bluuebunny/crossref_metadata_2025 huggingface dataset:
O documentário A Jornada de Josué: um acervo literário em foco
Authors: Rettenmaier Miguel
Published: April 2024

Este trabalho pretende refletir sobre o processo de elaboração do documentário A jornada de Josué, produzido pela UPFTV e pelo ALJOG/UPF, com direção de Deisi Fanfa e roteiro de Miguel Rettenmaier. A Jornada de Josué é um documentário comemorativo aos 90 anos de nascimento do escritor Josué Guimarães, associados aos 30 anos de existência das Jornadas Literárias de Passo Fundo. Josué Guimarães foi o primeiro autor a dar respaldo à ideia de se fazer um encontro entre leitores e escritores em Passo Fundo, cidade que seria, em 2006, oficialmente reconhecida como Capital Nacional da Literatura. O audiovisual costura depoimentos de escritores, pesquisadores, amigos e familiares do autor, os quais tratam de sua vida jornalística, política e literária, ressaltando também sua importância como formador de leitores. Dentre os entrevistados estão Moacyr Scliar, Lya Luft, Sérgio Capparelli, Regina Zilberman, Luis Fernando Verissimo, além de Nydia Guimarães, viúva do escritor, e de seus filhos. O documentário apresenta ainda uma das raras entrevistas de Josué Guimarães, concedida a Luiz Antônio Pinheiro Machado, em 1984. Na discussão proposta ao XI Congresso Internacional APCG, mais do que a apresentação de trechos do documentário, está a reflexão sobre o trabalho em acervo literário – a preservação, a organização e a classificação dos seus itens – associado à memória verbalizada por pessoas das relações do autor. Pelas lembranças dessas pessoas, os itens são reatualizados como partes de testemunhos relacionados tanto às histórias particulares dos sujeitos, quanto à história política contemporânea ao autor. De outra parte, no que diz respeito ao escritor Josué Guimarães, serão estabelecidas ponderações sobre a dificuldade de se fazer uma biografia em audiovisual de um homem que resistiu a construir a própria biografia, mesmo que representada em uma possibilidade de destino a uma de suas mais queridas personagens: Camilo Mortágua. A base teórica da apresentação “O Documentário A jornada de Josué: um acervo literário em foco” consiste nos estudos de Remédios, sobre Josué Guimarães, e de Lejeune, sobre autobiografia.
A Casa de Rui Barbosa e sua contribuição à preservação e acesso da memória no Brasil
Authors: Pessoa Ana
Published: April 2024

Relato sobre o legado do patrono, o político e advogado Rui Barbosa (1849 – 1923), a trajetória institucional, de 1930 a 2013, e as iniciativas de renovação e modernização de procedimentos técnicos e infraestrutura da Casa de Rui Barbosa; as atividades hoje desenvolvidas de preservação, acesso, pesquisa e capacitação desenvolvidas, sob a coordenação do Centro de Memória e Informação, dos bens culturais sob sua guarda: museu-casa e jardim histórico, arquivos histórico e literário, biblioteca Rui Barbosa e biblioteca São Clemente.
Bajo sospecha: Idea Vilariño y un diario reescrito
Authors: Borges Ana Inés Larre
Published: April 2024

No es la primera vez que me ocupo del tema de la “reescritura” del Diario de la poeta uruguaya Idea Vilariño y me pregunto, no sin ansiedad, si no he sobredimensionado un hecho que es, a fin de cuentas, una práctica bastante común entre escritores diaristas. Desde que Gide publicó su Diario en vida dando legitimidad al género, es relativamente frecuente que los Diarios sean editados por sus autores. Y sin embargo, el hecho de que el Diario de Idea no fuese el original sino una copia que Idea hizo a los 67 años, ha condicionado insidiosamente mi recepción lectora.
Environmental Exposome and Atrial Fibrillation: Emerging Evidence and Future Directions
Authors: Wass Sojin Youn , Hahad Omar , Asad Zain , Li Shuo , Chung Mina K. , Benjamin Emelia J. , Nasir Khurram , Rajagopalan Sanjay , Al-Kindi Sadeer G.
Published: April 2024

There has been increased awareness of the linkage between environmental exposures and cardiovascular health and disease. Atrial fibrillation is the most common sustained cardiac arrhythmia, affecting millions of people worldwide and contributing to substantial morbidity and mortality. Although numerous studies have explored the role of genetic and lifestyle factors in the development and progression of atrial fibrillation, the potential impact of environmental determinants on this prevalent condition has received comparatively less attention. This review aims to provide a comprehensive overview of the current evidence on environmental determinants of atrial fibrillation, encompassing factors such as air pollution, temperature, humidity, and other meteorologic conditions, noise pollution, greenspace, and the social environment. We discuss the existing evidence from epidemiological and mechanistic studies, critically evaluating the strengths and limitations of these investigations and the potential underlying biological mechanisms through which environmental exposures may affect atrial fibrillation risk. Furthermore, we address the potential implications of these findings for public health and clinical practice and identify knowledge gaps and future research directions in this emerging field.
An End-to-End Musical Instrument System That Translates
Electromyogram Biosignals to Synthesized Sound
Authors: Tanaka Atau , Visi Federico , Donato Balandino Di , Klang Martin , Zbyszyński Michael
Published: April 2024

