bluuebunny/crossref_metadata_2025 huggingface dataset:
Gender, life events, and mental well-being in emerging adulthood
Authors: Matud M. Pilar , Ibáñez Ignacio , Hernández-Lorenzo D. Estefanía , Bethencourt Juan Manuel
Published: April 2023

Background:

Emerging adulthood is a critical period of life involving many life transitions that may generate stress and compromise health and mental well-being.

Aims:

To know the most frequent life events of women and men in emerging adulthood, analyzing also the relevance that such stressors have on their psychological well-being and life satisfaction. A second aim is to determine the relevance of age, educational level, most frequent life events, coping styles, and perceived social support as risk and protective factors for well-being.

Method:

The sample consisted of 2,000 individuals from the general Spanish population (55% women), aged between 18 and 29, who were assessed using five questionnaires and scales measuring life events, coping styles, life satisfaction, psychological well-being, and social support.

Results:

The findings showed that 90% of the sample had experienced one or more life events during the previous year and that a higher number of life events experienced over the past year was associated with lower mental well-being. Multiple regression analyses made clear that, although some events experienced in the previous year (namely, family conflicts and change in the relationship with parents) were associated with lower women’s and men’s well-being, the most important determinants of well-being in either gender were coping styles; however, some predictors of women’s well-being proved different from those of men. In the case of women, family and intimate partner conflicts predicted lower life satisfaction and psychological well-being was lower in the case of family conflicts. As for men, work or academic life events predicted lower life satisfaction.

Conclusion:

These research findings are relevant for the design of programs and strategies to improve mental well-being in emerging adulthood.
Workplace democracy and democratic legitimacy in Europe
Authors: Hassan Bilal
Published: April 2023

This study investigates the political spillover and stealth democracy hypotheses as complementary mechanisms to account for any relationship between workplace democracy and democratic legitimacy in Europe from micro (employee-level) and macro (country-level) perspectives. The results from the micro-level analyses reveal that neither workplace democracy nor self-reported membership in trade unions has any direct impact on democratic legitimacy; rather, past union membership produces a negative impact. However, the effect of workplace democracy on democratic legitimacy becomes salient only when mediated by job satisfaction and political interest. On the other hand, the macro-level analysis demonstrates that union density, a measure of workplace democracy at the country level, plays a significant role in explaining democratic legitimacy. The relevance of union density may indicate that employees wish to keep democratic institutions in check by recruiting into the trade unions and applying legal and mobilizational pressure on the mainstream political institutions.
Stability and Change of Individual Differences in Ideal Partner Preferences Over 13 Years
Authors: Driebe Julie C. , Stern Julia , Penke Lars , Gerlach Tanja M.
Published: April 2023

Ideal partner preferences for traits in a partner are said to be stable cognitive constructs. However, longitudinal studies investigating the same participants’ ideals repeatedly have so far been limited to relatively short retest intervals of a maximum of 3 years. Here, we investigate the stability and change of ideals across 13 years and participants’ insight into how ideals have changed. A total of 204 participants ( M = 46.2 years, SD = 7.4, 104 women) reported their ideals at two time points. We found a mean rank-order stability of r = .42 and an overall profile stability of r = .73 (distinctive r = .53). Some ideals changed over time, for example, increased for status-resources in relation to age and parenthood. We found some but varying insight into how ideals had changed (mean r = .20). Results support the idea of ideals being stable cognitive constructs but suggest some variability related to the demands of different life stages.
Educational Expectation-Attainment Gaps and Mental Health over the Early Adult Life Course
Authors: Lee Eun Hye , McLeod Jane D.
Published: April 2023

We advance research on the association of educational expectation–attainment gaps with mental health by asking two questions that derive from the stress process and life course frameworks: (1) How does the association change over the early adult life course? and (2) To what extent is the association attributable to adult social roles and socioeconomic attainment? Using the National Longitudinal Study of Adolescent to Adult Health, we find that close to the time when the expectation would have been realized, educational attainment is associated with mental health but expectations and the interaction between expectations and attainments are not, independent of selection factors. As respondents age, expectations themselves become more consistently associated with mental health. Adult social roles and socioeconomic status contribute little to explaining these associations. We discuss the implications for the stress process framework and life course research.
Development and pilot testing of an occupational therapy intervention program based on Occupational Adaptation Model for caregivers of people with multiple sclerosis
Authors: Motaharinezhad Fatemeh , Ghahari Setareh , Hassani Mehraban Afsoon , Lajevardi Laleh
Published: April 2023

Introduction:

Multiple sclerosis (MS) can have negative consequences on caregivers’ level of performance and adaptive process. This study aimed to (i) describe the steps of developing an occupation-based program based on the Occupational Adaptation Model (OAM), and (ii) make a preliminary assessment of the feasibility of the program prepared for caregivers of people with MS.

Method:

In a mixed-method approach, the occupation-based program of “Adapting to the Occupational Challenges of Caregivers of people with MS” (AOCCMS) was developed in four steps. During Steps 1, 2, and 3 the AOCCMS program was developed and in step 4, the feasibility and acceptability of the program were evaluated.

