bluuebunny/crossref_metadata_2025 huggingface dataset:
Confocal laser scanning microscopy reveals species-specific differences in distribution of fluorescent proteins in coral tissues
Authors: Marchioro Giulia M. , Coelho David , Bouderlique Thibault , Abed-Navandi Daniel , Schagerl Michael , D’Angelo Cecilia , Kruckenhauser Luise , Adameyko Igor , Frade Pedro R.
Published: November 2024

Reef-building corals have a variety of green fluorescent protein (GFP)-like proteins, also known as fluorescent proteins (FPs). These proteins have broad spectral properties covering most of the visible spectrum, with fluorophores fluorescing from cyan to red. However, the role of FPs is still a topic of debate and requires further investigation, particularly in the direction of mapping these FPs within the coral tissue and describing their cell- and tissue-level distributions. This study applied confocal laser scanning microscopy (CLSM) to investigate species-specific differences in the distribution of FPs in three coral taxa (Stylophora sp., Acropora sp., Echinopora sp.), combined with their photoacclimation response and that of associated symbiotic algae to light gradients in a controlled aquarium experiment. CLSM produced high-resolution images that enabled the identification of different FPs, their tissue distribution and quantification of their fluorescence intensity, as well as quantification of symbiont chlorophyll a (chl-a) fluorescence. Emission scans revealed three emission peaks between 490 - 501 nm (cyan, CFPs), 510 - 515 nm (green, GFPs), and 679 nm (chl-a fluorescence signal; Fchl) shared by all three studied species. The distribution of GFPs in Stylophora was concentrated in the intermesenterial muscle bands of the polyp, whereas CFPs were typically located at the tips of the tentacles. In contrast, Acropora and Echinopora exhibited agglomeration of CFPs and GFPs primarily in the epidermis. In general, species-specific differences in FP distribution remained unaltered during the experiment. However, linear regression models showed a significant negative relationship between CFP fluorescence intensity and light irradiance in Stylophora, whereas Echinopora exhibited a negative relation between chlorophyll fluorescence (Fchl) and light. In summary, the CLSM methodology provided a high-resolution tool to study coral FP patterns and symbiont response to irradiance, revealing ecophysiological differences among coral species at the tissue and cellular levels. CLSM has the potential to elucidate the intricacies of coral photobiology within the natural environment and to discern their adaptive responses in situ.
Bridging the educational gaps of health professionals in oncogenomics: results from a pilot e-learning course
Authors: Stellacci Emilia , Martinelli Simone , Carbone Pietro , Demuru Elena , Genuardi Maurizio , Ghiorzo Paola , Novelli Giuseppe , Di Pucchio Alessandra , Regini Federica Maria , Guerrera Debora , Vittozzi Andrea , Barbina Donatella , Venanzi Serenella , van den Bulcke Marc , Boccia Stefania , Mazzaccara Alfonso , De Nicolo Arcangela , De Angelis Roberta
Published: November 2024

Background

Genetic and genomic literacy of health professionals is of utmost importance to realize the full potential of personalized medicine. As part of a European Union project, we piloted an e-learning course on oncogenomics, primarily targeted to physicians, and we assessed both its effectiveness and users’ satisfaction.

Methods

The course materials were developed in English according to the Problem-Based Learning method. Learning objectives, covering the basic principles of genetics and the OMICS technologies applied to oncology, were defined based on previously identified core competencies. We used a pre-test vs. post-test study design to assess knowledge improvements. Performance results by demographic and professional characteristics of participants were analyzed using univariate or multivariate statistical methods.

Results

Overall, 346 Italian professionals (61% physicians, 39% biologists) successfully completed the course. Their average post-test score was almost 19% higher than the pre-test (71.6% vs. 52.9%), with no significant differences by sex. Older age (>50 years) and southern area of residence were both correlated with higher gains. The average proportion of correct answers in the final certification test after three attempts was 85% (69% at first attempt), with some differences across professional categories. Methodology, quality of content and usability of the e-learning platform were all highly rated via satisfaction questionnaire (average scores between 4 and 5, scale 1 to 5).

Conclusion

The pilot phase confirmed the suitability of the e-learning as a cost-effective method to improve oncogenomic literacy of health professionals. Translation into natural languages and accreditation by European or country-specific Continuing Medical Education systems will be the main incentives for wider dissemination.
The value of off-pump coronary artery bypass grafting in the surgery for combined valvular and coronary heart disease
Authors: Qin Haokai , Si Pengrui , Hua Kun , Yang Xiubin
Published: November 2024

Background

Combined valve and coronary surgery is a commonly performed surgical technique for treating coexisting valvular and coronary artery disease. This study aims to investigate the effect of reducing the duration of cardiopulmonary bypass by utilizing the off-pump coronary artery bypass grafting (OPCABG) technique on the short-term prognosis of patients.

Methods

In this retrospective cohort study, 884 patients were divided into groups undergoing OPCABG or on-pump CABG combined with valve surgery based on the CABG technique. We evaluated the relationship between the surgical technique and operative mortality, postoperative atrial fibrillation (POAF), stroke, acute kidney failure (AKI), and perioperative myocardial infarction. Propensity score matching and inverse probability weighting (IPTW) were employed to mitigate differences in baseline characteristics between the two groups.

