bluuebunny/crossref_metadata_2025 huggingface dataset:
Purpose in Life and Risk of Falls: A Meta-Analysis of Cross-Sectional and Prospective Associations
Authors: Sutin Angelina R. , Luchetti Martina , Stephan Yannick , Canada Brice , Terracciano Antonio
Published: March 2024

Background and Aim: Purpose in life is an aspect of well-being that is associated with better health outcomes in older adulthood. We examine the association between purpose in life and likelihood of a recent fall and risk of an incident fall over time. Methods: Purpose in life and falls were reported concurrently and falls were reported again up to 16 years later in four established longitudinal studies of older adults (total N = 25,418). Results: A random-effects meta-analysis of the four samples indicated that purpose was associated with a 14% lower likelihood of having fallen recently at baseline (meta-analytic OR = 0.88, 95% CI [0.84–0.92]). Among participants who reported no falls at baseline ( N = 15,632), purpose was associated with a nearly 10% lower risk of an incident fall over the up to 16-year follow-up (meta-analytic HR = 0.92, 95% CI [0.90–0.94]). These associations were independent of age, sex, race, ethnicity, and education, were not moderated by these factors, and persisted controlling for physical activity and disease burden. Conclusion and Recommendations: Purpose in life is a meaningful aspect of well-being that may be useful to identify individuals at risk for falling, particularly among individuals without traditional risk factors, and be a target of intervention to reduce fall risk.
Perceived Challenges and Emotional Responses in the Daily Lives of Older Adults With Disabilities: A Text Mining Study
Authors: Choi Soyoung
Published: March 2024

This study explored the daily challenges and emotional reactions experienced by older adults living with various disabilities, employing both traditional and text mining approaches to ensure rigorous interpretation of qualitative data. In addition to employing a traditional qualitative data analysis method, such as thematic analysis, this paper also leveraged a text mining approach. By utilizing topic modeling and sentiment analysis, the study attempted to mitigate potential researcher bias and diminishes subjectivity in interpreting qualitative data. The findings indicated that older adults with visual impairments predominantly encountered challenges related to navigation, technology utilization, and online shopping. Individuals with hearing impairments chiefly struggled with communicating with healthcare providers, while those with mobility impairments face significant barriers in public participation and managing personal hygiene, such as showering. A prevailing sentiment of negative emotional states was identifiable among all participant groups, with those having visual impairments exhibiting more pronounced negative language patterns. The challenges perceived by participants varied depending on the types of disabilities they have. This study can serve as a valuable reference for researchers interested in a mixed-method strategy that combines conventional qualitative analysis with machine-assisted text analysis, illuminating the varied daily experiences and needs of the older adult population with disabilities.
Opinion Article on Empowering Nurses: The Cornerstone of Exceptional Patient Care
Authors: Dalab Maram
Published: March 2024

The patients’ journey is a complex network involving multiple layers of impactful stakeholders, among these stakeholders are nurses. Nurses’ impact is critical to achieving better health outcomes and an uplifted experience, yet there are gaps in supporting nurses and empowering them to maximize their contribution to patients. Empowering nurses can take place in the form of educational support, recognition, and reducing their workload to limit their burn-out. The impact of such support to nurses would result in improved health outcomes, reduced mortality rates and an increase in patient satisfaction.
Network-entropy-based morphological polycentricity in 1851-1881 England and Wales
Authors: Mazzamurro Matteo , Guo Weisi
Published: March 2024

A system of cities is morphologically polycentric when its cities are similarly sized and evenly spaced across its territory. In this paper, we adapt established spatial interaction models and entropy-based measures of heterogeneity of weighted networks to the problem of measuring morphological polycentricity. We study the evolution of the morphological polycentricity of the system of English and Welsh towns from 1851 to 1881, a period characterised by rapid urbanisation and expansion of railways. Our approach enables us to account for morphological aspects of the system that are often neglected by existing measures of morphological polycentricity, such as the evolution of transport infrastructure and its impact on travel distances. We show that the trend towards a greater concentration of the population in fewer urban centres in England and Wales was accompanied by a more diverse network of connections and potential intercity interactions.
Testing an implementation package in a housing skills training pilot for homeless-experienced persons with serious mental illness
Authors: Gabrielian Sonya , Hamilton Alison B. , Gelberg Lillian , Koosis Ella R. , Hoffmann Lauren , Carlson David M. , Young Alexander S.
Published: March 2024

Background

Evidence-based practices (EBPs) improve housing and health for persons who have experienced homelessness with serious mental illness (PEH-SMI) but are challenging to implement. We tested a strategy to support pilot implementation of a 12-session housing skills training intervention for PEH-SMI, tailored from effective social skills training interventions. We aimed to optimize the implementation strategy and intervention prior to an implementation trial.

Method

We provided training and technical assistance to nine providers to support pilot implementation of this intervention to six groups of PEH-SMI ( n = 35) engaged in VA Greater Los Angeles’ homeless services. We used scales and semi-structured interviews with 14 PEH-SMI and all interventionists to inform implementation strategy adaptations, identify factors that impacted implementation, and assess perceptions of the intervention. Attendance was tracked and we observed a random sample of each interventionist's groups to assess treatment fidelity.

