bluuebunny/crossref_metadata_2025 huggingface dataset:
Renal glucose transporters play a role in removal of cadmium from kidney cells mediated by GMDTC – A novel metal chelator
Authors: Tang Xiaojiang , Xiao Bo , Zhao Qile , Hu Wei , McKenery Amber , Zhong Zhiyong
Published: June 2023

Cadmium (Cd) is a toxic heavy metal, exposure to which leads to adverse health effects including chronic kidney damage. Tremendous efforts have been explored in identifying safe chelating agents for removing accumulated Cd from kidney, but with limited success owing to their associated side effects and the ineffectiveness in eliminating Cd. A newly developed chelating agent, sodium (S)-2-(dithiocarboxylato((2S,3 R,4R,5 R)-2,3,4,5,6-pentahydroxyhexyl) amino)-4(methylthio)butanoate (GMDTC), has been shown to effectively mobilize Cd from kidney. However, the mechanism(s) of removal are unclear, while it has been hypothesized that renal glucose transporters potentially play key roles mainly because GMDTC contains an open chain glucose moiety. To test this hypothesis, we utilized the CRISPR/Cas9 technology and human kidney tubule HK-2 cells, and constructed sodium-dependent glucose transporter 2 ( SGLT2) or glucose transporter 2 ( GLUT2) gene knockout cell lines. Our data showed that GMDTC’s ability in removing Cd from HK-2 cells was significantly reduced both in GLUT2 −/− or SGLT2 −/− cells, with a removal ratio reduced from 28.28% in the parental HK-2 cells to 7.37% in GLUT2 −/− cells and 14.6% in SGLT2 −/− cells. Similarly, knocking out the GLUT2 or SGLT2 led to a compromised protective effect of GMDTC in reducing cytotoxicity of HK-2 cells. This observation was further observed in animal studies, in which the inhibition of GLUT2 transporter by phloretin treatment resulted in reduced efficiency of GMDTC in removing Cd from the kidney. Altogether, our results show that GMDTC is safe and highly efficient in removing Cd from the cells, and this effect is mediated by renal glucose transporters.
Stem alignment with short tapered-wedge cementless stems affects bone mineral density continuously for at least 5 years after primary total hip arthroplasty
Authors: Masuda Sho , Iwakiri Kentaro , Ohta Yoichi , Minoda Yukihide , Kobayashi Akio , Nakamura Hiroaki
Published: June 2023

Aim:

This study aimed to assess the relationship between the three-dimensional (3D) alignment of short tapered-wedge cementless stems and bone mineral density (BMD) changes in patients followed up for 5 years after total hip arthroplasty (THA).

Methods:

We retrospectively analysed the hips of 52 patients who underwent THA using short tapered-wedge cementless stems at our institution from 2013 to 2016 with complete 5-year follow-up data. We evaluated the relationship between stem alignment, measured using a 3D-templating software, and BMD changes in the 7 Gruen zones.

Results:

After 1 year, significant negative correlations between varus insertion and a decrease in BMD in zone 7 and between flexed insertion and decreases in BMD in zones 3 and 4 were noted. After 5 years, significant negative correlations between varus insertion and a decrease in BMD in zone 7 and between flexed insertion and decreases in BMD zones 2, 3, and 4 were observed. With increased amounts of varus/flexion stem alignment, the amount of BMD loss decreased. There was no correlation between anteverted stem insertion and changes in BMD levels.

Conclusions:

Our data showed that stem alignment affects BMD based on 5-year follow-up data after surgery. Careful observation is necessary, especially when using short tapered-wedge cementless stems, as stem alignment may affect changes in BMD levels more than 5 years after surgery.
Is the development of physical literacy ubiquitous in high-quality physical education?
Authors: Wilkie Brett , Santana Cáceres Pablo José , Marchena Joaquín Martín , Jordan Alastair
Published: June 2023

Current physical literacy recommendations include a focus on enhancing teachers’ knowledge and understanding of the concept. This paper explores whether physical education (PE) practitioners in a country where physical literacy is not foregrounded in educational practice are naturally aligning their approach towards the creation of learning experiences that would nurture physical literacy. Ten in-service Spanish PE teachers delivering Educación Secundaria Obligatoria and Bachillerato education programmes to students aged 13 to 18 years (seven male, three female; mean age: 45 years; mean teaching experience: 17.4 years), unfamiliar with the concept of physical literacy, participated in semi-structured interviews exploring their experiences of delivering PE. Thematic analysis revealed teaching craft, curriculum implementation, differentiation strategies, assessment behaviours, utility of feedback, psychomotor development, and sensitivity to affective domains of learning as overarching themes. Findings provide insight into the practices and behaviours of PE teachers who self-identified as being unfamiliar with the concept of physical literacy. Results suggest that learners are well served through the provision of high-quality PE that ubiquitously satisfies the requirements of developing physically literate individuals, implying how teaching is conducted in relation to developing physical literacy is as important, perhaps more so, than what is understood of the concept.
Prevalence of current smoking and association with meeting 24-h movement guidelines: Results from a national convenience sample of autistic adults
Authors: Laxton Paige , Healy Sean , Brewer Benjamin , Patterson Freda
Published: June 2023

