bluuebunny/crossref_metadata_2025 huggingface dataset:
Ability difference or gender symbolism? An empirical research on gender differences in academic career development of doctoral graduates in China
Authors: Ma Liping , Cai Hongbo , Ye Xiaomei , Zhao Shuyi
Published: February 2024

The reform and opening-up of China have greatly improved the scale and quality of doctoral education for women. However, female doctors still face the “leaky pipeline” and the “unbreakable glass ceiling” in their development of academic careers. In this study, gender differences are investigated in doctoral graduates’ career choices, the level of educational institutions they attend, and their scientific research productivity after joining the institution. We analyzed the administrative data and scientific research publication information from ten years of doctoral graduates at a top research university in China. Results suggest that compared to their male counterparts, female doctors are more likely to pursue an academic career upon graduation, but they are also more likely to be employed in lower-level institutions as well as to publish Chinese scientific studies with lower influence and poorer quality. Moreover, gender differences in academic disciplines are heterogeneous. While academic career development for doctors in natural sciences is not gender-biased, female doctors in social sciences face the most significant challenges, and these results persist even after controlling for their scientific publications during graduate school. In other words, gender differences in academic career development are likely to result from gender symbols rather than differences in academic ability.
Robotics in Massage: A Systematic Review
Authors: Yang Juan , Lim Kia Hui , Mohabbat Arya B. , Fokken Shawn C. , Johnson Devan E. , Calva Jason J. , Do Alexander , Mueller Michael R. , Chon Tony Y. , Bauer Brent A.
Published: February 2024

Background

Over the past few years, a growing number of studies have explored massage robots. However, to date, a dedicated systematic review focused solely on robot-assisted massage has not been conducted.

Objective

To systematically identify and summarize evidence from studies concerning robot-assisted massage in healthcare settings.

Methods

An extensive literature search, involving electronic databases Ovid and Scopus, was conducted from the inception of the databases up to March 2023. This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, and relevant papers were chosen based on the predefined inclusion criteria. Given the substantial methodological diversity among the included studies, a qualitative analysis was conducted.

Results

Seventeen studies met the inclusion criteria, comprising 15 preliminary trials, one quasi-experimental study, and one randomized controlled trial. Approximately 29% of the studies focused on the application of robotic massage for patients, 24% targeted both healthy volunteers and patients, and the remaining 47% were preclinical trials assessing the effectiveness of robotic massage solely on healthy volunteers. Primary interventions included robotic massage for oral rehabilitation, scalp massage, low back massage, shoulder massage, and full-body massage. All studies provided evidence that robotic massage interventions can enhance health and well-being, indicating a promising future for the integration of robotics in the field of massage therapy.

Conclusions

In general, robotic massage interventions offer physical and mental health benefits. Robot-assisted massage may be integrated into care provision as an adjunct to enhance human well-being. Nonetheless, further research is needed to confirm these findings.
Use of Fibula Nails With Proximal and Distal Fixation
Authors: Rodriguez-Materon Solangel , Trynz Samantha , Fanfan Dino , Fleites Jorge , Gil Jorge , Hodgkins Christopher
Published: February 2024

Background:

Ankle fractures are a frequent injury in the adult population and a quarter of all ankle fractures are classified as unstable, requiring surgical intervention. Plate-and-screw construct is the traditionally used fixation method for fibula fractures. The use of an intramedullary nail is an alternative fixation method, with current literature supporting very low complication rates and hardware removal surgeries. The purpose of this study was to evaluate the outcomes, including complication rates and implant removal rates, using a fibula nail with both proximal and distal fixation capabilities by an experienced surgeon.

Methods:

We retrospectively reviewed 203 consecutive fibula nail cases from a single surgeon using a mini-open technique for anatomic reduction. Demographic, operative, clinical, and radiographic outcome data were analyzed, specifically examining complication rates and need for implant removal.

Results:

The average follow-up was 18.8 months (6-54 months). All fractures healed. We identified 2 cases of superficial wound infection, 1 superficial peroneal nerve irritation, and 1 case of implant removal. In the first 110 cases, 2 fractures were converted to a plate intraoperatively prior to a technique modification which has prevented this occurrence. No deep infection, delayed union, or nonunion occurred.

Conclusion:

Our data support that fibula nails with proximal and distal locking capabilities offer an alternative to plating with the potential for lower complication rates and lower need for implant removal.

Level of evidence:

Level IV, case series.
The PEP++ study protocol: a cluster-randomised controlled trial on the effectiveness of an enhanced regimen of post-exposure prophylaxis for close contacts of persons affected by leprosy to prevent disease transmission
Authors: Hinders Duane C. , Taal Anneke T. , Lisam Suchitra , da Rocha Aymée M. , Banstola Nand Lal , Bhandari Prativa , Saha Abhijit , Kishore Jugal , Fernandes Virginia O. , Chowdhury Abu Sufian , van ‘t Noordende Anna T. , Mieras Liesbeth , Richardus Jan Hendrik , van Brakel Wim H.
Published: February 2024

Background

Leprosy is an infectious disease with a slow decline in global annual caseload in the past two decades. Active case finding and post-exposure prophylaxis (PEP) with a single dose of rifampicin (SDR) are recommended by the World Health Organization as measures for leprosy elimination. However, more potent PEP regimens are needed to increase the effect in groups highest at risk (i.e., household members and blood relatives, especially of multibacillary patients). The PEP++ trial will assess the effectiveness of an enhanced preventive regimen against leprosy in high-endemic districts in India, Brazil, Bangladesh, and Nepal compared with SDR-PEP.

