bluuebunny/crossref_metadata_2025 huggingface dataset:
Spinal infection caused by Coxiella burnetii
Authors: Yang Sumin , Xue Bai , Hu Xiaowen , Zhou Weidong , Zhang Minglei , Zhao Mingwei
Published: January 2023

Background

Spinal infection caused by Coxiella burnetii is rare and difficult to diagnose. Here we reported a case of spinal infection from Coxiella burnetii detected by the metagenomic next-generation sequencing (mNGS).

Case presentation

A 66-year-old male farmer with no medical history reported severe sharp low back pain, numbness and lower limb weakness for three years. Magnetic resonance imaging (MRI) revealed bone destruction and spinal cord compression within L1 and L2. mNGS testing showed that the inspected specimen collected from spinal lesion was detected positively for Coxiella burnetii. After receiving the combined treatment of antibiotic therapy and surgical intervention, the patient recovered well, and the sagittal MRI showed that vertebral edema signals disappeared and the graft of bone fused 16 months after surgery.

Conclusion

The mNGS may be benefit for early diagnosis and intervention of non-specific spinal infection, and future studies should validate its effectiveness for clinical use in spinal infections. Additionally, antibiotic therapy combined with surgical intervention plays an important role on the treatment of spinal infection caused by Coxiella burnetii.
Analysis of the expression and prognostic significance of DDK complex in Hepatocarcinoma
Authors: Wang Min , Qiu Zu-Hua , Wang Yu-Zhuo , Lian Bo , Bai Jing-Kun , Zhou Yong-Jie , Ji Hong-Jie
Published: January 2023

Background

Hepatocellular carcinoma (HCC) remains one of the most common and lethal malignancies worldwide. Although DBF4-dependent kinase (DDK) complex composed of CDC7 kinase and its regulatory subunit DBF4 has been shown to be overexpressed in primary tumors and promotes tumor development, while its role and prognostic value in HCC remain largely unknown. In the present study, the expression of DBF4 and CDC7 and their relationship with clinical characteristics were comprehensively analyzed.

Methods

The mRNA expression profiles of HCC and the corresponding clinical data of HCC patients were downloaded from TCGA and GEO databases, respectively. The differences in DBF4 and CDC7 expression in tumor tissues and adjacent normal tissues were analyzed. HCC-derived tissue microarray (TMA) was used to evaluate and score the expression of CDC7 by immunohistochemistry (IHC) staining. The Kaplan–Meier method and the Cox regression method were used to analyze the relationship between overall survival and clinical characteristics of the patients. Gene set enrichment analysis (GSEA) was used to analyze the pathway enrichment of DBF4 and CDC7.

Results

DBF4 and CDC7 had similar expression patterns in HCC patients. Detailly, compared with adjacent tissues, both mRNA and protein of DBF4 and CDC7 were significantly higher in HCC, and their expression was positively correlated with AJCC_T stage, clinical stage and G stage (grade) of liver cancer patients, and higher DBF4 or CDC7 expression predicted a worse prognosis in HCC patients with shorter overall survival (OS), recurrence-free survival (RFS), disease-specific survival (DSS) and progress-free survival (PFS). Cox regression analysis suggested that both DBF4 and CDC7 were independent risk factors for the prognosis of HCC patients in TCGA dataset. GSEA suggested that both DBF4 and CDC7 were positively correlated with cell cycle and DNA replication. Finally, the prognostic value of CDC7 was furtherly confirmed by TMA-based IHC staining results.

Conclusions

Our study showed that DDK complex was significantly increased in HCC. Both DBF4 and CDC7 may be potential diagnostic and prognostic markers for HCC, and high expression of DDK members predicts a worse prognosis in patients with HCC, which may be associated with high tumor cell proliferation rate.
Investigating the functional role of SETD6 in lung adenocarcinoma
Authors: Xu Jing , Zhou Hui , Luo Ziling , Chen Jie , Liu Man
Published: January 2023

Background

SET domain containing 6 (SETD6) has been shown to be upregulated in multiple human cancers and can promote malignant cell survival. However, expression and function of SETD6 in lung adenocarcinoma (LUAD) remains unaddressed. This study aimed to demonstrate the expression pattern, biological roles and potential mechanisms by which SETD6 dysregulation is associated with LUAD.

Methods

The expression level of SETD6 was evaluated in LUAD clinical specimens and its correlation with clinical parameters were analyzed. In vitro, gain-of-function and loss-of-function experiments were performed to evaluate the effects of SETD6 on cell proliferation, apoptosis, migration, and colony formation of LUAD cell line A549. Western-blot was performed to investigate the involvement of nuclear factor-κB (NF-κB) and nuclear factor erythroid 2–related factor 2 (Nrf2) pathways as downstream signaling of SETD6 in LUAD cells.

Results

Compared with non-tumorous tissues, SETD6 was overexpressed in tumor tissues, and its overexpression significantly correlates with higher rates of regional lymph node metastasis and poor prognosis in patients with LUAD. In A549 cell line, SETD6 overexpression could promote cell proliferation, migration, colony formation and inhibit cell apoptosis, whereas SETD6 knockdown caused the opposite effects. Furthermore, we demonstrated that the mechanisms underlying the effect of SETD6 on LUAD biological behaviors may be through its interaction with NF-κB and Nrf2 signaling pathways.

