bluuebunny/crossref_metadata_2025 huggingface dataset:
Financial Inclusion and Macroeconomic Stability in South Africa
Authors: Matsebula Velenkosini , Sheefeni Johannes
Published: July 2022

While Financial inclusion has been largely considered to play an important role to eradicate poverty and boost economic prosperity, some empirical literature has shown differing sentiments, suggesting that vast access to finance may potentially bring about market instability to the economy. This relationship between financial inclusion and macroeconomic stability is in greatly under researched, from a global and local perspective. This paper utilizes a VAR model to analyse the relationship between financial inclusion and macroeconomic stability in South Africa, using quarterly time series data from 2004 to 2019. To measure macroeconomic stability, the study used two macroeconomic factors, namely output and inflation, and commercial bank branches per 100,000 adults (CBB) was used as a measure of financial inclusion.  The results find a positive relationship between financial inclusion and output, a 1% increase in CBB causes output to increase by 0.04%. Financial inclusion is also found to have a positive impact on inflation in the long run. Important policy implications point to the importance of financial inclusion in impacting output, and the need to find a balance between financial inclusion and inflation control. As such, Macroeconomic policy maker can use financial inclusion as a tool to retain macroeconomic stability.
Avaliação da ansiedade e depressão em familiares de crianças em tratamento quimioterápico
Authors: Salum Ariana Aparecida Lins Aleksandrov , Siqueira Fernanda Paula Cerântola , Rodrigues Josiane Ramos Garcia , Siqueira Júnior Antonio Carlos
Published: July 2022

Introdução: Com o surgimento inesperado do câncer na vida de crianças, seus familiares vivenciam sentimentos como angústia, sofrimento e derrota devido à possibilidade de morte que pode levá-los ao estresse com riscos de desenvolverem sintomas de ansiedade e depressão alterando a qualidade de vida. A equipe de saúde, especialmente o enfermeiro, tem a importante função de criar vínculos para uma boa integração, buscando a confiabilidade do cuidado com expectativa de amenizar os sintomas desencadeados durante o processo. Desta forma, este estudo teve como pergunta de pesquisa se os pais e responsáveis de crianças e adolescentes apresentam sintomas de ansiedade e depressão no acompanhamento do tratamento quimioterápico de seus filhos. Objetivo: Investigar a presença de sintomas de ansiedade e depressão nos familiares de crianças com câncer durante o tratamento quimioterápico ambulatorial. Método: A pesquisa foi realizada em um Ambulatório de Quimioterapia Infantil, com abordagem quantitativa e aplicação dos questionários de Ansiedade e Depressão de Hamilton em acompanhantes de crianças em tratamento quimioterápico. O nível de significância adotado foi de 5% (p-valor≤ 0,05) e os dados foram analisados no software SPSS. Resultados: Participaram da pesquisa 27 familiares com predomínio materno. Observou-se que a distribuição da depressão foi de 59,3% e da ansiedade 48,1%, sendo esses sintomas graves para ambas. Identificou-se a relação entre a presença de ansiedade leve/ausente com o escore de depressão leve/ausente e a de ansiedade grave com a depressão grave. Conclusão: Este estudo indica que os acompanhantes de crianças em tratamentos quimioterápicos apresentam sofrimento emocional justificado pela presença de sintomas de ansiedade e ou depressão.
Türkiye’de Yapılmış Çalışmalardan Yararlanılarak Siyah Alaca Süt Sığırlarında Bazı Özelliklerin Yönelimine Dair Sistematik Bir Derleme
Authors: ŞEN Ercan , SAVAŞ Türker
Published: July 2022

Türkiye sığır popülasyonunda en yüksek pay Siyah Alaca ırkına aittir. Ülkemiz zootekni literatüründe sığır konusunda çok çalışılan konulardan biri Siyah Alaca sığır ırkıdır. Bu çalışmada Türkiye’de Siyah Alaca sığır ırkı ile ilgili çalışmalardan yararlanılarak ırka ait 305 gün laktasyon süt verimi, ilkine buzağılama yaşı ve buzağılama aralığı ortalamalarının yıllara bağlı değişiminin tespit edilmesi hedeflenmiştir. Çalışmanın materyalini Siyah Alaca sığır ırkıyla ilgili yapılmış olan 14 makale 10 yüksek lisans ve 9 doktora tezi oluşturmaktadır. İlkine buzağılama yaşı, buzağılama aralığı ve 305 gün laktasyon süt veriminin yıllara bağlı değişimine ilişkin tahmin edilen regresyon katsayıları ve standart hataları sırasıyla 44,3±11,3 l, -0,1±0,03 ay, 1,1±0,25 gün olarak belirlenmiş olup üçü de istatistiksel açıdan önemli bulunmuştur (P
Kesalahan siswa kelas unggulan dalam menyelesaikan soal materi pecahan berdasarkan langkah-langkah Polya
Authors: Yulita Yuki , Ishartono Naufal
Published: July 2022

