bluuebunny/crossref_metadata_2025 huggingface dataset:
Key determinates of job satisfaction for acute care nurse practitioners in Taiwan
Authors: Huang Sheng-Shiung , Chen Cheng-Yuan , Kau Kevin , Tsai Jung-Mei , Tsay Shiow-Luan
Published: January 2023

Background

Taiwan is a super-aged society, and the shortage of hospital doctors; nurse practitioners (NPs) became vital healthcare providers to fulfill the healthcare demands of the population. The purpose of this study was to explore the key determinates of job satisfaction for NPs in acute care practices using significant practice variables, such as empowerment and burnout.

Methods

Participants of this descriptive survey study were recruited from a national sample of NPs with membership in the Taiwan Association of Nurse Practitioners. The data were collected utilizing an online questionnaire based on demographic and practice variables, the Misener Nurse Practitioner Job Satisfaction Scale (MNPJSS), the Condition for Work Effectiveness Questionnaire II (CWEQ II), and the Copenhagen Burnout Inventory (CBI). A total of 1,211 NPs completed the online survey. A multiple regression model with the stepwise selection was used to explore job satisfaction.

Results

The mean overall satisfaction score indicated that the level of satisfaction was between slightly dissatisfied and slightly satisfied. Regression results indicated that formal power, work-related burnout, access to information, and needed resources were critical components of job satisfaction, and accounted for 63% of the variance. Moreover, NPs who were married, had a higher annual salary, worked only during the day shift, and had lower patients-related burnout showed better job satisfaction.

Conclusions

This study provides evidence for healthcare organizations to formulate policies to strengthen NP job satisfaction. Empowerment and burnout are vital factors in NPs’ job satisfaction. Healthcare organizations have an obligation to implement policies to empower NPs in practice and provide interventions to mitigate burnout. Implementing these changes will improve job satisfaction and with it the quality of patient care.
A scoping review on the impact of austerity on healthcare access in the European Union: rethinking austerity for the most vulnerable
Authors: Doetsch Julia Nadine , Schlösser Clara , Barros Henrique , Shaw David , Krafft Thomas , Pilot Eva
Published: January 2023

Background

There is consensus that the 2008 financial and economic crisis and related austerity measures adversely impacted access to healthcare. In light of the growing debt caused by the COVID-19 crisis, it is uncertain whether a period of austerity will return.

Objective

This study aims to provide a structured overview of the impact of austerity policies in the EU-28 zone, applied in response to the Great Recession, on access to health care for the adult population, using the five access dimensions by Levesque et al. (2013).

Methods

This study followed the PRISMA extension for Scoping Reviews guideline. Medline (PubMed) and Web of Science were searched between February 2021 and June 2021. Primary studies in the English language published after the 1st of January 2008 reporting on the possible change in access to the healthcare system for the adult population induced by austerity in an EU28 country were included.

Results

The final search strategy resulted in 525 articles, of which 75 studies were reviewed for full-text analysis, and a total of 21 studies were included. Results revealed that austerity policy has been primarily associated with a reduction in access to healthcare, described through four main categories: i) Increase in rates of reported unmet needs (86%); ii) Affordability (38%); iii) Appropriateness (38%); iv) and Availability and Accommodation (19%). Vulnerable populations were more affected by austerity measures than the general population when specific safeguards were not in place. The main affected adult vulnerable population groups were: patients with chronic diseases, elderly people, (undocumented) migrants, unemployed, economically inactive people and individuals with lower levels of education or socioeconomic status.

Conclusion

Austerity measures have led to a deterioration in access to healthcare in the vast majority of the countries studied in the EU-28 zone. Findings should prompt policymakers to rethink the fiscal agenda across all policies in times of economic crisis and focus on the needs of the most vulnerable populations from the health perspective.
Prognostic significance of pretreatment systemic immune-inflammation index in patients with prostate cancer: a meta-analysis
Authors: Zhang Buwen , Xu Tao
Published: January 2023

Background

The SII (systemic immune-inflammation index) has been extensively reported to have a prognostic value in prostate cancer (PCa), despite the unconformable results. The purpose of this meta-analysis is to quantify the effect of pretreatment SII on survival outcomes in patients with PCa.

Methods

The following databases were searched: Web of Science, Cochrane Library, PubMed, Embase, and China National Knowledge Infrastructure (CNKI). For exploration of the SII’s correlations with the overall survival (OS) and the progression-free survival/biochemical recurrence-free survival (PFS/bRFS) in PCa, the pooled hazard ratios (HRs) were assessed within 95% confidence intervals (CIs).

Results

The present meta-analysis covered 10 studies with 8133 patients. Among the PCa population, a high SII was linked significantly to poor OS (HR = 2.63, 95% CI = 1.87–3.70, p < 0.001), and worse PFS/bRFS (HR = 2.49, 95% CI = 1.30–4.77, p = 0.006). However, a high SII was not linked significantly to T stage (OR = 1.69, 95% CI = 0.86–3.33, p = 0.128), the metastasis to lymph node (OR = 1.69, 95% CI = 0.69–4.16, p = 0.251), age (OR = 1.41, 95% CI = 0.88–2.23, p = 0.150), or the Gleason score (OR = 1.32, 95% CI = 0.88–1.96, p = 0.178).

