bluuebunny/crossref_metadata_2025 huggingface dataset:
SOCS3 inhibits the mesenchymal stromal cell secretory factor SDF-1-mediated improvement of islet function in non-obese diabetic mice
Authors: Sui Mingxing , Li Tuo , Lu Hanlan , Li Yanhua , Huang Juan , Zhang Pei , Wang Shusen , Zeng Li
Published: July 2023

Background

Islet transplantation is used therapeutically in a minority of patients with type 1 diabetes (T1D). However, successful outcomes are hampered by early islet β-cell loss caused by immune rejection and autoimmunity. Recent studies have demonstrated that mesenchymal stromal cells can enhance islet function both in vitro and in vivo by secreting ligands that activate islet G-protein coupled receptors (GPCRs). Stromal cell-derived factor 1 (SDF-1) is an MSC-secreted GPCR ligand, whereas the suppressor of cytokine signaling 3 (SOCS3) is a negative regulator of STAT3-activating cytokines. Here, we determined whether improvement in islet function mediated by exogenous SDF-1 is impaired by SOCS3 in experimental models of T1D.

Methods

Isolated islets were cultured for 48 h with SDF-1. Cytokine-induced apoptosis was measured immediately. Islets from Socs3−/− mice were pre-cultured with exogenous SDF-1 and transplanted underneath the kidney capsule of C57BL/6 mice with streptozotocin-induced diabetes. Blood glucose levels were monitored for 28 days. AMD3100, an antagonist of the SDF-1 ligand CXCR4, was administered subcutaneously to islet transplanted mice to inhibit CXCR4 before and after transplantation.

Results

SDF-1 protected islet cells from cytokine-induced apoptosis in vitro. SOCS3-knockout (KO) islets pretreated with SDF-1 were effective in reducing blood glucose in non-obese diabetic mice in vivo. We found that SDF-1 elicits localized immunosuppression in transplanted SOCS3-KO islets. Immunomodulation was observed when SOCS-KO islets were preconditioned with SDF-1. Gene expression and flow cytometric analyses revealed significantly decreased immune cell infiltration, inflammatory cytokines, and concomitant increases in FOXP3+ regulatory T cells, alternatively activated M2 macrophages, and dendritic cell phenotypes. Administration of AMD3100 impaired the SDF-1-mediated improvement in SOCS3-KO islet function and local immune suppression.

Conclusion

SDF-1 improves the function of islet grafts in autoimmune diabetes through regulation by CXCR4; however, the presence of SOCS3 reverses the protective effect of SDF-1 on islet grafts. These data reveal a molecular pathway that can elicit localized immunosuppression and delay graft destruction in transplanted islets.
Predictive value of 99mTc-MAA-based dosimetry in personalized 90Y-SIRT planning for liver malignancies
Authors: Riveira-Martin Mercedes , Akhavanallaf Azadeh , Mansouri Zahra , Bianchetto Wolf Nicola , Salimi Yazdan , Ricoeur Alexis , Mainta Ismini , Garibotto Valentina , López Medina Antonio , Zaidi Habib
Published: July 2023

Background

Selective internal radiation therapy with90Y radioembolization aims to selectively irradiate liver tumours by administering radioactive microspheres under the theragnostic assumption that the pre-therapy injection of99mTc labelled macroaggregated albumin (99mTc-MAA) provides an estimation of the90Y microspheres biodistribution, which is not always the case. Due to the growing interest in theragnostic dosimetry for personalized radionuclide therapy, a robust relationship between the delivered and pre-treatment radiation absorbed doses is required. In this work, we aim to investigate the predictive value of absorbed dose metrics calculated from99mTc-MAA (simulation) compared to those obtained from90Y post-therapy SPECT/CT.

Results

A total of 79 patients were analysed. Pre- and post-therapy 3D-voxel dosimetry was calculated on99mTc-MAA and90Y SPECT/CT, respectively, based on Local Deposition Method. Mean absorbed dose, tumour-to-normal ratio, and absorbed dose distribution in terms of dose-volume histogram (DVH) metrics were obtained and compared for each volume of interest (VOI). Mann–Whitney U-test and Pearson’s correlation coefficient were used to assess the correlation between both methods. The effect of the tumoral liver volume on the absorbed dose metrics was also investigated. Strong correlation was found between simulation and therapy mean absorbed doses for all VOIs, although simulation tended to overestimate tumour absorbed doses by 26%. DVH metrics showed good correlation too, but significant differences were found for several metrics, mostly on non-tumoral liver. It was observed that the tumoral liver volume does not significantly affect the differences between simulation and therapy absorbed dose metrics.

