bluuebunny/crossref_metadata_2025 huggingface dataset:
Menstrual blood-derived stromal cells: insights into their secretome in acute hypoxia conditions
Authors: de Pedro María Ángeles , Pulido María , Álvarez Verónica , Marinaro Federica , Marchena Ana María , Sánchez-Margallo Francisco Miguel , Casado Javier G. , López Esther
Published: April 2023

Background

Despite constant advances in regenerative medicine, the closure of chronic wounds is still challenging. Therapeutic approaches using locally administered MSCs have been considered a promising option. However, the viability of these cells is seriously threatened by acute hypoxic stress linked to wound healing. In this work, we aimed to study the tolerance of Menstrual blood-derived stromal cells (MenSCs) to acute hypoxia and their therapeutic paracrine effect.

Methods

Isolated MenSCs were phenotypically characterized and evaluated in terms of proliferation, viability, and gene expression, under acute hypoxia (AH) compared with conventional cultured condition or normoxia (N). A step further, the secretome of MenSCs under acute hypoxia was analyzed with respect to their miRNAs content and by in vitro functional assays. For the analysis of differences between the two groups, Student’st-test was performed and one-way ANOVA and Tukey’s multiple comparisons test for multiple groups were used.

Results

Our results revealed that the viability of MenSCs was not affected under acute hypoxia, although proliferation rate slowed down. Gene analysis revealed 5 up-regulated (BNIP3,ANGPTL4,IL6,IL1B, andPDK1) and 4 down-regulated genes (IDO1,HMOX1,ANGPTL2, andHGF) in AH compared to N. Global gene expression analysis revealed a decrease in the gene ontology functions of migration and wound response with respect to the normoxic condition. In contrast, functions such as angiogenesis were enriched under the AH condition. Regarding the secretome analysis, two miRNAs involved in angiogenic processes (hsa-miR-148a-3p and hsa-miR-378a-3p), were significantly up-expressed when compared to the normoxic condition, beingMYCgene, the unique target of both. Functional assays on HUVECs revealed a potential pro-angiogenic capacity of MenSCs cultured in both oxygen conditions (N and AH) based on the wound closure and tube formation results of their released paracrine factors. However, when compared to normoxia, the paracrine factors of MenSCs under acute hypoxia slightly reduced the proliferation, migration, and in vitro wound closure of HUVECs.

Conclusions

MenSC exhibited a good survival capacity under acute hypoxic conditions as well as beneficial properties applicable in the field of tissue regeneration through their secretome, which makes them a potential cell source for wound healing interventions.
Comparative transcriptomic analysis of germinating rice seedlings to individual and combined anaerobic and cold stress
Authors: Thapa Ranjita , Tabien Rodante E. , Johnson Charles D. , Septiningsih Endang M.
Published: April 2023

Background

Rice is one of the most important cereals consumed worldwide. Two major abiotic factors affecting rice plants in different growth stages are flooding stress and cold stress. These abiotic stresses can take place independently or simultaneously and significantly affect rice plants during germination and seedling growth. Fortunately, a wide array of phenotypic responses conferring flooding stress and chilling stress tolerance exist within the rice germplasm, indicating the presence of different molecular mechanisms underlying tolerance to these stresses. Understanding these differences may assist in developing improved rice cultivars having higher tolerance to both stresses. In this study, we conducted a comparative global gene expression analysis of two rice genotypes with contrasting phenotypes under cold stress, anaerobic stress, and combined cold and anaerobic stress during germination.

Results

The differential gene expression analysis revealed that 5571 differentially expressed genes (DEGs), 7206 DEGs, and 13279 DEGs were identified under anaerobic stress, cold stress, and combined stress, respectively. Genes involved in the carbohydrate metabolic process, glucosyltransferase activity, regulation of nitrogen compound metabolic process, protein metabolic process, lipid metabolic process, cellular nitrogen compound biosynthetic process, lipid biosynthetic process, and a microtubule-based process were enriched across all stresses. Notably, the common Gene Ontology (GO) analysis identified three hub genes, namely Os08g0176800 (similar to mRNA-associated protein mrnp 41), Os11g0454200 (dehydrin), and OS10g0505900 (expressed protein).

Conclusion

A large number of differentially expressed genes were identified under anaerobic, cold conditions during germination and the combination of the two stress conditions in rice. These results will assist in the identification of promising candidate genes for possible manipulation toward rice crops that are more tolerant under flooding and cold during germination, both independently and concurrently.
Genome-wide characterization and expression analysis of α-amylase and β-amylase genes underlying drought tolerance in cassava
Authors: Yang Taiyi , Li Hengrui , Li Liangwu , Wei Wanling , Huang Yuanhang , Xiong Faqian , Wei Maogui
Published: April 2023

Background

Starch hydrolysates are energy sources for plant growth and development, regulate osmotic pressure and transmit signals in response to both biological and abiotic stresses. The α-amylase (AMY) and the β-amylase (BAM) are important enzymes that catalyze the hydrolysis of plant starch. Cassava (Manihot esculenta Crantz) is treated as one of the most drought-tolerant crops. However, the mechanisms of how AMY and BAM respond to drought in cassava are still unknown.

