bluuebunny/crossref_metadata_2025 huggingface dataset:
Mycobacterium tuberculosis EspR modulates Th1-Th2 shift by transcriptionally regulating IL-4, steering increased mycobacterial persistence and HIV propagation during co-infection
Authors: Yandrapally Sriram , Agarwal Anushka , Chatterjee Archismita , Sarkar Satarupa , Mohareer Krishnaveni , Banerjee Sharmistha
Published: October 2023

Mycobacterium tuberculosis (Mtb) and HIV are known to mutually support each other during co-infection by multiple mechanisms. This synergistic influence could be either by direct interactions or indirectly through secreted host or pathogen factors that work in trans. Mtb secretes several virulence factors to modulate the host cellular environment for its persistence and escaping cell-intrinsic immune responses. We hypothesized that secreted Mtb transcription factors that target the host nucleus can directly interact with host DNA element(s) or HIV LTR during co-infection, thereby modulating immune gene expression, or driving HIV transcription, helping the synergistic existence of Mtb and HIV. Here, we show that the Mtb-secreted protein, EspR, a transcription regulator, increased mycobacterial persistence and HIV propagation during co-infection. Mechanistically, EspR localizes to the nucleus of the host cells during infection, binds to its putative cognate motif on the promoter region of the host IL-4 gene, activating IL-4 gene expression, causing high IL-4 titers that induce a Th2-type microenvironment, shifting the macrophage polarization to an M2 state as evident from CD206 dominant population over CD64. This compromised the clearance of the intracellular mycobacteria and enhanced HIV propagation. It was interesting to note that EspR did not bind to HIV LTR, although its transient expression increased viral propagation. This is the first report of an Mtb transcription factor directly regulating a host cytokine gene. This augments our understanding of the evolution of Mtb immune evasion strategies and unveils how Mtb aggravates comorbidities, such as HIV co-infection, by modulating the immune microenvironment.
Case report: Successful treatment with contezolid in a patient with tuberculous meningitis who was intolerant to linezolid
Authors: Xu Zhe , Zhang Jing , Guan Tingting , Wan Guichuan , Jiang Chao , Lang Linchuan , Wang Lianzhi
Published: October 2023

Tuberculous meningitis (TBM) is the most common form of central nervous system tuberculosis (TB) and the most severe form of extrapulmonary TB. It often presents with non-specific symptoms initially and has a high mortality and disability rate. With good central nervous system penetration, linezolid is recommended for treating drug-resistant, severe, or refractory tuberculous meningitis in China. Despite the benefits of linezolid on TBM treatment, the adverse effects of long-term therapy, such as myelosuppression, peripheral neuritis, and optic neuritis, are notable and can be severe and even life-threatening, leading to discontinuation and compromising treatment expectations. Contezolid is a novel oxazolidinone antibacterial agent approved by the National Medical Products Administration of China in 2021, which has a more favorable safety profile than linezolid in terms of myelosuppression and monoamine oxidase inhibition. Here we first report a case of TBM in a patient who was intolerant to antituberculosis treatment with linezolid and achieved good efficacy and safety results after the compassionate use of contezolid. Given the widespread use of linezolid in TB treatment and the potential risks for long-term use, multi-center prospective controlled clinical trials in TB and TBM patients are needed to investigate the appropriate use of contezolid further.
Using the modified Delphi technique to develop a framework for interprofessional education during international electives in health professions training institutions in Sub-Saharan Africa
Authors: Nawagi Faith , Munabi Ian Guyton , Vyt Andre , Kiguli Sarah , Rabin Tracy , Waggie Firdouza , Mubuuke Aloysius Gonzaga
Published: October 2023

Background

International electives provide a learning platform where interprofessional education and collaborative practice (IPECP) skills can be cultivated. However, hardly any frameworks to guide the implementation of interprofessional education (IPE) during international electives, especially in the context of low-income settings have been published. To address this gap, this study used the modified Delphi approach to develop an IPE framework guide for international electives to be used by health professions training institutions in Sub-Saharan Africa.

Methods

A rapid literature review and a study among students and faculty in four African health professional training institutions were done to inform the process. This was followed by the modified Delphi technique that used three Delphi rounds with a panel of eight experts to build consensus on the final framework for IPE during international electives. The level of consensus was set at ≥70% on each of the statements in all rounds.

Results

Out of the 52 statements in round 1 (n = 37, 71%) reached consensus while (n = 15, 29%) of the statements did not reach consensus and were discussed in round 2. Round 2 led to 42 statements to be utilized for round 3. In round 3, all statements (42) reached a consensus and an IPE framework to guide the implementation of international electives was developed. The framework consists of three sections. Section one highlights the various IPECP competencies to be gained by learners in the areas of teamwork, interprofessional communication, roles and responsibilities of interprofessional collaborative practice, values and ethics of interprofessional collaboration, and reflection and evaluation of oneself and the team. Section two gives guidance on the structuring of the IPE international electives in health professional training institutions. This includes subsections on operational/institutional needs, acculturation considerations, teaching strategies, assessment strategies, mode of delivery, and public health considerations. Section three consists of the various practical guides and approaches that health professional training institutions could use according to what works best in their setting.