Conclusion

This study supports the strong correlation between absorbed dose metrics from simulation and therapy dosimetry based on90Y SPECT/CT, highlighting the predictive ability of99mTc-MAA, not only in terms of mean absorbed dose but also of the dose distribution.
A pathogenic and recombinant infectious bronchitis virus variant (CK/CH/GX/202109) with multiorgan tropism
Authors: Wang Chenyan , Hou Bo
Published: July 2023

Despite vaccine use, novel strains and variants of infectious bronchitis virus (IBV) have emerged continuously, leading to economic losses to the poultry industry worldwide. This study aimed to characterize the IBV isolate CK/CH/GX/202109 from three yellow broilers in Guangxi, China. Recombination was shown to have occurred in regions of the 1ab gene. Compared to the whole genome of ck/CH/LGX/130530, which is genotypically related to tl/CH/LDT3-03, the 202109 strain had 21 mutations. The pathological assessment showed that this variant caused 30% and 40% mortality in 1-day-old chicks infected with oral and ocular inoculum, respectively. Nephritis, enlarged proventriculus, inflammation of the gizzard, and atrophy of the bursa of Fabricius were also observed at both 7 and 14 days post-infection (dpi). Viral loads in the trachea, proventriculus, gizzard, kidney, bursa, and cloacal swabs were higher at 7 dpi than at 14 dpi. Clinicopathological and immunohistochemical analyses revealed that this virus exhibited multiple organ tropisms capable of infecting the trachea, proventriculus, gizzard, kidney, bursa, ileum, jejunum, and rectum. Almost none of the 1-day-old infected chicks seroconverted until 14 dpi. While the virus was found in the ileum, jejunum, and rectum in the 28-day-old ocular group, the majority of 28-day-old infected chickens seroconverted at 10 dpi. These study findings demonstrate that recombination events and mutations during the evolution of IBV may greatly alter tissue tropism and emphasize the need for the continued surveillance of novel strains and variants in order to control this infection.
Secrecy performance analysis of IRS-NOMA systems
Authors: Ghavami Hossein , Akhbari Bahareh
Published: July 2023

In this paper, we propose to utilize an intelligent reflecting surface (IRS) as a promising technology to enhance the coverage and physical layer security of non-orthogonal multiple access (NOMA) system. In particular, an IRS-assisted NOMA system is considered with the aid of careful channel ordering of the NOMA users, in which the transmitter sends superposed signals to multiple legitimate users by virtue of the IRS in the presence of multiple eavesdroppers. Meanwhile, the secrecy performance of the IRS-assisted NOMA system is investigated under two wiretapping cases: non-colluding and colluding external eavesdroppers. In the non-colluding case, eavesdroppers operate independently, while in the colluding case, every eavesdroppers can combine their observations to decode the messages. To this end, we derive the approximate closed-form expressions for the secrecy outage probability (SOP) and the asymptotic SOP for each wiretapping case. Also, we assume that the phase of the IRS elements is set by using the ON–OFF control method. Based on analytical results, we show that the secrecy diversity order of the IRS-NOMA at legitimate users is in connection with the number of reflecting elements. From the numerical results, it can be seen that the IRS-NOMA can achieve superior secrecy performance with increasing the number of reflecting elements of the IRS. However, we also find out that using the finite ON state reflective elements can improve the secrecy performance. Actually, increasing the number of ON state reflective elements above five has a negative effect on the system’s secrecy performance.
Dissemination of knowledge from Cochrane Public Health reviews: a bibliographic study
Authors: Helmer Stefanie Maria , Matthias Katja , Mergenthal Lea , Reimer Mia , De Santis Karina Karolina
Published: July 2023

Background

Appropriate dissemination of public health evidence is of high importance to ensure that scientific knowledge reaches potential stakeholders and relevant population groups. A wide distrust towards science and its findings indicates that communication thereof remains below its potential. Cochrane Public Health provides an important source of high-quality scientific evidence in the field of public health via reviews with systematic methodology. The aims of this study were to identify (1) dissemination strategies and (2) stakeholders of Cochrane Public Health reviews.

Methods

This is a bibliographic study with a cross-sectional design. All 68 records (reviews or review protocols) listed on the Cochrane Public Health website (https://ph.cochrane.org/cph-reviews-and-topics) up to 8 March 2022 were included. Record characteristics, dissemination strategies, and potential stakeholder details were coded by one author, and 10% of records were checked by another author. Data were analyzed using descriptive statistics or narratively into common themes.

Results

The 68 records were published between 2010 and 2022 and included 15 review protocols and 53 reviews with systematic methodology (46 systematic, 6 rapid, and 1 scoping review). All 53 reviews were disseminated via open-access plain language summaries (PLS) in English with translations into 3–13 other languages. Other dissemination strategies included information on Cochrane websites (e.g., clinical answers or guidelines) available for 41/53 reviews and Cochrane news or blogs that mentioned 19/53 reviews. Overall, 23/68 records mentioned the actual stakeholder involvement in review production, protocol development, or formulation of dissemination plans. The potential stakeholders included several highly diverse groups, such as the general population or specific communities (e.g., racial minority groups), policy and decision makers, and researchers and professionals in various fields (e.g., nutrition, physical activity, education, or care).

Conclusions

This study shows that Cochrane Public Health reviews are disseminated predominantly via PLS in different languages and via review information on Cochrane websites. Planned dissemination strategies were rarely reported although actual stakeholders were involved in the planning and production of some reviews. The relevance of Cochrane Public Health reviews for non-academic stakeholders and the general population highlights the need for the dissemination of evidence from such reviews beyond academia.

Systematic review registration

The study was prospectively registered at the Open Science Framework (https://osf.io/ga9pt/).
Seeking adverse effects in systematic reviews of orthodontic interventions: a cross-sectional study (part 1)
Authors: Steegmans Pauline A. J. , Di Girolamo Nicola , Bipat Shandra , Reynders Reint A. Meursinge
Published: July 2023

Background

Systematic reviews that assess the benefits of interventions often do not completely capture all dimensions of the adverse effects. This cross-sectional study (part 1 of 2 studies) assessed whether adverse effects were sought, whether the findings on these effects were reported, and what types of adverse effects were identified in systematic reviews of orthodontic interventions.

