bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigating the risk and protective factors of ageing at work: A reflexive thematic analysis
Authors: Bacci Giulia , Viotti Sara , Guidetti Gloria , Sottimano Ilaria , Converso Daniela , Edge Clare
Published: February 2025

Background

The ageing of the working population and the sustainability of work throughout the life cycle represent a significant challenge for many European countries, particularly in relation to the implementation of legislation raising the retirement age.

Objective

The objective of this study was to examine the physical, psychological and social risk and protective factors that influence the sustainability of work during the ageing process.

Methods

Twenty-five interviews were conducted, followed by a reflexive thematic analysis, with the aim of gathering the perspectives of a company's employees regarding factors related to ageing in the workplace.

Results

Two key themes emerged from the analysis, encapsulating the participants’ different perceptions of risk and protective factors. Among the physical risk factors were those related to stress caused by job characteristics, which affect physical health. In addition, the study identified continuous shift work as a significant risk factor, which affects both physical health and the ability to reconcile work and family life. In addition, the responsibility of caring for dependent elderly family members and childcare responsibilities were highlighted as social factors that may affect employees’ well-being.

Conclusions

The study provides a useful basis for the implementation of company interventions to improve the work sustainability of older employees, with possible applications in other similar companies.
An active sitting chair can increase energy expenditure while performing standardized data entry work
Authors: Davidson Jessa M , Pulford-Thorpe Alexis , Callaghan Jack P , Dominelli Paolo B
Published: February 2025

Background

Active sitting chairs have been proposed as an effective approach for reducing sedentary behaviour in the workplace.

Objective

This cross-sectional study evaluated how an active sitting chair altered energy expenditure compared to a traditional office chair during seated computer work.

Methods

Sixteen participants (8M/8F) completed two 20-min sessions of seated standardized computer work in an active sitting chair, with a multiaxial rotating seat pan, and traditional office chair. Metabolic and ventilatory variables were collected with a customized metabolic cart and cardiac variables were collected by a Hexoskin© shirt. Average ventilatory, metabolic, and cardiac variables from the last 15-min of each block were compared between chairs and sexes.

Results

Statistically significant increases in oxygen uptake (V˙O2) emerged in active sitting (0.02 L/min; 7.6%), and ultimately led to a 1.5 kcal increase in energy expenditure compared to traditional sitting. Proportional and significant changes in minute ventilation (V˙E; + 0.9 L/min), heart rate (HR; + 5.8 bpm), and heart rate variability (HRV; −0.05 s) occurred, which further support the greater metabolic demand in active sitting.

Conclusions

A 1.5 kcal per 15-min increase in energy expenditure translates to 6 kcal/hour and 48 kcal/day. Compared to other literature, this change is similar to caloric expenditure when climbing three to six flights of stairs and when using alternative workstation designs (e.g., standing or sitting on a stability ball). An active sitting chair with a multiaxial rotating seat pan and no back support, appears to be a good alternative for increasing energy expenditure at a workstation.
Investigating the impact of shift work on depression: Insights from sleep duration and physical activity
Authors: Zhou Yating , Xue Fei
Published: February 2025

Background

Shift work has been associated to a higher risk of depression and other health problems.

Objective

This study aims to explore the connection between shift work and depression using NHANES data, with a focus on the roles of sleep duration and physical activity.

Methods

NHANES data from 2007 to 2025 were examined using weighted multivariable logistic regression and stratified analysis, adjusting for demographic, chronic disease, and lifestyle factors. The impact of sleep duration and physical activity on depression among shift workers was examined using generalized additive models.

Results

The study included 4965 participants. Adjusting for all covariates, shift work was significantly linked to increased depression risk (OR = 1.25, 95% CI: 1.05–1.48, p = 0.0127). For shift workers, each additional hour of sleep reduced depression risk by 19% (OR = 0.81, 95% CI: 0.72–0.91, p = 0.0007), and those with adequate sleep had a 40% lower depression risk compared to those with insufficient sleep (OR = 0.60, 95% CI: 0.42–0.87, p = 0.0072). Regular physical activity reduced depression risk by 44% (OR = 0.56, 95% CI: 0.36–0.87, p = 0.0104), whereas insufficient activity showed no significant impact (OR = 0.83, 95% CI: 0.50–1.38, p = 0.4731).

Conclusions

Shift work increases depression risk, while sufficient sleep and physical activity are protective. These findings underscore the importance of improving conditions for shift workers and developing preventive strategies.
Exploring musculoskeletal pain among Italian olive pickers: A cross-sectional investigation into prevalence, attitudes, expectations, and beliefs
Authors: Giardulli Benedetto , Battista Simone , Sansone Lucia Grazia , Leuzzi Gaia , Giordano Riccardo , Testa Marco
Published: February 2025

Background

Olive pickers confront ergonomic hazards when performing work activities that may lead to musculoskeletal pain (MSK) that must be adequately managed. The success of MSK pain prevention and treatment strategies is linked to olive pickers’ state of empowerment, shaped by expectations and beliefs.

Objective

This study highlighted the prevalence of MSK pain among Italian olive pickers and explored their attitudes, expectations, and beliefs about MSK pain prevention and care.

