bluuebunny/crossref_metadata_2025 huggingface dataset:
Women’s Intention to Abort a Fetus Diagnosed With a Genetic Disease: Results From Israel, Cyprus, and Germany
Authors: Kivity Sara , Barnoy Sivia
Published: July 2023

Developments in genetics enable detection of fetal genetic abnormalities. The decision whether to abort is affected by culture, perceived severity of abnormality, and legal regulations. The study aimed to assess the cultural differences in women’s intention to abort if their fetus is diagnosed with a genetic disease. A cross-sectional study was conducted in Israel, Germany, and Cyprus. A questionnaire presented six scenarios where the fetus of a pregnant woman is diagnosed with a mild, moderate, or severe genetic disease. For each scenario, the participating women were asked to rate their perceived severity of having a child with the disease, sense of control over performing an abortion, and intention to undergo an abortion. 141 Israeli, 121 German, and 96 Cypriot women participated in the study. The results revealed that Israeli women were more inclined to perform an abortion (Israel: Mild-Disease M ±  SD = 3.20 ± 1.37; Moderate-Disease 2.90 ± 1.39; Severe-Disease 4.08 ± 1.51) compared to Cyprus (Mild-Disease SD = 2.74 ± 1.52; Moderate-Disease 2.53 ± 1.27; Severe-Disease 3.41 ± 1.70) and Germany (Mild Disease, M ±  SD = 2.38 ± 1.42; Moderate Disease 2.23 ± 1.44; Severe-Disease 2.98 ± 1.51). In all cases, Israeli women reported a higher sense of control over performing an abortion and Cypriot women expressed the highest perceived severity. Sense of control, perceived severity, being Israeli, and increased age explained 31% of the variance in the intention to abort ( F = 54.39). Intention to abort following the diagnosis of a fetus with a genetic disease varies by country. There is a greater intention to abort when women feel more control, and have a higher perceived severity, regardless of the severity of the disease.
Relaxation Methods to Reduce Occupational Stress
Authors: Williams-Southers TaShana
Published: July 2023

Background:

Healthcare providers putting their patient’s health before their own has negative consequences. Utilizing evidence-based research, nurse leaders can implement practices to positively affect employee health. This project assessed the utilization of a workplace relaxation room to reduce occupational stress.

Method:

Multiple methods were used to recruit participants. Participants completed pre/post surveys (demographic, PSS-10, GallupQ12, and open-ended questions) via email. The relaxation room contained stress reducing items for staff to utilize while at work. Data was collected using Qualtrics Survey software.

Findings:

Data from the PSS-10 and GallupQ12 did not reveal statistically significant results. The participants responses to the open-ended questions did indicate a positive impact.

Conclusions/Application to Practice:

While the aims of the project were not met during the intervention, the open-ended responses indicated that for the employees who participated in the project, the intervention was a positive addition to the workplace.
Chinese women in society: Confucian past, ambiguous emancipation and access to higher education
Authors: Gromkowska-Melosik Agnieszka , Boron Aleksandra
Published: July 2023

The article aims to draw attention to educational inequalities concerning Chinese women. The text is dedicated to the following areas: Confucian conditions of social practices and beliefs, ambiguous emancipation in the post-imperial period, and contemporary problems of gender inequality in access to higher education.
Native BK Polyomavirus Nephropathy in an Orthotopic Heart Transplant Patient
Authors: Thompson Zachary M. , Ajene George , Kulkarni Prathit A. , Aggarwal Nidhi , Fedson Savitri , Shah Maulin K.
Published: July 2023

BK polyomavirus nephropathy (BKVN) is a common cause of nephropathy in kidney transplant patients and is typically seen within the first year after transplantation. BK polyomavirus nephropathy can occur in the native kidneys of patients with nonrenal solid-organ transplants (NRSOT). However, this is rare, especially outside the early post-transplant period, and BKVN is not usually considered in the differential diagnosis for acute kidney injury in NRSOT patients. We present a case of a 75-year-old man who had undergone orthotopic heart transplant 13 years prior with stable allograft function who developed progressive renal dysfunction in the setting of recent unilateral obstructive nephrolithiasis requiring ureteral stenting. Kidney biopsy demonstrated evidence of polyomavirus nephritis. Serum BK viral load was elevated. Despite reducing immunosuppression and initiating leflunomide, viral clearance was never achieved. The patient experienced progressive failure to thrive before ultimately transitioning to hospice care and dying. The intensity of immunosuppression is a well-known risk factor for viral replication; ureteral stenting has also been associated with BKVN. However, since clinical manifestations of BK viral infections often include a genitourinary (GU) tract pathology, it is important for clinicians to consider BKVN in patients with NRSOT with progressive renal dysfunction, especially in the clinical context of known GU disease.
Caring for Dementia Caregivers: Understanding Caregiver Stress During the COVID-19 Pandemic
Authors: Lancashire Lee , Biggar Virginia , Comer Meryl , Frangiosa Terry , Gage Allyson , Paulsen Russ , Roniger Amber , Wolfe Jessica
Published: July 2023

