bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of chemoradiotherapy on the dynamics of circulating lymphocyte subsets in patients with non-metastatic nasopharyngeal carcinoma
Authors: Yi Lilan , Gu Yinfang , Guo Longhua , Zou Xiaofang , Wu Guowu
Published: February 2025

Background

Chemoradiotherapy (CRT) is the primary and most effective treatment for non-metastatic nasopharyngeal carcinoma (NPC), exerting antitumor effects by modulating immune cells. Distinct subpopulations of immune cells exhibit specific sensitivity to CRT. This study aimed to characterize the dynamics of the proportions and absolute counts of peripheral circulating lymphocyte subsets in non-metastatic NPC before and after CRT, and to elucidate their association with clinical responses.

Methods

A total of 91 patients with non-metastatic NPC were enrolled. Flow cytometry was employed to detect the expression of CD3, CD4, CD8, CD56, and CD19 on peripheral blood cells. The composition of lymphocyte subsets before treatment, post-completion of CRT, and one month following CRT was retrospectively analyzed. Further, the relationship between the composition of circulating lymphocyte subpopulations and distinguish clinical responses was evaluated.

Results

The proportion of CD3+ T cells showed an initial increase followed by a significant decrease at baseline, post-completion of CRT, and one month following CRT. The proportions of CD3+CD4+ T cells, CD4+/CD8+ ratio, and CD19+ B cells continued to decline at baseline, post-completion of CRT, and one month following CRT, while the proportions of CD3+CD8+ T cells and CD16+CD56+ NK cells progressively increased. The absolute counts of circulating lymphocyte subsets, including CD3+ T cells, CD3+CD4+ T cells, CD3+CD8+ T cells, CD45+, CD19+ B cells, and CD16+CD56+ NK cells, demonstrated a trend of initial decrease followed by an increase at baseline, post-completion of CRT, and one month following CRT. Patients with complete response (CR) and partial response (PR) presented similar dynamic trends in the percentages and absolute counts of circulating lymphocyte subpopulations at baseline, post-completion of CRT, and one month following CRT. The proportions and absolute counts of CD3+CD4+ T cells in CR patients were distinctly higher than those in PR patients at the end of CRT, whereas the absolute counts of CD16+CD56+ NK cells were remarkably lower in CR patients compared to PR patients. The baseline proportion and absolute count of CD19+ B cells, as well as the absolute count of CD3+CD4+ T cells, were significantly higher in CR patients compared with PR patients.

Conclusion

CRT induced dynamic alterations in the peripheral lymphocyte profile of non-metastatic NPC patients. Assessing the variations in the distribution of circulating lymphocyte subsets among patients with different clinical treatment responses will be helpful in developing protocols for the concurrent utilization of immunotherapeutic drugs and CRT.
Two rare cases of primary clear cell adenocarcinoma of the urethra: clinical experience, case report and literature review
Authors: Jiang Bohao , Hu Jiyuan , Wang Benqiao , Liu Xujia , Tong Ling , Xu Yitong , Zhang Hao
Published: February 2025

Background

Primary clear cell adenocarcinoma of the urethra (CCAU) is a kind of extremely rare genitourinary cancer. Despite the similarity in the clinical manifestations of these reported cases, diagnosis and determination of standard therapy remain challenging due to the rarity of findings and similarity with other urethral tumors.

Case presentation

Herein, we reported two cases of CCAU with the same chief complaint of hematuria: a 71-year-old female and a 66-year-old male. The male patient reported concomitant symptoms of frequent and painful urination. CT scans show abnormal enhancements. After a cystoscopy examination, both patients are diagnosed with malignant urethral tumors. Surgical resections and additional pathological examinations support the diagnosis of CCAU (palliative resection for case 1 and transurethral resection for case 2). Case 1 undergone progression 6 months after initial treatment with transurethral resection and chemotherapy with a 15-month overall survival. In contrast, the prognosis of case 2 remained uneventful 10 months after surgery without recurrence. After presenting our cases, we launched a literature review that included 23 articles and 33 cases of CCAU to summarize the characteristics of the disease.

Conclusion

Primary clear cell adenocarcinoma of the urethra is a rare malignant urethral tumor with controversial histological origins. Primary symptoms include hematuria and changes in voiding habits. Middle-aged and elderly females are more susceptible to primary clear-cell adenocarcinoma of the urethra. Unfortunately, it is difficult to differentiate primary clear-cell adenocarcinoma of the urethra from other urethral tumors due to similar clinical features. However, imaging tools such as CT, MRI, and cystoscopy are adjunctive in confirming diagnoses. Even though surgical resection is the primary treatment to relieve clinical symptoms, prevent recurrence, and confirm diagnosis, no standard surgical protocol is available. The therapeutic effect of postoperative adjuvant therapies remains unclear. Future investigations on CCAU are necessary to advance clinical knowledge and to provide treatment guidance.
Perception of uncertainty concerning illness and coping styles among parents of children with central nervous system tumors: a correlation analysis
Authors: Lan Bai , Qinqin Zhao , Ying Li , Zhihuan Zhou
Published: February 2025

Purpose

To investigate the perception of uncertainty concerning illness among parents of children with central nervous system tumors and their coping styles and to analyze correlations to provide a basis for developing targeted intervention measures.

