Morpho-mechanical intestinal remodeling in type 2 diabetic GK rats--is it related to advanced glycation end product formation?

Elevated Serum Histamine N-Methyltransferase Levels Are Associated With the Pathophysiology of Major Depressive Disorder: A Case-Control Study

Major depressive disorder (MDD) is a common neuropsychiatric disorder with persistent low mood, feelings of weakness, and a lack of interestin daily tasks. Histamine N-methyltransferase (HNMT) protein is involved in the inactivation process of histamine in human physiology. Here, we aimed to assess the role of HNMT in the pathophysiology and development of MDD. This case-control study included 56 MDD patients and 32 healthy controls (HCs) by matching age, sex, body mass index (BMI), and other sociodemographic characteristics. A clinical psychiatrist assessed the MDD patients and HCs according to the DSM-5 criteria. We used the Ham-D scale in evaluating the severity of depressive symptoms. We used ELISA kits to estimate serum HNMT levels. We observed elevated serum HNMT concentration in MDD patients (29.25 ± 5.34 pg/ml) compared with HCs (23.13 ± 2.10 pg/ml). Serum HNMT levels and Ham-D scores are positively correlated with each other in MDD patients (r = 0.632, p < 0.001). Also, the receiver operating characteristic curve analysis illustrated a significant diagnostic value for HNMT with the area under the curve (AUC = 0.916) at p < 0.001. The promising findings from this study anticipate that the elevated serum levels of HNMT may be associated with the pathophysiology and mechanism of MDD. We recommend further interventional studies to produce more precise and accurate results on this biomarker in depression.

Cross-species Standardised Cortico-Subcortical Tractography

Despite their importance for brain function, cortico-subcortical white matter tracts are under-represented in diffusion MRI tractography studies. Their non-invasive mapping is more challenging and less explored compared to other major cortico-cortical bundles. We introduce a set of standardised tractography protocols for delineating tracts between the cortex and various deep subcortical structures, including the caudate, putamen, amygdala, thalamus and hippocampus. To enable comparative studies, our protocols are designed for both human and macaque brains. We demonstrate how tractography reconstructions follow topographical principles obtained from tracers in the macaque and how these translate to humans. We show that the proposed protocols are robust against data quality and preserve aspects of individual variability stemming from family structure in humans. Lastly, we demonstrate the value of these species-matched protocols in mapping homologous grey matter regions in humans and macaques, both in cortex and subcortex.

Oxidative damage to DNA, expression of Mt-1, and activation of repair mechanisms induced by vanadium trioxide in cultures of human lymphocytes

Vanadium (V) has garnered attention due to its pharmacological properties; however, its toxic effects have also been documented. Among the vanadium compounds that are found in the environment, vanadium trioxide (V2O3) has attracted interest because of its impact on biomolecules such as DNA, RNA, and proteins. However, its precise mechanism of action remains unclear, although it is suspected to be related to oxidative stress. Therefore, this study aimed to determine the mechanisms involved in DNA damage and the associated cellular response pathways. Primary cultures of human lymphocytes were exposed to 2, 4, 8, or 16 µg/mL V2O3. DNA damage due to oxidized bases was evaluated via a comet assay. The expression levels of sensor proteins (ATM and ATR) involved in DNA damage were determined via Western blotting, and the mRNA expression levels of metallothionein 1 (Mt-1) and genes involved in DNA repair (OGG1, APE1, XPB, XPD, MRE11, RAD50, Ku70, and Ku80) were estimated via RT-PCR and qPCR. The results showed that V2O3 is an oxidant that is responsible for DNA damage through oxidized bases, as demonstrated by increased DNA migration in the presence of the FPG enzyme. At the molecular level, V2O3 treatment also increased ATM protein expression. In terms of mRNA expression, the overexpression of Mt-1, OGG1, APE1, Ku70, and Ku80 was observed. This finding suggests that DNA damage is primarily repaired via two mechanisms: base excision repair (BER) and nonhomologous end joining (NHEJ). In conclusion, one mechanism of action of V2O3 involves the oxidation of nitrogenous bases in DNA, the activation of damage sensors (such as ATMs), and the overexpression of Mt-1 as part of the antioxidant response to mitigate the effects of V and facilitate DNA repair pathways (including BER and NHEJ).

The impact of inpatient medication administration technologies on nursing autonomy and practice: a meta-ethnographic synthesis of the qualitative literature

OBJECTIVE

To conduct a meta-ethnographic synthesis summarizing the overarching themes of the qualitative literature on nurse interaction with medication administration technologies (MAT) comprising electronic medication administration record (eMAR) and bar-coded medication administration (BCMA).

MATERIALS AND METHODS

We searched scientific databases from their inception until September 23, 2024, resulting in 2270 unique articles, and extracted data from 27 articles. Scientific rigor was assessed by the Standards for Reporting Qualitative Research (SRQR) checklist. Noblit and Hare's methodology was used to conduct a meta-ethnography to identify and interpret emergent themes.

RESULTS

SRQR revealed low-to-medium methodological quality and theoretical framing of the literature. We found 6 overarching themes connecting MAT with nursing work: (1) View of the MAT system as mechanistic and invariant vs living and co-evolving with its users drives the research approach; (2) MAT limits nurse autonomy; (3) MAT unnaturally splits the medication administration workflow; (4) Nurses must manage MAT challenges at the sharp end; (5) MAT does not align with social dependencies of nursing work; and (6) MAT increases perceived safety but can also result in new types of errors.

DISCUSSION

MAT does not support key cognitive work that nurses must perform to maintain safety. Additionally, MAT can impede problem solving during medication management and limit nursing autonomy that is essential for safe medication administration.

CONCLUSION

Recommendations based in human factors engineering recognizing how MAT design impacts nursing work and workload are essential in improving the fit of MAT to nurse cognitive workflows.

Anti-PGL-I seropositivity and development of leprosy in contacts: a comprehensive analysis of sociodemographic determinants, genetic susceptibility, and exposure characteristics to Mycobacterium leprae

BACKGROUND

Leprosy is an infectious disease that remains hyperendemic in several Brazilian regions. Patient contacts face a higher risk for infection and illness, which can subsequently contribute to the persistence of the disease.

OBJECTIVE

This study investigates the risk factors associated with anti-phenolic glycolipid-I (anti-PGL-I) seropositivity and leprosy development among contacts of leprosy patients in a highly endemic region.

METHODS

A cohort of 629 contacts from the Almenara microregion, Minas Gerais, Brazil, was followed from 1998 to 2018. Our research group assessed risk factors, including sociodemographic determinants, bacillus exposure, and genetic susceptibility.

FINDINGS

Analysis revealed that living with a multibacillary (MB) leprosy patient [odds ratio (OR): 3.01, 95% confidence interval (CI): 1.02-8.86] and with a patient with grade II disabilities (OR: 4.43, 95% CI: 1.08-18.1) significantly increased the likelihood of anti-PGL-I seropositivity among asymptomatic contacts. Risk factors for leprosy included living with a patient in a shared residence (OR: 2.84, 95% CI: 1.21-6.67) and blood relation to the patient (OR: 2.56, 95% CI: 1.18-5.54). Notably, 98% of contacts who developed leprosy had lived with more than one patient.

MAIN CONCLUSIONS

Clinical characteristics of index patients play a critical role in infection risk among contacts. Leprosy progression appears to depend on genetic susceptibility, type of contact, and extent of bacillus exposure.

Intravascular Imaging of Left Circumflex Occlusion After Mitral Surgery

Left circumflex coronary artery occluson rarely occurs after mitral valve surgery. The underlying mechanisms, as well as the clinical presentation and severity may vary. No consensus on the best therapeutic strategy exists. We present a case of left circumflex dynamic occlusion after mitral valve replacement, in which the use of intravascular ultrasound helped in clarifying the mechanism of the occlusion and in guiding the percutaneous revascularization.

After 75 Years of Methotrexate, Can Treatment Results Be Improved With Appropriate Folinic Acid Rescue?

After 75 years of clinical use of folic acid antagonists such as methotrexate, relevant pharmacological data currently important for the effective and safe use of methotrexate were reviewed to see if it is possible to improve outcomes. Specifically, to improve how high-dose methotrexate (HD-MTX) can be given safely, what doses of MTX (methotrexate) are adequate to achieve therapeutic levels, and what is the appropriate folinic acid (FA) dose for effective rescue. This review is based on 50 years of personal experience with the use of HD-MTX in published literature. Many pharmacologic studies were performed over 50 years ago, but are still relevant and stand up to scrutiny today. What should be considered HD-MTX and how it can be given safely and effectively without late toxicity are presented. The variables responsible for effective folinic acid rescue, especially the doses of MTX and folinic acid and the time to start of rescue, are discussed. Understanding these highlighted aspects of therapy could help to prevent acute toxicity, improve treatment results, and prevent late effects.