This article presents a custom system combining hardware and software that senses physiological signals of the performer's body resulting from muscle contraction and translates them to computer-synthesized sound. Our goal was to build upon the history of research in the field to develop a complete, integrated system that could be used by nonspecialist musicians. We describe the Embodied AudioVisual Interaction Electromyogram, an end-to-end system spanning wearable sensing on the musician's body, custom microcontroller-based biosignal acquisition hardware, machine learning–based gesture-to-sound mapping middleware, and software-based granular synthesis sound output. A novel hardware design digitizes the electromyogram signals from the muscle with minimal analog preprocessing and treats it in an audio signal-processing chain as a class-compliant audio and wireless MIDI interface. The mapping layer implements an interactive machine learning workflow in a reinforcement learning configuration and can map gesture features to auditory metadata in a multidimensional information space. The system adapts existing machine learning and synthesis modules to work with the hardware, resulting in an integrated, end-to-end system. We explore its potential as a digital musical instrument through a series of public presentations and concert performances by a range of musical practitioners.
A new species and new records of the spider genus Dubiaranea (Araneae, Linyphiidae) from southern Brazil and Uruguay, with an analysis of the potential distribution of the species
Authors: CAJADE MANUEL , HAGOPIÁN DAMIÁN , RODRIGUES EVERTON N. L. , GUERRERO JOSÉ C. , LABORDA ÁLVARO , SIMÓ MIGUEL
Published: April 2024

Dubiaranea magatama Cajade, Hagopián & Rodrigues n. sp. is described from Uruguay, and southern Brazil based on males and females from several types of native forests, and a potential distribution for this species is modeled. The predicted model for this species indicates a Pampean province and southern Atlantic Forest biome distribution. Three variables contributed significantly to the model with positive influence: the spatial component, the proximity to large rivers, and the tree cover. Also, we provide new records of Dubiaranea difficilis (Mello-Leitão 1944) for Uruguay and a model of its potential distribution was performed. It showed that tree cover, the proximity to large rivers, the spatial component and precipitation/evapotranspiration constraints were recovered for the model with positive influence, expanding the potential distribution area previously proposed.
New genus of Pleminiini Brunner von Wattenwyl, 1878 (Orthoptera: Tettigoniidae: Pseudophyllinae) from the Colombian Andes
Authors: MENDES DIEGO M. M. , PÁDUA DIEGO G. , ARAUJO RODRIGO O. , MAZARIEGOS LUIS A. , FERNANDES DANIELL R. R.
Published: April 2024

The Pleminiini tribe (Pseudophyllinae: Tettigoniidae) currently comprises 51 genera and 227 valid species with a Neotropical and Afrotropical distribution. Herein, the new monotypic genus Muscuspina Mendes gen. nov. is described with a new species, Muscuspina neblina Mendes sp. nov., distributed in the Andean montane forest of Antioquia, Colombia. Maps and natural history observations are provided.
Vitisma coriacea sp.n. (Insecta: Dictyoptera) from the mid-Cretaceous in northern Myanmar, first record of the genus in amber
Authors: SENDI HEMEN
Published: April 2024

The genus Vitisma Vršanský, 1999 is characterised by a shield-like, convex pronotum with transverse margins, scleroritized forewings with sometimes white macula, long clavus and rather simplified venation (simple Sc, straight and expanded M veins, CuA narrow and branched, A simple, R reaching apex). The hindwing venation is similar to the Blattulidae with a distinct pterostigma, but R1 is comb-like and CuA branched. The first record of Vitisma coriacea sp. n. in Burmese amber extends its palaeogeographic distribution to Gondwana, similar to other Umenocoleoidea. So far, the genus was only known from sediments in Spain, Russia, Mongolia, and possibly Japan. It also suggests that representatives of Vitisma inhabited warmer, tropical forest biomes.
Cronbach’s Alpha: Genesis, Issues and Alternatives
Authors: Kumar Rohit Vishal
Published: April 2024

The most widely used metric for assessing a scale’s reliability is Cronbach’s alpha. Since its introduction in 1951 by Lee Cronbach, it has evolved into the accepted benchmark for scale reliability. A quick search for ‘Cronbach’s alpha’ in Google Scholar yields more than 8 hundred thousand results. By any measure, this is enormous, and the usage of alpha appears to be present in practically every domain of academics. The fact that alpha has been so successful is surprising, as researchers have consistently criticised and have pointed out a plethora of problems with it. For instance, is that Cronbach never suggested alpha as a reliability metric—rather he proposed alpha as an alternative measure for equivalency in a test-retest context. Another issue Cronbach never suggested the lower bound of 0.70 as a benchmark of reliability. However, the lower bound of 0.70 has become the holy grail of scale reliability. Alpha continues to lead all measures of scale reliability despite its numerous issues. This article examines the history of alpha, its derivations based on classical test theory, and its limitations. It then suggests three alternative measures, along with software procedures to calculate them: alpha with confidence interval, omega and greatest lower bound. The purpose of this article is to enable researchers to have a better idea about the limitations of Cronbach’s alpha, and to make them aware of other measures of reliability which are available. It is hoped that this article will help researchers report better and more accurate reliability measures in their research works alongside the alpha.
Mitotic gene regulation by the N-MYC-WDR5-PDPK1 nexus
Authors: Streeter Sarah A. , Williams Alexandria G. , Evans James R. , Wang Jing , Guarnaccia Alissa D. , Florian Andrea C. , Al-Tobasei Rafet , Liu Qi , Tansey William P. , Weissmiller April M.
Published: April 2024

Background

During mitosis the cell depends on proper attachment and segregation of replicated chromosomes to generate two identical progeny. In cancers defined by overexpression or dysregulation of the MYC oncogene this process becomes impaired, leading to genomic instability and tumor evolution. Recently it was discovered that the chromatin regulator WDR5—a critical MYC cofactor—regulates expression of genes needed in mitosis through a direct interaction with the master kinase PDPK1. However, whether PDPK1 and WDR5 contribute to similar mitotic gene regulation in MYC-overexpressing cancers remains unclear. Therefore, to characterize the influence of WDR5 and PDPK1 on mitotic gene expression in cells with high MYC levels, we performed a comparative transcriptomic analysis in neuroblastoma cell lines defined by MYCN-amplification, which results in high cellular levels of the N-MYC protein.

