bluuebunny/crossref_metadata_2025 huggingface dataset:
Quality of obstetric and newborn care in health centers of Addis Ababa City: using the WHO quality framework
Authors: Abebe Amaha Haile , Mmusi-Phetoe Rose
Published: May 2023

Objective

The study aims to assess the quality of obstetric and newborn care using the WHO quality framework.

Design

The study used explanatory sequential mixed methods design.

Setting

This study was conducted in 50 health centers in Addis Ababa city administration from January 25 to December 31, 2021.

Methods

A total of 50 health centers were surveyed using a structured questionnaire and 500 women in the postpartum period were interviewed using a structured questionnaire. Delivery records of the 500 women were reviewed using a structured checklist. A total of 338 midwives were interviewed using a structured questionnaire. The quantitative data was analyzed using Statistical Package for Social Sciences (SPSS).

Results

The study revealed that only a third of the 50 health centers were providing good quality care (a quality score ≥ 75%). All the health centers had the physical resources (100%) to deliver obstetric and newborn care. The majority of the health centers had a system for actionable information (92%), functional referral (80%), and providing dignified care (80%). On the other hand, only a few of the health centers met the quality threshold for effective communication (24%), evidence-based practice of routine obstetric and newborn care (36%), and availability of mechanisms to support and motivate skilled birth attendants (24%). None of the health centers met the quality threshold for emotional support during labour and delivery. Obstetric caregivers’ high workload and job dissatisfaction were barriers to quality care.

Conclusion

Ensuring quality obstetric and newborn care needs effective quality improvement interventions that aim to ensure women had effective communication, emotional support, and dignity during labour and delivery. Reducing the workload and increasing motivation of birth attendants play a critical role in improving the quality of care.
Community Health Teams: a qualitative study about the factors influencing the decision-making process
Authors: Natkin Lisa W. , van den Broek-Altenburg Eline , Benson Jamie S. , Atherly Adam
Published: May 2023

Background

The purpose of this study was to explore the factors influencing how individual Community Health Teams (CHTs) make decisions about what services to offer and how to allocate their resources.

Methods

We conducted thirteen semi-structured interviews with all 13 CHTs program managers between January and March, 2021. We analyzed interviewees descriptions of their service offerings, resources allocation, and decision-making process to identify themes.

Results

Four major themes emerged from the interview data as factors influencing community health team program managers’ decision-making process: commitment to offering high-quality care coordination, Blueprint’s stable and flexible structure, use of data in priority setting, and leveraging community partnerships and local resources.

Conclusions

Community-based CHTs with flexible funding allowed programs to tailor service offerings in response to community needs. It is important for teams to have access to community-level data. Teams are cultivating and leveraging community partners to increase their care coordination capacity, which is focus of their work. CHTs are a model for leveraging community partnerships to increase service capacity and pubic engagement in health services for other states to replicate.
Effects of rye inclusion in dog food on fecal microbiota and short-chain fatty acids
Authors: Palmqvist Hanna , Ringmark Sara , Höglund Katja , Pelve Erik , Lundh Torbjörn , Dicksved Johan
Published: May 2023

Background

Rye intake has been associated with beneficial effects on health in human interventions, possibly due to dietary fiber in rye. In dogs, few studies have explored the effects on health of dietary fiber in general, and rye fiber in particular. The aim of this study was to investigate how inclusion of rye, compared with wheat, influenced fecal microbiota composition, short chain fatty acids (SCFA) and apparent total tract digestibility (ATTD) in dogs. Six male Beagle dogs (mean age 4.6 years, SEM 0.95 years; mean body weight 14.6 kg, SEM 0.32 kg) were fed three experimental diets, each for 21 days, including an adaptation period of six days and with 2–2.5 months between diet periods. The diets were similar regarding energy and protein, but had different carbohydrate sources (refined wheat (W), whole grain rye (R), or an equal mixture of both (RW)) comprising 50% of total weight on a dry matter (DM) basis. The diets were baked and titanium dioxide was added for ATTD determination. Fecal samples were collected before and in the end of each experimental period. Fecal microbiota was analyzed by sequencing 16S rRNA gene amplicons and fecal SCFA by high-performance liquid chromatography. Crude protein, crude fat, neutral detergent fiber, and gross energy (GE) in food and feces were analyzed and ATTD of each was determined. Univariate and multivariate statistical methods were applied in data evaluation.

Results

Faecal microbiota composition, differed depending on diet (P = 0.002), with samples collected after consumption of the R diet differing from baseline. This was primarily because of a shift in proportion of Prevotella, which increased significantly after consumption of the R diet (P < 0.001). No significant differences were found for SCFA, but there was a tendency (P < 0.06) for higher molar proportions of acetic acid following consumption of the R diet. The ATTD of crude protein, crude fat, neutral detergent fiber, and GE was lower after consumption of the R diet compared with the other diets (P < 0.05).

Conclusions

Consumption of the R diet, but not RW or W diets, was associated with specific shifts in microbial community composition and function, but also with lower ATTD.
Impact of individual microvascular disease on the risks of macrovascular complications in type 2 diabetes: a nationwide population-based cohort study
Authors: Yen Fu-Shun , Wei James Cheng-Chung , Shih Ying-Hsiu , Hsu Chih-Cheng , Hwu Chii-Min
Published: May 2023

Background

This study compared the risks of cardiovascular morbidity and mortality between patients with type 2 diabetes (T2D) with and without microvascular diseases, and between matched patients with microvascular diseases.

