bluuebunny/crossref_metadata_2025 huggingface dataset:
Testing the dysregulation of goal and activity identification hypothesis on mental health outcomes: The moderating effect of psychological flexibility
Authors: Faulkner Josh W. , Grattan Rebecca , Darroch Lisetta
Published: June 2023

The objective of this study is to test the dysregulation of goal/activity identification hypothesis and the role of psychological flexibility within it. A nonclinical sample of 247 adults completed the Personalized Psychological Flexibility Index (PPFI) and DASS-21. Participants' goal on the PPFI were categorized into abstract or concrete. The moderating effect of psychological flexibility on the relationship between goal abstraction and stress, depression and anxiety were examined. These relationships were explored using specific dimensions of psychological flexibility: harnessing, avoidance and acceptance. A significant interaction was found between psychological flexibility and goal abstraction on stress. Individuals who stipulated an abstract goal and had lower levels of psychological flexibility had significantly higher levels of stress. This relationship was not evident for concrete goals. These findings did not emerge when examining specific dimensions of psychological flexibility suggesting that multiple facets of psychological flexibility contribute to these findings. Harnessing was, however, unique. Individuals with a concrete goal and higher levels of harnessing had significantly higher stress. This study provides preliminary findings regarding the influence of psychological flexibility within the dysregulation of goal/action identification hypothesis. Future research, particularly in clinical samples is needed to confirm these associations and their combined role as a transdiagnostic process.
The feasibility and effectiveness of telecare consultations in nurse-led post-acute stroke clinics: A study protocol
Authors: Wong Arkers Kwan Ching , Bayuo Jonathan , Wong Frances Kam Yuet , Kwok Vivian Wai Yan , Yuen Bernard Man Kam , Fong Ching Sing , Chan Shun Tim , Pung Hoi Lam , Kwek Oi Lam
Published: June 2023

Background

Globally, nurse-led post-acute stroke clinics have been developed to provide secondary care services to stroke survivors. Although synthesized evidence supports the idea that the secondary prevention services delivered by nurses in these clinics can improve the functional ability of stroke survivors and reduce their readmission rates, long travel and waiting times, high costs, and the pandemic have limited the utilization of such clinics. Telecare consultations are a new modality for expanding public access to healthcare services, although how it can be applied in nurse-led clinics has not been reported.

Objective

The aim of this study is to determine the feasibility and effects of telecare consultations in nurse-led post-acute stroke clinics.

Methods

The study adopts a quasi-experimental design. The participants will receive three secondary stroke care consultations in 3 months provided via telecare by experienced advanced practice nurses. The outcome measures include feasibility (reasons for refusing to participate and for dropping-out, the attitudes and satisfaction of both the advanced practice nurses and their patients towards the programme), and preliminary effectiveness (degree of disability after stroke, activities of daily living, instrumental activities of daily living, health-related quality of life, depression) outcomes. Data will be collected at pre-(T1) and post-(T2) intervention.

Conclusions

The findings of this study may help facilitate the implementation of telecare consultations in a nurse-led post-acute stroke clinic, which may benefit the stroke survivors who are having mobility restrictions from accessing customary healthcare services and may protect them from being exposed to the infectious risk.
Assessing the Use of Land as Collateral for Accessing Credit from Institutional Sources in Rural India
Authors: Prabhakar Prerna , Pal Nishika , Sanan Deepak , Sen Somnath
Published: June 2023

Data on access to credit in rural India are mostly available from periodic largescale surveys and some primary research in different parts of India. The growth of institutional sources of credit was quite dramatic during the first four decades after Independence. There appears to have been a regression since then. There is some evidence to show that land as collateral is a frequent requirement for institutional lenders. There is also some scattered evidence that land is more likely to be used as collateral by larger landholders and a clear title favours extension of loans. However, there are very little data on the extent to which these hypotheses hold well across states. Textual records (copies of Record of Rights) gathered for the construction of the NCAER Land Records and Services Index 2020 offered an opportunity to understand the situation in different states with respect to the issues mentioned above. This article assesses the data gathered for six Indian states/Union Territories (UTs): Chhattisgarh, Gujarat, Himachal Pradesh, Madhya Pradesh, Uttar Pradesh and Uttarakhand. The article highlights the extent to which various hypotheses prevalent in the literature are borne out by the evidence obtained through the sample data gathered for the states/UTs that are the subject of this article. While adding to the knowledge on the subject, it will help enhance an understanding of both the subject and policy making in the area of rural credit.
Cure & Care 1Malaysia Clinics: Measuring the Effectiveness via Dyads Lens Involving Receivers and Providers
Authors: Mustapha Siti Zulaikha , Ahmad Yarina , Aziz Nur Amalina , Abd Hamid Siti Nur Fathanah
Published: June 2023

