bluuebunny/crossref_metadata_2025 huggingface dataset:
Case report: The presence of third-degree atrioventricular block caused by pulmonary embolism masquerading as acute ST-segment elevation myocardial infarction
Authors: Ma Min , Liang Shichu , He Yong , Wang Hua
Published: August 2023

Background

Pulmonary embolism (PE) typically presents with chest pain, tachypnea, hemoptysis, syncope, and increased markers of myocardial injury. On an electrocardiogram (ECG), sinus tachycardia, right bundle branch block (RBBB), S1Q3T3 pattern, and/or precordial T-wave inversion may be observed. Despite being one of the common causes of chest pain, a third-degree atrioventricular block (III° AVB) is rare in cases of PE, which can lead to difficulties in diagnosis or even overlooking this condition.

Case summary

In this case report, we present a patient who was transferred to our hospital with suspected acute myocardial infarction (AMI). The patient's ECG showed ST-segment elevation in the inferior wall and a III° AVB, combined with significantly increased markers of myocardial injury. Interestingly, the patient also had a history of cerebral hemorrhage (ICH) for 7 days prior to being transferred to our hospital. After undergoing a systematic examination and evaluation, the final diagnosis for the patient was PE.

Conclusions

In addition to considering common symptoms, it is important not to overlook rare symptoms when diagnosing a disease. This case serves as an example of how the misdiagnosis rate for PE can be reduced by conducting a comprehensive clinical evaluation and paying attention to all clinical clues and examination results.
Prediction and prevention of preeclampsia in women with preexisting diabetes: the role of home blood pressure, physical activity, and aspirin
Authors: Do Nicoline Callesen , Vestgaard Marianne , Nørgaard Sidse Kjærhus , Damm Peter , Mathiesen Elisabeth R. , Ringholm Lene
Published: August 2023

Women with type 1 or type 2 (preexisting) diabetes are four times more likely to develop preeclampsia compared with women without diabetes. Preeclampsia affects 9%–20% of pregnant women with type 1 diabetes and 7%–14% of pregnant women with type 2 diabetes. The aim of this narrative review is to investigate the role of blood pressure (BP) monitoring, physical activity, and prophylactic aspirin to reduce the prevalence of preeclampsia and to improve pregnancy outcome in women with preexisting diabetes. Home BP and office BP in early pregnancy are positively associated with development of preeclampsia, and home BP and office BP are comparable for the prediction of preeclampsia in women with preexisting diabetes. However, home BP is lower than office BP, and the difference is greater with increasing office BP. Daily physical activity is recommended during pregnancy, and limiting sedentary behavior may be beneficial to prevent preeclampsia. White coat hypertension in early pregnancy is not a clinically benign condition but is associated with an elevated risk of developing preeclampsia. This renders the current strategy of leaving white coat hypertension untreated debatable. A beneficial preventive effect of initiating low-dose aspirin (150 mg/day) for all in early pregnancy has not been demonstrated in women with preexisting diabetes.
Multigenerational exposure of microplastics on the microbiota of E. affinis (copepod): a comparative study between biodegradable and nonbiodegradable microplastics
Authors: Thery Jérémy , Li Luen-Luen , Das Shagnika , Dufour Dylan , Benali Samira , Raquez Jean-Marie , Souissi Sami , Monchy Sébastien
Published: August 2023

The accumulation of plastic debris around the world, especially in marine environments, has been well documented during the past decades. Recent studies have found that inorganic surfaces of microplastics (MPs) can be used by microorganisms as living substrates and form an ecosystem named “plastisphere.” Some microorganisms present in MPs are capable of producing polymer-degrading enzymes. In addition, MPs can also serve as vectors and carry microorganisms (including potential pathogens) into higher trophic levels through their ingestion by animals. In this study, impacts on copepod microbiota during chronic exposure to MPs were investigated by exposing copepods to a classic single-use polymer (low-density polyethylene (LDPE)) and a biodegradable polymer (polybutylene adipate terephthalate (PBAT)). Copepods were exposed to “virgin” and “weathered” MPs during four generations at an environmentally relevant concentration of 300 µg/L, followed by one “detoxification” generation without MP exposition. Impacts of MP exposure on copepod microbiota were investigated using 16S rRNA gene high-throughput sequencing. The result of nonmetric multidimensional scaling (NMDS) analysis showed that copepods (with or without MP exposure) carried distinguishable microbiota as compared with the microbiota of water and microalgae used for maintaining copepods. According to the results of permutational analysis of variance (PERMANOVA), the microbiota of MP-exposed (both PBAT and LDPE) copepods was significantly different from the microbiota of unexposed copepods during generations one to four. After “detoxification,” however, no significant difference in microbiota composition was observed among all generation five copepods. Altogether, impacts on copepod microbiota of MP exposure for multiple generations were observed, despite plastic origin (biodegradable or not) and aging conditions. Furthermore, copepod microbiota seemed to return to their original structure as soon as the MP exposure stopped.
iLncDA-RSN: identification of lncRNA-disease associations based on reliable similarity networks
Authors: Li Yahan , Zhang Mingrui , Shang Junliang , Li Feng , Ren Qianqian , Liu Jin-Xing
Published: August 2023