Cancer vaccine trial evaluations: immunobridging and potential immunological endpoints

Therapeutic cancer vaccines are an emerging class of immunotherapy, but challenges remain in effectively adapting approved vaccines to a growing number of adjuvants, combination therapies, and antigen-selection methods. Phase III clinical trials remain the gold standard in determining clinical benefit, but are slow and resource intensive, whilst radiological surrogates often fail to reliably predict clinical benefit. Using immunological surrogates of efficacy, deployed in 'immunobridging trials', could present a viable alternative, safely speeding up cancer vaccine development in a cost-effective manner. Whilst this approach has proven successful in infectious disease vaccines, identifying reliable immunological correlates of protection has proven difficult for cancer vaccines. Most clinical trials, which present the richest source of data to establish a correlate, rely on peripheral blood samples and standard immunoassays that are ill-equipped to capture the complexity of the vaccine-induced anti-tumour response. This review is the first to outline the importance and challenges of establishing immunological surrogates for cancer vaccines in the context of immunobridging trials, evaluating current immunoassay methods, and highlighting the need for techniques that can characterize tumour-infiltrating lymphocytes and the suppressive tumour microenvironment across a range of patients. The authors propose adapting trial designs for surrogate discovery, including combining phase I/II trials and the use of multi-omics approaches. Successful immunological surrogate development could enable future immunobridging trials to accelerate the optimization of approved cancer vaccines without requiring new phase III trials, promoting faster clinical implementation of scientific advances and patient benefits.

Correlation of organelle interactions in the development of non-alcoholic fatty liver disease

Organelles, despite having distinct functions, interact with each other. Interactions between organelles typically occur at membrane contact sites (MCSs) to maintain cellular homeostasis, allowing the exchange of metabolites and other pieces of information required for normal cellular physiology. Imbalances in organelle interactions may lead to various pathological processes. Increasing evidence suggests that abnormalorganelle interactions contribute to the pathogenesis of non-alcoholic fatty liver disease (NAFLD). However, the key role of organelle interactions in NAFLD has not been fully evaluated and researched. In this review, we summarize the role of organelle interactions in NAFLD and emphasize their correlation with cellular calcium homeostasis, lipid transport, and mitochondrial dynamics.

Intensifying Nutrient Removal in Hybrid-Constructed Wetlands Treating Urban Streamwater

This study investigated the influence of hydraulic retention time (HRT) variation and the presence of macrophytes on the efficiency of two pilot-scale hybrid-constructed wetlands (HCWs) treating urban streamwater contaminated with nontreated sanitary sewage contributions from the surrounding communities. Each HCW comprises a vertical unit (VF) and a horizontal unit (HF) filled with sand and gravel. HCW-P was planted withEichornia crassipes onto the filtering media, and HCW-C was set up as a control unit with no macrophytes. The novelty of this study consists of evaluating the combination of these factors (HRT and macrophytes) in the operation of HCWs for removing organic matter and nutrients. The operation of the HCWs was divided into step I, with a hydraulic retention time (HRT) of 9 days for 133 days, and step II, with an HRT of 5 days for 131 days. Neither HRT variation (p-value = 0.7691) nor the presence of macrophytes (p-value = 0.0941) influenced the COD removal, as the HCWs achieved high removal efficiencies (>87%) during the operation. HCW-P achieved higher total nitrogen (TN) removal efficiencies in steps I and II (56% and 78%) compared to HCW-C (31% and 48%) during the operation, demonstrating the improvement in removing TN due to the presence of macrophytes (p-value ≤ 0.05). In addition, the shorter HRT promoted an increase of 22% in TN removal for HCW-P (p-value ≤ 0.05). The macrophytes and longer HRT enhanced total ammonia nitrogen (TAN) removal, as HCW-P (46% and 88%) achieved higher removal efficiencies than HCW-C (29% and 72%) in steps I and II, respectively (p-value ≤ 0.05). Regarding total phosphorus (TP), HCW-C and HCW-P achieved removal efficiencies of 63% and 89% in step I and 69% and 96% in step II, confirming the influence of HRT and macrophytes on TP removal. Finally, macrophytes demonstrated adaptability and resilience to the operational conditions, even when fixed in HCWs, which presented robustness in removing organic matter and nutrients from the urban streamwater via biofilm assimilation and adsorption under HRT variations.

Bacillus velezensis TB918 mitigates garlic dry rot disease by forming consortia with Pseudomonas in the rhizosphere and bulb

Garlic dry rot (GDR), primarily caused by Fusarium proliferatum, is a significant postharvest disease that leads to substantial economic losses. Our previous research demonstrated that supplementing Bacillus-based biocontrol formulations with sucrose could boost its efficiency in protecting plants by building a hostile rhizomicrobiome for destructive soil-borne pathogens. B. velezensis TB918, previously isolated from pepper rhizosphere soil, exhibited a strong in vitro antifungal effect on Fusarium. In this study, we conducted a field experiment to investigate the efficacy of B. velezensis TB918 in controlling GDR, and explored the changes in microbial communities in garlic plants and rhizosphere soil following the application of TB918 with or without sucrose supplementation. Using 16S rRNA and ITS amplicon sequencing, we found that the introduction of TB918 significantly increased the abundance of Pseudomonas in garlic rhizosphere, especially when combined with sucrose. Three Pseudomonas strains were isolated from garlic tissues and rhizosphere soil treated with TB918 and sucrose, among which the GP2 strain exhibited antagonistic effects against pathogen ad planta. Co-culture and colonization assays showed that TB918 facilitated the biofilm formation of Pseudomonas strain by forming consortia. Interestingly, the abundance of potentially non-pathogenic Fusarium concentricum also increased, suggesting a potential niche exclusion effect. Our results demonstrated that TB918 in combination with sucrose effectively reduced the incidence of GDR during storage. This study provides valuable insights into the use of biocontrol agents and sucrose to modulate the garlic microbial community and suppress soil-borne pathogens.

How to properly define immunological nonresponse to antiretroviral therapy in people living with HIV? an integrative review

In recent decades, significant progress has been made in understanding the mechanisms underlying human immunodeficiency virus (HIV) infection and its treatment. Antiretroviral therapy (ART) has notable improved the life expectancy and quality of life for people living with HIV (PLHIV) by suppressing viral replication and promoting CD4+ T-cell recovery. However, despite its efficacy, approximately 10-40% of ART-treated PLHIV with virological suppression (<50 RNA copies/mL) do not achieve adequate immunological reconstitution. These PLHIV, classified as immunological non-responders (INR), experience higher morbidity and mortality rates compared to those with satisfactory immune reconstitution, known as immunological responders (IR). Various studies have explored the mechanisms contributing to immunological nonresponse, yet a major challenge remains: the lack of a standardized definition of immunological response and nonresponse across studies. Currently, definitions are inconsistent, limiting comparability between studies. This review proposes a clear and adequate classification for IR and INR PLHIV to support future advancements in understanding immunological recovery and improving the quality of life for ART-treated PLHIV.

Stakeholders' perceptions and experiences of factors influencing the commissioning, delivery, and uptake of general health checks: a qualitative evidence synthesis

BACKGROUND

General health checks are integral to preventive services in many healthcare systems. They are offered, for example, through national programmes or commercial providers. Usually, general health checks consist of several screening tests to assess the overall health of clients who present without symptoms, aiming to reduce the population's morbidity and mortality. A 2019 Cochrane review of effectiveness studies suggested that general health checks have little or no effect on either all-cause mortality, cancer or cardiovascular mortality or cardiovascular morbidity. These findings emphasise the need to explore the values of different stakeholder groups associated with general health checks.

OBJECTIVES

To identify how stakeholders (i.e. healthcare managers or policymakers, healthcare providers, and clients) perceive and experience general health checks and experience influencing factors relevant to the commissioning, delivery and uptake of general health checks. Also, to supplement and contextualise the findings and conclusions of a 2019 Cochrane effectiveness review by Krogsbøll and colleagues.

SEARCH METHODS

We searched MEDLINE (Ovid) and CINAHL (EBSCO) and conducted citation-based searches (e.g. reference lists, effectiveness review-associated studies and cited references in our included studies). The original searches cover the period from inception to August 2022. The results from the update search in September 2023 have not yet been incorporated.

SELECTION CRITERIA

We included primary studies that utilised qualitative methods for data collection and analysis. Included studies explored perceptions and experiences of commissioning, delivery and uptake of general health checks. Stakeholders of interest were healthcare managers, policymakers, healthcare providers and adults who participate (clients) or do not participate (potential clients) in general health checks. The general health check had to include screening tests for at least two diseases or risk factors. We considered studies conducted in any country, setting, and language.

DATA COLLECTION AND ANALYSIS

We applied a prespecified sampling frame to purposefully sample a variety of eligible studies. This sampling approach allowed us to capture conceptually rich studies that described the viewpoints of different stakeholder groups from diverse geographical regions and different settings. Using the framework synthesis approach, we developed a framework representing individual, intervention and contextual factors, which guided data extraction and synthesis. We assessed the methodological limitations of each study using an adapted version of the Critical Appraisals Skills Programme (CASP) tool. We applied the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative Research) approach to assess our confidence in each finding.

