bluuebunny/crossref_metadata_2025 huggingface dataset:
Hypertonic glucose in the treatment of low back pain: A randomized clinical trial
Authors: Pereira Pires Jose Alberto , Rey Moura Ed Carlos , Oliveira Caio Marcio Barros de , Vieira Dibai-Filho Almir , Soares Brandão Nascimento Maria do Desterro , da Cunha Leal Plinio
Published: September 2023

Background:

Chronic low back pain (LBP) is defined as pain lasting longer than 3 months and is one of the conditions with the most significant social impact. Treatment is complex and includes proliferative agents used in prolotherapy. The mechanism is not known, but osmotic agents (hypertonic solutions of dextrose or glucose) cause cellular rupture and an inflammatory response that releases cytokines and growth factors that lead to scarring and reinnervation.

Methods:

Patients with chronic LBP (>12 weeks) who were non-traumatic and unresponsive to at least 1 month of physical therapy were selected. All patients were followed up at a return visit at 1, 3, and 6 months for pain assessment using validated pain questionnaires and scales.

Results:

Nineteen patients were included in the conservative group and 19 in the glucose group, with the majority being women (57.9%). The patients were between 47 and 59 years of age (39.5%), mixed race (76.33%), married or in a committed relationship (73.7%), and had completed the study for 5.2 years. Overall mean body mass index was 27.3 ± 4.4 kg/m2 and was higher in the conservative group (28.0 ± 4.7 kg/m2). The groups showed differences in Visual Analog Scale scores, with median and amplitude values close to each other between the time points evaluated and increasing values in the glucose group, which had significantly higher values for this scale at the third evaluation (P = .031). When comparing the Rolland-Morris scale scores between the groups, there was a significant difference only in the 3-m assessment (P = .021). In the follow-up assessment, both groups showed significant improvement between T0 and the other assessment time points (P < .05) in all evaluations.

Conclusion:

Both groups significantly improved on the evaluated scales during follow-up. Overall, no effects were attributable to the glucose components or the prolotherapy protocol.
Self-perceived halitosis and its social impact on females: A cross-sectional study
Authors: Alssum Lamees , Alsaleh Lama , Alzoman Hamad
Published: September 2023

Halitosis refers to socially unacceptable levels of breath odors. This affects the social life and psychological well-being of individuals. The purpose of this study was to evaluate the prevalence of self-perceived halitosis (SPH) among females and its effect on social life. This was a cross-sectional study. A previously validated questionnaire was distributed electronically through a secure link. The questionnaire consisted of 5 different parts that collected information on sociodemographic, medical history, oral hygiene and other health habits. It also included questions related to participant’s knowledge and perception of halitosis and its social impact. All females who were at least 18 years were invited to participate. Data were transferred for analysis using the Statistical Package for Social Sciences program for Windows (IBM SPSS Statistics Version 26, Chicago, IL). Simple descriptive statistics such as frequency distributions and percentages were calculated for the study variables. The relationship between the variables and SPH was also evaluated using the chi-squared test of independence at 95% confidence (P ≤ .05). In total, 1089 subjects completed the questionnaire. The SPH prevalence was 62% among females. The correlation between SPH and sinusitis, gastrointestinal tract disorders, periodontal diseases were significant (P < .05). In addition, subjects with good tooth brushing habits reported no halitosis (91.6%) compared to subjects with poor tooth brushing habits who reported no halitosis (8.9%), and the difference was statistically significant (P < .001). Not using floss and tounge cleaners daily was significantly related to self-reported halitosis (P < .001). Females who reported SPH indicated that they were hesitant to talk to others (68.1%), uncomfortable around others (80.5%), did not like meeting others (44.2%), avoided by others (15%), and that halitosis affected their personal life (31.9%). This association was statistically significant for all variables of social life (P < .001). The prevalence of SPH is high and can have an incapacitating effect on females social lives. The management of halitosis includes active involvement of dental professionals and the incorporation of psychological support.
Effects of dural puncture epidural technique with different drug delivery methods for labor analgesia: A randomized controlled clinical trial
Authors: Wang Xin , Guo Yaqiu , Wang Meijian
Published: September 2023

This study aimed to investigate the effect of dural puncture epidural (DPE) combined with small-dose lidocaine for labor analgesia. Parturients were randomly divided into epidural anesthesia (EA), DPE1, and DPE2 groups. In the EA group, 5 mL of 1% lidocaine was administered via conventional L2–L3 puncture catheterization; in the DPE1 group, epidural drug was administered after catheterization using the DPE technique; in the DPE2 group, epidural puncture drug was administered through the epidural puncture needle before catheterization using the DPE technique. The primary outcome was the onset time of analgesia. The secondary outcomes included the numerical rating scale (NRS) scores during uterine contraction before bolus injection of experimental dose (T0) and the second time (T1), the fifth time (T2) and the tenth time (T3) after bolus injection of experimental dose; NRS scores at the second stage of labor (T4) and during perineal suture (T5); operation time of anesthesia; puncture related complications; anesthesia related complications; delivery outcome; use of local anesthesia during vaginal suture; and Apgar score of the neonates. There were 115 women included. The onset time in the DPE2 group was markedly shorter than in the EA and DPE1 groups (P < .001). The NRS scores in the DEP2 group at T1 and T4 were significantly lower than in the EA and DEP1 groups (P < .001). The overall incidence of puncture related complications in the DEP1 and DEP2 groups was markedly higher than in the EA group (P < .05). In dural puncture epidural analgesia, when the experimental dose was injected directly through the epidural puncture needle, the onset time was shorter and the analgesic effect was better as compared to the injection of test dose after inserting the epidural catheter.
Treatment of glenohumeral internal rotation deficit in the general population with shoulder pain: An open single-arm clinical trial
Authors: Jácome-López Rafael , Tejada-Gallego Javier , Silberberg José María , García-Sanz Fernando , García-Muro San José Francisco
Published: September 2023

