bluuebunny/crossref_metadata_2025 huggingface dataset:
The Role of Escin as a Topical Agent for Lymphedema Treatment in a Rat Model
Authors: Jeong Hyung Hwa , Kim Donggeun , Kim Taehyun , Suh HyunSuk Peter , Pak ChangSik John , Jeon Jae Yong , Hong Joon Pio
Published: August 2023

Escin, a naturally derived material isolated from horse chestnut, is used as an anti-inflammatory and anti-edema agent. This study aimed to evaluate its effects on lymphedema in a rat tail model. We divided the rats into five groups. The treatment groups received topical application of escin gel at concentrations of 20%, 10%, 2%, and 0.5% for 4 weeks. The fifth group served as a control. We performed volumetric (water displacement) tests, H&E staining, and LYVE-1 immunohistochemical staining, followed by statistical evaluation. All treatment groups showed significant volumetric reductions compared with the control group, but no significant differences were observed between the treatment groups. H&E staining showed a significant reduction in dermal thickness in the 20%, 10%, and 2% escin treatment groups compared to the control group. Within the treatment groups, the 2% escin group showed a significant difference compared with the 20% and 10% escin groups (p = 0.021 for both). LYVE-1 immunohistochemical staining revealed a significantly higher mean lymphatic vessel count in the 2% escin group compared with the 20%, 10%, and 0.5% escin-treated groups and the control group (p = 0.019, p = 0.025, p = 0.019, and p = 0.032 respectively). Topical escin applied to a rat tail model of acute lymphedema resulted in a significant reduction in tail volume, reduced dermal thickness, and increased lymphatic structures. The 2% escin concentration may be the optimal dose for improving lymphedema in this model. Further research is warranted to explore the clinical application of escin in patients with lymphedema.
Updated ultrafast dynamic computed tomography myelography technique for cerebrospinal fluid leaks
Authors: Mark Ian T , Madhavan Ajay A , Benson John C , Verdoorn Jared T , Yu Lifeng
Published: August 2023

We present an updated ultrafast dynamic computed tomography myelography technique that can be used for the localization of spontaneous spinal cerebrospinal fluid leaks in the setting of spontaneous intracranial hypotension. This has over twice the temporal resolution of previously described techniques at the same radiation dose output.
Prevalence of primary and secondary hypertension among hospitalized patients with cancer in the United States
Authors: Park Chanhyun , Han Sola , Litten Kathryn P , Mehta Sanica , Ng Boon Peng
Published: August 2023

Background

Hypertension is the most common comorbidity in patients with cancer. We aimed to estimate the prevalence of hypertension by demographic characteristics and cancer type among hospitalized patients with cancer.

Methods

Hospitalized cancer patients were included using 2016–2018 National Inpatient Sample data. The independent variable was the presence of hypertension, which was further classified as primary, secondary, and other hypertension. Patient characteristics were grouped by age, sex, race/ethnicity, and the 12 most common cancer types. Multinomial logistic regression was used.

Results

Among 638,670 hospitalized patients with cancer, 56.8% had hypertension. The predicted percentages of having any hypertension were higher with age, male gender, and black race. The predicted percentages of any hypertension were the highest in kidney cancer patients across all age and race/ethnicity groups. Uterine cancer was associated with the highest percentages of primary hypertension, followed by kidney cancer. Leukemia was associated with the highest percentages of secondary hypertension, followed by non-Hodgkin lymphoma.

Discussion

Kidney cancer patients had the highest predicted percentage of hypertension overall, while uterine cancer and leukemia had the highest percentages of primary and secondary hypertension, respectively. This study provides evidence for identifying cancer patients who need more attention for the prevention and management of hypertension.
Comparison of early aggressive versus nonaggressive fluid resuscitation in acute pancreatitis: a meta-analysis
Authors: Guo Jian , Hong Jiaze , He Yujing , Li Qingyuan , Huang Tongmin , Lou Dandi , Zhang Jie
Published: August 2023

Background:

Early fluid resuscitation is one of the main therapeutic strategies for acute pancreatitis (AP). This study investigated the effects of early aggressive and nonaggressive hydration on AP.

Objectives:

The aim of this meta-analysis is to investigate the differences between aggressive and nonaggressive intravenous fluid resuscitation in AP.

Design:

This study was based on publicly available data, all of which have been extracted from previous ethically approved studies.

Data sources and methods:

Two authors systematically searched PubMed, Embase (via OVID), Web of Science, and Cochrane Library to find all published research before February 2023. In-hospital mortality were set as primary endpoints.

Results:

This meta-analysis included seven randomized controlled trials (RCTs) and eight cohort studies with 4072 individuals in nonaggressive ( n = 2419) and aggressive ( n = 1653) hydration groups. The results showed that patients in the nonaggressive group had a lower mortality rate than those in the aggressive hydration group [relative risks (RR), 0.66; p = 0.02]. Subgroup analysis results showed that patients in the nonaggressive hydration group had lower mortality rates in RCTs (RR, 0.39; p = 0.001), studies conducted in Eastern countries (RR, 0.63; p = 0.002), and studies with severe pancreatitis (RR, 0.65; p = 0.02). In addition, the nonaggressive hydration group had lower rates of infection (RR, 0.62; p < 0.001), organ failure (RR, 0.65; p = 0.02), and shock (RR, 0.21; p = 0.02), as well as a shorter hospital stay (weighted mean difference, −1.63; p = 0.001) than the aggressive hydration group.

