bluuebunny/crossref_metadata_2025 huggingface dataset:
Seroprevalence of hepatitis B and C viruses among waste handlers in Ethiopia: A systematic review and meta-analysis
Authors: Gedefie Alemu , Getaneh Fekadeselassie Belege , Debash Habtu , Sebsibe Saleamlak , Erkihun Yonas , Alemayehu Ermiyas , Metaferia Yeshi , Kassa Yeshimebet , Shibabaw Agumas , Tilahun Mihret , Bambo Getachew Mesfin , Kebede Samuel Sahile , Alemu Mekuanent , Demsiss Wondmagegn
Published: May 2024

Objective:

Hepatitis B virus and hepatitis C virus are the leading causes of global liver-related morbidity and mortality. Waste handlers are one of the high-risk groups for hepatitis B virus and hepatitis C virus acquisition. Thus, the aim of this study was to assess the pooled prevalence of hepatitis B virus and hepatitis C virus among waste handlers in Ethiopia.

Methods:

Articles were extensively searched in bibliographic databases and gray literature using entry terms or phrases. Studies meeting eligibility criteria were extracted in MS Excel and exported to STATA version 14 software for statistical analysis. A random-effects model was used to compute the pooled magnitude of hepatitis B virus and hepatitis C virus. Heterogeneity was quantified by using the I2 value. Publication bias was assessed using a funnel plot and Egger’s test. Sensitivity analysis was performed to assess the impact of a single study on pooled effect size.

Result:

Of the 116 studies identified, 8 studies were selected for meta-analysis. All studies reported hepatitis B virus, while 5 studies reported hepatitis C virus infection among waste handlers. The overall pooled prevalence of hepatitis B virus and hepatitis C virus infection among waste handlers in Ethiopia was 5.07% (2.0–8.15) and 1.46% (0.52–2.4), respectively. Moreover, the pooled prevalence of lifetime hepatitis B virus exposure among Ethiopian waste handlers was 33.98% (95% CI: 21.24–46.72). Hepatitis B virus and hepatitis C virus infection were not statistically associated with the type of waste handlers, that is, there was no difference between medical and nonmedical waste handlers.

PROSPERO registration:

CRD42023398686.

Conclusion:

The pooled prevalence of hepatitis B virus and hepatitis C virus infection among waste handlers in Ethiopia was intermediate and moderate, respectively. This showed that there is a strong need to scale up preventive efforts and strategic policy directions to limit the spread of these viruses. Moreover, we also conclude that handling healthcare and domestic waste is associated with a similar risk of hepatitis B virus and hepatitis C virus infection.
Influence of Knowledge and Attitudes on Youth Smoking in Rural Areas of the Mymensigh Districts of Bangladesh: A Cross-Sectional Study
Authors: Rahman K. M. Mustafizur , Gietel-Basten Stuart
Published: May 2024

The development of a country is strongly influenced by a higher smoking rate among the young population. Understanding knowledge and attitudes regarding smoking among young people lies at the heart of effective tobacco control policies. Bangladesh is a large, low-income country in South Asia with a high rate of youth smoking. As yet, however, little attention has been paid to knowledge and attitudes among rural youth. Face-to-face interviews were conducted with 385 youth males from the rural Mymensingh district of Bangladesh aged 15 to 24 were interviewed face-to-face. Univariate distribution (i.e., frequency analysis), bivariate analysis (i.e., Chi-square tests), and multivariate analysis (i.e., binary logistic regression model) were performed to determine the influence of knowledge and attitudes on youth male smoking. The percentage of youth smoking is 40.3 with knowledge and attitudes revealed as the more influential factors of smoking. For example, the chance of being a smoker with a satisfactory knowledge score is significantly lower than their counterparts (Odds ratio [OR]: 0.47 [0.30, 0.70]). Similarly, respondents with satisfactory attitudes scores have a significantly lower chance (OR: 0.40 [0.26, 0.61]) to be a smoker than those having an unsatisfactory score. This study exposes the influences of knowledge and attitudes among the youth toward smoking in rural parts of the Mymensingh district of Bangladesh. The findings and recommendations of this study will be more helpful to the authorities in revising the existing smoking policies accordingly to reduce and prevent youth smoking for the betterment of the country.
Revisiting the mechanism of β-O-4 bond cleavage during acidolysis of lignin part 10: reactions of C6–C2-type non-phenolic syringyl model compounds and comparison of the reactions with those of the guaiacyl analogues
Authors: Mizutani Ryota , Katsumata Kyoko S. , Komatsu Toshihiro , Yokoyama Tomoya
Published: May 2024

A C6–C2-type non-phenolic syringyl lignin model compound (I, 2-(2-methoxyphenoxy)-1-(3,4,5-trimethoxyphenyl)ethanol) as well as its derivatives was acidolyzed in aqueous 82vol% 1,4-dioxane containing 0.2 mol/L HBr, HCl, or H2SO4 at 85ºC. The results were compared with those on the guaiacyl analogues (V as well as its derivatives) obtained in our previous reports. The acidolysis of compound I was slower than that of compound V, which is in accordance with our previous result on the formation rates of the benzyl cation intermediates (BC) from a syringyl compound and its guaiacyl analogue. The enol ether-type compound was primarily produced in the acidolysis of compound I, similar to that of compound V. The acidolysis using HBr or HCl was faster than that using H2SO4, indicating the participation of Br¯ or Cl¯, respectively, in the acidolysis. It was suggested that Br¯ (as well as Cl¯) adds to the cation center of the BC to afford the adduct in the acidolysis of compound I, similar to that of compound V, and hence, this adduct formation is a major bypass of the common route. The bypass activity in the acidolysis of compound I was about half in that of compound V.
Unveiling the hidden role of the interaction between CD36 and FcγRIIb: implications for autoimmune disorders
Authors: He Chenfei , Hua Guoying , Liu Yong , Li Shuijie
Published: May 2024