Results:

Based on the results of step 1 that have been published in the past; time limitations in occupation implementation; care needs in occupation implementation; psychological reactions affecting occupations were occupational challenges affecting the daily occupations of caregivers. Also, occupational adaptation strategies were strategies to alleviate intrapersonal challenges of occupational adaptation and strategies to alleviate environmental challenges of occupational adaptation. In step 2, the intervention programs of studies on caregivers were reviewed. During step 3, the data obtained from steps 1 and 2 were merged and integrated. Finally, the AOCCMS program was developed. In step 4, during the feasibility and acceptability of the program, 75% caregivers were satisfied with the program content. The quality of the program content was excellent and very good for 100%.

Conclusion:

The AOCCMS is an occupation-based program which was evaluated to be feasible and acceptable, which may be further addressed in future research and clinical practice.
ChatGPT has Aced the Test of Understanding in College Economics: Now What?
Authors: Geerling Wayne , Mateer G. Dirk , Wooten Jadrian , Damodaran Nikhil
Published: April 2023

The Test of Understanding in College Economics (TUCE) is a standardized test of economics knowledge performed in the United States which primarily targets principles-level understanding. We asked ChatGPT to complete the TUCE. ChatGPT ranked in the 91st percentile for Microeconomics and the 99th percentile for Macroeconomics when compared to students who take the TUCE exam at the end of their principles course. The results show that ChatGPT is capable of providing answers that exceed the mean responses of students across all institutions. The emergence of artificial intelligence presents a significant challenge to traditional assessment methods in higher education. An important implication of this finding is that educators will likely need to redesign their curriculum in at least one of the following three ways: reintroduce proctored, in-person assessments; augment learning with chatbots; and/or increase the prevalence of experiential learning projects that artificial intelligence struggles to replicate well.
Displacing the other to unite the nation: The parallel society legislation in Denmark
Authors: Lundsteen Martin
Published: April 2023

In 2018, the then right-wing government in Denmark led by Lars Løkke Rasmussen and supported by the extreme right-wing party Danish People’s Party presented new legislation to end ‘parallel societies’ in Denmark by toughening the criminal law, enforcing Danish knowledge and nursery school assistance to toddlers, and, more importantly for this article, a series of urban interventions in ‘ghetto areas’ considered as such mainly when the proportion of immigrants and descendants from non-Western countries exceeded 50 per cent. Until recently research has focused on either the discursive elements of the ‘ghetto politics’ in Denmark or the urban interventions from an architectural or urban planning point of view. However, newfangled research deal with the entwined economic elements. In this article, I compare the different developmental plans proposed in the affected areas because of the legislation, with an aim to reach further and point at the inherent elements of urban b/ordering, that is, measures taken to attain social order and gain legitimacy by demarcating categories of people to incorporate some and exclude others through urban space. Indeed, through this comparison, I conclude that the ghetto legislation is a compelling example of the urban b/ordering inherent to the politics and dynamics of current liberal capitalist social democracies. It is a social experiment that remodels the geography of Denmark in terms that recall the eugenic and hygienic social and urban policies of the 19th century and form part of a worrying pattern that may have consequences that go beyond the stated ones.
The association between adverse childhood experiences and metabolic syndrome in severe mental illness: A literature review
Authors: Balaji Shoba , Sankaranarayanan Anoop
Published: April 2023

Objective

A history of adverse childhood experiences (ACE) is common among people with severe mental illness (SMI), and they are also associated with physical health problems, including metabolic syndrome (MetS) in general adult populations. We aimed to evaluate and synthesise the evidence relating to the association between ACE and MetS and/or its components in patients with SMI.

Methods

We systematically searched multiple databases (MEDLINE, PubMed, PsycINFO, EMBASE, Emcare, Cochrane Library, Health Technology Assessments, Joanna Briggs Institute, and Maternity and Infant Care database) and reviewed studies that described an association between ACE and MetS or its components in SMI adult patients.

Results

Twenty studies were reviewed. Most studies described a significant association between ACE and at least one to three components of MetS, with obesity being the most studied and, therefore, showing a more consistent association compared to the other MetS components. ACE and the components of MetS did not remain significant, in most of the studies, after adjusting for confounders. None of the studies showed an association with MetS as a whole entity.

Conclusion

Adults with SMI with a history of ACE are more likely to demonstrate health problems such as MetS and cardiovascular disease-related risk factors.
Prevention of Cardiovascular Events in Patients With Chronic Kidney Disease
Authors: Terpening Chris M.
Published: April 2023

Objective:

To examine the evidence base for lifestyle and pharmacologic interventions to reduce the risk of cardiovascular events in patients with chronic kidney disease, with an emphasis on reporting available data in distinct subtypes.

Data Sources:

A PubMed search (origin to February 2023) was conducted and references for selected studies were reviewed to identify additional articles. Search terms included chronic kidney disease, major adverse cardiovascular events, and heart failure hospitalization.

Study Selection and Data Analysis:

English language studies reporting cardiovascular outcomes data in patients with chronic kidney disease were included.

Data Synthesis:

Much of the data on interventions to prevent cardiovascular events in patients with chronic kidney disease are derived from observational studies or subgroup analyses of trials of broader populations. Some common recommendations, such as weight loss, may be harmful in certain patients. Others may only offer benefits in subgroups, such as those with albuminuria. Newer agents, such as SGLT2 inhibitors and finerenone, have clearer evidence of cardiovascular benefit, but these may also apply only to specific subgroups.