Conclusions:

Early nonaggressive fluid resuscitation is associated with lower mortality, lower risk of organ failure and infection, and shorter hospital stays than aggressive fluid resuscitation.

Registration (prospero registration number):

CRD42023396388.
Smartphone Bolus Feature Increases Number of Insulin Boluses in People With Low Bolus Frequency
Authors: Messer Laurel H. , D’Souza Edwin , Merchant Gina , Mueller Lars , Farnan Jason , Habif Steph , Pinsker Jordan E.
Published: August 2023

Background:

The t:connect mobile app from Tandem Diabetes Care recently added a feature to allow t:slim X2 insulin pump users to initiate an insulin bolus from their personal smartphone. User experience and user interface considerations prioritized safety and ease of use, and we examined whether the smartphone bolus feature changed bolus behavior in individuals who bolused less than three times/day.

Methods:

We performed a retrospective analysis of t:slim X2 insulin pump users in the United States who had remotely updated their insulin pump software to be compatible with the smartphone bolus version of the app and who gave less than three boluses per day prior to the smartphone bolus update.

Results:

Of the 4470 early adopters who met these criteria, the median number of boluses was 2.2 per day (prior to smartphone bolus update) versus 2.7 per day (after smartphone bolus update), equating to approximately half a bolus more delivered per day ( P < .001). Overall, a median of one bolus per day was administered by smartphone app as opposed to being initiated from the screen on the insulin pump.

Conclusion:

This analysis found a significant increase in bolusing behavior among early adopters of the smartphone bolus feature of the t:connect mobile app.
Biophilic Design and Its Effectiveness in Creating Emotional Well-Being, Green Satisfaction, and Workplace Attachment Among Healthcare Professionals: The Hospice Context
Authors: Untaru Elena-Nicoleta , Han Heesup , David Andreea , Chi Xiaoting
Published: August 2023

Objective:

The present study aimed to explore the biophilic design attributes within a hospice care center from the healthcare professionals’ perspective by utilizing a qualitative research and investigated the effect of hospice professionals’ attitudes toward the uncovered green features on the prediction of their workplace attachment through a quantitative research.

Background:

In hospice establishments, studies showed that applying biophilic design principles significantly reduces stress and improves emotional well-being. Yet, despite its importance, attitude toward biophilic design, and its significant influence on well-being, satisfaction and attachment to the workplace of hospice healthcare professionals have not yet been researched.

Methods:

The qualitative research used semi-structured in-depth interviews among hospice professionals to reveal biophilic design features that exert an influence on their activity, while the quantitative research employed a confirmatory factor analysis and the structural equation modeling to analyze the data.

Results and Conclusions:

The qualitative research generated five biophilic design features, such as open spaces with natural light, natural decorative elements, landscape provided by nature through windows, wooden furniture, and colors that create a warm atmosphere within the hospice care center. The quantitative approach indicated that attitude toward the uncovered biophilic design features in the context of the COVID-19 pandemic significantly improved the healthcare providers’ emotional well-being. This dimension, in turn, contributed to their satisfaction with green features/natural decor and attachment to the workplace. Results of this study provide practitioners and researchers valuable strategies to incorporate biophilic design features in the working environments of hospice settings.
A blockchain-based computerized network infrastructure for the transparent, immutable calculation and dissemination of quantitative, measurable parameters of academic and medical research publications
Authors: Segal Gad , Martsiano Yonatan , Markinzon Alina , Mayer Amit , Halperin Avner , Zimlichman Eyal
Published: August 2023

Digital transformation of healthcare systems should rely on decentralized computer networks and take advantage of the unique characteristics of blockchain technology. Decentralization ensures process transparency and data transparency for all relevant stakeholders. These values are essential in the realms of populations’ healthcare information communications and processing, control and tracking of medical logistics supply chains, clinical research management, and control of certified healthcare services organizations. Mounting decentralized processes onto a blockchain-based computerized network will endow the values of immutability, improved cybersecurity, and potential for incentivizing stakeholders for relevant, pre-determined activities. One of the most relevant processes that would benefit from a decentralized, blockchain-based architecture is the submission, review, and publishing of scientific manuscripts. Current structures and processes in this world are non-transparent, poorly incentivizing significant stakeholders such as manuscripts’ reviewers, and many are potentially corrupted. In this review, we suggest a blockchain-based architecture for such systems and advocate further research and development in several domains of modern healthcare systems—offering medicine to become “the new guy on the block (chain).”
Potholes and Power: A Multimodal Critical Discourse Analysis of “Look At This F*ckin’ Street” on Instagram
Authors: Turvy Alex
Published: August 2023

