bluuebunny/crossref_metadata_2025 huggingface dataset:
Radar in the darkness. The dreams and art of a psychotherapist in a forensic institution
Authors: Price Marcus
Published: May 2024

Under the assault of disturbing experiences that seem sealed into a bodily discourse, there appears an increased permeability between the dream space and the psychotherapy space. It is in the forensic in-patient hospital environment that I have commonly sat with a calm and compliant patient to find myself grappling with an overwhelming pull toward sleep. Such tiredness in countertransference can be understood as a manifestation of the weight of buried or repressed disturbance which can only seemingly be registered at a bodily level. Forensic patients are usually the subject of vilification from the courtrooms to sensationalist media reports in a system that further bottlenecks their emotional lives. It seems to me that sometimes there can be a fine line between continuing the trend of condemnation and the taking up of clinical responsibility. It is perhaps one of the most helpful aspects of psychoanalytic work, that we consider the projective processes involved in the criminal justice system. That we look to ourselves and our own countertransference for greater clinical clarity, a radar in the darkness. It is with this in mind that I write an introspective paper focussing on the lens of my own dream life and artistic responses to the environment of a forensic institution.
Numerical investigation on dynamic characteristics of oil-water annular flow-induced vibration in curved pipes
Authors: Wang Yuhan , Wang Xiaochuan , Huang Yuxuan , Xu Chaoyu , Hu Jincheng
Published: May 2024

To improve the stability of water-lubricated transportation and reliability of pipes in service, the fluid–structure interaction numerical model has been established to investigate the dynamic characteristics of oil-water annular flow-induced vibration in curved pipes and the effect of main parameters in this study. The results illustrate that a single vibration mode of curved pipes is excited by oil-water annular flow, and there exists no multi-modality due to the limited pulsation of pressure and interface of two-phase flow. The change of velocities and oil-water ratios leads to change of flow pattern, making the dynamic response severer. When the oil-water ratio is larger than 2.035, its effect is greater than velocity. The physical properties of oil have a significant effect on the dynamic response. The root-mean-square dimensionless displacement AY,RMS/D and maximum dimensionless displacement AY,MAX/D of fuel oil-water annular flow-induced vibration decrease to 75.6% and 76.5% respectively, which means that the increase of dynamic viscosity reduces the fluid force and suppresses the vibration. AY,RMS/D and AY,MAX/D increases by 1.62 times when the bending angle θ increases from 30° to 90°, indicating that the increase of bending angles also leads to the severer dynamic response.
Angular acceleration estimation and aerodynamic parameter identification based on angular velocity equivalent model
Authors: Wang Lixin , Zhao Rong , Zhang Yi , Yue Ting
Published: May 2024

Conventional angular acceleration estimation methods generate non-negligible errors when the control surface rapidly deflects; hence, the estimated angular acceleration cannot be used for aerodynamic parameter identification directly. This paper proposes an angular acceleration estimation method based on angular velocity equivalent model. The angular acceleration of the angular velocity equivalent model, whose angular velocity response is consistent with the flight test data, is used as the estimated angular acceleration. Firstly, the equivalent angular velocity model is established by combining the generic aerodynamic model with the rotational dynamic equations of aircraft. Secondly, the angular velocity data and the control surface deflection data are synchronized. Finally, the angular velocity response of the equivalent model is used as the predictor, and the estimated angular acceleration is obtained by extended Kalman filter. The aerodynamic parameter identification and validation are carried out using the estimated angular acceleration of a large civil aircraft flight test data. The results show that the angular acceleration obtained through the proposed angular acceleration estimation method meets the accuracy requirement of aerodynamic parameter identification.
Nanocrystal cellulose from diverse biological sources: Application and innovations
Authors: Nimker Vanshika , Dong Cheng-Di , Patel Anil Kumar , Chauhan Ajeet Singh , Chen Chiu-Wen , Singhania Reeta Rani
Published: May 2024

Cellulose is the most abundant renewable polymer on Earth which is extensively distributed in diverse ecosystems. It is present in higher plants, marine organisms, and also produced through microbial processes in organisms like algae, fungi, and bacteria. From an industrial perspective, the semicrystalline nature of cellulose present in different plant and microbial sources enables the fabrication of various types of nanocellulose, such as nanofibre and nanocrystals, through mechanical disintegration and chemical methods, respectively. Nanocellulose distinguishes itself as a sustainable, nonharmful, and biodegradable polymer. It will enable sustainable development for responsible consumption and production. Possessing a range of excellent properties, it can be seamlessly integrated into various materials. Research on nanocellulose is gaining momentum in response to current issues related to fossil fuels, including concerns about CO2emissions, plastic pollution, and the need for renewable energy sources. This review addresses nanocrystals production method from cellulose found in agricultural, microbial sources, and its applications in fields such as materials science, electronics, medicine, and environmental science.
Trade Unions in Contemporary India: Revitalisation Strategies and Migrant Workers
Authors: Kulkarni Pranita , Datta Amrita
Published: May 2024

