bluuebunny/crossref_metadata_2025 huggingface dataset:
Platelet Concentrates Preconditioning of Mesenchymal Stem Cells and Combined Therapies: Integrating Regenerative Strategies for Enhanced Clinical Applications
Authors: Li Xu-huan , Xiao Han-xi , Wang Zu-xiu , Tang Xin-rong , Yu Xue-feng , Pan Yong-ping
Published: March 2024

This article presents a comprehensive review of the factors influencing the efficacy of mesenchymal stem cells (MSCs) transplantation and its association with platelet concentrates (PCs). It focuses on investigating the impact of PCs’ composition, the age and health status of platelet donors, application methods, and environmental factors on the outcomes of relevant treatments. In addition, it delves into the strategies and mechanisms for optimizing MSCs transplantation with PCs, encompassing preconditioning and combined therapies. Furthermore, it provides an in-depth exploration of the signaling pathways and proteomic characteristics associated with preconditioning and emphasizes the efficacy and specific effects of combined therapy. The article also introduces the latest advancements in the application of biomaterials for optimizing regenerative medical strategies, stimulating scholarly discourse on this subject. Through this comprehensive review, the primary goal is to facilitate a more profound comprehension of the factors influencing treatment outcomes, as well as the strategies and mechanisms for optimizing MSCs transplantation and the application of biomaterials in regenerative medicine, offering theoretical guidance and practical references for related research and clinical practice.
The gender-affirming model of care is incompatible with competent, ethical medical practice
Authors: Amos Andrew
Published: March 2024

Objective

To examine the compatibility of gender-affirming care with the principles and practices of psychiatry.

Conclusions

The assumption that there is no pathology involved in the development of gender diversity is a necessary precondition for the unquestioning affirmation of self-reported gender identity. Cases where psychosis is the undeniable cause of gender diversity demonstrate this assumption is categorically false. To protect this false assumption, gender-affirming guidelines forbid the application of the core psychiatric competencies of phenomenology and psychopathology to the assessment of gender diversity. They substitute the political goal of expanding personal liberty for the evidence-based medicine processes of clinical reasoning, rendering them incompatible with competent, ethical medical practice.
Dynamic mechanical response and deformation mechanism of poly (ε-caprolactone) (PCL) / epoxy resin(EP) shape memory polymer composites
Authors: Wei Yongjian , Tan Zhuhua
Published: March 2024

The dynamic mechanical response and deformation mechanism of poly (ε-caprolactone) (PCL) and epoxy resins shape memory polymer (SMP) composites were investigated in this paper. The SMP composites were a blend of PCL and epoxy resins by using the facile melt-mixing method. The distribution of PCL in the composites was observed by SEM, which was in from microparticle morphology to continuous morphology with the increasing PCL content. And the dynamic mechanical analyzer (DMA) tests were performed to demonstrate the viscoelastic properties and shape memory effect of the PCL/EP composites. Based on the above characterization of PCL/EP composites, the split Hopkinson pressure bar (SHPB) tests were performed to study the dynamic mechanical properties at the strain rates of 4000/s to 7000/s. The results showed that the flow stress increased with the increasing strain rate, which exhibited an obvious sensitivity to strain rate. However, the flow stress of PCL/EP decreases with the increasing PCL content due to the low strength of PCL. And PCL/EP composites failed in a typical ductile failure mode under quasi-static loading, whereas an excellent plastic deformation ability was observed at high strain rates, which was attributed to the heat generated by the plastic work during the adiabatic compression. Combining with the experimental results, the corresponding deformation mechanism was also discussed.
Teamwork Coaching in the Research Development Process
Authors: Stephens Bryan , Downer Joanna B. , Cummings Jonathon N.
Published: March 2024

Proposal teams play a critical, yet understudied, role in team science. This study advances our understanding of teamwork coaching in the research development (RD) process by analyzing proposal support in a U.S. Medical School (2009–2019). We find that teamwork coaching mediates the positive association between team size and awarded outcomes. We also find that teams with proposer team familiarity need less teamwork coaching and that teamwork coaching is particularly valuable for teams with proposers who have both clinical and research responsibilities. We discuss contributions to team science and team coaching literatures as well as implications for training and educating RD coaches.
Identification of Inflammatory Mediators in Saliva Samples From Hospitalized Newborns: Potential Biomarkers?
Authors: Rocha Vanderlei Amadeu da , Cruz-Machado Sanseray da Silveira , Silva Isília Aparecida , Fernandes Pedro Augusto Carlos Magno , Markus Regina Pekelmann , Bueno Mariana
Published: March 2024