Background:

Maladaptation can provoke important alterations in the arthrokinematics such as an internal rotation reduction in the dominant shoulder compared with the nondominant shoulder known as glenohumeral internal rotation deficit (GIRD). Though the number of studies investigating GIRD in athletic population, there are not studies reporting the efficacy of the GIRD treatment in the nonathlete population, a kind of study required to improve our understanding of patient care with this pathology. This study aimed to describe the efficacy of the GIRD treatment in nonathlete population with shoulder pain.

Methods:

An open single-arm trial with 35 patients was adopted for evaluating the efficacy of GIRD treatment in patients with shoulder pain. All patients with shoulder pain who attended the consultation, accepted, and agreed to participate in the study between October 2020 and March 2021 were included. A treatment sequence including joint manual therapy techniques and soft tissue release techniques was applied in the consultation. Then, patients were instructed to adapt the daily active biological stimulus at home. The IR before (IR0) and after (IR1) the treatment was considered the outcome measure. The GIRD was calculated as the difference between the IR of the non-painful shoulder and the IR of the painful shoulder before (GIRD0) and after treatment (GIRD1). A paired Student t test was used to compare the GIRD of each patient before and after the treatment.

Results:

Treatment of the patients significantly increased the IR of the painful shoulder in all the patients (P-value < .0001) So, the mean IR0 was 26.09 ± 14.46º (23.64–28.53), and after the treatment the mean IR1 was 67.98 ± 15.03º (65.48–70.52). The mean difference after the treatment (IR1–IR0) was 41.89 ± 14.74º (39.4–44.39). The treatment also significantly reduced GIRD (P-value < .0001). So, the mean GIRD0 was 42.95 ± 16.26º (40.2–45.7), and after the treatment the mean GIRD1 was –1.05 ± 17.18º (–3.96 to 1.85).

Conclusions:

The treatment administrated in this study significantly increased the internal rotation of the treated and painful shoulder and reduced the GIRD from the first consultation.

Level of evidence:

Level 3.
Efficacy of rehabilitation initiated in the early phase after simultaneous deceased donor liver and kidney transplantation: A case report
Authors: Tanaka Shinya , Mizuno Yota , Nojiri Shusuke , Futamura Daiki , Nagaya Motoki , Nishida Yoshihiro , Sano Yuta , Ishida Shohei , Kato Masashi , Kurata Nobuhiko , Jobara Kanta , Fujimoto Yasuhiro , Ogura Yasuhiro
Published: September 2023

Rationale:

The purpose of this case report is to describe a case of successful early rehabilitation intervention for simultaneous liver and kidney transplantation (SLKT).

Patient concerns:

A 51-year-old Japanese man was diagnosed with Caroli disease 27 years ago. Hemodialysis was introduced due to end-stage renal disease 17 years ago.

Diagnoses:

After successful SLKT, the patient was extubated on postoperative day (POD) 1, liberated from dialysis on POD 4, and discharged from the intensive care unit on POD 9.

Interventions:

Supervised rehabilitation was started on POD 2, and the patient was able to walk 100 m on POD 9. Electrical muscle stimulation therapy was started to improve muscle weakness in both legs on POD 16, and aerobic exercise using a cycle-ergometer was started on POD 24.

Outcomes:

The 6-minute walking distance improved from 324 m on POD 14 to 501 m on POD 28. The patient could walk 4000 to 5000 steps per day at hospital discharge, and was discharged home on POD 32. There were no adverse events, including worsening hepatic or renal function, during the rehabilitation period. One month after discharge, the patient was able to perform 30 to 40 minutes of aerobic exercise every day, and returned to work 5 months after discharge.

Lessons:

This case shows that early rehabilitation intervention immediately after SLKT safely and rapidly improved physical performance without adverse events. The results in the present case suggest that regular physical assessment and appropriate interventions with a variety of exercise modalities can contribute to improved physical performance in SLKT patients.
Diagnostic challenges in tuberculous meningitis: a case report with negative genexpert result
Authors: Ghimire Bardan , Thapaliya Ishwor , Yadav Jeshika , Bhandari Sujata , Paudyal Man B. , Mehta Neha , Bhandari Sagar , Adhikari Yagya R. , Sapkota Sanjaya , Bhattarai Madhur
Published: September 2023

Introduction:

Tuberculous meningitis (TBM) is a severe form of tuberculosis affecting the meninges, primarily caused byMycobacterium tuberculosis. Diagnosis of TBM poses numerous challenges due to its nonspecific clinical presentation and the limitations of diagnostic tests like GeneXpert.

Case presentation:

The authors report a case of a 22-year-old female from Eastern Nepal presenting with acute-onset fever, headache, vomiting, and neck pain. Cerebrospinal fluid (CSF) analysis showed lymphocytic pleocytosis, elevated protein, low glucose levels, and cobweb coagulum indicative of TBM. However, the GeneXpert test revealed negative results.

