bluuebunny/crossref_metadata_2025 huggingface dataset:
Triglyceride glucose index predicts all-cause mortality in oldest-old patients with acute coronary syndrome and diabetes mellitus
Authors: Shen Jian , Feng Bin , Fan Li , Jiao Yang , Li Ying , Liu Henan , Hou Xiaoling , Su Yongkang , Li Dongyun , Fu Zhenhong
Published: February 2023

Background

Acute coronary syndrome (ACS) and diabetes mellitus (DM) are the leading health risks for the elderly. Triglyceride-glucose (TyG) index is a novel and reliable indicator of insulin resistance (IR). This study aims to explore the relationship between the TyG index and all-cause mortality in oldest-old patients with ACS and DM.

Methods

Seven hundred twenty hospitalized patients with ACS aged ≥ 80 years were enrolled, and 699 patients signed informed consent for the study. During the follow-up period, 37 were lost to follow-up, and the follow-up rate was 94.7%. 231 ACS patients with DM were selected for the study’s analyses. Kaplan–Meier curve, Cox regression model and receiver operating characteristic (ROC) curve were used to analyze the association between the TyG index and all-cause mortality.

Results

The mean age of participants was 81.58 ± 1.93 years, and 32.47% were women. Compared to TyG tertile 1, the Hazard Ratio (HR) [95% confidence interval (CI)] of all-cause mortality was 2.04 (1.09, 3.81) for TyG tertile 3 in the fully adjusted model. For the TyG index per standard deviation (SD) increment, the HR (95% CI) of all-cause mortality was 1.44 (1.13, 1.83). Further, the association between the TyG index and all-cause mortality was dose–response (P for trend = 0.026). ROC curve analyses indicated that the TyG index outperformed FBG and TG in the prediction of mortality risk and improved the prognostic value of the Gensini score combined with LVEF.

Conclusion

The TyG index predicts the risk of all-cause mortality in the oldest-old ACS patients with DM.
The clinical outcomes of COVID-19 critically ill patients co-infected with other respiratory viruses: a multicenter, cohort study
Authors: Al Sulaiman Khalid , Aljuhani Ohoud , Badreldin Hisham A. , Korayem Ghazwa B. , Alenazi Abeer A. , Alharbi Ahlam H. , Alghamdi Albandari , Alhubaishi Alaa , Altebainawi Ali F. , Bosaeed Mohammad , Alotaibi Rand , Alawad Ahad , Alnajjar Nirvana , Bin Saleh Khalid , Sait Walaa A. , Alsohimi Samiah , Alanizy Meshari M. , Almuqbil Sarah A. , Al Sulaihim Ibrahim , Vishwakarma Ramesh , Alalawi Mai , Alhassan Fatimah , Alghnam Suliman
Published: February 2023

Background

Previous studies have shown that non-critically ill COVID-19 patients co-infected with other respiratory viruses have poor clinical outcomes. However, limited studies focused on this co-infections in critically ill patients. This study aims to evaluate the clinical outcomes of critically ill patients infected with COVID-19 and co-infected by other respiratory viruses.

Methods

A multicenter retrospective cohort study was conducted for all adult patients with COVID-19 who were hospitalized in the ICUs between March, 2020 and July, 2021. Eligible patients were sub-categorized into two groups based on simultaneous co-infection with other respiratory viruses throughout their ICU stay. Influenza A or B, Human Adenovirus (AdV), Human Coronavirus (i.e., 229E, HKU1, NL63, or OC43), Human Metapneumovirus, Human Rhinovirus/Enterovirus, Middle East Respiratory Syndrome Coronavirus (MERS-CoV), Parainfluenza virus, and Respiratory Syncytial Virus (RSV) were among the respiratory viral infections screened. Patients were followed until discharge from the hospital or in-hospital death.

Results

A total of 836 patients were included in the final analysis. Eleven patients (1.3%) were infected concomitantly with other respiratory viruses. Rhinovirus/Enterovirus (38.5%) was the most commonly reported co-infection. No difference was observed between the two groups regarding the 30-day mortality (HR 0.39, 95% CI 0.13, 1.20; p = 0.10). The in-hospital mortality was significantly lower among co-infected patients with other respiratory viruses compared with patients who were infected with COVID-19 alone (HR 0.32 95% CI 0.10, 0.97; p = 0.04). Patients concomitantly infected with other respiratory viruses had longer median mechanical ventilation (MV) duration and hospital length of stay (LOS).

Conclusion

Critically ill patients with COVID-19 who were concomitantly infected with other respiratory viruses had comparable 30-day mortality to those not concomitantly infected. Further proactive testing and care may be required in the case of co-infection with respiratory viruses and COVID-19. The results of our study need to be confirmed by larger studies.
Characteristics, risk factors and outcome of BKV nephropathy in kidney transplant recipients: a case–control study
Authors: Gras Julien , Le Flécher Arnaud , Dupont Axelle , Vérine Jérôme , Amara Ali , Delaugerre Constance , Molina Jean Michel , Peraldi Marie Noëlle
Published: February 2023

Background

Following kidney transplantation, BK virus associated nephropathy (BKVN) occurs in 1 to 10% of kidney transplant recipients (KTR) and represents a major cause of graft loss. We aim at identifying factors associated with biopsy proven BKVN among KTR.

Methods

We conducted a retrospective case–control study including all KTR with a biopsy-proven diagnosis of BKVN between 2005 and 2019. Clinical characteristics and outcome were described. For each case, one control KTR without BKV infection was identified and matched by age, transplant date, and donor status. Factors associated with BKVN diagnosis were identified using exact conditional logistic regression. Comparative survival was described using Kaplan–Meier estimator.