Telah banyak hasil penelitian terdahulu yang mengkaji terkait kesalahan siswa dalam mengerjakan soal pecahan ditinjau dari langkah-langkah Polya. Namun ditemukan masih sedikit penelitian yang mengkaji kasus tersebut terhadap siswa di kelas unggulan. Oleh karena itu, tujuan penelitian ini adalah untuk menganalisis kesalahan siswa kelas unggulan dalam menyelesaikan soal materi pecahan berdasarkan langkah-langkah Polya serta faktor-faktornya. Penelitian ini adalah penelitian kualitatif dengan pendekatan deskriptif. Jumlah siswa yang menjadi sample dalam penelitian ini adalah sebanyak enam orang siswa kelas unggulan di SMA Negeri 1 Cilacap pada bulan Oktober 2020 sampai dengan bulan Februari 2021 yang dipilih menggunakan tehnik purposive sampling. Hasil dari penelitian ini, siswa cenderung salah pada tiga tahapan Polya yaitu  (1) pada langkah Understanding The Problem dimana siswa tidak menuliskan apa yang diketahui dan tidak menuliskan apa yang ditanyakan pada soal serta hanya menuliskan apa yang diketahui tetapi tidak menuliskan apa yang ditanyakan, (2) pada langkah Make A Plan dimana siswa salah dan tidak sesuai dengan permasalahan dalam membuat rencana yang digunakan untuk menyelesaikan soal, menuliskan langkah-langkah dalam menyelesaikan soal tetapi kurang tepat, dan (3) pada langkah Carry Out The Plan dimana siswa melakukan kesalahan dalam perhitungan. Sedangkan pada tahap Look Back, siswa tidak mengalami kesalahan. Sedangkan faktor-faktor yang menyebabkan siswa melakukan kesalahan antara lain siswa merasa takut terkait tidak cukupnya waktu untuk menjawab soal, siswa terburu-buru dalam menjawab soal, kebiasaan siswa dalam menjawab soal, siswa tidak paham maksud soal, siswa tidak teliti dalam membaca soal, siswa kurang memahami soal, tergesa-gesa dalam menjawab dan menghitung dan tidak teliti dalam melakukan perhitungan.
PERKEMBANGAN PENDIDIKAN MATEMATIKA TINGKAT SD DI INDONESIA, MALAYSIA, DAN JEPANG
Authors: Novikasari Ifada
Published: July 2022

Improving the quality of teaching and learning of primary mathematics has always been a major concern of mathematics educators. TIMSS is a collaborative research project sponsored by the International Association for the Evaluatioan of Educational Achievement (IEA). It is the largest and most ambitious study of comparative educational achievement tests in mathematics and science ever undertaken. Every effort was made to help ensure that the tests represented the curricula of the participating countries and that the items did not exhibit any bias towards or against particular countries, including modifying specifications of the items by subject matter specialists within the participating countries, and conducting thorough statistical item analysis of data collected in the pilot testing. This article briefly summarizes develompment of Indonesian, Malaysian and Japanese mathematics education. It concludes with description of a method for teaching mathematics in those countries.
Analisis kemampuan pemecahan masalah dalam menyelesaikan soal cerita matematika materi aritmatika sosial berdasarkan prosedur Newman
Authors: Vitaloka Wike Pratiwi , Habibi Mhmd , Putri Rahmi , Putra Aan
Published: July 2022

Pemecahan masalah merupakan suatu rangkain proses tertentu yang dilakukan siswa dalam menghadapi situasi yang direpresentasikan ke dalam pertanyaan. Permasalahan dalam kehidupan sehari-hari yang terkait dengan matematika biasanya dituangkan dalam soal cerita. Tujuan penelitian ini adalah untuk mengetahui penyebab terjadinya kesalahan siswa dalam menyelesaikan soal cerita materi Aritmetika Sosial berdasarkan prosedur Newman. Penelitian yang dilakukan secara deskriptif dengan pendekatan kualitatif. Instrumen penelitian menggunakan soal tes dan wawancara terhadap siswa MTsS Nurul Haq Semurup. Berdasarkan hasil tes, 17 dari 23 siswa telah memahami soal dengan baik dan mengerti istilah, kata-kata, kalimat dan simbol dalam masalah melalui ketepatan mengartikan kedalam bahasa. Selain itu 73.91% siswa menguasai tahapan membaca masalah, memahami masalah dan transformasi masalah. Namun hanya 17.39% siswa yang menguasai keterampilan proses/prosedur dan penulisan jawaban.
Namık Kemal Tiyatrosunda Modern Osmanlı Yurttaşlığının Askeri Yönünün İnşası
Authors: SAÇAR Ali
Published: July 2022

Bu çalışmada, Osmanlı modernleşmesinin erken dönem edebiyat örneklerinden Namık Kemal’in tiyatroları vasıtasıyla, yurttaşın askeri yönüyle inşası incelenmektedir. Avrupa örnek alınarak inşa edilmeye çalışılan yeni bir Osmanlı yurttaşlığının askeri yönünün Namık Kemal ve tiyatrosu üzerinden takip edilmeye çalışılmasının sebebi, söz konusu Osmanlı aydınının, daha sonra II. Meşrutiyet ve Cumhuriyet dönemlerinde olgunlaşacak pek çok düşüncenin Avrupa’dan Osmanlı’ya aktarılmasında en erken örnekleri sunmuş olmasıdır. Namık Kemal, tiyatro ve diğer birçok modern edebiyat türünde ilk örnekleri vererek Avrupa edebiyatını Osmanlı’ya getirmekle kalmamaktadır. Bunların eğitici işlevini açıkça vurgulayarak, siyasi ve hukuki kurumları da edebiyat yoluyla yeni Osmanlı yurttaşlarına tanıtmaktadır. Dolayısıyla, genel olarak Türk modernleşmesinin hızlandığı sonraki dönemleri de derinden etkileyecek biçimde, yaşadığı tarihsel dönemde Avrupa’da yaygın olarak kullanılan pek çok farklı edebiyat türünü kullanarak, yeni bir kuramsal düzlemi inşa etmektedir. Bu kuramsal düzlemin önemli bir unsuru Osmanlı yurttaşlığıdır. Avrupa’da olduğu gibi Osmanlı’da da Fransız Devrimi ile Birinci Dünya Savaşı arasındaki tarihsel dönemde, yurttaşlığın askeri yönünün inşası, ayrıca önem kazanmaktadır. İlk örneklerini Namık Kemal’in verdiği modern Osmanlı tiyatrosu, henüz kurumsallaşmakta olan modern Osmanlı düzenli ordusunun ve buna asker sağlamak için gerekli zorunlu, genel bir askerlik hizmetinin yurttaşlarca kabul görmesini sağlama işlevini üstlenmiştir. Bu çalışmada ana fikir tiyatro türünden eserlere dayanmakla birlikte, Namık Kemal’in düzyazı biçimindeki farklı edebiyat türlerindeki çalışmaları da tiyatrolarındaki düşünceleri destekleyecek biçimde, bütünselci bir yaklaşımla göz önünde bulundurulmaktadır. Sonuç olarak, Namık Kemal, Avrupa’da tanıştığı tiyatroya özel bir önem vererek, Osmanlı’nın Avrupa sömürgeciliği karşısında durabilmesini sağlayacak güçte düzenli ordu oluşturabilmesi için modern Osmanlı yurttaşlığının askeri yönüyle birlikte inşa edilmesine katkı sağlamaktadır.
Bir Hukuka Uygunluk Sebebi Olarak Sosyal Medyada Örgütlenme Hürriyeti
Authors: BALCI Murat , ÇAKIR Kerim
Published: July 2022

