bluuebunny/crossref_metadata_2025 huggingface dataset:
Post-operative glioblastoma multiforme segmentation with uncertainty estimation
Authors: Holtzman Gazit Michal , Faran Rachel , Stepovoy Kirill , Peles Oren , Shamir Reuben Ruby
Published: November 2022

Segmentation of post-operative glioblastoma multiforme (GBM) is essential for the planning of Tumor Treating Fields (TTFields) treatment and other clinical applications. Recent methods developed for pre-operative GBM segmentation perform poorly on post-operative GBM MRI scans. In this paper we present a method for the segmentation of GBM in post-operative patients. Our method incorporates an ensemble of segmentation networks and the Kullback–Leibler divergence agreement score in the objective function to estimate the prediction label uncertainty and cope with noisy labels and inter-observer variability. Moreover, our method integrates the surgery type and computes non-tumorous tissue delineation to automatically segment the tumor. We trained and validated our method on a dataset of 340 enhanced T1 MRI scans of patients that were treated with TTFields (270 scans for train and 70 scans for test). For validation, we developed a tool that uses the uncertainty map along with the segmentation result. Our tool allows visualization and fast editing of the tissues to improve the results dependent on user preference. Three physicians reviewed and graded our segmentation and editing tool on 12 different MRI scans. The validation set average (SD) Dice scores were 0.81 (0.11), 0.71 (0.24), 0.64 (0.25), and 0.68 (0.19) for whole-tumor, resection, necrotic-core, and enhancing-tissue, respectively. The physicians rated 72% of the segmented GBMs acceptable for treatment planning or better. Another 22% can be edited manually in a reasonable time to achieve a clinically acceptable result. According to these results, the proposed method for GBM segmentation can be integrated into TTFields treatment planning software in order to shorten the planning process. To conclude, we have extended a state-of-the-art pre-operative GBM segmentation method with surgery-type, anatomical information, and uncertainty visualization to facilitate a clinically viable segmentation of post-operative GBM for TTFields treatment planning.
Exploring the pathogenesis of age-related macular degeneration: A review of the interplay between retinal pigment epithelium dysfunction and the innate immune system
Authors: Wong Josephine H. C. , Ma Jessica Y. W. , Jobling Andrew I. , Brandli Alice , Greferath Ursula , Fletcher Erica L. , Vessey Kirstan A.
Published: November 2022

Age-related macular degeneration (AMD) is a leading cause of irreversible vision loss in the older population. Classical hallmarks of early and intermediate AMD are accumulation of drusen, a waste deposit formed under the retina, and pigmentary abnormalities in the retinal pigment epithelium (RPE). When the disease progresses into late AMD, vision is affected due to death of the RPE and the light-sensitive photoreceptors. The RPE is essential to the health of the retina as it forms the outer blood retinal barrier, which establishes ocular immune regulation, and provides support for the photoreceptors. Due to its unique anatomical position, the RPE can communicate with the retinal environment and the systemic immune environment. In AMD, RPE dysfunction and the accumulation of drusen drive the infiltration of retinal and systemic innate immune cells into the outer retina. While recruited endogenous or systemic mononuclear phagocytes (MPs) contribute to the removal of noxious debris, the accumulation of MPs can also result in chronic inflammation and contribute to AMD progression. In addition, direct communication and indirect molecular signaling between MPs and the RPE may promote RPE cell death, choroidal neovascularization and fibrotic scarring that occur in late AMD. In this review, we explore how the RPE and innate immune cells maintain retinal homeostasis, and detail how RPE dysfunction and aberrant immune cell recruitment contribute to AMD pathogenesis. Evidence from AMD patients will be discussed in conjunction with data from preclinical models, to shed light on future therapeutic targets for the treatment of AMD.
Analysis of laser Doppler flowmetry long-term recordings for investigation of cerebral microcirculation during neurointensive care
Authors: Mauritzon Stina , Ginstman Fredrik , Hillman Jan , Wårdell Karin
Published: November 2022

Cerebral blood flow is monitored in the neurointensive care unit (NICU) to avoid further brain damage caused by secondary insults following subarachnoid hemorrhage and brain trauma. Current techniques are mainly snap-shot based and focus on larger vessels. However, continuous monitoring of the smaller vessels may help detect the onset of secondary insults at an earlier stage. In this study, long-term measurements of brain microcirculation with laser Doppler flowmetry (LDF) were performed and evaluated. The aim was to identify and describe physiological signal variations and separate these from movement artifacts. Fiberoptic probes for subcortical LDF recordings of perfusion and total light intensity (TLI) were implanted in three patients with subarachnoid hemorrhage. Data were successfully collected and visualized in real-time over 4 days, resulting in 34, 12, and 8.5 h per patient. Visual observation, wavelet transforms, moving medians, and peak envelopes were used to identify and describe movement artifacts and physiological changes. Artifacts occurred in <5% of the total recording time and could be identified through signal processing. Identified physiological signal patterns included a slowly increasing perfusion trend over hours, vasomotion mainly at 2 cycles/min both in the perfusion and the TLI, and rapid, synchronized changes in the TLI and the perfusion on 38 occasions. Continuous LDF recordings indicating changes in the microvascular blood flow can increase the understanding of the microcirculation in the injured brain. In the long run, this may become a complement for the detection of secondary insults at an earlier stage than possible with today’s techniques.
Signaling underlying kappa opioid receptor-mediated behaviors in rodents
Authors: Liu-Chen Lee-Yuan , Huang Peng
Published: November 2022

