bluuebunny/crossref_metadata_2025 huggingface dataset:
The postoperative prognosis of skip-N2 metastasis is favorable in small-cell lung carcinoma patients with pathological N2 classification: a propensity-score-adjusted retrospective multicenter study
Authors: Wu Lei-Lei , Liang Shen-Hua , Jiang Feng , Qiu Li-Hong , Chen Xiaolu , Yu Wan-Jun , Li Chong-Wu , Qian Jia-Yi , Huang Yang-Yu , Lin Peng , Long Hao , Li Zhi-Xin , Li Kun , Ma Guo-Wei , Xie Dong
Published: January 2023

Background:

The study on skip-N2 metastasis in small-cell lung cancer (SCLC) is lacking. Therefore, this study aimed to explore the prognostic significance of skip-N2 metastasis based on a multicenter cohort.

Methods:

We collected 176 SCLC patients with pathological categories T1-4N1-2M0 from four hospitals in China. Survival curves were drawn through the Kaplan–Meier method and compared by the log-rank test. The Cox regression method was used to calculate the hazard ratio (HR) and 95% confidence interval of the characteristics for cancer-specific survival (CSS). Two propensity-score methods were used to reduce the bias, including the inverse probability of treatment weighting (IPTW) and propensity-score matching (PSM).

Results:

This multicenter database included 64 pN1 patients, 63 non-skip-N2 cases, and 49 skip-N2 cases. Skip-N2 and the non-skip-N2 patients had gap CSS rates (skip-N2 no versus yes: 41.0% versus 62.0% for 1-year CSS, 32.0% versus 46.0% for 2-year CSS, and 20.0% versus 32.0% for 3-year CSS). After PSM, there were 32 pairs of patients to compare survival differences between N2 and skip-N2 diseases, and 34 pairs of patients to compare prognostic gaps between N1 and skip-N2 diseases, respectively. The results of IPTW and PSM both suggested that skip-N2 cases had better survival outcomes than the non-skip-N2 cases (IPTW-adjusted HR = 0.578; PSM-adjusted HR = 0.510; all log-rank p < 0.05). Besides, the above two analytic methods showed no difference in prognoses between pN1 and skip-N2 diseases (all log-rank p > 0.05).

Conclusions:

Skip-N2 patients were confirmed to have a better prognosis than non-skip-N2 patients. Besides, there was no survival difference between pN1 and skip-N2 cases. Therefore, we propose that the next tumor-node-metastasis staging system needs to consider the situation of skip metastasis with lymph nodes in SCLC.
Spinal procedures, pneumocephalus, and cranial nerve palsies: A review of the literature
Authors: Jumah Ammar , Alsaif Ali , Fana Michael , Aboul Nour Hassan , Zoghoul Sohaib , Eltous Lara , Miller Daniel
Published: January 2023

Purpose: Minimally invasive and surgical spine procedures are commonplace with various risks and complications. Cranial nerve palsies, however, are infrequently encountered, particularly after procedures such as lumbar punctures, epidural anesthesia, or intrathecal injections, and are understandably worrisome for clinicians and patients as they may be interpreted as secondary to a sinister etiology. However, a less commonly considered source is a pneumocephalus which may, in rare cases, abut cranial nerves and cause a palsy as a benign and often self-resolving complication. Here, we present the case of a patient who underwent an intrathecal methotrexate infusion for newly diagnosed non-Hodgkin’s T-cell lymphoma and subsequently developed an abducens nerve palsy due to pneumocephalus. We highlight the utility of various imaging modalities, treatment options, and review current literature on spinal procedures resulting in cranial nerve palsies attributable to pneumocephalus presenting as malignant etiologies.
Out of control: The role of spider movement and intolerance of uncertainty in spider fear
Authors: Grill Markus , Haberkamp Anke
Published: January 2023

When asking spider-phobic individuals what they find most frightening about spiders, many report spiders’ unique movement characteristics. Here, we experimentally tested whether spider-specific movements are indeed a major cue in triggering spider fear. One-hundred-and-twenty participants (55 spider-fearful) viewed realistic 3D-animated videos of spiders and ladybugs moving on different paths and with different speeds. We found that spider-fearful individuals perceived spiders as more uncontrollable and unpredictable than ladybugs and non-fearful individuals. This held true to a certain degree even when spiders moved on predictable movement paths. Spiders also elicited more fear and disgust in spider-fearful individuals, which was amplified by curvy movement paths. Finally, spider-fearful individuals reported higher intolerance of uncertainty (IU), which may potentially increase distress in subjectively uncontrollable and unpredictable spider encounters. As far as we are aware, our study provides first experimental evidence of the effects of spider movement on cognition and emotion in spider fear, expanding the current knowledge about fear-related triggers.
A retrospective study of articular surface mounting computer-assisted total knee arthroplasty in alignment, knee function, and survival
Authors: Ng Eugene Pak-Lin , Wong Hing-Cheong
Published: January 2023

Background

Hong Kong Chinese exhibits a greater varus lower limb mechanical axis and coronal bowing when compared to Caucasians. This anatomical difference may affect the accuracy of bone cuts in total knee arthroplasty (TKA) using western anatomy-based intramedullary TKA cutting jigs. Use of computer navigation may avoid suboptimal cuts due to altered anatomy. This is the first study evaluating clinical function, radiological alignment and long-term survival of computer-assisted TKA amongst Hong Kong Chinese patients.

