bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of Support, a self-guided online type 1 diabetes self-management education and support web application—a mixed methods study
Authors: Xie Li Feng , Housni Asmaa , Roy-Fleming Amélie , Bandini Aude , Delormier Treena , Costa Deborah Da , Brazeau Anne-Sophie
Published: September 2023

Background

Type 1 diabetes requires making numerous daily decisions to maintain normoglycemia. Support is an evidence-based self-guided web application for type 1 diabetes diabetes self-management.

Objective

Evaluate users’ satisfaction with Support and investigate changes in self-reported frequency of-, fear of- hypoglycemia, and diabetes-related self-efficacy.

Methods

Adults from a Quebec type 1 diabetes registry used Support. Data was collected through online surveys or extracted from the registry at 0, 6, and 12 months (number of episodes and fear of hypoglycemia). At 6 months, participants reported satisfaction with Support and diabetes-related self-efficacy. A sub-group of 16 users was interviewed about their experience . Transcripts were analyzed using inductive and deductive approaches.

Results

In total, 207 accounts were created (35% men, 96% White, mean age and diabetes duration: 49.3 ± 13.8 and 25.2 ± 14.7 years). At 6 months, the median [Q1; Q3] satisfaction was 40/49 [35; 45] with a mean decrease in hypoglycemia frequency of 0.43 episodes over 3 days (95% CI: −0.86; 0.00, p = 0.051) and of −1.98 score for fear (95% CI: −3.76; −0.20, p = 0.030). Half of the participants reported increased diabetes-related self-efficacy.

Conclusions

Participants reported a high level of satisfaction with Support. Its use has the potential to facilitate hypoglycemia management and increase diabetes-related self-efficacy.

Trial registration

This study is registered on ClinicalTrials.gov NCT04233138.
Music Moves Me in More Ways Than One: An Online Survey Investigating the Everyday Use of Music among People with Parkinson's
Authors: Rose Dawn C. , Poliakoff Ellen , Young William R. , Phillips Michelle
Published: September 2023

Background

Music has been used in interventions designed for people with Parkinson's (PwP) either to engage mechanisms involved in phenomena such as sensorimotor synchronization or as an integral part of the activity (e.g., dance). However, little research has been conducted concerning what music PwP use in everyday life and how and why this might differ based on situation/context.

Methods

We used an online survey to investigate what music PwP listen to, for which perceived reasons, and in which situations. In addition to demographic and Parkinson's-specific questions, we included standardized measures of quality of life, music and dance sophistication and bespoke items to explore music use.

Results

The sample ( N = 217, age range 20–88 years, Mean = 65.2, SD = 8.45) included 109 females (50%); 64% of participants reported a mild impact of Parkinson's on Activities of Daily Living. The top three uses of music were Aesthetic Appreciation (98%), Relaxation (92%), and Motivation (90%). The least popular category was using music for walking (36%). The duration of attentive listening was significantly higher for those who reported using music for managing their feelings than those who did not ( p < .01). Better quality of life was associated with higher participatory dance experience ( p < .001).

Conclusion

PwP listen to a wide range of music genres, most notably for enjoyment but also as a personalized “charge” and “re-charge” resource. Understanding the everyday use of music among PwP might facilitate the development of playlists and interventions to improve daily life for PwP.
Recurrent Instability After Arthroscopic Bankart Repair in Patients With Hyperlaxity and Near-Track Lesions
Authors: Boden Stephanie A. , Charles Shaquille , Hughes Jonathan D. , Miller Liane , Rodosky Mark , Popchak Adam , Musahl Volker , Lesniak Bryson P. , Lin Albert
Published: September 2023

Background:

Recurrent anterior shoulder instability after arthroscopic Bankart repair presents a challenging clinical problem, with the primary stabilization procedure often portending the best chance for clinical success.

Purpose:

To determine if capsuloligamentous laxity affects failure (recurrent dislocation, subluxation, and/or perceived instability symptoms) after arthroscopic Bankart repair in patients with near-track lesions (ie, those with smaller distance to dislocation [DTD]).

Study Design:

Case-control study; Level of evidence, 3.

Methods:

The authors retrospectively reviewed consecutive patients who underwent primary arthroscopic Bankart repair for recurrent anterior glenohumeral instability at a single institution between 2007 and 2019 and who had at least 2 years of follow-up data. Patients with glenoid bone loss >20%, off-track lesions, concomitant remplissage, or rotator cuff tear were excluded. Capsuloligamentous laxity, or hyperlaxity, was defined as external rotation >85° with the arm at the side and/or grade ≥2 in at least 2 planes with the shoulder at 90° of abduction. Near-track lesions were defined as those with a DTD <10 mm.

Results:

Included were 173 patients (mean age, 20.5 years; mean DTD, 16.2 mm), of whom 16.8% sustained a recurrent dislocation and 6.4% had recurrent subluxations (defined as any subjective complaint of recurrent instability without frank dislocation), for an overall recurrent instability rate of 23.1%. The rate of revision stabilization was 15.6%. The mean time to follow-up was 7.4 years. Independent predictors of recurrent instability were younger age ( P = .001), smaller DTD ( P = .021), >1 preoperative instability episode ( P < .001), and the presence of hyperlaxity during examination under anesthesia ( P = .013). Among patients with near-track lesions, those with hyperlaxity had a recurrent instability rate almost double that of patients without hyperlaxity (odds ratio, 34.1; P = .04). The increased rate of failure and recurrent dislocation in the near-track hyperlaxity cohort remained elevated, even in patients with no bone loss.

