bluuebunny/crossref_metadata_2025 huggingface dataset:
Child marriage, marital disruption, and marriage thereafter: evidence from a national survey
Authors: Islam M. Mofizul
Published: December 2022

Background

This study examines the relationship between women’s ages at their first marriages and the marital disruption among those who experienced child marriages and those who did not as well as identifies some compromises that women make in their remarriages after previous marital disruptions.

Methods

The data of 57,476 women from the 2019 Bangladesh Multiple Indicator Cluster Survey were analysed using multivariable logistic and linear regressions. Women’s compromises in their remarriages were examined by determining the age differences with their current husbands, whether the current husband has another wife and their attitudes toward the justification of intimate partner violence by husbands.

Results

Almost 65% of women experienced child marriage, and its prevalence is higher in rural (66.5%) than in urban areas (59.2%). The probability of marital disruptions decreases as the ages at the first marriages rise among women who experienced child marriages and increase among women who did not. Women living in rural areas are less likely than those living in urban areas to report marital dissolution (AOR 0.81, 95% CI 0.73–0.90). Also, women who completed relatively more years of education or have greater wealth are less likely to report marital disruptions and those who never gave birth are more likely to report these (AOR 3.54, 95% CI 3.14–3.99). Women who remarried after previous disruptions are more likely to report that their new husbands are, on average, almost 12 years older than they are, and have another wife. Also, those who experienced marital disruptions are more likely than others to believe that husbands are justified in beating their wives in certain circumstances.

Conclusion

The odd of marital disruption decreases with the ages at first marriage among women who experienced child marriage and increase among women who did not. There is a curvilinear relationship between women’s ages at their first marriages and the probability of marital disruptions. Making compromises in remarriages after disruptions is common. Because marital disruption is increasing, appropriate policies are needed to address the adverse outcomes of divorces that ensue.
Using Silva pattern system to predict prognosis and plan treatment of invasive endocervical adenocarcinoma: a single-center retrospective analysis
Authors: Li Xiao , Pang Shujie , Shen Yan , Qu Pengpeng
Published: December 2022

Background

This study evaluated the prognostic value of the Silva pattern system for invasive endocervical adenocarcinoma (EAC) by analysing its association with clinical and pathological features to provide more appropriate clinical management.

Methods

A retrospective analysis including 63 patients with pathological diagnosis of invasive EAC was performed from March 2011 to December 2016 at our hospital. All pathological slides were reviewed by three senior pathologists, and cases were stratified into patterns A, B, or C by consensus according to the Silva pattern system criteria. Clinicopathological characteristics and follow-up of the three Silva subgroups were analysed.

Results

Silva A, B, and C EAC patients were compared based on tumour size, clinical stage, lymphovascular invasion (LVI), and depth of invasion (DOI). The differences were found to be statistically significant (p < 0.01). There was no statistically significant difference in the proportion of lymph node metastasis among the three groups (p > 0.05) or in the recurrence and mortality rates of patients with Silva A, B, and C EAC (p > 0.05). Single factor analysis showed that tumour size, clinical stage, lymph node metastasis, LVI, and DOI were related to postoperative recurrence, whereas age, Silva classification, and postoperative recurrence were not correlated.

Conclusion

The Silva classification system can predict lymph node status and prognosis of invasive EAC, but it cannot be used as an independent indicator. Individualized treatment plans should be adopted for patients with EAC.
Medical student exam performance and perceptions of a COVID-19 pandemic-appropriate pre-clerkship medical physiology and pathophysiology curriculum
Authors: Chang Melissa , Cuyegkeng Andrew , Breuer Joseph A. , Alexeeva Arina , Archibald Abigail R. , Lepe Javier J. , Greenberg Milton L.
Published: December 2022

Background

Medical schools were compelled to abruptly transition pre-clerkship curricula to remote learning formats due to the emergence of the Coronavirus Disease 2019 (COVID-19) pandemic. We evaluated student perceptions of remote learning, exam performance, and utilization of third-party learning resources to assess the implementation of a newly developed pandemic-appropriate physiology curriculum.

Methods

This was an observational study based on a survey conducted in the Spring of 2021 at the University of California, Irvine, School of Medicine (UCISOM). This study aimed to assess first (MS1) and second year (MS2) medical students’ perceptions of satisfaction, support, academic performance, and connectedness before and during the COVID-19 pandemic. The MS1 class began medical school during the first year of the COVID-19 pandemic, whereas the MS2 class did so prior to the start of the pandemic. A survey instrument was developed and validated to identify the impact remote learning had on student self-perceptions of the Medical Physiology and Pathophysiology course. Surveys were distributed to all students and responses were collected on a voluntary basis. Exam scores on a customized National Board of Medical Examiners (NBME) physiology shelf exam were also compared to objectively identify how the remote curriculum during the pandemic impacted academic performance.

Results

Of 204 students enrolled, 74 responses were analyzed, with 42 MS1 (40% of MS1s) and 32 MS2 (31% of MS2s) responses. Overall, MS1s and MS2s were satisfied with the curriculum they received (95 and 97% respectively) and the school’s support of their concerns (86 and 100% respectively). Notably, only 50% of MS1s felt connected to their peers, compared to 94% of MS2s. Lecture attendance and self-perception of their academic performance were similar between both classes. Interestingly, the intra-pandemic class’s NBME exam average in 2020 (60.2% ± 8.9, n = 104) was significantly higher than the pre-pandemic class average in 2019 (56.8% ± 11.3, n = 100). Both classes primarily used course materials over third-party learning resources. An additional set of survey questions distributed only to the MS1 class found that the majority of MS1s reported minimal barriers with regards to accessibility, including internet connectivity, study-conducive environments, and balancing family commitments. Overall, pre-clerkship medical students had positive perceptions of the newly developed pandemic-appropriate physiology curriculum.

