bluuebunny/crossref_metadata_2025 huggingface dataset:
Association Between Acute Kidney Injury Hospital Visits and Environmental Heat Stress at a Nicaraguan Sugarcane Plantation
Authors: Hansson Erik , Jakobsson Kristina , Glaser Jason R. , Wesseling Catharina , Chavarría Denis , Lucas Rebekah A. I. , Wegman David H.
Published: April 2024

Background:

Mesoamerican sugarcane cutters are at a high risk of chronic kidney disease of non-traditional origin, a disease likely linked to heat-related acute kidney injury (AKI). Studies in general populations have described a positive association between high environmental temperatures and clinically assessed kidney outcomes, but there are no studies in occupational settings.

Method:

We accessed routine records of clinically diagnosed AKI (AKI-CD) and wet bulb globe temperatures (WBGT) at a large Nicaraguan sugarcane plantation and modeled the relationship between these using negative binomial regression. A rest-shade-hydration intervention was gradually enhanced during the study period, and efforts were made to increase the referral of workers with suspected AKI to healthcare.

Results:

Each 1°C WBGT was associated with an 18% (95% confidence interval [CI]: [4, 33%]) higher AKI-CD rate on the same day and a 14% (95% CI [−5, 37%]) higher rate over a week. AKI-CD rates and severity, and time between symptoms onset and diagnosis decreased during the study period, that is, with increasing rest-shade-hydration intervention. Symptoms and biochemical signs of systemic inflammation were common among AKI-CD cases.

Discussion:

Occupational heat stress, resulting from heavy work in environmental heat, was associated with a higher rate of clinically diagnosed AKI in a population at risk of CKDnt. Promoting rest-shade-hydration may have contributed to reducing AKI rates during the study period. Occupational health and safety personnel have key roles to play in enforcing rest, shade, and hydration practices, referring workers with suspected AKI to healthcare as well as collecting and analyzing the data needed to support workplace heat stress interventions.
The Impact of Social Media Marketing on Consumers’ Buying Decisions in the Restaurant Industry: Mediating Role of Trustworthiness
Authors: Pervin Most. Tahura , Khan Md. Rahat
Published: April 2024

This study aimed to measure the impact of social media marketing on the consumer purchasing process in the restaurant industry of Dhaka city. The random selection provided a structured questionnaire to 200 participants, and 113 replies were deemed appropriate for the research. An MS Excel sheet, SPSS (V, 24), and SPSS AMOS (V, 22) were used to validate the demographic, descriptive, and inferential analyses. The Pearson product–moment correlation exposes a significant positive correlation among the variables. In regression analysis, the proposed model and the independent variable (trustworthiness, business process, user experience, and consumer engagement) can describe 27.5% of the selected dependent variable (consumer purchasing behavior). Finally, the hypothesis testing from the research survey data depicts that trustworthiness and consumer engagement significantly impact consumer purchasing behavior. In addition, the model proposed three mediating effects of trustworthiness relating to social media marketing and consumers’ buying decisions in the restaurant industry, and the outcomes revealed that the direct effect of both business processes and user experience on consumer purchasing behavior does not work. Meanwhile, the presence of consumers’ trust in social media marketing enhances the predictive ability of business processes and user experience, significantly impacting consumer purchasing behavior.
Do Institutional Quality and Natural Resources Affect the Outward Foreign Direct Investment of India?
Authors: Singhal Nidhi , Rani Ritu , Kumar Naresh
Published: April 2024

The institutional quality and natural resources of the host country are among the essential determinants of outward foreign direct investment (OFDI). The present study is performed to examine the role of the host country’s institutional quality and natural resources on Indian OFDI for the panel of 15 countries concerning the period from 2001 to 2020. The study uses the fixed-effect panel regression model and found that host nations’ political stability, voice and accountability, absence of violence or terrorism, rule of law, and control of corruption attract FDI from India. Further, the government’s efficacy and regulatory quality do not have a considerable impact on Indian OFDI. The study also found that the natural resources of the host nation play an important role in the international diversification of investments made by Indian investors. It is recommended to the government of host nations to strengthen their institutional quality as good-quality institutions add to the growth of entrepreneurship, encourage investment, and therefore stimulate the economic growth of the economy.
Overcoming political polarization: Strategies for diminishing intransigence & reducing intergroup animus
Authors: Bersoff David M.
Published: April 2024

Data from over 25,000 nationally representative respondents to an online survey conducted in 22 countries were analyzed to understand the predictors and potential mitigators of political polarization. The analysis yielded two key findings. First, perceiving that your country is very divided on key societal issues is not by itself enough to generate affective polarization, the state in which groups that differ ideologically feel hostile toward each other and are unwilling to collaborate in constructive problem-solving: a belief that the ideological divisions are not likely to be overcome is also required. This finding suggests that affective polarization may be mitigated by new types of interventions that try to change perceptions of the dispute itself rather than views of the combatants. Instead of attempting to decrease intergroup animus, such interventions would aim to increase confidence or engagement in dispute-resolution processes. Second, employers were the only institution examined that were able to garner the trust of people who saw their country’s ideological divisions as insurmountable. This ability puts employers in a unique position to address polarization durably and at scale, especially when it comes to interventions centered on fostering positive interactions.
“Not doing it justice”: Perspectives of Recent Family Medicine Graduates on Mental Health and Addictions Training in Residency
Authors: Ramdawar Abigail , Bozinoff Nikki , Lazare Kimberly
Published: April 2024

OBJECTIVES

Family physicians report feeling inadequately prepared to meet the evolving mental health care needs of the population. Little scholarship exists evaluating the effectiveness of curricula designed to teach mental health and addiction (MH&A) care to family medicine (FM) residents. As such, the purpose of this study was to explore the experiences of recent FM residency graduates in providing mental health care, and their perceptions of mental health training gaps during their residencies.