Results

Interventionists perceived the implementation strategy and the intervention favorably. However, interventionists often lacked physical space, staff, and resources (e.g., computers) to conduct the intervention. Interventionists found the content valuable for participants and a few suggested that group engagement should be a prerequisite for obtaining housing services. PEH-SMI were interested in the intervention's content and receptive to the group-based format. Participants attended a mean of 4 ± 3/12 groups; all groups observed had acceptable fidelity. Problems with intervention retention were described, suggesting challenges maintaining group participation when participants transitioned between VA homeless services.

Conclusions

To support the implementation of an EBP for PEH-SMI in homeless programs, these data suggest the value of training/technical assistance and strategies that enhance program-level buy-in to address resource concerns. Intervention adaptations, e.g., using a drop-in, open group format, in community-based settings that are easily accessible to PEH-SMI, may also increase adoption. This project was registered as “Improving Housing Outcomes for Homeless Veterans” Trial registration NCT03646149, registered 8/24/2018.
Digital food apartheid: The uneven food geographies of Seattle in the era of Amazon
Authors: Vaughan-Wynn Natalie , Jung Jin-Kyu
Published: March 2024

This article puts forward the concept of “digital food apartheid” to articulate differentiation in terms of one’s agency concerning their food that is mediated by, reified through, or materialized from data or digital infrastructure given the omnipresence of racial capitalism. We examine the digitization of public food assistance in the United States in conversation with Black digital geographies, food geographies, and critical GIS, paying particular attention to the US Department of Agriculture’s COVID-19-era Online Grocery Purchase Program (OPP), which gives Supplemental Nutrition Assistance Program (SNAP) participants access to online grocery shopping and delivery. We call into question the conditions of possibility that gave rise to this program through a historicization of US food assistance. Empirically, we map the “Amazon Fresh” grocery delivery area around Seattle overlaid with SNAP participants and census tracts designated as “low income and low food access” by the US Department of Agriculture (USDA) to visualize the program’s current operationalization. Our critical GIS approach allows us to analyze our empirics in relation to the rhetorical and political moves of the state to demonstrate how digital food apartheid determines which foods are marketed to, available to, and accessible to whom.
Germ line genetic NBN variation and predisposition to B-cell acute lymphoblastic leukemia in children
Authors: Escherich Carolin S. , Chen Wenan , Li Yizhen , Yang Wenjian , Nishii Rina , Li Zhenhua , Raetz Elizabeth A. , Devidas Meenakshi , Wu Gang , Nichols Kim E. , Inaba Hiroto , Pui Ching-Hon , Jeha Sima , Camitta Bruce M. , Larsen Eric , Hunger Stephen P. , Loh Mignon L. , Yang Jun J.
Published: March 2024

Biallelic mutation in the DNA-damage repair gene NBN is the genetic cause of Nijmegen breakage syndrome, which is associated with predisposition to lymphoid malignancies. Heterozygous carriers of germ line NBN variants may also be at risk for leukemia development, although this is much less characterized. By sequencing 4325 pediatric patients with B-cell acute lymphoblastic leukemia (B-ALL), we systematically examined the frequency of germ line NBN variants and identified 25 unique, putatively damaging NBN coding variants in 50 patients. Compared with the frequency of NBN variants in gnomAD noncancer controls (189 unique, putatively damaging NBN coding variants in 472 of 118 479 individuals), we found significant overrepresentation in pediatric B-ALL (P = .004; odds ratio, 1.8). Most B-ALL–risk variants were missense and cluster within the NBN N-terminal domains. Using 2 functional assays, we verified 14 of 25 variants with severe loss-of-function phenotypes and thus classified these as nonfunctional or partially functional. Finally, we found that germ line NBN variant carriers, all of whom were identified as heterozygous genotypes, showed similar survival outcomes relative to those with wild type status. Taken together, our findings provide novel insights into the genetic predisposition to B-ALL, and the impact of NBN variants on protein function and suggest that heterozygous NBN variant carriers may safely receive B-ALL therapy. These trials were registered at www.clinicaltrials.gov as #NCT01225874, NCT00075725, NCT00103285, NCI-T93-0101D, and NCT00137111.
Acute pulmonary injury in hematology patients supported with pathogen-reduced and conventional platelet components
Authors: Wheeler Allison P. , Snyder Edward L. , Refaai Majed , Cohn Claudia S. , Poisson Jessica , Fontaine Magali , Sehl Mary , Nooka Ajay K. , Uhl Lynne , Spinella Philip C. , Fenelus Maly , Liles Darla , Coyle Thomas , Becker Joanne , Jeng Michael , Gehrie Eric A. , Spencer Bryan R. , Young Pampee , Johnson Andrew , O’Brien Jennifer J. , Schiller Gary J. , Roback John D. , Malynn Elizabeth , Jackups Ronald , Avecilla Scott T. , Liu Kathy , Bentow Stanley , Varrone Jeanne , Benjamin Richard J. , Corash Laurence M.
Published: March 2024

