bluuebunny/crossref_metadata_2025 huggingface dataset:
Randomized Sham-Controlled Pilot Study of Neurocardiac Function in Patients With Acute Ischaemic Stroke Undergoing Heart Rate Variability Biofeedback
Authors: Siepmann Timo , Ohle Paulin , Sedghi Annahita , Simon Erik , Arndt Martin , Pallesen Lars-Peder , Ritschel Gerhard , Barlinn Jessica , Reichmann Heinz , Puetz Volker , Barlinn Kristian
Published: May 2021

Background: Neurocardiac dysfunction worsens clinical outcome and increases mortality in stroke survivors. We hypothesized that heart rate variability (HRV) biofeedback improves neurocardiac function by modulating autonomic nervous system activity after acute ischaemic stroke (AIS).

Methods: We randomly allocated (1:1) 48 acute ischaemic stroke patients to receive nine sessions of HRV- or sham biofeedback over 3 days in addition to comprehensive stroke unit care. Before and after the intervention patients were evaluated for HRV via standard deviation of normal-to-normal intervals (SDNN, primary outcome), root mean square of successive differences between normal heartbeats (RMSSD), a predominantly parasympathetic measure, and for sympathetic vasomotor and sudomotor function. Severity of autonomic symptoms was assessed via survey of autonomic symptom scale total impact score (TIS) at baseline and after 3 months.

Results: We included 48 patients with acute ischaemic stroke [19 females, ages 65 (4.4), median (interquartile range)]. Treatment with HRV biofeedback increased HRV post intervention [SDNN: 43.5 (79.0) ms vs. 34.1 (45.0) ms baseline, p = 0.015; RMSSD: 46.0 (140.6) ms vs. 29.1 (52.2) ms baseline, p = 0.015] and alleviated autonomic symptoms after 3 months [TIS 3.5 (8.0) vs. 7.5 (7.0) baseline, p = 0.029], which was not seen after sham biofeedback (SDNN: p = 0.63, RMSSD: p = 0.65, TIS: 0.06). There were no changes in sympathetic vasomotor and sudomotor function (p = ns).

Conclusions: Adding HRV biofeedback to standard stroke unit care led to improved neurocardiac function and sustained alleviation of autonomic symptoms after acute ischaemic stroke, which was likely mediated by a predominantly parasympathetic mechanism.

Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT03865225.
Top-Down Proteomics of Human Saliva Highlights Anti-inflammatory, Antioxidant, and Antimicrobial Defense Responses in Alzheimer Disease
Authors: Contini Cristina , Olianas Alessandra , Serrao Simone , Deriu Carla , Iavarone Federica , Boroumand Mozhgan , Bizzarro Alessandra , Lauria Alessandra , Faa Gavino , Castagnola Massimo , Messana Irene , Manconi Barbara , Masullo Carlo , Cabras Tiziana
Published: May 2021

Alzheimer disease (AD) is the most prevalent neurodegenerative disease in the elderly, characterized by accumulation in the brain of misfolded proteins, inflammation, and oxidative damage leading to neuronal cell death. By considering the viewpoint that AD onset and worsening may be influenced by environmental factors causing infection, oxidative stress, and inflammatory reaction, we investigated the changes of the salivary proteome in a population of patients with respect to that in healthy controls (HCs). Indeed, the possible use of saliva as a diagnostic tool has been explored in several oral and systemic diseases. Moreover, the oral cavity continuously established adaptative and protective processes toward exogenous stimuli. In the present study, qualitative/quantitative variations of 56 salivary proteoforms, including post-translationally modified derivatives, have been analyzed by RP-HPLC-ESI-IT-MS and MS/MS analyses, and immunological methods were applied to validate MS results. The salivary protein profile of AD patients was characterized by significantly higher levels of some multifaceted proteins and peptides that were either specific to the oral cavity or also expressed in other body districts: (i) peptides involved in the homeostasis of the oral cavity; (ii) proteins acting as ROS/RNS scavengers and with a neuroprotective role, such as S100A8, S100A9, and their glutathionylated and nitrosylated proteoforms; cystatin B and glutathionylated and dimeric derivatives; (iii) proteins with antimicrobial activity, such as α-defensins, cystatins A and B, histatin 1, statherin, and thymosin β4, this last with a neuroprotective role at the level of microglia. These results suggested that, in response to injured conditions, Alzheimer patients established defensive mechanisms detectable at the oral level. Data are available via ProteomeXchange with identifier PXD021538.
Brain Microstructural Changes Associated With Neurocognitive Outcome in Intracranial Germ Cell Tumor Survivors
Authors: Tso Winnie Wan Yee , Hui Edward Sai Kam , Lee Tatia Mei Chun , Liu Anthony Pak Yin , Ip Patrick , Vardhanabhuti Vince , Cheng Kevin King Fai , Fong Daniel Yee Tak , Chang Dorita Hue Fung , Ho Frederick Ka Wing , Yip Ka Man , Ku Dennis Tak Loi , Cheuk Daniel Ka Leung , Luk Chung Wing , Shing Ming Kong , Leung Lok Kan , Khong Pek Lan , Chan Godfrey Chi-Fung
Published: May 2021

Background

Childhood intracranial germ cell tumor (GCT) survivors are prone to radiotherapy-related neurotoxicity, which can lead to neurocognitive dysfunctions. Diffusion kurtosis imaging (DKI) is a diffusion MRI technique that is sensitive to brain microstructural changes. This study aimed to investigate the association between DKI metrics versus cognitive and functional outcomes of childhood intracranial GCT survivors.