This study aimed to identify the prevalence of current smoking and examine the association between meeting combinations of the 24-h movement guidelines and current smoking in autistic adults. This cross-sectional study administered an electronic survey to a national sample of autistic adults in the United States. The study outcome was current smoking. Independent variables included the 24-h movement behaviors. Multivariable statistical modeling was used to assess the study aims. The study sample ( n = 259) had a mean age of 31.05 years (standard deviation = 7.70), 58.7% were male, 11.2% were fully independent, and 35.5% were current smokers. Current smokers met significantly fewer 24-h movement guidelines than non-smokers (mean = 1.52 (standard deviation = 0.73) vs mean= 1.93 (standard deviation = 0.88), respectively, t = 3.77, p < 0.01). Autistic adults with high levels of sedentary behavior were almost three times more likely (odds ratio = 2.784, 95% confidence interval = 1.490, 5.237) to be a current smoker than those who did not meet these guidelines. Autistic adults not meeting sleep and sedentary behavior recommendations had a 1.581 increased odds (odds ratio = 1.581 95% confidence interval = 1.25, 2.001) of being a smoker as compared to those meeting these recommendations. Current smoking was highly prevalent in this sample. Improving sleep health and reducing sedentary time may be viable intervention targets to help promote smoking cessation in autistic adults.

Lay abstract

Cigarette smoking is a leading risk behavior for cardiovascular disease; yet its prevalence and determinants are not clear in autistic adults. We examined the prevalence of current smoking and its association between meeting 24-h movement (i.e. sleep, physical activity, and sedentary behavior) guidelines in a self-selecting convenience sample of 259 autistic adults in the United States. We found that current smokers met fewer 24-h movement guidelines. Most significant, those who had insufficient sleep and those with high levels of sedentary behavior were more likely to be current smokers. Therefore, targeting these movement behaviors may be potential intervention targets for smoking cessation.
Dysglycemia-Based Chronic Disease and Lifestyle Medicine: Mechanistic Interpretation Using the Allostatic Load Model
Authors: Bartoskova Polcrova Anna , Pavlovska Iuliia , Mechanick Jeffrey I. , Gonzalez-Rivas Juan P. , Pikhart Hynek
Published: June 2023

Dysglycemia-based chronic disease (DBCD) comprises insulin resistance, prediabetes, and type 2 diabetes, and their staged progression, complications, and impact contribute to one of the largest public health burdens worldwide. The clinical and economic effects of DBCD are fueled by external stressors related to modern society and lifestyles, especially in low socioeconomic strata. Chronic stressor exposure leads to chronic stress, characterized by immune-neuroendocrine activation and mobilization/depletion of metabolic resources. This complex adaptive response engaging many different signaling pathways is termed allostasis and principally regulates homeostatic mechanisms. Allostatic load is the metabolic cost of adaptation to environmental factors and can lead to numerous adverse health outcomes and behaviors. In this narrative review, the bidirectional relationship between allostatic load and unhealthy behaviors is analyzed in the context of DBCD development and progression, with a focus to reduce individual vulnerabilities.
It Has Been a Big Year for NASN’s Advocacy Efforts!
Authors: Largent Piper
Published: June 2023

Annually, the National Association of School Nurses (NASN) sets advocacy goals, including legislative priorities. This past January, the NASN Board of Directors resumed their in-person Hill Day, with over 100 appointments with Members of Congress and Senators. This article highlights NASN’s 2022–2023 legislative priorities and advocacy efforts, along with briefly discussing the relationship of Bipartisan Safer Communities Act to Medicaid reimbursement for school nursing services.
Predictors of the Intention to Participate in Slum Upgrading Projects: Perceptions of Slum Dwellers in Mauritius
Authors: Swapan Mohammad Shahidul Hasan , Sadeque Saalem , Iftekhar Md. Sayed , Sooben Neshen
Published: June 2023

A global shift in urban slum improvement programmes is underway to step beyond the conventional approach by practicing a more participatory approach. Previous studies have found that slum upgrading projects are likely to be ineffective and unsustainable without the active participation of slum dwellers. Therefore, it is imperative to identify the pathways to improve or enhance slum dwellers’ participation in slum upgrading projects. Several studies highlight the need to consider socio-psychological attributes of the community. However, empirical evidence of the comparative significance of these attributes in predicting participatory behavioural intention of the slum dwellers has not been previously explored. In this article, we examine the factors that influence slum dwellers’ intention to participate in slum upgrading projects in Mauritius, which has been one of the early implementers of UN-Habitat’s flagship initiative, Participatory Slum Upgrading Programme. We conducted a household survey in highly dense slum areas in Cité EDC and Barkly. Using the Partial Least Squares Structural Equation Modelling approach to analyse the relationships among the constructs affecting participatory behaviour, we find that enhancement of awareness and trust on authority can promote willingness to participate at a higher level in slum upgrading projects. Such information can be useful to design appropriate pathways to increase effective participation in slum upgrading programmes.
Book review: Jan Breman, The Poverty Regime in Village India: Half a Century of Work and Life at the Bottom of the Rural Economy in South Gujarat
Authors: Vrishali
Published: June 2023