Background

The role of the scavenger receptor CD36 in cell metabolism and the immune response has been investigated mainly in macrophages, dendritic cells, and T cells. However, its involvement in B cells has not been comprehensively examined.

Methods

To investigate the function of CD36 in B cells, we exposed Cd36fl/flMB1cre mice, which lack CD36 specifically in B cells, to apoptotic cells to trigger an autoimmune response. To validate the proteins that interact with CD36 in primary B cells, we conducted mass spectrometry analysis following anti-CD36 immunoprecipitation. Immunofluorescence and co-immunoprecipitation were used to confirm the protein interactions.

Results

The data revealed that mice lacking CD36 in B cells exhibited a reduction in germinal center B cells and anti-DNA antibodies in vivo. Mass spectrometry analysis identified 30 potential candidates that potentially interact with CD36. Furthermore, the interaction between CD36 and the inhibitory Fc receptor FcγRIIb was first discovered by mass spectrometry and confirmed through immunofluorescence and co-immunoprecipitation techniques. Finally, deletion of FcγRIIb in mice led to decreased expression of CD36 in marginal zone B cells, germinal center B cells, and plasma cells.

Conclusions

Our data indicate that CD36 in B cells is a critical regulator of autoimmunity. The interaction of CD36-FcγRIIb has the potential to serve as a therapeutic target for the treatment of autoimmune disorders.
Adsorption of Cd and Mn from neutral mine effluents using bentonite, zeolite, and stabilized dewatered sludge
Authors: Prepilková Veronika , Poništ Juraj , Ďuricová Anna , Salva Jozef , Schwarz Marián , Samešová Dagmar , Mordačová Martina
Published: May 2024

This study aimed to investigate the adsorption efficiency of Cd and Mn using natural sorbents—bentonite, zeolite and stabilized digested dewatered waste sludge. The main contributions of the scientific article are in adding to the scientific knowledge of the use of natural and waste sorbents in the removal of heavy metals from neutral mine effluents. Current studies mainly focus on metal removal by sorption using natural sorbents from acid mine drainage. This study investigates sorption in neutral mine drainage. The efficiency of the sorption process was evaluated using the following parameters: efficiency (%) of metal ion removal, Freudlich and Langmuir adsorption isotherm constant. The AES–ICP method (atomic emission spectrometry with inductively coupled plasma) was used for the initial metal analysis of the materials used. The atomic absorption spectrometry (AAS) method was used for the analysis of Cd and Mn in the sorption process. The maximum efficiency of Mn removal by bentonite at the end of the test was approximately 90%. The removal of Mn by zeolite was considerably lower—about 20% compared to the use of sludge—80%. Based on the sorption efficiency, the sludge was suitable for sorption. Much higher levels of Cd sorption were achieved using sludge compared to using natural bentonite and zeolite. The main novelty of the work lies in the sorption of metals using dewatered digested sludge. Previous studies have focused on metal sorption using activated sludge. Most previous studies focused on sorption from acid mine drainage. The novelty of this study is that we focused on the sorption of neutral mine drainages, which are typical for the location we are monitoring.
Genomic identification and evolutionary analysis of chemosensory receptor gene families in two Phthorimaea pest species: insights into chemical ecology and host adaptation
Authors: Chen Ruipeng , Yan Junjie , Wickham Jacob D. , Gao Yulin
Published: May 2024

Background

Insects rely on sophisticated sensitive chemosensory systems to sense their complex chemical environment. This sensory process involves a combination of odorant receptors (ORs), gustatory receptors (GRs) and ionotropic receptors (IRs) in the chemosensory system. This study focused on the identification and characterization of these three types of chemosensory receptor genes in two closely related Phthorimaea pest species, Phthorimaea operculella (potato tuber moth) and Phthorimaea absoluta (tomato leaf miner).

Results

Based on manual annotation of the genome, we identified a total of 349 chemoreceptor genes from the genome of P. operculella, including 93 OR, 206 GR and 50 IR genes, while for P. absoluta, we identified 72 OR, 122 GR and 46 IR genes. Through phylogenetic analysis, we observed minimal differences in the number and types of ORs and IRs between the potato tuber moth and tomato leaf miner. In addition, we found that compared with those of tomato leaf miners, the gustatory receptor branch of P. operculella has undergone a large expansion, which may be related to P. absoluta having a narrower host range than P. operculella. Through analysis of differentially expressed genes (DEGs) of male and female antennae, we uncovered 45 DEGs (including 32ORs, 9 GRs, and 4 IRs).

