bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of Anodization Mode and Temperature on the Optical Properties of Photonic Crystals Based on Porous Anodic Alumina
Authors: Białek Ewelina , Włodarski Maksymilian , Norek Małgorzata
Published: December 2023

Porous anodic alumina (PAA) with periodic structure was produced by sinusoidal pulse anodization (SPA) of aluminum under time-controlled voltage (U

t
), time-controlled current density (j

t
), and charge density-controlled voltage (U

q
) modes. The effect of anodizing temperature and the modes on the optical properties of PAA-based photonic crystals (PCs) was analyzed in detail. It was shown that depending on the anodizing temperature, either broad or narrow bandpass filters can be produced with variable optical quality that depends strongly on the anodization mode and the parameters of the SPA function. Broad bandpass PCs (Q-factor < 10) tend to form during high-temperature SPA, with the first order photonic stop band (λ
1) at near infrared (NIR) region and almost 100% reflectivity and 0% transmittivity at the λ
1 in the PC produced under the U

t
mode. At these electrochemical conditions, the λ
1 peak broadens and become less intensive in the PCs formed under the U

q
, and j

t
modes. At low temperature, narrow bandpass filters are produced (Q-factor > 10), with the highest Q-factor (67) and PSB at NIR obtained during high-field SPA under the j

t
mode. The most intensive λ
1 was, however, attained during the high-field SPA under the U

q
mode, after post-process pore widening.
How Safe and Technical Is Modified Dunn Osteotomy in the Management of Patients with SCFE: A Clinical Trial with Short-Term Follow-Up
Authors: Elsiofy Amro , Elsherif Mahmoud , Eladawy Moawed F. , Mahmoud Tarek , Sakr Ahmed F.
Published: December 2023

Objective. Over the last decade, modified Dunn osteotomy has been widely used in the management of slipped capital femoral epiphysis (SCFE) with varying degrees of complications. Different conclusions have been adopted. Our study represented our experience in using such a technique in stable and unstable SCFE and tried to determine its safety and applicability for routine practice. Methods. Our study adopted an interventional prospective design performed on 24 hips divided evenly between both sexes with a mean age of 13.25. On the Southwick classification, the cases were distributed between moderate and severe, which constituted 41.7% and 58.33%, respectively. Three quarters of the study subjects were stable according to the Loder classification. Each underwent modified Dunn osteotomy after a safe surgical hip dislocation. Results. Over the period of about 1-year follow-up, clinical evaluation was performed by examining the surgical site and assessing the legs’ length, range of hip movement, Harris hip score, and iHOT-12 score. Radiological assessment was performed by calculation of slip angle from the frog lateral view, assessment of union, and occurrence of any complications. The study showed that there was significant improvement in patients in terms of radiological and clinical outcomes, with the occurrence of AVN in 16.7% of cases (4 out of 24). All cases of AVN occurred in unstable hips. Conclusion. Despite the complication of AVN, we believe the results of this study add to the current literature which suggests that modified Dunn osteotomy is an effective and safe technique for the management of moderate and severe SCFE. This trial is registered with PACTR202312819351504.
Supplemental Figure 19 from Infusion Product TNFα, Th2, and STAT3 Activities Are Associated with Clinical Responses to Transgenic T-cell Receptor Cell Therapy
Authors: Nowicki Theodore S. , Peters Cole W. , Quiros Crystal , Kidd Conner K. , Kawakami Moe , Klomhaus Alexandra M. , Baselga-Carretero Ignacio , Kaplan-Lefko Paula , Macabali Mignonette H. , Perez Garcilazo Ivan , Berent-Maoz Beata , Comin-Anduix Begoña , Ribas Antoni
Published: December 2023

Association of preinfusion serum Flt-3L levels with clinical responsiveness to therapy. Serum levels of Flt-3L displayed a weak correlation with peak percent change in tumor burden, but did not fully achieve statistical significance.
Supplemental Figure 12 from Infusion Product TNFα, Th2, and STAT3 Activities Are Associated with Clinical Responses to Transgenic T-cell Receptor Cell Therapy
Authors: Nowicki Theodore S. , Peters Cole W. , Quiros Crystal , Kidd Conner K. , Kawakami Moe , Klomhaus Alexandra M. , Baselga-Carretero Ignacio , Kaplan-Lefko Paula , Macabali Mignonette H. , Perez Garcilazo Ivan , Berent-Maoz Beata , Comin-Anduix Begoña , Ribas Antoni
Published: December 2023

Correlation matrix between intracellular cytokine FSIs and phosphoprotein FSIs with the CD4 compartment. Values for the tonic conditions (A) and stimulated conditions (B) are shown. Heatmap and numerical values for the corresponding Pearson’s r for each correlation condition are shown.
Supplemental Figure 10 from Infusion Product TNFα, Th2, and STAT3 Activities Are Associated with Clinical Responses to Transgenic T-cell Receptor Cell Therapy
Authors: Nowicki Theodore S. , Peters Cole W. , Quiros Crystal , Kidd Conner K. , Kawakami Moe , Klomhaus Alexandra M. , Baselga-Carretero Ignacio , Kaplan-Lefko Paula , Macabali Mignonette H. , Perez Garcilazo Ivan , Berent-Maoz Beata , Comin-Anduix Begoña , Ribas Antoni
Published: December 2023

