bluuebunny/crossref_metadata_2025 huggingface dataset:
Inequality in healthcare-seeking behavior among women with pelvic organ prolapse: a systematic review and narrative synthesis
Authors: Siyoum Melese , Teklesilasie Wondwosen , Alelgn Yitateku , Astatkie Ayalew
Published: May 2023

Introduction

Pelvic organ prolapse (POP) affects women’s quality of life in various aspects. However, evidence on the healthcare-seeking behavior of women with POP is limited. Therefore, this review aimed to identify and synthesize the existing evidence on the healthcare-seeking behavior among women with POP.

Methods

This systematic review and narrative synthesis of the literature on healthcare-seeking behavior among women with POP was conducted from 20 June to 07 July 2022. The electronic databases PubMed, African Journals Online, Cumulative Index to Nursing and Allied Health Literature, African Index Medicus and Directory of Open Access Journal, and Google Scholar were searched for relevant literature published from 1996 to April 2022. The retrieved evidence was synthesized using a narrative synthesis approach. The characteristics of included studies and the level of healthcare-seeking behavior were summarized in a table and texts. Error bar was used to show the variability across different studies.

Results

A total of 966 articles were retrieved of which only eight studies with 23,501 women (2,683 women with pelvic organ prolapse) were included in the synthesis. The level of healthcare-seeking behavior ranges from 21.3% in Pakistan to 73.4% in California, USA. The studies were conducted in four different populations, used both secondary and primary data, and were conducted in six different countries. The error bar shows variation in healthcare-seeking behavior.

Conclusions

The level of health-care seeking behavior among women with POP is low in low-income countries. There is substantial variability in the characteristics of the reviewed studies. We recommend a large-scale and robust study which will help to better understand the healthcare-seeking behavior among women with POP.
The impact of the COVID-19 pandemic on the provision of HIV/AIDS-related services in Iran: a qualitative study
Authors: Jaafari Zahra , Mirzaei Hossein , Moradi Yousef , Nasiri Naser , Mehmandoost Soheil , Khezri Mehrdad , Tavakoli Fatemeh , Abbaszadeh Samaneh , Sharifi Hamid
Published: May 2023

Background

Providing services to people living with HIV (PLWH) faced many challenges during the COVID-19 pandemic. This study aimed to examine the impact of the COVID-19 pandemic on providing HIV/AIDS-related services in Iran.

Methods

In this qualitative study, the participants were included by purposive sampling between November 2021 and February 2022. Virtually focused group discussion (FGD) meetings were conducted with the first group including policymakers, service providers, and researchers (n = 17), and the interviews were conducted telephonic and face-to-face using a semi-structured guide with the second group including people who received services (n = 38). Data were analyzed by content analysis using the inductive method in MAXQDA 10 software.

Results

Six categories were obtained, including mostly affected services, ways of the effect of COVID-19, healthcare systems reaction, effects on social inequality, opportunities created by the pandemic, and suggestions for the future. In addition, people who received services believed the COVID-19 pandemic has affected their life in several ways, including getting COVID-19, mental and emotional problems during the pandemic, financial problems, changes in the care plan, and changes in high-risk behaviors.

Conclusion

Considering the level of community involvement with the issue of COVID-19 and the shock caused by the pandemic, as mentioned by the world health organization, it is necessary to improve health systems’ resilience for better preparedness for similar conditions.
Health outcomes, health services utilization, and costs consequences of medicare uninsurance among migrants in Canada: a systematic review
Authors: Garasia Sophiya , Bishop Valerie , Clayton Stephanie , Pinnington Genevieve , Arinze Chika , Jalil Ezza
Published: May 2023

Background

Medically uninsured groups, many of them migrants, reportedly delay using healthcare services due to costs and often face preventable health consequences. This systematic review sought to assess quantitative evidence on health outcomes, health services use, and health care costs among uninsured migrant populations in Canada.

Methods

OVID MEDLINE, Embase, Global Health, EconLit, and grey literature were searched to identify relevant literature published up until March 2021. The Cochrane Risk of Bias in Non-randomized Studies – of Interventions (ROBINS-I) tool was used to assess the quality of studies.

Results

Ten studies were included. Data showed that there are differences among insured and uninsured groups in reported health outcomes and health services use. No quantitative studies on economic costs were captured.

Conclusions

Our findings indicate a need to review policies regarding accessible and affordable health care for migrants. Increasing funding to community health centers may improve service utilization and health outcomes among this population.
The management of healthcare employees’ job satisfaction: optimization analyses from a series of large-scale surveys
Authors: Cantarelli Paola , Vainieri Milena , Seghieri Chiara
Published: May 2023

Background

Measuring employees’ satisfaction with their jobs and working environment have become increasingly common worldwide. Healthcare organizations are not extraneous to the irreversible trend of measuring employee perceptions to boost performance and improve service provision. Considering the multiplicity of aspects associated with job satisfaction, it is important to provide managers with a method for assessing which elements may carry key relevance. Our study identifies the mix of factors that are associated with an improvement of public healthcare professionals’ job satisfaction related to unit, organization, and regional government. Investigating employees’ satisfaction and perception about organizational climate with different governance level seems essential in light of extant evidence showing the interconnection as well as the uniqueness of each governance layer in enhancing or threatening motivation and satisfaction.

