bluuebunny/crossref_metadata_2025 huggingface dataset:
Record Setting Temperatures in the Setting of SARS-CoV-2 Suggests Dexmedetomidine Drug-Induced Fever: A Case Report
Authors: Meier Megan , Linn Becky S
Published: June 2024

Patients infected with COVID-19 can develop coinfections or acute respiratory disorder that result in ventilation. Dexmedetomidine is a common medication used to sedate ventilated patients in the intensive care unit and for nonintubated patients prior to a surgical procedure. As a highly selective alpha-2 agonist, dexmedetomidine provides sedation while reducing the need for anxiolytics or opioids. However, previous case reports suggest dexmedetomidine can induce fever in a variety of conditions. The purpose of this case report is to describe a patient who acquired a fever of 42.6°C in the setting of COVID-19 after administration of dexmedetomidine.
Pickleball-Related Fractures in the United States From 2002 to 2022: An Analysis Using the NEISS Database
Authors: Ghattas Yasmine S. , Zeblisky Peter , Cassinat Joshua , Aceto Matthew , Spindler Kurt P. , Cannada Lisa K.
Published: June 2024

Background:

Pickleball is one of the fastest-growing sports in the United States, with more than an 11-fold increase in injuries from 2010 to 2019.

Purpose:

To (1) determine the prevalence and demographic variables associated with pickleball-related fractures among patients evaluated at emergency departments in the United States between 2002 and 2022 and (2) identify variables influencing patient disposition status.

Study Design:

Descriptive epidemiology study.

Methods:

The US Consumer Product Safety and Commission's publicly available database, the National Electronic Injury Surveillance System (NEISS), was used in this study. Analyses consisted of descriptive statistics for fracture prevalence and demographic variables as well as univariate analysis for disposition status (discharged home vs hospital admission).

Results:

A total of 397 pickleball-related fractures were recorded between 2002 and 2022, which indicated a 90-fold increase in our study period. Based on weighted national average of NEISS sampling, this equated to approximately 5400 fractures annually. Players who sustained pickleball fractures were primarily aged >60 years (n = 344 [87%]; P < .001) and female (n = 273 [69%]; P < .001). Most fractures involved the upper extremity (n = 262 [66%]; P < .001), with the most common ones involving the radius (n = 79 [30%]), humerus (n = 22 [8%]), and ulna (n = 8 [3%]). Fractures were due most commonly to falls (n = 365 [92%]; P < .001) and occurred in the winter months (n = 142 [36%]; P < .001). There was a significant difference in disposition status, with most patients discharged (n = 320 [81%] vs n = 77 [19%] for hospital admission; P < .001). Univariate analysis revealed that age >60 years, male sex, and fractures to the trunk and lower extremity all led to significantly increased odds of being admitted (odds ratios: 2.27, 2.31, 2.89, and 13.8, respectively).

Conclusion:

Between 2002 and 2022, there was a 90-fold increase in pickleball-related fractures. Most fractures were of the upper extremity after a fall in women aged >60 years. Despite female fracture predominance, men were 2.3 times more likely to be admitted after sustaining a fracture.
Economic and Chronologic Optimization of Fecal Donors Screening Process
Authors: Levy Bar , Fliss Isakov Naomi , Ziv-Baran Tomer , Leshno Moshe , Maharshak Nitsan , Werner Lael
Published: June 2024

Background. Fecal microbial transplantation (FMT) is the delivery of fecal microbiome, isolated from healthy donors, into a patient’s gastrointestinal tract. FMT is a safe and efficient treatment for recurrent Clostridioides difficile infection. Donors undergo strict screening to avoid disease transmission. This consists of several blood and stool tests, which are performed in a multistage, costly process. We performed a cost-minimizing analysis to find the optimal order in which the tests should be performed. Methods. An algorithm to optimize the order of tests in terms of cost was defined. Performance analysis for disqualifying a potential healthy donor was carried out on data sets based on either the published literature or our real-life data. For both data sets, we calculated the total cost to qualify a single donor according to the optimal order of tests, suggested by the algorithm. Results. Applying the algorithm to the published literature revealed potential savings of 94.2% of the cost of screening a potential donor and 7.05% of the cost to qualify a single donor. In our cohort of 87 volunteers, 53 were not eligible for donation. Of 34 potential donors, 10 were disqualified due to abnormal lab tests. Applying our algorithm to optimize the order of tests, the average cost for screening a potential donor resulted in potential savings of 49.9% and a 21.3% savings in the cost to qualify a single donor. Conclusions. Improving the order and timing of the screening tests of potential FMT stool donors can decrease the costs by about 50% per subject.