Methods

A web-based cross-sectional survey instrument was developed to collect data from an Italian olive pickers’ cohort in the Liguria region. The survey investigated the sample on (1) MSK pain prevalence and characteristics, (2) preventive and treatment activities for MSK pain, (3) expectations about MSK pain treatments, and (4) beliefs about their job and MSK pain onset.

Results

From January to July 2021, we collected data from 127 participants (78% men); mean age 52 ± 13). Prevalence of MSK pain over one month, six months, and one year was 61.6%, 77.8%, and 84.8%, respectively. The most affected joints were the lumbar spine (61%), the shoulders (57%), and the cervical spine (46%). To prevent the onset of MSK pain, 44% of participants did nothing, and 94% of them never attended any preventive physical activity.

Conclusions

MSK pain strongly impacts Ligurian olive pickers, as three out of four experienced it during the last six months. Participants emphasised the need to be educated on working ergonomics and the perceived importance of physical activity for health.
Workplace supports for early pregnancy loss: A scoping review of international literature
Authors: Kelly-Harrington Ruadh , Leitao Sara , O’Donoghue Keelin , Dalton-O’Connor Caroline , Donnelly Mary , Murray Claire , Nuzum Daniel , O’Sullivan Maeve , Hennessy Marita
Published: February 2025

Background

Despite the prevalence and impacts of pregnancy loss, there is a lack of statutory or workplace-based supports for workers experiencing pregnancy loss, especially before the point of viability. As reproductive and working ages overlap, workplaces can play a significant role in pregnancy loss experiences.

Objective

The aim of this study is to map the available literature on workplace supports for pregnancy loss before viability.

Methods

We conducted a scoping review following JBI Guidance and a pre-registered protocol. We searched eight academic databases/platforms, grey literature sources, and reference lists for eligible documents (2012–2022).

Results

Following title and abstract screening and full-text review, 48 records were included for analysis: 18 reports, 15 journal articles, 6 guides/codes of practice, 3 theses, 2 book/book chapters, and 4 other narrative records. Secondary research was the most common methodology employed ( n = 16) followed by primary research ( n = 14). Reports mainly originated from South-East Asia, while all empirical studies took place in high-income, English-speaking countries. Leave from work was the most discussed/important form of workplace support. Helpful organisational measures were also identified.

Conclusions

Our review found a lack of empirical research on workplace supports and experiences of pregnancy loss. Further research is needed to understand experiences and develop and implement appropriate supports.
Improving asbestos knowledge among demolition workers through training after earthquakes
Authors: Tuncer Kevser , Gomleksiz Mehtap
Published: February 2025

Background

Asbestos was widely used as insulation material in Türkiye's construction. It poses severe health risks, including mesothelioma, a type of lung cancer that is often fatal.

Objective

This study aimed to determine and improve the knowledge about asbestos among employees of a building demolition workers in Elazığ.

Methods

Out of 82 employees in the demolition workers, 75 volunteered for the study after ethical approval was obtained. Training materials and survey forms were developed through a review of the literature. Surveys were conducted before and after the training sessions. Data were analyzed using SPSS 22.0, and a p-value of less than 0.05 indicated statistical significance.

Results

The participants were exclusively male, with an average age of 39.06 years. Among them, 40% were current smokers. Most had not received prior training on asbestos. Before the training, nearly half of the respondents (49.4%) were unaware of the procedures for asbestos check and removal prior to demolition. knowledge across all surveyed areas. The knowledge of demolition workers increased significantly after training.

Conclusion

Training significantly improved asbestos-related knowledge which was low before among the demolition workers, a group at high risk for asbestos exposure.
A machine learning-based analysis for the effectiveness of online teaching and learning in Pakistan during COVID-19 lockdown
Authors: Zeeshan Hafiz Muhammad , Sultana Arshiya , Bin Heyat Md Belal , Akhtar Faijan , Parveen Saba , Bin Hayat Mohd Ammar , Sayeed Eram , Sayed Abdelgeliel Asmaa , Muaad Abdullah Y.
Published: February 2025

Background

The COVID-19 pandemic has significantly disrupted daily life and education, prompting institutions to adopt online teaching.

Objective

This study delves into the effectiveness of these methods during the lockdown in Pakistan, employing machine learning techniques for data analysis.

Methods

A cross-sectional online survey was conducted with 300 respondents using a semi-structured questionnaire to assess perceptions of online education. Artificial intelligence methods analyzed the specificity, sensitivity, accuracy, and precision of the collected data.

Results

Among participants, 42.3% expressed satisfaction with online learning, while 49.3% preferred using Zoom. Convenience was noted with 72% favoring classes between 8 AM and 12 PM. The survey revealed 87.33% felt placement activities were negatively impacted, and 85% reported effects on individual growth. Additionally, 90.33% stated that online learning disrupted their routines, with 84.66% citing adverse effects on physical health. The Decision Tree classifier achieved the highest accuracy at 86%. Overall, preferences leaned toward traditional in-person teaching despite satisfaction with online methods.