Relevance to Patient Care and Clinical Practice:

Given the prevalence of chronic kidney disease and its attendant cardiovascular risk, it is important to understand which interventions offer the greatest benefit.

Conclusions:

Patients diagnosed with chronic kidney disease have markedly increased risk of cardiovascular events, including myocardial infarction, stroke, heart failure, and cardiovascular death. However, until recently, there were few cardiovascular outcome studies that targeted enrollment specifically to those patients. Certain drugs now have shown benefits to cardiovascular end points in this population.
In search of the common good: The postliberal project Left and Right
Authors: Borg Stefan
Published: April 2023

This article contributes to an understanding of the backlash against liberalism by reconstructing the emergence and development of an increasingly influential strand of Anglo-American thought that challenges liberalism, known as postliberalism. The central diagnostic claim of postliberalism is that the two dominant forms of post-WW2 liberalism, market liberalism and social liberalism, instead of being somehow opposed, have coalesced around an all-encompassing sociopolitical project that above all else seeks to maximize individual autonomy. As a result, postliberals hold, the liberal order has become increasingly unable to cultivate the communal resources on which human sociability depends and erodes the values liberalism purportedly defends. The article argues that a central, albeit not necessarily insurmountable, challenge for postliberalism lies in moving from a critique of liberalism to proposed remedies for its perceived deficiencies, without slipping into a political project with clear illiberal rather than merely non-liberal implications.
Assessment of Large Animal Vascular Dimensions for Intra-Aortic Device Research and Development: A Systematic Review
Authors: Georges Gabriel , Couture Thomas , Voisine Pierre
Published: April 2023

Animal studies are often required to evaluate new cardiovascular medical devices before they reach the market. Moreover, first-generation novel devices including aortic endovascular prostheses and circulatory support devices are often larger than later iterations or tested in a limited range of sizes. One of the challenges in evaluating these devices is finding a model that is both accessible and anatomically similar to humans, as there is a paucity of data on vascular dimensions in large animals. We set out to complete a comprehensive review of available reports on vascular dimensions in swine, ovine, and bovine models, with a particular focus on the descending aorta and ilio-femoral arteries. We searched Embase and MEDLINE databases for reports of descending aorta and peripheral vascular dimension in large animal models. Data from swine, ovine, and bovine models were separated by weight into 3 categories: 40 to 60 kg, 61 to 80 kg, and >80 kg. We also incorporate our computed tomography angiography data from 4 large sheep and 9 calves into this review. Swine, sheep, and calf >80 kg may serve as the best models to maximize aortic diameter resemblance to humans. If device implantation can be achieved in aortas of smaller dimensions, care should be taken to ensure access site suitability such as the common femoral artery in these smaller animals.
Postoperative Day 1 Discharge After Robotic Totally Endoscopic Coronary Bypass: The Ultimate in Enhanced Recovery After Surgery
Authors: Nisivaco Sarah , Patel Brooke , Coleman Charocka , Kitahara Hiroto , Torregrossa Gianluca , Balkhy Husam H.
Published: April 2023

Objective:

The benefits of Enhanced Recovery After Surgery (ERAS) protocols are being recognized in multiple surgical specialties, including following coronary bypass surgery to improve quality of care and decrease costs. We developed a fast-track discharge protocol for patients undergoing robotic totally endoscopic coronary bypass surgery (TECAB) to be discharged on postoperative day (POD) 1, the subjects of this study.

Methods:

In a retrospective study of 720 patients undergoing robotic beating-heart TECAB over 8 years at our institution, 93 patients were selected for a fast-track POD1 discharge protocol. We compared the outcomes of this group to the remaining 627 patients who were discharged per standard protocol (non-POD1 discharge).

Results:

The early discharge group was significantly younger, had lower Society of Thoracic Surgeons (STS) risk of mortality, and had a lower prevalence of obesity, diabetes, and chronic kidney disease. Patients discharged on POD1 were more often extubated in the operating room (56% vs 42%, P = 0.010). The readmission rate for the early discharge group was 3.2%, which was similar to the readmission rate of 6.7% for the standard discharge protocol group ( P = 0.329). Time to return to work was shorter in the early discharge group, although it did not quite reach statistical significance (12 vs 18 days, P = 0.051). There was no difference in midterm cardiac mortality.