Öz: Çağın getirdiği iletişim imkanları sayesinde örgütlenme hürriyeti sosyal ağlarda da ön plana çıkmaya başlamıştır. İnternet ağının genişliği ve bu ağlarda anonim kalarak iletişim kurmanın kolaylığı, başta sosyal medya olmak üzere kullanıcıların yoğun bir biçimde içerik paylaşmasına ve sürekli etkileşim halinde olmasına neden olmuştur. Bir hukuka uygunluk sebebi olan örgütlenme hürriyetinin sosyal medyaya taşınmasıyla birlikte suç işlemeye ve kanunlara uymamaya tahrik, örgüte üye kazandırma, örgüt propagandası yapma şeklindeki suçlar sosyal medyada sıklıkla işlenir hale gelmiştir.
Çalışmada, insanların internet ortamında ortak bir konu ve fikir üzerinde nasıl iletişim kurduğu izah edildikten sonra atipik örgütlenmenin bir örneği olan dijital aktivizm ile benzeri örgütlenmeler hakkında bilgi verilecektir. Daha sonra bir hukuku uygunluk sebebi olan örgütlenme hürriyetinin sosyal medyada ne şekilde sınırlandırılabileceği tartışılacak ve ifade hürriyetinin himaye etmediği suçlar incelenecektir.
Not breastfeeding and risk of autism spectrum disorders among children: a meta-analysis
Authors: Jenabi Ensiyeh , Bashirian Saeid , Salehi Amir Mohammad , Khazaei Salman
Published: July 2022

Background: To our knowledge, this is the first meta-analysis of the association of not breastfeeding and the risk of autism spectrum disorder (ASD) based on observational studies.Purpose: This meta-analysis aimed to evaluate of the association of not breastfeeding and the risk of ASD.Methods: Three databases (PubMed, Web of Science, and Scopus) were systematically searched until December 2021. Heterogeneity was determined using the chi-square test and its quantity was measured using the I2 statistic. The Begg line regression test was used to assess publication bias. A random-effects model was used to analyze the data. Seven studies were included in this meta-analysis.Results: The total study population included 3,270 individuals. According to the random-effects model, the estimated odds ratio of the risk of ASD associated with not breastfeeding was 1.81 (95% confidence interval, 1.35–2.27; I2=0%).Conclusion: The results of the included studies were homogeneous. Our findings showed that not breastfeeding is a risk factor for ASD. These results suggest the importance of breastfeeding in decreasing the risk of ASD in children.
Interventions for Reducing the Effects of Adverse Childhood Experiences Among Black/African American Children and Adolescents: A Systematic Review
Authors: Ajani Tywan
Published: July 2022

Purpose: Research demonstrates tremendous harmful effects for children and adolescents that have experienced trauma of various forms before the age of eighteen. These effects are profound as not only are they linked to current detrimental effects such as increased rates of substance abuse, early sexual activity, higher rates of depression, and suicidal ideation, but they also have shown to be damaging in adulthood. This systematic review provides an examination of interventions that reduce the effects of Adverse Childhood Experiences (ACEs) for Black/African American children and adolescents.

Methods: This study used an intervention assessment tool to determine the methodological rigor derived from the American Psychological Association on assessing interventions as the risk of bias tool. The methodological rigor was used to assess the interventions that reduce the effects of ACEs. Effect sizes for controlled trials, pre-post effect sizes, and pilot studies were calculated.

Results: This search identified a total of 1,594 studies in which 617 were screened and five were selected. The five utilized harm reduction interventions to address the effects of ACEs. All of the study participants were Black/African American children and adolescents. The effect sizes that were available ranged from medium to large. The Strong African American Families Program (SAAF) intervention had the strongest methodological rigor with a medium effect size.

Conclusion: The review suggests that the combination of individual therapy, group therapy, and psychoeducational training techniques provided positive effects on the reduction of ACE related symptoms for Black/African American children and adolescents. The randomized control trials yielded the greatest improvements from the interventions. However, the findings were few and the need for interventions for this population continue to grow.
Immobilization of Superoxide Dismutase in Mesoporous Silica and its Applications in Strengthening the Lifespan and Healthspan of Caenorhabditis elegans
Authors: Yang Yiling , Wang Wenbin , Liu Kefeng , Zhao Jie
Published: July 2022

Senescence is a major inductive factor of aging-related diseases in connection with an accumulation of reactive oxygen species (ROS). Therefore, it is important to maintain ROS at an appropriate level to keep homeostasis in organisms. Superoxide dismutase (SOD) is a vital enzyme in defending against oxidative damage in vivo. Because of the defects in the direct application of SOD and SOD mimics, mounting delivery systems have been developed for the efficient applications of SOD to realize antioxidant treatment. Among these systems, mesoporous silica nanoparticles (MSNs) have been widely studied because of various advantages such as desirable stability, low toxicity, and adjustable particle sizes. Herein, SOD was immobilized on MSNs using a physical absorption strategy to construct the nanosystem SOD@MSN. The nematode Caenorhabditis elegans (C. elegans) was selected as the model organism for the subsequent antioxidant and anti-aging studies. The research results suggested the nanosystem could not only be effectively internalized by C. elegans but could also protect the nematode against external stress, thus extending the lifespan and healthspan of C. elegans. Therefore, SOD@MSN could be applied as a promising medicine in anti-aging therapeutics.
One-Pot Synthesis of Ag/Quaternary Ammonium Salt Co-Decorated Mesoporous Silica Nanoparticles for Synergistic Treatment of Cancer and Bacterial Infections
Authors: Zhang Hanyuan , Xu Jianxiang , Zhang Xu , Wang Teng , Zhou Dairan , Shu Wei , Zhao Tingting , Fang Weijun
Published: July 2022