Methods

We identified newly diagnosed type 2 diabetes patients from National Health Insurance Research Database in Taiwan from January 1, 2008, to December 31, 2019. Propensity score matching was applied to construct matched pairs of patients with diabetic kidney disease, retinopathy, or neuropathy. Multivariable Cox proportional-hazard models were adopted to compare the risks of cardiovascular morbidity and mortality.

Results

Patients with microvascular disease had a significantly higher risk of cardiovascular morbidities and mortality than those without microvascular disease. Among the matched cohorts, patients with diabetic retinopathy had a significantly higher risk of stroke development than those with diabetic kidney disease (aHR 1.11, 95%CI 1.03–1.2). Diabetic neuropathy showed a significantly higher risk of stroke development than diabetic kidney disease (aHR 1.17, 95%CI 1.1–1.25) and diabetic retinopathy (aHR 1.12, 95%CI 1.03–1.21). Diabetic retinopathy had a significantly higher risk of incident heart failure than diabetic kidney disease (aHR 1.43, 95%CI 1.3–1.57), and diabetic neuropathy had a significantly lower risk of incident heart failure than diabetic retinopathy (aHR 0.79, 95%CI 0.71–0.87).

Conclusions

T2D patients with microvascular disease have a significantly higher risk of cardiovascular morbidities and mortality than those without microvascular disease. In the matched cohorts, diabetic neuropathy was significantly associated with stroke development, and diabetic retinopathy had a significant association with heart failure compared to other microvascular diseases.
1-3-7 surveillance and response approach in malaria elimination: China’s practice and global adaptions
Authors: Yi Boyu , Zhang Li , Yin Jianhai , Zhou Shuisen , Xia Zhigui
Published: May 2023

There has been a significant reduction in malaria morbidity and mortality worldwide from 2000 to 2019. However, the incidence and mortality increased again in 2020 due to the disruption to services during the COVID-19 pandemic. Surveillance to reduce the burden of malaria, eliminate the disease and prevent its retransmission is, therefore, crucial. The 1-3-7 approach proposed by China has played an important role in eliminating malaria, which has been internationally popularized and adopted in some countries to help eliminate malaria. This review summarizes the experience and lessons of 1-3-7 approach in China and its application in other malaria-endemic countries, so as to provide references for its role in eliminating malaria and preventing retransmission. This approach needs to be tailored and adapted according to the region condition, considering the completion, timeliness and limitation of case-based reactive surveillance and response. It is very important to popularize malaria knowledge, train staff, improve the capacity of health centres and monitor high-risk groups to improve the performance in eliminating settings. After all, remaining vigilance in detecting malaria cases and optimizing surveillance and response systems are critical to achieving and sustaining malaria elimination.
Aberrant m5C hypermethylation mediates intrinsic resistance to gefitinib through NSUN2/YBX1/QSOX1 axis in EGFR-mutant non-small-cell lung cancer
Authors: Wang Yueqin , Wei Jingyao , Feng Luyao , Li Ouwen , Huang Lan , Zhou Shaoxuan , Xu Yingjie , An Ke , Zhang Yu , Chen Ruiying , He Lulu , Wang Qiming , Wang Han , Du Yue , Liu Ruijuan , Huang Chunmin , Zhang Xiaojian , Yang Yun-gui , Kan Quancheng , Tian Xin
Published: May 2023

Background

RNA 5-methylcytosine (m5C) modification plays critical roles in the pathogenesis of various tumors. However, the function and molecular mechanism of RNA m5C modification in tumor drug resistance remain unclear.

Methods

The correlation between RNA m5C methylation, m5C writer NOP2/Sun RNA methyltransferase family member 2 (NSUN2) and EGFR-TKIs resistance was determined in non-small-cell lung cancer (NSCLC) cell lines and patient samples. The effects of NSUN2 on EGFR-TKIs resistance were investigated by gain- and loss-of-function assays in vitro and in vivo. RNA-sequencing (RNA-seq), RNA bisulfite sequencing (RNA-BisSeq) and m5C methylated RNA immunoprecipitation-qPCR (MeRIP-qPCR) were performed to identify the target gene of NSUN2 involved in EGFR-TKIs resistance. Furthermore, the regulatory mechanism of NSUN2 modulating the target gene expression was investigated by functional rescue and puromycin incorporation assays.

Results

RNA m5C hypermethylation and NSUN2 were significantly correlated with intrinsic resistance to EGFR-TKIs. Overexpression of NSUN2 resulted in gefitinib resistance and tumor recurrence, while genetic inhibition of NSUN2 led to tumor regression and overcame intrinsic resistance to gefitinib in vitro and in vivo. Integrated RNA-seq and m5C-BisSeq analyses identified quiescin sulfhydryl oxidase 1 (QSOX1) as a potential target of aberrant m5C modification. NSUN2 methylated QSOX1 coding sequence region, leading to enhanced QSOX1 translation through m5C reader Y-box binding protein 1 (YBX1).

Conclusions

Our study reveals a critical function of aberrant RNA m5C modification via the NSUN2-YBX1-QSOX1 axis in mediating intrinsic resistance to gefitinib in EGFR-mutant NSCLC.
Syndemic conditions and quality of life in the PISCIS Cohort of people living with HIV in Catalonia and the Balearic Islands: a cross sectional study
Authors: Mesías-Gazmuri Jocelyn , Folch Cinta , Palacio-Vieira Jorge , Bruguera Andreu , Egea-Cortés Laia , Forero Carlos G. , Hernández Juan , Miró José M. , Navarro Jordi , Riera Melchor , Peraire Joaquim , Alonso-García Lucía , Díaz Yesika , Casabona Jordi , Reyes-Urueña Juliana
Published: May 2023

Background

People living with HIV (PLWH) face structural and psychosocial factors that affect health-related quality of life (HRQoL). We aimed to evaluate how syndemic conditions affected HRQoL in PLWH.

