bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparing regime types – ‘most similar’ cases in East Asia
Authors: Berg-Schlosser Dirk , Hoffmann-Lange Ursula
Published: April 2023

The People's Republic of China (PRC), the Special Administrative Region of Hong Kong, the Republic of China (Taiwan) and the Republic of Singapore represent different types of political regimes and provide a fascinating contrast concerning their performance with regard to the global conflict between liberal democracies and autocracies. This paper examines briefly their common historical backgrounds and provides a detailed analysis of common ‘Asian’ cultural features and popular support for democracy on the micro-level. It then systematically assesses their performance concerning liberal democracy and quality, governance scores, and socio-economic development. Finally, the reactions to the Covid-19 pandemic are documented showing again specific regime characteristics. We use most recent V-Dem, World Bank, United Nations Development Programme, World Values Surveys and similar data. The conclusions point to possible international consequences and the crucial position of Taiwan.
Mental Health Among People Presenting for Care of Physical Symptoms: The Factors Associated with Suicidality and Symptoms of Depression and Anxiety are Similar Across Specialties
Authors: Ramtin Sina , Carberry Kathleen , Correa Maria , Ring David , Alter Carol , Shanor Donna
Published: April 2023

Background

To identify differences in thoughts of suicide and symptoms of depression and anxiety by specialty among people presenting for care of physical symptoms, we analyzed data from routine mental health measurement in a small multispecialty practice and asked: 1. Are there any differences in suicidality (analyzed as an answer of 1 or greater or 2 or greater on the Patient Health Questionnaire [PHQ] question 9) in non-specialty and various types of specialty care? 2. Are there any factors—including specialty–associated with symptoms of depression (mean PHQ score), PHQ thresholds (greater than 0, 3 or greater, 10 or greater), Generalized Anxiety Disorder instrument [GAD] score of 3 or greater, and either GAD score 3 or greater or PHQ score 3 or greater? and 3. What factors are associated with referral to a social worker?

Methods

As part of routine specialty and non-specialty care, 13,211 adult patients completed a measure of symptoms of depression (PHQ) that included a question about suicidality and a measure of symptoms of anxiety (GAD). Factors associated with suicidality and symptoms of depression and anxiety at various thresholds, and visit with a social worker, were sought in multivariable models.

Results

Accounting for potential confounding in multivariable analyses, a score higher than 0 on the suicidality question (present in 18% of people) was associated with men, younger age, English-speakers, and neurodegenerative specialty care. Symptoms of depression on their continuum and using various thresholds (28% of people had a PHQ score greater than 2) were associated with non-Spanish-speakers, younger age, women, and county insurance or Medicaid insurance. Care from the social worker was associated with PHQ score of 3 or greater and having any suicidal thoughts (score of 1 or greater on question 9) but was less common with Medicare or Commercial Insurance and less common in the unit treating cognitive decline.

Conclusion

The notable prevalence of symptoms of depression and suicidality among people presenting for care of physical symptoms across specialties and the relatively similar factors associated with suicidality, symptoms of depression, and symptoms of anxiety at various thresholds suggests that both non-specialty and specialty clinicians can be vigilant for opportunities for improved mental health. Increased recognition that people seeking care for physical symptoms often have mental health priorities has the potential to improve comprehensive care strategies, alleviate distress, and reduce suicide.
Biomarkers of moderate alcohol intake and alcoholic beverages: a systematic literature review
Authors: Trius-Soler Marta , Praticò Giulia , Gürdeniz Gözde , Garcia-Aloy Mar , Canali Raffaella , Fausta Natella , Brouwer-Brolsma Elske M. , Andrés-Lacueva Cristina , Dragsted Lars Ove
Published: April 2023

The predominant source of alcohol in the diet is alcoholic beverages, including beer, wine, spirits and liquors, sweet wine, and ciders. Self-reported alcohol intakes are likely to be influenced by measurement error, thus affecting the accuracy and precision of currently established epidemiological associations between alcohol itself, alcoholic beverage consumption, and health or disease. Therefore, a more objective assessment of alcohol intake would be very valuable, which may be established through biomarkers of food intake (BFIs). Several direct and indirect alcohol intake biomarkers have been proposed in forensic and clinical contexts to assess recent or longer-term intakes. Protocols for performing systematic reviews in this field, as well as for assessing the validity of candidate BFIs, have been developed within the Food Biomarker Alliance (FoodBAll) project. The aim of this systematic review is to list and validate biomarkers of ethanol intake per se excluding markers of abuse, but including biomarkers related to common categories of alcoholic beverages. Validation of the proposed candidate biomarker(s) for alcohol itself and for each alcoholic beverage was done according to the published guideline for biomarker reviews. In conclusion, common biomarkers of alcohol intake, e.g., as ethyl glucuronide, ethyl sulfate, fatty acid ethyl esters, and phosphatidyl ethanol, show considerable inter-individual response, especially at low to moderate intakes, and need further development and improved validation, while BFIs for beer and wine are highly promising and may help in more accurate intake assessments for these specific beverages.
Mechanical protective effect of lens anterior capsule disc on corneal endothelial cells during femtosecond laser-assisted cataract surgery in a rabbit model
Authors: Wu Bowen , Ding Xue , Li Shaowei , Huo Dongmei , Zhang Fan , Liang Weiyan , Li Ling , Dou Zexia
Published: April 2023

Purpose

To evaluate the effects of a novel technique using an isolated lens anterior capsule disc (LACD) to protect corneal endothelial cells in rabbit eyes during femtosecond laser-assisted cataract surgery.

