bluuebunny/crossref_metadata_2025 huggingface dataset:
Molecular pathways underlying sympathetic autonomic overshooting leading to fear and traumatic memories: looking for alternative therapeutic options for post-traumatic stress disorder
Authors: Azevedo Márcia , Martinho Raquel , Oliveira Ana , Correia-de-Sá Paulo , Moreira-Rodrigues Mónica
Published: January 2024

The sympathoadrenal medullary system and the hypothalamic-pituitary-adrenal axis are both activated upon stressful events. The release of catecholamines, such as dopamine, norepinephrine (NE), and epinephrine (EPI), from sympathetic autonomic nerves participate in the adaptive responses to acute stress. Most theories suggest that activation of peripheral β-adrenoceptors (β-ARs) mediates catecholamines-induced memory enhancement. These include direct activation of β-ARs in the vagus nerve, as well as indirect responses to catecholamine-induced glucose changes in the brain. Excessive sympathetic activity is deeply associated with memories experienced during strong emotional stressful conditions, with catecholamines playing relevant roles in fear and traumatic memories consolidation. Recent findings suggest that EPI is implicated in fear and traumatic contextual memories associated with post-traumatic stress disorder (PTSD) by increasing hippocampal gene transcription (e.g., Nr4a) downstream to cAMP response-element protein activation (CREB). Herein, we reviewed the literature focusing on the molecular mechanisms underlying the pathophysiology of memories associated with fear and traumatic experiences to pave new avenues for the treatment of stress and anxiety conditions, such as PTSD.
Nutritional status of hospitalized elderly patients in Ethiopia: a cross-sectional study of an important yet neglected problem in clinical practice
Authors: Tesfaye Behailu Terefe , Yizengaw Mengist Awoke , Birhanu Tesema Etefa , Bosho Dula Dessalegn
Published: January 2024

Background

Malnutrition is a common geriatric syndrome affecting approximately half of the older population with a more pronounced occurrence rate in those hospitalized. It affects the physiology, and results in poor humanistic and clinical outcomes. In Africa, particularly in Ethiopia, albeit multiple studies are available on malnutrition in non-hospitalized older population, similar studies in inpatient settings are scarce. Therefore, this study was conducted with the intention to quantify the prevalence of malnutrition in older patients on inpatient admission and determine its associated factors.

Methods

A total of 157 older inpatients aged 60 years and above were included in the present study. The data collection format was developed after an in-depth review of relevant literatures. The full Mini-Nutritional Assessment (MNA) tool was employed to assess the nutritional status on admission. Data completeness was checked thoroughly. Descriptive statistics and logistic regression analysis were conducted using STATA 15.0. The area under the receiver operating characteristic curve (ROC), Hosmer–Lemeshow test, and classification table were computed to evaluate the final model goodness-of-fit.

Results

Of the total study subjects, 81% were malnourished (MNA score <17) and 17% were at risk for malnutrition (MNA score of 17.5–23.5). However, upon review of the patients’ medical charts, malnutrition diagnosis was recorded in only two patients. Rural residence (AOR = 2.823, 95%CI: 1.088, 7.324), self-reported financial dependence for expenses (AOR = 4.733, 95%CI: 1.011, 22.162), and partial dependence in functional autonomy on admission (AOR = 3.689, 95%CI: 1.190, 11.433) significantly increased the risk of malnutrition. The area under the ROC curve (0.754) and the Hosmer–Lemeshow test (p = 0.7564) indicated that the final model reasonably fits the data. The model`s sensitivity is 96.85%.

Conclusion

In the present study, an alarmingly high prevalence of malnutrition was identified older inpatients. The problem went undiagnosed in a similar percentage of patients. Several available literatures indicate the presence of an association between nutritional status and patient outcomes, thus strict nutritional screening at inpatient admission and intervention are recommended with special emphasis for those from rural areas, with financial dependence, and with functional impairment on admission.
Prospective cohort study of broccoli consumption frequency and all-cause and cause-specific mortality risks
Authors: Liu Xiangliang , Chang Yu , Li Yuguang , Zhang Xinwei , Li Fangqi , Song Jia , Shi Hanping , Chen Xiao , Cui Jiuwei
Published: January 2024

Background

Broccoli is rich in vitamins, minerals, and antioxidants with broad health benefits, but its intake frequency and dose–response relationship with mortality risk remain unclear.

Methods

Using data from the U.S. National Health and Nutrition Examination Survey 2003–2006, 12,486 adults were included. Broccoli intake frequency was evaluated by a food frequency questionnaire, and all-cause and cause-specific mortality risks were followed up. The relationship between broccoli intake and mortality risk was analyzed using Cox models.

Results

Compared with never consumption of broccoli, different frequencies of broccoli consumption were associated with significantly decreased risks of all-cause mortality (p for trend <0.001). Consuming broccoli 1–2 times per week was associated with a 32–43% lower mortality risk. More frequent broccoli consumption was negatively correlated with cardiovascular and cancer mortality risks (p < 0.05). Consuming broccoli 1–2 times per week for males and ≥ 3 times per week for females could significantly reduce all-cause mortality risk.

