bluuebunny/crossref_metadata_2025 huggingface dataset:
The Evolution of Alternative Care in Nepal over the Last Decade and Way Forward
Authors: Lama Dhan Bahadur , Pun Anju , Maharjan Rija
Published: August 2023

Our article focuses on the national efforts advancing children’s right to alternative care services in Nepal. It presents the government’s existing laws and policies in providing responsible care to children in need of special protection and for children who cannot be placed in parental care due to various reasons for family separation. This article also looks into the history of alternative care in Nepal and discusses the alternative forms of care practised in the communities and their evolution, upholding the best interest of the child. We share the promising practices of kinship care and foster care (informal and formal) for children at risk of separation and child institutionalisation and for children removed from orphanages and children’s homes for family reintegration, implemented by The Himalayan Innovative Society in Nepal in partnership with Forget Me Not and Hope and Homes for Children. We, finally, conclude by sharing the key challenges and opportunities in the implementation of alternative care services for children in Nepal driving the care reform in the country.
Untouchables in Love: An Investigation of Rebellion Against Casteism in Nagraj Manjule’s Select Features
Authors: Verma Surya Prakash , Mishra Binod
Published: August 2023

The present article aims at analysing the revolutionary function of love in Marathi filmmaker Nagraj Manjule’s (b. 1978) selected feature films. The first two of Manjule’s feature films are set in a society ingrained in the vicious circle of the caste system. Fandry (2013) portrays the one-sided love story of a boy, and Sairat (2016) is based on the heart-rending story of Honour Killing in a realized love relationship between a lower-caste boy and an upper-caste girl. In contemporary India, the unprivileged people, whom the four-tier caste system addresses as untouchable, have been conditioned to eat, wear, work, and form human relationships in a particular manner that serves the purpose of casteism. The article will further explore how falling in love works as a constructive vehicle to carry forward the rebellion of both the protagonists against the inhuman norms of the destructive system. To discuss the nature of love in the films under discussion, the article takes the philosophical background from In Praise of Love (2009) by Alain Badiou, and The Radicality of Love (2015) by Srec ´ko Horvat, at the same time, it takes its arguments against casteism from the ideas of Jyotirao Govindrao Phule (1827–1890), Babasaheb Bhimrao Ambedkar (1891-1956), and other alike thinkers in this line.
Three year outcomes of intravitreal ranibizumab and aflibercept treatment of patients with diabetic macular edema: A comparative study
Authors: Akbas Yusuf Berk , Alagoz Cengiz , Cakmak Semih , Demir Gokhan , Alagoz Nese , Artunay Halil Ozgur
Published: August 2023

Background:

Diabetic macular edema (DME) is the most common cause of visual deterioration in patients with diabetes mellitus. Various treatment options have been used for DME, including intravitreal injection of steroids and anti-vascular endothelial growth factors.

Objectives:

To evaluate and compare the functional and anatomical outcomes of intravitreal ranibizumab (IVR) and intravitreal aflibercept (IVA) treatments in patients with DME.

Design:

Retrospective study.

Methods:

Four hundred three eyes of 235 naïve patients who underwent IVR or IVA treatment for DME followed up to 36 months included in the study. Best corrected visual acuity (BCVA) and central macular thickness (CMT) were measured at baseline, year 1, 2 and 3. Primary endpoint of the study was the change in BCVA and CMT each year from baseline and requirement of additional treatment (laser/steroid injection).

Results:

There were 198 eyes in IVR group and 205 eyes in IVA group. The changes in mean BCVA were 0.09 ± 0.32 versus 0.17 ± 0.41 Logarithm of the minimum angle of resolution (logMAR) ( p = 0.042) at year 1, 0.09 ± 0.37 versus 0.12 ± 0.45 logMAR ( p = 0.512) at year 2 and 0.13 ± 0.36 versus 0.15 ± 0.48 logMAR ( p = 0.824) at year 3 in IVA and IVR groups, respectively. The baseline mean BCVA were lower ( p = 0.004) in IVA group. The mean total number of injections was 7.93 ± 3.38 versus 7.42 ± 3.05 ( p = 0.112).

Conclusion:

At year 1, change in mean BCVA was statistically significantly higher in IVA group; however this difference did not persist at years 2 and 3. Although the mean total number of injections was similar between groups, the requirement for adjuvant steroid treatment was significantly higher in ranibizumab group, which may affect the number of visits and treatment costs. Both ranibizumab and aflibercept treatments achieved a good long-term visual and anatomical response in DME patients.
Concept of the term long lie: a scoping review
Authors: Kubitza Jenny , Schneider Iris T. , Reuschenbach Bernd
Published: August 2023

Background & aims

The term “long lie” is often used when individuals who have fallen are unable to stand up on their own, so they have to lie unintentionally for a longer period of time until they are noticed and can be helped. Although long lie can lead to both short- and long-term physical and psychological effects, little is known about what describes the term. The aim of this review is to identify what characterizes the term.

Methods

Using the Arksey and O’Malley’s framework for scoping reviews in accordance with the modified Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework, a systematic search was conducted for papers and gray literature that define, explain, or describe a long lie. The literature research was conducted via seven databases and Google Scholar.

Findings

The search yielded 921 hits, of which 22 research papers are included; most studies were published after 2010. Emergency medicine and public health in particular have studied long lies and have found that it does not only affect the older adults who have fallen and cannot stand up on their own because of their frailty but also individuals with restricted mobility, which can be related to several reasons.

