bluuebunny/crossref_metadata_2025 huggingface dataset:
Why Didn’t You Walk Yesterday? Factors Associated With Slow Early Recovery After Adult Spinal Deformity Surgery
Authors: Kazarian Gregory S. , Lovecchio Francis , Merrill Robert , Clohisy John , Zhang Bo , Du Jerry , Jordan Yusef , Pajak Anthony , Knopp Rachel , Kim David , Samuel Justin , Elysee Jonathan , Akosman Izzet , Shahi Pratyush , Johnson Mitchell , Schwab Frank J. , Lafage Virginie , Kim Han Jo
Published: August 2023

Study Design

This is a retrospective case-control study.

Objectives

The objectives of this study are to identify (1) risk factors for delayed ambulation following adult spinal deformity (ASD) surgery and (2) complications associated with delayed ambulation.

Methods

One-hundred and ninety-one patients with ASD who underwent posterior-only fusion (≥5 levels, LIV pelvis) were reviewed. Patients who ambulated with physical therapy (PT) on POD2 or later (LateAmb, n = 49) were propensity matched 1:1 to patients who ambulated on POD0-1 (NmlAmb, n = 49) based on the extent of fusion and surgical invasiveness score (ASD-S). Risk factors, as well as inpatient medical complications were compared. Logistic regressions were used to identify risk factors for late ambulation.

Results

Of the patients who did not ambulate on POD0-1, 32% declined participation secondary to pain or dizziness/fatigue, while 68% were restricted from participation by PT/nursing due to fatigue, inability to follow commands, nausea/dizziness, pain, or hypotension. Logistic regression showed that intraoperative estimated blood loss (EBL) >2L (OR = 5.57 [1.51-20.55], P = .010) was independently associated with an increased risk of delayed ambulation, with a 1.25 times higher risk for every 250 mL increase in EBL ( P = .014). Modified 5-Item Frailty Index (mFI-5) was also independently associated with delayed ambulation (OR = 2.53 [1.14-5.63], P = .023). LateAmb demonstrated a higher hospital LOS (8.4 ± 4.0 vs 6.2 ± 2.6, P < .001). The LateAmb group trended toward an increase in medical complications on POD3+ (14.3% vs 26.5%, P = .210).

Conclusions

EBL demonstrates a dose-response relationship with risk for delayed ambulation. Delayed ambulation increases LOS and may impact medical complications.
Early Childhood Caries Intervention in Aboriginal Australian Children: A Cross-in Randomized Trial
Authors: Ju X. , Mittinty M.N , Smithers L. , Jamieson L.
Published: August 2023

Introduction:

Early childhood caries (ECC) is the strongest predictor of dental caries in adulthood. Indigenous children have higher levels of ECC compared with non-Indigenous children. The study aimed to estimate the efficacy of an ECC intervention among Aboriginal Australian children.

Methods:

Baby Teeth Talk was an outcome assessor-blinded, closed-cohort cross-in randomized controlled trial conducted in South Australia, Australia. We randomly allocated 448 women pregnant with an Aboriginal child to either an immediate (II) or delayed (DI) intervention group between January 2011 and May 2012. The immediate intervention comprised (1) provision of dental care to mothers during pregnancy; (2) application of fluoride varnish to teeth of children at ages 6, 12; and 18 mo; (3) motivational interviewing delivered in conjunction; and (4) anticipatory guidance. Mothers/children in the DI group received the same intervention commencing when the child was 24 mo of age. The outcomes were assessed by the number of decayed, missing, and filled teeth (dmft) in children aged 24, 36, and 60 mo. Regression-based approaches with generalized linear mixed effect (log-Poisson) model characterized the mean dmft to estimate risk ratios (RRs) and 95% confidence intervals (95% CIs).

Results:

A total of 223 participants were randomly allocated to the II group and 225 to the DI group. Three hundred sixty-five children (178 II, 187 DI) received at least 1 dental clinical examination at 24, 36, and 60 mo of follow-up. The mean dmft was lower in the II group (0.48, 1.32, and 2.06) than in the DI group (0.82, 1.90, and 3.29) at each time point, respectively. The direct ECC intervention effect was to prevent/decrease dental decay experience (dmft) occurrence by 84% (RR = 1.84, 95% CI: 1.20–2.48) after adjusting for all covariates.

Conclusions:

Our analysis indicated that the time-varied ECC intervention had immediate and longer-term effects on the prevention of ECC among Indigenous Australian children.

Knowledge Transfer Statement:

The study aimed to estimate the efficacy of an early childhood caries (ECC) intervention among Aboriginal Australian children. The findings indicated that the culturally appropriate ECC intervention is effective for the preventive of ECC and can be used by clinicians, educators, and policy makers when planning an ECC intervention, so as to prevent and reduce ECC and meet identified oral health needs across the Australian population, which is important for preventive dental care.
Livelihood Challenges in Handicraft Industry: A Qualitative Study on Poverty and Exploitation of Women Artisans in Srinagar
Authors: Khan Tanveer Ahmad , Bhat Akhter Hussain , Mohsin Abdul , Majeed Ishfaq
Published: August 2023

