bluuebunny/crossref_metadata_2025 huggingface dataset:
Retinal Detachment Associated With Giant Retinal Tears: Surgical Management and Outcomes in the Past 2 Decades
Authors: San Martín Varela José Antonio , Gallegos Morales Manuel Andrés , Verdaguer Díaz Juan Ignacio , Zacharias Santamaría Sergio Javier , Carpentier Giglio Cristián Andrés , Filsecker López Luis Hernán , Ibañez Langlois Santiago , López Astaburuaga José Manuel , Orellana Ríos Jorge Andrés , Pérez Argandoña Efraín Alonso , Ried Undurraga José Miguel
Published: April 2023

Purpose: To describe the surgical outcomes of rhegmatogenous retinal detachments (RRDs) associated with giant retinal tears (GRTs) and define factors associated with primary anatomic failure. Methods: This retrospective consecutive study comprised primary GRT-RRD surgeries between 1999 and 2021 at a single institution. Exclusion criteria were a follow-up of less than 3 months and incomplete surgical data. Results: The series included 69 eyes (64 patients). Single-surgery anatomic success (SSAS) was achieved in 75% and final anatomic success (FAS) in 90%. The mean logMAR visual acuity improved from 1.5 ± 1.1 to 0.6 ± 0.9. Preoperative factors significantly associated with redetachment were proliferative vitreoretinopathy (PVR) (odds ratio [OR], 6.2; P < .01), hypotony (OR, 13.6; P < .01), and a 180-degree or larger GRT (OR, 3.3; P = .04). All cases were treated with pars plana vitrectomy (PPV) and perfluoro-N-octane (PFCL). Perfluoropropane (C3F8) was used in 59% and silicone oil in 41%; the redetachment rate was significantly lower in gas cases (15% vs 39%) ( P = .02). An encircling band, placed in 84% eyes, had a tendency to reduce redetachment (22% vs 36%) ( P = .32). Lensectomy was performed in 61% of phakic eyes, with no effect on redetachment (20% vs 21%) ( P = .92). On multivariate analysis, PVR and hypotony were significantly associated with redetachment. Conclusions: PPV with PFCL achieved high SSAS and FAS rates. PVR and hypotony were the main preoperative factors associated with anatomic failure. In cases without PVR, C3F8 tamponade significantly increased SSAS. Encircling scleral buckling showed a nonsignificant tendency toward an increase in SSAS. Lensectomy had no effect on SSAS.
Unusual Post-operative Surgical Site Infection with Corynebacterium striatum in Oral Submucous Fibrosis: A Case Report
Authors: Chauhan Nishtha , Singh Akhilesh Kumar , Sharma Naresh Kumar , Mahajan Arjun
Published: April 2023

Corynebacterium striatum is considered to be notoriously associated with multidrug resistant nosocomial infections with high mortality. This article encases an unusual case of C. striatum associated postoperative surgical site infection in post-operative case of oral submucous fibrosis. The prognosis depends majorly on meticulous debridement and regular dressing with concomitant anti-microbials. Patient factors such as immunodeficiency and debilitating comorbidities contribute equally to final outcome.
Qualitative Analysis of Coping Strategies Among Older Persons During COVID-19 Lockdown in Nigeria: Considerations for Community Health Promotion
Authors: Adedeji Isaac A. , Lawal Saheed Akinmayowa , Aluko-Arowolo Sola
Published: April 2023

Background: The challenge of COVID-19 and the disease control restrictions in Nigeria directly affected social life. Older adults were disproportionately affected because of social vulnerabilities, socio-economic dependency, and the high risk of COVID-19 infectious disease in the population.Purpose: To this end, the study explored the instrumental coping strategies of older adults duirng the COVID-19 lockdown in Nigeria.

Research Design: An exploratory research design using qualitative approach based on in-depth interviews was adopted.

Study Sample: Twenty-seven (27) older adults aged 60 years and more in Ibadan, Nigeria were purposively selected for participation in the research.

Data Collection and/or Analysis: Community living older adults participated in in-depth telephone interviews during the COVID-19 restrictions. Using Atlas ti 8.4, the 27 transcripts were analyzed and validated through content analysis.

Results: Older adults coped with fear, anxiety, depression, and other health challenges, and three major themes emerged as problem-focused coping strategies. Older adults explored spirituality, engaged in their social networks through telephones, and focused on a healthy diet and physical activities.

Conclusions: Community health promotion strategies for older adults should explore the identified problem-focused coping strategies to optimize the health and wellbeing of older adults.
Seismic performance of soil–tunnel–building systems in stiff soils
Authors: Mayoral Juan M , Alcaraz Mauricio , Tepalcapa Simón
Published: April 2023

In order to study seismic soil–tunnel–building interaction in stiff soils, a metro station currently under construction, located near by a 5-story masonry building, was selected as a test site for seismic instrumentation. The site is in Mexico City, in the so-called hill zone, where very cemented sandy silt and silty sands can be found. An arrangement of five accelerometers were deployed, to assess free-field, near-field, and building seismic response. This article presents the results gathered from the seismic instrumentation after recording five low- to high-magnitude earthquakes (i.e. ranging from 4.8 to 7.7 Mw) from both interface and intraplate events. The results clearly indicate that even in low- to medium-magnitude events, the presence of the tunnel leads to peak ground acceleration (PGA) amplification both in the horizontal and vertical components, ground motion incoherence, and spectral accelerations (Sa) amplification at high frequencies. Although Sa amplification is more important for intraplate and interface low- to medium-magnitude events, frequency content modification occurs regardless of the earthquake magnitude. These facts must be accounted for when designing low- to medium-rise structures underlaid or nearby underground infrastructure such as tunnels in highly populated urban areas.
Voices of a Rural Community: How to Sustain and Improve Work Experiences for Youth with Disabilities
Authors: Mahiko Joy
Published: April 2023