Methods

A cross-sectional survey was conducted among 861 PLWH, to determine whether syndemic conditions (monthly income; sexual satisfaction; depressive symptoms; social role satisfaction; social isolation; cognitive function; nicotine dependence; perception of stigma) have an effect on HRQoL. A linear regression model and measures of Additive Interaction (AI) were used to determine the effects of syndemic conditions on HRQoL, controlling for other risk factors.

Results

Overall, the most frequently observed were stigma perception (56.9%), poor cognitive function (50.6%) and the perception of social isolation (51.6%). The presence of depressive symptoms was the risk factor most associated with worse Physical Health (PH) (B 3.93, 2.71–5.15) and Mental Health (MH) (B 5.08, 3.81–6.34) in linear regression model. Specifically, an interaction was observed between poor cognitive function and poor satisfaction with social role on worse PH and MH (AI 2.08, 0.14–4.02; AI 2.69, 0.15–5.22, respectively); and low income and perception of stigma (AI 2.98, 0.26–5.71), low income and perception of social isolation (AI 2.79, 0.27–5.32), and low income and poor satisfaction with social role (AI 3.45, 0.99–5.91) on MH.

Conclusion

These findings provide evidence that syndemic factors impact HRQoL. HIV prevention programs should screen and address co-occurring health problems to improve patient-centered health care and outcomes.
Evaluation of the EQ-5D-5L, EQ-VAS stand-alone component and Oxford knee score in the Australian knee arthroplasty population utilising minimally important difference, concurrent validity, predictive validity and responsiveness
Authors: Lin D-Yin , Cheok Tim Soon , Kaambwa Billingsley , Samson Anthony J. , Morrison Craig , Chan Teik , Kroon Hidde M. , Jaarsma Ruurd L.
Published: May 2023

Purpose

To evaluate the Oxford Knee Score (OKS), EQ-5D-5L utility index and EQ-5D visual analogue scale (EQ-VAS) for health-related quality of life outcome measurement in patients undergoing elective total knee arthroplasty (TKA) surgery.

Methods

In this prospective multi-centre study, the OKS and EQ-5D-5L index scores were collected preoperatively, six weeks (6w) and six months (6 m) following TKA. The OKS, EQ-VAS and EQ-5D-5L index were evaluated for minimally important difference (MID), concurrent validity, predictive validity (Spearman's Rho of predicted and observed values from a generalised linear regression model (GLM)), responsiveness (effect size (ES) and standard response mean (SRM)). The MID for the individual patient was determined utilising two approaches; distribution-based and anchor-based.

Results

533 patients were analysed. The EQ-5D-5L utility index showed good concurrent validity with the OKS (r = 0.72 preoperatively, 0.65 at 6w and 0.69 at 6 m). Predictive validity for the EQ-5D-5L index was lower than OKS when regressed. Responsiveness was large for all fields at 6w for the EQ-5D-5L and OKS (EQ-5D-5L ES 0.87, SRM 0.84; OKS ES 1.35, SRM 1.05) and 6 m (EQ-5D-5L index ES 1.31, SRM 0.95; OKS ES 1.69, SRM 1.59). The EQ-VAS returned poorer results, at 6w an ES of 0.37 (small) and SRM of 0.36 (small). At 6 m, the EQ-VAS had an ES of 0.59 (moderate) and SRM of 0.47 (small). It, however, had similar predictive validity to the OKS, and better than the EQ-5D-5L index. MID determined using anchor approach, was shown that for OKS at 6 weeks it was 8.84 ± 9.28 and at 6 months 13.37 ± 9.89. For the EQ-5D-5L index at 6 weeks MID was 0.23 ± 0.39, and at 6 months 0.26 ± 0.36.

Conclusions

The EQ-5D-5L index score and the OKS demonstrate good concurrent validity. The EQ-5D-5L index demonstrated lower predictive validity at 6w, and 6 m than the OKS, and both PROMs had adequate responsiveness. The EQ-VAS had poorer responsiveness but better predictive validity than the EQ-5D-5L index.

This article includes MID estimates for the Australian knee arthroplasty population.
Postoperative intermittent pneumatic compression for preventing venous thromboembolism in Chinese lung cancer patients: a randomized clinical trial
Authors: Li Jingyao , Huang Aihong , Han Zhaojie , Zhou Yi , Tang Meng , Wu Wei , Zhang Shixin , Liao Kelong , Xie Yihui , Chen Qiao , Zou Xinliang , Liu Shuai , Gao Shuaixiang , Ren Junlong , Xu Qingyuan , Liu Xi , Liao Yi , Jing Tao , Tan WenFeng , Qiu Yang , Wang Haidong
Published: May 2023

Background

Postoperative lung cancer patients belong to the high-risk group for venous thromboembolism (VTE). The standardized preventive measures for perioperative VTE in lung cancer are not perfect, especially for the prevention and treatment of catheter-related thrombosis (CRT) caused by carried central venous catheters (CVCs) in lung cancer surgery.

Patients and methods

This study included 460 patients with lung cancer undergoing video-assisted thoracic surgery (VATS) in our center from July 2020 to June 2021. Patients were randomized into two groups, and intraoperatively-placed CVCs would be carried to discharge. During hospitalization, the control group was treated with low-molecular-weight heparin (LMWH), and the experimental group with LMWH + intermittent pneumatic compression (IPC). Vascular ultrasound was performed at three time points which included before surgery, before discharge, and one month after discharge. The incidence of VTE between the two groups was studied by the Log-binomial regression model.