This study was framed to gain an in-depth understanding and first-hand experiences of women artisans of Srinagar, Jammu & Kashmir (J&K). Purposive and snowball sampling were employed in conducting the study. In this study, 20 Kashmiri women artisans were interviewed. Face-to-face interviews based on open-ended and descriptive questions were probed. Several interpretative and specific questions were also asked during the interview process to ensure thoroughness. The collected data were read multiple times to achieve familiarization and then compared with other data sets and interpreted thematically. The following themes emerged from the data set by application of descriptive phenomenology (a) financial hardships, (b) exploitation of women artisans in handicrafts sector under different agents, (c) exploitation in the form of low wages, (d) impact of conflict and (e) livelihood challenges and pathways to sustain women artisans livelihood. The findings also reveal that artisans had suffered dramatically due to two lockdowns: the lockdown imposed because of the removal of Article 370 of India’s constitution, which guaranteed special status to citizens of J&K, and the lockdown imposed as a result of Covid-19.
Book review: Ashok Gopal, A Part Apart: The Life and Thought of B.R. Ambedkar
Authors: Srutheesh S
Published: August 2023

Ashok Gopal, A Part Apart: The Life and Thought of B.R. Ambedkar. New Delhi: Navayana Publishing Pvt Ltd, 2023, 864 pp., ₹999 (Hardback). ISBN: 9788195838516.
‘If We Must Wait for Total Peace Before Thinking of Returning, We May Never Have a Place Called Home’: Support Mechanisms for Displaced Victims of Herder-Farmers Conflict in Benue State, Nigeria
Authors: Achem Victor Onyilor , Aderinto Adeyinka Abideen
Published: August 2023

This research investigates the relationship between reintegration outcomes and support systems for displaced populations, with a focus on agricultural communities and returnees in Benue state, Nigeria. The study examines the impact of displacement experiences and return settings on reintegration, as well as the subjective evaluations of individuals regarding their support systems and its influence on successful reintegration. Snowball and purposeful sampling methods were employed to select 44 respondents from various IDP camps, and data was collected through group discussions, in-depth interviews, and key informant interviews. Thematic analysis using NVIVO12plus software was conducted. The findings reveal a complex relationship between reintegration decisions and experiences with displacement support and return settings. In Benue state, displaced victims have two primary support systems: government assistance in collaboration with NGOs, and assistance from private organizations and individuals.
Exploiting the CD200-CD200R immune checkpoint axis in multiple myeloma to enhance CAR T-cell therapy
Authors: Tang Yan , Liu Wei , Kadu Siddhant , Johnson Omar , Hasanali Zainul S. , Kelly Andre , Shestov Alexander , Pajarillo Raymone , Greenblatt Eli , Holmes Matthew , Wang Li-Ping , Shih Natalie , O’Connor Roddy S. , Ruella Marco , Garfall Alfred L. , Allman David , Vogl Dan T. , Cohen Adam , June Carl H. , Sheppard Neil C.
Published: August 2023

Patients with multiple myeloma (MM) treated with B-cell maturation antigen (BCMA)-specific chimeric antigen receptor (CAR) T cells usually relapse with BCMA+ disease, indicative of CAR T-cell suppression. CD200 is an immune checkpoint that is overexpressed on aberrant plasma cells (aPCs) in MM and is an independent negative prognostic factor for survival. However, CD200 is not present on MM cell lines, a potential limitation of current preclinical models. We engineered MM cell lines to express CD200 at levels equivalent to those found on aPCs in MM and show that these are sufficient to suppress clinical-stage CAR T-cells targeting BCMA or the Tn glycoform of mucin 1 (TnMUC1), costimulated by 4-1BB and CD2, respectively. To prevent CD200-mediated suppression of CAR T cells, we compared CRISPR-Cas9–mediated knockout of the CD200 receptor (CD200RKO), to coexpression of versions of the CD200 receptor that were nonsignaling, that is, dominant negative (CD200RDN), or that leveraged the CD200 signal to provide CD28 costimulation (CD200R-CD28 switch). We found that the CD200R-CD28 switch potently enhanced the polyfunctionality of CAR T cells, and improved cytotoxicity, proliferative capacity, CAR T-cell metabolism, and performance in a chronic antigen exposure assay. CD200RDN provided modest benefits, but surprisingly, the CD200RKO was detrimental to CAR T-cell activity, adversely affecting CAR T-cell metabolism. These patterns held up in murine xenograft models of plasmacytoma, and disseminated bone marrow predominant disease. Our findings underscore the importance of CD200-mediated immune suppression in CAR T-cell therapy of MM, and highlight a promising approach to enhance such therapies by leveraging CD200 expression on aPCs to provide costimulation via a CD200R-CD28 switch.
Severe asthma trajectories in adults: findings from the NORDSTAR cohort
Authors: von Bülow Anna , Hansen Susanne , Sandin Patrik , Ernstsson Olivia , Janson Christer , Lehtimäki Lauri , Kankaanranta Hannu , Ulrik Charlotte , Aarli Bernt Bøgvald , Geale Kirk , Tang Sheila Tuyet , Wolf Maija , Backer Vibeke , Hilberg Ole , Altraja Alan , Backman Helena , Lúdvíksdóttir Dóra , Björnsdóttir Unnur Steina , Kauppi Paula , Sandström Thomas , Sverrild Asger , Yasinska Valentyna , Kilpeläinen Maritta , Dahlén Barbro , Viinanen Arja , Bjermer Leif , Bossios Apostolos , Porsbjerg Celeste
Published: August 2023

Background

There is limited evidence on the pathways leading to severe asthma and we are presently unable to effectively predict the progression of the disease. We aimed to describe the longitudinal trajectories leading to severe asthma and to describe clinical events preceding disease progression in a nationwide population of patients with severe asthma.

