bluuebunny/crossref_metadata_2025 huggingface dataset:
Recombinant
Saccharomyces cerevisiae
EBY100/pYD1-FaeG: a candidate for an oral subunit vaccine against F4+ ETEC infection
Authors: Hu Dayue , Li Xiangmin , Duan Xiaochao , Yang Liuyue , Luo Baizhi , Wang Linkang , Hu Zihui , Zhou Yang , Qian Ping
Published: November 2024

Diarrheal diseases attributable to multidrug-resistant F4+ enterotoxigenic
Escherichia coli
(ETEC) are escalating in severity, posing significant risks to the health and safety of both humans and animals. This study used
Saccharomyces cerevisiae
EBY100 to display the FaeG subunit of F4 colonizing factor as an oral vaccine against F4+ ETEC infection. Mice were orally immunized twice with 10
8
CFU of EBY100/pYD1-FaeG, followed by a challenge with F4+ ETEC EC6 on day 7 post-immunization. The results showed that the recombinant strain EBY100/pYD1-FaeG orally enhanced the growth of the small intestine villi, significantly boosted the expression of tight junction proteins (
ZO-1
,
Occludin
,
MUC2
, and
Claudin
) (
P
< 0.05), and modulated the gut microbiota composition. Additionally, immunization with EBY100/pYD1-FaeG also upregulated the levels of IL-2, IL-4, and IFN-γ in the intestines of mice (
P
< 0.01), while serum IgG and fecal sIgA titer significantly increased (
P
< 0.05). These immune responses enhanced the capacity to fight against ETEC, leading to an increased survival rate of mice and relieved damage to tissues and organs of mice infection. In summary, the study suggested that the recombinant
Saccharomyces cerevisiae
EBY100/pYD1-FaeG could effectively stimulate the immune response and generate specific antibodies against F4+ ETEC, showing its potential to serve as a subunit oral vaccine candidate for preventing F4+ ETEC infection.

IMPORTANCE

The multidrug-resistant F4+ enterotoxigenic
Escherichia coli
(ETEC) strains are the primary clinical pathogens responsible for post-weaning diarrhea in piglets, resulting in substantial economic losses in the pig farming industry. In the study, we developed an oral vaccine candidate,
Saccharomyces cerevisiae
EBY100/pYD1-FaeG, to prevent diarrhea caused by multidrug-resistant F4+ ETEC. Oral administration of EBY100/pYD1-FaeG significantly enhanced immune responses, improved intestinal health, and provided protection against F4+ ETEC infection in mice. This approach offers a potential application prospect for preventing F4+ ETEC infections that lead to post-weaning diarrhea in clinical settings and provides a promising solution for addressing the growing threat of antibiotic resistance in bacterial pathogens.
Gut microbiota dysbiosis induced by alcohol exposure in pubertal and adult mice
Authors: Yang Jinlong , Wang Haoyu , Lin Xiaoqian , Liu Jincen , Feng Yue , Bai Yuyin , Liang Hewei , Hu Tongyuan , Wu Zhinan , Lai Jianghua , Liu Jianmei , Zou Yuanqiang , Wei Shuguang , Yan Peng
Published: November 2024

Alcohol intake causes many diseases including neuropsychiatric symptoms, nutritional deficiency, progressive pancreatitis, liver cirrhosis, and ischemic heart disease. The gut microbiota changes significantly after alcohol exposure. Alcohol consumption tends to increase in underage and young people, but the feature of the gut microbiota in puberty remains largely unexplored. In this study, we conducted alcohol-exposed pubertal and adult mice model to investigate the intestinal damage and gut microbiota change. Interestingly, the responses of pubertal mice and adult mice after alcohol exposure were different. We found that alcohol dehydrogenase decreased and aldehyde dehydrogenase increased in the liver of pubertal mice, thus reducing the accumulation of toxic acetaldehyde. Furthermore, alcohol exposure caused less intestinal injury in pubertal mice. Through the analysis of metagenome assembly genome, we obtained many unrecognized bacterial genomes.
Limosillactobacillus reuteri
(cluster_56) and
Lactobacillus intestinalis
(cluster_57) were assembled from the samples of pubertal mice, which were involved in the production of indole acetic acid and the transformation of bile acids in response to alcohol exposure. This study provided a new insight to investigate the gut microbiota change and explained the difference of the gut microbiota after alcohol exposure between pubertal mice and adult mice.

IMPORTANCE

This study elucidates the significant impact of alcohol exposure on the gut microbiota and metabolic pathways in mice, highlighting the differential responses between adolescent and adult stages. Alcohol exposure was found to damage the intestinal barrier, alter the microbial composition by decreasing beneficial bacteria like
Lactobacillus
, and increase harmful bacteria such as
Alistipes
. The study also discovered unique microbial changes and resilience in pubertal mice. Species-level metagenomic analysis revealed specific microbial taxa and metabolic functions affected by alcohol. Metagenome-assembled genomes (MAGs) found many species that could not be annotated by conventional methods including many members of
Lachnospiraceae
, greatly expanding our understanding of the gut microbiota composition. These findings underscore the need for further research on alcohol’s effects on various organs and the implications of microbial metabolites on disease progression.
Seawater retreated from the Tethyan Himalaya of south Tibet at ca. 49 Ma, not ca. 34 Ma
Authors: Zhang Qian , Zhang Qinghai , Ding Lin , Wang Tianyang , Ma Xuesong , Gao Bintao , Yue Yahui
Published: November 2024

