bluuebunny/crossref_metadata_2025 huggingface dataset:
The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment: a systematic review and meta-analysis
Authors: Ren Xiaolin , Zhang Yuhan , Xiang Yong , Hu Tao , Cheng Ran , Cai He
Published: April 2023

Background

Mouthwashes were convenient adjuncts to mechanical cleaning procedures. This review aimed to evaluate the efficacy of mouthwashes on oral microorganisms and gingivitis in orthodontic patients.

Methods

By April 16, 2022, multiple databases and grey literature were searched based on the PICOS strategy. Randomized controlled trials in orthodontic patients evaluating the efficacy of mouthwashes with at least one microbial parameter and/or plaque- and/or gingival inflammation-related index were included. Relevant data were extracted, and the risk of bias was evaluated using Cochrane's tool. Individual mean and standard deviation of the outcomes in mouthwashes and placebos/blank controls were pooled to estimate the weighted mean differences (WMDs) and 95% confidence intervals (95%CIs). Sensitivity analysis, and certainty of evidence were evaluated.

Results

Of 1684 articles, 32 studies satisfied the eligibility criteria, and nine were included for meta-analysis. Missing outcome data was the primary source of bias. Compared to blank controls, the short-term application of fluoride mouthwashes significantly reduced the colony counts ofMutans streptococci (MS), while the long-term application may not be effective. Compared to placebos or blank controls, Chlorhexidine mouthwashes significantly reduced the colony counts of multiple microorganisms in the short-term. Compared to placebos or blank controls, herbal mouthwashes showed the inhibitory effect ofMSin the short-term, with some results lacking statistical significance. After meta-analysis, significant lower plaque- and gingival inflammation-related indexes were observed in the Chlorhexidine mouthwashes groups [Gingival Index: WMD = -0.45, 95%CI = -0.70 to -0.20 (placebos as control); WMD = -0.54, 95%CI = -0.96 to -0.13 (blank controls); Plaque Index: WMD = -0.70, 95%CI = -1.12 to -0.27 (blank controls)]. Significant lower gingival inflammation-related indexes were observed in the herbal mouthwashes groups [Gingival Index: WMD = -0.20, 95%CI = -0.32 to -0.09 (blank controls)].

Conclusions

The short-term application of fluoride mouthwashes may reduce the colony counts of cariogenic bacteria, but the long-term effect is not evident. Chlorhexidine may reduce the colony counts of multiple microorganisms in the short-term. Short-term application Chlorhexidine and herbal mouthwashes may effectively reduce plaque- and gingival inflammation-related indexes. However, the risk of bias, inconsistency, and imprecision in the included studies may reduce the certainty of the evidence.
Impact of information and communication software on multiprofessional team collaboration in outpatient palliative care – a qualitative study on providers’ perspectives
Authors: Suslow Anastasia , Giehl Chantal , Hergesell Jannis , Vollmar Horst Christian , Otte Ina
Published: April 2023

Background

The communication processes between different stakeholders in outpatient palliative care face challenges when multiprofessional teams want to keep each other updated on patient information. Meanwhile, the software market offers different tools to connect these teams in real-time to improve communication. In the research project ADAPTIVE (Impact of Digital Technologies in Palliative Care), we investigated how information and communication technology affects collaboration and work in multiprofessional teams and what advantages and disadvantages the use of said software might entail.

Methods

We conducted 26 semi-structured interviews between August and November 2020 with general practitioners (n = 8), palliative care nurses (n = 17), and a pharmacist (n = 1). They were conducted in a hybrid format, meaning that both face-to-face interviews and telephone interviews were carried out. Subsequently, we analyzed the interviews following the qualitative content analysis according to Kuckartz.

Results

Information and communication software has the potential to enable faster communication and delegation of tasks and to simplify communication and task management between providers. Furthermore, it creates the opportunity to decrease unnecessary supervision of duties and responsibilities for physicians in multiprofessional teams. Therefore, it allows facilitating the collaboration between multiprofessional teams that work independently of each other but care for the same patients. All providers have the same knowledge about their patients without time-consuming coordination such as phone calls or search processes in paper documentation. On the other hand, mishandling, poor Internet connection, and unfamiliarity with various features can diminish these benefits.

Conclusion

Even though the use of such software offers many advantages, these advantages only reveal themselves if the software is used as it was intended by the developers. Misuse and unawareness of the individual functions can lead to the full potential not being realized. The software developers frequently offer specialized training, and the multiprofessional teams should utilize that to improve team communication, facilitate tasks, and allow physicians to delegate tasks.

Trial registration

The study is registered in the German Clinical Trials Register (DRKS): https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00021603 (Registration number: DRKS00021603; date of first registration: 02/07/2020).
The impact of the COVID-19 pandemic on processes, resource use and cost in palliative care
Authors: Hodiamont Farina , Schatz Caroline , Schildmann Eva , Syunyaeva Zulfiya , Hriskova Katerina , Rémi Constanze , Leidl Reiner , Tänzler Susanne , Bausewein Claudia
Published: April 2023

Background

The COVID-19 pandemic impacts on working routines and workload of palliative care (PC) teams but information is lacking how resource use and associated hospital costs for PC changed at patient-level during the pandemic. We aim to describe differences in patient characteristics, care processes and resource use in specialist PC (PC unit and PC advisory team) in a university hospital before and during the first pandemic year.

