bluuebunny/crossref_metadata_2025 huggingface dataset:
Estimating disease incidence rates and transition probabilities in elderly patients using multi-state models: a case study in fragility fracture using a Bayesian approach
Authors: Llopis-Cardona Fran , Armero Carmen , Sanfélix-Gimeno Gabriel
Published: February 2023

Background

Multi-state models are complex stochastic models which focus on pathways defined by the temporal and sequential occurrence of numerous events of interest. In particular, the so-called illness-death models are especially useful for studying probabilities associated to diseases whose occurrence competes with other possible diseases, health conditions or death. They can be seen as a generalization of the competing risks models, which are widely used to estimate disease-incidences among populations with a high risk of death, such as elderly or cancer patients. The main advantage of the aforementioned illness-death models is that they allow the treatment of scenarios with non-terminal competing events that may occur sequentially, which competing risks models fail to do.

Methods

We propose an illness-death model using Cox proportional hazards models with Weibull baseline hazard functions, and applied the model to a study of recurrent hip fracture. Data came from the PREV2FO cohort and included 34491 patients aged 65 years and older who were discharged alive after a hospitalization due to an osteoporotic hip fracture between 2008-2015. We used a Bayesian approach to approximate the posterior distribution of each parameter of the model, and thus cumulative incidences and transition probabilities. We also compared these results with a competing risks specification.

Results

Posterior transition probabilities showed higher probabilities of death for men and increasing with age. Women were more likely to refracture as well as less likely to die after it. Free-event time was shown to reduce the probability of death. Estimations from the illness-death and the competing risks models were identical for those common transitions although the illness-death model provided additional information from the transition from refracture to death.

Conclusions

We illustrated how multi-state models, in particular illness-death models, may be especially useful when dealing with survival scenarios which include multiple events, with competing diseases or when death is an unavoidable event to consider. Illness-death models via transition probabilities provide additional information of transitions from non-terminal health conditions to absorbing states such as death, what implies a deeper understanding of the real-world problem involved compared to competing risks models.
Evaluation of the advantages of robotic versus laparoscopic surgery in elderly patients with colorectal cancer
Authors: Xue Yonggan , Li Sen , Guo Shaohua , Kuang Yanshen , Ke Mu , Liu Xin , Gong Fangming , Li Peng , Jia Baoqing
Published: February 2023

Background

The incidence of colorectal cancer increases with aging. Curative-intent surgery based on a minimally invasive concept is expected to bring survival benefits to elderly patients (aged over 80 years) with colorectal cancer who are frequently with fragile health status and advanced tumors. The study explored survival outcomes in this patient population who received robotic or laparoscopic surgery and aimed to identify an optimal surgical option for those patients.

Methods

We retrieved the clinical materials and follow-up data on elderly patients with colorectal carcinoma who received robotic or laparoscopic surgery in our institution. The pathological and surgical outcomes were compared to examine the efficacy and safety of the two approaches. The DFS (disease-free survival) and OS (overall survival) results at 3 years after surgery were assessed to explore the survival benefits.

Results

A total of 111 patients were screened for the study, including 55 in the robotic group and 56 in the laparoscopic group. The demographic details were generally similar between the two groups. No statistically significant difference in the number of removed lymph nodes was observed between the two approaches, with a median of 15 versus 14 (P = 0.053). The intraoperative blood loss was significantly reduced by robotic technique when compared to the laparoscopic approach, with a mean of 76.9 ml versus 161.6 ml (P = 0.025). There were no significant differences in operation time, conversion, postoperative complications and recovery, and long-term outcomes between the two groups.

Conclusion

Robotic surgery was prized for elderly patients with colorectal cancer who developed anemia and/or hematological conditions.
Prevalence of extended spectrum beta lactamase and molecular detection of blaTEM, blaSHV and blaCTX-M genotypes among Gram negative bacilli isolates from pediatric patient population in Gaza strip
Authors: El Aila Nabil Abdullah , Al Laham Nahed Ali , Ayesh Basim Mohammed
Published: February 2023

Background

Extended-spectrum β lactamases (ESBLs), have the ability to hydrolyze and cause resistance to various types of the β-lactam antibiotics, including the extended-spectrum (or third-generation) cephalosporins (e.g., cefotaxime, ceftriaxone, ceftazidime) and monobactams (e.g., aztreonam). ESBL-producing Gram negative bacteria is still posing significant therapeutic challenges.

Objectives

To assess the prevalence and molecular characteristics of ESBL producing Gram negative bacilli, isolated from a cohort of pediatric patients in Gaza hospitals.

Methods

A total of 322 isolates of Gram-negative bacilli were collected from four referral pediatric hospitals in Gaza, namely: Al-Nasr, Al-Rantisi, Al-Durra and Beit Hanoun hospitals. These isolates were tested for ESBL production using the double disk synergy and CHROMagar phenotypic methods. Molecular characterization of the ESBL producing strains was performed using PCR targeting the CTX-M, TEM and SHV genes. Antibiotic profile was done using Kirby Bauer method according to Clinical and Laboratory Standard Institute.

