bluuebunny/crossref_metadata_2025 huggingface dataset:
Applying the principles of Evidence-Based Public Health in addressing the diabetes mellitus epidemic among African-American communities living in the district of Colombia: A literature review
Authors: Opara Nnennaya U , Opara Emmanuel U
Published: August 2022

Diabetes is an epidemic in the United States and is ranked as the sixth leading cause of death in the District of Columbia. According to the US Census population in 2010, >52,000 out of 610,000 residents have been diagnosed with diabetes. The highest prevalence was noted in wards 4, 5, 7, and 8, with the worst impact recorded in ward 8. The diabetes death rate among African Americans is five times that for Caucasians living in Colombia district, according to the DC department of health. There is an 11% disparity in the prevalence of diabetes when comparing black- and white people in the district (14% and 3%, respectively). This amounts to more than double the 6% disparity in the national population. This is also evident at both district and nationwide levels (prevalence of diabetes among people with no high school diploma, 21%; that in college graduates, 5%). The incidence of end-stage renal disease (ESRD), a life-threatening condition and diabetes-related complication is increasing in Colombia district and is rated as the number one cause of death from diabetes. In 2010, the newly diagnosed ESRD cases (420) and total number of ESRD cases due to diabetes (642) in the district were twice that of neighboring states (Maryland, Virginia, and West Virginia) and the entire US. In this review, the importance of implementing an evidence-based public health program in solving the epidemic of diabetes among the black community living in Ward 8 is emphasized. This study applies to every poor or minority ethnic group worldwide and in the US.
Comparative evaluation of two collagen-based biomaterials with different compositions used for bone graft: An experimental animal study
Authors: Gehrke Sergio Alexandre , Aramburú Júnior Jaime , Treichel Tiago Luis Eliers , Rodriguez Fernando , N de Aza Piedad , Dedavid Berenice Anina
Published: August 2022

A large number of materials with different compositions and shapes have been proposed and studied for the purpose of bone tissue regeneration. Collagen-based materials have shown promising results for this application, with improved physicochemical properties. The aim of the present in vivo animal study was to evaluate and compare two commercially available collagen-based biomaterials for bone regeneration, with these being implanted in circumferential bone defects created in the calvarium of rabbits. Twenty rabbits received bilateral parietal osteotomies, performed with the aid of a 6.5 mm diameter trephine. Two groups were created: the BC group, where the defect was filled with a scaffold composed of 90% bovine bone particles and 10% porcine collagen, and the EG group, where the defect was filled with a scaffold composed of 75% hydroxyapatite particles of bovine origin and 25% bovine collagen. Ten animals were sacrificed at 30 days and another 10 at 45 days after implantation, and the samples were processed and histologically analyzed. In the evaluations of the samples at 30 days, no important differences were found in the results. However, in the samples at 45 days after surgery, the EG group showed better results than the BC group samples, mainly in terms of the amount of bone matrix formation ( P < 0.0001) and the volume in area measured in each sample, where the EG group had a value 65% higher than that in the BC group samples. Based on the results obtained, we conclude that the amount of collagen and the particle characteristics present in the composition of the scaffolds can directly influence the amount of neoformation and/or bone regeneration.
Baclofen Withdrawal–Induced Psychosis in the Setting of Renal Insufficiency
Authors: Amanda Guilmette , Ambra Palushi , Hundaol Shamsan , Aniruddha Bhattacharyya , Miriam Michael
Published: August 2022

Baclofen is used to treat muscle spasticity, acting at GABA B receptors in the central nervous system. The abrupt cessation of baclofen causes baclofen withdrawal–induced psychosis. The risk is exacerbated if the patient has renal insufficiency or if the drug has been taken for a long time at high doses. Gradual tapering of baclofen usually does not produce symptomatic adverse effects. However, abrupt termination of the drug, especially in an inpatient hospital setting, can lead to symptoms such as increased spasticity, agitation, confusion, hallucinations, and seizures. We present a case of a patient who initially presented with seizures and experienced hallucinations after abrupt cessation of the medication. She had baseline chronic kidney disease but presented with acute worsening of her renal function. Impaired renal function decreases baclofen clearance and causes increased concentration of baclofen in circulation. This put the patient at higher risk of developing baclofen withdrawal, even at a lower dose.
Anatomical Components Associated With Increased Tibial Tuberosity–Trochlear Groove Distance
Authors: Xu Chenyue , Cui Zhaoxia , Yan Lirong , Chen Zheng , Wang Fei
Published: August 2022

Background:

Increased tibial tuberosity–trochlear groove (TT-TG) distance is an important indicator of medial tibial tubercle transfer in the surgical management of lateral patellar dislocation (LPD). Changes to TT-TG distance are determined by a combination of several anatomical factors.

Purpose:

To (1) determine the anatomical components related to increased TT-TG distance and (2) quantify the contribution of each to identify the most prominent component.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

Included were 80 patients with recurrent LPD and 80 age- and body mass index–matched controls. The 2 groups were compared in TT-TG distance and its related anatomical components: tibial tubercle lateralization (TTL), trochlear groove medialization, femoral anteversion, tibiofemoral rotation (TFR), tibial torsion, and mechanical axis deviation (MAD). The Pearson correlation coefficient ( r) was calculated to evaluate the association between increased TT-TG distance and its anatomical parameters, and factors that met the inclusion criteria of P < .05 and r ≥ 0.30 were analyzed via stepwise multivariable linear regression analysis to predict TT-TG distance.

