bluuebunny/crossref_metadata_2025 huggingface dataset:
Hematological profiles of newborns of mothers with hypertensive disorders of pregnancy delivered at the University of Gondar comprehensive specialized hospital: a comparative cross-sectional study
Authors: Mulatie Zewudu , Aynalem Melak , Getawa Solomon
Published: January 2024

Background

Hypertensive disorders in pregnancy can cause prenatal placental perfusion with insufficient blood supply to the fetus, resulting in fetal exposure to hypoxia and leading to disturbance of neonatal hematopoietic stem cells. This study aimed to compare the hematological profiles of newborns from mothers with hypertensive disorders and normotensive delivered at the University of Gondar comprehensive specialized hospital.

Methods

A comparative cross-sectional study was conducted from March to May 2022 among 308 newborns from hypertensive and normotensive mothers in equal proportions. A systematic random sampling technique was used to select study participants. Three milliliters of cord blood were collected to perform a complete blood count by Beckman coulter. The results were presented using tables and graphs. Independent t-test and Mann-Whitney U test were done to compare the hematological profiles of the two groups. P-value < 0.05were considered statistically significant.

Results

The majority of hypertensive and normotensive mothers’ ages were between 20 and 34 years (83.77% and 90.91%, respectively). The hematocrit levels were significantly higher in neonates of hypertensive mothers than the neonates of normotensive mothers (49.10 ± 5.19% and 46.09 ± 7.63% respectively) (P < 0.001) while neutrophil counts were significantly lower in neonates of hypertensive mothers than the neonates of normotensive mothers (6.62 ± 3.30 and 7.55 ± 3.31 × 103 /ul respectively) (P = 0.007). Also, platelets counts were significantly lower in neonates of hypertensive mothers than neonates of normotensive mothers (221.25 ± 83.56 and 260.24 ± 83.01 × 103/ul respectively) (P < 0.001). The platelet and nucleated red blood cell count showed a statistically significant difference among newborns from mothers with superimposed preeclampsia and gestational hypertension.

Conclusion

Newborns delivered from hypertensive disorders of pregnancy had low white blood cell parameters, low platelet count and high red blood cell parameters compared to controls. As result, newborns may develop leukopenia, thrombocytopenia and polycythemia, respectively. Therefore, newborns should be monitored for early detection and follow-up of hematological abnormalities before complications occurred.
Adherence to option B + antiretroviral therapy and associated factors in pregnant and breastfeeding women in Sub-Saharan Africa: a systematic review and meta-analysis
Authors: Fassinou Lucresse Corine , Songwa Nkeunang Diane , Delvaux Thérèse , Nagot Nicolas , Kirakoya-Samadoulougou Fati
Published: January 2024

Background

To assess the adherence to option B + antiretroviral therapy (ART) and associated factors in pregnant and breastfeeding women in Sub-Saharan Africa (SSA).

Methods

We conducted a comprehensive search from 01st January 2012 to 03rd October 2022, across four databases: PubMed, Scopus, Proquest Central, and Index Medicus Africain, to identify studies focused on pregnant and/or breastfeeding women living with HIV and receiving option B+ ART in SSA. Studies reporting adherence data were included in the meta-analysis. Were excluded studies published before 01st January 2012, grey literature, systematic reviews, and meta-analysis studies. Articles selection and data extraction were performed independently by two reviewers. We evaluated pooled adherence and pooled association between various factors and adherence using a random-effects model.

Results

Overall, 42 studies involving 15,158 participants across 15 countries contributed to the meta-analysis. The overall pooled adherence was 72.3% (95% CI: 68.2–76.1%). Having high education level (pooled odds ratio (OR): 2.25; 95% CI: 1.57–3.21), living in urban area (pooled OR: 1.75; 95% CI: 1.10–2.81), disclosing status to a family/partner (pooled OR: 1.74; 95% CI: 1.27–2.40), having a support system (pooled OR: 3.19; 95% CI: 1.89–5.36), receiving counseling (pooled OR: 3.97; 95% CI: 2.96–5.34), initiating ART at early clinical HIV stage (pooled OR: 2.22; 95% CI: 1.08–4.56), and having good knowledge on PMTCT/HIV (pooled OR: 2.71; 95% CI: 1.40–5.25) were factors significantly associated with adherence to option B + ART.

Conclusions

Despite the implementation of option B+ ART, the level of adherence among pregnant and breastfeeding women in SSA falls short of meeting the critical thresholds for viral load suppression as outlined in the 95-95-95 objectives set for 2025. These objectives are integral for achieving HIV elimination, and in turn, preventing HIV mother-to-child transmission. To bridge this gap, urgent tailored interventions based on individual and structural factors are essential to enhance adherence within these subgroups of women. This targeted approach is crucial in striving towards the HIV elimination target in SSA.
ILD-GAP combined with the monocyte ratio could be a better prognostic prediction model than ILD-GAP in patients with interstitial lung diseases
Authors: Hirata Momo , Hara Yu , Fujii Hiroaki , Murohashi Kota , Saigusa Yusuke , Zhao Shiqi , Kobayashi Miyu , Nagasawa Ryo , Tagami Yoichi , Izawa Ami , Otsu Yukiko , Watanabe Keisuke , Horita Nobuyuki , Kobayashi Nobuaki , Kaneko Takeshi
Published: January 2024

Background

The ILD-GAP scoring system is known to be useful in predicting prognosis in patients with interstitial lung disease (ILD). An elevated monocyte count was associated with increased risks of IPF poor prognosis. We examined whether the ILD-GAP scoring system combined with the monocyte ratio (ILD-GAPM) is superior to the conventional ILD-GAP model in predicting ILD prognosis.

