bluuebunny/crossref_metadata_2025 huggingface dataset:
Phytochemical Constituents, Antioxidant and Antidiabetic Efficacies of the Crude Extract and Fractions of Ethulia conyzoides Leaves
Authors:   Department of Biochemistry, Faculty of Life Sciences, Ahmadu Bello University, Zaria, 810107, Nigeria, Okotie Helen , Anjuwon Tayo ,   Department of Biochemistry, Faculty of Life Sciences, Ahmadu Bello University, Zaria, 810107, Nigeria, Adepoju Oluwafemi ,   Department of Biochemistry, Faculty of Life Sciences, Ahmadu Bello University, Zaria, 810107, Nigeria, Okolo Ijeoma ,   Department of Biochemistry, Faculty of Life Sciences, Ahmadu Bello University, Zaria, 810107, Nigeria, Forcardos Gilead ,   Department of Biochemistry, Faculty of Life Sciences, Ahmadu Bello University, Zaria, 810107, Nigeria, James Dorcas ,   Department of Biochemistry, Faculty of Life Sciences, Ahmadu Bello University, Zaria, 810107, Nigeria
Published: October 2022

Ethulia conyzoides is a plant traditionally used in managing diabetes in Nigeria. Unfortunately, its antidiabetic potential has not been scientifically examined. The research investigated the phytochemical constituents, in vitro antioxidant, and antidiabetic efficacies of E. conyzoides leaves extract. Seventy percent methanol extraction of E. conyzoides leaves was done to obtain its crude extract. It then was partitioned with n-hexane and ethyl acetate to obtain three fractions (n-hexane, ethylacetate and residual aqueous). Then, they were subjected to various phytochemistry investigations: 1,1-diphenyl 2-picryl hydrazyl (DPPH) radical scavenging activity assay and in vivo antidiabetic effects in mice. The fasting blood glucose (FBG) levels, weight change, feed and fluid intakes were determined using standard procedures. Phyto-profiles tests for the extract and its fractions revealed the presence of phenolics, tannins, cardiac glycosides, saponins and alkaloids. The result showed that the residual aqueous fraction had the nearest inhibitory concentration (IC50) of 0.011µg/ml to the standard ascorbic acid with 0.010µg/ml compared with other extract and fractions. There was a substantial (p < 0.05) rise in fluid and feed intakes and serum levels of FBG in the type 2 diabetic mice. Treatment of the mice using 100 mg/kg b.w. residual aqueous fraction for 21 days significantly (p < 0.05) reduced the fluid intake, feed intake and FBG and statistically (p < 0.05) improved the body weight. This study revealed that the residual aqueous fraction of E. conyzoides has antioxidant and antidiabetic activities against induced type 2 diabetic mice. Keywords: Antioxidant, Ethulia conyzoides, Fasting blood glucose, Phytochemical, Type 2 diabetes
Validation of Polygenic Risk Scores for Coronary Heart Disease in a Middle Eastern Cohort Using Whole Genome Sequencing
Authors: Saad Mohamad , El-Menyar Ayman , Kunji Khalid , Ullah Ehsan , Al Suwaidi Jassim , Kullo Iftikhar J.
Published: October 2022

Background:

Enthusiasm for using polygenic risk scores (PRSs) in clinical practice is tempered by concerns about their portability to diverse ancestry groups, thus motivating genome-wide association studies in non-European ancestry cohorts.

Methods:

We conducted a genome-wide association study for coronary heart disease in a Middle Eastern cohort using whole genome sequencing and assessed the performance of 6 PRSs developed with methods including LDpred (PGS000296), metaGRS (PGS000018), Pruning and Thresholding (PGS000337), and an EnsemblePRS we developed. Additionally, we evaluated the burden of rare variants in lipid genes in cases and controls. Whole genome sequencing at 30× coverage was performed in 1067 coronary heart disease cases (mean age=59 years; 70.3% males) and 6170 controls (mean age=40 years; 43.5% males).

Results:

The majority of PRSs performed well; odds ratio (OR) per 1 SD increase (OR
1sd
) was highest for PGS000337 (OR
1sd
=1.81, 95% CI [1.66–1.98],
P
=3.07×10
−41
). EnsemblePRS performed better than individual PRSs (OR
1sd
=1.8, 95% CI [1.66–1.96],
P
=5.89×10
−44
). The OR for the 10th decile versus the remaining deciles was >3.2 for PGS000337, PGS000296, PGS000018, and reached 4.58 for EnsemblePRS. Of 400 known genome-wide significant loci, 33 replicated at
P
<10
−4
. However, the 9p21 locus did not replicate. Six suggestive (
P
<10
−5
) new loci/genes with plausible biological function were identified (eg,
CORO7
,
RBM47
,
PDE4D
). The burden of rare functional variants in
LDLR
,
APOB
,
PCSK9
, and
ANGPTL4
was greater in cases than controls.

Conclusions:

Overall, we demonstrate that PRSs derived from European ancestry genome-wide association studies performed well in a Middle Eastern cohort, suggesting these could be used in the clinical setting while ancestry-specific PRSs are developed.
Suppression and Replacement Gene Therapy for
KCNH2
-Mediated Arrhythmias
Authors: Bains Sahej , Zhou Wei , Dotzler Steven M. , Martinez Katherine , Kim CS John , Tester David J. , Ye Dan , Ackerman Michael J.
Published: October 2022

Background:

KCNH2
-mediated arrhythmia syndromes are caused by loss-of-function (type 2 long QT syndrome [LQT2]) or gain-of-function (type 1 short QT syndrome [SQT1]) pathogenic variants in the
KCNH2
-encoded K
v
11.1 potassium channel, which is essential for the cardiac action potential.