Methods

Experimental study. 40 rabbits were divided into endothelium-protected (experimental) and control groups, with 20 rabbits in each group. In the experimental group, after femtosecond laser capsulotomy, the isolated capsule disc was lifted to the corneal endothelium by an ophthalmic viscosurgical device. The endothelium was damaged for 1 min with an ultrasonic probe. The control group underwent the same surgery, except that the disc was removed immediately after capsulorhexis. Corneal endothelioscopy was performed preoperatively and on postoperative days (PODs) 3 and 7 to observe endothelial cell counts (ECC) and endothelial cell loss rate. Central corneal thickness (CCT) was measured before and at PODs 1, 3 and 7.

Results

There were 3.59%±1.88% (p < 0.001) and 2.92%±2.14% (p < 0.001) loss of ECC in experimental group at POD3 and POD7, respectively, while those in the control group were 11.62%±7.43% and 10.34%±5.77%, respectively. On POD 1, the difference in central corneal thickness was significant(P = 0.019) between the two groups. At POD 3 and POD 7, CCT was not significantly different (P = 0.597;0.913) between the two groups.

Conclusions

The isolated LACD technique significantly reduced damage to the endothelium caused by ultrasonic energy and protects corneal endothelial cells during phacoemulsification.
Insights into barriers and facilitators in PrEP uptake and use among migrant men and transwomen who have sex with men in Belgium
Authors: Van Landeghem Ella , Dielen Stef , Semaan Aline , Rotsaert Anke , Vanhamel Jef , Masquillier Caroline , Wouters Edwin , Wouters Kristien , Vuylsteke Bea , Reyniers Thijs , Nöstlinger Christiana
Published: April 2023

Background

PrEP uptake is low among non-Belgian men and transwomen who have sex with men, although the HIV epidemic among men who have sex with men in Belgium is diversifying in terms of nationalities and ethnicity. We lack an in-depth understanding of this gap.

Methods

We conducted a qualitative study using a grounded theory approach. The data consists of key informants interviews and in-depth interviews with migrant men or transwomen who have sex with men.

Results

We identified four underlying determinants which shape our participants’ experiences and contextualize the barriers to PrEP use. These include (1) the intersectional identities of being migrant and men and transwomen who have sex with men, (2) migration related stressors, (3) mental health and (4) socio-economic vulnerability. Identified barriers include: the accessibility of services; availability of information, social resources and providers’ attitudes. These barriers influence PrEP acceptance and mediated by individual agency this influences their PrEP uptake.

Conclusion

An interplay of several underlying determinants and barriers impacts on PrEP uptake among migrant men and transwomen who have sex with men, illustrating a social gradient in access to PrEP. We need equitable access to the full spectrum of HIV prevention and care for all priority populations, including undocumented migrants. We recommend social and structural conditions that foster exercising these rights, including adapting PrEP service delivery, mental health and social support.
Heart health for South Asians: improved cardiovascular risk factors with a culturally tailored health education program
Authors: Vafaei Paniz , Liu Chi-Mei , Davis Hank , Patel Priyal , Vadlakonda Uma , Pursnani Seema
Published: April 2023

Background/Aim

The Kaiser Permanente (KP) Northern California Heart Health for South Asians (HHSA) Program is a two-hour educational class that provides culturally relevant lifestyle and dietary recommendations to South Asian (SA) patients, in an effort to reduce their known disproportionate burden of cardiovascular (CV) disease. We evaluated the impact of the HHSA Program on CV risk factors and major adverse CV events (MACE).

Methods

A retrospective cohort study identified 1517 participants of SA descent, ≥ 18 years old from 2006 to 2019. We evaluated the change in risk factors with program attendance (median follow up of 6.9 years) for systolic blood pressure (SBP), diastolic blood pressure (DBP), triglycerides (TG), LDL, HDL, BMI, and HbA1c. We also performed a propensity matched analysis to evaluate differences in MACE including stroke, myocardial infarction (MI), coronary revascularization, and all-cause mortality.

Results

There were significant improvements in DBP, TG, LDL-c, HDL-c, BMI, and HbA1c at one year follow up and sustained improvements in DBP (-1.01mmHg, p = 0.01), TG (-13.74 mg/dL, p = 0.0001), LDL-c (-8.43 mg/dL, p = < 0.0001), and HDL-c (3.16 mg/dL, p = < 0.0001) levels at the end of follow up. In the propensity matched analysis, there was a significant reduction in revascularization (OR 0.33, 95% CI 0.14–0.78, p = 0.011) and mortality (OR 0.41, 95% CI 0.22–0.79, p = 0.008), and a trend towards reduction in stroke.

Conclusions

Our study demonstrates the efficacy of a culturally tailored SA health education program in improving CV risk factors and reducing MACE. The program highlights the importance and value of providing culturally tailored health education in primary CV disease prevention.
Efficacy of surgical methods for peri-implantitis: a systematic review and network meta-analysis
Authors: Cheng Jing , Chen Liang , Tao Xian , Qiang Xiang , Li Ruiying , Ma Jia , Shi Dong , Qiu Zijin
Published: April 2023

Background

Peri-implantitis is the most difficult biological complication associated with dental implants, often requiring surgical treatments in advanced stages. This study compares the effectiveness of different surgical methods for peri-implantitis.

