates.

Results

Here, we generate a Grb7 KO mouse model. We show that during fetal development the expression patterns of Grb7 and Grb14 each overlap with that of Grb10. Despite this, Grb7 and Grb14 did not have a major role in influencing fetal growth, either alone or in combination with Grb10. At birth, in most respects both Grb7 KO and Grb14 KO single mutants were indistinguishable from wild type, while Grb7:Grb10 double knockout (DKO) were near identical to Grb10 KO single mutants and Grb10:Grb14 DKO mutants were slightly smaller than Grb10 KO single mutants. In the developing kidney Grb7 had a subtle positive influence on growth. An initial characterisation of Grb7 KO adult mice revealed sexually dimorphic effects on energy homeostasis, with females having a significantly smaller renal white adipose tissue depot and an enhanced ability to clear glucose from the circulation, compared to wild type littermates. Males had elevated fasted glucose levels with a trend towards smaller white adipose depots, without improved glucose clearance.

Conclusions

Grb7 and Grb14 do not have significant roles as inhibitors of fetal growth, unlike Grb10, and instead Grb7 may promote growth of the developing kidney. In adulthood, Grb7 contributes subtly to glucose mediated energy homeostasis, raising the possibility of redundancy between all three adaptors in physiological regulation of insulin signalling and glucose handling.
Intersectionality matters for Hispanic health: A replication study using the All of Us Research Program
Authors: Rodrigues Mariana , Risner Emma , Rhodes-Bratton Brennan , Cook Stephanie H. , Cuevas Adolfo
Published: September 2024

Background

Despite research dedicated to understanding the health profiles and health-related outcomes of Hispanic individuals, the prevailing body of literature frequently homogenizes the Hispanic population, failing to address the role of race in Hispanic health discourse. Thus, the current study applies an intersectional lens to identify health differences and similarities among Hispanic subgroups.

Methods

Sociodemographic characteristics and health domain variables (i.e., health status, health services, and health behaviors) from participants (N = 11,192) were included in the analyses. Bivariate Chi-squared tests examined the relationship between sociodemographic and health domain variables Black Hispanic individuals, white Hispanic individuals, and non-Hispanic Black individuals.

Results

Findings suggest that Non-Hispanic Black American individuals reported the highest rates of hypertension (49.09%) and diabetes (19.62%) compared to Black-Hispanic individuals (22.45% and 12.98%) and white Hispanic individuals (22.22% and 8.02%). Black Hispanic individuals reported the greatest proportion of asthma diagnoses (35.10%) and those who saw a doctor in the previous year (95.52%) compared to white Hispanic individuals (26.84%, and 91.10%, respectively) and non-Hispanic Black individuals ( 21.74%, and 94.69%, respectively).

Conclusion

Specifically, we found that several health behaviors and health-related outcomes significantly varied across different racial/ethnic groups, demonstrating the advantage of an intersectional approach to identify health disparities among racially diverse ethnic groups.

Public Health significance

We encourage the development of health care services with an awareness of the complexities resulting from racial differences within the Hispanic diaspora.