bluuebunny/crossref_metadata_2025 huggingface dataset:
The Vertical Structure of Internal Lee-Wave-Driven Benthic Mixing Hotspots
Authors: He Ying , Hibiya Toshiyuki
Published: November 2023

In global ocean circulation and climate models, bottom-enhanced turbulent mixing is often parameterized such that the vertical decay scale of the energy dissipation rate ζ is universally constant at 500 m. In this study, using a nonhydrostatic two-dimensional numerical model in the horizontal–vertical plane that incorporates a monochromatic sinusoidal seafloor topography and the Garrett–Munk (GM) background internal wave field, we find that ζ of the internal lee-wave-driven bottom-enhanced mixing is actually variable depending on the magnitude of the steady flow U0, the horizontal wavenumber kH, and the height hT of the seafloor topography. When the steepness parameter (Sp = NhT/U0 where N is the buoyancy frequency near the seafloor) is less than 0.3, internal lee waves propagate upward from the seafloor while interacting with the GM internal wave field to create a turbulent mixing region with ζ that extends farther upward from the seafloor as U0 increases, but is nearly independent of kH. In contrast, when Sp exceeds 0.3, inertial oscillations (IOs) not far above the seafloor are enhanced by the intermittent supply of internal lee-wave energy Doppler-shifted to the near-inertial frequency, which occurs depending on the sign and magnitude of the background IO shear. The composite flow, consisting of the superposition of U0 and the IOs, interacts with the seafloor topography to efficiently generate internal lee waves during the period centered on the time of the composite flow maximum, but their upward propagation is inhibited by the increased IO shear, creating a turbulent mixing region of small ζ.
Unusual Tropical Cyclone Tracks under the Influence of Upper-Tropospheric Cold Low
Authors: Li Han , Yan Ziyu , Peng Melinda , Ge Xuyang , Wang Zhuo
Published: November 2023

Tropical cyclones (TCs) accompanied by an upper-tropospheric cold low (CL) can experience unusual tracks. Idealized simulations resembling observed scenarios are designed in this study to investigate the impacts of a CL on TC tracks. The sensitivity of the TC motion to its location relative to the CL is examined. The results show that a TC follows a counterclockwise semicircle track if initially located east of a CL, while a TC experiences a small southward-looping track, followed by a sudden northward turn if initially located west of a CL. A TC on the west side experiences opposing CL and β steering, while they act in the same direction when a TC is on the east side of CL. The steering flow analyses show that the steering vector is dominated by upper-level flow induced by the CL at an early stage. The influence of CL extends downward and contributes to the lower-tropospheric asymmetric flow pattern of TC. As these two systems approach, the TC divergent outflow erodes the CL. The CL circulation is deformed and eventually merged with the TC when they are close. Since the erosion of CL, the TC motion is primarily related to β gyres at a later stage. The sensitivity of TC motion to the CL depth is also examined. TCs located west of a CL experience a westward track if the CL is shallow. In contrast, TCs initially located east of a CL all take a smooth track irrespective of the CL depth, and the CL depth mainly influences the track curvature and the TC translation speed.

Significance Statement

The purpose of this study is to better understand how an upper-tropospheric cold low affects the motion of a nearby tropical cyclone. Our findings highlight distinct track patterns based on the relative positions of the tropical cyclone and the cold low. When the tropical cyclone is located on the east side of a cold low, a mutual rotation occurs, leading to a counterclockwise semicircle track of tropical cyclone. Conversely, if the tropical cyclone is located to the west side of a cold low, the cold low approaches and captures it, resulting in an abrupt northward turn when the cold low is eroded by the tropical cyclone. These insights improve the predictability of tropical cyclones in the vicinity of cold lows.
Quantifying Platinum and Palladium in Solid Ore Using Laser-Induced Breakdown Spectroscopy Assisted by the Laser-Induced Fluorescence (LIBS-LIF) Technique
Authors: Elhamdaoui Ismail , Selmani Samira , Sabsabi Mohamad , Constantin Marc , Bouchard Paul , Vidal François
Published: November 2023

The laser-induced breakdown spectroscopy assisted by laser-induced fluorescence (LIBS-LIF) in a two-step process was used to measure the concentration of platinum (Pt) and palladium (Pd) by surface analysis of a solid ore core from the Lac des Iles mine followed by analysis of the same core that was pulverized and compacted. This work focuses mainly on the measurement of Pt since the case of Pd has been extensively discussed in previous work. The excitation of Pt is performed at 235.71 nm with fluorescence emission observed near 269.84 nm. Calibration was performed with synthetic samples prepared from the same ore as the samples studied and the calibration curve shows good linearity in Pt content over several orders of magnitude. A limit of detection (LOD) of approximately 0.15 parts per million (ppm) over an average of 200 laser shots was demonstrated. In contrast, conventional LIBS provides a LOD of about 21 ppm over an average of 200 laser shots due to low signal-to-noise ratio and spectral interference from other elements and does not meet the requirements for estimating the average Pt concentration in the ore. The Pt concentrations obtained using LIBS-LIF on solid ore are generally in good agreement with those obtained in its pulverized and compacted form, as well as with laboratory measurements made by conventional chemical methods. However, the comparison of the results obtained for Pd using LIBS-LIF with the laboratory showed a less satisfactory agreement, probably due to its more inhomogeneous distribution in the ore.
Evolution of Wolbachia reproductive and nutritional mutualism: insights from the genomes of two novel strains that double infect the pollinator of dioecious Ficus hirta
Authors: Liu Wanzhen , Xia Xue , Hoffmann Ary A. , Ding Yamei , Fang Ji-Chao , Yu Hui
Published: November 2023

