bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient-perceived barriers to early initiation of prenatal care at a large, urban federally qualified health center: a mixed-methods study
Authors: Holt Valerie N. , Pelegrí Elan , Hardy Mary , Buchin Lindsey , Dapkins Isaac , Chuang Meleen
Published: June 2024

Background

Early initiation of prenatal care is widely accepted to improve the health outcomes of pregnancy for both mothers and their infants. Identification of the various barriers to entry into care that patients experience may inform and improve health care provision and, in turn, improve the patient’s ability to receive necessary care.

Aim

This study implements a mixed-methods approach to establish methods and procedures for identifying barriers to early entry to prenatal care in a medically-vulnerable patient population and areas for future quality improvement initiatives.

Methods

An initial chart review was conducted on obstetrics patients that initiated prenatal care after their first trimester at a large federally qualified health center in Brooklyn, NY, to determine patient-specified reasons for delay. A thematic analysis of these data was implemented in combination with both parametric and non-parametric analyses to characterize the population of interest, and to identify the primary determinants of delayed entry.

Results

The age of patients in the population of interest (n = 169) was bimodal, with a range of 15 – 43 years and a mean of 28 years. The mean gestational age of entry into prenatal care was 19 weeks. The chart review revealed that 8% recently moved to Brooklyn from outside of NYC or the USA. Nine percent had difficulty scheduling an initial prenatal visit within their first trimester. Teenage pregnancy accounted for 7%. Provider challenges with documentation (21%) were noted. The most common themes identified (n = 155) were the patient being in transition (21%), the pregnancy being unplanned (17%), and issues with linkage to care (15%), including no shows or patient cancellations. Patients who were late to prenatal care also differed from their peers dramatically, as they were more likely to be Spanish-speaking, to be young, and to experience a relatively long delay between pregnancy confirmation and entry into care. Moreover, the greatest determinant of delayed entry into care was patient age.

Conclusion

Our study provides a process for other like clinics to identify patients who are at risk for delayed entry to prenatal care and highlight common barriers to entry. Future initiatives include the introduction of a smart data element to document reasons for delay and use of community health workers for dedicated outreach after no show appointments or patient cancellations.
Do promotions of healthier or more sustainable foods increase sales? Findings from three natural experiments in UK supermarkets
Authors: Luick Madison , Bandy Lauren , Piernas Carmen , Jebb Susan A. , Pechey Rachel
Published: June 2024

Background

Dietary changes are necessary to improve population health and meet environmental sustainability targets. Here we analyse the impact of promotional activities implemented in UK supermarkets on purchases of healthier and more sustainable foods.

Methods

Three natural experiments examined the impact of promotional activities on sales of a) no-added-sugar (NAS) plant-based milk (in 199 stores), b) products promoted during ‘Veganuary’ (in 96 stores), and c) seasonal fruit (in 100 non-randomised intervention and 100 matched control stores). Data were provided on store-level product sales, in units sold and monetary value (£), aggregated weekly. Predominant socioeconomic position (SEP) of the store population was provided by the retailer. Analyses used interrupted time series and multivariable hierarchical mixed-effects models.

Results

Sales of both promoted and total NAS plant-based milks increased significantly during the promotional period (Promoted:+126 units, 95%CI: 105–148; Overall:+307 units, 95%CI: 264–349). The increase was greater in stores with predominately low SEP shoppers. During Veganuary, sales increased significantly for plant-based foods on promotion (+60 units, 95%CI: 37–84), but not for sales of plant-based foods overall (dairy alternatives: -1131 units, 95%CI: -5821–3559; meat alternatives: 1403 units, 95%CI: -749–3554). There was no evidence of a change in weekly sales of promoted seasonal fruit products (assessed via ratio change in units sold: 0.01, 95%CI: 0.00–0.02), and overall fruit category sales slightly decreased in intervention stores relative to control (ratio change in units sold: -0.01, 95%CI: -0.01–0.00).

Conclusion

During promotional campaigns there was evidence that sales of plant-based products increased, but not seasonal fruits. There was no evidence for any sustained change beyond the intervention period.
Medicinal flora of the baiku yao people — An ethnobotanical documentation in South China
Authors: Li Tingting , Luo Binsheng , Tong Yuanming , Wei Guiyuan , Chai Ling , Hu Renchuan
Published: June 2024

Background

This study explores the medicinal plant knowledge of the Baiku Yao, a unique ethnic group in China. Despite existing research on their ethnobotanical practices, a comprehensive understanding of their medicinal flora remains lacking. This study aims to document and analyze the species distribution, utilization, and traditional knowledge of medicinal plants used by Baiku Yao.

Methods

Ethnobotanical surveys were conducted in various Baiku Yao villages across different seasons from 2019 to 2023. Informants were interviewed, and plant specimens were collected and identified. Statistical analyses, including the Relative Frequency of Citation (RFC), were employed to understand plant importance in Baiku Yao culture.

