bluuebunny/crossref_metadata_2025 huggingface dataset:
Designing an implementation science clinical trial to integrate hypertension and cardiovascular diseases care into existing HIV services package in Botswana (InterCARE)
Authors: Youssouf Nabila , Mogaetsho Gaone Edwin , Moshomo Thato , Gaolathe Tendani , Ponatshego Ponego , Ramotsababa Mareko , Molefe-Baikai Onkabetse Julia , Dintwa Evelyn , Kiki Tsaone , Van Pelt Amelia E. , Steger-May Karen , Bogart Laura M. , Jaffar Shabbar , Gala Pooja , Wang Duolao , Seipone Khumo , Bennett Kara , Hurwitz Kathleen Wirth , Kebotsamang Kago , Hirschhorn Lisa R. , Mosepele Mosepele
Published: July 2024

Background

Despite success in HIV treatment, diagnosis and management of hypertension (HTN) and cardiovascular disease (CVD) remains suboptimal among people living with HIV (PLWH) in Botswana, with an overall HTN control of only 19% compared to 98% HIV viral suppressed. These gaps persist despite CVD primary care national guidelines and availability of free healthcare including antihypertensive medications. Our study aims to develop and test strategies to close the HTN care gap in PLWH, through integration into HIV care, leveraging the successful national HIV care and treatment program and strategies.

Methods

The InterCARE trial is a cluster randomized controlled hybrid type 2 effectiveness-implementation trial at 14 sites designed to enroll 4652 adults living with HIV and HTN plus up to 2326 treatment partners. Primary outcomes included effectiveness (HTN control) and implementation outcomes using the Reach Effectiveness Adoption Implementation and Maintenance framework, with explanatory mixed methods used to understand variability in outcomes.

InterCARE trial’s main strategies include healthcare worker HTN and CVD care training plus long-term practice facilitation, electronic health record (EHR) documentation of key indicators and use of reminders, and use of treatment partners to provide social support to people living with HIV and HTN. InterCARE started with formative research to identify contextual factors influencing care gaps using the Consolidated Framework for Implementation Research. Results were used to adapt initial and develop additional implementation strategies to address barriers and leverage facilitators. The package was pilot tested in two clinics, with findings used to further adapt or add strategies for the clinical trial.

Discussion

If successful, the InterCARE model can be scaled up to HIV clinics nationwide to improve diagnosis, management, and support in Botswana. The trial will provide insights for scale-up of HTN integration into HIV care in the region.

Trial registration

ClinicalTrials.gov reference NCT05414526. Registered 18 May 2022, https://clinicaltrials.gov/study/NCT05414526?term=NCT05414526.&rank=1.
Cardiovascular disease among bariatric surgery candidates: coronary artery screening and the impact of metabolic syndrome
Authors: Nie Yuntao , Zong Haoyu , Li Zhengqi , Wang Pengpeng , Zhang Nianrong , Zhou Biao , Wang Zhe , Zhang Lei , Wang Siqi , Huang Yishan , Tian Ziru , Chou Sai , Zhao Xingfei , Liu Baoyin , Meng Hua
Published: July 2024

Background

Obesity is known as a risk factor for cardiovascular disease (CVD). However, there is an absence of preoperative cardiac risk assessment in bariatric surgery candidates and the incidence of CVD among these high-risk patients is still unknown.

Methods

A consecutive series of bariatric surgery candidates at two Chinese tertiary hospitals received coronary CT angiography or coronary angiography from 2017 to 2023. Patients were categorized as metabolically unhealthy obesity (MUO) and metabolically healthy obesity (MHO) based on the presence or absence of MetS. CVD was diagnosed based on the maximum intraluminal stenosis > 1% in any of the segments of the major epicardial coronary arteries. Obstructive CVD was defined as coronary stenosis ≥ 50%. Binary multivariable logistic regression was performed to analyze the association between CVD and metabolic status. The number of principal MetS components was categorized into zero (without glycemic, lipid, and BP components), one (with one of the components), two (with any two components), and three (with all components) to explore their association with CVD.

Results

A total of 1446 patients were included in the study. The incidence of CVD and obstructive CVD were 31.7% and 9.6%. Compared with MHO patients, MUO patients had a significantly higher incidence of mild (13.7% vs. 6.1%, P < 0.05), moderate (7.4% vs. 0.8%, P < 0.05), and severe CVD (3.1% vs. 0%, P < 0.05). Following complete adjustment, compared with zero or one component, two principal MetS components was found to be associated with a notable increase in the risk of CVD (OR 2.05, 95% CI 1.18–3.58, P < 0.05); three principal MetS components were observed to have a higher risk of CVD and obstructive CVD (OR 2.68, 95% CI 1.56–4.62, P < 0.001; OR 3.93, 95% CI 1.19–12.93, P < 0.05). Each increase in the number of principal MetS components correlated with a 1.47-fold (95% CI 1.20–1.81, P < 0.001) and 1.78-fold (95% CI 1.24–2.55, P < 0.05) higher risk of CVD and obstructive CVD, respectively.

