bluuebunny/crossref_metadata_2025 huggingface dataset:
General Anesthesia in Patients with Hepatic Encephalopathy and Acute Variceal Bleeding Undergoing Endoscopic Treatment: A Retrospective Study
Authors: Chen Tao , Wen Lin , Zhong Rui , Chen Xia
Published: November 2022

Background: The management of cirrhotic patient with encephalopathy and acute variceal bleeding（AVB） remains a clinical challenge with a high mortality. Early endoscopic therapies are frequently applied in patients with AVB. However, the application of general anesthesia in endoscopic surgery for patients with hepatic encephalopathy (HE) is pretty challenging. The present study aimed to evaluate the possible effect of general anesthesia with tracheal intubation on patient complicated with encephalopathy and AVB during endoscopic procedure.
Methods: Thirty-six cirrhotic patients with encephalopathy and AVB were retrospectively studied, 14 patients underwent endoscopic treatment under general anesthesia with tracheal intubation, and 22 patients received pharmacological treatment, or and endoscopic therapy without general anesthesia served as control group. Routine clinical and laboratory data were collected.
Results: The total mortality rate was 13.9% (5/36), 2(14.3%) in anesthesia group, 3 (13.6%) in control group. The child-Pugh class of death cases were all grade C，3 (60%) of them were in the stage IV of HE. The stage of HE was all improved in the two groups, 12 (85.8 %) patients were totally recovered from consciousness disturbance in anesthesia group and 16 (72.7 %) in control group respectively, the difference between the two groups was not significant (P＞0.05). Except the death cases, there were still 3 patients in control group had impaired consciousness at discharge. Child-Pugh score, Child-Pugh class and the stage of HE in anesthesia group were significantly improved at discharge compared with those before operation.
Conclusions: General anesthesia does not aggravate the severity of encephalopathy, and endoscopic treatment under general anesthesia with tracheal intubation is effective for HE patients complicated with AVB.
Comparative transcriptome profiling of hair follicles from forest musk deer (Moschus berezovskii) at different stages
Authors: Zhao Qi , Hu Lifan , Li Guangqin , Wang Xiaoli , Duan Zhengang , Xiao Guosheng , Jie Hang , Qi Wenhua
Published: November 2022

Background: Forest musk deer (FMD) is a valuable species distributed throughout southwest China, but there is a lack of comprehensive and reliable information on its growth and development.
Methods: We sequenced the hair follicle transcriptome of FMD from 13 individuals by RNA-seq. Vital biological processes or pathways of differentially expressed genes (DEGs) in FMD were examined by GO and KEGG enrichment analyses and constructed a network of DEGs protein-protein interactions based on the STRING protein interaction database.
Results: The assembly yielded 71167 transcripts with a maximum length of 101907 bp and N50 value of 4942 bp. A total of 219 differentially expressed genes were identified in the study, of which 10 up-regulated and 209 down-regulated genes were at the anagen stage of hair follicles compared to their catagen stage. We identified ESR1, CAV1, FSTL1, TLR2, REM1, and FGFR1 as the hub genes. The result of the KEGG pathway enrichment analysis showed that 31 KEGG pathways were significantly enriched in these two hair follicle groups. Including glycosaminoglycan binding proteins, endocrine system, cellular community-eukaryotes, etc.
Conclusion: An analysis of both GO and KEGG enrichment revealed that up-regulated genes were mostly associated with cell development and regulated signaling pathway. On the other hand, down-regulated genes were closely associated with diseases and the immune system. In conclusion, our findings provide insight into the mechanism of molecular regulation in hair follicle growth and will lay the groundwork for future studies on diseases caused by captive FMD.
The Epidemiological Profile of Juvenile Idiopathic Arthritis: Single Center Study in Delta Region of Egypt
Authors: El-Refaey Ahmed M , Sobh Neven Nashat , Shahin Dina , Darwish Ahmad
Published: November 2022

BackgroundJuvenile idiopathic arthritis (JIA) is children's most common autoimmune musculoskeletal disease. The spectrum of patients’ profiles of JIA showed many similarities and differences among different populations.Aim of the workThe purpose of this study is to determine the prevalence, subtypes, distribution, and characteristic features of JIA among children in Rheumatology outpatient clinic at Mansoura University Children's Hospital (MUCH).Patients and methodsThe study was a cross-sectional observational study carried out in the rheumatology outpatient clinic in Mansoura University children’s Hospital, on 73 patients diagnosed with JIA according to the International League of Associations for Rheumatology (ILAR) from April 2019 to April 2020.ResultsThere was a statistically significant difference between JIA types as regard age of patients, age of onset of disease, duration of the disease affected at the time of diagnosis, fever, rash, and organomegaly with the highest value in psoriatic type. There was a statistically significant difference in methotrexate (MTX), Humera, Enbrel, and Leflunomaide usage between JIA subtypes. The severity of the disease was correlated significantly with laboratory parameters including the erythrocyte sedimentation rate, C reactive protein, and platelets count. MTX, Pulse steroid, Actemra, and Lefluonamide usage differed significantly according to the severity of the disease while Humera, Endoxan, Enbrel, and NSIAD showed no significant difference.ConclusionThe types of JIA differ significantly from each other as regards fever, rash, and organomegaly with an increase in systemic onset rather than other types. While ophthalmic affection shows no significant difference between JIA subtypes. A low percentage of cases had uveitis indicating low severity of disease in the studied cases. Biological treatment was given to severe and resistant cases when indicated.
Production of Ni0.5Co0.5Fe2O4/Activated Carbon@Chitosan Magnetic Nanobiocomposite as a Novel Adsorbent of Methylene Blue in Aqueous Solutions
Authors: Dastoom Zakaria
Published: November 2022