Results

In an ethnobotanical survey conducted in the Baiku Yao region, 434 medicinal plant species were documented, highlighting significant ethnobotanical diversity and a deep cultural integration of traditional medicinal practices. The study revealed pronounced geographical variations in plant knowledge among villages, with a notable reliance on wild plants, as 85.48% were sourced from the wild, reflecting unique local ethnobotanical knowledge. Predominantly herbs and shrubs were used due to their accessibility and abundance in the local environment. High Relative Frequency of Citation (RFC) values for certain species underscored their importance for local health needs and additional economic value. The utilization of various plant parts, particularly whole plants, roots, and leaves, indicates a holistic approach to medicinal applications, adapted to combat prevalent health issues such as skin and infectious diseases. The study also uncovered the Baiku Yao’s cultural practices for countering “Gu” afflictions—a range of pathogenic conditions—with 18 diverse antidote plants used for skin, digestive, and musculoskeletal disorders. The study underscores the imperative of preserving this rich medicinal heritage through innovative models that engage youth and leverage new media, ensuring the inheritance and evolution of Baiku Yao’s traditional knowledge.

Conclusions

Baiku Yao’s medicinal plant use reflects a deep, culturally ingrained knowledge, closely tied to local ecology. The study highlights the importance of preserving this unique ethnobotanical heritage and suggests interdisciplinary approaches for future research.
COVID-19 healthcare success or failure? Crisis management explained by dynamic capabilities
Authors: Rosenbäck Ritva , Eriksson Kristina M.
Published: June 2024

Introduction

This paper presents a structured review of the use of crisis management, specifically examining the frameworks of surge capacity, resilience, and dynamic capabilities in healthcare organizations. Thereafter, a novel deductive method based on the framework of dynamic capabilities is developed and applied to investigate crisis management in two hospital cases during the COVID-19 pandemic.

Background

The COVID-19 pandemic distinguishes itself from many other disasters due to its global spread, uncertainty, and prolonged duration. While crisis management in healthcare has often been explained using the surge capacity framework, the need for adaptability in an unfamiliar setting and different information flow makes the dynamic capabilities framework more useful.

Methods

The dynamic capabilities framework’s microfoundations as categories is utilized in this paper for a deductive analysis of crisis management during the COVID-19 pandemic in a multiple case study involving two Swedish public hospitals. A novel method, incorporating both dynamic and static capabilities across multiple organizational levels, is developed and explored.

Results

The case study results reveal the utilization of all dynamic capabilities with an increased emphasis at lower organizational levels and a higher prevalence of static capabilities at the regional level. In Case A, lower-level managers perceived the hospital manager as brave, supporting sensing, seizing, and transformation at the department level. However, due to information gaps, sensing did not reach regional crisis management, reducing their power. In Case B, with contingency plans not initiated, the hospital faced a lack of management and formed a department manager group for patient care. Seizing was robust at the department level, but regional levels struggled with decisions on crisis versus normal management. The novel method effectively visualizes differences between organizational levels and cases, shedding light on the extent of cooperation or lack thereof within the organization.

Conclusion

The researchers conclude that crisis management in a pandemic, benefits from distributed management, attributed to higher dynamic capabilities at lower organizational levels. A pandemic contingency plan should differ from a plan for accidents, supporting the development of routines for the new situation and continuous improvement. The Dynamic Capabilities framework proved successful for exploration in this context.
Associations between the TyG index and the ɑ-Klotho protein in middle-aged and older population relevant to diabetes mellitus in NHANES 2007–2016
Authors: Qiu Shujuan , Li Chunlei , Zhu Jinhua , Guo Zhentao
Published: June 2024

Background

The anti-aging protein Klotho has diverse functions in antioxidative stress and energy metabolism through several pathways. While it has been reported that α-Klotho is downregulated in patients with insulin resistance (IR), the association between Klotho and IR is complex and controversial. The triglyceride-glucose (TyG) index has provided a practical method for assessing IR. With this in mind, our study aimed to investigate the relationship between the TyG index and soluble α-Klotho protein levels in US populations, both with and without diabetes mellitus.

Methods

This cross-sectional study analyzed data from middle-aged and older participants in the National Health and Nutrition Examination Survey (NHANES) conducted between 2007 and 2016. The participants were divided into two groups based on their diabetes mellitus status: those with diabetes and those without diabetes. To evaluate the relationship between the TyG index and the concentration of the α-Klotho protein in each group, a series of survey-weighted multivariable linear regression models were employed. Furthermore, to examine the association between these two variables, multivariable-adjusted restricted cubic spline curves and subgroup analysis were generated.

Results

The study involved 6,439 adults aged 40 years or older, with a mean age of 57.8 ± 10.9 years. Among them, 1577 (24.5%) had diabetes mellitus. A subgroup analysis indicated that the presence of diabetes significantly affected the relationship between the TyG index and the α-Klotho level. After considering all covariables, regression analysis of the participants without diabetes revealed that the α-Klotho concentration decreased by 32.35 pg/ml (95% CI: -50.07, -14.64) with each one unit increase in TyG (p < 0.001). The decline in α-Klotho levels with elevated TyG was more pronounced in the female population. In patients with diabetes mellitus, a non-linear association between the TyG index and α-Klotho was observed. There was no significant correlation observed between the two when TyG index were below 9.7. However, there was an increase in klotho levels of 106.44 pg/ml for each unit increase in TyG index above 9.7 (95% CI: 28.13, 184.74) (p = 0.008).