Conclusions

Our research provides a foundation for exploring the chemical ecology of these two pests and offers new insights into the dietary differentiation of lepidopteran insects, while simultaneously providing molecular targets for developing environmentally friendly pest control methods based on insect chemoreception.
Comparison of the sputum microbiome between patients with stable nontuberculous mycobacterial pulmonary disease and patients requiring treatment
Authors: Song Min Jong , Kim Dae Hun , Kim Su-Young , Kang Noeul , Jhun Byung Woo
Published: May 2024

Background

We evaluated whether the sputum bacterial microbiome differs between nontuberculous mycobacteria pulmonary disease (NTM-PD) patients with stable disease not requiring antibiotic treatment and those requiring antibiotics.

Methods

We collected sputum samples from 21 clinically stable NTM-PD patients (stable group) and 14 NTM-PD patients needing antibiotic treatment (treatment group). We also obtained 13 follow-up samples from the stable group. We analyzed the 48 samples using 16S rRNA gene sequencing (V3–V4 region) and compared the groups.

Results

In the linear discriminant analysis effect size (LEfSe) analysis, the species Porphyromonas pasteri, Haemophilus parahaemolyticus, Prevotella nanceiensis, and Gemella haemolysans were significantly more prevalent in the sputum of the stable group compared to the treatment group. No taxa showed significant differences in alpha-/beta-diversity or LEfSe between the 21 baseline and 13 follow-up sputum samples in the stable group. In the stable group, the genus Bergeyella and species Prevotella oris were less common in patients who achieved spontaneous culture conversion (n = 9) compared to those with persistent NTM positivity (n = 12) (effect size 3.04, p = 0.039 for Bergeyella; effect size 3.64, p = 0.033 for P. oris). In the treatment group, H. parainfluenzae was more common in patients with treatment success (n = 7) than in treatment-refractory patients (n = 7) (effect size 4.74, p = 0.013).

Conclusions

Our study identified distinct bacterial taxa in the sputum of NTM-PD patients based on disease status. These results suggest the presence of a microbial environment that helps maintain disease stability.
Cold atmospheric plasma enhances morphological and biochemical attributes of tomato seedlings
Authors: Sultan Sadoun M. E. , Yousef Ahmed Fathy , Ali Waleed M. , Mohamed Amal A. A. , Ahmed Abdel-Raddy M. , Shalaby Mohamed. E. , Teiba Islam I. , Hassan A. M. , Younes Nabil A. , Kotb E. F.
Published: May 2024

Cold atmospheric plasma (CAP) is a physical technology with notable effects on living organisms. In the present study, tomato seeds (Solanum lycopersicum var. Bassimo Mill.) were exposed to CAP for various time intervals, ranging from 1 to 5 min, in both continuous and intermittent periods, and were compared with a control group that received no CAP treatment. Seedlings grown from treated seeds exhibited improvements in levels of growth traits, photosynthetic pigments, and metabolite contents when compared to the control group. Seedlings from seeds treated with S04 displayed significant increases in shoot and root lengths, by 32.45% and 20.60% respectively, compared to the control group. Moreover, seedlings from seeds treated with S01 showed a 101.90% increase in total protein, whereas those treated with S02 experienced a 119.52% increase in carbohydrate content. These findings highlight the substantial improvements in growth characteristics, photosynthetic pigments, and metabolite levels in seedlings from treated seeds relative to controls. Total antioxidant capacity was boosted by CAP exposure. The activities of enzymes including superoxide dismutase, catalase, and peroxidases were stimulated by S02 and exceeded control treatment by (177.48%, 137.41%, and 103.32%), respectively. Additionally, exposure to S04 increased the levels of non-enzymatic antioxidants like flavonoids, phenolics, saponins, and tannins over the control group (38.08%, 30.10%, 117.19%, and 94.44%), respectively. Our results indicate that CAP-seed priming is an innovative and cost-effective approach to enhance the growth, bioactive components, and yield of tomato seedlings.
Genome-wide identification, classification and expression analysis of the heat shock transcription factor family in Garlic (Allium sativum L.)
Authors: Hao Xiaomeng , He Shutao
Published: May 2024

Background

The heat shock transcription factor (HSF) plays a crucial role in the regulatory network by coordinating responses to heat stress as well as other stress signaling pathways. Despite extensive studies on HSF functions in various plant species, our understanding of this gene family in garlic, an important crop with nutritional and medicinal value, remains limited. In this study, we conducted a comprehensive investigation of the entire garlic genome to elucidate the characteristics of the AsHSF gene family.

Results

In this study, we identified a total of 17 AsHSF transcription factors. Phylogenetic analysis classified these transcription factors into three subfamilies: Class A (9 members), Class B (6 members), and Class C (2 members). Each subfamily was characterized by shared gene structures and conserved motifs. The evolutionary features of the AsHSF genes were investigated through a comprehensive analysis of chromosome location, conserved protein motifs, and gene duplication events. These findings suggested that the evolution of AsHSF genes is likely driven by both tandem and segmental duplication events. Moreover, the nucleotide diversity of the AsHSF genes decreased by only 0.0002% from wild garlic to local garlic, indicating a slight genetic bottleneck experienced by this gene family during domestication. Furthermore, the analysis of cis-acting elements in the promoters of AsHSF genes indicated their crucial roles in plant growth, development, and stress responses. qRT-PCR analysis, co-expression analysis, and protein interaction prediction collectively highlighted the significance of Asa6G04911. Subsequent experimental investigations using yeast two-hybridization and yeast induction experiments confirmed its interaction with HSP70/90, reinforcing its significance in heat stress.

