bluuebunny/crossref_metadata_2025 huggingface dataset:
Long‐term outcome of epileptic dogs treated with implantable vagus nerve stimulators
Authors: Harcourt‐Brown Thomas R. , Carter Michael
Published: October 2023

Background

The long‐term effect of implantable vagus nerve stimulators (VNS) on seizures has not been evaluated in epileptic dogs.

Objectives

Report seizure frequency in medication‐resistant epileptic dogs before and after VNS implantation.

Animals

Twelve client‐owned dogs with idiopathic epilepsy and >1 seizure day per 3 weeks despite 3 months of appropriate use of 2 antiseizure medications and seizure diaries maintained 6 months before and >12 months after VNS implantation.

Methods

Uncontrolled, open‐label, before and after study. Mean monthly seizures and inter‐seizure periods obtained from contemporaneous seizure diaries in the 6 months before implantation were compared with 0 to 6 months, 7 to 12 months, and subsequent 12‐month periods after implantation. The number of dogs with >50% decrease in seizure frequency, >3 times increase in inter‐ictal period interval, and seizure freedom for >3 months at the time of death or last follow‐up were recorded.

Results

Five of 12 dogs were euthanized <12 months after implantation. All 7 remaining dogs showed >50% decrease in seizure frequency until last follow‐up, starting at a median of 37 to 48 months after implantation (range, 0‐6 to 61‐72 months) and a >3‐fold increase in mean inter‐seizure interval starting a median of 25 to 36 months after implantation (range, 0‐6 months to 49‐60 months), 3/7 dogs were seizure‐free at death or last follow‐up.

Conclusions and Clinical Importance

Monthly seizure frequencies decreased and inter‐seizure intervals increased in all dogs 2 to 3 years after VNS implantation, but a high proportion were euthanized before this time point. Prospective clinical trials are required to establish causality and the magnitude of this association.
Molecular mapping of virus‐infected cells with immunogold and metal‐tagging transmission electron microscopy
Authors: Sachse Martin , de Castro Isabel Fernández , Tenorio Raquel , Risco Cristina
Published: October 2023

Transmission electron microscopy (TEM) has been essential to study virus–cell interactions. The architecture of viral replication factories, the principles of virus assembly and the components of virus egress pathways are known thanks to the contribution of TEM methods. Specially, when studying viruses in cells, methodologies for labeling proteins and other macromolecules are important tools to correlate morphology with function. In this review, we present the most widely used labeling method for TEM, immunogold, together with a lesser known technique, metal‐tagging transmission electron microscopy (METTEM) and how they can contribute to study viral infections. Immunogold uses the power of antibodies and electron dense, colloidal gold particles while METTEM uses metallothionein (MT), a metal‐binding protein as a clonable tag. MT molecules build gold nano‐clusters inside cells when these are incubated with gold salts. We describe the necessary controls to confirm that signals are specific, the advantages and limitations of both methods, and show some examples of immunogold and METTEM of cells infected with viruses.
Lipidome remodeling in response to nutrient replenishment requires the tRNA modifier Deg1/Pus3 in yeast
Authors: Matos Gabriel Soares , Vogt Leonie , Santos Rosangela Silva , Devillars Aurélien , Yoshinaga Marcos Yukio , Miyamoto Sayuri , Schaffrath Raffael , Montero‐Lomeli Monica , Klassen Roland
Published: October 2023

In the yeast Saccharomyces cerevisiae, the absence of the pseudouridine synthase Pus3/Deg1, which modifies tRNA positions 38 and 39, results in increased lipid droplet (LD) content and translational defects. In addition, starvation‐like transcriptome alterations and induced protein aggregation were observed. In this study, we show that the deg1 mutant increases specific misreading errors. This could lead to altered expression of the main regulators of neutral lipid synthesis which are the acetyl‐CoA carboxylase (Acc1), an enzyme that catalyzes a key step in fatty acid synthesis, and its regulator, the Snf1/AMPK kinase. We demonstrate that upregulation of the neutral lipid content of LD in the deg1 mutant is achieved by a mechanism operating in parallel to the known Snf1/AMPK kinase‐dependent phosphoregulation of Acc1. While in wild‐type cells removal of the regulatory phosphorylation site (Ser‐1157) in Acc1 results in strong upregulation of triacylglycerol (TG), but not steryl esters (SE), the deg1 mutation more specifically upregulates SE levels. In order to elucidate if other lipid species are affected, we compared the lipidomes of wild type and deg1 mutants, revealing multiple altered lipid species. In particular, in the exponential phase of growth, the deg1 mutant shows a reduction in the pool of phospholipids, indicating a compromised capacity to mobilize acyl‐CoA from storage lipids. We conclude that Deg1 plays a key role in the coordination of lipid storage and mobilization, which in turn influences lipid homeostasis. The lipidomic effects in the deg1 mutant may be indirect outcomes of the activation of various stress responses resulting from protein aggregation.
Evaluation of the deficiency status of 25‐hydroxyvitamin D and associated factors in Southwest China: A hospital‐based retrospective cross‐sectional analysis of a low‐latitude, high‐altitude, multiracial region
Authors: Chan Ying , Cai Dongling , Guo Rongfen , Zhou Xiaoyan , He Guangyu , Li Huiping , Geng Zibiao , Guo Yan , Lin Junyue , Wang Ruihong , Jiang Lihong , Zhu Baosheng
Published: October 2023