Methods

In patients with ILD treated between April 2013 and April 2017, we were retrospectively assessed the relationships between baseline clinical parameters, including age, sex, Charlson Comorbidity Index score (CCIS), ILD diagnosis, blood biomarkers, pulmonary function test results, and disease outcomes. In ILD patients were included idiopathic pulmonary fibrosis (IPF), idiopathic nonspecific interstitial pneumonia (iNSIP), collagen vascular disease-related interstitial pneumonia (CVD-IP), chronic hypersensitivity pneumonitis (CHP), and unclassifiable ILD (UC-ILD). We also assessed the ability to predict prognosis was compared between the ILD-GAP and ILD-GAPM models.

Results

A total of 179 patients (mean age, 73 years) were assessed. All of them were taken pulmonary function test, including percentage predicted diffusion capacity for carbon monoxide. ILD patients included 56 IPF cases, 112 iNSIP and CVD-IP cases, 6 CHP cases and 5 UC-ILD cases. ILD-GAPM provided a greater area under the receiver-operating characteristic curve (0.747) than ILD-GAP (0.710) for predicting 3-year ILD-related events. Furthermore, the log-rank test showed that the Kaplan-Meier curves in ILD-GAPM were significantly different by stage (P = 0.015), but not by stage in ILD-GAP (P = 0.074).

Conclusions

The ILD-GAPM model may be a more accurate predictor of prognosis for ILD patients than the ILD-GAP model.
Physical activity practiced at a young age is associated with a less severe subsequent clinical presentation in facioscapulohumeral muscular dystrophy
Authors: Bettio Cinzia , Banchelli Federico , Salsi Valentina , Vicini Roberto , Crisafulli Oscar , Ruggiero Lucia , Ricci Giulia , Bucci Elisabetta , Angelini Corrado , Berardinelli Angela , Bonanno Silvia , D’Angelo Maria Grazia , Di Muzio Antonio , Filosto Massimiliano , Frezza Erica , Maggi Lorenzo , Mongini Tiziana , Pegoraro Elena , Rodolico Carmelo , Scarlato Marina , Vattemi Gaetano , Velardo Daniele , Tomelleri Giuliano , D’Amico Roberto , D’Antona Giuseppe , Tupler Rossella
Published: January 2024

Background

In facioscapulohumeral muscular dystrophy (FSHD), it is not known whether physical activity (PA) practiced at young age is associated with the clinical presentation of disease. To assess this issue, we performed a retrospective cohort study concerning the previous practice of sports and, among them, those with medium-high cardiovascular commitment in clinically categorized carriers of a D4Z4 reduced allele (DRA).

Methods

People aged between 18 and 60 were recruited as being DRA carriers. Subcategory (classical phenotype, A; incomplete phenotype, B; asymptomatic carriers, C; complex phenotype, D) and FSHD score, which measures muscle functional impairment, were assessed for all participants. Information on PAs was retrieved by using an online survey dealing with the practice of sports at a young age.

Results

368 participants were included in the study, average age 36.6 years (SD = 9.4), 47.6% male. The FSHD subcategory A was observed in 157 (42.7%) participants with average (± SD) FSHD score of 5.8 ± 3.0; the incomplete phenotype (category B) in 46 (12.5%) participants (average score 2.2 ± 1.7) and the D phenotype in 61 (16.6%, average score 6.5 ± 3.8). Asymptomatic carriers were 104 (subcategory C, 28.3%, score 0.0 ± 0.2). Time from symptoms onset was higher for patients with A (15.8 ± 11.1 years) and D phenotype (13.3 ± 11.9) than for patients with B phenotype (7.3 ± 9.0). The practice of sports was associated with lower FSHD score (-17%) in participants with A phenotype (MR = 0.83, 95% CI = 0.73–0.95, p = 0.007) and by 33% in participants with D phenotype (MR = 0.67, 95% CI = 0.51–0.89, p = 0.006). Conversely, no improvement was observed in participants with incomplete phenotype with mild severity (B).

Conclusions

PAs at a young age are associated with a lower clinical score in the adult A and D FSHD subcategories. These results corroborate the need to consider PAs at the young age as a fundamental indicator for the correct clinical stratification of the disease and its possible evolution.
Comparative analysis of different types of occlusal splints for the management of sleep bruxism: a systematic review
Authors: Ainoosah Sultan , Farghal Ahmed E. , Alzemei Marwa Saad , Saini Ravinder S. , Gurumurthy Vishwanath , Quadri Syed Altafuddin , Okshah Abdulmajeed , Mosaddad Seyed Ali , Heboyan Artak
Published: January 2024

Background

Sleep bruxism is a prevalent condition in dentistry practice, characterized by involuntary grinding or clenching of the teeth during sleep. Several therapies, including occlusal splints, have been used to manage sleep bruxism and temporomandibular disorders, including occlusal splints. This study aimed to compare the effectiveness of different occlusal splints in managing sleep bruxism.