Discussion:

In resource-limited settings like Nepal, where access to GeneXpert MTB/Rif is limited, CSF analysis and clinical algorithms play a crucial role in diagnosing TBM. Relying solely on GeneXpert results may lead to false negatives, so a high level of suspicion based on patient risk factors is essential. Prompt initiation of empirical antitubercular therapy is vital for a favorable outcome in TBM cases.

Conclusion:

Negative MTB PCR results from CSF can be misleading in diagnosis of tubercular meningitis. Therefore, comprehensive evaluations, including detailed patient history, physical examination, and CSF fluid analysis, are crucial in high tuberculous prevalence countries to ensure accurate and timely diagnosis.
Risk Factors for Primary Angle-closure Glaucoma: A Systematic Review and Meta-analysis of 45 Studies
Authors: Wang Ying , Dong Xing-Xuan , Hou Xiao-Wen , Pan Chen-Wei
Published: September 2023

SIGNIFICANCE

This study summarized primary angle-closure glaucoma (PACG)–related factors across different dimensions.

OBJECTIVES

This review aimed at systematically summarizing the associated factors of PACG in published literatures.

METHODS

A systematic review and meta-analysis were conducted by searching the electronic databases including PubMed, EMBASE, and Web of Science from their inception to November 2021. The pooled risk estimates of continuous and categorical variables were calculated using weighted mean difference (WMD) and odds ratio (OR; 95% confidence intervals [CIs]), respectively.

RESULTS

We included 45 studies in this review. In the meta-analysis, intraocular pressure (WMD, 3.13; 95% CI, 2.37 to 3.89), anterior chamber depth (WMD, −0.52; 95% CI, −0.70 to −0.34), axial length (WMD, −0.77; 95% CI, −1.26 to −0.28), retinal nerve fiber layer (WMD, −21.23; 95% CI, −30.21 to −12.25), and spherical equivalent (WMD, 1.02; 95% CI, 0.66 to 1.38) were the most common ophthalmic anatomic factors, and lower body weight (WMD, −3.65; 95% CI, −6.48 to −0.82) was the most significant general morphological indicators. The presence of cataract (OR, 3.77; 95% CI, 3.46 to 4.11) and hyperlipidemia (OR, 1.10; 95% CI, 1.02 to 1.20) were significantly associated with PACG. Increased level of triglyceride (WMD, 0.17; 95% CI, 0.06 to 0.27) was associated with PACG. In addition, an association between short-term antidepressant exposure (OR, 1.36; 95% CI, 1.08 to 1.70) and acute angle-closure glaucoma was observed.

CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS

This review identified a few consistent factors related to PACG, providing important information for primary care physicians, general ophthalmologists, and public health professionals to counsel their patients on PACG risks.
Financial Inequities in Optometric Education in Canada: A Comparison of Two Optometry Programs
Authors: Bitton Etty , Jones Deborah , Wittich Walter
Published: September 2023

SIGNIFICANCE

The advancing age of the population will require increased access to eye care services to manage eye diseases and vision correction. Optometric education requires a sound financial plan to manage student debt. This study evaluates the financial inequalities of optometric programs in Canada and how this may impact the provision of eye care professionals.

PURPOSE

The objective of this study was to compare the financial inequities in optometric education in Canada from the 2020 graduating class.

METHODS

A cross-sectional study assessed monetary variables related to the study of optometry in Canada, including academic and personal expenses, and overall debt and expenses related to the COVID-19 lockdown for the 2020 graduating class.

RESULTS

A total of 108 optometry students from the 2020 graduating classes of the University of Montreal and the University of Waterloo responded, with 68 (female/male respondents, 53:15; mean [standard deviation] age, 25.66 [2.01] years) completing the study. Waterloo students spent more years in university (P < .001), had higher academic fees (P < .001), spent more on traveling to their family residence (P = .007), and received more provincial (P = .002) and federal (P < .001) loans than Montreal students. Overall debt before optometry was similar among students but differed (P < .001) at the end of their program, with Waterloo students having a higher debt burden.

CONCLUSIONS

There is a financial inequity in optometric education in Canada depending on the chosen program. Cumulative optometry student debt for the 2020 graduating class in Canada ranges from Can $0 to $189,000 with an average of Can $65,800 and a median of Can $50,000. The results of this study can assist financial and government agencies, and future optometry students to better understand the financial burdens and establish a financial plan to study optometry in Canada, to respond to the growing eye care needs of the public.
The Effect of Varied Microperimetric Biofeedback Training in Central Vision Loss: A Randomized Trial
Authors: Silvestri Valeria , De Rossi Francesca , Piscopo Paola , Perna Fabiana , Mastropasqua Leonardo , Turco Simona , Rizzo Stanislao , Mariotti Silvio Paolo , Amore Filippo
Published: September 2023

Significance

This investigation reports for the first time the effects of different microperimetric biofeedback strategies in visually impaired subjects with central field loss.

Purpose

To evaluate the effects of two MP-3 micro-perimeter biofeedback strategies on the visual performance of subjects with central vision loss. Moreover, changes between the groups were compared to provide indications of practice with biofeedback stimulation in subjects with central vision loss.