Conclusion

Moderate and frequent consumption of broccoli may reduce the risks of all-cause and cause-specific mortality. Optimal intake frequencies may differ by gender.
Cuban policosanol improves high-density lipoprotein cholesterol efflux capacity in healthy Japanese subjects
Authors: Uehara Yoshinari , Komatsu Tomohiro , Sasaki Kei , Abe Satomi , Nakashima Shihoko , Yamamoto Taiki , Kim Ji-Eun , Cho Kyung-Hyun
Published: January 2024

Policosanol supplementation has been reported to increase high-density lipoprotein (HDL)-cholesterol (HDL-C). However, the association between Cuban policosanol supplementation and HDL cholesterol efflux capacity (CEC), an important function of HDL, remains unclear. We performed a lipoprotein analysis investigating 32 Japanese healthy participants (placebo, n = 17 or policosanol supplementation for 12 weeks, n = 15) from a randomized Cuban policosanol clinical trial. First, HDL CEC and HDL-related factors were measured before and after policosanol supplementation. Then, through electron microscopy after ultracentrifugation and high-performance liquid chromatography, HDL morphology and subclass were analyzed, respectively. Finally, the effects of policosanol supplementation regarding HDL function, HDL-related factors, and HDL morphology/component were examined. Cuban policosanol considerably increased the HDL CEC and HDL-C and apolipoprotein A-I (ApoA-I) levels. Furthermore, policosanol supplementation led to larger HDL particles, increased cholesterol content in larger HDL particles, and reduced triglyceride content in smaller HDL particles. In participants with high baseline HDL-C levels, the policosanol effects for HDL CEC are observed. HDL CEC fluctuation induced by policosanol was highly associated with HDL-C and ApoA-I changes. In conclusion, for the first time, we demonstrated that policosanol supplementation increased the HDL CEC in healthy participants.
The association between plant-based diet indices and metabolic syndrome: a systematic review and dose–response meta-analysis
Authors: Nikparast Ali , Etesami Elahe , Rahmani Jamal , Rafiei Nazgoli , Ghanavati Matin
Published: January 2024

Aim/introduction

The prevalence of metabolic syndrome (MetS) and its components have markedly increased worldwide. Among lifestyle factors introduced to lower the risk of MetS, healthy dietary patterns have gained considerable attention. This study aimed to assess the association between adherence to plant-based diet indices including O-PDI (overall plant-based diet index), H-PDI (healthy plant-based diet index), U-PDI (unhealthy plant-based diet index), and risk of MetS development.

Methods

To find related observational studies which assessed the association between Plant-based Diet indices and risk of MetS development, PubMed/Medline, Scopus, and Web of Science databases were searched from January 2016 to November 2023. A random effects model was used to estimate pooled odds ratios (OR) and 95% confidence intervals (95% CI). To assess the heterogeneity of included studies, the I2 index was used.

Results

Nine studies including 34,953 participants from the initial 288 studies were recognized to include in this meta-analysis study. According to pooled analysis, there was a significant relationship between the adherence to H-PDI and the lower risk of MetS (ES: 0.81; 95% CI: 0.67, 0.97; I2 = 77.2%, p < 0.001), while greater adherence to U-PDI was associated with 27% increases in the risk of MetS (ES: 1.27; 95% CI: 1.05, 1.54; I2 = 76.8%, p < 0.001). According to our analysis of the association between adherence to PDIs and the risk of MetS components, greater adherence to O-PDI and H-PDI was significantly associated with a higher risk of elevated FBS and obesity, respectively. As well, greater adherence to U-PDI was significantly associated with a higher risk of obesity, hypertriglyceridemia, low HDL-C, and elevated FBS.

Conclusion

Our results highlighted the importance of food choices in the context of a plant-based dietary pattern, indicating that adherence to unhealthy plant-based dietary patterns rich in less healthful carbohydrates may induce the risk of MetS development.

Systematic review registration

PROSPERO CRD42023428981.
Does knowledge and concern regarding food supplement safety affect the behavioral intention of consumers? An experimental study on the theory of reasoned action
Authors: Bayır Talha , Çam Selim , Tuna Murat Fatih
Published: January 2024

In recent years, health crises have led consumers to make more frequent purchases of food supplements. The global food supplement market, which reached $61.20 billion in 2020, is estimated to reach $163.12 billion by 2022 and $350.96 billion by 2032. However, many consumers still have concerns about the safety of food supplements. Within the scope of the research, firstly, the health consciousness (HC) level of food supplement consumers was determined. Secondly, food safety knowledge (FSK) and food safety concerns (FSCs) were measured. Thirdly, consumers’ attitudes (ATUs), subjective norms (SNs), and behavioral intentions (BIs) toward food supplements were determined within the scope of the theory of reasoned action. The study used a convenient sampling, and 327 participants were included in the sample population. The data for the analysis was collected using the online survey method in the third quarter of 2023. The relationships between hypothesized items in the structural model were tested using the Smart-PLS. The validity and reliability of the measurement model were evaluated at the start of the structural equation modelling approach using confirmatory factor analysis (CFA). Regression analyses were performed in the structural model phase to evaluate overall fit and suggested relationships by way of the Smart-PLS. In light of the findings, it was determined that the interaction between HC and ATU was mediated by FSK, and the interaction between HC and the SN was mediated by FSK. Consequently, this research presents a variety of theoretical and practical implications to give clues for consumers’ health regarding food supplement consumption.
Emerging insights into keratin 7 roles in tumor progression and metastasis of cancers
Authors: Hosseinalizadeh Hamed , Hussain Qusay Mohammed , Poshtchaman Zahra , Ahsan Muhammad , Amin Ali H. , Naghavi Soroush , Mahabady Mahmood Khaksary
Published: January 2024