Conclusions

The study highlights the significant challenges in transitioning to online education, emphasizing disruptions to daily routines and overall well-being. Notably, age and gender did not significantly influence perceptions of growth or health. Finally, collaborative efforts among educators, policymakers, and stakeholders are crucial for ensuring equitable access to quality education in future crises.
Centrally inserted central catheter placement using a novel, handheld, image-guided, robotic device: Results of initial feasibility trial in patients
Authors: Herlihy James P , Cohn William E , Ebner Adrian
Published: February 2025

Background:

Central venous access devices (CVADs) are an essential and widely used tool for the treatment of the critically ill, patients undergoing major surgery, and for many patients requiring hemodialysis. Automation of centrally inserted central catheters (CICCs) could potentially make CVAD placement safer, more effective, and more accessible. A new device that uses ultrasound image-guided, robotic needle placement, in addition to traditional Seldinger technique, to place a CICC is described.

Objective:

The device was used in a small, first-in-human, trial for placing non-tunneled hemodialysis catheters (NTHDCs), in order to determine feasibility of clinical use.

Methods:

Consecutive patients requiring a NTHDC, at one institution, over a 48 h period, were recruited to consent to placing the catheter by the device. Observations of safety, efficacy, and efficiency of the procedure were recorded.

Results:

There were 19 catheter placement attempts in 17 patients. All placements were successful (100%). The first placement attempt was successful in 16/19 catheterizations (84%). Two catheterizations required two attempts and one required three attempts. There were no complications for any catheterization. The device provided rapid access to the target central vein and required relatively little training time for operators.

Conclusions:

The study demonstrates the feasibility for clinical application of a novel central venous access robotic device.
Tele-allergy improves access to allergy care within the Veterans Health Administration
Authors: Temiño Viviana M , Medina Yanelys
Published: February 2025

The shortage of Allergy & Immunology providers in the United States restricts access to specialty care. Telemedicine has the potential to expand access beyond physical locations, however, little is known regarding patient preferences for tele-allergy or the ability to successfully manage atopic conditions virtually. This retrospective analysis of a tele-allergy program at the Veterans Health Administration demonstrates that tele-allergy can provide efficient allergy care for veterans, including rural patients, although some reliance on local ancillary services was necessary. A hybrid model of virtual and in-person care is likely needed in Allergy & Immunology to overcome geographical barriers and optimize resource allocation.
Collective narcissism of White supremacy and minority resistance
Authors: Keenan Oliver , Golec de Zavala Agnieszka
Published: February 2025

In four cross-sectional studies ( N = 2,228; three preregistered), we hypothesized and found that U.S. American and White collective narcissism is associated with opposition to racial equality, whereas racial collective narcissism among Blacks and Latinx in the United States (US) is associated with support for racial equality. In Studies 1 and 2, American national and White racial collective narcissism was positively associated with support for state repression of the Black Lives Matter (BLM) movement, antiegalitarianism, and legitimization of racial inequality. Black racial collective narcissism was negatively associated with the same variables. In Studies 3 and 4, American national and White racial collective narcissism was positively associated with antiegalitarianism, support for the alt-right movement, and opposition to policies to advance racial minorities. Latinx racial collective narcissism was negatively associated with the same variables. In sum, in the US, national collective narcissism among Whites and racial minorities and White racial collective narcissism hinder the pursuit of racial equality. However, Black and Latinx racial collective narcissism is associated with pursuit of racial equality.
Navigating the Limitations of Algorithmic Management: An Integrative Framework of Sociotechnical Systems Theory (STS) and Strategic HRD
Authors: Zhang Panpan , Dillard Nicole , Cavallo Taylor
Published: February 2025

This research integrates Sociotechnical Systems (STS) theory with strategic human resource development (SHRD) to address the potential biases and inequities in algorithmic management within workplaces. Given SHRD’s strategic orientation and focus on human development, integrating these frameworks has the potential to achieve both technological efficiency and organizational growth, while also promoting employee well-being. By analyzing the strategic design, operating systems, and work design of STS through an SHRD lens, we propose an STS-SHRD framework highlighting human resource development’s (HRD) strategic role in aligning organizational objectives and technological processes for enhanced algorithmic management. The proposed framework guides the development of both technological integration and employee well-being. This research contributes to ongoing HRD discourse by offering theoretical insights into collaborative approaches that balance organizational effectiveness with human development, while also providing practical strategies for HRD professionals to foster employee engagement, promote equitable organizational practices, and enhance employee well-being.
Troubling Foundations: A Case Study in Principal Turnover
Authors: Grano Karissa
Published: February 2025

When Ms. Levi decided to become the founding principal of a new charter high school, she was initially optimistic about the opportunity. Fast forward 3 years and the stress of the role has led to burnout and an eventual resignation. This case study is intended to explore the multiple factors that can lead to principal turnover, including enrollment and staffing struggles, accountability pressures, and the impact of trauma. The discussion challenges current and future leaders to consider the best ways to support principals in staying in their roles.
Coloniality of Immigration Law and the False Dichotomies of Dunki and the Right Way
Authors: Jayasinghe Dharshani Lakmali
Published: February 2025

