bluuebunny/crossref_metadata_2025 huggingface dataset:
Management of Splanchnic Vein Thrombosis in Patients With Acute Pancreatitis
Authors: Ghazanfar Mudassar A. , Ke Lu , Ramsay George , Smith Martin , Giovinazzo Francesco , Mohamed Moustafa , Pandanaboyana Sanjay , Huang Wei , Ahmed Irfan , Siriwardena Ajith K. , Windsor John A. , Bekheit Mohamed
Published: April 2023

Objectives

Splanchnic venous thrombosis (SpVT) is a complication of acute pancreatitis (AP). There is scarce literature on the prevalence and treatment of SpVT in AP. The aim of this international survey was to document current approaches to the management of SpVT in patients with AP.

Methods

An online survey was designed by a group of international experts in the management of AP. Twenty-eight questions covered the level of experience of the respondents, disease demographics, and management of SpVT.

Results

There were 224 respondents from 25 countries. Most respondents (92.4%, n = 207) were from tertiary hospitals and predominantly consultants (attendings, 86.6%, n = 194). More than half of the respondents (57.2%, n = 106) “routinely” prescribed prophylactic anticoagulation for AP. Less than half of the respondents (44.3%, n = 82) “routinely” prescribed therapeutic anticoagulation for SpVT. A clinical trial was considered justified by most respondents (85.4%, n = 157) and 73.2% (n = 134) would be willing to enroll their patients.

Conclusions

The approach to anticoagulation in the treatment of patients with SpVT complicating AP was highly variable. Respondents indicate that a position of equipoise exists to justify randomized evaluation.
Impact of Preoperative Muscle Mass Maintenance and Perioperative Muscle Mass Loss Prevention After Pancreatectomy
Authors: Maekawa Takeru , Maehira Hiromitsu , Iida Hiroya , Mori Haruki , Nitta Nobuhito , Tokuda Aya , Kaida Sachiko , Miyake Toru , Takebayashi Katsushi , Tani Masaji
Published: April 2023

Objectives

We investigated how preoperative sarcopenia and perioperative muscle mass changes affect postoperative nutritional parameters in patients undergoing pancreatectomy.

Methods

This study included 164 patients undergoing pancreatectomy between January 2011 and October 2018. Skeletal muscle area was measured by computed tomography before and 6 months after surgery. Sarcopenia was defined as the lowest sex-specific quartile, and patients with muscle mass ratios less than −10% were classified into the high-reduction group. We examined the relationship between perioperative muscle mass and postoperative nutritional parameters 6 months after pancreatectomy.

Results

There were no significant differences in nutritional parameters between the sarcopenia and nonsarcopenia groups at 6 months after surgery. In contrast, albumin (P < 0.001), cholinesterase (P < 0.001), and prognostic nutritional index (P < 0.001) were lower in the high-reduction group. According to each surgical procedure, albumin (P < 0.001), cholinesterase (P = 0.007), and prognostic nutritional index (P < 0.001) were lower in the high-reduction group of pancreaticoduodenectomy. In distal pancreatectomy cases, only cholinesterase (P = 0.005) was lower.

Conclusions

Postoperative nutritional parameters were correlated with muscle mass ratios but not with preoperative sarcopenia in patients undergoing pancreatectomy. Improvement and maintenance of perioperative muscle mass are important to maintain good nutritional parameters.
Lower Interobserver Reliability for Nondimensional Intracystic Features Among Abdominal Radiologists for Characterizing Intraductal Papillary Mucinous Neoplasms Using Magnetic Resonance Imaging
Authors: Scherer John A. , Gebhard Robyn , Firkins Stephen A. , Shah Zarine K. , Urbina Andersson Irma K. , Barker Samantha J. , Fiorillo Lauren E. , Hollander Ephraim , Shaheen Nicholas , Koay Eugene J. , Conwell Darwin L. , Krishna Somashekar G.
Published: April 2023

Objectives

Current guidelines recommend magnetic resonance imaging (MRI)/magnetic resonance cholangiopancreatography (MRCP) for risk stratification of intraductal papillary mucinous neoplasms (IPMNs). We assessed the interobserver agreement among radiologists in evaluating and risk stratifying IPMNs.

Methods

This single-center study evaluated 30 patients with IPMNs who had undergone MRI/MRCP, endoscopic ultrasound, and/or surgical resection. Six abdominal radiologists evaluated the MRI/MRCPs to document multiple parameters. The analysis applied Landis and Koch κ interpretation for categorical variables and intraclass correlation coefficient (r) for continuous variables.

Results

Radiologists demonstrated almost perfect agreement for location (κ = 0.81, 95% confidence interval [CI], 0.74–0.87), size (r = 0.95; 95% CI, 0.89–0.98), and main pancreatic duct diameter (r = 0.98; 95% CI, 0.96–0.99). Substantial agreement was observed for communication with the main pancreatic duct (κ = 0.66; 95% CI, 0.57–0.75) and classification of IPMN subtype (κ = 0.77; 95% CI, 0.67–0.86). Presence of intracystic nodules (κ = 0.31; 95% CI, 0.21–0.42) and wall thickening (κ = 0.09; 95% CI, −0.01 to 0.18) reached only fair and slight agreement, respectively.