Results

Six MeAMY genes and ten MeBAM genes were identified and characterized in the cassava genome. Both MeAMY and MeBAM gene families contain four genes with alternative splicing. Tandem and fragment replications play important roles in the amplification of MeAMY and MeBAM genes. Both MeBAM5 and MeBAM10 have a BZR1/BES1 domain at the N-terminus, which may have transcription factor functions. The promoter regions of MeAMY and MeBAM genes contain a large number of cis-acting elements related to abiotic stress. MeAMY1, MeAMY2, MeAMY5, and MeBAM3 are proven as critical genes in response to drought stress according to their expression patterns under drought. The starch content, soluble sugar content, and amylase activity were significantly altered in cassava under different levels of drought stress.

Conclusions

These results provide fundamental knowledge for not only further exploring the starch metabolism functions of cassava under drought stress but also offering new perspectives for understanding the mechanism of how cassava survives and develops under drought.
MeJA-mediated enhancement of salt-tolerance of Populus wutunensis by 5-aminolevulinic acid
Authors: Liu Huan , Sun Jingliang , Zou Jixiang , Li Baisheng , Jin Hua
Published: April 2023

Background

5-Aminolevulinic acid (ALA) is a natural and environmentally benign multifunctional plant growth regulator involved in the regulation of plant tolerance to various environmental stresses. This research aimed to explore the molecular mechanisms of salt tolerance in Populus wutunensis induced by exogenous ALA using physiological and transcriptomic analyses.

Results

Physiological results showed that 50 mg·L− 1 ALA-treatment significantly reduced the malondialdehyde (MDA) content and the relative electrical conductivity (REC) and enhanced antioxidant activities of enzymes such as SOD, POD and CAT in salt-stressed P. wutunensis seedlings. Transcriptome analysis identified ALA-induced differentially expressed genes (DEGs) associating with increased salt-tolerance in P. wutunensis. GO and KEGG enrichment analyses showed that ALA activated the jasmonic acid signaling and significantly enhanced the protein processing in endoplasmic reticulum and the flavonoid biosynthesis pathways. Results of the hormone-quantification by LC-MS/MS-based assays showed that ALA could increase the accumulation of methyl jasmonate (MeJA) in salt-stressed P. wutunensis. Induced contents of soluble proteins and flavonoids by exogenous ALA in salt-treated seedlings were also correlated with the MeJA content.

Conclusion

5-aminolevulinic acid improved the protein-folding efficiency in the endoplasmic reticulum and the flavonoid-accumulation through the MeJA-activated jasmonic acid signaling, thereby increased salt-tolerance in P. wutunensis.
Comprehensiveness of cardiac rehabilitation program in Korea: a nation-wide survey result
Authors: Sung Jidong , Kim Chul , Han Jae-Young , Jee Sungju , Lee Jang Woo , Lee Jong Hwa , Kim Won-Seok , Bang Heui Je , Baek Sora , Joa Kyung-Lim , Kim Ae Ryoung , Lee So Young , Kim Jihee , Kim Chung Reen , Kwon Oh Pum
Published: April 2023

Background

Cardiac rehabilitation (CR) is an essential component in secondary prevention of cardiovascular diseases. Current guidelines recommend that the program should be comprehensive including multidisciplinary behavioral intervention, not only exercise training. While the utilization of CR is gradually increasing, the comprehensiveness of the program has not been systemically evaluated in Korea.

Methods

During the year 2020, nation-wide survey was done to evaluate the current status of CR in Korea. Survey was done by web-based structured questionnaire. Survey was requested to 164 hospitals performing percutaneous coronary intervention.

Results

Among 164 hospitals, 47 (28.7%) hospitals had CR programs. In hospitals with CR, multidisciplinary intervention other than exercise-based program was provided only partially: nutritional counseling (63%), vocational counseling for return to work (39%), stress management (31%), psychological evaluation (18%). Personnel for CR was commonly not dedicated to the program or even absent: (percentage of dedicated, concurrent with other work, absent) physical therapist (59, 41, 0%), nurse (31, 69, 0%), dietician (6, 65, 29%), clinical psychologist (0, 37, 63%).

Conclusion

Comprehensiveness of CR in Korea is suboptimal and human resource for it is poorly disposed. More awareness of current status by both clinicians and health policy makers is needed and insurance reimbursement for educational program should be improved.
Comparison of endoscopic retrograde cholangiopancreatography outcomes between cap-fitted forward and side viewing endoscopes in patients with Billroth II anastomosis
Authors: Kim Sung Bum , Kim Kook Hyun , Kim Tae Nyeun
Published: April 2023

Background

There have been no previous studies that directly compared outcomes between cap-fitted forward-viewing and side viewing endoscopes (SE). This study aimed to compare the technical success rate and occurrence of adverse events between the side viewing and cap-fitted forward-viewing endoscope (CE) groups among patients with Billroth II anatomy who underwent ERCP.

Methods

The medical records of patients with a previous history of subtotal gastrectomy using Billroth II reconstruction who underwent ERCP at Yeungnam University Hospital between January 2004 and December 2020 were reviewed retrospectively. The patients were divided into CE and SE group. Propensity score matching analysis was performed to minimize selection bias.