Methods

Systematic reviews of orthodontic interventions on human patients of any health status, sex, age, and demographics, and socio-economic status, in any type of setting assessing any type of adverse effect scored at any endpoint or timing were eligible. The Cochrane Database of Systematic Reviews and 5 leading orthodontic journals were manually searched for eligible reviews between August 1 2009 and July 31 2021. Study selection and data extraction was conducted by two researchers independently. Prevalence proportions were calculated for four outcomes on seeking and reporting of adverse effects of orthodontic interventions. Univariable logistic regression models were used to determine the association between each one of these outcomes and the journal in which the systematic review was published using the eligible Cochrane reviews as reference.

Results

Ninety-eight eligible systematic reviews were identified. 35.7% (35/98) of reviews defined seeking of adverse effects as a research objective, 85.7% (84/98) sought adverse effects, 84.7% (83/98) reported findings related to adverse effects, and 90.8% (89/98) considered or discussed potential adverse effects in the review. Reviews in the journal Orthodontics and Craniofacial Research compared with Cochrane reviews had approximately 7 times the odds (OR 7.20, 95% CI 1.08 to 47.96) to define seeking of adverse effects in the research objectives. Five of the 12 categories of adverse effects accounted for 83.1% (162/195) of all adverse effects sought and reported.

Conclusions

Although the majority of included reviews sought and reported adverse effects of orthodontic interventions, end-users of these reviews should beware that these findings do not give the complete spectrum on these effects and that they could be jeopardized by the risk of non-systematically assessing and reporting of adverse effects in these reviews and in the primary studies that feed them. Much research is ahead such as developing core outcome sets on adverse effects of interventions for both primary studies and systematic reviews.
Economic and legal bases of the Carpathian Euroregion development during the COVID-19 pandemic (Hungary, Slovakia, Poland, Ukraine)
Authors: Khusainov Ruslan V. , Lisnik Anton , Zatrochová Monika , Babiuk Alla M. , Mashkov Kostiantyn Ye.
Published: July 2023

The article dwells upon the history of the Carpathian Euroregion as the form of a cross-border cooperation. The peculiarities of the economic development of the Carpathian Euroregion before the COVID-19 pandemic were considered. The main ways of obtaining financial resources for the development of the Euroregion economy were identified. The structure of the Carpathian Euroregion and the system of normative legal acts regulating the activity of this association were analyzed. The main consequences and impact of the COVID-19 pandemic on the economic development of the Carpathian Euroregion were identified. Priority measures and activities for tourism development in the Carpathian Euroregion were discussed. The expediency of creating a tourist brand of the Euroregion and the need to promote tourism in the Euroregion at the international level were argued. The main international projects and programs of the Carpathian Euroregion regarding the cooperation between the states of the EU were studied. Proposals were made to improve the investment attractiveness of the Carpathian Euroregion and to overcome the consequences of the pandemic. The need to create a separate authority that will operate independently and ensure active communication in the Euroregion was established. It will also help find new sources of financial resources, develop a set of measures to support small and medium businesses, connections between the territories of the Euroregion and ensure an effective border and customs regime in the Carpathian Euroregion.
Cardiopulmonary exercise testing before and after intravenous iron in preoperative patients: a prospective clinical study
Authors: Plumb James O. M. , Otto James M. , Kumar Shriya B. , Bali Sitara , Wakatsuki Mai , Schmidt Walter F. J. , Montgomery Hugh E. , Grocott Michael P. W. , Levett Denny Z.
Published: July 2023

Background

Anemia is associated with impaired physical performance and adverse perioperative outcomes. Iron-deficiency anemia is increasingly treated with intravenous iron before elective surgery. We explored the relationship between exercise capacity, anemia, and total hemoglobin mass (tHb-mass) and the response to intravenous iron in anemic patients prior to surgery.

Methods

A prospective clinical study was undertaken in patients having routine cardiopulmonary exercise testing (CPET) with a hemoglobin concentration ([Hb]) < 130 g.l−1 and iron deficiency/depletion. Patients underwent CPET and tHb-mass measurements before and a minimum of 14 days after receiving intravenous (i.v.) Ferric derisomaltose (Monofer®) at the baseline visit. Comparative analysis of hematological and CPET variables was performed pre and post-iron treatment.

Results

Twenty-six subjects were recruited, of whom 6 withdrew prior to study completion. The remaining 20 (9 [45%] male; mean ± SD age 68 ± 10 years) were assessed 25 ± 7 days between baseline and the final visit. Following i.v. iron, increases were seen in [Hb] (mean ± SD) from 109 ± 14 to 116 ± 12 g l−1 (mean rise 6.4% or 7.3 g l−1, p =  < 0.0001, 95% CI 4.5–10.1); tHb-mass from 497 ± 134 to 546 ± 139 g (mean rise 9.3% or 49 g, p =  < 0.0001, 95% CI 29.4–69.2). Oxygen consumption at anerobic threshold ($$\dot{\text{V}}$$

V
˙

O2 AT) did not change (9.1 ± 1.7 to 9.8 ± 2.5 ml kg−1 min−1, p = 0.09, 95% CI − 0.13 − 1.3). Peak oxygen consumption ($$\dot{\text{V}}$$

V
˙

O2 peak) increased from 15.2 ± 4.1 to 16 ± 4.4 ml.kg.−1 min−1, p = 0.02, 95% CI 0.2–1.8) and peak work rate increased from 93 [67–112] watts to 96 [68–122] watts (p = 0.02, 95% CI 1.3–10.8).