Results

Using RNA-seq analysis, we identify the genes regulated by N-MYC and PDPK1 in multiple engineered CHP-134 neuroblastoma cell lines and compare them to previously published gene expression data collected in CHP-134 cells following inhibition of WDR5. We find that as expected N-MYC regulates a multitude of genes, including those related to mitosis, but that PDPK1 regulates specific sets of genes involved in development, signaling, and mitosis. Analysis of N-MYC- and PDPK1-regulated genes reveals a small group of commonly controlled genes associated with spindle pole formation and chromosome segregation, which overlap with genes that are also regulated by WDR5. We also find that N-MYC physically interacts with PDPK1 through the WDR5-PDPK1 interaction suggesting regulation of mitotic gene expression may be achieved through a N-MYC-WDR5-PDPK1 nexus.

Conclusions

Overall, we identify a small group of genes highly enriched within functional gene categories related to mitotic processes that are commonly regulated by N-MYC, WDR5, and PDPK1 and suggest that a tripartite interaction between the three regulators may be responsible for setting the level of mitotic gene regulation in N-MYC amplified cell lines. This study provides a foundation for future studies to determine the exact mechanism by which N-MYC, WDR5, and PDPK1 converge on cell cycle related processes.
A murine model for the del(GJB6-D13S1830) deletion recapitulating the phenotype of human DFNB1 hearing impairment: generation and functional and histopathological study
Authors: Domínguez-Ruiz María , Murillo-Cuesta Silvia , Contreras Julio , Cantero Marta , Garrido Gema , Martín-Bernardo Belén , Gómez-Rosas Elena , Fernández Almudena , del Castillo Francisco J. , Montoliu Lluís , Varela-Nieto Isabel , del Castillo Ignacio
Published: April 2024

Inherited hearing impairment is a remarkably heterogeneous monogenic condition, involving hundreds of genes, most of them with very small (< 1%) epidemiological contributions. The exception is GJB2, the gene encoding connexin-26 and underlying DFNB1, which is the most frequent type of autosomal recessive non-syndromic hearing impairment (ARNSHI) in most populations (up to 40% of ARNSHI cases). DFNB1 is caused by different types of pathogenic variants in GJB2, but also by large deletions that keep the gene intact but remove an upstream regulatory element that is essential for its expression. Such large deletions, found in most populations, behave as complete loss-of-function variants, usually associated with a profound hearing impairment. By using CRISPR-Cas9 genetic edition, we have generated a murine model (Dfnb1em274) that reproduces the most frequent of those deletions, del(GJB6-D13S1830). Dfnb1em274 homozygous mice are viable, bypassing the embryonic lethality of the Gjb2 knockout, and present a phenotype of profound hearing loss (> 90 dB SPL) that correlates with specific structural abnormalities in the cochlea. We show that Gjb2 expression is nearly abolished and its protein product, Cx26, is nearly absent all throughout the cochlea, unlike previous conditional knockouts in which Gjb2 ablation was not obtained in all cell types. The Dfnb1em274 model recapitulates the clinical presentation of patients harbouring the del(GJB6-D13S1830) variant and thus it is a valuable tool to study the pathological mechanisms of DFNB1 and to assay therapies for this most frequent type of human ARNSHI.
Integrated metabolomic and transcriptomic analyses provide insights into regulation mechanisms during bulbous stem development in the Chinese medicinal herb plant, Stephania kwangsiensis
Authors: Huang Hao , Wei Ying , Huang Shaojun , Lu Shijian , Su Huasheng , Ma Liuhui , Huang Weiping
Published: April 2024

Background

Stephania kwangsiensis Lo (Menispermaceae) is a well-known Chinese herbal medicine, and its bulbous stems are used medicinally. The storage stem of S. kwangsiensis originated from the hypocotyls. To date, there are no reports on the growth and development of S. kwangsiensis storage stems.

Results

The bulbous stem of S. kwangsiensis, the starch diameter was larger at the stable expanding stage (S3T) than at the unexpanded stage (S1T) or the rapidly expanding stage (S2T) at the three different time points. We used ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) and Illumina sequencing to identify key genes involved in bulbous stem development. A large number of differentially accumulated metabolites (DAMs) and differentially expressed genes (DEGs) were identified. Based on the differential expression profiles of the metabolites, alkaloids, lipids, and phenolic acids were the top three differentially expressed classes. Compared with S2T, significant changes in plant signal transduction and isoquinoline alkaloid biosynthesis pathways occurred at both the transcriptional and metabolic levels in S1T. In S2T compared with S3T, several metabolites involved in tyrosine metabolism were decreased. Temporal analysis of S1T to S3T indicated the downregulation of phenylpropanoid biosynthesis, including lignin biosynthesis. The annotation of key pathways showed an up-down trend for genes and metabolites involved in isoquinoline alkaloid biosynthesis, whereas phenylpropanoid biosynthesis was not completely consistent.

