bluuebunny/crossref_metadata_2025 huggingface dataset:
Loaded Euler-Bernoulli beam with the distributed hysteresis properties
Authors: Karpov Evgeny , Semenov Mikhail , Meleshenko Peter
Published: November 2023

In this article, we propose a new perspective mathematical model of the beam with the distributed hysteresis properties. Hysteresis properties are formalized within two approaches: phenomenological (Bouc-Wen model) and design (Prandtl-Ishlinskii model). The equations for the beam vibrations are obtained using the well-known Hamilton approach. The dynamical response of the beam with distributed hysteresis is considered under various types of external load, such as impulse, periodic, and a seismic load. Numerical simulations show that the hysteresis beam is more “resistant” to external loads than the classical Euler-Bernoulli beam. Particularly, with the same types of the external load, the amplitude of oscillations of the hysteresis beam as well as its energy characteristics are lower than those of the classical one. These results may find some applications in the field of the design of earthquake-resistant constructions and buildings.
Application of Mind Mapping in Nursing Care of Neurology Patients During the COVID-19 Pandemic
Authors: Bai Xue
Published: November 2023

This study explored the application of mind mapping in the nursing care of neurology patients during the COVID-19 epidemic. Mind mapping was used to streamline and systematize all the links involved in the care process, from admission to discharge, giving nurses increased clarity in accurately implementing quality and safety measures.
Pediatric anterior choroidal artery aneurysm successfully coiled after re-rupture
Authors: Crowe Jonathan R , Geffrey Alexandra L , Vranic Justin , Regenhardt Robert W , Patel Aman , Armstrong-Javors Amy
Published: November 2023

Pediatric cerebral aneurysms are rare, and pediatric anterior choroidal artery aneurysms are very rarely reported. A 14-month-old male with no personal or family history of connective tissue disorders or Moyamoya disease presented with a right temporal intracerebral hemorrhage with intraventricular extension. CTA was negative for vascular pathology, but digital subtraction angiography revealed an anterior choroidal artery aneurysm that was successfully coiled. This case underscores the importance of performing digital subtraction angiography in children presenting with intracerebral hemorrhage concerning for vascular pathology even if non-invasive vascular imaging is negative.
Scrub typhus in a febrile patient and challenges faced in a diagnosis-constrained health centre: A case report
Authors: Nepal Tej Nath , Drukpa Sonam
Published: November 2023

Scrub typhus is an acute febrile bacterial illness and has a high mortality if left untreated. It is caused by bacterium called Orientia tsutsugamushi which is transmitted to humans as zoonosis by bite of chigger mites that are infected by the bacterium. The diagnosis is based on clinical features and specific laboratory tests. Treatment of Scrub typhus is done with antibiotics and symptoms management. This report is a case of a 24-year-old female febrile patient who presented with complications of Scrub typhus due to missed diagnosis at Primary Health Centre and managed at district hospital. This case report highlights the challenges faced by health workers in management of acute febrile illness in a diagnosis-constrained setting.
The Role of Prevailing Agrarian Relations in Lower Crop Productivity and Profitability: Evidence from Uttar Pradesh, India
Authors: Varkey Shinu
Published: November 2023

This study analyzes the agricultural performance of two regions of Uttar Pradesh (UP), Eastern UP and Bundelkhand, representing two distinct agrarian systems: the former falling mostly within the Gangetic plains and the latter being dry land. Despite the regional differences, it appears that differences in the levels of productivity and net incomes earned in the case of major crops cultivated are more specific to class than region. The study raises the broader question: What explains the lower crop productivity and output and the higher costs of production and meager returns from cultivation of the lower-class cultivators? The mainstream economic explanations for this question are mostly confined to factors related to technology and state policy. While acknowledging that these factors are important, it is argued that the existing agrarian relations also play an important role in lowering crop productivity and profitability in the study areas and, therefore, these must also be considered in an ideal analytical framework for understanding agrarian change in the countryside.
An Expert Evaluation of Oncology Website Resources for Use in Pediatric Oncology Clinical Nursing Education in Low-Resource Settings
Authors: Banayat Aprille C. , Challinor Julia , Sniderman Elizabeth
Published: November 2023

Background: Online healthcare information is often used by pediatric oncology nurse educators in low- and middle-income countries (LMICs) for teaching clinical nurses as part of their initial orientation or continuing education. Access to peer-reviewed nursing journals via paid subscriptions or sub-specialty nursing textbooks in these settings is rare. This project identified and evaluated websites appropriate for pediatric oncology nurse educators in LMICs for teaching staff nurses, and for clinical staff nurses engaging in self-directed learning. Method: A strategic Google search for childhood cancer websites and an appropriate scoring tool was conducted. The Currency, Relevance, Authority, Accuracy, and Purpose Test, along with a previously published scoring rubric that was further adapted by the authors for pediatric oncology were used. Pediatric content, language options, and reading levels were appraised. Results: Of 86 identified websites, 51 met the inclusion criteria for evaluation. Websites were classified as highly recommended ( n = 36), recommended ( n = 12), or not recommended ( n = 3) based on scores (range 14–30; maximum possible score = 30). Half offered content in multiple languages. Most websites were 9–10th-grade reading level. Discussion: Childhood cancer information appropriate for clinical nurse orientation and self-directed learning by LMIC nurses is available on free websites. Some information (diagnosis, chemotherapy, psychosocial support) is repeated across websites, while some is lacking (pediatric cancer genetics and health equity disparities). Reading levels are higher than recommended for health literacy. The reviewed websites were rarely peer-reviewed, inconsistently updated, and generally self-regulated. However, 48 websites on childhood cancer were deemed appropriate pediatric oncology clinical nursing education resources.
What Constitutes Engaged Dialogue in Urban Research? Thoughts From a Long Time “Outside-Insider”
Authors: Lees Loretta
Published: November 2023