MAIN RESULTS

One hundred and forty-six studies met the inclusion criteria, and we sampled 36 of these for our analysis. While most of the studies were set in high-income countries in Europe, nearly a third (11/36) were set in culturally diverse middle-income countries across Eastern Europe, South and Southeast Asia, and Latin America. Sixteen sampled studies were conducted in primary and community healthcare settings, four in workplace settings and four in community settings. Included studies explored the perceptions and experiences of clients (n = 25), healthcare providers (n = 15) and healthcare managers or commissioners (n = 9). We grouped the findings at the individual level, intervention level and surrounding context. The findings at the individual level mainly reflect the client's perspective. General health checks helped motivate most clients to change their lifestyles. They were trusted to assess their health objectively, finding reassurance through professional confirmation (moderate confidence). However, those who feared negative results or relied on symptom-based care were more reluctant to attend (moderate confidence). Perceptions of disease, risk factors and prevention affected uptake (high confidence). Some clients felt an obligation to their families and society to maintain and improve their health through general health checks (moderate confidence). Healthcare providers played a crucial role in motivating participation, but negative experiences with unqualified providers discouraged attendance (moderate confidence). The availability and accessibility of general health checks and awareness systems played significant roles in clients' decision-making. Factors such as time and concerns that health insurance may not cover potential treatment costs influenced attendance (moderate confidence). The findings at the intervention level drew on the perspectives of all three stakeholder groups, with a strong focus on the healthcare provider's perspective. Healthcare providers and clients considered it essential that general health check providers were skilled and culturally competent (high confidence). Barriers to delivery included time competition with curative care, staff changes and shortages, resource limitations, technical issues, and reimbursement challenges (moderate confidence). Stakeholders thought innovative and diverse settings might improve access (moderate confidence). The evidence suggests that clients appreciated a comprehensive approach, with various tests. At the same time, healthcare providers deemed individualised approaches tailored to clients' health risks suitable, focusing on improving rather than abandoning general health checks (low confidence). The perspectives on the effectiveness of general health checks differed among healthcare commissioners, managers, providers, and clients (moderate confidence). Healthcare providers and clients recognised the importance of information, invitation systems, and educational approaches to create awareness of general health check availability and their respective advantages or disadvantages (moderate confidence). Clients considered explaining test results and providing recommendations as key elements of general health checks (low confidence). We have low or very low confidence in findings related to the contextual level and reasons for commissioning general health checks. The evidence suggests that cultural background, social norms, religion, gender, and language shape the perception of prevention and disease, thereby influencing the uptake of general health checks. Policymakers thought that a favourable political climate and support from various stakeholders are needed to establish general health checks.

AUTHORS' CONCLUSIONS

Despite the lack of effectiveness in the quantitative review, our findings showed that general health checks remain popular amongst clients, healthcare providers, managers and policymakers across countries and settings. Our data did not offer strong evidence on why these are commissioned, but it did point to these interventions being valued in contexts where general health checks have long been established. General health checks fulfil specific wants and needs, and de-implementation strategies may need to offer alternatives before a constructive debate can take place about fundamental changes to this widely popular or, at least, accepted service.

Lipid metabolism in ferroptosis: mechanistic insights and therapeutic potential

Ferroptosis, an iron-dependent form of regulated cell death driven by lipid peroxidation, plays a pivotal role in various physiological and pathological processes. In this review, we summarize the core mechanisms of ferroptosis, emphasizing its intricate connections to lipid metabolism, including fatty acid synthesis, phospholipid remodeling, and oxidation dynamics. We further highlight advancements in detection technologies, such as fluorescence imaging, lipidomics, and in vivo PET imaging, which have deepened our understanding of ferroptotic regulation. Additionally, we discuss the role of ferroptosis in human diseases, where it acts as a double-edged sword, contributing to cancer cell death while also driving ischemia-reperfusion injury and neurodegeneration. Finally, we explore therapeutic strategies aimed at either inducing or inhibiting ferroptosis, including iron chelation, antioxidant modulation, and lipid-targeted interventions. By integrating mechanistic insights, disease relevance, and therapeutic potential, this review provides a comprehensive perspective on ferroptosis as a crucial interface between lipid metabolism and oxidative stress.

Models of actor-specific range of motion are encoded in the extrastriate body area

Models of actor-specific range of motion (or biomechanical limits) shapes perception and (inter)actions. This functional magnetic resonance imaging study tested the hypothesis that these models are encoded in the extrastriate body area. Participants were first introduced with the maximal amplitude of arm and leg movements of a "rigid" and a "flexible" actor. Then, we measured the blood oxygenation level dependent response in 25 participants while they watched video clips depicting these actors performing either "small" movements that were "possible" to perform for both actors, "large" ones that were "impossible" for both actors and "intermediate" ones that were possible only for the "flexible" actor. Results aligned with the 2 predictions of our hypothesis: (i) extrastriate body area responded more strongly to impossible than possible movements; (ii) extrastriate body area categorized intermediate movements as "possible" or "impossible" depending on each actor's specific range of motion. The results of additional analyses suggested that extrastriate body area encodes actor-specific range of motion at the level of specific body parts, and as a probability function. Finally, the results of whole brain and functional connectivity analyses suggested that the right posterior superior temporal sulcus may also play an important role in encoding information about actor-specific biomechanical limits.

Rationing of nursing care in a developing country: A cross-sectional study

AIM

This study aimed to determine the effect of nurses' work environment, individual and work schedule features on the rationing of nursing care.

INTRODUCTION

Rationing of nursing care is a concern in healthcare settings worldwide, as it is associated with negative outcomes for both patients and nursing staff.

BACKGROUND

Little is known about the precursors of rationing of nursing care in developing countries.

METHODS

This descriptive, correlational and cross-sectional study was conducted with 405 nurses in Türkiye. Data were collected Nurse Information Form, Basel Extent of Rationing of Nursing Care-R and Nursing Work Index-The Practice Work Environment Scale. The study was reported following the STROBE and RANCARE guideline.

RESULTS

Nurses' mean rationing of nursing care score was 1.58 ± 0.59, and the mean work environment perception score was 2.58 ± 0.47, with no statistically significant relationship between the scale scores. However, working ward, working hours and working schedule significantly affected the total rationing of nursing care scores.

DISCUSSION

In this study, contrary to the literature, no relationship was found between the rationing of nursing care and the perception of the work environment. Supporting the literature, nurses' individual/work schedule features affected the rationing of nursing care.

CONCLUSION

Improving nurses' work schedule features and nurse staffing may help reduce the rationing of nursing care.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

This study emphasised the importance of nurses' work schedule features and nurse staffing in the rationing of nursing care. The data from this study can guide nurse managers in identifying factors related to work schedules that may affect the rationing of nursing care and strategies to follow to make the necessary improvements.

Association Between Two Novel Visceral Obesity Indicators and Heart Failure Among US Adults: A Cross-Sectional Study

Background: This study aimed to explore the association of cardiometabolic index (CMI), CMI-age, visceral adiposity index (VAI), and VAI-age with heart failure (HF) and to compare those indicators for early identification of HF. Methods: Drawing from the National Health and Nutrition Examination Survey (NHANES) for 2011-2018, we enrolled 8999 participants in a cross-sectional study. The association of different visceral obesity indicators (CMI, CMI-age, VAI, and VAI-age) with HF was estimated by multivariable regression analysis. Receiver operating characteristic (ROC) curves were used to examine the predictive ability of CMI, CMI-age, VAI, and VAI-age on patients with HF. Results: CMI, CMI-age, VAI and VAI-age showed positive correlations with HF. When indicators were analyzed as continuous variables, CMI, CMI-age, VAI, and VAI-age showed positive correlations with HF in both the crude and adjusted models (all P < 0.05). When indicators were analyzed as categorical variables, it was found that in all four models, the ORs of group Q4 was significantly different compared to Q1 (all P < 0.05), suggesting the risk of HF is significantly increased with higher CMI, CMI-age, VAI, or VAI-age. The association between those indicators (CMI, CMI-age, VAI, and VAI-age) and HF was similar in all stratified populations (P for interaction >0.05).The areas under the ROC curve (AUCs) of four indicators in predicting HF were significantly different (CMI: 0.610, 95% CI, 0.578-0.643; CMI-age: 0.700, 95% CI, 0.669-0.726; VAI: 0.593, 95% CI, 0.561-0.626; VAI-age: 0.689, 95% CI, 0.661-0.718), suggesting that CMI-age was significantly better than the other three indicators in predicting HF (P < 0.001). Conclusions: CMI, CMI-age, VAI, and VAI-age were all independently correlated with the risk of HF. In four indicators, the CMI-age was significantly better than the other three indicators in predicting HF, which provides new insights into the prevention and management of HF.