This article explores diverse strategies adopted by Indian trade unions (TUs) to counteract their decline, with a specific focus on migrant labour in contemporary India. While studies in the past have analysed unionism and strategies at the nation-state level, this article draws from interviews with senior leaders of the three central Indian TUs to underscore the diversity of approaches among the TUs. It first draws on Frege and Kelly’s work on union revitalisation to make sense of the organisational strategies adopted by unions to adapt to globalisation and neoliberal policies in the context of India’s transition from a command to a market economy, characterised by intricate institutional arrangements and a prevalence of informal labour. It then uses Alberti’s framework that distinguishes between universalistic and particularistic approaches, with a focus on intersectionality, to explore whether Indian TUs adopt the former approach rooted in class identity, or the latter approach based on the intersecting and complex dimensions of inequality experienced by migrant workers. The article finds that individual union strategies vary on account of their historical origins, ideological underpinnings and relationship with the state and the market. It argues that the disconnect between TUs and the vast migrant workforce in India holds critical significance due to the substantial number of migrant workers in the country, their vulnerability to exploitation, and the role their exclusion has played in the TUs’ decline. The article suggests a combination of universalistic and particularistic approaches to bridge this disconnect, and in doing so it offers a novel disaggregated perspective of TU strategies at the subnational level, scrutinising the approaches of three central Indian TUs through an intersectionality lens and advocating for necessary course correction.
A coupling method for wheel–rail longitudinal interaction
Authors: Pan Liu , Xu Lei , DU Xiang gang
Published: May 2024

Longitudinal wheel–rail interaction is often neglected in railway engineering research. In order to analyze the system dynamics with consideration of the braking force, a new longitudinal wheel–rail interaction model is proposed in this paper. Then, the reliability of the proposed model is verified by comparing the results obtained from the traditional vehicle-track coupled dynamic model. The calculated dynamic responses of the system with different time steps are compared to illustrate the stability of the proposed method. In the case study, the influence of the track irregularity on the dynamic response of the system is analyzed in detail, and it is found that the influence of the lateral track irregularity on the longitudinal dynamic response of the system is significant. In addition, the effect of the nonlinearity of ballasted bed longitudinal resistance on the longitudinal dynamic response, and it is found that the nonlinear characteristics of the ballast bed cannot be ignored.
Efficacy and safety of niraparib in platinum-sensitive recurrent ovarian cancer: retrospective observational study in a tertiary hospital
Authors: Prado-Mel Elena , Suárez-Casillas Paloma , Rodríguez-de Francisco Lupe , Estévez-García Purificación , Jiménez-Galán Rocío
Published: May 2024

Background

Niraparib has been authorized for maintenance treatment of epithelial ovarian cancer after first-line treatment with platinum, in partial or complete response.

Objectives

To evaluate the effectiveness and safety of maintenance niraparib in platinum-sensitive recurrent ovarian cancer (PSROC) patients in a tertiary hospital.

Materials and Methods

This retrospective observational unicentre study included women diagnosed with ovarian adenocarcinoma who received niraparib. Eligibility criteria encompassed women with PSROC, in response to platinum chemotherapy, and not previously treated with other PARPis. Data on demographics, comorbidities, BRCA mutation status, disease stage, treatment history and adverse events were recorded. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan–Meier method.

Results

A total of 33 patients were included, with a median age of 63.5 years. The majority of patients received niraparib at 200 mg/day based on Research on Adverse Drug Events and Report criteria. Median OS was 30 months (95% CI: 16.76–43.23), and median PFS was 8 months (95% CI: 2.48–13.52). Adverse effects were more frequent during the initial months of treatment, with most classified as CTCAE v5 grade 1–2. Dose reductions, interruption of treatment and discontinuations were observed due to haematologic toxicities primarily.

Conclusion

This real-world study showed that maintenance niraparib in PSROC patients had effectiveness and safety profiles consistent with clinical trials and other observational studies. Median PFS and OS were comparable to previous reports, and most adverse events were manageable with dose modifications. The results support the use of niraparib as a maintenance therapy option in this patient population.
Spiritual issues, beliefs, needs, and resources in palliative healthcare providers: An Italian qualitative study
Authors: Bovero Andrea , Gottardo Francesco , Tosi Chiara , Pidinchedda Alexa , Pesce Sara , Botto Rossana , Caserta Mario , Ostacoli Luca , Rossini Pierre Gilbert
Published: May 2024

The significance of spirituality in navigating the meaning of illness and death has been well-established. However, healthcare professionals working with palliation also grapple with their own spiritual dimensions when confronted with these circumstances. This study aimed to explore spirituality from a subjective standpoint among a sample of palliative care professionals, investigating its role and associated needs. For the first time, the FICA Spiritual History Tool was applied in a focus group setting. The meetings were transcribed, and thematic analysis was performed. The findings underscore how spirituality is perceived as more relational than transcendent, potentially fostering connections between the self, patients, and colleagues, thereby enhancing resilience. Simultaneously, spirituality needs to be considered as a potential source of suffering that could impact both the quality of life and work of healthcare workers involved. This issue should be addressed through dedicated moments of shared reprocessing, with beneficial implications for public health.
Estimating the incapacitation effect among first-time incarcerated offenders
Authors: Al Weswasi Enes
Published: May 2024