Patients treated with antineoplastic therapy often develop thrombocytopenia requiring platelet transfusion, which has potential to exacerbate pulmonary injury. This study tested the hypothesis that amotosalen-UVA pathogen–reduced platelet components (PRPCs) do not potentiate pulmonary dysfunction compared with conventional platelet components (CPCs). A prospective, multicenter, open-label, sequential cohort study evaluated the incidence of treatment-emergent assisted mechanical ventilation initiated for pulmonary dysfunction (TEAMV-PD). The first cohort received CPC. After the CPC cohort, each site enrolled a second cohort transfused with PRPC. Other outcomes included clinically significant pulmonary adverse events (CSPAE) and the incidence of treatment-emergent acute respiratory distress syndrome (TEARDS) diagnosed by blinded expert adjudication. The incidence of TEAMV-PD in all patients (1068 PRPC and 1223 CPC) was less for PRPC (1.7 %) than CPC (3.1%) with a treatment difference of –1.5% (95% confidence interval [CI], –2.7 to –0.2). In patients requiring ≥2 PCs, the incidence of TEAMV-PD was reduced for PRPC recipients compared with CPC recipients (treatment difference, –2.4%; 95% CI, –4.2 to –0.6). CSPAE increased with increasing PC exposure but were not significantly different between the cohorts. For patients receiving ≥2 platelet transfusions, TEARDS occurred in 1.3% PRPC and 2.6% CPC recipients (P = .086). Bayesian analysis demonstrated PRPC may be superior in reducing TEAMV-PD and TEARDS for platelet transfusion recipients compared with CPC recipients, with 99.2% and 88.8% probability, respectively. In this study, PRPC compared with CPC demonstrated high probability of reduced severe pulmonary injury requiring assisted mechanical ventilation in patients with hematology disorders dependent on platelet transfusion. This trial was registered at www.ClinicalTrials.gov as #NCT02549222.
Large-scale analysis of the N-terminal regulatory elements of the kinase domain in plant Receptor-like kinase family
Authors: Fu Qiong , Liu Qian , Zhang Rensen , Chen Jia , Guo Hengchang , Ming Zhenhua , Yu Feng , Zheng Heping
Published: March 2024

Background

The N-terminal regulatory element (NRE) of Receptor-like kinases (RLKs), consisting of the juxtamembrane segment in receptor kinases (RKs) and the N-terminal extension segment in RLCKs, is a crucial component that regulates the activities of these proteins. However, the features and functions of the NRE have remained largely unexplored. Herein, we comprehensively analyze 510,233 NRE sequences in RLKs from 528 plant species, using information theory and data mining techniques to unravel their common characteristics and diversity. We also use recombinant RKs to investigate the function of the NRE in vitro.

Results

Our findings indicate that the majority of NRE segments are around 40–80 amino acids in length and feature a serine-rich region and a 14-amino-acid consensus sequence, ‘FSYEELEKAT[D/N]NF[S/D]’, which contains a characteristic α-helix and ST motif that connects to the core kinase domain. This conserved signature sequence is capable of suppressing FERONIA’s kinase activity. A motif discovery algorithm identifies 29 motifs with highly conserved phosphorylation sites in RK and RLCK classes, especially the motif ‘VGPWKpTGLpSGQLQKAFVTGVP’ in LRR-VI-2 class. Phosphorylation of an NRE motif in an LRR-VI-2 member, MDIS1, modulates the auto-phosphorylation of its co-receptor, MIK1, indicating the potential role of NRE as a ‘kinase switch’ in RLK activation. Furthermore, the characterization of phosphorylatable NRE motifs improves the accuracy of predicting phosphorylatable sites.

Conclusions

Our study provides a comprehensive dataset to investigate NRE segments from individual RLKs and enhances our understanding of the underlying mechanisms of RLK signal transduction and kinase activation processes in plant adaptation.
Nutrient availability and plant phenological stage influence the substrate microbiome in container-grown Impatiens walleriana ‘Xtreme Red’
Authors: Quijia Pillajo Juan , Chapin Laura J. , Quiroz-Moreno Cristian D. , Altland James E. , Jones Michelle L.
Published: March 2024

Background

The microbiome plays a fundamental role in plant health and performance. Soil serves as a reservoir of microbial diversity where plants attract microorganisms via root exudates. The soil has an important impact on the composition of the rhizosphere microbiome, but greenhouse ornamental plants are commonly grown in soilless substrates. While soil microbiomes have been extensively studied in traditional agriculture to improve plant performance, health, and sustainability, information about the microbiomes of soilless substrates is still limited. Thus, we conducted an experiment to explore the microbiome of a peat-based substrate used in container production of Impatiens walleriana, a popular greenhouse ornamental plant. We investigated the effects of plant phenological stage and fertilization level on the substrate microbiome.

Results

Impatiens plants grown under low fertilization rates were smaller and produced more flowers than plants grown under optimum and high fertilization. The top five bacterial phyla present in the substrate were Proteobacteria, Actinobacteria, Bacteriodota, Verrucomicrobiota, and Planctomycetota. We found a total of 2,535 amplicon sequence variants (ASV) grouped into 299 genera. The substrate core microbiome was represented by only 1.8% (48) of the identified ASV. The microbiome community composition was influenced by plant phenological stage and fertilizer levels. Phenological stage exhibited a stronger influence on microbiome composition than fertilizer levels. Differential abundance analysis using DESeq2 identified more ASVs significantly affected (enriched or depleted) in the high fertilizer levels at flowering. As observed for community composition, the effect of plant phenological stage on microbial community function was stronger than fertilizer level. Phenological stage and fertilizer treatments did not affect alpha-diversity in the substrate.

