bluuebunny/crossref_metadata_2025 huggingface dataset:
Diabetes and anti-diabetic interventions and the risk of gynaecological and obstetric morbidity: an umbrella review of the literature
Authors: Semertzidou Anita , Grout-Smith Harriet , Kalliala Ilkka , Garg Akanksha , Terzidou Vasso , Marchesi Julian , MacIntyre David , Bennett Phillip , Tsilidis Konstantinos , Kyrgiou Maria
Published: April 2023

Background

Diabetes has reached epidemic proportions in recent years with serious health ramifications. The aim of this study was to evaluate the strength and validity of associations between diabetes and anti-diabetic interventions and the risk of any type of gynaecological or obstetric conditions.

Methods

Design: Umbrella review of systematic reviews and meta-analyses.

Data sources: PubMed, Medline, Embase, Cochrane Database of Systematic Reviews, manual screening of references.

Eligibility criteria: Systematic reviews and meta-analyses of observational and interventional studies investigating the relationship between diabetes and anti-diabetic interventions with gynaecological or obstetric outcomes. Meta-analyses that did not include complete data from individual studies, such as relative risk, 95% confidence intervals, number of cases/controls, or total population were excluded.

Data analysis: The evidence from meta-analyses of observational studies was graded as strong, highly suggestive, suggestive or weak according to criteria comprising the random effects estimate of meta-analyses and their largest study, the number of cases, 95% prediction intervals, I2 heterogeneity index between studies, excess significance bias, small study effect and sensitivity analysis using credibility ceilings. Interventional meta-analyses of randomised controlled trials were assessed separately based on the statistical significance of reported associations, the risk of bias and quality of evidence (GRADE) of included meta-analyses.

Results

A total of 117 meta-analyses of observational cohort studies and 200 meta-analyses of randomised clinical trials that evaluated 317 outcomes were included. Strong or highly suggestive evidence only supported a positive association between gestational diabetes and caesarean section, large for gestational age babies, major congenital malformations and heart defects and an inverse relationship between metformin use and ovarian cancer incidence. Only a fifth of the randomised controlled trials investigating the effect of anti-diabetic interventions on women’s health reached statistical significance and highlighted metformin as a more effective agent than insulin on risk reduction of adverse obstetric outcomes in both gestational and pre-gestational diabetes.

Conclusions

Gestational diabetes appears to be strongly associated with a high risk of caesarean section and large for gestational age babies. Weaker associations were demonstrated between diabetes and anti-diabetic interventions with other obstetric and gynaecological outcomes.

Trial registration

Open Science Framework (OSF) (Registration https://doi.org/10.17605/OSF.IO/9G6AB).
Previous pulmonary infection impacts thoracoscopic procedure outcomes in patients with congenital lung malformations: a retrospective cohort study
Authors: Luo Dengke , Cheng Kaisheng , Yuan Miao , Xu Chang , He Taozhen , Jia Ru , Dai Shiyi , Liu Chenyu
Published: April 2023

Background and objectives

Patients with congenital lung malformations (CLMs) are at high risk for developing pulmonary infection. Nonetheless, prophylactic surgical excision of asymptomatic CLMs is controversial and often delayed to symptoms occurring out of concern for potential operative risks. This study aims to evaluate the impact of previous pulmonary infection on the outcome of thoracoscopic procedures in CLMs patients.

Methods

This was a retrospective cohort study of CLMs patients who received an elective operation at a tertiary care center from 2015 to 2019. Patients were divided into pulmonary infection (PI) or non-infection of pulmonary (NPI) groups according to the history of pulmonary infection. Propensity score matching was used to minimize the bias between groups. The primary outcome was conversion to thoracotomy. Postoperative outcomes were compared between patients with and without PI.

Results

We identified 464 patients, of whom 101 had a history of PI. Propensity score matching yielded a well-balanced cohort of 174 patients. PI was associated with higher conversion to thoracotomy (adjusted odds ratio = 8.7, 95% confidence interval, CI, 1.1–71.2, p = 0.039), blood loss (p = 0.044), and longer operative time (p < 0.001), chest tube placement time (p < 0.001), length of stay (p < 0.001), and postsurgical length of stay (p < 0.001).

Conclusions

Elective operation in CLMs patients with a history of PI was associated with an increased risk of conversion to thoracotomy, operative time, blood loss, chest tube placement time, length of stay, and postsurgical length of stay. Elective thoracoscopic procedures in asymptomatic CLMs patients are safe and effective, and earlier surgical intervention may be warranted.
Improvement in Neisseria gonorrhoeae culture rates by bedside inoculation and incubation at a clinic for sexually transmitted infections
Authors: Brendefur Corwin LM , Campbell P , Jakobsen K , Müller F , Lai X , Unemo M , Leegaard TM , Vildershøj Bjørnholt J , Olsen AO
Published: April 2023

Background

Culture of Neisseria gonorrhoeae is essential for surveillance of complete antimicrobial susceptibility profiles. In 2014, the culture success rate of N. gonorrhoeae from samples taken at the clinic for sexually transmitted infections (STI clinic), Oslo University Hospital, Norway, was only 20%. The present study aimed to improve gonococcal culture rates using bedside inoculation of patient samples on gonococcal agar plates and incubation at the STI clinic.