Highlights

What is known: Fecal microbial transplantation (FMT) is the transfer of microbiome from healthy donors to patients. Fecal donors undergo multiple strict screening tests to exclude any transmissible disease. Screening tests of potential fecal donors is expensive and time consuming. FMT is the most efficient treatment for recurrent C difficile infection. What is new here: An algorithm to optimize the order of donors’ screening tests in terms of cost was defined. Optimizing the order tests can save nearly 50% in costs of screening a potential donor.
Nonlinear Characteristic Analysis of Gas-Interconnected Quasi-Zero Stiffness Pneumatic Suspension System: A Theoretical and Experimental Study
Authors: Jiang Xinwei , Xu Xing , Shi Tianling , Atindana Vincent Akolbire
Published: June 2024

Because of significantly changed load and complex and variable driving road conditions of commercial vehicles, pneumatic suspension with lower natural frequencies is widely used in commercial vehicle suspension system. However, traditional pneumatic suspension system is hardly to respond the greatly changed load of commercial vehicles. To address this issue, a new Gas-Interconnected Quasi-Zero Stiffness Pneumatic Suspension (GIQZSPS) is presented in this paper to improve the vibration isolation performance of commercial vehicle suspension systems under frequent load changes. This new structure adds negative stiffness air chambers on traditional pneumatic suspension to reduce the natural frequency of the suspension. It can adapt to different loads and road conditions by adjusting the solenoid valves between the negative stiffness air chambers. Firstly, a nonlinear mechanical model including the dimensionless stiffness characteristic and interconnected pipeline model is derived for GIQZSPS system. By the nonlinear mechanical model of GIQZSPS system, the force transmissibility rate is chosen as the evaluation index to analyze characteristics. Furthermore, a testing bench simulating 1/4 GIQZSPS system is designed, and the testing analysis of the model validation and isolating performance is carried out. The results show that compared to traditional pneumatic suspension, the GIQZSPS designed in the article has a lower natural frequency. And the system can achieve better vibration isolation performance under different load states by switching the solenoid valves between air chambers.
CAraCAl: CAMML with the integration of chromatin accessibility
Authors: Schiebout Courtney , Frost H. Robert
Published: June 2024

Background

A vital step in analyzing single-cell data is ascertaining which cell types are present in a dataset, and at what abundance. In many diseases, the proportions of varying cell types can have important implications for health and prognosis. Most approaches for cell type annotation have centered around cell typing for single-cell RNA-sequencing (scRNA-seq) and have had promising success. However, reliable methods are lacking for many other single-cell modalities such as single-cell sequencing assay for transposase-accessible chromatin (scATAC-seq), which quantifies the extent to which genes of interest in each cell are epigenetically “open” for expression.

Results

To leverage the informative potential of scATAC-seq data, we developed CAMML with the integration of chromatin accessibility (CAraCAl), a bioinformatic method that performs cell typing on scATAC-seq data. CAraCAl performs cell typing by scoring each cell for its enrichment of cell type-specific gene sets. These gene sets are composed of the most upregulated or downregulated genes present in each cell type according to projected gene activity.

Conclusions

We found that CAraCAl does not improve performance beyond CAMML when scRNA-seq is present, but if only scATAC-seq is available, CAraCAl performs cell typing relatively successfully. As such, we also discuss best practices for cell typing and the strengths and weaknesses of various cell annotation options.
Comparative transcriptome analysis reveals genes involved in trichome development and metabolism in tobacco
Authors: Chen Mingli , Li Zhiyuan , He Xinxi , Zhang Zhe , Wang Dong , Cui Luying , Xie Minmin , Zhao Zeyu , Sun Quan , Wang Dahai , Dai Jiameng , Gong Daping
Published: June 2024

Background

The glandular trichomes of tobacco (Nicotiana tabacum) can efficiently produce secondary metabolites. They act as natural bioreactors, and their natural products function to protect plants against insect-pests and pathogens and are also components of industrial chemicals. To clarify the molecular mechanisms of tobacco glandular trichome development and secondary metabolic regulation, glandular trichomes and glandless trichomes, as well as other different developmental tissues, were used for RNA sequencing and analysis.

Results

By comparing glandless and glandular trichomes with other tissues, we obtained differentially expressed genes. They were obviously enriched in KEGG pathways, such as cutin, suberine, and wax biosynthesis, flavonoid and isoflavonoid biosynthesis, terpenoid biosynthesis, and plant–pathogen interaction. In particular, the expression levels of genes related to the terpenoid, flavonoid, and wax biosynthesis pathway mainly showed down-regulation in glandless trichomes, implying that they lack the capability to synthesize certain exudate compounds. Among the differentially expressed genes, 234 transcription factors were found, including AP2-ERFs, MYBs, bHLHs, WRKYs, Homeoboxes (HD-ZIP), and C2H2-ZFs. These transcription factor and genes that highly expressed in trichomes or specially expressed in GT or GLT. Following the overexpression of R2R3-MYB transcription factor Nitab4.5_0011760g0030.1 in tobacco, an increase in the number of branched glandular trichomes was observed.

Conclusions

Our data provide comprehensive gene expression information at the transcriptional level and an understanding of the regulatory pathways involved in glandular trichome development and secondary metabolism.
Melody transcatheter pulmonary valve replacement: a single-center case series in Southeast Asia
Authors: Satawiriya Marin , Chandavimol Mann , Limsuwan Alisa
Published: June 2024

Background

Studies of transcatheter pulmonary valve replacement (TPVR) with the Melody valve have demonstrated good clinical and hemodynamic outcomes. Our study analyzes the midterm clinical and hemodynamic outcomes for patients who underwent Melody valve implantation in Southeast Asia.

Methods

Patients with circumferential conduits or bioprosthetic valves and experiencing post-operative right ventricular outflow tract (RVOT) dysfunction were recruited for Melody TPVR.

