bluuebunny/crossref_metadata_2025 huggingface dataset:
Job stress, a source of hypertension among workers in Sub-Saharan Africa: a scoping review
Authors: Khonde Kumbu Rodrigue , Matondo Hervé , Labat Aline , Kianu Bernard , Godin Isabelle , Kiyombo Guillaume , Coppieters Yves
Published: November 2023

Background

Hypertension remains one of the leading risk factors for cardiovascular disease. Contrasting with the high-income countries where the rates of hypertension decline, it increases in Sub-Saharan African countries. The age group most affected by hypertension is the working population. Several studies carried out in Europe, North America, and Asia, underline the influence of job stress on the occurrence of hypertension. The objective of this review was to explore current knowledge about hypertension and job stress in Sub-Saharan Africa.

Methods

We conducted a scoping review using Arksey and O’Malley’s framework to synthesize findings. We searched in PubMed, Scopus, and ProQuest databases. The inclusion criteria were peer-reviewed manuscripts published on March 1, 2023, conducted among workers in Sub-Saharan Africa, reported hypertension and job stress, and using quantitative methodologies. Data were assessed independently by two researchers.

Results

In total, 295 articles were identified from databases. Of these, only 12 articles met the inclusion criteria and were included in the review (9 cross-sectional studies and 3 case–control studies). These studies focused on sectors reported as stressful (health, banking, education, and industries). The prevalence of hypertension varied from 14.3% to 45.9%, with a high proportion of hypertensive participants (35.4%-70.6%) who were unaware that they had hypertension. Job stress was significantly associated with hypertension (OR = 2.4 [1.5–4.4]) and stress management was inversely associated with hypertension (r = -0.14, p < 0.05). However, no study reported an existing workplace health promotion program implemented, especially regarding cardiovascular disease risk factors.

Conclusion

Data available in the literature show that stressful working conditions may be associated with hypertension. We are faced with an increasing prevalence of hypertension among workers in Sub-Saharan Africa, where a large proportion of them are unaware that they have hypertension. Thus, there is a need to implement workplace prevention and health promotion strategies in Sub-Saharan Africa.
Prevalence and associated factors of insomnia symptoms among pregnant women in the third trimester in a moderately developing region of China
Authors: Chen Xu , Liu Yuan , Liu Meilin , Min Fanli , Tong Jiao , Wei Wei , Sun Lizhou , Zhang Teng , Meng Qian
Published: November 2023

Background

Insomnia is the most common sleep disorder in the general population, especially among pregnant women, and it is considered a major public health issue. Not only can it cause mental and physical problems in pregnant women, but it may also affect the growth of the fetus. However, there are few reports on the prevalence and influencing factors of insomnia symptoms in third-trimester women in China. The objective of this study was to assess the prevalence of insomnia symptoms among pregnant women in the third trimester in a moderately developing region of China and to further explore the associated factors of insomnia symptoms from various aspects.

Methods

A cross-sectional survey was conducted among eligible pregnant women in the third trimester from December 2022 to February 2023. Data on socio-demographic characteristics, clinical characteristics, and behavioral and psychological characteristics of pregnant women were collected through a structured questionnaire. The Chi-square test and multivariate logistics regression were applied to explore the associated factors of insomnia symptoms.

Results

A total of 535 pregnant women in the third trimester were included in this study, and the prevalence of insomnia symptoms was 59.8%. Multivariate logistic regression analysis revealed that pregnant women who lived together with elders (OR: 0.58, 95%CI: 0.40–0.86), had low perceived stress (OR: 0.58, 95%CI: 0.35–0.97), had no threatened abortion (OR: 0.55, 95%CI: 0.32–0.93) and had good doctor-patient communication (OR: 0.66, 95%CI: 0.45–0.98) were more likely to stay away from insomnia symptoms. However, pregnant women with anxiety symptoms (OR: 2.27, 95%CI: 1.28–4.03), fear of childbirth (OR: 1.63, 95%CI: 1.11–2.40) and a high experience of COVID-19 fear (OR: 1.61, 95%CI: 1.03–2.54) tended to have insomnia symptoms.

Conclusions

The prevalence of insomnia symptoms in pregnant women is high in Lianyungang city in eastern China in the third trimester. Insomnia symptoms is influenced by multiple factors. There is an urgent need to develop interventions to reduce the prevalence of insomnia symptoms in the third trimester and to focus on pregnant women with risk factors for insomnia symptoms.
Tomographic analysis of relationship of mandibular morphology and third molars eruption
Authors: Segantin Jéssica de Fátima , Bisson Gabriela Barbosa , Chihara Letícia Liana , Ferreira Júnior Osny
Published: November 2023

Background

Lower third molars (L3M) are the last teeth to erupt in the oral cavity. Uneruption of these teeth still raises questions about its causes, in the literature (1) genetic factors, (2) dental lamina activity and, mainly, (3) insufficient growth and development of the bone bases are included. While the lack of space theory influenced by mandibular morphology and size of L3M was argued to be the main reason for L3M impaction, there is a limitation in the literature in examining such association using more accurate tomographic analysis obtained from CBCT. This work aimed to evaluate the relationship between mandibular morphology and the eruption of L3M.

Methods

In this regard, 85 Cone Beam Computed Tomographies (CBCT), with 147 L3M, were selected from the archives of the Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, obtained using an Accuitomo® Morita device and using the Dolphin Imaging 11.9 software. L3M eruption was related to linear measurements of jaw length (Co-Gn), retromolar space dimension (D2R), mesiodistal width of the L3M crowns, mandibular first molars (L1M) and mandibular canines (LC) and the angle mandibular (Ar-Go-Me). Independent samples t-test, chi-square tests and logistic regression were performed adopting a significance level of 5%.