Methods

Using simple randomization, 19 participants were trained according to two different biofeedback stimulation approaches using the MP-3 microperimeter. Patients were assigned to two different groups: subjects trained for 2 days a week (Group A) and 3 days a week (Group B). The patients in each group were randomized to perform a total of 10 or 15 sessions.

Results

Fixation stability increased from 4.5°2 (± 2.8) to 2.3°2 (± 2.2) and from 8.2°2 (± 6.9) to 1.4°2 (± 1) after 2 and 3 weekly biofeedback training sessions, respectively (P < .05). Biofeedback training induced a significant improvement of 40.7% and 29.4% in reading speed for groups A and B, respectively (P < .05). A comparison of two weekly biofeedback training sessions with three weekly biofeedback sessions demonstrated greater fixation stability in Group B (P < .05).

Conclusions

This study conclude that a biofeedback intervention is effective in enhancing oculomotor control in patients with central vision loss. In our study, a more intensive biofeedback strategy seemed to produce significantly better results in terms of functional vision parameters.
Nonresuscitation Fluid Accumulation and Outcomes After Pediatric Cardiac Surgery: Single-Center Retrospective Cohort Study
Authors: Hudkins Matthew R. , Miller-Smith Laura , Evers Patrick D. , Muralidaran Ashok , Orwoll Benjamin E.
Published: September 2023

OBJECTIVES:

Postoperative patients after congenital cardiac surgery are at high risk of fluid overload (FO), which is known to be associated with poor outcomes. “Fluid creep,” or nonresuscitation IV fluid in excess of maintenance requirement, is recognized as a modifiable factor associated with FO in the general PICU population, but has not been studied in congenital cardiac surgery patients. Our objective was to characterize fluid administration after congenital cardiac surgery, quantify fluid creep, and the association between fluid creep, FO, and outcome.

DESIGN:

Retrospective, observational cohort study.

SETTING:

Single-center urban mixed-medical and cardiac PICU.

PATIENTS:

Patients admitted to the PICU after cardiac surgery between January 2010 and December 2020.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

There were 1,459 postoperative encounters with 1,224 unique patients. Total fluid intake was greater than maintenance requirements on 3,103 of 4,661 patient days (67%), with fluid creep present on 2,624 patient days (56%). Total nonresuscitation intake was higher in patients with FO (defined as cumulative fluid balance 10% above body weight) versus those without. Fluid creep was higher among patients with FO than those without for each of the first 5 days postoperatively. Each 10 mL/kg of fluid creep in the first 24 hours postoperatively was associated with 26% greater odds of developing FO (odds ratio [OR] 1.26; 95% CI, 1.17–1.35) and 17% greater odds of mortality (OR 1.17; 95% CI, 1.05–1.30) after adjusting for risk of mortality based on surgical procedure, age, and day 1 resuscitation volume. Increasing fluid creep in the first 24 hours postoperatively was associated with increased postoperative duration of mechanical ventilation and PICU length of stay.

CONCLUSIONS:

Fluid creep is present on most postoperative days for pediatric congenital cardiac surgery patients, and fluid creep is associated with higher-risk procedures. Fluid creep early in the postoperative PICU stay is associated with greater odds of FO, mortality, length of mechanical ventilation, and PICU length of stay. Fluid creep may be under-recognized in this population and thus present a modifiable target for intervention.
Anatomy of the Facial Glideplanes, Deep Plane Spaces, and Ligaments: Implications for Surgical and Nonsurgical Lifting Procedures
Authors: Minelli Lennert , Brown Cameron P. , van der Lei Berend , Mendelson Bryan
Published: September 2023

Background:

The soft-tissue glideplanes of the face are functionally important and have a role in facial rejuvenation surgery. The aim of this study was to improve understanding of soft-tissue mobility of the face and its effect on the redraping of tissues involved in face lifting. The consequences of no-release and extensive-release lifting were analyzed to explain the difference in efficacy and potential longevity between these 2 contrasting philosophies.

Methods:

Preliminary dissections and macrosectioning were followed by a definitive series of standardized layered dissections on 50 cadaver heads, along with histologic analysis, sheet plastination, and mechanical testing.

Results:

The previously described spaces are potential surgical dissection planes deep to the superficial fascia layer. The classically described retaining ligaments are local reinforcements of a system of small retaining fibers (retinacula cutis and deep retinacula fibers) that provide support to the soft tissues of the face and neck against gravitational sagging while allowing certain mobility. This mobility is used when mobile tissues are lifted without surgical release. However, the process of dragging up these fibers results in a loss of their previous antigravitational, supportive orientation.

Conclusions:

No-release lifting techniques, such as thread lifts and minimal-invasive face lifts, tighten tissue laxity with a change of the gravity-opposing tissue architecture, placing the weight of the flap solely on the fixation, which limits longevity of the lift. The alternative—full release with redraping—enables reattachment of the flap to a higher position, with preservation of the original deep fascial architecture with its antigravity orientation and natural mobility, conceivably improving the longevity of the lift.
Elemental Bioimaging of Sheep Bone and Articular Cartilage After Single Application of Gadolinium-Based Contrast Agents
Authors: Richter Henning , Verlemann Christine , Jeibmann Astrid , Martin Louise F. , Luebke Andreas M. , Karol Agnieszka , Sperling Michael , Radbruch Alexander , Karst Uwe
Published: September 2023

Background

Gadolinium-based contrast agents (GBCAs) are applied to enhance magnetic resonance imaging. Gadolinium (Gd), a rare earth metal, is used in a chelated form when administered as GBCA to patients. There is an ongoing scientific debate about the clinical significance of Gd retention in tissues after administration of GBCAs. It is known that bone serves as Gd reservoir, but only sparse information on localization of Gd in bone is available.

