bluuebunny/crossref_metadata_2025 huggingface dataset:
Does the comorbidity of borderline personality disorder affect the response to treatment in bipolar patients?
Authors: Esposito Cecilia Maria , Barkin Jennifer L. , Ceresa Alessandro , Buoli Massimiliano
Published: August 2023

Bipolar disorder (BD) is a highly prevalent condition whose response to pharmacological treatment is associated with a number of factors including psychiatric comorbidity. Borderline personality disorder (BPD) shares clinical symptoms and biological vulnerability with BD and the two conditions are frequently comorbid, thus representing a clinical challenge. The purpose of the present review is to summarize the data related to treatment response in bipolar patients with comorbid BPD. According to systematic review process, a literature search was performed on the PubMed, Embase, PsycInfo, Isi Web of Knowledge, Medscape, and Cochrane Library databases. Peer-reviewed articles until December 2022 were eligible for inclusion. Comorbidity with BPD seems to be associated with a more difficult clinical stabilization in bipolar patients, often requiring poly-therapy or a longer duration of hospitalization. However, three studies, assessing the effectiveness of mood stabilizers in bipolar patients, did not demonstrate a prominent influence of BPD comorbidity in achieving clinical response. The most frequently administered pharmacological treatments in the selected studies include mood stabilizers and atypical antipsychotics. The presence of comorbid BPD in bipolar patients may hamper treatment effectiveness. Future studies, comparing different treatments and with larger samples, are needed to confirm the results critically summarized in the present review.
Relationship between clinical efficacy and plasma concentration-dose ratio of risperidone in patients with schizophrenia
Authors: Chen Qiuying , Min Jie , Yin Haibo , Xia Wenying , Shen Yimin , Shu Ming
Published: August 2023

This study aimed to retrospectively explore the relationship between clinical efficacy and plasma concentration–dose ratio of risperidone (RIS) in 252 patients with schizophrenia taking RIS orally. After the same dose of RIS treatment, the plasma concentration of RIS/9-hydroxyrisperidone (9-OH-RIS), the total plasma concentration of RIS, and the ratio of the steady-state plasma concentration to the daily dose of the total active product (C/D) showed individual difference. The RIS plasma concentration was significantly higher in patients taking high doses than those taking lower doses (P = 0.003). There was a statistically significant difference in C/D ratio between males and females (P = 0.003). There were significant differences in ratio of C/D and the total plasma concentration of RIS between patients under 60 years and over 60 years (P = 0.016; P = 0.005). Logistic regression analysis showed that the therapeutic effect and adverse reactions of RIS were correlated with the ratio of C/D in patients with schizophrenia (P = 0.038; P < 0.001). It has been suggested that the importance of monitoring of the plasma concentration of RIS in patients with schizophrenia and the ratio of C/D may be used as the reference for RIS personalized treatment.
Open reading frames M12/M13 jointly contribute to MHV-68 latency
Authors: Steer Beatrix , Adler Barbara , Adler Heiko
Published: August 2023

Murine gammaherpesvirus 68 (MHV-68), a widely used small-animal model for the analysis of gammaherpesvirus pathogenesis, encodes the MHV-68-specific ORFs M12 and M13. The function of M12 and M13 has not been investigated so far. Therefore, we constructed and analysed recombinant MHV-68 with mutations in either M12, M13 or M12/M13. Both the M12 and M13 mutants did not display any phenotype in vitro or in vivo. However, although the M12/13 double mutant showed similar lytic growth in fibroblasts in vitro and in the lungs of infected mice as wild-type MHV-68, it was significantly attenuated in vivo during latency. This phenotype was completely restored in a revertant of the M12/13 double mutant. Thus, it appears that M12 and M13 might have redundant functions that are only revealed if both genes are lacking. The observation that M12/13 have a function during latency not only contributes to the further understanding of the pathogenesis of MHV-68 infection but might also be of interest considering that M12/13 are located at a genomic position similar to that of LMP2A and K15. The latter are important proteins of their respective human gammaherpesviruses EBV and KSHV that contribute to cellular survival, cell activation and proliferation, which was deduced from in vitro studies.
Drug resistance prediction for Mycobacterium tuberculosis with reference graphs
Authors: Hall Michael B. , Lima Leandro , Coin Lachlan J. M. , Iqbal Zamin
Published: August 2023

Tuberculosis is a global pandemic disease with a rising burden of antimicrobial resistance. As a result, the World Health Organization (WHO) has a goal of enabling universal access to drug susceptibility testing (DST). Given the slowness of and infrastructure requirements for phenotypic DST, whole-genome sequencing, followed by genotype-based prediction of DST, now provides a route to achieving this. Since a central component of genotypic DST is to detect the presence of any known resistance-causing mutations, a natural approach is to use a reference graph that allows encoding of known variation. We have developed DrPRG (Drug resistance Prediction with Reference Graphs) using the bacterial reference graph method Pandora. First, we outline the construction of a

