bluuebunny/crossref_metadata_2025 huggingface dataset:
Adrenal crisis as initial manifestation of bilateral adrenal hemorrhage due to antiphospholipid syndrome: A case report
Authors: Diana Henao , Diana Romero , Daniela Rosero , Oscar Lucero
Published: June 2023

A 62-year-old man was admitted to the emergency department with hypotension and altered consciousness. On physical examination, he had hyperpigmentation of the skin and mucous membranes. Admission tests revealed hypoglycemia, hyponatremia, and hyperkalemia. Fluid resuscitation was initiated with no improvement in blood pressure. Because adrenal crisis was suspected, blood samples for cortisol and adrenocorticotropic hormone were collected before commencing hydrocortisone, after which blood pressure improved and electrolyte disturbances disappeared. The tests revealed decreased serum cortisol and an increase in adrenocorticotropic hormone. A magnetic resonance imaging scan of the abdomen revealed evidence of bilateral adrenal hemorrhage. Positive antiphospholipid antibodies were detected during the investigations. This case underscores the importance of prompt evaluation of clinical signs and symptoms that may indicate adrenal crisis.
Elasticity for computable (re)insurance
Authors: Ma Megan , Galka Klaudia
Published: June 2023

Elasticity offers contractual parties the linguistic space to manage the unknown. While this has historically operated as a powerful tool in negotiation, elasticity has also behaved as a double-edged sword. That is, elastic language facilitates the present, but does not account for the future. In this article, we consider that by understanding the role of vagueness in contracts, and in effect, making the implicit explicit, it may be more rewarding strategically for contractual parties in the long term. Specific to the context of reinsurance, we notice that elasticity may be regarded as a mirror to negotiation dynamics, traceable by the linguistic complexity of contractual clauses. Therefore, a determination of elasticity, through a diagnostic tool, can offer insights to enable for more intentional drafting and certainty at the contract performance stage.
After 30 Years, What Has Happened to Activity-Based Costing? A Systematic Literature Review
Authors: Sánchez-Rebull Maria-Victòria , Niñerola Angels , Hernández-Lara Ana-Beatriz
Published: June 2023

After more than 30 years of using Activity-Based Costing (ABC) to determine costs, just a few studies have analyzed its publications. This article aims to conduct a systematic, comprehensive literature review analyzing papers on ABC to overview what has been researched and give future research directions. The study includes descriptive, relational and content analyses of 1,260 articles retrieved from Scopus over 32 years (1988–2019). Our research shows publication trends, the most influential journals, authors and countries, citations, H-index, authorship, objectives, keywords co-occurrences, and research methods. Moreover, twelve objective categories are proposed. The results show a still-growing interest in ABC, especially in health and manufacturing, where there have been more practical applications. The case study is the most used research methodology, and the United States is the leading country regarding academic productivity and citations. The study provides useful information for professionals and business managers, and academics.
Covering the 2020 Tokyo Olympics as the Recovery Olympics After Fukushima
Authors: Abe Yasuhito
Published: June 2023

This article examines how major Japanese national newspapers - t he Asahi Shimbun, the Mainichi Shimbun, the Yomiuri Shimbun, the Nihon Keizai Shimbun, and the Sankei Shimbun - discussed the 2020 Tokyo Olympics as the “Recovery Olympics” in relation to radioactive materials as a key post-Fukushima environmental contamination issue. Although many scholars have critically examined the concept of the Recovery Olympics in the context of the Great East Japan Earthquake, Tsunami, and Fukushima Daiichi nuclear disaster, this study employs Beck’s risk society and Boykoff’s celebration capitalism theories to distinguish between the recovery discourses of the earthquake and tsunami versus the Fukushima disaster. It then explores the media’s depiction of the Recovery Olympics in relation to radioactive contamination. Using Fairclough’s dialectical-relational approch to critical discourse analysis, this study demonstrates that the leading Japanese national newspapers localized the issue of post-Fukushima environmental contamination within Fukushima Prefecture, thereby obscuring broader impacts for the Olympics. Additionally, it uncovers how these newspapers emphasized safety standards, transforming post-Fukushima environmental contamination below such standards into a symbol legitimizing the Recovery Olympics.
Effect of Land Allocation on Agricultural Productivity in Nigeria Using ARDL Approach to Cointegration
Authors: Okunola Akinbode
Published: June 2023

To test the validity of the inverse relationship between land productivity and land size within the context of Nigeria, this study employed the use of Autoregressive Distributed Lag (ARDL) model to test for the presence of long-run relationship between the two variables using data from 1980 to 2017 sourced from the Food and Agriculture Organisation. Prior to the test for cointegration, the Modified Granger Causality of the Toda and Yamamoto (1995) was used to test for the causality to be sure that causality indeed runs from land size to land productivity. The Granger Causality confirmed that land size Granger-cause land productivity. Given this result, the semi-log ARDL model was estimated to test for cointegration and also estimate the elasticity of the relationship in both the short and long runs. The result showed that while land size has inverse relationship with land productivity in both the short and long run, its influence in determining yield was only significant in the short run. The Error Correction Term, ECT(−1) which is the speed of adjustment of short-run disequilibrium to long-run steady state was both negative and significant, implying that there is going to be convergence to long-run equilibrium at the speed of about 24%.
Non-shunt Management of Communicating Hydrocephalus in an Immunocompetent Host With Disseminated Central Nervous System Coccidioidomycosis
Authors: Menghani Sanjay V. , Takamatsu Chelsea L. , Ibrahim Ramzi , Molina Lupita , Jaswal Neha , Donovan Fariba M.
Published: June 2023