Methods

We conducted an observational study based on Swedish data from the NORdic Dataset for aSThmA Research (NORDSTAR) research collaboration platform. We identified adult patients with severe asthma in 2018 according to the European Respiratory Society/American Thoracic Society definition and used latent class analysis to identify trajectories of asthma severity over a 10-year retrospective period from 2018.

Results

Among 169 128 asthma patients, we identified 4543 severe asthma patients. We identified four trajectories of severe asthma that were labelled as: trajectory 1 “consistently severe asthma” (n=389 (8.6%)), trajectory 2 “gradual onset severe asthma” (n=942 (20.7%)), trajectory 3 “intermittent severe asthma” (n=1685 (37.1%)) and trajectory 4 “sudden onset severe asthma” (n=1527 (33.6%)). “Consistently severe asthma” had a higher daily inhaled corticosteroid dose and more prevalent osteoporosis compared with the other trajectories. Patients with “gradual onset severe asthma” and “sudden onset severe asthma” developed type 2-related comorbidities concomitantly with development of severe asthma. In the latter group, this primarily occurred within 1–3 years preceding onset of severe asthma.

Conclusions

Four distinct trajectories of severe asthma were identified illustrating different patterns of progression of asthma severity. This may eventually enable the development of better preventive management strategies in severe asthma.
Management of systemic to pulmonary shunts and elevated pulmonary vascular resistance
Authors: Linder Alexandra N. , Hsia Jill , Krishnan Sheila V. , Bacha Emile A. , Crook Sarah , Rosenzweig Erika B. , Krishnan Usha S.
Published: August 2023

Background

Repair of systemic to pulmonary shunts is timed to prevent the development of irreversible pulmonary vascular disease, including in patients with other factors contributing to pulmonary hypertension. This study assessed outcomes of an individualised strategy for managing patients with mild–moderately elevated pulmonary vascular resistance (PVR) deemed borderline eligible for repair.

Methods

A retrospective chart review was conducted of patients with systemic to pulmonary shunts and baseline indexed PVR (PVRi) ≥3 WU·m2treated at a single centre from 1 January 2005 to 30 September 2019. Data included demographics, World Health Organization functional class (WHO FC), medications and haemodynamic data at baseline and serial follow-up.

Results

30 patients (18 females) met criteria for inclusion. Median age at diagnosis of pulmonary arterial hypertension was 1.3 years (range 0.03–54 years) and at surgery was 4.1 years (range 0.73–56 years). Median follow-up time was 5.8 years (range 0.2–14.6 years) after repair. Most patients received at least one targeted pulmonary arterial therapy prior to repair and the majority (80%) underwent fenestrated shunt closure. There was a significant decrease in mean pulmonary arterial pressure (mPAP) (p<0.01), PVRi (p=0.0001) and PVR/systemic vascular resistance (p<0.01) between baseline and preoperative catheterisation and a decrease in PVRi (p<0.005), mPAP (p=0.0001) and pulmonary to systemic flow ratio (p<0.03) from baseline to most recent catheterisation. WHO FC improved from FC II–III at baseline to FC I post repair in most patients (p<0.003).

Conclusions

In carefully selected patients with systemic to pulmonary shunts and elevated PVR considered borderline for operability, the use of preoperative targeted therapy in conjunction with fenestrated or partial closure of intracardiac shunts is associated with improvement in WHO FC and clinical outcomes.
The Influence of Crystallographic Orientation and Grain Boundary on Nanoindentation Behavior of Inconel 718 Superalloy Based on Crystal Plasticity Theory
Authors: Zhu Wenbo , Yuan Guangjian , Tan Jianping , Chang Shuai , Tu Shantung
Published: August 2023

The crystal plasticity finite element method (CPFEM) is widely used to explore the microscopic mechanical behavior of materials and understand the deformation mechanism at the grain-level. However, few CPFEM simulation studies have been carried out to analyze the nanoindentation deformation mechanism of polycrystalline materials at the microscale level. In this study, a three-dimensional CPFEM-based nanoindentation simulation is performed on an Inconel 718 polycrystalline material to examine the influence of different crystallographic parameters on nanoindentation behavior. A representative volume element model is developed to calibrate the crystal plastic constitutive parameters by comparing the stress-strain data with the experimental results. The indentation force-displacement curves, stress distributions, and pile-up patterns are obtained by CPFEM simulation. The results show that the crystallographic orientation and grain boundary have little influence on the force-displacement curves of the nanoindentation, but significantly influence the local stress distributions and shape of the pile-up patterns. As the difference in crystallographic orientation between grains increases, changes in the pile-up patterns and stress distributions caused by this effect become more significant. In addition, the simulation results reveal that the existence of grain boundaries affects the continuity of the stress distribution. The obstruction on the continuity of stress distribution increases as the grain boundary angle increases. This research demonstrates that the proposed CPFEM model can well describe the microscopic compressive deformation behaviors of Inconel 718 under nanoindentation.
Assessment of Lubrication Property and Machining Performance of Nanofluid Composite Electrostatic Spraying (NCES) Using Different Types of Vegetable Oils as Base Fluids of External Fluid
Authors: Su Yu , Chu Zepeng , Gong Le , Wang Bin , Liu Zhiqiang
Published: August 2023

