bluuebunny/crossref_metadata_2025 huggingface dataset:
Three-Dimensional Printing Applications in Pediatric Spinal Surgery: A Systematic Review
Authors: Katiyar Prerana , Boddapati Venkat , Coury Josephine , Roye Benjamin , Vitale Michael , Lenke Lawrence
Published: June 2023

Study Design

Systematic Review

Objective

3DP technology use has become increasingly more common in the field of medicine and is notable for its growing utility in spine surgery applications. Many studies have evaluated the use of pedicle screw placement guides and spine models in adult spine patients, but there is little evidence assessing its efficacy in pediatric spine patient populations. This systematic review identifies and evaluates the current applications and surgical outcomes of 3-Dimensional Printing (3DP) technology in pediatric spinal surgery.

Methods

A search of publications was conducted using literature databases and relevant keywords in concordance with PRISMA guidelines. Inclusion criteria consisted of original studies, and studies focusing on the use of 3DP technology in pediatric spinal surgery. Studies with a focus on adult populations, non-deformity surgery, animal subjects, systematic or literature reviews, editorials, or non-English studies were excluded from further analysis.

Results

After application of inclusion/exclusion criteria, we identified 25 studies with 3DP applications in pediatric spinal surgery. Overall, the studies found significantly improved screw placement accuracy using 3DP pedicle screw placement guides but did not identify significant differences in operative time or blood loss. All studies that utilized 3D spine models in preoperative planning found it helpful and noted an increased screw placement accuracy rate of 89.9%.

Conclusions

3DP applications and techniques are currently used in pre-operative planning using pedicle screw drill guides and spine models to improve patient outcomes in pediatric spinal deformity patients.
Revision Rotator Cuff Repair With Versus Without an Arthroscopically Inserted Onlay Bioinductive Implant in Workers’ Compensation Patients
Authors: Ting Ryan S. , Loh Yao Chen , Rosenthal Ron , Zhong Kaitlin , Al-Housni Hilal S.A. , Shenouda Mina , Hackett Lisa , Lam Patrick H. , Murrell George A.C.
Published: June 2023

Background:

The addition of onlay biological grafts to augment difficult rotator cuff repairs has shown encouraging results in a case series.

Purpose/Hypothesis:

The purpose of this study was to determine whether the addition of an onlay bioinductive implant would improve repair integrity, shear wave elastographic appearance of the repaired tendon and patch, and patient-rated and/or surgeon-measured shoulder function when used in workers' compensation patients undergoing revision arthroscopic rotator cuff repair. We hypothesized that the addition of the bioinductive implant would enhance repair integrity and clinical outcomes compared with standard repair.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A post hoc matched-cohort study was conducted on prospectively recruited workers’ compensation patients who received a bioinductive implant for revision rotator cuff repair (n = 19). The control group was selected from consecutive workers’ compensation revision rotator cuff repair patients before the introduction of bioinductive implants. Then, they were matched for age and tear size (n = 32). Kaplan-Meier curves were generated to compare the primary outcome of repair integrity between groups. The secondary outcomes were to evaluate the elastographic appearance of the tendon and patch in the bioinductive implant group and to compare patient-rated and surgeon-measured shoulder function between groups preoperatively and at 1 week, 6 weeks, 3 months, and 6 months postoperatively.

Results:

No major complications associated with the bioinductive implants were identified. Six months after the revision rotator cuff repair, the retear rate in the bioinductive implant group was 16% (3/19), compared with 19% (6/32) in the age- and tear size-matched control group ( P = .458). At the final follow-up, the retear rate in the bioinductive implant group was 47% (9/19) at a mean of 14 months compared with 38% (12/32) at a mean of 29 months in the control group ( P = .489). The shear wave elastographic stiffness of repaired tendons augmented with the bioinductive implant remained unchanged at 6 m/s from 1 week to 6 months postoperatively, which is lower than the stiffness of 10 m/s in healthy tendons. There were no significant differences in patient-rated or surgeon-measured outcomes between groups 6 months postoperatively.

Conclusion:

There were no differences in repair integrity or clinical outcomes between workers’ compensation patients who underwent revision arthroscopic rotator cuff repair with an onlay bioinductive implant compared to those who underwent standard revision rotator cuff repair.
Mating in Captivity: The Influence of Social Location on Sexual Satisfaction through Phases of the COVID-19 Pandemic
Authors: McElroy Elizabeth E. , Perry Samuel L. , Grubbs Joshua B.
Published: June 2023

The recent global pandemic provides a natural experiment “intervention” to examine how differing baseline social dynamics such as gender, education, and politics shaped diverging patterns of well-being during rapidly shifting societal conditions. Using married adults from a nationally representative panel study in the United States from August 2019 to August 2021, discontinuous growth curves reveal a large drop in average married sexual satisfaction in both quality and frequency directly following the pandemic onset. Moreover, sexual satisfaction remained largely suppressed for the subsequent 18 months, apart from a brief “optimism blip” in the fall of 2020. Race, age, income, employment, parenthood, education, and political affiliation all appear as meaningful predictors, but these differ across various phases of the pandemic and by gender. These results reveal evidence of lingering changes in subjective sexual well-being as well as patterns of catastrophe risk and resilience moderated by social location factors.
Tidyproteomics: an open-source R package and data object for quantitative proteomics post analysis and visualization
Authors: Jones Jeff , MacKrell Elliot J. , Wang Ting-Yu , Lomenick Brett , Roukes Michael L. , Chou Tsui-Fen
Published: June 2023

Background

The analysis of mass spectrometry-based quantitative proteomics data can be challenging given the variety of established analysis platforms, the differences in reporting formats, and a general lack of approachable standardized post-processing analyses such as sample group statistics, quantitative variation and even data filtering. We developedtidyproteomicsto facilitate basic analysis, improve data interoperability and potentially ease the integration of new processing algorithms, mainly through the use of a simplified data-object.