Conclusions

Although MRI/MRCP is excellent in the evaluation of spatial aspects, there is lower reliability for nondimensional characteristics of IPMNs. These data support guideline-recommended complementary evaluation of IPMNs with MRI/MRCP and endoscopic ultrasound.
The Pediatric Crohn Disease Morbidity Index (PCD-MI): Development of a Tool to Assess Long-Term Disease Burden Using a Data-Driven Approach
Authors: Ashton James J. , Gurung Abhilasha , Davis Cai , Seaby Eleanor G. , Coelho Tracy , Batra Akshay , Afzal Nadeem A. , Ennis Sarah , Beattie R. Mark
Published: April 2023

Background/Objective:

Heterogeneity and chronicity of Crohn disease (CD) make prediction of outcomes difficult. To date, no longitudinal measure can quantify burden over a patient’s disease course, preventing assessment and integration into predictive modeling. Here, we aimed to demonstrate the feasibility of constructing a data driven, longitudinal disease burden score.

Methods:

Literature was reviewed for tools used in assessment of CD activity. Themes were identified to construct a pediatric CD morbidity index (PCD-MI). Scores were assigned to variables. Data were extracted automatically from the electronic patient records at Southampton Children’s Hospital, diagnosed from 2012 to 2019 (inclusive). PCD-MI scores were calculated, adjusted for duration of follow up and assessed for variation (ANOVA) and distribution (Kolmogorov-Smirnov).

Results:

Nineteen clinical/biological features across five themes were included in the PCD-MI including blood/fecal/radiological/endoscopic results, medication usage, surgery, growth parameters, and extraintestinal manifestations. Maximal score was 100 after accounting for follow-up duration. PCD-MI was assessed in 66 patients, mean age 12.5 years. Following quality filtering, 9528 blood/fecal test results and 1309 growth measures were included. Mean PCD-MI score was 14.95 (range 2.2–32.5); data were normally distributed (P = 0.2) with 25% of patients having a PCD-MI < 10. There was no difference in the mean PCD-MI when split by year of diagnosis, F-statistic 1.625, P = 0.147.

Conclusions:

PCD-MI is a calculatable measure for a cohort of patients diagnosed over an 8-year period, integrating a wide-range of data with potential to determine high or low disease burden. Future iterations of the PCD-MI require refinement of included features, optimized scores, and validation on external cohorts.
Threat of resurgence or hope for global eradication of poliovirus?
Authors: Kim Carla Y. , Piamonte Bernadeth , Allen Rebecca , Thakur Kiran T.
Published: April 2023

Purpose of review

Recent outbreaks of poliomyelitis in countries that have been free of cases for decades highlight the challenges of eradicating polio in a globalized interconnected world beset with a novel viral pandemic. We provide an epidemiological update, advancements in vaccines, and amendments in public health strategy of poliomyelitis in this review.

Recent findings

Last year, new cases of wild poliovirus type 1 (WPV1) were documented in regions previously documented to have eradicated WPV1 and reports of circulating vaccine-derived poliovirus type 2 (cVDPV2) and 3 (cVDPV3) in New York and Jerusalem made international headlines. Sequencing of wastewater samples from environmental surveillance revealed that the WPV1 strains were related to WPV1 lineages from endemic countries and the cVDPV2 strains from New York and Jerusalem were not only related to each other but also to environmental isolates found in London. The evidence of importation of WPV1 cases from endemic countries, and global transmission of cVDPVs justifies renewed efforts in routine vaccination programs and outbreak control measures that were interrupted by the COVID-19 pandemic. After the novel oral poliovirus vaccine type 2 (nOPV2) received emergency authorization for containment of cVDPV2 outbreaks in 2021, subsequent reduced incidence, transmission rates, and vaccine adverse events, alongside increased genetic stability of viral isolates substantiates the safety and efficacy of nOPV2. The nOPV1 and nOPV3 vaccines, against type 1 and 3 cVDPVs, and measures to increase accessibility and efficacy of inactivated poliovirus vaccine (IPV) are in development.

A revised strategy utilizing more genetically stable vaccine formulations, with uninterrupted vaccination programs and continued active surveillance optimizes the prospect of global poliomyelitis eradication.
Addressing vaccine-preventable encephalitis in vulnerable populations
Authors: Piamonte Bernadeth Lyn C. , Easton Ava , Wood Greta K. , Davies Nicholas W.S. , Granerod Julia , Michael Benedict D. , Solomon Tom , Thakur Kiran T.
Published: April 2023

Purpose of review

Vaccinations have been pivotal in lowering the global disease burden of vaccine-preventable encephalitides, including Japanese encephalitis, tick-borne encephalitis, measles encephalitis, and rabies encephalitis, among others.

Recent findings

Populations vulnerable to vaccine-preventable infections that may lead to encephalitis include those living in endemic and rural areas, military members, migrants, refugees, international travelers, younger and older persons, pregnant women, the immunocompromised, outdoor, healthcare and laboratory workers, and the homeless. There is scope for improving the availability and distribution of vaccinations, vaccine equity, surveillance of vaccine-preventable encephalitides, and public education and information.

Addressing these gaps in vaccination strategies will allow for improved vaccination coverage and lead to better health outcomes for those most at risk for vaccine-preventable encephalitis.
Choroid plexuses at the interface of peripheral immunity and tissue repair in multiple sclerosis
Authors: Ricigliano Vito A.G. , Stankoff Bruno
Published: April 2023

Purpose of review

Choroid plexuses (ChPs) are key actors of the blood-to-cerebrospinal-fluid barrier and serve as brain immune checkpoint. The past years have seen a regain of interest about their potential involvement in the physiopathology of neuroinflammatory disorders like multiple sclerosis (MS). This article offers an overview of the recent findings on ChP alterations in MS, with a focus on the imaging tools able to detect these abnormalities and on their involvement in inflammation, tissue damage and repair.