Methods

We studied 108 parents of children with central nervous system tumors admitted from January 2023 to January 2024. Information about these children and their parents were analyzed using the modified Parents' Perception of Uncertainty in Illness Scale (PPUS) and the Coping Health Inventory for Parents to calculate correlations of parents' perceptions of uncertainty concerning illness and coping styles.

Results

The total score of PPUS was 45.28 ± 8.428 for the parents of children. The most common coping styles were the maintenance of family unity, cooperation, and optimism. The correlation analysis revealed that parents' perception of uncertainty concerning illness negative correlated with coping style (p < 0.05).

Conclusion

The parents of children with central nervous system tumors show substantial perception of uncertainty concerning the illness and are susceptible to lack of communication and expression. Positive, effective coping methods should be adopted to reduce uncertainty concerning illness to reduce the psychological pressure on parents.
Use of a specialized peptide-based enteral formula containing medium-chain triglycerides for enteral tube feeding in children with cerebral palsy and previous tube feeding intolerance on standard enteral formula: a prospective observational TolerUP study
Authors: Kansu Aydan , Kutluk Gunsel , Caltepe Gonul , Arikan Cigdem , Urganci Nafiye , Tumgor Gokhan , Yuce Aysel , Tuna Kirsaclioglu Ceyda , Demir Arzu Meltem , Demirbas Fatma , Usta Merve , Yavuz Sibel , Demirtas Guner Duygu , Gumus Ersin , Dalgic Buket , Dogan Yasar , Gerenli Nelgin , Kocamaz Halil , Gulerman Fulya , Sag Elif , Alptekin Sarioglu Aysugul , Eksi Bozbulut Neslihan , Teker Duztas Demet , Altug Demirol Hatice , Celtik Coskun , Gungor Olcay , Demiroren Kaan , Uncuoglu Aydogan Aysen , Bekem Ozlem , Arslan Zeynep , Cakir Murat , Ekici Arzu , Uyar Aksu Nihal , Ecevit Cigdem , Erdogan Simge
Published: February 2025

Objective

Use of peptide-based formulas supplemented with medium chain triglycerides (MCTs) is considered a beneficial strategy to decrease the tube-feeding associated gastrointestinal tolerance. In children with cerebral palsy (CP), overall effects of enteral tube feeding as well as the utility of peptide-based specialized enteral formulas in those with gastrointestinal intolerance have not been extensively studied. This study aimed to evaluate the utility of enteral tube feeding via specialized peptide-based formula containing MCTs in children with CP in terms of gastrointestinal intolerance, anthropometrics, defecation characteristics and parental satisfaction with enteral formula.

Methods

Children with CP who received enteral tube feeding via specialized peptide-based formula containing MCTs were included in this prospective observational study. Anthropometrics (z scores for weight for age [WFA], weight for height [WFH], triceps skinfold thickness [TSFT] and mid-upper arm circumference [MUAC]), gastrointestinal intolerance symptoms, defecation frequency and stool patterns and formula satisfaction were recorded at baseline and during 6-month follow up.

Results

A total of 96 children with CP (mean ± SD age: 5.6 ± 3.2 years, 56.3% were boys) were included. Significant improvements were noted in MUAC, TSFT and WFH z scores at the 6th month visit. The rate of “severe symptoms” and the likelihood of Type-1/Type-2 (constipation) stool pattern were significantly decreased. Majority of parents were satisfied with the study formula.

Conclusion

Our findings revealed favorable efficacy and safety of using a specialized peptide-based formula containing MCT in provision of enteral tube feeding among children with CP in terms of improved anthropometrics, amelioration of gastrointestinal intolerance symptoms and normalization of bowel movements along with a high parental satisfaction.
Review of rhythm disturbances in patient after fontan completion: epidemiology, management, and surveillance
Authors: Wall Kevin , Hebson Camden , D’Souza Roshan , Balaji Seshadri
Published: February 2025

Purpose

The Fontan operation is commonly associated with alterations in heart rhythms, both tachycardic and bradycardic. Despite modifications to attempt to mitigate these complications, arrythmias still frequently occur. The purpose of this review is to examine the literature regarding the scope of the problem, therapeutic options, and current recommendations regarding screening and surveillance.

Recent findings

Modifications to the original Fontan procedure, antiarrhythmic medications, and improvements in catheter ablation procedures have improved the management of patients with arrhythmias following Fontan palliation. There is growing interest in the role of junctional rhythm in the role of Fontan dysfunction. While chronotropic incompetence has often been blamed for poor exercise testing, there is evidence that decreased performance may be related to ventricular filling and Fontan hemodynamics.