The current study of minimum quantity lubrication (MQL) concentrates on its performance improvement. By contrast with nanofluid MQL and electrostatic atomization (EA), the proposed nanofluid composite electrostatic spraying (NCES) can enhance the performance of MQL more comprehensively. However, it is largely influenced by the base fluid of external fluid. In this paper, the lubrication property and machining performance of NCES with different types of vegetable oils (castor, palm, soybean, rapeseed, and LB2000 oil) as the base fluids of external fluid were compared and evaluated by friction and milling tests under different flow ratios of external and internal fluids. The spraying current and electrowetting angle were tested to analyze the influence of vegetable oil type as the base fluid of external fluid on NCES performances. The friction test results show that relative to NCES with other vegetable oils as the base fluids of external fluid, NCES with LB2000 as the base fluid of external fluid reduced the friction coefficient and wear loss by 9.4%-27.7% and 7.6%-26.5%, respectively. The milling test results display that the milling force and milling temperature for NCES with LB2000 as the base fluid of external fluid were 1.4%-13.2% and 3.6%-11.2% lower than those for NCES with other vegetable oils as the base fluids of external fluid, respectively. When LB2000/multi-walled carbon nanotube (MWCNT) water-based nanofluid was used as the external/internal fluid and the flow ratio of external and internal fluids was 2:1, NCES showed the best milling performance. This study provides theoretical and technical support for the selection of the base fluid of NCES external fluid.
Understanding the underlying genetic mechanisms for age at first calving, inter-calving period and scrotal circumference in Bonsmara cattle
Authors: Reding Jason J , van der Westhuizen Robert R , Berry Donagh P , van Marle-Köster Este
Published: August 2023

Background

Reproduction is a key feature of the sustainability of a species and thus represents an important component in livestock genetic improvement programs. Most reproductive traits are lowly heritable. In order to gain a better understanding of the underlying genetic basis of these traits, a genome-wide association was conducted for age at first calving (AFC), first inter-calving period (ICP) and scrotal circumference (SC) within the South African Bonsmara breed. Phenotypes and genotypes (120,692 single nucleotide polymorphisms (SNPs) post editing) were available on 7,128 South African Bonsmara cattle; the association analyses were undertaken using linear mixed models.

Results

Genomic restricted maximum likelihood analysis of the 7,128 SA Bonsmara cattle yielded genomic heritability’s of 0.183 (SE = 0.021) for AFC, 0.207 (SE = 0.022) for ICP and 0.209 (SE = 0.019) for SC. A total of 16, 23 and 51 suggestive (P ≤ 4 × 10-6) SNPs were associated with AFC, ICP and SC, while 11, 11 and 44 significant (P ≤ 4 × 10-7) SNPs were associated with AFC, ICP and SC respectively. A total of 11 quantitative trait loci (QTL) and 11 candidate genes were co-located with these associated SNPs for AFC, with 10 QTL harbouring 11 candidate genes for ICP and 41 QTL containing 40 candidate genes for SC. The QTL identified were close to genes previously associated with carcass, fertility, growth and milk-related traits. The biological pathways influenced by these genes include carbohydrate catabolic processes, cellular development, iron homeostasis, lipid metabolism and storage, immune response, ovarian follicle development and the regulation of DNA transcription and RNA translation.

Conclusions

This was the first attempt to study the underlying polymorphisms associated with reproduction in South African beef cattle. Genes previously reported in cattle breeds for numerous traits bar AFC, ICP or SC were detected in this study. Over 20 different genes have not been previously reported in beef cattle populations and may have been associated due to the unique genetic composite background of the SA Bonsmara breed.
Identification of immune-related lncRNA in sepsis by construction of ceRNA network and integrating bioinformatic analysis
Authors: Wang Tianfeng , Xu Si , Zhang Lei , Yang Tianjun , Fan Xiaoqin , Zhu Chunyan , Wang Yinzhong , Tong Fei , Mei Qing , Pan Aijun
Published: August 2023

Background

Sepsis is a high mortality disease which seriously threatens human life and health, for which the pathogenetic mechanism still unclear. There is increasing evidence showed that immune and inflammation responses are key players in the development of sepsis pathology. LncRNAs, which act as ceRNAs, have critical roles in various diseases. However, the regulatory roles of ceRNA in the immunopathogenesis of sepsis have not yet been elucidated.

Results

In this study, we aimed to identify immune biomarkers associated with sepsis. We first generated a global immune-associated ceRNA (IMCE) network based on data describing interactions pairs of gene–miRNA and miRNA–lncRNA. Afterward, we excavated a dysregulated sepsis immune-associated ceRNA (SPIMC) network from the global IMCE network by means of a multi-step computational approach. Functional enrichment indicated that lncRNAs in SPIMC network have pivotal roles in the immune mechanism underlying sepsis. Subsequently, we identified module and hub genes (CD4 and STAT4) via construction of a sepsis immune-related PPI network. Then, we identified hub genes based on the modular structure of PPI network and generated a ceRNA subnetwork to analyze key lncRNAs associated with sepsis. Finally, 6 lncRNAs (LINC00265, LINC00893, NDUFA6-AS1, NOP14-AS1, PRKCQ-AS1 and ZNF674-AS1) that identified as immune biomarkers of sepsis. Moreover, the CIBERSORT algorithm and the infiltration of circulating immune cells types were performed to identify the inflammatory state of sepsis. Correlation analyses between immune cells and sepsis immune biomarkers showed that the LINC00265 was strongly positive correlated with the macrophages M2 (r = 0.77).