Results

Sixty-four cases of BKVN were identified among 1737 new kidney transplantation (3.7% prevalence). Clinical characteristics did not differ between groups, except for a higher c-PRA among cases. BKVN occurred in a median time of 11 (5–14.5) months after KT, and was associated with a significantly impaired graft function at diagnosis. Following BKVN, 61 (95%) of the patients had immunosuppression reduction, which led to BKV DNAemia resolution in 49% of cases. In multivariate analysis, factors associated with BKVN diagnosis were lymphopenia < 500/mm3 and a prednisone dose > 7.5 mg/day. Median duration of follow-up was 40 months for both groups. BKVN was associated with a significantly increased risk of graft rejection (P = 0.02) and return to dialysis (P = 0.01).

Conclusions

BKVN remains a severe complication in KTR and is associated with an increased risk for acute rejection and return to dialysis. Lymphopenia below 500/mm3 and corticosteroid maintenance therapy are significantly associated with biopsy-proven BKVN diagnosis.
Comparison of clinical outcomes for different morphological scores of D5 and D6 blastocysts in the frozen-thawed cycle
Authors: Jiang Yaping , Jiang Rui , He Hui , Ren Xinling , Yu Qiong , Jin Lei
Published: February 2023

Background

Both embryo development speed and embryo morphology score played a significant role in frozen-thawed embryo transfer cycle (FET) outcomes. Most of the literature indicates that D5 embryos performed better than D6 embryos, although a few also indicate that there is no difference in clinical outcomes between D5 and D6 embryos. Clinically, D5 embryos are preferred for equal morphological scores. But how to choose embryos when the morphological score of D6 embryos is better than D5?

Methods

A retrospective study including 8199 frozen-thawed embryo transfers (FETs) was conducted to analyze patients who underwent IVF-FET from January 2018 to December 2020. Patients were divided into 8 groups according to the rate of embryonic development and morphological scores to compare pregnancy outcomes. We further compared clinical pregnancy outcomes and neonatal outcomes between BC embryos on day 5 (D5) and BA/BB embryos on day 6 (D6).

Results

Our study found no difference in clinical pregnancy rate (CPR) and live birth rate (LBR) between AA/AB blastocysts in D5 or D6 frozen blastocysts. However, for BA/BB/BC blastocysts, embryonic pregnancy outcome was significantly better in D5 than in D6. In our further analysis and comparison of BC embryos in D5 and BA/BB embryos in D6, we found no difference in clinical pregnancy outcomes and neonatal outcomes, but D6 BA/BB embryos had a higher rate of miscarriage. After adjusting for confounding factors, none of the indicators differed between groups.

Conclusion

Our study provides suggestions for embryo selection: AA/AB embryos are preferred, regardless of the embryo development day, and the second choice is BA or BB embryos on D5. BA/BB embryos in D6 had a higher miscarriage rate than BC embryos in D5 but were not statistically significant after adjusting for confounding factors.
Safety and efficacy of Pucotenlimab (HX008) - a humanized immunoglobulin G4 monoclonal antibody in patients with locally advanced or metastatic melanoma: a single-arm, multicenter, phase II study
Authors: Cui Chuanliang , Chen Yu , Luo Zhiguo , Zou Zhengyun , Jiang Yu , Pan Hongming , Fan Qingxia , Zhao Jianfu , Xu Qing , Jiang Renbing , Wang Xuan , Ma Taiyang , Guo Zhen , Si Lu , Chi Zhihong , Sheng Xinan , Dou Yiwei , Tan Qian , Wu Di , Guo Jun
Published: February 2023

Background

Pucotenlimab is a novel recombinant humanized anti-PD-1 (Programmed death-1) monoclonal antibody, which belongs to the human IgG4/kappa subtype, and can selectively block the binding of PD-1 with its ligands PD-L1 and PD-L2.

Methods

In this phase 2 trial, patients with locally advanced or metastatic melanoma who had failed conventional treatment (chemotherapy, targeted therapy, interferon, IL-2, et al.) were recruited. The patients were administrated with Pucotenlimab of 3 mg/kg every 3 weeks until disease progression, intolerable toxicity, or treatment discontinuation for any other reasons. The primary endpoint was the overall response rate (ORR). The secondary endpoints were disease control rate (DCR), duration of response (DOR), progression-free survival (PFS), overall survival (OS), and toxicity.

Results

One-hundred and nineteen patients were enrolled and followed up for 19.32 (ranging from 15.901 to 24.608) months by the cutoff date of July 30th, 2021. The ORR was 20.17% (24/119, 95% CI, 13.370%-28.506%) based on both independent review committee (IRC) and the investigator’s assessment per RECIST v1.1. The median PFS were 2.89 (95% CI, 2.037–4.074) months and 2.46 (95% CI, 2.004–4.008) months based on IRC and investigator’s assessment, respectively, per RECIST v1.1. The median OS was 16.59 (95% CI, 13.963–26.973) months. Treatment-related adverse events (TRAEs) occurred in 77.3% (92/119) of the patients. The incidence of Grade ≥ 3 TRAEs was 15.1% (18/119). In addition, none of the patients died because of TRAEs. As for biomarker analysis, Eotaxin (CCL11) and MCP-1 (CCL2) were related to treatment response, while TNF-α and VEGF were related to treatment failure.

Conclusions

Pucotenlimab as a ≥ 2nd line therapy showed promising efficacy and tolerable toxicity for patients with locally advanced or metastatic melanoma.

