bluuebunny/crossref_metadata_2025 huggingface dataset:
Is ‘Learning’ the Tipping Point for Innovation in Small Firms
Authors: Paul Bino , Patnaik Unmesh , Narayanan Krishnan
Published: November 2024

Small firms choose to innovate even in a challenging environment. Unlike stylised facts, innovation by small and medium firms in South Asia is not just technology-based but is rather human resource oriented. Using microdata from the World Bank Enterprise Surveys, we find that learning, research and development, and formal training impact innovation the most. We use a mix of frequentist statistics and machine learning algorithms. Learning is the core factor valid for all streams of innovation. Combining the learning with the other two causes a discernible increase in the chance to innovate. Any improvement in learning in the firm will make strides in innovation. However, to sustain this, there is a need for policies that combine innovation with research and development and with training. An innovation ecosystem that fosters these combinations through collaborations will be impactful. Learning is the tipping point of innovation to have new products and processes, an adaptive organisation and a new marketing strategy.
Overseas Experience and Elite Scientists’ Career Mobility: A Case Study from China
Authors: Huang Haigang , Wang Xiaoxiao , Yuan Dayong
Published: November 2024

Overseas experience constitutes an important feature for Chinese elite scientists, the returnees not only enhance the reputation of China's higher education system, but also profoundly change China's academic ecology. In this paper, we analyze whether and how overseas experience affects elite scientists’-career mobility in China. The research concludes that, compared with the local, those with overseas experience are more likely to choose job hopping. Moreover, elite scientists with overseas experience tend to move to provinces with better academic support conditions, and the research suggests that overseas experience is important for career mobility owing to the fact that it promotes scholars’-willingness to move by loosening the connection between scholars and local academic networks and by reducing flow costs.
What Is Islamophobia? Teaching Strategies for Critical Literacy
Authors: Kysia Alison
Published: November 2024

This article explores my teaching experiences that informed my distinction between religious literacy and critical religious literacy, ultimately leading to the creation of the Challenge Islamophobia Project. I highlight the impacts of post-9/11 criminalization and dehumanization of Muslims, which have significantly shaped public perceptions of Islam and its followers. Central to the discussion are specific activities from the lesson plan titled “What is Islamophobia,” where students engage with various evidence, data, and artifacts to formulate their own definitions of Islamophobia. These lesson plans are tailored for secondary and college students, although adaptations for elementary education remain unaddressed at this time. Through this exploration, I aim to provide insights into fostering a deeper understanding of Islamophobia in educational settings.
A NSGA-II-based approach for optimizing structural component pre-reinforcement to enhance cable-stayed bridge resilience
Authors: Yang Guojun , Zhang Tieyao , Mao Jianbo , Tian Li , Du Yongfeng
Published: November 2024

As critical transportation nodes, the resilience of cable-stayed bridges has always been a focal point of interest. This paper proposes an optimization decision framework for the pre-seismic reinforcement of cable-stayed bridges based on the NSGA-II algorithm, considering temporal, economic, and performance resilience. In this method, time, seismic resilience, and cost efficiency are used as resilience evaluation indicators for the pre-seismic reinforcement stage of cable-stayed bridges. Based on the NSGA-II algorithm, optimized results for the pre-seismic reinforcement sequence are provided. An actual cable-stayed bridge is used as an example to illustrate the effectiveness of this method. The results show that, when performance resilience is used as the primary objective function, the optimization achieved through this decision framework can reduce time by 2.0%, improve economic resilience by 17.9%, and enhance seismic resilience by 1.8%. If economic resilience is used as the primary objective function, time can be reduced by 2.5%, while economic resilience is increased by 43.1%, with a slight improvement in performance resilience (0.7%).
Evolving dementia care: An explorative study on the lived experience of older adults living with dementia in nursing homes using observational and biometric sensor data
Authors: Hammink JHW (Coosje) , van Buuren LPG (Leonie) , Moor JA (Nienke) , Derks DAJA (Daantje) , Mohammadi M (Masi)
Published: November 2024

Introduction

This study explores the lived experiences of older adults with dementia in Dutch nursing homes, focusing on daily activities and emotional responses. With a growing number of older adults with dementia, gaining a deeper understanding of their lived experience is imperative.

Methods

Using a mixed-method narrative approach involving observations, informal interviews, and physiological monitoring through wearable sensors, the study engaged eight participants in psychogeriatric wards across two Dutch nursing homes. Observations and interviews aimed to provide context to daily activities, while wearable sensors tracked emotional responses through heart rate (HR) and heart rate variability (HRV).

Results

Key activities included eating, drinking, communication, mobility, and inactivity. Positive experiences were consistently observed during eating and drinking and communication, respectively influenced by the nursing home’s social and organizational structures and social and personal contexts. In contrast, mobility and inactivity exhibited diverse physiological responses, reflecting a range of stress, concentration, or relaxation.