Conclusion

Collectively, these results may suggest that these lncRNAs (LINC00265, LINC00893, NDUFA6-AS1, NOP14-AS1, PRKCQ-AS1 and ZNF674-AS1) played important roles in the immune pathogenesis of sepsis and provide potential therapeutic targets for further researches on immune therapy treatment in patients with sepsis.
Whole genome analyses of toxicants tolerance genes of Apis mellifera gut-derived Enterococcus faecium strains
Authors: Zaghloul Heba A. H. , El Halfawy Nancy M.
Published: August 2023

Background

Because of its social nature, the honeybee is regularly exposed to environmental toxicants such as heavy metals and xenobiotics. These toxicants are known to exert strong selective pressure on the gut microbiome’s structure and diversity. For example, resistant microbial members are more likely to dominate in maintaining a stable microbiome, which is critical for bee health. Therefore, the aim of this study was to examine the Enterococcus faecium strains isolated from bee guts for their in vitro growth and tolerability to diverse heavy metals and xenobiotics. An additional aim was to analyze the genomes of E. faecium isolates to assess the molecular bases of resistance and compare them with E. faecium species isolated from other environmental sources.

Results

The E. faecium bee isolates were able to tolerate high levels (up to 200 mg/L) of toxicants, including cadmium, zinc, benzoate, phenol and hexane. Moreover, the isolates could tolerate toluene and copper at up to 100 mg/L. The genome of E. faecium Am5, isolated from the larval stage of Apis mellifera gut, was about 2.7 Mb in size, had a GC content of 37.9% and 2,827 predicted coding sequences. Overall, the Am5 genome features were comparable with previously sequenced bee-gut isolates, E. faecium Am1, Bee9, SM21, and H7. The genomes of the bee isolates provided insight into the observed heavy metal tolerance. For example, heavy metal tolerance and/or regulation genes were present, including czcD (cobalt/zinc/cadmium resistance), cadA (exporting ATPase), cutC (cytoplasmic copper homeostasis) and zur (zinc uptake regulation). Additionally, genes associated with nine KEGG xenobiotic biodegradation pathways were detected, including γ-hexachlorocyclohexane, benzoate, biphenyl, bisphenol A, tetrachloroethene, 1,4-dichlorobenzene, ethylbenzene, trinitrotoluene and caprolactam. Interestingly, a comparative genomics study demonstrated the conservation of toxicant resistance genes across a variety of E. faecium counterparts isolated from other environmental sources such as non-human mammals, humans, avians, and marine animals.

Conclusions

Honeybee gut-derived E. faecium strains can tolerate a variety of heavy metals. Moreover, their genomes encode many xenobiotic biodegradation pathways. Further research is required to examine E. faecium strains potential to boost host resistance to environmental toxins.
GMMAD: a comprehensive database of human gut microbial metabolite associations with diseases
Authors: Wang Cheng-Yu , Kuang Xia , Wang Qiao-Qiao , Zhang Gu-Qin , Cheng Zhen-Shun , Deng Zi-Xin , Guo Feng-Biao
Published: August 2023

Background

The natural products, metabolites, of gut microbes are crucial effect factors on diseases. Comprehensive identification and annotation of relationships among disease, metabolites, and microbes can provide efficient and targeted solutions towards understanding the mechanism of complex disease and development of new markers and drugs.

Results

We developedGutMicrobialMetaboliteAssociation withDisease (GMMAD), a manually curated database of associations among human diseases, gut microbes, and metabolites of gut microbes. Here, this initial release (i) contains 3,836 disease-microbe associations and 879,263 microbe-metabolite associations, which were extracted from literatures and available resources and then experienced our manual curation; (ii) defines an association strength score and a confidence score. With these two scores, GMMAD predicted 220,690 disease-metabolite associations, where the metabolites all belong to the gut microbes. We think that the positive effective (with both scores higher than suggested thresholds) associations will help identify disease marker and understand the pathogenic mechanism from the sense of gut microbes. The negative effective associations would be taken as biomarkers and have the potential as drug candidates. Literature proofs supported our proposal with experimental consistence; (iii) provides a user-friendly web interface that allows users to browse, search, and download information on associations among diseases, metabolites, and microbes. The resource is freely available athttp://guolab.whu.edu.cn/GMMAD.

Conclusions

As the online-available unique resource for gut microbial metabolite-disease associations, GMMAD is helpful for researchers to explore mechanisms of disease- metabolite-microbe and screen the drug and marker candidates for different diseases.
Related neural networks underlie suppression of emotion, memory, motor processes as identified by data-driven analysis
Authors: Hunt Karisa J. , Knight Lindsay K. , Depue Brendan E.
Published: August 2023

Background

Goal-directed behavior benefits from self-regulation of cognitive and affective processes, such as emotional reactivity, memory retrieval, and prepotent motor response. Dysfunction in self-regulation is a common characteristic of many psychiatric disorders, such as PTSD and ADHD. This study sought to determine whether common intrinsic connectivity networks (ICNs; e.g. default mode network) are involved in the regulation of emotion, motor, and memory processes, and if a data-driven approach using independent component analysis (ICA) would successfully identify such ICNs that contribute to inhibitory regulation.

Methods

Eighteen participants underwent neuroimaging while completing an emotion regulation (ER) task, a memory suppression (Think/No-Think; TNT) task, and a motor inhibition (Stop Signal; SS) task. ICA (CONN; MATLAB) was conducted on the neuroimaging data from each task and corresponding components were selected across tasks based on interrelated patterns of activation. Subsequently, ICNs were correlated with behavioral performance variables from each task.

Results

ICA indicated a common medial prefrontal network, striatal network, and frontoparietal executive control network, as well as downregulation in task-specific ROIs.