Keratin 7 (KRT7), also known as cytokeratin-7 (CK-7) or K7, constitutes the principal constituent of the intermediate filament cytoskeleton and is primarily expressed in the simple epithelia lining the cavities of the internal organs, glandular ducts, and blood vessels. Various pathological conditions, including cancer, have been linked to the abnormal expression of KRT7. KRT7 overexpression promotes tumor progression and metastasis in different human cancers, although the mechanisms of these processes caused by KRT7 have yet to be established. Studies have indicated that the suppression of KRT7 leads to rapid regression of tumors, highlighting the potential of KRT7 as a novel candidate for therapeutic interventions. This review aims to delineate the various roles played by KRT7 in the progression and metastasis of different human malignancies and to investigate its prognostic significance in cancer treatment. Finally, the differential diagnosis of cancers based on the KRT7 is emphasized.
Deep learning application for abdominal organs segmentation on 0.35 T MR-Linac images
Authors: Zhou You , Lalande Alain , Chevalier Cédric , Baude Jérémy , Aubignac Léone , Boudet Julien , Bessieres Igor
Published: January 2024

Introduction

Linear accelerator (linac) incorporating a magnetic resonance (MR) imaging device providing enhanced soft tissue contrast is particularly suited for abdominal radiation therapy. In particular, accurate segmentation for abdominal tumors and organs at risk (OARs) required for the treatment planning is becoming possible. Currently, this segmentation is performed manually by radiation oncologists. This process is very time consuming and subject to inter and intra operator variabilities. In this work, deep learning based automatic segmentation solutions were investigated for abdominal OARs on 0.35 T MR-images.

Methods

One hundred and twenty one sets of abdominal MR images and their corresponding ground truth segmentations were collected and used for this work. The OARs of interest included the liver, the kidneys, the spinal cord, the stomach and the duodenum. Several UNet based models have been trained in 2D (the Classical UNet, the ResAttention UNet, the EfficientNet UNet, and the nnUNet). The best model was then trained with a 3D strategy in order to investigate possible improvements. Geometrical metrics such as Dice Similarity Coefficient (DSC), Intersection over Union (IoU), Hausdorff Distance (HD) and analysis of the calculated volumes (thanks to Bland-Altman plot) were performed to evaluate the results.

Results

The nnUNet trained in 3D mode achieved the best performance, with DSC scores for the liver, the kidneys, the spinal cord, the stomach, and the duodenum of 0.96 ± 0.01, 0.91 ± 0.02, 0.91 ± 0.01, 0.83 ± 0.10, and 0.69 ± 0.15, respectively. The matching IoU scores were 0.92 ± 0.01, 0.84 ± 0.04, 0.84 ± 0.02, 0.54 ± 0.16 and 0.72 ± 0.13. The corresponding HD scores were 13.0 ± 6.0 mm, 16.0 ± 6.6 mm, 3.3 ± 0.7 mm, 35.0 ± 33.0 mm, and 42.0 ± 24.0 mm. The analysis of the calculated volumes followed the same behavior.

Discussion

Although the segmentation results for the duodenum were not optimal, these findings imply a potential clinical application of the 3D nnUNet model for the segmentation of abdominal OARs for images from 0.35 T MR-Linac.
Breast cancer in pregnancy: concurrent cesarean section, nipple-sparing mastectomy, and immediate breast reconstruction—case report
Authors: Innocenti Alessandro , Susini Pietro , Grimaldi Luca , Susini Tommaso
Published: January 2024

Background

Pregnancy-associated breast cancer (PABC), with an incidence rate from 1:3,000 to 1:10,000 deliveries, is the most frequent cancer during pregnancy. PABC appropriate management must take into consideration both the maternal oncological safety and the fetal health, thus posing a challenge for the mother, the baby, and the clinicians. The treatment should adhere as closely as possible to the breast cancer (BC) guidelines. Therefore, surgery is a mainstay, and, when mastectomy is required, breast reconstruction (BR) is a topic of debate. To minimize the risks to the baby, most surgeons postpone BR to delivery. However, a delayed breast reconstruction (DBR) could affect the outcome. In the present case, we report cesarean section concurrent with mastectomy and immediate breast reconstruction (IBR).

Methods

A 37-year-old patient, at the 36th week of pregnancy with PABC, underwent simultaneous cesarean delivery, nipple-sparing mastectomy, and IBR. To minimize risks for the newborn, cesarean was firstly performed under spinal anesthesia. Immediately after, breast surgery, including mastectomy and IBR, was performed under general anesthesia. Partial submuscular IBR with an acellular porcine dermal matrix concluded the surgical procedure. Lactation was inhibited, and adjuvant chemotherapy and hormone therapy were administered to the patient.

Results

In a single surgical session, cesarean delivery, subcutaneous mastectomy, axillary dissection, and IBR were successfully carried out. No early or late postoperative complications were reported for both the patient and the newborn. Histopathological investigation reported a multifocal and multicentric infiltrating ductal carcinoma. After a 6-year follow-up, the patient is alive and well.

Conclusion

To the best of our knowledge, this is the first reported case of concomitant cesarean delivery, PABC mastectomy, axillary dissection, and IBR. This surgical strategy allowed PABC treatment by the BC guideline, minimizing the newborn’s disadvantage and permitting, at the same time, the best final BR outcome.
Optically stimulated luminescence dosimeters for simultaneous measurement of point dose and dose-weighted LET in an adaptive proton therapy workflow
Authors: Bobić Mislav , Christensen Jeppe B. , Lee Hoyeon , Choulilitsa Evangelia , Czerska Katarzyna , Togno Michele , Safai Sairos , Yukihara Eduardo G. , Winey Brian A. , Lomax Antony J. , Paganetti Harald , Albertini Francesca , Nesteruk Konrad P.
Published: January 2024

Purpose

To demonstrate the suitability of optically stimulated luminescence detectors (OSLDs) for accurate simultaneous measurement of the absolute point dose and dose-weighted linear energy transfer (LETD) in an anthropomorphic phantom for experimental validation of daily adaptive proton therapy.