Conclusions:

Early discharge on POD1 after robotic TECAB is appropriate in selected patients and is associated with low readmission rates and a trend towards earlier return to work. Patients suitable for this “ultrafast-track” approach were more likely to be younger, have lower STS risk, and fewer comorbidities.
Fatigue reliability assessment method for wind power gear system based on multidimensional finite element method
Authors: Li Ming , Luo Yuan , Xie Liyang , Tong Cao , Chen Chuan
Published: April 2023

As a core strategic technology industry, the wind power plays an important role in protecting national energy reserves. The large gear component is one of the core foundation parts in wind turbines, and its quality indexes greatly affect the service performance of the wind turbine drive chain and even the wind turbine as a whole. This paper calculates the fatigue load history of the wind power large gear system under the coupling mechanism of elastic behavior based on a multidimensional finite element method, and obtains the probabilistic fatigue strength of gear teeth through the gear low circumference fatigue test and life distribution transformation method, and deeply explores the inherent characteristics of the wind power gear system in functional implementation and then establishes a system fatigue reliability evaluation model. Finally, a mapping path from the global structural elements of the wind power gearbox to the reliability indexes of the gear system is constructed with significant simulation and test cost advantages. It can provide structural optimization guidance in the development and design of large wind power gear systems, and significantly reduce the cost of achieving reliability indexes in the design iterations of such large high-end equipment. At the same time, it can provide cost-effective training data for intelligent optimization algorithms such as the deep reinforcement learning, which will eventually achieve multi-objective optimal stiffness matching for wind power gearboxes under reliability index constraints.
Blastomyces dermatitidis Septic Arthritis in a Renal Transplant Patient
Authors: Ploom Stacy , Cooley Marcus , Nagpal Avish , Guerrero Dubert M.
Published: April 2023

Blastomycosis is a rare endemic fungal infection caused by the dimorphic fungus Blastomyces dermatitidis. It is more likely to occur in persons living in areas of the United States and Canada, which border the Ohio and Mississippi River Valleys and the Great Lakes region. Most infections are localized to the lungs, often presenting as acute or chronic pneumonia. Occasionally, patients progress to develop disseminated disease and extrapulmonary infections. Blastomycosis tends to be misdiagnosed initially at clinical evaluation as it is rare and may resemble other common conditions. We present a case of a 78-year-old immunosuppressed renal transplant patient who was suspected of having gout but eventually was diagnosed with an unusual presentation of septic arthritis of the ankle secondary to blastomycosis.
The Limitations of Intergroup Friendship: Using Social Network Analysis to Test the Pathways Linking Contact and Intergroup Attitudes in a Multigroup Context
Authors: Khuu Thoa V. , Schaefer David R. , Umaña-Taylor Adriana J. , Ryan Allison M.
Published: April 2023

Recent research on intergroup contact theory has emphasized the potency of cross-group friendship for reducing prejudice. Evaluating this claim requires consideration of competing friend influence and selection processes. Few studies have jointly tested these mechanisms and often only in limited, majority/minority group contexts. In this study, the authors articulate several mechanisms linking friendships with intergroup attitudes and test them in a diverse U.S. context (two large high schools with significant representations of multiple ethnoracial groups). The analysis involves a longitudinal network model of friendship and attitude coevolution. The findings indicate that ingroup friends influenced intergroup contact attitudes (ICAs) over time, while more open ICAs promoted selection into cross-group friendship. By contrast, effects of cross-group friendships on ICAs were limited to White students with Black friends. These findings suggest that the effect of intergroup contact is overstated in the context of friendship and that more focus should be paid to understanding other friendship dynamics.
Serous Retinopathy Associated With Combination MEK and Fibroblast Growth Factor Receptor Inhibitor
Authors: Day H. Russell , Finn Avni P.
Published: April 2023

Purpose: To present a case of a chemotherapy regimen combining a fibroblast growth factor receptor (FGFR) and mitogen-activated protein kinase kinase (MEK) inhibitor leading to serous retinopathy. Methods: A retrospective chart review of a single case was performed. Results: A 67-year-old man with pancreatic and prostate cancer developed bilateral multifocal pockets of subretinal fluid while on an experimental chemotherapy regimen combining an MEK inhibitor (trametinib) and an FGFR inhibitor (erdafitinib). Conclusions: Given that FGFR lies upstream to the mitogen-activated protein kinase signaling pathway, retinal toxicity may be more severe and more common with FGFR–MEK combination therapy. Future studies are necessary to guide ophthalmic surveillance.
Clinical impact of cryopreservation of allogeneic hematopoietic cell grafts during the onset of the COVID-19 pandemic
Authors: Devine Steven M. , Bo-Subait Stephanie , Kuxhausen Michelle , Spellman Stephen R. , Bupp Caitrin , Ahn Kwang Woo , Stefanski Heather E. , Auletta Jeffery J. , Logan Brent R. , Shaw Bronwen E.
Published: April 2023

At the onset of the COVID-19 pandemic, the National Marrow Donor Program mandated the cryopreservation of hematopoietic cell grafts from volunteer unrelated donors because of numerous patient and donor safety concerns and logistical hurdles. Using the Center for International Blood and Marrow Transplant Research outcomes database, we report the impact of cryopreservation on overall survival (OS) and other outcomes within 1 year after hematopoietic cell transplantation (HCT). We analyzed 1543 recipients of cryopreserved allografts receiving HCT at US centers during the first 6 months of the pandemic and compared them with 2499 recipients of fresh allografts during a 6-month period in 2019. On multivariable regression analysis, we observed no difference in the OS (P = .09), nonrelapse mortality (P = .89), graft-versus-host disease (GVHD), or GVHD- and relapse-free survival (P = .58) in recipients of cryopreserved vs fresh allografts. Disease-free survival (DFS) was lower in the cryopreserved allograft recipients (P = .006) because of a higher risk of relapse (P = .01) compared with the fresh allograft recipients. Primary graft failure was higher (P = .01), and the risk of chronic GVHD was lower (P = .001) with cryopreservation compared with fresh grafts. In conclusion, although there was no negative impact of cryopreservation on OS, relapse was higher, and DFS was lower than that with no cryopreservation. Fresh grafts are recommended as the pandemic-related logistical hurdles resolve. Cryopreservation should be considered an option for patients when fresh grafts are not feasible.
Root morphological and physiological traits are committed to the phosphorus acquisition of the desert plants in phosphorus-deficient soils
Authors: Gao Yanju , Zhang Zhihao , Zeng Fanjiang , Ma Xingyu
Published: April 2023