Methods

The PEP++ study is a cluster-randomised controlled trial in selected districts of India, Brazil, Bangladesh, and Nepal. Sub-districts will be allocated randomly to the intervention and control arms. Leprosy patients detected from 2015 − 22 living in the districts will be approached to list their close contacts for enrolment in the study. All consenting participants will be screened for signs and symptoms of leprosy and tuberculosis (TB). In the intervention arm, eligible contacts receive the enhanced PEP++ regimen with three doses of rifampicin (150 − 600 mg) and clarithromycin (150 − 500 mg) administered at four-weekly intervals, whereas those in the control arm receive SDR-PEP. Follow-up screening for leprosy will be done for each individual two years after the final dose is administered. Cox’ proportion hazards analysis and Poisson regression will be used to compare the incidence rate ratios between the intervention and control areas as the primary study outcome.

Discussion

Past studies have shown that the level of SDR-PEP effectiveness is not uniform across contexts or in relation to leprosy patients. To address this, a number of recent trials are seeking to strengthen PEP regimens either through the use of new medications or by increasing the dosage of the existing ones. However, few studies focus on the impact of multiple doses of chemoprophylaxis using a combination of antibiotics. The PEP++ trial will investigate effectiveness of both an enhanced regimen and use geospatial analysis for PEP administration in the study communities.

Trial registration

NL7022 on the Dutch Trial Register on April 12, 2018. Protocol version 9.0 updated on 18 August 2022 https://www.onderzoekmetmensen.nl/en/trial/23060
Evaluation of characteristics and prognosis of COVID-19 patients requiring invasive mechanical ventilation during dominance of nonvariant, alpha, delta, and omicron variants in tertiary hospitals of Japan
Authors: Sakuramoto Kazuhito , Wada Daiki , Maruyama Shuhei , Muroya Takashi , Saito Fukuki , Nakamori Yasushi , Kuwagata Yasuyuki
Published: February 2024

Background

In November 2021, the B.1.1.529 (omicron) variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was detected in South Africa and subsequently rapidly spread around the world. Despite the reduced severity of the omicron variants, many patients become severely ill after infection and undergo invasive mechanical ventilation, but there are few reports on their background and prognosis throughout all variant periods. This study aimed to evaluate risk factors affecting patients requiring invasive mechanical ventilation with each variant of COVID-19 pandemic in Japan from nonvariants to omicron variants.

Method

This retrospective observational study was conducted at the Department of Emergency and Critical Care Medicine, Kansai Medical University Hospital and Kansai Medical University Medical Center, Osaka, Japan, from March 2020 to March 2023. Eligible patients were those who underwent invasive ventilation for COVID-19 pneumonia. We set the primary endpoint as in-hospital mortality. Multivariable logistic regression analysis adjusted for clinically important variables was performed to evaluate the clinical outcomes.

Results

We included 377 patients: 118 in the Nonvariant group, 154 in the Alpha group, 42 in the Delta group, and 63 patients in the Omicron group. Mortality rates for each group were 23.7% for the Nonvariant group, 12.3% for the Alpha group, 7.1% for the Delta group, and 30.5% for the Omicron group. Patient age was significantly associated with increased mortality (adjusted odds ratio [AOR]: 1.097; 95% confidence interval [CI]: 1.057–0.138, P < 0.001). Immunodeficiency (AOR: 3.388, 95% CI: 1.377–8.333, P = 0.008), initial SOFA score (AOR: 1.190, 95% CI: 1.056–1.341, P = 0.004), dialysis prior to COVID-19 (AOR: 3.695, 95% CI: 1.117–11.663, P = 0.026), and smoking history (AOR: 2.548, 95% CI: 1.153–5.628, P = 0.021) were significantly associated with increased mortality. Differences in variants were not significant factors associated with high mortality.

Conclusion

We compared the background and prognosis of patients with COVID-19 pneumonia requiring invasive mechanical ventilation between SARS-CoV-2 variants. In these patients, differences in variants did not affect prognosis. Hospital mortality in critically ill COVID-19 patients was significantly higher in the older patients with bacterial coinfection, or patients with immunodeficiency, COPD, and chronic renal failure on dialysis.
PPARG activation promotes the proliferation of colorectal cancer cell lines and enhances the antiproliferative effect of 5-fluorouracil
Authors: Schöckel Leah , Woischke Christine , Surendran Sai Agash , Michl Marlies , Schiergens Tobias , Hölscher Andreas , Glass Florian , Kreissl Peter , Klauschen Frederick , Günther Michael , Ormanns Steffen , Neumann Jens
Published: February 2024

Background

Peroxisome proliferator-activated receptor gamma (PPARG) is a member of the nuclear receptor family. It is involved in the regulation of adipogenesis, lipid metabolism, insulin sensitivity, vascular homeostasis and inflammation. In addition, PPARG agonists, known as thiazolidinediones, are well established in the treatment of type 2 diabetes mellitus. PPARGs role in cancer is a matter of debate, as pro- and anti-tumour properties have been described in various tumour entities. Currently, the specific role of PPARG in patients with colorectal cancer (CRC) is not fully understood.