Vitamin D deficiency is widespread in different populations and regions worldwide and has become a global health issue. The vitamin D status of the population in the Yunnan Province of Southwest China has not been evaluated to date. Therefore, in this study, we evaluated the vitamin D status according to the serum concentrations of 25‐hydroxyvitamin D (25(OH)D) in individuals of Yunnan Province, a low‐latitude, high‐altitude and multiracial region in China. The data on 25(OH)D concentrations from October 2012 to December 2017 were retrospectively collected and assessed using the laboratory information system from 52 950 hospital‐based participants (age, 1 day–96 years; females, 73.74%). The serum concentration of 25(OH)D was evaluated using a chemiluminescent immunoassay. The analysis was stratified by sex, age, sampling season, testing year, minority, residential district, latitude, altitude and meteorological factors. Vitamin D status was classified as follows: severe deficiency: <10 ng/mL; deficiency: <20 ng/mL; insufficiency: <30 ng/mL; and sufficiency: ≥30 ng/mL. The results showed that vitamin D deficiency is highly prevalent in Yunnan Province in a hospital‐based cohort, with a deficiency and severe deficiency rate of 65.1% and a sufficiency rate of 5.30%. Significantly lower vitamin D levels and sufficiency rates were observed in females than in males (20.13 ± 7.22 ng/mL vs. 17.56 ± 6.66 ng/mL and 8.20% vs. 4.20%; p < 0.01, respectively); in spring and winter (16.93 ± 6.24 ng/mL; 2.97% and 16.38 ± 6.43 ng/mL; 3.06%, respectively) than in summer and autumn (20.23 ± 7.14 ng/mL; 8.02% and 19.10 ± 6.97 ng/mL; 6.61% [p < 0.01], respectively); and in older individuals (0–6 years: 28.29 ± 13.13 ng/mL vs. >60 years: 14.88 ± 8.39 ng/mL; p < 0.01). Relatively higher vitamin D levels were observed in individuals of Yi, Zhuang, Hani, Dai, Miao and Lisu minorities and lower levels in individuals of Hui and Zang minorities compared with those of the Han nationality (p < 0.01). The mean sunlight duration, mean air temperature, maximum ultraviolet value and latitude were significantly correlated with vitamin D levels (r = −0.53, 0.60, 0.31, −0.68, respectively; p < 0.05). These results suggest that vitamin D status is influenced by sex, age, minority, latitude and some meteorological factors in areas with high and low altitudes. Hence, new public health policies, such as advice on sunshine exposure, food fortification and nutrition education, as well as the implementation of vitamin D supplementation programmes must be considered to alleviate vitamin D deficiency in Yunnan province, Southwest China.
A pilot study of anti‐nephrin antibodies in podocytopaties among adults
Authors: Chebotareva Natalia , Vinogradov Anatoliy , Birukova Yevgeniya , Alentov Igor , Sergeeva Natalia , Chemodanova Daria , Kononikhin Alexey S. , Moiseev Sergey V.
Published: October 2023

Aim

Minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS) are podocytopathies characterized by damage to the glomerular filtration barrier, leading to proteinuria and nephrotic syndrome. The production of anti‐podocyte antibodies has been proposed as potential circulating factors contributing to the development of these conditions. The aim of the study is to evaluate the levels of anti‐nephrin antibodies in patients with podocytopathies and healthy subjects.

Methods

In this study, a total of 77 patients with active glomerulopathy and 11 healthy subjects were included. Forty one patients were diagnosed with FSGS, 11 with MCD, and 25 with MN. To measure the levels of anti‐nephrin antibodies, enzyme‐linked immunosorbent assay was used.

Results

The levels of antibodies to nephrin were significantly higher in patients with MCD 61.2 [28.9–66.3] ng/mL and FSGS 32.5 [17.2–58.4] ng/mL compared to MN 20.3 [14.4–38.4] and healthy individuals 15.3 [12–18.9] ng/mL, p < .05. In patients with primary FSGS, the levels of antibodies to nephrin were significantly higher 45.2 [20–64.3] ng/mL compared to patients with secondary FSGS 26.7 [11.2–44.1] ng/mL, p < .05. There were no significant differences in the remission rate between the anti‐nephrin antibodies positive and negative groups (log‐rank test: p = .158).

Conclusion

The level of anti‐nephrin antibodies was found to be significantly higher in patients with MCD and pFSGS compared to those with sFSGS, MN, and healthy subjects. Anti‐nephrin antibodies in MCD and primary FSGS may be associated with the severity of podocytopathies, however they did not have an impact on the response to therapy.
How likely is the sense‐B‐noise to affect patients with subcutaneous implantable cardioverter‐defibrillators and can we solve that problem in every case?
Authors: Budrejko Szymon , Zienciuk‐Krajka Agnieszka , Olędzki Szymon , Daniłowicz‐Szymanowicz Ludmiła , Kempa Maciej
Published: October 2023

Background

Sense‐B‐noise is a newly reported possible cause of inappropriate shocks in patients with subcutaneous implantable cardioverter‐defibrillators (S‐ICDs). The nature of that noise is unknown, it is not related to mechanical failure of the S‐ICD system. Reprogramming to the secondary sensing vector is suggested by the producer as a possible solution.