Results

The average mandible length of 116.446 mm + 6.415 mm, retromolar space of 11.634 mm + 2.385 mm, mesiodistal size of the L3M of 10.054 mm + 0.941 mm, sum of the mesiodistal widths of the L1M and LC of 15.564 mm + 1.218 mm and mandibular angle of 127.23° + 6.109. There was no statistically significant association between these factors and the eruption.

Conclusion

With the results obtained in this study, we conclude that the length and angle of the mandible, teeth size and dimension of the retromolar space are not associated with the L3M eruption.
Sophomore nursing students’ perception of their Professional Behavior toward Rehabilitation patients: a cross-sectional study
Authors: Amit-Aharon Anat , Warshawski Sigalit
Published: November 2023

Background

Rehabilitation is considered one of the elements of universal health coverage, emphasizing its importance for every person in need throughout the life course. Nurses play a pivotal role in the rehabilitation team as they possess the competencies to help individuals manage health problems and maximize potential well-being. Yet, little is known regarding knowledge of this subject among nursing students, as well as regarding their attitudes, thoughts, and professional behavior. This study aimed to explore: (a) Sophomore students’ attitudes, feelings, thoughts, and professional behavior toward rehabilitation patients; and (b) Differences in the research variables as affected by students’ previous exposure to rehabilitation patients.

Methods

A cross-sectional survey design among sophomore nursing students. A questionnaire was distributed through a commercial internet survey provider (Qualtrics.com) before the beginning of a mandatory course on “nursing rehabilitation”, introduced for the first time in 2022 in all Israeli universities. Students were divided into three groups according to their previous exposure to rehabilitation patients: no professional or personal previous exposure to rehabilitation patients; previous professional or personal exposure to rehabilitation patients; and previous exposure to rehabilitation patients both in one’s professional and personal life. The study adhered to the STROBE guidelines.

Results

The sample consisted of 122 participants. Significant differences were found between the groups by their previous exposure to rehabilitation patients. Participants with no previous exposure to rehabilitation patients were found to have lower self-perceived capability to care for rehabilitation patients and more negative professional behavior toward rehabilitation patients and their families compared to the other two groups (H = 22.06, p = 0.006, H = 23.86, p = 0.03, respectively). No other statistical differences were observed between the groups.

Conclusions

The findings emphasize the importance of exposing students to the field of nursing rehabilitation and to the care of rehabilitation patients. Exposure to nursing rehabilitation specifically during one’s studies, through theoretical learning and clinical experience, can promote positive attitudes, professional values, and positive professional behavior toward these patients and their families.
Interleukin-31 in serum and cerebrospinal fluid of dogs with syringomyelia
Authors: Lemke Laura , Carlson Regina , Flegel Thomas , Volk Andrea , Volk Holger Andreas , Tipold Andrea , Nessler Jasmin Nicole
Published: November 2023

Background

Syringomyelia is a spinal cord cavity containing cerebrospinal fluid (CSF)-like fluid. If syringomyelia asymmetrically involves the dorsal horn grey matter of the spinal cord, affected dogs show increased signs of dysesthesia and neuropathic pain, like increased itching behaviour. In the dorsal horn, amongst others, receptors for Interleukin-31 (IL-31) can be found. IL-31 is one of the main cytokines involved in the pathogenesis of pruritus in atopic dermatitis in different species. This study investigates suspected elevated levels of IL-31 in serum and CSF of dogs showing signs of pain or increased itching behaviour related to syringomyelia. The IL-31 were measured in archived samples (52 serum and 35 CSF samples) of dogs with syringomyelia (n = 48), atopic dermatitis (n = 3) and of healthy control dogs (n = 11) using a competitive canine IL-31 ELISA.

Results

Mean serum IL-31 level in dogs with syringomyelia was 150.1 pg/ml (n = 39), in dogs with atopic dermatitis 228.3 pg/ml (n = 3) and in healthy dogs 80.7 pg/ml (n = 10). Mean CSF IL-31 value was 146.3 pg/ml (n = 27) in dogs with syringomyelia and 186.2 pg/ml (n = 8) in healthy dogs. Individual patients with syringomyelia (especially dogs with otitis media or otitis media and interna or intervertebral disc herniation) showed high IL-31 levels in serum and CSF samples, but the difference was not statistically significant. IL-31 serum and CSF levels did not differ significantly in dogs with syringomyelia with or without itching behaviour and with or without signs of pain.

Conclusion

Based on this study, increased IL-31 levels seem not to be correlated with itching behaviour or signs of pain in dogs with syringomyelia, but might be caused by other underlying diseases.
Microenvironment of pancreatic inflammation: calling for nanotechnology for diagnosis and treatment
Authors: Liu Lu , Zhang Yiqing , Li Xinghui , Deng Jun
Published: November 2023

Acute pancreatitis (AP) is a common and life-threatening digestive disorder. However, its diagnosis and treatment are still impeded by our limited understanding of its etiology, pathogenesis, and clinical manifestations, as well as by the available detection methods. Fortunately, the progress of microenvironment-targeted nanoplatforms has shown their remarkable potential to change the status quo. The pancreatic inflammatory microenvironment is typically characterized by low pH, abundant reactive oxygen species (ROS) and enzymes, overproduction of inflammatory cells, and hypoxia, which exacerbate the pathological development of AP but also provide potential targeting sites for nanoagents to achieve early diagnosis and treatment. This review elaborates the various potential targets of the inflammatory microenvironment of AP and summarizes in detail the prospects for the development and application of functional nanomaterials for specific targets. Additionally, it presents the challenges and future trends to develop multifunctional targeted nanomaterials for the early diagnosis and effective treatment of AP, providing a valuable reference for future research.