Conclusions

This study is the first to unravel and analyze the AsHSF genes in garlic, thereby opening up new avenues for understanding their functions. The insights gained from this research provide a valuable resource for future investigations, particularly in the functional analysis of AsHSF genes.
Establishment of in-hospital nutrition support program for middle-aged and elderly patients with acute decompendated heart failure
Authors: Li Yongliang , Zhu Fang , Ren Dongmei , Tong Jianping , Xu Qin , Zhong Minhui , Zhao Wei , Duan Xia , Xu Xiangdong
Published: May 2024

Objective

To construct a nutrition support program for middle-aged and elderly patients with acute decompensated heart failure (ADHF) during hospitalization.

Methods

Based on the JBI Evidence-Based Health Care Model as the theoretical framework, the best evidence was extracted through literature analysis and a preliminary nutrition support plan for middle-aged and elderly ADHF patients during hospitalization was formed. Two rounds of expert opinion consultation were conducted using the Delphi method. The indicators were modified, supplemented and reduced according to the expert’s scoring and feedback, and the expert scoring was calculated.

Results

The response rates of the experts in the two rounds of consultation were 86.7% and 100%, respectively, and the coefficient of variation (CV) for each round was between 0.00% and 29.67% (all < 0.25). In the first round of expert consultation, 4 items were modified, 3 items were deleted, and 3 items were added. In the second round of the expert consultation, one item was deleted and one item was modified. Through two rounds of expert consultation, expert consensus was reached and a nutrition support plan for ADHF patients was finally formed, including 4 first-level indicators, 7 s-level indicators, and 24 third-level indicators.

Conclusion

The nutrition support program constructed in this study for middle-aged and elderly ADHF patients during hospitalization is authoritative, scientific and practical, and provides a theoretical basis for clinical development of nutrition support program for middle-aged and elderly ADHF patients during hospitalization.
Stacked probability plots of the extended illness-death model using constant transition hazards – an easy to use shiny app
Authors: Grodd Marlon , Weber Susanne , Wolkewitz Martin
Published: May 2024

Background

Extended illness-death models (a specific class of multistate models) are a useful tool to analyse situations like hospital-acquired infections, ventilation-associated pneumonia, and transfers between hospitals. The main components of these models are hazard rates and transition probabilities. Calculation of different measures and their interpretation can be challenging due to their complexity.

Methods

By assuming time-constant hazards, the complexity of these models becomes manageable and closed mathematical forms for transition probabilities can be derived. Using these forms, we created a tool in R to visualize transition probabilities via stacked probability plots.

Results

In this article, we present this tool and give some insights into its theoretical background. Using published examples, we give guidelines on how this tool can be used. Our goal is to provide an instrument that helps obtain a deeper understanding of a complex multistate setting.

Conclusion

While multistate models (in particular extended illness-death models), can be highly complex, this tool can be used in studies to both understand assumptions, which have been made during planning and as a first step in analysing complex data structures. An online version of this tool can be found at https://eidm.imbi.uni-freiburg.de/.
Insights from end-of-career general practitioners on changing working conditions and generational differences: considerations for future strategies
Authors: Schrimpf Anne , Scheiwe Elisabeth , Bleckwenn Markus
Published: May 2024

The landscape of general practice has experienced notable transformations in recent decades, profoundly influencing the working conditions of general practitioners (GPs). This study aimed to examine the most salient changes affecting GPs' daily practices. Through semi-structured qualitative interviews with 15 end-of-career GPs, the study explored how these changes affected work organization, equipment, working hours, work-life balance, job satisfaction, training, patient relationships, and reputation. The interviews revealed that these changes were perceived as barriers, opportunities, or a complex interplay of both for general practice. While the interviewed GPs valued technological advancements and reported positive developments in working conditions, challenges included a gradual reduction in the range of tasks, growing administrative burdens, and less practical training for young physicians. Other changes, such as new doctor-patient dynamics, the transition from single to group practice, and differing professional expectations of the younger generation, were seen as both challenging and strengthening for general practice. By combining these factors and trade-offs observed by end-of-career GPs in our study over the past few decades with general societal changes, we provide ideas for the design of future framework conditions in general practice that might enhance the attractiveness of the profession. These insights offer key considerations that can guide future strategies for general practice and medical education.
Prevalence, perceptions and associated factors of health insurance enrollment among older persons in selected cash grant communities in Ghana: a cross-sectional mixed method
Authors: Ottie-Boakye Doris , Bawah Ayagah Agula , Dodoo Naa Dodua , Anarfi J. K.
Published: May 2024

Background

Universal Health Coverage has been openly recognized in the United Nations health-related Sustainable Development Goals by 2030, though missing under the Millennium Development Goals. Ghana implemented the National Health Insurance Scheme programme in 2004 to improve financial access to healthcare for its citizens. This programme targeting low-income individuals and households includes an Exempt policy for older persons and indigents. Despite population ageing, evidence of the participation and perceptions of older persons in the scheme in cash grant communities is unknown. Hence, this paper examined the prevalence, perceptions and factors associated with health insurance enrollment among older persons in cash grant communities in Ghana.