Identification of disease-associated long non-coding RNAs (lncRNAs) is crucial for unveiling the underlying genetic mechanisms of complex diseases. Multiple types of similarity networks of lncRNAs (or diseases) can complementary and comprehensively characterize their similarities. Hence, in this study, we presented a computational model iLncDA-RSN based on reliable similarity networks for identifying potential lncRNA-disease associations (LDAs). Specifically, for constructing reliable similarity networks of lncRNAs and diseases, miRNA heuristic information with lncRNAs and diseases is firstly introduced to construct their respective Jaccard similarity networks; then Gaussian interaction profile (GIP) kernel similarity networks and Jaccard similarity networks of lncRNAs and diseases are provided based on the lncRNA-disease association network; a random walk with restart strategy is finally applied on Jaccard similarity networks, GIP kernel similarity networks, as well as lncRNA functional similarity network and disease semantic similarity network to construct reliable similarity networks. Depending on the lncRNA-disease association network and the reliable similarity networks, feature vectors of lncRNA-disease pairs are integrated from lncRNA and disease perspectives respectively, and then dimensionality reduced by the elastic net. Two random forests are at last used together on different lncRNA-disease association feature sets to identify potential LDAs. The iLncDA-RSN is evaluated by five-fold cross-validation to analyse its prediction performance, results of which show that the iLncDA-RSN outperforms the compared models. Furthermore, case studies of different complex diseases demonstrate the effectiveness of the iLncDA-RSN in identifying potential LDAs.
Comparative effects of hepatocyte growth factor and tacrolimus on acute liver allograft early tolerance
Authors: Chen Quanyu , Yang Zhiqing , Lin Heng , Lai Jiejuan , Hu Deyu , Yan Min , Wu Zhifang , Liu Wei , Li Zhehai , He Yu , Sun Zhe , Shuai Ling , Peng Zhiping , Wang Yangyang , Li Sijin , Cui Youhong , Zhang Hongyu , Zhang Leida , Bai Lianhua
Published: August 2023

Allostimulated CD8+ T cells (aCD8+ T cells), as the main mediators of acute liver rejection (ARJ), are hyposensitive to apoptosis due to the inactivation of death receptor FAS-mediated pathways and fail to allow tolerance induction, eventually leading to acute graft rejection. Although tacrolimus (FK506), the most commonly used immunosuppressant (IS) in the clinic, allows tolerance induction, its use is limited because its target immune cells are unknown and it is associated with increased incidences of malignancy, infection, and nephrotoxicity, which substantially impact long-term liver transplantation (LTx) outcomes. The dark agouti (DA)-to-Lewis rat LTx model is a well-known ARJ model and was hence chosen for the present study. We show that both hepatocyte growth factor (HGF) (cHGF, containing the main form of promoting HGF production) and recombinant HGF (h-rHGF) exert immunoregulatory effects mainly on allogeneic aCD8+ T cell suppression through FAS-mediated apoptotic pathways by inhibiting cMet to FAS antagonism and Fas trimerization, leading to acute tolerance induction. We also showed that such inhibition can be abrogated by treatment with neutralizing antibodies against cMet (HGF-only receptor). In contrast, we did not observe these effects in rats treated with FK506. However, we observed that the effect of anti-rejection by FK506 was mainly on allostimulated CD4+ T cell (aCD4+ T cell) suppression and regulatory T cell (Treg) promotion, in contrast to the mechanism of HGF. In addition, the protective mechanism of HGF in FK506-mediated nephrotoxicity was addressed. Therefore, HGF as a tolerance inducer, whether used in combination with FK506 or as monotherapy, may have good clinical value. Additional roles of these T-cell subpopulations in other biological systems and studies in these fields will also be meaningful.
Property mapping of LDPE during 3D printing: evaluating morphological development with X-ray scattering
Authors: da Silva Daniel P. , Pinheiro Joao , Abdulghani Saba , Kamma-Lorger Christina , Martínez Juan Carlos , Solano Eduardo , Mateus Artur , Pascoal-Faria Paula , Mitchell Geoffrey R.
Published: August 2023

Direct digital manufacturing has been identified as one of the key tools of Industry 4.0 and it enables the creation of products directly through digital definition. Commonly known as additive manufacturing, it comprises a set of technologies that are expressively agile in small-scale productions and prototyping, in comparison to conventional mass manufacturing processes, such as injection molding of plastics. It streamlines mass customization, allows the production of highly complex objects, and has been broadly applied in several fields, from medical devices to the aerospace industry. Although a new era of design possibilities and accessibility was unveiled, most developments are focused on shape reproduction precision and the development of new feeding systems and materials. This work is focused on a shift in design for additive manufacturing, where the polymer properties, by means of the adjustment of the process conditions (extrusion rate, the write speed, and the nozzle temperature, among others), constitute a decision-making variable. In order to evaluate the morphology of semicrystalline polymers during extrusion-based 3D printing,in-situtime-resolving small and wide-angle X-ray scattering measurements were performed at the ALBA synchrotron light source in Barcelona (Spain). The goal of this research is to develop a material property mapping methodology during semicrystalline polymer melt extrusion-based 3D printing Some experiments were performed with low-density polyethylene, and we were able to confirm a correlation between the extrusion rate and writing speed of the printing with the level of preferred orientation of the chain folded lamellar crystals in the extrudate.
Classification of genotypes based on the VP1 gene of feline calicivirus and study of cross-protection between different genotypes
Authors: Yang Yupeng , Liu Zhe , Chen Mengru , Feng Kexin , Qi Ruibin , Zheng Yating , Wang Ying , Kang Hongtao , Jiang Qian , Yang Mingfa , Qu Liandong , Liu Jiasen
Published: August 2023