Results

Out of 322 isolates tested by phenotypic methods, 166 (51.6%) were ESBL positive. The prevalence of ESBL production in Al-Nasr, Al-Rantisi, Al-Durra and Beit Hanoun hospitals was 54%, 52.5%, 45.5% and 52.8% respectively. The prevalence of ESBL production among Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter spp., Proteus mirabilis, Enterobacter spp., Citrobacter spp., and Serratia marcescens is 55.3%, 63.4%, 17.8%, 57.1%, 33.3%, 28.5%, 38.4%, and 4% respectively.

ESBL production among urine, pus, blood, CSF and sputum was 53.3%, 55.2%, 47.4%, 33.3%, and 25% respectively. Out of the 322 isolates, 144 were screened for CTX-M, TEM and SHV production. Using PCR, 85 (59%) had at least one gene. The prevalence rate of CTX-M, TEM and SHV genes was 60%, 57.6%, and 38.3% respectively.

Meropenem and amikacin were highest rates of susceptibility antibiotics against ESBLs producers (83.1% and 82.5% respectively), while the least effective antibiotics were amoxicillin (3.1%) and cephalexin (13.9%). Moreover, ESBLs producers showed high resistance rate to cefotaxime, ceftriaxone and ceftazidime (79.5%, 78.9% and 79.5% respectively).

Conclusion

Our results show high prevalence of ESBL production among Gram negative bacilli isolated from children in different pediatric hospitals in Gaza strip. A substantial level of resistance to first and second generation cephalosporins was also observed. This ascertains the need for a rational antibiotic prescription and consumption policy.
Incidence, susceptibility and outcomes of candidemia in adults living in Calgary, Alberta, Canada (2010–2018)
Authors: Bourassa-Blanchette Samuel , Biesheuvel Marit M. , Lam John C. , Kipp Alexander , Church Deirdre , Carson Julie , Dalton Bruce , Parkins Michael D. , Barkema Herman W. , Gregson Daniel B.
Published: February 2023

Background

Candidemia is increasing in frequency and is associated with high mortality. We sought to determine the burden of illness, the population it affects and its resistance profile in our region.

Methods

The Calgary Zone (CZ) provides all care for residents of Calgary and surrounding communities (~ 1.69 million) via five tertiary hospitals each served by a common single laboratory for acute care microbiology. All adult patients in the CZ with at least one Candida spp.-positive blood culture between January 1, 2010, and December 31, 2018, were identified using microbiological data from Calgary Lab Services, the laboratory that processes > 95% of all blood culture samples in the CZ, were reviewed for the study.

Results

The overall annual incidence of candidemia among individuals living in the CZ was 3.8 per 100,000 persons (Median age 61 years (IQR 48–72) and 221/455 (47.4%) were female). C. albicans was the most common species (50.6%), followed by C. glabrata, (24.0%). No other species accounted for more than 7% of cases. Overall mortality at 30, 90, and 365 days was 32.2, 40.1, and 48.1% respectively. Mortality rate did not differ by Candida species. Of individuals who developed candidemia, more than 50% died within the next year. No new resistance pattern has emerged in the most common Candida species in Calgary, Alberta.

Conclusions

In Calgary, Alberta, the incidence of candidemia has not increased in the last decade. C. albicans was the most common species and it remains susceptible to fluconazole.
Use machine learning to help identify possible sarcopenia cases in maintenance hemodialysis patients
Authors: Liao Hualong , Yang Yujie , Zeng Ying , Qiu Ying , Chen Yang , Zhu Linfang , Fu Ping , Yan Fei , Chen Yu , Yuan Huaihong
Published: February 2023

Background

Maintenance hemodialysis (MHD) patients often suffer from sarcopenia, which is strongly associated with their long-term mortality. The diagnosis and treatment of sarcopenia, especially possible sarcopenia for MHD patients are of great importance. This study aims to use machine learning and medical data to develop two simple sarcopenia identification assistant tools for MHD patients and focuses on sex specificity.

Methods

Data were retrospectively collected from patients undergoing MHD and included patients’ basic information, body measurement results and laboratory findings. The 2019 consensus update by Asian working group for sarcopenia was used to assess whether a MHD patient had sarcopenia. Finally, 140 male (58 with possible sarcopenia or sarcopenia) and 102 female (65 with possible sarcopenia or sarcopenia) patients’ data were collected. Participants were divided into sarcopenia and control groups for each sex to develop binary classifiers. After statistical analysis and feature selection, stratified shuffle split and Synthetic Minority Oversampling Technique were conducted and voting classifiers were developed.

Results

After eliminating handgrip strength, 6-m walk, and skeletal muscle index, the best three features for sarcopenia identification of male patients are age, fasting blood glucose, and parathyroid hormone. Meanwhile, age, arm without vascular access, total bilirubin, and post-dialysis creatinine are the best four features for females. After abandoning models with overfitting or bad performance, voting classifiers achieved good sarcopenia classification performance for both sexes (For males: sensitivity: 77.50% ± 11.21%, specificity: 83.13% ± 9.70%, F1 score: 77.32% ± 5.36%, the area under the receiver operating characteristic curves (AUC): 87.40% ± 4.41%. For females: sensitivity: 76.15% ± 13.95%, specificity: 71.25% ± 15.86%, F1 score: 78.04% ± 8.85%, AUC: 77.69% ± 7.92%).