Conclusions

For the PCa sufferers, the SII might be a promising prognostic biomarker, which is applicable to the high-risk subgroup identification, and provide personalized therapeutic strategies.
14-3-3γ haploinsufficiency leads to altered dopamine pathway and Parkinson’s disease-like motor incoordination in mice
Authors: Cho Eunsil , Park Jinsil , Hwang Eun Mi , Kim Hyung Wook , Park Jae-Yong
Published: January 2023

The 14-3-3 protein family with seven isoforms found in mammals is widely expressed in the brain and plays various roles in cellular processes. Several studies have reported that 14-3-3γ, one of the 14-3-3 protein isoforms, is associated with neurological and psychiatric disorders, but the role of 14-3-3γ in the pathophysiology of brain diseases is unclear. Although studies have been conducted on the relationship between 14-3-3γ protein and Parkinson’s disease (PD), a common neurodegenerative disorder with severe motor symptoms such as bradykinesia and rigidity, a direct connection remains to be elucidated. We recently showed that adult heterozygous 14-3-3γ knockout mice are hyperactive and exhibit anxiety-like behavior. In this study, we further characterized the molecular and behavioral changes in aged 14-3-3γ heterozygous mice to investigate the role of 14-3-3γ in the brain. We observed decreased dopamine levels and altered dopamine metabolism in the brains of these mice, including changes in the phosphorylation of proteins implicated in PD pathology. Furthermore, we confirmed that they displayed PD symptom-like behavioral deficits, such as impaired motor coordination and decreased ability to the nest-building activity. These findings suggest an association between 14-3-3γ dysfunction and PD pathophysiology.
KLF14 regulates the growth of hepatocellular carcinoma cells via its modulation of iron homeostasis through the repression of iron-responsive element-binding protein 2
Authors: Zhou Hui , Chen Junru , Fan Mingjie , Cai Huajian , Dong Yufei , Qiu Yue , Zhuang Qianqian , Lei Zhaoying , Li Mengyao , Ding Xue , Yan Peng , Lin Aifu , Zheng Shusen , Yan Qingfeng
Published: January 2023

Background

Hepatocellular carcinoma (HCC) is a multifactor-driven malignant tumor with rapid progression, which causes the difficulty to substantially improve the prognosis of HCC. Limited understanding of the mechanisms in HCC impedes the development of efficacious therapies. Despite Krüpple-Like factors (KLFs) were reported to be participated in HCC pathogenesis, the function of KLF14 in HCC remains largely unexplored.

Methods

We generated KLF14 overexpressed and silenced liver cancer cells, and nude mouse xenograft models for the in vitro and in vivo study. Luciferase reporter assay, ChIP-qPCR, Co-IP, immunofluorescence were performed for mechanism research. The expression of KLF14 in HCC samples was analyzed by quantitative RT-PCR, Western blotting, and immunohistochemistry (IHC) analysis.

Results

KLF14 was significantly downregulated in human HCC tissues, which was highly correlated with poor prognosis. Inhibition of KLF14 promoted liver cancer cells proliferation and overexpression of KLF14 suppressed cells growth. KLF14 exerts its anti-tumor function by inhibiting Iron-responsive element-binding protein 2 (IRP2), which then causes transferrin receptor-1(TfR1) downregulation and ferritin upregulation on the basis of IRP-IREs system. This then leading to cellular iron deficiency and HCC cells growth suppression in vitro and in vivo. Interestingly, KLF14 suppressed the transcription of IRP2 via recruiting SIRT1 to reduce the histone acetylation of the IRP2 promoter, resulting in iron depletion and cell growth suppression. More important, we found fluphenazine is an activator of KLF14, inhibiting HCC cells growth through inducing iron deficiency.

Conclusion

KLF14 acts as a tumor suppressor which inhibits the proliferation of HCC cells by modulating cellular iron metabolism via the repression of IRP2. We identified Fluphenazine, as an activator of KLF14, could be a potential compound for HCC therapy. Our findings therefore provide an innovative insight into the pathogenesis of HCC and a promising therapeutic target.
The gut microbiota in multiple sclerosis varies with disease activity
Authors: Thirion Florence , Sellebjerg Finn , Fan Yong , Lyu Liwei , Hansen Tue H. , Pons Nicolas , Levenez Florence , Quinquis Benoit , Stankevic Evelina , Søndergaard Helle B. , Dantoft Thomas M. , Poulsen Casper S. , Forslund Sofia K. , Vestergaard Henrik , Hansen Torben , Brix Susanne , Oturai Annette , Sørensen Per Soelberg , Ehrlich Stanislav D. , Pedersen Oluf
Published: January 2023

Background

Multiple sclerosis is a chronic immune-mediated disease of the brain and spinal cord resulting in physical and cognitive impairment in young adults. It is hypothesized that a disrupted bacterial and viral gut microbiota is a part of the pathogenesis mediating disease impact through an altered gut microbiota-brain axis. The aim of this study is to explore the characteristics of gut microbiota in multiple sclerosis and to associate it with disease variables, as the etiology of the disease remains only partially known.

Methods

Here, in a case-control setting involving 148 Danish cases with multiple sclerosis and 148 matched healthy control subjects, we performed shotgun sequencing of fecal microbial DNA and associated bacterial and viral microbiota findings with plasma cytokines, blood cell gene expression profiles, and disease activity.