Graphical Abstract
Temporal changes in regulatory T cell subsets defined by the transcription factor Helios in stroke and their potential role in stroke-associated infection: a prospective case–control study
Authors: Lukasik Maria , Telec Magdalena , Kazmierski Radoslaw , Wojtasz Izabela , Andrzejewska-Gorczyńska Natalia , Kociemba Wojciech , Dworacki Grzegorz , Kozubski Wojciech P. , Frydrychowicz Magdalena
Published: November 2023

Background

Regulatory T cells (Tregs) are involved in the systemic immune response after ischemic stroke. However, their role remains unclear, and the effect appears to be both neuroprotective and detrimental. Treg suppressor function may result in immunodepression and promote stroke-associated infection (SAI). Thus we assume that the bidirectional effects of Tregs may be in part attributed to the intracellular transcription factor Helios. Tregs with Helios expression (H+ Tregs) constitute 70–90% of all Treg cells and more frequently than Helios-negative Tregs (H− Tregs) express molecules recognized as markers of Tregs with suppressor abilities.

Methods and results

We prospectively assessed the circulating Treg population with flow cytometry in 52 subjects on days 1, 3, 10 and 90 after ischemic stroke and we compared the results with those obtained in concurrent age-, sex- and vascular risk factor-matched controls. At all studied time points the percentage of H+ Tregs decreased in stroke subjects—D1: 69.1% p < 0.0001; D3: 62.5% (49.6–76.6), p < 0.0001; D10: 60.9% (56.5–72.9), p < 0.0001; D90: 79.2% (50.2–91.7), p = 0.014 vs. controls: 92.7% (81.9–97.0) and the percentage of H− Tregs increased accordingly. In patients with SAI the percentage of pro-suppressor H+ Tregs on post-stroke day 3 was higher than in those without infection (p = 0.03). After adjustment for confounders, the percentage of H+ Tregs on day 3 independently correlated with SAI [OR 1.29; CI 95%: 1.08–1.27); p = 0.02]. Although the percentage of H+ Tregs on day 3 correlated positively with NIHSS score on day 90 (rS = 0.62; p < 0.01) and the infarct volume at day 90 (rS = 0.58; p < 0.05), in regression analysis it was not an independent risk factor.

Conclusions

On the first day after stroke the proportion of H+ vs. H− Tregs changes in favor of pro-inflammatory H− Tregs, and this shift continues toward normalization when assessed on day 90. A higher percentage of pro-suppressive H+ Tregs on day 3 independently correlates with SAI and is associated positively with NIHSS score, but it does not independently affect the outcome and stroke area in the convalescent phase of stroke.
Experiences of coordinated care for people in the UK affected by rare diseases: cross-sectional survey of patients, carers, and healthcare professionals
Authors: Walton Holly , Ng Pei Li , Simpson Amy , Bloom Lara , Chitty Lyn S. , Fulop Naomi J. , Hunter Amy , Jones Jennifer , Kai Joe , Kerecuk Larissa , Kokocinska Maria , Leeson-Beevers Kerry , Parkes Sharon , Ramsay Angus I. G. , Sutcliffe Alastair , Taylor Christine , Morris Stephen
Published: November 2023

Background

Poorly coordinated care can have major impacts on patients and families affected by rare conditions, with negative physical health, psychosocial and financial consequences. This study aimed to understand how care is coordinated for rare diseases in the United Kingdom.

Methods

We undertook a national survey in the UK involving 760 adults affected by rare diseases, 446 parents/carers of people affected by rare diseases, and 251 healthcare professionals who care for people affected by rare diseases.

Results

Findings suggested that a wide range of patients, parents and carers do not have coordinated care. For example, few participants reported having a care coordinator (12% patients, 14% parents/carers), attending a specialist centre (32% patients, 33% parents/carers) or having a care plan (10% patients, 44% parents/carers). A very small number of patients (2%) and parents/carers (5%) had access to all three—a care coordinator, specialist centre and care plan. Fifty four percent of patients and 33% of parents/carers reported access to none of these. On the other hand, a higher proportion of healthcare professionals reported that families with rare conditions had access to care coordinators (35%), specialist centres (60%) and care plans (40%).

Conclusions

Care for families with rare conditions is generally not well coordinated in the UK, with findings indicating limited access to care coordinators, specialist centres and care plans. Better understanding of these issues can inform how care coordination might be improved and embrace the needs and preferences of patients and families affected by rare conditions.
Research progress of biomimetic materials in oral medicine
Authors: Luo Xinyu , Niu Jiayue , Su Guanyu , Zhou Linxi , Zhang Xue , Liu Ying , Wang Qiang , Sun Ningning
Published: November 2023

Biomimetic materials are able to mimic the structure and functional properties of native tissues especially natural oral tissues. They have attracted growing attention for their potential to achieve configurable and functional reconstruction in oral medicine. Though tremendous progress has been made regarding biomimetic materials, significant challenges still remain in terms of controversy on the mechanism of tooth tissue regeneration, lack of options for manufacturing such materials and insufficiency of in vivo experimental tests in related fields. In this review, the biomimetic materials used in oral medicine are summarized systematically, including tooth defect, tooth loss, periodontal diseases and maxillofacial bone defect. Various theoretical foundations of biomimetic materials research are reviewed, introducing the current and pertinent results. The benefits and limitations of these materials are summed up at the same time. Finally, challenges and potential of this field are discussed. This review provides the framework and support for further research in addition to giving a generally novel and fundamental basis for the utilization of biomimetic materials in the future.
Transcriptomic landscape based on annotated clinical features reveals PLPP2 involvement in lipid raft-mediated proliferation signature of early-stage lung adenocarcinoma
Authors: Wang Yibei , Miao Ziwei , Qin Xiaoxue , Yang Yi , Wu Si , Miao Qi , Li Beibei , Zhang Mingyu , Wu Pengfei , Han Yun , Li Bo
Published: November 2023

