bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of a Finite Element Model to Analyze the Lateral Drift of Autonomous Vehicles and Its Impacts on Rutting Depth on Flexible Pavements Under Mixed Traffic Scenarios
Authors: Liang Kaidi , Qian Zhendong , Xie Yuxin , Wang Haibo
Published: August 2023

The continuous development of technologies, including intelligent networking, machine vision, and new energy vehicles, has made autonomous driving vehicles a research focus. Autonomous vehicles significantly affect road performance under mixed traffic flow conditions with their excellent lateral control ability and driving stability. A finite element model is established to analyze the impact of these modes on pavement deformation under maximum air temperature in Nanjing, China. Based on the simulation results, it has been shown that lateral control of autonomous vehicles significantly reduces pavement deformation. The proportion of autonomous vehicles affects the difference in distribution modes, and the uniform distribution mode is the most favorable for horizontal distribution. Additionally, the edge lane experiences less pavement deformation than the center lane and varies more when the distribution pattern changes. By comparing the deformation of the center and edge lanes, the edge lane experiences a significant reduction in deformation under the uniform distribution mode, with a maximum reduction of 73.7%. Comparing the pavement deformation of center and edge lanes under normal distribution mode and uniform distribution mode shows that safe solutions for the lateral distribution of autonomous vehicles depend on the proportion of autonomous vehicles. The optimal driving speed for autonomous vehicles is 80 km/h under the uniform distribution model, while under the normal distribution model it is 90 km/h or 110 km/h. These findings provide a theoretical basis for the lateral control of autonomous vehicles in the future and propose safe solutions for the lateral distribution of autonomous vehicles.
Elevated levels of tumor necrosis factor alpha in postdialysis fatigue
Authors: Dreisbach A.W. , Hendrickson T. , Beezhold D. , Riesenberg L.A. , Sklar A.H.
Published: August 2023

Postdialysis fatigue (PDF) has been ascribed to excessive ultrafiltration and decline in osmolality during hemodialysis. We evaluated the potential role for the sommogenic cytokines, interleukin-1 beta (IL-1β) and tumor necrosis factor alpha (TNFα), in the genesis of PDF. Patients dialyzing with cuprophane membrane were assigned to PDF (N=25) and non-PDF (N=25) groups based on a fatigue index questionnaire. Pre- and postdialysis samples were obtained from 3 consecutive treatments and later assayed for serum levels of IL-1β and TNFα by ELISA. Our results show significant intradialytic elevation of TNFα in both non-PDF groups (non-PDF: pre- 3.36±0.80 pg/ml to post 3.75±0.88 pg/ml, p<0.04; PDF: pre- 5.95±0.80 pg/ml to post- 8.66±1.35 pg/ml, p<0.02). The degree of intradialytic augmentation was significantly greater for TNFα in the PDF group (46 ± 18% vs 11 ± 5%; p<0.03). There were no significant intradialytic changes in serum levels of IL-1β in either the PDF or non-PDF groups. There also were no significant differences in dialysis-related body weights, systolic blood pressures, or osmolalities. These findings suggest that TNFα may be involved in the pathogenesis of PDF. (Int J Artif Organs 1998; 21:83–6)
DEHP-induced alterations in the lining tissue of the rat air pouch
Authors: Stabellini G. , Bedani RL , Fiocchi O. , Calastrini C. , Pagliarini A. , Lunghi M. , Carinci F. , Pellati A. , Giuliani A. , Berti G.
Published: August 2023

The direct effects of D(2-ethylhexyl)phthalate (DEHP), on subcutaneous tissue were studied in the rat, using the air pouch technique. Two ml of DEHP, either undiluted or diluted in olive oil (10 μm/ml), were introduced into a previously created air pouch in the rats. The air pouch was removed and specimens of the lining tissue examined by optical and electron microscopy. The persistence of DEHP for 7 days is sufficient to cause alterations in the tissue. The major histological changes were the destruction of the tissue organization with cytoplasmic and nuclear alterations resulting in apoptotic bodies. The histochemical data showed an increase of sulphated glycosaminoglycans, showing proof of alterations in fibroblast functions. The authors suggest that the hyperplastic-type alteration induced by DEHP may be connected with the sclerosis of the peritoneal membrane described in uremic patients in CAPD. (Int J Artif Organs 1998; 21:87–94)
CAPD catheter rupture without deterioration
Authors: Kushihata S. , Yorioka N. , Ito T. , Nishida Y. , Amimoto D. , Ye X.F. , Yamakido M.
Published: August 2023

Continuous ambulatory peritoneal dialysis (CAPD) is associated with various problems, including damage to the CAPD catheter. We encountered catheter rupture around the titanium adaptor in a patient who had been on CAPD for 7 years. The area near the adaptor generally suffers damage secondary to deterioration of the silicon composing the catheter. However, stereoscopic and electron microscopic observation of the surface of the catheter revealed no deterioration. Instead, there were fine scratches around the site of rupture and the broken surface was rough. Since the patient did not protect the catheter with gauze near the titanium adaptor, it was probably damaged by the adaptor and then ruptured by some external force. (Int J Artif Organs 1998; 21:95–6)
Artificial Intelligence and Pay Information Disclosure: Changing How Pay is Communicated
Authors: Nyberg Anthony J. , Cragun Ormonde R. , Conroy Samantha A. , Weller Ingo
Published: August 2023