Conclusions

In container-grown ornamental plants, the substrate serves as the main microbial reservoir for the plant, and the plant and agricultural inputs (fertilization) modulate the microbial community structure and function of the substrate. The differences observed in substrate microbiome composition across plant phenological stage were explained by pH, total organic carbon (TOC) and fluoride, and across fertilizer levels by pH and phosphate (PO4). Our project provides an initial diversity profile of the bacteria occurring in soilless substrates, an underexplored source of microbial diversity.
Lessons learned from implementation of four HIV self-testing (HIVST) distribution models in Zambia: applying the Consolidated Framework for Implementation Research to understand impact of contextual factors on implementation
Authors: Simwinga Musonda , Gwanu Lwiindi , Hensen Bernadette , Sigande Lucheka , Mainga Mwami , Phiri Thokozile , Mwanza Eliphas , Kabumbu Mutale , Mulubwa Chama , Mwenge Lawrence , Bwalya Chiti , Kumwenda Moses , Mubanga Ellen , Mee Paul , Johnson Cheryl C. , Corbett Elizabeth L. , Hatzold Karin , Neuman Melissa , Ayles Helen , Taegtmeyer Miriam
Published: March 2024

Background

Although Zambia has integrated HIV-self-testing (HIVST) into its Human Immunodeficiency Virus (HIV) regulatory frameworks, few best practices to optimize the use of HIV self-testing to increase testing coverage have been documented. We conducted a prospective case study to understand contextual factors guiding implementation of four HIVST distribution models to inform scale-up in Zambia.

Methods

We used the qualitative case study method to explore user and provider experiences with four HIVST distribution models (two secondary distribution models in Antenatal Care (ANC) and Antiretroviral Therapy (ART) clinics, community-led, and workplace) to understand factors influencing HIVST distribution. Participants were purposefully selected based on their participation in HIVST and on their ability to provide rich contextual experience of the distribution models. Data were collected using observations (n = 31), group discussions (n = 10), and in-depth interviews (n = 77). Data were analyzed using the thematic approach and aligned to the four Consolidated Framework for Implementation Research (CFIR) domains.

Results

Implementation of the four distribution models was influenced by an interplay of outer and inner setting factors. Inadequate compensation and incentives for distributors may have contributed to distributor attrition in the community-led and workplace HIVST models. Stockouts, experienced at the start of implementation in the secondary-distribution and community-led distribution models often disrupted distribution. The existence of policy and practices aided integration of HIVST in the workplace. External factors complimented internal factors for successful implementation. For instance, despite distributor attrition leading to excessive workload, distributors often multi-tasked to keep up with demand for kits, even though distribution points were geographically widespread in the workplace, and to a less extent in the community-led models. Use of existing communication platforms such as lunchtime and safety meetings to promote and distribute kits, peers to support distributors, reduction in trips by distributors to replenish stocks, increase in monetary incentives and reorganisation of stakeholder roles proved to be good adaptations.

Conclusion

HIVST distribution was influenced by a combination of contextual factors in variable ways. Understanding how the factors interacted in real world settings informed adaptations to implementation devised to minimize disruptions to distribution.
Relationship between serum phosphorus and mortality in non-dialysis chronic kidney disease patients: evidence from NHANES 2001–2018
Authors: Fan Zhongcheng , Li Rugang , Pan Miaoxia , Jiang Yangyang , Li Ying , Liu Li , Li Yang
Published: March 2024

Background

Hyperphosphatemia is common in chronic kidney disease (CKD), associated with higher mortality in dialysis patients. Its impact in non-dialysis patients, especially those with preserved kidney function, remains uncertain.

Methods

A prospective cohort study was conducted using data from the National Health and Nutrition Examination Survey (2001–2008). Serum phosphorus was analyzed as a continuous variable, or categorized into three groups: < 3.5 mg/dL, 3.5 to < 4.5 mg/dL, and ≥ 4.5 mg/dL. Cox proportional hazards models were used to analyze the association between phosphorus with all-cause and cardiovascular disease (CVD) mortality, with or without adjustment for age, sex, race, hemoglobin, estimated glomerular filtration rate (eGFR), serum albumin, serum calcium, 25(OH)D, obesity, hypertension, diabetes, and CVD.

Results

A total of 7694 participants were included in the analysis, representing 28 million CKD patients in the United States. During mean 92 months of follow up, 2708 all-cause deaths (including 969 CVD deaths) were observed. Per 1 mg/dL increase in phosphorus was associated with a 13% and 24% increased risk of all-cause mortality (hazard ratio [HR], 1.13; 95%CI, 1.02–1.24) and CVD mortality (HR, 1.24; 95%CI, 1.07–1.45), respectively. Compared with the < 3.5 mg/dL, phosphorus ≥ 4.5 mg/dL was associated with a 28% and 57% increased risk of all-cause mortality (HR, 1.28; 95%CI, 1.05–1.55) and CVD mortality (HR, 1.57; 95CI, 1.19–2.08), respectively. In participants with eGFR < 60 ml/min/1.73m2, elevated phosphorus (≥ 4.5 mg/ dL) were significantly associated with increased risk of all-cause mortality (HR, 1.36; 95%CI, 1.07–1.72). No significant association was observed in eGFR ≥ 60 ml/min/1.73m2 group (HR, 1.31; 95%CI, 0.86–1.99). This correlation does not differ significantly between subgroups defined by eGFR level (P for interaction = 0.889).