More than 16 million Americans provide unpaid care for someone with Alzheimer’s disease and related dementias (ADRD). During the COVID-19 pandemic, unpaid caregivers experienced increased chronic severe stress from widespread closures and social distancing. We conducted eight surveys from March 2020 to March 2021 among a cohort of over 10,000 individuals. Cross-sectional analysis was conducted to investigate frequency and ratios of groups reporting increased stress across surveys. A longitudinal analysis was also performed with the 1,030 participants who took more than one survey. We found a growing crisis among dementia caregivers: By Survey 8, current caregivers reported 2.9 times higher stress levels than the comparator group. By that time, 64% of current caregivers reported having multiple stress symptoms typically found in people experiencing severe stress. Both analyses reported increased levels of stressors over time that were more associated with certain caregiver groups. Our findings underscore the urgent need for public policy initiatives and supportive community infrastructure to support ADRD caregivers.
Authentic Leadership and Its Role in Registered Nurses’ Mental Health and Experiences of Workplace Bullying
Authors: Al-Hassan Nadira Salman , Rayan Ahmad Hussien , Baqeas Manal Hassan , Hamaideh Shaher H. , Khrais Huthaifah
Published: July 2023

Introduction

Bullying is a widespread problem in healthcare organizations, resulting in nurses’ poor mental health. Effective leadership, such as authentic leadership, may help to overcome this problem.

Objective

To examine the relationship between authentic leadership, workplace bullying, and nurses’ mental health, controlling for demographic characteristics.

Methods

A descriptive correlational design was utilized with a sample of 170 nurses. Nurses were recruited from four private hospitals in Jordan and completed a survey about their perception of managers’ authentic leadership, their experience of workplace bullying, and their mental health.

Results

About 48.8%, 25.9%, and 25.3% were categorized as “not bullied,” “occasionally bullied,” and “severely bullied,” respectively. Participant nurses had mild depression ( m = 12.11) and moderate anxiety ( m = 10.92). Workplace bullying was higher among nurses who earn less than 600 Jordanian dinars and nurses working in the smallest hospital, with 130 beds. Authentic leadership explains 6% of the variance of workplace bullying, 3% of anxiety, 7% of stress, and 7% of depression above and beyond the variance explained by other variables.

Conclusions

Healthcare organizations are facing a challenge in providing a healthy work environment. Employing authentic leadership in the workplace could be one of the factors that could help in addressing this issue.
Student Employment Models for Undergraduate Nurses and Midwives in Australia: A Scoping Review
Authors: Lindsay David J. , Ahern Tracey A. , Pardon Madelyn K. , McAuliffe Marie T. , Rannard Sam G.
Published: July 2023

Introduction

Evidence has shown that throughout their undergraduate years, many nursing and midwifery students obtain paid employment in a wide variety of clinical and non-clinical positions. Across Australia, inconsistencies exist in the models of clinical employment available to these student groups. Previous Australian studies have described the employment of undergraduate nursing and midwifery students in regulated and unregulated clinical roles. No studies have reported on the various regulated roles available to both student nurses and midwives in Australia. The purpose of this scoping review is to identify and synthesize evidence related to nursing and/or midwifery students employed in regulated and unregulated clinical roles in Australia.

Methods

This scoping review utilized published recommendations for data screening, abstraction, and synthesis. One of the authors, a librarian, undertook systematic searches in CINAHL Complete (1937–present), Emcare on Ovid (1995–present), Scopus (1969–present), and Ovid MEDLINE(R) (including Epub Ahead of Print, In-Process, and In-Data-Review & Other Non-Indexed Citations, 1946–present). The initial searches were completed in April 2019 and repeated in March 2021 and May 2022 to identify any new literature. Manual searching of reference lists in the included papers was also undertaken, together with selected organizational websites. The extracted data included the lead author, date, title, study design, study sample and location, and key findings.

Results

From the 53 items retrieved, 23 peer-reviewed studies met the inclusion criteria and were included in the review. All items were published between 2011 and 2022. Only four of the studies focused upon student midwives. Undergraduate nursing and midwifery students in Australia obtain paid employment in a variety of regulated and unregulated clinical roles.

Conclusion

The literature reported here demonstrates that there are differing models, nomenclature, educational requirements, and pay scales in place for student employment in clinical roles across Australian states and territories.
Family Nurse Practitioner Students’ Readiness for Board Certification Utilizing a Full Board Review Course and Simulation
Authors: Wolf Lindsay , Buschini Laurie , Logsdon Roberta
Published: July 2023

Background

The aim of this project was to determine if the implementation of a three-tiered model consisting of a full board review course, round table case analysis, and on call scenarios in the final clinical course of the Family Nurse Practitioner Doctor of Nursing Practice program improved readiness for board certification testing for graduating students.

Methods

An anonymous pre- and post-survey design was utilized. Institutional Review Board (IRB) approval was obtained prior to implementation. A full board review course, including a predictor exit exam component, was utilized in this cohort's final clinical course. Additionally, in-class case review and “on-call” scenarios were facilitated by the faculty to simulate critical decision-making scenarios. A 58% survey response rate was elicited. Prior to the full board review, 16% of respondents felt ready to answer general board-style questions as compared to 100% following the review. Thirty three percent of respondents felt ready to prescribe and provide evidence-based care prior to the project, following the project, 100% of respondents felt ready. Open-ended questions revealed positive feedback for the course and simulated scenarios, however students did feel overwhelmed by the amount of work the course entailed over the course the semester.