Conclusion

This study reported the incidence of CVD based on multicenter bariatric surgery cohorts. CVD is highly prevalent in patients with obesity, especially in MUO patients. Increased number of principal MetS components will significantly elevate the risk of CVD.
Transmission of Norwegian reindeer CWD to sheep by intracerebral inoculation results in an unusual phenotype and prion distribution
Authors: Harpaz Erez , Cazzaniga Federico Angelo , Tran Linh , Vuong Tram T. , Bufano Giuseppe , Salvesen Øyvind , Gravdal Maiken , Aldaz Devin , Sun Julianna , Kim Sehun , Celauro Luigi , Legname Giuseppe , Telling Glenn C. , Tranulis Michael A. , Benestad Sylvie L. , Espenes Arild , Moda Fabio , Ersdal Cecilie
Published: July 2024

Chronic wasting disease (CWD), a prion disease affecting cervids, has been known in North America (NA) since the 1960s and emerged in Norway in 2016. Surveillance and studies have revealed that there are different forms of CWD in Fennoscandia: contagious CWD in Norwegian reindeer and sporadic CWD in moose and red deer. Experimental studies have demonstrated that NA CWD prions can infect various species, but thus far, there have been no reports of natural transmission to non-cervid species. In vitro and laboratory animal studies of the Norwegian CWD strains suggest that these strains are different from the NA strains. In this work, we describe the intracerebral transmission of reindeer CWD to six scrapie-susceptible sheep. Detection methods included immunohistochemistry (IHC), western blot (WB), enzyme-linked immunosorbent assay (ELISA), real-time quaking-induced conversion (RT-QuIC) and protein misfolding cyclic amplification (PMCA). In the brain, grey matter vacuolation was limited, while all sheep exhibited vacuolation of the white matter. IHC and WB conventional detection techniques failed to detect prions; however, positive seeding activity with the RT-QuIC and PMCA amplification techniques was observed in the central nervous system of all but one sheep. Prions were robustly amplified in the lymph nodes of all animals, mainly by RT-QuIC. Additionally, two lymph nodes were positive by WB, and one was positive by ELISA. These findings suggest that sheep can propagate reindeer CWD prions after intracerebral inoculation, resulting in an unusual disease phenotype and prion distribution with a low amount of detectable prions.
Baicalin and probenecid protect against Glaesserella parasuis challenge in a piglet model
Authors: Fu Shulin , Liu Siyu , Li Jingyang , Dong Qiaoli , Fu Yunjian , Luo Ronghui , Sun Yamin , Tian Xinyue , Liu Wei , Zong Bingbing , Ye Chun , Lu Qirong , Qiu Yinsheng , Guo Ling
Published: July 2024

Glaesserella parasuis (G. parasuis) induces vascular damage and systemic inflammation. However, the mechanism by which it causes vascular damage is currently unclear. Baicalin has important anti-inflammatory, antibacterial and immunomodulatory functions. In this study, we explored the ability of baicalin and probenecid to protect against G. parasuis challenge in a piglet model. Sixty piglets were randomly divided into a control group; an infection group; a probenecid group; and 25 mg/kg, 50 mg/kg and 100 mg/kg baicalin groups. The probenecid group and the 25 mg/kg, 50 mg/kg and 100 mg/kg baicalin groups were injected intramuscularly with 20 mg/kg body weight (BW) probenecid and 25 mg/kg BW, 50 mg/kg BW and 100 mg/kg BW baicalin, respectively. All piglets except those from the control group were injected intraperitoneally with 1 × 108 CFU of G. parasuis. The control group was injected intraperitoneally with TSB. The results showed baicalin and probenecid protected piglets against G. parasuis challenge, improved body weight and decreased temperature changes in piglets. Baicalin and probenecid attenuated IL-1β, IL-10, IL-18, TNF-α and IFN-γ mRNA levels in the blood for 48 h, inhibited the production of the nucleosides ATP, ADP, AMP and UMP from 24 to 72 h, reduced Panx-1/P2Y6/P2X7 expression, weakened NF-kB, AP-1, NLRP3/Caspase-1 and ROCK/MLCK/MLC signalling activation, and upregulated VE-cadherin expression in the blood vessels of piglets challenged with G. parasuis. Baicalin and probenecid alleviated pathological tissue damage in piglets induced by G. parasuis. Our results might provide a promising strategy to control and treat G. parasuis infection in the clinical setting.
Therapeutic impact of basic critical care echocardiography performed by residents after limited training
Authors: Goudelin Marine , Evrard Bruno , Donisanu Roxana , Gonzalez Céline , Truffy Christophe , Orabona Marie , Galy Antoine , Lapébie François-Xavier , Jamilloux Yvan , Vandeix Elodie , Belcour Dominique , Hodler Charles , Ramirez Lucie , Gagnoud Rémi , Chapellas Catherine , Vignon Philippe
Published: July 2024

Background

The objective was to assess the agreement between therapeutic proposals derived from basic critical care echocardiography performed by novice operators in ultrasonography after a limited training (residents) and by experts considered as reference. Secondary objectives were to assess the agreement between operators’ answers to simple clinical questions and the concordance between basic two-dimensional measurements.

Methods

This observational, prospective, single-center study was conducted over a 3-year period in a medical-surgical intensive care unit. Adult patients with acute circulatory and/or respiratory failure requiring a transthoracic echocardiography (TTE) examination were studied. In each patient, a TTE was performed by a resident novice in ultrasonography after a short training program and by an expert, independently but within 1 h and in random order. Each operator addressed standardized simple clinical questions and subsequently proposed a therapeutic strategy based on a predefined algorithm.