In this plenary for the new journal Dialogues in Urban Research, I discuss what constitutes (and should constitute going forward) engaged dialogue in urban research. Engaged dialogue is the process of working collaboratively with groups of people, whoever they are, in relation to particular issues that affect them, to understand those issues better. So what does engaged dialogue in urban research look like? Who is engaging with who, where, why, and how? Has it changed over time? Most, if not all, urban research engages beyond academia, but that engaged dialogue rarely makes it into the pages of academic journals in an inclusionary way. Who usually takes part in conversations on urban research in journals, but also who does not (or is less likely to), and who should? In a new world of publishing and government-funded research that is promoting open access, making research more publicly accessible and inclusive, there has been much less discussion of those engaged in the dialogue that is published. And, if academics do publish with nonacademics it is not usually in an academic journal; this is not inclusive, indeed it is exclusionary.
The implications of Fe speciation for the humic substance stability of ternary Fe(III)–montmorillonite–humic substance systems
Authors: Lei Qinkai , Lv Yahui , Liu Chengshuai , Xu Wenpo , Hu Shujie , Chen Manjia , Bu Hongling , Li Junhui
Published: November 2023

Mineral–organic matter (OM) associations play an important role in determining the long-term retention of OM in soils. However, the retention mechanisms of OM in cation–mineral–OM systems remain unclear. Taking into account the dominance of montmorillonite (Mnt) in the soil of the temperate zone, we investigated the stability of humic substances (HSs) in the Fe(III)–Mnt–HS system using thermal analysis. The HS degradation started at ~387°C in the Fe(III)–Mnt–HS system, which was higher than that of the Fe(III)–HS system (290°C). The formed ferrihydrite (Fhy) mainly contributed to the enhanced labile OM retention through adsorption and/or co-precipitation, whereas Mnt inhibited the initial formation and subsequent transformation of Fhy, thus improving the stability of OM. These results suggest that the HS stability in Fe(III)–clay–HS systems depends on the Fe speciation affected by clay minerals, and this finding provides insights into OM–mineral interactions in temperate-zone soils.
Preparation of phase-change microcapsules with illite as a filler and their applications in foaming materials
Authors: Li Ming , Zhang Shuhua , Liu Weijun , Liu Binyan , Wang Yu
Published: November 2023

To solve the problem of the leakage of phase-change materials and expand the application of clay minerals in the field of phase-change materials, illite and paraffin wax were used for the first time as a new binary hybrid core material with silica as the wall material. Phase-change microcapsules were prepared using the sol–gel method and successfully applied in silicone rubber foams. Differential scanning calorimetry showed that the microcapsules had a melting temperature of 62.99°C and a latent heat capacity of 98.24 J g–1, indicating their good heat-storage capacity. Furthermore, the effectiveness of using illite as a filler for preventing paraffin leakage was demonstrated through 200 thermal cycling tests, which demonstrated a leakage rate of only 2.6% compared to 3.2% exhibited by microcapsules without illite.
Tiger attack at a Japanese safari park: a case report
Authors: Fujii Kouichi , Kikuchi Jin , Uchida Masatoshi , Machida Masanari , Tsuchiya Midori , Hayashi Kentaro , Maekawa Nana , Houzumi Hajime , Honda Arata , Wake Koji
Published: November 2023

Background

Big cat bites are highly lethal due to the enormous bite force of these animals. This article reviews the morphology of these types of injuries and key points of management through a survival case at a Japanese safari park.

Case presentation

We report the case of a 26-year-old female keeper who was attacked by a tiger. She was quickly transported to our university hospital by ambulance helicopter. The keeper was severely bitten on the head and face and had wounds all over her body. Craniofacial repair was performed by emergency surgery. She suffered mild facial nerve paralysis and trismus because of being bitten by the tiger and is currently recovering.

Conclusions

A multidisciplinary approach of the severe tiger bites successfully treated a young woman cosmetically and mentally. Animal farms and zoos that keep tigers should take strict measures to avoid direct confrontation with tigers.
Pediatric injury attendances in different population groups in Israel before, during, and after COVID-19 lockdowns: a descriptive study, 2018–2022
Authors: Bernstine Tomer , Edelstein Michael , Krupik Danna
Published: November 2023

Background

Lockdowns and quarantines during the COVID-19 pandemic influenced healthcare services’ usage patterns such as emergency department (ED) attendance. During the pandemic, Israel issued three lockdowns (March–May 2020, September–October 2020, and December 2020–February 2021) to mitigate the spread of COVID-19. Little is known about the impact of these lockdowns on ED attendance for injuries in the diverse population of Northern Israel.

Methods

We described patterns of ED attendance before, during, and after COVID-19 lockdowns. We extracted data from medical records of all northern Israeli children aged 0–17 years old who attended Ziv Medical Center (ZMC) emergency department (ED) due to injury, between 01/01/2018 and 10/02/2022. We compared the volume and characteristics of ED attendance during lockdown periods to the same time periods in the 2 years before the pandemic and 1 year after the lockdowns, using chi-square tests.