Recent findings

On MRI, ChPs are enlarged in people with MS (PwMS) versus healthy individuals. This size increase is an early event, already detected in presymptomatic and pediatric MS. Enlargement of ChPs is linked to local inflammatory infiltrates, and their dysfunction selectively impacts periventricular damage, larger ChPs predicting the expansion of chronic active lesions, smoldering inflammation and remyelination failure in tissues surrounding the ventricles. ChP volumetry may add value for the prediction of disease activity and disability worsening.

ChP imaging metrics are emerging as possible biomarkers of neuroinflammation and repair failure in MS. Future works combining multimodal imaging techniques should provide a more refined characterization of ChP functional changes, their link with tissue damage, blood to cerebrospinal-fluid barrier dysfunction and fluid trafficking in MS.
Spirosoma oryzicola sp. nov., isolated from dried rice husk
Authors: Won Miyoung , Heo Jun , Weon Hang-Yeon , Lee Daseul , Han Byeong-Hak , Hong Seung-Beom , Kwon Soon-Wo
Published: April 2023

Strain RHs26T is an aerobic, Gram-stain-negative, non-flagellated and rod- or filamentous-shaped (1.0–1.1×2.3–50 µm) bacterium that was isolated from dried rice husk. It was positive for oxidase and catalase, hydrolysed starch and Tween 80, and weakly hydrolysed CM-cellulose. The strain grew at temperatures between 10 and 37 °C (optimum, 28 °C), in 0–1 % NaCl (optimum, 0 %) and at pH 6.0–9.0 (optimum, pH 7.0–8.0). The predominant membrane fatty acids were summed feature 3 (C16 : 1
ω7c and/or C16 : 1
ω6c), C16 : 1
ω5c, iso-C15 : 0 and iso-C17 : 0 3-OH. The major polar lipids were phosphatidylethanolamine, an unidentified aminolipid, two unidentified aminophospholipids and two unidentified lipids. The predominant quinone was menaquinone MK-7. Phylogenetic analysis based on 16S rRNA gene sequences indicated that strain RHs26T belongs to the genus

Spirosoma

, presenting the highest sequence similarity to

Spirosoma agri

S7-3-3T (95.8 %). The genomic DNA G+C content of strain RHs26T was 49.5 %. Strain RHs26T showed the highest orthologous average nucleotide identity (OrthoANI) and digital DNA–DNA hybridization (dDDH) values of 76.4 % and 20.0 % with

S. agri

KCTC 52727T while sharing OrthoANI and dDDH values of 74.6 % and 19.2 % with

Spirosoma terrae

KCTC 52035T, the closest relative in the phylogenomic tree. Based on the results of a polyphasic taxonomic study, strain RHs26T represents a novel species in the genus

Spirosoma

, for which the name Spirosoma oryzicola sp. nov. is proposed. The type strain is RHs26T (=JCM 35224T=KACC 17318T).
A Phase I trial to inform clinical protocols for the safe administration of psilocybin-assisted psychotherapy
Authors: Bennett Jennifer N. , Blough Michael D. , Mitchell Ian , Galloway Lyle , Bains Ravinder
Published: April 2023

This Phase I trial aims to inform the development of safety protocols for psilocybin-assisted therapy. Psychedelics, including psilocybin, are increasingly being recognized as a successful treatment option for many mental health concerns. In order to decrease the risks associated with its clinical use, more data is required regarding its physiological effects in healthy individuals. Safety assessments (heart rate, blood pressure, temperature, and ECG data), as well as adverse event evaluations were the primary outcome measures used to assess the physiological effects of 25 mg of psilocybin extract administered to 14 healthy individuals. We hypothesized that there would be a transient, clinically insignificant rise in both blood pressure and heart rate that would not result in any long-term adverse effects. No unexpected effects were observed, blood pressure and heart rate returned to normal as drug effects waned, and all participants had normal two-month follow-ups. Mean peak systolic and diastolic blood pressures during the psilocybin session were 145.93 (SD= 19.01) and 93.93 (SD= 9.75), respectively. While this represents a significant increase from baseline (p< 0.0001), a healthy cardiovascular system is capable of tolerating such levels for a longer time period than the brief duration of drug effects. Therefore, we suggest implementing focused and limited screening protocols to balance patient safety and accessibility. Secondary outcomes of this trial centered on the subjective effects of psilocybin, assessed via the QIDS-SR16 and the MEQ-30. There was a statistically significant decrease in QIDS-SR16 scores from baseline scores (M= 3.50,SD= 2.35) to eight-week follow-up scores (M= 1.86,SD= 0.86),p= 0.018. Mean MEQ-30 scores, assessed on day two and seven after the psilocybin session, indicate participants had full mystical experiences.
Inflammation induced epigenetic activation of bivalent genes in osteoarthritic cartilage
Authors: Du Hao , Zhang Yao , Yu Xi , You Xuanhe , Wu Diwei , Luo Zhenyu , Cai Yongrui , Lu Hanpeng , Liao Zhixin , Ding Bi-Sen , Zhao Ya , Wang Yan , Xiao Ke , Yang Fan , Gan Fangji , Ning Ning , Zeng Jiancheng , Zhou Zongke , Huang Shishu
Published: April 2023