Results

We found 61 bacterial species that were differentially abundant when comparing all multiple sclerosis cases with healthy controls, among which 31 species were enriched in cases. A cluster of inflammation markers composed of blood leukocytes, CRP, and blood cell gene expression of IL17A and IL6 was positively associated with a cluster of multiple sclerosis-related species. Bacterial species that were more abundant in cases with disease-active treatment-naïve multiple sclerosis were positively linked to a group of plasma cytokines including IL-22, IL-17A, IFN-β, IL-33, and TNF-α. The bacterial species richness of treatment-naïve multiple sclerosis cases was associated with number of relapses over a follow-up period of 2 years. However, in non-disease-active cases, we identified two bacterial species, Faecalibacterium prausnitzii and Gordonibacter urolithinfaciens, whose absolute abundance was enriched. These bacteria are known to produce anti-inflammatory metabolites including butyrate and urolithin. In addition, cases with multiple sclerosis had a higher viral species diversity and a higher abundance of Caudovirales bacteriophages.

Conclusions

Considerable aberrations are present in the gut microbiota of patients with multiple sclerosis that are directly associated with blood biomarkers of inflammation, and in treatment-naïve cases bacterial richness is positively associated with disease activity. Yet, the finding of two symbiotic bacterial species in non-disease-active cases that produce favorable immune-modulating compounds provides a rationale for testing these bacteria as adjunct therapeutics in future clinical trials.
Glucose metabolism tests and recurrent pregnancy loss: evidence from a systematic review and meta-analysis
Authors: Hantoushzadeh Sedigheh , Kohandel Gargari Omid , Shafiee Arman , Seighali Niloofar , Ghaemi Marjan
Published: January 2023

Objective

To synthesize the published citations to determine the association between glucose metabolism tests and recurrent pregnancy loss (RPL).

Method

The electronic databases including PubMed, Scopus and Web of Science were searched for the original articles that evaluated the correlation between glucose metabolism tests including fasting blood glucose (FBG), fasting insulin (FI), homeostatic model assessment for insulin resistance (HOMA-IR), the rate of individuals with HOMA-IR  > 4.5, insulin resistance, fasting glucose/fasting insulin (FG/FI) and FG/FI  > 4.5.and recurrent pregnancy loss with a combination of proper keywords.

Results

The database search led to finding 390 articles. Detailed screening of titles and abstracts for potential eligibility was performed, and after excluding the duplicated and irrelevant citations, finally, 8 studies were selected to be included in this study, 7 observational studies and one controlled clinical trial. A significant difference in the amount of FI, HOMA-IR, the rate of HOMA-IR  > 4.5, the rate of individuals with insulin resistance, fasting glucose/fasting insulin (FG/FI), and the rate of FG/FI  > 4.5 were found among RPL patients compared to controls. There was no difference when comparing FBG between the groups.

Conclusion

This study indicates an important link between abnormal glucose metabolism tests and a history of recurrent pregnancy loss. These data may encourage clinicians to request glucose metabolism tests other than FBG in women with recurrent pregnancy loss.
East African cichlid fishes
Authors: Santos M. Emília , Lopes João F. , Kratochwil Claudius F.
Published: January 2023

Cichlid fishes are a very diverse and species-rich family of teleost fishes that inhabit lakes and rivers of India, Africa, and South and Central America. Research has largely focused on East African cichlids of the Rift Lakes Tanganyika, Malawi, and Victoria that constitute the biodiversity hotspots of cichlid fishes. Here, we give an overview of the study system, research questions, and methodologies. Research on cichlid fishes spans many disciplines including ecology, evolution, physiology, genetics, development, and behavioral biology. In this review, we focus on a range of organismal traits, including coloration phenotypes, trophic adaptations, appendages like fins and scales, sensory systems, sex, brains, and behaviors. Moreover, we discuss studies on cichlid phylogenies, plasticity, and general evolutionary patterns, ranging from convergence to speciation rates and the proximate and ultimate mechanisms underlying these processes. From a methodological viewpoint, the last decade has brought great advances in cichlid fish research, particularly through the advent of affordable deep sequencing and advances in genetic manipulations. The ability to integrate across traits and research disciplines, ranging from developmental biology to ecology and evolution, makes cichlid fishes a fascinating research system.
Immune activation during pregnancy exacerbates ASD-related alterations in Shank3-deficient mice
Authors: Atanasova Ekaterina , Arévalo Andrea Pérez , Graf Ines , Zhang Rong , Bockmann Juergen , Lutz Anne-Kathrin , Boeckers Tobias M.
Published: January 2023

Background

Autism spectrum disorder (ASD) is mainly characterized by deficits in social interaction and communication and repetitive behaviors. Known causes of ASD are mutations of certain risk genes like the postsynaptic protein SHANK3 and environmental factors including prenatal infections.

Methods

To analyze the gene-environment interplay in ASD, we combined the Shank3Δ11−/− ASD mouse model with maternal immune activation (MIA) via an intraperitoneal injection of polyinosinic/polycytidylic acid (Poly I:C) on gestational day 12.5. The offspring of the injected dams was further analyzed for autistic-like behaviors and comorbidities followed by biochemical experiments with a focus on synaptic analysis.

Results

We show that the two-hit mice exhibit excessive grooming and deficits in social behavior more prominently than the Shank3Δ11−/− mice. Interestingly, these behavioral changes were accompanied by an unexpected upregulation of postsynaptic density (PSD) proteins at excitatory synapses in striatum, hippocampus and prefrontal cortex.

Limitations

We found several PSD proteins to be increased in the two-hit mice; however, we can only speculate about possible pathways behind the worsening of the autistic phenotype in those mice.