Methods

Randomized controlled trials (RCTs) of different surgical treatments for peri-implantitis were extracted from EMBASE, Web of Science, Cochrane Library databases, and PubMed systematically. Pairwise comparisons and network meta-analyses (NMA) were conducted to analyze the effect of surgical treatments on probing depth (PD), radiographic bone fill (RBF), mucosal recession (MR), bleeding on probing (BOP), and clinical attachment level (CAL). In addition, risk of bias, quality of evidence, and statistical heterogeneity of the selected studies were evaluated. A total of 13 articles were included in this study, involving open flap debridement (OFD), resective therapy (RT), and augmentative therapy (AT) with and without adjunctive treatments (laser therapy, photodynamic therapy, local antibiotics, phosphoric acid, and ozone therapy).

Results

AT improved RBF and CAL more than OFD, but does not outperform OFD in reducing peri-implant soft-tissue inflammation. AT, OFD and RT did not significantly alter the levels of MR. Addition of ozone therapy improved the effect of AT, but addition of photodynamic therapy did not affect PD reduction and CAL gain significantly. Similarly, adjuvant treatment with phosphoric acid during RT did not significantly change the outcome of BOP.

Conclusions

Within the limitation of this systematic review and NMA, AT was superior to OFD in improving peri-implantitis outcomes. While adjunct use of ozone therapy may further improve the efficacy of AT, the limited evidence supporting this combination therapy argues for cautionary interpretation of these results.
A pilot study on sports activities in pediatric palliative care: just do it
Authors: Avagnina Irene , Santini Anna , Maghini Irene , Salamon Eleonora , Papa Simonetta , Giacomelli Luca , Perilongo Giorgio , Agosto Caterina , Benini Franca
Published: April 2023

Background

There has been a growing interest in studying the value of physical exercise in children with disabilities or chronic health conditions because of evidence of improvement in quality of life, social acceptance, and physical functioning. However, only scant evidence exists for routine sports activities in children requiring pediatric palliative care (PPC), and in most cases, such evidence has been collected in oncological patients. The Pediatric Hospice of Padua is the referral center for PPC in the Veneto region (northern Italy). Starting from the experience of this PPC center, this pilot study aims to describe the personal experience of children and young people who practice physical activity and their caregivers’ perspectives, focusing particularly on the emotional and social impact of exercise and sports practice.

Methods

Patients involved in at least one regular and structured sports activity were included in the pilot analysis. Two different ICF-CY (International Classification of Functioning, Disability and Health-Children and Youth Version) scales (“Body Function” and “Activity and Participation”) were filled out to assess the children’s global functional competence. Two online ad hoc questionnaires were created and administered to children, when able to respond, and caregivers.

Results

A total of 9% of patients reported being involved in a sports activity. All children who played sports did not have indications of cognitive retardation. The most practiced sport was swimming. The use of standardized methods such as ICF-CY shown that severe motor impairments do not limit sports accessibility. Questionnaires result suggest that sports are a positive experience for both children needing PPC and their parents. Children encourage other children to do sports and can find the positive side even in difficulties.

Conclusion

Since PPC is encouraged as early as the diagnosis of incurable pathologies, the inclusion of sports activities in the context of a PPC plan should be considered from the perspective of improving quality of life.
A mechanically validated open-source silicone model for the training of gastric perforation sewing
Authors: Warnung Lukas , Sattler Stefan , Haiden Elmar , Schober Sophie , Pahr Dieter , Reisinger Andreas
Published: April 2023

Background

Gastrointestinal perforation is commonly seen in emergency departments. The perforation of the stomach is an emergency situation that requires immediate surgical treatment. The necessary surgical skills require regular practical training. Owing to patient`s safety, in vivo training opportunities in medicine are restricted. Animal tissue especially porcine tissue, is commonly used for surgical training. Due to its limiting factors, artificial training models are often to be preferred. Many artificial models are on the market but to our knowledge, none that mimic the haptic- and sewing properties of a stomach wall at the same time. In this study, an open source silicone model of a gastric perforation for training of gastric sewing was developed that attempts to provide realistic haptic- and sewing behaviour.

Methods

To simulate the layered structure of the human stomach, different silicone materials were used to produce three different model layups. The production process was kept as simple as possible to make it easily reproducible. A needle penetration setup as well as a systematic haptic evaluation were developed to compare these silicone models to a real porcine stomach in order to identify the most realistic model.

Results

A silicone model consisting of three layers was identified as being the most promising and was tested by clinical surgeons.

Conclusions

The presented model simulates the sewing characteristics of a human stomach wall, is easily reproducible at low-costs and can be used for practicing gastric suturing techniques.