Objectives: To estimate how many offenses are averted through the incapacitation of first-time incarcerated offenders with sentences of two years or less. Methods: The counterfactual challenge of estimating criminal acts that would have been committed had the offender not been incarcerated is approached utilizing a matching design. Data comprise all offenders convicted in Sweden in 2018, matched on a vector of time-stable and time-varying covariates drawn from an extensive set of Swedish registers. Each incarcerated offender is matched to a nonincarcerated offender whose offending frequency is used to infer the incapacitation effect. Full sample estimates are provided as well as subgroup estimates for males, females, and various risk groups. Results: The annual incapacitation effect for first-time incarcerated offenders is estimated to be 0.53 when measured as the number of averted convictions and 1.14 when measured as the number of averted offenses that would have resulted in a conviction. For males, the annual number of convictions averted through incapacitation is 0.51, and for females 0.37. For the highest risk group, the annual number of averted convictions is 1.22, and the number of averted offenses resulting in conviction is 2.55. For offenders in the low-to-medium risk groups, the corresponding figures are approximately 0.31 averted convictions and approximately 0.68 averted offenses. Conclusion: For first-time incarcerated offenders, the incapacitation effect is modest and the heterogeneous effects found across different risk groups warrant considering whether the crime-preventive effect is sufficiently large for low-risk inmates and whether noncustodial sanctions might constitute an alternative that would ease overcrowding without producing any considerable risk for costs in terms of recidivism.
Differences in the risk of clinical failure between thiopurine and methotrexate in bio-naïve patients with Crohn’s disease: a Korean nationwide population-based study
Authors: Jun Yu Kyung , Ji Eunjeong , Yang Hye Ran , Choi Yonghoon , Shin Cheol Min , Park Young Soo , Kim Nayoung , Lee Dong Ho , Yoon Hyuk
Published: May 2024

Background:

Although immunomodulators are widely prescribed in patients with Crohn’s disease (CD), it is unclear whether there is a difference in treatment outcomes between thiopurines and methotrexate (MTX).

Objective:

To compare the risk of clinical failure between thiopurines and MTX in bio-naïve patients with CD.

Design:

Nationwide, population-based study.

Methods:

We used claims data from the Korean National Health Insurance Service. After inverse probability of treatment weighting, logistic regression and Cox proportional hazard analyses were used to evaluate the risk of clinical failure in bio-naïve patients with CD treated with thiopurine (thiopurine group) or MTX (MTX group).

Results:

Overall, 10,296 adult and pediatric patients with CD [9912 (96.3%) and 384 (3.7%) in the thiopurine and MTX groups, respectively] were included. The odds ratios (ORs) of failure to induce remission were significantly higher in the MTX group than in the thiopurine group [adjusted OR (aOR), 1.115; 95% confidence interval (CI), 1.045–1.190; p = 0.001]. However, the opposite result was observed only in patients without concomitant steroid use: the MTX group had a lower risk of induction failure than the thiopurine group (aOR, 0.740; 95% CI, 0.673–0.813; p < 0.001). The risk of overall maintenance failure was higher in the MTX group than in the thiopurine group [adjusted hazard ratio (aHR), 1.117; 95% CI, 1.047–1.191; p = 0.001]. The risk of overall maintenance failure was higher in the standard-dose MTX group than in the low-dose MTX group (aHR, 1.296; 95% CI, 1.134–1.480; p < 0.001). There was no significant difference in the risk of maintenance failure according to the administration route of MTX.

Conclusion:

Thiopurine is more effective than MTX in inducing and maintaining remission in bio-naïve patients with CD; however, the concomitant use of steroids influences inducing remission.
Studies Toward the Total Synthesis of Natalamycin A: Stereoselective Synthesis of the C9–C21 Segment
Authors: Suzuki Momoko , Takatori Kazuhiko , Kobayashi Kenichi
Published: May 2024

Toward the total synthesis of natalamycin A, we have synthesized the C9-C21 segment corresponding to the northwestern part of the natural product. Key features of this synthesis were an asymmetric α-chlorination of an aldehyde using MacMillan's catalyst and stereoselective assembly of three contiguous stereocenters via a butenolide intermediate.
Reliability of continuous vital sign monitoring in post-operative patients employing consumer-grade fitness trackers: A randomised pilot trial
Authors: Helmer Philipp , Hottenrott Sebastian , Wienböker Kathrin , Pryss Rüdiger , Drosos Vasileios , Seitz Anna Katharina , Röder Daniel , Jovanovic Aleksandar , Brugger Jürgen , Kranke Peter , Meybohm Patrick , Winkler Bernd E , Sammeth Michael
Published: May 2024

Introduction

Fitness trackers can provide continuous monitoring of vital signs and thus have the potential to become a complementary, mobile and effective tool for early detection of patient deterioration and post-operative complications.

Methods

To evaluate potential implementations in acute care setting, we included 36 patients after moderate to major surgery in a recent randomised pilot trial to compare the performance of vital sign monitoring by three different fitness trackers (Apple Watch 7, Garmin Fenix 6pro and Withings ScanWatch) with established standard clinical monitors in post-anaesthesia care units and monitoring wards.

Results

During a cumulative period of 56 days, a total of 53,197 heart rate (HR) measurements, as well as 12,219 measurements of the peripheral blood oxygen saturation (SpO2) and 28,954 respiratory rate (RR) measurements were collected by fitness trackers. Under real-world conditions, HR monitoring was accurate and reliable across all benchmarked devices (r = [0.95;0.98], p < 0.001; Bias = [−0.74 bpm;−0.01 bpm]; MAPE∼2%). However, the performance of SpO2 (r = [0.21;0.68]; p < 0.001; Bias = [−0.46%;−2.29%]; root-mean-square error = [2.82%;4.1%]) monitoring was substantially inferior. RR measurements could not be obtained for two of the devices, therefore exclusively the accuracy of the Garmin tracker could be evaluated (r = 0.28, p < 0.001; Bias = −1.46/min). Moreover, the time resolution of the vital sign measurements highly depends on the tracking device, ranging from 0.7 to 117.94 data points per hour.