Conclusion:

Capsuloligamentous shoulder laxity was a significant independent risk factor for failure after primary arthroscopic Bankart repair without remplissage and was more predictive of failure in patients with versus without near-track lesions.
Treatment of Intra-Articular Lesions After Posterior Inferior Tibiofibular Ligament Injury: A Case Series of Elite Rugby Players
Authors: Sugimoto Kazuya , Isomoto Shinji , Ishida Eiwa , Miura Kimio , Hyakuda Yoshinobu , Ohta Yuichi , Tanaka Yasuhito , Taniguchi Akira
Published: September 2023

Background:

Surgical intervention is not typically used to treat symptoms after mild tibiofibular ligament injuries without ankle dislocation or subluxation.

Purpose:

To describe outcomes in patients arthroscopically treated for unique intra-articular lesions after sustaining syndesmosis injury of the ankle.

Study Design:

Case series; Level of evidence, 4.

Methods:

A total of 11 elite male rugby players with a mean age of 21.0 years (range, 17-28 years) were referred to our hospital for prolonged posterior ankle pain after a high ankle sprain during rugby football. The patients were examined using standing view radiography, computed tomography (CT) and magnetic resonance imaging (MRI) to determine the extent of ligament damage. Posterior ankle arthroscopy was performed to examine intra-articular lesions. The patients were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle/hindfoot rating scale and sports activity score of the Self-Administered Foot Evaluation Questionnaire (SAFE-Q).

Results:

The average reduced tibiofibular overlap on the standing mortise view was 1.2 mm (range, 0.5-2.0 mm) compared with the opposite ankles. Mason type 1 fracture was detected on CT in 6 patients, and ossification of the interosseous membrane was detected in 2 patients. A bone bruise in the posterior malleolus was observed on MRI in all but 1 patient. Intra-articular fragments located in the posterior ankle were observed and removed arthroscopically. Symptoms improved rapidly after arthroscopic treatment in all patients. All patients returned to rugby games at a median of 11 weeks postoperatively. The median AOFAS scores improved from 77 preoperatively to 100 postoperatively ( P < .01), and the median SAFE-Q sports activity subscale score improved from 49.4 to 100 ( P < .01).

Conclusion:

All unique intra-articular lesions that developed in rugby football players after syndesmosis injury were able to be treated arthroscopically. Patients returned to playing rugby football without syndesmosis reduction. Posterior ankle arthroscopy was effective in patients with residual symptoms after syndesmosis injury.
Every Month Like Clockwork? Patterns and Prevalence of Serial Eviction Filing among Landlords
Authors: Watson Henry , Garboden Philip M. E. , McCabe Brian J. , Rosen Eva
Published: September 2023

In this study, the authors draw on a unique dataset of eviction filings in Washington, D.C., over a six-year period, merged with building ownership data from the District of Columbia Office of Tax and Revenue, to better understand patterns of serial filing, a practice whereby landlords file for eviction on a single household in a single unit multiple times. The authors create an empirical typology of serial filing chains to categorize the patterns observed in the dataset. They then test a series of hypotheses about the relationship between landlord portfolio size and serial filings. Households that are filed against in buildings owned by larger landlords are substantially more likely to experience serial eviction filing, and longer serial filing chains, relative to households living in buildings owned by smaller landlords. These results offer the first empirical evidence documenting multiple patterns of serial eviction filing and underscore how landlord filing strategies differ by portfolio size.
Framework for Accurate Classification of Self-Reported Stress From Multisession Functional MRI Data of Veterans With Posttraumatic Stress
Authors: Goel Rahul , Tse Teresa , Smith Lia J. , Floren Andrew , Naylor Bruce , Williams M. Wright , Salas Ramiro , Rizzo Albert S. , Ress David
Published: September 2023

Background: Posttraumatic stress disorder (PTSD) is a significant burden among combat Veterans returning from the wars in Iraq and Afghanistan. While empirically supported treatments have demonstrated reductions in PTSD symptomatology, there remains a need to improve treatment effectiveness. Functional magnetic resonance imaging (fMRI) neurofeedback has emerged as a possible treatment to ameliorate PTSD symptom severity. Virtual reality (VR) approaches have also shown promise in increasing treatment compliance and outcomes. To facilitate fMRI neurofeedback-associated therapies, it would be advantageous to accurately classify internal brain stress levels while Veterans are exposed to trauma-associated VR imagery. Methods: Across 2 sessions, we used fMRI to collect neural responses to trauma-associated VR-like stimuli among male combat Veterans with PTSD symptoms (N = 8). Veterans reported their self-perceived stress level on a scale from 1 to 8 every 15 s throughout the fMRI sessions. In our proposed framework, we precisely sample the fMRI data on cortical gray matter, blurring the data along the gray-matter manifold to reduce noise and dimensionality while preserving maximum neural information. Then, we independently applied 3 machine learning (ML) algorithms to this fMRI data collected across 2 sessions, separately for each Veteran, to build individualized ML models that predicted their internal brain states (self-reported stress responses). Results: We accurately classified the 8-class self-reported stress responses with a mean (± standard error) root mean square error of 0.6 (± 0.1) across all Veterans using the best ML approach. Conclusions: The findings demonstrate the predictive ability of ML algorithms applied to whole-brain cortical fMRI data collected during individual Veteran sessions. The framework we have developed to preprocess whole-brain cortical fMRI data and train ML models across sessions would provide a valuable tool to enable individualized real-time fMRI neurofeedback during VR-like exposure therapy for PTSD.
Political ecologies of a university and land at Cairo's urban periphery: The American University in Cairo's suburban desert campus
Authors: Al-Saleh Danya , Arefin Mohammed Rafi
Published: September 2023

