bluuebunny/crossref_metadata_2025 huggingface dataset:
Data from Epithelial Expressed B7-H4 Drives Differential Immunotherapy Response in Murine and Human Breast Cancer
Authors: Wescott Elizabeth C. , Sun Xiaopeng , Gonzalez-Ericsson Paula , Hanna Ann , Taylor Brandie C. , Sanchez Violeta , Bronzini Juliana , Opalenik Susan R. , Sanders Melinda E. , Wulfkuhle Julia , Gallagher Rosa I. , Gomez Henry , Isaacs Claudine , Bharti Vijaya , Wilson John T. , Ballinger Tarah J. , Santa-Maria Cesar A. , Shah Payal D. , Dees Elizabeth C. , Lehmann Brian D. , Abramson Vandana G. , Hirst Gillian L. , Brown Swigart Lamorna , van ˈt Veer Laura J. , Esserman Laura J. , Petricoin Emanuel F. , Pietenpol Jennifer A. , Balko Justin M.
Published: April 2024

Abstract
Combinations of immune checkpoint inhibitors (ICI, including anti-PD-1/PD-L1) and chemotherapy have been FDA approved for metastatic and early-stage triple-negative breast cancer (TNBC), but most patients do not benefit. B7-H4 is a B7 family ligand with proposed immunosuppressive functions being explored as a cancer immunotherapy target and may be associated with anti-PD-L1 resistance. However, little is known about its regulation and effect on immune cell function in breast cancers. We assessed murine and human breast cancer cells to identify regulation mechanisms of B7-H4 in vitro. We used an immunocompetent anti-PD-L1–sensitive orthotopic mammary cancer model and induced ectopic expression of B7-H4. We assessed therapy response and transcriptional changes at baseline and under treatment with anti-PD-L1. We observed B7-H4 was highly associated with epithelial cell status and transcription factors and found to be regulated by PI3K activity. EMT6 tumors with cell-surface B7-H4 expression were more resistant to immunotherapy. In addition, tumor-infiltrating immune cells had reduced immune activation signaling based on transcriptomic analysis. Paradoxically, in human breast cancer, B7-H4 expression was associated with survival benefit for patients with metastatic TNBC treated with carboplatin plus anti-PD-L1 and was associated with no change in response or survival for patients with early breast cancer receiving chemotherapy plus anti-PD-1. While B7-H4 induces tumor resistance to anti-PD-L1 in murine models, there are alternative mechanisms of signaling and function in human cancers. In addition, the strong correlation of B7-H4 to epithelial cell markers suggests a potential regulatory mechanism of B7-H4 independent of PD-L1.
Significance:
This translational study confirms the association of B7-H4 expression with a cold immune microenvironment in breast cancer and offers preclinical studies demonstrating a potential role for B7-H4 in suppressing response to checkpoint therapy. However, analysis of two clinical trials with checkpoint inhibitors in the early and metastatic settings argue against B7-H4 as being a mechanism of clinical resistance to checkpoints, with clear implications for its candidacy as a therapeutic target.
Renal Cystinuria and Immune Cells (T Lymphocytes) Dysfunction: What We Know about?
Authors: Caprio Francesca , Orefice Giuseppe , Secondulfo Floriana , Carone Fabiani Filippo , Iervolino Anna , Capasso Giovambattista , Simeoni Mariadelina , Zacchia Miriam , Trepiccione Francesco , Capolongo Giovanna
Published: April 2024

Introduction: Cystinuria (CYS) is the most common monogenic kidney stone disease. Methods: Starting from an unusual case of CYS associated to primary sclerosing cholangitis, inflammatory bowel disease (IBD), and autoimmune hepatitis in a young male, we carefully review the literature and propose here a working hypothesis regarding the potential risk of cystinuric patients to develop conditions due to immune system dysregulation. To corroborate this hypothesis, we retrospectively evaluate the frequency of dysimmunity in a monocentric cohort including 36 cystinuric patients compared to healthy and disease controls. Results: CYS patients have an increased prevalence of atopic disease compared to disease controls (p = 0.03) and 16.7% of CYS subjects were diagnosed with allergic disease to a variety of antigens. Conclusion: Further studies are needed to define the relationship between proximal tubular transport defect of CYS and dysregulated immunity.
Diplopoda from Rondônia, Brasil. I. Two new genera and species of Spirostreptidae
Authors: Hoffman Richard L.
Published: April 2024

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Aportes al conocimiento del sistema reproductor de imagos y reinas De Termitidae Neotropicales (Isoptera, Nasutitermitinae Y Termitinae)
Authors: Godoy Maria C. , Torales Gladys J.
Published: April 2024

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A New (and very old) Species of Leptotyphlops from Northeastern Brasil (Serpentes, Leptotyphlopidae)
Authors: Vanzolini P. E.
Published: April 2024

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As implicações da pandemia da Covid-19 no cotidiano das crianças sob suas próprias perspectivas
Authors: Camargo Ana Paula , Fernandes Amanda Dourado Souza Akahosi
Published: April 2024