Kappa opioid receptor (KOR) agonists are potentially useful as analgesic and anti-pruritic agents, for prevention and treatment of substance use disorders, and for treatment of demyelinating diseases. However, side effects of KOR agonists, including psychotomimesis, dysphoria, and sedation, have caused early termination of clinical trials. Understanding the signaling mechanisms underlying the beneficial therapeutic effects and the adverse side effects may help in the development of KOR agonist compounds. In this review, we summarize the current knowledge in this regard in five sections. First, studies conducted on mutant mouse lines (GRK3-/-, p38alpha MAPK-/-, β-arrestin2-/-, phosphorylation-deficient KOR) are summarized. In addition, the abilities of four distinct KOR agonists, which have analgesic and anti-pruritic effects with different side effect profiles, to cause KOR phosphorylation are discussed. Second, investigations on the KOR agonist nalfurafine, both in vitro and in vivo are reviewed. Nalfurafine was the first KOR full agonist approved for clinical use and in the therapeutic dose range it did not produce significant side effects associated with typical KOR agonists. Third, large-scale high-throughput phosphoproteomic studies without a priori hypotheses are described. These studies have revealed that KOR-mediated side effects are associated with many signaling pathways. Fourth, several novel G protein-biased KOR agonists that have been characterized for in vitro biochemical properties and agonist biases and in vivo behavior effects are described. Lastly, possible mechanisms underlying KOR-mediated CPA, hypolocomotion and motor incoordination are discussed. Overall, it is agreed upon that the analgesic and anti-pruritic effects of KOR agonists are mediated via G protein signaling. However, there is no consensus on the mechanisms underlying their side effects. GRK3, p38 MAPK, β-arrestin2, mTOR pathway, CB1 cannabinoid receptor and protein kinase C have been implicated in one side effect or another. For drug discovery, after initial in vitro characterization, in vivo pharmacological characterizations in various behavior tests are still the most crucial steps and dose separation between beneficial therapeutic effects and adverse side effects are the critical determinant for the compounds to be moved forward for clinical development.
The circadian system modulates the cortisol awakening response in humans
Authors: Bowles Nicole P. , Thosar Saurabh S. , Butler Matthew P. , Clemons Noal A. , Robinson LaTroy D. , Ordaz Omar H. , Herzig Maya X. , McHill Andrew W. , Rice Sean P. M. , Emens Jonathan , Shea Steven A.
Published: November 2022

Background

In humans, circulating cortisol usually peaks 30–60 min after awakening from nocturnal sleep, this is commonly referred to as the cortisol awakening response (CAR). We examined the extent to which the CAR is influenced by the circadian system, independent of behaviors including sleep.

Materials and methods

We examined the CAR in 34 adults (20 female) using two complementary multiday in-laboratory circadian protocols performed in dim light, throughout which behavioral factors were uniformly distributed across the 24-hour circadian cycle. Protocol 1 consisted of 10 identical consecutive 5-hour 20-minute sleep/wake cycles, and protocol 2 consisted of 5 identical consecutive 18-hour sleep/wake cycles. Salivary melatonin was used as the circadian phase marker (0° = dim light melatonin onset). During each sleep/wake cycle, salivary cortisol was measured upon scheduled awakening and 50-minutes later, with the change in cortisol defined as the CAR. Cosinor analyses were used to detect any significant circadian rhythmicity in the CAR. In secondary analyses, we adjusted the models for time awake before lights on, total sleep time, percent of rapid eye movement (REM) sleep, and percent of non-rapid eye movement (NREM) sleep.

Results

Both protocols revealed a similar circadian rhythm in the CAR, with peaks occurring at a circadian phase corresponding to 3:40–3:45 a.m., with no detectable CAR during the circadian phases corresponding to the afternoon. In addition to the sinusoidal component of the circadian rhythm, total sleep time was also associated with the CAR for protocol 1. The percent of sleep spent in REM or NREM sleep were not associated with the CAR in either protocol.

Conclusion

Our results show that the CAR exhibits a robust circadian rhythm that persists even after adjusting for prior sleep. Presuming that the CAR optimizes physiological responses to the anticipated stressors related to awakening, these findings may have implications for shift workers who wake up at unusual circadian phases. A blunted CAR in shift workers upon awakening in the evening may result in diminished responses to stressors.
Animal models to investigate the effects of inflammation on remyelination in multiple sclerosis
Authors: Gharagozloo Marjan , Mace Jackson W. , Calabresi Peter A.
Published: November 2022

