bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of maternal nutritional status and small for gestational age neonates in peri-urban communities of Karachi, Pakistan: findings from the PRISMA study
Authors: Ambreen Sobia , Yazdani Nida , Alvi Abdul Salam , Qazi Muhammad Farrukh , Hoodbhoy Zahra
Published: March 2024

Background

Early pregnancy nutritional status can be associated with adverse birth outcomes such as small-for-gestational age (SGA) and low birth weight (LBW). BMI (Body Mass Index) and MUAC (Mid-upper arm circumference) are easy to use assessments and are indicative of the pre-pregnancy nutritional status if obtained in the first trimester. This study primarily assesses the association of maternal nutritional status using BMI and MUAC with SGA in a community-based cohort of Pakistani women. It also aims to determine the predictive ability of MUAC and BMI in predicting SGA. Secondarily, we assessed the association between maternal nutrition and large for gestational age (LGA) and LBW.

Methods

This study is a secondary analysis of an ongoing pregnancy cohort “Pregnancy Risk Infant Surveillance and Measurement Alliance (PRISMA)“in Ibrahim Hyderi and Rehri Goth, Karachi. PRISMA participants who were enrolled between January 2021 to August 2022 were included given they had a gestational age < 14 weeks confirmed via ultrasound, MUAC and BMI measurements were available and birth weight was captured within 72 hours. Multivariable logistic regression was used to determine an association between maternal nutritional status and SGA. The PRISMA study was approved by the Aga Khan University Ethics Review Committee (2021–5920-15,518).

Results

Of 926 women included in the analysis, 26.6% (n = 247) had a low MUAC (< 23 cm) while 18.4% (n = 171) were underweight (BMI < 18.5 kg/m2). Nearly one third of low MUAC and underweight women delivered SGA infants (34.4 and 35.1% respectively). Underweight women and women with low MUAC had a statistically significant association with SGA (Underweight: OR 1.49, 95% CI 1.1,2.4; Low MUAC-OR 1.64, 95% CI 1.2,2.3) as well as LBW (Underweight: OR-1.63, 95% CI 1.1,2.4; Low MUAC-OR-1.63, 95% CI 1.2,2.3). ROC curves showed that MUAC and BMI had modest predictability for SGA (AUC < 0.7).

Conclusion

Maternal nutritional status as indicated by BMI and MUAC are strongly associated with adverse pregnancy outcomes including SGA, LGA and LBW. Although MUAC and BMI are widely used to determine maternal nutritional status, they have poor predictive ability for newborn size. Further research is needed to identify other tools or a combination of tools to better predict adverse birth outcomes in resource-limited settings and plan interventions.
Covid-19 skepticism and public health norms during refugee assistance: does skepticism always lead to poor safety protocol adherence?
Authors: Nawyn Stephanie J. , Karaoğlu Ezgi , Qaji Natalie , Qaji Natalynn
Published: March 2024

Background

Skepticism about COVID-19’s existence or severity has spread as fast as the disease itself, and in some populations has been shown to undermine protective public health behaviors that can mitigate infection. For populations that are especially vulnerable to COVID spread and severity, such as refugees, COVID skepticism is particularly problematic.

Methods

We examine data collected from observations of humanitarian services provided to refugees in Lebanon, Türkiye, and Jordan to determine if skepticism is related to adherence to specific health-protective protocols (masking, social distancing, and hand sanitizing), and whether the effects of COVID skepticism are mediated by particular populations of refugees or the country in which those refugees receive assistance.

Results

We found that community skepticism (the frequency of COVID skepticism expressed by others within a service location) is associated with lower adherence to certain protocols and not others. We also found that with certain protocols, the country in which refugees receive services mediates the relationship between community skepticism and protocol adherence, but for other protocols the relationship between skepticism and adherence is independent of either country in which refugees reside or the refugee population being served.

Conclusions

The existence of skepticism about COVID-19 does not always lead to an unwillingness to take protective measures to avoid infection. The mechanisms underlying the relationship between skepticism and adherence to health-protective protocols vary based on the type of protocol in question. In order to increase protocol adherence, the specific variables predicting adherence to different protocols need to be assessed in order to increase adherence and improve public health during humanitarian services.
Curettage combined with decompression for the treatment of ameloblastoma in children: report of two cases
Authors: Xu Chen , Hu Yuhua , Sun Yuhuan , Shao Qiang , Song Yonghai , He Jie
Published: March 2024

Background

Ameloblastoma (AM) is the most common benign odontogenic tumor, which is more often detected in the mandible than maxilla, especially the mandibular body and mandibular angle. Pediatric AM is a rare disease, especially in patients aged 10 and younger. Compared with the mainstream osteotomy and reconstructive surgery for adult ameloblastoma, there is more room for discussion in the treatment of pediatric ameloblastoma. The postoperative functional and psychological influence can not be ignored. Especially for children in the period of growth and development, an osteotomy is often challenging to be accepted by their parents. We report two patients with ameloblastoma under 10 years old who are treated with curettage and fenestration, which is a beneficial method for children with ameloblastoma.

Case presentation

We present two cases of classic ameloblastoma in children. We describe in detail the patients’ characteristics, treatment processes, and follow-up result. The bone formation and reconstruction in the lesion area after fenestration decompression and curettage are recorded at every clinic review. The surgical details and principles of curettage and decompression are also described and discussed. The two patients have good bone shape recovery and no recurrence.