Feline calicivirus (FCV) causes upper respiratory tract diseases and even death in cats, thereby acting as a great threat to feline animals. Currently, FCV prevention is mainly achieved through vaccination, but the effectiveness of vaccination is limited. In this study, 105 FCV strain VP1 sequences with clear backgrounds were downloaded from the NCBI and subjected to a maximum likelihood method for systematic evolutionary analysis. Based on the genetic analysis results, FCV-positive sera were prepared using SPF mice and Chinese field cats as target animals, followed by a cross-neutralization assay conducted on the different genotype strains and in vivo challenge tests were carried out to further verify with the strain with best cross-protection effect. The results revealed that FCV was mainly divided into two genotypes: GI and GII. The GI genotype strains are prevalent worldwide, but all GII genotype strains were isolated from Asia, indicating a clear geographical feature. This may form resistance to FCV prevention in Asia. The in vitro neutralization assay conducted using murine serum demonstrated that the cross-protection effect varied among strains. A strain with broad-spectrum neutralization properties, DL39, was screened. This strain could produce neutralizing titers (10 × 23.08–10 × 20.25) against all strains used in this study. The antibody titers against the GI strains were 10 × 23.08–10 × 20.5 and those against the GII strains were 10 × 20.75–10 × 20.25. Preliminary evidence suggested that the antibody titer of the DL39 strain against GI was higher than that against GII. Subsequent cross-neutralization assays with cat serum prepared with the DL39 strain and each strain simultaneously yielded results similar to those described above. In vivo challenge tests revealed that the DL39 strain-immunized cats outperformed the positive controls in all measures. The results of several trials demonstrated that strain DL39 can potentially be used as a vaccine strain. The study attempted to combine the genetic diversity and phylogenetic analysis of FCV with the discovery of potential vaccines, which is crucial for developing highly effective FCV vaccines.
Nordcan.R: a new tool for federated analysis and quality assurance of cancer registry data
Authors: Larønningen Siri , Skog Anna , Engholm Gerda , Ferlay Jacques , Johannesen Tom Børge , Kristiansen Marnar Fríðheim , Knoors Daan , Kønig Simon Mathis , Olafsdottir Elinborg J. , Pejicic Sasha , Pettersson David , Skovlund Charlotte Wessel , Storm Hans H. , Tian Huidong , Aagnes Bjarte , Miettinen Joonas
Published: August 2023

Aim of the article

We present our new GDPR-compliant federated analysis programme (nordcan.R), how it is used to compute statistics for the Nordic cancer statistics web platform NORDCAN, and demonstrate that it works also with non-Nordic data.

Materials and methods

We chose R and Stata programming languages for writing nordcan.R. Additionally, the internationally used CRG Tools programme by International Agency for Research on Cancer (IARC/WHO) was employed. A formal assessment of (GDPR-compliant) anonymity of all nordcan.R outputs was performed. In order to demonstrate that nordcan.R also works with non-Nordic data, we used data from the Netherlands Cancer Registry.

Results

nordcan.R, publicly available on Github, takes as input cancer and general population data and produces tables of statistics. Each NORDCAN participant runs nordcan.R locally and delivers its results to IARC for publication. According to our anonymity assessment the data can be shared with international organizations, including IARC. nordcan.R incidence results on Norwegian and Dutch data are highly similar to those produced by two other independent methods.

Conclusion

nordcan.R produces accurate cancer statistics where all personal and sensitive data are kept within each cancer registry. In the age of strict data protection policies, we have shown that international collaboration in cancer registry research and statistics reporting is achievable with the federated analysis approach. Undertakings similar to NORDCAN should consider using nordcan.R.
The genetic variant rs55986091 HLA-DQB1 is associated with a protective effect against cervical cancer
Authors: Vinokurov Michael A. , Mironov Konstantin O. , Domonova Elvira A. , Romanyuk Tatiana N. , Popova Anna A. , Akimkin Vasiliy G.
Published: August 2023

Introduction

Cervical cancer (CC) is a prevalent malignancy affecting women globally. The primary causative factor of CC is the high-risk oncogenic human papillomavirus (HR-HPV). However, it is noteworthy that not all women infected with HR-HPV develop cancer, indicating the potential involvement of genetic predisposition in the development of CC. This study aims to identify genetic risks and their distribution in groups of women with different epidemiological features of HR-HPV.

Materials and methods

A comparison was conducted among four groups of women, comprising 218 HPV-negative women, 120 HPV-positive women, 191 women diagnosed with cervical intraepithelial neoplasia (CIN) grade 2 or 3, and 124 women diagnosed with CC. The analysis focused on four single nucleotide polymorphisms (SNPs): rs55986091 in HLA-DQB1, rs138446575 in TTC34, rs1048943 in CYP1A1, and rs2910164 in miRNA-146a.

Results

The rs55986091-A allele exhibited a protective effect within the “CC” group when compared to the “HPV-Negative” group (OR = 0.4, 95% CI= 0.25-0.65) using a log-additive model. Additionally, similar protective effects were observed in the “CIN 2/3” group compared to the “HPV-Negative” group (OR = 0.47, 95% CI = 0.28-0.79).