Conclusions

The results show that a standard concept of a long lie is lacking. The duration of lying and the location alone are not relevant criteria. Further factors (helplessness, psychological and physical consequences, etc.) should also be taken into account.
Anatomical observation and transcriptome analysis of branch-twisted mutations in Chinese jujube
Authors: Luo Zhi , Gao Mengjiao , Zhao Xuan , Wang Lihu , Liu Zhiguo , Wang Lixin , Wang Lili , Zhao Jin , Wang Jiurui , Liu Mengjun
Published: August 2023

Background

Plant organs grow in a certain direction and organ twisted growth, a rare and distinctive trait, is associated with internal structure changes and special genes. The twisted branch mutant of Chinese jujube jujube, an important fruit tree native to China and introduced to nearly 50 countries, provides new typical materials for exploration of plant twisted growth.

Results

In this study, the cytological characteristics and related genes of twisted branches in Chinese jujube were revealed by microscopy observation and transcriptome analysis. The unique coexistence of primary and secondary structures appeared in the twisted parts of branches, and special structures such as collateral bundle, cortical bundles, and internal phloem were formed. Ninety differentially expressed genes of ‘Dongzao’ and its twisted mutant were observed, in which ZjTBL43, ZjFLA11, ZjFLA12 and ZjIQD1 were selected as candidate genes. ZjTBL43 was homologous to AtTBL43 in Arabidopsis, which was involved in the synthesis and deposition of cellular secondary wall cellulose. The attbl43 mutant showed significant inflorescence stem bending growth. The transgenic lines of attbl43 with overexpression of ZjTBL43 were phenotypically normal.The branch twisted growth may be caused by mutations in ZjTBL43 in Chinese jujube. AtIQD10, AtFLA11 and AtFLA12 were homologous to ZjIQD1, ZjFLA11 and ZjFLA12, respectively. However, the phenotype of their function defect mutants was normal.

Conclusion

In summary, these findings will provide new insights into the plant organ twisted growth and a reference for investigation of controlling mechanisms of plant growth direction.
HIV specific Th1 responses are altered in Ugandans with HIV and Schistosoma mansoni coinfection
Authors: Obuku Andrew Ekii , Lugemwa Jacqueline Kyosiimire , Abaasa Andrew , Joloba Moses , Ding Song , Pollara Justin , Ferrari Guido , Harari Alexandre , Pantaleo Giuseppe , Kaleebu Pontiano
Published: August 2023

Background

Fishing communities surrounding Lake Victoria in Uganda have HIV prevalence of 28% and incidence rates of 5 per 100 person years. More than 50% of the local fishermen are infected with Schistosoma mansoni (S. mansoni). We investigated the role of S. mansoni coinfection as a possible modifier of immune responses against HIV. Using polychromatic flow cytometry and Gran-ToxiLux assays, HIV specific responses, T cell phenotypes, antibody-dependent cell-mediated cytotoxic (ADCC) potency and titres were compared between participants with HIV-S. mansoni coinfection and participants with HIV infection alone.

Results

S. mansoni coinfection was associated with a modified pattern of anti-HIV responses, including lower frequency of bifunctional (IFNγ + IL-2 − TNF-α+) CD4 T cells, higher overall CD4 T cell activation and lower HIV ADCC antibody titres, compared to participants with HIV alone.

Conclusions

These results support the hypothesis that S. mansoni infection affects T cell and antibody responses to HIV in coinfected individuals.
Contribution of trehalose to ethanol stress tolerance of Wickerhamomyces anomalus
Authors: Li Yinfeng , Jiang Guilan , Long Hua , Liao Yifa , Wu Liuliu , Huang Wenyue , Liu Xiaozhu
Published: August 2023

Background

The ascomycetous heterothallic yeast Wickerhamomyces anomalus (WA) has received considerable attention and has been widely reported in the winemaking industry for its distinctive physiological traits and metabolic attributes. An increased concentration of ethanol during ethanol fermentation, however, causes ethanol stress (ES) on the yeast cells. Trehalose has been implicated in improving survival under various stress conditions in microorganisms. Herein, we determined the effects of trehalose supplementation on the survival, differentially expressed genes (DEGs), cellular morphology, and oxidative stress tolerance of WA in response to ES.

Results

The results indicated that trehalose improved the survival and anomalous surface and ultrastructural morphology of WA. Additionally, trehalose improved redox homeostasis by reducing the levels of reactive oxygen species (ROS) and inducing the activities of antioxidant enzymes. In addition, DEGs affected by the application of trehalose were enriched in these categories including in gene expression, protein synthesis, energy metabolism, and cell cycle pathways. Additionally, trehalose increased the content of intracellular malondialdehyde (MDA) and adenosine triphosphate.