Saliva measurements serve as a noninvasive tool for clinically monitoring newborns (NB) and children, a vulnerable population with promising potential for both research and clinical practice. Saliva acts as a repository for various inflammatory biomarkers involved in diverse biological functions. Particularly for children, it offers numerous advantages when compared to plasma and urine sampling. Nevertheless, there is a significant knowledge gap regarding detectable levels of cytokines in the saliva of newborns and children, as well as studies aiming to assess the relationship of this content with physiological and pathological processes. Objectives: To characterize the levels of 11 inflammatory mediators (IFNg, IL1b, IL2, IL4, IL6, IL8, IL10, IL12, IL17, TNF, and VEGF) in saliva samples from NB on the first and second day of hospitalization in the Neonatal Intensive Care Unit (NICU). Method: Exploratory study, descriptive, nested within a primary clinical, observational, and prospective study, conducted in the NICU of a public hospital in São Paulo, Brazil. Demographic data and vital signs were recorded in the clinical records of 90 NB, and five saliva samples from 5 NB were collected between the first and second day of life (D1–D2) at approximately 8-hr intervals (8–9 am, 4–5 pm, and 11–12 pm). Saliva samples were used for the measurement of 11 cytokines (IFNg, IL1b, IL2, IL4, IL6, IL8, IL10, IL12, IL17, TNF, and VEGF). Results: Five NBs participated in this exploratory study, and the vital signs showed variability from the first (D1) to the second day (D2) of hospitalization, variability similar to that of the total population of the primary study. The presence and levels of the 11 cytokines were detected in the saliva samples, as well as a statistical correlation between 10 cytokines (IFNg, IL1b, IL2, IL4, IL6, IL10, IL12, IL17, TNF, and VEGF) and vital signs. Conclusions: The novelty of measuring inflammatory mediators in saliva samples from hospitalized NBs in the NICU is highlighted, providing support and new perspectives for the development of clinical and experimental research and an opportunity for developing and implementing new salivary biomarkers in different population segments.
The Reconsecration of the Self: A Qualitative Analysis of Sex Trafficking Survivors’ Experience of the Body
Authors: Juraschek Elise , Legg Alexander , Raghavan Chitra
Published: March 2024

The understudied bodily harm women experience after commercial sex (CS) may be partially explained by the prominence of Cartesian mind–body dualism in psychological science. Accordingly, we qualitatively explored the mind–body relationship among 79 female sex trafficking survivors. Survivors reported long-term negative alterations in feelings about the body, sex, and physical touch posttrafficking and these negative outcomes did not differ across women who self-perceived as consenting and women who self-perceived as forced. Implications for future research are presented, particularly on measuring dehumanization in CS which contributes to extensive harm even in the absence of physical aggression.
Longitudinal Associations Between Symptoms of ADHD and Life Success: From Emerging Adulthood to Early Middle Adulthood
Authors: Henning Colin T. , Summerfeldt Laura J. , Parker James D. A.
Published: March 2024

Objective:

To expand on current adult ADHD literature by investigating the stability of ADHD symptomatology (i.e., inattention and hyperactivity-impulsivity) across a 15-year period (from emerging adulthood to early middle adulthood) and the relative contributions of ADHD symptomatology to life success.

Method:

A sample of 320 post-secondary students was initially assessed for ADHD symptomatology using the Conners’ Adult ADHD Rating Scale (CAARS). Fifteen years later, participants were re-assessed using the CAARS and several measures of life success (e.g., relationship satisfaction, career satisfaction, and stress levels).

Results:

Inattention and hyperactivity-impulsivity symptoms showed strong stability across the 15-year period. Additionally, inattention symptoms during emerging adulthood and early middle adulthood were consistently associated with poorer life success (i.e., lower relationship and career satisfaction), particularly for men. Associations for hyperactivity-impulsivity symptoms were less consistent.

Conclusion:

ADHD symptomatology can be conceptualized as a stable, dimensional trait across adulthood, with important impacts on life success.
Perioperative Pain Management for Thoracic Surgery: A Multi-Layered Approach
Authors: Tong Larry , Solla Che , Staack Jeffrey B. , May Keith , Tran Bryant
Published: March 2024

Cardiothoracic surgeries frequently pose unique challenges in the management of perioperative acute pain that require a multifaceted and personalized approach in order to optimize patient outcomes. This article discusses various analgesic strategies including regional anesthesia techniques such as thoracic epidurals, erector spinae plane blocks, and serratus anterior plane blocks and underscores the significance of perioperative multimodal medications, while providing nuanced recommendations for their use. This article further attempts to provide evidence for the efficacy of the different modalities and compares the effectiveness of the choice of analgesia. The roles of Acute Pain Services (APS) and Transitional Pain Services (TPS) in mitigating opioid dependence and chronic postsurgical pain are also discussed. Precision medicine is also presented as a potential way to offer a patient tailored analgesic strategy. Supported by various randomized controlled trials and meta-analyses, the article concludes that an integrated, patient-specific approach encompassing regional anesthesia and multimodal medications, while also utilizing the services of the Acute Pain Service can help to enhance pain management outcomes in cardiothoracic surgery.
Bicavitary effusion in cats: retrospective analysis of signalment, clinical investigations, diagnosis and outcome
Authors: Hardwick Joshua J , Ioannides-Hoey Christopher S F K , Finch Natalie , Black Victoria
Published: March 2024

Objectives

The aim of this study was to describe the clinical and diagnostic findings and outcome of cats with bicavitary effusion presenting to a referral centre.

Methods

Medical records of cats presenting with bicavitary effusion were identified and their history, physical examination findings, clinicopathological data, diagnostic imaging findings, aetiology of bicavitary effusions (cardiac disease, neoplasia, infectious disease, sterile inflammatory disease, severe hypoalbuminaemia, trauma, coagulopathy or ‘open’ if no definitive diagnosis was reached) and outcome were recorded. Cox regression analysis was performed to identify independent predictors of death in cats with bicavitary effusion. Kaplan–Meier curves were generated for survival analysis.