Conclusion

The data obtained emphasize the importance of developing PCR-based diagnostic kits for the identification of SNP alleles, particularly for rs55986091, among HR-HPV-positive women within the Russian population.
Multi-organ spatial stratification of 3-D dose distributions improves risk prediction of long-term self-reported severe symptoms in oropharyngeal cancer patients receiving radiotherapy: development of a pre-treatment decision support tool
Authors: Wentzel Andrew , Mohamed Abdallah S. R. , Naser Mohamed A. , van Dijk Lisanne V. , Hutcheson Katherine , Moreno Amy M. , Fuller Clifton D. , Canahuate Guadalupe , Marai G. Elisabeta
Published: August 2023

Purpose

Identify Oropharyngeal cancer (OPC) patients at high-risk of developing long-term severe radiation-associated symptoms using dose volume histograms for organs-at-risk, via unsupervised clustering.

Material and methods

All patients were treated using radiation therapy for OPC. Dose-volume histograms of organs-at-risk were extracted from patients’ treatment plans. Symptom ratings were collected via the MD Anderson Symptom Inventory (MDASI) given weekly during, and 6 months post-treatment. Drymouth, trouble swallowing, mucus, and vocal dysfunction were selected for analysis in this study. Patient stratifications were obtained by applying Bayesian Mixture Models with three components to patient’s dose histograms for relevant organs. The clusters with the highest total mean doses were translated into dose thresholds using rule mining. Patient stratifications were compared against Tumor staging information using multivariate likelihood ratio tests. Model performance for prediction of moderate/severe symptoms at 6 months was compared against normal tissue complication probability (NTCP) models using cross-validation.

Results

A total of 349 patients were included for long-term symptom prediction. High-risk clusters were significantly correlated with outcomes for severe late drymouth (p <.0001, OR = 2.94), swallow (p = .002, OR = 5.13), mucus (p = .001, OR = 3.18), and voice (p = .009, OR = 8.99). Simplified clusters were also correlated with late severe symptoms for drymouth (p <.001, OR = 2.77), swallow (p = .01, OR = 3.63), mucus (p = .01, OR = 2.37), and voice (p <.001, OR = 19.75). Proposed cluster stratifications show better performance than NTCP models for severe drymouth (AUC.598 vs.559, MCC.143 vs.062), swallow (AUC.631 vs.561, MCC.20 vs -.030), mucus (AUC.596 vs.492, MCC.164 vs -.041), and voice (AUC.681 vs.555, MCC.181 vs -.019). Simplified dose thresholds also show better performance than baseline models for predicting late severe ratings for all symptoms.

Conclusion

Our results show that leveraging the 3-D dose histograms from radiation therapy plan improves stratification of patients according to their risk of experiencing long-term severe radiation associated symptoms, beyond existing NTPC models. Our rule-based method can approximate our stratifications with minimal loss of accuracy and can proactively identify risk factors for radiation-associated toxicity.
Identification of a novel lncRNA prognostic signature and analysis of functional lncRNA AC115619.1 in hepatocellular carcinoma
Authors: Gan Binliang , He Youwu , Ma Yonggang , Mao Linfeng , Liao Chuanjie , Deng Ganlu
Published: August 2023

Background: Hepatocellular carcinoma (HCC) is the deadliest malignancy. Long non-coding RNAs (lncRNAs) are involved in the development of multiple human malignancies. This study aimed to establish a reliable signature and identify novel biomarkers for HCC patients.

Methods: Differentially expressed lncRNAs (DElncRNAs) were identified from Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) databases. Univariate, LASSO, and multivariate Cox regression analyses were applied to screen the prognostic lncRNAs and establish a prognostic model. Receiver operating characteristic (ROC) curves and Kaplan–Meier analyses were conducted to validate the prognostic value of this model. The association between lncRNAs and differential m6A genes was analyzed by Spearman’s analysis. A series of bioinformatic and in vitro experiments were applied to explore the function of hub lncRNA.

Results: A total of 32 DElncRNAs were identified, and 12 DElncRNAs were associated with the prognosis of HCC patients. A prognostic signature comprising six prognostic lncRNAs (LINC02428, LINC02163, AC008549.1, AC115619.1, CASC9, and LINC02362) was constructed, and the model exhibited an excellent capacity for prognosis prediction. Furthermore, 12 differential m6A regulators were identified, and RBMX was found to be correlated negatively with the hub lncRNA AC115619.1. The expression level of AC115619.1 was lower in HCC tissues than that in normal tissues and was significantly related to clinicopathologic features, survival rate, and drug sensitivity. Overexpression of AC115619.1 notably inhibited the proliferation, migration, and invasion of HCC cells.

Conclusion: This study provided a promising prognostic signature for HCC patients and identified AC115619.1 as a novel biomarker, which plays an essential role in regulating the progression of HCC.
Regulation of mitotic clonal expansion and thermogenic pathway are involved in the antiadipogenic effects of cyanidin-3-O-glucoside
Authors: Molonia Maria Sofia , Salamone Federica Lina , Muscarà Claudia , Costa Gregorio , Vento Grazia , Saija Antonella , Speciale Antonio , Cimino Francesco
Published: August 2023

Introduction: Obesity is a metabolic disease with an increase both in cell size (hypertrophy) and in cell number (hyperplasia) following differentiation of new adipocytes. Adipogenesis is a well-orchestrated program in which mitotic clonal expansion (MCE) occurs in the early step followed by the late terminal differentiation one.

