bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Comprehensive Rehabilitation Training Based on Balance Function on Postoperative Recovery and Function of Hip Fracture in the Elderly: A Systematic Review and Meta-Analysis
Authors: Chang Hai , Luan Chunliang , Li Chen
Published: July 2024

Introduction

In China, the proportion of the elderly population is gradually increasing, followed by the increasing medical demands of elderly patients. Hip fracture is a common fracture in the elderly. The elderly are prone to serious postoperative complications, resulting in failure to restore normal hip function, which seriously affects patients’ quality of life and further increases their mortality rate. Thus, hip fracture represents a remarkable public health issue within the realm of geriatric medical care.

Significance

This study systematically evaluated the impact of comprehensive rehabilitation training, with a focus on balance function, on elderly individuals with hip fractures’ postoperative recovery and functional outcomes.

Result

Results showed a significant difference in BBS scores favoring comprehensive rehabilitation training based on balance function over conventional intervention. Similarly, AM-PAC scores favored the balance-focused training. TUTG meta-analysis indicated its adoption in comprehensive rehabilitation training. FIM scores showed improvement with balance-focused training. Harris score meta-analysis also favored this approach. A funnel plot analysis revealed potential publication bias, likely due to study heterogeneity and limited publications.

Conclusions

In conclusion, comprehensive rehabilitation training centered around balance function displayed clinical efficacy in enhancing postoperative hip joint function in elderly hip fracture patients. This approach improved balance, coordination, and posture control, facilitating lower limb function recovery and overall prognosis. It holds promise as a valuable treatment approach.
The Gender Gap in Pension Income for Urban Employees in China
Authors: Li Dehua , Niu Juling
Published: July 2024

Gender interests are crucial in the redistributive equity of the pension system. This paper investigates the gender gap in retirement pension incomes of urban employees in China by using data from the Chinese Household Income Project and decomposes the main factors contributing to the gender gap. We find that the pension income of female employees after retirement is significantly lower than that of male employees. Decomposition reveals that age, pre-retirement wage level, and type of work unit are the main factors contributing to the gender gap. Further, we find that the gender gap in pension incomes is lower for employees employed in the public sector than for those employed in enterprises, because enterprises are more affected by the market environment than the public sector, and female employees tend to suffer more market discrimination. In general, females still face the challenge of having significantly lower pension standards than males after retirement.
The Association of College Students’ Epidemic Stress Perception and Life Satisfaction in China: Role of Coping Flexibility and Perceived Social Support
Authors: Xue Rui , Chai Hongqin , Fu Wangqian
Published: July 2024

The mental health problems caused by COVID-19 pandemic to every person and every group cannot be ignored, especially for college students, who are the main force of the society. Few studies explore the mechanism of action between college students’ epidemic stress perception and life satisfaction in China. The study aims to understand the association between the epidemic stress perception of COVID-19 on life satisfaction, and examines the effect of coping flexibility and perceived social support in China. We investigated 597 college students by questionnaire and found college students’ epidemic stress perception of COVID-19 was significantly negatively associated with life satisfaction; coping flexibility partially mediated the relationship between college students’ epidemic stress perception of COVID-19 and their life satisfaction; perceived social support moderated role in the first half of the mediating pathway. Practical strategies to improve college students’ life satisfaction were discussed in the paper.
Management of Uveitis Patients on Anti-TNF Agents Who Develop Demyelinating Disease – A Case Series
Authors: Hamdan Abel , Sharma Sumit , Baynes Kimberly , Hajj Ali Rula A. , Lowder Careen Y. , Srivastava Sunil K.
Published: July 2024

Background/Aims

Anti-tumor necrosis factor (Anti-TNF) agents have proven beneficial for the treatment of chronic non-infectious uveitis, yet rare neurological complications and demyelinating disease can occur with their use. Management of uveitis and neurological disease after developing these rare complications is not well understood. We sought to identify these specific cases and their outcomes through a retrospective observational case series.

Methods

Electronic Medical Record (EMR) chart review of 394 non-infectious uveitis patients on anti-TNF therapy focused on identifying patients seen by uveitis specialists at a single institution who were on anti-TNF therapy and had developed neurological symptoms. Cases were reviewed for subsequent management and outcomes of both their neurologic and ocular inflammatory disease.

Results

Five (5) patients were included following complaints of neurological symptoms while on anti-TNF therapy. Subsequent demyelinating diagnosis, acute treatment, and long-term course were described. All five patients continue to be inactive at around three years of anti-TNF discontinuation.

Conclusion

Unidentified rare neurological symptoms and demyelinating disease associated with the use of anti-TNF agents can be detrimental to patient treatment outcomes. Emphasis is given on possible avoidance and early identification of exacerbating underlying disease through a detailed neurologic history and use of imaging when suspicion is high. Patients may have no evidence of higher neurological risk prior to starting an anti-TNF treatment. Discontinuation of an anti-TNF agent and subsequent control of disease is possible with alternative immunosuppressive treatments.
The impact of heterogeneity on the analysis of platform trials with normally distributed outcomes
Authors: Lee Kim May , Emsley Richard
Published: July 2024

Background

A platform trial approach allows adding arms to on-going trials to speed up intervention discovery programs. A control arm remains open for recruitment in a platform trial while intervention arms may be added after the onset of the study and could be terminated early for efficacy and/or futility when early stopping is allowed. The topic of utilising non-concurrent control data in the analysis of platform trials has been explored and discussed extensively. A less familiar issue is the presence of heterogeneity, which may exist for example due to modification of enrolment criteria and recruitment strategy.