Results

The incidence of POAF and AKI were lower in the OPCABG group after IPTW (POAF: 29.5% vs. 39.5%, p = 0.016; AKI: 14.5% vs. 21.2%, p = 0.047). OPCABG technique was independently associated with the POAF (adjusted OR: 0.63, 95% CI: 0.44–0.91, p = 0.014) and AKI (adjusted OR: 0.63, 95% CI: 0.39–0.98, p = 0.049). These results remained even following PSM and IPTW analyses.

Conclusion

The OPCABG technique is associated with reduced occurrences of POAF and AKI in patients undergoing valve and concomitant coronary surgery and can be safely used.
Impact of COVID-19 lock-down period on orthopedic and trauma surgical activity in a northern Italian hospital
Authors: Turati Marco , Gatti Simone , Rigamonti Luca , Zatti Giovanni , Munegato Daniele , Crippa Marco , Benedettini Erik , Piscitelli Daniele , Bigoni Marco , Turati Riccardo
Published: November 2024

Objectives

This study aims to describe the impact of COVID-19 on Orthopedic and Trauma surgical activity in a single level-I trauma center in Northern Italy during the lockdown period. We proposed comparing surgical procedures performed during the outbreak and in the same period the previous year.

Methods

In this single-center retrospective epidemiological cohort study, the “lockdown cohort” of patients who were treated from March 1st to May 24th, 2020, was compared to the “control cohort” who received treatment during the same period in 2019. The primary outcome was to evaluate the differences between the lockdown and control cohorts regarding surgical volumes. The secondary outcome was to evaluate any differences in the type of surgical procedures performed in the two cohorts in the elective and emergency setting.

Results

Orthopedic surgical activity has suffered a global reduction of 72.4% during the lockdown period (from 36 ± 6.1 to 10.7 ± 8.4 per week; p < 0.01), with the ratio of emergency to elective operations increasing from 0.7:1 in 2019 to 3.3:1 in 2020. Elective surgery has in fact been almost completely suspended and was affected with a reduction of 88.9% (from 20.8 ± 5.2 to 4.3 ± 2.8 cases per week; p < 0.01), while emergency trauma surgery suffered a 49.7% reduction (from 15.1 ± 3.2 to 8.2 ± 6.1 cases per week; p < 0.01).

Conclusion

The COVID-19 outbreak severely impacted Italy, particularly the Lombardy region, and affected the national health system. The 2020 COVID-19 lockdown has heavily conditioned our Orthopedic and Trauma department surgical activity.
Identifying biomarkers of endoplasmic reticulum stress and analyzing immune cell infiltration in chronic obstructive pulmonary disease using machine learning
Authors: Zhang Shuaiyang , Duan Hangyu , Yan Jun
Published: November 2024

Background

Endoplasmic reticulum stress (ERS) is a crucial factor in the progression of chronic obstructive pulmonary disease (COPD). However, the key genes associated with COPD and immune cell infiltration remain to be elucidated. Therefore, this study aimed to identify biomarkers pertinent to the diagnosis of ERS in COPD and delve deeper into the association between pivotal genes and their possible interactions with immune cells.

Methods

We selected the genetic data of 189 samples from the Gene Expression Omnibus database, including 91 control and 98 COPD samples. First, we identified the differentially expressed genes between patients with COPD and controls and then screened the ERS genes associated with COPD. Second, 22 core ERS genes associated with COPD were screened using the Least Absolute Shrinkage and Selection Operator (LASSO) regression model and Support Vector Machine Recursive Feature Elimination (SVM-RFE), and the predictive effects of the screened core genes in COPD were evaluated. Third, we explored immune cell infiltration associated with COPD and conducted an in-depth analysis to explore the possible connections between the identified key genes and their related immune cells.

Results

A total of 66 differentially expressed endoplasmic reticulum stress–related genes (DE-ERGs) were identified in this study, among which 12 were upregulated and 54 were downregulated. The 22 key genes screened were as follows: AGR3, BCHE, CBY1, CHRM3, CYP1B1, DCSTAMP, DDHD1, DMPK, EDEM3, EDN1, FKBP10, HSPA2, KPNA2, LGALS3, MAOB, MMP9, MPO, MTTP, PIK3CA, PTGIS, PURA, and TMCC1. Their expression was significantly different between COPD and healthy samples, and the difference between the groups was significant. Receiver operating characteristic curve analysis revealed that CBY1 (area under the curve [AUC] = 0.800), BCHE (AUC = 0.773), EDEM3 (AUC = 0.768), FKBP10 (AUC = 0.760), MAOB (AUC = 0.736), and MMP9 (AUC = 0.729) showed a strong ability to distinguish COPD samples from normal samples. Immune cell infiltration results associated with the three key genes were also obtained.

Conclusion

The insights of our study have the potential to present new evidence for exploring emerging diagnostic signs of COPD while also contributing to a better understanding of its developmental mechanisms.
Atypical presentation of acute retinal necrosis mimicking Vogt-Koyanagi-Harada disease leading to misdiagnosis: a case report
Authors: Zhu Wei , Yu Cuiyun , Guo Qianqian , Kang Qingran , Cao Xusheng
Published: November 2024

Acute retinal necrosis (ARN) is a serious, sight-threatening condition characterized by rapidly progressive necrotizing retinitis, most commonly caused by varicella-zoster virus and herpes simplex virus. We report an atypical case of ARN in a 57-year-old immunocompetent male, initially misdiagnosed as Vogt-Koyanagi-Harada (VKH) disease. This case highlights the challenges in the early differential diagnosis of infectious and non-infectious uveitis. Misdiagnosis can lead to a delay in initiating antiviral therapy, potentially accelerating disease progression and worsening visual outcomes.
Investigating the feasibility and effectiveness of bacterial culture in negative pressure wound drainage fluid
Authors: Wu Junjie , Chang Zhengqi
Published: November 2024

Purpose

To analyze the feasibility and effectiveness of bacterial culture in negative pressure wound drainage (NPWD) fluid in patients with Pyogenic Vertebral Osteomyelitis (PVO).