Conclusions

SETD6, which is highly expressed in LUAD tumor tissues, plays an important role in promoting the malignant behaviors of LUAD via likely the NF-κB and Nrf2 signaling pathways.
Implementation of a home-based colorectal cancer screening intervention in Malaysia (CRC-SIM)
Authors: Schliemann Désirée , Ramanathan Kogila , Ibrahim Tamin Nor Saleha Binti , O’Neill Ciaran , Cardwell Christopher R , Ismail Roshidi , Kassim Zaid , Kee Frank , Su Tin Tin , Donnelly Michael
Published: January 2023

Introduction

The Colorectal Cancer Screening Intervention for Malaysia (CRC-SIM) was a CRC study of home-based testing designed to improve low screening uptake using the immunochemical fecal occult blood test (iFOBT) in Malaysia.

Methods

This quasi-experimental study was informed by the Implementation Research Logic Model and evaluated with the RE-AIM framework. Trained data collectors recruited by phone, randomly selected, asymptomatic adults aged 50-75 years from Segamat District, who previously completed a health census form for the South East Asia Community Observatory (SEACO). Participants were posted an iFOBT kit and asked to return a photo of the completed test for screening by health care professionals. A regression analysis of evaluation data was conducted to identify which variables were associated with the outcome indicators of ‘study participation’ and ‘iFOBT completion’ and the CRC-SIM was evaluated in terms of its appropriateness, feasibility and acceptability.

Results

Seven hundred forty-seven eligible adults (52%) agreed to participate in this study and received an iFOBT kit. Participation was significantly lower amongst Chinese Malaysians (adjusted OR 0.45, 95% CI 0.35 - 0.59, p<0.001) compared to Malays and amongst participants from the rural sub-district (Gemereh) (adjusted OR 0.71, 95% CI 0.54 - 0.92, p=0.011) compared to the urban sub-district (Sungai Segamat). Less than half of participants (42%, n=311/747) completed the iFOBT. Test-kit completion was significantly higher amongst Chinese Malaysians (adjusted OR 3.15, 95% CI 2.11 - 4.69, p<0.001) and lower amongst participants with a monthly household income ≥RM 4,850 (adjusted OR 0.58, 95% CI 0.39 - 0.87, p=0.009) compared to participants with a lower household income. The main reported reason for non-participation was ‘not interested’ (58.6%) and main implementation challenges related to invalid photographs from participants and engaging iFOBT positive participants in further clinic consultations and procedures.

Conclusion

Home-testing for CRC (test completion) appeared to be acceptable to only around one-fifth of the target population in Malaysia. However, mindful of the challenging circumstances surrounding the pandemic, the CRC-SIM merits consideration by public health planners as a method of increasing screening in Malaysia, and other low- and middle-income countries.
The prognostic significance of tumor-associated neutrophils and circulating neutrophils in glioblastoma (WHO CNS5 classification)
Authors: Wang Xuezhen , Li Xiaoxia , Wu Yufan , Hong Jinsheng , Zhang Mingwei
Published: January 2023

Background

Tumor-associated neutrophils (TANs) in the tumor microenvironment are prognostic biomarkers in many malignancies. However, it is unclear whether TANs can serve as a prognostic marker for clinical outcomes in patients with glioblastoma (GBM), as classified according to World Health Organization Classification of Tumors of the Central Nervous System, fifth edition (CNS5). In the present study, we analyzed correlations of TANs and peripheral blood neutrophils prior to radiotherapy with overall survival (OS) in GBM (CNS5).

Methods

RNA-seq expression profiles of patients with newly diagnosed GBM (CNS5) were extracted from The Cancer Genome Atlas (TCGA), and The Chinese Glioma Genome Atlas (CGGA). TAN infiltration was inferred using CIBERSORTx algorithm. Neutrophil counts prior to radiotherapy in newly diagnosed GBM (CNS5) were obtained from the First Affiliated Hospital of Fujian Medical University. The prognostic value of TANs and peripheral blood neutrophils before radiotherapy was investigated using Kaplan-Meier analysis and Cox proportional hazards models. The robustness of these findings was evaluated by sensitivity analysis, and E values were calculated.

Results

A total of 146 and 173 individuals with GBM (CNS5) were identified from the TCGA and CGGA cohorts, respectively. High infiltration of TANs was of prognostic of poor OS in TCGA (HR = 1.621, 95% CI: 1.004–2.619) and CGGA (HR = 1.546, 95% CI: 1.029–2.323). Levels of peripheral blood neutrophils before radiotherapy (HR = 2.073, 95% CI: 1.077–3.990) were independently associated with poor prognosis. Sensitivity analysis determined that the E-value of high TANs infiltration was 2.140 and 2.465 in the TCGA and CGGA cohorts.

Conclusions

TANs and peripheral blood neutrophil levels before radiotherapy are prognostic of poor outcomes in GBM (CNS5).
Association of perinatal factors with suspected developmental delay in urban children aged 1–36 months - a large-scale cross-sectional study in China
Authors: Yang You , Shi Lei , Jin Xingming , Tong Shilu
Published: January 2023

Background

Studies on perinatal risk factors and the developmental delay of children have been inconclusive and few studies have assessed the association between infants and toddlers’ body mass index (BMI) and developmental outcomes.

Methods

We conducted a cross-sectional study of children aged 1—36 months who had a routine physical examination in the child health departments of hospitals from March 2018 to November 2021 in 16 provinces, 4 autonomous regions and 2 municipalities directly under the central government by using the Infant Toddler Growth Development Screening Test (ITGDST). Normal children were defined as those with scores ≥ mean – 2 standard deviations (SD), while children with developmental delay were those with scores < mean—2SD in terms of overall development, gross motor, fine motor and language development. Binary logistic regression was used to analyze the risk factors of gross motor, fine motor, language and overall neurodevelopment.