Introduction: Faced with the Covid-19 pandemic and the emergency measures to control and combat the spread of the virus, children were severely impacted, as their dailylives were interrupted. Objective: To understand how children experienced daily life during the Covid-19 pandemic, from their own perspective. Methodology: exploratory study, with a qualitative approach, carried out with 19 children aged 9 to 11 years old, linked to a public school. For data collection, graphic elucidation and a semi-structured interview were used. Both the narratives arising from the graphic elucidations and the data produced in the interviews were analyzed based on thematic analysis. Results: three themes emerged - Playing as the main activity in daily life; The use of screens during the pandemic; School and learning. The results showed that playing continued to be present, based on the inventiveness of the children. The use of technological devices was one of the main entertainment resources used, they barely managed to apprehend remotely. Conclusion: it is expected that the data collected can contribute to a better understanding of one of the biggest health crises ever experienced, favoring new reflections and discussions about public policies and interventionstrategies aimed at this population.
Intervenções não farmacológicas para manejo de delirium: atuação de terapeutas ocupacionais no centro de terapia intensiva
Authors: Bernardo Thais Thatiane , Delsim Juliana Carla
Published: April 2024

Delirium is an acute neurological disorder frequently observed in patients admitted to the Intensive Care Unit, characterized by transient changes in consciousness and cognition, generally for a short period of time. The objective of this research was to identify and categorize non-pharmacological occupational therapeutic interventions for the management of delirium in adult individuals treated at the intensive care center of a highly complex public teaching hospital. Through a qualitative, retrospective, applied study, based on documentary analysis, with an exploratory descriptive character, sociodemographic variables, diagnoses, information on assessments and occupational therapeutic interventions for the non-pharmacological management of delirium and outcome of the cases of 26 individuals. The majority of the sample was composed of males, with the predominant age group of 25-44 years and almost half had completed elementary school II. Most hospitalizations were due to traumatic urgencies. Of the most prevalent occupational therapeutic interventions in non-pharmacological management, the following stand out: temporal and spatial orientation; environmental organization and positioning; affective touch and welcoming and the naming, function and orientation of the devices respectively. Twenty-two non-pharmacological interventions for managing delirium were identified and categorized.
O brincar na zona rural: uma comparação entre o ontem e o hoje
Authors: Queiroz Tamyres de França , Lima Ana Carollyne Dantas de , Marcelino Juliana Fonseca de Queiroz , Silva Lucas de Paiva , Albuquerque Raquel Costa
Published: April 2024

Playing is considered one of the main occupations of the child. Based on the understanding of influences on playing, this work proposes to describe the childhood playing of rural residentes, from an intergenerational perspective. This is a descriptive-exploratory study, with a qualitative approach, carried out with eight mothers and eight daughters living in ​​Limoeiro-PE. In the data collection, the interview technique, the Drawing-History procedure and the field diary were used. For analysis, Bardin's Content Analysis methodology was adopted based on Romeu Gomes' framework. The results identified similarities in play between both generations: space where play usually takes place, family members as the main partners in play and the characteristics of games, toys and pranks. The insertion of new technologies into children´s daily lives, the ease in purchasing industrialized toys and the quality of the toys are seen as the most obvious differences. Given the objective of this study, the number of participants, and unique characteristics of the sampling, the data presented may differ from similar studies in relation to the characteristics of games, toys and games experienced in rural spaces. It could become a guide for new studies and concerns involving the topic.
Heterogeneous Forgetting Rates and Greedy Allocation in Slot-Based Memory Networks Promotes Signal Retention
Authors: Jones BethAnna , Snyder Lawrence , Ching ShiNung
Published: April 2024

A key question in the neuroscience of memory encoding pertains to the mechanisms by which afferent stimuli are allocated within memory networks. This issue is especially pronounced in the domain of working memory, where capacity is finite. Presumably the brain must embed some “policy” by which to allocate these mnemonic resources in an online manner in order to maximally represent and store afferent information for as long as possible and without interference from subsequent stimuli. Here, we engage this question through a top-down theoretical modeling framework. We formally optimize a gating mechanism that projects afferent stimuli onto a finite number of memory slots within a recurrent network architecture. In the absence of external input, the activity in each slot attenuates over time (i.e., a process of gradual forgetting). It turns out that the optimal gating policy consists of a direct projection from sensory activity to memory slots, alongside an activity-dependent lateral inhibition. Interestingly, allocating resources myopically (greedily with respect to the current stimulus) leads to efficient utilization of slots over time. In other words, later-arriving stimuli are distributed across slots in such a way that the network state is minimally shifted and so prior signals are minimally “overwritten.” Further, networks with heterogeneity in the timescales of their forgetting rates retain stimuli better than those that are more homogeneous. Our results suggest how online, recurrent networks working on temporally localized objectives without high-level supervision can nonetheless implement efficient allocation of memory resources over time.
3. Status and Indoctrination
Authors: Richter Michael , Rubinstein Ariel
Published: April 2024

In this chapter, the parameter which brings harmony is a commonly accepted public ordering on the set of alternatives. Its main interpretation is of a status ranking. Society restricts an agent's ability to replace the alternative he has. He can only move “down” to a “less prestigious” one, but not “up”.