No association between CD8 secreted IFN-γ FSI and clinical response to transgenic TCR T cell therapy. (A) CD8 secreted IFN-γ FSI levels showed no significant difference between clinical responders and non-responders to TCR T cell therapy (unpaired t-test), and showed no significant correlation with peak change in tumor burden (B) nor overall survival (C) by Pearson’s r.
FIGURE 1 from Integrin-αvβ3 is a Therapeutically Targetable Fundamental Factor in Medulloblastoma Tumorigenicity and Radioresistance
Authors: Echavidre William , Durivault Jérôme , Gotorbe Célia , Blanchard Thays , Pagnuzzi Marina , Vial Valérie , Raes Florian , Broisat Alexis , Villeneuve Rémy , Amblard Régis , Garnier Nicolas , Ortholan Cécile , Faraggi Marc , Serrano Benjamin , Picco Vincent , Montemagno Christopher
Published: December 2023

Integrin-αvβ3 is differentially expressed in medulloblastoma cell lines and promotes their proliferation, migration, and invasion. A, IHC staining of integrin-αvβ3 in human medulloblastomas using tissue array slides (US Biomax, n = 20). Staining intensity was classified as no, low, or moderate expression. B, A heat map showing integrin gene expression in medulloblastoma cell lines quantified by qRT-PCR. Results are expressed in comparison to normal cerebellum (log10-fold change). The mean values of three independent experiments are shown. C, A Western blot analysis of β3-integrin protein expression in medulloblastoma cell lines. D and E, Representative Western blots of β3-integrin expression in DAOY (control vs. KO and β3-integrin–overexpressing cells) and HD-MB03 (LacZ vs. β3-integrin–overexpressing cells) cell lines. Three independent experiments were performed. The proliferation of DAOY_Control, KO_#22, KO_#22-rescue (F, left), KO_#36, KO_#36-rescue (F, right), and HD-MB03-LacZ and overexpressing-β3-integrin (G). Proliferation rates represent the percentage change versus day 0. Three independent experiments were performed, and data are presented as mean ± SEM. The migration of DAOY_Control, KO_#22, KO_#22-rescue (H, left), KO_#36, KO_#36-rescue (H, right), and HD-MB03-LacZ and overexpressing-β3-integrin (I). Serum-starved cells were allowed to migrate for 12 (DAOY) or 24 hours (HD-MB03). Migrations were performed using Boyden chamber assays, and the results are presented as the percentage of control cells. Three independent experiments were performed, and data are expressed as mean ± SEM. The invasion of DAOY_Control, KO_#22, KO_#22-rescue (J, left), KO_#36, KO_#36-rescue (J, right), and HD-MB03-LacZ and overexpressing-β3-integrin (K). Serum-starved cells were allowed to invade for 12 (DAOY) or 24 hours (HD-MB03). Invasions were performed in a Boyden chamber coated with Matrigel, and results are presented as the percentage of control cells. Three independent experiments were performed, and data are presented as mean ± SEM. Key: *, P < 0.05; **, P < 0.01; ***, P < 0.001 versus control; ##, P < 0.01 versus KO_cells.
Chemical components separation with the use of botulinum toxin A: a critical review for correction of ventral hernia
Authors: Mesquita Gustavo Heluani Antunes de , Jardim Yuri Justi , Martines Diego Ramos , Nii Fernanda , Iuamoto Leandro Ryuchi , Waisberg Daniel Reis , Meyer Alberto
Published: December 2023

Background: Ventral hernias are prevalent results in abdominal surgeries and may represent a surgical challenge in complex cases, mainly due to tension in abdominal wall musculature. Failure of surgical correction may lead to a more morbid treatment, in addition to a considerable socioeconomic impact. In order to have a lower risk of complications, the use of botulinum toxin A (BTA), may be a preoperative alternative to reduce abdominal wall tension by causing sustained and reversible paralysis. This critical review of the literature proposes to evaluate the adjacent use of BTA in surgical ventral hernias corrections.Methods: Using the PubMed database, the keywords ‘ventral hernia’, and ‘botulinum toxin’ were searched using the Boolean operator AND. Articles were selected based on their relevance and updated information. The outcomes of interest included the change in ventral hernia defect width and in lateral abdominal wall muscle length, pain, hernia recurrence and complications.Results: A total of 20 articles from 2009 to 2018 were found. We excluded some articles due to irrelevant technique, use of animal models and lack of outcome data. Reduction of the abdominal wall thickness increasing its length, less perioperative pain, hernia reduction and the correction with less tension were observed after the use of BTA injection. No complications occurred during applications.Conclusion: The use of BTA seems to be a promising alternative in the management of ventral hernias due to its capacity of reducing tension in the abdominal wall. However, more studies are necessary to determine the efficacy of this method.
Factors associated to vascular pedicle width in ARDS
Authors: Silva Alex França da , Toufen Junior Carlos , Carvalho Carlos Roberto Ribeiro de
Published: December 2023