Results

Residents performed an average of 33 TTE studies in 244 patients (156 men; age: 63 years [52–74]; SAPS2: 45 [34–59]; 182 (75%) mechanically ventilated). Agreement between the therapeutic proposals of residents and experienced operators was good-to-excellent. The concordance was excellent for suggesting fluid loading, inotrope or vasopressor support (all Kappa values > 0.80). Inter-observer agreement was only moderate when considering the indication of negative fluid balance (Kappa: 0.65; 95% CI 0.50–0.80), since residents proposed diuretics in 23 patients (9.5%) while their counterparts had the same suggestion in 35 patients (14.4%). Overall agreement of responses to simple clinical questions was also good-to-excellent. Intraclass correlation coefficient exceeded 0.75 for measurement of ventricular and inferior vena cava size.

Conclusions

A limited training program aiming at acquiring the basic level in critical care echocardiography enables ICU residents novice in ultrasonography to propose therapeutic interventions with a good-to-excellent agreement with experienced operators.
Application of attenuated total reflectance—Fourier transform infrared spectroscopy—(ATR-FTIR) and principal component analysis (PCA) in identification of copying pencils on different paper substrates
Authors: Grzelec Małgorzata
Published: July 2024

Presence of copying pencils in heritage objects poses a significant challenge for conservators due to their proneness to fading, sensitivity to solvents and difficulties in differentiation from regular graphite pencils. In this paper a method of copying pencils identification by means of ATR—FTIR spectroscopy is used. A protocol for spectra processing and dimensionality reduction of spectral data by means of principal component analysis has been developed, allowing for pencil types differentiation and providing an easy to read visual representation of the collected data. The protocol has been developed on mock-up samples and tested on objects from the archives of the State Museum Auschwitz – Birkenau.
In vitro and in vivo analyses of eFAP: a novel FAP-targeting small molecule for radionuclide theranostics and other oncological interventions
Authors: van der Heide Circe D. , Ma Hanyue , Hoorens Mark W.H. , Campeiro Joana D. , Stuurman Debra C. , de Ridder Corrina M.A. , Seimbille Yann , Dalm Simone U.
Published: July 2024

Background

Fibroblast activation protein (FAP), a transmembrane serine protease overexpressed by cancer-associated fibroblasts in the tumor stroma, is an interesting biomarker for targeted radionuclide theranostics. FAP-targeting radiotracers have demonstrated to be superior to [18F]FDG PET/CT in various solid cancers. However, these radiotracers have suboptimal tumor retention for targeted radionuclide therapy (TRT). We aimed to develop a novel FAP-targeting pharmacophore with improved pharmacokinetics by introducing a substitution at the 8-position of (4-quinolinoyl)-glycyl-2-cyanopyrrolidine, which allows for conjugation of a chelator, dye, or other payloads.

Results

Here we showed the synthesis of DOTA-conjugated eFAP-6 and sulfo-Cyanine5-conjugated eFAP-7. After chemical characterization, the uptake and specificity of both tracers were determined on FAP-expressing cells. In vitro, [111In]In-eFAP-6 demonstrated a superior affinity and a more rapid, although slightly lower, peak uptake than gold standard [111In]In-FAPI-46. Confocal microscopy demonstrated a quick FAP-mediated internalization of eFAP-7. Studies with HT1080-huFAP xenografted mice confirmed a more rapid uptake of [177Lu]Lu-eFAP-6 vs. [177Lu]Lu-FAPI-46. However, tumor retention at 24 h post injection of [177Lu]Lu-eFAP-6 was lower than that of [177Lu]Lu-FAPI-46, hereby currently limiting its use for TRT.

Conclusion

The superior affinity and faster tumor accumulation of eFAP-6 over FAPI-46 makes it a suitable compound for radionuclide imaging. After further optimization, the eFAP series has great potential for various oncological interventions, including fluorescent-guided surgery and effective targeted radionuclide theranostics.
Screening of indigenous Bacillus thuringiensis for dipteran active cry gene profiles and potential toxicity against melon fruit fly, Zeugodacus cucurbitae (Coquillett)
Authors: Aarthi N. , Shylesha A. N. , Dubey V. K. , Aditya K. , Kandan A. , Rangeshwaran R. , Manjunatha C.
Published: July 2024

Background

Melon fruit fly, Zeugodacus cucurbitae Coquillett (Diptera: Tephritidae), is a devastating polyphagous pest attacking large number of fruits and vegetables causing huge economic yield losses across the world. Management of this notorious pest is very challenging as the larvae feed inside the fruit. Hence, the present research study aimed to screen the indigenous Bacillus thuringiensis Berliner (Bacillales: Bacillaceae) strains causing toxicity to larvae and to identify the insecticidal toxicity-related genes present in respective strains. In the present study, 50 indigenous B. thuringiensis (Bt) strains along with one reference strain were screened against second-instar larvae Z. cucurbitae. All the strains were analyzed for presence of 21 dipteran active cry genes.

Results

Mortality in Z. cucurbitae larvae due to Bt strains ranged from 16 to 92%. PCR results revealed that each strain tested positive for a minimum of three cry genes to maximum of nine cry genes. Among the cry genes, cry1A, cry2A, cry1C, cry19, cry11 and cry70 were detected in high frequency of 100, 88, 84, 74, 58 and 54%, respectively. Bioassay studies revealed that ten out of fifty strains displayed more than 50% mortality. Hence, these ten strains, along with the reference strain, were further tested for mortality for the calculation of the median lethal concentration (LC50). The LC50 values ranged between 38.48 and 105.18 μg/ml. The lowest LC50 found for the strain NBAIR Bt107 was 38.48 μg/ml and was on par with the reference strain (Bti 4Q1) (31.3 μg/ml).