Conclusion

Our findings suggested that the presence of diabetes may influence the relationship between the TyG index and soluble α-Klotho. Furthermore, there seem to be sex differences in individuals without diabetes. Further studies are necessary to validate these findings.
Identification of the central role of RNA polymerase mitochondrial for angiogenesis
Authors: Huan Meng-Jia , Fu Ping-ping , Chen Xia , Wang Zhao-Xia , Ma Zhou-rui , Cai Shi-zhong , Jiang Qin , Wang Qian
Published: June 2024

Mitochondria are central to endothelial cell activation and angiogenesis, with the RNA polymerase mitochondrial (POLRMT) serving as a key protein in regulating mitochondrial transcription and oxidative phosphorylation. In our study, we examined the impact of POLRMT on angiogenesis and found that its silencing or knockout (KO) in human umbilical vein endothelial cells (HUVECs) and other endothelial cells resulted in robust anti-angiogenic effects, impeding cell proliferation, migration, and capillary tube formation. Depletion of POLRMT led to impaired mitochondrial function, characterized by mitochondrial depolarization, oxidative stress, lipid oxidation, DNA damage, and reduced ATP production, along with significant apoptosis activation. Conversely, overexpressing POLRMT promoted angiogenic activity in the endothelial cells. In vivo experiments demonstrated that endothelial knockdown of POLRMT, by intravitreous injection of endothelial specific POLRMT shRNA adeno-associated virus, inhibited retinal angiogenesis. In addition, inhibiting POLRMT with a first-in-class inhibitor IMT1 exerted significant anti-angiogenic impact in vitro and in vivo. Significantly elevated expression of POLRMT was observed in the retinal tissues of streptozotocin-induced diabetic retinopathy (DR) mice. POLRMT endothelial knockdown inhibited pathological retinal angiogenesis and mitigated retinal ganglion cell (RGC) degeneration in DR mice. At last, POLRMT expression exhibited a substantial increase in the retinal proliferative membrane tissues of human DR patients. These findings collectively establish the indispensable role of POLRMT in angiogenesis, both in vitro and in vivo.
A follow-up study of vibration-induced injuries in workers exposed to transient and high frequency vibrations
Authors: Gerhardsson Lars
Published: June 2024

Background

In a previous study from 2018, 38 wheel loader assembly workers were examined, showing high exposures to transient and high-frequency vibrations. After the investigation, preventive measures were immediately implemented to reduce the vibration exposure. In 2022, a follow-up study was carried out to examine the effect of these measures.

Methods

The follow-up study included 35 (27 men and 8 women) of the original 38 workers. They were divided into two groups, 24 workers with ongoing vibration exposure and 11 workers, not vibration exposed since 2018. All participants completed a questionnaire and underwent a thorough examination, including several neurophysiological tests and a comprehensive assessment of musculoskeletal symptoms. The questionnaire responses and on-site vibration level measurements formed the basis for the individual vibration exposure assessment.

Results

In 2018, clear differences were noted between the two groups regarding vibration perception thresholds (VPT), needle test, 2-PD (2-point discrimination), and monofilament test with deviating results in the unexposed group. The difference between the two groups was significantly smaller at the follow-up examination in 2022, where differences remained for VPT and monofilament tests, with deviating test results in the unexposed group. When comparing variable values between 2018 and 2022 within the exposed and unexposed groups, respectively, the unexposed group showed mostly unchanged values, while a deterioration was observed for VPT, needle test and temperature sensitivity test among the exposed workers during follow-up. The prevalence of VWF (Vibration white fingers) was around 30–40% and neuropathy around 75% among exposed workers during follow-up compared to about 60% and 85% respectively, in the unexposed group.

Conclusion

The overall categorization of white fingers and neuropathy, according to the Stockholm Workshop Scale, remained largely unchanged in both study groups from 2018 to 2022. The introduction of cost-effective and relatively simple preventive measures may have contributed to this result. Throughout the follow-up period, the number of exposed workers who developed musculoskeletal disorders and newly reported cases of vibration injuries at the factory decreased. Without this preventive program, increased vascular and nerve symptoms would most likely have occurred during follow-up due to continued vibration exposure.
Attitudes toward and training in medications for opioid use disorders: a descriptive analysis among employees in the youth legal system and community mental health centers
Authors: O’Reilly Lauren M. , Schwartz Katherine , Brown Steven A. , Dir Allyson , Gillenwater Logan , Adams Zachary , Zapolski Tamika , Hulvershorn Leslie A. , Aalsma Matthew
Published: June 2024

Background

Research demonstrates gaps in medications for opioid use disorder uptake (MOUDs; methadone, buprenorphine, and naltrexone) especially among adolescents. These gaps may be partly attributable to attitudes about and training in MOUDs among youth-serving professionals. We extended prior research by conducting descriptive analyses of attitudes regarding effectiveness and acceptability of MOUDs, as well as training in MOUDs, among youth legal system (YLS) employees and community mental health center (CMHC) personnel who interface professionally with youth.