Conclusions

These results illustrate that common ICNs were exhibited across three distinct inhibitory regulation tasks, as successfully identified through a data-driven approach (ICA).
The national moroccan registry of ST-elevation myocardial infarction (MR-MI)
Authors: Soufiani Aida , Chraibi Hamza , Asfalou Ilyasse , Ouafi Noha El , Hattaoui Mustapha El , Habbal Rachida , Chaib Ali , Fellat Rokya , Akoudad Hafid , Benyass Aatif , Cherti Mohamed , Abouqal Redouane , Bendagha Nesma , Ztot Samir
Published: August 2023

Background

MR-MI is the first national Moroccan ST-elevation myocardial infarction (STEMI) registry. Its objectives are to assess patient management modalities and highlight the clinical and therapeutic characteristics of this pathology in all cardiology centres on a national scale.

Methods

Adult patients presenting with STEMI within 5 days of symptoms onset were enrolled over a period of 18 weeks from April to August 2018. 57 cardiology centres distributed in 22 cities in Morocco participated in the study, including 5 university hospitals, representing 70% of Moroccan centres managing STEMI patients. A case report form was sent to the investigators in both electronic and paper forms. Sociodemographic, clinical, management, revascularization, and follow-up data were collected.

Results

A total of 809 patients were recruited. The population was mostly male (74.8%) with an average age of 62.6 ± 11.6 years. The most common risk factors were smoking (38.3%) arterial hypertension (30.7%), and diabetes (28%). 30% of patients were admitted within the first 6 h of symptoms onset and early revascularization was performed on 49.6%. Mortality rate was 5.2% in-hospital and 3.2% at the one-month follow-up.

Conclusion

MR-MI is the first Moroccan STEMI registry on a national scale. Relevant management delays are much longer than other countries, and less than 50% of the patients that present on time benefit from early revascularization. Efforts remain to be done on the optimal diagnosis and treatment of STEMI.
Considerations for pooling real-world data as a comparator cohort to a single arm trial: a simulation study on assessment of heterogeneity
Authors: Backenroth Daniel , Royce Trevor , Pinheiro Jose , Samant Meghna , Humblet Olivier
Published: August 2023

Background

Novel precision medicine therapeutics target increasingly granular, genomically-defined populations. Rare sub-groups make it challenging to study within a clinical trial or single real-world data (RWD) source; therefore, pooling from disparate sources of RWD may be required for feasibility. Heterogeneity assessment for pooled data is particularly complex when contrasting a pooled real-world comparator cohort (rwCC) with a single-arm clinical trial (SAT), because the individual comparisons are not independent as all compare a rwCC to the same SAT. Our objective was to develop a methodological framework for pooling RWD focused on the rwCC use case, and simulate novel approaches of heterogeneity assessment, especially for small datasets.

Methods

We present a framework with the following steps: pre-specification, assessment of dataset eligibility, and outcome analyses (including assessment of outcome heterogeneity). We then simulated heterogeneity assessments for a binary response outcome in a SAT compared to two rwCCs, using standard methods for meta-analysis, and an Adjusted Cochran’s Q test, and directly comparing the individual participant data (IPD) from the rwCCs.

Results

We found identical power to detect a true difference for the adjusted Cochran’s Q test and the IPD method, with both approaches superior to a standard Cochran’s Q test. When assessing the impact of heterogeneity in the null scenario of no difference between the SAT and rwCCs, a lack of statistical power led to Type 1 error inflation. Similarly, in the alternative scenario of a true difference between SAT and rwCCs, we found substantial Type 2 error, with underpowered heterogeneity testing leading to underestimation of the treatment effect.

Conclusions

We developed a methodological framework for pooling RWD sources in the context of designing a rwCC for a SAT. When testing for heterogeneity during this process, the adjusted Cochran’s Q test matches the statistical power of IPD heterogeneity testing. Limitations of quantitative heterogeneity testing in protecting against Type 1 or Type 2 error indicate these tests are best used descriptively, and after careful selection of datasets based on clinical/data considerations. We hope these findings will facilitate the rigorous pooling of RWD to unlock insights to benefit oncology patients.
Prevalence and factors associated with a prescription of a Lyme borreliosis serology for erythema migrans diagnosis in general practice: a study from the French sentinel network, 2009–2020
Authors: Bonnet Camille , Figoni Julie , Souty Cécile , Septfons Alexandra , de Martino Sylvie , de Valk Henriette , Fournier Lucie , Hanslik Thomas , Jaulhac Benoît , Blanchon Thierry
Published: August 2023

Background

Serological testing of patients consulting for typical erythema migrans (EM) is not recommended in European recommendations for diagnosis of Lyme borreliosis (LB). Little is known on the level of adherence of French general practitioners to these recommendations. The objectives were to estimate the proportion of Lyme borreliosis serological test prescription in patients with erythema migrans seen in general practice consultations in France, and to study the factors associated with this prescription.

Methods

LB cases with an EM reported by the French general practitioners (GPs) of the Sentinelles network between January 2009 and December 2020 were included. To assess the associations with a prescription of a serological test, multilevel logistic regression models were used.

Results

Among the 1,831 EM cases included, a prescription for a LB serological test was requested in 24.0% of cases. This proportion decreased significantly over the study period, from 46.8% in 2009 to 15.8% in 2020. A LB serological prescription was associated with patients with no reported tick bite (Odds Ratio (OR): 1.95; 95% confidence interval [1.23–3.09]), multiple EM (OR: 3.82 [1.63–8.92]), EM of five centimeters or more (OR: 4.34 [2.33–8.08]), and GPs having diagnosed less than one EM case per year during the study period (OR: 5.28 [1.73–16.11]).