Results

CRT occurred in 71.7% of the experimental group and 79.7% of the control group. The multivariate regression showed that the risk of developing CRT in the experimental group was lower than in the control group (Adjusted RR = 0.889 [95%CI0.799–0.989], p = 0.031), with no heterogeneity in subgroups (P for Interaction > 0.05). Moreover, the fibrinogen of patients in the experimental group was lower than control group at follow-up (P = 0.019).

Conclusion

IPC reduced the incidence of CRT during hospitalization in lung cancer patients after surgery.

Trial registration

No. ChiCTR2000034511.
Drivers of retention of the HIV workforce transitioned from PEPFAR support to the Uganda government payroll
Authors: Zakumumpa Henry , Rujumba Joseph , Kyomuhendo Marjorie , Stempler llyse , Amde Woldekidan
Published: May 2023

Background

Health worker (HW) retention in the public health sector in Uganda is an enduring health system constraint. Although previous studies have examined the retention of in-service HWs, there is little research focusing on donor-recruited HWs. The objective of this study was to explore drivers of retention of the HIV workforce transitioned from PEPFAR support to the Uganda government payroll between 2015 and 2017.

Methods

We conducted ten focus group discussions with HWs (n = 87) transitioned from PEPFAR support to the public sector payroll in 10 purposively selected districts across Uganda. In-depth interviews were conducted with national-level stakeholders (n = 17), district health and personnel officers (n = 15) and facility in-charges (n = 22). Data were analyzed by a hybrid approach of inductive and deductive thematic development based on the analytical framework by Schaefer and Moos regarding individual-level and organizational-context drivers.

Results

At the individual level, job security in the public sector was the most compelling driver of health worker retention. Community embeddedness of HWs in the study districts, opportunities for professional development and career growth and the ability to secure salary loans due to ‘permanent and pensionable’ terms of employment and the opportunity to work in ‘home districts’, where they could serve their ‘kinsmen’ were identified as enablers. HWs with prior private sector backgrounds perceived public facilities as offering more desirable challenging professional work. Organizational context enablers identified include perceptions that public facilities had relaxed supervision regimes and more flexible work environments. Work environment barriers to long-term retention include frequent stock-out of essential commodities, heavy workloads, low pay and scarcity of rental accommodation, particularly in rural Northern Uganda. Compared to mid-cadres (such as nurses and midwives), higher calibre cadres, such as physicians, pharmacists and laboratory technologists, expressed a higher affinity for seeking alternative employment in the private sector in the immediate future.

Conclusions

Overall, job security was the most compelling driver of retention in public service for the health workforce transitioned from PEPFAR support to the Uganda government payroll. Monetary and non-monetary policy strategies are needed to enhance the retention of upper cadre HWs, particularly physicians, pharmacists and laboratory technologists in rural districts of Uganda.
The involvement of NLRP3 inflammasome in CUMS-induced AD-like pathological changes and related cognitive decline in mice
Authors: Li Jia-Mei , Hu Ting , Zhou Xiao-Na , Zhang Ting , Guo Jia-Hui , Wang Min-Yuan , Wu Yi-Lin , Su Wen-Jun , Jiang Chun-Lei
Published: May 2023

Background

Numerous studies have found that inhibiting the expression of NLRP3 inflammasome can significantly improve depressive-like behaviors in mice, but the research on its effect on cognitive decline in depression and its mechanism is still lacking. This study aimed to elucidate the role of NLRP3 inflammasome in cognitive decline in depression and explore the common neuro-immunological mechanisms of depression and Alzheimer’s disease (AD).

Methods

Male C57BL/6 mice were subjected to chronic unpredictable mild stress (CUMS) for 5 weeks, treatment group was administered with the NLRP3 inhibitor MCC950 (10 mg/kg, i.p.), fluoxetine served as positive control. Then, the mice were assessed for cognitive behaviors and depression-like behaviors, and changes of microglia and neurons in hippocampus and levels of Aβ metabolic pathway and tau protein were measured. To explore the mechanism of NLRP3 activation on neurons, we performed in vitro studies using BV2 microglia and mouse primary neurons. Furthermore, we focused on the role of NLRP3 inflammasome in the function of neurons and the expression of AD pathological indicators.

Results

CUMS induced depressive-like behaviors and cognitive decline in mice, which could be reversed by inhibiting NLRP3 inflammasome. MCC950, a specific NLRP3 inhibitor, alleviated CUMS-induced neuron injury and AD-like pathological changes, including the abnormal expression of Aβ metabolic pathway and the hyper-phosphorylation of tau protein. LPS (1 μg/mL) + ATP (1 mM) treatment activated the expression of NLRP3 inflammasome and IL-1β in vitro. In vitro experiment also proved that inhibiting the expression of NLRP3 inflammasome in microglia can restore the Aβ metabolic pathway to normal, decrease neuronal tau protein phosphorylation and protect neurons.