Conclusions

Children are in the growth and development period and possess an extremely strong ability of bone formation and reconstruction. Based on the principles of minimally invasive and functional preservation, we believe that curettage combined with decompression can be the first choice for treating AM in children, especially for mandibular lesions.
Thriving at work as a mediator of the relationship between psychological resilience and the work performance of clinical nurses
Authors: Shen Zhou-Min , Wang Yang-Yang , Cai Yi-Min , Li Ai-Qun , Zhang Yu-Xin , Chen Hong-Jiao , Jiang Yuan-Yuan , Tan Juan
Published: March 2024

Objective

This study aims to investigate the relationship between psychological resilience, thriving at work, and work performance among nurses, as well as analyse the mediating role of thriving at work in the relationship between psychological resilience and the work performance of nurses. The findings are intended to serve as a reference for nursing managers to design tailored work performance intervention programs.

Method

Using convenience sampling, 308 clinical nurses were selected from a tertiary hospital in Changsha City, Hunan Province, China, from February to April 2023. The Connor–Davidson Resilience Scale (CD-RISC), the Thriving at Work Scale, and the Work Performance Scale were employed for the questionnaire survey. Pearson correlation analysis was used to explore the relationship between psychological resilience, thriving at work and work performance. The SPSS 26.0 software’s ‘Process’ plugin was utilised for mediation effect analysis.

Results

Significantly positive correlations were found between psychological resilience and thriving at work (r = 0.806, P < 0.01), thriving at work and work performance (r = 0.571, P < 0.01) as well as psychological resilience and work performance (r = 0.572, P < 0.01). Psychological resilience significantly predicted work performance positively (β = 0.558, t = 11.165, P < 0.01), and this prediction remained significant when thriving at work (the mediating variable), was introduced (β = 0.371, t = 4.772, P < 0.01). Psychological resilience significantly predicted thriving at work positively (β = 0.731, t = 20.779, P < 0.01), and thriving at work significantly predicted work performance positively (β = 0.256, t = 3.105, P < 0.05). The mediating effect size of thriving at work between psychological resilience and work performance was 33.49% (P < 0.05).

Conclusion

Thriving at work plays a partial mediating role between psychological resilience and work performance. The level of work performance among clinical nurses was relatively high. Nursing managers can enhance thriving at work by fostering psychological resilience among clinical nurses, thereby further improving their work performance to ensure high-quality and efficient nursing care.
The relationship between organizational dehumanization and work engagement: the mediating effect of nurses’ work stress
Authors: Abou Zeid Mennat-Allah G. , Khedr Mahmoud Abdelwahab , Rayan Heba Nasser , mostafa Boshra , El-Ashry Ayman Mohamed
Published: March 2024

Background

Organizational dehumanization has detrimental consequences for nurses’ wellbeing and leads to a stressful work environment. Moreover, it is very destructive to work engagement.

Aim

To examine the mediating role of nurses’ work stress between organizational dehumanization and work engagement.

Method

A cross-sectional research design was conducted with 245 staff nurses over a one-month period. The researchers used structured equation modeling.

Results

Work engagement and organizational dehumanization levels were both moderate. In addition, the degree of job stress among the nurses was moderate, too. The results of the structural equation modeling showed that the association between organizational dehumanization and job engagement is partially mediated by work stress.

Conclusions

For staff nurses to exhibit high levels of caring behaviors, this study emphasized the need to establish a work environment that employs tactics to improve workplace engagement and happiness. In addition to changing the organizational culture of nurses to eradicate organizational dehumanization and pressures related to the job.
Progress with the Learning Health System 2.0: a rapid review of Learning Health Systems’ responses to pandemics and climate change
Authors: Smith Carolynn L. , Fisher Georgia , Dharmayani Putu Novi Arfirsta , Wijekulasuriya Shalini , Ellis Louise A. , Spanos Samantha , Dammery Genevieve , Zurynski Yvonne , Braithwaite Jeffrey
Published: March 2024

Background

Pandemics and climate change each challenge health systems through increasing numbers and new types of patients. To adapt to these challenges, leading health systems have embraced a Learning Health System (LHS) approach, aiming to increase the efficiency with which data is translated into actionable knowledge. This rapid review sought to determine how these health systems have used LHS frameworks to both address the challenges posed by the COVID-19 pandemic and climate change, and to prepare for future disturbances, and thus transition towards the LHS2.0.

Methods

Three databases (Embase, Scopus, and PubMed) were searched for peer-reviewed literature published in English in the five years to March 2023. Publications were included if they described a real-world LHS’s response to one or more of the following: the COVID-19 pandemic, future pandemics, current climate events, future climate change events. Data were extracted and thematically analyzed using the five dimensions of the Institute of Medicine/Zurynski-Braithwaite’s LHS framework: Science and Informatics, Patient-Clinician Partnerships, Continuous Learning Culture, Incentives, and Structure and Governance.

Results

The search yielded 182 unique publications, four of which reported on LHSs and climate change. Backward citation tracking yielded 13 additional pandemic-related publications. None of the climate change-related papers met the inclusion criteria. Thirty-two publications were included after full-text review. Most were case studies (n = 12, 38%), narrative descriptions (n = 9, 28%) or empirical studies (n = 9, 28%). Science and Informatics (n = 31, 97%), Continuous Learning Culture (n = 26, 81%), Structure and Governance (n = 23, 72%) were the most frequently discussed LHS dimensions. Incentives (n = 21, 66%) and Patient-Clinician Partnerships (n = 18, 56%) received less attention. Twenty-nine papers (91%) discussed benefits or opportunities created by pandemics to furthering the development of an LHS, compared to 22 papers (69%) that discussed challenges.