Methods

Retrospective, cross-sectional study using routine data of all patients cared for in a PC unit and a PC advisory team during 10–12/2019 and 10–12/2020. Data included patient characteristics (age, sex, cancer/non-cancer, symptom/problem burden using Integrated Palliative Care Outcome Scale (IPOS)), information on care episode, and labour time calculated in care minutes. Cost calculation with combined top-down bottom-up approach with hospital’s cost data from 2019. Descriptive statistics and comparisons between groups using parametric and non-parametric tests.

Results

Inclusion of 55/76 patient episodes in 2019/2020 from the PC unit and 135/120 episodes from the PC advisory team, respectively.

IPOS scores were lower in 2020 (PCU: 2.0 points; PC advisory team: 3.0 points). The number of completed assessments differed considerably between years (PCU: episode beginning 30.9%/54.0% in 2019/2020; PC advisory team: 47.4%/40.0%). Care episodes were by one day shorter in 2020 in the PC advisory team. Only slight non-significant differences were observed regarding total minutes/day and patient (PCU: 150.0/141.1 min., PC advisory team: 54.2/66.9 min.). Staff minutes showed a significant decrease in minutes spent in direct contact with relatives (PCU: 13.9/7.3 min/day in 2019/2020, PC advisory team: 5.0/3.5 min/day).

Costs per patient/day decreased significantly in 2020 compared to 2019 on the PCU (1075 Euro/944 Euro for 2019/2020) and increased significantly for the PC advisory team (161 Euro/200 Euro for 2019/2020). Overhead costs accounted for more than two thirds of total costs. Direct patient cost differed only slightly (PCU: 134.7 Euro/131.1 Euro in 2019/2020, PC advisory team: 54.4 Euro/57.3 Euro).

Conclusions

The pandemic partially impacted on daily work routines, especially on time spent with relatives and palliative care problem assessments. Care processes and quality of care might vary and have different outcomes during a crisis such as the COVID-19 pandemic. Direct costs per patient/day were comparable, regardless of the pandemic.
Chronic conditions in women: the development of a National Institutes of health framework
Authors: Temkin Sarah M. , Barr Elizabeth , Moore Holly , Caviston Juliane P. , Regensteiner Judith G. , Clayton Janine A.
Published: April 2023

Rising rates of chronic conditions were cited as one of the key public health concerns in the Fiscal Year (FY) 2021 U.S. Senate and House of Representatives appropriations bills, where a review of current National Institutes of Health (NIH) portfolios relevant to research on women’s health was requested. Chronic conditions were last defined by the US Department of Health and Human Services (HHS) in 2010. However, existing definitions of chronic conditions do not incorporate sex or gender considerations. Sex and gender influence health, yet significant knowledge gaps exist in the evidence-base for prevention, diagnosis, and treatment of chronic diseases amongst women. The presentation, prevalence, and long-term effects of chronic conditions and multimorbidity differs in women from men. A clinical framework was developed to adequately assess the NIH investment in research related to chronic conditions in women. The public health needs and NIH investment related to conditions included in the framework were measured. By available measures, research within the NIH has not mapped to the burden of chronic conditions among women. Clinical research questions and endpoints centered around women can be developed and implemented; clinical trials networks with expanded or extended eligibility criteria can be created; and data science could be used to extrapolate the effects of overlapping or multiple morbidities on the health of women. Aligning NIH research priorities to address the specific needs of women with chronic diseases is critical to addressing women’s health needs from a life course perspective.
Protocatechuic aldehyde acts synergistically with dacarbazine to augment DNA double-strand breaks and promote apoptosis in cutaneous melanoma cells
Authors: Pei Junxia , Su Zhou , Zeng Xin , Zhong Ya , Zhang Yamei , Yang Yixi , Lu Qiuxia , Li Jian , Deng Yu
Published: April 2023

Background

Despite rapid developments in immunotherapy and targeted therapy, dacarbazine (DTIC)-based chemotherapy still has been placed at the first-line for advanced melanoma patients who are after failure of immunotherapy or targeted therapy. However, the limited response rate and survival benefit challenge the DTIC-based chemotherapy for advanced melanoma patients.

Methods

Two melanoma cell lines, A375 and SK-MEL-28 were cultured with PA and DTIC over a range of concentrations for 72 h and the cell viabilities were detected by CCK8 assay. The Bliss model and ZIP model were used for calculating the synergistic effect of PA and DTIC. DNA double-strand breaks in the two cell lines were examined by the Comet assay, and cell apoptosis was analyzed by flow cytometry. The short hairpin RNA (shRNA)-mediated knockdown, Real-time polymerase chain reaction (RT-PCR) and Western blot were performed for molecular analysis.

Results

In the present study, we report that Protocatechuic aldehyde (PA) synergistically enhances the cytotoxicity of DTIC to two melanoma cell lines, A375 and SK-MEL-28. The combination of PA and DTIC augments DNA double-strand breaks and increases cell apoptosis. Further mechanism study reveals that PA destabilizes MGMT protein (O-6-Methylguanine-DNA Methyltransferase) through the ubiquitin-proteasome process and directly repairs DTIC-induced genetic lesions. Knockdown of MGMT compromises the synergistic effect between PA and DTIC.