Timing of seawater retreat from the Tethyan Himalaya is of great importance, as it provides a minimum age control on the initial India-Asia collision. In south Tibet, however, it is still in dispute, with suggested ages ranging from >50 Ma to ca. 34 Ma. Here we present data of (1) larger benthic foraminifera from the topmost Zongpu Formation; (2) planktonic foraminifera; and (3) detrital zircon U-Pb ages from the Youxia and Shenkeza Formations at Guru, Tingri, and Gamba, with a special emphasis on the poorly studied Guru area. At Guru, existence of the Shallow Benthic Zonation (SBZ) 7 Zone index fossils of Alveolina moussoulensis Hottinger and Al. laxa Hottinger constrains the initial deposition of the Youxia Formation at ca. 54 Ma. Coexistence of the youngest planktonic foraminifera Acarinina boudreauxi Fleisher, Ac. coalingensis (Cushman and Hanna), and Ac. bullbrooki (Bolli) from the Youxia and Shenkeza Formations indicates their final deposition at ca. 49 Ma (E 7 Zone, where E stands for Eocene Planktonic foraminiferal Zone). Zircon U-Pb data are generally similar, with the youngest age peak of ca. 68−50 Ma resulting from input of the Gangdese Arc volcanic detritus. The complete lack of <49 Ma data among >1000 accepted ages implies that marine deposition probably ceased at ca. 49 Ma, consistent with the planktonic foraminiferal result. Integrating with previous results, we conclude that seawater retreated from both south Tibet and Zanskar at ca. 49 Ma. The initial collision happened quasi-simultaneously in the western and eastern Tethyan Himalaya, before ca. 49 Ma. Our findings do not support either a younger collisional age or a diachronous collisional process from the west to the east.
Refractory immune thrombocytopenic purpura (ITP) secondary to prior COVID-19 infection requiring a splenectomy
Authors: Hein Moki , Fernandez Vielka , Barrientos Jacqueline C , Hochwald Steven
Published: November 2024

Immune thrombocytopenic purpura (ITP) is an uncommon condition resulting from the autoimmune destruction of platelets. A man in his mid-30s, who had received three doses of the SARS-CoV-2 vaccine a year prior, was diagnosed with ITP 3 weeks after contracting COVID-19. Mechanisms of SARS-CoV-2 induced thrombocytopenia may include bone marrow depletion, coagulation consumption, mutations resulting in cytokine release or molecular mimicry leading to autoimmunity. Initial treatment involved glucocorticoids, but the disease course progressed into glucocorticoid-resistant ITP. Subsequently, the patient was diagnosed with ITP refractory to intravenous immunoglobulin, thrombopoietin receptor agonist, rituximab, cyclophosphamide, inhibitors of BTK and SYK, and other pharmacological agents. Despite exhaustive medical interventions, bleeding diathesis and platelet counts worsened, so the patient underwent a splenectomy resulting in the resolution of the thrombocytopenia.
Bilateral autologous penetrating keratoplasty following periorbital necrotising fasciitis
Authors: Khan Attam , Baker Diya , Husain Syed , Jenyon Tom
Published: November 2024

The case report describes a rare instance of a man in his 70s with periorbital necrotising fasciitis (NF) who underwent bilateral autologous penetrating keratoplasty. NF is an acute infection that can lead to severe complications, including vision loss. The patient presented with severe facial swelling and necrosis of the right eyelid, treated with surgical debridement and antibiotics. Post-surgery, he lost vision in the right eye due to compressive optic neuropathy and developed exposure keratopathy, which was managed with tarsorrhaphy. His left eye had poor vision due to herpetic corneal scarring. He met the criteria for a bilateral autologous keratoplasty, transferring his healthy right cornea to his otherwise healthy left eye and the damaged left cornea to the right eye. The surgery was successful, and at 9 months post-operation, the patient achieved improved vision (6/36) and is awaiting contact lens fitting. The report highlights the advantages and considerations of autokeratoplasty over conventional corneal transplants.
Real-world patient characteristics and survival outcomes in patients with advanced or recurrent endometrial cancer in England: a retrospective, population-based study
Authors: Banerjee Susana , Ingles Russo Garces Alvaro , Garside Jamie , Rahman Tameera , Pearson Clare , Heffernan Kiera
Published: November 2024

Objective

This study defined a retrospective cohort of patients in England with primary advanced or recurrent (A/R) endometrial cancer (EC) who may have been eligible for clinical trials evaluating immune checkpoint inhibitors (ICIs) in the first-line (1L) setting within a real-world dataset, and described the characteristics, treatment patterns and outcomes within this cohort.

Design

This was a retrospective, population-based study.

Setting

Routine population-level data from the National Cancer Registration and Analysis Service in England were used. Patients diagnosed with A/R EC between 1 January 2013 and 31 December 2019 were included (follow-up until 23 August 2021). ICI-eligible patients who received any 1L therapy (defined as first systemic treatment for A/R EC with or without radiotherapy) and met key eligibility criteria for the RUBY trial (NCT03981796; 1L cohort) were included. A subpopulation who solely received carboplatin–paclitaxel at 1L (carboplatin–paclitaxel subcohort) was identified.

Methods

Demographics, characteristics and therapy received were reported. Overall survival (OS), time to next treatment (TTNT) and time to treatment discontinuation (TTD) from 1L chemotherapy initiation were assessed using Kaplan-Meier methodology.