Methods

DKI was performed on childhood intracranial GCT survivors (n = 20) who had received cranial radiotherapy, and age and gender-matched healthy control subjects (n = 14). Neurocognitive assessment was performed using the Hong Kong Wechsler Intelligence Scales, and functional assessment was performed using the Lansky/Karnofsky performance scales (KPS). Survivors and healthy controls were compared using mixed effects model. Multiple regression analyses were performed to determine the effects of microstructural brain changes of the whole brain as well as the association between IQ and Karnofsky scores and the thereof.

Results

The mean Intelligence Quotient (IQ) of GCT survivors was 91.7 (95% CI 84.5 – 98.8), which was below the age-specific normative expected mean IQ (P = 0.013). The mean KPS score of GCT survivors was 85.5, which was significantly lower than that of controls (P < 0.001). Cognitive impairments were significantly associated with the presence of microstructural changes in white and grey matter, whereas functional impairments were mostly associated with microstructural changes in white matter. There were significant correlations between IQ versus the mean diffusivity (MD) and mean kurtosis (MK) of specific white matter regions. The IQ scores were negatively correlated with the MD of extensive grey matter regions.

Conclusion

Our study identified vulnerable brain regions whose microstructural changes in white and grey matter were significantly associated with impaired cognitive and physical functioning in survivors of pediatric intracranial GCT.
NOTCH1 Activation Negatively Impacts on Chronic Lymphocytic Leukemia Outcome and Is Not Correlated to the NOTCH1 and IGHV Mutational Status
Authors: Baldoni Stefano , Del Papa Beatrice , De Falco Filomena , Dorillo Erica , Sorrentino Carlo , Rompietti Chiara , Adamo Francesco Maria , Nogarotto Manuel , Cecchini Debora , Mondani Elena , Silva Barcelos Estevao Carlos , Moretti Lorenzo , Mameli Maria Grazia , Fabi Bianca , Sorcini Daniele , Stella Arianna , Giancola Raffaella , Guardalupi Francesco , Ulbar Francesca , Plebani Sara , Guarente Valerio , Rosati Emanuela , Di Nicola Marta , Marchioni Michele , Di Ianni Mauro , Sportoletti Paolo
Published: May 2021

NOTCH1 mutations and deregulated signal have been commonly found in chronic lymphocytic leukemia (CLL) patients. Whereas the impact of NOTCH1 mutations on clinical course of CLL has been widely studied, the prognostic role of NOTCH1 activation in CLL remains to be defined. Here, we analyzed the activation of NOTCH1/NOTCH2 (ICN1/ICN2) and the expression of JAGGED1 (JAG1) in 163 CLL patients and evaluated their impact on TTFT (Time To First Treatment) and OS (Overall Survival). NOTCH1 activation (ICN1+) was found in 120/163 (73.6%) patients. Among them, 63 (52.5%) were NOTCH1 mutated (ICN1+/mutated) and 57 (47.5%) were NOTCH1 wild type (ICN1+/WT). ICN1+ patients had a significant reduction of TTFT compared to ICN1-negative (ICN1−). In the absence of NOTCH1 mutations, we found that the ICN1+/WT group had a significantly reduced TTFT compared to ICN1− patients. The analysis of IGHV mutational status showed that the distribution of the mutated/unmutated IGHV pattern was similar in ICN1+/WT and ICN1− patients. Additionally, TTFT was significantly reduced in ICN1+/ICN2+ and ICN1+/JAG1+ patients compared to ICN1−/ICN2− and ICN1−/JAG1− groups. Our data revealed for the first time that NOTCH1 activation is a negative prognosticator in CLL and is not correlated to NOTCH1 and IGHV mutational status. Activation of NOTCH2 and JAGGED1 expression might also influence clinical outcomes in this group, indicating the need for further dedicated studies. The evaluation of different NOTCH network components might represent a new approach to refine CLL risk stratification.
Antidiabetic Agent DPP-4i Facilitates Murine Breast Cancer Metastasis by Oncogenic ROS-NRF2-HO-1 Axis via a Positive NRF2-HO-1 Feedback Loop
Authors: Li Rui , Zeng Xin , Yang Meihua , Xu Xiaohui , Feng Jinmei , Bao Liming , Xue Bingqian , Wang Xin , Huang Yi
Published: May 2021

Cancer has been as one of common comorbidities of diabetes. Long-term antidiabetic treatment may potentially exert uncertain impacts on diabetic patients with cancer including breast cancer (BC). Dipeptidyl peptidase-4 inhibitors (DPP-4i) are currently recommended by the AACE as first-line hypoglycemic drugs in type 2 diabetes mellitus (T2DM). Although the safety of DPP-4i has been widely evaluated, the potential side-effects of DPP-4i in cancer metastasis were also reported and remain controversial. Here, we revealed that Saxagliptin (Sax) and Sitagliptin (Sit), two common DPP-4i compounds, potentially promoted murine BC 4T1 metastasis in vitro and in vivo under immune-deficient status. Mechanically, we observed that DPP-4i treatment induced aberrant oxidative stress by triggering ROS overproduction, as well as ROS-dependent NRF2 and HO-1 activations in BC cells, while specific inhibition of ROS, NRF2 or HO-1 activations abrogated DPP-4i-driven BC metastasis and metastasis-associated gene expression in vitro. Furthermore, ALA, a NRF2 activator significantly promoted BC metastasis in vitro and in vivo, which can be abrogated by specific HO-1 inhibition in vitro. Moreover, specific HO-1 inhibition not only reversed DPP-4i-induced NRF2 activation but also abrogated ALA-induced NRF2 activation, resulting in a decrease of metastasis-associated genes, indicating a positive-feedback NRF2-HO-1 loop. Our findings suggest that DPP-4i accelerates murine BC metastasis through an oncogenic ROS-NRF2-HO-1 axis via a positive-feedback NRF2-HO-1 loop. Therefore, this study not only offers novel insights into an oncogenic role of DPP-4i in BC progression but also provides new strategies to alleviate the dark side of DPP-4i by targeting HO-1.
Effect of Early Supplemental Formula Intervention on Body Weight and Hyperbilirubinemia in Neonates During 72 h After Birth
Authors: Zhao Lu-Lu , Lee En-Pei , Kuo Raymond Nein-Chen , Yang Stephen Shei-Dei , Huang Su-Cheng , Wu Han-Ping
Published: May 2021