Developing drug delivery nanosystems with both anticancer and antibacterial effects is of great clinical value. Herein, we report a facile approach to synthesize Ag and quaternary ammonium salt (QAS) co-decorated mesoporous silica nanoparticles (MSNs), namely, Ag/QAS-MSNs, for synergistic treatment of cancer and bacterial infections. In vitro studies demonstrated that Ag/QAS-MSNs not only had a strong antibacterial activity against the bacterial pathogens but also could efficiently induce cancer cell death through an apoptotic pathway. Moreover, in vivo combination therapy with Ag and QAS in Ag/QAS-MSNs was also tested in a nude mouse tumor model, and a significant synergistic anticancer effect, which is superior to that obtained by therapy with Ag-MSNs or QAS-MSNs alone, was achieved. Such excellent anticancer and antibacterial activity of Ag/QAS-MSNs could be attributed to the synergistic effect of Ag ions and QAS. Thus, Ag/QAS-MSNs have a promising future as potent anticancer agents with high antibacterial performance.
Force-Bioreactor for Assessing Pharmacological Therapies for Mechanobiological Targets
Authors: Scholp Austin J. , Jensen Jordan , Chinnathambi Sathivel , Atluri Keerthi , Mendenhall Alyssa , Fowler Timothy , Salem Aliasger K. , Martin James A. , Sander Edward A.
Published: July 2022

Tissue fibrosis is a major health issue that impacts millions of people and is costly to treat. However, few effective anti-fibrotic treatments are available. Due to their central role in fibrotic tissue deposition, fibroblasts and myofibroblasts are the target of many therapeutic strategies centered primarily on either inducing apoptosis or blocking mechanical or biochemical stimulation that leads to excessive collagen production. Part of the development of these drugs for clinical use involves in vitro prescreening. 2D screens, however, are not ideal for discovering mechanobiologically significant compounds that impact functions like force generation and other cell activities related to tissue remodeling that are highly dependent on the conditions of the microenvironment. Thus, higher fidelity models are needed to better simulate in vivo conditions and relate drug activity to quantifiable functional outcomes. To provide guidance on effective drug dosing strategies for mechanoresponsive drugs, we describe a custom force-bioreactor that uses a fibroblast-seeded fibrin gels as a relatively simple mimic of the provisional matrix of a healing wound. As cells generate traction forces, the volume of the gel reduces, and a calibrated and embedded Nitinol wire deflects in proportion to the generated forces over the course of 6 days while overhead images of the gel are acquired hourly. This system is a useful in vitro tool for quantifying myofibroblast dose-dependent responses to candidate biomolecules, such as blebbistatin. Administration of 50 μM blebbistatin reliably reduced fibroblast force generation approximately 40% and lasted at least 40 h, which in turn resulted in qualitatively less collagen production as determined via fluorescent labeling of collagen.
Design of an Integrated Microvascularized Human Skin-on-a-Chip Tissue Equivalent Model
Authors: Jones Christian F. E. , Di Cio Stefania , Connelly John T. , Gautrot Julien E.
Published: July 2022

Tissue-engineered skin constructs have been under development since the 1980s as a replacement for human skin tissues and animal models for therapeutics and cosmetic testing. These have evolved from simple single-cell assays to increasingly complex models with integrated dermal equivalents and multiple cell types including a dermis, epidermis, and vasculature. The development of micro-engineered platforms and biomaterials has enabled scientists to better recreate and capture the tissue microenvironment in vitro, including the vascularization of tissue models and their integration into microfluidic chips. However, to date, microvascularized human skin equivalents in a microfluidic context have not been reported. Here, we present the design of a novel skin-on-a-chip model integrating human-derived primary and immortalized cells in a full-thickness skin equivalent. The model is housed in a microfluidic device, in which a microvasculature was previously established. We characterize the impact of our chip design on the quality of the microvascular networks formed and evidence that this enables the formation of more homogenous networks. We developed a methodology to harvest tissues from embedded chips, after 14 days of culture, and characterize the impact of culture conditions and vascularization (including with pericyte co-cultures) on the stratification of the epidermis in the resulting skin equivalents. Our results indicate that vascularization enhances stratification and differentiation (thickness, architecture, and expression of terminal differentiation markers such as involucrin and transglutaminase 1), allowing the formation of more mature skin equivalents in microfluidic chips. The skin-on-a-chip tissue equivalents developed, because of their realistic microvasculature, may find applications for testing efficacy and safety of therapeutics delivered systemically, in a human context.
Crosstalk between the CBM complex/NF-κB and MAPK/P27 signaling pathways of regulatory T cells contributes to the tumor microenvironment
Authors: Qi Tongbing , Luo Ying , Cui Weitong , Zhou Yue , Ma Xuan , Wang Dongming , Tian Xuewen , Wang Qinglu
Published: July 2022