Conclusion

Indigenous Bt strains displayed a toxicity against the larvae of Z. cucurbitae. The probable dipteran active cry genes responsible for toxicity were interpreted. Thus, the Cry toxins from Bt can play a very important role in the management of Z. cucurbitae.
Loop-mediated isothermal amplification (LAMP) assay proved the mechanism of biological control against root rot pathogens
Authors: Elsharkawy Mohsen Mohamed , Kuno Shuhei , Alotaibi Nahaa M. , Hyakumachi Mitsuro
Published: July 2024

Background

The soil-borne fungi, Rhizoctonia solani and Sclerotium rolfsii, are major pathogens of Brassicae crops. This study was performed to clarify the relationship between the accumulation pattern of the genus Trichoderma and disease suppression in frequently inoculated soils with binucleate Rhizoctonia (BNR), Rhizoctonia solani and Sclerotium rolfsii.

Results

As compared to the control group, five Trichoderma virens strains isolated from soil inoculated with R. solani or BNR significantly reduced the severity of S. rolfsii (85.6–100% covering percentage) and R. solani (95.7–100% covering percentage). Similarly, five T. hamatum strains obtained from soil inoculated with R. solani were shown to be highly suppressive against S. rolfsii (83.9–97.1% covering percentages) and R. solani (60.2–96.2% covering percentages). Four out of five T. hamatum strains obtained from soil infected with S. rolfsii exhibited considerable suppression against S. rolfsii (63.7–91.2% covering percentages), while the SM5 strain did not. The phylogenetic analysis of the TEF and ITS regions of Trichoderma hamatum revealed that most isolates were classified into the same cluster with homology of 99–100%. Five strains of each T. virens and T. hamatum were isolated from the suppressive soil with high antagonistic potentials against R. solani and S. rolfsii. Suppression and antagonistic activity of T. hamatum isolated from soil frequently inoculated with sterile barley grains were negligible, whereas T. hamatum isolated from frequently inoculated soil with BNR and R. solani demonstrated considerable suppression of the pathogens and antagonistic activity. Accumulation and quantification of T. virens and T. hamatum were confirmed using loop-mediated isothermal amplification (LAMP).

Conclusion

In conclusion, disease suppression in frequently inoculated soil with BNR, R. solani and S. rolfsii was due to Trichoderma spp. accumulated selectively in each replicate of soil inoculation.
A review on the applications of artificial intelligence and big data for glioblastoma multiforme management
Authors: Mehmandoost Mahdi , Konjin Fatemeh Torabi , Jajin Elnaz Amanzadeh , Fahim Farzan , Yazdani Saeed Oraee
Published: July 2024

Glioblastoma is known as an aggressive type of brain tumor with a very poor survival rate and resistance to different treatment methods. Considering the difficulties in studying glioblastoma, the development of alternative methods for the identification of prognostic factors in this disease seems necessary. Noteworthy, imaging, pathologic, and molecular data obtained from patients are highly valuable because of their potential for this purpose. Artificial intelligence (AI) has emerged as a powerful tool to perform highly accurate analyses and extract more detailed information from available patient data. AI is usually used for the development of prediction models for prognosis, response/resistance to treatments, and subtype identification in cancers. Today, the number of AI-aided developed algorithms is increasing in the field of glioblastoma. Challenges in the diagnosis of tumors using imaging data, prediction of genetic alterations, and prediction of overall survival are among the most popular studies related to glioblastoma. Hereby, we reviewed peer-reviewed articles in which AI methods were used for various targets in glioblastoma. Reviewing the published articles showed that the use of clinical imaging data is reasonably more popular than other assessments because of its noninvasive nature. However, the use of molecular assessments is becoming extended in this disease. In this regard, we summarized the developed algorithms and their applications for the diagnosis and prognosis of glioblastoma tumors. We also considered the accuracy rates of algorithms to shed light on the advancements of different methodologies in the included studies.
The reversed halo sign with a reticulonodular pattern as unusual findings of pulmonary infarct in acute pulmonary embolism: case report and literature review
Authors: Pierro Antonio , Totaro Antonio , Testa Gianluca , Apollonio Biagio Francesco Pio , Carafa Stefano , Bontempo Attilio , Vallo Antonio , Cilla Savino , Basilico Raffaella
Published: July 2024

Background

The reversed halo, also known as the atoll sign, is a distinct sign with ring-shaped consolidation and central lucency. The reversed halo sign, initially emerging in cryptogenic organizing pneumonia, has been observed in various pulmonary diseases, including pulmonary embolism. The presence of this sign in the subpleural, posterior basal parts of the lower lobes, predominantly when solitary, should raise the possibility of other causes, such as pulmonary infarction.

Case presentation

We present a case of acute pulmonary embolism with pulmonary infarction discovered on a CT pulmonary angiogram in our emergency department, where the pulmonary infarction appears as a reverse halo sign with a reticulonodular pattern. The reticular nodular pattern in the halo sign is not typical of a pulmonary infarct presenting with a reverse halo sign.

Conclusions

To our knowledge, this is the first case of pulmonary infarction in acute pulmonary embolism with the appearance of a reverse halo sign with a reticulonodular pattern.
Analytical method development and validation for simultaneous estimation of seven markers in polyherbal formulation JKC by using RP-HPLC
Authors: Misro Lakshminarayana , Boini Thirupataiah , Maurya Rahul , Radhakrishnan Thulasi , Rohith K. S. , Kumar Vijay , Sharma Preeti , Singh Arjun , Singh Ravindra , Srikanth Naryanam , Acharya Rabinarayan
Published: July 2024

Background

The RP-HPLC method has been established to simultaneous estimation of seven markers in polyherbal formulation JKC using the C18 (25 × 0.46 cm, i.d,5 µm) column. The mobile phase consisted of methanol: water (80:20) at a flow rate of 1.0 mL/min and observed retention time at 2 to 11 min with sharp points. The marker compounds viz. Andrographolide (AG), Piperine (PP), Picroside-I (P-I), Picroside-II (P-II), α-Cyprone (AC), 6-Shogaol (6S), and 6-Gingerol (6G) were quantified in JKC formulations by HPLC method. Detection was performed at the wavelength (λ) of 229 nm for AG, 343 nm for PP, 279 nm for P-I, 264 nm for P-II, 254 nm for AC, and 280 nm for both 6S and 6G by HPLC–PDA detector.