Methods: Aim of the study was to evaluate the in vitro effects of cyanidin-3-O-glucoside (C3G), an anthocyanin present in many fruits and vegetables, in the early or late phase of 3T3-L1 preadipocytes differentiation.

Results: C3G exposure in the early phase of adipogenesis process induced a more marked reduction of CCAAT/enhancer-binding protein-β (C/EBPβ), peroxisome proliferator-activated receptor γ (PPAR-ɣ) and fatty acid synthase (Fasn) expression than late phase exposure and these effects were associated to a reduced MCE with cell cycle arrest at G0/G1 phase via p21 expression. Furthermore, C3G exposure during the early phase activated AMP-activated protein kinase (AMPK) pathway better than in the late phase promoting the enhancement of beige-like adipocytes. In fact, C3G induced thermogenic biomarkers uncoupling protein-1 (Ucp1) and peroxisome proliferator-activated receptor-gamma coactivator-1 alpha (Pgc1) and these effects were more evident during early phase exposure.

Conclusion: Our data demonstrate that C3G reduces the terminal adipogenic process affecting the early phase of differentiation and inducing a thermogenic program.
The induction of oocyte maturation and ovulation in the European eel (Anguilla anguilla): in vitro and in vivo comparison of progesterone with 17α,20β-dihydroxy-4-pregnen-3-one
Authors: Jéhannet Pauline , Palstra Arjan P. , Meijerhof Miriam , Schipper Henk , Giménez Ignacio Nebot , Dirks Ron P. , Swinkels William , Heinsbroek Leon T. N. , Komen Hans
Published: August 2023

Ovulation in European eel is induced by injection of 17α,20β-dihydroxy-4-pregnen-3-one (DHP) as the maturation-inducing hormone (MIH). Female eels need to ovulate within 18 h after injection to release good quality eggs. Progesterone (P), as an upstream precursor of DHP, may promote endogenous DHP production and improve egg quality. The purpose of this study was therefore to compare treatment of P with DHP on batch level, in vitro, to determine dose-response effects, and in vivo, at a single dose. For the in vitro experiment, ovarian tissue was extracted and placed in culture plates containing hormone-free medium and media supplemented with the treatment: DHP at 1, 10 and 100 ng mL−1, or P at 10, 100 and 1,000 ng mL−1. At the start of incubation, the folliculated oocytes were sampled for histology, microscopy and qPCR. After incubation for 12 and 18 h, the oocytes were sampled for microscopy and qPCR analysis. For the in vivo experiment, females were either injected with DHP or P at a dose of 2 mg kg−1 to assess their effects on ovulation and reproductive success. At the moment of release, eggs were sampled for RNA sequencing to compare effects of DHP and P on the expression of genes involved in egg quality aspects. Remaining eggs were fertilized and larval viability was recorded. Both DHP and P were able to induce GVBD (DHP at 10 and 100 ng mL−1, P at 100 and 1,000 ng mL−1) in vitro. Expression of genes involved in oocyte maturation and ovulation was similar in vitro for both DHP and P treatments. Regarding the in vivo results, RNAseq results reflected similar DHP and P effects on the expression of genes involved in egg quality aspects. Females injected with either DHP or P ovulated, released eggs, and were equally able to produce larvae without any differences in reproductive success. Our results support the conclusion that DHP and P work equally well in vitro and in vivo. P is more attractive to apply as the price is 3,000 times lower than the price of DHP.
COVID-19 crisis management of German ICU clinicians in leadership – a metaphor analysis
Authors: Piel Julia , Hörold Madlen , Brandstetter Susanne , Drewitz Karl-Philipp , Hrudey Ilona , Schmitt Rudolf , Apfelbacher Christian
Published: August 2023

The COVID-19 pandemic coincided with an already long-standing crisis in health systems around the world characterized by economic pressure and increasing staff shortage. “Crisis” became a global metaphor to convey collective experiences of the COVID-19 threat. Little is known on how crisis metaphors influence thought and speech on crisis management and the challenging staff situation of intensive care unit (ICU) clinicians in leadership positions and how they act. Therefore, we were interested in (1) which metaphorical concepts ICU clinicians in leadership use to express experiences and strategies in dealing with coinciding crises, (2) how these change over time, and (3) how metaphors in speech reveal self-images of crisis management. We conducted a systematic metaphor analysis focusing on data from three participants of a qualitative interview study with twenty-four healthcare professionals in ICUs in Germany. The participants were interviewed at two time points between April 2020 and March 2021. We identified and reconstructed metaphorical concepts of three interviewees (ICU clinicians in leadership) with regard to the pandemic management, and developed a typology based on the dimensions of mood, modus operandi, location, and scope. The typology consists of eight self-images (protagonists) for the crisis management of ICU clinicians in leadership, such as the figure of the soldier (“to unite everyone behind this flag”), the distributor (“sometimes it is a crazy patchwork [wahnsinniges Gestückel]”) or the critic (“we are the fool for everything”). They embody different qualities of a leader and refer to intra- and inter-role conflicts within multiple crisis conditions. Metaphor analysis reveals different self-images of ICU leadership clinicians in relation to crisis management. This illustrates that thinking and perceptions of crisis management may strongly differ between and within leaders and may change over the course of crises. Our findings highlight the need both to improve knowledge on challenges associated with leadership in crises and preparedness, and to support clinicians in their leadership by recognizing and addressing differences and changes in leaders’ self-image.
Dementia care in gerontological social work: emerging issues and challenges in Saudi Arabia
Authors: Shubair Sultan Ali
Published: August 2023

