bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of contextual effects in exercise therapy for low back pain: a systematic review and meta-analysis.
Authors: de Roode Aaltje , Heymans Martijn W , Lankveld Wim van , Staal J. Bart
Published: April 2024

Background: Low back pain is the leading cause of global disability for which exercise therapy is a widely recommended treatment. Research indicates that nonspecific contextual factors may also influence treatment outcomes in low back pain. Examples include the patient-therapist relationship and other treatment-related circumstances that affect patient expectations. By focusing on the specific treatment effect, clinical trials often ignore the effect of contextual factors, thereby contributing to the so-called efficacy paradox. This means that treatment effects observed in clinical practice are often greater than those reported in clinical trials.
This systematic review aims to investigate the proportion of improvement in pain and disability that can be attributed to contextual effects in the outcome of exercise therapy for patients with low back pain.
Methods: A meta-analysis was conducted. Pubmed, Embase and the Cochrane database were searched for eligible articles reporting randomized controlled trials that compared exercise therapy to placebo interventions. Risk of bias was assessed with the Revised Cochrane Risk of Bias Tool. Outcomes of interest were pain and disability. Meta-analysis was carried out to calculate the proportion attributable to contextual effects for both pain and disability. The body of evidence was assessed using GRADE methodology.
Results: Eight studies met the inclusion criteria and were included in the meta-analysis. Five studies were rated as having moderate risk of bias and two studies had low risk of bias. Proportion attributable to contextual effects was 0.60 (95% CI 0.40-0.89) for pain and 0.69 (95% CI 0.48-1.00) for disability. Certainty of the evidence as assessed with the GRADE methodology was low.
Conclusions: A large extent of pain and disability improvement after exercise therapy in low back pain is attributable to contextual effects.
Assessment of Compressive Strength of Brick Chip-Based Concrete Using the CAPO Test
Authors: Khair Abul
Published: April 2024

The CAPO-TEST, also known as the pull-out test, is gaining popularity as a method for estimating the compressive strength of existing concrete structures due to its reliability, less structural damage compared to core collection, and quick in-place strength. The manufacturer of the pull-out machine has provided a general correlation for assessing the in-place concrete strength of stone chip-based concrete. Many of the concrete buildings in Bangladesh are made of brick chip-based concrete. In a few projects in Bangladesh, the CAPO test has been used to assess the concrete strength of existing structures. However, the reliability of this test for concrete made of brick chips has yet to be investigated. Twenty columns from five distinct structures, which varied in age from ten to forty-five years at the time of testing, underwent the CAPO and core tests for this study. Based on the fundamental findings of this investigation, a general correlation has been established regarding concrete composed of brick chips. Since no correlation has been established using the CAPO test to assess the strength of concrete composed of brick chis, this study suggested a general correlation between pull-out force and concrete core strength.
WITHDRAWN: Double Burden of Malnutrition among households in Ethiopia: Systematic review and Meta-analysis
Authors: Belay Mahider Awoke , Bogale Eyob Ketema , Haile Mitiku Tefera , Bogale Solomon Ketema , Desalew Eyob Getachew , Andarge Getnet Alemu , Seid Kedir , Lakew Gebeyehu , Yirsaw Amalku Nigussie , Gebreegziabher Zenebe Abebe , Semagn Birhan Ewunu , Alemu Ayenew Takele
Published: April 2024

Introduction: The double burden of malnutrition coexists in communities, families, and individuals due to rapid changes in global food systems and increased urbanization. The occurrence of double-burden malnutrition at the household level has increased significantly in sub-Saharan African countries. The concurrent existence of overweight or obese mothers with undernourished (stunted, wasted, underweight) children in the same households embraces particular significance. However, the national evidence of the double burden of malnutrition among mother-child pairs has not yet been summarized by systematic review and meta-analysis. Therefore, this study aimed to assess the pooled prevalence of double burden of malnutrition at household level in Ethiopia, 2024.
Methods: This systematic review and meta-analysis study was conducted using the advanced search of electronic databases and search engines, on the prevalence of double burden of malnutrition and associated factors at households in Ethiopia, published in English. The standardized JBI is used for data extraction after being generated on a Microsoft Excel spreadsheet and evaluating the quality of each article. The analysis was done through STATA V.17.
Result: A total of 7 articles met the inclusion criteria among 56877 and 43770 mother-child pairs for systematic review and Meta-analysis respectively. The pooled prevalence of double burden of malnutrition among mother-child pairs was 8.30 (95% CI: 1.51, 15.09). The heterogeneity test for the pooled prevalence was very high (I2=99.91% and p value=0.00). Regarding the subgroup analysis of sample size, the pooled estimated prevalence of double burden of malnutrition was high from a sample size of less than 1000 mother-child pairs (11.69% (95% CI: 3.11, 2028)). The pooled estimates of the subgroup analysis of the data collected 8 years back were (8.61(1.11, 22.33)). Some factors affect the double burden of malnutrition among mother-child pairs were identified as residence, household size, housing quality, wealth index, household food security, mother’s age and educational status, and child’s age.
Conclusion: The double burden of malnutrition among mother-child pairs in Ethiopia was highly emerging. Therefore, double-duty interventions should be used to address the double burden of malnutrition, considering different factors at the household level.
Single-molecule RNA-FISH analysis reveals stochasticity in reactivation of latent HIV-1 regulated by Nuclear Orphan Receptors NR4A and cMYC
Authors: LaPorte Annalena , Pathak Rajiv , Eliscovich Carolina , Martins Laura , Nell Rachel , Spivak Adam , Suzuki Masako , Planelles Vicente , Singer Robert , Kalpana Ganjam
Published: April 2024