Conclusions

With this study, we demonstrate that there is an interplay between genetic susceptibility and environmental factors defining the severity of ASD symptoms. Moreover, we show that a general misbalance of PSD proteins at excitatory synapses is linked to ASD symptoms, making this two-hit model a promising tool for the investigation of the complex pathophysiology of neurodevelopmental disorders.
CDK8/19 inhibition plays an important role in pancreatic β-cell induction from human iPSCs
Authors: Sakuma Kensuke , Tsubooka-Yamazoe Noriko , Hashimoto Kiyohiro , Sakai Nozomu , Asano Shinya , Watanabe-Matsumoto Saori , Watanabe Takeshi , Saito Bunnai , Matsumoto Hirokazu , Ueno Hikaru , Ito Ryo , Toyoda Taro
Published: January 2023

Background

Transplantation of differentiated cells from human-induced pluripotent stem cells (hiPSCs) holds great promise for clinical treatments. Eliminating the risk factor of malignant cell transformation is essential for ensuring the safety of such cells. This study was aimed at assessing and mitigating mutagenicity that may arise during the cell culture process in the protocol of pancreatic islet cell (iPIC) differentiation from hiPSCs.

Methods

We evaluated the mutagenicity of differentiation factors used for hiPSC-derived pancreatic islet-like cells (iPICs). We employed Ames mutagenicity assay, flow cytometry analysis, immunostaining, time-resolved fluorescence resonance energy transfer-based (TR-FRET) cell-free dose–response assays, single-cell RNA-sequencing and in vivo efficacy study.

Results

We observed a mutagenic effect of activin receptor-like kinase 5 inhibitor II (ALK5iII). ALK5iII is a widely used β-cell inducer but no other tested ALK5 inhibitors induced β-cells. We obtained kinase inhibition profiles and found that only ALK5iII inhibited cyclin-dependent kinases 8 and 19 (CDK8/19) among all ALK5 inhibitors tested. Consistently, CDK8/19 inhibitors efficiently induced β-cells in the absence of ALK5iII. A combination treatment with non-mutagenic ALK5 inhibitor SB431542 and CDK8/19 inhibitor senexin B afforded generation of iPICs with in vitro cellular composition and in vivo efficacy comparable to those observed with ALK5iII.

Conclusion

Our findings suggest a new risk mitigation approach for cell therapy and advance our understanding of the β-cell differentiation mechanism.
Neuroblasts migration under control of reactive astrocyte-derived BDNF: a promising therapy in late neurogenesis after traumatic brain injury
Authors: Wu Na , Sun Xiaochuan , Zhou Chao , Yan Jin , Cheng Chongjie
Published: January 2023

Background

Traumatic brain injury (TBI) is a disease with high mortality and morbidity, which leads to severe neurological dysfunction. Neurogenesis has provided therapeutic options for treating TBI. Brain derived neurotrophic factor (BDNF) plays a key role in neuroblasts migration. We aimed to investigate to the key regulating principle of BDNF in endogenous neuroblasts migration in a mouse TBI model.

Methods

In this study, controlled cortical impact (CCI) mice (C57BL/6J) model was established to mimic TBI. The sham mice served as control. Immunofluorescence staining and enzyme-linked immunosorbent assay were performed on the CCI groups (day 1, 3, 7, 14 and 21 after CCI) and the sham group. All the data were analyzed with Student’s t-test or one-way or two-way analysis of variance followed by Tukey’s post hoc test.

Results

Our results revealed that neuroblasts migration initiated as early as day 1, peaking at day 7, and persisted till day 21. The spatiotemporal profile of BDNF expression was similar to that of neuroblasts migration, and BDNF level following CCI was consistently higher in injured cortex than in subventricular zone (SVZ). Reactive astrocytes account for the major resource of BDNF along the migrating path, localized with neuroblasts in proximity. Moreover, injection of exogenous CC chemokine ligand 2 (CCL2), also known as monocyte chemoattractant protein-1, at random sites promoted neuroblasts migration and astrocytic BDNF expression in both normal and CCI mice (day 28). These provoked neuroblasts can also differentiate into mature neurons. CC chemokine ligand receptor 2 antagonist can restrain the neuroblasts migration after TBI.

Conclusions

Neuroblasts migrated along the activated astrocytic tunnel, directed by BDNF gradient between SVZ and injured cortex after TBI. CCL2 might be a key regulator in the above endogenous neuroblasts migration. Moreover, delayed CCL2 administration may provide a promising therapeutic strategy for late neurogenesis post-trauma.
Analysis of financial development and open innovation oriented fintech potential for emerging economies using an integrated decision-making approach of MF-X-DMA and golden cut bipolar q-ROFSs
Authors: Mikhaylov Alexey , Dinçer Hasan , Yüksel Serhat
Published: January 2023

