bluuebunny/crossref_metadata_2025 huggingface dataset:
Navigating the asthma network on Twitter: Insights from social network and sentiment analysis
Authors: Pratiwi Hening , Benkő Ria , Kusuma Ikhwan Yuda
Published: January 2024

Background

Asthma is a condition in which the airways become inflamed and constricted, causing breathing difficulties, wheezing, coughing, and chest tightness. Social networks can have a substantial effect on asthma management and results. However, no studies of social networks addressing asthma have been undertaken.

Objective

The aim of this research was to identify the significant social network structures, key influencers, top topics, and sentiments of asthma-related Twitter conversations.

Methods

All the tweets collected for this study included the keyword “asthma” or were mentioned in or in replies to tweets that were performed. For this study, a random sample of Twitter data was collected using NodeXL Pro software between December 1, 2022, and January 29, 2023. The data collected includes the user's display name, Twitter handle, tweet text, and the tweet's publishing date and time. After being imported into the Gephi application, the NodeXL data were then shown using the Fruchterman-Reingold layout method. In our study, SNA (Social Network Analysis) metrics were utilized to identify the most popular subject using hashtags, sentiment-related phrases (positive, negative, or neutral), and top influencer by centrality measures (degree, betweenness).

Results

The study collected 48,122 tweets containing the keyword “asthma” or mentioned in replies. News reporters and journalists emerged as top influencers based on centrality measures in Twitter conversations about asthma, followed by government and healthcare institutions. Education, trigger factors (e.g., cat exposure, diet), and associated conditions were highly discussed topics on asthma-related social media posts (e.g., sarscov2, copd). Our study's sentiment analysis revealed that there were 8427 phrases associated neutral comments (18%), 12,582 words reflecting positive viewpoints (26%), and 27,111 words reflecting negative opinions (56%).

Conclusion

This study investigates the relevance of social media influencers, news reporters, health experts, health organizations, and the government in the dissemination and promotion of asthma-related education and awareness during public health information.
Macro-engagement in mHealth: Exploring user engagement beyond the screen
Authors: Villegas Mejía Camila , Remmerswaal Danielle , Engels Rutger C.M.E. , Ludden Geke D.S. , Boffo Marilisa
Published: January 2024

While digital technology holds great promise for health and well-being, some users feel sceptical about the time they spend online and how they use their mobile devices. This attitude could hamper uptake of digital health technologies and engagement with them. This study uses the concept of macro-engagement as a starting point to investigate how users of digital behaviour change interventions (DBCIs) engage with their behaviour change goals beyond the screens of their tools. Thirty semi-structured interviews were conducted with individuals who take part in behaviour change processes in different ways (i.e. mental health professionals, digital health experts and users of DBCIs). A qualitative analysis of their data through a grounded theory approach highlighted a wide array of offscreen behaviors and strategies that complement a behavior change process offscreen. Furthermore, implications for designing technology that encourages progressive non-reliance on DBCI usage are drawn out.
Who’s Viewing My Post? Extending the Imagined Audience Process Model Toward Affordances and Self-Disclosure Goals on Social Media
Authors: Yao Yueyang , Taylor Samuel Hardman , Leiser Ransom Sarah
Published: January 2024

This study investigates how individuals use the imagined audience to navigate context collapse and self-presentational concerns on Instagram. Drawing on the imagined audience process model, we analyze how structural (i.e., social media affordances) and individual factors (i.e., self-disclosure goals) impact the imagined audience composition along four dimensions: size, diversity, specificity, and perceived closeness. In a retrospective diary study of U.S. Instagram users, we compared the imagined audiences on Instagram posts versus Stories ( n = 1,270). Results suggested that channel ephemerality predicted a less diverse and less close imagined audience; however, channel ephemerality interacted with self-disclosure goals to predict imagined audience composition. Imagined audience closeness was positively related to disclosure intimacy, but size, diversity, and specificity were unassociated. This study advances communication theory by describing how affordances and disclosure goals intersect to predict the imagined audience construction and online self-presentation.
A Critical Evaluation of a Racial Literacy Education Program for Police Recruits
Authors: Valgoi Maria J. , Neville Helen A. , Schlosser Michael , Cha-Jua Sundiata K.
Published: January 2024

We used a practical–participatory evaluation method to develop and critically evaluate a racial literacy education program for police recruits. The 10-h Racial Literacy Project (RLP) education was developed over the course of a year and across two training cohorts. The programming was informed by the literature and using the input of a core academic team, veteran police officers, and community members. A quasi-experimental design was used to assess the influence of the RLP intervention on a third cohort. Recruits participated in either the RLP intervention ( n = 34) or a Nonracial Diversity intervention ( n = 37). Participants’ pre- and posttest scores were compared on racial colorblind beliefs (or denial and minimization of racism) and ethnocultural empathic feelings. There were no significant differences on posttest racial colorblindness scores across the two intervention groups. Also, surprisingly, recruits in the RLP intervention group displayed statistically significant lower levels of empathetic feeling towards People of Color at posttest compared to their Nonracial Diversity intervention group counterparts. These findings suggest that 10 h of exposure to racial literacy education is insufficient to produce targeted desired changes. Several recommendations for future development of the RLP are included.
Cross-cultural adaptation, reliability and validity analysis of the Cantonese-Chinese Manchester Oxford Foot Questionnaire for Foot and Ankle Disorder (Manchester-Oxford Foot Questionnaire HK)
Authors: Chia Shu MC , Ho Leung P , Ko Violet Man-Chi , Xin He , Chow Long CB , Yung Patrick Shu-Hang , Ling Samuel Ka-Kin
Published: January 2024