Method

We conduct a simulation study to explore the impact of heterogeneity on the analysis of a two-stage platform trial design. We consider heterogeneity in treatment effects and heteroscedasticity in outcome data across stages for a normally distributed endpoint. We examine the performance of some hypothesis testing procedures and modelling strategies. The use of non-concurrent control data is also considered accordingly. Alongside standard regression analysis, we examine the performance of a novel method that was known as the pairwise trials analysis. It is similar to a network meta-analysis approach but adjusts for treatment comparisons instead of individual studies using fixed effects.

Results

Several testing strategies with concurrent control data seem to control the type I error rate at the required level when there is heteroscedasticity in outcome data across stages and/or a random cohort effect. The main parameter of treatment effects in some analysis models correspond to overall treatment effects weighted by stage wise sample sizes; while others correspond to the effect observed within a single stage. The characteristics of the estimates are not affected significantly by the presence of a random cohort effect and/ or heteroscedasticity.

Conclusion

In view of heterogeneity in treatment effect across stages, the specification of null hypotheses in platform trials may need to be more subtle. We suggest employing testing procedure of adaptive design as opposed to testing the statistics from regression models; comparing the estimates from the pairwise trials analysis method and the regression model with interaction terms may indicate if heterogeneity is negligible.
Comparison between asymptotic and re-randomisation tests under non-proportional hazards in a randomised controlled trial using the minimisation method
Authors: Kimura Ryusei , Nomura Shogo , Nagashima Kengo , Sato Yasunori
Published: July 2024

Background

Pocock-Simon’s minimisation method has been widely used to balance treatment assignments across prognostic factors in randomised controlled trials (RCTs). Previous studies focusing on the survival outcomes have demonstrated that the conservativeness of asymptotic tests without adjusting for stratification factors, as well as the inflated type I error rate of adjusted asymptotic tests conducted in a small sample of patients, can be relaxed using re-randomisation tests. Although several RCTs using minimisation have suggested the presence of non-proportional hazards (non-PH) effects, the application of re-randomisation tests has been limited to the log-rank test and Cox PH models, which may result in diminished statistical power when confronted with non-PH scenarios. To address this issue, we proposed two re-randomisation tests based on a maximum combination of weighted log-rank tests (MaxCombo test) and the difference in restricted mean survival time (dRMST) up to a fixed time point $$\tau$$
τ
, both of which can be extended to adjust for randomisation stratification factors.

Methods

We compared the performance of asymptotic and re-randomisation tests using the MaxCombo test, dRMST, log-rank test, and Cox PH models, assuming various non-PH situations for RCTs using minimisation, with total sample sizes of 50, 100, and 500 at a 1:1 allocation ratio. We mainly considered null, and alternative scenarios featuring delayed, crossing, and diminishing treatment effects.

Results

Across all examined null scenarios, re-randomisation tests maintained the type I error rates at the nominal level. Conversely, unadjusted asymptotic tests indicated excessive conservatism, while adjusted asymptotic tests in both the Cox PH models and dRMST indicated inflated type I error rates for total sample sizes of 50. The stratified MaxCombo-based re-randomisation test consistently exhibited robust power across all examined scenarios.

Conclusions

The re-randomisation test is a useful alternative in non-PH situations for RCTs with minimisation using the stratified MaxCombo test, suggesting its robust power in various scenarios.
The effect of education of self-care behaviors on the quality of life and resilience of multiple sclerosis patients
Authors: Rakhshani Tayebeh , Afroozeh Shohreh , Kashfi Seyyed Mansour , Kamyab Amirhossein , Khani Jeihooni Ali
Published: July 2024

Background

Multiple sclerosis (MS) is one of the most common causes of non-traumatic disability in young adults. Typically, doctors diagnose MS between the ages of 20 and 50. This study aims to determine the effect of educational intervention on self-care behaviors on MS patients’ quality of life and resilience in Shiraz, Iran.

Methods

This interventional study included 90 individuals, aged 15 to 50, who were members of the support association for MS patients in Shiraz city, Iran. The study employed a convenient sampling method. Patients were randomly assigned to two experimental and control groups, and the self-care educational program was conducted during six educational sessions. The quality of life and resilience of the patients were measured before and after the study. Information was collected by completing the questionnaires before and three months after the intervention. To analyze the data, SPSS 23 was used. To describe the data, frequency, percentage, mean, and standard deviation indicators were used, and for analysis, independent t-tests and paired t-tests were used.

Results

This study examined a total of 90 MS patients. 50.4% of the people in the study were married, 40% of them had a high school diploma, and 78.5% were unemployed. The results of the t-test showed that there was a significant difference between all the components of self-care, quality of life, and resilience before and after the intervention (P < 0.05).

