bluuebunny/crossref_metadata_2025 huggingface dataset:
Coverage-level and predictors of maternity continuum of care in Nigeria: implications for maternal, newborn and child health programming
Authors: Oyedele Oyewole Kazeem , Fagbamigbe Adeniyi Francis , Akinyemi Odunayo Joshua , Adebowale Ayo Stephen
Published: January 2023

Background

Completing maternity continuum of care from pregnancy to postpartum is a core strategy to reduce the burden of maternal and neonatal mortality dominant in sub-Saharan Africa, particularly Nigeria. Thus, we evaluated the level of completion, dropout and predictors of women uptake of optimal antenatal care (ANC) in pregnancy, continuation to use of skilled birth attendants (SBA) at childbirth and postnatal care (PNC) utilization at postpartum in Nigeria.

Methods

A cross-sectional analysis of nationally representative 21,447 pregnancies that resulted to births within five years preceding the 2018 Nigerian Demographic Health Survey. Maternity continuum of care model pathway based on WHO recommendation was the outcome measure while explanatory variables were classified as; socio-demographic, maternal and birth characteristics, pregnancy care quality, economic and autonomous factors. Descriptive statistics describes the factors, backward stepwise regression initially assessed association (p < 0.10), multivariable binary logistic regression and complementary-log–log model quantifies association at a 95% confidence interval (α = 0.05).

Results

Coverage decrease from 75.1% (turn-up at ANC) to 56.7% (optimal ANC) and to 37.4% (optimal ANC and SBA) while only 6.5% completed the essential continuum of care. Dropout in the model pathway however increase from 17.5% at ANC to 20.2% at SBA and 30.9% at PNC. Continuation and completion of maternity care are positively drive by women; with at least primary education (AOR = 1.27, 95%CI = 1.01–1.62), average wealth index (AOR = 1.83, 95%CI = 1.48 –2.25), southern geopolitical zone (AOR = 1.61, 95%CI = 1.29–2.01), making health decision alone (AOR = 1.39, 95%CI = 1.16–1.66), having nurse as ANC provider (AOR = 3.53, 95%CI = 2.01–6.17) and taking at least two dose of tetanus toxoid vaccine (AOR = 1.25, 95%CI = 1.06–1.62) while women in rural residence (AOR = 0.78, 95%CI = 0.68–0.90) and initiation of ANC as late as third trimester (AOR = 0.44, 95%CI = 0.34–0.58) negatively influenced continuation and completion.

Conclusions

6.5% coverage in maternity continuum of care completion is very low and far below the WHO recommended level in Nigeria. Women dropout more at postnatal care than at skilled delivery and antenatal. Education, wealth, women health decision power and tetanus toxoid vaccination drives continuation and completion of maternity care. Strategies optimizing these factors in maternity packages will be supreme to strengthen maternal, newborn and child health.
Quality of life in Norwegian pregnant women and men with pregnant partners, and association with perception of sleep and depressive symptoms: a cross-sectional study
Authors: Brekke Malene , Amro Amin , Småstuen Milada Cvancarova , Glavin Kari , Solberg Beate , Øygarden Anne-Martha Utne , Sæther Kristin Marie , Haugland Trude
Published: January 2023

Background

Pregnant women and men with pregnant partners experience variations in quality of life (QoL) during pregnancy, a period characterized by physical, psychological, and social changes. Pregnancy is associated with reduced QoL, depressive symptoms, and sleep problems. This study aimed to: (1) determine whether Norwegian pregnant women and men with pregnant partners differed in QoL levels in the third trimester of pregnancy; (2) determine whether the relationship between perception of sleep and QoL is moderated by depressive symptoms, when analyzed separately in pregnant women and men with pregnant partners; and (3) determine whether selected possible predictive factors were associated with QoL when stratified by level of depressive symptoms, in pregnant women and men with pregnant partners separately.

Methods

A cross-sectional study conducted between October 2018 and January 2020 included 228 pregnant women and 197 men with pregnant partners in the third trimester of pregnancy. The age range was 22–50 years. QoL was assessed using the World Health Organization Quality of Life Questionnaire brief version, depressive symptoms using the Edinburgh Postnatal Depression Scale, and perception of sleep by a single item. Data were analyzed in SPSS version 28 using descriptive statistics, the PROCESS macro for moderation analyses, and multivariate linear regression. The level of statistical significance was p < 0.05.

Results

Pregnant women reported significantly lower QoL scores on the physical health and psychological domains than the men with pregnant partners. Our data did not reveal any moderating effect of depressive symptoms on the relationship between the perception of sleep and QoL. Depressive symptoms in the pregnant women were found to be a significant predictor of lower QoL in all domains. In the men with pregnant partners, getting enough sleep was a significant predictor of higher QoL in all domains. In the pregnant women without depressive symptoms, higher QoL in the physical health domain was significantly associated with the perception of getting enough sleep.

Conclusion

Women in the final trimester of pregnancy experience poor QoL compared to the men with pregnant partners. Pregnant women with depressive symptoms have lower QoL compared to those without depressive symptoms. The perception of getting enough sleep was associated with better QoL.
Biparametric magnetic resonance imaging-based radiomics features for prediction of lymphovascular invasion in rectal cancer
Authors: Tong Pengfei , Sun Danqi , Chen Guangqiang , Ni Jianming , Li Yonggang
Published: January 2023

Background

Preoperative assessment of lymphovascular invasion(LVI) of rectal cancer has very important clinical significance. However, accurate preoperative imaging evaluation of LVI is highly challenging because the resolution of MRI is still limited. Relatively few studies have focused on prediction of LVI of rectal cancer with the tool of radiomics, especially in patients with negative statue of MRI-based extramural vascular invasion (mrEMVI).The purpose of this study was to explore the preoperative predictive value of biparametric MRI-based radiomics features for LVI of rectal cancer in patients with the negative statue of mrEMVI.