HIV-1 eradication strategies require complete reactivation of HIV-1 latent cells by Latency Reversing Agents (LRA). Current methods lack effectiveness due to incomplete proviral reactivation. We employed a single-molecule RNA-FISH (smRNA-FISH) and FISH-Quant analysis and found that proviral reactivation is highly variable from cell-to-cell, stochastic, and occurs in bursts and waves, with different kinetics in response to diverse LRAs. Approximately 1–5% of latent cells exhibited stochastic reactivation without LRAs. Through single-cell RNA-seq analysis, we identified NR4A3 and cMYC as extrinsic factors associated with stochastic HIV-1 reactivation. Concomitant with HIV-1 reactivation cMYC was downregulated and NR4A3 was upregulated in both latent cell lines and primary CD4+ T-cells from aviremic patients. By inhibiting cMYC using SN-38, an active metabolite of irinotecan, we induced NR4A3 and HIV-1 expression. Our results suggest that inherent stochasticity in proviral reactivation contributes to cell-to-cell variability, which could potentially be modulated by drugs targeting cMYC and NR4A3.
Study on the effect of microwave irradiation improvement on the long-term stability of expansive soil
Authors: Zhang RenLing , Hu Qijun , Gu yucheng , He Le-Ping
Published: April 2024

In dry-wet cycles, the clay minerals of expansive soil repeatedly hydrate and dehydrate, causing its expansion and contraction, resulting in many cracks, which will bring harm to human engineering construction. Microwave, as an efficient material improvement method, has been used in clay mineral synthesis and material manufacturing. Our previous studies have proved that microwave technology can improve the performance of soil, but the long-term stability of expansive soil by microwave has not been studied. In this paper, microwave technology is used to improve the performance of expansive soil, and the effect of microwave on the damage law and long-term stability of expansive soil under dry-wet cycles is studied. The soil was heated to 200°C, 300°C, 400°C and 500°C respectively by microwave irradiation, and dry-wet cycle tests were carried out. According to the data of SEM, unconfined compressive strength and free expansion rate, the damage law and long-term stability of expansive soil were analyzed. The results show that, compared with original samples, the compressive strength can be increased by 27 times and the expansion rate can be reduced to 0 by microwave heating to 500°C. In addition, microwave irradiation changes the way of fracture development. The change of fracture development pattern leads to the improvement of water resistance and strength of expansive soil, and thus the long-term stability of expansive soil is improved. The researches result of this paper can provide a reference for stability evaluation and design of expansive soil slope engineering.
Dental Students' Healthy Lifestyle Behaviors, Physical Activity Levels and Social Media Use: Cross Sectional Study
Authors: EYMIRLI Pınar SERDAR , MUSTULOĞLU Şeyma , KÖKSAL Eda , TURGUT Melek Dilek , TEKÇİÇEK Meryem UZAMIŞ
Published: April 2024

Background
Healthy lifestyle behavior includes appropriate behaviors such as eating habits, physical activity and weight control in order to stay healthy and prevent diseases. The aim of this cross-sectional study is to evaluate healthy lifestyle behaviors, physical activity levels and social media use of dental students.
Methods
An online questionnaire including demographic characteristics, International Physical Activity Questionnaire Short Version (IPAQ-S) and Health Promoting Lifestyle Profile (HPLP) was filed by 420 dental students. The data were evaluated statistically.
Results
The mean age was 21.6 ± 1.96 years and the majority of the students (71.7%) were living with their families. Obesity and overweight in males and underweight in females were statistically higher. There was no difference between the genders in terms of social media use. The most preferred applications were Instagram (92.7%), YouTube (85%) and Twitter (59.7%). In terms of IPAQ durations and HPLP scores, there was no gender difference. According to the IPAQ classification, while the majority of students (64.3%) were physically low active, 23.1% were physically inactive. As the total HPLP score increased, the total IPAQ score increased.
Conclusion
It is concluded that as the university students make up the majority of the young adults, encouraging their health-promoting behaviors is crucial for improving public health.
Comprehensive Genomic Profiling of Taiwanese Breast Cancer Using a Novel Targeted Sequencing Panel
Authors: Huang Chi-Cheng , Yeh Yi-Chen , Liu Chun-Yu , Tsai Yi-Fang , Ho Hsiang-Ling , Tseng Ling-Ming
Published: April 2024