The purpose of this study was to develop an understanding of how work experiences in rural Hawai’ian communities can be sustained and improved for youth with disabilities. Employing a basic qualitative research design, this study captured the perspectives of rural community members who provided work experiences for youth with disabilities. Data analysis revealed key factors to sustain work experience partnerships between schools and community members: (a) effective communication, (b) competent personnel, and (c) the dispositions of students. The findings also revealed that there were missed opportunities for youth with disabilities during their work experiences because schools did not fully disclose the work needs and goals of students. The community members and their work sites could have been more effective if disability training and support was provided. The findings provide valuable insight into how work experiences can be sustained and improved for rural youth with disabilities.
A new approach to using Diffusive Gradient in Thin-films (DGT) labile concentration for Water Framework Directive chemical status assessment: adaptation of Environmental Quality Standard to DGT for cadmium, nickel and lead
Authors: Amouroux Isabelle , Gonzalez Jean-Louis , Guesdon Stephane , Belzunce-Segarra María Jesús , Bersuder Philippe , Bolam Thi , Caetano Miguel , Correia Dos Santos Margarida , Larreta Joana , Lebrun Luc , Marras Barbara , Millán Gabet Vanessa , McHugh Brendan , Menchaca Iratxe , Menet-Nédélec Florence , Montero Natalia , Perceval Olivier , Pierre-Duplessix Olivier , Regan Fiona , Rodríguez Jose Germán , Rodrigo Sanz Marta , Schintu Marco , White Blánaid , Zhang Hao
Published: April 2023

Integrative passive samplers, such as DGT (Diffusive Gradients in Thin-films), are identified in European Technical Guidance Documents as promising tools to improve the quality of the assessment, in the context of the WFD (EU Water Framework Directive). However, DGT results cannot yet be used directly in a regulatory framework to assess the chemical status of water bodies, as DGT labile concentrations cannot be directly compared to the metal AA-EQSmarine water (Annual Average Environmental Quality Standard) established by the WFD, which are defined in the dissolved concentration. Therefore, prior to using DGT results in a regulatory context, for cadmium, nickel and lead, an adaptation of existing AA-EQSmarine water for DGTs should be pursued, ensuring at least the same level of protection. In this sense, in the framework of the MONITOOL project, a robust database of dissolved and labile metal concentrations in transitional and coastal waters, for adapting the existing AA-EQSmarine water for DGT technique, was obtained. Building on these results, this study proposes a methodology and provides values and equations for using DGT results for the chemical status assessment of marine waters, by adapting the EQSmarine water to adapted EQSDGT or predicting dissolved concentrations from DGT results. Based on available dataset, a first simulation of “chemical status” assessment per MONITOOL sampling site using DGT measured labile concentrations was carried out and the results were compared to an assessment based on dissolved concentration to check their compliance. These results demonstrate that the use of DGT passive samplers is appropriate for the metal concentrations level encountered in the marine environment. Further work is recommended to test the effectiveness of the methodology proposed in this study under WFD conditions on more sites and to establish common strategy guidelines for the use of DGT passive samplers in monitoring.
Heat-killed Lacticaseibacillus paracasei GMNL-653 ameliorates human scalp health by regulating scalp microbiome
Authors: Tsai Wen-Hua , Fang Yi-Ting , Huang Tsuei-Yin , Chiang Ying-Ju , Lin Ching-Gong , Chang Wen-Wei
Published: April 2023

Background

The equilibrium of the scalp microbiome is important for maintaining healthy scalp conditions, including sebum secretion, dandruff, and hair growth. Many different strategies to improve scalp health have been reported; however, the effect of postbiotics, such as heat-killed probiotics, on scalp health remains unclear. We examined the beneficial effects of heat-killed probiotics consisting of Lacticaseibacillus paracasei, GMNL-653, on scalp health.

Results

Heat-killed GMNL-653 could co-aggregate with scalp commensal fungi, Malassezia furfur, in vitro, and the GMNL-653-derived lipoteichoic acid inhibited the biofilm formation of M. furfur on Hs68 fibroblast cells. The mRNA of hair follicle growth factors, including insulin-like growth factor-1 receptor (IGF-1R), vascular endothelial growth factor, IGF-1, and keratinocyte growth factor was up-regulated in skin-related human cell lines Hs68 and HaCaT after treatment with heat-killed GMNL-653. For clinical observations, we recruited 22 volunteer participants to use the shampoo containing the heat-killed GMNL-653 for 5 months and subsequently measured their scalp conditions, including sebum secretion, dandruff formation, and hair growth. We applied polymerase chain reaction (PCR) to detect the scalp microbiota of M. restricta, M. globosa, Cutibacterium acnes, and Staphylococcus epidermidis. A decrease in dandruff and oil secretion and an increase in hair growth in the human scalp were observed after the use of heat-killed GMNL-653-containing shampoo. The increased abundance of M. globosa and the decreased abundance of M. restricta and C. acnes were also observed. We further found that accumulated L. paracasei abundance was positively correlated with M. globosa abundance and negatively correlated with C. acnes abundance. S. epidermidis and C. acnes abundance was negatively correlated with M. globosa abundance and positively correlated with M. restricta. Meanwhile, M. globosa and M. restricta abundances were negatively associated with each other. C. acnes and S. epidermidis abundances were statistically positively correlated with sebum secretion and dandruff, respectively, in our shampoo clinical trial.