Dyes are carcinogenic and mutagenic molecules that are used in various industries. Disposal of dyes into water sources can lead to the death of organisms. Methylene blue is a cationic toxic dye due to the presence of aromatic rings in its structure and cannot be degraded through natural methods. Therefore, chemical, physical, and biological water treatment methods have been proposed for the elimination of toxic dyes. Adsorption is one of the most appropriate methods in this regard because of its cost-effectiveness and high efficiency. In this study, we synthesized a magnetic nanobiocomposite of ferrite nickel-cobalt/activated carbon@chitosan as an adsorbent. VSM, BET, FESEM, XRD, and FT-IR analyses were performed to evaluate the properties of this nanomaterial including crystallinity, nanostructure, reactions correctness, and magnetism of the compound. We tested the adsorption of methylene blue by the nanobiocomposite through UV-Vis. The results of the analyses and the adsorption test were used to evaluate the efficiency of nanocompound adsorption. This study can pave the way for a wide range of other projects such as changes in reactants and their ratio or change in reaction conditions.
Atrial Myxoma Embolization of the Basilar Artery Presenting with a Convulsive Seizure
Authors: Xu Yaning , Jiang Jiaojin , Zhang Meng
Published: November 2022

Atrial myxoma is a rare cause of acute ischemic stroke. A small number of patients with basilar artery occlusion (BAO) present with convulsive seizures. We have herein presented a case of atrial myxoma embolization of the basilar artery, resulting in convulsions as the initial symptom. This patient was treated with atrial myxoma resection following endovascular treatment with a favorable outcome. This case illustrates the importance of timely diagnosis of BAO with atypical symptoms. Endovascular treatment for distal moderate vascular occlusion in posterior circulation is feasible, and atrial myxoma should be resected as soon as possible to prevent further embolic complications.
Quality of life and nutritional status in peritoneal dialysis patients: a cross-sectional study from Palestine
Authors: Ali Iyad , Haddad Dania , Soliman Mostafa A , Al-Sabi Ahmed , Jebreen Kamel , Abuzahra Dana , Shrara Bakrieh , Ghanayem Diana , Natour Nihal , Hassan Mohanad , Alsedfy M. Yasser , Nawajah Inad , Shellah Duha
Published: November 2022

Background
End-stage renal disease (ESRD) is a growing cause of morbidity worldwide. Protein malnutrition is common among patients with ESRD. Peritoneal dialysis (PD) offers greater lifestyle flexibility and independence compared to the widely used treatments for ESRD. In this study, we aimed to evaluate the nutritional status and the quality of life (QOL) along with the factors influencing these two outcomes among Palestinian patients undergoing PD.
Methods
We performed a cross-sectional study on patients receiving PD at Najah Hospital University, Palestine. Malnutrition was assessed by the malnutrition-inflammation scale (MIS) and the QOL score was evaluated by using the Dutch WHOQOL-OLD module.
Results
A total of 74 patients on PD were included with the mean age of participants was 50.5 ± 16.38, more than half of them were females. We observed a significant association between the MIS and the WHOQOL-OLD scores (p < 0.001). Malnutrition was associated with a lower QOL score among patients receiving PD. Younger age group and those with an occupation had better chances of a good QOL (p = 0.01). Patients with pitting edema and diabetes had higher risk of a lower QOL (p < 0.001).
Conclusions
Elderly patients, patients showing signs of pitting edema, and those suffering from diabetes should be carefully considered due to their higher risk of malnutrition and low QOL.
Outcomes and Cost Analysis of Patients with Dementia in the Intensive Care Unit: A Population-based Cohort Study
Authors: Dziegielewski Claudia , Fernando Shannon M. , Milani Christina , Mahdavi Roshanak , Talarico Robert , Thompson Laura H. , Tanuseputro Peter , Kyeremanteng Kwadwo
Published: November 2022

Background: Dementia is a neurological syndrome affecting the growing elderly population. While patients with dementia are known to require significant hospital resources, little is known regarding the outcomes and costs of patients admitted to the intensive care unit (ICU) with dementia.
Methods: We conducted a population-based retrospective cohort study of patients with dementia admitted to the ICU in Ontario, Canada from 2016-2019. We compared the characteristics and outcomes of these patients to those with dementia admitted to non-ICU hospital settings. The primary outcome was hospital mortality but we also assessed length of stay (LOS), discharge disposition, and costs.
Results: Among 114,844 patients with dementia, 11,341 (9.9%) were admitted to the ICU. ICU patients were younger, more comorbid, and had less cognitive impairment (81.8 years, 22.8% had ≥3 comorbidities, 47.5% with moderate-severe dementia), compared to those in non-ICU settings (84.2 years, 15.0% had ≥3 comorbidities, 54.1% with moderate-severe dementia). Total mean LOS for patients in the ICU group was nearly 20 days, compared to nearly 14 days for the acute care group. Mortality in hospital was nearly three-fold greater in the ICU group compared to non-ICU group (22.2% vs. 8.8%). Total healthcare costs were increased for patients admitted to ICU vs. those in the non-ICU group ($67,201 vs. $54,080).
Conclusions: Patients with dementia admitted to the ICU have longer length of stay, higher in-hospital mortality, and higher total healthcare costs. Future studies should investigate preventable costs and while optimizing quality of life in this high risk and vulnerable population.
Characteristics of Talaromyces marneffei infection associated with inborn errors of immunity
Authors: Xing Shubin , Zhang Zhenzhen , Liu Cong , Zhang Wenjing , Zhang Zhiyong , Tang Xuemei , Chen Yongwen , Zhao Xiaodong , An Yunfei
Published: November 2022

