bluuebunny/crossref_metadata_2025 huggingface dataset:
Are maternal wards in government hospitals disaster prepared?: Systematic review
Authors: Horn Carla , Bam Nokwanda E. , Matsipane Molekodi
Published: June 2023

Background
Disasters go hand in hand with injuries and medical emergencies. Hospitals need to be able to function and render services during a disaster or pandemic outbreak and overall disaster preparedness should be in place as disasters can strike at any moment. Disasters may include floods, earthquakes, and fires but also violence infliction and pandemics. Effective disaster preparedness would entail each hospital and every ward having its own individual plan in place and a prepared team to execute the plan. The purpose of this literature review was to explore the disaster-preparedness of maternity wards of a government hospital.
Methods
The research methodology consisted of a literature review of fewer than twenty articles and an analysis of the literature and aspects of disaster preparedness. All relevant databases were searched from 2005 to October 2022. The results were filtered by means of a PICO diagram and the inclusion and exclusion criteria. The researcher and co-reviewer reviewed the articles. The final list of articles were analysed and the key findings were extracted and analysed.
Findings:
An exploration of the literature may indicate which factors need to be improved. Findings indicate that many shortcomings can be identified as a repetitive pattern and theme that is evident in many of the articles reviewed. Key themes were identified such as special considerations for obstetric wards, guidelines for allocations of resources, surge capacity, communication systems, and a specialized train team for evacuation.
Conclusion
The implications of this study stretch from research knowledge and theory and implications for practice by making recommendations in both fields. The research findings may assist government hospitals and their obstetric wards to better understand and to improve their state of disaster preparedness.
Loss of Fascin2 increases susceptibility to cisplatin-induced hearing impairment and cochlear cell apoptosis in mice
Authors: Wang Yan , Liu Yingying , Xie Yi , Luan Jun , Liu Rongrong , Zhu Yongjia , Ma Ying , Fan Yi , Sun Yan , Shang Wenjing , Han Fengchan
Published: June 2023

Objectives. Deletion of Fscn2 gene in mice has been linked to progressive hearing loss and degeneration of cochlear cells. Cisplatin, an antitumor drug, can cause various side effects, including ototoxicity. The aim of this study was to investigate the effects of Fscn2 on cisplatin-induced hearing impairment in mice and to explore the possible mechanism.
Methods. Two-week-old Fscn2+/+ mice and Fscn2-/- mice were treated with two doses of cisplatin, with a 3-day recovery period in between. ABR (auditory evoked brain stem response) thresholds were measured and cochlear pathology was observed at 3 weeks of age.
Results. Both Fscn2+/+ and Fscn2-/- mice showed hearing loss under the effect of cisplatin, but the impairment was more severe in Fscn2-/- mice. Further experiments showed that the percentages of outer hair cell (OHC) and spiral ganglion neuron (SGN) loss were significantly higher in cisplatin-treated Fscn2-/- mice compared to Fscn2+/+ mice. Additionally, knockdown of Fscn2 in HEI-OC1 cells worsened cisplatin-induced cell apoptosis.
Conclusion. FSCN2 mediates reduction of CDDP induced ototoxicity by inhibiting cell apoptosis
Early Tongue Cancer Detection in Photographs Using a Pretrained Convolutional Neural Network
Authors: Lee Sung-Jae , Kwon Ik-Jae , Son Young-Don , Kim Jong-Hoon , Kwon Dohyun , Kim Bongju , Lee Jong-Ho , Kim Hang-Keun
Published: June 2023

Although the tongue is an easily visible organ, tongue cancer often goes undetected until an advanced stage because it is difficult to distinguish between malignant lesions and non-malignant lesions. This study assessed the detection potential of tongue cancer, precancerous lesions, and inflammatory lesions using a pretrained convolutional neural network (CNN) and evaluated its effectiveness in a situation with multiple classes and imbalanced datasets. In total, 1,810 tongue images, each carefully labeled by medical specialists, were used for model training. Transfer learning, data augmentation, and fine-tuning were used to overcome the problems associated with limited datasets. Also, the weight balancing method was introduced to mitigate class imbalance. Three popular pretrained CNNs, namely VGG16, Inception-ResNet-V2, and EfficientNet, were evaluated as a backbone network. The final model achieved an accuracy of 0.9167, a precision of 0.9212, a recall of 0.9167, and an F2 score of 0.9176. Our results show that a pretrained CNN with a moderate complexity and a deep architecture based on data bypassing can detect and differentiate tongue lesions by applying currently available deep learning techniques, even with multiple classes and a limited and disproportionate number of images. Thus, these strategies can facilitate timely tongue lesion diagnosis and prompt treatment.
Rh-Catalyzed cyclization of carbamates – synthesis of a new heterocyclic system: tetrahydro-3H-4-oxa-2-thia-2b-azacyclopropa[cd]pentalen-3-one 2,2-dioxide
Authors: Dil Kateryna V. , Kozyriev Yevhenii K. , Palchykov Vitalii A.
Published: June 2023