Trial registration

Clinicaltrials.gov Identifier: NCT04749485 (registered retrospectively on 11/02/2021).
1,5-Anhydroglucitol promotes pre-B acute lymphocytic leukemia progression by driving glycolysis and reactive oxygen species formation
Authors: Zhu Huasu , Ma Huixian , Dong Na , Wu Min , Li Dong , Liu Linghong , Shi Qing , Ju Xiuli
Published: February 2023

Background

Precursor B-cell acute lymphoblastic leukemia (pre-B ALL) is the most common hematological malignancy in children. Cellular metabolic reorganization is closely related to the progression and treatment of leukemia. We found that the level of 1,5-anhydroglucitol (1,5-AG), which is structurally similar to glucose, was elevated in children with pre-B ALL. However, the effect of 1,5-AG on pre-B ALL was unclear. Here, we aimed to reveal the roles and mechanisms of 1,5-AG in pre-B ALL progression.

Methods

The peripheral blood plasma level of children with initial diagnosis of pre-B ALL and that of healthy children was measured using untargeted metabolomic analysis. Cell Counting Kit-8 assay, RNA sequencing, siRNA transfection, real-time quantitative PCR, and western blot were performed using pre-B ALL cell lines Reh and HAL-01. Cell cycle, cell apoptosis, ROS levels, and the positivity rate of CD19 were assessed using flow cytometry. Oxygen consumption rates and extracellular acidification rate were measured using XFe24 Extracellular Flux Analyzer. The lactate and nicotinamide adenine dinucleotide phosphate levels were measured using kits. The effect of 1,5-AG on pre-B ALL progression was verified using the In Vivo Imaging System in a xenotransplantation leukemia model.

Results

We confirmed that 1,5-AG promoted the proliferation, viability, and intracellular glycolysis of pre-B ALL cells. Mechanistically, 1,5-AG promotes glycolysis while inhibiting mitochondrial respiration by upregulating pyruvate dehydrogenase kinase 4 (PDK4). Furthermore, high levels of intracellular glycolysis promote pre-B ALL progression by activating the reactive oxygen species (ROS)-dependent mitogen-activated protein kinase/extracellular signal-regulated kinase (MAPK/ERK) pathway. Conversely, N-acetylcysteine or vitamin C, an antioxidant, effectively inhibited 1,5-AG-mediated progression of leukemia cells.

Conclusions

Our study reveals a previously undiscovered role of 1,5-AG in pre-B ALL, which contributes to an in-depth understanding of anaerobic glycolysis in the progression of pre-B ALL and provides new targets for the clinical treatment of pre-B ALL.
Cost and community acceptability of enhanced antibiotic distribution approaches for trachoma in the Republic of South Sudan: enhancing the A in SAFE (ETAS) study protocol
Authors: Sanders Angelia M. , Makoy Samuel , Deathe Andrew R. , Ohidor Stephen , Jesudason Timothy C. , Nute Andrew W. , Odongi Patrick , Boniface Lochebe , Abuba Stella , Delahaut Alexis S. , Sebit Wilson , Niquette James , Callahan E. Kelly , Walker Damian G. , Nash Scott D.
Published: February 2023

Background

The World Health Organization targeted trachoma for global elimination as a public health problem by 2030. Reaching elimination thresholds by the year 2030 in the Republic of South Sudan will be a considerable challenge, as the country currently has many counties considered hyper-endemic (> 30% trachomatous inflammation-follicular [TF]) that have yet to receive interventions. Evidence from randomized trials, modeling, and population-based surveys suggests that enhancements may be needed to the standard-of-care annual mass drug administration (MDA) to reach elimination thresholds in a timely manner within highly endemic areas. We describe a protocol for a study to determine the cost and community acceptability of enhanced antibiotic strategies for trachoma in South Sudan.

Methods

The Enhancing the A in SAFE (ETAS) study is a community randomized intervention costing and community acceptability study. Following a population-based trachoma prevalence survey in 1 county, 30 communities will be randomized 1:1 to receive 1 of 2 enhanced MDA interventions, with the remaining communities receiving standard-of-care annual MDA. The first intervention strategy will consist of a community-wide MDA followed by 2 rounds of targeted treatment to children ages 6 months to 9 years, 2 weeks and 4 weeks after the community MDA. The second strategy will consist of a community-wide biannual MDA approximately 6 to 8 months apart. The costing analysis will use a payer perspective and identify the total cost of the enhanced interventions and annual MDA. Community acceptability will be assessed through MDA coverage monitoring and mixed-methods research involving community stakeholders. A second trachoma-specific survey will be conducted 12 months following the original survey.

Discussion

ETAS has received ethical clearance and is expected to be conducted between 2022 and 2023. Results will be shared through subsequent manuscripts. The study’s results will provide information to trachoma programs on whether enhanced interventions are affordable and acceptable to communities. These results will further help in the design of future trachoma-specific antibiotic efficacy trials. Enhanced MDA approaches could help countries recover from delays caused by conflict or humanitarian emergencies and could also assist countries such as South Sudan in reaching trachoma elimination as a public health problem by 2030.

Trial registration

This trial was registered on December 1st, 2022 (clinicaltrails.org: NCT05634759).
Disparities in COVID-19 testing and outcomes among Asian American and Pacific Islanders: an observational study in a large health care system
Authors: Li Jiang , Chhoa Davis , Palaniappan Latha , Hays Kevin J. , Pressman Alice , Wang Nancy E.
Published: February 2023

Background

The COVID-19 pandemic has disproportionately impacted racial and ethnic minorities in the United States, including Asian Americans, Native Hawaiians and Pacific Islanders (Asian Americans and NH/PIs). However, few studies have highlighted nor disaggregated these disparities by Asian Americans and NH/PIs ethnic subgroups.