Material and methods

The prognostic impact of PPARG expression was investigated by immunohistochemistry in a case-control study using a matched pair selection of CRC tumours (n = 246) with either distant metastases to the liver (n = 82), lung (n = 82) or without distant metastases (n = 82). Its effect on proliferation as well as the sensitivity to the chemotherapeutic drug 5-fluorouracil (5-FU) was examined after activation, inhibition, and transient gene knockdown of PPARG in the CRC cell lines SW403 and HT29.

Results

High PPARG expression was significantly associated with pulmonary metastasis (p = 0.019). Patients without distant metastases had a significantly longer overall survival with low PPARG expression in their tumours compared to patients with high PPARG expression (p = 0.045). In the pulmonary metastasis cohort instead, a trend towards longer survival was observed for patients with high PPARG expression in their tumour (p = 0.059). Activation of PPARG by pioglitazone and rosiglitazone resulted in a significant dose-dependent increase in proliferation of CRC cell lines. Inhibition of PPARG by its specific inhibitor GW9662 and siRNA-mediated knockdown of PPARG significantly decreased proliferation. Activating PPARG significantly increased the CRC cell lines sensitivity to 5-FU while its inhibition decreased it.

Conclusion

The prognostic effect of PPARG expression depends on the metastasis localization in advanced CRC patients. Activation of PPARG increased malignancy associated traits such as proliferation in CRC cell lines but also increases sensitivity towards the chemotherapeutic agent 5-FU. Based on this finding, a combination therapy of PPARG agonists and 5-FU-based chemotherapy constitutes a promising strategy which should be further investigated.
Barriers to cervical cancer screening in Africa: a systematic review
Authors: Mantula Fennie , Toefy Yoesrie , Sewram Vikash
Published: February 2024

Introduction

Africa has one of the highest burdens of cervical cancer in the world. The unacceptably high incidence and mortality rates could be reduced through implementing a comprehensive approach to its prevention and control that includes screening, which however, is low in most low-and-middle-income countries. Hence, this systematic review aims at exploring factors that prevent women from utilising cervical cancer screening services in the region.

Methods

A mixed method systematic review was conducted. A search was performed on PubMed (Medline), EMBASE, CINAHL (EBSCOHOST) and Scopus databases for articles published until May 2019 without time, language or study design limits. Two reviewers critically appraised the included studies independently using the standard quality assessment criteria for evaluating primary research papers. Results of the quantitative and mixed methods studies were transformed into qualitative data and synthesised using thematic analysis.

Results

From a potential 2 365 studies, 24 from 11 countries met the eligibility criteria and were selected; eight qualitative, 13 quantitative, and three that used the mixed-method approach. The primary barriers were identified as poor access to screening services, lack of awareness and knowledge on cervical cancer and screening, and socio-cultural influences. Service providers perceived lack of skills, screening equipment and supplies, and staff shortages as the major barriers to the provision of screening services.

Conclusion

Barriers to cervical cancer screening in Africa are multifaceted and require a holistic approach that will address them concurrently at the health system, individual, interpersonal, community and structural levels. Political will complimented by stakeholder involvement is required in the development and implementation of strategies that will ensure acceptability, availability, accessibility, and affordability of screening to minimise barriers in accessing the service.
Risks and protection: a qualitative study on the factors for internet addiction among elderly residents in Southwest China communities
Authors: Wang Dan , Liu Xinyi , Chen Kun , Gu Chunyan , Zhao Hongyan , Zhang Yong , Luo Yu
Published: February 2024

Background

In the global trend of actively promoting the participation of older adults in the digital age, the relevant negative issues featuring potential Internet Addiction (IA) among them has risen to be a new challenge facing the global public health. However, there is a severe lack of related research. This study aimed to gain a comprehensive understanding of the phenomenon and process of IA among the elderly. The purpose of this paper is to introduce factors that may influence IA in the demographic.

Methods

This study employed qualitative descriptive research methods to investigate older adults’ perceptions and experiences of IA. Semi-structured in-depth personal interviews were conducted between March and June 2023 with 36 senior citizens from urban communities in Chongqing, Southwest China. Data were analyzed via inductive content analysis methods.