Drug treatment and rehabilitation programs are one of the initiatives to alleviate the global epidemic of drug addiction. The efforts were undertaken by everyone, particularly the government. However, the rising number of drug relapses among patients or clients ponders the effectiveness of the drug treatment and rehabilitation programs implemented in the country. This paper aims to study the drug relapse prevention initiatives and the effectiveness of the center in dealing with drug addiction issues. A case study of 4 drug treatment and rehabilitation centers, namely Cure & Care 1Malaysia Clinics in Selangor, Malacca, Penang, and Kelantan, was selected. In-depth interviews were conducted with 37 participants—26 clients and 11 providers, and the data were analyzed using thematic analysis and NVivo version 12. The findings indicate that relapse prevention initiatives are a signal for the effectiveness of the center to reduce drug relapse cases. The implementation of drug treatment and rehabilitation programs was effective based on key aspects consisting of (1) knowledge and life skills learned; (2) staff reception; (3) individual changes; and (4) client acceptance. Therefore, by experiencing relapse prevention activities, it helps to improve the effectiveness of the implementation of drug treatment and rehabilitation programs.
Platelet functional abnormalities in pediatric patients with kaposiform hemangioendothelioma/Kasabach-Merritt phenomenon
Authors: Martyanov Alexey A. , Tesakov Ivan P. , Khachatryan Lili A. , An Olga I. , Boldova Anna E. , Ignatova Anastasia A. , Koltsova Ekaterina M. , Korobkin Julia-Jessica D. , Podoplelova Nadezhda A. , Svidelskaya Galina S. , Yushkova Eugenia , Novichkova Galina A. , Eble Johannes A. , Panteleev Mikhail A. , Kalinin Dmitrii V. , Sveshnikova Anastasia N.
Published: June 2023

Kaposiform hemangioendothelioma (KHE) is a rare vascular tumor of infancy that is commonly associated with a life-threatening thrombocytopenic condition, Kasabach-Merritt phenomenon (KMP). Platelet CLEC-2, tumor podoplanin interaction is considered the key mechanism of platelet clearance in these patients. Here, we aimed to assess platelet functionality in such patients. Three groups of 6 to 9 children were enrolled: group A with KHE/KMP without hematologic response (HR) to therapy; group B with KHE/KMP with HR; and group C with healthy children. Platelet functionality was assessed by continuous and end point flow cytometry, low-angle light scattering analysis (LaSca), fluorescent microscopy of blood smears, and ex vivo thrombi formation. Platelet integrin activation in response to a combination of CRP (GPVI agonist) and TRAP-6 (PAR1 agonist), as well as calcium mobilization and integrin activation in response to CRP or rhodocytin (CLEC-2 agonist) alone, were significantly diminished in groups A and B. At the same time, platelet responses to ADP with or without TRAP-6 were unaltered. Thrombi formation from collagen in parallel plate flow chambers was also noticeably decreased in groups A and B. In silico analysis of these results predicted diminished amounts of CLEC-2 on the platelet surface of patients, which was further confirmed by immunofluorescence microscopy and flow cytometry. In addition, we also noted a decrease in GPVI levels on platelets from group A. In KHE/KMP, platelet responses induced by CLEC-2 or GPVI activation are impaired because of the diminished number of receptors on the platelet surface. This impairment correlates with the severity of the disease and resolves as the patient recovers.
The value of sonication in the differential diagnosis of septic and aseptic femoral and tibial shaft nonunion in comparison to conventional tissue culture and histopathology: a prospective multicenter clinical study
Authors: Trenkwalder Katharina , Erichsen Sandra , Weisemann Ferdinand , Augat Peter , Militz Matthias , von Rüden Christian , Hentschel Tobias ,   SAND Research Group, Baumgartner Heiko , Reumann Marie , Reiter Georg , Freischmidt Holger , Kemmerer Matthias , Langwald Steffen , Hanke John , Glombitza Martin , Steinhausen Eva , Gerlach Ulf-Joachim , Spranger Nikolai , Stengel Dirk , Hackl Simon
Published: June 2023

Background

Septic and aseptic nonunion require different therapeutic strategies. However, differential diagnosis is challenging, as low-grade infections and biofilm-bound bacteria often remain undetected. Therefore, the examination of biofilm on implants by sonication and the evaluation of its value for differentiating between femoral or tibial shaft septic and aseptic nonunion in comparison to tissue culture and histopathology was the focus of this study.

Materials and methods

Osteosynthesis material for sonication and tissue samples for long-term culture and histopathologic examination from 53 patients with aseptic nonunion, 42 with septic nonunion and 32 with regular healed fractures were obtained during surgery. Sonication fluid was concentrated by membrane filtration and colony-forming units (CFU) were quantified after aerobic and anaerobic incubation. CFU cut-off values for differentiating between septic and aseptic nonunion or regular healers were determined by receiver operating characteristic analysis. The performances of the different diagnostic methods were calculated using cross-tabulation.

Results

The cut-off value for differentiating between septic and aseptic nonunion was ≥ 13.6 CFU/10 ml sonication fluid. With a sensitivity of 52% and a specificity of 93%, the diagnostic performance of membrane filtration was lower than that of tissue culture (69%, 96%) but higher than that of histopathology (14%, 87%). Considering two criteria for infection diagnosis, the sensitivity was similar for one tissue culture with the same pathogen in broth-cultured sonication fluid and two positive tissue cultures (55%). The combination of tissue culture and membrane-filtrated sonication fluid had a sensitivity of 50%, which increased up to 62% when using a lower CFU cut-off determined from regular healers. Furthermore, membrane filtration demonstrated a significantly higher polymicrobial detection rate compared to tissue culture and sonication fluid broth culture.

Conclusions

Our findings support a multimodal approach for the differential diagnosis of nonunion, with sonication demonstrating substantial usefulness.

