Influencing factors for decision-making delay in seeking medical care among acute ischemic stroke patients in rural areas.

OBJECTIVE: To explore the factors influencing decision-making delay in seeking medical care for patients with acute ischemic stroke (AIS) in rural areas. METHODS: From September to December 2021, we conducted a questionnaire survey of 260 patients with AIS who were hospitalized in the neurology departments of four county-level hospitals in Daqing. A decision-tree and logistic regression model was used to investigate the elements contributing to decision-making delays. RESULTS: This study found that the decision-making delay rate for rural patients with AIS was 71.5%. The results of the univariate analysis showed that factors associated with decision-making delay included educational level, National Institute of Health stroke scale (NIHSS) score, self-assessed health, monthly income, social support, attitude toward medical help-seeking, health belief, and family dynamics (P < 0.05). Further, we combined logistic regression (LR) and decision-tree (DT) models for multivariate analysis, and finally obtained five factors affecting decision-making delay in AIS patients in rural areas: disease severity, health belief, monthly income (common factors), educational level (only DT model), and social support (only LR model). CONCLUSIONS: This study found that a few variables, including disease severity, educational level, monthly income, health belief, and social support, affected rural AIS patients' decision-making delay in seeking medical care. PRACTICE IMPLICATIONS: To achieve the goal of reducing decision-delay and increasing thrombolysis rate, this study thoroughly examined the influencing factors of decision-making delay in seeking medical care of rural AIS patients from various angles. This analysis provides guidance for medical and healthcare professionals on how to best provide future health education for the high-risk population for stroke in rural areas.

Behavioral Activation Therapy for Subthreshold Depression in Stroke Patients: An Exploratory Randomized Controlled Trial.

Background: Subthreshold depression (SD) is known to be a major risk factor for the development of post-stroke depression (PSD). Appropriate intervention to prevent the transition from SD to PSD is thus imperative. As a form of short-term psychotherapy adapted for individuals with cognitive and communication impairments, behavioral activation therapy (BAT) may be a suitable choice. However, the effects of BAT on psychological outcomes in stroke patients with SD has not been established. This study investigated the feasibility and effectiveness of BAT in reducing the development of depressive symptoms in this patient population. Methods: A double-blind, randomized controlled trial was performed. Seventy participants were randomized to either a BAT group (n=35) or a control group (n=35). Participants in the BAT group received a six-week BAT intervention. The feasibility of BAT was assessed by the number of sessions attended by participants, and the acceptability of BAT to participants and the incidence of adverse events were recorded. The primary clinical outcome measure was the Center for Epidemiological Studies Depression Scale (CES-D) and the 17-item Hamilton Depression Scale (HAMD-17) at baseline, six weeks, and three months after the group allocation. Secondary outcomes included behavioral activation and the incidence of depression. Results: The intervention was feasible and acceptable, with 94.3% of participants in the BAT group (33 of 35) attending at least five sessions. No adverse events were reported in either group. Compared with the control group, the BAT group showed significant improvements in the CES-D (F=67.689, P<0.05), HAMD-17 (F=4.170, P<0.05), and behavioral activation (F=25.355, P<0.05) scores after intervention, and these differences were maintained at the three-month assessment. Conclusion: BAT appears to be feasible and efficacious for reducing depressive symptoms and increasing behavioral activation among stroke patients with SD. The findings of this study may contribute to the primary prevention of PSD.

Spindle pole body component 25 and platelet-derived growth factor mediate crosstalk between tumor-associated macrophages and prostate cancer cells.

Tumor-associated macrophages (TAMs) are involved in the growth of prostate cancer (PrC), while the molecular mechanisms underlying the interactive crosstalk between TAM and PrC cells remain largely unknown. Platelet-derived growth factor (PDGF) is known to promote mesenchymal stromal cell chemotaxis to the tumor microenvironment. Recently, activation of spindle pole body component 25 (SPC25) has been shown to promote PrC cell proliferation and is associated with PrC stemness. Here, the relationship between SPC25 and PDGF in the crosstalk between TAM and PrC was investigated. Significant increases in both PDGF and SPC25 levels were detected in PrC specimens compared to paired adjacent normal prostate tissues. A significant correlation was detected between PDGF and SPC25 levels in PrC specimens and cell lines. SPC25 increased PDGF production and tumor cell growth in cultured PrC cells and in xenotransplantation. Mechanistically, SPC25 appeared to activate PDGF in PrC likely through Early Growth Response 1 (Egr1), while the secreted PDGF signaled to TAM through PDGFR on macrophages and polarized macrophages, which, in turn, induced the growth of PrC cells likely through their production and secretion of transforming growth factor ß1 (TGFß1). Thus, our data suggest that SPC25 triggers the crosstalk between TAM and PrC cells via SPC25/PDGF/PDGFR/TGFß1 receptor signaling to enhance PrC growth.