Results

Through data analysis, 2 main categories concerning IA in older adults were identified: risk factors and protective factors. The risk factor categories include 5 individual factors (e.g., Internet as the major avenue for pursuing personal hobbies and interests, etc.), 3 family factors (e.g., household WIFI increasing the risk of prolonged Internet use indoors, etc.), 2 peer factors (e.g., peer recommendation and guidance as catalysts for intensified Internet engagement, etc.), 2 socio-environmental factors (e.g., the widespread daily Internet use spurs offline intolerance, etc.), and 3 Internet platform factors (e.g., the plenitude of online content triggers endless viewing/browsing behaviors, etc.). The category of protective factors encompasses 2 individual factors (e.g., a higher level of perceived risk regarding internet health hazards, etc.) and 2 family factors (e.g., more family commitment, etc.).

Conclusions

Older adults’ Internet addictive behaviors are shaped by multiple and complex internal and external factors. A higher level of online health risk perception is a key protective factor to effectively avoid the occurrence and deterioration of IA among the aged, a distinct finding from this study. It is believed that the “individual-family-peer-community” synergy strategy is expected to become an essential direction for IA intervention for older adults, in order to promote healthy Internet use among older adults.
National and regional prevalence of gestational diabetes mellitus in India: a systematic review and Meta-analysis
Authors: Mantri Neha , Goel Akhil Dhanesh , Patel Mamta , Baskaran Pritish , Dutta Gitashree , Gupta Manoj Kumar , Yadav Vikas , Mittal Madhukar , Shekhar Shashank , Bhardwaj Pankaj
Published: February 2024

Background

Gestational diabetes mellitus (GDM) is frequently misdiagnosed during pregnancy. There is an abundance of evidence, but little is known regarding the regional prevalence estimates of GDM in India. This systematic review and meta-analysis aims to provide valuable insights into the national and regional prevalence of GDM among pregnant women in India.

Methods

We conducted an initial article search on PubMed, Scopus, Google Scholar, and ShodhGanga searches to identify quantitative research papers (database inception till 15th June,2022). This review included prevalence studies that estimated the occurrence of GDM across different states in India.

Results

Two independent reviewers completed the screening of 2393 articles, resulting in the identification of 110 articles that met the inclusion criteria, which collectively provided 117 prevalence estimates. Using a pooled estimate calculation (with an Inverse square heterogeneity model), the pooled prevalence of GDM in pregnant women was estimated to be 13%, with a 95% confidence interval (CI) ranging from 9 to 16%.. In India, Diabetes in Pregnancy Study of India (DIPSI) was the most common diagnostic criteria used, followed by International Association of Diabetes and Pregnancy Study Groups (IADPSG) and World Health Organization (WHO) 1999. It was observed that the rural population has slightly less prevalence of GDM at 10.0% [6.0–13.0%, I2=96%] when compared to the urban population where the prevalence of GDM was 12.0% [9.0–16.0%, I2 = 99%].

Conclusions

This review emphasizes the lack of consensus in screening and diagnosing gestational diabetes mellitus (GDM), leading to varied prevalence rates across Indian states. It thoroughly examines the controversies regarding GDM screening by analyzing population characteristics, geographic variations, diagnostic criteria agreement, screening timing, fasting vs. non-fasting approaches, cost-effectiveness, and feasibility, offering valuable recommendations for policy makers. By fostering the implementation of state-wise screening programs, it can contribute to improving maternal and neonatal outcomes and promoting healthier pregnancies across the country.
Perception, sentiments, and the level of awareness toward the dental implant among general population in Sulaimaniyah City, Iraq
Authors: Amin Nzar Abdulqadr Muhammed
Published: February 2024

Background

Edentulism is one of the most commonly encountered conditions affecting the oral cavity. Dental implants have emerged as a widely accepted treatment option prosthodontically. However, lack of public awareness and the cost of the treatment act as barriers to limit their applicability.

Objectives

To investigate the perception, sentiments, and level of awareness toward dental implants among the general population in Sulaimaniyah City, Iraq.

Materials and methods

A questionnaire-based survey was conducted on 1132 participants in Sulaimaniyah City, Iraq, from February 15, 2023, till August 15, 2023, to collect their sociodemographic data, knowledge and attitudes toward dental implants for their missing tooth/teeth.

Results

The mean age of participants was 41.3 ± 14.6 years, and most (30.7%) belong to the age group 31–44 years. Also, most of them were males (63.6%), married (75.3%), educated (91.3%), from rural areas (82.3%), and had > 1 missing tooth (75%). Regarding the participants’ knowledge of dental implants, most had information (78.4%)/heard about it (83.3%), mainly from dentists (43.6%); however, least of them (21.5%) /their family members (43%) had replaced missing teeth by dental implants. Additionally, the participant’s attitudes toward the dental implant indicated that most of them were interested in replacing their missing teeth (88.8%) but did not do it due to financial reasons (87%) and considered replacement as a significant (92.5%) and safe process (79.2%). Also, most of them thought there was no substantial difference between artificial and natural tooth appearance/function (47.9%), preferred the delayed implant for dental implant (47.7%), and would like to do an implant due to problems in dental appearance, speech, or dental function (81.5%). Finally, significant/highly significant differences were seen between each participant’s factor (age, gender, marital status, education level, and residency) with most items of attitude/awareness toward dental implants.