Methods

This study investigates the correlates of job satisfaction among 73,441 employees in healthcare regional governments in Italy. Across four cross sectional surveys in different healthcare systems, we use an optimization model to identify the most efficient combination of factors that is associated with an increase in employees’ satisfaction at three levels, namely one’s unit, organization, and regional healthcare system.

Results

Findings show that environmental characteristics, organizational management practices, and team coordination mechanisms correlates with professionals’ satisfaction. Optimization analyses reveal that improving the planning of activities and tasks in the unit, a sense of being part of a team, and supervisor’s managerial competences correlate with a higher satisfaction to work for one’s unit. Improving how managers do their job tend to be associated with more satisfaction to work for the organization.

Conclusions

The study unveils commonalities and differences of personnel administration and management across public healthcare systems and provides insights on the role that several layers of governance have in depicting human resource management strategies.
Efficacy analysis and research progress of complementary and alternative medicines in the adjuvant treatment of COVID-19
Authors: Lin Jaung-Geng , Huang Guan-Jhong , Su Yi-Chang
Published: May 2023

The coronavirus disease 2019 (COVID-19) pandemic has impacted human lifestyles around the world, causing huge distress in terms of public health systems, emergency response capacity and economic development. The causative agent of COVID-19, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is associated with respiratory involvement, cardiovascular-related diseases, and ultimately causes multiple organ failure and death in severely affected individuals. Thus, effective prevention or early treatment of COVID-19 is critical. An effective vaccine offers a way out of the pandemic for governments, the scientific community and people worldwide, but we still lack effective drug therapies, including treatments for the prevention and treatment of COVID-19. This had led to a high global demand for many complementary and alternative medicines (CAMs). Moreover, many healthcare providers are now requesting information about CAMs that prevent, relieve, or treat the symptoms of COVID-19 and even alleviate vaccine-related side effects. Experts and scholars must therefore become familiar with the use of CAMs in COVID-19, current research directions and effectiveness of CAMs for COVID-19. This narrative review updates the current status and research worldwide on the use of CAMs for COVID-19. The review provides reliable evidence on theoretical viewpoints and therapeutic efficacies of CAM combinations, and evidence in support of the therapeutic strategy of Taiwan Chingguan Erhau (NRICM102) against moderate-to-severe novel coronavirus infectious disease in Taiwan.
Systematic identification of endogenous strong constitutive promoters from the diazotrophic rhizosphere bacterium Pseudomonas stutzeri DSM4166 to improve its nitrogenase activity
Authors: Yu Guangle , Li Xiaochen , Duan Qiuyue , Fu Jun , Zhang Youming , Wang Hailong , Luan Ji
Published: May 2023

Background

Biological nitrogen fixation converting atmospheric dinitrogen to ammonia is an important way to provide nitrogen for plants. Pseudomonas stutzeri DSM4166 is a diazotrophic Gram-negative bacterium isolated from the rhizosphere of cereal Sorghum nutans. Endogenous constitutive promoters are important for engineering of the nitrogen fixation pathway, however, they have not been systematically characterized in DSM4166.

Results

Twenty-six candidate promoters were identified from DSM4166 by RNA-seq analysis. These 26 promoters were cloned and characterized using the firefly luciferase gene. The strengths of nineteen promoters varied from 100 to 959% of the strength of the gentamicin resistance gene promoter. The strongest P12445 promoter was used to overexpress the biological nitrogen fixation pathway-specific positive regulator gene nifA. The transcription level of nitrogen fixation genes in DSM4166 were significantly increased and the nitrogenase activity was enhanced by 4.1 folds determined by the acetylene reduction method. The nifA overexpressed strain produced 359.1 µM of extracellular ammonium which was 25.6 times higher than that produced by the wild-type strain.

Conclusions

The endogenous strong constitutive promoters identified in this study will facilitate development of DSM4166 as a microbial cell factory for nitrogen fixation and production of other useful compounds.
Production of bioactive β-carotene by the endophytic bacterium Citricoccus parietis AUCs with multiple in vitro biological potentials
Authors: Hagaggi Noura Sh. A. , Abdul-Raouf Usama M.
Published: May 2023

Background

Although microalgae and plants are traditionally used for obtaining natural pigments, overexploitation and overharvesting threaten them. Bacteria represent a superior alternative for the production of pigments due to their ability to produce greater amounts in a short time without seasonal restrictions; furthermore, bacterial pigments have a wide range of uses and are safe and biodegradable. This study is the first on the production of ß-carotene as a promising bioactive agent from endophytic bacteria.

Results

The yellow pigment produced by the endophytic bacterium Citricoccus parietis AUCs (NCBI accession number: OQ448507.1) was extracted by methanol and then purified and identified. One band was obtained by TLC analysis, which was identified as ß-carotene based on its spectroscopic and chromatographic characteristics. The pigment exhibited remarkable antibacterial, antioxidant and antidiabetic activities.

Conclusions

This research may serve as a valuable starting point for exploiting C. parietis AUCs as a potent source of ß-carotene for biomedical therapies. To validate the findings of this research, in vivo studies must be performed.
COVID-19 vaccination and HIV transmission among persons who inject drugs during the first two years of the COVID-19 pandemic in New York City
Authors: Des Jarlais Don C. , Weng Chenziheng Allen , Feelemyer Jonathan , McKnight Courtney
Published: May 2023

Background

To examine COVID-19 vaccination and HIV transmission among persons who inject drugs (PWID) during the COVID-19 pandemic (2020–2022) in New York City (NYC).