Background
Breast cancer is one of the leading causes of cancer-related deaths in women. Limited therapeutic options currently available, especially for those with triple negative breast cancer, demands identification of more biomarkers to facilitate precision medicine. This study adopted an updated large comprehensive genomic profiling (CGP) for targeted sequencing to reveal actionable alterations associated with novel therapeutics from a sub-cohort of the VGH-TARLOR study.
Method
The study population comprised of patients with either early (defined by first-line surgery or neoadjuvant therapy) or late (defined by relapse or de novo metastatic disease) breast cancer. CGP was conducted with the Illumina TruSight Oncology 500 assay. Level of actionability was evaluated against the European Society for Medical Oncology (ESMO) Scale of Clinical Actionability of molecular Targets (ESCAT) criteria with additional annotations from the PierianDx software and the OncoKB database.
Results
A total of 108 breast cancers were successfully assayed, with the majority (n = 104) being triple. The most common alterations (> 5% of study cohort) among actionable genes were PIK3CA (39%), BRCA2 (24%), PTEN (15%), ERBB2 (13%), BRCA1 (12%), and ERBB3 (10%). With the standard cut-off of 10 mutations/mega-base, 25 samples were tumor mutation burden (TMB)-high and 83 were TMB-low. The proportion of TMB-high was much lower among the early than late breast cancer patients (19% vs. 34.5%, respectively; P = 0.0499).
Conclusion
Our study showed the clinical applicability and feasibility of large-sized CGP, with more genes and multi-gene signatures such as TMB and microsatellite instability (MSI) investigated. Detection of more actionable biomarkers could potentially expand therapeutic opportunities for patients: e.g., immune checkpoint inhibitors (for TMB-high and MSI), poly ADP- ribose polymerase (PARP) inhibitor (for BRCA1/2 and PALB2), selective estrogen receptor degrader (for ESR1), tyrosine kinase inhibitor (for ERBB2/3), phosphoinositide 3-kinase inhibitor (for PIK3CA).
Predicting Suicide Risk Using Facial Action Units : A Machine Learning Approach to Objective and Large-Scale Screening
Authors: Li Huihuang , Yang Yuqing , Zhong Huiqun , Zhao Jiubo
Published: April 2024

Background:
Suicide is a global concern, and adolescents currently have the highest suicide risk because they are more prone to extreme behaviors such as suicide and self-injury due to their emotions and coping styles. Research suggests that suicide can be predicted, and therefore, early detection of suicide risk is crucial for suicide prevention and treatment.
Methods:
This study collected data from 98 participants using the Trier Social Stress Test (TSST) paradigm. Videos were recorded during the normal and stressful phases
Results:
In the normal state, the most efficient features for identification were action unit (AU) 17, AU20, and AU23; in the stress state, the features AU2 and AU5 were added. In the combined model integrating both subjective and objective measures, the accuracy increased to 83.1%, which was the best performance in this study.
Conclusions:
This study enriches the empirical evidence that AU features can be used to identify suicide risk, provides a way to formulate and implement policies related to suicide prevention.
Spinocerebellar ataxias: phenotypic spectrum of polyQ versus non-repeat expansion forms
Authors: Moura João , Oliveira Jorge , Santos Mariana , Costa Sara , Silva Lénia , Lemos Carolina , Barros José , Sequeiros Jorge , Damásio Joana
Published: April 2024

Spinocerebellar ataxias (SCA) are most frequently due to (CAG)n (coding for polyglutamine, polyQ) expansions and, less so, to expansion of other oligonucleotide repeats (non-polyQ) or other type of variants (non-repeat expansion SCA). In this study we compared polyQ and non-repeat expansion SCA, in a cohort of patients with hereditary ataxia followed at a tertiary hospital. From a prospective study, 88 patients (51 families) with SCA were selected, 74 (40 families) of whom genetically diagnosed.
Thirty-eight patients (51.4%, 19 families) were confirmed as having a polyQ (no other repeat-expansions were identified) and 36 (48.6%, 21 families) a non-repeat expansion SCA. Median age-at-onset was 39.5 [30.0-45.5] for polyQ and 7.0 years [1.00-21.50] for non-repeat expansion SCA. PolyQ SCA were associated with cerebellar onset, and non-repeat expansion forms with non-cerebellar onset. Time to diagnosis was longer for non-repeat expansion SCA. The most common polyQ SCA were Machado-Joseph disease (MJD/SCA3) (73.7%) and SCA2 (15.8%); whereas in non-repeat expansion SCA ATX-CACNA1A (14.3%), ATP1A3-related ataxia, ATX-ITPR1, ATX/HSP-KCNA2, and ATX-PRKCG (9.5% each) predominated. Disease duration (up to inclusion) was significantly higher in non-repeat expansion SCA, but the difference in SARA score was not statistically significant. Cerebellar peduncles and pons atrophy were more common in polyQ ataxias, as was axonal neuropathy.
SCA had a wide range of genetic etiology, age-at-onset and presentation. Proportion of polyQ and non-repeat expansion SCA was similar; the latter had a higher genetic heterogeneity. While polyQ ataxias were typically linked to cerebellar onset in adulthood, non-repeat expansion forms associated with early onset and non-cerebellar presentations.
Infertility and Lifestyle Among Finnish Men and Women
Authors: Vilanti Titta , Klemetti Reija , Eetu Ervasti , Koponen Päivikki
Published: April 2024

Background: The aim of this population-based study is to examine lifestyle factors (smoking and alcohol consumption) and body mass index (BMI) among fertile and infertile Finnish women and men.
Methods: Infertility was defined based on reporting having ever tried to become pregnant or to get a child unsuccessfully over a year. Logistic regression analysis was used to investigate the association of smoking, alcohol consumption and BMI with infertility when adjusted first for age and then additionally for marital status, education and employment status. Men (n=201) and women (n=267) who had ever experienced infertility were compared to those with no experience of infertility (n=1677 men and n=1257 women) and further separately for those who had despite the infertility experience received a child or not.
Results: No significant differences between smoking or BMI were found in men by the infertility experience, compared to childless infertile and infertile men with a child. However, men with infertility experience had higher total alcohol consumption (g/year) than fertile men (p=0.005). The odds ratio for total consumption of alcohol at an average or high level was 2.49 (95 % CI 1.39-4.45) in the age adjusted model and 2.01 (CI 1.11-3.67) in the fully adjusted model for males who had experienced infertility by using the fertile men as a reference group.
No differences in smoking, alcohol consumption or BMI were found between women with or without infertility experience.
Conclusions: The results indicate that in fertility counselling and care given by midwifes and health care professionals, attention should be paid to men’s lifestyle, especially to alcohol consumption. The small numbers of those having experienced infertility limited analyses in this study.
Enhanced Breast Cancer Therapy Using Multifunctional Lipid- Coated Nanoparticles Combining Curcumin Chemotherapy and Nitric Oxide Gas Delivery
Authors: Yan Zhirong , Xiao Peihan , Ji Peng , Su Rongjian , Ren Zhenkun , Xu Li , Qiu Xun , Li Dan
Published: April 2024