Conclusions

Changes to the pre-clerkship physiology curriculum during the COVID-19 pandemic were met with overall satisfaction from the students and an increase in NBME scores. More attention to student connectedness is needed to improve how remote learning can be best optimized into future curricula development.
Leadership behaviours in interprofessional student teamwork
Authors: van Diggele Christie , Roberts Chris , Lane Stuart
Published: December 2022

Background

Effective leaders support high-quality patient care and improve patient safety by embodying a collective leadership style. Training in leadership skills needs to be integrated longitudinally throughout a clinician’s career. Models of leadership drawn from organisational theories can provide a conceptual framework for cultivating student leadership qualities during teamwork and the evaluation of emergent outcomes. Using the conceptual framework of Situational Leadership Theory, we sought to explore the leadership qualities identified by students of their team members, during a large scale interprofessional learning activity.

Methods

In 2018, 1674 students from 11 health disciplines were required to participate in the “Health Collaboration Challenge” (HCC). The HCC required students to work in small interprofessional teams of five or six students. Following team activities, students were required to provide constructive written feedback to their team members. Peer feedback data were coded and categorised into themes using the conceptual framework of Situational Leadership Theory. Data were then quantified within each theme.

Results

A total of 1282 comments were analysed. The most frequent comments related to ‘delegating’ (456/1282, 36%) and ‘supporting’ (402/1282, 31%). This was followed by comments categorised as ‘directing’ (244/1282, 19%), and ‘coaching’ (180/1282, 14%) leadership styles. Notably, a total of 1112/2597 (43%) of comments were unconstructive. A total of 298 comments provided by students informed their peers of areas for self-improvement. The most frequent comments were recommendations relating to ‘active team member contribution’ (111/298; 37%), followed by ‘communication’ (83/298; 28%), ‘interprofessional practice’ (77/298; 26%), and ‘disciplinary knowledge’ (27/298; 9%).

Conclusion

Although most students demonstrated a reasonable ability to display leadership behaviours appropriate to teamwork, further development is needed through training. Leadership skills are an expectation of health professional graduates, and should be explicitly taught and vertically integrated within interprofessional education curricula. Further research is warranted in how students contribute to and understand the requirements of leadership within interprofessional teams.
Usability evaluation of mHealth apps for elderly individuals: a scoping review
Authors: Wang Qiuyi , Liu Jing , Zhou Lanshu , Tian Jing , Chen Xuemei , Zhang Wei , Wang He , Zhou Wanqiong , Gao Yitian
Published: December 2022

Background

Usability is a key factor affecting the acceptance of mobile health applications (mHealth apps) for elderly individuals, but traditional usability evaluation methods may not be suitable for use in this population because of aging barriers. The objectives of this study were to identify, explore, and summarize the current state of the literature on the usability evaluation of mHealth apps for older adults and to incorporate these methods into the appropriate evaluation stage.

Methods

Electronic searches were conducted in 10 databases. Inclusion criteria were articles focused on the usability evaluation of mHealth apps designed for older adults. The included studies were classified according to the mHealth app usability evaluation framework, and the suitability of evaluation methods for use among the elderly was analyzed.

Results

Ninety-six articles met the inclusion criteria. Research activity increased steeply after 2013 (n = 92). Satisfaction (n = 74) and learnability (n = 60) were the most frequently evaluated critical measures, while memorability (n = 13) was the least evaluated. The ratios of satisfaction, learnability, operability, and understandability measures were significantly related to the different stages of evaluation (P < 0.05). The methods used for usability evaluation were questionnaire (n = 68), interview (n = 36), concurrent thinking aloud (n = 25), performance metrics (n = 25), behavioral observation log (n = 14), screen recording (n = 3), eye tracking (n = 1), retrospective thinking aloud (n = 1), and feedback log (n = 1). Thirty-two studies developed their own evaluation tool to assess unique design features for elderly individuals.

Conclusion

In the past five years, the number of studies in the field of usability evaluation of mHealth apps for the elderly has increased rapidly. The mHealth apps are often used as an auxiliary means of self-management to help the elderly manage their wellness and disease. According to the three stages of the mHealth app usability evaluation framework, the critical measures and evaluation methods are inconsistent. Future research should focus on selecting specific critical measures relevant to aging characteristics and adapting usability evaluation methods to elderly individuals by improving traditional tools, introducing automated evaluation tools and optimizing evaluation processes.
Open visitation policy in intensive care units in Jordan: cross-sectional study of nurses' perceptions
Authors: Maloh Haya Ibrahim Ali Abu , Jarrah Samiha , Al-Yateem Nabeel , Ahmed Fatma Refaat , AbuRuz Mohannad Eid
Published: December 2022

Introduction

Intensive care unit patients and families experience significant stress. It creates frustrations, nervousness, irritability, social isolation for patients, anxiety, and depression for families. An open visitation policy with no time or duration limits may assist in reducing these negative experiences. However, most Jordanian and regional hospitals within the Middle-East and Northern Africa (MENA) have not implemented this strategy.