Methods

Two hundred and seventy five PWID were recruited from October 2021 to September 2022. A structured questionnaire was used to measure demographics, drug use behaviors, overdose experiences, substance use treatment history, COVID-19 infection, vaccination, and attitudes. Serum samples were collected for HIV, HCV, and SARS-CoV-2 (COVID-19) antibody testing.

Results

Participants were: 71% male, the mean age was 49 (SD 11), 81% reported at least one COVID-19 immunization, 76% were fully vaccinated and 64% of the unvaccinated had antibodies for COVID-19. Self-reported injection risk behaviors were very low. HIV seroprevalence was 7%. Eighty-nine percent of the HIV seropositive respondents reported knowing they were HIV seropositive and being on antiretroviral therapy prior to the COVID-19 pandemic. There were two likely seroconversions in 518.83 person-years at risk from the March 2020 start of the pandemic to the times of interviews, for an estimated incidence rate of 0.39/100 person-years, 95% Poisson CI 0.05–1.39/100 person-years.

Conclusions

There is concern that the COVID-19 pandemic disruptions to HIV prevention services and the psychological stress of the pandemic may lead to increased risk behavior and increased HIV transmission. These data indicate adaptive/resilient behaviors in both obtaining COVID-19 vaccination and maintaining a low rate of HIV transmission among this sample of PWID during the first two years of the COVID-19 pandemic in NYC.
Sequential treatment with a TNFR2 agonist and a TNFR1 antagonist improves outcomes in a humanized mouse model for MS
Authors: Pegoretti Valentina , Bauer Jan , Fischer Roman , Paro Iskra , Douwenga Wanda , Kontermann Roland E. , Pfizenmaier Klaus , Houben Evelien , Broux Bieke , Hellings Niels , Baron Wia , Laman Jon D. , Eisel Ulrich L. M.
Published: May 2023

TNF signaling is an essential regulator of cellular homeostasis. Through its two receptors TNFR1 and TNFR2, soluble versus membrane-bound TNF enable cell death or survival in a variety of cell types. TNF-TNFRs signaling orchestrates important biological functions such as inflammation, neuronal activity as well as tissue de- and regeneration. TNF-TNFRs signaling is a therapeutic target for neurodegenerative diseases such as multiple sclerosis (MS) and Alzheimer’s disease (AD), but animal and clinical studies yielded conflicting findings. Here, we ask whether a sequential modulation of TNFR1 and TNFR2 signaling is beneficial in experimental autoimmune encephalomyelitis (EAE), an experimental mouse model that recapitulates inflammatory and demyelinating aspects of MS. To this end, human TNFR1 antagonist and TNFR2 agonist were administered peripherally at different stages of disease development in TNFR-humanized mice. We found that stimulating TNFR2 before onset of symptoms leads to improved response to anti-TNFR1 therapeutic treatment. This sequential treatment was more effective in decreasing paralysis symptoms and demyelination, when compared to single treatments. Interestingly, the frequency of the different immune cell subsets is unaffected by TNFR modulation. Nevertheless, treatment with only a TNFR1 antagonist increases T-cell infiltration in the central nervous system (CNS) and B-cell cuffing at the perivascular sites, whereas a TNFR2 agonist promotes Treg CNS accumulation. Our findings highlight the complicated nature of TNF signaling which requires a timely balance of selective activation and inhibition of TNFRs in order to exert therapeutic effects in the context of CNS autoimmunity.
Epidural stimulation restores muscle synergies by modulating neural drives in participants with sensorimotor complete spinal cord injuries
Authors: Singh Rajat Emanuel , Ahmadi Aliya , Parr Ann M. , Samadani Uzma , Krassioukov Andrei V. , Netoff Theoden I. , Darrow David P.
Published: May 2023

Multiple studies have corroborated the restoration of volitional motor control after motor-complete spinal cord injury (SCI) through the use of epidural spinal cord stimulation (eSCS), but rigorous quantitative descriptions of muscle coordination have been lacking. Six participants with chronic, motor and sensory complete SCI underwent a brain motor control assessment (BMCA) consisting of a set of structured motor tasks with and without eSCS. We investigated how muscle activity complexity and muscle synergies changed with and without stimulation. We performed this analysis to better characterize the impact of stimulation on neuromuscular control. We also recorded data from nine healthy participants as controls. Competition exists between the task origin and neural origin hypotheses underlying muscle synergies. The ability to restore motor control with eSCS in participants with motor and sensory complete SCI allows us to test whether changes in muscle synergies reflect a neural basis in the same task. Muscle activity complexity was computed with Higuchi Fractal Dimensional (HFD) analysis, and muscle synergies were estimated using non-negative matrix factorization (NNMF) in six participants with American Spinal Injury Association (ASIA) Impairment Score (AIS) A. We found that the complexity of muscle activity was immediately reduced by eSCS in the SCI participants. We also found that over the follow-up sessions, the muscle synergy structure of the SCI participants became more defined, and the number of synergies decreased over time, indicating improved coordination between muscle groups. Lastly, we found that the muscle synergies were restored with eSCS, supporting the neural hypothesis of muscle synergies. We conclude that eSCS restores muscle movements and muscle synergies that are distinct from those of healthy, able-bodied controls.
Safety and efficacy of CT-guided radioactive iodine-125 seed implantation as a salvage treatment for recurrent head and neck cancer after two or more courses of radiotherapy
Authors: Li Yue , Jiang Yuliang , Wang Junjie
Published: May 2023

Background

In the past, patients with recurrent head and neck cancer (rHNC) who had previously received a high dose of radiation and were unable to undergo surgery were mainly treated with palliative chemotherapy due to the high incidence of side effects from re-irradiation. With the development of radiotherapy technology, re-irradiation of recurrent lesions by radioactive iodine-125 seed implantation (RISI) has been proposed as a feasible therapeutic approach. This study aimed to investigate the safety and efficacy of computed tomography (CT)-guided RISI in the treatment of rHNC after two or more courses of radiotherapy, and to analyze the prognostic factors.