Conclusion

Serum phosphorus above 4.5 mg/dL is significantly associated with a 28% and 57% increased risk of all-cause and CVD death in non-dialysis CKD patients, respectively. This relationship still demonstrated in patients with eGFR < 60 ml/min/1.73m2. However, for population with eGFR ≥ 60 ml/min/1.73m2, further verification is needed.
Transversal approach via a bladder neck and prostate combined longitudinal incision versus standard approach of robotic-assisted radical prostatectomy for localized prostate cancer: a retrospective analysis
Authors: Shen Zefan , Yao CenChao , Bai YuChen , Wang YiFan , Zhang Qi
Published: March 2024

Background

Transversal approach for robotic-assisted radical prostatectomy via a bladder neck and prostate combined longitudinal incision (L-RALP) is a novel surgical method for patients with respectable prostate cancer.

Methods

There were 669 patients with prostate cancer underwent L-RALP or S-RALP which identified from April 2016 to April 2020. The perioperative outcomes, Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-CP) scores, sexual function and urinary control ability were included and compared between two groups.

Results

In the 669 patients, 277 of them were included into the final analysis. 151 patients received S-RALP and 126 received L-RALP. Baseline features were balanced. Patients in the S-RALP group had significantly shorter average surgical time (135.93 vs 150.04 min; p < 0.001) than those in L-RALP group. Intraoperative bleeding volume, early postoperative complications rates, postoperative catheter removal time and hospital stays were comparable between two groups. There was no difference in biochemical recurrence at 3, 6, 12 and 18 months of follow-up. Of note, the urinary control function recovers of patients in the L-RALP group was significantly better than those in the S-RALP group. Moreover, patients in the L-RALP group had much better results of EPIC-CP (including urinary control and total score) than those in the S-RALP group at 6 week and 3, 6, 12 and 18 months.

Conclusions

Both S-RALP and L-RALP were safe and effective with similar long-term clinical outcomes in patients with respectable prostate cancer. Patients received L-RALP had significantly better postoperative outcomes including urinary control, and recovery period.
Pretreatment prostate-specific antigen density as a predictor of biochemical recurrence in patients with prostate cancer: a meta-analysis
Authors: Cui Feilun , Qiu Yue , Xu Wei , Zou Chen , Fan Yu
Published: March 2024

Background

A consensus has not been reached on the value of prostate-specific antigen density (PSAD) as a predictor of biochemical recurrence of prostate cancer. This meta-analysis aimed to evaluate the association between PSAD and biochemical recurrence of prostate cancer after primary treatment.

Methods

Two authors systematically searched PubMed, Web of Science, and Embase databases (up to August September 10, 2023) to identify studies that assessed the value of pretreatment PSAD in predicting biochemical recurrence after primary treatment (radical prostatectomy or radiotherapy) of prostate cancer. A random effect model was used to pool adjusted hazard ratios (HR) with 95% confidence intervals (CI) for biochemical recurrence.

Results

Nine studies with 4963 patients were eligible for the meta-analysis. The reported prevalence of biochemical recurrence ranged from 4 to 55.1%. For patients with higher PSAD compared to those with low PSAD, the pooled HR of biochemical recurrence was 1.59 (95% CI 1.21–2.10). Subgroup analysis showed that the pooled HR of biochemical recurrence was 1.80 (95% CI 1.34–2.42) for patients who received radical prostatectomy, and 0.98 (95% CI 0.66–1.45) for patients who received radiotherapy.

Conclusions

Elevated pretreatment PSAD may be an independent predictor for biochemical recurrence of prostate cancer after radical prostatectomy. Determining PSAD could potentially improve the prediction of biochemical recurrence in patients with prostate cancer.
Depressive symptoms and visual attention to others’ eyes in healthy individuals
Authors: Suslow Thomas , Hoepfel Dennis , Kersting Anette , Bodenschatz Charlott Maria
Published: March 2024

Background

Eye contact is a fundamental part of social interaction. In clinical studies, it has been observed that patients suffering from depression make less eye contact during interviews than healthy individuals, which could be a factor contributing to their social functioning impairments. Similarly, results from mood induction studies with healthy persons indicate that attention to the eyes diminishes as a function of sad mood. The present screen-based eye-tracking study examined whether depressive symptoms in healthy individuals are associated with reduced visual attention to other persons’ direct gaze during free viewing.

Methods

Gaze behavior of 44 individuals with depressive symptoms and 49 individuals with no depressive symptoms was analyzed in a free viewing task. Grouping was based on the Beck Depression Inventory using the cut-off proposed by Hautzinger et al. (2006). Participants saw pairs of faces with direct gaze showing emotional or neutral expressions. One-half of the face pairs was shown without face masks, whereas the other half was presented with face masks. Participants’ dwell times and first fixation durations were analyzed.

Results

In case of unmasked facial expressions, participants with depressive symptoms looked shorter at the eyes compared to individuals without symptoms across all expression conditions. No group difference in first fixation duration on the eyes of masked and unmasked faces was observed. Individuals with depressive symptoms dwelled longer on the mouth region of unmasked faces. For masked faces, no significant group differences in dwell time on the eyes were found. Moreover, when specifically examining dwell time on the eyes of faces with an emotional expression there were also no significant differences between groups. Overall, participants gazed significantly longer at the eyes in masked compared to unmasked faces.