Results:

The LPD and control groups differed significantly in TT-TG distance, TTL, TFR, and MAD ( P < .001 for all). Increased TT-TG distance was significantly positively correlated with TTL ( r = 0.376; P < .001), femoral anteversion ( r = 0.166; P = .036), TFR ( r = 0.574; P < .001), and MAD ( r = 0.415; P < .001), and it was signficantly negatively correlated with trochlear groove medialization ( r = −0.178; P = .024). The stepwise multivariable analysis revealed that higher TTL, excessive knee external rotation, and excessive knee valgus were statistically significant predictors of greater TT-TG distance ( P < .001 for all). The standardized estimates that were used for evaluating the predictive values were larger for TFR compared with those for TTL and MAD.

Conclusion:

TTL, TFR, and MAD were the main independent anatomical components associated with increased TT-TG distance, with the most prominent component being TFR. The association of TT-TG distance to each component analyzed in our study may help guide surgical planning.
Understanding Heritage Conservation from Project Management Perspectives: Case Study Chandannagar
Authors: Bose Lina , Mukherjee Jenia
Published: August 2022

Historic buildings and structures that formerly served as the collective identity of a town are being demolished haphazardly, making way for global architectural icons. It will not be an exaggeration to say that our existence, evolution and collective identity depend on the built structures that we inhabit and artefacts that are seamlessly woven with intangible memories, stories and ethos. Chandannagar, a city located in the Hooghly district sof West Bengal and a former French colony, is renowned for its historical heritage structures, including private and public constructions. Several historical identification and restoration projects have been carried out in Chandannagar during the past few decades. But what have been the impacts of the restorative work on the city and the local community? There is a dearth of scholarship on historical conservation in India from the standpoint of project management. In this article, we have attempted to address the gap by bringing to the fore three heritage projects in Chandannagar—a small town drawing lesser attention in the policy circle and media. As there is emerging research on the Hooghly Corridor, the findings will inform both scholars and practitioners about more comprehensive upscaling heritage initiative projects in specific urban sites—in this particular case—Chandannagar. The research tool used in this article is qualitative; secondary sources have also been consulted to offer an overview of the heritage conservation projects of Chandannagar.
Freedom Rangers™ and landscapes that move people
Authors: Schniedewind Daniel
Published: August 2022

Born out of long-term fieldwork in New York's Hudson Valley, this article begins and ends with reflections on a fraught attempt to conduct ethnographic research with captive chickens, paradoxically called Freedom Rangers™, living on small-scale, organic animal farms. With no available ecological and economic justifications for their confinement, I had to turn instead to animal agriculture's long-standing role in a regional landscape tradition that generates a White sense of place and personhood. Since the dawn of the colonial period, agriculture, especially animal agriculture, has constituted a powerful landscape-making assemblage in the Hudson Valley, one both deeply dependent on racial slavery and uniquely responsible for (never complete) Native displacement. Imported European farm animals and their associate organisms remade the region ecologically, enabling the proliferation of colonial settlement. Then as now, the remaking of the land is itself a site of politics and a means of realizing possible futures. Watching as Whiteness emerges along the human/nonhuman interface, I argue that meat is but one product yielded from these confined chicken bodies and that the unspectacular terror they experience on a daily basis radiates far beyond their enclosures. Addressing the persistence of settler colonialism, antiblackness, and White supremacy requires attention to a wider range of political scenes and actors than are often considered in studies of these formations. What are the banal practices and everyday affects that secure a social order? What are the possibilities for more-than-human ethnography given the violence that saturates this venerated landscape?
Cultivating informatics capacity for multimorbidity: A learning health systems use case
Authors: Williams Tremaine B , Garza Maryam , Lipchitz Riley , Powell Thomas , Baghal Ahmad , Swindle Taren , Sexton Kevin Wayne
Published: August 2022

Background

The aim of this study was to characterize patterns of multimorbidity across patients and identify opportunities to strengthen the informatics capacity of learning health systems that are used to characterize multimorbidity across patients.

Methods

Electronic health record (EHR) data on 225,710 multimorbidity patients were extracted from the Arkansas Clinical Data Repository as a use case. Hierarchical cluster analysis identified the most frequently occurring combinations of chronic conditions within the learning health system’s captured data.

Results

Results revealed multimorbidity was highest among patients ages 60 to 74, Caucasians, females, and Medicare payors. The largest numbers of chronic conditions occurred in the smallest numbers of patients (i.e., 70,262 (31%) patients with two conditions, two (<1%) patients with 22 chronic conditions). The results revealed urgent needs to improve EHR systems and processes that collect and manage multimorbidity data (e.g., creating new, multimorbidity-centric data elements in EHR systems, detailed longitudinal tracking of compounding disease diagnoses).