Conclusions

Downregulation of the phenylpropanoid biosynthesis pathway may be the result of carbon flow into alkaloid synthesis and storage of lipids and starch during the development of S. kwangsiensis bulbous stems. A decrease in the number of metabolites involved in tyrosine metabolism may also lead to a decrease in the upstream substrates of phenylpropane biosynthesis. Downregulation of lignin synthesis during phenylpropanoid biosynthesis may loosen restrictions on bulbous stem expansion. This study provides the first comprehensive analysis of the metabolome and transcriptome profiles of S. kwangsiensis bulbous stems. These data provide guidance for the cultivation, breeding, and harvesting of S. kwangsiensis.
The influence of climate change on the future distribution of two Thymus species in Iran: MaxEnt model-based prediction
Authors: Hosseini Naser , Ghorbanpour Mansour , Mostafavi Hossein
Published: April 2024

Within a few decades, the species habitat was reshaped at an alarming rate followed by climate change, leading to mass extinction, especially for sensitive species. Species distribution models (SDMs), which estimate both present and future species distribution, have been extensively developed to investigate the impacts of climate change on species distribution and assess habitat suitability. In the West Asia essential oils of T. daenensis and T. kotschyanus include high amounts of thymol and carvacrol and are commonly used as herbal tea, spice, flavoring agents and medicinal plants. Therefore, this study aimed to model these Thymus species in Iran using the MaxEnt model under two representative concentration pathways (RCP 4.5 and RCP 8.5) for the years 2050 and 2070. The findings revealed that the mean temperature of the warmest quarter (bio10) was the most significant variable affecting the distribution of T. daenensis. In the case of T. kotschyanus, slope percentage was the primary influencing factor. The MaxEnt modeling also demonstrated excellent performance, as indicated by all the Area Under the Curve (AUC) values exceeding 0.9. Moreover, based on the projections, the two mentioned species are expected to undergo negative area changes in the coming years. These results can serve as a valuable achievement for developing adaptive management strategies aimed at enhancing protection and sustainable utilization in the context of global climate change.
Pre-COVID-19-pandemic RSV epidemiology and clinical burden in pediatric primary care in Italy: a comparative analysis across two regions for the 2019/2020 season
Authors: Pandolfi Elisabetta , Loconsole Daniela , Chironna Maria , van Summeren Jojanneke , Paget John , Raponi Massimiliano , Russo Luisa , Campagna Ilaria , Croci Ileana , Concato Carlo , Perno Carlo Federico , Tozzi Alberto Eugenio , Linardos Giulia , Bartolucci Veronica , Ciampini Sara , Muda Andrea Onetti , De Angelis Luigi , Ciofi Degli Atti Marta Luisa , Rizzo Caterina
Published: April 2024

Background

Respiratory syncytial virus (RSV) infection in children under 5 years have a significant clinical burden, also in primary care settings. This study investigates the epidemiology and burden of RSV in Italian children during the 2019/20 pre-pandemic winter season.

Methods

A prospective cohort study was conducted in two Italian regions. Children with Acute Respiratory Infection (ARI) visiting pediatricians were eligible. Nasopharyngeal swabs were collected and analyzed via multiplex PCR for RSV detection. A follow-up questionnaire after 14 days assessed disease burden, encompassing healthcare utilization and illness duration. Statistical analyses, including regression models, explored associations between variables such as RSV subtype and regional variations.

Results

Of 293 children with ARI, 41% (119) tested positive for RSV. Median illness duration for RSV-positive cases was 7 days; 6% required hospitalization (median stay: 7 days). Medication was prescribed to 95% (110/116) of RSV cases, with 31% (34/116) receiving antibiotics. RSV subtype B and regional factors predicted increased healthcare utilization. Children with shortness of breath experienced a 36% longer illness duration.

Conclusions

This study highlights a significant clinical burden and healthcare utilization associated with RSV in pre-pandemic Italian primary care settings. Identified predictors, including RSV subtype and symptomatology, indicate the need for targeted interventions and resource allocation strategies. RSV epidemiology can guide public health strategies for the implementation of preventive measures.
Epidemiological investigation of dengue fever outbreak and its socioeconomic determinants in Banadir region, Somalia
Authors: Mohamed Mohamed Abdelrahman , Hassan Nuralein Yusuf , Osman Marian Muse , Gedi Saido , Maalin Bisma Abdullahi Ali , Sultan Kasim Mahdi , Garba Bashiru , Osman Ali Abdirahman , Osman Abdinasir Yusuf , Ahmed Abdifatah Diriye
Published: April 2024

Background

Dengue has become an alarming global problem and is endemic in many countries, particularly in tropical and subtropical countries. The aim of this study was to investigate dengue fever outbreak in Banadir Region, Somalia, to understand the risk factors (time, place, personal characteristics).

Methods

A descriptive cross-sectional study was undertaken to determine the levels of circulating anti-dengue virus antibodies and DENV NS1 antigen among Banadir Region residents, while a questionnaire survey was conducted to understand the clinical and demographic characteristics of the patients.

Results

A total of 735 febrile patients were studied, with 55.6% men and 44.3% women. The majority of the participants were children aged 14 years and younger. Among them, 10.8% tested positive for IgM antibodies against dengue virus (DENV), while the prevalence of DENV NS1 antigen was 11.8%. Fever and myalgia were the most common symptoms observed in the DENV-positive patients.