The Manchester–Oxford Foot Questionnaire is a validated English 16-item patient-reported outcome measure for evaluating foot and ankle function. This study aimed to translate a Cantonese Chinese version of the questionnaire and evaluate its validity and reliability among patients with foot and ankle disorders. The translation and cross-cultural adaptation were conducted by forward translation, synthesis of translated versions, backward translation, review, and pre-testing by a panel of healthcare professionals. The test-retest reliability was conducted within 2–4 weeks. Internal consistency and construct validity were evaluated using the Visual Analogue Scale and Short-Form 36. 135 participants were recruited to complete the validation process. The overall reliability coefficient constituted 0.86 (intraclass correlation coefficient = 0.72–0.93). A strong, statistically significant correlation was found between the bodily pain subscale of Short-Form 36 and the pain subscale of the Cantonese Chinese-Manchester-Oxford Foot Questionnaire ( r = −0.77, p < 0.001). This was similar to the pain subscale of the Cantonese Chinese-Manchester-Oxford Foot Questionnaire and visual analogue pain score ( r = 0.77, p < 0.001). The overall score for the Cantonese Chinese Manchester-Oxford Foot Questionnaire between the healthy control group and the pathological group was statistically different ( p < 0.001). A good consistency level was found in the questionnaire with a Cronbach's alpha coefficient of 0.78, 0.86, 0.78, 0.85 for pain, walking/standing, social interaction, and the overall domain of the Cantonese Chinese-Manchester-Oxford Foot Questionnaire, respectively. Therefore, this questionnaire can be adapted as a reliable clinical assessment and an outcome measure among the Cantonese Chinese-speaking population.
Time Series Data Analysis of Mindfulness Breathing Method Using Electroencephalogram
Authors: Togo Eiichi
Published: January 2024

Introduction

Workers and students are often stressed and distressed by a variety of factors, including work and study. However, support for individual psychological stress is not yet well established.

Objective

This study aimed to evaluate the effect of mindfulness breathing on the mental load of college students using an electroencephalogram (EEG).

Methods

Twenty participants were randomly allocated into treatment or control groups, with 10 participants in each group. Mindfulness breathing was applied to participants in the treatment group, while those in the control group received no treatment. The regression equation was evaluated from the EEG, and time series analysis was performed based on autocorrelation and partial autocorrelation.

Results

In the After condition after mindfulness breathing exercises in the Mi group, the alpha wave content of the regression equation at eye closure after task performance showed an upward trend, and the autocorrelation coefficient showed repeated upward and downward fluctuations.

Conclusion

It was suggested that alpha wave content may increase over time with mindfulness breathing exercises. The EEG after mindfulness breathing exercises was shown not to be constant and to have non-linear characteristics. This suggested that the effects of mindfulness breathing exercises could be evaluated using time series data.
Dislodged Deployed DES (Drug-eluting Stent) Dismantles a Doyen—Case report
Authors: Mondal Sudipta , Iliyas Mohamed , Sasidharan Bijulal
Published: January 2024

Background

Left main stenting with significant stenosis in symptomatic patients is an alternative strategy of revascularization in cases of low syntax scores with high surgical risk. Stent dislodgement is a rare complication, even rarer when it is already deployed. Percutaneous retrieval of a stent when it is fully deployed, is usually not recommended as it predisposes to a higher rate of dreaded vascular complications.

Case presentation

A case of dislodgment of a fully deployed stent in the left main is reported here, which was successfully deployed in another vascular bed without requiring invasive surgical retrieval.

Conclusions

Meticulous efforts for stent sizing, landing zone, and balloon expansion are of utmost importance, especially in cases of left main stenting where the risk of systemic embolization is higher. Monitoring stent position during balloon deflation, withdrawal, or manipulation of guide catheters is critical for promptly detecting stent dislodgement. Deploying a fully dilated dislodged stent in a favorable vascular bed is an important bail-out strategy.
Effect of stacking position on drying rate during radio-frequency vacuum combined with mechanical press drying of Douglas-fir and Radiata pine
Authors: Lee Changjin
Published: January 2024