Conclusion

According to the results of the present study, tracker devices are generally reliable and accurate for HR monitoring, whereas SpO2 and RR measurements should be interpreted carefully, considering the clinical context of the respective patients.
Daratumumab, cyclophosphamide, bortezomib, and dexamethasone for transplant-ineligible myeloma: AMaRC 03-16
Authors: Mollee Peter , Reynolds John , Janowski Wojt , Quach Hang , Campbell Philip , Gibbs Simon , Lee Sophie , Lee Edwin , Taylor Kerry , Cochrane Tara , Wallington-Gates Craig , Kwok Fiona , Weber Nicholas , Kerridge Ian , Weston Helen , Ho P. Joy , Leahy Michael Francis , Horvath Noemi , Spencer Andrew
Published: May 2024

In newly diagnosed transplant-ineligible patients with myeloma, daratumumab has improved outcomes when added to the standard-of-care regimens. In a randomized trial, we tested whether similar improvements would be observed when daratumumab was added to the bortezomib, cyclophosphamide, and dexamethasone (VCD) regimen. Transplant-ineligible patients with untreated myeloma were randomized to receive VCD or VCD plus daratumumab (VCDD). A total of 121 patients were randomized: 57 in the VCD arm and 64 in the VCDD arm. Baseline characteristics were balanced between the 2 arms. The median progression-free survival (PFS) was 16.8 months (95% confidence interval [CI], 15.3-21.7) and 25.8 months (95% CI, 19.9-33.5) in the VCD and VCDD arms, respectively (hazard ratio, 0.67; log-rank test P = .066). In a preplanned analysis, it was demonstrated that the daratumumab-containing arm showed a significant improvement in PFS from 18 months onward, based on estimates at fixed time points after randomization. The proportions of patients who were progression-free at the following time points were: 18 months, 48% vs 68% (P = .0002); 24 months, 36% vs 52% (P = .0001); and 30 months, 27% vs 41% (P < .0001) in the VCD and VCDD arms, respectively. The best overall response and very good partial response rate were significantly higher in the daratumumab arm compared with the VCD and VCDD arms, respectively (65% vs 86%, P = .007; and 28% vs 52%, P = .009). Seventy-two percent of the VCDD patients completed the 9 cycles of induction therapy with no grade 3 or 4 peripheral neuropathy adverse events. This study supports VCDD as an option for the initial treatment of transplant-ineligible patients with myeloma. This trial was registered at the Australian New Zealand Clinical Trials Registry (ACTRN12617000202369).
Impact of coating and microstructure on wear resistance of tool steels for wood cutting: a novel approach to quantification and analysis of wear-related damages
Authors: Mbakop Nanshie Vanella , Aidibe Ali , Heidari Majid , Jahazi Mohammad
Published: May 2024

Squaring, a wood transformation process, is an operation which consists of introducing the logs into a squaring machine which then uses sharp tools to cut the wood into pieces with high surface quality. Tool steels used in this process experience significant wear, damaging the wood surface and hence leading to substantial scrape rate. This study investigates the wear resistance of three tool steels specifically designed for wood cutting applications: modified AISI A8, modified steels with 0% and 1% tungsten, and powder metallurgy prepared W360 steel. Furthermore, the influence of a PVD coating on the wear resistance of the three alloys was investigated. ASTM G65 abrasive wear tests were conducted using the dry sand/rubber wheel abrasion test. A methodology using a non-contact 3D measurement system and specialized software was developed, allowing for a thorough quantitative assessment of the wear of these steels. The results revealed that the coated A8mod + 1%W steel exhibits the best resistance among the coated steels. Despite the excellent intrinsic resistance of W360 steel, the coating did not provide a significant improvement for this steel, showing only a 10% reduction in wear. Microstructural analysis revealed that the predominant wear mechanisms were abrasion and impact. The relative performance of each steel was quantified and is reported. Field trials conducted under actual cutting conditions, indicate the superiority of W360 steel in terms of resilience to wear and impacts compared to other tested alloys, while confirming the effectiveness of surface treatments in mitigating material wear. However, A8 steel modified with 1% tungsten exhibits increased wear under coating.
Psychological and physiological effects of sole contact with oil-finished wood
Authors: Ikei Harumi , Jo Hyunju , Miyazaki Yoshifumi
Published: May 2024