Conclusion

Our study provides a new strategy for human scalp health care using the heat-killed probiotics GMNL-653-containing shampoo. The mechanism may be correlated with the microbiota shift.
Myocardial function including estimates of myocardial work in young adults born very preterm or with extremely low birthweight - a cohort study
Authors: Engan Britt , Omdal Tom R. , Greve Gottfried , Vollsaeter Maria , Leirgul Elisabeth
Published: April 2023

Background

Preterm birth and low birthweight have been associated with increased risk of heart failure and cardiovascular disease in young adulthood. However, results from clinical studies of myocardial function are not consistent. Echocardiographic strain analyses allow detection of early stages of cardiac dysfunction, and non-invasive estimates of myocardial work can provide additional information on cardiac function. We aimed to evaluate left ventricular (LV) myocardial function including measures of myocardial work in young adults born very preterm (gestational age < 29 weeks) or with extremely low birthweight (< 1000 g) (PB/ELBW), compared with term-born age- and sex matched controls.

Methods

63 PB/ELBW and 64 controls born in Norway in the periods 1982–1985, 1991–1992, and 1999–2000 were examined with echocardiography. LV ejection fraction (EF) and LV global longitudinal strain (GLS) were measured. Myocardial work was estimated from LV pressure-strain loops after determination of GLS and construction of a LV pressure curve. Diastolic function was evaluated by determination of the presence or absence of elevated LV filling pressure, including measures of left atrial longitudinal strain.

Results

The PB/ELBW with mean birthweight 945 (standard deviation (SD) 217) grams, mean gestational age 27 (SD 2) weeks, and mean age 27 (SD 6) years had LV systolic function mainly within normal range. Only 6% had EF < 50% or impaired GLS >-16%, but 22% had borderline impaired GLS between − 16% and − 18%. Mean GLS in PB/ELBW (-19.4% (95% confidence interval (CI) -20.0, -18.9)) was impaired compared to controls (-20.6% (95% CI -21.1, -20.1)), p = 0.003. Lower birthweight was associated to more impaired GLS (Pearson correlation coefficient − 0.2). Means of EF, measures of diastolic function including left atrial reservoir strain, global constructive and wasted work, global work index and global work efficiency was similar in PB/ELBW and controls.

Conclusion

The young adults born very preterm or with extremely low birthweight had impaired LV-GLS compared to controls, although systolic function mainly within normal range. Lower birthweight was associated with more impaired LV-GLS. These findings could indicate an elevated lifetime risk of developing heart failure in preterm born individuals. Measures of diastolic function and myocardial work were similar compared to controls.
Expanding the role of PSMA PET in active surveillance
Authors: Jain Anika , Nassour Anthony-Joe , Dean Thomas , Patterson Imogen , Tarlinton Lisa , Kim Lawrence , Woo Henry
Published: April 2023

Introduction

Accurate grading at the time of diagnosis is fundamental to risk stratification and treatment decision making, particularly for men being considered for Active Surveillance (AS). With the introduction of prostate-specific membrane antigen (PSMA) positron emission tomography (PET) there has been considerable improvement in sensitivity and specificity for the detection and staging of clinically significant prostate cancer. Our study aims to determine the role of PSMA PET/CT in men with newly diagnosed low or favourable intermediate risk prostate cancer to better select men for AS.

Method

This is a retrospective single centre study performed from January 2019 and October 2022. This study includes men identified from electronic medical record system who had undergone a PSMA PET/CT following newly diagnosed low or favourable-intermediate risk prostate cancer. Primary outcome was to assess the change in management for men being considered for AS following PSMA PET/CT results on the basis of PSMA PET characteristics.

Results

In total, there were 11 of 30 men (36.67%) who were assigned management by AS and 19 of 30 men (63.33%) who had definitive treatment. 15 of the 19 men that needed treatment had concerning features on PSMA PET/CT results. Of the 15 men with concerning features on PSMA PET, 9 (60%) men were found to have adverse pathological features on final prostatectomy features.

Conclusion

This retrospective study suggests that PSMA PET/CT has potential to influence the management of men with newly diagnosed prostate cancer that would otherwise be appropriate for active surveillance.
Effect of hospital assignment on mortality for AMI patients
Authors: Grøsland Mari , Telle Kjetil E. , Øien Henning
Published: April 2023

Background

International guidelines recommend percutaneous coronary intervention (PCI) to treat acute myocardial infarction (AMI) if PCI can be performed within two hours. PCI is a centralized treatment, and therefore a common trade-off is whether to send AMI patients directly to a hospital that performs PCI, or postpone a potential PCI-treatment by first receiving acute treatment at a local hospital that can not perform PCI. In this paper, we estimate the effect of sending patients directly to a PCI-hospital on AMI mortality.

Methods

Using nation-wide individual-level data from 2010 to 2015, we studied mortality rates for AMI patients sent directly to a hospital that performs PCI (N=20 336) compared to AMI patients sent to a hospital not performing PCI (N=33 437). Since the underlying health of patients may affect both hospital assignment and mortality, estimates from traditional multivariate risk adjustment models are likely biased. We therefore apply an instrumental variable (IV) model using the historical municipal share sent directly to a PCI-hospital as an instrument for being sent directly to a PCI-hospital.