Methods

We analyzed the medical records of S‐ICD recipients from two university clinical centers (Gdansk and Szczecin, Poland). Our aim was to determine the rate of sense‐B‐noise, and whether the secondary sensing vector would be available for reprogramming if such a problem occurred in our patients.

Results

The sense‐B‐noise issue affected three patients in our cohort (3%), which corresponds to the incidence of 0.012 events per patient‐year of follow‐up. The primary vector was permanently used in 47 patients (52%), secondary in 28 (31%), and alternate in 16 (17%), respectively. Therefore, the total number of patients potentially vulnerable to sense‐B noise (with the primary or alternate vector programmed permanently) was 63 (69%). Among those 63 patients, 51 individuals (81%) had also the secondary vector available for permanent use.

Conclusion

The sense‐B‐noise affected 3% of patients in our cohort, with an incidence of 0.012 per patient‐year of follow‐up. Most patients potentially vulnerable to sense‐B noise could be reprogrammed to the secondary sensing vector, if necessary. Further investigation of the sense‐B‐noise issue is needed.
Cassava brown streak: A deadly virus on the move
Authors: Robson Fran , Hird Diane L. , Boa Eric
Published: October 2023

The beginning of the 21st century witnessed a vast and devastating upsurge in the incidence and spread of cassava brown streak ipomovirus disease (CBSD) in eastern countries of sub‐Saharan Africa that decimated crops and jeopardized food security in the region. The disease pandemic may have resulted from an increase in superabundant African whitefly populations, the insect vector, in the early 2000s, and the unintended dissemination of infected or highly disease‐susceptible cassava planting material during agricultural development and relief programmes. This plant pandemic report, one of a series of plant disease reports commissioned by the British Society for Plant Pathology, tells the story of CBSD, its history, its impact, the devastating storage root decay it triggers, and the efforts to understand the causal agent and mitigate its damaging effect on an important staple crop.
Patterns of multiple chronic conditions in pregnancy: Population‐based study using latent class analysis
Authors: Brown Hilary K. , Fung Kinwah , Cohen Eyal , Dennis Cindy‐Lee , Grandi Sonia M. , Rosella Laura C. , Varner Catherine , Vigod Simone N. , Wodchis Walter P. , Ray Joel G.
Published: October 2023

Background

Adults with multiple chronic conditions (MCC) are a heterogeneous population with elevated risk of future adverse health outcomes. Yet, despite the increasing prevalence of MCC globally, data about MCC in pregnancy are scarce.

Objectives

To estimate the population prevalence of MCC in pregnancy and determine whether certain types of chronic conditions cluster together among pregnant women with MCC.

Methods

We conducted a population‐based cohort study in Ontario, Canada, of all 15–55‐year‐old women with a recognised pregnancy, from 2007 to 2020. MCC was assessed from a list of 22 conditions, identified using validated algorithms. We estimated the prevalence of MCC. Next, we used latent class analysis to identify classes of co‐occurring chronic conditions in women with MCC, with model selection based on parsimony, clinical interpretability and statistical fit.

Results

Among 2,014,508 pregnancies, 324,735 had MCC (161.2 per 1000, 95% confidence interval [CI] 160.6, 161.8). Latent class analysis resulted in a five‐class solution. In four classes, mood and anxiety disorders were prominent and clustered with one additional condition, as follows: Class 1 (22.4% of women with MCC), osteoarthritis; Class 2 (23.7%), obesity; Class 3 (15.8%), substance use disorders; and Class 4 (22.1%), asthma. In Class 5 (16.1%), four physical conditions clustered together: obesity, asthma, chronic hypertension and diabetes mellitus.

Conclusions

MCC is common in pregnancy, with sub‐types dominated by co‐occurring mental and physical health conditions. These data show the importance of preconception and perinatal interventions, particularly integrated care strategies, to optimise treatment and stabilisation of chronic conditions in women with MCC.
Natural variation in a short region of the Acidovorax citrulli type III‐secreted effector AopW1 is associated with differences in cytotoxicity and host adaptation
Authors: Jiménez‐Guerrero Irene , Sonawane Monica , Eckshtain‐Levi Noam , Tuang Za Khai , da Silva Gustavo Mateus , Pérez‐Montaño Francisco , Leibman‐Markus Meirav , Gupta Rupali , Noda‐Garcia Lianet , Bar Maya , Burdman Saul
Published: October 2023

Bacterial fruit blotch, caused by Acidovorax citrulli, is a serious disease of melon and watermelon. The strains of the pathogen belong to two major genetic groups: group I strains are strongly associated with melon, while group II strains are more aggressive on watermelon. A. citrulli secretes many protein effectors to the host cell via the type III secretion system. Here we characterized AopW1, an effector that shares similarity to the actin cytoskeleton‐disrupting effector HopW1 of Pseudomonas syringae and with effectors from other plant‐pathogenic bacterial species. AopW1 has a highly variable region (HVR) within amino acid positions 147 to 192, showing 14 amino acid differences between group I and II variants. We show that group I AopW1 is more toxic to yeast and Nicotiana benthamiana cells than group II AopW1, having stronger actin filament disruption activity, and increased ability to induce cell death and reduce callose deposition. We further demonstrated the importance of some amino acid positions within the HVR for AopW1 cytotoxicity. Cellular analyses revealed that AopW1 also localizes to the endoplasmic reticulum, chloroplasts, and plant endosomes. We also show that overexpression of the endosome‐associated protein EHD1 attenuates AopW1‐induced cell death and increases defense responses. Finally, we show that sequence variation in AopW1 plays a significant role in the adaptation of group I and II strains to their preferred hosts, melon and watermelon, respectively. This study provides new insights into the HopW1 family of bacterial effectors and provides first evidence on the involvement of EHD1 in response to biotic stress.
Picky eaters: selective autophagy in plant cells
Authors: Cadena‐Ramos Alexis I. , De‐la‐Peña Clelia
Published: October 2023