Conclusion & Discussion

This study offers valuable insights into the lived experiences of older adults with dementia in nursing homes. It highlights the generally positive nature of eating and drinking, shaped by social and organizational factors. Communication’s impact varies with individual context. The study also reveals a complex interplay of emotions during activities related to mobility and inactivity, as evidenced by diverse physiological responses. Regarding implications for dementia care, the study emphasizes the need to redefine ‘inactivity’ as ‘under-stimulation,’ assess appropriate (in)activity levels, and acknowledge the significance of the nursing home’s physical and organizational context. This redefinition should distinguish between ‘physical’ and ‘mental’ inactivity, address concerns related to under-stimulation, and cater to individual preferences. Recognizing the residents’ restricted environment and reliance on care professionals and volunteers underscores the urgency of tailored approaches. Addressing these implications can provide fresh perspectives for evolving dementia care, creating a more supportive environment that promotes well-being.
Seismic fragility analysis of an anchored vertical gas steel storage tank using tri-axial shaking table testing
Authors: Lee Sang-Moon , Yun Da-Woon , Park Dong-Uk , Jung Woo-Young
Published: November 2024

Hydrogen and gas storage tanks installed in facilities are typically vertical cylindrical structures made of steel. To allow for the discharge of stored materials, these tanks are anchored onto concrete blocks with sufficient height. However, this design results in a higher center of gravity, making the tanks more vulnerable to external forces such as earthquakes. This study fabricated a storage tank model and foundation concrete based on the results of the field investigation of the hydrogen storage tank. Then, an artificial earthquake was generated by referring to ICC-ES AC 156, a shaking table test method for non-structural elements. Experimenting on a full-scale structure is ideal; however, a storage tank model was fabricated and settled on the foundation concrete for tri-axial shaking table testing due to limited testing facilities and equipment performance. In the shaking table test, the presence or absence of water inside the storage tank was set as the condition for storing gases and liquids. The seismic behavior characteristics and failure mode of the storage tank model fixed in the foundation concrete were analyzed using the testing results. A seismic fragility curve was drawn up, and the high confidence and low probability of failure (HCLPF) was calculated.
UK paediatric clinical trial protocols: A review of guidance for participant management and care in the event of premature termination
Authors: Pluess-Hall Helen , Smith Paula , Menzies Julie
Published: November 2024

Background/Aims:

Clinical trials provide an opportunity to identify new treatments and can offer patients access to treatments otherwise unavailable. However, approximately 10% of paediatric clinical trials discontinue before the trial has completed. If this premature termination is because the trial treatment(s) being investigated are identified to be ineffective or unsafe, it results in the abrupt discontinuation of the investigational medicinal product for participants. For some participants, there may not be other treatment options to pursue at the trial-end. Trials prematurely terminating can be a distressing experience for all involved and currently there is little published evidence about the guidance provided to healthcare professionals in the event of premature trial termination. The study protocol is the source of guidance for healthcare professionals delivering clinical research, detailing how to conduct all aspects of the trial. The aim was to quantify the proportion of clinical trial protocols that included premature trial termination and subsequently those that provided instructions related to participant management and care. In addition, to analyse the context in which premature termination was included and the detail of any instructions for participant management and care.

Methods:

The ClinicalTrials.gov database was searched by a single reviewer for UK interventional drug trials enrolling children with an available study protocol. Protocols were searched to assess if the risk of premature trial termination was identified, the context for premature termination being included, if information was provided to support the management and care of participants should this situation occur and the detail of those instructions. Data were summarised descriptively.

Results:

Of 245 clinical trial protocols, 235 (95.9%) identified the possibility of premature trial termination, the majority within the context of the sponsor asserting their right to terminate the trial (82.7%, 115/235) and providing reasons why the trial could be stopped (65.5%, 91/235). Forty-two percent (98/235) provided guidance for participant management and care, most commonly to contact/inform the participant (45.9%, 45/98). Directions varied in the quantity and level of detail.

Conclusions:

This review of UK clinical trial protocol highlights that information surrounding premature termination is lacking, with only 42% providing guidance on the care of trial participants. While this ensures regulatory compliance, it fails to consider the challenge for healthcare professionals in managing participants on-going care or the duty of care owed to participants. Further research is required to understand if additional documents are being used in practice, and if these meet the needs of healthcare professionals in supporting research participants and families during premature trial termination.
Impact load characterization for security barrier performance assessment through simulations using generic vehicle models
Authors: Markovic Damijan , Scattina Alessandro , Larcher Martin
Published: November 2024

The threat stemming from the use of vehicles as a weapon in urban environments may be mitigated by employing properly designed protective structures such as bollards, street furniture or landscaping options. In order to assess the performance of a barrier resistance to a vehicle impact, the initial step involves characterizing the load on the barrier. To this aim, two recently developed generic vehicle models are utilized to conduct numerical simulations of vehicle impacts on a security barrier. Various impact configurations are examined and compared based on force-time functions. In addition to comparing the impact loadings in terms of peak forces, comparisons are also done in terms of equivalent static loads, determined by computing the dynamic load factors (DLF). The study provides new insights into the characterization of vehicle impact loads on security barriers, which could improve current engineering practices in the field.
Toward a Comprehensive Model of Medical-Dental-Behavioral Integration
Authors: McNeil D.W. , Pereira D.B. , Ensz O.S. , Lukose K. , Harrell G. , Feller D.B.
Published: November 2024

Introduction:

Existing models of medical-dental integration, as well as those from behavioral health care integrated with primary medical treatment, provide a basis for a truly synthesized and expanded model incorporating medical, dental, and behavioral components. Such a comprehensive model allows for collaborative health care serving patients seamlessly without disciplinary silos, promoting optimal whole-person health. This innovative approach is consistent with recent developments in the behavioral and social oral health sciences that include an imperative for their full inclusion in dental health care, research, and education.