In 2008, the American University in Cairo (AUC) moved from its downtown campus in Tahrir Square to the center of New Cairo. Through an analysis of AUC's historical land acquisitions at Cairo's urban periphery, this article examines how the university sought to influence land use over the past century. We argue that AUC's relatively recent role in New Cairo is an expression of the institution's century-long aspirations to acquire land on Cairo's periphery for a permanent suburban style campus. Drawing on the tools of political ecology and critical university studies, we trace how a suburban desert campus is consistently envisioned as a mechanism for the institution to play a significant role in influencing land politics and use in and beyond its campus. We highlight two key ways that AUC has historically situated itself in the city's development. First, purchasing land in order to relocate to the outskirts of the city has been central to AUC's strategy for accumulating wealth to ensure its long-term presence in Egypt. Second, acquiring large tracts of land for a suburban desert campus has been instrumental to AUC's educational mission to shape its student body, Egyptian society, and the political ecology of desert land in Egypt. Through archival research, we show how AUC's relationship to land positions the university as a significant institutional force in Cairo's rapidly urbanizing desert periphery. This situated case study contributes to an emerging body of scholarship examining the fraught historical and contemporary relationship between universities, land, environmental knowledge, and uneven urbanization in the Middle East and beyond.
Phylodynamics of dengue virus 2 in Nicaragua leading up to the 2019 epidemic reveals a role for lineage turnover
Authors: Thongsripong Panpim , Edgerton Sean V. , Bos Sandra , Saborío Saira , Kuan Guillermina , Balmaseda Angel , Harris Eva , Bennett Shannon N.
Published: September 2023

Background

Dengue is a mosquito-borne viral disease posing a significant threat to public health. Dengue virus (DENV) evolution is often characterized by lineage turnover, which, along with ecological and immunological factors, has been linked to changes in dengue phenotype affecting epidemic dynamics. Utilizing epidemiologic and virologic data from long-term population-based studies (the Nicaraguan Pediatric Dengue Cohort Study and Nicaraguan Dengue Hospital-based Study), we describe a lineage turnover of DENV serotype 2 (DENV-2) prior to a large dengue epidemic in 2019. Prior to this epidemic, Nicaragua had experienced relatively low levels of DENV transmission from 2014 to 2019, a period dominated by chikungunya in 2014/15 and Zika in 2016.

Results

Our phylogenetic analyses confirmed that all Nicaraguan DENV-2 isolates from 2018 to 2019 formed their own clade within the Nicaraguan lineage of the Asian/American genotype. The emergence of the new DENV-2 lineage reflects a replacement of the formerly dominant clade presiding from 2005 to 2009, a lineage turnover marked by several shared derived amino acid substitutions throughout the genome. To elucidate evolutionary drivers of lineage turnover, we performed selection pressure analysis and reconstructed the demographic history of DENV-2. We found evidence of adaptive evolution by natural selection at the codon level as well as in branch formation.

Conclusions

The timing of its emergence, along with a statistical signal of adaptive evolution and distinctive amino acid substitutions, the latest in the NS5 gene, suggest that this lineage may have increased fitness relative to the prior dominant DENV-2 strains. This may have contributed to the intensity of the 2019 DENV-2 epidemic, in addition to previously identified immunological factors associated with pre-existing Zika virus immunity.
Regulation of root development in nitrogen-susceptible and nitrogen-tolerant sweet potato cultivars under different nitrogen and soil moisture conditions
Authors: Duan Wenxue , Zhang Haiyan , Wang Qingmei , Xie Beitao , Zhang Liming
Published: September 2023

Background

Due to unreasonable nitrogen (N) application and water supply, sweet potato vines tend to grow excessively. Early development of storage roots is conducive to inhibiting vine overgrowth. Hence, we investigated how N and soil moisture affect early root growth and development.

Results

A pot experiment was conducted using the sweet potato cultivars Jishu26 (J26, N-susceptible) and Xushu32 (X32, N-tolerant). Two N application rates of 50 (N1) and 150 mg kg− 1 (N2) and two water regimes, drought stress (DS) (W1) and normal moisture (W2), were applied to each cultivar. For J26, the lowest expansion root weight was observed in the N2W2 treatment, while for X32, the N1W2 and N2W2 treatments resulted in higher root weights compared to other treatments. The interaction between N rates and water regimes significantly affected root surface area and volume in J26. Root cross-sections revealed that N2W2 increased the percentage of root area covered by xylem vessels and decreased the amount of secondary xylem vessels (SXV) in J26. However, in X32, it increased the number of SXV. A high N rate reduced the 13 C distribution ratio in J26 expansion roots, but had no significant effect on X32. In J26, N2W2 inhibited starch synthesis in roots by downregulating the expression of AGPa, AGPb, GBSS I, and SBE I.