Age and Latent Cytomegalovirus Infection Do Not Affect the Magnitude of De Novo SARS-CoV-2-Specific CD8+ T Cell Responses

Immunosenescence, age-related immune dysregulation, reduces immunity upon vaccinations and infections. Cytomegalovirus (CMV) infection results in declining naïve (Tnaïve) and increasing terminally differentiated (Temra) T cell populations, further aggravating immune aging. Both immunosenescence and CMV have been speculated to hamper the formation of protective T-cell immunity against novel or emerging pathogens. The SARS-CoV-2 pandemic presented a unique opportunity to examine the impact of age and/or CMV on the generation of de novo SARS-CoV-2-specific CD8+ T cell responses in 40 younger (22-40 years) and 37 older (50-66 years) convalescent individuals. Heterotetramer combinatorial coding combined with phenotypic markers were used to study 35 SARS-CoV-2 epitope-specific CD8+ T cell populations directly ex vivo. Neither age nor CMV affected SARS-CoV-2-specific CD8+ T cell frequencies, despite reduced total CD8+ Tnaïve cells in older CMV- and CMV+ individuals. Robust SARS-CoV-2-specific central memory CD8+ T (Tcm) responses were detected in younger and older adults regardless of CMV status. Our data demonstrate that immune aging and CMV status did not impact the SARS-CoV-2-specific CD8+ T cell response. However, SARS-CoV-2-specific CD8+ T cells of older CMV- individuals displayed the lowest stem cell memory (Tscm), highest Temra and PD1+ populations, suggesting that age, not CMV, may impact long-term SARS-CoV-2 immunity.

Influence of human capital, urbanization, fuel imports and other macroeconomic factors on electric vehicle adoption

Given that the transport sector is one of the largest emitters of CO₂, promoting the growth of electric vehicles is an option in the fight against climate change, and individual policies need to develop appropriate measures. The study examined the factors influencing the spread of electric passenger cars using panel data from 2012 to 2021 in 18 European countries. Electricity prices, urbanization, fuel imports, real GDP per capita, human capital and household saving rate were included in the multivariable non-linear model. To the best of our knowledge, there is no previous study on the impact of household savings and the inclusion of these variables in one model for the sample of selected countries and periods. Based on the results, human capital, household savings, and urbanization have a significant positive effect on the spread of electric cars, while fuel import has a significant negative effect. The biggest impact was found on urbanization and human capital. Reducing dependence on fuel imports can positively affect the uptake of electric vehicles. At the same time, providing information on the environmental impact of electric vehicles and policies that support investment in human capital can also have a favourable indirect effect on the uptake of electric vehicles.

Azathioprine and 6-mercaptopurine for maintenance of remission in ulcerative colitis

BACKGROUND

Maintenance of remission is essential in inflammatory bowel disease (IBD) in terms of disease course and long-term prognosis. The thiopurines azathioprine and 6-mercaptopurine have longstanding merit in ulcerative colitis, but more therapeutic options have been developed. This review is an update and extension of a review last published in 2016.

OBJECTIVES

To assess the effectiveness and safety of azathioprine and 6-mercaptopurine in monotherapy or combined therapy regimens compared to placebo or active controls for the maintenance of remission in ulcerative colitis.

SEARCH METHODS

We searched Cochrane Central Register of Controlled Trials (until May 2023), ClinicalTrials.gov (until May 2023), Embase (until August 2022), MEDLINE (until May 2023), and WHO ICTRP (until May 2023). We checked reference lists of the included studies and, if needed, contacted the authors to request more data or information.

SELECTION CRITERIA

Randomized controlled trials (RCTs) of at least 24 weeks' duration comparing azathioprine or 6-mercaptopurine with placebo or any other medication, or comparing different treatment modalities of azathioprine or 6-mercaptopurine, in persons of any age with quiescent ulcerative colitis were eligible. We only considered studies with mixed IBD populations or with a preceding induction period if separate results on participants with ulcerative colitis in remission were available or could be calculated. The primary outcome was failure to maintain clinical or endoscopic remission (relapse). Secondary outcomes included change in disease activity, quality of life, hospitalization, need for surgery, days off work, adverse events, and withdrawal due to adverse events.

DATA COLLECTION AND ANALYSIS

Two authors independently extracted data using standard forms, resolved any disagreements by consensus, and assessed study quality using the Cochrane risk of bias tool (RoB 2). We conducted separate analyses by type of control, calculated pooled risk ratios (RRs) or risk differences (RDs) using the fixed-effect model unless heterogeneity was likely, and assessed the certainty of evidence using the GRADE approach.

MAIN RESULTS

We included 10 studies in the review, including 468 adult participants with ulcerative colitis. The risk of bias across these was low for most outcomes, but we considered some outcomes to have some concerns or high risk of bias due to insufficient information on concealment of allocation and outcome measurement. Based on five placebo-controlled studies, azathioprine or 6-mercaptopurine may reduce the risk of failing to maintain remission. In the thiopurine group, 45% (64/143) of participants failed to maintain remission compared to 67% (96/143) of participants receiving placebo (RR 0.66, 95% confidence interval (CI) 0.54 to 0.82; 5 studies, 286 participants; low-certainty evidence). Three studies reported withdrawals due to adverse events. Among participants on azathioprine, 4% (3/80) withdrew due to adverse events compared to 0% (0/82) of placebo participants (RD 0.04, 95% CI -0.02 to 0.09; 3 studies, 162 participants; low-certainty evidence). The evidence is of low certainty when comparing 6-mercaptopurine to 5-aminosalicylate. Based on one three-armed trial, 27% (3/11) of 6-mercaptopurine participants failed to maintain remission compared to 100% (2/2) of 5-aminosalicylate participants (RR 0.35, 95% CI 0.13 to 0.97; 1 study, 13 participants; low-certainty evidence). This trial also involved an induction phase; we only included the results for participants in remission. The single trial comparing 6-mercaptopurine to 5-aminosalicylate did not report separate data on adverse events and withdrawals due to adverse events for the subgroup with successful induction of remission, so we could not analyze these outcomes for this comparison.

AUTHORS' CONCLUSIONS

Low-certainty evidence suggests that azathioprine or 6-mercaptopurine therapy may be more effective than placebo for the maintenance of remission in ulcerative colitis. More research is needed to evaluate the value of therapeutic drug monitoring and the effects of various treatment modalities on long-term safety.

Serum Vitamin D levels in males with premature androgenetic alopecia: a prospective case-control study

INTRODUCTION

Androgenetic alopecia (AGA), the predominant form of hair loss, affects a significant global population. While emerging research suggests a potential correlation between serum vitamin D levels and AGA severity, the current body of evidence remains inconclusive, necessitating further investigation to elucidate this relationship and its clinical implications.

The dose-effect relationship between acupuncture and its effect on primary insomnia: a systematic review and meta-analysis

Background

The benefits of acupuncture on primary insomnia (PI) have been well established in previous studies. However, different acupuncture dosages may lead to controversy over its efficacy. Therefore, this systematic review and meta-analysis was conducted to assess the relationship between the dose and efficacy of acupuncture for the treatment of PI.

Methods

Seven databases were searched from inception until May 30, 2024. The included randomized controlled trials (RCTs) with acupuncture for PI on the Pittsburgh Sleep Quality Index (PSQI) scores were divided into three categories according to the therapeutic dose of acupuncture (frequency, session, and course): low dosage, medium dosage, and high dosage. The correlation between the dose and the effect of treatment was analyzed. Risk of bias was assessed using Cochrane Collaboration's risk of bias tool. Meta-analyses were performed using RevMan v.5.4 and Stata 16.0 software.

Results

A total of 56 studies were included. There were 17 sham acupuncture-controlled RCTs that are notable because of their high quality. Overall, the effect on the reduction of the PSQI scores varied across the different acupuncture dosages. For the frequency of acupuncture, the results showed a significant improvement in the moderate frequency (three sessions per week) and high frequency (five to seven sessions per week) categories. With regard to the acupuncture session, it was shown that moderate session (12-20 sessions) and high session (24-30 sessions) had better effects on the reduction of the PSQI scores, with low session (≤10 sessions) being not significant. For the acupuncture course, there were no differences in the short course (≤2 weeks) and the long course (>4 weeks) between the acupuncture group and the control group. Medium course (3-4 weeks) was considered as the optimal course. In addition, there were no differences between acupuncture and SATV (sham acupuncture therapy at verum points) on the same acupuncture points in the PSQI scores. The results of GRADE assessment demonstrated that the level of evidence was very low to moderate, probably due to the poor methodological quality and the substantial heterogeneity among studies.

Conclusions

A dose-effect relationship was found between the acupuncture dose and the PSQI scores. Although sham acupuncture needling at the same points as those in acupuncture may not be a true placebo control, this was utilized in a minority of studies. Collectively, the data suggest that at least three sessions per week for 3-4 weeks and a total of at least 12 acupuncture sessions would be the optimal clinical response.

Systematic review registration

https://www.crd.york.ac.uk/, identifier CRD42024560078.

The link between hyperuricemia and diabetes: insights from a quantitative analysis of scientific literature

Background

Hyperuricemia (HUA) is a significant public health issue, ranking second only to diabetes in prevalence. While existing research demonstrates a robust correlation between these two conditions, the precise etiological mechanisms remain inadequately elucidated. This study utilized scientometric analysis to investigate the global association between HUA and diabetes.

Methods

Data on HUA and diabetes were retrieved from the Web of Science Core Collection database, encompassing the period from its inception until September 30, 2024. Collaboration networks were examined using VOSviewer, cluster analysis was executed with CiteSpace, and systematic mapping was conducted using Bibliometrix.