Conclusion

Preoperative administration of intravenous iron to iron-deficient/deplete anemic patients is associated with increases in [Hb], tHb-mass, peak oxygen consumption, and peak work rate. Further appropriately powered prospective studies are required to ascertain whether improvements in tHb-mass and performance in turn lead to reductions in perioperative morbidity.

Trial registration

ClinicalTrials.gov identifier: NCT 033 46213.
The impact of enhanced screening for carbapenemase-producing Enterobacterales in an acute care hospital in South Korea
Authors: Park Sun Hee , Yi Yunmi , Suh Woosuck , Ji Seul Ki , Han Eunhee , Shin Soyoung
Published: July 2023

Background

Carbapenemase-producing Enterobacterales (CPE) poses a significant challenge to infection control in healthcare settings. Active screening is recommended to prevent intra-hospital CPE transmission.

Methods

CPE screening was initiated at a 660-bed hospital in South Korea in September 2018, targeting patients previously colonized/infected or admitted to outside healthcare facilities (HCFs) within 1 month. Universal intensive care unit (ICU) screening was performed at the time of admission. After a hospital-wide CPE outbreak in July-September 2019, the screening program was enhanced by extending the indications (admission to any HCF within 6 months, receipt of hemodialysis) with weekly screening of ICU patients. The initial screening method was changed from screening cultures to the Xpert Carba-R assay. The impact was assessed by comparing the CPE incidence per 1000 admissions before (phase 1, September 2018-August 2019) and after instituting the enhanced screening program (phase 2, September 2019-December 2020).

Results

A total of 13,962 (2,149 and 11,813 in each phase) were screened as indicated, among 49,490 inpatients, and monthly screening compliance increased from 18.3 to 93.5%. Compared to phase 1, the incidence of screening positive patients increased from 1.2 to 2.3 per 1,000 admissions (P = 0.005) during phase 2. The incidence of newly detected CPE patients was similar (3.1 vs. 3.4, P = 0.613) between two phases, but the incidence of hospital-onset CPE patients decreased (1.9 vs. 1.1, P = 0.018). A significant decrease was observed (0.5 to 0.1, P = 0.014) in the incidence of patients who first confirmed CPE positive through clinical cultures without a preceding positive screening. Compared to phase 1, the median exposure duration and number of CPE contacts were also markedly reduced in phase 2: 10.8 days vs. 1 day (P < 0.001) and 11 contacts vs. 1 contact (P < 0.001), respectively. During phase 2, 42 additional patients were identified by extending the admission screening indications (n = 30) and weekly in-ICU screening (n = 12).

Conclusions

The enhanced screening program enabled us to identify previously unrecognized CPE patients in a rapid manner and curtailed a hospital-wide CPE outbreak. As CPE prevalence increases, risk factors for CPE colonization can broaden, and hospital prevention strategies should be tailored to the changing local CPE epidemiology.
Association between leptin and NAFLD: a two-sample Mendelian randomization study
Authors: Guo Ziwei , Du Hongbo , Guo Yi , Jin Qian , Liu Ruijia , Yun Zhangjun , Zhang Jiaxin , Li Xiaoke , Ye Yong’an
Published: July 2023

Background

The etiology of nonalcoholic fatty liver disease (NAFLD) involves a complex interaction of genetic and environmental factors. Previous observational studies have revealed that higher leptin levels are related to a lower risk of developing NAFLD, but the causative association remains unknown. We intended to study the causal effect between leptin and NAFLD using the Mendelian randomization (MR) study.

Methods

We performed a two-sample Mendelian randomization (TSMR) analysis using summary GWAS data from leptin (up to 50,321 individuals) and NAFLD (8,434 cases and 770,180 controls) in a European population. Instrumental variables (IVs) that satisfied the three core assumptions of Mendelian randomization were selected. The TSMR analysis was conducted using the inverse variance weighted (IVW) method, MR-Egger regression method, and weighted median (WM) method. To ensure the accuracy and stability of the study results, heterogeneity tests, multiple validity tests, and sensitivity analyses were conducted.

Results

The findings of the TSMR correlation analysis between NAFLD and leptin were as follows: IVW method (odds ratio (OR) 0.6729; 95% confidence interval (95% CI) 0.4907–0.9235; P = 0.0142), WM method (OR 0.6549; 95% CI 0.4373–0.9806; P = 0.0399), and MR-Egger regression method (P = 0.6920). Additionally, the findings of the TSMR correlation analysis between NAFLD and circulating leptin levels adjusted for body mass index (BMI) were as follows: IVW method (OR 0.5876; 95% CI 0.3781–0.9134; P = 0.0181), WM method (OR 0.6074; 95% CI 0.4231–0.8721; P = 0.0069), and MR-Egger regression method (P = 0.8870). It has also been shown that higher levels of leptin are causally linked to a lower risk of developing NAFLD, suggesting that leptin may serve as a protective factor for NAFLD.