Methods

A retrospective analysis was performed on 17 patients with PVO who were treated with negative pressure drainage at the Department of Orthopedics in our hospital from January 1, 2018 to December 31, 2021. Data was obtained while the patients were in the hospital, including 12 males and 5 females with an average age of 57.71 ± 9.93 years. After applying the negative pressure drainage technique, the drainage fluid was collected and a bacterial culture was performed. The positive rate of bacterial culture in the drainage fluid was recorded. Comparing the positive rate of specimen culture obtained by this surgical method with other methods reported in the literature, the effectiveness of negative pressure drainage in the treatment of PVO was analyzed.

Results

All patients were placed with negative pressure sponge during operation and underwent continuous negative pressure aspiration after operation. The average of total drainage volume was 186.47 ± 29.44 mL. The drainage fluid was successfully retained for bacterial culture, and the results of bacterial culture were negative in 3 patients. Pathogenic bacteria were successfully obtained from negative pressure drainage fluid in 14 cases, with a positive rate of 82.4% (14/17).

Conclusion

Using negative pressure drainage to retain drainage fluid for bacterial culture can significantly increase the positive rate, which is helpful for the diagnosis of PVO and rational antibiotic treatment.
Effect of fatty liver disease on liver function and fibrosis in patients with chronic hepatitis B: a cross-sectional study
Authors: Fang Xiaohui , Yin Yuhang , Zhao Haonan , Wang Cai’e , Li Hui , Shang Yiyang , Li Jiayu , Gao Yue , Méndez-Sánchez Nahum , Qi Xingshun
Published: November 2024

Purpose

Chronic hepatitis B (CHB) and fatty liver disease (FLD) are common chronic liver diseases, both of which can progress to advanced liver diseases with poor outcome. However, it remains controversial whether the presence of FLD aggravates the disease severity of CHB patients.

Patients and methods

All consecutive outpatients who were diagnosed with CHB at our department between March 1, 2021 and September 30, 2023 were retrospectively screened. They were divided into FLD and non-FLD groups. Liver function parameters and non-invasive indicators of liver fibrosis, including liver stiffness measurement (LSM) value, fibrosis-4 index (FIB-4) score, and aspartate aminotransferase to platelet ratio index (APRI) score, were compared between the two groups. Subgroups analyses were performed in HBeAg-positive, HBeAb-positive, HBV DNA > 10 IU/mL, mild FLD, and moderate/severe FLD patients.

Results

Overall, 201 CHB patients were included, of whom 76 (37.81%) had FLD. In the overall analyses, CHB patients with FLD had a significantly higher alanine aminotransferase (ALT) (47.04 ± 53.28 vs. 32.95 ± 35.10, p = 0.003) than those without FLD, but there was no significant difference in the LSM value (7.79 ± 5.16 vs. 8.19 ± 4.99, p = 0.508), FIB-4 score (1.13 ± 0.75 vs. 1.28 ± 0.99, p = 0.679), and APRI score (0.41 ± 0.46 vs. 0.36 ± 0.47, p = 0.535) between CHB patients with and without FLD. The above-mentioned statistical results in all subgroup analyses were nearly consistent with those in the overall analyses.

Conclusion

FLD may intensify abnormal liver function reflected by increased ALT level in CHB patients, but not influence the progression of liver fibrosis.
The diagnostic and prognostic value of soluble ST2 in Sepsis
Authors: Ye Xinghua , Wang Jia , Hu Le , Zhang Ying , Li Yixuan , Xuan Jingchao , Han Silu , Qu Yifan , Yang Long , Yang Jun , Wang Junyu , Wei Bing
Published: November 2024

Objective

To determine the diagnostic and prognostic value of soluble suppression of tumorigenicity 2 (sST2) in patients with sepsis.

Methods

A total of 113 critically ill patients were enrolled at the emergency department of Beijing Chaoyang Hospital Jing Xi Branch. Venous blood levels of sST2 were measured using the AFIAS-6 dry fluorescence immunoassay analyzer. Based on Sepsis 3.0 criteria, patients were categorized into a sepsis group (76 cases) and a non-sepsis group (37 cases). The sepsis group was further divided into non-survivors (38 cases) and survivors (38 cases) based on 28-day survival outcomes. The vital signs, blood gas analysis, routine blood tests, liver and kidney function tests, procalcitonin (PCT), C-reactive protein (CRP), sST2, left ventricular ejection fraction (LVEF), and other basic characteristics of the patients were recorded. Further, the SOFA, qSOFA and APACHE II scores of each patient were calculated. Statistical analysis was performed using SPSS 25.0, including logistic regression and ROC curve analysis to assess prognostic factors.