The issues and challenges in the current state of gerontological social work policy, practice, and education related to dementia care in Saudi Arabia are discussed in this article. The following primary issues were explored: (1) the impact of the biomedical model’s global dominance on gerontological social work policy and research for dementia care and health promotion; (2) the position of the older adults in Middle Eastern nations and its connection to the lack of gerontological social work policies, programs, and care services for older adults with dementia and their family caregivers; (3) the effect of the profession of social work’s lack of recognition on the potential evolution of gerontological social work practice in dementia care; (4) the state of dementia patients’ rights, dementia patients’ safety, and dementia patients’ rights to self-determination on the gerontological social work support provided for older adults with dementia; (5) the unequal distribution of dementia care resources and gerontological social work; and (6) the social work education programs’ inability to supply the market with sufficient number of skilled gerontological social workers and its effect on the advancement of dementia care in gerontological social work practice. Approaches for advancing policy, practice, and education are provided to support the evolution of gerontological social work in dementia care in the region.
Behaviour and sun exposure in holidaymakers alters skin microbiota composition and diversity
Authors: Willmott Thomas , Campbell Paul M. , Griffiths Christopher E. M. , O’Connor Clare , Bell Michael , Watson Rachel E. B. , McBain Andrew J. , Langton Abigail K.
Published: August 2023

Introduction:The skin microbiota plays a crucial role in maintaining epidermal homeostasis. Ultraviolet radiation (UVR) and other environmental challenges can impact the skin microbiota through direct and indirect mechanisms. This study aimed to investigate the effects of sun exposure on the skin microbiota and its relationship with individual skin phototypes.

Methods:Healthy volunteers (n= 21 [4M, 17 F], mean age 33.2 years) holidayed in a sunny destination for a minimum of 7 days with swabs taken pre-holiday and up to 84 days post-holiday. Participant group was categorised by individual typology angle (ITA) classification and the composition of the skin microbiota was examined using 16S rRNA gene sequencing.

Results:In the entire cohort and at all time points, the major bacterial phyla were Actinobacteria, Proteobacteria and Firmicutes. There was a significant change in microbial beta diversity at day 28 post-holiday, compared to baseline, for all participants. However, when participants were segregated into three cohorts dependent on the degree of skin tanning response between baseline (pre-holiday) and immediately one-day post-holiday, there was a reduction in Proteobacteria in the sun-seeking participants 1 day after the holiday, which recovered over time.

Discussion:These findings suggest that sun exposure can affect the diversity and composition of the skin microbiota, which may have downstream effects on skin health.
Male partners’ support and influence on pregnant women’s oral PrEP use and adherence in Malawi
Authors: Young Alinda M. , Saidi Friday , Phanga Twambilile , Tseka Jennifer , Bula Agatha , Mmodzi Pearson , Pearce Lisa D. , Maman Suzanne , Golin Carol E. , Mutale Wilbroad , Chi Benjamin H. , Hill Lauren M.
Published: August 2023

Introduction

Daily oral pre-exposure prophylaxis (PrEP) is a safe and effective HIV prevention method for pregnant and postpartum women, but adherence barriers exist. Understanding the role of male partners in supporting PrEP use may inform strategies to support PrEP adherence among pregnant and breastfeeding women.

Methods

To understand male partners’ involvement in women's use of PrEP, we conducted in-depth interviews with pregnant women in Lilongwe, Malawi who had recently decided to use PrEP (n = 30) and their male partners (n = 20) in the context of a PrEP adherence trial. Women were purposively recruited to ensure variation in their partners’ HIV status. Interviews were conducted in Chichewa using a semistructured guide. We followed a thematic approach to analyze the interview data.

Results

Most male partners were receptive to women using PrEP during pregnancy because it eased their fears of the woman and baby acquiring HIV. Men often played a key role in women's PrEP adherence by providing daily reminders and encouragement to adhere to their medication. The majority of women appreciated this support from the men as it lessened the burden of remembering to take their medications daily on their own and aided their adherence. However, several women who lacked male partner support spoke of wanting their partners to be more involved. Many men living with HIV found the mutual support beneficial for their antiretroviral therapy adherence, while men without HIV or with status unknown appreciated knowing that the family was protected. While most men were open to women continuing PrEP beyond the current study, some would only support it if women were still at risk for acquiring HIV.

Conclusion

In this study, male partners were strongly motivated to support the PrEP adherence of their female partners as a way of ensuring that the pregnant women and unborn babies were protected against HIV. Promoting disclosure and tangible support that arises organically among men may be helpful, but programs to enhance this support and identify ways to support women who do not receive support from their partners or do not wish to disclose their PrEP use to partners may be needed.
Heliospheric 3-D MHD ENLIL simulations of multi-CME and multi-spacecraft events
Authors: Odstrcil Dusan
Published: August 2023