Results

The R packagetidyproteomicswas developed as both a framework for standardizing quantitative proteomics data and a platform for analysis workflows, containing discrete functions that can be connected end-to-end, thus making it easier to define complex analyses by breaking them into small stepwise units. Additionally, as with any analysis workflow, choices made during analysis can have large impacts on the results and as such,tidyproteomicsallows researchers to string each function together in any order, select from a variety of options and in some cases develop and incorporate custom algorithms.

Conclusions

Tidyproteomicsaims to simplify data exploration from multiple platforms, provide control over individual functions and analysis order, and serve as a tool to assemble complex repeatable processing workflows in a logical flow. Datasets intidyproteomicsare easy to work with, have a structure that allows for biological annotations to be added, and come with a framework for developing additional analysis tools. The consistent data structure and accessible analysis and plotting tools also offers a way for researchers to save time on mundane data manipulation tasks.
Mitigation of heat stress in wheat (Triticum aestivum L.) via regulation of physiological attributes using sodium nitroprusside and gibberellic acid
Authors: Zhang Xueping , Ma Mingjun , Wu Chengcheng , Huang Shoucheng , Danish Subhan
Published: June 2023

Heat stress poses a threat to plants in arid and semiarid regions, leading to soil salinization and plant mortality. Researchers are exploring remedies to alleviate these effects, including using gibberellic acid (GA3) to regulate plant enzymes and antioxidants. Additionally, sodium nitroprusside (SNP) is gaining attention, but its combined effect with GA3 requires further research. To address this gap, we investigated the effects of GA3 and SNP on plants under heat stress conditions. For that, wheat plants were cultivated under 40 °C for 6 h per day (15 days). Sodium nitroprusside (donor of NO and SNP) and gibberellic acid (GA3), respectively, with 100 µM and 5 µg/ml concentrations, were applied as foliar sprays at 10 days after sowing (DAS). Results showed that SNP + GA3 treatment had the highest plant height (4.48% increase), plant fresh weight (29.7%), plant dry weight (87%), photosynthetic rate (39.76%) and stomatal conductance (38.10%), and Rubisco (54.2%) compared to the control. Our findings indicate a significant increase in NO, H2O2, TBARS, SOD, POD, APX, proline, GR, and GB that greatly scavenged reactive oxygen species (ROS) for decreasing the adverse effect of stress. Such findings confirmed the efficacy of the combined treatment of SNP + GA3 under high-temperature stress compared to the solitary application of GA3, SNP, and control. In conclusion, using SNP + GA3 is a better strategy for mitigating heat stress in wheat than individual applications. Further research is recommended to validate the effectiveness of SNP + GA3 in other cereal crops.

Graphical Abstract
The long-term effects of the Covid-19 infection on cardiac symptoms
Authors: Golchin Vafa Reza , Heydarzadeh Reza , Rahmani Mohammadhossein , Tavan Ali , Khoshnoud Mansorkhani Soroush , Zamiri Bardia , Amiri Farhang , Azadian Alireza , Khademolhosseini Amin , Montaseri Mohammad , Hosseini Nazanin , Hosseini Seyed Ali , Kojuri Javad
Published: June 2023

Background

Besides the lungs, coronavirus disease 2019 (COVID-19) can affect the cardiovascular, digestive, urinary, hepatic, and central nervous systems. Other than its short-term effects, COVID-19 may also cause long-term complications. In this study, we assessed long-term COVID-19 cardiovascular symptoms among patients in a cardiovascular clinic.

Method

A retrospective cohort was conducted between October 2020 to May 2021 on patients at an outpatient cardiovascular clinic in Shiraz, Iran. Patients with a history of COVID-19 at least one year before their referral were included. Baseline information was extracted from the clinic’s database. Data were collected regarding symptoms like dyspnea, chest pain, fatigue, and palpitations after a year of COVID-19. We also noted any major adverse cardiac events (MACE).

Results

Most common symptoms after a year of COVID-19 were exertional dyspnea (51.2%), dyspnea at rest (41.6%), fatigue (39%), and chest pain (27.1%). The symptoms were more prevalent in hospitalized patients than in non-hospitalized patients. The prevalence of MACE was about 6.1% during the 12-month follow-up, with this rate being higher in those with a history of hospitalization or comorbid diseases.

Conclusion

The prevalence of cardiovascular symptoms was fairly high in patients at our clinic a year after COVID-19, and the most common symptom was dyspnea. Hospitalized patients had more MACE. (Clinicaltrial.gov number: NCT05715879)(04/02/2023).
The associations between personality traits and quality of life, satisfaction with life, and well-being over time in people with dementia and their caregivers: findings from the IDEAL programme
Authors: Hunt Anna , Martyr Anthony , Gamble Laura D. , Morris Robin G. , Thom Jeanette M. , Pentecost Claire , Clare Linda
Published: June 2023

Background

Cross-sectional evidence indicates that certain personality traits may influence how well people with dementia and their caregivers are able to live alongside the condition. However, no studies to date have explored these associations longitudinally. The present study aimed to explore whether each of the Five-Factor personality traits were associated with change over two years in perceptions of ‘living well’ for people with dementia and their caregivers. ‘Living well’ was conceptualized as a composite of quality of life, satisfaction with life, and subjective well-being.