Jan Breman, The Poverty Regime in Village India: Half a Century of Work and Life at the Bottom of the Rural Economy in South Gujarat. Oxford University Press, 2007, 544 pp., ₹795. ISBN: 9780195690835.
Influence of Personality Type on Investment Preference and Perceived Success as an Investor
Authors: Rao Aniruddha S. , Lakkol Savitha G.
Published: June 2023

Over the last two decades, the behavioural finance literature has extensively relied on personality type to explain the non-rational behaviour of investors. This study considers Dark triad (Machiavellianism, narcissism and psychopathy) to explain its influences on investment preference and perceived success in investment. A primary survey was conducted on 227 individuals who invest in securities. Dark triad was measured using 27 items Short Triad Scale (SD3). The data were analyzed using multinomial logistic regression. The investment preference was evaluated by asking the respondents about their preferred investment avenues, individuals were asked how they evaluate their investment success. Personality variables were grouped into high, average and low based on the mean responses to the items under each variable. The results of the study indicate that individuals with low and average levels of psychopathy and low-level narcissism preferred investing only in mutual funds, bonds and equity. It was also found that Machiavellianism, narcissism, psychopathy and dark triad, all have a significant impact on investment preference. The dark triad also significantly impacted success, especially for those individuals who perceived their investment strategy as ‘Very Successful’. This study helps financial advisors to suggest appropriate portfolios or investment avenues based on their personalities.
Detecting patterns of accessory genome coevolution in Staphylococcus aureus using data from thousands of genomes
Authors: Mehta Rohan S , Petit Robert A , Read Timothy D , Weissman Daniel B
Published: June 2023

Bacterial genomes exhibit widespread horizontal gene transfer, resulting in highly variable genome content that complicates the inference of genetic interactions. In this study, we develop a method for detecting coevolving genes from large datasets of bacterial genomes based on pairwise comparisons of closely related individuals, analogous to a pedigree study in eukaryotic populations. We apply our method to pairs of genes from the Staphylococcus aureus accessory genome of over 75,000 annotated gene families using a database of over 40,000 whole genomes. We find many pairs of genes that appear to be gained or lost in a coordinated manner, as well as pairs where the gain of one gene is associated with the loss of the other. These pairs form networks of rapidly coevolving genes, primarily consisting of genes involved in virulence, mechanisms of horizontal gene transfer, and antibiotic resistance, particularly the SCCmec complex. While we focus on gene gain and loss, our method can also detect genes that tend to acquire substitutions in tandem, or genotype-phenotype or phenotype-phenotype coevolution. Finally, we present the R package that allows for the computation of our method.
Examining differential success in recruitment using respondent driven sampling (RDS) in a multi-site study of gay, bisexual and other men who have sex with men
Authors: Sang Jordan M. , Gholamian Bita , Wang Lu , Barath Justin , Noor Syed W. , Lachowsky Nathan J. , Hart Trevor A. , Cox Joseph , Lambert Gilles , Grace Daniel , Skakoon-Sparling Shayna , Lal Allan , Parlette Abbie , Apelian Herak , Jollimore Jody , Hogg Robert S. , Moore David M.
Published: June 2023

Background

The Engage Study is a longitudinal biobehavioral cohort study of gay, bisexual and other men who have sex with men (GBM) in Toronto, Montreal, and Vancouver. Baseline data (2,449 participants) were collected from February 2017 - August 2019 using respondent-driven sampling (RDS). Recruitment in Montreal required fewer seeds, had a much shorter recruitment period, and recruited the largest sample.

Methods

To better understand why RDS recruitment was more successful in Montreal compared to other sites, we conducted an analysis to examine RDS recruitment characteristics for GBM in each of the three study sites, explore demographic characteristics and measures of homophily, that is, the tendency of individuals to recruit other study participants who are like themselves, and compared motivations for study participation.

Results

Montreal had the greatest proportion of participants over the age of 45 (29.1% in Montreal, 24.6% in Vancouver, and 21.0% in Toronto) and the highest homophily for this age group, but homophily was high across the three cities. Montreal also reported the lowest percentage of participants with an annual income greater or equal to $60,000 (7.9% in Montreal, 13.1% in Vancouver and 10.6% in Toronto), but homophily was similar across all three cities. The majority of participants indicated interest in sexual health and HIV as the main reason for participating (36.1% in Montreal, 34.7% in Vancouver, and 29.8% in Toronto). Financial interest as the main reason for participation was low (12.7% in Montreal, 10.6% in Vancouver, and 5.7% in Toronto).

Conclusion

Taken together, although we found some differences in study demographic characteristics and homophily scores, we were unable to fully explain the different recruitment success based on the data available. Our study underlines the fact that success of RDS implementation may vary by unknown factors, and that researchers should be proactive and flexible to account for variability.
Diagnostic stewardship to limit repeat plasma cytomegalovirus viral load testing
Authors: Trirattanapikul Akeatit , Pasomsub Ekawat , Siriyotha Sukanya , Pattanaprateep Oraluck , Phuphuakrat Angsana
Published: June 2023

Background

Frequent serial monitoring of plasma cytomegalovirus (CMV) viral load caused unnecessary budgets for laboratory testing without changes in treatment. We aimed to implement diagnostic stewardship to limit CMV viral load testing at appropriate intervals.