Conclusion

The observed effects were more pronounced in J26. For X32, relatively high N and moisture levels did not significantly impact storage root development. Therefore, special attention should be paid to N supply and soil moisture for N-susceptible cultivars during the early growth stage.
Policy and practices in primary care that supported the provision and receipt of care for older persons during the COVID-19 pandemic: a qualitative case study in three Canadian provinces
Authors: Elliott Jacobi , Tong Catherine , Gregg Susie , Mallinson Sara , Giguere Anik , Brierley Meaghan , Giosa Justine , MacNeil Maggie , Juzwishin Don , Sims-Gould Joanie , Rockwood Kenneth , Stolee Paul
Published: September 2023

Background

The effects of the COVID-19 pandemic on older adults were felt throughout the health care system, from intensive care units through to long-term care homes. Although much attention has been paid to hospitals and long-term care homes throughout the pandemic, less attention has been paid to the impact on primary care clinics, which had to rapidly change their approach to deliver timely and effective care to older adult patients. This study examines how primary care clinics, in three Canadian provinces, cared for their older adult patients during the pandemic, while also navigating the rapidly changing health policy landscape.

Methods

A qualitative case study approach was used to gather information from nine primary care clinics, across three Canadian provinces. Interviews were conducted with primary care providers (n = 17) and older adult patients (n = 47) from October 2020 to September 2021. Analyses of the interviews were completed in the language of data collection (English or French), and then summarized in English using a coding framework. All responses that related to COVID-19 policies at any level were also examined.

Results

Two main themes emerged from the data: (1) navigating the noise: understanding and responding to public health orders and policies affecting health and health care, and (2) receiving and delivering care to older persons during the pandemic: policy-driven challenges & responses. Providers discussed their experiences wading through the health policy directives, while trying to provide good quality care. Older adults found the public health information overwhelming, but appreciated the approaches adapted by primary care clinics to continue providing care, even if it looked different.

Conclusions

COVID-19 policy and guideline complexities obliged primary care providers to take an important role in understanding, implementing and adapting to them, and in explaining them, especially to older adults and their care partners.
Relationship between early life asthma and chronic airway disease in adult life – in search for disease trajectories over the life span- the RELATE study based on the Kongsberg cohort
Authors: Savran Osman , Bønnelykke Klaus , Ulrik Charlotte Suppli
Published: September 2023

Background

Chronic airway disease in adults may have its origin in early life. The purpose of this study is to investigate the long-term prognosis of severe childhood asthma in search for an association between asthma in early life and obstructive lung disease in adulthood.

Methods

This study is based on the Kongsberg cohort, which includes approximately 5000 children with severe asthma with a 4-month stay at the asthma care facility in Kongsberg, Norway during the years 1950 to 1979. An on average 60-year observational study based on a follow-up examination will be performed including questionnaires, blood samples, and tests of lung function and bronchial responsiveness. Blood samples will be stored in a biobank. In addition, we will conduct further analyses of the cohort based on nationwide register data, including socio-economic parameters and mortality.

Discussion

Chronic airway disease is associated with substantial burden for both the individual patient and society. Our knowledge of early life origins of chronic airway disease later in life has been increasing in recent decades but is still limited. By exploring early life risk factors for chronic airway disease in adulthood, we may gain insights paving the way for future reduction in the burden of chronic airway diseases.
No difference in biomechanical properties of simple, horizontal mattress, and double row repair in Bankart repair: a systematic review and meta-analysis of biomechanical studies
Authors: Kim Jun-Ho , Koo Bon-Ki , Ku Ki Hyeok , Kim Myung Seo
Published: September 2023

Background

Arthroscopic Bankart repair is the most common procedure in patients with anterior shoulder instability. Various repair techniques using suture anchors have been used to improve the strength of fixation and surgical outcomes in arthroscopic Bankart surgery. However, evidence regarding which method is superior is lacking. This systematic review and meta-analysis study was designed to compare the biomechanical results of simple versus horizontal mattress versus double-row mattress for Bankart repair.

Methods

A systematic search of the MEDLINE, Embase, and Cochrane Library databases was performed to identify comparative biomechanical studies comparing the simple, horizontal mattress, and double-row techniques commonly used in Bankart repair for anterior shoulder instability. Biomechanical results included the ultimate load to failure, stiffness, cyclic displacement, and mode of failure after the ultimate load. The methodological quality was assessed based on the Quality Appraisal for Cadaveric Studies (QUACS) scale for biomechanical studies.

Results

Six biomechanical studies comprising 125 human cadavers were included in this systematic review. In biomechanical studies comparing simple and horizontal mattress repair and biomechanical studies comparing simple and double-row repair, there were no significant differences in the ultimate load to failure, stiffness, or cyclic displacement between the repair methods. The median QUACS scale was 11.5 with a range from 10 to 12, indicating a low risk of bias.

Conclusion

There was no biomechanically significant difference between the simple, horizontal mattress, and double-row methods in Bankart repair. Clinical evidence such as prospective randomized controlled trials should be conducted to evaluate clinical outcomes according to the various repair methods.