Purpose

To evaluate nurse managers' and nurses' perspectives on the effects of an open visitation policy at intensive care units (ICUs) on patients, families, and nurses' care.

Method

A cross-sectional, descriptive, and comparative survey design was used.

Results

A total of 234 nurses participated in the study; 59.4% were males, and 40.6% were females. The mean of their age was 28.6 years, with a mean of 4.1 years of experience. Nurses generally had negative perceptions and attitudes toward the open visitation policy and its consequences on the patient, family, and nursing care.

Conclusions

ICU managers and staff nurses did not favor implementing an open visitation in their units despite its known benefits, international recommendations, and relevance and compatibility with the local religious and cultural context. A serious discussion regarding this hesitation from the side of the healthcare professionals should be started to find a suitable solutions that consider the benefits of the open visitation policy and the challenges that prevent its implementation in the Jordanian and Arabic cultures.
Authoritarian leadership and nurse presenteeism: the role of workload and leader identification
Authors: Shan Geyan , Wang Wei , Wang Shengnan , Zhang Yongjun , Guo Shujie , Li Yongxin
Published: December 2022

Background

Nurses’ health in the workplace is crucial for ensuring the quality of healthcare. However, presenteeism, the behavior of working in a state of ill health, is widespread in the nursing industry. Considering that the origin of authoritarian leadership and the prevalence of presenteeism are inseparable from Chinese workplace culture, this study aimed to explore the impact and mechanism of authoritarian leadership on presenteeism.

Methods

A total of 528 nurses were recruited from four grade III level A hospitals in the present survey, which was distributed across 98 nursing teams. Participants were required to complete self-report measures on authoritarian leadership, presenteeism, workload, and leader identification. Description, correlation, and multilevel linear regressions were applied for data analysis.

Results

The present study found that presenteeism was significantly related to participants’ demographic characteristics, such as marital status, educational level, technological title, and general health. There was a positive relationship between authoritarian leadership and presenteeism, and workload acted as a mediator in authoritarian leadership and presenteeism. Furthermore, leader identification moderated the relationship between authoritarian leadership and workload. When nurses were under high leader identification, the positive impact of authoritarian leadership on workload was reinforced.

Conclusions

This study revealed the potential antecedents and mechanisms of nurse presenteeism from the perspective of workplace culture. Results indicated that the excessive authoritarianism of leaders and the heavy workload faced by nurses may be the significant triggers for nurses’ presenteeism. The role of leader identification is not always protective, which may heighten the relationship between dark leadership and its outcomes. These observations contribute to enriching research on presenteeism and authoritarian leadership, and provide valuable insights for cultivating healthy working behaviors.
Psychometric testing of the Determinants of Salt-Restriction Behaviour Questionnaire in people of Chinese ancestry: a methodological study
Authors: Chan Alex , Kinsman Leigh , Chan Sally Wai-chi
Published: December 2022

Purpose

Nurses play a key role in educating people about a salt-reduced diet to prevent or manage hypertension or cardiac failure. Assessment tools such as the Chinese Determinants of Salt-Restriction Behaviour Questionnaire (DSRBQ) can provide essential evidence to inform education strategies. This study aimed to translate the DSRBQ into English and evaluate the psychometric properties of the Chinese and English versions for people of Chinese ethnicity in Australia.

Methods

A two-phase cross-sectional descriptive study was conducted. Phase 1: The questionnaire was translated into English using the back-translation method. The translation equivalence and content relevance were evaluated by an expert panel. Three items were revised and eight items were removed. Phase 2: Internal consistency and stability of the questionnaires were evaluated by a group of Chinese Australians.

Results

Both the English and Chinese versions had satisfactory psychometric properties. In phase 2, 146 participants completed the questionnaire (test), and 49 participants completed the retest. The Cronbach’s alpha scores were 0.638 and 0.584 respectively, and the overall intra-class correlation coefficients were 0.820 and 0.688 respectively for the English and Chinese versions. The Item-Content Validity Index (CVI) ranged from 0.50 to 1.00. The Scale-CVI was 0.94.

Conclusion

The DSRBQ has been translated into English. Both English and Chinese versions have acceptable validity and reliability. The tools can be used in people from a Chinese cultural background living in Australia. Further validation testing may allow the tools to be adapted for use with other Chinese diaspora groups. The validated DSRBQ will support the development of evidence-based salt reduction nursing assessment tool and interventions for Chinese diasporas who reside in a country where Chinese cultural practices are employed by a minority.
At-home blood self-sampling in rheumatology: a qualitative study with patients and health care professionals
Authors: Muehlensiepen Felix , May Susann , Zarbl Joshua , Vogt Ekaterina , Boy Katharina , Heinze Martin , Boeltz Sebastian , Labinsky Hannah , Bendzuck Gerlinde , Korinth Marianne , Elling-Audersch Corinna , Vuillerme Nicolas , Schett Georg , Krönke Gerhard , Knitza Johannes
Published: December 2022

Background

The goal of the study was to investigate patients’ with systemic rheumatic diseases and healthcare professionals’ experiences and preferences regarding self-sampling of capillary blood in rheumatology care.