The main equilibrium notion is a status equilibrium which is a public ordering and a feasible profile of choices such that no agent strictly prefers any weakly lower-status alternative than the one he is assigned to. As in a market, deviations are purely self-serving and contemplated without regard to feasibility.

We also study a variant, the initial status equilibrium, which operates on a model of an economy that is extended to include an initial profile. In the initial profile, each agent is assigned an alternative which he can always choose and which together with the public ordering determines his choice set. In an initial status equilibrium no agent strictly prefers any weakly lower-status alternative than the one he is assigned to initially.

The equilibrium concepts are discussed in abstract, ``welfare'' theorems are shown, and they are applied to a variety of examples.
Prevention of Catheter-Associated Bloodstream Infections in Hemodialysis Patients
Authors: He Xiaoping , Hu Yingying , Fu Qianqian
Published: April 2024

This study aimed to assess the efficacy of preventive measures against catheter-associated bloodstream infections in hemodialysis patients. Seventy patients undergoing hemodialysis treatment at our hospital from January 2020 to January 2023 were recruited and randomly assigned in a
1:1 ratio to receive either conventional nursing (control group) or targeted preventive nursing (observation group), with 35 cases in each group. Outcome measures for nursing effects assessment included nursing outcomes, the incidence of catheter-related bloodstream infections, patient stress,
and quality of life. Targeted preventive nursing demonstrated a significantly lower incidence of catheter-related bloodstream infection and adverse catheter events compared to conventional care (P <0.05). Moreover, targeted preventive nursing significantly reduced catheter retention
duration in comparison to conventional care (P <0.05). The higher quality of nursing associated with targeted preventive nursing was evident in the elevated nursing quality scores (P <0.05). Patients who underwent targeted preventive nursing exhibited milder stress compared
to those receiving routine care, as indicated by lower hemodialysis stress scale (HSS) scores (P <0.05). Furthermore, the observation group, receiving targeted preventive nursing, reported higherWorld Health Organization quality of life (WHOQOL-BREF) scores than the control group,
suggesting an improved quality of life (P <0.05). Targeted preventive care for catheter-associated bloodstream infections in hemodialysis patients not only fortifies the rigor and standard of care but also effectively reduces the infection rate, shortens catheter retention time,
alleviates patient stress, and enhances their overall quality of care and survival.
Bibliometric Analysis on Stem Cell Transplantation Treatment for Premature Ovarian Failure
Authors: Yimamuyushan Seyida , Yi Jinling , Muheremu Aikeremujiang
Published: April 2024

To carry out bibliometric analysis on stem cell transplantations for premature ovarian insufficiency (POI), and quickly grasp the clinical significance and potential of stem cell transplantation in the treatment of POI, the current study used the Web of Science core collection to retrieve
relevant literature using keywords “stem cells” and “primary ovarian dysfunction”. VOSviewer was used for network visualization analysis of key words, authors, institutions, and countries. The results showed that, annual publications increased steadily from 2000 to
2023 with some fluctuations. China, Shanghai Jiao Tong University, and “Human Reproduction” are the countries, organizations, and journals with the highest output. The keyword map reflects that fertility preservation and hormone replacement therapy are currently hot topics in the
treatment of POI. Mesenchymal stem cells (MSCs) and in vitro activation may have the highest potential to be applied in the future. Based on the current bibliometric analysis, the study on clinical efficacy, prognosis, and mechanism of POI treatment using MSCs and their exosomes is
a research hotspot with great potential in this field.
Female-selective mechanisms promoting migraine
Authors: Singh Shagun , Kopruszinski Caroline M. , Watanabe Moe , Dodick David W. , Navratilova Edita , Porreca Frank
Published: April 2024

Sexual dimorphism has been revealed for many neurological disorders including chronic pain. Prelicinal studies and post-mortem analyses from male and female human donors reveal sexual dimorphism of nociceptors at transcript, protein and functional levels suggesting different mechanisms that may promote pain in men and women. Migraine is a common female-prevalent neurological disorder that is characterized by painful and debilitating headache. Prolactin is a neurohormone that circulates at higher levels in females and that has been implicated clinically in migraine. Prolactin sensitizes sensory neurons from female mice, non-human primates and humans revealing a female-selective pain mechanism that is conserved evolutionarily and likely translationally relevant. Prolactin produces female-selective migraine-like pain behaviors in rodents and enhances the release of calcitonin gene-related peptide (CGRP), a neurotransmitter that is causal in promoting migraine in many patients. CGRP, like prolactin, produces female-selective migraine-like pain behaviors. Consistent with these observations, publicly available clinical data indicate that small molecule CGRP-receptor antagonists are preferentially effective in treatment of acute migraine therapy in women. Collectively, these observations support the conclusion of qualitative sex differences promoting migraine pain providing the opportunity to tailor therapies based on patient sex for improved outcomes. Additionally, patient sex should be considered in design of clinical trials for migraine as well as for pain and reassessment of past trials may be warranted.
Physicians’ experiences with reporting domestic violence against women: a cross-sectional study in Saudi Arabia
Authors: Almuammar Sarah , Alhowig Wijdan
Published: April 2024

Background

Domestic violence, including violence against women, is a global public health concern with significant implications for women’s health and well-being. Despite its prevalence, healthcare providers often face barriers when reporting cases of domestic violence. This study aims to estimate the prevalence of reporting domestic violence against women by physicians and to explore the barriers to reporting.