Level of evidence

Systematic review, Therapeutic level IV.
Comparing the effect of transcutaneous electrical nerve stimulation and massage therapy on post laparoscopic shoulder pain: a randomized clinical trial
Authors: Mottahedi Mobin , Shamsi MohammadBagher , Babani Samira Fatahi , Goli Shahrbanoo , Rizevandi Parisa
Published: September 2023

Background

Shoulder pain is a common clinical problem after laparoscopic surgeries. The use of non-pharmacological massage and transcutaneous electrical nerve stimulation (TENS) as an adjunct to routine treatment is increasing to provide optimal pain relief. Therefore, we aimed to determine the effect of TENS and massage therapy on post laparoscopic shoulder pain (PLSP).

Methods

This study was conducted on 138 patients who underwent laparoscopic cholecystectomy. Patients were randomly divided into three groups: massage plus conventional pharmacological treatment (n = 46), TENS plus conventional pharmacological treatment (n = 46), and conventional pharmacological treatment (n = 46). Massage and TENS were performed three consecutive times after the patients regained consciousness in the inpatient wards. The intensity of Shoulder pain was evaluated using a visual analog scale before and 20 min after each treatment.

Results

Both massage therapy and TENS led to a significant reduction in the intensity of PLPS compared to the control group in all three measured times (p < 0.001). However, no significant difference was observed between TENS and massage at any of the three-time points.

Conclusions

This study’s findings demonstrated that massage and TENS techniques could reduce PLSP.

Trial registration

Registered in the Iranian registry of clinical trials (www.irct.ir) in 05/02/2022 with the following code: IRCT20200206046395N1.
The online interactive visual learning improves learning effectiveness and satisfaction of physicians with postgraduate year during the COVID-19 pandemic in Taiwan
Authors: Ho Kung-Chen , Huang Tun-Sung , Lin Jiunn-Chang , Chiang Huihua-Kenny
Published: September 2023

Backgrounds

Medical education has shifted from passive forms of teaching to more active learning strategies, particularly in response to the COVID-19 pandemic. Research has discussed the challenges and disadvantages associated with online education, but there is limited documentation on physicians’ perceptions of this sudden and unexpected transformation in medical education. This study aimed to determine the effect of online interactive visual learning on physicians’ perceptions of the effectiveness and their satisfaction with this online learning experience.

Methods

We routinely recruited 64 unclassified physicians in the hospital’s postgraduate year (PGY) program between September 2021 and April 2022. PGY physicians received an online interactive visual learning course. Online (Google Form) testing and questionnaires before and after this course evaluated learning performance, learning attitude and satisfaction of these physicians.

Results

The interactive online learning tools facilitated the physicians’ active learning processes by reducing their learning burden (burden vs. no burden: 4.69% vs. 68.75%) and increasing their learning interest (interest vs. no interest: 84.38% vs. 3.12%) in the online format. Post-test scores were significantly improved compared with pretest scores (post-test vs. pre-test: 5 vs. 4; p < 0.05) and their imaging recognition was markedly improved from baseline (post-test vs. pre-test: 85.19% vs. 61.11%). Levels of satisfaction correlated positively with the physicians’ learning burden (rs = 0.541), learning interest (rs = 0.562), and perceived benefits of imaging recognition (post-course: rs = 0.508; future: rs = 0.563) (all p < 0.05).

Conclusions

Our online course with interactive visual learning facilitated PGY physicians’ learning performance, levels of satisfaction, interest, and perceived benefits of online learning. Hospitals and policymakers need to be aware that this learning approach can markedly enhance physicians’ academic outcomes and levels of clinical practice.
Levels and predictors of nurses’ knowledge about diabetes care and management: disparity between perceived and actual knowledge
Authors: Albagawi Bander , Alkubati Sameer A. , Abdul-Ghani Rashad
Published: September 2023

Background

Nurses have a crucial role in managing, educating, and caring for diabetic patients. However, their knowledge should be regularly assessed to avoid preventable complications and reduce costs. Therefore, the present study assessed the perceived and actual knowledge about diabetes among nurses in Hail province of Saudi Arabia and investigated predictors of such knowledge.

Methods

A cross-sectional study was conducted among 325 conveniently sampled nurses from all public hospitals and primary healthcare centres in Hail province from September to December 2022. A pre-designed questionnaire was used to collect demographic and practice-related characteristics of the nurses. In addition, data on nurses’ perceived and actual knowledge about diabetes were collected using the Diabetes Self-Report Tool (DSRT) and Diabetes Basic Knowledge Tool (DBKT) self-report questionnaires, respectively. The mean knowledge scores for demographic and practice-related variables were compared using the independent-samples t-test and one-way analysis of variance. Multiple linear regression was used to identify significant predictors of perceived and actual knowledge. The correlation between perceived and actual knowledge was investigated using Pearson’s correlation coefficient. A P-value ˂0.05 was considered statistically significant.

Results

Based on a highest maximum score of 60 using the DSRT, the mean score of perceived knowledge was 38.4 ± 12.0, corresponding to a percentage mean score of 64%. On the other hand, based on a highest maximum score of 49 using the DBKT, the mean score of actual knowledge was 23.2 ± 9.6, corresponding to a percentage mean score of 47.3% of correct responses. Being Indian, having a diploma or a bachelor’s degree, and having a poor or fair self-perception of competence in diabetes care were predictors of lower perceived knowledge scores, whereas having no access to diabetes guidelines was a predictor of higher scores. However, being non-Saudi and having experience of at least 16 years were predictors of higher actual knowledge scores. The correlation between actual and perceived knowledge about diabetes was negligible and statistically non-significant (r = 0.011, P = 0.055).