Methods

Data of 33 patients with rHNC who received CT-guided RISI after two or more courses of radiotherapy were collected and statistically analyzed. The median cumulative dose of the previous radiotherapy was 110 Gy. Short-term efficacy was assessed by Response Evaluation Criteria in Solid Tumors (version 1.1) criteria, while adverse events were evaluated by Common Terminology Criteria for Adverse Events (version 5.0) criteria.

Results

The median gross tumor volume (GTV) was 29.5 cc, and the postoperative median dose to 90% of target volume (D90) was 136.8 Gy. For adverse reactions, enhanced pain was found in 3 (9.1%) patients, followed by grade 1 to 2 acute skin reactions in 3 (9.1%) patients, grade 2 to 3 late skin reactions in 2 (6.1%) patients, grade 1 to 2 early mucosal reactions in 4 (12.1%) patients, and mandibular osteonecrosis in 1 (3.0%) patient. Regarding the treatment efficacy, the 1- and 2-year local control (LC) rates were 47.8% and 36.4% (median LC time, 10 months), and the 1- and 2-year overall survival (OS) rates were 41.3% and 32.2% (median OS time, 8 months). The absence of adverse events was associated with better LC.

Conclusions

CT-guided RISI, as a salvage therapy, demonstrated acceptable safety and efficacy in the treatment of rHNC after two or more courses of radiotherapy.

Trial registration

This study was registered at Chinese Clinical Trial Register database (Registration No. ChiCTR2200063261) in September 2, 2022.
Objective measurement of oral function in adults with spinal muscular atrophy
Authors: Kruse T. , Shamai S. , Leflerovà D. , Wirth B. , Heller R. , Schloss N. , Lehmann H. C. , Brakemeier S. , Hagenacker T. , Braumann B. , Wunderlich G.
Published: May 2023

Background

Impairment of bulbar function in adult individuals with spinal muscular atrophy (SMA) usually is not assessed by established motor scores. Measurements of oral function including quantitative muscle and endurance tests are able to detect subtle changes. The aim of this study was to systematically evaluate the measurement of maximum bite force and endurance, maximum tongue pressure and endurance, as well as maximum mouth opening in adult individuals with SMA types 2 and 3.

Methods

Data from oral function tests in 43 individuals were analyzed. Differences in oral function between individuals with different SMA types and numbers of SMN2 copies were tested. Spearman´s rho correlations among oral function measures themselves as well as with established clinical outcome scales were analyzed.

Results

The absolute maximum measures of oral function (maximum bite force, maximum tongue pressure, maximum mouth opening) were able to discriminate between individuals with different SMA types, individuals with a different number of SMN2 copies and with different walking abilities. The pairwise correlations of the absolute maximum measures of oral function were fair to moderate in size; the same was true for their correlations with the established motor scores. All correlations assessing endurance measures of oral function were weaker and statistically insignificant.

Conclusions

Among the oral function tests maximum tongue pressure and maximum mouth opening are particulary promising as clinical and sensitive outcome measures for clinical trials. Oral function tests may supplement existing motor scores, in particular concerning specific questions about bulbar function or in severely affected non-ambulatory individuals where mild (treatment-related) changes would otherwise remain undetected.

Trial registration DRKS, DRKS00015842. Registered 30 July 2019, https://drks.de/search/de/trial/DRKS00015842
Indonesia free from pasung: a policy analysis
Authors: Hidayat Muhamad Taufik , Oster Candice , Muir-Cochrane Eimear , Lawn Sharon
Published: May 2023

Background

Many people with mental illnesses remain isolated, chained, and inside cages, called Pasung in Indonesia. Despite numerous policies introduced to eradicate Pasung, Indonesia has made slow progress in decreasing this practice. This policy analysis examined existing policies, plans and initiatives in Indonesia targeted at eradicating Pasung. Policy gaps and contextual constraints are identified in order to propose stronger policy solutions.

Methods

Eighteen policy documents were examined, including government news releases and organisational archives. A content analysis was undertaken of national-level policies that address Pasung within the context of the health system, social system and human rights since the establishment of Indonesia. This was followed by a case study analysis of policy and program responses particularly in West Java Province.

Findings

While policy to address Pasung exists at a national level, implementation at national and local levels is complicated. Pasung policy has generated a sense of awareness but the different directions and ambiguous messaging across all stakeholders, including policy actors, has created a lack of clarity about institutions’ roles and responsibilities in the implementation process, as well as accountability for outcomes. This situation is exacerbated by an incomplete decentralisation of healthcare policymaking and service delivery, particularly at the primary level. It is possible that policymakers have overlooked international obligations and lessons learned from successful policymaking in comparable regional countries, resulting in disparities in target-setting, implementation mechanisms, and evaluation.