Methods

This cross-sectional study was conducted at King Abdulaziz University Hospital in Saudi Arabia. Data were collected through a self-administered questionnaire distributed to physicians from various specialties. The questionnaire covered sociodemographic information, physicians’ experiences with domestic violence cases, and barriers to reporting.

Results

The study included 400 physicians. Approximately 39.8% of physicians reported encountering cases of domestic violence, with 33.0% documenting such cases. Reporting rates varied among occupational levels, with specialists (50.85%) and consultants (38.78%) reporting more frequently than general practitioners (16.67%) and residents (28.93%). Physicians with over 10 years of experience were more likely to report (49.40%, p = 0.001). Among the various categories of barriers examined, a lower score in physician-related barriers was the only category significantly associated with higher reporting rates (p < 0.01). However, health administration- and victim-related barriers were not significant factors in reporting.

Conclusion

This study highlights variations in reporting rates among medical specialties and underscores the positive impact of physician experience on reporting domestic violence cases. Addressing physician-related barriers and promoting a reporting culture are crucial steps toward combating domestic violence in Saudi Arabia. Healthcare providers play a vital role in identifying and addressing this public health issue.
RNA methylation patterns, immune characteristics, and autophagy-related mechanisms mediated by N6-methyladenosine (m6A) regulatory factors in venous thromboembolism
Authors: Zhang Deshuai , Fu Wenxia , Zhu Shiwei , Pan Yitong , Li Ruogu
Published: April 2024

Recent studies have found a link between deep vein thrombosis and inflammatory reactions. N6-methyladenosine (m6A), a crucial element in immunological regulation, is believed to contribute to the pathophysiology of venous thromboembolism (VTE). However, how the m6A-modified immune microenvironment is involved in VTE remains unclear. In the present study, we identified a relationship between VTE and the expression of several m6A regulatory elements by analyzing peripheral blood samples from 177 patients with VTE and 88 healthy controls from public GEO databases GSE19151 and GSE48000. We used machine learning to identify essential genes and constructed a diagnostic model for VTE using multivariate logistic regression. Unsupervised cluster analysis revealed a marked difference between m6A modification patterns in terms of immune cell infiltration, inflammatory reactivity, and autophagy. We identified two m6A-related autophagy genes (i.e., CHMP2B and SIRT1) and the crucial m6A regulator YTHDF3 using bioinformatics. We also examined two potential mechanisms through which YTHDF3 may affect VTE. m6A modification, immunity, and autophagy are closely linked in VTE, offering novel mechanistic and therapeutic insights.
The characteristics of microbiome in the upper respiratory tract of COVID-19 patients
Authors: Zhang Xilong , Nurxat Nadira , Aili Jueraiti , Yasen Yakupu , Wang Qichen , Liu Qian
Published: April 2024

Background

Co-infection with other pathogens in coronavirus disease 2019 (COVID-19) patients exacerbates disease severity and impacts patient prognosis. Clarifying the exact pathogens co-infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is premise of the precise treatment for COVID-19 patients.

Methods

Sputum samples were collected from 17 patients in the COVID-19 positive group and 18 patients in the COVID-19 negative group. DNA extraction was performed to obtain the total DNA. Sequencing analysis using 16S and ITS rRNA gene was carried out to analyze the composition of bacterial and fungal communities. Meanwhile, all the samples were inoculated for culture.

Results

We did not observe significant differences in bacterial composition between the COVID-19 positive and negative groups. However, a significantly higher abundance of Candida albicans was observed in the upper respiratory tract samples from the COVID-19 positive group compared to the COVID-19 negative group. Moreover, the Candida albicans strains isolated from COVID-19 positive group exhibited impaired secretion of aspartyl proteinases.

Conclusion

COVID-19 positive patients demonstrate a notable increase in the abundance of Candida albicans, along with a decrease in the levels of aspartyl proteinases, indicating the alteration of microbiota composition of upper respiratory tract.
Study of cabbage antioxidant system response on early infection stage of Xanthomonas campestris pv. campestris
Authors: Liu Zeci , Wang Jie , Yue Zhibin , Wang Jue , Dou Tingting , Chen Tongyan , Li Jinbao , Dai Haojie , Yu Jihua
Published: April 2024