Results

After removing some provinces with a small sample size and children with incomplete data, 178,235 children with 12 complete variables were included in the final analysis. The rate of overall developmental delay was 4.5%, while 12.5% of children had at least one developmental delay aspect. Boys, parity, advanced maternal age, multiple birth, cesarean section, neonatal injury, family heredity history, microcephaly, abnormal BMI at birth and at physical examination after controlling the confounding of other factors had a significant effect on development delay (overall neurodevelopment, gross motor, fine motor or language development). Per capita gross domestic product was a protective factor for the children’s neuropsychological development.

Conclusions

This study reveals significant associations of perinatal factors and BMI with developmental delay in the Chinese children aged 1–36 months, which may be crucial for early intervention.
Prevalence and correlates of tobacco use in Botswana: evidence from the 2014 Botswana STEPwise survey
Authors: Keetile Mpho , Ndlovu Kagiso , Setshegetso Naomi , Yaya Sanni , Serojane Fattimah
Published: January 2023

Background

Tobacco use is one of the notable risk factors for non-communicable diseases globally. The objective of this study was to assess the prevalence of tobacco use and identify its correlates in the general population of Botswana aged 15 to 69 years.

Methods

This study used a nationally representative WHO STEPwise Approach to Non-Communicable Disease Risk Factor Surveillance (STEPS) risk factors conducted in 2014 to explore the prevalence of tobacco use and its correlates in Botswana. Using IBM SPSS version 27, data on 4062 people aged 15 to 69 years who had been selected using multistage cluster sampling and had successfully completed the individual questionnaire were analysed. The prevalence of current tobacco smoking and smokeless tobacco use was determined using descriptive statistics while multivariable logistic regression was employed to assess correlates of current tobacco smoking and smokeless tobacco use. All comparisons were statistically significant at 5% significance level.

Results

From a total sample of 4062 participants the prevalence of current tobacco smoking was estimated to be 12.9% while smokeless tobacco use was 3.2%. Adjusted results indicate that the odds of current tobacco smoking were eight times (AOR = 8.57, C.I = 6.28-11.7) higher among males compared to their female counterparts; six(AOR = 6.52, C.I 3.64-11.6) and three (AOR = 3.27, C.I. =2.07-5.15) times higher among respondents with no education and primary level education respectively, compared to their counterparts with tertiary or higher education; while for alcohol users the odds of current tobacco smoking were four times (AOR = 4.28, C.I = 2.93-6.24) higher than among non-alcohol users. The odds of smokeless tobacco use were significantly higher among women compared to men (AOR = 7.34, C.I = 4.01-13.4); individuals aged 50-59 (AOR = 1.15, C.I = 1.06-3.37) and 60-69 years (AOR = 1.23, C.I. =1.08-3.63) compared to 15-29 years; individuals with no education (AOR = 2.07, C.I = 1.03-4.02) and primary education (AOR = 1.05, C.I = 1.01-2.23) compared to individuals with tertiary education. However, the odds of smokeless tobacco use were significantly lower among individuals who consume alcohol (AOR = 0.48, C.I. = 0.29-0.80) compared to non-alcohol consumers.

Conclusion

Findings of this study indicate the need to strengthen existing national policies to reduce harmful use of tobacco among men, women, older adults, no or primary education level individuals and alcohol users.
Household catastrophic health expenditure for COVID-19 during March-August 2021, in South India: a cross-sectional study
Authors: Rajalakshmi Elumalai , Sasidharan Akhil , Bagepally Bhavani Shankara , Kumar Muthusamy Santhosh , Manickam Ponnaiah , Selva Vinayagam T. S. , Sampath P. , Parthipan K
Published: January 2023

Background

The Coronavirus disease 2019 (COVID-19) pandemic increased the utilisation of healthcare services. Such utilization could lead to higher out-of-pocket expenditure (OOPE) and catastrophic health expenditures (CHE). We estimated OOPE and the proportion of households that experienced CHE by conducting a cross-sectional survey of 1200 randomly selected confirmed COVID-19 cases.

Methods

A cross-sectional survey was conducted by telephonic interviews of 1200 randomly selected COVID-19 patients who tested positive between 1 March and 31 August 2021. We collected household-level information on demographics, income, expenditure, insurance coverage, direct medical and non-medical costs incurred toward COVID-19 management. We estimated the proportion of CHE with a 95% confidence interval. We examined the association of household characteristics; COVID-19 cases, severity, and hospitalisation status with CHE. A multivariable logistic regression analysis was conducted to ascertain the effects of variables of interest on the likelihood that households face CHE due to COVID-19.

Results

The mean (95%CI) OOPE per household was INR 122,221 (92,744–1,51,698) [US$1,643 (1,247–2,040)]. Among households, 61.7% faced OOPE, and 25.8% experienced CHE due to COVID-19. The odds of facing CHE were high among the households; with a family member over 65 years [OR = 2.89 (2.03–4.12)], with a comorbid individual [OR = 3.38 (2.41–4.75)], in the lowest income quintile [OR = 1.82 (1.12–2.95)], any member visited private hospital [OR = 11.85 (7.68–18.27)]. The odds of having CHE in a household who have received insurance claims [OR = 5.8 (2.81- 11.97)] were high. Households with one and more than one severe COVID-19 increased the risk of CHE by more than two-times and three-times respectively [AOR = 2.67 (1.27–5.58); AOR = 3.18 (1.49–6.81)].