Conclusions

These results reveal the protective role of trehalose in ES mitigation and strengthen the possible uses of WA in the wine fermentation sector.
Multi-omics analysis of fecal samples in colorectal cancer Egyptians patients: a pilot study
Authors: Khattab Randa H. , Abo-Hammam Rana H. , Salah Mohammed , Hanora Amro M. , Shabayek Sarah , Zakeer Samira
Published: August 2023

Background

Colorectal cancer (CRC) is a public health concern and the second most common disease worldwide. This is due to genetic coding and is influenced by environmental aspects, in which the gut microbiota plays a significant role. The purpose of this study was to compare the microbiota makeup of CRC patients with that of healthy control and to identify upregulated and downregulated proteins and metabolites in CRC patients. Using a next-generation sequencing approach, fecal samples of five females (4 CRC patients and one healthy control) were analyzed by BGI DNBSEQ-T7, Hong Kong, China. Furthermore, proteomics and metabolomics analysis were performed using LC-MS/MS technique.

Results

Dysbiosis of gut microbiota has been observed in patients with CRC, with an increase in microbiota diversity at all taxonomic levels relative to healthy control. Where, at the functional level the bacterial species participate in many different pathways among them de novo nucleotide synthesis and amino acids pathways were aberrantly upregulated in CRC patients. Proteomics and metabolomics profiles of CRC patients showed different proteins and metabolites, a total of 360 and 158 proteins and metabolites, respectively were highly expressed compared to healthy control with fold change ≥ 1.2. Among the highly expressed proteins were transketolase, sushi domain-containing protein, sulfide quinone oxidoreductase protein, AAA family ATPase protein, carbonic anhydrase, IgG Fc-binding protein, nucleoside diphosphate kinase protein, arylsulfatase, alkaline phosphatase protein, phosphoglycerate kinase, protein kinase domain-containing protein, non-specific serine/threonine protein kinase, Acyl-CoA synthetase and EF-hand domain-containing protein. Some of the differential metabolites, Taurine, Taurocholic acid, 7-ketodeoxycholic acid, Glycochenodeoxycholic acid, Glycocholic acid, and Taurochenodeoxycholic acid that belong to bile acids metabolites.

Conclusions

Some bacterial species, proteins, and metabolites could be used as diagnostic biomarkers for CRC. Our study paves an insight into using multi-omics technology to address the relationship between gut microbiota and CRC.
Ceusia-Breast: computer-aided diagnosis with contrast enhanced ultrasound image analysis for breast lesions
Authors: Kondo Satoshi , Satoh Megumi , Nishida Mutsumi , Sakano Ryousuke , Takagi Kazuya
Published: August 2023

Background

In recent years, contrast-enhanced ultrasonography (CEUS) has been used for various applications in breast diagnosis. The superiority of CEUS over conventional B-mode imaging in the ultrasound diagnosis of the breast lesions in clinical practice has been widely confirmed. On the other hand, there have been many proposals for computer-aided diagnosis of breast lesions on B-mode ultrasound images, but few for CEUS. We propose a semi-automatic classification method based on machine learning in CEUS of breast lesions.

Methods

The proposed method extracts spatial and temporal features from CEUS videos and breast tumors are classified as benign or malignant using linear support vector machines (SVM) with combination of selected optimal features. In the proposed method, tumor regions are extracted using the guidance information specified by the examiners, then morphological and texture features of tumor regions obtained from B-mode and CEUS images and TIC features obtained from CEUS video are extracted. Then, our method uses SVM classifiers to classify breast tumors as benign or malignant. During SVM training, many features are prepared, and useful features are selected. We name our proposed method "Ceucia-Breast" (Contrast Enhanced UltraSound Image Analysis for BREAST lesions).

Results

The experimental results on 119 subjects show that the area under the receiver operating curve, accuracy, precision, and recall are 0.893, 0.816, 0.841 and 0.920, respectively. The classification performance is improved by our method over conventional methods using only B-mode images. In addition, we confirm that the selected features are consistent with the CEUS guidelines for breast tumor diagnosis. Furthermore, we conduct an experiment on the operator dependency of specifying guidance information and find that the intra-operator and inter-operator kappa coefficients are 1.0 and 0.798, respectively.

Conclusion

The experimental results show a significant improvement in classification performance compared to conventional classification methods using only B-mode images. We also confirm that the selected features are related to the findings that are considered important in clinical practice. Furthermore, we verify the intra- and inter-examiner correlation in the guidance input for region extraction and confirm that both correlations are in strong agreement.
Long-term effects of natalizumab on MRI activity and clinical outcomes in Japanese patients with relapsing-remitting multiple sclerosis
Authors: Saida Takahiko , Hao Qi , Kanda Michihiro , Tani Yumiko
Published: August 2023

Background

Relapsing-remitting multiple sclerosis (RRMS) is the most common phenotype of multiple sclerosis (MS), and its active stage is characterized by active T2 lesions with or without gadolinium (Gd) enhancement on magnetic resonance imaging (MRI). Natalizumab is indicated as monotherapy in adults with active RRMS in Japan. The main objective of this study was to investigate the long-term effect of natalizumab on disease progression in Japanese patients with RRMS using MRI data.

Methods

This retrospective, chart review study was conducted at a single center in Japan. The main study outcome was the yearly proportion of patients with active T2-weighted image lesions detected with or without Gd enhancement on brain MRI (incidence rate) after treatment initiation for up to 5 years. Additional endpoints included annual relapse rate (ARR) and expanded disability status scale (EDSS) score.