Background:Talaromycosis is a systemic disease caused byTalaromycesmarneffei. To capture the characteristics of talaromycosis patients with inborn errors of immunity (IEI) prompts us to develop a systematic review.Objective:To systematically review studies reporting cases of talaromycosis with IEI. We aimed to describe the susceptibility genotypes and clinical characteristics of talaromycosis in IEI patients and understand the underling mechanism ofTalaromyces marneffeidefence.Methods:A systematic literature review was performed by searching PubMed, Cochrane Central Register of Controlled Trials, Web of Science, EMBASE, and Scopus. Data from patients with genetic diagnosis of IEI with talaromycosis, IEI genotypes, immunology, and clinical characteristics were collected.Results:Fifty talaromycosis patients with IEI were included: XHIM (30.00%), STAT3-LOF (20.00%), STAT1-GOF (20.00%), IL2RG (6.00%), IFNGR1 (6.00%), IL12RB1 (4.00%), CARD9 (4.00%), COPA (4.00%), ADA (2.00%), RELB deficiency (2.00%), and NFKB2 (2.00%) were the underlying genetic mutations. mNGS was a rapid and effective diagnostic method. The onset of clinical manifestations included atypical presentations, generally with fever, cough, lymphadenopathy, abdominal discomfort, and pneumonia. Respiratory, skin, lymph node, digestive, and hematologic systems were commonly involved. Variable lung CT findings were commonly misdiagnosed as tuberculosis. Forty-seven patients received antifungal therapy, and 34 patients improved.Conclusions:TheXHIM, STAT1-GOF, and STAT3-LOF genotypes exhibited the highest susceptibility to talaromycosis. Pathogen infection should be tested by mNGS in IEI patients with suspected talaromycosis, and antifungal therapy should be rapidly initiated. Immunological and genetic diagnoses are necessary for non-HIV patients with talaromycosis in children.
Recovery from (treatment-resistant) depression after lifestyle changes and micronutrient precision supplementation: a preliminary field study in patients
Authors: Mader Isabella M.
Published: November 2022

Background and purpose: The incidence of depression is increasing, despite continued advances in psychological and pharmacological interventions. New treatment approaches are urgently needed. Here we assess the effects on depression of individualized micronutrient supplementation, in concert with a standard set of lifestyle changes.
Methods: We conducted a small field-study with 17 participants in Austria. Patients with depression (n = 11) and healthy volunteers (n = 6) underwent laboratory serum analysis and filled out the DASS-21 and a questionnaire about their medical history and condition. The list of parameters to be tested in the serum analysis was derived from an expert heuristic compilation of factors known to influence depression, narrowed down to a workable list to be tested in this initial study. On the basis of the results, the participants (n = 17) received individualized recommendations for micronutrient supplementation, in collaboration with their treating physician. Participants followed the individual supplementation regime for two months, along with a standard set of lifestyle changes. After two months the laboratory serum analyses, the DASS-21, and the questionnaire were repeated.
Results: All patients with micronutrient deficiencies were in the patient group; none of the healthy volunteers showed any micronutrient deficiencies. After two months of precision supplementation and lifestyle changes, all but one patient had recovered from their depression or had considerably improved. The one patient who didn’t recover was the only one with a known trigger of their depression (trauma). Of 11 patients with depression, the trigger was unknown for the other ten.
Conclusions: These results have promising implications for further research, treatment, drug development, and public health. We propose that systematic screening of patients with symptoms of depression be developed for future research, medical care, and practice. Psychiatry and psychotherapy may see improved results once they no longer have to push against the underlying constraints of existing micronutrient deficiencies.
Transition in the Ages at Key Reproductive Events and its determinants in India: Evidence from NFHS 1992-93 to 2019-21
Authors: Singh Mayank , Shekhar Chander , Gupta Jagriti
Published: November 2022

Reproductive health events have changed fertility and family planning needs, depicting the changing life patterns of women and the population to which they belong. Understanding the pattern at which these events occur helps in understanding the fertility pattern, family formation and the idea about health essential needs for women. This paper attempts to see the variation in reproductive events (first cohabitation, first sex and first birth) over three decades and also to see potential contributing factors among the reproductive age group of women using secondary data from five rounds of the National Family Health Survey (1992-93 to 2020–2021). Cox Proportional Hazard Model illustrates that all regions have initiated cohabitation later than women who belong to the east region similar pattern has been obtained for first sex and first birth. Multiple Classification Analysis (MCA) depicts the increasing pattern in the predicted mean age at first cohabitation, sex and birth for all demographic characteristics; the highest increment was found in SC women, Uneducated women and Muslim women. Kaplan Meier Curve demonstrates that women with no education, primary or secondary, are shifting towards higher educated women. Though reproductive health has long been an essential event in women's lives, they are still very confined to specific domains. Over time the government has formulated several proper legislative measures relating to various domains of reproductive events. However, given that the large size and heterogeneity in social and cultural norms result in changing ideas and choices regarding the initiation of reproductive events, national policy formulation needs to be improved or amended.
Clinical and functional characteristics of at-risk mental state among non-help seeking adolescents: a cross-sectional study
Authors: Švancer Patrik , Dorazilová Aneta , Voráčková Veronika , Knytl Pavel , Rodriguez Mabel , Jonáš Juraj , Sebela Antonin , Mohr Pavel
Published: November 2022