Methods

Retrospective study comparing articular surface mounting computer-assisted TKA (ASM-CATKA) and conventional TKA performed in a single centre from 2008 to 2010. Patients were followed up for ​assessment of clinical parameters including range of motion, Knee Society Knee score, and radiological parameters such as limb alignment, component alignment, and survival.

Results

Seventy-five patients were included in this study. Baseline clinical and radiological data were similar between groups. The computer-navigated group had superior radiological mechanical alignment ( p < 0.001), tibial component alignment ( p = 0.016) and femoral component alignment ( p < 0.01) when compared to conventional TKA. There were no differences in knee scores ( p = 0.488), range of motion ( p = 0.432) and survival at 117 months ( p = 0.986) between the two groups.

Conclusion

This retrospective study showed that ASM-CATKA was more accurate in achieving neutral mechanical axis and component alignment amongst Hong Kong Chinese. Clinical outcomes and implant survival were comparable.
Chronic Undernutrition and Associated Factors Among Children Aged 6 to 59 Months in South Ari, South Omo Zone, Ethiopia: A Community-Based Cross-Sectional Study
Authors: Wana Ermias Wabeto , Tesfaye Getamesay Aynalem , Workie Moges Getie
Published: January 2023

Background

Chronic undernutrition (stunting) among children is associated with an increased risk of morbidity and mortality. The global community is committed to end all forms of malnutrition by 2030. Regardless of this, children are suffering from some form of malnutrition but the reason is unclear. This study thus was intended to identify stunting and associated factors among children aged 6 to 59 months in the South Ari Woreda of South Omo Zone.

Methods

A community-based cross-sectional study was conducted in South Ari Woreda from 1, January 2022 to 30, February 2022, and 409 children participated. A simple random sampling technique was used to identify study participants, and mothers/caregivers were interviewed. Data on sociodemographic, economic, and environmental determinants were collected by trained professional nurses using interviewer-administered questionnaires and anthropometric data were collected via weighting and measuring the height/length of the child. Emergency Nutrition Assessment for Standardized Monitoring and Assessment of Relief and Transitions 2020 software was used to generate an anthropometric index, and a child with a height for age index below −2standard deviations of the standard population was considered stunted. Factors of stunting were assessed using multivariate binary logistic regression at a 5% significance level.

Results

The study revealed that 44.0% (95% confidence interval (CI) = 39.19%-48.81%) of children were stunted in the study area. Household's wealth status (the poorest; adjusted odds ratio (AOR) = 4.14 [95% CI = 2.08-8.22] and poor; AOR = 3.31 [95% CI = 1.60-6.82]), improper solid waste management practice of the household (AOR = 2.67 [95% CI = 1.56-4.55]), and the children sleeping under insecticide-treated bed nets (ITN) (AOR = 0.37 [95%CI = 0.22-0.60]) were statistically significantly associated with stunting status of the children.

Conclusion

Stunting among the children in the study area was very high. Improving household's (HH) economy, safe management of domestic solid waste, and ensuring that the children are sleeping under ITNs are expected to reduce stunting.
Ethical Issues in Long-term Care in Low-, Middle- and High-Income Countries During the COVID-19 Pandemic
Authors: Gandhi Preet , Petropanagos Angel , Popescu Andreea , Bugaresti Darren , Nitti Theresa , Chauhan Nipa , Chidwick Paula , Oliver Jill
Published: January 2023

Long-term care (LTC) centers experienced an unprecedented emergency involving exponential mortality during the COVID-19 pandemic. Individuals residing in long-term care were particularly vulnerable to the effects of COVID-19, placing residents, staff, families, and organizations in a precarious position. Complex issues surrounding how to manage vulnerable populations during the pandemic have highlighted the importance of gathering information on ethical issues that require effective policy and decision-making. This project sought to identify the ethical issues faced in long-term care by residents, families, staff, and organizations from stakeholders themselves. A total of 305 participants from 45 countries responded, highlighting numerous ethical issues in long-term care during COVID-19. While numerous issues were mentioned, there was an overlap in the themes of responses between stakeholders. Visitation, isolation, harm, staff well-being, and the overall enforcement of policies during the pandemic represented the most often discussed issues. As a preliminary study of this issue, future research is necessary in order to effectively guide pandemic policymaking moving forward.
Improving Fall Detection Devices for Older Adults Using Quality Function Deployment (QFD) Approach
Authors: Abdul Rahman Kawthar , Ahmad Siti Anom , Che Soh Azura , Ashari Asmidawati , Wada Chikamune , Gopalai Alpha Agape
Published: January 2023

Engineering invention must be in tandem with public demands. Often it is difficult to identify the priorities of consumers where technological advancement is needed. In line with the global challenge of increasing fall prevalence among older adults, providing prevention solutions is the key. This study aims at developing an improved fall detection device using an approach called Quality Function Deployment (QFD). The goal is to investigate features to incorporate in existing device from consumer’s perspectives. A three-phases design process is constructed; (1) Questionnaire, (2) Ishikawa Method, and (3) QFD. The proposed method begins with identifying customer needs as the requirement analysis, followed by a method to convert them to design specifications to be added in a fall detection device using QFD tool. As the top feature is monitoring balance, the new improved fall detection devices incorporating balance features will help older adults to monitor their level of risk of falling.
She is Sivagami: The Epitome of Women’s Leadership
Authors: Ali Esrafil , Gupta Deepika R
Published: January 2023