Methods:

A dual-component “suppression-and-replacement” (SupRep)
KCNH2
gene therapy was created by cloning into a single construct a custom-designed
KCNH2
short hairpin RNA with ~80% knockdown (suppression) and a “short hairpin RNA-immune”
KCNH2
cDNA (replacement). Induced pluripotent stem cell-derived cardiomyocytes and their CRISPR-Cas9 variant-corrected isogenic control (IC) induced pluripotent stem cell-derived cardiomyocytes were made for 2 LQT2- (G604S, N633S) and 1 SQT1- (N588K) causative variants. All variant lines were treated with KCNH2-SupRep or non-targeting control short hairpin RNA (shCT). The action potential duration (APD) at 90% repolarization (APD
90
) was measured using FluoVolt voltage dye.

Results:

KCNH2-SupRep achieved variant-independent rescue of both pathologic phenotypes. For LQT2-causative variants, treatment with KCNH2-SupRep resulted in shortening of the pathologically prolonged APD
90
to near curative (IC-like) APD
90
levels (G604S IC, 471±25 ms; N633S IC, 405±55 ms) compared with treatment with shCT (G604S: SupRep-treated, 452±76 ms versus shCT-treated, 550±41 ms;
P
<0.0001; N633S: SupRep-treated, 399±105 ms versus shCT-treated, 577±39 ms,
P
<0.0001). Conversely, for the SQT1-causative variant, N588K, treatment with KCNH2-SupRep resulted in therapeutic prolongation of the pathologically shortened APD
90
(IC: 429±16 ms; SupRep-treated: 396±61 ms; shCT-treated: 274±12 ms).

Conclusions:

We provide the first proof-of-principle gene therapy for correction of both LQT2 and SQT1. KCNH2-SupRep gene therapy successfully normalized the pathologic APD
90
, thereby eliminating the pathognomonic feature of both LQT2 and SQT1.
Cost-Effectiveness of Empagliflozin in Patients With Heart Failure and Preserved Ejection Fraction
Authors: Zhou Jennifer , Liew Danny , Kaye David M. , Zoungas Sophia , Stub Dion
Published: October 2022

Background:

Empagliflozin is the first medication to demonstrate clinical benefit in patients with heart failure with preserved ejection fraction, but its cost-effectiveness is unknown. We aimed to evaluate the cost-effectiveness of adding empagliflozin to standard therapy in patients with heart failure with preserved ejection fraction.

Methods:

A Markov model from the perspective of the Australian health care system was constructed to compare empagliflozin plus standard care to standard care alone among a hypothetical cohort of patients with heart failure with preserved ejection fraction. Clinical probabilities were derived from The EMPEROR-Preserved (Empagliflozin Outcome Trial in Patients with Chronic Heart Failure with Preserved Ejection Fraction). Costs and utilities were derived from published sources. The main outcome was the incremental cost-effectiveness ratio per quality-adjusted life-year gained. Deterministic and probabilistic sensitivity analyses were performed to assess model uncertainty. Costs and benefits were discounted at 5% annually.

Results:

Over a lifetime, the addition of empagliflozin to standard care prevented 167 heart failure hospitalizations and 155 heart failure-related urgent care visits for every 1000 patients treated and increased mean quality-adjusted survival by 0.16 quality adjusted life-years per patient. Mean lifetime costs in the empagliflozin and standard care groups were AUD$63 218 and AUD$58 478 per patient, respectively. This resulted in an incremental cost-effectiveness ratio of AUD$29 202 per quality adjusted life-year gained. In probabilistic sensitivity analyses, empagliflozin was cost-effective in 85% of 10 000 Monte Carlo simulations at a willingness-to-pay threshold of AUD$50 000 per quality adjusted life-year gained.

Conclusions:

In patients with heart failure with preserved ejection fraction, adding empagliflozin to standard care is likely to be cost-effective when compared with standard care alone in the Australian health care setting.
Inpatient Quality-of-Care Measures for Heart Failure: Treatment Gaps and Opportunities in the Contemporary Era
Authors: Warner Alberta L. , Lu Lingyun , Ghaznavi Zunera , Jackevicius Cynthia A.
Published: October 2022

Background:

Quality of care measures are vital tools to assess processes of care within and between health care systems. The 2020 American College of Cardiology/AHA performance measures for heart failure provide a new set of such measures. We evaluated the achievement of these and other performance measures within the Veterans Affairs hospital system in a contemporary cohort of patients hospitalized for heart failure.

Methods:

Hospital discharges from January 2010 to February 2021 with a primary diagnosis of heart failure (n=289 810) were evaluated. Adherence to each measure was determined using the measure’s stated definition and by site.

Results:

Among patients with reduced ejection fraction (53.0%), beta blocker use was high (89.0%), ACE (angiotensin-converting enzyme) inhibitor, angiotensin receptor blocker, or angiotensin receptor-neprilysin inhibitor (ARNI) use decreased over time (75.3% in 2010, 55.8% in 2020), and hydralazine/nitrate use in eligible Black patients (19.3%) was low. While 68.1% were eligible for ARNI, only 6.0% received them, reaching 17.2% by 2020. Mineralocorticoid receptor antagonists were used in 49.3% of those eligible; laboratory testing 7 days after their initiation was 73.0%, detecting hyperkalemia in 2.2%, although it occurred in 13.7% by 90 days. Achievement of ≥50% target dose was low (beta blocker 45.9%, ACE inhibitor/angiotensin receptor blocker 31.6%, ARNI 19.0%) and for ACE inhibitor/angiotensin receptor blocker/ARNI, decreased over time. Discharge appointments were 56.2% at 7 days and 78.8% at 14 days. Cardiac rehabilitation referral was low (10.5%) but increased. There were significant site-level differences, particularly for hydralazine, ARNI, devices, and cardiac rehabilitation.