Conclusions

Quantitative and Qualitative results indicated positive outcomes and provide support for adoption of the full board review, case-based simulation, and on-call scenarios for all practicum courses at the university. Adjustment of the time requirement and expectations should be reviewed prior to further implementation. In addition, limitations included a small cohort of students in this study; additional studies should be implemented before generalization can occur.
Struggling for Life and Livelihood: Tribal Household’s Economic Activities in the Rarh Region of West Bengal, India
Authors: Satpati Sandip , Sharma Kaushal Kumar
Published: July 2023

Studies on economic activity at the household level to understand the tribal economy today that are based on primary data are limited. This article’s aim is to look into the household economic activities of tribal people in West Bengal’s Rarh region. Most of the source materials were collected from primary surveys. A single base map was compiled and made from a secondary source. By means of a well-structured questionnaire, the primary information is collected. Totally, 150 households located in four regions were surveyed. Around 28 villages and a total of 17 Community Development (CD) blocks have been included in 150 tribal household sample surveys. The size of the landholding (large, medium and small) has been addressed during respondent selection. A stratified purposive random sampling procedure is adopted to achieve the goals and objectives of the research. The study reveals that in regions with high degrees of livelihood resources, household economic activity is strong overall and gradually deteriorates towards regions with very low levels of livelihood resources. Distance migration is a common event in areas with little or no resources for a living. Increasing infrastructure is essential to increasing both farm and non-farm income sources. To help impoverished families diversify their sources of income, agricultural and forest-based industrial units should be promoted, and required skill development initiatives should be put in place.
Lipoma of the Teres Minor in Rotator Cuff Arthropathy—A Case Report
Authors: Vargas Lara Rodrigo , Serrano Rafael , Chaves Carlos , Perez Oriana
Published: July 2023

Although lipomas are the most common mesenchymal tumors, the intramuscular type is rare. We report the case of a patient with rotator cuff arthropathy with a lipoma in the teres minor. Wide surgical excision and total shoulder arthroplasty with reverse prosthesis was performed and 18 months of follow up showed excellent results with any recurrence. The teres minor is extremely important for the proper function of a reverse prosthesis, and lipoma growth in the muscular belly can compromise the functionality of the prosthesis. To the best of our knowledge, this is the first case report of a rotator cuff arthropathy with a lipoma in the teres minor.
School and Intrapersonal Predictors and Stability of Rural Special Education Teacher Burnout
Authors: Ruble Lisa , McGrew John , Fischer Melanie , Findley Jordan , Stayton Rebecca
Published: July 2023

Special education teacher attrition is a significant and chronic problem that has worsened since the pandemic. A longitudinal survey of burnout was conducted with rural special education teachers ( N = 48) over four timepoints through the school year just prior to COVID-19. Both school and intrapersonal predictors of burnout obtained at the beginning of the school year were used to predict burnout at the end of the school year. Findings revealed that burnout is highly stable over the course of the school year. Furthermore, the strongest predictors of burnout at the end of the school year were baseline scores of burnout. Only one school factor—excessive work demands—and several teacher intrapersonal variables—coping, social support, and mindfulness skills—predicted at least one indicator of burnout. In a regression analysis, the baseline scores of each of the different domains of burnout (emotional exhaustion, depersonalization, personal accomplishment) accounted for the most variance in burnout reported at the end of the school year, except for passive avoidance. Passive avoidance accounted for unique variance with depersonalization. These findings suggest that burnout is stable and help identify teacher intrapersonal or school factors that might be useful targets for prevention or intervention research related to burnout.
Circulating microbial cell–free DNA is increased during neutropenia after hematopoietic stem cell transplantation
Authors: Blair Lily M. , Akhund-Zade Jamilla , Katsamakis Zoe A. , Smibert Olivia C. , Wolfe Alex E. , Giardina Paul , Slingerland John , Bercovici Sivan , Perales Miguel-Angel , Taur Ying , van den Brink Marcel R. M. , Peled Jonathan U. , Markey Kate A.
Published: July 2023

We used a next-generation sequencing platform to characterize microbial cell–free DNA (mcfDNA) in plasma samples from patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HCT). In this observational study, we sought to characterize plasma mcfDNA in order to explore its potential association with the immunologic complications of transplantation. We compared serially collected patient samples with plasma collected from healthy control subjects. We observed changes in total mcfDNA burden in the plasma after transplantation, which was most striking during the early posttransplant neutropenic phase. This elevation could be attributed to a number of specific bacterial taxa, including Veillonella, Bacteroides, and Prevotella (genus level). For an additional cohort of patients, we compared the data of mcfDNA from plasma with 16s-ribosomal RNA sequencing data from stool samples collected at matched time points. In a number of patients, we confirmed that mcfDNA derived from specific microbial taxa (eg, Enterococcus) could also be observed in the matched stool sample. Quantification of mcfDNA may generate novel insights into mechanisms by which the intestinal microbiome influences systemic cell populations and, thus, has been associated with outcomes for patients with cancer.
Polygenic risk of major depressive disorder as a risk factor for venous thromboembolism
Authors: Ward Joey , Le Ngoc-Quynh , Suryakant Suryakant , Brody Jennifer A. , Amouyel Philippe , Boland Anne , Bown Rosemary , Cullen Breda , Debette Stéphanie , Deleuze Jean-François , Emmerich Joseph , Graham Nicholas , Germain Marine , Anderson Jana J. , Pell Jill P. , Lyall Donald M. , Lyall Laura M. , Smith Daniel J. , Wiggins Kerri L. , Soria José Manuel , Souto Juan Carlos , Morange Pierre-Emmanuel , Smith Nicholas L. , Trégouët David-Alexandre , Sabater-Lleal Maria , Strawbridge Rona J.
Published: July 2023