Results

Of 13 954 patients identified, 2376 ICI-eligible patients were included in the 1L cohort (median [range] age: 67.9 [26.7–94.0] years); 902 patients received solely carboplatin–paclitaxel at 1L. Demographics and disease characteristics were generally similar between cohorts. Median (95% CI) OS, TTNT and TTD from 1L chemotherapy were 27.2 (24.7, 30.2), 16.9 (15.8, 18.5) and 3.4 (3.4, 3.4) months, respectively, in the 1L cohort, and 17.2 (15.5, 19.0), 12.4 (11.6, 13.5) and 3.4 (3.4, 3.4) months, respectively, in the carboplatin–paclitaxel subcohort.

Conclusion

Long-term outcomes were poor for both cohorts, particularly the carboplatin–paclitaxel subcohort, where patients did not receive radiotherapy and had predominantly metastatic disease. This reflects the unmet need for more durable treatment options to prevent relapse and prolong survival in this patient population. This real-world study will help contextualise outcomes from ongoing phase III clinical trials investigating 1L ICI treatments.
Multicentre online registration of bronchopulmonary dysplasia in very preterm infants in China: protocol for a prospective, open, observational cohort study
Authors: He Shengnan , Peng Haibo , Zhou Ping , Hu Fei , Yan Xudong , Su Qian , Yu Boshi , Li Yubai , Chen Cheng , Guo Xin , Liu Ying , Guo Yanping , Liu Jiebo , Rao Dan Dan , Zhang Lian , Yu Zhangbin
Published: November 2024

Introduction

Bronchopulmonary dysplasia (BPD) in very preterm infants (VPIs) has adverse long-term outcomes and affects the quality of survival. There are no registry studies on BPD in VPIs in China. Our aim was to conduct a prospective, multicentre, open, longitudinal, observational cohort study to investigate the epidemiological characteristics, diagnosis, treatment, and short-term and long-term outcomes of BPD in a real-life setting in China and lay the grounds for establishing a nationwide registry with clinical data and biological specimens.

Methods

This study aims to recruit a minimum of 2000 VPIs and start research in January 2024 in Shenzhen, China. We will collect clinical data from the beginning of the life of VPIs and follow them up to 3 years old. Short-term outcomes, such as the incidence of BPD, necrotising enterocolitis, retinopathy of prematurity, intraventricular haemorrhage and porencephalic ventricular leukomalacia, as well as the cost of hospitalisation, are the major variables of concern. Bayley-III Scale assessment, gross motor function and pulmonary function evaluation will be performed at the age of correction, that is, 18–24 months and 30–36 months. The follow-up outcomes include loss to follow-up, survival status, moderate-to-severe neurodevelopmental deficits and severe respiratory complications. Cord blood, peripheral blood, tracheal aspirate, faeces and urine from VPIs, as well as mother’s milk, will be collected and stored at −80°C. All the data will be registered, stored and managed in a cloud-based database. This knowledge will be useful for establishing diagnostic criteria and predictive models for BPD in the Chinese population.

Ethics and dissemination

Our protocol has been approved by the Medical Ethics Committee of Shenzhen People’s Hospital (LL-KY-2023174-02) and the local ethics committee of each participating centre. Our goal is to present our findings at national conferences and in peer-reviewed paediatric journals.

Trial registration number

Chinese Clinical Trial Registry (ChiCTR2400081615).
Predictors of medicine-related perceptions towards deprescribing inappropriate medications among older adult outpatients in Jordan: a cross-sectional study
Authors: Rababa Mohammad J , Al Ghazo Ali , Hayajneh Audai A
Published: November 2024

Objectives

To examine the predictors of medicine-related perceptions towards deprescribing inappropriate medications among older adults in Jordan.

Design

A cross-sectional, correlational study.

Setting

Data were collected by a graduate nursing student from five outpatient clinics in a selected public hospital in Jordan via inperson interviews 5 days a week over a period of 4 months.

Participants

A convenience sample of 200 older adults who regularly visited the outpatient clinics of the selected public hospital for regular check-ups during July 2023 were recruited.

Outcome measures

Predictors of patients’ perceived medication concerns, interest in stopping medications, perceived unimportance of medications, and beliefs about medication overuse were examined.

Results

Increased perceived medication concerns among patients were significantly associated with older age (p=0.037), lower level of self-rated general health (p=0.002), less perceived care-provider knowledge of medications (p=0.041), higher perceived unimportance of medicines (p=0.018), less collaboration with care providers (p=0.017), being seen by a clinical pharmacist (p<0.001) and an increased number of prescribed medicines (p<0.001). Increased perceived interest in stopping medications was significantly associated with lower levels of self-rated general health (p=0.029), less perceived involvement in decision-making (p=0.013), higher perceived unimportance of medicines (p=0.002), being seen by a clinical pharmacist (p=0.024) and an increased number of prescribed medicines (p=0.001). Furthermore, increased perceived unimportance of medications among patients was significantly associated with more perceived beliefs about medication overuse (p=0.007), more perceived interest in stopping medicines (p=0.001) and greater perceived medication concerns (p=0.001). Moreover, greater perceived beliefs about medication overuse were significantly associated with older age (p=0.018), higher perceived unimportance of medicines (p=0.016), more collaboration with care providers (p=0.038), having post-traumatic disorder (p=0.018) and an increased number of prescribed medicines (p=0.038).