Multiple sclerosis (MS) is a chronic inflammatory, demyelinating, and neurodegenerative disease of the central nervous system (CNS). In people with MS, impaired remyelination and axonal loss lead to debilitating long-term neurologic deficits. Current MS disease-modifying drugs mainly target peripheral immune cells and have demonstrated little efficacy for neuroprotection or promoting repair. To elucidate the pathological mechanisms and test therapeutic interventions, multiple animal models have been developed to recapitulate specific aspects of MS pathology, particularly the acute inflammatory stage. However, there are few animal models that facilitate the study of remyelination in the presence of inflammation, and none fully replicate the biology of chronic demyelination in MS. In this review, we describe the animal models that have provided insight into the mechanisms underlying demyelination, myelin repair, and potential therapeutic targets for remyelination. We highlight the limitations of studying remyelination in toxin-based demyelination models and discuss the combinatorial models that recapitulate the inflammatory microenvironment, which is now recognized to be a major inhibitor of remyelination mechanisms. These models may be useful in identifying novel therapeutics that promote CNS remyelination in inflammatory diseases such as MS.
Association between the ratio of serum eicosapentaenoic acid to arachidonic acid and risk of coronary artery disease in young Chinese patients
Authors: Liu Xiong , Sun Lichang , Wen Weixing , Qiu Min , Luo Jianjing , Li Weiwen , Hao Shali , He Mingli , Wu Jiandi , Hu Yunzhao , Huang Yuli
Published: November 2022

Objective

Long-chain (LC) omega-3 PUFAs, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), may play an anti-inflammatory effect and decrease the risk of coronary artery disease (CAD). In contrast, omega-6 PUFA, mainly arachidonic acid (AA), has pro-inflammatory and pro-aggregatory effects, which may increase the risk of CAD. This study evaluated the associations between EPA, DHA, AA, and their ratios (EPA/AA and DHA/AA) with the risk of CAD in young Chinese patients.

Methods

A total of 182 young patients with CAD and 143 age-matched controls were included. Traditional cardiovascular risk factors were recorded. Serum EPA, DHA and AA were measured by ultra-performance liquid chromatography-mass spectrometry.

Results

The level of AA was significantly higher, while the level of EPA was lower in the CAD group than that in the control group. There was no significant difference in DHA level in the two groups. Both the ratios of EPA/AA and DHA/AA were lower in the CAD group than that in the control. Multivariate logistic regression analysis showed that higher serum AA level was associated with the increased risk of CAD, while EPA was a protective factor for CAD. There was no significant association between DHA level and the risk of CAD. Although both higher ratios of EPA/AA [per tertile increment, adjusted odds ratios (ORs) (OR) 0.356, 95% confidence intervals (CI) 0.247–0.513] and DHA/AA (adjusted OR = 0.465, 95%CI = 0.332–0.653) were associated with a lower risk of CAD in young patients. Receiver operating characteristic (ROC) curve analysis showed that compared with AA, the diagnostic value was increased in EPA/AA, but not in DHA/AA.

Conclusion

EPA, but not DHA may play a protective role in CAD, while AA may be associated with the increased risk of CAD in young Chinese patients. The ratio of EPA/AA can increase the predictive value for diagnosing CAD than EPA or AA alone.
Socioeconomic differences in animal food consumption: Education rather than income makes a difference
Authors: Klink Urte , Mata Jutta , Frank Roland , Schüz Benjamin
Published: November 2022

Background/aims

Evidence points toward more sustainable and health-conscious dietary behaviors among individuals with higher socioeconomic status. However, these differences vary considerably depending on which indicator of socioeconomic status is examined. Here, we present a systematic parallel investigation of multiple indicators of socioeconomic status as predictors of animal food consumption frequency and selected food-related behaviors in Germany.

Methods

Data from the German subsample of two large representative European consumer studies (Study 1 n = 1,954; Study 2 n = 2,045) was used. We assessed the associations between the socioeconomic indicators income, current occupation as well as education and consumption frequency of animal foods and selected food-related behaviors in separate ordinal logistic regressions.

Results

Individuals with higher educational attainment engaged in more sustainable and health-conscious dietary behaviors, indicated by significant associations between educational attainment and the consumption frequency of animal foods. Low- and middle-income participants consumed processed meat more frequently (Study 1 only; medium income: OR 1.5, CI 1.09–2.05, p = 0.012; low income: OR 1.43, CI 1.01–2.05, p = 0.047) and fish less frequently (Study 2 only; medium income: OR 0.76, CI 0.59–0.97, p = 0.026; low income: OR 0.061, CI 0.46–0.82, p < 0.001) than participants with high income. Current occupation did not predict the consumption of animal foods or food-related behaviors. Intake frequency of animal-based foods indicates that most participants exceeded national dietary recommendations for meat and processed meat and remained below recommendations for fish and dairy/eggs intake.

Conclusion

Educational attainment appears to be the strongest and most consistent socioeconomic indicator of sustainable dietary choices in Germany based on current large, representative studies. Future efforts should be directed toward education interventions about nutrition and interpretation of food labels to compensate for differences in dietary behavior among groups with different levels of education.
ER stress as a trigger of UPR and ER-phagy in cancer growth and spread
Authors: Cherubini Alessandro , Zito Ester
Published: November 2022