Level of Evidence: Level 2

Trial registration DRKS00014657 (date of registration: 2018/04/26)
Orthogonal proteomics methods warrant the development of Duchenne muscular dystrophy biomarkers
Authors: Johansson Camilla , Hunt Helian , Signorelli Mirko , Edfors Fredrik , Hober Andreas , Svensson Anne-Sophie , Tegel Hanna , Forstström Björn , Aartsma-Rus Annemieke , Niks Erik , Spitali Pietro , Uhlén Mathias , Szigyarto Cristina Al-Khalili
Published: June 2023

Background

Molecular components in blood, such as proteins, are used as biomarkers to detect or predict disease states, guide clinical interventions and aid in the development of therapies. While multiplexing proteomics methods promote discovery of such biomarkers, their translation to clinical use is difficult due to the lack of substantial evidence regarding their reliability as quantifiable indicators of disease state or outcome. To overcome this challenge, a novel orthogonal strategy was developed and used to assess the reliability of biomarkers and analytically corroborate already identified serum biomarkers for Duchenne muscular dystrophy (DMD). DMD is a monogenic incurable disease characterized by progressive muscle damage that currently lacks reliable and specific disease monitoring tools.

Methods

Two technological platforms are used to detect and quantify the biomarkers in 72 longitudinally collected serum samples from DMD patients at 3 to 5 timepoints. Quantification of the biomarkers is achieved by detection of the same biomarker fragment either through interaction with validated antibodies in immuno-assays or through quantification of peptides by Parallel Reaction Monitoring Mass Spectrometry assay (PRM-MS).

Results

Five, out of ten biomarkers previously identified by affinity-based proteomics methods, were confirmed to be associated with DMD using the mass spectrometry-based method. Two biomarkers, carbonic anhydrase III and lactate dehydrogenase B, were quantified with two independent methods, sandwich immunoassays and PRM-MS, with Pearson correlations of 0.92 and 0.946 respectively. The median concentrations of CA3 and LDHB in DMD patients was elevated in comparison to those in healthy individuals by 35- and 3-fold, respectively. Levels of CA3 vary between 10.26 and 0.36 ng/ml in DMD patients whereas those of LDHB vary between 15.1 and 0.8 ng/ml.

Conclusions

These results demonstrate that orthogonal assays can be used to assess the analytical reliability of biomarker quantification assays, providing a means to facilitate the translation of biomarkers to clinical practice. This strategy also warrants the development of the most relevant biomarkers, markers that can be reliably quantified with different proteomics methods.
Integration of beef cattle international pedigree and genomic estimated breeding values into national evaluations, with an application to the Italian Limousin population
Authors: Bonifazi Renzo , Calus Mario P. L. , ten Napel Jan , Veerkamp Roel F. , Biffani Stefano , Cassandro Martino , Savoia Simone , Vandenplas Jérémie
Published: June 2023

Background

International evaluations combine data from different countries allowing breeders to have access to larger panels of elite bulls and to increase the accuracy of estimated breeding values (EBV). However, international and national evaluations can use different sources of information to compute EBV (EBVINT and EBVNAT, respectively), leading to differences between them. Choosing one of these EBV results in losing the information that is contained only in the discarded EBV. Our objectives were to define and validate a procedure to integrate publishable sires’ EBVINT and their associated reliabilities computed from pedigree-based or single-step international beef cattle evaluations into national evaluations to obtain “blended” EBV. The Italian (ITA) pedigree-based national evaluation was used as a case study to validate the integration procedure.

Methods

Publishable sires’ international information, i.e. EBVINT and their associated reliabilities, was included in the national evaluation as pseudo-records. Data were available for 444,199 individual age-adjusted weaning weights of Limousin cattle from eight countries and 17,607 genotypes from four countries (ITA excluded). To mimic differences between international and national evaluations, international evaluations included phenotypes (and genotypes) of animals born prior to January 2019, while national evaluations included ITA phenotypes of animals born until April 2019. International evaluations using all available information were considered as reference scenarios. Publishable sires were divided into three groups: sires with ≥ 15, < 15 and no recorded offspring in ITA.

Results

Overall, for these three groups, integrating either pedigree-based or single-step international information into national pedigree-based evaluations improved the similarity of the blended EBV with the reference EBV compared to national evaluations without integration. For instance, the correlation with the reference EBV for direct (maternal) EBV went from 0.61 (0.79) for a national evaluation without integration to 0.97 (0.88) when integrating single-step international information, on average across all groups of publishable sires.

Conclusions

Our proposed one-animal-at-a-time integration procedure yields blended EBV that are in close agreement with full international EBV for all groups of animals analysed. The procedure can be directly applied by countries since it does not rely on specific software and is computationally inexpensive, allowing straightforward integration of publishable sires’ EBVINT from pedigree-based or single-step based international beef cattle evaluations into national evaluations.
Integrin alpha 6 homozygous splice-site mutation causes a new form of junctional epidermolysis bullosa in Charolais cattle
Authors: Boussaha Mekki , Boulling Arnaud , Wolgust Valérie , Bourgeois-Brunel Lorraine , Michot Pauline , Grohs Cécile , Gaiani Nicolas , Grivaud Pierre-Yves , Leclerc Hélène , Danchin-Burge Coralie , Vilotte Marthe , Rivière Julie , Boichard Didier , Gourreau Jean-Marie , Capitan Aurélien
Published: June 2023

Background

Inherited epidermolysis bullosa (EB) is a group of painful and life-threatening genetic disorders that are characterized by mechanically induced blistering of the skin and mucous membranes. Congenital skin fragility resembling EB was recently reported in three Charolais calves born in two distinct herds from unaffected parents. Phenotypic and genetic analyses were carried out to describe this condition and its molecular etiology.