Methods

Patients performed a supervised and consecutive unsupervised capillary blood self-collection using an upper arm based device. Subsequently, patients (n = 15) and their attending health care professionals (n = 5) participated in an explorative, qualitative study using problem-centered, telephone interviews. Interview data were analyzed using structured qualitative content analysis.

Results

Interviewed patients reported easy application and high usability. Patients and health care professionals alike reported time and cost savings, increased independence and flexibility, improved monitoring and reduction of risk of infection during Covid-19 as benefits. Reported drawbacks include limited blood volume, limited usability in case of functional restrictions, and environmental concerns. Older, immobile patients with long journeys to traditional blood collection sites and young patients with little time to spare for traditional blood collection appointments could be user groups, likely to benefit from self-sampling services.

Conclusions

At-home blood self-sampling could effectively complement current rheumatology telehealth care. Appropriateness and value of this service needs to be carefully discussed with patients on an individual basis.

Trial Registration

WHO International Clinical Trials Registry: DRKS00024925. Registered on 15/04/2021.
Histone modifications and DNA methylation act cooperatively in regulating symbiosis genes in the sea anemone Aiptasia
Authors: Nawaz Kashif , Cziesielski Maha J. , Mariappan Kiruthiga G. , Cui Guoxin , Aranda Manuel
Published: December 2022

Background

The symbiotic relationship between cnidarians and dinoflagellates is one of the most widespread endosymbiosis in our oceans and provides the ecological basis of coral reef ecosystems. Although many studies have been undertaken to unravel the molecular mechanisms underlying these symbioses, we still know little about the epigenetic mechanisms that control the transcriptional responses to symbiosis.

Results

Here, we used the model organism Exaiptasia diaphana to study the genome-wide patterns and putative functions of the histone modifications H3K27ac, H3K4me3, H3K9ac, H3K36me3, and H3K27me3 in symbiosis. While we find that their functions are generally conserved, we observed that colocalization of more than one modification and or DNA methylation correlated with significantly higher gene expression, suggesting a cooperative action of histone modifications and DNA methylation in promoting gene expression. Analysis of symbiosis genes revealed that activating histone modifications predominantly associated with symbiosis-induced genes involved in glucose metabolism, nitrogen transport, amino acid biosynthesis, and organism growth while symbiosis-suppressed genes were involved in catabolic processes.

Conclusions

Our results provide new insights into the mechanisms of prominent histone modifications and their interaction with DNA methylation in regulating symbiosis in cnidarians.
Secretory autophagy promotes Rab37-mediated exocytosis of tissue inhibitor of metalloproteinase 1
Authors: Wu Shan-Ying , Chen Jia-Wen , Liu Hsi-Yu , Wang Yi-Ching , Chu Yeh-Shiu , Huang Chi-Ying , Lan Kai-Ying , Liu Hsiao-Sheng , Lan Sheng-Hui
Published: December 2022

Background

Rab37-mediated exocytosis of tissue inhibitor of metalloproteinase 1 (TIMP1), an inflammatory cytokine, under serum-depleted conditions which leads to suppression of lung cancer cell metastasis has been reported. Starvation is also a stimulus of autophagic activity. Herein, we reveal that starvation activates Rab37 and induces autophagy.

Methods

We used an overexpression/knockdown system to determine the relationship between autophagy and Rab37 in vitro and in vivo. The autophagy activity was detected by immunoblotting, transmission electron microscope, autophagosome purification, and immunofluorescence under the confocal microscope. Lung-to-lung metastasis mouse model was used to clarify the role of autophagy and Rab37 in lung cancer. Clinical lung cancer patient specimens and an online big database were analyzed.

Results

Initially, we demonstrated that active-form Rab37 increased LC3-II protein level (the marker of autophagosome) and TIMP1 secretion. Accordingly, silencing of Rab37 gene expression alleviated Rab37 and LC3-II levels as well as TIMP1 secretion, and induction of autophagy could not increase TIMP1 exocytosis under such conditions. Moreover, silencing the Atg5 or Atg7 gene of lung cancer cells harboring active-mutant Rab37 (Q89L) led to decreased autophagy activity and TIMP1 secretion. In the lung-to-lung metastasis mouse model, increased TIMP1 expression accompanied by amiodarone-induced autophagy led to decreased tumor nodules and cancer cell metastasis. These phenomena were reversed by silencing the Atg5 or Atg7 gene. Notably, increasing autophagy activity alone showed no effect on TIMP1 secretion under either Rab37 or Sec22b silencing conditions. We further detected colocalization of LC3 with either Rab37 or TIMP1, identified Rab37 and Sec22b proteins in the purified autophagosomes of the lung cancer cells harboring the active-form Rab37 gene, and confirmed that these proteins are involved in the secretion of TIMP1. We reveal that autophagic activity was significantly lower in the tumors compared to the non-tumor parts and was associated with the overall lung cancer patient survival rate.