Methods

Using survey data from participants (n = 181) recruited from eight Midwest counties, we examined: (1) differences in MOUD attitudes/training by MOUD type and (2) by respondent demographics, and (3) prediction of MOUD attitudes/training by participant-reported initiatives to implement evidence-based practices (EBPs), workplace culture around EBPs, and workplace stress. Attitudes and training were measured in reference to five MOUD types (methadone, oral buprenorphine, injectable buprenorphine, oral naltrexone, injectable naltrexone) on three subscales (effectiveness, acceptability, training).

Results

Wilcoxon signed-rank tests demonstrated that most outcomes differed significantly by MOUD type (differences observed among 22 of 30 tests). Kruskal-Wallis tests suggested MOUD differences based on demographics. For methadone, CMHC providers endorsed greater perceived effectiveness than YLS providers and age explained significant differences in perceived effectiveness. For buprenorphine, CHMC providers viewed oral or injectable buprenorphine as more effective than YLS employees, respondents from more rural counties viewed oral buprenorphine as more effective than those from less rural counties, and age explained differences in perceived effectiveness. For naltrexone, perceived gender differed by gender. Hierarchical ordinal logistic regression analysis did not find an association between personal initiatives to implement EBPs, workplace culture supporting EBPs, or workplace stress and effectiveness or acceptability of MOUDs. However, personal initiatives to implement EBPs was associated with training in each MOUD.

Conclusions

These results highlight a few key findings: effectiveness/acceptability of and training in MOUDs largely differ by MOUD type; setting, rurality, age, gender, and education explain group differences in perceived effectiveness of and training in MOUDs; and implementing EBPs is associated with training in MOUDs. Future research would benefit from examining what predicts change in MOUD attitudes longitudinally.
Analysis of long non-coding RNA RMRP in the diagnosis and prognosis of coronary artery disease
Authors: Xiao Haiyan , Pu Jun , Jiang Gaxue , Pan Chenliang , Xu Jizhe , Zhang Bo , Bai Ming
Published: June 2024

Background

Long non-coding RNAs (lncRNAs) are abundant and closely related to the occurrence and development of human diseases. LncRNAs are known to play a key role in many cardiovascular diseases. The purpose of this study was to investigate the effect of the RNA component of mitochondrial RNA-processing endoribonuclease (RMRP) on the degree of coronary artery lesions and prognosis in patients with coronary artery disease (CAD).

Methods

Patients who underwent coronary angiography (CAG) and dynamical-single photon emission computed tomography (D-SPECT) were selected as study subjects, and the results of CAG were reviewed, and the patients were grouped according to SYNTAX score. Evaluate the factors affecting SYNTAX scores. The follow-up analysis was conducted, and the endpoint events were major adverse cardiovascular events (MACEs). Kaplan–Meier method was used to estimate the survival rate, and multivariate Cox regression was used to analyze the relationship between RMRP and MACEs.

Results

The expression level of serum RMRP in patients with CAD was significantly higher than that in healthy people. Multivariate Logistic regression analysis showed that age, low-density lipoprotein cholesterol (LDL-C), RMRP and rest left ventricular ejection fraction (LVEF) were independent factors that affected SYNTAX scores. There were 19 cases of MACEs in the high RMRP group and 9 cases in the low RMRP group, and there was a significant difference in the MACE free survival curve between the two groups. Multivariate Cox regression analysis showed that age, SYNTAX score, rest LVEF and RMRP were risk factors for MACEs.

Conclusions

Serum RMRP is a key factor affecting the degree of coronary artery disease and prognosis in CAD patients.
Pretreatment with or without GnRH-agonist before frozen–thawed embryo transfer in patients with PCOS: a systematic review and meta-analysis
Authors: Li Jie , Lin Zhong , Mo Sien , Wang Shujia , Li Yanmei , Shi Qiuling
Published: June 2024

Purpose

This study was aimed to systematically evaluate the efficacy of artificial cycle-prepared frozen–thawed embryo transfer (FET) with or without gonadotrophin-releasing hormone agonist (GnRH-a) pretreatment for women with polycystic ovary syndrome (PCOS).

Methods

The analysis was carried out by searching the PubMed, EMBASE, and CNKI databases with a combination of keywords before October 2021. The available studies of the effects of GnRH-a pretreatment or no pretreatment on FET in PCOS patients were considered. The risk ratios (RRs) or standardized mean differences (SMD) with 95% confidence intervals (CIs) were calculated with using subgroups and sensitivity analysis. The quality evaluation for this analysis was followed.

Results

Seventeen studies including 3646 women were analyzed. GnRH-a pretreatment was significantly associated with a higher implantation rate (RR = 1.12, 95%CI: 1.00–1.24) and clinical pregnancy rate (RR = 1.19, 95%CI: 1.08–1.32) than the placebo. Moreover, in the GnRH-a pretreatment group, significant differences were detected for increasing the endometrium thickness among PCOS patients (SMD = 0.56, 95%CI: 0.20–0.92). However, for RCTs subgroup, no differences were observed, even after sensitivity analyses. In addition, the miscarriage rates, ectopic pregnancy rates, multiple pregnancy rates, and live birth rates were similar in both two groups.