Results

Genealogical, pathological and histological investigations confirmed the diagnosis of recessive EB. However, the affected calves showed milder clinical signs compared to another form of EB, which was previously reported in the same breed and is caused by a homozygous deletion of the ITGB4 gene. Homozygosity mapping followed by analysis of the whole-genome sequences of two cases and 5031 control individuals enabled us to prioritize a splice donor site of ITGA6 (c.2160 + 1G > T; Chr2 g.24112740C > A) as the most compelling candidate variant. This substitution showed a perfect genotype–phenotype correlation in the two affected pedigrees and was found to segregate only in Charolais, and at a very low frequency (f = 1.6 × 10−4) after genotyping 186,154 animals from 15 breeds. Finally, RT-PCR analyses revealed increased retention of introns 14 and 15 of the ITGA6 gene in a heterozygous mutant cow compared with a matched control. The mutant mRNA is predicted to cause a frameshift (ITGA6 p.I657Mfs1) that affects the assembly of the integrin α6β4 dimer and its correct anchoring to the cell membrane. This dimer is a key component of the hemidesmosome anchoring complex, which ensures the attachment of basal epithelial cells to the basal membrane. Based on these elements, we arrived at a diagnosis of junctional EB.

Conclusions

We report a rare example of partial phenocopies observed in the same breed and due to mutations that affect two members of the same protein dimer, and provide the first evidence of an ITGA6 mutation that causes EB in livestock species.
Transcriptional profile of Trichomonas vaginalis in response to metronidazole
Authors: Xie Yiting , Zhong Ping , Guan Wei , Zhao Yanqing , Yang Shuguo , Shao Yan , Li Jian
Published: June 2023

Background

Trichomoniasis caused by Trichomonas vaginalis, combined with its complications, has long frequently damaged millions of human health. Metronidazole (MTZ) is the first choice for therapy. Therefore, a better understanding of its trichomonacidal process to ultimately reveal the global mechanism of action is indispensable. To take a step toward this goal, electron microscopy and RNA sequencing were performed to fully reveal the early changes in T. vaginalis at the cellular and transcriptome levels after treatment with MTZ in vitro.

Results

The results showed that the morphology and subcellular structures of T. vaginalis underwent prominent alterations, characterized by a rough surface with bubbly protrusions, broken holes and deformed nuclei with decreased nuclear membranes, chromatin and organelles. The RNA-seq data revealed a total of 10,937 differentially expressed genes (DEGs), consisting of 4,978 upregulated and 5,959 downregulated genes. Most DEGs for the known MTZ activators, such as pyruvate:ferredoxin oxidoreductase (PFOR) and iron-sulfur binding domain, were significantly downregulated. However, genes for other possible alternative MTZ activators such as thioredoxin reductase, nitroreductase family proteins and flavodoxin-like fold family proteins, were dramatically stimulated. GO and KEGG analyses revealed that genes for basic vital activities, proteostasis, replication and repair were stimulated under MTZ stress, but those for DNA synthesis, more complicated life activities such as the cell cycle, motility, signaling and even virulence were significantly inhibited in T. vaginalis. Meanwhile, increased single nucleotide polymorphism (SNP) and insertions - deletions (indels) were stimulated by MTZ.

Conclusions

The current study reveals evident nuclear and cytomembrane damage and multiple variations in T. vaginalis at the transcriptional level. These data will offer a meaningful foundation for a deeper understanding of the MTZ trichomonacidal process and the transcriptional response of T. vaginalis to MTZ-induced stress or even cell death.
HealthyRHearts - reducing cholesterol in rural adults via telehealth-based medical nutrition therapy: protocol for a cluster randomised controlled trial
Authors: Schumacher Tracy L. , Herbert Jaimee , May Jennifer , Ramanathan Shanthi , Brown Leanne J. , Guppy Michelle , Williams Annabelle , Rollo Megan E. , Attia John , Collins Clare E.
Published: June 2023

Background

Few randomised controlled trials specifically focus on prevention in rural populations. Cardiovascular disease (CVD) contributes to approximately one quarter of deaths in Australia. Nutrition is a key component affecting many risk factors associated with CVD, including hypercholesterolaemia. However, access to medical nutrition therapy (MNT) is limited for people living in rural areas, potentially exacerbating inequities related to health outcomes. Telehealth services present an opportunity to improve MNT access and address healthcare disparities for rural populations. The present study aims to evaluate feasibility, acceptability, and cost-effectiveness of a telehealth MNT CVD intervention program in lowering CVD risk over 12-months in regional and rural primary health care settings.

Methods/design

A cluster randomised controlled trial set in rural and regional general practices in NSW, Australia, and their consenting patients (n = 300 participants). Practices will be randomised to either control (usual care from their General Practitioner (GP) + low level individualised dietetic feedback) or intervention groups (usual care from their GP + low level individualised dietetic feedback + telehealth MNT intervention). Telehealth consultations will be delivered by an Accredited Practising Dietitian (APD), with each intervention participant scheduled to receive five consultations over a 6-month period. System-generated generic personalised nutrition feedback reports are provided based on completion of the Australian Eating Survey – Heart version (AES-Heart), a food frequency questionnaire. Eligible participants must be assessed by their GP as at moderate (≥ 10%) to high (> 15%) risk of a CVD event within the next five years using the CVD Check calculator and reside in a regional or rural area within the Hunter New England Central Coast Primary Health Network (HNECC PHN) to be eligible for inclusion. Outcome measures are assessed at baseline, 3, 6 and 12 months. The primary outcome is reduction in total serum cholesterol. Evaluation of the intervention feasibility, acceptability and cost-effective will incorporate quantitative, economic and qualitative methodologies.