The case study reflects various leadership traits by taking inspiration from the character of Sivagami in the movie series - Baahubali. In this case, the leadership characteristics exhibited by Sivagami are discussed, followed by an understanding of the specific aspects of women’s leadership behaviors. Sivagami’s practice of leadership styles had positive impact on the followers of the Mahishmati kingdom. Through her increased support and leadership capabilities, she shouldered the guardian role for the throne and saved Mahishmati from traitors. She made strategic decisions at various stages and rose to power and respect, excellence, and admiration as the Rajamatha of the kingdom. The case configures some relevant occurrences from the movie series to bring out the nuances to understand the requisite skills and traits for women leadership.
Inpatient end-of-life care delivery: discordance and concordance analysis of Canadian palliative care professionals’ and South Asian family caregivers’ perspectives
Authors: Weerasinghe Swarna
Published: January 2023

Background:

End-of-life care involves a multitude of functions delivered by a team of healthcare professionals. Family caregivers get involved in every aspect of the palliative care journey. Meeting the needs of ethnically diverse patients can be a daunting task for Western-trained healthcare professionals. Family and professional caregivers need to have a mutual understanding of perspectives and expectations to integrate family caregivers into end-of-life care. The South Asian population in Canada is fast growing, and very little is known about their understanding and expectations of end-of-life care.

Methods:

The purpose is to provide research-based knowledge on discordances and concordances of encounters and perceptions of end-of-life care delivery between South Asian family caregivers and palliative care health professionals. Individual interviews were conducted among seven palliative care professionals, in a tertiary care center, and seven South Asian family caregivers who have provided care, in the same inpatient center, for the same period. The constant comparison, a component of the grounded theory approach, was employed to compare the two types of caregivers’ perspectives that emerged in the qualitative data.

Findings:

The family caregivers were divided in their perception based on death denial and acceptance. The findings weaved the discordances and concordances of meaning assigned to palliative care to the three themes that emerged: the role of the family caregiver, communication needs and challenges, and barriers to the family caregiver participation in decision-making. The discordance between professionals and family caregivers arose in the death-denial group and concorded with the death-accepted group. The findings revealed a consequence of the survival optimistic bias, as creating dissatisfaction toward the end-of-life care delivery system when the palliative care professionals prognosticate imminent end-of-life.

Conclusion:

The family caregivers’ interactions and encounters were shaped by their acceptance or denial of the death of their family member in care. Gaining conceptual clarity on the meaning of palliative care and providing education on the process of end-of-life care delivery are crucial to integrating ethnically diverse family caregivers into the decision-making process.
Blockade of CCR1 induces a phenotypic shift in macrophages and triggers a favorable antilymphoma activity
Authors: Le Kang , Sun Jing , Ghaemmaghami Javid , Smith Mitchell R. , Ip W. K. Eddie , Phillips Tycel , Gupta Mamta
Published: January 2023

Tumor-associated macrophages (TAMs) within the tumor microenvironment (TME) play an important role in tumor growth and progression. TAMs have been involved in producing immunosuppressive TME via various factors; however, the underlying mechanisms remain unclear in B-cell lymphoma, including mantle cell lymphoma (MCL). We identified that chemokine receptor-1 (CCR1) is highly expressed on monocytes (Mo) and macrophages (MΦ), and CCR1 pharmacological inhibition or CCR1 siRNA abolished lymphoma-mediated Mo/MΦ migration in a chemotaxis assay. The deficiency of host CCR1 (CCR1 KO) was associated with decreased infiltration of peritoneal-MΦ compared with WT-CCR1. Functional studies indicated that the genetic depletion of CCR1 or treatment inhibited protumor MΦ (M2-like) phenotype by decreasing CD206 and IL-10 expression. Moreover, CCR1 depletion reprogrammed MΦ toward an MHCII+/TNFα+ immunogenic phenotype. Mechanistically, protumor MΦ driven–IL-10 provides a positive feedback loop to tumor-CCL3 by regulating the CCL3 promoter via STAT1 signaling. Therapeutic in vivo targeting of CCR1 with CCR1 antagonist BX-471 significantly reduced FC-muMCL1 mouse tumors in the syngeneic MCL model by the depletion of M2-TAMs and increased infiltration of cytotoxic CD8+ T cells. Our study established that CCR1 exerts a pivotal role in macrophage programming, thus shaping protumor TME and lymphoma progression. CCR1 inhibition through CCR1 antagonists may be a promising therapeutic strategy to reprogram macrophages in lymphoma-TME and achieve better clinical outcomes in patients.
Haploidentical vs matched unrelated donors for patients with ALL: donor age matters more than donor type
Authors: Mehta Rohtesh S. , Marin David , Alousi Amin , Kanakry Christopher G. , Champlin Richard E. , Rezvani Katayoun , Shpall Elizabeth J. , Page Kristin , Gadalla Shahinaz M. , Weisdorf Daniel , Kebriaei Partow
Published: January 2023