Tachyarrhythmias are an important cause of mortality and morbidity after the Fontan operation. Prompt and aggressive management of arrhythmias with the goal of maintaining sinus rhythm is vital. Management strategies such as anti-arrhythmic medications, ablation, anti-tachycardia pacing and Fontan conversion should be seen as complementary and used early to prevent hemodynamic deterioration. Bradyarrythmias likely also contribute to Fontan failure. Pacing is the primary management strategy with evidence supporting use of atrial pacing. However, ventricular pacing seems to often lead to deleterious effects. Current guidelines recommend surveillance with Holter monitor every 2–3 years in adolescents and every 1–2 years in adults. Future directions for research include further assessment of junctional rhythm and its management as well as further identifying patients in which pacing would be beneficial.
Alginate oligosaccharides trigger multiple defense responses in tobacco and induce resistance to Phytophthora infestans
Authors: Peng Chune , Xu Wei , Wang Xipan , Meng Fanxiao , Zhao Yumeng , Wang Qingbin , Wang Xinkun , Lodi Rathna Silviya , Dong Xiaodan , Zhu Changxiang , Peng Lizeng
Published: February 2025

Alginate oligosaccharides (AOSs), important plant immunity inducers, are widely used in agriculture because of their important role in the biological control of crop diseases. However, the mechanism by which AOSs induce plant resistance to pathogens is not clear. Here, we report AOS with a degree of polymerization of 2–5, which was obtained by a newly reported enzyme Aly2. AOS treatment exhibited high activity in enhancing resistance to Phytophthora infestans (P. infestans). AOS significantly induced reactive oxygen species (ROS) accumulation, calcium influx, stomata closure, and callose deposition. The salicylic acid (SA) synthesis-related gene and the defense-related genes were upregulated after AOS treatment. A transcriptome file generated from AOS-treated seedlings verified the SA pathway and suggested the presence of chitin elicitor receptor kinase (CERK). The subsequent results showed that AtCERK1 binds AOS tightly, suggesting that AtCERK1 is responsible for AOS recognition. This study laid a theoretical foundation for the broad application of AOS.
Exploring drought tolerance in wild and traditional olive varieties from the Southern Levant
Authors: Adi Basappa , Dag Arnon , Ben-Dor Elad , Gabay Gilad , Barazani Oz
Published: February 2025

Local olive germplasm of the southern Levant includes wild populations of var. sylvestris and local traditional cultivars that are thought to be well-adapted to the region’s arid conditions. By controlling water availability, we tested the response of the Barnea cultivar, two local traditional cultivars (MLL1 and MLL7) and var. sylvestris to low (100%), moderate (33%), and severe (10%) evapotranspiration (ETa) conditions. Measurements of stomatal conductance, relative water content, stem water potential, and the net photosynthesis showed a stronger response of the Barnea cultivar to reduced ETa conditions in comparison to the other three investigated groups. Additionally, when exposed to 100% ETa, the net photosynthesis capacity of MLL1 was significantly higher than that measured in MLL7. Therefore, net photosynthesis, as an indicator of tree productivity, can explain the dominance of MLL1 (Souri cultivar) in local traditional orchards and the negligible abundance of MLL7 (unknown cultivar) as a fruit-bearing tree. Considering that climate change is already influencing olive cultivation, the results of this study stress the potential of the southern Levant local olive germplasm in maintaining sustainable olive horticulture.
A tale of two belongings: social and academic belonging differentially shape academic and psychological outcomes among university students
Authors: Lawrie Smaranda Ioana , Carter Delwin B. , Nylund-Gibson Karen , Kim Heejung S.
Published: February 2025

The benefits of belonging in academic settings are well established; however, past empirical research has for the most part conflated academic and social belonging. This study utilized latent class analysis (LCA) with a sample of undergraduates (N = 837) to determine whether distinct classes or profiles of belonging exist on a college campus and whether class membership predicts academic and psychological outcomes. Four distinct belonging classes emerged: High Social, High Academic belonging (35%), Low Social, High Academic belonging (15%), High Social, Low Academic belonging (38%), and Low Social, Low Academic belonging (12%). The results show that belonging classes play different roles. For academic outcomes (GPA), academic belonging was important, but not social belonging. For psychological outcomes (stress and self-esteem), both academic and social belonging mattered but academic belonging mattered more. These findings demonstrate that investigating the distinctive roles of academic and social belonging is a fruitful theoretical and applied endeavor.
The impact of empathy on professional identity among Chinese junior male nurses: a moderated mediation model
Authors: Mu Hezi , Cui Yi , Zhang Lihua , Liu Qin , Zhang Lanfang , Yang Haoshuang , Chen Changchang , Liu Na , Zhang Yinling
Published: February 2025

Background

Nursing care is essential, but the role of junior male nurses in medical and health services is underestimated; thus, many junior male nurses leave the profession due to a lack of professional identity.

Objective

This study examined how the mediating effect of emotional intelligence and the moderating role of locomotion mode influence the relationship between empathy and professional identity among Chinese junior male nurses.

Methods

This cross-sectional descriptive study was conducted among junior male nurses in China from December 2021 to May 2022. We asked participants from ten hospitals to complete a questionnaire regarding empathy, emotional intelligence, locomotion mode, and professional identity. Bootstrap and simple slope methods were used to test the moderated mediation model.

Results

Emotional intelligence partly mediated the effects of perspective-taking on professional identity (β = 0.253, p < 0.05). Furthermore, locomotion mode moderated the relationships between perspective-taking and emotional intelligence, perspective-taking and professional identity, and emotional intelligence and professional identity (β = 0.136, p < 0.01; β = 0.107, p < 0.05; β = −0.155, p < 0.01).