Background:The full breastfeeding may lead to insufficient milk intake of newborns and increase the rate of body weight loss (BWL). Severe BWL was generally believed as a cause of significant hyperbilirubinemia in newborn babies. The study aimed to investigate the effect if early supplemental feeding in newborns with birth weight loss at the first 3 days after birth could decrease the rate of hyperbilirubinemia 72 h of birth.

Methods:A total of 395 neonates with gestational age >37 weeks and birth body weight >2500g were prospectively collected between 2016 and 2018. We analyzed 280 neonates with BWL rate reaching the predictive value (4.5%, 7.5%, and 8% on the first, second, third day after birth, respectively) for subsequent hyperbilirubinemia after 72 hours after birth. The enrolled cases were divided into four subgroups as interventional consecutive milk supplement for 0, 1, 2, and 3 days after birth for further analysis

Results:For newborns with BWL reaching the predictive value on the first day after birth, the serum bilirubin levels were lower in the experimental group than those in the non-involved control group (p< 0.05). For newborns with three consecutive days of interventional milk supplementation, the serum bilirubin levels at the 72 h after birth showed the lowest levels compared with the other sub-groups with two consecutive days and one consecutive day of interventional milk supplementation (p< 0.05). Moreover, there was a significantly decreasing trend in the consecutive days of interventional milk supplementation (p< 0.05).

Conclusion:Newborns with BWL over 4.5% on the first day after birth receiving early intervention milk supplementation could significantly reduce serum bilirubin levels at the

72 h after birth. The more days of consecutive milk supplementation after birth may lead to the lower the 72 h serum bilirubin levels. It is recommended to early and consecutive milk supplementation after birth to be an effective way in reducing serum bilirubin levels.
Interventions to Reduce Medication Dispensing, Administration, and Monitoring Errors in Pediatric Professional Healthcare Settings: A Systematic Review
Authors: Koeck Joachim A. , Young Nicola J. , Kontny Udo , Orlikowsky Thorsten , Bassler Dirk , Eisert Albrecht
Published: May 2021

Introduction: Pediatric patients cared for in professional healthcare settings are at high risk of medication errors. Interventions to improve patient safety often focus on prescribing; however, the subsequent stages in the medication use process (dispensing, drug administration, and monitoring) are also error-prone. This systematic review aims to identify and analyze interventions to reduce dispensing, drug administration, and monitoring errors in professional pediatric healthcare settings.

Methods: Four databases were searched for experimental studies with separate control and intervention groups, published in English between 2011 and 2019. Interventions were classified for the first time in pediatric medication safety according to the “hierarchy of controls” model, which predicts that interventions at higher levels are more likely to bring about change. Higher-level interventions aim to reduce risks through elimination, substitution, or engineering controls. Examples of these include the introduction of smart pumps instead of standard pumps (a substitution control) and the introduction of mandatory barcode scanning for drug administration (an engineering control). Administrative controls such as guidelines, warning signs, and educational approaches are lower on the hierarchy and therefore predicted by this model to be less likely to be successful.

Results: Twenty studies met the inclusion criteria, including 1 study of dispensing errors, 7 studies of drug administration errors, and 12 studies targeting multiple steps of the medication use process. A total of 44 interventions were identified. Eleven of these were considered higher-level controls (four substitution and seven engineering controls). The majority of interventions (n = 33) were considered “administrative controls” indicating a potential reliance on these measures. Studies that implemented higher-level controls were observed to be more likely to reduce errors, confirming that the hierarchy of controls model may be useful in this setting. Heterogeneous study methods, definitions, and outcome measures meant that a meta-analysis was not appropriate.

Conclusions: When designing interventions to reduce pediatric dispensing, drug administration, and monitoring errors, the hierarchy of controls model should be considered, with a focus placed on the introduction of higher-level controls, which may be more likely to reduce errors than the administrative controls often seen in practice. Trial Registration Prospero Identifier: CRD42016047127.
Pyroptosis in the Initiation and Progression of Atherosclerosis
Authors: Qian Zhengtao , Zhao Yilin , Wan Chuandan , Deng Yimai , Zhuang Yaoyao , Xu Yeqiong , Zhu Yanping , Lu Shourong , Bao Zhengyang
Published: May 2021