Results

The serum sST2 levels in the sepsis group (125.00 ± 60.32 ng/mL) were significantly higher than in the non-sepsis group (58.55 ± 39.03 ng/mL) (p < 0.05). The SOFA score (8.08 ± 2.88), APACHE II score (18.00 ± 4.72), blood sST2 levels (168.06 ± 36.75 ng/mL) and lactic acid levels (2.89 ± 3.28) in the non-survivor group were significantly higher than the survivor group (p < 0.05). Multiple logistic regression analysis showed that sST2, SOFA score, APACHE II score and lactic acid levels were independent risk factors for poor prognosis in patients with sepsis. The ROC curve analysis of the above indexes showed no significant differences between the AUC of sST2 (0.912) and the SOFA score (0.929) (z = 0.389, p = 0.697), or the APACHE II score (0.933) (z = 0.484, p = 0.627). However, there was a significant difference between the AUC of sST2 (0.912) and lactic acid levels (0.768) (z = 2.153, p = 0.030).

Conclusion

Blood levels of sST2 show a clinically diagnostic and prognostic value in sepsis. Further, sST2 shows a similar predictive ability as the SOFA and APACHE II scores in determining the prognosis of sepsis patients. However, sST2 has a higher predictive ability than lactic acid levels in determining prognosis in sepsis.
Effect of extracorporeal shock wave therapy on nerve conduction: a systematic review and meta-analysis
Authors: Yang Liuxin , Li Xuan , Li Shuhan , Yang Jiao , Meng Dianhuai
Published: November 2024

Background

Extracorporeal shock wave therapy (ESWT), as a non-invasive physical agent modality, was effective in relieving spasticity, reducing pain, and improving dysfunction. This systematic review and meta-analysis aimed to investigate the effect of ESWT on nerve conduction, and to find out whether the ESWT group is superior to the control or other comparison groups, thus providing support for guiding the rehabilitation of peripheral nerve injury in clinical work.

Methods

PubMed, Web of Science, the Cochrane Library, and Embase were searched from inception to August 20, 2024. This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered in the PROSPERO database (registration number CRD42024500891). It aimed to compare (1) the ESWT group (ESWT) and baseline, and (2) subgroup analyses: ESWT and the control group (Control), ESWT and the local corticosteroid injection group (LCI), ESWT combined with physical therapy (ESWT + PT) and PT alone, and ESWT and PT. Outcome indicators extracted were nerve conduction study results: sensory nerve action potential (SNAP) amplitude, SNAP distal latency, sensory nerve conduction velocity (SNCV), compound muscle action potential (CMAP) amplitude, motor nerve distal latency (MNDL), motor nerve conduction velocity (MNCV), H/M ratio and H-reflex latency.

Results

A total of 879 papers were identified through the database searches. Twenty-four trials were included in the systematic review, and 22 trials were included in the meta-analysis. The results showed that: (1) compared to the baseline, ESWT reduced SNAP distal latency mid-term (MD, −0.39; 95% CI: −0.52, −0.26; I2 = 85%), and improved SNCV both short-term (MD, 4.36; 95% CI: 1.23, 7.49; I2 = 91%) and mid-term (MD, 2.65; 95% CI: 1.79, 3.51; I2 = 61%). At the same time, it reduced MNDL short-term (MD, −0.61; 95% CI: −0.91, −0.30; I2 = 92%), but had no significant effect on MNCV. (2) Subgroup analyses showed that ESWT was superior to Control but not significantly better than LCI, especially in SNCV. The excitatory effect of ESWT + PT on the sensory and motor nerves was significantly better than that of PT alone.

Conclusion

ESWT had some excitatory effect on peripheral nerves, especially on sensory nerve studies. Although the efficacy of this treatment was superior to that of the control group, and the combined treatment with PT was more effective than PT alone, its efficacy might not exceed that of LCI.

Systematic review registration

Unique identifier: PROSPERO (CRD42024500891).
Synergistic effects of combined motor and language interventions on stroke rehabilitation: a holistic approach
Authors: Saber-Moghadam Reihaneh , Zeinalzadeh Afsaneh , Jamali Jamshid , Farzadfard Mohammad Taghi , Sobhani-Rad Davood
Published: November 2024

Background

Stroke patients typically suffer from a range of symptoms, such as motor and language impairments, due to shared neural networks. The recovery process after stroke is intricate and requires a comprehensive approach. While previous studies have investigated the motor and language interventions independently, this study aimed to explore the relationship between these domains and compared the effectiveness of individual interventions versus their combined use.

Methods

We divided 45 stroke patients into three groups: Speech and Language Therapy (SLT) group; Arm Ability Training (AAT) group; and consecutive combination of SLT and AAT group. Participants attended 40-min sessions three days a week for three weeks. Standardized assessments, including picture naming test, syntactic comprehension test, and Test d’Evaluation des Membres Supérieurs de Personnes Âgées (TEMPA) test, were conducted pre-and post-treatment and during the first and second weeks of the intervention.

Results

Within-group comparisons demonstrated a significant enhancement in test scores for all groups post-intervention compared to pre-intervention (p < 0.05). Between-group comparisons revealed significant differences (p < 0.05) in performance on the picture naming test during the first week, the syntactic comprehension test in the second week, the functional rating subscale of Tempa test changes pre-and post-treatment and the first week, and the length of the time subscale of Tempa test improvements from pre-intervention to the first week.

Conclusion

Findings underscored the mutual and synergistic benefits of integrating motor and language in stroke rehabilitation. While SLT and AAT were effective when applied independently, their combined application yielded superior outcomes, emphasizing the holistic advantages of integrating these interventions, as supported by existing literature on dual-task rehabilitation strategies.