The condition of road infrastructure in New Orleans is recognized among citizens as unacceptably poor. This problem is one in a long list of problems with the municipal government and city services that have combined to create an atmosphere of distrust and deep frustration. On Instagram, “Look At This F*ckin Street” (LATFS) exists to document failing local infrastructure and has over 94,000 followers and an active culture of crowdsourced user submissions and regular engagement in comments and reposts. In this article, I utilize Multimodal Critical Discourse Analysis to explore all of the relevant discursive modalities seen in the account in order to uncover how they work to challenge and ultimately undermine power. Via an open coding process, I identify three main strategies employed by the anonymous account manager and the participating followers: Shaming, Mocking, and Exposing. Within each of these strategies, I explore the specific techniques observed within these discourses that contribute to the effectiveness of these strategies. I argue that LATFS is an effective and powerful participatory platform for exposing a broad range of systemic problems and their causes, allowing residents to take back the narrative of their city’s infrastructure challenges, diminish and demean the powerful interests responsible, and ultimately attempt to reclaim the power lost to negligent or even bad-faith municipal authorities in New Orleans.
Biomechanical Analysis Evaluating Meniscal Extrusion After Knotless Suture Anchor Fixation for Segmental Medial Meniscal Allograft Transplantation
Authors: Ganokroj Phob , Fossum Bradley W. , Hollenbeck Justin , Whalen Ryan J. , Garcia Alexander R. , Foster Michael J. , Provencher CAPT Matthew T.
Published: August 2023

Background:

Segmental medial meniscal allograft transplantation (MAT) has been shown to restore knee biomechanics; however, stable fixation of the transplantation is critical to avoid extrusion and maximize healing.

Purpose:

To evaluate the degree of meniscal extrusion and biomechanical function of segmental medial MAT performed with meniscocapsular sutures versus repair augmentation with knotless suture anchors.

Study Design:

Controlled laboratory study.

Methods:

Segmental midbody medial meniscectomy and subsequent segmental medial MAT were performed on 10 fresh-frozen cadaveric knees. The knees were then loaded in a dynamic tensile testing machine to 1000 N for 60 seconds at 0°, 30°, 60°, and 90° of flexion, and 4 conditions were tested: (1) intact, (2) segmental defect, (3) inside-out segmental repair, and (4) anchor plus inside-out segmental repair of the medial MAT. Meniscal extrusion was measured using high-fidelity ultrasound imaging. The mean contact area and the mean and peak contact pressures were assessed with submeniscal pressure-mapping sensors. Data from testing conditions were compared with 2-way repeated-measures analysis of variance, with pairwise comparison using the Bonferroni method.

Results:

At 90° of flexion, the segmental defect state showed a higher degree of meniscal extrusion compared with all other states ( P ≤ .012). There was no difference in the degree of meniscal extrusion between the intact state and the inside-out repair or anchor plus inside-out segmental repair states at all knee flexion angles ( P > .05). There was no significant difference in the mean and peak contact pressures among the 4 states at all flexion angles except that at 0° of knee flexion there was significantly lower peak contact pressure at the medial compartment after anchor plus inside-out segmental repair compared with the segmental defect state ( P = .048).

Conclusion:

Meniscal extrusion was not significantly increased at any flexion angle after segmental resection. The addition of knotless anchors did not improve meniscal extrusion or contact pressures/area compared with capsular repair alone. The addition of knotless anchors did improve contact mechanics from the segmental defect state, but only at 0° of flexion.

Clinical Relevance:

The addition of knotless suture anchors to segmental meniscal transplantation increased stabilization of the meniscus at full extension compared with repair with sutures alone. This increased stabilization may lead to better long-term outcomes.
Nation-building, Minority Rights, and Denotified Communities: A Conceptual Understanding
Authors: Alam Md Moshabbir
Published: August 2023

The complicated connections between nation-building, minority rights, and denotified communities in India are examined in this article. It offers an epistemological knowledge of the historical, political and social influences that have moulded these populations’ experiences, which are frequently left out of discussions about fostering national identity and minority rights. The study makes the case that nation-building initiatives in India frequently rest on a homogenized notion of national identity that ignores the varied cultural, linguistic, and ethnic identities of marginalized communities. This has led to the systematic marginalization of groups that have been notified and the violation of minority rights. This article adopts the library research method. The utilization of library research is a significant resource for the researchers seeking to acquire a more profound comprehension of a specific topic or subject matter. The methodology offers a methodical and organized strategy for collecting and evaluating data, which can aid scholars in discovering novel avenues for their investigations or contribute to advancing fresh concepts or principles within their discipline. This study addresses the issue’s cultural, social, and political elements and considers more inclusive and equitable nation-building strategies while drawing on multidisciplinary scholarship. In the end, it makes the case that in order to be genuinely democratic, society must place a high priority on recognizing and defending the rights of all of its members, especially those who have historically been marginalized and excluded.
Toward representative genomic research: the children’s rare disease cohorts experience
Authors: Frazier Zoë J. , Brown Eurnestine , Rockowitz Shira , Lee Ted , Zhang Bo , Sveden Abigail , Chamberlin Nancy L. , Dies Kira A. , Poduri Annapurna , Sliz Piotr , Chopra Maya
Published: August 2023

Background:

Due to racial, cultural, and linguistic marginalization, some populations experience disproportionate barriers to genetic testing in both clinical and research settings. It is difficult to track such disparities due to non-inclusive self-reported race and ethnicity categories within the electronic health record (EHR). Inclusion and access for all populations is critical to achieve health equity and to capture the full spectrum of rare genetic disease.