Methods

A clinically realistic intensity-modulated proton therapy (IMPT) treatment plan was created based on a CT of an anthropomorphic head-and-neck phantom made of tissue-equivalent material. The IMPT plan was optimized with three fields to deliver a uniform dose to the target volume covering the OSLDs. Different scenarios representing inter-fractional anatomical changes were created by modifying the phantom. An online adaptive proton therapy workflow was used to recover the daily dose distribution and account for the applied geometry changes. To validate the adaptive workflow, measurements were performed by irradiating Al2O3:C OSLDs inside the phantom. In addition to the measurements, retrospective Monte Carlo simulations were performed to compare the absolute dose and dose-averaged LET (LETD) delivered to the OSLDs.

Results

The online adaptive proton therapy workflow was shown to recover significant degradation in dose conformity resulting from large anatomical and positioning deviations from the reference plan. The Monte Carlo simulations were in close agreement with the OSLD measurements, with an average relative error of 1.4% for doses and 3.2% for LETD. The use of OSLDs for LET determination allowed for a correction for the ionization quenched response.

Conclusion

The OSLDs appear to be an excellent detector for simultaneously assessing dose and LET distributions in proton irradiation of an anthropomorphic phantom. The OSLDs can be cut to almost any size and shape, making them ideal for in-phantom measurements to probe the radiation quality and dose in a predefined region of interest. Although we have presented the results obtained in the experimental validation of an adaptive proton therapy workflow, the same approach can be generalized and used for a variety of clinical innovations and workflow developments that require accurate assessment of point dose and/or average LET.
Association of serum levels of inflammatory cytokines with retinopathy of prematurity in preterm infants
Authors: Ling Xiao Chun , Huang Pin-Hsuan , Chen Hung-Chi , Hsueh Yi-Jen , Lee Chia-Wen , Lien Reyin , Lee Chien-Chung , Chu Shih-Ming , Chen Kuan-Jen , Hwang Yih-Shiou , Lai Chi-Chun , Chiang Ming-Chou , Wu Wei-Chi
Published: January 2024

Introduction

Retinopathy of prematurity (ROP) is a retinal vascular developmental disease associated with risks factors such as supplementary oxygen use or low birth weight/early gestational age. Multiple studies have reported associations between ROP and systemic inflammation. In this study, we investigated serum cytokines associated with ROP development and severity and assessed their applicability as potential biomarkers of ROP.

Methods

This prospective study was conducted at an institutional referral center between 2019 and 2021. To measure the serum levels of 40 inflammatory cytokines in eligible premature patients, we collected their serum samples during the enrollment of patients or the intravitreal injection of anti–vascular endothelial growth factor (VEGF) agents and after 2 and 4 weeks.

Results

Fifty patients were enrolled. In patients with type 1 ROP who received anti-VEGF agents (n = 22), the levels of serum intercellular adhesion molecule-1 decreased significantly (p < 0.05) at 4 weeks compared with the baseline level, whereas those of serum granulocyte–macrophage colony-stimulating factor increased significantly (p < 0.05). In patients with ROP who did not require any treatment (n = 14), no significant change was noted in the level of any of the 40 inflammatory cytokines. In control infants without ROP (n = 14), the serum levels of tumor necrosis factor-α, interleukin (IL)-15, and IL-12p40 increased significantly (p < 0.05) at 4 weeks. The changes in the levels of serum inflammatory cytokines did not vary significantly among the aforementioned three groups. A generalized estimating equation indicated that zone 1 ROP, stage 3 ROP, older postmenstrual age, respiratory distress syndrome, necrotizing enterocolitis, and sepsis were associated with the changes in serum cytokine levels.

Conclusions

Although significant changes (compared with baseline) were observed in the serum levels of certain inflammatory cytokines in patients with type 1 ROP and infants without ROP, no significant difference in cytokine level fluctuations were noted among the three groups. Changes in serum inflammatory cytokine levels may not predict ROP development or severity. Additional comprehensive studies are warranted to establish their definitive role and significance in ROP, emphasizing the need for continued research in this area.
To use a simple hernia needle for single-port laparoscopic percutaneous inguinal hernia repair in children: a 5-year experience study
Authors: Zhang Li , Zhang Rui , Zhang Jianfa , Hu Hailong , Chen Zihan , Fu Yanxiang , Li Saihua
Published: January 2024

Purpose

The aim of this study is to investigate the technique and practical significance of using a simple hernia needle in single-port laparoscopic herniorrhaphy in pediatric patients.

Methods

The study conducted a retrospective analysis of all pediatric patients who underwent treatment for inguinal hernia using single-port laparoscopic herniorrhaphy with a simple hernia needle at Yellow River Sanmenxia Hospital from June 2018 to May 2023. The medical records of all the children were collected, and clinical characteristics, procedural information, and follow-up data were carefully reviewed.