Tumors can survive environmental and metabolic stress by triggering homeostatic responses that re-establish the pre-stress status and permit them to grow and thrive. The endoplasmic reticulum (ER) is the organelle where proteins undergo post-translational modifications and are folded and exported to the secretory pathway. Its environment and activity are therefore fundamental for proteostasis, i.e., the plethora of mechanisms controlling protein formation, folding, degradation, and secretion, needed to assure protein balance and cellular health. In different tumor-related conditions, such as after the activation of oncogenes or under hypoxia and nutrient deprivation, the ER experiences stress, triggered by a high load of proteins to be folded compared to the limited folding capacity of the organelle. As a consequence, three ER membrane sensors and the related unfolded protein response (UPR) are activated. The UPR comprises a complex interconnection between signal transduction pathways that promote a homeostatic response that acts by increasing the amount of protein chaperones and of proteins involved in ER-associated protein degradation (ERAD) on one hand and attenuating protein translation on the other. ER-phagy, literally “eating” the ER, is part of another homeostatic response consisting of the clearance of non-functional ER portions including misfolded proteins. This response is also activated by a set of dedicated ER-phagy receptors after ER stimuli, which overlap the stimuli generating ER stress. Thus, the UPR and ER-phagy are two closely related homeostatic mechanisms that cooperate in re-establishing ER homeostasis. However, while the role of the UPR in favoring cancer growth and thriving by promoting angiogenesis, metastasis, chemotherapy resistance, and epithelial-to-mesenchymal transition is consolidated, that of ER-phagy is still in its infancy. This essay provides an overview of emerging concepts on ER stress, the UPR, and ER-phagy and their crosstalk in tumorigenesis. We also critically review new findings on their pharmacological targeting in cancer.
Feasibility and basic acoustic characteristics of intelligent long-term bowel sound analysis in term neonates
Authors: Zhou Ping , Lu Meiling , Chen Ping , Wang Danlei , Jin Zhenchao , Zhang Lian
Published: November 2022

Objective

Bowel dysfunction continues to be a serious issue in neonates. Traditional auscultation of bowel sounds as a diagnostic tool in neonatal gastrointestinal problems is limited by skill and inability to document and reassess. Consequently, in order to objectively and noninvasively examine the viability of continuous assessment of bowel sounds, we utilized an acoustic recording and analysis system to capture bowel sounds and extract acoustic features in term neonates.

Methods

From May 1, 2020 to September 30, 2020, 82 neonates who were hospitalized because of hyperbilirubinemia were included. For 20 h, a convolutional neural network-based acoustic recorder that offers real-time, wireless, continuous auscultation was employed to track the bowel sounds of these neonates.

Results

(1) Usable data on five acoustic parameters of bowel sound was recorded for 68 neonates, and the median values were as follows: The rate was 25.80 times/min [interquartile range (IQR): 15.63–36.20]; the duration was 8.00 s/min (IQR: 4.2–13.20); the amplitude was 0.46 (IQR: 0.27–0.68); the frequency was 944.05 Hz (IQR: 848.78–1,034.90); and the interval time was 2.12 s (IQR: 1.3–3.5). (2) In comparison to the parameters of the bowel sounds recorded from the right lower abdomen in 68 infants, the acoustic parameters of the 10 out of 68 infants from chest controls and blank controls were considerably different. (3) The 50%–75% breast milk intake group had the highest rate, the longest duration, and the highest amplitude of bowel sounds, while the >75% breast milk intake group had the highest frequency of bowel sounds. (4) Compared with neonates without hyperbilirubinemia, there was no significant difference in the five parameters of bowel sounds in hyperbilirubinemia infants; nor was there a significant effect of phototherapy and non-phototherapy status on the parameters of bowel sounds during bowel sound monitoring in hyperbilirubinemia patients. (5) A mild transient skin rash appeared on the skin of three infants. No other adverse events occurred.

Conclusion

The acoustic recording and analysis system appears useful for monitoring bowel sounds using a continuous, invasive, and real-time approach. Neonatal bowel sounds are affected by various feeding types rather than hyperbilirubinemia and phototherapy. Potential influencing factors and the significance of their application in neonatal intestinal-related disorders require further research.
Mechanical ventilation characteristics and their prediction performance for the risk of moderate and severe bronchopulmonary dysplasia in infants with gestational age <30 weeks and birth weight <1,500 g
Authors: Yin Jing , Liu Linjie , Li Huimin , Hou Xuewen , Chen Jingjing , Han Shuping , Chen Xiaohui
Published: November 2022

Introduction

Moderate and severe bronchopulmonary dysplasia (BPD) is a common pulmonary complication in premature infants, which seriously affects their survival rate and quality of life. This study aimed to describe the mechanical ventilation characteristics and evaluate their prediction performance for the risk of moderate and severe BPD in infants with gestational age <30 weeks and birth weight <1,500 g on postnatal Day 14.

Methods

In this retrospective cohort study, 412 infants with gestational age <30 weeks and birth weight <1,500 g were included in the analysis, including 104 infants with moderate and severe BPD and 308 infants without moderate and severe BPD (as controls). LASSO regression was used to optimize variable selection, and Logistic regression was applied to build a predictive model. Nomograms were developed visually using the selected variables. To validate the model, receiver operating characteristic (ROC) curve, calibration plot, and clinical impact curve were used.

Results

From the original 28 variables studied, six predictors, namely birth weight, 5 min apgar score, neonatal respiratory distress syndrome (≥Class II), neonatal pneumonia, duration of invasive mechanical ventilation (IMV) and maximum of FiO2 (fraction of inspiration O2) were identified by LASSO regression analysis. The model constructed using these six predictors and a proven risk factor (gestational age) displayed good prediction performance for moderate and severe BPD, with an area under the ROC of 0.917 (sensitivity = 0.897, specificity = 0.797) in the training set and 0.931 (sensitivity = 0.885, specificity = 0.844) in the validation set, and was well calibrated (PHosmer-Lemeshow test = 0.727 and 0.809 for the training and validation set, respectively).