Major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia (SCZ) are associated with an increased risk of cardiovascular diseases, including venous thromboembolism (VTE). The reasons for this are complex and include obesity, smoking, and use of hormones and psychotropic medications. Genetic studies have increasingly provided evidence of the shared genetic risk of psychiatric and cardiometabolic illnesses. This study aimed to determine whether a genetic predisposition to MDD, BD, or SCZ is associated with an increased risk of VTE. Genetic correlations using the largest genome-wide genetic meta-analyses summary statistics for MDD, BD, and SCZ (Psychiatric Genetics Consortium) and a recent genome-wide genetic meta-analysis of VTE (INVENT Consortium) demonstrated a positive association between VTE and MDD but not BD or SCZ. The same summary statistics were used to construct polygenic risk scores for MDD, BD, and SCZ in UK Biobank participants of self-reported White British ancestry. These were assessed for impact on self-reported VTE risk (10 786 cases, 285 124 controls), using logistic regression, in sex-specific and sex-combined analyses. We identified significant positive associations between polygenic risk for MDD and the risk of VTE in men, women, and sex-combined analyses, independent of the known risk factors. Secondary analyses demonstrated that this association was not driven by those with lifetime experience of mental illness. Meta-analyses of individual data from 6 additional independent cohorts replicated the sex-combined association. This report provides evidence for shared biological mechanisms leading to MDD and VTE and suggests that, in the absence of genetic data, a family history of MDD might be considered when assessing the risk of VTE.
Tanshinone I specifically suppresses NLRP3 inflammasome activation by disrupting the association of NLRP3 and ASC
Authors: Zhao Jia , Liu Hongbin , Hong Zhixian , Luo Wei , Mu Wenqing , Hou Xiaorong , Xu Guang , Fang Zhie , Ren Lutong , Liu Tingting , Wen Jincai , Shi Wei , Wei Ziying , Yang Yongping , Zou Wenjun , Zhao Jun , Xiao Xiaohe , Bai Zhaofang , Zhan Xiaoyan
Published: July 2023

Background

Abnormal activation of NLRP3 inflammasome is related to a series of inflammatory diseases, including type 2 diabetes, gouty arthritis, non-alcoholic steatohepatitis (NASH), and neurodegenerative disorders. Therefore, targeting NLRP3 inflammasome is regarded as a potential therapeutic strategy for many inflammatory diseases. A growing number of studies have identified tanshinone I (Tan I) as a potential anti-inflammatory agent because of its good anti-inflammatory activity. However, its specific anti-inflammatory mechanism and direct target are unclear and need further study.

Methods

IL-1β and caspase-1 were detected by immunoblotting and ELISA, and mtROS levels were measured by flow cytometry. Immunoprecipitation was used to explore the interaction between NLRP3, NEK7 and ASC. In a mouse model of LPS-induced septic shock, IL-1β levels in peritoneal lavage fluid and serum were measured by ELISA. Liver inflammation and fibrosis in the NASH model were analyzed by HE staining and immunohistochemistry.

Results

Tan I inhibited the activation of NLRP3 inflammasome in macrophages, but had no effect on the activation of AIM2 or NLRC4 inflammasome. Mechanistically, Tan I inhibited NLRP3 inflammasome assembly and activation by targeting NLRP3-ASC interaction. Furthermore, Tan I exhibited protective effects in mouse models of NLRP3 inflammasome-mediated diseases, including septic shock and NASH.

Conclusions

Tan I specifically suppresses NLRP3 inflammasome activation by disrupting the association of NLRP3 and ASC, and exhibits protective effects in mouse models of LPS-induced septic shock and NASH. These findings suggest that Tan I is a specific NLRP3 inhibitor and may be a promising candidate for treating NLRP3 inflammasome-related diseases.

Graphical Abstract
NNAT is a novel mediator of oxidative stress that suppresses ER + breast cancer
Authors: Plasterer Cody , Semenikhina Marharyta , Tsaih Shirng-Wern , Flister Michael J , Palygin Oleg
Published: July 2023

Background

Neuronatin (NNAT) was recently identified as a novel mediator of estrogen receptor-positive (ER+) breast cancer cell proliferation and migration, which correlated with decreased tumorigenic potential and prolonged patient survival. However, despite these observations, the molecular and pathophysiological role(s) of NNAT in ER + breast cancer remains unclear. Based on high protein homology with phospholamban, we hypothesized that NNAT mediates the homeostasis of intracellular calcium [Ca2+]i levels and endoplasmic reticulum (EndoR) function, which is frequently disrupted in ER + breast cancer and other malignancies.

Methods

To evaluate the role of NNAT on [Ca2+]i homeostasis, we used a combination of bioinformatics, gene expression and promoter activity assays, CRISPR gene manipulation, pharmacological tools and confocal imaging to characterize the association between ROS, NNAT and calcium signaling.

Results

Our data indicate that NNAT localizes predominantly to EndoR and lysosome, and genetic manipulation of NNAT levels demonstrated that NNAT modulates [Ca2+]i influx and maintains Ca2+ homeostasis. Pharmacological inhibition of calcium channels revealed that NNAT regulates [Ca2+]i levels in breast cancer cells through the interaction with ORAI but not the TRPC signaling cascade. Furthermore, NNAT is transcriptionally regulated by NRF1, PPARα, and PPARγ and is strongly upregulated by oxidative stress via the ROS and PPAR signaling cascades.