Conclusion

The findings revealed that,the mediating effect of emotional intelligence on the relation between perspective-taking and professional adaptability was moderated by locomotion mode. Whereas. These findings are meaningful for early intervention and the improvement of professional identity among junior male nurses.
Nicotine dependence is associated with an increased risk of developing chronic, non-communicable inflammatory disease: a large-scale retrospective cohort study
Authors: Kridin Khalaf , Papara Cristian , Bieber Katja , De Luca David A. , Klein Jan Philipp , Ludwig Marlene A. , Curman Philip , Vorobyev Artem , Dempfle Astrid , Ludwig Ralf J.
Published: February 2025

Introduction

Chronic, non-communicable inflammatory diseases (CIDs) affect a large portion of the population, imposing a significant morbidity, encompassing a substantial mortality. Thus, they are a major medical burden with a high unmet need. CIDs develop over the span of several years, and the risk of developing CIDs has been linked to genetic and environmental factors. Thus, modification of environmental factors is a promising approach for the prevention of CIDs. Among modifiable environmental factors that have been linked to the CID risk is nicotine dependence. However, for only few CIDs, compelling evidence suggests that nicotine dependence increases (e.g., rheumatoid arthritis and asthma) or decreases (e.g., pemphigus) the CID risk. For most CIDs, there are inconsistent, scant, or no reports on the risk of CID associated with nicotine dependence.

Methods

To address this gap, we leveraged TriNetX, analyzing data from over 120 million electronic health records (EHRs). Using propensity score matching (PSM) to control for age, sex, ethnicity, and other CID risk factors, we contrasted the risk of developing any or any of the 38 CIDs in 881,192 EHRs from individuals with nicotine dependence to PSM-matched unexposed counterparts.

Results

The analytical pipeline was validated by demonstrating an increased risk of individuals exposed to nicotine dependence for subsequent diagnosis of myocardial infarction, malignant neoplasm of the lung, and chronic obstructive pulmonary disease. Overall, 16.8% of individuals with nicotine dependence developed CIDs, compared to 9.6% of individuals not exposed to nicotine dependence (hazard ratio 2.12, confidence interval 2.10–2.14, p < 0.0001). Investigating single CIDs, nicotine dependence imposed increased risks for 23 of the 38 investigated diseases, i.e., dermatomyositis, granulomatosis with polyangiitis, pyoderma gangrenosum, and immune thrombocytopenic purpura. The sex-stratified analysis revealed few sex-specific differences in CID risk.

Discussion

Our study emphasizes the importance of preventive measures targeting nicotine addiction to reduce the global burden of CIDs.
Evaluating the effectiveness of integrated traditional Chinese and Western treatment based on symptom grading: a study protocol for a multi-center, randomized controlled trial of patients with depressive disorder
Authors: Mai Jiaxi , Zhou Tingwei , Wang Chen , Ye Junrong , Chen Jiao , Wang Wen , Pan Yuanxin , Wei Yanheng , Yuan Lexin , Yang Hang , Wu Shengwei , Guo Jianxiong , Xiao Aixiang
Published: February 2025

Background

Approximately one-third of depressed individuals receive treatment globally. The application rate of traditional Chinese medicine (TCM) for treating depression globally remains relatively low. The proposed study presents a pilot trial to evaluate the effectiveness of interventions at different levels in improving depression status in community populations.

Methods

A randomized controlled trial will be conducted in two communities in Guangdong, China, with a follow-up period of 12 weeks. Participants will be randomly allocated to control or intervention groups. Participants in the control group will be assigned to routine care, while participants in the intervention group will receive TCM intervention measures. The participants in the intervention group will receive integrated traditional Chinese and Western treatment according to the symptom grading of depression severity. Primary outcome measurements include the Patient Health Questionnaire (PHQ-9), the Hamilton Depression Rating Scale (HAMD-17), and the Self-Rating Depression Scale (SDS). Secondary outcome measurements include the Athens Insomnia Scale (AIS), the Epworth Sleepiness Scale (ESS), the Multiple Mental Health Literacy Scale (MMHL), the Short-Form 12 (SF-12), and the Treatment Emergent Symptom Scale (TESS). The data will be collected at baseline (T1), 2 weeks after intervention (T2), 4 weeks after intervention (T3), 8 weeks after intervention (T4), and 12 weeks after intervention (T5).

Discussion

This study will provide an experimental basis for the effectiveness of hierarchical integrated traditional Chinese and Western medicine (ITCWM) in improving the condition of patients with different degrees of depression. At the end of the study, it is expected for the experimental group to have an improvement in depressive symptoms and sleep quality and an enhancement in mental health awareness.

Clinical trial registration

http://www.chictr.org.cn, identifier ChiCTR2300075169.
ENVOLVER+: a tool for the promotion of positive nursing practice environments
Authors: Ribeiro Olga Maria Pimenta Lopes , Schacht Ligia , Gonçalves Mariana Filipa Mendes , Faria Ana da Conceição Alves , Ribeiro Marlene Patrícia , Ventura-Silva João Miguel Almeida
Published: February 2025

Introduction

Patients, nurses, and the organization itself can benefit from a good work environment. One of the weaknesses most often cited by nurses was the lack of involvement and participation in setting workplace policies. Using games is a promising strategy for promoting positive caregiving environments. The purpose of this study is to describe the process by which the ‘ENVOLVER+’ board game has been developed and validated.

Methods

We carried out a methodological study from September 2023 to May 2024 in three phases: (1) modified e-Delphi to validate the content to be included in the game; (2) development of the prototype board game; (3) application of the game in four practice contexts.