Osteoarthritis (OA) is the most prevalent joint disorder occurring with articular cartilage degradation, which includes a switch from an articular to a growth-plate chondrocyte phenotype. Epigenetics serves as a new therapeutic target but histone modification changes in OA remain elusive. Here, we investigated the profiles of four histone modifications in normal and OA chondrocytes. The repressive mark H3K27me3 was significantly lost in OA, associated with up-regulated gene expression. Surprisingly, many of these genes were occupied by both H3K27me3 and H3K4me3 in normal chondrocytes, showing a poised bivalent state. These bivalent genes are deemed to be activated during the hypertrophy of growth plate chondrocytes. Furthermore, inflammation induced the expression of demethylase KDM6B and decreased H3K27me3 level in OA chondrocytes, which was rescued by the KDM6B inhibitor GSK-J4. Altogether, our results suggest an inherited bivalent epigenetic signature on developmental genes that makes articular chondrocytes prone to hypertrophy and contribute to a promising epigenetic therapy for OA.

The Paper Explained

Problem

Osteoarthritis (OA) affects as much as 40% of the elderly population, representing the largest cause of age-related disability. The high susceptibility to OA suggests an intrinsic and systemic characteristic in articular chondrocytes that makes cartilage prone to degeneration.

Results

Epigenetic bivalent genes, which are occupied with both H3K27me3 and H3K4me3, are considered to poise expression of developmental genes. Surprisingly, we reported bivalency for hypertrophy related genes in normal articular chondrocytes. These bivalent genes need to be activated in growth plate chondrocytes for extracellular matrix degradation and ossification, but are left as a “bomb” for degeneration in articular chondrocytes. We further found that inflammation induced KDM6B remove H3K27me3 to activate hypertrophy related genes that promote OA.

Impact

Our results suggest an inherited epigenetic signature that makes articular chondrocytes prone to hypertrophy and ossification and contribute to a promising epigenetic therapy for OA.
Catheter Laboratory Facilities in Indonesia: Number, Growth, and Distribution in The Largest Archipelago Nation
Authors: Muharram Farizal Rizky , Andrianto Andrianto , Salsabilla Senitza Anisa , Multazam Chaq El Chaq Zamzam , Harmadha Wigaviola Socha , Dakota Iwan , Andriantoro Hananto , Firman Doni , Prakoso Radityo
Published: April 2023

Background

Indonesia, the world’s largest archipelago and fourth most populous nation, has limited transportation due to geographical obstacles. This affects the provision of acute time-dependent therapy such as Percutaneous Coronary Intervention (PCI). Indonesia’s ageing population, which will increase Acute Coronary Syndrome prevalence in the next decade, will worsen this problem. Therefore, the analysis and enhancement of cardiovascular care are crucial. The catheterization laboratory (cath lab) performs PCI procedures. This study maps the number and distribution of Indonesia’s cath lab facilities.

Methods

A direct survey was used to collect the cath lab location data. Population data came from the Ministry of Home Affairs. The growth of cath labs is shown and analyzed by region. The ratio and the Gini index are the primary comparison tools between regions and over time.

Findings

The number of cath labs in Indonesia significantly increased from 181 to 310 in the last five years, with 44 of the 119 new labs built in an area that did not have one. Java has the most cath labs (208, 67%). The cath lab ratio in the provinces of Indonesia ranges from 0·0 in West Papua and Maluku to 4·46 in Jakarta; the median is 1·09. (IQR 0·71–1·18). The distribution remains a problem, as shown by the high cath lab Gini index (0·48).

Interpretation

The number of cath labs in Indonesia has increased significantly recently. However, maldistribution remains a concern. In order to improve Indonesia’s cardiovascular emergency services, Future cath lab development must be planned better by considering the facility accessibility and density.

Funding

The study was conducted with the researcher’s funds

Evidence Before Study

Indonesia is the fourth-largest nation by population and the largest archipelagic country. Unfortunately, the number of cath lab facilities nationwide in Indonesia was never examined or mentioned in any previous scientific articles that we could find. According to earlier studies, cathlab accessibility is critical in reducing the time ACS patients take to receive care. It is become crucial to map cathlab locations and plan them in strategic locations.

What this Study Adds

This study provides data on the number of cathlabs, their primary geographic distribution, their cath lab-to-population ratio, and their evolution over the previous five years in Indonesia.

Our research demonstrates that to ensure equity access, Indonesia, as the largest archipelagic nation, needs government policies that initiate the distribution of cathlabs and the strategic placing of cathlabs as critical factors.
Brief Multimodal Intervention to Address Bedtime Procrastination and Sleep through Self-Compassion and Sleep Hygiene during Stressful Times
Authors: Bistricky Steven L. , Lopez Alicia K. , Pollard Tarryn B. , Egan Alana , Gimenez-Zapiola Malena , Pascuzzi Bailey , Velasquez Kenia M. , Graves Miana
Published: April 2023