In Japanese households, it is customary to walk barefoot on wooden floors. Previous reports on the psychological and physiological relaxing effects of feet contact with uncoated solid wood have already been published. However, there are no studies on the effects of feet contact with coated wood, which is commonly used for residential floors. This study aimed to validate the psychological and physiological relaxing effects of sole contact with oil-finished wood. In total, 27 women university students (mean age: 21.9 ± 1.9 years) participated in this study. Psychological indices such as the modified semantic differential method and the Profile of Mood States Second Edition were used. The oxyhemoglobin (oxy-Hb) concentrations in the prefrontal cortex were determined using near-infrared time-resolved spectroscopy. The sympathetic nervous activity and the parasympathetic nervous activity were measured using heart rate variability. The flat plate for tactile stimulation was oil-finished wood, and uncoated wood and marble were used for comparison. The sole of the feet of each participant touched each material for 90 s. Feet contact with oil-finished and uncoated wood had relaxing effects on psychological and physiological responses compared with marble. The relaxing effects of oil-finished wood and uncoated wood were similar. That is, they significantly increased subjective feelings of comfort and relaxation, improved mood states, and decreased oxy-Hb concentration in the left prefrontal cortex compared with marble. However, there were no statistically significant differences in terms of right prefrontal cortex and sympathetic nervous activities between oil-finished wood and marble. Oil-finished wood had a slightly weaker physiological relaxation effect than uncoated wood.
Analysis of the components of Mycobacterium tuberculosis heat-resistant antigen (Mtb-HAg) and its regulation of γδ T-cell function
Authors: Wei Jing , Guo Fangzheng , Song Yamin , Feng Tong , Wang Ying , Xu Kun , Song Jianhan , Kaysar Eldana , Abdukayyum Reyima , Lin Feiyang , Li Kangsheng , Li Baiqing , Qian Zhongqing , Wang Xiaojing , Wang Hongtao , Xu Tao
Published: May 2024

Background

Mycobacterium tuberculosisheat-resistant antigen (Mtb-HAg) is a peptide antigen released from the mycobacterial cytoplasm into the supernatant ofMycobacterium tuberculosis(Mtb) attenuated H37Ra strain after autoclaving at 121 °C for 20 min. Mtb-HAg can specifically induce γδ T-cell proliferation in vitro. However, the exact composition of Mtb-HAg and the protein antigens that are responsible for its function are currently unknown.

Methods

Mtb-HAg extracted from the Mtb H37Ra strain was subjected to LC‒MS mass spectrometry. Twelve of the identified protein fractions were recombinantly expressed inEscherichia coliby genetic engineering technology using pET-28a as a plasmid and purified by Ni–NTA agarose resin to stimulate peripheral blood mononuclear cells (PBMCs) from different healthy individuals. The proliferation of γδ T cells and major γδ T-cell subset types as well as the production of TNF-α and IFN-γ were determined by flow cytometry. Their proliferating γδ T cells were isolated and purified using MACS separation columns, and Mtb H37Ra-infected THP-1 was co-cultured with isolated and purified γδ T cells to quantifyMycobacteriumviability by counting CFUs.

Results

In this study, Mtb-HAg from the attenuated Mtb H37Ra strain was analysed by LC‒MS mass spectrometry, and a total of 564 proteins were identified. Analysis of the identified protein fractions revealed that the major protein components included heat shock proteins and Mtb-specific antigenic proteins. Recombinant expression of 10 of these proteins in byEscherichia coligenetic engineering technology was used to successfully stimulate PBMCs from different healthy individuals, but 2 of the proteins, EsxJ and EsxA, were not expressed. Flow cytometry results showed that, compared with the IL-2 control, HspX, GroEL1, and GroES specifically induced γδ T-cell expansion, with Vγ2δ2 T cells as the main subset, and the secretion of the antimicrobial cytokines TNF-α and IFN-γ. In contrast, HtpG, DnaK, GroEL2, HbhA, Mpt63, EsxB, and EsxN were unable to promote γδ T-cell proliferation and the secretion of TNF-α and IFN-γ. None of the above recombinant proteins were able to induce the secretion of TNF-α and IFN-γ by αβ T cells. In addition, TNF-α, IFN-γ-producing γδ T cells inhibit the growth of intracellular Mtb.

Conclusion

Activated γδ T cells induced by Mtb-HAg components HspX, GroES, GroEL1 to produce TNF-α, IFN-γ modulate macrophages to inhibit intracellular Mtb growth. These data lay the foundation for subsequent studies on the mechanism by which Mtb-HAg induces γδ T-cell proliferation in vitro, as well as the development of preventive and therapeutic vaccines and rapid diagnostic reagents.
N6-methyladenosine modification of KLF2 may contribute to endothelial-to-mesenchymal transition in pulmonary hypertension
Authors: Kang Kang , Xiang Jingjing , Zhang Xingshi , Xie Yuting , Zhou Mengting , Zeng Le , Zhuang Junhao , Kuang Jiahao , Lin Yuanyuan , Hu Bozhe , Xiong Qianmin , Yin Qing , Su Qiang , Liao Xiaoyun , Wang Jun , Niu Yanqin , Liu Cuilian , Tian Jinglin , Gou Deming
Published: May 2024

Background

Pulmonary hypertension (PH) is a progressive disease characterized by pulmonary vascular remodeling. Increasing evidence indicates that endothelial-to-mesenchymal transition (EndMT) in pulmonary artery endothelial cells (PAECs) is a pivotal trigger initiating this remodeling. However, the regulatory mechanisms underlying EndMT in PH are still not fully understood.

Methods

Cytokine-induced hPAECs were assessed using RNA methylation quantification, qRT-PCR, and western blotting to determine the involvement of N6-methyladenosine (m6A) methylation in EndMT. Lentivirus-mediated silencing, overexpression, tube formation, and wound healing assays were utilized to investigate the function of METTL3 in EndMT. Endothelial-specific gene knockout, hemodynamic measurement, and immunostaining were performed to explore the roles of METTL3 in pulmonary vascular remodeling and PH. RNA-seq, RNA Immunoprecipitation-based qPCR, mRNA stability assay, m6A mutation, and dual-luciferase assays were employed to elucidate the mechanisms of RNA methylation in EndMT.