The purpose of the paper is to identify the factors of financial development that have the greatest impact on open innovation in 7 emerging countries. The analysis was performed featuring the MF-X-DMA method, as well as its further verification for autocorrelation and heteroscedasticity. The time period covers years from 2002 to 2020. The article states that the main indicators to improve financial development should enhance the process of bank lending and equity market development. An important area is the development of competition by providing equal access to information to all market participants in a continuously refining technical infrastructure. Regression analysis with the MF-X-DMA method confirms the statistical significance of this influence. The article fills the knowledge gap into the link between open innovations and the relatively low capitalization of the modern emerging countries’ financial market, low liquidity in small cap stocks at the financial market and concentration of the banking sector, as well as risks arising in the process of globalization. Another analysis has also been conducted by generating a novel fuzzy decision-making model. In the first stage, the determinants of open innovation-based fintech potential are weighted for the emerging economies. For this purpose, M-SWARA methodology is taken into consideration based on bipolar q-ROFSs and golden cut. The second stage of the analysis includes evaluating the emerging economies with the determinants of open innovation-based fintech potential. In this context, emerging seven countries are examined with ELECTRE methodology. It found the most significant factor is the open innovation-based fintech potential.
Asymmetric relationship between global and national factors and domestic food prices: evidence from Turkey with novel nonlinear approaches
Authors: Kartal Mustafa Tevfik , Depren Özer
Published: January 2023

This study investigates the asymmetric relationship between global and national factors and domestic food prices in Turkey, considering the recent rapid and continuous increase in domestic food prices. In this context, six global and three national explanatory variables were included, and monthly data for the period from January 2004 to June 2021 were used. In addition, novel nonlinear time-series econometric approaches, such as wavelet coherence, Granger causality in quantiles, and quantile-on-quantile regression, were applied for examination at different times, frequencies, and quantiles. Moreover, the Toda-Yamamoto (TY) causality test and quantile regression (QR) approach were used for robustness checks. The empirical results revealed that (i) there is a significant relationship between domestic food prices and explanatory variables at different times and frequencies; (ii) a causal relationship exists in most quantiles, excluding the lowest quantile, some middle quantiles, and the highest quantile for some variables; (iii) the power of the effect of the explanatory variables on domestic food prices varies according to the quantiles; and (iv) the results were validated by the TY causality test and QR, which show that the results were robust. Overall, the empirical results reveal that global and national factors have an asymmetric relationship with domestic food prices, highlighting the effects of fluctuations in global and national variables on domestic food prices. Thus, the results imply that Turkish policymakers should consider the asymmetric effects of global and national factors on domestic food prices at different times, frequencies, and quantiles.
Mixed reality for extraction of maxillary mesiodens
Authors: Koyama Yu , Sugahara Keisuke , Koyachi Masahide , Tachizawa Kotaro , Iwasaki Akira , Wakita Ichiro , Nishiyama Akihiro , Matsunaga Satoru , Katakura Akira
Published: January 2023

Background

Mesiodentes are the most common supernumerary teeth. The cause is not fully understood, although proliferations of genetic factors and the dental lamina have been implicated. Mesiodentes can cause delayed or ectopic eruption of permanent incisors, which can further alter occlusion and appearance. Careful attention should be paid to the position and direction of the mesiodentes because of possible damage to adjacent roots in the permanent dentition period, errant extraction in the deciduous and mixed dentition periods, and damage to the permanent tooth embryo. To avoid these complications, we applied mixed reality (MR) technology using the HoloLens® (Microsoft, California). In this study, we report on three cases of mesiodentes extraction under general anesthesia using MR technology.

Results

The patients ranged in age from 6 to 11 years, all three were boys, and the direction of eruption was inverted in all cases. The extraction approach was palatal in two cases and labial in one case. The average operative time was 32 min, and bleeding was minimal in all cases. No intraoperative or postoperative complications occurred. An image was shared preoperatively with all the surgeons using an actual situation model. Three surgeons used Microsoft HoloLens® during surgery, shared MR, and operated while superimposing the application image in the surgical field.

Conclusions

The procedure was performed safely; further development of MR surgery support systems in the future is suggested.
Hip fracture or not? The reversed prevalence effect among non-experts’ diagnosis
Authors: Zhang Hanshu , Hung Shen-Wu , Chen Yu-Pin , Ku Jan-Wen , Tseng Philip , Lu Yueh-Hsun , Yang Cheng-Ta
Published: January 2023

Despite numerous investigations of the prevalence effect on medical image perception, little research has been done to examine the effect of expertise, and its possible interaction with prevalence. In this study, medical practitioners were instructed to detect the presence of hip fracture in 50 X-ray images with either high prevalence (Nsignal = 40) or low prevalence (Nsignal = 10). Results showed that compared to novices (e.g., pediatricians, dentists, neurologists), the manipulation of prevalence shifted participant’s criteria in a different direction for experts who perform hip fracture diagnosis on a daily basis. That is, when prevalence rate is low (pfracture-present = 0.2), experts held more conservative criteria in answering “fracture-present,” whereas novices were more likely to believe there was fracture. Importantly, participants’ detection discriminability did not vary by the prevalence condition. In addition, all participants were more conservative with “fracture-present” responses when task difficulty increased. We suspect the apparent opposite criteria shift between experts and novices may have come from medical training that made novices to believe that a miss would result in larger cost compared to false positive, or because they failed to update their prior belief about the signal prevalence in the task, both would suggest that novices and experts may have different beliefs in placing the optimal strategy in the hip fracture diagnosis. Our work can contribute to medical education training as well as other applied clinical diagnosis that aims to mitigate the prevalence effect.
COVID-19: introduction of a new lifestyle and diet among the Malaysians
Authors: Pitol Md. Najmus Sayadat , Sapir Ana Shakirah Md.
Published: January 2023

Background

The stay-at-home conditions due to the COVID-19 pandemic significantly alter the Malaysian lifestyle, and all Malaysians faced difficulties adopting the new lifestyle. A hypothetico-deductive technique has been conducted in this study, to find out what kind of changes the COVID-19 has brought about in the behavior of Malaysians and how they are coping with the changing lifestyles. According to G* Power 3.1 sample size determination in Malaysia, the entire sample of 112 was sufficient to provide the value for the medium effect size for the computation of the F-tests and the findings were reliable (The Cronbach's alpha values were all above 0.70.). To calculate the mean of the lifestyle during COVID-19, the mean scores range between 1.00 and 5.00 marks indicating much reduced to much increased.