Results

Patients sent directly to a PCI-hospital are younger and have fewer comorbidities than patients who are first sent to a non-PCI-hospital. IV results suggest that those initially sent to PCI-hospitals have 4.8 percentage points decrease (95% CI (- 18.1)-8.5) in mortality after one month compared to those initially sent to non-PCI-hospitals.

Conclusion

Our IV results suggest that there is a non-significant decrease in mortality for AMI patients sent directly to a PCI hospital. The estimates are too imprecise to conclude that health personnel should change their practice and send more patients directly to a PCI-hospital. Moreover, the results may be taken to suggest that health personnel navigate AMI patients to the best treatment option.
Extremes of both weight gain and weight loss are associated with increased incidence of heart failure and cardiovascular death: evidence from the CANVAS Program and CREDENCE
Authors: Ferrannini Giulia , Pollock Carol , Natali Andrea , Yavin Yshai , Mahaffey Kenneth W. , Ferrannini Ele
Published: April 2023

Background

Obesity is an independent risk factor for cardiovascular disease (CVD) in patients with type 2 diabetes (T2D). However, it is not known to what extent weight fluctuations might be associated with adverse outcomes. We aimed at assessing the associations between extreme weight changes and cardiovascular outcomes in two large randomised controlled trials of canagliflozin in patients with T2D and high cardiovascular (CV) risk.

Methods

In the study populations of the CANVAS Program and CREDENCE trials, weight change was evaluated between randomization and week 52–78, defining subjects in the top 10% of the entire distribution of weight changes as gainers, subjects in the bottom 10% as losers and the remainder as stable. Univariate and multivariate Cox proportional hazards models were used to test the associations between weight changes categories, randomised treatment and covariates with heart failure hospitalisation (hHF) and the composite of hHF and CV death.

Results

Median weight gain was 4.5 kg in gainers and median weight loss was 8.5 kg in losers. The clinical phenotype of gainers as well as that of losers were similar to that of stable subjects. Weight change within each category was only slightly larger with canagliflozin than placebo. In both trials, gainers and losers had a higher risk of hHF and of hHF/CV death compared with stable at univariate analysis. In CANVAS, this association was still significant by multivariate analysis for hHF/CV death in both gainers and losers vs. stable (hazard ratio – HR 1.61 [95% confidence interval - CI: 1.20–2.16] and 1.53 [95% CI 1.14–2.03] respectively). Results were similar in CREDENCE for gainers vs. stable (adjusted HR for hHF/CV death 1.62 [95% CI 1.19–2.16])

Conclusions

Extremes of weight gain or loss were independently associated with a higher risk of the composite of hHF and CV death. In patients with T2D and high CV risk, large changes in body weight should be carefully assessed in view of individualised management.

Trials registration

CANVAS ClinicalTrials.gov number: NCT01032629. CREDENCE ClinicalTrials.gov number: NCT02065791
Serum triglyceride glucose index is a valuable predictor for visceral obesity in patients with type 2 diabetes: a cross-sectional study
Authors: Yang Qing , Xu Huichao , Zhang Hongli , Li Yanying , Chen Shuxiong , He Dongye , Yang Guangzhi , Ban Bo , Zhang Mei , Liu Fupeng
Published: April 2023

Background

Since the triglyceride glucose (TyG) index can reflect insulin resistance, it has been proven to be an efficient predictor of glycolipid-metabolism-related diseases. Therefore, this study aimed to investigate the predictive value of the TyG index for visceral obesity (VO) and body fat distribution in patients with type 2 diabetes mellitus (T2DM).

Methods

Abdominal adipose tissue characteristics in patients with T2DM, including visceral adipose area (VAA), subcutaneous adipose area (SAA), VAA-to-SAA ratio (VSR), visceral adipose density (VAD), and subcutaneous adipose density (SAD), were obtained through analyses of computed tomography images at the lumbar 2/3 level. VO was diagnosed according to the VAA (> 142 cm2 for males and > 115 cm2 for females). Logistic regression was performed to identify independent factors of VO, and receiver operating characteristic (ROC) curves were used to compare the diagnostic performance according to the area under the ROC curve (AUC).

Results

A total of 976 patients were included in this study. VO patients showed significantly higher TyG values than non-VO patients in males (9.74 vs. 8.88) and females (9.59 vs. 9.01). The TyG index showed significant positive correlations with VAA, SAA, and VSR and negative correlations with VAD and SAD. The TyG index was an independent factor for VO in both males (odds ratio [OR] = 2.997) and females (OR = 2.233). The TyG index ranked second to body mass index (BMI) for predicting VO in male (AUC = 0.770) and female patients (AUC = 0.720). Patients with higher BMI and TyG index values showed a significantly higher risk of VO than the other patients. TyG-BMI, the combination index of TyG and BMI, showed significantly higher predictive power than BMI for VO in male patients (AUC = 0.879 and 0.835, respectively) but showed no significance when compared with BMI in female patients (AUC = 0.865 and 0.835, respectively).

Conclusions

. TyG is a comprehensive indicator of adipose volume, density, and distribution in patients with T2DM and is a valuable predictor for VO in combination with anthropometric indices, such as BMI.
Circulating biosignatures in multiple myeloma and their role in multidrug resistance
Authors: Krishnan S. Rajeev , Bebawy M.
Published: April 2023

A major obstacle to chemotherapeutic success in cancer treatment is the development of drug resistance. This occurs when a tumour fails to reduce in size after treatment or when there is clinical relapse after an initial positive response to treatment. A unique and serious type of resistance is multidrug resistance (MDR). MDR causes the simultaneous cross resistance to unrelated drugs used in chemotherapy. MDR can be acquired through genetic alterations following drug exposure, or as discovered by us, through alternative pathways mediated by the transfer of functional MDR proteins and nucleic acids by extracellular vesicles (M Bebawy V Combes E Lee R Jaiswal J Gong A Bonhoure GE Grau, 23 9 1643 1649, 2009).

