bluuebunny/crossref_metadata_2025 huggingface dataset:
Herbal Products as Complementary or Alternative Medicine for the Management of Hyperglycemia and Dyslipidemia in Patients with Type 2 Diabetes: Current Evidence Based on Findings of Interventional Studies
Authors: Farhadnejad Hossein , Saber Niloufar , Neshatbini Tehrani Asal , Kazemi Jahromi Mitra , Mokhtari Ebrahim , Norouzzadeh Mostafa , Teymoori Farshad , Asghari Golaleh , Mirmiran Parvin , Azizi Fereidoun
Published: July 2024

Type 2 diabetes (T2D) is known as a major public health problem with a noticeable adverse impact on quality of life and health expenditures worldwide. Despite using routine multiple pharmacological and nonpharmacological interventions, including diet therapy and increasing physical activity, controlling this chronic disease remains a challenging issue, and therapeutic goals are often not achieved. Therefore, recently, other therapeutic procedures, such as using herbal products and functional foods as complementary or alternative medicine (CAM), have received great attention as a new approach to managing T2D complications, according to the literature. We reviewed the existing evidence that supports using various fundamental medicinal herbs, including cinnamon, saffron, ginger, jujube, turmeric, and barberry, as CAM adjunctive therapeutic strategies for T2D patients. The current review addressed different aspects of the potential impact of the abovementioned herbal products in improving glycemic indices and lipid profiles, including the effect size reported in the studies, their effective dose, possible side effects, herbs‐drug interactions, and their potential action mechanisms.
High Incidence of Gastric Cancer in El Salvador: A National Multisectorial Study during 2000 to 2014
Authors: Ruiz de Campos Lisseth , Valdez de Cuellar Marisabel , Norwood Dalton A. , Carrasco Tiffany Y. , Montalvan-Sanchez Eleazar E. , Rodriguez Funes Maria-Virginia , Beasley Timothy , Dominguez Ricardo L. , Bravo Luis E. , Morgan Douglas R.
Published: July 2024

Background:

Gastric adenocarcinoma is the fourth leading cause of global cancer mortality and leading infection-associated cancer. Gastric cancer has significant geographic variability, with a high incidence in East Asia and mountainous regions of Latin America. In the United States, gastric cancer represents a marked disparity with incidence rates that are two to three times higher in Hispanics compared to non-Hispanic Whites.

Methods:

We conducted a national retrospective study of incident gastric cancer in El Salvador from to 2000 to 2014 to estimate the age-standardized incidence rate (ASIR) by using a combination of pathology and endoscopy databases. A unique multisectorial coalition was formed between the Ministry of Health (MINSAL) and ES Gastroenterology Society (AGEDES), representing public hospitals (n = 5), governmental employee hospitals (ISSS, n = 5), and private facilities (n = 6), accounting for >95% of national endoscopy capacity. HER2 and EBV tumor status was ascertained in a representative sample during 2014 to 2016.

Results:

A total of 10,039 unique cases of gastric cancer were identified, 45.5% female, and mean age of 65. 21% and 9.4% were <55 and <45 years old, respectively. ASIRs (M, F) were 18.9 (95% CI, 14.4–20.7) and 12.2 per 100,000 persons (95% CI, 10.9–13.5), respectively, in the period 2010 to 2014 with all centers operational. Intestinal gastric cancer was 2.8 times more common than diffuse gastric cancer; 23.2% had partial or complete pyloric obstruction. The HER2 2+/3+ status was 16.7% and EBV-encoded RNA positivity was 10.2%.

Conclusions:

A high incidence of gastric cancer was confirmed in El Salvador and nearly half of the patients were female.

Impact:

The findings have implications for cancer control in the Central America LMICs and for US Latino populations.

See related commentary by Riquelme and Abnet, p. 1550
Supplementary Tables Legend from The Tumor Microbiome Reacts to Hypoxia and Can Influence Response to Radiation Treatment in Colorectal Cancer
Authors: Benej Martin , Hoyd Rebecca , Kreamer McKenzie , Wheeler Caroline E. , Grencewicz Dennis J. , Choueiry Fouad , Chan Carlos H.F. , Zakharia Yousef , Ma Qin , Dodd Rebecca D. , Ulrich Cornelia M. , Hardikar Sheetal , Churchman Michelle L. , Tarhini Ahmad A. , Robinson Lary A. , Singer Eric A. , Ikeguchi Alexandra P. , McCarter Martin D. , Tinoco Gabriel , Husain Marium , Jin Ning , Tan Aik C. , Osman Afaf E.G. , Eljilany Islam , Riedlinger Gregory , Schneider Bryan P. , Benejova Katarina , Kery Martin , Papandreou Ioanna , Zhu Jiangjiang , Denko Nicholas , Spakowicz Daniel
Published: July 2024

Legend for Supplementary Tables
Supplementary Data from The Tumor Microbiome Reacts to Hypoxia and Can Influence Response to Radiation Treatment in Colorectal Cancer
Authors: Benej Martin , Hoyd Rebecca , Kreamer McKenzie , Wheeler Caroline E. , Grencewicz Dennis J. , Choueiry Fouad , Chan Carlos H.F. , Zakharia Yousef , Ma Qin , Dodd Rebecca D. , Ulrich Cornelia M. , Hardikar Sheetal , Churchman Michelle L. , Tarhini Ahmad A. , Robinson Lary A. , Singer Eric A. , Ikeguchi Alexandra P. , McCarter Martin D. , Tinoco Gabriel , Husain Marium , Jin Ning , Tan Aik C. , Osman Afaf E.G. , Eljilany Islam , Riedlinger Gregory , Schneider Bryan P. , Benejova Katarina , Kery Martin , Papandreou Ioanna , Zhu Jiangjiang , Denko Nicholas , Spakowicz Daniel
Published: July 2024