Haploidentical hematopoietic cell transplantation (HCT) with posttransplant cyclophosphamide (PTCy) graft-versus-host-disease (GVHD) prophylaxis yields a similar overall survival (OS) to HLA-matched unrelated donor (MUD) HCT with conventional prophylaxis. Given the prognostic implications of donor age, we investigated the impact of donor age (younger [<35 years, n = 868] vs older [≥35 years, n = 418]) and donor type (haploidentical [n = 373] vs MUD [n = 913]) on OS in adult patients with acute lymphoblastic leukemia (ALL). Older donor age was independently associated with significantly poor OS, whereas donor type was not. Next, we directly compared the outcomes of a younger haploidentical donor (n = 187) vs an older MUD (n = 232). In this cohort, more patients in the haploidentical group had B-cell immunophenotype (89% vs 77%, respectively, P < .001), poor cytogenetics (61% vs 51%, respectively, P = .44), Philadelphia chromosome–negative (53% vs 48%, respectively, P = .38), received bone marrow graft (42% vs 16%, respectively, P < .001), and reduced-intensity conditioning (45% vs 23%, respectively, P < .001). In the multivariate analysis, the older MUD group was associated with a significantly higher risk of chronic GVHD, higher nonrelapse mortality (NRM), lower relapse, and poorer OS. Despite a higher risk of relapse, younger donor haploidentical HCT with PTCy prophylaxis may be preferred over older MUD HCT with conventional prophylaxis in patients with ALL due to lower NRM and better OS. Further analysis comparing the effect of donor age in haploidentical PTCy vs MUD PTCy is warranted.
Optimization of glutathione production in Saccharomyces cerevisiae HBSD-W08 using Plackett–Burman and central composite rotatable designs
Authors: Hu Xinyi , Shen Xinlei , Zhu Shen , Zeng Huawei , Shuai Yuying
Published: January 2023

Background

Glutathione is an important bioactive tripeptide and is widely used in the food, medicine, and cosmetics industries. The aim of this study was to provide an efficient method for producing GSH and to explore its synthesis mechanism. Saccharomyces cerevisiae strain HBSD-W08 was screened for GSH production, and its fermentation medium was optimized using single-factor experiments of the Plackett-Burman and central composite rotatable designs. This method was used to analyze the effects of the presence and concentration of various carbon sources, organic and inorganic nitrogen sources, metal ions, and precursor amino acids on GSH production and catalase, superoxide dismutase, and γ-glutamylcysteine synthetase activity.

Results

The three most significant factors affecting GSH production were peptone (optimal concentration [OC]: 2.50 g L− 1), KH2PO4 (OC: 0.13 g L− 1), and glutamic acid (OC: 0.10 g L− 1). GSH productivity of HBSD-W08 was obtained at 3.70 g L− 1 in the optimized medium. The activity of γ-GCS, which is a marker for oxidative stress, was found to be highly positively correlated with GSH production.

Conclusions

This finding revealed an underlying relationship between GSH synthesis and oxidative stress, providing useful information for developing effective GSH fermentation control strategies.
Effects of low-doses of methamphetamine on d-fenfluramine-induced head-twitch response (HTR) in mice during ageing and c-fos expression in the prefrontal cortex
Authors: Sun Yina , Chebolu Seetha , Skegrud Stone , Kamali Setareh , Darmani Nissar A.
Published: January 2023

Background

The head-twitch response (HTR) in mice is considered a behavioral model for hallucinogens and serotonin 5-HT2A receptor function, as well as Tourette syndrome in humans. It is mediated by 5-HT2A receptor agonists such as ( ±)− 2,5-dimethoxy-4-iodoamphetamine (DOI) in the prefrontal cortex (PFC). The 5-HT2A antagonist EMD 281014, can prevent both DOI-induced HTR during ageing and c-fos expression in different regions of PFC. Moreover, the nonselective monoamine releaser methamphetamine (MA) suppressed DOI-induced HTR through ageing via concomitant activation of inhibitory 5-HT1A receptors, but enhanced DOI-evoked c-fos expression. d-Fenfluramine is a selective 5-HT releaser and induces HTR in mice, whereas MA does not. Currently, we investigated whether EMD 281014 or MA would alter: (1) d-fenfluramine-induced HTR frequency in 20-, 30- and 60-day old mice, (2) d-fenfluramine-evoked c-fos expression in PFC, and (3) whether blockade of inhibitory serotonergic 5-HT1A- or adrenergic ɑ2-receptors would prevent suppressive effect of MA on d-fenfluramine-induced HTR.

Results

EMD 281014 (0.001–0.05 mg/kg) or MA (0.1–5 mg/kg) blocked d-fenfluramine-induced HTR dose-dependently during ageing. The 5-HT1A antagonist WAY 100635 countered the inhibitory effect of MA on d-fenfluramine-induced HTR in 30-day old mice, whereas the adrenergic ɑ2 antagonist RS 79948 reversed MA’s inhibitory effect in both 20- and 30- day old mice. d-Fenfluramine significantly increased c-fos expressions in PFC regions. MA (1 mg/kg) pretreatment significantly increased d-fenfluramine-evoked c-fos expression in different regions of PFC. EMD 281014 (0.05 mg/kg) failed to prevent d-fenfluramine-induced c-fos expression, but significantly increased it in one PFC region (PrL at − 2.68 mm).