Conclusions

For faces without mask, our results suggest that depressiveness in healthy individuals goes along with less visual attention to other persons’ eyes but not with less visual attention to others’ faces. When factors come into play that generally amplify the attention directed to the eyes such as face masks or emotions then no relationship between depressiveness and visual attention to the eyes can be established.
The relationship of personality, alexithymia, anxiety symptoms, and odor awareness: a mediation analysis
Authors: Zhang Binfeng , Li Xiuxia , Deng Hongzhen , Tan Peixuan , He Wanyong , Huang Shuling , Wang Lu , Xu Hao , Cao Lei , Nie Guanghui
Published: March 2024

Objective

Personality, emotions, and olfaction exhibit partial anatomical overlap in the limbic system structure, establishing potential mechanisms between personality, affective disorders, and olfactory-related aspects. Thus, this study aims to investigate the associations among the Big Five personality traits, alexithymia, anxiety symptoms, and odor awareness.

Methods

A total of 863 college participants were recruited for this study. All participants completed the Chinese Big Five Personality Inventory-15, the Odor Awareness Scale (OAS), the Toronto Alexithymia Scale-20, and the Generalized Anxiety Disorder Screener-7. Structural equation modeling was employed to examine the hypothesized mediated model.

Results

The findings revealed the majority of significant intercorrelations among the dimensions of the Big Five personality traits, alexithymia, anxiety symptoms, and OAS (|r| = 0.072–0.567, p < 0.05). Alexithymia and anxiety symptoms exhibited a serial mediation effect between neuroticism and OAS (95%CI[0.001, 0.014]), conscientiousness and OAS (95%CI[-0.008, -0.001]), and extraversion and OAS (95%CI[-0.006, -0.001]). Anxiety symptoms mediated the relationship between agreeableness and OAS (95%CI[-0.023, -0.001]) and between openness and OAS (95%CI [0.004, 0.024]).

Conclusion

The mediating roles of alexithymia and anxiety symptoms between the Big Five personality traits and odor awareness support the idea of a certain level of association among personality, emotions, and olfaction, with the underlying role of the limbic system structure. This enhances our understanding of personality, emotions, and olfaction and provides insights for future intervention measures for affective disorders and olfactory dysfunctions.
Impact of exercise training and diet therapy on the physical fitness, quality of life, and immune response of people living with HIV/AIDS: a randomized controlled trial
Authors: Qin Xin-Min , Allan Robert , Park Ji-Young , Kim Sung-Hoon , Joo Chang-Hwa
Published: March 2024

Background

Exercise and dietary nutrition are considered crucial in human immunodeficiency virus (HIV)/ acquired immunodeficiency syndrome (AIDS) treatment protocols and people living with HIV/AIDS (PLWHA) rehabilitation care. However, there is no well-studied research evaluating the effects of combined interventions on the fitness and immune systems of PLWHA. Therefore, this study aimed to analyze the effects of exercise and dietary intervention on physical fitness, quality of life and immune response in PLWHA.

Methods

This was an experimental study, with a sample of 25 male PLWHA divided into two groups: the intervention group (IG: 12 participants) and the control group (CG: 13 participants). All participants have not had any exercise habits and nutritional supplements in the past six months. The participants in the IG completed 45 min of exercise (60-80% HRmax) 4 times per week for 4 weeks. The exercise was in the form of brisk walking or running. They were also given a nutritional dietary supplement 3 times a day for 4 weeks. The 13 individuals in the CG continued their normal daily life (physical activity and diet). The following parameters were evaluated before and after the intervention: body composition, physical fitness, immune response, quality of life (QoL), stress, dietary behavior, dietary habits, exercise motivation, and physical self-efficacy.

Results

The significant changes were observed in burnout of stress variables and physical efficiency index (PEI) of physical fitness in the IG (p =.023). Moreover, in the saliva samples, sal-T levels significantly increased only after the intervention in the IG (p =.012). Additionally, regarding the analysis of the interaction (group × time), there was a significant improvement in the reaction speed (p =.001) and grip strength (left:p =.002, right:p =.030) and a significant difference in physical satisfaction in QoL (p =.001), stress burnout (p =.043), self-confidence in physical efficacy (p =.045), external display (p =.008), and fulfillment (p =.047) in exercise motivation. Moreover, the significant effect of the intervention on emotional eating in dietary behavior was shown in the comparison of the IG before and after intervention (p =.001) and in the comparison of the IG group with the CG after the experiment (p =.013). However, there was no significant effect of time or interaction between the condition and time on body composition.

Conclusions

In conclusion, exercise training and diet therapy caused changes in physical fitness and Sal-T levels, which had positive effects on the health promotion of PLWHA.
Development and validation of a deep learning model for predicting postoperative survival of patients with gastric cancer
Authors: Wu Mengjie , Yang Xiaofan , Liu Yuxi , Han Feng , Li Xi , Wang Jufeng , Guo Dandan , Tang Xiance , Lin Lu , Liu Changpeng
Published: March 2024

Background

Deep learning (DL), a specialized form of machine learning (ML), is valuable for forecasting survival in various diseases. Its clinical applicability in real-world patients with gastric cancer (GC) has yet to be extensively validated.