Results

A total of 848 patients underwent inguinal hernia repair, with ages ranging from 7 months to 13 years (2.99 ± 2.49 years), including 756 males and 92 females. A total of 528 cases of unilateral hernia and 310 cases of bilateral hernia were reported, with intra-operative findings revealing contralateral occult hernia in 253 cases. Single-port laparoscopic herniorrhaphy was successfully completed in all patients, with no instances of conversion to open surgery. The mean operation time for unilateral hernia repair was (7.50 ± 4.80) min, while for bilateral hernia repair it was (11.55 ± 7.27) min. Five patients presented with subcutaneous emphysema, while two patients experienced a recurrence of inguinal hernia. No complications, such as scrotal hematoma, trocar umbilical hernia and testicular atrophy, were observed. The duration of the follow-up period ranged from 3 to 24 months.

Conclusion

The promotion and utilization of single-port laparoscopy combined with a simple hernia needle in clinical practice are justified. Our initial investigation indicates that this surgical approach is both safe and dependable for the management of pediatric inguinal hernia. The procedure presents numerous benefits, including the utilization of uncomplicated instruments, straightforward operation, a clear curative impact, minimal tissue damage, rapid recovery, and the absence of scarring.
Parental perceptions of informed consent in a study of tracheal intubations in neonatal intensive care
Authors: Tippmann Susanne , Schäfer Janine , Arnold Christine , Winter Julia , Paul Norbert W. , Mildenberger Eva , Kidszun André
Published: January 2024

Background and objective

Obtaining informed consent in neonatal emergency research is challenging. The aim of this study was to assess parental perceptions of informed consent following participation in a clinical trial in neonatal emergency care.

Methods

This was a supplementary analysis of a randomised controlled trial comparing video and direct laryngoscopy for neonatal endotracheal intubation in the delivery room and neonatal intensive care unit. After obtaining informed consent for the clinical trial, parents were asked to answer a series of self-administered questions about their perceptions of clinical trial participation and the consent process. Informed consent had been given either before birth, after birth but before inclusion in the trial, or after inclusion in the trial.

Results

We received responses from 33 mothers and 27 fathers (n = 60) of the 63 preterm and term infants who participated in the study. Fifty-three (89.8%, n = 59) parents agreed that infants should participate in clinical trials, and 51 (85%, n = 60) parents agreed that parents should be asked for informed consent. Fifty-three (89.8%, n = 59) parents felt that their infant's participation in this particular trial would be beneficial. Fifty-two (86.7%, n = 60) parents felt that the informed consent process was satisfactory. One parent (100%, n = 1) approached before birth, 23 parents (82.1%, n = 28) approached after birth but before enrolment and 26 (83.9%, n = 31) parents approached after enrolment were satisfied with the timing of the consent process. Eight (13.3%, n = 60) parents felt some pressure to provide informed consent. Of these, two (25%) were approached before enrolment and six (75%) were approached after enrolment.

Conclusion

Parents valued their infant's participation in an emergency neonatal clinical trial and considered it important to be asked for consent. In this study, it seemed less important whether consent was obtained before or after the intervention. Future studies may need to investigate which form of consent is most acceptable to parents for the individual study in question.
Self-medication practice among pregnant and postpartum women attending the regional hospital center of Souss Massa, Morocco: a cross-sectional study
Authors: Bouqoufi Afaf , Lahlou Laila , Ait El Hadj Fatima , Boujraf Said , Abdessadek Mohammed , Khabbal Youssef
Published: January 2024

Background: Self-medication among pregnant women represents a serious risk to the mother’s and child’s health. It is a global concern that requires careful attention from professionals in healthcare. In Morocco, there is a lack of available data on self-medication and predicting variables among pregnant and postpartum women. The purpose of this study was to determine the incidence of self-medication and the factors that contributed to it among pregnant and postpartum women in the Sous Massa Regional Hospital.

Methods: A cross-sectional study was conducted using a pretested questionnaire among 420 pregnant and postpartum women who were attending the regional hospital center of the Sous Massa region from April to December 2022. Statistical analysis was performed using Jamovi Software. The logistic regression analysis was used to determine the significance of the association between the outcome and independent variables.

Results: The research enrolled 420 pregnant and postpartum women. During the current pregnancy, 24.8% of the women used self-medication. The leading common causes/symptoms that necessitate self-medication among pregnant and postpartum women were Anemia (84.8%), epigastralgia (16.8%), vomiting, pyrosis (15.2%), and urinary and vaginal infections The therapeutic families concerned with self-medication practice were Analgesics (41.4%), Antacids (20.3%), antimicrobials (13.5%), and Vitamin supplements (9%). According to the findings, the most frequent sources of information were pharmacists (45.6%), followed by physicians (44.3%). The primary reasons given by respondents for self-medication were the need for rapid release (51.7%), previous treatments with the same drugs (31.7%), and 20% reported difficulty of access to healthcare professionals. Out of 95.9% of the participants reported that they knew the dangers of self-medication and 96% of them were informed and received information about the dangers and contraindications of self-medication during pregnancy. This was significantly statistically associated with self-medication respectively with p-value = 0.031 and p-value = 0.005.

Conclusion: The findings of the present study provide an initial awareness of the state of self-medication among pregnant and postpartum women attending the regional hospital centers. It is recommended that healthcare professionals increase their interventions to improve the consciousness of pregnant women; this might require implementing suitable strategies to regulate the commercialization, delivery, and use of conventional medications.
Antibiotic exposure is associated with decreased risk of psychiatric disorders
Authors: Kerman Ilan A. , Glover Matthew E. , Lin Yezhe , West Jennifer L. , Hanlon Alexandra L. , Kablinger Anita S. , Clinton Sarah M.
Published: January 2024

Objective: This study sought to investigate the relationship between antibiotic exposure and subsequent risk of psychiatric disorders.