In this study, the effect of stacking position in the dryer on the drying rate during radio-frequency vacuum combined with mechanical press (RF/VP) drying was investigated for Douglas-fir and Radiata pine. Drying test was performed at a temperature of 40 °C using RF/VP dryer with approximately 3 m3. The results showed that the stacking position has a significant effect on the drying rate, with a more pronounced decrease in drying rate as the stacking position of specimens approaches the ground plate. Previous moisture content was an important factor in determining the drying rate in both species. The MC distribution of specimens in the dryer before drying was very irregular, but over time, specimens stacked on the RF charge plate side in the dryer tended to have lower MC distributions than those stacked on the ground plate side, which was serious at the specimens in contact with the upper ground plate. In addition, as the MC decreases below the fiber saturation point during RF/VP drying, the difference in MC distribution within the dryer according to the stacking position became clearer. These findings provide new insights into the effect of stacking position on drying rate during the RF/VP drying and are expected to improve RF/VP drying technology.
Designing nanostructured lipid carriers modified with folate-conjugated chitosan for targeted delivery of osthole to HT-29 colon cancer cells: investigation of anticancer, antioxidant, and antibacterial activities
Authors: Hosseini Torshizi Ghazal , Homayouni Tabrizi Masoud , Karimi Ehsan , Younesi Atefeh , Larian Zahra
Published: January 2024

The present study proposed to design nanostructured lipid carriers (NLC) coated with chitosan (CS) conjugated folate (FA) for the targeted delivery of Osthole (OST) to the HT-29 colon cancer cell line and improve its anticancer capability. To assess the physicochemical characteristics of OST-loaded NLC decorated with CS-conjugated FA (OST-NCF-NPS), several techniques, including DLS, SEM, and FTIR, were applied. After determining the encapsulation efficiency of OST in CSFA-modified NLC-NPs, an MTT test was conducted to evaluate the cytotoxic effects of this nano platform on the HT-29 cancer cell line in comparison to normal HFF cells. Possible mechanisms of apoptosis in cancer cells treated with OST-NCF-NPs were examined using qPCR, flow cytometry, and AO/PI fluorescent staining methods. Moreover, the antioxidant capacity of these biosynthesized nanocarriers was determined using ABTS and DPPH methods, and their antibacterial potential was measured through disk diffusion, MIC, and MBC assays. According to the findings, OST-NCF-NPS had the ideal average size of 179.19 nm, low polydispersity (PI = 0.23), acceptable physical stability (ζ-potential =  + 18.99 mV), and high entrapment efficiency (83.5%). The MTT data demonstrated the selective cytotoxicity of NPs toward cancerous cells compared to normal cells. Cell cycle and Annexin V/Propidium Iodide (AnV/PI) analysis indicated that OST-NCF-NPs increased the sub-G1 population and AnV/PI-positive cells. The occurrence of programmed cell death in the treated cells was also verified by altered expression of proapoptotic (BAX and caspase-3) and antiapoptotic (Bcl-2) genes. Furthermore, the NPs exhibited strong antibacterial activity, particularly against gram-negative bacteria, and high antioxidant effects in reducing ABTS and DPPH-free radicals.

Graphical Abstract
Clustering on hierarchical heterogeneous data with prior pairwise relationships
Authors: Han Wei , Zhang Sanguo , Gao Hailong , Bu Deliang
Published: January 2024

Background

Clustering is a fundamental problem in statistics and has broad applications in various areas. Traditional clustering methods treat features equally and ignore the potential structure brought by the characteristic difference of features. Especially in cancer diagnosis and treatment, several types of biological features are collected and analyzed together. Treating these features equally fails to identify the heterogeneity of both data structure and cancer itself, which leads to incompleteness and inefficacy of current anti-cancer therapies.

Objectives

In this paper, we propose a clustering framework based on hierarchical heterogeneous data with prior pairwise relationships. The proposed clustering method fully characterizes the difference of features and identifies potential hierarchical structure by rough and refined clusters.

Results

The refined clustering further divides the clusters obtained by the rough clustering into different subtypes. Thus it provides a deeper insight of cancer that can not be detected by existing clustering methods. The proposed method is also flexible with prior information, additional pairwise relationships of samples can be incorporated to help to improve clustering performance. Finally, well-grounded statistical consistency properties of our proposed method are rigorously established, including the accurate estimation of parameters and determination of clustering structures.

Conclusions

Our proposed method achieves better clustering performance than other methods in simulation studies, and the clustering accuracy increases with prior information incorporated. Meaningful biological findings are obtained in the analysis of lung adenocarcinoma with clinical imaging data and omics data, showing that hierarchical structure produced by rough and refined clustering is necessary and reasonable.
Computational analysis of the AP2/ERF family in crops genome
Authors: Choudhury Shouhartha
Published: January 2024

Background

The Apetala 2/ethylene-responsive factor family has diverse functions that enhance development and torment resistance in the plant genome. In variation, the ethylene-responsive factor (ERF) family of TF’s genes is extensive in the crop genome. Generally, the plant-specific ethylene-responsive factor family may divided by the dehydration-responsive element-binding (DREB) subfamily. So, the AP2/ERF super-family demonstrated the repeated AP2 domain during growth. The sole AP2 domain function represents abiotic stress resistance. Also, the AP2 with B3 domain enhances during the replication of brassinosteroid.

Objective

The study objective is to investigate the Apetala 2/ethylene-responsive factor family in a model organism of the Arabidopsis thaliana for comparative analysis towards Solanum lycopersicum (Tomato), Brassica juncea (Indian and Chinese mustard), Zea mays L. (Maize) and Oryza sativa (Indian and Japanese Rice). So, examinations of the large AP2/ERF super-family are mandatory to explore the Apetala 2 (AP2) family, ERF family, DREB subfamily, and RAV family involved during growth and abiotic stress stimuli in crops.