METHODS

A qualitative descriptive study design was conducted by 8 recent graduates of the University of Toronto's FM residency program, who participated in semi-structured video interviews. A thematic analysis approach was used to collect and analyze the data.

RESULTS

Through thematic analysis, 3 overarching themes were developed: (1) barriers in providing mental health and addiction care, (2) curriculum renewal, and (3) the role of FPs and professional identity. Consistent with the literature, the majority of recent FM graduates expressed discomfort when managing patients with mental health and addiction concerns. Additionally, participants perceived residency program time constraints, rotational site differences, and limited exposure to marginalized populations all impacted learning and mastery of skills.

CONCLUSION

The findings of this study underscore current gaps within the FM residency curriculum and highlight the need to address current curricular deficits.
Anatomy of the Naviculocuneiform Joint Complex
Authors: Borrelli George , Albiero Maxwell , Jastifer James
Published: April 2024

Background:

The purpose of this study was to quantify the articular surfaces of the naviculocuneiform (NC) joint to help clinicians better understand common pathologies observed such as navicular stress fractures and arthrodesis nonunions.

Methods:

Twenty cadaver NC joints were dissected and the articular cartilage of the navicular, medial, middle, and lateral cuneiforms were quantified by calibrated digital imaging software. Statistical analysis included calculating the mean cartilage surface area dimensions of the distal navicular and proximal cuneiform bones. Length measurements on the navicular were obtained to estimate the geographic location of the interfacet ridges. Lastly, all facets of the articular surfaces were described in regard to the shape and location of cartilaginous or fibrous components. Results were compared using Student t tests.

Results:

Navicular cartilage was present over 75.4% of the surface area of the proximal NC joint, compared with 72.6% of combined cuneiform cartilage distally. The mean height of the deepest (dorsal-plantar) measurement of navicular articular cartilage was 18 ± 3 mm. The mean heights of the distal medial, middle, and lateral cuneiform articular facets were 15 ± 1 mm, 17 ± 2 mm, and 15 ± 2 mm, respectively.

Conclusion:

There is significant variation among the articular surfaces of the NC joint. Additionally, the central third of the navicular was calculated to lie in the inter-facet ridge between the medial and middle articular facets of the navicular.

Clinical Relevance:

Surgeons may consider this study data when performing joint preparation for NC arthrodesis as cartilage was present to a mean depth of 18 mm at the NC joint. Additionally, this study demonstrates that the central third of the navicular, where most navicular stress fractures occur, lies in the interfacet ridge between the medial and middle articular facets of the navicular.
“You can’t manage what you can’t measure”: Regenerative agriculture, farming by numbers, and calculability in soil microbiopolitics
Authors: Krzywoszynska Anna
Published: April 2024

Microbes are increasingly central to visions of sustainable and healthy futures, including in farming movements such as regenerative agriculture. In social science and environmental humanities scholarship, (re)connecting with microbes is seen as a way to challenge, conceptually and practically, the very ontology of human-nature separation which underpins the destruction and violence in human relations with other living beings and with environments. The crux of this onto-ethical potential is a shift towards relational modes of knowing microbes, rooted in localised, proximate, and sensuous practice, and expressed in embodied expertise. This paper engages critically with this promise by calling attention to persistence of calculability to people's self-governance within current microbiopolitics. Through a case study of regenerative agriculture in the United Kingdom, I argue that while embodied expertise of soil microbes is seen as crucial to soil health-oriented farming, it is also dismissed as an insufficient in guiding farmers and shaping future practice, including by farmers themselves. Regenerative agriculture continues to function within “farming by numbers”, an agri-biopolitical regime in which farmers’ and advisors’ subjectivity is that of calculating managers situated in calculable environments. As a result, calculability acts as a ‘break’ on the development of alternative microbial onto-ethics, and regenerative agriculture practitioners look for ways to bring soil microbes into the realm of calculability (e.g., through metagenomics). Consequently, the way microbes are being incorporated into future agri-environmental relations reinforces rather than threatens existing structures of biopolitical power. Overall, I argue that human-microbe research, potentially due to its empirical focus on alternative practices, has underplayed the importance of calculability to people's self-governance in relations with microbes. The struggle for a new microbiopolitics, especially in agriculture and environmental management, will require addressing the continued importance of calculability, and a creative and socially relevant experimentation with alternative forms of expertise.
Unveiling a Misdiagnosed Midline Cervical Cleft: A Case Report and Review of the Literature
Authors: Rezania Nikki , O’Neill Elizabeth S. , Harmon Kelly A. , Arnold Sydney H. , Tragos Christina
Published: April 2024