Black rot, caused by Xanthomonas campestris pv. campestris (Xcc) significantly affects the production of cabbage and other cruciferous vegetables. Plant antioxidant system plays an important role in pathogen invasion and is one of the main mechanisms underlying resistance to biological stress. Therefore, it is important to study the resistance mechanisms of the cabbage antioxidant system during the early stages of Xcc. In this study, 108 CFU/mL (OD600 = 0.1) Xcc race1 was inoculated on “zhonggan 11” cabbage using the spraying method. The effects of Xcc infection on the antioxidant system before and after Xcc inoculation (0, 1, 3, and 5 d) were studied by physiological indexes determination, transcriptome and metabolome analyses. We concluded that early Xcc infection can destroy the balance of the active oxygen metabolism system, increase the generation of free radicals, and decrease the scavenging ability, leading to membrane lipid peroxidation, resulting in the destruction of the biofilm system and metabolic disorders. In response to Xcc infection, cabbage clears a series of reactive oxygen species (ROS) produced during Xcc infection via various antioxidant pathways. The activities of antioxidant enzymes such as superoxide dismutase (SOD), peroxidase (POD), and catalase (CAT) increased after Xcc infection, and the ROS scavenging rate increased. The biosynthesis of non-obligate antioxidants, such as ascorbic acid (AsA) and glutathione (GSH), is also enhanced after Xcc infection. Moreover, the alkaloid and vitamin contents increased significantly after Xcc infection. We concluded that cabbage could resist Xcc invasion by maintaining the stability of the cell membrane system and improving the biosynthesis of antioxidant substances and enzymes after infection by Xcc. Our results provide theoretical basis and data support for subsequent research on the cruciferous vegetables resistance mechanism and breeding to Xcc.
Integrated genome-wide association and transcriptomic analysis to identify receptor kinase genes to stripe rust resistance in wheat germplasm from southwestern China
Authors: Qiao Liang , Luo Jianfei , Wang Huiyutang , Kong Yixi , Du Tingting , Qin Peng , Yang Baoju
Published: April 2024

Stripe rust of wheat, caused by Puccinia striiformis f. sp. tritici (Pst), is one of the most important diseases of wheat worldwide. Identification of new and elite Pst-resistance loci or genes has the potential to enhance overall resistance to this pathogen. Here, we conducted an integrated genome-wide association study (GWAS) and transcriptomic analysis to screen for loci associated with resistance to stripe rust in 335 accessions from Yunnan, including 311 landraces and 24 cultivars. Based on the environmental phenotype, we identified 113 protein kinases significantly associated with Pst resistance using mixed linear model (MLM) and generalized linear model (GLM) models. Transcriptomic analysis revealed that 52 of 113 protein kinases identified by GWAS were up and down regulated in response to Pst infection. Among these genes, a total of 15 receptor kinase genes were identified associated with Pst resistance. 11 candidate genes were newly discovered in Yunnan wheat germplasm. Our results revealed that resistance alleles to stripe rust were accumulated in Yunnan wheat germplasm, implying direct or indirect selection for improving stripe rust resistance in elite wheat breeding programs.
Waistline to thigh circumference ratio as a predictor of MAFLD: a health care worker study with 2-year follow-up
Authors: Hao Xiaoyan , He Honghai , Tao Liyuan , Zhao Wei , Wang Peng
Published: April 2024

Background

This study aimed to determine whether the waist-to-thigh ratio (WTTR) is associated with the incidence of metabolic-associated fatty liver disease (MAFLD) in health care workers.

Methods

There were 4517 health care workers with baseline data and results from 2 follow-up examinations. We divided the subjects into 3 groups according to baseline WTTR and used the Cox hazard regression model to estimate MAFLD risk.

Results

The WTTRs were categorized by tertiles at baseline using the values 1.58 and 1.66. Patients with higher WTTR tended to have significantly greater values for the following factors, body mass index (BMI), fasting blood glucose (FPG), systolic blood pressure, diastolic blood pressure, total cholesterol (TC), triglycerides (TG), low-density lipoprotein-cholesterol (LDL-C) and neck circumference. The incidence of MAFLD significantly increased with increasing WTTR tertiles (5.74%, 12.75% and 22.25% for the first, second and third tertiles, respectively, P < 0.05 for trend). Kaplan-Meier(K-M) survival analysis revealed a significant tendency towards increased MAFLD risk with increasing WTTR tertile. In the fully adjusted model, the hazard ratios (95% CIs) for MAFLD in the second, third WTTR tertiles compared with the first quartile were 2.17(1.58,2.98), 3.63(2.70,4.89), respectively, third neck circumference tertiles compared with the first quartile were 2.84(1.89,4.25), 8.95(6.00,13.35), respectively. Compared with those of individuals with a BMI > 23 kg/m2, the associations between WTTR and MAFLD incidence were more pronounced in subjects with a BMI < 23 kg/m2. Similarly, the difference in neck circumference was more pronounced in these patients with a BMI < 23 kg/m2.

Conclusions

Our results revealed that the WTTR is an independent risk factor for MAFLD, and there was a dose‒response relationship between the WTTR and MAFLD risk. The neck circumference was significantly different in subjects with a BMI < 23 kg/m2. This approach provides a new way to predict the incidence rate of MAFLD.
The relationship between marital status and cognitive impairment in Chinese older adults: the multiple mediating effects of social support and depression
Authors: Zhang Donghang , Zheng Wenhao , Li Keyang
Published: April 2024

Background

Marital status is a potentially essential factor for cognitive impairment. Relevant research examining the potential pathways through which the marital status of spouseless older people is associated with cognitive impairment needs to be more adequate. Therefore, this study aims to investigate the serial mediating effects of various forms of social support and depression between marital status and cognitive impairment in older Chinese people.