Conclusion

Our study demonstrates that the bioactive compound, Protocatechuic aldehyde, synergistically promotes the cytotoxicity of DTIC to melanoma cells through destabilization of MGMT protein. It could be a potential candidate for melanoma chemotherapy.
Future physicians’ behavioral intentions towards collaborative practice - a qualitative study on polish final-year medical students guided by the theory of planned behavior
Authors: Przymuszała Piotr , Szmelter Jagoda , Zielińska-Tomczak Łucja , Cerbin-Koczorowska Magdalena , Marciniak Ryszard
Published: April 2023

Background

Interprofessional collaboration constitutes a vital part of modern patient care, and many of its benefits for patients, medical staff, and the healthcare system have been described. However, little is known about factors influencing medical students’ intentions to work in a collaborative practice after graduation. Therefore, with the theory of planned behavior by Ajzen as a framework, this study aimed to evaluate their intentions and identify factors that influence their attitudes, subjective norms, and perceived behavioral control.

Methods

For this purpose, eighteen semi-structured interviews were conducted with medical students following a thematic guide developed according to the theory. They were thematically analyzed by two independent researchers.

Results

The results showed that their attitudes contained positive (better patient care, comfort and safety of work, learning and development opportunities) and negative examples like the fear of conflicts, losing authority and mistreatment. Sources of social pressure regarding the behavior (subjective norms) involved their peers, other physicians, representatives of other medical professions, patients, and managing bodies. Finally, perceived behavioral control included limited occasions for contacts and interprofessional learning during the studies, existing stereotypes and prejudices, legal regulations and systemic solutions, organizational aspects, and existing relations at the ward.

Conclusions

Analysis showed that Polish medical students generally seem to hold positive views on interprofessional collaboration and feel positive social pressure to get involved in interprofessional teams. However, factors listed in perceived behavioral control may act as barriers in the process.
Decision curve analysis confirms higher clinical utility of multi-domain versus single-domain prediction models in patients with open abdomen treatment for peritonitis
Authors: Huber Markus , Schober Patrick , Petersen Sven , Luedi Markus M.
Published: April 2023

Background

Prediction modelling increasingly becomes an important risk assessment tool in perioperative systems approaches, e.g. in complex patients with open abdomen treatment for peritonitis. In this population, combining predictors from multiple medical domains (i.e. demographical, physiological and surgical variables) outperforms the prediction capabilities of single-domain prediction models. However, the benefit of these prediction models for clinical decision-making remains to be investigated. We therefore examined the clinical utility of mortality prediction models in patients suffering from peritonitis with a decision curve analysis.

Methods

In this secondary analysis of a large dataset, a traditional logistic regression approach, three machine learning methods and a stacked ensemble were employed to examine the predictive capability of demographic, physiological and surgical variables in predicting mortality under open abdomen treatment for peritonitis. Calibration was examined with calibration belts and predictive performance was assessed with the area both under the receiver operating characteristic curve (AUROC) and under the precision recall curve (AUPRC) and with the Brier Score. Clinical utility of the prediction models was examined by means of a decision curve analysis (DCA) within a treatment threshold range of interest of 0–30%, where threshold probabilities are traditionally defined as the minimum probability of disease at which further intervention would be warranted.

Results

Machine learning methods supported available evidence of a higher prediction performance of a multi- versus single-domain prediction models. Interestingly, their prediction performance was similar to a logistic regression model. The DCA demonstrated that the overall net benefit is largest for a multi-domain prediction model and that this benefit is larger compared to the default “treat all” strategy only for treatment threshold probabilities above about 10%. Importantly, the net benefit for low threshold probabilities is dominated by physiological predictors: surgical and demographics predictors provide only secondary decision-analytic benefit.

Conclusions

DCA provides a valuable tool to compare single-domain and multi-domain prediction models and demonstrates overall higher decision-analytic value of the latter. Importantly, DCA provides a means to clinically differentiate the risks associated with each of these domains in more depth than with traditional performance metrics and highlighted the importance of physiological predictors for conservative intervention strategies for low treatment thresholds. Further, machine learning methods did not add significant benefit either in prediction performance or decision-analytic utility compared to logistic regression in these data.
Patterns of work-related stress and their predictors among emergency department nurses and emergency medical services staff in a time of crisis: a latent profile analysis
Authors: Charzyńska Edyta , Habibi Soola Aghil , Mozaffari Naser , Mirzaei Alireza
Published: April 2023

Background

Previous studies have shown that a disease outbreak may cause high stress among healthcare workers. However, the vast majority of those studies applied a variable-centered approach, in which relationships between the variables are believed to be identical across the studied population. The main purpose of this study was to identify latent profiles of healthcare workers with similar combinations of levels of various work-related stressors during the coronavirus disease 2019 (COVID-19) pandemic and to examine their predictors.

Methods

A cross-sectional paper-and-pencil study was conducted among a convenience sample of 297 emergency department (ED) nurses and 219 emergency medical services (EMS) staff members working in 10 hospital EDs and 52 EMS centers in Ardabil province, Iran. Data were collected using the Health and Safety Executive Management Standards Indicator Tool (HSE-MS IT).