Results

The four sessions of the ‘ENVOLVER+’ game lasted an average of 80 min. Each session had twelve participants in four groups. At the end of the sessions, we asked the participants to comment on the advantages and disadvantages of the game.

Discussion

The ‘ENVOLVER+’ game can be a valuable tool in promoting a positive nursing practice environment by providing an innovative and interactive approach to ensuring nurse involvement and participation.
Analysis of community older adult care facility construction and demand differentiation based on residential area and population attribute differences
Authors: Liu Yanzhe , Wang Yaolei , Guo Guiping , Yang Tubao , Liu Yupeng , Gao Hongmei , Jiang Tiejian , Li Xiangmin
Published: February 2025

Currently, China has fully entered an aging society. The construction and efficient utilization of community older adult care facilities have become urgent issues that need to be addressed. To explore the differences in the needs of older adult people in the community for older adult care services, this study selected three basic needs: life care, medical security, and cultural and entertainment, as the primary indicators of community older adult care needs. A community older adult care demand indicator system was constructed, which included three primary indicators and 11 secondary indicators. Based on the indicator system, a survey questionnaire was designed, and validity analysis was conducted using Kaiser Meyer Olkin test and Bartlett sphericity test. 490 survey questionnaires were distributed to 22 communities in Wuhan, and 447 valid questionnaires were collected, with a response rate of 91.22%. The results indicated that there were significant differences in the distribution of older adult population in different communities. Different types of residential areas and housing prices affected its construction and use. The demand for home-based older adult care services in communities varied significantly. Through analysis of variance, the type of residential area did not show significant differences in older adult bathing assistance, daytime care, mental comfort, sports activities, etc. (p > 0.05), while there were statistical differences in nighttime care, medical care, rehabilitation care, older adult canteens, chess and card entertainment, artistic activities, etc. (p < 0.05). No significant difference existed in different housing prices for daytime care, nighttime care, mental comfort, and fitness activities (p > 0.05), but there was statistical difference for rehabilitation care, medical care, chess and card entertainment, senior dining halls, and artistic activities (p < 0.05). According to logistic regression analysis, the income level, self-care ability, and education level had obvious impacts on their basic needs for life care, with OR values of 11.68, 2.621, and 1.792, respectively. This study can provide effective reference for building diversified community home-based older adult care service facilities.
Prevalence and associated factors of adult overweight and obesity in Southwestern China
Authors: Zhang Xiao-Qiang , Du Hua-An , Huang Chuan , Liu Jian-Xiong , Hu Yong-Mei , Liu Ya , Huang Xiao-Bo
Published: February 2025

Background

Data on the prevalence of overweight and obesity in Southwestern China were limited. The aims of this study were to estimate the prevalence of overweight/obesity and their associated factors in this area.

Methods

A cross-sectional study was conducted from 2013 to 2014 in Chengdu and Chongqing, two megacities in Southwestern China. Data were obtained from questionnaires, physical examinations and lab tests. A total of 11,096 residents aged 35–79 years were included in the final analysis of this study.

Results

The prevalence of overweight and obesity among adults aged 35–79 years in Southwestern China were 29.7 and 4.4%, respectively. Multivariable logistic regression analysis suggested that women, non-smokers, ex-smokers, being hypertensive and diabetic were related to higher obesity prevalence, and that physically active adults and those aged 65–79 years were less likely to have obesity.

Conclusion

Obesity and overweight were prevalent in Southwestern China, especially among women, those with diabetes and/or hypertension, and those who have quitted smoking for more than 3 years.
Trend of skin cancer mortality and years of life lost in China from 2013 to 2021
Authors: Li Jingyi , Zeng Jiaqi , Yang Yuanchao , Huang Biran
Published: February 2025

Background

The mortality rates of skin cancer in Chinese population are increasing. However, research on skin cancer trends in China is limited. This study aimed to estimate the mortality trends of skin cancer in China within 2013–2021.

Methods

A retrospective analysis of skin cancer deaths within 2013–2021 was performed using the China death cause surveillance dataset compiled by the National Health Commission Statistics Information Center and the China Center for Disease Control and Prevention Chronic Non-Communicable Diseases Prevention and Control Center. The mortality rates of skin cancer were stratified by gender, age group, and area (urban or rural).

Results

From 2013 to 2021 in China, the crude mortality rate (CMR) of skin cancer increased, and the age-standardized mortality rate (ASMR), and age-standardized years of life lost (YLL) rate decreased. The ASMR and age-standardized YLL rate were 0.85/100,000 and 18.95/100,000 in 2013, respectively, and decreased to 0.75/100,000 and 16.84/100,000, respectively, in 2021. From 2013 to 2021, the CMR, ASMR, and age-standardized YLL rate of skin cancer were higher in males than in females and higher in rural areas rather than in urban ones. In terms of the highest age-specific mortality rate, it appeared in the age group of over 85 years old.

Conclusion

The burden of skin cancer remained heavily from 2013 to 2021 in China. Especially males, older adult, and rural residents had higher mortality. Thus, effective measures and strategies should be taken to reduce the incidence and mortality of skin cancer.
Global burden of ischemic heart disease in older adult populations linked to non-optimal temperatures: past (1990–2021) and future (2022–2050) analysis
Authors: Liu Lihui , He Yisong , Huang Gang , Zeng Yangxi , Lu Jiaan , He Ru , Chen Haiqing , Gu Yuheng , Hu Qingwen , Liao Bin , Wan Juyi
Published: February 2025

Background

Ischemic heart disease (IHD) is a leading cause of death and disability, particularly affecting the older adult population. Extreme temperatures, especially very low and very high temperatures, are known to exacerbate cardiovascular disease burden. With the ongoing global climate change, understanding the impact of non-optimal temperatures on IHD burden becomes increasingly important, especially in vulnerable populations such as the older adult.