Results

This study included data from 85 patients with RRMS who had received natalizumab for ≥ 1 year; of these, 65 (76.5%) were female and the mean ± standard deviation (SD) age at baseline was 37.5 ± 10.0 years. The incidence rate of active T2 lesions was 52.9% (45/85) in the year prior to natalizumab treatment (Year − 1), which decreased to 2.4% and 1.6% in Year 0.5–1.5 and Year 1.5–2.5, respectively. No active T2 lesions were detected in Year 2.5–5.5 in patients who continued natalizumab treatment. EDSS score was stable, improved, and worsened in 61.8%, 26.3%, and 11.8% of patients, respectively. The median (range) EDSS score was 2.0 (0.0–7.0) at baseline (n = 85) and remained within a similar range (median score between 1.0 and 2.25 during Years 1–5). ARR decreased from 1.12 relapses per year at baseline to 0.12 relapses per year during Year 1 and remained below 0.15 relapses per year up to Year 5.

Conclusion

The results of this first long-term study evaluating the effect of natalizumab on MRI activity and clinical outcomes in Japanese patients with RRMS suggest that natalizumab markedly reduced disease activity and maintained effectiveness over several years.
Automated breast volume scanner based Radiomics for non-invasively prediction of lymphovascular invasion status in breast cancer
Authors: Li Yue , Wu Xiaomin , Yan Yueqiong , Zhou Ping
Published: August 2023

Purpose

Lymphovascular invasion (LVI) indicates resistance to preoperative adjuvant chemotherapy and a poor prognosis and can only be diagnosed by postoperative pathological examinations in breast cancer. Thus, a technique for preoperative diagnosis of LVI is urgently needed. We aim to explore the ability of an automated breast volume scanner (ABVS)-based radiomics model to noninvasively predict the LVI status in breast cancer.

Methods

We conducted a retrospective analysis of data from 335 patients diagnosed with T1-3 breast cancer between October 2019 and September 2022. The patients were divided into training cohort and validation cohort with a ratio of 7:3. For each patient, 5901 radiomics features were extracted from ABVS images. Feature selection was performed using LASSO method. We created machine learning models for different feature sets with support vector machine algorithm to predict LVI. And significant clinicopathologic factors were identified by univariate and multivariate logistic regression to combine with three radiomics signatures as to develop a fusion model.

Results

The three SVM-based prediction models, demonstrated relatively high efficacy in identifying LVI of breast cancer, with AUCs of 79.00%, 80.00% and 79.40% and an accuracy of 71.00%, 80.00% and 75.00% in the validation cohort for AP, SP and CP plane image. The fusion model achieved the highest AUC of 87.90% and an accuracy of 85.00% in the validation cohort.

Conclusions

The combination of radiomics features from ABVS images and an SVM prediction model showed promising performance for preoperative noninvasive prediction of LVI in breast cancer.
Predictor factors affecting emotional and behavioral problems in school-aged (6–12 years) children during the COVID-19 pandemic: a cross-sectional study
Authors: Mahmoodi Zohreh , Rostami Mahnoosh , Bahrami Giti , Rasouli Fatemeh , Ghavidel Nooshin
Published: August 2023

Objectives

The prolonged outbreak of COVID-19 has caused psychological problems in the community, especially in children. Given that limited studies have been conducted on this vulnerable group in Iran, we conducted this study to determine the predictor factors affecting emotional and behavioral problems in school-aged (6–12 years) children during the COVID-19 pandemic.

Methods

We conducted a cross-sectional study on 322 mothers of elementary school-aged children (6–12 years) from April 21 to June 21, 2021, in Karaj, Alborz, Iran. Sociodemographic checklist, socioeconomic status scale (SES), Depression, Anxiety, and Stress Scale (DASS-21), Corona Disease Anxiety Scale (CDAS), and the Rutter Children's Behavior Questionnaire (RCBQ) were used to evaluate the children's behavioral symptoms, the mental health of their mothers, and sociodemographic factors.

Results

In total, 17.7% of children (male = 27.0%, female = 11.7%) had behavioral problems. Results showed income (p-value = 0.007, 95%CI (-3.85- -0.607)), and physical activity of the child (p-value = 0.026, 95%CI (-1.03- -0.067)), were indirectly associated with children's behavioral symptoms. Having underlying disease (p-value = 0.00, 95%CI (1.712–5.949)), breastfeeding (p-value = 0.027, 95%CI (0.335–5.61)), corona-related anxiety (p-value = 0.00, 95%CI (0.158–0.318)), and DASS score (p-value = 0.00, 95%CI (0.149–0.334)) in the mothers, as well as male gender (p-value = 0.003, 95%CI (0.724–3.471)) were directly associated with children's behavioral symptoms. The most factors involved in the behavioral symptom score of children were corona-related anxiety (β = .298), DASS (β = 0.273), underlying disease of mothers (β = 0.163), income (β = -0.154), child's gender (β = 0.142) and physical activity (β = -0.101), and breastfeeding (β = 0.099) respectively.