Mycobacterium tuberculosis

drug resistance reference graph. The graph is built from a global dataset of isolates with varying drug susceptibility profiles, thus capturing common and rare resistance- and susceptible-associated haplotypes. We benchmark DrPRG against the existing graph-based tool Mykrobe and the haplotype-based approach of TBProfiler using 44 709 and 138 publicly available Illumina and Nanopore samples with associated phenotypes. We find that DrPRG has significantly improved sensitivity and specificity for some drugs compared to these tools, with no significant decreases. It uses significantly less computational memory than both tools, and provides significantly faster runtimes, except when runtime is compared to Mykrobe with Nanopore data. We discover and discuss novel insights into resistance-conferring variation for

M. tuberculosis

– including deletion of genes katG and pncA – and suggest mutations that may warrant reclassification as associated with resistance.
Regulation of type VI secretion systems at the transcriptional, posttranscriptional and posttranslational level
Authors: Hespanhol Julia Takuno , Nóbrega-Silva Luize , Bayer-Santos Ethel
Published: August 2023

Bacteria live in complex polymicrobial communities and are constantly competing for resources. The type VI secretion system (T6SS) is a widespread antagonistic mechanism used by Gram-negative bacteria to gain an advantage over competitors. T6SSs translocate toxic effector proteins inside target prokaryotic cells in a contact-dependent manner. In addition, some T6SS effectors can be secreted extracellularly and contribute to the scavenging scarce metal ions. Bacteria deploy their T6SSs in different situations, categorizing these systems into offensive, defensive and exploitative. The great variety of bacterial species and environments occupied by such species reflect the complexity of regulatory signals and networks that control the expression and activation of the T6SSs. Such regulation is tightly controlled at the transcriptional, posttranscriptional and posttranslational level by abiotic (e.g. pH, iron) or biotic (e.g. quorum-sensing) cues. In this review, we provide an update on the current knowledge about the regulatory networks that modulate the expression and activity of T6SSs across several species, focusing on systems used for interbacterial competition.
Personalized chronic adaptive deep brain stimulation outperforms conventional stimulation in Parkinson’s disease
Authors: Oehrn Carina R , Cernera Stephanie , Hammer Lauren H , Shcherbakova Maria , Yao Jiaang , Hahn Amelia , Wang Sarah , Ostrem Jill L , Little Simon , Starr Philip A
Published: August 2023

1.

Deep brain stimulation is a widely used therapy for Parkinson’s disease (PD) but currently lacks dynamic responsiveness to changing clinical and neural states. Feedback control has the potential to improve therapeutic effectiveness, but optimal control strategy and additional benefits of “adaptive” neurostimulation are unclear. We implemented adaptive subthalamic nucleus stimulation, controlled by subthalamic or cortical signals, in three PD patients (five hemispheres) during normal daily life. We identified neurophysiological biomarkers of residual motor fluctuations using data-driven analyses of field potentials over a wide frequency range and varying stimulation amplitudes. Narrowband gamma oscillations (65-70 Hz) at either site emerged as the best control signal for sensing during stimulation. A blinded, randomized trial demonstrated improved motor symptoms and quality of life compared to clinically optimized standard stimulation. Our approach highlights the promise of personalized adaptive neurostimulation based on data-driven selection of control signals and may be applied to other neurological disorders.
Use of Drama for Improving Breastfeeding Initiation, Exclusive Breastfeeding and Breastfeeding Self-efficacy among Rural Pregnant Women from Selected Communities in Two Local Government Areas (LGAs) in Ibadan, Nigeria
Authors: Yetunde Ogundairo Omotola , Thomas Adepoju Oladejo , Adesola Olumide Olufunmilola
Published: August 2023

Background:

Breastfeeding self-efficacy (BFSE) is a key variable that enhances exclusive breastfeeding (EBF) and promotes positive health outcomes for infants and their mothers. To increase BFSE and EBF of mothers, numerous interventions targeting prenatal and postnatal periods have been developed. However, there is paucity of studies utilizing drama interventions for improving BFSE and EBF.

Objectives:

This study assessed the effect of drama usage on breastfeeding self-efficacy, initiation, and exclusive breastfeeding of pregnant women in rural communities in Lagelu and Egbeda Local Government Areas (LGAs).

Methodology:

A quasi-experimental designed was carried out with pregnant women in their second trimester. Selected communities from Lagelu and Egbeda LGAs were randomized into experimental and control groups. A total of 200 pregnant women (100 experimental and 100 control groups) were enlisted as well as followed-up at one, three, and six months after giving birth. Six-session program comprising four episodes of drama and two sessions on hygiene practices were presented to experimental groups in the communities prior to delivery, while the control group received only hygiene talk. An electronic questionnaire (ODK) was used to obtain information on socio-demographic, BFSE, initiation, and exclusive breastfeeding during prenatal and postnatal periods. BSFE score was categorized as low (14–32), average (33–51), and high (52–70). Descriptive and inferential statistics was used to analyzed data α0.05.