Results

In total, 103 cats with bicavitary effusion were included. Neoplasia and cardiac disease were the most common aetiologies of bicavitary effusion, in 21 (20.4%) and 20 (19.4%) cats, respectively, followed by infectious disease (n = 11, 10.7%), trauma (n = 13, 12.6%), hypoalbuminaemia (n = 6, 5.8%), sterile inflammatory disease (n = 4, 3.9%) and coagulopathy (n = 1, 1.0%). The median survival time for all cats with bicavitary effusion was 3 days. Cats with a neoplastic aetiology had a 2.03 times greater risk of death compared with cats in which no diagnosis was achieved. Neoplasia ( P = 0.030) and pedigree breed status ( P = 0.016) were independent predictors of death in the multivariable Cox regression model.

Conclusions and relevance

This study highlights that bicavitary effusions in cats generally carry a guarded to poor prognosis, particularly if neoplasia is the underlying aetiology or if the cat is a pedigree breed. Cardiac disease appeared to be associated with a better prognosis, suggesting that assessment for congestive heart failure should be considered early when evaluating cats with bicavitary effusion. The prognosis for cats with feline infectious peritonitis is likely to be markedly improved by the advent of novel antiviral drugs, compared with the historical cohort of cats presented here.
Risk of infections related to endovascular catheters and cardiac implantable devices in hemodialysis patients
Authors: Alfano Gaetano , Morisi Niccolò , Giovanella Silvia , Frisina Monica , Amurri Alessio , Tei Lorenzo , Ferri Maria , Ligabue Giulia , Donati Gabriele
Published: March 2024

Patients requiring dialysis are extremely vulnerable to infectious diseases. The high burden of comorbidities and weakened immune system due to uremia and previous immunosuppressive therapy expose the patient on dialysis to more infectious events than the general population. The infectious risk is further increased by the presence of endovascular catheters and implantable cardiologic devices. The former is generally placed as urgent vascular access for dialysis and in subjects requiring hemodialysis treatments without autogenous arteriovenous fistula. The high frequency of cardiovascular events also increases the likelihood of implanting indwelling implantable cardiac devices (CIED) such as pacemakers (PMs) and defibrillators (ICDs). The simultaneous presence of CVC and CIED yields an increased risk of developing severe prosthetic device-associated bloodstream infections often progressing to septicemia. Although, antibiotic therapy is the mainstay of prosthetic device-related infections, antibiotic resistance of biofilm-residing bacteria reduces the choice of infection eradication. In these cases, the resolution of the infection process relies on the removal of the prosthetic device. Compared to CVC removal, the extraction of leads is a more complex procedure and poses an increased risk of vessel tearing. As a result, the prevention of prosthetic device-related infection is of utmost importance in hemodialysis (HD) patients and relies principally on avoiding CVC as vascular access for HD and placement of a new class of wireless implantable medical devices. When the combination of CVC and CIED is inevitable, prevention of infection, mainly due translocation of skin bacteria, should be a mandatory priority for healthcare workers.
Role of Oxaliplatin in the Neoadjuvant Concurrent Chemoradiotherapy in Locally Advanced Rectal Cancer: a Review of Evidence
Authors: Nazari Reza , Piozzi Guglielmo Niccolò , Ghalehtaki Reza , Ahmadi-Tafti Seyed Mohsen , Behboudi Behnam , Mousavi Darzikolaee Nima , Aghili Mahdi , Gambacorta Maria Antonietta
Published: March 2024

The treatment of locally advanced rectal cancer (LARC) is a challenging situation for radiation oncologists and colorectal surgeons. Most current approaches recommend neoadjuvant fluorouracil or capecitabine-based chemoradiotherapy followed by surgery as a standard of care. Intensification of concurrent chemotherapy by adding oxaliplatin to fluorouracil or capecitabine backbone to get better outcomes is the matter that has remained unresolved. In this review, we searched Medline and Google Scholar databases and selected 28 prospective phase II and III clinical trials that addressed this question. We discussed the potential advantages and drawbacks of incorporating oxaliplatin into concurrent chemoradiation therapy. We tried to define whether adding oxaliplatin to concurrent chemoradiation with excellent performance and high-risk features benefits some subpopulations. The available literature suggests that by adding oxaliplatin there are some benefits in enhancing response to neoadjuvant chemoradiotherapy, however, without any translated improvements in long-term outcomes including overall and disease-free survival.
Identification of Transcriptomic Signatures of Pancreatic Ductal Adenocarcinoma–Derived Exosomes That Promote Macrophage M2 Polarization and Predict Prognosis: S100A9 Reveals Tumor Progression
Authors: Tan Siyuan , Tang Haodong , Zhang Zheng , Wang Yang , Li Haifeng , Shi Wenyuan , Ye Hao , Xie Peng , Zhou Jiahua
Published: March 2024

Background:

Exosomes play a role in intercellular communication and participate in the interaction between pancreatic ductal adenocarcinoma (PDAC) cells and immune cells. Macrophages can receive tumor cell–derived exosomes to polarize into M2-type macrophages, which can enhance the invasion and metastasis of pancreatic cancer, leading to poor prognosis. However, the mechanism by which pancreatic cancer cell–derived exosomes promote M2-type macrophages is still unclear.