Conclusions:

Important inpatient quality of care measures can be readily measured across the Veterans Administration health care system from electronic health records. Treatment gaps and site-level differences persisted into the contemporary era and will likely be exacerbated as newer treatments are added to this complex baseline. These measures and methods also offer the opportunity to target global, local, and individual processes of care for innovative quality improvement initiatives.
Rare Variants in Genes Encoding Subunits of the Epithelial Na
+
Channel Are Associated With Blood Pressure and Kidney Function
Authors: Blobner Brandon M. , Kirabo Annet , Kashlan Ossama B. , Sheng Shaohu , Arnett Donna K. , Becker Lewis C. , Boerwinkle Eric , Carlson Jenna C. , Gao Yan , Gibbs Richard A. , He Jiang , Irvin Marguerite R. , Kardia Sharon L.R. , Kelly Tanika N. , Kooperberg Charles , McGarvey Stephen T. , Menon Vipin K. , Montasser May E. , Naseri Take , Redline Susan , Reiner Alexander P. , Reupena Muagututi‘a S. , Smith Jennifer A. , Sun Xiao , Vaidya Dhananjay , Viaud-Martinez Karine A. , Weeks Daniel E. , Yanek Lisa R. , Zhu Xiaofeng ,   NHLBI Trans-Omics for Precision Medicine (TOPMed) Consortium*, Minster Ryan L. , Kleyman Thomas R.
Published: October 2022

Background:

The epithelial Na
+
channel (ENaC) is intrinsically linked to fluid volume homeostasis and blood pressure. Specific rare mutations in
SCNN1A
,
SCNN1B
, and
SCNN1G
, genes encoding the α, β, and γ subunits of ENaC, respectively, are associated with extreme blood pressure phenotypes. No associations between blood pressure and
SCNN1D
, which encodes the δ subunit of ENaC, have been reported. A small number of sequence variants in ENaC subunits have been reported to affect functional transport in vitro or blood pressure. The effects of the vast majority of rare and low-frequency ENaC variants on blood pressure are not known.

Methods:

We explored the association of low frequency and rare variants in the genes encoding ENaC subunits, with systolic blood pressure, diastolic blood pressure, mean arterial pressure, and pulse pressure. Using whole-genome sequencing data from 14 studies participating in the Trans-Omics in Precision Medicine Whole-Genome Sequencing Program, and sequence kernel association tests.

Results:

We found that variants in
SCNN1A
and
SCNN1B
were associated with diastolic blood pressure and mean arterial pressure (
P
<0.00625). Although
SCNN1D
is poorly expressed in human kidney tissue,
SCNN1D
variants were associated with systolic blood pressure, diastolic blood pressure, mean arterial pressure, and pulse pressure (
P
<0.00625). ENaC variants in 2 of the 4 subunits (
SCNN1B
and
SCNN1D
) were also associated with estimated glomerular filtration rate (
P
<0.00625), but not with stroke.

Conclusions:

Our results suggest that variants in extrarenal ENaCs, in addition to ENaCs expressed in kidneys, influence blood pressure and kidney function.
First-Trimester Normotension Is a Weak Indicator of Normal Maternal Cardiovascular Function
Authors: Gyselaers Wilfried , Dreesen Pauline , Staelens Anneleen Simone , Tomsin Kathleen , Bruckers Liesbeth , Vonck Sharona
Published: October 2022

Background:

As by definition, mean arterial pressure equals the product of cardiac output (CO) and total vascular resistance (TPR), we hypothesized that, irrespective of thresholds to define hypertension, a CO-TPR imbalance might exist in first-trimester normotensive pregnancies with altered risks for adverse gestational outcomes.

Methods:

A standard protocol was used for automated blood pressure measurement combined with impedance cardiography assessment of CO and TPR (NICCOMO). First-trimester normotensive pregnant women were categorized into 3 groups relative to the reference 75th percentile (P75) of CO and TPR: (1) normal CO and TPR, (2) high CO, and (3) high TPR. These subgroups were compared at blood pressure thresholds 140/90, 130/85, and 130/80 mmHg. The gestational outcome was categorized after birth according to International Society for Studies of Hypertension in Pregnancy criteria.

Results:

Compared with pregnancies with normal CO and TPR (≤P75), women with high TPR at blood pressure <140/90 mmHg are at risk for developing gestational hypertension (odds ratio, 3.795 [1.321–10.904];
P
<0.010), late-onset preeclampsia (odds ratio, 3.137 [1.060–9.287];
P
<0.050), and neonates small for gestational age (odds ratio, 1.780 [1.056–2.998];
P
<0.050).

Conclusions:

Cardiovascular imbalance can present in normotensive women in the first trimester and is associated with increased risks for adverse gestational outcomes. This study illustrates the relevance of CO and TPR assessments as an adjunct to blood pressure measurement and invites for further exploring their value in screening algorithms for gestational hypertensive disorders and/or small for gestational age.
Cost-Effectiveness of Intensive Versus Standard Blood Pressure Treatment in Older Patients With Hypertension in China
Authors: Fan Jiali , Zheng Wanji , Liu Wei , Xu Juan , Zhou Lan , Liu Shihe , Bai Jingjing , Qi Yue , Huang Weidong , Liu Kejun , Cai Jun
Published: October 2022

Background:

In the STEP trial (Strategy of Blood Pressure Intervention in older Hypertensive Patients), the risk of cardiovascular events is significantly lower in patients who received intensive systolic blood psressure (BP) treatment than in those who received standard treatment. This study compared the lifetime health benefits and medical costs of intensive BP treatment with those of standard BP treatment.