Regulatory T cells (Tregs), which execute their immunosuppressive functions by multiple mechanisms, have been verified to contribute to the tumor microenvironment (TME). Numerous studies have shown that the activation of the CBM complex/NF-κB signaling pathway results in the expression of hypoxia-inducible factor-1 (HIF-1α) and interleukin-6 (IL-6), which initiate the TME formation. HIF-1α and IL-6 promote regulatory T cells (Tregs) proliferation and migration through the MAPK/CDK4/6/Rb and STAT3/SIAH2/P27 signaling pathways, respectively. IL-6 also promotes the production of HIF-1α and enhances the self-regulation of Tregs in the process of tumor microenvironment (TME) formation. In this review, we discuss how the crosstalk between the CARMA1–BCL10–MALT1 signalosome complex (CBM complex)/NF-κB and MAPK/P27 signaling pathways contributes to the formation of the TME, which may provide evidence for potential therapeutic targets in the treatment of solid tumors.
Chemorheological Monitoring of Cross-Linking in Slide-ring Gels Derived From α-cyclodextrin Polyrotaxanes
Authors: Dikshit Karan , Bruns Carson J.
Published: July 2022

Despite hundreds of studies involving slide-ring gels derived from cyclodextrin (CD)-based polyrotaxanes (PRs), their covalent cross-linking kinetics are not well characterized. We employ chemorheology as a tool to measure the gelation kinetics of a model slide-ring organogel derived fromα-cyclodextrin/poly (ethylene glycol) PRs cross-linked with hexamethylenediisocyanate (HMDI) in DMSO. The viscoelastic properties of the gels were monitoredin situby small-amplitude oscillatory shear (SAOS) rheology, enabling us to estimate the activation barrier and rate law for cross-linking while mapping experimental parameters to kinetics and mechanical properties. Gelation time, gel point, and final gel elasticity depend on cross-linker concentration, but polyrotaxane concentration only affects gelation time and elasticity (not gel point), while temperature only affects gelation time and gel point (not final elasticity). These measurements facilitate the rational design of slide-ring networks by simple parameter selection (temperature, cross-linker concentration, PR concentration, reaction time).
Role of endothelial cells in vascular calcification
Authors: Jiang Han , Li Lihua , Zhang Lili , Zang Guangyao , Sun Zhen , Wang Zhongqun
Published: July 2022

Vascular calcification (VC) is active and regulates extraosseous ossification progress, which is an independent predictor of cardiovascular disease (CVD) morbidity and mortality. Endothelial cells (ECs) line the innermost layer of blood vessels and directly respond to changes in flow shear stress and blood composition. Together with vascular smooth muscle cells, ECs maintain vascular homeostasis. Increased evidence shows that ECs have irreplaceable roles in VC due to their high plasticity. Endothelial progenitor cells, oxidative stress, inflammation, autocrine and paracrine functions, mechanotransduction, endothelial-to-mesenchymal transition (EndMT), and other factors prompt ECs to participate in VC. EndMT is a dedifferentiation process by which ECs lose their cell lineage and acquire other cell lineages; this progress coexists in both embryonic development and CVD. EndMT is regulated by several signaling molecules and transcription factors and ultimately mediates VC via osteogenic differentiation. The specific molecular mechanism of EndMT remains unclear. Can EndMT be reversed to treat VC? To address this and other questions, this study reviews the pathogenesis and research progress of VC, expounds the role of ECs in VC, and focuses on the regulatory factors underlying EndMT, with a view to providing new concepts for VC prevention and treatment.
Survival and risk factors associated with surgical repair of ventricular septal rupture after acute myocardial infarction: A single-center experience
Authors: Zhao Keyan , Li Baoyin , Sun Biao , Tao Dengshun , Jiang Hui , Wang Huishan
Published: July 2022

Objective

To analyze the survival and risk factors associated with the surgical treatment of ventricular septal rupture (VSR) after acute myocardial infarction (AMI).

Methods

We retrospectively analyzed 45 consecutive patients with VSR after AMI whose procedures were performed in the Department of Cardiovascular Surgery at the General Hospital of Northern Theater Command between January 2012 and December 2021. Relevant clinical data, surgery-related conditions, and follow-up data of all patients were summarized. Patients were divided into the survival group and the death group. The Kaplan–Meier method and log-rank test were used to determine the cumulative incidence of all-cause mortality. Multivariate logistic regression was used to evaluate the independent risk factors for all-cause mortality.

Results

The average postoperative follow-up time was 42.1 ± 34.1 months. The overall mortality rate was 20% (9/45 patients) and the operative mortality rate was 8.9% (4/45 patients). Logistic analysis showed that the death group had higher serum creatinine (127.32 ± 47.82 vs. 82.61 ± 27.80 μmol/L, respectively; P = 0.0238) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) [8,654.00 pg/mL (6,197.00–11,949.00 pg/mL) vs. 4,268.96 pg/mL (1,800.00–7,894.00 pg/mL), respectively; P = 0.0134] levels than the survival group. The cardiopulmonary bypass time (CPB) was longer in the death group than in the survival group [131.00 min (121.00–184.00 min) vs. 119.00 min (103.00–151.50 min), respectively; P = 0.0454]. Significantly more red blood cells were transfused in the death group than in the survival group [11.60 units (6.10–16.50) vs. 3.75 units (0.00–7.00 units), respectively; P = 0.0025]. Intra-aortic balloon pump (IABP) implantation (P = 0.016) and ventilation time (P = 0.0022) were risk factors for mortality. A 1-month landmark analysis showed that compared with patients with VSR to surgical time >14 days, patients who underwent surgery within 14 days had a higher rate of all-cause mortality (25.00 vs. 3.33%; log-rank P = 0.023). Patients with VSR within 14 days also had a higher rate of residual shunts that were higher than moderate. Multivariate analysis showed that transfusion of red blood cells and NT-proBNP level were risk factors for all-cause mortality, as well as major adverse cardiovascular and cerebrovascular events.