Discussion

Research outcomes will provide knowledge on effectiveness of MNT provision in reducing serum cholesterol, and feasibility, acceptability, and cost-effectiveness of delivering MNT via telehealth to address CVD risk in rural regions. Results will inform translation to health policy and practice for improving access to clinical care in rural Australia.

Trial registration

This trial is registered at anzctr.org.au under the acronym HealthyRHearts (Healthy Rural Hearts), registration number ACTRN12621001495819.
Incidence and risk factors of fasting hyperglycaemia following first-attack acute pancreatitis before discharge: a retrospective study
Authors: Liu Chengsi , Shi Qiao , Zhang Xiaoyi , Xue Enfu , Li Hanjun , Wang Weixing
Published: June 2023

Background

Pancreatic endocrine insufficiency is more likely to occur after acute pancreatitis (AP), but the risk factors affecting pancreatic endocrine function remain controversial. Therefore, exploring the incidence and risk factors of fasting hyperglycaemia following first-attack AP is important.

Methods

Data were collected from 311 individuals with first-attack AP without previous diabetes mellitus (DM) or impaired fasting glucose (IFG) history treated in the Renmin Hospital of Wuhan University. Relevant statistical tests were performed. A two-sided p-value < 0.05 was considered statistically significant.

Results

The incidence of fasting hyperglycaemia in individuals with first-attack AP was 45.3%. Univariate analysis showed that age (χ2 = 6.27, P = 0.012), aetiology (χ2 = 11.184, P = 0.004), serum total cholesterol (TC) (χ2 = 14.622, P < 0.001), and serum triglyceride (TG) (χ2 = 15.006, P < 0.001) were significantly different between the hyperglycaemia and non-hyperglycaemia groups (P < 0.05). The serum calcium concentration (Z=-2.480, P = 0.013) was significantly different between the two groups (P < 0.05). Multiple logistic regression analysis showed that age- ≥60 years (P < 0.001, OR = 2.631, 95%Cl = 1.529–4.527) and TG ≥ 5.65 mmol/L (P < 0.001, OR = 3.964, 95%Cl = 1.990–7.895) were independent risk factors for fasting hyperglycaemia in individuals with first-attack AP (P < 0.05).

Conclusions

Old age, serum triglycerides, serum total cholesterol, hypocalcaemia, and aetiology are associated with fasting hyperglycaemia following first-attack AP. Age ≥ 60 years and TG ≥ 5.65 mmol/L are independent risk factors for fasting hyperglycaemia following first-attack AP.
Incidence rate and predictors of COVID-19 in the two largest cities of Burkina Faso - prospective cohort study in 2021 (ANRS-COV13)
Authors: Kaboré Nongodo Firmin , Ouédraogo Samiratou , Mamguem Ariane Kamga , Traoré Isidore Tiandiogo , Kania Dramane , Badolo Hermann , Sanou Guillaume , Koné Amariane , Yara Mimbouré , Kagoné Thérèse , Ouédraogo Esperance , Konaté Blahima , Médah Rachel , de Rekeneire Nathalie , Poda Armel , Diendéré Arnaud Eric , Ouédraogo Boukary , Billa Oumar , Paradis Gilles , Dabakuyo-Yonli Tienhan Sandrine , Tinto Halidou
Published: June 2023

Background

Early data on COVID-19 (based primarily on PCR testing) indicated a low burden in Sub-Saharan Africa. To better understand this, this study aimed to estimate the incidence rate and identify predictors of SARS-CoV-2 seroconversion in the two largest cities of Burkina Faso. This study is part of the EmulCOVID-19 project (ANRS-COV13).

Methods

Our study utilized the WHO Unity protocol for cohort sero-epidemiological studies of COVID-19 in general population. We conducted random sampling stratified by age group and sex. Individuals aged 10 years and older in the cities of Ouagadougou and Bobo-Dioulasso, Burkina Faso were included and surveyed at 4 time points, each 21 days apart, from March 3 to May 15, 2021. WANTAI SARS-CoV-2 Ab ELISA serological tests were used to detect total antibodies (IgM, IgG) in serum. Predictors were investigated using Cox proportional hazards regression.

Results

We analyzed the data from 1399 participants (1051 in Ouagadougou, 348 in Bobo-Dioulasso) who were SARS-CoV-2 seronegative at baseline and had at least one follow-up visit. The incidence rate of SARS-CoV-2 seroconversion was 14.3 cases [95%CI 13.3–15.4] per 100 person-weeks. The incidence rate was almost three times higher in Ouagadougou than in Bobo-Dioulasso (Incidence rate ratio: IRR = 2.7 [2.2–3.2], p < 0.001). The highest incidence rate was reported among women aged 19–59 years in Ouagadougou (22.8 cases [19.6–26.4] per 100 person-weeks) and the lowest among participants aged 60 years and over in Bobo-Dioulasso, 6.3 cases [4.6–8.6] per 100 person-weeks. Multivariable analysis showed that participants aged 19 years and older were almost twice as likely to seroconvert during the study period compared with those aged 10 to 18 years (Hazard ratio: HR = 1.7 [1.3–2.3], p < 0.001). Those aged 10–18 years exhibited more asymptomatic forms than those aged 19 years and older, among those who achieved seroconversion (72.9% vs. 40.4%, p < 0.001).