Results

Our cohort (n = 14) was evenly divided between pediatric and adult patients. The median age was 19 years (8–38 years), a male-to-female ratio of 6:1 with a median follow-up period of 48 months (16–79 months), and the smallest patient was an 8-year-old boy weighing 18 kg. All TPVR procedures were uneventful and successful with no immediate mortality or conduit rupture. The primary implant indication was combined stenosis and regurgitation. The average conduit diameter was 21 ± 2.3 mm. Concomitant pre-stenting was done in 71.4% of the patients without Melody valve stent fractures (MSFs). Implanted valve size included 22-mm (64.3%), 20-mm (14.3%), and 18-mm (21.4%). After TPVR, the mean gradient across the RVOT was significantly reduced from 41 mmHg (10–48 mmHg) to 16 mmHg (6–35 mmHg) at discharge, p < 0.01. Late follow-up infective endocarditis (IE) was diagnosed in 2 patients (14.3%). Overall freedom from IE was 86% at 79 months follow-up. Three patients (21.4%) developed progressive RVOT gradients.

Conclusion

For patients in Southeast Asia with RVOT dysfunction, Melody TPVR outcomes are similar to those reported for patients in the US in terms of hemodynamic and clinical improvements. A pre-stenting strategy was adopted and no MSFs were observed. Post-implantation residual stenosis and progressive stenosis of the RVOT require long term monitoring and reintervention. Lastly, IE remained a concern despite vigorous prevention and peri-procedural bacterial endocarditis prophylaxis.
Unravelling the Belgian cascade of hypertension care and its determinants: insights from a cross-sectional analysis
Authors: Bos Philippe , Wouters Edwin , Danhieux Katrien , van Olmen Josefien , Remmen Roy , Klipstein-Grobusch Kerstin , Boateng Daniel , Buffel Veerle
Published: June 2024

Background

Hypertension is a major risk factor for cardiovascular disease and all-cause mortality worldwide. Despite the widespread availability of effective antihypertensives, blood pressure (BP) control rates remain suboptimal, even in high-income countries such as Belgium. In this study, we used a cascade of care approach to identify where most patients are lost along the continuum of hypertension care in Belgium, and to assess the main risk factors for attrition at various stages of hypertension management.

Methods

Using cross-sectional data from the 2018 Belgian Health Interview Survey and the Belgian Health Examination Survey, we estimated hypertension prevalence among the Belgian population aged 40–79 years, and the proportion that was (1) screened, (2) diagnosed, (3) linked to care, (4) in treatment, (5) followed up and (6) well-controlled. Cox regression models were estimated to identify individual risk factors for being unlinked to hypertension care, untreated and not followed up appropriately.

Results

The prevalence of hypertension based on self-reported and measured high BP was 43.3%. While 98% of the hypertensive population had their BP measured in the past 5 years, only 56.7% were diagnosed. Furthermore, 53.4% were linked to care, 49.8% were in treatment and 43.4% received adequate follow-up. Less than a quarter (23.5%) achieved BP control. Among those diagnosed with hypertension, males, those of younger age, without comorbidities, and smokers, were more likely to be unlinked to care. Once in care, younger age, lower BMI, financial hardship, and psychological distress were associated with a higher risk of being untreated. Finally, among those treated for hypertension, females, those of younger age, and without comorbidities were more likely to receive no adequate follow-up.

Conclusion

Our results show that undiagnosed hypertension is the most significant barrier to BP control in Belgium. Health interventions are thus needed to improve the accurate and timely diagnosis of hypertension. Once diagnosed, the Belgian health system retains patients fairly well along the continuum of hypertension care, yet targeted health interventions to improve hypertension management for high-risk groups remain necessary, especially with regard to improving treatment rates.
The association between the child’s age and mothers’ physical activity: results from the population-based German National Cohort study
Authors: Scharfenberg Lisa , Negash Sarah , Kluttig Alexander , Mikolajczyk Rafael
Published: June 2024

Background

Since physical activity is an important determinant of physical and mental health, lower levels of physical activity among mothers reported in previous research are concerning. The aim of this study was to examine whether physical activity levels differ among mothers depending on the age of the youngest child.

Methods

Cross-sectional data from the German National Cohort study, comprising 3959 mothers aged 22–72 years with offspring aged 0–54 years (grouped into 0–5, 6–11, 12–17, 18–29 and > 30 years) was used. The Global Physical Activity Questionnaire (GPAQ) was used to assess physical activity among mothers in leisure time, transport and (occupational and non-occupational) work settings, quantified as MET-minutes per week. Means (with 95% confidence interval) of mothers’ weekly MET-minutes were visualized in graphs, stratified by mothers’ and the youngest child’s age. Linear regression analyses assessed the association between the child’s age and self-reported time and intensity of mothers’ physical activity within each activity domain and for the total physical activity.

Results

Adjusted results suggested that the MET-minutes in work settings were lower among mothers with younger children. This association was clearest in mothers whose youngest child was under 12 years old, among whom lower self-reported physical activity at work compared to mothers with children at age 30 and older was found. No association was observed between the age of the youngest child and mothers’ MET-minutes in leisure nor in transport settings. The self-reported physical activity of mothers whose youngest child was in the same child age group was found to be lower with increased maternal age. As expected, the work related activity dominated the self-reported physical activity.