Trial registrations

Not applicable.
Barriers and facilitators to training delivery and subsequent implementation of a localised child and adolescent mental health initiative: a qualitative content analysis
Authors: Banwell Emily , Qualter Pamela , Humphrey Neil
Published: April 2023

Background

Ensuring that children and young people (CYP) can obtain mental health support from a broad variety of sources is of upmost importance. This is especially true given the increasing prevalence of mental health difficulties in this population, and the associated challenges with receiving support from specialised healthcare services. Equipping professionals, from a wide range of sectors, with the skills needed to provide this support is a vital starting point. This study explored the experiences of professionals who had participated in CYP mental health training modules that related directly to the local implementation of the THRIVE Framework for System Change in Greater Manchester, UK (GM i-THRIVE) to establish the perceived barriers and facilitators behind the implementation of this training programme.

Methods

Directed qualitative content analysis of semi-structured interview data from nine CYP-facing professionals was conducted. Both the interview schedule and initial deductive coding strategy were developed using the findings of a systematic literature review by the authors, that was conducted to explore wider CYP mental health training experiences. This methodology was used to establish the presence or absence of these findings within GM i-THRIVE, before generating tailored recommendations for their training programme.

Results

When the interview data were coded and analysed, a strong level of thematic similarity with the authors’ review was found. However, we deduced that the emergence of additional themes might reflect the contextual uniqueness of GM i-THRIVE, that is likely to be further compounded by the COVID-19 pandemic. Six recommendations were made for further improvement. These included the facilitation of unstructured peer interaction during training, and ensuring that jargon and key words are fully clarified.

Conclusions

Methodological limitations, guidance for usage, and potential applications of the study’s findings are explored. Whilst the findings were largely akin to those of the review, subtle yet important differences were found. These are likely to reflect the nuances of the training programme discussed, however, we tentatively suggest that our findings are transferable to similar training interventions. This study provides a valuable example of how qualitative evidence syntheses can be used to aid study design and analysis: an underused approach.
The impact of metabolic endotoxaemia on the browning process in human adipocytes
Authors: Omran Farah , Murphy Alice M. , Younis Awais Z. , Kyrou Ioannis , Vrbikova Jana , Hainer Vojtech , Sramkova Petra , Fried Martin , Ball Graham , Tripathi Gyanendra , Kumar Sudhesh , McTernan Philip G. , Christian Mark
Published: April 2023

Background

Dysfunctional adipose tissue (AT) is known to contribute to the pathophysiology of metabolic disease, including type 2 diabetes mellitus (T2DM). This dysfunction may occur, in part, as a consequence of gut-derived endotoxaemia inducing changes in adipocyte mitochondrial function and reducing the proportion of BRITE (brown-in-white) adipocytes. Therefore, the present study investigated whether endotoxin (lipopolysaccharide; LPS) directly contributes to impaired human adipocyte mitochondrial function and browning in human adipocytes, and the relevant impact of obesity status pre and post bariatric surgery.

Methods

Human differentiated abdominal subcutaneous (AbdSc) adipocytes from participants with obesity and normal-weight participants were treated with endotoxin to assess in vitro changes in mitochondrial function and BRITE phenotype. Ex vivo human AbdSc AT from different groups of participants (normal-weight, obesity, pre- and 6 months post-bariatric surgery) were assessed for similar analyses including circulating endotoxin levels.

Results

Ex vivo AT analysis (lean & obese, weight loss post-bariatric surgery) identified that systemic endotoxin negatively correlated with BAT gene expression (p < 0.05). In vitro endotoxin treatment of AbdSc adipocytes (lean & obese) reduced mitochondrial dynamics (74.6% reduction; p < 0.0001), biogenesis (81.2% reduction; p < 0.0001) and the BRITE phenotype (93.8% reduction; p < 0.0001). Lean AbdSc adipocytes were more responsive to adrenergic signalling than obese AbdSc adipocytes; although endotoxin mitigated this response (92.6% reduction; p < 0.0001).

Conclusions

Taken together, these data suggest that systemic gut-derived endotoxaemia contributes to both individual adipocyte dysfunction and reduced browning capacity of the adipocyte cell population, exacerbating metabolic consequences. As bariatric surgery reduces endotoxin levels and is associated with improving adipocyte functionality, this may provide further evidence regarding the metabolic benefits of such surgical interventions.
Nutritional and immunological evaluation of Nannochloropsis oculata as a potential Nile tilapia-aquafeed supplement
Authors: Zahran Eman , Elbahnaswy Samia , Ahmed Fatma , Ibrahim Iman , Khaled Asmaa A. , Eldessouki Elsayed A.
Published: April 2023

Nannochloropsis oculata (N. oculata) is a marine microalga containing bioactive compounds and a high omega-3 polyunsaturated fatty acid (ω-3 PUFAs). Therefore, it is very promising for nutraceutical and the functional food industry applications. Three groups of Nile tilapia (forty-five fish/group) were fed on basal diets or diets containing 5% (N5) or 10% (N10) of the microalga N. oculata for seven weeks. Fish growth performance, proximate composition, and lipid (fatty acids/ FAs and lipoproteins) profile were estimated. In addition, the expression pattern of some lipid metabolism and immune-relevant genes were assessed. An enhancement in whole body crude protein and growth indices of Nile tilapia was observed on both the supplemented groups N5 and N10. Higher levels of high-density lipoproteins (HDL); and lower levels of the low-density lipoproteins (LDL) were evident in both supplemented groups, while the cholesterol and triglycerides (TG) levels were similar among groups. Ω-3 PUFAs were the significant FAs profile of tilapia fed on N. oculata-supplemented diets in terms of eicosapentaenoic acid, docosahexaenoic acid, and n3/n6 ratio. Concerning the gene expression pattern, heat-shock protein70, glutathione-S-transferase, glutathione peroxidase, and interleukin-1β (IL-1β) were elevated significantly in both supplemented groups. IL-10 is only upregulated in the N10 group. The lipid metabolism-related gene expression showed downregulation of only fatty acid synthase (FAS) in both supplemented groups, with no statistical changes in Peroxisome proliferator-activated receptor alpha (PPARα). Tumor necrosis factor-α (TNF-α), Transforming growth factor-β1 (TGF-β1), and the apoptotic related genes [caspase3 and Proliferating cell nuclear antigen (PCNA)] showed insignificant changes among groups. The histopathological examination of the intestine, liver, and spleen supports our findings and confirms the benefits and safeness of N. oculata dietary inclusion. Collectively, N. oculata is a very promising nutraceutical for improving fish health and sustainability of aquaculture production.