Conclusions

Endometrial preparation using GnRH agonist pretreatment prior to FET seems to be the better choice for PCOS patients. However, well-designed RCTs are required for confirmation.
Combined analysis of estradiol and β-hCG to predict the early pregnancy outcome of FET: a retrospective study
Authors: Wu Man , Xiao Xiao , Wang Chen , Zhao Min , Xiong Fang , Jin Xin , Zheng Xiaomin
Published: June 2024

Background

The accurate prediction of pregnancy outcomes in in vitro fertilization (IVF) cycles is crucial. While several studies have been conducted on the predictive power of serum estradiol (E2) and β-hCG concentrations post-embryo transfer (ET) for pregnancy outcomes, there is debate on the predictive value of E2. The objective of this study was to investigate the predictive efficacy of combining serum E2 and β-hCG levels on early reproductive outcomes 12 days after embryo transfer.

Methods

A total of 1521 patients with β-hCG positive values on day 12 following frozen-thawed embryo transfer (FET) with natural endometrial preparation cycles (NCs) were gathered in affiliated Women’s Hospital of Jiangnan University. Using logistic regression, the relationship between pregnancy outcome and early serum E2 and β-hCG concentrations was examined. The receiver-operating characteristic (ROC) analysis was used to assess the predictive accuracy of the serum E2 and β-hCG concentrations.

Results

Notable distinctions were observed in the serum E2 and β-hCG levels on the twelfth day following FET with NCs between the groups classified as clinical pregnancy group (CP Group) and biochemical pregnancy group (BP Group). In addition, the cutoff values for E2 and β-hCG on day 12 following FET with NCs in cleavage embryo group (CE Group) were 129.25 pg/mL and 156.60 mIU/mL, respectively. The threshold values for E2 and β-hCG for the blastocyst group (B Group) were 174.45 pg/mL and 217.70 mIU/mL. Serum E2 day12 and β-hCG day12 were found to be substantially linked with clinical pregnancy by logistic regression analysis.

Conclusions

Serum E2 and β-hCG concentrations were found to be significantly different between the CP Group and BP Group in infertility women underwent FET with NCs. Our retrospective cohort study’s findings suggest that the combination of early E2 and β-hCG levels on day 12 post-FET could be used as a predictive tool to evaluate the likelihood of both positive and negative pregnancy outcomes in FET with NCs.
Embryonic development of a centralised brain in coleoid cephalopods
Authors: Elagoz Ali M. , Van Dijck Marie , Lassnig Mark , Seuntjens Eve
Published: June 2024

The last common ancestor of cephalopods and vertebrates lived about 580 million years ago, yet coleoid cephalopods, comprising squid, cuttlefish and octopus, have evolved an extraordinary behavioural repertoire that includes learned behaviour and tool utilization. These animals also developed innovative advanced defence mechanisms such as camouflage and ink release. They have evolved unique life cycles and possess the largest invertebrate nervous systems. Thus, studying coleoid cephalopods provides a unique opportunity to gain insights into the evolution and development of large centralised nervous systems. As non-model species, molecular and genetic tools are still limited. However, significant insights have already been gained to deconvolve embryonic brain development. Even though coleoid cephalopods possess a typical molluscan circumesophageal bauplan for their central nervous system, aspects of its development are reminiscent of processes observed in vertebrates as well, such as long-distance neuronal migration. This review provides an overview of embryonic coleoid cephalopod research focusing on the cellular and molecular aspects of neurogenesis, migration and patterning. Additionally, we summarize recent work on neural cell type diversity in embryonic and hatchling cephalopod brains. We conclude by highlighting gaps in our knowledge and routes for future research.
Effect of regular winter swimming on blood morphological, rheological, and biochemical indicators and activity of antioxidant enzymes in males
Authors: Teległów Aneta , Konieczny Kamil , Dobija Ignacy , Kuśmierczyk Justyna , Tota Łukasz , Rembiasz Konrad , Maciejczyk Marcin
Published: June 2024

Background

Exposure of the human body to cold water triggers numerous beneficial physiological changes. The study aimed to assess the impact of regular winter swimming on blood morphological, rheological, and biochemical indicators and activity of antioxidant enzymes in males.

Methods

The study involved 10 male winter swimmers (the same participants examined before the season and after the season) and 13 males (not winter swimming, leading a sedentary lifestyle) in the control group. Fasting blood was collected twice: in November and in March of the following year. Basic blood morphological indicators, red cell elongation index (EI) and aggregation index (AI), concentrations of testosterone, cortisol, urea, and creatinine, as well as plasma activity of antioxidant enzymes of catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GPx) were determined.

Results

The data were collected from the same winter swimmers at the beginning and end of the season. Winter swimming resulted in a significant increase of EI values at a shear stress of 0.30 (p = 0.40), 0.58 (p < 0.001), 4.24 (p = 0.021), 8.23 (p = 0.001), 15.59 (p = 0.001), 30.94 (p = 0.004), and 60.00 Pa (p = 0.043); haemoglobin was lower than before the season (p < 0.027). No significant changes were observed in AI, AMP, T1/2, the levels of urea, creatinine, eGFR, testosterone, cortisol, or the activity of CAT or SOD. There was a statistically significant increase in GPx activity (p = 0.014) and increase in testosterone concentration (p = 0.035) in the group of winter swimmers examined before the season as compared with the control group. No statistically significant differences were found for the mean values of blood morphological indicators and other parameters.