Conclusion

The model included gestational age, birth weight, 5 min apgar score, neonatal respiratory distress syndrome (≥Class II), neonatal pneumonia, duration of IMV and maximum of FiO2 had good prediction performance for predicting moderate and severe BPD in infants with gestational age <30 weeks and birth weight <1,500 g on postnatal Day 14.
Early prelingual auditory and language development in children with simultaneous bilateral and unilateral cochlear implants
Authors: Yin Xiaoling , Gu Hailing , Kong Weili , Li Gang , Zheng Yun
Published: November 2022

Purpose

This current study aimed to explore early prelingual auditory development (EPLAD) and early language development in Mandarin-speaking children who received simultaneous bilateral cochlear implants (BICI) during the first year of cochlear implantation and compare the performance of the children who received BICI with those received unilateral cochlear implant (UCI).

Methods

39 Mandarin-speaking children who received BICIs simultaneously and 36 children with UCIs were enrolled in this study. To access the EPLAD, the Infant-Toddler Meaningful Auditory Integration Scale (IT/MAIS) was conducted, and a subtest of the simplified short-form version of the Mandarin Communicative Development Inventory (SSF-MCDI) was used to evaluate the development of expressive and receptive vocabulary for the children at indicated time points after surgery.

Results

In both the simultaneous BICI and UCI groups, we observed significantly increased scores of the SSF-MCDI and IT/MAIS 1 year after the surgery. There are indications of early advantages in children with BICI in IT/MAIS scores (at 1, 3, and 6 months after activation). For early development of language, a great difference between the expressive vocabulary scores and the receptive vocabulary scores was observed in both groups. We found there were not significant differences between the two groups on expressive or receptive vocabulary scores, the use of more differentiated measures might be required in future research. We further found that the development of the receptive or expressive vocabulary is dramatically correlated with the age at implantation and the total scores of IT/MAIS for children with simultaneous BICIs.

Conclusion

These results may supplement the skills development of early language and auditory in Mandarin-native children with simultaneous CIs. It is obvious that children with normal hearing have mastery of receptive vocabulary before that of expressive vocabulary, which is the same as children with unilateral and bilateral CIs in this research. IT/MAIS total scores and age at CI were important factors for early language performance in children with simultaneous BICIs.
Supplementation with Tex261 provides a possible preventive treatment for hypoxic pulmonary artery hypertension
Authors: Chen Shaokun , Wei Xiaozhen , Zhang Xu , Yao Mengge , Qiu Zhihuang , Chen Liangwan , Zhang Li
Published: November 2022

Objectives: Pulmonary artery hypertension (PAH) is a serious disease for which there is no effective treatment. Its pathogenesis is complex and has not yet been clarified. Tex261 is a protein-coding gene whose functional enrichment nodes include the transporter activity of COP II. However, the role of Tex261 in PAH remains unknown.

Methods: Sugen5416/Hypoxic PAH models were established, and pulmonary arteries (PAs) were isolated for proteomic sequencing. The binding sites between Hif-1α and Tex261 were verified by dual-luciferase reporter gene assay. Cell proliferation was detected by MTS and EdU assays. For determination of the preventive and therapeutic effects of Tex261, intratracheal instillation of adeno-associated virus (AVV6) with Tex261 vectors was performed.

Results: Tex261 was screened according to the proteomic sequencing data. Hif-1α inhibited Tex261 promoter activity under hypoxia. Decreased Tex261 expression promoted PASMC proliferation. Tex261 regulated Sec23 via the Ndrg1-mediated Akt pathway. Tex261 overexpression improved the pressure and vessel remodeling of PAs induced by Sugen5416/hypoxia.

Conclusion: Hypoxia suppressed Tex261 expression through Hif-1α activation. The decreased Tex261 could promote Ndrg1 and depress Akt activity and then inhibit Sec23 activity, which leads to cell proliferation and vessel remodeling. Elevated Tex261 has some preventive and therapeutic effects on rats with PAH.
Genetic diversity and phylogeography of the endemic species Chimonobambusa utilis growing in southwest China: Chloroplast DNA sequence and microsatellite marker analyses
Authors: Liu Yanjiang , Wu Mingli , Xu Xue , Zhu Xiao , Dai Zhaoxia , Gou Guangqian
Published: November 2022