Methods:

Existing models of medical-dental integration are described, along with current models from integrated primary medical and behavioral health care. Using these existing approaches as a basis, a new multilevel model is proposed to include social and cultural determinants of health.

Results:

Contemporary approaches to providing health care across disciplines include referral to a geographically separate entity, co-location of services, and integrated, side-by-side care. Integration of electronic health records and interoperability are necessary (but not sufficient) factors that affect transdisciplinary health care. Effective communication among health care providers and the need for interprofessional education, comprehensive training, and ongoing cross-disciplinary consultation also are noted as crucial factors in truly collaborative care. Evidence for existing models varies greatly depending on the target population and type of services provided.

Conclusions:

A fully integrated, transdisciplinary model of health care is possible, theoretically and practically. Combining aspects of extant integrated models and extending them provides opportunity for a greater focus on systemic factors and more emphasis on prevention. Consistent with this new model, medical and dental home concepts can be expanded to that of a person-centered health care home that includes interprofessional practice. This transdisciplinary approach contributes to greater health equity given the multilevel approach. Multidirectional integration of diverse disciplines representing the various realms of medicine, dentistry, and behavioral health care is essential for optimal health of all.

Knowledge Transfer Statement:

This article can be used by clinicians, scientists, administrators, and policy makers in developing and implementing integrated systems of care that provide for patients’ medical, dental, and behavioral health needs.
Renal biopsy in the era of immune-based combination therapies for metastatic renal cell carcinoma: Current practices and considerations
Authors: Pirovano Marta , Re Sartò Giulia Vanessa , Ganini Carlo , Cosmai Laura , Porta Camillo
Published: November 2024

The rise of immune-based combination therapies has revolutionized the treatment landscape for metastatic renal cell carcinoma (mRCC), offering significant improvements in response rates and survival. However, along with these advancements come challenges in managing treatment-related adverse events, particularly renal toxicities. Kidney biopsies represent the gold standard in diagnosing and managing these complications, providing insights into histopathological patterns and guiding therapeutic strategies. It is important to emphasize that in most of the cases expertise in onco-nephrology can enable accurate diagnosis and management of nephrotoxicities, and that in clinical practice, renal biopsy is often not easily feasible. Research efforts are underway to identify biomarkers and imaging techniques that can accurately detect renal damage characteristics without the need for invasive procedures. Promising candidates have been identified; however, validation studies are essential to enhance their effectiveness and integrate them into standard clinical practice. This paper underscores the importance of individualized approaches in managing renal adverse events and calls for further research to improve diagnostic capabilities for acute kidney injury in the context of immune-based combination therapies.
Group-Based Integrative Pain Management in Primary Care: A Study Protocol for Multilevel Interventions to Address Health Disparities
Authors: Chao Maria T. , Thompson-Lastad Ariana , Swedlow Pamela , Prathikanti Sudha , Hartogensis Wendy , Wolfe-Modupe Folashade , Wennik Jesse
Published: November 2024

Background

Socioeconomically disadvantaged populations have a high prevalence of chronic pain, exacerbated by social isolation, intersectional stigma, and disparities in pain assessment and treatment. Effective interventions using a multilevel, biopsychosocial approach are needed to decrease the unequal burden of pain. Group-based integrative pain management in primary care safety net clinics is a promising model to improve pain care for racially and ethnically diverse low-income people.

Objective

To describe a study protocol to test the impacts of 2 group-based models – group acupuncture and integrative group medical visits – on multilevel pain-related outcomes.

Methods

The study uses a 2x2 factorial randomized clinical trial to test two 12 week group-based models: group acupuncture and integrative group medical visits (IGMV, with psychoeducation, mind-body approaches, and social support). English or Spanish-speaking adults with chronic pain for ≥3 months receiving care in San Francisco Department of Public Health primary care clinics are eligible for the trial. All participants will receive usual care and be randomized to group acupuncture, IGMV, both, or waitlist control. The primary outcomes are changes from baseline to 3 month follow-up in pain impact and in social support for chronic pain. Secondary outcomes include pain interference, pain intensity, depression, anxiety, quality of life, and social isolation. Data will include patient-reported outcomes, electronic health record data, and qualitative interviews, focus groups and observations to assess multilevel individual, interpersonal and organizational outcomes.