Introduction: In previous studies, vascular pedicle width (VPW) was the best radiographic sign of intravascular volume status in critically ill patients and may enhance implementation and acceptance of the conservative fluid strategy into routine clinical practice. Objective: Our aim was to find the relationship among VPW and parameters of mechanical ventilation (MV) and baseline data. The hypothesis was that pressures, tidal volume and baseline data, as age, could be related to VPW in acute respiratory distress syndrome (ARDS). Methodology: It was a retrospective cohort study enrolled in the Open Lung Approach trial performed in moderate-severe acute respiratory distress syndrome recruited in São Paulo, Brazil. VPW was measured by two investigators in chestradiographs taken at diagnosis and after 24 hours of mechanical ventilation adjustments. The relationship between VPW, age, predicted body weight (PBW), positive end-expiratory pressure (PEEP), plateau pressure and tidal volume adjusted by PBW were evaluated. Results: 26 patients were included in analysis, with a total of 52 chest radiography analyzed. There was a significant change in VPW between diagnosis and after 24hours from MV adjustments (r = 0.64, p < 0.01).  Age was related to VPW before and after adjustments in MV (r= 0.57, p < 0.01). No correlation was found between MV parameters (PEEP, plateau pressure and tidal volume) with VPW. Conclusions: There was no correlation among pressures and tidal volume applied during MV and PDW, reinforcing thismethod as an easy, wide available and noninvasive way to estimate intravascular volume status in ARDS patients. Age was related to VPW, suggesting that the measure of VPW could be improved after correction based in this parameter.
Immune thrombocytopenia: clinical features and analysis of risk factors to response to the treatment
Authors: Yonekura Aline Mitie , Lira Lucas Nathã Almeida , Stefanello Bianca , Funke Vaneuza Araujo Moreira
Published: December 2023

Introduction: Immune thrombocytopenia (ITP) is an acquired decrease of platelets, caused by autoantibodies against platelets, in the absence of an associated condition. ITP is associated to low morbidity and mortality, however there is reduced quality of life on the patients under treatment. This study has as objectives to describe the clinical features of the patients and the evaluation of risk factors related to the response to treatment. Methods: A retrospective analysis was achieved, regarding the medical records of 99 patients diagnosed with ITP and seen between May of 1992 and August of 2016 in a hospital.Results: 99 patients were analyzed, 71 female (71.7%). Mean age 39 years old to diagnosis (variation 2-84). 83.3% of the patients were chronic ITP and the mean follow up 49.2 months (0,1-289). 74.7% of patients presented bleeding to diagnosis. 76.7% of patients required treatment, and there was remission in 7 (30.4%) of the 23 patients who did not receive any treatment. 37 patients were submitted to splenectomy, 30 (81.1%) of those obtained partial or complete response and 18 (48.6%) presented loss of response. 30% of patients were submitted to posterior treatments. Only two patients had death related to ITP. In bivariate analysis of risk factors to response to the treatment, the only predictors of chronicity were initially the absence of corticosteroid dependence and absence of response to splenectomy, however in multivariate analysis those factors had their significance discarded. Conclusion: The presented results did not confirm a higher progression rate to chronicity in non corticosteroid-dependent patients and in those who did not present response to splenectomy. The clinical features, response pattern and survival of analyzed patients were similar to other studies reported.
Melatonin action on luteal - granulosa cells in women with marital infertility undergoing in vitro fertilization
Authors: Luquetti Camilla Maganhin , Maganhin Carla Cristina , Cipolla-Neto José , Baracat Edmund Chada , Soares Júnior José Maria
Published: December 2023

Introduction of the subject: Melatonin is a hormone related to the light-dark cycle and it plays an influential role in the reproductive system. In humans, researchers have shown there is three times more melatonin in follicular fluid than in the blood flow, suggesting the influence of the hormone on follicular maturation. However, little is known about melatonin action on granulosa cells in women with infertility, especially the molecular mechanisms involved. We are, therefore, conducting this study to evaluate melatonin action pathways in granulosa cells in the ovaries of women with infertility. To achieve our aim, we will use molecular biology, involving diverse signaling pathways, such as angiogenesis. Objective(s): to analyze melatonin action on luteal - granulosa cells in women with marital infertility undergoing in vitro fertilization. Methodology: For this, 68 patients, aged between 20 and 35 years, attended at the Human Reproduction Sector of the Federal University of São Paulo, were submitted to in vitro fertilization treatment. After all preparatory procedures were performed, luteal granulosa cells were removed and routed to the cell culture. The cells were divided into four groups: a) control; b) 0.1 μM melatonin; c) 1 μM melatonin; d) melatonin at 10μM. After a period of 10 days, the cells were trypsinized for extraction of the total RNA and later analysis of the gene expression by Real Time PCR of the angiogenesis signaling pathway. Results: Our data evaluated 96 genes, which are related to the angiogenesis pathway. The results of transcriptional expression showed important genes involved in this pathway that are hypo or hyperexpressed after treatment with melatonin. The main hyperexpressed genes were: fibroblast growth factor 1 (FGF1) genes; interleukin 1-beta (IL1B); receptor tyrosine kinase (VEGFR-2); folliculogenesis regulating genes (TGFB1). They act in the dynamics of follicular growth. On the other hand, the genes inducing factor 1-alpha (HIF1A), fibroblast growth factor 2 (FGF2), insulin-like growth factor 1 (IGF-1) and vascular endothelial growth factor (VEGFA) melatonin decreased its expression. Discussion and conclusion of the results: It is concluded that melatonin in high concentration (above 1 μM) may have dual function in increasing the expression of some growth factors and cytokines, in the decrease of other genes and mechanism of physiological compensation and also modulates negative angiogenesis, mainly in the dose (10 uM) of granulosa cells from women submitted to in vitro fertilization. Perhaps this fact is important for adequate follicular growth, avoiding excessive growth, which could turn the follicle into cyst, making ovulation difficult.
Management of choledochal cysts:
Authors: Andrade Lucas Arjona de , Tannuri Ana Cristina Aoun , Paganoti Guilherme Freitas , Andrade Wagner de Castro , Tannuri Uenis
Published: December 2023