Bedtime procrastination is increasingly recognized as a widespread impediment to health-promoting sleep. Based on its potential malleability, bedtime procrastination is starting to be targeted for intervention using traditional health behavior models, but other cognitive and emotional factors that potentially modulate bedtime procrastination warrant more targeted intervention. The present research recruited college students (n = 93) with self-reported tendencies toward bedtime procrastination and low self-compassion early in the COVID-19 pandemic, and it examined a hybrid intervention model involving a single group meeting and home practices that focused on comprehensive sleep hygiene or intentional self-compassion practices, simultaneously leveraging social motivation and commitment. It also examined bedtime procrastination, sleep, emotion regulation, and procrastinatory cognitions. The study showed evidence for feasibility, acceptability, reduced bedtime procrastination, improved sleep, and moderated mediation whereby the relationship between increased self-compassion and decreased bedtime procrastination was mediated by improved emotion regulation for those with elevated reductions in procrastinatory cognition. Predictors of bedtime procrastination reduction and other relevant sequelae differed between self-compassion and sleep hygiene virtual trainings. Thus, the present research expands and synthesizes a burgeoning literature, suggesting that integrating effective elements into acceptable interventions may help reverse a cycle of self-criticism, emotion dysregulation, bedtime procrastination, and sleep-related difficulties for many who might benefit.
The Effect of COVID-19 Public Health Measures On Mental Health in California
Authors: Mehrabadi Milad Asgari , Nurmi Erika L. , Borelli Jessica L. , Lambert Natalie , Rahmani Amir M. , Downs Charles A. , Pinto Melissa D.
Published: April 2023

California was the first state to implement statewide public health measures, including lockdown and curfews, to mitigate transmission of SARS-CoV-2. The implementation of these public health measures may have had unintended consequences related to mental health for persons in California. This study is a retrospective review of electronic health records of patients who sought care in the University of California Health System to examine changes in mental health status during the pandemic. Data were extracted prior to the pandemic (March-October 2019) and during the pandemic (March-October 2020). Weekly values of new mental health disorders were extracted and further classified based on age. Paired t-tests were performed to test for differences in the occurrence of each mental health disorder for each age group. A two-way ANOVA was performed to assess for between group differences. When compared with pre-pandemic diagnoses, persons aged 26-35 had the greatest increase in mental health diagnoses overall during the pandemic, specifically for anxiety, bipolar disorder, depression, mood disturbance, and psychosis. The mental health of persons age 25-35 were more affected than any other age group.
Preliminary clinical characteristics of Pediatric Covid-19 cases during the ongoing Omicron XBB.1.16 driven surge in a north Indian city
Authors: Vashishtha Vipin M. , Kumar Puneet
Published: April 2023

India is experiencing a new surge in Covid-19 cases in most parts of the country. A new sub-variant of Omicron, XBB.1.16 which is far more aggressive and immune evasive than other sub-lineages of Omicron, is responsible for this outbreak. In this preliminary account, we describe key clinical characteristics of SARS-CoV-2 infected children, visiting an outdoor department of a pediatric hospital in a north Indian city. Our preliminary findings show a higher involvement of young infants than older children and mild respiratory illness predominates other presentations. One interesting finding was the presence of itchy, non-purulent conjunctivitis with mucoid discharge and stickiness of eyelids in 42.8% of positive infants. None of the children required hospitalization. All recovered with symptomatic treatment.

Key findings

The current ongoing XBB.1.16 driven surge of Covid-19 is causing mild febrile illness in children in India

Young infants are disproportionately more affected than older children.

Unlike the previous BA.2 Omicron wave, respiratory symptoms are predominating the clinical presentation in young infants in the ongoing surge.

Conjunctival involvement is seen in 42.8% of affected infants.
The efficacy of an online behavioural intervention for improving dietary habits with a focus on self-compassion, goal-setting and self-monitoring: A randomised controlled trial
Authors: Rahimi-Ardabili Hania , Reynolds Rebecca Charlotte , Zwar Nicholas , Briggs Nancy , Vartanian Lenny R.
Published: April 2023

Issue addressed

To examine the efficacy of an online intervention that combined self-compassion with goal-setting and self-monitoring to improve dietary habits.

Methods

Australian adults with overweight and obesity were randomly assigned to the intervention or control group. A 12-week online nutrition intervention that included self-compassion, goal-setting and self-monitoring compared to a control group who received nutrition information only. Measures assessed before and after the intervention included primary outcomes of self-compassion; eating pathology; depression, anxiety and stress; and dietary intake, and a secondary outcome of anthropometry (weight and body mass index). Analyses were completed by a series of 2 (time: pre- and post-intervention) by 2 (group: intervention and control) mixed analyses of variance (ANOVAs) using the ‘intention-to-treat’ approach.

Results

117 people (73 intervention, 44 control) participated; of those, 74 participants (35 intervention, 39 control) completed the intervention. The analysis of all 117 participants showed that some aspects of dietary intake improved in the intervention group but not in the control group (i.e. time*group interaction), including a decrease in energy intake (Coefficient=2139.23, p<0.001 vs Coefficient=169.29, p=0.82), carbohydrate intake (Coefficient=56.22, p=0.006 vs Coefficient=-9.43, p=0.71); and a marginal reduction (ps=0.06) in saturated fat intake and improvement in fruit scores.

Conclusions

The findings suggest that the intervention could improve dietary habits. Further studies are needed to confirm these findings, examine the efficacy of the intervention over a longer period, and determine the mechanism underlying these changes.