Conclusions

The results show differences in mothers’ self-reported physical activity by the age of the youngest child. The strongest difference was related to physical activity in work settings, indicating the need for supportive actions.
Systemic inflammatory biomarkers are novel predictors of all-cause and cardiovascular mortality in individuals with osteoarthritis: a prospective cohort study using data from the NHANES
Authors: Zhou Erye , Wu Jian , Zhou Xin , Yin Yufeng
Published: June 2024

Background

Chronic inflammation may contribute to increased mortality risk in individuals with osteoarthritis (OA), but research on the prognostic value of inflammatory biomarkers is limited. We aimed to evaluate the associations of the systemic immune–inflammation index (SII) and systemic inflammation response index (SIRI) with all-cause and cardiovascular mortality among US adults with OA.

Methods

This cohort study included 3545 adults with OA aged ≥ 20 years from the National Health and Nutrition Examination Survey 1999–2020. The SII and SIRI were calculated using complete blood cell count data. Participants were categorized as having a higher or lower SII and SIRI using cutoff points derived by the maximally selected rank statistics method. Cox proportional hazards models, Fine–Gray competing risk regression models and time-dependent receiver operating characteristic (ROC) analysis were used to evaluate the associations between the SII/SIRI and mortality in OA patients.

Results

Over a median follow-up of 5.08 (3.42–9.92) years, 636 (17.94%) deaths occurred, including 149 (4.20%) cardiovascular deaths. According to multivariable-adjusted models involving demographic, socioeconomic, and health factors, OA patients with a higher SII had a twofold greater risk of all-cause mortality than patients with a lower SII (HR 2.01; 95% CI: 1.50–2.68). Similarly, a higher SIRI was associated with an 86% increased risk of all-cause mortality relative to a lower SIRI (HR 1.86; 95% CI: 1.46–2.38). Similar to the trend found with all-cause mortality, patients with an elevated SII and SIRI had a 88% and 67% increased risk of cardiovascular mortality, respectively, compared to patients with a lower SII (HR 1.88; 95% CI: 1.16–3.03) and SIRI (HR 1.67; 95% CI: 1.14–2.44). Time-dependent ROC curves showed that both the SII and SIRI have moderate and valid performance in predicting short- and long-term mortality in patients with OA.

Conclusions

Higher SII and SIRI values were associated with greater all-cause and cardiovascular mortality among US adults with OA.
Work-related musculoskeletal disorders among desludging operators in Uganda
Authors: Tamale Bridget Nagawa , Ssekamatte Tonny , Isunju John Bosco , Nalugya Aisha , Mukasa Mujjabi Martin , Tigaiza Arnold , Nakalembe Doreen , Kansiime Winnifred K. , Kimbugwe Ceaser , Mselle Jane Sembuche , Mugambe Richard K.
Published: June 2024

Background

Despite the limited evidence, desludging operators remain at a heightened risk of work-related musculoskeletal disorders (WMSDs). This study established the prevalence and predictors of WMSDs among desludging operators in Uganda.

Methods

A digitalized structured questionnaire was used to collect cross-sectional data on musculoskeletal disorders and routine workplace activities from 303 desludging operators in 11 cities in Uganda. These cities were purposively selected based on the presence of a fecal sludge treatment plant or wastewater treatment plant. The Nordic Musculoskeletal Questionnaire (NMQ) was used to assess WMSDs. Simple random sampling with replacements was used to select respondents. Data were analyzed using STATA version 15.0. Modified Poisson Regression was used to measure the strength of association between the independent variables and WMSDs.

Results

A total of 303 study participants were interviewed (97.7% response rate). The average age of the respondents was 34.0 years (SD ± 9.8). The prevalence of WMSDs among desludging operators was 29.7%. The body parts affected by MSDs were; the elbow for 4.6% (14/303), shoulder for 5.0% (15/303), and wrist/hand for 6.3% (19/303) of the respondents. At multivariable analysis, after controlling for age, desludging operators’ ability to influence the availability of equipment needed to do their work (APR = 0.45, 95% CI: 0.20–0.99), and feeling that everything done was an effort (APR = 1.70, 95% CI: 1.01–2.87) were significantly associated with WMSDs.

Conclusion

The prevalence of WMSDs was high among desludging operators in Uganda. Desludging operators’ ability to influence the availability of equipment needed to do their work and frequency of feeling that everything done was an effort were significantly associated with WMSDs. Interventions should focus on ensuring adequate provision of ergonomic equipment and promoting practices that reduce the physical strain associated with desludging tasks. Additionally, comprehensive training programs addressing proper lifting techniques and posture awareness could significantly mitigate the risk of WMSDs among desludging-operators.
A distinct dimer configuration of a diatom Get3 forming a tetrameric complex with its tail-anchored membrane cargo
Authors: Chen Chi-Chih , Huang Yu-Ru , Chan Yuen Ting , Lin Hung-Yun , Lin Han-Jia , Hsiao Chwan-Deng , Ko Tzu-Ping , Lin Tai-Wen , Lan Ya-Hsuan , Lin Hsuan-Ya , Chang Hsin-Yang
Published: June 2024

Background

Most tail-anchored (TA) membrane proteins are delivered to the endoplasmic reticulum through a conserved posttranslational pathway. Although core mechanisms underlying the targeting and insertion of TA proteins are well established in eukaryotes, their role in mediating TA protein biogenesis in plants remains unclear. We reported the crystal structures of algal arsenite transporter 1 (ArsA1), which possesses an approximately 80-kDa monomeric architecture and carries chloroplast-localized TA proteins. However, the mechanistic basis of ArsA2, a Get3 (guided entry of TA proteins 3) homolog in plants, for TA recognition remains unknown.