Clinical trial registration

https://irct.behdasht.gov.ir/search/result?query=IRCT20200114046134N1, IRCT20200114046134N1.
Combination of triple chemotherapy and sequential re-irradiation as salvage for recurrent treatment-refractory hemangiopericytoma of extraspinal dura: a case report
Authors: Wang Min , Lv Wanrui , Chen Xi , Cheng Ke
Published: November 2024

Introduction

Hemangiopericytoma (HPC) in the central nervous system (CNS) is rare. Our report aims to present an HPC case with multiple surgeries at the lumbar spine, and demonstrates an effective treatment as salvage.

Case report

In this report, we present the case of a young girl with recurrent meningeal invasion of lumbar spinal HPC. The patient underwent multiple surgeries to remove the tumors, and adjuvant radiotherapy was administered after the initial resection. And it presented a pathological anaplastic transformation with subsequent accelerated recurrence. A combination therapy approach involving triple chemotherapy and sequential re-irradiation was found to be effective as salvage treatment at the third recurrence.

Conclusions

Surgical resection remains the primary treatment modality for HPC in the spine, despite its high tendency for local recurrence and the risk of metastasis. For unresectable recurrent HPC, combining chemotherapy and sequential re-irradiation might be a highly effective, and safe reference regimen as the salvage treatment for the refractory case.
Superior survival benefits of triple combination immunotherapy compared to standard chemotherapy as second-line treatment for advanced biliary tract cancer: a retrospective analysis
Authors: Shang Peipei , Xu Heming , Zeng Tianmei , Lou Cheng , Wei Wei , Yang Guang , Cheng Zhuo , Cui Xiaowen , Hong Weipeng , Shen Weidong , Lian Zhicong , Yuan Zhengang
Published: November 2024

Background

Advanced biliary tract cancer (BTC) is associated with a poor prognosis and limited options for second-line treatment. The TOPAZ-1 and KEYNOTE-966 trials have demonstrated the benefits of combining immune checkpoint inhibitors (ICIs) with chemotherapy in treating BTC. However, the efficacy of FOLFOX as a second-line therapy is limited, highlighting the need for more effective treatment approaches.

Methods

This retrospective study compared a triple regimen—comprising ICIs, tyrosine kinase inhibitors, and chemotherapy—to standard chemotherapy in patients with metastatic BTC who had progressed on first-line gemcitabine-based therapy. The primary endpoint was progression-free survival (PFS), with secondary endpoints including overall survival (OS), overall response rate (ORR), disease control rate (DCR), and safety.

Results

Of the 121 patients, 86 received the triple regimen and 35 received standard chemotherapy. The triple regimen showed a significantly higher ORR (37.2% vs. 2.8%, p < 0.0001) and DCR (89.5% vs. 71.4%). The median PFS was 6 months for the triple regimen compared to 2.0 months for standard chemotherapy (HR 0.29, p < 0.0001). The median OS was 16.0 months for the triple regimen versus 6.0 months for standard chemotherapy (HR 0.35, p < 0.0001). Treatment-related adverse events were comparable between the groups.

Conclusion

The triple combination of immunotherapy offers superior survival benefits compared to standard chemotherapy as a second-line treatment for advanced BTC, warranting further investigation for potential clinical adoption.
Opportunistic infections among schoolchildren who were on antiretroviral therapy in Ethiopia: a systematic review and meta-analysis
Authors: Birhanu Molla Yigzaw , Telayneh Animut Takele , Kassie Abere , Tegegne Eniyew , Jemberie Selamawit Shita
Published: November 2024

Introduction

The most common and severe cause of morbidity and mortality among HIV- positive children is opportunistic infections (OIs). All HIV-infected children are at risk of developing a variety of OIs. Healthcare workers, programmers, and other stakeholders are in doubt about using the onset and predictors of OIs among schoolchildren on antiretroviral therapy (ART) due to the presence of conflicting results found in the primary studies. Hence, this study was conducted to provide a single figure of onset and specific predictors of OIs by overcoming the existing heterogeneity in Ethiopia.

Methods

The included studies were searched from different national and international databases systematically. The included studies were cohort in design and published in English between 2015 and 2022. The data were extracted using a validated Microsoft Excel tool after the quality of the included studies was assured. The extracted data were exported to Stata Version 17.0 for further management and analysis. The presence of heterogeneity across studies was checked using the Chi-square test and quantified using the I2 test. Various methods, including forest plots, publication bias assessment, sensitivity tests, subgroup analysis, and meta-regression, were employed to determine the source of heterogeneity, but none were successful. The overall onset of OIs was estimated by pooling the incidence of primary studies using a random-effects meta-analysis model. The predictors were identified using meta-regression and the presence of significant association was declared using a p-value of 0.05 with 95% CI. The strength of association was reported using an adjusted hazard ratio with 95% CI.

Results

Eleven studies were included in this systematic review and meta-analysis. The onset of OIs among schoolchildren on ART in Ethiopia was 5.58 (95% CI: 4.50, 6.67) per 100 children-years of OI-free observations. Those children who had no parents had a 1.41 (95% CI: 1.10, 1.80) times higher chance of getting OIs when compared with those children having one or both parents. Children who had poor ART adherence had a 2.96 (95% CI: 1.66, 5.29) times higher chance of experiencing OIs than children who had good ART adherence. Finally, the chance of experiencing OIs among rural children was 2.15 (95% CI: 1.63, 2.83) times higher than their counterparts in Ethiopia.