Conclusions

A dengue fever outbreak has been confirmed in Banadir region, Somalia. This study provides information on the most affected districts and identifies risk factors contributing to DF outbreaks. The study recommends improving outbreak readiness and response, particularly in surveillance and laboratory diagnostics, by fostering intersectoral collaboration and establishing regulatory frameworks for financial and operational participation.
Low-dose aspirin for the prevention of preterm birth in nulliparous women: systematic review and meta-analysis
Authors: Yan Xin , Zheng Wei , Wang Jia , Yuan Xianxian , Li Guanghui
Published: April 2024

Objective

The objective was to assess the efficacy and safety of low-dose aspirin for the prevention of preterm birth in nulliparous women.

Data sources

We searched PubMed, Embase and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception to June 2022.

Study eligibility criteria

Randomized controlled trials that compared aspirin to placebo in nulliparous women were eligible.

Methods

This study was reported in accordance with the PRISMA 2020 checklist. The primary outcomes of this study were the rates of preterm birth at less than 37 weeks and less than 34 weeks of gestation. The secondary outcomes included postpartum hemorrhage, placental abruption, cesarean section, any hypertensive disorder of pregnancy and small for gestational age. Relative risks with their 95% confidence intervals were calculated for analysis. Heterogeneity was assessed by Cochran’s Q test and Higgins’s I2. A random-effects model was used when I2 was > 50% to generate the RR and 95% CI; otherwise, a fixed-effects model was used. The risk of publication bias was assessed by funnel plots. We performed sensitivity analysis by sequentially omitting each included study to confirm the robustness of the analysis.

Results

Seven studies with a total of 29,029 participants were included in this review. Six studies were assessed as having a low risk of bias or an unclear risk of bias, and one study was judged as having a high risk of bias. In nulliparous women, low-dose aspirin was associated with a significant reduction in the rate of preterm birth at less than 34 weeks of gestational age (RR 0.84,95% CI: 0.71–0.99; I2 = 0%; P = 0.04), but we did not observe a significant difference in the rate of preterm birth at less than 37 weeks of gestation (RR 0.96,95% CI: 0.90–1.02; I2 = 31%; P = 0.18). Low-dose aspirin was associated with a significant increase in the rates of postpartum hemorrhage (RR 1.32,95% CI: 1.14–1.54; I2 = 0%; P = 0.0003), placental abruption (RR 2.18,95% CI: 1.10–4.32; I2 = 16%; P = 0.02) and cesarean section (RR 1.053, 95% CI: 1.001–1.108; I2 = 0%; P = 0.05) in nulliparous women. We also did not observe a significant effect of low-dose aspirin on the rates of any hypertensive disorder of pregnancy (RR 1.05, 95% CI: 0.96–1.14; I2 = 9%; P = 0.28) or small for gestational age (RR 0.96, 95% CI: 0.91–1.02; I2 = 0%; P = 0.16) in nulliparous women. Funnel plots indicated that no significant publication bias existed in this meta-analysis. Except for preterm birth at less than 34 weeks of gestation, placental abruption and cesarean section, the sensitivity analysis showed similar results, which confirmed the robustness of this meta-analysis.

Conclusions

Low-dose aspirin might reduce the risk of preterm birth at less than 34 weeks of gestation in nulliparous women. The use of low-dose aspirin in nulliparous women increased the risk of postpartum hemorrhage and might increase the risk of placental abruption and cesarean section.
Pregnant and postpartum women’s experiences of the indirect impacts of the COVID-19 pandemic in high-income countries: a qualitative evidence synthesis
Authors: Tan Annie , Blair Amanda , Homer Caroline SE. , Digby Robin , Vogel Joshua P. , Bucknall Tracey
Published: April 2024

Background

Pregnant and postpartum women’s experiences of the COVID-19 pandemic, as well as the emotional and psychosocial impact of COVID-19 on perinatal health, has been well-documented across high-income countries. Increased anxiety and fear, isolation, as well as a disrupted pregnancy and postnatal period are widely described in many studies. The aim of this study was to explore, describe and synthesise studies that addressed the experiences of pregnant and postpartum women in high-income countries during the first two years of the pandemic.

Methods

A qualitative evidence synthesis of studies relating to women’s experiences in high-income countries during the pandemic were included. Two reviewers extracted the data using a thematic synthesis approach and NVivo 20 software. The GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) was used to assess confidence in review findings.

Results

Sixty-eight studies were eligible and subjected to a sampling framework to ensure data richness. In total, 36 sampled studies contributed to the development of themes, sub-themes and review findings. There were six over-arching themes: (1) dealing with public health restrictions; (2) navigating changing health policies; (3) adapting to alternative ways of receiving social support; (4) dealing with impacts on their own mental health; (5) managing the new and changing information; and (6) being resilient and optimistic. Seventeen review findings were developed under these themes with high to moderate confidence according to the GRADE-CERQual assessment.

Conclusions

The findings from this synthesis offer different strategies for practice and policy makers to better support women, babies and their families in future emergency responses. These strategies include optimising care delivery, enhancing communication, and supporting social and mental wellbeing.
Glucose control during pregnancy in patients with type 1 diabetes correlates with fetal hemodynamics: a prospective longitudinal study
Authors: Simjak Patrik , Anderlova Katerina , Smetanová Dagmar , Kršek Michal , Mráz Miloš , Haluzík Martin
Published: April 2024

Background

Maternal diabetes adversely affects fetal cardiovascular system development. Previous studies have reported that the fetuses of mothers with diabetes exhibit both structural and functional changes; nevertheless, prior studies have not examined the association between glucose control and fetal cardiac morphology and performance. Thus, the objective was to determine the association between fetal cardiac morphology and function and maternal glucose control in type 1 diabetes and to compare the differences in measured cardiac parameters between the fetuses of mothers with diabetes and healthy controls.