Background

Phosphorus (P) deficiency in desert ecosystems is widespread. Generally, desert species may allocate an enormous proportion of photosynthetic carbon to their root systems to adjust their P-acquisition strategies. However, root P-acquisition strategies of deep-rooted desert species and the coordination response of root traits at different growth stages to differing soil P availability remains unclear. In this study, a two-year pot experiment was performed with four soil P-supply treatments (0, 0.9, 2.8, and 4.7 mg P kg–1 y–1 for the control, low-, intermediate-, and high-P supply, respectively). Root morphological and physiological traits of one- and two-year-old Alhagi sparsifolia seedlings were measured.

Results

For two-year-old seedlings, control or low-P supply significantly increased their leaf Mn concentration, coarse and fine roots’ specific root length (SRL), specific root surface area (SRSA), and acid phosphatase activity (APase), but SRL and SRSA of one-year-old seedlings were higher under intermediate-P supply treatment. Root morphological traits were closely correlated with root APase activity and leaf Mn concentration. One-year-old seedlings had higher root APase activity, leaf Mn concentration, and root tissue density (RTD), but lower SRL and SRSA. Two-year-old seedlings had higher root APase activity, leaf Mn concentration, SRL and SRSA, but a lower RTD. Root APase activity was significantly positively correlated with the leaf Mn concentration, regardless of coarse or fine roots. Furthermore, root P concentrations of coarse and fine roots were driven by different root traits, with root biomass and carboxylates secretion particularly crucial root traits for the root P-acquisition of one- and two-year-old seedlings.

Conclusions

Variation of root traits at different growth stages are coordinated with root P concentrations, indicating a trade-off between root traits and P-acquisition strategies. Alhagi sparsifolia developed two P-activation strategies, increasing P-mobilizing phosphatase activity and carboxylates secretion, to acclimate P-impoverished in soil. The adaptive variation of root traits at different growth stages and diversified P-activation strategies are conducive to maintaining the desert ecosystem productivity.
Multi-omic characterization of the maize GPI synthesis mutant gwt1 with defects in kernel development
Authors: Tian Runmiao , Jiang Jianjun , Bo Shirong , Zhang Hui , Zhang Xuehai , Hearne Sarah Jane , Tang Jihua , Ding Dong , Fu Zhiyuan
Published: April 2023

Background

Glycosylphosphatidylinositol (GPI) and GPI-anchored proteins (GAPs) are important for cell wall formation and reproductive development in Arabidopsis. However, monocot counterparts that function in kernel endosperm development have yet to be discovered. Here, we performed a multi-omic analysis to explore the function of GPI related genes on kernel development in maize.

Results

In maize, 48 counterparts of human GPI synthesis and lipid remodeling genes were identified, in which null mutation of the glucosaminyl-phosphatidylinositol O-acyltransferase1 gene, ZmGWT1, caused a kernel mutant (named gwt1) with defects in the basal endosperm transport layer (BETL). We performed plasma membrane (PM) proteomics to characterize the potential GAPs involved in kernel development. In total, 4,981 proteins were successfully identified in 10-DAP gwt1 kernels of mutant and wild-type (WT), including 1,638 membrane-anchored proteins with different posttranslational modifications. Forty-seven of the 256 predicted GAPs were differentially accumulated between gwt1 and WT. Two predicted BETL-specific GAPs (Zm00001d018837 and Zm00001d049834), which kept similar abundance at general proteome but with significantly decreased abundance at membrane proteome in gwt1 were highlighted.

Conclusions

Our results show the importance of GPI and GAPs for endosperm development and provide candidate genes for further investigation of the regulatory network in which ZmGWT1 participates.
Mammalian sterile 20-like kinase 1 acts as a candidate biomarker of mortality of emergency surgical repair for acute type a aortic dissection
Authors: He Xiaohui , Wang Jing , Xue Yuan , Wang Shipan , Dong Yanjun , Zhang Hongjia , Wang Meili
Published: April 2023

Background

Acute type A aortic dissection (ATAAD) is a life-threatening pathological change of the aorta. Patients who have undergone aortic surgery are usually at high risk of mortality.

Aim

We investigated the predictive value of serum Mammalian sterile 20-like kinase 1 (MST1) as a biomarker for the risk of mortality of ATAAD patients.

Methods

In this retrospective cohort study, we analyzed 160 consecutive ATAAD patients who had undergone emergency surgery from July 2016 to April 2017. Medical records and blood samples were collected and analyzed. ELISA assays were performed to detect the concentrations of several proteins including MST1. The relationship between these potential biomarkers and the primary endpoint of death was evaluated using Cox proportional hazard regression analysis.