Objective:

We aimed to create revised race and ethnicity categories. Additionally, we identified racial and ethnic under-representation amongst three cohorts: (1) the general Boston Children’s Hospital patient population (general BCH), (2) the BCH patient population that underwent clinical genomic testing (clinical sequencing), and (3) Children’s Rare Disease Cohort (CRDC) research initiative participants.

Design and Methods:

Race and ethnicity data were collected from the EHRs of the general BCH, clinical sequencing, and CRDC cohorts. We constructed a single comprehensive set of race and ethnicity categories. EHR-based race and ethnicity variables were mapped within each cohort to the revised categories. Then, the numbers of patients within each revised race and ethnicity category were compared across cohorts.

Results:

There was a significantly lower percentage of Black or African American/African, non-Hispanic/non-Latine individuals in the CRDC cohort compared with the general BCH cohort, but there was no statistically significant difference between the CRDC and the clinical sequencing cohorts. There was a significantly lower percentage of multi-racial, Hispanic/Latine individuals in the CRDC cohort than the clinical sequencing cohort. White, non-Hispanic/non-Latine individuals were over-represented in the CRDC compared to the two other groups.

Conclusion:

We highlight underrepresentation of certain racial and ethnic populations in sequencing cohorts compared to the general hospital population. We propose a range of measures to address these disparities, to strive for equitable future precision medicine-based clinical care and for the benefit of the whole rare disease community.
Identification and molecular evolution of the GLX genes in 21 plant species: a focus on the Gossypium hirsutum
Authors: Xu Menglin , Zuo Dongyun , Wang Qiaolian , Lv Limin , Zhang Youping , Jiao Huixin , Zhang Xiang , Yang Yi , Song Guoli , Cheng Hailiang
Published: August 2023

Background

The glyoxalase system includes glyoxalase I (GLXI), glyoxalase II (GLXII) and glyoxalase III (GLXIII), which are responsible for methylglyoxal (MG) detoxification and involved in abiotic stress responses such as drought, salinity and heavy metal.

Results

In this study, a total of 620 GLX family genes were identified from 21 different plant species. The results of evolutionary analysis showed that GLX genes exist in all species from lower plants to higher plants, inferring that GLX genes might be important for plants, and GLXI and GLXII account for the majority. In addition, motif showed an expanding trend in the process of evolution. The analysis of cis-acting elements in 21 different plant species showed that the promoter region of the GLX genes were rich in phytohormones and biotic and abiotic stress-related elements, indicating that GLX genes can participate in a variety of life processes. In cotton, GLXs could be divided into two groups and most GLXIs distributed in group I, GLXIIs and GLXIIIs mainly belonged to group II, indicating that there are more similarities between GLXII and GLXIII in cotton evolution. The transcriptome data analysis and quantitative real-time PCR analysis (qRT-PCR) show that some members of GLX family would respond to high temperature treatment in G.hirsutum. The protein interaction network of GLXs in G.hirsutum implied that most members can participate in various life processes through protein interactions.

Conclusions

The results elucidated the evolutionary history of GLX family genes in plants and lay the foundation for their functions analysis in cotton.
Impacts of kinetin implementation on leaves, floral and root-related traits during seed production in hybrid rice under water deficiency
Authors: Ghazy Mohamed I. , Hamad Hassan Sh. , Gewaily Elsayed E. , Bleih Eman M. , Arafat Elsayed F. A. , EL-Kallawy Wael H. , EL-Naem Sabry A. , Rehan Medhat , Alwutayd Khairiah Mubarak , Abd El Moneim Diaa
Published: August 2023

Background

Water deficit is one of the most significant abiotic factors affecting rice and agricultural production worldwide. In hybrid rice, cytoplasmic male sterility (CMS) is an important technique for creating high-yielding crop based on heterosis. The phytohormone kinetin (Kin) regulates cell division in plant during the early stages of grain formation, as well as flow assimilation and osmotic regulation under water stress. The present study performed to estimate the effects of irrigation intervals (irrigation each six days (I6), nine days (I9), twelve days (I12) and fifteen days (I15) against continuous flooding (CF, each three days)) and kinetin exogenously application (control, 15 mg L−1 and 30 mg L−1) on hybrid rice (L1, IR69625A; L2, G46A and R, Giza 178 R) seed production.

Results

Leaves traits (Chlorophyll content (CHC), relative water content (RWC), stomatal conductance (SC), Leaf temperature (LT) and transpiration rate (TR)), floral traits such as style length (SL) and total stigma length (TSL), in addition to root traits (i.e., root length (RL), root volume (RV), root: shoot ratio (RSR), root thickness (RT), root xylem vessels number (RXVN) and root xylem vessel area (RXVA) were evaluated and a significant enhancement in most traits was observed. Applying 30 mg L−1 kinetin significantly and positively enhanced all growth, floral and roots traits (RV and RXVA recorded the most increased values by 14.8% and 23.9%, respectively) under prolonging irrigation intervals, in comparison to non-treated plants.

Conclusions

Subsequently, spraying kinetin exogenously on foliar could be an alternative method to reduce the harmful influences of water deficiency during seed production in hybrid rice.
The relationship between living alone or not and depressive symptoms in older adults: a parallel mediation effect of sleep quality and anxiety
Authors: Huang Mina , Liu Kun , Liang Chunguang , Wang Yongzhu , Guo Zhanpeng
Published: August 2023

Background

With modernization and ageing in China, the population of older adults living alone is increasing. Living alone may be a potential risk factor for depressive symptoms. However, no parallel mediation model analysis has investigated the mediating factors for living alone or not (living arrangements) and depressive symptoms.