Methods

This study used data from the Global Burden of Disease Study 2021 (GBD 2021) to analyze the spatiotemporal trends of low and high temperatures on IHD burden in the older adult population (aged 60 and above) from 1990 to 2021. We used age-standardized rates (ASR), annual percentage change (EAPC), and the Bayesian age-period-cohort (BAPC) model to forecast 2050. Additionally, the geographic differences in IHD burden were analyzed using World Bank regions.

Results

From 1990 to 2021, the IHD burden in the older adult population was mainly attributed to low temperatures. However, it has increased the burden of IHD due to high temperatures, especially in tropical and low-income regions. The analysis of gender difference revealed that men are usually more affected by high temperatures, though generally, women are more sensitive to low temperatures. Forecasts are that in the future, the burden of IHD due to high temperatures will continue to rise, especially in areas with limited adaptive capacity.

Conclusion

Although low temperature remains the most important contributor to IHD burden among the older adult, the burden attributable to high temperature is on the rise, which increases the need to address the extreme temperature fluctuation. That is more so in poor-income and tropical regions where the most vulnerable populations bear a higher risk for health. Thus, there is an urgent need to develop adaptive public health measures against the dual health risks from extreme temperatures. The findings emphasize that targeted interventions are necessary, with adjustments in regional differences and gender-specific risks to effectively address the growing health threats from climate change.
Enhanced vehicle routing for medical waste management via hybrid deep reinforcement learning and optimization algorithms
Authors: Khallaf Norhan , Abd-El Rouf Osama , Algarni Abeer D. , Hadhoud Mohy , Kafafy Ahmed
Published: February 2025

Modern technologies, particularly artificial intelligence, play a crucial role in improving medical waste management by developing intelligent systems that optimize the shortest routes for waste transport, from its generation to final disposal. Algorithms such as Q-learning and Deep Q Network enhance the efficiency of transport and disposal while reducing environmental pollution risks. In this study, artificial intelligence algorithms were trained using Homogeneous agent systems with a capacity of 3 tons to optimize routes between hospitals within the Closed Capacitated Vehicle Routing Problem framework. Integrating AI with pathfinding techniques, especially the hybrid A*-Deep Q Network approach, led to advanced results despite initial challenges. K-means clustering was used to divide hospitals into zones, allowing agents to navigate the shortest paths using the Deep Q Network. Analysis revealed that the agents’ capacity was not fully utilized. This led to the application of Fractional Knapsack dynamic programming with Deep Q Network to maximize capacity utilization while achieving optimal routes. Since the criteria used to compare the algorithms’ effectiveness are the number of vehicles and the utilization of the total vehicle capacity, it was found that the Fractional Knapsack with DQN stands out by requiring the fewest number of vehicles (4), achieving 0% loss in this metric as it matches the optimal value. Compared to other algorithms that require 5 or 7 vehicles, it reduces the fleet size by 20 and 42.86%, respectively. Additionally, it maximizes vehicle capacity utilization at 100%, unlike other methods, which utilize only 33 to 66% of vehicle capacity. However, this improvement comes at the cost of a 9% increase in distance, reflecting the longer routes needed to serve more hospitals per trip. Despite this trade-off, the algorithm’s ability to minimize fleet size while fully utilizing vehicle capacity makes it the optimal choice in scenarios where these factors are critical. This approach not only improved performance but also enhanced environmental sustainability, making it the most effective and challenging solution among all the algorithms used in the study.
Intraductal papilloma of minor salivary gland: a case report and literature review
Authors: Wang Yifei , Li Xiaowei , Yao Chunfang , Wu Yi , Ni Hengli
Published: February 2025

Intraductal papilloma is a rare benign neoplasm arising from the secretory ducts of the salivary glands. A 79-year-old man with an intraductal papilloma located in the minor salivary gland of sublingual mucosa was reported. The lesion, characterized by extensive internal papillomatous hyperplasia, was confirmed through histopathology and immunohistochemistry. We conducted a literature review to clarify intraductal papilloma and differences between inverted ductal papilloma, highlighting the significance of CK7 and MUC-1 immunohistochemical staining in diagnosing intraductal papilloma.
Pervasive systemic disparities: medical-related gaslighting, trauma, and distrust among LGBTQ+ people in the United States
Authors: Nowaskie Dustin Z. , Blackwood Dehandra , Garcia Frank
Published: February 2025

Introduction

Historically, LGBTQ+ people have and continue to endure discrimination across many contexts, including healthcare. Research and data from nationwide samples in the United States regarding medical-related stigma experienced by LGBTQ+ people are scant.

Methods

A cross-sectional survey was distributed online to a national sample of United States residents. Participants answered questions about their healthcare, including experiences with medical-related gaslighting, trauma, and trust.