Methods

Therefore, perform bioinformatics and computational methods to the current knowledge of the Apetala 2/ethylene-responsive factor family and their subfamilies in the crop genome. This method may be valuable for functional analysis of particular genes and their families in the plant genome.

Results

Observation data provided evidence of the Apetala 2/ethylene-responsive factor (AP2/ERF) super-family and their sub-family present in Arabidopsis thaliana (Dicots) and compared with Solanum lycopersicum (Dicots), Brassica juncea (Dicots), Zea mays L. (Monocots) and Oryza sativa (Monocots). Also, remarks genes in Oryza sativa. This report upgraded the Apetala 2/ethylene-responsive factor (AP2/ERF) family in the crop genome. So, the analysis documented the conserved domain, motifs, and phylogenetic tree towards Dicots and Monocots species. Those outcomes will be valuable for future studies of the defensive Apetala 2/ethylene-responsive factor family in crops.

Conclusion

Therefore, the study concluded that the several species-specific TF genes in the Apetala 2/ethylene-responsive factor (AP2/ERF) family in Arabidopsis thaliana and compared with crop-species of Solanum lycopersicum, Brassica juncea, Zea mays L. and Oryza sativa. Those plant-specific genes regulate during growth and abiotic stress control in plants.
Molecular and metabolic insights into purplish leaf coloration through the investigation of two mulberry (Morus alba) genotypes
Authors: Li Shusong , Yang Yuqing , Yu Jie , Zhou Hong , Hou Zhiwei , Wang Xiling
Published: January 2024

Background

Leaf coloration in plants, attributed to anthocyanin compounds, plays a crucial role in various physiological functions, and also for pharmaceutical and horticultural uses. However, the molecular mechanisms governing leaf coloration and the physiological significance of anthocyanins in leaves remain poorly understood.

Results

In this study, we investigated leaf color variation in two closely related mulberry genotypes, one with purplish-red young leaves (EP) and another with normal leaf color (EW). We integrated transcriptomic and metabolomic approaches to gain insights into the metabolic and genetic basis of purplish-red leaf development in mulberry. Our results revealed that flavonoid biosynthesis, particularly the accumulation of delphinidin-3-O-glucoside, is a key determinant of leaf color. Additionally, the up-regulation of CHS genes and transcription factors, including MYB family members, likely contributes to the increased flavonoid content in purplish-red leaves.

Conclusion

These findings enhance our understanding of the molecular mechanisms responsible for the purplish coloration observed in mulberry leaves and also offer supporting evidence for the hypothesis that anthocyanins serve a protective function in plant tissues until the processes of light absorption and carbon fixation reach maturity, thereby ensuring a balanced equilibrium between energy capture and utilization.
Risk factors for transmission of carbapenem-resistant Acinetobacter baumannii in outbreak situations: results of a case-control study
Authors: Schlosser Beate , Weikert Beate , Fucini Giovanni-Battista , Kohlmorgen Britta , Kola Axel , Weber Anna , Thoma Norbert , Behnke Michael , Schwab Frank , Gastmeier Petra , Geffers Christine , Aghdassi Seven Johannes Sam
Published: January 2024

Background

An increase in patients with multidrug-resistant organisms and associated outbreaks during the COVID-19 pandemic have been reported in various settings, including low-endemic settings. Here, we report three distinct carbapenem-resistant Acinetobacter baumannii (CRAB) outbreaks in five intensive care units of a university hospital in Berlin, Germany during the COVID-19 pandemic.

Methods

A case-control study was conducted with the objective of identifying risk factors for CRAB acquisition in outbreak situations. Data utilized for the case-control study came from the investigation of three separate CRAB outbreaks during the COVID-19 pandemic (August 2020– March 2021). Cases were defined as outbreak patients with hospital-acquired CRAB. Controls did not have any CRAB positive microbiological findings and were hospitalized at the same ward and for a similar duration as the respective case. Control patients were matched retrospectively in a 2:1 ratio. Parameters routinely collected in the context of outbreak management and data obtained retrospectively specifically for the case-control study were included in the analysis. To analyze risk factors for CRAB acquisition, univariable and multivariable analyses to calculate odds ratios (OR) and 95% confidence intervals (CI) were performed using a conditional logistic regression model.

Results

The outbreaks contained 26 cases with hospital-acquired CRAB in five different intensive care units. Two exposures were identified to be independent risk factors for nosocomial CRAB acquisition by the multivariable regression analysis: Sharing a patient room with a CRAB patient before availability of the microbiological result was associated with a more than tenfold increase in the risk of nosocomial CRAB acquisition (OR: 10.7, CI: 2.3–50.9), while undergoing bronchoscopy increased the risk more than six times (OR: 6.9, CI: 1.3–38.1).