Conclusions

Surgical repair resulted in good outcomes for patients with VSR after AMI. Patients with VSR to surgical time >14 days had a lower rate of all-cause mortality. Treatment strategies for VSR should be based on the patient's condition and comprehensively determined through real-time evaluation and monitoring.
Ablation and antiarrhythmic drug effects on PITX2+/− deficient atrial fibrillation: A computational modeling study
Authors: Jin Ze , Hwang Inseok , Lim Byounghyun , Kwon Oh-Seok , Park Je-Wook , Yu Hee-Tae , Kim Tae-Hoon , Joung Boyoung , Lee Moon-Hyoung , Pak Hui-Nam
Published: July 2022

Introduction

Atrial fibrillation (AF) is a heritable disease, and the paired-like homeodomain transcription factor 2 (PITX2) gene is highly associated with AF. We explored the differences in the circumferential pulmonary vein isolation (CPVI), which is the cornerstone procedure for AF catheter ablation, additional high dominant frequency (DF) site ablation, and antiarrhythmic drug (AAD) effects according to the patient genotype (wild-type and PITX2+/− deficient) using computational modeling.

Methods

We included 25 patients with AF (68% men, 59.8 ± 9.8 years of age, 32% paroxysmal AF) who underwent AF catheter ablation to develop a realistic computational AF model. The ion currents for baseline AF and the amiodarone, dronedarone, and flecainide AADs according to the patient genotype (wild type and PITX2+/− deficient) were defined by relevant publications. We tested the virtual CPVI (V-CPVI) with and without DF ablation (±DFA) and three virtual AADs (V-AADs, amiodarone, dronedarone, and flecainide) and evaluated the AF defragmentation rates (AF termination or changes to regular atrial tachycardia (AT), DF, and maximal slope of the action potential duration restitution curves (Smax), which indicates the vulnerability of wave-breaks.

Results

At the baseline AF, mean DF (p = 0.003), and Smax (p < 0.001) were significantly lower in PITX2+/− deficient patients than wild-type patients. In the overall AF episodes, V-CPVI (±DFA) resulted in a higher AF defragmentation relative to V-AADs (65 vs. 42%, p < 0.001) without changing the DF or Smax. Although a PITX2+/− deficiency did not affect the AF defragmentation rate after the V-CPVI (±DFA), V-AADs had a higher AF defragmentation rate (p = 0.014), lower DF (p < 0.001), and lower Smax (p = 0.001) in PITX2+/− deficient AF than in wild-type patients. In the clinical setting, the PITX2+/− genetic risk score did not affect the AF ablation rhythm outcome (Log-rank p = 0.273).

Conclusion

Consistent with previous clinical studies, the V-CPVI had effective anti-AF effects regardless of the PITX2 genotype, whereas V-AADs exhibited more significant defragmentation or wave-dynamic change in the PITX2+/− deficient patients.
Prescribing Time in Nature for Human Health and Well-Being: Study Protocol for Tailored Park Prescriptions
Authors: Schultz Courtney L. , Bocarro Jason N. , Hipp J. Aaron , Bennett Gary J. , Floyd Myron F.
Published: July 2022

Background

eHealth technologies offer an efficient method to integrate park prescriptions into clinical practice by primary health care (PHC) providers to help patients improve their health via tailored, nature-based health behavior interventions. This paper describes the protocol of the GoalRx Prescription Intervention (GPI) which was designed to leverage community resources to provide tailored park prescriptions for PHC patients.

Methods

The GPI study was designed as a 3-arm, multi-site observational study. We enrolled low-income, rural adults either at-risk of or living with hypertension or diabetes (n = 75) from Federally Qualified Health Centers (FQHC) in two counties in North Carolina, USA into the 3-month intervention. Eligible participants self-selected to receive (1) a tailored park prescription intervention; (2) a tailored home/indoor PA prescription intervention; or (3) a healthy eating prescription (with no PA prescription beyond standard PA counseling advice that is already routinely provided in PHC) as the comparison group. The GPI app paired patient health data from the electronic health record with stated patient preferences and triggered app-integrated SMS motivation and compliance messaging directly to the patient. Patients were assessed at baseline and at a 3-month follow-up upon the completion of the intervention. The primary outcome (mean difference in weekly physical activity from baseline (T0) to post-intervention (T1) as measured by the Fitbit Flex 2) was assessed at 3 months. Secondary outcomes included assessment of the relationship between the intervention and biological markers of health, including body mass index (BMI), systolic and diastolic blood pressure, HbA1c or available glucose test (if applicable), and a depression screen score using the Patient Health Questionnaire 9. Secondary outcomes also included the total number of SMS messages sent, number of SMS messages responded to, number of SMS messages ignored, and opt-out rate.

Discussion

The goal was to create a protocol utilizing eHealth technologies that addressed the specific needs of rural low-income communities and fit into the natural rhythms and processes of the selected FQHC clinics in North Carolina. This protocol offered a higher standard of health care by connecting patients to their PHC teams and increasing patient motivation to make longer-lasting health behavior changes.
The Interface Between Metacognitive Strategy Training and Locus of Control in Developing EFL Learners’ Listening Comprehension Skill
Authors: Taherkhani Bahador , Aliasin Seyed Hesamuddin , Khosravi Robab , Izadpanah Siros
Published: July 2022

This study investigated the effects of metacognitive listening strategy instruction (MLSI) and learners’ locus of control orientation on the listening comprehension of EFL learners. 100 EFL students at the University of Zanjan and Imam Khomeini International University of Qazvin were randomly chosen. The participants were randomly assigned to an experimental group (N = 50) and a control group (N = 50). The experimental group received 10 weeks of treatment including 10 sessions of metacognitive listening strategy training. Both groups took the Metacognitive Awareness Listening Questionnaire and Rotter’s Internal-External Locus of Control Scale before the treatment sessions. Then, they took the listening pre-test and after the treatment, the listening post-test was administered and the required data was obtained. The findings revealed that MLSI had a significant impact on the learners’ listening comprehension for the learners with internal LoC; However, external LoC did not have any significant moderating effect on listening comprehension ability. Pedagogical implications are suggested for an EFL teaching/learning context.
Non-Occlusive Mesenteric Ischemia in Children With Diabetic Ketoacidosis: Case Report and Review of Literature
Authors: Frontino Giulio , Di Tonno Raffaella , Castorani Valeria , Rigamonti Andrea , Morotti Elisa , Sandullo Federica , Scialabba Francesco , Arrigoni Francesca , Foglino Riccardo , Dionisi Benedetta , Ferri Chiara Irene Carla , Zirpoli Salvatore , Barera Graziano , Meschi Franco , Bonfanti Riccardo
Published: July 2022