Results

The marker compounds in JKC formulations were observed in different retention times (Rt) i.e. AG at 3.060 ± 0.01 min, PP at 5.460 ± 0.03 min, P-I at 2.789 ± 0.02 min, P-II at 2.553 ± 0.03 min, AC at 10.951 ± 0.02 min, 6S at 6.302 ± 0.03 min, and 6G at 4.111 ± 0.02 min respectively. The proposed method was validated with acceptable linearity (r2 0.9995–0.9999), precision, robustness, ruggedness, and accuracy (RSD < 2%) under optimum conditions. The limit of detection and quantification of bioactive markers were as: AG (1.386; 4.200 ppm), PP (2.033; 6.161 ppm), P-I (2.822; 8.553 ppm), P-II (2.538; 7.691 ppm), AC (0.269; 0.815 ppm), 6G (0.158; 0.480 ppm), 6S (0.188; 0.569 ppm). The amount (mg/g) of bioactive markers detected and estimated in plants and formulation were as: AG (41.282 ± 0.48; 10.06 ± 0.18), PP (53.81 ± 0.25, 13.82 ± 0.37 in PN, PL; 4.27 ± 0.07), P-I (15.97 ± 0.01; 0.48 ± 0.003), P-II (63.24 ± 0.35; 2.31 ± 0.006), AC (0.42 ± 0.01; 0.36 ± 0.006), 6G (0.71 ± 0.03; 0.16 ± 0.001), and 6S (2.64 ± 0.09; 0.12 ± 0.004) respectively. Method was found to be rugged and robust. The results found for all the validation parameters were within the limits according to ICH guidelines.

Conclusion

The proposed method is fast, precise, economic, and specific and used for the simultaneously quantifiable analysis of seven major bioactive markers in the ingredients (herbs) and the JKC formulations.
Associations of activity, sedentary and sleep behaviors with oral health indictors in children and adolescents: a cross-sectional analysis
Authors: Burns Ryan D. , Almes Hayley , Fu You
Published: July 2024

Background

The purpose of this study was to examine the associations of physical activity (PA), recreational screen time, and sleep with indicators of poor oral health in youth.

Methods

Participants were children and adolescents whose parents completed the 2022 National Survey of Children’s Health (N = 34,342; 49% female; Mean age = 11.9 +/- 3.5 years). The dependent variables were three binary response items that indicated the presence of toothaches, bleeding gums, and cavities within the previous 12 months. Independent variables were three items indicating the weekly frequency of 60 min of PA, hours of recreational screen time, and hours of weeknight sleep. Relationships between variables were examined using double-selection logistic regression with demographic, dietary, oral hygiene, and dental service covariates selected using the plug-in method of the least absolute shrinkage and selection operator.

Results

Compared to zero days of PA, 4–6 days of PA per week was associated with 30% lower odds of bleeding gums (p = 0.021). Compared to less than 1 h of recreational screen time, 2 h or more hours of recreational screen time were associated with a 1.26 to 1.62 times higher odds of cavities (p < 0.01). Compared to 5 h or less of sleep, 7 to 10 h of sleep was associated with 47–61% lower odds of bleeding gums and 31–47% lower odds of cavities (p < 0.01). Secondary analyses indicated that at least 2 of the movement behavior recommendations had to have been adhered to for positive associations with indicators of oral health to be observed. For toothaches, bleeding gums, and cavities, meeting 2 or 3 recommendations was associated with lower odds of poor oral health; whereas adhering to only one recommendation was not.

Conclusion

Children with higher PA and sleep durations had improved oral health indicators and children with longer periods of screen time exposure had poorer oral health indicators. Our findings recommend adhering to multiple movement behavior recommendations to achieve improvements in oral health indicators.
Morphological and functional assessment of the left atrial appendage in daily practice: a comprehensive approach using basic and advanced echocardiography with practical tips
Authors: Anwar Ashraf M.
Published: July 2024

Cardioembolic stroke is the most serious and life-threatening complication of atrial fibrillation (AF), with an associated mortality up to 30% at 12 months. Approximately 47% of thrombi in valvular AF and 91% of thrombi in nonvalvular AF are localized in the left atrial appendage (LAA). Therefore, identification or exclusion of LAA thrombi is critical in many clinical situations. It is essential to assess LAA morphology and function using imaging modalities (particularly echocardiography) before, during, and after interventional procedures such as AF ablation and LAA occlusion. This review article describes the anatomical, physiological, and pathological background of the LAA, followed by an assessment of different echocardiographic modalities. Many practical points are included to improve the diagnostic accuracy and to minimize errors during image acquisition and interpretation. In each clinical scenario where LAA is the crucial target, specific and essential information and parameters are collected.
Navigating the Hematology-Oncology Fellowship Journey: Website Analysis and Insights
Authors: Abbagoni Vaidarshi , Ingawale Sushrut , Darooka Naitica , Kadam Esha , Ganguly Arup
Published: July 2024

PURPOSE

The Hematology-Oncology (HO) fellowship stands as one of the most dynamic specialties within internal medicine. Applicants primarily rely on program websites for information gathering. Our study aims to assess the comprehensiveness of these websites, scrutinizing various categories crucial to applicants. We also evaluate website quality and accessibility of curriculum and recruitment content, identifying areas for enhancement.