Conclusions

Inhibition of NLRP3 inflammasome effectively alleviated CUMS-induced depressive-like behaviors and cognitive decline in mice, and inhibited the activation of AD physiological indicators.
Inhibition of lysophosphatidic acid receptor 1 relieves PMN recruitment in CNS via LPA1/TSP1/CXCR2 pathway and alleviates disruption on blood-brain barrier following intracerebral haemorrhage in mice
Authors: Gao Ling , Peng Li , Sherchan Prativa , Tang Hong , Liu Yu , Xiao Jie , Shi Hui , Luo Yujie , Tang Jiping , Zhang John H. , Xia Ying
Published: May 2023

Backgroud

The frequencies of morbidity and impairment associated with spontaneous intracerebral haemorrhage (ICH) are comparatively high. Blood-brain barrier (BBB) integrity was compromised due to subsequent brain injury induced by ICH, which is crucial for a poor prognosis. Polymorphonuclear leukocyte (PMN) strongly modulate the disruption of BBB in the central nervous system (CNS). The lysophosphatidic acid receptor 1 (LPA1) mediated thrombospondin-1 (TSP1) regulation in astrocytes, which induce macrophage inflammatory protein 2(MIP2) secretion. MIP2 enhance PMN recruitment through CXC chemokine type 2 (CXCR2) activation. The purpose of this study was to investigate whether the LPA1-mediated inhibition of PMN recruitment and BBB protection after ICH is regulated by TSP1 and CXCR2 networks.

Methods

ICH induction was performed in CD1 mice using collagenase administration. AM966, a targeted LPA1 antagonist, was orally administered 1 and 12 h following ICH. further identify possible LPA1-mediated BBB protection mechanisms, we intracerebroventricularly (ICV) administered a CXCR2 ligand MIP2, as well as TSP1 CRISPR activation (ACT) with AM966. Consequently, we performed neurobehavioral, brain water content (BWC), Evans blue staining (EBS), immunofluorescence (IF), and western blot (WB) analyses.

Results

After ICH, astrocytes showed signs of LPA1, which peaked after 24 h, while PMN\ displayed evidence of CXCR2. The AM966-mediated LPA1 suppression relieved PMN recruitment, diminished brain oedema, demonstrated extravasation (as evidenced by EBS), protected BBB integrity, and enhanced neurologic activity following ICH. AM966 treatment strongly reduced TSP1, CXCR2, Occludin, and Claudin-5 expressions and PMN recruitment following ICH, and their expressions were restored by MIP2 and TSP1 CRISPR (ACT).

Conclusions

This study shows that LAP1 suppression reduced PMN recruitment after ICH in mice via TSP1/CXCR2 signalling, which minimized BBB disruption and improved the CNS’s neurobehavioral functioning. Hence, LPA1 is a strong candidate for therapy to reduce PMN recruitment and offer protection of BBB integrity after ICH.
Second-generation bone cement-injectable cannulated pedicle screws for osteoporosis: biomechanical and finite element analyses
Authors: Li Congcan , Song Lei , Xiao Jun , Wu Wenwen , Jiang Yifan , Zhou Rui , Dai Fei
Published: May 2023

Background

Biomechanical and finite element analyses were performed to investigate the efficacy of second-generation bone cement-injectable cannulated pedicle screws (CICPS) in osteoporosis.

Methods

This study used the biomechanical test module of polyurethane to simulate osteoporotic cancellous bone. Polymethylmethacrylate (PMMA) bone cement was used to anchor the pedicle screws in the module. The specimens were divided into two groups for the mechanical tests: the experimental group (second-generation CICPS) and control group (first-generation CICPS). Safety was evaluated using maximum shear force, static bending, and dynamic bending tests. Biomechanical stability evaluations included the maximum axial pullout force and rotary torque tests. X-ray imaging and computed tomography were used to evaluate the distribution of bone cement 24 h after PMMA injection, and stress distribution at the screw fracture and screw–cement–bone interface was assessed using finite element analysis.

Results

Mechanical testing revealed that the experimental group (349.8 ± 28.6 N) had a higher maximum axial pullout force than the control group (277.3 ± 8.6 N; P < 0.05). The bending moments of the experimental group (128.5 ± 9.08 N) were comparable to those of the control group (113.4 ± 20.9 N; P > 0.05). The screw-in and spin-out torques of the experimental group were higher than those of the control group (spin-in, 0.793 ± 0.015 vs. 0.577 ± 0.062 N, P < 0.01; spin-out, 0.764 ± 0.027 vs. 0.612 ± 0.049 N, P < 0.01). Bone cement was mainly distributed at the front three-fifths of the screw in both groups, but the distribution was more uniform in the experimental group than in the control group. After pullout, the bone cement was closely connected to the screw, without loosening or fragmentation. In the finite element analysis, stress on the second-generation CICPS was concentrated at the proximal screw outlet, whereas stress on the first-generation CICPS was concentrated at the screw neck, and the screw–bone cement–bone interface stress of the experimental group was smaller than that of the control group.

Conclusion

These findings suggest that second-generation CICPS have higher safety and stability than first-generation CICPS and may be a superior choice for the treatment of osteoporosis.
Correcting gradient-based interpretations of deep neural networks for genomics
Authors: Majdandzic Antonio , Rajesh Chandana , Koo Peter K.
Published: May 2023

Post hoc attribution methods can provide insights into the learned patterns from deep neural networks (DNNs) trained on high-throughput functional genomics data. However, in practice, their resultant attribution maps can be challenging to interpret due to spurious importance scores for seemingly arbitrary nucleotides. Here, we identify a previously overlooked attribution noise source that arises from how DNNs handle one-hot encoded DNA. We demonstrate this noise is pervasive across various genomic DNNs and introduce a statistical correction that effectively reduces it, leading to more reliable attribution maps. Our approach represents a promising step towards gaining meaningful insights from DNNs in regulatory genomics.
Combined treatment of nerve growth factor and transcranical direct current stimulations to improve outcome in children with vegetative state after out-of-hospital cardiac arrest
Authors: Curatola Antonietta , Graglia Benedetta , Granata Giuseppe , Conti Giorgio , Capossela Lavinia , Manni Luigi , Ferretti Serena , Di Giuda Daniela , Romeo Domenico Marco , Calcagni Maria Lucia , Soligo Marzia , Castelli Enrico , Piastra Marco , Mantelli Flavio , Marca Giacomo Della , Staccioli Susanna , Romeo Tiziana , Pani Marcello , Cocciolillo Fabrizio , Mancino Aldo , Gatto Antonio , Chiaretti Antonio
Published: May 2023