Results:

The experimental and control mean ages were 28.40 ±6.50 and 27.00±6.20 respectively. Average and high BSE pre-intervention (11.0%; 89.0% and 9.0%; 91.0%) and six months post-intervention (97.3%;100% and 95.2%; 95%) for intervention and control. Age, marital status and occupation were predictors of BFSE (R2= 22.3; p<0.001)

Conclusion:

Experimental women had an increase in BFSE, initiation, and EBF practice compared to control women.
Severe obesity may be an oligogenic condition: evidence from 1,714 adults seeking treatment in the UK National Health Service
Authors: Sumaya Almansoori , Amin Hasnat A , Alsters Suzanne I. , Handley Dale , Yiorkas Andrianos M , Hashim Nikman Adli Nor , Ramzi Nurul Hanis , Agrawal Sanjay , Bonaomi Gianluca , Ahmed Javed , Small Peter , Purkayastha Sanjay , van Haelst Mieke , Walters Robin G. , le Roux Carel W , Chahal Harvinder S. , Drenos Fotios , Blakemore Alexandra I
Published: August 2023

Severe (class III) obesity is a chronic, relapsing condition, with a high burden of co-morbidity and mortality. Previous evidence has established genetics as an important contributing factor. We therefore designed a custom genotyping array to screen a cohort of UK patients seeking treatment for severe obesity. 1,714 participants were genotyped using a custom AXIOM array, focusing on rare (minor allele frequency <0.01) variants, with CADD-PHRED ≥15 in 78 genes known/suspected to cause Mendelian forms of obesity. Concordance analyses of 22 duplicate samples and 66 samples with whole exome sequence data revealed good genotyping reliability. We identified the proportion of study participants who carried, or were homozygous for, rare, predicted-deleterious variants in genes with dominant and recessive modes of inheritance (MOI), respectively. 27% of patients carried relevant mutations consistent with the expected MOI, which was very similar to the rate observed in the UKB 50K whole exome sequencing dataset. However, the clinical obesity cohort were more likely to carry two or more such variants, in separate genes, than UK Biobank participants (p = 0.018). In conclusion, our results provide evidence: that (i) custom genotyping arrays, used with improved algorithms can allow reliable, cost-effective screening for rare genetic variants; (ii) rare mutations in “obesity genes” may be at high prevalence among bariatric patients, as well as in the general population; and (iii) that severe obesity may have an oligogenic pattern of inheritance in some cases.
Wastewater Based Epidemiology as a surveillance tool during the current COVID-19 pandemic on a college campus (East Carolina University) and its accuracy in predicting SARS-CoV-2 outbreaks in dormitories
Authors: White Avian , Iverson Guy , Wright LaNika , Fallon John T. , Briley Kimberly P. , Yin Changhong , Huang Weihua , Humphrey Charles
Published: August 2023

The COVID-19 outbreak led governmental officials to close many businesses and schools, including colleges and universities. Thus, the ability to resume normal campus operation required adoption of safety measures to monitor and respond to COVID-19. The objective of this study was to determine the efficacy of wastewater-based epidemiology as a surveillance method in monitoring COVID-19 on a college campus. The use of wastewater monitoring as part of a surveillance program to control COVID-19 outbreaks at East Carolina University was evaluated. During the Spring and Fall 2021 semesters, wastewater samples (N= 830) were collected every Monday, Wednesday, and Friday from the sewer pipes exiting the dormitories on campus. Samples were analyzed for SARS-CoV-2 and viral quantification was determined using qRT-PCR. During the Spring 2021 semester, there was a significant difference in SARS-CoV-2 virus copies in wastewater when comparing dorms with the highest number student cases of COVID-19 and those with the lowest number of student cases, (p= 0.002). Additionally, during the Fall 2021 semester it was observed that when weekly virus concentrations exceeded 20 copies per ml, there were new confirmed COVID-19 cases 85% of the time during the following week. Increases in wastewater viral concentration spurred COVID-19 swab testing for students residing in dormitories, aiding university officials in effectively applying COVID testing policies. This study showed wastewater-based epidemiology can be a cost-effective surveillance tool to guide other surveilling methods (e.g., contact tracing, nasal/salvia testing, etc.) to identify and isolate afflicted individuals to reduce the spread of pathogens and potential outbreaks within a community.
Influenza hospitalization burden by subtype, age, comorbidity and vaccination status: 2012/13 to 2018/19 seasons, Quebec, Canada
Authors: Carazo Sara , Guay Charles-Antoine , Skowronski Danuta M , Amini Rachid , Charest Hugues , De Serres Gaston , Gilca Rodica
Published: August 2023

Background

The primary objective of influenza immunization programs is to reduce the risk and burden of severe outcomes. To inform optimal program strategies, we monitored influenza hospitalizations over several seasons of varying subtype predominance, stratified by age, comorbidity and vaccination status.

Methods

We assembled data from an active hospital-based surveillance network involving systematic swabbing and PCR-confirmation of influenza virus infection by type/subtype during peak-weeks of seven influenza seasons (2012/13 to 2018/19) in Quebec, Canada. We estimated seasonal, population-based incidence of influenza-associated hospitalizations (interpreted as risk) by subtype, age, comorbidity and vaccine status, and derived the number-needed-to-vaccinate to prevent one hospitalization per stratum.