Conclusions

The current study examined predictors of medicine-related perceptions towards deprescribing inappropriate medications among older adults. Care providers should discuss the benefits of deprescribing inappropriate medications with their patients to prevent the side effects associated with long-term unnecessary use. Future studies on the effectiveness of an evidence-based deprescribing protocol on minimising the clinical side effects associated with the inappropriate prescription of medications among older adults are recommended.
Physical activity promotion intervention improved physical activity knowledge, confidence and behaviour among diverse immigrant women: pre–post multiple methods feasibility study
Authors: Iziduh Sharon , Lee Jocelyn , Umutoni Bora , Brahmbhatt Priya , Sabiston Catherine M , Friedenreich C M , Khanlou Nazilla , Smith-Turchyn Jenna , Tomasone Jennifer R , Gagliardi Anna R
Published: November 2024

Objectives

Little prior research investigated how to promote physical activity (PA), which can reduce cancer risk, to immigrant women. The overall aim of the current study was to pilot test education session feasibility. The objectives were to assess participation in, satisfaction with and potential impact of the education session, knowledge needed to refine the education session prior to a future trial.

Design

Pre–post multiple-methods comparative cohort,

Setting

Canadian immigrant settlement agencies recruited intervention and control women.

Participants

Intervention: 60 baseline, 53 education (49 virtual group, 4 video only), 1 month (43 virtual, 4 video), 6 months (38 virtual, 4 video), 37% African black; control: 41, 32% African black.

Results

Among intervention women, PA knowledge increased significantly from baseline at 1 (p<0.001) and 6 (p=0.01) months, as did PA confidence at both time points (p<0.001). PA behaviour increased significantly from baseline at 1 and 6 months for (p<0.001), moderate (p=0.02) and mild (p=0.05) intensity PA. Total PA metabolic equivalent units (METs) also increased significantly from baseline at both time points (p=0.01). PA confidence (p=0.002) and behaviour assessed by weekly minutes of vigorous (p=0.04, n2=0.05) and moderate (p=0.005) intensity PA, and total PA METs (p=0.01) were significantly greater among intervention women compared with control women. PA knowledge was greater among intervention women compared with control women but not significantly (p=0.8).

Conclusions

The findings underscore an important health promotion role for community agencies, which may interest policy-makers, healthcare leaders and health promotion specialists.
Study protocol of Elective Para-aortic and pelvic versus Pelvic only Irradiation in pelvic node positive Cervical cancer: a multicentric open labelled phase III randomised controlled trial (EPIC Study)
Authors: Shinghal Abhishek , Pradhan Satyajit , Chopra Supriya , Kapoor Ankita Rungta , Gupta Ankita , Mittal Prachi , Saini Vinay , Jain Jeevanshu , Sanju Sanju , Kapoor Akhil , Giridhar Prashanth , Pujari Lincoln , Chowdhury Zachariah , Gupta Sudeep
Published: November 2024

Introduction

The revision of International Federation of Gynaecology and Obstetrics staging in 2018 with recommendations to include cross-sectional imaging and a separate stage for node positive disease have opened a lot of uncertainties in implementing the correct treatment approach in these patients. While studies have suggested higher chances of occult para-aortic lymph node (PALN) even with advanced imaging, especially in pelvic node positive disease which tend to recur after pelvic radiation therapy. This study intends to study these patients and isolate the subset who will benefit most from elective PALN irradiation.

Methods and analysis

This is an ongoing multicentric phase III randomised controlled trial with a sample size of 274 subjects in two arms (137 in each arm) to determine the superiority of limited elective para-aortic irradiation compared with no irradiation. Arm one includes radiation to the lower PALN and pelvis; Arm two includes radiation to the pelvis. Concurrent chemotherapy followed by brachytherapy is standard in both arms. Patients with cervical cancer and radiologically positive pelvic LNs aged>18 years and<70 years are screened for the study. The primary endpoint of this study is 3-year disease-free survival. The secondary endpoints include 3-year para-aortic recurrence-free survival, 3-year distant metastasis-free survival, 3-year overall survival, acute and late toxicity, quality of life. Translational study to evaluate systemic immune response by FAPI-PETCT (fibroblast activator protein inhibitor positron emission tomography) and assessment of p16, L1 cell adhesion molecule (L1CAM) and protein death ligand-1 (PDL-1) expression by immunohistochemistry.

Ethics and dissemination

The study has been approved by the institutional ethics committee and will be routinely monitored according to standard guidelines. The results of the study will be published in peer-reviewed scientific journals, presented at conferences and submitted to regulatory authorities.

Trial registration number

The study was registered on 17 January 2022 under CTRI/2022/01/039495 (http://ctri.nic.in).
Investigating disease awareness of cutaneous leishmaniasis in rural Sri Lanka to inform public health services: a cross-sectional study
Authors: Gunasekara Sonali Dinushika , Agampodi Thilini Chanchala , Weerasinghe Manjula , Fernando Manoj Sanjeewa , Price Helen Philippa , Wickramasinghe Nuwan Darshana , Agampodi Suneth Buddhika
Published: November 2024

Objective

To assess community awareness of cutaneous leishmaniasis (CL) in a disease-endemic district in Sri Lanka.

Design

Population-based cross-sectional study.

Setting

This study was conducted in selected 158 Grama Niladhari divisions covering all the 22 Divisional Secretariat areas of the Anuradhapura district, Sri Lanka.