Methods

This study involved a secondary analysis of data from the 2014–2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), with a total of 2,647 Chinese older adults and 53.6% being males. Mediation analysis using the SPSS process macro was conducted.

Results

The results indicated that marital status was significantly predictive of cognitive impairment among older people, and those with a spouse exhibited higher cognitive functioning. Informal social support and depression were found to play partial mediating roles in the association between marital status and cognitive impairment. The findings also revealed that marital status was unrelated to formal social support, and no association between formal social support and cognitive impairment was found.

Conclusions

The study findings highlight the need for social service providers to design programs for promoting connections associated with informal support to reduce their risk of depression and cognitive impairment and for policymakers to develop effective formal social support systems for older people without spouses. This study indicated that older people could regain the benefits of marriage to lower the risk of depression and improve their mental health.
Determinants of early antenatal care visits among women of reproductive age in Ghana: evidence from the recent Maternal Health Survey
Authors: Abuosi Aaron Asibi , Anaba Emmanuel Anongeba , Daniels Anita Anima , Baku Anita Asiwome Adzo , Akazili James
Published: April 2024

Background

Antenatal care services play a crucial role in promoting positive pregnancy outcomes by facilitating the early identification of pregnancy risk factors and early diagnosis of pregnancy-related complications. This study aimed to assess the frequency and timing of ANC attendance of mothers in Ghana as well as determine the predictors of early ANC attendance.

Methods

The data for this study was extracted from the 2017 Ghana Maternal Health Survey (GMHS). The study population was women aged 15–49 years with a live birth or stillbirth in the 5 years preceding the survey. Data was analysed using STATA/SE version 17, using descriptive statistics and multiple binary logistic regression analysis.

Results

It was found that 44.4% of the women obtained eight (8) + ANC visits. A majority of the women (66%) initiated ANC visits in the first trimester of pregnancy. Early ANC visit was significantly associated with age of the respondent, education, wealth index, religion, region and reason for first ANC visit. For instance, women between the ages of 25–29 years (aOR = 1.75, 95% CI: 1.31–2.33) had increased odds of early ANC visit compared to those aged 15–19 years. Women with higher education (aOR = 1.83, 95% CI: 1.27–2.64) were about twice as likely to initiate early ANC visits compared to those with no education. Also, women in the highest wealth index (aOR = 2.43, 95% CI: 1.83–3.23) were two times more likely to initiate early ANC visits compared to those in the lowest wealth index.

Conclusion

This study has shown that a majority of women in Ghana start their first ANC visit during the first trimester of pregnancy. A considerable proportion of the women failed to meet the WHO’s recommendation of having a minimum of eight ANC visits throughout pregnancy. Early ANC visit was determined by socio-demographic factors. Going forward, it should be a priority for stakeholders to ensure that ANC services are accessible to all mothers in a timely manner.
Effects of a single subanesthetic dose of esketamine on postoperative subthreshold depressive symptoms in patients undergoing unilateral modified radical mastectomy: a randomised, controlled, double-blind trial
Authors: Wang Huanwei , Te Rigen , Zhang Jianxing , Su Yanbing , Zhou Hongxia , Guo Na , Chi Dongmei , Huang Wan
Published: April 2024

Background

Breast cancer is the most common malignant tumor in females worldwide. During disease development, breast cancer patients suffer anxious and depressed, which may lead to worse quality of life or even higher mortality. Esketamine has been regarded as an antidepressant in breast cancer patients with mild or moderate depression. Here, we wonder whether the administration of esketamine could reduce the postoperative depressive symptom score of breast cancer patients who have no preoperative depression.

Methods

A total of 64 patients treated with unilateral modified radical mastectomy were randomly divided into an experimental group (esketamine group, Group E) and a control group (Group C), with 32 cases in each one. After anesthesia induction, Group C received 0.2 ml/kg of normal saline intravenously and Group E was administered 0.2 mg/kg intravenous esketamine. The primary outcome was the Patient Health Questionnaire-9 (PHQ-9) scores. The secondary outcomes included the Visual Analogue Scale (VAS) scores for pain, inflammatory markers, perioperative-related indicators, and the incidence of postoperative delirium, nausea and vomiting.

Results

The PHQ-9 score on postoperative day (POD) 1 in Group E declined from the preoperative level, while the score in Group C was higher than before, and the former was far lower than the latter (P = 0.047). There is no statistically significant difference in PHQ-9 scores between Group E and Group C on POD 3, 7, and 30. Moreover, the postoperative leukocyte level of Group E was higher than that of Group C, and the difference was statistically significant (P = 0.030).

Conclusions

A single subanesthetic dose of esketamine can result in lower postoperative score on subthreshold depressive symptoms compared to the Group C on POD 1, without increasing the occurrence of postoperative adverse reactions.