Conclusions

Three in every 33 schoolchildren on ART developed OIs in Ethiopia. Predictors of OIs included schoolchildren without parents, those with poor adherence to ART, and rural residents. This suggests that social support, medication adherence, and access to healthcare services may play important roles in preventing and controlling OIs among schoolchildren living with HIV in rural areas.
Respiratory syncytial virus burden in children under 2 years old in understudied areas worldwide: gap analysis of available evidence, 2012–2022
Authors: Sini de Almeida Rodrigo , Leite João , Atwell Jessica E. , Elsobky Malak , LaRotta Jorge , Mousa Mostafa , Thakkar Karan , Fletcher Mark A.
Published: November 2024

Background

We evaluated published evidence (2012–2022) on pediatric RSV burden in 149 countries within World Health Organization (WHO) regions of Africa (AFRO), Americas (AMRO, excluding Canada and the USA), Eastern Mediterranean (EMRO), Europe (EURO, excluding European Union countries and the UK), Southeast Asia (SEARO), and Western Pacific (WPRO, excluding Australia, China, Japan, New Zealand, and South Korea).

Methods

Gap analysis on RSV-associated disease (hospitalizations, hospital course, mortality or case fatality, detection, and incidence) in children ≤2 years old, where hospitalization rates, hospital course, mortality rate, case fatality rate (CFR), and postmortem detection rates were summarized, by region, for each country.

Results

Forty-two publications were identified covering 19% of included countries in AFRO, 18% in AMRO, 14% in EMRO, 15% in EURO, 18% in SEARO, and 13% in WPRO. Methods, case definitions, and age groups varied widely across studies. Of these 42 publications, 25 countries reported hospitalization rate, hospital course, mortality rate, CFR, and/or postmortem detection rate. RSV hospitalization rate (per 1,000 children per year/child-years) was higher among ≤3-month-olds (range, 38 in Nicaragua to 138 in the Philippines) and ≤6-month-olds (range, 2.6 in Singapore to 70 in South Africa) than in 1–2-year-olds (from 0.7 in Guatemala to 19 in Nicaragua). Based on 11 studies, in AFRO (South Africa), AMRO (Chile and Mexico), EMRO (Lebanon and Jordan), EURO (Israel and Turkey), and SEARO (India), hospitalized children ≤2 years old remained hospitalized for 3–8 days, with 9%–30% requiring intensive care and 4%–26% needing mechanical ventilation. Based on a study in India, community-based CFR was considerably higher than that in the hospital (9.1% vs. 0% in ≤3-month-olds; 7.1% vs. 2.8% in ≤6-month-olds).

Conclusions

National and regional heterogeneity of evidence limits estimates of RSV burden in ≤2-year-olds in many WHO region countries, where further country-specific epidemiology is needed to guide prioritization, implementation, and impact assessment of RSV prevention strategies.
Case Report: Multi-targeted therapy in the treatment of severe toxic epidermal necrolysis
Authors: Kwong Elaine Yi Lee , Kuok Manson Chon In , Lam King Fai , Chan Winnie Kwai Yu
Published: November 2024

We reported a 10-year-old child who suffered from severe toxic epidermal necrolysis triggered by trimethoprim–sulfamethoxazole and managed successfully with multi-targeted therapy. He was jointly managed by a paediatric intensivist, a dermatologist, an otolaryngologist, a urologist, a wound nurse, a pain management specialist, a dietitian, and a clinical psychologist. Systemic intravenous immunoglobulin and pulsed-dose methylprednisolone were initiated after admission. Oral cyclosporin A was added in the early stage of the disease in view of severe ocular involvement with progressive inflammation of bilateral upper and lower eyelids, the presence of pseudomembrane, diffuse conjunctival injection, and progression of central epithelial defects in bilateral eyes. He underwent amniotic membrane transplantation. Subcutaneous injection of etanercept was added on the treatment to allow rapid tapering of steroids. Finally, the disease progression was halted with re-epithelisation on day 13. He experienced no side effects from the multi-targeted therapy and recovered well without clinical sequelae.
The impact of SARS-CoV-2 infection on immunity reconstitution among pediatric patients after allogeneic hematopoietic stem cell transplantation: a propensity score-matched analysis
Authors: Wang Xin , Liu LiPeng , Zhang Luyang , Shang Yue , Chen Xia , Ren Yuanyuan , Liu Fang , An Wenbin , Wan Yang , Li Xiaolan , Yang Wenyu , Zhu Xiaofan , Guo Ye
Published: November 2024

Background

Immunity reconstitution (IR) is crucial for pediatric patients undergoing hematopoietic stem cell transplantation (HSCT), but the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on lymphocyte subsets post-transplant remains unclear. Therefore, we assessed immune cell dynamics in children after SARS-CoV-2 infection.

Methods

We enrolled 42 children, including 21 post-HSCT SARS-CoV-2 infected and 21 matched, non-infected historical controls (1:1 matching based on propensity scores). The time from HSCT to SARS-CoV-2 infection in the infected group was determined by the beginning of follow-up for the non-infected group. The primary endpoint was 270-day IR kinetics post-infection.