Conclusion

By accepting the responsibility of self-care, patients would improve the inadequacies and disabilities resulting from the disease, use the power of self-care to solve problems, and improve their quality of life and resilience.
Association between watching eating broadcasts like mukbang and cookbang and generalized anxiety disorder among Korean adolescents
Authors: Kim Jung-Hwan , Kim Jinhyun , Jang Suk-Yong , Park Eun-Cheol
Published: July 2024

Background

Anxiety disorders are common during adolescence; therefore, detecting anxiety disorders among adolescents and providing appropriate treatment are crucial. Studies have suggested that watching online audiovisual broadcasts like mukbang and cookbang (hereafter mukbang), where hosts eat or cook food, may influence anxiety disorders. However, there is insufficient research on the association between watching mukbang and generalized anxiety disorder (GAD). Therefore, we investigated the association between watching mukbang and GAD among Korean adolescents.

Methods

We analyzed 51,764 adolescents who participated in the 2020 Korea Youth Risk Behavior Web-Based Survey (KYRBS). The participants were asked how frequently they watched mukbang per week over the past 12 months. Anxiety disorders were assessed using the generalized anxiety disorder-7 (GAD-7) questionnaire. A multiple logistic regression analysis was performed after adjusting for confounding variables.

Results

The prevalence of GAD was higher among adolescents who watched mukbang compared to those who did not (aOR: 1.100, 95% CI: 1.026–1.180, P = 0.008 in male participants; aOR: 1.090, 95% CI: 1.003–1.185, P = 0.042 in female participants). The frequency of watching mukbang showed a dose-dependent relationship with a greater likelihood of GAD in female adolescents.

Conclusion

This study’s results showed that watching mukbang is associated with GAD in Korean adolescents. Proper interventions for mental health are needed for adolescents who watch mukbang.
Pattern of sleep disorders among children with autism spectrum disorder
Authors: Mohammed Muaath Ahmed , Abdalkhalig Elham Mohammed , Ali Ibrahim Abdelrhim , Hassan Salma Shakir , Osman Hayat
Published: July 2024

Background

Sleep disorders (SDs) are among many co-morbid medical conditions that affect children with autism spectrum disorder (ASD). Raising awareness and improving the standard of care for children diagnosed with ASD may result from identifying SDs among them. This study aims to evaluate patterns of SDs among Sudanese children diagnosed with ASD.

Method

Using the Childhood Sleep Habit Questionnaire (CSHQ) to gather data on sleep disorders and SPSS version 26.0 for data analysis, a descriptive cross-sectional study was carried out in the five main autistic centres in Khartoum state covering all registered patients with ASD between April and June 2022. Ninety-two children diagnosed with ASD were enrolled in this study after the purpose of the research was explained and consent was obtained from their guardians. A p-value < 0.05 was considered to indicate statistical significance.

Results

The mean age was 6.90 (± 2.6) years with a boys-to-girls ratio of 2.17:1. The prevalence of SDs (at least one sleep condition almost daily) was 95.65%. Sleep onset 71 (77.2%), limit setting 32 (32.6%), resistant onset to sleep 48 (52.2%), and combined 52 (56.5%) insomnia affected the majority of children. Additionally, there were significant associations between sex and Limit-setting insomnia, advanced sleep phase disorder, and narcolepsy type 2 (P values = 0.033, 0.009, and 0.037, respectively). Additionally, there was a significant association between age and sleep-related breathing disorders-snoring (p value = 0.031).

Conclusion

The frequency of SDs is significant among children diagnosed with ASD from Sudan, and certain SDs are associated with age and sex. Subsequent studies are required to develop national guidelines for the prevalence, presentation, screening, and treatment of SDs in children diagnosed with ASD.
Drug supply and assurance: a cross-sectional study of drug shortage monitoring varieties in China
Authors: Lan Yipeng , Lin Xiaofeng , Chen Qiannan , Wang Li , Sun Lihua , Huang Zhe
Published: July 2024

Background

Drug shortage is a worldwide problem that seriously threatens public health. China released the most comprehensive list of key drug shortage monitoring varieties ever in 2022. We aim to analyze the attributes and characteristics of the medicines within the list to provide a reference for improving China’s supply security of shortage drugs.

Methods

We used public data to extract information on drug types, dosage forms, indications, classification of clinical uses, whether they were included in medical catalogs such as the National Essential Drugs, and the number of drug and active pharmaceutical ingredient (API) manufacturers. A descriptive statistical analysis was used.

Results

Of the 980 drugs on the list, 99.59% were chemicals and 92.65% were injectables. Drugs for blood and hematopoietic organs, the cardiovascular system, and the digestive tract and metabolism ranked among the top three shortages. Verification of the medical catalogs showed that 90.41% of the drugs belonged to the national essential drugs, 95.10% were medicare drugs, 2.55% were volume-based procurement drugs, and 14.70% were for rare diseases, and 42.04% were for children. In terms of drug supply capacity, 21.33% of drug approvals are less than 10, and there were even 26 drugs for exclusive production, close to 90% of manufacturers need to purchase APIs from outside. Among the 256 APIs included in the list, 152 APIs had less than 10 manufacturers, and there were even 5 APIs produced by only one enterprise nationwide.