Methods

A quasi-experimental study was performed. To avoid unnecessary plasma CMV viral load testing, the inpatient electronic pop-up reminder was launched in 2021. In cases with plasma CMV viral load testing was ordered in intervals of less than five days, telephone interview and feedback were performed. Pre-post intervention data was compared in terms of clinical and monetary outcomes. The rate of plasma CMV viral load testing performed in intervals of less than five days was compared between 2021 and 2019 using the Poisson regression model.

Results

After the protocol implementation, there was a significant decrease in the rate of plasma CMV viral load test orders in intervals of less than five days from 17.5% to 8.0% [incidence rate ratio 0.40, p < 0.001]. There was no statistically significant difference in the incidence of CMV DNAemia and CMV disease (p = 0.407 and 0.602, respectively). As a result, the hospital could save the costs of plasma CMV viral load testing per 1,000 patients performed with intervals of less than five days from 2,646,048.11 to 1,360,062.89 Thai Baht.

Conclusions

The diagnostic stewardship program is safe and helpful in reducing unnecessary plasma CMV viral load testing and costs.
Neuropsychological, neuroimaging and autopsy findings of butane encephalopathy
Authors: Yun Jaeseob , Jang Sung Hwan , Cho Huiran , Lee Myung Jun , Jung Na-Yeon , Lee Jae-Hyeok , Shin Jin-Hong , Lee Young Min , Yoon Jin A , Pak Kyoungjune , Ko Junkyeung , Lee Jae Meen , Hwang Chungsu , Ahn Jae Woo , Sung Suk , Choi Kyung-Un , Huh Gi Yeong , Kim Eun-Joo
Published: June 2023

Background

Butane is an aliphatic hydrocarbon used in various commercial products. While numerous reports of sudden cardiac-related deaths from butane inhalation have been described, butane-associated acute encephalopathy has rarely been reported.

Case presentation

A 38-year-old man presented with cognitive dysfunction after butane gas inhalation. Neuropsychological test results showed impairments in verbal and visual memory, and frontal executive function. Diffusion weighted MRI revealed symmetric high-signal changes in the bilateral hippocampus and globus pallidus. FDG-PET demonstrated decreased glucose metabolism in the bilateral precuneus and occipital areas and the left temporal region. At the 8-month follow-up, he showed still significant deficits in memory and frontal functions. Diffuse cortical atrophy with white matter hyperintensities and extensive glucose hypometabolism were detected on follow-up MRI and FDG-PET, respectively. Brain autopsy demonstrated necrosis and cavitary lesions in the globus pallidus.

Conclusions

Only a few cases of butane encephalopathy have been reported to date. Brain lesions associated with butane encephalopathy include lesions in the bilateral thalamus, insula, putamen, and cerebellum. To the best of our knowledge, this is the first report on bilateral hippocampal and globus pallidal involvement in acute butane encephalopathy. The pathophysiology of central nervous system complications induced by butane intoxication is not yet fully understood. However, the direct toxic effects of butane or anoxic injury secondary to cardiac arrest or respiratory depression have been suggested as possible mechanisms of edematous changes in the brain after butane intoxication.
Socioeconomic and geographical inequalities in using skilled birth attendants during delivery in Bangladesh over two decades
Authors: Chowdhury Syed Sharaf Ahmed , Kundu Satyajit , Sharif Azaz Bin
Published: June 2023

Background

Maternal and neonatal mortality is a major public health concern globally. Evidence supports that skilled birth attendants (SBA) can significantly reduce maternal and neonatal mortality. Despite the improvement in SBA use, Bangladesh lacks evidence of equality in SBA use across socioeconomic and geographic regions. Therefore, we aim to estimate the trends and magnitude of inequality in SBA use in Bangladesh over the last two decades.

Methods

Data from the last 5 rounds of Bangladesh Demographic and Health Surveys (BDHS; 2017-18, 2014, 2011, 2007, and 2004) were used to measure the inequalities in the SBA use utilizing the WHO’s Health Equity Assessment Toolkit (HEAT) software. Inequality was assessed by four summary measures, namely, Population Attributable Risk (PAR), Population Attributable Fraction (PAF), Difference (D), and Ratio (R) based on the four equity dimensions: wealth status, education level, place of residence, and subnational regions (divisions). Point estimates and a 95% confidence interval (CI) were reported for each measure.

Results

An increasing trend in the overall prevalence of SBA use was observed (From 15.6% in 2004 to 52.9% in 2017). We found significant inequalities in SBA use in every wave of BDHS (from 2004 to 2017), with the result concentrating on the rich (in 2017, PAF: 57.1; 95% CI: 52.5–61.7), educated (in 2017, PAR: 9.9; 95% CI: 5.2–14.5),  and people from urban areas (in 2017, PAF: 28.0; 95% CI: 26.4–29.5). We also identified geographic disparities in SBA use favoring Khulna and Dhaka divisions (in 2017, PAR: 10.2; 95% CI: 5.7–14.7). Our study also observed inequality in using SBA among Bangladeshi women decreased over time.