Conclusions

Serological testing of patients consulting for EM is not recommended in European recommendations for diagnosis of Lyme borreliosis. Therefore, the significant decrease in the rate of LB serological test for EM over the study period is encouraging. The factors identified in this study can be used to improve messaging to GPs and patients. Further efforts are needed to continue to disseminate diagnostic recommendations for LB to GPs, especially those who rarely see patients with EM.
Comprehensive geriatric assessment delivered by advanced nursing practitioners within primary care setting: a mixed-methods pilot feasibility randomised controlled trial
Authors: Safari Reza , Jackson Jessica , Boole Louise
Published: August 2023

Background

Comprehensive Geriatric Assessment (CGA)is a widely accepted intervention for frailty and can be cost-effective within a primary care setting.

Objective

To explore the feasibility of identifying older adults with frailty and assess the subsequent implementation of a tailored CGA with care and support plan by Advanced Nursing Practitioners (ANPs).

Methods

A mixed-method parallel randomised controlled trial was conducted. Participants were recruited from two General Practice (GP) centres between January and June 2019. Older adults with confirmed frailty, as assessed by practice nurses, were randomised, using a web service, to the intervention or treatment-as-usual (TAU) groups for six months with an interim and a final review. Data were collected on feasibility, health service usage, function, quality of life, loneliness, and participants' experience and perception of the intervention. Non-parametric tests were used to analyse within and between-group differences.P-values were adjusted to account for type I error. Thematic analysis of qualitative data was conducted.

Results

One hundred sixty four older adults were invited to participate, of which 44.5% (n = 72) were randomised to either the TAU (n = 37) or intervention (n = 35) groups. All participants in the intervention group were given the baseline, interim and final reviews. Eight participants in each group were lost to post-intervention outcome assessment. The health service use (i.e. hospital admissions, GP/emergency calls and GP/Accident Emergency attendance) was slightly higher in the TAU group; however, none of the outcome data showed statistical significance between-group differences. The TAU group showed a deterioration in the total functional independence and its motor and cognition components post-intervention (p < .05), though the role limitation due to physical function and pain outcomes improved (p < .05). The qualitative findings indicate that participants appreciated the consistency of care provided by ANPs, experienced positive therapeutic relationship and were connected to wider services.

Discussion

Frailty identification and intervention delivery in the community by ANPs were feasible. The study shows that older adults with frailty living in the community might benefit from intervention delivered by ANPs. It is suggested to examine the cost-effectiveness of the intervention in sufficiently powered future research.

Trial registrations

The protocol is available at clinicaltirals.gov, ID: NCT03394534; 09/01/2018.
Clinical characteristics and outcomes of COVID-19 patients with varying renal functions statuses during the Omicron pandemic in Shanghai
Authors: Xu Tian , Bao Zhiyao , Zhou Min , Wang Weiming
Published: August 2023

Objective

This study aims to provide an academic summary of the clinical characteristics, outcomes and risk factors associated with prolonged hospital stays among the patients with varying renal function statuses during the Omicron pandemic in Shanghai.

Methods

Clinical data was collected from COVID-19 patients admitted to Shanghai Jiaotong University School of Medicine Ruijin Hospital Northern District. Based on their baseline eGFR, the patients were divided into three groups: Group A (eGFR > = 90ml/min/1.73m2, n = 384), Group B (15ml/min/1.73m2 < = eGFR < 90ml/min/1.73m2, n = 220), and Group C (Hemodialysis-dependent patient, n = 92). Clinical characteristics and laboratory data were compared among the three groups. The cumulative hazards of ICU admission were compared using the Kaplan-Meier method. Univariate and multivariate linear regression analyses were conducted to identify the factors influencing the duration of positive nucleic acid test.

Results

Between March 25, 2022, and May 31, 2022, a total of 696 COVID-19 patients were included in the study. Among the dialysis patients, 92% (85) of dialysis patients had not received any COVID-19 vaccination, and 14.1%(13) of hemodialysis (HD) patients eventually progressed to severe or critical cases. A total of 13 (2.15%) patients were admitted to the ICU, with 8 (61.5%) were HD patients. The duration of nucleic acid positivity showed a negative correlation with eGFR (B: -0.048, 95%CI: -0.059~-0.037, P = 0.000), platelet counts (B: -0.011, 95%CI: -0.017~-0.005, P = 0.001) or lymphocyte counts (B: -0.658, 95%CI: -1.229~-0.086, P = 0.024).

Conclusions

The majority of Omicron patients have a favorable prognosis, while HD patients experience relatively poorer outcomes and higher rates of ICU admission. Decreased eGFR and low lymphocyte/platelet counts are the important risk factors associated with prolonged Omicron infection.
The correlation between serum uric acid and diabetic kidney disease in type 1 diabetes patients in Anhui, China
Authors: Jiang Jun , Zhou Xiaowan , Lan Lei , Ren Wei
Published: August 2023

Background/Aim

To assess the correlation between serum uric acid (UA) level and diabetic kidney disease (DKD) in Type 1 diabetes (T1DM) patients in Anhui, China.

Methods

A total of 231 patients diagnosed with T1DM in our hospital were enrolled between January 2014 and December 2016. Urinary albumin-creatinine ratio (ACR) in patients with hyperuricemia was compared with those without hyperuricemia. The relationship between serum UA level and urinary ACR was examined by Spearman's correlational analysis and multiple stepwise regression analysis. The binary logistic multivariate regression analysis was performed to analyze the correlated factors for type 1 DKD.