Conclusions

Two simple sex-specific sarcopenia identification tools for MHD patients were developed. They performed well on the case finding of sarcopenia, especially possible sarcopenia.
Area postrema syndrome with linear enhancement along the surface of the brainstem and fourth ventricle in autoimmune GFAP astrocytopathy
Authors: Liang Xinming , Shen Yaoyao
Published: February 2023

Background

Glial fibrillary acidic protein (GFAP) astrocytopathy, a novel autoimmune disease of the nervous system, was first defined in 2016. To our knowledge, area postrema syndrome (APS) with linear enhancement along the surface of the brainstem and fourth ventricle is extremely rare in this disorder.

Case presentation

A Chinese woman presented with intractable nausea and vomiting after onset of flu-like symptoms. Brain magnetic resonance imaging (MRI) disclosed abnormal signal intensities in the dorsal medulla oblongata including area postrema. Besides, linear enhancement surrounding the surface of the brainstem and fourth ventricle was visualized after gadolinium injection. Cerebrospinal fluid (CSF) analysis showed increased cell count and protein. A cell-based assay was positive for anti-GFAP IgG in CSF. She was diagnosed with autoimmune GFAP astrocytopathy and treated with high-dose glucocorticoid. The patient received a quick recovery with entire resolution of the initial abnormalities.

Conclusions

Isolated APS can be the initial manifestation of autoimmune GFAP astrocytopathy. Linear enhancement surrounding the surface of the brainstem and fourth ventricle is another neuroradiological hallmark.
Application of the child community health inclusion index for measuring health inclusion of children with disabilities in the community: a feasibility study
Authors: Yejong Yoo Paul , Majnemer Annette , Wilton Robert , Ahmed Sara , Shikako Keiko
Published: February 2023

Background

Participation in the community is a fundamental human right for children with disabilities and is a key component of their health and development. Inclusive communities can enable children with disabilities to participate fully and effectively. The Child Community Health Inclusion Index (CHILD-CHII) is a comprehensive assessment tool developed to examine the extent to which community environments foster healthy, active living for children with disabilities.

Objectives

To assess the feasibility of applying the CHILD-CHII measurement tool across different community settings.

Methods

Participants recruited through maximal representation, and purposeful sampling from four community sectors (Health, Education, Public Spaces, Community Organizations) applied the tool on their affiliated community facility. Feasibility was examined by assessing length, difficulty, clarity, and value for measuring inclusion; each rated on a 5-point Likert scale. Participants provided comments for each indicator through the questionnaire and a follow-up interview.

Results

Of the 12 participants, 92% indicated that the tool was ‘long’ or ‘much too long’; 66% indicated that the tool was clear; 58% indicated that the tool was ‘valuable’ or ‘very valuable’. No clear consensus was obtained for the level of difficulty. Participants provided comments for each indicator.

Conclusion

Although the length of the tool was regarded as long, it was seen to be comprehensive and valuable for stakeholders in addressing the inclusion of children with disabilities in the community. The perceived value and the evaluators’ knowledge, familiarity, and access to information can facilitate use of the CHILD-CHII. Further refinement and psychometric testing will be conducted.
The lived experience of stigma and parkinson’s disease in Kenya: a public health challenge
Authors: Fothergill-Misbah Natasha
Published: February 2023

Background

As a disease characterised by non-motor and very visible motor symptoms, Parkinson’s disease has been associated with multiple forms of stigma, while awareness about the disease globally remains low. The experience of stigma relating to Parkinson’s disease from high-income nations is well-documented, while less is known about low- and middle-income countries (LMICs). Literature on stigma and disease from Africa and the Global South has described the added complexities people face resulting from structural violence, as well as perceptions about symptoms and disease associated with supernatural beliefs, which can have significant implications for access to healthcare and support. Stigma is a recognised barrier to health-seeking behaviour and a social determinant of population health.

Methods

This study draws on qualitative data collected as part of a wider ethnographic study to explore the lived experience of Parkinson’s disease in Kenya. Participants include 55 people diagnosed with Parkinson’s and 23 caregivers. The paper draws on the Health Stigma and Discrimination Framework as a tool to understand stigma as a process.

Results

Data from interviews identified the drivers and facilitators of stigma, including poor awareness of Parkinson’s, lack of clinical capacity, supernatural beliefs, stereotypes, fear of contagion and blame. Participants reported their lived realities of stigma, and experiences of stigma practices, which had significant negative health and social outcomes, including social isolation and difficulty accessing treatment. Ultimately, stigma had a negative and corrosive effect on the health and wellbeing of patients.

Conclusion

This paper highlights the interplay of structural constraints and the negative consequences of stigma experienced by people living with Parkinson’s in Kenya. The deep understanding of stigma made possible through this ethnographic research leads us to see stigma as a process, something that is embodied and enacted. Targeted and nuanced ways of tackling stigma are suggested, including educational and awareness campaigns, training, and the development of support groups. Importantly, the paper shows that awareness of, and advocacy for the recognition of, Parkinson’s globally needs to improve. This recommendation is in line with the World Health Organization’s Technical Brief on Parkinson disease, which responds to the growing public health challenge posed by Parkinson’s.
Physiotherapy with integrated virtual reality for patients with complex chronic low back pain: protocol for a pragmatic cluster randomized controlled trial (VARIETY study)
Authors: Slatman Syl , Ostelo Raymond , van Goor Harry , Staal J. Bart , Knoop Jesper
Published: February 2023

Background

Chronic low back pain (CLBP) is the most common chronic pain condition worldwide. Currently, primary care physiotherapy is one of the main treatment options, but effects of this treatment are small. Virtual Reality (VR) could be an adjunct to physiotherapy care, due to its multimodal features. The primary aim of this study is to assess the (cost-)effectiveness of physiotherapy with integrated multimodal VR for patients with complex CLBP, compared to usual primary physiotherapy care.