Introduction: Choledochal cyst is a rare pathology of the biliary tree, leading to hepatic cirrhosis and predisposition to malignancy if untreated. Excision and biliodigestive reconstruction is the standard treatment. Our objective in this study is to perform a retrospective analysis of choledochal cysts cases in our institution, focusing in diagnostic imaging and surgical management.Methods and materials: We analysed the medical records from patients with choledochal cysts in our institution from January 1994 to December 2017. Our research included gender, symptoms at presentation, age, preoperative and postoperative bilirubin levels, medical imaging, type of dilatation (following the Todani classification), performed surgery, complications and survival in 70 patients.Results: Ultrasonography was the only required exam to the diagnosis in 50 cases (71,4%), and used in 68 cases (97,1%). All Todani type I and IV cases were treated through cyst excision and biliodigestive reconstruction by proximal and distal hepaticojejunostomy through Roux-en-Y. Thirty-one patients were subjected to proximal hepaticojejunostomy. Eight (25,1%) presented postoperative complications, two of which died due to postoperative sepsis. Thirty-eight patients were subjected to distal hepaticojejunostomy. From this group, two patients (5,2%) presented postoperative complications. Thep-value between groups was 0.016.Conclusion: US is the only necessary diagnostic imaging prior to surgery. The surgeon should weight the risk of biliary cancer and postoperative complications upon choosing the height of the anastomosis in choledochal cysts. We preconize that it’s safer to perform a distal hepaticojejunostomy, maintaining the proximal part of a dilated common hepatic duct, than proximal hepaticojejunostomy.Keywords: Choledochal; Cyst; Management; Hepaticojejunostomy; Ultrasonography.
Morphometry and frequency of the pyramidalis muscle in adult humans
Authors: Kogima Rudolph Octaviano , Simões Pedro Antonio Araújo , Santos Lesley Mirian De Paula , Moyses Raquel Ajub , Hojaij Flávio Carneiro , Jacomo Alfredo Luiz
Published: December 2023

The pyramidalis muscle presents variable morphometry and frequency among populations, and the knowledge of such variations may serve as a support for clinical practice and surgical procedures. However, this muscle is little described in the medical literature, and studies of this order have not been performed in the brazilian population. Thus, we dissected 30 cadavers, exposing the pyramidalis and taking photos for posterior measuring in image processing program. We verified frequency - bilaterality, unilaterality and absence - and morphometry - medial border length and width at basis - of the muscle. We verified that there was length symmetry between right and left sides, but no width symmetry. Moreover, there were no statistically significant correlations between the muscle dimensions (length and width) and age, height, weight, nor gender, although, in the present study, men presented longer - but women wider - pyramidalis muscle. Furthermore, the dimensions range of the pyramidalis were bigger in men. Note: it was adopted significance level of 0.05; and two degrees of decimal accuracy. The data obtained was also compared to other studies, revealing that the brazilian population presented an average incidence compared to other populations and that unilaterality was more prevalent and its absence less prevalent than in other populations. Therefore: 1. Due to the muscle´s great variability it’s hard to use it as a reference for incisions; 2. The pyramidalis muscle proved to be very prevalent, enhancing the viability of using it as a graft and as source of stem cells for various purposes.
Denoising task-correlated head motion from motor-task fMRI data with multi-echo ICA
Authors: Reddy Neha A. , Zvolanek Kristina M. , Moia Stefano , Caballero-Gaudes César , Bright Molly G.
Published: December 2023

Motor-task functional magnetic resonance imaging (fMRI) is crucial in the study of several clinical conditions, including stroke and Parkinson’s disease. However, motor-task fMRI is complicated by task-correlated head motion, which can be magnified in clinical populations and confounds motor activation results. One method that may mitigate this issue is multi-echo independent component analysis (ME-ICA), which has been shown to separate the effects of head motion from the desired blood oxygenation level dependent (BOLD) signal but has not been tested in motor-task datasets with high amounts of motion. In this study, we collected an fMRI dataset from a healthy population who performed a hand grasp task with and without task-correlated amplified head motion to simulate a motor-impaired population. We analyzed these data using three models: single-echo (SE), multi-echo optimally combined (ME-OC), and ME-ICA. We compared the models’ performance in mitigating the effects of head motion on the subject level and group level. On the subject level, ME-ICA better dissociated the effects of head motion from the BOLD signal and reduced noise. Both ME models led to increased t-statistics in brain motor regions. In scans with high levels of motion, ME-ICA additionally mitigated artifacts and increased stability of beta coefficient estimates, compared to SE. On the group level, all three models produced activation clusters in expected motor areas in scans with both low and high motion, indicating that group-level averaging may also sufficiently resolve motion artifacts that vary by subject. These findings demonstrate that ME-ICA is a useful tool for subject-level analysis of motor-task data with high levels of task-correlated head motion. The improvements afforded by ME-ICA are critical to improve reliability of subject-level activation maps for clinical populations in which group-level analysis may not be feasible or appropriate, for example, in a chronic stroke cohort with varying stroke location and degree of tissue damage.
The Application of the Salini Test Beyond Article 25 of the ICSID Convention: Analysis of Recent Trends in Treaty and Arbitral Practice
Authors: Petsche Markus
Published: December 2023