Conclusions

An LHS 2.0 approach appears well-suited to responding to the rapidly changing and uncertain conditions of a pandemic, and, by extension, to preparing health systems for the effects of climate change. LHSs that embrace a continuous learning culture can inform patient care, public policy, and public messaging, and those that wisely use IT systems for decision-making can more readily enact surveillance systems for future pandemics and climate change-related events.

Trial registration

PROSPERO pre-registration: CRD42023408896.
A qualitative assessment of barriers and facilitators of telemedicine volunteerism during the COVID-19 pandemic in India
Authors: D’Souza Karishma , Singh Saksham , Westgard Christopher M. , Barnhardt Sharon
Published: March 2024

Background

The COVID-19 pandemic further propelled the recent growth of telemedicine in low-resource countries, with new models of telemedicine emerging, including volunteer-based telemedicine networks. By leveraging existing infrastructure and resources to allocate health personnel more efficiently, these volunteer networks eased some of the pandemic burden placed on health systems. However, there is insufficient understanding of volunteer-based telemedicine models, especially on the human resources engagement on such networks. This study aims to understand the motivations and barriers to health practitioner engagement on a volunteer telemedicine network during COVID-19, and the mechanisms that can potentially sustain volunteer engagement to address healthcare demands beyond the pandemic.

Methods

In-depth qualitative interviews were conducted with health practitioners volunteering on an Indian, multi-state telemedicine network during the COVID-19 pandemic. Data were analyzed using thematic content analysis methods.

Results

Most practitioners reported being motivated to volunteer by a sense of duty to serve during the pandemic. Practitioners suggested organizational-level measures to make the process more efficient and facilitate a more rewarding provider–patient interaction. These included screening calls, gathering patient information prior to consultations, and allowing for follow-up calls with patients to close the loop on consultations. Many practitioners stated that non-financial incentives are enough to maintain volunteer engagement. However, practitioners expressed mixed feelings about financial incentives. Some stated that financial incentives are needed to maintain long-term provider engagement, while others stated that financial incentives would devalue the volunteer experience. Most practitioners highlighted that telemedicine could increase access to healthcare, especially to the rural and underserved, even after the pandemic. Practitioners also expressed an interest in continuing to volunteer with the network if the need arose again.

Conclusion

Our study findings suggest that practitioners are highly intrinsically motivated to volunteer during large healthcare emergencies and beyond to address the healthcare needs of the underserved. Following the recommendations presented in the study, telemedicine networks can more successfully engage and maintain volunteer practitioners. Volunteer-based telemedicine networks have the potential to bridge shortages of health personnel in resource-constrained settings both in times of crises and beyond.
Juglone induces ferroptosis in glioblastoma cells by inhibiting the Nrf2-GPX4 axis through the phosphorylation of p38MAPK
Authors: Guo Fangzhou , Ling Guoyuan , Qiu Jianting , Li Jicheng , Gan Yu , Yu YingYing , Tang Jiamei , Mo Ligen , Piao Haozhe
Published: March 2024

Background

Ferroptosis, a non-apoptotic form of cell death induced by accumulation of free iron ions and lipid peroxidation, its importance for cancer treatment is gradually being recognized. Research on the anti-cancer mechanism of juglone is accumulating. However, the specific mechanism by which it directs glioblastoma (GBM) to death is unknown.

Methods

We used in vitro and in vivo experiments to explore the anti-GBM effect generated by juglone through the ferroptosis pathway.

Results

Juglone mainly causes cell death by inducing ferroptosis. Mechanistically, juglone can significantly activate the phosphorylation of p38MAPK. According to transcriptome sequencing and protein interaction analysis, the Nrf2-GPX4 signaling pathway is identified as the primary pathway through which juglone mediates ferroptosis. In vitro and in vivo experiments further verified that juglone induces the ferroptosis of GBM by activating the phosphorylation of p38MAPK and negatively regulating the Nrf2-GPX4 signaling pathway.

Conclusion

Juglone induces ferroptosis and inhibits the growth of GBM by targeting the Nrf2/Gpx4 signaling pathway and thus holds promise as a novel ferroptosis inducer or anti-GBM drug.
The effects of Phoniatric PREhabilitation in Head and Neck Cancer patients on Aspiration and Preservation of Swallowing (PREHAPS): study protocol of a monocentric prospective randomized interventional outcome-blinded trial
Authors: Kuenzel Julian , Duerr Stephan , Vester Sarah , Zeman Florian , Huppertz Gunnar , Koller Michael , Pfleger Gerda , Woertgen Annika , Salloum Hazem , Klinkhammer-Schalke Monika , Pukrop Tobias , Kummer Peter
Published: March 2024

Background

Dysphagia, with its negative impact on life expectancy and quality of life, is a major side effect of head and neck squamous cell carcinoma (HNSCC). In a typical Head and Neck Cancer Center, more than half of patients are affected. Improving treatment, and ideally prevention respectively prehabilitation, therefore seems more than desirable.

Methods

The study is planned as a monocentric, prospective, outcome-blinded, randomized interventional study comparing an advanced phoniatric-logopedic prehabilitation with a control (standard of care). Seventy patients (30 control group, 30 intervention group, 10 drop-out rate of 15%) with an initial diagnosis of invasive HNSCC and curative treatment intention will be included over a period of 17 months. In addition to the previous standard, both groups will undergo both detailed subjective assessment of swallowing function and quality of life by means of various questionnaires and objective analyses by bioelectrical impedance measurements and phoniatric endoscopic swallowing examinations. In the intervention group, risk-related nutritional counseling (face-to-face) and phoniatric-logopedic prehabilitation are provided: detailed counseling with video demonstration and exercises to strengthen and improve the range of motion of the oral, pharyngeal, and laryngeal muscles (guided by exercise diary). Controls are performed at 6 weeks, 3 and 6 months, and 9 or 12 months after the end of therapy during the regular tumor follow-up. Primary study endpoints are swallowing function and emotional distress at 6 weeks of control visit.