Chimonobambusa utilis (Keng) Keng F is an endemic species distributed only in the Daluoshan Mountains, southwest China. Ch. utilis is popular due to its unique flavor and deliciousness and plays an important role in the industrial revolution in many counties in China. A total of 20 natural populations were sampled from the entire distribution range of Ch. utilis. In the present study, we used five EST-SSR molecular markers, three chloroplast DNA (trnH-psbA, atpF-atpH, and psbK-psbI), and one ITS molecular marker to elucidate the genetic diversity and phylogeography analyses of these Ch. utilis populations. The results exhibited that Ch. utilis populations showed lower genetic diversity than other angiosperms (HT = 0.752, HS = 0.364, and FST = 0.05021 for EST-SSR; HT = 0.956, Hs = 0.507, and FST = 0.70121 for cpDNA; HT = 0.868, Hs = 0.495, and FST = 0.70121 for nrDNA). A total of 40 alleles were detected for five polymorphic loci. We detected 20 polymorphic sites and 11 haplotypes within 1,398 bp of cpDNA and 59 polymorphic sites and 32 haplotypes within the 589 bp of the ITS sequence. Based on the haplotype distribution, we infer that there were at least two glacial refuges of Ch. utilis populations during the Quaternary Ice Age. The genetic and geographic distance were correlated (p < 0.05), indicating that narrow distribution might be the primary cause of the low genetic differentiation of Ch. utilis populations. Based on the genetic diversity of Ch. utilis populations, we recommend implementing effective genetic resource management and sustainable utilization.
The implications of stakeholder consultation on employee engagement: An African cross-border acquisition
Authors: van Niekerk Annelize
Published: November 2022

Objective

The objective of the study was to explore the power of stakeholder consultation on employee engagement during a cross-border acquisition in a multi-cultural context. Further, to describe the psychosocial factors at play during the employee involvement process towards enhancing employee engagement.

Methods

This qualitative study presents the results from data collected in Tanzania through semi-structured interviews (46 participants) and analyzed in accordance with the hermeneutic circle and Tesch’s content analysis method.

Results

The results of this study contribute to the body of knowledge to better understand the psychosocial factors at play within a multi-cultural environment which inform stakeholder consultation and will enable or hinder employee engagement. A transitional space should be created, fostering mature stakeholder engagement, promoting employee inclusion, engagement, and knowledge sharing.

Conclusion

Bringing together two worlds requires building bridges to cross the cliff between contexts and overcoming diversity challenges, while incorporating diversity management in the consulting process. A multi-cultural team should be established, incorporating diversity management, applying the principles of respect, participation and transparent communication, with regular feedback on decisions made. External stakeholders in authoritative positions are not well received and should consider traditional superiority versus business hierarchy when establishing leader-follower relationships.
Perceived stress and associated factors among university students in Ethiopia during the late stage of the COVID-19 pandemic: A cross-sectional study
Authors: Simegn Wudneh , Yohannes Lamrot , Seid Abdulwase Mohammed , Kasahun Asmamaw Emagn , Sema Faisel Dula , Flatie Adane , Elias Asrat , Dagne Henok
Published: November 2022

Background

During extensive outbreaks of infectious diseases, people who are impacted, particularly the subgroups of the community who are at an increased risk of mental health problems, may experience increased stress and mental health difficulties. University students are one such susceptible population and are prone to experiencing high levels of stress as compared with the general population. Therefore, this study aimed at assessing perceived stress and identifying its associated factors among university students in Ethiopia during the late stage of the COVID-19 pandemic.

Methods

A cross-sectional study was conducted among university students in Ethiopia from 30 May to 30 June 2021. Students were asked to fill out an online survey on Google Forms that included consent, sociodemographic information, the UCLA-8 Loneliness Scale, the standard validated stress scale (PSS-10) questionnaire, and the three-item Oslo Social Support Scale (OSSS-3) to assess social support. The collected data were exported to SPSS 26. Descriptive and analytical statistics were carried out. Binary and multiple logistic regression analyses were performed to find associated factors, and variables with a p-value of 0.05 were considered statistically significant variables.

Results

A total of 426 university students were included in the survey, among whom 268 (62.9%) were male participants. The age of the participants ranged from 18 to 37 years. Health-related departments accounted for 37.1% of the participants, while non-health-related departments accounted for 62.9%. The prevalence of stress was 18.3% in the study population. In this study, extreme susceptibility to COVID-19, sleeping problems, poor self-efficacy to prevent COVID-19, and loneliness were significantly associated with perceived stress.

Conclusion

Stress was prevalent among university students in Ethiopia during the late stage of the COVID-19 pandemic. Extreme susceptibility to COVID-19, sleeping problems, poor self-efficacy, and loneliness were identified as factors for stress. Therefore, we suggest that universities should provide opportunities for safe social connection, counseling, and guidance for students.
Effect of body dissatisfaction on binge eating behavior of Chinese university students: A moderated mediation model
Authors: Yan Jimin , Su Haodong , Li Chunlu
Published: November 2022

The relationship between body dissatisfaction and binge eating behavior has been highlighted by previous studies. However, the psychological mechanisms underlying body dissatisfaction-induced binge eating behavior remain unclear. Here, we further addressed this issue in the framework of the sociocultural model of eating disorders. Firstly, we investigated the mediation effect of perceived stress on the relationship between body dissatisfaction and binge eating. Secondly, we examined the moderation role of the self-acceptance and emotion regulation strategies on the indirect effect of body dissatisfaction on binge eating behavior mediated by perceived stress. Data from 903 Chinese university students were analyzed using SPSS 26.0 and SPSS PROCESS Macro. Results indicated that perceived stress mediates the relationship between body dissatisfaction and binge eating behavior. Main interactional effects have been observed when self-acceptance and cognitive reappraisal but not expressive suppression are introduced in the model as a moderator. Implications and limitations of the study are discussed.
The predictive ability of emotional creativity in motivation for adaptive innovation among university professors under COVID-19 epidemic: An international study
Authors: Čábelková Inna , Dvořák Marek , Smutka Luboš , Strielkowski Wadim , Volchik Vyacheslav
Published: November 2022