Autophagy, a fundamental cellular process, plays a vital role in maintaining cellular homeostasis by degrading damaged or unnecessary components. While selective autophagy has been extensively studied in animal cells, its significance in plant cells has only recently gained attention. In this review, we delve into the intriguing realm selective autophagy in plants, with specific focus on its involvement in nutrient recycling, organelle turnover, and stress response. Moreover, recent studies have unveiled the interesting interplay between selective autophagy and epigenetic mechanisms in plants, elucidating the significance of epigenetic regulation in modulating autophagy‐related gene expression and finely tuning the selective autophagy process in plants. By synthesizing existing knowledge, this review highlights the emerging field of selective autophagy in plant cells, emphasizing its pivotal role in maintaining nutrient homeostasis, facilitating cellular adaptation, and shedding light on the epigenetic regulation that governs these processes. Our comprehensive study provides the way for a deeper understanding of the dynamic control of cellular responses to nutrient availability and stress conditions, opening new avenues for future research in this field of autophagy in plant physiology.
The impact of IdeS (imlifidase) on allo‐specific, xeno‐reactive, and protective antibodies in a sensitized rhesus macaque model
Authors: DeLaura Isabel , Zikos Joanna , Anwar Imran J. , Yoon Janghoon , Ladowski Joseph , Jackson Annette , Van Rompay Koen , Magnani Diogo , Knechtle Stuart J. , Kwun Jean
Published: October 2023

Background

Highly sensitized patients face many barriers to kidney transplantation, including higher rates of antibody‐mediated rejection after HLA‐incompatible transplant. IdeS, an endopeptidase that cleaves IgG nonspecifically, has been trialed as desensitization prior to kidney transplant, and successfully cleaves donor‐specific antibody (DSA), albeit with rebound.

Methods

IdeS was generated and tested (2 mg/kg, IV) in two naïve and four allosensitized nonhuman primates (NHP). Peripheral blood samples were collected at regular intervals following IdeS administration. Total IgG, total IgM, and anti‐CMV antibodies were quantified with ELISA, and donor‐specific antibody (DSA) and anti‐pig antibodies were evaluated using flow cytometric crossmatch. B cell populations were assessed using flow cytometry.

Results

IdeS successfully cleaved rhesus IgG in vitro. In allosensitized NHP, robust reduction of total, DSA, anti‐pig, and anti‐CMV IgG was observed within one day following IdeS administration. Rapid rebound of all IgG antibody populations was observed, with antibody levels returning to baseline around day 14 post‐infusion. Total IgM level was not affected by IdeS. Interestingly, a comparable reduction in antibody populations was observed after the second dose of IdeS. However, we have not observed any significant modulation of B cell subpopulations after IdeS.

Conclusions

This study evaluated efficacy of IdeS in the allosensitized NHP in IgG with various specificities, mirroring antibody kinetics in human patients. The efficacy of IdeS on preexisting anti‐pig antibodies may be useful in clinical xenotransplantation. However, given the limitation of IdeS on its durability as a monotherapy, optimization of IdeS with other agents targeting the humoral response is further needed.
Klotho regulates the myogenic response of muscle to mechanical loading and exercise
Authors: Ochi Eisuke , Barrington Alice , Wehling‐Henricks Michelle , Avila Marcus , Kuro‐o Makoto , Tidball James G.
Published: October 2023

Muscle growth is influenced by changes in the mechanical environment that affect the expression of genes that regulate myogenesis. We tested whether the hormone Klotho could influence the response of muscle to mechanical loading. Applying mechanical loads to myoblasts in vitro increased RNA encoding transcription factors that are expressed in activated myoblasts (Myod) and in myogenic cells that have initiated terminal differentiation (Myog). However, application of Klotho to myoblasts prevented the loading‐induced activation of Myog without affecting loading‐induced activation of Myod. This indicates that elevated Klotho inhibits mechanically‐induced differentiation of myogenic cells. Elevated Klotho also reduced the transcription of genes encoding proteins involved in the canonical Wnt pathway or their target genes (Wnt9a, Wnt10a, Ccnd1). Because the canonical Wnt pathway promotes differentiation of myogenic cells, these findings indicate that Klotho inhibits the differentiation of myogenic cells experiencing mechanical loading. We then tested whether these effects of Klotho occurred in muscles of mice experiencing high‐intensity interval training (HIIT) by comparing wild‐type mice and klotho transgenic mice. The expression of a klotho transgene combined with HIIT synergized to tremendously elevate numbers of Pax7+ satellite cells and activated MyoD+ cells. However, transgene expression prevented the increase in myogenin+ cells caused by HIIT in wild‐type mice. Furthermore, transgene expression diminished the HIIT‐induced activation of the canonical Wnt pathway in Pax7+ satellite cells. Collectively, these findings show that Klotho inhibits loading‐ or exercise‐induced activation of muscle differentiation and indicate a new mechanism through which the responses of muscle to the mechanical environment are regulated.
Hypochlorous acid exposure impairs skeletal muscle function and Ca2+ signalling: implications for Duchenne muscular dystrophy pathology
Authors: Lea Thomas A. , Panizza Peter M. , Arthur Peter G. , Bakker Anthony J. , Pinniger Gavin J.
Published: October 2023