Methods

This prospective quality improvement study was conducted by the STI clinic and the Department of Microbiology at Oslo University Hospital from May 2016 - October 2017. When culture of N. gonorrhoeae was clinically indicated, we introduced a parallel ‘bedside culture’ at the STI clinic and compared results with the standard culture at the microbiology department. Samples were taken from urethra, anorectum, pharynx and cervix. Culture rates were compared across symptomatic and asymptomatic anatomical sites.

Results

From 596 gonococcal-positive PCR samples, bedside culture had a significantly higher success rate of 57% compared to 41% with standard culture (p < 0.05). Overall, culture rate from symptomatic sites was 91% v. 45% from asymptomatic sites. The culture rates from different anatomical sites were as follows: urethra 93%, anorectum 64%, pharynx 28% and cervix 70%. Bedside culture significantly (p < 0.05) improved the culture rates for symptomatic urethral and asymptomatic pharyngeal samples.

Conclusions

Where feasible, bedside inoculation on gonococcal agar plates and incubation of samples from patients with gonorrhoea is recommended. This will improve the culture diagnostics and provide additional gonococcal isolates for antimicrobial resistance surveillance.
The association between the body roundness index and the risk of colorectal cancer: a cross-sectional study
Authors: Gao Wenxing , Jin Lujia , Li Dingchang , Zhang Yue , Zhao Wen , Zhao Yingjie , Gao Jingwang , Zhou Lin , Chen Peng , Dong Guanglong
Published: April 2023

Background

Colorectal cancer (CRC), has a link between obesity, especially visceral fat. The body roundness index (BRI) can more accurately assess body fat and visceral fat levels. It is, however, unknown whether BRI is associated with CRC risk.

Methods

53,766 participants were enrolled from the National Health and Nutrition Examination Survey (NHANES). Analysing the corelation between BRI and CRC risk was performed using logistic regression. Stratified analyses revealed the association based on the population type. Receiver operating characteristic curve (ROC) was performed for predicting CRC risk using different anthropometric indices.

Results

The risk of CRC mounting apparently with elevated BRI for participants with CRC compared to normal participants (P-trend < 0.001). The association persisted even after adjusting for all covariates (P-trend = 0.017). In stratified analyses, CRC risk increased with increasing BRI, especially among those who were inactive (OR (95% CI): Q3 3.761 (2.139, 6.610), P < 0.05, Q4 5.972 (3.347, 8.470), P < 0.01), overweight (OR (95% CI): Q3 2.573 (1.012, 7.431), P < 0.05, Q4 3.318 (1.221, 9.020), P < 0.05) or obese (OR (95% CI): Q3 3.889 (1.829, 8.266), P < 0.001, Q4 4.920 (2.349, 10.308), P < 0.001). ROC curve showed that BRI had a better ability in forecasting the risk of CRC than other anthropometric indices such as body weight etc. (all P < 0.05).

Conclusions

CRC risk and BRI have a positive and significant relationship, particularly in inactive participants with BMI ≥ 25 kg/m2. It is hoped that these results will raise awareness of the importance of reducing visceral fat deposition.
Anticoagulation strategy and safety in critically ill COVID-19 patients: a French retrospective multicentre study
Authors: Lamouche-Wilquin Pauline , Perrin Léa , Pere Morgane , Raymond Matthieu , Asfar Pierre , Darreau Cedric , Reizine Florian , Colin Gwenhaël , Delbove Agathe , Auchabie Johann , Hourmant Baptiste , Frérou Aurélien , Combe Béatrice La , Morin Jean , Kergoat Pierre , Lorber Julien , Egreteau Pierre-Yves , Souchard Jérome , Canet Emmanuel , Lascarrou Jean-Baptiste
Published: April 2023

Background

Patients with critical illness due to COVID-19 exhibit increased coagulability associated with a high risk of venous thrombo-embolism (VTE). Data on prophylactic anticoagulation for these patients are limited and conflicting. The purpose of this study was to evaluate whether intermediate-dose prophylactic anticoagulation in patients with COVID-19 requiring ICU admission was associated with better outcomes compared to standard-dose prophylactic anticoagulation.

Methods

We retrospectively included adults admitted with severe COVID-19 to any of 15 ICUs, in 2020 or 2021. We compared the groups given intermediate-dose vs. standard-dose prophylactic anticoagulation. The primary outcome was all-cause day-90 mortality. Secondary outcomes were VTE (pulmonary embolism or deep vein thrombosis), ICU stay length, and adverse effects of anticoagulation.

Results

Of 1174 included patients (mean age, 63 years), 399 received standard-dose and 775 intermediate-dose prophylactic anticoagulation. Of the 211 patients who died within 90 days, 86 (21%) received intermediate and 125 (16%) standard doses. After adjustment on early corticosteroid therapy and critical illness severity, there were no significant between-group differences in day-90 mortality (hazard ratio [HR], 0.73; 95%CI, 0.52–1.04; p = 0.09) or ICU stay length (HR, 0.93; 95%CI, 0.79–1.10; p = 0.38). Intermediate-dose anticoagulation was significantly associated with fewer VTE events (HR, 0.55; 95%CI, 0.38–0.80; p < 0.001). Bleeding events occurred in similar proportions of patients in the two groups (odds ratio, 0.86; 95%CI, 0.50–1.47; p = 0.57).

