bluuebunny/crossref_metadata_2025 huggingface dataset:
Prolonged Transient Global Amnesia: Part of the Clinical Spectrum or a Separate Disease Entity?
Authors: Yong Heather Y.F. , Camara-Lemarroy Carlos R.
Published: June 2023

Background

Transient global amnesia (TGA) is the prototypical neurologic disease for acute-onset reversible amnesia. It is currently defined by resolution of symptoms within 24-hours. In this case report we describe an atypical case of prolonged TGA, emphasizing our current lack of knowledge surrounding this disease entity and its pathophysiology.

Results

A 66-year old female presented acutely with profound anterograde amnesia and variable retrograde amnesia with no inciting event. A thorough workup to exclude alternative causes of amnesia (including computed tomography angiogram and electroencephalogram) was normal. Her magnetic resonance imaging was consistent with TGA, with punctate diffusion restriction changes bilaterally in the hippocampi. She was also mildly hypoxemic with no discernible cause. She was ultimately diagnosed with TGA although her diagnosis remains controversial as her symptoms persisted for 72-hours.

Conclusion

Our patients clinical and imaging features (apart from her protracted time-course and hypoxemia) were in keeping with a diagnosis of TGA. The association of hypoxemia, COVID-19, obstructive sleep apnea, and the development of TGA remains to be elucidated. Although the underlying pathophysiology for TGA is unknown several mechanisms have been postulated including cortical spreading depression and reversible hypoxic-ischemic injury. The time course for symptom resolution, could be an important clue in discerning the pathophysiology of TGA on an individual basis. Importantly, a clinician should not be deterred by amnestic symptoms lasting >24-hours, if the patients clinical/radiologic presentation is consistent with TGA.
Effectiveness of medication review services on diabetes self-care in primary care patients-A randomised controlled study
Authors: Tay Sarah Siew Cheng , Lim Christina Jit Fan , Tan Daphne Soo Chieng , Tan Maureen Seok Yee , Chen Jieying , Oh Wan Lin , Khoo Shu Yuen , Goh Boon Kwang , Tang Woh Peng , Goh Bandy Qiuling
Published: June 2023

Background

Though self-care is a critical component of diabetes management, it is unknown whether pharmacist-run medication review service (MRS) can be an additional intervention to enhance self-care in diabetic patients.

Objectives

Hence, this study aims to determine the effectiveness of MRS in addition to existing care protocol in improving self-care in diabetic patients.

Methods

This randomised controlled study was conducted in five polyclinics from December 2014 to October 2016. Participants were 40 to 80 years of age and had been diagnosed with type 2 diabetes. These participants were prescribed with five or more chronic medications, of which at least one was an antidiabetic medication, by the primary healthcare centres’ doctors. The participants were randomly recruited into the intervention or control arm. A self-developed questionnaire which incorporated the validated Diabetes Self-Management Questionnaire (DSMQ) was administered face-to-face by the study team to the participants prior to and after MRS. MRS was not administered to participants in the control group.

Results

A total of 221 participants completed the follow up. There were 105 participants in the control arm and 116 in the intervention arm. The DSMQ Sum Scale score of the control group improved by 0.16 ± 1.11 ( p = 0.136) while the intervention group improved by 0.40 ± 0.99 ( p = 0.000). Participants in the intervention group reported a better improvement in their self-care of diabetes, specifically in glucose management ( p = 0.003), dietary control ( p = 0.096) and physical activity ( p = 0.003).

Conclusions

Pharmacist-run MRS can be included in addition to existing care to improve self-care in patients with diabetes.
International lives and Finnish rhythms: Mobile professionals’ children, time and agency
Authors: Korpela Mari
Published: June 2023

This article investigates temporality in the everyday lives of 9-year-old children of international professionals in Finland. The children’s transnational mobility causes ruptures and discontinuities in their position within various timescapes. The institutional timescapes of schools in different countries appear to be somewhat incompatible, which can be challenging for these mobile children, especially if their sojourns are temporary. At the same time, the timescapes of the Finnish school system provide children with particular agency beyond the school setting, since school days are relatively short. Children also view differing timescapes differently depending on the length of their stay in the country. The article shows how past, present and future timescapes, and potential ruptures within these, become entangled when mobile professionals’ children negotiate their position and agency within various timescapes.
Developing an eMental health monitoring module for older mourners using fuzzy cognitive maps
Authors: Brandl Lena , van Velsen Lex , Brodbeck Jeannette , Jacinto Sofia , Hofs Dennis , Heylen Dirk
Published: June 2023

Objective

Effective internet interventions often combine online self-help with regular professional guidance. In the absence of regularly scheduled contact with a professional, the internet intervention should refer users to professional human care if their condition deteriorates. The current article presents a monitoring module to recommend proactively seeking offline support in an eMental health service to aid older mourners.

Method

The module consists of two components: a user profile that collects relevant information about the user from the application, enabling the second component, a fuzzy cognitive map (FCM) decision-making algorithm that detects risk situations and to recommend the user to seek offline support, whenever advisable. In this article, we show how we configured the FCM with the help of eight clinical psychologists and we investigate the utility of the resulting decision tool using four fictitious scenarios.