Pyroptosis, a newly discovered form of programmed cell death, is characterized by cell swelling, the protrusion of large bubbles from the plasma membrane and cell lysis. This death pathway is mediated by the pore formation of gasdermin D (GSDMD), which is activated by human caspase-1/caspase-4/caspase-5 (or mouse caspase-1/caspase11), and followed with the releasing of both cell contents and proinflammatory cytokines. Pyroptosis was initially found to function as an innate immune effector mechanism to facilitate host defense against pathogenic microorganisms, and subsequent studies revealed that pyroptosis also plays an eventful role in inflammatory immune diseases and tumor resistance. Recent studies have also shown that pyroptosis is involved in the initiation, the progression and complications of atherosclerosis. Here, we provide an overview of the role of pyroptosis in atherosclerosis by focusing on three important participating cells: ECs, macrophages, and SMCs. In addition, we also summarized drugs and stimuli that regulate the progression of atherosclerosis by influencing cell pyroptosis.
Identification of Key Biomarkers and Immune Infiltration in Sciatic Nerve of Diabetic Neuropathy BKS-db/db Mice by Bioinformatics Analysis
Authors: Lin Yixuan , Wang Fanjing , Cheng Lianzhi , Fang Zhaohui , Shen Guoming
Published: May 2021

Diabetic neuropathy (DN) is one of the chronic complications of diabetes which can cause severe harm to patients. In order to determine the key genes and pathways related to the pathogenesis of DN, we downloaded the microarray data set GSE27382 from Gene Expression Omnibus (GEO) and adopted bioinformatics methods for comprehensive analysis, including functional enrichment, construction of PPI networks, central genes screening, TFs-target interaction analysis, and evaluation of immune infiltration characteristics. Finally, we examined quantitative real- time PCR (qPCR) to validate the expression of hub genes. A total of 318 differentially expressed genes (DEGs) were identified, among which 125 upregulated DEGs were enriched in the mitotic nuclear division, extracellular region, immunoglobulin receptor binding, and p53 signaling pathway, while 193 downregulated DEGs were enriched in ion transport, membrane, synapse, sodium channel activity, and retrograde endocannabinoid signaling. GSEA plots showed that condensed nuclear chromosome kinetochore were the most significant enriched gene set positively correlated with the DN group. Importantly, we identified five central genes (Birc5, Bub1, Cdk1, Ccnb2, and Ccnb1), and KEGG pathway analysis showed that the five hub genes were focused on progesterone-mediated oocyte maturation, cell cycle, and p53 signaling pathway. The proportion of immune cells from DN tissue and normal group showed significant individual differences. In DN samples, T cells CD4 memory resting and dendritic cells resting accounted for a higher proportion, and macrophage M2 accounted for a lower proportion. In addition, all five central genes showed consistent correlation with immune cell infiltration levels. qPCR showed the same expression trend of five central genes as in our analysis. Our research identified key genes related to differential genes and immune infiltration related to the pathogenesis of DN and provided new diagnostic and potential therapeutic targets for DN.
Animal and Organoid Models of Liver Fibrosis
Authors: Bao Yu-long , Wang Li , Pan Hai-ting , Zhang Tai-ran , Chen Ya-hong , Xu Shan-jing , Mao Xin-li , Li Shao-wei
Published: May 2021

Liver fibrosis refers to the process underlying the development of chronic liver diseases, wherein liver cells are repeatedly destroyed and regenerated, which leads to an excessive deposition and abnormal distribution of the extracellular matrix such as collagen, glycoprotein and proteoglycan in the liver. Liver fibrosis thus constitutes the pathological repair response of the liver to chronic injury. Hepatic fibrosis is a key step in the progression of chronic liver disease to cirrhosis and an important factor affecting the prognosis of chronic liver disease. Further development of liver fibrosis may lead to structural disorders of the liver, nodular regeneration of hepatocytes and the formation of cirrhosis. Hepatic fibrosis is histologically reversible if treated aggressively during this period, but when fibrosis progresses to the stage of cirrhosis, reversal is very difficult, resulting in a poor prognosis. There are many causes of liver fibrosis, including liver injury caused by drugs, viral hepatitis, alcoholic liver, fatty liver and autoimmune disease. The mechanism underlying hepatic fibrosis differs among etiologies. The establishment of an appropriate animal model of liver fibrosis is not only an important basis for the in-depth study of the pathogenesis of liver fibrosis but also an important means for clinical experts to select drugs for the prevention and treatment of liver fibrosis. The present study focused on the modeling methods and fibrosis characteristics of different animal models of liver fibrosis, such as a chemical-induced liver fibrosis model, autoimmune liver fibrosis model, cholestatic liver fibrosis model, alcoholic liver fibrosis model and non-alcoholic liver fibrosis model. In addition, we also summarize the research and application prospects concerning new organoids in liver fibrosis models proposed in recent years. A suitable animal model of liver fibrosis and organoid fibrosis model that closely resemble the physiological state of the human body will provide bases for the in-depth study of the pathogenesis of liver fibrosis and the development of therapeutic drugs.
The Assessment of Daily Energy Expenditure of Commercial Saturation Divers Using Doubly Labelled Water
Authors: Deb Sanjoy K. , Dolan Eimear , Hambly Catherine , Speakman John R. , Eftedal Olav , Zariwala Mohammed Gulrez , Eftedal Ingrid
Published: May 2021