Conclusions

Without additional capacity to collect and aggregate large-scale data, multimorbidity patients cannot benefit from the recent advancements in informatics (i.e., clinical data registries, emerging data standards) that are abundantly working to improve the outcomes of patients with single chronic conditions. Additionally, robust socio-technical system studies of clinical workflows are needed to assess the feasibility of integrating the collection of risk factor data elements (i.e., psycho-social, cultural, ethnic, and socioeconomic attributes of populations) into primary care encounters. These approaches to advancing learning health systems for multimorbidity could substantially reduce the constraints of current technologies, data, and data-capturing processes.
How well can we predict earthquake site response so far? Machine learning vs physics-based modeling
Authors: Zhu Chuanbin , Cotton Fabrice , Kawase Hiroshi , Nakano Kenichi
Published: August 2022

In site-specific site-response assessments, observation-based site-specific approaches requiring a target–reference recording pair or a regional recording network cannot be implemented at many sites of interest. Thus, various estimation techniques have to be used. How effective are these techniques in predicting site-specific site responses (average over many earthquakes)? To address this question, we conduct a systematic comparison using a large data set which consists of detailed site metadata and Fourier outcrop linear site responses based on observations at 1725 K-NET and KiK-net sites. We first develop machine learning (i.e. random forest ( RF)) amplification models on a training data set (1580 sites). Then we test and compare their predictive powers at 145 independent testing sites with that of the one-dimensional (1D) ground response analysis (GRA). The standard deviation of residuals between observations and predictions, that is, between-site (site-to-site or inter-site) variability, is used as the benchmark. Results show that the machine learning model using a few predictor variables, surface roughness, peak frequency fP, HV, VS30, and depth Z2.5 achieves better performance than the physics-based modeling (GRA) using detailed 1D velocity profiles. This implies that machine learning can be more effective in using existing site information than 1D GRA which is inflicted by a high level of parametric and modeling uncertainties. This finding warrants the further exploration of machine learning in site effect characterization, especially on model transferability across different regions.
Lymphatic coagulation and neutrophil extracellular traps in lung-draining lymph nodes of COVID-19 decedents
Authors: MacDonald Margo E. , Weathered Rachel K. , Stewart Emma C. , Magold Alexandra I. , Mukherjee Anish , Gurbuxani Sandeep , Smith Heather , McMullen Phillip , Mueller Jeffrey , Husain Aliya N. , Salles Calixto M. , Briquez Priscilla S. , Rouhani Sherin J. , Yu Jovian , Trujillo Jonathan , Pyzer Athalia R. , Gajewski Thomas F. , Sperling Anne I. , Kilarski Witold W. , Swartz Melody A.
Published: August 2022

Clinical manifestations of severe COVID-19 include coagulopathies that are exacerbated by the formation of neutrophil extracellular traps (NETs). Here, we report that pulmonary lymphatic vessels, which traffic neutrophils and other immune cells to the lung-draining lymph node (LDLN), can also be blocked by fibrin clots in severe COVID-19. Immunostained tissue sections from COVID-19 decedents revealed widespread lymphatic clotting not only in the lung but also in the LDLN, where the extent of clotting correlated with the presence of abnormal, regressed, or missing germinal centers (GCs). It strongly correlated with the presence of intralymphatic NETs. In mice, tumor necrosis factor α induced intralymphatic fibrin clots; this could be inhibited by DNase I, which degrades NETs. In vitro, TNF-α induced lymphatic endothelial cell upregulation of ICAM-1 and CXCL8, among other neutrophil-recruiting factors, as well as thrombomodulin downregulation; in decedents, lymphatic clotting in LDLNs. In a separate cohort of hospitalized patients, serum levels of Myeloperoxidase-DNA (MPO-DNA, a NET marker) inversely correlated with antiviral antibody titers, but D-dimer levels, indicative of blood thrombosis, did not correlate with either. Patients with high MPO-DNA but low D-dimer levels generated poor antiviral antibody titers. This study introduces lymphatic coagulation in lungs and LDLNs as a clinical manifestation of severe COVID-19 and suggests the involvement of NETosis of lymphatic-trafficking neutrophils. It further suggests that lymphatic clotting may correlate with impaired formation or maintenance of GCs necessary for robust antiviral antibody responses, although further studies are needed to determine whether and how lymphatic coagulation affects adaptive immune responses.
Relationship between the xylem maturation process based on radial variations in wood properties and radial growth increments of stems in a fast-growing tree species, Liriodendron tulipifera
Authors: Nezu Ikumi , Ishiguri Futoshi , Ohshima Jyunichi , Yokota Shinso
Published: August 2022

Promoting wood utilization from fast-growing tree species is one solution to address supply and demand issues relating to wood resources while sequestering carbon dioxide in large quantities. Information on the quality of wood from fast-growing tree species and its relationship with changes in stem size is essential for promoting the establishment of plantations and wood utilization of fast-growing tree species. To explore the relationship between the xylem maturation process and radial growth increments of stems in fast-growing tree species, we examined radial variations in annual ring widths and wood properties in Liriodendron tulipifera in Japan. The cambial ages at which current annual increment and mean annual increment values were greatest were 4.9 years and 7.4 years, respectively. Based on radial variations evaluated by mixed-effects modeling of wood properties, all properties increased or decreased near the pith before becoming stable towards the cambium. Changing ratios of multiple wood properties at 1-year intervals became stable after a cambial age of 9 years. These results point to an ecological strategy in L. tulipifera, in which there is a tradeoff between radial growth increments and wood properties. As part of this strategy, in response to competition among individual trees within a stand, the tree produces a large volume of xylem with lower physical and mechanical properties, allowing it to increase its volume faster than that of the surrounding trees. Subsequently, it produces xylem that is more stable, with greater physical and mechanical properties. This wood forms at a slower growth rate compared to the xylem that forms at the time of initial tree growth. Based on the ecological strategy adopted by L. tulipifera, wood that forms before a cambial age of 9 years can be used for utility applications, and wood that forms after a cambial age of 9 years can be used for structural applications.
Molecular characterization of multidrug-resistant ESKAPEE pathogens from clinical samples in Chonburi, Thailand (2017–2018)
Authors: Ruekit Sirigade , Srijan Apichai , Serichantalergs Oralak , Margulieux Katie R. , Mc Gann Patrick , Mills Emma G. , Stribling William C. , Pimsawat Theerasak , Kormanee Rosarin , Nakornchai Suthisak , Sakdinava Chaiwat , Sukhchat Prawet , Wojnarski Mariusz , Demons Samandra T. , Crawford John M. , Lertsethtakarn Paphavee , Swierczewski Brett E.
Published: August 2022

Background

ESKAPEE pathogens Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp. and Escherichia coli are multi-drug resistant (MDR) bacteria that present increasing treatment challenges for healthcare institutions and public health worldwide.