Interpreting multi-spacecraft heliospheric observations of the evolving solar wind (SW) streams with propagating and interacting coronal mass ejections (CMEs) is challenging. Numerical simulations can provide global context and suggest what may and may not be observed. The heliospheric three-dimensional (3D) magnetohydrodynamic (MHD) ENLIL model can provide a near-real-time prediction of heliospheric space weather, and it is used at NASA Community Coordinated Modeling Center (CCMC), NOAA Space Weather Prediction Center (SWPC), and UK Meteorological Office (MetOffice). However, this version does not show its full potential, especially in the case of multi-CME events observed by various spacecraft. We describe tools developed to interpret remote observations and in-situ measurements better and apply them to multi-CME events observed by ACE, STEREO-A, Parker Solar Probe (PSP), BepiColombo, and Solar Orbiter. We present some results on 1) global structures of the SW speed and density at the ecliptic, 2) the evolution of SW parameters at the spacecraft, 3) magnetic field connectivity at the spacecraft, 4) automatic detection of shock parameters and alert plots, and 5) synthetic white-light (WL) imaging. This paper is not on model initialization or analyzing specific CME events, but it describes features not used at space weather prediction centers and provided by NASA/CCMC Run-On-Request service. This paper advertises new tools and shows their benefits when applied to selected heliospheric space weather events observed at near-Earth, PSP, Solar Orbiter, and STEREO-A spacecraft.
Refugee Telehealth Utilization for Hypertension Management During the COVID-19 Pandemic
Authors: Salameh Zaid , Kaki Dahlia A. , Abu Baker Dania , Hijazi Tarek , Godino Job , Al-Rousan Tala
Published: August 2023

Objectives: The COVID-19 pandemic limited refugees’ access to healthcare. Increased use of telehealth could enable continuity of care but also create barriers to chronic disease management. This study explores refugees’ experience with telehealth and hypertension management during the pandemic.

Methods: We recruited 109 refugee participants diagnosed with hypertension. We conducted semi-structured interviews about their experience with telehealth during the COVID-19 pandemic. Interviews were transcribed, translated, and data was coded using inductive thematic analysis.

Results: 86% used telehealth modalities at least once during the pandemic. Interviews highlighted three main themes: (1) Social isolation worsened mental health, affecting their motivation to manage their blood pressure; (2) telehealth alleviated discontinuity of care but posed logistical and cultural challenges; (3) participants relied on public blood pressure monitors that were not available during the pandemic which affected disease management.

Conclusion: Refugees faced challenges managing their hypertension during the COVID-19 pandemic. Virtual community building may alleviate their stress and isolation. Telehealth must be adapted to account for language, cultural, and technological barriers. Communities with hypertension should increase access to personal or public blood pressure monitors.
Investigating Routing in the VANET Network: Review and Classification of Approaches
Authors: Sangaiah Arun Kumar , Javadpour Amir , Hsu Chung-Chian , Haldorai Anandakumar , Zeynivand Ahmad
Published: August 2023

Vehicular Ad Hoc Network (VANETs) need methods to control traffic caused by a high volume of traffic during day and night, the interaction of vehicles, and pedestrians, vehicle collisions, increasing travel delays, and energy issues. Routing is one of the most critical problems in VANET. One of the machine learning categories is reinforcement learning (RL), which uses RL algorithms to find a more optimal path. According to the feedback they get from the environment, these methods can affect the system through learning from previous actions and reactions. This paper provides a comprehensive review of various methods such as reinforcement learning, deep reinforcement learning, and fuzzy learning in the traffic network, to obtain the best method for finding optimal routing in the VANET network. In fact, this paper deals with the advantages, disadvantages and performance of the methods introduced. Finally, we categorize the investigated methods and suggest the proper performance of each of them.
Entrepreneurship’s Creation School and Its Comparison-Based Approach: Assessing the Lessons for Theory’s Progression
Authors: Arend Richard J.
Published: August 2023

The creation school of opportunity formation is a relatively new partial theory of entrepreneurship built upon a relatively new approach to theorizing. Given their significant respective impacts, we critically evaluate both that school and that approach to better understand their respective values to theorizing. We apply a comprehensive, critical framework to evaluate the creation school. We determine that it is not yet a theory, but that it raises several important theoretical questions, from the origins of valuable heterogeneity to which meta-heuristics should be assumed and to what types of uncertainty are involved in entrepreneurial opportunities. We then describe its comparison-based approach for theorizing, delineating it from similar approaches that also contrast against the given benchmark ideas in a field, to determine its benefits and costs to advancing the modeling of phenomena. We determine that this new approach differs from problematization and constrastivity; instead of developing assumptions from induction, it uses a strawman to simply assert them. We finish by discussing the implications for how we can take more control over what kinds of theories affect the definition, and the legitimacy earned, in important fields of research like entrepreneurship.
Nitroxide—HMP—Protects Human Trophoblast HTR-8/SVneo Cells from H2O2-Induced Oxidative Stress by Reducing the HIF1A Signaling Pathway
Authors: Pintye Diana , Sziva Réka Eszter , Mastyugin Maxim , Török Marianna , Jacas Sonako , Lo Agnes , Salahuddin Saira , Zsengellér Zsuzsanna K.
Published: August 2023