Multiple myeloma is an incurable cancer of bone marrow plasma cells. Treatment involves high dose combination chemotherapy and patient response is unpredictable and variable due to the presence of multisite clonal tumour infiltrates. This clonal heterogeneity can contribute to the development of MDR. There is currently no approved clinical test for the minimally invasive testing of MDR in myeloma.

Extracellular vesicles comprise a group of heterogeneous cell-derived membranous structures which include; exosomes, microparticles (microvesicles), migrasomes and apoptotic bodies. Extracellular vesicles serve an important role in cellular communication through the intercellular transfer of cellular protein, nucleic acid and lipid cargo. Of these, microparticles (MPs) originate from the cell plasma membrane and vary in size from 0.1-1um. We have previously shown that MPs confer MDR through the transfer of resistance proteins and nucleic acids. A test for the early detection of MDR would benefit clinical decision making, improve survival and support rational drug use. This review focuses on microparticles as novel clinical biomarkers for the detection of MDR in Myeloma and discusses their role in the therapeutic management of the disease.
The application of extracellular vesicles in colorectal cancer metastasis and drug resistance: recent advances and trends
Authors: Xiong Linjin , Wei Yumeng , Jia Qiang , Chen Jinglin , Chen Tao , Yuan Jiyuan , Pi Chao , Liu Huiyang , Tang Jia , Yin Suyu , Zuo Ying , Zhang Xiaomei , Liu Furong , Yang Hongru , Zhao Ling
Published: April 2023

Colorectal cancer (CRC) has high incidence and mortality rates and is one of the most common cancers of the digestive tract worldwide. Metastasis and drug resistance are the main causes of cancer treatment failure. Studies have recently suggested extracellular vesicles (EVs) as a novel mechanism for intercellular communication. They are vesicular particles, which are secreted and released into biological fluids, such as blood, urine, milk, etc., by a variety of cells and carry numerous biologically active molecules, including proteins, nucleic acids, lipids, metabolites, etc. EVs play a crucial part in the metastasis and drug resistance of CRC by delivering cargo to recipient cells and modulating their behavior. An in-depth exploration of EVs might facilitate a comprehensive understanding of the biological behavior of CRC metastasis and drug resistance, which might provide a basis for developing therapeutic strategies. Therefore, considering the specific biological properties of EVs, researchers have attempted to explore their potential as next-generation delivery systems. On the other hand, EVs have also been demonstrated as biomarkers for the prediction, diagnosis, and presumed prognosis of CRC. This review focuses on the role of EVs in regulating the metastasis and chemoresistance of CRC. Moreover, the clinical applications of EVs are also discussed.

Graphical Abstract
Anaplastic lymphoma kinase expression in PDGFRA-mutated gastrointestinal stromal tumors probably correlates with poor prognosis
Authors: Wu Ying , Gao Beibei , Xia Qin , Zhu Yili , Wang Na , Chang Xiaona , Huang Bo , Luo Danju , Zhang Jiwei , Zhang Peng , Shi Heshui , Fan Jun , Nie Xiu
Published: April 2023

Background

Anaplastic lymphoma kinase (ALK) overexpression and gene alterations have been detected in several mesenchymal tumors, with significant implications for diagnosis, therapy and prognosis. However, few studies have investigated the correlation between ALK expression status and clinicopathological characteristics in patients with gastrointestinal stromal tumors (GISTs).

Methods

A total of 506 GIST patients were enrolled. Sanger sequencing was employed to detect c-KIT and PDGFRA gene mutations. The tissue microarray (TMA) technique and immunohistochemistry were employed to identify the ALK (clone: 1A4 and D5F3) expression status in the tumor tissues. The ALK gene variants of IHC-positive cases were analyzed by fluorescence in situ hybridization (FISH) and next-generation sequencing (NGS). The clinicopathological data were analyzed using SPSS Statistics 26.0.

Results

Among the 506 GIST patients, the c-KIT mutation accounted for 84.2% (426/506), followed by PDGFRA mutation (10.3%, 52/506), while the wild-type accounted for the least (5.5%, 28/506). ALK-positive expression was detected in PDGFRA-mutant GISTs (7.7%, 4/52) but negative for c-KIT-mutant or wild-type GISTs by IHC. Four ALK IHC-positive patients were all male. The tumors all occurred outside the stomach. The predominant patterns of growth were epithelioid (2/4), spindle (1/4), and mixed type (1/4). They were all identified as high-risk classification according to the National Institutes of Health (NIH) classification. Aberrant ALK mutations were not identified by DNA-based NGS except in one of the 4 cases with amplification by FISH.

Conclusion

Our study revealed 7.7% (4/52) of ALK expression in PDGFRA-mutant GISTs, indicating that molecular tests were required to rule out the possibility of PDGFRA-mutant GISTs when encountering ALK-positive mesenchymal tumors with CD117-negative or weakly positive in immunohistochemical staining.
Time to postpartum family planning initiation and its predictors among mothers coming for first measles vaccination at Family Guidance Association of Ethiopia, Dessie Model Clinic, Northeast Ethiopia: cox-regression model
Authors: Adane Bezawit , Addisu Elsabeth , Yalew Melaku , Damtie Yitayish , Arefaynie Mastewal , Zewdie Segenet , Wasihun Yitbarek , Kefale Bereket
Published: April 2023

Background

Timing of initiation of family planning is an important determinant for the health status of the mother and her child. One-fourths of mothers in developing countries who wanted to space or limit their children were not using family planning methods at right time after delivery. Despite, the existence of many literatures about postpartum family planning, the timing of it is not yet studied. Thus, this study aimed to assess time to postpartum family planning and its predictors among mothers coming for first measles vaccination in Dessie city, Northeast Ethiopia.