Results

Propensity score matching resulted in 55 matched pairs for further analysis. Patients’ characteristics were comparable in the matched cohorts. Final success rate of selective bile duct cannulation was not significantly different between the SE and CE groups (98.2% vs. 94.5%, p = 0.308). The complete CBD stone removal rate in CBD stone and successful biliary drainage rate in malignant biliary obstruction were not significantly different between the two groups. The rate of total ERCP-related adverse events was higher in the CE group than in the SE group, but the difference was not statistically significant (10.9% vs. 7.3%, p = 0.507). Among adverse events, the rate of post-ERCP pancreatitis showed higher tendency in the CE group than in the SE group (10.9% vs. 5.5%, p = 0.297).

Conclusion

In conclusion, CE seems to be equally effective as SE for ERCP in patients with Billroth II anatomy. However, attention should be paid to development of post ERCP complications, especially pancreatitis, when performed by CE.
Comparison of spatio-temporal gait parameters between the GAITRite® platinum plus classic and the GAITRite® CIRFACE among older adults: a retrospective observational study
Authors: Sacco Guillaume , Ben-Sadoun Grégory , Gautier Jennifer , Simon Romain , Goupil Maude , Laureau Pauline , Terrien Jade , Annweiler Cédric
Published: April 2023

Background

The GAITRite® system is one of the gold standards for gait electronic analysis, especially for older adults. Previous GAITRite® systems were composed of an electronic roll-up walkway. Recently, a new GAITRite® electronic walkway, named CIRFACE, was commercialized. It is composed of a changeable association of stiff plates, unlike previous models. Are the gait parameters measured similar between these two walkways among older adults and according to the cognitive status, the history of falls, and the use of walking aids?

Methods

In this retrospective observational study, 95 older ambulatory participants (mean, 82.6 ± 5.8 years) were included. Ten spatio-temporal gait parameters were measured simultaneously with the two GAITRite® systems in older adults while walking at comfortable self-selected pace. The GAITRite® Platinum Plus Classic (26’) was superimposed on the GAITRite® CIRFACE (VI). Comparisons between the parameters of the two walkways were performed using Bravais-Pearson correlation, between-method differences (corresponding to bias), percentage errors and Intraclass Correlation Coefficients (ICC2,1). Subgroup analyses were performed according to the cognitive status, the history of falls in the last 12 months and the use of walking aids.

Results

The whole walk parameters recorded by the two walkways were extremely correlated with a Bravais-Pearson correlation coefficient ranging from 0.968 to 0.999,P < .001, indicating a very high correlation. According to the ICC2,1calculated for absolute agreement, all gait parameters had excellent reliability (ranging from 0.938 to 0.999). Mean bias for 9 parameters out of 10 were ranged from − 0.27 to 0.54, with clinically acceptable percentage errors (1.2–10.1%). Step length showed a substantially higher bias (1.4 ± 1.2 cm), nevertheless the percentage errors remained clinically acceptable (5%).

Conclusion

When walking at comfortable self-selected pace, the standard spatio-temporal walk parameters provided by both the GAITRite® PPC and the GAITRite® CIRFACE seem similar and very highly correlated in older adults with various cognitive or motor status. The data of studies using these systems can be compared and mixed with a very low risk of bias in a meta-analytic process. Also, the geriatric care units can choose the most ergonomic system according to their infrastructure without affecting their gait data.

Trial registration

NCT04557592 (21/09/2020).
A Core Outcome Set for nutritional intervention studies in older adults with malnutrition and those at risk: a study protocol
Authors: Visser Marjolein , Mendonça Nuno , Avgerinou Christina , Cavdar Sibel , Cederholm Tommy , Cruz-Jentoft Alfonso J. , Kiesswetter Eva , Siebentritt Hanna M. , Sieber Cornel , Torbahn Gabriel , Volkert Dorothee
Published: April 2023

Background

Malnutrition (i.e., protein-energy malnutrition) in older adults has severe negative clinical consequences, emphasizing the need for effective treatments. Many, often small, randomized controlled trials (RCTs) testing the effectiveness of nutritional interventions for the treatment of malnutrition showed mixed results and a need for meta-analyses and data pooling has been expressed. However, evidence synthesis is hampered by the wide variety of outcomes and their method of assessment in previous RCTs. This paper describes the protocol for developing a Core Outcome Set (COS) for nutritional intervention studies in older adults with malnutrition and those at risk.

Methods

The project consists of five phases. The first phase consists of a scoping review to identify frequently used outcomes in published RCTs and select additional patient-reported outcomes. The second phase includes a modified Delphi Survey involving experienced researchers and health care professionals working in the field of malnutrition in older adults, followed by the third phase consisting of a consensus meeting to discuss and agree what critical outcomes need to be included in the COS. The fourth phase will determine how each COS outcome should be measured based on a systematic literature review and a second consensus meeting. This will be followed by a dissemination and implementation phase. Patient and Public Involvement (PPI) representatives will contribute to study design, oversight, consensus, and dissemination.

Conclusions

The result of this project is a COS that should be included in any RCT evaluating the effect of nutritional interventions in older adults with malnutrition and those at risk. This COS will facilitate comparison of RCT results, will increase efficient use of research resources and will reduce bias due to measurement of the outcome and publication bias. Ultimately, the COS will support clinical decision making by identifying the most effective approaches for treating and preventing malnutrition in older adults.
Towards a core-set of mobility measures in ageing research: The need to define mobility and its constructs
Authors: Reijnierse Esmee M. , Geelen Sven J.G. , van der Schaaf Marike , Visser Bart , Wüst Rob C.I. , Pijnappels Mirjam , Meskers Carel G. M.
Published: April 2023

Background

Mobility is a key determinant and outcome of healthy ageing but its definition, conceptual framework and underlying constructs within the physical domain may need clarification for data comparison and sharing in ageing research. This study aimed to (1) review definitions and conceptual frameworks of mobility, (2) explore agreement on the definition of mobility, conceptual frameworks, constructs and measures of mobility, and (3) define, classify and identify constructs.