Graphical Abstract
Integrated microbiome and metabolome analysis reveals novel urinary microenvironmental signatures in interstitial cystitis/bladder pain syndrome patients
Authors: Zheng Zhenming , Hu Jintao , Li Wenshuang , Ma Kaiqun , Zhang Caixia , Li Kuiqing , Yao Yousheng
Published: April 2023

Background

The pathogenesis of interstitial cystitis/bladder pain syndrome (IC/BPS) has not been elucidated, but urinary microorganisms and metabolites have been shown to be closely associated with the inflammatory response of IC/BPS. Nevertheless, the exact mechanisms related to this response have not been clarified.

Methods

16S rRNA sequencing and untargeted metabolomics techniques were used to analyse the urinary microbial and metabolite profiles of 30 IC/BPS patients and 30 healthy controls, and correlation analyses were performed to explore the mechanisms by which they might be involved in the inflammatory response of IC/BPS.

Results

Twenty-eight differential genera, such as Lactobacillus and Sphingomonas, were identified. A total of 44 differential metabolites such as 1,3,7-trimethyluric acid and theophylline were screened. The abundance of Lactobacillus and Escherichia-Shigella was significantly higher in the urine of female IC/BPS patients and healthy controls compared to males, while Bacteroides and Acinetobacter were lower than in males. The results of the Pearson correlation analysis suggested that differential microorganisms may influence the composition of metabolites. The Lactobacillus genus may be a protective bacterium against IC/BPS, whereas Sphingomonas may be a pathogenic factor. The differential metabolite theophylline, as an anti-inflammatory substance, may downregulate the inflammatory response of IC/BPS.

Conclusions

This study revealed microbial and metabolite profiles in the urine of IC/BPS patients versus healthy controls in both males and females. We also found some microorganisms and metabolites closely related to the inflammatory response of IC/BPS, which provided directions for future aetiological and therapeutic research.
The interplay between human papillomavirus and vaginal microbiota in cervical cancer development
Authors: Sharifian Kimia , Shoja Zabihollah , Jalilvand Somayeh
Published: April 2023

Over the past few decades, we have grown accustomed to the idea that human papillomavirus can cause tumors. The genetic and environmental factors that make the difference between elimination of viral infection and the development of cancer are therefore an area of active investigation at present. Microbiota has emerged as an important factor that may affect this balance by increasing or decreasing the ability of viral infection to promote. The female reproductive system has its specific microbiota that helps to maintain health and prevent infection with pathogens. In contrast to other mucosal sites, the vaginal microbiota typically has low diversity and contains few Lactobacillus spp. which by using high-throughput 16s rRNA gene sequencing, classified into five different community state types. According to emerging information, increased diversity of vaginal microbiota and reduced abundance of Lactobacillus spp. contribute to HPV acquisition, persistence, and development of cervical cancer. In this review, the role of normal female reproductive tract microbiota in health, mechanisms which dysbiosis can cause diseases through interaction with microbes and several therapeutic approaches were addressed.
Monotropein attenuates apoptosis and pyroptosis in chondrocytes and alleviates osteoarthritis progression in mice
Authors: Li Zhen , Chen Zhenyue , Chen Jiayi , Liu Zhutong , Li Zehui , Sun He , Wang Xiaochao , Wei Jinqiang , Cao Xuewei , Zheng Decai
Published: April 2023

Background

Osteoarthritis (OA) is a chronic degenerative joint disease characterized by loss of joint function, which seriously reduces the quality of life of the elderly and imposes a heavy socioeconomic burden worldwide. Monotropein (MON), the main active ingredient ofMorinda officinalisF.C. How, has exhibited therapeutic effects in different disease models. However, its potential effects on chondrocytes in an arthritic model remain unclear. This study aimed to evaluate the effects of MON in chondrocytes and a mouse model of OA, and explore the potential mechanisms.

Materials and methods

Murine primary chondrocytes were pretreated with 10 ng/ml interleukin (IL)-1β for 24 h to establish an in vitro model of OA, and then treated with different concentrations of MON (0, 25, 50 and 100 μM) for 24 h. The proliferation of the chondrocytes was assayed using ethynyl-deoxyuridine (EdU) staining. Immunofluorescence staining, western blotting and TUNEL staining were performed to assess the effects of MON on cartilage matrix degradation, apoptosis and pyroptosis. The mouse model of OA was constructed by surgical destabilization of the medial meniscus (DMM), and the animals were randomly divided into the sham-operated, OA and OA + MON groups. Following OA induction, the mice were given intraarticular injection of 100 μM MON or equal volume of normal saline twice a week for 8 weeks. The effects of MON on cartilage matrix degradation, apoptosis and pyroptosis were assessed as indicated.