Methods

Data were from a cross-sectional household survey of 400 older persons(60 + years) and eight FGDs between 2017 and 2018. For the survey, stratified and simple random sampling techniques were utilised in selecting participants. Purposive and stratified sampling techniques were employed in selecting the focus group discussion participants. Data analyses included descriptive, modified Poisson regression approach tested at ap-value of 0.05 and thematic analysis. Stata and Atlas-ti software were used in data management and analyses.

Results

The mean age was 73.7 years. 59.3% were females, 56.5% resided in rural communities, while 34.5% had no formal education. Two-thirds were into agriculture. Three-fourth had non-communicable diseases. Health insurance coverage was 60%, and mainly achieved as Exempt by age. Being a female [Adjusted Prevalence Ratio (APR) 1.29, 95%CI:1.00–1.67], having self-rated health status as bad [APR = 1.34, 95%CI:1.09–1.64] and hospital healthcare utilisation [APR = 1.49, 95%CI:1.28–1.75] were positively significantly associated with health insurance enrollment respectively. Occupation in Agriculture reduced insurance enrollment by 20.0%. Cited reasons for poor perceptions of the scheme included technological challenges and unsatisfactory services.

Conclusion

Health insurance enrollment among older persons in cash grant communities is still not universal. Addressing identified challenges and integrating the views of older persons into the programme have positive implications for securing universal health coverage by 2030.
Predictive value of Cmmi-MHR combined with thromboelastography parameters in acute cerebral infarction
Authors: Rao Zhongxian , Tan Wei , Wang Junmin , Zhou You , Yang Xue , Hu Shanshan
Published: May 2024

Cerebral infarction is a common neurological disease with high rates of morbidity, mortality, and recurrence, posing a great threat to human life and health. Cerebral infarction is the second leading cause of death in the world and the leading cause of long-term disability in humans. The results of the third national retrospective sampling survey on causes of death in 2008 showed that cerebral infarction has become the leading cause of death in China and its mortality rate is 4–5 times that of European and American countries. Therefore, this article proposed a study on the predictive value of Cmmi-MHR combined with thromboelastography parameters that was performed for acute cerebral infarction. This paper mainly proposed a high frame rate imaging technology and analyzed its algorithm. In this article, in the experimental part, an in-depth analysis of the predictive value of the Monocyte-to-high-density lipoprotein cholesterol ratio (MHR) combined with thromboelastography parameters was performed for acute cerebral infarction. The final experimental results showed that HDL (OR = 1.695%, P-trend = 0.049) had a probability of death within 90 days of hospitalization (OR = 0.81, 95% CI = 1.06–3.11, P-trend = 0.523). There were no significant differences in mortality rate after 90 days. Regardless of adjusting for confounders such as age, gender, and NIHSS score, there was no significant difference in the risk of MHR or monocyte count within 90 days of hospitalization. The conclusion indicates that the combination of Cmmi-MHR and thromboelastography parameters provides a new perspective and method for the diagnosis and treatment of cerebral infarction, and provides important support for personalized treatment and management of cerebral infarction.
Fruquintinib-induced renal-limited thrombotic microangiopathy: a case report
Authors: Zhao Ruiping , Fan Ruichen , Pan Yan , Han Yuze , Wang Ying , Chen Weidong
Published: May 2024

Background

Fruquintinib is a highly selective inhibitor of vascular endothelial growth factor receptor (VEGFR). Currently, there are no reported cases of fruquintinib causing kidney-restrictive thrombotic microangiopathy (TMA) in the available Chinese and foreign literature.

Case presentation

In this case report, we presented a 73-year-old patient receiving fruquintinib for metastatic colon cancer, manifesting abundant proteinuria, in which kidney-restrictive TMA was also diagnosed through renal biopsy. As far as we were concerned, this was the frst reported in terms of fruquintinib-induced kidney-restrictive TMA confrmed by renal biopsy.

Conclusion

This case indicates that fruquintinib may result in kidney-restrictive TMA, which is a rare but life-threatening complication of cancer treatment drug. Therefore, regular monitoring of proteinuria and blood pressure is imperative for all patients undergoing anti-VEGF drug therapy. And renal biopsy should be promptly conducted to facilitate early detection of thrombotic microangiopathy.
Adverse drug reactions in paediatric surgery: prospective study on frequency and risk related factors
Authors: Pérez-Ingidua C , Rivas-Paterna AB , González-Perrino C , Aleo-Luján E , Ascaso-del-Rio A , Laredo-Velasco L , Portolés-Pérez A , Vargas-Castrillón E
Published: May 2024

Background

Paediatric patients are especially prone to experiencing adverse drug reactions (ADRs), and the surgical environment gathers many conditions for such reactions to occur. Additionally, little information exists in the literature on ADRs in the paediatric surgical population. We aimed to quantify the ADR frequency in this population, and to investigate the characteristics and risk factors associated with ADR development.

Methods

A prospective observational study was conducted in a cohort of 311 paediatric patients, aged 1–16 years, admitted for surgery at a tertiary referral hospital in Spain (2019–2021). Incidence rates were used to assess ADR frequency. Odds ratios (ORs) were calculated to evaluate the influence of potential risk factors on ADR development.