Methods

The data of 146 cases of rectal adenocarcinoma confirmed by postoperative pathology were retrospectively collected. In the cases, 38 had positive status of LVI. All patients were examined by MRI before the operation. The biparametric MRI protocols included T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI). We used whole-volume three-dimensional method and two feature selection methods, minimum redundancy maximum relevance (mRMR) and least absolute shrinkage and selection operator (LASSO), to extract and select the features. Logistics regression was used to construct models. The area under the receiver operating characteristic curve (AUC) and DeLong’s test were used to evaluate the diagnostic performance of the radiomics based on T2WI and DWI and the combined models.

Results

Radiomics models based on T2WI and DWI had good predictive performance for LVI of rectal cancer in both the training cohort and the validation cohort. The AUCs of the T2WI model were 0.87 and 0.87, and the AUCs of the DWI model were 0.94 and 0.92. The combined model was better than the T2WI model, with AUCs of 0.97 and 0.95. The predictive performance of the DWI model was comparable to that of the combined model.

Conclusions

The radiomics model based on biparametric MRI, especially DWI, had good predictive value for LVI of rectal cancer. This model has the potential to facilitate the clinical recognition of LVI in rectal cancer preoperatively.
Acute phase characteristics and long-term complications of pulmonary embolism in COVID-19 compared to non-COVID-19 cohort: a large single-centre study
Authors: Franco-Moreno A. , Brown-Lavalle D. , Campos-Arenas M. , Rodríguez-Ramírez N. , Muñoz-Roldán C. , Rubio-Aguilera A. I. , Muñoz-Rivas N. , de Girón J. Bascuñana-Morejón , Fernández-Vidal E. , Palma-Huerta E. , Estévez-Alonso S. , Rodríguez-Gómez B. , Manzano-Valera S. , Pedrero-Tomé R. , Casado-Suela M. , Bibiano-Guillén C. , Mir-Montero M. , Torres-Macho J. , Bustamante-Fermosel A. ,   the Infanta Leonor Thrombosis Research Group, Moya-Mateo E. , Mestre-Gómez B. , Lorente-Ramos R. M. , Rogado J. , Obispo B. , Salazar-Chiriboga D. , Sáez-Vaquero T. , Abad-Motos A. , Cortina-Camarero C. , Such-Díaz A. , Ruiz-Velasco E. , Sierra-Hidalgo F. , de Carranza-López M. , Herrera-Morueco M. A. , Akasbi-Montalvo M. , Medrano-Izquierdo P. , Mariscal-Gómez E. , Marín-Mori K. , Figueras-González C. , López-Lallave S. , Díaz-Díaz D. , Mauleón-Fernández C. , Martín-Navarro J. , Torres-Rubio P. , Matesanz C. , Moro-Álvarez M. J. , Hernández-Rivas J. A.
Published: January 2023

Background

To compare the severity of pulmonary embolism (PE) and the long-term complications between patients with and without COVID-19, and to investigate whether the tools for risk stratification of death are valid in this population.

Methods

We retrospectively included hospitalized patients with PE from 1 January 2016 to 31 December 2022. Comparisons for acute episode characteristics, risk stratification of the PE, outcomes, and long-term complications were made between COVID and non-COVID patients.

Results

We analyzed 116 (27.5%) COVID patients and 305 (72.4%) non-COVID patients. In patients with COVID-19, the traditional risk factors for PE were absent, and the incidence of deep vein thrombosis was lower. COVID patients showed significantly higher lymphocyte count, lactate dehydrogenase, lactic acid, and D-dimer levels. COVID patients had PE of smaller size (12.3% vs. 25.5% main pulmonary artery, 29.8% vs. 37.1% lobar, 44.7% vs. 29.5% segmental and 13.2% vs. 7.9% subsegmental, respectively; p < 0.001), less right ventricular dysfunction (7.7% vs. 17.7%; p = 0.007) and higher sPESI score (1.66 vs. 1.11; p < 0.001). The need for mechanical ventilation was significantly higher in COVID patients (8.6% vs. 1.3%; p < 0.001); However, the in-hospital death was less (5.2% vs. 10.8%; p = 0.074). The incidence of long-term complications was lower in COVID cohort (p < 0.001). PE severity assessed by high sPESI and intermediate and high-risk categories were independently associated with in-hospital mortality in COVID patients.

Conclusion

The risk of in-hospital mortality and the incidence of long-term complications were lower in COVID-19. The usual tools for risk stratification of PE are valid in COVID patients.
Beneficial effects of Panax notoginseng (Burkill) F. H. Chen flower saponins in rats with metabolic hypertension by inhibiting the activation of the renin–angiotensin–aldosterone system through complement 3
Authors: Huang Qiqi , Su Jie , Xu Jie , Yu Huanhuan , Jin Xiaohu , Wang Yajun , Yan Meiqiu , Yu Jingjing , Chen Suhong , Wang Youhua , Lv Guiyuan
Published: January 2023

Background

Metabolic hypertension (MH) has become the most common type of hypertension in recent years due to unhealthy eating habits and lifestyles of people, such as over-eating alcohol, high fat, and sugar diets (ACHFSDs). Therefore, effective means to combat MH are needed. Previous studies have shown that Panax notoginseng (Burkill) F. H. Chen flower saponins (PNFS) can lower blood pressure in spontaneously hypertensive rats (SHR). However, whether it acts on MH and its mechanism of action remain unclear. 