Background

Image-based screening improves the detection of early-stage lung adenocarcinoma (LUAD)but also highlights the issue of high false-positive diagnoses, which puts patients at a risk of unnecessary over-treatment. Therefore, more precise discrimination criteria are required to ensure that patients with early-stage LUAD receive appropriate treatments.

Methods

We integrated 158 early-stage LUAD cases from 2 independent cohorts, including 30 matched resected specimens with complete radiological and pathological information, and 128 retrospective pathological pair-samples with partial follow-up data. This integration allowed us to conduct a correlation analysis between clinical phenotype and transcriptome landscape. Immunohistochemistry was performed using tissue microarrays to examine the expression of phospholipid phosphatase 2 (PLPP2) and lipid-raft markers. Lipidomics analysis was used to determine the changes of lipid components in PLPP2-overexpressed cells. To assess the effects of PLPP2 on the malignant phenotypes of LUAD cells, we conducted mice tumor-bearing experiments and in vitro cellular experiments by knocking down PLPP2 and inhibiting lipid raft synthesis with MβCD, respectively.

Results

Bioinformatics analysis indicated that the co-occurrence of lipid raft formation and rapid cell proliferation might exhibit synergistic effects in driving oncogenesis from lung preneoplasia to adenocarcinoma. The enhanced activation of the cell cycle promoted the transition from non-invasive to invasive status in early-stage LUAD, which was related to an increase in lipid rafts within LUAD cells. PLPP2 participated in lipid raft formation by altering the component contents of lipid rafts, such as esters, sphingomyelin, and sphingosine. Furthermore, elevated PLPP2 levels were identified as an independent prognostic risk factor for LUAD patients. Further results from in vivo and in vitro experiments confirmed that PLPP2 could induce excessive cell proliferation by enhancing lipid raft formation in LUAD cells.

Conclusions

Our study has revealed the characteristics of gene expression profiles in early-stage LUAD patients with the different radiological and pathological subtypes, as well as deciphered transcriptomic evolution trajectory from preneoplasia to invasive LUAD. Furthermore, it suggests that PLPP2-mediated lipid raft synthesis may be a significant biological event in the initiation of early-stage LUAD, offering a potential target for more precise diagnosis and therapy in clinical settings.
circ-hnRNPU inhibits NONO-mediated c-Myc transactivation and mRNA stabilization essential for glycosylation and cancer progression
Authors: Li Hongjun , Jiao Wanju , Song Jiyu , Wang Jianqun , Chen Guo , Li Dan , Wang Xiaojing , Bao Banghe , Du Xinyi , Cheng Yang , Yang Chunhui , Tong Qiangsong , Zheng Liduan
Published: November 2023

Background

Recent evidence reveals the emerging functions of circular RNA (circRNA) and protein glycosylation in cancer progression. However, the roles of circRNA in regulating glycosyltransferase expression in gastric cancer remain to be determined.

Methods

Circular RNAs (circRNAs) were validated by Sanger sequencing. Co-immunoprecipitation, mass spectrometry, and RNA sequencing assays were applied to explore protein interaction and target genes. Gene expression regulation was observed by chromatin immunoprecipitation, RNA immunoprecipitation, dual-luciferase reporter, real-time quantitative RT-PCR, and western blot assays. Gain- and loss-of-function studies were performed to observe the impacts of circRNA and its partners on the glycosylation, growth, invasion, and metastasis of gastric cancer cells.

Results

Circ-hnRNPU, an exonic circRNA derived from heterogenous nuclear ribonuclear protein U (hnRNPU), was identified to exert tumor suppressive roles in protein glycosylation and progression of gastric cancer. Mechanistically, circ-hnRNPU physically interacted with non-POU domain containing octamer binding (NONO) protein to induce its cytoplasmic retention, resulting in down-regulation of glycosyltransferases (GALNT2, GALNT6, MGAT1) and parental gene hnRNPU via repression of nuclear NONO-mediated c-Myc transactivation or cytoplasmic NONO-facilitated mRNA stability. Rescue studies indicated that circ-hnRNPU inhibited the N- and O-glycosylation, growth, invasion, and metastasis of gastric cancer cells via interacting with NONO protein. Pre-clinically, administration of lentivirus carrying circ-hnRNPU suppressed the protein glycosylation, tumorigenesis, and aggressiveness of gastric cancer xenografts. In clinical cases, low circ-hnRNPU levels and high NONO or c-Myc expression were associated with poor survival outcome of gastric cancer patients.