Methods

The PICO framework encompasses the characterization of the population, intervention, comparison, and pertinent outcomes. A comprehensive and systematic literature review was conducted on PubMed, Scopus, and Google Scholar to identify grey literature. The search specifically targeted scientific studies published before September 20, 2023. The Cochrane Collaboration Risk of Bias Tool assessed the accuracy of the included Randomized Control Trials (RCTs). The modified Newcastle–Ottawa Scale assessed non-randomized studies. Data were systematically extracted, synthesized, and reported thematically.

Results

Out of the total of 808 articles that were evaluated, only 15 articles were found to meet the specified inclusion criteria. Adjustable splints, such as full-occlusion biofeedback splints, were more effective in reducing sleep bruxism episodes, improving patient-reported symptoms, and enhancing overall well-being. The impact of different occlusal sprints on electromyographic activity varies, and potential adverse effects should be considered individually.

Conclusions

This review provides valuable insights into the effectiveness of occlusal splints in managing sleep bruxism. The results of this study indicate that occlusal splint therapy is a viable treatment approach for sleep bruxism.
Reliability, validity, and simplification of the Chinese version of the Global Pain Scale in patients with rheumatoid arthritis
Authors: Chen Haoyang , Wang Xiaoxiao , Bai Ting , Cui Hengmei , Shi Songsong , Li Yunyun , Xu Guang-yin , Li Huiling , Shen Biyu
Published: January 2024

Background

Persistent pain is the most reported symptom in patients with rheumatoid arthritis (RA); however, effective and brief assessment tools are lacking. We validated the Chinese version of the Global Pain Scale (C-GPS) in Chinese patients with RA and proposed a short version of the C-GPS (s-C-GPS).

Method

The study was conducted using a face-to-face questionnaire survey with a multicenter cross-sectional design from March to December 2019. Patients aged > 18 years who met the RA diagnostic criteria were included. Based on the classical test theory (CTT) and the item response theory (IRT), we assessed the validity and reliability of the C-GPS and the adaptability of each item. An s-C-GPS was developed using IRT-based computerized adaptive testing (CAT) analytics.

Results

In total, 580 patients with RA (mean age, 51.04 ± 24.65 years; mean BMI, 22.36 ± 4.07 kg/m2), including 513 (88.4%) women, were included. Most participants lived in a suburb (49.3%), were employed (72.2%) and married (91.2%), reported 9–12 years of education (66.9%), and had partial medical insurance (57.8%). Approximately 88.1% smoked and 84.5% drank alcohol. Analysis of the CTT demonstrated that all items in the C-GPS were positively correlated with the total scale score, and the factor loadings of all these items were > 0.870. A significant positive relationship was found between the Visual Analog Scale (VAS) and the C-GPS. IRT analysis showed that discrimination of the C-GPS was between 2.271 and 3.312, and items 6, 8, 13, 14, and 16 provided a large amount of information. Based on the CAT and clinical practice, six items covering four dimensions were included to form the s-C-GPS, all of which had very high discrimination. The s-C-GPS positively correlated with the VAS.

Conclusion

The C-GPS has good reliability and validity and can be used to evaluate pain in RA patients from a Chinese cultural background. The s-C-GPS, which contains six items, has good criterion validity and may be suitable for pain assessment in busy clinical practice.

Trial registration

This cross-sectional study was registered in the Chinese Clinical Trial Registry (ChiCTR1800020343), granted on December 25, 2018.
Mental comorbidities in adolescents and young adults with juvenile idiopathic arthritis: an analysis of German nationwide health insurance data
Authors: Milatz Florian , Albrecht Katinka , Minden Kirsten , Marschall Ursula , Klotsche Jens , Callhoff Johanna
Published: January 2024

Background

Studies on prevalence rates of mental comorbidities in patients with juvenile idiopathic arthritis (JIA) have reported varying results and provided limited information on related drugs. The purpose of this study was to determine the prevalence of selected mental health diagnoses and the range of associated drug prescriptions among adolescents and young adults (AYA) with JIA compared with general population controls.

Findings

Nationwide statutory health insurance data of the years 2020 and 2021 were used. Individuals aged 12 to 20 years with an ICD-10-GM diagnosis of JIA in ≥ 2quarters, treated with disease-modifying antirheumatic drugs and/or glucocorticoids were included. The frequency of selected mental health diagnoses (depression, anxiety, emotional and adjustment disorders) was determined and compared with age- and sex-matched controls. Antirheumatic, psychopharmacologic, psychiatric, and psychotherapeutic therapies were identified by Anatomical Therapeutic Chemical (ATC) codes and specialty numbers. Based on data from 628 AYA with JIA and 6270 controls, 15.3% vs. 8.2% had a diagnosed mental health condition, with 68% vs. 65% receiving related drugs and/or psychotherapy. In both groups, depression diagnosis became more common in older teenagers, whereas emotional disorders declined. Females with and without JIA were more likely to have a mental health diagnosis than males. Among AYA with any psychiatric diagnosis, 5.2% (JIA) vs. 7.0% (controls) received psycholeptics, and 25% vs. 27.3% psychoanaleptics.