Methods

Data were analyzed from 1487 people with dementia and 1234 caregivers who took part in the IDEAL cohort. Participants were categorized into low, medium, and high groups for each trait using stanine scores. Latent growth curve models investigated associations between these groups and ‘living well’ scores for each trait at baseline and at 12 and 24 months. Covariates included cognition in people with dementia and stress in caregivers. A Reliable Change Index was calculated against which to evaluate changes in ‘living well’ scores over time.

Results

At baseline, neuroticism was negatively associated with ‘living well’ scores for people with dementia, while conscientiousness, extraversion, openness, and agreeableness were positively associated. For caregivers, neuroticism was negatively associated with ‘living well’ scores at baseline while conscientiousness and extraversion were positively associated. ‘Living well’ scores were mostly stable over time with no influence of personality traits on observed changes.

Conclusions

Findings suggest that personality traits, particularly neuroticism, have a meaningful impact on how people with dementia and caregivers rate their capability to ‘live well’ at baseline. Over time ‘living well’ scores for each personality trait group were largely stable. Studies utilizing longer follow-up periods and more appropriate measures of personality are needed to corroborate and extend the findings of the present study.
Exploring the shared decision making process of caesarean sections at a teaching hospital in Ghana: a mixed methods study
Authors: Asah-Opoku Kwaku , Onisarotu Aisha N. , Nuamah Mercy A. , Syurina Elena , Bloemenkamp Kitty , Browne Joyce L. , Rijken Marcus J.
Published: June 2023

Background

Caesarean section (CS) rates are rising. Shared decision making (SDM) is a component of patient-centered communication which requires adequate information and awareness. Women in Ghana have varying perceptions about the procedure. We sought to explore mothers’ knowledge. perceptions and SDM-influencing factors about CSs.

Methods

A transdisciplinary mixed-methods study was conducted at the maternity unit of Korle-Bu Teaching Hospital in Accra, Ghana from March to May, 2019. Data collection was done in four phases: in-depth interviews (n = 38), pretesting questionnaires (n = 15), three focus group discussions (n = 18) and 180 interviewer administered questionnaires about SDM preferences. Factors associated with SDM were analyzed using Pearson’s Chi-square test and multiple logistic regression.

Results

Mothers depicted a high level of knowledge regarding medical indications for their CS but had low level of awareness of SDM. The perception of a CS varied from dangerous, unnatural and taking away their strength to a life-saving procedure. The mothers had poor knowledge about pain relief in labour and at Caesarean section. Health care professionals attributed the willingness of mothers to be involved in SDM to their level of education. Husbands and religious leaders are key stakeholders in SDM. Insufficient consultation time was a challenge to SDM according to health care professionals and post-partum mothers. Women with parity ≥ 5 have a reduced desire to be more involved in shared decision making for Caesarean section. AOR = 0.09, CI (0.02–0.46).

Conclusion

There is a high knowledge about the indications for CS but low level of awareness of and barriers to SDM. The fewer antenatal care visits mothers had, the more likely they were to desire more involvement in decision making. Aligned to respectful maternity care principles, greater involvement of pregnant women and their partners in decision making process could contribute to a positive pregnancy experience. Education, including religious leaders and decision- making tools could contribute to the process of SDM.
S100A8, S100A9 and S100A8/A9 heterodimer as novel cachexigenic factors for pancreatic cancer-induced cachexia
Authors: Liao Wei-Chih , Chen Chih-Ta , Tsai You-Shu , Wang Xin-Ya , Chang Yen-Tzu , Wu Ming-Shiang , Chow Lu-Ping
Published: June 2023

Background

Cancer cachexia, occurring in ~ 80% pancreatic cancer (PC) patients overall, is a paraneoplastic syndrome mediated by cancer-induced systemic inflammation and characterized by weight loss and skeletal muscle wasting. Identifying clinically relevant PC-derived pro-inflammatory factors with cachexigenic potential may provide novel insights and therapeutic strategies.

Methods

Pro-inflammatory factors with cachexigenic potential in PC were identified by bioinformatic analysis. The abilities of selected candidate factors in inducing skeletal muscle atrophy were investigated. Expression levels of candidate factors in tumors and sera was compared between PC patients with and without cachexia. Associations between serum levels of the candidates and weight loss were assessed in PC patients.

Results

S100A8, S100A9, and S100A8/A9 were identified and shown to induce C2C12 myotube atrophy. Tumors of PC patients with cachexia had markedly elevated expression of S100A8 (P = 0.003) and S100A9 (P < 0.001). PC patients with cachexia had significantly higher serum levels of S100A8, S100A9 and S100A8/A9. Serum levels of these factors positively correlated with percentage of weight loss [correlation coefficient: S100A8: 0.33 (P < 0.001); S100A9: 0.30 (P < 0.001); S100A8/A9: 0.24 (P = 0.004)] and independently predicted the occurrence of cachexia [adjusted odds ratio (95% confidence interval) per 1ng/ml increase: S100A8 1.11 (1.02–1.21), P = 0.014; S100A9 1.10 (1.04–1.16), P = 0.001; per 1 µg/ml increase: S100A8/A9 1.04 (1.01–1.06), P = 0.009].