Methods: This retrospective cohort study used a national database of 69 million patients from 54 large healthcare organizations. We identified a cohort of 20,214 (42.5% male; 57.9 ± 15.1 years old [mean ± SD]) adults without prior neuropsychiatric diagnoses who received antibiotics during hospitalization. Matched controls included 41,555 (39.6% male; 57.3 ± 15.5 years old) hospitalized adults without antibiotic exposure. The two cohorts were balanced for potential confounders, including demographics and variables with potential to affect: the microbiome, mental health, medical comorbidity, and overall health status. Data were stratified by age and by sex, and outcome measures were assessed starting 6 months after hospital discharge.

Results: Antibiotic exposure was consistently associated with a significant decrease in the risk of novel mood disorders and anxiety and stressor-related disorders in: men (mood (OR 0.84, 95% CI 0.77, 0.91), anxiety (OR 0.88, 95% CI 0.82, 0.95), women (mood (OR 0.94, 95% CI 0.89,1.00), anxiety (OR 0.93, 95% CI 0.88, 0.98), those who are 26–49 years old (mood (OR 0.87, 95% CI 0.80, 0.94), anxiety (OR 0.90, 95% CI 0.84, 0.97)), and in those ≥50 years old (mood (OR 0.91, 95% CI 0.86, 0.97), anxiety (OR 0.92, 95% CI 0.87, 0.97). Risk of intentional harm and suicidality was decreased in men (OR 0.73, 95% CI 0.55, 0.98) and in those ≥50 years old (OR 0.67, 95% CI 0.49, 0.92). Risk of psychotic disorders was also decreased in subjects ≥50 years old (OR 0.83, 95 CI: 0.69, 0.99).

Conclusion: Use of antibiotics in the inpatient setting is associated with protective effects against multiple psychiatric outcomes in an age- and sex-dependent manner.
Bridging the new drug access gap between China and the United States and its related policies
Authors: Zhu Xingyue , Chen Yang
Published: January 2024

Introduction:The access gap for novel pharmaceuticals between China and the developed countries is a major public health issue in China. It is crucial to understand the determinants of this gap to ensure timely access to new drugs and enhance patient health.

Methods:We included all new drugs approved by the US Food and Drug Administration (FDA) between 2012 and 2019, and collected their approval timings in China. Major factors of interest comprised orphan designation and expedited review pathways granted by the FDA, along with the proportion of Asian subjects in the pivotal trial supporting the FDA approval and whether the trial included study sites in China. The elapsed time from the FDA approval to the market authorization in China constituted the time-to-event outcome, and Cox proportional-hazards regression was used for multivariate analysis.

Results:A total of 327 new drugs were approved by the FDA between 2012 and 2019, among which 41.3% were found to be authorized in China as of 1 November 2023. The median lag time for the mutually approved drugs was 3.5 years. The Cox model found that orphan drugs had lower likelihood of being approved in China (HR = 0.59, 95% CI 0.39–0.89;p= 0.011), while the FDA’s Breakthrough-Therapy drugs (HR = 2.33, 95% CI 1.39–3.89;p= 0.001) and Fast-Track drugs (HR = 1.58, 95% CI 1.05–2.38;p= 0.028) had shorter lag times. In the pivotal trials that supported the FDA approvals, a higher proportion of Asian subjects was associated with faster drug entry into the Chinese market (HR = 1.02, 95% CI 1.01–1.03;p< 0.001), and the inclusion of study sites in China mainland was likewise conducive to reducing the drug lag (HR = 5.30, 95% CI 3.20–8.77;p< 0.001). After the trials with China-based sites supported the FDA approvals, 77.8% of the trials also supported the subsequent approvals in China.

Discussion:China’s involvement in global drug co-development can streamline clinical development, by reducing repeated trials solely in the Chinese population. This is primarily due to the openness of the Chinese drug agency towards overseas clinical data and is a positive sign that encourages global drug developers to include Chinese patients in their development plans as early as possible.
Umbelliprenin via increase in the MECP2 and attenuation of oxidative stress mitigates the autistic-like behaviors in mouse model of maternal separation stress
Authors: Karimi Parnian , Ghahfarroki Mehryar Shahgholian , Lorigooini Zahra , Shahrani Mehrdad , Amini-Khoei Hossein
Published: January 2024

Introduction: Autism spectrum disorder (ASD) is a complex neurodevelopmental condition. Maternal separation (MS) stress is an early-life stress factor associated with behaviors resembling Autism. Both MECP2 and oxidative stress are implicated in the pathophysiology of Autism. Umbelliprenin (UMB) is a coumarin compound with various pharmacological properties. Our study aimed to investigate the potential effects of UMB in mitigating autistic-like behaviors in a mouse model subjected to MS stress, focusing on probable alterations in MECP2 gene expression in the hippocampus.

Methods: MS paradigm was performed, and mice were treated with saline or UMB. Behavioral tests consisting of the three-chamber test (evaluating social interaction), shuttle box (assessing passive avoidance memory), elevated plus-maze (measuring anxiety-like behaviors), and marble-burying test (evaluating repetitive behaviors) were conducted. Gene expression of MECP2 and measurements of total antioxidant capacity (TAC), nitrite level, and malondialdehyde (MDA) level were assessed in the hippocampus.

Results: The findings demonstrated that MS-induced behaviors resembling Autism, accompanied by decreased MECP2 gene expression, elevated nitrite, MDA levels, and reduced TAC in the hippocampus. UMB mitigated these autistic-like behaviors induced by MS and attenuated the adverse effects of MS on oxidative stress and MECP2 gene expression in the hippocampus.