Conclusion

The modified Delphi technique was an adequate approach to aid the development of an IPE framework to guide implementation during international electives in various health professional training institutions.
An exploration of mechanism of high quality and yield of Gastrodia elata Bl. f. glauca by the isolation, identification, and evaluation of Mycena
Authors: Yu En , Liu Qun , Gao Yugang , Li Yaqi , Zang Pu , Zhao Yan , He Zhongmei
Published: October 2023

Gastrodia elata Bl. f. glauca is an important traditional Chinese medicinal plant. The yield and quality of Gastrodia elata Bl. have significantly decreased due to multigenerational asexual reproduction. Therefore, it is necessary to have sexual reproduction of Gastrodia elata Bl. to supplement the market supply. Seeds of G. elata Bl. have no endosperm, and their sexual reproduction depends on the nutrients provided by the embryo cells infected by Mycena fungi to complete seed germination. However, Mycena fungi are small and have many species, and not all Mycena fungi can promote the germination of G. elata Bl. seeds. Therefore, it is of great significance to isolate and identify suitable germination fungi and explore the mechanism for improving the production performance and yield, and quality of G. elata Bl. Six closely related Mycena isolates, JFGL-01, JFGL-02, JFGL-03, JFGL-04, JFGL-05, and JFGL-06, were isolated from the leaves and protocorms of G. elata Bl. f. glauca and were identified as Mycena purpureofusca. The mycelial state and number of germinating protocorms were used as indicators to preferentially select Mycena fungi, and it was concluded that JFGL-06 had the best mycelial state and ability to germinate G. elata Bl. seeds. Finally, a mechanism to increase the yield of G. elata Bl. was explored by comparing the changes in nutrient elements and microbial diversity in the soil around G. elata Bl. with different strains. JFGL-06 proved to be an excellent Mycena fungal strain suitable for G. elata Bl. f. glauca. Compared with the commercial strain, JFGL-06 significantly increased the C, N, Na, Mg, S, Cl, K, Ca, and Fe contents of the soil surrounding the protocorms of G. elata Bl. f. glauca. JFGL-06 improved the composition, diversity, and metabolic function of the surrounding soil microbial community of G. elata Bl. f. glauca protocorms at the phylum, class, and genus levels, significantly increased the relative abundance of bacteria such as Acidobacteria and fungi such as Trichoderma among the dominant groups, and increased the abundance of functional genes in metabolic pathways such as nucleotide metabolism and energy metabolism. There was a significant reduction in the relative abundance of bacteria, such as Actinomycetes, and fungi, such as Fusarium, in the dominant flora, and a reduced abundance of functional genes, such as amino acid metabolism and xenobiotic biodegradation and metabolism. This is the main reason why the JFGL-06 strain promoted high-quality and high-yield G. elata Bl. f. glauca in Changbai Mountain.
Effect of silencing Thrips palmi Btk29A and COL3A1 on fitness and virus acquisition
Authors: Rajesh Vavilapalli , Jangra Sumit , Ghosh Amalendu
Published: October 2023

Thrips palmi (Thysanoptera: Thripidae) is a major agricultural pest infesting over 200 plant species. Along with direct injury caused by feeding, T. palmi spreads several orthotospoviruses. Groundnut bud necrosis orthotospovirus (GBNV, family Tospoviridae, genus Orthotospovirus) is the predominant orthotospovirus in Asia, vectored by T. palmi. It is responsible for almost 89 million USD losses in Asia annually. Several transcripts of T. palmi related to innate immune response, receptor binding, cell signaling, cellular trafficking, viral replication, and apoptosis are responsive to the infection of orthotospoviruses in thrips. Expression of T. palmi tyrosine kinase Btk29A isoform X1 (Btk29A) and collagen alpha-1(III) chain-like (COL3A1) are significantly regulated post-GBNV and capsicum chlorosis orthotospovirus infection. In the present study, T. palmi Btk29A and COL3A1 were silenced and the effect on virus titer and fitness was assessed. The expression of Btk29A and COL3A1 was significantly reduced by 3.62 and 3.15-fold, respectively, 24 h post-dsRNA exposure. Oral administration of Btk29A and COL3A1 dsRNAs induced 60 and 50.9% mortality in T. palmi. The GBNV concentration in T. palmi significantly dropped post-silencing Btk29A. In contrast, the silencing of COL3A1 led to an increase in GBNV concentration in T. palmi compared to the untreated control. To the best of our knowledge, this is the first report on the effect of silencing Btk29A and COL3A1 on the fitness and GBNV titer in T. palmi.
Vertical dynamics of free-living and particle-associated vibrio communities in the eastern tropical Indian Ocean
Authors: Zhu Shaodong , Wang Xiaolei , Zhao Wenbin , Zhang Yulin , Song Derui , Cheng Haojin , Zhang Xiao-Hua
Published: October 2023