Results

The average seasonal incidence of influenza-associated hospitalization was 89/100,000 (95%CI: 86, 93), lower during A(H1N1) (49-82/100,000) than A(H3N2) seasons (73-143/100,000). Overall risk followed a J-shaped age pattern, highest among infants 0-5 months and adults ≥75 years. Hospitalization risks were highest for children <5 years during A(H1N1) but for adults ≥75 years during A(H3N2) subtype- predominant seasons. Age-adjusted hospitalization risks were 7-fold higher among individuals with versus without comorbidities (214 versus 30/100,000). The number-needed-to-vaccinate to prevent hospitalization was 82-fold lower for ≥75-years-olds with comorbidity (n=1,995), who comprised 39% of all hospitalizations, than for healthy 18-64-year-olds (n=163,488), who comprised just 6% of all hospitalizations.

Conclusions

In the context of broad-based influenza immunization programs (targeted or universal), severe outcome risks should be simultaneously examined by subtype, age, comorbidity, and vaccine status. Policymakers require such detail to prioritize further promotional efforts and expenditures toward the greatest and most efficient program impact.

40-word summary

This hospital-based study involving systematic PCR testing over seven seasons revealed important differences in influenza hospitalization risk by subtype, age, comorbidity, and vaccination status. The findings highlight the need for data-driven decision-making to optimize vaccination strategies and minimize healthcare burden.
Cortical Thickness Patterns of Cognitive Impairment Phenotypes in Drug-Resistant Temporal Lobe Epilepsy
Authors: Miron Gadi , Müller Paul Manuel , Hohmann Louisa , Oltmanns Frank , Holtkamp Martin , Meisel Christian , Chien Claudia
Published: August 2023

Background

In temporal lobe epilepsy (TLE), a taxonomy classifying patients into three cognitive phenotypes has been adopted: minimally, focally, or generally cognitively impaired (CI). We examined grey matter (GM) thickness patterns of cognitive phenotypes in drug-resistant TLE and assessed potential use for predicting post-surgical cognitive outcomes.

Methods

TLE patients undergoing presurgical evaluation were categorized into cognitive phenotypes. Network edge weights and distances were calculated using ANOVA-III F-statistics from comparisons of GM regions between each TLE cognitive phenotype and age- and sex-matched healthy participants. In resected patients, logistic regression models (LRMs) based on network analysis results were used for prediction of post-surgical cognitive outcome.

Results

A total of 124 patients (63 females, mean age±SD=36.0±12.0 years) and 117 healthy controls (63 females, mean age±SD=36.1±12.0 years) were analyzed. In the generalized CI group (n=66, 53.2%), 28 GM regions were significantly thinner compared to HCs. Focally impaired patients (n=37, 29.8%) showed 13 regions, while minimally impaired patients (n=21, 16.9%) had 2 significantly thinner GM regions. Regions affected in both generalized and focally impaired patients included the anterior cingulate cortex, medial prefrontal cortex, medial temporal, and lateral temporal regions. In 69 (35 females, mean age±SD=33.6±18.0) patients that underwent surgery, LRMs based on network-identified GM regions predicted post-surgical verbal memory worsening with a receiver operating curve-area under the curve of 0.70±0.15.

Conclusions

A differential pattern of GM thickness can be found across different cognitive phenotypes in TLE. Including MRI with clinical measures associated with cognitive profiles has potential in predicting post-surgical cognitive outcomes in drug-resistant TLE.
Transcriptomic Response of Postprandial Blood, Subcutaneous Adipose Tissue and Muscle to a combined lifestyle intervention in older adults
Authors: Bogaards F.A. , Gehrmann T. , Beekman M. , Lakenberg N. , Suchiman E. , de Groot C.P.G.M. , Reinders M.J.T. , Slagboom P.E.
Published: August 2023

Molecular effects of lifestyle interventions are typically studied in a single tissue. Here, we investigated the sex-specific effects of the Growing Old TOgether (GOTO) study, a moderate 13-week combined lifestyle intervention on the transcriptomes of postprandial blood, subcutaneous adipose tissue (SAT) and muscle tissue in healthy older adults, the overlap in effect between tissues and their relation to whole-body parameters of metabolic health. The GOTO intervention had virtually no effect on the postprandial blood transcriptome, while the SAT and muscle transcriptomes responded significantly. In SAT, pathways involved in HDL remodeling, O2/CO2exchange and signaling were overrepresented, while in muscle, collagen and extracellular matrix pathways were significantly overexpressed. Additionally, we found that the effects of the SAT transcriptome closest associated with gains in metabolic health. Lastly, in males, we identified a shared variation between the transcriptomes of the three tissues. We conclude that the GOTO intervention had a significant effect on metabolic and muscle fibre pathways in the SAT and muscle transcriptome, respectively. Aligning the response in the three tissues revealed a blood transcriptome component which may act as an integrated health marker for metabolic intervention effects across tissues.
Updating estimates ofPlasmodium knowlesimalaria risk in response to changing land use patterns across Southeast Asia
Authors: Tobin Ruarai J , Harrison Lucinda E , Tully Meg K , Lubis Inke N D , Noviyanti Rintis , Anstey Nicholas M , Rajahram Giri S , Grigg Matthew J , Flegg Jennifer A , Price David J , Shearer Freya M
Published: August 2023

Background

Plasmodium knowlesiis a zoonotic parasite that causes malaria in humans. The pathogen has a natural host reservoir in certain macaque species and is transmitted to humans via mosquitoes of theAnophelesLeucosphyrus Group. The risk of humanP. knowlesiinfection varies across Southeast Asia and is dependent upon environmental factors. Understanding this geographic variation in risk is important both for enabling appropriate diagnosis and treatment of the disease and for improving the planning and evaluation of malaria elimination. However, the data available onP. knowlesioccurrence are biased towards regions with greater surveillance and sampling effort. Predicting the spatial variation in risk ofP. knowlesimalaria requires methods that can both incorporate environmental risk factors and account for spatial bias in detection.