METHODS

Our investigation encompasses 181 ACGME-accredited HO programs across the United States. We analyze data across 10 categories, encompassing program characteristics, faculty, fellows, alumni information, diversity inclusion, curriculum, visa requirements, and website navigation. Websites lacking accessible links are excluded from the search.

RESULTS

Data from 176 out of 181 programs are collected. 5 programs are excluded due to website unavailability. Across analyzed domains, most programs provide extensive information on training hospitals (88.6%). While 79.5% list current fellows and their educational backgrounds, only 33% mention alumni—a critical aspect for post-fellowship opportunities. Information on rotation sites (75.6%) and curriculum (81.8%) is prevalent. However, details on advanced fellowship programs are sparse, mentioned in only 13.6% of cases. Board pass rates are the least mentioned (1.1%).

CONCLUSION

Given the burgeoning demand for this specialty, it's imperative to enhance recruitment information on program websites to aid applicants in selecting the best fit. Information gaps persist, particularly regarding available positions and visa sponsorship—vital for applicants. While over half of the websites are easy to navigate, content richness requires further enhancement.
Optimizing HPV Vaccination Strategies in Multicultural and Diverse Settings: Defining Target Beneficiary Sub-Groups for Enhanced Coverage in Nigeria
Authors: Abdulkarim Amina , Ibrahim Raihanah , Osoteku Demilade , Aigbogun Eric , Anthony Joseph , Udhawuve Oghenekaro , Mustapha Zulaikatu Tun , Igbokwe Uchenna , Wonodi Chizoba , Aina Muyi
Published: July 2024

PURPOSE

HPV Vaccine introduction plans in LMICs targeting adolescent girls 9-15 years old usually categorize them as in-school and out-of-school girls and develop strategies to reach them. However, in diverse and multicultural countries like Nigeria, this broad categorization is insufficient to guarantee successful HPV vaccine introduction. There is a need to decompose these broad categories into sub-groups that can be targeted through distinct supply, demand, and advocacy strategies. This research provides the various sub-categories of eligible girls in Nigeria beyond the general in-school vs. out-of-school categories, emphasizing the need for targeted strategies that leave no one behind!

METHODS

A mixed-method study combining literature article from online databases and qualitative interviews. Literature sources included PUBMED, Google Scholar, Science Direct, and grey literatures, which were categorized into four research themes: financing, partnerships, service delivery, and demand generation. Qualitative interviews comprised structured key informant interviews (KIIs) with government and non-government health and education managers and focus groups with various stakeholders such as adolescent girls, parents, religious leaders, etc. Thematic analysis was used to organize the findings from the qualitative interviews.

RESULTS

In-school adolescent girls can be sub-categorized based on classes (Primary/secondary school class), type of school (public vs private), and the location of school (urban, rural). Out-of-school adolescent girls who are presently not enrolled in any educational institution include adolescent girls in itinerant or nomadic communities, internally displaced persons camps, urban slums, remote rural, and those in security-challenged places. The various sub-categories may overlap. HPV vaccine introduction programs must develop targeted demand, supply, communication, and advocacy strategies to reach these distinct sub-categories of eligible girls. While school-based vaccination strategies are likely to succeed in Southern Nigeria, given the average adolescent school attendance rate of 77%, the Northern region must rely on out-of-school strategies targeting the various subgroups, given that the school attendance rate is only 49%.

CONCLUSION

Tailoring service delivery, demand, and advocacy strategies based on specific sub-categories of eligible girls is essential for successful HPV vaccination program implementation in Nigeria and similar LMICs. This research provides actionable insights to ensure comprehensive vaccination coverage, ultimately reducing cervical cancer burden.
Prevalence of Tobacco Use and Oral Malignant Precancerous Lesions Among Auto Rickshaw Drivers in Chennai City, Tamil Nadu, India
Authors: Francis Delfin Lovelina , SP Saravanan
Published: July 2024

PURPOSE

Tobacco use is a major preventable cause of premature death and diseases, currently leading to five million deaths worldwide which are expected to raise over eight million deaths worldwide by 2030. India is the second largest consumer of tobacco in the world. Tobacco use is a leading cause of deaths and disabilities in India as well, killing about 1.2 lakh people in 2010. Approximately 29% of adults are daily tobacco users, with a further 5% using it occasionally. This study aims to assess the prevalence of tobacco consumption and total premalignant lesion among auto rickshaw drivers that plays a significant role in the country's workforce.

METHODS

A cross-sectional descriptive study was carried out using Cluster random sampling on auto rickshaw drivers in Chennai City who had been working for over two years and were present for the assessment. 400 samples were chosen from 40 auto stands. Data was gathered by a Survey Proforma that included a Questionnaire designed to evaluate the frequency, age of onset, quantity of consumption, mental stress, economic influences, any previous medical history, and particularly the awareness of oral cancer. Oral examination was done by a single examiner to assess the oral malignant pre-cancerous lesions.