Conclusions

We are the first to report that autophagy plays a promoting role in TIMP1 secretion and metastasis in a Rab37-dependent manner in lung cancer cells and the lung-to-lung mouse model.
Antibodies in action: the role of humoral immunity in the fight against atherosclerosis
Authors: Taylor Joshua A. , Hutchinson Mark A. , Gearhart Patricia J. , Maul Robert W.
Published: December 2022

The sequestering of oxidation-modified low-density lipoprotein by macrophages results in the accumulation of fatty deposits within the walls of arteries. Necrosis of these cells causes a release of intercellular epitopes and the activation of the adaptive immune system, which we predict leads to robust autoantibody production. T cells produce cytokines that act in the plaque environment and further stimulate B cell antibody production. B cells in atherosclerosis meanwhile have a mixed role based on subclass. The current model is that B-1 cells produce protective IgM antibodies in response to oxidation-specific epitopes that work to control plaque formation, while follicular B-2 cells produce class-switched antibodies (IgG, IgA, and IgE) which exacerbate the disease. Over the course of this review, we discuss further the validation of these protective antibodies while evaluating the current dogma regarding class-switched antibodies in atherosclerosis. There are several contradictory findings regarding the involvement of class-switched antibodies in the disease. We hypothesize that this is due to antigen-specificity, and not simply isotype, being important, and that a closer evaluation of these antibodies’ targets should be conducted. We propose that specific antibodies may have therapeutical potential in preventing and controlling plaque development within a clinical setting.
Factors associated with exclusive breastfeeding at discharge during the COVID-19 pandemic in 17 WHO European Region countries
Authors: Chertok Ilana Azulay , Artzi-Medvedik Rada , Arendt Maryse , Sacks Emma , Otelea Marina Ruxandra , Rodrigues Carina , Costa Raquel , Linden Karolina , Zaigham Mehreen , Elden Helen , Drandic Daniela , Grylka-Baeschlin Susanne , Miani Céline , Valente Emanuelle Pessa , Covi Benedetta , Lazzerini Marzia , Mariani Ilaria
Published: December 2022

Background

Exclusive breastfeeding is the optimal infant nutrition, providing infants immunoprotection against many diseases including SARS-CoV-2 infection. Restrictions during the COVID-19 pandemic may have negatively affected breastfeeding practices in maternity care facilities. The aims of the study were to examine exclusive breastfeeding rates at discharge over time and to identify factors associated with exclusive breastfeeding during the pandemic.

Methods

A cross-sectional survey was conducted among mothers who gave birth in a maternity care facility in the World Health Organization (WHO) European Region countries during the COVID-19 pandemic. The socio-ecological model was employed to examine intrapersonal, interpersonal, organizational, and community/society factors associated with maternal report of exclusive breastfeeding at the time of discharge.

Results

There were 26,709 participating mothers from 17 European Region countries who were included in the analysis. Among the mothers, 72.4% (n = 19,350) exclusively breastfed and 27.6% (n = 7,359) did not exclusively breastfeed at discharge. There was an overall decline in exclusive breastfeeding rates over time (p = 0.015) with a significantly lower rate following the publication of the WHO breastfeeding guidelines on 23 June 2020 (AOR 0.88; 95% CI 0.82, 0.94). Factors significantly associated with exclusive breastfeeding outcomes in the logistic regression analysis included maternal age, parity, education, health insurance, mode of birth, inadequate breastfeeding support, lack of early breastfeeding initiation, lack of full rooming-in, birth attendant, perceived healthcare professionalism and attention, facility room cleanliness, timing of birth, and location of birth.

Conclusions

Results from the study indicate the decline in exclusive breastfeeding rates in the WHO European Region during the COVID-19 pandemic. Using the socio-ecological model to identify factors associated with breastfeeding outcomes facilitates an integrated and holistic approach to address breastfeeding needs among women across the region. These findings demonstrate the need to augment breastfeeding support and to protect exclusive breastfeeding among mother-infant dyads, in an effort to reverse the declining exclusive breastfeeding rates. The study highlights the need to educate mothers and their families about the importance of exclusive breastfeeding, reduce maternal-infant separation, increase professional breastfeeding support, and follow evidence-based practice guidelines to promote breastfeeding in a comprehensive and multi-level manner.

Trial registration number

Clinical Trials NCT04847336.
Exploration of the mechanisms underlying the beneficial effect of Luo Tong formula on retinal function in diabetic rats via the “gut microbiota–inflammation–retina” axis
Authors: Di Sha , Yao Chensi , Qiao Liping , Li Xiuyang , Pang Bing , Lin Jiaran , Wang Jia , Li Min , Tong Xiaolin
Published: December 2022

Background

Diabetic retinopathy (DR) is a common microvascular complication of diabetes. Luo Tong formula (LTF), a classical traditional Chinese medicine (TCM) prescription, consists of four plants that have been widely and effectively used to treat DR. Previous work in our laboratory has confirmed that LTF can effectively ameliorate DR. However, the potential mechanism underlying the therapeutic effect of LTF on DR has not been fully elucidated. To explore the potential mechanism of action through which LTF prevents and alleviates DR from an inflammation and gut microbiota perspective.

Materials and methods

Metabolite profiling of LTF was performed using liquid chromatography–mass spectrometry (LC–MS) and gas chromatography–mass spectrometry (GC–MS). Type 1 diabetes was induced in male Sprague Dawley (SD) rats via tail vein injection of 45 mg/kg streptozotocin. Next, 100 SD rats were randomly divided into four groups, normal control; diabetic control; diabetic + insulin + calcium dobesilate; and diabetic + insulin + LTF. After 12 weeks of treatment, glucose metabolism, fundus oculi, blood-retinal barrier permeability, retinal thickness, microvascular damage, as well as cell junction expression in retinas were measured and the changes observed in different groups were compared. Finally, the alteration in gut microbiota and inflammatory cytokine expression in serum and tissues were monitored, and their correlation was analyzed.