Conclusion

To increase SBA use and to decrease inequality in all four equity dimensions, disadvantaged sub-groups should be prioritized in policies and planning for program implementation.
Clinical outcome analysis of modified B-Lynch sutures in the fundus uteri and part of the corpus uteri for the prevention of intraoperative haemorrhage during caesarean delivery in women with twin pregnancy: a retrospective study
Authors: Shi Chunbo , Chen Jinliang , Chen Aner
Published: June 2023

Objective

To explore the efficacy of modified B-Lynch sutures in the fundus uteri and part of the corpus uteri for the prevention of intraoperative haemorrhage during caesarean delivery in women with twin pregnancy.

Methods

This retrospective analysis covers the clinical data of 40 women with postpartum haemorrhage caused by uterine inertia during caesarean section in women with twin pregnancy in our hospital from January 2018 to May 2022. These women were divided into the group with modified B-Lynch sutures at the fundus and part of the corpus uteri (Group A, 20 patients) and the group with classic B-Lynch sutures (Group B, 20 patients) according to the treatment received. The treatment effect and safety of the two uterine compression sutures were compared.

Results

In this study, no statistically significant differences were found in the outcomes of haemostasis or intraoperative and 24-h postoperative blood loss between the two uterine compression suture groups (P > 0.05). Compared to Group B, Group A showed a significantly reduced operative time, postoperative hospital stay, puerperal morbidity rate, pain score and duration of lochia.

Conclusion

Modified B-Lynch sutures at the fundus and part of the corpus uteri can achieve a haemostatic effect similar to that of the classic B-Lynch suture, while it allows for a shortened operative time and reduced postoperative complications. Modified B-Lynch sutures can serve as a safe, rapid and effective haemostatic method for the prevention and treatment of postpartum haemorrhage during caesarean section in women with twin pregnancy, showing certain validity for promotion in clinics.
Diagnostic and prognostic value of deregulated long non-coding RNA RPPH1 in patients with severe community-acquired pneumonia: a retrospective cohort study
Authors: Su Pengtao , Hu Pengbo , Xu Ling , Zhang Bing
Published: June 2023

Background

Severe community-acquired pneumonia (SCAP) is one of the most common critical and acute diseases in the respiratory and acute medicine department. The expression and significance of lncRNA RPPH1 (RPPH1) in SCAP were assessed aiming to explore a biomarker assisting in the screening and management of SCAP.

Methods

This study is a retrospective study enrolled 97 SCAP patients, 102 mild community-acquired pneumonia (MCAP) patients, and 65 healthy individuals. The serum expression of RPPH1 of study subjects was evaluated using PCR. The diagnostic and prognostic significance of RPPH1 in SCAP was evaluated by ROC and Cox analyses. Meanwhile, the correlation of RPPH1 with patients’ clinicopathological features was evaluated by spearman correlation analysis to evaluate its role in assessing disease severity.

Results

A significant downregulation of RPPH1 was observed in the serum of SCAP patients compared with MCAP and healthy individuals. RPPH1 was positively correlated with ALB (r = 0.74) and negatively correlated with C-reactive protein (r = -0.69), neutrophil-to-lymphocyte ratio (r = -0.88), procalcitonin (r = -0.74), and neutrophil (r = -0.84) of SCAP patients, which are associated with the development and severity of SCAP. Additionally, reduced RPPH1 was closely associated with the 28-day development-free survival of SCAP patients and served as an adverse prognostic indicator together with procalcitonin.

Conclusions

Downregulated RPPH1 in SCAP could act as a diagnostic biomarker screening SCAP from healthy and MCAP individuals and act as a prognostic biomarker predicting patients’ disease conditions and outcomes. The demonstrated significance of RPPH1 in SCAP could assist the clinical antibiotic therapies of SCAP patients.
Effect of continuous chelation on the dentinal tubule penetration of a calcium silicate–based root canal sealer: a confocal laser microscopy study
Authors: Hassan Reham , Roshdy Nehal Nabil
Published: June 2023

Background

This study aimed to evaluate the effect of various irrigation protocols on the penetration depth of a calcium silicate–based sealer into dentinal tubules using confocal laser scanning microscopy (CLSM).

Methods

Twenty single-rooted mandibular premolars were endodontically prepared and divided into the following two groups according to the irrigation protocol used (n = 10): Group I: NaOCl + EDTA and Group II: continuous chelation (NaOCl/Dual Rinse). Obturation was performed with the warm vertical compaction technique using TotalFill HiFlow bioceramic sealer mixed with a fluorophore dye. Samples were observed using CLSM at 10× to measure the percentage of sealer penetration and its maximum depth into the dentinal tubules. Data were analysed using one-way ANOVA followed by Tukey’s post-hoc test. The significance level was set at p < 0.05 within all tests.

Results

Comparing the overall results of all sections tested, no statistically significant differences existed between the groups regarding the percentage of sealer penetration (p = 0.612) and maximum depth of penetration (p > 0.05).

Conclusions

With both types of irrigation used, dentinal tubule penetration was higher in the coronal section than in the apical section. Continuous chelation using NaOCl/Dual Rinse HEDP performed better in the coronal segments, while irrigation using NaOCl + EDTA promoted a higher percentage of sealer penetration in the apical segment.
Risk of uterine leiomyomata with menstrual and reproductive factors in premenopausal women: Korea nurses’ health study
Authors: Song Sihan , Park Soojin , Song Bo Mi , Lee Jung Eun , Cha Chiyoung , Park Hyun-Young
Published: June 2023

Background

Uterine leiomyomata (UL) are benign smooth muscle tumors that may cause significant morbidity in women of reproductive age. This study aimed to investigate the relationship of menstrual and reproductive factors with the risk of UL in premenopausal women.