Results

The current FCM algorithm succeeds in detecting unambiguous risk situations, as well as unambiguously safe situations, but it has more difficulty classifying borderline cases correctly. Based on recommendations from the participants and an analysis of the algorithm's erroneous classifications, we propose how the current FCM algorithm can be further improved.

Conclusion

The configuration of FCMs does not necessarily demand large amounts of privacy-sensitive data and their decisions are scrutable. Thus, they hold great potential for automatic decision-making algorithms in mental eHealth. Nevertheless, we conclude that there is a need for clear guidelines and best practices for developing FCMs, specifically for eMental health.
Grouping by Time and Pitch Facilitates Free but Not Cued Recall for Word Lists in Normally-Hearing Listeners
Authors: Sares Anastasia G. , Gilbert Annie C. , Zhang Yue , Iordanov Maria , Lehmann Alexandre , Deroche Mickael L. D.
Published: June 2023

Auditory memory is an important everyday skill evaluated more and more frequently in clinical settings as there is recently a greater recognition of the cost of hearing loss to cognitive systems. Testing often involves reading a list of unrelated items aloud; but prosodic variations in pitch and timing across the list can affect the number of items remembered. Here, we ran a series of online studies on normally-hearing participants to provide normative data (with a larger and more diverse population than the typical student sample) on a novel protocol characterizing the effects of suprasegmental properties in speech, namely investigating pitch patterns, fast and slow pacing, and interactions between pitch and time grouping. In addition to free recall, and in line with our desire to work eventually with individuals exhibiting more limited cognitive capacity, we included a cued recall task to help participants recover specifically the words forgotten during the free recall part. We replicated key findings from previous research, demonstrating the benefits of slower pacing and of grouping on free recall. However, only slower pacing led to better performance on cued recall, indicating that grouping effects may decay surprisingly fast (over a matter of one minute) compared to the effect of slowed pacing. These results provide a benchmark for future comparisons of short-term recall performance in hearing-impaired listeners and users of cochlear implants.
Impact of an Observation Medicine Educational Intervention on Residents’ Confidence, Knowledge, and Attitudes: A Quasi-Experimental Study
Authors: Sabir Riffat , Umar Muhammad , Medarametla Venkatrao , Sreedhrala Aseesh
Published: June 2023

OBJECTIVES

Driven by innovations in healthcare, observation medicine (OM) is expanding as a medical specialty. Despite exponential growth, education on OM remains underemphasized in the internal medicine (IM) residency programs. We assessed the impact of an educational intervention pairing didactic and experiential learning with an interdepartmental approach on IM residents’ confidence, knowledge, and attitudes when providing observation care to patients with neuro-cardiovascular diseases in the hospital setting.

METHODS

Our multifaceted intervention incorporated OM’s principles and practice in a flipped classroom with the team-, case-, lecture- and evidence-based learning model. Kirkpatrick’s evaluation model was used to assess the educational intervention’s effectiveness according to the first three levels, ie, reaction, learning, and behavior, using quantitative surveys. The surveys were completed pre-intervention, and immediately upon completion of the educational intervention.

RESULTS

Of 55 eligible residents, 55 (100%) participated in this intervention. Fifty (90%) completed the pre-intervention survey, and 21 (38%) completed the immediate post-intervention survey. Kirkpatrick’s evaluation framework showed that the intervention had a positive impact on residents’ motivational reaction ( attention, relevance, confidence, and satisfaction [ARCS], M = 3.8, SD = 0.87), their knowledge of common observation diagnoses (pre = 49%, post = 63%), particularly on cardiac diagnostic workup and approach to patients with transient neurological symptoms ( P < .05), and their behavior and self-assessment of core competency domains (pre-mean = 2.69, post-mean = 3.18, P < .001).

CONCLUSIONS

Our multimodal intervention provides a framework for a structured OM educational experience that can be incorporated into residency training, even without a formal observation unit rotation. The analysis also offers literary data on the current state of OM education in an IM residency program and supports the need to expand OM's educational resources to counteract the growth in hospital observation services. Future research should include an analysis of residents’ knowledge and skills from a longitudinal OM experience and advancing the results to residency programs where observation care is as applicable as ours.
Geographical origin classification of Phoebe zhennan and Phoebe bournei by solid phase micro-extraction and gas chromatography-mass spectrometry
Authors: Chen Zhenan , Xue Xiaoming , Cheng Ruoyi , Wu Haoqi , Gao Handng , Gao Zexun
Published: June 2023

Phoebe zhennan and Phoebe bournei are favored for their fine-grain, insect resistance, special fragrance, not easily cracked and deformed, which had been widely used in furniture and construction. Wood authenticity regarding different varieties and geographical origins is increasingly becoming a concern for consumers. Due to the difference in wood quality characteristics and economic value of genus Phoebe species from different geographical origins, it is important to establish a fast, efficient, and reliable method to discriminate the geographical origin of Phoebe zhennan and Phoebe bournei. Solid phase micro-extraction (SPME) was used as sample preparation approach and gas chromatography-mass spectrometry (GC–MS) technique was employed to analyze the volatile compounds. As a result, a total of 40 volatiles were identified by SPME–GC–MS among Phoebe zhennan samples from four origins, while 34 substances identified among Phoebe bournei samples. The wood samples of Phoebe zhennan and Phoebe bournei from different major production areas in China were able be discriminated by GC–MS spectroscopy. This finding indicated that genus Phoebe species from different climate zones had different chemical composition, which verified that the SPME–GC–MS technique can be used to classify different species of wood with characteristic compounds.
BeEM: fast and faithful conversion of mmCIF format structure files to PDB format
Authors: Zhang Chengxin
Published: June 2023