Emotional creativity (EC) refers to cognitive abilities and personality traits related to the originality of emotional experience and expression. Previous studies have found that the COVID-19 epidemic and the restrictions imposed increased the levels of negative emotions, which obstructed adaptation. This research suggests that EC predicts the motivation for innovative adaptive behavior under the restrictions of COVID-19. In the case study of university professors, we show that EC predicts the motivation to creatively capitalize on the imposed online teaching in looking for innovative research and personal development. Methodologically, we rely on the Emotional Creativity Inventory (ECI) administered to a sample of 463 university professors (41.5% men, aged 22–100. M ± SD = 45.53 ± 11.46, median 44) from the Czech Republic (N = 137), Slovak Republic (N = 61), and Russia (N = 265). The indicators for motivation for innovative performance included motivations to use distant methods of scientific research, to look for partners for conducting scientific research in other cities or abroad, to conduct interdisciplinary research, starting distance learning to enhance qualifications, and the perception that due to online teaching, there is more time for personal development. We employ a set of ordinal regression analyses controlling for age, gender, position (lecturer, researcher, and manager), type of science (formal, natural, social, and applied), and country. The results suggest that Emotional Creativity and its three components predict the motivation of university professors to creatively capitalize on the imposed online teaching in looking for innovative research and personal development under the conditions of COVID-19. Furthermore, our results confirmed the gender and age differences in EC. The differences in EC according to position (lecturer, researcher, and manager) and type of science were not statistically significant. These results compel us to be aware of the importance of the emotional side of creativity to optimize stress-related behavior under the conditions of limited abilities to continue as usual. More space devoted to the manifestation of all the aspects of emotional creativity would improve adaptation to challenging circumstances and even allow one to capitalize on new opportunities. Moreover, we suggest that if personal intrinsic Emotional Creativity is high, the crises, such as the COVID-19 epidemic, may improve adaptation and trigger creative outcomes.
Therapeutic management of buying/shopping disorder: A systematic literature review and evidence-based recommendations
Authors: Vasiliu Octavian
Published: November 2022

The prevalence of buying/shopping disorder (B/SD) has been increasing in the last two decades, and this disorder has a substantial negative impact on general functioning and quality of life. Therefore, a systematic review of the studies dedicated to the efficacy and tolerability of therapeutic interventions, both psychological and pharmacological, might help clinicians to decide on the most evidence-based treatment for these patients. In order to further increase the clinical usefulness of the current review, GRADE-based recommendations were formulated, where enough evidence was found to support such an approach. A number of five electronic databases were searched for single case reports, case series, open-label and double-blind, placebo/active intervention-controlled trials, but other secondary reports (i.e., systematic reviews and meta-analyses) were also included in this analysis. Studies with unspecified designs or those that do not report either qualitatively or quantitively the evolution of B/SD core manifestations were excluded. All data included in the secondary analysis were evaluated using the Joanna Briggs Institute critical appraisal checklists. A total number of 24 manuscripts (i.e., 12 clinical trials, eight case reports, and four reviews) were included. Most of the reviewed studies were of moderate quality, representing a certain limitation of this review and preventing the formulation of high-validity recommendations. Psychotherapy, especially cognitive behavioral therapy (CBT) seems to be the main intervention supported by the current evidence, followed by the combination of antidepressants and CBT, and serotoninergic antidepressants as monotherapy. There is an obvious need to further develop good-quality trials with a more significant number of participants with B/SD and longer follow-up periods.
Social environment exposure to electronic cigarettes and its association with e-cigarette use among adolescents in Shanghai, China
Authors: Dai Luojia , Lu Weiyi , Wang Juanjuan , Zhang Lulu , Zhu Jingfen
Published: November 2022

Objective

This study investigated adolescents' social-environmental exposure to e-cigarettes in association with e-cigarette use in Shanghai, China. We also explored these differences by gender and school type.

Methods

Sixteen thousand one hundred twenty-three students were included by a stratified random cluster sampling, and the number was weighted according to selection probability. Association between social environment exposure and e-cigarette use was examined by multivariate logistic regressions.

Results

There were 35.07, 63.49, 75.19, 9.44, and 18.99% students exposed to secondhand e-cigarette aerosol (SHA), e-cigarette sales, e-cigarette information, parents' and friends' e-cigarette use. Students exposed to SHA (aOR = 1.73, 95% CI 1.40–2.14), e-cigarette sales from ≥2 sources (aOR = 1.55, 95% CI 1.18–2.03), e-cigarette information exposure from ≥2 sources (aOR = 1.39, 95% CI 1.05–1.83), and having a social e-smoking environment (friends' e-cigarette use: aOR = 2.56, 95% CI 2.07–3.16; parents' e-cigarette use: aOR = 1.54, 95% CI 1.17–2.02) were significantly associated with their intention to use e-cigarettes. More girls were exposed to e-cigarette sales in the malls, e-cigarette information at points of sale and on social media (P < 0.01), and exposure to sales from ≥2 sources were associated with girls' intention to use e-cigarettes (aOR = 1.84, 95% CI 1.22–2.78). However, boys were more likely to be exposed to friends' e-cigarette use (P < 0.001), and having friends using e-cigarettes was associated with greater intention to use them in boys (aOR = 2.64, 95% CI 1.97–3.55). Less vocational high school students were exposed to parents' e-cigarette use (P < 0.001), but they were more likely to use e-cigarettes in the future after being exposed (aOR = 2.27, 95% CI 1.50–3.43). A similar phenomenon was observed between junior high students and their exposure to SHA.