Results

Seven thousand six hundred nineteen northern children attended ZMC ED during the time periods of the study for injuries and were analyzed. Mean attendance numbers during lockdowns decreased compared to previous years, with an increase in injuries proportion (67.8% (1502/2216) vs. 52.7% (2038/3868) p < 0.001). The proportion of 0–4-year-olds attending for injuries during the lockdown increased compared to pre-pandemic (39.68% vs. 30.7%, p < 0.0001). Minority population attendance decreased (27.47% vs. 30.71% p = 0.02). Hospitalization rates increased (13.21% vs. 10.65% p = 0.01). Post-lockdown periods saw a return to the pre-pandemic age and ethnicity distribution.

Conclusions

Compared to previous years, the volume of injuries was lower during lockdowns for all ages, with a relative increase in the proportion of injuries among younger children attending the ED. A lower proportion of attendance from minority groups suggests different health-seeking behavior patterns during emergencies compared to the general population. Understanding these differences will help better plan for future emergencies.
Sensitive and rapid detection of tet(X2) ~ tet(X5) by loop-mediated isothermal amplification based on visual OTG dye
Authors: Chen Guiling , Chen Lulin , Lin Sisi , Yang Congzhu , Liang Huanlin , Huang Kuang , Guo Zhusheng , Lv Fei
Published: November 2023

The emergence of tigecycline-resistant tet(X2/X3/X4/X5) genes poses a new threat to the efficacy of anti-infective therapy and the safety of our food and environment. To control the transfer of such genes, a sensitive and rapid molecular method is warranted to detect tet(X2/X3/X4/X5) genes in clinical isolates. Herein, we established a loop-mediated isothermal amplification (LAMP) assay to rapidly detect tet(X2/X3/X4/X5) genes, and the results were assessed by chromogenic visualization. The specificity and sensitivity of the primers during the LAMP assay for the simultaneous detection of tet(X2/X3/X4/X5) genes were determined in this study. All 48 clinical strains without tet(X2/X3/X4/X5) genes yielded negative results during the LAMP assay, substantiating the high specificity of the LAMP primers. The detection thresholds of this assay were 1.5 × 102 CFU/ml and 0.2 fg/uL corresponding to a 10 to 100-fold and 100-fold increase in sensitivity compared to polymerase chain reaction (PCR) assays. Out of 52 bacterial strains tested, using PCR as a reference, our research revealed that the LAMP assay demonstrated a sensitivity and specificity of 100%. To sum up, our novel approach has huge prospects for application in the simultaneous detection of tet(X2/X3/X4/X5) genes and can be applied to detect other drug-resistance genes.
Assessment of the relationship between plasma fibrinogen-to-albumin ratio and slow coronary flow phenomenon in patients without obstructive coronary artery disease
Authors: Yang Shao-bing , Cui Ying , Hou Jian-jun , Zhang Hui , Pei Xiao-yang , Wang Yong
Published: November 2023

Background

Prior studies have suggested that the chronic inflammatory response has an important role in the pathophysiology of slow coronary flow phenomenon (SCFP). However, data are scarce regarding the role of plasma fibrinogen-to-albumin ratio (PFAR) in patients having SCFP without obstructive coronary artery disease (CAD). In this study, we investigated the relationship between PFAR and the presence of SCFP in patients without obstructive CAD.

Methods

From January 2021 to January 2023, we consecutively recruited 1085 patients without obstructive CAD according to the diagnostic and exclusion criteria. In total, SCFP was diagnosed in 70 patients. A 1:2 age-matched case–control study was then conducted using comparators without SCFP. Ultimately, this study enrolled 70 patients with angiographically normal coronary arteries and SCFP, along with 140 comparators with angiographically normal coronary arteries and normal coronary flow. Plasma fibrinogen and albumin levels were measured, and the PFAR was then calculated for each patient.

Results

PFARs were significantly greater in the SCFP group than in the comparators with normal coronary flow (82.8 ± 15.4 vs 73.1 ± 19.5, p < 0.001). PFAR increased with increasing numbers of vessels affected by SCFP. Multivariate logistic regression analysis showed that PFAR was an independent predictor of SCFP (odds ratio: 1.818, p = 0.015). Receiver operating characteristic (ROC) curve analysis indicated that PFAR showed a better predictive value of SCFP than fibrinogen or albumin, although not significantly (p > 0.05).

Conclusion

PFAR is an independent predictor of SCFP in patients without obstructive CAD. PAFR could improve the predictive value of SFCP than albumin or fibrinogen alone, but not significantly.
Sero-prevalence of syphilis infection among people living with HIV in Sierra Leone: a cross-sectional nationwide hospital-based study
Authors: Jiba Darlinda F. , Lakoh Sulaiman , Wang Shuchao , Sun Wei , Barrie Umu , Kamara Matilda N. , Jalloh Abdulai Tejan , Tamba Francis K. , Yendewa George A. , Song Jin-Wen , Yang Guang
Published: November 2023

Background

Globally, there were an estimated 7.1 million new syphilis infections in 2020, with more than 30% of these new infections reported in African countries such as Sierra Leone. Despite this, there is no HIV-specific syphilis screening program in Sierra Leone. Thus, data are needed to inform public health practice. In this study, we aimed to determine the prevalence of syphilis seropositivity and factors associated with syphilis seropositivity among people living with HIV (PLHIV).