Background

Although mmCIF is the current official format for deposition of protein and nucleic acid structures to the protein data bank (PDB) database, the legacy PDB format is still the primary supported format for many structural bioinformatics tools. Therefore, reliable software to convert mmCIF structure files to PDB files is needed. Unfortunately, existing conversion programs fail to correctly convert many mmCIF files, especially those with many atoms and/or long chain identifies.

Results

This study proposed BeEM, which converts any mmCIF format structure files to PDB format. BeEM conversion faithfully retains all atomic and chain information, including chain IDs with more than 2 characters, which are not supported by any existing mmCIF to PDB converters. The conversion speed of BeEM is at least ten times faster than existing converters such as MAXIT and Phenix. Part of the reason for the speed improvement is the avoidance of conversion between numerical values and text strings.

Conclusion

BeEM is a fast and accurate tool for mmCIF-to-PDB format conversion, which is a common procedure in structural biology. The source code is available under the BSD licence at https://github.com/kad-ecoli/BeEM/.
Investigation of KIR/HLA relationship and other clinical variables after T-cell-replete haploidentical bone marrow transplantation in patients with acute myeloid leukemia (AML)
Authors: Bakhtiari Tahereh , Ahmadvand Mohammad , Yaghmaie Marjan , Sadeghi Alireza , Mousavi Seied Asadollah , Rostami Tahereh , Ganjalikhani-Hakemi Mazdak
Published: June 2023

Background

KIR/HLA mismatch in hematopoietic stem cell transplantation (HSCT), particularly in patients with acute myeloid leukemia (AML), was related to decreased recurrence rates, improved engraftment, and a reduction in graft-versus-host disease, according to recent research (GVHD). Uncertainty exists about the impact of KIR/HLA mismatch on haploidentical-HSCTs treated with post-transplant cyclophosphamide (PTCy). We attempted to analyze the effects of KIR/HLA mismatch on clinical outcomes on transplant outcomes using the cohort of 54 AML patients who received a haplo-HSCT with PTCy.

Results

In contrast to KIR/HLA match, our findings showed that donor KIR/HLA mismatch was substantially associated with superior OS (HR, 2.92; (P = 0.04)). Moreover, donor KIR/HLA mismatch (KIR2DS1D/C2+R and KIR2DS2D/C1+R mismatch versus KIR2DL1D/C2−R mm, KIR2DL2/3D/C1−R mm and KIR3DL1D/Bw4− mm) was correlated with the improvements in OS (HR, 0.74; P = 0.085) and activating. KIR/HLA mismatch versus KIR/HLA match was significantly correlated with improvements in OS (HR, .46; P = 0.03) and inhibitory. KIR/HLA mismatch versus KIR/HLA match was enhancement in the OS (HR, .93; P = 0.06). Despite a higher rate of aGvHD (grade I-IV) in the patients with KIR/HLA mismatch compared to KIR/HLA matched (57% vs. 33% (p = 0.04). However, the KIR/HLA mismatch group saw a decreased relapse rate (3.2% vs. 23%, p = 0.04).

Conclusion

This analysis shows the significance of KIR/HLA Incompatibility, other clinical variables like CMV, the relationship between donor/recipient and donor age, and the relationship between donor/recipient and donor age in the haplo-donor selection process. It also suggests that KIR and HLA mismatching between donor and recipient could be routinely performed for haplo-donor selection and may improve clinical outcomes after haplo-HSCTs with PTCy.
Genome-wide identification and expression analysis of VQ gene family under abiotic stress in Coix lacryma-jobi L.
Authors: Wang Yujiao , Lu Xianyong , Fu Yuhua , Wang Hongjuan , Yu Chun , Chu Jiasong , Jiang Benli , Zhu Jiabao
Published: June 2023

Background

Valine-glutamine (VQ) proteins are non-specific plant proteins that have a highly conserved motif: FxxhVQxhTG. These proteins are involved in the development of various plant organs such as seeds, hypocotyls, flowers, leaves and also play a role in response to salt, drought and cold stresses. Despite their importance, there is limited information available on the evolutionary and structural characteristics of VQ family genes in Coix lacryma-jobi.

Results

In this study, a total of 31 VQ genes were identified from the coix genome and classified into seven subgroups (I–VII) based on phylogenetic analysis. These genes were found to be unevenly distributed on 10 chromosomes. Gene structure analysis revealed that these genes had a similar type of structure within each subfamily. Moreover, 27 of ClVQ genes were found to have no introns. Conserved domain and multiple sequence alignment analysis revealed the presence of a highly conserved sequences in the ClVQ protein. This research utilized quantitative real-time PCR (qRT-PCR) and promoter analysis to investigate the expression of ClVQ genes under different stress conditions. Results showed that most ClVQ genes responded to polyethylene glycol, heat treatment, salt, abscisic acid and methyl jasmonate treatment with varying degrees of expression. Furthermore, some ClVQ genes exhibited significant correlation in expression changes under abiotic stress, indicating that these genes may act synergistically in response to adversarial stress. Additionally, yeast dihybrid verification revealed an interaction between ClVQ4, ClVQ12, and ClVQ26.