Results

It seemed that the jobs traveling (mean 1.80) and outdoor sports time (mean = 1.94) were somewhat reduced. In contrast, indoor sports activities (mean = 3.01), online games (mean = 2.76), physical exercises (mean = 2.63), and the number of staycations (mean = 2.46) during the pandemic stayed the same. However, religious activities (mean = 3.73), body mass index (mean = 3.54), online shopping (mean = 3.90), sleeping time (mean = 3.43), amount of anxiety (mean = 3.38), amount of caffeine (mean = 3.15), medical consumption (mean = 3.10), watching movies (mean = 3.26), and watching drama series (mean = 3.37) during COVID-19 were somewhat increased. In addition, respondents' time spent on social media (mean = 4.27) and online meetings (mean = 4.37) during COVID-19 were much increased. We found no significant differences in the means of the dependent variables (lifestyle of COVID-19) among all demographic characteristics except age and employment status.

Conclusions

New behavioral changes bring new challenges. Malaysians should need to adopt some precautions to minimize the negative effect of new behavioral changes in post-COVID-19 life. The results will help policymakers to make the right decisions about improving the quality of life after COVID-19.
A low dislocation rate after revision total hip arthroplasty performed through the anterior approach
Authors: Kahhaleh Edward , Charles Tatiana , Collard Xavier , Jayankura Marc
Published: January 2023

Background

Dislocation is a major complication in revision total hip arthroplasties. This study aimed to evaluate the dislocation rate, complications, and functional scores of revision total hip arthroplasty performed through the direct anterior approach.

Methods

Between January 2014 and March 2020, 84 patients undergoing revision total hip arthroplasty were retrospectively reviewed. All operations were performed through the direct anterior approach. At the final follow-up, incidences of dislocation, reoperation, acute deep infections, periprosthetic fractures and psoas impingement were assessed. The median postoperative Oxford Hip Score was also calculated.

Results

At revision surgery, the mean age was 66 ± 12 years (range, 28–91). During an average follow-up of 4.2 ± 1.2 years, reoperation rate for major complications in the non-infected revisions was 15% (n = 11), including five acute deep infections (7%), four periprosthetic fractures (5%), one dislocation and one psoas impingement (1%). The median postoperative Oxford Hip Score was 39 (interquartile range = 14).

Conclusion

In our series, revision total hip arthroplasty through direct anterior approach was associated with a very low dislocation rate, acceptable complication rates and good functional results. Our results suggest that this procedure is safe and reliable.

Trial registration

Ethical approval for this study was obtained, before enrollment of the first participant, by CUB Erasme's research ethics committee (P2020/323) and C.H.U Ambroise Paré's research ethics committee.
The value of PRECISE-DAPT score and lesion complexity for predicting all-cause mortality in patients with NSTEMI
Authors: Alıcı Gökhan , Genç Ömer , Urgun Örsan Deniz , Erdoğdu Tayfur , Yıldırım Abdullah , Quisi Alaa , Kurt İbrahim Halil
Published: January 2023

Background

We aimed to evaluate the prognostic effects of stroke risk scores (SRS), SYNTAX score (SX score), and PRECISE-DAPT score on mortality in patients with non-ST-segment elevation myocardial infarction (NSTEMI). Three hundred forty-three patients hospitalized with a diagnosis of NSTEMI and underwent coronary angiography (CAG) between January 1, 2022, and June 1, 2022, were included retrospectively in this single-center study. Patients' demographic, clinical and routine biochemical parameters were recorded. The scores (CHADS2, CHA2DS2-VASc, R2CHA2DS2-VASc, ATRIA, SX score, PRECISE-DAPT) of each patient were calculated. Participants were then divided into two groups by in-hospital status; all-cause mortality (+) and all-cause mortality (−).

Results

Overall, the mean age was 63.5 ± 11.8 years, of whom 63.3% (n = 217) were male. In-hospital mortality occurred in 31 (9.3%) patients. In the study population, those who died had significantly higher SX (p < 0.001), PRECISE-DAPT (p < 0.001), and ATRIA (p = 0.002) scores than those who survived. In logistic regression analysis, PRECISE-DAPT score [Odds ratio (OR) = 1.063, 95% CI 1.014–1.115; p = 0.012] and SX score [OR: 1.061, 95% CI 1.015–1.109, p = 0.009] were found to be independent predictors of in-hospital all-cause mortality among NSTEMI patients. In ROC analysis, the PRECISE-DAPT score performed better discriminative ability than the SX score in determining in-hospital mortality [Area under the curve = 0.706, 95% CI 0.597–0.814; p < 0.001].