Conclusion

While the public has become more informed of the need to eradicate Pasung, ongoing communication with the various clusters of policy actors on the aforementioned issues will be critical. Addressing the various segments of the policy actors and their challenges in response to policy will be critical as part of building the evidence base to establish a feasible and effective policy to combat Pasung in Indonesia.
Myeloid-like tumor hybrid cells in bone marrow promote progression of prostate cancer bone metastasis
Authors: Ye Xinyu , Huang Xin , Fu Xing , Zhang Xiao , Lin Risheng , Zhang Wen , Zhang Jian , Lu Yi
Published: May 2023

Background

Bone metastasis is the leading cause of death in patients with prostate cancer (PCa) and currently has no effective treatment. Disseminated tumor cells in bone marrow often obtain new characteristics to cause therapy resistance and tumor recurrence. Thus, understanding the status of disseminated prostate cancer cells in bone marrow is crucial for developing a new treatment.

Methods

We analyzed the transcriptome of disseminated tumor cells from a single cell RNA-sequencing data of PCa bone metastases. We built a bone metastasis model through caudal artery injection of tumor cells, and sorted the tumor hybrid cells by flow cytometry. We performed multi-omics analysis, including transcriptomic, proteomic and phosphoproteomic analysis, to compare the difference between the tumor hybrid cells and parental cells. In vivo experiments were performed to analyze the tumor growth rate, metastatic and tumorigenic potential, drug and radiation sensitivity in hybrid cells. Single cell RNA-sequencing and CyTOF were performed to analyze the impact of hybrid cells on tumor microenvironment.

Results

Here, we identified a unique cluster of cancer cells in PCa bone metastases, which expressed myeloid cell markers and showed a significant change in pathways related to immune regulation and tumor progression. We found that cell fusion between disseminated tumor cells and bone marrow cells can be source of these myeloid-like tumor cells. Multi-omics showed the pathways related to cell adhesion and proliferation, such as focal adhesion, tight junction, DNA replication, and cell cycle, were most significantly changed in these hybrid cells. In vivo experiment showed hybrid cells had a significantly increased proliferative rate, and metastatic potential. Single cell RNA-sequencing and CyTOF showed tumor-associated neutrophils/monocytes/macrophages were highly enriched in hybrid cells-induced tumor microenvironment with a higher immunosuppressive capacity. Otherwise, the hybrid cells showed an enhanced EMT phenotype with higher tumorigenicity, and were resistant to docetaxel and ferroptosis, but sensitive to radiotherapy.

Conclusion

Taken together, our data demonstrate that spontaneous cell fusion in bone marrow can generate myeloid-like tumor hybrid cells that promote the progression of bone metastasis, and these unique population of disseminated tumor cells can provide a potential therapeutic target for PCa bone metastasis.
Loss of Ufl1/Ufbp1 in hepatocytes promotes liver pathological damage and carcinogenesis through activating mTOR signaling
Authors: Chen Fanghui , Sheng Le , Zhou Tianci , Yan Li , Loveless Reid , Li Honglin , Teng Yong , Cai Yafei
Published: May 2023

Background

Ufm1-specific ligase 1 (Ufl1) and Ufm1-binding protein 1 (Ufbp1), as putative targets of ubiquitin-fold modifier 1 (Ufm1), have been implicated in several pathogenesis-related signaling pathways. However, little is known about their functional roles in liver disease.

Methods

Hepatocyte-specific Ufl1Δ/Δhep and Ufbp1Δ/Δhep mice were used to study their role in liver injury. Fatty liver disease and liver cancer were induced by high-fat diet (HFD) and diethylnitrosamine (DEN) administration, respectively. iTRAQ analysis was employed to screen for downstream targets affected by Ufbp1 deletion. Co-immunoprecipitation was used to determine the interactions between the Ufl1/Ufbp1 complex and the mTOR/GβL complex.

Results

Ufl1Δ/Δhep or Ufbp1Δ/Δhep mice exhibited hepatocyte apoptosis and mild steatosis at 2 months of age and hepatocellular ballooning, extensive fibrosis, and steatohepatitis at 6–8 months of age. More than 50% of Ufl1Δ/Δhep and Ufbp1Δ/Δhep mice developed spontaneous hepatocellular carcinoma (HCC) by 14 months of age. Moreover, Ufl1Δ/Δhep and Ufbp1Δ/Δhep mice were more susceptible to HFD-induced fatty liver and DEN-induced HCC. Mechanistically, the Ufl1/Ufbp1 complex directly interacts with the mTOR/GβL complex and attenuates mTORC1 activity. Ablation of Ufl1 or Ufbp1 in hepatocytes dissociates them from the mTOR/GβL complex and activates oncogenic mTOR signaling to drive HCC development.

Conclusions

These findings reveal the potential role of Ufl1 and Ufbp1 as gatekeepers to prevent liver fibrosis and subsequent steatohepatitis and HCC development by inhibiting the mTOR pathway.
Efficacy and safety of human umbilical cord-derived mesenchymal stem cells (hUC-MSC PLEB001) for the treatment of grade II–IV steroid-refractory acute graft-versus-host disease: a study protocol for a multicenter, randomized, double-blind, placebo-controlled, phase II trial
Authors: Yang Donglin , Hou Xiaoqiang , Qian Kun , Li Yuhang , Hu Liangding , Li Liang , Han Mingzhe , Yao Chen , Liu Daihong
Published: May 2023

Background

Systemic corticosteroid therapy failure is quite common in patients with newly diagnosed acute graft-versus-host disease (aGVHD). Growing evidence has suggested that mesenchymal stem cell (MSC) therapy could be a promising treatment option for aGVHD due to its distinctive immunomodulating functions. However, there is a lack of randomized well-controlled clinical trials.

