bluuebunny/crossref_metadata_2025 huggingface dataset:
Kiai sebagai Konselor: Pendekatan Spiritual dalam Mereduksi Panic Attack Santri di Pesantren
Authors: Kumala Shofa Aulia
Published: February 2025

High academic pressure, strict discipline, and social dynamics in Islamic boarding schools trigger panic attacks. This study aims to examine the role of Kiai as a counselor in overcoming panic attacks with a spiritual approach in Islamic boarding schools. This study used a qualitative method with a phenomenological approach at the Pesantren Takhasus Al-Qur'an Kalibeber Wonosobo. The results showed that the psychological pressure experienced by students was quite significant. The symptoms were excessive anxiety, restlessness, and difficulty in social interaction. Kiai played an essential role in relieving panic attacks through dhikr and prayer, Islamic reflection therapy, counseling based on Al-Qur'an values, and an individual approach. Several of these methods were able to reduce panic attack symptoms, increase emotional stability, and provide students with confidence in dealing with stress. The dynamics of interpersonal relationships between Kiai and students were the main supporting factors for the effectiveness of this approach. This study concluded that the integration of spiritual guidance, Islamic counseling methods, and social support created a conducive Islamic boarding school environment for students' mental recovery. These findings provide theoretical and practical contributions by emphasizing the importance of a holistic approach combining spiritual, psychological, and social aspects to support students' mental health.
Pendidikan Inklusi: Integrasi Konsep Konstruktivistik Vygotsky dan Landasan Al-Qur'an untuk Mendukung SDGs 4
Authors: Ashoumi Hilyah , Yusuf Moh Asror
Published: February 2025

Students with special needs often face discrimination in formal education, posing a challenge for the Indonesian government to ensure equitable and fair education for all. Inclusive education serves as a strategic approach to providing quality education access for everyone, supporting the achievement of SDG 4 on inclusive and quality education. This study aims to examine inclusive education from the perspective of Lev Vygotsky's constructivist learning theory and Islamic principles to explore their relevance to the principles of the Sustainable Development Goals (SDGs). The research employs a library research method. The findings reveal that Lev Vygotsky's constructivist theory, particularly the Zone of Proximal Development (ZPD), significantly contributes to inclusive education. ZPD emphasizes social interaction and teacher guidance as key elements of learning, promoting collaboration, active student engagement, and dynamic learning processes. The implementation of this theory fosters an inclusive learning environment that values diversity. Islamic values, as reflected in QS An-Nisa verse 58 and QS Al-Hujurat verse 13, support justice, trustworthiness, and respect for diversity, aligning with the principles of inclusive education and Vygotsky's theory. These verses underline the importance of justice, social interaction, and collaboration for holistic human development. The implications of this study highlight the need for teacher training to implement collaborative learning based on ZPD and strengthen the values of justice and respect for diversity within the curriculum. This supports the creation of inclusive, fair, and quality education in line with SDG 4.
Observer or Doer – Nursing Students’ Experiences of Different Roles in Simulation
Authors:   Senior Lecturer Tampere University of Applied Sciences, Finland, Lasse Tervajärvi , Sanna Tervajärvi ,   Teacher, City of Virrat, Finland, Sari Himanen ,   Coxa Hospital of Joint Replacement, Finland
Published: February 2025

Introduction: Although simulation has been much researched, there is less information on the role of
observers. Therefore, the purpose of this study was to find out, how healthcare students experience the
roles of observer and doer during the simulation.
Methods: Nursing students in the final stages of their studies participated in several different simulations
both as observers and doers. Following the simulation, they answered in a questionnaire, the result of
which were used to analyze their experiences in different roles.
Results: The students’ experience on their own learning is similar regardless of their role. As a doer,
the students bring out concrete doing whereas in the role of observer they highlight the observing of the
general view.
Conclusion: Simulation consisting of observers and doers is a worthy teaching method as it enables
greater amount of participant with good learning outcome. Acting in different roles gives the students
various perspectives during the learning process.
Effective Supplementation With Micronutrients in a Patient With Non-Obstructive Azoospermia and Varicocele: A Case Report
Authors:   Urologist, Levant Hospital, Lebanon, Ziade Adib , Choueiry Patrick ,   Medical Director, Surveal, Lebanon
Published: February 2025

Background: Non-obstructive azoospermia (NOA) is a form of male infertility, often associated with
conditions influencing spermatogenesis, such as varicoceles. While varicocele repair is a standard
intervention, the role of micronutrient supplementation in improving semen parameters and enhancing
fertility outcomes in men with NOA and varicocele is promising.
Case Summary: The patient is a 30-year-old white Lebanese Caucasian male presenting with a previous
diagnosis of NOA, with low testosterone levels and elevated follicle-stimulating hormone and luteinizing
hormone levels. Clinical examination, hormonal assessment, scrotal ultrasound, and semen analysis
revealed non-obstructive azoospermia associated with bilateral varicoceles. After ongoing bilateral
varicocelectomy, the patient was prescribed Cyclofert MaleTM, a combination of L-carnitine L-tartrate,
N-acetyl-cysteine, coenzymeq10, Zinc, folic acid, selenium, vitamin C, vitamin E, and Lycopene, at
a dose of two tablets per day, for six months. At follow-up, semen analysis revealed improved sperm
concentration; and successful in vitro fertilization (IVF) with blastocyst transfer was achieved.
Conclusion: This case reveals the potential role of micronutrient supplementation in improving semen
parameters and IVF outcomes. Cyclofert MaleTM offers a promising adjunctive and non-invasive
treatment option for men with NOA and infertility
A Hybrid Surgical Management Approach for Adjacent Segment Disease in the Lumbar Region
Authors:   Institute of Translational Neurosciences, CUCS, University of Guadalajara, México, Ramos-Zúñiga Rodrigo , Velázquez-Garcí , Francisco ,   Hospital V.G.F. ISSSTE, Guadalajara, México, Trejo-Gallegos Sandra A ,   Hospital V.G.F. ISSSTE, Guadalajara, México, Lara-Reynoso Laura ,   Institute of Translational Neurosciences, CUCS, University of Guadalajara, México, Ramírez-Bañale Carlos I ,   Institute of Translational Neurosciences, CUCS, University of Guadalajara, México, Mercado-Lopez Rudy ,   Institute of Translational Neurosciences, CUCS, University of Guadalajara, México
Published: February 2025