Methods

A multicenter, two-arm, cluster randomized controlled trial (RCT) including 120 patients with CLBP from 20 physiotherapists will be conducted. Patients in the control group will receive 12 weeks of usual primary physiotherapy care for CLBP. Patients in the experimental group will receive treatment consisting of 12 weeks of physiotherapy with integrated, immersive, multimodal, therapeutic VR. The therapeutic VR consists of the following modules: pain education, activation, relaxation and distraction. The primary outcome measure is physical functioning. Secondary outcome measures include pain intensity, pain-related fears, pain self-efficacy and economic measures. Effectiveness of the experimental intervention compared to the control intervention on primary and secondary outcome measures will be analyzed on an intention-to-treat principle, using linear mixed-model analyses.

Discussion

This pragmatic, multicenter cluster randomized controlled trial, will determine the clinical and cost-effectiveness of physiotherapy with integrated, personalized, multimodal, immersive VR in favor of usual physiotherapy care for patients with CLBP.

Trial registration

This study is prospectively registered atClinicalTrials.gov(identifier: NCT05701891).
Determinants of national health insurance enrolment among people at risk of statelessness in the Awutu Senya East Municipality and Gomoa East District of Ghana
Authors: Quartey Theophilus , Peprah Charles , Morgan Anthony Kwame
Published: February 2023

Background

This paper investigates the factors influencing the decision to enrol in Ghana’s National Health Insurance Scheme (NHIS) among people at risk of statelessness, with emphasis on the individual's demographic and socioeconomic factors. 

Methods

The study used data from a cross-sectional household survey undertaken in the Awutu Senya East Municipality and Gomoa East District of Ghana's Central Region between March 9 and June 26, 2021, on healthcare utilization culture among people at risk of statelessness. Descriptive statistics and binary logistic regression were used in analysing data from a sample of 384 people at risk of statelessness. 

Results

The results reveal that about 51% of the at-risk population have ever enrolled while 48% of the respondents were enrolled on the NHIS at the time of the survey (active members). The majority of the enrolled members acquired their membership through self-payment of the enrolment fee. Additionally, respondents aged 26–35 had higher odds of enrolling, whiles those within 56–65 years had lower odds of enrolling in health insurance. Also, persons who are married and have a high school education or an equivalent qualification were more likely to enrol, while persons with no employment were less likely to enrol.

Conclusion

According to the paper, while the gap in coverage between rich and poor, married and single appears to have narrowed, these factors continue to determine NHIS coverage among people at risk of statelessness. The same is true for education. Efforts must be increased to ensure equal access to healthcare financing interventions for better access to health services.
How Zambia reduced inequalities in under-five mortality rates over the last two decades: a mixed-methods study
Authors: Jacobs Choolwe , Musukuma Mwiche , Sikapande Brivine , Chooye Ovost , Wehrmeister Fernando C. , Boerma Ties , Michelo Charles , Blanchard Andrea K.
Published: February 2023

Background

Zambia experienced a major decline in under-five mortality rates (U5MR), with one of the fastest declines in socio-economic disparities in sub-Saharan Africa in the last two decades. We aimed to understand the extent to which, and how, Zambia has reduced socio-economic inequalities in U5MR since 2000.

Methods

Using nationally-representative data from Zambia Demographic Health Surveys (2001/2, 2007, 2013/14 and 2018), we examined trends and levels of inequalities in under-five mortality, intervention coverage, household water and sanitation, and fertility. This analysis was integrated with an in-depth review of key policy and program documents relevant to improving child survival in Zambia between 1990 and 2020.

Results

The under-five mortality rate (U5MR) declined from 168 to 64 deaths per 1000 live births between 2001/2 and 2018 ZDHS rounds, particularly in the post-neonatal period. There were major reductions in U5MR inequalities between wealth, education and urban–rural residence groups. Yet reduced gaps between wealth groups in estimated absolute income or education levels did not simultaneously occur. Inequalities reduced markedly for coverage of reproductive, maternal, newborn and child health (RMNCH), malaria and human immunodeficiency virus interventions, but less so for water or sanitation and fertility levels.

Several policy and health systems drivers were identified for reducing RMNCH inequalities: policy commitment to equity in RMNCH; financing with a focus on disadvantaged groups; multisectoral partnerships and horizontal programming; expansion of infrastructure and human resources for health; and involvement of community stakeholders and service providers.

Conclusion

Zambia’s major progress in reducing inequalities in child survival between the poorest and richest people appeared to be notably driven by government policies and programs that centrally valued equity, despite ongoing gaps in absolute income and education levels. Future work should focus on sustaining these gains, while targeting families that have been left behind to achieve the sustainable development goal targets.
Chromosome-level genome assembly and population genomics of Mongolian racerunner (Eremias argus) provide insights into high-altitude adaptation in lizards
Authors: Li Weiming , Du Juan , Yang Lingyun , Liang Qiqi , Yang Mengyuan , Zhou Xuming , Du Weiguo
Published: February 2023

Background

Although the extreme environmental adaptation of organisms is a hot topic in evolutionary biology, genetic adaptation to high-altitude environment remains poorly characterized in ectothermic animals. Squamates are among the most diverse terrestrial vertebrates, with tremendous ecological plasticity and karyotype diversity, and are a unique model system to investigate the genetic footprints of adaptation.