Methods

This cross-sectional study included a total number of 10,980 participants from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), 1699 of whom lived alone and 9281 of whom did not live alone. Binary logistic regression and parallel mediation effect model were used to explore the relationship between living alone or not and depressive symptoms and possible mediation effects. Bootstrap analysis was used to examine the mediation effect of living alone or not on depressive symptoms.

Results

Compared to the participants who were not living alone, the living alone group had a higher rate of depressive symptoms. The binary logistic regression showed that after adjusting for other covariates, the risk of depressive symptoms was approximately 0.21 times higher for living alone compared to not living alone (OR = 1.21, 95% CI: 1.06, 1.37). Further, the results of the bootstrap analysis supported the partial mediating role of sleep quality and anxiety. Mediation analysis revealed that sleep quality and anxiety partially mediate the relationship between living alone and depressive symptoms (β = 0.008, 95% CI [0.003, 0.014]; β = 0.015, 95% CI [0.008, 0.024], respectively).

Conclusions

Sleep quality and anxiety were identified as partially parallel mediators between living alone or not and depressive symptoms. Older adults living alone with poorer sleep quality and more pronounced anxiety were positively associated with higher levels of depressive symptoms. Older adults living alone should be encouraged to engage in social activities that may improve sleep quality, relieve anxiety, and improve feelings of loneliness caused by living alone. Meanwhile, older adults living alone should receive attention and support to alleviate their depressive symptoms.
A national screening for the prevalence and profile of disability types among Egyptian children aged 6–12 years: a community-based population study
Authors: Metwally Ammal M. , Salah El-Din Ebtissam M. , Abdel-Latif Ghada A. , Nagi Dina A. , El Etreby Lobna A. , Abdallah Ali M. , Khadr Zeinab , Bassiouni Randa I. , Abdel Raouf Ehab R. , Elsaied Amal , Elkhatib Alshaimaa A. , Sallam Sara F. , El-Sonbaty Marwa M. , Shehata Manal A. , Elghareeb Nahed A. , Badawy Hala Y. , Ahmed Doaa E. , Ibrahim Nihad A. , Emam Hanaa , Abd El Dayem Soha M. , Fathy Asmaa M.
Published: August 2023

Aim

This study aimed to determine the prevalence of disability domains among Egyptian children in the age group of 6–12 years as well as assess their socio-demographic, epidemiological, and perinatal predictors.

Methods

A national population-based cross-sectional household survey targeting 20,324 children from eight governorates was conducted. The screening questionnaire was derived from the WHO ten-question survey tool validated for the identification of disabilities.

Results

The prevalence of children with at least one type of disability was 9.2%. Learning/ comprehension was the most prevalent type (4.2%), followed by speech/communication (3.7%), physical/ mobility and seizures (2.2% for each), intellectual impairment (1.5%), visual (0.7%), and hearing (0.4%). The commonest predictors for disabilities were children who suffered from convulsions or cyanosis after birth and maternal history of any health problem during pregnancy. However, preterm and low birth weight (LBW) babies or being admitted to incubators for more than two days were strong predictors for all disabilities except hearing disability. A history of jaundice after birth significantly carried nearly twice the odds for seizures (AOR = 2.2, 95% CI:1.5–3.4). History of difficult labor was a predictor of intellectual impairment (AOR = 1.5, 95% CI:1.1–2.0). A disabled mother was a strong predictor for all disabilities except seizures, while a disabled father was a predictor for visual and learning/ comprehension disabilities (AOR = 3.9, 95% CI:2.2–7.1 & AOR = 1.6, 95% CI:1.1–2.4 respectively). Meanwhile, both higher maternal and paternal education decreased significantly the odds to have, physical/ mobility and Learning/ comprehension by at least 30%.

Conclusion

The study found a high prevalence of disability among Egyptian children aged 6–12 years. It spotted many modifiable determinants of disability domains. The practice of early screening for disability is encouraged to provide early interventions.
Spatial analysis of overweight prevalence in China: exploring the association with air pollution
Authors: Wang Peihan , Li Kexin , Xu Chengdong , Fan Zixuan , Wang Zhenbo
Published: August 2023

Background

Overweight is a known risk factor for various chronic diseases and poses a significant threat to middle-aged and elderly adults. Previous studies have reported a strong association between overweight and air pollution. However, the spatial relationship between the two remains unclear due to the confounding effects of spatial heterogeneity.

Methods

We gathered height and weight data from the 2015 China Health and Retirement Long-term Survey (CHARLS), comprising 16,171 middle-aged and elderly individuals. We also collected regional air pollution data. We then analyzed the spatial pattern of overweight prevalence using Moran's I and Getis-Ord Gi* statistics. To quantify the explanatory power of distinct air pollutants for spatial differences in overweight prevalence across Southern and Northern China, as well as across different age groups, we utilized Geodetector's q-statistic.