Results

The average serum UA levels were 257.7 [215.0, 338.0]μmol/L. The median levels of urinary ACR were significantly higher in patients with hyperuricemia than those without hyperuricemia. In multiple stepwise regression analysis, Serum UA levels were positively correlated with the urinary ACR. The logistic multivariate regression analysis showed that hyperuricemia (OR: 5.24, 95% CI: 1.40—19.65, P = 0.014) had an independent positive correlation with DKD in T1DM patients, and the odds of Serum UA to DKD were both elevated as the serum UA levels rose no matter whether adjustment for traditional confounders. The area under the receiver operating characteristic curve was 0.62 (95% CI: 0.55–0.70) in assessing the discrimination of the serum UA level for DKD in T1DM patients.

Conclusions

In Chinese patients with T1DM, the serum UA level is positively correlated with urinary ACR and DKD. The correlation between Serum UA and DKD gradually increases with serum UA levels. Serum UA level is not a good predictor for DKD in T1DM patients. Serum UA may directly contribute to initiating DKD, while it has little direct but an indirect effect on an already established DKD in T1DM patients.
Prenatal ultrasound manifestations of partial urorectal septum malformation sequence from the first trimester to postnatal: a case report
Authors: She Lingna , Lin Hualan , Huang Shuxian , Liu Lina , Chen Liyan
Published: August 2023

Background

Urorectal septum malformation sequence (URSMS) is characterized by incomplete partitioning of the genital, rectal, and urinary tracts, resulting in a severe form of anorectal malformation. The partial URSMS, also known as the persistent cloaca, represents a milder variant where a single perineal opening serves as a passage for the urinary, gastrointestinal, and reproductive tracts.

Case presentation

We present a rare case of partial URSMS accompanied by duplicated vagina and uterus, hydronephrosis, ascites, and anal atresia.

Conclusions

This case report describes the sonographic findings at different stages of pregnancy and their changes throughout gestation.
Health professional assisted Kangaroo mother care practice in Ethiopian health care facilities: evidence from the 2016 Ethiopian demographic and health survey
Authors: Kassaw Mesfin Wudu , Abebe Ayele Mamo , Abate Biruk Beletew , Kassie Ayelign Mengesha , Tegegne Kirubel Dagnaw
Published: August 2023

Background

Worldwide, 15 million children born prematurely every year and over one million of them died because of prematurity caused complications. However, three-fourths of deaths from preterm related complications are preventable by using Kangaroo Mother Care (KMC). The Ethiopian government has been implementing a guideline that declares putting all low birth weight neonates at KMC. The aim of this study was to assess health professionals’ assisted KMC practice and its associated factors among Ethiopian mothers who gave birth at health facilities.

Methodology

This study used the 2016Ethiopian Demographic and Health Survey data (EDHS). The 2016EDHS used a stratified two stage sampling method to select a representative sample using validated questioner. The sample we used in this study after cleaning the children’s data set from the 2016EDHS was 2,960. Logistic regression model was used to assess the association of health professional assisted KMC practice and predictor variables.

Results

Mothers who gave birth in health facilities and practiced kangaroo mother care were 1808(62.1%). In the multivariable logistic regression analysis, women from poorest (AOR, (95%CI)), (0.60, (0.43, 0.81)) and poorer (0.62, (0.46, 0.86)) socio-economic status were not practicing KMC.

Conclusions

The coverage of health professional assisted KMC practice was far lower than the expectation for mothers who gave birth in health facilities (100%). Low socio-economic status was associated with not practicing KMC. A further study on why mothers from low wealth index did not practicing KMC while they were in health facilities may be needed.
Increasing prevalence of mental disorders in smokers seeking treatment of tobacco dependence: a retrospective observational study
Authors: Zvolska Kamila , Tichopad Ales , Stepankova Lenka , Pankova Alexandra , Adamcekova Zuzana , Donin Gleb , Rafl Jakub , Kralikova Eva
Published: August 2023

Background

There has been a noticeable relative increase in psychiatric comorbidities among smokers as opposed to the general population. This is likely due to comparatively slower decrease in smoking prevalence among individuals with mental health conditions. This study aims to assess the prevalence trend of past or current mental health disorders in individuals seeking specialized smoking cessation assistance.

Methods

We conducted a retrospective single-centre observational study to assess the presence of mental disorders such as anxiety, depression, bipolar affective disorder, or schizophrenia in personal history of 6,546 smokers who sought treatment at the Centre for Treatment of Tobacco Dependence in Prague, Czech Republic between 2006 and 2019. The study examined the impact of gender, age, and the effect of successive years on the prevalence of the mental disorders using Poisson distribution regression.

Results

In the studied cohort, 1,743 patients (26.6%) reported having one or more mental disorders. Compared to patients without a psychiatric disorder, they exhibited similar levels of carbon monoxide in expired air (mean 17 ppm, SD 11 ppm) and scored one point higher on the Fagerström Test of Cigarette Dependence. Among smokers with a mental disorder, women were more prevalent (62%) than men (38%). The prevalence of mental disorders increased on average by 4% every year, rising from 23% in 2006 to 35% in 2019.

Conclusions

Consistent with the observation that the prevalence of smoking among people with any mental disorder is higher and declining at a slower rate than in the general population, there is a steadily increasing percentage of these patients seeking specialized treatment over time. Professionals who offer tobacco dependence treatment should be aware of the upward trend in psychiatric disorders among smokers, as more intensive treatment may be needed. Similarly, psychiatric care should pay attention to smoking of their patients.