The limitations of conventional treatment modalities for cancer, particularly breast cancer, have promoted the need to develop safer drug delivery systems (DDS). Chemotherapy combined with gas therapy has emerged as an attractive cancer treatment strategy. In this study, curcumin (Cur) loaded amorphous calcium carbonate nanoparticles (Cur-CaCO3) were prepared by gas diffusion reaction. A "one-step" ethanol injection method was then used to prepare lipid-coated calcium carbonate nanoparticles (Cur-CaCO3@LA-Lip) loaded with L-arginine (LA) to achieve a combination of chemotherapy and NO to enhance the antitumor effect. The prepared Cur-CaCO3@LA-Lip was characterized and evaluated by transmission electron microscopy (TEM), dynamic light scattering (DLS), UV-vis spectrometry, Fourier transform infrared spectroscopy (FTIR), X-ray powder diffraction (XRD) and differential scanning calorimetry (DSC). TEM observed that the Cur-CaCO3@LA-Lip nanoparticles were subspherical and had a distinct lipid layer covering the periphery. FTIR, XRD, and DSC indicated the successful synthesis of Cur-CaCO3@LA-Lip. Cur-CaCO3@LA-Lip exhibited a large drug loading capacity of 8.89% and 3.1% for Cur and LA, respectively, effectively preventing drug leakage. Furthermore, in vitro and in vivo, Cur-CaCO3@LA-Lip nanoparticles exhibited Cur sustained-release, high cellular uptake, high tumor accumulation, good biocompatibility, robust cytotoxicity, and antitumor efficacy.
The effectiveness of immediate weight bearing as tolerated versus delayed weight bearing following intramedullary fixation for geriatric intertrochanteric fractures: a post-hoc analysis
Authors: Li Ning , Cheng Kai-Yuan , Zhang Jing , Liu Gang , Zhou Li , Zhu Shi-Wen , Yang Ming-Hui , Wu Xin-Bao , Jiang Xie-Yuan
Published: April 2024

Background
Early weight bearing is an essential variable for fracture healing after osteosynthesis for Intertrochanteric fractures (ITF), which may impact morbidity and mortality. The optimal period to start weight bearing after surgery is still under debate, despite the recommendation of guidelines. The objective of this study was to evaluate the effectiveness of both a delayed and an immediate weight-bearing regimen following intramedullary fixation for elderly ITF.
Methods
This study is a post-hoc analysis of the multicenter prospective non-randomized controlled study (NCT03184896) listed on Clinicaltrials.gov. Eligible patients were aged ≥ 65 years with X-ray confirmed ITF, admitted within 21 days after injury and received intramedullary fixation surgery. Patients would be excluded if they were diagnosed with pathologic fractures, unable to comply with the rehabilitation program due to physical or psychological problems or received conservative treatment or other types of surgery. Patients bearing weight as tolerated during hospitalization were identified as the immediate weight bearing (IWB) group and patients bearing weight after discharge were identified as the delayed weight bearing (DWB) group in this study. The primary outcome was EQ5D score of patients at 120 days post-surgery. Secondary outcomes include EQ5D score of patients at 30 days and 365 days post-surgery, complication rate and mortality.
Results
410 eligible patients enrolled (190 patients with IWB and 220 patients with DWB). Compared to the DWB group, the IWB group had a higher EQ5D score at 30 days and 120 days after surgery (30d, P < 0.001; 120d, P = 0.002). The DWB group had a higher EQ5D score at 365 days after surgery (P = 0.012) than the IWB group. There were no statistical differences in the incidence of any complication, reoperation rate, or cumulative complication rate between the two groups. The one-year mortality was 5.79% in the IWB group and 4.55% in the DWB group (P = 0.542).
Conclusions
Immediate weight bearing as tolerated following intramedullary fixation for intertrochanteric fractures in elderly patients improves functional outcomes in the early stage (within 120 days after surgery) without increasing the incidence of complications, reoperation, or mortality compared with delayed weight bearing.
Intrinsically Stretchable OLEDs with a Designed Morphology-Sustainable Layer and Stretchable Metal Cathode
Authors: Park Jin-Woo , Oh Je-Heon , Jeon Kun-Hoo
Published: April 2024

Recently, the growing desire to conformally integrate electronics with the human body in the form of wearable devices has spurred the need for additional form factors, skin-like softness, and stretchability of organic light-emitting diodes (OLEDs). Traditional intrinsically stretchable OLED (is-OLED) approaches have focused on improving the luminance and stretchability through methods such as blending materials to endow the component layers with stretchability and complex lamination processes. However, the designed microstructure of the blended layer cannot be maintained due to the different orthogonality between the solvents of subsequently coated layers. In addition, the lamination method often leads to degradation of the performance due to delamination induced by formed defects. To overcome these challenges, we developed a sequentially coated is-OLED and confirmed the maintenance of the designed morphologies of each layer and a highly stretchable metallic is-cathode. Our is-OLEDs achieved a maximum total luminance of 3,151 cd m-2 and a total current efficiency of 5.4 cd A-1 (on both the anode and cathode sides). Furthermore, our is-OLEDs exhibited a higher static stretchability of up to 70% than previous work and a notable cyclic stretchability, maintaining 80% of the luminance at 0% strain after 300 stretching cycles under 40% strain. This breakthrough in the fabrication process, coupled with the use of novel stretchable materials, represents a significant step forward in the field of is-OLED technology, potentially leading to a new era of highly durable and efficient soft electronic devices.
Lean non-alcoholic fatty liver disease is associated with increased all-cause mortality in the United States
Authors: Wu Yutong , Wang Lili , Yi Jiayi , Ren Xiangpeng
Published: April 2024