Introduction

Despite the use of technology, recurrent diabetic ketoacidosis (DKA) prevention remains an unmet need in children and adolescents with T1D and may be accompanied by life-threatening acute complications. We present a rare case of non-occlusive mesenteric ischemia (NOMI) with overt manifestation after DKA resolution and a discussion of recent literature addressing DKA-associated NOMI epidemiology and pathogenesis in children and adolescents.

Case Presentation

A 13-year-old female with previously diagnosed T1D, was admitted at our emergency department with hypovolemic shock, DKA, hyperosmolar state and acute kidney injury (AKI). Mildly progressive abdominal pain persisted after DKA correction and after repeated ultrasound evaluations ultimately suspect for intestinal perforation, an intraoperative diagnosis of NOMI was made.

Conclusion

The diagnosis of DKA-associated NOMI must be suspected in pediatric patients with DKA, persistent abdominal pain, and severe dehydration even after DKA resolution.
Correlation Between Bioelectrical Impedance Analysis and Chest CT-Measured Erector Spinae Muscle Area: A Cross-Sectional Study
Authors: Cao Jie , Zuo Didi , Han Tingting , Liu Hongxia , Liu Wenwen , Zhang Jia , Weng Yurong , Jin Xian , Chen Zengai , Hu Yaomin
Published: July 2022

Background

Skeletal muscle mass (SMM) plays an important part in diverse health and disease states. Bioelectrical impedance analysis (BIA) and computed tomography (CT) are available for its assessment. However, muscle mass assessed by BIA may be influenced by multiple factors. The erector spinae muscle area (ESA) on chest CT is recently presumed to be representative of SMM. This study aimed to derive BIA from the ESA and evaluate the magnitude of association (between ESA measured from chest CT) and BIA.

Methods

Subjects hospitalized for health checkups between December 2020 and December 2021, having undergone both BIA (50 kHz, 0.8 mA) and chest CT, were included. ESA was quantified at the level of the 12th thoracic vertebra (T12-ESA) by a standardized semi-automated segmentation algorithm. Low SMM was defined using the Asian Working Group for Sarcopenia criteria. The association between T12-ESA and BIA was then evaluated. Stratified analyses by sex and BMI were also performed.

Results

Among 606 included subjects (59.7 ± 16.6 years, 63.5% male), 110 (18.2%) had low SMM. BMI in low and normal SMM groups was 20.1 and 24.7 kg/m2, respectively. Current smoking, drinking, chronic obstructive pulmonary disease, and chronic renal dysfunction were more frequently seen in the low SMM group than in the normal SMM group. The final regression model included T12-ESA, weight, BMI, and age, and had an adjusted R2 of 0.806 with BIA. In the validation group, the correlation between T12-ESA-derived BIA and BIA remained high (Pearson correlation = 0.899). Stratified analysis disclosed a stronger correlation between T12-ESA and BIA in male subjects than in female subjects (adjusted R2 = 0.790 vs. adjusted R2 = 0.711, p < 0.05), and a better correlation was observed in obese (BMI ≥ 30 kg/m2) compared with underweight (BMI < 18.5 kg/m2) subjects (adjusted R2 = 0.852 vs. adjusted R2 = 0.723, p < 0.05). Additional analysis revealed a significant correlation between T12-ESA and skeletal muscle cross-sectional area at the 3rd lumbar vertebra (L3-CSA) (adjusted R2 = 0.935, p < 0.001).

Conclusions

CT-based assessment of ESA at the T12 level is feasible and correlated well with BIA, especially in male subjects and obese subjects.
Using Glycated Albumin and Stimulated C-Peptide to Define Partial Remission in Type 1 Diabetes
Authors: Shi Mei , Ji Xiaolin , Xie Yuting , Zhong Ting , Tang Rong , Fan Li , Li Xia
Published: July 2022

Objective

To propose a new definition of partial remission (PR) for patients with type 1 diabetes (T1D) of all-ages using insulin dose and glycated albumin (GA), and find the optimal cut-off values for stimulated C-peptide to diagnose PR in different age-groups.

Research Design and Methods

Patients with newly diagnosed T1D (n=301) were included. GA/insulin dose was used to diagnose PR, and insulin dose-adjusted glycated albumin (IDAGA) was proposed to facilitate clinical application. The optimal diagnostic levels of IDAGA and stimulated C-peptide were determined in different age-groups (≤ 12y, 12-18y and ≥ 18y). Furthermore, the diagnostic consistency between different PR definitions was studied.

Results

GA≤ 23%/insulin dose ≤ 0.5u/kg/day was used to define PR, and IDAGA (GA (%) + 40 * insulin dose(u/kg/day)) ≤ 40 was feasible in all age-groups. Whereas, the optimal diagnostic level showed difference for stimulated C-peptide (265.5, 449.3 and 241.1 pmol/L for the ≤ 12y, 12-18y and ≥ 18y age-group, respectively). About 40% of patients met the PR definition by stimulated C-peptide but not GA/insulin dose or IDAGA, who showed dyslipidemia and higher insulin resistance.