Results

A total of 1024 valid peaks were obtained for LTF using GC–MS. The HbA1c and fasting blood glucose (FBG) levels in the LTF group were slightly decreased. LTF exerted protective effects on fundus oculi and the retina structure to different degrees. LTF attenuated systemic and local retinal inflammation by significantly decreasing the levels of seven pro-inflammatory cytokines, including ICAM-1, IL-6, IL-8, MCP-1, VCAM-1, VEGF, and IL-1β. LTF restored the intestinal microbiota of diabetic rats to levels that were similar to those of normal rats. Further analysis revealed that Enterobacteriales, Prevotellaceae, Enterobacteriaceae, Bacteroides, and Klebsiella were significantly and positively correlated with the inflammatory factors in DR after LTF treatment.

Conclusions

Our results revealed the mechanisms underlying the preventive effects of LTF on DR development and progression. LTF inhibited pathological changes in retinal histopathology, cell composition, and cell junction proteins while effectively ameliorating systemic and local retinal inflammation via regulating pivotal gut microbiota.
Post-transplant cyclophosphamide for GVHD prophylaxis in pediatrics with chronic active Epstein-Barr virus infection after haplo-HSCT
Authors: Luo Rongmu , Zhang Xiaomei , Wang Ya , Man Qihang , Gu Wenjing , Tian Zhengqin , Wang Jingbo
Published: December 2022

Background

Chronic active Epstein-Barr virus infection (CAEBV) is a rare but life-threatening progressive disease. Human leukocyte antigen (HLA)-haploidentical hematopoietic stem cell transplantation (haplo-HSCT) is the best choice as sometimes HLA-matched donor is not accessible. However, graft-versus-host-disease (GVHD) following transplantation remains a major cause of treatment failure and elevated mortality. Post-transplant cyclophosphamide (PTCy) has recently emerged for effective GVHD prophylaxis in a haploidentical setting in many hematologic malignancies. Here, we report the performance of PTCy for GVHD prophylaxis in a series of CEABV patients treated with haplo-HSCT.

Methods

Consecutive pediatric CAEBV patients who were treated with haplo-HSCT and give PTCy for GVHD prophylaxis were analyzed. 1-year GVHD and relapse-free survival (GRFS), overall survival (OS) and cumulative incidence of moderate-to-severe chronic GVHD (cGVHD) were estimated.

Results

A total of 8 patients ranging from 2 to 15 years old were included. Among them, 4 patients had early complications after haplo-HSCT. Counts of T-cell subsets increased within 6 months post transplantation, indicating an immune reconstitution. Only 1 patient developed grade II acute GVHD, and 2 patients had moderate cGVHD. One patient died from diffuse alveolar hemorrhage within the first year after transplantation. The 1-year GRFS rate, OS rate and cumulative incidence of moderate-to-severe cGVHD were 62.5%, 87.5% and 25.0%, respectively.

Conclusion

Our findings suggest that, among CAEBV patients treated with haplo-HSCT, PTCy may be an alternative choice for the prevention of GVHD.
In vivo models of Escherichia coli infection in poultry
Authors: Kromann Sofie , Jensen Henrik Elvang
Published: December 2022

Escherichia coli represents a significant challenge to the poultry industry due to compromised animal welfare, vast productivity losses, elevated mortality, and increased use of antimicrobial compounds. Therefore, effective preventive strategies and insight into the pathogenesis and disease mechanisms of colibacillosis are essential to secure a healthy poultry production. Consequently, discriminative in vivo models of colibacillosis are prerequisite tools for evaluating e.g., preventive measures, exploring novel treatments and understanding disease development. Numerous models of colibacillosis are applied for experimental studies in poultry. Yet, few studies provide a proper characterisation of the model enabling other authors to reproduce experiments or use the model in general. The present paper provides a literature review on avian in vivo models of primary colibacillosis.
The importance of familial risk factors in children with ADHD: direct and indirect effects of family adversity, parental psychopathology and parenting practices on externalizing symptoms
Authors: Jendreizik Lea Teresa , Hautmann Christopher , von Wirth Elena , Dose Christina , Thöne Ann-Kathrin , Treier Anne-Katrin , Banaschewski Tobias , Becker Katja , Brandeis Daniel , Geissler Julia , Hebebrand Johannes , Hohmann Sarah , Holtmann Martin , Huss Michael , Jans Thomas , Kaiser Anna , Millenet Sabina , Poustka Luise , Schneider Priska , Döpfner Manfred
Published: December 2022

Background

Children experiencing unfavorable family circumstances have an increased risk of developing externalizing symptoms. The present study examines the direct, indirect and total effects of family adversity, parental psychopathology, and positive and negative parenting practices on symptoms of attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) in children with ADHD.

Methods

Data from 555 children (M = 8.9 years old, 80.5% boys) who participated in a multicenter study on the treatment of ADHD (ESCAschool) were analyzed using structural equation modeling (SEM).