Methods

This is a clinical trial protocol for a multicenter, randomized, double-blind, placebo-controlled phase II study. The aim of the trial is to evaluate the efficacy and safety of the administration of the human umbilical cord-derived MSC product hUC-MSC PLEB001 in patients with grade II–IV, steroid-refractory aGVHD. A total of 96 patients will be randomized 1:1 to receive MSC or placebo treatment twice per week for 4 weeks, in addition to second-line therapy according to institutional standards. Patients who achieve partial response (PR) at day 28 will be eligible to receive further infusions twice per week for an additional 4 weeks.

Discussion

This study will evaluate the efficacy and safety of MSC therapy in patients who have failed first-line steroid treatment for grade II–IV aGVHD.

Trial registration

Chinese Clinical Trial Registry (ChiCTR), ChiCTR2000035740. Registered on 16 August 2020.
Impacts of plasma microbial lipopolysaccharide translocation on B cell perturbations and anti-CD4 autoantibody production in people with HIV on suppressive antiretroviral therapy
Authors: Fu Xiaoyu , Cheng Da , Luo Zhenwu , Heath Sonya L. , Adekunle Ruth , McKinnon John E , Martin Lisa , Sheng Zizhang , Espinosa Enrique , Jiang Wei
Published: May 2023

Background

. Up to 20% of people with HIV (PWH) who undergo virologically suppressed antiretroviral therapy (ART) fail to experience complete immune restoration. We recently reported that plasma anti-CD4 IgG (antiCD4IgG) autoantibodies from immune non-responders specifically deplete CD4 + T cells via antibody-dependent cytotoxicity. However, the mechanism of antiCD4IgG production remains unclear.

Methods

. Blood samples were collected from 16 healthy individuals and 25 PWH on suppressive ART. IgG subclass, plasma lipopolysaccharide (LPS), and antiCD4IgG levels were measured by ELISA. Gene profiles in B cells were analyzed by microarray and quantitative PCR. Furthermore, a patient-derived antiCD4IgG–producing B cell line was generated and stimulated with LPS in vitro. B cell IgG class switch recombination (CSR) was evaluated in response to LPS in splenic B cells from C57/B6 mice in vitro.

Results

. Increased plasma anti-CD4 IgGs in PWH were predominantly IgG1 and associated with increased plasma LPS levels as well as B cell expression of TLR2, TLR4, and MyD88 mRNA in vivo. Furthermore, LPS stimulation induced antiCD4IgG production in the antiCD4IgG B cell line in vitro. Finally, LPS promoted CSR in vitro.

Conclusion

. Our findings suggest that persistent LPS translocation may promote anti-CD4 autoreactive B cell activation and antiCD4IgG production in PWH on ART, which may contribute to gradual CD4 + T cell depletion. This study suggests that reversing a compromised mucosal barrier could improve ART outcomes in PWH who fail to experience complete immune restoration.
Sharp inequalities related to the volume of the unit ball in $\mathbb{R}^{n}$
Authors: Han Xue-Feng , Chen Chao-Ping
Published: May 2023

Let$\Omega _{n}=\pi ^{n/2}/\Gamma (\frac{n}{2}+1)$Ωn=πn/2/Γ(n2+1)($n \in \mathbb{N}$n∈N) denote the volume of the unit ball in$\mathbb{R}^{n}$Rn. In this paper, the logarithmically complete monotonicity of a function involving the ratio of two gamma functions is presented, which yields a sharp double inequality for the quantity$\Omega _{n}^{2}/(\Omega _{n-1}\Omega _{n+1})$Ωn2/(Ωn−1Ωn+1). Also, we establish new sharp inequalities for the quantity$\Omega _{n}^{2}/(\Omega _{n-1}\Omega _{n+1})$Ωn2/(Ωn−1Ωn+1).
Effect of using 5G and cloud computing environment for independent college english vocabulary learning
Authors: Wang Tiantian
Published: May 2023