Conclusions

This study conducted a genome-wide analysis of the VQ gene family in coix, including an examination of phylogenetic relationships, conserved domains, cis-elements and expression patterns. The goal of the study was to identify potential drought resistance candidate genes, providing a theoretical foundation for molecular resistance breeding.
Ecological factors affecting first-time mothers’ satisfaction with Sanhujoriwons (postpartum care centres) from South Korea: a cross-sectional and correlational study
Authors: Song Ju-Eun , Lee Soyeon , Lee Min Kyong , Chae Hyun-Ju
Published: June 2023

Background

In South Korea, commercial postpartum care centres, known asSanhujoriwons, have emerged as important institutions aiding mothers’ physical recovery after childbirth. Although previous studies have measured mothers’ satisfaction level withSanhujoriwons, this study applies Bronfenbrenner’s ecological model to identify the factors influencing first-time mothers’ satisfaction withSanhujoriwons.

Methods

This descriptive correlational study involved 212 first-time mothers admitted toSanhujoriwons for two weeks with their new-borns (healthy babies weighing at least 2.5 kg) after giving birth after 37 weeks of pregnancy. Data were collected using a self-report questionnaire at five postpartum care centres in the metropolitan area of South Korea from October to December 2021, on the day of the mothers’ discharge. This study considered ecological factors such as perceived health status, postpartum depression, childcare stress, maternal identity at the individual level; partnership withSanhujoriwonstaff at the microsystem level; and theSanhujoriwons’ education support system at the exo-system level. The data were analysed using descriptive statistics, t-test, one-way ANOVA, correlation analysis, and hierarchical regression analysis using the SPSS 25.0 Win program.

Results

The mean score of satisfaction withSanhujoriwonswas 59.67 ± 10.14 out of 70, indicating a high level of satisfaction. The hierarchical regression analysis showed that satisfaction withSanhujoriwonswas significantly affected by the perceived health status (β = 0.19,p < 0.001), partnership between mothers and the caregivers (β = 0.26,p < 0.001), and education support system of theSanhujoriwons(β = 0.47,p < 0.001). The explanatory power of the model for these variables was 62.3%.

Conclusions

Our results indicate that not only the mother’s health status but also the educational support system of postpartum care centres and partnerships are important for improving first-time mothers’ satisfaction with postpartum care centres. Thus, when developing an intervention program for postpartum care centres, practitioners should focus on developing various kinds of support and strategies to improve the physical health condition of mothers, build partnerships between mothers and care staff, and improve the quality of the educational support offered to mothers. Further studies to develop and test the effectiveness of such intervention programs are strongly suggested.
Contemplating the necessity of surgical treatment for posterior lenticonus: a case report
Authors: Lu Ming-zhi , Cao Wen-li , Xing Yi-qiao
Published: June 2023

Background

Posterior lenticonus is an uncommon congenital abnormality that causes a progressive, localized spherical or conical bulging of the posterior capsular membrane, resulting in an abnormal shape of the lens.

Case presentation

A 13-year-old girl presented with ametropia in both eyes. After mydriasis, examination revealed an oval bubble-shaped alteration with a distinct boundary above the temporal region on the center of the posterior capsule of her left lens. The subcortical region surrounding the alteration appeared feathery and turbid. The patient had no history of trauma or family history of visual impairment. Systemic investigations were normal. A thorough eye examination was performed, which included optometry, ultrasound biomicroscopy, ocular B-Scan, and anterior segment optical coherence, to assess the disease. The patient was diagnosed with posterior lenticonus in the left eye, as well as ametropia and anisometropia in both eyes. Conservative treatment was initiated since the patient’s current best corrected visual acuity was good, and regular monitoring of the condition’s progression was scheduled.

Conclusions

This case report presents a rare instance of posterior lenticonus. The findings of this report raise new considerations regarding the necessity of surgical intervention for this condition.
Exploring the reciprocal relationship between activities of daily living disability and depressive symptoms among middle-aged and older Chinese people: a four-wave, cross-lagged model
Authors: Wang Jiayi , Luo Nansheng , Sun Yu , Bai Ru , Li Xueying , Liu Libing , Wu Hui , Liu Li
Published: June 2023

Background

Early studies have shown a relationship between activities of daily living (ADL) disability and depressive symptoms in older people. However, discussions on the direction of this relationship are insufficient. The study’s objective was to assess the reciprocal relationship between ADL disability and depressive symptoms among middle-aged and older Chinese people.

Method

Data was collected in four waves of a nationwide survey, the China Health and Retirement Longitudinal Study (CHARLS), which was carried out in 2011, 2013, 2015, and 2018. In total, this study included 4,124 participants aged ≥ 45 years at baseline. A summing score of the eleven items for basic activities of daily living (BADL) and instrumental activities of daily living (IADL) was calculated to indicate the degree of ADL disability. The 10-item Centre for Epidemiological Studies Depression Scale (CESD-10) was adopted to measure depressive symptoms. The reciprocal relationship between ADL disability and depressive symptoms was tested by cross-lagged models.