Background At-risk mental state (ARMS) individuals are at high risk to develop psychosis. In addition to attenuated symptoms, ARMS is associated with cognitive and functional impairment.
Aim Our study goal was to explore prevalence rates of ARMS, comorbidities, functioning, and cognitive performance among non-help seeking adolescents.
Methods In a cross-sectional design, a sample of high school students were examined with Comprehensive Assessment of At Risk Mental States interview. All participants were administered Kiddie-Schedule for Affective Disorders and Schizophrenia, Social and Occupational Functioning Assessment Scale (SOFAS), KIDSCREEN-52, and a battery of cognitive tests.
Results The total of 82 adolescents was enrolled, 21 of them met the ARMS criteria. Subthreshold mental disorders were more frequent in the at-risk mental state positive (ARMS+) group than in the at-risk mental state negative (ARMS-) group. Lower score in (SOFAS) were observed in the ARMS+ group compared to the ARMS- group. In the total sample, high risk symptoms intensity was negatively associated with the SOFAS score. No significant differences in the KIDSCREEN-52 scores or cognitive functioning were found between the groups.
Conclusion Our findings suggest that non-help seeking adolescents with at-risk mental state have worse level of functioning compared to controls and higher rates of non-psychotic psychiatric comorbidities. In the management of ARMS individuals, the guidelines recommend non-pharmacological interventions as the first-line option, pharmacotherapy with antipsychotics is reserved for non-responders, more severe, or progressive high-risk symptoms.
BTK is a Prognostic Biomarker for Multiple Human Tumors
Authors: Yang Tao , Hao Lizheng , Chen Jian , Zhu Xueying , Sun Keyi , Wang Peipei , Lei Ji , Yang Xinyu , Li Guoping , Jiang Min
Published: November 2022

Bruton's tyrosine kinase (BTK), a key B-cell and macrophage kinase, plays a pivotal role in oncogenic pathways in many B-cell malignancies. BTK inhibitors have shown promising anti-tumor activity, first in B-cell malignancies and subsequently in other tumors. However, the prognostic role of BTK in human tumors remains largely unexplored. In this study, we aim to explore the prognostic value of BTK expression in 33 human tumors using pan-cancer analyses. Survival analyses, including Kaplan-Meier analysis and Cox analysis, were performed to explore the prognostic value of BTK for pan-cancer based on survival data from The Cancer Genome Atlas (TCGA) database. Spearman’s correlation analysis was conducted to determine the interrelations between BTK and tumor mutational burden (TMB) and between BTK and microsatellite instability (MSI). The Estimation of Stromal and Immune cells in Malignant Tumor tissues using the Expression data (ESTIMATE) algorithm was used to explore the association of BTK with the tumor microenvironment and Gene Set Enrichment Analysis (GSEA) was used to examine the underlying mechanisms of BTK’s role in multiple tumors. BTK expression is closely associated with the prognosis of head and neck squamous cell carcinoma (HNSC), brain lower grade glioma (LGG), skin cutaneous melanoma (SKCM), and lung adenocarcinoma (LUAD). BTK expression was correlated with clinical stage, TMB, and MSI in 10 types of tumors. In HNSC, LGG, LUAD, and SKCM, BTK expression was positively correlated with immune and stromal scores. BTK is a prognostic biomarker in multiple tumors, especially in HNSC, LGG, LUAD, and SKCM, and this is closely associated with tumor microenvironment remodeling.
Statistical Methods for Process Parameter Optimization of Additively Manufactured AlSi10Mg components
Authors: Krasniqi Mergim , Löffler Frank
Published: November 2022

Demand in industry for lightweight metallic parts with individual component geometries and optimum material properties has prompted the rise of additive manufacturing (AM). AM focuses on laser powder bed fusion (L-PBF); here, the layered architecture allows complex component structures to be created, making it particularly suited to single-batch or small-batch production.
In this study, links between process parameters in L-PBF and material properties are investigated using statistical methods, followed by an optimization using AlSi10Mg as an example.
The results show that the mechanical properties of AlSi10Mg components could be tailored through process parameter optimization and post-processing such as stress relief heat treatment. Statistical methods are used to show how target values such as density, hardness, etc. can be individually optimized or how a component can be optimized with regard to all target values, which is an important step in the customer and application-specific manufacturing of L-PBF components.
The significance and novelty of this research work results from a large-scale central composite design (CCD) with a total of 96 test specimens (40 density cubes, 56 tensile specimens) to determine optimal process parameters for the examined target variables, such as density (up to 100 %), hardness (up to 158.7 HV 1), roughness (approx. Ra = 2 µm), tensile strength (up to 465.6 MPa) and elongation at break (up to 18.0 %).
Due to the use of a CCD as the basis for the parametric study, the results of the study have general validity for AlSi10Mg components manufactured by L-PBF for standard machine settings; thus, the findings can be applied to other systems and are not restricted to the L-PBF system presented in this work.
Significance of Computed Tomography combined with Postural Stimulation Test in Predicting Laterality of Primary Aldosteronism
Authors: Wu Yingxing , Wu Zuxiang , Hu Huan , Rao Jingan , Hu Chenkai , Peng Qiang , Li Ping
Published: November 2022