Conclusion

EMD 281014 suppressed d-fenfluramine-induced HTR but failed to prevent d-fenfluramine-evoked c-fos expression which suggest involvement of additional serotonergic receptors in the mediation of evoked c-fos. The suppressive effect of MA on d-fenfluramine-evoked HTR is due to well-recognized functional interactions between stimulatory 5-HT2A- and the inhibitory 5-HT1A- and ɑ2-receptors. MA-evoked increases in c-fos expression in PFC regions are due to the activation of diverse monoaminergic receptors through increased synaptic concentrations of 5-HT, NE and/or DA, which may also account for the additive effect of MA on d-fenfluramine-evoked changes in c-fos expression. Our findings suggest potential drug receptor functional interaction during development when used in combination.
Validation of the self-reported domains of the Edmonton Frail Scale in patients 65 years of age and older
Authors: Sirisegaram Luxey , Owodunni Oluwafemi P. , Ehrlich April , Qin Caroline Xu , Bettick Dianne , Gearhart Susan L.
Published: January 2023

Introduction

In the era of virtual care, self-reported tools are beneficial for preoperative assessments and facilitating postoperative planning. We have previously reported the use of the Edmonton Frailty Scale (EFS) as a valid preoperative assessment tool.

Objective

We wished to validate the self-reported domains of the EFS (srEFS) by examining its association with loss of independence (LOI) and mortality.

Methods

This is a post-hoc analysis of a single-institution observational study of patients 65 years of age or older undergoing multi-specialty surgical procedures and assessed with the EFS in the preoperative setting. Exploratory data analysis was used to determine the threshold for identifying frailty using the srEFS. Procedures were classified using the Operative Stress Score (OSS) scored 1 to 5 (lowest to highest). Hierarchical Condition Category (HCC) was utilized to risk-adjust. LOI was described as requiring more support at discharge and mortality was defined as death occurring up to 30 days following surgery. Receiver operating characteristic (ROC) curves were used to determine the ability of the srEFS to predict the outcomes of interest in relation to the EFS.

Results

Five hundred thirty-five patients were included. Exploratory analysis confirmed best positive predictive value for srEFS was greater or equal to 5. Overall, 113 (21 percent) patients were considered high risk for frailty (HRF) and 179 (33 percent) patients had an OSS greater or equal to 5. LOI occurred in 7 percent (38 patients) and the mortality rate was 4 percent (21 patients). ROC analysis showed that the srEFS performed similar to the standard EFS with no difference in discriminatory thresholds for predicting LOI and mortality. Examination of the domains of the EFS not included in the srEFS demonstrated a lack of association between cognitive decline and the outcomes of interest. However, functional status assessed with either the Get up and Go (EFS only) or self-reported ADLs was independently associated with increased risk for LOI.

Conclusion

This study shows that self-reported EFS may be an optional preoperative tool that can be used in the virtual setting to identify patients at HRF. Early identification of patients at risk for LOI and mortality provides an opportunity to implement targeted strategies to improve patient care.
Tryptophan catabolites and depression in the general population: results from the Gutenberg Health Study
Authors: Michal Matthias , Schulz Andreas , Wild Philipp S. , Koeck Thomas , Münzel Thomas , Schuster Alexander K. , Strauch Konstantin , Lackner Karl , Süssmuth Sigurd D. , Niessen Heiko G. , Borta Andreas , Allers Kelly A. , Zahn Daniela , Beutel Manfred E.
Published: January 2023

Previous studies reported significantly altered tryptophan catabolite concentrations in major depression. Thus, tryptophan catabolites were considered as potential biomarkers of depression and their modulators as potential targets for psychopharmacotherapy. However, the results were based mainly on studies with small sample sizes limiting their generalizability. Against this background, we investigated the relationship of peripheral tryptophan catabolites with depression in a population-based sample with n = 3,389 participants (with fasting status ≥ 8 h and C-reactive protein < 10 mg/L). N = 248 had clinically significant depression according to a PHQ-9 score of ≥ 10, n = 1,101 subjects had mild depressive symptoms with PHQ-9 scores between 5 and 9, and n = 2,040 had no depression. After multivariable adjustment, clinically significant depression was associated with lower kynurenine and kynurenic acid. Spearman correlation coefficients of the tryptophan catabolites with the severity of depression were very small (rho ≤ 0.080, p ≤ 0.015). None of the tryptophan catabolites could diagnostically separate depressed from not depressed persons. Concerning linear associations, kynurenine and kynurenic acid were associated only with the severity and the cognitive dimension of depression but not its somatic dimension. Tryptophan catabolites were not associated with persistence or recurrence of depression at the 5 year follow-up. The results replicated the association between kynurenine and kynurenic acid with depression. However, the associations were small raising doubts about their clinical utility. Findings underline the complexity of the relationships between depression and tryptophan catabolites. The search for subgroups of depression with a potentially higher impact of depression might be warranted.
Geographic disparities in COVID-19 testing and outcomes in Florida
Authors: Khan Md Marufuzzaman , Odoi Agricola , Odoi Evah W.
Published: January 2023

Background

Understanding geographic disparities in Coronavirus Disease 2019 (COVID-19) testing and outcomes at the local level during the early stages of the pandemic can guide policies, inform allocation of control and prevention resources, and provide valuable baseline data to evaluate the effectiveness of interventions for mitigating health, economic and social impacts. Therefore, the objective of this study was to identify geographic disparities in COVID-19 testing, incidence, hospitalizations, and deaths during the first five months of the pandemic in Florida. 

Methods

Florida county-level COVID-19 data for the time period March-July 2020 were used to compute various COVID-19 metrics including testing rates, positivity rates, incidence risks, percent of hospitalized cases, hospitalization risks, case-fatality rates, and mortality risks. High or low risk clusters were identified using either Kulldorff’s circular spatial scan statistics or Tango’s flexible spatial scan statistics and their locations were visually displayed using QGIS.