Congenital midline cervical cleft (CMCC) is a rare congenital abnormality of the ventral neck that is often misdiagnosed. We present a case of a 12-year-old male with a history of incomplete CMCC excision and limited neck extension. We highlight the need for increased awareness of this anomaly and propose a clinical algorithm for clinicians when faced with this rare congenital condition. CMCC typically presents at birth and involves a defect along the midline of the neck, characterized by a nipple-like protrusion of the skin and a fibrous cord with an underlying sinus. Micrognathia and mandibular growth restriction are anticipated consequences of CMCC, requiring early intervention. Current treatment guidelines recommend surgical excision prior to age two using a Z-plasty technique. This report emphasizes the rarity and diagnostic challenges of CMCC. It underscores the significance of accurate identification and appropriate surgical planning in a timely manner. Based on the authors’ experience with this case and a review of the literature, we propose a clinical algorithm aimed to enhance CMCC diagnosis and management.
Transcriptional and metabolic profiling of sulfur starvation response in two monocots
Authors: Zenzen Ivan , Cassol Daniela , Westhoff Philipp , Kopriva Stanislav , Ristova Daniela
Published: April 2024

Background

Sulfur (S) is a mineral nutrient essential for plant growth and development, which is incorporated into diverse molecules fundamental for primary and secondary metabolism, plant defense, signaling, and maintaining cellular homeostasis. Although, S starvation response is well documented in the dicot model Arabidopsis thaliana, it is not clear if the same transcriptional networks control the response also in the monocots.

Results

We performed series of physiological, expression, and metabolite analyses in two model monocot species, one representing the C3 plants, Oryza sativa cv. kitaake, and second representing the C4 plants, Setaria viridis. Our comprehensive transcriptomic analysis revealed twice as many differentially expressed genes (DEGs) in S. viridis than in O. sativa under S-deficiency, consistent with a greater loss of sulfur and S-containing metabolites under these conditions. Surprisingly, most of the DEGs and enriched gene ontology terms were species-specific, with an intersect of only 58 common DEGs. The transcriptional networks were different in roots and shoots of both species, in particular no genes were down-regulated by S-deficiency in the roots of both species.

Conclusions

Our analysis shows that S-deficiency seems to have different physiological consequences in the two monocot species and their nutrient homeostasis might be under distinct control mechanisms.
Long-term survival after neoadjuvant therapy for triple-negative breast cancer under different treatment regimens: a systematic review and network meta-analysis
Authors: Liu Zhilin , Li Jinming , Zhao Fuxing , Ren Dengfeng , Li Zitao , Chen Yongzhi , Huang Shifen , Liu Zhen , Zhao Yi , Wang Miaozhou , Li Huihui , Xu ZhengBo , Shen Guoshuang , Zhao Jiuda
Published: April 2024

Background

Triple-negative breast cancer (TNBC) is a life-threatening subtype of breast cancer with limited treatment options. Therefore, this network meta-analysis (NMA) aimed to evaluate and compare the effect of various neoadjuvant chemotherapy (NCT) options on the long-term survival of patients with TNBC.

Methods

PubMed, Embase, Medline, Cochrane Library, Web of Science, and major international conference databases were systematically searched for randomized controlled trials (RCTs) on the efficacy of various NCT options in patients with TNBC. Searches were performed from January 2000 to June 2023. Study heterogeneity was assessed using the I2 statistic. Hazard ratios (HRs) and 95% confidence intervals (CIs) were used to evaluate disease-free survival (DFS) and overall survival (OS). Odds ratios (ORs) and 95% CIs were used to evaluate the pathologic complete response (pCR). The primary outcome was DFS.

Results

We conducted an NMA of 21 RCTs involving 8873 patients with TNBC. Our study defined the combination of anthracyclines and taxanes as the preferred treatment option. On this basis, the addition of any of the following new drugs is considered a new treatment option: bevacizumab (B), platinum (P), poly-ADP-ribose polymerase inhibitors (PARPi), and immune checkpoint inhibitor (ICI). Based on the surface under the cumulative ranking curve (SUCRA) values, the top three SUCRA area values of DFS were taxanes, anthracycline, and cyclophosphamide (TAC; 89.23%); CT (84.53%); and B (81.06%). The top three SUCRA area values of OS were CT (83.70%), TAC (62.02%), and B-containing regimens (60.06%). The top three SUCRA area values of pCR were B + P-containing regimens (82.7%), ICI + P-containing regimens (80.2%), and ICI-containing regimens (61.8%).

Conclusions

This NMA showed that standard chemotherapy is a good choice with respect to long-term survival. Moreover, B associated with P-containing regimens is likely to be the optimal treatment option for neoadjuvant TNBC in terms of pCR.
Insulin eye drops improve corneal wound healing in STZ-induced diabetic mice by regulating corneal inflammation and neuropeptide release
Authors: Chen Shudi , Li Yingsi , Song Wenjing , Cheng Yu , Gao Yuan , Xie Luoying , Huang Meiting , Yan Xiaoming
Published: April 2024

Introduction

In recent years, insulin eye drops have attracted increasing attention from researchers and ophthalmologists. The aim of this study was to investigate the efficacy and possible mechanism of action of insulin eye drops in diabetic mice with corneal wounds.