Conclusions

Mortality on day 90 did not differ between the groups given standard-dose and intermediate-dose prophylactic anticoagulation, despite a higher incidence of VTE in the standard-dose group.
The “Great Debate” at Melanoma Bridge 2022, Naples, December 1st–3rd, 2022
Authors: Ascierto Paolo A. , Blank Christian , Eggermont Alexander M. , Garbe Claus , Gershenwald Jeffrey E. , Hamid Omid , Hauschild Axel , Luke Jason J. , Mehnert Janice M. , Sosman Jeffrey A. , Tawbi Hussein A. , Mandalà Mario , Testori Alessandro , Caracò Corrado , Osman Iman , Puzanov Igor
Published: April 2023

The Great Debate session at the 2022 Melanoma Bridge congress (December 1–3) featured counterpoint views from leading experts on five contemporary topics of debate in the management of melanoma. The debates considered the choice of anti-lymphocyte-activation gene (LAG)-3 therapy or ipilimumab in combination with anti-programmed death (PD)-1 therapy, whether anti-PD-1 monotherapy is still acceptable as a comparator arm in clinical trials, whether adjuvant treatment of melanoma is still a useful treatment option, the role of adjuvant therapy in stage II melanoma, what role surgery will continue to have in the treatment of melanoma. As is customary in the Melanoma Bridge Great Debates, the speakers are invited by the meeting Chairs to express one side of the assigned debate and the opinions given may not fully reflect personal views. Audiences voted in favour of either side of the argument both before and after each debate.
Genomic characterization of an Omono River virus isolated from Culex tritaeniorhynchus in eastern China
Authors: Lin Xiaojuan , Sun Bo , Liu Guifang , Wu Yunjiao , Liu Yao , Ji Feng , Tao Zexin , Xu Aiqiang
Published: April 2023

Omono River virus (OMRV) is a newly reported, unclassified RNA virus in the family Totiviridae, which infects mosquitoes and bats. In this study, we report the isolation of an OMRV strain SD76 from Culex tritaeniorhynchus captured in Jinan city, China. The cytopathic effect was characterized by cell fusion on C6/36 cell line. Its complete genome was 7611 nucleotides in length, with 71.4–90.4% similarities with other OMRV strains. Phylogenetic analysis based on complete genomes showed all OMRV-like strains can be divided into 3 groups with between-group distances ranging from 0.254 to 0.293. These results revealed that the OMRV isolate had high genetic diversity with those identified previously, and enriched the genetic information of family Totiviridae.
Financing of health services for undocumented immigrants in Iran: common challenges and potential solutions
Authors: Etemadi Manal , Shahabi Saeed , Lankarani Kamran Bagheri , Heydari Seyed Taghi
Published: April 2023

Introduction

Iran is host to one of the largest urban refugee populations worldwide, about two million of whom are undocumented immigrants (UIs). UIs are not eligible to enroll in the Iranian health insurance scheme and have to pay out-of-pocket to access most health services. This increases the likelihood that they will delay or defer seeking care, or incur substantial costs if they do seek care, resulting in worse health outcomes. This study aims to improve understanding of the financial barriers that UIs face in utilizing health services and provide policy options to ensure financial protection to enhance progress towards UHC in Iran.

Methods

This qualitative study was conducted in 2022. A triangulation approach, including interviews with key informants and comparing them with other informative sources to find out the complementary findings, was applied to increase data confirmability. Both purposive and snowball sampling approaches were used to select seventeen participants. The data analysis process was done based on the thematic content analysis approach.

Results

The findings were explained under two main themes: the financial challenges in accessing health services and the policy solutions to remove these financial barriers, with 12 subthemes. High out-of-pocket payments, high service prices for UIs, fragmented financial support, limited funding capacity, not freeing all PHC services, fear of deportation, and delayed referral are some of the barriers that UIs face in accessing health care. UIs can get insurance coverage by using innovative ways to get money, like peer financing and regional health insurance, and by using tools that make it easier, like monthly premiums without policies that cover the whole family.

Conclusion

The formation of a health insurance program for UIs in the current Iranian health insurance mechanism can significantly reduce management costs and, at the same time, facilitate risk pooling. Strengthening the governance of health care financing for UIs in the form of network governance may accelerate the inclusion of UIs in the UHC agenda in Iran. Specifically, it is necessary to enhance the role of developed and rich regional and international countries in financing health services for UIs.
Monozygotic twin cases of endometriosis with Glanzmann thrombasthenia: a case report and review of literature
Authors: Rokhgireh Samaneh , Mehdizadehkashi Abolfazl , Chaichian Shahla , Faranoush Mohammad , Salmanpour Fardis , Samieefar Noosha , Derakhshan Roya
Published: April 2023

Background

Glanzmann thrombasthenia (GT) is a rare bleeding disorder with a high prevalence in communities where consanguineous marriages are mainstream. Endometriosis is a chronic inflammatory disease, and its risk increases in women with menstrual periods of longer than six days. The phenotypic expression of endometriosis is determined by the frequency and rate of the menstrual flow, as well as genetic and environmental factors.

Result and case presentation

14-year-old monozygotic twin sisters with GT who developed ovarian endometriosis were referred to Hazrat Rasoul Hospital due to severe dysmenorrhea. In ultrasonic examination, endometrioma cysts were reported in both patients. They both went under endometrioma cystectomy, and the bleeding was managed using antifibrinolytic drugs, followed by recombinant activated coagulation factor VII. Both were discharged after 3 days. In the ultrasound examination performed one year after the surgery, ovaries were normal in the first twin, while the second twin had a 28 × 30 hemorrhagic cyst in the left ovary.