Conclusion: In conclusion, UMB likely attenuated autistic-like behaviors caused by MS stress, probably, through the reduction of oxidative stress and an increase in MECP2 gene expression.
The efficacy and safety of high-dose isoniazid-containing therapy for multidrug-resistant tuberculosis: a systematic review and meta-analysis
Authors: Zhou Ming , Liu Ai-Mei , Yang Xiao-Bing , Guan Cui-Ping , Zhang Yan-An , Wang Mao-Shui , Chen Ya-Li
Published: January 2024

Objectives: Accumulating evidence are available on the efficacy of high-dose isoniazid (INH) for multidrug-resistant tuberculosis (MDR-TB) treatment. We aimed to perform a systematic review and meta-analysis to compare clinical efficacy and safety outcomes of high-dose INH- containing therapy against other regimes.

Methods: We searched the following databases PubMed, Embase, Scopus, Web of Science, CINAHL, the Cochrane Library, and ClinicalTrials.gov. We considered and included any studies comparing treatment success, treatment unsuccess, or adverse events in patients with MDR-TB treated with high-dose INH (>300 mg/day or >5 mg/kg/day).

Results: Of a total of 3,749 citations screened, 19 studies were included, accounting for 5,103 subjects, the risk of bias was low in all studies. The pooled treatment success, death, and adverse events of high-dose INH-containing therapy was 76.5% (95% CI: 70.9%–81.8%; I2: 92.03%), 7.1% (95% CI: 5.3%–9.1%; I2: 73.75%), and 61.1% (95% CI: 43.0%–77.8%; I2: 98.23%), respectively. The high-dose INH administration is associated with significantly higher treatment success (RR: 1.13, 95% CI: 1.04–1.22; p < 0.01) and a lower risk of death (RR: 0.45, 95% CI: 0.32–0.63; p < 0.01). However, in terms of other outcomes (such as adverse events, and culture conversion rate), no difference was observed between high-dose INH and other treatment options (all p > 0.05). In addition, no publication bias was observed.

Conclusion: In MDR-TB patients, high-dose INH administration is associated with a favorable outcome and acceptable adverse-event profile.

Systematic review registration: identifier CRD42023438080
A hybrid finite volume method and smoothed particle hydrodynamics approach for efficient and accurate blast simulations
Authors: Myers Conner , Musk Jeffrey , Palmer Todd , Palmer Camille
Published: January 2024

Modeling strong shock waves in fluids remains a persistent challenge in computational physics. Essential to research efforts in industry and defense, numerous methods have been devised to improve the accuracy and efficiency of shock simulations. A novel, hybrid Finite Volume Method (FVM)-Smoothed Particle Hydrodynamics (SPH) approach is capable of further improving efficiency and retaining accuracy by exploiting the favorable characteristics of each respective method. This hybrid approach is presented for shock capturing in compressible fluids. The Python framework Pyro2 is employed to simulate a coarse FVM mesh, while the Python framework PySPH is utilized to model the fluid in regions with high gradients through SPH particles. The performance of the hybrid FVM-SPH scheme, compared to the individual FVM and SPH methods, is assessed in 1 kt and 10 kt blast simulations. Our results indicate that the hybrid approach offers higher computational efficiency than SPH while preserving its accuracy and characteristics. The hybrid approach had a relative speedup of 11.3x and 22.3x over the FVM and SPH approaches for the 1 kt simulation and a relative speedup of 14.7x and 20.9x over the FVM and SPH approaches for the 10 kt simulation. The hybrid SPH algorithm enables future compressible fluid simulations with more extensive capabilities than grid-based methods alone, presenting potential applications in modeling fluid-structure interactions and solid deformation and fracturing in blast simulations.
Differential impact of heat and hypoxia on dynamic oxygen uptake and deoxyhemoglobin parameters during incremental exhaustive exercise
Authors: Geng Zhizhong , Wang Jinhao , Cao Guohuan , Tan Chenhao , Li Longji , Qiu Jun
Published: January 2024

Purpose: This study aims to explore the relationship between the dynamic changes in oxygen uptake (V˙O2) and deoxyhemoglobin (HHb) and peripheral fatigue in athletes during incremental exhaustive exercise under different environmental conditions, including high temperature and humidity environment, hypoxic environment, and normal conditions.

Methods: 12 male modern pentathlon athletes were recruited and performed incremental exhaustive exercise in three different environments: normal condition (23°C, 45%RH, FiO2 = 21.0%, CON), high temperature and humidity environment (35°C, 70%RH, FiO2 = 21.0%, HOT), and hypoxic environment (23°C, 45%RH, FiO2 = 15.6%, HYP). Gas metabolism data of the athletes were collected, and muscle oxygen saturation (SmO2) and total hemoglobin content in the vastus lateralis muscles (VL) were measured to calculate the deoxyhemoglobin content. Linear and nonlinear function models were used to fit the characteristic parameters of V˙O2 and HHb changes.

Results: The results showed that compared to the CON, V˙O2, V˙CO2, and exercise time were decreased in the HOT and HYP (p < 0.05). ΔEV˙O2 and OUES were reduced in the HOT and HYP compared to the CON (p < 0.05). The Gas exchange threshold in the CON corresponded to higher V˙O2 than in the HYP and HOT (p < 0.05). ΔEV˙O2‐1 was reduced in the HOT compared to the HYP (p < 0.05). ΔEHHb was higher in the HOT compared to the CON (p < 0.05). ΔEHHb-1 was increased in the HYP compared to the CON (p < 0.05). There was a negative correlation between ΔEHHb and corresponding V˙O2⁡max in the HOT (r = −0.655, p < 0.05), and a negative correlation between ΔEHHb-1 and corresponding V˙O2⁡max in the HYP (r = −0.606, p < 0.05).