Results

Distinct ADRs (103) were detected in 80 patients (25.7%). The most frequent being hypotension (N = 32; 35%), nausea (N = 16; 15.5%), and emergence delirium (N = 16; 15.5%). Most ADRs occurred because of drug-drug interactions. The combination of sevoflurane and fentanyl was responsible for most of these events (N = 32; 31.1%). The variable most robustly associated to ADR development, was the number of off-label drugs prescribed per patient (OR = 2.99; 95% CI 1.73 to 5.16), followed by the number of drugs prescribed per patient (OR = 1.26, 95% CI 1.13 to 1.41), and older age (OR = 1.26, 95% CI 1.07 to 1.49). The severity of ADRs was assessed according to the criteria of Venulet and the Spanish Pharmacovigilance System. According to both methods, only four ADRs (3.9%) were considered serious.

Conclusions

ADRs have a high incidence rate in the paediatric surgical population. The off-label use of drugs is a key risk factor for ADRs development.
Bivariate extreme value analysis of extreme temperature and mortality in Canada, 2000-2020
Authors: Zhang Yuqing , Wang Kai , Ren Junjie , Liu Yixuan , Ma Fei , Li Tenglong , Chen Ying , Ling Chengxiu
Published: May 2024

Climate change increases the risk of illness through rising temperature, severe precipitation and worst air pollution. This paper investigates how monthly excess mortality rate is associated with the increasing frequency and severity of extreme temperature in Canada during 2000-2020. The extreme associations were compared among four age groups across five sub-blocks of Canada based on the datasets of monthly T90 and T10, the two most representative indices of severe weather monitoring measures developed by the actuarial associations in Canada and US. We utilize a combined seasonal Auto-regressive Integrated Moving Average (ARIMA) and bivariate Peaks-Over-Threshold (POT) method to investigate the extreme association via the extreme tail index $$\chi$$
χ
and Pickands dependence function plots. It turns out that it is likely (more than 10%) to occur with excess mortality if there are unusual low temperature with extreme intensity (all $$\chi >0.1$$

χ
>
0.1

except Northeast Atlantic (NEA), Northern Plains (NPL) and Northwest Pacific (NWP) for age group 0-44), while extreme frequent high temperature seems not to affect health significantly (all $$\chi \le 0.001$$

χ
≤
0.001

except NWP). Particular attention should be paid to NWP and Central Arctic (CAR) since population health therein is highly associated with both extreme frequent high and low temperatures (both $$\chi =0.3182$$

χ
=
0.3182

for all age groups). The revealed extreme dependence is expected to help stakeholders avoid significant ramifications with targeted health protection strategies from unexpected consequences of extreme weather events. The novel extremal dependence methodology is promisingly applied in further studies of the interplay between extreme meteorological exposures, social-economic factors and health outcomes.
Longitudinal association of health behaviors and health-related quality of life with military spouse readiness
Authors: Corry Nida H. , Radakrishnan Sharmini , Williams Christianna S. , Woodall Kelly A. , Stander Valerie A.
Published: May 2024

Background

Unhealthy behaviors impose costs on health-related quality of life (HRQOL) reducing productivity and readiness among military members (Hoge et al., JAMA 295:1023–32, 2006; Mansfield et al. 362:101–9, 2010). Among married personnel in particular, patterns of spouse health behaviors may play an interdependent role. As a result, the identification of military spouse health factors related to readiness may inform strategies to screen for and identify those in need of greater support and enhance readiness. This study explored behavioral and HRQOL predictors and potential mediators of military spouse readiness utilizing data from the Millennium Cohort Family Study.

Methods

The analytic sample comprised of 3257 spouses of active-duty, non-separated service members who responded to both waves 1 and 2 of the survey. Sample characteristics are described with respect to demographics (e.g., age, sex, race/ethnicity, etc.), readiness measures (i.e., military satisfaction, lost workdays, health care utilization, military-related stress, and satisfaction), health behaviors (i.e., exercise, sleep, smoking, and alcohol use) and HRQOL (Veterans RAND 12-Item Short Form Survey). We conducted multivariate mediation analyses to evaluate the role of mental and physical HRQOL as mediators between the baseline health behaviors and the health readiness outcomes at follow-up, while adjusting for spouse and service member demographics.

Results

HRQOL had direct effects for all five readiness outcomes examined. Multiple health behaviors (insomnia, smoking, binge drinking, and exercise) were further significantly associated with spouse readiness outcomes, although most effects were mediated through HRQOL, suggesting this may be a useful index of military spouse readiness. Insomnia was the specific health behavior most consistently associated with poorer readiness across outcomes, and effects were only partially mediated by physical and mental HRQOL.

Conclusions

The results show spouse health behaviors are directly and indirectly (through HRQOL) associated with readiness indicators. This suggests that assessments of modifiable health behaviors (e.g., insomnia symptoms) and mental and physical HRQOL are important indicators of readiness among military spouses and should be used to inform future programs designed to improve population health.
Association of physical activity and screen time with cardiovascular disease risk in the Adolescent Brain Cognitive Development Study
Authors: Nagata Jason M. , Weinstein Shayna , Alsamman Sana , Lee Christopher M. , Dooley Erin E. , Ganson Kyle T. , Testa Alexander , Gooding Holly C. , Kiss Orsolya , Baker Fiona C. , Pettee Gabriel Kelley
Published: May 2024

Background

According to the Physical Activity Guidelines Advisory Committee Scientific Report, limited evidence is available on sedentary behaviors (screen time) and their joint associations with physical activity (steps) for cardiovascular health in adolescence. The objective of this study was to identify joint associations of screen time and physical activity categories with cardiovascular disease (CVD) risk factors (blood pressure, hemoglobin A1c, cholesterol) in adolescence.