Sampling technique and participants

A probability sample of households was selected using multistage cluster sampling. Adults (≥18 years) who resided permanently in the Anuradhapura district during the data collection period were eligible, and individuals who could not comprehend or respond to the questions were excluded. The primary or secondary healthcare-related decision-maker of 1555 households participated in the study, in which 1479 (95.1%) were Sinhalese in ethnicity, including 1157 (74.4%) females.

Primary and secondary outcome measures

The primary outcome measure was ‘CL awareness,’ operationalised by awareness of the disease name, transmission mode and the primary disease characteristic based on a systematic expert consensus approach. Secondary outcome measures included awareness and perceptions of CL curability, treatment centres and perceived susceptibility.

Results

Only 3.6% (n=56) demonstrated CL awareness based on the definition. We observed low disease awareness even among people who claimed having CL or previously had the disease (n=6, 27.3%). While 1065 (68.5%) had heard the correct name (‘leishmaniasis’) or the local name (‘wæli mæssāgē leḍē’) for the disease, only 224 (21.0%) out of that knew the mode of transmission and 128 (12.0%) the chronic nature of CL skin lesions, respectively. Among the respondents with CL awareness (n=56), 42 (75.0%), 54 (96.4%) and 44 (88.0%) perceived CL as curable, were aware of treatment centres and expressed self-perceived susceptibility, respectively. Despite 423 (46.4%) who claimed to know more beyond the disease name, only 35 (8.3%) demonstrated actual CL awareness.

Conclusion

Findings highlight significantly low CL awareness in the disease-endemic Anuradhapura district, and we recommend developing evidence-based, context-specific public health interventions targeting CL awareness gaps.
MuSic Moves—co-creating a music-supported exercise programme with and for people with multiple sclerosis: a bicentre participatory mixed methods study
Authors: Fasching Bernhard , Mildner Sarah , Fink Franziska , Wanitschek Andreas , Hotz Isabella , Langweil Nadine , Monschein Tobias , Berger Thomas , Brenneis Christian , Leutmezer Fritz , Seebacher Barbara
Published: November 2024

Objectives

To collaboratively develop a music-supported video-based exercise programme for people with multiple sclerosis (pwMS) with mild to severe disability.

Design and setting

We performed this participatory mixed methods study from 15 March 2022 to 22 July 2023 at two Austrian multiple sclerosis (MS) centres.

Participants

This research included 67 pwMS, of whom 18 pwMS (including two patient representatives and five MS support group leaders/members) and an additional three family members served as stakeholders. Six neurologists and six physiotherapists, each with >5 years of experience in treating pwMS were interviewed.

Intervention

Stakeholders actively participated as members of study advisory, project steering and research groups. Researcher-supported peer-to-peer focus groups and individual interviews, conducted in three stages, gathered information on musical preferences and exercise needs. We co-developed, co-evaluated and co-adapted the music-supported exercise programme with the stakeholders. Involvement levels were measured using the Participation Check and Patient Public Involvement (PPI) Assessment Survey, self-efficacy with the Unidimensional Self-Efficacy Scale for Multiple Sclerosis and emotional states with the Self-Assessment Manikin.

Results

We identified four themes through reflexive thematic analysis: (1) engagement; (2) ease; (3) autonomy; (4) musical meaning. Integration of qualitative and quantitative components highlighted the success of PPI activities: (a) 148 co-created, free videos are publicly available; (b) four videos provide expert interviews with general information, while 144 offer music-supported exercises tailored to pwMS with mild to severe disability; (c) patients found the videos relevant, feasible and usable in interviews and focus groups; (d) ‘easy’ category exercises (seated or lying) are suitable for severely affected pwMS; (e) stakeholders felt included, respected and heard, as shown by quantitative PPI assessments.

Conclusions

Stakeholders were essential in identifying key aspects, preferences and constraints early on. Their feedback on music and exercise shaped the project. This study transformed our approach to exercise for pwMS. Future studies are required to evaluate the programme’s efficacy.

Trial registration number

DRKS00027979.
Factors associated with delayed health-seeking behaviour and disease severity on admission among patients diagnosed with acute encephalitis syndrome: an observational study from North India
Authors: Alam Umaer , Srivastava Neha , Agrawal Aman , Beniwal Rohit , Pandey Ashok Kumar , Mittal Mahim , Sharma Bhoopendra , Gupta Urmila , Kant Rajni , Murhekar Manoj , Mittal Mahima
Published: November 2024

Introduction

Acute encephalitis syndrome (AES) poses a significant health challenge to children across India. Late arrival at tertiary care hospitals is a primary contributor to disease severity and poor outcomes. This study identifies the determinants of delayed health seeking and disease severity in AES cases.

Methods

We interviewed the parents/guardians/caregivers of 242 patients with AES admitted at a tertiary care centre. Multivariable analyses identified factors for delayed health seeking, defined as >3 days spent at home after symptom onset; and disease severity on admission, defined as need for oxygen support. 131 patients were evaluated for long-term outcomes after 3 years using the Liverpool Outcome Score.

Results

90 (37.2%) patients had delayed health seeking and 202 (83.5%) had severe disease on admission. Lack of awareness about AES was a significant risk factor (OR 2.4, 95% CI 1.2 to 5.0, p=0.01) for delayed health seeking. Disease severity was associated with seeking treatment from uncertified medical practitioners (UMPs) (OR 7.3, 95% CI 2.7 to 19.8, p<0.01) and ≥2 days of time spent between the first healthcare provider and tertiary care admission (OR 3.0, 95% CI 1.3 to 7.3, p=0.01). At follow-up, disability was observed in 18.3% (n=24) of the patients.