Fold-changes and adjusted p-values for all microbes associated with hypoxic or normoxic tumors in the ORIEN and TCGA datasets (associated with Figure 2A). Results of survival analyses of interactions between microbes and hypoxia in COADREAD patients receiving radiation therapy.
Supplementary Data from The Tumor Microbiome Reacts to Hypoxia and Can Influence Response to Radiation Treatment in Colorectal Cancer
Authors: Benej Martin , Hoyd Rebecca , Kreamer McKenzie , Wheeler Caroline E. , Grencewicz Dennis J. , Choueiry Fouad , Chan Carlos H.F. , Zakharia Yousef , Ma Qin , Dodd Rebecca D. , Ulrich Cornelia M. , Hardikar Sheetal , Churchman Michelle L. , Tarhini Ahmad A. , Robinson Lary A. , Singer Eric A. , Ikeguchi Alexandra P. , McCarter Martin D. , Tinoco Gabriel , Husain Marium , Jin Ning , Tan Aik C. , Osman Afaf E.G. , Eljilany Islam , Riedlinger Gregory , Schneider Bryan P. , Benejova Katarina , Kery Martin , Papandreou Ioanna , Zhu Jiangjiang , Denko Nicholas , Spakowicz Daniel
Published: July 2024

Cox proportional hazards model results for the interaction terms between hypoxia (binary, low or high) with microbe relative abundance in COADREAD tumors treated with radiotherapy.
Supplementary Data from The Tumor Microbiome Reacts to Hypoxia and Can Influence Response to Radiation Treatment in Colorectal Cancer
Authors: Benej Martin , Hoyd Rebecca , Kreamer McKenzie , Wheeler Caroline E. , Grencewicz Dennis J. , Choueiry Fouad , Chan Carlos H.F. , Zakharia Yousef , Ma Qin , Dodd Rebecca D. , Ulrich Cornelia M. , Hardikar Sheetal , Churchman Michelle L. , Tarhini Ahmad A. , Robinson Lary A. , Singer Eric A. , Ikeguchi Alexandra P. , McCarter Martin D. , Tinoco Gabriel , Husain Marium , Jin Ning , Tan Aik C. , Osman Afaf E.G. , Eljilany Islam , Riedlinger Gregory , Schneider Bryan P. , Benejova Katarina , Kery Martin , Papandreou Ioanna , Zhu Jiangjiang , Denko Nicholas , Spakowicz Daniel
Published: July 2024

Numbers at risk for the association between survival and Fusobacterium canifelinum abundance in COADREAD tumors treated with radiation.
Figure 4 from The Tumor Microbiome Reacts to Hypoxia and Can Influence Response to Radiation Treatment in Colorectal Cancer
Authors: Benej Martin , Hoyd Rebecca , Kreamer McKenzie , Wheeler Caroline E. , Grencewicz Dennis J. , Choueiry Fouad , Chan Carlos H.F. , Zakharia Yousef , Ma Qin , Dodd Rebecca D. , Ulrich Cornelia M. , Hardikar Sheetal , Churchman Michelle L. , Tarhini Ahmad A. , Robinson Lary A. , Singer Eric A. , Ikeguchi Alexandra P. , McCarter Martin D. , Tinoco Gabriel , Husain Marium , Jin Ning , Tan Aik C. , Osman Afaf E.G. , Eljilany Islam , Riedlinger Gregory , Schneider Bryan P. , Benejova Katarina , Kery Martin , Papandreou Ioanna , Zhu Jiangjiang , Denko Nicholas , Spakowicz Daniel
Published: July 2024

Model tumors also have oxygen-dependent microbial strain differences. A, CT26 colorectal cancer tumors grown in immune-deficient hosts have increased microbial burden with increased hypoxia. B, CT26 colorectal cancer tumors grown in immune-deficient or immune-competent hosts can be stratified into low and high hypoxia groups by the tumor Buffa score. C, Metatranscriptomic identification of microbial strains spontaneously colonizing individual tumors. D, Volcano plot of strains identified in (C) with tropism for tumor of either high or low hypoxia score. E, Bray–Curtis distances of gut samples from nude and BALB/c mice, showing comparisons within each group and with each other. F, Venn diagram of species shared between nude and BALB/c mouse gut microbiomes. G, Enumeration of the consistencies between the mouse and human data. We show microbes enriched in hypoxic or normoxic tumors in humans and the particular mouse strain noted in the table.
Widespread, perception-related information in the human brain scales with levels of consciousness
Authors: Vigotsky Andrew D. , Jabakhanji Rami , Branco Paulo , Iannetti Gian Domenico , Baliki Marwan N. , Apkarian A. Vania
Published: July 2024

How does the human brain generate coherent, subjective perceptions—transforming yellow and oblong visual sensory information into the perception of an edible banana? This is a hard problem. According to the standard viewpoint, processing in groups of dedicated regions—identified as active “blobs” when using functional magnetic resonance imaging (fMRI)—gives rise to perception. Here, we reveal a new organizational concept by discovering that stimulus-specific information distributed throughout the whole brain. Using fMRI, we found stimulus-specific information across the neocortex, even in voxels previously considered “noise,” challenging traditional analytical approaches. Surprisingly, these stimulus-specific signals were also present in the subcortex and cerebellum and could be detected from across-subject variances. Finally, we observed that stimulus-specific signal in brain regions beyond the primary and secondary sensory cortices is influenced by sedation levels, suggesting a connection to perception rather than sensory encoding. We hypothesize that these widespread, stimulus-specific, and consciousness level-dependent signals may underlie coherent and subjective perceptions.
Notes on Iberian Mutillidae (Hymenoptera) part I: a new species, new records and some taxonomic and faunistic remarks
Authors: PAREJO-PULIDO DANIEL , ROMANO MARCELLO
Published: July 2024