Discussion

Prehabilitation measures have already proven successful in other patient groups, e.g., transplant patients. In the field of head and neck oncology, interest in such concepts has increased significantly in recent years. However, usually, only subgroups, e.g., patients with swallowing problems after radiochemotherapy alone, are in focus. Our study aims to investigate the general benefit of prehabilitation with regard to swallowing function, which is so important for protection of aspiration and quality of life.

Trial registration

German Clinical Trials Register DRKS00029676. International Clinical Trials Registry Platform DRKS00029676. Registered on 19 July 2022.
Recurrent bladder leiomyoma: a case report
Authors: Yogeeta Fnu , Malik Zubda , Rauf Sameer Abdul , Devi Muskan , Tooba Fnu , Jamalvi Syed Abdan , Rashid Marium , Erum Humaira
Published: March 2024

Background

Bladder leiomyomas are rare benign growths in the bladder, comprising less than 0.5% of bladder tumors with only 250 cases reported globally. They are more common in women. This case involves a 70-year-old woman with recurrent leiomyoma, presenting with lower urinary tract symptoms and painless hematuria. A recurrent bladder leiomyoma is rarely reported, making its presence exceptionally rare.

Case presentation

A 70-year-old Pakistani woman with hypertension and diabetes presented with lower urinary tract symptoms (LUTS) and painless hematuria. She had a history of similar symptoms in 2010, leading to a diagnosis of bladder leiomyoma via cystoscopy and biopsy. Imaging studies revealed a substantial 3.7 × 4 × 4.0 cm isodense mass with calcifications at the bladder base, along with bladder wall thickening and diverticula. Pathological examination during Transurethral Resection of Bladder Tumor (TURBT) confirmed the presence of bladder tissue with smooth muscle, ruling out malignancy. Immunohistochemical studies supported the diagnosis. A successful TURBT was performed, and the patient recovered well.

Discussion

Recurrent bladder leiomyoma is a rarely-discussed topic in medical literature. This article primarily aims to review existing studies and present a detailed case study, shedding light on this rare phenomenon.
Identification of potential biomarkers for aging diagnosis of mesenchymal stem cells derived from the aged donors
Authors: Hao Miao , Jiang Hongyu , Zhao Yuan , Li Chunyi , Jiang Jinlan
Published: March 2024

Background

The clinical application of human bone-marrow derived mesenchymal stem cells (MSCs) for the treatment of refractory diseases has achieved remarkable results. However, there is a need for a systematic evaluation of the quality and safety of MSCs sourced from donors. In this study, we sought to assess one potential factor that might impact quality, namely the age of the donor.

Methods

We downloaded two data sets from each of two Gene Expression Omnibus (GEO), GSE39035 and GSE97311 databases, namely samples form young (< 65 years of age) and old (> 65) donor groups. Through, bioinformatics analysis and experimental validation to these retrieved data, we found that MSCs derived from aged donors can lead to differential expression of gene profiles compared with those from young donors, and potentially affect the function of MSCs, and may even induce malignant tumors.

Results

We identified a total of 337 differentially expressed genes (DEGs), including two upregulated and eight downregulated genes from the databases of both GSE39035 and GSE97311. We further identified 13 hub genes. Six of them,TBX15, IGF1, GATA2, PITX2, SNAI1andVCAN, were highly expressed in many human malignancies in Human Protein Atlas database. In the MSCs in vitro senescent cell model, qPCR analysis validated that all six hub genes were highly expressed in senescent MSCs. Our findings confirm that aged donors of MSCs have a significant effect on gene expression profiles. The MSCs from old donors have the potential to cause a variety of malignancies. TheseTBX15, IGF1, GATA2, PITX2, SNAI1, VCANgenes could be used as potential biomarkers to diagnosis aging state of donor MSCs, and evaluate whether MSCs derived from an aged donor could be used for therapy in the clinic. Our findings provide a diagnostic basis for the clinical use of MSCs to treat a variety of diseases.

Conclusions

Therefore, our findings not only provide guidance for the safe and standardized use of MSCs in the clinic for the treatment of various diseases, but also provide insights into the use of cell regeneration approaches to reverse aging and support rejuvenation.
Antibacterial activity of the antimicrobial peptide PMAP-36 in combination with tetracycline against porcine extraintestinal pathogenic Escherichia coli in vitro and in vivo
Authors: Tao Qi , Lu Yi , Liu Qian , Chen Runqiu , Xu Yating , Li Gang , Hu Xiaoxiang , Ye Chao , Peng Lianci , Fang Rendong
Published: March 2024