Results

Our findings showed similar recovery trends between the infected group and non-infected group both in UCB and HID recipients. In the UCB cohort, the NK cell reconstitution in the infected group was poorer compared to the non-infected group, but this difference did not reach statistical significance (P = 0.178). Furthermore, HID transplantation might be a trend towards poor CD19+ T-cell reconstitution [hazard ratio (HR): 0.43, 95% CI: 0.18–1.04, p = 0.06]. No statistically significant difference was observed in terms of secondary infections across the UCB (P = 0.150) and HID (P = 0.980) cohorts as well as there was no discernible difference in overall survival between the two groups (P = 1).

Conclusions

Our analysis reveals that SARS-CoV-2 might temporarily impaired the IR process in the short term, with recovery to a comparable trend as observed in non-infected patients approximately 9 months post-infection.
Chrysophanol attenuates cognitive impairment, neuroinflammation, and oxidative stress by TLR4/NFκB-Nrf2/HO-1 and BDNF/VEGF signaling in stress-intensified PTZ induced epilepsy in mice
Authors: Khan Jehan Zeb , Zainab Syeda Rida , Rehman Mujeeb Ur , Abid Muhammad , Shah Fawad Ali , Rehman Najeeb Ur , Tipu Muhammad Khalid
Published: November 2024

Background

Stress is among the most common comorbid conditions with epilepsy and a strong factor in the pathophysiology of seizures. An imbalance in neuronal circuits causes recurrent unprovoked seizures in epilepsy. Dysregulation of BDNF/VEGF expression, oxidative stress, increased levels of neuroinflammatory cytokines, and increased expression of apoptotic genes contribute to the underlying cause of the seizure.

Objectives

Chrysophanol, an anthraquinone, has broad-spectrum therapeutic potential. This study evaluated the neuroprotective effect of chrysophanol with underlying pathways in PTZ-induced epilepsy with stress as a comorbid condition.

Methods

Male mice were given 35 mg/kg of PTZ every other day to induce seizures. In addition, they were exposed to 120 min of daily restraint stress for 21 days to induce stress. Chrysophanol (0.1, 1, 10 mg/kg) was administered to the mice 30 min before the PTZ in the acute study. The most effective dose (10 mg/kg) was proceeded for the chronic epilepsy model. Following this, various tests were conducted, including behavioral assessments for memory impairment and stress, analysis of antioxidant levels, histopathological and immunohistochemistry examinations, measurement of cortisol levels using ELISA, and gene expression analysis using RT-PCR.

Results

Chrysophanol demonstrated a notable decrease in both the intensity and frequency of seizures. Additionally, it effectively boosted the levels of important antioxidants such as GSH, GST, and CAT, while simultaneously reducing the levels of MDA and Nitric oxide. The histopathological analysis also showed improvement in overall morphology and survival of neurons. Chrysophanol treatment effectively showed an increase in the expression of BCL-2, and Nrf-2 with a decrease in BAX expression confirmed by immunohistochemistry. Dysregulation of vascular permeability factor, production of inflammatory cytokines, and apoptotic gene expression was successfully reversed after chrysophanol treatment analyzed through RT-PCR. Cortisol concentration was decreased in treatment groups analyzed through Enzyme-linked immunoassay. Molecular docking of chrysophanol with different proteins declared the binding affinity of the ligands with the target sites of proteins.

Conclusion

In conclusion, chrysophanol demonstrated remarkable neuroprotective and antiepileptic effects at a dose of 10 mg/kg in stress-exacerbated PTZ-induced epilepsy following the TLR4/NFκB -Nrf2/HO-1 and BDNF/VEGF pathways.
Factors influencing intrapatient variability of tacrolimus and its association with 1-year post-transplant outcomes in pediatric liver transplant recipients
Authors: Fang Chuxuan , Dong Chunqiang , Huang Kaiyong , Wen Ningyu , Chen Yiyu , Tang Shuangyi
Published: November 2024

Objective

This study aims to explore the factors influencing tacrolimus intrapatient variability (TAC-IPV) and its association with 1-year post-transplant outcomes in pediatric liver transplant recipients.

Methods

Clinical and biological data of pediatric patients after liver transplantation were collected. The patients were divided into high- and low-IPV groups according to the median TAC-IPV for statistical comparisons. Factors with p < 0.05 in univariate analysis were introduced into binomial logistic regression analysis. Correlation analysis was used to test the connections between the Tac-IPV and outcomes within 1 year after liver transplantation (LT), and Kaplan–Meier was used to draw the survival curves.

Results

A total of 116 children underwent 746 measurements of TAC trough concentrations. The median TAC-IPV was 32.31% (20.81%, 46.77%). Hematocrit (p = 0.017) and concomitant medications (p = 0.001) were identified as independent influencing factors for TAC-IPV. The incidence of transplant rejection (p = 0.008), CMV infection (p < 0.001), and hospital admission due to infection (p = 0.003) were significantly higher in the high-IPV group than in the low-IPV group. Kaplan–Meier survival analysis suggests that after considering the time factor, high IPV (IPV > 32.31%) was still significantly associated with transplant rejection (HR = 3.17 and p = 0.005) and CMV infection (HR = 2.3 and p < 0.001) within 1 year after LT.

Conclusion

The study highlights the significant variation in TAC-IPV among children post-liver transplantation, emphasizing the impact of hematocrit levels and concomitant medications on TAC-IPV. Elevated TAC-IPV is associated with increased risks of transplant rejection, CMV infection, and readmission due to infection in the first year after liver transplantation. Close monitoring of patients with high TAC-IPV is recommended to promptly detect adverse reactions and provide timely intervention and treatment.
Drug-induced hearing disorders: a disproportionality analysis of the FAERS database
Authors: Li Baojian , Hu Xiaoling , Yue Zichen
Published: November 2024

Background

To evaluate and identify reports of adverse events related to hearing impairment with drugs approved in the past 20 years, to identify new adverse reaction signals related to hearing impairment that have not yet been reported, and to improve the safety of drug treatments.