Discussion

Multilevel approaches are needed to advance health equity in pain management. Our study contributes to knowledge of group-based integrative pain management in primary care safety net clinics to address multilevel barriers and disparities in pain care.
Changes in gut microbiota predict neutropenia after induction treatment in childhood acute lymphoblastic leukemia
Authors: Sørum Maria Ebbesen , Boulund Ulrika , De Pietri Silvia , Weischendorff Sarah , Enevold Christian , Rathe Mathias , Als-Nielsen Bodil , Hasle Henrik , Pamp Sünje Johanna , Stokholm Jakob , Müller Klaus
Published: November 2024

Delayed neutrophil recovery during acute lymphoblastic leukemia (ALL) treatment increases risk of infection and causes delay in chemotherapy. Emerging evidence implicates the gut microbiota in neutrophil reconstitution after chemotherapy. We explored the interplay between the gut microbiota and neutrophil dynamics, including neutrophil chemoattractants, in 51 children with newly-diagnosed ALL. Daily absolute neutrophil count (ANC), weekly plasma chemokines (CXCL1 and CXCL8), granulocyte colony-stimulating factor (G-CSF), and fecal samplings were monitored until day 29 during ALL induction treatment. Fecal sequencing by 16S rRNA revealed an overall significant reduction in bacterial diversity and Enterococcus overgrowth throughout the induction treatment. Prolonged neutropenia (ANC<0.5x109 cells/L at day 36) and elevated chemokines levels were associated with decreased abundance of genera from the Ruminococcaceae and Lachnospiraceae families, decreased Veillonella genus, and Enterococcus overgrowth from diagnosis and throughout induction treatment. G-CSF was upregulated in response to neutropenia but unrelated to microbiota changes. Overall, this study reveals that diminished abundance of specific intestinal commensals and Enterococcus overgrowth are associated with delayed neutrophil reconstitution and increased chemokine signaling, indicating that disruption of the microbiota may contribute to prolonged neutropenia. These findings lay the groundwork for future investigations into the mechanisms behind these associations and their clinical implications for developing gut-sparring strategies to minimize the impact of gut dysbiosis on immune recovery.
Different amyloid β42 preparations induce different cell death pathways in the model of SH-SY5Y neuroblastoma cells
Authors: Özdemir Alp Yigit , Hofbauerová Kateřina , Kopecký Vladimír , Novotný Jiří , Rudajev Vladimír
Published: November 2024

Amyloid β42 (Aβ42) plays a decisive role in the pathology of Alzheimer’s disease. The Aβ42 peptide can aggregate into various supramolecular structures, with oligomers being the most toxic form. However, different Aβ species that cause different effects have been described. Many cell death pathways can be activated in connection with Aβ action, including apoptosis, necroptosis, pyroptosis, oxidative stress, ferroptosis, alterations in mitophagy, autophagy, and endo/lysosomal functions. In this study, we used a model of differentiated SH-SY5Y cells and applied two different Aβ42 preparations for 2 and 4 days. Although we found no difference in the shape and size of Aβ species prepared by two different methods (NaOH or NH4OH for Aβ solubilization), we observed strong differences in their effects. Treatment of cells with NaOH-Aβ42 mainly resulted in damage of mitochondrial function and increased production of reactive oxygen species, whereas application of NH4OH-Aβ42 induced necroptosis and first steps of apoptosis, but also caused an increase in protective Hsp27. Moreover, the two Aβ42 preparations differed in the mechanism of interaction with the cells, with the effect of NaOH-Aβ42 being dependent on monosialotetrahexosylganglioside (GM1) content, whereas the effect of NH4OH-Aβ42 was independent of GM1. This suggests that, although both preparations were similar in size, minor differences in secondary/tertiary structure are likely to strongly influence the resulting processes. Our work reveals, at least in part, one of the possible causes of the inconsistency in the data observed in different studies on Aβ-toxicity pathways.

Graphical Abstract
Genome wide identification of BjSWEET gene family and drought response analysis of BjSWEET12 and BjSWEET17 genes in Brassica juncea
Authors: Heng Shuangping , He Jingjuan , Zhu Xinyu , Cai Jiayu , Fu Mengke , Zhang Shaoheng , Zeng Wei , Xing Feng , Mao Guangzhi
Published: November 2024

Background

Sugars Will Eventually be Exported Transporter (SWEET) gene family is a unique type of sugar transporter that plays a vital role in metabolic regulation, growth, development, and stress response in multiple species. This study aimed to systematically identify the SWEET gene family members and detect the regulation of gene expression and their potential roles of the SWEET gene family in Brassica juncea.

Results

A total of 66 BjSWEET (Brassica juncea Sugar Will Eventually be Exported Transporter) genes distributed across 17 chromosomes were identified. The gene structure and motifs were relatively conserved, with all members containing the MtN3/saliva domain. Phylogenetic analysis revealed that the SWEET gene family can be classified into four subfamilies (Clades I, II, III, and IV). Collinearity analysis revealed that there were 118 pairs of segment duplicates, indicating that some BjSWEET genes were obtained via segmental duplication. The promoter regions of the BjSWEET genes contained many plant hormone-related response elements, stress-related response elements, growth and development elements, and light-responsive regulatory elements. Furthermore, analysis of the expression profiles revealed that the expression levels of the BjSWEET genes differed among the eight different tissues. qRT‒PCR analysis of six selected BjSWEET genes revealed that the expression levels of BjSWEET17.2, BjSWEET17.4, BjSWEET12.2, and BjSWEET12.3 were significantly upregulated under drought treatment, suggesting that these genes may respond to drought stress in B. juncea.