Conclusion

Collectively, these data suggest that NNAT expression is mediated by oxidative stress and acts as a regulator of Ca2+ homeostasis to impact ER + breast cancer proliferation, thus providing a molecular link between the longstanding observation that is accumulating ROS and altered Ca2+ signaling are key oncogenic drivers of cancer.
Single-cell RNA sequencing for the study of kidney disease
Authors: Zhu Jiayi , Lu Jinrong , Weng Huachun
Published: July 2023

The kidney is an important organ for maintaining normal metabolism and stabilising the internal environment, in which, the heterogeneity of cell types has hindered the progress in understanding the mechanisms underlying kidney disease. In recent years the application of single-cell RNA sequencing (scRNA-seq) in nephrology has developed rapidly. In this review, we summarized the technical platform related to scRNA-seq and the role of this technology in investigating the onset and development of kidney diseases, starting from several common kidney diseases (mainly including lupus nephritis, renal cell carcinoma, diabetic nephropathy and acute kidney injury), and provide a reference for the application of scRNA-seq in the study of kidney disease diagnosis, treatment and prognosis.
Associations and gastrointestinal symptoms in women with endometriosis in comparison to women with irritable bowel syndrome: a study based on a population cohort
Authors: Junkka Sofie Stark , Ohlsson Bodil
Published: July 2023

Background

Endometriosis and irritable bowel syndrome (IBS) have similar symptoms, pathogenesis, and risk factors. These diagnoses often coexist and are frequently misdiagnosed leading to diagnostic delays. This study of a population-based cohort aimed to investigate associations relating to endometriosis and IBS and to compare gastrointestinal symptoms between endometriosis and IBS.

Method

The study cohort included women from the Malmö Offspring Study with information about endometriosis and IBS diagnoses from the National Board of Health and Welfare. The participants answered a questionnaire about lifestyle habits, medical and drug history, and self-reported IBS. The visual analog scale for IBS was used to estimate gastrointestinal symptoms the past 2 weeks. Endometriosis diagnosis and self-reported IBS were used as dependent variables to study associations with age, body mass index (BMI), education, occupation, marital status, smoking, alcohol habits, and physical activity using logistic regression. Mann-Whitney U Test or Kruskal-Wallis tests were used to calculate the differences in symptoms between groups.

Results

Of the 2,200 women with information from medical records, 72 participants had endometriosis; 21 (29.2%) of these had self-reported IBS. Of the 1,915 participants who had answered the questionnaire, 436 (22.8%) had self-reported IBS. Endometriosis was associated with IBS (OR:1.86; 95%CI:1.06–3.26; p = 0.029), as well as with age 50–59 years (OR:6.92; 95%CI:1.97–24.32; p = 0.003), age ≥ 60 years (OR:6.27; 95%CI:1.56–25.17; p = 0.010), sick leave (OR:2.43; 95%CI:1.08–5.48; p = 0.033), and former smoking (OR:3.02; 95%CI:1.19–7.68; p = 0.020). There was an inverse association with BMI (OR:0.36; 95%CI:0.14–4.91; p = 0.031). IBS was associated with endometriosis (OR:1.77; 95%CI:1.02–3.07; p = 0.041) and sick leave (OR:1.77; 95%CI:1.14–2.73; p = 0.010), with a tendency to association with smoking (OR:1.30; 95%CI:0.98–1.72; p = 0.071). When excluding participants using drugs associated with IBS, the condition was associated with current smoking (OR:1.39; 95%CI:1.03–1.89; p = 0.033) and inversely with age 50–59 years (OR:0.58; 95%CI:0.38–0.90; p = 0.015). There were differences in the gastrointestinal symptoms between IBS and healthy participants, but not between endometriosis and IBS or healthy participants.

Conclusion

There were associations between endometriosis and IBS, without differences in gastrointestinal symptoms. Both IBS and endometriosis were associated with smoking and sick leave. Whether the associations reflect causality or depend on common risk factors and pathogenesis remains to be determined.
Optimized screening of DNA methylation sites combined with gene expression analysis to identify diagnostic markers of colorectal cancer
Authors: Ye Zhen , Song Guangle , Liang Jianwei , Yi Shuying , Gao Yuqi , Jiang Hanming
Published: July 2023

Background

The prognosis of patients with colorectal cancer is related to early detection. However, commonly used screening markers lack sensitivity and specificity. In this study, we identified diagnostic methylation sites for colorectal cancer.

Methods

After screening the colorectal cancer methylation dataset, diagnostic sites were identified via survival analysis, difference analysis, and ridge regression dimensionality reduction. The correlation between the selected methylation sites and the estimation of immune cell infiltration was analyzed. The accuracy of the diagnosis was verified using different datasets and the 10-fold crossover method.

Results

According to Gene Ontology, the main enrichment pathways of genes with hypermethylation sites are axon development, axonogenesis, and pattern specification processes. However, the Kyoto Encyclopedia of Genes and Genomes (KEGG) suggests the following main enrichment pathways: neuroactive ligand–receptor interaction, calcium signaling, and cAMP signaling. In The Cancer Genome Atlas (TCGA) and GSE131013 datasets, the area under the curve of cg07628404 was > 0.95. For the NaiveBayes machine model of cg02604524, cg07628404, and cg27364741, the accuracies of 10-fold cross-validation in the GSE131013 and TCGA datasets were 95% and 99.4%, respectively. The survival prognosis of the hypomethylated group (cg02604524, cg07628404, and cg27364741) was better than that of the hypermethylated group. The mutation risk did not differ between the hypermethylated and hypomethylated groups. The correlation coefficient between the three loci and CD4 central memory T cells, hematological stem cells, and other immune cells was not high (p < 0.05).