Results

Visual examination of spatial patterns showed high estimates of all COVID-19 metrics for Southern Florida. Similar to the spatial patterns, high-risk clusters for testing and positivity rates and all COVID-19 outcomes (i.e. hospitalizations and deaths) were concentrated in Southern Florida. The distributions of these metrics in the other parts of Florida were more heterogeneous. For instance, testing rates for parts of Northwest Florida were well below the state median (11,697 tests/100,000 persons) but they were above the state median for North Central Florida. The incidence risks for Northwest Florida were equal to or above the state median incidence risk (878 cases/100,000 persons), but the converse was true for parts of North Central Florida. Consequently, a cluster of high testing rates was identified in North Central Florida, while a cluster of low testing rate and 1–3 clusters of high incidence risks, percent of hospitalized cases, hospitalization risks, and case fatality rates were identified in Northwest Florida. Central Florida had low-rate clusters of testing and positivity rates but it had a high-risk cluster of percent of hospitalized cases.

Conclusions

Substantial disparities in the spatial distribution of COVID-19 outcomes and testing and positivity rates exist in Florida, with Southern Florida counties generally having higher testing and positivity rates and more severe outcomes (i.e. hospitalizations and deaths) compared to Northern Florida. These findings provide valuable baseline data that is useful for assessing the effectiveness of preventive interventions, such as vaccinations, in various geographic locations in the state. Future studies will need to assess changes in spatial patterns over time at lower geographical scales and determinants of any identified patterns.
Multiple micronutrients fortified salt: consumers’ acceptability survey, Tanzania
Authors: Mdoe Paschal , Mannar Venkatesh , Paulo Bernadetha , Guga Godfrey , Mushi Castory , Kimathi Caroline , Paschal John , Jatosh Samwel , Assey Vincent , Abdallah Fatma , Mduma Estomih , Diosady Levente
Published: January 2023

Background

Food fortification with micronutrients is an insufficiently used technology in developing countries. Salt is consumed in small, constant daily amounts by most people globally. Salt has been instrumental in delivering iodine to a wide population globally through fortification. There is a proven effective technology for fortifying iodinated salt with iron, folate, and Vitamin B12. Findings have shown that both Double (Iodine and iron) fortified salt (DFS) and quadruple (iron, iodine, folate, and vitamin B12) fortified salt (QFS) are effective in raising hemoglobin levels.

Aim

To assess the acceptability and gauge consumers’ willingness to use double-fortified and quadruple-fortified salt formulations.

Methods

We conducted an observational study involving 300 households at Haydom Lutheran Hospital catchment area in Northern rural Tanzania between October 2021 and April 2022. Each household was supplied with one type of salt (iodized salt (IS), DFS or QFS) for cooking common family dishes for one week. Thereafter, at least two adult members of the family who used the dishes cooked with study salt were interviewed using the adopted 5-point Hedonic scale.

Results

A total of 899 individuals were interviewed after using study salt for one week: 286 IS, 305 DFS, and 308 QFS. The overall acceptability for the salts was QFS (82%), DFS (78%), and IS (79%). The mean sensory (taste, color and appearance) scores of the QFS (1.7) and DFS (1.7) were comparable to standard iodized salt (1.6).

Conclusion

Quadruple-fortified salt and double-fortified salt are equally acceptable and have similar sensory scores as standard iodized salt when used to cook commonly eaten dishes in the study population.
Detection of high risk people for diabetes by American diabetes association risk score in PERSIAN Guilan cohort study
Authors: Hasandokht Tolou , Joukar Farahnaz , Maroufizadeh Saman , Sibeveih Zahra , Naghipour Mohammadreza , Hedayaztadeh Zahra , Mansour-Ghanaei Fariborz
Published: January 2023

Background

Diabetes mellitus (DM) is known as one of the most prevalent non communicable diseases with high cost of health services in the world. Present study was conducted to assess the frequency of high risk people for diabetes mellitus based on American Diabetes Association (ADA) risk score among Iranian people.

Methods

Present study was a cross sectional study on non-diabetic subjects aged 35–70 years from 10,520 PERSIAN Guilan Cohort Study (PGCS). ADA risk score was calculated for every individual through an online calculator. Receiver operating characteristic (ROC) curves was used to assess diagnostic accuracy of the anthropometric indices to identify individuals with high risk ADA score for developing DM, represented by the area under the curve (AUC).

Results

From 7989 study subjects, ADA risk score found 3874 (48.5%) and 1912 (23%) at risk for developing PreDM and DM, respectively. The results of ROC curve analyses showed the highest diagnostic value was related to waist circumference (WC) in total population and Waist to Height Ratio in both sex (0.695 total, 0.743 female, 0.744 male). The cut-points of WC in total population to identifying high risk group were 97 cm.

Conclusions

A considerable number of populations were classified as high ADA risk for developing DM and PreDM that provide the importance of prevention strategies. Present study showed WC and Waist to Height Ratio have the highest diagnostic value to identify high risk people for DM.
Incidence, time to occurrence and predictors of peripheral intravenous cannula-related complications among neonates and infants in Northwest Ethiopia: an institutional-based prospective study
Authors: Baye Nega Dagnew , Teshome Assefa Agegnehu , Ayenew Atalo Agimas , Amare Tadeg Jemere , Mulu Anmut Tilahun , Abebe Endeshaw Chekol , Tiruneh Gebrehiwot Ayalew , Ayele Teklie Mengie , Muche Zelalem Tilahun , Teklemariam Awgichew Behaile , Melese Biruk Demissie , Agidew Melaku Mekonnen , Seid Mohammed Abdu
Published: January 2023

Background

Peripheral intravenous cannulas (PIVC) are venous access devices commonly used for the administration of intravenous fluids, drugs, blood products, and parenteral nutrition. Despite its frequent use, it has complications that can seriously threaten patient safety, prolong hospital stays, and increases medical care costs. PIVC complications are associated with increased morbidity and reinsertion attempts are painful and anxiety-provoking for children and their parents. Therefore, this study was aimed to assess the incidence, time to occurrence and identify predictors for PIVC complications among infants admitted to Debre Tabor Comprehensive Specialized Hospital (DTCSH), Northwest Ethiopia.