Conclusion

COVID-19 severity increases household OOPE and CHE. Strengthening the public healthcare and health insurance with higher health financing is indispensable for financial risk protection of households with severe COVID-19 from CHE.
Menstrual hygiene practice and associated factors among adolescent girls in sub-Saharan Africa: a systematic review and meta-analysis
Authors: Anbesu Etsay Woldu , Asgedom Dejen Kahsay
Published: January 2023

Background

Menstrual hygiene has not received adequate attention in Sub-Saharan Africa, and there is a lack of regional representative data. Therefore, this study aimed to estimate the pooled prevalence of good menstrual hygiene practices and associated factors among adolescent girls in sub-Saharan Africa.

Methods

In this study,the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were used to develop the review manuscript. Online electronic databases, such as PubMed/Medline, Google Scholar, and CINAHL, were searched to retrieve available studies. The database search was conducted from January 1 to May 17, 2022. The selection, quality assessment, and data extraction of the studies were performed. Quality assessment of the studies was performed using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument. Subgroup analysis and meta-regression were performed based on country, study area, and sample size. Publication bias was examined by funnel plots and Egger’s test. The statistical analysis was conducted using STATA version 14 software and RevMan software, and statistical significance was declared at apvalue of less than 0.05.

Protocol registration number

CRD42020165628.

Results

A total of 229 studies were retrieved, and 14 studies were included in the final meta-analysis. The pooled prevalence of good menstrual hygiene practices was 45% (95% CI, (37, 53). Adolescents from urban residences (OR = 3.03, 95% CI (2.3, 3.97)), able to afford menstrual sanitary products (OR = 2.17, 95% CI (1.42, 3.3)), and from educated mothers (OR = 2.33, 95% CI (1.32, 4.12)) were associated with increased odds of good menstrual hygiene practice.

Conclusion

The pooled prevalence of menstrual hygiene practices was low compared to the SDG 6.2 target by 2030. “Achieve access to adequate and equitable sanitation and hygiene for all, paying special attention to the needs of women and girls and those in vulnerable situations”. Therefore, improving the accessibility of a safe water supply, hygiene, sanitation facilities and affordability of menstrual products and promoting maternal education are mandatory and should be part of government-level public health policy to prevent related health issues, loss of economic output and education opportunities.
Complexity and interplay of faced adversities and perceived health and well-being in highly vulnerable pregnant women—the Mothers of Rotterdam program
Authors: Bertens L. C. M. , Mohabier K. S. C. , van der Hulst M. , Broekharst D. S. E. , Ismaili M’hamdi H. , Burdorf A. , Kok R. , de Graaf J. P. , Steegers E. A. P.
Published: January 2023

Background

Living in socially disadvantaged circumstances has a widespread impact on one’s physical and mental health. That is why individuals living in this situation are often considered vulnerable. When pregnant, not only the woman’s health is affected, but also that of her (unborn) child. It is well accepted that vulnerable populations experience worse (perinatal) health, however, little is known about the lived adversities and health of these vulnerable individuals.

Objectives

With this article, insights into this group of highly vulnerable pregnant women are provided by describing the adversities these women face and their experienced well-being.

Methods

Highly vulnerable women were recruited when referred to tailored social care during pregnancy. Being highly vulnerable was defined as facing at least three different adversities divided over two or more life-domains. The heat map method was used to assess the interplay between adversities from the different life domains. Demographics and results from the baseline questionnaires on self-sufficiency and perceived health and well-being were presented.

Results

Nine hundred nineteen pregnant women were referred to social care (2016–2020). Overall, women had a median of six adversities, distributed over four life-domains. The heat map revealed a large variety in lived adversities, which originated from two parental clusters, one dominated by financial adversities and the other by a the combination of a broad range of adversities. The perceived health was moderate, and 25–34% experienced moderate to severe levels of depression, anxiety or stress. This did not differ between the two parental clusters.

Conclusions

This study shows that highly vulnerable pregnant women deal with multiple adversities affecting not only their social and economic position but also their health and well-being.
Comparison of diaphyseal and metaphyseal ulnar shortening osteotomies for the treatment of ulnar impaction syndrome
Authors: Yang Haoyu , Qi Weiya , Zhang Fei , Zhang Qian , Liu Yuzhou , Lu Zhengfeng , Mi Jingyi , Zhao Gang
Published: January 2023

Background

Ulnar shortening osteotomy (USO) is a common surgical procedure for the treatment of ulnar impaction syndrome (UIS). The purpose of this study was to compare the results of metaphyseal and diaphyseal USO. 

Methods

This retrospective study compared the clinical outcomes and complications of 32 patients who underwent diaphyseal step-cut USO (n = 10), diaphyseal oblique USO (n = 12), or metaphyseal USO (n = 10).

Results

Patient characteristics, ulnar variance, wrist range of motion, preoperative pain, grip strength, and functional scores (quick disability of the arm, shoulder, and hand and patient-rated wrist evaluation) were comparable. Both operation time (79.5 vs. 138/139 min) and incision length (7.80 vs. 9.67/13.00 cm) were shorter in the metaphyseal USO than in the diaphyseal oblique/step-cut USO. Compared with diaphyseal oblique/step-cut USO, metaphyseal osteotomies were associated with greater improvement in the pain on postoperative day 3 and shorter bone healing time. The requirements for implant removal were the same among the three groups. No complications were observed in any group.