Results

The average prevalence of overweight among middle-aged and elderly individuals in each city was 67.27% and 57.39%, respectively. In general, the q-statistic in southern China was higher than that in northern China. In the north, the prevalence was significantly higher at 54.86% compared to the prevalence of 38.75% in the south. SO2exhibited a relatively higher q-statistic in middle-aged individuals in both the north and south, while for the elderly in the south, NO2was the most crucial factor (q = 0.24,p < 0.01). Moreover, fine particulate matter (PM2.5and PM10) also demonstrated an important effect on overweight. Furthermore, we found that the pairwise interaction between various risk factors improved the explanatory power of the prevalence of overweight, with different effects for different age groups and regions. In northern China, the strongest interaction was found between NO2and SO2(q = 0.55) for middle-aged individuals and PM2.5and SO2(q = 0.27) for the elderly. Conversely, in southern China, middle-aged individuals demonstrated the strongest interaction between SO2and PM10(q = 0.60), while the elderly showed the highest interaction between NO2and O3(q = 0.42).

Conclusion

Significant spatial heterogeneity was observed in the effects of air pollution on overweight. Specifically, air pollution in southern China was found to have a greater impact on overweight than that in northern China. And, the impact of air pollution on middle-aged individuals was more pronounced than on the elderly, with distinct pollutants demonstrating significant variation in their impact. Moreover, we found that SO2had a greater impact on overweight prevalence among middle-aged individuals, while NO2had a greater impact on the elderly. Additionally, we identified significant statistically interactions between O3and other pollutants.
Analysis of abnormal muscle activities in patients with loss of cervical lordosis: a cross-sectional study
Authors: Lim Jiwoon , Lee Dajeong , Kim Sangyoung , Lee Seungeun , Ryu Ju Seok
Published: August 2023

Background

This study aimed to detect the differences in cervical muscle activation patterns in people with versus without cervical lordosis and explore the possible mechanism of cervical pain originating therein.

Methods

This cross-sectional design included 39 participants without and 18 with normal cervical lordosis. Muscular activation was measured for 5 s in both groups using surface electromyography. Subsequently, the root mean square (RMS) of muscle amplitude was obtained at the bilateral splenius capitis, upper and lower parts of the splenius cervicis, upper and lower parts of the semispinalis cervicis, sternocleidomastoid, upper trapezius, and rhomboid muscles in five cervical positions: 0° (resting), 30° of flexion, 30° of extension, 60° of extension, and upon a 1-kg load on the head in a resting posture.

Results

The RMS values of the upper trapezius muscle at all postures and the rhomboid muscles at 60° of extension were significantly lower in the loss of lordosis than control group. Comparing the RMS ratio of each posture to the resting position, the ratio of the upper trapezius at flexion was significantly higher and that of the rhomboids at 60° of extension and upon loading was significantly lower in the loss of lordosis than control group. Moreover, the pattern changes in the RMS values according to posture showed a similar shape in these two muscles, and lower in the loss of lordosis than the normal group.

Conclusions

The loss of normal cervical alignment may correlate with predisposed conditions such as reduced muscle activation of the trapezius and rhomboid muscle, and may also provoke over-firing of the upper trapezius muscle, possibly increasing neck musculoskeletal pain.

Trial registration.

Clinicaltrials.gov, registration number: NCT03710785.
A scoping review on the factors associated with the lost to follow-up (LTFU) amongst patients with chronic disease in ambulatory care of high-income countries (HIC)
Authors: Tong Ching Yi Michelle , Koh Rui Ying Victoria , Lee Eng Sing
Published: August 2023

Background

Despite the importance of long term follow-up care for patients with chronic disease, many patients fail to adhere to their follow-ups, which increase their risk of further health complications. Therefore, the purpose of this scoping review was to find out the factors associated with lost to follow-up (LTFU) amongst patients with chronic disease in the ambulatory care setting of high-income countries (HICs) to gain insights for better quality of care. Understanding the definition of LTFU is imperative in informing patients, health professionals and researchers for clinical and research purposes. This review also provided an overview of the terms and definitions used to describe LTFU.

Methods

The following databases: CINAHL, EMBASE, Medline, PsycINFO and Web of Science were searched for studies investigating the factors associated to LTFU from the date of inception until 07 January 2022.

Results

Five thousand one hundred and seven records were obtained across the databases and 3,416 articles were screened after removing the duplicates. 25 articles met the inclusion criteria, of which 17 were cohort studies, five were cross-sectional studies and three were case-control studies. A total of 32 factors were found to be associated with LTFU and they were categorised into patient factors, clinical factors and healthcare provider factors.

Conclusion

Overall, the factors associated with LTFU were generally inconsistent across studies. However, some factors such as financial factors (i.e., no insurance coverage) and low accessibility of care were consistently associated with LTFU for both mental and physical chronic conditions. The operational definitions of LTFU also varied greatly across studies. Given the mixed findings, future research using qualitative aproaches would be pivotal in understanding LTFU for specific chronic diseases and the development of targeted interventions. Additionally, there is a need to standardise the operational definition of LTFU for research as well as clinical practice purposes.
Pomegranate (Punica granatum L.) peel extract ameliorates metabolic syndrome risk factors in patients with non-alcoholic fatty liver disease: a randomized double-blind clinical trial
Authors: Barghchi Hanieh , Milkarizi Narges , Belyani Saba , Norouzian Ostad Andisheh , Askari Vahid Reza , Rajabzadeh Farnood , Goshayeshi Ladan , Ghelichi Kheyrabadi Seyede Yegane , Razavidarmian Maryam , Dehnavi Zahra , Sobhani Seyyed Reza , Nematy Mohsen
Published: August 2023

Introduction

Non-alcoholic fatty liver disease (NAFLD) is a metabolic syndrome (MS)-related liver disorder that has an increasing prevalence. Thus, the aim of our study is to evaluate the effects of pomegranate peel extract (PP) supplementation on hepatic status and metabolic syndrome risk factors.