Methods

The pharmacodynamic effects of PNFS were evaluated in rats with ACHFSDs-induced MH. The blood pressure, blood biochemical, grip strength, face temperature, vertigo time, and liver index were estimated. The histological changes in the liver and aorta were observed using hematoxylin and eosin staining. The levels of ET-1, TXB2, NO, PGI2, Renin, ACE, Ang II, and ALD in plasma were detected using ELISA. The levels of C3, KLF5, LXRα, and Renin in kidney tissues were measured using qRT-PCR.The expression levels of C3, KLF5, LXRα, and Renin in kidney tissues were examined using Western blotting.

Results

In the present study, PNFS was found to reduce blood pressure, face temperature, and vertigo time, increase grip strength and improve dyslipidemia in rats with MH. In addition, PNFS decreased the plasma levels of ET-1 and TXB2, elevated the levels of NO and PGI2, and improved pathological aortic injury. Meanwhile, PNFS decreased the plasma levels of Renin, ACE, Ang II, and ALD. QRT-PCR and Western bolt showed that PNFS downregulated C3, KLF5, LXRα, and Renin protein and mRNA expression in the kidneys of rats with MH.

Conclusion

The finding of the present study suggested that PNFS could downregulate C3 and KLF-5 expression in rats with MH, thereby inhibiting the overactivation of the renin–angiotensin–aldosterone system, while improving vascular endothelial function and ultimately reducing blood pressure in rats with MH.
Well-being variations on students of health sciences related to their learning opportunities, resources, and daily activities in an online and on-crisis context: a survey-based study
Authors: Pérez-Villalobos Cristhian , Ventura-Ventura Juan , Spormann-Romeri Camila , Paredes-Villarroel Ximena , Rojas-Pino Marcos , Jara-Reyes Catherine , Lopez Mildred , Castillo-Rabanal Isidora , Schilling-Norman Mary Jane , Baquedano-Rodríguez Marjorie , Parra-Ponce Paula , Toirkens-Niklitschek Josselinne , Briede-Westermeyer Juan Carlos , Alvarado-Figueroa Débora
Published: January 2023

Background

Universities’ training process intensely relies on face-to-face education. The COVID-19 pandemic interrupted it and forced them to reinvent their process online. But this crisis seems not to be the last we will face, and we take it as a lesson to prepare for future crises. These critical contexts are especially challenging because they imply changing teaching strategies, and students may not have the technology access or the living conditions to connect as they need. They also lived through a pandemic where the virus and the life changes added stress to their learning process and threatened their well-being. So, this study aims to analyze how well-being variations reported by Health sciences students relate to their learning opportunities, access conditions, and daily activities.

Method

We surveyed 910 Health sciences students from six different Chilean universities at the end of the first semester of 2020, the first in pandemic conditions. Respondents answered online questionnaires about 1) Remote teaching activities, 2) Learning resources availability, 3) Daily life activities, and 4) Well-being changes. We performed descriptive analysis and Structural Equation Modelling.

Results

Live videoconference classes were the most frequent teaching activity; only a third of the students had quiet spaces to study online, and most had to housekeep daily. More than two third reported some well-being deterioration. The structural equation model showed a good fit.

Conclusion

Results show an online learning scenario that tries to emulate traditional learning focusing on expositive strategies. Most students reported that their well-being deteriorated during the semester, but tutorials, workplace availability, and social support were protective factors.
How to become an excellent pediatric resident: a qualitative comparative study from China
Authors: Feng Xingmiao , Wang Yujia , Wei Linjiang , Meng Kai
Published: January 2023

Background

Competency-oriented medical education has become a global trend. However, most current studies focus on the independent effects of various competencies and lack an examination of the combined effects. Therefore, the purpose of this study was to explore the competency configurations of excellent pediatric residents and general pediatric residents and to provide a scientific reference for the talent training and career development of pediatric residents.

Methods

Behavioral event interviews were conducted with 23 pediatric residents at a children's hospital in Beijing in July and August 2019. Two researchers coded the interview data to summarize the competency of pediatric residents. The research group scored the performance of 23 pediatric residents in various aspects of competency and used the crisp-set qualitative comparative analysis method to explore the competency configurations of excellent pediatric residents and general pediatric residents.

Results

This study concludes that pediatric residents should have six core competencies: professional spirit, clinical skills, communication ability, learning ability, mental capacity and research ability. There are 4 combinations of competencies for becoming an excellent pediatric resident: the clinical type, scientific research type, all-around development type and high emotional intelligence type. In addition, there are 3 combinations of competencies for becoming a general pediatric resident: the comprehensive ability deficiency type, lack of professionalism and mental capacity type, lack of communication ability type.

Conclusions

There are differences in competence between excellent and general pediatric residents. Excellent pediatric residents do not need to possess all competencies but should specialize in clinical practice, scientific research or communication skills. This study suggests that training in mental capacity, professional spirit and communication ability should be strengthened during pediatric resident training. Pediatric residents should make career development plans according to their actual situation, and hospitals should arrange suitable positions according to the characteristics of pediatric residents.
LRRC superfamily expression in stromal cells predicts the clinical prognosis and platinum resistance of ovarian cancer
Authors: Zhu Xiaoying , You Shijing , Du Xiuzhen , Song Kejuan , Lv Teng , Zhao Han , Yao Qin
Published: January 2023

Background

Leucine-rich repeat sequence domains are known to mediate protein‒protein interactions. Recently, some studies showed that members of the leucine rich repeat containing (LRRC) protein superfamily may become new targets for the diagnosis and treatment of tumours. However, it is not known whether any of the LRRC superfamily genes is expressed in the stroma of ovarian cancer (OC) and is associated with prognosis.