Methods

A type 1 diabetes model was induced, and a corneal epithelial injury model of 2.5 mm was established. We used corneal fluorescein staining, hematoxylin-eosin (H-E) staining and the Cochet-Bonnet esthesiometer to examine the process of wound healing. Subsequently, the expression levels of Ki-67, IL-1β, β3-tubulin and neuropeptides, including substance P (SP) and calcitonin gene-related peptide (CGRP), were examined at 72 h after corneal injury.

Results

Fluorescein staining demonstrated an acceleration of the recovery of corneal epithelial injury in diabetic mice compared with the saline treatment, which was further evidenced by the overexpression of Ki-67. Moreover, 72 h of insulin application attenuated the expression of inflammatory cytokines and neutrophil infiltration. Remarkably, the results demonstrated that topical insulin treatment enhanced the density of corneal epithelial nerves, as well as neuropeptide SP and CGRP release, in the healing cornea via immunofluorescence staining.

Conclusions

Our results indicated that insulin eye drops may accelerate corneal wound healing and decrease inflammatory responses in diabetic mice by promoting nerve regeneration and increasing levels of neuropeptides SP and CGRP.
Resistance training presents beneficial effects on bone development of adolescents engaged in swimming but not in impact sports: ABCD Growth Study
Authors: Agostinete Ricardo R. , Werneck André O. , Narciso Pedro H. , Ubago-Guisado Esther , Coelho-e-Silva Manuel J. , Bielemann Renata M. , Gobbo Luis Alberto , Lynch Bruna Turi , Fernandes Romulo Araújo , Vlachopoulos Dimitris
Published: April 2024

Background

Sports practice during adolescence is important to enhance bone development, although it may provide different effects depending on the mechanical impact present in the sport. Besides, resistance training (RT) may also induce bone changes directly (via muscle contractions) and indirectly (via myokines). However, there have been no studies analyzing the longitudinal influence of engaging in sport with and without added mechanical load. Thus, this study aims to analyze the combined effects of sports participation and resistance training on areal bone mineral density (aBMD) accrual in adolescent athletes participating in swimming and impact sports for 12-months.

Methods

This was a 12-month longitudinal study. The sample comprised 91 adolescents (21 females) aged 10 to 18 years, engaged in impact sports (basketball, tennis, track & field, baseball and gymnastics, n = 66) and non-impact sport (swimming, n = 25). The sample was divided according to resistance training participation: impact sports only (n = 45), impact sports + resistance training (n = 21), swimming-only (n = 17) and swimming + resistance training (n = 8). aBMD and soft tissues were measured using dual-energy X-ray absorptiometry. Generalized linear models analysis was used for the resistance training (RT) x type of sport interaction in predicting aBMD changes overtime, adjusting for maturation, sex and baseline aBMD.

Results

After 12-months, all groups showed a significant increase in aBMD, except for the swimming groups (regardless of resistant training), which showed a significant loss in spine aBMD (-0.045 [-0.085 to -0.004] g/cm2 in swimming-only and − 0.047 [-0.073 to -0.021] g/cm2 in swimming + RT). In comparisons between groups, only swimming + RT group, compared with swimming-only group presented higher upper limbs aBMD (0.096 g/cm2 [0.074 to 0.118] in swimming + RT vs. 0.046 [0.032 to 0.060] g/cm2 in swimming only; p < 0.05) and whole body less head (WBLH) aBMD (0.039 [0.024 to 0.054] g/cm2 in swimming + RT vs. 0.017 [0.007 to 0.027] g/cm2 swimming-only; p < 0.05).

Conclusion

Despite the significant gain in aBMD in all groups and body sites after 12-months, except for the spine site of swimmers, the results indicate that participation in RT seems to improve aBMD accrual in swimmers at the upper limbs and WBLH.
Effects of yoga on impulsivity in patients with and without mental disorders: a systematic review
Authors: Machado Yuri de Castro , Oliveira Mariana , Lima Jogiely Larissa Ferreira , Bhargav Hemant , Varambally Shivarama , de Miranda Débora Marques , Romano-Silva Marco Aurélio
Published: April 2024

Background

Yoga can be used as a complementary intervention to conventional treatments, whether pharmacological or non-pharmacological. Sustained practice of yoga can generate a series of benefits for individuals' quality of life and improve their physical fitness.

Objective

To investigate the potential effects of yoga as an adjunct intervention in conditions involving impulse control issues, such as attention deficit hyperactivity disorder (ADHD), borderline personality disorder, bipolar affective disorder, and substance use disorders.

Methods

We performed a systematic review of placebo-controlled, randomized trials of yoga in patients with impulsivity. PubMed, Web of Science, and Science Direct databases were searched for trials published up to January, 2023. Data were extracted from published reports and quality assessment was performed per Cochrane recommendations.

Results

Out of 277 database results, 6 RCT were included in this systematic review. To assess the level of attention and impulsiveness, the following scales were analyzed: Barratt Impulsiveness, UPPS-P Impulsive Behavior scale, Conners’ Continuous Performance Test IIª and Conners’ Parent Rating Scale–Revised: Long.

Conclusions

Yoga didn’t have a significant improvement in impulsivity when compared to placebo. There are many tools to assess impulsivity, but they mean different concepts and domains consisting in a weakness on comparison of yoga effects.