Conclusions

Winter swimming can prove to be a health-promoting factor in males, as indicated by a rise in the deformability of red blood cells in the blood vessel system after a full season of winter swimming, leading to better body oxygenation, and improves the antioxidant defence and testosterone concentration (within standard limits) in the group of winter swimmers examined before the season as compared with the control group. Winter swimming helps maintain appropriate levels of blood rheological indicators, urea, creatinine, eGFR, cortisol, testosterone, and activity of antioxidant enzymes.

Trial registration

ClinicalTrials.gov identifier NCT06223087, 15.01.2024.
Vaginal Lactobacillus crispatus persistence following application of a live biotherapeutic product: colonization phenotypes and genital immune impact
Authors: Armstrong Eric , Hemmerling Anke , Miller Steve , Huibner Sanja , Kulikova Maria , Crawford Emily , Castañeda Gloria R. , Coburn Bryan , Cohen Craig R. , Kaul Rupert
Published: June 2024

Background

Bacterial vaginosis (BV) increases HIV acquisition risk, potentially by eliciting genital inflammation. After BV treatment, the vaginal administration of LACTIN-V, a live biotherapeutic containing the Lactobacillus crispatus strain CTV-05, reduced BV recurrence and vaginal inflammation; however, 3 months after product cessation, CTV-05 colonization was only sustained in 48% of participants.

Results

This nested sub-study in 32 participants receiving LACTIN-V finds that 72% (23/32) demonstrate clinically relevant colonization (CTV-05 absolute abundance > 106 CFU/mL) during at least one visit while 28% (9/32) of women demonstrate colonization resistance, even during product administration. Immediately prior to LACTIN-V administration, the colonization-resistant group exhibited elevated vaginal microbiota diversity. During LACTIN-V administration, colonization resistance was associated with elevated vaginal markers of epithelial disruption and reduced chemokines, possibly due to elevated absolute abundance of BV-associated species and reduced L. crispatus. Colonization permissive women were stratified into sustained and transient colonization groups (31% and 41% of participants, respectively) based on CTV-05 colonization after cessation of product administration. These groups also exhibited distinct genital immune profiles during LACTIN-V administration.

Conclusions

The genital immune impact of LACTIN-V may be contingent on the CTV-05 colonization phenotype, which is in turn partially dependent on the success of BV clearance prior to LACTIN-V administration.
Effects of early and late continuous renal replacement therapy on intensive care unit mortality in patients with COVID-19 with acute respiratory distress syndrome and acute kidney injury: a comparative study
Authors: Tuna Verda , Senturk Emre , Orhun Gunseli , Polat Ozlem , Anakli Ilkay , Alay Gulcin , Celiksoy Emre , Kilic Mehmet , Mutlu Mercan , Figen Esen , Ergin Ozcan Perihan
Published: June 2024

Introduction

Acute kidney injury (AKI) is linked to disease severity and prognosis in patients with coronavirus disease 2019 (COVID-19), and mortality increases even with milder stages. This study primarily investigated the effects of continuous renal replacement therapy (CRRT) timing on intensive care unit (ICU) mortality in patients with COVID-19 with acute respiratory distress syndrome (ARDS) and AKI. Secondary goals were secondary goals for the ICU, days without life support treatment, and change in post-CRRT day biomarker levels, the length of ICU and overall hospital stay.

Methods

In this retrospective study, patients with COVID-19 with ARDS and AKI were divided into CRRT initiated at AKI stages 1 and 2, early-CRRT (E-CRRT) and AKI stage 3, late-CRRT (L-CRRT) and followed until discharge or death.

Results

E-CRRT had 20 patients and L-CRRT had 18 patients. No association between CRRT timing and ICU mortality was detected (p = 0.724). Moreover, the timing was not associated with ICU, total hospital stay, or days without life support treatment. However, it was associated with D-dimer levels for both groups and ferritin and C-reactive protein (CRP) levels for E-CRRT. There were no associations for other markers, such as procalcitonin, troponin T, pro-brain natriuretic peptide (pro-BNP), interleukin-6, fibrinogen, or antithrombin III levels.

Conclusions

CRRT timing was not associated with ICU mortality, total hospital stay, or days without life support treatment in this cohort. For E-CRRT, ferritin and CRP levels, and for both groups, D-dimer levels, were associated with CRRT timing. Randomized controlled trials are needed to examine the effects of CRRT timing in patients with COVID-19 with ARDS and AKI.
Harnessing the power of a novel gene to combat Asian soybean rust: a promising breakthrough
Authors: Wang Yuanchao
Published: June 2024

Plant diseases have significant implications on agriculture and food security. Recent research published in Nature Communications by Hao et al. (Nat Commun 15:3310, 2024) has identified a novel disease-resistant gene, Rpp6907-7, which shows high potential in enhancing resistance to Asian Soybean Rust (ASR), a major threat to soybean production. This discovery provides valuable insights for developing improved soybean varieties with enhanced disease resistance.
Effects of Android phone vs. iPhone use on BlackBerry thumb symptoms among university students in Bangladesh
Authors: Haque Md Ariful , Baroi Liton , Koly Ismat Ara Chowdhury , Hasan Md Shakibul , Mahmud Faiza , Eva Sifat Ara , Labib Moinul Karim , Nafisa Hazika Tuz-Zohura , Islam Salwa , Eva Irfat Islam , Islam Md. Rafiqul , Bose Lita , Tian Faming
Published: June 2024

Background

In Bangladesh, the most prevalent musculoskeletal condition among office employees is considered as BlackBerry thumb (BBT). Alike official perspectives, our educational system was significantly regulating with the digital interfaces at COVID-19 lockdown, where a greater reliance on Android phones were experienced among the adults. Numerous studies have been conducted in studying the incidences of BBT in young individuals as a result of hazards of Android phone usage (HAPU) in Bangladesh.