Methods

The clinical data and transcriptional profiles of OC patients from the public databases TCGA (n = 427), GTEx (n = 88) and GEO (GSE40266 and GSE40595) were analysed by R software. A nomogram model was also generated through R. An online public database was used for auxiliary analysis of prognosis, immune infiltration and protein‒protein interaction (PPI) networks. Immunohistochemistry and qPCR were performed to determine the protein and mRNA levels of genes in high-grade serous ovarian cancer (HGSC) tissues of participants and the MRC-5 cell line induced by TGF-β.

Results

LRRC15 and LRRC32 were identified as differentially expressed genes from the LRRC superfamily by GEO transcriptome analysis. PPI network analysis suggested that they were most enriched in TGF-β signalling. The TCGA-GTEx analysis results showed that only LRRC15 was highly expressed in both cancer-associated fibroblasts (CAFs) and the tumour stroma of OC and was related to clinical prognosis. Based on this, we developed a nomogram model to predict the incidence of adverse outcomes in OC. Moreover, LRRC15 was positively correlated with CAF infiltration and negatively correlated with CD8 + T-cell infiltration. As a single indicator, LRRC15 had the highest accuracy (AUC = 0.920) in predicting the outcome of primary platinum resistance.

Conclusions

The LRRC superfamily is related to the TGF-β pathway in the microenvironment of OC. LRRC15, as a stromal biomarker, can predict the clinical prognosis of HGSC and promote the immunosuppressive microenvironment. LRRC15 may be a potential therapeutic target for reversing primary resistance in OC.
Lifestyle-, environmental-, and additional health factors associated with an increased sperm DNA fragmentation: a systematic review and meta-analysis
Authors: Szabó Anett , Váncsa Szilárd , Hegyi Péter , Váradi Alex , Forintos Attila , Filipov Teodóra , Ács Júlia , Ács Nándor , Szarvas Tibor , Nyirády Péter , Kopa Zsolt
Published: January 2023

Introduction

Infertility affects one in every six couples in developed countries, and approximately 50% is of male origin. In 2021, sperm DNA fragmentation (SDF) testing became an evidence-based test for fertility evaluations depicting fertility more clearly than standard semen parameters. Therefore, we aimed to summarize the potential prognostic factors of a higher SDF.

Methods

We conducted a systematic search in three medical databases and included studies investigating any risk factors for SDF values. We calculated mean differences (MD) in SDF with 95% confidence interval (CI) for exposed and non-exposed individuals.

Results

We included 190 studies in our analysis. In the group of associated health conditions, varicocele (MD = 13.62%, CI: 9.39–17.84) and impaired glucose tolerance (MD = 13.75%, CI: 6.99–20.51) had the most significant increase in SDF. Among malignancies, testicular tumors had the highest impact, with a maximum of MD = 11.3% (CI: 7.84–14.76). Among infections, the overall effects of both Chlamydia and HPV were negligible. Of lifestyle factors, smoking had the most disruptive effect on SDF – an increase of 9.19% (CI: 4.33–14.06). Different periods of sexual abstinence did not show significant variations in SDF values. Age seemed to have a more drastic effect on SDF from age 50 onwards, with a mean difference of 12.58% (CI: 7.31–17.86). Pollution also had a detrimental effect – 9.68% (CI: 6.85–12.52).

Conclusion

Of the above risk factors, varicocele, impaired glucose tolerance, testicular tumors, smoking, pollution, and paternal age of over 50 were associated with the highest SDF.

Trial registration

CRD42021282533.
The persistent viral infections in the development and severity of myalgic encephalomyelitis/chronic fatigue syndrome
Authors: Rasa-Dzelzkaleja Santa , Krumina Angelika , Capenko Svetlana , Nora-Krukle Zaiga , Gravelsina Sabine , Vilmane Anda , Ievina Lauma , Shoenfeld Yehuda , Murovska Modra ,   the VirA project
Published: January 2023

Background

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a multifactorial disease with an unexplained aetiology in which viral infections are possible trigger factors.

The aim of this study was to determine the involvement of human herpesvirus (HHV)-6A/B, HHV-7, and parvovirus B19 (B19V) in the etiopathogenesis of ME/CFS.

Methods

200 patients with clinically diagnosed ME/CFS and 150 apparently healthy individuals were enrolled in this study. Single-round, nested, and quantitative real-time polymerase chain reactions (PCR) were used to detect the presence and load of HHV-6A/B, HHV-7, and B19V. HHV-6A and HHV-6B were distinguished by PCR and restriction analysis. Immunoenzymatic assays were applied to estimate the presence of virus-specific antibodies and the level of cytokines.

Results

HHV-6A/B, HHV-7, and B19V specific antibodies were detected among patients and healthy individuals in 92.1% and 76.7%, 84.6% and 93.8%, and 78% and 67.4% of cases. HHV-6B had 99% of HHV-6 positive patients.

Latent HHV-6A/B, HHV-7, and B19V infection/co-infection was observed in 51.5% of the patients and 76.7% of the healthy individuals, whereas active–45% of the ME/CFS patients and 8.7% of healthy individuals. HHV-6A/B load in patients with a persistent infection/co-infection in a latent and active phase was 262 and 653.2 copies/106 cells, whereas HHV-7 load was 166.5 and 248.5 copies/106 cells, and B19V-96.8 and 250.8 copies/106 cells, respectively.