It remains unclear whether lean non-alcoholic fatty liver disease (NAFLD) patients had worse outcomes. This study aims to investigate the long-term outcome of NAFLD in comparison to overweight and obese NAFLD using data from the National Health and Nutrition Examination Survey (NHANES) III. A total of 11860 participants (mean age, 43.4 years; 6498 [54.8%] women) were analyzed. NAFLD was assessed by hepatic ultrasonography and stratified into lean (body mass index, [BMI] < 25), overweight (BMI 25.0-29.9), and obese (BMI ≥ 30) subgroups. The Cox proportional hazards models were used to compute hazard ratios (HRs) and 95% CIs for the associations of NAFLD subgroups with risks of mortality. Lean NAFLD patients showed younger age and a lower prevalence of diabetes, hypertension, dyslipidemia, and insulin resistance. During a median follow-up period of 276 months, 3484 (29.4%) all-cause mortality occurred. All NAFLD subgroups were associated with increased all-cause mortality risk compared with healthy controls. However, only lean NAFLD was independently associated with all-cause mortality (HR, 1.23; 95% CI, 1.03–1.47) after the adjustment of confounders. This national-wide cohort study showed that lean NAFLD was significantly associated with higher all-cause mortality. A more granular assessment was needed to further characterize the phenotypes of the lean NAFLD population.
Anti-inflammatory effects of astaxanthin supplementation in the pathogenesis of diabetes mellitus and its complications: Emphasis on the role of inflammation-related microRNAs, lysophosphatidylcholine, and α-hydroxybutyrate in diabetic complications
Authors: Sharifi-Rigi Ali , Zal Fatemeh , Aarabi Mohammad-Hossein , Dehghani Mehdi , Rad Nikoo Roustaei , Taghiyar Sana
Published: April 2024

Background: Astaxanthin is a carotenoid compound that has several beneficial qualities, including antioxidant, anti-inflammatory, anti-apoptotic, and anti-diabetic effects. This study examined the effects of astaxanthin supplementation on inflammation-related microRNAs, lysophosphatidylcholine, and α-hydroxybutyrate in individuals with type 2 diabetes. Methods: Fifty people with type 2 diabetes volunteered in a placebo-controlled, randomized, double-blind clinical trial. Subjects were randomly assigned to consume either 10 mg of astaxanthin (n = 25) or a placebo (n = 25) for 12 weeks. Before and after the intervention, we determined the inflammation-related microRNAs in peripheral blood mononuclear cells, as well as the serum levels of lysophosphatidylcholine and α-hydroxybutyrate.
Results: After 12 weeks of supplementation, compared with the placebo, astaxanthin supplementation led to a remarkable reduction (p < 0.05) in hsa-miR-21, hsa-miR-34a, and hsa-miR-155 expression. In addition, astaxanthin supplementation substantially decreased (p < 0.05) the levels of lysophosphatidylcholine and α-hydroxybutyrate compared with the placebo. Furthermore, compared to the placebo, astaxanthin supplementation substantially reduced serum plasma glucose, HbA1c, lipid profile, and albumin-to-creatinine ratio levels.
Conclusion: Overall, the present research indicates that daily supplementation with 10 mg/day astaxanthin might be a beneficial approach for improving inflammation-related diabetic complications and insulin resistance in type 2 diabetes patients.
Machine learning developed a macrophage signature for predicting prognosis, immune infiltration and immunotherapy features in head and neck squamous cell carcinoma
Authors: Wang Yao , Mou Ya‐Kui , Liu Wan-Chen , Wang Han‐Rui , Song Xiao-Yu , Yang Ting , Ren Chao , Song Xi-cheng
Published: April 2024

Macrophages played an important role in the progression and treatment of cancer. Nevertheless, there is a limited amount of research that has comprehensively elucidated the characteristics of macrophages associated genes in head and neck squamous cell carcinoma (HNSCC). We employed weighted gene co-expression network analysis (WGCNA) to identify macrophage-related genes (MRGs) and classify patients with HNSCC into two distinct subtypes. A macrophage-related risk signature (MRS) model, comprising nine genes: IGF2BP2, PPP1R14C, SLC7A5, KRT9, RAC2, NTN4, CTLA4, APOC1, and CYP27A1, was formulated by integrating 101 machine learning algorithm combinations. We observed lower overall survival (OS) in the high-risk group and the high-risk group showed elevated expression levels in most of the differentially expressed immune checkpoint and human leukocyte antigen (HLA) genes, suggesting a strong immune evasion capacity in these tumors. Correspondingly, TIDE score positively correlated with risk score, implying that high-risk tumors may resist immunotherapy more effectively. At the single-cell level, we noted macrophages in the TME predominantly stalled in the G2/M phase, potentially hindering epithelial-mesenchymal transition and playing a crucial role in the inhibition of tumor progression. Additionally, we validated MRS gene expression levels using RT-qPCR and immunohistochemistry (IHC). The current study constructed a novel MRS for HNSCC, which could serve as an indicator for predicting the prognosis, immune infiltration and immunotherapy benefits for HNSCC patients.
Epidemiological, Clinical And Therapeutic Factors influencing Second Eye Cataract Surgery Among Patients Utilizing Outreach Surgical Facilities
Authors: Sebastian Stephanie , Nagarajan Swathi , R Rajalakshmi A. , Jha Kirti N
Published: April 2024