Methods

This prospective study included 7,360 premenopausal women aged 22–48 years who were part of the Korea Nurses’ Health Study. Information on the menstrual cycle and reproductive history was assessed between 2014 and 2016, and self-reported cases of UL were obtained through 2021. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs).

Results

During 32,072 person-years of follow-up, 447 incident cases of UL were reported. After adjusting for other risk factors, women with late age at menarche had a lower incidence of UL (≥ 16 vs. 12–13 years: HR 0.68; 95% CI 0.47–0.99; p for trend = 0.026). The risk of UL was inversely associated with current menstrual cycle length (≥ 40 or too irregular to estimate vs. 26–31 days: HR 0.40; 95% CI 0.24–0.66) and cycle length at ages 18–22 years (HR 0.45; 95% CI 0.31–0.67; p for trend < 0.001, each). Parous women had lower risk of UL than nulliparous women (HR 0.40; 95% CI 0.30–0.53) and women who were aged 29–30 years at first birth had a lower risk of UL than those who were aged ≤ 28 years at first birth (HR 0.58; 95% CI 0.34–0.98). There was no significant association of the number of births or breastfeeding with the risk of UL among parous women. Neither a history of infertility nor oral contraceptive use was associated with the risk of UL.

Conclusions

Our results suggest that age at menarche, menstrual cycle length, parity, and age at first birth are inversely associated with the risk of UL in premenopausal Korean women. Future studies are warranted to confirm the long-term effects of menstrual and reproductive factors on women’s health.
Clinical effects of Emblica officinalis fruit consumption on cardiovascular disease risk factors: a systematic review and meta-analysis
Authors: Brown Paul D. S. , Ketter Nicole , Vis-Dunbar Mathew , Sakakibara Brodie M.
Published: June 2023

Background

Emblica officinalis (EO) fruit consumption has been found to have a beneficial effect on cardiovascular disease (CVD) physiological risk factors in preliminary clinical intervention trials; however, questions remain regarding the overall effectiveness of EO on CVD risk. The purpose of this systematic review and meta-analysis is to: 1) systematically describe the clinical research examining EO; and 2) quantitatively assess the effects of EO on CVD physiological risk factors.

Methods

The Pubmed, Embase, Web of Science, and Google Scholar electronic platforms were searched for relevant randomized controlled trials (RCTs) published until April 7, 2021. Studies were included if they involved adults (age ≥ 18 years) ingesting a form of EO fruit; included blood lipids, blood pressure, and/or inflammatory biomarkers as outcomes; had clearly defined intervention and control treatments with pre- and post-intervention data; were peer-reviewed; and were written in English. Studies were excluded if they compared EO with another risk reduction intervention without a usual care control group. RCTs were assessed for methodological quality using the Cochrane risk-of-bias version 2 (ROB2) tool, qualitatively described, and quantitatively evaluated using random and fixed effect meta-analysis models.

Results

A total of nine RCTs (n = 535 participants) were included for review. Included studies followed parallel-group (n = 6) and crossover (n = 3) designs, with EO dosage ranging from 500 mg/day to 1500 mg/day, and treatment duration ranging from 14 to 84 days. Meta-analyses revealed EO to have a significant composite effect at lowering low-density lipoprotein cholesterol (LDL-C; Mean difference (MD) = -15.08 mg/dL [95% Confidence interval (CI) = -25.43 to -4.73], I2 = 77%, prediction interval = -48.29 to 18.13), very low-density lipoprotein cholesterol (VLDL-C; MD = -5.43 mg/dL [95% CI = -8.37 to -2.49], I2 = 44%), triglycerides (TG; MD = -22.35 mg/dL [95% CI = -39.71 to -4.99], I2 = 62%, prediction interval = -73.47 to 28.77), and high-sensitivity C-reactive protein (hsCRP; MD = -1.70 mg/L [95% CI = -2.06 to -1.33], I2 = 0%) compared with placebo.

Conclusions

Due to statistical and clinical heterogeneity in the limited number of clinical trials to date, the promising effects of EO on physiologic CVD risk factors in this review should be interpreted with caution. Further research is needed to determine if EO offers an efficacious option for primary or secondary prevention of CVD as either monotherapy or adjunct to evidence-based dietary patterns and/or standard pharmacotherapy.
Discharge interventions for First Nations people with a chronic condition or injury: a systematic review
Authors: Coombes Julieann , Holland Andrew J.A , Ryder Courtney , Finlay Summer May , Hunter Kate , Bennett-Brook Keziah , Orcher Phillip , Scarcella Michele , Briscoe Karl , Forbes Dale , Jacques Madeleine , Maze Deborah , Porykali Bobby , Bourke Elizabeth , Kairuz Santos Camila A.
Published: June 2023

Background

Aboriginal and Torres Strait Islander peoples have a unique place in Australia as the original inhabitants of the land. Similar to other First Nations people globally, they experience a disproportionate burden of injury and chronic health conditions. Discharge planning ensures ongoing care to avoid complications and achieve better health outcomes. Analysing discharge interventions that have been implemented and evaluated globally for First Nations people with an injury or chronic conditions can inform the implementation of strategies to ensure optimal ongoing care for Aboriginal and Torres Strait Islander people.