Purpose

The aim of this study was to compare Gd tissue concentration and spatial distribution in femoral epiphysis and diaphysis 10 weeks after single-dose injection of linear and macrocyclic GBCAs in a large animal model.

Materials and Methods

In this prospective animal study, Swiss-Alpine sheep (n = 36; age range, 4–10 years) received a single injection (0.1 mmol/kg) of macrocyclic (gadobutrol, gadoteridol, and gadoterate meglumine), linear (gadodiamide and gadobenate dimeglumine) GBCAs, or saline. Ten weeks after injection, sheep were killed, and femur heads and shafts were harvested. Gadolinium spatial distribution was determined in 1 sample of each treatment group by laser ablation–inductively coupled plasma–mass spectrometry. All bone specimens were analyzed histopathologically.

Results

Injection of GBCAs in female Swiss-Alpine sheep (n = 36) resulted in Gd localization at the endosteal and periosteal surface and in a subset of GBCAs additionally at the cement lines and the bone cartilage junction. No histopathological alterations were observed in the investigated tissue specimens.

Conclusions

Ten weeks after single injection of a clinically relevant dose in adult sheep, both linear species of GBCA resulted in considerably higher accumulation than macrocyclic GBCAs. Gadolinium deposits were restricted to distinct bone and cartilage compartments, such as in bone linings, cement lines, and bone cartilage junctions. Tissue histology remained unaffected.
Artificial Intelligence and the Simulationists
Authors: Rodgers David L. , Needler Mathew , Robinson Alexander , Barnes Roxie , Brosche Theresa , Hernandez Jessica , Poore Julie , VandeKoppel Paul , Ahmed Rami
Published: September 2023

Summary Statement

The recent introduction of ChatGPT, an advanced, easy-to-use, and freely available artificial intelligence (AI) program, created new possibilities across many industries and professions including healthcare simulation. ChatGPT has the potential to streamline healthcare simulation-based education while also providing insights for the scenario development process that conventional case development may miss. However, there are issues related to accuracy, relevance, and structure of the products produced by the ChatGPT AI program. This article examines 2 AI-generated simulation case examples highlighting strengths and weaknesses while providing guidance on the use of ChatGPT as a simulation resource.
Effectiveness of Sinopharm’s BBIBP-CorV Booster Vaccination Against COVID-19-Related Severe and Critical Cases and death in Morocco During the Omicron Wave
Authors: Belayachi Jihane , Mhayi Abdelkader , Majidi Hind , Fahime ElMostapha El , Abouqal Redouane
Published: September 2023

Objective

This study investigates the effectiveness of booster doses on the Omicron wave in Morocco against COVID-19 severe and critical hospitalizations and deaths;

Participants/methods

This study uses nationally representative data on COVID-19 from 15 December 2021 to 31 January 2022. To investigate the effectiveness of the inactivated COVID-19 vaccine BBIBP-CorV (Vero Cells) Sinopharm booster doses on the Omicron wave in morocco by using real-world data established from nationally representative statistics on COVID-19 cases, deaths and vaccinations.

Statistical Analyses

The screening method was used to estimate vaccine effectiveness against COVID-19 severe or critical hospitalization and COVID-19-related deaths. The data were grouped by, age subgroup, sex, week, and geographical area and were analyzed by using binary logistic regression with an offset for vaccine coverage.

Results

The overall sinopharm VE estimate is 89% (95% CI 85 to 92) effective in curbing COVID-19 death, and 81% (95% CI 78 to 84 in curbing COVID-19 severe critical hospitalization. Death-related VE estimate was 86% (95% CI 81 to 90) for patients aged 1Z65 years, 96% (95% CI 90 to 98) for those aged < 65 years, 95% (95% CI 88 to 98) in no risk factor patient was, 91% (95% CI 85 to 94) with 1 risk factor; 90% (95% CI 83 to 95) with 2 risk factors; 72% (95% CI 52 to 84) in patient with 3 risk factors and more. Severe critical hospitalization VE, estimate was 78% (95% CI 74 to 82) for patients aged 1Z65 years, 87% (95% CI 82 to 90) for those aged < 65 years, 86% (95% CI 80 to 90) in no risk factor patient was, 80% (95% CI 73 to 84) with 1 risk factor; 80% (95% CI 70 to 85) with 2 risk factors; 80% (95% CI 68 to 86) in patient with 3 risk factors and more.

Conclusions

Sinopharm Boosters are effective in increasing protection against Omicron variant-related COVID-19 death and severe critical hospitalization. The protection is reduced with older age and higher risk factors. These findings emphasize the importance of targeted vaccination strategies for different demographic groups and underscore the protective benefits of the third booster Sinopharm vaccine.
Early initiation of polymyxin B hemoperfusion therapy for cancer patients with refractory septic shock
Authors: Lee Jae Hoon , Han Won Ho
Published: September 2023

Purpose

In this study, we analyzed correlations between 28-day mortality and hemodynamic changes, measured using polymyxin B-immobilized fiber column direct hemoperfusion initiation time, in patients with cancer with refractory septic shock.