Rajkumar Hirani’s film Dunki (2023) takes its name from an immigration method that is popular among undocumented immigrants originating from states such as Punjab, Haryana, and Gujarat in India. Using this film as a case study, this article critiques immigration and visa laws that engender methods of crossing borders such as dunki, identifies the inherent classicism and racism embedded in such laws, and explores how they generate a false dichotomy between dunki and the “right way” of immigrating. It argues how such laws are aligned with neocolonial ideological projects that seek to contain and control the mobility and circulation of bodies and epistemologies from former colonies, demonstrating how what Aníbal Quijano terms the “coloniality of power” operates in the context of contemporary visa and immigration law.
Cervical spinal cord stimulation for treatment of upper limb paralysis: a narrative review
Authors: Lo Yu Tung , Lam Jordan LW , Jiang Lei , Lam Wee Leon , Edgerton Victor R , Liu Charles Y
Published: February 2025

Recent advances in cervical spinal cord stimulation (SCS) have demonstrated improved efficacy as a therapeutic intervention for restoring hand functions in individuals with spinal cord injuries or stroke. Accumulating evidence consistently shows that cervical SCS yields significant improvements in grip force, proximal arm strength and muscle activation, with both immediate and sustained effects. This review synthesizes the evidence that electrical stimulations modulate the spinal and supraspinal organization of uninjured descending motor tracts, primarily the residual corticospinal tract, reticulospinal tract and propriospinal network of neurons, as well as increasing the sensitivity of spinal interneurons at the stimulated segments to these inputs. Additionally, we examine contemporary strategies aimed at achieving more precise patterned stimulations, including intraspinal microstimulation, ventral cord stimulation and closed-loop neuromodulation, and discuss the potential benefits of incorporating cervical SCS into a multimodal treatment paradigm.

Level of evidence: V
An Assessment of Human Rights Abuses in Biu Township IDPs Camp
Authors: Avon Lanshima Nancy , Lanshima Cletus A. , Isah Benjamin
Published: February 2025

The Universal Declaration of Human Rights adopted by the United Nations on 10 December 1948 declared that human rights are universal and should be enjoyed by all people, no matter who they are or where they live. However, there are strong claims that Internally Displaced Persons (IDPs) in camps are subjected to human rights abuses. This study investigated this claim in Biu Township IDP camp. Social Disorganization and Broken Windows Theories were adopted as the theoretical framework. A survey research design was used and 115 IDPs, male and female, aged 18 and above provided data via questionnaire for quantitative and in-depth interviews were used to collect qualitative data. Findings revealed there is very high level of human rights abuses (76 percent and above) in the camp. It is recommended that government and NGOs on human rights address abuses, monitor, and evaluate adherence to protection of human rights in the IDP camp periodically.
In vitro and ex vivo models of the oral mucosa as platforms for the validation of novel drug delivery systems
Authors: Macartney Robyn A , Das Abijit , Imaniyyah Atina G , Fricker Annabelle TR , Smith Andrew M , Fedele Stefano , Roy Ipsita , Kim Hae-Won , Lee Dongjoon , Knowles Jonathan C
Published: February 2025

The benefit of complex 3D models to facilitate the robust testing of new drugs and drug delivery systems during the developmental stages of pharmaceutical manufacturing has recently become distinguished within the field. Recognition of this need by the pharmaceutical industry has provided a motivation for research into the development of reliable complex models for use in drug delivery, biomaterials, and tissue engineering. Both 3D in vitro and ex vivo models can enhance drug-testing and discovery prospects over the more traditionally used 2D, monolayer culture systems and animal models. Despite the widespread acceptance that 3D tissue modelling is advantageous in this field, there remains a lack of standardisation in the models throughout literature. This article provides an extensive review of current literature on in vitro, and ex vivo models of the oral mucosa for drug delivery applications; the advantages, limitations, and recommendations for future development of improved models for this application.
Education Paradigm Shifts in the Age of AI: A Spatiotemporal Analysis of Learning
Authors: Zhong (仲若君) Ruojun , Zhao (赵勇) Yong
Published: February 2025

Purpose

The purpose of this article is to analyze how to make changes to prescribed curriculum, pedagogy, activities, learning environments, and assessments to loosen control over time and space of learning to increase time for student autonomy.

Design/Approach/Methods

A theoretical analysis of functions of the five elements (curriculum, pedagogy, activities, learning environments, and assessments) of schooling in controlling time and space in learning.

Findings

Students’ time available for autonomy is limited due to prescribed curriculum, which occupies all students’ school time. Pedagogical practices that aim to efficiently implement the prescribed curriculum force and tempt students to spend all available time on the prescribed curriculum and extend work on the prescribed curriculum beyond classrooms through time concentration. Furthermore, the design and implementation of learning activities alter students’ perception of time, making activities long and tedious. Moreover, students’ time occupation by the prescribed curriculum compresses their space in learning environments. Finally, assessments and evaluations are typically limited to a distorted picture of students due to misplaced observers on different time scales and from an observation perspective. All these can be changed and we proposed possible directions of change.

Originality/Value

This article furthers our positions in the previous article published in ECNU Review of Education—“Paradigm Shifting in Education: An Ecological Analysis.” In this article, we provided a more detailed analysis of schooling from spatiotemporal perspectives and gave a uniquely fresh perspective on changes we need in the age of AI to increase the time available for autonomy.
Medical Practitioners’ Views on Barriers in Collaboration with Dentists in Long-Term Care Settings
Authors: Tada S. , Koh S.M.Y. , Lee G.K.Y. , Wong M.L.
Published: February 2025

Introduction:

In long-term care settings (LTCs), oral health care often remains fragmented from other geriatric care services. Medical practitioners (MPs) typically take the lead in addressing medical aspects of geriatric care plans, making it essential for them to understand the importance of oral health and to collaborate with dental professionals. However, little is known about MPs’ perceptions toward oral health management in LTCs. This qualitative study aimed to gain an in-depth understanding of MPs’ views on oral health management in LTCs and explore challenges in collaborating with dental professionals in Singapore.