Result

At baseline, 911 (22.1%) participants were classified as having difficulties with ADL, and the prevalence of depressive symptoms was 34.4% (1,418). Among middle-aged and older people in China, there was a significant reciprocal and longitudinal relationship between ADL disability and depressive symptoms. People who had difficulty with ADL faced a higher risk of depressive symptoms, and those who suffered from depressive symptoms were accompanied by an increase in ADL disability in the following years. The subgroup analysis on age also showed that ADL disability was reciprocally and longitudinally related to depressive symptoms. However, only women showed similar results in the subgroup analysis on gender.

Conclusion

This study shows that ADL disability is bi-directionally related to depressive symptoms in middle-aged and older Chinese people over time. The results suggest we should identify ADL disability and bad psychological conditions in time to prevent subsequent mutual damage among middle-aged and older Chinese people, a vulnerable group rising in the future.
The impact of secondhand smoke on the development of kidney stone disease is not inferior to that of smoking: a longitudinal cohort study
Authors: Chen Yi-Hsuan , Lee Jia-In , Shen Jung-Tsung , Wu Yi-Hsuan , Tsao Yao-Hsuan , Jhan Jhen-Hao , Wang Hsun-Shuan , Lee Yung-Chin , Huang Shu-Pin , Chen Szu-Chia , Geng Jiun-Hung
Published: June 2023

Background

Tobacco use and secondhand smoke (SHS) are risk factors of kidney stone disease (KSD). The hypothesis is that tobacco produces chemicals that increase oxidative stress and vasopressin, which leads to decreased urine output, and contributes to stone formation. The aim of this study was to examine the effects of smoking and SHS on the development of KSD.

Materials and methods

We analyzed a total of 25,256 volunteers with no history of KSD participated in the Taiwan Biobank. The presence of underlying and follow-up KSD was surveyed by a self-administrated questionnaire. They were classified into three groups on the basis of smoking and SHS exposure, accessed with survey questionnaires; never-smokers with no SHS exposure, never-smokers with SHS exposure and ever-smokers groups.

Results

KSD was noted in 352 (2.0%), 50 (3.3%) and 240 (4.1%) subjects in the never-smokers with no SHS exposure, never-smokers with SHS exposure and ever-smokers groups, respectively, with a mean follow-up of 4 years. The odds ratio (OR) of KSD was higher in the never-smokers with SHS exposure (OR, 1.622; 95% confidence interval [95% CI], 1.225 to 2.255) and ever-smokers groups (OR, 1.282; 95% CI, 1.044 to 1.574) than in the never-smokers with no SHS exposure group after adjustment of confounders. In addition, never-smokers with SHS exposure had similar effects on the development of KSD than ever-smokers (OR, 1.223; 95% CI, 0.852 to 1.756).

Conclusion

Our study suggests that both smoking and SHS are a risk factor for developing KSD and that the impact of SHS is not inferior to that of smoking.

Trial registration

The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of Kaohsiung Medical University Hospital (KMUHIRB-E(I)-20,210,058).
Time series analysis of cutaneous leishmaniasis incidence in Shahroud based on ARIMA model
Authors: Majidnia Mostafa , Ahmadabadi Zahra , Zolfaghari Poneh , Khosravi Ahmad
Published: June 2023

Background

Leishmaniasis is a zoonotic disease and Iran is one of the ten countries with has the highest estimated cases of leishmaniasis. This study aimed to determine the time trend of cutaneous leishmaniasis (CL) incidence using the ARIMA model in Shahroud County, Semnan, Iran.

Methods

In this study, 725 patients with leishmaniasis were selected in the Health Centers of Shahroud during 2009–2020. Demographic characteristics including; history of traveling, history of leishmaniasis, co-morbidity of other family members, history of treatment, underlying disease, and diagnostic measures were collected using the patients’ information listed in the Health Ministry portal. The Box-Jenkins approach was applied to fit the SARIMA model for CL incidence from 2009 to 2020. All statistical analyses were done by using Minitab software version 14.

Results

The mean age of patients was 28.2 ± 21.3 years. The highest and lowest annual incidence of leishmaniasis were in 2018 and 2017, respectively. The average ten-year incidence was 132 per 100,000 population. The highest and lowest incidence of the disease were 592 and 195 for 100,000 population in the years 2011 and 2017, respectively. The best model was SARIMA (3,1,1) (0,1,2)4(AIC: 324.3, BIC: 317.7 and RMSE: 0.167).