PROSPERO registration

CRD42023389088.
Acceptability and experience of a smartphone symptom monitoring app for people with psychosis in China (YouXin): a qualitative study
Authors: Zhang Xiaolong , Lewis Shôn , Chen Xu , Zhou Jiaojiao , Wang Xingyu , Bucci Sandra
Published: April 2024

Background

Access to high-quality mental healthcare remains challenging for people with psychosis globally, including China. Smartphone-based symptom monitoring has the potential to support scalable mental healthcare. However, no such tool, until now, has been developed and evaluated for people with psychosis in China. This study investigated the acceptability and the experience of using a symptom self-monitoring smartphone app (YouXin) specifically developed for people with psychosis in China.

Methods

Semi-structured interviews were conducted with 10 participants with psychosis to explore the acceptability of YouXin. Participants were recruited from the non-randomised feasibility study that tested the validity, feasibility, acceptability and safety of the YouXin app. Data analysis was guided by the theoretical framework of acceptability.

Results

Most participants felt the app was acceptable and easy to use, and no unbearable burdens or opportunity costs were reported. Participants found completing the self-monitoring app rewarding and experienced a sense of achievement. Privacy and data security were not major concerns for participants, largely due to trust in their treating hospital around data protection. Participants found the app easy to use and attributed this to the training provided at the beginning of the study. A few participants said they had built some form of relationship with the app and would miss the app when the study finished.

Conclusions

The YouXin app is acceptable for symptom self-monitoring in people with experience of psychosis in China. Participants gained greater insights about their symptoms by using the YouXin app. As we only collected retrospective acceptability in this study, future studies are warranted to assess hypothetical acceptability before the commencement of study to provide a more comprehensive understanding of implementation.
A mobile app to challenge obsessional beliefs in adolescents: a protocol of a two-armed, parallel randomized controlled trial
Authors: Saman Yuliya , Pascual-Vera Belén , Corberán Marta , Arnáez Sandra , Roncero María , García-Soriano Gemma
Published: April 2024

Background

Adolescence is a crucial stage for the development of OCD symptoms that, in most cases, persist into adulthood. This requires designing preventive strategies tailored to this population. Therefore, we aim to describe the study protocol that will be used to examine the effectiveness of a mobile health application to challenge obsessional beliefs in adolescents.

Methods

A two-armed randomized controlled trial will be conducted on an adolescent sample from the general population. The experimental group will use the intervention module (GGOC-AD) of a mobile app on the GGtude platform for 14 days whereas the control group will use a non-active module (GGN-AD) of said app. Primary outcome measures will be obsessional beliefs and obsessive-compulsive symptoms, and secondary measures will be self-esteem and emotional symptoms. Three assessment points will be conducted at baseline, post-intervention, and one-month follow-up. A linear multiple regression model with an intention to treat approach will be used. The expected total sample size will be 55 participants.

Discussion

We expect that the intervention group will show a reduction in obsessional beliefs and OCD-symptoms at post and follow-up in comparison with the control group. Additionally, we expect that the app will improve participants’ self-esteem. This study could provide an accessible mobile health tool to prevent OCD-related symptoms in adolescents.

Trial registration

ClinicalTrials.gov identifier:NCT06033391. Registered September 4, 2023.

Graphical Abstract
Depressive symptoms, parenting attitude, and violent discipline among caregivers of left-behind children in rural China: a cross-sectional study
Authors: Qiu Yunfei , Li Mengshi , Shi Huifeng , Zhao Chunxia , Du Yufeng , Wang Xiaoli , Zhang Jingxu
Published: April 2024

Background

The situation of mental health and discipline behaviors of left-behind children’s caregivers were not optimistic in rural China. Caregivers’ depression might increase the risk of using violent discipline. However, the specific ways in which depressive symptoms impact violent discipline have rarely been explored in rural areas. This study aims to assess the prevalence of violent discipline among left-behind children under 6 years of age in rural China and explore the potential mechanisms of how caregivers’ depressive symptoms affect violent discipline.

Methods

We enrolled a total of 396 pairs of left-behind children and their caregivers in our study, which was conducted in 5 counties of Hebei, Henan, Jiangxi, Guizhou, and Sichuan provinces in China. The depressive symptoms of caregivers were measured by using Zung Self-rating Depression Scale (ZSDS) and violent discipline was assessed by the Child Discipline Module of Multiple Indicator Cluster Surveys (MICS). A self-designed questionnaire was utilized to measure caregiver’s parenting attitude. Based on the cross-sectional data, controlling for potential confounders, structural equation modeling (SEM) was used to assess the direct and indirect effects of the mediation models by applying the weighted least squares with mean and variance adjusted (WLSMV) estimate.

Results

The prevalence of violent discipline, psychological aggression, and physical punishment was 72.7%, 59.3%, and 60.4% respectively of left-behind children under 6 years of age. According to the results of SEM, parenting attitude acted as a suppressor, suppressing the association between caregivers’ depressive symptoms and physical punishment/psychological aggression/violent discipline. The caregivers’ depressive symptoms positively influenced all the outcome variables by affecting parenting attitudes (p = 0.002, p = 0.013, p = 0.002).