Conclusions

Using TSMR analysis and the GWAS database, we investigated the genetic relationship between elevated leptin levels and lowered risk of NAFLD in this study. However, further research is required to understand the underlying mechanisms.
Predictors of bacteremia and death, including immune status, in a large single-center cohort of unvaccinated ICU patients with COVID-19 pneumonia
Authors: Frattari Antonella , Polilli Ennio , Rapacchiale Giorgia , Coladonato Simona , Ianniruberto Stefano , Mazzotta Elena , Patarchi Alessandro , Battilana Mariangela , Ciulli Raffaella , Moretta Angelo , Visocchi Lina , Savini Vincenzo , Spacone Antonella , Zocaro Rosamaria , Carinci Fabrizio , Parruti Giustino
Published: July 2023

Background

We investigated the possible role of the immune profile at ICU admission, among other well characterized clinical and laboratory predictors of unfavorable outcome in COVID-19 patients assisted in ICU.

Methods

Retrospective analysis of clinical and laboratory data collected for all consecutive patients admitted to the ICUs of the General Hospital of Pescara (Abruzzo, Italy), between 1st March 2020 and 30th April 2021, with a confirmed diagnosis of COVID-19 respiratory failure. Logistic regressions were used to identify independent predictors of bacteremia and mortality.

Results

Out of 431 patients included in the study, bacteremia was present in N = 191 (44.3%) and death occurred in N = 210 (48.7%). After multivariate analysis, increased risk of bacteremia was found for viral reactivation (OR = 3.28; 95% CI:1.83–6.08), pronation (3.36; 2.12–5.37) and orotracheal intubation (2.51; 1.58–4.02). Increased mortality was found for bacteremia (2.05; 1.31–3.22), viral reactivation (2.29; 1.29–4.19) and lymphocytes < 0.6 × 103c/µL (2.32; 1.49–3.64).

Conclusions

We found that viral reactivation, mostly due to Herpesviridae, was associated with increased risk of both bacteremia and mortality. In addition, pronation and intubation are strong predictors of bacteremia, which in turn together with severe lymphocytopenia due to SARS-CoV2 was associated with increased mortality. Most episodes of bacteremia, even due to Acinetobacter spp, were not predicted by microbiological evidence of colonization.
Factors affecting soil quality among smallholder macadamia farms in Malawi
Authors: Zuza Emmanuel Junior , Maseyk Kadmiel , Bhagwat Shonil A. , Chemura Abel , Brandenburg Rick L. , Emmott Andrew , Rawes Will , Hancock Wayne , Mnthambala Frank , Araya Yoseph N.
Published: July 2023

Declining soil fertility limits smallholder macadamia productivity in Malawi. To reverse this trend, it is essential to apply organic and inorganic fertilisers in an efficient and effective manner. Yet, fertilizer recommendations for smallholder macadamia (Macadamia integrifolia) production in Malawi are not site-specific. Nutrient imbalances can occur if fertilisers are applied without a clear understanding of whether they are required or not. This may lead to yield losses, unnecessary costs, and other environmental issues associated with excess fertiliser application. To address this research need/ knowledge gap, our study examined the current soil fertility status among smallholder macadamia farms in Malawi. Specifically, the objective was to establish an evidence base for promoting soil fertility restoration interventions for smallholder macadamia production. One hundred and eighty nine soil samples at a depth of 0–15 cm were collected from sixty three smallholder macadamia farms belonging to the Highlands Macadamia Cooperative Union Limited members in central and southern Malawi. We found that the majority of the soils were sandy loams (52%), strongly acidic (mean pH ≤ 5.1), and deficient in essential nutrients required for the healthy growth of macadamia. The soils had an average low cation exchange capacity of 1.67 cmol ( +) kg−1, which is inadequate for macadamia cultivation. More than half of the sampled soils had very low organic matter content (≤ 1%). The low soil organic matter content, coupled with the sandy texture and high acidity, contributed to the observed low concentrations of essential nutrients and cation exchange capacity. Poor agronomic practices and inherent soil characteristics are responsible for this low soil fertility. Altogether, our findings underscore the urgent need to identify and implement more sustainable and effective soil nutrient management practices that help to improve the soil fertility of macadamia farms under smallholder systems.
Gut barrier-microbiota imbalances in early life lead to higher sensitivity to inflammation in a murine model of C-section delivery
Authors: Barone M. , Ramayo-Caldas Y. , Estellé J. , Tambosco K. , Chadi S. , Maillard F. , Gallopin M. , Planchais J. , Chain F. , Kropp C. , Rios-Covian D. , Sokol H. , Brigidi P. , Langella P. , Martín R.
Published: July 2023

Background

Most interactions between the host and its microbiota occur at the gut barrier, and primary colonizers are essential in the gut barrier maturation in the early life. The mother–offspring transmission of microorganisms is the most important factor influencing microbial colonization in mammals, and C-section delivery (CSD) is an important disruptive factor of this transfer. Recently, the deregulation of symbiotic host-microbe interactions in early life has been shown to alter the maturation of the immune system, predisposing the host to gut barrier dysfunction and inflammation. The main goal of this study is to decipher the role of the early-life gut microbiota-barrier alterations and its links with later-life risks of intestinal inflammation in a murine model of CSD.

Results

The higher sensitivity to chemically induced inflammation in CSD mice is related to excessive exposure to a too diverse microbiota too early in life. This early microbial stimulus has short-term consequences on the host homeostasis. It switches the pup’s immune response to an inflammatory context and alters the epithelium structure and the mucus-producing cells, disrupting gut homeostasis. This presence of a too diverse microbiota in the very early life involves a disproportionate short-chain fatty acids ratio and an excessive antigen exposure across the vulnerable gut barrier in the first days of life, before the gut closure. Besides, as shown by microbiota transfer experiments, the microbiota is causal in the high sensitivity of CSD mice to chemical-induced colitis and in most of the phenotypical parameters found altered in early life. Finally, supplementation with lactobacilli, the main bacterial group impacted by CSD in mice, reverts the higher sensitivity to inflammation in ex-germ-free mice colonized by CSD pups’ microbiota.