Wolbachiais a genus of maternally inherited endosymbionts that can affect reproduction of their hosts and influence metabolic processes. The pollinator,Valisia javana, is common in the male syconium of the dioecious figFicus hirta. Based on a high-quality chromosome-levelV. javanagenome with PacBio long-read and Illumina short-read sequencing, we discovered a sizeable proportion ofWolbachiasequences and used these to assemble two novelWolbachiastrains belonging to supergroup A. We explored its phylogenetic relationship with describedWolbachiastrains based on MLST sequences and the possibility of induction of CI (cytoplasmic incompatibility) in this strain by examining the presence ofcifgenes known to be responsible for CI in other insects. We also identified mobile genetic elements including prophages and insertion sequences, genes related to biotin synthesis and metabolism. A total of two prophages and 256 insertion sequences were found. The prophage WOjav1 is cryptic (structure incomplete) and WOjav2 is relatively intact. IS5 is the dominant transposon family. At least three pairs of type Icifgenes with three copies were found which may cause strong CI although this needs experimental verification; we also considered possible nutritional effects of theWolbachiaby identifying genes related to biotin production, absorption and metabolism. This study provides a resource for further studies ofWolbachia-pollinator-host plant interactions.
Association of triglyceride-glucose index and neutrophil-to-lymphocyte ratio with coronary artery disease
Authors: Zhang Bing , Peng Aihong , Li Shu , Li Fei , Wan Jing , Lu Jinping
Published: November 2023

Objective

The present study aimed to investigate the association of triglyceride-glucose (TyG) index and neutrophil-to-lymphocyte ratio (NLR) with coronary artery disease (CAD), and evaluate the cumulative value of TyG index and NLR in identifying CAD, as well as the severity of CAD.

Methods

This retrospective study enrolled 2867 patients who underwent coronary angiography (CAG) for the first time between January 2013 and June 2022 in Zhongnan Hospital of Wuhan University. There were 2109 patients with CAD and 758 patients without CAD. The CAD patients were divided into two groups based on the median of Gensini score (mild stenosis CAD group: Gensini score < 26 points; severe stenosis CAD group: Gensini score ≥ 26 points). To further evaluate the cumulative value of TyG index and NLR in identifying CAD and CAD severity, all patients were classified into four groups based on median of TyG index and NLR: (1) the control group: patients with low-TyG and low-NLR; (2) isolated high-NLR group: patients with low-TyG and high- NLR; (3) isolated high- TyG group: patients with high-TyG and low- NLR; (4) high-TyG combined with high-NLR group: patients with high-TyG and high- NLR.

Results

Multivariate logistic regression analysis showed that both the TyG index and NLR were independent risk factors for CAD, and they were also independent risk factors for severe stenosis in CAD (P < 0.05). Compared with the low-TyG and low- NLR group, patients in high-TyG and high- NLR group had a 1.418 times higher odds ratio (OR) of having CAD and a 1.692 times higher OR of having severe stenosis in CAD in the multivariable logistic regression model. It is worth noting that the OR values of the high-TyG and high- NLR group were higher than those of the isolated high-NLR group and the isolated high- TyG group. The ROC analysis showed that the combination of the TyG index and NLR was superior to TyG index or NLR in predicting CAD and CAD severity.

Conclusion

Compared to TyG index or NLR, the combination of the TyG index and NLR is beneficial to improve the diagnostic accuracy of CAD and CAD severity.
Association of LDL-cholesterol subfractions with cardiovascular disorders: a systematic review
Authors: Chary Abdolreza , Tohidi Maryam , Hedayati Mehdi
Published: November 2023

Background

Cardiovascular disorders (CVDs) are the leading cause of death worldwide. This study aimed to evaluate the association between low-density lipoprotein (LDL) subfractions and cardiovascular disorders.

Methods

To ensure the rigor of the systematic review, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. For this systematic review, a comprehensive search strategy was performed in important databases including PubMed, Scopus, Embase, International Statistical Institute (ISI) Web of Science, and google scholar from 2009 to February 2021. The following terms were used for systematic search: low-density lipoprotein, LDL, subfractions, subclasses, nuclear magnetic resonance, NMR, chromatography, high-pressure liquid, HPLC, cardiovascular disease, cerebrovascular, and peripheral vascular disease. Also, for evaluating the risk of bias, the Newcastle-Ottawa scale was employed.

Results

At the end of the search process, 33 articles were included in this study. The results of most of the evaluated studies revealed that a higher LDL particle number was consistently associated with increased risk for cardiovascular disease, independent of other lipid measurements. Also, small dense LDL was associated with an increased risk of CVDs. There was no association between LDL subfraction and CVDs in a small number of studies.

Conclusions

Overall, it seems that the evaluation of LDL subclasses can be used as a very suitable biomarker for the assessment and diagnosis of cardiovascular diseases. However, further studies are required to identify the mechanisms involved.
Reinfection rates, change in antibody titers and adverse events after COVID-19 vaccination among patients previously infected with COVID-19 in Metro Manila, Philippines: a secondary analysis of a completed cohort study
Authors: Tan-Lim Carol Stephanie C. , Gonzales Ma. Liza Antoinette M. , Dans Leonila F. , Cordero Cynthia P. , Alejandria Marissa M. , dela Paz Eva C. Cutiongco , Dator Melissa A. , Infantado-Alejandro Myzelle Anne J. , Sulit Maria Vanessa V. , Lansang Mary Ann D.
Published: November 2023

Background

Variation in immune response to COVID-19 vaccines is observed among different ethnicities. We aimed to describe the reinfection rates, change in antibody titers, and adverse events among Filipinos.