So what? Online interventions that contain self-compassion, goal-setting and self-monitoring have the potential to promote healthy dietary habits.
B cell receptor analysis using single cell sequencing reveals preferential antibody expression in a HIV candidate vaccine study
Authors: Bassano Irene , Watson Simon , Malangone Cinzia , Pinder Christopher L. , Paschos Kostas , Cheeseman Hannah M. , Shattock Robin J. , Kellam Paul
Published: April 2023

HIV (human immunodeficiency virus) is a virus that infects different cell types in the immune system. While different monoclonal antibodies have been identified, because of the antigenic diversity of HIV, defining broad neutralising antibodies (bnAbs) it has been very challenging. Using the 10x Chromium technology partitioning system, we performed single-cell sequencing of the B cell repertoire and analysed a cohort of 48 HIV-negative subjects randomised into 4 groups each receiving a different HIV vaccine regime to investigate the type of antibody response to each of the proteins in the vaccine groups, namely ConM SOSIP, EDC ConM SOSIP, ConS UFO and EDC ConS UFO. We recovered over >300,000 single cells and reconstructed full-length antibody heavy- and light-chain variable regions from individual memory B cells, plasmablasts, naïve B cells and activated B cells as well as retrieved their transcriptome profile to correctly separate the different populations within each individual. We identified seven clonotypes representing functional antibodies against vaccine candidate proteins. We reconstructed their phylogenetic tree and confirmed they were novel antibodies in response to HIV. These were mainly antibodies in response to two of the four protein candidates, namely ConS UFO and EDC ConS UFO.
A rapid review of the effectiveness and cost effectiveness of interventions that make homes warmer and cheaper to heat for households in fuel poverty in rural and remote areas
Authors: Edwards Deborah , Csontos Judit , Gillen Liz , Carrier Judith , Lewis Ruth , Cooper Alison , Edwards Adrian
Published: April 2023

The cost-of-living across the UK has been on the increase since the start of 2021. Living in a rural community is often associated with additional costs compared to those in urban areas. For example, people living in rural areas are not always connected to the gas grid, often using oil and liquid petroleum gas for heating that are more expensive and not subjected to energy price caps. Moreover, housing in rural areas is generally older, not as well insulated and less energy efficient than houses in urban locations, leading to increased risk of fuel poverty. Home energy advice, energy efficiency measures, and financial support all have the potential to mitigate fuel poverty.

The aim of this rapid evidence review was to determine the effectiveness of interventions that make homes warmer and cheaper to heat for households in fuel poverty in rural and remote areas.

Fourteen studies and eight sources of grey literature were included in the review. The included studies and grey literature were published between 2007 and 2022.

There was some evidence of effectiveness for interventions such as energy efficiency home improvements / retrofitting, home improvements (including replacing lightbulbs and electric heaters, external insulation, heating systems, loft insulation installing central heating), Welsh Government Arbed (home improvement and energy efficiency measures) and Nest (home improvements and advice) interventions, provision of energy and home energy advice, and referral for support and/or insulation measures or home improvements. Interventions such as social energy subsidies might not be effective in reducing fuel poverty, and energy efficient social housing was a more efficient method of alleviating fuel poverty. However, the certainty of the evidence is very low, primarily due to the study design and poor quality of the included studies.

Policy makers and funding bodies need to make further investments into research focusing on measures to alleviate fuel poverty, with particular focus on economic analysis. There is a need for high quality, well-developed randomised controlled trials to investigate the effectiveness and cost-effectiveness of energy efficiency measures and advice. Future research should investigate which interventions are the most effective in what types of housing in rural areas to help the targeting of interventions better.

Funding statement

The Wales Centre For Evidence Based Care was funded for this work by the Health and Care Research Wales Evidence Centre, itself funded by Health and Care Research Wales on behalf of Welsh Government.
Updated Results of 3,050 Non-melanoma Skin Cancer (NMSC) Lesions in 1725 Patients Treated with High Resolution Dermal Ultrasound-Guided Superficial Radiotherapy, A Multi-institutional Study
Authors: Moloney Mairead , Kaczmarksi Peter , Zheng Songzhu , Malik Ariana , Ladd Daniel , Serure Donna , Yu Lio
Published: April 2023

Background

Image-guided superficial radiation therapy (IGSRT) using a high resolution dermal ultrasound, is becoming an attractive non-surgical curative treatment option for nonmelanoma skin cancer (NMSC). We previously reported IGSRT treatment results from a multi-institutional study of 1616 patients with 2917 NMSC lesions (Yuet al. Oncol Ther 2021,https://doi.org/10.1007/s40487-021-00138-4) showing excellent local control (LC) of 99.3% with mean follow-up of 69.8 weeks (16.06 months).

Methods

This abstract analyzes an additional 93 patients with 133 lesions, updates previous findings with longer follow-up, using Kaplan-Meier statistics, and performs subgroup analysis. A total of 1709 patients with 3,050 Stage 0, I, and II NMSC lesions treated from 2017 to 2020 were retrospectively analyzed.

Results

Lesions received a median of 20 fractions of 50, 70, or 100 kilovoltage(kV) IGSRT using image guidance. Average follow-up was 25.06 months (108.9 weeks) with a maximum follow up of 65.6 months (285.0 weeks) for the entire cohort. 68 patients expired from unrelated causes with no-evidence of disease (NED) at last follow-up prior to death, thus Disease-Free-Survival (DFS) was 100%. Overall, 3,027 of 3,050 lesions achieved an absolute LC of 99.2%. Overall absolute LC for BCC, SCC, and SCCis was 99.0%, 99.2%, and 99.8%, respectively. No additional late complications were found to date as of January 2022.