Results

The SEM analyses revealed that (a) family adversity and parental psychopathology are associated with both child ADHD and ODD symptoms while negative parenting practices are only related to child ODD symptoms; (b) family adversity is only indirectly associated with child ADHD and ODD symptoms, via parental psychopathology and negative parenting practices; (c) the detrimental effect of negative parenting practices on child ADHD and ODD symptoms is stronger in girls than in boys (multi-sample SEM); (d) there are no significant associations between positive parenting practices and child ADHD or ODD symptoms.

Conclusions

Family adversity, parental psychopathology, and negative parenting practices should be routinely assessed by clinicians and considered in treatment planning.

Trial registration (18th December 2015): German Clinical Trials Register (DRKS) DRKS00008973.
Predictors of participants’ retention—socioeconomic factors or nonadherence: insights from a urological clinical prospective study
Authors: Wheeler Allison J. , Garg Harshit , Kaushik Dharam , Mansour Ahmed , Pruthi Deepak , Liss Michael A.
Published: December 2022

Background

To investigate various patient-level variables, specifically socioeconomic status, as risk factors for withdrawal in a recently completed clinical study. We specifically investigated a non-interventional prospective study assessing the role of novel imaging as a biomarker for cancer upgradation in prostate cancer for this objective.

Methods

In this retrospective analysis, we assessed the association between various patient-level factors including clinic-demographic factors, socioeconomic status, and the number of non-adherences with the participants’ retention or withdrawal from the study. For socioeconomic status (SES), we used the zip code–based Economic Innovation Group Distressed Community Index (DCI) which classifies into five even distress tiers: prosperous, comfortable, mid-tier, at-risk, or distressed. Low SES was defined as those with a DCI Distress tier of at-risk or distressed. We compared values between the two retention and withdrawal groups using t-test, chi-square test, and logistic regression analysis.

Results

Of 273 men screened, 123 men were enrolled. Among them, 86.2% (106/123) retained through the study whereas 13.8% (17/123) withdrew from the study. The mean (SD) age was 64 (6.4) years. Overall, 31.7% (39/123) were Hispanics and 24.3% (30/123) were African Americans. The median (IQR) DCI score was 34 (10.3, 68.1) and 30.8% (38/123) of patients belonged to low SES. The median DCI score in participants who retained in the study was statistically similar to those who withdrew from the study (p=0.4). Neither the DCI tiers (p=0.7) nor the low SES (p=0.9) were associated with participants’ retention or withdrawal of the study. In terms of non-adherence, all participants in the withdrawn group had at least one non-adherent event compared to 48.1% in the retained group (p<0.001). Repetitive non-adherence was significantly higher in participants who withdrew from the study vs those who retained in the study [88.2% vs 16.9%, p <0.001]. On multivariate logistic regression analysis, the number of non-adherences (OR=12.5, p<0.001) and not DCI (OR=0.99, p=0.7) appeared to be an independent predictor for participants’ retention or withdrawal from the study.

Conclusions

Expanding diverse inclusion and limiting withdrawal with real-time non-adherence monitoring will lead to more efficient clinical research and greater generalizability of results.
Group psychoeducation for persons with bipolar disorder in Rwanda: a study protocol for a randomized controlled trial
Authors: Musoni-Rwililiza E. , Arnbjerg C. J. , Murekatete C. , Carlsson J. , Kallestrup P. , Gishoma D.
Published: December 2022

Background

The efficacy of psychoeducation as an add-on treatment to pharmacotherapy is well documented in treating symptoms and in relapse prevention for persons with bipolar disorder in western countries. Yet, no studies on psychosocial interventions for persons with bipolar disorder have been conducted in a low-income country in Africa.

Aim

To develop a bipolar group psychoeducation program contextualized to the Rwandese setting, and determine its effect on symptom severity, medical adherence, and internalized stigma.

Methods

A culturally adapted guide manual was developed by local mental health professionals, including nurses, psychologists, and medical doctors. In-depth interviews with participants were held prior to and will be held following the intervention to address the cultural aspect of living with bipolar disease and the impact of the program. A two-armed randomized controlled trial has been set up at the tertiary mental health hospitals in Rwanda, with an intervention and a waiting list arm. A sample size of at least 50 in each arm was calculated as a requirement. The study’s primary outcome measure will be the difference in relapse rate measured on the Young Mania Rating Scale and Hamilton Depression Scale-17. Differences in mean change on scales for medical adherence and internalized stigma will be secondary outcomes. Data will be analyzed according to the intention-to-treat principle. Participants will be assessed subsequently at baseline, at the end of the intervention period, and three months and 12 months post-intervention.

Discussion

This study will be one of the first intervention trials on bipolar disorder in a low-income country. If proven successful in reducing morbidity and increasing the quality of life in persons with bipolar disorder, it is anticipated that the psychoeducation program can be implemented at the district and community level and act as inspiration for other low-resource settings.