Pay information disclosure (PID), or communicating pay information between and among actors, affects employees, organizations, and societies. Disruptions resulting from artificial intelligence (AI) will also change how pay is communicated. Based on AI, AI and human resources (HR), and PID, as well as anecdotal data involving organizations that are integrating AI in their pay practices, we introduce areas of AI relevant to PID and describe opportunities and challenges. HR should play a critical role in developing employee trust in AI systems by protecting employee privacy, training AI on high-quality data, and ensuring AI algorithms are ethical. AI can transform PID by supporting advanced pay methodologies, reducing barriers to sharing information, and educating employees. However, research needs to be conducted on all of these areas and practitioners should strive to keep an open, but cautious mind about both the benefits and challenges of integrating AI into HR practices.
Testing for Hiv and Consent: Law and Public Policy
Authors: Wright Moira
Published: August 2023

HIV challenges much of our thinking about civil liberties and consent to medical treatment. Some commentators have argued that since the consequences of a diagnosis of HIV are so grave no testing for the virus may be undertaken in the absence of fully informed consent and the counselling of the patient. This article argues that this misrepresents the current stance of the law. No legal rights are infringed when blood is tested for HIV without specific consent. This is not to deny that there are public policy and human rights issues which ought to be addressed when considering the legality of testing without consent. However these do not arise exclusively in the context of HIV: they are relevant to arguments about consent whenever it arises in the medical arena. HIV may be an impetus for legal change but it would be regrettable if change were to be confined to the sphere of AIDS and HIV testing alone.
India–US Strategic Cooperation through the LEMOA Lens
Authors: Khurshid Imran
Published: August 2023

Since Narendra Modi took office, India and the United States’ strategic ties have become stronger. It took almost 12 years to sign the ‘Logistics Exchange Memorandum of Agreement (LEMOA)’. The LEMOA offers a framework for governing the logistical assistance, supplies and services exchanged between the Indian and US forces on a reciprocal and reimbursable basis. Concerns in India’s strategic elite and political class over the endangerment of India’s strategic autonomy and compromising India’s sovereignty for a long time prevented the execution of this agreement. However, after the BJP government came to power in 2014, it negotiated this agreement with the United States. India has strategically moved closer to the United States by signing this agreement, which will have a lot of positive effects on the development of India’s strategic capabilities and the strengthening of Indian defence forces’ operational capabilities. It will also allow India to expand its strategic influence in the Indo-Pacific region. This study analyses the LEMOA, its implications for India’s strategic autonomy, and its subsequent implications for expanding India’s strategic footprint in the region.
Patients languishing in emergency departments: A descriptive analysis of mental health-related emergency department presentations in Australia between 2016-17 and 2020-21
Authors: Brazel Matthew , Allison Stephen , Bastiampillai Tarun , Kisely Stephen R , Looi Jeffrey CL
Published: August 2023

Objective

In the context of concerns regarding hospital access block, this paper provides a descriptive longitudinal analysis of mental health–related ED episodes in Australian public hospitals between 2016-17 and 2020-21.

Method

We descriptively analysed Australian Institute of Health and Welfare data for mental health–related ED presentations, outcomes and 5-year trends for Australian public hospitals.

Results

There were more than 300,000 Australian mental health–related ED presentations in 2020-21. Presentations increased by an average annual rate of 2.8% between 2016-17 and 2020-21, commonly involving first responder (police, paramedic) attendance. From 2016-17 to 2020-21, the average annual rate of mental health–related ED presentations receiving a triage category of resuscitation increased by 13.7%, emergency by 9.4% and urgent by 4.7%. 90% of MH-related ED presentations were completed within 14 h, which was longer than the 90th percentile for all ED presentations (up to 8 h).

Conclusions

Current mental health policies have not stemmed the rising tide of ED presentations. Mental health–related ED presentations are increasing in number and severity, likely due to health systemic and societal factors. Psychiatry patients stay longer in EDs than other patients. Healthcare reforms should be targeted to provide the best outcome based on principles of equity of access.
Rivaroxaban Versus Low-Molecular-Weight Heparins in a Broad Cohort of Patients With Cancer-Associated Venous Thromboembolism: An Analysis of the OSCAR-US Program
Authors: Caroti Kimberly Snow , Khorana Alok A. , Becattini Cecilia , Lee Agnes Y.Y. , Ekbom Anders , Carrier Marc , Cohen Alexander T. , Brescia Christopher , Abdelgawwad Khaled , Psaroudakis George , Rivera Marcela , Schaefer Bernhard , Brobert Gunnar , Coleman Craig I.
Published: August 2023