Objective

This research sought to determine the relationship between BBT symptoms and the risks associated with the using Android phones among Bangladeshi university students.

Methods

A nationwide cross-sectional study was undertaken on a group of university students between the ages of 18 and 25 to determine if BBT symptoms were present based on the Finkelstein test and HAPU, which were also assessed using a well-designed questionnaire. We calculated the crude and adjusted prevalence ratios (aPR) and used a generalized linear model from the Poisson family, using their respective 95% confidence intervals (CI).

Results

There were 2455 individuals in this research, with a median age of 20 and an interquartile range (IQR) of 19 to 23. Of them, 1185 males (48.27%) and 1270 women (51.75%) made up the study’s participant population. Physical exams showed that 1300 individuals had positive Finkelstein test results (52.95%), whereas 1040 people had occasional risks from using an Android phone and 115 participants had occasional risks from using an iPhone. In our generalized linear model, we observed that participants with occasional and frequent HAPU had higher rates of BBT symptoms than responders without HAPU (aPR = 1.73, 95% CI: 1.47–2.05, and aPR = 1.61, 95% CI: 1.29–2.00), respectively.

Conclusion

The current study found that Bangladeshi university students experiencing BlackBerry thumb symptoms were more likely to have risks associated with using Android phones.
Staged resection versus simultaneous resection for conversion surgery for initially unresectable colorectal liver metastasis: A prospective cohort study.
Authors: Chen Yijiao , Zhu Dexiang , Xu Jianmin
Published: June 2024

3582

Background: Patients with initially unresectable colorectal liver metastasis (CRLM) who undergo successful conversion therapy have two treatment options to consider for surgery: simultaneous resection or staged resection. Numerous studies have conducted comparisons between both strategies in cases of initially resectable CRLM. However, almost were retrospective and conclusions were contradictory. Moreover, there have been no research studies that have directly compared the safety and effectiveness of these two approaches in patients with initially unresectable CRLM who are undergoing conversion surgery. Methods: We recruited prospectively patients undergoing conversion surgery for initially unresectable CRLM on the basis of completed randomized controlled trials (RCT) and ongoing multicenter RCT studies. The major outcomes included the rate of perioperative complications within 60 days following surgery, overall survival (OS), and relapse-free survival (RFS). Results: A total of 351 CRLM patients were recruited. Three-hundred-ten eligible patients (203 and 107 in the staged- and simultaneous-resection groups, respectively) were analyzed. In comparison to the staged-resection group, the simultaneous-resection group exhibited a significantly higher percentage of perioperative complications (37.4% VS. 50.5%, P=0.027). The start of adjuvant chemotherapy was significantly later in simultaneous-resection group (the percentage of time to start adjuvant chemotherapy >4 weeks: 14.8% VS. 28.0%, P=0.010). In the staged-resection group, two (1.0%) patients did not reach the liver resection stage, and this was due to disease progression. As compared with simultaneous-resection group, the staged-resection group showed a significantly improved RFS (HR=0.762, 95%CI 0.600-0.969, P=0.024) and liver-specific RFS (HR=0.709, 95%CI 0.554-0.908, P=0.005). The OS analysis did not differ between groups after a median follow-up of 49.7 months (HR=0.798, 95%CI 0.580-1.098, P=0.163). Conclusions: Among patients undergoing conversion surgery for initially unresectable CRLM, simultaneous resection of the primary tumor and liver metastases was associated with an increased incidence of postoperative complications and impaired relapse-free survival.
Genomic alterations in early-onset versus average-onset stage IV colorectal cancer.
Authors: Lander Eric Michael , Rivero-Hinojosa Samuel , Aushev Vasily N. , Jurdi Adham A , Liu Minetta C. , Eng Cathy
Published: June 2024