Methods

431 MDR ESKAPEE pathogens were collected from Queen Sirikit Naval Hospital, Chonburi, Thailand between 2017 and 2018. Species identification and antimicrobial resistance (AMR) phenotype were determined following CLSI and EUCAST guidelines on the BD Phoenix System. Molecular identification of antibiotic resistant genes was performed by polymerase chain reaction (PCR), real-time PCR assays, and whole genome sequencing (WGS).

Results

Of the 431 MDR isolates collected, 1.2% were E. faecium, 5.8% were S. aureus, 23.7% were K. pneumoniae, 22.5% were A. baumannii, 4.6% were P. aeruginosa, 0.9% were Enterobacter spp., and 41.3% were E. coli. Of the 401 Gram-negative MDR isolates, 51% were carbapenem resistant, 45% were ESBL producers only, 2% were colistin resistance and ESBLs producers (2%), and 2% were non-ESBLs producers. The most prevalent carbapenemase genes were blaOXA-23 (23%), which was only identified in A. baumannii, followed by blaNDM (17%), and blaOXA-48-like (13%). Beta-lactamase genes detected included blaTEM,blaSHV, blaOXA, blaCTX-M, blaDHA, blaCMY, blaPER and blaVEB. Seven E. coli and K. pneumoniae isolates showed resistance to colistin and carried mcr-1 or mcr-3, with 2 E. coli strains carrying both genes. Among 30 Gram-positive MDR ESKAPEE, all VRE isolates carried the vanA gene (100%) and 84% S. aureus isolates carried the mecA gene.

Conclusions

This report highlights the prevalence of AMR among clinical ESKAPEE pathogens in eastern Thailand. E. coli was the most common MDR pathogen collected, followed by K. pneumoniae, and A. baumannii. Carbapenem-resistant Enterobacteriaceae (CRE) and extended spectrum beta-lactamases (ESBLs) producers were the most common resistance profiles. The co-occurrence of mcr-1 and mcr-3 in 2 E. coli strains, which did not affect the level of colistin resistance, is also reported. The participation of global stakeholders and surveillance of MDR remain essential for the control and management of MDR ESKAPEE pathogens.
Preoperative anxiety and its associated factors among women undergoing elective caesarean delivery: a cross-sectional study
Authors: Fentie Yewlsew , Yetneberk Tikuneh , Gelaw Moges
Published: August 2022

Background

Anxiety is a behavioral expression of tension and unpleasant emotion that arises from multifactorial dimensions that might increase the mortality of patients during anesthesia and surgery. This study aimed to verify the prevalence and associated factors of preoperative anxiety among women undergoing elective cesarean delivery.

Method

A cross-sectional study design was conducted on a total of 392 patients who underwent elective cesarean delivery in Debre Tabor Comprehensive Specialized Hospital, in North Central Ethiopia from October 15, 2020, to September 15, 2021. Data was collected using a validated Amsterdam questionnaire, after translating to the local language (Amharic). Descriptive statistics were expressed in percentages and presented in tables. Bivariable and multivariable logistic analyses were done to identify factors associated with preoperative anxiety. The statistical significance level was set at P < 0.05 with 95% CI.

Results

The overall prevalence of preoperative anxiety in women undergoing elective cesarean delivery was 67.9 [95% CI = (63.0–72.7)]. Participants who came from rural areas [AOR = 2.65; 95%CI: 1.27–5.53], farmers [AOR = 2.35; 95%CI: 1.02–5.40], participants with no previous surgical and anesthesia history [AOR = 2.91; 95%CI: 1.69–5.01], and primiparous women [AOR = 1.69; 95%CI: 1.01–2.83] were more significantly associated with preoperative anxiety.

Conclusion

The prevalence of preoperative anxiety among elective cesarean deliveries was found to be high. So, preoperative maternal counseling and anxiety reduction services should therefore be given top priority, particularly for those women who came from rural areas, are farmers, have no prior surgical or anesthetic experience, and are primiparous.
Quality of life and its influencing factors among breast cancer patients at Tikur Anbessa specialised hospital, Addis Ababa, Ethiopia
Authors: Getu Mikiyas Amare , Chen Changying , Wang Panpan , Kantelhardt Eva Johanna , Addissie Adamu
Published: August 2022

Background

Quality of life (QoL) has become an important measure for evaluating cancer patients’ treatment and prognosis. Breast cancer patients are at an increased risk of experiencing poor QoL during active treatment of cancer. This study aimed to assess QoL and it’s influencing factors among breast cancer patients using the newly updated breast cancer specific tool of the European Organisation for Research and Treatment of Cancer EORTC Breast Cancer Specific Quality of Life Questionnaire QLQ-BR45.

Methods

An institutional based crossectional study was conducted with 248 breast cancer patients at Tikur Anbessa Specialized Hospital (TASH). Descriptive statistics, one-way analysis of variance (ANOVA), and linear regression were used to describe and analyze the data.