Methods

A combined cohort of 11,414 GC patients from the Surveillance, Epidemiology and End Results (SEER) database and 2,846 patients from a Chinese dataset were utilized. The internal validation of different algorithms, including DL model, traditional ML models, and American Joint Committee on Cancer (AJCC) stage model, was conducted by training and testing sets on the SEER database, followed by external validation on the Chinese dataset. The performance of the algorithms was assessed using the area under the receiver operating characteristic curve, decision curve, and calibration curve.

Results

DL model demonstrated superior performance in terms of the area under the curve (AUC) at 1, 3, and, 5 years post-surgery across both datasets, surpassing other ML models and AJCC stage model, with AUCs of 0.77, 0.80, and 0.82 in the SEER dataset and 0.77, 0.76, and 0.75 in the Chinese dataset, respectively. Furthermore, decision curve analysis revealed that the DL model yielded greater net gains at 3 years than other ML models and AJCC stage model, and calibration plots at 3 years indicated a favorable level of consistency between the ML and actual observations during external validation.

Conclusions

DL-based model was established to accurately predict the survival rate of postoperative patients with GC.
Effects of positive end-expiratory pressure on regional cerebral oxygen saturation in elderly patients undergoing thoracic surgery during one-lung ventilation: a randomized crossover-controlled trial
Authors: Zhao Liying , Lv Shuang , Xiao Qian , Zhang Yuan , Yi Wenbo , Bai Yu , Lu Kangping , Bermea Kevin C. , Semel Jessica , Yang Xiaomei , Wu Jianbo
Published: March 2024

Background

A significant reduction in regional cerebral oxygen saturation (rSO2) is commonly observed during one-lung ventilation (OLV), while positive end-expiratory pressure (PEEP) can improve oxygenation. We compared the effects of three different PEEP levels on rSO2, pulmonary oxygenation, and hemodynamics during OLV.

Methods

Forty-three elderly patients who underwent thoracoscopic lobectomy were randomly assigned to one of six PEEP combinations which used a crossover design of 3 levels of PEEP—0 cmH2O, 5 cmH2O, and 10 cmH2O. The primary endpoint was rSO2 in patients receiving OLV 20 min after adjusting the PEEP. The secondary outcomes included hemodynamic and respiratory variables.

Results

After exclusion, thirty-six patients (36.11% female; age range: 60–76 year) were assigned to six groups (n = 6 in each group). The rSO2 was highest at OLV(0) than at OLV(10) (difference, 2.889%; [95% CI, 0.573 to 5.204%]; p = 0.008). Arterial oxygen partial pressure (PaO2) was lowest at OLV(0) compared with OLV(5) (difference, -62.639 mmHg; [95% CI, -106.170 to -19.108 mmHg]; p = 0.005) or OLV(10) (difference, -73.389 mmHg; [95% CI, -117.852 to -28.925 mmHg]; p = 0.001), while peak airway pressure (Ppeak) was lower at OLV(0) (difference, -4.222 mmHg; [95% CI, -5.140 to -3.304 mmHg]; p < 0.001) and OLV(5) (difference, -3.139 mmHg; [95% CI, -4.110 to -2.167 mmHg]; p < 0.001) than at OLV(10).

Conclusions

PEEP with 10 cmH2O makes rSO2 decrease compared with 0 cmH2O. Applying PEEP with 5 cmH2O during OLV in elderly patients can improve oxygenation and maintain high rSO2 levels, without significantly increasing peak airway pressure compared to not using PEEP.

Trial registration

Chinese Clinical Trial Registry ChiCTR2200060112 on 19 May 2022.
Severe megaloblastic anemia in a patient with advanced lung adenocarcinoma during treatment with erlotinib: a case report and literature review
Authors: Yan Xin , Kong Jingxian , Wang Jiacheng , Wang Caixia , Shen Hongchang
Published: March 2024

Background

Erlotinib is a first-generation, tyrosine kinase inhibitor of the epidermal growth factor receptor (EGFR-TKI) used for the treatment patients with NSCLC. Erlotinib is considered as a safe and effective treatment option, with generally good tolerance. Diarrhea and rash are the most common side effects, and more rare side effects appear in long-term real-world applications. Severe erlotinib related megaloblastic anemia is rare and remains unreported. This is the first case report of severe megaloblastic anemia in a patient with advanced lung adenocarcinoma with an EGFR L858R mutation treated with erlotinib. In this report, the clinical manifestations, diagnosis and treatment of erlotinib related severe megaloblastic anemia are described, and the possible pathogenesis and related treatment options are discussed.

Case description

Herein, we present a 57- year-old non-smoking female diagnosed with metastatic lung adenocarcinoma harboring an EGFR L858R mutation, who had received erlotinib as the first-line therapy. After 44 weeks of treatment, the patient developed severe anemia. Anemia was manifested as megaloblastic anemia with elevated mean corpuscular volume and mean corpuscular hemoglobin. The total vitamin B12 level was below the detection limit of 50.00 pg /mL. Bone marrow smear suggested megaloblastic anemia. Her hematologic parameters were markedly recovered following the withdrawal of erlotinib and vitamin B12 supplement. As a result, the patient was diagnosed with erlotinib-associated megaloblastic anemia.