Conclusion

Study findings showed that some factors affect the emotional and behavioral problems of school-aged (6–12 years) children during the COVID-19 pandemic. These data may help future researchers and policymakers with early intervention.
Body mass index and sex differences for mortality in hospitalized COVID-19 patients: a path analysis using a brazilian national database
Authors: dos Reis Erika Cardoso , de Freitas Monteiro Elma Lúcia , Meneguci Joilson , Rodrigues Phillipe , Palma Alexandre , Virtuoso Junior Jair Sindra , Passos Sonia Regina Lambert , Borges dos Santos Maria Angelica
Published: August 2023

Previous studies have shown that associations between obesity and other comorbidities favor worse outcomes in COVID-19. However, it is not clear how these factors interrelate and whether effects on men and women differ. We conducted an observational, cross-sectional study using a national COVID-19 inpatient database. We studied differences in direct and indirect effects of obesity and comorbidities according to sex and body mass index (BMI) categories in hospitalized COVID-19 patients in Brazil using path analysis models and logistic regression. For men, path analysis showed a direct association between BMI and death and a negative correlation of death and chronic cardiovascular disease (CCD). For women, the association of BMI and death was indirect, mediated by admission to the ICU and comorbidities and association with CCD was non-significant. In the logistic regression analyses, there was a positive association between death and BMI, age, diabetes mellitus, kidney and lung diseases and ICU admission. We highlight the need to consider the distinct impact of obesity and sex on COVID-19, of monitoring of BMI and of the design for specific male-targeted approaches to manage obesity.
Vitamin D in adolescent idiopathic scoliosis: a meta-analysis
Authors: Kim Dong Suk , Lee Jung Sub
Published: August 2023

Objective

The aim of this study was to compare serum vitamin D levels in girls with adolescent idiopathic scoliosis (AIS) and controls using meta-analysis methods. We searched Medline (via PubMed), Cochrane, Scopus, and Embase databases for studies evaluating outcomes in AIS, including patient age, body mass index, bone mineral density (BMD), and serum levels of parathyroid hormone (PTH), calcium, and phosphate, published between January 2000 and June 2020. We searched for studies that were limited to humans only. The inclusion criteria were a scoliosis study that measured vitamin D levels. We excluded duplicate publications such as review articles, case reports, and letters without original data. Two authors extracted data independently and resolved any discrepancies by consensus.

Results

Eight comparative studies were identified. Demographic characteristics, bone density, serum levels of vitamin D, parathyroid hormone, and phosphate levels were not significantly different between AIS group and controls, except for serum calcium levels. The serum calcium levels were lower in AIS group than in the controls.

Conclusions

This review includes eight comparative studies reporting serum vitamin D and/or parathyroid hormone levels in AIS. Due to heterogeneity, a limited number of meta-analyses have shown a weak correlation between serum vitamin D levels and the incidence of AIS. Larger, multicenter studies are therefore needed to validate the results.
Determinants of precancerous cervical lesion among HIV infected women on ART in Woldia comprehensive specialized hospital NorthEast Ethiopia
Authors: Dessie Tazeb Melkie , Kassaw Abebe Tarekegn , Alen Gedefaw Diress
Published: August 2023

Background

Precancerous cervical lesion is a priority public health problem that jeopardizes the life of enormous women. previous studies in Ethiopia were more focused on knowledge, attitude, and practices of Cervical cancer screening. studies on the risk factors of pre-cancerous cervical lesions among the risk population (HIV infected) relative to the general population were limited. This study aimed to identify the determinants of precancerous cervical lesions among HIV Infected Women in Woldia Comprehensive Specialized Hospital in Northeast Ethiopia, 2022.

Methods

Hospital-based unmatched case-control study was conducted in Woldia Comprehensive Specialized Hospital among HIV-infected women from June to August 2022. Data were collected from 104 cases and 208 controls using an interviewer-administered questionnaire and clinical data from the patient chart using Electronic Medical Record _ Anti-Retroviral Therapy Smart care database checklist. The binary logistic regression model was used to identify the determinants of the precancerous cervical lesion. An odds ratio with a 95% Confidence interval was used to measure the association and p-value < 0.05 were considered significant.

Results

Women who have two or more lifetime sexual partners (AOR = 3.21,95% CI: 1.71–6.04), history of sexually transmitted infection (AOR = 4.97, 95% CI: 2.78–8.78), early age at first sexual intercourse (< 18 years) (AOR = 4.35,95% CI: 2.48–7.67) and baseline CD4 count < 200 cells/mm3 (AOR = 1.89, 95% CI: 1–3.57) had a higher odd of developing a precancerous cervical lesion.

Conclusion

This study confirms that having a history of sexually transmitted infection, two or more lifetime sexual Partners, the initiation of sexual intercourse before the age of 18 years, and Baseline CD4 count < 200 cells/mm3 were determinants for precancerous cervical lesions. So it should be focused on prevention through early detection and treatment of sexually transmitted infections.
Efficacy and safety of self-administered acupressure on symptoms, quality of life and nasal mucosal function in patients with perennial allergic rhinitis: study protocol for a randomized controlled exploratory trial
Authors: Li Kai , Huang Wei , Li Rui-Jian , Feng Xiao-Cong , Chen Zong , Tan Shu-Yi , Xie Mei-Feng , Huang Jian-Peng , Liu Ru-Jia , Li Yun-Ying
Published: August 2023

Introduction

Allergic rhinitis is a global health problem that can potentially be managed through acupressure. Our clinical observations have identified Allergic Rhinitis Acupressure Therapeutic (ARAT) as a novel acupressure treatment acting on specific acupoints, which may enhance the effectiveness of acupressure. Therefore, we propose a three-arm randomized controlled trial will be conducted to investigate the efficacy and safety of ARAT for perennial allergic rhinitis (PAR).