Discussion and conclusion

Menstrual bleeding and genetic factors are two theories that could be related to GT and endometriosis association, and GT could be considered a risk factor for endometriosis.
Effects of an asymmetrical high flow nasal cannula interface in hypoxemic patients
Authors: Slobod Douglas , Spinelli Elena , Crotti Stefania , Lissoni Alfredo , Galazzi Alessandro , Grasselli Giacomo , Mauri Tommaso
Published: April 2023

Background

Optimal noninvasive respiratory support for patients with hypoxemic respiratory failure should minimize work of breathing without increasing the transpulmonary pressure. Recently, an asymmetrical high flow nasal cannula (HFNC) interface (Duet, Fisher & Paykel Healthcare Ltd), in which the caliber of each nasal prong is different, was approved for clinical use. This system might reduce work of breathing by lowering minute ventilation and improving respiratory mechanics.

Methods

We enrolled 10 patients ≥ 18 years of age who were admitted to the Ospedale Maggiore Policlinico ICU in Milan, Italy, and had a PaO2/FiO2 < 300 mmHg during HFNC support with a conventional cannula. We investigated whether the asymmetrical interface, compared to a conventional high flow nasal cannula, reduces minute ventilation and work of breathing. Each patient underwent support with the asymmetrical interface and the conventional interface, applied in a randomized sequence. Each interface was provided at a flow rate of 40 l/min followed by 60 l/min. Patients were continuously monitored with esophageal manometry and electrical impedance tomography.

Results

Application of the asymmetrical interface resulted in a −13.5 [−19.4 to (−4.5)] % change in minute ventilation at a flow rate of 40 l/min, p = 0.006 and a −19.6 [−28.0 to (−7.5)] % change at 60 l/min, p = 0.002, that occurred despite no change in PaCO2 (35 [33–42] versus 35 [33–43] mmHg at 40 l/min and 35 [32–41] versus 36 [32–43] mmHg at 60 l/min). Correspondingly, the asymmetrical interface lowered the inspiratory esophageal pressure–time product from 163 [118–210] to 140 [84–159] (cmH2O*s)/min at a flow rate of 40 l/min, p = 0.02 and from 142 [123–178] to 117 [90–137] (cmH2O*s)/min at a flow rate of 60 l/min, p = 0.04.

The asymmetrical cannula did not have any impact on oxygenation, the dorsal fraction of ventilation, dynamic lung compliance, or end-expiratory lung impedance, suggesting no major effect on PEEP, lung mechanics, or alveolar recruitment.

Conclusions

An asymmetrical HFNC interface reduces minute ventilation and work of breathing in patients with mild-to-moderate hypoxemic respiratory failure supported with a conventional interface. This appears to be primarily driven by increased ventilatory efficiency due to enhanced CO2 clearance from the upper airway.
Identification of genetic variants that impact gene co-expression relationships using large-scale single-cell data
Authors: Li Shuang , Schmid Katharina T. , de Vries Dylan H. , Korshevniuk Maryna , Losert Corinna , Oelen Roy , van Blokland Irene V. ,   BIOS Consortium, sc-eQTLgen Consortium, Groot Hilde E. , Swertz Morris A. , van der Harst Pim , Westra Harm-Jan , van der Wijst Monique G.P. , Heinig Matthias , Franke Lude
Published: April 2023

Background

Expression quantitative trait loci (eQTL) studies show how genetic variants affect downstream gene expression. Single-cell data allows reconstruction of personalized co-expression networks and therefore the identification of SNPs altering co-expression patterns (co-expression QTLs, co-eQTLs) and the affected upstream regulatory processes using a limited number of individuals.

Results

We conduct a co-eQTL meta-analysis across four scRNA-seq peripheral blood mononuclear cell datasets using a novel filtering strategy followed by a permutation-based multiple testing approach. Before the analysis, we evaluate the co-expression patterns required for co-eQTL identification using different external resources. We identify a robust set of cell-type-specific co-eQTLs for 72 independent SNPs affecting 946 gene pairs. These co-eQTLs are replicated in a large bulk cohort and provide novel insights into how disease-associated variants alter regulatory networks. One co-eQTL SNP, rs1131017, that is associated with several autoimmune diseases, affects the co-expression of RPS26 with other ribosomal genes. Interestingly, specifically in T cells, the SNP additionally affects co-expression of RPS26 and a group of genes associated with T cell activation and autoimmune disease. Among these genes, we identify enrichment for targets of five T-cell-activation-related transcription factors whose binding sites harbor rs1131017. This reveals a previously overlooked process and pinpoints potential regulators that could explain the association of rs1131017 with autoimmune diseases.

Conclusion

Our co-eQTL results highlight the importance of studying context-specific gene regulation to understand the biological implications of genetic variation. With the expected growth of sc-eQTL datasets, our strategy and technical guidelines will facilitate future co-eQTL identification, further elucidating unknown disease mechanisms.
A robust reprogramming strategy for generating hepatocyte-like cells usable in pharmaco-toxicological studies
Authors: Garcia-Llorens Guillem , Martínez-Sena Teresa , Pareja Eugenia , Tolosa Laia , Castell José V. , Bort Roque
Published: April 2023

Background

High-throughput pharmaco-toxicological testing frequently relies on the use of established liver-derived cell lines, such as HepG2 cells. However, these cells often display limited hepatic phenotype and features of neoplastic transformation that may bias the interpretation of the results. Alternate models based on primary cultures or differentiated pluripotent stem cells are costly to handle and difficult to implement in high-throughput screening platforms. Thus, cells without malignant traits, optimal differentiation pattern, producible in large and homogeneous amounts and with patient-specific phenotypes would be desirable.