Trial registration

Registration number: Chinese Clinical Trial Registry ChiCTR2200057028. Date of registration: 26/02/2022.
Association of cognitive impairment with the interaction between chronic kidney disease and depression: findings from NHANES 2011–2014
Authors: Zhou Tong , Zhao Jiayu , Ma Yimei , He Linqian , Ren Zhouting , Yang Kun , Tang Jincheng , Liu Jiali , Luo Jiaming , Zhang Heping
Published: April 2024

Background

Cognitive impairment (CoI), chronic kidney disease (CKD), and depression are prevalent among older adults and are interrelated, imposing a significant disease burden. This study evaluates the association of CKD and depression with CoI and explores their potential interactions.

Method

Data for this study were sourced from the 2011–2014 National Health and Nutritional Examination Survey (NHANES). Multiple binary logistic regression models assessed the relationship between CKD, depression, and CoI while controlling for confounders. The interactions were measured using the relative excess risk of interaction (RERI), the attributable proportion of interaction (AP), and the synergy index (S).

Results

A total of 2,666 participants (weighted n = 49,251,515) were included in the study, of which 700 (16.00%) had CoI. After adjusting for confounding factors, the risk of CoI was higher in patients with CKD compared to non-CKD participants (odds ratio [OR] = 1.49, 95% confidence interval [CI]:1.12–1.99). The risk of CoI was significantly increased in patients with depression compared to those without (OR = 2.29, 95% CI: 1.73–3.03). Furthermore, there was a significant additive interaction between CKD and depression in terms of the increased risk of CoI (adjusted RERI = 2.01, [95% CI: 0.31–3.71], adjusted AP = 0.50 [95% CI: 0.25–0.75], adjusted S = 2.97 [95% CI: 1.27–6.92]).

Conclusion

CKD and depression synergistically affect CoI, particularly when moderate-to-severe depression co-occurs with CKD. Clinicians should be mindful of the combined impact on patients with CoI. Further research is needed to elucidate the underlying mechanisms and assess the effects specific to different CKD stages.
1 plus 1 is more than 2: mental health problems, financial difficulties, and social exclusion in a cross-sectional study of 28,047 general-population adults
Authors: Haugland Siri Håvås , Topor Alain , Friesinger Jan Georg
Published: April 2024

Background

Mental health problems and financial difficulties each increase the risk of social exclusion. However, few large studies representing a broad age range have investigated the combined social effect of having both difficulties. The purpose of this cross-sectional study was to examine associations of mental health problems, financial difficulties, and the combination of both with social exclusion.

Methods

This analysis was based on responses from 28,047 adults (age > 18 years) from the general population participating in The Norwegian Counties Public Health Survey 2019. Respondents answered questions about their financial situation, mental health problems, and social exclusion. Social exclusion was measured as a lack of social support, low participation in organized social activities, low participation in other activities, missing someone to be with, feeling excluded, and feeling isolated. Adjustments for sex and age were made in multivariable logistic regression analyses.

Results

Having mental health problems or financial difficulties was associated with various measures of social exclusion (odds ratios [ORs] with 95% confidence intervals [CIs]: 1.33 [1.23–1.43] to 12.63 [10.90–14.64]). However, the odds of social exclusion strongly increased for respondents who reported a combination of mental health problems and financial difficulties compared with those who did not report either (ORs [CIs]: 2.08 [1.90–2.27] to 29.46 [25.32–34.27]).

Conclusions

Having the combination of mental health problems and financial difficulties is strongly associated with increased risk for social exclusion, far beyond the effect of either factor alone.
Retrospective analysis of the incidence of appendiceal neoplasm and malignancy in patients treated for suspected acute appendicitis
Authors: Dohner Eliane , Kierdorf Fiona Joséphine , Langer Rupert , Zuber Markus , Fahrner René
Published: April 2024

Background

Nonoperative management of uncomplicated appendicitis is currently being promoted as treatment option, albeit 0.7–2.5% of appendectomies performed due to suspected acute appendicitis show histologically malignant findings. The purpose of this study was to investigate the incidence of neoplasm and malignancy of the appendix in patients presenting with suspected acute appendicitis in real world setting.

Methods

This is a retrospective single-centre investigation of 457 patients undergoing appendectomy between the years 2017–2020. The patients’ demographics, symptoms and diagnosis, intraoperative findings, and histopathological results were analysed.

Results

In 3.7% (n = 17) histological analysis revealed neoplasms or malignancies. Median age was 48 years (20–90 years), without sex predominance. Leukocytes (11.3 ± 3.7 G/l) and C-reactive protein (54.2 ± 69.0 mg/l) were elevated. Histological analysis revealed low-grade mucinous appendiceal neoplasia (n = 3), sessile serrated adenoma of the appendix (n = 3), neuroendocrine tumours (n = 7), appendiceal adenocarcinoma of intestinal type (n = 3), and goblet cell carcinoma (n = 1). Additional treatment varied between no treatment or follow-up due to early tumour stage (n = 4), follow-up care (n = 3), additional surgical treatment (n = 8), or best supportive care (n = 2).