Cancer-associated venous thromboembolism (CAT) guidelines recommend direct oral anticoagulants as alternatives to low-molecular-weight heparin (LMWH) in most patients. This study compared the effectiveness and safety of rivaroxaban versus LMWH for a broad CAT cohort. The cohort study used electronic health data from January 2012 to December 2020 to evaluate patients with active cancer experiencing acute venous thromboembolism (VTE) and treated with rivaroxaban or LMWH. Propensity score-overlap weighted hazard ratios (HRs) and 95% confidence intervals (CIs) for VTE, bleeding-related hospitalization, and all-cause mortality were calculated. In total, 4935 patients were identified (27.9% on rivaroxaban and 72.1% on LMWH). The cancer types included gastrointestinal (29.4%), genitourinary (26.2%), lung (24.0%), breast (19.7%), and hematologic (14.4%). Rivaroxaban was associated with a reduction in recurrent VTE versus LMWH among all patients with cancer (HR = 0.78; 95%CI = 0.61-0.99) at 3 months. No differences in bleeding-related hospitalization or all-cause mortality were observed. Directionally similar results to those at 3 months were observed at 6 months for all outcomes. In conclusion, we observed fewer recurrent VTE cases and no increase in bleeding-related hospitalizations with rivaroxaban versus LMWH at 3 months in this patient cohort with various cancer types.
Antimicrobial effect of dried koruk (Vitis vinifera L.) pomace against food-borne pathogens inoculated in kofte
Authors: Kilic Gulden , Ozturk Berna , Kirmizigul Peker Aysegul , Yucel Sengun Ilkin
Published: August 2023

This study aimed to investigate the antimicrobial effects of various concentrations of dried koruk pomace (1%, 1.5%, and 2%) used in kofte formulations. To detect the inactivation effect of dried koruk pomace on food-borne pathogens, kofte samples were separately inoculated with Escherichia coli O157:H7, Listeria monocytogenes, and Salmonella Typhimurium at high and low levels. During the storage period, E. coli O157:H7, L. monocytogenes, and S. Typhimurium counts of the samples inoculated with high levels were decreased in the range of 1.1–1.3 log CFU/g, 0.1–0.2 log CFU/g and 1.1–1.2 log CFU/g, respectively. When low inoculum levels were used, E. coli O157:H7 and S. Typhimurium counts of the samples were reduced to an undetectable level at the beginning and after 2 months of storage, respectively. Although L. monocytogenes counts of the samples were reduced to an undetectable level immediately, the counts were increased during storage till the end of the fifth month. The results indicated that dried koruk pomace was more effective in eliminating E. coli O157:H7 and S. Typhimurium than L. monocytogenes inoculated in kofte. The results suggest that using dried koruk pomace in kofte formulations is an effective method to improve the safety of the products, especially when low levels of contamination occur.
Towards a theory of African learning city
Authors: Biao Idowu , Tsimane Ditiro
Published: August 2023

This article discusses the UNESCO concept of learning city in relation to the peculiarities of the African city. After reviewing earlier theoretical frameworks recommended for the promotion of learning city projects within sub-Saharan Africa, the article comes to the conclusion that those earlier theoretical frameworks are prescriptive. Upon further analysis of the peculiarities of the African city, the article opines that only within a reflexive theoretical framework that is supported by traditional African pedagogies would a learning city project in sub-Saharan Africa succeed.
The impact of bronchoalveolar lavage on the diagnosis of undifferentiated interstitial lung disease alongside a multidisciplinary discussion
Authors: Khan Wafa B , Gallagher Harry M , Jayasimhan Dilip , Dray Michael , Chang Catherina L
Published: August 2023

Background and objective

Cellular analysis of bronchoalveolar lavage (BAL) fluid may aid diagnosis in patients with undifferentiated interstitial lung disease (ILD). The utility of this test in the diagnostic process in conjunction with a multidisciplinary discussion (MDD) is not known. We aim to assess and compare interobserver agreement and diagnostic confidence before and after presenting BAL results in an ILD-MDD.

Methods

Patients undergoing investigations for ILD at Waikato Hospital were recruited. At the ILD-MDD two respiratory physicians and one respiratory radiologist participated in the discussion, and their diagnosis and diagnostic confidence were assessed at four sequential time points. Assessors were blinded to each others diagnosis and diagnostic confidence scores. The four sequential time points were (1) after clinical and radiology presentation; (2) after subsequent MDD; (3) after reviewing BAL results; (4) after final MDD with all results. Interobserver agreements were calculated using Fleiss κ statistic.

Results

36 patients were recruited, and 77.8% were male. In the first step, the interobserver agreement was substantial κ = 0.622 (95% CI 0.47–0.77), improving in step 2 following MDD to κ = 0.78 (95% CI 0.624–0.935), in step 3 κ = 0.776 (95% CI 0.614–0.937) and step 4 achieved almost perfect agreement of κ = 0.969 (95% CI 0.828-1.11). The diagnostic confidence for individual and group diagnosis increased with the presentation of BAL with and without multidisciplinary MDD.