Backgrounds
Adrenal venous sampling (AVS) represents the gold standard for classifying primary aldosteronism (PA). However, AVS is a technically demanding, expensive and invasive procedure. Computed tomography (CT) scans is recommended as the initial study of classification diagnosis by the current guidelines. In addition, postural stimulation test (PST) has been used to provide additional subtype diagnostic information.
Objective
This work aimed to evaluate the diagnostic utility of the adrenal CT combined with PST in the classification diagnosis of PA.
Methods
We analyzed PA patients who underwent AVS from November 2017 to February 2022 at a single center. Subtype classification of PA was determined by AVS. We analyze the concordance rate between AVS outcomes, adrenal CT, and PST, and explore the value of adrenal CT combined with PST for predicting laterality of PA.
Results
Total 531 PA patients were included the present study. The concordance rate between AVS and the adrenal CT was 51.0%(271/531). Receiver operating characteristic (ROC) curve of PST showed that the area under curve (AUC) was 0.604 [95% confidence interval (CI): 0.556, 0.652], the optimal cut-off value was 30%. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (+ LR), and negative likelihood ratio (-LR) of PST for diagnosis bilateral PA on AVS was 72.8%, 46.2%, 0.48, 0.71, 1.35, and 0.59, respectively. The prevalence of unilateral PA on AVS in patients with unilateral lesion on CT and negative PST, unilateral lesion on CT and positive PST, bilateral normal or lesions on CT and negative PST, and bilateral normal or lesions on CT and positive PST was 82.4% (108/131), 59.9% (91/152), 50.7% (37/73), and 44.6% (78/175), respectively. The sensitivity, specificity, PPV, NPV, +LR, and -LR of adrenal CT combined with PST for the diagnosis of unilateral PA were 34.4%, 89.4%, 0.82, 0.49, 3.25, and 0.73, respectively.
Conclusions
The combination of CT findings and PST can improve the accuracy of predicting laterality of PA.
Anti-pruritic and anti-inflammatory effects of dihydromyricetin in a mouse model of allergic contact dermatitis
Authors: Yin Chunwei , Zhao Jiacheng , Zhu Xiang
Published: November 2022

Background
Allergic contact dermatitis (ACD) is a highly prevalent inflammatory disease of the skin with limited treatment options. Its pathogenesis is believed to be driven by activation of inflammasome induced by allergens and irritants. Dihydromyricet(DHM) is a wild woody vine extract of Vitis viridis in the family Vitis. The main active ingredient is flavonoids, which exhibita wild range of pharmacological effects such as anti-inflammation and anti-oxidation. In this study, we investigated the anti-inflammatory and antipruritic effects of DHM and its mechanism in ACD mouse models.
Methods
Sixty ICR male mice were randomly divided into control group, DHM-treated control group (250 mg· kg-1), ACD model group, and three DHM-treated ACD groups (50, 150, 250 mg· kg-1). To induce ACD, 1-fluoro-2, 4-dinitrofluorobenzo (DNFB) was applied to the neck surface of ICR mice, which were treated with DHM by gavage. Cervical skin changes and scratching behaviors were recorded. HE staining was used for pathological observation, immunohistochemistry and western blot were used to determine the expression level of spinal cord glial cells, and Real-time qPCR was used to determine the level of local and central cytokines.
Results
DHM treatment significantly reduced skin inflammation and scratching episodes. It repaired epidermal keratinization and inflammatory cell infiltration in ACD mice. DHM treatment inhibited the activation of microglia and astrocytes to a certain extent. In addition, it reduced toll-like receptor (TLRs) 4 protein expression levels. At the same time, it significantly reduced the mRNA expression levels of TNF-α, IL-1β and IL-6 in local area and in central area.
Conclusion
This study demonstrates that DHM exhibits anti-pruritus and anti-inflammatory effects in ACD mice by modulating inflammatory mediators. DHM may be a potential treatment for itching and skin inflammation in patients with ACD.
Evaluation and optimization of the syndromic management of female genital tract infections in Nairobi, Kenya
Authors: Omosa-Manyonyi Gloria S. , de Kam Marloes , Tostmann Alma , Masido Mwasi A. , Nyagah Nyawira , Obimbo Moses M. , Ven Andre J.A.M. , Oever Jaap ten
Published: November 2022