Conclusion

Compared with diaphyseal USO, metaphyseal USO has advantages for operation time and incision length, early postoperative pain, bone healing in UIS management. The results suggested that metaphyseal USO could be widely applied to the surgical treatment of UIS. However, the long-term outcomes of these techniques still require further evaluation using more large-scale, randomized clinical trials.
Effectiveness and prognostic factors of different minimally invasive surgeries for vertebral compression fractures
Authors: Wang Wei , Liu Yi , Wan Hao , Zeng LiangPing , Peng ZongLi , Yang DanDan , Tian Kun
Published: January 2023

Background

The aging of China's population has led to an increase in the incidence rate of osteoporosis, which indirectly increases the risk of OVCF in osteoporosis patients. Low back pain is the main symptom of OVCF, and severe patients can further develop kyphosis. Although the conservative treatment of OVCF can effectively control the patient's condition, long-term bed rest will increase the risk of OVCF complications. Minimally invasive surgery is a common solution for OVCF.

Methods

100 OVCF patients admitted to our hospital from January 2021 to January 2022 are selected for analysis and randomly divided into PVP group and PKP group, 50 cases in each group. The PVP group and the PKP group undergo PVP and PKP operations respectively. The differences in efficacy indicators and adverse reactions are compared, and the multivariate Logistic regression method is used to analyze the influencing factors of postoperative secondary fractures in patients with vertebral compression fractures.

Results

Compared with the PVP group, the total effective rate of PKP group is significantly increased, and the VAS, ODI score, kyphotic Cobb Angle, lateral distribution rate of bone cement and bone cement leakage rate are significantly decreased (P < 0.05). Age ≥ 80 years old, female, glucocorticoid use, lateral distribution of bone cement and bone cement leakage are significantly higher in the proportion of secondary fractures and are independent risk factors for postoperative secondary fractures in patients with OVCF.

Conclusion

PKP surgery has a higher efficacy in the treatment of OVCF patients, which can reduce the incidence of pain, adverse reactions and promote the recovery of kyphotic Cobb Angle. PKP surgery has a higher value in the treatment of OVCF. In addition, the influencing factors of secondary fracture after minimally invasive surgery in OVCF patients include age, gender, glucocorticoid use, bone cement distribution pattern, bone cement leakage, etc.
Is local autogenous morselized bone harvested from decompression through a posterior-transforaminal approach sufficient for single-level interbody fusion in the lower lumbar spine?
Authors: Yang Jin , Yang Yong , Wang Gaoju , Xu Shuang , Li Guangzhou , Zhang Shuai , Yang Chaohua , Wang Song , Wang Qing
Published: January 2023

Background

To determine the volume and applicability of local autogenous morselized bone (LAMB) harvested and used during posterior-transforaminal lumbar interbody fusion (P-TLIF) in the lower lumbar spine.

Methods

Clinical and radiographic data of 147 patients (87 males) undergoing P-TLIF from January 2017 to December 2019 for lumbar degenerative diseases were retrospectively analyzed. Computed tomography was used to assess the fusion status (at 6 months, 1 year, and the last follow-up postoperatively), restored disc height, graft fusion area and volume, and the minimum required bone volume (MRBV). Clinical outcomes of P-TLIF were assessed using the Oswestry Disability Index (ODI) and visual analog scale (VAS) for low back pain (LBP) and leg pain (LP).

Results

The mean follow-up period was 28.4 ± 4.49 months. The patient’s age and diagnosis were correlated to the volume and weight of LAMB (mean volume and weight: 3.50 ± 0.45 mL and 3.88 ± 0.47 g, respectively). The ratio of actual fusion area to the total disc endplate and the ratio of actual fusion volume to the total volume of the disc space were > 40%. MRBV ranged from 1.83 ± 0.48 cm3 to 2.97 ± 0.68 cm3. The proportion of grade 4 or 5 fusions increased from 60.6% at 6 months to 96.6% at the last follow-up. The ODI, VAS-LP, and VAS-LBP scores significantly improved after surgery and remained unchanged during the follow-up.

Conclusion

When combined with a cage, the volume of LAMB harvested from decompression through the unilateral approach at a single-level is sufficient to achieve a solid interbody fusion in the lower lumbar spine with excellent clinical and radiographic outcomes.
Novel hormonal therapies in the management of advanced prostate cancer: extrapolating Asian findings to Southeast Asia
Authors: Ong Teng Aik , Saad Marniza , Lim Jasmine , Lee Hsien Hooi
Published: January 2023

There is a paucity of information on the use of novel hormonal agents in Southeast Asian patients. We reviewed the clinical roles of novel hormonal therapy (NHT), namely abiraterone acetate (AA), enzalutamide, apalutamide and darolutamide, in the management of advanced prostate cancer, and data on its use in Asian patients, in order to extrapolate these findings to the Southeast Asian patient population. There are some differences in the molecular features between the NHTs, which influenced their respective permeabilities through the blood–brain barrier. The Asian sub-analyses of the landmark studies of each NHT were limited. The primary endpoints of the Asian sub-analyses generally reflect the efficacy outcomes of the respective landmark study. Hypertension, fatigue, musculoskeletal disorders, rash, and hot flushes were among the common toxicities observed in Asian patients. Real-world data on AA in the Asian setting is favourable, but data is limited for enzalutamide, apalutamide and darolutamide. Based on the sub-analyses and real-world data, the efficacy and safety of NHTs in the Asian patients showed a similar trend to the respective landmark studies. The lack of clinical trials in the Southeast Asian region hampers the ability to make a robust conclusion on any specific efficacy or safety differences that may be present; clinicians must assume that the broader Asian sub-analyses and real-world data reflects Southeast Asian patients' outcomes.
Production and bioprocessing of camptothecin from Aspergillus terreus, an endophyte of Cestrum parqui, restoring their biosynthetic potency by Citrus limonum peel extracts
Authors: El-Sayed Ashraf S. A. , George Nelly M. , Abou-Elnour Amira , El-Mekkawy Rasha M. , El-Demerdash Marwa M.
Published: January 2023

