bluuebunny/crossref_metadata_2025 huggingface dataset:
Guiding the Lean Design of a Hospital’s New Laboratory: A Case Study
Authors: Audibert Pablo Flores , Heim Joseph A. , Vetch Angela
Published: April 2023

Purpose:

To present the process used by a clinical laboratory to guide the design of their new facility, part of a major campus expansion at a pediatric hospital.

Objective:

The primary objective was to generate information about arrangement and allocation of laboratory space and functional flows in the early phases of the expansion project.

Background:

Seattle Children's Hospital has increased the capacity of their primary campus in response to growing demand for specialized services. The clinical laboratory was identified as one of the functional groups that would move their operations to the new building.

Methods:

The clinical laboratory team agreed on a three-stage process to guide the development of their initial design specifications: formulate the concept, develop design alternatives, and evaluate those alternatives.

Case Study:

The different tasks were executed successfully. The process defined—based on Plan, Do, Check, Act (PDCA)—provided a context for collaboration among sections of the clinical laboratory, reducing silo thinking, so common in the specialized sections within a large clinical laboratory.

Discussion:

The process was developed to guide the lean design efforts, even when initial space and location parameters had not yet been decided and was sufficiently flexible to accommodate changes in the project constraints and emergent information generated by the concurrent design activities of other hospital functional groups to be included in the campus expansion. The three-stage process allowed the team to review each laboratory section’s complexity, create multiple conceptual designs for review, and ultimately increase the likelihood of an efficient physical configuration that would satisfy a diverse group of stakeholders.
HTLV-1 uveitis in Colombia, an underrecognized complication of a hitherto neglected condition: a case series
Authors: Villamil-Gomez Wilmer , Torres Jaime R. , Rojas-Hernández Juan , Merlano Jose Ignacio Restom , Vergara-Corena Jairo , Salgado Patricia , Viloria-Ruiz Jorge , Castro Alvaro , Cabrera Lasso Andrés Mauricio , Gotuzzo Eduardo
Published: April 2023

Three Colombian patients with chronic HTLV-1 infection and severe intermediate and/or posterior uveitis are described. In one case, retinal ablation was necessary due to extensive peripheral degeneration, while the other two were successfully managed with local anti-inflammatory therapy. Gradual resolution of ocular findings was observed in all three patients on follow-up. Uveitis is a rarely recognized late complication of this infection, which represents a diagnostic and therapeutic challenge for clinicians in endemic countries. The real extension of HTLV-1 prevalence in Colombia and the frequency of its ophthalmologic complications remain to be determined.
Who tweets what about personalised medicine? Promises and concerns from Twitter discussions in Denmark
Authors: Skovgaard Lea , Grundtvig Anders
Published: April 2023

Digital health data are seen as valuable resources for the development of better and more efficient treatments, for instance through personalised medicine. However, health data are information about individuals who hold opinions and can challenge how data about them are used. Therefore it is important to understand public discussions around reuse of digital health data. Social media have been heralded as enabling new forms of public engagement and as a place to study social issues. In this paper, we study a public debate on Twitter about personalised medicine. We explore who participates in discussions about personalised medicine on Twitter and what they tweet about. Based on user-generated biographies we categorise users as having a ‘Professional interest in personalised medicine’ or as ‘Private’ users. We describe how users within the field tweet about the promises of personalised medicine, while users unaffiliated with the field tweet about the concrete realisation of these ambitions in the form of a new infrastructure and express concerns about the conditions for the implementation. Our study serves to remind people interested in public opinion that Twitter is a platform used for multiple purposes by different actors and not simply a bottom-up democratic forum. This study contributes with insights relevant to policymakers wishing to expand infrastructures for reuse of health data. First, by providing insights into what is discussed about health data reuse. Second, by exploring how Twitter can be used as a platform to study public discussions about reuse of health data.
Social Needs Assessment and Linkage to Community Health Workers in a Large Urban Hospital System
Authors: Shi Marc , Fiori Kevin , Kim Ryung S. , Gao Qi , Umanski Galina , Thomas Iby , Telzak Andrew , Chambers Earle
Published: April 2023

Objectives:

Identifying social needs is a growing priority in primary care, but there is significant variation in how patients access services to meet such needs. This study identifies predictors of successful linkage with a community health worker (CHW) among patients with social needs seen in an outpatient setting.

Methods:

This study uses a cross-sectional analysis of social needs assessments administered in an urban health system between April 2018 and December 2019. Social needs included: food insecurity, housing quality, housing instability, healthcare cost, healthcare related transportation, utilities, care for dependents, legal assistance, safety, and getting along with household members. Patients with at least 1 social need and accepting help were included in the analysis. On contact with a CHW, patients were entered into a separate database. The primary outcome was successful “linkage,” defined by having a positive social needs assessment in the medical record and a corresponding record in the CHW database. Multivariate logistic regression was used to assess predictors of linkage.

Results:

Among patients with at least 1 social need accepting help, 25% (758/3064) were linked to a CHW. Positive predictors included female gender (OR 1.28 [95% CI 1.01-1.63]), Spanish language preference compared to English (1.51 [1.14-1.03]), and having a food related need (1.35 [1.03-1.79]). Negative predictors included age 18 to 65 (0.34 [0.17-0.71] for age 18-24) and 0 to 5 (0.45 [0.24-0.78]) compared to over 65, non-Hispanic White race compared to Hispanic race (0.39 [0.18-0.84]), and having needs of getting along with household members (0.52 [0.38-0.71]) and safety (0.64 [0.42-0.98]).