Results

Compared to cisgender and heterosexual people (n = 857), LGBTQ+ people (n = 815) reported significantly higher rates of medical-related gaslighting (46.5% vs. 26.5%, ORs 1.75–2.80) and trauma (18% vs. 8.9%, ORs 1.63–2.66). Likewise, LGBTQ+ people conveyed significantly less trust (ORs 0.46–0.53) in primary care providers (59.8% vs. 74.1%), medical specialists (56.5% vs. 71.7%), pharmaceutical companies (17% vs. 28%), insurance companies (15.9% vs. 29.3%), and U.S. healthcare systems (17.8% vs. 30.4%).

Discussion

Medical-related gaslighting, trauma, and distrust are pervasive systemic disparities among LGBTQ+ people. Addressing these challenges will require ongoing, lifelong motivation, dedication, and commitment for LGBTQ+ education, advocacy, and leadership to dismantle current prejudiced practices and foster more inclusive, supportive, affirming healthcare environments.
A randomized comparative effectiveness trial to evaluate two programs for promotion of physical activity after spinal cord injury in manual wheelchair users
Authors: Martinez Jenna M. , Haubert Lisa L. , Eberly Valerie J. , Weiss Walter B. , Rankin Jeffery W.
Published: February 2025

Objective

The goal of this study was to determine the effectiveness of a novel whole of day activity accumulation (WODAA) physical exercise program. WODAA physical activity and physiological outcomes were compared to outcomes from individuals using a traditional planned arm crank exercise (PACE) program. Both programs included progressive exercise instruction and goal setting over a 4-month period, and utilization of a wrist-worn activity monitor (Fitbit Blaze/Versa, Fitbit Inc., San Francisco, CA).

Design

Longitudinal, randomized, comparative effectiveness trial with collaborative goal setting.

Setting

Research laboratory at a rehabilitation hospital and in participants' homes and communities.

Participants

Forty-nine manual wheelchair users with paraplegia.

Outcome measures

Physical activity measurements and cardiometabolic data were collected before, during, and after the program. The primary measures were amount of daily arm activity (Steps) and time spent in different activity and heart rate zones.

Results

Relative to baseline measures, participants in the WODAA group had significantly more daily arm movement/propulsion activity (Steps) and time spent in the Fairly and Very Active Zones and the Cardio Heart Rate Zone compared to those in the PACE group over the final month of the intervention (p < 0.05). Minutes spent in other Activity and Heart Rate Zones were similar between groups. At final evaluation, diastolic blood pressure after a 6-Minute Push Test was significantly lower in the WODAA group, while no differences were found in distance traveled, systolic, or pre-test diastolic blood pressures. Metabolic bloodwork and shoulder pain scores did not change and were similar between groups.

Conclusion

Depending on the measure used, these findings suggest that a WODAA approach to PA is comparable or more effective than a traditional PACE program in promoting physical activity in low-active manual wheelchair users with paraplegia.
Eucalyptus-based livelihoods: enhancing household food security and resilience in Northwest Ethiopia
Authors: Belay Fasika , Mulugeta Messay , Makonnen Teferee
Published: February 2025

Farmers in northwest Ethiopia have been transforming their livelihood strategies, however, the impact of this transformation on food security status and resilience is hardly investigated. The study aimed to analyze the contribution of livelihood strategy transformation to farmers' food security and capital assets in the Senan district, Ethiopia. A multistage sampling technique was utilized, and a total of 332 households were taken, of whom 166 households that had transformed their livelihood strategy, and 166 households had not. The results of the independent sample t-test revealed a statistically significant difference in average scores for the Household Food Insecurity Access Scale (M = 8.06 compared to 11.29) and the Household Dietary Diversity Score (M = 5.28 compared to 4.73) between households with and without eucalyptus plantations. The econometric analysis revealed that variables such as total land holding size, annual income, and livelihood diversification had a positive influence on the probability of a household being categorized as food secure. Moreover, the outcome of the livelihood asset index reveals that households that possess eucalyptus plantations exhibit higher indices for natural, physical, financial, and social assets compared to households without plantations. However, households that own eucalyptus plantations demonstrate a lower index for human capital than those without eucalyptus plantations. These findings underscore the role of eucalyptus plantations in enhancing food security and improving livelihoods for farmers in the study area. Furthermore, diversifying income sources through eucalyptus plantations can significantly amplify its overall benefits for local households.
Understanding barriers to veterinary involvement in dairy calf health management
Authors: Edwards Kristen Y. , Abuelo Angel , LeBlanc Stephen J. , DeVries Trevor J. , Steele Michael A. , Costa Joao H. C. , Renaud David L.
Published: February 2025