Methods:

M2 macrophage–associated exosome-derived key module genes were identified by differentially expressed genes (DEGs) and weighted gene co-expression network analysis (WGCNA) analysis using exoRbase 2.0, The Cancer Genome Atlas (TCGA), and The International Cancer Genome Consortium (ICGC) databases. Multivariate Cox regression analysis was used to identify key prognostic genes and obtain regression coefficients to establish prognostic signature. Immune infiltration, tumor mutations, and GSEA among different risk groups were compared. exoRbase 2.0, Gene Expression Profiling Interactive Analysis 2 (GEPIA2), HPA, and TISCH2 databases were used to further analyze the expression pattern of S100A9 in pancreatic cancer. In vitro experiments, cell-derived exosome isolation, quantitative polymerase chain reaction (qPCR), western blot, flow cytometry analysis, cell transfection, transwell assay, and CCK-8 assay were applied to investigate the roles of S100A9 in macrophage M2 polarization and tumor progression.

Results:

The key genes of PDAC-derived exosomes promoting M2-type macrophage polarization were identified, and a risk score model was established. The risk score is related to the expression of common immune checkpoints, immune score, and stromal score, and the tumor mutational burden and biological function of high- and low-risk groups were also different. S100A9 was positively correlated with M2-type macrophage marker. In addition, scRNA-seq data from the TISCH2 database revealed that S100A9 is predominantly expressed in pancreatic cancer cells and mono/macrophage cells, suggesting that S100A9 in pancreatic cancer cells could be received by macrophages, thereby inducing macrophage polarization. In vitro, we used exosomes from BxPC-3 cell lines to coculture macrophages and found that macrophages were mainly polarized toward M2 type, which further promoted the proliferation and metastasis of PDAC.

Conclusions:

Our study established a reliable risk score model for PDAC-derived exosomes and M2 macrophages, identified the important role of S100A9 in macrophage M2 polarization, which provides a new strategy for the diagnosis and treatment of PDAC, and strengthened the understanding of the mechanism of tumor development and metastasis.
Travel in trouble: Examining travel resilience in pilgrimage tourism
Authors: Senbeto Dagnachew Leta
Published: March 2024

This study develops a conceptual model demonstrating the impact of spiritual adherence on travel resilience in pilgrimage tourism. The study also investigated the role of religious leaders and stress-coping mindsets in helping pilgrims overcome stressful situations during their travels, leading to successful resilience strategies when the pilgrims return home. Data were collected from pilgrims who participated in pilgrimage during a crisis in Ethiopia, Africa. A two-step structural equation modeling procedure was conducted to test the proposed hypotheses, including a mediation and moderation-mediation path analysis. The study found that a stress-coping mindset partially mediates the role of spiritual adherence on resilience. Additionally, spiritual leadership strengthens the relationships (direct and indirect, through a stress-coping mindset) between spiritual adherence and resilience. The findings explained the role of spiritual adherence in the resilience of the pilgrims, along with the influence of a stress-coping mindset and spiritual leadership. Implications for theory and practice are discussed.
Enhancing law enforcement training: A gamified approach to detecting terrorism financing
Authors: Zola Francesco , Segurola Lander , King Erin , Mullins Martin , Orduna Raul
Published: March 2024

Tools for fighting cyber-criminal activities using new technologies are promoted and deployed every day. However, too often, they are unnecessarily complex and hard to use, requiring deep domain and technical knowledge. These characteristics often limit the engagement of law enforcement and end-users in these technologies, which despite their potential, remain misunderstood. For this reason, in this study, we describe our experience in combining learning and training methods and the potential benefits of gamification to enhance technology transfer and increase adult learning. In this case, participants are experienced practitioners in professions/industries that are exposed to terrorism financing (such as law enforcement officers, financial investigation officers, private investigators). We define training activities on different levels for increasing the exchange of information about new trends and criminal modus operandi among and within law enforcement agencies, intensifying cross-border cooperation and supporting efforts to combat and prevent terrorism-funding activities. A game (hackathon) is designed to address realistic challenges related to the darknet, crypto-assets, new payment systems and dark web marketplaces that could be used for terrorist activities. The entire methodology was evaluated using quizzes, contest results and engagement metrics. In particular, training events show that ∼60% of participants complete the 11-week training course, whereas the hackathon results, gathered in two pilot studies (Madrid and The Hague), show increasing expertise among participants (progression in the points achieved on average). At the same time, more than 70% of participants positively evaluate use of the gamification approach, and more than 85% consider the implemented use cases suitable for their investigations. These outcomes are further discussed to detect the introduced approach's benefits and limitations and improve future events.
Relations between the meaning of work, psychological well-being, and psychological distress: A study in the state military police in São Paulo, Brazil
Authors: Mendes Fernando Edson , Barrichello Alcides , Rodrigues Andréa Leite
Published: March 2024