Conclusion

This study systematically identified and analyzed the SWEET gene family members in B. juncea for the first time, laying the foundation for further research on the molecular mechanisms of drought resistance in B. juncea and providing theoretical guidance for the application of these genes in other species.
Fundamental care in the emergency room: insights from patients with life-threatening conditions in the emergency room
Authors: Pavedahl Veronica , Muntlin Åsa , Von Thiele Schwarz Ulrica , Summer Meranius Martina , Holmström Inger K.
Published: November 2024

Background

Persons who become life-threateningly ill or injured (due to for example trauma or cardiac arrest) are cared for in hospitals’ designated emergency rooms at the emergency department (ED). In these rooms, the life-threatening condition and biomedical focus may reinforce a culture that value the medical-technical care. Meeting patients fundamental care needs (integrating physical, psychosocial and relational care needs) in a person-centred way might hence be challenging in emergency rooms. Little is known about how person-centred fundamental care is experienced and valued by vulnerable and exposed patients in emergency rooms. This study aims to describe fundamental care needs experienced by patients with a life-threating condition in the emergency room.

Methods

A descriptive deductive qualitative study with individual interviews were carried out with 15 patients who had been life-threateningly ill or injured and admitted in an emergency room, in Sweden. Data collection was conducted during 2022. Transcribed interviews were analyzed with deductive content analysis, based on the Fundamentals of Care framework.

Results

Despite being life-threateningly ill or injured, patients were still able to describe their unique needs—which were not only related to biomedical care. A relationship was established between healthcare professionals and the patient in the initial stage, but not maintained during their stay at the emergency room. Patients felt their physical needs were met to a greater extent than psychosocial and relational needs, despite their prioritizing the latter. Patients preferred personalized care but described care as task oriented. The physical environment limited patients from having their fundamental care needs met, and they adopted to a “patient role” to avoid adding to staff stress. The emergency room situation evoked existential thoughts.

Conclusions

This paper provides unique insights into patients’ experiences of being cared for in an emergency room. From the patient perspective, physical care was not enough. Relationship, timely and personalized information, and existential needs were identified as essential fundamental care needs, which were not, or only partly met. The finding highlights the need to embed and prioritize fundamental care in practice also for patients who are life-threateningly ill or injured, which in turn calls for focus on organizational prerequisites to enable person-centred fundamental care.
Widespread asymmetries of amygdala nuclei predict auditory verbal hallucinations in schizophrenia
Authors: Dumitru Magda L. , Johnsen Erik , Kroken Rune A. , Løberg Else-Marie , Lilleskare Lin , Ersland Lars , Hugdahl Kenneth
Published: November 2024

Background

Auditory verbal hallucinations, which frequently involve negative emotions, are reliable symptoms of schizophrenia. Brain asymmetries have also been linked to the condition, but the relevance of asymmetries within the amygdala, which coordinates all emotional signals, to the content of and response to auditory verbal hallucinations has not been explored.

Methods

We evaluated the performance of two asymmetry biomarkers that were recently introduced in literature: the distance index, which captures global asymmetries, and a revised version of the laterality index, which captures left–right local asymmetries. We deployed random forest regression models over values computed with the distance index and with the laterality index over amygdala nuclei volumes (lateral, basal, accessory-basal, anterior amygdaloid area, central, medial, cortical, cortico-amygdaloid area, and paralaminar) for 71 patients and 71 age-matched controls.

Results

Both biomarkers made successful predictions for the 35 items of the revised version of the Belief About Voices Questionnaire, such that hallucination severity increased with increasing local asymmetries and with decreasing global asymmetries of the amygdala.

Conclusions

Our findings highlight a global reorganization of the amygdala, where left and right nuclei volumes differ pairwise but become proportionally more similar as hallucinations increase in severity. Identifying asymmetries in particular brain structures relevant to specific symptoms could help monitor the evolution and outcome of psychopathological conditions.
Transcriptional and post-transcriptional regulation of CARMN and its anti-tumor function in cervical cancer through autophagic flux blockade and MAPK cascade inhibition
Authors: Zhang Xing , Yan Wenjing , Jin Hua , Yu Bingjia , Zhang Hao , Ding Bo , Chen Xue , Zhang Yan , Xia Qianqian , Meng Dan , Hu Jing , Liu Haohan , Nie Yamei , Liu Fengying , Zheng Yun , Lu Yiran , Wang Juan , Du Mulong , Wang Meilin , Yu Evan Yi-Wen , Li Xiuting , Wang Shizhi
Published: November 2024

Background

LncRNAs play essential roles in multiple tumors. However, research on genome-wide lncRNA alterations and their functions in cervical cancer (CC) is limited. This study aims to explore key lncRNAs in CC progression and uncover the molecular mechanisms involved in the development of CC.