Conclusion

We found that BAL cellular analysis improves interobserver agreement and confidence in diagnosis following MDD, thus aiding decision-making in cases with undifferentiated ILD.
Dynamic consent, communication and return of results in large-scale health data reuse: Survey of public preferences
Authors: Muller Sam HA , van Thiel Ghislaine JMW , Mostert Menno , van Delden Johannes JM
Published: August 2023

Dynamic consent forms a comprehensive, tailored approach for interacting with research participants. We conducted a survey study to inquire how research participants evaluate the elements of consent, information provision, communication and return of results within dynamic consent in a hypothetical health data reuse scenario. We distributed a digital questionnaire among a purposive sample of patient panel members. Data were analysed using descriptive and nonparametric inferential statistics. Respondents favoured the potential to manage changing consent preferences over time. There was much agreement between people favouring closer and more specific control over data reuse approval and those in favour of broader approval, facilitated by an opt-out system or an independent data reuse committee. People want to receive more information about reuse, outcomes and return of results. Respondents supported an interactive model of research participation, welcoming regular, diverse and interactive forms of communication, like a digital communication platform. Approval for reuse and providing meaningful information, including meaningful return of results, are intricately related to facilitating better communication. Respondents favoured return of actionable research results. These findings emphasize the potential of dynamic consent for enabling participants to maintain control over how their data are being used for which purposes by whom. Allowing different options to shape a dynamic consent interface in health data reuse in a personalized manner is pivotal to accommodate plurality in a flexible though robust manner. Interaction via dynamic consent enables participants to tailor the elements of participation they deem relevant to their own preferences, engaging diverse perspectives, interests and preferences.
What determines Tanzania's trade? A gravity approach
Authors: Nyarire Makilagi Bertha , Oh Jinhwan
Published: August 2023

Based on the gravity model, this study examines the determinants of trade flows between Tanzania and its trading partners and attempts to predict the country's trade potential. Using a panel dataset of Tanzania's trade flows of 100 countries from 2000 to 2016, this study finds that the results are consistent with the predictions of the gravity model, with positive and negative coefficients for gross domestic product and distance, respectively. The predicted trade potential reveals that neighboring countries and some middle and superpowers have significant trade potential. Considering the important contribution of trade to economic growth and notwithstanding Tanzania's active membership in regional economic communities, such as the East African Cooperation, Southern African Development Cooperation, and the anticipated engagement in the African Continental Free Trade Agreement, this study provides policy recommendations to reduce trade barriers and diversify production to promote intra-African trade and enhance trade with the rest of the world.
Spiritual Care in Action for Oncology Patients in the uMgungundlovu and eThekwini Health Districts, KwaZulu-Natal, South Africa: A Qualitative Study
Authors: Sewkarran Vashni , Gumede Emelda Zandile
Published: August 2023

Introduction

Globally the inclusion of spiritual activities has been well adopted into nursing care. Empirical work related to the inclusion of spiritual activities in nursing within the South African context particularly within the oncology setting is sparse. Being diagnosed with cancer can be unsettling because of the severity and vigorous treatment that one has to endure. Spiritual activities could be used as one of the coping strategies for cancer patients in times of spiritual distress. Strengthening spiritual care by including spiritual activities into daily nursing care could be beneficial to the patient and the institution.

Objective

This study aimed to explore spiritual activities that could strengthen spiritual care in oncology nursing practice.

Methods

The research study followed a phenomenological qualitative descriptive design. The study population consisted of professional nurses working in the oncology units for more than 6 months. Four health care institutions were purposively selected. Data was collected through individual in-depth interviews and field notes. Ten professional nurses were recruited at the point of data saturation. Data analysis followed inductively using content analysis enrolling steps from Elo and Kyngas.

Results

The findings revealed the nurse's willingness to embrace spiritual care in action into their daily nursing care. Three subthemes: holding patient's hands, hospital policy for patient visits, and music therapy outline how patients are comforted by nurses.

Conclusion

Nurses are integral in the provision of spiritual care for cancer patients from diagnosis up until the end of life. The essence of spiritual activities gives patients a distraction and an escape from their pain and predicament thus improving their quality of life. The findings provide policy makers with an indication that patients do not only need medical and physical care but spiritual care in their nursing care plan.
Safety of geriatric patients undergoing endobronchial ultrasound-guided transbronchial needle aspiration with deep sedation: a retrospective study
Authors: Tunç Mehtap , Sazak Hilal , Öztürk Ayperi , Yılmaz Aydın , Alagöz Ali
Published: August 2023

Background

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) can be performed in a wide range, from minimal sedation to general anesthesia. Advanced age increases perioperative risks related to anesthesia and is also associated with many pathological processes that further increase morbidity and mortality. The ideal sedation protocol for EBUS-TBNA has yet to be determined in geriatric patients. Deep sedation (DS) may increase the safety and performance of the procedure. There are limited studies evaluating the effectiveness and safety of EBUS-TBNA under DS in elderly patients.

Methods

280 patients who underwent EBUS-TBNA under DS were included in this retrospective study. 156 patients aged 65 years and over (Group 1) and 124 patients under 45 (Group 2) were compared. Demographic data, comorbidities, pulmonary function tests (PFTs), hemodynamic measurements, and peripheral oxygen saturation (SpO2) before the procedure were evaluated. In addition, the duration of the EBUS-TBNA procedure, sedation agents and dosages, recovery time, and complications related to the procedure in the 24 h and applied medications and treatments were recorded.

Results

There was no difference in body mass index, EBUS-TBNA procedure duration, and recovery time between geriatric and young patients(p > 0.05). The proportion of female patients, pre-anesthesia SpO2, and PFTs were found to be significantly lower in geriatric patients(p < 0.05). ASA classification, frequency of comorbidities, and initial mean arterial pressure were found to be significantly higher in the geriatric group(p < 0.05). The propofol-ketamine combination was the most preferred sedative in both groups. The dose of propofol used in the regimen in which propofol was administered alone was found to be lower in the elderly group (p < 0.05). The increase in the HR was significant in Group 2 in the T4 and T5 periods with respect to T1 when the differences were compared (p < 0.05). As a complication, the frequency of high blood pressure during the procedure was higher in the elderly group (p < 0.05).