Methods

An institutional-based retrospective follow-up study was conducted among mothers coming for infant vaccination at Family Guidance Association of Ethiopia, Dessie Model Clinic in Dessie City. A systematic sampling technique was used. The data were entered and analyzed using Epi Data version 3.1 and STATA version 14.0, respectively. Kaplan–Meier and Cox regression model were used to test the time and predictors of postpartum family planning initiation. Adjusted hazard ratio with 95% CI was used to test the strength of association at a p-value of 0.05.

Results

The rate of postpartum FP initiation was 0.6% with 95% CI  (0.0056, 0.0069). Keeping the effect of confounder constant, age of the women 20–24 [AHR = 2.63, 95% CI (1.65,4.19)], 25–29 [AHR = 3.66, 95% CI (2.35,5.73)], 30–34 [AHR = 2.79, 95% CI (1.75,4.46)], getting family planning counseling [AHR = 1.78, 95% CI (1.26, 2.52)], want more child [AHR = 0.47, 95% CI (0.34, 0.66)], having history of abortion [AHR = 0.54, 95% CI (0.36,0.81)] and wanted last pregnancy [AHR = 0.69, 95% CI (0.49, 0.97) were significantly associated with postpartum family planning initiation.

Conclusions

Age, history of abortion, counseling about family planning, the status of last pregnancy and want more child were significantly associated with postpartum family planning use. Continuous emphasis should be given for health care providers to encourage their counseling services for their customers at different age groups with special attention given for elders.
A high quality, high molecular weight DNA extraction method for PacBio HiFi genome sequencing of recalcitrant plants
Authors: Nishii Kanae , Möller Michael , Foster Robert G. , Forrest Laura L. , Kelso Nathan , Barber Sadie , Howard Caroline , Hart Michelle L.
Published: April 2023

Background

PacBio HiFi sequencing provides highly accurate long-read sequencing datasets which are of great advantage for whole genome sequencing projects. One limitation of the method is the requirement for high quality, high molecular weight input DNA. This can be particularly challenging for plants that frequently contain common and species-specific secondary metabolites, which often interfere with downstream processes. Cape Primroses (genus Streptocarpus), are some of these recalcitrant plants and are selected here as material to develop a high quality, high molecular weight DNA extraction protocol for long read genome sequencing.

Results

We developed a DNA extraction method for PacBio HiFi sequencing for Streptocarpus grandis and Streptocarpus kentaniensis. A CTAB lysis buffer was employed to avoid guanidine, and the traditional chloroform and phenol purification steps were replaced with pre-lysis sample washes. Best cells/nucleus lysis was achieved with 4 h at 58 °C. The obtained high quality and high molecular weight DNAs were tested in PacBio SMRTBell™ library preparations, which resulted in circular consensus sequencing (CCS) reads from 17 to 27 Gb per cell, and a read length N50 from 14 to 17 kbp. To evaluate the quality of the reads for whole genome sequencing, they were assembled with HiFiasm into draft genomes, with N50 = 49 Mb and 23 Mb, and L50 = 10 and 11. The longest contigs were 95 Mb and 57 Mb respectively, showing good contiguity as these are longer than the theoretical chromosome length (genome size/chromosome number) of 78 Mb and 55 Mb, for S. grandis and S. kentaniensis respectively.

Conclusions

DNA extraction is a critical step towards obtaining a complete genome assembly. Our DNA extraction method here provided the required high quality, high molecular weight DNA for successful standard-input PacBio HiFi library preparation. The contigs from those reads showed a high contiguity, providing a good starting draft assembly towards obtaining a complete genome. The results obtained here were highly promising, and demonstrated that the DNA extraction method developed here is compatible with PacBio HiFi sequencing and suitable for de novo whole genome sequencing projects of plants.
Comparison of outcomes between transcatheter tricuspid valve repair and surgical tricuspid valve replacement or repair in patients with tricuspid insufficiency
Authors: Wang Xiqiang , Ma Yanpeng , Liu Zhongwei , Fan Xiude , Guan Gongchang , Pan Shuo , Wang Junkui , Zhang Yong
Published: April 2023

Background

Tricuspid regurgitation is associated with significant morbidity and mortality, but with limited treatment options. The objective of this study is to compare the demographic characteristics, complications, and outcomes of transcatheter tricuspid valve repair (TTVr) versus surgical tricuspid valve replacement (STVR) or surgical tricuspid valve repair (STVr), using real-world data from the National Inpatient Sample (NIS) database.