Methods

In phase one, the hydro-alcoholic extraction of the peel of 750 kg of pomegranate (Punica granatum L.) was performed by the soaking method. Then, in phase two, NAFLD patients received 1500 mg of placebo (n = 37) or pomegranate peel capsules (n = 39) with a 500-kcal deficit diet for 8 weeks. Gastrointestinal intolerance, dietary intake, lipid and glycemic profiles, systolic and diastolic blood pressure, body composition, insulin resistance indexes, and elastography-evaluated NAFLD changes were followed.

Results

The mean age of participants was 43.1 ± 8.6 years (51.3% female). Following the intervention, the mean body weight (mean changes: -5.10 ± 2.30 kg), waist circumference (-7.57 ± 2.97 cm), body mass index (-1.82 ± 0.85 kg/m2), body fat index (-1.49 ± 0.86), and trunk fat (− 3.93 ± 3.07%), systolic (-0.63 ± 0.29 cmHg) and diastolic (-0.39 ± 0.19 cmHg) blood pressure, total cholesterol (-10.51 ± 0.77 mg/dl), triglyceride (-16.02 ± 1.7 mg/dl), low-density lipoprotein cholesterol (-9.33 ± 6.66 mg/dl; all P < 0.001), fat free mass (− 0.92 ± 0.90 kg; P < 0.003), and fasting blood sugar (-5.28 ± 1.36 mg/dl; P = 0.02) decreased significantly in PP in contrast to the placebo group in the raw model and when adjusted for confounders. Also, high-density lipoprotein cholesterol (5.10 ± 0.36 mg/dl), liver steatosis and stiffness (− 0.30 ± 0.17 and − 0.72 ± 0.35 kPa, respectively, all P < 0.001) improved in the PP group. However, fasting insulin (P = 0.81) and homeostatic model assessment for insulin resistance (HOMA-IR) (P = 0.93) were not significantly different when comparing two groups during the study in the raw and even adjusted models.

Conclusion

In conclusion, 1500 mg pomegranate peel extract along with a weight-loss diet improved metabolic syndrome risk factors and reduced hepatic steatosis in patients with NAFLD after 8 weeks.
Engineered extracellular vesicles-like biomimetic nanoparticles as an emerging platform for targeted cancer therapy
Authors: Liu Xinyi , Xiao Chunxiu , Xiao Kai
Published: August 2023

Nanotechnology offers the possibility of revolutionizing cancer theranostics in the new era of precision oncology. Extracellular vesicles (EVs)-like biomimetic nanoparticles (EBPs) have recently emerged as a promising platform for targeted cancer drug delivery. Compared with conventional synthetic vehicles, EBPs have several advantages, such as lower immunogenicity, longer circulation time, and better targeting capability. Studies on EBPs as cancer therapeutics are rapidly progressing from in vitro experiments to in vivo animal models and early-stage clinical trials. Here, we describe engineering strategies to further improve EBPs as effective anticancer drug carriers, including genetic manipulation of original cells, fusion with synthetic nanomaterials, and direct modification of EVs. These engineering approaches can improve the anticancer performance of EBPs, especially in terms of tumor targeting effectiveness, stealth property, drug loading capacity, and integration with other therapeutic modalities. Finally, the current obstacles and future perspectives of engineered EBPs as the next-generation delivery platform for anticancer drugs are discussed.
Development, acceptability and feasibility of a personalised, behavioural intervention to prevent bacterial skin and soft tissue infections among people who inject drugs: a mixed-methods Person-Based Approach study
Authors: Kesten Joanna , Hussey Deborah , Lord Catherine , Roberts Leonie , Bayliss James , Erswell Helen , Preston Andrew , Telfer Maggie , Scott Jenny , Harris Magdalena , Mellon Dominic , Hickman Matthew , MacArthur Georgie , Fisher Harriet
Published: August 2023

Background

Skin and soft tissue infections (SSTI) among people who inject drugs (PWID) are a public health concern. This study aimed to co-produce and assess the acceptability and feasibility of a behavioural intervention to prevent SSTI.

Methods

The Person-Based Approach (PBA) was followed which involves: (i) collating and analysing evidence; (ii) developing guiding principles; (iii) a behavioural analysis; (iv) logic model development; and (v) designing and refining intervention materials. Co-production activities with target group representatives and key collaborators obtained feedback on the intervention which was used to refine its design and content. The intervention, harm reduction advice cards to support conversation between service provider and PWID and resources to support safer injecting practice, was piloted with 13 PWID by four service providers in Bristol and evaluated using a mixed-methods approach. Semi-structured interviews were conducted with 11 PWID and four service providers. Questionnaires completed by all PWID recorded demographic characteristics, SSTI, drug use and treatment history. Interviews were analysed thematically and questionnaires were analysed descriptively.