Methods

A three-step approach was adopted: a literature review and two rounds of expert questionnaires (n = 64, n = 31, respectively). Agreement on statements was assessed using a five-point Likert scale; the answer options ‘strongly agree’ or ‘agree’ were combined. The percentage of respondents was subsequently used to classify agreements for each statement as: strong (≥ 80%), moderate (≥ 70% and < 80%) and low (< 70%).

Results

A variety of definitions of mobility, conceptual frameworks and constructs were found in the literature and among respondents. Strong agreement was found on defining mobility as the ability to move, including the use of assistive devices. Multiple constructs and measures were identified, but low agreements and variability were found on definitions, classifications and identification of constructs. Strong agreements were found on defining physical capacity (what a person is maximally capable of, ‘can do’) and performance (what a person actually does in their daily life, ‘do’) as key constructs of mobility.

Conclusion

Agreements on definitions of mobility, physical capacity and performance were found, but constructs of mobility need to be further identified, defined and classified appropriately. Clear terminology and definitions are essential to facilitate communication and interpretation in operationalising the physical domain of mobility as a prerequisite for standardisation of mobility measures.
Together, at a distance: experiences with a novel technology for social contact among older people and their relatives in Norway during the COVID-19 pandemic
Authors: Badawy Abeer , Solberg Mads , Obstfelder Aud Uhlen , Alnes Rigmor Einang
Published: April 2023

Background

The recognition that people are social beings is fundamental for person-centered care. During the COVID-19 pandemic, the lives of older people were restricted in ways that dramatically reduced their opportunities for face-to-face contact. Limited contact with family members due to social distancing raised concerns about the well-being of older people. In Norway, interactive technologies were therefore introduced to older people to help them maintain social contact while practicing physical distancing.

Objectives

This study was designed to examine how older people and their relatives experienced the use of technology-mediated communication through KOMP, a tablet-like device for supporting social contact in care facilities and homes during the pandemic.

Methods

We adopted an open phenomenological approach inspired by Kvale and Brinkmann (2009) to explore how the use of KOMP became meaningful during the pandemic. The study was based on individual interviews with 4 residents in care facilities and 13 relatives.

Results

The lived experiences of using KOMP among older people and their relatives revealed that adopting digital communication helped older people, and their families mitigate social distancing and maintain relationships with each other, despite the restrictions imposed by the government. Virtual involvement through KOMP afforded meaningful interconnections in the social lives of the users and their distant family members, thereby supporting their roles as parents and grandparents despite the distance, and promoting cross-generational connections among family members. Digital meetings also provided opportunities for older people and their relatives to enjoy each other’s presence in favored places, by conveying a homely atmosphere, for instance. These virtual encounters did not rely exclusively on talk as the only means of communication.

Conclusion

This study suggests that communicating via KOMP was a meaningful activity for the participants. Technologies for social contact can, to some extent, facilitate person-centered care for older people in care facilities and their private homes, despite circumstances requiring social distancing.
Factors associated with relapse and hospital death in patients coinfected with visceral leishmaniasis and HIV: a longitudinal study
Authors: Costa Larissa D. L. N. , Lima Uiara S. , Rodrigues Vandilson , Lima Mayara I. S. , Silva Lucilene A. , Ithamar Jorim , Azevedo Conceição M. P. S.
Published: April 2023

Objective

Visceral leishmaniasis (VL) is an endemic parasitic disease in Latin America, and its clinical picture is aggravated in coinfections with the human immunodeficiency virus (HIV). The objective of this study was to investigate clinical factors and laboratory variables associated with VL relapse and death in VL/HIV coinfected patients.

Methods

A prospective longitudinal study was conducted from January 2013 to July 2020 among 169 patients coinfected with VL and HIV. The outcomes investigated were the occurrence of VL relapse and death. Chi-square test, Mann–Whitney test and logistic regression models were used for statistical analysis.

Results

The occurrence rates were 41.4% for VL relapse and 11.2% for death. Splenomegaly and adenomegaly were associated with the increased risk of VL relapse. Patients with VL relapse had higher levels of urea (p = .005) and creatinine (p < .001). Patients who died had lower red blood cell counts (p = .012), hemoglobin (p = .017) and platelets (p < .001). The adjusted model showed that antiretroviral therapy for more than 6 months was associated with a decrease in VL relapse, and adenomegaly was associated with an increase in VL relapse. In addition, edema, dehydration, poor general health status, and paleness were associated with an increase in hospital death.

Conclusion

The findings suggest that adenomegaly, antiretroviral therapy, and renal abnormalities can be associated with VL relapse, while hematological abnormalities, and clinical manifestations like paleness, and edema can be associated with an increased odds of hospital death.