Results

By September 30, 2024, 1,464 studies indicated a consistent yearly increase in publications connecting HUA and diabetes despite some fluctuations. The lead authors were Richard J. Johnson, Miguel A. Lanaspa, and Masanari Kuwabara, with most contributors from China, the United States, and Japan. Key institutions include China Medical University, Shanghai Jiao Tong University, and Capital Medical University. The most published journal was Nutrition, Metabolism and Cardiovascular Diseases (CVDs), whereas the most cited journal was Diabetes Care. The reference network from 1987 to September 30, 2024, identified 19 clusters highlighting key research areas in HUA and diabetes, such as metabolic syndrome, uropathology, chronic kidney disease (CKD), and CVD. Exploring pathological mechanisms and pharmacological interventions linked to diabetes concomitant with HUA has emerged as a focal point of research and a burgeoning trend within the field.

Conclusion

This study is the first scientometric analysis to synthesize research trends on HUA and diabetes, revealing molecular mechanisms and treatment strategies and providing theoretical insights for future clinical use.

Art therapy's engagement of brain networks for enduring recovery from addiction

The field of addiction in its priority to save lives has emphasized harm reduction and medication therapies that have taken precedence over counseling and psychotherapy. The extensive mental health needs, traumatic histories and cognitive challenges of this population call for more availability of all treatments, but also in-depth treatment for the causes of the addiction. The prevalence of trauma is examined with regard to the challenge it presents in treatment for substance use disorder (SUD), and other comorbidities. Two case examples are offered that exemplify how art therapy expedites key information about underlying trauma. Art therapy is proposed as a treatment approach for SUD for its apparent activation of key neural networks that are also impacted by trauma, and its usefulness in engaging those who have cognitive challenges experientially. Quantitative research is cited that suggests art therapy's activation of the reward system, which may make art therapy useful in treating the stress and inhibition coefficients of addiction that map to neural networks of addiction. The need for additional empirical research is cited that may improve the efficiency and effectiveness of art therapy and mental health treatment.

Demystifying furan formation in foods: Implications for human health, detection, and control measures: A review

Furan (C₄H₄O), an unintended hazardous compound, is formed in various thermally processed foods through multiple pathways, raising concerns due to its potential carcinogenicity in humans. The aim of this comprehensive review was to synthesize and evaluate the latest research on furan, from its formation by different precursors to its presence in diverse food matrices, as well as the emerging methods for its detection and mitigation. Emphasizing the toxicity of furan, it explored evidence from in vitro and in vivo studies, including reproductive toxicity, carcinogenic effects, and related biomarkers. Additionally, this review focused on human risk assessments of furan exposure and discussed innovative research approaches to better understand its health risks. By consolidating current knowledge, this review provided a comprehensive perspective on furan's impact on human health and suggested future research directions to further research on furan.

The Significance of Mono- and Dual-Effective Agents in the Development of New Antifungal Strategies

Invasive fungal infections (IFIs) pose significant challenges in clinical settings, particularly due to their high morbidity and mortality rates. The rising incidence of these infections, coupled with increasing antifungal resistance, underscores the urgent need for novel therapeutic strategies. Current antifungal drugs target the fungal cell membrane, cell wall, or intracellular components, but resistance mechanisms such as altered drug-target interactions, enhanced efflux, and adaptive cellular responses have diminished their efficacy. Recent research has highlighted the potential of dual inhibitors that simultaneously target multiple pathways or enzymes involved in fungal growth and survival. Combining pharmacophores, such as lanosterol 14α-demethylase (CYP51), heat shock protein 90 (HSP90), histone deacetylase (HDAC), and squalene epoxidase (SE) inhibitors, has led to the development of compounds with enhanced antifungal activity and reduced resistance. This dual-target approach, along with novel chemical scaffolds, not only represents a promising strategy for combating antifungal resistance but is also being utilized in the development of anticancer agents. This review explores the development of new antifungal agents that employ mono-, dual-, or multi-target strategies to combat IFIs. We discuss emerging antifungal targets, resistance mechanisms, and innovative therapeutic approaches that offer hope in managing these challenging infections.

Feedback Survey for an Online Learning Module: Developing and Validating a Scale to Measure Nursing Students' Self-Assessed Knowledge and Perceptions of Older People and Confidence in Working With Them

PURPOSE

To determine if an online learning module on older people's care improved nursing students' self-assessed knowledge, and perceptions of older people, we developed a brief Feedback Survey. The aim of this study was to examine the internal consistency (a type of reliability) and construct validity of the feedback survey.

DESIGN AND METHODS

Secondary analysis of data from the Awakening Canadian's to Ageism and McCalla e-learning intervention studies for postsecondary nursing students. Factor analysis and reliability analysis (via standardised Cronbach's alpha) were performed on the four-question, five-point Likert-type Feedback Survey, which was included in both intervention studies.

RESULTS

Factor analysis yielded one factor interpretable as general satisfaction in students' experience with the module and perceived benefits of having completed it. Standardised Cronbach's alpha for this scale was high at 0.92, which suggests excellent internal consistency.

IMPLICATIONS FOR PRACTICE

The feedback survey is a convenient and time-efficient measure to examine student nurses' self-assessed improvements in knowledge, perceptions about older people. The survey has potential for adaptation to measure perceived outcomes of other nursing student- focused education.

Inherited Spinocerebellar Ataxia Segregates with Intra-Familial Genetic Heterogeneity in a Consanguineous Pakistani Family: A Report of a Potential Novel Candidate Gene

Hereditary spinocerebellar ataxia (SCA) is a group of genetic neurodegenerative disorders caused by a variety of gene variants. At least 44 types of SCAs have been identified to date, and more than 35 genes and hundreds of variants have been reported that are associated with SCAs. We have investigated a Pakistani consanguineous six-generation family with SCA by using whole-exome sequencing analysis. We identified a reported SCA-associated variant, c.C2687G (p.P896R) in CACNA1A, in only a subgroup of the family, while a c.C262T (p.P88S) variant in ARFIP1 serves as a candidate pathogenic variant in the other subgroup as a possible novel cause of SCA. Our study showed that intra-familial heterogeneity may exist in SCA families and presented a candidate new causative gene for SCA.

First Documented Successful Treatment of Chronic Postoperative Fungal Endophthalmitis Induced by Trichosporon Inkin with Fluconazole

This report details an uncommon occurrence of chronic endophthalmitis following cataract surgery attributed to an infection by Trichosporon inkin (T. inkin). The infection was identified through MALDI-TOF mass spectrometry along with sequencing analysis. Although the patient exhibited a robust immune response, the infection escalated quickly from the right eye to the left. Treatment involved vitrectomy and peeling surgery on the right eye, paired with systemic fluconazole antifungal therapy and intravitreal injection, resulting in significant recovery. The visual acuity of the right eye enhanced from finger counting to 20/63. This account represents the inaugural documented instance of endophthalmitis caused by T. inkin that was effectively managed with fluconazole. This underscores the critical role of vitreous humor enrichment culture and antifungal susceptibility testing of T. inkin in the treatment of endophthalmitis.

Population-scale skeletal muscle single-nucleus multi-omic profiling reveals extensive context specific genetic regulation

Skeletal muscle, the largest human organ by weight, is relevant in several polygenic metabolic traits and diseases including type 2 diabetes (T2D). Identifying genetic mechanisms underlying these traits requires pinpointing cell types, regulatory elements, target genes, and causal variants. Here, we use genetic multiplexing to generate population-scale single nucleus (sn) chromatin accessibility (snATAC-seq) and transcriptome (snRNA-seq) maps across 287 frozen human skeletal muscle biopsies representing nearly half a million nuclei. We identify 13 cell types and integrate genetic variation to discover >7,000 expression quantitative trait loci (eQTL) and >100,000 chromatin accessibility QTLs (caQTL) across cell types. Learning patterns of e/caQTL sharing across cell types increased precision of effect estimates. We identify high-resolution cell-states and context-specific e/caQTL with significant genotype by context interaction. We identify nearly 2,000 eGenes colocalized with caQTL and construct causal directional maps for chromatin accessibility and gene expression. Almost 3,500 genome-wide association study (GWAS) signals across 38 relevant traits colocalize with sn-e/caQTL, most in a cell-specific manner. These signals typically colocalize with caQTL and not eQTL, highlighting the importance of population-scale chromatin profiling for GWAS functional studies. Finally, our GWAS-caQTL colocalization data reveal distinct cell-specific regulatory paradigms. Our results illuminate the genetic regulatory architecture of human skeletal muscle at high resolution epigenomic, transcriptomic, and cell-state scales and serve as a template for population-scale multi-omic mapping in complex tissues and traits.

Silicon regulation of manganese homeostasis in plants: mechanisms and future prospective

Manganese (Mn), a plant micronutrient element, is an important component of metalloprotein involved in multiple metabolic processes, such as photosynthesis and scavenging reactive oxygen species (ROS). Its disorder (deficiency or excess) affects the Mn-dependent metabolic processes and subsequent growth and development of plants. The beneficial element of Si has a variety of applications in agricultural fields for plant adaptation to various environmental stresses, including Mn disorder. The probable mechanisms for Si alleviation of Mn toxicity in plants are summarized as follows: (1) Si alters the rhizosphere acidification, root exudates and microorganisms to decrease the bioavailability of Mn in the rhizosphere; (2) Si down-regulates Mn transporter gene and reinforces the apoplastic barriers for inhibiting the Mn uptake and translocation; and (3) Si promotes the Mn deposition onto cell wall and Mn compartmentation into vacuole. Under Mn-deficient conditions, the probable mechanisms for Si promotion of Mn absorption in some plants remain an open question. Moreover, scavenging ROS is a common mechanism for Si alleviating Mn disorder. This minireview highlights the current understanding and future perspectives of Si regulation of manganese homeostasis in plants.