Disseminated coccidioidomycosis is associated with significant morbidity and mortality. Involvement of the meninges is often fatal if untreated, typically requiring lifelong antifungal therapy and neurosurgical intervention. We present the case of a young male without any known immunocompromising conditions who opted exclusively for medical management of newly diagnosed coccidioidomycosis meningitis with communicating hydrocephalus and discuss the controversy associated with this approach. This case highlights the importance of shared decision-making between patient and clinician, even if the plan diverges from available guidelines. Furthermore, we discuss clinical considerations in approaching the close outpatient monitoring of patients with central nervous system coccidioidomycosis with hydrocephalus.
COVID-19 Vaccine Evolution and Beyond
Authors: Brice Yardley , Morgan Larry , Kirmani Maaida , Kirmani Maha , Udeh Mercy C
Published: June 2023

In December 2019, a new severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) was first reported in China. It would quickly spread and emerge as a COVID-19 pandemic. The illness caused by SARS CoV-2 would fall on a clinical spectrum ranging from asymptomatic, mild to severe respiratory symptoms, ARDS, and death. This led to significant morbidity and mortality further impacting at-risk populations with severe complications. Thus, a concerted worldwide effort to meet the challenges of diagnosing, treating, and preventing COVID-19 led to rapid advances in medicine. Some mitigating methods of masking, social distancing, and frequent handwashing, helped to slow the spread of SARS-CoV-2. Effective therapeutics consisting of antivirals and monoclonal antibodies, plus their use for prophylaxis, contributed to the management of COVID-19. The vaccines from various platforms (mRNA, viral vectors, protein base, and inactivated) contributed to decreased incidence, severity, and overall decreased hospitalizations and mortality. This article aims to review the novel mRNA vaccines (Moderna + Pfizer/BioNTech), viral vector (Janssen& Johnson), and protein base (Novavax), their side effects, and their use as boosters.
Telehealth as a public health approach to mitigate the COVID-19 pandemic in Pakistan: A narrative review
Authors: Jabeen Rawshan , Rabbani Unaib
Published: June 2023

Technology is instrumental in delivering health services, especially telehealth during the COVID-19 pandemic. This article aimed to explore the role of telehealth as a public health approach to support responses to address the COVID-19 pandemic in Pakistan. We developed this article by mapping existing telehealth initiatives developed and implemented during the COVID-19 pandemic in Pakistan. The initiatives were identified searching online portals such as Google Scholar, PubMed, and websites of various governmental and non-governmental agencies. The services are categorized into teleconsultation and follow-ups, online vaccine registration, information dissemination, high-risk subset tracking, virtual Health Care Worker (HCW) and medical student training, and tele-psychological counseling. The teleconsultation category offers online registration and follow-ups. Information dissemination services include federal helpline, SMS alerts, and social media campaigns. The high-risk subset tracking services include app-based COVID-19 checks and online surveys. Virtual HCW and medical student training services include tele-ICU support, COVID-19 critical care courses, and COVID management courses. The tele-psychological counseling services offer helplines for emotional support, proactive counseling for COVID-19 patients, and mental health support and psychiatry services. Telehealth interventions provided novel solutions amid health and social crises such as the COVID-19 pandemic. Health care systems need to expand telehealth services and ensure that health care organizations deliver effective and safe medical care. However, future research should focus on assessing the impact of telehealth on population health.
Cefiderocol For Injection: Compatibility Testing Using the MINI-BAG Plus Container System and the VIAL-MATE Adaptor
Authors: Rathod Dhaval , Chen Zhengming , Slover Christine M. , Kung Frank , Morita Junichi , Nguyen Sean T.
Published: June 2023

Background: Cost-effective and convenient modalities are required to facilitate the administration of antibiotics in hospital and outpatient settings. Objective: This study investigated the physical compatibility of the MINI-BAG Plus Container System and VIAL-MATE Adaptor with the 1 g drug product vials used for cefiderocol. Methods: Qualitative testing of the MINI-BAG Plus Container System (50 and 100 mL of 5% dextrose injection or 0.9% sodium chloride injection), using empty vials and vials containing lyophilized cefiderocol powder, was conducted in triplicate on MINI-BAGs that were hung and observed over 3 hours. Connection security between empty vials and the VIAL-MATE Adaptor was assessed in triplicate. Results: All predefined physical compatibility criteria between cefiderocol 1 g vials and the MINI-BAG Plus Container System were met, including a secure connection, successful multiple transfers of solution between vial and bag, successful reconstitution of cefiderocol, and lack of leaking into the vial or from the connections. There was no particulate matter in the prepared solution and no precipitation or discoloration. Secure connections between the VIAL-MATE Adaptor and cefiderocol vials were demonstrated. Conclusion and Relevance: Use of these systems is relevant even where resources are limited and may increase the efficiency of cefiderocol administration in hospitals, outpatient settings, or long-term healthcare facilities.
The analysis of the function, diversity, and evolution of the Bacillus phage genome
Authors: Zhang Yating , Miao Jianjia , Zhang Ning , Wang Xiaoyu , Li Zijing , Richard Owusu Ansah , Li Bingxue
Published: June 2023

Background

Phages play a pivotal role in the evolution of microbial populations. The interactions between phages and their hosts are complex and may vary in response to host physiology and environmental conditions. Here, we have selected the genomes of some representative Bacillus prophages and lysosomes from the NCBI database for evolutionary analysis. We explored their evolutionary relationships and analyzed the protein information encoded by hundreds of Bacillus phages.