Commercial saturation divers are exposed to unique environmental conditions and are required to conduct work activity underwater. Consequently, divers’ physiological status is shown to be perturbed and therefore, appropriate strategies and guidance are required to manage the stress and adaptive response. This study aimed to evaluate the daily energy expenditure (DEE) of commercial saturation divers during a 21-day diving operation in the North Sea. Ten saturation divers were recruited during a diving operation with a living depth of 72 metres seawater (msw) and a maximum working dive depth of 81 msw. Doubly labelled water (DLW) was used to calculate DEE during a 10-day measurement period. Energy intake was also recorded during this period by maintaining a dietary log. The mean DEE calculated was 3030.9 ± 513.0 kcal/day, which was significantly greater than the mean energy intake (1875.3 ± 487.4 kcal; p = 0.005). There was also a strong positive correction correlation between DEE and total time spent performing underwater work (r = 0.7, p = 0.026). The results suggested saturation divers were in a negative energy balance during the measurement period with an intraindividual variability in the energy cost present that may be influenced by time spent underwater.
Gut Microbiota and Chemical-Induced Acute Liver Injury
Authors: Chen Tao , Li Rui , Chen Peng
Published: May 2021

Background: Drug overdose or chemical exposures are the main causes of acute liver injury (ALI). Severe liver injury can develop into liver failure that is an important cause of liver-related mortality in intensive care units in most countries. Pharmacological studies have utilized a variety of comprehensive chemical induction models that recapitulate the natural pathogenesis of acute liver injury. Their mechanism is always based on redox imbalance-induced direct hepatotoxicity and massive hepatocyte cell death, which can trigger immune cell activation and recruitment to the liver. However, the pathogenesis of these models has not been fully stated. Many studies showed that gut microbiota plays a crucial role in chemical-induced liver injury. Hepatotoxicity is likely induced by imbalanced microbiota homeostasis, gut mucosal barrier damage, systemic immune activation, microbial-associated molecular patterns, and bacterial metabolites. Meanwhile, many preclinical studies have shown that supplementation with probiotics can improve chemical-induced liver injury. In this review, we highlight the pathogenesis of gut microorganisms in chemical-induced acute liver injury animal models and explore the protective mechanism of exogenous microbial supplements on acute liver injury.
Bioactivity of Humic Acids Extracted From Shale Ore: Molecular Characterization and Structure-Activity Relationship With Tomato Plant Yield Under Nutritional Stress
Authors: Monda Hiarhi , McKenna Amy M. , Fountain Ryan , Lamar Richard T.
Published: May 2021

The increasing demands for biostimulants in the agricultural market over the last years have posed the problem of regulating this product category by requiring the industry to make available the information about efficacy and safety, including the explanation of mode of action and the definition of bioactive constituents. In the present study, we tested the biostimulant proprieties of a sedimentary shale ore-extracted humic acid (HA) on Micro Tom tomato plants under increasing nutritional stress and investigated the correlation with the chemical features of HA by means of ultra-high resolution FT-ICR MS, FT-ATR, and13C-NMR. Humic acid application proved effective in alleviating the nutritional stress by improving nutrient use efficiency, with results comparable to the control treatment supplied with higher NPK nutrition. Increased yield (up to +19%) and fruit quality (in the range +10–24%), higher ascorbic acid content and a better root growth were the main parameters affected by HA application. Molecular-level characterization identified the possible chemical drivers of bioactivity, and included flavonoids, quinones, and alkaloids among the most represented molecules, some of which exhibiting antioxidant, pro-oxidant, and antimicrobial activity. The redox effect was discussed as a determinant of the delicate homeostasis balance, capable of triggering plant defense response and eventually inducing a protective priming effect on the plants.
Post-traumatic Growth and Related Influencing Factors in Discharged COVID-19 Patients: A Cross-Sectional Study
Authors: Yan Shixin , Yang Jun , Ye Man , Chen Shihao , Xie Chaoying , Huang Jin , Liu Haiyang
Published: May 2021

The purpose of this study is to investigate the current state of post-traumatic growth (PTG) and identify its influencing factors in discharged COVID-19 patients. PTG refers to individual experiences of significant positive change arising from the struggle with a major life crisis. This descriptive cross-sectional study used the convenient sampling method to recruit 140 discharged COVID-19 patients in Hunan, China. The results show that the PTG of the discharged COVID-19 patients was positively correlated with self-esteem, post-traumatic stress disorder, coping style tendency, and social support, but negatively correlated with the time from onset to diagnosis. Our findings could provide guidance on improving the psychological state and well-being of discharged COVID-19 patients.
Adults With Special Educational Needs Participating in Interactive Learning Environments in Adult Education: Educational, Social, and Personal Improvements. A Case Study
Authors: Díez-Palomar Javier , Ocampo Castillo María del Socorro , Pascual Ariadna Munté , Oliver Esther
Published: May 2021

Previous scientific contributions show that interactive learning environments have contributed to promoting learners' learning and development, as interaction and dialogue are key components of learning. When it comes to students with special needs, increasing evidence has demonstrated learning improvements through interaction and dialogue. However, most research focuses on children's education, and there is less evidence of how these learning environments can promote inclusion in adult learners with SEN. This article is addressed to analyse a case study of an interactive learning environment shared by adults with and without special needs. This case shows several improvements identified by adult learners with special needs participating in this study. Based on a documental analysis and a qualitative study, this study analyses a context of participatory and dialogic adult education. From the analysis undertaken, the main results highlight some improvements identified in the lives of these adult women and men with SEN, covering educational improvements, increased feeling of social inclusion, and enhanced well-being.
A Career Crafting Training Program: Results of an Intervention Study
Authors: van Leeuwen Evelien H. , Taris Toon W. , van den Heuvel Machteld , Knies Eva , van Rensen Elizabeth L. J. , Lammers Jan-Willem J.
Published: May 2021