The metabolic potency of fungi as camptothecin producer elevates their prospective use as an industrial platform for commercial production, however, the loss of camptothecin productivity by fungi with the storage and subculturing are the major obstacle. Thus, screening for endophytic fungal isolates inhabiting ethnopharmacological plants with an obvious metabolic stability and sustainability for camptothecin biosynthesis could be one of the most feasible paradigms. Aspergillus terreus ON908494.1, an endophyte of Cestrum parqui was morphologically and molecularly verified, displaying the most potent camptothecin biosynthetic potency. The chemical identity of A. terreus camptothecin was confirmed from the HPLC, FTIR and LC–MS/MS analyses, gave the same molecular structure and mass fragmentation patterns of authentic one. The purified putative camptothecin displayed a strong anticancer activity towards HepG-2 and MCF-7 with IC50 values 0.96 and 1.4 µM, respectively, with no toxicity to OEC normal cells. As well as, the purified camptothecin displayed a significant antifungal activity towards fungal human pathogen Candida albicans, Aspergillus flavus, and A. parasiticus, ensuring the unique structural activity relationships of A. terreus camptothecin, as a powerful dually active anticancer and antimicrobial agent. The camptothecin productivity of A. terreus was maximized by bioprocessing with Plackett–Burman design, with an overall 1.5 folds increment (170.5 µg/L), comparing to control culture. So, the optimal medium components for maximum yield of camptothecin by A. terreus was acid why (2.0 mL/L), Diaion HP20 (2.0 g/L), Amberlite XAD (2.0 g/L), dextrin (5.0 g/L), glucose (10.0 g/L), salicylic acid (2.0 g/L), serine (4.0 g/L), cysteine (4.0 g/L) and glutamate (10.0 g/L), at pH 6 for 15 days incubation. By the 5th generation of A. terreus, the camptothecin yield was reduced by 60%, comparing to zero culture. Interestingly, the productivity of camptothecin by A. terreus has been completely restored and over increased (210 µg/L), comparing to the 3rd generation A. terreus (90 µg/L) upon addition of methanolic extracts of Citrus limonum peels, revealing the presence of some chemical signals that triggers the camptothecin biosynthetic machinery. The feasibility of complete restoring of camptothecin biosynthetic-machinery of A. terreus for stable and sustainable production of camptothecin, pave the way for using this fungal isolate as new platform for scaling-up the camptothecin production.
Study designs, measures and indexes used in studying the structural racism as a social determinant of health in high income countries from 2000–2022: evidence from a scoping review
Authors: Ahmed Md Koushik , Scretching Desiree , Lane Sandra D.
Published: January 2023

Background

Globally, structural racism has been well documented as an important social determinant of health (SODH) resulting in racial inequality related to health. Although studies on structural racism have increased over the years, the selection of appropriate designs, measures, and indexes of measurement that respond to SODH has not been comprehensively documented. Therefore, the lack of evidence seems to exist. This scoping review was conducted to map and summarize global evidence on the use of various designs, measures, and indexes of measurement when studying structural racism as a social determinant of health.

Methods

We performed a scoping review of global evidence from 2000 to 2022 published in 5 databases: PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo, Web of Science, ProQuest, and relevant grey literature on structural racism. We conducted a systematic search using keywords and subject headings around 3 concepts. We included peer reviewed original research/review articles which conceived the framework of social determinants of health (SODH) and studied structural racism.

Results

Our review identified 1793 bibliographic citations for screening and 54 articles for final review. Articles reported 19 types of study design, 87 measures of exposure and 58 measures of health outcomes related to structural racism. 73 indexes or scales of measurement were used to assess health impacts of structural racism. Majority of articles were primary research (n = 43/54 articles; 79.6%), used quantitative research method (n = 32/54 articles; 59.3%) and predominantly conducted in the United States (n = 46/54 articles; 85.2.6%). Cross-sectional study design was the most used design (n = 17/54 articles; 31.5%) followed by systematic review (n = 7/54 articles; 13.0%) and narrative review (n = 6/54 articles; 11.1%). Housing and residential segregation was the largest cluster of exposure with the highest impact in infant health outcome.

Conclusions

Our review found several key gaps and research priorities on structural racism such as lack of longitudinal studies and availability of structural or ecological data, lack of consensus on the use of consolidated appropriate measures, indexes of measurement and appropriate study designs that can capture complex interactions of exposure and outcomes related to structural racism holistically.
Male-specific, replicable and functional roles of genetic variants and cerebral gray matter volumes in ADHD: a gene-wide association study across KTN1 and a region-wide functional validation across brain
Authors: Luo Xingguang , Lin Xiandong , Ide Jaime S. , Luo Xinqun , Zhang Yong , Xu Jianying , Wang Leilei , Chen Yu , Cheng Wenhong , Zheng Jianming , Wang Zhiren , Yu Ting , Taximaimaiti Reyisha , Jing Xiaozhong , Wang Xiaoping , Cao Yuping , Tan Yunlong , Li Chiang-Shan R.
Published: January 2023