Preeclampsia (PE) is a pregnancy-specific syndrome affecting 5–7% of patients. There is no effective treatment available. Early abnormal placental development is associated with oxidative stress (OS) and a release of reactive oxygen species (ROS) in the placenta. This phenomenon leads to downstream signaling, Hypoxia Inducible Factor 1A (HIF1A) stabilization and transcription of the anti-angiogenic factors soluble fms-like tyrosine kinase 1 (sFLT1) and soluble endoglin (sEng), which are known to cause endothelial and trophoblast dysfunction and cardinal features of PE: hypertension, proteinuria and, in severe cases, eclampsia. We tested whether 3-(Hydroxymethyl)-1-oxy-2,2,5,5-tetramethylpyrrolidine (HMP)—a nitroxide-type antioxidant molecule—can reduce placental OS and mitigate PE symptoms in vitro. We induced OS in human trophoblast (HTR-8/SVneo) cells with hydrogen peroxide (H2O2) and assessed whether modulating cell redox function with HMP reduces cell injury, mitochondrial stress and HIF1A and sFLT1 production. Pre-treatment with HMP reduced mitochondrial-derived ROS production, restored LC3B expression and reduced HIF1A and sFLT1 expression in H2O2-exposed HTR-8/SVneo trophoblast cells. HMP improved the mitochondrial electron chain enzyme activity, indicating that a reduction in OS alleviates mitochondrial stress and also reduces anti-angiogenic responses. In reducing placental trophoblast OS, HMP presents a potential novel therapeutic approach for the treatment of PE. Future investigation is warranted regarding the in vivo use of HMP.
Advances in the Astonishing World of Phytochemicals: State-of-the-Art for Antioxidants
Authors: Lauricella Marianna , D’Anneo Antonella
Published: August 2023

In recent years, research on phytochemicals has underscored pleiotropic actions and medicinal and health-promoting properties which certainly deserve serious attention [...]
Learning from the Past: Parametric Analysis of Cob Walls
Authors: Jiménez Rios Alejandro
Published: August 2023

In this paper, the results obtained from a series of parametric analyses, where the influence that geometric and mechanical parameters have in the structural response of existing vernacular cob walls within an Irish context, are presented. A design of experiments using central composite designs was implemented along with analysis of variance following two computational approaches, namely, the finite element method and kinematic limit analysis. As results, a series of response surfaces and parametric equations with which it is possible to compute safety factors and collapse multipliers (within the range of values studied) are provided. Based on the results obtained, it could be concluded that traditional cob walls in Ireland are very robust. Relatively high acceleration values, unlikely to happen in a low seismic hazard region such as Ireland, would be needed to start the collapse mechanisms studied or cause yielding in typical vernacular cob walls. Furthermore, the equations generated with the refined regression models can be used by practitioners as a first approach to estimate the safety levels of existing cob buildings with similar characteristics.
Optical-Fiber-Embedded Beam for Subgrade Distributed Settlement Monitoring: Experiments and Numerical Modeling
Authors: Li Zhen , Yuan Kun , Zhao Li-Guo
Published: August 2023

In this study, Brillouin optical time domain analysis (BOTDA) sensing technology was utilized for monitoring settlement in a similarity model of a highway subgrade. As contact winding cannot be used for an optical fiber that is buried directly in the soil, uncoupling between the fiber and the soil can occur. Thus, an optical-fiber-embedded beam (OFEB) was developed, and a method for measuring and calculating the beam’s deformation was proposed. A calibration test and a test on a similarity model of a subgrade were carried out to investigate the applicability and monitoring accuracy of the OFEB. It was concluded that the OFEB can accurately measure beam deflection, and the maximum relative error between measurements by the optical fiber and a displacement transducer was approximately 5%. The OFEB was embedded directly into a similarity model of a subgrade to monitor settlement. The deflection deformation of the OFEB was found to be close to the subgrade settlement over a certain settlement range, with a relative error below 8.1%. Thus, the OFEB can be used to measure large-range distributed settlement in a subgrade. A numerical simulation was performed to identify appropriate beam dimensions and material design parameters, thereby extending the measurement range before decoupling of the OFEB and the soil occurs. The enhancement of the measurement range and the accuracy of the OFEB based on the preliminary experiments carried out in this study enables further investigation of settlement monitoring.
Human Activity Recognition Method Based on Edge Computing-Assisted and GRU Deep Learning Network
Authors: Huang Xiaocheng , Yuan Youwei , Chang Chaoqi , Gao Yiming , Zheng Chao , Yan Lamei
Published: August 2023

Human Activity Recognition (HAR) has been proven to be effective in various healthcare and telemonitoring applications. Current HAR methods, especially deep learning, are extensively employed owing to their exceptional recognition capabilities. However, in pursuit of enhancing feature expression abilities, deep learning often introduces a trade-off by increasing Time complexity. Moreover, the intricate nature of human activity data poses a challenge as it can lead to a notable decrease in recognition accuracy when affected by additional noise. These aspects will significantly impair recognition performance. To advance this field further, we present a HAR method based on an edge-computing-assisted and GRU deep-learning network. We initially proposed a model for edge computing to optimize the energy consumption and processing time of wearable devices. This model transmits HAR data to edge-computable nodes, deploys analytical models on edge servers for remote training, and returns results to wearable devices for processing. Then, we introduced an initial convolution method to preprocess large amounts of training data more effectively. To this end, an attention mechanism was integrated into the network structure to enhance the analysis of confusing data and improve the accuracy of action classification. Our results demonstrated that the proposed approach achieved an average accuracy of 85.4% on the 200 difficult-to-identify HAR data, which outperforms the Recurrent Neural Network (RNN) method’s accuracy of 77.1%. The experimental results showcase the efficacy of the proposed method and offer valuable insights for the future application of HAR.