Members of the family Vibrionaceae (vibrios) are widely distributed in estuarine, offshore, and marginal seas and perform an important ecological role in the marine organic carbon cycle. Nevertheless, there is little knowledge about whether vibrios play ecological roles in the oligotrophic pelagic area, which occupies a larger water volume. In this study, we investigated the abundance, diversity, and composition of free-living and particle-associated vibrios and their relationships with environmental factors along the water depth in the eastern tropical Indian Ocean (ETIO). The abundance of vibrios in free-living fractions was significantly higher than that of particle-associated fractions on the surface. Still, both were similar at the bottom, indicating that vibrios may shift from free-living lifestyles on the surface to mixed lifestyles at the bottom. Vibrio-specific 16S rRNA gene amplicon sequencing revealed that Paraphotobacterium marinum and Vibrio rotiferianus were dominant species in the water column, and Vibrio parahaemolyticus (a clinically important pathogen) was recorded in 102 samples of 111 seawater samples in 10 sites, which showed significant difference from the marginal seas. The community composition also shifted, corresponding to different depths in the water column. Paraphotobacterium marinum decreased with depth, and V. rotiferianus OTU1528 was mainly distributed in deeper water, which significantly correlated with the alteration of environmental factors (e.g., temperature, salinity, and dissolved oxygen). In addition to temperature and salinity, dissolved oxygen (DO) was an important factor that affected the composition and abundance of Vibrio communities in the ETIO. Our study revealed the vertical dynamics and preferential lifestyles of vibrios in the ETIO, helping to fill a knowledge gap on their ecological distribution in oligotrophic pelagic areas and fully understanding the response of vibrios in a global warming environment.
The first genomic characterization of a stable, hemin-dependent small colony variant strain of Staphylococcus epidermidis isolated from a prosthetic-joint infection
Authors: Bogut Agnieszka , Koper Piotr , Marczak Małgorzata , Całka Paulina
Published: October 2023

Phenotype switching from a wild type (WT) to a slow-growing subpopulation, referred to as small colony variants (SCVs), supports an infectious lifestyle of Staphylococcus epidermidis, the leading cause of medical device-related infections. Specific mechanisms underlying formation of SCVs and involved in the shaping of their pathogenic potential are of particular interest for stable strains as they have been only rarely cultured from clinical specimens. As the SCV phenotype stability implies the existence of genetic changes, the whole genome sequence of a stable, hemin-dependent S. epidermidis SCV strain (named 49SCV) involved in a late prosthetic joint infection was analyzed. The strain was isolated in a monoculture without a corresponding WT clone, therefore, its genome was compared against five reference S. epidermidis strains (ATCC12228, ATCC14990, NBRC113846, O47, and RP62A), both at the level of the genome structure and coding sequences. According to the Multilocus Sequence Typing analysis, the 49SCV strain represented the sequence type 2 (ST2) regarded as the most prominent infection-causing lineage with a worldwide dissemination. Genomic features unique to 49SCV included the absence of the Staphylococcal Cassette Chromosome (SCC), ~12 kb deletion with the loss of genes involved in the arginine deiminase pathway, and frameshift-generating mutations within the poly(A) and poly(T) homopolymeric tracts. Indels were identified in loci associated with adherence, metabolism, stress response, virulence, and cell wall synthesis. Of note, deletion in the poly(A) of the hemA gene has been considered a possible trigger factor for the phenotype transition and hemin auxotrophy in the strain. To our knowledge, the study represents the first genomic characterization of a clinical, stable and hemin-dependent S. epidermidis SCV strain. We propose that previously unreported indels in the homopolymeric tracts can constitute a background of the SCV phenotype due to a resulting truncation of the corresponding proteins and their possible biological dysfunction. Streamline of genetic content evidenced by the loss of the SCC and a large genomic deletion can represent a possible strategy associated both with the SCV phenotype and its adaptation to chronicity.
Non-thermal regimes of laser annealing of semiconductor nanostructures: crystallization without melting
Authors: Mirza Inam , Bulgakov Alexander V. , Sopha Hanna , Starinskiy Sergey V. , Turčičová Hana , Novák Ondřej , Mužík Jiří , Smrž Martin , Volodin Vladimir A. , Mocek Tomáš , Macak Jan M. , Bulgakova Nadezhda M.
Published: October 2023

As-prepared nanostructured semiconductor materials are usually found in an amorphous form, which needs to be converted into a crystalline one for improving electronic properties and achieving enhanced application functionalities. The most utilized method is thermal annealing in a furnace, which however is time- and energy-consuming and not applicable for low-temperature melting substrates. An alternative is laser annealing, which can be carried out in a relatively short time and, additionally, offers the possibility of annealing localized areas. However, laser-annealed nanostructures are often distorted by melting, while preserving the as-prepared morphology is essential for practical applications. In this work, we analyze conditions of non-thermal ultrafast laser annealing of two kinds of nanostructures: anodic TiO2 nanotube layers and Ge/Si multilayer stacks. For both cases, regimes of crystallization have been found, which yield in preserving the initial nanomaterial morphologies without any melting signs. On these examples, ultrafast non-thermal mechanisms of structural material transformation are discussed, which can provide new opportunities for conversion of amorphous semiconductor nanomaterials into a desired crystalline form that is of high demand for existing and emerging technologies.
Autogenous cerebral processes: an invitation to look at the brain from inside out
Authors: Maldonado Pedro E. , Concha-Miranda Miguel , Schwalm Miriam
Published: October 2023