What Radiographic and Spinopelvic Parameters do Spine Surgeons Consider in Decision-Making for Treatment of Degenerative Lumbar Spondylolisthesis?

STUDY DESIGN

Cross-sectional survey.

OBJECTIVE

Surgical treatment of degenerative lumbar spondylolisthesis is remarkably varied due to heterogeneity of clinical-radiological presentations. This study aimed to assess which spinopelvic radiological parameters were considered for decision-making.

METHODS

Survey distributed to International AO Spine members to analyze surgeons' considerations for treatment. Data collected includes demographics, training background, years of experience, and treatment decisions based on various radiographical findings, including segmental and global spinopelvic parameters.

RESULTS

From 479 responses, the most frequently radiological parameter considered was slippage on dynamic X-rays (79.1%), followed by disc height (78.9%), global sagittal balance SVA (71.4%), and PI-LL mismatch (69.7%), while the least important was absolute spondylolisthesis on static lateral radiograph (22.8%). Fellowship-trained surgeons were likelier to use SVA (OR = 1.73, 95% CI = 1.02-2.99, P = 0.049), and disc height (2.13, 1.14-3.98, P < 0.05). There was no difference between orthopedics and neurosurgery in applying SVA and PI-LL mismatch. Surgeons from Asia Pacific emphasizes segmental lordosis (2.39, 1.11-5.15, P = 0.026) as from Latin America (2.55, 1.09-5.95, P = 0.030) and Middle East (4.33, 1.66-11.28, P = 0.003). However, surgeons from Latin America and Middle East also significant consider disc height (2.95, 1.07-8.15, P = 0.037) and (3.03, 1.04-8.83, P = 0.043), respectively. Additionally, the surgeons' age was associated with using angular motion on flexion-extension radiographs, and volume of treated cases yearly with consideration for disc height.

CONCLUSIONS

Treatment of degenerative lumbar spondylolisthesis was influenced by slippage on dynamic radiographs, disc height, global alignment, and PI-LL mismatch. Surgeons' age and Region, fellowship-trained, and volume of treated cases were significantly associated to apply these radiological parameters.

Salmonella biofilm formation diminishes bacterial proliferation in the C. elegans intestine

Non-typhoidal Salmonella serovars are a significant global cause of foodborne infections, owing their transmission success to the formation of biofilms. While the role of these biofilms in Salmonella's persistence outside the host is well understood, their significance during infection remains elusive. In this study, we investigated the impact of Salmonella biofilm formation on host colonization and virulence using the nematode model Caenorhabditis elegans. This infection model enables us to isolate the effect of biofilm formation on gut colonization and proliferation, as no gut microbiome is present and Salmonella cannot invade the intestinal tissue of the nematode. We show that a biofilm-deficient ΔcsgD mutant enhances gut proliferation compared to the wild-type strain, while the pathogen's virulence, the host's immune signaling pathways, and host survival remain unaffected. Hence, our work suggests that biofilm formation does not significantly contribute to Salmonella infection in C. elegans. However, complementary assays in higher-order in vivo models are required to further characterize the role of biofilm formation during infection and to take into account the impact of biofilm formation on competition with gut microbiome and epithelial invasion.

First-trimester medication abortion via telemedicine: A retrospective cohort study

Background

Following the decriminalization of abortion in Colombia and amidst a global health crisis due to COVID-19, Profamilia implemented a telemedicine-assisted first-trimester Medication Abortion (MAB) program. This is an opportunity to reduce inequalities in access and to promote empowerment and sexual and reproductive rights. This study aims to describe socio-demographic and clinical characteristics of users and to assess its effectiveness and safety.

Study design

A retrospective cohort study.

Methods

The study analyzed data from users who received Profamilia's telemedicine abortion services between August 2021 and August 2022 (n = 3073). A descriptive analysis of their sociodemographic and clinical characteristics was performed, grouping, and comparing them according to follow-up status and abortion outcome. Effectiveness was assessed by the percentage of complete abortions without surgical intervention, and safety by the incidence of complications, potential adverse events, and potentially dangerous signs.

Results

Most of the users were less than 8 weeks gestation at the start of treatment (88.3 %), from low socioeconomic strata (84.8 %), affiliated to the subsidized healthcare system (87.6 %), with educational levels up to secondary school (81.6 %), between 18 and 35 years (87.4 %), from urban areas (97.8 %) and singles (90,8 %). 94.9 % of users had a complete abortion using medication, and 0.3 % of cases reported complications.

Conclusions

First-trimester MAB through telemedicine in the Latin American context is an effective and safe choice. Telehealth is an important strategy to expand access to safe abortion care, especially for those with limited financial means or educational backgrounds. Rural and marginalized populations need more attention to improve access.

Gameful Experience Scale: Reliability and Validity in Nursing Students

Objective: Nursing students are among the groups where gamification applications are used effectively and frequently in educational technologies. This study aimed to adapt the Gameful Experience Scale (GAMEX) to the Turkish language and test its validity and reliability. Materials and Methods: The study was conducted with 620 nursing students studying an undergraduate nursing program between March and May, 2023. Data were collected using a personal information form and GAMEX-Turkish Form. Results: The validity and reliability of the five-factor structure scale with 27 items were confirmed. In confirmatory factor analysis, all factor loads were found to be >0.56. The fit indexes of the scale were χ2/df = 2.8, goodnessof-fit index = 0.90, comparative fit index = 0.94, and root mean square error of approximation = 0.55. Cronbach's alpha coefficient of the overall scale was 0.89. Conclusion: As a result of this study, the Turkish version of GAMEX was found to be a valid and reliable tool that can be used to evaluate the game experience in nursing students' training.

Invagination of Giant Unilamellar Vesicles upon Membrane Mixing with Native Vesicles

We demonstrate rapid membrane mixing between GUVs of pure lipid compositions and membrane vesicles (MVs) isolated from the plasma membrane of Vero cells, resulting in the transfer of native lipids and proteins to the GUVs. The steps involved in the membrane mixing are docking followed by membrane fusion. We show that positively charged lipids of the GUVs are essential for the docking, and the native membrane components of MVs drive the fusion. The interleaflet and lateral asymmetry and a change in the membrane tension upon the membrane mixing trigger membrane invagination. We detected outward and inward invagination sites at the rim of the GUVs within 10-40 min of the membrane mixing. The extent of the invaginations depends on the cholesterol and sphingomyelin (SM) contents in the GUVs. Cholesterol content above a critical concentration disfavors membrane invaginations, and the SM lipid is an essential molecular factor for membrane invagination.

Environmental monitoring of the Capo Frasca military training site (West Sardinia): Operability and environmental protection balanced plan

Military activities in training areas can contaminate soil and groundwater through different persistent pollutants. This article reports the design of the operating procedure to assess and monitor the environmental impact of training activities carried out at the Capo Frasca military firing range (PCF) on the west coast of Sardinia. The procedure includes two steps: (i) a baseline investigation of soil to detect the impact of previous training activities at PCF, and (ii) the development of a post-training monitoring plan. Results of the baseline investigations revealed that the activities conducted at PCF over many decades have not significantly affected the soil quality. Energetic compounds (ECs) were found below the limit of detection (LOD), and some low exceedances of the screening values (SVs) for Cd, Cu, and Ni were recorded in small areas that coincided with parts of two operational areas. A human health risk assessment (HHRA) identified no relevant issues. Results of baseline investigation allowed the planning of a light, noninvasive post-training monitoring plan based on two levels, L1 and L2, where L1 involves only manual sampling of topsoil (0-0.2 m). If L1 reveals contamination, a more in-depth and extensive L2 follow-up monitoring will be implemented. Results of post-training monitoring are not yet available. This environmental investigation protocol is intended to be a practical tool for regulatory provisions and is expected to be useful and effective for firing range management. This investigation also emphasized that, compared with the international state-of-the-art, environmental surveys in Italian military ranges require the improvement of ECs set to be analyzed, lowering EC LOD, and establishing ECs SVs. In Sardinia, many military areas, including PCF, are considered areas of significant natural interest. Therefore, it is deemed beneficial to move beyond HHRA and undertake the ecological risk assessment. Integr Environ Assess Manag 2024;20:2060-2075. © 2024 SETAC.

Relationships Between Burnout and Neuroticism Among Emergency Department Nurses: A Network Analysis

AIM

Although neuroticism has a negative impact on burnout among healthcare workers, there is little research exploring the specific interactions between different components of burnout and neuroticism. This study aims to investigate this relationship among nurses in Emergency Departments (ED) through network analysis method (NAM).

DESIGN

A cross-sectional investigative survey was conducted.