Results

Using the latent profile analysis (LPA), five work-related stress profiles were identified: “high stress with a good understanding of one’s job role” (11.1%), “moderate stress” (41.9%), “relatively high stress with average demands and a very low understanding of one’s job role” (23.8%), “low stress” (18.0%), and “generally low stress but with very high job demands and relational conflicts” (5.2%). Age, marital status, service location, workplace, and the number of overtime hours significantly predicted profile membership.

Conclusion

The results of the study suggest the importance of incorporating various sources of stress and using the person-centered approach when investigating the work-related stress of healthcare workers during disease outbreaks. Identifying sociodemographic and work-related predictors of profile membership may be useful for preparing interventions that will be better suited to healthcare workers’ needs.
Beyond heroism: a qualitative study on the lived experiences of nurses caring for patients with COVID-19 in Pakistan
Authors: Afzal Mahreen , Hassan Rashid Muhammad Abo ul , Fischer Florian
Published: April 2023

Background

Healthcare professionals around the globe suffered severely during the COVID-19 pandemic. The present study aims to explore the lived experiences of nurses caring for COVID-19 patients in Pakistan.

Methods

The study is a qualitative exploration of the lived experiences caring for patients with COVID-19 in Pakistan. This research was conducted in two government hospitals there. Face-to-face in-depth interviews were conducted amongst 30 nurses who had been selected using purposive sampling technique. Thematic analysis was applied to extract the themes from respondents’ answers.

Results

By using thematic analysis, social response, impacts on physical and mental health, and experience of handling COVID-19 patients were extracted as major themes.

Conclusions

The findings of this research are of immense importance in showing the impact of COVID-19 on mental and physical health, along with the social and personal consequences for nurses providing care to COVID-19 patients.
The effectiveness of clinical guideline implementation strategies in oncology—a systematic review
Authors: Bora Ana-Mihaela , Piechotta Vanessa , Kreuzberger Nina , Monsef Ina , Wender Andreas , Follmann Markus , Nothacker Monika , Skoetz Nicole
Published: April 2023

Importance

Guideline recommendations do not necessarily translate into changes in clinical practice behaviour or better patient outcomes.

Objective

This systematic review aims to identify recent clinical guideline implementation strategies in oncology and to determine their effect primarily on patient-relevant outcomes and secondarily on healthcare professionals' adherence.

Methods

A systematic search of five electronic databases (PubMed, Web of Science, GIN, CENTRAL, CINAHL) was conducted on 16 december 2022. Randomized controlled trials (RCTs) and non-randomized studies of interventions (NRSIs) assessing the effectiveness of guideline implementation strategies on patient-relevant outcomes (overall survival, quality of life, adverse events) and healthcare professionals' adherence outcomes (screening, referral, prescribing, attitudes, knowledge) in the oncological setting were targeted. The Cochrane risk-of-bias tool and the ROBINS-I tool were used for assessing the risk of bias. Certainty in the evidence was evaluated according to GRADE recommendations. This review was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO) with the identification number CRD42021268593.

Findings

Of 1326 records identified, nine studies, five cluster RCTs and four controlled before-and after studies, were included in the narrative synthesis. All nine studies assess the effect of multi-component interventions in 3577 cancer patients and more than 450 oncologists, nurses and medical staff.

Patient-level

Educational meetings combined with materials, opinion leaders, audit and feedback, a tailored intervention or academic detailing may have little to no effect on overall survival, quality of life and adverse events of cancer patients compared to no intervention, however, the evidence is either uncertain or very uncertain.

Provider-level

Multi-component interventions may increase or slightly increase guideline adherence regarding screening, referral and prescribing behaviour of healthcare professionals according to guidelines, but the certainty in evidence is low. The interventions may have little to no effect on attitudes and knowledge of healthcare professionals, still, the evidence is very uncertain.

Conclusions and relevance

Knowledge and skill accumulation through team-oriented or online educational training and dissemination of materials embedded in multi-component interventions seem to be the most frequently researched guideline implementation strategies in oncology recently. This systematic review provides an overview of recent guideline implementation strategies in oncology, encourages future implementation research in this area and informs policymakers and professional organisations on the development and adoption of implementation strategies.
Associations of risk factor burden and genetic predisposition with the 10-year risk of atrial fibrillation: observations from a large prospective study of 348,904 participants
Authors: Zhang Junguo , Chen Ge , Wang ChongJian , Wang Xiaojie , Qian Zhengmin , Cai Miao , Vaughn Michael G. , Bingheim Elizabeth , Li Haitao , Gao Yanhui , Lip Gregory Y. H. , Lin Hualiang
Published: April 2023

Background

Understanding the effects of risk factor burden and genetic predisposition on the long-term risk of atrial fibrillation (AF) is important to improve public health initiatives. However, the 10-year risk of AF considering risk factor burden and genetic predisposition is unknown.

Methods

A total of 348,904 genetically unrelated participants without AF at baseline from the UK were categorized into three groups: index ages 45 years (n = 84,206), 55 years (n=117,520), and 65 years (n=147,178). Optimal, borderline, or elevated risk factor burden was determined by body mass index, blood pressure, diabetes mellitus, alcohol consumption, smoking status, and history of myocardial infarction or heart failure. Genetic predisposition was estimated using the polygenic risk score (PRS), constructed using 165 predefined genetic risk variants. The combined effects of risk factor burden and PRS on the risk of incident AF in 10 years were estimated for each index age. Fine and Gray models were developed to predict the 10-year risk of AF.