Methods

We have designed and implemented a novel and robust approach to obtain hepatocytes from individuals by direct reprogramming, which is based on a combination of a single doxycycline-inducible polycistronic vector system expressing HNF4A, HNF1A and FOXA3, introduced in human fibroblasts previously transduced with human telomerase reverse transcriptase (hTERT). These cells can be maintained in fibroblast culture media, under standard cell culture conditions.

Results

Clonal hTERT-transduced human fibroblast cell lines can be expanded at least to 110 population doublings without signs of transformation or senescence. They can be easily differentiated at any cell passage number to hepatocyte-like cells with the simple addition of doxycycline to culture media. Acquisition of a hepatocyte phenotype is achieved in just 10 days and requires a simple and non-expensive cell culture media and standard 2D culture conditions. Hepatocytes reprogrammed from low and high passage hTERT-transduced fibroblasts display very similar transcriptomic profiles, biotransformation activities and show analogous pattern behavior in toxicometabolomic studies. Results indicate that this cell model outperforms HepG2 in toxicological screening. The procedure also allows generation of hepatocyte-like cells from patients with given pathological phenotypes. In fact, we succeeded in generating hepatocyte-like cells from a patient with alpha-1 antitrypsin deficiency, which recapitulated accumulation of intracellular alpha-1 antitrypsin polymers and deregulation of unfolded protein response and inflammatory networks.

Conclusion

Our strategy allows the generation of an unlimited source of clonal, homogeneous, non-transformed induced hepatocyte-like cells, capable of performing typical hepatic functions and suitable for pharmaco-toxicological high-throughput testing. Moreover, as far as hepatocyte-like cells derived from fibroblasts isolated from patients suffering hepatic dysfunctions, retain the disease traits, as demonstrated for alpha-1-antitrypsin deficiency, this strategy can be applied to the study of other cases of anomalous hepatocyte functionality.
The COVID-19 pandemic posed many dilemmas for policymakers, which sometimes resulted in unprecedented decision-making
Authors: Ash Nachman , Triki Noa , Waitzberg Ruth
Published: April 2023

Background

The COVID-19 pandemic evolved through five phases, beginning with ‘the great threat’, then moving through ‘the emergence of variants', ‘vaccines euphoria’, and ‘the disillusionment’, and culminating in ‘a disease we can live with’. Each phase required a different governance response. With the progress of the pandemic, data were collected, evidence was created, and health technology was developed and disseminated. Policymaking shifted from protecting the population by limiting infections with non-pharmaceutical interventions to controlling the pandemic by prevention of severe disease with vaccines and drugs for those infected. Once the vaccine became available, the state started devolving the responsibility for the individual’s health and behavior.

Main body

Each phase of the pandemic posed new and unique dilemmas for policymakers, which resulted in unprecedented decision-making. Restrictions to individual’s rights such as a lockdown or the ‘Green Pass policy’ were unimaginable before the pandemic. One of the most striking decisions that the Ministry of Health made was approving the third (booster) vaccine dose in Israel, before it was approved by the FDA or any other country. It was possible to make an informed, evidence-based decision due to the availability of reliable and timely data. Transparent communication with the public probably promoted adherence to the booster dose recommendation. The boosters made an important contribution to public health, even though their uptake was less than the uptake for the initial doses. The decision to approve the booster illustrates seven key lessons from the pandemic: health technology is key; leadership is crucial (both political and professional); a single body should coordinate the actions of all stakeholders involved in the response, and these should collaborate closely; policymakers need to engage the public and win their trust and compliance; data are essential to build a suitable response; and nations and international organizations should collaborate in preparing for and responding to pandemics, because viruses travel without borders.

Conclusion

The COVID-19 pandemic posed many dilemmas for policymakers. The lessons learned from the actions taken to deal with them should be incorporated into preparedness for future challenges.
Access control scheme based on blockchain and attribute-based searchable encryption in cloud environment
Authors: Yan Liang , Ge Lina , Wang Zhe , Zhang Guifen , Xu Jingya , Hu Zheng
Published: April 2023