Methods

In this study, we analyzed 30 tissues from CC, cervical intraepithelial neoplasia (CIN), and normal (NOR) using transcriptome sequencing and weighted gene co-expression network analysis to establish gene modules related to the NOR-CIN-CC transition. Machine learning diagnostic models were employed to investigate the role of lncRNAs in this transition. Molecular biological experiments were conducted to elucidate the potential mechanisms of CARMN in CC, with a particular focus on its transcriptional and post-transcriptional regulation of abnormal expression in CC.

Results

CARMN was identified as a hub gene in two modules significantly associated with the NOR-CIN-CC transition. Analysis using ten machine learning models confirmed its critical role in this progression. The results of RNA-seq, qPCR and RNAScope performed in another cohort of 83 cervical tissues all showed that CARMN was significantly downregulated in CC. CARMN significantly enhanced the interaction between Keap1 and Nrf2, leading to increased ROS levels. The elevated ROS levels suppressed the Akt/mTOR signaling pathway, leading to autophagy arrest via autophagic flux blockade. Additionally, CARMN interacted with TFAP2α to repress MAPK13 transcription, further inhibiting the MAPK cascade. A promoter SNP (rs12517403) was found to increase CC risk (OR = 1.34, 95% CI = 1.11–1.61) and reduce CARMN expression by decreasing SP1 binding. Furthermore, the RNA binding proteins that could modulate CARMN RNA stability were also determined using RNA-pulldown assay. The results demonstrated that YBX1, a component of the coding region instability determinant (CRD)-mediated mRNA stabilization complex, promoted CARMN RNA stability. DHX9, another component of complex, acted as a scaffold to bridge YBX1 and CARMN.

Conclusions

CARMN exerts an anti-cancer effect in CC progression by inhibiting the Akt-mTOR and MAPK signaling pathways. rs12517403 and the YBX1/DHX9 complex are key mechanisms influencing its transcription and stability in CC cells. CARMN represents a promising biomarker for CC diagnosis and therapeutic target.
New chemometrics-assisted spectrophotometric methods for simultaneous determination of co-formulated drugs montelukast, rupatadine, and desloratadine in their different dosage combinations
Authors: Sharkawi Marco M. Z. , Farid Nehal F. , Hassan Moataz H. , Hassan Said A.
Published: November 2024

Two accurate, precise and robust multivariate chemometric methods were developed for the simultaneous determination of montelukast sodium (MON), rupatadine fumarate (RUP) and desloratadine (DES). These methods provide a cost-effective alternative to chromatographic techniques by utilizing spectrophotometry in pharmaceutical quality control. The proposed approaches, partial least squares-1 (PLS-1) and artificial neural network (ANN), were optimized using genetic algorithm (GA) to select the most influential wavelengths, enhancing model performance. A five-level, three-factor design was employed to construct a calibration set with 25 mixtures, utilizing concentration ranges of 3–19, 5–25, and 4–20 µg.mL−1 for MON, RUP, and DES, respectively. An independent validation set was employed to assess the performance of the models. GA significantly improved the PLS-1 and ANN models for RUP and DES, though minimal enhancement was observed for MON. These methods were successfully applied to the simultaneous quantification of the compounds in pharmaceutical formulations and proved useful as stability-indicating assays for RUP, given that DES is a known degradation product. The developed methods offer a valuable tool for impurity profiling and quality control in pharmaceutical analysis.
Assessing disordered eating behaviours and attitudes: Factor structure and measurement invariance of the Arabic version of the eating attitudes test (EAT-26) in Saudi Arabia
Authors: Alyami Mohsen M. , Al-Dossary Saeed A.
Published: November 2024

Background

The factorial structure of the Eating Attitudes Test (EAT-26) has been found to be inconsistent across studies and samples. This study aimed to resolve inconsistencies in the factorial structure of the Arabic version of the EAT-26 by identifying the best-fitting model and test its measurement invariance across sexes and BMI categories in a large non-clinical Saudi sample.

Methods

1,734 Saudi adults (Mage 26.88 and SD 9.13), predominantly female, completed an online survey. Several existing models were tested (e.g., original 26-item three-factor model, second order 26-item three-factor model, 20-item four-factor model, and 16-item four-factor model) using confirmatory factor analysis (CFA). Fit indices including the CFI, SRMR, and RMSEA were used to identify the best-fitting model for Arabic version of the EAT-26. Multi-group confirmatory factor analysis (MGCFA) was used to test measurement invariance.

Results

The original three-factor model and two other common models demonstrated poor fit (e.g., CFI = 0.727; SRMR = 0.0911; RMSEA = 0.085 [90% CI 0.082–0.087] for the original three-factor model). Instead, a 16-item, four-factor structure [(Self-Perceptions of Body Weight), (Dieting), (Awareness of Food Contents), and (Food Preoccupation)] showed acceptable fit ([CFI = 0.904; SRMR = 0.0554; RMSEA = 0.073 [90% CI 0.068- 0.077]). Internal consistency was good (α and ω = 0.88), and measurement invariance was supported across sex (male and female) and BMI categories (underweight, normal weight, overweight, and obese).