Conclusions

Selected mental health conditions among 12-20-year-old JIA patients are diagnosed more frequently compared to general population. They tend to occur more frequently among females and later in childhood. They are treated similarly among AYA regardless of the presence of JIA.
The environmental health impacts of Russia’s war on Ukraine
Authors: Hryhorczuk Daniel , Levy Barry S. , Prodanchuk Mykola , Kravchuk Oleksandr , Bubalo Nataliia , Hryhorczuk Alex , Erickson Timothy B.
Published: January 2024

Background

Russia’s invasion of Ukraine in February 2022 ignited the largest armed conflict in Europe since World War II. Ukrainian government agencies, civil society organizations, and international agencies have gathered an unprecedented amount of data about the impact of war on the environment, which is often the silent victim of war. We review these data and highlight the limitations of international governance for protection of the environment during time of war.

Methods

We performed an integrative review of academic, institutional, and media information resources using the search terms “Ukraine”, “Russia”, “war”, “environment”, “health”, “human rights”, “international humanitarian law”, “international human rights law”, “ecocide”, and “war crimes”.

Main text

Nearly 500,000 military personnel have been killed or wounded during the war, and more than 30,000 civilians have been killed or injured. Indirect health effects of the war have likely accounted for an even greater amount of civilian morbidity and mortality. The war has displaced more than 11 million people. Russia’s military forces have caused extensive damage to civilian infrastructure. The war has devastated Ukraine’s economy and reduced food and energy security in many countries.

The war has caused more than $56.4 billion in damage to the environment. There has been widespread chemical contamination of air, water, and soil, and 30% of Ukraine has been contaminated with landmines and unexploded ordnance. Landscape destruction, shelling, wildfires, deforestation, and pollution have adversely affected 30% of Ukraine’s protected areas. Russia’s seizure of the Zaporizhzhia Nuclear Power Plant and destruction of the Nova Kakhovka Dam have posed risks of long-term environmental catastrophe. Most of these environmental impacts threaten human health.

Conclusion

In addition to enormous human costs, Russia’s war on Ukraine has had devastating impacts on the natural environment and the built environment. International law mandates that methods of warfare must be implemented with due regard to the protection and preservation of the natural environment. A just and lasting peace necessitates, among other requirements, rebuilding and restoration of Ukraine’s natural environment and built environment. The environmental consequences of all wars need to be investigated and more effective measures need to be implemented to protect the environment during war.
A predictive nomogram for surgical site infection in patients who received clean orthopedic surgery: a retrospective study
Authors: Li Zhi , Song Lihua , Qin Baoju , Li Kun , Shi Yingtao , Wang Hongqing , Wang Huiwang , Ma Nan , Li Jinlong , Wang Jitao , Li Chaozheng
Published: January 2024

Background

Surgical site infection (SSI) is a common and serious complication of elective clean orthopedic surgery that can lead to severe adverse outcomes. However, the prognostic efficacy of the current staging systems remains uncertain for patients undergoing elective aseptic orthopedic procedures. This study aimed to identify high-risk factors independently associated with SSI and develop a nomogram prediction model to accurately predict the occurrence of SSI.

Methods

A total of 20,960 patients underwent elective clean orthopedic surgery in our hospital between January 2020 and December 2021, of whom 39 developed SSI; we selected all 39 patients with a postoperative diagnosis of SSI and 305 patients who did not develop postoperative SSI for the final analysis. The patients were randomly divided into training and validation cohorts in a 7:3 ratio. Univariate and multivariate logistic regression analyses were conducted in the training cohort to screen for independent risk factors of SSI, and a nomogram prediction model was developed. The predictive performance of the nomogram was compared with that of the National Nosocomial Infections Surveillance (NNIS) system. Decision curve analysis (DCA) was used to assess the clinical decision-making value of the nomogram.

Results

The SSI incidence was 0.186%. Univariate and multivariate logistic regression analysis identified the American Society of Anesthesiology (ASA) class (odds ratio [OR] 1.564 [95% confidence interval (CI) 1.029–5.99, P = 0.046]), operative time (OR 1.003 [95% CI 1.006–1.019, P < 0.001]), and D-dimer level (OR 1.055 [95% CI 1.022–1.29, P = 0.046]) as risk factors for postoperative SSI. We constructed a nomogram prediction model based on these independent risk factors. In the training and validation cohorts, our predictive model had concordance indices (C-indices) of 0.777 (95% CI 0.672–0.882) and 0.732 (95% CI 0.603–0.861), respectively, both of which were superior to the C-indices of the NNIS system (0.668 and 0.543, respectively). Calibration curves and DCA confirmed that our nomogram model had good consistency and clinical predictive value, respectively.

Conclusions

Operative time, ASA class, and D-dimer levels are important clinical predictive indicators of postoperative SSI in patients undergoing elective clean orthopedic surgery. The nomogram predictive model based on the three clinical features demonstrated strong predictive performance, calibration capabilities, and clinical decision-making abilities for SSI.
Treatment of effluents from Food Services Establishment (FSEs) by physico-chemical processes: a case study for Trinidad & Tobago
Authors: Shamika Cudjoe , Goutam Banerjee , Vincent Cooper
Published: January 2024

Background

Effluents from Food Services Establishments (FSEs) contain primarily Fats, Oil and Grease (FOG) which severely impact on sewers and the environment when released in high concentrations. In Trinidad & Tobago, it is estimated that approximately 231,304 kg/day of unaccounted for FOG bearing wastewaters from FSEs, are released into the environment with no viable treatment in the country. This research explored the optimization of physico-chemical processes for the treatment of FOGs for subsequent release into sewers.