Methods and setting

An institutional-based prospective cohort study was conducted on 358 infants admitted to a neonatal intensive care unit and pediatric ward, DTCSH from January 1 to April 30, 2022. A systematic sampling technique was employed.

Results

The incidence rate of PIVC complication was 11.6 per 1000 person-hours observation. PIVC complication was observed in 56.4% (202) of PIVCs, of which infiltration (42.1%) was the most common complication followed by phlebitis (29.7%). The median time to complication was 46 h. Anatomical insertion site (AHR = 2.85, 95%CI: 1.63–6.27),admission unit (AHR = 1.88, 95%CI: 1.07–4.02), sickness (AHR = 0.24, 95% CI: 1.31–4.66), medication type (AHR = 2.04, 95%CI: 1.13–3.66), blood transfusion (AHR = 0.79, 95%CI: 0.02–0.99), clinical experience (AHR = 0.52, CI:0.26–0.84), and flushing (AHR = 0.71, 95%CI: 0.34–0.98) were potential predictors of PIVC complication.

Conclusion

Knowing the predictor factors helps clinicians to provide effective care and to detect complications early.
Dietary supplementation with full-fat Hermetia illucens larvae and multi-probiotics, as a substitute for antibiotics, improves the growth performance, gut health, and antioxidative capacity of weaned pigs
Authors: Phaengphairee Pheeraphong , Boontiam Waewaree , Wealleans Alexandra , Hong Jinsu , Kim Yoo Yong
Published: January 2023

Background

Dietary supplementation of full-fat black soldier fly larvae (BSFL full-fat meal; alone or in combination with multi-probiotics) was tested as an alternative to dietary antibiotics in weaning piglets. We also tested the effects of these diets on growth performance, nutrient digestibility coefficients, immune status, oxidative stress, intestinal histomorphology, and rectal microbial modulations in weaned pigs. A total of 80 piglets [(Landrace × Large White) × Duroc] of both sexes (a ratio of gilts and barrows; 1:1), were randomly allotted to four diet groups: positive control (PC) diet supplemented with 0.02% amoxicillin; negative control (NC) diet without supplement addition; BSFL12 diet (NC + 12% BSFL full-fat meal); and BSFL + Pro diet (BSFL full-fat meal + 0.1% multi-probiotics, including Bacillus subtilis, B. licheniformis, and Saccharomyces cerevisiae). All groups had five replicates, with four piglets per replicate.

Results

Dietary BSFL + Pro improved the overall average daily gain (P = 0.013), and gain-to-feed ratio (P = 0.032). The BSFL12 and BSFL + Pro diets improved nutrient digestibility and increased the serum levels of immunoglobulin A and glutathione peroxidase, while reducing the levels of pro-inflammatory cytokines. The spleen weight was higher and caecal pH was lower in pigs fed the BSFL + Pro diet than in those fed the NC diet (P = 0.011 and P = 0.021, respectively). Pigs fed the BSFL diets had longer duodenal villi, a higher villus height-to-crypt depth ratio (P = 0.004), and shorter crypt depth (P = 0.017) than those fed NC. The BSFL + Pro diet also increased faecal Lactobacillus spp. count (P = 0.008) and reduced Escherichia coli (P = 0.021) counts compared with that seen with PC and NC diets, respectively.

Conclusions

Dietary supplementation with BSFL or BSFL + multi-probiotics can improve the growth performance and intestinal health of pigs and may be an effective strategy to replace antibiotics for weaned pigs.
Occurrence of Escherichia Coli O157:H7 in lactating cows and dairy farm environment and the antimicrobial susceptibility pattern at Adami Tulu Jido Kombolcha District, Ethiopia
Authors: Mesele Frehiwot , Leta Samson , Amenu Kebede , Abunna Fufa
Published: January 2023

Background

Food-borne pathogens are the foremost causes of food-borne human illness in the world. Escherichia coli O157:H7 (E. coli O157:H7) is one of the major food-borne pathogenic bacteria around the world. Though evidence is lacking; especially in developing countries like Ethiopia, the potential health impact of E. coli O157:H7 can be high where food production, handling and consumption is often taking place under unhygienic conditions. In Ethiopia, studies reported E. coli and E. coli O157: H7 from food of animal origin, mainly meat and milk, and also animal surfaces and feces. The objective of the present study was to investigate the occurrence of E. coli O157:H7 in raw milk and the dairy production farm environment and further assess the antimicrobial resistance pattern of the bacterium.

Methods

Samples of milk from individual lactating cows’ and dairy farm environmental samples (feces, water and manure) were collected at Adami Tulu Jido Kombolcha district (ATJKD) and analyzed for the presence of E. coli O157:H7. Standard microbiological techniques including culture, biochemical testing and serological test were performed to isolate and identify the bacterium. The bacterial isolates were evaluated for antimicrobial susceptibility patterns using disk diffusion method. A questionnaire was used to collect possible factors affecting E. coli O157:H7 occurrence.