Conclusions

Atrophic effects of S100A8, S100A9, and S100A8/A9 indicated them as potential pathogenic factors of PC-induced cachexia. In addition, the correlation with the degree of weight loss and prediction of cachexia in PC patients implicated their potential utility in the diagnosis of PC-induced cachexia.
Hyperreflective material in patients with non-neovascular pachychoroid disease
Authors: Maruyama-Inoue Maiko , Yanagi Yasuo , Mohamed Shaheeda , Inoue Tatsuya , Kitajima Yoko , Ikeda Shoko , Kadonosono Kazuaki
Published: June 2023

Background

This study aimed to report eleven cases of non-neovascular pachychoroid disease with hyperreflective material (HRM) that occurred in Japanese patients.

Methods

A retrospective review of data from eleven patients who had non-neovascular retinal pigment epithelium (RPE) protrusion with HRM in the neurosensory retina between March 2017 and June 2022 was conducted. Clinical examination, color fundus photography, fluorescein angiography, spectral-domain optical coherence tomography (SD-OCT), and OCT angiography data were analyzed. Main outcome measures were patient characteristics, changes in SD-OCT findings, and symptom outcomes.

Results

All cases had RPE protrusion and HRM with dilated choroidal veins, which were characteristic of pachychoroid disease. However, none of the cases had macular neovascularization (MNV). In 9 eyes (81.8%), HRM improved spontaneously without intervention and resulted in alterations in RPE, referred to as pachychoroid pigment epitheliopathy (PPE) or focal choroidal excavation (FCE). In these cases, symptoms such as metamorphopsia and distortion improved without treatment. In the remaining two cases (18.2%), HRM still persisted during the follow-up period.

Conclusion

There are some cases of non-neovascular pachychoroid disorder with HRM, which might be a new entity of pachychoroid spectrum disease or an early stage of PPE or FCE. These cases should not be misdiagnosed as MNV, and careful observation is necessary.
Meaningful Activities and Recovery (MA&R): a co-led peer occupational therapy intervention for people with psychiatric disabilities. Results from a randomized controlled trial
Authors: Bjørkedal Siv-Therese Bogevik , Bejerholm Ulrika , Hjorthøj Carsten , Møller Tom , Eplov Lene Falgaard
Published: June 2023

Background

Activity and participation are critical to health and wellbeing. Limited evidence exists on how to support people with mental illness in participating in everyday activities.

Aim

To investigate the effectiveness of Meaningful Activities and Recovery (MA&R), a co-led peer occupational therapy intervention focusing on activity engagement, functioning, quality of life, and personal recovery.

Methods

In a statistician blinded, multicenter RCT including 139 participants from seven community and municipal mental health services in Denmark, participants were randomly assigned to 1) MA&R and standard mental health care or 2) standard mental health care. The MA&R intervention lasted 8 months and consisted of 11 group sessions, 11 individual sessions, and support to engage in activities. The primary outcome, activity engagement, was measured using Profile of Occupational Engagement in People with Severe Mental Illness (POES-S). Outcomes were measured at baseline and post-intervention follow-up.

Results

Meaningful Activities and Recovery was delivered with high fidelity and 83% completed the intervention. It did not demonstrate superiority to standard mental health care, as intention-to treat analysis revealed no significant differences between the groups in activity engagement or any of the secondary outcomes.

Conclusion

We did not find positive effects of MA&R, possibly because of COVID-19 and related restrictions. Fidelity assessments and adherence rates suggest that MA&R is feasible and acceptable. However, future studies should focus on refining the intervention before investigating its effectiveness.

Trial registration

The trial was registered 24/05/2019 at ClinicalTrials.gov NCT03963245.
Socioeconomic disparities and concentration of the spread of the COVID-19 pandemic in the province of Quebec, Canada
Authors: Lefebvre Gabrielle , Haddad Slim , Moncion-Groulx Dominique , Saint-Onge Mélanie , Dontigny André
Published: June 2023

Background

Recent studies suggest that the risk of SARS-CoV-2 infection may be greater in more densely populated areas and in cities with a higher proportion of persons who are poor, immigrant, or essential workers. This study examines spatial inequalities in SARS-CoV-2 exposure in a health region of the province of Quebec in Canada.

Methods

The study was conducted on the 1206 Canadian census dissemination areas in the Capitale-Nationale region of the province of Quebec. The observation period was 21 months (March 2020 to November 2021). The number of cases reported daily in each dissemination area was identified from available administrative databases. The magnitude of inequalities was estimated using Gini and Foster-Greer-Thorbecke (FGT) indices. The association between transmission and socioeconomic deprivation was identified based on the concentration of transmission in socially disadvantaged areas and on nonparametric regressions relating the cumulative incidence rate by area to ecological indicators of spatial disadvantage. Quantification of the association between median family income and degree of exposure of dissemination areas was supplemented by an ordered probit multiple regression model.