Results

The global levels of m6A and METTL3 expression were found to decrease in TNF-α- and TGF-β1-induced EndMT in human PAECs (hPAECs). METTL3 inhibition led to reduced endothelial markers (CD31 and VE-cadherin) and increased mesenchymal markers (SM22 and N-cadherin) as well as EndMT-related transcription factors (Snail, Zeb1, Zeb2, and Slug). The endothelial-specific knockout of Mettl3 promoted EndMT and exacerbated pulmonary vascular remodeling and hypoxia-induced PH (HPH) in mice. Mechanistically, METTL3-mediated m6A modification of kruppel-like factor 2 (KLF2) plays a crucial role in the EndMT process. KLF2 overexpression increased CD31 and VE-cadherin levels while decreasing SM22, N-cadherin, and EndMT-related transcription factors, thereby mitigating EndMT in PH. Mutations in the m6A site of KLF2 mRNA compromise KLF2 expression, subsequently diminishing its protective effect against EndMT. Furthermore, KLF2 modulates SM22 expression through direct binding to its promoter.

Conclusions

Our findings unveil a novel METTL3/KLF2 pathway critical for protecting hPAECs against EndMT, highlighting a promising avenue for therapeutic investigation in PH.
Frailty and depressive symptoms in older kidney transplant recipients: opportunities for collaboration between transplant nephrologists and geriatricians
Authors: Vankova Hana , Schmalz Michal , Andel Ross , Rajnochova Bloudickova Silvie
Published: May 2024

Background

Frailty is one of the key syndromes in geriatric medicine and an important factor for post-transplant outcomes. We aimed to describe the prevalence of frailty and examine the correlates of frailty and depressive symptoms in older kidney transplant recipients (KTRs).

Methods

This cross-sectional study involved 112 kidney transplant recipients (KTRs) aged 70 and above. Frailty syndrome was assessed using the Fried frailty criteria, and patients were categorized as frail, pre-frail, or non-frail based on five frailty components: muscle weakness, slow walking speed, low physical activity, self-reported exhaustion, and unintentional weight loss. Depressive symptoms were measured using the 15-item Geriatric Depression Scale (GDS). The relationship between frailty and depressive symptoms was evaluated using multinomial logistic regression, with the three frailty categories as the dependent variable and the severity of depressive symptoms as the independent variable, while controlling for age, gender, renal graft function, and time since transplant surgery.

Results

The participants had a mean age of 73.3 ± 3.3 years, and 49% were female. The prevalence of frailty syndrome was 25% (n = 28), pre-frailty was 46% (n = 52), and 29% (n = 32) of the KTRs were non-frail. The mean score for depressive symptoms was 3.1 ± 2.4 points, with 18% scoring above the clinical depression cutoff. Depressive symptoms were positively correlated with frailty (r = .46, p < .001). Among the frailty components, self-reported exhaustion (r = .43, p < .001), slow walking speed (r = .26, p < .01), and low physical activity (r = .44, p < .001) were significantly positively correlated with depressive symptoms, while muscle strength (p = .068) and unintentional weight loss (p = .050) were not. A multinomial logistic regression adjusted for covariates indicated that, compared to being non-frail, each additional point on the GDS increased the odds of being pre-frail by 39% (odds ratio [OR] = 1.39, 95% confidence interval [CI] 1.01–1.96) and roughly doubled the odds of being frail (OR = 2.01, 95% CI 1.39–2.89).

Conclusion

There is a strong association between frailty and depression in KTRs aged 70 years and older. Targeted detection has opened up a new avenue for collaboration between geriatricians and transplant nephrologists.
Prognostic impact of chronic lymphocytic leukemia comorbidity index in a young population: a real-world evidence study of a national gulf region cohort
Authors: Alshemmari Salem H. , AlSarraf Ahmad , Kaempf Andy , Danilov Alexey V.
Published: May 2024

In chronic lymphocytic leukaemia (CLL), comorbidities assessed by the CLL comorbidity index (CLL-CI) have been associated with outcomes in Western cohorts. We conducted a retrospective analysis of an unselected Middle Eastern cohort of newly diagnosed CLL patients seen at the Kuwait Cancer Control Center (n = 300). Compared to Western studies, these Middle Eastern patients were diagnosed at a younger age (median of 59) and had a higher comorbidity burden (69% non-low risk CLL-CI). A higher CLL-CI score was independently associated with significantly shorter event-free survival and greater risk of death. Our analysis demonstrates that CLL-CI is a valuable tool for comorbidity assessment and prognostic influence in (relatively young) Middle Eastern CLL patients.
How did the use of the social marketing approach in Egyptian communities succeed in improving breastfeeding practices and infants’ growth?
Authors: Metwally Ammal M. , Basha Walaa A. , Elshaarawy Ghada A. , Sallam Sara F. , El-Alameey Inas R. , Rifay Amira S. El , Yousef Walaa , Goda Amira A. , Elashry Galal A. , Ahmed Doaa E. , Hassan Nayera E. , El-Masry Sahar A. , Ibrahim Nihad A. , Dayem Soha M. Abd El , Kandeel Wafaa A. , El-Din Ebtissam M. Salah , Banna Rokia Abd Elshafy S. El , Kamel Iman H. , Abdelhamid Enas M. , Abdelrahman Mohamed , Mahmoud Walaa S.
Published: May 2024

Introduction

Improving breastfeeding practices does not always link to interventions relying only on improving nutrition awareness and education but needs cultural and behavioral insights
.