RESULTS

Prevalence among auto rickshaw drivers for consumption of tobacco products was very high (87%). They mostly used tobacco in the form of Gutkha (72%) and bidi (40%) in comparison to other products. 47% prevalence of oral malignant pre-cancerous lesions were observed, however the users were not aware. Most of the auto rickshaw drivers start using tobacco products in age less than 18 years (80%) and associated factors for tobacco use are due to friends and their influence (78%). 70% of auto rickshaw drivers have a good level of awareness of its hazards, although 66% still use tobacco products due to addiction.

CONCLUSION

The prevalence of tobacco use and oral malignant pre-cancerous lesions among auto rickshaw drivers was exceedingly high. Many individuals were experiencing tobacco-related ailments such as cough, mouth ulcers, and lung disorders. They are in definite need of tobacco cessation activities.
Primary Site and Race on Survival Patterns in Esophageal Cancer: A NCDB Study
Authors: Litz Hunter , Al Kurnas Mohammed , Wu XinXin , Silberstein Peter
Published: July 2024

PURPOSE

Esophageal cancer (EC) can arise from the cricopharyngeal muscle to the lower esophageal sphincter. The disparity in anatomical location causes difficulty in clinical decision making and analysis of outcomes data. Previous studies show that Black patients are less likely to undergo surgical intervention and experience higher mortality in resectable disease. Studies relating EC location to outcomes are lacking. Data from the National Cancer Database (NCDB) were used to explore the effect that EC location and race has on survival.

METHODS

A retrospective cohort analysis of the NCDB included 167,189 patients diagnosed with a malignant neoplasm of the upper, middle, and lower third of the esophagus between the years 2004 and 2020. The impact of EC location on overall survival was analyzed by the Kaplan-Meier method. The impact of location against race on survival was compared using Cox Regression.

RESULTS

Of the 167,189 patients in the study 13,381 (8.0%) were Black, 2,959 (1.8%) were Asian, 1,444 (0.9%) were other, and 147,825 (88.4%) were White. 53.9%, 45.3%, and 28.4% of EC diagnosed in Black, Asian, and patients of other race, respectively, were of an upper or middle esophageal primary in contrast to 18.4% in white patients. There was a statistically significant increase in mean survival time in lower EC (48.5 months) vs. upper EC and middle EC (37 months and 37.7 months, respectively, p<.001). Multivariate analysis of cancer location and race showed there was a lower risk of death when comparing Asian patients and those of other race to White patients across all locations (hazard ratio (HR) .848 and .865, respectively, p<.001); however, there was a statistically significant increased risk of death in Black patients when compared to White patients (HR 1.238, p<.001).

CONCLUSION

Black, Asian, and other non-White patients are more likely to have upper or middle EC. Upper and middle EC portend a worse survival from diagnosis in comparison to lower EC. However, risk of death is only increased in Black patients with EC when compared to other races. These data suggest that decreased survival in upper and middle EC may be influenced not only by the primary site, but also by social determinants disproportionately affecting Black patients.
Regional Patterns of Invasive Interventions for Unresectable Liver Cancer: Perspectives of Elective and Urgent Care in Brazil
Authors: da Silva de Carvalho Luiza , Krug Alana Bruna , Vitória da Silva Vieira Laynara , da Silva Meneses Beatriz , Eduarda de Aguiar Tavares Marcella , Dornelas Luana Baptistele , Pitombo Marcos Bettini
Published: July 2024

PURPOSE

Assess invasive hospital procedures for palliative treatment in unresectable liver cancer, highlighting differences between elective and urgent care in Brazil.

METHODS

This retrospective study followed the STROBE checklist, and used DATASUS's Hospital Information System and 2010 Census. Data confidentiality and ethical approval were ensured. Based on the PICO principle: People with liver cancer (Population);percutaneous alcohol injection (Cod: 0416040179), radiofrequency ablation (Cod:0416040187), and chemoembolization (Cod: 0416040195) in elective versus urgent care (Interest);Brazilian region from 2013 to 2023 (Context).

RESULTS

In unresectable liver cancer treatment assessment, 79% were elective (11,136) across Brazil's regions; 21% were urgent (2,968). The Southeast region experienced 8,142 cases, covering 6,757 elective and 1,385 urgent. There are approximately 101.31 interventions per million inhabitants, furthermore, 51.61% of the total procedures at the national level take place in the aforementioned region. However, the Northern part of Brazil stands out with the lowest volume of procedures (17) - 12 elective and 5 urgent cases -, totaling only 3.59% of the procedures and about 1.07 interventions per million inhabitants. Regarding the monetary origin of the funds that covered the procedures, approximately 11,641 hospital procedures out of 14,104 had their financial nature disregarded. The average expenditure on hospitalization varies by region in Brazil, averaged R$ 2956.88. The North region spends below the average, R$ 2166.31, while the Southeast region surpasses the average significantly, with an expenditure of R$ 3,622.88 per procedure. The mortality rates of Brazilian regions revealed that the Northeast and South surpass the national average (0.71%), accounting for 0.9% and 0.82%, respectively. Despite the Northeast having the highest mortality rate, its average hospital stay was 2.4 days, lower than the national average (2.8), close to the Southeast (2.2), while the South had the highest length (4.8).

CONCLUSION

Regional disparities in unresectable approaches in Brazil were studied, emphasizing elective procedures over urgent interventions. Identification of financial origins is essential to adapt public health strategies, with variations in mortality rates and hospital stay, which highlights the urge for equitable health policies.
Transcriptional Profiling for Innate Immunity Receptor CD36 in the Regulation of Endothelial Cell Immunity Via Fatty Acid Metabolism
Authors: Kumar Atul , Beck Adam W. , Ren Bin
Published: July 2024

PURPOSE

The immune system of living being has evolved via the action of immune defense mechanism by utilizing the cells of innate and adaptive immunity. Among these cells endothelial cell (EC) Immunity are least studied. ECs are emerging as innate immune cells and have some adaptive immunity features as well. How these EC immune cells can contribute to the brain immunity when implicated by CD36 (an innate immune receptor) is widely unknown.