Conclusion

Nurses affiliated with public health facilities in Hail province lack adequate knowledge about diabetes, with no correlation between what is perceived to be known and what is actually known. Indian citizenship, having a diploma or bachelor’s degree, not having access to diabetes guidelines, not attending courses/workshops, and having a poor or fair self-perception of competence in diabetes care can significantly predict nurses’ perceived knowledge. However, being non-Saudi (Filipino or Indian) and having at least 16 years of experience can significantly predict their actual knowledge of diabetes.
Validation of a short version of the high-fidelity simulation satisfaction scale in nursing students
Authors: Martínez-Arce Alejandro , Rodríguez-Almagro Julián , Vélez-Vélez Esperanza , Rodríguez-Gómez Paloma , Tovar-Reinoso Alberto , Hernández-Martínez Antonio
Published: September 2023

Background

Clinical simulation provides a practical and effective learning method during the undergraduate education of health professions. Currently there is only one validated scale in Spanish to assess nursing students’ satisfaction with the use of high-fidelity simulation, therefore, our objective is to validate a brief version of this scale in undergraduate nursing students with or without clinical experience.

Method

A cross-sectional descriptive study was performed. Between 2018 and 2020, the students from all academic courses of the Fundación Jiménez Díaz nursing school completed the satisfaction scale at the end of their simulation experiences. To validate this scale, composed of 33 items and eight dimensions, exploratory factor analysis (EFA) of the principal components was performed, the internal consistency was studied using Cronbach’s alpha, and the corrected item-test correlation of each of the items of the total scale was reviewed.

Results

425 students completed the scale, after the exploratory factor analysis, a scale consisting of 25 items distributed into six subscales, each containing between two and six items, explained a variance of 66.5%. The KMO test (Kaiser-Meyer-Olkin) obtained a value of 0.938, Bartlett’s sphericity test was < 0.01 and Goodness of Fit Index (GFI) was 0.991.

Conclusion

The modified ESSAF scale, reduced from 33 to 25 items and divided into six subscales, is as valid and reliable as the original scale for use in nursing students of different levels, with, or without clinical experience.
Economical production of Pichia pastoris single cell protein from methanol at industrial pilot scale
Authors: Meng Jiao , Liu Shufan , Gao Le , Hong Kai , Liu Shuguang , Wu Xin
Published: September 2023

Background

Methanol, synthesized from CO2, is a potentially sustainable one-carbon (C1) resource for biomanufacturing. The use of methanol as a feedstock to produce single cell protein (SCP) has been investigated for decades as an alternative to alleviate the high global demand for animal-derived proteins. The methylotrophic yeast Pichia pastoris is an ideal host for methanol-based SCP synthesis due to its natural methanol assimilation ability. However, improving methanol utilization, tolerance to higher temperature, and the protein content of P. pastoris are also current challenges, which are of great significance to the economical industrial application using methanol as a feedstock for SCP production.

Results

In the present work, adaptive laboratory evolution (ALE) has been employed to overcome the low methanol utilization efficiency and intolerance to a higher temperature of 33 °C in P. pastoris, associated with reduced carbon loss due to the lessened detoxification of intracellular formaldehyde through the dissimilation pathway and cell wall rearrangement to temperature stress resistance following long-term evolution as revealed by transcriptomic and phenotypic analysis. By strengthening nitrogen metabolism and impairing cell wall synthesis, metabolic engineering further increased protein content. Finally, the engineered strain via multi-strategy produced high levels of SCP from methanol in a pilot-scale fed-batch culture at 33 °C with a biomass of 63.37 g DCW/L, methanol conversion rate of 0.43 g DCW/g, and protein content of 0.506 g/g DCW. SCP obtained from P. pastoris contains a higher percentage of protein compared to conventional foods like soy, fish, meat, whole milk, and is a source of essential amino acids, including methionine, lysine, and branched-chain amino acids (BCAAs: valine, isoleucine, leucine).

Conclusions

This study clarified the unique mechanism of P. pastoris for efficient methanol utilization, higher temperature resistance, and high protein synthesis, providing a P. pastoris cell factory for SCP production with environmental, economic, and nutritional benefits.
Cytotoxic effects of halophilic archaea metabolites on ovarian cancer cell lines
Authors: Kowalewicz-Kulbat Magdalena , Krawczyk Krzysztof T. , Szulc-Kielbik Izabela , Rykowski Sebastian , Denel-Bobrowska Marta , Olejniczak Agnieszka B. , Locht Camille , Klink Magdalena
Published: September 2023

Background

Ovarian cancer is one of the most frequent and deadly gynaecological cancers, often resistant to platinum-based chemotherapy, the current standard of care. Halophilic microorganisms have been shown to produce a large variety of metabolites, some of which show toxicity to various cancer cell lines. However, none have yet been shown to be active against ovarian cancer cells. Here, we examined the effects of metabolites secreted by the halophilic archaea Halorhabdus rudnickae and Natrinema salaciae on various cancer cell lines, including ovarian cancer cell lines.