Trial registration

ClinicalTrials.gov NCT04671225. Registered on November 2020.
Synthesis, antimalarial, antileishmanial evaluation, and molecular docking study of some 3-aryl-2-styryl substituted-4(3H)-quinazolinone derivatives
Authors: Seifu Girma Worku , Birhan Yihenew Simegniew , Beshay Botros Youssef , Hymete Ariaya , Bekhit Adnan Ahmed
Published: December 2022

Quinazolinones are a diverse group of nitrogen-containing heterocyclic compounds with promising antimalarial and antileishmanial activities. Herein, some 3-aryl-2-styryl substituted-4(3H)-quinazolinones were synthesized via cyclization, condensation, and hydrolysis reactions. 1H NMR, FTIR and elemental microanalysis was used to verify the structures of the synthesized compounds. The in vivo antimalarial and in vitro antileishmanial activities of the target compounds were investigated using mice infected with Plasmodium berghi ANKA and Leishmania donovani strain, respectively. Among the test compounds, 8 and 10 showed better antimalarial activities with percent suppression of 70.01 and 74.18, respectively. In addition, (E)-2-(4-nitrostyryl)-3-phenylquinazolin-4(3H)-one (6) showed promising antileishmanial activity (IC50 = 0.0212 µg/mL). It is two and 150 times more active than the standard drugs amphotericin B deoxycholate (IC50 = 0.0460 µg/mL) and miltefosine (IC 50 = 3.1911 µg/mL), respectively. Its superior in vitro antileishmanial activity was supported by a molecular docking study conducted in the active site of Lm-PTR1. Overall, the synthesized 3-aryl-2-styryl substituted-4(3H)-quinazolinones showed promising antileishmanial and antimalarial activities and are desirable scaffolds for the synthesis of different antileishmanial and antimalarial agents.
Gender differences in the association between insulin resistance and chronic kidney disease in a Chinese population with metabolic syndrome
Authors: Lin Chieh-An , Li Wen-Cheng , Lin Szu-Yu , Chen Yi-Chuan , Yu Wei , Huang Hsiung-Ying , Xiong Xue-Jie , Chen Jau-Yuan
Published: December 2022

Background

Insulin resistance (IR) was reported to be associated with renal function impairment, but little is known about the gender difference. Hence, our study aimed to investigate the relationship between IR (estimated by the homeostasis model assessment of IR (HOMA-IR) index) and chronic kidney disease (CKD) in a Chinese population with metabolic syndrome (MetS) and discern whether there was any gender disparity or not.

Methods

This retrospective cross-sectional study enrolled 13,638 men and 10,450 women who received health examinations from 2013 to 2016 at Xiamen Chang Gung Hospital. Among the participants, 3,253 men (64.3%) and 1,808 women (35.7%) who had MetS and met the inclusion criteria were included for analysis. Spearman’s correlation was conducted to analyze the relationship between HOMA-IR and cardio-metabolic risk factors. Multivariable linear regression was analyzed to explore the relationship between HOMA-IR and cardio-metabolic variables. Logistic regression analysis was performed to assess the association between HOMA-IR and CKD.

Results

The median HOMA-IR and prevalence of CKD was 2.2 and 11.31%, respectively, for men and 2.09 and 15.93%, respectively, for women. In multivariable linear regression analysis, HOMA-IR was significant associated with estimated GFR, albumin/creatinine ratio in men. Multivariable logistic regression revealed a significant difference between HOMA-IR value and the prevalence of CKD in men but not in women (odds ratio in male = 1.21; 95% CI 1.14–1.28, p ≤ 0.001; odds ratio in female = 1.01; 95% CI 0.99–1.02, p = 0.38).

Conclusions

HOMA-IR was independently associated with CKD among men with MetS but not in women.
Fibrinogen function indexes are potential biomarkers for evaluating the occurrence and severity of diabetic foot
Authors: Zhang Jinying , Lin Jiayu , Liang Bo , Chen Lijun , Yang Xinna , Li Mimi
Published: December 2022

Background and objectives

Research suggests that fibrinogen (Fib) concentrations are used to assess the occurrence and severity of diabetic foot (DF) and to monitor the progression of diabetic foot in patients. However, its correlation with Fib function has not been reported. Here, angle α and k value, reflecting the Fib function, were used to analyse its correlation with DF, and their potential as biological indicators for evaluating the occurrence and severity of DF was explored.

Subjects and methods

This clinical study enrolled 163 type 2 diabetes mellitus (T2DM) patients, who were divided into the diabetes with DF (84 cases) group, diabetes with no DF (79 cases) group. Meanwhile, 90 healthy unrelated subjects were enrolled as controls.

Results

Angle α and fibrinogen levels increased greatly in subjects with DF compared with those without. The k value levels greatly decreased in subjects with DF compared with those without (P < 0.01). Spearman correlation analysis showed that angle α and fibrinogen were positively correlated with DF grading (r = 0.635, P < 0.01; r = 0.616, P < 0.01), k value was negatively correlated with DF (r= − 0.589, P < 0.01). ROC curve analysis showed that the optimal cut-off point for angle α to distinguish patients with DF from those without was 62.85 deg, with a sensitivity of 78.6% and specificity of 78.7%. The optimal cut-off point for k value was 1.75 min, with a sensitivity of 82.1% and specificity of 65.8%. The optimal cut-off point for fibrinogen was 3.85 g/l, with a sensitivity of 63.1% and specificity of 98.2%. The optimal cut-off point for angle α to evaluate the risk of diabetic foot progression was 70.20 deg, with a sensitivity of 73.2% and specificity of 90.7%. The optimal cut-off point for k value was 1.25 min, with a sensitivity of 67.9% and specificity of 90.8%. The optimal cut-off point for fibrinogen was 4.12 g/l, with a sensitivity of 85.7% and specificity of 93.5%.

Conclusion

Angle α, k-value and fibrinogen have clinical significance on the risk of occurrence and development of diabetic foot, which can contribute to early diagnosis and early clinical intervention in DF.