Conclusions

Early-life gut microbiota-host crosstalk alterations related to CSD could be the linchpin behind the phenotypic effects that lead to increased susceptibility to an induced inflammation later in life in mice.
‘Terminal anorexia’: a lived experience perspective
Authors: Asaria Alykhan
Published: July 2023

Having suffered from longstanding anorexia nervosa (AN) for more than a decade, and after meeting many patients who have also been labelled as ‘treatment-resistant’, ‘treatment-refractory’, or similar terms, I feel a strong responsibility to express my deep fears and sadness about the more harmful new label of ‘terminal anorexia’. This article is based on a reflective and private email that I emotionally wrote in Autumn 2022, soon after reading a thought-provoking paper (Guarda et al. in J Eat Disord 10:79, 2022) about the new term. When I wrote the email, I had not read the Gaudiani et al. (J Eat Disord 10:23, 2022) paper that proposed clinical characteristics for the new diagnosis. Hence, my email was not, and this article is not, a response to Gaudiani et al. (2022). Challenging the criteria that they proposed is beyond the scope of this article, which is just a lived experience reaction to the concept of ‘terminal anorexia’ (regardless of who created it and who tries to define it).

Before learning about ‘terminal anorexia’ in 2022, I assumed that ‘unconditional positive regard’ included mental health professionals’ unconditional hope for their patients’ ability to live meaningful lives, irrespective of how severe or chronic their patients’ conditions were. Therefore, I was very disheartened when the label ‘terminal anorexia’ was circulated by professionals. Research is not just read, seen, and heard about by the professionals who promote it. Vulnerable and conflicted eating disorder (ED) sufferers, and their families, can be victims of theoretical academic discourse that has real-world, life-or-death implications.

The purpose of my article is not to suppress the arbitrary new term, which is sadly already commonly used in clinical practice and amongst very young ED sufferers, despite it having no agreed definition. I intend to outline some of the reasons why I believe that the term (not its hypothesised criteria, which are beyond the scope of my article) is harming ED sufferers, so that these harms can be addressed before it is too late. I have grouped these reasons into six key themes that inevitably overlap and cannot be perfectly separated. They are: [1] Hope and identity destruction; [2] Avoidance and collusion; [3] Self-diagnosis and misdiagnosis; [4] Comparisons; [5] Dangerous precedents; [6] Current and future treatments.
Association of body mass index with mortality of sepsis or septic shock: an updated meta-analysis
Authors: Bai Le , Huang Jingyi , Wang Dan , Zhu Dongwei , Zhao Qi , Li Tingyuan , Zhou Xianmei , Xu Yong
Published: July 2023

Background

The effects of body mass index (BMI) on mortality of sepsis remain unknown, since previous meta-analyses have reported conflicting results. Several observational studies published recently have provided new evidence. Thus, we performed this updated meta-analysis.

Methods

PubMed, Embase, Web of Science, and Cochran Library were searched for articles published before February 10, 2023. Observational studies that assessed the association of BMIs with mortality of sepsis patients aged > 18 years were selected. We excluded studies of which data were unavailable for quantitative synthesis. Odds ratios (OR) with 95% confidence interval (CI) were the effect measure, which were combined using fixed-effect or random-effect models. The Newcastle–Ottawa Scale was applied for quality assessment. Subgroups analyses were conducted according to potential confounders.

Results

Fifteen studies (105,159 patients) were included in the overall analysis, which indicated that overweight and obese BMIs were associated with lower mortality (OR: 0.79, 95% CI 0.70–0.88 and OR: 0.74, 95% CI 0.67–0.82, respectively). The association was not significant in patients aged ≤ 50 years (OR: 0.89, 95% CI 0.68–1.14 and OR: 0.77, 95% CI 0.50–1.18, respectively). In addition, the relationship between morbidly obesity and mortality was not significant (OR: 0.91, 95% CI 0.62–1.32).

Conclusions

Overweight and obese BMIs (25.0–39.9 kg/m2) are associated with reduced mortality of patients with sepsis or septic shock, although such survival advantage was not found in all crowds.

Trial registration The protocol of this study was registered in PROSPERO (registration number CRD42023399559).
Correlation between tissue Doppler-derived left ventricular systolic velocity (S’) and left ventricle ejection fraction in sepsis and septic shock: a retrospective cohort study
Authors: Chawla Sanchit , Sato Ryota , Duggal Abhijit , Alwakeel Mahmoud , Hasegawa Daisuke , Alayan Dina , Collier Patrick , Sanfilippo Filippo , Lanspa Michael , Dugar Siddharth
Published: July 2023

Background

Tissue Doppler-derived left ventricular systolic velocity (mitral S’) has shown excellent correlation to left ventricular ejection fraction (LVEF) in non-critically patients. However, their correlation in septic patients remains poorly understood and its impact on mortality is undetermined. We investigated the relationship between mitral S’ and LVEF in a large cohort of critically-ill septic patients.