Results

Spatial disparities were elevated (Gini = 0.265; 95% CI [0.251, 0.279]). The spread was more limited in the less densely populated areas of the Quebec City agglomeration and outlying municipalities. The mean cumulative incidence in the subsample made up of the areas most exposed to the pandemic was 0.093. The spread of the epidemic was concentrated in the most disadvantaged areas, especially in the densely populated areas. Socioeconomic inequality appeared early and increased with each successive pandemic wave. The models showed that areas with economically disadvantaged populations were three times more likely to be among the areas at highest risk for COVID-19 (RR = 3.55; 95% CI [2.02, 5.08]). In contrast, areas with a higher income population (fifth quintile) were two times less likely to be among the most exposed areas (RR = 0.52; 95% CI [0.32, 0.72]).

Conclusion

As with the H1N1 pandemics of 1918 and 2009, the SARS-CoV-2 pandemic revealed social vulnerabilities. Further research is needed to explore the various manifestations of social inequality in relation to the pandemic.
Burden of long COVID among adults experiencing sheltered homelessness: a longitudinal cohort study in King County, WA between September 2020—April 2022
Authors: Cox Sarah N. , Scott Emily M. , Rogers Julia H. , Chow Eric J. , Wasse Jessica K. , Carone Marco , Hughes James P. , Chu Helen Y.
Published: June 2023

Background

People experiencing homelessness (PEH) are at increased risk for acquiring SARS-CoV-2, but the burden of long COVID in this population is unknown.

Methods

We conducted a matched prospective cohort study to assess the prevalence, characteristics, and impact of long COVID among sheltered PEH in Seattle, WA between September 2020—April 2022. Adults ≥ 18 years, residing across nine homeless shelters with active respiratory virus surveillance, were eligible to complete in-person baseline surveys and interval follow-up phone surveys. We included a subset of 22 COVID-19-positive cases who tested positive or inconclusive for SARS-CoV-2 and 44 COVID-19-negative controls who tested negative for SARS-CoV-2, frequency matched on age and sex. Among controls, 22 were positive and 22 were negative for one of 27 other respiratory virus pathogens. To assess the impact of COVID-19 on the risk of symptom presence at follow-up (day 30–225 post-enrollment test), we performed log-linear regression with robust standard errors, adjusting for confounding by shelter site and demographic variables determined a priori.

Results

Of 53 eligible COVID-19 cases, 22 (42%) completed ≥ 1 follow-up survey. While five (23%) cases reported ≥ 1 symptom at baseline, this increased to 77% (10/13) between day 30–59 and 33% (4/12) day 90 + . The most commonly reported symptoms day 30 + were fatigue (27%) and rhinorrhea (27%), with 8 (36%) reporting symptoms that interfered with or prevented daily activities. Four (33%) symptomatic cases reported receiving medical care outside of a medical provider at an isolation facility. Of 44 controls, 12 (27%) reported any symptoms day 90 + . Risk of any symptoms at follow-up was 5.4 times higher among COVID-19 cases compared to controls (95% CI: 2.7–10.5).

Conclusions

Shelter residents reported a high prevalence of symptoms 30 + days after their SARS-CoV-2 detection, though few accessed medical care for persistent illness. The impact of COVID-19 extends beyond acute illness and may exacerbate existing challenges that marginalized populations face in maintaining their health and wellbeing.
Pathogenic bacteria recovered from Gene X-pert tuberculosis-negative adult patients in Gondar, Northwest Ethiopia
Authors: Yohannes Hana , Belachew Teshome , Assefa Muluneh , Getaneh Eden , Zeray Haymanot , Kegne Asamirew , Angawu Samre , Belay Gizeaddis , Biset Sirak , Tigabu Abiye
Published: June 2023

Introduction

Lower respiratory tract infections (LRTIs) caused by drug-resistant pathogenic bacteria is a major problem in developing countries including Ethiopia. Therefore, this study aimed to determine the pathogenic bacteria and their antimicrobial susceptibility patterns among Gene X-pert tuberculosis-negative adult patients with clinically suspected LRTIs at the University of Gondar Comprehensive Specialized Referral Hospital, Gondar, Northwest Ethiopia.

Methods

This institutional-based cross-sectional study was conducted from February 01 to March 15, 2020. Socio-demographic data were collected by using a structured questionnaire. A total of 254 sputum specimens were collected from Gene X-pert tuberculosis-negative patients. Bacterial recovery was performed using blood, chocolate, and MacConkey agar plates. Bacterial isolates were identified based on Gram staining, colony characteristics, and biochemical reactions. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method. Methicillin resistance of S. aureus was confirmed using cefoxitin (30 µg). Descriptive statistics were calculated for each variable and results are shown in tables and figures.

Results

In this study, the overall sputum culture positivity rate was 145/254 (57.1%). Gram-negative bacteria 111 (64.9%) were predominant compared to Gram-positive bacteria 60 (35.1%). Of the 145 culture-positive cases, 26 (14.8%) had poly-bacterial infections. S. aureus 40 (66.7%) was the predominant Gram-positive bacterium whereas K. pneumoniae 33 (29.7%), was the most isolated Gram-negative bacterium. Bacterial species, such as S. aureus were sensitive to ciprofloxacin 38/40 (95.0%), gentamicin 37/40 (92.5%), cefoxitin 36/40 (90.0%), and clindamycin 34/40 (85.0%). The proportion of Methicillin-resistant S. aureus was low, 4(10.0%). S. pneumoniae was sensitive to chloramphenicol 8/9 (88.9%) and resistant to ciprofloxacin 6/9 (66.7%). K pneumoniae, P. aeruginosa, E. coli, Serratia species, and H. influenzae also demonstrated high levels of resistance to ampicillin at rates of 21/33 (63.6%), 8/8 (100.0%), 15/17 (88.2%), 7/10 (70.0%), and 6/6 (100.0%), respectively.