Conclusions

The risk factors identified, sharing a patient room with a CRAB patient and undergoing bronchoscopy, could point to an underperformance of basic infection control measure, particularly hand hygiene compliance and handling of medical devices. Both findings reinforce the need for continued promotion of infection control measures. Given that the outbreaks occurred in the first year of the COVID-19 pandemic, our study serves as a reminder that a heightened focus on airborne precautions should not lead to a neglect of other transmission-based precautions.
The risk prediction of intergenerational transmission of overweight and obesity between mothers and infants during pregnancy
Authors: Wei Xiaotong , Hu Jiajin , Wen Deliang
Published: January 2024

Background

Overweight and obesity in mothers before pregnancy lead to overweight and obesity in their offspring, which is the main form of intergenerational transmission of overweight and obesity in early life. Many factors, especially non-genetic factors, may influence intergenerational transmission, but little prediction research has been conducted. Therefore, we analyzed the status of intergenerational transmission in maternal and infant overweight and obesity. Second, we explored the factors during the pregnancy that might affect the the intergenerational transmission; According to the two application scenarios of pregnancy screen and self-management, risk prediction models for pregnant women were carried out.

Methods

Based on a prospective birth cohort, a total of 908 mothers and offspring were followed up during early life. Follow-up visits were performed at the first trimester, second trimester, third trimester, delivery, 42 days after delivery, and 6 months and 12 months of age. The investigation methods included questionnaire survey, physical examination, biological sample collection and clinical data collection. In terms of risk prediction, univariate analysis was used to screen candidate predictors. Second, multivariable Cox proportional hazard regression models were used to determine the final selected predictors. Third, the corresponding histogram models were drawn, and then the 10-fold cross-validation methods were used for internal verification.

Results

Regarding intergenerational transmission of overweight and obesity between mothers and infants during pregnancy, the risk prediction model for pregnancy screen was constructed. The model established: h(t|X) = h0(t)exp.(− 0.95 × (Bachelor Degree or above) + 0.75 × (Fasting blood glucose in the second trimester) + 0.89 × (Blood pressure in the third trimester) + 0.80 × (Cholesterol in third trimester) + 0.55 × (Abdominal circumference in third trimester))., with good discrimination (AUC = 0.82) and calibration (Hosmer–Lemeshow2 = 4.17). The risk prediction model for self-management was constructed. The model established: h(t|X) = h0(t)exp. (0.98 × (Sedentary >18METs) + 0.88 × (Sleep index≥8) + 0.81 × (Unhealthy eating patterns Q3/Q4) + 0.90 × (Unhealthy eating patterns Q4/Q4) + 0.85 × (Depression)), with good discrimination (AUC = 0.75) and calibration (Hosmer–Lemeshow2 = 3.81).

Conclusions

The risk predictions of intergenerational transmission of overweight and obesity between mothers and infants were performed for two populations and two application scenarios (pregnancy screening and home self-management). Further research needs to focus on infants and long-term risk prediction models.
Co-expression of IL-21-Enhanced NKG2D CAR-NK cell therapy for lung cancer
Authors: Zhang Yan , Zhang Cong , He Minghong , Xing Weipeng , Hou Rui , Zhang Haijin
Published: January 2024

Background

Adoptive cell therapy has achieved great success in treating hematological malignancies. However, the production of chimeric antigen receptor T (CAR-T) cell therapy still faces various difficulties. Natural killer (NK)-92 is a continuously expandable cell line and provides a promising alternative for patient’s own immune cells.

Methods

We established CAR-NK cells by co-expressing natural killer group 2 member D (NKG2D) and IL-21, and evaluated the efficacy of NKG2D-IL-21 CAR-NK cells in treating lung cancer in vitro and in vivo.

Results

Our data suggested that the expression of IL-21 effectively increased the cytotoxicity of NKG2D CAR-NK cells against lung cancer cells in a dose-dependent manner and suppressed tumor growth in vitro and in vivo. In addition, the proliferation of NKG2D-IL-21 CAR-NK cells were enhanced while the apoptosis and exhaustion of these cells were suppressed. Mechanistically, IL-21-mediated NKG2D CAR-NK cells function by activating AKT signaling pathway.

Conclusion

Our findings provide a novel option for treating lung cancer using NKG2D-IL-21 CAR-NK cell therapy.
Can neoadjuvant chemoradiotherapy before lateral pelvic lymph node dissection improve local control and prognosis in rectal cancer patients with clinically suspected lateral lymph node metastasis? A multicenter lateral node study in China
Authors: Xie Zhongshi , Chen Qichen , Feng Bo , Jiang Yujuan , Wang Xin , Xing Wei , Liu Qian ,   on behalf of the Chinese Lateral Node Collaborative Group
Published: January 2024

Aims

Selective lateral pelvic lymph node (LPN) dissection (LPND) following neoadjuvant chemoradiotherapy (nCRT) for rectal cancer is widely recognized. This study aimed to determine the effects of nCRT before LPND on local control and prognosis of rectal cancer patients.

Materials and methods

Data were retrieved from a prospective database for rectal cancer patients with clinical LPN metastasis receiving total mesorectal excision and LPND at three institutions between January 2012 and December 2019. Selection bias was minimized using propensity score matching (PSM) and short-term and clinical outcomes were compared.