Conclusions

This is the first case of severe megaloblastic anemia reported with erlotinib. Few of these hematologic adverse effects have been observed in studies on erlotinib, this case report highlights this possibility for long-term erlotinib administration. Close clinical and blood monitoring is recommended for patients receiving long-term TKI therapy.
Women’s access to sexual and reproductive health services and information in Ismailia, Egypt
Authors: Elsayed Reem , Zembe-Mkabile Wanga
Published: March 2024

Background

Sexual and reproductive health (SRH) is a right that should be guaranteed to every woman worldwide in order to have a healthy and safe sex life. In most Arab countries, including Egypt, there are different cultural, political, and religious factors that have contributed significantly to how society views and treats women’s bodies and sexuality. As a result, it is difficult to provide solid data and information to guide policymakers, policies, and to implement awareness and preventive programmes. This study sought to address this gap by looking at the intersectionality of women’s access to SRH services and information in Ismailia, Egypt.

Methods

The study utilised qualitative research methods. Semi-structured interviews were conducted with twelve married women and two key informant interviews with health professionals (a gynecologist and a pharmacist) in the study area.

Results

The study revealed that married women suffer from scarcity of understanding and knowledge of their SRH and lack of access to adequate SRH services and information. Married women’s experiences of accessing SRH services and information were influenced by intersecting factors located at the micro and macro levels. These intersected factors (e.g., power dynamics, socioeconomic factors, cultural norms, and religious misconception) shaped oppression and privilege structures which created unequal access to SRH information and services.

Conclusion

There is a need for building quality parental relationships for women before and after marriage in order to promote positive SRH attitudes and behavior. There is an urgent need to empower women before and after marriage with accurate, safe, and affordable SRH services and information that could have life-long benefits to protect them. There is a need to conduct educational programmes, and initiate media awareness campaigns, to equip women with information and knowledge about their SRH services and information.
Triptolide mitigates the inhibition of osteogenesis induced by TNF-α in human periodontal ligament stem cells via the p-IκBα/NF-κB signaling pathway: an in-vitro study
Authors: Chen Hao , Zhang Lina , Du Simeng , Yang Daiwei , Cui Xiaobin , Zhao Huadong , Zhang Jun
Published: March 2024

Background

Triptolide is a widely utilized natural anti-inflammatory drug in clinical practice. Aim of this study was to evaluate effects of triptolide on hPDLSCs osteogenesis in an inflammatory setting and to investigate underlying mechanisms.

Methods

Using the tissue block method to obtain hPDLSCs from extracted premolar or third molar. Flow cytometry, osteogenic and adipogenic induction were carried out in order to characterise the features of the cells acquired. hPDLSC proliferative activity was assessed by CCK-8 assay to determine the effect of TNF-α and/or triptolide. The impact of triptolide on the osteogenic differentiation of hPDLSCs was investigated by ALP staining and quantification. Osteogenesis-associated genes and proteins expression level were assessed through PCR and Western blotting assay. Finally, BAY-117,082 was used to study the NF-κB pathway.

Results

In the group treated with TNF-α, there was an elevation in inflammation levels while osteogenic ability and the expression of both osteogenesis-associated genes and proteins decreased. In the group co-treated with TNF-α and triptolide, inflammation levels were reduced and osteogenic ability as well as the expression of both osteogenesis-associated genes and proteins were enhanced. At the end of the experiment, both triptolide and BAY-117,082 exerted similar inhibitory effects on the NF-κB pathway.

Conclusion

The osteogenic inhibition of hPDLSCs by TNF-α can be alleviated through triptolide, with the involvement of the p-IκBα/NF-κB pathway in this mechanism.
Swiss medical schools’ experiences with online teaching during the COVID-19 pandemic in light of international experiences
Authors: Gogollari Artemisa , Mitchell Sharon , Guttormsen Sissel
Published: March 2024

Background

During the pandemic, all universities had to switch to digital learning and teaching (DLT), the experiences were diverse. The advantages and obstacles of DLT are well reported in research. To ensure a sustainable DLT implementation, the requirements of institutions, educators and students should be aligned.

Objective

This paper aims at identifying and describing the experiences made at the Swiss medical schools after having to switch from on-site to on-line teaching; in particular, the experienced issues, requirements, and solutions were investigated and compared to international literature.

Methods

We conducted a literature review to derive themes and subthemes regarding the central aspects of the transition from on-site to on-line teaching. Also, we conducted semi-structured interviews with people responsible for the medical curricula at the Swiss Medical Schools. We used a purposive sampling method and invited eleven curriculum managers at the seven Swiss Medical Schools. The interviews were conducted in English, audio-recorded and transcribed. Subsequently the data was analysed with the software NVivo. We used a qualitative, deductive, content analysis to explore faculty experiences.

Results

Twenty-four articles met the eligibility criteria and were included for full text screening. Of the included articles, 15 reported on DLT in general and nine articles reported on DLT during the Pandemic. The thematic analysis of the interviews resulted in four overall themes, requirements, obstacles, facilitators and advantages. Curriculum managers reported that institutions were relatively unprepared for the quick transition from onsite to online at the onset of the pandemic.

Conclusions

Our research reports a lack of institutional structures, communication, digital competences and literacy, teaching strategies, as well as a theoretical foundation for DLT implementation. A conceptual framework for DLT adapted to the Swiss universities beyond the current situation is needed.