Results

The overall 10-year risk of AF was 0.67% (95% CI: 0.61–0.73%) for index age 45 years, 2.05% (95% CI: 1.96–2.13%) for index age 55 years, and 6.34% (95% CI: 6.21–6.46%) for index age 65 years, respectively. An optimal risk factor burden was associated with later AF onset regardless of genetic predisposition and sex (P < 0.001). Significant synergistic interactions were observed for risk factor burden with PRS at each index age (P < 0.05). Participants with an elevated risk factor burden and high PRS had the highest 10-year risk of AF in reference to those who had both an optimal risk factor burden and a low PRS. At younger ages, optimal risk burden and high PRS might also lead to later onset of AF, compared to the joint effect of elevated risk burden and low/intermediate PRS.

Conclusions

Risk factor burden together with a genetic predisposition is associated with the 10-year risk of AF. Our results may be helpful in selecting high-risk individuals for primary prevention of AF and facilitating subsequent health interventions.
Molecular subtypes predict therapeutic responses and identifying and validating diagnostic signatures based on machine learning in chronic myeloid leukemia
Authors: Zhong Fang-Min , Yao Fang-Yi , Yang Yu-Lin , Liu Jing , Li Mei-Yong , Jiang Jun-Yao , Zhang Nan , Xu Yan-Mei , Li Shu-Qi , Cheng Ying , Xu Shuai , Huang Bo , Wang Xiao-Zhong
Published: April 2023

Chronic myeloid leukemia (CML) is a hematological tumor derived from hematopoietic stem cells. The aim of this study is to analyze the biological characteristics and identify the diagnostic markers of CML. We obtained the expression profiles from the Gene Expression Omnibus (GEO) database and identified 210 differentially expressed genes (DEGs) between CML and normal samples. These DEGs are mainly enriched in immune-related pathways such as Th1 and Th2 cell differentiation, primary immunodeficiency, T cell receptor signaling pathway, antigen processing and presentation pathways. Based on these DEGs, we identified two molecular subtypes using a consensus clustering algorithm. Cluster A was an immunosuppressive phenotype with reduced immune cell infiltration and significant activation of metabolism-related pathways such as reactive oxygen species, glycolysis and mTORC1; Cluster B was an immune activating phenotype with increased infiltration of CD4 + and CD8 + T cells and NK cells, and increased activation of signaling pathways such as interferon gamma (IFN-γ) response, IL6-JAK-STAT3 and inflammatory response. Drug prediction results showed that patients in Cluster B had a higher therapeutic response to anti-PD-1 and anti-CTLA4 and were more sensitive to imatinib, nilotinib and dasatinib. Support Vector Machine Recursive Feature Elimination (SVM-RFE), Least Absolute Shrinkage Selection Operator (LASSO) and Random Forest (RF) algorithms identified 4 CML diagnostic genes (HDC, SMPDL3A, IRF4 and AQP3), and the risk score model constructed by these genes improved the diagnostic accuracy. We further validated the diagnostic value of the 4 genes and the risk score model in a clinical cohort, and the risk score can be used in the differential diagnosis of CML and other hematological malignancies. The risk score can also be used to identify molecular subtypes and predict response to imatinib treatment. These results reveal the characteristics of immunosuppression and metabolic reprogramming in CML patients, and the identification of molecular subtypes and biomarkers provides new ideas and insights for the clinical diagnosis and treatment.
Factors influencing treatment status of syphilis among pregnant women: a retrospective cohort study in Guangzhou, China
Authors: Liu Huihui , Chen Niannian , Tang Weiming , Shen Songying , Yu Jia , Xiao Huiyun , Zou Xingwen , He Jianrong , Tucker Joseph D. , Qiu Xiu
Published: April 2023

Background

Many syphilis infected pregnant women do not receive treatment, representing a major missed opportunity to reduce the risk of syphilis-related adverse pregnancy outcomes. This study explored correlates of treatment among pregnant women with syphilis in Guangzhou, China.

Methods

Pregnant women with a diagnosis of syphilis in Guangzhou between January 2014 and December 2016 were included. Information of syphilis treatment and correlates were extracted from a comprehensive national case-reporting system. Multivariate logistic regression was used to identify the correlations between information on the demographic characteristics, previous history, clinical characteristics about current syphilis, information of diagnosing hospital, and receiving no treatment or inadequate treatment among syphilis-seropositive pregnant women. A causal mediation analysis was used to explore the potential mediating role of the timing of syphilis diagnosis in the correlates.

Results

Among 1248 syphilis-seropositive pregnant women, 379 (30.4%) women received no treatment or inadequate treatment. Migrant pregnant women (adjusted OR = 1.83, 95% CI: 1.25–2.73), multiparous participants (adjusted OR = 3.68, 95% CI: 2.51–5.50), unmarried participants (adjusted OR = 3.21, 95% CI: 1.97–5.28) and unemployed participants (adjusted OR = 2.43, 95% CI: 1.41–4.39) were more likely to receive no treatment or inadequate treatment. Participants who with history of syphilis infection (adjusted OR = 0.59, 95% CI: 0.42–0.82) and with high school and higher education participants (adjusted OR = 0.69, 95% CI: 0.49–0.97) were less likely to receive untreated or inadequately treatment. And that the impact of all these factors (except for the migrants) on treatment status are fully mediated through the syphilis diagnosis time, with the direct effect of migrants that would have resulted in a higher rate of no or inadequate treatment (OR = 2.34, 95% CI: 1.08–5.32) was partially cancelled out by the syphilis diagnosis time.