This intervention study examined the effects of a career crafting training on physicians' perceptions of their job crafting behaviors, career self-management, and employability. A total of 154 physicians working in two hospitals in a large Dutch city were randomly assigned to a waitlist control group or an intervention group. Physicians in the intervention group received an accredited training on career crafting, including a mix of theory, self-reflection, and exercises. Participants developed four career crafting goals during the training, to work on in the subsequent weeks, after which a coaching conversation took place over the phone. Physicians in the control group received no intervention. A pre- and post-test 8 weeks later measured changes in job crafting and career self-management (primary outcomes) and employability (secondary outcome) of 103 physicians that completed the pre- and post-test. RM ANOVAs showed that the intervention enhanced perceptions of career self-management and job crafting behavior to decrease hindering job demands. No support was found for the effect of the intervention on other types of job crafting and employability. This study offers novel insights into how career crafting can be enhanced through training, as this is the first empirical study to examine a career crafting intervention. HR managers can use the outcomes to develop tailored career policies and career development practices.
Serotonin Reuptake Inhibitors and the Gut Microbiome: Significance of the Gut Microbiome in Relation to Mechanism of Action, Treatment Response, Side Effects, and Tachyphylaxis
Authors: Sjöstedt Peter , Enander Jesper , Isung Josef
Published: May 2021

The monoamine hypothesis of psychopharmacology has been dominating the biological psychiatric research field for decades. Currently psychiatric research has increasingly appreciated psychiatric disorders and suicidal behavior as being highly complex and multi-etiological. In this pathway the gut microbiome and its interrelationship with the brain is gaining traction. The usage of selective serotonin reuptake inhibitors (SSRIs) is increasing in the general population. This is due to their effect on a broad range of psychiatric disorders, and their favorable side effect profile. Still, there are enigmatic aspects about SSRIs, such as the difficulty to predict effect in individual patients, inter-individual differences in side effect, tachyphylaxis (a sudden loss of response to a certain drug), and to date, uncertainties on how they exert their clinical effect. A majority of the serotonin in the human body is produced within the gut, and SSRIs affect enteric neurons. They also exhibit antimicrobial properties that comes with the potential of disrupting microbial hemostasis. We propose that the role of the gut-brain axis and the gut microbiome in relation to psychopharmacology should be more highlighted. With this article, together with similar articles, we would like to provide a hypothetical framework for future studies within this field. We believe that this would have the potential to provide a paradigm shift within the field of psychopharmacology, and result in findings that potentially could contribute to the development of a more personalized and tailored treatment.
Improving the Robustness of Object Detection Through a Multi-Camera–Based Fusion Algorithm Using Fuzzy Logic
Authors: Khan Md Nazmuzzaman , Al Hasan Mohammad , Anwar Sohel
Published: May 2021

A single camera creates a bounding box (BB) for the detected object with certain accuracy through a convolutional neural network (CNN). However, a single RGB camera may not be able to capture the actual object within the BB even if the CNN detector accuracy is high for the object. In this research, we present a solution to this limitation through the usage of multiple cameras, projective transformation, and a fuzzy logic–based fusion. The proposed algorithm generates a “confidence score” for each frame to check the trustworthiness of the BB generated by the CNN detector. As a first step toward this solution, we created a two-camera setup to detect objects. Agricultural weed is used as objects to be detected. A CNN detector generates BB for each camera when weed is present. Then a projective transformation is used to project one camera’s image plane to another camera’s image plane. The intersect over union (IOU) overlap of the BB is computed when objects are detected correctly. Four different scenarios are generated based on how far the object is from the multi-camera setup, and IOU overlap is calculated for each scenario (ground truth). When objects are detected correctly and bounding boxes are at correct distance, the IOU overlap value should be close to the ground truth IOU overlap value. On the other hand, the IOU overlap value should differ if BBs are at incorrect positions. Mamdani fuzzy rules are generated using this reasoning, and three different confidence scores (“high,” “ok,” and “low”) are given to each frame based on accuracy and position of BBs. The proposed algorithm was then tested under different conditions to check its validity. The confidence score of the proposed fuzzy system for three different scenarios supports the hypothesis that the multi-camera–based fusion algorithm improved the overall robustness of the detection system.
Longitudinal Observation of Outcomes and Patient Access to Integrated Care Following Point-of-Care Glycemic Screening in Community Health Center Dental Safety Net Clinics
Authors: Glurich Ingrid , Berg Richard , Panny Aloksagar , Shimpi Neel , Steinmetz Annie , Nycz Greg , Acharya Amit
Published: May 2021

Introduction: Rates of diabetes/prediabetes continue to increase, with disparity populations disproportionately affected. Previous field trials promoted point-of-care (POC) glycemic screening in dental settings as an additional primary care setting to identify potentially at-risk individuals requiring integrated care intervention. The present study observed outcomes of POC hemoglobin A1c (HbA1c) screening at community health center (CHC) dental clinics (DC) and compliance with longitudinal integrated care management among at-risk patients attending dental appointments.