Methods

This retrospective, cross-sectional observational study aimed to assess variation of Asian Americans and NH/PIs COVID-19 testing and outcomes compared to non-Hispanic Whites (NHW). The study utilized data from the electronic health records (EHR) and the COVID-19 Universal Registry for Vital Evaluations (CURVE) from all patients tested for SARS-CoV-2 (n = 556,690) at a large, health system in Northern and Central California between February 20, 2020 and March 31, 2021. Chi-square tests were used for testing differences in the severity of COVID-19 (hospitalization, ICU admission, death) and patient demographic and clinical characteristics across the Asian Americans and NH/PIs subgroups and NHW. Unadjusted and adjusted Odds Ratios (ORs) were estimated for measuring effect of race ethnicity on severity of COVID-19 using multivariable logistic regression.

Results

Of the entire tested population, 70,564/556,690 (12.7%) tested positive for SARS-CoV-2. SARS-CoV-2 positivity of Asian subgroups varied from 4% in the Chinese and Korean populations, to 11.2%, 13.5%, and 12.5% for Asian Indian, Filipino, and “other Asian” populations respectively. Pacific Islanders had the greatest subgroup test positivity at 20.1%. Among Asian Americans and NH/PIs patients with COVID-19 disease, Vietnamese (OR = 2.06, 95% CI = 1.30–3.25), “Other Asian” (OR = 2.13, 95% CI = 1.79–2.54), Filipino (OR = 1.78, 95% CI = 1.34–2.23), Japanese (OR = 1.78, 95% CI = 1.10–2.88), and Chinese (OR = 1.73, 95% CI = 1.34–2.23) subgroups had almost double the odds of hospitalization compared to NHW. Pacific Islander (OR = 1.58, 95% CI = 1.19–2.10) and mixed race subgroups (OR = 1.55, 95% CI = 1.10–2.20) had more than one and a half times odds of hospitalization compared to NHW. Adjusted odds of ICU admission or death among hospitalized patients by different Asian subgroups varied but were not statistically significant.

Conclusions

Variation of COVID-19 testing and hospitalization by Asian subgroups was striking in our study. A focus on the Asian Americans and NH/PIs population with disaggregation of subgroups is crucial to understand nuances of health access, utilization, and outcomes among subgroups to create health equity for these underrepresented populations.
Status of health care waste management plans and practices in public health care facilities in Gauteng Province, South Africa
Authors: Ramodipa Tumisang , Engelbrecht Koos , Mokgobu Ingrid , Mmereki Daniel
Published: February 2023

Background

Health care waste management is a challenge due to the composition of the waste generated within a health care facility, of which 85% is domestic waste, and at least 15% is hazardous waste or health care risk waste (has been in contact with blood, body fluids or tissues from humans and could cause disease). In this study, we evaluated the status quo of health care waste management plans (HCWMPs) and practices in public health care facilities in Gauteng Province, South Africa.

Methods

A situational analysis was employed in health care facilities (HCFs) that generated more than 20 kg (N = 42) of health care risk waste (HCRW) per day. Data was collected from officials responsible for the management of health care waste using a self-administered questionnaire whilst Chief Executive Officers/ managers of the HFCs were interviewed.

Results

The results showed that most (79.0%) of the health care waste officers (HCWOs) as well as management (84.6%) agreed to have HCWMPs in place. The majority (76.9%) of the HCFs have a dedicated person appointed to manage health care waste with the majority (67%) being environmental health practitioners. According to management, only 30.8% have formally appointed an integrated HCW committee. Only 11.7% of the HCWOs are guided by the Occupational Health and Safety Act to develop their HCWMPs with only 20.5% with health care waste minimisation strategies in place.

Conclusion

The study concluded that there is limited integration of HCWMPs as inadequate health and safety aspects, environmental pollution as well as community participation was reported. The novelty of the study is to contribute to a body of knowledge, information on the establishment of an effective health care waste management system in public health care facilities and for decision-making purposes.
Examining activity-friendly neighborhoods in the Norwegian context: green space and walkability in relation to physical activity and the moderating role of perceived safety
Authors: Juul Vilde , Nordbø Emma Charlott Andersson
Published: February 2023

Background

Despite the well-known health benefits of regular physical activity, inactivity remains a major public health concern. Understanding how the built environment can encourage physical activity is therefore important to inform current policy strategies for creating activity-friendly neighborhoods. This study aimed to examine whether neighborhood walkability and greenness were associated with physical activity, and if perceived safety moderated any such relations, among adult citizens in Norway.

Methods

This cross-sectional study included a sample of 5670 adults aged ≥ 18 years living in urban areas of Stavanger. Information on physical activity (PA) levels, perceived neighborhood safety, and socio-demography were obtained from questionnaire data collected in the Norwegian county public health survey of Rogaland. Geographic information systems were utilized to compute walkability, vegetation scores and proportion of green space within postcode areas, which subsequently were linked to the survey data. Hierarchical linear regression models were fitted to examine associations between walkability, amount of vegetation, proportion of green space and weekly minutes of PA, and to estimate main and interaction effects of perceived safety on these relationships.

Results

The adults were on average physically active 148.3 min/week. The amount of green vegetation in the neighborhood was positively related to physical activity when adjusting for potential confounders. No such relations were observed for proportion of green space and walkability. Perceived neighborhood safety was significantly related to increased levels of physical activity, but no moderating role of perceived safety was observed.