Methods & Results

We extend and apply an environmental niche modelling framework as implemented by a previous mapping study ofP. knowlesitransmission risk which included data up to 2015. We reviewed the literature from October 2015 through to March 2020 and identified 264 new records ofP. knowlesi, with a total of 524 occurrences included in the current study following consolidation with the 2015 study. The modelling framework used in the 2015 study was extended, with changes including the addition of new covariates to capture the effect of deforestation and urbanisation onP. knowlesitransmission.

Discussion

Our map ofP. knowlesirelative transmission suitability estimates that the risk posed by the pathogen is highest in Malaysia and Indonesia, with localised areas of high risk also predicted in the Greater Mekong Subregion, The Philippines and Northeast India. These results highlight areas of priority forP. knowlesisurveillance and prospective sampling to address the challenge the disease poses to malaria elimination planning.

Author Summary

Plasmodium knowlesiis a parasite that can cause malaria when it infects humans. Although most people do not experience severe illness fromPlasmodium knowlesiinfection, a small number will develop serious or even fatal disease. The parasite is found naturally in some monkeys throughout Southeast Asia, and spreads from these monkeys to humans through mosquitoes. Previous research predicted where the risk of being infected is highest according to what we know about the environment across Southeast Asia, such as if there are forests in an area or if the altitude is high. In this work, we extend this previous research with more up-to-date data on environmental conditions and infections to predict the risk of being infected withPlasmodium knowlesi. We show that the riskPlasmodium knowlesiposes to humans is high across much of Southeast Asia, and that the disease will continue to challenge national goals to eliminate malaria.
Features and Networks of the Mandible on Computed Tomography
Authors: Pham Tuan D. , Holmes Simon B. , Patel Mangala , Coulthard Paul
Published: August 2023

The mandible or lower jaw is the largest and hardest bone in the human facial skeleton. Fractures of the mandible are reported to be a common facial trauma in emergency medicine and gaining insights into mandibular morphology in different facial types can be helpful for trauma treatment. Furthermore, features of the mandible play an important role in forensics and anthropology for identifying gender and individuals. Thus, discovering hidden information of the mandible can benefit interdisciplinary research. Here, for the first time, a method of artificial intelligence-based nonlinear dynamics and network analysis are utilized for discovering dissimilar and similar radiographic features of mandibles between male and female subjects. Using a public dataset of ten computed tomography scans of mandibles, the results suggest a difference in the distribution of spatial autocorrelation between genders, uniqueness in network topologies among individuals, and shared values in recurrence quantification.
The analysis of heart rate variability and accelerometer mobility data in the assessment of symptom severity in psychotic disorder patients using a wearable Polar H10 sensor
Authors: Książek Kamil , Masarczyk Wilhelm , Głomb Przemysław , Romaszewski Michał , Stokłosa Iga , Ścisło Piotr , Dębski Paweł , Pudlo Robert , Buza Krisztián , Gorczyca Piotr , Piegza Magdalena
Published: August 2023

Background and Objective

Advancement in mental health care requires easily accessible diagnostic and treatment assessment tools. There is an ongoing search for biomarkers that would enable objectification and automatization of the diagnostic and treatment process dependent on a psychiatric interview. Current wearable technology and computational methods make it possible to incorporate heart rate variability (HRV), an indicator of autonomic nervous system functioning and a potential biomarker of disease severity in mental disorders, into accessible diagnostic and treatment assessment frameworks.

Methods

We used a commercially available electrocardiography (ECG) chest strap with a built-in accelerometer, i.e. Polar H10, to record R-R intervals and activity of 30 hospitalized schizophrenia or bipolar disorder patients and 30 control participants for 1.5-2 hours time periods. We performed an analysis to assess the relationship between HRV and the Positive and Negative Syndrome Scale (PANSS) test scores. The source code for the reproduction of all experiments is available on GitHub while the dataset is available in Zenodo.

Results and Conclusions

Mean HRV values were lower in the patient group and negatively correlated with the results of the PANSS general subcategory. For the control group, we also discovered the inversely proportional dependency between the mobility coefficient based on accelerometer data and HRV. This relationship was less pronounced for the patient group. This indicates that HRV and mobility may be promising markers in disease diagnosis.
A mixed methods study of attitudes on location of gynaecological oncology outpatient care: a patient and healthcare professional questionnaire
Authors: Newhouse Rebecca , Cullimore Victoria , Hotton Emily , Maxwell Hilary , Jones Eleanor , Morrison Jo
Published: August 2023

Objective

Gynaecological oncology place of care is often based on evolution of services, along historical professional boundaries, rather than user needs or preferences. We aimed to assess existing evidence, gather views of patients in the United Kingdom (UK) on their preferred place of outpatient care for gynaecological malignancies and evaluate alignment with preferences of healthcare professionals.