A simple method for the synthesis of five- and six-membered ring sulfone carbamates was elaborated. The method includes reaction of the corresponding starting alcohols with trichloroacetyl isocyanate following the hydrolysis of trichloroacetyl protecting group with potassium carbonate in methanol. Rh2(OAc)4 catalyzed cyclization of carbamates was investigated. It was shown that carbamates with saturated sulfone moiety tend to give products of elimination of carbamic acid (corresponding unsaturated sulfones) due to high acidity of C-H bond in α-position of sulfone ring. Unsaturated sulfone carbamate (1,1-dioxido-2,3-dihydrothiophen-3-yl carbamate) in similar reaction conditions afforded new heterocyclic system confirmed by 2D NMR: tetrahydro-3H-4-oxa-2-thia-2b-azacyclopropa[cd]pentalen-3-one 2,2-dioxide. This result can be explained by more favorable aziridination of the double C=C bond by the nitrenoid intermediate compared to the elimination pathway. In silico pharmacological profile of new heterocyclic compound was evaluated. The compound showed good ADME and acute toxicity properties and high probability level of anticancer activity for prostate carcinoma cell line PC-3.
Comparison of dye-based and probe-based RT-LAMP in detection of canine astrovirus
Authors: Shen Hai Xiao , Shen Haixiao , Yang Dequan , Li Xin , Ju Houbin , Ge Feifei , Yang Xianchao , Wang Jian , Xia Luming , Zhao Hongjin , Jiang Ping
Published: June 2023

A rapid and sensitive assay is essential to promote reliable surveillance and diagnosis of canine astrovirus (CaAstV). In this study, two real-time reverse transcription loop-mediated isothermal amplification (RT-LAMP) assays with high sensitivity, rapidity and reliability were developed using fluorescence dye and FRET-Based Assimilating Probes for real-time CaAstV detection. Two real time RT-LAMP assays specifically amplified the ORF2 gene of CaAstV and did not amplify other canine enterovirus nucleic acids. The limit of detection (LOD) of both the probe-based and dye-based RT-LAMPs was 100 copy/μL. Fluorescence signals were generated within 30 min for the lowest concentration of a standard RNA sample, which was significantly faster than that achieved by real-time fluorescence quantitative PCR (qRT-PCR) assay. In the clinical samples assay, the positive and negative agreement of the dye-based RT-LAMP assay with qRT-PCR was 87.5% (14/16) and 93.55% (29/31), respectively. The positive and negative agreement of the probe-based RT-LAMP assay with qRT-PCR was 94.11% (16/17) and 96.55% (28/29), respectively. The RT-LAMP assays developed in this study showed a high potential for use as an on-site diagnostic assay for rapid, specific and reliable detection of CaAstV in clinical samples.
Registration and Follow-up Study of Focused Ultrasound Ablation Surgery Treatment of Uterine Fibroids
Authors: Wang Ting , Wang Zhibiao , Wen Yingang
Published: June 2023

The prevalence of uterine fibroids is increasing year by year. Focused ultrasound ablation surgery (FUAS) has been widely used in the treatment of uterine fibroids due to its advantages of non-invasive, non-ionizing radiation and uterine preservation. In the treatment of uterine fibroids with FUAS, ultrasound images are used as the monitor of the surgical process. The combination of ultrasound image guidance and magnetic resonance image can achieve more accurate and efficient navigation in FUAS. The current image navigation is not accurate and intelligent. Therefore, this paper investigates intelligent registration of ultrasound images and magnetic resonance images and intelligent tracking and registration correction techniques for FUAS. In our study, 90% of the cases had good tracking effect, which was equal to the manual registration results of experienced doctors. 5% of cases need a small amount of manual adjustment. In addition, 5% of the cases could not achieve the expected tracking effect due to the large deformation of the body state during the treatment compared with the MRI examination.
Exploring Autophagy-Associated Genes in the Endometrium of Recurrent Spontaneous Abortion and Examining their Relationship with Immune Infiltration
Authors: Shuai Ruzhen , Li Dandan , Liu Dan , He Jing , Wu Qiong , Zhou Yuan
Published: June 2023

Recurrent spontaneous abortion (RSA) is a common complication in pregnant women. Autophagy impacts the initiation and progression of various diseases,the specific role of autophagy in the process of endometrial decidualization in RSA paitents is still largely unknown. The purpose of this research was to examine the involvement of autophagy-related genes (ARGs) in decidualization associated with RSA using bioinformatics approaches.To identify differentially expressed genes (DEGs), the Gene Expression Omnibus database provided gene expression datasets GSE165004 and GSE26787. ARGs were retrieved from the Human Autophagy Database and the Human Autophagy Modulator Database, and their intersection with DEGs resulted in 109 differentially expressed ARGs which were significantly enriched in 14 GO terms and and 10 KEGG pathways. To assess the diagnostic capacity of the genes, an receiver operating characteristic curve was utilized. Simultaneously,The disparities in RSA immune microenvironments between low- and high- expression gene groups were analyzed using CIBERSORT, indicating that AKT2, BCL2L1, CTNNB1, GRB2, GSK3B, PTEN, and PTPN11 may be linked to the immune response during decidualization within the endometrial microenvironment. Among them, hub genes exhibited positive correlations with neutrophils, mast cells, and dendritic cells, and negative correlations with plasma, memory B and naive B cells. The results show that the 10 DEARGs (AKT2, RPS27A, PTPN11, PIK3CD, PTEN, CTNNB1, KRAS, GSK3B, BCL2L1, and GRB2) could act as potential biomarkers for the diagnosis of RSA. Furthermore, a noteworthy correlation was detected between DEARGs and the immune landscape of the endometrium in RSA patients.
Exploration of Underlying Mechanisms for Modified Xi-Xin-TangIII in Treating Alzheimer’s Disease through Network Integration Investigation
Authors: Zhao Kun , Zhang Hui , Bei Shifang , Wu Yinyan , Zhao Dongliang , Lin Jianyang , Wang Xiangyang , Wang Yuanwei
Published: June 2023