Results

Bench-scale studies analysed the characteristics of FSE’s effluents from three popular sources, conducted the treatment of these effluents using Jar Tests, and subsequently confirm results via a pilot plant study. Characterization showed the mean concentration of the parameters examined to be; FOG (511 mg/l ± 116 mg/l), Suspended Solids (446 mg/l ± 146 mg/l), Chemical Oxygen Demand (2229 mg/l ± 963 mg/l) and pH (6 ± 0.3). Jar Tests were conducted using Poly-aluminium Chloride (PACl) as coagulant, anionic and cationic polyelectrolytes as flocculant aids with suitable pH adjustments of samples to determine the isoelectric point for the coagulant. Effluent results showed FOG removal levels of 99.9% and final effluent concentration of 0.17 mg/l. This was attained using PACl concentration of 250 mg/l, a 0.1% low cationic polyelectrolyte (CP 1154) at 4 mg/l with the pH of sample adjusted to 8. The pilot plant achieved a 97.4% removal of FOG (residual of 16.8 mg/l) using the same coagulant dosing, and pH value, but increasing the strength of the flocculant aid to 0.1% medium cationic (CP1156) at 5 mg/l.

Conclusion

Experimentation showed high concentrations of emulsified FOG can be efficiently removed to levels below the permissible requirements (20 mg/l) for entry into sewer systems in Trinidad and Tobago using coagulation, flocculation and sedimentation techniques. Pilot scale study also revealed that a higher strength and/or dose of the cationic polyelectrolyte and increased times in primary and final tanks were required to attain the desired results as in the bench level study, where equipment limitations in the flocculation tank were faced. This is in alignment with theory where factors critical for agglomeration is equipment type and density charge. It is, concluded that the optimum combination of chemicals and the respective dosages attained at the bench level study should prove effective should the right equipment be made available.
Sign-changing solutions for Kirchhoff-type variable-order fractional Laplacian problems
Authors: Zhou Jianwen , Yang Yueting , Wang Wenbo
Published: January 2024

In this paper, we are concerned with the Kirchhoff-type variable-order fractional Laplacian problems involving critical exponents and logarithmic nonlinearity. By using the constraint variational method, we show the existence of one least energy sign-changing solution. Moreover, we show that this energy is strictly larger than twice the ground energy.
Comprehensive analysis of a tryptophan metabolism-related model in the prognostic prediction and immune status for clear cell renal carcinoma
Authors: Yao Qinfan , Zhang Xiuyuan , Wang Yucheng , Wang Cuili , Wei Chunchun , Chen Jianghua , Chen Dajin
Published: January 2024

Background

Clear cell renal cell carcinoma (ccRCC) is characterized as one of the most common types of urological cancer with high degrees of malignancy and mortality. Due to the limited effectiveness of existing traditional therapeutic methods and poor prognosis, the treatment and therapy of advanced ccRCC patients remain challenging. Tryptophan metabolism has been widely investigated because it significantly participates in the malignant traits of multiple cancers. The functions and prognostic values of tryptophan metabolism-related genes (TMR) in ccRCC remain virtually obscure.

Methods

We employed the expression levels of 40 TMR genes to identify the subtypes of ccRCC and explored the clinical characteristics, prognosis, immune features, and immunotherapy response in the subtypes. Then, a model was constructed for the prediction of prognosis based on the differentially expressed genes (DEGs) in the subtypes from the TCGA database and verified using the ICGC database. The prediction performance of this model was confirmed by the receiver operating characteristic (ROC) curves. The relationship of Risk Score with the infiltration of distinct tumor microenvironment cells, the expression profiles of immune checkpoint genes, and the treatment benefits of immunotherapy and chemotherapy drugs were also investigated.

Results

The two subtypes revealed dramatic differences in terms of clinical characteristics, prognosis, immune features, and immunotherapy response. The constructed 6-gene-based model showed that the high Risk Score was significantly connected to poor overall survival (OS) and advanced tumor stages. Furthermore, increased expression of CYP1B1, KMO, and TDO2 was observed in ccRCC tissues at the translation levels, and an unfavorable prognosis for these patients was also found.

Conclusion

We identified 2 molecular subtypes of ccRCC based on the expression of TMR genes and constructed a prognosis-related model that may be used as a powerful tool to guide the prediction of ccRCC prognosis and personalized therapy. In addition, CYP1B1, KMO, and TDO2 can be regarded as the risk prognostic genes for ccRCC.
Biological and glucocorticoids treatment impair the medium-term immunogenicity to SARS-CoV-2 mRNA vaccines in autoimmune inflammatory rheumatic diseases
Authors: Garcia-Cirera Silvia , Calvet Joan , Delgado de la Poza Juan Francisco , Berenguer-Llergo Antoni , Orellana Cristóbal , Rusiñol Menna , Llop Maria , Arévalo Marta , Garcia-Pinilla Alba , Costa Ester , Aymerich Cristina , Gómez Rafael , Carreras Anna , Gratacós Jordi
Published: January 2024

Background

This study aims to assess the sustained immunological response to the SARS-CoV-2 vaccine in patients with autoimmune inflammatory rheumatic diseases (AIRD) undergoing different treatment regimens.