Conclusions

The situation of drug shortages in China was severe and complex, with serious shortages of medicines adapted to basic medical and healthcare needs and clinically necessary medicines, and a need to improve the production capacity of drugs and the ability to supply APIs. We recommend strengthening drug monitoring and stockpiling and accelerating the approval of shortage drugs to improve drug supply security.
Dietary intake of luteolin is negatively associated with all-cause and cardiovascular mortality in chronic kidney disease patients
Authors: Yao Xiaotian , Zhou Zhengxi
Published: July 2024

Background

Luteolin (Lut), a flavonoid present in the daily diet, exhibits potent anti-inflammatory and renoprotective effects. However, the association between Lut and chronic kidney disease (CKD) remains uncertain. The objective of this study is to explore the potential correlation.

Methods

A total of 2,393 CKD patients were enrolled in a prospective cohort in the National Health and Nutrition Examination Survey (NHANES). A 24-h dietary recall was utilized to estimate the intake of dietary Lut based on the type and amount of food consumed. The National Death Index mortality data was utilized to ascertain all-cause and cardiac mortality (as of December 27, 2023). Cox proportional hazards model was used to estimate the relationship between Lut intake and mortality risk.

Results

The median Lut intake was 0.305 mg/day, with interquartile range was 0.105–0.775 mg/day. During the follow-up period (median, 93 months), 682 all-cause deaths (217 cardiovascular disease [CVD] deaths) were recorded. Per unit increase in Lut intake reduced all-cause mortality by 27% (P < 0.001) and cardiac mortality by 34% (P = 0.01) in CKD patients. There was an inverse dose–response association between Lut intake (range: 0–8.945 mg/day) and mortality risk. Consistent results were also shown when stratified by age, sex, race, marital status, body mass index, CKD stage, urine protein creatinine ratio strata, CKD progression risk, hypertension, and CVD.

Conclusion

Dietary Lut intake is associated with a reduction in all-cause and cardiac mortality among CKD patients, potentially attributable to the anti-inflammatory characteristics of Lut.
The Chinese version of rating scale of pain expression during childbirth (ESVADOPA): reliability and validity assessment
Authors: Wu Yu , Chu Yanxin , Zhao Xin , Wang Xiaoli , Chen Liyuan , Duan Ruihan , Li Yunfeng , Liu Xia
Published: July 2024

Background

Childbirth pain is a physiological phenomenon during the delivery process, the intense pain of childbirth could bring harmful effects to pregnant women and their babies. Assessment of childbirth pain is the first step in childbirth pain intervention. Some pain assessment scales have shortcomings such as interfering in the birthing process and affecting pain perception during delivery, while the Rating Scale of Pain Expression during Childbirth (ESVADOPA) could be used as an auxiliary scale to compensate for these shortcomings. The purpose of this study was to introduce the ESVADOPA and adapt it among Chinese pregnant women to check on the psychometric properties of the translated version of ESVADOPA.

Methods

A new translation model based on Brislin’s classical back translation model was used to translate and cross-cultural adapt the ESVADOPA. During June 2021 and June 2022, pregnant women at Shandong Provincial Hospital Affiliated to Shandong First Medical University were invited. In the stage of translation and cross-culturally adaptation, 18 midwives and 30 pregnant women were invited to participate in the first round of pre-experiment. And in the second round of pre-experiment, 15 midwives and 20 pregnant women were invited to participate. The Chinese version of ESVADOPA was tested on a group of pregnant women (N = 487). Construct validity was evaluated by exploratory factor analysis, confirmatory factor analysis and criterion-related validity. Reliability was assessed by Cronbach’s α coefficient, McDonald Omega, Spearman-Brown split-half reliability and Guttman split-half reliability.

Results

The item statistical analysis and construct validity resulted in six items and one factor that explained 61.064% of the total variance. Confirmatory factor analysis showed that the data fit the one-factor structure. Criterion-related validity indicated that the scale is significantly and positively correlated with the Numeric Rating Scale (NRS). Cronbach’s α coefficient, McDonald Omega, Spearman-Brown split-half reliability, and Guttman split-half reliability of the Chinese version of ESVADOPA were 0.868, 0.896, 0.845, 0.842, respectively.

Conclusion

The Chinese version of the ESVADOPA with good reliability and validity data could be used to assess the pain rating of pregnant women during childbirth without interfering in the birthing process.
Use of an electronic wellness instrument in the integrated health and social care of older adults: a group concept mapping study
Authors: Northwood Melissa , Saari Margaret , Heckman George , Alexander Ted , Eastway Bill , Gerantonis Patricia , Gillies Deanne , Gregg Susie , McKinnon Wilson Jane , Morrison Adam , Sultan Heebah , Turcotte Luke
Published: July 2024

Background

Health system fragmentation directly contributes to poor health and social outcomes for older adults with multiple chronic conditions and their care partners. Older adults often require support from primary care, multiple specialists, home care, community support services, and other health-care sectors and communication between these providers is unstructured and not standardized. Integrated and interprofessional team-based models of care are a recommended strategy to improve health service delivery to older adults with complex needs. Standardized assessment instruments deployed on digital platforms are considered a necessary component of integrated care. The aim of this study was to develop strategies to leverage an electronic wellness instrument, interRAI Check Up Self Report, to support integrated health and social care for older adults and their care partners in a community in Southern Ontario, Canada.