Duchenne muscular dystrophy (DMD) is a fatal X‐linked disease characterised by severe muscle wasting. The mechanisms underlying the DMD pathology likely involve the interaction between inflammation, oxidative stress and impaired Ca2+ signalling. Hypochlorous acid (HOCl) is a highly reactive oxidant produced endogenously via myeloperoxidase; an enzyme secreted by neutrophils that is significantly elevated in dystrophic muscle. Oxidation of Ca2+‐handling proteins by HOCl may impair Ca2+ signalling. This study aimed to determine the effects of HOCl on skeletal muscle function and its potential contribution to the dystrophic pathology. Extensor digitorum longus (EDL), soleus and interosseous muscles were surgically isolated from anaesthetised C57 (wild‐type) and mdx (dystrophic) mice for measurement of ex vivo force production and intracellular Ca2+ concentration. In whole EDL muscle, HOCl (200 μM) significantly decreased maximal force and increased resting muscle tension which was only partially reversible by dithiothreitol. The effects of HOCl (200 μM) on maximal force in slow‐twitch soleus were lower than found in the fast‐twitch EDL muscle. In single interosseous myofibres, HOCl (10 μM) significantly increased resting intracellular Ca2+ concentration and decreased Ca2+ transient amplitude. These effects of HOCl were reduced by the application of tetracaine, Gd3+ or streptomycin, implicating involvement of ryanodine receptors and transient receptor potential channels. These results demonstrate the potent effects of HOCl on skeletal muscle function potentially mediated by HOCl‐induced oxidation to Ca2+ signalling proteins. Hence, HOCl may provide a link between chronic inflammation, oxidative stress and impaired Ca2+ handling that is characteristic of DMD and presents a potential therapeutic target for DMD.

image

Key points

Duchenne muscular dystrophy is a fatal genetic disease with pathological mechanisms which involve the complex interaction of chronic inflammation, increased reactive oxygen species production and increased cytosolic Ca2+ concentrations.

Hypochlorous acid can be endogenously produced by neutrophils via the enzyme myeloperoxidase. Both neutrophil and myeloperoxidase activity are increased in dystrophic mice.

This study found that hypochlorous acid decreased muscle force production and increased cytosolic Ca2+ concentrations in isolated muscles from wild‐type and dystrophic mice at relatively low concentrations of hypochlorous acid.

These results indicate that hypochlorous acid may be key in the Duchenne muscular dystrophy disease pathology and may provide a unifying link between the chronic inflammation, increased reactive oxygen species production and increased cytosolic Ca2+ concentrations observed in Duchenne muscular dystrophy.

Hypochlorous acid production may be a potential target for therapeutic treatments of Duchenne muscular dystrophy.
Regional differences in the utilisation of antenatal care and skilled birth attendant services during the COVID-19 pandemic in Nigeria: an interrupted time series analysis
Authors: Afolabi Rotimi Felix , Salawu Mobolaji M , Bamgboye Eniola A , Bello Segun , Adebowale Ayo Stephen , Dairo Magbagbeola David , Kabwama Steven N , Wanyana Irene , Kizito Susan , Ndejjo Rawlance , Wanyenze Rhoda K , Fawole Olufunmilayo Ibitola
Published: October 2023

Introduction

The COVID-19 pandemic has had a substantial negative impact on the utilisation of essential health services (EHS) globally, especially in resource-limited settings such as Nigeria. High maternal deaths associated with low access to and utilisation of EHS such as antenatal care (ANC) and skilled birth attendants (SBAs) remain a concern during the COVID-19 era. The study assessed the COVID-19 pandemic effects on ANC and SBA utilisation across regions in Nigeria.

Methods

Monthly data on ANC and SBA between January 2017 and July 2021 were obtained from the Federal Ministry of Health database. An interrupted time-series analysis, implemented using the Prophet model, was conducted to compare the regional variation of outcomes during the COVID-19 pandemic. Average percentage changes (PC) between the observed and predicted outcomes including their 95% CI were reported.

Results

From March 2020 to July 2021, the number of ANC visits was significantly lower than expected by a 16%–43% change in five of the six regions in Nigeria. The highest significant reduction was in North-West (PC=−43.4; 95% CI: −52.6 to –34.1) and the least in South-West (PC=−15.5; 95% CI: −24.8 to –6.1), with no significant change in the South-East. The number of deliveries by SBA was significantly lower than expected by a 18%–43% change in all the regions (p<0.01). North-East (PC=−43.3; 95% CI: –51.7 to –34.9) and South-West (PC=−18.3; 95% CI: −25.2 to –11.5), respectively, had the highest and the least decline in SBA utilisation. Overall, ANC and SBA patterns of change were relatively similar across the north-south divide though the change effect was considerably pronounced in the north.