Materials and Methods: POC HbA1c screening utilizing Food and Drug Administration (FDA)-approved instrumentation in DC settings and periodontal evaluation of at-risk dental patients with no prior diagnosis of diabetes/prediabetes and no glycemic testing in the preceding 6 months were undertaken. Screening of patients attending dental appointments from October 24, 2017, through September 24, 2018, was implemented at four Wisconsin CHC-DCs serving populations with a high representation of disparity. Subjects meeting at-risk profiles underwent POC HbA1c screening. Individuals with measures in the diabetic/prediabetic ranges were advised to seek further medical evaluation and were re-contacted after 3 months to document compliance. Longitudinal capture of glycemic measures in electronic health records for up to 2 years was undertaken for a subset (n = 44) of subjects with available clinical, medical, and dental data. Longitudinal glycemic status and frequency of medical and dental access for follow-up care were monitored.

Results: Risk assessment identified 224/915 (24.5%) patients who met inclusion criteria following two levels of risk screening, with 127/224 (57%) qualifying for POC HbA1c screening. Among those tested, 62/127 (49%) exhibited hyperglycemic measures: 55 in the prediabetic range and seven in the diabetic range. Moderate-to-severe periodontitis was more prevalent in patients with prediabetes/diabetes than in individuals with measures in the normal range. Participant follow-up compliance at 3 months was 90%. Longitudinal follow-up documented high rates of consistent access (100 and 89%, respectively), to the integrated medical/DC environment over 24 months for individuals with hyperglycemic screening measures.

Conclusion: POC glycemic screening revealed elevated HbA1c measures in nearly half of at-risk CHC-DC patients. Strong compliance with integrated medical/dental management over a 24-month interval was observed, documenting good patient receptivity to POC screening in the dental setting and compliance with integrated care follow-up by at-risk patients.
Drivers, Opportunities, and Challenges for Integrated Resource Co-management and Sustainable Development in Galapagos
Authors: Garcia Ferrari Soledad , Bain Amelia A. , Crane De Narváez Stephanie
Published: May 2021

The Galapagos archipelago represents an insular system with finite natural resources, a growing population, and an economy heavily weighted on tourism that leaves it vulnerable to shocks, such as the Covid-19 crisis. This work proposes an alternative scenario developed through creating intersections between water-energy-food (WEF) nexus and adaptive co-management (ACM) approaches to resource management. This framework allows the identification of novel synergies that are applied to the analysis of Galapagos as case study. Within this approach, qualitative analysis is applied to data collected via a set of interviews with local stakeholders (including community, business, third sector, and government actors) to evaluate (i) how a deeper understanding of community perceptions and needs can help to identify pathways toward more sustainable development in line with conservation goals, (ii) what governance frameworks should be implemented to promote community-based resource management and resilience, and (iii) what role education and capacitation can play in supporting alternative forms of economic activity. The research suggests that the implementation of an integrated WEF-ACM framework for resource management in Galapagos could promote resilience by opening a space for deliberation and conflict resolution between legitimate stakeholders, thus supporting more effective and balanced participative governance. The current Covid-19 crisis has led to the emergence of alternative forms of community collaboration that demonstrate the potential for a more economically diverse and more sustainable future. By placing different sources of knowledge on a level platform in such a framework, greater community ownership of resource management and conservation goals could be achieved. The incorporation of an ACM approach within the management of WEF resources would also allow Galapagueños to determine their own vision of a future sustainable socio-ecosystem, based on optimising system outcomes by co-identifying the trade-offs and synergies between the interrelated resource sectors, but requires a transformation in institutional culture.
Sport Concussion Assessment Tool-5th Edition (SCAT5): Normative Reference Values for the National Rugby League Women's Premiership
Authors: Iverson Grant L. , Howell David R. , Van Patten Ryan , Bloomfield Paul , Gardner Andrew J.
Published: May 2021

Objective: To establish normative reference values for the Sport Concussion Assessment Tool-5th Edition (SCAT5) for the new National Rugby League Women's Premiership.

Methods: Preseason SCAT5 baseline testing was administered individually to all National Rugby League Women's Premiership players (N = 117). Testing was completed by the medical staff. Normative reference values were calculated for the components of the SCAT5, including the Standardized Assessment of Concussion, modified Balance Error Scoring System, and the Symptom Scale. A small case series of players who sustained concussions were included to illustrate the use of the new normative data.

Results: The median Standardized Assessment of Concussion total score was 27.0 (M = 26.9, SD = 2.1). The median modified Balance Error Scoring System score was 2.0 (M = 2.4, SD = 2.2). The median number of symptoms score was 1.0 (M = 3.2, SD = 4.7) and the median symptom severity score was 2.0 (M = 5.4, SD = 8.2). The most common baseline symptom was fatigue or low energy (33%), followed by trouble sleeping (24%), headache (23%), neck pain (22%), and difficulty remembering (21%). In the total sample, 41% reported no symptoms. The clinical interpretation of these new normative data to a case series of women with concussions is provided.

Conclusions: Normative reference values are provided for the SCAT5 for women who are professional rugby league players. Using these normative data will improve clinical interpretation of SCAT5 scores following a concussion.
Education, Political Party, and Football Viewership Predict Americans' Attention to News About Concussions in Sports
Authors: Lindner Andrew M. , Hawkins Daniel N.
Published: May 2021