Results

MON significantly accelerated the proliferation of chondrocytes, and inhibited cartilage matrix degradation, apoptosis and pyroptosis in the IL-1β-stimulated cells by blocking the nuclear factor-kappa B (NF-κB) signaling pathway. In the mouse model as well, MON treatment alleviated OA progression and promoted cartilage repair by inhibiting cartilage matrix degradation, and chondrocyte apoptosis and pyroptosis through the inactivation of the NF-κB signaling pathway. Furthermore, the MON-treated arthritic mice exhibited better articular tissue morphology and lower OARSI scores.

Conclusions

MON alleviated OA progression by inhibiting cartilage matrix degradation, and the apoptosis and pyroptosis of chondrocytes via NF-κB pathway inactivation, and is a promising alternative for the treatment of OA.
Subjective and objective survival prediction in mechanically ventilated critically ill patients: a prospective cohort study
Authors: Boeck Lucas , Pargger Hans , Schellongowski Peter , Luyt Charles-Edouard , Maggiorini Marco , Jahn Kathleen , Muller Grégoire , Lötscher Rene , Bucher Evelyne , Cueni Nadine , Staudinger Thomas , Chastre Jean , Siegemund Martin , Tamm Michael , Stolz Daiana
Published: April 2023

Background

ICU risk assessment tools, routinely used for predicting population outcomes, are not recommended for evaluating individual risk. The state of health of single patients is mostly subjectively assessed to inform relatives and presumably to decide on treatment decisions. However, little is known how subjective and objective survival estimates compare.

Methods

We performed a prospective cohort study in mechanically ventilated critically ill patients across five European centres, assessed 62 objective markers and asked the clinical staff to subjectively estimate the probability of surviving 28 days.

Results

Within the 961 included patients, we identified 27 single objective predictors for 28-day survival (73.8%) and pooled them into predictive groups. While patient characteristics and treatment models performed poorly, the disease and biomarker models had a moderate discriminative performance for predicting 28-day survival, which improved for predicting 1-year survival. Subjective estimates of nurses (c-statistic [95% CI] 0.74 [0.70–0.78]), junior physicians (0.78 [0.74–0.81]) and attending physicians (0.75 [0.72–0.79]) discriminated survivors from non-survivors at least as good as the combination of all objective predictors (c-statistic: 0.67–0.72). Unexpectedly, subjective estimates were insufficiently calibrated, overestimating death in high-risk patients by about 20% in absolute terms. Combining subjective and objective measures refined discrimination and reduced the overestimation of death.

Conclusions

Subjective survival estimates are simple, cheap and similarly discriminative as objective models; however, they overestimate death risking that live-saving therapies are withheld. Therefore, subjective survival estimates of individual patients should be compared with objective tools and interpreted with caution if not agreeing.

Trial registration ISRCTN ISRCTN59376582, retrospectively registered October 31st 2013.
PAUSE: principled feature attribution for unsupervised gene expression analysis
Authors: Janizek Joseph D. , Spiro Anna , Celik Safiye , Blue Ben W. , Russell John C. , Lee Ting-I , Kaeberlin Matt , Lee Su-In
Published: April 2023

As interest in using unsupervised deep learning models to analyze gene expression data has grown, an increasing number of methods have been developed to make these models more interpretable. These methods can be separated into two groups: post hoc analyses of black box models through feature attribution methods and approaches to build inherently interpretable models through biologically-constrained architectures. We argue that these approaches are not mutually exclusive, but can in fact be usefully combined. We propose PAUSE (https://github.com/suinleelab/PAUSE), an unsupervised pathway attribution method that identifies major sources of transcriptomic variation when combined with biologically-constrained neural network models.
Optimal statin use for prevention of sepsis in type 2 diabetes mellitus
Authors: Sun Mingyang , Tao Yuan , Chen Wan-Ming , Wu Szu-Yuan , Zhang Jiaqiang
Published: April 2023

Purpose

To investigate the dose-dependent protective effects of statins, specific classes of statins, and different intensities of statin use on sepsis risk in patients with type 2 diabetes mellitus (T2DM).

Methods

We included patients with T2DM aged  ≥ 40 years. Statin use was defined as the use of statin on most days for  > 1 months with a mean statin dose of  ≥ 28 cumulative defined daily doses (cDDDs) per year (cDDD-year). An inverse probability of treatment-weighted Cox hazard model was used to investigate the effects of statin use on sepsis and septic shock while considering statin use status as a time-dependent variable.