Conclusion

The spread of COVID-19 is more rapid in adults and in large cities. Strategies to control this pandemic in Burkina Faso, must take this into account. Adults living in large cities should be the priority targets for vaccination efforts against COVID-19.
Memory B-cells are enriched in the blood of patients with acute Buruli ulcer disease: a prospective observational study
Authors: Adjei Jonathan Kofi , Aniagyei Wilfred , Adankwah Ernest , Seyfarth Julia , Mayatepek Ertan , Berko Daniel Antwi , Ackam Nancy , Annani-Akollor Max Efui , Sakyi Samuel Asamoah , Amoako Yaw Ampem , Owusu Dorcas , Jacobsen Marc , Phillips Richard Odame
Published: June 2023

Background

Buruli ulcer disease (BUD) caused by Mycobacterium (M.) ulcerans is characterized by necrotic skin lesions. As for other mycobacterial infections, e.g., tuberculosis, the immune response is important for host protection. B-cells may play a role in antimycobacterial immunity but studies characterizing the B-cell repertoire and memory generation in BUD and during the course of treatment are scarce.

Methods

We investigated the adaptive immune cell repertoire in children with BUD and healthy matched controls by flow cytometry. Analyses prior to treatment, also in a study group of patients with tuberculosis, as well as three time points during BUD treatment (i.e., week 8, 16, and 32) were performed. In addition, BUD disease severity as well as treatment response were analysed for association with B-cell repertoire differences.

Results

Children with BUD had comparable total B- and T-cell proportions but differed largely in B-cell subsets. Memory B-cell (B mem) proportions were higher in children with BUD whereas regulatory B-cell (B reg) proportions were lower as compared to healthy controls and tuberculosis patients. Lower naïve (B naïve) and higher transitional B-cell (B trans) proportions characterized children with BUD in comparison with tuberculosis patients. Under treatment, B mem proportions decreased significantly whereas proportions of B reg and B naive increased concomitantly in children with BUD. Also, we found significant correlation between lesion size and B mem as well as B reg. However, we did not detect associations between treatment efficacy and B-cell proportions.

Conclusions

These results suggest a role of B-cell subsets in the immune response against M. ulcerans. Furthermore, changes in B-cell subset proportions may be used as markers for treatment monitoring in BUD.
Comparison of endotracheal aspirate and bronchoalveolar lavage fluid metagenomic next-generation sequencing in severe pneumonia: a nested, matched case–control study
Authors: Bao Renren , Mei Qing , Yang Tianjun , Zhang Lei , Zhu Chunyan , Fan Xiaoqin , Wang Yinzhong , Tong Fei , He Yuxi , Fang Xiaowei , Geng Shike , Yang Yu , Sheng Ximei , Pan Aijun
Published: June 2023

Objectives

To compare clinical outcomes in patients with severe pneumonia according to the diagnostic strategy used.

Methods

In this retrospective, nested, case–control study, patients with severe pneumonia who had undergone endotracheal aspirate (ETA) metagenomic next-generation sequencing of (mNGS) testing (n = 53) were matched at a ratio of 1 to 2 (n = 106) by sex, age, underlying diseases, immune status, disease severity scores, and type of pneumonia with patients who had undergone bronchoalveolar lavage fluid (BALF) mNGS. The microbiological characteristics and patient’s prognosis of the two groups were compared.

Results

An overall comparison between the two groups showed no significant differences in bacterial, fungal, viral, or mixed infections. However, subgroup analysis of 18 patients who received paired ETA and BALF mNGS showed a complete agreement rate for the two specimens of 33.3%. There were more cases for whom targeted treatment was initiated (36.79% vs. 22.64%; P = 0.043) and fewer cases who received no clinical benefit after mNGS (5.66% vs. 15.09%; P = 0.048) in the BALF group. The pneumonia improvement rate in the BALF group was significantly higher than in the ETA group (73.58% vs. 87.74%, P = 0.024). However, there were no significant differences in ICU mortality or 28-day mortality.

Conclusions

We do not recommend using ETA mNGS as the first-choice method for analyzing airway pathogenic specimens from severe pneumonia patients.
Leishmania species and clinical characteristics of Pacific and Amazon cutaneous leishmaniasis in Ecuador and determinants of health-seeking delay: a cross-sectional study
Authors: Bezemer Jacob M. , Freire-Paspuel Byron P. , Schallig Henk D. F. H. , de Vries Henry J.C. , Calvopiña Manuel
Published: June 2023

Background

Cutaneous Leishmaniasis (CL) affects up to 5.000 people in Ecuador each year.L. guyanensisandL. braziliensisare the most common of the eight CL-causingLeishmaniaspecies. Earlier CL research concentrated on the easily accessible Pacific region. This study aims to describe theLeishmaniaspecies in Pacific and Amazon ecoregions, to analyze regional differences in CL patient clinical presentation, and to identify determinants of health-seeking delay.

Methods

All cases in this cross-sectional study were diagnosed using smear slide microscopy, PCR, or both. Cytochrome B gene sequencing was used to identify the causativeLeishmaniaspecies in qPCR-positive samples.

Results

This study included 245 patients, with 154 (63%) infected in the Pacific region and 91 (37%) infected in the Amazon. CausativeLeishmaniaspecies were identified in 135 patients (73% of qPCR positives).L. guyanensiswas identified in 76% (102/135) of the samples andL. braziliensisin 19% (26/135). The Pacific region had a low prevalence of 6% (5/89) ofL. braziliensis. For the first time, we reportL. guyanensisfrom the central Amazon,L. braziliensisfrom the northern Pacific, andL. lainsonifrom both the central Amazon and northern Pacific. Amazon cases had a longer median health-seeking delay in months (2.0, IQR 3.0) than Pacific cases (1.0, IQR 1.5). Prolonged health-seeking delay was associated with older age, Amerindian ethnicity, infection at lower altitudes, non-ulcerative lesions, and lesions on the lower limbs.