Conclusions

This study suggested that time series models would be useful tools for predicting cutaneous leishmaniasis incidence trends; therefore, the SARIMA model could be used in planning public health programs. It will predict the course of the disease in the coming years and run the solutions to reduce the cases of the disease.
ERBB2-PTGS2 axis promotes intervertebral disc degeneration by regulating senescence of nucleus pulposus cells
Authors: Li Zhao-Cheng. , An Fu.
Published: June 2023

Intervertebral disc degeneration (IDD) is considered one of the main causes of low back pain and lumbar disc herniation. Various studies have shown that disc cell senescence plays a critical role in this process. however, its role in IDD is yet unclear. In this study, we explored the role of senescence-related genes (SR-DEGs) and its underlying mechanism in IDD. A total of 1325 differentially expressed genes (DEGs) were identified using Gene Expression Omnibus (GEO) database GSE41883. 30 SR-DEGs were identified for further functional enrichment and pathway analysis, and two hub SR-DEGs (ERBB2 and PTGS2) were selected to construct transcription factor (TF)–gene interaction and TF-miRNA coregulatory networks, and 10 candidate drugs were screened for the treatment of IDD. Last but not least, in vitro experiments show that ERBB2 expression decreased and PTGS2 expression increased in human nucleus pulposus (NP) cell senescence model treated with TNF-α. After lentivirus-mediated overexpression of ERBB2, the expression of PTGS2 decreased and the senescence level of NP cells decreased. Overexpression of PTGS2 reversed the anti-senescence effects of ERBB2. The findings in this study suggested that ERBB2 overexpression further reduced NP cell senescence by inhibiting PTGS2 levels, which ultimately alleviated IDD. Taken together, our findings provide new insights into the roles of senescence-related genes in IDD and highlight a novel target of ERBB2-PTGS2 axis for therapeutic strategies.
Expression and characterization of recombinant IL-1Ra in Aspergillus oryzae as a system
Authors: Mahmoudi Azar Lena , Karaman Elif , Beyaz Burcu , Göktan Işılay , Eyüpoğlu Alp Ertunga , Kizilel Seda , Erman Batu , Gül Ahmet , Uysal Serdar
Published: June 2023

Background

The interleukin-1 receptor antagonist (IL-1Ra) is a crucial molecule that counteracts the effects of interleukin-1 (IL-1) by binding to its receptor. A high concentration of IL-1Ra is required for complete inhibition of IL-1 activity. However, the currently available Escherichia coli-expressed IL-1Ra (E. coli IL-1Ra, Anakinra) has a limited half-life. This study aims to produce a cost-effective, functional IL-1Ra on an industrial scale by expressing it in the pyrG auxotroph Aspergillus oryzae.

Results

We purified A. oryzae-expressed IL-1Ra (Asp. IL-1Ra) using ion exchange and size exclusion chromatography (53 mg/L). Sodium dodecyl sulfate–polyacrylamide gel electrophoresis (SDS-PAGE) analysis revealed that Asp. IL-1Ra is N-glycosylated and approximately 17 kDa in size. We conducted a comparative study of the bioactivity, binding kinetics, and half-life between Asp. IL-1Ra and E. coli IL-1Ra. Asp. IL-1Ra showed good bioactivity even at a low concentration of 0.5 nM. The in vitro half-life of Asp. IL-1Ra was determined for different time points (0, 24, 48, 72, and 96 h) and showed higher stability than E. coli IL-1Ra, despite exhibiting a 100-fold lower binding affinity (2 nM).

Conclusion

This study reports the production of a functional Asp. IL-1Ra with advantageous stability, without extensive downstream processing. To our knowledge, this is the first report of a recombinant functional and stable IL-1Ra expressed in A. oryzae. Our results suggest that Asp. IL-1Ra has potential for industrial-scale production as a cost-effective alternative to E. coli IL-1Ra.
Potential of methacrylated acemannan for exerting antioxidant-, cell proliferation-, and cell migration-inducing activities in vitro
Authors: Chou Meng-Han , Chen Yu-Hsu , Cheng Ming-Te , Chiang Hung-Chi , Chen Hou-Wen , Wang Ching-Wei
Published: June 2023

Background

Acemannan is an acetylated polysaccharide of Aloe vera extract with antimicrobial, antitumor, antiviral, and antioxidant activities. This study aims to optimize the synthesis of acemannan from methacrylate powder using a simple method and characterize it for potential use as a wound-healing agent.

Methods

Acemannan was purified from methacrylated acemannan and characterized using high-performance liquid chromatography (HPLC), Fourier-transform infrared spectroscopy (FTIR), and 1H-nuclear magnetic resonance (NMR). 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assays were performed to investigate the antioxidant activity of acemannan and its effects on cell proliferation and oxidative stress damage, respectively. Further, a migration assay was conducted to determine the wound healing properties of acemannan.

Results

We successfully optimized the synthesis of acemannan from methacrylate powder using a simple method. Our results demonstrated that methacrylated acemannan was identified as a polysaccharide with an acetylation degree similar to that in A. vera, with the FTIR revealing peaks at 1739.94 cm−1 (C = O stretching vibration), 1370 cm−1 (deformation of the H-C–OH bonds), and 1370 cm−1 (C–O–C asymmetric stretching vibration); 1H NMR showed an acetylation degree of 1.202. The DPPH results showed the highest antioxidant activity of acemannan with a 45% radical clearance rate, compared to malvidin, CoQ10, and water. Moreover, 2000 µg/mL acemannan showed the most optimal concentration for inducing cell proliferation, while 5 µg/mL acemannan induced the highest cell migration after 3 h. In addition, MTT assay findings showed that after 24 h, acemannan treatment successfully recovered cell damage due to H2O2 pre-treatment.