Adjacent segment disease (ASD) is a well-recognized clinical entity associated with surgical
instrumentation history. A hybrid approach to achieving an extension of the transpedicular system
without altering the already stable segment is another alternative for the selective management of ASD.
Echocardiographic Assessment of Left Ventricular Multidirectional Deformation in Patients of Hypertension and Chronic Renal Failure with Normal Versus Reduced Left Ventricular Ejection Fraction
Authors:   Associate Professor, Department of Cardiology, Jawaharlal Nehru Medical College, KLES Dr. Prabhakar Kore Hospital and MRC, Belagavi, India, Metgudmath Vijayanand , Patted Suresh ,   Professor, Department of Cardiology, Jawaharlal Nehru Medical College, KLES Dr. Prabhakar Kore Hospital and MRC, Belagavi, India, Porwal Sanjay ,   Professor and Head, Department of Cardiology, Jawaharlal Nehru Medical College, KLES Dr. Prabhakar Kore Hospital and MRC, Belagavi, India, Khobragade Abhishek ,   DM Resident, Department of Cardiology, Jawaharlal Nehru Medical College, KLES Dr. Prabhakar Kore Hospital and MRC, Belagavi, India, Gadagi Somesh Ishwarappa ,   MSc in Echocardiography, Department of Cardiology, Jawaharlal Nehru Medical College, KLES Dr. Prabhakar Kore Hospital and MRC, Belagavi, India
Published: February 2025

Background: End-stage renal disease (ESRD) significantly increases cardiovascular (CV) risk, with
CV mortality rates 10 to 100 times higher in dialysis patients compared to the general population.
Hypertension, a key CV risk factor, contributes to this elevated risk. This study aimed to assess left
ventricle (LV) multidirectional deformation in patients of hypertension and chronic renal failure with
normal versus reduced LV ejection fraction (LVEF).
Materials and methods: This hospital based prospective study was conducted May 2021 to May 2022.
Study included 61 patients, aged 18-70 years, with chronic kidney disease (CKD) undergoing dialysis,
with good echocardiographic images. Demographic profile (age, gender) of study patients was recorded
and they were subjected to trans-thoracic Echocardiography (TTE) evaluation. Data thus collected was
subjected to statistical analysis.
Results: Majority of patients were in the age group of 40-59 years (44.26%), and 83.61% were male. End
Systolic Volume (ESV), End Diastolic Volume (EDV), and LV mass were higher in Reduced LVEF group
patients, as compared to Normal LVEF group patients. There was statistically significant correlation of
LVEF with both global longitudinal strain (GLS) and global circumferential strain (GCS) (p<0.001).
Significant difference was observed in A-velocity (p=0.005), E/A ratio (p=0.009), and deceleration time
(p=0.05) between the two study groups
Conclusion: Myocardial deformation analysis by GLS and GCS are a good method to assess LV function
to detect early heart failure in chronic renal failure patients as compared to previous methods.
Program Intervensi Promosi Kesehatan Yang Efektif Mengurangi Perilaku Merokok Di Kalangan Wanita : Literature Review
Authors: Safitri Yolanda , Hamda Fadhilah Habibul
Published: February 2025

Merokok masih menjadi masalah kesehatan yang signifikan di kalangan wanita, yang berkontribusi terhadap berbagai penyakit kronis dan hasil yang merugikan. Program promosi kesehatan yang efektif sangat penting dalam mengatasi masalah ini, dengan menggunakan intervensi yang disesuaikan untuk mengurangi tingkat merokok dan meningkatkan kesehatan secara keseluruhan. Penelitian ini bertujuan untuk mengetahui efektivitas program promosi kesehatan dalam mengurangi perilaku merokok di kalangan wanita. Penelitian ini menggunakan desain systematic review dan mencari artikel dari beberapa database yaitu PubMed, Scopus, Cochrane Library, dan Google Scholar dengan memasukkan kata kunci dengan menggunakan kata kunci women AND smoking cessation AND community health promotion, didapatkan jumlah artikel sebanyak 2.558. Metode yang digunakan untuk menyaring artikel menggunakan tools Rayyan untuk cek duplikasi, review berdasarkan judul dan abstrak, terakhir review fulltext artikel. Jumlah akhir artikel yang masuk untuk kriteria review ada 9 artikel. Hasil dari penelitian-penelitian ini menunjukkan bahwa program promosi kesehatan dapat secara signifikan mengurangi tingkat merokok di kalangan wanita, terutama jika program tersebut disesuaikan dengan konteks budaya dan sosial tertentu. Namun, efektivitas program-program ini dapat bervariasi tergantung pada faktor-faktor seperti intensitas intervensi, durasi program, dan karakteristik populasi sasaran. Kesimpulannya, program promosi kesehatan memiliki potensi untuk secara efektif mengurangi perilaku merokok di kalangan wanita, namun keberhasilannya bergantung pada pendekatan komprehensif yang membahas berbagai faktor dan disesuaikan dengan kebutuhan spesifik populasi sasaran.
Karakteristik Ibu Hamil terhadap Perilaku Pencegahan Stunting
Authors: Fitri Media , Andriani Desi , Fany Fiona , Handayani Yellyta Ulsafitri
Published: February 2025