The increase in the emergence of antimicrobial resistance has led to great challenges in controlling porcine extraintestinal pathogenic Escherichia coli (ExPEC) infections. Combinations of antimicrobial peptides (AMPs) and antibiotics can synergistically improve antimicrobial efficacy and reduce bacterial resistance. In this study, we investigated the antibacterial activity of porcine myeloid antimicrobial peptide 36 (PMAP-36) in combination with tetracycline against porcine ExPEC PCN033 both in vitro and in vivo. The minimum bactericidal concentrations (MBCs) of AMPs (PMAP-36 and PR-39) against the ExPEC strains PCN033 and RS218 were 10 μM and 5 μM, respectively. Results of the checkerboard assay and the time-kill assay showed that PMAP-36 and antibiotics (tetracycline and gentamicin) had synergistic bactericidal effects against PCN033. PMAP-36 and tetracycline in combination led to PCN033 cell wall shrinkage, as was shown by scanning electron microscopy. Furthermore, PMAP-36 delayed the emergence of PCN033 resistance to tetracycline by inhibiting the expression of the tetracycline resistance gene tetB. In a mouse model of systemic infection of PCN033, treatment with PMAP-36 combined with tetracycline significantly increased the survival rate, reduced the bacterial load and dampened the inflammatory response in mice. In addition, detection of immune cells in the peritoneal lavage fluid using flow cytometry revealed that the combination of PMAP-36 and tetracycline promoted the migration of monocytes/macrophages to the infection site. Our results suggest that AMPs in combination with antibiotics may provide more therapeutic options against multidrug-resistant porcine ExPEC.
A secure cross-domain authentication scheme based on threshold signature for MEC
Authors: Chen Lei , Guo Chong , Gong Bei , Waqas Muhammad , Deng Lihua , Qin Haowen
Published: March 2024

The widespread adoption of fifth-generation mobile networks has spurred the rapid advancement of mobile edge computing (MEC). By decentralizing computing and storage resources to the network edge, MEC significantly enhances real-time data access services and enables efficient processing of large-scale dynamic data on resource-limited devices. However, MEC faces considerable security challenges, particularly in cross-domain service environments, where every device poses a potential security threat. To address this issue, this paper proposes a secure cross-domain authentication scheme based on a threshold signature tailored to MEC’s multi-subdomain nature. The proposed scheme employs a (t,n) threshold mechanism to bolster system resilience and security, catering to large-scale, dynamic, and decentralized MEC scenarios. Additionally, the proposed scheme features an efficient authorization update function that facilitates the revocation of malicious nodes. Security analysis confirmed that the proposed scheme satisfies unforgeability, collusion resistance, non-repudiation and forward security. Theoretical evaluation and experimental simulation verify the effectiveness and feasibility of the proposed scheme. Compared with existing schemes, the proposed scheme has higher computational performance while implementing secure authorization updates.
Development and application of a high-performance liquid chromatography diode-array detection (HPLC–DAD) method for the simultaneous quantification of phenolic compounds in the aerial part of Glehnia littoralis
Authors: Park Yun Ji , Choi Yeong Bin , Oh Sang-Bin , Moon Jinyoung , Truong To Quyen , Huynh Phuong Kim , Kim Sang Min
Published: March 2024

Glehnia littoralis, a medicinal herb employed in traditional practices for alleviating fatigue, cough, and a dry throat, is recognized for its beneficial properties due to a diverse array of active compounds found in its extracts. For example, the G. littoralis roots (Radix Glehniae) mainly contain coumarins and phenolic acids, serving as the primary focus of this study. Despite the widespread use of the tools in various industries and the development of multiple analytical methods for their examination, the edible aerial parts have industrial potential, and there is currently no analytical method available to identify their key components. In this study, a high-performance liquid chromatography method combined with diode array detection (HPLC–DAD) was developed to simultaneously detect 16 phenolic compounds previously reported to be present in the edible aerial parts of G. littoralis. The proposed approach included using gradient elution to change the solvent system from water/acetonitrile to water/methanol. Furthermore, the method validation was conducted, assessing its linearity, limit of detection, limit of quantification, precision, accuracy, and recovery, all of which demonstrated satisfactory results. Subsequently, the developed method was applied to quantify the phenolic compounds in various G. littoralis samples obtained from different organs, solvent extraction processes, and processing methods. Moreover, the online HPLC-ABTS (2,2ʹ-azino-bis(3-ethylbenzthiazoline-6-sulfonic acid) assay was used to evaluate the antioxidant capacities of individual constituents, identifying four important antioxidants and estimate the overall antioxidant capacity of the G. littoralis extract.
Structural rearrangements as a recurrent pathogenic mechanism for SETBP1 haploinsufficiency
Authors: Alesi V. , Genovese S. , Roberti M. C. , Sallicandro E. , Di Tommaso S. , Loddo S. , Orlando V. , Pompili D. , Calacci C. , Mei V. , Pisaneschi E. , Faggiano M. V. , Morgia A. , Mammì C. , Astrea G. , Battini R. , Priolo M. , Dentici M. L. , Milone R. , Novelli A.
Published: March 2024

Chromosomal structural rearrangements consist of anomalies in genomic architecture that may or may not be associated with genetic material gain and loss. Evaluating the precise breakpoint is crucial from a diagnostic point of view, highlighting possible gene disruption and addressing to appropriate genotype–phenotype association. Structural rearrangements can either occur randomly within the genome or present with a recurrence, mainly due to peculiar genomic features of the surrounding regions. We report about three non-related individuals, harboring chromosomal structural rearrangements interrupting SETBP1, leading to gene haploinsufficiency. Two out of them resulted negative to Chromosomal Microarray Analysis (CMA), being the rearrangement balanced at a microarray resolution. The third one, presenting with a complex three-chromosome rearrangement, had been previously diagnosed with SETBP1 haploinsufficiency due to a partial gene deletion at one of the chromosomal breakpoints. We thoroughly characterized the rearrangements by means of Optical Genome Mapping (OGM) and Whole Genome Sequencing (WGS), providing details about the involved sequences and the underlying mechanisms. We propose structural variants as a recurrent event in SETBP1 haploinsufficiency, which may be overlooked by laboratory routine genomic analyses (CMA and Whole Exome Sequencing) or only partially determined when associated with genomic losses at breakpoints. We finally introduce a possible role of SETBP1 in a Noonan-like phenotype.
Gas exchange and chlorophyll fluorescence responses of Camellia sinensis grown under various cultivations in different seasons
Authors: Chen Chung-I , Lin Kuan-Hung , Huang Meng-Yuan , Yang Chih-Kai , Lin Yu-Hsiu , Hsueh Mei-Li , Lee Li-Hua , Lin Shiou-Ruei , Wang Ching-Wen
Published: March 2024