Results

1H NMR analyses of Hrd. rudnickae and Nnm. salaciae culture supernatants contain a complex mixture of metabolites that differ between species, and even between two different strains of the same species, such as Hrd. rudnickae strains 64T and 66. By using the MTT and the xCELLigence RTCA assays, we found that the secreted metabolites of all three halophilic strains expressed cytotoxicity to the ovarian cancer cell lines, especially A2780, as well as its cisplatin-resistant derivative A2780cis, in a dose-dependent manner. The other tested cell lines A549, HepG2, SK-OV-3 and HeLa were only minimally, or not at all affected by the archaeal metabolites, and this was only seen with the MTT assay.

Conclusions

The halophilic archaea Hrd. rudnickae and Nnm. salaciae, isolated from a Polish salt mine and Lake Medee in the Mediterranean Sea, respectively, secrete metabolites that are active against ovarian cancer cells, including those that are resistant to cisplatin. This opens potential new possibilities for the treatment of these frequent and deadly gynaecological cancers.
Targeting MYH9 represses USP14-mediated NAP1L1 deubiquitination and cell proliferation in glioma
Authors: Chen Zigui , Yan Xin , Miao Changfeng , Liu Longyang , Liu Su , Xia Ying , Fang Weiyi , Zheng Dandan , Luo Qisheng
Published: September 2023

Myosin heavy chain 9 (MYH9) plays an important role in a number of diseases. Nevertheless, the function of MYH9 in glioma is unclear. The present research aimed to investigate the role of MYH9 in glioma and determine whether MYH9 is involved in the temozolomide chemoresistance of glioma cells. Our results showed that MYH9 increased the proliferation and temozolomide resistance of glioma cells. The mechanistic experiments showed that the binding of MYH9 to NAP1L1, a potential promoter of tumor proliferation, inhibited the ubiquitination and degradation of NAP1L1 by recruiting USP14. Upregulation of NAP1L1 increased its binding with c-Myc and activated c-Myc, which induced the expression of CCND1/CDK4, promoting glioma cell temozolomide resistance and proliferation. Additionally, we found that MYH9 upregulation was strongly related to patient survival and is therefore a negative factor for patients with glioma. Altogether, our results show that MYH9 plays a role in glioma progression by regulating NAP1L1 deubiquitination. Thus, targeting MYH9 is a potential therapeutic strategy for the clinical treatment of glioma in the future.
Epidemiology of malaria in Rohingya refugee camps in Bangladesh within 2017–2020
Authors: Khan Md. Ariful Anwar , Maude Richard James , Musa Sharmin , Khanum Hamida
Published: September 2023

Background

Malaria causes significant morbidity and mortality in tropical and sub-tropical regions, particularly in humanitarian emergencies including refugee camps in malaria endemic areas. An epidemiological investigation was conducted on malaria disease distribution and risk factors in the world’s largest refugee settlement, the Rohingya refugee camps on the south-eastern border area of Bangladesh, within 2017–2020.

Methods

From February 2017 to March 2020, 30,460 febrile patients were tested for malaria using light microscopy and rapid diagnostic tests. Most were self-presenting symptomatic patients and a minority were from door-to-door malaria screening. Diagnostic tests were done by trained medical technologists upon the advice of the concerned physicians in the camps. Test positivity rate (%) and annual parasite incidence were calculated and compared using chi-squared (χ 2) test or odds ratios.

Results

The overall average annual test positivity rate (TPR) was 0.05%. TPR was highest in people who had travelled to the forest in the previous 2 months, at 13.60%. Cases were clustered among male adults aged 15–60 years. There were no cases among children under five years or pregnant women and no deaths from malaria.

Conclusion

This study found very few malaria cases among Rohingya refugees with the majority of cases being imported from hilly forested areas, which were thus assumed to act as the reservoir for transmission.
Novel scaffold platforms for simultaneous induction osteogenesis and angiogenesis in bone tissue engineering: a cutting-edge approach
Authors: Saberi Arezoo , Kouhjani Maryam , Mohammadi Marzieh , Hosta-Rigau Leticia
Published: September 2023

Despite the recent advances in the development of bone graft substitutes, treatment of critical size bone defects continues to be a significant challenge, especially in the elderly population. A current approach to overcome this challenge involves the creation of bone-mimicking scaffolds that can simultaneously promote osteogenesis and angiogenesis. In this context, incorporating multiple bioactive agents like growth factors, genes, and small molecules into these scaffolds has emerged as a promising strategy. To incorporate such agents, researchers have developed scaffolds incorporating nanoparticles, including nanoparticulate carriers, inorganic nanoparticles, and exosomes. Current paper provides a summary of the latest advancements in using various bioactive agents, drugs, and cells to synergistically promote osteogenesis and angiogenesis in bone-mimetic scaffolds. It also discusses scaffold design properties aimed at maximizing the synergistic effects of osteogenesis and angiogenesis, various innovative fabrication strategies, and ongoing clinical studies.