Survei Status Gizi Indonesia (SSGI) sumatera barat mencatat tahun 2024, angka kejadian stunting 23,6% masih diatas rata-rata nasional 21,6 % dan target pemerintah sebesar 14% di tahun 2024. Salah satu faktor penyebab masih tingginya angka stunting adalah perilaku ibu dalam upaya pencegahan stunting. Prevalensi stunting di Bukittinggi per Agustus 2024 adalah 10,3%. Angka ini berada di bawah target RPJMN yaitu dibawah 14%. Pencegahan stunting telah dimulai semenjak 1000 hari pertama kehidupan, salah satunya peningkatan pengetahuan ibu dalam upaya pencegahan stunting sehingga ibu dapat berperilaku baik dalam penanganan stunting. Penelitian bertujuan untuk menganalisis hubungan karakteristik dengan perilaku ibu dalam pencegahan stunting. Studi ini merupakan penelitian deskriptif analitik dengan pendekatan cross sectional terhadap 45 ibu hamil trimester II dan III yang dipilih secara accidental. Pada penelitian ini variabel independen adalah karakteristik ibu sedangkan variabel dependen perilaku ibu dalam upaya pencegahan stunting. Penelitian dilakukan di RSI Ibnu Sina Bukittinggi dengan jumlah responden 45 ibu hamil yang datang berkunjung ke RS Ibnu Sina Bukittinggi. Hasil penelitian menunjukkan ada hubungan yang signifikan antara usia ibu hamil, pendidikan dan status gravida dengan perilaku pencegahan stunting (p=0,000), namun tidak ada hubungan pekerjaan ibu hamil dengan pencegahan stunting (p=0,206). Kesimpulan dalam penelitian ini adalah terdapat hubungan yang signifikan karakteristik dengan perilaku ibu dalam pencegahan stunting.
Upaya Meningkatkan Indeks Massa Tubuh Balita (Usia 3-5 Tahun) Melalui Demonstrasi Pengolahan Bahan Makanan
Authors: Siregar Renince , Junita Friska , Yulianah Finna , Khoerunnisa Ririn
Published: February 2025

Penelitian ini menyelidiki efektivitas demonstrasi pengolahan makanan sebagai intervensi untuk meningkatkan Indeks Massa Tubuh (IMT) balita usia 3-5 tahun di Posyandu Melati 1, Rawalumbu, Bekasi. quasi eksperimen dengan desain one group pre and post test design, penelitian ini melibatkan 15 balita yang diukur IMT-nya sebelum dan sesudah intervensi selama 30 hari. Intervensi yang dilakukan adalah dengan mendemonstrasikan teknik penyiapan makanan kepada orang tua dan memantau pelaksanaannya melalui pengiriman foto harian dan laporan kesehatan. Analisis data menunjukkan penurunan balita yang dikategorikan sangat kurus dari 73,3% menjadi 60%, sementara mereka yang diklasifikasikan sebagai kurus meningkat dari 20% menjadi 33,3%. Terlepas dari perbaikan ini, jumlah balita dengan IMT normal tetap konstan di angka 7%. Temuan ini menyoroti bahwa pendidikan orang tua tentang persiapan makanan yang seimbang dan bergizi dapat secara signifikan berdampak pada gizi anak. Uji statistik menggunakan uji Wilcoxon untuk mengkonfirmasi hubungan yang signifikan antara intervensi pengolahan makanan dan peningkatan IMT, dengan variabel independen menjelaskan 29,2% dari perubahan yang diamati. Namun, faktor-faktor lain seperti status sosial ekonomi dan lingkungan rumah juga dapat mempengaruhi hasil. Penelitian ini menggarisbawahi pentingnya mengintegrasikan program edukasi tentang persiapan makanan ke dalam inisiatif kesehatan masyarakat untuk mengatasi malnutrisi dan meningkatkan hasil kesehatan balita. Penelitian lebih lanjut direkomendasikan untuk mengeksplorasi aplikasi yang lebih luas dari intervensi tersebut.
Agencia comunicativa de mujeres migrantes centroamericanas en su tránsito por territorio mexicano
Authors: Doncel de la Colina Juan Antonio , Román-Fajardo Eloísa
Published: February 2025

Desde una aproximación cualitativa, se caracterizan las formas en que mujeres migrantes originarias de los países más al norte de Centroamérica ejercen su agencia comunicativa durante su trayecto por el territorio mexicano. A partir de entrevistas en profundidad y observaciones en casas de migrantes, se documenta cómo la acción comunicativa de dichas mujeres plantea una resistencia efectiva a un entramado estructural hostil, lo que subraya su capacidad para resistir su sistemática vulneración, al transitar de la sujeción a la agencia. Se presta atención especial al papel clave que juega la acción comunicativa durante el proceso migratorio y a la problematización que plantea el novedoso concepto de “agencia comunicativa”, lo que enriquece el campo de estudio centrado en la migración femenina y el sentido y significado que estas mujeres dan a su experiencia. Los hallazgos invitan a ser contrastados con realidades similares en diferentes contextos.
Urticaria and other mimickers of urticaria
Authors: Rojo-Gutierrez María Isabel , Moncayo-Coello Carol-Vivian , Macias Weinmann Alejandra , Gomez Rene Maximiliano , Ensina Luis Felipe , Cherrez-Ojeda Ivan , Piraino Sosa Pedro , Latour Staffeid Patricia , Valentin Rostan Marylin
Published: February 2025