Background
Genital tract infections pose a public health concern. In many low-middle-income countries, symptom-based algorithms guide treatment decisions. Advantages notwithstanding, this strategy has important limitations. We aimed to determine the infections causing lower genital tract symptoms in women, evaluated the Kenyan syndromic treatment algorithm for vaginal discharge, and proposed an improved algorithm.
Methods
This cross-sectional study included symptomatic non-pregnant adult women presenting with lower genital tract symptoms at seven outpatient health facilities in Nairobi. Clinical, socio-demographic information and vaginal swabs microbiological tests were obtained. Multivariate logistic regression analyses were performed to find predictive factors for the genital infections and used to develop an alternative vaginal discharge treatment algorithm (using 60% of the dataset). The other 40% of data was used to assess the performance of each algorithm compared to laboratory diagnosis.
Results
Of 813 women, 66% had an infection (vulvovaginal candidiasis 40%, bacterial vaginosis 17%, Neisseria gonorrhoea 14%, multiple infections 23%; 56% of women reported ≥ 3 lower genital tract symptoms episodes in the preceding 12 months. Vulvovaginal itch predicted vulvovaginal candidiasis (odds ratio (OR) 2.20, 95% CI 1.40–3.46); foul-smelling vaginal discharge predicted bacterial vaginosis (OR 3.63, 95% CI 2.17–6.07), and sexually transmitted infection (Neisseria gonorrhoea, Trichomonas vaginalis, Chlamydia trachomatis, Mycoplasma genitalium) (OR 1.64, 95% CI 1.06–2.55). Additionally, contraceptive use (OR 2.27, 95% CI 1.06–4.88) and lower abdominal pain (OR 1.73, 95% CI 1.07–2.79) predicted sexually transmitted infection. Inappropriate treatment was 117% and 75% by the current and alternative algorithms respectively. Treatment specificity for bacterial vaginosis/Trichomonas vaginalis was 27% and 82% by the current and alternative algorithms, respectively. Performance by other parameters was poor to moderate and comparable between the two algorithms.
Conclusion
Single and multiple genital infections are common among women presenting with lower genital tract symptoms at outpatient clinics in Nairobi. The conventional vaginal discharge treatment algorithm performed poorly, while the alternative algorithm achieved only modest improvement. For optimal care of vaginal discharge syndrome, we recommend the inclusion of point-of-care diagnostics in the flowcharts.
Estimated preventable COVID-19-associated deaths due to non-vaccination in the United States
Authors: Jia Katherine M. , Hanage William P. , Lipsitch Marc , Johnson Amelia G. , Amin Avnika B. , Ali Akilah R. , Scobie Heather M. , Swerdlow David L.
Published: November 2022

While some studies have previously estimated lives saved by COVID-19 vaccination, we estimate how many deaths could have been averted by vaccination in the US but were not because of a failure to be vaccinated. We used a simple method based on a nationally representative dataset to estimate the preventable deaths among unvaccinated individuals in the U.S. from May 30, 2021 to April 30, 2022 adjusted for the effects of age and time. We estimated that at least 215,000 deaths could have been prevented among unvaccinated adults during the 11 months had they been vaccinated with at least a primary series. While more granular data on other factors causing differences in death rates between the vaccinated and unvaccinated groups could inform these estimates, this method addresses an important public health question and provides an estimate of vaccine-preventable deaths due to SARS-CoV-2. The same methods can be used during future public health emergencies.
A high power, fully implanted and battery free platform for chronic functional electrical stimulation enabled by passive resonator antenna design.
Authors: Burton Alex , Wang Zhong , Song Dan , Tran Sam , Hanna Jessica , Bakall Jakob , Clausen David , Anderson Jerry , Peralta Roberto , Sandepudi Kirtana , Benedetto Alex , Yang Ethan , Basrai Diya , Miller Lee , Tresch Matthew , Gutruf Philipp
Published: November 2022

Electrical stimulation of the neuromuscular system holds promise for both scientific and therapeutic biomedical applications. Supplying and maintaining the power necessary to drive stimulation chronically is a fundamental challenge in these applications, especially when high voltages or currents are required. Wireless systems, in which energy is supplied through near field power transfer, could eliminate complications caused by battery packs or external connections, but currently do not provide the harvested power and the voltages for applications such as muscle stimulation. Here, we introduce a passive resonator optimized power transfer design that overcomes these limitations, enabling voltage compliances of ± 20 V and power over 300 mW at device volumes of 0.2 cm2, thereby improving power transfer 500% over previous systems. This improved performance enables multichannel, biphasic, current-controlled operation at clinically relevant voltage and current ranges with digital control and telemetry. Implanted devices remain operational over 6 weeks in both intact and spinal cord injured rats and are capable of producing fine control of spinal and muscle stimulation.
Dental panoramic imaging by use of CBCT projection data
Authors: Kwon Taejin , Choi Da-in , Hwang Jaehong , Lee Taewon , Lee Inje , Cho Seungryong
Published: November 2022

Dental CBCT and panoramic images are important imaging modalities used in dental diagnosis and treatment planning. In order to acquire a panoramic image without an additional panoramic scan, in this study, we proposed a method of reconstructing a panoramic image by extracting panoramic projection data from dental CBCT projection data. After specifying the patient's dental arch from the patient's CBCT image, panoramic projection data are extracted from the CBCT projection data along the appropriate panoramic scan trajectory that fits the dental arch. A total of 40 clinical human datasets and one head phantom dataset were used to test the proposed method. The clinical human dataset used in this study includes cases in which it is difficult to reconstruct panoramic images from CBCT images, such as data with severe metal artifacts or data without teeth. As a result of applying the panoramic image reconstruction method proposed in this study, we were able to successfully acquire panoramic images from the CBCT projection data of various patients. The proposed method acquires a universally applicable panoramic image that is less affected by CBCT image quality and metal artifacts by extracting panoramic projection data from dental CBCT data and reconstructing a panoramic image.
Can Circadian Rhythm Predict Neurocognitive Functioning and Treatment Response in Bipolar Disorder Patients: Protocol of A 12-month Prospective Observational Study
Authors: Huirong Luo , Xueqian Wang , Yinlin Zhang , Junyao Li , Renqin Hu , Zheng Zhang , Qian Liao , Xiaoxin Zhou , Wei Deng , Jian Yang , Qinghua Luo
Published: November 2022