Conclusion

Delayed health seeking, treatment from UMPs and multiple healthcare consultations contributed to disease severity in patients with AES on admission at tertiary care health facilities.
Trends of mortality from chronic respiratory diseases by sex and ethnicity in the USA: a secular analysis from 1979 to 2021 using data from death certificates
Authors: Meng Yaxian , Han Xiaojie , Ji Qianqian , Zhang Aijie , Zhan Yiqiang , Chen Xiaoliang
Published: November 2024

Background

Over the past decades, the prevalence of chronic respiratory diseases (CRDs) has undergone significant changes. Analysing long-term mortality trends by sex and ethnicity can inform more targeted public health interventions.

Methods

Using data from death certificates, we calculated age-standardised mortality rates of chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD), asthma and pneumoconiosis among the US population from 1979 to 2021, stratified by sex and ethnicity. Trend analyses of mortality rates were conducted using joinpoint regression models.

Results

Mortality trends varied significantly by demographic groups and disease types. Specifically, COPD mortality exhibited an overall increasing trend among females and white individuals throughout the study period while remaining stable among males and black individuals. ILD mortality showed an overall increasing trends for both males and females as well as individuals of white ethnicity. Asthma mortality showed an increase before 1996 followed by a consistent decline across all populations from about 1996 to 2021. In contrast, pneumoconiosis mortality has risen among white individuals since 2001 with a notable increase among females after 2009.

Conclusion

Our analysis reveals fluctuating trends in CRD mortality rates from 1979 to 2021 with varying patterns across sex, ethnicity and disease types. These findings underscore the need for ongoing research and tailored interventions to address these disparities.
Association of food insecurity with mental health status, mental health services utilisation and general healthcare utilisation among US adults
Authors: Park Sungchul , Berkowitz Seth A
Published: November 2024

Background

Food insecurity poses a substantial threat to mental health. However, there is limited understanding of how food-insecure adults experience mental health challenges and access necessary health services. We examined the association of food insecurity with mental health status, mental health service utilisation and general healthcare utilisation among US adults.

Methods

A retrospective longitudinal cohort study was conducted to analyse data from 9906 US adults participating in the 2016–2017 Medical Expenditure Panel Survey. Outcomes included mental health status, mental health service utilisation and general healthcare utilisation. The primary independent variable was food insecurity measured using the 10-item Food Security Survey Module. Two separate models were used: A lagged-dependent model and a fixed-effect model.

Results

The lagged dependent model showed that food insecurity in 1 year was associated with a higher likelihood of reporting mental health symptoms based on the Patient Health Questionnaire and the Kessler 6 Psychological Distress Scale (3.5 percentage points (95% CI: 1.3 to 5.8)) and self-reported poor mental health (5.8 percentage points (2.9 to 8.7)) in the subsequent year. However, compared with food-secure adults, food-insecure adults were no more likely to have outpatient mental health visits, specialty mental health visits or psychotropic medication fills. Moreover, food-insecure adults were 4.1 (1.2 to 7.0) percentage points more likely to have an emergency room visit than food-secure adults. These findings were consistent with the fixed-effect model.

Conclusion

Food insecurity is associated with worse mental health. However, food-insecure adults may not access adequate mental health services and instead rely on emergency room visits.
Morbid obesity is associated with outcomes in patients undergoing vertebroplasty or kyphoplasty for osteoporotic vertebral compression fractures: a nationwide inpatient sample analysis
Authors: Chu Yo-Lun , Chen Cheng-Kuang , Chia Liu-Yu
Published: November 2024

Background

Osteoporotic vertebral compression fractures (OVCF) significantly affect older adults, leading to considerable morbidity and healthcare costs. Despite the known health risks of morbid obesity, its impact on surgical outcomes of OVCF remains underexplored. This study examines the influence of morbid obesity on the clinical outcomes of patients undergoing vertebral augmentation procedures, specifically vertebroplasty (VP) or kyphoplasty (KP).

Methods

We analyzed data from the National Inpatient Sample (NIS) for hospitalized patients aged 60 years or older undergoing VP or KP for OVCF from 2005 to 2020. Morbid obesity was defined as a body mass index (BMI) above 40 kg/m². The primary outcomes assessed in-hospital mortality, discharge destinations, hospital stays, costs, and complications. Logistic and linear regressions adjusted for confounders were used to determine the impact of morbid obesity on these outcomes.

Results

The analysis included 4734 patients. Patients with morbid obesity accounted for 30.1% of the study sample. After adjustment for relevant demographic and clinical confounders, morbid obesity was significantly associated with increased risks of unfavorable discharge (adjusted OR (aOR): 1.24, 95% confidence interval (CI): 1.08–1.42, P=0.002) and overall complication (aOR=1.15, 95% CI 1.01 to 1.30, P=0.041), including venous thromboembolism (VTE; aOR=1.57, 95% CI 1.07 to 2.30, P=0.020, P=0.003), urinary tract infection (aOR=1.35, 95% CI 1.14 to 1.60, P=0.001), and acute kidney injury (AKI; aOR: 1.47, 95% CI 1.21 to 1.78, P<0.001).