Conclusions

These findings indicate that circ-hnRNPU inhibits NONO-mediated c-Myc transactivation and mRNA stabilization essential for glycosylation and cancer progression.
The prevalence of foot pain and association with baseline characteristics in people participating in education and supervised exercise for knee or hip osteoarthritis: a cross‐sectional study of 26,003 participants from the GLA:D® registry
Authors: Gates Lucy S. , Cherry Lindsey , Grønne Dorte T. , Roos Ewa M. , Skou Søren T.
Published: November 2023

Background

Osteoarthritis (OA) affecting the knee or hip is highly prevalent in the general population and has associated high disease burden. Early identification of modifiable risk factors that prevent, limit, or resolve disease symptoms is critical. Foot pain may represent a potentially modifiable factor however little is known about the prevalence of foot pain in people with knee or hip OA nor whether foot pain is associated with clinical characteristics. The main aim of this study was therefore to determine the prevalence of foot pain in people with knee or hip OA attending an education and supervised exercise‐based intervention in Denmark (GLA:D®) and determine if baseline demographic or clinical characteristics are associated with foot pain.

Methods

Analysis was conducted on baseline data of 26,003 people with symptomatic knee or hip OA completing a pain mannequin as part of the Good Life with osteoArthritis in Denmark (GLA:D®) primary care programme. Odds Ratios (OR) and 95% confidence intervals (CI) were calculated to estimate the strength of association between baseline clinical characteristics (including pain severity in worst knee/hip joint, number of painful knee/hip joints, pain medication use and physical activity level) and the presence of baseline foot pain.

Results

Twelve percent of participants (n = 3,049) reported foot pain. In those people with index knee OA (n = 19,391), knee pain severity (OR 1.01 CI 1.00, 1.01), number of painful knee/hip joints (OR 1.67 CI 1.58, 1.79), and use of pain medication (OR 1.23 CI 1.12, 1.36) were statistically associated with foot pain. Excluding use of pain medication, similar associations were seen in those with index hip OA.

Conclusion

Twelve percent of people with knee or hip OA participating in GLA:D® had foot pain. Those with worse knee/hip pain, and greater number of painful joints were more likely to report foot pain. This study is the first to demonstrate a significant relationship between clinical characteristics and foot pain in people with knee or hip OA participating in education and supervised exercise. Future investigation should consider the role that foot pain may play on knee and hip related outcomes following therapeutic intervention.
Dose inhibin B or anti-Müllerian hormone relate to precocious puberty in girls? result of a systematic review and meta-analysis
Authors: Jiang Mei , Gao Ying , Qu Tiange , Ji Yuechen , Niu Yiwen , Zhang Jiaxin , Huang Ling
Published: November 2023

Backgrounds

Existing studies have investigated the relationship between the levels of serum inhibin B (INHB), anti-müllerian hormone (AMH) and precocious puberty in girls, but the results are inconsistent.

Objective

The aim of this meta-analysis was to assess whether the INHB and AMH levels changed in girls with precocious puberty relative to healthy controls.

Methods

PubMed, Embase, Cochrane Library and Web of Science were searched through June 2022. We included observational clinical studies reporting the serum levels INHB and AMH in girls with precocious puberty. Conference articles and observational study abstracts were included if they contained enough information regarding study design and outcome data. Case series and reports were excluded. An overall standard mean difference (SMD) between precocious puberty and healthy controls was estimated using a DerSimonian-Laird random-effects model.

Results

A total of 11 studies featuring 552 girls with precocious puberty and 405 healthy girls were selected for analysis. The meta-analysis showed that the INHB level of precocious puberty [including central precocious puberty (CPP) and premature the larche (PT)] were significantly increased. While there was no significant association between precocious puberty [including CPP, PT, premature pubarche (PP) and premature adrenarche (PA)] and the level of serum AMH.

Conclusion

Scientific evidence suggested that the INHB level, but not the AMH level, altered in girls with precocious puberty compared with healthy controls. Through our results we think that INHB level might be a marker for the auxiliary diagnosis of precocious puberty (especially CPP and PT). Therefore, it is important to evaluate and thoroughly investigate the clinical indicators (e.g., INHB) in order to ensure early diagnosis and medical intervention, and the risk of physical, psychological and social disorders in immature girls with precocious puberty is minimized.
Study protocol for a randomised controlled trial to investigate the effectiveness of thoracic epidural and paravertebral blockade in reducing chronic post-thoracotomy pain: 2 (TOPIC 2)
Authors: Shelley Ben , Goebel Andreas , Grant Stephen , Jackson Louise , Jarrett Hugh , Jepson Marcus , Kerr Amy , Marczin Nandor , Mehta Rajnikant , Melody Teresa , Middleton Lee , Naidu Babu , Szentgyorgyi Lajos , Tearne Sarah , Watkins Ben , Wilson Matthew , Worrall Andrew , Yeung Joyce , Smith Fang Gao
Published: November 2023

Background

Thoracotomy is considered one of the most painful surgical procedures and can cause debilitating chronic post-surgical pain lasting months or years postoperatively. Aggressive management of acute pain resulting from thoracotomy may reduce the likelihood of developing chronic pain. This trial compares the two most commonly used modes of acute analgesia provision at the time of thoracotomy (thoracic epidural blockade (TEB) and paravertebral blockade (PVB)) in terms of their clinical and cost-effectiveness in preventing chronic post-thoracotomy pain.

Methods

TOPIC 2 is a multi-centre, open-label, parallel group, superiority, randomised controlled trial, with an internal pilot investigating the use of TEB and PVB in 1026 adult (≥ 18 years old) patients undergoing thoracotomy in up to 20 thoracic centres throughout the UK. Patients (N = 1026) will be randomised in a 1:1 ratio to receive either TEB or PVB. During the first year, the trial will include an integrated QuinteT (Qualitative Research Integrated into Trials) Recruitment Intervention (QRI) with the aim of optimising recruitment and informed consent. The primary outcome is the incidence of chronic post-surgical pain at 6 months post-randomisation defined as ‘worst chest pain over the last week’ equating to a visual analogue score greater than or equal to 40 mm indicating at least a moderate level of pain. Secondary outcomes include acute pain, complications of regional analgesia and surgery, health-related quality of life, mortality and a health economic analysis.