Methods

We conducted a retrospective cohort study between 01/2011 and 12/2020. All adult patients (≥ 18 years) who were admitted to the medical intensive care unit (MICU) with sepsis and septic shock that underwent a transthoracic echocardiogram (TTE) within 72 h were included. Pearson correlation test was used to assess correlation between average mitral S’ and LVEF. Pearson correlation was used to assess correlation between average mitral S’ and LVEF. We also assessed the association between mitral S’, LVEF and 28-day mortality.

Results

2519 patients met the inclusion criteria. The study population included 1216 (48.3%) males with a median age of 64 (IQR: 53–73), and a median APACHE III score of 85 (IQR: 67, 108). The median septal, lateral, and average mitral S’ were 8 cm/s (IQR): 6.0, 10.0], 9 cm/s (IQR: 6.0, 10.0), and 8.5 cm/s (IQR: 6.5, 10.5), respectively. Mitral S’ was noted to have moderate correlation with LVEF (r = 0.46). In multivariable logistic regression analysis, average mitral S’ was associated with an increase in both 28-day ICU and in-hospital mortality with odds ratio (OR) 1.04 (95% CI 1.01–1.08, p = 0.02) and OR 1.04 (95% CI 1.01–1.07, p = 0.02), respectively.

Conclusions

Even though mitral S’ and LVEF may be related, they are not exchangeable and were only found to have moderate correlation in this study. LVEF is U-shaped, while mitral S’ has a linear relation with 28-day ICU mortality. An increase in average mitral S’ was associated with higher 28-day mortality.

Graphical Abstract
Short implants compared to regular dental implants after bone augmentation in the atrophic posterior mandible: umbrella review and meta-analysis of success outcomes
Authors: Sáenz-Ravello Gustavo , Ossandón-Zúñiga Benjamín , Muñoz-Meza Vicente , Mora-Ferraro Dante , Baeza Mauricio , Fan Shengchi , Sagheb Keyvan , Schiegnitz Eik , Díaz Leonardo
Published: July 2023

Purpose

To assess the body of evidence of short versus regular implants after bone augmentation (BA) in the atrophic posterior mandible in the context of implant treatment success outcomes.

Methods

Seven databases, two registries, and reference lists were searched for systematic reviews and meta-analysis (SR/MA), randomized controlled trials (RCTs) and longitudinal studies published in English, Spanish or German since 2012. Confidence in the SR/MA methodology was evaluated using AMSTAR-2 and the risk of bias of primary studies using Cochrane’s RoB 2.0 and ROBINS-I. A random-effects meta-analysis and a meta-regression were performed for continuous and dichotomous outcomes. GRADE approach was used to assess the certainty of the evidence.

Results

Eighteen SRs/MAs, most of them “critically low” and “low” confidence with substantial overlap, included 14 relevant RCTs with a high risk of bias. A cohort study with moderate risk of bias was added. Quantitative synthesis of 595 implants and 281 hemiarches/patients indicates that the use of short implants (< 10 mm) compared to regular implants and BA may reduce implant failure at 1-year follow-up, and marginal bone loss (MBL) at 3-, 5-, and 8-year follow-up; is likely to reduce the risk of biological complications at 1-, 3-, 5-, and 8-year follow-up; and may be the patient's preferred alternative. There is a correlation between bone height, MBL and biological complications.

Conclusions

The available evidence partially suggests that the use of short implants could decrease implant failure, MBL, and biological complications, and increase patient satisfaction. However, given the need for further RCTs and real-world evidence to fully evaluate short- and long-term outcomes, it would be prudent for clinicians to carefully consider the individual needs and circumstances of the patients before deciding whether to use short implants.

Trial registrationPROSPERO CRD42022333526

Graphical Abstract
Hernia Active Living Trial (HALT): a feasibility study of a physical activity intervention for people with a bowel stoma who have a parastomal hernia/bulge
Authors: Munro Julie , Goodman William , Oliphant Raymond , Russell Sarah , Taylor Claire , Beeken Rebecca J. , Hubbard Gill
Published: July 2023

Background

Parastomal bulging/hernia is a common complication associated with a stoma. Strengthening of the abdominal muscles via exercise may be a useful self-management strategy. The aim of this feasibility work was to address uncertainties around testing a Pilates-based exercise intervention for people with parastomal bulging.

Methods

An exercise intervention was developed and tested in a single-arm trial (n = 17 recruited via social media) followed by a feasibility randomised controlled trial RCT (n = 19 recruited from hospitals). Adults with an ileostomy or colostomy with a bulge or diagnosed hernia around their stoma were eligible. The intervention involved a booklet, videos, and up to 12 online sessions with an exercise specialist. Feasibility outcomes included intervention acceptability, fidelity, adherence, and retention. Acceptability of self-report measures for quality of life, self-efficacy, and physical activity were assessed based on missing data within surveys pre- and post-intervention. Interviews (n = 12) explored participants’ qualitative experiences of the intervention.

Results

Nineteen of 28 participants referred to the intervention completed the programme (67%) and received an average of 8 sessions, lasting a mean of 48 min. Sixteen participants completed follow-up measures (44% retention), with low levels of missing data across the different measures, apart from body image and work/social function quality of life subscales (50% and 56% missing, respectively). Themes from qualitative interviews related to the benefits of being involved, including behavioural and physical changes in addition to improved mental health. Identified barriers included time constraints and health issues.