Conclusion

This study revealed a higher burden of Gram-negative and Gram-positive pathogenic bacterial agents, which is responsible for LRTs. Therefore, routine sputum culture identification and antibiotic susceptibility testing should be performed in Gene X-pert tuberculosis-negative patients.
Co-inhibition of TIGIT and PD-1/PD-L1 in Cancer Immunotherapy: Mechanisms and Clinical Trials
Authors: Chu Xianjing , Tian Wentao , Wang Ziqi , Zhang Jing , Zhou Rongrong
Published: June 2023

Over the past decade, immune checkpoint inhibitors (ICIs) have emerged as a revolutionary cancer treatment modality, offering long-lasting responses and survival benefits for a substantial number of cancer patients. However, the response rates to ICIs vary significantly among individuals and cancer types, with a notable proportion of patients exhibiting resistance or showing no response. Therefore, dual ICI combination therapy has been proposed as a potential strategy to address these challenges. One of the targets is TIGIT, an inhibitory receptor associated with T-cell exhaustion. TIGIT has diverse immunosuppressive effects on the cancer immunity cycle, including the inhibition of natural killer cell effector function, suppression of dendritic cell maturation, promotion of macrophage polarization to the M2 phenotype, and differentiation of T cells to regulatory T cells. Furthermore, TIGIT is linked with PD-1 expression, and it can synergize with PD-1/PD-L1 blockade to enhance tumor rejection. Preclinical studies have demonstrated the potential benefits of co-inhibition of TIGIT and PD-1/PD-L1 in enhancing anti-tumor immunity and improving treatment outcomes in several cancer types. Several clinical trials are underway to evaluate the safety and efficacy of TIGIT and PD-1/PD-L1 co-inhibition in various cancer types, and the results are awaited. This review provides an overview of the mechanisms of TIGIT and PD-1/PD-L1 co-inhibition in anti-tumor treatment, summarizes the latest clinical trials investigating this combination therapy, and discusses its prospects. Overall, co-inhibition of TIGIT and PD-1/PD-L1 represents a promising therapeutic approach for cancer treatment that has the potential to improve the outcomes of cancer patients treated with ICIs.
Meeting report: International Symposium on Mitochondria, Cell Death and Human Diseases: Jawaharlal Nehru University, New Delhi, India, February 18–19, 2023
Authors: Singh Rana P. , Birge Raymond B. , Chandra Dhyan
Published: June 2023

The School of Life Sciences at the Jawaharlal Nehru University in New Delhi, India held an International Symposium on Mitochondria, Cell Death and Human Diseases on February 18–19, 2023. The meeting provided a highly interactive forum for scientific discussion, cultural exchange, and collaborations between international scientists working in diverse areas of mitochondrial biology, cell death, and cancer. The two-day symposium attracted more than 180 delegates that included leading international scientists, early career researchers in India, as well as postdoctoral fellows and students. Several of the students, postdoctoral fellows, and junior faculty presented platform talks and had a chance to showcase the depth and emerging progress in biomedical research in India. The meeting will be instrumental for planning future congresses and symposium throughout India, not only to focus on mitochondrial biology, cell death and cancer but to foster continued ferment and collaborations in the biological sciences throughout India.
Translation of the mental health literacy questionnaire for young adults into Chichewa for use in Malawi: preliminary validation and reliability results
Authors: Jumbe Sandra , Nyali Joel , Newby Chris
Published: June 2023

Background

Mental Health Literacy (MHL) is the ability to recognise mental disorders, have knowledge of professional help available, effective self-help strategies, skills to give support to others, and knowledge of how to prevent mental disorders. Sufficient MHL is linked to better help seeking behaviour and management of mental illness. Assessing MHL importantly helps identify knowledge gaps and inaccurate beliefs about mental health issues, whilst informing development and better evaluation of MHL interventions. This study aimed to translate the English version of a self-reporting Mental Health Literacy questionnaire (MHLq) for young adult populations (16–30 years-old) into Chichewa for use in Malawi and evaluate the psychometric properties of this Chichewa version.

Methods

An established translation methodology was employed, involving back-translation, comparison, forward-translation, comparison, and piloting. The translated Chichewa questionnaire was initially piloted with 14 young adults in a Malawi university, then subsequently administered to 132 young adults in rural community settings across Malawi.

Results

Overall internal consistency of the Chichewa translated MHLq was good (Cronbach’s alpha = 0.67) although subscales’ scores ranged from acceptable (factor 1 and 3) to unacceptable (factor 2 and 4). Confirmatory factor analysis found Factor 1 (Knowledge of mental health problems), Factor 3 (First aid skills and help seeking behaviour) and Factor 4 (Self-help strategies) of the Chichewa version fit very well with related factors of the original English MHLq. For Factor 2 (Erroneous beliefs/stereotypes), 5 out of its 8 items correlated well with the original version. This suggests a four-factor solution is a reasonably good fit to the data.