Discussion

Both TEB and PVB have been demonstrated to be effective in the prevention of acute pain following thoracotomy and nationally practice is divided. Identification of which mode of analgesia is both clinically and cost-effective in preventing chronic post-thoracotomy pain could ameliorate the debilitating effects of chronic pain, improving health-related quality of life, facilitating return to work and caring responsibilities and resulting in a cost saving to the NHS.

Trial registration

NCT03677856 [ClinicalTrials.gov] registered September 19, 2018. https://clinicaltrials.gov/ct2/show/NCT03677856. First patient recruited 8 January 2019.
Rationale and design of a randomized clinical trial evaluating the efficacy of mechanical neuroprotection in reducing the risk of silent brain infarcts associated with percutaneous left atrial appendage closure: study protocol for a LAAC-SBI trial
Authors: Streb Witold , Lasek-Bal Anetta , Mitręga Katarzyna , Kowalczyk Jacek , Podolecki Tomasz , Kowalska Wiktoria , Olma Anna , Sobczyk Agata , Kalarus Zbigniew
Published: November 2023

Background

Left atrial appendage closure (LAAC) procedures prevent cardioembolic stroke in patients with atrial fibrillation who have contraindications to oral anticoagulant medications. However, these procedures carry certain risks of peri-procedural complications. One such complication is silent brain infarcts (SBI), which can lead to cognitive impairment and mood disturbances. The implementation of mechanical neuroprotection systems during LAAC procedures may reduce the risk of SBI and associated cognitive and mood disorders.

Methods

The LAAC-SBI trial is a prospective, multicenter, randomized, and double-blind interventional study. The study aims to enroll a total of 240 patients, with 120 patients allocated to each group. The study group will evaluate the use of the Sentinel CPS during LAAC, while the control group will undergo LAAC procedures without the Sentinel CPS. The primary endpoint of the study is the number of new SBIs or stroke foci detected by diffusion-weighted magnetic resonance imaging (DW MRI). Secondary endpoints include deterioration of cognitive function, development of dementia syndrome, and occurrence of depressive disorders. These endpoints will be assessed using questionnaire tools such as the Montreal Cognitive Assessment (MoCA), Trail Making Test (TMT), Controlled Oral Word Association Test (COWAT), and Hospital Anxiety and Depression Scale (HADS). The observational period for patients in the study is 2 years.

Discussion

If the study demonstrates a favorable outcome with reduced incidence of SBI and improved cognitive and mood outcomes in patients receiving cerebral protection devices during LAAC, it will have significant implications for clinical management standards. This would support the use of neuroprotection devices not only for LAAC but also in procedures such as atrial fibrillation ablation or transcatheter mitral valve interventions, where the risk of embolic events and subsequent brain injury may also be present.

Trial registration

ClinicalTrials.gov NCT05369195. Registration on 11.05.2022.
Enhancing prediction of supraspinatus/infraspinatus tendon complex injuries through integration of deep visual features and clinical information: a multicenter two-round assessment study
Authors: Alike Yamuhanmode , Li Cheng , Hou Jingyi , Long Yi , Zhang Jinming , Zhou Chuanhai , Zhang Zongda , Zhu Qi , Li Tao , Cao Shinan , Zhang Yuanhao , Wang Dan , Cheng Shuangqin , Yang Rui
Published: November 2023

Objective

Develop and evaluate an ensemble clinical machine learning–deep learning (CML-DL) model integrating deep visual features and clinical data to improve the prediction of supraspinatus/infraspinatus tendon complex (SITC) injuries.

Methods

Patients with suspected SITC injuries were retrospectively recruited from two hospitals, with clinical data and shoulder x-ray radiographs collected. An ensemble CML-DL model was developed for diagnosing normal or insignificant rotator cuff abnormality (NIRCA) and significant rotator cuff tear (SRCT). All patients suspected with SRCT were confirmed by arthroscopy examination. The model’s performance was evaluated using sensitivity, specificity, accuracy, and area under the curve (AUC) metrics, and a two-round assessment was conducted to authenticate its clinical applicability.

Results

A total of 974 patients were divided into three cohorts: the training cohort (n = 828), the internal validation cohort (n = 89), and the external validation cohort (n = 57). The CML-DL model, which integrates clinical and deep visual features, demonstrated superior performance compared to individual models of either type. The model’s sensitivity, specificity, accuracy, and area under curve (95% confidence interval) were 0.880, 0.812, 0.836, and 0.902 (0.858–0.947), respectively. The CML-DL model exhibited higher sensitivity and specificity compared to or on par with the physicians in all validation cohorts. Furthermore, the assistance of the ensemble CML-DL model resulted in a significant improvement in sensitivity for junior physicians in all validation cohorts, without any reduction in specificity.

Conclusions

The ensembled CML-DL model provides a solution to help physicians improve the diagnosis performance of SITC injury, especially for junior physicians with limited expertise.

Critical relevance statement

The ensembled clinical machine learning–deep learning (CML-DL) model integrating deep visual features and clinical data provides a superior performance in the diagnosis of supraspinatus/infraspinatus tendon complex (SITC) injuries, particularly for junior physicians with limited expertise.