Methods:

A microsimulation model included 10 000 hypothetical samples of Chinese adults aged 60 to 80 years old with baseline systolic BP higher than 140 mm Hg. Primary outcome was the incremental cost-effectiveness ratio from a payer’s perspective. Secondary outcome was cardiovascular events, including acute coronary syndrome, stroke, acute decompensated heart failure, atrial fibrillation, and death from cardiovascular causes.

Results:

The model simulated that cardiovascular events occurred in 36.88% of the patients in the intensive treatment group, as compared to 41.28% of the patients in the standard treatment group over the lifetime horizon. The mean number of quality-adjusted life-years would be 0.16 higher in patients who received intensive treatment than in those who received standard treatment and would cost Chinese yuan 12 614 (International dollars 3018) more per quality-adjusted life-year gained. Most simulation results indicated that intensive treatment would be cost-effective (82%–95% below the willingness-to-pay threshold of Chinese yuan 72 000 [1× the gross domestic product per capita in China in 2020]). Sensitivity analyses showed that these conclusions were robust.

Conclusions:

In this study, intensive BP treatment prevented cardiovascular events among older patients with hypertension in China and was cost-effective in most scenarios.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03015311
Penser le droit dans la Chine des Qing
Authors: Constant Frédéric
Published: October 2022

L’article propose un aperçu des relations entre le droit et les sciences dans la Chine des Qing (1644-1911), mises en perceptive avec la façon dont ces liens ont été décrits par les historiens de l’Europe moderne. Savoirs scientifiques et savoir juridique découlaient en Chine d’une matrice commune déterminant les conditions d’accès au savoir. Cette théorie de la connaissance, fixée dans les Classiques confucéens, somme d’ouvrages au cœur du curriculum des lettrés et au fondement de l’organisation bureaucratique, était commune à l’ensemble des champs disciplinaires. Se dégageaient ainsi une heuristique ou encore des formes communes de structuration du raisonnement semblables quelles que soient les sciences considérées. Nous illustrons ces points à travers l’étude de plusieurs facettes de l’organisation du savoir juridique, mis au regard des principes structurant le savoir mathématique.
Class Actions in Civil Law Systems
Authors: Talouni Zakaria , Rabczun Aleksandra
Published: October 2022

Class actions appear as a mechanism for regulating markets and encouraging honest practices. In light of economic developments, civil law systems today focus on adopting lawsuits capable of protecting aggrieved persons and easing pressure on courts as well as remedying the shortcomings of some other types of group lawsuits, which are ineffective, as we may learn from previous cases.

This article is based on civil law jurisdictions; it analyses and highlights various legal principles that impede the adoption and efficiency of class actions to show that they are not an unfit lawsuit but rather a hindered one. The article adopts a comparative approach to two different law systems to demonstrate how each system regulates class actions: French legislation as an example of a civil law system and American legislation as an example of a common law system.
Communism’s Lasting Effect? Former Communist States and COVID-19 Vaccinations
Authors: Martens Jason P.
Published: October 2022

Historical cultural practices that no longer exist can have modern day effects. Because communism has been linked with distrust of government, it was hypothesized that (a) historical communism would be negatively associated with COVID-19 vaccination rates, and (b) trust in government would mediate the association. Two studies assessed these hypotheses. Study 1 tested the hypotheses among European, Asian, and African countries, while Study 2 focused on East and West Germany within Europe. All samples except Africa found support for an association between historical communism and lower COVID-19 vaccination rates. However, trust in government did not mediate the association in Study 1, though a significant indirect effect did emerge within Germany in Study 2. Associations held controlling for GDP and age of population. Together, the studies suggest that historical communism in Europe and Asia is associated with real-world behavior today, and that trust in government might be partly responsible for the effect within Germany but less likely within Europe as a whole.
ALDH2 knockout protects against aortic dissection
Authors: Luo Chentao , Zhou Bing , Cui Yong , Liu Zhifang , Wang Shuwei
Published: October 2022

Background

The incidence and mortality of aortic dissection (AD) are increasing. In pathological studies, macrophages, T lymphocytes and dendritic cells were found in the tunica media of the aorta. Acetaldehyde dehydrogenase 2 (ALDH2) gene polymorphisms are associated with a high incidence of hypertension in Asian populations. However, there is no clear evidence of the relationship between ALDH2 and aortic dissection in Asians. The aim of this study was to investigate the incidence of aortic dissection in different ALDH2 genotypes and explore changes in the vasculature.

Materials and methods

Three-week-old male mice were administered freshly prepared β-aminopropionitrile solution dissolved in drinking water (1 g/kg/d) for 28 days to induce TAD. An animal ultrasound imaging system was used to observe the formation of arterial dissection and changes in cardiac function. Subsequently, mice were euthanized by cervical dislocation. The aortas were fixed for HE staining and EVG staining to observe aortic elastic fiber tears and pseudoluma formation under a microscope.

Results

Knockout of ALDH2 mitigated β-aminopropionitrile-induced TAD formation in animal studies. Ultrasound results showed that ALDH2 knockout reduced the degree of ascending aortic widening and the incidence of aortic dissection rupture. Pathological sections of multiple aortic segments showed that the protective effect of ALDH2 knockout was observed in not only the ascending aorta but also the aortic arch and descending aorta. The expression levels of genes related to NK CD56bright cells, Th17 cells, T cells and T helper cells were decreased in ALDH2 knockout mice treated with β-aminopropionitrile for 28 days.