Results

The participant’s Global health status/QoL mean score was 65.6. Among the functional scales, future perspective scored the lowest (57.1, SD ± 37.3). The highest mean score on the symptom scales/items were financial difficulties (50, SD ± 38.6), followed by appetite loss (37.4, SD ± 36.4) and fatigue (34.3, SD ± 27.1) while the lowest symptom score was diarrhoea (6.4 ± 18.4). EORTC QLQ-BR45, future perspective (mean = 57.1, SD ± 37.3) and upset by hair loss (41.8, SD ± 34.6) were the most affected functioning and symptoms scales respectively. An increased stage of tumor was associated with more pain (P = 0.041), appetite loss (P = 0.042), and arm symptoms (P = 0.003). Patients who had no comorbidity had better physical (P < 0.001), cognitive (P = 0.013), and social (P = 0.009) function.

Conclusion

These specific functional scales and symptoms should be assessed individually to address unmet needs. Clinicians could design psychosocial interventions to improve these function and to reduce symptoms.
Communicating the Spinal Muscular Atrophy diagnosis to children and the principle of autonomy
Authors: Fernandes Isabella Araujo Mota , Menezes Renata Oliveira Almeida , Rego Guilhermina
Published: August 2022

Introduction

The trinomial relationship between physicians/children/guardians is essential in the process of communicating a disease and its prognosis.

Objective

Analyzing the exercise of autonomy by this trinomial relationship in communicating the diagnosis of spinal muscular atrophy (SMA).  

Methodology

Caregivers of SMA patients answered a questionnaire containing a structured interview and the Event Impact Scale – Revised.

Results

The sample comprised 50 volunteers, 94% of whom were female caregivers. Psychological trauma was predominantly reported when caregivers communicated the diagnosis to children. 22% have a high risk of post-traumatic stress, relating the feeling of unpreparedness in communicating this to the child.

Conclusions

It was identified that the failure in communication is the main factor for negative repercussions on the autonomy of children and their guardians, with self-reported psychological trauma, besides the high risk for post-traumatic stress syndrome.
miR-215-5p regulates osteoporosis development and osteogenic differentiation by targeting XIAP
Authors: Yin Zilong , Shen Jian , Wang Qiang , Wen Liangyuan , Qu Wenjing , Zhang Yaonan
Published: August 2022

Background

Osteoporosis (OP) is a metabolic disease that involves microstructure destruction and fracture damage. The present study probed into the significance of miR-215-5p in OP progression.

Methods

Serum samples were collected from surgical patients and healthy controls. qRT-PCR analysis was utilized to determine the miR-215-5p level in clinical samples and human bone mesenchymal stem cells (hBMSCs) induced by β-glycerol phosphate. A dual luciferase reporter assay was exploited to examine the targeted relationship between miR-215-5p and XIAP. The mineralization and calcium deposition of hBMSCs were assessed by detection of ALP activity, Alizarin red staining, and osteoblast marker expression. Protein expression was determined by western blot analysis.

Results

MiR-215-5p was significantly reduced in patients with OP and increased in hBMSCs treated with β-glycerophosphate. Enhanced miR-215-5p level triggered augment in osteoblast markers (Alkaline phosphatase/ ALP, Osteocalcin/ OCN, and Runt-Related Transcription Factor 2/ Runx2), which was accompanied by the increase of ALP activity in hBMSCs and accumulation of Calcium. Functional experiments show that XIAP was a target of miR-215-5p and negatively modulated by miR-215-5p. XIAP expression levels were increased in OP samples, and decreased XIAP in β-glycerophosphate-treated hBMSCs inhibited its’ osteogenic differentiation. Functional loss and acquisition experiments depicted that miR-215-5p promoted the differentiation of hBMSCs by inhibiting the XIAP level, playing a protective role in the pathogenesis of OP.

Conclusions

β-glycerophosphate promoted the osteogenic differentiation of hBMSCs, increased miR-215-5p level, and decreased XIAP. miR-215-5p stimulated osteogenic differentiation of hBMSCs by targeting XIAP, shedding new insights for the detection and therapy of OP.
Sexual dysfunction among men with diabetes; a cross-sectional study at a specialised diabetes clinic in Sri Lanka
Authors: de Silva Nipun Lakshitha , Athukorala Tharaka , Gamage Jayathra Liyana , Katulanda Gaya , de Silva Prasad , Sumanatilleke Manilka , Somasundaram Noel
Published: August 2022

Background

Male sexual dysfunction in diabetes is often an unrevealed clinical issue. Though many publications report the prevalence, there is limited data on its associations, impact, and health-seeking behaviour. The objectives were to assess the prevalence of male sexual dysfunction, its associations, impact and treatment-seeking among men with diabetes in a selected tertiary care Diabetes Clinic.

Methods

A cross-sectional study was conducted at the Diabetes Clinic, National Hospital of Sri Lanka, from January to September 2020. Men with diabetes aged 18 to 70 years undergoing annual assessment were recruited consecutively. Socio-demographic and clinical information were collected using an interviewer-administered questionnaire. Erectile dysfunction (ED), premature ejaculation, mental health and quality of life were assessed using validated self-administered questionnaires. Cardiovascular autonomic reflex tests and total testosterone levels were performed. Penile colour Doppler ultrasonography was performed on consenting participants with erectile dysfunction. Associations were assessed using the chi-square test or Fisher’s exact for dichotomous variables and independent sample t-test for continuous variables.