This article explores two developments that have led to an extension of the sphere of application of the Salini test, a set of ‘objective’ requirements for the existence of an investment established by the Salini tribunal under Article 25 ICSID Convention. The first such trend consists of the formal incorporation of Salini-type criteria or ‘characteristics’ into treaty definitions of the term ‘investment’. The second development relates to arbitral rulings (based on Romak v Uzbekistan) in which investment tribunals have held that the ‘objective’ Salini criteria apply not only under Article 25 ICSID Convention, but also under treaty definitions of ‘investment’. The present contribution provides a detailed analysis of these two trends, exploring the reasons for these developments and assessing the merits of the Romak case law. It also examines the practical challenges raised by these developments, including the redundancy of the traditional Salini test and the risk of inconsistent case law.
New Limaiinae (Neuroptera: Chrysopidae) from the early Eocene Fur Formation, Denmark, including an unexpected finding of a Mesozoic genus
Authors: MAKARKIN VLADIMIR N. , PERKOVSKY EVGENY E.
Published: December 2023

Two species of Limaiinae (Chrysopidae) are described from the early Eocene Fur Formation of Denmark: Mesypochrysa nielseni sp. nov. and Limaiinae gen. et sp. A. All forewing character states of M. nielseni sp. nov. are similar to those of the widely distributed Mesozoic genus Mesypochrysa Martynov, 1927, which was formerly known from the Middle Jurassic to mid-Cretaceous. Limaiinae gen. et sp. A is represented by an incomplete forewing. Although it differs from other species known from the formation, we refrained to name it pending a more complete specimen. The relatively high diversity of Limaiinae in the early Eocene of Denmark, with at least by two genera and four or five species is surprising. This diversity in the Fur Formation is nearly equal to that of Nothochrysinae.
Progress in the contrary effects of glucagon-like peptide-1 and chemerin on obesity development
Authors: Zhang Qilong , Ye Jianping , Wang Xiaohui
Published: December 2023

Glucagon-like peptide-1 (GLP-1), secreted by intestinal L-cells, plays a pivotal role in the modulation of β-cell insulin secretion in a glucose-dependent manner, concurrently promoting β-cell survival and β-cell mass. Notably, GLP-1 has emerged as an effective second-line treatment for type 2 diabetes mellitus, gaining further prominence for its pronounced impact on body weight reduction, positioning it as a potent antiobesity agent. However, the mechanism by which GLP-1 improves obesity remains unclear. Some reports suggest that this mechanism may be associated with the regulation of adipokine synthesis within adipose tissue. Chemerin, a multifunctional adipokine and chemokine, has been identified as a pivotal player in adipocyte differentiation and the propagation of systemic inflammation, a hallmark of obesity. This review provides a comprehensive overview of the mechanisms by which GLP-1 and chemerin play crucial roles in obesity and obesity-related diseases. It discusses well-established aspects, such as their effects on food intake and glycolipid metabolism, as well as recent insights, including their influence on macrophage polarization and adipose tissue thermogenesis. GLP-1 has been shown to increase the population of anti-inflammatory M2 macrophages, promote brown adipose tissue thermogenesis, and induce the browning of white adipose tissue. In contrast, chemerin exhibits opposite effects in these processes. In addition, recent research findings have demonstrated the promising potential of GLP-1-based therapies in directly or indirectly regulating chemerin expression. In an intriguing reciprocal relationship, chemerin has also been newly identified as a negative regulator of GLP-1 in vivo. This review delineates the intricate interplay between GLP-1 and chemerin, unraveling their mutual inhibitory interactions. To the best of our knowledge, no previous reviews have focused on this specific topic, making this review particularly valuable in expanding our understanding of the endocrine mechanisms of obesity and providing potential strategies for the treatment of obesity and related diseases.
The phylogenomic landscape of extended-spectrum β-lactamase producing Citrobacter species isolated from surface water
Authors: Chenhaka Lee-Hendra , Van Wyk Deidré A.B. , Mienie Charlotte , Bezuidenhout Cornelius C. , Lekota Kgaugelo E.
Published: December 2023

Background

Citrobacter species are Gram-negative opportunistic pathogens commonly reported in nosocomial-acquired infections. This study characterised four Citrobacter species that were isolated from surface water in the North West Province, South Africa.

Results

Phenotypic antimicrobial susceptibility profiles of the isolates demonstrated their ability to produce the extended-spectrum β-lactamase (ESBL). Whole genomes were sequenced to profile antibiotic resistance and virulence genes, as well as mobile genetic elements. In silico taxonomic identification was conducted by using multi-locus sequence typing and average nucleotide identity. A pangenome was used to determine the phylogenomic landscape of the Citrobacter species by using 109 publicly available genomes. The strains S21 and S23 were identified as C. braakii, while strains S24 and S25 were C. murliniae and C. portucalensis, respectively. Comparative genomics and sequenced genomes of the ESBL-producing isolates consisted of n = 91; 83% Citrobacter species in which bla-CMY−101 (n = 19; 32,2%) and bla-CMY−59 (n = 12; 38,7%) were prevalent in C. braakii, and C. portucalensis strains, respectively. Macrolide (acrAB-TolC, and mdtG) and aminoglycoside (acrD) efflux pumps genes were identified in the four sequenced Citrobacter spp. isolates. The quinolone resistance gene, qnrB13, was exclusive to the C. portucalensis S25 strain. In silico analysis detected plasmid replicon types IncHI1A, IncP, and Col(VCM04) in C. murliniae S24 and C. portucalensis S25, respectively. These potentially facilitate the T4SS secretion system in Citrobacter species. In this study, the C. braakii genomes could be distinguished from C. murliniae and C. portucalensis on the basis of gene encoding for cell surface localisation of the CPS (vexC) and identification of genes involved in capsule polymer synthesis (tviB and tviE). A cluster for the salmochelin siderophore system (iro-BCDEN) was found in C. murliniae S24. This is important when it comes to the pathogenicity pathway that confers an advantage in colonisation.