Methods

A cross-sectional study was conducted at 10 health facilities in Sierra Leone, among adults with HIV, aged 18 years or older, from September 2022 to January 2023. Parameters of interest were collected including age, sex, marriage, antiretroviral therapy (ART) regimen, HIV viral load, duration of ART treatment, and hospital level of care. The syphilis antibody was detected by a rapid test based on immunochromatography assay. Data were analyzed using R-software version 4.2.3 (R Core Team, Vienna, Austria). Pearson’s χ2 test, Fisher’s exact test and Kruskal–Wallis H test were applied to assess the differences in syphilis seropositivity between groups as appropriate. Univariate logistic regression and multivariate logistic regression analysis was used to assess factors associated with syphilis seropositivity. The level of statistical significance was set at P < 0.05.

Results

Of the 3082 PLHIV individuals in our study, 2294 (74.4%) were female and 2867 (93.0%) were receiving ART. With a median age of 36 years, 211 (6.8%, 95% CI 6.0–7.7) were positive for syphilis. The prevalence of syphilis was highest in people aged 60 years and over (21.1%, 95%CI 14.7–29.2), followed by people aged 50–60 years (15.5%, 95%CI 11.9–19.9) and in the widowed population (11.9%, 95%CI 8.9–15.8). There were no differences in syphilis seropositivity between gender, ART status, ART regimen, duration of ART, HIV viral load and hospital level of care. Older age (50–60 years: adjusted OR 3.49, 95%CI 2.09–5.85 P < 0.001; 60–100 years: adjusted OR 4.28, 95%CI 2.21–8.17, P < 0.001) was an independent predictor of seropositive syphilis.

Conclusions

We observed a high prevalence of syphilis among PLHIV. Older people and widowed population have higher syphilis seropositivity. Older age was an independent predictor of syphilis positivity. Therefore, we call for the integration of syphilis screening, treatment and prevention in HIV services.
Prognostic impact of pretreatment skeletal muscle index and CONUT score in diffuse large B-cell Lymphoma
Authors: Go Se-Il , Choi Bong-Hoi , Park Mi Jung , Park Sungwoo , Kang Myoung Hee , Kim Hoon-Gu , Kang Jung Hun , Jeong Eun Jeong , Lee Gyeong-Won
Published: November 2023

Background

Although the prognostic value of the Controlling Nutritional Status (CONUT) score in diffuse large B-cell lymphoma (DLBCL) has been reported in several previous studies, its clinical relevance for the presence of sarcopenia has not been assessed.

Methods

In this study, 305 DLBCL patients were reviewed. They were categorized into normal/mild (n = 219) and moderate/severe (n = 86) CONUT groups. Sarcopenia was assessed using the L3-skeletal muscle index measured by baseline computed tomography imaging. Based on CONUT score and sarcopenia, patients were grouped: A (normal/mild CONUT and no sarcopenia), B (either moderate/severe CONUT or sarcopenia, but not both), and C (both moderate/severe CONUT and sarcopenia).

Results

The moderate/severe CONUT group showed higher rates of ≥ grade 3 febrile neutropenia, thrombocytopenia, non-hematologic toxicities, and early treatment discontinuation not related to disease progression, compared to the normal/mild CONUT group. The moderate/severe CONUT group had a lower complete response rate (58.1% vs. 80.8%) and shorter median overall survival (18.5 vs. 162.6 months) than the normal/mild group. Group C had the poorest prognosis with a median survival of 8.6 months, while groups A and B showed better outcomes (not reached and 60.1 months, respectively). Combining CONUT score and sarcopenia improved the predictive accuracy of the Cox regression model (C-index: 0.763), compared to the performance of using either CONUT score (C-index: 0.754) or sarcopenia alone (C-index: 0.755).

Conclusions

In conclusion, the moderate/severe CONUT group exhibited treatment intolerance, lower response, and poor prognosis. Additionally, combining CONUT score and sarcopenia enhanced predictive accuracy for survival outcomes compared to individual variables.
The predicting role of serum tumor-specific growth factor for prognosis of esophageal squamous cell carcinoma
Authors: Xu Xiaoqin , Wang Weigang , Tian Baoguo , Zhang Xiaofang , Ji Yanfen , Jing Jiexian
Published: November 2023

Objective

Tumor-specific growth factor (TSGF) is an immune-related factor that offers good performance in the clinical management of human cancers. However, the role of serum TSGF in esophageal squamous cell carcinoma (ESCC) has not been fully clarified.

Methods

A total of 562 ESCC cases were collected in our study, with available information on preoperative serum levels of TSGF at diagnosis. Preoperative serum TSGF was detected using the rate method. We retrospectively analyzed its correlation with clinicopathological features of ESCC and survival.

Results

The cut-off value of serum TSGF was determined to be 60.5 U/mL by receiver operating characteristic (ROC) analysis. Serum TSGF was associated with gender (P < 0.001), tumor location (P = 0.022), tobacco use (P < 0.001), alcohol consumption (P < 0.001), lymph node involvement (P = 0.007), and TNM staging (P = 0.004). The survival analysis revealed that ESCC patients with high levels of serum TSGF had poorer prognosis than those with high TSGF (P = 0.006), especially for male ESCC cases (P = 0.001), under 60 year (P = 0.036), male middle location (P = 0.023), tobacco consumption (P = 0.004), G1 + G2 (P = 0.031), advanced T staging (P = 0.033), lymph node involvement (P = 0.003), TNM staging (P = 0.003). Univariate Cox regression analysis indicated that exposure to smoking and drinking, tumor grade, T staging, lymph node metastasis, TNM staging, and serum TSGF level were the prognosis-related factors of ESCC. Multivariate regression analysis revealed that smoking history, higher serum TSGF levels, and advanced T stage enhanced the risk of ESCC-related death.