ME/CFS patients with persistent infection in an active phase had a higher level of pro-inflammatory cytokines (interleukin(IL)-6, tumor necrosis factor-alpha(TNF-α) and IL-12) and anti-inflammatory (IL-10) than with a persistent infection in a latent phase. A significant difference was revealed in the levels of TNF-α, IL-12, and IL-10 among the patient groups without infection, with latent infection/co-infection, active single, double and triple co-infection. The levels of TNF-α, IL-12, and IL-10 are significantly higher in patients with severe compared with a moderate course of ME/CFS.

Conclusions

Significantly more persistent HHV-6A/B, HHV-7, and B19V infection/co-infection in an active phase with a higher viral load and elevated levels of pro- and anti-inflammatory cytokines among patients with ME/CFS than healthy individuals indicate the importance of these infections/co-infections in ME/CFS development. The presence of these infections/co-infections influences the ME/CFS clinical course severity.
Exposure to cosmetic talc and mesothelioma
Authors: Moline Jacqueline , Patel Kesha , Frank Arthur L.
Published: January 2023

Aim

Mesothelioma is associated with asbestos exposure. In this case series, we present 166 cases of individuals who had substantial asbestos exposure to cosmetic talc products as well as some who had potential or documented additional exposures to other asbestos-containing products and who subsequently developed mesothelioma.

Methods

Data were gathered for all subjects referred to an occupational and environmental medicine specialist as part of medicolegal review. Years of total cosmetic talcum powder usage was noted as well as the latency from the onset of talcum powder use to the mesothelioma diagnosis. Alternate asbestos exposure in addition to the exposure from cosmetic talc was categorized as none, possible, likely, and definite.

Results

In 122 cases, the only known exposure to asbestos was from cosmetic talc. For 44 cases, potential or documented alternate exposures in addition to the cosmetic talc were described.

Conclusion

Cumulative exposure to asbestos leads to mesothelioma; for individuals with mixed exposures to asbestos, all exposures should be considered. Use of cosmetic talc is often overlooked as a source of asbestos exposure. All individuals with mesothelioma should have a comprehensive history of asbestos exposure, including cosmetic talc exposure.
A method for rapid and homogenous initiation of post-harvest physiological deterioration in cassava storage roots identifies Indonesian cultivars with improved shelf-life performance
Authors: Zainuddin Ima M. , Lecart Brieuc , Sudarmonowati Enny , Vanderschuren Hervé
Published: January 2023

Cassava is the most cultivated and consumed root crop in the world. One of the major constraints to the cassava value chain is the short shelf life of cassava storage roots which is primarily due to the so-called post-harvest physiological deterioration (PPD). The identification of natural sources of PPD tolerance represents a key approach to mitigating PPD losses by generating farmer- and industry-preferred cassava cultivars with prolonged shelf life. In the present study, a PPD assessment method was developed to screen for PPD tolerance in the cassava germplasm. The proposed PPD assessment method displayed a reduced rate of microbial infection and allowed a rapid and homogenous development of typical PPD symptoms in the cassava storage roots. We successfully used the PPD assessment method in combination with an image-based PPD scoring method to identify and characterize PPD tolerance in 28 cassava cultivars from the Indonesian cassava germplasm. Our analysis showed a significant and positive correlation between PPD score and dry matter content (r = 0.589–0.664, p-value < 0.001). Analysis of additional root parameters showed a significant and positive correlation between PPD scores at 2 days post-harvest (dph) and root length (r = 0.388, p-value < 0.05). Our analysis identified at least 4 cultivars displaying a significantly delayed onset of PPD symptoms as compared to the other selected cultivars. The availability of cassava cultivars contrasting for tolerance to PPD will be particularly instrumental to understanding the molecular mechanisms associated with delayed PPD in cassava roots.
Establishment of an efficient cotton root protoplast isolation protocol suitable for single-cell RNA sequencing and transient gene expression analysis
Authors: Zhang Ke , Liu Shanhe , Fu Yunze , Wang Zixuan , Yang Xiubo , Li Wenjing , Zhang Caihua , Zhang Dongmei , Li Jun
Published: January 2023

Background

Cotton has tremendous economic value worldwide; however, its allopolyploid nature and time-consuming transformation methods have hampered the development of cotton functional genomics. The protoplast system has proven to be an important and versatile tool for functional genomics, tissue-specific marker gene identification, tracking developmental trajectories, and genome editing in plants. Nevertheless, the isolation of abundant viable protoplasts suitable for single-cell RNA sequencing (scRNA-seq) and genome editing remains a challenge in cotton.

Results

We established an efficient transient gene expression system using protoplasts isolated from cotton taproots. The system enables the isolation of large numbers of viable protoplasts and uses an optimized PEG-mediated transfection protocol. The highest yield (3.55 × 105/g) and viability (93.3%) of protoplasts were obtained from cotton roots grown in hydroponics for 72 h. The protoplasts isolated were suitable for scRNA-seq. The highest transfection efficiency (80%) was achieved when protoplasts were isolated as described above and transfected with 20 μg of plasmid for 20 min in a solution containing 200 mM Ca2+. Our protoplast-based transient expression system is suitable for various applications, including validation the efficiency of CRISPR vectors, protein subcellular localization analysis, and protein–protein interaction studies.

Conclusions

The protoplast isolation and transfection protocol developed in this study is stable, versatile, and time-saving. It will accelerate functional genomics and molecular breeding in cotton.
A novel nanohydroxyapatite/polyamide-66 cage for reducing the subsidence rate after single-level anterior cervical discectomy and fusion: a comparative study of 7-year follow-up
Authors: Zeng Zhimou , Zhu Ce , Deng Zhipeng , Liu Limin , Song Yueming
Published: January 2023

Background

A novel nanohydroxyapatite/polyamide-66 cage (n-HA/PA66 cage) with a horseshoe shape was designed to lower the subsidence rate of the traditional hollow cylindrical n-HA/PA66 cage. However, no studies have compared the incidence of subsidence in the two cages. The purpose of this study was to compare the long-term clinical and radiological outcomes of the novel n-HA/PA66 cage with the hollow cylindrical n-HA/PA66 cage after anterior cervical discectomy and fusion (ACDF) to treat single-level cervical degenerative disk disease (CDDD).