Conclusions

This study reported adolescents' high exposure rates to the social environment of e-cigarettes. Exposure to SHA, e-cigarette sales from ≥2 sources, e-cigarette information from ≥2 sources and having a social e-smoking environment were related to adolescents' intention to use e-cigarettes. Differences in gender and school type were observed. More attention should be paid to girls, and different interventions should be designed for different types of school students. Additionally, comprehensive tobacco control policies are needed.
Economic value and characteristics of cloud pharmacy for children based on internet hospital in western China during the COVID-19 pandemic: Cross-sectional survey study
Authors: Yang Bin , Wen Qiang , Zhang Yi , Wang Xiuling , Yin Xiangdong , Li Qianbo , Li Qinling , Song Lin
Published: November 2022

Background

Online health care services have been encouraged by the Chinese government in recent years, and the COVID-19 pandemic catalyzed the rapid growing of internet hospitals. As an integral part of online health care services, little is known about the economic value and characteristics of cloud pharmacy especially for children. This study aimed to reveal the economic value and comprehensive characteristics of pediatric cloud pharmacy during the COVID-19 pandemic in a tertiary children's hospital in western China.

Methods

A total of 33,254 online prescriptions over the course of February 2020 through December 2021 were analyzed with respect to the user profiles, diseases, consulting behaviors, distribution of departments, delivery region and distance, drug information and degree of satisfaction. The cost savings for patients calculated lost wages and the high-speed railway fees for transport to and from hospital.

Results

A total of 33,254 prescriptions, including 56,216 drugs were delivered to 27 provinces and municipalities of China. The internet cloud pharmacy saved a total of more than RMB 11.17 million in financial costs for patients. Of the 33,254 delivered prescriptions, 50.40% were sent to Chongqing Province, the top 5 provinces for out-of-province prescription deliveries were Sichuan (37.77%), Guizhou (8.00%), Yunnan (1.18%), Hubei (0.66%) and Guangdong (0.42%). In terms of department distribution, neurology (31.7%), respiratory (15.0%) and endocrinology (14.6%) were the top three departments. Epilepsy (16.2%), precocious puberty (10.3%) and asthma (8.7%) were the top three frequently consulted diseases. The peak times of day for online prescriptions occurred at 9 AM and 8 PM. 99.67% of users gave full marks for their internet counseling.

Conclusion

The pediatric cloud pharmacy is efficient, cost-saving and convenient for children with chronic disease or mild symptoms during the COVID-19 pandemic. The widespread use of this pediatric cloud pharmacy can help alleviating pressure on offline hospitals and facilitated people's lives beyond geographical and time-related limitations. Further efforts are needed to be made to improve the quality and acceptance of pediatric cloud pharmacy, as well as to regulate and standardize the management of this novel online health care service.
Systematic review: Clinical outcomes of discontinuation of oral antivirals in hepatitis B-related liver cirrhosis
Authors: Yao Yuhao , Zhang Jiaxin , Li Xiaoke , Zao Xiaobin , Cao Xu , Chen Guang , Ye Yong'an
Published: November 2022

Background

Discontinuation of Nucleos(t)ide analogs (NAs) remains one of the most controversial topics in the management of hepatitis B-related liver cirrhosis. However, clinical outcomes after NAs discontinuation have not been studied.

Aim

The aim of this systematic review is to evaluate existing data on clinical outcomes of NAs withdrawal in chronic hepatitis B (CHB) patients with cirrhosis.

Methods

A literature search (until May 2022) was performed in order to identify all published studies including hepatitis B-related cirrhotic patients who discontinued NAs in virological remission with off-therapy follow-up >12 months.

Results

Nineteen studies with 1,287 hepatitis B-related cirrhotic patients were included. Most cirrhotic patients were compensated and achieved complete virological suppression when they stopped the antiviral therapy. The pooled proportions of virological relapse and clinical relapse after NAs discontinuation in cirrhotic patients were 55.23 (95% CI: 40.33–69.67) and 43.56% (95% CI: 26.13–61.85), respectively. HBsAg loss was observed in 56 of 500 (pooled proportion = 13.68%, 95% CI: 5.82–24.18) cirrhotic patients. And the pooled proportions of HCC development, hepatic decompensation and overall mortality were 8.76 (95% CI: 2.25–18.95), 3.63 (95% CI: 1.31–7.03), and 0.85% (95% CI: 0.35–1.57), respectively, after NAs discontinuation in cirrhotic patients.

Conclusion

In hepatitis B-related compensated cirrhosis, who have achieved complete virological suppression, discontinuation of oral antivirals still carries a high relapse rate, but the incidence of adverse events is generally low and controlled during follow-up of at least 12 months. Of attention is that discontinuation of NAs can achieve a high rate of HBsAg seroclearance. This study may be helpful in the management of NAs in cirrhotic patients.

Systematic review registration

http://www.crd.york.ac.uk/PROSPERO, identifier: CRD42020170103.