Results

Published literature highlighted structural barriers to safer injecting practices, such as access to hygienic injecting environments and injecting practices associated with SSTI included: limited handwashing/injection-site swabbing and use of too much acidifier to dissolve drugs. Co-production activities and the literature indicated vein care and minimisation of pain as PWID priorities. The importance of service provider–client relationships and non-stigmatising delivery was highlighted through the co-production work. Providing practical resources was identified as important to address environmental constraints to safer injecting practices. Most participants receiving the intervention were White British, male, had a history of SSTI and on average were 43.6 years old and had injected for 22.7 years. The intervention was well-received by PWID and service providers. Intervention content and materials given out to support harm reduction were viewed positively. The intervention appeared to support reflections on and intentions to change injecting behaviours, though barriers to safer injecting practice remained prominent.

Conclusions

The PBA ensured the intervention aligned to the priorities of PWID. It was viewed as acceptable and mostly feasible to PWID and service providers and has transferability promise. Further implementation alongside broader harm reduction interventions is needed.
Dose-related immunomodulatory effects of recombinant TRAIL in the tumor immune microenvironment
Authors: Wang Xupu , Wang Lizheng , Liu Wenmo , Liu Xinyao , Jia Xinyuan , Feng Xinyao , Li Fangshen , Zhu Rui , Yu Jiahao , Zhang Haihong , Wu Hui , Wu Jiaxin , Wang Chu , Yu Bin , Yu Xianghui
Published: August 2023

Background

In addition to specifically inducing tumor cell apoptosis, recombinant tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL) has also been reported to influence the cancer immune microenvironment; however, its underlying effects and mechanisms remain unclear. Investigating the immunomodulatory effects and mechanisms of recombinant TRAIL in the tumor microenvironment (TME) may provide an important perspective and facilitate the exploration of novel TRAIL strategies for tumor therapy.

Methods

Immunocompetent mice with different tumors were treated with three doses of recombinant TRAIL, and then the tumors were collected for immunological detection and mechanistic investigation. Methodological approaches include flow cytometry analysis and single-cell sequencing.

Results

In an immunocompetent mouse model, recombinant soluble mouse TRAIL (smTRAIL) had dose-related immunomodulatory effects. The optimal dose of smTRAIL (2 mg/kg) activated innate immune cells and CD8+ T cells, whereas higher doses of smTRAIL (8 mg/kg) promoted the formation of a tumor-promoting immune microenvironment to counteract the apoptotic effects on tumor cells. The higher doses of smTRAIL treatment promoted M2-like macrophage recruitment and polarization and increased the production of protumor inflammatory cytokines, such as IL-10, which deepened the suppression of natural killer (NK) cells and CD8+ T cells in the tumor microenvironment. By constructing an HU-HSC-NPG.GM3 humanized immune system mouse model, we further verified the immunomodulatory effects induced by recombinant soluble human TRAIL (shTRAIL) and found that combinational administration of shTRAIL and trabectedin, a macrophage-targeting drug, could remodel the tumor immune microenvironment, further enhance antitumor immunity, and strikingly improve antitumor effects.

Conclusion

Our results highlight the immunomodulatory role of recombinant TRAIL and suggest promising therapeutic strategies for clinical application.

Graphical Abstract
The effect of human menstrual blood-derived stem cells on ovarian folliculogenesis, angiogenesis and collagen volume in female rats affected by the polycystic ovary syndrome
Authors: Roodbari Ali Sarhadi , Solhjoo Somayeh , Palmerini Maria Grazia , Mansouri Mahna , Ezzatabadipour Massood
Published: August 2023

Background

Infertility is one of the common problems among couples, affecting millions of people worldwide. Polycystic ovary syndrome (PCOS) is one of the main causes of infertility in women and is associated with abnormal folliculogenesis, angiogenesis and fibrosis. Common treatments may lead to numerous adverse effects on the patient’s quality of life. The present study aimed to investigate the effects of human menstrual blood-derived stem cells on the ovarian histology of a PCOS model of Wistar rats.

Results

Based on the Papanicolaou test and H&E staining results, the number of primary, secondary and antral follicles in the PCOS and PCOS-Sham groups significantly increased compared to the control group, while they significantly decreased in the PCOS + Stem cells group compared to the PCOS and PCOS-Sham groups. Further, the number of atretic follicles in both PCOS and PCOS-Sham groups significantly increased in comparison with the control group and decreased in the PCOS + Stem cells group, compared to the two mentioned groups. Moreover, the Graafian follicles number was decreased in the PCOS and PCOS-Sham groups to significantly increase in the PCOS + Stem cells group. Based on Masson’s trichrome staining, the number of blood vessels in PCOS and PCOS-Sham groups significantly increased compared to the control group, while a decrease was observed in the PCOS + Stem cells group, compared to PCOS and PCOS-Sham groups.

Conclusion

The administration of MenSCs improved folliculogenesis in rats with polycystic ovaries. Also, MenSCs could ameliorate PCOS symptoms by improving fibrosis as well as angiogenesis and weight gain.