Materials and methods

We retrospectively analyzed 45 patients with cancer who received polymyxin B-immobilized fiber column direct hemoperfusion due to refractory septic shock. Patients were categorized into early (<12 h between refractory septic shock and initiation of polymyxin B-immobilized fiber column direct hemoperfusion) and late (>12 h) initiation groups. Changes in vasoactive inotrope scores, sequential organ failure assessment scores, and PaO2/FiO2ratios before and 24 h after polymyxin B-immobilized fiber column direct hemoperfusion, were compared.

Results

Univariable analysis showed that 28-day mortality risk was associated with diabetes mellitus (odds ratio=3.081; 95% confidence interval =1.290–7.360;p=0.011), lactic acid (odds ratio=1.010; 95% confidence interval =1.005– 1.014;p<0.0001), and sequential organ failure assessment score (odds ratio=1.190; 95% confidence interval =1.044–1.357;p=0.009). Multivariable analysis showed that 28-day mortality risk was associated with diabetes mellitus (odds ratio=2.718; 95% confidence interval =1.013–7.291;p=0.047), early initiation (odds ratio=0.268; 95% confidence interval =0.094–0.765;p=0.014), and lactic acid (odds ratio=1.009; 95% confidence interval =1.004– 1.014;p<0.0001). Overall survival was slightly higher in the early than in the late initiation group (p=0.0515). Comparisons of variables before and 24 h after polymyxin B-immobilized fiber column direct hemoperfusion revealed that vasoactive inotrope scores decreased in both the early and late groups (Δ318vs.Δ114;p=0.001 andp=0.005, respectively), whereas the PaO2/FiO2ratio slightly increased (Δ127.5vs.Δ95.6;p=0.350 andp=0.390, respectively) over time.

Conclusions

In patients with cancer with refractory septic shock, early initiation of polymyxin B-immobilized fiber column direct hemoperfusion reduced inotrope-vasopressor requirement and 28-day mortality.
Fish oil supplementation modifies the genetic potential for blood lipids
Authors: Sun Yitang , McDonald Tryggvi , Baur Abigail , Xu Huifang , Bateman Naveen Brahman , Shen Ye , Li Changwei , Ye Kaixiong
Published: September 2023

Background

Dyslipidemia is a well-known risk factor for cardiovascular disease, which has been the leading cause of mortality worldwide. Although habitual intake of fish oil has been implicated in offering cardioprotective effects through triglyceride reduction, the interactions of fish oil with the genetic predisposition to dysregulated lipids remain elusive.

Objectives

We examined whether fish oil supplementation can modify the genetic potential for the circulating levels of four lipids, including total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides.

Methods

A total of 441,985 participants with complete genetic and phenotypic data from the UK Biobank were included in our study. Polygenic scores (PGS) were calculated in participants of diverse ancestries. Multivariable linear regression models were used to assess associations with adjustment for relevant risk factors.

Results

Fish oil supplementation mitigated genetic susceptibility to elevated levels of total cholesterol, LDL-C, and triglycerides, while amplifying genetic potential for increased HDL-C among 424,090 participants of European ancestry (Pinteraction< 0.05). Consistent significant findings were obtained using PGS calculated based on multiple genome-wide association studies or alternative PGS methods. We also showed that fish oil significantly attenuated genetic predisposition to high triglycerides in African-ancestry participants.

Conclusions

Fish oil supplementation attenuated the genetic susceptibility to elevated blood levels of total cholesterol, LDL-C, and triglycerides, while accentuating genetic potential for higher HDL-C. These results suggest that fish oil may have a beneficial impact on modifying genome-wide genetic effects on elevated lipid levels in the general population.
Neural differential equations enable early-stage prediction of preterm birth using vaginal microbiota
Authors: Karambelkar Kaushik , Baranwal Mayank
Published: September 2023

Abstract

Preterm births (PTBs), i.e., births before 37 weeks of gestation are completed, are one of the leading issues concerning infant health, and is a problem that plagues all parts of the world. Millions of infants are born preterm globally each year, resulting in developmental disorders in infants and increase in neonatal mortality. Although there are known risk factors for PTB, the current procedures used to assess PTB risk are effective only at the later stages of pregnancy, which reduces the impact of currently possible interventions administered to prevent PTB or mitigate its ill-effects. Vaginal microbial communities have recently garnered attention in the context of PTB, with the notion that a highly diverse microbiome is detrimental as far as PTB is concerned. Increased abundance or scarcity of certain microbial species belonging to specific genera has also been linked to PTB risk. Consequently, attempts have been made towards establishing a correlation between alpha-diversity indices associated with vaginal microbial communities, and PTB. However, the vaginal microbiome varies greatly from individual to individual, and this variation is more pronounced in racially, ethnically and geographically diverse populations, which diversity indices may not be able to overcome. Machine learning (ML)-based approaches have also previously been explored, however, the success of these approaches reported thus far has been limited. Additionally, microbial communities have been reported to evolve during the duration of the pregnancy, and capturing such a signature may require higher, more complex modeling paradigms. Thus, alternative approaches are necessary to identify signatures in these microbial communities that are capable of distinguishing PTB from a full-term pregnancy. In this study, we have highlighted the limitations of diversity indices for prediction of PTB in racially diverse cohorts. We applied Deep Learning (DL)-based methods to vaginal microbial abundance profiles obtained at various stages of pregnancy, and Neural Controlled Differential Equations (CDEs) are able to identify a signature in the temporally-evolving vaginal microbiome during trimester 2 and can predict incidences of PTB (mean test set ROC-AUC = 0.81, accuracy = 75%, F1-score = 0.71) significantly better than traditional ML classifiers such as Random Forests (mean test set ROC-AUC = 0.65, accuracy = 66%, F1-score = 0.42) and Decision Trees (mean test set ROC-AUC = 0.48, accuracy = 46%, F1-score = 0.40), thus enabling effective early-stage PTB risk assessment.