Conclusion

In brief, serum TSGF levels had in relation to malignant features of ESCC. It was positively correlated with survival but was identified as an independent risk factor for ESCC.
Development and validation of the ADHD Symptom and Side Effect Tracking - Baseline Scale (ASSET-BS): a novel short screening measure for ADHD in clinical populations
Authors: Young Joel L. , Powell Richard N. , Zabel Celeste , Saal Jaime , Welling Lisa L. M. , Fortain Jillian , Ceresnie Ashley
Published: November 2023

Objective

The aim was to develop and test a novel screen of adult ADHD, with a specific focus on clinical use. We designed a series of three studies to accomplish this aim.

Method

Study One (n = 155) and Study Two (n = 591) collected data via surveys to conduct exploratory and confirmatory factor analyses, respectively. Study Three analyzed the scale’s psychometrics in a clinical sample (n = 151).

Results

Study One and Study Two identified a 10-item scale with a two-factor structure. Study Three found good discriminant validity, sensitivity = 80.0%, specificity = 80.2%, and convergent validity with both the Brown Executive Function/Attention Scales, r (131) = .76, p < .001, and the Conner’s Adult ADHD Rating Scales r (131) = .71, p < .001.

Conclusion

The scale demonstrated effectiveness in screening for ADHD in a psychiatric outpatient population. Its results may be used to identify patients that may benefit from thorough ADHD diagnostic procedures.
Dynamics of usage of menstrual hygiene and unhygienic methods among young women in India: a spatial analysis
Authors: Meher Trupti , Sahoo Harihar
Published: November 2023

Background

Menstruation, especially the menstrual cycle, is a vital sign for female adolescent health and maintaining menstrual hygiene is of utmost importance for menstruating girls and women. However, menstrual hygiene and management are issues that have not received adequate attention. Therefore, the present study aimed to explore spatial patterns of menstrual hygiene practices in India and to identify their socioeconomic and demographic determinants among women aged 15–24 years.

Methods

The study utilized data from the fifth round of the National Family Health Survey (NFHS-5) conducted during 2019–21 in India. The analysis was limited to 241,180 women aged 15–24 years. The statistical methods range from multinomial logistic regression, spatial autocorrelation in terms of Moran’s I statistics, to spatial regression in order to understand the spatial dependence and clustering in different methods of menstrual practices across the districts of India.

Results

Almost half of the respondents (49.8 percent) reported using hygienic methods of bloodstain protection, while 22.7 percent still relied on unhygienic methods and 27.5 percent reported using both hygienic and unhygienic methods during their menstruation. Factors like age, place of residence, caste, religion, education, wealth index and toilet facility were found to be significantly associated with the use of unhygienic and both methods. It was also observed that the percentage of women practicing hygienic methods was predominantly higher in the Southern region. On the other hand, states like Madhya Pradesh and Bihar appeared to be hotspots for unhygienic menstrual practices. The univariate Moran’s I value for unhygienic and both methods were 0.722 and 0.596, respectively, depicting high spatial autocorrelation across districts in India. In spatial regression, rural residence, illiteracy, poverty, and no toilet facility were found to be statistically significant predictors of the use of unhygienic method and both methods.

Conclusion

Young women should be educated about the importance of menstrual hygiene practices and the physiological consequences of unhygienic practices. Furthermore, interventions should target socio-economically disadvantaged women to increase the use of sanitary napkins.
Assessment of a venous thromboembolism prophylaxis shared decision-making intervention (DASH-TOP) using the decisional conflict scale: a mixed-method study
Authors: León‑García Montserrat , Humphries Brittany , Morales Pablo Roca , Gravholt Derek , Eckman Mark H. , Bates Shannon M. , Suárez Nataly R. Espinoza , Xie Feng , Perestelo‑Pérez Lilisbeth , Alonso‑Coello Pablo
Published: November 2023

Background

Venous thromboembolism (VTE) in pregnancy is a major cause of maternal morbidity and death. The use of low-molecular-weight heparin (LMWH), despite being the standard of care to prevent VTE, comes with some challenges. Shared decision-making (SDM) interventions are recommended to support patients and clinicians in making preference-sensitive decisions. The quality of the SDM process has been widely assessed with the decisional conflict scale (DCS). Our aim is to report participants’ perspectives of each of the components of an SDM intervention (DASH-TOP) in relation to the different subscales of the DCS.

Methods

Design: A convergent, parallel, mixed-methods design.

Participants: The sample consisted of 22 health care professionals, students of an Applied Clinical Research in Health Sciences (ICACS) master program.

Intervention: We randomly divided the participants in three groups: Group 1 received one component (evidence -based information), Group 2 received two components (first component and value elicitation exercises), and Group 3 received all three components (the first two and a decision analysis recommendation) of the SDM intervention.

Analysis: For the quantitative strand, we used a non-parametric test to analyze the differences in the DCS subscales between the three groups. For the qualitative strand, we conducted a content analysis using the decisional conflict domains to deductively categorize the responses.