While external stimulation can reliably trigger neuronal activity, cerebral processes can operate independently from the environment. In this study, we conceptualizeautogenous cerebral processes (ACPs)as intrinsic operations of the brain that exist on multiple scales and can influence or shape stimulus responses, behavior, homeostasis, and the physiological state of an organism. We further propose that the field should consider exploring to what extent perception, arousal, behavior, or movement, as well as other cognitive functions previously investigated mainly regarding their stimulus–response dynamics, are ACP-driven.
Improved first-pass effect in acute stroke thrombectomy using Solitaire-X compared to Solitaire-FR
Authors: Biederko Ron , Honig Asaf , Shabad Ksenia , Zlotnik Yair , Ben-Arie Gal , Alguayn Farouq , Shelef Ilan , Horev Anat
Published: October 2023

Background

In acute ischemic stroke (AIS), successful endovascular thrombectomy (EVT) of large vessel occlusion (LVO) necessitates the most suited device. Solitaire-X has longer and larger diameter pusher wires than Solitaire-FR.

As the role of a larger pusher-wire diameter is uncertain, we aim to compare procedural, clinical, and radiological outcomes for AIS patients undergoing EVT using either type of Solitaire device. Procedures were performed using the Solumbra technique, which combines a large-bore aspiration catheter with a stentriever. The primary outcome was to compare rates of successful first-pass recanalization (defined as TICI 2b/3 score). The secondary objectives were procedural (rates of successful recanalization), clinical (post-procedural NIHSS and days of hospitalization), and radiological (post-procedural ASPECT score and hemorrhagic transformation) outcome measures.

Design

Consecutive AIS patients undergoing EVT for LVO were recruited into a prospective multicenter database at our academic center. We have used Solitaire-FR until October 2020 and Solitaire-X ever since. We retrospectively analyzed our prospective consecutive registry. Included in our analysis are patients undergoing EVT using Solitaire only; patients with tandem lesions or underlying stenosis requiring emergent stenting during the procedure were excluded. The cohort of patients treated with Solitaire-X was compared with a cohort consisting of the most recent consecutive cases undergoing EVT with the Solitaire-FR.

Results

A total of 182 (71.9 ± 14, 61% male patients) AIS patients were included in the analysis with both groups (n = 91 each) sharing similar demographic characteristics, premorbid conditions, and stroke characteristics (time from symptom-onset, NIHSS, ASPECTS, occlusion site, and rates of intravenous-tPA treatment). The Solitaire-X group had a higher rate of first-pass recanalization (65.9% vs. 50.5%, p = 0.049). On 24-h post-procedural head-CT, the Solitaire-X group had higher ASPECT scores (6.51 ± 2.9 vs. 5.49 ± 3.4, p = 0.042) and lower post-procedural average bleeding volumes (0.67 ± 2.1 vs. 1.20 ± 3.4 mL, p = 0.041). The Solitaire-X group had shorter duration of hospitalization (16.6 ± 13.1 days vs. 25.1 ± 23.2, p = 0.033). On multivariate analysis, using Solitaire-X was the sole independent predictor of first-pass recanalization (OR 2.17, 95% CI 1.12–4.26, p = 0.023).

Conclusion

In our study, the use of the Stentriever-X with a larger pusher-wire diameter was associated with a higher likelihood of first-pass effect and improved procedural, clinical, and radiological outcomes in AIS patients.
A not so incidental ‘incidentaloma’ − pediatric ganglioneuroma-associated cerebellar degeneration and super-refractory status epilepticus: case report and literature review
Authors: Aboseif Albert , Palmer Kaitlyn , Abrams Aaron W. , Lachhwani Deepak , Knight Elia Margarita Pestana , Valappil Ahsan Moosa Naduvil , Zeft Andrew
Published: October 2023

Paraneoplastic neurological disorders are rare in children, with paraneoplastic cerebellar degeneration (PCD) considered highly atypical. We describe a 13-year-old girl with progressive neurobehavioral regression, cerebellar ataxia, and intractable epilepsy presenting in super-refractory status epilepticus. After an extensive evaluation, her clinical picture was suggestive of probable autoimmune encephalitis (AE). Further diagnostic testing revealed a molecularly undefined neural-restricted autoantibody in both serum and CSF, raising suspicion over an adrenal mass previously considered incidental. Surgical resection led to a robust clinical improvement, and pathology revealed a benign ganglioneuroma. This report widens the spectrum of paraneoplastic manifestations of ganglioneuroma, reviews the diagnostic approach to antibody-negative pediatric AE, and raises important clinical considerations regarding benign and incidentally found tumors in the setting of a suspected paraneoplastic neurologic syndrome.
Differences in resting state functional connectivity relative to multiple sclerosis and impaired information processing speed
Authors: Carter Sean L. , Patel Ronak , Fisk John D. , Figley Chase R. , Marrie Ruth Ann , Mazerolle Erin L. , Uddin Md Nasir , Wong Kaihim , Graff Lesley A. , Bolton James M. , Marriott James J. , Bernstein Charles N. , Kornelsen Jennifer
Published: October 2023

Background

Fifty-one percent of individuals with multiple sclerosis (MS) develop cognitive impairment (CI) in information processing speed (IPS). Although IPS scores are associated with health and well-being, neural changes that underlie IPS impairments in MS are not understood. Resting state fMRI can provide insight into brain function changes underlying impairment in persons with MS.