Key points

1. Integrating clinical and deep visual features improves diagnosing SITC injuries.

2. Ensemble CML-DL model validated for clinical use in two-round assessment.

3. Ensemble model boosts sensitivity in SITC injury diagnosis for junior physicians.

Graphical Abstract
An example of a convergent mixed-methods analysis to examine food security: the case of Popokabaka in the Democratic Republic of Congo
Authors: Mbunga Branly Kilola , Mapatano Mala Ali , Egbende Landry , Strand Tor A. , Hatloy Anne , Engebretsen Ingunn M. S.
Published: November 2023

Background

Food insecurity is alarming in all four dimensions—availability, access, utilization, and stability—in Popokabaka, DR Congo. In such cases, a unique indicator may not help to develop adapted and local long-term actions. A comprehensive analysis of food insecurity is needed. We aimed to examine the burden and extent of food insecurity and suggest integrative pathways using a mixed approach for transformative actions at the local level.

Methods

We designed a convergent parallel mixed-methods study with four-level data sources collected in Popokabaka: (1) a household food survey (using the Household Food Insecurity Access Scale (HFIAS), a Household Dietary Diversity Score (HDDS) and the Food Consumption Score (FCS), (2) a market food census (assessing food availability and cost per 100 g), and (3) an exit food market survey (assessing buyers' food choices and client satisfaction), and (4) on-farm qualitative study among food producers (exploring challenges and opportunities). Descriptive statistics from our quantitative data were triangulated with themes emerging from qualitative data.

Results

Popokabaka experienced severe food access insecurity (89%), poor food consumption (40.7%), and low dietary diversity (30.2%) at the household level. The quantitative findings at the household level were linked to market characteristics and farmer-reported themes under three pathways: poor diet quality, culturally grounded diet, and risk perception.

Conclusions

The focus should be on improving livestock development, developing adapted communications about nutrition to change established dietary habits, and engaging the government and all stakeholders to empower local communities for improved food security.
Tree and shrub richness modifies subtropical tree productivity by regulating the diversity and community composition of soil bacteria and archaea
Authors: Tao Siqi , Veen G. F. , Zhang Naili , Yu Tianhe , Qu Laiye
Published: November 2023

Background

Declines in plant biodiversity often have negative consequences for plant community productivity, and it becomes increasingly acknowledged that this may be driven by shifts in soil microbial communities. So far, the role of fungal communities in driving tree diversity-productivity relationships has been well assessed in forests. However, the role of bacteria and archaea, which are also highly abundant in forest soils and perform pivotal ecosystem functions, has been less investigated in this context. Here, we investigated how tree and shrub richness affects stand-level tree productivity by regulating bacterial and archaeal community diversity and composition. We used a landscape-scale, subtropical tree biodiversity experiment (BEF-China) where tree (1, 2, or 4 species) and shrub richness (0, 2, 4, 8 species) were modified.

Results

Our findings indicated a noteworthy decline in soil bacterial α-diversity as tree species richness increased from monoculture to 2- and 4- tree species mixtures, but a significant increase in archaeal α-diversity. Additionally, we observed that the impact of shrub species richness on microbial α-diversity was largely dependent on the level of tree species richness. The increase in tree species richness greatly reduced the variability in bacterial community composition and the complexity of co-occurrence network, but this effect was marginal for archaea. Both tree and shrub species richness increased the stand-level tree productivity by regulating the diversity and composition of bacterial community and archaeal diversity, with the effects being mediated via increases in soil C:N ratios.

Conclusions

Our findings provide insight into the importance of bacterial and archaeal communities in driving the relationship between plant diversity and productivity in subtropical forests and highlight the necessity for a better understanding of prokaryotic communities in forest soils.
Nationwide urban ground deformation in Japan for 15 years detected by ALOS and Sentinel-1
Authors: Morishita Yu , Sugimoto Ryu , Nakamura Ryosuke , Tsutsumi Chiaki , Natsuaki Ryo , Shimada Masanobu
Published: November 2023

InSAR time series analysis has become a major tool for nationwide land deformation monitoring. Sentinel-1 SAR data have enabled us to measure and monitor ground deformation globally with high accuracy and resolution through InSAR time series analysis, due to its constant and frequent global coverage and open data policy since 2014. Although several datasets from previous SAR satellites were available before Sentinel-1, such comprehensive deformation monitoring was not performed due to several limitations such as data quality, analysis technique, data policy, and processing capacity at that time. However, since a large amount of ALOS InSAR products and an open-source InSAR time series analysis tool LiCSBAS have become openly and freely available, we can easily derive the deformation from 2006 to 2011 by using them. In this study, we detected the deformation time series and velocity in all major urban areas in Japan from 2006 to 2011 and compared the results with the deformation from 2014 to 2020 detected by Sentinel-1 data. The two deformation datasets with different time periods revealed various 15-year deformation histories, such as long-term constant subsidence in Tomakomai and Niigata, changes in deformation areas and/or velocities in Hirosaki, Kujyukuri, Kanazawa, and Matsushiro, and appearance or disappearance of deformation in Joso, Yoyogi, and Kyoto. Future abundant and continuous SAR data acquisitions will reveal more long-term deformation transitions and help to understand the details of the mechanisms.
Unintended pregnancy and contraceptive use among women in low- and middle-income countries: systematic review and meta-analysis
Authors: Gelaw Kelemu Abebe , Atalay Yibeltal Assefa , Gebeyehu Natnael Atnafu
Published: November 2023

Introduction

Unintended pregnancy is a leading cause of maternal mortality associated with abortion, inadequate contraceptive use, contraceptive failure, and contraceptive discontinuation in low- and middle-income countries. Most unintended pregnancies occur in regions with limited availability of maternal health services, resulting in a significant number of maternal deaths. Therefore, this review aimed to assess the overall prevalence of unintended pregnancy among women using contraceptives in low- and middle-income countries.