Conclusion

ALDH2 knockout protects against aortic dissection by altering the inflammatory response and immune response and protecting elastic fibers.
Comparison of the safety and immunogenicity of the BNT-162b2 vaccine and the ChAdOx1 vaccine for solid organ transplant recipients: a prospective study
Authors: Ajlan Aziza A. , Ali Tariq , Aleid Hassan , Almeshari Khalid , DeVol Edward , Alkaff Morad Ahmed , Fajji Layal , Alali Ali , Halabi Dani , Althuwaidi Sahar , Alghamdi Saad , Ullah Asad , Alrajhi Abdulrahman , Bzeizi Khalid , Almaghrabi Reem , Marquez Kris Ann Hervera , Elmikkaoui Bilal , Albogumi Eid , Aldakhil Haifa , Al-Awwami Moheeb , Broering Dieter C.
Published: October 2022

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and its resulting disease, coronavirus disease 2019 (COVID-19), has spread to millions of people worldwide. Preliminary data from organ transplant recipients have shown reduced seroconversion rates after the administration of different SARS-CoV-2 vaccination platforms. However, it is unknown whether different vaccination platforms provide different levels of protection against SARS-CoV-2. To answer this question, we prospectively studied 431 kidney and liver transplant recipients (kidney: n = 230; liver: n = 201) who received either the ChAdOx1 vaccine (n = 148) or the BNT-162b2 vaccine (n = 283) and underwent an assessment of immunoglobulin M/immunoglobulin G spike antibody levels. The primary objective of the study is to directly compare the efficacy of two different vaccine platforms in solid organ transplant recipients by measuring of immunoglobulin G (IgG) antibodies against the RBD of the spike protein (anti-RBD) two weeks after first and second doses. Our secondary endpoints were solicited specific local or systemic adverse events within 7 days after the receipt of each dose of the vaccine. There was no difference in the primary outcome between the two vaccine platforms in patients who received two vaccine doses. Unresponsiveness was mainly linked to diabetes. The rate of response after the first dose among younger older patients was significantly larger; however, after the second dose this difference did not persist (p = 0.079). Side effects were similar to those that were observed during the pivotal trials.
Previous caesarean delivery and the presence of caesarean scar defects could affect pregnancy outcomes after in vitro fertilization frozen-thawed embryo transfer: a retrospective cohort study
Authors: Zhang Yinfeng , de Ziegler Dominique , Hu Xinyu , Tai Xiaomei , Han Ying , Ma Junfang , Zhang Yunshan , Luo Haining
Published: October 2022

Background

Due to various iatrogenic and social factors, the global caesarean delivery (CD) rate has risen sharply in the past 30 years. It is more complicated and dangerous for women with a scarred uterus to experience pregnancy again than for women with a previous vaginal delivery (VD). In this study we investigated the impact of previous caesarean delivery (CD) and caesarean scar defects (CSDs) on pregnancy outcomes after in vitro fertilization frozen-thawed embryo transfer (IVF-FET).

Methods

We conducted a retrospective cohort study that included 1122 women aged < 40 years who had a history of only one parturition (after 28 weeks of pregnancy) and who underwent their first FET cycle between January 2014 and January 2020. Patients were divided into the CD group, VD group, and CSD group. Thereafter, according to the number of transferred embryos, the CD, VD, and CSD groups were divided into the single embryo transfer (SET) group and the double embryo transfer (DET) group. Outcome measures in this study were live birth, clinical pregnancy, multiple pregnancy, ectopic pregnancy, pregnancy loss, pregnancy complications, preterm birth, and neonatal birth weight. Multivariate logistic regression was performed to evaluate the relationship between pregnancy outcomes and CD.

Results

In SET patients, the clinical pregnancy and live birth rates were decreased in the CSD group compared with the VD and CD groups. In DET patients, the clinical pregnancy and live birth rates were significantly lower in theCSD group than in the CD and VD groups. After adjustment for confounders, previous CD and CSD were associated with a significantly lower clinical pregnancy rate and live birth rate than previous VD in the total sample. This effect was observed in DET patients, but not in SET patients. Additionally, DET patients with previous CD had a significantly higher multiple pregnancy rate (AOR = 0.47, 95% CI = 0.29, 0.75, P = 0.002) than those with previous VD, but no significant associations were observed in CSD and multiple pregnancies (AOR = 0.55, 95% CI = 0.23, 1.34, P = 0.192) between DET patients with CD and those with VD after adjusting for potential confounders.

Conclusions

Our study showed that during an FET cycle, previous CD and the presence of a CSD could negatively affect pregnancy outcomes especially in DET patients.
Clinical analysis of women with ovarian pregnancy: a retrospective case–control study
Authors: Li Hongyi , Liu Yu , Yang Yang , Zhao Xia , Qi Xiaorong
Published: October 2022

Background

To address the clinical features and potential risk factors of ovarian pregnancy (OP).

Methods

In this retrospective case–control study performed in West China Second University Hospital from March 17, 2005 to December 8, 2018, 146 OP patients were selected as a case group, 292 patients with tubal pregnancy (TP) and 292 women with intrauterine pregnancy (IUP) were matched as controls at a ratio of 1:2:2.

Results

When compared with TP patients, OP patients tend to have worse clinical complications (hemorrhagic shock (7.41% vs 2.89%), rupture of pregnancy sac (54.07% vs 37.78%), hemoperitoneum (363.1 ± 35.46 ml vs 239.3 ± 27.61 ml) and increased need for emergency laparotomy (9.60% vs 3.97%) at an early gestational age. Assisted reproductive technology (ART) (adjusted OR1 2.08, 95%CI 1.04 to 4.18; adjusted OR2 2.59, 95%CI 1.25 to 5.37) and intrauterine contraceptive device (IUD) use (adjusted OR1 2.19, 95%CI 1.10 to 4.36; adjusted OR2 2.77, 95%CI 1.74 to 5.71) may be risk factors for ovarian ectopic pregnancy as compared to the control groups of TP and IUP patients.