Conclusions:

Twenty-five percent of patients who had at least 1 social need and were accepting help had a successful CHW linkage. Predictors of linkage suggest areas of further system-level improvements to screening and referral interventions to target at risk patients and communities.
Global Outward Foreign Direct Investment and Economic Growth Across Income Groups: The Mediating Effect of Home Country Institutions
Authors: Osarumwense Osabuohien-Irabor , Igor M. Drapkin
Published: April 2023

Although some empirical studies have examined the direct impact of outward foreign direct investment (outward FDI) on economic growth, but the indirect role play by home country institutions in outward FDI-induced economic growth remain unexplored. To cover this research gap, this study examines the impact of outward FDI on economic growth mediated by home country institutions in global panel of 161 economies, divided into World Bank income clusters such as high, upper-middle, lower-middle, and low-income economies for the period 1998 to 2019. For empirical analysis, this study utilized the Cross-Sectionally Augmented ARDL (CS-ARDL) and the Common Correlated Effect Mean Group (CCEMG) techniques robust to numerous econometric problems. In low-income countries, results indicate that outward FDI internationalization activities have adverse effect on economic growth, and the impact of home country institutions in stimulating outward FDI-induced growth appears weak both in the short term and long-term. In the case of high income, upper-middle income and lower-middle income countries, finding highlights that the joint impact of outward FDI and home country institutions stimulate higher economic growth and accelerate economic integration into the global economy. These impacts were found to diminish moving from high to low-income countries, which suggests that home country institutional development and income economy level matters for outward FDI-induced growth effects. The study also discusses key implications for policy.
The Study of Hierarchical Learning Behaviors and Interactive Cooperation Based on Feature Clusters
Authors: Wang Tianjiao , Xia Xiaona
Published: April 2023

The study of learning behaviors with multi features is of great significance for interactive cooperation. The data prediction and decision are to realize the comprehensive analysis and value mining. In this study, hierarchical learning behavior based on feature cluster is proposed. Based on the massive data in interactive learning environment, the descriptive model and learning algorithm suitable for feature clustering are designed, and sufficient experiments obtain the optimal performance indexes. The data analysis results are reliable. On this basis, the hierarchical learning behaviors based on feature clusters are visualized, the rules of different learning behaviors are summarized, then we propose the practical scheme of interactive cooperation. The hierarchical learning behaviors can be realized by feature clusters, which can effectively improve the modes of interactive cooperation, and help to improve the learning effectiveness.
Spinal Orthoses in the Treatment of Osteoporotic Thoracolumbar Vertebral Fractures in the Elderly: A Systematic Review With Quantitative Quality Assessment
Authors: Pieroh Philipp , Spiegl Ulrich J. A. , Völker Anna , Märdian Sven , von der Höh Nicolas H. , Osterhoff Georg , Heyde Christoph-E. ,   Spine Section of the German Society for Orthopaedics and Trauma
Published: April 2023

Study Design

Systematic review.

Objectives

Spinal orthoses are frequently used to non-operatively treat osteoporotic vertebral fractures (OVF), despite the available evidence is rare. Previously systematic reviews were carried out, presenting controversial recommendations. The present study aimed to systematic review the recent and current literature on available evidence for the use of orthoses in OVF.

Methods

A systematic review was conducted using PubMed, Medline, EMBASE and CENTRAL databases. Identified articles including previous systematic reviews were screened and selected by three authors. The results of retrieved articles were presented in a narrative form, quality assessment was performed by two authors using scores according to the study type.

Results

Thirteen studies (n = 5 randomized controlled trials, n = 3 non- randomized controlled trials and n = 5 prospective studies without control group) and eight systematic reviews were analyzed. Studies without comparison group reported improvements in pain, function and quality of life during the follow-up. Studies comparing different types of orthoses favor non-rigid orthoses. In comparison to patients not wearing an orthosis three studies were unable to detect beneficial effects and two studies reported about a significant improvement using an orthosis. In the obtained quality assessment, three studies yielded good to excellent results. Previous reviews detected the low evidence for spinal orthoses but recommended them.

Conclusion

Based on the study quality and the affection of included studies in previous systematic reviews a general recommendation for the use of a spinal orthosis when treating OVF is not possible. Currently, no superiority for spinal orthoses in OVF treatment was found.
Clinical Evaluation of the Osteoporotic Fracture Treatment Score (OF-Score): Results of the Evaluation of the Osteoporotic Fracture Classification, Treatment Score and Therapy Recommendations (EOFTT) Study
Authors: Ullrich Bernhard W. , Schnake Klaus John , Schenk Philipp , Katscher Sebastian , Bäumlein Martin , Zimmermann Volker , Schwarz Falko , Schmeiser Gregor , Scherer Michael , Müller Michael , Sprengel Kai , Liepold Katja , Schramm Simon , Baron Hagen-Christopher , Siekmann Holger , Franck Alexander , Scheyerer Max J. , Kirtas Seyma , Spiegl Ulrich J. A. , Osterhoff Georg ,   Working Group Osteoporotic Fractures of the Spine Section of the German Society of Orthopaedics and Trauma
Published: April 2023

Study Design

Multicenter prospective cohort study.