Methods

This is a secondary analysis of a cohort study of 307 participants within one year of having COVID-19 infection. We measured COVID-19 antibody levels at pre-determined timepoints (Days 21, 90, 180, 270, and 360 from initial infection). We monitored for COVID-19 symptoms and obtained details on COVID-19 vaccination. An adjudication committee classified the participants as probable, possible, or unlikely COVID-19 reinfection. We determined the probable reinfection rate, adverse events, and the geometric mean titer (GMT) ratio of pre- and post-vaccination antibody levels according to type and brand of COVID-19 vaccine.

Results

At the end of the follow-up period, 287 (93.5%) out of 307 study participants were fully vaccinated, 1 was partially vaccinated (0.3%), and 19 were unvaccinated (6.2%). Among the fully vaccinated participants, those given mRNA vaccines had the lowest reinfection rate (19.2 cases/100 person-years, 95% CI 9.6, 38.4), followed by viral vector vaccines (29.8 cases/100 person-years, 95% CI 16.9, 52.4). We observed the highest reinfection rate among those given inactivated virus vaccines (32.7 cases/100 person-years, 95% CI 23.6, 45.3). The reinfection rate was 8.6 cases/100 person-years (95% CI 4.1, 17.9) for unvaccinated participants and 3.6 cases/100 person-years (95% CI 0.5, 25.3) for partially vaccinated participants. We observed the largest rise in antibody titers among those given mRNA vaccines (GMT ratio 288.5), and the smallest rise among those given inactivated virus vaccines (GMT ratio 16.7). We observed the highest percentage of adverse events following immunization with viral vector vaccines (63.8%), followed by mRNA vaccines (62.7%), and the lowest for inactivated virus vaccines (34.7%). No serious adverse events were reported.

Conclusion

Vaccinees given the mRNA vaccines had the lowest reinfection rate and the highest rise in antibody titers. Vaccinees given inactivated virus vaccines had the highest reinfection rate, smallest rise in antibody titers, and lowest percentage of adverse events. The small sample size and imbalanced distribution of the type of vaccines received limits the external generalizability of our results.

Study Registration

The cohort study was registered at the Philippine Health Research Registry on December 14, 2020 (PHRR201214-003199).
Dietary pattern and other factors of breast cancer among women: a case control study in Northwest Ethiopia
Authors: Fentie Hiwot , Ntenda Peter Austin Morton , Tiruneh Fentanesh Nibret
Published: November 2023

Introduction

Breast cancer is presently the most commonly diagnosed cancer in women, and it stands as the leading cause of cancer-related deaths worldwide. Notably, breast cancer rates have seen a significant increase in sub-Saharan African countries, including Ethiopia. Several risk factors contribute to breast cancer, some of which can be modified, while others are inherent. Promoting a healthier diet is strongly encouraged as a preventive measure against breast cancer. However, it’s noteworthy that no previous research has investigated the connection between dietary patterns and the risk of breast cancer among Ethiopian women. Therefore, the primary objective of the current study is to examine the relationship between dietary patterns, socioeconomic and behavior factors associated with breast cancer in Ethiopian women.

Methods

A case-control study was conducted at an institution in Bahir Dar, Northwest Ethiopia, involving 260 women, comprising 86 cases and 174 controls. We administered a standardized and validated questionnaire to assess a range of sociodemographic, reproductive, clinical, lifestyle, and dietary characteristics through face-to-face interviews. To analyze the differences between the cases and controls, we employed the Chi-square test. Furthermore, we assessed the relationships between these variables using binary multivariate logistic regression. To measure the association between variables, we utilized odds ratios with 95% confidence intervals.

Results

The results of the multivariate analysis indicated that participants in the younger age group had significantly lower odds of developing breast cancer (AOR = 0.05; 95% CI: 0.00-0.91) compared to those in the older age group. Additionally, women who breastfed their children for shorter durations were 3.66 times more likely to develop breast cancer (AOR = 3.66; 95% CI: 2.78–6.89) than those who breastfed for longer periods. Furthermore, women with sedentary lifestyles faced a significantly higher risk of breast cancer, with odds 10.53 times greater (AOR = 10.53; 95% CI: 5.21–21.36) than their counterparts who engaged in moderate or highly active lifestyles. Lastly, participants who had previously undergone chest therapy were 6.43 times more likely to develop breast cancer (AOR = 6.43; 95% CI: 3.20–13.90) compared to those who had not.

Conclusions

Breast cancer prevention interventions, including breastfeeding counseling and increased physical activity should be recognized as a central strategy for lowering breast cancer risk. Furthermore, healthcare providers should aim to minimize exposure to chest radiation therapy.
Opioid use disorder in two samples of the Lebanese population: scale validation and correlation with sleep and mood disorders
Authors: Chamoun Karam , Mouawad Joseph , Salameh Pascale , Sacre Hala , Haddad Ramzi , Khabbaz Lydia Rabbaa , Megarbane Bruno , Hajj Aline
Published: November 2023

Background

The revised Opioid Risk Tool (ORT-OUD) is a brief, self-report scale designed to provide clinicians with a simple, validated method to screen for the risk of developing an Opioid Use Disorder (OUD) in patients without a prior history of substance abuse. This study aimed to translate and validate the Arabic version of ORT-OUD in the Lebanese population and assess its clinical validity in a sample of patients with OUD.