In this work, we contribute to the knowledge of Iberian mutillids by addressing and solving the problems associated with some taxa. A new species, Physetopoda fresnoi Romano & Parejo-Pulido, sp. nov., is described from the male sex. The type material of Ph. defixa (Invrea, 1953), comb. nov., Mutilla rufipes var. dusmeti Mercet, 1905 (S. dusmeti stat. resurr.) confirming its synonymy with S. verhoeffi Suárez, 1959, and S. andradei Suárez, 1954, stat. resurr. =S. andradei notomelanicus Suárez, 1954, syn. nov. are revised. New synonymies are proposed for Dasylabris egregia (Klug, 1835) =Mutilla (Dasylabris) egregia var. atriventris (André, 1902), syn. nov. and Ph. nuptura (Mercet, 1905) =M. nuptura var. bofilli Mercet, 1905, syn. nov. We also provide the first Iberian records of S. inermus (Schwartz, 1984) and S. sicanus (De Stefani, 1887). The validity of the Iberian records of M. marginata Baer, 1848, Ronisia barbara (Linnaeus, 1758) and R. brutia (Petagna, 1787) is discussed and the distribution of S. pardoi Suárez, 1953 is clarified. A key to the males of the Iberian Physetopoda Schuster, 1949 and Smicromyrme Thomson, 1870 is provided. Our study underscores the need for further research on Iberian mutillids and emphasises the importance of type-material studies to clarify the mutillid species inhabiting the Iberian Peninsula and their current taxonomic status.
Description of two new species of the leafhopper genus Longicornus (Hemiptera: Cicadellidae: Deltocephalinae) from China
Authors: HU SHANGMI , XING JICHUN
Published: July 2024

Two new leafhopper species, Longicornus concavus sp. nov. and Longicornus nonprocessus sp. nov., are described and illustrated from Tibet Autonomous Region, China. A key based on the aedeagus is given to distinguish all species of the genus. The type specimens of the new species are deposited in the Institute of Entomology, Guizhou University, Guiyang, China (GUGC).
New frameworks for hematopoiesis derived from single-cell genomics
Authors: Safina Ksenia , van Galen Peter
Published: July 2024

Recent advancements in single-cell genomics have enriched our understanding of hematopoiesis, providing intricate details about hematopoietic stem cell biology, differentiation, and lineage commitment. Technological advancements have highlighted extensive heterogeneity of cell populations and continuity of differentiation routes. Nevertheless, intermediate “attractor” states signify structure in stem and progenitor populations that link state transition dynamics to fate potential. We discuss how innovative model systems quantify lineage bias and how stress accelerates differentiation, thereby reducing fate plasticity compared with native hematopoiesis. We conclude by offering our perspective on the current model of hematopoiesis and discuss how a more precise understanding can translate to strategies that extend healthy hematopoiesis and prevent disease.
Pathogenomics analysis of high-risk clone ST147 multidrug-resistant Klebsiella pneumoniae isolated from a patient in Egypt
Authors: Elgayar Fatma A. , Gouda Mona K. , Badran Alaa Aboelnour , El Halfawy Nancy M.
Published: July 2024

Background

The emergence of multi-drug-resistant Klebsiella pneumoniae (MDR-KP) represents a serious clinical health concern. Antibiotic resistance and virulence interactions play a significant role in the pathogenesis of K. pneumoniae infections. Therefore, tracking the clinical resistome and virulome through monitoring antibiotic resistance genes (ARG) and virulence factors in the bacterial genome using computational analysis tools is critical for predicting the next epidemic.

Methods

In the current study, one hundred extended spectrum β-lactamase (ESBL)-producing clinical isolates were collected from Mansoura University Hospital, Egypt, in a six-month period from January to June 2022. One isolate was selected due to the high resistance phenotype, and the genetic features of MDR-KP recovered from hospitalized patient were investigated. Otherwise, the susceptibility to 25 antimicrobials was determined using the DL Antimicrobial Susceptibility Testing (AST) system. Whole genome sequencing (WGS) using Illumina NovaSeq 6000 was employed to provide genomic insights into K. pneumoniae WSF99 clinical isolate.

Results

The isolate K. pneumoniae WSF99 was phenotypically resistant to the antibiotics under investigation via antibiotic susceptibility testing. WGS analysis revealed that WSF99 total genome length was 5.7 Mb with an estimated 5,718 protein-coding genes and a G + C content of 56.98 mol%. Additionally, the allelic profile of the WSF99 isolate was allocated to the high-risk clone ST147. Furthermore, diverse antibiotic resistance genes were determined in the genome that explain the high-level resistance phenotypes. Several β-lactamase genes, including blaCTX−M−15, blaTEM−1, blaTEM−12, blaSHV−11, blaSHV−67, and blaOXA−9, were detected in the WSF99 isolate. Moreover, a single carbapenemase gene, blaNDM−5, was predicted in the genome, positioned within a mobile cassette. In addition, other resistance genes were predicted in the genome including, aac(6’)-Ib, aph(3’)-VI, sul1, sul2, fosA, aadA, arr-2, qnrS1, tetA and tetC. Four plasmid replicons CoIRNAI, IncFIB(K), IncFIB(pQil), and IncR were predicted in the genome. The draft genome analysis revealed the occurrence of genetic mobile elements positioned around the ARGs, suggesting the ease of dissemination via horizontal gene transfer.