Results

Two hundred and twelve participants were recruited with a mean age of 54.1 (SD = 10.1) years. Erectile dysfunction was present in 168 (79.2%), (mild: 45, mild-moderate: 56, moderate: 26, severe: 41). Premature ejaculation was present in 26 (18.7%). Libido was low among 16%. Sexual dysfunction was not revealed to a health provider by 85.6% despite 60.5% experiencing psychological and/or relationship effects. Out of 18 who sought treatment, only 4 achieved a good response. Mean age (55.4 ± 9.5 vs 48.7 ± 10.6 years, p < 0.001) and duration of diabetes (10.9 ± 7.6 vs 5.8 ± 4.6 years, p < 0.001) were higher while eGFR was lower (73.9 ± 27.7 vs 100.51 ± 28.08 years, p < 0.008) among those with ED compared to those without. Diabetic retinopathy (4% vs 42%, p < 0.001), peripheral neuropathy (17.9% vs 38.4%, p = 0.041) and lower limb arterial disease (0% vs 12.2%, p = 0.04) were associated with ED. Arterial insufficiency was seen among 50% of the participants who underwent penile colour Doppler ultrasonography.

Conclusions

Male sexual dysfunction is a pervasive yet underappreciated problem in diabetes care despite its effect on the individual. Patient and disease characteristics would guide the identification of high-risk individuals for targeted screening in clinical practice.
Fetuin-A mediates the difference in adipose tissue insulin resistance between young adult pakistani and norwegian patients with type 2 diabetes
Authors: Lee-Ødegård Sindre , Ueland Thor , Thorsby Per M. , Aukrust Pål , Michelsen Annika E. , Halvorsen Bente , Drevon Christian A. , Birkeland Kåre I.
Published: August 2022

Background

South-Asian immigrants to Western countries have a high prevalence of type 2 diabetes mellitus (T2DM) and increased adipose tissue insulin resistance (AT-IR), as compared to their Western counterparts. Fetuin-A is a hepatokine known to influence AT-IR.

Aim

Can plasma fetuin-A concentrations explain an ethnic difference in adipose tissue insulin resistance?

Methods

We performed a two-step euglycemic-hyperinsulinaemic clamp and measured plasma concentrations of fetuin-A and non-esterified fatty acids (NEFA), in 18 Pakistani and 21 Norwegians with T2DM (age 29–45y) in Norway. AT-IR was calculated as NEFA-suppression during the clamp. The adipokines/cytokines leptin, adiponectin, visfatin, PTX3, IL-1β, INF-γ, and IL-4 were measured in fasting plasma. Liver fat was estimated by CT-scans.

Results

Despite a lower BMI, Pakistani patients displayed higher AT-IR than Norwegians. NEFA-suppression during clamp was lower in Pakistani than Norwegians (mean=-20.6%, 95%CI=[-40.8, -0.01] and p = 0.046). Plasma fetuin-A concentration was higher in Pakistani than Norwegians (43.4 ng/mL[12.7,74.0], p = 0.007) and correlated negatively to %NEFA-suppression during clamp (rho=-0.39, p = 0.039). Plasma fetuin-A concentration explained 22% of the ethnic difference in NEFA-suppression during the clamp. Pakistani patients exhibited higher plasma leptin and lower PTX3 levels than Norwegian, and plasma visfatin correlated positively to plasma fetuin-A levels in the Pakistani patients. We observed no correlation between plasma fetuin-A and liver fat, but fetuin-A correlated negatively with plasma IL-1β, INF-γ, and IL-4 concentrations. Plasma IL-4 concentration was lower in Pakistani than in Norwegian patients.

Conclusion

Fetuin-A may contribute to explain the discrepancy in T2DM prevalence between Pakistani and Norwegians patients by influencing AT-IR.
Patterns of adult and youth inpatient admissions before and after the COVID-19 pandemic in a psychiatric ward: an observational study
Authors: Rodrigues Carolina Alves , Rodrigues Nuno , Nascimento Miguel , Oliveira-Silva Joana
Published: August 2022

Background

The current pandemic situation led to deep changes not only in social relationships, but also on clinical care and access to healthcare facilities. The authors aimed to understand whether this context affected the main characteristics of psychiatric hospitalizations, measured by admissions in a portuguese acute psychiatric ward.

Methods

Retrospective data collection of all patients admitted in Centro Hospitalar Psiquiátrico de Lisboa, in two different time periods: pre-COVID-19 (march 11th, 2019 to march 10th, 2020, n = 1845) and COVID-19 (march 11th, 2020 to march 10th, 2021, n = 1278); comparing the number of total admissions, compulsory ones, age, sex, median days of admission, median days to readmission and diagnosis at discharge. Distribution of disorders in both groups, as well as in compulsory admissions were also evaluated. The same comparisons were evaluated in the 15–25-year-old patient group.

Results

Statistical significance was found regarding total number of admissions (reduction of around 30.7%), as well as compulsory ones (reduction of 14%, although the relative frequency had increased), days of admission and distribution between admissions (with lower reductions regarding dementias, schizophrenia and affective disorders, while substance use disorders and intellectual disabilities presented reductions of over 50%), with no differences between gender, median age, previous admissions or readmissions. Distribution between compulsory admissions did not present differences before and during COVID periods.

For patients between 15 and 25 years of age, statistical significance was found regarding total number of compulsory ones (94 versus 44, p-value = 0.01), and in all groups of diagnoses (all with p-value = 0.001).