Trial registration number: The study was submitted to the Ethics and Research Committee of the Federal University of Maranhão (Protocol: 409.351).
Association between bacterial vaginosis and 25-Hydroxy vitamin D: a case-control study
Authors: Mojtahedi Seyede Faezeh , Mohammadzadeh Alireza , Mohammadzadeh Fatemeh , Jalili Shahri Jelveh , Bahri Narjes
Published: April 2023

Introduction

Bacterial vaginosis (BV) is the most common vaginal dysbiosis among women of reproductive age. Micronutrient deficiencies, including vitamin D deficiency, can increase the risk of BV. The findings of previous studies regarding the relationship between vitamin D deficiency and BV were conflicting. Therefore, this study aimed to evaluate the association between BV and serum level of 25-hydroxy vitamin D.

Materials and methods

This case-control study was conducted in Gonabad County in 2021. One hundred and twenty-five confirmed BV cases and 125 controls who were matched based on age and intercourse frequency (maximum difference of two days per week) enrolled in the study. Data collection was performed using a demographic and reproductive data questionnaire and a checklist for recording Whiff test results, serum 25-hydroxy vitamin D level, litmus paper observation, and microscopic findings (clue cells). Serum level of vitamin D was evaluated based on enzyme-linked immunoassay method (Monobind kit) from 0.5 ml venous blood drawn from each participant. The conditional logistic regression model was used to analyze data.

Results

The BV cases had significantly lower 25-hydroxy vitamin D serum levels than controls. The odds of BV increased with vitamin D deficiency (Adjusted odds ratio (AOR): 4.34, 95% confidence interval (CI): 1.39–13.4, p = 0.011, FDR q-value = 0.051), vitamin D insufficiency (AOR: 3.65, 95% CI: 1.23–10.85; p = 0.020; FDR q-value = 0.053), cigarette/hookah smoking (AOR: 3.65, 95% CI: 1.23, 10.85; p = 0.020; FDR q-value = 0.053) and lower age at first intercourse (AOR: 1.16, 95% CI: 1.05, 1.28; p = 0.004; FDR q-value = 0.048). The odds of BV was 0.80 and 0.78 times lower in participants who had coitus interruptus (AOR: 0.20, 95% CI: 0.06, 0.63; p = 0.006; FDR q-value = 0.048) and condom use (AOR: 0.28, 95% CI: 0.10, 0.79; p = 0.016; FDR q-value = 0.051), respectively, compared to participants who did not use contraceptives.

Conclusion

These findings suggested that lower serum vitamin D levels were associated with an increased risk of developing BV. However, further studies are needed to confirm the results of the present study.
Severe malaria in children and adolescents in Southeast Gabon
Authors: Lendongo Wombo Judicaël Boris , Ibinga Euloge , Oyegue-Liabagui Sandrine Lydie , Imboumy Limoukou Roméo Karl , Okouga Alain Prince , Mounioko Franck , Maghendji-Nzondo Sydney , Lekana-Douki Jean Bernard , Ngoungou Edgard Brice
Published: April 2023

Introduction

Malaria remains a significant public health problem in sub-Saharan Africa. Child mortality due to severe malaria remains high in developing countries despite improvements in malaria management and a better understanding of its pathophysiology. To address the lack of epidemiological studies on severe malaria in Gabon, this study describes the epidemiological aspects of severe malaria in rural, semi-rural, and urban areas of southeast Gabon.

Methods

Demographic, clinical, and laboratory data for children and adolescents aged 0–18 years were collected in 2019 from hospital records at three health facilities in southeastern Gabon. The patients included in the study were positive for P falciparum malaria diagnosed by microscopy with at least one of the malaria severity criteria.

Results

Severe malaria accounted for 18.8% (667/3552) of malaria cases. Children aged 0–5 years accounted for 71.8% (479/667) of all severe malaria cases. Adolescents over 15 years of age were the least affected by severe malaria with 4.2% (28/667). Across the study, severe anemia (49.0%, 327/667), convulsions (43.0%, 287/667), respiratory distress (5.1%, 34/667), and altered consciousness (4.8%, 32/667) were the most frequent clinical signs of severe malaria in children. Franceville was the locality most affected by severe malaria with 49.2% (328/667), followed by Koulamoutou with 42.0% (280/667) and Lastourville with 8.8% (59/667). Convulsions (50.6%, 166/328) and coma (6.1%, 20/328) were more frequent in children living in urban areas. In contrast, severe anemia (56.7%, 186/339) and jaundice (6.8%, 23/339) were more common in children living in semi-rural areas.

Conclusion

Severe malaria is more prevalent in urban areas in regions with a high malaria transmission intensity. However, in this study, the epidemiological characteristics of severe malaria were similar in the three settings (urban, rural, and semi-rural areas) despite different levels of urbanization. Nevertheless, the various signs of severity were more frequent in Franceville, an urban area. Children under 5 years of age remain the most vulnerable age group.
Clinical characteristics and prognostic factors of 60 patients with acquired immune deficiency syndrome combined with Cryptococcus neoformans
Authors: Liu Saiduo , Chen Wei , Cheng Fang , Ye Xinchun , Pan Ning , Lu Hongzhou
Published: April 2023

Objective

Cryptococcal meningitis (CM) threatens people’s health and is the main cause of opportunistic fungus-related death in acquired immune deficiency syndrome (AIDS) patients. Herein, we investigate the clinical characteristics and prognostic factors of AIDS patients with Cryptococcus neoformans in Wenzhou, Zhejiang Province, China.