Methods:

Participants were recruited using a purposive sampling strategy, initially through targeted outreach to those with experience in LTCs, followed by snowball sampling to identify additional participants until data saturation was achieved. One-to-one interviews with participants were conducted via teleconferencing using a semi-structured interview guide. The transcripts were analyzed using a hybrid (inductive and deductive) thematic analysis supported by NVivo data management software.

Results:

Participants (n = 13) felt that oral health care was currently not well-integrated into the existing LTC system. They frequently encountered oral health issues but arranged for dental appointments only when their patients complained of acute symptoms. Key barriers identified were (1) a cultural misconception within the eldercare community that poor oral health was an inevitable part of aging, (2) systemic barriers related to the inadequate geriatric oral health care services and infrastructure, and (3) knowledge gaps in geriatric oral health management among MPs. These factors collectively hindered effective collaboration with dental professionals in LTCs.

Conclusion:

Participants emphasized the lack of oral health care integration in LTCs, identifying cultural, systemic, and internal barriers. Strengthening collaboration with dental professionals in LTCs, implementing oral health education for the eldercare community, and introducing domiciliary services could address these challenges and support more effective geriatric care, with insights for similar systems globally.

Knowledge Transfer Statement:

This qualitative study highlighted a critical gap in oral health care integration within eldercare described by the MPs in this study in Singapore’s long-term care settings. Although findings are context specific, they may offer insights for aging nations facing similar challenges. Overcoming misconceptions about aging and oral health, improving systems, and educating MPs are key to fostering interdisciplinary collaboration and enhancing eldercare. Addressing these barriers could improve the overall well-being of care-dependent older adults.
Miglustat ameliorates isoproterenol-induced cardiac fibrosis via targeting UGCG
Authors: Liu Jing , Li Wenqi , Jiao Ran , Liu Zhigang , Zhang Tiantian , Chai Dan , Meng Lingxin , Yang Zhongyi , Liu Yuming , Wu Hongliang , Gu Xiaoting , Li Xiaohe , Yang Cheng
Published: February 2025

Background

Cardiac fibrosis is significant global health problem, which is associated with numerous cardiovascular diseases, and ultimately leads to the progression to heart failure. β-adrenergic receptor (β-AR) overactivation play a role in the development of cardiac fibrosis. Miglustat (Mig) has shown anti-fibrosis effects in multiple fibrotic diseases. However, it is unclear whether and how Mig can ameliorate cardiac fibrosis induced by β-AR overactivation.

Methods

In vivo, mice were injected with isoproterenol (ISO) to induce cardiac fibrosis and treated with Mig. In vitro, primary cardiac fibroblasts were stimulated by ISO and treated with Mig. Levels of cardiac fibrosis, cardiac dysfunction, activation of cardiac fibroblasts were evaluated by real-time polymerase chain reaction, western blots, sirius red staining, immunohistochemistry staining and echocardiography. Through GEO data and knockdown UDP-glucose ceramide glycosyltransferase (UGCG) in primary cardiac fibroblasts, whether Mig alleviates cardiac fibrosis by targeting UGCG was explored.

Results

The results indicated that Mig alleviated ISO-induced cardiac dysfunction. Consistently, Mig also suppressed ISO-induced cardiac fibrosis. Moreover, Mig attenuated ISO-induced cardiac fibroblasts (CFs) activation. To identify the protective mechanism of Mig on cardiac fibrosis, several classical β-AR downstream signaling pathways, including ERK, STAT3, Akt and GSK3β, were further analyzed. As expected, ISO activated the ERK, STAT3, Akt and GSK3β in both CFs and mouse hearts, but this effect was reversed pretreated with Mig. Besides, Mig ameliorates ISO-induced cardiac fibrosis by targeting UDP-glucose ceramide glycosyltransferase (UGCG) in CFs.

Conclusions

Mig ameliorates β-AR overactivation-induced cardiac fibrosis by inhibiting ERK, STAT3, Akt and GSK3β signaling and UGCG may be a potential target for the treatment of cardiac fibrosis.
Human cytomegalovirus tegument protein UL23 promotes gastric cancer immune evasion by facilitating PD-L1 transcription
Authors: Feng Shiyu , Shen Yitian , Zhang Haoke , Liu Wanfeng , Feng Weixu , Chen Xiuting , Zhang Liang , Chen Jiangli , Lu Mingdong , Xue Xiangyang , Shen Xian
Published: February 2025