Methods

Group concept mapping, a participatory mixed-methods approach, was conducted. Participants included older adults, care partners, and representatives from: home care, community support services, specialized geriatric services, primary care, and health informatics. In a series of virtual meetings, participants generated ideas to implement the interRAI Check Up and rated the relative importance of these ideas. Hierarchical cluster analysis was used to map the ideas into clusters of similar statements. Participants reviewed the map to co-create an action plan.

Results

Forty-one participants contributed to a cluster map of ten action areas (e.g., engagement of older adults and care partners, instrument’s ease of use, accessibility of the assessment process, person-centred process, training and education for providers, provider coordination, health information integration, health system decision support and quality improvement, and privacy and confidentiality). The health system decision support cluster was rated as the lowest relative importance and the health information integration was cluster rated as the highest relative importance.

Conclusions

Many person-, provider-, and system-level factors need to be considered when implementing and using an electronic wellness instrument across health- and social-care providers. These factors are highly relevant to the integration of other standardized instruments into interprofessional team care to ensure a compassionate care approach as technology is introduced.
Metabolic reprogramming and heterogeneity during the decidualization process of endometrial stromal cells
Authors: Jia Zhaoyu , Wei Yuan , Zhang Ye , Song Kun , Yuan Jia
Published: July 2024

The human endometrial decidualization is a transformative event in the pregnant uterus that involves the differentiation of stromal cells into decidual cells. While crucial to the establishment of a successful pregnancy, the metabolic characteristics of decidual cells in vivo remain largely unexplored. Here, we integrated the single-cell RNA sequencing (scRNA-seq) datasets on the endometrium of the menstrual cycle and the maternal-fetal interface in the first trimester to comprehensively decrypt the metabolic characteristics of stromal fibroblast cells. Our results revealed that the differentiation of stromal cells into decidual cells is accompanied by increased amino acid and sphingolipid metabolism. Furthermore, metabolic heterogeneity exists in decidual cells with differentiation maturity disparities. Decidual cells with high metabolism exhibit higher cellular activity and show a strong propensity for signaling. In addition, significant metabolic reprogramming in amino acids and lipids also occurs during the transition from non-pregnancy to pregnancy in the uteri of pigs, cattle, and mice. Our analysis provides comprehensive insights into the dynamic landscape of stromal fibroblast cell metabolism, contributing to our understanding of the metabolism at the molecular dynamics underlying the decidualization process in the human endometrium.
CircRHBDD1 promotes immune escape via IGF2BP2/PD-L1 signaling and acts as a nanotherapeutic target in gastric cancer
Authors: Li Yanna , Wang Zhixiong , Gao Peng , Cao Danping , Dong Runyu , Zhu Menglin , Fei Yao , Zuo Xueliang , Cai Juan
Published: July 2024

Background

Circular RNAs (circRNAs) have been implicated in the development and progression of gastric cancer (GC). However, it remains unclear whether dysregulated circRNA affects immune escape and the efficacy of immunotherapy in GC. Our aim is to investigate the molecular mechanism of circRNA affecting GC immunotherapy and identify effective molecular therapeutic targets.

Methods

The differential expression profile of circRNAs was established through circRNA sequencing, comparing three paired GC tissues with their adjacent non-cancerous gastric tissues. The expression level of circRHBDD1 in GC tissues was then assessed using quantitative reverse transcription polymerase chain reaction (qRT-PCR). The biological characteristics of circRHBDD1 were verified through a series of experiments, including agarose gel electrophoresis assays, RNase R treatment, and actinomycin D experiments. The prognostic value of circRHBDD1 in GC was evaluated by conducting both univariate and multivariate survival analyses. Furthermore, loss- and gain-of-function approaches were utilized to investigate the impact of circRHBDD1 on GC immune escape. RNA-sequencing, immunoprecipitation, flow cytometry, and methylated RNA immunoprecipitation (meRIP) analysis were performed to elucidate the underlying molecular mechanisms.

Results

We discovered that circRHBDD1 exhibited remarkably high expression levels in GC tissues and cell lines. Notably, the high expression of circRHBDD1 was significantly correlated with poor overall survival and disease-free survival among GC patients. Both in vitro and in vivo experiments revealed that circRHBDD1 upregulated the expression of PD-L1 and impeded the infiltration of CD8+ T cells. Further, we found that circRHBDD1 binds to IGF2BP2, disrupting the interaction between E3 ligase TRIM25 and IGF2BP2, and ultimately inhibiting IGF2BP2 ubiquitination and degradation. Intriguingly, IGF2BP2 enhances PD-L1 mRNA stability through m6A modification. Additionally, we developed Poly (lactide-co-glycolic acid) (PLGA)-Polyethylene glycol (PEG)-based nanoparticles loaded with circRHBDD1 siRNA. In vivo experiments validated that the combination of PLGA-PEG(si-circRHBDD1) and anti-PD-1 offers a safe and efficacious nano-drug regimen for cancer immunotherapy.