Conclusion

Although our findings should be interpreted with caution, the results point towards the importance of policymakers, planners, and public health professionals to advocate for safe environments with green vegetation for physical activity in the neighborhood.
Risk factors and prognostic value of osteoporosis in hospitalized patients with bronchiectasis
Authors: Zou Xin , Ma Zhiyi , Liu Xiaohong , Zhang Kaijun , Qiu Chenchen , Liang Rongzhang , Weng Duanli , Xie Lingyan , Cao Xiaoming , Wu Yongquan , Wen Liwen
Published: February 2023

Background

The risk factors for osteoporosis and its prognostic value in patients with bronchiectasis is not well characterized. We explored the risk factors for osteoporosis and its prognostic impact in hospitalized non-cystic fibrosis bronchiectasis (NCFB) patients in Southeast China.

Methods

This observational cohort study consecutively enrolled 179 hospitalized patients with NCFB bronchiectasis between 2017 and 2021. The risk factors and the impact of osteoporosis on all-cause mortality were assessed.

Results

21.2% (38/179) of hospitalized NCFB patients were diagnosed with osteoporosis. Patients with osteoporosis had more severe symptoms (assessed by chronic airway assessment test, CAT, median 22 vs. 17, P = 0.017), poorer quality of life (assessed by St. George Respiratory Questionnaires, SQRC, median 42 vs. 27, P = 0.007), more severe disease stage (assessed by bronchiectasis severity index, BSI, median 14 vs. 11, P = 0.02), more comorbidities (assessed by Bronchiectasis Aetiology Comorbidity Index, BACI, median 5 vs. 4, P = 0.021) than patients without. Age, female sex, anemia, post-infection, and history of regular inhaled corticosteroid treatment were independent risk factors for osteoporosis in those patients. 21 patients (11.7%) died over a median follow-up period of 32 months. The all-cause mortality in NCFB patients with osteoporosis [28.94% (11/38)] was significantly higher than those without osteoporosis [7.09% (10/141)] [hazard ratio (HR) 5.34, 95% confidence interval (CI) 2.26–12.67, P < 0.001]. After adjusting for BSI and other confounding factors, osteoporosis was still independently associated with all-cause mortality in hospitalized NCFB patients (HR 4.29, 95% CI 1.75–10.49, P < 0.001).

Conclusions

Osteoporosis had an independent effect on all-cause mortality in hospitalized NCFB patients. Management of comorbidities, including bone health, is a critical aspect of treating NCFB patients.
Relevant factors of posterior mandible lingual plate perforation during immediate implant placement: a virtual implant placement study using CBCT
Authors: Sun Yingjia , Hu Sai , Xie Zhijian , Zhou Yiqun
Published: February 2023

Background

To explore the influence of cross-sectional type and morphological parameters at the mandibular molar sites on lingual plate perforation (LPP) during the immediate implant placement (IIP).

Methods

181 implants were virtually placed in the mandibular molar sites on the cone beam computed tomography (CBCT). Each cross-section of the implantation site was divided into the Undercut (U)/Parallel (P)/Convex (C) types. Morphologically relevant parameters were measured on the cross-sections, including width of the upper end (Wb), width of the lower end (Wc), vertical height (V), angle between the natural crown axis and the alveolar bone axis (∠β), LC depth (LCD), LC height, and angle between the horizontal line and the line connecting the most prominent point and the most concave point of lingual plate (∠α). Besides, the distance from the end of the virtual implant and the lingual bone plate of the cross-section (DIL) was calculated. Relationships between all the morphologically relevant parameters and the DIL were further analyzed.

Results

A total of 77 (42.5%) cross-sections were classified as U-type, which was the most common one, accounting for 63% of the second molar regions. All LPP cases and most of the nearly LPP (87.9%) cases occurred at the U-type cross-sections, and the relationship between the DIL and the morphological parameters can be expressed by a multivariate linear equation.

Conclusions

The occurrence rate of U-type cross-sections in the second molar region was very high, and the risk of LPP should be considered during IIP. Except for the U-type, significant large LCD, small Wc, and large ∠β were the important relevant factors. CBCT and multivariate linear equations could help to assess the LPP risk and provide a reference for implant placement design pre-surgery.
Antimicrobial analysis of honey against Staphylococcus aureus isolates from wound, ADMET properties of its bioactive compounds and in-silico evaluation against dihydropteroate synthase
Authors: Edet Uwem Okon , Mbim Elizabeth Nkagafel , Ezeani Esu , Henshaw Okoroiwu Uchechi , Ibor Oju R. , Bassey Ini Ubi , Asanga Edet Effiong , Antai Ekpo Eyo , Nwaokorie Francisca O. , Edet Bassey Okon , Bebia Glory P. , Tega Curtis , Mboto Clement I. , Nkang Ani , Nneoyi-Egbe Ada Francesca
Published: February 2023

Background

One of the main challenges of wound healing is infection with multi-drug resistant (MDR) bacteria such as Staphylococcus aureus. The spectrum of antibiotics used to treat them is declining; thus, there is a need for alternatives. Our study was designed to evaluate the antimicrobial properties of honey, its pharmacokinetics (ADMET) properties and in-silico analysis of its bioactive compounds against dihydropteroate synthase of S. aureus using trimethoprim as control.

Methods

Standard protocols were employed in collection and preparation of samples, generation of canonical strings, and conduction of microbiological analyses. Bioactive compounds’ ADMET properties were evaluated using the SWISSADME and the MCULE toxicity checker tools. The MCULE one-click docking tool was used in carrying out the dockings.