Objectives

We aimed to assess functional connectivity (FC) differences in (i) persons with MS compared to healthy controls (HC), (ii) persons with both MS and CI (MS-CI) compared to HC, (iii) persons with MS that are cognitively preserved (MS-CP) compared to HC, (iv) MS-CI compared to MS-CP, and (v) in relation to cognition within the MS group.

Methods

We included 107 participants with MS (age 49.5 ± 12.9, 82% women), and 94 controls (age 37.9 ± 15.4, 66% women). Each participant was administered the Symbol Digit Modalities Test (SDMT) and underwent a resting state fMRI scan. The MS-CI group was created by applying a z-score cut-off of ≤−1.5 to locally normalized SDMT scores. The MS-CP group was created by applying a z-score of ≥0. Control groups (HCMS-CI and HCMS-CP) were based on the nearest age-matched HC participants. A whole-brain ROI-to-ROI analysis was performed followed by specific contrasts and a regression analysis.

Results

Individuals with MS showed FC differences compared to HC that involved the cerebellum, visual and language-associated brain regions, and the thalamus, hippocampus, and basal ganglia. The MS-CI showed FC differences compared to HCMS-CI that involved the cerebellum, visual and language-associated areas, thalamus, and caudate. SDMT scores were correlated with FC between the cerebellum and lateral occipital cortex in MS. No differences were observed between the MS-CP and HCMS-CP or MS-CI and MS-CP groups.

Conclusion

Our findings emphasize FC changes of cerebellar, visual, and language-associated areas in persons with MS. These differences were apparent for (i) all MS participants compared to HC, (ii) MS-CI subgroup and their matched controls, and (iii) the association between FC and SDMT scores within the MS group. Our findings strongly suggest that future work that examines the associations between FC and IPS impairments in MS should focus on the involvement of these regions.
The association between hypertensive angiopathy and cerebral amyloid angiopathy in primary intracerebral hemorrhage
Authors: Zhu Yuyi , Liu Lu , Zhong Luyao , Cheng Yajun , Zhang Shihong , Wu Bo , Wang Deren , Xu Mangmang
Published: October 2023

Objective

To determine the association between the burden of cerebral small vessel disease (CSVD) due to hypertensive angiopathy (HA) and cerebral amyloid angiopathy (CAA) on MRI in patients with primary intracerebral hemorrhage (ICH).

Methods

Patients with primary ICH admitted to our center from March 2012 to November 2021 were consecutively enrolled. We used multivariate binary and ordinal regression analyses to assess the association between HA-CSVD burden and CAA-CSVD burden. Lobar cerebral microbleeds (CMBs) were categorized into three level of severity: 0–1, 2–4, and ≥ 5 lobar CMBs. A high CAA-CSVD score was defined as a CAA-CSVD score of ≥3.

Results

Overall, 222 participants (mean age 59.88 ± 13.56) were included into analysis. Age and ICH etiology differed among different lobar CMB severity and between the presence and absence of high CAA-CSVD score (all p < 0.05). Positive associations between HA-related markers and both lobar CMB severity and high CAA-CSVD score (p < 0.05 for the presence of lacune, deep CMBs ≥5, the presence of WMH, and HA-CSVD score) were observed in univariate analysis. These associations remained significant after adjusting for age, sex, ICH etiology, and potential vascular risk factors. The distribution of CAA-CSVD score was significantly different between patients with and without CMBs ≥5 (adjusted OR 2.351, 95% CI 1.242–4.455, p = 0.009) after correcting for age, sex, ICH etiology, and vascular risk factors.

Conclusion

Our study provides evidence of an association between HA-CSVD and CAA-CSVD in patients with primary ICH, which needs to be verified in future studies.
Premature drug reduction after subthalamic nucleus deep brain stimulation leading to worse depression in patients with Parkinson's disease
Authors: Diao Yu , Hu Tianqi , Xie Hutao , Fan Houyou , Meng Fangang , Yang Anchao , Bai Yutong , Zhang Jianguo
Published: October 2023

Background

Reduction of medication in Parkinson's disease (PD) following subthalamic nucleus deep brain stimulation (STN-DBS) has been recognized, but the optimal timing for medication adjustments remains unclear, posing challenges in postoperative patient management.

Objective

This study aimed to provide evidence for the timing of medication reduction post-DBS using propensity score matching (PSM).

Methods

In this study, initial programming and observation sessions were conducted over 1 week for patients 4–6 weeks postoperatively. Patients were subsequently categorized into medication reduction or non-reduction groups based on their dyskinesia evaluation using the 4.2-item score from the MDS-UPDRS-IV. PSM was employed to maintain baseline comparability. Short-term motor and neuropsychiatric symptom assessments for both groups were conducted 3–6 months postoperatively.

Results

A total of 123 PD patients were included. Baseline balance in motor and non-motor scores was achieved between the two groups based on PSM. Short-term efficacy revealed a significant reduction in depression scores within the non-reduction group compared to baseline (P < 0.001) and a significant reduction compared to the reduction group (P = 0.037). No significant differences were observed in UPDRS-III and HAMA scores between the two groups. Within-group analysis showed improvements in motor symptoms, depression, anxiety, and subdomains in the non-reduction group, while the reduction group exhibited improvements only in motor symptoms.