Methods

The adverse event report data from the FAERS database from the first quarter of 2004 to the fourth quarter of 2023 were retrieved. “Hearing disorders” was used as the keyword to screen for drugs related to the adverse event. After standardizing the drug name and the adverse drug event name, the adverse event reports with hearing disorders as the main suspect were collected, and the proportional imbalance algorithm was used to detect the potential adverse event signals to drug-related hearing impairment.

Results

The top five drugs with the highest number of reported adverse events to hearing impairment were sacubitril/valsartan (2,674), adalimumab (2,479), etanercept (1,834), tofacitinib (1,812), and apixaban (1,600). Except for adalimumab, the risk of hearing impairment is not mentioned in the instructions. The top five drugs for new signal strength are pancuronium (n = 13, ROR 67.57, PRR 53.61, IC5.74, EBGM 53.06), paromomycin (n = 6, ROR 46.3, PRR 39.33, IC5.30, EBGM 39.33), tafamidis (n = 300, ROR 14.90, PRR 14.13, IC3.82, EBGM 14.07), vildagliptin/metformin (n = 83, ROR 11.47, PRR 11.02, IC3.46, EBGM 11.01), and atorvastatin calcium/ezetimibe (n = 6, ROR 10.76, PRR 10.36, IC3.37, EBGM 10.36).

Conclusion

Our study covered 20 years of real-world data on reports of adverse events related to hearing impairment in the FAERS database, validating previous reports and studies, as well as identifying drugs that signal new adverse events of hearing impairment, especially some drugs commonly used for the treatment of chronic diseases (a combination of hypoglycemic drugs, antihypertensive drugs, and lipid modulators) and some new drugs in the 5-year post-market period.
Significant improvement of organic solar cells with ternary additives
Authors: Wang Minshuai
Published: November 2024

Organic photovoltaics (OPVs) are gaining traction as a cost-effective and scalable alternative to conventional silicon-based solar cells, owing to their lightweight, flexibility, and tunable optical and electrical properties. Despite these advantages, the performance of OPVs is frequently hindered by non-optimal phase-separated morphologies that limit charge transport and extraction. A promising avenue to enhance the power conversion efficiency (PCE) of OPVs involves the incorporation of ternary additives, which have been shown to significantly refine the morphology of organic semiconductor blends. These additives promote the formation of a fibrillar-like nanoscale interpenetrating network, enhancing charge separation and transport. The dual-connected morphology achieved through ternary additives is crucial for improving the PCE. Additionally, the parallel bulk-heterojunction model formed by ternary additives has been instrumental in elucidating the photovoltaic parameters and understanding the effects of cascading heterojunction formation. Notably, block copolymer additives as one of ternary additives have demonstrated potential in stabilizing mixed donor-acceptor morphologies, leading to more efficient charge transfer. This review will explore the role of ternary additives in optimizing the morphology of OPVs and their impact on device performance, highlighting the mechanisms of block copolymer additives.
Broadband continuous absorber based on dual-mode coupling resonance
Authors: Liu Haixia , Liu Yu , Li Wenjie , Li Tianqi , Zhang Shashi
Published: November 2024

The continuous detection of visible to near-infrared light is a critical focus in optics due to its broad application value. To address this challenge, we present a graphene-based gradient groove metasurface (GGM) that enables efficient broadband absorption by simultaneously exciting surface plasmon polariton (SPP) resonance and Fabry-Pérot (FP)-like cavity resonance within multiple grooves. This dual-mode coupling effectively mitigates SPP losses and overcomes the size constraints of FP cavities, allowing for broadband, angle-insensitive absorption from 600 to 1,100 nm with an average absorption rate of 87.5%. Finite element simulations further show that variations in groove fillet radius variations from 5 nm to 20 nm and sidewall inclination variations from 0.02 to 0.22, result in absorption deviations of less than 2% and 6%, respectively, demonstrating the structure’s robustness against industrial processing errors. These findings suggest that the proposed GGM structure can significantly expand the application range of photodetectors in the visible to near-infrared wavelength bands, offering a promising solution for optical sensing applications.
Flower morphology, flower color, flowering and floral fragrance in Paeonia L.
Authors: Fan Yongming , Jin Xing , Wang Mengshan , Liu Huadong , Tian Weili , Xue Yandong , Wang Kai , Li Hu , Wu Yan
Published: November 2024

Paeonia have diverse flower colors, rich flower types, varying bloom periods, and delightful fragrances, rendering them highly valuable for both ornamental and economic purposes in horticulture. Investigating the developmental mechanisms of morphology, flower color, flowering and floral fragrance in Paeonia holds significant value for enhancing their ornamental traits and conducting germplasm improvement. This review provides an overview of research progress on Paeonia flower morphology (including flower bud differentiation, classification, omics applications in shape studies, and functional genes regulating flower morphology), flower colors (omics applications in color research and functional genes regulating flower colors), bloom periods (flower bud dormancy, flowering time), and fragrances (preparation, analysis, components, and molecular biology research of flower fragrances) within the Paeonia. Additionally, it offers a comprehensive analysis of current research challenges and future directions.