Conclusions

This study reports a comprehensive pathogenomic analysis of MDR-KP isolated from a hospitalized patient. These findings could be relevant for future studies investigating the diversity of antimicrobial resistance and virulence in Egypt.
Clinical characteristics of extracorporeal cardiopulmonary resuscitation in China: a multicenter retrospective study
Authors: Yuan Zhiyong , Liu Ying , Wei Guangyao , Wang Fuhua , Yao Bo , Hou Xiaotong , Xing Jinyan
Published: July 2024

Purpose

Extracorporeal cardiopulmonary resuscitation (ECPR) might markedly increase the survival of selected patients with refractory cardiac arrest. But the application situation and indications remained unclear.

Materials and methods

We respectively reviwed all adult patients who underwent ECPR from January 2017 to March 2021. Patient characteristics, initiation and management of ECMO, complications, and outcomes were collected and compared between the survivors and nonsurvivors. LASSO regression was used to screen risk factors. Multivariate logistic regression was performed with several parameters screened by LASSO regression.

Results

Data were reported from 42 ECMO centers covering 19 provinces of China. A total of 648 patients were included in the study, including 491 (75.8%) males. There were 11 ECPR centers in 2017, and the number increased to 42 in 2020. The number of patients received ECPR increased from 33 in 2017 to 274 in 2020, and the survival rate increased from 24.2% to 33.6%. Neurological complications, renal replacement therapy, epinephrine dosage after ECMO, recovery of spontaneous circulation before ECMO, lactate clearance and shockable rhythm were risk factors independently associated with outcomes of whole process. Sex, recovery of spontaneous circulation before ECMO, lactate, shockable rhythm and causes of arrest were pre-ECMO risk factors independently affecting outcomes.

Conclusions

From January 2017 to March 2021, the numbers of ECPR centers and cases in mainland China increased gradually over time, as well as the survival rate. Pre-ECMO risk factors, especially recovery of spontaneous circulation before ECMO, shockable rhythm and lactate, are as important as post-ECMO management,. Neurological complications are vital risk factors after ECMO that deserved close attention.

Trial registration

NCT04158479, registered on 2019/11/08. https://clinicaltrials.gov/NCT04158479
Identification of hub glycolysis-related genes in acute myocardial infarction and their correlation with immune infiltration using bioinformatics analysis
Authors: Zhang Xiaoqing , Zhang Lina , Gao Ya , Liu Zhangyu , Gong Kaizheng
Published: July 2024

Purpose

Glycolysis and immune metabolism play important roles in acute myocardial infarction (AMI). Therefore, this study aimed to identify and experimentally validate the glycolysis-related hub genes in AMI as diagnostic biomarkers, and further explore the association between hub genes and immune infiltration.

Methods

Differentially expressed genes (DEGs) from AMI peripheral blood mononuclear cells (PBMCs) were analyzed using R software. Glycolysis-related DEGs (GRDEGs) were identified and analyzed using the Database for Annotation, Visualization, and Integrated Discovery (DAVID) for functional enrichment. A protein–protein interaction network was constructed using the STRING database and visualized using Cytoscape software. Immune infiltration analysis between patients with AMI and stable coronary artery disease (SCAD) controls was performed using CIBERSORT, and correlation analysis between GRDEGs and immune cell infiltration was performed. We also plotted nomograms and receiver operating characteristic (ROC) curves to assess the predictive accuracy of GRDEGs for AMI occurrence. Finally, key genes were experimentally validated using reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and western blotting using PBMCs.

Results

A total of 132 GRDEGs and 56 GRDEGs were identified on the first day and 4–6 days after AMI, respectively. Enrichment analysis indicated that these GRDEGs were mainly clustered in the glycolysis/gluconeogenesis and metabolic pathways. Five hub genes (HK2, PFKL, PKM, G6PD, and ALDOA) were selected using the cytoHubba plugin. The link between immune cells and hub genes indicated that HK2, PFKL, PKM, and ALDOA were significantly positively correlated with monocytes and neutrophils, whereas G6PD was significantly positively correlated with neutrophils. The calibration curve, decision curve analysis, and ROC curves indicated that the five hub GRDEGs exhibited high predictive value for AMI. Furthermore, the five hub GRDEGs were validated by RT-qPCR and western blotting.

Conclusion

We concluded that HK2, PFKL, PKM, G6PD, and ALDOA are hub GRDEGs in AMI and play important roles in AMI progression. This study provides a novel potential immunotherapeutic method for the treatment of AMI.
Effect of NLRP3 gene knockdown on pyroptosis and ferroptosis in diabetic cardiomyopathy injury
Authors: Wang Jiahui , Li Yuping , Li Lu , Liang Huan , Ye Hongwei , Kang Pinfang , Li Zhenghong , Yu Ying , Gao Qin
Published: July 2024