Background

Out-of-hospital cardiac arrest (OHCA) is one of the most dramatic events in pediatric age and, despite advanced neurointensive care, the survival rate remains low. Currently, no effective treatments can restore neuronal loss or produce significant improvement in these patients. Nerve Growth Factor (NGF) is a neurotrophin potentially able to counteract many of the deleterious effects triggered by OHCA. Transcranial Direct Current Stimulation (tDCS) has been reported to be neuroprotective in many neurological diseases, such as motor deficit and cognitive impairment. Children with the diagnosis of chronic vegetative state after OHCA were enrolled. These patients underwent a combined treatment of intranasal administration of human recombinant NGF (hr-NGF), at a total dose of 50 gamma/kg, and tDCS, in which current intensity was increased from zero to 2 mA from the first 5 s of stimulation and maintained constant for 20 min. The treatment schedule was performed twice, at one month distance each. Neuroradiogical evaluation with Positron Emission Tomography scan (PET), Single Photon Emission Computed Tomography (SPECT), Electroencephalography (EEG) and Power Spectral Density of the brain (PSD) was determined before the treatment and one month after the end. Neurological assessment was deepened by using modified Ashworth Scale, Gross Motor Function Measure, and Disability Rating Scale.

Results

Three children with a chronic vegetative state secondary to OHCA were treated. The combined treatment with hr-NGF and tDCS improved functional (PET and SPECT) and electrophysiological (EEG and PSD) assessment. Also clinical conditions improved, mainly for the reduction of spasticity and with the acquisition of voluntary finger movements, improved facial mimicry and reaction to painful stimuli. No side effects were reported.

Conclusions

These promising preliminary results and the ease of administration of this treatment make it worthwhile to be investigated further, mainly in the early stages from OHCA and in patients with better baseline neurological conditions, in order to explore more thoroughly the benefits of this new approach on neuronal function recovery after OHCA.
Expression of S100A8 protein on B cells is associated with disease activity in patients with systemic lupus erythematosus
Authors: Kitagori Koji , Oku Takuma , Wakabayashi Masaki , Nakajima Tomoya , Nakashima Ran , Murakami Kosaku , Hirayama Yoshitaka , Ishihama Yasushi , Ohmura Koichiro , Morinobu Akio , Mimori Tsuneyo , Yoshifuji Hajime
Published: May 2023

Background

Systemic lupus erythematosus (SLE) is an intractable disease characterized by autoantibody production and autoreactive B and T cell proliferation. Although several studies have revealed multiple genetic and environmental associations, the underlying mechanisms remain unknown.

Methods

We performed proteomics and transcriptomics using liquid chromatography-mass spectrometry and DNA microarray, using peripheral blood B cells from patients with SLE, and healthy controls (HC). We explored molecules associated with the pathophysiology of SLE by flow cytometry and B cell stimulation assay.

Results

We identified for the first time that expression of both S100A8 protein and mRNA were markedly upregulated in SLE B cells. The results obtained using flow cytometry showed that S100A8 was highly expressed on the surface of B cells of patients with active SLE (MFI; HC 102.5 ± 5.97, stable SLE 111.4 ± 12.87, active SLE 586.9 ± 142.9), and S100A8 on the cell surface was decreased after treatment (MFI; pre-treat 1094.5 ± 355.38, post-treat 492.25 ± 247.39); therefore, it is suggested that S100A8 may be a marker for disease activity. The mRNA expression of S100A8 was particularly upregulated in memory B cells of SLE (56.68 fold higher than HC), suggesting that S100A8 may be mainly secreted by memory B cells in the pathogenesis of SLE.

Conclusions

Our results imply that the S100A8 proteins secreted from memory B cells may stimulate granulocytes and monocytes through pattern recognition receptors, activate the innate immune system, and are involved in the pathogenesis of SLE.
Femoral vein pulsatility: a simple tool for venous congestion assessment
Authors: Bhardwaj V. , Rola P. , Denault A. , Vikneswaran G. , Spiegel R.
Published: May 2023

Background

Femoral vein Doppler (FVD) is simpler than the VExUS score which is a multimodal scoring system based on combination of IVC diameter, hepatic venous Doppler, portal vein pulsatility and renal vein Doppler, may be useful in assessing right ventricular overload and signs of venous congestion. There is limited data on the relationship between FVD and VExUS score.

Results

Adult post-cardiac surgery patients were assessed for venous congestion using the VExUS score and FVD. Agreement between VExUS and FVD was studied using Kappa test, sensitivity, specificity, PPV and NPV for VExUS and FVD was calculated keeping CVP as gold standard. In total, 107 patients were enrolled, with a mean age of 55.67 ± 12.76. The accuracy of VExUS and FVD for detecting venous congestion was 80.37 (95% CI of 71.5 to 87.4) and 74.7 (95% CI of 65.4 to 82.6), respectively. The level of agreement between FVD and VExUS was moderate (Kappa value of 0.62, P < 0.001) while the agreement between FVD and CVP was weak (Kappa value of 0.49, P < 0.001).