Results

We report the first chromosome-level assembly of the Mongolian racerunner (Eremias argus) and our comparative genomics analyses found that multiple chromosome fissions/fusions events are unique to lizards. We further sequenced the genomes of 61 Mongolian racerunner individuals that were collected from altitudes ranging from ~ 80 to ~ 2600 m above sea level (m.a.s.l.). Population genomic analyses revealed many novel genomic regions under strong selective sweeps in populations endemic to high altitudes. Genes embedded in those genomic regions are mainly associated with energy metabolism and DNA damage repair pathways. Moreover, we identified and validated two substitutions of PHF14 that may enhance the lizards’ tolerance to hypoxia at high altitudes.

Conclusions

Our study reveals the molecular mechanism of high-altitude adaptation in ectothermic animal using lizard as a research subject and provides a high-quality lizard genomic resource for future research.
Genomic profiling of dioecious Amaranthus species provides novel insights into species relatedness and sex genes
Authors: Raiyemo Damilola A. , Bobadilla Lucas K. , Tranel Patrick J.
Published: February 2023

Background

AmaranthusL. is a diverse genus consisting of domesticated, weedy, and non-invasive species distributed around the world. Nine species are dioecious, of whichAmaranthus palmeriS. Watson andAmaranthus tuberculatus(Moq.) J.D. Sauer are troublesome weeds of agronomic crops in the USA and elsewhere. Shallow relationships among the dioeciousAmaranthusspecies and the conservation of candidate genes within previously identifiedA. palmeriandA. tuberculatusmale-specific regions of the Y (MSYs) in other dioecious species are poorly understood. In this study, seven genomes of dioecious amaranths were obtained by paired-end short-read sequencing and combined with short reads of seventeen species in the family Amaranthaceae from NCBI database. The species were phylogenomically analyzed to understand their relatedness. Genome characteristics for the dioecious species were evaluated and coverage analysis was used to investigate the conservation of sequences within the MSY regions.

Results

We provide genome size, heterozygosity, and ploidy level inference for seven newly sequenced dioeciousAmaranthusspecies and two additional dioecious species from the NCBI database. We report a pattern of transposable element proliferation in the species, in which seven species had moreTy3elements thancopiaelements whileA. palmeriandA. watsoniihad morecopiaelements thanTy3elements, similar to the TE pattern in some monoecious amaranths. Using a Mash-based phylogenomic analysis, we accurately recovered taxonomic relationships among the dioeciousAmaranthusspecies that were previously identified based on comparative morphology. Coverage analysis revealed eleven candidate gene models within theA. palmeriMSY region with male-enriched coverages, as well as regions on scaffold 19 with female-enriched coverage, based onA. watsoniiread alignments. A previously reportedFLOWERING LOCUS T(FT) withinA. tuberculatusMSY contig was also found to exhibit male-enriched coverages for three species closely related toA. tuberculatusbut not forA. watsoniireads. Additional characterization of theA. palmeriMSY region revealed that 78% of the region is made of repetitive elements, typical of a sex determination region with reduced recombination.

Conclusions

The results of this study further increase our understanding of the relationships among the dioecious species of theAmaranthusgenus as well as revealed genes with potential roles in sex function in the species.
Prediabetes as a risk factor for new-onset atrial fibrillation: the propensity-score matching cohort analyzed using the Cox regression model coupled with the random survival forest
Authors: Hsu Jung-Chi , Yang Yen-Yun , Chuang Shu-Lin , Lin Lian-Yu , Chen Tony Hsiu-Hsi
Published: February 2023

Background

The glycemic continuum often indicates a gradual decline in insulin sensitivity leading to an increase in glucose levels. Although prediabetes is an established risk factor for both macrovascular and microvascular diseases, whether prediabetes is independently associated with the risk of developing atrial fibrillation (AF), particularly the occurrence time, has not been well studied using a high-quality research design in combination with statistical machine-learning algorithms.

Methods

Using data available from electronic medical records collected from the National Taiwan University Hospital, a tertiary medical center in Taiwan, we conducted a retrospective cohort study consisting 174,835 adult patients between 2014 and 2019 to investigate the relationship between prediabetes and AF. To render patients with prediabetes as comparable to those with normal glucose test, a propensity-score matching design was used to select the matched pairs of two groups with a 1:1 ratio. The Kaplan–Meier method was used to compare the cumulative risk of AF between prediabetes and normal glucose test using log-rank test. The multivariable Cox regression model was employed to estimate adjusted hazard ratio (HR) for prediabetes versus normal glucose test by stratifying three levels of glycosylated hemoglobin (HbA1c). The machine-learning algorithm using the random survival forest (RSF) method was further used to identify the importance of clinical factors associated with AF in patients with prediabetes.