Conclusions

While there was a general reduction in the overall number of patients admitted, in the most severe conditions (compulsory admissions and schizophrenia diagnosis) did not present such a reduction. Difficulties in social, clinical and family networks can explain the reduction of the time to readmission. Future research could show whether there is a rebound increase number of admissions in the other diagnoses.

Trial Registration

The current study was approved by the hospital’s scientific and ethics committees (CCP number 0060/2021 and CES 09/2021).
Real-time video communication between ambulance paramedic and scene – a simulation-based study
Authors: Sonkin Roman , Jaffe Eli , Wacht Oren , Morse Helena , Bitan Yuval
Published: August 2022

Introduction

Telemedicine has been widely used in various medical settings including in Emergency Medical Services (EMS). The goal of this study was to assess the possible roles of real-time video communication between paramedics and bystanders at scenes of emergency, in the analysis and treatment of patients.

Methods

44 experienced paramedics participated in a simulation. Participants communicated with the experimenter presenting video clips showing patients that simulated three emergency scenarios: trauma, an unresponsive patient with cardiac arrest, and an opiate overdose. The simulation sessions were conducted through Zoom™, recorded, and then analyzed to document participants’ questions, requests, instructions, and their timings during each scenario.

Results

The trauma scenario was assessed most promptly, with instructions to handle the bleeding provided by all paramedics. In the unresponsive patient with cardiac arrest scenario, most of the participants achieved a correct initial diagnosis, and in the opiate overdose scenario over half of paramedics sought visual clinical clues for the differential diagnoses of loss of consciousness and their causes. Additional results show the type of assessment, treatment and diagnosis participants provided in each scenario, and their confidence about situation.

Conclusions

The findings show that direct video communication between paramedic and scene may facilitate correct diagnosis, provision of instructions for treatment, and early preparation of medications or equipment. These may decrease time to correct diagnosis and lifesaving treatment and impact patient morbidity and mortality. Moreover, the findings highlight the difference between incidents with higher visual clarity, such as trauma, and conditions that require an extended diagnosis to reveal, such as unresponsive patients. This may also increase the paramedics’ mental preparedness for what is expected at the scene.
Effect of formic acid treatment on colostrum quality, and on absorption and function of immunoglobulins: a randomized controlled trial in Holstein dairy calves
Authors: Smith Billy I. , Cady Sarah V. , Aceto Helen W.
Published: August 2022

Background

Good quality colostrum is characterized by high immunoglobulin concentration and low pathogen load. Some methods of pathogen reduction can decrease immunoglobulin concentration and potentially affect their function. Objectives were to determine the effect of formic acid treatment on colostral bacterial and immunoglobulin (IgG) levels before feeding, and serum immunoglobulin concentration and neutralizing capabilities after feeding. Fifteen female Holstein calf pairs born < 12 h apart from different dams were randomly assigned to receive four liters of either untreated pooled (both dams) colostrum (MC) or colostrum acidified to pH 4.0–4.5 (AC). Colostrum characteristics estimated; pH, bacterial load, IgG concentration, and neutralization of Infectious Bovine Rhinotracheitis (IBRV/BoHV-1), Bovine Viral Diarrhea (BVDV) Types 1 and 2. Blood samples were collected on days 1, 3 and monthly for 6 months and were analyzed for IgG, and both viral plus leptospiral neutralization, and total protein (day 3 only).

Results

Compared to MC (mean 6.7, SD 0.4; median 6.8, range 6.0–7.3), AC pH was significantly reduced (mean 4.3, SD 0.2; median 4.3, range 4.0–4.5;P < 0.001). Total coliform count (cfu/mL) was also reduced (MC mean 149, SD 444; median 1, range 0–1,700; AC mean 8, SD 31; median 0, range 0–120;P = 0.02). Colostrum IgG concentration was not significantly different between MC (mean 93.3, SD 39.7; median 92.8, range 36.7–164.4 g/L) and AC (mean 101.9, SD 36.7; median 108.3, range 33.8–164.4 g/L;P = 0.54). In calves, serum IgG peaked on day 3 (MC mean 26.1, SD 34.9; median 169.2, range 8.3–151.0 g/L; AC mean 30.2, SD 48.7; median 188.8, range 3.1–204.4 g/L;P = 0.77), and apparent efficiency of IgG absorption was not different between groups (MC mean 24.3, SD 11.4, median 25.3, range 8.6–51.3%; AC mean 22.6, SD 21.7, median 21.6, range 4.1–58.9%;P = 0.65). Thereafter, IgG levels declined but did not differ between groups. MC and AC serum neutralizing titers for IBRV, BVDV Types 1 and 2, orLeptospira interrogansserovars Canicola, and Pomona andL. borgpeterseniiserovar Hardjo were not different.

Conclusions

Colostrum acidification significantly decreased bacterial load fed to newborn calves without affecting colostral IgG concentration or virus neutralization. In addition, acid treatment did not affect serum IgG concentration in calves or its activity against common pathogens.
Antibacterial activity of recently approved antibiotics against methicillin-resistant Staphylococcus aureus (MRSA) strains: A systematic review and meta-analysis
Authors: Liu Fei , Rajabi Sajad , Shi Chunhua , Afifirad Ghazale , Omidi Nazanin , Kouhsari Ebrahim , Khoshnood Saeed , Azizian Khalil
Published: August 2022

Background

Methicillin-resistant Staphylococcus aureus (MRSA) infections are considered an important public health problem, and treatment options are limited. Accordingly, in this meta-analysis, we analyzed published studies to survey in vitro activity of recently approved antibiotics against MRSA isolates.