Conclusions

The presence of depressive symptoms in caregivers increases the use of violent discipline through negative parenting attitudes. The mental health status of primary caregivers of left-behind children in rural China needed emphasis and improvement.
It’s about living a normal life: parents’ quality of life when their child has a life-threatening or life-limiting condition - a qualitative study
Authors: Kittelsen Trine Brun , Lorentsen Vibeke Bruun , Castor Charlotte , Lee Anja , Kvarme Lisbeth Gravdal , Winger Anette
Published: April 2024

Background

Pediatric palliative care (PPC) seeks to enhance the quality of life (QoL) for both children and their families. While most studies within PPC have focused on the ill child’s QoL, less is known about parents’ experiences of their own QoL. The aim of this study was to explore parents’ QoL when their child has a life-threatening or life-limiting condition.

Methods

The study has a qualitative, hermeneutic phenomenological design inspired by van Manen’s phenomenology of practice. In-depth interviews were conducted with 12 fathers and 12 mothers of children living with cancer or a genetic condition. A deeper understanding of parents’ lived experiences was obtained through an adapted photo elicitation method. Two rounds of thematic analysis were conducted, covering both the photo elicitation data, and interview data.

Results

The findings describe four themes related to parents’ QoL: living a normal life, giving my child a good life, having time to fulfill siblings’ needs, and feeling heard and respected in the health and social care system.

Conclusions

The complexity of elements shaping parents’ QoL is evident. The interconnectedness between parents, the ill child, siblings, and interactions with the health and social care system, highlights the need to understand and address diverse aspects in enhancing parents QoL.
Prevalence of menthol cigarette use among adults who smoke from the United States by census division and demographic subgroup, 2002–2020: findings from the International Tobacco Control (ITC) project
Authors: Driezen Pete , Gravely Shannon , Kasza Karin A. , Thompson Mary E. , Cummings K. Michael , Hyland Andrew , Fong Geoffrey T.
Published: April 2024

Background

Targeted marketing of menthol cigarettes in the US influences disparities in the prevalence of menthol smoking. There has been no analysis of sub-national data documenting differences in use across demographic subgroups. This study estimated trends in the prevalence of menthol use among adults who smoke in the nine US census divisions by sex, age, and race/ethnicity from 2002 to 2020.

Methods

Data from 12 waves of the US ITC Survey were used to estimate the prevalence of menthol cigarette use across census divisions and demographic subgroups using multilevel regression and post-stratification (n = 12,020). Multilevel logistic regression was used to predict the prevalence of menthol cigarette use in 72 cross-classified groups of adults who smoke defined by sex, age, race/ethnicity, and socioeconomic status; division-level effects were fit with a random intercept. Predicted prevalence was weighted by the total number of adults who smoke in each cross-classified group and aggregated to divisions within demographic subgroup. Estimates were validated against the Tobacco Use Supplement to the Current Population Survey (TUS-CPS).

Results

Overall modeled prevalence of menthol cigarette use was similar to TUS-CPS estimates. Prevalence among adults who smoke increased in each division from 2002 to 2020. By 2020, prevalence was highest in the Middle (46.3%) and South Atlantic (42.7%) and lowest in the Pacific (25.9%) and Mountain (24.2%) divisions. Prevalence was higher among adults aged 18–29 (vs. 50+) and females (vs. males). Prevalence among non-Hispanic Black people exceeded 80% in the Middle Atlantic, East North Central, West North Central, and South Atlantic in all years and varied most among Hispanic people in 2020 (Pacific: 26.5%, New England: 55.1%).

Conclusions

Significant geographic variation in the prevalence of menthol cigarette use among adults who smoke suggests the proposed US Food and Drug Administration (FDA) menthol cigarette ban will exert differential public health benefits and challenges across geographic and demographic subgroups.
Csn5 inhibits autophagy by regulating the ubiquitination of Atg6 and Tor to mediate the pathogenicity of Magnaporthe oryzae
Authors: Shen Zi-Fang , Li Lin , Wang Jing-Yi , Liao Jian , Zhang Yun-Ran , Zhu Xue-Ming , Wang Zi-He , Lu Jian-Ping , Liu Xiao-Hong , Lin Fu-Cheng
Published: April 2024

Csn5 is subunit 5 of the COP9 signalosome (CSN), but the mechanism by which it strictly controls the pathogenicity of pathogenic fungi through autophagy remains unclear. Here, we found that Csn5 deficiency attenuated pathogenicity and enhanced autophagy in Magnaporthe oryzae. MoCSN5 knockout led to overubiquitination and overdegradation of MoTor (the core protein of the TORC1 complex [target of rapamycin]) thereby promoted autophagy. In addition, we identified MoCsn5 as a new interactor of MoAtg6. Atg6 was found to be ubiquitinated through linkage with lysine 48 (K48) in cells, which is necessary for infection-associated autophagy in pathogenic fungi. K48-ubiquitination of Atg6 enhanced its degradation and thereby inhibited autophagic activity. Our experimental results indicated that MoCsn5 promoted K48-ubiquitination of MoAtg6, which reduced the MoAtg6 protein content and thus inhibited autophagy. Aberrant ubiquitination and autophagy in ΔMocsn5 led to pleiotropic defects in the growth, development, stress resistance, and pathogenicity of M. oryzae. In summary, our study revealed a novel mechanism by which Csn5 regulates autophagy and pathogenicity in rice blast fungus through ubiquitination.
In situ chemoimmunotherapy hydrogel elicits immunogenic cell death and evokes efficient antitumor immune response
Authors: Liu Qin , Xu Rui , Shen Jingwen , Tao Yaping , Shao Jingyi , Ke Yaohua , Liu Baorui
Published: April 2024

Background

Chemoimmunotherapy has shown promising advantages of eliciting immunogenic cell death and activating anti-tumor immune responses. However, the systemic toxicity of chemotherapy and tumor immunosuppressive microenvironment limit the clinical application.