Immune checkpoint therapy targeting PD-1/PD-L1 has shown promise in treating tumors, however, its clinical benefits are limited to a subset of gastric cancer (GC) patients. Recent research has highlighted a the correlation between PD-L1 expression and the clinical efficacy of anti-PD-1/PD-L1 therapies. Human cytomegalovirus (HCMV) has been implicated in GC, but its specific role in modulating this disease remains elusive. In this study, we analyzed clinical tissue samples using bioinformatics and real-time quantitative polymerase chain reaction (RT-qPCR). We found that GC tissues infected with HCMV presented higher PD-L1 expression compared to those without virus. Furthermore, we demonstrated that HCMV infection enhances PD-L1 expression in GC cells. Cytotoxicity assays revealed that HCMV modulates cancer immune responses via the PD-1/PD-L1 pathway. Mechanistically, we showed that HCMV activates the PI3K-Akt signaling cascade and modulates PD-L1 expression through its tegument protein UL23. Functionally, increased UL23 expression leads to elevated PD-L1 levels, which diminishes tumor cell sensitivity to T-cell-mediated cytotoxicity and triggers T-cell apoptosis. Additionally, in vivo experiments revealed that UL23-induced PD-L1 upregulation inhibits CD8+ T-cell infiltration and reduces the expression of inflammatory factors in tumor microenvironment, ultimately weakening antitumor immunity. Our findings reveal a novel mechanism whereby HCMV and its tegument protein UL23 contribute to cancer immunosuppression through the regulation of PD-L1 expression. This discovery may serve as a potential therapeutic target for enhancing the efficacy of cancer immunotherapy.
Association between sensory impairment and sarcopenia in older Chinese adults: a 4-Year longitudinal study
Authors: Huang Chunjie , He Xiaoqing
Published: February 2025

Objectives

Sarcopenia is a common geriatric syndrome that significantly increases the risk of falls, fractures, disability, and death in older adults. Sensory impairments are also prevalent among the elderly and may exacerbate the decline in physical function, even affecting muscle health. Understanding whether sensory impairments are risk factors affecting sarcopenia in older adults is crucial for developing effective public health policies and intervention strategies. Therefore, this study aims to explore the association between sensory impairments and sarcopenia and its components.

Methods

This study, based on the Chinese Health and Retirement Longitudinal Study (CHARLS), included 4,195 participants aged 60 and above. The assessment of sensory impairment was based on self-reported visual and hearing capabilities. The diagnosis of sarcopenia followed the consensus of the Asian Working Group on Sarcopenia (AWGS) from 2019. Data analysis was conducted using an ordered logistic regression model, and the results report the odds ratios (ORs) and their 95% confidence intervals (CI).

Results

Single sensory impairments at baseline showed no significant correlation with sarcopenia four years later, while dual sensory impairments (DSI) at baseline were significantly associated with sarcopenia (ORs: 1.308, 95% CI: 1.126–1.519). In the analysis of trends over time, transitions from no sensory impairments (NSI) to DSI (ORs: 1.372, 95% CI: 1.028–1.830), from hearing impairments (HI) to DSI (ORs: 1.334, 95% CI: 1.002–1.778), and persistent DSI (ORs: 1.470, 95% CI: 1.159–1.864) were all significantly associated with sarcopenia. Additionally, we found DSI is associated with poor physical performance and muscle mass but not muscle strength.

Conclusions

Our study indicates that DSI have a more severe impact on sarcopenia compared to single sensory impairments. Our findings offer a new perspective for prevention and intervention strategies, suggesting the inclusion of sensory impairment assessments in the clinical evaluation of sarcopenia risk. For elderly individuals with DSI, comprehensive intervention measures should be provided, such as sensory rehabilitation, nutritional support, and guidance on physical activities. For those with only a single sensory impairment, proactive preventive measures should be taken to prevent the progression to DSI.
Association between isolated abnormal 1-hour glucose challenge test and adverse pregnancy outcomes: a retrospective review from an urban tertiary care center in the United States
Authors: Hosier Hillary , Lundsberg Lisbet S. , Culhane Jennifer , Partridge Caitlin , Son Moeun
Published: February 2025

Background

The objective of this study was to investigate whether an isolated abnormal 1-hour glucose challenge test (GCT) among patients without gestational diabetes (GDM) is associated with adverse outcomes.

Methods

This is a retrospective cohort study of patients who underwent GDM screening at ≥ 24 weeks’ gestation with a 1-hour GCT and delivered a singleton fetus at > 35 weeks’ gestation at an urban tertiary hospital from 1/2013 to 10/2021. Data were extracted from an electronic medical record data warehouse using standardized billing/diagnosis codes. Individuals were categorized into 3 groups: normal screening (1-hour GCT value < 140 mg/dL), intermediate screening (1-hour GCT value ≥ 140 and < 200 but normal 3-hour glucose tolerance test (GTT)), and GDM (1-hour GCT ≥ 200 mg/dL or abnormal 3-hour GTT). The primary composite perinatal morbidity outcome included any of the following: large for gestational age (LGA) birthweight, birth injury, hypoglycemia with neonatal intensive care unit (NICU) admission, respiratory distress syndrome, transient tachypnea of the newborn, apnea, NICU admission, or perinatal death. Multiple secondary outcomes were also evaluated. Bivariable analyses and multivariable logistic regression modeling were performed.