GraphicalAbstract
Single-cell mechanical analysis reveals viscoelastic similarities between normal and neoplastic brain cells
Authors: Onwudiwe Killian , Najera Julian , Holen Luke , Burchett Alice A. , Rodriguez Dorielis , Zarodniuk Maksym , Siri Saeed , Datta Meenal
Published: September 2023

Understanding cancer cell mechanics allows for the identification of novel disease mechanisms, diagnostic biomarkers, and targeted therapies. In this study, we utilized our previously established fluid shear stress assay to investigate and compare the viscoelastic properties of normal immortalized human astrocytes (IHAs) and invasive human glioblastoma (GBM) cells when subjected to physiological levels of shear stress that are present in the brain microenvironment. We used a parallel-flow microfluidic shear system and a camera-coupled optical microscope to expose single cells to fluid shear stress and monitor the resulting deformation in real-time, respectively. From the video-rate imaging, we fed cell deformation information from digital image correlation into a three-parameter generalized Maxwell model to quantify the nuclear and cytoplasmic viscoelastic properties of single cells. We further quantified actin cytoskeleton density and alignment in IHAs and GBM cells via immunofluorescence microscopy and image analysis techniques. Results from our study show that contrary to the behavior of many extracranial cells, normal and cancerous brain cells do not exhibit significant differences in their viscoelastic behavior. Moreover, we also found that the viscoelastic properties of the nucleus and cytoplasm as well as the actin cytoskeletal densities of both brain cell types are similar. Our work suggests that malignant GBM cells exhibit unique mechanical behaviors not seen in other cancer cell types. These results warrant future study to elucidate the distinct biophysical characteristics of the brain and reveal novel mechanical attributes of GBM and other primary brain tumors.
Directional integration and pathway enrichment analysis for multi-omics data
Authors: Slobodyanyuk Mykhaylo , Bahcheli Alexander T. , Klein Zoe P. , Bayati Masroor , Strug Lisa J. , Reimand Jüri
Published: September 2023

Omics techniques generate comprehensive profiles of biomolecules in cells and tissues. However, a holistic understanding of the data requires joint multi-omics analyses that are challenging. Here we present DPM, a data fusion method for combining multiple omics datasets using directionality and significance estimates of genes, transcripts, or proteins. DPM allows users to define how the input datasets are expected to interact directionally, reflecting the initial experimental design or regulatory relationships between the datasets. DPM statistically prioritises genes and pathways that change consistently across the datasets, while penalising those violating the constraints. Joint analyses of transcriptomic, proteomic, DNA methylation, and clinical datasets of cancer samples demonstrate how directional integration identifies genes and pathways modulated across omics datasets, highlights those with inconsistent evidence, and reveals candidate biomarkers with prognostic signals in multiple datasets. DPM is implemented in the ActivePathways method and provides a general framework for testing detailed hypotheses in multi-omics data.
Sex differences in avoidance behavior and cued threat memory dynamics in mice: Interactions between estrous cycle and genetic background
Authors: Ryherd Garret L. , Bunce Averie L. , Edwards Haley A. , Baumgartner Nina E. , Lucas Elizabeth K.
Published: September 2023

Anxiety disorders are the most prevalent mental illnesses worldwide, exhibit high heritability, and affect twice as many women as men. To evaluate potential interactions between genetic background and cycling ovarian hormones on sex differences in susceptibility to negative valence behaviors relevant to anxiety disorders, we assayed avoidance behavior and cued threat memory dynamics in gonadally-intact adult male and female mice across four common inbred mouse strains: C57Bl/6J, 129S1/SVlmJ, DBA/2J, and BALB/cJ. Independent of sex, C57Bl/6J mice exhibited low avoidance but high threat memory, 129S1/SvlmJ mice high avoidance and high threat memory, DBA/2J mice low avoidance and low threat memory, and BALB/cJ mice high avoidance but low threat memory. Within-strain comparisons revealed reduced avoidance behavior in the high hormone phase of the estrous cycle (proestrus) compared to all other estrous phases in all strains except DBA/2J, which did not exhibit cycle-dependent behavioral fluctuations. Robust and opposing sex differences in threat conditioning and extinction training were found in the C57Bl/6J and 129S1/SvlmJ lines, whereas no sex differences were observed in the DBA/2J or BALB/cJ lines. C57Bl/6J males exhibited enhanced acute threat memory, whereas 129S1/SvlmJ females exhibited enhanced sustained threat memory, compared to their sex-matched littermates. These effects were not mediated by estrous cycle stage or sex differences in active versus passive defensive behavioral responses. Our data demonstrate that core features of behavioral endophenotypes relevant to anxiety disorders, such as avoidance and threat memory, are genetically driven yet dissociable and can be influenced further by cycling ovarian hormones.
The invasive brown seaweedRugulopteryx okamurae(Dictyotales, Ochrophyta) continues to expand: first record in Italy
Authors: Bellissimo Giancarlo , Altamirano María , Muñoz Antonio Román , De la Rosa Julio , Hung Tin Hang , Rizzuto Gabriele , Vizzini Salvatrice , Tomasello Agostino
Published: September 2023