Conclusions

The EBUS-TBNA procedure performed under DS was safe in elderly and young patients. Our study showed that the procedure and recovery times were similar in the elderly and young groups. The incidence of temporary high blood pressure during the procedure was higher in the elderly patients. The other complication rates during the procedure were similar in groups. Decreased propofol dose in the regimen using propofol alone has shown us that anesthetists are more sensitive to the administration of sedative agents in geriatric patients, taking into account comorbidities and drug interactions.
Sarcopenia is associated with non-motor symptoms in Han Chinese patients with Parkinson's Disease: a cross-sectional study
Authors: Liu Qiu-Wan , Mao Cheng-Jie , Lu Zhao-Hui , Shi Rong-Fang , Zhang Ying-Chun , Zhao Ping , Liu Chun-Feng
Published: August 2023

Background

Sarcopenia is commonly seen in the older adults and increases in incidence with age, also in Parkinson’s disease (PD). Although research has indicated that the development of sarcopenia in patients with PD may be related to both motor symptoms and non-motor symptoms (NMS), the precise relationship between the two conditions remains unclear. Therefore, we aimed to investigate the incidence of sarcopenia in patients with PD and its association with NMS.

Methods

The study included 123 patients with PD and 38 age- and sex-matched healthy controls (HC). All participants were evaluated for sarcopenia using the 2019 Asian Sarcopenia Diagnostic Criteria, and patients with PD underwent standard assessments of motor symptoms and NMS. Multiple logistic regression and receiver operating characteristic (ROC) curve analyses were used to examine the association between sarcopenia and NMS in patients with PD.

Results

The incidence of sarcopenia was significantly higher in patients with PD than in HC (26.8% vs. 10.4%, p = 0.046). Multiple logistic regression analysis revealed that poorer sleep quality (odds ratio [OR]: 1.245; 95% confidence interval [CI]: 1.011–1.533; p = 0.040) and fatigue (OR: 1.085, 95% CI: 1.006–1.170, p = 0.034) were independently associated with sarcopenia. ROC analysis indicated that the optimal cut-off value for Pittsburgh Sleep Quality Index (PSQI) scores was 10, with 72.7% sensitivity and 74.4% specificity (area under the curve [AUC] = 0.776, 95% CI: 0.683–0.868, p < 0.001). The optimal cut-off value for Fatigue Severity Scale (FSS) scores was 39, with 87% sensitivity and 50% specificity (AUC = 0.725, 95% CI: 0.629 –0.820, p < 0.001). Joint use of FSS and PSQI scores increased the predictive value for sarcopenia(AUC = 0.804, 95% CI: 0.724–0.885, p < 0.001).

Conclusion

Patients with PD are more susceptible to sarcopenia than healthy older adults, and fatigue and poorer sleep are positively associated with sarcopenia. Further longitudinal studies are needed to clarify the causal relationships.
Targeting sphingolipid metabolism with the sphingosine kinase inhibitor SKI-II overcomes hypoxia-induced chemotherapy resistance in glioblastoma cells: effects on cell death, self-renewal, and invasion
Authors: Sousa Nadia , Geiß Carsten , Bindila Laura , Lieberwirth Ingo , Kim Ella , Régnier-Vigouroux Anne
Published: August 2023

Background

Glioblastoma patients commonly develop resistance to temozolomide chemotherapy. Hypoxia, which supports chemotherapy resistance, favors the expansion of glioblastoma stem cells (GSC), contributing to tumor relapse. Because of a deregulated sphingolipid metabolism, glioblastoma tissues contain high levels of the pro-survival sphingosine-1-phosphate and low levels of the pro-apoptotic ceramide. The latter can be metabolized to sphingosine-1-phosphate by sphingosine kinase (SK) 1 that is overexpressed in glioblastoma. The small molecule SKI-II inhibits SK and dihydroceramide desaturase 1, which converts dihydroceramide to ceramide. We previously reported that SKI-II combined with temozolomide induces caspase-dependent cell death, preceded by dihydrosphingolipids accumulation and autophagy in normoxia. In the present study, we investigated the effects of a low-dose combination of temozolomide and SKI-II under normoxia and hypoxia in glioblastoma cells and patient-derived GCSs.

Methods

Drug synergism was analyzed with the Chou-Talalay Combination Index method. Dose–effect curves of each drug were determined with the Sulforhodamine B colorimetric assay. Cell death mechanisms and autophagy were analyzed by immunofluorescence, flow cytometry and western blot; sphingolipid metabolism alterations by mass spectrometry and gene expression analysis. GSCs self-renewal capacity was determined using extreme limiting dilution assays and invasion of glioblastoma cells using a 3D spheroid model.