Conclusion

This study provides evidence for the timing of medication reduction following DBS. Our findings suggest that early maintenance of medication stability is more favorable for improving neuropsychiatric symptoms.
Impact of sarcopenia and sarcopenic obesity on survival in patients with primary liver cancer: a systematic review and meta-analysis
Authors: Li Xuanmei , Huang Xue , Lei Lifu , Tong Shiwen
Published: October 2023

Background

Sarcopenia and sarcopenic obesity are associated with an increased possibility of adverse clinical outcomes; however, the effects of sarcopenia and sarcopenic obesity on patients with primary liver cancer remain controversial. Therefore, the present study aimed to determine the impact of sarcopenia and sarcopenic obesity on survival in patients with primary liver cancer.

Methods

We searched studies published in English in PubMed, Embase, Web of Science, and Cochrane Library databases up to 13 November 2022. Cohort studies that reported the association among sarcopenia, sarcopenic obesity, and patient survival were included.

Results

A total of 64 cohort studies with data on 11,970 patients with primary liver cancer were included in the meta-analysis. Sarcopenia was associated with poor overall survival in patients with primary liver cancer [adjusted hazard ratio (HR) 2.11, 95% confidence interval (CI): 1.89–2.36, P < 0.0001], with similar findings for sarcopenic obesity (adjusted HR: 2.87, 95% CI: 2.23–3.70, P < 0.0001). Sarcopenia was also associated with poor overall survival across the subgroups analyzed by ethnicity, type of liver cancer, treatment modalities, method used to define sarcopenia, and etiology of liver cancer. We also found a negative correlation among sarcopenia, sarcopenic obesity, and recurrence-free/disease-free survival (adjusted HR: 1.73, 95% CI: 1.50–1.99, P < 0.001; adjusted HR: 2.28, 95% CI: 1.54–3.35, P < 0.001, respectively).

Conclusion

Sarcopenia and sarcopenic obesity were significantly associated with poor overall survival and recurrence-free/disease-free survival in patients with primary liver cancer.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=378433, PROSPERO [42022378433].
Symptomatic presentation influences outcomes in pediatric restrictive cardiomyopathy
Authors: Lorenzo Melissa , Lynch Aine , Ashkanase Jenna , Fazari Linda , George Kristen , Arathoon Katelyn , Minn Sunghoon , Nicolson Dawn , Jeewa Aamir , Jean-St-Michel Emilie
Published: October 2023

Introduction

Children with restrictive cardiomyopathy (RCM) traditionally have a poor prognosis, with most patients either dying or requiring heart transplantation within 2 years of diagnosis. The development of symptoms in RCM suggests advanced disease. However, as screening practices evolve and lead to diagnosis of early disease, identifying appropriate timing of transplant listing becomes increasingly important. In this context we compared outcomes of children with RCM presenting with clinical symptoms to those asymptomatic at initial presentation.

Methods

This retrospective cohort study included 25 patients with RCM presenting to a quaternary care center between 2001 and 2018. Times to transplantation, death, and a composite outcome of adverse cardiac events (CPR, cardioversion, inotropic support, mechanical ventilation, mechanical support, or heart transplant) were compared between those symptomatic and asymptomatic at presentation.

Results

At 2 years following diagnosis, patients asymptomatic at presentation had a significantly better transplant-free survival at 57% compared to 17% for symptomatic patients (p = 0.03). Those asymptomatic at diagnosis also had significantly improved cardiac event-free survival at 71% compared to symptomatic patients at 25% (p = 0.01). In multivariable analysis, cardiac symptoms at presentation remained an independent risk factor for heart-transplant or death [hazard ratio 5.17 (1.28–20.85), p = 0.02].

Conclusion

Patients with RCM who are symptomatic at time of diagnosis have significantly worse transplant-free survival and cardiac event-free survival. Given current practice variability in timing of transplant listing, the presence of any cardiac symptoms is an important negative prognostic marker and should prompt urgent transplant listing.
Entrepreneurial well-being and performance: antecedents and mediators
Authors: Tisu Luca , Vîrgă Delia , Taris Toon
Published: October 2023

Entrepreneurial well-being is tied to increasing firm performance because entrepreneurs possess additional resources to invest in their businesses. However, research integrating antecedents, specific mechanisms related to the emergence of entrepreneurial well-being (EWB), and performance is scarce. Furthermore, the collective impact of their roles as entrepreneurs and individuals outside the work context is yet to be investigated concerning venture performance. The present study addresses these issues by presenting and testing a comprehensive model employing entrepreneurs’ psychological capital as an antecedent of EWB and, indirectly, performance. We investigate this relationship through a serial mediation mechanism enabled by work engagement and entrepreneurial satisfaction regarding entrepreneurs’ work roles. Also, we employ work-life balance and mental health as mediators regarding their home roles. Drawing on data from 217 Romanian entrepreneurs, structural equation modeling analyses supported our model. PsyCap was a precursor of entrepreneurial satisfaction both directly and through work engagement. Also, PsyCap predicted entrepreneurs’ mental health directly and through work-life balance. Furthermore, both EWB components – entrepreneurial satisfaction and mental health – were associated with business performance. Hence, our model provides valuable insights regarding the interplay between entrepreneurs’ work and home roles and their relation to EWB and venture performance. It also provides the basis for future interventions that can psychologically prepare entrepreneurs to be successful in their entrepreneurial endeavors.
Reading in the city: mobile eye-tracking and evaluation of text in an everyday setting
Authors: Chana Kirren , Mikuni Jan , Schnebel Alina , Leder Helmut
Published: October 2023