Conclusion

FVD has good accuracy for detecting venous congestion and shows moderate agreement with VExUS grading. With potentially easier physical accessibility and a shorter learning curve for novices, it may be a simple and valuable tool for assessing venous congestion.
Association between clinical use of lansoprazole and the risk of type 2 diabetes mellitus: a pharmacoepidemiological cohort study
Authors: Lin Ming-Hsun , Wu Wen‐Tung , Chen Yong-Chen , Lin Tsung-Kun , Chou Yu‐Ching , Sun Chien‐An
Published: May 2023

Background

Proton pump inhibitors (PPIs) are common and widely used for gastrointestinal-related disorders. Lansoprazole is one of PPIs with potential benefits of anti-inflammation, reduced oxidative stress, and anti-diabetes. The aims of this study are to determine whether lansoprazole imparts differential risk of type 2 diabetes as compared with other PPIs.

Methods

A population-based retrospective cohort study was conducted using the National Health Insurance Research Database in Taiwan. Patients who received lansoprazole more than 90 days and without records of use of other PPIs between January 1, 2000 and December 31, 2005 (the exposure period) were considered as the exposed cohort (n = 1668). In comparison, patients who received other PPIs more than 90 days and without use of lansoprazole in the exposure period were treated as the comparison cohort (n = 3336).The primary outcome was the new-onset of type 2 diabetes mellitus (T2DM). The association between use of lansoprazole and the risk of T2DM was determined by hazard ratios (HRs) and 95% confidence intervals (CIs) derived from multivariable Cox proportional hazards models.

Results

The lansoprazole cohort showed a significantly reduced risk of T2DM with an adjusted HR of 0.65 (95% CI 0.56–0.76). Interestingly, the inverse association between use of lansoprazole and risk of T2DM was observed in both genders and in various age groups.

Conclusion

The present study findings suggest that lansoprazole was associated with a reduced risk of T2DM compared with other PPIs. Further studies are needed to determine the clinical implications of the present study.
Emerging applications of phage therapy and fecal virome transplantation for treatment of Clostridioides difficile infection: challenges and perspectives
Authors: Raeisi Hamideh , Noori Maryam , Azimirad Masoumeh , Mohebbi Seyed Reza , Asadzadeh Aghdaei Hamid , Yadegar Abbas , Zali Mohammad Reza
Published: May 2023

Clostridioides difficile, which causes life-threatening diarrheal disease, is considered an urgent threat to healthcare setting worldwide. The current standards of care solely rely on conventional antibiotic treatment, however, there is a risk of promoting recurrent C. difficile infection (rCDI) because of the emergence of antibiotic-resistant strains. Globally, the alarming spread of antibiotic-resistant strains of C. difficile has resulted in a quest for alternative therapeutics. The use of fecal microbiota transplantation (FMT), which involves direct infusion of fecal suspension from a healthy donor into a diseased recipient, has been approved as a highly efficient therapeutic option for patients with rCDI. Bacteriophages or phages are a group of viruses that can infect and destroy bacterial hosts, and are recognized as the dominant viral component of the human gut microbiome. Accumulating data has demonstrated that phages play a vital role in microbial balance of the human gut microbiome. Recently, phage therapy and fecal virome transplantation (FVT) have been introduced as promising alternatives for the treatment of C. difficile -related infections, in particular drug-resistant CDI. Herein, we review the latest updates on C. difficile- specific phages, and phage-mediated treatments, and highlight the current and future prospects of phage therapy in the management of CDI.
The coding of telephone consultations in UK primary care databases: are we picking up all the calls?
Authors: Atkinson Mark D , Cooksey Roxanne , Jones Jenna K , Brophy Sinead
Published: May 2023

Objectives

To examine the use of two coding systems used in the THIN UK primary care research database for the coding of telephone encounters between patient and healthcare professional in primary care. This is relevant to other research databases built on GP clinical systems. Consideration of telephone consultations was particularly important during the COVID-19 pandemic as remote interactions between patient and GP are more numerous than before and are likely to remain at a higher frequency.

Results

Telephone encounters could either be indicated by a consultation-type code or by a Read code. All three possible combinations (coded by one method, the other method and both) were in use. In 2014, 30% were coded by the consultation-type, 55% by Read codes and 15% by both. In contrast, in 2000, 77% were coded by the consultation-type, 21% by Read codes and 2% by both. This has important implications because national and regional consultation rates by GPs are often estimated from these research databases by looking only at the consultation-type codes and consequently many encounters will not be detected.
Overexpression of miR-32 in Chinese hamster ovary cells increases production of Fc-fusion protein
Authors: Bazaz Masoume , Adeli Ahmad , Azizi Mohammad , Karimipoor Morteza , Mahboudi Freidoun , Davoudi Noushin
Published: May 2023