Conclusions

Most participants were aware of the knowledge and attitude of dental implants for replacing missing tooth/teeth, especially males, married ones, educated individuals, and those from urban areas; however, financial problems are the main obstacle. Additionally, the delayed implant is preferable for replacing missing tooth/teeth using dental implants among studied individuals.
Psychometric evaluation of the endometriosis impact questionnaire (EIQ) in an Iranian population
Authors: Mirghafourvand Mojgan , Ghavami Vahid , Moradi Maryam , Najmabadi Khadijeh Mirzaii , Mollazadeh Sanaz
Published: February 2024

Background

Endometriosis is a benign and chronic gynecological estrogen-dependent disease. Considering the prevalence and the importance of measuring the long-term effects of endometriosis in affected women’s lives t the EIQ scale was designed and psychometrically analyzed in English in Australia, in three recall periods (last 12 months, 1 to 5 years ago and more than 5 years ago). It has never been used in Iran and its validity and reliability have not been assessed either. Therefore, the present study aimed to translate and investigate the psychometric properties of the EIQ.

Methods

In this study, 200 women were selected through random sampling in 2022. After forward and backward translation, the face validity, content validity, and construct validity of EIQ (through Corrected Item-Total Correlation) were examined. To assess the reliability of the scale, both internal consistency (Cronbach’s alpha) and test-retest stability methods were employed.

Results

Impact Score with a score above 1.5 was approved. CVI and CVR values of the EIQ tool were 0.97 and 0.94, respectively. The Item to total Correlation confirmed the construct validity of all seven dimensions of the tool, more than the cut-off (0.3) except lifestyle. Cronbach’s alpha coefficient and Intra Correlation Coefficient (ICC) were acceptable for all dimensions.

Conclusion

The Persian version of EIQ is a valid and reliable scale. This tool is valid and reliable for investigating the long-term impact of endometriosis in Iranian society.
E-learning in medical education: a perspective of pre-clinical medical students from a lower-middle income country
Authors: Abbas Uzair , Parveen Memoona , Sahito Falak Sehar , Hussain Niaz , Munir Sundas
Published: February 2024

Background

Many of the educational institutions in developed countries have shifted to online learning. While transition from traditional to electronic learning (e-learning) has remained a great challenge in low-middle income countries, where limited resources for teaching and learning are important factors. Medical education involves not only lecturing but also deep understanding through laboratories and patient exposure. The debate about the effectiveness of e-learning in medical education is still in contradiction due to its limitations. This cross-sectional survey was conducted to assess pre-clinical undergraduate medical students’ perception of their first online learning in a lower-middle income country.

Methodology

The survey was conducted among the students who had participated in online learning during COVID-19 for at least a year. A total of 824 preclinical medical students who completed the survey from public and private medical universities in Sindh, Pakistan were included in the study. We used a validated online-based questionnaire, distributed through E-mail and social media platforms to assess the perception of students regarding their first online learning experience.

Results

The response rate of the survey was 87.9%. The mean age of students was 20.7 ± 3.8 years. 392/824 (47%) were males and 57% were females. Our study indicated that 613/824 (75%) of students were experiencing online learning for the very first time while 631/824 (77%) were facing technical issues like internet accessibility and lack of IT-related skills. 381/824 (46%) were not satisfied with the institute’s readiness for online teaching. However, 79% (654/824) of participants were of the idea that traditional learning is more effective in developing their practical skills as compared to e-learning. Of note, 668/824 (81%) showed overall dissatisfaction with e-learning.

Conclusion

Based on our study findings, we concluded that most students have a negative perception of e-learning. Difficulty in connectivity, electricity issues, less interaction with colleagues and teachers, and issues with the structure of online courses were the most frequently reported problems by the students.
Effect of digital based nursing intervention on knowledge of self-care behaviors and self-efficacy of adult clients with diabetes
Authors: Shaban Marwa Mamdouh , Sharaa Heba Magdy , Amer Fatma Gomaa Mohamed , Shaban Mostafa
Published: February 2024

Background

In recent years, there has been growing interest in the use of Digital Based Nursing Intervention to support diabetes management. This study aimed to evaluate the effect of digital based nursing intervention on knowledge of self-care behaviors and self-efficacy of clients with diabetes.

Methods

Employing a quasi-experimental design, a sample of 120 adult participants diagnosed with type 2 diabetes, aged more than 18 years with focus on older adults was drawn from outpatient clinics at Cairo University Hospital. The intervention was approved and registered by the ethical committee of the faculty of nursing with IRB number: RHDIRB2019041701. The intervention group (n = 60) received a digital-based nursing intervention, while the control group (n = 60) received standard care. Data were collected using adopted standardized tools including the Diabetes Knowledge Test, the Diabetes Self-Efficacy Scale, and the Summary of Diabetes Self-Care Activities. Demographic characteristics were analyzed, and pre- and post-intervention scores were compared using paired t-tests were statistical methods.

Results

The digital-based nursing intervention resulted in significant enhancements in participants with diabetes knowledge and self-efficacy levels. Moreover, the intervention group demonstrated marked improvements in various self-care behaviors encompassing diet, exercise, medication adherence, blood glucose testing, and foot care. While the control group also exhibited some progress, the effects were less pronounced. Regression analyses highlighted age as a consistent factor associated with knowledge, self-efficacy, and specific self-care behaviors.