Methods

Our study enrolled AIDS patients diagnosed with Cryptococcus neoformans infection who were hospitalised in our hospital. They were divided into Group A (32 patients with CM) and Group B (28 patients without CM) according to their diagnosis. The differences between the two groups of patients’ clinical symptoms, imaging examinations and laboratory examinations were observed. Statistical methods were used to analyse the difference in prognosis between the two groups.

Results

Headache and fever were the most common clinical characteristics for patients with CM, while respiratory symptoms and fever were the most common clinical characteristics for patients without CM. The positive rate of cryptococcal capsular antigen, India ink staining and culture in the cerebrospinal fluid examination was higher in the CM patients than in the non-CM patients. The overall morbidity and mortality rate after systemic antifungal therapy was higher in the CM patients than in the non-CM patients. A higher incidence of headache, impaired consciousness, nuchal rigidity, first intracranial pressure > 200 mmH2O and mortality was observed in the CM patients than in the non-CM patients. Multifactorial logistic regression analysis showed that headache risk factors affecting the patient’s prognosis at 12 weeks.

Conclusion

Patients with AIDS diagnosed with Cryptococcus neoformans infection have insidious clinical symptoms in the early stage, and their manifestation is often non-specific, resulting in poor prognosis and high mortality among CM patients compared to patients without CM. Therefore, early identification and timely antifungal therapy before the disease progresses to meningitis are of great value in improving the survival rate of patients.
Survival of community-acquired Bacillus cereus sepsis with venous sinus thrombosis in an immunocompetent adult man – a case report and literature review
Authors: Wang Zengrong , Xia Han , Fan Fangfang , Zhang Jin , Liu Hong , Cao Jing
Published: April 2023

Background

Bacillus cereus infections in immunocompetent patients are uncommon and mainly observed in fragile patients. It can cause lethal infections with multiple organ dysfunction syndrome (MODS). However, a patient presenting as venous sinus thrombosis and survival without sequela has not been reported.

Case presentation

A 20-year-old previously healthy male developed gastroenteritis after a meal, followed by fever, convulsions, and severe disturbance of consciousness. The patient had significant leukocytosis with a mildly elevated D-dimer, creatinine level, and respiratory failure. The CT(computed tomography) revealed fatal brain edema and subarachnoid hemorrhage. Previous blood culture in a local hospital revealed B. cereus, which was confirmed by mNGS(metagenomic next-generation sequencing) using blood and urine in our hospital. Accordingly, B. cereus sepsis with MODS were considered. Later, cerebral venous sinus thrombosis was proved. After anti-infection (linezolid 0.6 g, Q12h; and meropenem 1.0 g, Q8h), anti-coagulant (enoxaparin 6000U, Q12h), and other symptomatic treatments, the patient recovered completely without sequela at the 6-month follow-up.

Conclusions

This case suggests that in immunocompetent adults, there is still a risk of infection with B. cereus, causing severe MODS. Special attention should be paid to venous sinus thrombosis and subarachnoid hemorrhage in such cases, while, anti-coagulant is essential therapy.
Subsequent pregnancy after stillbirth: a qualitative narrative analysis of Canadian families’ experiences
Authors: Gower Sarah , Luddington Justice , Khosa Deep , Thaivalappil Abhinand , Papadopoulos Andrew
Published: April 2023

Background

In Canada, nearly nine pregnancies end in stillbirth daily. Most of these families will go on to have subsequent pregnancies, but research into how best to care for these parents is lacking. This study explores the lived experiences and the most important aspects of person-centred care for Canadian families experiencing a pregnancy after a stillbirth.

Methods

This qualitative descriptive design used secondary data collected from an online, international survey for bereaved parents who reported having experienced a pregnancy subsequent to a stillbirth. Only parents who identified as Canadian were included in this study. Three open text questions were asked about parents’ experiences in their subsequent pregnancy. An inductive thematic analysis approach was used with open coding and a constant comparative method.

Results

Families’ responses fell into six main themes that identified what they would have preferred for high quality, excellent care. These included: (1) recognizing anxiety throughout the subsequent pregnancy, (2) wanting one’s voices and concerns to be heard and taken seriously, (3) needing additional and specific clinical care for reassurance, (4) desiring kindness and empathy from caregivers and others, (5) seeking support from others who had also experienced pregnancy after stillbirth; and (6) addressing mixed emotions including guilt, continuity of care and carer, positive thoughts versus more realistic ones, and poignant feelings of self-blame.

Conclusions

Participants’ responses identified that pregnancy after stillbirth is an extremely stressful time requiring patient-oriented care and support, both physically and psychologically. Families were able to articulate specific areas that would have improved the experience of their subsequent pregnancy. Parents asked for high-quality clinical and psychosocial prenatal care that was specific to them having experienced a prior stillbirth. They also requested connections to others experiencing this similar scenario. Further research is needed to delineate what supports and resources would be needed to ensure this care would be available to all families experiencing pregnancy after stillbirth across Canada and their caregivers.
Evaluating the prognostic significance of p53 and TP53 mutations in HPV-negative hypopharyngeal carcinoma patients: a 5-year follow-up retrospective study
Authors: Huang Qiang , Li Feiran , Ji Mengyou , Lin Lan , Hu Chunyan
Published: April 2023

Purpose

To evaluate prognostic significance of human papillomavirus (HPV) in hypopharyngeal squamous cell carcinoma patients, and to investigate the effect of p53 and TP53 mutations on the prognosis of patients.