Methods

Here, an injectable sodium alginate hydrogel (ALG) loaded with nanoparticle albumin-bound-paclitaxel (Nab-PTX) and an immunostimulating agent R837 was developed for local administration. Two murine hepatocellular carcinoma and breast cancer models were established. The tumor-bearing mice received the peritumoral injection of R837/Nab-PTX/ALG once a week for two weeks. The antitumor efficacy, the immune response, and the tumor microenvironment were investigated.

Results

This chemoimmunotherapy hydrogel with sustained-release character was proven to have significant effects on killing tumor cells and inhibiting tumor growth. Peritumoral injection of our hydrogel caused little harm to normal organs and triggered a potent antitumor immune response against both hepatocellular carcinoma and breast cancer. In the tumor microenvironment, enhanced immunogenic cell death induced by the combination of Nab-PTX and R837 resulted in 3.30-fold infiltration of effector memory T cells and upregulation of 20 biological processes related to immune responses.

Conclusions

Our strategy provides a novel insight into the combination of chemotherapy and immunotherapy and has the potential for clinical translation.
Expression of the SARS-CoV-2 receptor-binding domain by live attenuated influenza vaccine virus as a strategy for designing a bivalent vaccine against COVID-19 and influenza
Authors: Stepanova Ekaterina , Isakova-Sivak Irina , Mezhenskaya Daria , Niskanen Sergei , Matyushenko Victoria , Bazhenova Ekaterina , Rak Alexandra , Wong Pei Fong , Prokopenko Polina , Kotomina Tatiana , Krutikova Elena , Legotskiy Sergei , Neterebskii Bogdan , Ostroukhova Tatiana , Sivak Konstantin , Orshanskaya Yana , Yakovlev Kirill , Rudenko Larisa
Published: April 2024

Influenza and SARS-CoV-2 are two major respiratory pathogens that cocirculate in humans and cause serious illness with the potential to exacerbate disease in the event of co-infection. To develop a bivalent vaccine, capable of protecting against both infections, we inserted the receptor-binding domain (RBD) of the SARS-CoV-2 spike protein into hemagglutinin (HA) molecule or into the open reading frame of the truncated nonstructural protein 1 (NS1) of live attenuated influenza vaccine (LAIV) virus and assessed phenotypic characteristics of the rescued LAIV-RBD viruses, as well as their immunogenicity in mouse and Syrian hamster animal models. A panel of 9 recombinant LAIV-RBD viruses was rescued using the A/Leningrad/17 backbone. Notably, only two variants with RBD insertions into the HA molecule could express sufficient quantities of RBD protein in infected MDCK cells. Intranasal immunization of mice induced high levels of anti-influenza antibody responses in all chimeric LAIV-RBD viruses, which was comparable to the LAIV virus vector. The RBD-specific antibody responses were most pronounced in the variant expressing RBD194 fragment as a chimeric HA protein. This candidate was further tested in Syrian hamsters and was shown to be immunogenic and capable of protecting animals against both infections.
Body composition and body fat distribution in tissue-specific insulin resistance and in response to a 12-week isocaloric dietary macronutrient intervention
Authors: Trouwborst Inez , Jardon Kelly M. , Gijbels Anouk , Hul Gabby , Feskens Edith J.M. , Afman Lydia A. , Linge Jennifer , Goossens Gijs H. , Blaak Ellen E.
Published: April 2024

Background

Body composition and body fat distribution are important predictors of cardiometabolic diseases. The etiology of cardiometabolic diseases is heterogenous, and partly driven by inter-individual differences in tissue-specific insulin sensitivity.

Objectives

To investigate (1) the associations between body composition and whole-body, liver and muscle insulin sensitivity, and (2) changes in body composition and insulin sensitivity and their relationship after a 12-week isocaloric diet high in mono-unsaturated fatty acids (HMUFA) or a low-fat, high-protein, high-fiber (LFHP) diet.

Methods

This subcohort analysis of the PERSON study includes 93 individuals (53% women, BMI 25–40 kg/m2, 40–75 years) who participated in this randomized intervention study. At baseline and after 12 weeks of following the LFHP, or HMUFA diet, we performed a 7-point oral glucose tolerance test to assess whole-body, liver, and muscle insulin sensitivity, and whole-body magnetic resonance imaging to determine body composition and body fat distribution. Both diets are within the guidelines of healthy nutrition.