Conclusions

During the hospital stay, both PRECISE-DAPT and SX scores showed better performance than SRS in predicting all-cause mortality among NSTEMI patients undergoing CAG. Aside from their primary purpose, both scores might be useful in determining risk stratification for such patient populations.
Factors influencing suicidal ideation and self-harm among undergraduate students in a Nigerian private university
Authors: Kukoyi Olasumbo , Orok Edidiong , Oluwafemi Funmilayo , Oni Olawale , Oluwadare Tunrayo , Ojo Tolulope , Bamitale Toba , Jaiyesimi Boluwaji , Iyamu Debbie
Published: January 2023

Background

Suicide and self-harm have been documented as the main cause of death among young adults. Nigeria as well as other low-income countries is reported to have a higher prevalence rate of suicidal ideation and self-harm as compared to high-income countries. The aim of this study was to evaluate the factors that influence self-harm and suicidal ideation among university undergraduates.

Results

Four hundred fifty students consented to participate in this study where 61.3% were female with mean age of 20.02 + 1.88 years. More than 46% (208) had moderate social support while 80.4% had a high self-esteem and 72.7% low environmental factor scores. There was an association between self-esteem (p=0.001), social support (p<0.001), and self-harm but no association between social support and suicide ideation (p=0.199) as well as between gender and self-harm (p=0.118).

Conclusions

There was some form of influence from self-esteem, social support, and environmental factors on self-harm and suicidal ideation. Interventions tailored towards these factors in order to improve mental health outcomes among undergraduates are needed.
The relation between SNPs in the NME1 gene and response to sofosbuvir in Egyptian patients with chronic HCV
Authors: AbdElrahman Mohamed , Ibrahim Marwa K. , Tawfik Salwa , Omran Dalia , Bendary Mahmoud M. , Hassanin Soha Osama , Elbatae Hassan
Published: January 2023

Background

Hepatitis C virus (HCV) infection is considered one of the most urgent health problems in the world, with an incidence of approximately 71 million patients and 399,000 deaths per year from related liver diseases. In this study, we examined the association between 2 single nucleotide polymorphisms (SNPs) in the nucleoside diphosphate kinase 1 (NME1) gene (encoding one of the sofosbuvir metabolizing enzymes) and the response to the sofosbuvir plus daclatasvir regimen in Egyptian HCV-infected patients.

Results

Our data showed a similarity in the distribution of the CC, CT, and TT genotypes of NME1 rs2302254 C/T (p  =  0.847) and the CC, TC, and TT genotypes of NME1 rs16949649 T/C (p  =  0.937) among patients who were either treatment responders or relapsers. Based on the univariate and multivariate logistic regression analyses of the significant predictors for sustained virological response (SVR), five factors showed a robust predictive potency for the treatment outcome: age, fasting blood glucose level, platelets, albumin, and alpha-fetoprotein. Strikingly, there was a significant correlation between the rs16949649T/C polymorphism and serum creatinine (p  =  0.023). Higher creatinine levels were observed among the CC carriers than the TC or TT carriers.

Conclusions

The 2 studied SNPs of NME1 had no significant association with SVR in Egyptian HCV-infected patients; however, the noticeable relation between rs16949649T/C and creatinine level might represent a foundation for future studies on the renal extra-hepatic manifestation of HCV and SNPs of NME1 gene.
Disability prevalence: comparing four types of disability measures in the community
Authors: Ganesh G. Shankar , Gedamkar Garima , Rami Meet Alpeshkumar , Patel Milan Dipakkumar , Patel Deep Pankajbhai
Published: January 2023

Background

There is no general consensus on how to measure disability and disability prevalence rates. The results of previous estimates could not be compared due to the varied nature of the methodologies used and the lack of standardization in the measurement of disability. The primary objective of the study was to estimate the prevalence of disability using a population-based disability survey and questions selected by the National Center for Promotion of Employment for Disabled People (NCPEDP). The secondary objective is to determine whether there was any relationship between the severity of disability and essential sociodemographic factors.

The survey was carried out in the Indian state of Gujarat’s Piplag village. Eight final-year physiotherapy students gathered sociodemographic data and answers to the four disability-related questions—disability question asked in India census 2011, Washington Group (WG)-suggested question, United Nations Convention on the Rights of Persons with Disabilities (UNCRPD)-based question, and National Sample Survey Organization (NSSO)-based question.

Results

A greater percentage of the population was classified as having a functional limitation in the questions based on the UNCRPD (28.29%) (95% CI 25.1–31.3%) and the WG (29.69%) (95% CI 26.0–34.4%). Our findings demonstrated that there were significant relationships between the questions in different questionnaires (p < 0.01). Female gender strongly influences how people self-identify as having a disability (by 5.7 to 12.07 times), and the predictor variables based on the Indian census 2011 questions explained 61.7% of the variation in prevalence of disability.

Conclusions

The prevalence statistics may vary based on the questions used to gather information about disabilities. As gender and socioeconomic status can impact the prevalence of disabilities, it is important to focus on ways to improve economic growth, especially for women.
Platelet lymphocyte ratio, lymphocyte monocyte ratio, mean platelet volume, and neutrophil lymphocyte ratio in Behcet’s disease and their relation to disease activity
Authors: Selim Zahraa I. , Mostafa Naima M. , Ismael Esraa O. , Kamal Doaa
Published: January 2023

Background

Behcet’s disease (BD) does not have specific laboratory finding or pathological physical examination sign, and only few studies have investigated Neutrophil to lymphocyte ratio (NLR), platelets to lymphocytes ratio (PLR), lymphocytes to monocytes ratio (LMR), or mean platelet volume (MPV) values in patients with BD. We conducted this study to investigate the relationship between these indices and Behcet’s disease (BD) and to determine their relation to BD disease activity.