Conclusions

Pregnant women who were migrant without local residence and women with syphilis diagnosed at a later gestational age were more likely to slip through the cracks of the existing antenatal care system. More programs should focus on eliminating these gaps of residence-related health inequalities. This research highlights actionable elements for health services interventions that could increase syphilis treatment rates among pregnant women.
Anlotinib dramatically improved pulmonary hypertension and hypoxia caused by Pulmonary Tumor Thrombotic Microangiopathy (PTTM) associated with gastric carcinoma: a case report
Authors: Wang Yang , Ning Wei-wei , Jin Yi-fan , Zhu Qing-qing , Wang Zai-liang , Su Nan , Chen Yan-bin , Huang Jian-an , Chen Cheng
Published: April 2023

Background

Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare malignancy-related respiratory complication, demonstrating rapid progression of pulmonary hypertension (PH) and respiratory failure. Although a number of treatments have been attempted for patients diagnosed with or suspected of having PTTM, successful-treated cases of PTTM were mainly from imatinib therapy, which was a PDGF receptor inhibitor. Anlotinib was a novel tyrosine kinase inhibitor that targets VEGFR, FGFR, PDGFR, and c-kit.

Case presentation

We reported a patient of PTTM associated with gastric carcinoma, whom were treated with anlotinib, thereby exhibiting significant improvement of PH and respiratory dysfunction.

Conclusion

Our case provides a new understanding of therapy to PTTM, with implications for defining anlotinib as candidate drug for PTTM. Clinical diagnosis and prompt initiation of anlotinib might be one of the strategies in patients with unstable PTTM.
Online Health Communities: an alternative feasible data registry tool for developing countries
Authors: Abdelraheem Omnia , Sami Diana G. , Salama Mohamed
Published: April 2023

Given the many challenges facing healthcare access in many developing countries and the added limitations observed in emergencies like COVID-19 pandemic, the authors here discuss an alternative and feasible approach to overcome all these limitations.
Optical coherence tomography angiography measurements in multiple sclerosis: a systematic review and meta-analysis
Authors: Mohammadi Soheil , Gouravani Mahdi , Salehi Mohammad Amin , Arevalo J. Fernando , Galetta Steven L. , Harandi Hamid , Frohman Elliot M. , Frohman Teresa C. , Saidha Shiv , Sattarnezhad Neda , Paul Friedemann
Published: April 2023

Background and objectives

Recent literature on multiple sclerosis (MS) demonstrates the growing implementation of optical coherence tomography–angiography (OCT-A) to discover potential qualitative and quantitative changes in the retina and optic nerve. In this review, we analyze OCT-A studies in patients with MS and examine its utility as a surrogate or precursor to changes in central nervous system tissue.

Methods

PubMed and EMBASE were systematically searched to identify articles that applied OCT-A to evaluate the retinal microvasculature measurements in patients with MS. Quantitative data synthesis was performed on all measurements which were evaluated in at least two unique studies with the same OCT-A devices, software, and study population compared to controls. A fixed-effects or random-effects model was applied for the meta-analysis based on the heterogeneity level.

Results

The study selection process yielded the inclusion of 18 studies with a total of 1552 evaluated eyes in 673 MS-associated optic neuritis (MSON) eyes, 741 MS without optic neuritis (MSNON eyes), and 138 eyes without specification for the presence of optic neuritis (ON) in addition to 1107 healthy control (HC) eyes. Results indicated that MS cases had significantly decreased whole image superficial capillary plexus (SCP) vessel density when compared to healthy control subjects in the analyses conducted on Optovue and Topcon studies (bothP < 0.0001). Likewise, the whole image vessel densities of deep capillary plexus (DCP) and radial peripapillary capillary (RPC) were significantly lower in MS cases compared to HC (allP < 0.05). Regarding optic disc area quadrants, MSON eyes had significantly decreased mean RPC vessel density compared to MSNON eyes in all quadrants except for the inferior (allP < 0.05). Results of the analysis of studies that used prototype Axsun machine revealed that MSON and MSNON eyes both had significantly lower ONH flow index compared to HC (bothP < 0.0001).

Conclusions

This systematic review and meta-analysis of the studies reporting OCT-A measurements of people with MS confirmed the tendency of MS eyes to exhibit reduced vessel density in the macular and optic disc areas, mainly in SCP, DCP, and RPC vessel densities.
Development and validation of a novel scale for antiretroviral therapy readiness among pregnant women in urban Zambia with newly diagnosed HIV infection
Authors: Mubiana-Mbewe Mwangelwa , Bosomprah Samuel , Saroj Rakesh Kumar , Kadota Jillian , Koyuncu Aybuke , Thankian Kusanthan , Vinikoor Michael J.
Published: April 2023

Background

Women who are newly diagnosed with HIV infection during pregnancy may not be ready to immediately initiate lifelong antiretroviral therapy (ART; called Option B +) as is recommended. Lack of “readiness” drives early disengagement from care and undermines prevention of HIV transmission to infants. Several studies have shown high early attrition of women initiating ART in pregnancy. Although poor ART uptake and adherence have been attributed to various factors including stigma, disclosure issues and structural issues, there is no standard way of determining which pregnant woman will face challenges and therefore need additional support. We developed and validated a novel ART readiness tool in Lusaka, Zambia.