Conclusions

The emerging and genomic landscapes of these ESBL-producing Citrobacter species are of significant concern due to their dissemination potential in freshwater systems. The presence of these ESBL and multidrug-resistant (MDR) pathogens in aquatic environments is of One Health importance, since they potentially impact the clinical domain, that is, in terms of human health and the agricultural domain, that is, in terms of animal health and food production as well as the environmental domain.
Number of initial symptoms of SARS-CoV-2 infection is associated with the risk of otological symptoms: a retrospective study
Authors: Wang Qiang , Gu Hailing , Tao Yong , Zhao Yu , Meng Zhaoli
Published: December 2023

Background

The characteristics of otological symptoms in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are lacking. Almost no research has been conducted to explore the emergence of otological symptoms after coronavirus disease 2019 infection. The aims of this study were to investigate the prevalence and specific clinical characteristics of and risk factors for otological symptoms among patients with SARS-CoV-2 infection.

Methods

We included two groups to investigate the prevalence and clinical characteristics of otological symptoms among patients with SARS-CoV-2 infection. The first sample (S1) was drawn retrospectively from four communities via questionnaires, and the second sample (S2) from an outpatient clinic.

Results

A total of 189 participants were included in S1 (124 women [65.6%]; mean [standard deviation (SD)] age, 33.66 [13.56] years), and 47 in S2 (25 women [53.2%]; mean [SD] age, 45.28 [14.64] years). The most prevalent otological symptoms in S1 were dizziness (15.9%), tinnitus (7.9%), aural fullness (6.9%), otalgia (5.3%), hearing loss (1.6%), and otopyorrhoea (1.1%). Moreover, for each additional typical symptom of SARS-CoV-2 infection, the risk (odds ratio) of otological symptoms increased by 1.33 (95% confidence interval: 1.10–1.61, p = 0.003). The prevalence of aural fullness was higher in the unvaccinated group than that in the group receiving two or three vaccinations (p = 0.018).

Conclusions

Various otological symptoms may occur in patients with SARS-CoV-2 infection. The number of typical symptoms of SARS-CoV-2 infection is positively associated with the probability of otological symptoms. However, vaccination may reduce the probability of certain otological symptoms.
A repeated cross-sectional study of the association of community health worker intervention with the maternal continuum of care in rural Liberian communities
Authors: Blizzard Sam , Dennis Mardieh , Subah Marion , Tehoungue Bentoe Zoogley , Zizi Romax , Kraemer John D. , White Emily , Hirschhorn Lisa R.
Published: December 2023

Background

The maternal continuum of care (CoC) (antenatal care, facility-based delivery, postnatal care) is critical to maternal and neonatal health and reducing mortality, but completion in rural areas of low- and middle-income countries is often limited. We used repeated cross-sectional household surveys from a rural Liberian county to explore changes in rates of completion of all steps and no steps in the maternal CoC after implementation of the National Community Health Assistant Program (NCHAP), a community health worker (CHW) intervention designed to increase care uptake for families over five kilometers from a facility.

Methods

We analyzed repeated cross-sectional household surveys of women aged 18–49 served by NCHAP in Rivercess County, Liberia. We measured survey-weighted, before-to-after implementation difference in completion of all steps and no steps in the maternal CoC. We used multivariable regression to explore covariates associated with completion rates before and after NCHAP implementation.

Results

Data from surveys conducted at three timepoints (2015, n = 354; 2018, n = 312; 2021, n = 302) were analyzed. A significant increase in completing the full maternal CoC (2015:23.6%, 2018:53.4%, change:29.7% points (pp), 95% confidence interval (CI) [21.0,38.4]) and a decrease in completing no steps in the CoC (2015:17.6%, 2018:4.0%, change: -12.4pp [-17.6, -7.2]) after implementation of NCHAP were observed from 2015 to 2018, with rates maintained from 2018 to 2021. Living farther from a facility was consistently associated with less care across the continuum. Following implementation, living in a motorbike accessible community was associated with completing the CoC while living in a mining community was negatively associated with omitting the CoC. Household wealth was associated with differences in rates pre-NCHAP but not post-NCHAP.

Conclusions

Following NCHAP implementation, completion rate of the full maternal CoC in Rivercess County more than doubled while the rate of completing no steps in the continuum fell below 5%. These rates were sustained over time including during COVID-19 with reduced differences across wealth groups, although far distances remained a risk for less care. CHW programs providing active outreach to remote communities can be important tools for improving uptake of interventions and reducing risk of no formal care during and after pregnancy.
Long-term outcomes of single-incision plus one-port laparoscopic surgery versus conventional laparoscopic surgery for rectosigmoid cancer: a randomized controlled trial
Authors: Zhang Xuehua , Yuan Haitao , Tan Zilin , Li Gaohua , Xu Zhenzhao , Zhou Jinfan , Fu Jie , Wu Mingyi , Xi Jiafei , Wang Yanan
Published: December 2023

Background

Though our previous study has demonstrated that the single-incision plus one-port laparoscopic surgery (SILS + 1) is safe and feasible for sigmoid colon and upper rectal cancer and has better short-term outcomes compared with conventional laparoscopic surgery (CLS), the long-term outcomes of SILS + 1 remains uncertain and are needed to evaluated by an RCT.

Methods

Patients with clinical stage T1-4aN0-2M0 rectosigmoid cancer were enrolled. The participants were randomly assigned to either SILS + 1 (n = 99) or CLS (n = 99). The 3-year DFS, 5-year OS, and recurrence patterns were analyzed.