Reading is often regarded as a mundane aspect of everyday life. However, little is known about the natural reading experiences in daily activities. To fill this gap, this study presents two field studies (N = 39 and 26, respectively), where we describe how people explore visual environments and divide their attention toward text elements in highly ecological settings, i.e., urban street environments, using mobile eye-tracking glasses. Further, the attention toward the text elements (i.e., shop signs) as well as their memorability, measured via follow-up recognition test, were analysed in relation to their aesthetic quality, which is assumed to be key for attracting visual attention and memorability. Our results revealed that, within these urban streets, text elements were looked at most, and looking behaviour was strongly directed, especially toward shop signs, across both street contexts; however, aesthetic values were not correlated either with the most looked at signs or the viewing time for the signs. Aesthetic ratings did however have an effect on memorability, with signs rated higher being better recognised. The results will be discussed in terms aesthetic reading experiences and implications for future field studies.
The effectiveness of an immersive virtual reality and telemedicine-based cognitive intervention on prospective memory in Parkinson’s disease patients with mild cognitive impairment and healthy aged individuals: design and preliminary baseline results of a placebo-controlled study
Authors: De Simone Maria Stefania , Costa Alberto , Tieri Gaetano , Taglieri Sara , Cona Giorgia , Fiorenzato Eleonora , Carlesimo Giovanni Augusto , Caltagirone Carlo , Zabberoni Silvia
Published: October 2023

Introduction

Prospective memory (PM) impairments have been extensively documented in individuals with Parkinson’s disease associated with mild cognitive impairment (PD-MCI) and in those with healthy aging. Considering how PM failure decreases individuals’ quality of life and functional independence in the activities of daily living, training to enhance this ability could be a prior target of intervention.

Objective

Here, we aimed to present the study protocol and preliminary results of a novel immersive virtual reality (IVR) and telemedicine-based (TM) cognitive intervention focused on executive abilities (i.e., planning, shifting, and updating) to improve PM functioning in PD-MCI patients and healthy elderly individuals.

Methods

Outcome measures, collected before, immediately after and 2 months after the intervention, included: (1) pre-post training changes in objective cognitive functioning, evaluated with tests assessing executive functions and PM; (2) pre-post training changes in subjective perception of memory functioning, psychiatric symptoms, autonomy in daily living and quality of life, evaluated using the appropriate scales; (3) usability, feasibility and users’ compliance with the proposed IVR and telemedicine program. The efficacy of this intervention compared to an active control condition is currently being evaluated in a randomized, double-blind controlled trial, which will be conducted on 30 eligible PD-MCI patients and 30 older adults.

Results

Preliminary results concerning between-group comparisons of demographic and neuropsychological screening data show a good balance among the intervention groups considered in this study. The results also suggest good levels of usability, feasibility and acceptability, thus supporting the notion that our intervention can be used to promote cognitive functioning, even in people with cognitive decline.

Conclusion

Considering the relatively low costs and easy accessibility to this program, it could prove valuable in primary prevention initiatives and early cognitive rehabilitation for dementia risk reduction.
Leveraging behavioral science and artificial intelligence to support mental health in the workplace: a pilot study
Authors: West Ashley B. , Guo Yuzhen Valerie , Bucher Amy
Published: October 2023

Introduction

Many American employers seek to alleviate employee mental health symptoms through resources like employee assistance programs (EAPs), yet these programs are often underutilized. This pilot study explores the design of a behavioral science-based email campaign targeting engagement with stress management and mental health resources via an EAP, among employees of a large home builder in the Southeastern US.

Methods

Behavioral designers created a behavioral science intervention using a multi-step design approach and evidence based behavioral strategies. For this pilot intervention, employees received either a treatment message [i.e., behavioral science message assembled and delivered via the behavioral reinforcement learning (BRL) agent] or a control message (i.e., a single generic, supportive message with a stock photo) with a call to action to utilize their EAP.

Results

A total of 773 employees received emails over the course of 1 year. Engagement was high, with an 80% email open rate. Over 170 employees (22%, 159 treatment and 14 control) clicked the CTA and logged into the EAP site at least once.

Discussion

This pilot study suggests that using behavioral science and artificial intelligence can improve employee usage of EAP, specifically with the intention of exploring mental health and stress management resources, compared to benchmark rates of 5% per year.
Evaluation of the effect of the COVID-19 pandemic on the all-cause, cause-specific mortality, YLL, and life expectancy in the first 2 years in an Iranian population—an ecological study
Authors: Pirayesh Zahra , Riahi Seyed Mohammad , Bidokhti Ali , Kazemi Toba
Published: October 2023

Background

COVID-19 pandemic resulted in excess mortality and changed the trends of causes of death worldwide. In this study, we investigate the all-cause and cause-specific deaths during the COVID-19 pandemic (2020–2022) compared to the baseline (2018–2020), considering age groups, gender, place of residence, and place of death in south Khorasan, east of Iran.