Methods

The aim of this study was to develop and validate a tool that could be used to assess how ready a newly diagnosed pregnant woman living with HIV would be to initiate ART on the day of diagnosis. Using a mixed method design, we conducted this study in three public-setting health facilities in Lusaka, Zambia. Informed by qualitative research and literature review, we identified 27 candidate items. We assessed content validity using expert and target population judgment approaches. We administered the 27-item questionnaire to 454 newly diagnosed pregnant women living with HIV, who were enrolled into a randomized trial (trials number NCT02459678). We performed item reduction analysis and used Cronbach’s alpha coefficient of 0.70 as threshold for reliability.

Results

A total of 454 pregnant women living with HIV enrolled in the study between March 2017 and December 2017; 452 had complete data for analysis. The correlation coefficient between the 27 items on the completed ART readiness scale ranged from 0.31 to 0.70 while item discrimination index ranged from -0.01 to 2.38. Sixteen items were selected for the final scale, representing three domains, which we classified as “internalized and anticipated HIV stigma”, “partner support” and “anticipated structural barriers”.

Conclusion

We developed and validated a tool that could be used to assess readiness of newly diagnosed women living with HIV to initiate ART. This ART readiness tool could allow clinics to tailor limited resources to pregnant women living with HIV needing additional support to initiate and remain on ART.
Cooperative NF-κB and Notch1 signaling promotes macrophage-mediated MenaINV expression in breast cancer
Authors: Duran Camille L. , Karagiannis George S. , Chen Xiaoming , Sharma Ved P. , Entenberg David , Condeelis John S. , Oktay Maja H.
Published: April 2023

Metastasis is a multistep process that leads to the formation of clinically detectable tumor foci at distant organs and frequently to patient demise. Only a subpopulation of breast cancer cells within the primary tumor can disseminate systemically and cause metastasis. To disseminate, cancer cells must express MenaINV, an isoform of the actin regulatory protein Mena, encoded by the ENAH gene, that endows tumor cells with transendothelial migration activity, allowing them to enter and exit the blood circulation. We have previously demonstrated that MenaINV mRNA and protein expression is induced in cancer cells by macrophage contact. In this study, we discovered the precise mechanism by which macrophages induce MenaINV expression in tumor cells. We examined the promoter of the human and mouse ENAH gene and discovered a conserved NF-κB transcription factor binding site. Using live imaging of an NF-κB activity reporter and staining of fixed tissues from mouse and human breast cancer, we further determined that for maximal induction of MenaINV in cancer cells, NF-κB needs to cooperate with the Notch1 signaling pathway. Mechanistically, Notch1 signaling does not directly increase MenaINV expression, but it enhances and sustains NF-κB signaling through retention of p65, an NF-κB transcription factor, in the nucleus of tumor cells, leading to increased MenaINV expression. In mice, these signals are augmented following chemotherapy treatment and abrogated upon macrophage depletion. Targeting Notch1 signaling in vivo decreased NF-κB signaling activation and MenaINV expression in the primary tumor and decreased metastasis. Altogether, these data uncover mechanistic targets for blocking MenaINV induction that should be explored clinically to decrease cancer cell dissemination and improve survival of patients with metastatic disease.
FIPRESCI: droplet microfluidics based combinatorial indexing for massive-scale 5′-end single-cell RNA sequencing
Authors: Li Yun , Huang Zheng , Zhang Zhaojun , Wang Qifei , Li Fengxian , Wang Shufang , Ji Xin , Shu Shaokun , Fang Xiangdong , Jiang Lan
Published: April 2023

Single-cell RNA sequencing methods focusing on the 5′-end of transcripts can reveal promoter and enhancer activity and efficiently profile immune receptor repertoire. However, ultra-high-throughput 5′-end single-cell RNA sequencing methods have not been described. We introduce FIPRESCI, 5′-end single-cell combinatorial indexing RNA-Seq, enabling massive sample multiplexing and increasing the throughput of the droplet microfluidics system by over tenfold. We demonstrate FIPRESCI enables the generation of approximately 100,000 single-cell transcriptomes from E10.5 whole mouse embryos in a single-channel experiment, and simultaneous identification of subpopulation differences and T cell receptor signatures of peripheral blood T cells from 12 cancer patients.
Reading and writing of mRNA m6A modification orchestrate maternal-to-zygotic transition in mice
Authors: Zhu Wencheng , Ding Yufeng , Meng Juan , Gu Lei , Liu Wenjun , Li Li , Chen Hongyu , Wang Yining , Li Ziyi , Li Chen , Sun Yidi , Liu Zhen
Published: April 2023

N6-methyladenosine (m6A) modification has been shown to regulate RNA metabolism. Here, we investigate m6A dynamics during maternal-to-zygotic transition (MZT) in mice through multi-omic analysis. Our results show that m6A can be maternally inherited or de novo gained after fertilization. Interestingly, m6A modification on maternal mRNAs not only correlates with mRNA degradation, but also maintains the stability of a small group of mRNAs thereby promoting their translation after fertilization. We identify Ythdc1 and Ythdf2 as key m6A readers for mouse preimplantation development. Our study reveals a key role of m6A mediated RNA metabolism during MZT in mammals.
Insights on the in-vitro binding interaction between donepezil and bovine serum albumin
Authors: El Gammal Reem N. , Elmansi Heba , El-Emam Ali A. , Belal Fathalla , Elzahhar Perihan A. , Belal Ahmed S. F. , Hammouda Mohammed E. A.
Published: April 2023