Design of the Thermal Restructured Carbon-Inorganic Composite Aerogel for Efficient Thermal Protection of Aero-Engines.

The heat insulation ability and thermal stability of thermal protection materials play extremely important role in the thermal protection of aero-engines under high temperature. Herein, we design the carbon-SiO2-Al2O3 (CSA) composite aerogel through thermochemical restructuring from the phenol-formaldehyde resin-SiO2-Al2O3 (PSA) composite aerogel. This thermochemical restructured aerogel not only shows better adhesion property under room temperature but also possesses higher thermal stability and desirable heat insulation ability under high temperature. Taking the PSA-0.5 composite aerogel as an example, the compressive strain-stress test unveils that it can be compressed by 66% without catastrophic collapse, which is beneficial for the adhesion with the metallic matrix. Meanwhile, the transmission electron microscopy and scanning electron microscopy images exhibit the unbroken three-dimensional structure for the CSA-0.5 composite aerogel, which confirmed the structural stability of the composite aerogel after thermochemical restructuring. The thermal cycle test indicates that the weight loss of the CSA-0.5 composite aerogel is only ca. 8%, firmly confirming its thermal stability. Importantly, the thermal conductivity of the CSA-0.5 composite aerogel ranges from 0.024 to 0.083 W m-1 K-1, indicating the superior performance of heat insulation. Moreover, the numerical simulation is carried out to validate the thermal protection effect of the CSA-0.5 composite aerogel as a thermal protection layer. Together with laminated cooling, it could enhance the surface cooling effectiveness of the metallic matrix to above 0.8. Briefly, this work paves a new pathway for efficient thermal protection materials of aero-engines via the rational design of the thermochemical restructured composite aerogel under the guidance of ANSYS numerical simulations.

Design of Economical and Achievable Aluminum Carbon Composite Aerogel for Efficient Thermal Protection of Aerospace.

Insulation materials play an extremely important role in the thermal protection of aerospace vehicles. Here, aluminum carbon aerogels (AlCAs) are designed for the thermal protection of aerospace. Taking AlCA with a carbonization temperature of 800 °C (AlCA-800) as an example, scanning electron microscopy (SEM) images show an integrated three-dimensional porous frame structure in AlCA-800. In addition, the thermogravimetric test (TGA) reveals that the weight loss of AlCA-800 is only ca. 10%, confirming its desirable thermal stability. Moreover, the thermal conductivity of AlCA-800 ranges from 0.018 W m-1 K-1 to 0.041 W m-1 K-1, revealing an enormous potential for heat insulation applications. In addition, ANSYS numerical simulations are carried out on a composite structure to forecast the thermal protection ability of AlCA-800 acting as a thermal protection layer. The results uncover that the thermal protective performance of the AlCA-800 layer is outstanding, causing a 1185 K temperature drop of the structure surface that is exposed to a heat environment for ten minutes. Briefly, this work unveils a rational fabrication of the aluminum carbon composite aerogel and paves a new way for the efficient thermal protection materials of aerospace via the simple and economical design of the aluminum carbon aerogels under the guidance of ANSYS numerical simulation.

Mediation effect of perceived social support and resilience between physical disability and depression in acute stroke patients in China: A cross-sectional survey.