The state military police of the Brazilian state of São Paulo (PMESP) has the lowest number of police officers in the institution since the 1990s, compared to itself, with a vast number of unpaid leave and resignation requests. Low salaries appear to be a reason, but the police say that this is not the only factor to be rectified; lack of recognition and difficulties in overcoming trauma are also frequently mentioned. This picture refers to a situation that can be understood as low motivation, loss of meaning, and psychological suffering. This study aimed to understand whether there is a general loss of meaning at work in PMESP, together with well-being and psychological suffering. Using structural equation modeling, the study sought to understand the factors that give meaning to the work of these professionals and their consequences for well-being and psychological distress at work. Social usefulness and learning and development opportunities showed a meaningful relationship with meaning of work, with learning and development opportunities being the most important for the surveyed military police officers. Regarding the consequent constructs of meaning of work, significant relationships between psychological well-being at work and psychological suffering were verified. The study indicates that when meaning is constructed (via social utility and learning), there is an increase in psychological well-being, as well as a decrease in the effect of psychological suffering.
Effect of flow area ratio of scrolls to turbine on matching of exhaust pulse energy distribution of an asymmetric twin-scroll turbocharging heavy-duty diesel engine
Authors: Jin Jianjiao , Ru Qiusheng , Zhang Chenyun
Published: March 2024

The operation mode of an asymmetric twin-scroll turbine is significantly different from that of a steady state under exhaust pulse feeding conditions, which leads to a more complex matching between a turbine with an engine. In this paper, It was first studied that the matching effect of the flow area ratio of asymmetric twin-scroll to turbine wheel on the pulse energy distribution of asymmetric twin-scroll turbocharged engines. Firstly, It was compared that the deviation between turbine average efficiency on time average testing results and turbine cycle average efficiency based high frequency test results under the background of pulse energy distribution in the scheduling of asymmetric twin-scroll turbocharged engines, as well as a matching method based on pulse energy weight distribution was proposed. Furthermore, the impact of the flow area ratio of scrolls to turbine on matching was studied to further optimize turbine matching. Finally, the optimal and original turbines were tested on the engine to further demonstrate the accuracy and rationality of the results. The results showed that the turbine cycle-average efficiency and the engine fuel economy were improved by about 2%–4% and 0.8%, respectively at the middle and high speeds region of the engine with maintaining equivalent NOx emissions.
The postwar Columbia tradition in sociology: Its cognitive commonalities and social mechanisms
Authors: Crothers Charles
Published: March 2024

For a period of some three decades (1940s–1970s) the faculty and graduate students at the Department of Sociology at Columbia University, and its associated research unit (the Bureau of Applied Social Research: BASR), successfully produced a stream of innovative sociological studies which was particularly important in building on the foundations of classical sociology to establish modern sociology. Modern Sociology was produced as a theoretically sophisticated scientific enterprise firmly based on a solid empirical foundation produced by appropriate social research methods (as master-minded by Paul F. Lazarsfeld). The ‘Columbia Tradition’ is an approach, rather than being focussed on any particular subject matter, involved the development of ‘middle-range theory’, often broken-out from classic theory (as propounded by Robert K. Merton), and backed up by efforts at knowledge cumulation and institution building. But the School included a glittering array of important sociologists and hosts of others who extended the work of the two leaders, developing it in further directions, as is expected of any school. This school was sustained by the vision of a developing scientific sociology propounded by its founders, but it faltered as its founders retired from active leadership roles, in addition to being impacted by changes in Columbia University and broader Sociology environments.
Enhancing Behavioral Health Implementation in a Care Coordination Program at a Federally Qualified Health Center: A Case Study Applying Implementation Frameworks
Authors: Dickson Kelsey S. , Holt Tana , Arredondo Elva M.
Published: March 2024

Federally Qualified Health Centers are charged with providing comprehensive health care in traditionally underserved areas, underscoring their importance in caring for and promoting health equity for the large portion of historically marginalized communities in this setting. There is a significant need to ensure Federally Qualified Health Centers are equipped to appropriately address the immense behavioral health needs common among patients served. Care coordination is an evidence-based model that is increasingly utilized in Federally Qualified Health Centers to improve care equity and outcomes. Addressing and supporting behavioral health needs is a key aspect of such care coordination models. Context-specific considerations and programmatic supports, particularly those that address the needs of care coordinators and the complex patients they serve, are needed to ensure such models can appropriately meet and address the behavioral health concerns of the diverse populations served. The goal of this study was to present a mixed-methods case study that systematically applies implementation frameworks to conduct a needs and context assessment to inform the development and testing of evidence-based practice strategies and implementation support as part of a care coordination program within a partnered Federally Qualified Health Center.
Diabetic Foot and Work Outcomes: A Review
Authors: Panou Theodoros , Papanas Nikolaos , Gouveri Evanthia , Skoufi Georgia , Constantinidis Theodoros C. , Nena Evangelia
Published: March 2024

The aim of this review article was to discuss impact of diabetic foot ulcers (DFUs) on employment status and work productivity. We performed a literature search from 2000 to 2023 in PubMed, Scopus, Google Scholar and in national repositories. The major work outcomes studied were presenteeism and absenteeism. Many DFUs patients had a poor social and educational background. Overall, DFUs patients experienced increased loss of productivity in their workplaces: either they had to be absent more working hours than average or they faced increased difficulty in meeting their daily requirements. The total loss in productivity is estimated to exceed almost one-third of anticipated working time, while 15 to 34.3% of DFUs patients expressed concerns about severe changes in their working environment, attributed directly to their condition. More than 1 out of 5 DFUs patients (ranging from 20 to 31.7%) were even confronted with overall job loss and unemployment. Amputations had an even more marked negative effect. In conclusion, DFUs negatively affect employment status and work productivity. Therefore, we need more studies with large participant numbers to increase our experience and to explore potential measures to mitigate these adverse effects.
Clinical Efficacy and Gut Microbiota Regulating-Related Effect of Si-Jun-Zi Decoction in Postoperative Non-Small Cell Lung Cancer Patients: A Prospective Observational Study
Authors: He Yiyun , Qi Ao , Gu Yifeng , Zhang Congmeng , Wang Yichao , Yang Wenxiao , Bi Ling , Gong Yabin , Jiao Lijing , Xu Ling
Published: March 2024