Conclusions

Use of the Malawian MHLq among Chichewa speaking young adult populations is well supported for factors 1 and 3 but not for factors 2 and 4. More psychometric testing with a larger sample is vital to further validate the questionnaire. Further research is needed to carry out test/re-test reliability statistics.
The impact of gender medicine on neonatology: the disadvantage of being male: a narrative review
Authors: Migliori Claudio , Braga Marta , Siragusa Virginia , Villa Maria Cristina , Luzi Livio
Published: June 2023

This narrative non-systematic review addresses the sex-specific differences observed both in prenatal period and, subsequently, in early childhood. Indeed, gender influences the type of birth and related complications. The risk of preterm birth, perinatal diseases, and differences on efficacy for pharmacological and non-pharmacological therapies, as well as prevention programs, will be evaluated. Although male newborns get more disadvantages, the physiological changes during growth and factors like social, demographic, and behavioural reverse this prevalence for some diseases. Therefore, given the primary role of genetics in gender differences, further studies specifically targeted neonatal sex-differences will be needed to streamline medical care and improve prevention programs.
Hospitalization for bronchiolitis in children aged ≤ 1year, Southern Italy, year 2021: need for new preventive strategies?
Authors: Baldassarre Maria Elisabetta , Loconsole Daniela , Centrone Francesca , Caselli Desiree , Martire Baldassarre , Quartulli Lorenzo , Acquafredda Angelo , D’Amato Gabriele , Maffei Gianfranco , Latorre Giuseppe , Riganti Anita , Di Noia Michele , Chironna Maria , Laforgia Nicola
Published: June 2023

Background

Bronchiolitis is a major cause of hospitalization in infants, particularly in the first six months of life, with approximately 60–80% of admissions due to respiratory syncytial virus (RSV) infection. Currently, no prophylactic options are available for healthy infants. The present study aimed at describing the demographic, clinical, and epidemiological characteristics of infants hospitalized for bronchiolitis in the Apulia region of Italy in 2021.

Methods

From January to December 2021, data on children aged 0–12 months admitted for bronchiolitis in nine neonatal or pediatric units covering 61% of pediatric beds of hospitals in the Apulia region of Italy were analyzed. Demographic data, comorbidities, need for oxygen support, length of hospital stay, palivizumab administration, and outcomes were collected. For the purpose of the analysis, patients were divided into those aged 0–3 months and > 3 months. A multivariate logistic regression model was used to explore associations between the need for oxygen support and sex, age, comorbidities, history of prematurity, length of hospital stay, and palivizumab administration.

Results

This study included 349 children aged 0–12 months admitted for bronchiolitis, with a peak of hospitalization in November (7.4 cases/1,000 children). Of these patients, 70.5% were RSV positive, 80.2% were aged 0–3 months, and 73.1% required oxygen support. Moreover, 34.9% required observation in the sub-intensive care unit, and 12.9% in the intensive care unit. Of the infants who required intensive care, 96.9% were aged 0–3 months and 78.8% were born at term. Three patients required mechanical ventilation and one, who required Extra Corporeal Membrane Oxygenation, died. Children aged 0–3 months were more likely to show dyspnea, need oxygen support, and have a longer hospital stay.

Conclusions

The present study showed that almost all of the children who required intensive care support were aged ≤ 3 months and most were born at term. Therefore, this age group remains the highest risk group for severe bronchiolitis. Preventive measures such as single-dose monoclonal antibody immunoprophylaxis, and maternal and childhood vaccination against RSV, may reduce the high public health burden of bronchiolitis.
Mechanical ventilation in patients with acute brain injury: a systematic review with meta-analysis
Authors: Asehnoune Karim , Rooze Paul , Robba Chiara , Bouras Marwan , Mascia Luciana , Cinotti Raphaël , Pelosi Paolo , Roquilly Antoine
Published: June 2023

Objective

To describe the potential effects of ventilatory strategies on the outcome of acute brain-injured patients undergoing invasive mechanical ventilation.

Design

Systematic review with an individual data meta-analysis.

Setting

Observational and interventional (before/after) studies published up to August 22nd, 2022, were considered for inclusion. We investigated the effects of low tidal volume Vt < 8 ml/Kg of IBW versus Vt >  = 8 ml/Kg of IBW, positive end-expiratory pressure (PEEP) < or >  = 5 cmH2O and protective ventilation (association of both) on relevant clinical outcomes.

Population

Patients with acute brain injury (trauma or haemorrhagic stroke) with invasive mechanical ventilation for ≥ 24 h.

Main outcome measures

The primary outcome was mortality at 28 days or in-hospital mortality. Secondary outcomes were the incidence of acute respiratory distress syndrome (ARDS), the duration of mechanical ventilation and the partial pressure of oxygen (PaO2)/fraction of inspired oxygen (FiO2) ratio.

Results

The meta-analysis included eight studies with a total of 5639 patients. There was no difference in mortality between low and high tidal volume [Odds Ratio, OR 0.88 (95%Confidence Interval, CI 0.74 to 1.05), p = 0.16, I2 = 20%], low and moderate to high PEEP [OR 0.8 (95% CI 0.59 to 1.07), p = 0.13, I2 = 80%] or protective and non-protective ventilation [OR 1.03 (95% CI 0.93 to 1.15), p = 0.6, I2 = 11]. Low tidal volume [OR 0.74 (95% CI 0.45 to 1.21, p = 0.23, I2 = 88%], moderate PEEP [OR 0.98 (95% CI 0.76 to 1.26), p = 0.9, I2 = 21%] or protective ventilation [OR 1.22 (95% CI 0.94 to 1.58), p = 0.13, I2 = 22%] did not affect the incidence of acute respiratory distress syndrome. Protective ventilation improved the PaO2/FiO2 ratio in the first five days of mechanical ventilation (p < 0.01).