Conclusion

This study underscores the potential of tailored digital nursing interventions to complement traditional care approaches, empowering patients with type 2 diabetes to actively engage in self-management. The findings suggest that digital-based nursing interventions hold promise for enhancing patient knowledge, confidence, and proactive health behaviors. Nevertheless, limitations, including the relatively short intervention duration and a sample from a single clinic, warrant consideration. Future research should address these limitations to bolster the validity and applicability of the study’s conclusions.
Efficacy of interventions targeted at physician prescribers of opioids for chronic non-cancer pain: an overview of systematic reviews
Authors: Peri Katya , Honeycutt Lucy , Wennberg Erica , Windle Sarah B. , Filion Kristian B. , Gore Genevieve , Kudrina Irina , Paraskevopoulos Elena , Moiz Areesha , Martel Marc O. , Eisenberg Mark J.
Published: February 2024

Background

To combat the opioid crisis, interventions targeting the opioid prescribing behaviour of physicians involved in the management of patients with chronic non-cancer pain (CNCP) have been introduced in clinical settings. An integrative synthesis of systematic review evidence is required to better understand the effects of these interventions. Our objective was to synthesize the systematic review evidence on the effect of interventions targeting the behaviours of physician opioid prescribers for CNCP among adults on patient and population health and prescriber behaviour.

Methods

We searched MEDLINE, Embase, and PsycInfo via Ovid; the Cochrane Database of Systematic Reviews; and Epistemonikos. We included systematic reviews that evaluate any type of intervention aimed at impacting opioid prescriber behaviour for adult CNCP in an outpatient setting.

Results

We identified three full texts for our review that contained 68 unique primary studies. The main interventions we evaluated were structured prescriber education (one review) and prescription drug monitoring programmes (PDMPs) (two reviews). Due to the paucity of data available, we could not determine with certainty that education interventions improved outcomes in deprescribing. There is some evidence that PDMPs decrease the number of adverse opioid-related events, increase communication among healthcare workers and patients, modify healthcare practitioners’ approach towards their opioid prescribed patients, and offer more chances for education and counselling.

Conclusions

Our overview explores the possibility of PDMPs as an opioid deprescribing intervention and highlights the need for more high-quality primary research on this topic.
Characteristics and clinical treatment outcomes of chronic hepatitis B children with coexistence of hepatitis B surface antigen (HBsAg) and antibodies to HBsAg
Authors: Gu Yingping , Li Shuangjie , Yao Zhenzhen , Lai Xin , Yang Meng , Xu Yi , Peng Songxu
Published: February 2024

Background

The coexistence of hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody (HBsAb) represents an uncommon serological pattern observed in patients with hepatitis B virus (HBV) infection, and its underlying mechanism and clinical significance have not been well established. The aim of this study was to investigate the association between this serological profile and clinical treatment outcomes in children with chronic hepatitis B (CHB).

Methods

This retrospective cohort study included 372 treatment-naïve CHB children from the Hunan Children’s Hospital. The participants were categorized into HBsAb-positive group and HBsAb-negative group. The associations between HBsAb positive status to clinical outcomes were assessed using Cox proportional hazard regression. Receiver operating characteristic curve was conducted to evaluate the prediction ability in HBsAg loss.

Results

The coexistence of HBsAg and HBsAb accounted for 23.39% (87/372) of the participants. The crude incidence rates of HBsAg loss, hepatitis B e antigen (HBeAg) clearance, and HBV-DNA undetectability were higher in the HBsAb-positive group compared with the HBsAb-negative group (37.46 vs. 17.37, 49.51 vs. 28.66, 92.11 vs. 66.54 per 100 person-years, respectively, all P < 0.05). The Cox regression analysis revealed a significant association between this serological profile and an increased likelihood of HBsAg loss (HR = 1.78, P = 0.001), and HBeAg clearance (HR = 1.78, P = 0.001). In addition, a combination of HBsAb ≥ 0.84 log10 IU/L and age ≤ 5 years can help identify patients likely to achieve HBsAg loss after antiviral therapy, with an AUC of 0.71.

Conclusions

Children who are positive for both HBsAg and HBsAb demonstrate a higher probability of favorable outcomes after antiviral treatment. Thus, children with HBsAb-positive CHB should be actively treated to achieve functional cure.
Identification of functional genes in liver fibrosis based on bioinformatics analysis of a lncRNA-mediated ceRNA network
Authors: Zhang Feng , Pei Siya , Xiao Meifang
Published: February 2024

Background

Liver fibrosis is a major global healths problem; nevertheless, its molecular mechanism are not completely clear. This study aimed to build a lncRNA-miRNA-mRNA network, identify potentially related lncRNAs, and explore the pathogenesis of liver fibrosis.