Background
Chinese natural herbal formula modified Xi-Xin-Tang III (mXXTIII) exhibits therapeutic effects for Alzheimer’s disease(AD). This study aimed to explore the underlying mechanism of mXXTIII for treating AD and discover the main active ingredients and potential drug targets through a combination of network pharmacology-based strategy and molecular docking technique.
Methods
Single herbs in mXXTIII were screened for active ingredients, and target proteins were predicted. Target screening for AD was performed to establish a disease target database. Subsequently, a protein-protein interaction network was constructed and the correlation between proteins in the network was used to obtain gene clusters, export the subnetwork, and analyze the biological processes facilitated by the targets in this subnetwork. GO and KEGG enrichment analyses of key genes were conducted using the DAVID database. Finally, molecular docking of critical targets and active ingredients was conducted and their interaction patterns were visualized.
Results
The research received 81 active ingredients, 519 targets, and 3089 disease targets. A total of 264 potential targets of mXXTIII against AD were identified by drawing a Venn diagram and the top action pathways were recognized according to GO and KEGG enrichment analysis.
Conclusion
Multiple active ingredients, targets, and pathways may be involved in intrinsic molecular actions of mXXTIII in the recovery of AD. The major active ingredients (quercetin, baicalein, formononetin, etc.), critical targets, and key pathways could have played more important roles. The findings may provide a reference for further studies and assessments on the mechanism of resisting AD.
Characteristics of timely integration of palliative care into oncology hospital care for patients with incurable cancer: results of a Delphi Study
Authors: Heipon Carly S. , Brom Linda , Linden Yvette M. van der , Tange Dorien , Reyners Anna K. L. , Raijmakers Natasja J. H.
Published: June 2023

Purpose
To identify elements of timely integration of palliative care (PC) in oncology hospital care from best practices. Thereafter, to assess the level of consensus among oncology and PC specialists and patient- and relative representatives on the characteristics of timely integration of PC.
Methods
A three round modified Delphi study was conducted. The expert panel consisted of 83 healthcare professionals (HCPs) from 21 Dutch hospitals (43 physicians, 40 nurses), 6 patient- and 2 relative representatives. The first round regarded four elements of integrated PC: (1) identification of potential PC needs (2), advance care planning (ACP), (3) routine symptom monitoring and (4) involvement of the specialist palliative care team (SPCT). In subsequent rounds, the panellists assessed which characteristics were triggers for initiating an element. Consensus was set a priori at ≥ 70%.
Results
A total of 71 (78%) panellists completed the first questionnaire, 65 (71%) the second, and 49 (54%) the third. Panellists agreed that in all patients with incurable cancer PC needs should be assessed (97%), symptoms monitored (91%) and ACP initiated (86%). The SPCT should be involved at the patient’s request (86%) or when patients suffer from increased symptom burden on multiple dimensions (76%). Patients with a life expectancy of < 3 months should be offered a consultation (71%).
Conclusion
The expert panel agreed that timely integration of PC into oncology is important for all patients with incurable cancer, using early identification, ACP and routine symptom monitoring. Involvement of the SPCT is specifically needed in patients with multidimensional symptom burden and in those nearing death.
Factors Associated With Low Hiv Testing Rates Among People Aged 15-65 in Maroua 1 Health District, Far North Region
Authors: DJOKO Godfroy rostant POKAM , KETCHAJI Alice , F Juluis Visnel FOYET , TENGOCHE Béatrice , VESSAH Oussena NZIE , N Raoul DJIALA TAWE , TCHIEMOU Gwladys KAMWA , NDOHI Nicole Modeste , KENG Dorcas KAMGUEM , NGONOR Amandine KOE
Published: June 2023

Background:
The HIV/AIDS infection continues to cause enormous damage in the world despite the multiple strategies developed for the response. In view of this, UNAIDS has adopted an acceleration of this response aimed at eliminating it by the year 2030. Indeed, access to screening, which remains underserved in Cameroon, is the first pillar on which action must be taken to achieve this objective. This study aimed to identify factors associated with low HIV testing in Maroua 1 Health District (MHD1).
Methods:
This was an analytical cross-sectional quantitative study and was conducted for the benefit of 808 participants living in the MHD1 using a structured questionnaire. Bivariate logistic regression analyses were established and only significant variables were retained for multivariate analyses. Associations were estimated by calculating the odds ratio, 95% confidence intervals, and P-value.
Results:
Results showed that 383(47.40%) participants had ever been tested and 97(12%) had done so in the past 12 months. Factors associated with low screening were noted as being male(OR=2.79; CI= 1.83–4.31; p-value<0.001), young(OR=7.95; CI=4.02–16.2; p-value<0.001), single (AOR=1.97; CI=1.19 – 3.27; p-value = 0.02), not have been to school (OR=5.25; CI = 2.26 – 12.45; p-value<0.001), low knowledge about HIV (OR= 8.77; CI=4.60 – 17.24; p-value<0.001), have a stigmatizing opinion (OR=2.46; CI=1.36 – 4.38; p-value<0.001), not be related to a partner (OR=1.70; CI=1.04 – 2.79; p-value=0.03), have never been sensitized by health personnel(OR=1.82; CI=1.21–2.75; p-value = 0.001), and have not visited a FOSA in the past 12 months (OR=1.75; CI=1.06–2.75; p-value=0.02).
Conclusion:
The effective consideration of these factors among the interventions of the response in the SD of Maroua 1 will contribute in the achievement of the first target of 95-95-95 objectives and the eradication of HIV by 2030.
O-glycosylation Genes are associated with the immune microenvironment and Predict Prognosis in Esophageal carcinoma
Authors: Cui Junye , Yang Qiuxing , Tai Guomei , Cai Bo , Wang Gaoren
Published: June 2023