Results

Here, for the first time, we present the crystal structures of the diatom Pt-Get3a that forms a distinct ellipsoid-shaped tetramer in the open (nucleotide-bound) state through crystal packing. Pulldown assay results revealed that only tetrameric Pt-Get3a can bind to TA proteins. The lack of the conserved zinc-coordination CXXC motif in Pt-Get3a potentially leads to the spontaneous formation of a distinct parallelogram-shaped dimeric conformation in solution, suggesting a new dimer state for subsequent tetramerization upon TA targeting. Pt-Get3a nonspecifically binds to different subsets of TA substrates due to the lower hydrophobicity of its α-helical subdomain, which is implicated in TA recognition.

Conclusions

Our study provides new insights into the mechanisms underlying TA protein shielding by tetrameric Get3 during targeting to the diatom’s cell membrane.
MicroRNA-98: the multifaceted regulator in human cancer progression and therapy
Authors: Hazari Vajihe , Samali Sahar Ahmad , Izadpanahi Payam , Mollaei Homa , Sadri Farzad , Rezaei Zohreh
Published: June 2024

MicroRNA-98 (miR-98) stands as an important molecule in the intricate landscape of oncology. As a subset of microRNAs, these small non-coding RNAs have accompanied a new era in cancer research, underpinning their significant roles in tumorigenesis, metastasis, and therapeutic interventions. This review provides a comprehensive insight into the biogenesis, molecular properties, and physiological undertakings of miR-98, highlighting its double-edged role in cancer progression—acting both as a tumor promoter and suppressor. Intriguingly, miR-98 has profound implications for various aspects of cancer progression, modulating key cellular functions, including proliferation, apoptosis, and the cell cycle. Given its expression patterns, the potential of miR-98 as a diagnostic and prognostic biomarker, especially in liquid biopsies and tumor tissues, is explored, emphasizing the hurdles in translating these findings clinically. The review concludes by evaluating therapeutic avenues to modulate miR-98 expression, addressing the challenges in therapy resistance, and assessing the efficacy of miR-98 interventions. In conclusion, while miR-98’s involvement in cancer showcases promising diagnostic and therapeutic avenues, future research should pivot towards understanding its role in tumor-stroma interactions, immune modulation, and metabolic regulation, thereby unlocking novel strategies for cancer management.

Graphical Abstract
Prognostics of multiple malaria episodes and nutritional status in children aged 6 to 59 months from 2013 to 2017 in Dangassa, Koulikoro region, Mali
Authors: Keita Soumba , Thiero Oumar , Toure Mahamoudou , Kane Fousseyni , Keita Moussa , Sanogo Ibrahim , Konate Drissa , Sanogo Daouda , Diawara Sory Ibrahim , Coulibaly Hamady , Thiam Sidibé M.’Baye , Sogoba Nafomon , Diakite Mahamadou , Doumbia Seydou
Published: June 2024

Background

In Africa, the relationship between childhood nutritional status and malaria remains complex and difficult to interpret. Understanding it is important in the improvement of malaria control strategies. This study aimed to assess the influence of nutritional status on the occurrence of multiple malaria episodes in children aged 6 to 59 months between 2013 and 2017 living in the village of Dangassa, Mali.

Methods

A community-based longitudinal study was conducted using cross-sectional surveys (CSSs) at the beginning (June) and end (November) of the malaria transmission season associated with passive case detection (PCD) at the Dangassa Community Health Centre. Children with asymptomatic malaria infection during cross-sectional surveys were selected and their malaria episodes followed by PCD. Malaria indicators in person-months were estimated using an ordinal-logistic model repeated on subjects during follow-up periods.

Results

The incidence rate (IR) during the period of high transmission (June to October), for 1 episode and for 2 + episodes peaked in 2013 with 65 children (IR = 95.73 per 1000 person-months) and 24 cases (IR = 35.35 per 1000 person-months), respectively. As expected, the risk of multiple episodes occurring during the period of high transmission was 3.23 compared to the period of low transmission after adjusting for other model parameters (95% CI [2.45–4.26], p = 0.000). Children with anaemia were at high risk of having multiple episodes (OR = 1.6, 95% CI [1.12–2.30], p = 0.011). However, the risk of having 2 + episodes for anemic children was higher during the period of low transmission (RR = 1.67, 95% CI [1.15–2.42], p = 0.007) compared to the period of high transmission (RR = 1.58, 95% CI [1.09–2.29], p = 0.016). The trend indicated that anemic and underweight children were significantly associated with multiple malaria episodes during the period of low transmission (p < 0.001).