Results

At baseline, liver fat content was associated with worse liver insulin sensitivity (β [95%CI]; 0.12 [0.01; 0.22]). Only in women, thigh muscle fat content was inversely related to muscle insulin sensitivity (-0.27 [-0.48; -0.05]). Visceral adipose tissue (VAT) was inversely associated with whole-body, liver, and muscle insulin sensitivity. Both diets decreased VAT, abdominal subcutaneous adipose tissue (aSAT), and liver fat, but not whole-body and tissue-specific insulin sensitivity with no differences between diets. Waist circumference, however, decreased more following the LFHP diet as compared to the HMUFA diet (-3.0 vs. -0.5 cm, respectively). After the LFHP but not HMUFA diet, improvements in body composition were positively associated with improvements in whole-body and liver insulin sensitivity.

Conclusions

Liver and muscle insulin sensitivity are distinctly associated with liver and muscle fat accumulation. Although both LFHP and HMUFA diets improved in body fat, VAT, aSAT, and liver fat, only LFHP-induced improvements in body composition are associated with improved insulin sensitivity.

Trial registration

NCT03708419 (clinicaltrials.gov).
Family cascade screening for equitable identification of familial hypercholesterolemia: study protocol for a hybrid effectiveness-implementation type III randomized controlled trial
Authors: Johnson Christina , Chen Jinbo , McGowan Mary P. , Tricou Eric , Card Mary , Pettit Amy R. , Klaiman Tamar , Rader Daniel J. , Volpp Kevin G. , Beidas Rinad S.
Published: April 2024

Background

Familial hypercholesterolemia (FH) is a heritable disorder affecting 1.3 million individuals in the USA. Eighty percent of people with FH are undiagnosed, particularly minoritized populations including Black or African American people, Asian or Asian American people, and women across racial groups. Family cascade screening is an evidence-based practice that can increase diagnosis and improve health outcomes but is rarely implemented in routine practice, representing an important care gap. In pilot work, we leveraged best practices from behavioral economics and implementation science—including mixed-methods contextual inquiry with clinicians, patients, and health system constituents—to co-design two patient-facing implementation strategies to address this care gap: (a) an automated health system-mediated strategy and (b) a nonprofit foundation-mediated strategy with contact from a foundation-employed care navigator. This trial will test the comparative effectiveness of these strategies on completion of cascade screening for relatives of individuals with FH, centering equitable reach.

Methods

We will conduct a hybrid effectiveness-implementation type III randomized controlled trial testing the comparative effectiveness of two strategies for implementing cascade screening with 220 individuals with FH (i.e., probands) per arm identified from a large northeastern health system. The primary implementation outcome is reach, or the proportion of probands with at least one first-degree biological relative (parent, sibling, child) in the USA who is screened for FH through the study. Our secondary implementation outcomes include the number of relatives screened and the number of relatives meeting the American Heart Association criteria for FH. Our secondary clinical effectiveness outcome is post-trial proband cholesterol level. We will also use mixed methods to identify implementation strategy mechanisms for implementation strategy effectiveness while centering equity.

Discussion

We will test two patient-facing implementation strategies harnessing insights from behavioral economics that were developed collaboratively with constituents. This trial will improve our understanding of how to implement evidence-based cascade screening for FH, which implementation strategies work, for whom, and why. Learnings from this trial can be used to equitably scale cascade screening programs for FH nationally and inform cascade screening implementation efforts for other genetic disorders.

Trial registration

ClinicalTrials.gov, NCT05750667. Registered 15 February 2023—retrospectively registered, https://clinicaltrials.gov/study/NCT05750667.
The socioeconomic epidemiology of inherited retinal diseases in Portugal
Authors: Marta Ana , Marques João Pedro , Santos Cristina , Coutinho-Santos Luísa , Vaz-Pereira Sara , Costa José , Arede Pedro , Félix Raquel , Geada Sara , Gouveia Nuno , Silva Rui , Baptista Margarida , Lume Miguel , Parreira Ricardo , Azevedo Soares Célia , Menéres Maria João , Lemos Carolina , Melo Beirão João
Published: April 2024

Background

Inherited retinal diseases (IRDs) are a group of rare degenerative disorders of the retina that can lead to blindness from birth to late middle age. Knowing the target population and its resources is essential to better plan support measures. The aim of this study was to evaluate the socioeconomic characteristics of regions in Portugal where IRD patients reside to inform the planning of vision aid and rehabilitation intervention measures.

Results

This study included 1082 patients from 973 families, aged 3 to 92 years, with a mean age of 44.8 ± 18.1 years. Patients living with an IRD were identified in 190 of the 308 municipalities. According to this study, the estimated IRD prevalence in Portugal was 10.4 per 100,000 inhabitants, and by municipalities, it ranged from 0 to 131.2 per 100,000 inhabitants. Overall, regions with a higher prevalence of IRD have a lower population density (r=-0.371, p < 0.001), a higher illiteracy rate (r = 0.404, p < 0.001) and an overall older population (r = 0.475, p < 0.001). Additionally, there is a lower proportion of doctor per capita (r = 0.350, p < 0.001), higher social security pensions beneficiaries (r = 0.439, p < 0.001), worse water quality for human consumption (r=-0.194, p = 0.008), fewer audiences at the cinema (r=-0.315, p < 0.001) and lower proportion of foreign guests in tourist accommodations (r=-0.287, p < 0.001).

Conclusion

The number of identified patients with IRD varied between regions. Using data from national statistics (PORDATA), we observed differences in socioeconomic characteristics between regions. Multiple targeted aid strategies can be developed to ensure that all IRD patients are granted full clinical and socioeconomic support.