Purpose
Esophageal carcinoma (EC) is one of the most common cancers. Esophageal squamous cell carcinoma (ESCC) and adenocarcinoma (EAC) are the common histological types of esophageal cancer, with squamous carcinoma being more prevalent than adenocarcinoma in Asia. Although new treatments for esophageal carcinoma have emerged in recent years, the incidence of EC is increasing. O-linked glycosylation plays an important role in cancer development and immune escape and has been studied in different cancer species, but it has not been studied in esophageal carcinoma. To provide more possibilities for clinical treatment, we find a validated grouping method to predict the prognosis of O-linked glycosylation genes in esophageal carcinoma.
Methods
Clinical profiles of patients with esophageal carcinoma and corresponding RNA data were downloaded from the TCGA database. Estimate, Timer, PCM analyses were used to clarify the immune environment of the cancer and the immune status of identified subgroups. GO, KEGG and GSEA pathway analyses elucidate the underlying mechanisms. Prognostic risk models were constructed using the LASSO algorithm and multivariate COX regression analysis.
Results
In this study, O glycosylation genes in patients with esophageal carcinoma were divided into two groups, and it was found that the C1 group had higher immune scores compared to the C2 group. GO and KEGG enrichment analysis revealed that they were mainly enriched in cAMP signaling pathway and calcium signaling pathway. The risk model based on O glycosylation genes showed its strong predictive power for patients with esophageal carcinoma. Combining the risk model with clinical line graphs can accurately predict the prognosis of patients with esophageal carcinoma.
Conclusion
O glycosylation genes are associated with the immune microenvironment in patients with esophageal carcinoma and can accurately predict the prognosis of patients with esophageal carcinoma.
Associations between Self-Reported Anatomical Characteristics of the Penis, Age and Sexual Dysfunction in Men
Authors: Ventus Daniel , Jern Patrick , Santtila Pekka , Niu Caoyuan
Published: June 2023

Premature ejaculation and erectile dysfunction are common male sexual dysfunctions worldwide, causing substantial distress in men as well as their partners and decrease the quality and stability of romantic relationships. We investigated the associations between self-reported anatomical characteristics of the penis and sexual dysfunctions in an urban sample of Chinese men. We recruited 1085 Chinese urban men aged 18 to 50 (M = 31.37, SD = 5.52) to fill out an online questionnaire regarding anatomical characteristics of the penis as well as early ejaculation and erectile problems via two Chinese online survey platforms. Participants reported their age, height, weight, penile length, penile circumference, circumcision status, and foreskin characteristics as well as answered the International Index of Erectile Function-5 and Checklist for Early Ejaculation Symptoms. Both increasing penile length (M = 14.49, SD = 2.22) and girth (M =15.46, SD = 4.36) were associated with fewer early ejaculation problems, but only increasing penile length was associated with fewer erectile problems. Less foreskin covering the glans penis was associated with fewer early ejaculation and erectile problems. Age was found to have a non-linear relationship with early ejaculation and erectile problems in this cross-sectional study. Specifically, early ejaculation problems increased up to a certain age (31) and then decreased with further increases in age. In conclusion, the relationship between the anatomical characteristics of the penis and sexual function was complex. Also, the results suggest that there is a curvilinear non-monotonic relationship between age and sexual dysfunction.
Factors influencing the usage intention of mHealth apps. A pilot study among the students of healthcare faculties
Authors: Burzyńska Joanna , Jakubus Klaudia , Bartosiewicz Anna , Kruk Wacław
Published: June 2023

Background
Health mobile applications are currently a dynamically developing trend in healthcare. They are used as a diagnostic and therapeutic support, in storing data about the patient's health, in disease prevention, and in health education. The aim of this study was to investigate the technology acceptance and usability of a mobile health applications among selected groups of students of healthcare faculties.
Methods
The research adopted the Unified Theory of Acceptance and Use of Technology (UTAUT2) and extended it by including variables: Perceived Trust and Privacy Concerns. The model was validated, showing good fit of measurement to the collected data of 110 respondents from two universities.
Results
It was found that behavioral intention to use mobile health apps among students is significantly and positively influenced by all UTAUT2 factors, and Performance Expectancy and Habit are the strongest predictors. The weakest predictor were Privacy Concerns. Contrary to previous studies, it was shown that only place of residence of respondents has the significant impact on behavioral intentions related to the use of health mobile application – age, gender, education level, type of school did not play a significant role. The findings have both research and practical implications.
Development of non-covalent triazine framework decorated carbon nanotube as a photocatalyst support for methylene blue dye degradation
Authors: Ratnakumari Setty , Prasanna Dakshinamoorthy , Anuradha Vejendla , Rajeswari T. Raja
Published: June 2023