Conclusions

OP patients tend to have more severe clinical complications and this study has identified ART and IUD use as potential risk factors for OP. Results of this study may contribute to improve the understanding of OP and promote early surgical intervention.
Stakeholders analysis of COVID-19 management and control: a case of Iran
Authors: Mohamadian Mohammad , Nasiri Taha , Bahadori Mohammadkarim , Jalilian Habib
Published: October 2022

Background

The COVID-19 pandemic is a multi-faceted phenomenon with many political, economic and social consequences. Success in managing and controlling this pandemic depends on the coordinated efforts of many organizations and institutions. Therefore, this study aimed to identify and analyze the actors and stakeholders related to managing and controlling this pandemic in Iran.

Methods

This mix-method stakeholder analysis was conducted in 2021 nationwide as retrospectively. The purposive sampling method was applied when inviting eligible participants to participate in the study. Our study was conducted in two phases. In the qualitative phase, data were collected using a semi-structured interview. An interview guide was developed based on the WHO stakeholder analysis framework. In the quantitative phase, we used a questionnaire developed based on the study framework. Each question was scored on a 5-point Likert scale, with a score greater than 4 was considered as high, 3–4 was considered as moderate, and 1–3 was considered as low. Data were analyzed using framework analysis, WHO stakeholders’ analysis framework and MENDELOW matrix. MAXQDA qualitative data analysis software Version 11 and Policy Maker software (Version. 4) were used for data analysis.

Results

A total of 48 stakeholders were identified. Ministry of Health (MoH), National Headquarters for Coronavirus Control (NHCC) had the highest participation level, high supportive position, and knowledge of the subject. The Parliament of Iran (PoI), Islamic Revolutionary Guard Corps (IRGC), and Islamic Republic of Iran Broadcasting (IRIB) had the highest power/influence during the Covid-19 epidemic. Only two stakeholders (6.06%) had high participation, and 18.18% had moderate participation. All stakeholders except for the NHCC and the MoH lacked appropriate knowledge of the subject. Furthermore, only three stakeholders (9.09%) had high power/influence.

Conclusion

Given the multidimensional nature of Covid-19, most institutions and organizations were involved in managing this pandemic. Stakeholders with high power/authority and resources had a low/moderate participation level and a moderate supportive position. Moreover, organizations with a high supportive position and participation had low power/authority and resources to cope with COVID-19.
Leveraging 13 million responses to the U.S. COVID-19 Trends and Impact Survey to examine vaccine hesitancy, vaccination, and mask wearing, January 2021-February 2022
Authors: Nguyen Quynh C. , Yardi Isha , Gutierrez Francia Ximena Marin , Mane Heran , Yue Xiaohe
Published: October 2022

Background

The urgency of the COVID-19 pandemic called upon the joint efforts from the scientific and private sectors to work together to track vaccine acceptance and prevention behaviors.

Methods

Our study utilized individual responses to the Delphi Group at Carnegie Mellon University U.S. COVID-19 Trends and Impact Survey, in partnership with Facebook. We retrieved survey data from January 2021 to February 2022 (n = 13,426,245) to examine contextual and individual-level predictors of COVID-19 vaccine hesitancy, vaccination, and mask wearing in the United States. Adjusted logistic regression models were developed to examine individual and ZIP code predictors of COVID-19 vaccine hesitancy and vaccination status. Given the COVID-19 vaccine was rolled out in phases in the U.S. we conducted analyses stratified by time, January 2021-May 2021 (Time 1) and June 2021-February 2022 (Time 2).

Results

In January 2021 only 9% of U.S. Facebook respondents reported receiving the COVID-19 vaccine, and 45% were vaccine hesitant. By February 2022, 80% of U.S. Facebook respondents were vaccinated and only 18% were vaccine hesitant. Individuals who were older, held higher educational degrees, worked in white collar jobs, wore a mask most or all the time, and identified as white and Asian had higher COVID-19 vaccination rates and lower vaccine hesitancy across Time 1 and Time 2. Essential workers and blue-collar occupations had lower COVID vaccinations and higher vaccine hesitancy. By Time 2, all adults were eligible for the COVID-19 vaccine, but blacks and multiracial individuals had lower vaccination and higher vaccine hesitancy compared to whites. Those 55 years and older and females had higher odds of wearing masks most or all the time. Protective service, construction, and installation and repair occupations had lower odds of wearing masks. ZIP Code level percentage of the population with a bachelors’ which was associated with mask wearing, higher vaccination, and lower vaccine hesitancy.

Conclusion

Associations found in earlier phases of the pandemic were generally found to also be present later in the pandemic, indicating stability in inequities. Additionally, inequities in these important outcomes suggests more work is needed to bridge gaps to ensure that the burden of COVID-19 risk does not disproportionately fall upon subgroups of the population.
Concurrent validity of DorsaVi wireless motion sensor system Version 6 and the Vicon motion analysis system during lifting
Authors: Chang Ruth P , Smith Anne , Kent Peter , Saraceni Nic , Hancock Mark , O’Sullivan Peter B , Campbell Amity
Published: October 2022

Background

Wearable sensor technology may allow accurate monitoring of spine movement outside a clinical setting. The concurrent validity of wearable sensors during multiplane tasks, such as lifting, is unknown. This study assessed DorsaVi Version 6 sensors for their concurrent validity with the Vicon motion analysis system for measuring lumbar flexion during lifting.