Attention deficit hyperactivity disorder (ADHD) is associated with reduction of cortical and subcortical gray matter volumes (GMVs). The kinectin 1 gene (KTN1) has recently been reported to significantly regulate GMVs and ADHD risk. In this study, we aimed to identify sex-specific, replicable risk KTN1 alleles for ADHD and to explore their regulatory effects on mRNA expression and cortical and subcortical GMVs. We examined a total of 1020 KTN1 SNPs in one discovery sample (ABCD cohort: 5573 males and 5082 females) and three independent replication European samples (Samples #1 and #2 each with 802/122 and 472/141 male/female offspring with ADHD; and Sample #3 with 14,154/4945 ADHD and 17,948/16,246 healthy males/females) to identify replicable associations within each sex. We examined the regulatory effects of ADHD-risk alleles on the KTN1 mRNA expression in two European brain cohorts (n = 348), total intracranial volume (TIV) in 46 European cohorts (n = 18,713) and the ABCD cohort, as well as the GMVs of seven subcortical structures in 50 European cohorts (n = 38,258) and of 118 cortical and subcortical regions in the ABCD cohort. We found that four KTN1 variants significantly regulated the risk of ADHD with the same direction of effect in males across discovery and replication samples (0.003 ≤ p ≤ 0.041), but none in females. All four ADHD-risk alleles significantly decreased KTN1 mRNA expression in all brain regions examined (1.2 × 10–5 ≤ p ≤ 0.039). The ADHD-risk alleles significantly increased basal ganglia (2.8 × 10–22 ≤ p ≤ 0.040) and hippocampus (p = 0.010) GMVs but reduced amygdala GMV (p = 0.030) and TIV (0.010 < p ≤ 0.013). The ADHD-risk alleles also significantly reduced some cortical (right superior temporal pole, right rectus) and cerebellar but increased other cortical (0.007 ≤ p ≤ 0.050) GMVs. To conclude, we identified a set of replicable and functional risk KTN1 alleles for ADHD, specifically in males. KTN1 may play a critical role in the pathogenesis of ADHD, and the reduction of specific cortical and subcortical, including amygdalar but not basal ganglia or hippocampal, GMVs may serve as a neural marker of the genetic effects.
Developmental disorders among Norwegian-born children with immigrant parents
Authors: TM Hansen , S Qureshi , A Gele , LJ Hauge , GP Biele , P Surén , M Kjøllesdal
Published: January 2023

Background

Risk of being diagnosed with different developmental disorders is found to vary with immigrant background. Knowledge about such differences in Norway are a starting point for equity in health services quality, and for early identification and prevention. Our objective was to assess the risk of receiving diagnoses of developmental disorders among children born in Norway (2006–2017) to two or one immigrant parent compared to children with two Norwegian-born parents.

Methods

Information on developmental disorders was from the Norwegian Patient Register (NPR) and information on immigrant background, parental country of origin, parental education, and household income from Statistics Norway. We estimated hazard ratios (HR) with Cox proportional hazard regressions. With children with Norwegian background as reference category, we estimated HRs for immigration background and region of origin. All analyses were adjusted for sex, year of birth, parental education, and household income.

Results

Children with two immigrant parents had a lower risk of receiving any developmental disorder diagnosis [HR 0.80 (95% CI 0.77, 0.82)] than children with Norwegian background, and lower risk of being diagnosed with attention deficit hyperactivity disorder (ADHD) diagnosis [HR 0.24 (95% CI 0.22, 0.27)], learning difficulties diagnosis [HR 0.39 (95% CI 0.33, 0.47)], and behavioral and emotional disorders [HR 0.52 (95% CI 0.49, 0.55)]. Children with immigrant parents had higher hazard than Norwegian background children of autism spectrum disorder (ASD) [HR 2.21 (95% CI 2.04, 2.39)], mental retardation [HR 1.84 (95% CI 1.64, 2.07)], language disorders [HR 1.30 (95% CI 1.20, 1.40)], and unspecified developmental disorders [HR 1.22 (95% CI 1.17, 1.28)]. Children with only one immigrant parent had lower risk of diagnoses than children of two immigrants.

Conclusion

Risk of receiving a diagnosis of various developmental disorders varied substantially by immigrant background. Understanding the underlying mechanisms of these differences is warranted to ensure equity in health services and timely intervention.
Post-cardiac surgery fungal mediastinitis: clinical features, pathogens and outcome
Authors: Hariri Geoffroy , Genoud Mathieu , Bruckert Vincent , Chosidow Samuel , Guérot Emmanuel , Kimmoun Antoine , Nesseler Nicolas , Besnier Emmanuel , Daviaud Fabrice , Lagier David , Imbault Julien , Grimaldi David , Bouglé Adrien , Mongardon Nicolas
Published: January 2023

Objectives

The occurrence of mediastinitis after cardiac surgery remains a rare and severe complication associated with poor outcomes. Whereas bacterial mediastinitis have been largely described, little is known about their fungal etiologies. We report incidence, characteristics and outcome of post-cardiac surgery fungal mediastinitis.

Methods

Multicenter retrospective study among 10 intensive care units (ICU) in France and Belgium of proven cases of fungal mediastinitis after cardiac surgery (2009–2019).

Results

Among 73,688 cardiac surgery procedures, 40 patients developed fungal mediastinitis. Five were supported with left ventricular assist device and five with veno-arterial extracorporeal membrane oxygenation before initial surgery. Twelve patients received prior heart transplantation. Interval between initial surgery and mediastinitis was 38 [17–61] days. Only half of the patients showed local signs of infection. Septic shock was uncommon at diagnosis (12.5%). Forty-three fungal strains were identified: Candida spp. (34 patients), Trichosporon spp. (5 patients) and Aspergillus spp. (4 patients). Hospital mortality was 58%. Survivors were younger (59 [43–65] vs. 65 [61–73] yo; p = 0.013), had lower body mass index (24 [20–26] vs. 30 [24–32] kg/m2; p = 0.028) and lower Simplified Acute Physiology Score II score at ICU admission (37 [28–40] vs. 54 [34–61]; p = 0.012).