Non-covalent triazine framework decorated carbon nanotube were prepared by using cyanuric chloride (CC) and biphenyl (BP) and carbon nanotube (CNT) by Friedel-Crafts reaction. The prepared poly(cyanuric chloride-co-biphenyl)-carbon nanotube (Poly(CC-co-BP)-CNT) composite is used as a supporting materials for photocatalyst towards methylene blue (MB) dye degradation. Zinc sulphide (ZnS) and Zinc sulphide-Tin sulphide (ZnS-SnS) nanoparticles were doped on the surface of poly(cyanuric chloride-co-biphenyl)-carbon nanotube (Poly(CC-co-BP)-CNT) composite by using aqueous plant extract of Vanda Testacea as reducing agent. The ZnS/Poly(CC-co-BP)-CNT and ZnS-SnS/Poly(CC-co-BP)-CNT photocatalyst were analyzed using UV-DRS, PL, XRD, EDX and TEM methods. The durability of the prepared photocatalyst were tested using methylene blue dye under different UV light sources and sun light. The photocatalytic activity of ZnS-SnS/Poly(CC-co-BP)-CNT photocatalyst is found to be higher than ZnS/Poly(CC-co-BP)-CNT, unsupported ZnS and ZnS-SnS photocatalyst towards MB dye. This confirms that prepared ZnS-SnS/Poly(CC-co-BP)-CNT photocatalyst is effective for the removal of the methylene blue dye from waste water.
Unregulated Medication Use and Complications: A Case Study of Prolonged Self-Treated Tuberculosis in Nepal
Authors: Achhami Eliz , Lamichhane Seshkant , Mahaju Satyam , Kandel Ashim , Poudel Anubhav , KC Rabina
Published: June 2023

Background: Tuberculosis (TB) is a global public health issue, particularly in resource-constrained countries like Nepal. This case report highlights the consequences of prolonged self-treatment and non-compliance with TB management protocols, emphasizing the need for increased awareness and intervention.
Case Presentation: A 50-year-old male from Nepal self-medicated with anti-tubercular drugs for 13 years after completing the recommended course of treatment. He experienced worsening symptoms, including respiratory distress and visual impairment. Upon evaluation, he was diagnosed with chronic cavitary pulmonary aspergillosis, a complication of prolonged self-medication. The patient received comprehensive treatment, including antifungal therapy, steroids, antibiotics, and respiratory support, resulting in significant improvement.
Conclusions: This case highlights the dangers of self-treatment and non-compliance with TB management protocols. It emphasizes the importance of patient education, awareness programs, and regular follow-up to ensure treatment adherence and detect complications. The case also reveals gaps in the DOTS (Directly Observed Treatment, Short Course) program, including the need for improved surveillance, and a multidisciplinary approach. The complications arising from prolonged self-medication underscore the need for increased awareness, intervention, and patient education in TB management. Improving patient education, raising awareness about the risks of self-medication, and integrating ophthalmologic evaluations into standard management are essential for better TB control in Nepal.
First Appearance of Verticillium tricorpus Causing Verticillium Wilt in tested Okra varieties.
Authors: Farag M. Mohamed , Arafa Ramadan A. A. , Abou-Zeid Mohamed AbdElhalim , Alwutayd Khairiah M. , Moneim Diaa Abd El , Ghebrial Eman W.R.
Published: June 2023

Symptoms of Verticillium wilt were observed on okra (Abelmoschus esculentus L.) grown widely in Beni Suef Governorate (Nasser, Beba and El-Wasta Counties) in summer 2021. All disease symptoms are externally, infected shoots' leaves turn a light green to yellow colour, lose their turgor, and finally desiccate. Individual shoots in a portion of the plant stem may show symptoms, or the symptoms may emerge over the entire plant. In certain cases, the disease typically progresses over months. According to the morphological characteristics of the isolated fungus, disease symptoms and pathogenicity test, Verticillium tricorpus was identified as the causal agent of Verticillium wilt of okra. Identification of this species was confirmed by sequencing of internal transcribed space (ITS region) of ribosomal RNA gene. V. tricorpus absolutely has not previously been reported on okra. The sequencing of this fungus showed close ties with V. tricorpus, as evidenced by the 99.24–100% identity and 97–100% coverage with several strains of V. tricorpus, including the type strain CBS447.54 (NR_126128). The obtained sequences were deposited in the GenBank with accession number MZ936483. Pathogenicity tests confirmed that V. tricorpus was pathogenic showing the same disease symptoms previously observed on okra plants in the surveyed areas. The infection sensitivity showed that Iranian red cv. is more sensitive to infection than Balady green cv. This appears to be the first record of V. tricorpus associated with Verticillium okra wilt disease.
Assessment and identification of potential factors influencing medication literacy in maintenance hemodialysis patients: A cross-sectional study
Authors: Zhu Linfang , Liu Yang , Yang Fengxue , Yu Shaobin , Fu Ping , Yuan Huaihong
Published: June 2023

Background
Maintenance hemodialysis (MHD) patients have complex medication regimens that require a high level of skill to interpret medication information. However, there is currently a lack of research evaluating the ability to read and understand medication labels in Chinese MHD patients. In addition, the relationship between frailty and medication literacy among MHD patients remains unclear. Therefore, this study aims to assess the potential factors affecting medication literacy in MHD patients and to explore the relationship between frailty and medication literacy.
Methods
This cross-sectional study was conducted using convenience sampling in West China Hospital of Sichuan University, China. Using a general questionnaire, we collected demographic, clinical and laboratory data. Medication literacy was assessed by the Chinese Medication Literacy Scale, and frailty was assessed by the FRAIL Scale. Univariate analyses examined potential factors impacting medication literacy. An ordered logistic regression was used to analyze the relationships between medication literacy and these factors. Spearman's correlation was used to assess the association between medication literacy and frailty.
Results
A total of 290 MHD patients were included in the analysis. Inadequate, marginal, and adequate medication literacy was found in 56 (19.3%), 153 (52.8%), and 81 (27.9%) patients, respectively. Ordered logistic regression revealed factors impacting medication literacy: age (OR = 3.561, 95% CI = 1.769–7.171, p < 0.001 for < 65 years); education (OR = 0.116, 95% CI = 0.048–0.284, p < 0.001 for ≤ primary school education; OR = 0.294, 95% CI = 0.145–0.594, p = 0.001 for junior high school education); caregiver medication assistance (OR = 0.434, 95% CI = 0.221–0.852, p = 0.015); frailty (OR = 2.275, 95% CI = 1.120–4.621, p = 0.023 for prefrail patients); and β2-microglobulin (β2-MG) (OR = 0.990, 95% CI = 0.982–0.998, p = 0.012). Spearman's analysis showed that medication literacy was associated with frailty in MHD patients (R=-0.189, p = 0.001).
Conclusions
The Chinese version of the MedLitRxSE tool can help evaluate medication literacy in MHD patients. Medication literacy levels in MHD patients need improvement and differ among patient groups, such as by age, education, caregiver support, β2-microglobulin levels, and risk of frailty.
A retrospective analysis of adverse events reported by Tunisian intensive care professionals
Authors: Tlili Mohamed Ayoub , Aouicha Wiem , Gambashidze Nikoloz , Sahli Jihene , Cheikh Asma Ben , Weigl Matthias , Mtiraoui Ali , Latiri Houyem Said , Chelbi Souad , Mallouli Manel
Published: June 2023