Discussion

These updated results demonstrate that IGSRT continues to achieve a high level of LC with low complication rates. IGSRT should be considered an attractive first-line option for the non-surgical treatment of NMSC.
Multi-organ imaging-derived polygenic indexes for brain and body health
Authors: Yang Xiaochen , Sullivan Patrick F. , Li Bingxuan , Fan Zirui , Ding Dezheng , Shu Juan , Guo Yuxin , Paschou Peristera , Bao Jingxuan , Shen Li , Ritchie Marylyn D. , Nave Gideon , Platt Michael L. , Li Tengfei , Zhu Hongtu , Zhao Bingxin
Published: April 2023

The UK Biobank (UKB) imaging project is a crucial resource for biomedical research, but is limited to 100,000 participants due to cost and accessibility barriers. Here we used genetic data to predict heritable imaging-derived phenotypes (IDPs) for a larger cohort. We developed and evaluated 4,375 IDP genetic scores (IGS) derived from UKB brain and body images. When applied to UKB participants who were not imaged, IGS revealed links to numerous phenotypes and stratified participants at increased risk for both brain and somatic diseases. For example, IGS identified individuals at higher risk for Alzheimer’s disease and multiple sclerosis, offering additional insights beyond traditional polygenic risk scores of these diseases. When applied to independent external cohorts, IGS also stratified those at high disease risk in the All of Us Research Program and the Alzheimer’s Disease Neuroimaging Initiative study. Our results demonstrate that, while the UKB imaging cohort is largely healthy and may not be the most enriched for disease risk management, it holds immense potential for stratifying the risk of various brain and body diseases in broader external genetic cohorts.
In-silico modelling of the mitogen-activated kinase (MAPK) pathway in colorectal cancer: mutations and targeted therapy
Authors: Sommariva Sara , Berra Silvia , Biddau Giorgia , Caviglia Giacomo , Benvenuto Federico , Piana Michele
Published: April 2023

Chemical reaction networks are powerful tools for computing the complex nature of cancer’s onset, progression, and therapy. The main reason for their effectiveness is in the fact that these networks can be rather naturally encoded as a dynamical system whose asymptotic solution mimics the proteins’ concentration profile at equilibrium. The paper relies on this mathematical approach to investigate global and local effects on the chemical reaction network of the colorectal cancer, triggered by partial and complete mutations occurring in its mitogen-activated kinase (MAPK) pathway. Further, this same approach allowed the in-silico modelling and dosage of a multi-target therapeutic intervention that utilizes MAPK as its molecular target.
A whole nervous system atlas of glutamate receptors reveals distinct receptor roles in sensorimotor circuits
Authors: Borba Cezar , Kourakis Matthew J. , Miao Yishen , Guduri Bharath , Deng Jianan , Smith William C.
Published: April 2023

A goal of connectomics is to reveal the links between neural circuits and behavior. Larvae of the primitive chordateCionaare well-suited to make contributions in this area. The small size of theCionalarval nervous system (∼180 neurons) has facilitated the full characterization of a connectome. In addition, the larvae display a range of behaviors that are readily quantified in both normal and manipulated larvae. Moreover, the small number of neurons allows for a neuron-by-neuron characterization of attributes such as neurotransmitter use. We present here a nervous system-wide atlas of glutamate receptor expression. Included in the atlas are both ionotropic receptors (AMPA, NMDA, and Kainate), and metabotropic receptors. The expression of these receptors is presented in the context of known circuits driving behaviors such as phototaxis, mechanosensation, and looming shadow response. The expression of AMPA and NMDA receptors, in particular, helps to resolve the apparently paradoxical coproduction of GABA and glutamate by some photoreceptors. We find that the targets of these photoreceptors, midbrain relay neurons, primarily express NMDA receptors in the absence of AMPA receptors. This is in agreement with previous results indicating that GABA is the primary neurotransmitter from the photoreceptors evoking a behavioral response (swimming) through a disinhibition mechanism. We hypothesize that NMDA receptors have a modulatory effect in the relay neurons. Other findings reported here are more unexpected. For example, the targets of glutamatergic epidermal sensory neurons (ESNs) do not express any of the ionotropic receptors, yet the ESNs themselves express metabotropic receptors. Thus, we speculate that their production of glutamate may be for communication with neighboring ESNs, rather than to their interneuron targets.
Vegetable oil surfactants are synergists that can bias neonicotinoid susceptibility testing in adult mosquitoes
Authors: Ashu Fred A. , Fouet Caroline , Ambadiang Marilene M. , Penlap-Beng Véronique , Kamdem Colince
Published: April 2023

Background

The standard operating procedure for testing the susceptibility of adult mosquitoes to clothianidin, a neonicotinoid, recommends using a vegetable oil ester as surfactant. However, it has not yet been determined if the surfactant is an inert ingredient or if it can act as a synergist and bias the test.

Methodology/Principal Findings

Using standard bioassays, we tested the synergistic effects of a vegetable oil surfactant on a spectrum of active ingredients including four neonicotinoids (acetamiprid, clothianidin, imidacloprid and thiamethoxam) and two pyrethroids (permethrin and deltamethrin). Three different formulations of linseed oil soap used as surfactant were far more effective than the standard insecticide synergist piperonyl butoxide in enhancing neonicotinoid activity inAnophelesmosquitoes. At the concentration used in the standard operating procedure (1% v/v), vegetable oil surfactants lead to more than 10-fold reduction in lethal concentrations, LC50and LC99, of clothianidin in a multi-resistant field population and in a susceptible strain ofAnopheles gambiae. At 1% or 0.5% (v/v), the surfactant restored susceptibility to clothianidin, thiamethoxam and imidacloprid and increased mortality to acetamiprid from 43 ± 5.63% to 89 ± 3.25% (P<0.05) in resistant mosquitoes. By contrast, linseed oil soap had no effect on the level of resistance to permethrin and deltamethrin suggesting that the synergism of vegetable oil surfactants may be specific to neoniconoids.