With the rapid development of cloud computing technology, how to achieve secure access to cloud data has become a current research hotspot. Attribute-based encryption technology provides the feasibility to achieve the above goal. However, most of the existing solutions have high computational and trust costs. Furthermore, the fairness of access authorization and the security of data search can be difficult to guarantee. To address these issues, we propose a novel access control scheme based on blockchain and attribute-based searchable encryption in cloud environment. The proposed scheme achieves fine-grained access control with low computation consumption by implementing proxy encryption and decryption, while supporting policy hiding and attribute revocation. The encrypted file is stored in the IPFS and the metadata ciphertext is stored on the blockchain, which ensures data integrity and confidentiality. Simultaneously, the scheme enables the secure search of ciphertext keyword in an open and transparent blockchain environment. Additionally, an audit contract is designed to constrain user access behavior to dynamically manage access authorization. Security analysis proves that our scheme is resistant to chosen-plaintext attacks and keyword-guessing attacks. Theoretical analysis and experimental results show that our scheme has high computational and storage efficiency, which is more advantageous than other schemes.
Genome profiling of uropathogenic E. coli from strictly defined community-acquired UTI in paediatric patients: a multicentric study
Authors: Mohapatra Sarita , Ghosh Dipannita , Vivekanandan Perumal , Chunchanur Sneha , Venugopal Shwetha , Tak Vibhor , Panigrahy Rajashree , Chaudhuri Susmita , Pundir Swati , Sharma Tanya , Kocher Deepak , Singh Harpreet , Gautam Hitender , Sood Seema , Das Bimal Kumar , Kapil Arti , Kumar Arvind , Kumari Rajesh , Kalaivani Mani , Rangaiah Ambica , Salve Harshal Ramesh , Malhotra Sumit , Kant Shashi , Hari Pankaj ,   Investigators of CAUTION-ED STUDY (Community-acquired UTI & Emerging Drug Resistance), Mohapatra Sarita , Sneha K. C. , Shwetha J. V. , Tak Vibhor , Panigrahy Rajashree , Chaudhuri Susmita
Published: April 2023

Background

Urinary tract infection (UTI) in children is a common bacterial infection. The emergence of extended-spectrum beta-lactamases (ESBLs) poses a major challenge against the treatment of uropathogens. We aimed to characterize the E. coli isolates recovered from children with UTI for their resistance profile and circulating sequence types (ST).

Methods

Children (> 1.5–18 years of age) from different community health centres of India with symptoms of UTI were enrolled. Isolates causing significant bacteriuria were identified by Matrix-Assisted Laser Desorption Ionization Time of Flight Mass Spectrometry (MALDI-TOF MS) and tested for antimicrobial susceptibility by the automated system, VITEK-2 (Biomeriux, Durhum, US). Nineteen E. coli isolates (15 ESBL positive and 4 ESBL negative) were sequenced in Oxford Nanopore platform followed by core-genome phylogeny, accessory genome cluster analysis, identification of sequence types, mobile genetic elements, genetic antimicrobial resistance markers. The correlation between detection of antimicrobial resistance genes with phenotypic resistance profiles was also investigated.

Results

Eleven percent of children had significant bacteriuria [male:female—1:1, > 50% were 11–18 years of age group]. E. coli was predominant (86%) followed by K. pneumoniae (11%). Susceptibility of E. coli was highest against fosfomycin (100%) followed by carbapenems (90.7%) and nitrofurantoin (88.8%). ST131 (15.8%) and ST167 (10.5%) found as high-risk clones with the presence of plasmid [IncFIB (63.1%), IncFIA (52.6%)], and composite transposon [Tn2680 (46.6%)] in many isolates. Few isolates coharboured multiple beta-lactamases including blaNDM-5 (33.3%), blaOXA-1 (53.3%), blaCTX-M-15 (60%) and blaTEM-4 (60%).

Conclusions

This study highlights horizontal transmission of resistance genes and plasmids in paediatric patients at community centers across the nation harbouring multidrug-resistant genes such as blaNDM-5 and blaCTX-M-15 associated with high-risk clones ST131 and ST167. The data is alarming and emphasizes the need for rapid identification of resistance markers to reduce the spread in community. To our knowledge, this is the first multicentric study targeting paediatric UTI patients from the community setting of India.
Jasmine tea extract enhances human retinal pigment epithelial cells survival after UVB irradiation
Authors: Shang Hu , Guo Yaling , Wu Liangyu , Lin Jinke
Published: April 2023

To examine the protecting effect of jasmine tea extract (JTE) against ultraviolet B (UVB) induced damage on human retinal pigment epithelial (RPE) cells, the RPE cells were subjected to UVB exposure and sequential JTE administration. The cell viability, intracellular reactive oxygen species (ROS), and apoptosis were determined by MTT, 2ʹ,7ʹ-dichlorodihydrofluorescein diacetate and flow cytometer assays, respectively. Further, the cells treated with UVB irradiation and sequential JTE administration were subjected to RNA-sequencing analysis in order to identify genes and pathways involved in the UVB-induced damage and JTE protecting mechanisms. The results showed that JTE effectively attenuated the UVB-induced cell injury by reducing the excessive intracellular ROS generation, and inhibiting the expression of apoptotic genes such as Bax, Caspase-3/9. This finding may offer a promising candidate for the prevention of UVB exposure related eye diseases.
The effect of insurance status on treatment modality in advanced oral cavity cancer
Authors: Sivarajah Shanmugappiriya , Ghods-Esfahani Daniel , Quimby Alexandra , Makki Fawaz , Montagna Giacomo , Seikaly Hadi
Published: April 2023

Background

Insurance status has been shown to impact survival outcomes. We sought to determine whether insurance affects the choice of treatment modality among patients with advanced (T4) oral cavity squamous cell carcinoma.

Methods

This is a retrospective, population-based cohort study using the Survival, Epidemiology, and End Results Program database. The population included all adult (age ≥ 18) patients with advanced (T4a or T4b) oral cavity squamous cell carcinoma diagnosed from 2007 to 2016. The main outcome was the odds of receiving definitive treatment, defined as primary surgical resection. Insurance status was categorized into uninsured, any Medicaid, and insured groups. Univariable, multivariable, and subgroup analyses were performed.