Methods

Fifty-two patients with novel n-HA/PA66 cages (Group A) and fifty-five patients with hollow cylindrical n-HA/PA66 cages (Group B) were included. The radiological parameters included intervertebral height (IH), C2-7 angle (C2-7a), segmental alignment (SA), subsidence rate, and fusion rate. The clinical outcomes were visual analog scale (VAS) scores, Japanese Orthopedic Association (JOA) scores, and patient satisfaction rates.

Results

The pre- and postoperative SA, C2-7a, and fusion rates of the patients in Groups A and B were similar. The preoperative and 6-month postoperative IHs in both groups were comparable. However, the final follow-up IH in Group B was significantly smaller than that in Group A (35.9 mm vs. 36.7 mm). The difference in the subsidence rates at the final follow-up between Group A (5.8%, 3/52) and Group B (18.2%, 10/55) was significant. The VAS score, JOA score, and patient satisfaction rate were not significantly different.

Conclusions

The novel n-HA/PA66 cage had similar favorable SA, C2-7a, fusion rate, and clinical outcomes compared to the hollow cylindrical n-HA/PA66 cage for treating single-level ACDF. Moreover, the novel n-HA/PA66 cage achieved a lower subsidence rate and higher IH than the hollow cylindrical n-HA/PA66 cage at the final follow-up.
Human cytomegalovirus-encoded microRNAs expression profile in plasma of patients with aortic dissection
Authors: Cheng Yongqing , Du Yufan , Wang Qi , Lv Qinghe , Xue Yunxin , Zhou Weihong , Zhang Chenyu , Chen Xi , Wang Dongjin
Published: January 2023

Background

Aortic dissection (AD) is a rare disease with high mortality for which no effective diagnostic biomarkers are available. Human cytomegalovirus (HCMV) infection is an important cause of the occurrence and progression of many diseases, but the relationship between HCMV infection and AD is not clear.

Methods

In this study, we first used quantitative reverse transcription polymerase chain reaction (qRT-PCR) to determine the expression profile of 25 HCMV-encoded microRNAs (HCMV miRNAs) in the plasma within a training set consisting of 20 AD patients and 20 healthy controls. Then, abnormal expressed HCMV miRNAs were verified in a validation set of 12 AD patients and 12 healthy controls. In addition, HCMV infection was detected in the third cohort consisting of 20 AD patients and 20 healthy controls.

Results

The 95% quantile of the expression levels of HCMV miRNAs in the training set was used as the threshold for distinction between AD patients and healthy controls. The proportion of individuals with high level of five types of HCMV miRNAs was significantly different between AD patients and healthy controls. In the validation set, only the proportion of individuals with high levels of hcmv-miR-UL112-5p and hcmv-miR-UL22A-5p, two of the five HCMV miRNAs obtained in the preliminary screening, showed significant difference between AD patients and healthy controls. In the third cohort, there was no significant difference in HCMV DNA levels and anti-HCMV IgG concentrations between AD patients and healthy controls.

Conclusions

The HCMV miRNAs levels in plasma differed in AD patients and healthy controls. This finding may contribute to a further understanding of the relationship between HCMV infection and AD and are worthy of future research on the diagnosis and etiology of AD.
Effective treatment of severe stenosis of the carotid and coronary arteries: a case study
Authors: Sugiyama Kayo , Ato Fuminori , Watanuki Hirotaka , Tochii Masato , Miyachi Shigeru , Matsuyama Katsuhiko
Published: January 2023

It is considered acceptable to conservatively manage coronary artery bypass grafting patients with carotid artery disease without the need for preoperative corrective carotid revascularization. However, in the present case, rapidly progressive stroke symptoms with penumbra suggested in the arterial spin labeling, carotid artery stenting was performed successfully.
Phlebotomy resulting in controlled hypovolemia to prevent blood loss in major hepatic resections (PRICE-2): study protocol for a phase 3 randomized controlled trial
Authors: Martel Guillaume , Lenet Tori , Wherrett Christopher , Carrier François-Martin , Monette Leah , Workneh Aklile , Brousseau Karine , Ruel Monique , Chassé Michaël , Collin Yves , Vandenbroucke-Menu Franck , Hamel-Perreault Élodie , Perreault Michel-Antoine , Park Jeieung , Lim Shirley , Maltais Véronique , Leung Philemon , Gilbert Richard W. D. , Segedi Maja , Abou-Khalil Jad , Bertens Kimberly A. , Balaa Fady K. , Ramsay Tim , Fergusson Dean A.
Published: January 2023

Introduction

Blood loss and red blood cell (RBC) transfusion in liver surgery are areas of concern for surgeons, anesthesiologists, and patients alike. While various methods are employed to reduce surgical blood loss, the evidence base surrounding each intervention is limited. Hypovolemic phlebotomy, the removal of whole blood from the patient without volume replacement during liver transection, has been strongly associated with decreased bleeding and RBC transfusion in observational studies. This trial aims to investigate whether hypovolemic phlebotomy is superior to usual care in reducing RBC transfusions in liver resection.