Results

Groups that received more intervention components experienced less conflict and better decision-making quality, although the differences between groups were not statistically significant. The decision analysis recommendation improved the efficacy with the decision-making process, however there are some challenges when implementing it in clinical practice. The uncertainty subscale showed a high decisional conflict for all three groups; contributing factors included low certainty of the evidence-based information provided and a perceived small effect of the drug to reduce the risk of a VTE event.

Conclusions

The DASH-TOP intervention reduced decisional conflict in the decision -making process, with decision analysis being the most effective component to improve the quality of the decision. There is a need for more implementation research to improve the delivery of SDM interventions in the clinical encounter.
The effects of COVID-19 event strength on job burnout among primary medical staff
Authors: Li Xinru , Song Yiwen , Hu Bingqin , Chen Yitong , Cui Peiyao , Liang Yifang , He Xin , Yang Guofeng , Li Jinghua
Published: November 2023

Background

As a global pandemic, The Corona Virus Disease 2019 (COVID-19) has brought significant challenges to the primary health care (PHC) system. Health professionals are constantly affected by the pandemic’s harmful impact on their mental health and are at significant risk of job burnout. Therefore, it is essential to gain a comprehensive understanding of how their burnout was affected. The study aimed to examine the relationship between COVID-19 event strength and job burnout among PHC providers and to explore the single mediating effect of job stress and work engagement and the chain mediating effect of these two variables on this relationship.

Methods

Multilevel stratified convenience sampling method was used to recruit 1148 primary medical staff from 48 PHC institutions in Jilin Province, China. All participants completed questionnaires regarding sociodemographic characteristics, COVID-19 event strength, job stress, work engagement, and job burnout. The chain mediation model was analyzed using SPSS PROCESS 3.5 Macro Model 6.

Results

COVID-19 event strength not only positively predicted job burnout, but also indirectly influenced job burnout through the mediation of job stress and work engagement, thereby influencing job burnout through the “job stress → work engagement” chain.

Conclusions

This study extends the application of event systems theory and enriches the literature about how the COVID-19 pandemic impacted PHC medical staff job burnout. The findings derived from our study have critical implications for current and future emergency response and public policy in the long-term COVID-19 disease management period.
Taste receptor type 1 member 3 enables western diet-induced anxiety in mice
Authors: Song Jae Won , Lee Keon-Hee , Seong Hobin , Shin Dong-Mi , Shon Woo-Jeong
Published: November 2023

Background

Accumulating evidence supports that the Western diet (WD), a diet high in saturated fat and sugary drinks, contributes to the pathogenesis of anxiety disorders, which are the most prevalent mental disorders worldwide. However, the underlying mechanisms by which WD causes anxiety remain unclear. Abundant expression of taste receptor type 1 member 3 (TAS1R3) has been identified in the hypothalamus, a key brain area involved in sensing peripheral nutritional signals and regulating anxiety. Thus, we investigated the influence of excessive WD intake on anxiety and mechanisms by which WD intake affects anxiety development using wild-type (WT) and Tas1r3 deficient (Tas1r3−/−) mice fed a normal diet (ND) or WD for 12 weeks.

Results

WD increased anxiety in male WT mice, whereas male Tas1r3−/− mice were protected from WD-induced anxiety, as assessed by open field (OF), elevated plus maze (EPM), light–dark box (LDB), and novelty-suppressed feeding (NSF) tests. Analyzing the hypothalamic transcriptome of WD-fed WT and Tas1r3−/− mice, we found 1,432 genes significantly up- or down-regulated as a result of Tas1r3 deficiency. Furthermore, bioinformatic analysis revealed that the CREB/BDNF signaling-mediated maintenance of neuronal regeneration, which can prevent anxiety development, was enhanced in WD-fed Tas1r3−/− mice compared with WD-fed WT mice. Additionally, in vitro studies further confirmed that Tas1r3 knockdown prevents the suppression of Creb1 and of CREB-mediated BDNF expression caused by high levels of glucose, fructose, and palmitic acid in hypothalamic neuronal cells.

Conclusions

Our results imply that TAS1R3 may play a key role in WD-induced alterations in hypothalamic functions, and that inhibition of TAS1R3 overactivation in the hypothalamus could offer therapeutic targets to alleviate the effects of WD on anxiety.
Differentiating interstitial lung diseases from other respiratory diseases using electronic nose technology
Authors: van der Sar Iris G. , Wijsenbeek Marlies S. , Braunstahl Gert-Jan , Loekabino Jason O. , Dingemans Anne-Marie C. , In ‘t Veen Johannes C. C. M. , Moor Catharina C.
Published: November 2023

Introduction

Interstitial lung disease (ILD) may be difficult to distinguish from other respiratory diseases due to overlapping clinical presentation. Recognition of ILD is often late, causing delay which has been associated with worse clinical outcome. Electronic nose (eNose) sensor technology profiles volatile organic compounds in exhaled breath and has potential to detect ILD non-invasively. We assessed the accuracy of differentiating breath profiles of patients with ILD from patients with asthma, chronic obstructive pulmonary disease (COPD), and lung cancer using eNose technology.

Methods

Patients with ILD, asthma, COPD, and lung cancer, regardless of stage or treatment, were included in a cross-sectional study in two hospitals. Exhaled breath was analysed using an eNose (SpiroNose) and clinical data were collected. Datasets were split in training and test sets for independent validation of the model. Data were analyzed with partial least squares discriminant and receiver operating characteristic analyses.