Sod culture (SC) and conventional agriculture (CA) represent two distinct field management approaches utilized in the cultivation of tea plants in Taiwan. In this study, we employed gas exchange and chlorophyll fluorescence techniques to assess the impact of SC and CA methods on the photosynthetic machinery of Camellia sinensis cv. TTES No.12 (Jhinhsuan) in response to variable light intensities across different seasons. In spring, at photosynthetic photon flux densities (PPFD) ranging from 800 to 2,000 μmol photon m-2 s-1, the net photosynthesis rate (Pn, 10.43 μmol CO2 m-2 s-1), stomatal conductance (Gs, 126.11 mmol H2O m-2 s-1), electron transport rate (ETR, 137.94), and ΔF/Fm’ and Fv/Fm (50.37) values for plants grown using SC were comparatively higher than those cultivated under CA. Conversely, the non-photochemical quenching (NPQ) values for SC-grown plants were relatively lower (3.11) compared to those grown under CA at 800 to 2,000 PPFD in spring. Additionally, when tea plants were exposed to PPFD levels below 1,500 μmol photon m− 2 s− 1, there was a concurrent increase in Pn, Gs, ETR, and NPQ. These photosynthetic parameters are crucial for devising models that optimize cultivation practices across varying seasons and specific tillage requirements, and for predicting photosynthetic and respiratory responses of tea plants to seasonally or artificially altered light irradiances. The observed positive impacts of SC on maximum photosynthetic rate (Amax), Fv/Fm, Gs, water-use efficiency (WUE), and ETR suggest that SC is advantageous for enhancing the productivity of tea plants, thereby offering a more adaptable management model for tea gardens.
Biomechanical analysis of the human derived soft tissue graft Epiflex for use in oral soft tissue augmentation
Authors: Sagheb Keyvan , Noelken Robert , Schröger Saskia-Vanessa , Walter Christian , Graef Julian Jakob , Schumann Sven
Published: March 2024

Purpose

This study aimed to investigate the biomechanical properties, cell migration, and revascularization of the acellular dermal matrix Epiflex. As a decellularized, freeze–dried human skin graft, Epiflex has broad applications in medical fields, particularly in implantology and dentistry. Understanding its biomechanical characteristics is crucial for its clinical adoption as a novel soft tissue graft option.

Methods

Epiflex (n = 3) was evaluated in comparison to palatal tissue from body donors (n = 3). Key metrics, such as elongation and tear resistance, were quantified. Both graft types underwent histological analysis and scanning electron microscopy. Additionally, the healing properties of Epiflex were assessed using a Chorioallantoic Membrane (CAM) Assay.

Results

Biomechanically, Epiflex (mean = 116.01 N) demonstrated the ability to withstand greater forces (p = 0.013) than human palatal tissue (mean = 12.58 N). When comparing the elongation, no significant difference was measured (ASG mean = 9.93 mm, EF mean = 9.7 mm). Histologically, Epiflex exhibited a loosely connected network of collagen fibers with a dense upper layer. The CAM Assay indicated efficient revascularization.

Conclusion

Epiflex appears to be a viable option for soft tissue augmentation, particularly appealing to patient groups who avoid all or specific animal-derived products due to ethical or religious reasons.

Graphical Abstract
Early detection of occupational cholangiocarcinoma in a high-risk patient under intensive surveillance: a case study
Authors: Kounami Naoko , Maeda Sakae , Kitagawa Akihiro , Tomihara Hideo , Ushimaru Yuki , Ohara Nobuyoshi , Takeoka Tomohira , Imasato Mitsunobu , Kawabata Ryohei , Noura Shingo , Yasuhara Yumiko , Miyamoto Atsushi
Published: March 2024

Background

Occupational cholangiocarcinoma is associated with exposure to organic solvents, such as dichloromethane (DCM) and 1,2-dichloropropane (DCP). This report describes a case of occupational cholangiocarcinoma detected through regularly imaging following the discovery of elevated serum γ-glutamyl trans peptidase (γ-GTP) levels revealed during regular checkup.

Case presentation

A 43-year-old man who had been working in a printing company with 15 years of exposure to organic solvents presented to our hospital owing to abnormalities found during a routine checkup. Ultrasound (US) imaging revealed thickening of the gallbladder wall accompanied by gallstones, although in the blood tests, γ-GTP levels were within normal range. Given the high risk of cholangiocarcinoma development, the patient underwent regular monitoring with abdominal US and blood tests at a local doctor's office. At the age of 48, his serum γ-GTP level mildly elevated for the first time, prompting the initiation of semi-annual magnetic resonance cholangiopancreatography (MRCP). By the age of 50 years, dilation in B8 was detected, and one and a half years later, a tumor on the central side of the B8 dilation appeared. The patient was diagnosed with intrahepatic cholangiocarcinoma, which was treated with anterior sectionectomy. Pathological examination revealed an adenocarcinoma with a papillary glandular ductal structure at the root of the B8. In addition, biliary intraepithelial neoplasia (BilIN) and dysplasia have been identified around the tumor and periphery bile ducts and in noncancerous bile ducts. Postoperatively, the patient received 6 months of adjuvant chemotherapy with S-1monotherapy. Eight months after surgery, the patient remained under observation with no signs of recurrence.