Results

The overall prevalence of E. coli O157:H7 was 4.7% (19/408) (95% CI: 2.6; 6.7). Out of 19 E. coli O157:H7 isolates, 4/50, 7/154, 2/50, and 6/154 were from water, milk, manure, and feces samples, respectively. From potential risk factors considered in this study area, floor type, cleaning of pens, milking location and hand washing during the time of milking were significantly associated with the occurrence of E. coli O157:H7. The antimicrobial susceptibility pattern indicated varying degrees of resistance. All of the isolates were found to be resistant ampicillin, cephalothin, and rifampin, and 100% susceptibility was observed against the drugs: chloramphenicol, ciprofloxacin, gentamicin, nalidixic acid, kanamycin, and tetracycline. Concerning streptomycin, 63.15% of the isolates were susceptible and 36.8% showed intermediate susceptibility.

Conclusions

The occurrence of multi-drug resistance E. coli O157:H7 observed both in lactating cows and in dairy farm environments can sustain a continuous transmission of the bacteria. The occurrence of multidrug-resistant E. coli o157:H7could hamper the control and prevention efforts.
Gut microbiota composition can reflect immune responses of latent tuberculosis infection in patients with poorly controlled diabetes
Authors: Huang Hung-Ling , Luo Yong-Chun , Lu Po-Liang , Huang Cheng-Hsieh , Lin Kun-Der , Lee Meng-Rui , Cheng Meng-Hsuan , Yeh Yao-Tsung , Kao Cheng-Yuan , Wang Jann-Yuan , Yang Jinn-Moon , Chong Inn-Wen
Published: January 2023

Background

Diabetes mellitus (DM) is a major risk factor for tuberculosis (TB). Evidence has linked the DM-related dysbiosis of gut microbiota to modifiable host immunity to Mycobacterium tuberculosis infection. However, the crosslinks between gut microbiota composition and immunological effects on the development of latent TB infection (LTBI) in DM patients remain uncertain.

Methods

We prospectively obtained stool, blood samples, and medical records from 130 patients with poorly-controlled DM (pDM), defined as ever having an HbA1c > 9.0% within previous 1 year. Among them, 43 had LTBI, as determined by QuantiFERON-TB Gold in-Tube assay. The differences in the taxonomic diversity of gut microbiota between LTBI and non-LTBI groups were investigated using 16S ribosomal RNA sequencing, and a predictive algorithm was established using a random forest model. Serum cytokine levels were measured to determine their correlations with gut microbiota.

Results

Compared with non-LTBI group, the microbiota in LTBI group displayed a similar alpha-diversity but different beta-diversity, featuring decrease of Prevotella_9, Streptococcus, and Actinomyces and increase of Bacteroides, Alistipes, and Blautia at the genus level. The accuracy was 0.872 for the LTBI prediction model using the aforementioned 6 microbiome-based biomarkers. Compared with the non-LTBI group, the LTBI group had a significantly lower serum levels of IL-17F (p = 0.025) and TNF-α (p = 0.038), which were correlated with the abundance of the aforementioned 6 taxa.

Conclusions

The study results suggest that gut microbiome composition maybe associated with host immunity relevant to TB status, and gut microbial signature might be helpful for the diagnosis of LTBI.
Impaired cell–cell communication and axon guidance because of pulmonary hypoperfusion during postnatal alveolar development
Authors: Li Debao , Wang Jing , Fang Yuan , Hu Yuqing , Xiao Yingying , Cui Qing , Jiang Chuan , Sun Sijuan , Chen Hao , Ye Lincai , Sun Qi
Published: January 2023

Background

Pulmonary hypoperfusion is common in children with congenital heart diseases (CHDs) or pulmonary hypertension (PH) and causes adult pulmonary dysplasia. Systematic reviews have shown that some children with CHDs or PH have mitigated clinical outcomes with COVID-19. Understanding the effects of pulmonary hypoperfusion on postnatal alveolar development may aid in the development of methods to improve the pulmonary function of children with CHDs or PH and improve their care during the COVID-19 pandemic, which is characterized by cytokine storm and persistent inflammation.

Methods and results

We created a neonatal pulmonary hypoperfusion model through pulmonary artery banding (PAB) surgery at postnatal day 1 (P1). Alveolar dysplasia was confirmed by gross and histological examination at P21. Transcriptomic analysis of pulmonary tissues at P7(alveolar stage 2) and P14(alveolar stage 4) revealed that the postnatal alveolar development track had been changed due to pulmonary hypoperfusion. Under the condition of pulmonary hypoperfusion, the cell–cell communication and axon guidance, which both determine the final number of alveoli, were lost; instead, there was hyperactive cell cycle activity. The transcriptomic results were further confirmed by the examination of axon guidance and cell cycle markers. Because axon guidance controls inflammation and immune cell activation, the loss of axon guidance may explain the lack of severe COVID-19 cases among children with CHDs or PH accompanied by pulmonary hypoperfusion.

Conclusions

This study suggested that promoting cell–cell communication or supplementation with guidance molecules may treat pulmonary hypoperfusion–induced alveolar dysplasia, and that COVID-19 is less likely to cause a cytokine storm in children with CHD or PH accompanied by pulmonary hypoperfusion.

Graphical Abstract