Objective

The study aims to validate the recently developed OF score for treatment decisions in patients with osteoporotic vertebral compression fractures (OVCF).

Methods

This is a prospective multicenter cohort study (EOFTT) in 17 spine centers. All consecutive patients with OVCF were included. The decision for conservative or surgical therapy was made by the treating physician independent of the OF score recommendation. Final decisions were compared to the recommendations given by the OF score. Outcome parameters were complications, Visual Analogue Scale, Oswestry Disability Questionnaire, Timed Up & Go test, EQ-5D 5 L, and Barthel Index.

Results

In total, 518 patients (75.3% female, age 75 ± 10) years were included. 344 (66%) patients received surgical treatment. 71% of patients were treated following the score recommendations. For an OF score cut-off value of 6.5, the sensitivity and specificity to predict actual treatment were 60% and 68% (AUC .684, P < .001). During hospitalization overall 76 (14.7%) complications occurred. The mean follow-up rate and time were 92% and 5 ± 3.5 months, respectively. While all patients in the study cohort improved in clinical outcome parameters, the effect size was significantly less in the patients not treated in line with the OF score’s recommendation. Eight (3%) patients needed revision surgery.

Conclusions

Patients treated according to the OF score’s recommendations showed favorable short-term clinical results. Noncompliance with the score resulted in more pain and impaired functional outcome and quality of life. The OF score is a reliable and save tool to aid treatment decision in OVCF.
Geriatric Odontoid Fractures: Treatment Algorithms of the German Society for Orthopaedics and Trauma Based on Expert Consensus and a Systematic Review
Authors: Osterhoff Georg , Scholz Matti , Disch Alexander C. , Katscher Sebastian , Spiegl Ulrich J. A. , Schnake Klaus John , Scheyerer Max J.
Published: April 2023

Study Design

Systematic review/expert consensus.

Objectives

Fractures of the axis represent the most frequent injury of the spine in elderly patients. Both, operative and non-operative treatment are associated with a high rate of complications and mortality. The aim of this article was to summarize the current literature on the management of odontoid fractures in geriatric patients and to weigh it based on an expert consensus process.

Methods

In a joint consensus process, members of the Spine Section of the German Orthopaedic and Trauma Society (DGOU) aimed to formulate recommendations for the diagnostic workup and treatment of odontoid fractures in geriatric patients. Based on the previously published recommendations, this article is an updated version with incorporating a systematic review of the recent literature.

Results

Based on the new data available, the recommendations established in the initial consensus process were adapted.

Conclusions

Computed tomography represents the diagnostic standard for patients with suspected injuries of the upper cervical spine. Anderson/D’Alonzo odontoid fractures type 1, non-displaced type 2, and type 3 can be treated conservatively. Even non-unions do not necessarily result in poor clinical outcome. In Anderson/D’Alonzo type 2 fractures, surgical therapy offers the advantage of relatively safe osseous healing with no increased complication rate even in elderly patients and can thus be recommended. In very high aged patients, however, a case-by-case decision should be made. When surgical stabilization of osteoporotic odontoid fractures is indicated, posterior techniques are biomechanically advantageous and can be considered the standard.
A Rare Case of Cerebrotendinous Xanthomatosis Associated With a Mutation on COG8 Gene
Authors: Ghoshouni Hamed , Sarmadian Roham , Irilouzadian Rana , Biglari Habibe Nejad , Gilani Abolfazl
Published: April 2023

Cerebrotendinous xanthomatosis ( CTX) is a rare hereditary disease described by a mutation in the CYP27A1 gene, which encodes the sterol 27-hydroxylase enzyme involved in the synthesis of bile acid. Accumulation of cholesterol and its metabolite, cholestanol, in multiple body organs causes the symptoms of this disease. In addition, a mutation in the COG8 gene, which encodes a subunit of conserved oligomeric Golgi (COG) complex, causes another rare disorder attributed to type IIh of congenital disorder of glycosylation ( CDG). We described a rare case of CTX disorder associated with a mutation on COG8 gene, which presented by unusual symptoms.
Association Between Preoperative Multidimensional Psychological Distress and Physical Function After Surgery for Sports-Related Injury
Authors: Morriss Nicholas J. , Kim Billy I. , Poehlein Emily , Park Caroline N. , Lentz Trevor A. , Green Cynthia L. , Lau Brian C.
Published: April 2023

Background:

Psychological distress after orthopaedic surgery can lead to worse outcomes, including higher levels of disability and pain and lower quality of life. The 10-item Optimal Screening for Prediction for Referral and Outcome–Yellow Flag (OSPRO-YF) survey screens for multiple psychological constructs relevant to recovery from orthopaedic injury and may be useful to preoperatively identify patients who may require further psychological assessment and possible intervention after surgery.

Purpose/Hypothesis:

To determine the association between the OSPRO-YF and physiological patient-reported outcomes (PROs). It was hypothesized that higher OSPRO-YF scores (indicating worse psychological distress) would be associated with worse PRO scores at time of return to sport.

Study Design:

Case series; Level of evidence, 4.