Conclusions/Significance

Our findings indicate that vegetable oil surfactants are not inert ingredients in neonicotinoid formulations, and their synergistic effects undermine the ability of standard testing procedures to detect early stages of resistance.
Pregnancy and Parenthood in Surgical Training
Authors: Whitburn Jessica , Miah Saiful , Howles Sarah A.
Published: April 2023

Objectives

To describe pregnancy outcomes, rates of infertility, patterns of parental leave, and working schedules in surgical trainees in the United Kingdom.

Design

Cross sectional survey.

Setting

Surgical training programs in the United Kingdom

Participants

Four hundred and sixteen individuals who were enrolled on a surgical training program between June 2022 and March 2023.

Main Outcome Measures

Self-reported age, gender, infertility investigations, pregnancy loss, pregnancy-associated complications, live births, parental leave, and working patterns.

Results

Approximately half of all surgical trainees delayed attempting to have children due to training, over 80% regretted this decision and 23% of trainees had undergone fertility testing. Overall, childbearing surgical trainees experienced a pregnancy loss rate of 31%, and those aged less than 35 years had a pregnancy loss rate of 35%. A third of trainees did not take any time off work following pregnancy loss and over half of trainees did not disclose their loss to colleagues. Major pregnancy-associated complications occurred in 31% of pregnancies in surgical trainees, a significantly higher rate than pregnancies in a socio-demographically similar control group (9%, p=0.0001). Most trainees continued to work at night throughout their pregnancy and half continued to operate for more than 9 hours each week up until parental leave; trainees felt guilty for burdening their colleagues by reducing their workload. Childbearing surgical trainees on average took 10.2 months of parental leave whilst most non-childbearing surgical trainees took 2 weeks; two thirds of non-childbearing surgical trainees felt this was insufficient. After parental leave, 61% of childbearing and 15% of non-childbearing surgical trainees reduced their working hours to accommodate family life.

Conclusion

Surgical trainees often delay parenthood due to training and are at risk of high rates of infertility, pregnancy loss, and major pregnancy-associated complications. This study highlights the need for changes in surgical culture and training structures to improve obstetric health and facilitate family life for surgeons in training.
The effects of technological leapfrogging in transportation technologies in BRICS and G7 countries
Authors: Silva João Paulo Nascimento , de Oliveira Cledison Carlos , Pedrosa Gabriel , Grutzmann André
Published: April 2023

Purpose

This paper aims to analyse the technological, economic and environmental impacts of disruptive innovations in the transportation mobility market.

Design/methodology/approach

The paper gathered data from World Bank and 13 open sources in an exploratory, descriptive and applied investigation on potentially disruptive transport innovations outcomes in G7 and BRICS (Brazil, Russian Federation, India, China and South Africa) economies, businesses and societies.

Findings

The results suggest positive implications for technological leapfrogging of electric vehicles (EV), autonomous vehicles (AVs) and electric vertical take-off and landing (eVTOLs), such as gains in energy consumption, infrastructure improvement, greenhouse gas emissions reduction, economic growth and the opportunity for new disruptive technologies to improve or even revolutionize the transportation ecosystem.

Research limitations/implications

This study has clear limitations as it compares G7 and BRICS hypothetical scenarios where internal combustion vehicles were replaced by new technologies, ceteris paribus. Even so, as theoretical implications, the study presents market scenarios for EVs, AVs and eVTOLs technologies, bringing benefits to the disruptive innovation theory by expanding the understanding of the subject and also opening avenues of investigation by exploring new technological, economic and environmental possibilities.

Practical implications

This study emphasises potentially disruptive technologies’ technological, economic and sustainable benefits to countries through technological leapfrogging. The organizations can delve into results to investigate forthcoming markets and seek advantageous positions. Economic and social gains from leapfrogging could motivate government bodies to finance research focusing on EVs, AVs and eVTOLs diffusion.

Originality/value

The paper’s originality resides in aggregating multiple data sources to compare technological leapfrogging in G7 and BRICS transportation. The different views allowed for exploring the potential outcomes of EVs, AVs and eVTOLs on economic, sustainability and market dimensions in developed and developing countries.
Staff perceptions of patient inequalities in a UK secure mental healthcare setting
Authors: Bayo-Idowu Elizabeth , Fatima Sarrah , Brenisin Kristina , Trumm Aile , Wallang Paul , Breen Kieran
Published: April 2023

Purpose

Inequalities can have a cumulative effect that leads to the presentation and subsequent progression of mental health difficulties. The detrimental effects can be compounded in the healthcare environment if staff lack an awareness of patients’' inequalities, and therefore, educating staff is of particular importance. The development of awareness training requires a deep understanding of staff perceptions of patient inequalities in a secure mental health care setting and the impact that this can have on mental illness.

Design/methodology/approach

The study was carried out using a qualitative design, where staff were asked to complete a 22-question survey from which the output is analysed using thematic analysis. In total, 100 patient-facing staff members working in a secure mental health facility completed the survey.

Findings

The results highlight that staff employed in a secure mental health care setting have an understanding of patient inequalities and how these can impact on patients in both the short and longer terms. The results highlighted the importance of awareness by staff and how an increase can have a significant benefit on the quality of the care provided within secure mental health facilities.

Originality/value

There is an increasing awareness of the impact of inequalities on mental health and how this can influence a patient’s journey. This study involving staff employed in a secure care mental health facility highlights the role of staff awareness of inequalities and also underlines the importance of understanding the key role of staff awareness in mental ill health.