Methods

We searched electronic databases; PubMed, Scopus, and Web of Science to identify relevant studies (until November 30, 2020) that have focused on the in vitro activity of telavancin, dalbavancin, oritavancin, and tedizolid against MRSA isolates. Statistical analyses were conducted using STATA software (version 14.0).

Results

Thirty-eight studies were included in this meta-analysis. Overall in vitro activity of tedizolid on 12,204 MRSA isolates was 0.250 and 0.5 µg/mL for MIC50 and MIC90, (minimum inhibitory concentration at which 50% and 90% of isolates were inhibited, respectively), respectively. The overall antibacterial activity of dalbavancin on 28539 MRSA isolates was 0.060 and 0.120 µg/mL for MIC50 and MIC90, respectively. The overall antibacterial activity of oritavancin on 420 MRSA isolates was 0.045 and 0.120 µg/mL for MIC50 and MIC90, respectively. The overall antibacterial activity of telavancin on 7353 MRSA isolates was 0.032 and 0.060 µg/mL for MIC50 and MIC90, respectively. The pooled prevalence of tedizolid, telavancin, and dalbavancin susceptibility was 100% (95% CI: 100–100).

Conclusion

Telavancin, dalbavancin, oritavancin, and tedizolid had potent in vitro activity against MRSA isolates. The low MICs and high susceptibility rates of these antibiotics recommend a hopeful direction to introduce useful antibiotics in treating MRSA infections in the future.
Understanding heterogeneity among individuals who smoke cigarettes and vape: assessment of biomarkers of exposure and potential harm among subpopulations from the PATH Wave 1 Data
Authors: Lizhnyak Pavel N. , Noggle Brendan , Wei Lai , Edmiston Jeffery , Becker Elizabeth , Black Ryan A. , Sarkar Mohamadi
Published: August 2022

Introduction

People who both smoke cigarettes and vape are often considered as a homogenous group even though multiple subgroups may exist. We examined biomarkers of exposure (BOE) and biomarkers of potential harm (BOPH) to differentiate between subgroups of people who smoke and vape based on PATH Study Wave 1 (2013–2014) data.

Methods

We compared people who only smoke cigarettes everyday (Group A, n = 2442) and people who only vape everyday (Group C, n = 169) against people who smoke and vape segmented into subgroups of people who frequently smoke and vape (Group B1, n = 169), frequently smoke and infrequently vape (Group B2, n = 678), frequently vape and infrequently smoke (Group B3, n = 57), and infrequently smoke and vape (Group B4, n = 66). Eighteen BOEs (representing exposure to TSNAs, nicotine, heavy metals, PAHs, and volatile organic compounds) and four BOPHs (representing inflammation and oxidative stress) were compared within the subgroups.

Results

Levels of many BOEs/BOPHs were higher among Group B2 relative to Groups B1, B3, and B4. Compared to Group A, many BOEs were significantly lower in Groups B3 (15/18) and B4 (17/18), and some BOEs were higher among B2 (4/18). Compared to Group C, significantly lower BOEs were observed for Group B4 (2/18).

Conclusions

Overall, the levels of BOEs and BOPHs in people who smoke and vape are associated with frequency of cigarette smoking. Our findings indicate that not all people who smoke and vape are the same, and tobacco product use frequency should be considered when categorizing people who smoke and vape.
Rs6757 in microRNA-3976 binding site of CD147 confers risk of hepatocellular carcinoma in South Chinese population
Authors: Guo Fenfen , Li Hong , Wang Lizhong , Song Xiaoping , Wang Jiangfeng , Feng Qingqing , Zong Jinbao
Published: August 2022

Background

Cluster of differentiation 147 (CD147) overexpression plays a key role in the proliferation, differentiation, invasion, metastasis, and prognosis of hepatocellular carcinoma (HCC). The aim of this study was to explore the relationship between rs6757 and the HCC risk in the South Chinese population, and the functional significance of rs6757 by affecting the efficacy of microRNA-3976 (miR-3976) binding to the CD147 3′-UTR.

Methods

We performed a retrospective case-control study to analyze the association between rs6757 and the risk of HCC. We chose candidate microRNAs with the potential of interacting with rs6757 through a series of silico analyses. A luciferase reporter gene assay was implemented to detect the binding extent of microRNAs to each polymorphic allele of rs6757.

Results

An obvious association between rs6757 and the risk of HCC was detected in C vs. T (OR = 1.826, 95% CI [1.263–2.642]), CC vs. TT (OR = 4.513, 95% CI [1.510–13.489]), dominant genetic model (OR = 1.824, 95% CI [1.120–2.965]), and recessive genetic model (OR = 3.765, 95% CI [1.286–11.020]). Bioinformatics analysis indicated that miR-3976 binding sites containing the rs6757-T allele had lower free energies than those with the C allele, the lower free energies, the higher affinities. Luciferase activity was remarkably decreased by miR-3976 binding to the CD147 3′-UTR bearing rs6757 T allele, which could be reversed by miR-3976 inhibitors. Furthermore, miR-3976 reduced the luciferase expression in a manner of dose-dependent when cotransfected with constructs with the CD147-TT-pSICHECK2.

Conclusions

The research we have done suggests that rs6757 confers the CD147 allele-specific translational suppression by miR-3976, which provides a theoretical basis for antineoplastic therapy targeting CD147.