Results

Patients (n = 213) were enrolled and grouped as either nCRT (n = 97) or non-nCRT (n = 116). PSM was used to identify 83 matched pairs. In the matched cohort, nCRT patients had a longer operation duration (310.6 vs. 265.0 min, P = 0.001), lower pathological LPN metastasis rate (32.5% vs. 48.2%, P = 0.040), and fewer harvested lymph nodes (22 vs. 25, P = 0.018) compared to the non-nCRT group. However, after PSM, the two groups had similar estimated overall 3-year survival (79.5% vs. 80.7%, P = 0.922), 3-year disease-free survival (66.1% vs. 65.5, P = 0.820), and 3-year local recurrence-free survival (88.6% vs. 89.7%, P = 0.927). Distant metastasis was the predominant recurrence pattern in the overall (45/58, 77.6%) and matched (33/44, 75.0%) cohorts.

Conclusions

LPND without nCRT is effective and sufficient in preventing local recurrence in patients with LPN metastases. Future prospective randomized controlled studies are warranted to confirm these findings. Since systemic metastasis is the predominant recurrence pattern in patients with LPN metastasis post-LPND, improved perioperative systemic chemotherapy is needed to prevent micrometastasis.
Undernutrition in young children with congenital heart disease undergoing cardiac surgery in a low-income environment
Authors: Robyn Smith , Veronica Ntsiea , Stephen Brown , Joanne Potterton
Published: January 2024

Background

Malnutrition (undernutrition) in children with congenital disease (CHD) is a notable concern, with preoperative and persistent growth failure post-cardiac surgery contributing to poorer outcomes. Poor growth in children with CHD in low-income environments is exacerbated by feeding difficulties, poverty, delayed diagnosis, and late corrective surgery. This study describes and compares the growth of young children with CHD undergoing cardiac surgery in central South Africa from before to 6-months after cardiac surgery.

Methods

Children 30 months and younger, with their mothers, were included in this prospective observational descriptive study. Weight- height-, and head circumference-for-age z-scores were used to identify children who were underweight, stunted and microcephalic. Z-scores for growth indices were compared from baseline to 3-months and 6-months post-cardiac surgery. Changes in growth over time were calculated using a 95% confidence interval on the difference between means. Linear regression was used to determine the association between growth and development, health-related quality of life and parenting stress respectively.

Results

Forty mother-child pairs were included at baseline. Most children (n = 30) had moderate disease severity, with eight children having cyanotic defects. A quarter of the children had Down syndrome (DS). Twenty-eight children underwent corrective cardiac surgery at a median age of 7.4 months. Most children (n = 27) were underweight before cardiac surgery [mean z-score − 2.5 (±1.5)], and many (n = 18) were stunted [mean z-score − 2.2 (±2.5)]. A quarter (n = 10) of the children had feeding difficulties. By 6-months post-cardiac surgery there were significant improvements in weight (p = 0.04) and head circumference (p = 0.02), but complete catch-up growth had not yet occurred. Malnutrition (undernutrition) was strongly associated (p = 0.04) with poorer motor development [Mean Bayley-III motor score 79.5 (±17.5)] before cardiac surgery. Growth in children with cyanotic and acyanotic defects, and those with and without DS were comparable.

Conclusion

Malnutrition (undernutrition) is common in children with CHD in central South Africa, a low-income environment, both before and after cardiac surgery, and is associated with poor motor development before cardiac surgery. A diagnosis of CHD warrants regular growth monitoring and assessment of feeding ability. Early referral for nutritional support and speech therapy will improve growth outcomes.
Teachers as first responders: classroom experiences and mental health training needs of Australian schoolteachers
Authors: Gunawardena Harshi , Leontini Rose , Nair Sham , Cross Shane , Hickie Ian
Published: January 2024

Background

Schoolteachers are often the first to respond when a student presents with a mental health issue in the classroom. This places a burden on schools that impacts school staff, healthcare workers and teachers. More broadly, it places a responsibility on the education system to address students’ mental health. This study examines Australian teachers’ classroom experiences and the training areas identified by teachers as necessary to manage these issues.

Method

Interviews were undertaken with 18 in-service teachers between 2020 and 2021 from Catholic, Independent and Public schools. Data were gathered via multiple interviews and analysed using thematic content analysis.

Results

The major mental health issues identified by teachers related to mental disorders, depression, anxiety, and a complex range of negative emotional states. Teachers requested training in child and adolescent mental health, counselling skills, early detection and intervention, and training skills to manage the complex relationship with parents and external health and community personnel. Teachers also reported the need to access mental health resources, support and training, which were differentially accessed along socioeconomic status and postcodes.