Conclusions

Low tidal volume, moderate to high PEEP, or protective ventilation were not associated with mortality and lower incidence of ARDS in patients with acute brain injury undergoing invasive mechanical ventilation. However, protective ventilation improved oxygenation and could be safely considered in this setting. The exact role of ventilatory management on the outcome of patients with a severe brain injury needs to be more accurately delineated.
Improvement of synaptic plasticity and cognitive function in RASopathies—a monocentre, randomized, double-blind, parallel-group, placebo-controlled, cross-over clinical trial (SynCoRAS)
Authors: Jung Nikolai H. , Egert-Schwender Silvia , Schossow Beate , Kehl Victoria , Wahlländer Ute , Brich Louisa , Janke Viktoria , Blankenstein Christiane , Zenker Martin , Mall Volker
Published: June 2023

Background

Cognitive impairment is a common medical issue in rat sarcoma (RAS) pathway disorders, so-called RASopathies, like Neurofibromatosis type 1 (NF1) or Noonan syndrome (NS). It is presumed to be caused by impaired synaptic plasticity. In animal studies, pathway-specific pharmacological interventions with lovastatin (LOV) and lamotrigine (LTG) have been shown to improve synaptic plasticity as well as cognitive function. The aim of this clinical trial is to translate the findings of animal studies to humans and to probe the effect of lovastatin (NS) and lamotrigine (NS and NF1) on synaptic plasticity and cognitive function/alertness in RASopathies.

Methods

Within this phase IIa, monocentre, randomized, double-blind, parallel-group, placebo-controlled, cross-over clinical trial (syn. SynCoRAS), three approaches (approaches I–III) will be carried out. In patients with NS, the effect of LTG (approach I) and of LOV (approach II) is investigated on synaptic plasticity and alertness. LTG is tested in patients with NF1 (approach III). Trial participants receive a single dose of 300 mg LTG or placebo (I and III) and 200 mg LOV or placebo (II) daily for 4 days with a cross-over after at least 7 days. Synaptic plasticity is investigated using a repetitive high-frequency transcranial magnetic stimulation (TMS) protocol called quadri-pulse theta burst stimulation (qTBS). Attention is examined by using the test of attentional performance (TAP). Twenty-eight patients are randomized in groups NS and NF1 with n = 24 intended to reach the primary endpoint (change in synaptic plasticity). Secondary endpoints are attention (TAP) and differences in short interval cortical inhibition (SICI) between placebo and trial medication (LTG and LOV).

Discussion

The study is targeting impairments in synaptic plasticity and cognitive impairment, one of the main health problems of patients with RASopathies. Recent first results with LOV in patients with NF1 have shown an improvement in synaptic plasticity and cognition. Within this clinical trial, it is investigated if these findings can be transferred to patients with NS. LTG is most likely a more effective and promising substance improving synaptic plasticity and, consecutively, cognitive function. It is expected that both substances are improving synaptic plasticity as well as alertness. Changes in alertness may be a precondition for improvement of cognition.

Trial registration

The clinical trial is registered in ClinicalTrials.gov (NCT03504501; https://www.clinicaltrials.gov; date of registration: 04/11/2018) and in EudraCT (number 2016–005022-10).
Exploring the potential role of defensins in differential vector competence of body and head lice for Bartonella quintana
Authors: Yoon Kyungjae Andrew , Lee Do Eun , Lee Si Hyeock , Kim Ju Hyeon
Published: June 2023

Background

The body and head lice of humans are conspecific, but only the body louse functions as a vector to transmit bacterial pathogens such as Bartonella quintana. Both louse subspecies have only two antimicrobial peptides, defensin 1 and defensin 2. Consequently, any differences in the molecular and functional properties of these two louse subspecies may be responsible for the differential vector competence between them.

Methods

To elucidate the molecular basis of vector competence, we compared differences in the structural properties and transcription factor/microRNA binding sites of the two defensins in body and head lice. Antimicrobial activity spectra were also investigated using recombinant louse defensins expressed via baculovirus.

Results

The full-length amino acid sequences of defensin 1 were identical in both subspecies, whereas the two amino acid residues in defensin 2 were different between the two subspecies. Recombinant louse defensins showed antimicrobial activities only against the representative Gram-positive Staphylococcus aureus but not against either Gram-negative Escherichia coli or the yeast Candida albicans. However, they did show considerable activity against B. quintana, with body louse defensin 2 being significantly less potent than head louse defensin 2. Regulatory sequence analysis revealed that the gene units of both defensin 1 and defensin 2 in body lice possess decreased numbers of transcription factor-binding sites but increased numbers of microRNA binding sites, suggesting relatively lower transcription activities of body louse defensins.

Conclusions

The significantly lower antibacterial activities of defensin 2 along with the reduced probability of defensin expression in body lice likely contribute to the relaxed immune response to B. quintana proliferation and viability, resulting in higher vector competence of body lice compared to head lice.

Graphical Abstract