Conclusion

There was a substantial reduction in ANC and SBA utilisation due to the COVID-19 pandemic in Nigeria, especially in the northern regions. Targeted and contextually relevant interventions should be implemented to alleviate the impact of emergency response on access to EHS and promote access to care during the pandemic.
Human-centred design bolsters vaccine confidence in the Philippines: results of a randomised controlled trial
Authors: Reñosa Mark Donald C , Wachinger Jonas , Guevarra Jerric Rhazel , Landicho-Guevarra Jhoys , Aligato Mila F , Endoma Vivienne , Landicho Jeniffer , Bravo Thea Andrea , Malacad Carol , Demonteverde Maria Paz , Silvestre Catherine , Bärnighausen Kate , Bärnighausen Till , Chase Rachel P , McMahon Shannon A
Published: October 2023

Background

The public’s confidence in vaccinations has eroded, and anti-vaccination movements have gained traction around the world, including in the Philippines. ‘Salubong’, a Filipino term, refers to welcoming someone back into one’s life and elicits ideas about friendship and family relationships. We extended this concept to vaccines in efforts to design an intervention that would re-welcome vaccines into homes.

Methods

Using human-centred design, we developed and refined a story-based intervention that engages Filipino families, community leaders and community health workers. We conducted a randomised controlled trial among 719 caregivers of small children to test the developed intervention against a control video. We assessed the binary improvement (improvement vs no improvement) and the amount of improvement in vaccine attitudes and intentions after intervention exposure.

Results

Although the intervention group began with marginally higher baseline vaccine attitude scores, we found that 62% of the intervention group improved their vaccine attitude scores versus 37% of the control group (Fisher’s exact, p<0.001). Among individuals whose scores improved after watching the assigned video, the intervention group saw higher mean attitude score improvements on the 5-point scale (Cohen’s d=0.32 with 95% CI 0.10 to 0.54, two-sided t-test, p<0.01). We observed similar patterns among participants who stated that they had previously delayed or refused a vaccine for their child: 67% of 74 in the intervention group improved their vaccine attitude scores versus 42% of 54 in the control group (Fisher’s exact, p<0.001). Among the subset of these individuals whose scores improved after watching the assigned video, the intervention group saw higher mean attitude score improvements on the 5-point scale that were marginally significant (Cohen’s d=0.35 with 95% CI −0.01 to 0.70, two-sided t-test, p=0.06).

Conclusions

Our results provide solid evidence for the potential of co-designed vaccine confidence campaigns and regulations.
Prevalence and prognosis of bone metastases in common solid cancers at initial diagnosis: a population-based study
Authors: Zhang Jing , Cai Dongfeng , Hong Song
Published: October 2023

Objective

Bone is one of the most common target sites for advanced tumours. The objective was to survey the prevalence and prognosis of bone metastases in 12 common solid malignant tumours.

Design

A retrospective cohort study.

Methods

A total of 1 425 332 patients with a primary cancer between 2010 and 2015 were identified using the Surveillance, Epidemiology, and End Results database. We computed the prevalence and prognosis of bone metastases in each cancer and compared their survival in different stages. The Kaplan-Meier method and Cox logistic regression were used to analyse survival and quantify the effect of bone metastases.

Results

This study included 89 782 patients with bone metastases at diagnosis. Lung cancer had the highest prevalence (18.05%), followed by liver cancer (6.63%), nasopharyngeal carcinoma (6.33%) and renal cancer (5.45%). Breast cancer (32.1%), prostate cancer (25.9%), thyroid cancer (46.9%) and nasopharyngeal carcinoma (24.8%) with only bone metastases had a 5-year survival rate of over 20%. Compared with patients at the stage previous to metastasis, bone metastases significantly increased the risk of mortality and decreased survival, especially for those with prostate cancer (adjusted HR: 18.24). Other concomitant extraosseous metastases worsened patient survival. Bone was the most common site of metastasis for prostate cancer, while for colorectal cancer, multiorgan metastases were predominant.

Conclusions

This study provides the prevalence and prognosis of bone metastases at the initial diagnosis of common solid cancers. In addition, it demonstrates the impact of bone metastases on survival. These results can be used for early screening of metastases, clinical trial design and assessment of prognosis.
Variation in rates of sexual assault crisis counsellor usage during forensic examination in California: an observational study
Authors: Serenska Alice , Sarnquist Clea C , Darmstadt Gary L
Published: October 2023

Objectives

A critical asset to post-assault care of survivors is support from sexual assault crisis counsellors (SACCs). We sought to elucidate variation in implementation between California counties in SACC accompaniment during Sexual Assault Forensic Examination (SAFE).

Methods

SACC attendance data from 2019 was obtained from the California Governor’s Office of Emergency Services (CalOES). To assess SACC attendance rates during SAFEs, we requested SAFE quantity data from sheriffs and public health departments, the State Forensic Bureau, and the California Department of Justice (DOJ), but all requests were unanswered or denied. We also sought SAFE data from District Attorneys (DAs) in each county, and received responses from Marin and Contra Costa Counties. To estimate numbers of SAFEs per county, we gathered crime statistics from the Federal Bureau of Investigation’s (FBI’s) Uniform Crime Reporting Program and OpenJustice, a transparency initiative by the California DOJ. For each data source, we compared SACC attendance to SAFE quantities and incidences of sexual assault statewide.