Conclusions

These findings underscore the need for culturally relevant validation of the EAT-26 among Arabic-speaking populations, as the revised factorial structure diverged from previously established models. Future research should further examine this revised 16-item, four-factor structure in clinical settings.
Father involvement and emotion regulation during early childhood: a systematic review
Authors: Puglisi Nilo , Rattaz Valentine , Favez Nicolas , Tissot Hervé
Published: November 2024

Background

Father involvement, defined in terms of both the quantity and quality of ways in which fathers may be involved, affects the child’s development. How specifically father involvement links to emotion regulation during early childhood (0–5 years) is, however, less clear.

Methods

This literature review synthesizes research on the links between father involvement and emotion regulation during early childhood, as well as the measurement methods used to assess them. Ten relevant studies were identified via four databases (up to August 2023).

Results

Results showed no significant direct links, but significant links appeared between high father involvement and more adaptive emotion regulation when moderated by variables related to the assessment of father involvement and emotion regulation, as well as the characteristics of the father and the child.

Conclusions

Future research should continue to use observational measures of father behaviors and child emotion regulation, increase the use of physiological measures of emotion regulation, and consider the influence of maternal and family variables.
Resveratrol inhibits ferroptosis in the lung tissues of heat stroke-induced rats via the Nrf2 pathway
Authors: Du Liwen , Zhu Xueqi , Jiang Zhenluo , Wang Weidong , Liu Peng , Zhu Leilei , Zhang Fangqi
Published: November 2024

Background

Heat stroke (HS) can lead to the development of pulmonary ferroptosis. The inhibition of pulmonary ferroptosis during HS improves patient prognosis. The aim of this study was to investigate the effects of resveratrol (RES) on heat stress at an ambient temperature of 42 °C.

Methods

Heat stress was induced in Beas-2B cells and lung injury was induced in HS rats at an ambient temperature of 42 °C. The anti-oxidative stress and anti-ferroptotic effects of RES were confirmed through tail vein injection of nuclear factor-2 associated factor (Nrf2) shRNA recombinant adeno-associated virus 6 (AAV6-shNrf2).

Results

RES treatment attenuated the upregulation of reactive oxygen species (ROS) and malondialdehyde (MDA) levels and alleviated glutathione inhibition in HS. In addition, RES treatment reduced the accumulation of Fe2+ in heat-stressed Beas-2B cells and increased the ferroptosis resistance-related proteins FTH1, GPX4, and SLC7A11 as well as the anti-oxidative stress pathway proteins Nrf2, NQO1, and HO-1. The antioxidant and anti-ferroptotic effects of RES in heat-stressed Beas-2B cells were effectively reversed upon treatment with Nrf2-IN-1, an Nrf2 pathway inhibitor. In the HS rat model, the antioxidant and anti-ferroptotic effects of RES were reversed by an ambient temperature of 42 °C and relative humidity of 60 ± 5%.

Conclusions

RES effectively protected HS rats from lung injury, inhibited the accumulation of Fe2+, ROS, and MDA in the lung, and upregulated FTH1, GPX4, SLC7A11, Nrf2, NQO1, and HO-1.

Graphical Abstract
Barriers and facilitators to healthcare facility utilization by non-Ebola patients during the 2018–2020 Ebola outbreak in the Democratic Republic of Congo
Authors: Kyomba Gabriel Kalombe , Law Michael Robert , Grépin Karen Ann , Mayaka Serge Manitu , Mambu Thérèse Nyangi-Mondo , Mbunga Branly Kilola , Hategeka Celestin , Mapatano Mala Ali , Konde Joël Nkiama-Numbi , Ngo-Bebe Dosithée , Babakazo Pélagie Diambalula , Mafuta Eric Musalu , Kiyombo Guillaume Mbela
Published: November 2024

Background

An Ebola Virus Disease (EVD) outbreak occurred in North Kivu between 2018 and 2020. This eastern province of the Democratic Republic of Congo was also grappling with insecurity caused by several armed groups. This study aimed to explore the barriers and facilitators to utilizing Healthcare Facilities (HCFs) by non-Ebola patients during the crisis.

Methods

A qualitative case study was conducted in Beni and Butembo with 24 relatives of 15 deceased non-EVD patients, 47 key informants from healthcare workers (HCWs), as well as community leaders. Semi-structured interviews were conducted to explore three key areas: (i) the participants’ illness history, care pathway, care, and social support; (ii) their perceptions of how EVD affected the care outcome; and (iii) their opinions on the preparedness, supply, use, and quality of healthcare before and during the outbreak. All interviews were recorded, transcribed verbatim, and thematically analysed using Atlas-ti 8.0.