Methods

We conducted a prospective observational study involving 157 AIRD patients without prior COVID-19 infection. Treatment regimens included non-treatment or glucocorticoid-only (not-treated/GCs), non-biological drugs, biological therapy, and JAK inhibitors. All participants completed the two-dose vaccine schedule, and 110 of them received an additional booster dose. Serum samples were collected approximately 3–6 months after the second and third vaccine doses to measure antibodies against the Spike protein (antiS-AB) and neutralizing antibodies (nAB) targeting six SARS-CoV-2 variants.

Results

Following the third dose, all patients exhibited a significant increase in antiS-AB (FC = 15, p < 0.0001). Patients under biological therapy had lower titres compared to the non-biological (66% decrease, p = 0.038) and the not-treated/GCs group (62% decrease, p = 0.0132), with the latter persisting after the booster dose (86% decrease, p = 0.0027). GC use was associated with lower antiS-AB levels in the biological group (87% decrease, p = 0.0124), although not statistically significant after confounders adjustment. nABs showed the highest positivity rates for the wild-type strain before (50%) and after the booster dose (93%), while the Omicron variant exhibited the lowest rates (11% and 55%, respectively). All variants demonstrated similar positivity patterns and good concordance with antiS-AB (AUCs from 0.896 to 0.997).

Conclusions

The SARS-CoV-2 vaccine booster strategy effectively elicited a sustained antibody immune response in AIRD patients. However, patients under biological therapies exhibited a reduced response to the booster dose, particularly when combined with GCs.
Radiopharmaceuticals: navigating the frontier of precision medicine and therapeutic innovation
Authors: Dhoundiyal Shivang , Srivastava Shriyansh , Kumar Sachin , Singh Gaaminepreet , Ashique Sumel , Pal Radheshyam , Mishra Neeraj , Taghizadeh-Hesary Farzad
Published: January 2024

This review article explores the dynamic field of radiopharmaceuticals, where innovative developments arise from combining radioisotopes and pharmaceuticals, opening up exciting therapeutic possibilities. The in-depth exploration covers targeted drug delivery, delving into passive targeting through enhanced permeability and retention, as well as active targeting using ligand-receptor strategies. The article also discusses stimulus-responsive release systems, which orchestrate controlled release, enhancing precision and therapeutic effectiveness. A significant focus is placed on the crucial role of radiopharmaceuticals in medical imaging and theranostics, highlighting their contribution to diagnostic accuracy and image-guided curative interventions. The review emphasizes safety considerations and strategies for mitigating side effects, providing valuable insights into addressing challenges and achieving precise drug delivery. Looking ahead, the article discusses nanoparticle formulations as cutting-edge innovations in next-generation radiopharmaceuticals, showcasing their potential applications. Real-world examples are presented through case studies, including the use of radiolabelled antibodies for solid tumors, peptide receptor radionuclide therapy for neuroendocrine tumors, and the intricate management of bone metastases. The concluding perspective envisions the future trajectory of radiopharmaceuticals, anticipating a harmonious integration of precision medicine and artificial intelligence. This vision foresees an era where therapeutic precision aligns seamlessly with scientific advancements, ushering in a new epoch marked by the fusion of therapeutic resonance and visionary progress.

Graphical Abstract
In-between centers and suburbs? Increasing differentials in recent demographic dynamics of Italian metropolitan cities
Authors: Buonomo Alessio , Benassi Federico , Gallo Gerardo , Salvati Luca , Strozza Salvatore
Published: January 2024

Verifying the intrinsic stability of demographic processes over time and space is a pivotal task from both science and policy perspectives. Compared with other regions of the old continent, a latent peculiarity of demographic systems in Southern Europe is their persistent heterogeneity over space, especially observed across metropolitan regions. ‘Centers’ and ‘peripheries’ are thus becoming representative of, respectively, territories undergoing demographic growth and decline. The former corresponds to urban areas, being attractive for different population segments. The present study illustrates the results of a statistical analysis of total population data over time (2011–2020) and its decomposition in natural increase and net migration rates in 14 metropolitan cities of Italy. Assuming that central and peripheral (e.g., suburbs) locations show differential trends of natural increase and net migration, our analysis verifies whether (i) central locations behave homogeneously in terms of population dynamics, and whether (ii) a North–South gradient holds. Results indicate how (metropolitan) demographic patterns no longer reflect a traditional gap between Northern and Southern regions, while outlining a subtler divide in growing and declining contexts. The few still-growing metropolitan areas were all located in North-Central Italy, and reflect more polarized socioeconomic contexts than in the past. Internal migration was likely the most powerful factor that discriminates growing from declining cities. Such evidence indicates that strengthening the self-restraining capacity of Southern Italian territories contributes to increase their attractiveness of international migration flows, counteracting demographic shrinkage.
Serum soluble toll-like receptor 4 and risk for clinical severity in COVID-19 patients
Authors: Houssen Maha E. , Elmaria Marwa O. , Badr Dina , El-Mahdy Rasha , Ghannam Mayada A. , El-Ashwah Shaimaa , Denewer May , Mortada Metwaly Ibrahim
Published: January 2024