Conclusion

The data show that teachers are often placed as first responders when a student has a mental health issue but feel inadequately trained to manage these issues in the classroom. We identified mental health issues presenting in Australian classrooms and documented critical features of mental-health training asked for by teachers in order to address those issues. Given the increasing demands on teachers to address the mental health of children and adolescents, we argue that an urgent review of mental health training for teachers is needed.
Tuberculosis in Sudan: systematic review and meta analysis
Authors: Badawi M M , SalahEldin M A , Idris A B , Idris E B , Mohamed S G
Published: January 2024

Every year, 10 million people fall ill with tuberculosis (TB). Despite being a preventable and curable disease, 1.5 million people die from TB each year -making it the world’s top infectious disease. TB is the leading cause of death of people with HIV and also a major contributor to antimicrobial resistance. Its presumed that TB was the cause of 1% of the total deaths among inpatients in Sudan in 2017. The current study is aimed to provide pooled prevalence of Mycobacterium tuberculosis among Sudanese as well as to determine any socio-cultural risk factors associated. A systematic review of the literature was conducted and regulated in accordance with the PRISMA Statement. After abstract and full text screening only twenty-six articles met our inclusion criteria and passed the quality assessment procedure. Pulmonary tuberculosis prevalence was assessed in sixteen included studies among participants from Khartoum, Gezira, Kassala, Blue Nile, River Nile, White Nile, Gadarif, Red sea, North Kordofan, Northern State, Sennar and West Darfur States, representing a total sample size of 11,253 participants of suspected individuals such as febrile outpatients, TB patients’ contacts and other groups such as HIV/AIDS patients, hemodialysis patients, School adolescents as well as pregnant women. The pooled prevalence was 30.72% [CI: 30.64, 30.81]. Moreover, Khartoum State recorded the highest pooled prevalence as 41.86% [CI: 14.69, 69.02] based on a total sample size of 2,737 participants. Furthermore, male gender and rural residence were found to be significantly associated with TB infection. Further research with larger sample sizes targeting prevalence and risk factors of TB among Sudanese population is needed to be conducted.
Nursing students’ clinical practice education experience during the COVID-19 pandemic: a qualitative study
Authors: Kwon Soo Jin , Kim Yoonjung , Kwak Yeunhee
Published: January 2024

Background

Nursing education, including some elements of clinical practice, has largely been conducted online during the coronavirus disease 2019 (COVID-19) pandemic. Numerous studies have examined the experiences of nursing students in academia during the pandemic. However, research on nursing students’ clinical practice experiences is limited. This study aimed to analyze nursing students’ clinical practice experiences during the COVID-19 pandemic.

Methods

This study used a qualitative research design and performed thematic analysis. Participants comprised 13 nursing university students with clinical practice experience at a hospital during the COVID-19 pandemic. Interviews were conducted either online or face-to-face. Data were collected during June‒July 2021.

Results

Four themes and eight subthemes were generated through thematic analysis. Theme 1 was “Nursing students’ anxiety and strict adherence to quarantine practices,” with the subthemes of “Fear of infection” and “Protecting themselves.” Theme 2 was “Nursing students’ belief that their organization is protecting them,” with the subthemes of “Strict quarantine rules at hospitals and universities” and “The nursing students regretted the limited scope of practice but felt safe.” Theme 3 was “Learning through valuable practice,” with the subthemes of “Recognizing the importance of practice” and “Realizing the benefits of practice.” Theme 4 was “A sense of duty as a prospective nurse,” with the subthemes of “Accepting a sense of duty as a nurse” and “Establishing the expanded role of a nurse.”

Conclusions

The nursing students recognized the importance of nursing practice during the pandemic and worked harder. A better understanding of the experiences of nursing university students who completed their clinical practice during the COVID-19 pandemic can help nursing professors and managers more effectively train students during times of high stress.
Modelling the complex nature of the tumor microenvironment: 3D tumor spheroids as an evolving tool
Authors: Rodrigues Daniel B. , Reis Rui L. , Pirraco Rogério P.
Published: January 2024

Cancer remains a serious burden in society and while the pace in the development of novel and more effective therapeutics is increasing, testing platforms that faithfully mimic the tumor microenvironment are lacking. With a clear shift from animal models to more complex in vitro 3D systems, spheroids emerge as strong options in this regard. Years of development have allowed spheroid-based models to better reproduce the biomechanical cues that are observed in the tumor-associated extracellular matrix (ECM) and cellular interactions that occur in both a cell–cell and cell-ECM manner. Here, we summarize some of the key cellular interactions that drive tumor development, progression and invasion, and how successfully are these interactions recapitulated in 3D spheroid models currently in use in the field. We finish by speculating on future advancements in the field and on how these can shape the relevance of spherical 3D models for tumor modelling.
Dexamethasone exposure during pregnancy triggers metabolic syndrome in offspring via epigenetic alteration of IGF1
Authors: Xiao Hao , He Bo , Liu Heze , Chen Yawen , Xiao Di , Wang Hui
Published: January 2024

Background

Previous research has reported that prenatal exposure to dexamethasone (PDE) results in organ dysplasia and increased disease susceptibility in offspring. This study aimed to investigate the epigenetic mechanism of metabolic syndrome induced by PDE in offspring.

Methods

Pregnant Wistar rats were administered dexamethasone, and their offspring’s serum and liver tissues were analyzed. The hepatocyte differentiation model was established to unveil the molecular mechanism. Neonatal cord blood samples were collected to validate the phenomenon and mechanism.