Results

Of 37,277 eligible patients, 29,698 (79.7%) had normal screening results, 5092 (13.7%) had intermediate screening results, and 2487 (6.6%) were diagnosed with GDM. There were significant differences in baseline characteristics between the three groups, including age, parity, race and ethnicity, payer-type, obesity, and pre-pregnancy metformin use. Compared to normal screening, intermediate screening was associated with an increased risk for the composite perinatal morbidity outcome (OR 1.23, 95% CI 1.15–1.32), cesarean (OR 1.37, 95% CI 1.28–1.46), and hypertensive disorders of pregnancy (OR 1.30, 95% CI 1.20–1.40). Associations for these outcomes were further pronounced in those with GDM compared to normal screening (OR 1.86, 95% CI 1.70–2.03; OR 1.69, 95% CI 1.56–1.84; and OR 1.57, 95% CI 1.42–1.74, respectively). After adjusting for potential confounders, increased risks for the composite perinatal morbidity outcome persisted for those with intermediate screening (aOR 1.18, 95% CI 1.10–1.26).

Conclusions

In addition to patients with GDM, individuals an isolated abnormal 1-hour GCT without GDM were also at increased risks for adverse pregnancy outcomes. Further investigation is needed to understand if patients with mild dysregulation may still benefit from other interventions.
Health literacy disparities in Thai university students: exploring differences between health science and non-health science disciplines
Authors: Manochaiwuthikul Thanyaporn , Chaichutchouwakul Amornrat , Yunan Nantakarn , Winothai Niwarin , Kanta Peewara , Sapbamrer Ratana
Published: February 2025

Background

Health literacy (HL) in Thailand remains a significant issue, with a large portion of the population demonstrating limited HL, and limited research exists on specific determinants among Thai university students. Some culture shapes health decision-making and HL disparities within this group, highlighting the need to evaluate HL comprehensively. This study aims to assess and compare HL levels among health science and non-health science students, and identify key predictors associated with HL.

Methods

A cross-sectional study was conducted among 1,647 Thai university students, comprising 676 health science and 971 non-health science students, recruited through multi-stage stratified random sampling. Data were collected using validated questionnaires that measured sociodemographic characteristics, academic background, lifestyle behaviors, and HL levels across three sub-domains, including healthcare, disease prevention, and health promotion. Statistical analyses included univariable and multivariable regression models, with significance set at p-value < 0.05.

Results

Health sciences students demonstrated significantly higher HL scores across all sub-domains compared to non-health sciences students. Limited HL was found in 12.6% for health science students, and 28.4% for non-health science students. Key predictors of overall HL included gender, income, faculty of study, and lifestyle-related health behaviors. Female students showed higher total HL (β = 1.41; 95% CI: 0.62, 2.21), as did those with higher income (β = 1.28; 95% CI: 0.76, 1.80). Students enrolled in health sciences programs had higher HL scores (β = 2.86; 95% CI: 2.07, 3.64). Lifestyle behaviors also correlated with HL, with non-smoking (β = -0.58; 95% CI: -1.03, -0.13), no alcohol consumption (β = -0.45, 95%CI: -0.89, -0.01), and regular physical activity (β = 0.35; 95% CI: 0.04, 0.66). Consumption of sweet foods/drinks was inversely related to HL scores (β = -0.87; 95% CI: -1.49, -0.26).

Conclusions

HL among Thai university students varies significantly by sociodemographic factors, academic background, and lifestyle behaviors. Health sciences students exhibited stronger HL skills, underscoring the importance of integrating health education into non-health sciences curricula. Targeted HL interventions are recommended for non-health sciences students, males, and individuals from lower-income backgrounds to enhance health decision-making and reduce HL disparities. These findings have implications for policy and practice, emphasizing the integration of HL modules into university curricula, health promotion campaigns, and the provision of accessible health services to foster an inclusive and health-literate student population.
“ I can’t do it anymore”: a qualitative study on the emergence of crisis in outpatient palliative care—the perspective of family caregivers
Authors: Azhar Sofia , Herrmann-Johns Anne , Wolff Daniel , Rechenmacher Michael , Kaiser Ulrich , Wasner Maria
Published: February 2025

Background

The outpatient palliative care system is a central component of the palliative care structure in Germany, with family caregivers playing a vital role in ensuring and maintaining its success. However, crisis situations can destabilise and harm outpatient care. Previous studies have analysed hospitalisations and emergency admissions during palliative care. However, little is known about the factors that contribute to the emergence of crises in palliative outpatient care. The aim of this study was to identify factors contributing to the emergence of crisis in palliative outpatient care including the identification of protective strategies.

Methods

A qualitative study using semi-structured interviews with family caregivers recently involved in outpatient palliative care was performed. The analysis was conducted using thematic coding.

Results

A total of 15 family caregivers (13 female and 2 male) were recruited for the study. Crisis situations emerged through a cumulation of factors. Four categories of factors were identified: (1) structural factors, including limited access to health care professionals and a lack of necessary information, (2) illness related factors such as sudden progression in the illness trajectory and symptoms, (3) the intensity of care involvement and (4) emotional and psychological burden of family caregivers. A diverse range of protective strategies were employed by family caregivers, encompassing the involvement of the social network, the pursuit of information and the identification of a sense of purpose.