Results

The gas chromatography-mass spectrophotometry revealed twenty (20) bioactive compounds and was dominated by sugars (> 60%). We isolated a total of 47 S. aureus isolates from the wound samples. At lower concentrations, resistance to trimethoprim (95.74 to 100.00%) was higher than honey (70.21 to 96.36%). Only seven (7) isolates meet Lipinski’s rule of five and ADMET properties. The docking scores of the bioactive compounds ranged from -3.3 to -4.6 while that of trimethoprim was -6.1, indicating better binding or interaction with the dihydropteroate synthase. The bioactive compounds were not substrates to P450 cytochrome enzymes (CYP1A2, CYP2CI9 and CYP2D6) and p-glycoprotein, indicating better gastrointestinal tract (GIT) absorption.

Conclusion

The favourable docking properties shown by the bioactive compounds suggest they could be lead compounds for newer antimetabolites for management of MDR S. aureus.
Depression, anxiety and stress among metastatic breast cancer patients on chemotherapy in China
Authors: Guo Yi-Qiang , Ju Qing-Mei , You Miaoning , Liu Yang , Yusuf Azlina , Soon Lean Keng
Published: February 2023

Objective

This study aimed to assess the level of depression, anxiety and stress among metastatic breast cancer (MBC) patients undergoing chemotherapy (CT) in Beijing, China.

Methods

A cross-sectional study was conducted on 176 MBC women receiving CT, selected by purposive sampling. Data were collected using self-administered questionnaires that included participants’ socio-demographic status, DASS-21 and Brief COPE. Data were analyzed using descriptive statistics and general linear regression analysis.

Results

The incidence of depression, anxiety and stress among MBC women were 52.3%, 60.2% and 36.9%, respectively. General linear regression showed that age, marital status, monthly income, physical functioning, emotional functioning, pain, dyspnea, and appetite loss were associated with depression. All variance determined the depression (R2) was 35.6%. Marital status, self-blame and behavioral disengagement were the predictors of stress and accounted for a 35.4% stress variance in MBC women.

Conclusion

Our study demonstrated depression, anxiety, and stress prevalence are high in MBC women. Assessment of psychological distress (depression, anxiety, and stress) is important to recognise MBC patients who need help and further medical and mental help support. This study’s findings can increasingly highlight that depression, anxiety, and stress are substantial problems in MBC patients. Therefore, psychological interventions are needed to reduce depression, anxiety, and stress for MBC patients.
Testing the association between the enabling and enacting factors of patient safety culture and patient safety: structural equation modelling
Authors: Lee Seung Eun , Dahinten V. Susan , Lee Jong Hyun
Published: February 2023

Background

Despite evidence linking a safety culture with patient safety, the processes by which aspect of safety culture influences patient safety are not yet well understood. Thus, this study aimed to test a theoretical model of the relationships between three enabling factors (supervisor/clinical leader support for patient safety, hospital management support for patient safety, and psychological safety), and four enacting factors of patient safety culture (handoffs and information exchange, teamwork, error reporting intention, and withholding voice) with nurse assessments of patient safety.

Methods

A cross-sectional, descriptive correlational study design was used. Between May and June 2020, 526 nurses who provided direct care to patients in medical surgical units in three Korean hospitals completed an online survey that included four standardized scales or subscales. Structural equation modelling was used to test the hypothesized model.

Results

Among the three enabling factors, psychological safety was associated with all four enacting factors, and all enacting factors were associated with overall patient safety. Hospital management support was associated with all enacting factors except teamwork, but supervisor/clinical leader support was associated with only handoffs and information exchange, and withholding voice. Thus, teamwork was influenced only by psychological safety. Findings demonstrate overall support for the theoretical model of safety culture wherein enabling factors influence enacting factors which, in turn, lead to patient safety outcomes, but emphasize the critical nature of psychological safety among nursing staff.

Conclusion

This study provides further insight into the importance of support from hospital management and unit supervisors/clinical leaders for patient safety to motivate and enable hospital nurses to enact behaviours necessary for patient safety. However, such support must also take the form of enhancing psychological safety for nursing staff.
Longitudinal association of remnant cholesterol with joint arteriosclerosis and atherosclerosis progression beyond LDL cholesterol
Authors: Wu Zhiyuan , Wang Jinqi , Zhang Haiping , Pan Huiying , Li Zhiwei , Liu Yue , Miao Xinlei , Han Ze , Kang Xiaoping , Li Xia , Guo Xiuhua , Tao Lixin , Wang Wei
Published: February 2023

Background

Arteriosclerosis and atherosclerosis are closely related with cardiovascular disease (CVD) risk. Remnant cholesterol (RC) could predict CVD. However, its effect on joint arteriosclerosis and atherosclerosis progression remains unclear. This study aims to evaluate the association of RC with joint arteriosclerosis and atherosclerosis progression trajectories in the general population.

Methods

This study collected data across five biennial surveys of the Beijing Health Management Cohort from 2010 to 2019. Multi-trajectory model was used to determine the joint arteriosclerosis and atherosclerosis progression patterns by brachial-ankle pulse wave velocity (baPWV) and ankle brachial index (ABI). We also performed discordance analyses for RC vs. low density lipoprotein cholesterol (LDL-C) using ordinal logistics model.

Results

A total of 3186 participants were included, with three clusters following distinct arteriosclerosis and atherosclerosis progression patterns identified using a multi-trajectory model. In the multivariable-adjusted ordinal logistics analyses, RC was significantly associated with baPWV and ABI progression (OR: 1.20; 95% CI: 1.13–1.28, per 10 mg/dL). For the discordance analyses, the discordant low RC group was associated with decreased risk compared to the concordant group (OR: 0.73; 95% CI: 0.60–0.89). People with a high RC level were at an increased risk of joint arteriosclerosis and atherosclerosis progression, even with optimal LDL-C.