Background:

Postoperative non-small cell lung cancer (NSCLC) patients frequently encounter a deteriorated quality of life (QOL), disturbed immune response, and disordered homeostasis. Si-Jun-Zi Decoction (SJZD), a well-known traditional Chinese herbal formula, is frequently employed in clinical application for many years. Exploration is underway to investigate the potential therapeutic effect of SJZD for treating postoperative NSCLC.

Objective:

To assess the efficacy of SJZD on QOLs, hematological parameters, and regulations of gut microbiota in postoperative NSCLC patients.

Methods:

A prospective observational cohort study was conducted, enrolling 65 postoperative NSCLC patients between May 10, 2020 and March 15, 2021 in Yueyang Hospital, with 33 patients in SJZD group and 32 patients in control (CON) group. The SJZD group comprised of patients who received standard treatments and the SJZD decoction, while the CON group consisted of those only underwent standard treatments. The treatment period was 4 weeks. The primary outcome was QOL. The secondary outcomes involved serum immune cell and inflammation factor levels, safety, and alterations in gut microbiota.

Results:

SJZD group showed significant enhancements in cognitive functioning ( P = .048) at week 1 and physical functioning ( P = .019) at week 4. Lung cancer-specific symptoms included dyspnea ( P = .001), coughing ( P = .008), hemoptysis ( P = .034), peripheral neuropathy ( P = .019), and pain (arm or shoulder, P = .020, other parts, P = .019) eased significantly in the fourth week. Anemia indicators such as red blood cell count ( P = .003 at week 1, P = .029 at week 4) and hemoglobin ( P = .016 at week 1, P = .048 at week 4) were significantly elevated by SJZD. SJZD upregulated blood cell cluster differentiation (CD)3+ ( P = .001 at week 1, P < .001 at week 4), CD3+CD4+ ( P = .012 at week 1), CD3+CD8+ ( P = .027 at week 1), CD19+ ( P = .003 at week 4), increased anti-inflammatory interleukin (IL)-10 ( P = .004 at week 1, P = .003 at week 4), and decreased pro-inflammatory IL-8 ( P = .004 at week 1, p = .005 at week 4). Analysis of gut microbiota indicated that SJZD had a significant impact on increasing microbial abundance and diversity, enriching probiotic microbes, and regulating microbial biological functions.

Conclusions:

SJZD appears to be an effective and safe treatment for postoperative NSCLC patients. As a preliminary observational study, this study provides a foundation for further research.
Successful Retention Strategies for Research Targeting Hispanic/Latinx (Including Recent Immigrants) in the Midwest Region of the United States
Authors: Rodriguez Cindy , Gil Cindy , Maupomé Gerardo
Published: March 2024

Recruiting and retaining Hispanic/Latinx (H/L) participants, specifically undocumented immigrants, is challenging in part because of the mistrust and fear in participating in research studies. Additionally, only a few longitudinal studies describe the recruit and retention strategies among Mexican and Central American immigrants aiming to expand the knowledge base about those underprivileged groups; this was the objective of the 6-year longitudinal VidaSana study. In the present methods report, we specifically omit the presentation of results from the empirical data findings of the VidaSana study: the present report describes the process and offers a subjective appraisal of multiple and complementary approaches in the recruitment and retention strategies for Hispanics living in the Midwest region of the United States, including very recently arrived immigrants. This study was able to effectively recruit and retain (81.7%) a cohort of Mexican and Central American immigrants within a period of 36 months. Our recruitment and retention performance were successful in the context of the hostile environment against immigration that dominated the national landscape at the time of our study. The present methods report of the VidaSana study provides an insightful understanding in recruiting and, in particular, retaining H/Ls and H/L recent immigrants into longitudinal studies.
Prefrontal Cortex Activity During Gait in People With Persistent Symptoms After Concussion
Authors: Martini Douglas N. , Mancini Martina , Antonellis Prokopios , McDonnell Paul , Vitorio Rodrigo , Stuart Samuel , King Laurie A.
Published: March 2024

Background

Concussions result in transient symptoms stemming from a cortical metabolic energy crisis. Though this metabolic energy crisis typically resolves in a month, symptoms can persist for years. The symptomatic period is associated with gait dysfunction, the cortical underpinnings of which are poorly understood. Quantifying prefrontal cortex (PFC) activity during gait may provide insight into post-concussion gait dysfunction. The purpose of this study was to explore the effects of persisting concussion symptoms on PFC activity during gait. We hypothesized that adults with persisting concussion symptoms would have greater PFC activity during gait than controls. Within the concussed group, we hypothesized that worse symptoms would relate to increased PFC activity during gait, and that increased PFC activity would relate to worse gait characteristics.