Results

At the state level, data on SACC attendance per CalOES and DOJ archival data on sexual assault were used to approximate relative rates of SACC accompaniment at SAFEs; 83% (30 of 36) of counties had values <50%. The joint sexual assault crisis centre for Contra Costa and Marin Counties reported that 140 SACCs were dispatched in 2019, while DAs in Contra Costa and Marin reported completion of 87 SAFEs in 2019, for a calculated SACC accompaniment rate of 161%. Proxy data sourced from FBI and DOJ crime statistics displayed significant inconsistencies, and DOJ data was internally inconsistent.

Conclusions

SACC accompaniment at SAFEs appears to be low in most California counties, however, limited data accessibility and data discrepancies and inaccuracies (e.g., rates over 100%) prevented reliable determination of SACC accompaniment rates during SAFEs. Substantial improvements in data accuracy and transparency are needed to ensure survivors’ adequate access to resources.
Comparing the effect of intermittent blood flow restriction training and high-load resistance training in patients with patellofemoral pain: study protocol for a randomised trial
Authors: Kong Weiya , Wang Haonan , Cheng Lin , Ni Guoxin
Published: October 2023

Background

Patellofemoral pain (PFP) syndrome is a common knee joint functional disorder. Blood flow restriction (BFR) training has shown promise in improving PFP; however, the effectiveness of intermittent BFR (iBFR) training remains uncertain. This study aims to compare the rehabilitative effects of iBFR combined with low-load resistance training and high-load resistance training in PFP patients and to assess the effectiveness of iBFR combined with low-load resistance training for improving PFP.

Methods and analysis

This randomised, patient-assessor blinded, controlled trial will include 42 eligible PFP patients randomly allocated to an intervention group (iBFR combined with low-load resistance training) or a control group (high-load resistance training) in a 1:1 ratio. Participants will receive interventions three times per week for 8 weeks and will be followed up for 24 weeks. The primary outcome measure is pain, and the secondary outcomes include self-reported function, quality of life, muscle strength and muscle thickness. Assessments will be conducted at baseline, 8 weeks and 24 weeks during follow-up. Intention-to-treat analysis will be performed.

Collectively, we expect that the findings of this randomised clinical trial will contribute to understanding the potential benefits of iBFR training and provide insightful guidance for developing more effective treatment strategies for patients with PFP.

Ethics and dissemination

This study was approved by the Sports Science Experiment Ethics Committee of Beijing Sport University (2022274H). Written informed consent will be obtained from all participants. Trial results will be disseminated through peer-reviewed publications.

Trial registration number

Chinese Clinical Trial Registry (ChiCTR2300068281).
Nomogram incorporating log odds of positive lymph nodes improves prognostic prediction for ovarian serous carcinoma: a real-world retrospective cohort study
Authors: Zhang Shuming , Liu Xiwen , Li Qiao , Pan Yidan , Tian Ye , Gu Xingbo
Published: October 2023

Objectives

Ovarian serous carcinoma (OSC) is a major cause of gynaecological cancer death, yet there is a lack of reliable prognostic models. To address this, we developed and validated a nomogram based on conventional clinical characteristics and log odds of positive lymph nodes (LODDS) to predict the prognosis of OSC patients.

Setting

A Real-World Retrospective Cohort Study from the Surveillance, Epidemiology and End Results programme.

Participants

We obtained data on 4192 patients diagnosed with OSC between 2010 and 2015. Eligibility criteria included specific diagnostic codes, OSC being the primary malignant tumour and age at diagnosis over 18 years. Exclusion criteria were missing information on various factors and unknown cause of death or survival time.

Primary and secondary outcome measures

The primary outcome were overall survival (OS) and ovarian cancer-specific survival (OCSS).

Results

For OS and OCSS outcomes, we selected 7 and 5 variables, respectively, to establish the nomogram. In the training and validation cohorts, the C index for OS or OCSS was 0.716 or 0.718 and 0.731 or 0.733, respectively, with a 3-year time-dependent area under the curve (AUC) of 0.745 or 0.751 and a 5-year time-dependent AUC of 0.742 or 0.751. Calibration curves demonstrated excellent consistency between predicted and observed outcomes. The Net Reclassification Index, integrated discrimination improvement and decision curve analysis curves indicated that our nomogram performed better than the International Federation of Gynaecology and Obstetrics (FIGO) staging system in predicting OS and OCSS for OSC patients in both the training and validation cohorts.

Conclusion

Our nomogram, which includes LODDS, offers higher accuracy and reliability than the FIGO staging system and can predict overall and OCSS in OSC patients.
Can open label placebos improve pain and gluten tolerance via open label placebos in fibromyalgia patients? A study protocol for a randomised clinical trial in an outpatient centre
Authors: Paschke Lena , Dreyer Norma , Worm Margitta , Klinger Regine
Published: October 2023

Introduction

Fibromyalgia syndrome (FMS) is defined as a medical condition with chronic widespread musculoskeletal pain accompanied by mood disorders, fatigue and sleep disturbances. Treatment of this condition can often be challenging. As nutrition in general and nutritional interventions in the context of illness management become more and more important, current research also focuses on the relevance of diets for FMS, including gluten as field of interest. To date, there is no clear evidence that a gluten-free diet or other nutritional interventions are significantly important for the reduction of pain in the context of FMS. Only a very few studies show that FMS patients respond to a gluten-free diet and that cytokine production (also in FMS) can be reduced through the change. However, these studies have not investigated whether and to what extent cognitive factors, such as the expectation of symptom reduction triggered by diet, play a role. Recent research shows that treatment expectation plays an important role in the course of the disease and in the effectiveness of treatment approaches. For example, there are promising pain treatment options using open-label placebos (OLPs), which show that expectation alone, rather than the pharmacological substance of medication, can reduce pain experience. In our study protocol, we hypothesise that treatment expectation can be positively influenced by the given information regarding the placebos, resulting in improved treatment outcomes for pain and indigestions.