Results

The study population consisted of 2628 patients, of whom 1915 (72.9%) were insured, 561 (21.3%) had Medicaid, and 152 (5.8%) were uninsured. The multivariable model showed that patients who were 80 years or older, unmarried, received treatment in the pre-Affordable Care Act (ACA) period, and who were on Medicaid or uninsured were significantly less likely to receive definitive treatment. Insured patients were significantly more likely to receive definitive treatment compared to those on Medicaid or uninsured (OR = 0.59, 95% CI 0.46–0.77, p < 0.0001 [Medicaid vs. Insured]; and OR = 0.48, 95% CI 0.31–0.73 p = 0.001 [Uninsured vs. Insured]), however these differences did not persist when considering only those patients treated following the 2014 expansion of the ACA.

Conclusions

Insurance status is significantly associated with treatment modality among adults with advanced stage (T4a) oral cavity squamous cell carcinoma. These findings support the premise of expanding insurance coverage in the US.

Graphical Abstract
Patient perspectives on non-response to psychotherapy for borderline personality disorder: a qualitative study
Authors: Woodbridge Jane , Townsend Michelle L. , Reis Samantha L. , Grenyer Brin F. S.
Published: April 2023

Background

Despite increasing evidence for the effectiveness of psychotherapy for Borderline Personality Disorder (BPD), estimates show that approximately half of those in treatment do not clinically improve or reach reliable change criteria. There are limited qualitative descriptions of treatment factors associated with non-response from the perspectives of those struggling to improve.

Method

Eighteen people (72.2% female, mean age 29.4 (SD = 8)) with experience of receiving psychotherapeutic treatment for BPD were interviewed to obtain their perspectives on hindering factors in treatment and what may be helpful to reduce non-response. The data in this qualitative study was analysed thematically.

Results

Four domains were created from the insights patients shared on non-response and what may be needed to mitigate it. The focus of Domain 1 was that therapy cannot be effective until two factors are in place. First, the patient needs sufficient safety and stability in their environment in order to face the challenges of therapy. Second, they need to be able to access therapy. Domain 2 described factors the patients themselves contribute. The themes in this domain were described as phases that need to be progressed through before therapy can be effective. These phases were ceasing denial that help is warranted and deserved, taking responsibility for behaviours that contribute to unwellness, and committing to the hard work that is required for change. Domain 3 described how the lack of a safe alliance and ruptures in the safety of the relationship with the therapist can contribute to non-response. Domain 4 was comprised of factors that patients identified as supportive of moving through the barriers to response. The first theme in this domain was prioritising the safety of the therapy relationship. The second theme was giving a clear diagnosis and taking a collaborative approach in sessions. The final theme described the importance of focusing on practical goals with the patient to create tangible life changes.

Conclusion

This study found that non-response is complex and multifaceted. First, it is clear that systems need to be in place to support access to adequate care and foster life stability. Second, considerable effort may be needed at the engagement phase of therapy to clarify expectations. Third, attention to specific interpersonal challenges between patients and therapists is an important focus. Finally, structured work to improve relationships and vocational outcomes is indicated.
Towards a novel strategy for soot removal from water-soluble materials: the synergetic effect of hydrogels and cyclomethicone on gelatine emulsion-based photographs
Authors: Ortega Saez Natalia , Arno Robbe , Marchetti Andrea , Cauberghs Sabine , Janssens Koen , Van der Snickt Geert , Al-Emam Ehab
Published: April 2023

Gels are a popular cleaning method for paper conservators and a lot of research has been done concerning gel cleaning of paper objects over the last 15 years. Despite the close interconnection between the conservation fields of paper and photographic material, research on using gels for cleaning photographs is very scarce. However, gels can provide an excellent cleaning method for photographic material. Cleaning silver gelatine prints with aqueous solvents is very complex due to the hydrophilic properties and fragility of the gelatine layer which makes mechanical cleaning difficult. The properties of gels ensure better control over the flow and evaporation of the solvent, facilitating the cleaning process. This study is the first insight into the viability of using gellan gum gel and polyvinyl acetate-borax (PVAc-borax) gel to clean contaminants from the surface of silver gelatine photographs. It is based on self-made samples that were artificially aged and contaminated with soot. Water, ethanol (EtOH), and Kodak Photo-flo were studied as solvents to remove the soot from the silver gelatine-based prints. These solvents were loaded into the aforementioned gels and applied to the samples in two different methods. These gel cleaning methods were subsequently compared with traditional cleaning methods. In addition, the usage of cyclomethicone D4 as a protective mask for the gelatine layer was studied. Measuring methods used to evaluate the cleaning were visual comparison, microscopic observation, and densitometry. ATR-FTIR measurements were also conducted to investigate potential side-effects of the cleaning methods on the prints, such as unwanted chemical transformations or the presence of gel residues after the treatments. Most of the gel cleaning methods within this study proved to be inadequate, with the exception of the gellan gum gel loaded with 30% EtOH. It was used as a granulated gel applied mechanically on a print saturated with cyclomethicone (octamethylcyclotetrasiloxane D4). Cyclomethicone proved to be a very effective protective barrier for the water-sensitive gelatine layer with minimal reduction in cleaning effectiveness.
Morpho-anatomical, and chemical characterization of some calcareous Mediterranean red algae species
Authors: Ismail Mona M. , Ismail Gehan A. , Elshobary Mostafa E.
Published: April 2023