Results

Between April 2014 and July 2016, 198 patients were randomly assigned to either the SILS + 1 group (n = 99) or CLS group (n = 99). The median follow-up in the SILS + 1 group was 64.0 months and in CLS group was 65.0 months. The 3-year DFS was 87.8% (95% CI, 81.6–94.8%) in SILS + 1 group and 86.9% (95% CI, 81.3–94.5%) in CLS group (hazard ratio: 1.09 (95% CI, 0.48–2.47; P = 0.84)). The 5-year OS was 86.7% (95% CI,79.6–93.8%) in the SILS + 1 group and 80.5% (95% CI,72.5–88.5%) in the CLS group (hazard ratio: 1.53 (95% CI, 0.74–3.18; P = 0.25)). There were no significant differences in the recurrence patterns between the two groups.

Conclusions

We found no significant difference in 3-year DFS and 5-year OS of patients with sigmoid colon and upper rectal cancer treated with SILS + 1 vs. CLS. SILS + 1 is noninferior to CLS when performed by expert surgeons.

Trial registration

ClinicalTrials.gov: NCT02117557 (registered on 21/04/2014).
Prevalence and factors associated with female sterilization in Rwanda: evidence from the demographic and health survey data (2019–2020)
Authors: Ndayishimye Samuel , Olorunfemi Gbenga , Nahayo Bonfils
Published: December 2023

Background

Female sterilization is a safe and effective surgical procedure of achieving contraception. There is disparity in the prevalence of female sterilization globally, with high income countries having higher rates than low- and middle-income countries. However, current evidence of the uptake of female sterilization in Rwanda is not known. We therefore evaluated the prevalence and factors associated with female sterilization among women of reproductive age in Rwanda.

Methodology

This was a secondary data analysis of 14,634 women of reproductive age (15–49) in Rwanda. The data utilized was from the Rwanda Demographic Health and Survey (RDHS) 2019/2020. The predictors of female sterilization were determined using multivariable binary logistic regression analysis.

Results

We found that the prevalence of female sterilization was 1.1% among women of reproductive age in Rwanda. Women older than 35 years had about 8 times higher chance of being sterilized as compared to younger women (aOR: 7.87, 95% CI: 4.77–12.99). Women living with their partners had higher odds of being sterilized as compared to never married women (aOR: 19.23, 95% CI: 4.57–80.82), while women from minority religion are more likely to be sterilized as compared to those of the catholic religion (aOR: 2.12, 95% CI: 1.03–4.37). Women from rich household had a higher chance to be sterilized as compared to their counterparts from poor households (aOR: 3.13, 95% CI: 1.94–5.03). Women from the Western region were more likely to accept sterilization compared to women from Kigali (aOR: 2.025, 95% CI: 1.17–3.49) and women who had more than 5 children had higher odds when compared to women who had 5 or less children (aOR: 1.49, 95% CI: 1.06–2.10).

Conclusion

The overall prevalence of sterilization among Rwandan women of reproductive age was 1.1%, which was very low as compared to India (29%), China (14.1%) and United States of America (13.7%). The age, marital status, religion, household wealth quintile, region and children ever born were associated with the uptake of female sterilization among Rwandan women. Public awareness campaign on the advantages of female sterilization should be done to improve uptake.
Spatiotemporal variations of “triple-demic” outbreaks of respiratory infections in the United States in the post-COVID-19 era
Authors: Luo Wei , Liu Qianhuang , Zhou Yuxuan , Ran Yiding , Liu Zhaoyin , Hou Weitao , Pei Sen , Lai Shengjie
Published: December 2023

Background

The US confronted a “triple-demic” of influenza, respiratory syncytial virus (RSV), and COVID-19 in the winter of 2022, leading to increased respiratory infections and a higher demand for medical supplies. It is urgent to analyze these epidemics and their spatial-temporal co-occurrence, identifying hotspots and informing public health strategies.

Methods

We employed retrospective and prospective space-time scan statistics to assess the situations of COVID-19, influenza, and RSV in 51 US states from October 2021 to February 2022, and from October 2022 to February 2023, respectively. This enabled monitoring of spatiotemporal variations for each epidemic individually and collectively.

Results

Compared to winter 2021, COVID-19 cases decreased while influenza and RSV infections significantly increased in winter 2022. We found a high-risk cluster of influenza and COVID-19 (not all three) in winter 2021. In late November 2022, a large high-risk cluster of triple-demic emerged in the central US. The number of states at high risk for multiple epidemics increased from 15 in October 2022 to 21 in January 2023.

Conclusions

Our study offers a novel spatiotemporal approach that combines both univariate and multivariate surveillance, as well as retrospective and prospective analyses. This approach offers a more comprehensive and timely understanding of how the co-occurrence of COVID-19, influenza, and RSV impacts various regions within the United States. Our findings assist in tailor-made strategies to mitigate the effects of these respiratory infections.
Increased circulating FGF21 level predicts the burden of metabolic demands and risk of vascular diseases in adults with type 2 diabetes
Authors: Liu Zhen , Peng Yue , Li Supeng , Lin Yusheng , Huang Yunfeng , Chen Wenting , Bao Chunhua , Zhou Zengxian , Lin Zhuofeng , Chen Liangmiao
Published: December 2023

Objectives

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by chronic hyperglycemia and metabolic stress, involved in the stepwise development of cardiovascular complications. Fibroblast growth factor 21 (FGF21) is a novel hepatokine involved in regulating glucose and lipid metabolism, and has been linked to the prediction, treatment, and improvement of prognosis in multiple cardiovascular diseases (CVDs). The aim of this study is to explore the relationship between FGF21 levels and vascular diseases (VDs) including carotid atherosclerosis (CAS) and hypertension (HP) in patients with T2DM.