Introduction
Adverse events (AEs) that occur in hospitals remain a challenge worldwide, and especially in intensive care units (ICUs) where they are more likely to occur. Monitoring of AEs can provide insight into the status and advances of patient safety. This study aimed at examining the AEs reported during 20 months after the implementation of AE reporting system.
Methods
We conducted a retrospective analysis of a voluntary ICU AE reporting system. Incidents were reported by staff from 10 ICUs in the Sahloul University Hospital (Tunisia) between February 2020 and September 2021.
Results
A total of 265 reports were received, of which, 61.9% were deemed preventable. The most reported event was healthcare-associated infections (30.2%, n=80), followed by pressure ulcers (18.5%, n=49). At the time of reporting, 25 patients (9.4%) had died as a result of an AE and in 51.3% of cases, the event had resulted in an increased length of stay.
Provider-related factors contributed to 64.2% of the events, whilst patient-related factors contributed to 53.6% of the events. As for criticality, 34.3% of the events (n=91) were unacceptable (c3) and 36.3% of the events (n= 96) were ‘acceptable under control’ (c2).
Conclusions
The reporting system provided rich information on the characteristics of reported AEs that occur in ICUs and their consequences and may be therefore useful for designing effective and evidence-based interventions to reduce the occurrence of AEs.
The effect of PD-1/PD-L1 signaling axis on the interaction between CD19+B cells and CD4+T cells in peripheral blood of patients with systemic Lupus erythematosus
Authors: Xie Zhuobei , Dai Li , He Haohua , Hong Dengxiao , Tang Honghui , Xu Wenyan , Chen Zhongxin , Wang Hongtao , Li Baiqing , Xie Changhao , Wang Yuanyuan
Published: June 2023

Background The defect of B cell self-tolerance and the continuous antigen presentation by T cells (TCs) mediated by autoreactive B cells (BCs) play a key role in the occurrence and development of systemic lupus erythematosus (SLE). PD-1/PD-L1 signaling axis negatively regulates the immune response of TCs after activation and maintains immune tolerance. However, the effect of PD-1/PD-L1 signaling axis on the interaction between CD19+B/CD4+TCs in the peripheral blood of patients with SLE has not been studied in detail.
Methods PD-1/PD-L1 and Ki-67 levels in peripheral blood (PB) of 50 SLE patients and 41 healthy controls (HCs) were detected through flow cytometry, and then the expression of PD-1+/−cells and PD-L1+/−cells Ki-67 was further analyzed. CD19+B/CD4+TCs were separated for cell culture and the supernatant was collected to determine proliferation and differentiation of TCs. IL-10 and IFN-γ secretion in the supernatant was also determined using ELISA.
Results The PD-1, PD-L1, and Ki-67 levels on CD19+B/CD4+TCs in patients with SLE were higher than HCs. In CD19+B/CD4+TCs of SLE patients, the proliferative activity of PD-L1+ cells was higher than that of PD-L1− cells, and the proliferative activity of PD-1+ cells was higher than that of PD-1− cells. In the system co-culturing CD19+B/CD4+TCs from HCs/SLE patients, activated BCs promoted TCs proliferation and PD-L1 expression among TCs. Addition of anti-PD-L1 to co-culture system restored the proliferation of TCs, and inhibited IL-10/IFN-γ level. The addition of anti-PD-L1 to co-culture system also restored Tfh and downregulated Treg in HCs.
Conclusions Axis of PD-1/PD-L1 on CD19+B/CD4+TCs in PB of SLE patients is abnormal, and cell proliferation is abnormal. In CD19+B/CD4+TCs of SLE patients, the proliferative activity of PD-L1+ and PD-1+ cells compared with PD-L1− and PD-1− cells in SLE patients, respectively. CD19+B/CD4+TCs in SLE patients can interact through PD-1/PD-L1.
Development and validation of an in-hospital mortality risk prediction model for patients with severe community-acquired pneumonia in the intensive care unit
Authors: Pan Jingjing , Bu Wei , Guo Tao , Shao Min , Geng Zhi
Published: June 2023