Conclusions

In the Pacific region, health-seeking delay is relatively short andL. braziliensisprevalence remains low. Limited access to health care and stigma might explain the prolonged health-seeking delay in the Amazon. We recommend larger studies on the distribution ofLeishmaniaspecies in Amazon CL cases and additional regional research into diagnostic test accuracy. Furthermore, the determinants of health-seeking delay in Ecuador should be investigated further.
Digital panoramic radiography and CBCT as auxiliary tools for detection of low bone mineral density in post-menopausal women: a cross-sectional study
Authors: Abdinian Mehrdad , Milaei Mina , Soltani Parisa
Published: June 2023

Background

Osteoporosis is a chronic, multifactorial skeletal disease that occurs especially in women following a decrease in estrogen levels and decrease in bone mineral density. The aim of this study was to evaluate the relationship between qualitative and quantitative indexes in panoramic radiographs and quantitative indexes in CBCT images with femoral and vertebral BMD in postmenopausal women.

Methods

This comparative cross-sectional study was performed on postmenopausal women aging 40 to 80 years attending for obtaining either panoramic radiograph or mandibular CBCT scan. Dual energy X-ray absorptiometry (DEXA) was performed from the femur and lumbar vertebra. Quantitative parameters of mental index (MI), panoramic mandibular index (PMI), antegonial index (AI) as well as qualitative parameters of mandibular cortical index (MCI) and trabecular bone pattern (TP) were evaluated in panoramic radiographs. Quantitative parameters computed tomography mandibular index (CTMI), computed tomography index (inferior) [CTI(I)] and computed tomography index (superior) [CTI(S)] were analyzed in CBCT images. Kolmogorov-Smirnov tests and Pearson correlation coefficient were used (α = 0.05).

Results

In individuals with panoramic radiography, statistically significant correlations were observed between MI with vertebral and femoral T-score, AI with vertebral and femoral T-score (except for the right AI with femoral T-score), and TP with vertebral and femoral T-score (p < 0.05). In the group with CBCT scans, the correlations between CTMI with vertebral and femoral T-score, CTI(I) with vertebral and femoral T-score, and CTI(S) with vertebral and femoral T-score were statistically significant (p < 0.05).

Conclusions

in CBCT images, quantitative indexes of CTMI, CTI(I), and CTI(S), and in panoramic images, quantitative indexes of MI and AI and qualitative index of TP can be used to predict the possibility of osteoporosis in postmenopausal women.
Effect of dialytic phosphate reduction rate on mortality in maintenance hemodialysis patients: a matched case–control study
Authors: Yang Shuixiu , Diao Zongli , Liu Wenhu , Guo Wang
Published: June 2023

Background

Phosphates, similar to urea, are small molecular substances that can be cleared during dialysis. Dialytic phosphate reduction rate (PRR) may, to some extent, be related to the relative amount of phosphates cleared during dialysis. However, few studies have evaluated the associations between PRR and mortality in maintenance hemodialysis (MHD) patients. In this study, we investigated the association between PRR and clinical outcomes in MHD patients.

Methods

This was a retrospective, matched case–control study. Data were collected from the Beijing Hemodialysis Quality Control and Improvement Center. Patients were divided into four groups according to PRR quartile. Age, sex, and diabetes were matched between the groups. The primary outcome was all-cause death, and the secondary outcome was cardiocerebrovascular death.

Results

The study cohort comprised 4063 patients who were divided into four groups according to the PRR quartile: group PRR1 (< 48.35%), group PRR2 (48.35% — 54.14%), group PRR3 (54.14% — 59.14%), and group PRR4 (≥ 59.14%). We enrolled 2172 patients (543 in each study group) by case–control matching. The all-cause death rates were as follows: group PRR1: 22.5% (122/543), group PRR2: 20.1% (109/543), group PRR3: 19.3% (105/543), and group PRR4: 19.3% (105/543). No significant differences in all-cause and cardiocerebrovascular death rates according to the Kaplan–Meier survival curves were found between the groups (log-rank test, P > 0.05). Multivariable Cox regression analysis revealed no significant differences in all-cause and cardiocerebrovascular death rates between the four groups (P = 0.461; adjusted hazard ratio, 0.99; 95% confidence interval, 0.97 – 1.02 versus P = 0.068; adjusted hazard ratio, 0.99; 95% confidence interval, 0.97 – 1.00, respectively).

Conclusions

Dialytic PRR was not significantly associated with all-cause death and cardiocerebrovascular death in MHD patients.
Predicting acute radiation dermatitis in breast cancer: a prospective cohort study
Authors: Xie Yuxiu , Hu Ting , Chen Renwang , Chang Haiyan , Wang Qiong , Cheng Jing
Published: June 2023

Background

Acute radiation dermatitis (ARD) is one of the most common acute adverse reactions in breast cancer patients during and immediately after radiotherapy. As ARD affects patient quality of life, it is important to conduct individualized risk assessments of patients in order to identify those patients most at risk of developing severe ARD.