Background:
Bipolar disorder (BD) is a common and disabling mental disorder with circadian rhythm and neurocognitive features playing important roles in treatment response and rehabilitation. Limited evidence existed for circadian rhythm interaction with long-term neurocognitive functioning. This protocol is designed to investigate whether circadian rhythm could predict long-term change neurocognitive functioning and treatment response in BD patients.
Methods:
This is a prospective observational study protocol. We plan to include 47 BD patients within depressive episodes. Participants will be evaluated from clinical, circadian rhythm and neurocognitive perspectives at baseline, 6-month and 12-month follow-ups using questionnaires, actigraphy, vitamin D concentration and computed cognitive tests. Both cross-sectional and longitudinal associations between participants’ circadian rhythm patterns and cognitive functioning and treatment response will be detected. Spearman correlation, Pearson correlation and multiple linear regression models will be applied for statistical analysis.
Discussion:
We suppose that circadian rhythm could predict change of neurocognitive functioning and that circadian rhythm is associated with treatment response and adherence, social functioning and quality of life. Results using this protocol may provide additional information for BD pathophysiology, treatment targets and prediction.
Trial Registration:
This study was approved by Chinese Clinical Trial Registry (Registration Code: ChiCTR2200064922) registered on 21st October 2022.
Skeletal Muscle Alterations Indicate Poor Prognosis in Cirrhotic Patients: A Multicentre Cohort Study in China
Authors: ZENG Xin , SHI Zhi-Wen , YU Jia-Jun , WANG Li-Fen , Sun Chun-Yan , Luo Yuan-Yuan , SHI Pei-Mei , LIN Yong , CHEN Yue-Xiang , GUO Jia , ZHANG Chun-Qing , Xie Wei-Fen
Published: November 2022

Introduction: We aimed to determine the diagnostic criteria of myosteatosis in a Chinese populationand investigate the effect of skeletal muscle abnormalities on the outcomes of cirrhotic patients.
Methods: Totally 911 volunteers were recruited to determine the diagnostic criteria and impact factors of myosteatosis, and 480 cirrhotic patients were enrolled to verify the value of muscle alterations for prognosis prediction and establishnew noninvasive prognostic strategies.
Results: Multivariate analysis showed age, sex, weight, waist circumference and biceps circumference had remarkable influence on the L3 skeletal muscle density (L3-SMD). Based on the cut-off of a mean−1.28×SD among adults aged＜60 years, the diagnostic criteria for myosteatosis wasL3-SMD＜38.93 Hu in malesand L3-SMD＜32.82 Hu in females. Myosteatosis rather than sarcopenia has close correlation with portal hypertension. The concurrence of sarcopenia and myosteatosis not only is associated with poor liver function, but also evidently reduced the overall and liver transplantation-free survival of the cirrhotic patients (P<0.001). According to the stepwise Cox regression hazard model analysis, we established nomograms including TBil, albumin, history of HE, ascites grade, sarcopenia and myosteatosis for easily determining survival probabilities in cirrhotic patients. The AUC is 0.874 (95% CI, 0.800-0.949) for 6-month survival, 0.831 (95% CI, 0.764-0.898) for 1-year survival and 0.813 (95% CI, 0.756-0.871) for 2-year survival prediction, respectively.
Conclusions: This study provides evidence of the significant correlation between skeletal muscle alterations andpoor outcomes of cirrhosis, and establishes valid and convenient nomograms incorporating musculoskeletal disorders for the prognostic prediction of liver cirrhosis. Further large-scale prospective studies are necessary to verify the value of the nomograms.
Analysis of water pricing policy effects in a Mediterranean basin through a hydroeconomic model
Authors: Martínez-Dalmau Javier , Gutiérrez-Martín Carlos , Expósito Alfonso , Berbel Julio
Published: November 2022

This paper explores the impacts of water pricing as a demand management policy, at a regional level (or basin-sector). To this aim, a hydro-economic model for the Guadalquivir River basin (southern Spain) is proposed here. This basin constitutes a perfect example of a Mediterranean basin subject to frequent and long drought periods, where challenges related to water scarcity are increasing, leading to social conflicts among water users. Moreover, this basin is characterised by a closure state meaning that all available water resources are already allocated among users. In this context, water pricing policy may act as an effective tool to reduce water demand by encouraging changes of behaviour in water users. In particular, those who perform irrigation practices in the agricultural sector. This paper focuses on the irrigation sector since it is the main water user in the basin (87%). Additionally, alternative water-availability scenarios have been used to test the effect of water pricing under drought conditions. The hydro-economic model presented here has been sectorized into four basin sectors with common characteristics (hydro and economic). This enables the analysis of alternative price scenarios in the agricultural sector, in terms of water used, crop patterns and gross margin. Results show that water pricing policy should consider the regional characteristics at the basin-sector scale to gain effectiveness and equity at the river basin scale. Moreover, it has been found that both water availability and the crop pattern at the basin-sector scale have an effect on the reduction of water used (and therefore in gross margin.
Association of high kinesiophobia and pain catastrophizing with quality of life in severe hip osteoarthritis
Authors: Hidaka Ryo , Tanaka Takeyuki , Hashikura Kazuaki , Oka Hiroyuki , Matsudaira Kou , Moro Toru , Kawano Hirotaka , Tanaka Sakae
Published: November 2022