Visual improvement after cataract surgery in one eye diminishes the incentive for second-eye cataract surgery (SECS). This observational study aimed to determine if patients report for SECS with more advanced cataracts than for the first eye. Further, to explore the time gap between first-eye and SECS and factors influencing it. Adults requiring cataract surgery were included. Demographics, ocular and systemic conditions and peri-operative findings were compared between ‘First-eye cataract surgery’ and ‘SECS’ groups. Time elapsed since first-eye surgery and reasons thereof were analyzed in SECS group. Of 891 eyes operated, 376 (42.2%) were SECS. Frequency of advanced cataracts was comparable between the groups (p = 0.11), while ocular comorbidities was lower in SECS group (p < 0.05). Both groups encountered similar intra-operative (p = 0.72) and post-operative (p = 0.13) complications. Post-operative visual acuity was significantly better in SECS group (p = 0.007). Mean time interval between first-eye and SECS was 2.07 ± 1.8 years. A longer gap was associated with increased incidence of intra-operative complications (p = 0.04). Reasons for the time interval to SECS included “good vision in fellow eye”, “non-availability of caregiver” and “unsatisfactory outcomes with first-eye surgery”. Patients undergoing SECS did not have a higher incidence of advanced cataracts. Almost half the patients reported for SECS within 1 year. Experience of first-eye surgery influenced the decision to undergo SECS.
Risk factors for renal insufficiency after radical nephrectomy and thrombectomy in renal cell carcinoma with tumor thrombus: A systematic review
Authors: Huang Zhigao , Liu Zhuo , Zhuo Lin , Ma Xin , Jiang Zhenbin , Chen Kewei , Chen Jiyuan , Li Yuxuan , Wang Guoliang , Tian Xiaojun , Zhang Hongxian , Hong Kai , Ma Lulin , Liu Lei , Zhang Shudong
Published: April 2024

Background: Renal cell carcinoma (RCC) with venous tumor thrombus (VTT) is great burden over world. Radical nephrectomy (RN) with thrombectomy seems to be its gold standard operation, which might cause reduction of renal function. The aim of this systematic review was to provide evidence about the incidence, risk factors, possible reasons and influence of renal insufficiency in RCC patients undergoing RN with thrombectomy.
Methods: A systematic search using PubMed, Embase, Web of Science, the Cochrane Library and European Urology databases was conducted. Study selection followed the PRISMA guidelines. After screening, eleven articles and abstracted fully compatible with the PICOS were included in this systematic review. The study was registered with PROSPERO, CRD42024516596.
Results: Overall, a total of 1,668 patients who were diagnosed with RCC and VTT and underwent RN (open/laparoscopic/robotic) with thrombectomy were analyzed. The postoperative renal insufficiency was presen from 0.7% to 53.9%. Relevant risk factors of postoperative renal insufficiency could be summarized into three aspects: baseline characteristics (male gender, tumor thrombus level), intraoperative procedure (surgical method and inferior vena cava clamping time) and other factors (development of the times). The reason of renal insufficiency could be depletion of circulation volume, alteration in renal hemodynamics and condition of solitary kidney. Necessary managements like supplying blood volume, diuretic therapy and renal replacement therapy should be applied.
Conclusions: The present incidence of postoperative renal insufficiency was underestimated. More possible risk factors should be explored. Large cohort, multi-center, prospective, and well-designed studies would be necessary to corroborate these results and provided with high-grade recommendation for clinical practice.
Reporting on the Safety of Dementia Care for 2010-2021 in South Korea
Authors: Lee Jong hoon
Published: April 2024