Conclusion

Our study provides a suitable technique for effective acemannan production and presents acemannan as a potential agent for use in accelerating wound healing through its antioxidant properties, as well as cell proliferation- and migration-inducing activities.
Operation Remote Immunity: exploring the impact of a service-learning elective in remote Indigenous communities
Authors: Mikhail Hannah , Button Brenton , LeBlanc Joseph , Cervin Catherine , Cameron Erin
Published: June 2023

Background

The novel coronavirus, COVID-19, emerged in December 2019. Shortly after, vaccines against the virus were distributed in Canada for public use, but the remoteness of many northern Indigenous communities in Ontario posed a challenge for vaccine distribution and dissemination. The Ministry of Health partnered with the Northern Ontario School of Medicine University (NOSMU) and the air ambulance service, Ornge, to assist in delivering the vaccination doses to 31 fly-in communities in the Nishnawbe Aski Nation and Moosonee, all within Ontario. These deployments were considered “service-learning electives” for Undergraduate and Postgraduate medical learners from NOSMU who joined the operation in two-week deployments. NOSMU is renowned for its social accountability mandate and gives its medical learners opportunities to participate in service-learning to enhance their medical skills and cultural sensitivity. The purpose of this study is to examine the relationship between social accountability and medical learners’ experiences during a service-learning elective in northern Indigenous communities in Ontario during the COVID-19 pandemic.

Methods

Data were collected through a planned post-placement activity completed by eighteen Undergraduate and Postgraduate medical learners, who participated in the vaccine deployment. The activity consisted of a 500-word reflective response passage. Thematic analysis was used to identify, analyze, and report the themes within the collected data.

Results

Two themes were identified by the authors, which formed a concise overview of the collected data: (1) confronting the realities of working in Indigenous communities; and (2) service-learning as a path to social accountability.

Conclusions

These vaccine deployments were an opportunity for medical learners to engage in service-learning and engage with Indigenous communities in Northern Ontario. Service-learning is an exceptional method which provides an opportunity to expand knowledge on the social determinants of health, social justice, and social accountability. The medical learners in this study reiterated the idea that learning medicine through a service-learning model leads to a greater depth of knowledge on Indigenous health and culture, and enhances medical knowledge compared to classroom learning.
Understanding workplace violence against medical staff in China: a retrospective review of publicly available reports
Authors: He Yumei , Holroyd Eleanor , Koziol-McLain Jane
Published: June 2023

Background

Workplace violence against medical staff in China is a widespread problem that has negative impacts on medical service delivery. The study aimed to contribute to the prevention of workplace violence against medical staff in China by identifying patterns of workplace violence, key risk factors, and the interplay of risk factors that result in workplace violence.

Methods

Ninety-seven publicly reported Chinese healthcare violent incidents from late 2013 to 2017 were retrospectively collected from the internet and analysed using content analysis. A modified socio-ecological model guided analysis of the violent incidents focusing on risk.

Results

Physical violence, yinao, or a combination of physical and verbal violence were the typical forms of violence reported. The findings identified risk at all levels. Individual level risk factors included service users’ unreasonable expectations, limited health literacy, mistrust towards medical staff, and inadequacy of medical staff’s communication during the medical encounter. Organisational level risk factors under the purview of hospital management included problems with job design and service provision system, inadequacies with environmental design, security measures, and violence response mechanisms within hospitals. Societal level risk factors included lack of established medical dispute-handling mechanisms, problems in legislation, lack of trust and basic health literacy among service users. Situational level risks were contingent on risk factors on the other levels: individual, organisational, and societal.

Conclusions

Interventions at individual, situational, organisational, and societal levels are needed to systematically address workplace violence against medical staff in China. Specifically, improving health literacy can empower patients, increase trust in medical staff and lead to more positive user experiences. Organizational-level interventions include improving human resource management and service delivery systems, as well as providing training on de-escalation and violence response for medical staff. Addressing risks at the societal level through legislative changes and health reforms is also necessary to ensure medical staff safety and improve medical care in China.
Population health management in Belgium: a call-to-action and case study
Authors: Steenkamer Betty , Vaes Bert , Rietzschel Ernst , Crombez John , De Geest Sabina , Demeure Fabian , Gielen Marijke , Hermans Michel P. , Teughels Stefan , Vanacker Peter , van der Schueren Thierry , Simoens Steven
Published: June 2023

Background

Although there are already success stories, population health management in Belgium is still in its infancy. A health system transformation approach such as population health management may be suited to address the public health issue of atherosclerotic cardiovascular disease, as this is one of the main causes of mortality in Belgium. This article aims to raise awareness about population health management in Belgium by: (a) eliciting barriers and recommendations for its implementation as perceived by local stakeholders; (b) developing a population health management approach to secondary prevention of atherosclerotic cardiovascular disease; and (c) providing a roadmap to introduce population health management in Belgium.

Methods

Two virtual focus group discussions were organized with 11 high-level decision makers in medicine, policy and science between October and December 2021. A semi-structured guide based on a literature review was used to anchor discussions. These qualitative data were studied by means of an inductive thematic analysis.