Results

From 2008 to 2020, a total of 812 420 patients were diagnosed as having T2DM. Among these patients, 118,765 (27.79%) statin nonusers and 50 804 (12.03%) statin users developed sepsis. Septic shock occurred in 42,755 (10.39%) individuals who did not use statins and 16,765 (4.18%) individuals who used statins. Overall, statin users had a lower prevalence of sepsis than did nonusers. The adjusted hazard ratio (aHR) of statin use was 0.37 (95% CI 0.35, 0.38) for sepsis compared with no statin use. Compared with the patients not using statins, those using different classes of statins exhibited a more significant reduction in sepsis, with aHRs (95% CIs) of sepsis being 0.09 (0.05, 0.14), 0.32 (0.31, 0.34), 0.34 (0.32, 0.36), 0.35 (0.32, 0.37), 0.37 (0.34, 0.39), 0.42 (0.38, 0.44), and 0.54 (0.51, 0.56) for pitavastatin, pravastatin, rosuvastatin, atorvastatin, simvastatin, fluvastatin, and lovastatin use, respectively. In the patients with different cDDD-years of statins, multivariate analysis indicated a significant reduction in sepsis, with aHRs of 0.53 (0.52, 0.57), 0.40 (0.39, 0.43), 0.29 (0.27, 0.30), and 0.17 (0.15, 0.19) for Q1, Q2, Q3, and Q4 cDDD-years (P for trend < 0.0001). The optimal daily statin dose of 0.84 DDD was associated with the lowest aHR. Similar trends of higher cDDD-year and specific statin types use were associated with a decrease in septic shock when compared to statin non-users.

Conclusion

Our real-world evidence demonstrated that the persistent use of statins reduced sepsis and septic shock risk in patients with T2DM and a higher cDDD-year of statin use was associated with an increased reduction of sepsis and septic shock risk in these patients.
A Stackelberg reinsurance-investment game with derivatives trading
Authors: Gao Rui , Bai Yanfei
Published: April 2023

This paper studies a stochastic Stackelberg differential reinsurance-investment game with derivatives trading under a stochastic volatility model. The reinsurer who occupies a monopoly position can price a reinsurance premium and invest her wealth in the financial market consisting of a riskless asset and a stock and derivatives tied to the stock. The insurer, the follower of the Stackelberg game, purchases proportional reinsurance from the reinsurer and invests in the same financial market. The main target of the reinsurer and the insurer is to seek their own optimal strategy to maximize the CARA utility of the relative performance. An explicit equilibrium strategy with derivatives trading is deduced by solving Hamilton-Jacobi-Bellman (HJB) equations sequentially. The equilibrium investment strategy demonstrates that the insurer and the reinsurer imitate each other’s investment strategies, showing a herd effect. In numerical experiments, the sensitivity of the equilibrium strategy to model parameters is analyzed. For the optimal investment strategy, we find that a short position in the derivative may switch to a long position with parameters changing, which provides investors with important decision-making information.
The assessment of climatic, environmental, and socioeconomic aspects of the Brazilian Cerrado
Authors: Correia Filho Washington Luiz Félix , de Oliveira-Júnior José Francisco , Santiago Dimas de Barros , Abdo Hazem Ghassan , Almohamad Hussein , Al Dughairi Ahmed Abdullah , da Silva Junior Carlos Antonio
Published: April 2023

Background

The Cerrado is the most biodiverse savanna and maintains other biomes. Aware of its significance, this paper evaluated the Brazilian Cerrado’s climatic, environmental, and socioeconomic aspects using remote sensing data and spatial statistics (correlation analysis and principal components analysis—PCA). Following the measures of sample adequacy (MSA) and Kaiser–Meyer–Olkin (KMO) tests, seventeen variables were evaluated.

Results

The MSA revealed that the dataset had a good quality (0.76), and nine variables were selected: elevation, evapotranspiration, active fires, Human Development Index (HDI), land use and land cover (LULC; shrubland and cropland/rainfed), rainfall (spring and autumn), and livestock. The correlation matrix indicated a positive (negative) association between HDI and autumn rainfall (HDI and active fires) with a value of 0.77 (− 0.55). The PCA results determined which three principal components (PC) were adequate for extracting spatial patterns, accounting for 68.02% of the total variance with respective values of 38.59%, 16.89%, and 12.5%. Due to economic development and agribusiness, Cerrado’s northern (central, western, and southern) areas had negative (positive) score HDI values, as shown in PC1. Climatic (rainfall—spring and fall) and environmental (cropland/rainfed and shrubland) aspects dominated the PC2, with negative scores in northern and western portions due to the transition zone between Amazon and Cerrado biomes caused by rainfall variability. On the other hand, environmental aspects (LULC-shrubland and elevation) influenced the PC3; areas with high altitudes (> 500 m) received a higher score.

Conclusion

Agricultural expansion substantially affected LULC, leading to deforestation-caused suppression of native vegetation.
Revision and validation of the prosocialness scale for adults (PSA) among chinese college students
Authors: Zhan Qisheng , Wang Su , Li Chengze , Li Mengri , Liu Dan , Peng Wei , Song Fanglin , Shi Tongxiao , Li Yonghui
Published: April 2023

Background

Although prosocial behavior plays an important role in the development of individuals, there are few prosocial measurements for college students. This study examines the applicability of the Prosocialness Scale for Adults to a sample of Chinese college students and provides a measurement tool for prosocial behavior among Chinese college students.