This is the second report on the benefit or risk of treatment with anti-Alzheimer’s disease (AD) drugs (AADs). As a tool for monitoring citizen health, we use information from the National Health Service (NHIS) for all citizens via an information retrieval engine to link International Classification of Diseases (ICD)-10 codes and death tables of AADs with big data to create a standard comparison between AADs and deaths over 12 years. According to the International Classification of Disease-10 (ICD-10) codes, the correlation between the trend in the number of deaths and the number of deaths per 100,000 people was analyzed via the National Health Insurance System (NHIS) through the decision of the Open Data Mediation Committee of South Korea (case number: 2020-029) and information disclosure (20240110). The Dementia Management Act (DMA) in South Korea was enacted in 2012 and all dementia subjects are registered at Central Dementia Center. In completely blinded randomized states, we enrolled subjects from 2012 (the year of the Dementia Management Act) to 2018 (the year of the Dementia National Responsibility System was implemented). We observed a correlation between the AD and AAD groups from 2005 to 2019 on Sorok Island and from 2010 to 2021 on the NHIS of South Korea. This study investigated the increase and decrease in mortality in AD patients with AAD. We analyzed the mortality per 100,000 people with the R2. A simple linear equation was applied to trace the increase (+) or decrease (-) in deaths with the Friedman and Kolmogorov‒Smirnov tests for decisions on the listed, delisted, and sustainable drugs based on R2 > 0.75. Total deaths from AD caused by AAD decreased (R2, 0.993) from 2010 to 2021. From 2012 to 2018, the drugs listed to reduce deaths were fluoxetine (R2, 0.826), escitalopram (0.955) and galantamine (0.825) in South Korea. The delisted drugs used were donepezil (0.861), rivastigmine (0.754), risperidone (0.816), quetiapine (0.977), and haloperidol (0.973). The sustainable drugs used were memantine (0.108), olanzapine (0.124), fluvoxamine (0.001), oxcarbazepine (0.52), and trazodone (0.331). With the 12-year trend, galantamine, fluoxetine, could be therapeutics for AD, and sertraline and aripiprazole could be therapeutics; however, additional observation is needed. Deaths and AADs based on NHIS big data could be useful for safe dementia care.
Fostering the understanding of patient safety among medical and health sciences students in an environment of interprofessional education: An interventional study
Authors: Guraya Salman Yousuf , Sulaiman Nabil , Hasswan Ahmed , Salmanpour Vida Abdolhamid , Jirjees Feras Jassim , Taha Mohamed Hassan , Mahmoud Ibrahim , Alamara Jennat , Kawas Sausan AL , Awad Manal , Dias Jacqueline Maria , David Leena R , Haider Mohamed Aly , Guraya Shaista Salman , Dash Nihar Ranjan , Al-Qallaf Amal , Shorbagi Sarra
Published: April 2024

Background
Interprofessional education (IPE) plays an elementary role in improving healthcare outcomes by shared understanding and by reducing errors and adverse events. Unfortunately, most healthcare professionals have not received training for patient safety (PS) in an interprofessional setting, which can meet the needs of societal medical needs. This study aimed to foster the understanding of senior medical and health sciences students about PS at the University of Sharjah in UAE.
Methods
Using a stratified random sampling technique, we recruited students from College of Medicine (CoM), College of Pharmacy (CoP), College of Dental Medicine (CDM), and College of Health Sciences (CHS) of UoS. The online synchronous real-time workshop included interactive resource sessions, breakout room discussions using real clinical cases, and pre-post surveys using a questionnaire with three domains of PS; medical professionalism, leadership in healthcare, and precision medicine.
Results
A total of 248 students and 20 facilitators participated in the workshop. CoM had the highest representation (47.5%), followed by CoP (36.5%), CHS (13.3%), and CDM (2.7%). There was a statistically improved understanding in all domains of PS across all colleges (p < 0.001). Notably, students in years four and five from CoM and CoP showed significant improvement in their perceptions than other colleges (p < 0.001). The participants encountered challenges of weak internet connections, software issues, technical failures, and power outages during the workshop.
Conclusion
This study highlights a positive impact of an IPE-based interventional workshop on the students' understanding and insights of PS. This underscores the paramount role of IPE in improving perceptions and approaches towards PS in the context of healthcare education.
Experimental assessment of the effect of surfacecondition on aged adhesive joint performance
Authors: Vervaeke Rens , Weiland Josef , Buysschaert Frank , Debruyne Stijn , Vandepitte Dirk , Schiebahn Alexander , Moens David
Published: April 2024

Industries such as aerospace are very interested in the use of structural adhesives as a joining technique. Compared to riveting, they offer better stress distribution, eliminating stress peaks which can be quite problematic with thin sheet materials. The ability to bond different materials allows for a wider range of material combinations that result in weight reduction. Aluminium and other metals are popular in the aerospace industry, but their reactivity to water molecules compromises the bond strength. This presents problems for manufacturers in predicting and monitoring service life. This study addresses degradation at the interface and the importance of proper surface treatment. Two different adhesive types (epoxy and methylacrylate) and adherent materials (AW 5754 H111 and AISI 1.4301) result in four different sample configurations. Several pretreatments are applied, all using different mechanisms to improve adhesion Drozdziel2022 \cite{Ebnesajjad2015} Marques2020. After surface treatment, the contact angle with de-ionised water is measured, which is directly related to surface energy \cite{Ebnesajjad20151}. The samples are tested for residual lap shear strength after being subjected to an ageing trajectory for one week. Statistical analysis is used to establish a relationship between surface energy and residual lap shear strength. The importance of surface treatment is established, but there is no direct relationship between contact angle and joint durability. Corrosion protection appears to be important, and the adherent material and adhesive type determine the optimum surface treatment.
Influence of granite nanoparticles on the mechanical, damping and antimicrobial properties of silk-sisal hybrid nanocomposites
Authors: K Sripriyan , M karthigha
Published: April 2024

This paper focuses on the effect of granite-micro-filler on static mechanical properties, damping behavior, and physical characteristics of silk-sisal hybrid composite. The composites structures are fabricated by using three layers of plain weaves mat with varying weight percentages (2, 4, and 6 wt. %) of granite-micro-filler by hand layer process. The effect of granite-micro-filler on silk-sisal is analyzed and results are compared with pure silk-sisal (without granite-Micro-filler) hybrid composite. The results infer that; the tensile strength and flexural strength value of the developed silk-sisal hybrid composites are increased with the increase in wt.% of granite-micro-filler content than pure silk-sisal, approximately 5% and 9% improved value in order by adding 6 wt. % granite-micro-filler on silk-sisal. The tensile and flexural fracture morphology analysis indicated that composed plain weave of silk-sisal fiber mat with two (longitudinal and transverse) directions possesses higher mechanical properties and also observed that, granite-micro-filler dispersed on silk-sisal fiber mat and resin with closely packed. The improved damping factor is obtained by adding 6 wt. % of granite-micro-filler content, which is approximately 75.8% higher than pure silk-sisal. The physical properties of silk-sisal hybrid composite have also been analyzed and well discussed in this paper.
An ethical analysis of human fetal and embryological collections and informed consent: a focus group study
Authors: El-Haddad Joyce , Pather Nalini
Published: April 2024