Methods

Baseline serum FGF21 was determined in a cross-sectional study of 701 patients with T2DM and 258 healthy control.

Results

The morbidity of CAS was increased in T2DM patients with HP as compared with those without (p < 0.001). The average serum FGF21 level of healthy was [123.9 (67.2-219.3)]. Baseline FGF21 was significantly higher in those who developed CAS or HP than in those who did not [305.9 (177.2-508.4) vs. 197.2 (129.7-308.3) pg/mL, p < 0.001]. In addition, an elevated serum FGF21 was observed in T2DM patients with HP and CAS than that of T2DM patients with CAS or HP [550.5 (312.6-711.3) vs. 305.9 pg/mL, p < 0.001]. Serum FGF21 levels were positively correlated with body mass index and carotid intima media thicknes (p < 0.05), the association remained significant after adjusting for age and T2DM duration. Furthermore, the multinomial logistic regression showed that serum FGF21 was independently associated with CAS and HP in patients with T2DM after adjustment for demographic and traditional VDs risk factors (p < 0.001).

Conclusions

Baseline FGF21 is elevated in VDs during diabetes, changes of serum FGF21 levels were appropriately matched to metabolic stress. FGF21can be used as an independent predictor for diagnosing VDs and predicting prognosis.
Who is providing HIV testing services? The profile of lay counsellors providing HIV testing services in Johannesburg, South Africa in the treat-all era
Authors: Mokhele Idah , Sineke Tembeka , Vujovic Marnie , Ruiter Robert A.C. , Onoya Dorina
Published: December 2023

Background

Lay counsellors are critical in sustaining access to HIV testing services (HTS) and psychosocial support for persons living with HIV (PLHIV). We aimed to describe the professional and psychosocial profiles of lay counsellors in primary healthcare (PHC) clinics in Johannesburg, South Africa under the universal-test-and-treat (UTT) policy context.

Methods

We conducted a descriptive analysis of a cross-sectional survey among adult (≥ 18 years) lay counsellors from 20 PHC facilities (2–3/ clinic) in Johannesburg, South Africa. Consenting counsellors were interviewed between June 2018 and March 2019. We report on counsellors’ demographic profiles, training, work experience, and mental and emotional well-being.

Results

Overall, 55 consenting adult (≥ 18 years) lay counsellors (92.7% female, median age 37 years, interquartile range [IQR]: 33–44, and 27.3% HIV diagnosed) were surveyed. Most (85.5%) were Department of Health lay counsellors receiving a volunteer stipend at the time. Overall, 56.4% had been working as counsellors for five years or longer. The majority (87%) had completed the National HIV Testing Services Policy Guidelines-recommended 10-day basic counselling training, but 45.2% had not completed refresher training within the guideline’s required 24 months. Reported operational barriers include lack of designated space for counselling (56.4%), inadequate professional supervision and support (40.7%) and insufficient emotional support (over 56.4%), and 60% were overwhelmed by their workload. A total of 18.2% had major depressive symptoms, and the same proportion scored low for psychological well-being. While most (87.3%) reported moderate job satisfaction, 50.9% actively sought alternative employment.

Conclusion

Despite lay counsellors’ significant role in delivering HIV care in South Africa, there has been minimal investment in their skills development, emotional support, and integration into the formal health workforce. Counsellors’ persisting unmet psychosocial, training, and professional needs could impact their efficacy in the UTT era.
Clinical impact of pre-existing acute exacerbation in patients with interstitial lung disease who underwent lung transplantation
Authors: Kim Hyeon Hwa , Kim Ho Cheol , Shim Tae Sun , Ahn Jee Hwan , Huh Jin Won , Hong Sang-Bum , Lee Geun Dong , Kim Dong Kwan , Park Seung-Il , Choi Sehoon
Published: December 2023

Background

Acute exacerbation of interstitial lung disease (AE-ILD) significantly impacts prognosis, leading to high mortality rates. Although lung transplantation is a life-saving treatment for selected patients with ILD, its outcomes in those presenting with AE-ILD have yielded conflicting results compared with those with stable ILD. This study aims to investigate the impact of pre-existing AE on the prognosis of ILD patients who underwent lung transplantation.

Method

We conducted a single-center retrospective study by reviewing the medical records of 108 patients who underwent lung transplantation for predisposing ILD at Asan Medical Center, Seoul, South Korea, between 2008 and 2022. The primary objective was to compare the survival of patients with AE-ILD at the time of transplantation with those without AE-ILD.

Results

Among the 108 patients, 52 (48.1%) experienced AE-ILD at the time of lung transplantation, and 81 (75.0%) required pre-transplant mechanical ventilation. Although the type of ILD (IPF vs. non-IPF ILD) did not affect clinical outcomes after transplantation, AE-ILD was associated with worse survival outcomes. The survival probabilities at 90 days, 1 year, and 3 years post-transplant for patients with AE-ILD were 86.5%, 73.1%, and 60.1%, respectively, while those for patients without AE-ILD were higher, at 92.9%, 83.9%, and 79.6% (p = 0.032). In the multivariable analysis, pre-existing AE was an independent prognostic factor for mortality in ILD patients who underwent lung transplantation.

Conclusions

Although lung transplantation remains an effective treatment option for ILD patients with pre-existing AE, careful consideration is needed, especially in patients requiring pre-transplant mechanical respiratory support.