Conclusions

Morbid obesity is associated with an increased risk of adverse short-term outcomes in patients undergoing VP or KP for OVCF, including unfavorable discharge and specific complications. These findings contribute insights to preoperative risk stratification and encourage clinicians to be more vigilant in managing this high-risk population. Further prospective research is still needed to confirm these associations and develop effective interventions.
Altered structural and functional homotopic connectivity associated with cognitive changes in SLE
Authors: Ni Sha , An Ning , Li Chunlei , Ma Yue , Qiao Pengfei , Ma Xueying
Published: November 2024

Objective

Previous studies have revealed functional changes within the cerebral hemispheres of patients with SLE; however the changes between cerebral hemispheres are still unknown. The present study aimed to explore the functional and structural changes between bilateral hemispheres using functional MRI and find their relationship with cognition in patients with SLE.

Methods

54 patients with SLE and 32 age-matched and sex-matched healthy controls (HCs) underwent MRI scanning and neuropsychological testing, and clinical data was collected in patients with SLE. Voxel-mirrored homotopic connectivity (VMHC) values and grey matter volume were calculated for all subjects. Correlation analysis was established to determine the relationship between VMHC values, grey matter volume and cognitive scores, blood biochemical markers in patients with SLE.

Results

Compared with HCs, patients with SLE showed increased VMHC values in the insula and parahippocampal gyrus, while grey matter volume were reduced in these regions. Correlation analysis demonstrated that the increased VMHC values in insula was negatively correlated with decreased orientation function and positively correlated with decreased attention function. The grey matter volume in insula was negatively correlated with decreased attention and abstraction. The VMHC values and grey matter volume in insula and parahippocampal gyrus were negatively associated with lupus-specific antibodies.

Conclusion

The structural and functional changes of insula and parahippocampal gyrus might be potential neuroimaging markers, and specific antibodies associated with lupus might be involved in the pathophysiological mechanisms of brain dysfunction.

Trial registration number

NCT06226324.
Hypertrophic cardiomyopathy due to truncating variants in myosin binding protein C: a Spanish cohort
Authors: Melendo-Viu Maria , Salguero-Bodes Rafael , Valverde-Gómez María , Larrañaga-Moreira Jose María , Barriales Roberto , Díez-Lopez Carles , Limeres Freire Javier , Peña-Peña Maria Luisa , Garcia Pavia Pablo , Ripoll Tomas , Climent-Payá Vicente , Gallego Delgado Maria , Zorio Esther , Bermudez Jimenez Francisco José , García-Pinilla José Manuel , Méndez Fernández Irene , Sabater-Molina Maria , Perez Asensio Ana , Marchán-Lopez Álvaro , Arribas Ynsaurriaga Fernando , Bueno Hector , Palomino Doza Julián A
Published: November 2024

Background

Hypertrophic cardiomyopathy (HCM) is an inherited disorder whose causal variants involve sarcomeric protein genes. One of these is myosin-binding protein C (MYBPC3), being previously associated with a favourable prognosis. Our objective is to describe the clinical characteristics and events of a molecularly homogeneous HCM cohort associated with truncatingMYBPC3variants.

Methods and results

A cohort of patients and relatives with HCM diagnosis and carrying a truncatingMYBPC3variant were retrospectively recruited. Subjects had an average follow-up of 7.77 years, with an incident HCM phenotype of 10%. They were middle-aged adult patients (47±16.8 years) without significant comorbidities or symptoms. Hypertrophy was discrete with a significative difference between probands and relatives (17.5±4 mm vs 14.6±5 mm; p<0.0001). Ejection fraction was predominantly preserved (65%±10%). Despite it being the most common clinical event, relevant heart failure (observed in 8.1% of patients) was infrequent and commonly found in the presence of a second environmental precipitating agent. ESC-HCM risk calculator and modifier factors did not correlate with the risk of major events predicting events, which were low (1.51 per 100 patients/year) and associated with the severity of HCM, abnormal QRS in the ECG and age. Genetic factors and sex were not associated with major events.

Conclusions

This is the first molecularly homogeneous, contemporary cohort, including HCM patients secondary toMYBPC3truncating variants. Patients showed a good prognosis with a low event rate. In our cohort, major arrhythmic events were not related to measured environmental or genetic factors.
Improving relativistic energy density functionals with tensor couplings
Authors: Typel Stefan , Shlomo Shalom
Published: November 2024

Energy density functionals (EDFs) have been used extensively with great success to calculate properties of nuclei and to predict the equation of state of dense nuclear matter. Besides non-relativistic EDFs, mostly of the Skyrme or Gogny type, relativistic EDFs of different types are in widespread use. In these latter approaches, the effective in-medium interaction is described by an exchange of mesons between nucleons. In most cases, only minimal meson-nucleon couplings are considered. The effects of additional tensor couplings were rarely investigated. In this work, a new relativistic EDF with tensor couplings and density dependent minimal meson-nucleon couplings will be presented. The parameters of the model are determined using a carefully selected set of experimental data with realistic uncertainties that are determined self-consistently. Predictions for various nuclear observables, the nuclear matter equation of state, and properties of neutron stars are discussed.
Flow and equation of state of nuclear matter at $${\varvec{E_\textrm{kin}/A=0.25}}$$–1.5 GeV with the SMASH transport approach
Authors: Tarasovičová L. A. , Mohs J. , Andronic A. , Elfner H. , Kampert K.-H.
Published: November 2024