Results

Nine of the 15 deaths were female and their ages ranged from 7 to 79 years. The causes of death were non-communicable (13) or infectious (2) diseases. Conspiracy theories, failure to establish security, and the concept of the ''Ebola business'' were associated with misinformation and lower levels of trust in government and HCFs. The negative perceptions, fear of being identified as an Ebola case, apprehension about the triage unit, and inadequacy of personal protective equipment resulted in a preference for private or informal HCFs. For half of the deceased’s relatives, the Ebola outbreak hastened their death. Conversely, community involvement, employing familiar, neutral, and credible HCWs, and implementing a free care policy increased the number of visits. These results were observable despite a lack of funds, overstretched HCWs, and long waiting time.

Conclusions

Our findings can inform policies before and during future outbreaks to enhance the resilience of routine HCFs by maintaining dialogue between HCWs and patients, and rebuilding confidence in HCFs. Quantitative studies including context analysis are essential to identify the determinants of care-seeking during such a crisis.
Impact of access to coronary angiography and percutaneous coronary intervention on in-hospital and five-year mortality in patients with acute coronary syndrome: a propensity-matched cohort study in Thailand
Authors: Kumwichar Ponlagrit , Thungthong Jutatip , Liabsuetrakul Tippawan , Tachimori Hisateru , Hosozawa Mariko , Saito Eiko , Taniguchi Yuta , Chongsuvivatwong Virasakdi , Iso Hiroyasu
Published: November 2024

Background

Coronary artery angiography (CAG) and percutaneous coronary intervention (PCI) are superior to non-invasive approaches in reducing mortality in patients with ST-segment elevation myocardial infarction (STEMI). However, their efficacy remains uncertain in non-ST-elevation acute coronary syndromes (NSTE-ACS) and limited in low-resource settings. This study aimed to compare in-hospital and 5-year mortality rates between patients with a first event of STEMI and NSTE-ACS who underwent CAG and PCI and those with similar severity who did not undergo CAG and PCI.

Methods

A propensity-matched retrospective cohort study was conducted using population-based claims data of national universal coverage of Thailand for identification of patients with acute coronary syndromes. The mortality of recruited patients was additionally linked to the national database of vital registration. Patients aged ≥ 40 years who were hospitalized for STEMI and NSTE-ACS in 2017, with a focus on access to CAG and PCI were included. For each condition either STEMI or NSTE-ACS, patients who underwent CAG and PCI were matched to those who did not undergo using propensity score matching (PSM) to balance measured confounders, such as age, sex, and underlying conditions. In-hospital mortality rate ratio and 5-year mortality were analyzed as measures.

Results

Through PSM, 2,702 non-intervention STEMI patients were paired with an equal number of intervention patients, and similarly, 5,072 non-intervention NSTE-ACS patients were matched with an equivalent group who received interventions. For patients with STEMI, the in-hospital mortality rate ratio (95% confidence interval (CI)) for those who underwent CAG and PCI compared to those who did not was 30.1% (30.0%, 30.2%). Similar trends were observed in patients with NSTE-ACS with a mortality rate of 34.7% (34.6%, 34.8%). For the five-year mortality comparison, the hazard ratios (95% CI) of mortality after discharge were 0.55 (0.50, 0.62) for STEMI and 0.57 (0.54, 0.61) for NSTE-ACS cases.

Conclusions

Access to CAG and PCI was significantly associated with lower in-hospital and 5-year mortality rates in patients who experienced their first event of ACS, despite the limited availability of some unmeasured or residual confounders. Healthcare systems should expand their resources for CAG and PCI in Thailand and other countries to equitably enhance longevity.
Knowledge and perception of physiotherapy among healthcare science students at the Maldives National University
Authors: Qayyoom Isna Abdul , Suhail Ammar
Published: November 2024

Introduction

Physiotherapy is a crucial profession of interdisciplinary medical team, in which healthcare professionals need to comprehend the duties of other members in the team to offer a holistic management to the patients. Healthcare professionals who uphold negative beliefs and perceptions about other healthcare professions can be a barrier to ‘patient- centered’ approach. Nevertheless, there is a paucity of research on knowledge and awareness of physiotherapy by healthcare professionals or students. There has been no study conducted in the Maldives to investigate the knowledge and perception of physiotherapy by healthcare students. Therefore, the aim of the study was to explore the knowledge and perceptions among healthcare science students at The Maldives National University (MNU). 

Methods

A cross-sectional study was conducted at the Faculty of Health Sciences (FHS), School of Nursing (SN), and School of Medicine (SM). A stratified random sampling method was adopted to recruit the participants. A self-administered questionnaire was used to obtain the data from the participants. The data was analyzed using the SPSS version 25.

Results

A total of 318 students from three different schools and faculties of MNU participated in the study. The mean age of the respondents was 23 ± 4, with 89.9% being female. The overall K-score of 12 indicated poor knowledge, whereas the P-score of 10 reflected a positive perception among the participants, with no significant difference observed between genders. The Kruska-Wallis test indicated a significant difference in K-score across courses and years of study enrolled.

Conclusion

This study’s findings revealed a disparity between healthcare students’ positive perception towards physiotherapy and their lack of knowledge regarding the profession, indicating barriers to knowledge acquisition. Significant differences were found between different healthcare courses and years of study.