Conclusion

Our results demonstrated that circRHBDD1 promoted GC immune escape by upregulating the expression of PD-L1 and reprogramming T cell-mediated immune response. Inhibition of circRHBDD1 expression could potentially enhance the response of GC patients to immunotherapy, thus improving treatment outcomes. Additionally, the development of a nanodrug delivery system provides a feasible approach for future clinical applications.
Association between dietary branched-chain amino acids and multiple chronic conditions among older adults in Chinese communities
Authors: Song Yuanfeng , Zhang Ji , Luo Ziqiang , Wu Lanlan , Cai Zhaopei , Zhong Xiaoqi , Zeng Xiaoxue , Cao Tingxi , Chen Hong-en , Xu Shan , Wang Chang-yi
Published: July 2024

Background

The association of BCAAs (isoleucine, leucine, and valine) with cardiovascular and cerebrovascular diseases has been widely recognized by researchers, but there is limited evidence to support the relationship between BCAAs and multiple chronic conditions (MCCs) in older adults. This study aimed to explore the correlation between BCAA levels in the diets of older adults and MCCs.

Methods

Based on a health management cohort project in Nanshan District of Shenzhen, 4278 individuals over 65 years old were selected as participants via multi-stage stratified sampling from May 2018 to December 2019. Data were collected using a validated semi-quantitative food frequency questionnaire, as well as anthropometric and chronic disease reports. MCC was defined as the coexistence of two or more chronic diseases, namely, hypertension, dyslipidemia, diabetes, CAD, stroke, CKD, and CLD. Multivariate unconditional logistic regression analysis was used to analyze the relationship between dietary BCAAs and MCCs in older adults, and then, gender stratification analysis was performed. A restricted cubic spline model (a fitted smooth curve) was used to determine the dose–response relationship of isoleucine with MCCs.

Results

A total of 4278 older adults aged 65 and above were included in this study, with an average age of 72.73 ± 5.49 years. The cohort included 1861 males (43.50%). Regardless of whether confounding factors were corrected, isoleucine was a risk factor for MCCs (OR = 3.388, 95%CI:1.415,8.109). After gender stratification, the relationships between dietary isoleucine and MCCs (OR = 6.902, 95%CI:1.875,25.402) and between leucine (OR = 0.506,95%CI:0.309,0.830) and MCCs were significant in women, but not in men. No significant association between valine and MCCs was observed. In addition, isoleucine was a risk factor for MCCs when its intake was greater than 4.297 g/d.

Conclusion

Isoleucine may play an important role in regulating age-related diseases. BCAAs such as isoleucine can be used as risk markers for MCCs in older adults.
Impact of screw tip design on screw anchorage: mechanical testing and numerical simulation
Authors: Xie Shiming , Cui Liqiang , Liu Jinhui , Qing Peidong , Li Jingchi
Published: July 2024

Background

Screw loosening is a commonly reported issue following spinal screw fixation and can lead to various complications. The initial cause of screw loosening is biomechanical deterioration. Previous studies have demonstrated that modifications in screw design can impact the local biomechanical environment, specifically the stress distribution on bone-screw interfaces. There are several different designs of screw tips available for clinically used pedicle screws; however, it remains unclear whether these variations affect the local stress distribution and subsequent screw anchorage ability.

Methods

This study conducted comprehensive biomechanical research using polyurethane foam mechanical tests and corresponding numerical simulations to investigate this topic. Models of pedicle screw-fixed osteoporotic polyurethane foam were created with two different clinically used screw tip designs (flat and steep) featuring varying tip lengths, taper angles, and diameters, as well as identical flank overlap areas and thread designs. The anchorage ability of the different models was assessed through toggle and pull-out test. Additionally, numerical mechanical models were utilized to compute the stress distributions at the screw and bone-screw interfaces in the different models.

Results

Mechanical tests revealed superior anchorage ability in models utilizing flat-tipped screws. Furthermore, numerical modeling indicated improved anchorage ability and reduced stress concentration tendency in these models.

Conclusion

Changes in screw tip design can significantly impact the biomechanical anchoring capability of screws. Specifically, flatter tip pedicle screws may mitigate the risk of screw loosening by alleviating stress concentration on bone-screw interfaces.
Health economic evaluation of an electronic mindfulness-based intervention (eMBI) to improve maternal mental health during pregnancy – a randomized controlled trial (RCT)
Authors: Hasemann Lena , Elkenkamp Svenja , Müller Mitho , Bauer Armin , Wallwiener Stephanie , Greiner Wolfgang
Published: July 2024

Background

Anxiety and depression are the most prevalent psychiatric diseases in the peripartum period. They can lead to relevant health consequences for mother and child as well as increased health care resource utilization (HCRU) and related costs. Due to the promising results of mindfulness-based interventions (MBI) and digital health applications in mental health, an electronic MBI on maternal mental health during pregnancy was implemented and assessed in terms of transferability to standard care in Germany. The present study focused the health economic outcomes of the randomized controlled trial (RCT).

Methods

The analysis, adopting a payer’s and a societal perspective, included women of increased emotional distress at < 29 weeks of gestation. We applied inferential statistics (α = 0.05 significance level) to compare the intervention group (IG) and control group (CG) in terms of HCRU and costs. The analysis was primarily based on statutory health insurance claims data which covered the individual observational period of 40 weeks.