Conclusions

We report a case of occupational cholangiocarcinoma detected during a prolonged period of regular follow-up after exposure to DCM and DCP. Given the delayed carcinogenesis process, occupational cholangiocarcinomas manifest long after exposure to organic solvents, therefore, ongoing screening is extremely important. Vigilance is essential to avoid underdiagnosis, particularly for individuals who are at an increased risk of developing this form of cancer. Continuous monitoring is key to the early detection and effective management of occupational cholangiocarcinoma.
Lifestyle counselling as secondary prevention in patients with minor stroke or transient ischemic attack: a randomized controlled pilot study
Authors: Liljehult Jacob , Molsted Stig , Møller Tom , Overgaard Dorthe , Christensen Thomas
Published: March 2024

Background

Patients with minor stroke or transient ischemic attacks have an increased risk of future strokes. These patients are often discharged home with limited specialized follow-up, although close to half of them experience cognitive deficits. Simple encouragements to avoid smoking, be physically active, and to take preventive medication are often insufficient to ensure adherence and more comprehensive interventions are needed to support the patients in adapting healthy behaviour. The aim of this study was to test the feasibility and potential effect of an early initiated, patient-centred intervention to patients with minor stroke or transient ischemic attacks targeting smoking, physical activity, and medication adherence, in a randomized, controlled pilot trial.

Methods

Hospitalized patients were randomized to usual care or an intervention consisting of health behavioural counselling based on the 5A’s model, telephone follow-up (4 and 8 weeks), and monitoring of physical activity. Follow-up time was 12 weeks. Feasibility was on the following domains: eligibility, acceptance, demand and practicality, adherence, attrition, and implementation and integration.

Results

Forty patients of 84 potentially eligible were randomized to the two treatment arms (20 intervention/20 usual care). Thirty-two completed the 12-week follow-up, while 8 were either excluded or lost to follow-up. With few changes, the intervention was feasible and possible to deliver according to the protocol.

Conclusion

It was possible to identify relevant patients who could potentially benefit from a behavioural intervention, recruit and randomize them early after admission and retain most participants in the study until follow-up and derive statistical estimates to guide the design of large-scale randomized controlled trials.

Trial registration

ClinicalTrials.gov Identifier: NCT03648957. Registered 28 August 2018.
Evaluating the role of social context and environmental factors in mediating overwintering physiology in honey bees (Apis mellifera)
Authors: Quinlan Gabriela M. , Grozinger Christina M.
Published: March 2024

In temperate climates, honey bees show strong phenotypic plasticity associated with seasonal changes. In summer, worker bees typically only survive for about a month and can be further classified as young nurse bees (which feed the developing brood) and older forager bees. In winter, brood production and foraging halt and the worker bees live for several months. These differences in task and longevity are reflected in their physiology, with summer nurses and long-lived winter bees typically having large fat bodies, high expression levels of vitellogenin (a longevity-, nutrition- and immune-related gene), and large provisioning glands in their head. The environmental factors (both within the colony and within the surrounding environment) that trigger this transition to long-lived winter bees are poorly understood. One theory is that winter bees are an extended nurse bee state, brought on by a reduction in nursing duties in autumn (i.e. lower brood area). We examined that theory here by assessing nurse bee physiology in both the summer and autumn, in colonies with varying levels of brood. We found that season is a better predictor of nurse bee physiology than brood area. This suggests that seasonal factors beyond brood area, such as pollen availability and colony demography, may be necessary for inducing the winter bee phenotype. This finding furthers our understanding of winter bee biology, which could have important implications for colony management for winter, a critical period for colony survival.
Dramatherapy performance and schizophrenia
Authors: Γιώτης Λάμπρος
Published: March 2024