Methods:

This study evaluated 107 patients at a single, academic health center who were assessed at a sports orthopaedics clinic and ultimately treated surgically for injuries to the knee, shoulder, foot, or ankle. Preoperatively, patients completed the OSPRO-YF survey as well as the following PRO measures: Patient-Reported Outcomes Measurement Information System (PROMIS), Single Assessment Numeric Evaluation, numeric rating scale for pain; American Shoulder and Elbow Surgeons standardized shoulder assessment form for patients with shoulder injuries, the International Knee Documentation Committee score (for patients with knee injuries), and the Foot and Ankle Ability Measure (FAAM; for patients with foot or ankle injuries). At the time of anticipated full recovery and/or return to sport, patients again completed the same PRO surveys. Multivariable regression was used to evaluate the association between total OSPRO-YF score at baseline and PRO scores at the time of functional recovery.

Results:

The baseline OSPRO-YF score predicted postoperative PROMIS Physical Function and FAAM Sports scores only. A 1-unit increase in the OSPRO-YF was associated with a 0.55-point reduction in PROMIS Physical Function (95% CI, –1.05 to –0.04; P = .033) indicating worse outcomes. Among patients who underwent ankle surgery, a 1-unit increase in OSPRO-YF was associated with a 6.45-point reduction in FAAM Sports (95% CI, –12.0 to –0.87; P = .023).

Conclusion:

The study findings demonstrated that the OSPRO-YF survey predicts certain long-term PRO scores at the time of expected return to sport, independent of baseline scores.
Social Spending, Poverty, and Immigration: A Systematic Analysis of Welfare State Effectiveness and Nativity in 24 Upper- and Middle-Income Democracies
Authors: Bostic Amie , Hyde Allen
Published: April 2023

Previous research has highlighted the disadvantaged position immigrants often face in the economy, particularly when it comes to labor market outcomes such as employment or earnings. Extending this literature, the present study evaluates the economic exclusion of immigrants, conceptualized not as labor market outcomes but as relative poverty. This study examines the relationship between welfare generosity and immigrant poverty across rich western democracies and compares this relationship with that of native poverty. One publicly held belief is that immigrants disproportionately benefit from welfare generosity, while the literature on welfare chauvinism suggests greater social spending may not necessarily benefit immigrants. Furthermore, the effects may vary by spending and immigrant type. This study uses the Luxembourg Income Study to consider differences in the effects of welfare generosity on the odds an immigrant or native household is poor, how this effect varies by the type of spending, and how the effect changes depending on factors such as region of origin or citizenship status. Using four waves of data circa 2004 to 2014 across 24 upper- and middle-income democracies, the results show some support for welfare chauvinism and advantages to being an intra-EU immigrant and citizen immigrant.
Ocular biometry, anterior chamber morphometry, and their relationship with serum ferritin levels in children with beta thalassemia major
Authors: Naz Şimdivar Göksu Hande , Kurumoğlu Incekalan Tuğba , Tuncel Defne Ay
Published: April 2023

Background:

Ocular biometry and anterior segment evaluations are important to determine ocular development and pathological changes, especially in thalassemia patients in Mediterranean countries such as Turkey.

Objectives:

The objectives of this study were to compare ocular biometry and anterior segment parameters in children with thalassemia major and healthy controls and to examine the relationship between ferritin levels, anthropometric measurements, and ocular parameters.

Design:

This is a prospective case-control study.

Methods:

The height, weight, body mass index, and occipitofrontal circumference values of the participants were recorded. Anterior and vitreous chamber depth, lens thickness, axial length, central corneal thickness, anterior chamber volume, iridocorneal angle, pupil diameter, and mean keratometry were measured. Measurements were compared between patients and healthy children, and between patients with ferritin levels above and below 1000 ng/mL.

Results:

This study included 40 patients and 45 controls. Height, weight, and body mass index were significantly lower while ferritin level and occipitofrontal circumference were significantly higher in patients compared with the controls ( p < 0.001 for all). There were no statistically significant differences in the other ocular parameters ( p > 0.05). In comparisons between patients with ferritin levels below ( n = 15) and above 1000 ng/mL ( n = 25), there were no significant differences in age, height, weight, body mass index, occipitofrontal circumference, or ocular parameters ( p > 0.05). Occipitofrontal circumference and mean keratometry value were positively correlated in patients with ferritin levels below 1000 ng/mL ( r = 0.573, p = 0.025), while body mass index was negatively correlated with pupil diameter in patients with ferritin levels above 1000 ng/mL ( r = −0.469, p = 0.018).

Conclusion:

Children with thalassemia showed significant growth retardation and large occipitofrontal circumference but did not differ from controls in terms of biometrics and anterior segment morphology. Our results demonstrated a positive correlation between the occipitofrontal circumference and mean keratometry value in children with ferritin levels below 1000 ng/mL and a negative correlation between body mass index and pupil diameter in children with ferritin levels above 1000 ng/mL.
Feminizing Rhinoplasty: A Systematic and Institutional Review of Operative Techniques and Clinical Outcomes
Authors: Khetpal Sumun , Dejam Dillon , Baker Nusaiba F. , Morgan Katarina B. J. , Lee Justine C.
Published: April 2023

Background:

Facial gender-affirming surgery encompasses a myriad of procedures ranging from skeletal to soft tissue maneuvers depending on the manifestation of dysphoria in individual patients. In this work, we reviewed techniques for feminizing rhinoplasty in a single center and performed a systematic review of the literature.