Results

We obtained the following conclusions: First, Bacillus phages carried some known functional gene fragments and a large number of unknown functional gene fragments, which might have an important impact on Bacillus populations, such as the formation of spores and biofilms and the transmission of virulence factors. Secondly, the Bacillus phage genome showed diversity, with a clear genome boundary between Bacillus prophages and Bacillus lytic phages. Furthermore, genetic mutations, sequence losses, duplications, and host-switching have occurred during the evolution of the Bacillus phage, resulting in low genome similarity between the Bacillus phages. Finally, the lysis module played an important influence on the process of Bacillus phage cross-species infestation.

Conclusions

This study systematically described their protein function, diversity, and genome evolution, and the results of this study provide a basis for evolutionary diversity, horizontal gene transfer and co-evolution with the host in Bacillus phages.
Comparing the broth enrichment-multiplex lateral flow immunochromatographic assay with real time quantitative PCR for the rapid detection of carbapenemase-producing organisms in rectal swabs
Authors: Wang Yue , Song Huijuan , Xu Min , Li Dengju , Ran Xiao , Sun Ziyong , Chen Zhongju
Published: June 2023

Background

Rapid and accurate identification of carbapenemase-producing organism (CPO) intestinal carriers is essential for infection prevention and control. Molecular diagnostic methods can produce results in as little as 1 h, but require special instrumentation and are expensive. Therefore, it is urgent to find an alternative method. The broth enrichment-multiplex lateral flow immunochromatographic assay was recently reported, but using it to directly detect CPO intestinal carriers in rectal swabs still requires the evaluation of many samples. The aim of this study was to compare the performance of these two methods, and to explore the control measures of CPO infection.

Methods

Through CPO selective culture, PCR and DNA sequencing, 100 rectal swabs confirmed to be CPO-positive and 100 rectal swabs with negative results were collected continuously. After eluting the rectal swabs with saline, three aliquots were used: one for counting, one for detection by Xpert Carba-R, and one for culture in broth for 0 h, 1 h, 2 h, 3 h and 4 h, followed by NG-Test CARBA 5 assessment. The sensitivity and specificity of the NG-Test CARBA 5 method after different incubation times were calculated. The limit of detection (LoD) of this assay after 4 h broth incubation was estimated by examining the bacterial suspensions and simulated faecal suspensions prepared with CPOs producing different types of carbapenemases.

Results

Xpert Carba-R demonstrated a combined sensitivity of 99.0% and specificity of 98.0%. The sensitivity and specificity were higher than 90.0% for the different enzyme types. The specificities of five common carbapenemases detected by the broth enrichment NG-Test CARBA 5 combined method after different incubation times were 100%. The sensitivities increased with increasing incubation time. At 4 h, the Klebsiella pneumoniae carbapenemase (KPC), New Delhi metallo-beta-lactamase (NDM), imipenemase (IMP), Verona integron-encoded metallo-beta-lactamase (VIM), and oxacillinase (OXA) -48 detection sensitivities were 93.0%, 96.3%, 100%, 100% and 85.7%, respectively. The LoDs were between 102 and 104 CFU/mL for all five enzymes after 4 h of incubation.

Conclusions

This investigation highlighted that the broth enrichment-multiplex lateral flow immunochromatographic assay can be used as a new method for screening CPOs in rectal swabs.
The trinomial health, safety and happiness promote rural tourism
Authors: Robina-Ramírez Rafael , Ravina-Ripoll Rafael , Castellano-Álvarez Francisco Javier
Published: June 2023

Background

Health and safety protocols have become a requirement to promote rural tourism (PRT). From this perspective, this paper empirically analyses how the health and safety dimensions influence the happiness of hotel managers and rural tourists in the post-Covid 19 era.

Methods

A theory-based structural equation model will be carried out of activation of norms, that measure variables: sanitary, socioeconomic, and safety. Precisely, we will measure how those three attributes affect the managers-guests’ health in rural areas and their search for happiness at the rural destination. Based on the above, a field of study has been 215 rural tourist accommodations in the Extremadura region (Spain) and a sample population of 443 guests. Data were organised through the SEM-PLS path modelling.

Results

The results achieved statistically show the need to undertake a new model of healthier and safer tourism consumption that values the tourist resources of rural areas, especially nearby and sustainable destinations, based on the guiding principles of safety, health, and happiness.