Methods

This cross-sectional study in the Lebanese population used several validated scales to assess the risk of OUD, including the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). Other tools evaluated chronotype and sleep and mood disturbances. Principal component analysis with Varimax rotation was applied to assess ORT-OUD construct validity. Convergent validity with the Arabic version of ASSIST was evaluated. The ORT-OUD criterion validity was then assessed in a clinical sample of patients with OUD.

Results

This study included 581 participants. The prevalence of the OUD risk in the Lebanese population using the ORT-OUD scale and the ASSIST-opioids scale was estimated at 14.5% and 6.54%, respectively. No items of the ORT-OUD were removed; all items converged over a solution of four factors with an eigenvalue > 1, explaining a total of 68.2% of the variance (Cronbach’s alpha = 0.648). The correlation coefficients between the ORT-OUD total score and ASSIST subscales were as follows: ASSIST-opioids (r = 0.174; p = < 0.001), ASSIST-sedatives (r = 0.249; p < 0.001), and ASSIST-alcohol (r = 0.161; p = < 0.001). ORT-OUD clinical validation showed a correlation with ASSIST-opioids (r = 0.251; p = 0.093) and ASSIST-sedatives (r = 0.598; p < 0.001). Higher ORT-OUD scores were associated with a family and personal history of alcohol and substance consumption and higher insomnia and anxiety scores.

Conclusions

This study is the first to validate the Arabic version of ORT-OUD in the Lebanese population, an essential step towards improving the detection and management of OUD in this population.
Association of serum copper (Cu) with cardiovascular mortality and all-cause mortality in a general population: a prospective cohort study
Authors: Li Xiaozhong , Ling Jitao , Hu Qingwen , Fang Changchang , Mei Kaibo , Wu Yifan , Huang Jingyi , Ling Qin , Chen Yixuan , Yu Peng , Liu Xiao , Li Juxiang
Published: November 2023

Background

Copper (Cu) homeostasis and Cu-induced cell death are gaining recognition as crucial processes in the pathogenesis of cardiovascular disease (CVD). Circulating Cu associated with CVD and mortality is yet to be fully elucidated.

Objective

This national prospective cohort study is to estimate relationship between serum Cu and the risk of CVD and all-cause mortality.

Methods

This study included participants from the National Health and Nutrition Examination Survey 2011–2016. Weighted Cox proportional hazards regression analysis and exposure-response curves were applied.

Results

This included 5,412 adults, representing 76,479,702 individuals. During a mean of 5.85 years of follow-up (31,653 person-years), 96 CVD and 356 all-cause mortality events occurred. Age and sex-adjusted survival curves showed that individuals with higher levels of serum Cu experienced increased CVD and all-cause death rates (tertiles, p < 0.05). Compared with the participant in tertile 1 of serum Cu (< 16.31 mol/L), those in tertile 3 (≥ 19.84 mol/L) were significantly associated with CVD mortality (HR: 7.06, 95%CI: 1.85,26.96), and all-cause mortality (HR: 2.84, 95% CI: 1.66,4.87). The dose-response curve indicated a linear relationship between serum Cu and CVD mortality (p -nonlinear = 0.48) and all-cause (p -nonlinear = 0.62). A meta-analysis included additional three prospective cohorts with 13,189 patients confirmed the association between higher serum Cu and CVD (HR: 2.08, 95% CI: 1.63,2.65) and all-cause mortality (HR: 1.89, 95%CI: 1.58,2.25).

Conclusion

The present study suggests excessive serum Cu concentrations are associated with the risk of CVD and all-cause mortality in American adults. Our findings and the causal relationships require further investigation.

Graphical Abstract
Application of tip-bendable ureteral access sheath in flexible ureteroscopic lithotripsy: an initial experience of 224 cases
Authors: Liang Hui , Liang Lijian , Lin Yiwei , Yu Yin , Xu Xiaoling , Liang Zihao , Sheng Jinmin , Shen Baihua
Published: November 2023

Introduction

During the last decades, the advent of flexible ureteroscopic lithotripsy has revolutionized the management of upper urinary tract stones. We designed a patented tip-bendable ureteral access sheath to facilitate stone clearance. Our current study reported our initial experience of 224 cases.

Materials and methods

The study is a descriptive, retrospective analysis. The initial 224 cases, operated consecutively by one surgeon during 16 months, were reviewed. The novel tip-bendable ureteral access sheath was applied in the procedure. Demographics, laboratory tests, and peri- and postoperative findings (operation duration, stone-free rate (SFR), utilization of flexible instruments and complications) were analyzed.

Resutls

The median age of the patients was 56 years and the mean stones size was 2.3 ± 1.3 cm. There were 63 cases of upper ureteral stone, 93cases of renal stone and 68 cases of ureteral-renal stones. The mean operative time was 69.2 ± 65.2 min. The immediate stone-free rate was 76.8% and the 1 month post-operative stone-free rate was 97.3%. Most cases(95.5%)were success in single session. Two patient experienced post-operative fever. There was no unplanned readmission. The frequency of post-operative complications was estimated at 0.89% (Clavien I).