Urticaria is a mast cell-dependent skin disease characterized by the presence of hives, angioedema, or both in the absence of systemic symptoms. It may be acute, or chronic. (1) Acute urticaria (AU) is common in children, affecting boys and girls equally. Chronic urticaria (CU) affects adult women more (3). AU affects more than 20% of the population and CU 0.1 and 1.5%. There are many pathologies that do not meet the clinical criteria for urticaria, despite being called urticarias, which leads to erroneous diagnoses and inconclusive epidemiology. This review attempts to clarify when we should consider urticaria as such and what are the diagnoses that can be considered urticaria without being so.
CFAP410 has a bimodular architecture with a conserved surface patch on its N-terminal leucine-rich repeat motif for binding interaction partners
Authors: Stadler Alexander , Gabriel Heloisa B. , De Liz Laryssa V. , Alonso-Gil Santiago , Deng Xuan , Crickley Robbie , Korbula Katharina , Mikolaskova Barbora , Vaughan Sue , Huang Kaiyao , Žagrović Bojan , Sunter Jack D. , Dong Gang
Published: February 2025

Cilia and flagella associated protein 410 (CFAP410) is a protein localized at the basal body of cilia/flagella and plays essential roles in ciliogenesis. Multiple single amino acid mutations in CFAP410 have been identified in patients. However, the molecular mechanism for how the mutations cause these disorders remains poorly understood due to a lack of high-resolution structures of the protein. Our studies demonstrate that CFAP410 adopts a bimodular architecture. We have previously reported our structural studies on the C-terminal domain (CTD) of CFAP410 from various organisms. Here we report a 1.0-Å resolution crystal structure of the N-terminal domain (NTD) of Trypanosoma brucei CFAP410. We further examined how the disease-causing mutations in this domain may affect the folding and structural stability of CFAP410. Our results suggest that the single-residue mutations in the CFAP410-NTD cause human diseases by destabilizing the structure that subsequently disrupts its interaction with other partners.
Neurological and immunological characteristics of a novel immortalized bovine brainstem-derived cell line and its susceptibility to arbovirus infection
Authors: Ikeda Rina , Yanase Tohru , Konishi Misako , Murota Katsunori , Tanaka Shogo , Takenouchi Takato
Published: February 2025

Immortalized bovine neuronal cell lines provide a reliable in vitro model for studying interactions with bovine infectious pathogens that target the host nervous system. Although we previously established an immortalized fetal bovine brain-derived FBBC-1 cell line, there are currently no other bovine neuronal cell lines commonly available. In the present study, we developed a novel immortalized cell line, IKBM, derived from the adult bovine brainstem by transferring a SV40 large T antigen gene using lentiviral vectors, and compared its characteristics to the FBBC-1 cell line. As with FBBC-1 cells, IKBM cells extended neurite-like processes in response to agents that increase cytosolic cyclic AMP levels. A comprehensive analysis using RNA sequencing demonstrated that both cell lines potentially possess neural progenitor cell-like properties and differentiate into dopaminergic neuron-like cells after induction of the outgrowth of neurite-like processes. Unexpectedly, we found that the mRNAs of multiple immunomodulatory molecules were highly expressed in IKBM cells, but not in FBBC-1 cells. Although IKBM cells were susceptible to infection with arboviruses (Akabane and Chuzan viruses) that cause neurological symptoms in cattle, viral titers were lower in IKBM cell cultures than in hamster lung-derived HmLu-1 cell cultures, which are frequently used to isolate arboviruses. The reduced production of viruses in IKBM cell cultures may be related to the high expression of immunomodulatory molecules in these cells. Therefore, IKBM and FBBC-1 cell lines offer the opportunity to develop unique in vitro models of the bovine nervous system for the study of host-pathogen interactions based on their respective properties.
Evaluating the feasibility of using the Multiphase Optimization Strategy framework to assess implementation strategies for digital mental health applications activations: a proof of concept study
Authors: Aydin Ayla , van Ballegooijen Wouter , Cornelisz Ilja , Etzelmueller Anne
Published: February 2025

Background

Despite the effectiveness and potential of digital mental health interventions (DMHIs) in routine care, their uptake remains low. In Germany, digital mental health applications (DiGA), certified as low-risk medical devices, can be prescribed by healthcare professionals (HCPs) to support the treatment of mental health conditions. The objective of this proof-of-concept study was to evaluate the feasibility of using the Multiphase Optimization Strategy (MOST) framework when assessing implementation strategies.

Methods

We tested the feasibility of the MOST by employing a 24 exploratory retrospective factorial design on existing data. We assessed the impact of the implementation strategies (calls, online meetings, arranged and walk-in on-site meetings) individually and in combination, on the number of DiGA activations in a non-randomized design. Data from N = 24,817 HCPs were analyzed using non-parametric tests.

Results

The results primarily demonstrated the feasibility of applying the MOST to a non-randomized setting. Furthermore, analyses indicated significant differences between the groups of HCPs receiving specific implementation strategies [χ2 (15) = 1,665.2, p < .001, ɛ2 = 0.07]. Combinations of implementation strategies were associated with significantly more DiGA activations. For example, combinations of arranged and walk-in on-site meetings showed higher activation numbers (e.g., Z = 10.60, p < 0.001, χ2 = 1,665.24) compared to those receiving other strategies. We found a moderate positive correlation between the number of strategies used and activation numbers (r = 0.30, p < 0.001).