Conclusions

The first conclusion is that promoting tourist destinations under safe and healthy conditions has become a priority objective in the tourism industry. The second conclusion that follows from the first is that the variables safety and health and the pursuit of happiness are essential factors in promoting tourist destinations for rural hotel managers and rural tourists. The third conclusion related to the first two is that the opportunity that this study provides to develop strategies of an innovative, sustainable, and creative nature based on the relationships of the new trinomial of health, safety and happiness, from the perspective of happiness management.
A peer support program results in greater health benefits for peer leaders than other participants: evidence from the Kerala diabetes prevention program
Authors: Haregu Tilahun , Aziz Zahra , Cao Yingting , Sathish Thirunavukkarasu , Thankappan Kavumpurathu Raman , Panniyammakal Jeemon , Absetz Pilvikki , Mathews Elezebeth , Balachandran Sajitha , Fisher Edwin B. , Oldenburg Brian
Published: June 2023

Background

Peer support programs are promising approaches to diabetes prevention. However, there is still limited evidence on the health benefits of peer support programs for lay peer leaders.

Purpose

To examine whether a peer support program designed for diabetes prevention resulted in greater improvements in health behaviors and outcomes for peer leaders as compared to other participants.

Methods

51 lay peer leaders and 437 participants from the Kerala Diabetes Prevention Program were included. Data were collected at baseline, 12 months, and 24 months. We compared behavioral, clinical, biochemical, and health-related quality of life parameters between peer leaders and their peers at the three time-points.

Results

After 12 months, peer leaders showed significant improvements in leisure time physical activity (+ 17.7% vs. + 3.4%, P = 0.001) and health-related quality of life (0.0 vs. + 0.1, P = 0.004); and a significant reduction in alcohol use (-13.6% vs. -6.6%, P = 0.012) and 2-hour plasma glucose (-4.1 vs. + 9.9, P = 0.006), as compared to participants. After 24 months, relative to baseline, peer leaders had significant improvements in fruit and vegetable intake (+ 34.5% vs. + 26.5%, P = 0.017) and leisure time physical activity (+ 7.9% vs. -0.9%, P = 0.009); and a greater reduction in alcohol use (-13.6% vs. -4.9%, P = 0.008), and waist-to-hip ratio (-0.04 vs. -0.02, P = 0.014), as compared to participants. However, only the changes in fruit and vegetable intake and waist-to-hip ratio were maintained between 12 and 24 months.

Conclusion

Being a peer leader in a diabetes prevention program was associated with greater health benefits during and after the intervention period. Further studies are needed to examine the long-term sustainability of these benefits.
Residential inequalities in health-related quality of life among women of reproductive age in four regions of Ethiopia: a decomposition analysis
Authors: Shumet Tigist , Geda Nigatu Regassa
Published: June 2023

Background

Ethiopian rural-urban disparities in key domains of health-related quality of life among women in reproductive age have been huge. However, sources of such inequalities were not studied well. Therefore, this study aimed to assess inequalities in health-related quality of life among women residing in urban and rural areas in four regions of Ethiopia.

Methods

This study used data extracted from the 2016 Ethiopian Demographic and Health Survey; collected at national level from January 18, 2016, to June 27, 2016. Stratified two stage cluster sampling method were used. The data collected from 2385 women in the age group 15–49 years who were living in four regions (Afar, Benishangul-Gumuz, Gambela, and Somali regions) of Ethiopia were used for this study. The outcome variable, Health-Related Quality of Life (HRQoL), was generated by Principal Component Analysis. Further, Multivariable Ordinary Least Square and Oaxaca decomposition threefold (interaction) were used in the analysis with a p-value less than 0.05 and 95% confidence interval to declare statistical significances.

Results

Women education, region, religion, wealth index, and husband/partner education were identified as predictors of Health-Related Quality of Life. Women residing in rural areas had far lower health-related quality of life than those living in urban areas. The wealth index and educational level of women were the largest contributor of the inequality in health-related quality of life.

Conclusion

A substantial inequality in quality of life exist between women who reside in rural and urban areas in those four regions of Ethiopia. The socioeconomic factors more importantly wealth index and educational attainment explained the significant portion of the reported rural-urban disparities. Therefore, Policymakers and local administrators should pay more attention on interventions that promote education and narrowing gap in wealth in rural and urban settings.
Evaluation of a Point-of-care ultrasound (POCUS) workshop for peripheral intravenous cannulation
Authors: Steinwandel Ulrich , Coventry Linda L. , Kheirkhah Homa
Published: June 2023

Background

Point-of-care ultrasound (POCUS) is increasingly used as a non-invasive vascular access assessment method by clinicians from multiple disciplines worldwide, prior and during vascular access cannulations. While POCUS is a relatively new method to establish a vascular access in patients with complex vascular conditions, it is also essential to train and educate individuals who are novices in the techniques of cannulation so that they become proficient in performing this task subsequently on patients safely and successfully. A simulated environment may be a helpful tool to help healthcare providers establish skills in using POCUS safely and may also help them to successfully establish vascular access in patients. With this project, we sought to determine if participants of a simulated POCUS workshop for vascular access can use this technique successfully in their individual clinical environment after their attendance of a half-day workshop.