Diabetic cardiomyopathy (DCM) is a chronic disease caused by diabetes mellitus, which is recognized as a worldwide challenging disease. This study aimed to investigate the role and the potential mechanism of knocking down the NACHT-, LRR- and PYD domains-containing protein 3 (NLRP3), an inflammasome associated with onset and progression of various diseases, on high glucose or diabetes -induced cardiac cells pyroptosis and ferroptosis, two regulated non-necrosis cell death modalities discovered recent years. In the present study, both in vivo and in vitro studies were conducted simultaneously. Diabetic rats were induced by 55 mg/kg intraperitoneal injection of streptozotocin (STZ). Following the intraperitoneal injection of MCC950 (10 mg/kg), On the other hand, the DCM model in H9C2 cardiac cells was simulated with 35 mmol/L glucose and a short hairpin RNA vector of NLRP3 were transfected to cells. The results showed that in vivo study, myocardial fibers were loosely arranged and showed inflammatory cell infiltration, mitochondrial cristae were broken and the GSDMD-NT expression was found notably increased in the DM group, while the protein expressions of xCT and GPX4 was significantly decreased, both of which were reversed by MCC950. High glucose reduced the cell viability and ATP level in vitro, accompanied by an increase in LDH release. All of the above indicators were reversed after NLRP3 knockdown compared with the HG treated alone. Moreover, the protein expressions of pyroptosis- and ferroptosis-related fators were significantly decreased or increased, consistent with the results shown by immunofluorescence. Furthermore, the protective effects of NLRP3 knockdown against HG were reversed following the mtROS agonist rotenone (ROT) treatment. In conclusion, inhibition of NLRP3 suppressed DM-induced myocardial injury. Promotion of mitochondrial ROS abolished the protective effect of knockdown NLRP3, and induced the happening of pyroptosis and ferroptosis. These findings may present a novel therapeutic underlying mechanism for clinical diabetes-induced myocardial injury treatment.
Community-based exercises improve health status in pre-frail older adults: A systematic review with meta-analysis
Authors: Lim Huijun , Jani Nur Dalilah Binte , Pang Wai Teng , Lim Edwin Choon Wyn
Published: July 2024

Background

Pre-frailty is associated with increased healthcare utilization. Over the past decade, public health interventions such as community-based exercises to target pre-frailty have been increasingly studied. However, the effects of community-based exercises on clinical outcome measures amongst community-dwelling older adults with pre-frailty remain unclear. This review aims to better understand the effects of community-based exercise on physical function, cognition, quality of life and frailty status in community-dwelling pre-frail older adults. A secondary objective was to investigate the optimal exercise parameters on clinical outcomes.

Methods

Searches of MEDLINE, CINAHL, Google Scholar and Web of Science databases were conducted. Articles were included if they were randomized controlled trials (RCTs), and excluded if the participants consist of less than 50% pre-frail community-dwelling older adults. Meta-analyses (where possible) with either a fixed- or random- effect(s) model, standardized mean difference (SMD), odds ratio (OR) and tests of heterogeneity were performed. Multivariable meta-regression was performed to identify predictors of statistically significant outcome measures. The risk of bias was assessed using the modified Cochrane Risk-of-Bias tool.

Results

Twenty-two RCTs with 900 participants in the experimental group and 1015 participants in the control group were included. When compared to minimal intervention, community-based exercises significantly improved lower limb strength (10 RCTs, 384 participants in the experimental group and 482 participants in the control group) with SMD 0.67 (95% CI 0.29 to 1.04), and lower limb function (5 RCTs, 120 participants in the experimental group and 219 participants in the control group) with SMD 0.27 (95% CI 0.03 to 0.51). Those who have received community-based exercises were more likely to reverse from pre-frailty to healthy state (OR = 2.74, 95% CI 1.36 to 5.51) (6 RCTs, 263 participants in the experimental group and 281 participants in the control group). The frequency of exercise sessions was a significant predictor of the effect size for gait speed (P<0.05).

Conclusions

Community-based exercise intervention is superior to minimal intervention for improving health status in pre-frail older adults. This has implications on the implementation of community-based exercise intervention by healthcare providers and policymakers.

Other

Nil funding for this review. PROSPERO registration number CRD42022348556.
The impact of discharge letter content on unplanned hospital readmissions within 30 and 90 days in older adults with chronic illness – a mixed methods study
Authors: Adelsjö Igor , Lehnbom Elin C. , Hellström Amanda , Nilsson Lina , Flink Maria , Ekstedt Mirjam
Published: July 2024

Background

Care transitions are high-risk processes, especially for people with complex or chronic illness. Discharge letters are an opportunity to provide written information to improve patients’ self-management after discharge. The aim of this study is to determine the impact of discharge letter content on unplanned hospital readmissions and self-rated quality of care transitions among patients 60 years of age or older with chronic illness.

Methods

The study had a convergent mixed methods design. Patients with chronic obstructive pulmonary disease or congestive heart failure were recruited from two hospitals in Region Stockholm if they were living at home and Swedish-speaking. Patients with dementia or cognitive impairment, or a “do not resuscitate” statement in their medical record were excluded. Discharge letters from 136 patients recruited to a randomised controlled trial were coded using an assessment matrix and deductive content analysis. The assessment matrix was based on a literature review performed to identify key elements in discharge letters that facilitate a safe care transition to home. The coded key elements were transformed into a quantitative variable of “SAFE-D score”. Bivariate correlations between SAFE-D score and quality of care transition as well as unplanned readmissions within 30 and 90 days were calculated. Lastly, a multivariable Cox proportional hazards model was used to investigate associations between SAFE-D score and time to readmission.

Results

All discharge letters contained at least five of eleven key elements. In less than two per cent of the discharge letters, all eleven key elements were present. Neither SAFE-D score, nor single key elements correlated with 30-day or 90-day readmission rate. SAFE-D score was not associated with time to readmission when adjusted for a range of patient characteristics and self-rated quality of care transitions.