An independent university refers to an institution of higher learning that has a bachelor's degree or higher education, and cooperates with social organizations other than state institutions or individuals to use non-state financial funds to establish and implement undergraduate education. While welcoming the arrival of the fifth-generation communication technology (5G) era, China's independent universities are also carrying out educational reforms to adapt to social development. 5G has created new opportunities for the development of students. Cloud computing refers to a system with extremely strong computing power formed through computer networks (mostly the Internet), which can store, collect relevant resources and configure them as needed to provide personalized services to users. Therefore, this paper studied and discussed the application of 5G and cloud computing in English vocabulary learning in independent universities. This paper explores the impact of 5G and cloud computing environments on independent college English vocabulary learning. With the assistance of 5G technology and a cloud computing environment, students' vocabulary mastery and application abilities have achieved certain improvements. Students' vocabulary learning can not only effectively break through the constraints of region and time, but also improve the interaction of learning and promote the communication and exchange between learners. This can not only deepen the understanding of vocabulary but also stimulate students' learning initiative and improve their learning ability and level. Given the current situation of English vocabulary acquisition, this paper used the fuzzy evaluation method to establish an evaluation model. The learning platform built by 5G and cloud computing technology has been utilized to study the effect of applying it to learners' vocabulary learning. In the questionnaire survey, 43.00% of the students are generally satisfied with the current English vocabulary teaching, 33.20% of the students think that their learning effect is average, 43.00% of the students think that the arrangement of teaching content is not reasonable, and 35.40% of the students think that the arrangement of class hours is generally reasonable. Before the experiment, the vocabulary of 68 and 65 students in the experimental group and the control group were between 1500–3500. Through the experiment, 67 students in the experimental group had vocabularies in the range of 3501–6500, while the vast majority of students in the control group still had vocabularies in the range of 1500–3500. In addition, through the experiment, the average total score of English test scores increased from 67 to 87 for the experimental group and from 69 to 72 for the control group. Based on the above data, it can be seen that the learning of English vocabulary through independent learning platforms built on 5G and cloud computing has a significant effect on the learning of English vocabulary of independent university students.
Prognostic value of the early lung ultrasound B-line score for postoperative pulmonary insufficiency in patients undergoing thoracic surgery: an observational study
Authors: He Yipeng , Xu Xiaoxiao , Wang Chenhao , Wu Zhouquan
Published: May 2023

Background

Postoperative pulmonary insufficiency (PPI) is an important contributor to morbidity and mortality after thoracic surgery. Lung ultrasound is a reliable tool for assessing respiratory function. We sought to determine the clinical value of the early lung ultrasound B-line score for predicting changes in pulmonary function after thoracic surgery.

Methods

Eighty-nine patients undergoing elective lung surgery were included in this study. The B-line score was determined 30 min after removal of the endotracheal tube, and the PaO2/FiO2 ratio was recorded 30 min after extubation and on the third postoperative day. Patients were divided into normal (PaO2/FiO2 ≥ 300) and PPI (PaO2/FiO2 < 300) groups according to their PaO2/FiO2 ratios. A multivariate logistic regression model was used to identify independent predictors of postoperative pulmonary insufficiency. Receiver operating characteristic (ROC) analysis was performed for significantly correlated variables.

Results

Eighty-nine patients undergoing elective lung surgery were included in this study. We evaluated 69 patients in the normal group and 20 in the PPI group. Patients conforming to NYHA class 3 at administration were significantly more represented in the PPI group (5.8 and 55%; p < 0.001). B-line scores were significantly higher in the PPI group than in the normal group (16; IQR 13–21 vs. 7; IQR 5–10; p < 0.001). The B-line score was an independent risk factor (OR = 1.349 95% CI 1.154–1.578; p < 0.001), and its best cutoff value for predicting PPI was 12 (sensitivity: 77.5%; specificity: 66.7%).

Conclusions

Lung ultrasound B-line scores 30 min after extubation are effective in predicting early PPI in patients undergoing thoracic surgery.

Trial registration This study was registered with the Chinese Clinical Trials Registry (ChiCTR2000040374).
Functional outcomes and quality of life after surgically treated tibial plateau fractures
Authors: Bagherifard Abolfazl , Mirkamali Seyed Farzam , Rashidi Heeva , Naderi Nima , Hassanzadeh Mohammad , Mohammadpour Mehdi
Published: May 2023

Background

Tibial plateau fractures (TPF) are uncommon and challenging for orthopedic surgeons with controversial reported outcomes. In this study, we aimed to evaluate the functional outcomes and quality of life (QOL) of patients with surgically treated TPF.

Methods

A total of 80 consecutive patients and 82 controls participated in this case control study. The patients were all surgically treated in our tertiary center from April 2012 to April 2020. The functional outcome was evaluated using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) scale. Moreover, we used the Short Form 36 health survey (SF-36) health survey to evaluate the QOL.

Results

No significant difference was observed in the overall mean SF-36 score in the two groups. We found a significant positive correlation between the scores of the SF-36 and WOMAC questionnaires (r = 0.642, p < 0.001) and between the ROM and the WOMAC questionnaire score (r = 0.478, p < 0.001). Further, ROM and SF-36 showed a weak positive correlation (r = 0.248, p = 0.026). Age had a weak negative correlation with the pain subscale of SF-36 (r = − 0.255, p = 0.22), even though it was not correlated with the total score or other subscales (p > 0.05).

Conclusion

QoL after TPF is not significantly different from that of a matched control group. Also, neither age nor BMI correlates with the QoL and functional outcome.
Autoimmune alopecia areata due to thymoma without myasthenia gravis: a case report
Authors: Saito Yukino , Yazawa Tomohiro , Nagashima Toshiteru , Ohtaki Yoichi , Kawatani Natsuko , Narusawa Eiji , Yoshikawa Ryohei , Matsumura Nozomi , Maehara Tatsuro , Shirabe Ken
Published: May 2023

Background

Thymoma is associated with autoimmune diseases. Myasthenia gravis is frequently associated with thymoma, but cases of thymoma complicated by alopecia areata are very rare. In this report, we present a case of thymoma associated with alopecia areata, but without Myasthenia gravis.