Conclusion

The findings of this study confirm the importance of providing continuous, competent, and empathetic care to both family caregivers and patients in palliative outpatient care. The study highlights the importance of expanding the palliative care infrastructure, as well as ensuring unrestricted access to palliative care professionals, developing tailored information tools for family caregivers, and reducing bureaucracy. Further studies are needed to identify additional influencing factors and evaluate effective measures.
Metabolomics- and proteomics-based multi-omics integration reveals early metabolite alterations in sepsis-associated acute kidney injury
Authors: Huang Pengfei , Liu Yanqi , Li Yue , Xin Yu , Nan Chuanchuan , Luo Yinghao , Feng Yating , Jin Nana , Peng Yahui , Wang Dawei , Zhou Yang , Luan Feiyu , Wang Xinran , Wang Xibo , Li Hongxu , Zhou Yuxin , Zhang Weiting , Liu Yuhan , Yuan Mengyao , Zhang Yuxin , Song Yuchen , Xiao Yu , Shen Lifeng , Yu Kaijiang , Zhao Mingyan , Cheng Lixin , Wang Changsong
Published: February 2025

Background

Sepsis-associated acute kidney injury (SA-AKI) is a frequent complication in patients with sepsis and is associated with high mortality. Therefore, early recognition of SA-AKI is essential for administering supportive treatment and preventing further damage. This study aimed to identify and validate metabolite biomarkers of SA-AKI to assist in early clinical diagnosis.

Methods

Untargeted renal proteomic and metabolomic analyses were performed on the renal tissues of LPS-induced SA-AKI and sepsis mice. Glomerular filtration rate (GFR) monitoring technology was used to evaluate real-time renal function in mice. To elucidate the distinctive characteristics of SA-AKI, a multi-omics Spearman correlation network was constructed integrating core metabolites, proteins, and renal function. Subsequently, metabolomics analysis was used to explore the dynamic changes of core metabolites in the serum of SA-AKI mice at 0, 8, and 24 h. Finally, a clinical cohort (28 patients with SA-AKI vs. 28 patients with sepsis) serum quantitative metabolomic analysis was carried out to build a diagnostic model for SA-AKI via logistic regression (LR).

Results

Thirteen differential renal metabolites and 112 differential renal proteins were identified through a multi-omics study of SA-AKI mice. Subsequently, a multi-omics correlation network was constructed to highlight five core metabolites, i.e., 3-hydroxybutyric acid, 3-hydroxymethylglutaric acid, creatine, myristic acid, and inosine, the early changes of which were then observed via serum time series experiments of SA-AKI mice. The levels of 3-hydroxybutyric acid, 3-hydroxymethylglutaric acid, and creatine increased significantly at 24 h, myristic acid increased at 8 h, while inosine decreased at 8 h. Ultimately, based on the identified core metabolites, we recruited 56 patients and constructed a diagnostic model named IC3, using inosine, creatine, and 3-hydroxybutyric acid, to early identify SA-AKI (AUC = 0.90).

Conclusions

We proposed a blood metabolite model consisting of inosine, creatine, and 3-hydroxybutyric acid for the early screening of SA-AKI. Future studies will observe the performance of these metabolites in other clinical populations to evaluate their diagnostic role.
Touchscreen-based assessment of upper limb kinematics after stroke: Reliability, validity and sensitivity to motor impairment
Authors: Goizueta Sandra , Navarro María Dolores , Calvo Gabriela , Campos Gloria , Colomer Carolina , Noé Enrique , Llorens Roberto
Published: February 2025

Background

Conventional clinical tools for assessing upper limb motor function often lack the sensitivity and specificity needed to detect subtle changes in motor performance and may be subject to bias. Kinematic assessment offers a potential solution by providing objective, precise, and detailed data on movement quality. However, it is typically associated with high costs, complex equipment, time-consuming procedures, and the need for controlled environments, all of which limit its accessibility and practicality in clinical settings. This study aimed to evaluate the reliability, validity, and sensitivity of a low-cost, touchscreen-based kinematic assessment tool for measuring upper limb function in individuals post-stroke.

Methods

Sixty-four individuals with stroke participated in this study. Participants performed a visually guided reaching task on a large touch screen that consisted in reaching from a central target to five outer targets arranged in a circular pattern, each at a time, and then returning to the central target. Their motor function was assessed using the Fugl-Meyer Assessment for Upper Extremity, the Box and Block Test, and the Nine Hole Peg Test. Kinematic measures of the trajectories performed during the reaching task were extracted and analyzed for reliability, convergent validity with clinical assessments, and sensitivity to impairment severity.

Results

The kinematic measures demonstrated good to excellent test-retest reliability, with intraclass correlation coefficients ranging from moderate to excellent. The convergent validity analysis revealed multiple significant correlations between the kinematic parameters and clinical assessments, particularly in tests requiring higher skill and precision, such as the Coordination and Speed subscale of the Fugl-Meyer Assessment for Upper Extremity and the Nine Hole Peg Test. Additionally, the touchscreen-based assessment was sensitive to the severity of motor impairment, as reflected by notable differences in the kinematic measures among participants with varying levels of upper limb function.

Conclusions

The touchscreen-based kinematic assessment offered an affordable yet reliable, valid, and sensitive alternative for evaluating upper limb kinematics in individuals with stroke, which could complement clinical assessments by offering additional insights into motor performance. Furthermore, its low cost, high speed, and ease of use make it a practical option for widespread clinical adoption.