Materials and methods

We used the Gene Expression Omnibus databases and bioinformatics analysis to identify differentially expressed genes (DEGs) between liver fibrosis and normal tissues. The ceRNA network was constructed according to the interactions between DElncRNA, miRNA, and DEmRNA. Then, these DEGs were identified using functional enrichment analysis, and a protein–protein interaction (PPI) network was established. The critical lncRNAs were verified using the quantitative real-time polymerase chain reaction (qRT-PCR).

Results

The ceRNA network was composed of three lncRNAs, five miRNAs, and 93 mRNAs. Gene Ontology functional enrichment analysis revealed significant enhancement in cell components, molecular function, and biological process. Kyoto Encyclopedia of Genes and Genomes pathway analysis revealed pathways associated with transcriptional misregulation in cancer, including the Rap1 signaling pathway, proteoglycans in cancer, mineral absorption, HTLV-l infection, and central carbon metabolism in cancer. According to the PPI network and the GSE84044 database, seven hub genes associated with liver fibrosis were identified. In addition, qRT-PCR revealed that lncRNA AC100861 (lncRNA TNFRSF10A-DT) was explicitly decreased in liver fibrosis tissues and activated hepatic stellate cells.

Conclusions

In summary, this study preliminarily found that lncRNA TNFRSF10A-DT may be a biomarker for the diagnosis and outcome of liver fibrosis. We uncovered a novel lncRNA-mediated ceRNA regulatory mechanism in the pathogenesis of liver fibrosis.
Associations of the triglyceride-glucose index and atherogenic index of plasma with the severity of new-onset coronary artery disease in different glucose metabolic states
Authors: Wu Xiaosheng , Qiu Weiping , Yang Huancheng , Chen Yan-Jun , Liu Jianling , Zhao Guojun
Published: February 2024

Background

The triglyceride-glucose (TyG) index is considered a dependable biomarker for gauging insulin resistance. The atherogenic index of plasma (AIP) represents a marker reflecting atherosclerosis. However, there is currently no study specifically exploring the associations of these two biomarkers with the severity of new-onset coronary artery disease (CAD) under different glucose metabolic states. Therefore, this study aims to evaluate the correlations of these two biomarkers with CAD severity in patients newly diagnosed with CAD under various glucose metabolism conditions.

Method

Totally 570 subjects first administered coronary angiography were enrolled, including 431 first diagnosed CAD patients and 139 non-CAD patients. CAD severity  was gauged by the quantity of narrowed arteries (single-vessel and multi-vessel CAD). According to WHO diabetes guidelines, glucose metabolic states were divided into normal glucose regulation (NGR), pre-diabetes mellitus (Pre-DM), and diabetes mellitus (DM). The relationships of the TyG index and AIP with CAD severity were validated by logistic regression analysis, including adjustment for traditional cardiovascular risk elements and medical treatments. Their predictive efficacy for CAD was evaluated by receiver operating characteristic (ROC) curves.

Result

The TyG index and AIP were independently correlated with CAD in accordance with logistic regression analysis (both P < 0.05). Regardless of the glucose metabolic states, there was no statistical correlation between the TyG index and CAD severity. However, AIP in NGR patients was significantly related to CAD severity (P < 0.05). The areas under the curve of the TyG index and AIP for predicting CAD were 0.682 and 0.642 (both P < 0.001), respectively, and their optimal cut-off values were 3.210 (Youden index: 0.305) and 0.095 (Youden index:0.246), respectively.

Conclusion

The TyG index and AIP have significant associations with CAD. The TyG index had no association with CAD severity, regardless of glucose metabolic states. AIP exhibited a discernible link with CAD severity in NGR patients, but not in the pre-DM or DM populations. The TyG index and AIP have similar predictive values for new-onset CAD.
Intelligent systems for sitting posture monitoring and anomaly detection: an overview
Authors: Vermander Patrick , Mancisidor Aitziber , Cabanes Itziar , Perez Nerea
Published: February 2024

The number of people who need to use wheelchair for proper mobility is increasing. The integration of technology into these devices enables the simultaneous and objective assessment of posture, while also facilitating the concurrent monitoring of the functional status of wheelchair users. In this way, both the health personnel and the user can be provided with relevant information for the recovery process. This information can be used to carry out an early adaptation of the rehabilitation of patients, thus allowing to prevent further musculoskeletal problems, as well as risk situations such as ulcers or falls. Thus, a higher quality of life is promoted in affected individuals. As a result, this paper presents an orderly and organized analysis of the existing postural diagnosis systems for detecting sitting anomalies in the literature. This analysis can be divided into two parts that compose such postural diagnosis: on the one hand, the monitoring devices necessary for the collection of postural data and, on the other hand, the techniques used for anomaly detection. These anomaly detection techniques will be explained under two different approaches: the traditional generalized approach followed to date by most works, where anomalies are treated as incorrect postures, and a new individualized approach treating anomalies as changes with respect to the normal sitting pattern. In this way, the advantages, limitations and opportunities of the different techniques are analyzed. The main contribution of this overview paper is to synthesize and organize information, identify trends, and provide a comprehensive understanding of sitting posture diagnosis systems, offering researchers an accessible resource for navigating the current state of knowledge of this particular field.
Misfolded protein oligomers: mechanisms of formation, cytotoxic effects, and pharmacological approaches against protein misfolding diseases
Authors: Rinauro Dillon J. , Chiti Fabrizio , Vendruscolo Michele , Limbocker Ryan
Published: February 2024