Conclusions

While written summaries play a role, they may not be sufficient on their own to ensure safe care transitions and effective self-care management post-discharge.

Trial registration

Clinical Trials. giv, NCT02823795, 01/09/2016.
In silico homology modeling of dengue virus non-structural 4B (NS4B) protein and its molecular docking studies using triterpenoids
Authors: Ali Sajid , Ali Usman , Safi Khushboo , Naz Falak , Jan Muhammad Ishtiaq , Iqbal Zafar , Ali Tahir , Ullah Riaz , Bari Ahmed
Published: July 2024

Background

Dengue fever has become a significant worldwide health concern, because of its high morbidity rate and the potential for an increase in mortality rates due to lack of adequate treatment. There is an immediate need for the development of effective medication for dengue fever.

Methods

Homology modeling of dengue virus (DENV) non-structural 4B (NS4B) protein was performed by SWISS-MODEL to predict the 3D structure of the protein. Structure validation was conducted using PROSA, PROCHECK, Ramachandran plot, and VERIFY-3D. MOE software was used to find out the in-Silico inhibitory potential of the five triterpenoids against the DENV-NS4B protein.

Results

The SWISS-MODEL was employed to predict the three-dimensional protein structure of the NS4B protein. Through molecular docking, it was found that the chosen triterpenoid NS4B protein had a high binding affinity interaction. It was observed that the NS4B protein binding energy for 15-oxoursolic acid, betulinic acid, ursolic acid, lupeol, and 3-o-acetylursolic acid were − 7.18, − 7.02, − 5.71, − 6.67 and − 8.00 kcal/mol, respectively.

Conclusions

NS4B protein could be a promising target which showed good interaction with tested triterpenoids which can be developed as a potential antiviral drug for controlling dengue virus pathogenesis by inhibiting viral replication. However, further investigations are necessary to validate and confirm their efficacy.
Randomized investigation of increased dialyzer membrane hydrophilicity on hemocompatibility and performance
Authors: Ehlerding Götz , Ries Wolfgang , Kempkes-Koch Manuela , Ziegler Ekkehard , Ronová Petra , Krizsán Mária , Verešová Jana , Böke Mária , Erlenkötter Ansgar , Nitschel Robert , Zawada Adam M. , Kennedy James P. , Braun Jennifer , Larkin John W. , Korolev Natalia , Lang Thomas , Ottillinger Bertram , Stauss-Grabo Manuela , Griesshaber Bettina
Published: July 2024

Background

Hemodialyzers should efficiently eliminate small and middle molecular uremic toxins and possess exceptional hemocompatibility to improve well-being of patients with end-stage kidney disease. However, performance and hemocompatibility get compromised during treatment due to adsorption of plasma proteins to the dialyzer membrane. Increased membrane hydrophilicity reduces protein adsorption to the membrane and was implemented in the novel FX CorAL dialyzer. The present randomized controlled trial compares performance and hemocompatibility profiles of the FX CorAL dialyzer to other commonly used dialyzers applied in hemodiafiltration treatments.

Methods

This prospective, open, controlled, multicentric, interventional, crossover study randomized stable patients on post-dilution online hemodiafiltration (HDF) to FX CorAL 600, FX CorDiax 600 (both Fresenius Medical Care) and xevonta Hi 15 (B. Braun) each for 4 weeks. Primary outcome was β2-microglobulin removal rate (β2-m RR). Non-inferiority and superiority of FX CorAL versus comparators were tested. Secondary endpoints were RR and/or clearance of small and middle molecules, and intra- and interdialytic profiles of hemocompatibility markers, with regards to complement activation, cell activation/inflammation, platelet activation and oxidative stress. Further endpoints were patient reported outcomes (PROs) and clinical safety.

Results

82 patients were included and 76 analyzed as intention-to-treat (ITT) population. FX CorAL showed the highest β2-m RR (76.28%), followed by FX CorDiax (75.69%) and xevonta (74.48%). Non-inferiority to both comparators and superiority to xevonta were statistically significant. Secondary endpoints related to middle molecules corroborated these results; performance for small molecules was comparable between dialyzers. Regarding intradialytic hemocompatibility, FX CorAL showed lower complement, white blood cell, and platelet activation. There were no differences in interdialytic hemocompatibility, PROs, or clinical safety.

Conclusions

The novel FX CorAL with increased membrane hydrophilicity showed strong performance and a favorable hemocompatibility profile as compared to other commonly used dialyzers in clinical practice. Further long-term investigations should examine whether the benefits of FX CorAL will translate into improved cardiovascular and mortality endpoints.

Trial registration

eMPORA III registration on 19/01/2021 at ClinicalTrials.gov (NCT04714281).
miRNAs: possible regulators of toll like receptors and inflammatory tumor microenvironment in colorectal cancer
Authors: Matboli Marwa , Hossam Nourhan , Farag Doaa , Hassan Mohamed , Shehata Hanan , Aboelhussein Marwa , Ismail Nahed , Eissa Sanaa
Published: July 2024

Background

Colorectal cancer (CRC) is ranked as the third most commonly diagnosed cancer and the third cause of cancer related deaths. CRC is greatly attributed to genetic and epigenetic mutations and immune dysregulation. Tumor aberrant expression of Toll-like Receptors (TLRs) can contribute to tumorigenesis. Recent studies suggested that microRNAs act as direct ligands of TLRs altering their expression and signaling pathways.