Results

Overall, 258 women (IG: 117, CG: 141) were included in the health economic analysis. The results on total health care costs from a payer’s perspective indicated higher costs for the IGi compared to the CG (Exp(ß) = 1.096, 95% CI: 1.006–1.194, p = 0.037). However, the estimation was not significant after Bonferroni correction (p < 0.006). Even the analysis from a societal perspective as well as sensitivity analyses did not show significant results.

Conclusions

In the present study, the eMBI did neither reduced nor significantly increased health care costs. Further research is needed to generate robust evidence on eMBIs for women suffering from peripartum depression and anxiety.

Trial registration

German Clinical Trials Register: DRKS00017210. Registered on 13 January 2020. Retrospectively registered.
Existence of nontrivial solutions for a fractional $p\&q$-Laplacian equation with sandwich-type and sign-changing nonlinearities
Authors: Li Qin , Xiu Zonghu , Chen Lin
Published: July 2024

In this paper, we deal with the following fractional $p\&q$
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0
,
1
)
, $(-\Delta )_{m}^{s}$

(
−
Δ
)

m
s

$(m\in \{p,q\})$
(
m
∈
{
p
,
q
}
)
is the fractional m-Laplacian operator, $p,q,r,\theta \in (1,p_{s}^{*}]$
p
,
q
,
r
,
θ
∈
(
1
,

p
s
∗

]
, $p_{s}^{*}=\frac{Np}{N-sp}$

p
s
∗

=

N
p

N
−
s
p

, $\lambda , \mu >0$
λ
,
μ
>
0
, and the weights $a(x)$
a
(
x
)
and $b(x)$
b
(
x
)
are possibly sign changing. Using the concentration compactness principle for fractional Sobolev spaces and the Ekeland variational principle, we prove that the problem admits a nonnegative solution for the critical case $r=p_{s}^{*}$
r
=

p
s
∗

. Moreover, for the subcritical case $r< p_{s}^{*}$
r
<

p
s
∗

, we obtain two existence results by applying the Ekeland variational principle and the mountain pass theorem.
Perceived comfort with weight, body shape and eating pattern of young adults with type 1 diabetes and associations with clinical and psychological parameters in a clinical setting
Authors: Vidyasagar Sneha , Griffin Alison , d’Emden Helen , Hendrieckx Christel , D’Silva Neisha
Published: July 2024

Background

Higher prevalence of disordered eating in young adults with type 1 diabetes (T1D) culminates in higher levels of morbidity and mortality. In addition to validated questionnaires for diabetes distress, depression/anxiety symptoms and emotional well-being, the Diabetes Psychosocial Assessment Tool (DPAT) includes three questions about comfort with weight, body shape and eating pattern (WSE), which were derived from literature and multidisciplinary team consensus. Recognising individuals with low comfort with WSE, is the first step towards identifying those who may be at risk of developing eating disorders.

Aims

Observe comfort with WSE, in young adults with T1D, and its associations with demographic/clinical characteristics and psychological parameters.

Methods

276 young adults, aged 15–26, who attended routine clinical care at a Young Adult Diabetes Clinic, completed the DPAT. The WSE questions were scored on a 5-point Likert scale (1 indicating lowest comfort). Linear regression analysed differences in comfort with weight and eating pattern by demographic and psychological parameters.

Results

1 in 3 young adults (29%) reported low comfort with WSE (scores 1 or 2). In females, 40%, 41% and 35% had low comfort with weight, shape and eating patterns respectively, in comparison to males in whom it was 18.5%, 16% and 21.5%. Females reported lower comfort with weight and eating pattern (mean 2.9 and 3.0 respectively) than Males (mean 3.7 and 3.6 respectively), each p < 0.001. Lower comfort with weight (p < 0.001) and eating pattern (p = 0.001) was associated with higher body mass index (BMI). Young adults with low comfort with weight and eating pattern experienced elevated diabetes distress and depressive/anxiety symptoms (each p < 0.001), also when adjusted for sex and BMI.

Conclusions

The study has shown that low comfort with WSE is common among young adults with T1D. Adding these questions into routine care, can allow for easy and early identification of low comfort, initiation of a therapeutic dialogue and implementation of focused management strategies.
The Brief Symptom Inventory-9 (BSI-9): Development and validation in a German general population sample
Authors: MacDonald C. , Brophy K. , Coroiu A. , Braehler Elmar , Körner A.
Published: July 2024

Background

The Brief Symptom Inventory-18 (BSI-18) is a self-report questionnaire with three subscales, somatisation, anxiety, and depression, based on longer measures of distress. The present study proposes a shorter, nine-item version (BSI-9) of the BSI-18 as a brief screening tool for distress.

Methods

Confirmatory factor analyses and reliability and validity analyses were carried out using a representative sample of the German general population. Confirmatory factor analysis demonstrates a good model fit for the three-dimensional BSI-9.

Results

The total scale was found to have strong internal consistency (αCronbach = 0.87 for the global severity index). The internal consistency coefficients of the three-item subscales reflect the brevity of these scales (somatisation ﻿αCronbach = 0.72, depression ﻿α Cronbach = 0.79, anxiety ﻿αCronbach = 0.68). The subscales were found to be significantly related with subscales of the Patient Health Questionnaire-4 and Hopkins Symptom Checklist-25.