Results

Compared with a low level (< 1330.8 ng/L), high serum MST1 level (≥ 1330.8 ng/L) was positively associated with the 30-day mortality (OR = 5.233, 95%CI, 1.843–14.862, P < 0.01) and retained predictive after adjustment for sex, age, BMI, nasopharyngeal temperature and deep hypothermia circulatory arrest time (OR = 4.628 95% CI, 1.572–13.625, P < 0.01). A pre-existing basic clinical prediction model was improved with the inclusion of preoperative serum MST1. Specifically, the area under the ROC curve for base model (history of cerebrovascular disease, creatinine, time of operation) was 0.708 (95%CI, 0.546–0.836) and markedly increased to 0.823 when taking MST1 into consideration (95%CI, 0.700–0.912, P = 0.02).

Conclusion

Our study suggests that high preoperative circulating MST1, with a concentration greater than 1330.8 ng/L, was correlated with the 30-day mortality of ATAAD patients who underwent emergency surgery.
Systematic comparison of approaches to analyze clustered competing risks data
Authors: Schmitt Sabrina , Buchholz Anika , Ozga Ann-Kathrin
Published: April 2023

Background

In many clinical trials the study interest lies in the comparison of a treatment to a control group regarding a time to event endpoint like time to myocardial infarction, time to relapse, or time to a specific cause of death. Thereby, an event can occur before the primary event of interest that alters the risk for or prohibits observing the latter, i.e. a competing event. Furthermore, multi-center studies are often conducted. Hence, a cluster structure might be observed. However, commonly only the aspect of competing events or the aspect of the cluster structure is modelled within primary analysis, although both are given within the study design. Methods to adequately analyze data in such a design were recently described but were not systematically compared yet.

Methods

Within this work we provide a systematic comparison of four approaches for the analysis of competing events where a cluster structure is present based on a real life data set and a simulation study. The considered methods are the commonly applied cause-specific Cox proportional hazards model with a frailty, the Fine and Gray model for considering competing risks, and extensions of the latter model by Katsahian et al. and Zhou et al.

Results

Based on our simulation results, the model by Katsahian et al. showed the best performance in bias, square root of mean squared error, and power in nearly all scenarios. In contrast to the other three models this approach allows both unbiased effect estimation and prognosis.

Conclusion

The provided comparison and simulations help to guide applied researchers to choose an adequate method for the analysis of competing events where a cluster structure is present. Based on our simulation results the approach by Katsahian et al. can be recommended.
Assessment of subjective image quality, contrast to noise ratio and modulation transfer function in the middle ear using a novel full body cone beam computed tomography device
Authors: Heikkinen Anssi-Kalle , Rissanen Valtteri , Aarnisalo Antti A. , Nyman Kristofer , Sinkkonen Saku T. , Koivisto Juha
Published: April 2023

Background

Multi slice computed tomography (MSCT) is the most common used method in middle ear imaging. However, MSCT lacks the ability to distinguish the ossicular chain microstructures in detail resulting in poorer diagnostic outcomes. Novel cone beam computed tomography (CBCT) devices’ image resolution is, on the other hand, better than MSCT resolution. The aim of this study was to optimize imaging parameters of a novel full body CBCT device to obtain optimal contrast to noise ratio (CNR) with low effective dose, and to optimize its clinical usability.

Methods

Imaging of five anonymous excised human cadaver temporal bones, the acquisition of the effective doses and the CNR measurements were performed for images acquired on using Planmed XFI® full body CBCT device (Planmed Oy, Helsinki, Finland) with a voxel size of 75 µm. All images acquired from the specimens using 10 different imaging protocols varying from their tube current exposure time product (mAs) and tube voltage (kVp) were analyzed for eight anatomical landmarks and evaluated by three evaluators.

Results

With the exception of protocol with 90 kVp 100 mAs, all other protocols used are competent to image the finest structures. With a moderate effective dose (86.5 µSv), protocol with 90 kV 450 mAs was chosen the best protocol used in this study. A significant correlation between CNR and clinical image quality of the protocols was observed in linear regression model. Using the optimized imaging parameters, we were able to distinguish even the most delicate middle ear structures in 2D images and produce accurate 3D reconstructions.

Conclusions

In this ex vivo experiment, the new Planmed XFI® full body CBCT device produced excellent 2D resolution and easily created 3D reconstructions in middle ear imaging with moderate effective doses. This device would be suitable for middle ear diagnostics and for e.g., preoperative planning. Furthermore, the results of this study can be used to optimize the effective dose by selecting appropriate exposure parameters depending on the diagnostic task.
Autonomic function and inflammation in pregnant women participating in a randomized controlled study of Mindfulness Based Childbirth and Parenting
Authors: Rådmark Lina , Osika Walter , Wallén Martin Benka , Nissen Eva , Lönnberg Gunilla , Bränström Richard , Henje Eva , Gardner Renee , Fransson Emma , Karlsson Håkan , Niemi Maria
Published: April 2023

Background

Pregnancy and childbirth are significant events in many women’s lives, and the prevalence of depressive symptoms increases during this vulnerable period. Apart from well documented cognitive, affective, and somatic symptoms, stress and depression are associated with physiological changes, such as reduced heart-rate variability (HRV) and activation of the inflammatory response system. Mindfulness Based Interventions may potentially have an effect on both HRV, inflammatory biomarkers, and self-assessed mental health. Therefore, the aim of this study was to assess the effects of a Mindfulness Childbirth and Parenting (MBCP) intervention on HRV, serum inflammatory marker levels, through an RCT study design with an active control group.