Methods

Twelve participants (nine with, and three without back pain) wore sensors on T12 and S2 spinal levels with Vicon surface markers attached to those sensors. Participants performed 5 symmetrical (lifting from front) and 20 asymmetrical lifts (alternate lifting from left and right). The global-T12-angle, global-S2-angle and the angle between these two sensors (relative-lumbar-angle) were output in the sagittal plane. Agreement between systems was determined through-range and at peak flexion, using multilevel mixed-effects regression models to calculate root mean square errors and standard deviation. Mean differences and limits of agreement for peak flexion were calculated using the Bland Altman method.

Results

For through-range measures of symmetrical lifts, root mean squared errors (standard deviation) were 0.86° (0.78) at global-T12-angle, 0.90° (0.84) at global-S2-angle and 1.34° (1.25) at relative-lumbar-angle. For through-range measures of asymmetrical lifts, root mean squared errors (standard deviation) were 1.84° (1.58) at global-T12-angle, 1.90° (1.65) at global-S2-angle and 1.70° (1.54) at relative-lumbar-angle. The mean difference (95% limit of agreement) for peak flexion of symmetrical lifts, was − 0.90° (-6.80 to 5.00) for global-T12-angle, 0.60° (-2.16 to 3.36) for global-S2-angle and − 1.20° (-8.06 to 5.67) for relative-lumbar-angle. The mean difference (95% limit of agreement) for peak flexion of asymmetrical lifts was − 1.59° (-8.66 to 5.48) for global-T12-angle, -0.60° (-7.00 to 5.79) for global-S2-angle and − 0.84° (-8.55 to 6.88) for relative-lumbar-angle.

Conclusion

The root means squared errors were slightly better for symmetrical lifts than they were for asymmetrical lifts. Mean differences and 95% limits of agreement showed variability across lift types. However, the root mean squared errors for all lifts were better than previous research and below clinically acceptable thresholds. This research supports the use of lumbar flexion measurements from these inertial measurement units in populations with low back pain, where multi-plane lifting movements are assessed.
Efficacy and safety of combination of empagliflozin and metformin with combination of sitagliptin and metformin during Ramadan: an observational study
Authors: Ahmed Ibrar , Raja Umar Yousaf , Wahab Muhammad Umar , Rehman Tejhmal , Ishtiaq Osama , Aamir A. H. , Ghaffar Tahir , Raza Abbas , Kumar Suresh , Sherin Akhtar , Masood Faisal , Randhawa Fawad Ahmad , Asghar Ali , Khan Sehrish
Published: October 2022

Background

Management of diabetes during fasting is a clinical challenge. Sodium glucose co-transporter -2 inhibitors (SGLT2i) are considered safe with a low risk of hypoglycemia. However, studies on SGLT2i are scarce. This study was designed to compare the efficacy, safety, and tolerability of empagliflozin with metformin during Ramadan in comparison with sitagliptin and metformin.

Methods

It was a prospective, observational study, conducted at 11 different sites all across Pakistan on an outpatient basis during Ramadan (May 2021–June 2021). including 132 patients, 88 who received metformin and sitagliptin, and 44 patients who received metformin and empagliflozin.

Results

Patients of the SGLT-2i group experienced similar symptomatic hypoglycemic episodes (15.9%) as the sitagliptin group. There was an improvement in blood sugar levels after the use of SGLT-2i (RBS 181 ± 64 before Ramadan vs 162 ± 53 after Ramadan). HbA1c also improved after the use of SGLT-2i before and after Ramadan (7.2 ± 0.8 vs 6.9 ± 0.9 for Metformin + Empagliflozin and 7.8 ± 1.5 vs 7.6 ± 1.6 for Metformin and sitagliptin). Weight and BMI improved after the use of SGLT-2i (BMI 36.5 ± 4.8 before Ramadan and 33.7 ± 2.4 after Ramadan). There were no reported cases of urinary tract infection in the empagliflozin group.

Conclusion

SGLT-2 inhibitors combined with metformin for patients with diabetes during Ramadan fasting is as effective, safe and well tolerated as DPP4 combined with metformin.
Perceived professional identity and related factors in Iranian nursing students: a cross-sectional study
Authors: Gilvari Tahereh , Babamohamadi Hassan , Paknazar Fatemeh
Published: October 2022

Background

Professional identity, an important process in the development and expansion of the nursing profession, is built over time and includes gaining insight into professional performances and fostering ideals and values for the profession. Several factors influence the formation of professional identity. This study investigates the level of professional identity in nursing students and its predictors using a localized tool.

Methods

This cross-sectional study recruited 195 nursing students at Semnan University of Medical Sciences, Semnan, Iran, who were selected by census sampling in 2020. Data were collected using a researcher-made professional identity questionnaire and were then analyzed in SPSS-18 using descriptive and inferential (logistic regression) statistics.

Results

The mean total score of the students’ perceived professional identity was 316.72, indicating a strong professional identity. The students’ professional identity had a significant relationship with variables including GPA above 16 (OR = 2.65, P = 0.002), choosing the field out of interest (OR = 2.15, P = 0.015), and having work experience while studying (OR = 3.10, P = 0.006).

Conclusion

The findings showed that selecting the field of nursing out of interest, having a GPA above 16 and work experience while studying are associated with a higher perception of professional identity among nursing students. The professional identity of nursing students can be enhanced through reinforcing the mentioned factors and further attention to their role in the promotion and consolidation of professional identity. The researchers recommend that educational directors, nursing professors, and clinical nursing educators make greater efforts to develop and promote the professional identity of nursing students.
Effectiveness of early rhythm control in improving clinical outcomes in patients with atrial fibrillation: a systematic review and meta-analysis
Authors: Zhu Wengen , Wu Zexuan , Dong Yugang , Lip Gregory Y. H. , Liu Chen
Published: October 2022

Background

Current guidelines recommend rhythm control for improving symptoms and quality of life in symptomatic patients with atrial fibrillation (AF). However, the long-term prognostic outcomes of rhythm control compared with rate control are still inconclusive. In this meta-analysis, we aimed to assess the effects of early rhythm control compared with rate control on clinical outcomes in newly diagnosed AF patients.