Results

161 patients with ILD and 161 patients with asthma (n = 65), COPD (n = 50) or lung cancer (n = 46) were included. Breath profiles of patients with ILD differed from all other diseases with an area under the curve (AUC) of 0.99 (95% CI 0.97–1.00) in the test set. Moreover, breath profiles of patients with ILD could be accurately distinguished from the individual diseases with an AUC of 1.00 (95% CI 1.00–1.00) for asthma, AUC of 0.96 (95% CI 0.90–1.00) for COPD, and AUC of 0.98 (95% CI 0.94–1.00) for lung cancer in test sets. Results were similar after excluding patients who never smoked.

Conclusions

Exhaled breath of patients with ILD can be distinguished accurately from patients with other respiratory diseases using eNose technology. eNose has high potential as an easily accessible point-of-care medical test for identification of ILD amongst patients with respiratory symptoms, and could possibly facilitate earlier referral and diagnosis of patients suspected of ILD.
High-fat stimulation induces atrial neural remodeling by reducing NO production via the CRIF1/eNOS/P21 axi
Authors: Zhang An , Li Huilin , Song Qiyuan , Cui Yansong , Zhang Yujiao , Wang Ximin , Li Zhan , Hou Yinglong
Published: November 2023

Background

Autonomic remodeling of the atria plays a pivotal role in the development of atrial fibrillation (AF) and exerts a substantial influence on the progression of this condition. Hyperlipidemia is a predisposing factor for AF, but its effect on atrial nerve remodeling is unclear. The primary goal of this study was to explore the possible mechanisms through which the consumption of a high-fat diet (HFD) induces remodeling of atrial nerves, and to identify novel targets for clinical intervention.

Methods

Cell models were created in vitro by subjecting cells to palmitic acid (PA), while rat models were established by feeding them a high-fat diet. To investigate the interplay between cardiomyocytes and nerve cells in a co-culture system, we utilized Transwell cell culture plates featuring a pore size of 0.4 μm. The CCK-8 assay was employed to determine cell viability, fluorescent probe DCFH-DA and flow cytometry were utilized for measuring ROS levels, JC-1 was used to assess the mitochondrial membrane potential, the Griess method was employed to measure the nitric oxide (NO) level in the supernatant, a fluorescence-based method was used to measure ATP levels, and MitoTracker was utilized for assessing mitochondrial morphology. The expression of pertinent proteins was evaluated using western blotting (WB) and immunohistochemistry techniques. SNAP was used to treat nerve cells in order to replicate a high-NO atmosphere, and the level of nitroso was assessed using the iodoTMT reagent labeling method.

Results

The study found that cardiomyocytes’ mitochondrial morphology and function were impaired under high-fat stimulation, affecting nitric oxide (NO) production through the CRIF1/SIRT1/eNOS axis. In a coculture model, overexpression of eNOS in cardiomyocytes increased NO expression. Moreover, the increased Keap1 nitrosylation within neuronal cells facilitated the entry of Nrf2 into the nucleus, resulting in an augmentation of P21 transcription and a suppression of proliferation. Atrial neural remodeling occurred in the HFD rat model and was ameliorated by increasing myocardial tissue eNOS protein expression with trimetazidine (TMZ).

Conclusions

Neural remodeling is triggered by high-fat stimulation, which decreases the production of NO through the CRIF1/eNOS/P21 axis. Additionally, TMZ prevents neural remodeling and reduces the occurrence of AF by enhancing eNOS expression.
Beyond mothers: the crucial role of family caregivers’ knowledge on exclusive breastfeeding in rural western China
Authors: Nie Jingchun , Ye Jinbiao , Wu Shichong , Wang Nan , Li Yangyuan , Liu Yunjie , Reheman Zulihumaer , Wu Junhao , Yang Jie , Shi Yaojiang
Published: November 2023

Background

The exclusive breastfeeding rate in China remains significantly low. Numerous studies have identified the impact of maternal characteristics on exclusive breastfeeding; however, the correlation between primary family caregivers’ characteristics, such as health and nutrition knowledge, and exclusive breastfeeding still lacks clarity. The aim of this study is to investigate the association between the health and nutrition knowledge of primary family caregivers and exclusive breastfeeding in rural China.

Methods

In 2019, a cross-sectional study was conducted in two prefectures within the Qinba Mountains area, located in the southern region of Shaanxi province. Data on knowledge of health and nutrition, breastfeeding practices, breastfeeding family support, breastfeeding self-efficacy, and conflict frequency were collected via structured questionnaires from 372 caregiver-infant pairs. Infant feeding practices were assessed based on the caregivers’ recall of the previous day (within the 24 h before the interview). The mother was interviewed first, followed by a brief questionnaire for the primary family caregiver, both conducted individually to minimize disruptions from other family members. Univariate and multivariate regression analyses were conducted to explore the correlation between knowledge of mothers and primary family caregivers and exclusive breastfeeding.