Conclusion: Incremental exhaustive exercise in hypoxic environment and high temperature and humidity environments inhibits gas exchange and oxygen supply to skeletal muscle tissue in athletes. For athletes, the accelerated deoxygenation response of skeletal muscles during incremental exhaustive exercise in high temperature and humidity environments, as well as the excessive deoxygenation response before BP of deoxyhemoglobin in hypoxic environment, may be contributing factors to peripheral fatigue under different environmental conditions.
The sex effect on balance control while standing on vestibular-demanding tasks with/without vestibular simulations: implication for sensorimotor training for future space missions
Authors: Zhang Li , Qin Chao , Chien Jung Hung
Published: January 2024

Background: Anatomical differences between sexes in the vestibular system have been reported. It has also been demonstrated that there is a sex difference in balance control while standing on vestibular-demanding tasks. In 2024, NASA expects to send the first female to the Moon. Therefore, to extend the current knowledge, this study attempted to examine whether different sexes respond differently to vestibular-disrupted and vestibular-demanding environments.

Method: A total of fifteen males and fifteen females participated in this study. The vestibular function was quantified through different SOT conditions (SOT1: baseline; SOT5: vestibular demanding by standing with blindfolded and sway reference surface). The vestibular stimulation (VS) was applied either unilaterally or bilaterally to vestibular system to induce the sensory-conflicted and challenging tasks. Thus, a total of 6 conditions (2 SOT conditions X 3 VSs: no-VS, unilateral VS, and bilateral VS) were randomly given to these participants. Three approaches can be quantified the balance control: 1) the performance ratio (PR) of center of gravity trajectories (CoG), 2) the sample entropy measure (SampEn) of CoG, and 3) the total traveling distance of CoG. A mixed three-way repeated ANOVA measure was used to determine the interaction among the sex effect, the effect of SOT, and the effect of VS on balance control.

Results: A significant sex effect on balance control was found in the PR of CoG in the anterior-posterior (AP) direction (p = 0.026) and in the SampEn of CoG in both AP and medial-lateral (ML) directions (p = 0.025, p < 0.001, respectively). Also, a significant interaction among the sex effect, the effect of SOT, and the effect of VS on balance control was observed in PR of CoG in the ML direction (p < 0.001), SampEn of CoG in the AP and ML directions (p = 0.002, p < 0.001, respectively), and a traveling distance in AP direction (p = 0.041).

Conclusion: The findings in the present study clearly revealed the necessity to take sex effect into consideration while standing in vestibular-perturbed or/and vestibular demanding tasks. Also, the results in the present study could be a fundamental reference for future sensorimotor training.
Plant growth–promoting rhizobacteria: Peribacillus frigoritolerans 2RO30 and Pseudomonas sivasensis 2RO45 for their effect on canola growth under controlled as well as natural conditions
Authors: Świątczak Joanna , Kalwasińska Agnieszka , Brzezinska Maria Swiontek
Published: January 2024

Even though canola is one of the most important industrial crops worldwide, it has high nutrient requirements and is susceptible to pests and diseases. Therefore, natural methods are sought to support the development of these plants. One of those methods could be a plant growth–promoting rhizobacteria (PGPR) that have a beneficial effect on plant development. The aim of this study was a genomic comparison of two PGPR strains chosen based on their effect on canola growth: Peribacillus frigoritolerans 2RO30, which stimulated canola growth only in sterile conditions, and Pseudomonas sivasensis 2RO45, which promoted canola growth in both sterile and non-sterile conditions. First of all, six bacterial strains: RO33 (Pseudomonas sp.), RO37 (Pseudomonas poae), RO45 (Pseudomonas kairouanensis), 2RO30 (Peribacillus frigoritolerans), 2RO45 (Pseudomonas sivasensis), and 3RO30 (Pseudomonas migulae), demonstrating best PGP traits in vitro, were studied for their stimulating effect on canola growth under sterile conditions. P. frigoritolerans 2RO30 and P. sivasensis 2RO45 showed the best promoting effect, significantly improving chlorophyll content index (CCI) and roots length compared to the non-inoculated control and to other inoculated seedlings. Under non-sterile conditions, only P. sivasensis 2RO45 promoted the canola growth, significantly increasing CCI compared to the untreated control and to other inoculants. Genome comparison revealed that the genome of P. sivasensis 2RO45 was enriched with additional genes responsible for ACC deaminase (acdA), IAA (trpF, trpG), and siderophores production (fbpA, mbtH, and acrB) compared to 2RO30. Moreover, P. sivasensis 2RO45 showed antifungal effect against all the tested phytopathogens and harbored six more biosynthetic gene clusters (BGC), namely, syringomycin, pyoverdin, viscosin, arylpolyene, lankacidin C, and enterobactin, than P. frigoritolerans 2RO30. These BGCs are well known as antifungal agents; therefore, it can be assumed that these BGCs were responsible for the antifungal activity of P. sivasensis 2RO45 against all plant pathogens. This study is the first report describing P. sivasensis 2RO45 as a canola growth promoter, both under controlled and natural conditions, thus suggesting its application in improving canola yield, by improving nutrient availability, enhancing stress tolerance, and reducing environmental impact of farming practices.