The demand for industrial genetically modified host cells were increased with the growth of the biopharmaceutical market. Numerous studies on improving host cell productivity have shown that altering host cell growth and viability through genetic engineering can increase recombinant protein production. During the last decades, it was demonstrated that overexpression or downregulation of some microRNAs in Chinese Hamster Ovary (CHO) cells as the host cell in biopharmaceutical manufacturing, can improve their productivity. The selection of microRNA targets has been based on their previously identified role in human cancers. MicroRNA-32 (miR-32), which is conserved between humans and hamsters (Crisetulus griseus), was shown to play a role in the regulation of cell proliferation and apoptosis in some human cancers. In this study, we investigated the effect of miR-32 overexpression on the productivity of CHO-VEGF-trap cells. Our results indicated that stable overexpression of miR-32 could dramatically increase the productivity of CHO cells by 1.8-fold. It also significantly increases cell viability, batch culture longevity, and cell growth. To achieve these results, following the construction of a single clone producing an Fc-fusion protein, we transfected cells with a pLexJRed-miR-32 plasmid to stably produce the microRNA and evaluate the impact of mir-32 overexpression on cell productivity, growth and viability in compare with scrambled control. Our findings highlight the application of miRNAs as engineering tools and indicated that miR-32 could be a target for engineering CHO cells to increase cell productivity.
Improving stem quality assessment based on national forest inventory data: an approach applied to Spanish forests
Authors: Ruano Antonio , Alberdi Iciar , Adame Patricia , Moreno-Fernández Daniel , Amiano Alejandro Cantero , Fernández-Golfín Juan , Hermoso Eva , Hernández Laura , Merlo Esther , Sandoval Vicente , Cañellas Isabel
Published: May 2023

Key message

This paper proposes a methodology that could be considered as a base for a harmonized protocol for stem-quality reporting in Europe while conducting National Forest Inventories, in order to cost-efficiently obtain a visual wood quality proxy. The importance of the variables selected, the limitations identified, and some improvements to the methodology are suggested. Forest areas with better wood quality, which in turn it would be useful for breeding programs, can be easily detected.

Context

The establishment of harmonized standards or indicators that allow us to determine the quality of the wood present in a forest prior to its exploitation has long been demanded by the European forestry sector, although agreed methodologies for the evaluation of wood quality in standing trees, which is one of the sector’s most urgent requirements, have not, as yet, been implemented.

Aims

To develop a protocol that visually characterizes wood quality on standing trees in a cost-effective way for the National Forest Inventory (NFI). After some improvements, it can be considered as a base for a European harmonized protocol.

Methods

In this article, we analyze the implementation, in the NFI, of a visual wood-quality assessment methodology in forests of Central Spain based on the different European standards as well as on research papers addressing this issue.

Results

The silvicultural practices employed are of the utmost importance to obtain the best wood quality, regardless of the species. Several areas with higher wood quality were identified as well as areas most affected by specific pests in the studied region. The impact of the variables measured (e.g., branchiness, crookedness, maximum branch diameter) is discussed.

Conclusion

It is feasible to estimate a proxy for wood quality on standing trees in the NFI. Furthermore, after studying the inventory data provided, several enhancements are proposed, not only to improve wood-quality estimates but also to optimize fieldwork costs. Harmonizing NFIs to assess and map European standing wood quality can be achieved.
The role of clinical phenotypes in decisions to limit life-sustaining treatment for very old patients in the ICU
Authors: Mousai Oded , Tafoureau Lola , Yovell Tamar , Flaatten Hans , Guidet Bertrand , Beil Michael , de Lange Dylan , Leaver Susannah , Szczeklik Wojciech , Fjolner Jesper , Nachshon Akiva , van Heerden Peter Vernon , Joskowicz Leo , Jung Christian , Hyams Gal , Sviri Sigal
Published: May 2023

Background

Limiting life-sustaining treatment (LST) in the intensive care unit (ICU) by withholding or withdrawing interventional therapies is considered appropriate if there is no expectation of beneficial outcome. Prognostication for very old patients is challenging due to the substantial biological and functional heterogeneity in that group. We have previously identified seven phenotypes in that cohort with distinct patterns of acute and geriatric characteristics. This study investigates the relationship between these phenotypes and decisions to limit LST in the ICU.

Methods

This study is a post hoc analysis of the prospective observational VIP2 study in patients aged 80 years or older admitted to ICUs in 22 countries. The VIP2 study documented demographic, acute and geriatric characteristics as well as organ support and decisions to limit LST in the ICU. Phenotypes were identified by clustering analysis of admission characteristics. Patients who were assigned to one of seven phenotypes (n = 1268) were analysed with regard to limitations of LST.

Results

The incidence of decisions to withhold or withdraw LST was 26.5% and 8.1%, respectively. The two phenotypes describing patients with prominent geriatric features and a phenotype representing the oldest old patients with low severity of the critical condition had the largest odds for withholding decisions. The discriminatory performance of logistic regression models in predicting limitations of LST after admission to the ICU was the best after combining phenotype, ventilatory support and country as independent variables.

Conclusions

Clinical phenotypes on ICU admission predict limitations of LST in the context of cultural norms (country). These findings can guide further research into biases and preferences involved in the decision-making about LST.

Trial registrationClinical Trials NCT03370692 registered on 12 December 2017.
MRLCC: an adaptive cloud task scheduling method based on meta reinforcement learning
Authors: Xiu Xi , Li Jialun , Long Yujie , Wu Weigang
Published: May 2023

Task scheduling is a complex problem in cloud computing, and attracts many researchers’ interests. Recently, many deep reinforcement learning (DRL)-based methods have been proposed to learn the scheduling policy through interacting with the environment. However, most DRL methods focus on a specific environment, which may lead to a weak adaptability to new environments because they have low sample efficiency and require full retraining to learn updated policies for new environments. To overcome the weakness and reduce the time consumption of adapting to new environment, we propose a task scheduling method based on meta reinforcement learning called MRLCC. Through comparing MRLCC and baseline algorithms on the performance of shortening makespan in different environments, we can find that MRLCC is able to adapt to different environments quickly and has a high sample efficiency. Besides, the experimental results demonstrate that MRLCC can maintain a high utilization rate over all baseline algorithms after a few steps of gradient update.