Method

PubMed, Science Direct, Google Scholar, Scopus, and the Ethiopian University Online Library were searched. Data were extracted using Microsoft Excel and analyzed using STATA statistical software (version 14). Publication bias was checked using forest plot, Begg rank test, and Egger regression test. To check for heterogeneity, I2 was calculated and an overall estimation analysis was performed. Subgroup analysis was conducted by study setting, study design, and publication. The Joanna Briggs Institute quality assessment tool was used to assess the quality of each study. We performed a one-time sensitivity analysis.

Results

Of the 1304 articles retrieved, 23 studies (involving 40,338 subjects) met the eligibility criteria and were included in this study. The pooled prevalence of unintended pregnancy among women using contraceptives in low- and middle-income countries was 44.68% (95% CI: 35.16–54.20; I2 = 99.7%, P < 0.001). Based on subgroup analysis, the pooled prevalence of unintended events was 43.58% (CI: 32.99, 54.173) and 49.93% (CI: 28.298, 71.555) for cross-sectional and cohort studies, respectively. Based on the study design, it was 34.47% (CI: 27.012, 41.933) for community studies and 55.85% (CI: 33.364, 78.339) for institutional studies.

Conclusion

The overall prevalence of unintended pregnancy was high among women using contraceptives in low- and middle-income countries. Therefore, it is better to pay attention to prevention strategies for unintended pregnancy, such as information and education accessibility and contraceptive utilization.
Development and application of a self-assembling split-fluorescent protein toolkit to monitor geminiviral movement and infection in plant
Authors: Wang Yaqin , Hu Tao , Liu Hui , Su Chenlu , Xie Li , Wang Zhanqi , Zhou Xueping
Published: November 2023

Geminiviruses are a group of circular single-stranded DNA viruses that cause severe diseases in many crop plants. However, there is still no fluorescent protein tag suitable for labeling viral proteins endogenously due to the limited genomic space and structure of geminiviruses for foreign gene fragment insertion. Here, we established a split super-folder green fluorescent protein (sfGFP)-based imaging system that provides a platform to visualize the subcellular localization of geminiviral proteins in Nicotiana benthamiana. A short fragment of the GFP- coding sequence (GFP11) was inserted into a specific locus of the geminiviral genome, while the remainder of the GFP (GFP1–10) was transiently or constitutively expressed in N. benthamiana. Consequently, complementation fluorescence enables the examination of the subcellular localization of viral proteins in particular cells. Using this split sfGFP system, we examined the subcellular localization of the coat protein and BV1 protein of tomato golden mosaic virus (TGMV) and further monitored its intercellular and long-distance movement in N. benthamiana during viral infection. This approach allows us to study endogenously the subcellular localization and viral movement of geminiviruses in N. benthamiana. This new split sfGFP system may also hold the potential to provide orthogonal fluorescent proteins usable for geminiviral genome tagging in plants.
Έλεγχος της αντιλεϊσμανιακής δράσης νέων αιθερικών φωσφολιπιδίων
Authors: Φραγκιαδάκη Ειρήνη
Published: November 2023

Στην παρούσα διδακτορική διατριβή μελετήθηκαν in vitro και χαρακτηρίστηκαν 55 ανάλογα αιθερικών φωσφολιπιδίων ως προς την αντιπαρασιτική τους δράση στην προμαστιγωτή και ενδοκυττάρια αμαστιγωτή μορφή του παρασίτου Leishmania, την κυτταροτοξικότητα έναντι της ανθρώπινης κυτταρικής σειράς μακροφάγων THP1 και την αιμολυτική τους δράση, με στόχο την ανάδειξη της βέλτιστης χημικής δομής που προσδίδει μέγιστη παρασιτοκτόνο δράση σε συνδυασμό με τη μικρότερη δυνατή κυτταροτοξικότητα. Κατόπιν διερευνήθηκε ο μηχανισμός δράσης επιλεγμένων αναλόγων μελετώντας κυτταρικά φαινόμενα όπως η αυτοφαγία, η απόπτωση και το οξειδωτικό στρες. Μελετήθηκε η επίδραση των αναλόγων στη φυσιολογία του μιτοχονδρίου του παρασίτου καθώς και η ενδοκυττάρια κατανομή τους με τη χρήση φθοριζόντων αναλόγων. Μελετήθηκαν επίσης αλλαγές της έκφρασης των πρωτεϊνών σε στελέχη του παρασίτου, που έχουν προηγουμένως προσαρμοστεί στο εργαστήριο σε υποθεραπευτικές συγκεντρώσεις επιλεγμένου αναλόγου και μιλτεφοσίνης, με τη χρήση πρωτεωμικής. Ακολούθησε περιγραφή ορισμένων κεντρικών μηχανισμών του παρασίτου, η έκφραση των οποίων τροποποιείται ως αντίδραση στην παρατεταμένη επίδραση επιλεγμένων αναλόγων. Τα ευρήματα σχετικά με τον τρόπο δράσης των αναλόγων μας οδήγησαν στην αναζήτηση χημικών ουσιών διαφορετικής δομής, με παρόμοιο τρόπο δράσης. Χρησιμοποιήθηκαν μέλη της οικογένειας των peptaibols που κατέχουν αντιλεϊσμανιακή δράση και στοχεύουν στο μιτοχόνδριο των παρασίτων, για να διερευνηθεί η δυνατότητα συνέργειας με επιλεγμένα ανάλογα. Τέλος, επιλέχθηκε ένα ανάλογο για θεραπευτική δοκιμή in vivo σε σκύλo με kala azar.