Background: While fear of movement is an important predictor of pain and disability in osteoarthritis (OA), its impact on patients with hip OA remains uncertain. This study aimed to determine whether fear of movement, evaluated by the Tampa Scale for Kinesiophobia (TSK)-11, and pain catastrophizing, evaluated by the Pain Catastrophizing Scale (PCS), were associated with quality of life (QOL) in patients with hip OA.
Methods: This cross-sectional study was conducted between Nov 2017 and Dec 2018. Ninety-one consecutively enrolled patients with severe hip OA were scheduled for primary unilateral total hip arthroplasty. The EuroQOL-5 Dimensions questionnaire was used to measure general QOL. The Japanese Orthopedic Association Hip Disease Evaluation Questionnaire was used to assess disease-specific QOL. The covariates included age, sex, body mass index (BMI), pain intensity, high pain catastrophizing (PCS ≥ 30), and high kinesiophobia (TSK-11 ≥ 25). Variables were subjected to multivariate analysis using each QOL scale.
Results: In multiple regression analysis, pain intensity, high pain catastrophizing, and BMI were independently correlated with the disease-specific QOL scale. High pain catastrophizing, pain intensity, and high kinesiophobia were independently correlated with the general QOL scale.
Conclusions: High pain catastrophizing (PCS ≥ 30) was independently associated with disease and general QOL scales. High kinesiophobia (TSK-11 ≥ 25) was independently associated with the general QOL scale in preoperative patients with severe hip OA.
Realising radical potential: building community power in primary health care through Participatory Action Research
Authors: Mabetha Denny , Ojewola Temitope , Merwe Maria , Mabeka Reflect , Goosen Gerhard , Sigudla Jerry , Hove Jennifer , Witter Sophie , D'Ambruoso Lucia
Published: November 2022

BACKGROUND: While community participation is an established pro-equity approach in Primary Health Care (PHC), in practice it can take many forms, and the central category of power is under-theorised. The objectives of this paper were to (a) conduct theory-informed analysis of community power-building in PHC in a setting of structural deprivation and (b) develop practical guidance.
METHODS: Stakeholders representing rural communities, government departments and non-governmental organisations engaged through a participatory action research (PAR) process in a rural sub-district in South Africa. Three reiterative cycles of collective evidence generation, analysis, action, and reflection were progressed. Local health concerns were raised and framed by rural community stakeholders, who generated new data and evidence with researchers. Dialogue and learning were developed between the authorities and communities, with local action plans coproduced, implemented, and monitored. Throughout, efforts were made to shift and share power, and to adapt the process to improve practical and local relevance. We analysed participant and researcher reflections, project documents, and other project data using power-building and power-limiting frameworks.
RESULTS: Co-constructing evidence among community stakeholders in ‘safe spaces’ for dialogue and cooperative action built collective capabilities. The authorities embraced the platform as a space to safely engage with communities and the process was taken up in the district health system. Responding to COVID-19, the process was collectively re-designed to include a training package for community health workers (CHWs) in rapid PAR. New skills and competencies, new community and facility-based alliances and explicit recognition of CHW roles, value, and contribution at higher levels of the system were reported following the adaptions. The process was subsequently scaled across the sub-district.
CONCLUSIONS: Community power-building in rural PHC was multidimensional, non-linear, and deeply relational. Collective mindsets and capabilities for joint action and learning were built through a pragmatic, cooperative, adaptive process creating spaces where people could create and use evidence to make decisions. Impacts were seen in demand for implementation in outside the study setting. We offer a practice framework to expand community power in PHC: (1) prioritising community capability-building, (2) navigating social and institutional contexts and (3) developing and sustaining authentic learning spaces.
Impact of Covid-19 on Food Environment in Hong Kong a Cross-sectional Qualitative Study
Authors: Chui Szeto , Li Tonglu , Koh Keumseok
Published: November 2022

Background and objectives: As COVID-19 has invaded Hong Kong since 2020, the food environment had been changed in different aspects, such as food supply, retail, and catering. Previous studies illustrated the negative effects brought by the pandemic, which could induce health issues in the long run. For instance, people consumed more highly-processed food and less vegetables during COVID-19, resulting in higher risks of diabetes mellitus and being overweight. Given similar research was limited in Hong Kong, exploratory research is beneficial to investigate this topic.
Methods: This research conducted individual in-depth interviews to study the dietary changes of Hong Kong citizens during the pandemic. In total, 13 interviewees were recruited from the undergrads, middle-aged, and elderly groups.
Results and conclusions: Various impacts on food security were observed, including an unstable food supply, increased food prices, and unbalanced diets. Health outcomes were reported due to the dietary changes under COVID-19, such as weight gain and food-related illness. The government may work closely with society in addressing the problems promptly, as long-lasting effects on health are expected.