Results

The exclusive breastfeeding rate for six-month-old infants in the sample was 15.7%. On average, mothers scored 4.6 (SD 1.4) for health and nutrition knowledge, while primary family caregivers scored 3.6 (SD 1.4). Both maternal (OR 1.48; 95% CI 1.16, 1.88) and primary family caregiver’s (OR 1.34; 95% CI 1.05, 1.70) health and nutrition knowledge were significantly associated with exclusive breastfeeding. A positive correlation (OR 1.98; 95% CI 1.40, 2.80) existed between the average health and nutrition knowledge of the mother and primary family caregiver and exclusive breastfeeding. The primary family caregiver’s health and nutrition knowledge was positively correlated with the practical family support perceived by the mother (OR 1.23; 95% CI 1.02, 1.49) and breastfeeding self-efficacy of the mother (β = 1.40; 95% CI 0.29, 2.50).

Conclusions

The characteristics of the primary family caregiver play a large role in exclusive breastfeeding. To promote exclusive breastfeeding, interventions should address the needs of the whole family instead of just mothers.
MYL9 expressed in cancer-associated fibroblasts regulate the immune microenvironment of colorectal cancer and promotes tumor progression in an autocrine manner
Authors: Deng Shenghe , Cheng Denglong , Wang Jun , Gu Junnan , Xue Yifan , Jiang Zhenxing , Qin Le , Mao Fuwei , Cao Yinghao , Cai Kailin
Published: November 2023

Background

The tumor microenvironment (TME) is an important factor that regulates the progression of colorectal cancer (CRC). Cancer-associated fibroblasts (CAFs) are the main mesenchymal cells in the TME and play a vital role in tumor progression; however, the specific underlying mechanisms require further study.

Methods

Multiple single-cell and transcriptome data were analyzed and validated. Primary CAFs isolation, CCK8 assay, co-culture assay, western blotting, multiple immunofluorescence, qRT-PCR, ELISA, immunoprecipitation, ChIP, double luciferase, and animal experiments were used to explore the potential mechanism of MYL9 regulation in CRC.

Results

Our findings revealed that MYL9 was predominantly localized and expressed in CAFs rather than in CRC cells, and bioinformatics analysis revealed that high MYL9 expression was strongly associated with poor overall and disease-free survival in various tumors. In addition, high MYL9 expression is closely associated with M2 macrophage infiltration, which can lead to an immunosuppressive microenvironment in CRC, making it insensitive to immunotherapy. Mechanically, MYL9 can regulate the secretion of CAFs on CCL2 and TGF-β1, thus affecting the immune microenvironment and progression of CRC. In addition, MYL9 bounded with IQGAP1 to regulate CCL2 and TGF-β1 secretion through the ERK 1/2 pathway, and CCL2 and TGF-β1 synergistically promoted CRC cells progression through the PI3K-AKT pathway. Furthermore, MYL9 promotes epithelial-mesenchymal transition (EMT) in CRC. During the upstream regulation of MYL9 in CAFs, we found that the EMT transcription factor ZEB1 could bind to the MYL9 promoter in CAFs, enhancing the activity and function of MYL9. Therefore, MYL9 is predominantly expressed in CAFs and can indirectly influence tumor biology and EMT by affecting CAFs protein expression in CRC.

Conclusions

MYL9 regulates the secretion of cytokines and chemokines in CAFs, which can affect the immune microenvironment of CRC and promote CRC progression. The relationship between MYL9 expression and CRC clinical staging and immunotherapy is closer in CAFs than in tumor cells; therefore, studies using CAFs as a model deserve more attention when exploring tumor molecular targets in clinical research.
A nanoparticle vaccine displaying the ookinete PSOP25 antigen elicits transmission-blocking antibody response against Plasmodium berghei
Authors: Yao Guixiang , Min Hui , Yu Xinxin , Liu Fei , Cui Liwang , Cao Yaming
Published: November 2023

Background

Safe and effective vaccines are crucial for the control and eventual elimination of malaria. Novel approaches to optimize and improve vaccine efficacy are urgently required. Nanoparticle-based delivery platforms are considered potent and powerful tools for vaccine development.

Methods

In this study, we developed a transmission-blocking vaccine against malaria by conjugating the ookinete surface antigen PSOP25 to the Acinetobacter phage coat protein AP205, forming virus-like particles (VLPs) using the SpyTag/SpyCatcher adaptor system. The combination of AP205-2*SpyTag with PSOP25-SpyCatcher resulted in the formation of AP205-PSOP25 complexes (VLP-PSOP25). The antibody titers and avidity of serum from each immunization group were assessed by ELISA. Western blot and IFA were performed to confirm the specific reactivity of the elicit antisera to the native PSOP25 in Plasmodium berghei ookinetes. Both in vitro and in vivo assays were conducted to evaluate the transmission-blocking activity of VLP-PSOP25 vaccine.

Results

Immunization of mice with VLP-PSOP25 could induced higher levels of high-affinity antibodies than the recombinant PSOP25 (rPSOP25) alone or mixtures of untagged AP205 and rPSOP25 but was comparable to rPSOP25 formulated with alum. Additionally, the VLP-PSOP25 vaccine enhanced Th1-type immune response with remarkably increased levels of IgG2a subclass. The antiserum generated by VLP-PSOP25 specifically recognizes the native PSOP25 antigen in P. berghei ookinetes. Importantly, antisera generated by inoculation with the VLP-PSOP25 could inhibit ookinete development in vitro and reduce the prevalence of infected mosquitoes or oocyst intensity in direct mosquito feeding assays.

Conclusions

Antisera elicited by immunization with the VLP-PSOP25 vaccine confer moderate transmission-reducing activity and transmission-blocking activity. Our results support the utilization of the AP205-SpyTag/SpyCatcher platform for next-generation TBVs development.

Graphical abstract