Results

A sample of 14,309 pairs of patients with prediabetes and normal glucose test result were selected. The incidence of AF was 11.6 cases per 1000 person-years during a median follow-up period of 47.1 months. The Kaplan–Meier analysis revealed that the risk of AF was significantly higher in patients with prediabetes (log-rank p < 0.001). The multivariable Cox regression model indicated that prediabetes was independently associated with a significant increased risk of AF (HR 1.24, 95% confidence interval 1.11–1.39, p < 0.001), particularly for patients with HbA1c above 5.5%. The RSF method identified elevated N-terminal natriuretic peptide and altered left heart structure as the two most important risk factors for AF among patients with prediabetes.

Conclusions

Our study found that prediabetes is independently associated with a higher risk of AF. Furthermore, alterations in left heart structure make a significant contribution to this elevated risk, and these structural changes may begin during the prediabetes stage.
MicroRNA-122 in human cancers: from mechanistic to clinical perspectives
Authors: Faramin Lashkarian Mahboobeh , Hashemipour Nasrin , Niaraki Negin , Soghala Shahrad , Moradi Ali , Sarhangi Sareh , Hatami Mahsa , Aghaei-Zarch Fatemehsadat , Khosravifar Mina , Mohammadzadeh Alireza , Najafi Sajad , Majidpoor Jamal , Farnia Poopak , Aghaei-Zarch Seyed Mohsen
Published: February 2023

MicroRNAs (miRNAs) are endogenous short non-coding RNAs that can regulate the expression of target genes post-transcriptionally and interact with mRNA-coding genes. MiRNAs play vital roles in many biological functions, and abnormal miRNA expression has been linked to various illnesses, including cancer. Among the miRNAs, miR-122, miR-206, miR-21, miR-210, miR-223, and miR-424 have been extensively studied in various cancers. Although research in miRNAs has grown considerably over the last decade, much is yet to be discovered, especially regarding their role in cancer therapies. Several kinds of cancer have been linked to dysregulation and abnormal expression of miR-122, indicating that miR-122 may serve as a diagnostic and/or prognostic biomarker for human cancer. Consequently, in this review literature, miR-122 has been analyzed in numerous cancer types to sort out the function of cancer cells miR-122 and enhance patient response to standard therapy.
Malaria profile and socioeconomic predictors among under-five children: an analysis of 11 sub-Saharan African countries
Authors: Anjorin Seun , Okolie Elvis , Yaya Sanni
Published: February 2023

Background

African region accounts for 95% of all malaria cases and 96% of malaria deaths with under-five children accounting for 80% of all deaths in the region. This study assessed the socioeconomic determinants of malaria prevalence and provide evidence on the socioeconomic profile of malaria infection among under-five children in 11 SSA countries.

Methods

This study used data from the 2010 to 2020 Demographic and Health Survey (DHS). The survey used a two-stage stratified-cluster sampling design based on the sampling frame of the population and housing census of countries included. Statistical analyses relied on Pearson’s χ2, using the CHAID decision-tree algorithm and logistic regression implemented in R V.4.6.

Results

Of 8547 children considered, 24.2% (95% confidence interval CI 23.4–25.05%) had malaria infection. Also, the prevalence of malaria infection seems to increase with age. The following variables are statistically associated with the prevalence of malaria infection among under-five children: under-five child’s age, maternal education, sex of household head, household wealth index, place of residence, and African region where mother–child pair lives. Children whose mothers have secondary education have about 56% lower risk (odds ratio = 0.44; 95% CI 0.40–0.48) of malaria infection and 73% lower (odds ratio = 0.37; 95% CI 0.32–0.43) among children living in the richest households, compared to children living in the poorest households.

Conclusions

The findings of this study provide unique insights on how socioeconomic and demographic variables, especially maternal education level significantly predicts under-five malaria prevalence across the SSA region. Therefore, ensuring that malaria interventions are underpinned by a multisectoral approach that comprehensively tackles the interplay of maternal education and other socioeconomic variables will be critical in attaining malaria prevention and control targets in SSA.
Investigating continuation of folic acid supplementation during peri-conceptional period: a community-based cross-sectional study
Authors: Mao Yanyan , Hu Hong , Chen Dongyan , Fang Yuhang , Liu Jun , Li Min , Zhou Weijin
Published: February 2023

Background

Maternal folate may not reach an optimal level to prevent neural tube defects if supplementation commenced post-conception or took place pre-conception only. Our study aimed to investigate the continuation of folic acid (FA) supplementation from pre-conception to post-conception during peri-conceptional period and to examine its differences in FA supplementation between the subgroups taking the initiation timing into consideration.

Methods

This study was conducted in two community health service centers in Jing-an District of Shanghai. Women accompanying their children to pediatric health clinics of the centers were recruited and asked to recall information concerning their socioeconomic and previous obstetric characteristics, utilization of healthcare and FA supplementation before and/or during pregnancy. The continuation of FA supplementation during peri-conceptional period were categorized into three subgroups: Supplementing with FA pre- and post-conception; supplementing with FA preconception only or post-conception only; no FA supplements pre-conception and post-conception. The relationship between FA continuation and couples’ characteristics were examined as setting the first subgroup as the base reference.