Methods and results

Our study analyzed data from the National Inpatient Sample (NIS) database from 2016 to 2018 and identified 92, 86, and 84 patients with tricuspid insufficiency who underwent STVr, STVR, and TTVr, respectively. The mean ages of patients who received STVr, STVR, and TTVr were 65.03 years, 66.3 years, and 71.09 years, respectively, with TTVr patients significantly older than those who received STVr (P < 0.05). Patients who received STVr or STVR had higher mortality rates (8.7% and 3.5%, respectively) compared to those who received TTVr (1.2%). Patients who underwent STVr or STVR were also more likely to experience perioperative complications, including third-degree atrioventricular block (8.7% STVr vs. 1.2% TTVr, P = 0.329; 38.4% STVR vs. 1.2% TTVr, P < 0.05), respiratory failure (5.4% STVr vs. 1.2% TTVr, P = 0.369; 15.1% STVR vs. 1.2% TTVr, P < 0.05), respiratory complications (6.5% STVr vs. 1.2% TTVr, P = 0.372; 19.8% STVR vs. 1.2% TTVr, P < 0.05), acute kidney injury (40.2% STVr vs. 27.4% TTVr, P = 0.367; 34.9% STVR vs. 27.4% TTVr, P = 0.617), and fluid and electrolyte disorders (44.6% STVr vs. 22.6% TTVr, P = 0.1332; 50% STVR vs. 22.6% TTVr, P < 0.05). In addition, the average cost of care and the average length of hospital stay were higher for patients who underwent STVr or STVR than for those who received TTVr (USD$37995 ± 356008.523 STVr vs. USD$198397 ± 188943.082 TTVr, P < 0.05; USD$470948 ± 614177.568 STVR vs. USD$198397 ± 188943.082 TTVr, P < 0.05; 15.4 ± 15.19 STVr vs. 9.6 ± 10.21 days TTVr, P = 0.267; 24.7 ± 28.81 STVR vs. 9.6 ± 10.21 days TTVr, P < 0.05).

Conclusion

TTVr has shown to have favorable outcomes compared to STVr or STVR, but more research and clinical trials are required to help formulate evidence-based guidelines for the role of catheter-based management in tricuspid valve disease.
Sleep quality, anxiety, symptoms of depression, and caregiver burden among those caring for patients with Dravet syndrome: a prospective multicenter study in Germany
Authors: Maltseva Margarita , Schubert-Bast Susanne , Zöllner Johann Philipp , Bast Thomas , Mayer Thomas , von Spiczak Sarah , Ruf Susanne , Trollmann Regina , Wolff Markus , Hornemann Frauke , Klotz Kerstin A. , Jacobs Julia , Kurlemann Gerhard , Neubauer Bernd A. , Polster Tilman , Syrbe Steffen , Bertsche Astrid , Bettendorf Ulrich , Kluger Gerhard , Flege Silke , Rosenow Felix , Kay Lara , Strzelczyk Adam
Published: April 2023

Background

This study measured sleep quality among caregivers of patients with Dravet syndrome (DS) and assessed the impacts of mental health problems and caregiver burden on sleep quality.

Methods

This multicenter, cross-sectional study of patients with DS and their caregivers throughout Germany consisted of a questionnaire and a prospective 4-week diary querying disease characteristics, demographic data, living conditions, nocturnal supervision, and caregivers’ work situations. Sleep quality was assessed using the Pittsburgh Sleeping Quality Index (PSQI). The Hospital Anxiety and Depression Scale (HADS) and the Burden Scale for Family Caregivers (BSFC) were used to measure anxiety, symptoms of depression, and caregiver burden.

Results

Our analysis included 108 questionnaires and 82 four-week diaries. Patients with DS were 49.1% male (n = 53), with a mean age of 13.5 ± 10.0 years. Caregivers were 92.6% (n = 100) female, with a mean age of 44.7 ± 10.6 years. The overall mean PSQI score was 8.7 ± 3.5, with 76.9% of participants (n = 83) scoring 6 or higher, indicating abnormal sleep quality. The HADS for anxiety and depression had overall mean scores of 9.3 ± 4.3 and 7.9 ± 3.7, respectively; 61.8% and 50.9% of participants scored above the cutoff value of 8 for anxiety and depression, respectively. Statistical analyses revealed caregiver anxiety levels and patients’ sleep disturbances as major factors influencing PSQI scores. The overall mean BSFC score of 41.7 ± 11.7 indicates a moderate burden, with 45.3% of caregivers scoring 42 or higher.

Conclusions

Sleep quality is severely affected among caregivers of patients with DS, correlating with anxiety, comorbidities, and patients’ sleep disturbances. A holistic therapeutic approach should be implemented for patients with DS and their caregivers, focusing on the sleep quality and mental health of caregivers.

Trial registration: German Clinical Trials Register (DRKS), DRKS00016967. Registered 27 May 2019, http://www.drks.de/DRKS00016967
Mental health profiles of Finnish adolescents before and after the peak of the COVID-19 pandemic
Authors: Gustafsson Jasmine , Lyyra Nelli , Jasinskaja-Lahti Inga , Simonsen Nina , Lahti Henri , Kulmala Markus , Ojala Kristiina , Paakkari Leena
Published: April 2023

Background

The COVID-19 pandemic has had implications for adolescents’ interpersonal relationships, communication patterns, education, recreational activities and well-being. An understanding of the impact of the pandemic on their mental health is crucial in measures to promote the post-pandemic recovery. Using a person-centered approach, the current study aimed to identify mental health profiles in two cross-sectional samples of Finnish adolescents before and after the peak of the pandemic, and to examine how socio-demographic and psychosocial factors, academic expectations, health literacy, and self-rated health are associated with the emerging profiles.