Aim

To prove our concept that specific miRNA mimics may act as antagonists of their specific toll like receptors inhibiting their expression that could limit the release of pro-inflammatory and pro-tumorigenic cytokines leading to apoptosis of tumor cells.

Methods

From public microarray databases, we retrieved TLRs and miRNAs related to CRC followed by in silico docking of the selected miRNA ligands into the TLRs. Clinical validation after co-immunoprecipitation of TLRs and their interacting miRNA ligands was done. Expression of TLRs 1, 7,8 was determined by ELISA while miRNAs was measured by RT-qPCR. In addition, microRNA mimics of the down regulated miRNAs were transfected into human CRC cell lines.

Results

Our data demonstrate that TLRs 1, 7, 8 are up regulated in CRC compared to controls. Further, three miRNAs (-122, -29b and -15b) are relatively downregulated, while 4 miRNAs (-202, miRNA-98, -21 and -let7i) are upregulated in CRC patients compared to those with benign tumor and healthy controls. Transfection of down regulated miRNA mimics into CRC cell lines resulted in a significant reduction of the number and viability of cells as well as down regulating the expression of TLRs 1, 7 and 8 with ultimate reduction of downstream effector IL6 protein, suggesting that these miRNAs are negative regulators of carcinogenesis.

Conclusion

MicroRNAs could act as antagonistic ligands of TLRs limiting the inflammatory tumor microenvironment.
Trichohepatoenteric syndrome type 1: expanding the clinical spectrum of THES type 1 due to a homozygous variant in the SKIC3 gene
Authors: Alrammal Abdullah , Aljundi Rashed , Abu Ghedda Sedra , AlMurbati Buthaina Mustafa
Published: July 2024

Trichohepatoenteric syndrome (THES), also known as phenotypic diarrhea or syndromic diarrhea, is a rare autosomal recessive genetic disorder caused by mutations in SKIC2 (THES-type 2) or SKIC3 (THES-type 1) and is characterized by early onset diarrhea, woolly brittle hair, facial dysmorphic features and liver disease. We report the case of a 24-month-old girl who presented with chronic diarrhea since the neonatal period along with intrauterine growth restriction (IUGR), developmental delay, dysmorphic features, congenital heart defects, liver disease, and recurrent infections. The diagnosis was made through whole-exome sequencing analysis, which detected a homozygous variant (c.4070del, p.Pro1357Leufs*10) in the SKIC3 gene. The patient required parenteral nutrition and was hospitalized for the first 10 months of life and then discharged on PN after showing improvement. She remained stable on PN after discharge despite a few admissions for central line infections. Recent follow-up at the age of 2 years revealed that she was stable on long-term parenteral nutrition and that she had advanced chronic liver disease.
Relationship between social participation and depressive symptoms in patients with multimorbidity: the chained mediating role of cognitive function and activities of daily living
Authors: Ge Huaiju , Dong Shihong , Su Wenyu , Guan Weimin , Yu Qing , Liu Yan , Qi Yuantao , Sun Xialing , Zhang Huiqing , Ma Guifeng
Published: July 2024

Objective

The potential mechanisms linking social participation and depressive symptoms in Chinese individuals with multimorbidity are not yet fully understood. This study aims to explore how cognitive function and activities of daily living (ADLs) mediate the relationship between social participation and depressive symptoms in individuals with multimorbidity.

Methods

We selected 3782 participants with multimorbidity from the 2018 China Health and Retirement Longitudinal Study. Data related to social participation, cognitive function, ADLs, and depressive symptoms were extracted. Regression and Bootstrap analyses were used to explore the sequential mediating effects of social participation, cognitive function, ADLs, and depressive symptoms.

Results

(1) There was a significant correlation between social participation, cognitive function, activities of daily living, and depressive symptoms (p < 0.01). (2) Social participation directly affected depressive symptoms (β = -0.205, p < 0.05). (3) Cognitive function (β = -0.070, p < 0.01) and activities of daily living (β = -0.058, p < 0.01) played separate mediating roles in the effect of social participation on depressive symptoms. (4) Cognitive function and activities of daily living had a chain-mediated role in the relationship between social participation and depressive symptoms in patients with multimorbidity (β = -0.020, p < 0.01).

Conclusion

A chained mediating effect was found between cognitive function, ADLs, social participation, and depressive symptoms in patients with multimorbidity. Social participation was found to improve the cognitive function of patients with multimorbidity, which in turn enhanced their daily life activities and ultimately alleviated their depressive symptoms.
Assessing the impact of small firm dynamics on public mental health amid the pandemic in Latin America
Authors: Díaz Fernando , Henríquez Pablo A.
Published: July 2024

Objective

The aim of our study is to examine the relationship between the economic activity of small firms and the mental well-being of the population in five Latin American countries in the early stages of the pandemic.

Methods

We utilize the search volume of certain keywords on Google Trends (GT), such as “boredom,” “frustration,” “loneliness,” “sleep”, “anxiety”, and “depression”, as an indicator of the well-being of the population. By examining the data from Facebook Business Activity Trends, we investigate how social attention reacts to the activity levels of different economic sectors.

Results

Increased business activity is generally associated with reduced levels of boredom, loneliness, sleep problems and anxiety. The effect on depression varies by sector, with positive associations concentrated in onsite jobs. In addition, we observe that strict Non-Pharmaceutical Interventions (NPIs) tend to exacerbate feelings of boredom and loneliness, sleep issues, and anxiety.