Results

Seven inter-related barriers and recommendations towards the development of population health management in Belgium were identified. These related to responsibilities of different layers of government, shared responsibility for the health of the population, a learning health system, payment models, data and knowledge infrastructure, collaborative relationships and community involvement. The introduction of a population health management approach to secondary prevention of atherosclerotic cardiovascular disease may act as a proof-of-concept with a view to roll out population health management in Belgium.

Conclusions

There is a need to instill a sense of urgency among all stakeholders to develop a joint population-oriented vision in Belgium. This call-to-action requires the support and active involvement of all Belgian stakeholders, both at the national and regional level.
Abortion care availability, readiness, and access: linking population and health facility data in Kinshasa and Kongo Central, DRC
Authors: Magalona Sophia , Thomas Haley L. , Akilimali Pierre Z. , Kayembe Dynah , Moreau Caroline , Bell Suzanne O.
Published: June 2023

Background

The Democratic Republic of Congo (DRC) legalized abortion in 2018 to preserve health and pledged to provide quality postabortion care (PAC), yet little is known about the availability of abortion care services and if facilities are prepared to provide them; even less is known about the accessibility of these services. Using facility and population-based data in Kinshasa and Kongo Central, this study examined the availability of abortion services, readiness of facilities to provide them, and inequities in access.

Methods

Data on 153 facilities from the 2017–2018 DRC Demographic and Health Survey Service Provision Assessment (SPA) were used to examine signal functions and readiness of facilities to provide services across three abortion care domains (termination of pregnancy, basic treatment of abortion complications, and comprehensive treatment of abortion complications). To examine PAC and medication abortion provision before and after abortion decriminalization, we compared estimates from the 2017–2018 SPA facilities to estimates from the Performance Monitoring for Action (PMA) data collected in 2021 (n = 388). Lastly, we assessed proximity to PAC and medication abortion using PMA by geospatially linking facilities to representative samples of 2,326 and 1,856 women in Kinshasa and Kongo Central, respectively.

Results

Few facilities had all the signal functions under each abortion care domain, but most facilities had many of the signal functions: overall readiness scores were > 60% for each domain. In general, readiness was higher among referral facilities compared to primary facilities. The main barriers to facility readiness were stock shortages of misoprostol, injectable antibiotics, and contraception. Overall, provision of services was higher post-decriminalization. Access to facilities providing PAC and medication abortion was almost universal in urban Kinshasa, but patterns in rural Kongo Central showed a positive association with education attainment and wealth.

Conclusion

Most facilities had many of the necessary signal functions to provide abortion services, but the majority experienced challenges with commodity availability. Inequities in accessibility of services also existed. Interventions that address supply chain challenges may improve facility readiness to provide abortion care services, and further efforts are needed to narrow the gap in accessibility, especially among poor women from rural settings.
A double-blinded randomized placebo-controlled non-inferiority trial protocol for postoperative infections associated with canine pyometra
Authors: Ylhäinen Anna , Mölsä Sari , Grönthal Thomas , Junnila Jouni , Rantala Merja , Laitinen-Vapaavuori Outi , Thomson Katariina
Published: June 2023

Background

Pyometra is a common infectious condition, especially in elderly bitches. In addition to an infected uterus, dogs may have concurrent urinary tract infection (UTI). The preferred treatment is surgical removal of the ovaries and uterus, whereupon the general prognosis is excellent. In addition, antimicrobial therapy is frequently prescribed for postoperative treatment. However, no research exists on the benefit of postoperative antimicrobial treatment in uncomplicated canine pyometra. Antimicrobial resistance has become a major challenge in treatment of bacterial infections. Diminishing overuse of antimicrobial agents is essential for controlling the development of antimicrobial resistance in both animals and humans.

Methods

This double-blinded, randomized, placebo-controlled two-arm clinical trial is designed to compare the incidence of postoperative infections associated with surgical treatment of uncomplicated pyometra followed by two different treatment protocols. For the study, 150 dogs presenting with an uncomplicated pyometra and that are to undergo surgical treatment will be recruited. Dogs with body weight < 3 or > 93 kg, complicated pyometra, primary disease increasing the risk of infection, or immunosuppressive medication will be excluded. All dogs will receive one dose of sulfadoxine-trimethoprim intravenously as an antimicrobial prophylaxis. Postoperatively, dogs will be randomized to receive either a five-day course of placebo or an active drug, sulfadiazine-trimethoprim orally. During the surgery microbiological samples will be taken from urine and uterine content. The follow-up includes a control visit in 12 days and an interview of the owner 30 days after surgery. If bacteriuria is detected at the time of surgery, a urinary sample will be cultured for bacterial growth at the control visit. The primary outcome is the incidence of a postoperative surgical site infection (SSI), and the secondary outcome is the occurrence of clinical UTI with bacteriuria. Intention-to-treat and per-protocol analyses will be performed to compare outcome incidences between the treatment groups.

Discussion

Research-based evidence is necessary to create treatment guidelines for judicious use of antimicrobials. The goals of this study are to provide evidence for reducing the use of antimicrobials and targeting the treatment to patients proven to benefit from it. Publishing the trial protocol will increase transparency and promote open science practices.