METHODS

A total of 408 Chinese nurses were recruited from ED of five hospitals in 2023 through Questionnaire Star. Components of burnout were measured by the 15-item Maslach Burnout Inventory-General Survey (MBI-GS), while components of neuroticism were measured by a subscale of the Eysenck Personality Questionnaire-Revised, Short Scale for Chinese (EPQ-RSC) questionnaire. NAM was applied to build relationship between components of burnout and neuroticism and identify the bridge expected influence (BEI).

RESULTS

Within burnout-neuroticism network, the relations between the components of burnout and neuroticism were mainly positive. Nt5 ('Anxious')-EE1 ('Exhausted'; weight = 0.281) and Nt5 ('Anxious')-EE5 ('Breakdown'; weight = 0.280) had stronger connections. Among the neuroticism, Nt5 ('Anxious') showed the strongest positive BEI, while Nt12 ('Guilty') showed the strongest negative BEI. Feeling anxiety and less guilt conscience in neuroticism were the critical factors to impact burnout of nurses in ED. Awareness of these relationships can help to develop strategies to identify and curtail burnout.

PATIENT OR PUBLIC CONTRIBUTION

A total of 408 emergency nurses participated in this survey.

The beliefs and practices used to promote physical and mental health in youth who identify as lesbian, gay, bisexual, transgender, intersex, or queer plus (LGBTIQ+) experiencing housing insecurity: An integrative review

PURPOSE

The purpose of this integrative review was to explore the beliefs and practices used to promote physical and mental health among youth ages 18-25 years, identifying as LGBTIQ+ experiencing housing insecurity.

METHOD

The approach used strategies described by Whittemore and Knafl. Peer-reviewed, published research articles in English were identified using eight electronic databases. Eighteen research reports using qualitative, quantitative, and mixed methods were identified. Articles were evaluated for quality using the American Association of Critical Care Nurses Evidenced-Level Hierarchy evaluation tool. Data were analyzed and synthesized using Braun and Clarke's method.

FINDINGS

Four themes related to the purpose were extracted: pervasive experiences of stigma and discrimination, constantly attuned to navigating risks, inconsistent engagement in health information and care, and inner strength developed through personal and community experiences.

DISCUSSION

There are strong implications for future research, public health nursing practice, and health policy. Public health nurses should incorporate social determinants of health (addressing harmful social processes such as homophobia and racism) as well as a strength-based upstream approach in research, education, and health care practices. More research must also be done to assess engagement in physical and mental health information and care.

Ethnomedicinal Knowledge and Traditional Methodology for the Preparation of Fermented Butter "Smen" Among the Rural People of Northern Morocco: A Field Study

Several rural Moroccan people depend on natural remedies such as Smen (ghee) before visiting a health center due to their low cost and accessibility. However, knowledge of Smen traditional medicine is not documented but rather transferred orally from generation to generation. This is the first qualitative ethnomedicinal study that provides and documents information about the medicinal use of Smen in Northern Morocco. The present study aimed to investigate and gather information on the traditional medicinal practices of using Smen among rural people in Northern Morocco for a document and suggest the exploration of this product and its bioactive compounds in medical applications. The investigation was carried out by conducting individual semistructured interviews with 630 elderly people from March to April 2022. Data were analyzed using descriptive statistics and expressed as a percentage of responses to each question in the survey. The study revealed that 66.5% of the people surveyed were aware of the medical benefits of Smen, which had been passed down from their ancestors. It has been used to treat hemorrhoids, common colds, detoxification, rheumatism, and wound/burn injuries. This study showed that Moroccan's ethnomedicinal knowledge is closely related to Ayurveda, ancient Indian traditional medicine. For centuries, Smen has been used traditionally for medical purposes, just as it has been used in cooking. The diversity of ghee medicinal use in Northern Morocco could contribute to the discovery and development of ghee-based drugs, which have fewer side effects.

LC-MS/MS-based chemical profiling of water extracts of Moringa oleifera leaves and pharmacokinetics of their major constituents in rat plasma

Moringa oleifera leaves (MOL) are native to India and have high biological activities. To better understand the basic pharmacodynamic materials, the chemical components in MOL and their pharmacokinetic properties were studied and quantitated using UPLC-Q-Exactive Orbitrap-MS. Forty-two compounds were identified, including phenolic acids and their derivatives, flavonoids, isothiocyanates, nucleosides, alkaloids, and other compounds. Two phenolic acids and six flavonoids were studied for their pharmacokinetic properties using UHPLC-MS/MS. Precision, accuracy, stability, matrix effects, and extraction recovery were verified. All substances that were measured reached their maximum within 0.5 h. Vicenin-2 had a high peak concentration and bioavailability. Kaempferol-3-O-rutinoside had a longer biological half-life than other components. The results from this study provide the data basis for subsequent comprehensive qualitative evaluation and potential MOL use in clinical applications.

Alpha-Pinene-encapsulated lipid nanoparticles diminished inflammatory responses in THP-1 cells and imiquimod-induced psoriasis-like skin injury and splenomegaly in mice

Introduction

Psoriasis, a persistent skin condition caused by the disorder of the immune system, impacts approximately 1.25 million individuals globally. Nevertheless, the presence of adverse effects in conventional clinical drugs necessitates further exploration of novel medications or combination therapies to mitigate these reactions and enhance their effectiveness.

Methods

Hence, our intention here in this paper is to utilize the lipid nanoparticle delivery system for overcoming the volatility and hydrophobic properties of α-pinene, a naturally occurring compound renowned for its anti-inflammatory and antiviral effects, and further explore its potential pharmacological applications both in vitro and in vivo.

Results

The production of α-pinene lipid nanoparticles (APLNs) was achieved through the utilization of high pressure homogenization methods. APLNs was successfully fabricated with enhanced stability and water solubility. Meanwhile, the application of APLNs could drastically reduce the expression of lipopolysaccharide (LPS)-induced inflammation-related factors in THP-1 cells. Administration of APLNs to a mouse model of auricular swelling could effectively reduce redness and swelling in the auricles of mice as well. Furthermore, APLNs were also found to alleviate skin damage in mice with Imiquimod (IMQ)-induced psoriasis model, as well as decrease the levels of psoriasis-related protein nuclear factor kappa-B (NF-κB) and interleukin-17 (IL-17), interleukin-23 (IL-23), and other inflammation-related cytokines. More importantly, utilization of APLNs successfully mitigated the systemic inflammatory reactions in mice, resulting in the reduction of spleen-to-body ratio (wt%) and of inflammatory cytokines' expression in the serum.

Discussion

Overall, our results suggest that with the help of lipid nanoparticle encapsulation, APLNs possess a better pharmacological effect in anti-inflammation and could potentially serve as an anti-psoriasis drug.

Tumor suppressor NME1/NM23-H1 modulates DNA binding of NF-κB RelA

The dimeric NF-κB family of transcription factors activates transcription by binding sequence-specifically to DNA response elements known as κB sites, located within the promoters and enhancers of their target genes. While most NF-κB remain inactive in the cytoplasm of unstimulated cells, a small amount of RelA, one of its members, persists in the nucleus, ensuring low-level expression of genes essential for homeostasis. Several cofactors have been identified that aid in DNA binding of RelA. In this study, we identify NME1 (nucleoside diphosphate kinase 1) as a cofactor that enhances RelA's ability to bind κB sites within the promoters of a subset of its target genes, promoting their expression under both unstimulated and stimulated conditions. Depletion of NME1 influences activation or repression of several genes that are unresponsive to TNFα, despite containing κB sites in their promoters but not in clusters. This suggests that clustering of kB sites may be necessary for RelA-dependent transcription complex assembly. NME1 appears to act as a cofactor for other transcription factors to regulate these genes. NME1 does not directly contact κB DNA but interacts with RelA, with this interaction being further strengthened in the presence of κB DNA. Notably, NME1 alone has a marginal effect in enhancing RelA's DNA binding, suggesting that NME1 likely cooperate with other cofactors to regulate DNA binding and transcription through RelA. These observations underscore the intricate assembly of transcription complexes centered on NF-κB.

A Complex Relationship Among the Circadian Rhythm, Reward Circuit and Substance Use Disorder (SUD)

The human brain not only controls the various physiological functions but is also the prime regulator of circadian rhythms, rewards, and behaviors. Environmental factors, professional stress, and social disintegration are regarded as the initial causative factors of addiction behavior. Shift work, artificial light exposure at night, and chronic and acute jet lag influence circadian rhythm dysfunction. The result is impaired neurotransmitter release, dysfunction of neural circuits, endocrine disturbance, and metabolic disorder, leading to advancement in substance use disorder. There is a bidirectional relationship between chronodisruption and addiction behavior. Circadian rhythm dysfunction, neuroadaptation in the reward circuits, and alteration in clock gene expression in the mesolimbic areas influence substance use disorder (SUD), and chronotherapy has potential benefits in the treatment strategies. This review explores the relationship among the circadian rhythm dysfunction, reward circuit, and SUD. The impact of chronotherapy on SUD has also been discussed.