Methods/design

In this trial, eligible 111 participants diagnosed with PAR will be randomly assigned to one of three groups: the ARAT group, the non-specific acupoints group, or the blank control group. The primary outcome will be the change in the total nasal symptom score, and the secondary outcomes will include: 1) changes in the scores of the standard version of Rhinoconjunctivitis Quality of Life Questionnaire (RQLQs); 2) acoustic rhinometry and anterior rhinomanometry; 3) changes in the scores of relief medication usage; 4) incidence of adverse events. Additionally, we will measure and compare the changes in cytokine levels (IL-5, IL-13, IFN-γ, and TSLP) in nasal secretions.

The RQLQs and primary outcomes will be assessed at the beginning, middle, and end stages of the treatment period, with monthly follow-ups conducted over a total of three months. The secondary outcomes and biomarkers in nasal secretions will be measured at the beginning and end of the treatment period. Any adverse events or need for rescue medication will be carefully noted and recorded.

Discussion

This study may produce a new acupressure treatment prescription that is easy to learn, more targeted, and adaptable. This trial represents the first clinical investigation comparing ARAT treatment for PAR with the non-specific acupoints group and blank control group. Our data is expected to provide evidence demonstrating the safety and efficacy of ARAT for PAR patients, while also exploring the functional mechanism underlying ARAT treatment, moreover, the results offer valuable insights for healthcare professionals in managing PAR symptoms.

Trial registration

Chinese Clinical Trial Registry, ChiCTR2300072292. Registered on June 08, 2023.
ApoE gene polymorphisms and metals and their interactions with cognitive function
Authors: Ye Zeyan , Tan Dechan , Luo Tingyu , Gou Ruoyu , Cai Jianshen , Wei Yanfei , He Kailian , Xiao Song , Mai Tingyu , Tang Xu , Liu Qiumei , Mo Xiaoting , Lin Yinxia , Huang Shenxiang , Li You , Qin Jian , Zhang Zhiyong
Published: August 2023

Objective

To analyze the relationship between plasma metal elements, ApoE gene polymorphisms and the interaction between the two and impaired cognitive function in elderly population.

Method

A stratified sample was drawn according to the age of the study population, and 911 subjects were included. Baseline information and health indicators were obtained, and cognitive function status was assessed by health examination, a general questionnaire and Mini-Mental Status Examination. Plasma metal elements were measured, and SNP typing was performed. Binary logistic regression was used to analyze the factors influencing cognitive function status and the association between the SNP genetic pattern of the ApoE gene and cognitive function.

Results

The differences in gene frequencies and genotype frequencies of the ApoE rs7412 and rs7259620 genotype frequencies were statistically different between the cognitive impairment group and the control group (P < 0.05). statistically differences were found for the codominant model in rs7412-TT compared with the CC genotype (OR = 3.112 (1.159–8.359), P = 0.024) and rs7259620-AA compared with the GG genotype (OR = 1.588 (1.007–2.504), P = 0.047). Statistically differences were found in the recessive models rs7412-TT compared with (CC + CT) (OR = 2.979 (1.112–7.978), P = 0.030), rs7259620-AA compared with (GG + GA), and rs405509-GG compared with (TT + TG) (OR = 1.548(1.022–2.344), P = 0.039) all of which increased the risk of developing cognitive impairment. The differences in plasma Fe, Cu, and Rb concentrations between the case and control groups were significant (P < 0.05). The regression results showed that the plasma Cd concentrations in the Q1 range was a protective factor for cognitive function compared with Q4 (0.510 (0.291–0.892), P = 0.018). Furthermore, there was a multiplicative interaction between the codominant and recessive models for the Q2 concentrations of Cd and the rs7259620 loci, and the difference was significant, indicating increased risk of developing cognitive impairment (codominant model OR = 3.577 (1.496–8.555), P = 0.004, recessive model OR = 3.505 (1.479–8.307), P = 0.004). There was also a multiplicative interaction between Cd and the recessive model at the rs405509 loci, and the difference was significant, indicating increased risk of developing cognitive impairment (OR = 3.169 (1.400-7.175), P = 0.006).

Conclusion

The ApoE rs7412, rs7259620 and rs405509 loci were associated with cognitive impairment in the elderly population, and there was an interaction between plasma metalloid Cd and the rs7259620 and rs405509 loci that increased the risk of cognitive impairment in the elderly population.
Human milk extracellular vesicles enhance muscle growth and physical performance of immature mice associating with Akt/mTOR/p70s6k signaling pathway
Authors: Meng Zitong , Zhou Dong , Lv Dan , Gan Quan , Liao Yuxiao , Peng Zhao , Zhou Xiaolei , Xu Shiyin , Chi Penglong , Wang Zhipeng , Nüssler Andreas K. , Yang Xuefeng , Liu Liegang , Deng Dongrui , Yang Wei
Published: August 2023