Methods

Three sub-studies were conducted in this study to revise the Prosocialness Scale for Adults (PSA) and verify its applicability in Chinese college students. In Study 1, the translated Prosocialness Scale for Adults (PSA) was used to test (N = 436). In Study 2, confirmatory factor analysis was carried out (N = 576). The Scale of School Adjustment for College Students, the Scale of Regulatory Emotional Self-Efficacy, the Prosocial Tendencies Measure, and the Chinese Big Five Personality Inventory were used to test the concurrent validity. And the internal consistency reliability of the scale was tested. In Study 3, the test-retest reliability of the scale was tested 4 weeks after the completion of Study 2.

Results

The results show that the scale has a good single-factor structure (χ2/df = 4.180, CFI = 0.936, TLI = 0.922, GFI = 0.937, IFI = 0.937, NFI = 0.919, AGFI = 0.907, RMSEA = 0.074, SRMR = 0.042). The total score was positively correlated with the scores of the Scale of Regulatory Emotional Self-Efficacy (r = 0.394, p < 0.001), the Scale of School Adjustment for College Students (r = 0.429, p < 0.001), the Chinese Big Five Personality Inventory (r = 0.456, p < 0.001) ,and the Prosocial Tendencies Measure (r = 0.619, p < 0.001). The internal consistency reliability was robust (α = 0.890) and the test-retest reliability was 0.801.

Conclusion

These studies show that the Chinese version of the Prosocialness Scale for Adults (PSA) has good reliability and validity and can be used to measure the prosocial behavior of Chinese college students.
Effect of nano-calcium carbonate on morphology, antioxidant enzyme activity and photosynthetic parameters of wheat (Triticum aestivum L.) seedlings
Authors: Gao Yu , Chen Shuang , Li Yajun , Shi Yan
Published: April 2023

To meet the human demand for crop productivity, there are several challenges that researchers are involved in the photosynthetic efficiency of plants may be one of them. Nanotechnology can improve agricultural productivity by affecting the photosynthetic activity of plants. However, no studies have yet shown that nano-calcium carbonate (NCC) can play a role in improving photosynthetic performance of plants. In order to explore the effects of NCC on wheat seedling morphology, antioxidant enzyme activities and photosynthetic parameters, wheat roots were exposed to different concentrations of NCC (0, 25, 50, 100, 200, 400 mg L−1) through hydroponic experiments. Different concentrations affected root length, root surface area, root diameter, root volume and plant dry biomass. Compared to the control (0 mg L−1 of NCC) application (CK), wheat with 200 mg L−1 of NCC application showed 54% and 58% increase in superoxide dismutase (SOD) and ascorbate peroxidase (APX) activities, respectively. As for photosynthesis-related physiological indicators, compared with CK, 200 mg L−1 of NCC significantly enhanced chlorophyll a (38%), chlorophyll b (20%), carotenoid content (19%), Rubisco activity (3.02-fold), net photosynthetic rate (Pn, 56%), transpiration rate (Tr, 40%), and stomatal conductance (Gs, 71%). The PCR results showed that compared with CK, the psbA gene encoding the photosystem PSII reaction center D1 protein and the rbcL gene encoding the large subunit of Rubisco were up-regulated by 2.56- and 2.58-fold at 200 mg L−1 NCC treatment, and by 3.22- and 3.57-fold at 400 mg L−1 NCC treatment, respectively. Specifically, NCC has significant benefits on wheat seedling growth, and 200 mg L−1 is the optimal concentration. NCC enhanced photosynthetic performance of wheat by increasing antioxidant enzyme activity, photosynthetic pigment content, Rubisco activity, stomatal conductance and PSII reaction center activity.

Graphical Abstract
Stabilization and improved functionality of three-dimensional perfusable microvascular networks in microfluidic devices under macromolecular crowding
Authors: Wan Ho-Ying , Chen Jack Chun Hin , Xiao Qinru , Wong Christy Wingtung , Yang Boguang , Cao Benjamin , Tuan Rocky S. , Nilsson Susan K. , Ho Yi-Ping , Raghunath Michael , Kamm Roger D. , Blocki Anna
Published: April 2023

Background

There is great interest to engineer
in vitro
models that allow the study of complex biological processes of the microvasculature with high spatiotemporal resolution. Microfluidic systems are currently used to engineer microvasculature
in vitro
, which consists of perfusable microvascular networks (MVNs). These are formed through spontaneous vasculogenesis and exhibit the closest resemblance to physiological microvasculature. Unfortunately, under standard culture conditions and in the absence of co-culture with auxiliary cells as well as protease inhibitors, pure MVNs suffer from a short-lived stability.

Methods

Herein, we introduce a strategy for stabilization of MVNs through macromolecular crowding (MMC) based on a previously established mixture of Ficoll macromolecules. The biophysical principle of MMC is based on macromolecules occupying space, thus increasing the effective concentration of other components and thereby accelerating various biological processes, such as extracellular matrix deposition. We thus hypothesized that MMC will promote the accumulation of vascular ECM (basement membrane) components and lead to a stabilization of MVN with improved functionality.

Results

MMC promoted the enrichment of cellular junctions and basement membrane components, while reducing cellular contractility. The resulting advantageous balance of adhesive forces over cellular tension resulted in a significant stabilization of MVNs over time, as well as improved vascular barrier function, closely resembling that of
in vivo
microvasculature.

Conclusion

Application of MMC to MVNs in microfluidic devices provides a reliable, flexible and versatile approach to stabilize engineered microvessels under simulated physiological conditions.