Methods

The Neurobehavior Symptom Inventory (NSI) characterized concussion symptoms. Functional near-infrared spectroscopy quantified PFC activity (relative concentration changes of oxygenated hemoglobin [HbO2]) in 14 people with a concussion and 25 controls. Gait was assessed using six inertial sensors in the concussion group.

Results

Average NSI total score was 26.4 (13.2). HbO2 was significantly higher ( P = .007) for the concussed group (0.058 [0.108]) compared to the control group (−0.016 [0.057]). Within the concussion group, HbO2 correlated with NSI total symptom score (ρ = .62; P = .02), sagittal range of motion ( r = .79; P = .001), and stride time variability ( r = −.54; P = .046).

Conclusion

These data suggest PFC activity relates to symptom severity and some gait characteristics in people with persistent concussion symptoms. Identifying the neurophysiological underpinnings to gait deficits post-concussion expands our knowledge of motor behavior deficits in people with persistent concussion symptoms.
Atrial natriuretic peptide protects against gut barrier injury through PLC-γ1/ROS feedback loop in rats following traumatic hemorrhagic shock
Authors: Jiang Shou-Yin , Rao Tai-Wen , Shen Ye-Hua , Zhao Xiao-Gang
Published: March 2024

Introduction

The mechanisms underlying the protective effects of atrial natriuretic peptide (ANP) on the gut barrier during traumatic hemorrhagic shock (THS) remain elusive. This study aimed to explore the potential role of ANP in safeguarding against gut barrier dysfunction after THS, focusing on the PLC-γ1/ROS feedback loop.

Methods

In our THS rat model, we randomly allocated male Sprague-Dawley rats to receive intravenous ANP with or without a concurrent NADPH oxidase/p38 MAPK inhibitor during the shock phase. After 24 h, we assessed circulatory and jejunal ANP, ROS, intestinal tight junction proteins, and apoptosis to evaluate the effects of ANP on the gut barrier and its interplay with intestinal ANP and ROS. Rat small intestinal epithelial cells (IECs) were also treated with ANP and subjected to hypoxia/re-oxygenation injury, with or without PI3K/PLC inhibition, to elucidate the relationship between ANP/ROS signaling and PLC-γ1. Furthermore, we modulated PLC-γ1 expression in these IECs to examine its impact on ROS and ANP production.

Results

Intravenous ANP administration at 0.025 μg/kg/min during THS significantly increased intestinal ANP and ROS levels at 24 h. ANP treatment enhanced the expression of intestinal tight junction proteins and reduced IEC apoptosis. Inhibition of circulatory ROS diminished intestinal ANP levels, while suppression of circulatory ANP led to a reduction in intestinal ROS. Decreasing PLC-γ1 expression in hypoxia/re-oxygenation-treated IECs resulted in lower ROS and ANP levels, whereas augmenting PLC-γ1 expression did not alter these levels. Additionally, PI3K inhibition markedly decreased PLC-γ1 expression in these cells.

Conclusion

ANP-induced protection of the intestinal barrier in THS is mediated by an intrinsic PLC-γ1/ROS positive feedback loop. ANP preserves gut barrier integrity and reduces IEC apoptosis through this mechanism. Further studies are warranted to investigate the interaction between IECs and other cellular components within the PLC-γ1/ROS loop.
Internal load and wellness responses between consecutive collegiate female field hockey matches
Authors: Szymkowicz Joseph M , Saari Anssi , Hillman Angela
Published: March 2024

This study evaluated internal load (IL) and wellness between consecutive field hockey matches played over a 2-day period across a 7-week season consisting of 12 total matches. Twelve NCAA Division I hockey players’ IL was assessed by heart rate (HR) zones (zone 1 = 50–60% HRmax, zone 2 = 60–70% HRmax, zone 3 = 70–80% HRmax, zone 4 = 80–90% HRmax, and zone 5 > 90% HRmax) and HR-derived training impulse. Wellness items (sleep, stress, fatigue, soreness, and total wellness) were obtained to measure the players’ subjective responses. Linear mixed models were used to examine the main effects of time (matched pairs of games) and the interaction between match (match 1 vs 2) and week (week 1–6) for IL. For wellness, main effects for time (mid-week, post-match 1, and post-match 2) and the interaction between day (mid-week, post-match 1, and post-match 2) and week (week 1–5) were examined. More time was spent in HR zone 1 in match 2 versus 1 (mean difference (MD) = 4.2 ± 3.0 minutes). Total wellness, fatigue, and soreness were all worse post-match 2 compared to mid-week (MD = 1.8 ± 1.4 AU, MD = 0.4 ± 0.6 AU, and MD = 0.8 ± 0.4 AU, respectively). Our results indicate that evaluation of specific wellness items may help practitioners determine the source of decreased wellness and adjust the weekly training load or recovery strategies based off the results of the changes in IL.
The pains of going to court: Unrepresented defendants’ ability to effectively participate in court proceedings
Authors: Walker Charlotte
Published: March 2024