Conclusion

Flexible ureteroscopic lithotripsy with tip-bendable ureteral access sheath is a safe and effective procedure, which can achieve excellent stone clearance.
Clinical predictors and significance of adherent periadrenal fat in laparoscopic adrenalectomy
Authors: Olcucuoglu Erkan , Senel Samet , Uzun Emre , Ceviz Kazim , Gultekin Huseyin , Arabaci Hasan Batuhan , Koudonas Antonios , Aydin Cevdet
Published: November 2023

Background

Adrenalectomy requires the anatomic preparation of the adrenal gland in the fat-rich retroperitoneal space. In the literature, it was shown that the retroperitoneal fat area affects surgical outcomes in laparoscopic adrenalectomy (LA). Besides the quantity of retroperitoneal fat, its qualitative properties play hypothetically a significant role in the safety profile and perioperative parameters of LA. In this study, we aimed to evaluate the factors associated with adherent periadrenal fat.

Methods

The prospectively obtained demographic, preoperative, intraoperative, and postoperative data of 44 patients who underwent laparoscopic adrenalectomy in our clinic were analyzed retrospectively. The patients were divided into two groups as adherent periadrenal fat (APAF) and non-APAF group. Periadrenal fat tissue was defined as adherent or non-adherent by the attending surgeon according to the difficulty in dissection of the adrenal gland from the surrounding fat tissue during the operation.

Results

The rate of female gender and presence of diabetes mellitus (DM) was higher in the APAF group (respectively, p = 0.038 and p = 0.001). A ROC curve analysis showed that the cut-off point was − 97 HU for APAF. On multivariable analysis using a stepwise regression model, we identified the presence of DM (OR = 5.073; 95% Cl = 2.192–12.387; p = 0.006) and ARFD > -97 HU (OR = 3.727; 95% Cl = 1.898–11.454; p = 0.008) as an independent predictor of APAF.

Conclusion

APAF seems to affect the perioperative outcomes of LA in terms of operation duration but not perioperative complications.
The development of cultural competences in nursing students and their significance in shaping the future work environment: a pilot study
Authors: Ličen Sabina , Prosen Mirko
Published: November 2023

Background

Working in a culturally diverse environment entails a moral and professional responsibility to provide culturally competent care. This has been recognised as an important measure to reduce health inequalities, improve the quality of care and increase patient satisfaction. The aim of this study was to assess the level of cultural competence in nursing students a decade after the introduction of transcultural nursing content into the nursing curriculum in Slovenia.

Methods

A descriptive cross-sectional design with 180 s-year nursing students as a convenience sample was used. Cultural competence was assessed using the Cultural Competence Assessment Tool (CCATool) via an online survey. IBM SPSS facilitated statistical analysis, using descriptive statistics and inferential methods, including the chi-square test. Non-parametric tests (Mann Whitney U, Kruskal-Wallis H and Wilcoxon signed-rank) were used for non-normally distributed data (Shapiro-Wilk test, p < 0.05). The significance was set at p ≤ 0.05.

Results

The results indicate that students demonstrate a high level of cultural competence, although there is room for improvement in terms of cultural sensitivity, as determined by coding the CCATool. The results also show a remarkable contrast between their self-assessed scores and the objective scores obtained from CCATool coding of the statements in each subscale (p < 0.005). In addition, significant differences (p = 0.002) are found in subscale “Cultural Knowledge” particularly between students who have lived abroad for more than 6 months and those who have not. The latter group has a higher score in the CCATool, indicating greater cultural knowledge.

Conclusions

The study suggests that the presence of transcultural elements in the Slovenian nursing curriculum is associated with higher self-reported levels of cultural competence among nursing students, although the present research design does not allow for causal interpretations. This competence is of immense importance in preparing students for their future professional environment. However, it is crucial to further refine the nursing curriculum, especially through greater integration of transcultural content in all health disciplines. In addition, the introduction of innovative teaching and learning approaches can better prepare students to deal with the diverse cultural experiences they will encounter in their nursing careers.
Effects of chromosomal translocation characteristics on fertilization and blastocyst development — a retrospective cohort study
Authors: Wu Shanshan , Zhang Jianrui , Guan Yichun , Ren Bingnan , Zhang Yuchao , Liu Xinmi , Wang Kexin , Zhang Mingmei , Li Zhen
Published: November 2023

Objective

To determine the effect of different translocation characteristics on fertilization rate and blastocyst development in chromosomal translocation patients.

Methods

This retrospective cohort study was conducted at the Third Affiliated Hospital of Zhengzhou University From January 2017 to December 2022.All couples were diagnosed as reciprocal translocation or Robertsonian translocation by karyotype of peripheral blood lymphocytes test. After adjusting for confounding factors, the effect of chromosomal rearrangement characteristics, such as carrier sex, translocation type, chromosome length and break sites, on fertilization rate and embryo development were analysed separately using multiple linear regression.

Results

In cases of Robertsonian translocation (RobT), the carrier sex plays an independent role in fertilization rate, and the male carriers was lower than that of female carriers (76.16% vs.86.26%, P = 0.009). In reciprocal translocation (RecT), the carrier sex, chromosome types and break sites had no influence on fertilization rate, blastocyst formation rate (P > 0.05). However, patients with human longer chromosomal (chromosomes 1–5) translocation have a lower available blastocyst formation rate (Group AB vs. Group CD: 41.49%vs.46.01%, P = 0.027). For male carriers, the translocation types was an independent factor affecting the fertilization rate, and the RobT was the negative one (B = − 0.075, P = 0 0.009). In female carriers, we did not observe this difference (P = 0.227).