Conclusion

In cases of colorectal cancer, the main enrichment pathway of genes with hypermethylated sites was axon and nerve development. In the biopsy tissues, the hypermethylation sites were diagnostic for colorectal cancer, and the NaiveBayes machine model of the three loci showed good diagnostic performance. Site (cg02604524, cg07628404, and cg27364741) hypermethylation predicts poor survival for colorectal cancer. Three methylation sites were weakly correlated with individual immune cell infiltration. Hypermethylation sites may be a useful repository for diagnosing colorectal cancer.
RETRACTED ARTICLE: Upregulation of
hsa_circ_0002003 promotes hepatocellular carcinoma progression
Authors: Zhou Lisha , Wang Qianwen , Hou Jun , Wu Xiangwei , Wang Lianghai , Chen Xueling
Published: July 2023

Background

Circular RNAs (circRNAs), which are involved in various human
malignancies, have emerged as promising biomarkers. The present study aimed to
investigate unique expression profiles of circRNAs in hepatocellular carcinoma
(HCC) and identify novel biomarkers associated with HCC development and
progression.

Methods

CircRNA expression profiles of HCC tissues were jointly analyzed to
identify differentially expressed circRNAs. Overexpression plasmid and siRNA
targeting candidate circRNAs were used in functional assays in vitro.
CircRNA-miRNA interactions were predicted using miRNAs expressed in the
miRNA-seq dataset GSE76903. To further screen downstream genes targeted by the
miRNAs, survival analysis and qRT-PCR were conducted to evaluate their
prognostic role in HCC and construct a ceRNA regulatory network.

Results

Three significantly upregulated circRNAs, hsa_circ_0002003,
hsa_circ_0002454, and hsa_circ_0001394, and one significantly downregulated
circRNA, hsa_circ_0003239, were identified and validated by qRT-PCR. Our in
vitro data indicated that upregulation of hsa_circ_0002003 accelerated cell
growth and metastasis. Mechanistically, DTYMK, DAP3, and STMN1, which were targeted by hsa-miR-1343-3p, were
significantly downregulated in HCC cells when hsa_circ_0002003 was silenced and
were significantly correlated with poor prognosis in patients with HCC.

Conclusion

Hsa_circ_0002003 may play critical roles in HCC pathogenesis and
serve as a potential prognostic biomarker for HCC. Targeting the
hsa_circ_0002003/hsa-miR-1343-3p/STMN1 regulatory axis could be an effective
therapeutic strategy in patients with HCC.
The role of heavy metals in the development of colorectal cancer
Authors: Li Yongsheng , Lou Jingwei , Hong Shaozhong , Hou Dengfeng , Lv Yandong , Guo Zhiqiang , Wang Kai , Xu Yue , Zhai Yufeng , Liu Hongzhou
Published: July 2023

Objective

To investigate the relationship among 18 heavy metals, microsatellite instability (MSI) status, ERCC1, XRCC1 (rs25487), BRAF V600E and 5 tumor markers and their role in the development of colorectal cancer (CRC).

Methods

A total of 101 CRC patients and 60 healthy controls were recruited in the present study. The levels of 18 heavy metals were measured by ICP-MS. MSI status and the genetic polymorphism were determined by PCR (FP205-02, Tiangen Biochemical Technology Co., Ltd., Beijing, China) and Sanger sequencing. Spearman’s rank correlation was used to analyze the relationship among various factors.

Results

The level of selenium (Se) was lower in the CRC group compared with the control group (p < 0.01), while vanadium (V), arsenic (As), tin (Sn), barium (Ba) and lead (Pb) were higher (p < 0.05), chromium (Cr) and copper (Cu) were significantly higher (p < 0.0001) in the CRC group than those in the control group. Multivariate logistic regression analysis indicated that Cr, Cu, As and Ba were the risk factors for CRC. In addition, CRC was positively correlated with V, Cr, Cu, As, Sn, Ba and Pb, but negatively correlated with Se. MSI was positively correlated with BRAF V600E, but negatively correlated with ERCC1. BRAF V600E was positively correlated with antimony (Sb), thallium (Tl), CA19-9, NSE, AFP and CK19. XRCC1 (rs25487) was found to be positively correlated with Se but negatively correlated with Co. The levels of Sb and Tl were significantly higher in the BRAF V600E positive group compared to the negative group. The mRNA expression level of ERCC1 was significantly higher (P = 0.035) in MSS compared to MSI. And there was a significant correlation between XRCC1 (rs25487) polymorphism and MSI status (P<0.05).

Conclusion

The results showed that low level of Se and high levels of V, As, Sn, Ba, Pb, Cr, and Cu increased the risk of CRC. Sb and Tl may cause BRAF V600E mutations, leading to MSI. XRCC1 (rs25487) was positively correlated with Se but negatively correlated with Co. The expression of ERCC1 may be related to MSS, while the XRCC1 (rs25487) polymorphism is related to MSI.
Unhealthy lifestyles and clusters status among 3637 adolescents aged 11–23 years: a school-based cross-sectional study in China
Authors: Song Yalin , Liu Jingru , Zhao Yize , Gong Lu , Chen Qiuyuan , Jiang Xili , Zhang Jiangtao , Hao Yudan , Zhou Huijun , Lou Xiaomin , Wang Xian
Published: July 2023

Background

Unhealthy lifestyles are risk factors for non-communicable diseases (NCDs) and tend to be clustered, with a trajectory that extends from adolescence to adulthood. This study investigated the association of diets, tobacco, alcohol, physical activity (PA), screen time (ST) and sleep duration (SD) in a total of six lifestyles, separately and as cumulative lifestyle scores, with sociodemographic characteristics among school-aged adolescents in the Chinese city of Zhengzhou.