Results

Temozolomide resistance of glioblastoma cells was increased under hypoxia. However, combination of temozolomide (48 µM) with SKI-II (2.66 µM) synergistically inhibited glioblastoma cell growth and potentiated glioblastoma cell death relative to single treatments under hypoxia. This low-dose combination did not induce dihydrosphingolipids accumulation, but a decrease in ceramide and its metabolites. It induced oxidative and endoplasmic reticulum stress and triggered caspase-independent cell death. It impaired the self-renewal capacity of temozolomide-resistant GSCs, especially under hypoxia. Furthermore, it decreased invasion of glioblastoma cell spheroids.

Conclusions

This in vitro study provides novel insights on the links between sphingolipid metabolism and invasion, a hallmark of cancer, and cancer stem cells, key drivers of cancer. It demonstrates the therapeutic potential of approaches that combine modulation of sphingolipid metabolism with first-line agent temozolomide in overcoming tumor growth and relapse by reducing hypoxia-induced resistance to chemotherapy and by targeting both differentiated and stem glioblastoma cells.
Factors affecting students’ attitudes towards reproductive health in the north of Iran: Designing an educational program
Authors: Bakhtiari Afsaneh , Pasha Hajar , Kashefi Fatemeh , Nasiri-Amiri Fatemeh , Bakouei Fatemeh
Published: August 2023

Background

It is essential to empower young people to promote reproductive health (RH) and develop effective educational programs to prevent risky behaviors. This study aimed to investigate the factors affecting students’ attitudes towards RH based on the ecological model and then design an educational program.

Methods

This cross-sectional study was conducted on 461 female students aged 18–29 in the north of Iran. This study was done in two stages. In the first stage, factors affecting the attitude towards RH including demographic questionnaire, interpersonal communication skills, family communication pattern, depression, stress and anxiety, body self-image, and self-confidence were determined. In the second stage, an educational program was designed based on the most effective factors. Independent t-test, ANOVA, and multiple linear regression were employed using SPSS version 20 software. Also, STATA version 15 software was utilized for statistical modeling to predict the best predictive model of attitude towards RH.

Results

47.7% of students had a good attitude toward RH. The majority of students had problems with interpersonal communication skills (60.7%). Also, 28.5% experienced depression, 35.8% anxiety, and 12.8% stress at different levels. More than a quarter of the students (26.5%) had poor body self-image and 18.7% had Undesirable self-esteem. Interpersonal skills (P = 0.002), family communication pattern (P = 0.004), stress (p = 0.019), anxiety (P = 0.001), and body self-image (P = 0.034) have a significant relationship with the attitude towards RH. The multiple regression showed that the most important effective factor on RH is the dialogue orientation of family communication pattern (P = 0.041), stress (P = 0.002), and anxiety (P = 0.001).

Conclusion

Stress and anxiety management training and the use of dialogue orientation in the family communication pattern for young female students are recommended based on the scientific model.
Are exposure to health information and media health literacy associated with fruit and vegetable consumption?
Authors: Jindarattanaporn Nongnuch , Rittirong Jongjit , Phulkerd Sirinya , Thapsuwan Sasinee , Thongcharoenchupong Natjera
Published: August 2023

Background

Health information promotes a healthy lifestyle; however, media health literacy (MHL) is essential to personal intake, especially fruit and vegetables (F&V). This study aimed to determine how exposure to health information and MHL affect F&V consumption among Thai youth aged 10–14 years. Health behavior at this age can be an important determinant of consumption habits when transitioning into adulthood.

Methods

A stratified two-stage sample survey was conducted to recruit 1,871 youth across regions to be nationally representative. Qualtrics offline survey application was used for data collection face-to-face with all respondents. Multiple linear regression was used to analyze the explanatory variables on fruit consumption and vegetable consumption.

Results

This study found that almost 70% of Thai youth were exposed to health-related content via the Internet, and had low analytical skills to process that information. Grade Point Average (GPA), exposure to health information, various media types, frequency of exposure to health information, and MHL influenced the frequency of F&V intake. Health status related to fruit intake, age, place of residence, amount of pocket money, and body mass index (BMI) were associated with F&V consumption.

Conclusion

Exposure to health information and MHL are associated with F&V intake. Therefore, exposure to health information and MHL should be addressed for policy formulation in Thai schools and the health system.
Social isolation in COVID-19: a comparative study between Korea and Vietnam
Authors: Jo Hyeon , Baek Eun-Mi
Published: August 2023

Amidst the ongoing COVID-19 pandemic, social isolation has become a pressing issue worldwide, deeply affecting individuals’ mental and physical well-being. This study introduces a theoretical model to understand the factors influencing social isolation in the context of this global health crisis. We employed a survey methodology, collecting data from Korean and Vietnamese university students through a Google survey form. The theoretical model was evaluated using structural equation modeling (SEM), and multi-group analysis (MGA) was used to assess differences between the Korean and Vietnamese student groups. The investigation centered on affective risk perception, cognitive risk perception, social distancing attitude, social distancing intention, and demographic factors like age and gender. Our findings revealed that affective and cognitive risk perceptions have significant positive impacts on attitudes toward social distancing. Furthermore, attitudes towards social distancing were found to significantly influence social distancing intentions. Interestingly, social distancing intention was found to have a significant positive correlation with social isolation. Lastly, demographic factors such as gender and age were found to be significant factors influencing social isolation. Specifically, gender had a positive association, while age showed a negative correlation with social isolation. Moreover, our MGA results showed that the relationship between social distancing intention and social isolation significantly differed between the Korean and Vietnamese student groups, indicating potential cultural or societal influences on this relationship. Such understanding could inform policies and strategies aimed at mitigating the adverse effects of social isolation in the wake of global health crises.
Regional perspectives on the coordination and delivery of paediatric end-of-life care in the UK: a qualitative study
Authors: Papworth Andrew , Hackett Julia , Beresford Bryony , Murtagh Fliss , Weatherly Helen , Hinde Sebastian , Bedendo Andre , Walker Gabriella , Noyes Jane , Oddie Sam , Vasudevan Chakrapani , Feltbower Richard G. , Phillips Bob , Hain Richard , Subramanian Gayathri , Haynes Andrew , Fraser Lorna K.
Published: August 2023