Aim

This study aimed to evaluate the changes in core breastfeeding indicators as a result of the use of social marketing (SM) approach for improving breastfeeding practices of Egyptian women and the physical growth of infants aged 6 to 12 months. The core breastfeeding indicators were: Early initiation of breastfeeding within one hour of birth, Predominant and exclusive breastfeeding to 6 months (EBF), Bottle feeding with formula, continued breastfeeding to 1 and 2 years, and responsiveness to cues of hunger and satiety.

Methods

A quasi-experimental longitudinal study with a posttest-only control design was done over 3 years in three phases; the first was in-depth interviews and formative research followed by health education and counseling interventions and ended by measuring the outcome. Motivating mothers’ voluntary behaviors toward breastfeeding promotion “feeding your baby like a baby” was done using SM principles: product, price, place, and promotion. The interventions targeted 646 pregnant women in their last trimester and delivered mothers and 1454 women in their childbearing period. The statistical analysis was done by using SPSS program, version 26.

Results

Most mothers showed significantly increased awareness about the benefits of breastfeeding and became interested in breastfeeding their children outside the house using the breastfeeding cover (Gawn) (p < 0.05). Breastfeeding initiation, exclusive breastfeeding under 6 months, frequency of breastfeeding per day, and percentage of children who continued breastfeeding till 2 years, were significantly increased (from 30%, 23%, 56%, and 32% to 62%, 47.3%, 69%, and 43.5% respectively). The girls who recorded underweight results over boys during the first year of life were significantly improved (p < 0.01) after the intervention (from 52.1% to 18.8% respectively). At the same time, girls found to be obese before the intervention (15.6%) became no longer obese.

Conclusions

Improvement for the majority of the key breastfeeding indicators and physical growth of infants indicates that raising a healthy generation should start by promoting breastfeeding practices that are respectable to societal norms.
An investigation into the acceptability, adoption, appropriateness, feasibility, and fidelity of implementation strategies for birth companionship in Tehran: a qualitative inquiry on mitigating mistreatment of women during childbirth
Authors: Mirzania Marjan , Shakibazadeh Elham , Hantoushzadeh Sedigheh , Panahi Zahra , Bohren Meghan A. , Khajavi Abdoljavad
Published: May 2024

Background

A birth companion is a powerful mechanism for preventing mistreatment during childbirth and is a key component of respectful maternity care (RMC). Despite a growing body of evidence supporting the benefits of birth companions in enhancing the quality of care and birth experience, the successful implementation of this practice continues to be a challenge, particularly in developing countries. Our aim was to investigate the acceptability, adoption, appropriateness, feasibility, and fidelity of implementation strategies for birth companions to mitigate the mistreatment of women during childbirth in Tehran.

Methods

This exploratory descriptive qualitative study was conducted between April and August 2023 at Valiasr Hospital in Tehran, Iran. Fifty-two face-to-face in-depth interviews were conducted with a purposive sample of women, birth companions, and maternity healthcare providers. Interviews were audio-recorded, transcribed verbatim, and analyzed using content analysis, with a deductive approach based on the Implementation Outcomes Framework in the MAXQDA 18.

Results

Participants found the implemented program to be acceptable and beneficial, however the implementation team noticed that some healthcare providers were initially reluctant to support it and perceived it as an additional burden. However, its adoption has increased over time. Healthcare providers felt that the program was appropriate and feasible, and it improved satisfaction with care and the birth experience. Participants, however, highlighted several issues that need to be addressed. These include the need for training birth companions prior to entering the maternity hospital, informing women about the role of birth companions, assigning a dedicated midwife to provide training, and addressing any physical infrastructure concerns.

Conclusion

Despite some issues raised by the participants, the acceptability, adoption, appropriateness, feasibility, and fidelity of the implementation strategies for birth companions to mitigate the mistreatment of women during childbirth were well received. Future research should explore the sustainability of this program. The findings of this study can be used to support the implementation of birth companions in countries with comparable circumstances.
Analysis of the current situation and factors influencing bullying in junior high schools in backward areas of Western, China & A case study of Qingyang City in Gasu
Authors: Li Hongjing , Liu Chunyuan , Shen Xiping , Nan Yingdong , Feng Liya
Published: May 2024

Background

Qingyang is located in the northwest of China. By analyzing the current situation and risk factors of bullying in junior high schools in Qingyang City, and identify relevant data for formulating prevention and control measures of bullying in western backward areas.

Methods

Qingyang City is divided into four regions based on economic level and population quality. One junior high school is randomly selected from each region, a total of 1200 students from 4 junior high schools of different levels in Qingyang City were randomly selected, and the “Questionnaire on Middle School Students’ School bullying” was administered between December 2021 and February 2022.