Methods

A mixed-methods longitudinal study design was chosen to evaluate a point-of-care ultrasound workshop for peripheral intravenous cannula insertion. The workshops used simulation models for cannulation in combination with multiple ultrasound devices from various manufacturers to expose participants to a broader variety of POCUS devices as they may also vary in different clinical areas. Participants self-assessed their cannulation skills using questionnaires on a 10-point rating scale prior to and directly after the workshop.

Results

A total of 85 Individuals participated in eleven half-day workshops through 2021 and 2022. Workshop participants claimed that attending the workshop had significantly enhanced their clinical skill of using ultrasound for the purpose of cannulating a venous vessel. The level of confidence in using this technique had increased in all participants directly after conclusion of the workshop.

Conclusions

Globally, clinicians are increasingly using POCUS to establish vascular access in patients, and it is necessary that they receive sufficient and adequately structured and formal training to successfully apply this technique in their clinical practice. Offering a workshop which uses simulation models in combination with various POCUS devices to demonstrate this technique in a hands-on approach has proven to be useful to establish this newly learned skill in clinicians.
The mediating effects of self-directed learning ability and critical thinking ability on the relationship between learning engagement and problem-solving ability among nursing students in Southern China: a cross-sectional study
Authors: Huang Lingling , Li Xuanhua , Meng Ya , Lei Ming , Niu Yanru , Wang Shanshan , Li Rong
Published: June 2023

Background

Problem-solving ability has been identified as a core competence that nursing students should develop, and it plays a vital role in career development. Therefore, it is necessary to investigate factors related to problem-solving ability and the path relationships among those factors in the context of nursing students.

Objective

This study aims to identify the factors that affect problem-solving ability, and to investigate path relationships of self-directed learning ability, critical thinking ability, learning engagement, and problem-solving ability among nursing students.

Design

A cross-sectional study.

Settings

The Department of Nursing at a university located in Shanghai, China.

Sample

A total of 540 nursing students with a three-year education program were enrolled in the current study.

Methods

Data were collected by using a structured questionnaire, including general information, learning engagement, self-directed learning ability, critical thinking ability, and problem-solving ability of nursing students. Pearson’s correlations were used to explore the relationships between learning engagement, self-directed learning ability, critical thinking ability, and problem-solving ability. The path relationships were analyzed by constructing a structural equation model using AMOS software.

Results

Our results showed that learning engagement, self-directed learning ability, and critical thinking ability were positively associated with problem-solving ability. Furthermore, learning engagement did not influence problem-solving ability directly, but it affected problem-solving ability indirectly via self-directed learning ability and critical thinking ability among nursing students. Additionally, the total effects of self-directed learning (0.442) and critical thinking ability (0.581) were more prominent than learning engagement (0.361) on problem-solving ability.

Conclusions

To improve the problem-solving ability of nursing students, nursing educators should develop targeted strategies to enhance learning engagement, self-directed learning ability, and critical thinking ability.
Cost-effectiveness analysis of imatinib versus dasatinib in the treatment of pediatric Philadelphia chromosome-positive acute lymphoblastic leukemia when combined with conventional chemotherapy in China
Authors: Chen Min , Liu Lulu , Zhang Lingli , Lin Yunzhu , Lu Xiaoxi , Yang Hao , Ni Jiaqi
Published: June 2023

Background

Tyrosine kinase inhibitors combined with conventional chemotherapy (CC) in treating Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph-positive ALL) has achieved promising efficacy and safety outcomes. The study was conducted to compare the cost-effectiveness between imatinib (HANSOH Pharma, Jiangsu, China) and dasatinib (CHIATAI TIANQING Pharma, Jiangsu, China) in treating pediatric Ph-positive ALL when combined with CC from the perspective of the health system in China.

Methods

A Markov model was established to simulate a hypothetical cohort of pediatric Ph-positive ALL patients receiving imatinib or dasatinib, combined with CC. The model was designed using a 10-year horizon, a 3- month cycle, and a 5% discount rate. Three health states were included: alive with progression-free survival, progressed disease, and death. Patient characteristics and transition probabilities were estimated based on clinical trials. Other relevant data, such as direct treatment costs and health utility data were extracted from published literature and Sichuan Province’s centralized procurement and supervision platform. One-way sensitivity analysis and probabilistic sensitivity analysis were performed to assess the robustness of the results. The willingness-to-pay (WTP) was set as three times China’s GDP per capita in 2021.

Results

In the base-case analysis, the total medical costs were $89,701 and $101,182, and the quality-adjusted life years (QALYs) gained were 1.99 and 2.70, for imatinib and dasatinib regimens, respectively. The incremental cost-effectiveness ratio for dasatinib versus imatinib was $16,170/QALY. The probabilistic sensitivity analysis indicated that treatment with dasatinib combined with CC achieved a 96.4% probability of cost-effectiveness at a WTP threshold of $37,765/QALY.