Conclusions

The exercise intervention was feasible to deliver, acceptable to participants, and potentially helpful. Qualitative data suggests physical and psycholosical benefits. Strategies to improve retention need to be included in a future study.

Trial registration

ISRCTN, ISRCTN15207595. Registered on 11 July 2019
IMproving facial PRosthesis construction with contactlESs Scanning and Digital workflow (IMPRESSeD): study protocol for a feasibility crossover randomised controlled trial of digital versus conventional manufacture of facial prostheses in patients with orbital or nasal facial defects
Authors: Jablonski Rachael Y. , Coward Trevor J. , Bartlett Paul , Keeling Andrew J. , Bojke Chris , Pavitt Sue H. , Nattress Brian R.
Published: July 2023

Background

Facial prostheses can have a profound impact on patients’ appearance, function and quality of life. There has been increasing interest in the digital manufacturing of facial prostheses which may offer many benefits to patients and healthcare services compared with conventional manufacturing processes. Most facial prosthesis research has adopted observational study designs with very few randomised controlled trials (RCTs) documented. There is a clear need for a well-designed RCT to compare the clinical and cost-effectiveness of digitally manufactured facial prostheses versus conventionally manufactured facial prostheses. This study protocol describes the planned conduct of a feasibility RCT which aims to address this knowledge gap and determine whether it is feasible to conduct a future definitive RCT.

Methods

The IMPRESSeD study is a multi-centre, 2-arm, crossover, feasibility RCT with early health technology assessment and qualitative research. Up to 30 participants with acquired orbital or nasal defects will be recruited from the Maxillofacial Prosthetic Departments of participating NHS hospitals. All trial participants will receive 2 new facial prostheses manufactured using digital and conventional manufacturing methods. The order of receiving the facial prostheses will be allocated centrally using minimisation. The 2 prostheses will be made in tandem and marked with a colour label to mask the manufacturing method to the participants. Participants will be reviewed 4 weeks following the delivery of the first prosthesis and 4 weeks following the delivery of the second prosthesis. Primary feasibility outcomes include eligibility, recruitment, conversion, and attrition rates. Data will also be collected on patient preference, quality of life and resource use from the healthcare perspective. A qualitative sub-study will evaluate patients’ perception, lived experience and preference of the different manufacturing methods.

Discussion

There is uncertainty regarding the best method of manufacturing facial prostheses in terms of clinical effectiveness, cost-effectiveness and patient acceptability. There is a need for a well-designed RCT to compare digital and conventional manufacturing of facial prostheses to better inform clinical practice. The feasibility study will evaluate key parameters needed to design a definitive trial and will incorporate early health technology assessment and a qualitative sub-study to identify the potential benefits of further research.

Trial registration

ISRCTN ISRCTN10516986). Prospectively registered on 08 June 2021, https://www.isrctn.com/ISRCTN10516986.
The hidden arrow in the FedEx logo: Do we really unconsciously “see” it?
Authors: Ke Shih-Chiang , Gupta Ankit , Lo Yu-Hui , Ting Chih-Chung , Tseng Philip
Published: July 2023

The FedEx logo makes clever use of figure-ground ambiguity to create an “invisible” arrow in the background space between “E” and “x”. Most designers believe the hidden arrow can convey an unconscious impression of speed and precision about the FedEx brand, which may influence subsequent behavior. To test this assumption, we designed similar images with hidden arrows to serve as endogenous (but camouflaged) directional cues in a Posner’s orienting task, where a cueing effect would suggest subliminal processing of the hidden arrow. Overall, we observed no cue congruency effect, unless the arrow is explicitly highlighted (Experiment 4). However, there was a general effect of prior knowledge: when people were under pressure to suppress background information, those who knew about the arrow could do so faster in all congruence conditions (i.e., neutral, congruent, incongruent), although they fail to report seeing the arrow during the experiment. This was true in participants from North America who had heard of the FedEx arrow before (Experiment 1 & 3), and also in our Taiwanese sample who were just informed of such design (Experiment 2). These results can be well explained by the Biased Competition Model in figure-ground research, and together suggest: (1) people do not unconsciously perceive the FedEx arrow, at least not enough to exhibit a cueing effect in attention, but (2) knowing about the arrow can fundamentally change the way we visually process these negative-space logos in the future, making people react faster to images with negative space regardless of the hidden content.
Strategies for improving resilience of regional integrated energy systems in the prevention–resistance phase of integration
Authors: Wu Jiaqing , Gu Jie , Liu Shuqi , Jin Zhijian
Published: July 2023

The construction of integrated energy systems can help improve energy efficiency and promote global energy transition. However, in recent years, the occurrence of extreme natural disasters has brought certain threats to the safe and stable operation of the integrated energy system. Thus, it is necessary to improve the ability of the integrated energy system to resist disasters, reduce disaster losses, and restore energy supply as soon as possible, i.e., improve its resilience. Considering the influence of pre-disaster prevention measures and disaster-time operational measures on system disaster resilience and the correlation between the two, this paper proposes a system hardening strategy based on three-layer robust optimization. The upper layer formulates the optimal hardening strategy of the system before the disaster event occurs, the middle layer identifies the failed elements in the worst disaster situation, while the lower layer realizes the system operational optimization by coordinating the energy storage charging and discharging plan of each subsystem. The strategy can reduce the total supply shortage of the integrated energy system and improve the flexibility of the system in the pre-disaster prevention and disaster resistance integration stages.