Methods

We performed a mixed methods study, including a scoping review, a patient survey, and a health care practitioner questionnaire. We collected quantitative and qualitative data, performing content analysis to determine current practice and impact on patients.

Results

We performed a mixed methods study, using a scoping review of the literature, patient survey and a healthcare practitioner (HCP) questionnaire, collecting quantitative and qualitative data. No studies were identified in our scoping review. We received responses from 159 patients and 54 gynaecological oncology HCPs. There was a strong preference for a dedicated gynaecological oncology setting (89% somewhat or very happy) (P<0.0001). 53% of patients were somewhat or very unhappy to have care co-located with general obstetrics and gynaecology services. Specifically, two key themes were identified through content analysis of qualitative data from patients: “environment and getting this right is vital”; and “our cancer should be the priority”. HCPs un-der-estimated the strong patient-preference to be seen in dedicated units. Of those who see patients within general obstetrics and gynaecology, only 50% said patients were seen at separate times/locations from obstetric patients.

Conclusion

This study demonstrates the significant impact of place of care on gynaecological oncology patients, which may be underestimated by HCPs.

Key messages

What is already known on this topic

Studies have shown that design of healthcare environment can significantly affect patient care, but have focussed on environmental factors, rather than co-location of services.

What this study adds

Gynaecological oncology patients indicated that co-location of clinics with general obstetrics and gynaecology was psychologically distressing or inappropriate, as they were at a different point in their life journey.

Patients have a strong preference for their outpatient care to be provided in a dedicated gynaecologic oncology setting, away from women and children’s services.

However, gynaecologic oncology services were frequently co-located with general obstetrics and gynaecology services, reflecting evolution of the subspeciality and service development, rather than patient need.

How this study might affect research, practice or policy

It is important to advocate for gynaecological oncology patients, to ensure that healthcare service infrastructure is designed around patient need, not historical professional boundaries.
How do gender norms contribute to stunting in Ntchisi District, Malawi? A qualitative study
Authors: Mphangwe Whitney , Nolan Ann , Vallieres Frédérique , Finn Mairéad
Published: August 2023

Background and Aim

Despite adequate food production and nutrition intervention coverage, stunting remains an enduring problem in Ntchisi, Malawi. Globally, gender and social norms are known to influence nutritional outcomes in children. This study explores how gender norms contribute to child stunting, in Ntchisi district, Central Malawi.

Research Methods

Informed by the UNICEF Framework for Malnutrition, nine focus group discussions were conducted with mothers (n=24), fathers (n=23), and members of policy and health treatment committees (n=21), spanning three different areas of Ntchisi district. Data were analysed through inductive thematic analysis, guided by the framework for Research in Gender and Ethics (RinGs).

Results

Three primary themes were identified: 1) gender unequal decision making on the consumption, sale and distribution of food; 2) enshrined community norms influence feeding practices underpinned by gender-based violence; and 3) policy disconnections and gaps that reinforce gender norms regarding nutrition. Themes encompassed practices across household, health treatment, and policy level.

Conclusion

Gender norms that underpin inequalities in decision making for production and consumption of food undermine children’s nourishment and contributes towards sustained child malnutrition in Ntchisi. Existing policy documents should revise their guidelines to incorporate gender norms as key determinants of malnutrition.
Computational Strategies in Nutrigenetics: Constructing a Reference Dataset of Nutrition-Associated Genetic Polymorphisms
Authors: De Filippis Giovanni Maria , Monticelli Maria , Pollice Alessandra , Angrisano Tiziana , Hay Mele Bruno , Calabrò Viola
Published: August 2023

Objective

This study aims to create a comprehensive dataset of human genetic polymorphisms associated with nutrition by integrating data from multiple sources, including the LitVar database, PubMed, and the GWAS catalog. This consolidated resource is intended to facilitate research in nutrigenetics by providing a reliable foundation to explore genetic polymorphisms linked to nutrition-related traits.

Methods

We developed a data integration pipeline to assemble and analyze the dataset. The pipeline performs data retrieval from LitVar and PubMed, data merging to build a unified dataset, definition of comprehensive MeSH queries in order to retrieve relevant genetic associations, and cross-referencing the results with the GWAS data.

Results

The resulting dataset aggregates extensive information on genetic polymorphisms and nutrition-related traits. Through MeSH query, we identified key genes and SNPs associated with nutrition-related traits. Cross-referencing with GWAS data provided insights on potential effects or risk alleles associated with this genetic polymorphisms. The co-occurrence analysis revealed meaningful gene-diet interactions, advancing personalized nutrition and nutrigenomics research.