BACKGROUND: Physical disability is a cause of depression among acute stroke patients. Although previous studies have shown that physical disability, perceived social support, mental resilience, and post-stroke depression are significantly related, the interaction mechanism remains unclear. METHODS: Convenience sampling was used to recruit participants from a tertiary hospital in Daqing City, Heilongjiang Province, China from October 2020 to May 2021. Participants completed the Barthel Index Rating Scale, Multidimensional Scale of Perceived Social Support, Connor-Davidson Resilience Scale and Zung Self-Rating Depression Scale. We used the PROCESS macro for SPSS to determine the mediating effect of perceived social support and resilience between disability and depression. RESULT: A total of 259 acute stroke patients participated in this study and completed the questionnaire survey. Stroke patients' BI scores was positively correlated with perceived social support (r = 0.26, P < 0.01) and resilience (r = 0.25, P < 0.01), and negatively correlated with depression (r = -0.47, P < 0.01). Perceived social support was positively correlated with resilience (r = 0.55, P < 0.01) and negatively correlated with depression (r = -0.41, P < 0.01). Resilience was negatively correlated with depression (r = -0.43, P < 0.01). Perceived social support and resilience played a mediating role of 10.27% and 5.74% of the total effects of disability and post-stroke depression, respectively. Meanwhile, the chain mediating effect of perceived social support and resilience (7%) was also significant. LIMITATIONS: The cross-sectional study design limited the inference of causal relationships between variables. This study used convenience sampling to select research participants from a single hospital, they were all acute stroke patients from the same region of China. Participants in our study were in high BI status, and thirty of them had a low level of education, which may contribute to the possibility of selection bias. Meanwhile, the low level of education and the poor eye-sight of old people prevents them from completing the questionnaire by themselves. So we collected data in the form of "researcher reading questionnaire items and recording participant responses" for the majority of participants (257 subjects), and only 2 participants completed it independently. Furthermore, the findings of this study may not apply to stroke survivors from other backgrounds. CONCLUSION: This study found that disability can directly predict post-stroke depression, and indirectly predict post-stroke depression through the mediating effect of perceived social support and resilience, and the chain mediating effect of perceived social support-resilience. Therefore, reducing the degree of disability of acute stroke patients and improving their perceived social support and resilience may help prevent post-stroke depression.

hsa_circ_0119412 overexpression promotes cervical cancer progression by targeting miR-217 to upregulate anterior gradient 2.

BACKGROUND: Mounting evidence summarizes that circRNA is closely implicated in the development of numerous cancers. Our study aimed to investigate the role of circ_0119412 whose function was not explored in cervical cancer. METHODS: RT-qPCR analysis was utilized for the expression analysis of circ_0119412, miR-217, and anterior gradient 2 (AGR2). CCK-8 assay, transwell assay, and MTT assay were employed to assess cell proliferation, migration, and adhesion, respectively. Animal study was performed to check the role of circ_0119412 in vivo. Bioinformatics analysis was applied to predict the downstream targets of circ_0119412. RIP assay was utilized to examine miRNAs potentially bound by circ_0119412. The interplays between miR-217 and circ_0119412 or AGR2 were validated by dual-luciferase reporter assay. RESULTS: circ_0119412 expression was highly enhanced in cervical tumor tissues and cancer cells. circ_0119412 overexpression aggravated cervical cancer cell proliferation, migration, and adhesion, and its overexpression was also conducive to tumor formation and growth in animal models. AGR2 was upregulated in cervical cancer by the public bioinformatics data. circ_0119412 bound to miR-217, and miR-217 bound to AGR 3'UTR. The promoting effects of circ_0119412 overexpression on cancer cell malignant phenotypes were reversed by miR-217 enrichment. In addition, increased expression of miR-217 suppressed AGR2 expression, thus weakening the functional effects of AGR2. CONCLUSION: circ_0119412 functioned as an oncogenic driver to promote the malignant development of cervical cancer by targeting the miR-217/AGR2 pathway.

Role of spindle pole body component 25 in neurodegeneration.

BACKGROUND: Aberrant growth and polarization of microglia are critical for pathological initiation and progression of neurodegenerative conditions like Alzheimer's disease (AD). However, the molecular signals that govern the outgrowth of microglia have not yet been fully determined. Spindle pole body component 25 (SPC25) is an important part for forming NDC80 complex, which plays a key role in the assembly of the microtubule-binding domain of kinetochores. Nevertheless, the role of SPC25 in microglial growth during neurodegeneration has not been described before, and was thus addressed in the current study. METHODS: We generated an adeno-associated virus (AAV) serotype PHP.B carrying short hairpin RNA (shRNA) for SPC25 (shSPC25) under a microglia-specific TMEM119 promoter (AAV-pTMEM-shSPC25). Serotype PHP.B allowed the virus to cross blood-brain barrier, while TMEM119 promoter allowed specific targeting microglia in vitro and in vivo. We intravenously administrated AAV-pTMEM-shSPC25 to AD-prone APP/PS1 male and female mice and determined this effect on microglia proliferation and mouse behavior. RESULTS: Depletion of SPC25 did not alter polarization of microglia cell polarization in vitro. On the other hand, AD-prone APP/PS1 mice that had received AAV-pTMEM-shSPC25 significantly decreased SPC25 levels in microglia and attenuated microglia proliferation, resulting in significant improvement of the performance of the mice in behavior tests. CONCLUSIONS: Specific depletion of SPC25 in microglia may prevent AD development through suppression of microglia outgrowth. SPC25 may be a promising novel target for preventing AD through microglia.