Climatic changes are anticipated to have a detrimental effect on calcifying marine species. Calcareous red algae may be especially vulnerable to seasonal variations since they are common and essential biologically, but there is little research on the morpho-anatomical, and chemical characterization of such species. This study conducted the seasonal investigation of the three dominant Mediterranean calcified red algae. Morphological and 18S rRNA analysis confirmed the identification of collected species asCorallina officinalis, Jania rubens,andAmphiroa rigida. In general,C. officinaliswas represented in the four seasons and flourishing maximum in autumn (70% of total species individuals). WhileJ. rubensspecies was represented in winter, autumn, and spring and completely absent in summer.A. rigidawas abundant only in the summer season by 40%. A full morphological and anatomical description of these species were examined, and their chemical compositions (carbohydrate, protein, lipid, pigments, and elements content) were assessed in different seasons, where carbohydrates were the dominant accumulates followed by proteins and lipids. Pearson correlation analysis confirmed a positive correlation between salinity level and nitrogenous nutrients of the seawater with the pigment contents (phycobiliproteins, carotenoids, and chlorophyll a) of the studied seaweeds. The results proved that calcified red algae were able to deposit a mixture of calcium carbonates such as calcite, vaterite, calcium oxalate, calcite-III I calcium carbonate, and aragonite in variable forms depending on the species.
Identification of diverse antibiotic resistant bacteria in agricultural soil with H218O stable isotope probing combined with high-throughput sequencing
Authors: Hernández Marcela , Roy Shamik , Keevil C. William , Dumont Marc G.
Published: April 2023

Background

We aimed to identify bacteria able to grow in the presence of several antibiotics including the ultra-broad-spectrum antibiotic meropenem in a British agricultural soil by combining DNA stable isotope probing (SIP) with high throughput sequencing. Soil was incubated with cefotaxime, meropenem, ciprofloxacin and trimethoprim in 18O-water. Metagenomes and the V4 region of the 16S rRNA gene from the labelled “heavy” and the unlabelled “light” SIP fractions were sequenced.

Results

An increase of the 16S rRNA copy numbers in the “heavy” fractions of the treatments with 18O-water compared with their controls was detected. The treatments resulted in differences in the community composition of bacteria. Members of the phyla Acidobacteriota (formally Acidobacteria) were highly abundant after two days of incubation with antibiotics. Pseudomonadota (formally Proteobacteria) including Stenotrophomonas were prominent after four days of incubation. Furthermore, a metagenome-assembled genome (MAG-1) from the genus Stenotrophomonas (90.7% complete) was retrieved from the heavy fraction. Finally, 11 antimicrobial resistance genes (ARGs) were identified in the unbinned-assembled heavy fractions, and 10 ARGs were identified in MAG-1. In comparison, only two ARGs from the unbinned-assembled light fractions were identified.

Conclusions

The results indicate that both non-pathogenic soil-dwelling bacteria as well as potential clinical pathogens are present in this agricultural soil and several ARGs were identified from the labelled communities, but it is still unclear if horizontal gene transfer between these groups can occur.
Electrically assisted cycling for individuals with type 2 diabetes mellitus: a pilot randomized controlled trial
Authors: Bourne Jessica E. , Leary Sam , Page Angie , Searle Aidan , England Clare , Thompson Dylan , Andrews Robert C. , Foster Charlie , Cooper Ashley R.
Published: April 2023

Background

Type 2 diabetes mellitus (T2DM) and its associated complications puts considerable strain on healthcare systems. With the global incidence of T2DM increasing, effective disease management is essential. Physical activity (PA) is a key component of T2DM management; however, rates of PA engagement are low in this population. Developing effective and sustainable interventions that encourage PA is a high priority. Electrically assisted bicycles are becoming increasingly popular and may increase PA in healthy adults. This study aimed to provide evidence of the feasibility of conducting a randomized controlled trial to evaluate the efficacy of an e-cycling intervention to increase PA and improve health in individuals with T2DM.

Methods

A parallel-group two-arm randomized, waitlist-controlled pilot study was conducted. Individuals were randomized to either an e-bike intervention or standard care. The intervention incorporated two one-to-one e-bike skills training and behavioural counselling sessions delivered by a community-based cycling charity, followed by a 12-week e-bike loan with two further sessions with the instructors. Feasibility was assessed via measures related to recruitment, retention and intervention implementation. Post-intervention interviews with instructors and participants explored the acceptability of the study procedures and intervention. Clinical, physiological and behavioural outcomes were collected at baseline and post-intervention to evaluate the intervention’s potential.

Results

Forty participants (Mage = 57) were randomized, of which 34 were recruited from primary care practices. Thirty-five participants were retained in the trial. The intervention was conducted with high fidelity (> 80% content delivered). E-bike training provided participants with the skills, knowledge and confidence needed to e-bike independently. Instructors reported being more confident delivering the skills training than behavioural counselling, despite acknowledging its importance. The study procedures were found to be acceptable to participants. Between-group differences in change during the intervention were indicative of the interventions potential for improving glucose control, health-related quality of life and cardiorespiratory fitness. Increases in overall device measured moderate-to-vigorous PA behaviour following the intervention were found, and there was evidence that this population self-selected to e-cycle at a moderate intensity.

Conclusions

The study’s recruitment, retention, acceptability and potential efficacy support the development of a definitive trial subject to identified refinements.

Trial registration

ISRCTN, ISRCTN67421464. Registered 17/12/2018.