Methods

In this prospective, longitudinal case-control study — including 62 pregnant women with type 1 diabetes mellitus and 30 healthy pregnant women — fetal cardiac assessment using B-mode, M-mode, and spectral pulsed-wave Doppler was performed in the second and third trimesters. In women with T1DM, glycated hemoglobin and data obtained from glucose sensors — including the percentage of time in, below, and above the range (TIR, TBR, and TAR, respectively), and coefficient of variation (CV) — were analyzed across three time periods: the last menstrual period to 13 (V1), 14–22 (V2), and 23–32 weeks (V3) of gestation. Fetal cardiac indices were compared between groups, and the correlation between glucose control and fetal cardiac indices was assessed.

Results

At 28–32 weeks, the fetuses of women with T1DM exhibited increased left ventricular end-diastolic length, relative interventricular septum thickness, right ventricular cardiac output, and pulmonary valve peak systolic velocity compared with healthy controls. At 18–22 weeks, pulmonary and aortic valve diameters, left and right ventricular stroke volumes, and left cardiac output inversely correlated with the CV and glycated hemoglobin levels at V1 and V2. Furthermore, at 28–32 weeks, pulmonary and aortic valve diameters, left ventricular stroke volume, cardiac output, and right/left atrioventricular valve ratio inversely correlated with the TBR at V1, V2, and V3. Moreover, diastolic functional parameters correlated with the TAR and glycated hemoglobin levels, particularly after the first trimester.

Conclusion

In women with T1DM, maternal hyperglycemia during pregnancy correlates with fetal diastolic function, whereas glucose variability and hypoglycemia inversely correlate with fetal left ventricular systolic function in the second and third trimesters.
Using the WHO individual near miss case review (NMCR) cycle to improve quality of emergency obstetric care and maternal outcome in Keren hospital, Eritrea: an interrupted time series analysis
Authors: Zewde Henos Kiflom
Published: April 2024

Background

In 2016, the WHO regional office for Europe prepared a manual for conducting routine facility based individual near miss case review cycle. This study evaluates the effectiveness of the individual near miss case review (NMCR) cycle in improving quality of emergency obstetric care and maternal outcome in Keren hospital.

Methods

An interrupted time series design was used to achieve the objectives of this study. Monthly data on women with potentially life-threatening conditions (PLTCs) admitted between April 2018 and October 2022 (i.e. 33 months pre-implementation and 22 months post-implementation) were collected from medical records. Segmented regression analysis was used to assess the intervention’s effect on three process and outcome measures, namely, SMO, delayed care, and substandard care. The intervention was expected a priori to show immediate improvements without time-lag followed by gradual increment in slope. Segmented regression analyses were performed using the “itsa’ command in STATA.

Results

During the entire study period, 4365 women with potentially life threatening conditions were identified. There was a significant reduction in the post-implementation period in the proportion of mothers with PLTC who experienced SMO (− 8.86; p <  0.001), delayed care (− 8.76; p <  0.001) and substandard care (− 5.58; p <  0.001) compared to pre-implementation period. Results from the segmented regression analysis revealed that the percentage of women with SMO showed a significant 4.75% (95% CI: − 6.95 to − 2.54, p <  0.001) reduction in level followed by 0.28 percentage points monthly (95% CI: − 0.37 to − 0.14, p <  0.001) drop in trend. Similarly, a significant drop of 3.50% (95% CI: − 4.74 to − 2.26, p <  0.001) in the level of substandard care along with a significant decrease of 0.21 percentage points (95% CI: − 0.28 to − 0.14, p < 0.001) in the slope of the regression line was observed. The proportion of women who received delayed care also showed a significant 7% (95% CI: − 9.28 to − 4.68, p < 0.001) reduction in post-implementation level without significant change in slope.

Conclusions

Our findings suggest that the WHO individual NMCR cycle was associated with substantial improvements in quality of emergency obstetric care and maternal outcome. The intervention also bears a great potential for scaling-up following the guidance provided in the WHO NMCR manual.
Plasma extracellular vesicles in meningioma patients following radiotherapy as liquid biopsy- a prospective explorative biomarker study (ARO 2023-05/AG-NRO-07)
Authors: Deng Maximilian Y. , da Silva Amanda Salviano , Göller Pauline Carlotta , König Laila , Schäfer Henning , Maire Cecile , Lentz-Hommertgen Adriane , Held Thomas , Regnery Sebastian , Eichkorn Tanja , Stritzke Florian , Bauer Lukas , Schnell Daniel , Herfarth Klaus , von Deimling Andreas , Krieg Sandro , Wick Antje , Wick Wolfgang , Grosu Anca , Debus Jürgen , Sahm Felix , Ricklefs Franz
Published: April 2024

Background

While surgical resection remains the primary treatment approach for symptomatic or growing meningiomas, radiotherapy represents an auspicious alternative in patients with meningiomas not safely amenable to surgery. Biopsies are often omitted in light of potential postoperative neurological deficits, resulting in a lack of histological grading and (molecular) risk stratification. In this prospective explorative biomarker study, extracellular vesicles in the bloodstream will be investigated in patients with macroscopic meningiomas to identify a biomarker for molecular risk stratification and disease monitoring.