Toll-like receptor 4 (TLR4) signaling mediates sustained systemic inflammation in(COVID)-19 patients. We aimed to assess the serum levels of sTLR4 and sCD14 as negative regulators of Toll like receptor signaling and their association with laboratory markers and clinical severity in covid 19 patients. Ninety-eight patients with COVID-19 (70 severe and 28 non-severe) were enrolled in the study. Serum sCD14 andsTLR4were determined by ELISA. A significant increase in serum sTLR4 and sCD14 levels was detected in severe compared to non severe COVID19 patients.Receiver operating characteristic curve (ROC) analysis revealed significant diagnostic potential of serum sTLR4 and sCD14 in covid19 patients.We conclude that Serum sTLR4 and sCD14 may be promising clinical severity markers for COVID19 patients.
Exploration of tumor growth regression of quinoa and chia oil nanocapsules via the control of PIK3CA and MYC expression, anti-inflammation and cell proliferation inhibition, and their hepatorenal safety in rat breast cancer model
Authors: El makawy Aida I. , Abdel-Aziem Sekena H. , Mohammed Shaimaa E. , Ibrahim Faten M. , Abd EL-Kader Heba A. , Sharaf Hafiza A. , Youssef Dalia A. , Mabrouk Dalia M.
Published: January 2024

Background

The second most common cancer in the world is breast cancer. Chemotherapy is used to treat breast cancer, but instances of multidrug resistance, targets that are not selective, and physicochemical issues raise doubts about its efficacy. So, the exploration of chemopreventive agents from efficient natural sources has been required. The chia and quinoa seeds have health-promoting activities that include cardio-protective, antidiabetic, and anticancer effects. Given the paramount importance of their oils and their potential bioactivities, this work aimed to assess the repressive effect of their oil nanocapsules against mammary tumors in rats. Rat models of chemically induced mammary tumors were gavaged with chia and quinoa nanocapsules for one month. The repressive effect of nanocapsules was studied by quantifying TNF-α, assessing the gene expression of proto-oncogenes (PIK3CA and MYC) using qRT-PCR, and analyzing the cell cycle in mammary tissue.

Results

The studies clarified that the inhibition of tumors in response to quinoa and chia nanocapsules was associated with a reduction in TNF-α levels, proliferation capability, and motivation for apoptosis. Furthermore, quinoa and chia nanocapsule management repressed the activation of the MYC and PIK3CA genes. As well as nanocapsules modulated the liver enzymes and kidney function alterations induced in mammary tumor animals. Meanwhile, both oils' nanocapsules do not have an impact on the liver and kidneys of healthy rats.

Conclusions

The findings indicate that quinoa and chia nanocapsules are safe and can reduce tumor growth, suggesting a potential natural therapeutic target for breast cancer treatment.
Antioxidant capacity of sesamol in Caenorhabditis elegans model system
Authors: Huang Jinian , Qi Shuning , Sun Qiang , Song Guohui , Tang Jixing , Duan Yuquan
Published: January 2024

Senescence is a general and irreversible process which depends on both inherent (free radical and age) and external (Ultraviolet irradiation) factors. Antioxidants and other natural compounds like plant and plant products are widespread use for their medicinal and therapeutic values. The present study focuses on the role of sesamol which has been used to delay the effects of photoaging using model nematode Caenorhabditis elegans (C. elegan) by measuring the longest life, average life, reproductive capacity, and the variation of reactive oxygen of C. elegans under different stress conditions. The result showed that 200 µg·mL−1 sesamol significantly extended the life of C. elegans, that is, the mean lifespan of the treatment groups were 43.3% longer than control group. Meanwhile, sesamol significantly prolonged the lifespan of C. elegans under heat stress, ultraviolet irradiation stress, and oxidative stress. Above all, sesamol could be used as potential antioxidant compounds which will be of greater significance for health-based research.

Graphical Abstract
Use of implementation mapping in the planning of a hybrid type 1 pragmatic clinical trial: the BeatPain Utah study
Authors: Fritz Julie M. , Gibson Bryan , Wetter David W. , Del Fiol Guilherme , Solis Victor , Ford Isaac , Lundberg Kelly , Thackeray Anne
Published: January 2024

Background

Considerable disparities in chronic pain management have been identified. Persons in rural, lower income, and minoritized communities are less likely to receive evidence-based, nonpharmacologic care. Telehealth delivery of nonpharmacologic, evidence-based interventions for persons with chronic pain is a promising strategy to lessen disparities, but implementation comes with many challenges. The BeatPain Utah study is a hybrid type 1 effectiveness-implementation pragmatic clinical trial investigating telehealth strategies to provide nonpharmacologic care from physical therapists to persons with chronic back pain receiving care in ommunity health centers (CHCs). CHCs provide primary care to all persons regardless of ability to pay. This paper outlines the use of implementation mapping to develop a multifaceted implementation plan for the BeatPain study.

Methods

During a planning year for the BeatPain trial, we developed a comprehensive logic model including the five-step implementation mapping process informed by additional frameworks and theories. The five iterative implementation mapping steps were addressed in the planning year: (1) conduct needs assessments for involved groups; (2) identify implementation outcomes, performance objectives, and determinants; (3) select implementation strategies; (4) produce implementation protocols and materials; and (5) evaluate implementation outcomes.

Results

CHC leadership/providers, patients, and physical therapists were identified as involved groups. Barriers and assets were identified across groups which informed identification of performance objectives necessary to implement two key processes: (1) electronic referral of patients with back pain in CHC clinics to the BeatPain team and (2) connecting patients with physical therapists providing telehealth. Determinants of the performance objectives for each group informed our choice of implementation strategies which focused on training, education, clinician support, and tailoring physical therapy interventions for telehealth delivery and cultural competency. We selected implementation outcomes for the BeatPain trial to evaluate the success of our implementation strategies.