Conclusions

Dasatinib combined with CC is likely to be a cost-effective strategy compared to imatinib combination therapy for pediatric Ph-positive ALL in China at a WTP threshold of $37,765/QALY.
The compact genome of the sponge Oopsacas minuta (Hexactinellida) is lacking key metazoan core genes
Authors: Santini Sébastien , Schenkelaars Quentin , Jourda Cyril , Duchesne Marc , Belahbib Hassiba , Rocher Caroline , Selva Marjorie , Riesgo Ana , Vervoort Michel , Leys Sally P. , Kodjabachian Laurent , Le Bivic André , Borchiellini Carole , Claverie Jean-Michel , Renard Emmanuelle
Published: June 2023

Background

Explaining the emergence of the hallmarks of bilaterians is a central focus of evolutionary developmental biology—evodevo—and evolutionary genomics. For this purpose, we must both expand and also refine our knowledge of non-bilaterian genomes, especially by studying early branching animals, in particular those in the metazoan phylum Porifera.

Results

We present a comprehensive analysis of the first whole genome of a glass sponge, Oopsacas minuta, a member of the Hexactinellida. Studying this class of sponge is evolutionary relevant because it differs from the three other Porifera classes in terms of development, tissue organization, ecology, and physiology. Although O. minuta does not exhibit drastic body simplifications, its genome is among the smallest of animal genomes sequenced so far, and surprisingly lacks several metazoan core genes (including Wnt and several key transcription factors). Our study also provides the complete genome of a symbiotic Archaea dominating the associated microbial community: a new Thaumarchaeota species.

Conclusions

The genome of the glass sponge O. minuta differs from all other available sponge genomes by its compactness and smaller number of encoded proteins. The unexpected loss of numerous genes previously considered ancestral and pivotal for metazoan morphogenetic processes most likely reflects the peculiar syncytial tissue organization in this group. Our work further documents the importance of convergence during animal evolution, with multiple convergent evolution of septate-like junctions, electrical-signaling and multiciliated cells in metazoans.
Detrimental alteration of mesenchymal stem cells by an articular inflammatory microenvironment results in deterioration of osteoarthritis
Authors: Fan Mengqiang , Tong Peijian , Yan Li , Li Ting , Ren Jiadan , Huang Jiefeng , Du Wenxi , Zhou Li , Shan Letian
Published: June 2023

Background

Articular injection of mesenchymal stem cells (MSCs) has been applied to treat knee osteoarthritis (kOA), but its clinical outcomes are controversial. This study investigated whether an articular inflammatory microenvironment (AIM) impacts MSC-based therapy in a rat model of kOA.

Methods

The biological change of MSCs and the functional change of MSCs on chondrocytes were evaluated under AIM. The key mediator and mechanism for the AIM impact on MSC therapy were explored via gain- and loss-of-function approaches.

Results

The results showed that MSCs exerted potent anti-kOA effects in vivo and in vitro, but that this therapy become chondrodestructive if a chronic AIM was present. Mechanistically, the overexpression of MMP13 in the injected MSCs via a MAPKs-AP1 signaling axis was revealed as the underlying mechanism for the detriment outcome.

Conclusions

This study thus clarifies recent clinical findings while also suggesting a means to overcome any detrimental effects of MSC-based therapy while improving its efficacy.
A novel extrachromosomal circular DNA related genes signature for overall survival prediction in patients with ovarian cancer
Authors: Zhang Ying , Dong Kexian , Jia Xueyuan , Du Shuomeng , Wang Dong , Wang Liqiang , Qu Han , Zhu Shihao , Wang Yang , Wang Zhao , Zhang Shuopeng , Sun Wenjing , Fu Songbin
Published: June 2023

Objective

Ovarian cancer (OV) has a high mortality rate all over the world, and extrachromosomal circular DNA (eccDNA) plays a key role in carcinogenesis. We wish to study more about the molecular structure of eccDNA in the UACC-1598–4 cell line and how its genes are associated with ovarian cancer prognosis.

Methods

We sequenced and annotated the eccDNA by Circle_seq of the OV cell line UACC-1598–4. To acquire the amplified genes of OV on eccDNA, the annotated eccDNA genes were intersected with the overexpression genes of OV in TCGA. Univariate Cox regression was used to find the genes on eccDNA that were linked to OV prognosis. The least absolute shrinkage and selection operator (LASSO) and cox regression models were used to create the OV prognostic model, as well as the receiver operating characteristic curve (ROC) curve and nomogram of the prediction model. By applying the median value of the risk score, the samples were separated into high-risk and low-risk groups, and the differences in immune infiltration between the two groups were examined using ssGSEA.

Results

EccDNA in UACC-1598–4 has a length of 0-2000 bp, and some of them include the whole genes or gene fragments. These eccDNA originated from various parts of chromosomes, especially enriched in repeatmasker, introns, and coding regions. They were annotated with 2188 genes by Circle_seq. Notably, the TCGA database revealed that a total of 198 of these eccDNA genes were overexpressed in OV (p < 0.05). They were mostly enriched in pathways associated with cell adhesion, ECM receptors, and actin cytoskeleton. Univariate Cox analysis showed 13 genes associated with OV prognosis. LASSO and Cox regression analysis were used to create a risk model based on remained 9 genes. In both the training (TCGA database) and validation (International Cancer Genome Consortium, ICGC) cohorts, a 9-gene signature could successfully discriminate high-risk individuals (allp < 0.01). Immune infiltration differed significantly between the high-risk and low-risk groups. The model’s area under the ROC curve was 0.67, and a nomograph was created to assist clinician.