Results

The findings demonstrated that PDE leads to insulin resistance and typical metabolic syndrome traits in adult offspring rats, which originated from fetal liver dysplasia. Additionally, PDE reduced serum corticosterone level and inhibited hepatic insulin-like growth factor 1 (IGF1) signaling in fetal rats. It further revealed that liver dysplasia and functional impairment induced by PDE persist after birth, driven by the continuous downregulation of serum corticosterone and hepatic IGF1 signaling. Both in vitro and in vivo experiments confirmed that low endogenous corticosterone reduces the histone 3 lysine 9 acetylation (H3K27ac) level of IGF1 and its expression by blocking glucocorticoid receptor α, special protein 1, and P300 into the nucleus, resulting in hepatocyte differentiation inhibition and liver dysplasia. Intriguingly, neonatal cord blood samples validated the link between reduced liver function in neonates induced by PDE and decreased serum cortisol and IGF1 levels.

Conclusions

This study demonstrated that low endogenous glucocorticoid level under PDE lead to liver dysplasia by downregulating the H3K27ac level of IGF1 and its expression, ultimately contributing to metabolic syndrome in adult offspring.
A systematic two-sample and bidirectional MR process highlights a unidirectional genetic causal effect of allergic diseases on COVID-19 infection/severity
Authors: Chen Xiao-tong , Zhi Shuai , Han Xin-yu , Jiang Jian-wei , Liu Guang-ming , Rao Shi-tao
Published: January 2024

Background

Allergic diseases (ADs) such as asthma are presumed risk factors for COVID-19 infection. However, recent observational studies suggest that the assumed correlation contradicts each other. We therefore systematically investigated the genetic causal correlations between various ADs and COVID-19 infection/severity.

Methods

We performed a two-sample, bidirectional Mendelian randomization (MR) study for five types of ADs and the latest round of COVID-19 GWAS meta-analysis datasets (critically ill, hospitalized, and infection cases). We also further validated the significant causal correlations and elucidated the potential underlying molecular mechanisms.

Results

With the most suitable MR method, asthma consistently demonstrated causal protective effects on critically ill and hospitalized COVID-19 cases (OR < 0.93, p < 2.01 × 10–2), which were further confirmed by another validated GWAS dataset (OR < 0.92, p < 4.22 × 10–3). In addition, our MR analyses also observed significant causal correlations of food allergies such as shrimp allergy with the risk of COVID-19 infection/severity. However, we did not find any significant causal effect of COVID-19 phenotypes on the risk of ADs. Regarding the underlying molecular mechanisms, not only multiple immune-related cells such as CD4+ T, CD8+ T and the ratio of CD4+/CD8+ T cells showed significant causal effects on COVID-19 phenotypes and various ADs, the hematology traits including monocytes were also significantly correlated with them. Conversely, various ADs such as asthma and shrimp allergy may be causally correlated with COVID-19 infection/severity by affecting multiple hematological traits and immune-related cells.

Conclusions

Our systematic and bidirectional MR analyses suggest a unidirectional causal effect of various ADs, particularly of asthma on COVID-19 infection/severity, but the reverse is not true. The potential underlying molecular mechanisms of the causal effects call for more attention to clinical monitoring of hematological cells/traits and may be beneficial in developing effective therapeutic strategies for allergic patients following infection with COVID-19.

Graphical Abstract
Attitude towards assisted reproductive technology: acceptance of donors eggs, sperms, and embryos as treatment of human infertility: a systematic review and meta-analysis
Authors: Demissei Dereje Bayissa , Biratu Tolesa Diriba , Gamshe Eriste Nigussa , Deressa Ababe Tamirat
Published: January 2024

Introduction

Assisted Reproductive Technology utilizes human sperm, eggs, or embryos in vitro to produce pregnancy. However, there is no evidence of the acceptance of these technologies by the community.

Objective

This study aimed to determine the pooled prevalence of positive attitudes toward the acceptance of donor eggs, embryos, and sperm.

Methods

The protocol was registered in PROSPERO (number: CRD42022348036). The Condition, Context and Population (CoCoPop) protocol of the systematic review was used to address the relevant questions regarding the objective of the study. Data were extracted into Excel and pooled estimates were calculated using STATA Version 16.

Results

The pooled prevalence of positive attitudes toward accepting donor eggs, embryos, and sperms was 38.63%, 33.20%, and 31.34%, respectively. Subgroup analysis revealed that the pooled prevalence of positive attitudes toward accepting donor eggs was high in non-Asian countries (47.78%) and among infertile men (38.60%). Similarly, the pooled prevalence of positive attitudes toward accepting donor eggs was high in non-Asian countries (47.78%) and among infertile men (28.67%). However, the pooled prevalence of positive attitudes toward accepting donor sperm was high in non-Asian countries (37.6%) and among infertile women (28.19%).

Conclusion

The pooled estimate of the prevalence of positive attitudes toward accepting donor eggs was higher than the prevalence of positive attitudes toward accepting donor embryos and sperm. Infertile men and non-Asian countries have a higher prevalence of positive attitudes toward accepting eggs and embryos, whereas non-Asian countries and infertile women present a higher prevalence of positive attitudes toward accepting donor sperm. Therefore, regulatory bodies and policymakers should modify their rules and regulations to ensure the availability of minimum standards for the ethical and safe practice of donor conception as a treatment for infertility at national and international levels.