Limitations

The present study used a limited number of distress measures, and a more recent dataset would be useful to provide a more current picture of the general population’s distress levels.

Conclusions

The BSI-9 provides a short, valid, and reliable screener for distress in the general population. Future work should examine its utility in clinical settings and different cultural contexts.
Lysine methylation modifications in tumor immunomodulation and immunotherapy: regulatory mechanisms and perspectives
Authors: Luo Yiming , Lu Junli , Lei Zhen , Zhu He , Rao Dean , Wang Tiantian , Fu Chenan , Zhang Zhiwei , Xia Limin , Huang Wenjie
Published: July 2024

Lysine methylation is a crucial post-translational modification (PTM) that significantly impacts gene expression regulation. This modification not only influences cancer development directly but also has significant implications for the immune system. Lysine methylation modulates immune cell functions and shapes the anti-tumor immune response, highlighting its dual role in both tumor progression and immune regulation. In this review, we provide a comprehensive overview of the intrinsic role of lysine methylation in the activation and function of immune cells, detailing how these modifications affect cellular processes and signaling pathways. We delve into the mechanisms by which lysine methylation contributes to tumor immune evasion, allowing cancer cells to escape immune surveillance and thrive. Furthermore, we discuss the therapeutic potential of targeting lysine methylation in cancer immunotherapy. Emerging strategies, such as immune checkpoint inhibitors (ICIs) and chimeric antigen receptor T-cell (CAR-T) therapy, are being explored for their efficacy in modulating lysine methylation to enhance anti-tumor immune responses. By targeting these modifications, we can potentially improve the effectiveness of existing treatments and develop novel therapeutic approaches to combat cancer more effectively.
Ancient paintings inpainting based on dual encoders and contextual information
Authors: Sun Zengguo , Lei Yanyan , Wu Xiaojun
Published: July 2024

Deep learning-based inpainting models have achieved success in restoring natural images, yet their application to ancient paintings encounters challenges due to the loss of texture, lines, and color. To address these issues, we introduce an ancient painting inpainting model based on dual encoders and contextual information to overcome the lack of feature extraction and detail texture recovery when restoring ancient paintings. Specifically, the proposed model employs a gated encoding branch that aims to minimize information loss and effectively capture semantic information from ancient paintings. A dense multi-scale feature fusion module is designed to extract texture and detail information at various scales, while dilated depthwise separable convolutions are utilized to reduce parameters and enhance computational efficiency. Furthermore, a contextual feature aggregation module is incorporated to extract contextual features, enhancing the overall consistency of the inpainting results. Finally, a color loss function is introduced to ensure color consistency in the restored area, harmonizing it with the surrounding region. The experimental results indicate that the proposed model effectively restores the texture details of ancient paintings, outperforming other methods both qualitatively and quantitatively. Additionally, the model is tested on real damaged ancient paintings to validate its practicality and efficacy.
Latest findings highlight the continuing uncertainty over the utility of compulsory psychiatric treatment in the community
Authors: Kisely Steve , Zirnsak Tessa , Maylea Chris , Bull Claudia , Brophy Lisa
Published: July 2024

Community treatment orders (CTOs) have been introduced in many jurisdictions with evidence of increasing use over time as well as a disproportionate use in marginalised populations. Rates of CTOs also vary widely, both internationally and within the same country, for reasons that are poorly understood. This is despite evidence for effectiveness being mixed and, as a result, there have been calls for a reappraisal of this type of legislation. In the UK, a parliamentary committee on reforming the existing Mental Health Act recommended abolishing CTOs other than for people in the criminal justice system. Two recent Australian papers based on large state-wide administrative data-sets give conflicting results and came to markedly different conclusions regarding the desirability of reducing CTO rates. The debate about the effectiveness of CTOs therefore remains unresolved. This is of concern beyond Australia, as other jurisdictions such as England, Scotland and Canada have similar clinician-initiated orders.
High-resolution live cell imaging to define ultrastructural and dynamic features of the halotolerant yeast Debaryomyces hansenii
Authors: Xelhuantzi Martha S. C. , Ghete Daniel , Milburn Amy , Ioannou Savvas , Mudd Phoebe , Calder Grant , Ramos José , O'Toole Peter J. , Genever Paul G. , MacDonald Chris
Published: July 2024

Although some budding yeasts have proved tractable and intensely studied models, others are more recalcitrant. Debaryomyces hansenii, an important yeast species in food and biotechnological industries with curious physiological characteristics, has proved difficult to manipulate genetically and remains poorly defined. To remedy this, we have combined live cell fluorescent dyes with high-resolution imaging techniques to define the sub-cellular features of D. hansenii, such as the mitochondria, nuclei, vacuoles and the cell wall. Using these tools, we define biological processes like the cell cycle, organelle inheritance and various membrane trafficking pathways of D. hansenii for the first time. Beyond this, reagents designed to study Saccharomyces cerevisiae proteins were used to access proteomic information about D. hansenii. Finally, we optimised the use of label-free holotomography to image yeast, defining the physical parameters and visualising sub-cellular features like membranes and vacuoles. Not only does this work shed light on D. hansenii but this combinatorial approach serves as a template for how other cell biological systems, which are not amenable to standard genetic procedures, can be studied.