Results

Three hundred and ninety-six women were recruited. Over 40% of the women started FA supplementation after conception and 30.3% of them supplemented with FA from pre-conception to the first trimester of their pregnancy. Compared to this one-third of participants, women who didn’t supplemented with any FA during peri-conceptional period were more likely to have no utilization of pre-conception healthcare ($$OR$$

OR

= 2.47, 95% $$CI$$

CI

: 1.33–4.61) or antenatal care ($$OR$$

OR

= 4.05, 95% $$CI$$

CI

: 1.76–9.34), or who had a lower family socioeconomic status ($$OR$$

OR

= 4.36, 95% $$CI$$

CI

: 1.79–10.64). Women who supplemented with FA pre-conception only or post-conception only were more likely to have no utilization of pre-conception healthcare ($$OR$$

OR

= 2.94, 95% $$CI$$

CI

: 1.79–4.82), or to have no previous pregnancy complication ($$OR$$

OR

=1.80, 95% $$CI$$

CI

: 0.99–3.28).

Conclusion

Over two-fifth of the women started FA supplementation and only one-third of them had an optimal supplementation from pre-conception to the first trimester. Maternal utilization of healthcare before or during pregnancy together with maternal and paternal socioeconomic status may play a role in the continuation to FA supplementation pre- and post-conception.
Postoperative recurrence of mixed extragonadal germ cell tumor in the right shoulder: a case report
Authors: Li Yao , Huang Xiang , Meng Xue , Luo Yuqing , Luo Shuai , Wang Jinjing
Published: February 2023

Background

Extragonadal germ cell tumours (EGGCTs) originated in Shoulder are extremely rare, with 1 case described in the literature. We report a case of a patient with a primary Right Shoulder mixed EGGCT.

Case presentation

A 36-year-old male patient was hospitalized for 6 months due to progressive right shoulder swelling accompanied by pain. Subsequently, the right shoulder tumor was removed entirely. Gross pathological examination showed that the size of the tumor mass was about 14 × 10 × 6 cm.Mutations were observed in ENPEP (4q25), ZCCHC11, RREB1 (6p24.3), CKAP4 (12q23.3), and other genes were detected by whole exome sequencing. Histology revealed a mixed EGGCT of the Right Shoulder with immature teratoma and yolk sac tumour. The patient went through 6 cycles of chemotherapy. After 7 months of follow-up, the patient is recurrence.

Conclusion

The primary MEGCT of the shoulder is an extremely rare condition. However, the recurrence and metastasis rates are high. Therefore, further research is necessary to determine this rare disease’s genetic and clinical characteristics to develop an effective treatment plan.
Efficacy and safety of proton beam therapy for rhabdomyosarcoma: a systematic review and meta-analysis
Authors: Dong Meng , Wu Jianrong , Wu Renhua , Wang Dandan , Liu Ruifeng , Luo Hongtao , Wang Yuhang , Chen Junru , Ou Yuhong , Zhang Qiuning , Wang Xiaohu
Published: February 2023

Objective

This study aimed to evaluate and conduct a meta-analysis on the efficacy and safety of proton beam therapy (PBT) for rhabdomyosarcoma (RMS).

Methods

We searched for articles using PubMed, Embase, Cochrane Library, and Web of Science databases from their inception to December 22, 2022. Two researchers independently screened literature and extracted data. Statistical analyses were performed using STATA version 14.0.

Results

We got 675 candidate articles, of which 11 studies were included in our study according to the inclusion and exclusion criteria. Of the 544 RMS patients who received PBT. The local control (LC) rate at 1, 2, 3, 4, and 5 years were 96% (95% confidence interval (CI) 0.91–1.01), 93% (95% CI 0.86–1.00), 78% (95% CI 0.71–0.85), 85% (95% CI 0.78–0.92), and 84% (95% CI 0.74–0.95), respectively. The progression-free survival (PFS) rate at 1, 2, 3, 4, and 5 years were 82% (95% CI 0.72–0.92), 73% (95% CI 0.61–0.84), 63% (95% CI 0.47–0.79), 64% (95% CI 0.54–0.74), and 76% (95% CI 0.59–0.94), respectively. The overall survival (OS) rate at 1, 2, 3, 4, and 5 years were 93% (95% CI 0.86–1.00), 85% (95% CI 0.76–0.95), 80% (95% CI 0.63–0.96), 71% (95% CI 0.62–0.80), and 82% (95% CI 0.71–0.94), respectively. Acute and late toxicities were mainly grades 1 to 2 in all studies.

Conclusion

As an advantageous RT technique, PBT is an emerging option for patients with RMS, particularly children and adolescents patients. The data showed that PBT is a feasible, safe, and effective modality for RMS, showing promising LC, OS, PFS, and lower acute and late toxicities.

PROSPERO registration number: CRD42022329154.
Effectiveness of an 8-week overground walking with paretic lower limb loading on spatiotemporal gait parameters and motor function among chronic stroke survivors: a study protocol for a randomised controlled trial
Authors: Maje Abdulhamid U. , Ibrahim Aminu A.
Published: February 2023

Background

Post-stroke gait deviations contribute to significant functional disability, impaired walking ability and poor quality of life. Prior studies suggest that gait training with paretic lower limb loading may improve gait parameters and walking ability in post-stroke. However, most gait training methods used in these studies are not readily available, and studies using cheaper methods are limited.

Objective

The purpose of this study is to describe a protocol for a randomised controlled trial on the effectiveness of an 8-week overground walking with paretic lower limb loading on spatiotemporal gait parameters and motor function among chronic stroke survivors.