Results

The reporting rate of bullying in junior high schools in Qingyang was 47.35%. The incidence of campus bullying among urban-rural integration junior high schools, senior students, and male students is higher than that of municipal -level junior high schools, junior students, and female students (P< 0.05). The results of binary logistic regression showed that the second grade of junior high school (OR = 1.39,95% CI: 1.022–1.894), poor student performance (OR = 1.744,95% CI: 1.09–2.743), external dissatisfaction (OR = 2.09,95% CI: 1.177–3.427), mother working in an enterprise (OR = 1.623,95% CI: 1.074–2.453), and urban-rural integration middle school (OR = 3.631,95% CI: 2.547–5.177) were factors affecting bullying in junior high school campus.

Conclusion

The reporting rate of bullying in junior high schools in Qingyang City was relatively high, mostly occurring in places lacking supervision and after-school hours.

Trial registration

Not applicable.
Trends of physical activity and recreational screen time among Chinese children and adolescents: a national study from 2017 to 2019
Authors: Guo Ming Ming , Koh Koon Teck , Wang Xiao Zan
Published: May 2024

Background

The prevalence of physical inactivity and sedentary behavior among children and adolescents is a growing public health concern. This study aims to examine the trends in Physical Activity (PA) and Recreational Screen Time (RST) amongst children and adolescents in China, considering variations in genders, school levels, areas (urban versus rural), and regions (north versus south). The findings provide a foundation to guide policy and strategy making for future health promotion and development.

Methods

An annual national cross-sectional survey was conducted in China from 2017 to 2019 cumulatively involving 52,503 (48% female) children and adolescents from grades 4 to 12 (aged 12.72 ± 2.12). Data on PA and RST were collected through self-administered questionnaires. Weighted least squares regression was used to analyze the trends and differences in PA and RST among the participants’ profiles.

Results

There was an annual decreased in PA compliance rate of approximately 3.43% (95% CI: 0.79-6.08%) for primary school students, primarily among males residing in rural areas, and in northern regions. Middle school students experienced a yearly decrease of about 5.23% (95% CI: 2.55-7.92%) in PA compliance across all genders, regions, and urban areas. Similarly, the RST compliance rates for primary school students declined by approximately 3.18% (95% CI: 1.57-4.78%) annually for all genders and areas, but only in the northern regions.

Conclusions

This research highlights a downward trend in PA and RST compliance amongst Chinese children and adolescents, with variations based on school level, gender, area, and region. Urgent policies and interventions are imperative to promote PA while mitigating excessive RST within these populations.
An epidemiological and clinicopathological study of type 1 vs. type 2 morphological subtypes of papillary renal cell carcinoma– results from a nation-wide study covering 50 years in Iceland
Authors: Runarsson Thorri Geir , Bergmann Andreas , Erlingsdottir Gigja , Petursdottir Vigdis , Heitmann Leon Arnar , Johannesson Aevar , Asbjornsson Viktor , Axelsson Tomas , Hilmarsson Rafn , Gudbjartsson Tomas
Published: May 2024

Introduction

Papillary renal cell carcinoma (pRCC) is the second most common histology of renal cell carcinoma (RCC), accounting for 10–15% of cases. Traditionally, pRCC is divided into type 1 and type 2, although this division is currently debated as a prognostic factor of survival. Our aim was to investigate the epidemiology and survival of the pRCC subtypes in a whole nation cohort of patients during a 50-year period.

Materials and methods

A Population based retrospective study including consecutive cases of RCC in Iceland from 1971–2020. Comparisons were made between histological classifications of RCC, with emphasis on pRCC subtypes (type 1 vs. 2) for outcome estimation. Changes in RCC incidence were analyzed in 5-year intervals after age standardization. The Kaplan–Meier method and Cox regression were used for outcome analysis.

Results

A total of 1.725 cases were identified, with 74.4%, 2.1% and 9.2% having clear cell (ccRCC), chromophobe (chRCC), and pRCC, respectively. The age standardized incidence (ASI) of pRCC was 1.97/100.000 for males and 0.5/100.000 for females, and the proportion of pRCC increased from 3.7% to 11.5% between the first and last intervals of the study (p < 0.001). Age standardized cancer specific mortality (ASCSM) of pRCC was 0.6/100.000 and 0.19/100.000 for males and females, respectively. The annual average increase in ASI was 3.6% for type 1 pRCC, but the ASI for type 2 pRCC and ASCSM for both subtypes did not change significantly. Male to female ratio was 4.4 for type 1 pRCC and 2.3 for type 2. The average tumor size for type 1 and 2 was 58.8 and 73.7 mm, respectively. Metastasis at diagnosis was found in 8.7% in the type 1 pRCC, compared to 30.0% of patients with type 2 pRCC (p < 0.001). Estimated 5-year cancer-specific survival (CSS) were 94.4%, 80.7%, and 69.3% for chRCC, pRCC and ccRCC, respectively (p < 0.001). For the pRCC subtypes, type 1 was associated with better 5-year CSS than type 2 (86.3% vs. 66.0%, p < 0.001), although this difference was not significant after adjusting for cancer stage and grading.

Conclusions

pRCC histology was slightly less common in Iceland than in other countries. Males are more than three times more likely to be diagnosed with pRCC, compared to other RCC histologies. The subtype of pRCC was not found to be an independent risk factor for worse survival, and as suggested by the most recent WHO Classification of Urinary Tumors, grade and TNM-stage seem to be the most important factors for estimation of survival for pRCC patients.