Methods

This study analyzed data from the Adolescent Brain Cognitive Development (ABCD) Study, comprising a diverse sample of 4,718 U.S. adolescents aged 10–15 years between 2018 and 2021. Steps were measured by a Fitbit wearable device and levels were categorized as low (1,000–6,000), medium (> 6,000–12,000), and high (> 12,000) averaged daily step counts. Self-reported recreational screen time hours per day were classified as low (0–4), medium (> 4–8), and high (> 8) hours per day. CVD risk factors including blood pressure, hemoglobin A1c, and cholesterol (total and HDL) were measured.

Results

The analytical sample averaged 6.6 h of screen time per day and 9,722 steps per day. In models including both screen time and steps, the high screen time category was associated with a 4.27 higher diastolic blood pressure percentile (95% CI 1.83–6.73) and lower HDL cholesterol (B= -2.85, 95% CI -4.77 to -0.94 mg/dL) compared to the low screen time category. Medium (B = 3.68, 95% CI 1.24–6.11) and low (B = 7.64, 95% CI 4.07–11.20) step categories were associated with higher diastolic blood pressure percentile compared to the high step category. The medium step category was associated with lower HDL cholesterol (B= -1.99, 95% CI -3.80 to -0.19 mg/dL) compared to the high step category. Findings were similar when screen time and step counts were analyzed as continuous variables; higher continuous step count was additionally associated with lower total cholesterol (mg/dL).

Conclusions

Combinations of low screen time and high steps were generally associated with favorable cardiovascular health markers including lower diastolic blood pressure and higher HDL cholesterol, which can inform future adolescent health guidelines.
Predictive value of radiomic features extracted from primary lung adenocarcinoma in forecasting thoracic lymph node metastasis: a systematic review and meta-analysis
Authors: Wu Ting , Gao Chen , Lou Xinjing , Wu Jun , Xu Maosheng , Wu Linyu
Published: May 2024

Background

The application of radiomics in thoracic lymph node metastasis (LNM) of lung adenocarcinoma is increasing, but diagnostic performance of radiomics from primary tumor to predict LNM has not been systematically reviewed. Therefore, this study sought to provide a general overview regarding the methodological quality and diagnostic performance of using radiomic approaches to predict the likelihood of LNM in lung adenocarcinoma.

Methods

Studies were gathered from literature databases such as PubMed, Embase, the Web of Science Core Collection, and the Cochrane library. The Radiomic Quality Score (RQS) and the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) were both used to assess the quality of each study. The pooled sensitivity, specificity, and area under the curve (AUC) of the best radiomics models in the training and validation cohorts were calculated. Subgroup and meta-regression analyses were also conducted.

Results

Seventeen studies with 159 to 1202 patients each were enrolled between the years of 2018 to 2022, of which ten studies had sufficient data for the quantitative evaluation. The percentage of RQS was between 11.1% and 44.4% and most of the studies were considered to have a low risk of bias and few applicability concerns in QUADAS-2. Pyradiomics and logistic regression analysis were the most commonly used software and methods for radiomics feature extraction and selection, respectively. In addition, the best prediction models in seventeen studies were mainly based on radiomics features combined with non-radiomics features (semantic features and/or clinical features). The pooled sensitivity, specificity, and AUC of the training cohorts were 0.84 (95% confidence interval (CI) [0.73–0.91]), 0.88 (95% CI [0.81–0.93]), and 0.93(95% CI [0.90–0.95]), respectively. For the validation cohorts, the pooled sensitivity, specificity, and AUC were 0.89 (95% CI [0.82–0.94]), 0.86 (95% CI [0.74–0.93]) and 0.94 (95% CI [0.91–0.96]), respectively.

Conclusions

Radiomic features based on the primary tumor have the potential to predict preoperative LNM of lung adenocarcinoma. However, radiomics workflow needs to be standardized to better promote the applicability of radiomics.

Trial registration

CRD42022375712.
Musculoskeletal complaints and its economic impact in an Iranian army hospital
Authors: Soroosh Soosan G , Farbod Abolfazl
Published: May 2024

Aim

Musculoskeletal conditions constitute a remarkable portion of disability cases in the military. This study evaluated the distribution and types of musculoskeletal problems and estimated the direct and indirect costs due to these complaints in an Iranian military hospital.

Methods

All medical records of patients with musculoskeletal complaints that were referred to the medical committee of a military hospital, including rheumatology, orthopedics, and neuro-surgical specialists, from 2014 to 2016, were reviewed. Details of each complaint and the final opinion of the medical committees were recorded. The cost of each diagnostic step was calculated based on the recorded data. The treatment costs were estimated for each complaint by calculating the average cost of treatment plans suggested by two specialists, a physical medicine and a rheumatologist. The estimated cost for each part is calculated based on the army insurance low. Indirect costs due to absences, inability to work, and disability were assessed and added to the above-mentioned direct costs. Statistical analysis was performed using SPSS version 21.