Extracellular vesicles (EVs) play an important role in human and bovine milk composition. According to excellent published studies, it also exerts various functions in the gut, bone, or immune system. However, the effects of milk-derived EVs on skeletal muscle growth and performance have yet to be fully explored. Firstly, the current study examined the amino acids profile in human milk EVs (HME) and bovine milk EVs (BME) using targeted metabolomics. Secondly, HME and BME were injected in the quadriceps of mice for four weeks (1 time/3 days). Then, related muscle performance, muscle growth markers/pathways, and amino acids profile were detected or measured by grip strength analysis, rotarod performance testing, Jenner-Giemsa/H&E staining, Western blotting, and targeted metabolomics, respectively. Finally, HME and BME were co-cultured with C2C12 cells to detect the above-related indexes and further testify relative phenomena. Our findings mainly demonstrated that HME and BME significantly increase the diameter of C2C12 myotubes. HME treatment demonstrates higher exercise performance and muscle fiber densities than BME treatment. Besides, after KEGG and correlation analyses with biological function after HME and BME treatment, results showed L-Ornithine acts as a “notable marker” after HME treatment to affect mouse skeletal muscle growth or functions. Otherwise, L-Ornithine also significantly positively correlates with the activation of the AKT/mTOR pathway and myogenic regulatory factors (MRFs) and can also be observed in muscle and C2C12 cells after HME treatment. Overall, our study not only provides a novel result for the amino acid composition of HME and BME, but the current study also indicates the advantage of human milk on skeletal muscle growth and performance.
Police seizure of drugs without arrest among people who use drugs in Vancouver, Canada, before provincial ‘decriminalization’ of simple possession: a cohort study
Authors: Hayashi Kanna , Singh Kelsall Tyson , Shane Caitlin , Cui Zishan ,   Vancouver Area Network of Drug Users, Milloy M.-J. , DeBeck Kora , Kerr Thomas
Published: August 2023

Background

Several jurisdictions in Canada have recently considered decriminalizing possession of illicit drugs for personal use (henceforth, simple possession) as part of their responses to the ongoing drug toxicity/overdose crisis. In this context, we sought to examine an early implementation case of a de facto depenalization policy of simple possession offences in Vancouver, Canada, that was enacted in 2006. Specifically, we characterized experiences of people who use drugs (PWUD) whose drugs were discretionally seized by police without arrest.

Methods

Data were derived from three prospective cohorts of community-recruited PWUD in Vancouver over 16 months in 2019–2021. We conducted multivariable generalized estimating equations analyses to determine the prevalence of and factors associated with drug seizure. Sub-analyses used data collected in 2009–2012 and examined the trends over time.

Results

Among 995 participants who were interviewed in 2019–2021, 63 (6.3%) had their drugs seized by police at least once in the past 6 months. In multivariable analyses, factors significantly associated with drug seizure included: homelessness (adjusted odds ratio [AOR]: 1.98; 95% confidence interval [CI] 1.09–3.61), working in the unregulated drug market (AOR: 4.93; 95% CI 2.87–8.49), and naloxone administration (AOR: 2.15; 95% CI 1.23–3.76). In 2009–2012, 67.8% reported having obtained new drugs immediately after having their drugs seized by police. Odds of drug seizure were not significantly different between the two time periods (2019–2021 vs. 2009–2012) (AOR: 0.93; 95% CI: 0.64–1.35).

Conclusions

Despite the depenalization policy, the Vancouver Police Department has continued to seize illicit drugs from PWUD, even in cases where no arrest occurred. This policing practice may create health and safety risks for PWUD as it forces PWUD to increase the engagement with the unregulated illicit drug market. Our findings support calls for abolishing this often-undocumented discretionary policing practice that may exacerbate ongoing health inequities and interfere with peer-based overdose prevention efforts.
Successes and challenges of China’s health care reform: a four-decade perspective spanning 1985—2023
Authors: Jakovljevic Mihajlo , Chang Hanyu , Pan Jay , Guo Chao , Hui Jin , Hu Hao , Grujic Danko , Li Zhong , Shi Lizheng
Published: August 2023

Chinese health system remains the crucial one for understanding the wider healthcare landscape across the Global South and in particular the leading Emerging Markets. Purpose of our observation was to understand the inner dynamics of mainland Chinese health reforms adopting a lengthy time horizon. We have analysed the public reports and seminal evidence on Chinese of multiple waves of national health reforms taking place since 1980s in terms of medical care and pharmaceuticals provision and financing. Chinese international trade with ASEAN nations and wider South-East Asia is accelerating its growth after the recovery of trade routes. In terms of health sector this means that global demand and supply of medical goods, services and pharmaceuticals remains largely driven by Chinese domestic developments. Furthermore, Chinese domestic manufacturing and sales of decent quality medical devices and services have grown exponentially. Some temporary pitfalls and increasing in rural–urban inequalities in equity of access and affordability of medical care and pharmaceuticals did take place. Despite these difficulties to generate a balanced development strategy for the largest global market, this is a clear path upwards. Further upcoming improvements expanding health insurance coverage are in strong demand for certain layers of the society. Domestic bottleneck weaknesses yet remain manufacturing, import and market penetration of cutting-edge pharmaceuticals such as monoclonal antibodies and targeted oncology agents. Yet some of these obstacles are likely to be overcome in foreseeable future with the adoption of responsible strategies by governmental agencies in health care arena.
Midwife-led pandemic telemedicine services for maternal health and gender-based violence screening in Bangladesh: an implementation research case study
Authors: Islam Amirul , Begum Farida , Williams Anna , Basri Rabeya , Ara Rowsan , Anderson Rondi
Published: August 2023

Background

The COVID-19 pandemic disrupted maternal and newborn health services in Bangladesh, exacerbating the large gaps in service utilization that existed prior to the pandemic. As part of its response, Bangladesh initiated remote antenatal and postnatal care telemedicine services led by midwives in 36 sub-district hospitals across five of Bangladesh’s 64 districts. Gender-based violence screening and referral were integrated into the service to address a reported rise in violence following the country’s pandemic lockdown.