The objectives of this cross-sectional study were to identify barriers to veterinary involvement in calf health and assess knowledge gaps in calf care among American and Canadian bovine veterinarians. A questionnaire was administered to veterinarians, collecting data on demographics, satisfaction with calf health management knowledge, involvement in decision-making, satisfaction with calf health involvement, frequency of calf health record analysis and feedback, topics of interest for further learning, and preferred learning formats. Multivariable logistic regression models were used to assess associations between variables and outcomes. Only 28% of veterinarians frequently reviewed calf health records, and 44% made actionable recommendations after reviewing them. Female veterinarians were more likely than male veterinarians to frequently review calf health records (Odds ratio – OR: 2.9, 95% CI: 1.2–7.3). Additionally, the odds of frequently reviewing records increased with the amount of time spent working with calves (OR: 10.2 per 10% increment, 95% CI: 10.0–10.5). Veterinarians highly satisfied with their knowledge of neonatal calf diarrhea (NCD) prevention were more likely to make recommendations based on records (OR: 11.6, 95% CI: 1.9–72.4). Additionally, those frequently reviewing records were more likely to provide feedback (OR: 15.5, 95% CI: 4.0–60.3). Incomplete records was the most common reason for not reviewing records (60% of respondents) and why actionable recommendations were made less frequently than “most of the time” (67% of respondents). Veterinarians were least confident in their knowledge regarding milk feeding and weaning recommendations but they were interested in learning more about post-weaning nutrition and automated calf feeders. Further, they preferred conference presentations for continuing education. These findings suggest that veterinary involvement in calf health could be improved by facilitating better data capture and enhancing veterinarian knowledge.
RF-YOLOv7: A Model for the Detection of Poor-Quality Grapes in Natural Environments
Authors: Li Changyong , Zhang Shunchun , Ma Zhijie
Published: February 2025

This study addresses the challenges of detecting inferior fruits in table grapes in natural environments, focusing on subtle appearance differences, occlusions, and fruit overlaps. We propose an enhanced green grape fruit disease detection model named RF-YOLOv7. The model is trained on a dataset comprising images of small fruits, sunburn, excess grapes, fruit fractures, and poor-quality grape bunches. RF-YOLOv7 builds upon the YOLOv7 architecture by integrating four Contextual Transformer (CoT) modules to improve target-detection accuracy, employing the Wise-IoU (WIoU) loss function to enhance generalization and overall performance, and introducing the Bi-Former attention mechanism for dynamic query awareness sparsity. The experimental results demonstrate that RF-YOLOv7 achieves a detection accuracy of 83.5%, recall rate of 76.4%, mean average precision (mAP) of 80.1%, and detection speed of 58.8 ms. Compared to the original YOLOv7, RF-YOLOv7 exhibits a 3.5% increase in mAP, with only an 8.3 ms increase in detection time. This study lays a solid foundation for the development of automatic detection equipment for intelligent grape pruning.
The Role of Ligninolytic Enzymes in Sustainable Agriculture: Applications and Challenges
Authors: Gałązka Agnieszka , Jankiewicz Urszula , Orzechowski Sławomir
Published: February 2025

The most important ligninolytic enzymes in lignin degradation include laccases and peroxidases (lignin peroxidase, manganese peroxidase, versatile peroxidase). White-rot fungi (e.g., Cerrena sp., Phlebia sp. or Trametes sp.) are their main source in nature. The ability of ligninolytic enzymes to degrade both phenolic and non-phenolic compounds has found its application in sustainable agriculture. In recent years, ligninolytic enzymes’ important role has been demonstrated in the biodegradation of lignin, a poorly degradable component of plant biomass, and in removing hazardous environmental pollutants that threaten human health. These enzymes can be successfully used in waste management, composting, improving soil health and fertility, or bioremediation. The challenges of applying lignin-degrading enzymes such as laccases and peroxidases include their stability and resistance to harsh conditions. Still, the rapid development of biotechnological technologies offers the tools to overcome them. Applying biological solutions in agricultural systems involving microorganisms and their metabolic products will significantly reduce the environmental impact and develop a circular economy.
The Effects of Supplemental Feeding on Methane Emissions from Yak Grazing in the Warm Season
Authors: Ma Wanhao , Malik Muhammad Irfan , Iwaasa Alan D. , Wang Hong , Wang Hongli , Yang Jinfen , Bai Binqiang , Jing Jianwu , Hu Guangwei , Hao Lizhuang , Liu Shujie
Published: February 2025

The yak industry constitutes a pivotal segment of livestock development across the Qinghai–Tibetan Plateau and adjacent pastoral regions. Existing studies have shown that supplemental feeding for grazing yaks significantly improves meat quality and growth performance, but its effect on enteric methane (CH4) emission from yaks has never been reported, so the present experiment aimed to investigate the effect of supplemental feeding of grazing yaks on CH4 emissions in three different periods of the warm season. Thirty male yaks were randomly assigned to two groups, with 15 yaks per group, The groups were designated as the grazing group (GR), with traditional grazing methods and with an initial body weight of 94.56 ± 3.9 kg, and the supplemental feeding group (GRS) with an initial body weight of 95.01 ± 4.1 kg, which received 1500 g/d of supplemental feed for 120 days. The methane emissions of the two groups were measured at the late regreening period (LRP), the greening-grass period (GGP), and the browning period (BRP) using the SF6 tracer method. The results showed that GRS increased (p < 0.01) the total DMI during warm season but decreased (p < 0.01) the forage intake at the LRP and GGP, resulting in a significantly reduced methane yield per kg of BW gain and per kg of DMD in warm-season grazing yaks (p < 0.01), a significantly reduced methane production per kg of DMI and methane energy to gross energy ratio in grazing yaks during the GGP (p < 0.05), and a similarly significantly decrease in methane production per kg of DMI and methane energy to gross energy ratio in grazing yaks during the BRP (p < 0.01). In conclusion, supplemental nutrition for grazing yaks during the warm season in alpine grasslands significantly enhances growth performance, reduces methane emissions, and improves dietary energy utilization efficiency.