METHODS

To understand this question, we wanted to investigate how CD36 regulates EC immunity and therefore we created EC-specific CD36 knockout (KO) TRAP mice by using several transgenic mouse lines and a translating ribosome affinity purification (TRAP) technique. Mouse brain tissues were subjected to isolation of ribosome-bound mRNA in the endothelia directly in vivo for next generation of RNA-seq and transcriptional profiling.

RESULTS

By transcriptomic and transcriptional analysis of RNA-seq data, we observed significant upregulation in the mRNA levels of interleukin 10 (IL-10) and IL-16, among toll-like receptors (TLRs) that initiate the innate immune response, we found that TLR-8 was downregulated in CD36-deficient brain endothelia in the EC-specific CD36 KO TRAP mice and highly enriched gene signature involved in fatty acid (FA) metabolism including ACSM 5, acyl-CoA thioesterase 12 (ACOT12) and StarD5. Moreover, MAPK/Erk1/2 signaling pathway appeared to be activated.

CONCLUSION

In summary, this study reveals a novel role of CD36 in the regulation of EC immunological properties, in which FA metabolic pathways might contribute to the regulation via changes in the immunometabolism in ECs.
Unveiling Diagnostic Biomarkers in High-Grade Serous Ovarian Cancer Through Bioinformatics Analysis
Authors: Lakhssassi Aicha , Alsamman Alsamman , Abdullah Ibrahim Manar Samir , Nourouti Naima , Barakat Amina , Mechita Mohcine , Bakkach Joaira
Published: July 2024

PURPOSE

Ovarian cancer stands out among the most lethal gynecological malignancies worldwide, displaying a low survival rate, particularly alarming at stage IV, with only approximately 15% 5 years survival rate. Moreover, two-thirds of deaths attributable to ovarian cancer are specifically associated with high-grade serous ovarian cancer. The objective of the present study is to identify new biomarkers specific to the high grade serous ovarian carcinoma subtype using a bioinformatics approach.

METHODS

Two gene expression profiles of ovarian tissues and corresponding clinical data were downloaded from the GEO database. The second dataset was used to improve the accuracy of the analysis and find key hub genes that are solely specific for the high-grade serous carcinoma. Protein-Protein Interaction (PPI) network was systematically conducted. The mRNA sequencing (RNA-seq) data of both tumor and normal ovarian tissues was analyzed using R. Statistical significance was determined based on an adjusted p-value of less than 0.05. PPI network was visualized by cytoscape using Cytohubba plugin.

RESULTS

Altogether, 1290 genes were identified as differentially expressed genes (DEGs) between the two datasets, with 915 genes showing significant upregulation and 375 genes displaying significant downregulation. CRABP1 and SLCO6A1 were notably highly expressed in both datasets, exhibiting a fold change greater than 7. These genes displayed intriguing interactions with CDKN2A, CCNA2, CDC6, CDK1, CDC25C and AURKB which are known to have connection to the cell cycle pathway, and thus emphasizing their potential role in regulating cell division and proliferation.

CONCLUSION

Collectively, our study identifies dysregulated genes that would serve as novel potential biomarkers for high grade serous ovarian cancer and ultimately help us find novel cancer therapeutic targets. Validation through experimental assays and clinical studies will be necessary to confirm the functional significance and clinical relevance of these identified biomarkers.
An Overview of the U.S. National Cancer Institute's (NCI) 2023 International Research Portfolio
Authors: Le Tosca , Garton Elise M.
Published: July 2024

PURPOSE

As part of its goal to represent NCI and promote its engagement with international partners, the NCI Center for Global Health (CGH) conducts an annual analysis of NCI's international research portfolio, which includes NCI-funded extramural grants and NCI intramural projects with principal investigators (PIs) or collaborators at institutions outside of the U.S. This annual analysis gives insight to how NCI supports global oncology and informs global research opportunities.

METHODS

NCI CGH fielded a data call within NCI's two divisions that conduct intramural research. PIs reported intramural projects with active international collaborators in fiscal year (FY) 2023. NCI-funded extramural grants active in FY23 with any foreign collaborator were identified in NIH's internal database, Query-View-Report. Grants were categorized by common scientific outline (CSO) code and cancer site according to Dimensions for NIH and the International Cancer Research Partnership (ICRP). Analysis was conducted in Microsoft Excel and Python.

RESULTS

NCI funded 1,075 extramural research grants and 273 intramural research projects with international collaborators in FY23, including 248 extramural grants and 44 intramural projects initiated in the past year. These grants included collaborators at 1,633 international institutions in 117 countries. Forty-seven extramural grants were direct awards to international institutions across 16 countries, 9 of which are low- and middle-income countries (LMICs). The intramural research projects included collaborators at 478 institutions across 58 countries. The analysis presents details of trends in geographic, income groups, cancer site, and CSO code distribution of the identified grants and projects.

CONCLUSION

The NCI supports a broad and growing portfolio of research with international collaborators. While the majority of research includes collaborators in Canada and Europe, there is increasing collaboration with institutions in LMICs. This analysis continues to aid our understanding of existing collaborations and identify gaps in research funding and training.