Conclusions

Our findings suggest a strong association between different indicators of psychological well-being and the level of activity in different sectors of the economy. Given the essential role of small and medium-sized enterprises (SMEs) in generating employment, especially during crises like the pandemic, it is imperative that they remain resilient and adaptable to support economic recovery and job preservation. To accomplish this, policymakers need to focus on providing financial stability and support for SMEs, fostering social support networks within companies, and incorporating mental health services into workplace environments. This comprehensive strategy can alleviate mental health challenges and enhance public health resilience.
A separate-dural-incision method of extradural dumbbell spinal schwannoma resection: cumulative experience at a single center
Authors: Jia Li , Zeng Minghui , Xi Zhiyu , Wang Lin , Liu Jiang
Published: July 2024

Objective

To present our experience in the surgical management of completely extradural dumbbell spinal schwannomas with a new surgical strategy.

Method

This study is a case series of patients treated at the Neurosurgery Department of the First Affiliated Hospital of USTC, between January 2018 and June 2021.

Results

24 patients met the inclusion criteria, with cervical and lumbar spines being the most frequent locations. All patients underwent surgical treatment. Total gross resection was accomplished in all patients. Two cases had numbness and no case exhibited motor deficit. There was no postoperative CSF leakage or wound infection.

Conclusion

Based on a limited number of observations, we conclude that our technique was feasible and effective for the treatment of extradural dumbbell spinal schwannomas.

Clinical trial

http://www.chictr.org.cn/, No. ChiCTR2400086171.
Development and validation of a scale to measure the care needs of Crohn’s disease patients: a mixed-methods study
Authors: Chen Danlei , Liu Qing , Yu Zhihui , Pan Ting , Zhang Ailing , Chen Yan , Kong Fang , Ding ChengLiang
Published: July 2024

Background

Crohn’s disease (CD) patients require varying levels of supportive care. In order to facilitate caregivers and nurses in precisely evaluating the caregiving requirements of these patients, we developed the CD-specific Care Needs Scale (CD-CNS).

Methods

This study employed a mixed-methods approach, integrating qualitative and quantitative methodologies. The initial items of the scale were developed through qualitative interviews, Delphi expert consultation, and literature review, while the final items were refined through clinical testing. Qualitative interviews were conducted based on the supportive care needs framework and Maslow’s hierarchy of needs, and scale items were constructed through a literature search and qualitative interviews. The initial version of the scale with 45 items was obtained after the items were verified and modified by expert consultation. A total of 250 CD patients admitted to the gastroenterology department of a hospital in China were selected for verification of the initial version of the scale. A self-designed general questionnaire was used to obtain patients’ medical history and sociodemographic data, and the Chinese version of the Inflammatory Bowel Disease Questionnaire (IBDQ) was used as the criterion. Exploratory factor analysis (EFA) was performed on the CD-CNS to evaluate the dimensions, factor structure, reliability, criterion validity, and construct validity.

Results

EFA identified 5 dimensions and retained 27 items with strong internal consistency reliability (α = 0.940). The Cronbach’s α coefficients for each dimension ranged from 0.824 to 0.921. Criterion validity was assessed using Spearman’s coefficient, which demonstrated a significant correlation with the IBDQ (P < 0.050). The test-retest reliability for each dimension after two weeks ranged from 0.655 to 0.895.

Conclusions

We developed and validated a new scale that can be used to assess the care needs of CD patients. This new tool can guide the specific supportive care of CD patients.

Trial registration

This study was reviewed and approved by the Ethics Committee of the Second Hospital of Nanjing (2021-LS-ky-022). The study was duly registered and approved online through the Trial Center of the Second Hospital of Nanjing in 2021. Confidentiality was ensured by anonymizing all the data. The entire study process was conducted under the supervision of the Ethics Committee of Nanjing Second Hospital. Informed consent was obtained from the patients, and each patient volunteered and agreed to participate.
Prediction of COVID-19 patients’ participation in financing informal care using machine learning methods: willingness to pay and willingness to accept approaches
Authors: Ramezani-Doroh Vajihe , Najafi-Ghobadi Somayeh , Karimi Faride , Rangchian Maryam , Hamidi Omid
Published: July 2024

Background

Informal care plays an essential role in managing the COVID-19 pandemic. Expanding health insurance packages that reimburse caregivers' services through cost-sharing policies could increase financial resources. Predicting payers' willingness to contribute financially accurately is essential for implementing such a policy. This study aimed to identify the key variables related to WTP/WTA of COVID-19 patients for informal care in Sanandaj city, Iran.

Methods

This cross-sectional study involved 425 COVID-19 patients in Sanandaj city, Iran, and 23 potential risk factors. We compared the performance of three classifiers based on total accuracy, specificity, sensitivity, negative likelihood ratio, and positive likelihood ratio.

Results

Findings showed that the average total accuracy of all models was over 70%. Random trees had the most incredible total accuracy for both patient WTA and patient WTP(0.95 and 0.92). Also, the most significant specificity (0.93 and 0.94), sensitivity (0.91 and 0.87), and the lowest negative likelihood ratio (0.193 and 0.19) belonged to this model. According to the random tree model, the most critical factor in patient WTA were patient difficulty in personal activities, dependency on the caregiver, number of caregivers, patient employment, and education, caregiver employment and patient hospitalization history. Also, for WTP were history of COVID-19 death of patient's relatives, and patient employment status.

Conclusion

Implementing of a more flexible work schedule, encouraging employer to support employee to provide informal care, implementing educational programs to increase patients' efficacy, and providing accurate information could lead to increased patients' willingness to contribute and finally promote health outcomes in the population.