Methods

In total, 60 patients with meningiomas and an indication of radiotherapy (RT) and macroscopic tumor on the planning MRI will be enrolled. Blood samples will be obtained before the start, during, and after radiotherapy, as well as during clinical follow-up every 6 months. Extracellular vesicles will be isolated from the blood samples, quantified and correlated with the clinical treatment response or progression. Further, nanopore sequencing-based DNA methylation profiles of plasma EV-DNA will be generated for methylation-based meningioma classification.

Discussion

This study will explore the dynamic of plasma EVs in meningioma patients under/after radiotherapy, with the objective of identifying potential biomarkers of (early) tumor progression. DNA methylation profiling of plasma EVs in meningioma patients may enable molecular risk stratification, facilitating a molecularly-guided target volume delineation and adjusted dose prescription during RT treatment planning.
ESCO2’s oncogenic role in human tumors: a pan-cancer analysis and experimental validation
Authors: Huang Yue , Chen Dapeng , Bai Yi , Zhang Yamin , Zheng Zhiwen , Fu Qingfeng , Yi Bocun , Jiang Yuchen , Zhang Zhihong , Zhu Jianqiang
Published: April 2024

Purpose

Establishment of sister chromatid cohesion N-acetyltransferase 2 (ESCO2) is involved in the mitotic S-phase adhesins acetylation and is responsible for bridging two sister chromatids. However, present ESCO2 cancer research is limited to a few cancers. No systematic pan-cancer analysis has been conducted to investigate its role in diagnosis, prognosis, and effector function.

Methods

We thoroughly examined the ESCO2 carcinogenesis in pan-cancer by combining public databases such as The Cancer Genome Atlas (TCGA), Genotype-Tissue Expression Project (GTEx), UALCAN and Tumor Immune Single-cell Hub (TISCH). The analysis includes differential expression analysis, survival analysis, cellular effector function, gene mutation, single cell analysis, and tumor immune cell infiltration. Furthermore, we confirmed ESCO2’s impacts on clear cell renal cell carcinoma (ccRCC) cells’ proliferative and invasive capacities in vitro.

Results

In our study, 30 of 33 cancer types exhibited considerably greater levels of ESCO2 expression in tumor tissue using TCGA and GTEx databases, whereas acute myeloid leukemia (LAML) exhibited significantly lower levels. Kaplan-Meier survival analyses in adrenocortical carcinoma (ACC), kidney chromophobe (KICH), kidney renal clear cell carcinoma (KIRC), kidney renal papillary cell carcinoma (KIRP), brain lower grade glioma (LGG), liver hepatocellular carcinoma (LIHC), lung adenocarcinoma (LUAD), mesothelioma (MESO), and pancreatic adenocarcinoma (PAAD) demonstrated that tumor patients with high ESCO2 expression have short survival periods. However, in thymoma (THYM), colon adenocarcinoma (COAD) and rectum adenocarcinoma (READ), ESCO2 was a favorable prognostic factor. Moreover, ESCO2 expression positively correlates with tumor stage and tumor size in several cancers, including LIHC, KIRC, KIRP and LUAD. Function analysis revealed that ESCO2 participates in mitosis, cell cycle, DNA damage repair, and other processes. CDK1 was identified as a downstream gene regulated by ESCO2. Furthermore, ESCO2 might also be implicated in immune cell infiltration. Finally, ESCO2’S knockdown significantly inhibited the A498 and T24 cells’ proliferation, invasion, and migration.

Conclusions

In conclusion, ESCO2 is a possible pan-cancer biomarker and oncogene that can reliably predict the prognosis of cancer patients. ESCO2 was also implicated in the cell cycle and proliferation regulation. In a nutshell, ESCO2 is a therapeutically viable and dependable target.
Baseline knowledge on risk factors, symptoms and intended behavior of women and men towards screening and treatment of cervical cancer in rural Uganda: a cross-sectional study
Authors: Nakisige Carolyn , de Fouw Marlieke , Nakalembe Miriam , Orem Jackson , Atukonyera Dan , Musheshe Mwalimu , Koot Jaap , de Zeeuw Janine , Beltman Jogchum , Stekelenburg Jelle
Published: April 2024

Background

Knowledge of risk factors and symptoms of cervical cancer has been found to promote uptake of screening of cervical cancer. Most interventions targeted women without much involvement of men (husbands/decision makers) who are often decision makers in many low- and middle-income countries. This study aimed at assessing baseline knowledge and intended behavior of both women and men to enable design specific targeted messages to increase uptake of cervical cancer screening and promote early detection of women with symptoms.

Methods

This cross-sectional study was conducted in two districts in Western Uganda using the modified African Women Awareness of CANcer (AWACAN) questionnaire. Women aged 30—49 years and their husbands/decision makers were interviewed. Knowledge on risk factors and symptoms, intended behavior and barriers towards participation in cervical cancer screening and treatment were assessed. Descriptive and logistic regression analyses were done to establish the association between knowledge levels and other factors comparing women to men.

Results

A total of 724 women and 692 men were enrolled. Of these, 71.0% women and 67.2% men had ever heard of cervical cancer and 8.8% women had ever been screened. Knowledge of risk factors and symptoms of cervical cancer was high and similar for both women and men.

Lack of decision making by women was associated with low knowledge of risk factors (X2 = 14.542; p = 0.01), low education (X2 = 36.05, p < 0.01) and older age (X2 = 17.33, p < 0.01). Men had better help seeking behavior than women (X2 = 64.96, p < 0.01, OR = 0.39, 95% CI: 0.31—0.50) and were more confident and skilled in recognising a sign or symptom of cervical cancer (X2 = 27.28, p < 0.01, OR = 0.52, CI (0.40—0.67).