Methods

This study is a sub-study of a larger RCT, where significant intervention effects were found on perinatal depression (PND) and perceived stress. Participants were recruited through eight maternity health clinics in Stockholm, Sweden. In this sub-study, we included altogether 80 women with increased risk for PND, and blood samples and HRV measures were available from 60 of the participants (26 in the intervention and 34 in the control group).

Results

Participants who received MBCP reported a significantly larger reduction in perceived stress and a significantly larger increase in mindfulness, compared to participants who received the active control treatment. However, in this sub-study, the intervention had no significant effect on PND, inflammatory serum markers or measures of HRV.

Conclusions

No significant differences were found regarding changes in HRV measures and biomarkers of inflammation, larger studies may be needed in the future.

Trial registration

ClinicalTrials.gov ID: NCT02441595. Registered 12 May 2015 - Retrospectively registered.
Lifetime posttraumatic stress disorder as a predictor of mortality: a systematic review and meta-analysis
Authors: Nilaweera Dinuli , Phyo Aung Zaw Zaw , Teshale Achamyeleh Birhanu , Htun Htet Lin , Wrigglesworth Jo , Gurvich Caroline , Freak-Poli Rosanne , Ryan Joanne
Published: April 2023

Background

Posttraumatic Stress Disorder (PTSD) could potentially increase the risk of mortality, and there is a need for a meta-analysis to quantify this association. This study aims to determine the extent to which PTSD is a predictor of mortality.

Methods

EMBASE, MEDLINE, and PsycINFO were searched systematically on 12th February 2020, with updated searches conducted in July 2021, and December 2022 (PROSPERO CRD42019142971). Studies involving community-dwelling participants with a diagnosis of PTSD or PTSD symptoms, and a comparator group of individuals without PTSD, and which assessed mortality risk, were included. A random-effects meta-analysis was conducted on studies reporting Odds Ratio (OR), Hazard Ratio (HR), and Risk Ratio (RR), and subgroup analysis was also performed by age, sex, type of trauma experienced, PTSD diagnosis, and cause of death.

Results

A total of 30 eligible studies of mostly good methodological quality were identified, with a total of more than 2.1 million participants with PTSD. The majority of studies involved male-dominated, veteran populations. PTSD was associated with a 47% (95% CI: 1.06–2.04) greater risk of mortality across six studies that reported OR/RR, and a 32% increased risk across 18 studies which reported time to death (HR: 1.32, 95% CI: 1.10–1.59). There was very high study heterogeneity (I2 > 94%) and this was not explained by the prespecified subgroup analysis.

Conclusion

PTSD is associated with increased mortality risk, however further research is required amongst civilians, involving women, and in individuals from underdeveloped countries.
SDF-1α promotes subchondral bone sclerosis and aggravates osteoarthritis by regulating the proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells
Authors: Meng Zhiqiang , Xin Lujun , Fan Bosheng
Published: April 2023

Background

Subchondral bone sclerosis is a major feature of osteoarthritis (OA), and bone marrow mesenchymal stem cells (BMSCs) are presumed to play an important role in subchondral bone sclerosis. Accumulating evidence has shown that stromal cell-derived factor-1α (SDF-1α) plays a key role in bone metabolism-related diseases, but its role in OA pathogenesis remains largely unknown. The purpose of this study was to explore the role of SDF-1α expressed on BMSCs in subchondral bone sclerosis in an OA model.

Methods

In the present study, C57BL/6J mice were divided into the following three groups: the sham control, destabilization of the medial meniscus (DMM), and AMD3100-treated DMM (DMM + AMD3100) groups. The mice were sacrificed after 2 or 8 weeks, and samples were collected for histological and immunohistochemical analyses. OA severity was assessed by performing hematoxylin and eosin (HE) and safranin O-fast green staining. SDF-1α expression in the OA model was measured using an enzyme-linked immunosorbent assay (ELISA), quantitative real-time polymerase chain reaction (q-PCR), and immunohistochemistry. Micro-CT was used to observe changes in subchondral bone in the OA model. CD44, CD90, RUNX2, and OCN expression in subchondral bone were measured using q-PCR and immunohistochemistry. In vitro, BMSCs were transfected with a recombinant lentivirus expressing SDF-1α, an empty vector (EV), or siRNA-SDF-1α. Western blot analysis, q-PCR, and immunofluorescence staining were used to confirm the successful transfection of BMSCs. The effect of SDF-1α on BMSC proliferation was evaluated by performing a CCK-8 assay and cell cycle analysis. The effect of SDF-1α on the osteogenic differentiation of BMSCs was assessed by performing alkaline phosphatase (ALP) and alizarin red S (ARS) staining. Cyclin D1, RUNX2 and OCN expression were measured using Western blot analysis, q-PCR, and immunofluorescence staining.