Methods

A systematic review was conducted to analyse discharge interventions conducted globally among First Nations people who sustained an injury or suffered from a chronic condition. We included documents published in English between January 2010 and July 2022. We followed the reporting guidelines and criteria set in Preferred Reporting Items for Systematic Review (PRISMA). Two independent reviewers screened the articles and extracted data from eligible papers. A quality appraisal of the studies was conducted using the Mixed Methods Appraisal Tool and the CONSIDER statement.

Results

Four quantitative and one qualitative study out of 4504 records met inclusion criteria. Three studies used interventions involving trained health professionals coordinating follow-up appointments, linkage with community care services and patient training. One study used 48-hour post discharge telephone follow-up and the other text messages with prompts to attend check-ups. The studies that included health professional coordination of follow-up, linkage with community care and patient education resulted in decreased readmissions, emergency presentations, hospital length of stay and unattended appointments.

Conclusion

Further research on the field is needed to inform the design and delivery of effective programs to ensure quality health aftercare for First Nations people. We observed that discharge interventions in line with the principal domains of First Nations models of care including First Nations health workforce, accessible health services, holistic care, and self-determination were associated with better health outcomes.

Registration

This study was prospectively registered in PROSPERO (ID CRD42021254718).
The effects of mHealth interventions on improving institutional delivery and uptake of postnatal care services in low-and lower-middle-income countries: a systematic review and meta-analysis
Authors: Gayesa Reta Tsegaye , Ngai Fei Wan , Xie Yao Jie
Published: June 2023

Background

Maternal mortality due to pregnancy, childbirth and postpartum is a global challenge. Particularly, in low-and lower-income countries, the outcomes of these complications are quite substantial. In recent years, studies exploring the effect of mobile health on the improvement of maternal health are increasing. However, the effect of this intervention on the improvement of institutional delivery and postnatal care utilization was not well analyzed systematically, particularly in low and lower-middle-income countries.

Objective

The main aim of this review was to assess the effect of mobile heath (mHealth) interventions on improving institutional delivery, postnatal care service uptake, knowledge of obstetric danger signs, and exclusive breastfeeding among women of low and lower-middle-income countries.

Methods

Common electronic databases like PubMed, EMBASE, the Web of Science, Medline, CINAHL, Cochrane library, Google scholar, and gray literature search engines like Google were used to search relevant articles. Articles that used interventional study designs and were conducted in low and lower-middle-income countries were included. Sixteen articles were included in the final systematic review and meta-analysis. Cochrane’s risk of bias tool was used to assess the quality of included articles.

Results

The overall outcome of the systematic review and meta-analysis showed that MHealth intervention has a positive significant effect in improving the institutional delivery (OR = 2.21 (95%CI: 1.69–2.89), postnatal care utilization (OR = 4.13 (95%CI: 1.90–8.97), and exclusive breastfeeding (OR = 2.25, (95%CI: 1.46–3.46). The intervention has also shown a positive effect in increasing the knowledge of obstetric danger signs. The subgroup analysis based on the intervention characteristics showed that there was no significant difference between the intervention and control groups based on the intervention characteristics for institutional delivery (P = 0.18) and postnatal care utilizations (P = 0.73).

Conclusions

The study has found out that mHealth intervention has a significant effect on improving facility delivery, postnatal care utilization, rate of exclusive breastfeeding, and knowledge of danger signs. There were also findings that reported contrary to the overall outcome which necessitates conducting further studies to enhance the generalizability of the effect of mHealth interventions on these outcomes.
Evaluation for causal effects of socioeconomic traits on risk of female genital prolapse (FGP): a multivariable Mendelian randomization analysis
Authors: Zhang Wei , Ge Jing , Qu Zhaohui , Wu Wenjuan , Lei Hua , Pan Huiling , Chen Honggu
Published: June 2023

Background

Although observational studies have established some socioeconomic traits to be independent risk factors for pelvic organ prolapse (POP), they can not infer causality since they are easily biased by confounding factors and reverse causality. Moreover, it remains ambiguous which one or several of socioeconomic traits play predominant roles in the associations with POP risk. Mendelian randomization (MR) overcomes these biases and can even determine one or several socioeconomic traits predominantly accounting for the associations.

Objective

We conducted a multivariable Mendelian randomization (MVMR) analysis to disentangle whether one or more of five categories of socioeconomic traits, “age at which full-time education completed (abbreviated as “EA”)”, “job involving heavy manual or physical work (“heavy work”)”, “average total household income before tax (income)”, “Townsend deprivation index at recruitment (TDI)”, and “leisure/social activities” exerted independent and predominant effects on POP risk.

Methods

We first screened single-nucleotide polymorphisms (SNPs) as proxies for five individual socioeconomic traits and female genital prolapse (FGP, approximate surrogate for POP due to no GWASs for POP) to conduct Univariable Mendelian randomization (UVMR) analyses to estimate causal associations of five socioeconomic traits with FGP risk using IVW method as major analysis. Additionally, we conducted heterogeneity, pleiotropy, and sensitivity analysis to assess the robustness of our results. Then, we harvested a combination of SNPs as an integrated proxy for the five socioeconomic traits to perform a MVMR analysis based on IVW MVMR model.