We present a comparison of directed and elliptic flow data by the FOPI collaboration in Au–Au, Xe–CsI, and Ni–Ni collisions at beam kinetic energies from 0.25 to 1.5 GeV per nucleon to simulations using the SMASH hadronic transport model. The Equation of State is parameterized as a function of nuclear density and momentum dependent potentials are newly introduced in SMASH. With a statistical analysis, we show that within the present status of the SMASH transport model, the collective flow data at lower energies is in the best agreement with a soft momentum dependent potential, while the elliptic flow at higher energies requires a harder momentum dependent equation of state.
Infrared properties of the quark-gluon vertex in general kinematics
Authors: Aguilar A. C. , Ferreira M. N. , Oliveira B. M. , Papavassiliou J. , Teixeira G. L.
Published: November 2024

In the present work we determine the eight form factors of the transversely-projected quark-gluon vertex in general kinematics, in the context of Landau-gauge QCD with two degenerate light dynamical quarks. The study is based on the set of Schwinger–Dyson equations that govern the vertex form factors, derived within the formalism of the three-particle-irreducible (3PI) effective action. The analysis is performed by employing lattice data for the main ingredients, such as gluon and quark propagators, and three-gluon vertex. The numerical treatment is simplified by decoupling the system of integral equations: the classical form factor is determined from a single non-linear equation involving only itself, while the remaining ones are subsequently computed through simple integrations. The form factors are obtained for arbitrary values of space-like momenta, and their angular dependence is examined in detail. A clear hierarchy is established at the level of the corresponding dimensionless effective couplings, in agreement with results of earlier studies. Furthermore, the classical form factor is found to be in excellent agreement with recent unquenched lattice data in the soft-gluon configuration, while the two non-classical dressings depart substantially from the lattice results. Finally, the accurate implementation of multiplicative renormalizability is confirmed, and the transition from Minkoswski to Euclidean space is elucidated.
Analyzing the effects of variable fluid properties on radiative dissipative hybrid nanofluid over moving wedge with MHD and Joule heating
Authors: Rafique Khadija , Mahmood Zafar , Muhammad Taseer , Taj Muhammad , Alballa Tmader , Khalifa Hamiden Abd El-Wahed
Published: November 2024

Understanding and optimizing heat transfer processes in complex fluid systems is the driving force behind studying the magnetohydrodynamic (MHD) flow of [Formula: see text]–[Formula: see text] nanofluid across a radiative moving wedge, taking into account the impacts of viscous dissipation and Joule heating. Nanofluids, such as [Formula: see text]–[Formula: see text], increase heat transmission and thermal efficiency. However, the complicated challenges caused by fluid characteristics and radiative heating need a thorough investigation. This study examines MHD hybrid nanofluid heat transfer via a permeable wedge using joule heating, mass suction, viscous dissipation, variable viscosity, thermal radiation, variable thermal conductivity, and variable Prandtl number. We use similarity transformation to solve the ordinary differential equations that follow from the governing partial differential equations. We then check the results for correctness and dependability. To ensure the reliability and validity of the outcomes, source parameters are crucial to the validation process. The consequence of changing these parameters on the heat transmission properties of the MHD hybrid nanofluid is studied for both the scenario without and with thermal radiation by methodically analyzing the percentage increase or reduction. The validation process also includes a comparison of the computed values, such as the heat transfer rate and skin friction factor, with established theoretical predictions. This examination guarantees that the numerical solution, executed using the bvp4c technique in MATLAB, corresponds to the anticipated physical behavior of the system being studied. In addition, the findings exist using both graphical and tabular forms, which allows for a clear and succinct illustration of how different physical limitations affect flow characteristics.
A matrix model of a non-Hermitian β-ensemble
Authors: Mezzadri Francesco , Taylor Henry
Published: November 2024

We introduce the first random matrix model of a complex [Formula: see text]-ensemble. The matrices are tridiagonal and can be thought of as the non-Hermitian analogue of the Hermite [Formula: see text]-ensembles discovered by [I. Dumitriu and A. Edelman, Matrix models for beta ensembles, J. Math. Phys. 43 (2002) 5830–5847]. The main feature of the model is that the exponent [Formula: see text] of the Vandermonde determinant in the joint probability density function (j.p.d.f.) of the eigenvalues can take any value in [Formula: see text] However, when [Formula: see text], the j.p.d.f. does not reduce to that of the Ginibre ensemble, but it contains an extra factor expressed as a multidimensional integral over the space of the eigenvectors.
Meta-Review of Wearable Devices for Healthcare in the Metaverse
Authors: Vahdati Monireh (Monica) , Laamarti Fedwa , Saddik Abdulmotaleb El
Published: November 2024

In recent years, there has been a growing interest in leveraging the metaverse to enhance community engagement and healthcare. This paper provides a comprehensive examination of wearable devices and sensors utilized within immersive environments to improve well-being and healthcare outcomes. We categorize the healthcare application domains that employ wearable devices and identify commonly used devices and sensors based on a thorough review of the literature. Our study offers a detailed summary of these applications, highlighting their potential to enhance overall quality of life through remote monitoring, rehabilitation, and chronic disease management. Furthermore, we address existing research gaps and challenges in this field, offering insights for future research directions. This meta-review emphasizes the need for further exploration in the rapidly evolving domain of wearable healthcare technologies within the metaverse, presenting an overview of the current state of wearable devices in healthcare and underscoring their significance in advancing healthcare delivery and outcomes.