Background
A high mortality rate has always been observed in patients with severe community-acquired pneumonia (SCAP) admitted to the intensive care unit (ICU); however, there are few reported predictive models regarding the prognosis of this group of patients. This study aimed to screen for risk factors and assign a useful nomogram to predict mortality in these patients.
Methods
As a developmental cohort, we used 455 patients with SCAP admitted to ICU. Logistic regression analyses were used to identify independent risk factors for death. A mortality prediction model was built based on statistically significant risk factors. Furthermore, the model was visualized using a nomogram. As a validation cohort, we used 88 patients with SCAP admitted to ICU of another hospital. The performance of the nomogram was evaluated by analysis of the area under the receiver operating characteristic (ROC) curve (AUC), calibration curve analysis, and decision curve analysis (DCA).
Results
Lymphocytes, PaO2/FiO2, shock, and APACHE II score were independent risk factors for in-hospital mortality in the development cohort. External validation results showed a C-index of 0.903 (95% CI 0.838–0.968). The AUC for the development cohort was 0.850 and that for the validation cohort was 0.893. Calibration curves for both cohorts showed agreement between predicted and actual probabilities. The DCA curve results for both cohorts suggested a high clinical application value for the model.
Conclusions
We developed a predictive model based on lymphocytes, PaO2/FiO2, shock, and APACHE II scores to predict in-hospital mortality in patients with SCAP admitted to the ICU. The model has the potential to help physicians assess the prognosis of this group of patients.
Cardiac Metastasis from Cervical Cancer: A Case Report and literature review
Authors: Sun Zhaochen , Chen Yitian
Published: June 2023

Heart metastasis in cervical cancer is an exceptionally uncommon occurrence. Given the early onset of obscure clinical presentations and complex imaging features of cardiac tumors, cases diagnosed before death are exceedingly rare. In this report, we present a case of cervical cancer with cardiac tumor metastasis diagnosed pre-mortem, and conducted a review of the current literature. The following conclusions were drawn: (1) The incidence of cardiac metastasis is influenced by clinical stage and treatment modality at initial diagnosis. (2) The prognosis for patients with cervical cancer heart metastasis is poor, and those with severe complications struggle to accrue benefits from active treatment. (3) When cervical cancer patients present with unexplained dyspnea, cardiac color ultrasound and enhanced chest CT should be performed to rule out tumor cardiac metastasis.
Metformin protects diabetes-induced atrial mitochondrial from oxidative stress and improves mitochondrial biogenesis via the AMPK signaling pathway
Authors: Song Yanmei , Yuan Ming , Zhang Zhiwei , Zhang Yue , Yuan Meng , Wang Hui , Liang Xue , Tse Gary , Li Guangping , Liu Tong , Zhang Xiaowei
Published: June 2023

Background
Oxidative stress leads to adverse atrial remodeling in diabetes mellitus. AMP-activated protein kinase (AMPK) agonists have been shown to prevent cardiomyocytes from oxidative stress by improving mitochondrial function, but their underlying mechanisms are not completely understood. This study investigated the molecular changes and their underlying regulatory mechanisms by the AMPK agonists, metformin and AICA ribonucleotide (AICAR).
Methods
Mouse atrial cardiomyocytes (HL-1 cells) and rats with type 2 diabetes mellitus (DM) were used as study models. A total of 40 rats were randomly divided into control, DM alone, DM treated with metformin, AICAR, or metformin with the AMPK inhibitor Compound C. Echocardiographic, hemodynamic, and electrophysiological measurements were made in vivo. Reactive oxygen species (ROS) production rate and mitochondrial membrane potential (MMP) levels were performed in vitro. Protein expression of SOD, COX43 and mitochondrial biogenesis related proteins were measured using Western blotting.
Results
Compared with controls, the diabetes group demonstrated larger left atrial diameter and fibrosis area associated with a higher incidence of inducible atrial fibrillation (AF). Lower Mn-SOD, COX42, and mitochondrial biogenesis (PGC-1α, NRF1 and TFAM)-related proteins were observed, accompanied by mitochondrial swelling. Metformin treatment led to reversal of structural remodeling and lower inducible AF incidence, which were associated with higher Mn-SOD, COX42, and biogenesis-related proteins as well as improvement in the structure and function of mitochondria. Similar protective changes were observed following AICAR or metformin with Compound C treatment. In HL-1 cell line, compared with controls, the DM group demonstrated higher mitochondrial ROS production rat and lower MMP levels. Mn-SOD, COX42, and mitochondrial biogenesis (PGC-1α, NRF1 and TFAM)-related proteins expression were consistent with animal levels.
Conclusions
Diabetes mellitus induces adverse atrial structural, electrophysiological remodeling, and mitochondrial damage and dysfunction. Metformin prevented these abnormalities through activation of the AMPK signaling pathway.
Type 2 diabetes and Inflammatory Bowel Disease: A Bidirectional Two-sample Mendelian Randomization Study
Authors: Xu Guangyi , Xu Yanhong , Zheng Taohua , Liu Ting
Published: June 2023

Background Studies have shown that patients with inflammatory bowel diseases (IBD) coexisting with type 2 diabetes mellitus (T2DM) have higher risk of infection, increased healthcare utilization and decreased quality of life, while currently they are not treated with more effective immunosuppressive therapy. Observational studies have shown a bidirectional association between T2DM and IBD, including Crohn's disease (CD) and ulcerative colitis (UC). However, because of the difficulty in determining sequential timeliness, it is unclear whether the observed associations are causal. We investigated the association between T2DM and IBD by bidirectional two-sample Mendelian randomization (MR) to clarify the casual relationship.Methods Independent genetic variants for T2DM and IBD were selected as instruments from published genome-wide association studies (GWAS), mainly in European ancestry. Instrumental variables (IVs) associated with T2DM and IBD were extracted separately from the largest GWAS meta-analysis. MR analyses included inverse variance weighting, weighted median estimator, MR Egger regression, and sensitivity analyses with Steiger filtering and MR PRESSO.Results Genetically predicted T2DM (per log-odds ratio increase) was associated with risk for IBD. In the data samples for UC (6968 cases, 20464 controls) and CD (5956 cases, 14927 controls), the odds ratio [95% confidence interval] for T2DM on UC and CD were 0.882 (0.826,0.942), and 0.955(0.877,1.038), respectively. In contrast, among 62,892 patients with T2DM, no genetically influenced association between IBD and T2DM was observed.Conclusions The results of the bidirectional MR Study suggest that T2DM has a negative causal effect on UC, which provides implications for clinical treatment decisions in IBD patients with T2DM. The findings do not support a causal relationship between T2DM and CD, UC and T2DM, or CD and T2DM, and the impact of IBD on T2DM needs further investigation.
Relationship between arterial stiffness, left ventricular diastolic function, and renal function in IgA nephropathy
Authors: Sági Balázs , Késői István , Vas Tibor , Csiky Botond , Nagy Judit , Kovács Tibor József
Published: June 2023