Methods

The data of breast cancer patients who received radiotherapy were prospectively collected and analyzed. Serum ferritin, high-sensitivity C-reactive protein (hs-CRP) levels, and percentages of lymphocyte subsets were measured before radiotherapy. ARD was graded (0–6 grade), according to the Oncology Nursing Society Skin Toxicity Scale. Univariate and multivariate logistic regression analyses were used and the odds ratio (OR) and 95% confidence interval (CI) of each factor were calculated.

Results

This study included 455 breast cancer patients. After radiotherapy, 59.6% and 17.8% of patients developed at least 3 (3+) grade and at least 4 (4+) grade ARD, respectively. Multivariate logistic regression analysis found that body mass index (OR: 1.11, 95% CI: 1.01–1.22), diabetes (OR: 2.70, 95% CI: 1.11–6.60), smoking (OR: 3.04, 95% CI: 1.15–8.02), higher ferritin (OR: 3.31, 95% CI: 1.78–6.17), higher hs-CRP (OR: 1.96, 95% CI: 1.02–3.77), and higher CD3 + T cells (OR: 2.99, 95% CI: 1.10–3.58) were independent risk factors for 4 + grade ARD. Based on these findings, a nomogram model of 4 + grade ARD was further established. The nomogram AUC was 0.80 (95% CI: 0.75–0.86), making it more discriminative than any single factor.

Conclusion

BMI, diabetes, smoking history, higher ferritin, higher hs-CRP, and higher CD3 + T cells prior to radiotherapy for breast cancer are all independent risk factors for 4 + grade ARD. The results can provide evidence for clinicians to screen out high-risk patients, take precautions and carefully follow up on these patients before and during radiotherapy.
Cancer-specific survival in patients with cholangiocarcinoma after radical surgery: a Novel, dynamic nomogram based on clinicopathological features and serum markers
Authors: Zhou Shurui , Zhao Yue , Lu Yanzong , Liang Weiling , Ruan Jianmin , Lin Lijun , Lin Haoming , Huang Kaihong
Published: June 2023

Background

This study aims to (1) identify preoperative testing-based characteristics associated with enhanced prognosis and survival for cholangiocarcinoma patients, and (2)create a distinctive nomogram to anticipate each patient’s cancer-specific survival (CSS).

Methods

Retrospective analysis was performed on 197 CCA patients who underwent radical surgery at Sun Yat-sen Memorial Hospital; they were divided into a 131-person “training cohort” and a 66-person “internal validation cohort.“ The prognostic nomogram was created following a preliminary Cox proportional hazard regression search for independent factors influencing the patients’ CSS. Its applicable domain was examined via an external validation cohort, which included 235 patients from the Sun Yat-sen University Cancer Center.

Results

The median follow-up period for the 131 patients in the training group was 49.3 months (range, 9.3 to 133.9 months). One-, three-, and five-year CSS rates were 68.7%, 24.5%, and 9.2%, respectively, with the median CSS length being 27.4 months (range: 1.4 to 125.2 months). PLT, CEA, AFP, tumor location, differentiation, lymph node metastasis, chemotherapy, and TNM stage were determined to be independent risk factors for CCA patients by univariate and multivariate Cox proportional hazard regression analysis. We were able to accurately predict postoperative CSS after incorporating all of these characteristics into a nomogram. The AJCC’s 8th edition staging method’s C-indices were statistically substantially (P < 0.001) lower than the nomogram’s C-indices (0.84, 0.77, and 0.74 in the training, internal and external validation cohorts respectively).

Conclusions

A realistic and useful model for clinical decision-making and the optimization of therapy is presented as a nomogram that includes serum markers and clinicopathologic features for predicting postoperative survival in cholangiocarcinoma.
Donor lamella thickness after ultrathin Descemet stripping automated endothelial keratoplasty and its relation to postoperative visual acuity and pre-operative lamella measures
Authors: van Rooij Jeroen , Engel Angela , Steijger-Vermaat Petra , Molenaar Annemieke , Vigueras-Guillén Juan Pedro , Wubbels René J.
Published: June 2023

Background

To accurately measure ultrathin Descemet stripping automated endothelial keratoplasty (DSAEK) donor lamella thickness during the first postoperative year and to correlate this with pre-operative and other postoperative measurements.

Methods

Donor lamella thickness in 41 eyes undergoing DSAEK for Fuchs endothelial dystrophy (FED) was measured using the Tomey Casia OCT directly after graft preparation and at 1 week and 1, 3, 6 and 12 months postoperatively. Visual acuity and endothelial cell density were measured as the secondary parameters.

Results

Individual graft thickness profiles were shown to be fairly regular within the optically relevant area. There was a strong and highly significant correlation between the pre- and postoperative lamellar thicknesses at all time points (p < 0.0001). Compared with the measurements directly after preparation at the cornea bank, the lamella thickness decreased by 12% after 12 months. Between 1 and 12 months postoperatively, the lamella thickness (mean ± SD) changed from 112 ± 27 μm to 101 ± 21 μm. Best spectacle-corrected visual acuity (BSCVA) changed from 0.46 ± 0.30 logMAR pre-operatively through 0.36 ± 0.33 at 1 month to 0.13 ± 0.16 at 1 year postoperatively. The endothelial cell counts were comparable to those reported in previous studies.

Conclusions

Thickness profiles of individual grafts were fairly regular within the optically relevant area. A strong relationship between pre- and postoperative graft thicknesses was detected, and ultrathin DSAEK grafts prepared using methods similar to that applied in this study are expected to show a deswelling of around 12% during the first postoperative year. No correlation was detected between graft thickness and BSCVA.