Results

2,116 medical records of the committee were reviewed. 1252 (59.16%) cases were soldiers (who had to spend two years of mandatory duty in the army), and 864 (40.83%) cases were non-soldiers. The three most common complaints were fractures (301 cases, 14.22%), low back pain due to lumbar disc bulges and herniations (303 cases, 14.31%), and genu varus/genu valgus (257 cases, 12.14%). The most affected sites were the lower limbs and vertebral column. According to an official document in these subjects’ records, 4120 person-days absent from work were estimated annually, and nearly $1,172,149 of annual economic impact was calculated.

Conclusion

Musculoskeletal problems are common in the army, and establishing preventive strategies for these conditions is essential. The conservative and medical approach and the proper education for correct movement and the situation should be mentioned for the reduction of disability and its economic burden on the army’s staff.
Percutaneous bone marrow concentrate and platelet products versus exercise therapy for the treatment of rotator cuff tears: a randomized controlled, crossover trial with 2-year follow-up
Authors: Centeno Christopher J. , Fausel Zachary , Dodson Ehren , Berger Dustin R. , Steinmetz Neven J.
Published: May 2024

Background

Surgical repair is recommended for the treatment of high-grade partial and full thickness rotator cuff tears, although evidence shows surgery is not necessarily superior to non-surgical therapy. The purpose of this study was to compare percutaneous orthobiologic treatment to a home exercise therapy program for supraspinatus tears.

Methods

In this randomized-controlled, crossover design, participants with a torn supraspinatus tendon received either ‘BMC treatment’, consisting of a combination of autologous bone marrow concentrate (BMC) and platelet products, or underwent a home exercise therapy program. After three months, patients randomized to exercise therapy could crossover to receive BMC treatment if not satisfied with shoulder progression. Patient-reported outcomes of Numeric Pain Scale (NPS), Disabilities of the Arm, Shoulder, and Hand, (DASH), and a modified Single Assessment Numeric Evaluation (SANE) were collected at 1, 3, 6, 12, and 24 months. Pre- and post-treatment MRI were assessed using the Snyder Classification system.

Results

Fifty-one patients were enrolled and randomized to the BMC treatment group (n = 34) or the exercise therapy group (n = 17). Significantly greater improvement in median ΔDASH, ΔNPS, and SANE scores were reported by the BMC treatment group compared to the exercise therapy group (-11.7 vs -3.8, P = 0.01; -2.0 vs 0.5, P = 0.004; and 50.0 vs 0.0, P < 0.001; respectively) after three months. Patient-reported outcomes continued to progress through the study’s two-year follow-up period without a serious adverse event. Of patients with both pre- and post-treatment MRIs, a majority (73%) showed evidence of healing post-BMC treatment.

Conclusions

Patients reported significantly greater changes in function, pain, and overall improvement following BMC treatment compared to exercise therapy for high grade partial and full thickness supraspinatus tears.

Trial registration

This protocol was registered with www.clinicaltrials.gov (NCT01788683; 11/02/2013).
Index tumor location affected early biochemical recurrence after radical prostatectomy in patients with negative surgical margin: a retrospective study
Authors: Ogata Yoshihiko , Akatsuka Jun , Endo Yuki , Mikami Hikaru , Yanagi Masato , Takeda Hayato , Toyama Yuka , Yamamoto Yoichiro , Kimura Go , Kondo Yukihiro
Published: May 2024

Background

Index tumors are the most aggressive tumors of the prostate. However, their clinical significance remains unclear. This study aimed to assess the incidence of index tumor location according to the zonal origin and whether these locations affect the prognosis after radical prostatectomy in patients with negative surgical margins.

Methods

This single-centered, retrospective study evaluated 1,109 consecutive patients who underwent radical prostatectomies. An index tumor was defined as the largest tumor in the prostate gland. We detected these locations based on McNeal's zonal origin using whole-mount sections. Biochemical recurrence (BCR) free survival curves were generated using the Kaplan–Meier method. Univariate and multivariate analyses using the Cox proportional hazards model were performed to determine the predictive factors for early BCR (within 1-year).

Results

A total of 621 patients with negative surgical margins who did not receive adjuvant therapy were included in this study. The index tumor were located in the transitional zone in 191 patients (30.8%), the peripheral zone in 399 patients (64.3%), and the central zone in 31 patients (5.0%). In total, 22 of 621 patients (3.5%) experienced early BCR and 70 patients (11.2%) experienced overall BCR at a median follow-up of 61.7 months. According to the index tumor location, the early BCR-free rates were 99.5%, 95.7 %, and 83.3% in the transitional, peripheral, and central zones, respectively. On multivariate analysis, the index tumor in the central zone was an independent predictor of early BCR with negative surgical margins following radical prostatectomy, followed by prostatectomy pathological grade, index tumor in the peripheral zone, and high prostate-specific antigen level.

Conclusions

We assessed the significance of index tumor location in patients with negative surgical margins following radical prostatectomy. Index tumors located in the central zone, although infrequent, were the strongest predictive factors for early BCR. Our results may allow urologists and patients to reconsider the therapeutic strategies for prostate cancer.