Conclusions

In patients with chromosomal translocation, the fertilization rate may be influenced by carrier sex and translocation type, chromosomes 1–5 translocation may adversely affect the formation of available blastocysts. Break sites have no role in fertilization and blastocyst development.
The TFPI2–PPARγ axis induces M2 polarization and inhibits fibroblast activation to promote recovery from post-myocardial infarction in diabetic mice
Authors: Guo Mengqi , Xia Zongyi , Hong Yefeng , Ji Hongwei , Li Fuhai , Liu Wenheng , Li Shaohua , Xin Hui , Tan Kai , Lian Zhexun
Published: November 2023

Background

Diabetes mellitus is one of the causes of poor ventricular remodelling and poor cardiac recovery after myocardial infarction (MI). We previously reported that tissue factor pathway inhibitor-2 (TFPI2) was downregulated in response to hyperglycaemia and that it played a pivotal role in extracellular matrix (ECM) degradation and cell migration. Nonetheless, the function and mechanism of TFPI2 in post-MI remodelling under diabetic conditions remain unclear. Therefore, in the present study, we investigated the role of TFPI2 in post-MI effects in a diabetic mouse model.

Results

TFPI2 expression was markedly decreased in the infarcted myocardium of diabetic MI mice compared with that in non-diabetic mice. TFPI2 knockdown in the MI mouse model promoted fibroblast activation and migration as well as matrix metalloproteinase (MMP) expression, leading to disproportionate fibrosis remodelling and poor cardiac recovery. TFPI2 silencing promoted pro-inflammatory M1 macrophage polarization, which is consistent with the results of TFPI2 downregulation and M1 polarization under diabetic conditions. In contrast, TFPI2 overexpression in diabetic MI mice protected against adverse cardiac remodelling and functional deterioration. TFPI2 overexpression also inhibited MMP2 and MMP9 expression and attenuated fibroblast activation and migration, as well as excessive collagen production, in the infarcted myocardium of diabetic mice. TFPI2 promoted an earlier phenotype transition of pro-inflammatory M1 macrophages to reparative M2 macrophages via activation of peroxisome proliferator-activated receptor gamma.

Conclusions

This study highlights TFPI2 as a promising therapeutic target for early resolution of post-MI inflammation and disproportionate ECM remodelling under diabetic conditions.
Barriers and facilitators of implementing electronic monitors to improve adherence and health outcomes in tuberculosis patients: protocol for a systematic review based on the Consolidated Framework for Implementation Research
Authors: Li Wenhui , Su Min , Zhang Weile , Fan Xiaojing , Li Renzhong , Gao Yulong , Wei Xiaolin
Published: November 2023

Background

Tuberculosis (TB) has been regarded as ‘a relentless scourge’, increasing morbidity and mortality and burdening vulnerable populations. Poor adherence to TB treatment and ineffective traditional interventions hinders TB control. A novel TB approach called ‘electronic monitors’, equipping medication boxes with daily audio or visual reminders for electronically monitoring medication intake, seems promising in improving adherence and health outcomes and overcoming the weaknesses of traditional interventions. However, no review has systematically examined and synthesized the influencing factors of implementing electronic monitors. Implementation research offers the means to analyse the influencing factors of the implementation and its process, fitting well with the aim of this review. Therefore, the widely recognized Consolidated Framework for Implementation Research (CFIR), which offers a common taxonomy for evaluating intervention implementation, will be adopted to systematically identify barriers and facilitators of the electronic monitors for improving adherence and health outcomes in patients with TB.

Methods and analysis

The systematic review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Literature research will be conducted in five electronic databases (Ovid MEDLINE, CINAHL, EMBASE, Cochrane Library and Web of Science) to identify the barriers and facilitators of implementing electronic monitors in patients with TB. The CFIR will be used as a guide for categorizing and synthesizing the barriers and facilitators. Study screening, data extraction, quality appraisal and data analysis will be conducted by two independent reviewers. The use of additional reviewers will solve any disagreements between the two reviewers.

Discussion

Given the increased prominence of TB epidemiology and the adherence problem of electronic monitors, there is a solid rationale for synthesizing the existing studies via the CFIR. The findings and conclusion of this review will lay bare the achievements and effectiveness of implementing electronic monitors, as well as the attendant gaps and limitations. Further strategies for facilitating the implementation of electronic monitors will also be explored. This review will be of essential significance for research and practice, supporting future academic research initiatives centred on patients with TB and aiding electronic monitor design in lowering the morbidity and mortality associated with TB disease.

Trial registration number: PROSPERO: CRD42023395747.
Factors associated with an increased risk of osteochondral injuries after patellar dislocations: a systematic review
Authors: Yi Zhi , Zhang Xiaohui , Wu Meng , Jiang Jin , Xia Yayi
Published: November 2023

Purpose

The purpose of the study was to summarize the available evidence and identify risk factors for osteochondral injuries (OCIs) after patellar dislocations.

Methods

A systematic literature review was conducted in PubMed, Embase, Web of Science, Cochrane Library, and China national knowledge infrastructure from inception to December 22, 2022, according to the preferred reporting items for systematic reviews and meta-analyses guidelines. Studies regarding risk factors for OCIs after patellar dislocations were included. Literature search, data extraction, and quality assessment were performed independently by two authors.