Conclusions

A new definition of the PR phase is proposed using GA/insulin dose, and the calculated IDAGA≤ 40 applies to all age-groups. The stimulated C-peptide to diagnose PR is the highest in the 12-18y age-group, which reflects the effect of puberty on metabolism. For patients with insulin resistance, it is not recommended to use stimulated C-peptide alone to diagnose PR.
Linagliptin in Combination With Metformin Ameliorates Diabetic Osteoporosis Through Modulating BMP-2 and Sclerostin in the High-Fat Diet Fed C57BL/6 Mice
Authors: Nirwan Nikita , Vohora Divya
Published: July 2022

Background

Diabetic osteoporosis is a poorly managed serious skeletal complication, characterized by high fracture risk, increased bone resorption, reduced bone formation, and disrupted bone architecture. There is a need to investigate drugs that can improve bone health along with managing glycemic control. DPP-4 inhibitors and metformin have proven benefits in improving bone health. Here, we investigated the effects of linagliptin, a DPP inhibitor, and metformin alone and in combination to treat diabetic osteoporosis in high-fat-fed mice.

Methods

C57BL/6 mice were kept on the high-fat diet (HFD) for 22 weeks to induce diabetic osteoporosis. Linagliptin (10mg/Kg), metformin (150mg/Kg), and their combination were orally administered to the diabetic mice from the 18th-22nd week. Femur and tibial bone microarchitecture together with bone mineral density (BMD) were evaluated using µCT and histopathological changes were assessed. Further, bone turnover biomarkers namely bone morphogenetic protein-2 (BMP-2), sclerostin, tartrate-resistant acid phosphatase (TRAP), osteocalcin, alkaline phosphatase (ALP), calcium, and pro-inflammatory cytokines were assessed. Additionally, metabolic parameters including body weight, fasting blood glucose (FBG), glucose & insulin tolerance, lipids profile, and leptin were measured.

Results

HFD feeding resulted in impaired bone microarchitecture, reduced BMD, distorted bone histology, and altered bone turnover biomarkers as indicated by the significant reduction in bone ALP, BMP-2, osteocalcin, and an increase in sclerostin, TRAP, and serum calcium. Interestingly, treatment with linagliptin and its combination with metformin significantly reverted the impaired bone architecture, BMD, and positively modulated bone turnover biomarkers, while metformin alone did not exhibit any significant improvement. Further, HFD induced diabetes and metabolic abnormalities (including an increase in body weight, FBG, impaired glucose and insulin tolerance, leptin, triglycerides, cholesterol), and pro-inflammatory cytokines (TNF-alpha and IL-1β) were successfully reversed by treatment with linagliptin, metformin, and their combination.

Conclusion

Linagliptin and its combination with metformin successfully ameliorated diabetic osteoporosis in HFD-fed mice possibly through modulation of BMP-2 and sclerostin. The study provides the first evidence for the possible use of linagliptin and metformin combination for managing diabetic osteoporosis.
Differentially Regulated Apolipoproteins and Lipid Profiles as Novel Biomarkers for Polypoidal Choroidal Vasculopathy and Neovascular Age-Related Macular Degeneration
Authors: Zhang Xinyuan , Qiu Bingjie , Gong Zhizhong , Chen Xiaosi , Wang Yanhong , Nie Yao
Published: July 2022

Lipid dyshomeostasis has been implicated in the pathogenesis of various retinal and choroidal vascular diseases. This study aims to investigate whether apolipoprotein (apo) mediated differential regulation of lipid metabolism contributes to the phenotypes of polypoidal choroidal vasculopathy (PCV) and neovascular age-related macular degeneration (nAMD). This study involved 148 subjects including 53 patients with PCV, 44 patients with nAMD, and 51 age-, sex-matched subjects with normal fundus controls. Routine blood biochemistry profile was evaluated. Apolipoproteins was estimated by Luminex technology. After controlling for age, gender, body mass index, duration of hypertension and type 2 diabetes mellitus, apoB/non-high density lipoprotein cholesterol (HDL-C) (p=0.015) was an independent risk factor for nAMD, apoB was an independent risk factor for PCV(p=0.011), compared with control. Low-density lipoprotein cholesterol (LDL-C) was significantly higher in patients with PCV when compared with nAMD (p=0.037). Furthermore, apoB/non-HDL, LDL-C, triglycerides and were significantly correlated with the pathogenesis of subgroups of PCV and nAMD. We concluded that lipid profiles and apos are differential regulated in PCV, nAMD and their subtypes, indicating different pathogenicity contributed to the different phenotypes of PCV and nAMD. Non-pachy PCV shares pathological similarities with nAMD, which is highly correlated with age-related atherosclerosis.
Structural complexity and primary production resistance are coupled in a temperate forest
Authors: Niedermaier Kerstin M. , Atkins Jeff W. , Grigri Maxim S. , Bond-Lamberty Ben , Gough Christopher M.
Published: July 2022

The capacity of forests to resist structural change and retain material legacies–the biotic and abiotic resources that persist through disturbance–is crucial to sustaining ecosystem function after disturbance. However, the role of forest structure as both a material legacy and feature supporting carbon (C) cycling stability following disturbance has not been widely investigated. We used a large-scale disturbance manipulation to ask whether legacies of lidar-derived canopy structures drive 3-year primary production responses to disturbance. As part of the Forest Resilience Threshold Experiment (FoRTE) in northern Michigan, USA we simulated phloem-disrupting disturbances producing a range of severities and affecting canopy trees of different sizes. We quantified the legacies of forest structure using two approaches: one measuring the change in structure and primary production from pre-to post-disturbance and the second estimating resistance as log transformed ratios of control and treatment values. We found that total aboveground wood net primary production (ANPPw) was similar across disturbance severities as legacy trees rapidly increased rates of primary production. Experiment-wide, the disturbance had limited effects on change in mean structural complexity values; however, high variance underscored large differences in the magnitude and direction of complexity's response at the plot-scale. Plot-scale structural complexity, but not vegetation area index (VAI), resistance strongly predicted ANPPw resistance while temporal VAI and structural complexity changes did not. We conclude that the presence of material legacies in the form of forest structure may affect primary production stability following disturbance and that how legacies are quantified may affect the interpretation of disturbance response.