Within this article, the pains that unrepresented defendants experience when representing themselves in court will be discussed from the perspective of court professionals and the researcher. For the purpose of this article, an unrepresented defendant is someone who at some stage during court proceedings is not represented by a lawyer. Based upon data gathered from 20 semi-structured interviews with court actors and courtroom observations at two magistrates’ courts, it will be argued that while most defendants tend to struggle to effectively participate in court proceedings (e.g. follow and understand what is taking place), this is particularly the case for those who are unrepresented. It is important that defendants can participate in court proceedings for due process, human rights and liberal democratic reasons.
A review of the therapeutic potential of the cysteinyl leukotriene antagonist Montelukast in the treatment of bronchiolitis obliterans syndrome following lung and hematopoietic-stem cell transplantation and its possible mechanisms
Authors: Kordjazy Nastaran , Amini Shahideh
Published: March 2024

Lung and hematopoietic stem cell transplantation are therapeutic modalities in chronic pulmonary and hematological diseases, respectively. One of the complications in these patients is the development of bronchiolitis obliterans syndrome (BOS). The efficacy and safety of available treatment strategies in BOS remain a challenge. A few mechanisms have been recognized for BOS in lung transplant and graft- versus-host disease (GVHD) patients involving the TH-1 and TH-2 cells, NF-kappa B, TGF-b, several cytokines and chemokines, and cysteinyl leukotrienes (CysLT). Montelukast is a highly selective CysLT receptor antagonist that has been demonstrated to exert anti-inflammatory and anti-fibrotic effects in abundant experiments. One area of interest for the use of montelukast is lung transplants or GVHD-associated BOS. Herein, we briefly review data regarding the mechanisms involved in BOS development and montelukast administration as a treatment modality for BOS, and finally, the possible relationship between CysLTs antagonism and BOS improvement will be discussed.
Pharmacological Mechanisms of Periplocae Cortex Against Congestive Heart Failure Based on Network Pharmacology and Experimental Evaluation
Authors: Zhang Xiaojing , Liu Zhijie , Guo Baojian , Cui Qingbin , Gao Jun , Kang Zhanfang , Xiao Guanghui
Published: March 2024

Background

Periplocae cortex is a well-known Traditional Chinese Medicine with abundant effects, including the treatment of chronic congestive heart failure (CHF). However, the principal components and mechanisms have not been fully elucidated. This study aims to analyze the active ingredients and potential mechanisms of the periplocae cortex in CHF treatment.

Methods

TCMSP, GeneCards, and Comparative Toxicogenomics databases were used to mine the active ingredients and potential targets of the periplocae cortex. Cytoscape 3.9.1 software was employed to construct the “periplocae cortex-active ingredients-potential targets” and protein–protein interaction network. The DAVID 6.8 database was used for Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis of the predicted targets. The protective effects of β-sitosterol (BSS) were detected in doxorubicin (Dox)-induced H9c2 cells using MTT assay, while the regulatory pathways of BSS were examined using various assays, including real-time quantitative PCR and Western blot. The cardiac troponin I (cTn-I) concentration was also measured.

Results

A total of 13 active ingredients were identified, and 33 targets of CHF were predicted. Network analysis highlighted BSS as the key active ingredient, interacting with 29 targets. GO and KEGG analyses indicated significant involvement of these targets in calcium and apoptosis signaling pathways. Experimental findings demonstrated that BSS enhanced cell viability, reduced intracellular calcium ion concentration, and inhibited caspase 3 activity in Dox-induced H9c2 cells. BSS significantly altered the expression of CHRM1, CASP3, and CASP9 genes ( P < .05), and increased CHRM2 expression. Additionally, BSS significantly increased cTn-I concentration. Notably, suppression of calcium and apoptosis signaling pathways partially mitigated BSS's effects on cell viability and cTn-I concentration.

Conclusion

Through network pharmacology and experimental verification, establishes BSS as a key active ingredient in the periplocae cortex for CHF treatment. BSS appears to modulate calcium and apoptosis signaling pathways, thereby exerting therapeutic effects in the treatment of CHF.
Foot and Ankle Patient Education Materials and Artificial Intelligence Chatbots: A Comparative Analysis
Authors: Parekh Aarav S. , McCahon Joseph A.S. , Nghe Amy , Pedowitz David I. , Daniel Joseph N. , Parekh Selene G.
Published: March 2024

Background

The purpose of this study was to perform a comparative analysis of foot and ankle patient education material generated by the AI chatbots, as they compare to the American Orthopaedic Foot and Ankle Society (AOFAS)-recommended patient education website, FootCareMD.org.

Methods

ChatGPT, Google Bard, and Bing AI were used to generate patient educational materials on 10 of the most common foot and ankle conditions. The content from these AI language model platforms was analyzed and compared with that in FootCareMD.org for accuracy of included information. Accuracy was determined for each of the 10 conditions on a basis of included information regarding background, symptoms, causes, diagnosis, treatments, surgical options, recovery procedures, and risks or preventions.

Results

When compared to the reference standard of the AOFAS website FootCareMD.org, the AI language model platforms consistently scored below 60% in accuracy rates in all categories of the articles analyzed. ChatGPT was found to contain an average of 46.2% of key content across all included conditions when compared to FootCareMD.org. Comparatively, Google Bard and Bing AI contained 36.5% and 28.0% of information included on FootCareMD.org, respectively (P < .005).

Conclusion

Patient education regarding common foot and ankle conditions generated by AI language models provides limited content accuracy across all 3 AI chatbot platforms.

Level of Evidence:

Level IV