Conclusion

Fungal mediastinitis is a very rare complication after cardiac surgery, associated with a high mortality rate. This entity should be suspected in patients with a smoldering infectious postoperative course, especially those supported with short- or long-term invasive cardiac support devices, or following heart transplantation.
Compartment syndrome following a jellyfish sting: a case report
Authors: Elkafafi Mohamed , Hamed Hussein , Ali Yaser , Elgohary Mohamed
Published: January 2023

Background

While the majority of reported cases of jellyfish envenomation are self-limited with few lasting complications, a few can cause life-threatening and debilitating illnesses. We present the case of a 15-year-old male who had an unusual presentation of a jellyfish sting that led to acute compartment syndrome.

Case presentation

A 15-year-old Lebanese (Arab) boy was stung by a jellyfish, which led to acute compartment syndrome in the left arm. Decompression fasciotomy and local application of diluted nitroglycerin helped to relieve the ulnar and radial artery spasms. The patient was left with shoulder and elbow pain and elbow flexion weakness, which improved after physiotherapy over a period of 6 weeks.

Conclusions

Current therapy recommendations for acute compartment syndrome following jellyfish stings are mainly based on case reports. Urgent fasciotomy and local application of nitroglycerin have been demonstrated to be helpful in severe jellyfish stings associated with acute compartment syndrome.
Early urate-lowering therapy in gouty arthritis with acute flares: a double-blind placebo controlled clinical trial
Authors: Yang Deng-Ho , Chen Hsiang-Cheng , Wei James Cheng-Chung
Published: January 2023

Background

Gouty arthritis (GA) is a chronic systemic disease with recurrent acute monoarthritis. In a previous study, a higher incidence of acute flares was observed during the initial marked decrease in serum urate level. Our study evaluated the effect of early urate-lowering therapy in patients with acute GA flares.

Methods

This study included 40 patients with acute GA; of them, 20 received colchicine 0.5 mg colchicine twice daily, while 20 received probenecid 500 mg and colchicine 0.5 mg twice daily. We evaluated GA severity and laboratory data for 2 weeks after the initial therapy. Medians and interquartile ranges (IQRs) were calculated to evaluate clinical presentations between these two groups.

Results

Rapidly decreasing median serum uric acid levels was found in the patients treated with probenecid and colchicine compared with the patients treated with colchicine alone on day 8 (− 1.9 [IQR, − 3.7 to 0] vs 0.8 [IQR, − 0.1–2.2]; P < 0.001). However, the median decrease in visual analog scale score did not differ significantly between the two groups (− 5.5 [IQR, − 8.0 to − 3.0] vs − 3.5 [IQR, − 5.9 to − 2.0]; P = 0.080).

Conclusion

No significant increase was noted in acute gout flare severity or duration among GA patients treated with early aggressive control of hyperuricemia using probenecid plus colchicine.
Identification of a source of nephrite from late Shang Yinxu by multispectral imaging
Authors: Chen Dian , Tang Jigen , Yu Ming , Yang Yimin , Wang Changsui
Published: January 2023

The provenance of nephrite excavated from the capital of the late Shang dynasty is an important concern. Some nephrites with yellow-green color might have the same provenance. In this study, the provenance of three nephrite artifacts with yellow-green hue was determined by nondestructive multispectral imaging. The results show that they are very similar to nephrite from Xiuyan in northeastern China, suggesting that the Shang dynasty had some connection to regional cultures more than a thousand kilometers away. Of particular importance is the fact that the multispectral imaging method opens a new avenue for the study of the ancient jade circulation.
Comparison of clinical‐CT segmentation techniques for measuring subchondral bone cyst volume in glenohumeral osteoarthritis
Authors: Pucchio Aoife M. R. , Knowles Nikolas K. , Miquel Joan , Athwal George S. , Ferreira Louis M.
Published: January 2023

Purpose

This study aimed to assess the accuracy and reproducibility of four common segmentation techniques measuring subchondral bone cyst volume in clinical‐CT scans of glenohumeral OA patients.

Methods

Ten humeral head osteotomies collected from cystic OA patients, having undergone total shoulder arthroplasty, were scanned within a micro‐CT scanner, and corresponding preoperative clinical‐CT scans were gathered. Cyst volumes were measured manually in micro‐CT and served as a reference standard (n = 13). Respective cyst volumes were measured on the clinical‐CT scans by two independent graders using four segmentation techniques: Qualitative, Edge Detection, Region Growing, and Thresholding. Cyst volume measured in micro‐CT was compared to the different clinical‐CT techniques using linear regression and Bland–Altman analysis. Reproducibility of each technique was assessed using intraclass correlation coefficient (ICC).

Results

Each technique outputted lower volumes on average than the reference standard (‐0.24 to ‐3.99 mm3). All linear regression slopes and intercepts were not significantly different than 1 and 0, respectively (p < 0.05). Cyst volumes measured using Qualitative and Edge Detection techniques had the highest overall agreement with reference micro‐CT volumes (mean discrepancy: 0.24, 0.92 mm3). These techniques showed good to excellent reproducibility between graders.

Conclusions

Qualitative and Edge Detection techniques were found to accurately and reproducibly measure subchondral cyst volume in clinical‐CT. These findings provide evidence that clinical‐CT may accurately gauge glenohumeral cystic presence, which may be useful for disease monitoring and preoperative planning.

Level of evidence

Retrospective cohort Level 3 study.