Discussion and limitations

These findings support the feasibility of using the MOST to evaluate implementation strategies in digital mental health care. It also gives an exploratory example on how to conduct factorial designs with information on implementation strategies. However, limitations such as non-random assignment, underpowered analysis, and varying approaches to HCPs affect the robustness and generalizability of the results. Despite these limitations, the results demonstrate that the MOST is a viable method for assessing implementation strategies, highlighting the importance of planning and optimizing strategies before their implementation. By addressing these limitations, healthcare providers and policymakers can enhance the adoption of digital health innovations, ultimately improving access to mental health care for a broader population.
Characteristics of dust pollution and its influencing factors during cold period of open-pit coal mines in northern China
Authors: Wang Heng , Wang Zhiming , Wang Ruixin
Published: February 2025

Introduction

Winter dust pollution in China’s northern open-pit coal mines is serious, and the prevention and control of winter dust pollution is one of the important problems in the construction of green mines in northern open-pit coal mines.

Methods

In this study, we collected dust concentration data, meteorological data, and production data from the experimental mine from 1 December 2018, to 28 February 2019. The characteristics of changes in meteorological factors, production intensity and dust concentration in open-pit coal mines during the cold period are introduced, and the correlation between these factors and dust concentration was analyzed using multivariate statistical analysis methods, dust concentration estimation model including near-surface meteorological factors, high-altitude meteorological factors, and production intensity was developed.

Results

The results show that the temperature inside the pit is lower the humidity is higher and the wind speed is smaller than outside the pit in winter; there is a long time inversion phenomenon inside the quarry, and there is less vertical convection in the atmosphere (between 8 a.m. and 12 a.m.). Humidity, noise and particulate mass concentration were significantly positively correlated (the lowest correlation coefficient is 0.480 and 0.369 for humidity and noise); wind speed, solar radiation and boundary layer height were significantly negatively correlated with particulate mass concentration (the lowest correlation coefficient is −0.555, −0.280 and −0.510 for wind speed, solar radiation and boundary layer height). The relative frequency of small particulate dust mass concentrations exceeding the national ambient air quality standard limits is greater in winter, and there is a good correlation between the mass concentrations of Total Suspended Particulates (TSP), Particulate Matter 10 (PM10) and Particulate Matter 2.5 (PM2.5). The accuracy of the particulate matter concentration estimation model constructed by considering the influence of multiple factors was significantly higher (R2 for each model rose by nearly 0.3) than that of the model constructed by considering only the near-surface meteorological factors.

Discussion

The research results can provide a reference for the establishment of a more accurate dust estimation model to help the mining sector to better dust prevention and control.
Reading comprehension assessment for student selection: advantages of text availability in terms of validity
Authors: Sedlmayr Paul , Weissenbacher Barbara
Published: February 2025

Reading comprehension assessments are widely used in university entrance exams across various fields. These tests vary in text content, answer format, and whether the text remains available while the questions are being answered. We explored how the availability of the text impacts the psychometric quality of the test and what is the best format for assessing reading comprehension in university admissions. We developed a test with four educational texts and 88 questions. A group of 107 university students was tested on two texts under two conditions: with and without text availability, using identical true/false questions for both scenarios. Results show similar difficulties in both versions, but slightly higher item-total correlations and internal consistencies in the text-unavailable condition, although this varied between texts. The text-available condition showed better validity, with expected correlations with participants’ verbal intelligence and language scores. Overall, allowing text access during the test appears to be advantageous for assessing reading comprehension in university admissions.
Combined and mediating effects of remnant cholesterol and renal function on hypertension risk in Chinese middle-aged and elderly people
Authors: Zhao Mengjie , Xiao Mengli , Zhang Huie , Tan Qin , Ji Jinjin , Cheng Yurong , Lu Fang
Published: February 2025

Background

Emerging evidence indicates a potential correlation between remnant cholesterol (RC) and the development of vascular damage and hypertension. Nevertheless, the precise relationship between RC and hypertension in relation to renal function remains uncertain. The objective of this investigation was to employ a cohort design to evaluate the intricate correlation between RC and renal function in relation to hypertension.

Methods

The present investigation utilized data from the China Health and Retirement Longitudinal Study (CHARLS), encompassing a total of 5,109 participants, for comprehensive data analysis and examination. Cox regression analysis was employed to examine the interplay among RC, renal function, and hypertension within the context of this research study. This study utilized restricted cubic spline (RCS) analysis to elucidate the interaction between RC, renal function, and hypertension, specifically examining the mediating role of renal function in the RC-hypertension nexus. Furthermore, we employed mediation analysis to investigate the potential mediating role of renal function in the association between RC and hypertension.

Results

After a 9-year follow-up period, the incidence of hypertension in the population under investigation was observed to be 19.01%. The Kaplan-Meier curves demonstrated a notable and statistically significant elevation in the prevalence of hypertension within the subgroup characterized by higher RC and impaired renal function (P <0.001). However, in Cox regression analyses, the risk of developing hypertension was significantly higher (P <0.05) in those with high RC and high estimated glomerular filtration rate (eGFR), and those with high RC and low eGFR, compared with those with low RC and high eGFR, after adjusting for confounders. The analysis of RCS demonstrated a significant positive linear correlation between baseline RC and the prevalence of hypertension. Additionally, there was a notable negative linear correlation observed between eGFR levels and the prevalence of hypertension. RC and eGFR did not interact with any of the subgroup variables. eGFR lowering mediated 6% of the associations between RC and hypertension.