In this work, the binding mechanism between donepezil (DNP) and bovine serum albumin (BSA) was established using several techniques, including fluorimetry, UV- spectrophotometry, synchronous fluorimetry (SF), fourier transform infrared (FTIR), fluorescence resonance energy transfer (FRET) besides molecular docking study. The fluorescence quenching mechanism of DNP-BSA binding was a combined dynamic and static quenching. The thermodynamic parameters, binding forces, binding constant, and the number of binding sites were determined using a different range of temperature settings. Van't Hoff's equation was used to calculate the reaction parameters, including enthalpy change (ΔHο) and entropy change (ΔSο). The results pointed out that the DNP-BSA binding was endothermic. It was shown that the stability of the drug-protein system was predominantly due to the intermolecular hydrophobic forces. Additionally, the site probing method revealed that subdomain IIA (Site I) is where DNP and BSA's binding occurs. This was validated using a molecular docking study with the most stable DNP configuration. This study might help to understand DNP's pharmacokinetics profile and toxicity as well as provides crucial information for its safe use and avoiding its toxicity.
Shell field morphogenesis in the polyplacophoran mollusk Acanthochitona rubrolineata
Authors: Xia Yuxiu , Huan Pin , Liu Baozhong
Published: April 2023

Background

The polyplacophoran mollusks (chitons) possess serially arranged shell plates. This feature is unique among mollusks and believed to be essential to explore the evolution of mollusks as well as their shells. Previous studies revealed several cell populations in the dorsal epithelium (shell field) of polyplacophoran larvae and their roles in the formation of shell plates. Nevertheless, they provide limited molecular information, and shell field morphogenesis remains largely uninvestigated.

Results

In the present study, we investigated shell field development in the chiton Acanthochitona rubrolineata based on morphological characteristics and molecular patterns. A total of four types of tissue could be recognized from the shell field of A. rubrolineata. The shell field comprised not only the centrally located, alternatively arranged plate fields and ridges, but also the tissues surrounding them, which were the precursors of the girdle and we termed as the girdle field. The girdle field exhibited a concentric organization composed of two circularly arranged tissues, and spicules were only developed in the outer circle. Dynamic engrailed expression and F-actin (filamentous actin) distributions revealed relatively complicated morphogenesis of the shell field. The repeated units (plate fields and ridges) were gradually established in the shell field, seemingly different from the manners used in the segmentation of Drosophila or vertebrates. The seven repeated ridges also experienced different modes of ontogenesis from each other. In the girdle field, the presumptive spicule-formation cells exhibited different patterns of F-actin aggregations as they differentiate.

Conclusions

These results reveal the details concerning the structure of polyplacophoran shell field as well as its morphogenesis. They would contribute to exploring the mechanisms of polyplacophoran shell development and molluscan shell evolution.
Diagnostic accuracy of ultra-low-dose CT compared to standard-dose CT for identification of non-displaced fractures of the shoulder, knee, ankle, and wrist
Authors: Xiao Mengqiang , Zhang Meng , Lei Ming , Lin Fenghuan , Chen Yanxia , Chen Jun , Liu Jinfeng , Ye Jingzhi
Published: April 2023

Objectives

To compare the performance of ultra-low-dose computed tomography (ULD-CT) with standard-dose computed tomography (SD-CT) for the diagnosis of non-displaced fractures of the shoulder, knee, ankle, and wrist.

Methods

This prospective study enrolled 92 patients receiving conservative treatment for limb joint fractures who underwent SD-CT followed by ULD-CT at a mean interval of 8.85 ± 1.98 days. Fractures were characterized as displaced or non-displaced. Objective (signal-to-noise ratio, contrast-to-noise ratio) and subjective CT image quality were evaluated. Observer performance for ULD-CT and SD-CT detecting non-displaced fractures was estimated by calculating the area under the receiver operating characteristic (ROC) curve (Az).

Results

The effective dose (ED) for the ULD-CT protocol was significantly lower than the ED for the SD-CT protocol (F = 422.21~2112.25, p < 0.0001); 56 patients (65 fractured bones) had displaced fractures, and 36 patients (43 fractured bones) had non-displaced fractures. Two non-displaced fractures were missed by SD-CT. Four non-displaced fractures were missed by ULD-CT. Objective and subjective CT image quality was significantly improved for SD-CT compared to ULD-CT. The sensitivity, specificity, PPV, NPV, and diagnostic accuracy of SD-CT and ULD-CT for non-displaced fractures of the shoulder, knee, ankle and wrist were similar: 95.35% and 90.70%; 100% and 100%; 100% and 100%; 99.72% and 99.44%; and 99.74% and 99.47%, respectively. The Az was 0.98 for SD-CT and 0.95 for ULD-CT (p = 0.32).

Conclusion

ULD-CT has utility for the diagnosis of non-displaced fractures of the shoulder, knee, ankle, and wrist and can support clinical decision-making.