Graphical Abstract
Natural exosomes-like nanoparticles in mung bean sprouts possesses anti-diabetic effects via activation of PI3K/Akt/GLUT4/GSK-3β signaling pathway
Authors: He Chengxun , Wang Ke , Xia Jun , Qian Die , Guo Juan , Zhong Lian , Tang Dandan , Chen Xiuping , Peng Wei , Chen Yunhui , Tang Yong
Published: September 2023

Background

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease characterized by hyperglycemia and insulin resistance. Mung bean sprouts are traditionally considered a “folk” hypoglycemic food and their pharmacological effects and underlying mechanisms warrant further investigation.

Purpose

This study aimed to investigate the anti-diabetic effects of the exosomes-like nanoparticles in mung bean sprouts (MELNs) and explore the related molecular mechanisms.

Results

MELNs were isolated using a differential centrifugation-polyethylene glycol (PEG) method, and the identification of MELNs were confirmed by PAGE gel electrophoresis, agarose gel electrophoresis, thin-layer chromatography (TLC), and transmission electron microscopy (TEM). In the high-fat diet/streptozotocin (HFD/STZ) mouse model, MELNs ameliorated the progression of T2DM by increasing oral glucose tolerance test (OGTT) and insulin tolerance test (ITT) results, decreasing the fasting blood glucose level, and reducing the serum triglycerides (TG) and total cholesterol (TC). Histopathological examinations indicated MELNs diminished inflammatory infiltration of hepatocytes and amplified the area of islet B cells. In addition, MELNs decreased the oxidative stress levels in liver tissue and had good biocompatibility. In vitro experiments verified that MELNs improved the viability of glucosamine (GlcN) induced insulin-resistant hepatocytes. Furthermore, this study also revealed that MELNs upregulated GLUT4 & Nrf2 and down-regulated GSK-3β via activating the PI3K/Akt signaling pathway, promoting the production of antioxidant enzymes, such as HO-1 and SOD, to reduce oxidative stress.

Conclusion

MELNs mitigated the progression of type 2 diabetes in HFD/STZ mouse model. The underlying molecular mechanism is related to PI3K/Akt/GLUT4/GSK-3β signaling pathway.
Integrin signaling in cancer: bidirectional mechanisms and therapeutic opportunities
Authors: Li Siyi , Sampson Chibuzo , Liu Changhao , Piao Hai-long , Liu Hong-Xu
Published: September 2023

Integrins are transmembrane receptors that possess distinct ligand-binding specificities in the extracellular domain and signaling properties in the cytoplasmic domain. While most integrins have a short cytoplasmic tail, integrin β4 has a long cytoplasmic tail that can indirectly interact with the actin cytoskeleton. Additionally, 'inside-out' signals can induce integrins to adopt a high-affinity extended conformation for their appropriate ligands. These properties enable integrins to transmit bidirectional cellular signals, making it a critical regulator of various biological processes.

Integrin expression and function are tightly linked to various aspects of tumor progression, including initiation, angiogenesis, cell motility, invasion, and metastasis. Certain integrins have been shown to drive tumorigenesis or amplify oncogenic signals by interacting with corresponding receptors, while others have marginal or even suppressive effects. Additionally, different α/β subtypes of integrins can exhibit opposite effects. Integrin-mediated signaling pathways including Ras- and Rho-GTPase, TGFβ, Hippo, Wnt, Notch, and sonic hedgehog (Shh) are involved in various stages of tumorigenesis. Therefore, understanding the complex regulatory mechanisms and molecular specificities of integrins are crucial to delaying cancer progression and suppressing tumorigenesis. Furthermore, the development of integrin-based therapeutics for cancer are of great importance.

This review provides an overview of integrin-dependent bidirectional signaling mechanisms in cancer that can either support or oppose tumorigenesis by interacting with various signaling pathways. Finally, we focus on the future opportunities for emergent therapeutics based on integrin agonists.
Meta-analysis of senescent cell secretomes to identify common and specific features of the different senescent phenotypes: a tool for developing new senotherapeutics
Authors: Oguma Yo , Alessio Nicola , Aprile Domenico , Dezawa Mari , Peluso Gianfranco , Di Bernardo Giovanni , Galderisi Umberto
Published: September 2023

DNA damage resulting from genotoxic injury can initiate cellular senescence, a state characterized by alterations in cellular metabolism, lysosomal activity, and the secretion of factors collectively known as the senescence-associated secretory phenotype (SASP). Senescence can have beneficial effects on our bodies, such as anti-cancer properties, wound healing, and tissue development, which are attributed to the SASP produced by senescent cells in their intermediate stages. However, senescence can also promote cancer and aging, primarily due to the pro-inflammatory activity of SASP.

Studying senescence is complex due to various factors involved. Genotoxic stimuli cause random damage to cellular macromolecules, leading to variations in the senescent phenotype from cell to cell, despite a shared program. Furthermore, senescence is a dynamic process that cannot be analyzed as a static endpoint, adding further complexity.

Investigating SASP is particularly intriguing as it reveals how a senescence process triggered in a few cells can spread to many others, resulting in either positive or negative consequences for health. In our study, we conducted a meta-analysis of the protein content of SASP obtained from different research groups, including our own. We categorized the collected omic data based on: i) cell type, ii) harmful agent, and iii) senescence stage (early and late senescence).

By employing Gene Ontology and Network analysis on the omic data, we identified common and specific features of different senescent phenotypes. This research has the potential to pave the way for the development of new senotherapeutic drugs aimed at combating the negative consequences associated with the senescence process.