Methods

In the aggregate, 3,637 adolescents aged 11–23 years were included in the study. The questionnaire collected data on socio-demographic characteristics and lifestyles. Healthy and unhealthy lifestyles were identified and scored, depending on the individual score (0 and 1 for healthy and unhealthy lifestyles respectively), with a total score between 0 and 6. Based on the sum of the dichotomous scores, the number of unhealthy lifestyles was calculated and divided into three clusters (0–1, 2–3, 4–6). Chi-square test was used to analyze the group difference of lifestyles and demographic characteristics, and multivariate logistic regression was used to explore the associations between demographic characteristics and the clustering status of unhealthy lifestyles.

Results

Among all participants, the prevalence of unhealthy lifestyles was: 86.4% for diet, 14.5% for alcohol, 6.0% for tobacco, 72.2% for PA, 42.3% for ST and 63.9% for SD. Students who were in university, female, lived in country (OR = 1.725, 95% CI: 1.241–2.398), had low number of close friends (1–2: OR = 2.110, 95% CI: 1.428–3.117; 3–5: OR = 1.601, 95% CI: 1.168–2.195), and had moderate family income (OR = 1.771, 95% CI: 1.208–2.596) were more likely to develop unhealthy lifestyles. In total, unhealthy lifestyles remain highly prevalent among Chinese adolescents.

Conclusion

In the future, the establishment of an effective public health policy may improve the lifestyle profile of adolescents. Based on the lifestyle characteristics of different populations reported in our findings, lifestyle optimization can be more efficiently integrated into the daily lives of adolescents. Moreover, it is essential to conduct well-designed prospective studies on adolescents.
Association between night shift work and NAFLD: a prospective analysis of 281,280 UK Biobank participants
Authors: Huang Hangkai , Liu Zhening , Xie Jiarong , Xu Chengfu
Published: July 2023

Context

This study aimed to investigate the association between night shift work and the risk of nonalcoholic fatty liver disease (NAFLD).

Methods

We conducted a prospective analysis of 281,280 UK Biobank participants. Cox proportional hazards models were used to estimate the association of night shift work with incident NAFLD. Polygenic risk score analyses were performed to assess whether a genetic predisposition to NAFLD modified the association.

Results

During a median follow-up of 12.1 years (3,373,964 person-years), 2,555 incident NAFLD cases were identified. Compared with workers who never/rarely worked night shifts, those who worked some night shifts or usual/permanent night shifts were 1.12 (95% CI: 0.96–1.31) and 1.27 (95% CI: 1.08–1.48) times more likely to develop NAFLD, respectively. Among the 75,059 participants who had reports on lifetime experience of night shift work, those with a longer duration, a higher frequency, more consecutive night shifts and a longer length per shift all showed higher risks of incident NAFLD. Further analyses showed that the association between night shift work and incident NAFLD was not modified by a genetic predisposition to NAFLD.

Conclusions

Night shift work was associated with increased risks of incident NAFLD.
Roles of hypoxic environment and M2 macrophage-derived extracellular vesicles on the progression of non-small cell lung cancer
Authors: Chu Xiao , Wang Zetian , Wang Weiqing , Liu Wenjing , Cao Yunyun , Feng Liang
Published: July 2023

Background

Hypoxia contributes to the development of invasive and metastatic cancer cells, and is detrimental to cancer treatment. This study aimed to explore the molecular mechanisms by which hypoxic microenvironments affect hypoxic non-small cell lung cancer (NSCLC) development and the effects of M2 macrophage-derived extracellular vesicles (EVs) on NSCLC cells.

Methods

A549 cells were cultured in an anoxic incubator for 48 h to construct hypoxic A549 cells, and then normal and hypoxic A549 cells were harvested for RNA sequencing. Next, THP-1 cells were used to induce M2 macrophages, and EVs were isolated from THP-1 cells and M2 macrophages. Cell counting kit-8 and transwell assays were used to determine the viability and migration of hypoxic A549 cells, respectively.

Results

After sequencing, 2426 DElncRNAs and 501 DEmiRNAs were identified in normal A549 cells and hypoxic A549 cells. These DElncRNAs and DEmiRNAs were significantly enriched in “Wnt signaling pathway,” “Hippo signaling pathway,” “Rap1 signaling pathway,” “calcium signaling pathway,” “mTOR signaling pathway,” and “TNF signaling pathway.” Subsequently, ceRNA networks consisting of 4 lncRNA NDRG1 transcripts, 16 miRNAs and 221 target mRNAs were built, and the genes in the ceRNA networks were significantly associated with “Hippo signaling pathway” and “HIF-1 signaling pathway.” EVs were successfully extracted from THP-1 cells and M2 macrophages, and M2 macrophage-derived EVs significantly enhanced the viability and migration of hypoxic A549 cells. Finally, M2 macrophage-derived EVs further upregulated the expression of NDRG1-009, NDRG1-006, VEGFA, and EGLN3, while downregulating miR-34c-5p, miR-346, and miR-205-5p in hypoxic A549 cells.