Methods and analysis

In this trial, patients with FMS will undergo a food challenge and take an OLP (patients will be informed about the placebo), followed by a 3-week OLP treatment. The subjects will be randomised into four groups: (a) gluten-free porridge+neutral OLP instructions; (b) gluten-free porridge+positive OLP instructions; (c) gluten-containing porridge+neutral OLP instructions and (d) gluten-containing porridge+positive OLP instructions. Patients will be recruited via different institutions and support groups in Hamburg. The inclusion criteria are (a) diagnosed FMS, (b) absence of wheat allergy, coeliac disease or pain-related red flags and (c) being a minimum age of 18 years. The study requires 100 subjects to assess the primary outcomes: pain intensity and occurence of indigestion. Secondary outcomes are functional capacity, treatment expectation, and different pain-related and inflammation-related blood parameters. The measure time points will be before and after the food challenge and before and after the 3-week OLP treatment.

Ethics and dissemination

Ethical approval was obtained in October 2021 from the Hamburg Medical Ethics Council. The results of the study will be disseminated through publications, presentations and conference meetings.

Trial registration number

German Clinical Trials Register (DRKS; DRKS00027130).
Changing trends of the diseases burden attributable to high BMI in Asia from 1990 to 2019: results from the global burden of disease study 2019
Authors: Li Xue , Han Fang , Liu Na , Feng Xiaojin , Sun Xiaodong , Chi Yuhua , Hou Ningning , Liu Yongping
Published: October 2023

Objective

To analyse the trends of diseases burden attributed to high body mass index (BMI), including overweight and obesity, in Asia from 1990 to 2019.

Design

Observational study.

Setting

The data of 45 countries and regions in Asia were obtained from the Global Burden of Disease Study 2019 database.

Main outcome measures

Numbers, age-standardised rate (ASR) of deaths and disability-adjusted life years (DALYs), and the corresponding estimated annual percentage changes (EAPCs), attributable to high BMI in Asia from 1990 to 2019, were analysed by regions, genders and age. We also analysed changes in the causes of deaths and DALYs that are attributable to high BMI over this period.

Results

In 2019, all causes deaths attributable to high BMI in Asia were 2 329 503, with increases by 265% compared with 1990. Over three decades, DALYs related to high BMI have increased by 268%. The ASRs of deaths and DALYs in Asia both showed continuous upward trends during this period (EAPC 1.39; 95% certainty interval [95% CI] 1.35 to 1.43 for deaths; EAPC 1.8; 95% CI 1.76 to 1.84 for DALYs), while both were declined in high-income areas (EAPC −2.03 and −1.26). By geographical regions, disease burden in Central Asia and West Asia have been fluctuating at high levels, but high-income Asia Pacific showed decreasing trends of ASR of deaths (EAPC −2.03) and DALYs (EAPC −1.26). Over this period, disease burden in Asia was changing from women to men, and tends to ageing. In addition, diabetes were the diseases most affected by high BMI, and cancer burden was high in middle-aged and elderly people.

Conclusions

The disease burden attributed to high BMI in Asia has experienced great changes. It is necessary to promote the prevention of obesity and chronic diseases in a comprehensive manner, especially in low-income areas, men and elderly.
Protocol for a scoping review of the role of siblings in supporting middle-aged and older people with early-acquired severe mental illness
Authors: Cui Jialiang , Guo Siyuan , Kan Wan Sang , Zhang Lin , He Xin , Chen Renxing , Chen Na , Xun Kangwei
Published: October 2023

Introduction

For older individuals who developed severe mental illness (SMI) during late adolescence or early adulthood (referred to as early-acquired SMI), the combination of ageing and SMI presents persistent health and psychosocial challenges. This group, with a higher likelihood of being unmarried or experiencing marriage dissolution, often lacks social and economic resources to address the difficulties they face in later life. In recent years, there has been a growing interest in understanding the role of siblings in supporting the ageing process of individuals with early-acquired SMI. However, to date, no reviews have investigated the role of siblings in assisting their middle-aged and older brothers or sisters with SMI as they age within community settings. Our scoping review aims to explore and synthesise the existing literature on sibling support for individuals with early-acquired SMI, with the goal of informing further advancements in research, practice and policy.

Methods and analysis

The methodological framework developed by Arksey and O’Malley will inform this scoping review. Four groups of search keywords, derived from four related concepts (sibling, SMI, support and ageing), will be employed. Additionally, a group of keywords related to unrelated life stages and diseases will be used to exclude irrelevant articles. A search will be carried out across major online databases, namely PubMed, Scopus, PsycINFO, Ovid MEDLINE, ProQuest and Google Scholar to identify the articles between 2000 and 2023. English-language studies meeting specific eligibility criteria will be identified following a review of titles and abstracts and will then undergo a full-text review. The data from the selected articles will be extracted using a customised data-charting framework and content analysis will be conducted.

Ethics and dissemination

There are no requirements for ethical approval. The findings of this review will be shared through professional connections, academic conferences and scholarly journals.