Methods:

A systematic literature review was performed in order to survey articles that discussed techniques and clinical considerations when performing rhinoplasty among transgender females and non-binary patients. In addition, a retrospective review of such patients undergoing rhinoplasty by the senior author. Variables collected included demographic factors, operative details, and post-operative events.

Results:

Initial review yielded 56 articles. Standardized application of inclusion and exclusion criteria resulted in a total of 12 studies. Priorities of feminizing rhinoplasty entail reduction of dorsal hump, as well as tip refinement and deprojection. Sixty-five patients were included for analysis. The majority of patients underwent rhinoplasty through an open approach (83%). For the dorsum, 89% received dorsal reduction and 80% underwent percutaneous osteotomies. For tip work, 37 (56.9%) received a septal caudal extension graft, while a minority of patients required columellar strut (25%) or tip graft (8%). For functional restoration, septoplasty (71%) and spreader flaps/grafts (58%) were utilized to correct internal valve collapse, while alar rim (8%) and alar crural strut (3%) grafts were performed to address external valve collapse. Complications included septal deviation, hypertrophic scar, and contour irregularity. Two patients required revision (3%).

Conclusion:

The core tenets of the operation lie in the reduction of the nose, tip deprojection and rotation, as well as the creation of harmony with other facial structures. Our multi-pronged analysis presents an updated review of these principles, as well as a longitudinal outlook on outcomes associated with feminizing rhinoplasty.
Intestinal permeability in patients undergoing stem cell transplantation correlates with systemic acute phase responses and dysbiosis
Authors: Wang YunZu Michele , Abdullah Sheyar , Luebbering Nathan , Langenberg Lucille , Duell Alexandra , Lake Kelly , Lane Adam , Hils Brian , Vazquez Silva Ormarie , Trapp Monica , Nalapareddy Kodandaramireddy , Koo Jane , Denson Lee A. , Jodele Sonata , Haslam David B. , Faubion William A. , Davies Stella M. , Khandelwal Pooja
Published: April 2023

Intestinal permeability may correlate with adverse outcomes during hematopoietic stem cell transplantation (HSCT), but longitudinal quantification with traditional oral mannitol and lactulose is not feasible in HSCT recipients because of mucositis and diarrhea. A modified lactulose:rhamnose (LR) assay is validated in children with environmental enteritis. Our study objective was to quantify peri-HSCT intestinal permeability changes using the modified LR assay. The LR assay was administered before transplant, at day +7 and +30 to 80 pediatric and young adult patients who received allogeneic HSCT. Lactulose and rhamnose were detected using urine mass spectrometry and expressed as an L:R ratio. Metagenomic shotgun sequencing of stool for microbiome analyses and enzyme-linked immunosorbent assay analyses of plasma lipopolysaccharide binding protein (LBP), ST2, REG3α, claudin1, occludin, and intestinal alkaline phosphatase were performed at the same timepoints. L:R ratios were increased at day +7 but returned to baseline at day +30 in most patients (P = .014). Conditioning regimen intensity did not affect the trajectory of L:R (P = .39). Baseline L:R ratios did not vary with diagnosis. L:R correlated with LBP levels (r2 = 0.208; P = .0014). High L:R ratios were associated with lower microbiome diversity (P = .035), loss of anaerobic organisms (P = .020), and higher plasma LBP (P = .0014). No adverse gastrointestinal effects occurred because of LR. Intestinal permeability as measured through L:R ratios after allogeneic HSCT correlates with intestinal dysbiosis and elevated plasma LBP. The LR assay is well-tolerated and may identify transplant recipients who are more likely to experience adverse outcomes.
FUT1-mediated terminal fucosylation acts as a new target to attenuate renal fibrosis
Authors: Luo Jialiang , Mao Kaifeng , Zhu Zhengyumeng , Ye Junli , Li Lei , Wang Di , Zhou Jia , Lin Fenwang , Li Juan , Ye Junsheng
Published: April 2023

Backgrounds

Renal fibrosis is a common pathologic process of most chronic kidney diseases (CKDs), becoming one of the major public health problems worldwide. Terminal fucosylation plays an important role in physiological homeostasis and pathological development. The present study aimed to explore the role of terminal fucosylation during kidney fibrogenesis and propose a possible anti-fibrosis treatment via suppressing aberrant terminal fucosylation.

Methods

We investigated the expression level of fucosyltransferase1 (FUT1) in CKD patients by using public database. Then, we further confirmed the level of terminal fucosylation by UEA-I staining and FUT1 expression in unilateral ureteral obstruction (UUO)-induced renal fibrosis mice. Immunostaining, qPCR, western blotting and wound healing assay were applied to reveal the effect of FUT1 overexpression in human kidney proximal tubular epithelial cell (HK-2). What’s more, we applied terminal fucosylation inhibitor, 2-Deoxy-D-galactose (2-D-gal), to determine whether suppressing terminal fucosylation ameliorates renal fibrosis progression in vitro and in vivo.

Results

Here, we found that the expression of FUT1 significantly increased during renal fibrosis. In vitro experiments showed upregulation of epithelial-mesenchymal transition (EMT) after over-expression of FUT1 in HK-2. Furthermore, in vivo and in vitro experiments indicated that suppression of terminal fucosylation, especially on TGF-βR I and II, could alleviate fibrogenesis via inhibiting transforming growth factor-β (TGF-β)/Smad signaling.