Results

A total of 16 studies with 1945 patients were included. The risk factors for OCIs after patellar dislocation were categorized into four main categories, including demographic characteristics, patellar depth and position, femoral trochlear morphology, and other risk factors in this study. Five and three studies supported the idea that male sex and skeletal maturation may be risk factors, respectively. Normal femoral trochlea (two studies) and complete medial patellofemoral ligament (MPFL) injuries (two studies) may be associated with the development of OCIs. Three studies show that ligamentous laxity or joint hypermobility may prevent OCIs. Patellar depth and position (eight studies) may not be associated with the development of OCIs.

Conclusions

Based on the available evidence, an increased risk of OCIs following patellar dislocation may be associated with male sex and skeletal maturation. Furthermore, normal femoral trochlea and complete MPFL injuries may increase the risk of OCIs, while factors such as ligamentous laxity or joint hypermobility may reduce the risk.

Level of Evidence

Level IV, systematic review of Level II and IV studies.
Subphenotypes in patients with acute respiratory distress syndrome treated with high-flow oxygen
Authors: Blot Pierre-Louis , Chousterman Benjamin G. , Santafè Manel , Cartailler Jérôme , Pacheco Andrés , Magret Mònica , Masclans Joan R. , Artigas Antoni , Roca Oriol , García-de-Acilu Marina
Published: November 2023

Background

Acute respiratory distress syndrome (ARDS) subphenotypes differ in outcomes and treatment responses. Subphenotypes in high-flow nasal oxygen (HFNO)-treated ARDS patients have not been investigated.

Objectives

To identify biological subphenotypes in HFNO-treated ARDS patients.

Methods

Secondary analysis of a prospective multicenter observational study including ARDS patients supported with HFNO. Plasma inflammation markers (interleukin [IL]-6, IL-8, and IL-33 and soluble suppression of tumorigenicity-2 [sST2]) and lung epithelial (receptor for advanced glycation end products [RAGE] and surfactant protein D [SP-D]) and endothelial (angiopoietin-2 [Ang-2]) injury were measured. These biomarkers and bicarbonate were used in K-means cluster analysis to identify subphenotypes. Logistic regression was performed on biomarker combinations to predict clustering. We chose the model with the best AUROC and the lowest number of variables. This model was used to describe the HAIS (High-flow ARDS Inflammatory Subphenotype) score.

Results

Among 41 HFNO patients, two subphenotypes were identified. Hyperinflammatory subphenotype (n = 17) showed higher biomarker levels than hypoinflammatory (n = 24). Despite similar baseline characteristics, the hyperinflammatory subphenotype had higher 60-day mortality (47 vs 8.3% p = 0.014) and longer ICU length of stay (22.0 days [18.0–30.0] vs 39.5 [25.5–60.0], p = 0.034). The HAIS score, based on IL-8 and sST2, accurately distinguished subphenotypes (AUROC 0.96 [95%CI: 0.90–1.00]). A HAIS score ≥ 7.45 was predictor of hyperinflammatory subphenotype.

Conclusion

ARDS patients treated with HFNO exhibit two biological subphenotypes that have similar clinical characteristics, but hyperinflammatory patients have worse outcomes. The HAIS score may identify patients with hyperinflammatory subphenotype and might be used for enrichment strategies in future clinical trials.
Liver organoid culture methods
Authors: Hu Yiqing , Hu Xiaoyi , Luo Jia , Huang Jiacheng , Sun Yaohan , Li Haoyu , Qiao Yinbiao , Wu Hao , Li Jianhui , Zhou Lin , Zheng Shusen
Published: November 2023

Organoids, three-dimensional structures cultured in vitro, can recapitulate the microenvironment, complex architecture, and cellular functions of in vivo organs or tissues. In recent decades, liver organoids have been developed rapidly, and their applications in biomedicine, such as drug screening, disease modeling, and regenerative medicine, have been widely recognized. However, the lack of repeatability and consistency, including the lack of standardized culture conditions, has been a major obstacle to the development and clinical application of liver organoids. It is time-consuming for researchers to identify an appropriate medium component scheme, and the usage of some ingredients remains controversial. In this review, we summarized and compared different methods for liver organoid cultivation that have been published in recent years, focusing on controversial medium components and discussing their advantages and drawbacks. We aimed to provide an effective reference for the development and standardization of liver organoid cultivation.
Seismic Soundoff: How to chart a successful career in 2023
Authors: Geary Andrew
Published: November 2023

Kurt Marfurt reflects on his career and the recent award of SEG's highest honor, the Maurice Ewing Medal. He shares key takeaways from various career stops along his path and how volunteer roles at SEG advanced his career. He also provides wisdom on what has and has not changed in building a successful geophysical career. It is a privilege to hear from geophysicists at the top of their profession, and Marfurt provides actionable advice with a fun and insightful look back on his long career.
Impact on Survival of Early Versus Late Initiation of Adjuvant Chemotherapy After Pancreatic Adenocarcinoma Surgery: A Target Trial Emulation
Authors: Kirkegård Jakob , Ladekarl Morten , Lund Andrea , Mortensen Frank
Published: November 2023

Background

We examined the impact of early (0–4 weeks after discharge) versus late (> 4–8 weeks after discharge) initiation of adjuvant chemotherapy on pancreatic adenocarcinoma survival.

Methods

We used Danish population-based healthcare registries to emulate a hypothetical target trial using the clone-censor-weight approach. All eligible patients were cloned with one clone assigned to ‘early initiation’ and one clone assigned to ‘late initiation’. Clones were censored when the assigned treatment was no longer compatible with the actual treatment. Informative censoring was addressed using inverse probability of censoring weighting.