Conclusions

RC is independently associated with joint arteriosclerosis and atherosclerosis progression beyond LDL-C. RC could be an earlier risk factor than LDL-C of arteriosclerosis and atherosclerosis in the general population.
Impact of chronic GLP-1 RA and SGLT-2I therapy on in-hospital outcome of diabetic patients with acute myocardial infarction
Authors: Trombara Filippo , Cosentino Nicola , Bonomi Alice , Ludergnani Monica , Poggio Paolo , Gionti Luigia , Baviera Marta , Colacioppo Pierluca , Roncaglioni Maria Carla , Leoni Olivia , Bortolan Francesco , Agostoni Piergiuseppe , Genovese Stefano , Marenzi Giancarlo
Published: February 2023

Background

Glucagon-like peptide-1 receptor agonists (GLP-1 RA) and sodium glucose cotransporter-2 inhibitors (SGLT-2i) demonstrated cardiovascular and renal protection. Whether their benefits occur also during hospitalization for acute myocardial infarction (AMI) in patients with diabetes mellitus (DM) is not known. We evaluated in-hospital outcomes of patients hospitalized with AMI according to their chronic use of GLP-1 RA and/or SGLT-2i.

Methods

Using the health administrative databases of Lombardy, patients hospitalized with AMI from 2010 to 2019 were included. They were stratified according to DM status, then grouped into three cohorts using a propensity score matching: non-DM patients; DM patients treated with GLP-1 RA and/or SGLT-2i; DM patients not treated with GLP-1 RA/SGLT-2i. The primary endpoint of the study was the composite of in-hospital mortality, acute heart failure, and acute kidney injury requiring renal replacement therapy.

Results

We identified 146,798 patients hospitalized with AMI (mean age 71 ± 13 years, 34% females, 47% STEMI; 26% with DM). After matching, 3,090 AMI patients (1030 in each group) were included in the analysis. Overall, the primary endpoint rate was 16% (n = 502) and progressively increased from non-DM patients to DM patients treated with and without GLP-1 RA/SGLT-2i (13%, 16%, and 20%, respectively; P < 0.0001). Compared with non-DM patients, DM patients with GLP-1 RA/SGLT-2i had a 30% higher risk of the primary endpoint, while those not treated with GLP-1 RA/SGLT-2i had a 60% higher risk (P < 0.0001).

Conclusion

Chronic therapy with GLP-1 RA and/or SGLT-2i has a favorable impact on the clinical outcome of DM patients hospitalized with AMI.
Sustainable bacterial cellulose production by Achromobacter using mango peel waste
Authors: Hasanin Mohamed S. , Abdelraof Mohamed , Hashem Amr H. , El Saied Houssni
Published: February 2023

Bacterial Cellulose (BC) is still the most renewable available biopolymer produced in fine nature from alternative microbial sources as bacteria. In the present study, newly BC producing bacteria were successfully isolated from acidic fruits. The most potent producer was isolated from strawberry and identified genetically using 16 s rRNA technique as Achromobacter S3. Different fruit peels were screened to produce BC using the cheapest culture medium. Among them, Mango peel waste (MPW) hydrolysate proved to be the significant inducible alternative medium without any extra nutrients for the maximum productivity. Improvement of the BC yield was successfully achieved via statistical optimization of the MPW culture medium, from 0.52 g/L to 1.22 g/L with 2.5-fold increased about the standard HS culture medium. Additionally, the physicochemical analysis affirmed the cellulose molecular structure as well as observed the crystallinity of nanofiber as 72 and 79% for BC produced by Achromobacter S33 on HS and MPW media, respectively. Moreover, the topographical study illustrated that the BC nanofibers had close characteristics upon fiber dimeter and length as about 10 and 200 nm, respectively.
Effect of a rigid ankle foot orthosis and an ankle foot orthosis with an oil damper plantar flexion resistance on pelvic and thoracic movements of patients with stroke during gait
Authors: Ling Hua , Guo Hui , Zhou Hao , Chang Xiao-Qian , Guo Zi-Yang , Yamamoto Sumiko , Cai Li-Fei , Zhao Jun
Published: February 2023

Background

Impairments of trunk movements in gait of stroke are often reported. Ankle foot orthosis (AFO) is commonly used to improve gait of stroke; however, the effect of different types of AFOs on the pelvic and thoracic movements during gait in stroke has not been clarified.

Methods

Thirty-four patients with stroke were randomly allocated to undergo 2 weeks of gait training by physiotherapists while wearing a rigid AFO (RAFO) with a fixed ankle or an AFO with an oil damper (AFO-OD) that provides plantarflexion resistance and free dorsiflexion. A motion capture system was used for measurements of shod gait without AFO at baseline and with and without AFO after gait training. Two-way repeated ANOVA, Wilcoxon signed-rank test, and Mann–WhitneyUtest were performed for the data after the gait training to know the effect of different kinds of AFOs.

Results

Twenty-nine patients completed the study (AFO-OD group: 14, RAFO group: 15). Interactions were found in pelvic rotation angle, change of shank-to-vertical angle (SVA) in the stance, and paretic to non-paretic step length, which increased in AFO-OD group with AFOs (p < 0.05), while the SVA decreased in RAFO group with AFOs (p < 0.05). The main effects were found in pelvic rotation at the contralateral foot off, and thoracic tilt at foot off when an AFO was worn. The change of SVA in stance was positively correlated with the pelvic rotation in the AFO-OD group (r = 0.558). At initial contact, pelvic rotation was positively correlated with thoracic rotation in both groups.