Results

This study is a case-control study that included 36 Behcet’s disease patients and 36 healthy controls. BD patients showed significant increase in the mean of NLR and PLR in comparison to control (P = 0.008 and 0.011) respectively, and highly significant decrease in LMR and MPV levels in BD patients in comparison to control (P < 0.001 and < 0.001) respectively. Also, we found that NLR, PLR, and LMR were significantly related to BD activity, and there were significant associations between the studied hematological parameters with some of muco-cutaneous, articular, gastrointestinal, eye, and nervous system manifestations in BD patients.

Conclusion

The blood indices NLR, PLR, LMR, and MPV are potential inflammatory markers that can be used to evaluate inflammatory status and disease activity in patients with BD. NLR and PLR showed positive relation being higher in active disease and also higher in highly active disease than in low disease activity. Also, LMR was significantly decreased in Behcet’s disease patients in relation to disease activity. Furthermore, NLR and PLR levels were significantly more associated with muco-cutaneous and nervous system involvement while, LMR levels were significantly associated with muco-cutaneous, articular, gastrointestinal and eye manifestations and MPV levels were associated with articular manifestations being significantly related to disease activity. These easily evaluated markers could help in the management of this disease with multisystem affection that are sometimes serious and potentially life threatening.
Improved Cancer-Specific Risk Stratification by the Lymph Node Ratio-Based Nomogram: A Potential Role in Guiding Postoperative Management Decisions for Oral Cavity Carcinoma
Authors: Liu Yang , Ma Yuchao , Shayan Gulidanna , Sun Shiran , Huang Xiaodong , Wang Kai , Qu Yuan , Chen Xuesong , Wu Runye , Zhang Ye , Liu Qingfeng , Zhang Jianghu , Luo Jingwei , Xiao Jianping , Li Yexiong , Yi Junlin , Wang Jingbo
Published: January 2023

PURPOSE

To develop and validate a nomogram integrating lymph node ratio (LNR) to predict cancer-specific survival (CSS) and assist decision making for postoperative management in nonmetastatic oral cavity squamous cell carcinoma (OCSCC).

MATERIALS AND METHODS

We retrospectively retrieved 6,760 patients with OCSCC primarily treated with surgery from surveillance, epidemiology, and end results database between 2010 and 2015. They were randomly divided into training and validation cohorts. Performance of the nomogram was evaluated by calibration curve, consistency index, area under the curve, and decision curve analysis and was compared with that of the LNR, positive lymph nodes (PLN) and tumor node metastasis (TNM) staging. According to the individualized nomogram score, patients were classified into three risk cohorts. The therapeutic efficacy of postoperative radiotherapy and chemotherapy was evaluated in each cohort.

RESULTS

The nomogram incorporated six independent variables, including race, tumor site, grade, T stage, PLN, and LNR. Calibration plots demonstrated a good match between the predicted and observed CSS. C-indices for training and validation cohorts were 0.746 (95% CI, 0.740 to 0.752) and 0.726 (95% CI, 0.713 to 0.739), compared with 0.687, 0.695, and 0.669 for LNR, PLN, and TNM staging, respectively ( P < .001). Decision curve analyses confirmed that nomogram showed the best performance in clinical utility. Postoperative radiotherapy presented survival benefit in medium-and high-risk groups but showed a negative effect in the low-risk group. Chemotherapy was only beneficial in the high-risk group.

CONCLUSION

The LN status-incorporated nomogram demonstrated good discrimination and predictive accuracy of CSS for patients with OCSCC and could identify those most likely to benefit from adjuvant therapy.
Who Owns the Hebrew Doctors? Oriental Scholarship, Historical Proportionality, and the Puritan “Invention” of Avant-Garde Conformity
Authors: Ha Polly
Published: January 2023

Puritan and conformist divines both sought to “own the Hebrew doctors” just as they had appealed to patristic sources in the late sixteenth and early seventeenth centuries. The puritan Walter Travers drew upon the rabbinic commentary of Abraham Ibn Ezra to argue for the refashioning of the church in the 1570s. Elizabethan ecclesiastical controversy in turn helped “invent” central features of avant-garde conformity by prompting Richard Hooker's use of Jewish precedent to stabilize the church from the 1580s onward. Mutual claims to the Hebrew doctors exposed disagreement over how to proportion the New Testament church in relation to layered Jewish tradition. Yet, by the early seventeenth century, the separatist Henry Ainsworth began to make more extensive, even promiscuous, use of Maimonides. This signaled movement away from simply attempting to “own the Hebrew doctors” to conscripting Jewish authorities as more active, and less mediated, participants in early modern debate.
John Lightfoot (1602–1675), the Westminster Assembly, and the Horae Hebraicae et Talmudicae
Authors: Macfarlane Kirsten
Published: January 2023

The English Hebraist John Lightfoot has a Janus-faced legacy. On the one hand, he is known among historians of the British Reformation for his participation in the Westminster Assembly (1643 – 52), for which his journal remains a crucial source of evidence. On the other hand, among historians of scholarship, he is famous primarily for his Horae Hebraicae et Talmudicae (1658 – 78), an unprecedentedly thorough application of Hebrew scholarship to New Testament exegesis, now recognized as a milestone of biblical criticism. This article brings these facets of Lightfoot's legacy together by arguing that there are extensive connections between Lightfoot's contributions in the Westminster Assembly and his conclusions in the Horae. In doing so, it argues not only for the vitality and centrality of Jewish texts and learning to the history of the long Reformation, but also for the importance of theology and controversy to the history of scholarship.