Methods

We systematically searched the PubMed and Embase databases up to August 2022 for randomized and observational studies reporting the associations of early rhythm control (defined as within 12 months of AF diagnosis) with effectiveness outcomes. The primary outcome was a composite of death, stroke, admission to hospital for heart failure (HF), or acute coronary syndrome (ACS). Hazard ratios (HRs) and 95% confidence intervals (CIs) from each study were pooled using a random-effects model, complemented with an inverse variance heterogeneity or quality effects model.

Results

A total of 8 studies involving 447,202 AF patients were included, and 23.5% of participants underwent an early rhythm-control therapy. In the pooled analysis using the random-effects model, compared with rate control, the early rhythm-control strategy was significantly associated with reductions in the primary composite outcome (HR = 0.88, 95% CI: 0.86–0.89) and secondary outcomes, including stroke or systemic embolism (HR = 0.78, 95% CI: 0.71–0.85), ischemic stroke (HR = 0.81, 95% CI: 0.69–0.94), cardiovascular death (HR = 0.83, 95% CI: 0.70–0.99), HF hospitalization (HR = 0.90, 95% CI: 0.88–0.92), and ACS (HR = 0.86, 95% CI: 0.76–0.98). Reanalyses using the inverse variance heterogeneity or quality effects model yielded similar results.

Conclusions

Our current meta-analysis suggested that early initiation of rhythm control treatment was associated with improved adverse effectiveness outcomes in patients who had been diagnosed with AF within 1 year.

Registration

The study protocol was registered to PROSPERO (CRD42021295405).
Effects of sphingolipid metabolism disorders on endothelial cells
Authors: Lai Yali , Tian Yue , You Xintong , Du Jiangnan , Huang Jianmei
Published: October 2022

Many cardiovascular disorders, including atherosclerosis, hypertension, coronary heart disease, diabetes, etc., are characterized by endothelial cell dysfunction. Endothelial cell function is closely related to sphingolipid metabolism, and normal sphingolipid metabolism is critical for maintaining endothelial cell homeostasis. Sphingolipid metabolites or key enzymes in abnormal situation, including sphingosine, ceramide (Cer), sphingosine-1-phosphate (S1P), serine, sphingosine kinase (SPHK), ceramide kinase (Cerk), sphingosine-1-phosphate lyase (S1PL) etc., may have a protective or damaging effect on the function of endothelial cells. This review summarizes the effects of sphingolipid metabolites and key enzymes disordering in sphingolipid metabolism on endothelial cells, offering some insights into further research on the pathogenesis of cardiovascular diseases and corresponding therapeutic targets.
Clinical characteristics of sitosterolemic children with xanthomas as the first manifestation
Authors: Zhang Jun , Chen Qiu-li , Guo Song , Li Yan-hong , Li Chuan , Zheng Ru-jiang , Luo Xue-qun , Ma Hua-mei
Published: October 2022

Background:

Sitosterolemia (STSL) is an extremely rare genetic disease. Xanthomas as the first symptom are frequently misinterpreted as familial hypercholesterolemia (FH) in children. Inappropriate treatment may deteriorate the condition of STSL.

Objectives:

To present the clinical and laboratory characteristics of xanthomatous children diagnosed with sitosterolemia in comparison with childhood FH with xanthomas.

Methods:

We summarized and compared the clinical characteristics of STSL and FH patients with xanthomas as the first manifestations and investigated the different indicators between the STSL and FH groups, as well as their diagnostic values for STSL.

Results:

Two tertiary pediatric endocrinology departments contributed ten STSL cases. Five of the STSL patients (50%) experienced mild anemia, whereas two (20%) had vascular complications. The xanthomas of the STSL group displayed morphologies comparable to those of the FH group. There were ten cases of homozygous FH (HoFH) with xanthomas as the predominant symptom of the control group who had no anemia. The serum cholesterol (Chol) levels of the STSL and FH groups were 12.57 (9.55 ~ 14.62) mmol/L and 17.45 (16.04 ~ 21.47) mmol/L, respectively (p value 0.002). The serum low-density lipoprotein cholesterol (LDL-c) levels of the STSL and FH groups were 9.26 ± 2.71 mmol/L and 14.58 ± 4.08 mmol/L, respectively (p value 0.003). Meanwhile, the mean platelet volume (MPV) levels of the STSL and FH groups were 11.00 (9.79 ~ 12.53) fl. and 8.95 (8.88 ~ 12.28) fl., respectively (p value 0.009). The anemia proportions of the STSL and FH groups were 50% and 0%, respectively (p value 0.033). The AUC values of Chol, LDL-c, MPV, hemoglobin (Hb) for the diagnosis of STSL were 0.910, 0.886, 0.869, 0.879, respectively. Chol ≤ 15.41 mmol/L, LDL-c ≤ 13.22 mmol/L, MPV ≥ 9.05 fl., or Hb≤120 g/L were the best thresholds for diagnosing STSL with childhood xanthomas.

Conclusion

The xanthoma morphology of STSL patients resembles that of FH patients. Xanthomas as the initial symptom of a child with Chol ≤ 15.41 mmol/L, LDL-c≤13.22 mmol/L, MPV ≥ 9.05 fl., or Hb≤120 g/L, he was most likely to have STSL.