Conclusions

M2 macrophage-derived EVs may worsen the progression of NSCLC in a hypoxic microenvironment by regulating the NDRG1-009-miR-34c-5p-VEGFA, NDRG1-006-miR-346-EGLN3, NDRG1-009-miR-205-5p-VEGFA, and Hippo/HIF-1 signaling pathways.
Epicardial adipose tissue in patients with chronic obstructive pulmonary disease: systematic review with meta‑analysis and trial sequential analysis
Authors: Lan Yi , Ma Qianli , Luo Guangming , Yang Heping , Li Yingrui , Zhang Qiao
Published: July 2023

Background

Limited data suggest that chronic obstructive pulmonary disease (COPD) patients have pathologic elevated epicardial adipose tissue (EAT), which is splanchnic fat tissue with anti-inflammatory properties and regulating free fatty acids functions. Therefore, there is a need for meta-analysis to explore the relationship between EAT and COPD.

Methods

Online databases were systematically searched for studies about EAT in COPD patients published up to October 5th, 2022. The EAT data of the COPD patient group and the control group were included. Trial sequential analysis (TSA) and meta-analysis were applied to assess the difference in EAT between patients with and without COPD. TSA software and Stata 12.0 were used in all statistical analyses.

Results

The final analysis included 5 studies (n = 596 patients). COPD patients had significantly more EAT than control subjects (SMD: 0.0.802; 95% CI: 0.231, 1.372; P = 0.006; TSA-adjusted 95% CI 1.20, 1.80; P < 0.0001). And higher CRP levels in COPD patients than non-COPD patients, whereas triglycerides and LDL were not significantly different between patients with and without COPD.

Conclusion

EAT is abnormally elevated in COPD patients, which may be related to systemic inflammatory responses in COPD.

PROSPERO number

CRD42021228273.
The knowledge, attitudes and behaviors of hospital nurses on smoking cessation interventions: a cross-sectional study
Authors: Čivljak Marta , Ačkar Lovro , Puljak Livia
Published: July 2023

Background

Smoking is a major public health problem in Croatia. It is unknown to what extent nurses in Croatia use interventions for smoking cessation to help their patients. This study aimed to analyze the knowledge, attitudes and behaviors of hospital nurses on smoking cessation interventions.

Methods

We conducted a cross-sectional study in Zagreb, Croatia, in 2022 on a convenient sample of hospital nurses. We collected data with a questionnaire that included sociodemographic questions and questions about the frequency of implementation of 5 A’s (Ask, Advise, Assess, Assist, Arrange) interventions for smoking cessation during their work using the Helping Smokers Quit (HSQ) survey, participants’ attitudes and knowledge about smoking cessation skills and the smoking status of the nurses.

Results

There were 824 nurses employed in the targeted departments; 258 nurses participated in the study (response rate: 31%). Among them, 43% responded that they always ask patients about their use of tobacco products. Only 2.7% indicated that they always help the patient to stop smoking. Very few (2%) attended any training in the past two years about helping patients to quit smoking, and 82% never had such training. 44% of the included nurses were smokers. Nurses who smoked stated more frequently than nonsmokers they should not be role models for their patients by avoiding smoking (P 0.001). Additionally, patients were less frequently questioned about their inability to stop smoking by nurses who smoked than nurses who did not smoke (P = 0.010).

Conclusion

Even though smoking cessation interventions delivered by nurses were proven effective, such interventions are used by a small number of surveyed nurses. A small number of nurses have received training to help them support smokers in quitting. The high smoking prevalence among nurses may impact their attitudes and the implementation of workplace smoking cessation efforts.
Responsive and resilient healthcare? ‘Moments of Resilience’ in post-hospitalisation services for COVID-19
Authors: Overton Charlotte , Emerson Tristan , A Evans Rachael , Armstrong Natalie
Published: July 2023

Background

COVID-19 caused disruption to healthcare services globally, resulting in high numbers of hospital admissions and with those discharged often requiring ongoing support. Within the UK, post-discharge services typically developed organically and were shaped over time by local need, funding, and government guidance. Drawing on the Moments of Resilience framework, we explore the development of follow-up services for hospitalised patients by considering the links between resilience at different system levels over time. This study contributes to the resilient healthcare literature by providing empirical evidence of how diverse stakeholders developed and adapted services for patients following hospitalisation with COVID-19 and how action taken at one system level influenced another.

Methods

Qualitative research comprising comparative case studies based on interviews. Across three purposively selected case studies (two in England, one in Wales) a total of 33 semi-structured interviews were conducted with clinical staff, managers and commissioners who had been involved in developing and/or implementing post-hospitalisation follow-up services. The interviews were audio-recorded and professionally transcribed. Analysis was conducted with the aid of NVivo 12.

Results

Case studies demonstrated three distinct examples of how healthcare organisations developed and adapted their post-discharge care provision for patients, post-hospitalisation with COVID-19. Initially, the moral distress of witnessing the impact of COVID-19 on patients who were being discharged coupled with local demand gave clinical staff the impetus to take action. Clinical staff and managers worked closely to plan and deliver organisations’ responses. Funding availability and other contextual factors influenced situated and immediate responses and structural adaptations to the post-hospitalisation services. As the pandemic evolved, NHS England and the Welsh government provided funding and guidance for systemic adaptations to post-COVID assessment clinics. Over time, adaptations made at the situated, structural, and systemic levels influenced the resilience and sustainability of services.

Conclusions

This paper addresses understudied, yet inherently important, aspects of resilience in healthcare by exploring when and where resilience occurs across the healthcare system and how action taken at one system level influenced another. Comparison across the case studies showed that organisations responded in similar and different ways and on varying timescales to a disruption and national level strategies.