Conclusions

The development of kidney fibrosis is attributed to FUT1-mediated terminal fucosylation, shedding light on the inhibition of terminal fucosylation as a potential therapeutic treatment against renal fibrosis.
Activation of CB1R alleviates central sensitization by regulating HCN2-pNR2B signaling in a chronic migraine rat model
Authors: Zeng Xiaoxu , Mai Jia , Xie Hongjian , Yang Ling , Liu Xiaojuan
Published: April 2023

Background

Central sensitization has been widely accepted as an underlying pathophysiological mechanism of chronic migraine (CM), activation of cannabinoid type-1 receptor (CB1R) exerts antinociceptive effects by relieving central sensitization in many pain models. However, the role of CB1R in the central sensitization of CM is still unclear.

Methods

A CM model was established by infusing inflammatory soup (IS) into the dura of male Wistar rats for 7 days, and hyperalgesia was assessed by the mechanical and thermal thresholds. In the periaqueductal gray (PAG), the mRNA and protein levels of CB1R and hyperpolarization-activated cyclic nucleotide-gated cation channel 2 (HCN2) were measured by qRT–PCR and western blotting. After intraventricular injection of Noladin ether (NE) (a CB1R agonist), ZD 7288 (an HCN2 blocker), and AM 251 (a CB1R antagonist), the expression of tyrosine phosphorylation of N-methyl-D-aspartate receptor subtype 2B (pNR2B), calcium-calmodulin-dependent kinase II (CaMKII), and phosphorylated cAMP-responsive element binding protein (pCREB) was detected, and central sensitization was evaluated by the expression of calcitonin gene-related peptide (CGRP), c-Fos, and substance P (SP). Synaptic-associated protein (postsynaptic density protein 95 (PSD95) and synaptophysin (Syp)) and synaptic ultrastructure were detected to explore synaptic plasticity in central sensitization.

Results

We observed that the mRNA and protein levels of CB1R and HCN2 were both significantly increased in the PAG of CM rats. The application of NE or ZD 7288 ameliorated IS-induced hyperalgesia; repressed the pNR2B/CaMKII/pCREB pathway; reduced CGRP, c-Fos, SP, PSD95, and Syp expression; and inhibited synaptic transmission. Strikingly, the application of ZD 7288 relieved AM 251-evoked elevation of pNR2B, CGRP, and c-Fos expression.

Conclusions

These data reveal that activation of CB1R alleviates central sensitization by regulating HCN2-pNR2B signaling in CM rats. The activation of CB1R might have a positive influence on the prevention of CM by mitigating central sensitization.
Nanomaterials: a review of emerging contaminants with potential health or environmental impact
Authors: El-Kalliny Amer S. , Abdel-Wahed Mahmoud S. , El-Zahhar Adel A. , Hamza Ibrahim A. , Gad-Allah Tarek A.
Published: April 2023

Nanotechnologies have been advantageous in many sectors and gaining much concern due to the unique physical, chemical and biological properties of nanomaterials (NMs). We have surveyed peer-reviewed publications related to “nanotechnology”, “NMs”, “NMs water treatment”, “NMs air treatment”, and “NMs environmental risk” in the last 23 years. We found that most of the research work is focused on developing novel applications for NMs and new products with peculiar features. In contrast, there are relatively few of publications concerning NMs as environmental contaminants relative to that for NMs applications. Thus, we devoted this review for NMs as emerging environmental contaminants. The definition and classification of NMs will be presented first to demonstrate the importance of unifying the NMs definition. The information provided here should facilitate the detection, control, and regulation of NMs contaminants in the environment. The high surface-area-to-volume ratio and the reactivity of NMs contaminants cause the prediction of the chemical properties and potential toxicities of NPs to be extremely difficult; therefore, we found that there are marked knowledge gaps in the fate, impact, toxicity, and risk of NMs. Consequently, developing and modifying extraction methods, detection tools, and characterization technologies are essential for complete risk assessment of NMs contaminants in the environment. This will help also in setting regulations and standards for releasing and handling NMs as there are no specific regulations. Finally, the integrated treatment technologies are necessary for the removal of NMs contaminants in water. Also, membrane technology is recommended for NMs remediation in air.
Evaluation of the World Health Organization—International Committee of the Red Cross Basic Emergency Care course for senior medical students
Authors: Michaeli Nichole , De Luca Giovanna , Gitau Mary , Myers Justin , Ojuka Daniel , Ouma Derick , Wieland Travis , Wanjiku Grace
Published: April 2023

Background

The Basic Emergency Care: Approach to the acutely ill and injured course was developed to train health care providers to recognize, stabilize, and treat critically ill patients in resource-limited settings. This study evaluates the Basic Emergency Care course as a tool for improving the emergency medicine knowledge and skills of medical students in a lower-middle income country.

Methods

This prospective study was conducted with senior medical students at the University of Nairobi School of Medicine in October 2021. Participants’ knowledge was assessed with multiple choice pre- and post-course examinations. Pre- and post-course surveys assessed participants’ confidence in managing acutely ill and injured patients using a 4-point Likert scale.