Disability Status and Its Influencing Factors Among Stroke Patients in Northeast China: A 3-Year Follow-Up Study.

PURPOSE: To explore the rate of post-stroke disability and its associated factors in the third year following discharge from inpatient rehabilitation in Northeast China. DESIGN: A prospective cohort study. METHODS: A total of 522 persons who were hospitalized with a diagnosis of stroke were recruited consecutively between April 2015 and December 2015 and followed for 3 years. The primary outcome was disability, which was assessed using the Modified Barthel Index (MBI), a cutoff score of ≤95 indicates disability. Plausible risk factors of disability were selected from available variables to perform multivariate logistic regression analysis. FINDINGS: The proportion of post-stroke patients with disability decreased from 63.8% to 46.7% at 3-year follow-up. The factors associated with post-stroke disability were age, neurological deficits, cognitive function, depression, and social support. CONCLUSIONS/CLINICAL RELEVANCE: Disability continues to be a significant issue for individuals after a stroke, and community health workers should perform targeted assessments and interventions to decrease disability, and pay special attention to individuals who are at greatest risk of post-stroke disability.

The mediating effect of family function and medication adherence between symptoms and mental disability among Chinese patients with schizophrenia: a cross-sectional study.

Schizophrenia is a debilitating, chronic, and high-refractory mental illness. Researchers should focus considerable attention to patients with mental disability. This study aims to explore the mediating effect of family function and medication adherence between symptoms and mental disability among Chinese patients with schizophrenia during the convalescent stage. Data from a cross-sectional sample of 499 Chinese patients with schizophrenia were used in this study. The participants were recruited and independently interviewed using the General Information Sheet, Positive and Negative Syndrome Scale (PANSS), World Health Organization Disability Assessment Schedule II (WHO-DAS II), Family APGAR Index (APGAR), and Morisky Medication Adherence Scale (MMAS-8) as outcome measures. A structural equation modeling strategy was used to analyze data. To analyze the correlation matrix, we applied the maximum-likelihood method to estimate the parameters. Bootstrapping was used to validate the mediation effects. Findings from the structural equation modeling demonstrated that family function and medication adherence played mediating roles between psychiatric symptoms and disability. This study presents a partial mediation model. Psychiatrists and nurses should assess the level of family function and medication adherence for schizophrenia, as well as provide interventions to improve family function and medication adherence, thereby eventually mediating disability.

Five-year prognosis after mild to moderate ischemic stroke by stroke subtype: a multi-clinic registry study.

BACKGROUND AND PURPOSE: Mild to moderate ischemic stroke is a common presentation in the outpatient setting. Among the various subtypes of stroke, lacunar infarction (LI) is generally very common. Currently, little is known about the long-term prognosis and factors associated with the prognosis between LI and non-LI. This study aims to compare the risk of death and acute cardiovascular events between patients with LI and non-LI, and identify potential risk factors associated with these outcomes. METHODS: A total of 710 first-ever ischemic stroke patients (LI: 474, non-LI: 263) from 18 clinics were recruited consecutively from 2003 to 2004. They were prospectively followed-up until the end of 2008. Hazard ratios and 95% confidence intervals were calculated using multivariable Cox proportional hazards regression. RESULTS: After a 5-year follow up, 54 deaths and 96 acute cardiovascular events occurred. Recurrent stroke was the most common cause of death (19 cases, 35.18%) and new acute cardiovascular events (75 cases, 78.13%). There were no significant differences between patients with LI and non-LI in their risks of death, new cardiovascular events, and recurrent stroke after adjusting for age, sex, hypertension, diabetes, cardiac diseases, body mass index, dyslipidemia, smoking, alcohol consumption, ADL dependence, and depressive symptoms. Among the modifiable risk factors, diabetes, hypertension, ADL dependency, and symptoms of depression were independent predictors of poor outcomes in patients with LI. In non-LI patients, however, no modifiable risk factors were detected for poor outcomes. CONCLUSION: Long-term outcomes did not differ significantly between LI and non-LI patients. Detecting and managing vascular risk factors and depression as well as functional rehabilitation may improve the prognoses of LI patients.