Methods

A total of 111 patients were enrolled in our retrospective study. HPV infection status was detected in formalin-fixed paraffin-embedded tissue by real-time multiplex PCR test. p53 expression was evaluate by immunohistochemical staining. TP53 exon mutations were analyzed by PCR amplification and Sanger sequencing. HPV infection status, p53 expression and TP53 mutation were compared with clinical outcome including overall survival and recurrence-free survival by Kaplan-Meier method and Log-rank test.

Results

Of the 111 investigated patients, 18 (16.22%) were positive for HPV infection. HPV(-) patients have a worse clinical outcome than HPV(+) patients. TP53 mutations have similar mutation rates in patients with and without HPV (55.56% vs. 41.94%). p53 and TP53 mutation were not associated with prognosis of patients in HPV(-) patients. TP53 disruptive mutations were found both in patients with or without HPV infection. Furthermore, TP53 non-disruptive mutation had a significantly better clinical outcome than those with disruptive mutation in HPV(-) patients.

Conclusion

Our results showed that HPV infection status is a strong prognostic indicator of survival. p53 and TP53 mutations do not appear to significantly impact survival in HPV(-) patients. TP53 disruptive mutation is associated with reduced survival in HPV(-)/TP53 mutation patients.
Identification of hub genes and pathways in lung metastatic colorectal cancer
Authors: Dai Wei , Guo Caiyao , Wang Yu , Li Yumei , Xie Renjian , Wu Junhong , Yao Baole , Xie Dong , He Ling , Li Yingying , Huang Hao , Wang Yun , Liu Shenglan
Published: April 2023

Background

Colorectal cancer (CRC) is one of the most prevalent types of malignant tumours. Metastasis is the leading cause of cancer-related mortality, with lung metastases accounting for 32.9% of all metastatic CRCs. However, since the biological mechanism of lung metastatic CRC is poorly understood, limited therapeutic targets are available. In the present study, we aimed to identify the key genes and molecular processes involved in CRC lung metastasis.

Methods

The differentially expressed genes (DEGs) between primary and lung metastatic CRC patients were obtained from the Gene Expression Omnibus (GEO) database via the GEO2R tool. The enriched biological processes and pathways modulated by the DEGs were determined with Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and Reactome Gene Sets analyses. The search tool Retrieval of Interacting Genes (STRING) and Cytoscape were used to construct a protein–protein interaction (PPI) network among DEGs.

Results

The DEGs were enriched in surfactant metabolism, cell–cell communication and chemokine signaling pathways. The defined hub genes were included CLU, SFTPD, CCL18, SPP1, APOE, BGN and MMP3. Among them, CLU, SFTPD and CCL18 might be associated with the specific lung tropism metastasis in CRC. In addition, the expression and prognostic values of the hub genes in CRC patients were verified in database of The Cancer Genome Atlas (TCGA) and GEO. Moreover, the protein levels of the hub genes were detected in primary and lung metastatic CRC cells, serum or tissues. Furthermore, SFTPD was confirmed to facilitate cellular proliferation and lung metastasis in CRC.

Conclusion

This bioinformatics study may provide a better understanding of the candidate therapeutic targets and molecular mechanisms for CRC lung metastasis.
Analysis of potential impact factors of corneal biomechanics in myopia
Authors: Du Yangrui , Zhang Yuqing , Zhang Yu , Li Tao , Wang Jie , Du Zhiyu
Published: April 2023

Purpose

To investigate potential impact factors associated with corneal biomechanical properties in Chinese myopia and further to investigate quantifying corneal biomechanics in clinical work.

Methods

Three hundred fifty-five eyes from 181 healthy myopic subjects with a mean age of 25.1 ± 9.4 were recruited in this study. Each patient carried out a comprehensive ophthalmic examination, including corneal hysteresis(CH), corneal resistance factor(CRF), central corneal thickness(CCT), axial length(AL), intraocular pressure(IOP), spherical equivalence(SE) and corneal curvature (K). CH and CRF were measured with the ocular response analyzer(ORA). To analyze the corneal biomechanical characteristics of myopia patients and their association with other parameters.

Result

The multiple linear regression analysis showed that CH was positively associated with CCT, and corneal curvature (all with P < 0.05) and negatively associated with SE and AL)(all with P < 0.05); CRF was positively correlated with CCT, corneal curvature and IOP(all with P < 0.05), but negatively correlated with SE and AL(all with P < 0.05). The CH and CRF values in children group were both higher than adults group (≥ 18 years old) (P < 0.05), but it attributed to that the CCT of children was thicker than adults. Excluding factor of CCT, there was no significant difference in CH and CRF between children group and adult group. Excluding factor of CCT, there was no significant difference in CH and CRF among different stage of age (age 18–48).

Conclusion

The CCT played the most important role of affecting the CH and CRF. The SE, corneal curvature, AL and IOP had a certain influence on corneal biomechanics. Whether the CH and CRF values of individual patient are normal in clinical work, it should refer to the CH and CRF values corresponding CCT sectional range and SE.
A safe and successful capsulorhexis technique for the intumescent cataracts; modified two-stage continuous curvilinear capsulorhexis
Authors: Kılıç Raşit , Konuk Şerife Gülhan , Güneş Alper , Çomçalı Sebile Üstün
Published: April 2023

Background

Capsulorhexis is the most important step in intumescent cataract due to the high risk of radial extension of the capsular tear during the cataract surgery. The aim of this study is to present modified the two-stage capsulorhexis technique for intumescent cataract.