Conclusion

The baseline knowledge for cervical cancer was high in majority of participants and similar in both women and men. Their intended behavior towards screening was also positive but screening uptake was very low. This study suggests developing messages on multiple interventions to promote screening behavior in addition to education, consisting of male involvement, women empowerment and making services available, accessible and women friendly.
Biomarkers of lipid metabolism in gastric cancer: a case control study
Authors: Li Fangxuan , Dou Jinli , Wei Lijuan , Li Shixia , Liu Juntian
Published: April 2024

Background

The aim of this study was to explore the correlation between biomarkers of lipid metabolism and gastric cancer.

Methods

1120 gastric cancer patients and 1134 health examiners enrolled in this study. The clinic data and serum lipid level, including Total cholesterol (TC), Triglyceride (TG), Low-density lipoprotein cholesterol (LDL-C) and High-density lipoprotein cholesterol (HDL-C), were collected.

Results

Serum TG and LDL-C levels in patients with gastric cancer were higher than those in the control group. HDL-C levels were lower than the control group (P < 0.05). HDL-C and LDL-C were significantly correlated with the risk of gastric cancer. Concentrating on clinicopathological features, increased TG was more frequently in male patients with distal gastric cancer, N0 stage and early TNM stage. Increased TC was more frequently in early T, N and TNM stage. Decreased HDL-C was more common in distal location and low-undifferentiated gastric cancer. LDL-C elevation was more common in distal gastric cancer and early T stage.

Conclusions

The serum lipid level of gastric cancer patients was higher than healthy controls. HDL-C and LDL-C abnormal correlated with gastric cancer risk. However, as the progresses of gastric cancer, poor patient intake, increased tumor consumption, and continuous declining in nutritional status, the levels of TC and TG gradually decreased in advanced gastric cancer.
Association between socioeconomic status and post-stroke depression in middle-aged and older adults: results from the China health and retirement longitudinal study
Authors: Cai Qianru , Qian Mengyi , Chen Meiling
Published: April 2024

Introduction

Post-stroke depression (PSD) is a common neuropsychiatric complication that affects approximately one-third of stroke patients. The treatment and prognosis of this disease are poor. Socioeconomic status (SES) is closely related to health outcomes; however, only a few previous studies have focused on the association between SES and PSD. Given the substantial population of stroke patients in China, it is crucial to examine the potential risk factors associated with PSD. Conducting studies on this population and investigating the influence of economic conditions can provide valuable guiding theoretical insights into PSD prevention and management.

Methods

We used data from the 2018 China Health and Retirement Longitudinal Study and selected appropriate samples for analysis. Depression was estimated using the Center of Epidemiologic Studies Depression Scale-10, a validated tool for assessing depression in the general population. Multiple logistic regression analysis was employed to assess the association between SES and PSD and to evaluate any urban–rural differences.

Results

Of the 749 respondents, 370 (49.4%) had depression. Stroke patients with a middle school education demonstrated a greater risk of developing depression than those with a primary school education or below after adjusting for all control variables (odds ratio (OR) = 1.60, 95% confidence interval (CI): 1.03–2.51, P = 0.036). However, stroke patients with a high school education or above had a lower risk of developing depression than those with a primary school education or below (OR = 0.50, 95% CI: 0.28–0.88, P = 0.016). In rural areas, stroke patients with a high school or above education level had lower rates of depression than those with a primary school education or below (OR = 0.44, 95% CI: 0.21–0.91, P = 0.027). This difference was not significant in urban areas.

Conclusions

SES significantly influences the occurrence of PSD, which is reflected by education attainment and annual household expenditures. Education attainment was an independent influence on PSD, with a more pronounced effect in rural versus urban areas. We hope to reduce the prevalence of PSD and enhance the comprehensive management of this disease by modifying the influencing factors. Sex, self-reported health status, activities of daily living, night-time sleep duration, and life satisfaction also influenced the occurrence of PSD.
Perceptions of medical students on narrow learning objectives and structured debriefing in medical escape rooms: a qualitative study
Authors: Jørgensen Tami , Rosenkrantz Oscar , Eberhard Kristine Elisabeth , Jensen Theo Walther , Dieckmann Peter
Published: April 2024

Background

Escape rooms are increasingly used in medical education as a complementary learning technique or even alternative to traditional educational approaches. Few studies focus on debriefing following medical escape rooms and how escape rooms can be used to achieve pre-defined learning objectives. Evaluating the use of narrow learning objectives may increase the depth of reflections and transform an engaging team event into an effective learning opportunity. This study aimed to explore participants’ experiences and perceived learning outcomes of narrow learning objectives in a medical escape room with debriefing.

Methods

In this explorative, qualitative study, participants saw a video lecture, participated in an escape room experience, and in a following debriefing. Throughout this learning session, the learning objectives concerned “exchange of information” and are therefore relatively narrow. Participants then participated in a semi-structured focus group interview and completed a demographic questionnaire. Participants were volunteer final-year medical students. Focus group interview recordings were transcribed and analysed using systematic text condensation.

Results

Thirty-two students in eight groups completed the study. Five themes were described in the analysis of the focus group interviews: Experience with the narrow learning objectives, topics discussed in the debriefing, learning mechanisms, learning outcomes concerning exchange of information and influences of the learning approach.

Conclusions

Narrow learning objectives and structured debriefing seem to increase perceived learning depth of medical escape room sessions. Using semi-structured debriefing still allows for discussions of other elements relevant to the students.

Clinical trials

Clinical.trials ID NCT04783259.