Conclusions

The findings in 29 patients with stroke showed that pelvic and thoracic movements especially the rotation were affected by the type of AFOs. Pelvic rotation and lower limb kinematics exhibited significant improvements with AFO-OD, reflecting more desirable gait performance. On the other hand, the increase in thoracic in-phase rotation might expose the effect of insufficient trunk control and dissociation movement.

Trial registrationUMIN000038694, Registered 21 November 2019,https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_his_list.cgi?recptno=R000044048.
The relationship between the CUN-BAE body fatness index and incident diabetes: a longitudinal retrospective study
Authors: Peng Qing , Feng Zihao , Cai Zhuojian , Liu Dixing , Zhong Jiana , Zhao Hejia , Zhang Xiuwei , Chen Weikun
Published: February 2023

Background

The Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE) index has been recommended as an ideal indicator of body fat and exhibited significant correlation with cardiometabolic risk factors. However, whether the CUN-BAE index correlates with incident diabetes in Asian populations is unknown. Therefore, this longitudinal study was designed to evaluate the association between baseline CUN-BAE index and type 2 diabetes mellitus (T2DM).

Methods

This retrospective longitudinal study involved 15,464 participants of 18–79 years of age in the NAGALA (NAfld in the Gifu Area Longitudinal Analysis) study over the period of 2004–2015. Cox proportional hazards regression was performed to test the relationship between the baseline CUN-BAE index and diabetes incidence. Further stratification analysis was conducted to ensure that the results were robust. The diagnostic utility of the CUN-BAE index was tested by the receiver operating characteristic (ROC) curve.

Results

Over the course of an average follow-up of 5.4 years, 373 (2.41%) participants developed diabetes. A higher diabetes incidence was associated with higher CUN-BAE quartiles (P for trend< 0.001). Each 1 unit increase in CUN-BAE index was associated with a 1.08-fold and 1.14-fold increased risk of diabetes after adjustment for confounders in males and females, respectively (both P < 0.001). Stratification analysis demonstrated a consistent positive correlation between baseline CUN-BAE and diabetes incidence. Moreover, based on ROC analysis, CUN-BAE exhibited a better capacity for diabetes prediction than both body mass index (BMI) and waist circumference (WC) in both sexes.

Conclusions

The baseline CUN-BAE level was independently related to the incidence of diabetes. Increased adiposity determined by CUN-BAE could be used as a strong nonlaboratory predictor of incident diabetes in clinical practice.
Intraocular delivery of ZIF-90-RhB-GW2580 nanoparticles prevents the progression of photoreceptor degeneration
Authors: Cao Peipei , Cheng Yue , Li Zhi , Cheng Ya-Jia , Chu Xiaoqi , Geng Chao , Yin Xuebo , Li Yuhao
Published: February 2023

Photoreceptor degeneration is one of the major causes of progressive blindness which lacks of curative treatment. GW2580, a highly selective inhibitor of colony-stimulating factor 1 receptor, has the protective potential on neurons; however, little was known about the application of GW2580 on photoreceptor degeneration. In this study, BV-2 and 661W cells coculture system was constructed to investigate the interaction between microglia and photoreceptors. GW2580 was loaded into zeolitic imidazolate framework-90-rhodamine B (ZIF-90-RhB) to synthesize a novel kind of nanoparticles, namely, ZIF-90-RhB-GW2580, through a one-step self-assembly approach. A photoreceptor degeneration model was generated by intense light exposure in zebrafish and ZIF-90-RhB-GW2580 nanoparticles were delivered by the intraocular injection. The results showed that in vitro GW2580 treatment promoted phenotypic transformation in microglia and led to the blockade of photoreceptor apoptosis. Following the intraocular delivery of ZIF-90-RhB-GW2580 nanoparticles, the microglial proliferation and inflammatory response were significantly inhibited; moreover, the photoreceptors underwent alleviated injury with a recovery of retinal structure and visual function. In conclusion, the intraocular injection of ZIF-90-RhB-GW2580 at the early stage enables the precise delivery and sustained release of the GW2580, thus preventing the progression of photoreceptor degeneration.

Graphical Abstract
Novel opto-fluidic drug delivery system for efficient cellular transfection
Authors: Layachi Majid , Treizebré Anthony , Hay Laurent , Gilbert David , Pesez Jean , D’Acremont Quentin , Braeckmans Kevin , Thommen Quentin , Courtade Emmanuel
Published: February 2023

Intracellular drug delivery is at the heart of many diagnosis procedures and a key step in gene therapy. Research has been conducted to bypass cell barriers for controlled intracellular drug release and made consistent progress. However, state-of-the-art techniques based on non-viral carriers or physical methods suffer several drawbacks, including limited delivery yield, low throughput or low viability, which are key parameters in therapeutics, diagnostics and drug delivery. Nevertheless, gold nanoparticle (AuNP) mediated photoporation has stood out as a promising approach to permeabilize cell membranes through laser induced Vapour NanoBubble (VNB) generation, allowing the influx of external cargo molecules into cells. However, its use as a transfection technology for the genetic manipulation of therapeutic cells is hindered by the presence of non-degradable gold nanoparticles. Here, we report a new optofluidic method bringing gold nanoparticles in close proximity to cells for photoporation, while avoiding direct contact with cells by taking advantage of hydrodynamic focusing in a multi-flow device. Cells were successfully photoporated with$$\sim {70}{\%}$$∼70%efficiency with no significant reduction in cell viability at a throughput ranging from$$10^3$$103to$$10^4~\text {cells}~{\hbox {min}^{-1}}$$104cellsmin-1. This optofluidic approach provides prospects of translating photoporation from an R &D setting to clinical use for producing genetically engineered therapeutic cells.