Conclusion

The dataset presented in this study consolidates and organizes information on genetic polymorphisms associated with nutrition, facilitating detailed exploration of gene-diet interactions. This resource advances personalized nutrition interventions and nutrigenomics research. The dataset is publicly accessible athttps://zenodo.org/records/14052302, its adaptable structure ensures applicability in a broad range of genetic investigations.
Socio-demographic determinants of COVID-19 vaccine uptake in Ontario: Exploring differences across the Health Region model
Authors: Ortiz Ariel Mundo , Nasri Bouchra
Published: August 2023

The COVID-19 pandemic continues to be a worldwide public health concern. Although vaccines against this disease were rapidly developed, vaccination uptake has not been equal across all the segments of the population. In particular, it has been shown that there have been differences in vaccine uptake across different segments of the population. However, there are also differences in vaccination across geographical areas, which might be important to consider in the development of future public health vaccination policies. In this study, we examined the relationship between vaccination status (having received the first dose of a COVID-19 vaccine), and different socio-economic and geographical factors. Our results show that between October of 2021 and January of 2022, individuals from underrepresented communities were three times less likely to be vaccinated than White/Caucasian individuals across the province of Ontario in Canada, and that in some cases, within these groups, individuals in low-income brackets had significantly higher odds of vaccination when compared to their peers in high income brackets. Finally, we identified significantly lower odds of vaccination in the Central, East and West Health Regions of Ontario within certain underrepresented groups. This study shows that there is an ongoing need to better understand and address differences in vaccination uptake across diverse segments of the population of Ontario that the pandemic has largely impacted.
Estimates and determinants of health facility delivery in the Birhan cohort in Ethiopia
Authors: Hunegnaw Bezawit M. , Goddard Frederick G. B. , Bekele Delayehu , Haneuse Sebastien , Pons-Duran Clara , Zeleke Mesfin , Mohammed Yahya , Bekele Chalachew , Chan Grace J.
Published: August 2023

Health facility delivery is one of the critical indicators to monitor progress towards the provision of skilled delivery care and reduction in perinatal mortality. In Ethiopia, utilization of health facilities for skilled delivery care has been increasing but varies greatly by region and among specific socio-demography groups. We aim to measure the prevalence and determinants of health facility delivery in the Amhara region in Ethiopia.

From December 2018 to November 2020, we conducted a longitudinal study from a cohort of 2801 pregnant women and described the location of delivery and the association with determinants. We interviewed a subset of women who delivered in the community and analyzed responses using the three delays model to understand reasons for not using health facility services. A multivariable poisson regression model with robust error variance was used to estimate the presence and magnitude of association between location of delivery and the determinants.

Of the 2,482 pregnant women followed through to birth, 73.6% (n=1,826) gave birth in health facilities, 24.3% (n=604) gave birth at home and 2.1% (n=52) delivered on the way to a health facility. Determinants associated with increased likelihood of delivery at a health facility included formal maternal education, shorter travel times to health facilities, primiparity, higher wealth index and having attended at least one ANC visit. Most common reasons mothers gave for not delivering in a health facility were delays in individual/family decision to seek care. The proportion of deliveries occurring in health facilities is improving but falls below targets. Interventions that focus on the identified social-demographic determinants to improve uptake of health facility delivery care are warranted.
Equivalent Binding Of Sera From Omicron And Delta Period To Future Omicron Subvariants
Authors: Biswas Deepayan , Mahalingam Gokulnath , Subaschandrabose Rajesh Kumar , Priya Sangeetha , Ramachandran Rohini , Suresh Sevanthy , Mathivanan Tamil Venthan , Balu Nelson Vijaykumar , Selvaraj Kavitha , Nellickal Arun Jose , Christudoss Pamela , Samuel Prasanna , Devi KT Ramya , Marepally Srujan , Moorthy Mahesh
Published: August 2023

Throughout the COVID-19 pandemic, virus evolution and large-scale vaccination programs have caused multiple exposures to SARS CoV-2 spike protein, resulting in complex antibody profiles. Binding of sera to spike protein of future variants in the context of heterogeneous exposure, has not been studied. We tested archival sera (delta and omicron period) stratified by anti-spike levels for reactivity to omicron subvariant (BA.1, BA.2, BA.2.12.1, BA.2.75, BA.4/5 and BF.7) spike. Antibody reactivity to wild-type (CLIA) and subvariants (ELISA) spike were similar between periods (p>0.05). Both High S group and Low S group of delta and omicron periods were closely related to future subvariants by Antigenic Cartography. Anti-spike antibodies to wild type (S1/S2 and Trimeric S) clustered with subvariant-binding antibodies. Low S group interspersed between High S group on hierarchical clustering. Hybrid immunity caused by cumulative virus exposure in delta or omicron periods caused equivalent binding to future variants. Low S antibody group demonstrating similar binding is a prominent finding.
Spinal cord injury: a systematic review and meta-analysis of microRNA alterations
Authors: Tigchelaar Seth Stravers , Wadhwa Harsh , Mathur Maya B. , He Zihuai , Tharin Suzanne
Published: August 2023

Spinal cord injury (SCI) often results in life-long disability, lost wages, reduced quality of life, and high economic burden. A bottle neck in the performance of clinical trials exists, in part, due to a lack of diagnostic and prognostic markers of injury severity and neurologic recovery. In addition, while many interventions show promise in preclinical animal models, there are currently no neurorestorative treatments for SCI patients. The development of objective biological markers (biomarkers) and molecular targets for novel treatments for SCI represent two urgent unmet clinical needs. MicroRNAs (miRNAs) represent promising molecules as objective and informative molecules of injury severity and recovery and as potential therapeutic targets. miRNAs are small, stable, regulatory RNA molecules that are evolutionarily conserved across species. miRNAs represent powerful predictors of pathology, particularly with respect to neurologic disorders. Here, we present a systematic review and meta-analysis investigating the conserved inter- and intra-species miRNA changes that occur post-SCI and provide a comprehensive resource for the SCI community. Our analysis identifies a robust set of miRNAs that are involved in the pathophysiologic processes activated in response to SCI.
Computations and neural dynamics of audiovisual causal and perceptual inference in schizophrenia
Authors: Rohe Tim , Hesse Klaus , Ehlis Ann-Christine , Noppeney Uta
Published: August 2023