Case presentation

A 60-year-old woman had a complaint of rapid progression of alopecia areata. A hair follicular biopsy was performed, which showed the infiltration of CD8-positive lymphocytes. She was prescribed topical steroids for 2 months prior to surgery, but her hair loss was not improved. Screening computed tomography showed a mass in the anterior mediastinum, which was suspected to be a thymoma. Myasthenia gravis was ruled out because she had no relevant symptoms or physical findings, and no anti-acetylcholine receptor antibodies were detected in serum. We performed a transsternal extended thymectomy based on a diagnosis of thymoma Masaoka stage I, without myasthenia gravis. Pathological examination showed Type AB thymoma, Masaoka stage II. The chest drainage tube was removed on postoperative day 1, and the patient was discharged on postoperative day 6. The patient has continued topical steroids and showed improvement 2 months postoperatively.

Conclusions

Although alopecia areata is a rare complication in thymoma cases without myasthenia gravis, thoracic surgeons need to keep this condition in mind because alopecia reduces the patient's quality of life.
Data and model dual-driven seismic deconvolution via error-constrained joint sparse representation
Authors: Wang Yaojun , Zhang Guiqian , Chen Ting , Liu Yu , Shen Bingxin , Liang Jiandong , Hu Guangmin
Published: May 2023

Deconvolution is an essential step in seismic data processing. Sparse-spike deconvolution often is used to enhance the resolution of the seismic image by adding a model-driven regularization term. However, this method does not consider the features of the data, nor does it exactly describe the relationship between seismic data and the desired attribute (such as seismic reflectivity). We have developed a data and model dual-driven seismic deconvolution method based on error-constrained joint sparse representation (SR) using borehole measurement and surface seismic data. The combined features of the borehole reflectivity and the surface seismic data can be obtained through joint dictionary learning. With the help of the joint dictionary, the relationship between seismic waveforms and reflectivity is captured by the sparse coefficients. We construct the regularization term of deconvolution by alternately decomposing the error of the synthesized data via sparse reconstruction and the observed seismic data. Unlike model-driven methods, the constraint term of the new method can be established by the error-constrained SR. Based on this SR, the initial model of reflectivity is obtained to realize the sparse deconvolution of seismic data under the constraint of borehole data features. In general, this method is a data and model dual-driven deconvolution. Synthetic and field data tests demonstrate that this method can effectively improve the resolution and accuracy of deconvolution.
Destruction mechanism of organic matter enrichment controlled by tectonism in the lower Silurian organic-rich marine mudstone in the western South China Block
Authors: Sun Tong , Zhu Yiqing , Ran Bo , Liang Ke , Luo Chao , Han Yuyue
Published: May 2023

This destruction mechanism of organic matter enrichment plays an important role in improving the mudstone sedimentary structure system. For the lower Silurian marine mudstone in the western South China Block, the destruction mechanism of organic matter enrichment is unclear, with previous studies ignoring the control from paleogeography and spatial differences. Lamination is a typical sedimentary structure in mudstone and different types of lamination in mudstones can reflect a range of depositional environments. Lenticular lamination, composed of arranged lenses of variable composition, is a common type of lamination in marine mudstone and mainly occurs in organic-lean mudstone. The origin of lenticular lamination remains controversial, and a multidisciplinary approach is needed that integrates sedimentology, petrography, and paleogeography. The main objectives of this approach are to (1) interpret the formation mechanism of lenticular laminations in the Longmaxi marine mudstone, and (2) discuss the significance of lenticular lamination to organic matter destruction. The results not only allow for a complete understanding of the destruction mechanisms of the Silurian marine mudstones but also provide new insights into the sedimentary processes of marine mudstone.
Factors prompting and deterring suicides on the roads
Authors: Norman Hilary , Marzano Lisa , Winter Rachel , Crivatu Ioana , Mackenzie Jay-Marie , Marsh Ian
Published: May 2023

Background

In addition to the devastating impact on the individual and their families, suicides on the roads can cause distress and harm to other people who might be involved in a collision or witness an attempt. Despite an increased focus on the characteristics and circumstances of road-related suicides, little is known about why people choose to end their lives in this way.

Aims

The aim of the current study was to investigate the factors prompting and deterring the decision to attempt suicide on the roads.

Method

We conducted a secondary analysis of survey data, as well as seven in-depth qualitative interviews. Participants had lived experience of suicidal ideation or behaviour at a bridge or road location. We also carried out an online ethnography to explore interactions in different online communities relating to this method of suicide.

Results

Participants perceived a road-related suicide to be quick, lethal, easy and accessible and to have the potential to appear accidental. The proportion of participants who described their thoughts and attempts as impulsive appeared to be higher than had been observed with other method choices. The potential impact on other people was a strongly dissuasive factor.

Conclusions

Measures designed to prevent access to potentially lethal sites may be particularly important, given that many participants described their thoughts and behaviour as impulsive. In addition, fostering a culture of care and consideration for other road users may help to dissuade people from taking action on the roads.
A fractionally time-delayed SD-Van der Pol oscillator with a non-perturbative approach
Authors: El-Dib Yusry O. , Elgazery Nasser S. , Alyousef Haifa A.
Published: May 2023

The primary target of the present article is to use a fast and efficient technique to obtain an analytical solution for a Duffing-Van der Pol-SD (D-VDP-SD) oscillator with a time delay. Depending on the smoothness parameter, this kind of vibration behaves in both discontinuous and smooth dynamical systems. This novel technique is presented for transmission from a nonlinear delay fractional oscillator to a linear classical oscillator with ordinary derivatives. The transformation into an equivalent oscillator is described in detail. Based on the comparison, the convergence of the numerical and analytical solutions appears satisfactory, which is an indicator of the accuracy of the solutions produced by the suggested technique.