Conclusion

The findings of this study unveiled a substantial correlation between elevated RC, diminished eGFR levels, and the risk of developing hypertension. In addition, renal function may mediate the correlation between RC and hypertension risk.
Distinct gene signatures define the epithelial cell features of mucinous appendiceal neoplasms and pseudomyxoma metastases
Authors: Ayala Carlos , Sathe Anuja , Bai Xiangqi , Grimes Susan M. , Shen Jeanne , Poultsides George A. , Lee Byrne , Ji Hanlee P.
Published: February 2025

Introduction

Appendiceal mucinous neoplasms (AMN) are rare tumors of the gastrointestinal tract. They metastasize with widespread abdominal dissemination leading to pseudomyxoma peritonei (PMP), a disease with poor prognosis. There are many unknowns about the cellular features of origin, differentiation and progression of AMN and PMP.

Methods

We characterized AMNs, PMPs and matched normal tissues using single-cell RNA-sequencing. We validated our findings with immunohistochemistry, mass spectrometry on malignant ascites from PMP patients and gene expression data from an independent set of PMP tumors.

Results

We identified previously undescribed cellular features and heterogeneity in AMN and PMP tumors. There were gene expression signatures specific to the tumor epithelial cells among AMN and PMP. These signatures included genes indicative of goblet cell differentiation and elevated mucin gene expression. Metastatic PMP cells had a distinct gene expression signature with increased lipid metabolism, inflammatory, JAK-STAT and RAS signaling pathway among others. We observed clonal heterogeneity in a single PMP tumor as well as PMP metastases from the same patient.

Discussion

Our study defined tumor cell gene signatures of AMN and PMP, successfully overcoming challenges of low cellularity and mucinous composition of these tumors. These gene expression signatures provide insights on tumor origin and differentiation, together with the identification of novel treatment targets. The heterogeneity observed within an individual tumor and between different tumors from the same patient, represents a potential source of treatment resistance.
Clinical features of autoimmune cerebellar ataxia related to neuronal antibodies
Authors: Cai Yun , Hua Zhijuan , Chen Yanan , Chen Xue , Liu Na , Liu Ting , Zhou Qianwen , Li Jinghua , Di Weiying
Published: February 2025

Objective

This study aimed to investigate the clinical features of neuronal antibodies related to autoimmune cerebellar ataxia (ACA) and to provide guidance for the diagnosis and treatment of this disease.

Methods

Demographic and clinical data were collected from antibody-positive patients with ACA who were admitted to the Department of Neurology, Affiliated Hospital of Hebei University, from January 2018 to February 2023. A retrospective analysis on the clinical manifestations, laboratory examinations, imaging data, treatment, and prognosis was performed.

Results

A total of six patients, including one man and five women, with a median age of 52.5 years, were enrolled in this study. All patients presented with dizziness and gait abnormalities with or without dysarthria. No tumor was found in these patients. Three patients were at the prodromal stage of infection, while one patient exhibited post-ACA fever symptoms and aggravated disease phenotypes. Three patients were positive for anti-glutamate decarboxylase (GAD), while one patient was positive for each of the anti-Tr, anti-mGluR1, and anti-Homer-3 antibodies. The white blood cell (WBC) count and the protein levels of the cerebrospinal fluid (CSF) were increased in four patients, which was in agreement with predominant lymphocytic inflammation. One patient displayed positive signals for CSF-specific oligoclonal proteins. Of the six patients, two were diagnosed with bilateral cerebellar atrophy, and two patients had nonspecific white matter changes. All of the patients received immunotherapy and rehabilitation treatment. Except for the Homer-3-positive patient, the remaining patients showed good prognosis. One patient relapsed.

Conclusion

ACA can be induced or aggravated by infection. The detection of neuronal antibodies is crucial for the precise diagnosis of ACA. Cerebellar system symptoms, such as dizziness, unsteady walking, nystagmus, and dysarthria, are the first and main manifestations of ACA. The head magnetic resonance imaging (MRI) in patients with ACA may be normal or may exhibit abnormalities including cerebellar atrophy and nonspecific white matter changes. Immunotherapy could be effective in most patients with ACA.
Monocyte-derived Langerhans cells express Delta-like 4 induced by peptidoglycan and interleukin-4 mediated suppression
Authors: Ono Rei , Maeda Kohei , Tanioka Toshihiro , Isozaki Takeo
Published: February 2025

T cells contribute to immunotherapy and autoimmune pathogenesis and Langerhans cells (LCs) have a substantial ability to activate T cells. In vitro-generated monocyte-derived LCs (Mo-LCs) are useful models to study LC function in autoimmune diseases and to test future LC-based immunotherapies. Although dendritic cells (DCs) expressing high levels of Delta-like 4 (DLL4+ DCs), which is a member of the Notch ligand family, have greater ability than DLL4− DCs to activate T cells, the induction method of human DLL4+ DCs has yet to be determined. The aim of this study is to establish whether Mo-LCs express DLL4 and establish the induction method of antigen presenting cells, which most potently activate T cells, similar to our previously established induction method of human Mo-LCs. We compared the ratios of DLL4 expression and T cell activation via flow cytometry among monocyte-derived cells, which have a greater ability than the resident cells to activate T cells. Here, we discovered that Mo-LCs expressed DLL4, which most potently activated T cells among monocyte-derived cells, and that Mo-LCs and DLL4 expression were induced by DLL4, granulocyte macrophage colony-stimulating factor, and transforming growth factor-β1. Additionally, peptidoglycan was required for DLL4 expression, whereas interleukin-4 repressed it. These findings provide insights into the roles of DLL4-expressing cells such as DLL4+ Mo-LCs in human diseases, which will assist with the development of more effective therapeutic strategies in the future.
Modulation of double-negative T cells by Huang-Lian-Jie-Du Decoction attenuates neuroinflammation in ischemic stroke: insights from single-cell transcriptomics
Authors: Wang Kai , Sun Zijin , Shao Qi , Wang Zhaoyi , Zhang Haojia , Li Yuanhua , Ming Jingmei , Zhang Wenjing , Wang Tieshan , Zhao Yan , Wang Qingguo , Cheng Fafeng
Published: February 2025

Introduction

Ischemic stroke (IS) represents a significant global health challenge, characterized by elevated morbidity and mortality rates, largely driven by inflammatory responses. Double-negative T cells (DNTs), a distinct subset of T cells lacking both CD4 and CD8 markers, have been implicated in the pathogenesis of IS, exhibiting potentially dual roles. However, the precise functional contributions of DNTs in this context remain poorly understood.