Conclusion

Results show that multiple episodes of malaria are significantly related to the nutritional status (anaemia and underweight) of the child during the two transmission seasons and more pronounced during the dry season (period of low transmission). Further research including other malnutrition parameters will be needed to confirm these findings.
Struggling to resume childhood vaccination during war in Myanmar: evaluation of a pilot program
Authors: Poe April , Emily  , Aurora  , Aung Hein Thura , Reh Alfred Saw Ei , Grissom Brianna , Tinoo Cynthie , Fishbein Daniel B.
Published: June 2024

Background

After the military coup in Myanmar in February 2021, the health system began to disintegrate when staff who called for the restoration of the democratic government resigned and fled to states controlled by ethnic minorities. The military retaliated by blocking the shipment of humanitarian aid, including vaccines, and attacked the ethnic states. After two years without vaccines for their children, parents urged a nurse-led civil society organization in an ethnic state to find a way to resume vaccination. The nurses developed a vaccination program, which we evaluated.

Methods

A retrospective cohort study and participatory evaluation were conducted. We interviewed the healthcare workers about vaccine acquisition, transportation, and administration and assessed compliance with WHO-recommended practices. We analyzed the participating children’s characteristics. We calculated the proportion of children vaccinated before and after the program. We calculated the probability children would become up-to-date after the program using inverse survival.

Results

Since United Nations agencies could not assist, private donations were raised to purchase, smuggle into Myanmar, and administer five vaccines. Cold chain standards were maintained. Compliance with other WHO-recommended vaccination practices was 74%. Of the 184 participating children, 145 (79%, median age five months [IQR 6.5]) were previously unvaccinated, and 71 (41%) were internally displaced. During five monthly sessions, the probability that age-eligible zero-dose children would receive the recommended number of doses of MMR was 92% (95% confidence interval [CI] 83–100%), Penta 87% (95% CI 80%–94%); BCG 76% (95% CI 69%–83%); and OPV 68% (95% CI 59%–78%). Migration of internally displaced children and stockouts of vaccines were the primary factors responsible for decreased coverage.

Conclusions

This is the first study to describe the situation, barriers, and outcomes of a childhood vaccination program in one of the many conflict-affected states since the coup in Myanmar. Even though the proportion of previously unvaccinated children was large, the program was successful. While the target population was necessarily small, the program’s success led to a donor-funded expansion to 2,000 children. Without renewed efforts, the proportion of unvaccinated children in other parts of Myanmar will approach 100%.
Supporting Ontario public health units to address adverse childhood experiences in pandemic recovery planning: A priority-setting exercise
Authors: Harding Kimberly B. , Di Ruggiero Erica , Gonzalez Erick , Hicks Amanda , Harrington Daniel W. , Carsley Sarah
Published: June 2024

Background

Adverse childhood experiences (ACEs) are potentially traumatic exposures experienced during childhood, for example, neglect. There is growing evidence that the coronavirus disease 2019 (COVID-19) pandemic and related socioeconomic conditions contributed to an increased risk of ACEs. As public health programs/services are re-evaluated and restored following the state of emergency, it is important to plan using an ACEs-informed lens. The aim of this study was to identify and prioritize initiatives or activities that Public Health Ontario (PHO) could undertake to support Ontario public health units’ work towards ACEs-informed pandemic recovery plans.

Methods

The Child Health and Nutrition Research Initiative method was adapted to conduct a priority-setting exercise (May–October 2022). Two online surveys were administered with members of the Healthy Growth and Development (HGD) Evidence Network, comprised of public health unit staff working in child and family health/HGD from Ontario’s 34 public health units. In the first survey, participants were asked to propose activities or initiatives that PHO could undertake to support Ontario public health units’ work towards ACEs-informed planning. In the second survey, participants were asked to score the final list of options against pre-determined prioritization criteria (for example, relevance). Responses were numerically coded and used to calculate prioritization scores, which were used to rank the options.

Results

In all, 76% of public health units (n = 26) responded to the first survey to identify options. The 168 proposed ideas were consolidated into a final list of 13 options, which fall under PHO’s scientific and technical support mandate areas (data and surveillance, evidence synthesis, collaboration and networking, knowledge exchange and research). A total of 79% of public health units (n = 27) responded to the follow-up survey to prioritize options. Prioritization scores ranged from 76.4% to 88.6%. The top-ranked option was the establishment of a new provincial ACEs community of practice.

Conclusions

Over three quarters of public health units contributed to identifying and ranking 13 options for PHO to support public health units in considering and addressing ACEs through pandemic recovery planning. In consultation with the ACEs and Resilience Community of Practice, recently formed on the basis of this exercise, PHO will continue to use the ranked list of options to inform work-planning activities/priorities.
Wnt/β-catenin signaling in the development and therapeutic resistance of non-small cell lung cancer
Authors: Zhang Zixu , Westover David , Tang Zhantong , Liu Yue , Sun Jinghan , Sun Yunxi , Zhang Runqing , Wang Xingyue , Zhou Shihui , Hesilaiti Nigaerayi , Xia Qi , Du Zhenfang
Published: June 2024