Aim.
In chronic kidney disease, IgA nephropathy, and left ventricular diastolic dysfunction have prognostic significance as well. However, the relationship between diastolic dysfunction, arterial stiffness, and renal function has not been fully elucidated.
Methods.
79 IgA nephropathy patients (aged 46 ± 11 years) and 50 controls were investigated. Tissue Doppler imaging was used to measure early (Ea) and late (Aa) diastolic velocities. Arterial stiffness was measured by a photoplethysmographic (stiffness index (SI)) and an oscillometric method (aortic pulse wave velocity (PWVao)).
Results.
We compared the IgAN patients to a similar cardiovascular risk group with a preserved eGFR. A strong correlation was found between Ea/Aa and SI (p < 0.001), also with PWVao (p < 0.001), just in IgAN, and with eGFR (p < 0.001) in both groups. IgAN patients were divided into groups CKD1-2 vs. CKD3-5. In the CKD 3–5 group, the incidence of diastolic dysfunction increased significantly: 39% vs. 72% (p = 0.003). Left ventricle rigidity (LVR) was calculated, which showed a close correlation with SI (p = 0.009) and eGFR (p = 0.038). By linear regression analysis, the independent predictors of SI were age, E/A, and E/Ea; SI was the predictor of LVR; and E/A and hypertension were the predictors of eGFR.
Conclusion.
In IgA nephropathy, increased cardiac rigidity and vascular stiffness coexist with decreased renal function, which is directly connected to diastolic dysfunction and vascular stiffness. On the basis of comparing the CKD group to the control group, vascular alterations in very early CKD can be identified.
Seasonal wild dance of dual endosymbionts in the pear psyllid Cacopsylla pyricola (Hemiptera: Psylloidea): Endosymbiont titers tell two different stories
Authors: Serbina Liliya Štarhová , Corretto Erika , Garcia Juan Sebastian Enciso , Berta Michela , Giovanelli Tobia , Dittmer Jessica , Schuler Hannes
Published: June 2023

Most sap-feeding insects maintain obligate relationships with endosymbiotic bacteria that provide their hosts with essential nutrients. However, knowledge about the dynamics of endosymbiont titers across seasons in natural host populations is scarce. Here, we used quantitative PCR to investigate the seasonal dynamics of the dual endosymbionts “Candidatus Carsonella ruddii” and “Ca. Psyllophila symbiotica” in a natural population of the pear psyllid Cacopsylla pyricola (Hemiptera: Psylloidea: Psyllidae). Psyllid individuals were collected across an entire year, covering both summer and overwintering generations. Immatures harboured the highest titers of both endosymbionts, while the lowest endosymbiont density was observed in males. The density of Carsonella remained high and relatively stable across the vegetative period of the pear trees, but its density significantly dropped during the non-vegetative period, overlapping with C. pyricola’s reproductive diapause. In contrast, the titer of Psyllophila was consistently higher than Carsonella’s and exhibited fluctuations throughout the sampling year, which might be related to host age. Despite a tightly integrated metabolic complementarity between Carsonella and Psyllophila, our findings highlight differences in their density dynamics throughout the year, that might be linked to their metabolic roles at different life stages of the host.
Mechanism of DNA unwinding by hexameric MCM8-9 in complex with HROB
Authors: Acharya Ananya , Bret Helene , Huang Jen-Wei , Muetze Martin , Goese Martin , Kissling Vera , Seidel Ralf , Ciccia Alberto , Guérois Raphaël , Cejka Petr
Published: June 2023

The human MCM8-9 helicase functions in concert with HROB in the context of homologous recombination, but its precise function is unknown. To gain insights into how HROB regulates MCM8-9, we first used molecular modeling and biochemistry to define their interaction interface. We show that HROB makes important contacts with both MCM8 and MCM9 subunits, which directly promotes its DNA-dependent ATPase and helicase activities. MCM8-9-HROB preferentially binds and unwinds branched DNA structures, and single-molecule experiments reveal a low DNA unwinding processivity. MCM8-9 unwinds DNA as a hexameric complex that assembles from dimers on DNA in the presence of ATP, which is prerequisite for its helicase function. The hexamer formation thus involves two repeating protein-protein interfaces forming between the alternating MCM8 and MCM9 subunits. One of these interfaces is rather stable and forms an obligate heterodimer, while the other interface is labile and mediates the assembly of the hexamer on DNA, independently of HROB. The ATPase site composed of the subunits forming the labile interface disproportionally contributes to DNA unwinding. HROB does not affect the MCM8-9 ring formation, but promotes DNA unwinding downstream by possibly coordinating ATP hydrolysis with structural transitions accompanying translocation of MCM8-9 on DNA.