Background

Provision of and access to paediatric end-of-life care is inequitable, but previous research on this area has focused on perspectives of health professionals in specific settings or children with specific conditions.

This qualitative study aimed to explore regional perspectives of the successes, and challenges to the equitable coordination and delivery of end-of-life care for children in the UK.

The study provides an overarching perspective on the challenges of delivering and coordinating end-of-life care for children in the UK, and the impact of these on health professionals and organisations. Previous research has not highlighted the successes in the sector, such as the formal and informal coordination of care between different services and sectors.

Methods

Semi-structured interviews with Chairs of the regional Palliative Care Networks across the UK. Chairs or co-Chairs (n = 19) of 15/16 Networks were interviewed between October-December 2021. Data were analysed using thematic analysis.

Results

Three main themes were identified: one standalone theme (“Communication during end-of-life care”); and two overarching themes (“Getting end-of-life services and staff in the right place”, with two themes: “Access to, and staffing of end-of-life care” and “Inconsistent and insufficient funding for end-of-life care services”; and “Linking up healthcare provision”, with three sub-themes: “Coordination successes”, “Role of the networks”, and “Coordination challenges”). Good end-of-life care was facilitated through collaborative and network approaches to service provision, and effective communication with families. The implementation of 24/7 advice lines and the formalisation of joint-working arrangements were highlighted as a way to address the current challenges in the specialism.

Conclusions

Findings demonstrate how informal and formal relationships between organisations and individuals, enabled early communication with families, and collaborative working with specialist services. Formalising these could increase knowledge and awareness of end of life care, improve staff confidence, and overall improve professionals’ experiences of delivering care, and families’ experiences of receiving it.

There are considerable positives that come from collaborative working between different organisations and sectors, and care could be improved if these approaches are funded and formalised. There needs to be consistent funding for paediatric palliative care and there is a clear need for education and training to improve staff knowledge and confidence.
Developing student-centred perspectives in PBL: how teacher profiles reveal educational needs for faculty development programmes
Authors: Leatemia Lukas Daniel , Susilo Astrid Pratidina , Donkers Jeroen , van Merrienboer Jeroen J. G.
Published: August 2023

Background

In Asian higher education, PBL is not always successful, as few teachers have embraced a student-centred perspective. To cultivate such essential perspectives, faculty development programmes should address teachers’ specific educational needs, which sadly is currently not sufficiently the case. This study aimed to identify teacher profiles that would reveal these specific educational needs of teachers and to investigate the relationship between these profiles and the amount of PBL training previously received.

Methods

To identify the said profiles, we performed latent profile analysis on a stratified random sample of 543 teachers based on a survey of teaching perspectives on the six aspects of Korthagen’s onion model of reflection (environment, behaviour, competencies, beliefs, identity and mission). Additionally, we employed Chi-square and Mann-Whitney tests to investigate the aforementioned relationship.

Results

We identified six teacher profiles that resemble the diffusion of innovations theory’s classification of innovation adopters: Innovators, Early adopters, Early majority 1, Early majority 2, Late majority and Laggards. The Chi-square test demonstrated that the amount of PBL training received did not differ significantly across profiles, although teachers with a more innovative profile had undergone slightly more PBL training. The Mann-Whitney test furthermore revealed for three profiles that more PBL training was associated with a higher overall score for student-centredness. When aspects were considered separately, however, this was not the case.

Conclusions

The findings confirmed that current faculty development programmes are not sufficiently tailored to teachers’ needs. We therefore propose that faculty development programmes be redesigned to address teachers’ specific educational needs as reflected in the profiles based on the 6 aspects of the onion model. We expect such a tailored approach to more effectively promote the development of student-centred perspectives.
Peer feedback and Chinese medical students’ English academic writing development: a longitudinal intervention study
Authors: Wu Chenze , Zhang Yao-Wu , Li Albert W.
Published: August 2023

Background

Studies have documented that utilizing peer feedback can enhance students’ English academic writing skills. Little is known, however, about the effects of incorporating peer feedback to enhance English as a second language (L2) medical students’ academic writing performance.

Methods

This longitudinal interventional study examines Chinese medical students’ English academic writing skills development via peer feedback in four parallel classes over an 18-week semester between the experimental and control groups (n = 124).