Wnt/β-catenin signaling is a critical pathway that influences development and therapeutic response of non-small cell lung cancer (NSCLC). In recent years, many Wnt regulators, including proteins, miRNAs, lncRNAs, and circRNAs, have been found to promote or inhibit signaling by acting on Wnt proteins, receptors, signal transducers and transcriptional effectors. The identification of these regulators and their underlying molecular mechanisms provides important implications for how to target this pathway therapeutically. In this review, we summarize recent studies of Wnt regulators in the development and therapeutic response of NSCLC.
Nutritional counselling and risk factors for obesity: an observational study in toddlers
Authors: Limauro Raffaele , Cioffi Luigi , Bianco Vincenzo , Caruso Vincenzo , Casani Antonella , Del Gaizo Donatella , Esposito Aldo , Farris Evelina , Gallo Patrizia , Giuliano Maria , Iannone Agnese , Izzo Annamaria , La Vecchia Maria Teresa , Raineri Luca , Sabetti Patrizia , Sassi Roberto , Servodidio Carmela , Sorice Nunziatina , Cioffi Valentina , Antignani Angelo , Valerio Giuliana
Published: June 2024

Background

Nutrition exerts a fundamental role in the prevention of obesity (OB). The aim of this study was to assess the extent to which well recognized risk factors for early OB can be associated to overweight (OW) or OB under a standardized nutritional approach and surveillance in toddlers.

Methods

The eligible population was represented by 676 toddlers aged 24–36 months, assigned to 18 primary care pediatricians trained on nutritional issues who shared a standardized nutritional approach. Six-hundred-twenty-nine children (333 boys), mean age 27.8 ± 4.2 months were effectively included in this observational study. Parents received nutritional advice with particular emphasis to proteins and sugar composition supported by leaflets and reinforced at each visit. Body mass index was assessed at the age of 24–36 months. The following individual and family risk factors were considered: gestational age, birth weight, eutocic/caesarean delivery, milk feeding history, household smoking or antibiotics exposure, parents’ weight, height and educational level. Prevalence of OW/OB was compared to a group of 742 toddlers (373 boys) under usual care.

Results

Under a standardized nutritional counselling, 28.1% toddlers were classified as OW/OB compared to 36.9% toddlers under usual care (p = 0.005). In unadjusted models, parental OW/OB was significantly associated to OW/OB in toddlers (p < 0.01), while high birth weight did not reach statistical significance (p = 0.07). In adjusted models, including all the explanatory variables studied, only paternal OW/OB vs. normal weight was significantly associated to OW/OB in toddlers (OR 2.035, 95% confidence interval 1.206–3.436). No protective effect of exclusive breast feeding during the first 6 months of age was demonstrated.

Conclusions

Toddlers under a standardized nutrition counselling focused to limit protein and simple sugars, showed lower prevalence of OW/OB compared to usual care. Healthy promotion activities should take into account the influence of paternal BMI on the offspring adiposity.
Trends in chemotherapy use for early-stage breast cancer from 2006 to 2019
Authors: Bhimani Jenna , O’Connell Kelli , Ergas Isaac J. , Foley Marilyn , Gallagher Grace B. , Griggs Jennifer J. , Heon Narre , Kolevska Tatjana , Kotsurovskyy Yuriy , Kroenke Candyce H. , Laurent Cecile. A. , Liu Raymond , Nakata Kanichi G. , Persaud Sonia , Rivera Donna R. , Roh Janise M. , Tabatabai Sara , Valice Emily , Bowles Erin J.A. , Bandera Elisa V. , Kushi Lawrence H. , Kantor Elizabeth D.
Published: June 2024

Background

Little is known about how use of chemotherapy has evolved in breast cancer patients. We therefore describe chemotherapy patterns for women with stage I-IIIA breast cancer in the Optimal Breast Cancer Chemotherapy Dosing (OBCD) Study using data from KPNC (Kaiser Permanente Northern California) and KPWA (Kaiser Permanente Washington).

Findings

Among 33,670 women, aged 18 + y, diagnosed with primary stage I-IIIA breast cancer at KPNC and KPWA from 2006 to 2019, we explored patterns of intravenous chemotherapy use, defined here as receipt of intravenous cytotoxic drugs and/or anti-HER2 therapies. We evaluated trends in chemotherapy receipt, duration over which chemotherapy was received, and number of associated infusion visits. In secondary analyses, we stratified by receipt of anti-HER2 therapies (trastuzumab and/or pertuzumab), given their longer duration. 38.9% received chemotherapy intravenously, declining from 40.2% in 2006 to 35.6% in 2019 (p-trend < 0.001). Among 13,089 women receiving chemotherapy, neoadjuvant treatment increased (4.1–14.7%; p-trend < 0.001), as did receipt of anti-HER2 therapies (20.8–30.9%) (p-trend < 0.001). The average treatment duration increased (5.3 to 6.0 months; p-trend < 0.001), as did the number of infusion visits (10.8 to 12.5; p-trend < 0.001). For those receiving anti-HER2 therapies, treatment duration and average number of visits decreased; among those not receiving anti-HER2 therapies, number of visits increased, with no change in duration.