The conversion of native peptides and proteins into amyloid aggregates is a hallmark of over 50 human disorders, including Alzheimer’s and Parkinson’s diseases. Increasing evidence implicates misfolded protein oligomers produced during the amyloid formation process as the primary cytotoxic agents in many of these devastating conditions. In this review, we analyze the processes by which oligomers are formed, their structures, physicochemical properties, population dynamics, and the mechanisms of their cytotoxicity. We then focus on drug discovery strategies that target the formation of oligomers and their ability to disrupt cell physiology and trigger degenerative processes.
Diuresis and α-glucosidase inhibition by erythritol in Aedes aegypti (Diptera: Culicidae) and viability for efficacy against mosquitoes
Authors: Nelson Irvane E. , Baker Kobi A. , Faraji Ary , White Gregory S. , Bibbs Christopher S.
Published: February 2024

Background

Sugar alcohols, such as erythritol, are low-impact candidates for attractive toxic sugar baits (ATSB) to kill mosquitoes. To determine whether erythritol has a viable future in ATSB formulations, a suite of assays was conducted to diagnose toxicity mechanisms and starvation effects on mortality in Aedes aegypti (L.) as a model system.

Methods

We measured general carbohydrate load, glucosidase levels, and free glucose in intoxicated adult mosquitoes to observe whether sugar digestion was impaired. We assayed the effects of sugar combinations with erythritol on larvae and adults. To measure erythritol effects when mosquitoes were not resource-deprived, additional assays manipulated the prior starvation status.

Results

Up to 50,000 ppm of erythritol in water had no effect on larvae within 72 h, but an ammonia spike indicated diuresis in larvae as early as 4 h (F8,44 = 22.50, P < 0.0001) after sucrose/erythritol combinations were added. Adult consumption of erythritol was diuretic regardless of the sugar pairing, while sucrose and erythritol together generated above 80% mortality (F2,273 = 33.30, P < 0.0001) alongside triple the normal excretion (F5,78 = 26.80, P < 0.0004). Glucose and fructose paired individually with erythritol had less mortality, but still double the fecal excretion. When ingesting erythritol-laced meals, less sugar was detected in mosquitoes as compared to after sucrose meals (χ2 = 12.54, df = 1, P = 0.0004).

Conclusions

Data showed that erythritol is a linear competitive inhibitor of α-glucosidase, marking it as a novel class of insecticide in the current research climate. However, the efficacy on larvae was null and not persistent in adult mosquitoes when compared across various starvation levels. Despite significant diuresis, the combined effects from erythritol are not acute enough for vector control programs considering ATSB against mosquitoes.

Graphical Abstract
Single-cell RNA sequencing of submandibular gland reveals collagen type XV-positive fibroblasts as a disease-characterizing cell population of IgG4-related disease
Authors: Tanaka Shigeru , Yamamoto Takuya , Iwata Arifumi , Kiuchi Masahiro , Kokubo Kota , Iinuma Tomohisa , Sugiyama Takahiro , Hanazawa Toyoyuki , Hirahara Kiyoshi , Ikeda Kei , Nakajima Hiroshi
Published: February 2024

Objectives

IgG4-related disease (IgG4-RD) is a systemic autoimmune disease with an unknown etiology, affecting single/multiple organ(s). Pathological findings include the infiltration of IgG4-producing plasma cells, obliterative phlebitis, and storiform fibrosis. Although immunological studies have shed light on the dysregulation of lymphocytes in IgG4-RD pathogenesis, the role of non-immune cells remains unclear. This study aimed to investigate the demographics and characteristics of non-immune cells in IgG4-RD and explore potential biomarkers derived from non-immune cells in the sera.

Methods

We conducted single-cell RNA sequence (scRNA-seq) on non-immune cells isolated from submandibular glands of IgG4-RD patients. We focused on fibroblasts expressing collagen type XV and confirmed the presence of those fibroblasts using immunohistochemistry. Additionally, we measured the levels of collagen type XV in the sera of IgG4-RD patients.

Results

The scRNA-seq analysis revealed several distinct clusters consisting of fibroblasts, endothelial cells, ductal cells, and muscle cells. Differential gene expression analysis showed upregulation of COL15A1 in IgG4-RD fibroblasts compared to control subjects. Notably, COL15A1-positive fibroblasts exhibited a distinct transcriptome compared to COL15A1-negative counterparts. Immunohistochemical analysis confirmed a significant presence of collagen type XV-positive fibroblasts in IgG4-RD patients. Furthermore, immune-suppressive therapy in active IgG4-RD patients resulted in decreased serum levels of collagen type XV.

Conclusions

Our findings suggest that collagen type XV-producing fibroblasts may represent a disease-characterizing non-immune cell population in IgG4-RD and hold potential as a disease-monitoring marker.