Methods and findings

Survey data from the Health Behaviour in School-aged Children (HBSC) study conducted in Finland in 2018 (N = 3498, age M = 13.44) and 2022 (N = 3838, age M = 13.21) were analyzed. A four-profile model using cluster analysis was selected for both samples. In Sample 1, the identified profiles were (1) “Good mental health”, (2) “Mixed psychosocial health”, (3) “Somatically challenged”, and (4) “Poor mental health”. In Sample 2, the identified profiles were (1) “Good mental health”, (2) “Mixed psychosomatic health”, (3) “Poor mental health and low loneliness”, and (4) “Poor mental health and high loneliness”. The results of the mixed effect multinomial logistic regression analysis showed that in both samples, being a girl and reporting lower maternal monitoring; lower family, peer, and teacher support; higher intensity of online communication; a less positive home atmosphere and school climate; and poor self-rated health were most strongly linked to belonging to a poorer mental health profile. In addition, in Sample 2, low subjective health literacy was a key factor associated with poorer mental health profiles, and teacher support was more important than before COVID.

Conclusions

The current study stresses the importance of identifying those vulnerable to developing poor mental health. To maximize post-pandemic recovery, the role of schools, especially teacher support and health literacy, along with the factors that remained important over time should be taken into account in public health and health promotion interventions.
Frequency of antidepressant use and clinical characteristics of children and adolescents undergoing polysomnography: an observational study
Authors: DelRosso Lourdes M. , Bruni Oliviero , Mogavero Maria P. , Fickensher Amy , Schenck Carlos H. , Ferri Raffaele
Published: April 2023

Background

Antidepressants are increasingly used in children for various psychiatric disorders but also for sleep disorders such as insomnia; however, it is currently unknown how many children undergoing polysomnography (PSG) are taking anti-depressants. The aims were: to determine the frequency of use of antidepressants in paediatric patients referred for PSG, to identify the most common antidepressants used, to investigate the reasons for their use, and to analyse the PSG parameters found in children taking antidepressants.

Method

An observational cross-sectional retrospective chart review of all children undergoing PSG at Seattle Children’s Hospital from 6/14/2020 to 12/8/2022 was carried out. Clinical features (such as diagnosis, especially psychiatric), sleep disorders (such as insomnia and restless sleep), and class of antidepressant used [selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCA), or atypical antidepressants], and PSG parameters were collected for further analysis.

Results

Among 3,371 patients who underwent PSG during the study, 367 children were selected who were taking one antidepressant only (154 boys and 213 girls, mean age was 13.7 ± years 3.69). A significantly decreased sleep stage N3 was found in girls, who were older than boys. Children with insomnia had longer sleep latency than children without, but more N3. There was a prolonged rapid eye movement (REM) sleep latency in children with attention-deficit/hyperactivity disorder and children with autism. REM latency was longer and REM percentage smaller in children taking SNRIs. Periodic leg movement index ≥ 5/hour was found in a higher number of children taking SSRIs or SNRIs (24.9%) than in subjects taking TCA or atypical antidepressants (13.3%) (chi-square 5.29, p = 0.013).

Conclusions

Child and adolescent psychiatrists should question about the effects on sleep (both positive and negative) after initiating therapy with antidepressant medications.
Venetoclax Combined with Azacitidine and Homoharringtonine in Relapsed/Refractory AML: A Multicenter, Phase 2 Trial
Authors: Jin Hua , Zhang Yu , Yu Sijian , Du Xin , Xu Na , Shao Ruoyang , Lin Dongjun , Chen Yanqiu , Xiao Jie , Sun Zhiqiang , Deng Lan , Liang Xinquan , Zhang Hongyu , Guo Ziwen , Dai Min , Shi Pengcheng , Huang Fen , Fan Zhiping , Yin Zhao , Xuan Li , Lin Ren , Jiang Xuejie , Yu Guopan , Liu Qifa
Published: April 2023

Background

Relapsed or refractory acute myeloid leukemia (R/R AML) has a dismal prognosis. The aim of this study was to investigate the activity and tolerability of venetoclax combined with azacitidine plus homoharringtonine (VAH) regimen for R/R AML.

Methods

This phase 2 trial was done at ten hospitals in China. Eligible patients were R/R AML (aged 18–65 years) with an Eastern Cooperative Oncology Group performance status of 0–2. Patients received venetoclax (100 mg on day 1, 200 mg on day 2, and 400 mg on days 3–14) and azacitidine (75 mg/m2 on days 1–7) and homoharringtonine (1 mg/m2 on days 1–7). The primary endpoint was composite complete remission rate [CRc, complete response (CR) plus complete response with incomplete blood count recovery (CRi)] after 2 cycles of treatment. The secondary endpoints include safety and survival.

Results

Between May 27, 2020, and June 16, 2021, we enrolled 96 patients with R/R AML, including 37 primary refractory AML and 59 relapsed AML (16 relapsed after chemotherapy and 43 after allo-HSCT). The CRc rate was 70.8% (95% CI 60.8–79.2). In the patients with CRc, measurable residual disease (MRD)-negative was attained in 58.8% of CRc patients. Accordingly, overall response rate (ORR, CRc plus partial remission (PR)) was 78.1% (95% CI 68.6–85.4). At a median follow-up of 14.7 months (95% CI 6.6–22.8) for all patients, median overall survival (OS) was 22.1 months (95% CI 12.7–Not estimated), and event-free survival (EFS) was 14.3 months (95% CI 7.0–Not estimated). The 1-year OS was 61.5% (95% CI 51.0–70.4), and EFS was 51.0% (95% CI 40.7–60.5). The most common grade 3–4 adverse events were febrile neutropenia (37.4%), sepsis (11.4%), and pneumonia (21.9%).

Conclusions

VAH is a promising and well-tolerated regimen in R/R AML, with high CRc and encouraging survival. Further randomized studies are needed to be explored.

Trial registration clinicaltrials.gov identifier: NCT04424147.