Background
Human fetal and embryological collections refer to repositories or archives that house remains of human fetuses and embryos at different stages of development. Previous studies have highlighted that most remains in these collections have been obtained without informed consent from the next of kin, thus reflecting a time in history where this may have been acceptable. Previous studies seeking stakeholder perceptions towards these collections suggest that there is misalignment with the values of society today, and the current guiding frameworks pertaining to these collections. The aim of this study was to explore and analyse the perceptions of key stakeholders regarding fetal collections with a particular focus on informed consent.
Methods
Through conducting focus group interviews of 25 participants, the study sought to provide an in-depth exploration of how stakeholders perceive the value of fetal and embryological collections, and the importance of informed consent.
Results
The mean age of participants was 29.1 years of age with a gender distribution of 40% men and 55.6% of women. Thematic analysis identified four themes: Consent; preparation for clinical practice; 3. equity and fairness; and 4 educational value, with several subthemes identified at macro, meso, and micro ethical levels. Macro subthemes included importance of informed consent, and equity and fairness, and genetic composition. Meso subthemes included respect and privacy, and legal and institutional considerations. Micro subthemes included emotional considerations, preparation for clinical practice, and educational value.
Conclusions
The study advocates for consideration of the ethical issues surround human fetal and embryological collections from the macro, meso, and micro ethical frameworks.
Impact of zinc oxide nanoparticles and iron on Stevia rebaudiana Bertoni growth, nutrient uptake, and bioactive compounds under in vitro conditions
Authors: Lankarani Seyed Mohammad Javad , Karimi Jaber , Rezaei Ayatollah
Published: April 2024

The experiment investigated the effects of different levels of zinc oxide nanoparticles (ZnONPs) (0, 10, 20, and 30 mg/L) and iron sulfate (13.9, 27.8, and 55.6 mg/L) on morphological and physiological responses of Stevia rebaudiana Bertoni plant under in vitro conditions. Results indicated that the combined application of ZnONPs at 10 mg and iron at 27.8 mg led to the highest increase in shoot number, height, and biomass, showing a respective rise of 17.37%, 39.66%, and 45.02% compared to control cultures. The highest pigment content and tissue antioxidant activity (83.48%) was observed with the combined presence of 10 mg/L ZnONPs and 27.8 mg/L iron. As ZnONP concentration increased in the culture medium, the combined effect on lipid peroxidation rate became more pronounced. The impact of ZnONPs on phenolic compound production varied depending on the specific substance. The iron content of shoots increased significantly by 41.11% under the influence of 27.8 mg/L iron and 10 mg/L ZnONP compared to control cultures. Interaction effects of treatments at various levels resulted in increased zinc content in shoots, peaking at 27.8 mg/L iron when ZnONP reached 20 mg/L, representing a 56.28% increment over control levels before slightly decreasing. The most increases in stevioside and rebaudioside were observed with the combination of 10 mg/L ZnONP and 27.8 mg/L iron, showing enhancements of 75.04% and 63.08%, respectively. These findings suggest that ZnONPs could stimulate the growth and enhance the bioactive components of stevia plants, making them a viable option as elicitors in in vitro batch cultures.
Healthcare workers’ compliance with COVID-19 preventive and control measures at De Martino Hospital, Mogadishu, Somalia: a cross-sectional study
Authors: Janay Abdullahi Ibrahim , Kilic Bulent , Unal Belgin
Published: April 2024

Background
Healthcare workers are a high-risk group for COVID-19 and protecting them is crucial for healthcare delivery. Limited studies have explored compliance with infection prevention and control (IPC) practices among Somali healthcare workers. This study aimed to determine compliance with IPC practices among healthcare workers in De Martino Public Hospital, Somalia.
Methods
A cross-sectional study was conducted at De Martino Public Hospital, Mogadishu, Somalia from August to October 2022, with the participation of 204 healthcare workers (response rate = 97%). Compliance was assessed using responses to 25 questions on a five-point Likert-type scale, and a median score of 20 was used to dichotomize compliance scores. A chi-square test and logistic regression analysis were performed to check the associations between healthcare workers’ sociodemographic information, related factors to IPC, work conditions and practices on COVID-19, and IPC compliance during healthcare interventions using SPSS 23 version.
Results
In total, 58.3% of the participants had good compliance with IPC. There were significant associations between IPC compliance and the type of healthcare worker (doctors and doctor assistants: 72.3%, nurses and paramedical staff: 67.3%, non-clinical staff: 5.7%, p < 0.01). After adjusting for potential confounding factors, compared to non-clinical staff, doctors and doctor assistants (OR: 12.11, 95% CI: 2.23–65.84) and nurses and paramedical staff (OR: 21.38, 95% CI: 4.23–108.01) had higher compliance with infection prevention and control measures. There were no significant associations between compliance and sex, marital status, vaccination status, or smoking (p > 0.05 for all).
Conclusions
Inadequate compliance with COVID-19 IPC measures was observed among hospital workers. Prioritizing awareness campaigns and behavior change interventions, especially among non-clinical staff, is crucial for effective COVID-19 infection prevention and control within hospitals.