Evaluation of prognostic factors for late recurrence in clear cell renal carcinoma: an institutional study

Background and objectives

Following nephrectomy with curative intent, a subset of patients diagnosed with non-metastatic renal cell carcinoma (nmRCC) will present late recurrences, with metastatic relapses after 5 years from the surgical intervention. The aim of this study is to evaluate the prevalence of late recurrences in Romanian patients with nmRCC that have undergone surgery and to assess the clinicopathological characteristics prognostic for late-relapse RCC.

Materials and methods

This is a single-center, retrospective and observational study that analyzed patients with nmRCC with clear cell histology who underwent surgical resection of the primary tumor with curative intent. The patients included in the study were treated and further surveilled according to a personalized follow-up plan between January 2011 and December 2012 in The Oncology Institute "Prof. Dr. Ion Chiricuţă", Cluj-Napoca, Romania. Study endpoints included median disease-free survival (DFS), median overall survival (OS), as well as evaluation of possible prognostic factors indicative of late relapse.

Results

In the study cohort (n=51), the median DFS was 46 months and median OS was 130 months. DFS was significantly correlated with the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) score (p=0.04, HR=2.48; 95% CI [1.02, 6.01]), neutrophil to lymphocyte ratio (NLR) (a higher NLR value was associated with a poorer DFS, p=0.035), tumor size (T4 tumors vs. T1 p<0.05, HR=9,81; 95% CI [2.65, 36.27]) and Fuhrman nuclear grade (Fuhrman grade 1 vs. Fuhrman grade 3 p<0.05, HR=4,16; 95% CI = [1.13,15.22]). Fifty one percent of the patients included experienced disease relapse. From this subgroup, a significant percentage of 42% patients presented disease recurrence after 60 months from nephrectomy. OS was correlated to IMDC score (p=0.049, HR=2.36; 95% CI [1, 5.58]) and Fuhrman nuclear grade (Fuhrman grade 1 vs. Fuhrman grade 3 p<0.05, HR=3,97; 95% CI [1.08, 14.54]).

Conclusions

The results of this study support the previously presented biological behavior of RCC, demonstrating that late recurrences in RCC are not uncommon occurrences and patients with localized RCC should be followed up for a longer interval after the surgery for the primary tumor. In addition, the study strengthens the data supporting certain biomarkers as valuable prognostic factors determining survival outcomes of patients with RCC.

Women's mental health and COVID-19: increased vulnerability and inequalities

Introduction

The impact of COVID-19 on mental health has become a relevant object of research. Studies have demonstrated that women have experienced greater mental health challenges, highlighting the importance of public health systems to address women's specific needs.

Methods

This literature review explores the effects of the coronavirus pandemic on psychological distress among women, aiming to provide a comprehensive understanding of the subject and to explore how these research findings can guide public mental health care responses in crisis settings. A total of 131 studies were analyzed and four dimensions were discussed: study characteristics, factors impacting women's mental health in the pandemic setting, particularities of pregnancy and the postpartum period, and proposed interventions. Most studies exclusively addressed populations of adult women, predominantly during pregnancy and the postpartum period.

Results

Anxiety, depression, and stress were the most common outcomes. Lower education and income, preexisting mental health problems, and living alone or with children were risk factors for higher levels of anxiety and depression.

Discussion

A comprehensive care approach supported by public health policies and focused on intersectional factors, including race, socioeconomic status, and access to resources, is necessary to improve women's mental health care response in future crises.

Sex-specific differences in brain activity dynamics of youth with a family history of substance use disorder

An individual's risk of substance use disorder (SUD) is shaped by a complex interplay of potent biosocial factors. Current neurodevelopmental models posit vulnerability to SUD in youth is due to an overreactive reward system and reduced inhibitory control. Having a family history of SUD is a particularly strong risk factor, yet few studies have explored its impact on brain function and structure prior to substance exposure. Herein, we utilized a network control theory approach to quantify sex-specific differences in brain activity dynamics in youth with and without a family history of SUD, drawn from a large cohort of substance-naïve youth from the Adolescent Brain Cognitive Development Study. We summarize brain dynamics by calculating transition energy, which probes the ease with which a whole brain, region or network drives the brain towards a specific spatial pattern of activation (i.e., brain state). Our findings reveal that a family history of SUD is associated with alterations in the brain's dynamics wherein: i) independent of sex, certain regions' transition energies are higher in those with a family history of SUD and ii) there exist sex-specific differences in SUD family history groups at multiple levels of transition energy (global, network, and regional). Family history-by-sex effects reveal that energetic demand is increased in females with a family history of SUD and decreased in males with a family history of SUD, compared to their same-sex counterparts with no SUD family history. Specifically, we localize these effects to higher energetic demands of the default mode network in females with a family history of SUD and lower energetic demands of attention networks in males with a family history of SUD. These results suggest a family history of SUD may increase reward saliency in males and decrease efficiency of top-down inhibitory control in females. This work could be used to inform personalized intervention strategies that may target differing cognitive mechanisms that predispose individuals to the development of SUD.

The Chinese version of the tendency to stigmatize epidemic diseases scale: a translation and validation study

Objective

To translate the Tendency to Stigmatize Epidemics Diseases Scale (TSEDS) into Chinese and to evaluate its psychometric properties.

Methods

Translation and cross-cultural adaptation using the Brislin translation model, and pre-testing to form a Chinese version of TSEDS. A total of 434 adults participated in the study and the TSEDS were measured using the critical ratio method, Pearson correlation analysis, retest reliability, content validity, structural validity, and concurrent validity.

Results

The Chinese version of the TSEDS scale contains 27 items in 5 dimensions, including structural stigma, perceived stigma, organizational stigma, internalized stigma, and social stigma. The average content validity index of the scale was 0.975. The goodness of fit index (χ2/df= 1.981, RMSEA = 0.067, CFI= 0.930, IFI = 0.931, TLI = 0.922) indicated a good model fit. The Cronbach's alpha coefficient was 0.962 and the dimensionality ranged from 0.882 to 0.928. The retest reliability was 0.912.

Conclusion

The Chinese version of TSEDS has good reliability and validity, which can be used to assess the epidemiological stigma tendency of Chinese adults.

Water quality constrained adjustment planning for regional breeding management with nonlinear programming model under uncertainty in Wenchang City, China

Basin water pollution caused by livestock, poultry and fish breeding is still a serious problem for remote villages, however, reliable regional breeding management programming have the potentials to improve pollution status. This paper focuses on the optimal model design and water quality analysis of the livestock, poultry and fish breeding system for Wenchang City, China. Methods of multi-objective programming (MOP), interval parameter programming (IPP), fuzzy-stochastic parameter programming (FSPP), and chance constrained programming (CCP) were incorporated into the developed model to tackle multi uncertainties described by interval values, probability distributions, fuzzy membership function. Based on the estimation of local breeding potential and current situation of surface water section, a multi-objective mixed fuzzy-stochastic nonlinear programming optimization model is presented with one-dimensional water quality model. In order to evaluate the environmental carrying capacity of livestock, poultry and fishery manure, predict its development trend and investigate the implementation effect of different emission reduction policies, this paper designs quantization system of the urban water environmental carrying capacity for the model. The results indicated that the water environment pollutant absorption capacity and carrying capacity of Wenchang city have approached the limit especially the towns in the northeast of City which limited the overall development space of the City. The modeling results are valuable for supporting the adjustment of the existing livestock, poultry and fish breeding schemes within a complicated system benefit and surface water quality situation under uncertainty.

Association between NKILA and some apoptotic gene expression in atherosclerosis

Oxidized light-density lipoprotein (ox-LDL) causes endothelial dysfunction, which is an important determinant of atherogenesis, and subsequently leads to apoptosis. Atherosclerosis is one of the most significant cardiovascular diseases (CVDs) threatening human health and causes death worldwide. Recently, long noncoding RNAs (lncRNAs) have been suggested to involved in vascular biology. Ox-LDL activates nuclear factor kappa-B (NF-κB), and NF-κB interacting lncRNA (NKILA) inhibits NF-κB signaling. In this study, the hypothesis is that NKILA may regulate endothelial cell (EC) apoptosis and, therefore, play a role in the pathogenesis of atherosclerosis. This hypothesis is based on the knowledge that EC apoptosis contributes to atherosclerosis development and that NKILA has become a prominent lncRNA in CVDs. The expression of Bcl-2-associated X protein (BAX), caspase 9 (CASP9), cytochrome c (Cyt c, CYCS), apoptotic protease activating factor 1 (APAF1), and B-cell lymphoma 2 (BCL-2) genes in human umbilical vein endothelial cells (HUVEC) treated with ox-LDL and transfected with NKILA siRNA was analyzed using quantitative reverse transcription polymerase chain reaction (RT-qPCR). BAX, CASP9, CYCS, APAF1, and BCL-2 gene expression was downregulated in ox-LDL and NKILA siRNA-treated HUVEC. In addition, when threshold/quantification cycle (Cq) values of NKILA gene expression increased, Cq values of BAX, CASP9, APAF1, and BCL-2 gene expression increased statistics significantly. The expression detection of all these genes, resulting from NKILA gene silencing, may provide guidance for epigenetic studies on EC apoptosis in atherosclerosis.