Materials and methods

The two-stage capsulorhexis technique was used in this study. A small size capsulorhexis approximately 1.5-2 mm diameter was created in the first stage. Liquefied cortex was aspirated with a 25 G cannula to equalize anterior chamber pressure and intracapsular pressure after the small size capsulorhexis. In the second stage, a 5–6 mm capsulorhexis size was performed for a safe phacoemulsification.

Results

A total of 73 consecutive patients with intumescent cataract were evaluated in this study. There were 39 male cases and 34 female cases. Mean age was 66 years ± 8 (between 53 and 84 years). A well centered complete continuous curvilinear capsulorhexis approximately 5–6 mm size was achieved in 72 of 73 cases (98.6%). Peripheral extension of capsulorhexis occurred in one eye during the second stage capsulorhexis. In this case, the capsule was cut with Vannas scissors and the capsulorhexis was completed. The rest of surgery was continued with a standard procedure and in-the-bag IOL implantation was done.

Conclusions

This technique facilitates the creation of a safe capsulorhexis compared to the one-stage capsulorhexis technique. Surgeons may consider this technique to perform a safe phacoemulsification in the intumescent cataracts.
Understanding the telehealth experience of care by people with ILD during the COVID-19 pandemic: what have we learnt?
Authors: Tikellis Gabriella , Corte Tamera , Glaspole Ian N. , Goh Nicole , Khor Yet H. , Wrobel Jeremy , Symons Karen , Fuhrmeister Lisa , Glenn Laura , Chirayath Shiji , Troy Lauren , Holland Anne E.
Published: April 2023

Introduction

The COVID-19 pandemic resulted in a rapid transformation of health services. This study aimed to understand the experiences of healthcare by people with interstitial lung disease (ILD), to inform future service delivery.

Methods

Four specialist clinics in tertiary centres in Australia (Victoria:2 sites; New South Wales: 1 site; Western Australia: 1 site) recruited patients with ILD during an 8-week period from March 2021. Participants completed a COVID-specific questionnaire focused on health-related experiences during 2020.

Results

Ninety nine (65% of 153) participants completed the questionnaire. 47% had idiopathic pulmonary fibrosis or connective tissue disease-associated ILD, 62% were female and the average age was 66 years. Whilst 56% rated their overall health in 2020 as the same as months prior, 38% indicated a worsening in health attributed to reduced physical activity and fear of contracting the virus. Access to healthcare professionals was ‘good’ in 61%, and ‘fair-to-poor’ for 37% due to missed respiratory assessments, with telehealth (mainly telephone) being perceived as less effective. 89% had contact with respiratory physicians, 68% with general practitioners, predominantly via telephone, with few video consultations. High satisfaction with care was reported by 78%, with lower satisfaction attributed to delays in assessments, disruption to usual services such as pulmonary rehabilitation, and dissatisfaction with telehealth.

Conclusion

People with ILD were generally satisfied with their care during 2020, however reduced access to healthcare professionals was challenging for those experiencing a deterioration in health. Telehealth was largely well received but did not always meet the needs of people with ILD particularly when unwell.
Respiratory virus infections of the lower respiratory tract elevate bronchoalveolar lavage eosinophil fraction: a clinical retrospective study and case review
Authors: Nabeya Daijiro , Setoguchi Michika , Ueno Shiho , Kinjo Takeshi
Published: April 2023

Background

Eosinophilic airway inflammation caused by respiratory virus infection has been demonstrated in basic research; however, clinical investigations are lacking. To clarify the extent to which respiratory virus infection induces airway eosinophilic inflammation, we reviewed the results of bronchoalveolar lavage (BAL) and respiratory virus testing performed at our hospital.

Methods

Among the BAL procedures performed at the University of the Ryukyu Hospital from August 2012 to September 2016, we collected cases of acute respiratory disease in which multiplex polymerase chain reaction (PCR) was used to search for respiratory viruses. The effect of respiratory virus detection on BAL eosinophil fraction was analyzed using statistical analysis. A case study was conducted on respiratory virus detection, which showed an elevated BAL eosinophil fraction.

Results

A total of 95 cases were included in this study, of which 17 were PCR-positive. The most common respiratory virus detected was parainfluenza virus (eight cases). The PCR-positive group showed a higher BAL eosinophil fraction than the PCR-negative group (p = 0.030), and more cases had a BAL eosinophil fraction > 3% (p = 0.017). Multivariate analysis revealed that being PCR-positive was significantly associated with BAL eosinophil fraction > 1% and > 3%. There were nine PCR-positive cases with a BAL eosinophil fraction > 1%, of which two cases with parainfluenza virus infection had a marked elevation of BAL eosinophil fraction and were diagnosed with eosinophilic pneumonia.

Conclusions

Cases of viral infection of the lower respiratory tract showed an elevated BAL eosinophil fraction. The increase in eosinophil fraction due to respiratory virus infection was generally mild, whereas some cases showed marked elevation and were diagnosed with eosinophilic pneumonia. Respiratory virus infection is not a rare cause of elevated BAL eosinophil fraction and should be listed as a differential disease in the practice of eosinophilic pneumonia.