3586

Background: The etiology of the rising incidence of early-onset colorectal cancer (EOCRC), defined as in patients aged <50, remains unknown. EOCRC is diagnosed at advanced pathologic stages compared to average-onset colorectal cancer (AOCRC; age >60). We previously reported data for Stages I-III disease. In this analysis, we evaluated tumor genomic differences in stage IV EOCRC versus AOCRC. Methods: The cohort included 3212 patients diagnosed with stage IV colon or rectal cancer who had whole exome sequencing (WES) as part of clinical tumor-informed ctDNA testing (Signatera, bespoke mPCR NGS assay, Natera, Inc.). Tumor mutational burden (TMB) and microsatellite instability (MSI) status were derived from tumor WES analysis. The prevalence of somatic variants, gene mutations and mutational signatures were compared between EOCRC and AOCRC groups, stratified by TMB and MSI status. Fisher’s exact test was used to test significance between age groups and p-values were adjusted using the FDR method for multiple test correction. Results: A total of 1070 patients with EOCRC (75.8% colon, 22.2% rectal, 2% unknown) and 2141 patients with AOCRC (80.2% colon, 18.3% rectal, 1.5% unknown) were included. No significant differences were found in the frequency of MSI and TMB status between age groups. In the TMB-Low/MSS group (EOCRC N=982; AOCRC N=1930), TP53 mutations were more common in EOCRC (62% vs. 54.5%, p=0.0036), but APC gene mutations were less common in EOCRC (59% vs. 65%, p=0.02). In the TMB-High/MSI-H group (EOCRC N=64; AOCRC N=182), BRAFand BEND4 mutations were less common in EOCRC (6.2% vs. 59.3%, p<0.001 and 6.2% vs 31.9%, p=0.036), but KRASgene mutations were more common in EOCRC (54.7% vs. 17%, p<0.001). BRAF V600E was the only significant single variant (0% vs 59.3% p<0.001). No significant differences were found in the TMB-High/MSS group (EOCRC N=24; AOCRC N=29). In the mutational signature analysis for the TMB-Low/MSS group, the clock-like signature was less frequent in EOCRC (76.9% vs. 85.4%, p< 0.001). In the TMB-High/MSI-H group, MMR deficiency signature was the most frequent signature, however no significant differences were found between EOCRC and AOCRC (81.25% vs. 85.71, p=0.42). In the TMB-High/MSS group, POLE exonuclease domain mutations signature was 2.2 times more frequent in EOCRC (62.5% vs. 27.6%, p<0.024). MMR deficiency signature was also less common in EOCRC vs. AOCRC (33.33% vs. 55.17%; p<0.10). Conclusions: Tumors in EOCRC harbored unique genomic alterations that varied between the TMB-Low/MSS, TMB-High/MSI-H, and TMB-High/MSS subpopulations. In TMB-Low/MSS tumors, similar gene mutations and genomic signatures were observed. However, the TMB-High/MSI-H and TMB-High/MSS subgroups harbored gene mutations and signatures that differed between age groups, suggesting that EOCRC may arise from uniquely different mutagenic processes in these subgroups.
Artemin and immune checkpoint inhibitor (ICI) efficacy in metastatic colorectal cancer (mCRC): A correlative analysis of the Canadian Cancer Trials Group (CCTG) CO.26 trial.
Authors: Ma Lucy Xiaolu , Titmuss Emma , Jonker Derek J. , Kennecke Hagen Fritz , Berry Scott R. , Couture Felix , Ahmad Chaudhary E. , Goffin John R. , Kavan Petr , Harb Mohammed , Colwell Bruce , Samimi Setareh , Samson Benoit , Abbas Tahir , Aubin Francine , Koski Sheryl L. , Tu Dongsheng , O'Callaghan Christopher J. , Loree Jonathan M. , Chen Eric Xueyu
Published: June 2024

3587

Background: ICIs have limited efficacy in microsatellite stable (MSS) mCRC. The mechanisms of resistance to ICI remain incompletely understood. Recent findings suggest that erythyroid progenitor cells (EPCs) in the tumour microenvironment can exert immunosuppressive properties and promote tumour progression through the secretion of artemin, a neurotrophic factor. We conducted this post-hoc analysis of the Phase II CCTG CO.26 trial (NCT02870920) to investigate the relationship between artemin and ICI treatment outcomes in MSS mCRC. Methods: The CO.26 trial randomized patients (pts) with refractory mCRC to durvalumab plus tremelimumab (D+T) and best supportive care (BSC) compared to BSC alone in a 2:1 fashion. Serum artemin concentrations were determined from pre-treatment and serial on-treatment blood samples. The median artemin value (1.051ng/ml) was used to stratify pts into high versus low artemin groups. Progression-free (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method and compared between groups using the log-rank test. Cox proportional hazard models were used to analyze prognostic and predictive impacts of artemin on PFS and OS. Results: Of 180 pts enrolled in CO.26, blood samples were available for 161 pts (N= 114 D+T, 47 BSC) at baseline, 94 at week 8 and 69 at progression. In the BSC arm, OS was lower for pts with high artemin at baseline compared to low pts (mOS 3.17 vs. 5.65 months, HR 1.74 [0.94-3.25], p=0.080). In artemin high pts, D+T improved OS compared to BSC (mOS 6.44 vs. 3.17 months, HR 0.54 [0.33-0.91] p=0.020). There was no difference in OS between D+T and BSC arms in artemin low pts (mOS 6.64 vs. 5.65 months, HR 0.87 [0.53-1.43], p=0.58, multivariable p-interaction=0.061). In the D+T arm, pts with progressive disease had significant increases in artemin levels at week 8 compared to baseline (p=0.026), while there was no significant change in week 8 artemin levels in pts with stable disease (p=0.14). Conclusions: High baseline artemin may be a poor prognostic marker in MSS mCRC and increase in artemin level during treatment can be indicative of progressive disease. High baseline artemin may predict benefit from ICI treatment. Studies are warranted to better understand and explore targeting the EPC-artemin axis to enhance efficacy of ICI in MSS mCRC.