Results

A total of 30 students from the graduating medical school class participated in the study. Post-course examination scores (mean 94.5%, range 80–100%) showed a significant improvement (p < 0.05) compared to pre-course examination scores (mean 82%, range 64–96%). Participants’ comfort and confidence in providing emergency care and performing critical emergency skills significantly increased (p < 0.05) between the pre- and post-course surveys.

Conclusion

These findings suggest that the Basic Emergency Care course is effective in providing senior medical students with basic emergency medicine knowledge and increasing their confidence to identify and address life-threatening conditions prior to their intern year.
Per- and polyfluoroalkyl substances (PFAS) and immune system-related diseases: results from the Flemish Environment and Health Study (FLEHS) 2008–2014
Authors: van Larebeke Nicolas , Koppen Gudrun , De Craemer Sam , Colles Ann , Bruckers Liesbeth , Den Hond Elly , Govarts Eva , Morrens Bert , Schettgen Thomas , Remy Sylvie , Coertjens Dries , Nawrot Tim , Nelen Vera , Baeyens Willy , Schoeters Greet
Published: April 2023

Background

The successive FLEHS campaigns assess internal exposure to pollutants and associated early biological and health effects in participants of different age groups.

Materials and methods

Mother–newborn pairs (N = 220 in 2008–2009, age 18–42 years; N = 269 in 2013–2014, age 18–44 years), 197 adolescents 14–15 years (2010–2011), 201 adults 20–40 years (2008–2009) and 205 adults 50–65 years (2014) were recruited. For the various groups of subjects different sets of PFAS were assessed. Perfluorooctane sulfonate (PFOS), perfluorohexane sulfonate (PFHxS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA) and perfluorobutane sulfonate (PFBS) were determined in cord plasma and peripheral serum as these were the PFAS compounds for which we had access to high quality measurements and which were expected to be present in the highest concentrations. Participants filled out a questionnaire based on the European Community Respiratory Health Survey questionnaire on asthma and allergy. In these cross-sectional studies associations were assessed using stepwise multiple logistic regression, with confounders (including smoking and familial occurrence of the disease) and potential covariates selected on the basis of experience in our previous studies and a literature search. Forest plots of odds ratios summarize the associations between the various PFAS on the one hand and the different immune outcomes on the other hand.

Results

For several self-reported immune system-related diseases inverse associations with PFAS serum concentrations were observed. These inverse associations were more pronounced in mothers and adults than in adolescents. A significant inverse association was observed in adults and mothers (for mothers based on measurements on cord plasma) between PFNA, PFOS, and PFHxS and asthma (for mothers also for PFOA), in mothers between PFHxS, PFNA and PFOS and allergic rhinitis, in mothers and adults between PFHxS and PFOS and some forms of allergy (for mothers also for PFOA), in adults between PFOA and eczema, and in adolescents between PFOS and systemic allergy.

Conclusion

Internal exposure to PFAS was associated with changes in immunological processes consistent with what has been reported in the literature. Whereas these changes were observed in many publications to be associated with adverse health effects, our findings suggest that they can also lead to inverse associations with certain immune system-related diseases.
Exosomal microRNA-342-5p secreted from adipose-derived mesenchymal stem cells mitigates acute kidney injury in sepsis mice by inhibiting TLR9
Authors: Liu Wei , Hu Chenghuan , Zhang Buyao , Li Mingxia , Deng Fuxing , Zhao Shuangping
Published: April 2023

Background

Sepsis-related acute kidney injury (AKI) is an inflammatory disease associated with extremely high mortality and health burden. This study explored the possibility of exosomes secreted by adipose-derived mesenchymal stem cells (AMSCs) serving as a carrier for microRNA (miR)-342-5p to alleviate sepsis-related AKI and investigated the possible mechanism.

Methods

Serum was obtained from 30 patients with sepsis-associated AKI and 30 healthy volunteers for the measurement of miR-342-5p, blood urea nitrogen (BUN), and serum creatinine (SCr) levels. For in vitro experiments, AMSCs were transfected with LV-miR-342-5p or LV-miR-67 to acquire miR-342-5p-modified AMSCs and miR-67-modified AMSCs, from which the exosomes (AMSC-Exo-342 and AMSC-Exo-67) were isolated. The human renal proximal tubular epithelial cell line HK-2 was induced by lipopolysaccharide (LPS) to construct a cellular model of sepsis. The expression of Toll-like receptor 9 (TLR9) was also detected in AKI cells and mouse models. The interaction between miR-342-5p and TLR9 was predicted by dual luciferase reporter gene assay.

Results

Detection on clinical serum samples showed that BUN, SCr, and TLR9 were elevated and miR-342-5p level was suppressed in the serum of patients with sepsis-associated AKI. Transfection with LV-miR-342-5p reinforced miR-342-5p expression in AMSCs and AMSC-secreted exosomes. miR-342-5p negatively targeted TLR9. LPS treatment enhanced TLR9 expression, reduced miR-342-5p levels, suppressed autophagy, and increased inflammation in HK-2 cells, while the opposite trends were observed in LPS-induced HK-2 cells exposed to AMSC-Exo-342, Rapa, miR-342-5p mimic, or si-TLR9. Additionally, the effects of AMSC-Exo-342 on autophagy and inflammation in LPS-induced cells could be weakened by 3-MA or pcDNA3.1-TLR9 treatment. Injection of AMSC-Exo-342 enhanced autophagy, mitigated kidney injury, suppressed inflammation, and reduced BUN and SCr levels in sepsis-related AKI mouse models.