Methods

The present ecological study was conducted using South Khorasan Province death certificate data during 2018–2022. The number of death and all-cause and cause-specific mortality rates (per 100,000 people) were calculated and compared based on age groups, place of residence, place of death, and gender before (2018–2020) and during the COVID-19 pandemic (2020–2022). We also calculated total and cause-specific years of life lost (YLL) to death and gender-specific life expectancy at birth.

Results

A total of 7,766 deaths occurred from March 21, 2018, to March 20, 2020 (pre-pandemic) and 9,984 deaths from March 21, 2020, to March 20, 2022 (pandemic). The mean age at death increased by about 2 years during the COVID-19 pandemic. The mortality rate was significantly increased in the age groups 20 years and older. The most excess deaths were recorded in men, Aged more than 60 years, death at home, and the rural population. Mortality due to COVID-19 accounted for nearly 17% of deaths. The highest increase in mortality rate was observed due to endocrine and Cardiovascular diseases. Mortality rates due to the genitourinary system and Certain conditions originating in the perinatal period have decreased during the COVID-19 pandemic. The major causes of death during the pandemic were Cardiovascular diseases, COVID-19, cancer, chronic respiratory diseases, accidents, and endocrine diseases in both sexes, in rural and urban areas. Years of life lost (YLL) increased by nearly 15.0%, which was mostly due to COVID-19, life expectancy at birth has steadily declined from 2018 to202 for both genders (from 78.4 to 75).

Conclusion

In this study, we found that All-cause mortality increased by 25.5% during the COVID-19 pandemic, especially in men, older adult, Rural residents, and those who died at home (outside the hospital). Considering that the most common causes of death during the COVID-19 pandemic are also non-communicable diseases. It is necessary to pay attention to non-communicable diseases even during the pandemic of a serious infectious disease like COVID-19. The years of life lost also increased during the COVID-19 pandemic, which is necessary to pay attention to all age groups, especially the causes of death in young people. In most developing countries, the first cause of death of these groups is accidents.
Exploring the microbial landscape of the nasopharynx in children: a systematic review of studies using next generation sequencing
Authors: Zimmermann Petra
Published: October 2023

Introduction

The nasopharynx harbours a diverse and dynamic microbial community, which plays an important role in maintaining the health and homeostasis of the respiratory tract, as well as in immune system development. Understanding factors that influence the composition of the nasopharyngeal microbiome in children and its association with diseases is of particular importance, as children are at a heightened risk for respiratory infections and other adverse health outcomes.

Objectives

This review systematically summarises studies which investigated the nasopharyngeal microbiome in children, including its dynamics, stability over time, and the influence of intrinsic and extrinsic factors on its composition.

Methods

MEDLINE was searched using the OVID interface. Original studies which investigated the nasopharyngeal microbiome using next generation sequencing in children were summarised.

Results

The search identified 736 studies, of which 77 were included. The studies show that the nasopharyngeal microbiome in children is dynamic and influenced by many external factors. A high abundance of Haemophilus, Moraxella, and Streptococcus and a low abundance of Corynebacterium and Dolosigranlum are associated with adverse health outcomes such as respiratory tract infections, wheezing and asthma exacerbations. Factors which have been identified as risk factors for these adverse health outcomes, such as being born by Caesarean section, not being breast-fed, having siblings, day-care attendance, and antibiotic exposure have been shown to be associated with the aforementioned features in the nasopharyngeal microbiome.

Conclusion

The association between specific nasopharyngeal microbial profiles and adverse health outcomes highlights the potential of the nasopharyngeal microbiome as a marker for identifying children at risk for disease and even more importantly, as an avenue for targeted interventions and preventive strategies.
Zero-shot model-free learning of periodic movements for a bio-inspired soft-robotic arm
Authors: Oikonomou Paris , Dometios Athanasios , Khamassi Mehdi , Tzafestas Costas S.
Published: October 2023

In recent years, soft robots gain increasing attention as a result of their compliance when operating in unstructured environments, and their flexibility that ensures safety when interacting with humans. However, challenges lie on the difficulty to develop control algorithms due to various limitations induced by their soft structure. In this paper, we introduce a novel technique that aims to perform motion control of a modular bio-inspired soft-robotic arm, with the main focus lying on facilitating the qualitative reproduction of well-specified periodic trajectories. The introduced method combines the notion behind two previously developed methodologies both based on the Movement Primitive (MP) theory, by exploiting their capabilities while coping with their main drawbacks. Concretely, the requested actuation is initially computed using a Probabilistic MP (ProMP)-based method that considers the trajectory as a combination of simple movements previously learned and stored as a MP library. Subsequently, the key components of the resulting actuation are extracted and filtered in the frequency domain. These are eventually used as input to a Central Pattern Generator (CPG)-based model that takes over the generation of rhythmic patterns at the motor level. The proposed methodology is evaluated on a two-module soft arm. Results show that the first algorithmic component (ProMP) provides an immediate estimation of the requested actuation by avoiding time-consuming training, while the latter (CPG) further simplifies the execution by allowing its control through a low-dimensional parameterization. Altogether, these results open new avenues for the rapid acquisition of periodic movements in soft robots, and their compression into CPG parameters for long-term storage and execution.