Methods

This is a two-center, single-blind, two-arm parallel randomised controlled trial. Forty-eight stroke survivors with mild to moderate disability will be recruited from two tertiary facilities and randomly assigned into two intervention arms; overground walking with paretic lower limb loading or overground walking without paretic lower limb loading in a 1:1 ratio. All interventions will be administered thrice weekly for 8 weeks. Primary outcomes will be step length and gait speed whereas the secondary outcomes will include step length symmetry ratio, stride length, stride length symmetry ratio, stride width, cadence and motor function. All outcomes will be assessed at baseline, 4, 8 and 20 weeks after the start of intervention.

Discussion

This will be the first randomised controlled trial to report the effects of overground walking with paretic lower limb loading on spatiotemporal gait parameters and motor function among chronic stroke survivors from low-resource setting.

Trial registration

ClinicalTrials.gov NCT05097391. Registered on 27 October 2021.
Ultrastructural changes in the fat body of desert locust, Schistocerca gregaria (Orthoptera: Acrididae) treated with zinc chromium oxide nanostructures via chemical co-precipitation approach
Authors: Hashem Fatma M. , Elgazzar Elsayed , Mostafa Wageha A.
Published: February 2023

The present work aims to investigate the ultrastructural changes in the fat body of fifth instar nymphs Schistocerca gregaria (Orthoptera: Acrididae) treated with zinc chromium oxide (ZnCrO). The nanoparticles (NPs) were prepared by co-precipitation route and characterized using X-ray diffraction (XRD), energy dispersive X-ray spectroscopy (EDX), scanning electron microscopy (SEM), and transmission electron microscopy (TEM). The ZnCrO NPs exhibited polycrystalline hexagonal structure, composed of spherical–hexagonal shapes with an average size ~ 25 nm. Besides, the UV–Vis spectrophotometer (Jasco-V-570) was utilized for optical measurements. The energy gap $$\left( {{\text{E}}_{{\text{g}}} } \right)$$

E
g

was estimated from the transmittance (T%) and reflectance (R%) spectra through the range of 3.307–3.840 eV. In biological sections, S. gregaria 5th instar nymphs, TEM images demonstrated that the fat body was strongly impacted with the concentration 2 mg NPs result in great agglomeration of chromatin in the nucleus as well as haemoglobin cells (HGCs) pierced with malformed trachea (Tr) at 5th and 7th days post treatment. The obtained results indicated a positive action of the prepared nanomaterial on Schistocerca gregaria fat body organelles.

Graphical Abstract
Nanopore adaptive sampling for targeted mitochondrial genome sequencing and bloodmeal identification in hematophagous insects
Authors: Kipp Evan J. , Lindsey Laramie L. , Milstein Marissa S. , Blanco Cristina M. , Baker Julia P. , Faulk Christopher , Oliver Jonathan D. , Larsen Peter A.
Published: February 2023

Background

Blood-feeding insects are important vectors for an array of zoonotic pathogens. While previous efforts toward generating molecular resources have largely focused on major vectors of global medical and veterinary importance, molecular data across a large number of hematophagous insect taxa remain limited. Advancements in long-read sequencing technologies and associated bioinformatic pipelines provide new opportunities for targeted sequencing of insect mitochondrial (mt) genomes. For engorged hematophagous insects, such technologies can be leveraged for both insect mitogenome genome assembly and identification of vertebrate blood-meal sources.

Methods

We used nanopore adaptive sampling (NAS) to sequence genomic DNA from four species of field-collected, blood-engorged mosquitoes (Aedes and Culex spp.) and one deer fly (Chrysops sp.). NAS was used for bioinformatical enrichment of mtDNA reads of hematophagous insects and potential vertebrate blood-meal hosts using publically available mt genomes as references. We also performed an experimental control to compare results of traditional non-NAS nanopore sequencing to the mt genome enrichment by the NAS method.

Results

Complete mitogenomes were assembled and annotated for all five species sequenced with NAS: Aedes trivittatus, Aedes vexans, Culex restuans, Culex territans and the deer fly, Chrysops niger. In comparison to data generated during our non-NAS control experiment, NAS yielded a substantially higher proportion of reference-mapped mtDNA reads, greatly streamlining downstream mitogenome assembly and annotation. The NAS-assembled mitogenomes ranged in length from 15,582 to 16,045 bp, contained between 78.1% and 79.0% A + T content and shared the anticipated arrangement of 13 protein-coding genes, two ribosomal RNAs, and 22 transfer RNAs. Maximum likelihood phylogenies were generated to further characterize each insect species. Additionally, vertebrate blood-meal analysis was successful in three samples sequenced, with mtDNA-based phylogenetic analyses revealing that blood-meal sources for Chrysops niger, Culex restuans and Aedes trivittatus were human, house sparrow (Passer domesticus) and eastern cottontail rabbit (Sylvilagus floridanus), respectively.

Conclusions

Our findings show that NAS has dual utility to simultaneously molecularly identify hematophagous insects and their blood-meal hosts. Moreover, our data indicate NAS can facilitate a wide array of mitogenomic systematic studies through novel ‘phylogenetic capture’ methods. We conclude that the NAS approach has great potential for broadly improving genomic resources used to identify blood-feeding insects, answer phylogenetic questions and elucidate complex pathways for the transmission of vector-borne pathogens.

Graphical Abstract