Methods

In this study, we investigated the role of DNTs during the acute phase of IS and assessed the influence of Huang-Lian-Jie-Du Decoction (HLJD), a traditional Chinese medicinal formula, on these cells. Using single-cell transcriptomics, we identified two distinct subtypes of DNTs: an activated, cytotoxic phenotype (Kill+) and a resting, immunosuppressive phenotype (Kill-).

Results

Our findings indicate that HLJD treatment modulates the balance between these DNT subtypes, specifically reducing the proportion of cytotoxic DNTs while promoting an increase in immunosuppressive DNTs. This shift was associated with a reduction in immune cell infiltration and inflammation within the brain tissue, potentially mitigating neuronal damage.

Discussion

These results suggest that HLJD exerts neuroprotective effects in IS by modulating the activity and distribution of DNT cells, offering valuable insights into the therapeutic potential of traditional Chinese medicine for the treatment of IS. Further studies are required to elucidate the mechanisms underlying DNT-mediated immune responses in IS and to explore the broader applications of HLJD in other neuroinflammatory conditions.
PDK2-enhanced glycolysis aggravates fibrosis via IL11 signaling pathway in Graves’ orbitopathy
Authors: Peng Zhiyu , Huang Rui , Gan Lu , Wang Jinghan , Li Xiaofeng , Ding Jie , Han Yinan , Wu Jihong , Xue Kang , Guo Jie , Zhang Rui , Qian Jiang , Ma Ruiqi
Published: February 2025

Objectives

Transforming growth factor β1 (TGFβ1)-interleukin 11 (IL11) is a newly found critical signaling pathway in fibrotic diseases such as Graves’ orbitopathy (GO). It has now been confirmed that enhanced glycolysis plays a key role in the pathogenesis of GO. However, little is known about the relationship between glycolysis and IL11-mediated fibrosis in GO. This study aimed to identify the relationship between glycolysis and TGFβ1-IL11 signaling pathway and investigate the role of IL11 in glycolysis-facilitated fibrosis in GO.

Methods

Orbital connective tissues were collected from GO and control patients. Primary orbital fibroblasts (OFs) were cultured from clinical tissues. Patient-derived xenografts were established via intraorbital transplantation of GO orbital tissue in humanized NCG mice. Protein levels were measured using Capillary Western Immunoassay (WES). Small interfering RNA (siRNA) was used to construct transfected OF strains. Lactate production was measured to assess glycolysis status. Animal models were assessed by T2-weighted magnetic resonance (MR) scan. Immunohistochemistry staining was applied to patients’ orbital connective tissues.

Results

Orbital connective tissues were collected from GO patients. Immunohistochemical (IHC) staining of GO tissues revealed the phenomenon of pyruvate dehydrogenase kinase 2 (PDK2)-enhanced glycolysis and upregulated IL11-IL11Rα pathway. In vitro experiments showed successful induction of fibrosis of patient-derived orbital fat/connective tissues, which could be alleviated by dichloroacetic acid (DCA). MRI images and analysis of hematoxylin and eosin (HE) and Masson-stained section demonstrated enhanced glycolysis in GO, facilitating fibrosis of the orbital tissue. Targeting PDK2 decreased IL11 expression to suppress fibrosis. In vivo experiment confirmed anti-fibrotic effect of inhibition of glycolysis.

Conclusions

PDK2-enhanced glycolysis exacerbates fibrosis via IL11-IL11Rα signaling pathway, shedding light on a potential therapeutic role of metabolic modulators such as DCA in GO treatment.
Assessment of the implementation of antimicrobial stewardship programs in selected healthcare facilities in Kenya
Authors: Gitonga Nkatha , Okumu Mitchel , Agoro Oscar , Kusu Ndinda , Mukoko Joseph , Wangai Helen , Hafner Tamara , Joshi Mohan P.
Published: February 2025

Background

Antimicrobial resistance (AMR) is a growing concern globally and is notably prevalent in Kenya. The World Health Organization (WHO) Global Action Plan (GAP) and the Kenya National Action Plan (NAP) on AMR emphasize the need for effective antimicrobial stewardship (AMS) programs to combat AMR. The USAID-funded Medicines, Technologies, and Pharmaceutical Services (MTaPS) program has supported AMS implementation in 20 healthcare facilities (HCFs) in Nyeri, Kisumu, Murang’a, and Kilifi counties since 2019, focusing on developing and operationalizing AMS programs based on national, WHO, and Centres for Disease Control and Prevention (CDC) guidelines. However, there is paucity of information on how the AMS programs have been implemented in Nyeri and Kisumu Counties. This study evaluates the progress in AMS program implementation in these two counties between 2019 and 2023.

Methods

Baseline and follow up assessments were conducted using a 33-item AMS questionnaire adapted from the CDC’s Core Elements of Hospital Antibiotic Stewardship Programs (CEHASP) and WHO guidelines. The assessment evaluated 13 thematic areas.