Conclusions

While the prevalence of chemotherapy receipt has decreased over time, the use of neoadjuvant chemotherapy has increased, as has use of anti-HER2 therapies; duration and number of administration visits have also increased. Understanding these trends is useful to inform clinical and administrative planning.
Dose-response relationship of MSCs as living Bio-drugs in HFrEF patients: a systematic review and meta-analysis of RCTs
Authors: Ahmed Ziyad T. , Zain Al-Abeden Maha Saad , Al Abdin Mohamed Ghaith , Muqresh Mohamad Ayham , Al Jowf Ghazi I. , Eijssen Lars M. T. , Haider Khawaja Husnain
Published: June 2024

Background

Mesenchymal stem cells (MSCs) have emerged as living biodrugs for myocardial repair and regeneration. Recent randomized controlled trials (RCTs) have reported that MSC-based therapy is safe and effective in heart failure patients; however, its dose-response relationship has yet to be established. We aimed to determine the optimal MSC dose for treating HF patients with reduced ejection fraction (EF) (HFrEF).

Methods

The preferred reporting items for systematic reviews and meta-analyses (PRISMA) and Cochrane Handbook guidelines were followed. Four databases and registries, i.e., PubMed, EBSCO, clinicaltrials.gov, ICTRP, and other websites, were searched for RCTs. Eleven RCTs with 1098 participants (treatment group, n = 606; control group, n = 492) were selected based on our inclusion/exclusion criteria. Two independent assessors extracted the data and performed quality assessments. The data from all eligible studies were plotted for death, major adverse cardiac events (MACE), left ventricular ejection fraction (LVEF), left ventricular end-systolic volume (LVESV), and 6-minute walk distance (6-MWD) as safety, efficacy, and performance parameters. For dose-escalation assessment, studies were categorized as low-dose (< 100 million cells) or high-dose (≥ 100 million cells).

Results

MSC-based treatment is safe across low and high doses, with nonsignificant effects. However, low-dose treatment had a more significant protective effect than high-dose treatment. Subgroup analysis revealed the superiority of low-dose treatment in improving LVEF by 3.01% (95% CI; 0.65–5.38%) compared with high-dose treatment (-0.48%; 95% CI; -2.14-1.18). MSC treatment significantly improved the 6-MWD by 26.74 m (95% CI; 3.74–49.74 m) in the low-dose treatment group and by 36.73 m (95% CI; 6.74–66.72 m) in the high-dose treatment group. The exclusion of studies using ADRCs resulted in better safety and a significant improvement in LVEF from low- and high-dose MSC treatment.

Conclusion

Low-dose MSC treatment was safe and superior to high-dose treatment in restoring efficacy and functional outcomes in heart failure patients, and further analysis in a larger patient group is warranted.
Comparative examination of analytical instruments for detecting pentachlorophenol in wood and environmental samples
Authors: Koushika K. , He Quan , Niati H. , Emenike C. U.
Published: June 2024

Pentachlorophenol (PCP) is a manmade chemical that is widely present in the environment and is mostly used as a wood preservative. Therefore, to conduct remediation studies, it is imperative to determine the most effective PCP analytical technique. PCP can be analyzed using a variety of analytical tools, including non-destructible methods like X-ray fluorescence spectrometry (XRF) and electrochemical sensors (EC), destructible tools like gas chromatography (GC), thin layer chromatography (TLC), colorimetry, ultraviolet–visible and infrared spectroscopy (UV–vis/IR), and high-performance liquid chromatography (HPLC). the colorimetric approach is less recommended because of its low sensitivity and precision, whereas TLC offers superior recovery rates and precision but is expensive, takes longer, and is unable to resolve complicated combinations. Higher recovery rates, sensitivity, precision, and superior separation are all offered by HPLC; however, its effectiveness is impacted by time, money, and solvent compatibility. The most favored destructible approach is GC because it is efficient in terms of both cost and time and offers superior precision and separation. Although XRF is frequently used in the wood industry to test PCP in treated wood and treating solutions, scientific research has avoided using it because of its high cost and ability to identify chemicals based only on their elemental composition—in the case of PCP, it is chloride. Among all methods, EC is shown to be more dependable than the other methods listed because it is extremely specialized, less expensive, and offers a faster response. It is possible to make more changes to the current analytical techniques, such as enhancing extraction techniques, creating a universal HPLC column, developing more affordable and high-precision EC electrodes, and evaluating a larger variety of samples from different matrices. This review has shed light on the many analytical tools available for determining PCP and the knowledge gaps in the field of study.
Current Advances in the Management of Nonurothelial Subtypes of Bladder Cancer
Authors: Vlachou Evangelia , Johnson Burles Avner , Baraban Ezra , Nadal Rosa , Hoffman-Censits Jean
Published: June 2024

Urothelial cancer (UC) is the most common histology seen in bladder tumors. The 2022 WHO classification of urinary tract tumors includes a list of less common subtypes (formerly known as variants) for invasive UC which are considered high-grade tumors. This review summarizes the most recent advances in the management of selected nonurothelial subtypes of bladder cancer: squamous cell carcinoma, small cell carcinoma, sarcomatoid urothelial carcinoma, micropapillary carcinoma, plasmacytoid carcinoma, adenocarcinoma, and urachal carcinoma. The role of neoadjuvant and adjuvant chemotherapy has not been well characterized for most of these histologies, and prospective data are extremely limited. Participation in clinical trials is recommended in advanced disease.