Conclusions

Preoperative diagnosis of appendiceal tumours is difficult. Nonoperative management of patients with acute, uncomplicated appendicitis potentially prevents the correct diagnosis of malignant appendiceal pathologies. Therefore, close follow-up or surgical removal of the appendix is mandatory.
Efficacy and safety of fibrin sealant application in patients undergoing thyroidectomy: a systematic review and meta-analysis
Authors: Zheng XiaoGang , Wang Fan , Su Yong Cheng , Xu Chao Yang , Wang Ming Zheng
Published: April 2024

Various studies have focused on the application of fibrin sealants (FS) in thyroid surgery. Utilizing a meta-analysis, this systematic review analyzed the findings of recent randomized controlled trials on the safety and efficacy of FS in patients who underwent thyroidectomy. The Cochrane Library, Web of Science, Embase, PubMed, and Medline databases were searched for relevant studies, without any language restrictions. Seven randomized controlled trials were included in the originally identified 69 studies. Overall, 652 patients received FS during thyroid surgery; their outcomes were compared with those of conventionally treated patients. The primary outcomes were total volume of wound drainage, length of hospitalization, and operative time. Significant differences were observed in the total volume of wound drainage (mean deviation (MD): -29.75, 95% confidence interval (CI): -55.39 to -4.11, P = 0.02), length of hospitalization (MD: -0.84, 95% CI: -1.02 to -0.66, P < 0.00001), and surgery duration (MD: -7.60, 95% CI: -14.75 to -0.45, P = 0.04). Secondary outcomes were seroma and hypoparathyroidism development. The risk of hypoparathyroidism did not differ between the FS and conventional groups (I = 0%, relative risk = 1.31, P = 0.38). Analysis of “seroma formation that required invasive treatment” indicated that FS showed some benefit (I2 = 8%, relative risk 0.44, P = 0.15). Heterogeneity among the different trials limited their conclusions. The meta-analysis showed that although FS use did not significantly reduce seroma or hypoparathyroidism incidence in patients after thyroidectomy, it significantly reduced the total drainage volume, length of hospitalization, and duration of surgery.
A novel surgical treatment approach for the vertical root fracture of posterior teeth: a case report with 24-month review
Authors: Sun Qing , Han Furong , Fan Wei
Published: April 2024

Background

Up to 25% of the tooth extraction after root canal treatment could be attributed to the vertical root fracture (VRF). The treatment choice for teeth with VRF would mostly be the extraction despite some repairing methods were also reported. The repairing treatment result of VRF would mostly depend on the fixation strength and the bioactivity of the repairing materials, especially for the posterior teeth with high masticating stresses. This case report designed a novel surgical treatment approach for the VRF of posterior teeth.

Methods

a maxillary premolar with buccal-palatal complete VRF was treated with a new dual-layered repairing approach using adhesive resin + iRoot BP Plus bioceramic cement to fill the modified fracture line with retention forms through the intentional replantation.

Results

At the 24-month review, the tooth showed desirable periodontal healing and normal function.

Conclusions

This case report indicated that the dual-layered repairing approach might be effective for saving the posterior teeth with VRF. Nevertheless, further clinical trials are needed for its long-term result.
Perceptions of lecturers and students regarding discriminatory experiences and sexual harassment in academic medicine – results from a faculty-wide quantitative study
Authors: Ludwig Sabine , Jenner Sabine , Berger Ralph , Tappert Sylvie , Kurmeyer Christine , Oertelt-Prigione Sabine , Petzold Mandy
Published: April 2024

Background

Discrimination and sexual harassment are prevalent in higher education institutions and can affect students, faculty members and employees. Herein the aim was to assess the extent of discriminatory experiences and sexual harassment of students and lecturers at one of the largest teaching hospitals in Europe. We analyze whether there are differences between lecturers and students, different study programs as well as sex/gender differences.

Methods

In an interdisciplinary, iterative process, a semi-standardized questionnaire was developed and sent to N = 7095 students (S) of all study programs and N = 2528 lecturers (L) at Charité—Universitätsmedizin Berlin, Germany. The study was conducted from November 2018 to February 2019. Besides a broad range of questions on sociodemographic background allowing for diversity sensitive data analysis, they were asked if they had witnessed and/or experienced any form of discrimination or sexual harassment at the medical faculty, if yes, how often, the perceived reasons, situational factors and perpetrators.

Results

The response rate was 14% (n = 964) for students and 11% (n = 275) for lecturers. A proportion of 49.6% of students (L: 31%) reported that they have witnessed and/or experienced discriminatory behavior. Sexual harassment was witnessed and/or experienced by 23.6% of students (L: 19.2%). Lecturers (85.9%) were identified as the main source of discriminatory behavior by students. Directors/supervisors (47.4%) were stated as the main source of discriminatory behavior by lecturers. As the most frequent perceived reason for discriminatory experiences sex/gender (S: 71%; L: 60.3%) was reported. Women and dental students experienced more discriminatory behavior and sexual harassment.

Conclusions

Discriminatory behavior is experienced by a significant number of students and lecturers, with power structures having a relevant impact. Dental students and women appear to be particularly exposed. Specific institutional measures, such as training programs for lecturers and students are necessary to raise awareness and provide resources. Furthermore, national preventive strategies should be thoroughly implemented to fight discrimination and harassment at the workplace.