The brown seaweedRugulopteryx okamurae(Dictyotales, Ochrophyta), native to the Pacific Ocean and widely distributed in Asia, has been recently recognized as an emblematic case of biological invasion by marine macroalgae in European waters. Since 2015 and from the Strait of Gibraltar,R. okamuraehas rapidly spread towards Atlantic and Mediterranean coastal areas exhibiting an invasive behaviour with significant ecological and economic impacts. Here, we report by morphology and genetics the first observation of this species in Italy along the north-western coast of Sicily (Gulf of Palermo), as drifted material and an established population onPosidonia oceanica, representing its new eastern distribution limit in the Mediterranean Sea, previously established in Marseilles (France). Furthermore, we have performed with the current introduced distribution of the species a favorability distribution model for the Mediterranean, which shows most of the western Mediterranean, including the Balearic archipelago, Corsica and Sardinia, central Mediterranean, including Sicily, and the northern coast of Africa together with eastern Mediterranean basin, as highly favorable forR. okamurae. Arrival of the species into this new area is suggested by means of sea currents and maritime traffic, including fishing activities, hypothesis supported by some of the ranked variables that entered the favorability model, i.e, current velocity, and proximity of fishing ports. These results are a warning that the species can cover large sea distances favored by sea currents, thus also threatening the ecosystems and marine resources of the central and eastern Mediterranean, highly favorable regions for the species. We suggest coordinated actions at the European level regarding prevention, among which those that have the complicity of the fishing sector should be considered, both because it is a highly affected sector and because it potentially has a very important role in the dispersion of the species.
Visual Image Reconstructed Without Semantics from Human Brain Activity Using Linear Image Decoders and Nonlinear Noise Suppression
Authors: Li Qiang
Published: September 2023

In recent years, substantial strides have been made in the field of visual image reconstruction, particularly in its capacity to generate high-quality visual representations from human brain activity while considering semantic information. This advancement not only enables the recreation of visual content but also provides valuable insights into the intricate processes occurring within high-order functional brain regions, contributing to a deeper understanding of brain function. However, considering fusion semantics in reconstructing visual images from brain activity involves semantic-to-image guide reconstruction and may ignore underlying neural computational mechanisms, which does not represent true reconstruction from brain activity. In response to this limitation, our study introduces a novel approach that combines linear mapping with nonlinear noise suppression to reconstruct visual images perceived by subjects based on their brain activity patterns. The primary challenge associated with linear mapping lies in its susceptibility to noise interference. To address this issue, we leverage a flexible denoised deep convolutional neural network, which can suppress noise from linear mapping. Our investigation encompasses linear mapping as well as the training of shallow and deep autoencoder denoised neural networks, including a pre-trained, state-of-the-art denoised neural network. The outcome of our study reveals that combining linear image decoding with nonlinear noise reduction significantly enhances the quality of reconstructed images from human brain activity. This suggests that our methodology holds promise for decoding intricate perceptual experiences directly from brain activity patterns without semantic information. Moreover, the model has strong neural explanatory power because it shares structural and functional similarities with the visual brain.
Single cell analysis uncovers striking cellular heterogeneity of lung infiltrating Tregs during eosinophilic vs. neutrophilic allergic airway inflammation
Authors: Iamsawat Supinya , Yu Rongzhen , Kim Sohee , Qiu Kevin , Choi Jaehyuk , Min Booki
Published: September 2023

Allergic airway inflammation is a chronic inflammatory condition resulting from uncontrolled immune responses to environmental antigens. While it is well-established that allergic immune responses exhibit a high degree of diversity, driven by primary effector cell types like eosinophils, neutrophils, or CD4 T cells with distinct effector signatures, the exact mechanisms responsible for such pathogenesis remain largely elusive. Foxp3+regulatory T cells (Treg) is an essential immune regulator during chronic inflammation including allergic airway inflammation. Emerging evidence suggests that Tregs infiltrating inflamed tissues exhibit distinct phenotypes dependent on the specific tissue sites and can display significant heterogeneity and tissue residency. Whether diverse allergic inflammatory responses in the lung influences infiltrating Treg heterogeneity or Treg lung residency has not previously been explored. We employed an unbiased single-cell RNAseq approach to investigate lung-infiltrating Tregs in models of eosinophilic and neutrophilic airway inflammation models, in which Tregs are critical regulators of inflammation. We found that lung-infiltrating Tregs are highly heterogeneous and that Tregs displaying lung resident phenotypes are significantly different depending on the types of inflammation. Tregs expression of ST2, a receptor for alarmin cytokine IL-33, was predominantly induced by eosinophilic inflammation and by tissue residency. However, Treg-specific ST2 deficiency did not affect the development of eosinophilic allergic inflammation nor the generation of lung resident Tregs. These results uncover a striking heterogeneity among Tregs infiltrating the lungs during allergic airway inflammation. The results also indicate that varying types of inflammation may give rise to phenotypically distinct lung resident Tregs, underscoring a novel mechanism by which inflammatory cues may shape the composition of infiltrating Tregs, allowing them to regulate inflammatory responses through tissue-adapted mechanisms.