Results

Significant increases in the experimental group’s performance in the post-test were found after 18-week instructions (pre- vs. post-test: overall score, p < .001; task response, p < .001; coherence and cohesion, p < .001; lexical resource, p < .001; grammatical range and accuracy, p < .001), and the effects were retained in the delayed post-test 6 weeks later (post- vs. delayed post-test: overall score, p = .561; task response, p = .585; coherence and cohesion, p = .533; lexical resource, p = .796; grammatical range and accuracy, p = .670). Little improvement was found in the control group in the post-test (pre- vs. post-test: overall score, p = .213; task response, p = .275; coherence and cohesion, p = .383; lexical resource, p = .367; grammatical range and accuracy, p = .180) or the delayed post-test (post- vs. delayed post-test: overall score, p = .835; task response, p = .742; coherence and cohesion, p = .901; lexical resource, p = .897; grammatical range and accuracy, p = .695). Between-group comparisons indicate that the experimental group outperformed the control group in the post- and the delayed post-tests, as shown in their overall score and scores on the four components.

Conclusions

Incorporating peer feedback into process-oriented medical English writing classroom teaching can effectively enhance Chinese medical students’ English academic writing skills over time, while the traditional product-oriented writing instructions had little help in improving Chinese medical students’ academic writing skills. This longitudinal intervention study develops our understanding of the effectiveness of peer feedback in L2 academic writing pedagogy. It offers instructional implications for L2 writing teachers to teach English academic writing among medical students in China and beyond. Limitations and suggestions for future studies are discussed.
ATP6V1F is a novel prognostic biomarker and potential immunotherapy target for hepatocellular carcinoma
Authors: Hu Xinyao , Li Dan , Zhu Hua , Yu Tao , Xiong Xiaoxing , Xu Ximing
Published: August 2023

Hepatocellular carcinoma (HCC) is one of the deadliest malignancies worldwide, with late detection, ineffective treatment and poor overall survival. Immunotherapy, including immune checkpoint inhibitor (ICI) therapy, holds great potential for treatment of HCC. Although some patients respond well to ICIs, many fail to obtain a significant benefit. It is therefore of great interest to find appropriate markers to stratify patient responses to immunotherapy and to explore suitable targets for modulating the TME and immune cell infiltration. ATP6V1F encodes a constituent of vacuolar ATPase (V-ATPase). V-ATPase-mediated acidification of organelles is required for intracellular processes such as zymogen activation, receptor-mediated endocytosis, protein sorting and synaptic vesicle proton gradient generation. In this study, we confirmed for the first time that ATP6V1F is overexpressed in HCC and related to poor prognosis in these patients. We identified that overexpression of ATP6V1F is associated with infiltration of some immune cells and expression of several immune checkpoints. Furthermore, we explored the possible mechanisms of action of ATP6V1F. Finally, we conducted in vitro experiments, including wound healing, Transwell invasion, and apoptosis assays, to verify that ATP6V1F promotes development of HCC by promoting migration and invasion and inhibiting apoptosis of HCC cells. Our findings will contribute to providing precise immunotherapy to patients with HCC.
Durable response to afatinib in advanced lung adenocarcinoma harboring a novel NPTN-NRG1 fusion: a case report
Authors: Nie Xin , Zhang Ping , Bie Zhixin , Song Chenhui , Zhang Min , Ma Di , Cui Di , Cheng Gang , Li Hui , Lei Yan , Su Xiaoxing , Wu Wendy , Li Lin
Published: August 2023

Background

NRG1 fusions are rare oncogenic drivers in solid tumors, and the incidence of NRG1 fusions in non-small cell lung cancer (NSCLC) was 0.26%. It is essential to explore potential therapeutic strategies and efficacy predictors for NRG1 fusion-positive cancers.

Case presentation

We report an advanced lung adenocarcinoma patient harboring a novel NPTN-NRG1 fusion identified by RNA-based next-generation sequencing (NGS), which was not detected by DNA-based NGS at initial diagnosis. Transcriptomics data of the tissue biopsy showed NRG1α isoform accounted for 30% of total NRG1 reads, and NRG1β isoform was undetectable. The patient received afatinib as fourth-line treatment and received a progression-free survival (PFS) of 14 months.

Conclusions

This report supports afatinib can provide potential benefit for NRG1 fusion patients, and RNA-based NGS is an accurate and cost-effective strategy for fusion detection and isoform identification.
Communications between macrophages and cardiomyocytes
Authors: Yang Pengbo , Chen Ziwei , Huang Wei , Zhang Junhua , Zou Lihui , Wang Haiyan
Published: August 2023

The heart is a muscular organ that pumps blood throughout the body and is one of the most vital organs in human body. While cardiomyocytes are essential for maintaining the normal function of the heart, a variety of cardiovascular diseases such as coronary artery occlusion, arrhythmia, and myocarditis can lead to cardiomyocyte death, resulting in deterioration of heart function. The adult mammalian heart is incapable of regenerating sufficient cardiomyocytes following cardiac injuries, eventually leading to heart failure and death. Cardiac macrophages are ubiquitously distributed in the healthy heart and accumulated at the site of injury. Macrophages play essential roles in regulating homeostasis and proliferation of cardiomyocyte, promoting electrical conduction, and removing dead cardiomyocytes and debris through direct and indirect cell–cell crosstalk. In this review, we summarize the latest insights into the role of macrophages in maintaining cardiac homeostasis and the macrophage-cardiomyocyte crosstalk in both healthy and injured scenarios.