Conclusion

EccDNA is found in UACC-1598–4, and part of its genes linked to OV prognosis. Patients with OV may be efficiently evaluated using a prognostic model based on eccDNA genes, including SLC7A1, NTN1, ADORA1, PADI2, SULT2B1, LINC00665, CILP2, EFNA5, TOMM.
Diagnosis of invasive fungal infections: challenges and recent developments
Authors: Fang Wenjie , Wu Junqi , Cheng Mingrong , Zhu Xinlin , Du Mingwei , Chen Chang , Liao Wanqing , Zhi Kangkang , Pan Weihua
Published: June 2023

Background

The global burden of invasive fungal infections (IFIs) has shown an upsurge in recent years due to the higher load of immunocompromised patients suffering from various diseases. The role of early and accurate diagnosis in the aggressive containment of the fungal infection at the initial stages becomes crucial thus, preventing the development of a life-threatening situation. With the changing demands of clinical mycology, the field of fungal diagnostics has evolved and come a long way from traditional methods of microscopy and culturing to more advanced non-culture-based tools. With the advent of more powerful approaches such as novel PCR assays, T2 Candida, microfluidic chip technology, next generation sequencing, new generation biosensors, nanotechnology-based tools, artificial intelligence-based models, the face of fungal diagnostics is constantly changing for the better. All these advances have been reviewed here giving the latest update to our readers in the most orderly flow.

Main text

A detailed literature survey was conducted by the team followed by data collection, pertinent data extraction, in-depth analysis, and composing the various sub-sections and the final review. The review is unique in its kind as it discusses the advances in molecular methods; advances in serology-based methods; advances in biosensor technology; and advances in machine learning-based models, all under one roof. To the best of our knowledge, there has been no review covering all of these fields (especially biosensor technology and machine learning using artificial intelligence) with relevance to invasive fungal infections.

Conclusion

The review will undoubtedly assist in updating the scientific community’s understanding of the most recent advancements that are on the horizon and that may be implemented as adjuncts to the traditional diagnostic algorithms.
Healthcare for individuals without health insurance in Germany – a mixed methods approach to assess the situation and current challenges
Authors: Stötzler Mathilde , Kaifie Andrea
Published: June 2023

Background

Health insurance is mandatory in Germany; nevertheless, many individuals there have no health insurance and depend on a parallel healthcare structure. Voluntary associations, such as MediNetz and healthcare vouchers (“Anonymer Krankenschein” - AKS), support uninsured citizens. This study aimed to provide insights into associations, such as MediNetz and AKS that provide healthcare for individuals without health insurance in North Rhine-Westphalia, the largest federal state in Germany.

Methods

A mixed methods approach was chosen. A qualitative study using interviews with experts was performed to gain their knowledge and explore the various challenges that AKS and MediNetz associations faced and the possible improvements that could be made. A quantitative survey was conducted to analyse the demographic data of the patients who required AKS or MediNetz’s assistance and the characteristics of each association through a separate questionnaire. Data was received from the association in Aachen, Bielefeld, Bonn, Düsseldorf, and Essen.

Results

More women than men sought medical care; most were between 25 and 49 years old. The proportion of individuals without residency status accounted for the largest share (53.6%). Common reasons for patients to make contact were acute illnesses (40.2%) and pregnancies (22.3%). Most patients were sent to gynaecologists and general practitioners. Asking the experts, it became apparent that the existing system could not reach the standard of the regular healthcare in Germany. Financial and human resources were insufficient. Therefore, prevention was limited, especially chronically ill patients or patients with a severe illness requiring hospitalisation could not be treated. AKS had advantages compared to MediNetz, as the care came closer to the expected German medical standards.

Conclusions

The results showed a demand for associations providing healthcare for individuals without health insurance. However, the healthcare provided by MediNetz and AKS did not reach the standard of healthcare in Germany and mainly depended on the organisations’ resources. Funded projects such as an AKS combined with clearing centres significantly improved healthcare. Until structural measures are implemented, they can be a transitional solution by spreading nationwide.
Associations of Chinese visceral adiposity index and new-onset stroke in middle-aged and older Chinese adults: an observational study
Authors: Zhang Hongyu , Zhan Qi , Dong Fayan , Gao Xueting , Zeng Fanyue , Yao Jiahao , Gan Yifan , Zou Shuhuai , Gu Jianheng , Fu Hongqian , Wang Xuefeng
Published: June 2023

Background

Stroke represents the second most prevalent contributor to global mortality. The Chinese Visceral Adiposity Index (CVAI) serves as an established metric for assessing visceral adiposity in the Chinese population, exhibiting prognostic capabilities. This investigation aimed to explore the association of CVAI and new-onset stroke among middle-aged and older Chinese populations.

Methods

The study employed data from the 2011 and 2018 China Health and Retirement Longitudinal Study (CHARLS) to assess the association of CVAI and the incidence of new-onset stroke. Utilizing a directed acyclic graph (DAG), 10 potential confounders were identified. Moreover, to explore the association between CVAI and new-onset stroke, three multifactor logistic regression models were constructed, accounting for the identified confounders and mitigating their influence on the findings.