Conclusions

Implementation mapping provided a comprehensive and systematic approach to develop an implementation plan during the planning phase for our ongoing hybrid effectiveness-implementation trial. We will be able to evaluate the implementation strategies used in the BeatPain Utah study to inform future efforts to implement telehealth delivery of evidence-based pain care in CHCs and other settings.

Trial registration

ClinicalTrials.gov Identifier: NCT04923334. Registered June 11, 2021.
A hybrid approach for fatigue assessment of reinforced concrete bridge deck considering realistic bridge-traffic interaction
Authors: Zhou Yufen , Chen Suren
Published: January 2024

Reinforced concrete (RC) bridge decks are directly exposed to daily traffic loads and often experience surface cracking caused by excessive stress or fatigue accumulation. The bridge deck fatigue performance over traffic loads needs to be assessed based on accurate dynamic interaction analysis of the bridge and realistic moving vehicles. Most of existing studies on fatigue assessment focus on either the bridge global response without sufficient details about the bridge deck, or refined bridge deck modeling without considering the full dynamic interaction between moving traffic and the bridge structure realistically. A hybrid fatigue assessment approach is developed by combining mode-based global bridge-traffic dynamic interaction analysis, finite-element (FE)-based refined bridge deck model, and fatigue assessment method directly based on the vehicle loads and shear strength of the bridge deck. The proposed approach is demonstrated with a typical 3-span concrete bridge under realistic traffic and road surface conditions. Based on the dynamic interaction and stress analysis results, the fatigue damage factor is further investigated with different road surface roughness levels and heavy truck proportions. It is found that the proposed analytical approach provides a useful tool to predict the bridge deck response and potential fatigue damage under realistic traffic flow.
Bringing together the World Health Organization's QualityRights initiative and the World Psychiatric Association's programme on implementing alternatives to coercion in mental healthcare: a common goal for action
Authors: Gill Neeraj , Drew Natalie , Rodrigues Maria , Muhsen Hassan , Morales Cano Guadalupe , Savage Martha , Pathare Soumitra , Allan John , Galderisi Silvana , Javed Afzal , Herrman Helen , Funk Michelle
Published: January 2024

Background

Stakeholders worldwide increasingly acknowledge the need to address coercive practices in mental healthcare. Options have been described and evaluated in several countries, as noted recently in major policy documents from the World Health Organization (WHO) and World Psychiatric Association (WPA). The WHO's QualityRights initiative promotes human rights and quality of care for persons with mental health conditions and psychosocial disabilities. A position statement from the WPA calls for implementation of alternatives to coercion in mental healthcare.

Aims

We describe the engagement of both the WHO and WPA in this work. We discuss their mutual aim to support countries in improving human rights and quality of care, as well as the differences between these two organisations in their stated goals related to coercion in mental healthcare: the WHO's approach to eliminate coercion and the WPA's goal to implement alternatives to coercion.

Method

We outline and critically analyse the common ground between the two organisations, which endorse a similar range of rights-based approaches to promoting non-coercive practices in service provision, including early intervention in prevention and care and other policy and practice changes.

Results

Advocacy and action based on an agreed need to find practical solutions and advances in this area have the power to build consensus and unify key actors.

Conclusions

We conclude that persons with lived experience, families, mental health professionals and policy makers are now coming together in several parts of the world to work toward the common goals of improving quality, promoting human rights and addressing coercion in mental health services.
The high cost of care and limited evidence on cost-effective strategies for Lewy body dementia: systematic review of evidence
Authors: Boland Erin , Fitzpatrick Rachel , Ryan Dearbhail , Kane Joseph , Betzhold Sara , Leroi Iracema , Kinchin Irina
Published: January 2024

Background

Lewy body dementia (LBD) is a prevalent yet frequently underdiagnosed form of dementia, accounting for up to 15% of all dementia cases.

Aims

This study aims to increase awareness and advocacy for LBD by gathering and critically assessing the economic evidence, including the cost of illness and cost-effectiveness of interventions for managing LBD.

Method

A systematic literature review was undertaken with EMBASE, Medline, CINAHL, PsycINFO, NHS Economic Evaluation Database and EconLit. This search was supplemented by grey literature on Google Scholar and reviewing the reference lists of identified studies. The papers included in the review were published between 2008 and 2023, and involved participants with LBD (dementia with Lewy bodies or Parkinson's disease dementia), which either addressed the cost of illness or conducted an economic evaluation.

Results

Thirteen papers were included, comprising ten cost-of-illness studies and three economic evaluations. The cost of LBD tends to be higher than that of other forms of dementia, such as Alzheimer's disease, and these costs escalate more steeply as the disease progresses. These cost differences may not be solely influenced by the subtype of dementia, but possibly also by patient characteristics like physical and cognitive abilities. Cost-effectiveness of potential interventions for LBD is limited.

Conclusions

Despite numerous drug trials and other interventions for dementia, very few have targeted LBD, let alone explored the cost-effectiveness of such therapies for LBD. This disparity highlights the urgent need for cost-effective strategies and interventions targeting LBD. We propose the establishment of universally accepted standards for LBD research.