Η έρευνα αυτή διερευνά την επίδραση της κατασκευής μιας θεραπευτικής παράστασης στο πλαίσιο δραματοθεραπευτικής πρακτικής για θεραπευόμενους με σχιζοφρένεια. Η «Δραματοθεραπευτική Παράσταση», ορίζεται και παρουσιάζεται ως ένα ειδικό πρότυπο θεραπευτικής μεθόδου που περιλαμβάνει τη θεραπευτική διεργασία κατασκευής μιας θεατρικής παράστασης από θεραπευόμενους και της παρουσίασής της σε προσκεκλημένο κοινό που αποτελείται από τους Σημαντικούς τους Άλλους. Το πλαίσιο των δεδομένων μεθόδων αξιολόγησης στη Δραματοθεραπεία περιλαμβάνει είτε την ανάπτυξη δεξιοτήτων από τους θεραπευόμενους μέσω ομαδικής διεργασίας, όπως η υπόδυση ρόλων ή η δραματική συμμετοχή, ή τη μεταβολή των συμπτωμάτων τους μετά από μια ομαδική διεργασία, όπως μετράται από υπάρχουσες ψυχομετρικές κλίμακες. Ωστόσο, δεν έχει κατασκευαστεί έως τώρα κάποια ειδική μέθοδος αξιολόγησης της διεργασίας μιας θεατρικής παράστασης προς χρήση στην κλινική πρακτική. Για τον λόγο αυτό, επινοήθηκε ένα καινούργιο εργαλείο αξιολόγησης αυτής της θεραπευτικής μεθόδου, που συνδυάζει τη θεατρική με την ψυχιατρική σημειολογία και ονομάστηκε «Αξιολόγηση Δραματοθεραπευτικής Παράστασης». Πηγή έμπνευσης του εργαλείου αυτού, που αναλύει τα δομικά στοιχεία μιας παράστασης σε σχέση με τη σχιζοφρενική ψυχοπαθολογία ασθενών, αποτέλεσε η Ποιητική του Αριστοτέλη, που χρησιμοποιήθηκε για πρώτη φορά για λόγους εκτίμησης στη Δραματοθεραπεία. Επιπλέον, η ερευνητική αυτή μελέτη εξετάζει την επίδραση μιας δραματοθεραπυτικής παράστασης στη συνολική ψυχοπαθολογία ασθενών με σχιζοφρένεια και στη σχέση τους με Εαυτό και Άλλους. Μια κλινική έρευνα σε Νοσοκομείο Ημέρας για νεαρούς ενήλικες με σχιζοφρενική διαταραχή οδήγησε στην ποιοτική αξιολόγηση της θεραπευτικής διεργασίας και στην ποσοτική μέτρηση της μεταβολής των συμπτωμάτων των θεραπευόμενων. Τα αποτελέσματα αυτής της μελέτης κατέδειξαν ότι η «Δραματοθεραπευτική Παράσταση»ς είχε σημαντική επίδραση στη δραματική συμμετοχή των θεραπευόμενων μέσα στην ομαδική διεργασία, τη μείωση της συνολικής ψυχοπαθολογίας των αρνητικών συμπτωμάτων, τη βελτίωση της απόδοσης και αποτελεσματικότητάς τους και τη μεταβολή της υποστήριξης που θεωρούν ότι λαμβάνουν από τους Σημαντικούς τους Άλλους. Η «Αξιολόγηση Δραματοθεραπευτικής Παράστασης» έδειξε την σημασία μιας ενωτικής καθαρτικής δομής μιας τέτοιας παράστασης όπως και ότι οι μη λεκτικές θεραπευτικές διεργασίες ενισχύουν την επίδραση των λεκτικών διεργασιών. Ακόμη, διαφοροποίησε την αποτελεσματικότητα των ομαδικών τεχνικών - όπως τη συμμετοχή σε ένα χορικό - προς όφελος των λιγότερο λειτουργικών ασθενών σε αντιδιαστολή με τη διεργασία μέσω θεατρικών χαρακτήρων προς όφελος των περισσότερο λειτουργικών ασθενών. Η έρευνα αυτή επιβεβαιώνει την αξία μιας «Δραματοθεραπευτικής Παράστασης» ως ειδική θεραπεία για σχιζοφρενικά συμπτώματα σε συνδυασμό με τη φαρμακευτική αγωγή και προσφέρει στη δραματοθεραπευτική πρακτική ένα καινούργιο και χρήσιμο εργαλείο για την αξιολόγηση τόσο της θεραπευτικής διεργασίας όσο και της προόδου ασθενών με σχιζοφρένεια.
Patient decision-making in left ventricular assist devices for destination therapy
Authors: Morrison Megan L
Published: March 2024

Background:

Heart failure is a common life-limiting disease. A destination therapy for people who will not have a heart transplant is a left ventricular assist device.

Aims:

To discover how patients who have a left ventricular assist device for destination therapy make decisions about their healthcare after implantation of the device.

Methods:

A descriptive qualitative design with semi-structured, in-depth interviews with 11 participants who are living with a left ventricular assist device for destination therapy.

Findings:

People with a left ventricular assist device felt they had ‘no choice’ when making decisions about their healthcare.

Conclusion:

Engaging with patients to contemplate present and future healthcare decisions is a complex process that includes cognitive processes within the patient. Clinicians need to be aware that a gap may occur between what is said and what is heard in communication.
Implant retention in a rabbit model of fracture-related infection
Authors: Puetzler Jan , Vallejo Diaz Alejandro , Gosheger Georg , Schulze Martin , Arens Daniel , Zeiter Stephan , Siverino Claudia , Richards Robert G. , Moriarty Thomas F.
Published: March 2024

Aims

Fracture-related infection (FRI) is commonly classified based on the time of onset of symptoms. Early infections (< two weeks) are treated with debridement, antibiotics, and implant retention (DAIR). For late infections (> ten weeks), guidelines recommend implant removal due to tolerant biofilms. For delayed infections (two to ten weeks), recommendations are unclear. In this study we compared infection clearance and bone healing in early and delayed FRI treated with DAIR in a rabbit model.

Methods

Staphylococcus aureus was inoculated into a humeral osteotomy in 17 rabbits after plate osteosynthesis. Infection developed for one week (early group, n = 6) or four weeks (delayed group, n = 6) before DAIR (systemic antibiotics: two weeks, nafcillin + rifampin; four weeks, levofloxacin + rifampin). A control group (n = 5) received revision surgery after four weeks without antibiotics. Bacteriology of humerus, soft-tissue, and implants was performed seven weeks after revision surgery. Bone healing was assessed using a modified radiological union scale in tibial fractures (mRUST).

Results

Greater bacterial burden in the early group compared to the delayed and control groups at revision surgery indicates a retraction of the infection from one to four weeks. Infection was cleared in all animals in the early and delayed groups at euthanasia, but not in the control group. Osteotomies healed in the early group, but bone healing was significantly compromised in the delayed and control groups.

Conclusion

The duration of the infection from one to four weeks does not impact the success of infection clearance in this model. Bone healing, however, is impaired as the duration of the infection increases.

Cite this article: Bone Joint Res 2024;13(3):127–135.