Results

AMS implementation showed significant improvements, with Nyeri county increasing from 12% to 76% and Kisumu from 17% to 78%. Several elements achieved 100% implementation in both counties, including core governance structures, accountability, and medical expertise. Education programs reached 88% implementation in Kisumu and 100% in Nyeri. Leadership support improved from 0% to 54% in Nyeri and from 0% to 60% in Kisumu. However, tracking antimicrobial use (AMU) and AMR through process measures remained the lowest implemented element (33% in Kisumu, 19% in Nyeri). Other challenges included limited microbiology services affecting antibiogram production, inadequate monitoring of adherence to treatment guidelines (0-7% implementation), and suboptimal implementation of policies and guidelines (48-58%).

Conclusions

These findings suggest that the implementation of antimicrobial stewardship programs (ASP) in resource-limited settings can be successful, as evidenced by the improvements in core governance, accountability, and medical expertise observed in the selected healthcare facilities. However, critical gaps remain in tracking antimicrobial use and resistance and monitoring treatment guideline adherence. To strengthen ASPs, we recommend establishing standardized national protocols for tracking and monitoring, developing regional laboratory networks to improve microbiology services access, and implementing electronic health records systems.
Research on the effect of lithology of fine aggregates on the performance of rubberized asphalt mixtures
Authors: Zeng Lihao , Zhang Honggang , Jiang Shuo , Huang Hui , Xiong Baolin , Yuan Haitao
Published: February 2025

This study aims to investigate the effect of fine aggregate lithology on the performance of rubberized asphalt mixtures. SEM, XRD, and contact angle tests were used to analyze the microscopic physical and chemical properties of 0–3-mm grain-size diabase and limestone. The performance characteristics of two types of ARAC-13 rubberized asphalt mixtures (with the diabase coarse aggregates and diabase fine aggregates, and diabase coarse aggregates and limestone fine aggregates, respectively) were then compared through conventional high-temperature water stability performance tests, uniaxial penetration tests, and accelerated loading abrasion tests. The results show that the surface roughness, chemical composition, and surface adhesion properties of limestone are better than those of diabase, and the surface roughness of limestone is 13.9% higher than that of diabase, and the surface adhesion energy is 6.4% higher. However, the results show relatively small differences between the asphalt mixtures with the diabase coarse aggregates and diabase fine aggregates and those with diabase coarse aggregates and limestone fine aggregates in the conventional water stability performance test and the high-temperature performance test. Furthermore, the strength reaches 90% when cured for 8 h for limestone and 12 h for diabase, with the curing rate being faster for limestone. The anti-abrasion performance of diabase specimens is superior to that of limestone specimens, but the anti-abrasion decay performance is the opposite. In summary, it can be observed that limestone fine aggregate shows better adhesion performance with asphalt than diabase fine aggregate, and it was recommended that diabase coarse aggregate and limestone fine aggregate be used to improve the asphalt–aggregate interface and enhance the road performance of the asphalt pavement.
A preliminary study of the association between Blastocystis and quantification of selected yeasts in IBD and IBS patients
Authors: Khosravany Zohre , Khodavaisy Sadegh , Olyaiee Alireza , Sadeghi Amir , Nemati Sara , Shahrokh Shabnam , Mohammad Ali Gol Sara , Shojaei Sajad , Mohammad Rahimi Hanieh , Mirjalali Hamed
Published: February 2025

Objective

Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) are gastrointestinal disorders, which can be triggered by gut microbiota dysbiosis. The development of IBS-like symptoms has been linked to the overgrowth of Candida spp. In addition, the critical role of fungi has been highlighted in the pathogenesis of IBD. This study investigated the association between Blastocystis and selected yeasts in IBS and IBD patients.

Methods

This investigation is a cross-sectional study from 2022 to 2024, performed on 91 participants, including 20 healthy individuals, 27 patients with IBS, and 44 IBD patients [39 with ulcerative colitis (UC; 88.63%) and 5 (11.37%) Crohn’s disease (CD)], who were also categorized based on the presence of Blastocystis. Total DNA was extracted from stool samples, and the presence and quantity of yeasts including C. albicans, C. tropicalis, C. glabrata, C. parapsilosis, C. krusei, Geotrichum candidum, Rhodotorula spp., Cryptococcus neoformans, and Saccharomyces cerevisiae were evaluated by real-time PCR. Statistical tests were used to assess significant associations between variables.

Results

Saccharomyces cerevisiae and C. albicans were the most prevalent yeasts in all groups. Candida tropicalis and C. neoformans were identified in neither patients nor healthy subjects. The presence/absence of C. albicans was not significantly different between patients with IBD, IBS, and the control groups. This was similar for G. candidum. However, there was a difference in the presence of S. cerevisiae among patients, although it was insignificant (p-value = 0.077). There was a significant difference in the quantity of C. albicans between IBD (880.421 ± 2140.504), IBS (10.307 ± 15.206), and controls (2875.888 ± 8383.889) (p-value = 0.020). Specifically, the source of difference was seen between IBD patients and the control group (p-value = 0.005). In addition, considering the presence of Blastocystis, a statistically significant association was seen between the number of C. albicans and the sample groups (p-value = 0.013). The quantity of C. albicans was significantly different between IBS and IBD patients.

Conclusion

Regarding the presence of Blastocystis, the quantity of C. albicans and S. cerevisiae was increased and decreased in the studied groups, respectively. This is a preliminary study, and eukaryote–eukaryote association in IBS and IBD patients should be considered in further studies.