Results

SDF-1α expression in the DMM-induced OA model increased. In the DMM + AMD3100 group, subchondral bone sclerosis was alleviated, OA was effectively relieved, and CD44, CD90, RUNX2, and OCN expression in subchondral bone was decreased. In vitro, high levels of SDF-1α promoted BMSC proliferation and increased osteogenic differentiation. Cyclin D1, RUNX2, and OCN expression increased.

Conclusion

The results of this study reveal a new molecular mechanism underlying the pathogenesis of OA. The targeted regulation of SDF-1α may be clinically effective in suppressing OA progression.
Development of the educational leadership scale for nursing students: a methodological study
Authors: Karaman Funda , KavgaoĞlu Derya , YILDIRIM Gülay , RASHIDI Mahruk , ÜNSAL JAFAROV Gülşah , ZAHOOR Hina , KISKAÇ Neşe
Published: April 2023

Background

Educational leadership is one of the most demanding skills for healthcare staff to enhance the quality of health care. There is a need for a scale to evaluate the educational leadership levels of nurses. The objective of this study was to develop and examine the validity and reliability of the Education Leadership Scale for Nursing Students.

Methods

Data were collected from 280 Turkish nursing students. The validity and reliability of the tool were confirmed with exploratory and confirmatory factor analysis, Cronbach’s alpha and Pearson correlation. The scale was developed in five stages (reviewing the literature, developing items, sending scale items to the experts for content validity index, piloting test with students, performing the validity and reliability analysis of the tool).

Results

The Educational Leadership Scale for Nursing Students consisted of 19 items and a three factor structure. Confirmatory factor analysis results showed that there was a sufficient model fit. Construct validity was verified, and Cronbach’s α level of all factors was found to be greater than 0.70.

Conclusions

The currently developed scale can measure the educational leadership characteristics of nursing students.
Prevalence and correlates of workplace violence against medical assistants in Germany: a cross-sectional study
Authors: Mambrey Viola , Ritz-Timme Stefanie , Loerbroks Adrian
Published: April 2023

Background

Workplace violence is widespread, but studies on workplace violence against health professions in outpatient settings are sparse. We aimed to examine, for the first time, the prevalence of workplace violence against medical assistants as well as potential sociodemographic, occupational and health-related correlates of the exposure to workplace violence.

Methods

We used data from a survey (03–05/2021) among medical assistants in Germany (n = 424). We assessed the 12–month prevalence (yes/no) of verbal violence, physical violence, and sexual harassment as well as the types of perpetrators of workplace violence. Further, information was gathered on sociodemographic (e.g., age, educational level), occupational (e.g., years in job), and mental health-related factors (i.e., anxiety, depression). The 12–month prevalences of the different types of workplace violence were merged into a single variable (“any workplace violence” vs. none) for association analysis. We ran multivariable Poisson regression models to examine potential associations between sociodemographic and occupational correlates (i.e., independent variables) with any workplace violence as dependent variable and in addition between any workplace violence (independent variable) and dichotomized mental health as dependent variable.

Results

Overall, 59.4% of the medical assistants reported verbal violence, 5.9% reported physical violence, 3.8% reported sexual harassment, and 60.1% reported any workplace violence in the previous 12 months. Patients were reported to be the main perpetrators, followed by patients’ relatives. Younger age, being single, and working in a medical care center were sociodemographic and occupational correlates of workplace violence (PRs ≥ 1.27). Workplace violence was significantly associated with mental health variables (PRs ≥ 1.72).

Conclusion

Medical assistants experience workplace violence, in particular verbal violence. To devise preventive measures, prospective studies are needed to confirm the potential risk groups for workplace violence and the potential mental health sequels of workplace violence observed in our study.
Biomimetic liposomal nanozymes improve breast cancer chemotherapy with enhanced penetration and alleviated hypoxia
Authors: Li Juanjuan , Gong Chunai , Chen Xinlu , Guo Huanhuan , Tai Zongguang , Ding Nan , Gao Shen , Gao Yuan
Published: April 2023

Background

Doxorubicin (Dox) has been recommended in clinical guidelines for the standard-of-care treatment of breast cancer. However, Dox therapy faces challenges such as hypoxia, acidosis, H2O2-rich conditions and condensed extracellular matrix in TME as well as low targeted ability.

Methods

We developed a nanosystem H-MnO2-Dox-Col NPs based on mesoporous manganese dioxide (H-MnO2) in which Dox was loaded in the core and collagenase (Col) was wrapped in the surface. Further the H-MnO2-Dox-Col NPs were covered by a fusion membrane (MP) of inflammation-targeted RAW264.7 cell membrane and pH-sensitive liposomes to form biomimetic MP@H-MnO2-Dox-Col for in vitro and in vivo study.

Results

Our results shows that MP@H-MnO2-Dox-Col can increase the Dox effect with low cardiotoxicity based on multi-functions of effective penetration in tumor tissue, alleviating hypoxia in TME, pH sensitive drug release as well as targeted delivery of Dox.

Conclusions

This multifunctional biomimetic nanodelivery system exhibited antitumor efficacy in vivo and in vitro, thus having potential for the treatment of breast cancer.