News outlets, sports coverage, and even Hollywood movies have highlighted the growing body of research documenting the long-term negative consequences of traumatic injury in athletics, particularly, (sports-related) concussions. Despite so much media coverage, little is known about how much attention members of the American public pay to sports concussion news. Disparities in attention to concussion news among sociodemographic groups may contribute to further inequalities in rates of concussions that stem from participation in collision sports. In this study, using a 2017 nationally representative survey of US residents (n = 964), we examine the social, political, and demographic correlates of individuals' attention to news about concussions in sports. Regression results indicate that older, more educated, Democratic-leaning respondents reported that they pay more attention to news about concussions. Additionally, respondents with a greater past competitive athletic participation and those who regularly watch baseball and football reported higher levels of attention to concussion news. These findings are consistent with previous research showing higher levels of news consumption and trust in science among the highly educated and Democrats. The increased levels among football viewers may be in response to the inclusion of concussion news in game coverage.
Circulating Endocannabinoids as Diagnostic Markers of Canine Chronic Enteropathies: A Pilot Study
Authors: Febo Elettra , Crisi Paolo Emidio , Oddi Sergio , Pietra Marco , Galiazzo Giorgia , Piscitelli Fabiana , Gramenzi Alessandro , Prinzio Roberta Di , Di Tommaso Morena , Bernabò Nicola , Bisogno Tiziana , Maccarrone Mauro , Boari Andrea
Published: May 2021

Chronic enteropathies (CEs) in dogs, according to the treatment response to consecutive trials, are classified as food-responsive (FRE), antibiotic-responsive (ARE), and immunosuppressive-responsive (IRE) enteropathy. In addition to this classification, dogs with loss of protein across the gut are grouped as protein-losing enteropathy (PLE). At present, the diagnosis of CEs is time-consuming, costly and sometimes invasive, also because non-invasive biomarkers with high sensitivity and specificity are not yet available. Therefore, this study aimed at assessing the levels of circulating endocannabinoids in plasma as potential diagnostic markers of canine CEs. Thirty-three dogs with primary chronic gastrointestinal signs presented to Veterinary Teaching Hospitals of Teramo and Bologna (Italy) were prospectively enrolled in the study, and 30 healthy dogs were included as a control group. Plasma levels of N-arachidonoylethanolamine (AEA), 2-arachidonoylglycerol (2-AG), N-palmitoylethanolamine (PEA), and N-oleoylethanolamine (OEA) were measured at the time of the first visit in dogs with different CEs, as well as in healthy subjects. Plasma levels of 2-AG (p = 0.001) and PEA (p = 0.008) were increased in canine CEs compared to healthy dogs. In particular, PEA levels were increased in the FRE group compared to healthy dogs (p = 0.04), while 2-AG was higher in IRE than in healthy dogs (p = 0.0001). Dogs affected by FRE also showed decreased 2-AG (p = 0.0001) and increased OEA levels (p = 0.0018) compared to IRE dogs. Moreover, dogs with PLE showed increased 2-AG (p = 0.033) and decreased AEA (p = 0.035), OEA (p = 0.016) and PEA (p = 0.023) levels, when compared to dogs affected by CEs without loss of proteins. The areas under ROC curves for circulating 2-AG (0.91; 95% confidence interval [CI], 0.79–1.03) and OEA (0.81; 95% CI, 0.65–0.97) showed a good accuracy in distinguishing the different forms of CEs under study (FRE, ARE and IRE), at the time of the first visit. The present study demonstrated that endocannabinoid signaling is altered in canine CEs, and that CE subtypes showed distinct profiles of 2-AG, PEA and OEA plasma levels, suggesting that these circulating bioactive lipids might have the potential to become candidate biomarkers for canine CEs.
Metabolism and Tissue Distribution of Chelerythrine and Effects of Macleaya Cordata Extracts on Liver NAD(P)H Quinone Oxidoreductase
Authors: Huang Chong-Yin , Huang Ya-Jun , Zhang Zhuo-Yi , Liu Yi-Song , Liu Zhao-Ying
Published: May 2021

Background:Macleaya cordata (Willd.) (Papaveraceae) is listed as a feed additive in animal production by the European Food Authority.

Methods: The metabolites of chelerythrine in rats were measured in vitro and in vivo by rapid and accurate high-performance liquid chromatography/quadrupole-time-of-flight mass spectrometry (HPLC/QqTOF-MS). The structures of CHE metabolites were elucidated by comparing their changes in accurate molecular masses and fragment ions with those of parent ion or metabolite. The metabolic enzymes that were involved in chelerythrine reduction were investigated using an inhibition method. The tissue distribution of chelerythrine and the effects on NQO1 following intragastric administration with M. cordata extracts in rats were examined.

Results: A total of twelve metabolites of chelerythrine were characterized by this approach in rat liver S9 and in vivo. The reduction of the iminium bond of chelerythrine and subsequent O-demethylation was the main metabolic pathway of chelerythrine in rat liver S9 while the reduction of the iminium bond of chelerythrine was the main metabolic pathway of chelerythrine in rats in vivo. After the rats were given intragastric administration, the low concentration residues of sanguinarine and chelerythrine in different rat tissues were found at 48 h after the last dose, suggesting that both compounds could be widely distributed in tissues. The results also indicated that XO, NQO1, NQO2, and carbonyl reductase are involved in chelerythrine reduction. Macleaya cordata extracts treated female and male rats, respectively, showed different responses, inhibiting NQO1 activity in males, but inducing NQO1 activity in females. Chelerythrine had a weak impact on NQO1 activity, but sanguinarine inhibited NQO1 activity

Conclusion: Through studying the effects of cytosolic reductase inhibitors on chelerythrine reduction and the impact of chelerythrine and sanguinarine on the activity of NQO1 in vitro and in vivo, we clarified the potential drug interaction of Macleaya cordata extract in clinical application, so as to provide theoretical guidance for clinically safe medication. In addition, it provided a reference basis for the metabolic mechanism of chelerythrinein rats.