Results

We included 1491 patients in a hypothetical target trial, of whom 32.3% initiated chemotherapy within 0–4 weeks and 38.3% between > 4 and 8 weeks after discharge for pancreatic adenocarcinoma surgery; 206 (13.8%) initiated chemotherapy after > 8 weeks, and 232 (15.6%) did not initiate chemotherapy. Median overall survival was 30.4 and 29.9 months in late and early initiators, respectively. The absolute differences in OS, comparing late with early initiators, were 3.2% (95% confidence interval [CI] − 1.5%, 7.9%), − 0.7% (95% CI − 7.2%, 5.8%), and 3.2% (95% CI − 2.8%, 9.3%) at 1, 3, and 5 years, respectively. Late initiators had a higher increase in albumin levels as well as higher pretreatment albumin values.

Conclusions

Postponement of adjuvant chemotherapy up to 8 weeks after discharge from pancreatic adenocarcinoma surgery is safe and may allow more patients to receive adjuvant therapy due to better recovery.
Blue light photobiomodulation for reactivation of healing in wounds not responding to standard therapy
Authors: Ricci Elia , Pittarello Monica
Published: November 2023

Objective:

Blue light (410–430nm) has been suggested to be effective in the healing process of hard-to-heal wounds. The aim of this study was to test this hypothesis.

Method:

This single-centre observational study assessed the efficacy of photobiomodulation with blue light (120 seconds at a distance of 4cm from the wound bed once a week for four weeks) in activating healing in patients with hard-to-heal skin lesions (mean duration 23.9 months) of the lower limb that had not responded to four weeks of standard treatment.

Results:

A total of 59 patients were assessed. Wounds were divided into groups according to aetiology: hard-to-heal venous wound (30.5%); hard-to-heal arterial and mixed wounds (16.9%); hard-to-heal inflammatory wound (22.0%); other hard-to-heal wounds (13.6%); and acute wound (16.9%). The mean reduction in wound area at the end of the four-week treatment period with blue light compared with baseline was 51.38% (p<0.001) across all wounds. Among subgroups, the best performance was obtained for hard-to-heal venous wounds, achieving a 63.36% (p<0.001) mean reduction in wound size, and acute wounds, achieving a mean reduction of 82.76% (p<0.001). The greatest mean change in wound bed score was seen at the end of the four-week treatment period with blue light, with an increase in the mean score from 8.6 at baseline to 12.8 at week four (77.2%; p<0.001). There was a clear decrease in pain during blue light treatment, achieving a reduction in the average numeric rating scale (NRS) from 4.3 at baseline to 1.8 at week 4 (53.23%; p <0.001). At week 4, the highest proportion of complete healing was seen in acute (100.0%) and venous wounds (83.3%).

Conclusion:

Based on these results, photobiomodulation with blue light appears to reactivate the healing process in acute and hard-to-heal wounds that do not respond to standard treatment. Photobiomodulation with blue light treatment is easy to perform and safe, with no reported adverse events or side-effects.
Dark Kitchen e Marketplaces no Forno: Caminhos e Desafios Para o Crescimento da Palatos
Authors: Baesso Lucas , Romani-Dias Marcello
Published: November 2023

Este caso de ensino relata a trajetória da Palatos, fruto do sonho empreendedor de Flávio. A trajetória de sucesso e expansão da firma é hoje referência regional no ramo da panificação: suas três unidades recebem milhares de clientes diariamente.  Mas, diante do futuro da Palatos se impõem dilemas que envolvem sua operação de delivery. A possibilidade de expansão desta operação via investimento em uma dark kitchen é uma realidade, e Flávio deve ponderar entre aumentar sua capacidade instalada, com consequente extensão do seu raio de atuação, e a necessidade de altos investimentos. Outro dilema existente está relacionado ao posicionamento estratégico da Palatos quanto aos canais de aquisição de pedidos: a firma deve priorizar de marketplaces, apostando no ganho de eficiência e controle, em detrimento da maior proximidade ao cliente conferida pelo atendimento online humanizado? As informações foram obtidas a partir de documentos privados, entrevistas e dados secundários de mercado.  O caso contribui ao fomentar reflexões sobre tópicos atuais e relevantes ao setor de alimentação fora do lar, aplicáveis a outros setores e tipos organizacionais. Objetiva discutir as oportunidades e desafios enfrentados pelo negócio para seu ganho de competitividade com base em conceitos e ferramentas de estratégia empresarial, como o modelo VRIO e a matriz GUT.
Process of Departures: Conversations and Practice in Adapting Titus Andronicus
Authors: Drover Stephen
Published: November 2023

Abstract: While most adaptation scholarship has predominantly concentrated on product—comparing source material to adapted script—there is a noticeable lack of process analysis applied to understanding new adaptations. The focus of this article is to examine the working process of adaptation under the permissive classification of "departure" from a rehearsal room perspective, and to propose a framework for analyzing that process. This article endeavors to answer the question of what the working process of intentionally departing from Shakespeare looks like in our contemporary theater practice. Using autoethnography, ethnography, and literature review, I detail and compare the creation processes of two contemporary Shakespeare departures based on Titus Andronicus—The Society for the Destitute Presents Titus Bouffonius and Black Fly—and propose an analytical framework that is based on collaboration between artists, negotiations of fidelity, and a reclamation of narrative.