Methods

This study is a double-blind multicenter randomized controlled trial. Adult patients undergoing major hepatic resections for any indication will be randomly allocated in a 1:1 ratio to either hypovolemic phlebotomy and usual care or usual care alone. Exclusion criteria will be minor resections, preoperative hemoglobin <100g/L, renal insufficiency, and other contraindication to hypovolemic phlebotomy. The primary outcome will be the proportion of patients receiving at least one allogeneic RBC transfusion unit within 30 days of the onset of surgery. Secondary outcomes will include transfusion of other allogeneic blood products, blood loss, morbidity, mortality, and intraoperative physiologic parameters. The surgical team will be blinded to the intervention. Randomization will occur on the morning of surgery. The sample size will comprise 440 patients. Enrolment will occur at four Canadian academic liver surgery centers over a 4-year period. Ethics approval will be obtained at participating sites before enrolment.

Discussion

The results of this randomized control trial will provide high-quality evidence regarding the use of hypovolemic phlebotomy in major liver resection and its effects on RBC transfusion. If proven to be effective, this intervention could become standard of care in liver operations internationally and become incorporated within perioperative patient blood management programs.

Trial registration

ClinicalTrials.gov NCT03651154. Registered on August 29 2018.
On new general inequalities for s-convex functions and their applications
Authors: Yildiz Çetin , Yergöz Büşra , Yergöz Abdulvahit
Published: January 2023

In this work, we established some new general integral inequalities of Hermite–Hadamard type for s-convex functions. To obtain these inequalities, we used the Hölder inequality, power-mean integral inequality, and some generalizations associated with these inequalities. Also we compared some inequalities (e.g., Theorem 6 and Theorem 8). Finally, we gave some applications for special means.
Arthroscopic iliopsoas tenotomy after total hip arthroplasty: safe method for the right patient
Authors: Nikou Sarantos , Lindman Ida , Sigurdsson Arnar , Karlsson Louise , Öhlin Axel , Senorski Eric Hamrin , Sansone Mikael
Published: January 2023

Purpose

To evaluate the outcome of arthroscopic treatment for iliopsoas impingement after total hip arthroplasty (THA) 2 years after surgery using patient reported outcomes (PROM).

Methods

In this study 12 patients (13 hips) were included from a local hip arthroscopy registry. Patients completed web‐based PROMs preoperatively and at a minimum of 2 years postoperatively. The PROMs included the International Hip Outcome Tool short version (iHOT‐12), the Copenhagen Hip and Groin Outcome Score (HAGOS), the European Quality of Life‐5 Dimensions Questionnaire (EQ‐5D), the Hip Sports Activity Scale (HSAS) for physical activity level, the Visual Analog Scale (VAS) for overall hip function and a single question regarding overall satisfaction with the surgery.

Results

The mean age was 64.4 years (±15.1SD), mean body mass index (BMI) was 26.6 (±4.3SD), mean follow‐up time was 49.8 months (±25SD). Comparing PROMs preoperatively with 2‐year follow up showed an improvement for many of the PROMs used. The PROMs scores were iHOT‐12 (24.9 vs 34.5, p = 0.13), HAGOS subscales (symptoms 38.2 vs 54.5, p = 0.05; pain 36 vs 53, p = 0.04; sport 14.1 vs 35.1, p = 0.03; daily activity 31 vs 47.5, p = 0.04; physical activity 21.8 vs 24, p = 0.76; quality of life 24 vs 35, p = 0.03), EQ‐VAS (57.9 vs 58, p = 0.08), EQ‐5D (0.34 vs 0.13, p = 0.07) and VAS for overall hip function (43.1 vs 46.2, p = 0.14). In total, 10 out of the 12 patients (83%) were satisfied with the intervention.

Conclusion

Patients undergoing surgery for iliopsoas impingement after previous THA showed improved self‐reported hip function where most patients were satisfied with treatment.
Improving the geotechnical properties of a Nigerian termite reworked soil using pretest drying conditions and sawdust ash
Authors: Ale Temitayo Olamide
Published: January 2023

The environments of tropical regions favour the activities and growth of termitaria on soils and woods. The aim of this study is to determine the effect of pretest drying conditions and sawdust ash (SDA) on the strength properties of termite reworked soil for pre and post engineering construction. Twelve disturbed subsoil samples; six termite reworked soil samples and six neighboring residual soils of each of the termite reworked soils were obtained in Akungba Akoko, South-western Nigeria. The termite reworked soil and the surrounding residual soil met the Nigeria requirement of a good sub-grade soil. However, termite reworked soil shows better geotechnical ratings when compared to the surrounding residual soil samples. This result attested to the fact that termites’ activities promote forces of attraction and adhesion among the soil particles. On the addition of sawdust ash to termite reworked soil at 6% of the weight of the soil samples; the geotechnical properties of the termite reworked soils slightly improved. Again, the geotechnical properties of termite reworked soils were considered under varying pretest drying conditions; of air-dried condition as well as conditions obtained by drying the soils at 50°C ± 5, 75°C ± 5 and 110°C ± 5. The index and strength properties of the termite reworked soils improved with increase in pretest drying temperature. Statistical analysis of ANOVA shows that there is no significant statistical difference in the values of the geotechnical parameters of the sampled soils under pretest drying conditions. For Pearson’s correlation, SDA improved soil and pretest drying temperatures for fine contents with CBR and MDD values; the obtained test values of correlation are higher than the critical r value (0.497). Again we reject null hypothesis in favour of the test hypothesis.
Personalised exercise therapy and self-management support for people with multimorbidity: feasibility of the MOBILIZE intervention
Authors: Skou Søren T. , Brødsgaard Rasmus H. , Nyberg Mette , Dideriksen Mette , Bodtger Uffe , Bricca Alessio , Jäger Madalina
Published: January 2023

Background

Exercise therapy is safe and effective in people with single conditions, but the feasibility in people with two or more conditions is unclear. Therefore, the aim was to evaluate the feasibility of exercise therapy and self-management in people with multimorbidity prior to a randomised, controlled trial (RCT).