Conclusion

miR-342-5p transferred by exosomes from miR-342-5p-modified AMSCs ameliorated AKI by inhibiting TLR9 to accelerate autophagy.

Graphical Abstract
Optical coherence tomography-assisted interventional treatment of a woven coronary artery: a case report
Authors: Wei Wei , Zhang Qi , Gao Liming
Published: April 2023

Abstracts

Background

A woven coronary artery is a rare feature on coronary angiography. Distinguishing woven-like change and recanalization of an occluded artery is difficult.

Case presentation

A 59-year-old man was admitted to the hospital for chest tightness. Coronary angiography showed a woven coronary artery at the middle segment of the left anterior descending branch (LAD). The middle segment of the right coronary artery (RCA) exhibited 99% occlusion. A 3.5 × 26-mm drug-eluting stent was implanted in the middle segment of the RCA. One week later, we examined the LAD using optical coherence tomography (OCT). Considering the patient’s medical history and the results of OCT, a 2.7 × 38-mm drug-eluting stent was inserted into the LAD. Re-examination by OCT indicated that the stent was well attached to the wall, with no dissection at the edge of the stent. Antiplatelet therapy and statin-based plaque stabilization were continued. No obvious abnormality was found during follow-up one year later.

Conclusions

OCT can help distinguish woven-like change and recanalization of an occluded coronary artery. The evaluation and formulation of treatment strategies for a woven coronary artery are important.
To validate the integral conceptual model of frailty among community-dwelling older adults in China: a cross-sectional study
Authors: Fan Jun-Yao , Xie Wen , Zhang Wen-Ya , Liu Yue-Ting , Wang Quan , Zhao Hui-Min , Kong Ling-Lin , Li Jie
Published: April 2023

Purpose

The integral conceptual model of frailty (ICFM) integrates physical, psychological, social aspects of individuals and stresses that frailty is a dynamic state evolving over time. This study aimed to validate the ICMF among community-dwelling older adults in China.

Methods

The study recruited 341 older community-dwelling adults by convenient sampling method between June 1 and August 30, 2019 in Hubei province, China. The data was collected by questionnaire-based survey. Frailty was assessed by the Chinese version of the Tilburg Frailty Index. Participants were assessed for life-course determinants, disease and adverse health outcomes. Hierarchical regression analyses, Bootstrap method and the structural equation model were conducted in data analysis.

Results

Both linear and logistic hierarchical regression models were statistically significant. Life-course determinants, disease, and three domains of frailty together explained 35.6% to 50.6% of the variance of disability and all domains of quality of life. The mediation effect of frailty between disease and all adverse outcomes was significant, excluding hospitalization. The structural equation model guided by the ICMF fits the data well.

Conclusions

The ICMF is valid among community-dwelling older adults in China. Therefore, the multidimensional concept of frailty should be widely used in Chinese communities.
A Metabolomics study of metabolites associated with the glomerular filtration rate
Authors: Peng Hongquan , Liu Xun , Ieong Chiwa Ao , Tou Tou , Tsai Tsungyang , Zhu Haibin , Liu Zhi , Liu Peijia
Published: April 2023

Background

Chronic kidney disease (CKD) is a global public health issue. The diagnosis of CKD would be considerably enhanced by discovering novel biomarkers used to determine the glomerular filtration rate (GFR). Small molecule metabolites related to kidney filtration function that might be utilized as biomarkers to measure GFR more accurately could be found via a metabolomics analysis of blood samples taken from individuals with varied glomerular filtration rates.

Methods

An untargeted metabolomics study of 145 plasma samples was performed using ultrahigh-performance liquid chromatography tandem mass spectrometry (UPLC–MS/MS). The 145 samples were divided into four groups based on the patient’s measured glomerular filtration rates (mGFRs) determined by the iohexol plasma clearance rate. The data were analyzed using random forest analyses and six other unique statistical analyses. Principal component analysis (PCA) was conducted using R software.

Results

A large number of metabolites involved in various metabolic pathways changed significantly between groups with different GFRs. These included metabolites involved in tryptophan or pyrimidine metabolism. The top 30 metabolites that best distinguished between the four groups in a random forest plot analysis included 13 amino acids, 9 nucleotides, and 3 carbohydrates. A panel of metabolites (including hydroxyaparagine, pseudouridine, C-glycosyltryptophan, erythronate, N-acetylalanine, and 7-methylguanidine) for estimating GFR was selected for future testing in targeted analyses by combining the candidate lists with the six other statistical analyses. Both hydroxyasparagine and N,N-dimethyl-proline-proline are unique biomarkers shown to be inversely associated with kidney function that have not been reported previously. In contrast, 1,5-anhydroglucitol (1,5-AG) decreases with impaired renal function.

Conclusions

This global untargeted metabolomics study of plasma samples from patients with different degrees of renal function identified potential metabolite biomarkers related to kidney filtration. These novel potential metabolites provide more insight into the underlying pathophysiologic processes that may contribute to the progression of CKD, lead to improvements in the estimation of GFR and provide potential therapeutic targets to improve kidney function.