Hallucinations and perceptual abnormalities in psychosis are thought to arise from imbalanced integration of prior information and sensory inputs during perceptual inference. In this study, we combined psychophysics, Bayesian modelling and electroencephalography (EEG) to investigate potential changes in perceptual and causal inference in medicated individuals with schizophrenia when exposed to audiovisual sequences with varying numbers of flashes and beeps from either common or independent sources. Our findings reveal that individuals with schizophrenia, like their healthy controls, balance sensory integration and segregation in line with Bayesian causal inference rather than resorting to simpler heuristics. Both groups showed comparable weighting of prior information regarding the signals’ causal structure, with the schizophrenia group slightly overweighting prior information about the number of flashes or beeps. At the neural level, both groups computed Bayesian causal inference through dynamic encoding of perceptual estimates that segregate and flexibly combine audiovisual inputs. In conclusion, our results demonstrate that the computational and neural mechanisms of multisensory perceptual and causal inference remain remarkably intact in medicated individuals with schizophrenia during flash-beep scenarios.
Synchrony and amplitude modulation of cortical activity in humans performing manipulative visuomotor tasks
Authors: Aoki F. , Shupe L. , Ojemann G. A. , Fetz E. E.
Published: August 2023

Synchrony of oscillatory brain activity has been postulated to be a binding mechanism for cognitive and motor functions. Spectral analysis of human electrocorticogram (ECoG) in sensorimotor cortex has shown that power density of gamma band activity (30-60 Hz) increased and that of alpha-beta band activity (10-20 Hz) decreased during performance of manipulative visuomotor tasks, indicating that amplitude modulation of the gamma band activity occurred in relation to the task performance. Amplitude modulation may provide evidence for synchrony of local neuronal assembly. However, it does not implement the binding mechanisms for distributed networks that are necessary for cognitive and motor functions. To prove that oscillatory activity mediates a binding mechanism, phase modulation of oscillatory activity in a wide range area should be shown. We performed coherence analysis of the ECoG signals in sensorimotor cortex to study if synchrony of the gamma band activity between these areas occurs in relation to manipulative task performance. The ECoGs were recorded from 14 sites in sensorimotor cortex including hand-arm areas with subdural grid electrodes in four subjects. Coherence estimates in all pair-wise sites were calculated in different frequency bands with 10 Hz widths from 10 to 80 Hz. In all subjects, coherence estimates increased in the lower gamma band (20-50 Hz) during the performance of the manipulative tasks. But coherence in the alpha-beta band (10-20 Hz) also increased even though amplitude modulation did not occur in this frequency band. Coherence estimates increased in site pairs within and between sensory and motor areas, many separated by intervening sites. This interregional synchrony of the alpha-beta and the lower gamma activities may play a role in integration of sensorimotor information. Task-dependent increases in coherence estimates, i.e., greater increases during performance of the manipulative tasks than during the simple tasks, suggest another role of synchrony in attention mechanism. Time-series coherence analysis showed that phase modulation occurred in different timings for activities in the alpha-beta and the lower gamma bands. For the activity in higher gamma band (50-80 Hz), power density increased but coherence estimates decreased. Thus, only amplitude modulation occurred in this frequency band. Altogether these results suggest that oscillatory activities in different frequency bands may reflect different functional roles by modulating neural activity in different ways.
Material Properties of Nonpregnant and Pregnant Human Uterine Layers
Authors: Fodera Daniella M. , Russell Serena R. , Lund-Jackson Johanna L. , Fang Shuyang , Chen Xiaowei , Vink Joy-Sarah Y. , Oyen Michelle L. , Myers Kristin M.
Published: August 2023

The uterus has critical biomechanical functions in pregnancy and undergoes dramatic material growth and remodeling from implantation to parturition. The intrinsic material properties of the human uterus and how they evolve in pregnancy are poorly understood. To address this knowledge gap and assess the heterogeneity of these tissues, the time-dependent material properties of all human uterine layers were measured with nanoindentation. The endometrium-decidua layer was found to be the least stiff, most viscous, and least permeable layer of the human uterus in nonpregnant and third-trimester pregnant tissues. In pregnancy, endometrium-decidua becomes stiffer and less viscous with no material property changes observed in the myometrium or perimetrium. Additionally, uterine material properties did not significantly differ between third-trimester pregnant tissues with and without placenta accreta. The foundational data generated by this study will facilitate the development of physiologically accurate models of the human uterus to investigate gynecologic and obstetric disorders.

Highlights

Human uterine layers are distinct, heterogeneous and time-dependent

Pregnancy alters the material properties of the maternal-fetal interface

Largest dataset of uterine mechanical properties measured by nanoindentation

Graphical Abstract