Methods

This was a mixed-methods feasibility study performed in two general hospitals and one psychiatric hospital. 20 adult patients (8 females; mean age (SD) 67 (6.9)) with at least two long-term conditions and a score of ≥ 3 on Disease Burden Impact Scale for at least one condition (at least moderate limitations of daily activities) and of ≥ 2 for at least one other condition. Patients with unstable health conditions, at risk of serious adverse events (SAE) or with terminal conditions were excluded. Participants received 12 weeks of exercise (18 60-min group-based and 6 home-based sessions) and self-management support (6 90-min group-based sessions) supervised by physiotherapists. Pre-defined progression to RCT criteria were the primary outcomes and included recruitment rate (acceptable 20 participants in 3 months), retention through follow-up (75% retention), compliance (75% complete > 9 of exercise and > 3 self-management sessions), outcome burden (80% do not find outcomes too burdensome), improvement in quality of life (EQ-5D-5L) and function (6-min walk test; ≥ 50% experience clinically relevant improvements) and intervention-related SAEs (No SAEs). Furthermore, a purposeful sample including eleven participants and two facilitators were interviewed about their experiences of participating/facilitating. Qualitative data was analysed using thematic analysis.

Results

Recruitment rate (20 in 49 days), retention (85%), outcome burden (95%), and SAEs (0 related to intervention) were acceptable, while compliance (70%) and improvements (35% in quality of life, 46% in function) were not (amendment needed before proceeding to RCT). The intervention was found acceptable by both participants and physiotherapists with some barriers among participants relating to managing multiple chronic conditions while caring for others or maintaining a job. Physiotherapists expressed a need for additional training.

Conclusions

Exercise therapy and self-management are feasible in people with multimorbidity. The subsequent RCT, amending the intervention according to progression criteria and feedback, will determine whether the intervention is superior to usual care alone.

Trial registration

ClinicalTrials.gov registration: NCT04645732

Open Science Frameworkhttps://osf.io/qk6yg/
A customized regimen of intravitreal aflibercept for the treatment of choroidal neovascularization secondary to different chorioretinal diseases
Authors: Moussa Magdy , Leila Mahmoud , Ali Mohamed Mayada , Osama Hashem Ahmed
Published: January 2023

Background

To assess the response of CNV secondary to chorioretinal diseases to IVA and to explore the adequate dosing regimen and the long-term results.

Methods

A retrospective study including patients with treatment-naïve active CNV secondary to chorioretinal diseases. All patients received an initial IVA injection followed by a PRN regimen. The main outcome measures were improvement of BCVA, improvement of anatomical morphology and vascularity of the CNV on SS-OCT, and SS-OCTA, respectively, and ocular or systemic complications attributed to IVA.

Results

The study included 17 eyes of 15 patients. Nine patients (60%) were females. The median age was 20 years. The main primary chorioretinal disease was vitelliform macular dystrophy (29%). The mean baseline BCVA was 0.16. The mean follow-up period was 15 months. Final BCVA improved by a mean of 6 lines. The CNV regressed or became inactive in all eyes. The median number of IVA injections was 2. There were no ocular or systemic complications attributed to IVA.

Conclusion

The customized IVA regimen is effective in inducing long-term regression of secondary CNV and in improving BCVA. Multimodal imaging is fundamental in establishing the diagnosis of CNV, and in monitoring its response to IVA.
Intracranial peak pressure as a predictor for perioperative mortality after spontaneous intracerebral hemorrhage evacuation and decompressive craniectomy
Authors: Wang Zhong , Zhang Ruijian , Han Zhitong , Zhang Yisong , Wang Junqing , Wang Bo , Liu Baiyu , Yang Weiran
Published: January 2023

Background

An optimal intracranial pressure (ICP) management target is not well defined in patients with spontaneous intracerebral hemorrhage. The aim of this study was to explore the association between perioperative ICP monitoring parameters and mortality of patients with spontaneous intracerebral hematoma undergoing emergency hematoma removal and decompressive craniectomy (DC), to provide evidence for a target-oriented ICP management.

Methods

The clinical and radiological features of 176 consecutive patients with spontaneous intracerebral hemorrhage that underwent emergent hematoma evacuation and DC were reviewed. The Glasgow Coma Scale (GCS) and Glasgow Outcome Scale (GOS) scores were assessed 2 weeks after surgery. Multivariate logistic regression analysis was performed to identify predictors for perioperative death.

Results

Forty-four cases (25.0%) were assigned to the ICP group. In patients with an ICP monitor, the median peak ICP value was 25.5 mmHg; 50% of them had a peak ICP value of more than 25 mmHg. The median duration of ICP > 25 mmHg was 2 days. Without a target-specific ICP management, the mortality at 2 weeks after surgery was similar between patients with or without an ICP monitor (27.3% versus 18.2%, p = 0.20). In multivariable analysis, the peak ICP value (OR 1.11, 95% CI 1.004–1.234, p = 0.04) was significantly associated with perioperative death in the ICP group. The area under ROC curve of peak ICP value was 0.78 (95%CI 0.62–0.94) for predicting mortality, with a cut-off value of 31 mmHg.

Conclusion

Compared with a persistent hyperintracranial pressure, a high ICP peak value might provide a better prediction for the mortality of patients with spontaneous intracerebral hemorrhage evacuation and DC, suggesting a tailored ICP management protocol to decrease ICP peak value.