Results

The study comprised 7070 participants, among whom 417 (5.9%) experienced new-onset strokes. After controlling for confounding variables, regression analysis suggested that the new-onset stroke’s highest risk was linked to the fourth quartile (Q4) of the CVAI, with an odds ratio (OR) of 2.33 and a 95% confidence interval (CI) of 1.67–3.28. The decision tree analysis demonstrated a heightened probability of new-onset stroke among hypertensive individuals with a CVAI equal to or greater than 83, coupled with a C-reactive protein level no less than 1.1 mg/l. Age seemed to have a moderating influence on the CVAI and new-onset stroke association, exhibiting a more prominent interaction effect in participants under 60 years.

Conclusions

In middle-aged and older Chinese populations, a linear relationship was discerned between CVAI and the probability of new-onset stroke. CVAI provides a predictive framework for stroke incidence in this demographic, laying the groundwork for more sophisticated risk prediction models that improve the precision and specificity of stroke risk evaluations.
Comparative characterization of Crimean-Congo hemorrhagic fever virus cell culture systems with application to propagation and titration methods
Authors: Li Hongzhao , Smith Greg , Goolia Melissa , Marszal Peter , Pickering Bradley S.
Published: June 2023

Crimean-Congo hemorrhagic fever orthonairovirus (CCHFV) is a biosafety level 4 and World Health Organization top priority pathogen. Infection leads to an often fatal hemorrhagic fever disease in humans. The tick-borne virus is endemic in countries across Asia, Europe and Africa, with signs of spreading into new regions. Despite the severity of disease and the potential of CCHFV geographic expansion to cause widespread outbreaks, no approved vaccine or treatment is currently available. Critical for basic research and the development of diagnostics or medical countermeasures, CCHFV viral stocks are commonly produced in Vero E6 and SW-13 cell lines. While a variety of in-house methods are being used across different laboratories, there has been no clear, specific consensus on a standard, optimal system for CCHFV growth and titration. In this study, we perform a systematic, side-by-side characterization of Vero E6 and SW-13 cell lines concerning the replication kinetics of CCHFV under different culture conditions. SW-13 cells are typically cultured in a CO2-free condition (SW-13 CO2−) according to the American Type Culture Collection. However, we identify a CO2-compatible culture condition (SW-13 CO2+) that demonstrates the highest viral load (RNA concentration) and titer (infectious virus concentration) in the culture supernatants, in comparison to SW-13 CO2− and Vero E6 cultures. This optimal viral propagation system also leads to the development of two titration methods: an immunostaining-based plaque assay using a commercial CCHFV antibody and a colorimetric readout, and an antibody staining-free, cytopathic effect-based median tissue culture infectious dose assay using a simple excel calculator. These are anticipated to serve as a basis for a reproducible, standardized and user-friendly platform for CCHFV propagation and titration.
A single preoperative low-dose dexamethasone may reduce the incidence and severity of postoperative delirium in the geriatric intertrochanteric fracture patients with internal fixation surgery: an exploratory analysis of a randomized, placebo-controlled trial
Authors: Huang Jian-wen , Yang Yun-fa , Gao Xiao-sheng , Xu Zhong-he
Published: June 2023

Objective

Postoperative delirium (POD) is a common complication along with poor prognosis in geriatric intertrochanteric fracture (ITF) patients. However, the prevention and treatment of POD remain unclear. Previous studies have confirmed that POD is essentially a consequence of neuro-inflammatory responses. Dexamethasone is a glucocorticoid with comprehensive anti-inflammatory effects, while a high dose of dexamethasone correlates with many side effects or even adverse consequences. Thus, this prospective study aims to discuss whether a single preoperative low-dose dexamethasone can reduce the impact of POD on geriatric ITF patients with internal fixation surgery.

Methods

Between June 2020 and October 2022, there were 219 consecutive ITF patients assessed in our department. Of the 219 ITF patients, 160 cases who met the inclusion and exclusion criteria were finally enrolled and randomly allocated to the dexamethasone group and the placebo group (80 geriatric ITF patients in each group) in this prospective study. The patients in the dexamethasone group received intravenous 10 mg (2 ml) dexamethasone while the patients in the placebo group received intravenous 2 ml saline in 30 min before being sent to the operating room, respectively. The baseline characteristics, surgical information, incidence and severity of POD as the efficacy-related outcomes, and infection events and hyperglycemia as safety-related outcomes (adverse events), were collected and analyzed between the two groups. The severity of POD was evaluated by Memorial Delirium Assessment Scale (MDAS) score.

Results

There were no differences in baseline characteristics and surgical information between the dexamethasone group and the placebo group. The dexamethasone group had a lower incidence of POD than the placebo group within the first 5 days after surgery [(9/80, 11.3% vs. 21/80, 26.3%, RR = 0.83, 95% CI 0.71–0.97, P = 0.015]. The dexamethasone group had lower MDAS scores (Mean ± SD) than the placebo group [13.2 ± 1.0 (range 11 to 15) vs. 15.48 ± 2.9 (range 9 to 20), P = 0.011, effect size = 0.514]. There were no differences in infection events and hyperglycemia between the two groups.

Conclusions

A single preoperative low-dose dexamethasone may reduce the incidence and severity of POD in geriatric ITF patients with internal fixation surgery.

Trial registration: ChiCTR2200055281.