Methods

Mixed-methods implementation research was used to develop an intrinsic case study describing the design and implementation of the telemedicine program. Qualitative analysis comprised document review, key informant interviews, and focus group discussions. Quantitative analysis employed an interrupted time series analysis with segmented multi-variate regression to compare maternity care service use trends before and after implementation. Poisson regression analysis was used to examine the trend in number of gender-based violence remote screenings, sessions held, and cases identified.

Results

A statistically significant change in trend for onsite antenatal and postpartum care as well as women seeking care at the hospital as a result of postpartum hemorrhage arising in the community was observed following the introduction of telemedicine. Facility births and cases of eclampsia appropriately identified and managed also had significant increases. In addition, over 6917 women were screened for GBV, 223 received counseling and 34 referrals were made, showing a statistically significant increase in frequency over time following the implementation of the telemedicine program. Challenges included that not all midwives adopted GBV screening, some women were reluctant to discuss GBV, there was an unanticipated need to introduce a patient visit scheduling system in all intervention hospitals, and many women were not reachable by phone due to lack of access or network coverage.

Conclusions

Maternal health and gender-based violence telemedicine led by midwives was an effective, low-cost intervention in Bangladesh for addressing pandemic and pre-pandemic gaps in service use. Other low and middle-income countries planning to implement remote maternal health interventions via midwives should consider whether a patient visit scheduling system needs to be introduced, as well as limitations around mobile phone access and connectivity. Future research should include care quality oversight and improvement, and a more well-informed strategy for facilitating effective GBV screening.
The intersection of biological sex and gender in adverse events following seasonal influenza vaccination in older adults
Authors: Shapiro Janna R. , Seddu Kumba , Park Han-Sol , Lee John S. , Creisher Patrick S. , Yin Anna , Shea Patrick , Kuo Helen , Li Huifen , Abrams Engle , Leng Sean X. , Morgan Rosemary , Klein Sabra L.
Published: August 2023

Background

Women/females report more adverse events (AE) following immunization than men/males for many vaccines, including the influenza and COVID-19 vaccines. This discrepancy is often dismissed as a reporting bias, yet the relative contributions of biological sex and gender are poorly understood. We investigated the roles of sex and gender in the rate of AE following administration of the high-dose seasonal influenza vaccine to older adults (≥ 75 years) using an AE questionnaire administered 5–8 days post-vaccination. Participant sex (male or female) was determined by self-report and a gender score questionnaire was used to assign participants to one of four gender categories (feminine, masculine, androgynous, or undifferentiated). Sex steroid hormones and inflammatory cytokines were measured in plasma samples collected prior to vaccination to generate hypotheses as to the biological mechanism underpinning the AE reported.

Results

A total of 423 vaccines were administered to 173 participants over four influenza seasons (2019-22) and gender data were available for 339 of these vaccinations (2020-22). At least one AE was reported following 105 vaccinations (25%), by 23 males and 82 females. The majority of AE occurred at the site of injection, were mild, and transient. The odds of experiencing an AE were 3-fold greater in females than males and decreased with age to a greater extent in females than males. The effects of gender, however, were not statistically significant, supporting a central role of biological sex in the occurrence of AE. In males, estradiol was significantly associated with IL-6 and with the probability of experiencing an AE. Both associations were absent in females, suggesting a sex-specific effect of estradiol on the occurrence of AE that supports the finding of a biological sex difference.

Conclusions

These data support a larger role for biological sex than for gender in the occurrence of AE following influenza vaccination in older adults and provide an initial investigation of hormonal mechanisms that may mediate this sex difference. This study highlights the complexities of measuring gender and the importance of assessing AE separately for males and females to better understand how vaccination strategies can be tailored to different subsets of the population.
“When there is no money, that is when I vomit blood”: the domino effect and the unfettered lethal exploitation of Black labor on Dominican sugar plantations
Authors: Wilson Brenda K.
Published: August 2023

Background

In this article, I utilize the concept of the Plantationocene as an analytical framework to generate a holistic and historical understanding of the present-day struggles of a mostly Haitian migrant workforce on sugar plantations in the Dominican Republic.

Methods

Inspired by Paul Farmer’s methodology, I combine political economy, history, and ethnography approaches to interpret the experiences of sugarcane cutters across historical and contemporary iterations of colonial, post-colonial, and neo-colonial practices over the course of five centuries.

Results

My findings elucidate the enduring power of capitalism, implicating corporate and state elites, as the structural scaffolding for acts of racialized violence that condition the life-and-death circumstances of Black laborers on Caribbean plantations to this day. Although today’s sugarcane cutters may suffer differently than their enslaved or wage labor ancestors on the plantation, I argue that an unfettered racialized pattern of lethal exploitation is sustained through the structural violence of neoliberalism that links present conditions with the colonial past.

Conclusions

Ultimately, this paper contributes understandings of the plantationocene’s enduring effects in the global south by demonstrating how imperialist arrangements of capitalism are not a distant memory from the colonial past but instead are present yet hidden and obscured while relocated and reanimated overseas to countries like the Dominican Republic, where American capitalists still exploit Black bodies for profit and power.