Results

UVMR analyses based on IVW method identified causal effect of EA (OR 0.759, 95%CI 0.629–0.916, p = 0.004), but denied that of the other five traits on FGP risk (all p > 0.05). Heterogeneity analyses, pleiotropy analyses, “leave-one-out” sensitivity analyses and MR-PRESSO adjustments did not detect heterogeneity, pleiotropic effects, or result fluctuation by outlying SNPs in the effect estimates of six socioeconomic traits on FGP risk (all p > 0.05). Further, MVMR analyses determined a predominant role of EA playing in the associations of socioeconomic traits with FGP risk based on both MVMR Model 1 (OR 0.842, 95%CI 0.744–0.953, p = 0.006) and Model 2 (OR 0.857, 95%CI 0.759–0.967, p = 0.012).

Conclusion

Our UVMR and MVMR analyses provided genetic evidence that one socioeconomic trait, lower educational attainment, is associated with risk of female genital prolapse, and even independently and predominantly accounts for the associations of socioeconomic traits with risk of female genital prolapse.
The change of triglyceride-glucose index may predict incidence of stroke in the general population over 45 years old
Authors: Wu Yaoling , Yang Yongbiao , Zhang Jinsheng , Liu Shuo , Zhuang Weiduan
Published: June 2023

Background

Stroke has been found to be highly correlated with the triglyceride-glucose (TyG) index. The relation between the TyG index changes and stroke, however, has seldom been reported, and current researches mentioning the TyG index concentrate on individual values. We aimed to investigate whether the level and the change of TyG index was associated with the incidence of stroke.

Methods

Sociodemographic, medical background, anthropometric and laboratory information were retrospectively collected. Classification was conducted using k-means clustering analysis. Logistic regressions were to determine the relationship between different classes with changes in the TyG index and incidence of stroke, taking the class with the smallest change as a reference. Meanwhile, restricted cubic spline regression was applied to examine the links of cumulative TyG index and stroke.

Results

369 (7.8%) of 4710 participants had a stroke during 3 years. Compared to class 1 with the best control of the TyG Index, the OR for class 2 with good control was 1.427 (95% CI, 1.051–1.938), the OR for class 3 with moderate control was 1.714 (95% CI, 1.245–2.359), the OR for class 4 with worse control was 1.814 (95% CI, 1.257–2.617), and the OR for class 5 with consistently high levels was 2.161 (95% CI, 1.446–3.228). However, after adjusting for multiple factors, only class 3 still had an association with stroke (OR 1.430, 95%CI, 1.022-2.000). The relation between the cumulative TyG index and stroke was linear in restricted cubic spline regression. In subgroup analysis, similar results were shown in participants without diabetes or dyslipidemia. There is neither additive nor multiplicative interaction between TyG index class and covariates.

Conclusion

A constant higher level with worst control in TyG index indicated a higher risk of stroke.
Lactiplantibacillus plantarum: a new example of inclusion body producing bacteria
Authors: Baltà-Foix Ricardo , Serrano-Adrover Caterina , López-Cano Adrià , Gifre-Renom Laia , Sanchez-Chardi Alejandro , Arís Anna , Garcia-Fruitós Elena
Published: June 2023

Background

Lactic Acid Bacteria such as Lactococcus lactis, Latilactobacillus sakei (basonym: Lactobacillus sakei) and Lactiplantibacillus plantarum (basonym: Lactobacillus plantarum) have gained importance as recombinant cell factories. Although it was believed that proteins produced in these lipopolysaccharides (LPS)-free microorganisms do not aggregate, it has been shown that L. lactis produce inclusion bodies (IBs) during the recombinant production process. These protein aggregates contain biologically active protein, which is slowly released, being a biomaterial with a broad range of applications including the obtainment of soluble protein. However, the aggregation phenomenon has not been characterized so far in L. plantarum. Thus, the current study aims to determine the formation of protein aggregates in L. plantarum and evaluate their possible applications.

Results

To evaluate the formation of IBs in L. plantarum, the catalytic domain of bovine metalloproteinase 9 (MMP-9cat) protein has been used as model protein, being a prone-to-aggregate (PTA) protein. The electron microscopy micrographs showed the presence of electron-dense structures in L. plantarum cytoplasm, which were further purified and analyzed. The ultrastructure of the isolated protein aggregates, which were smooth, round and with an average size of 250–300 nm, proved that L. plantarum also forms IBs under recombinant production processes of PTA proteins. Besides, the protein embedded in these aggregates was fully active and had the potential to be used as a source of soluble protein or as active nanoparticles. The activity determination of the soluble protein solubilized from these IBs using non-denaturing protocols proved that fully active protein could be obtained from these protein aggregates.

Conclusions

These results proved that L. plantarum forms aggregates under recombinant production conditions. These aggregates showed the same properties as IBs formed in other expression systems such as Escherichia coli or L. lactis. Thus, this places this LPS-free microorganism as an interesting alternative to produce proteins of interest for the biopharmaceutical industry, which are obtained from the IBs in an important number of cases.
In France, distance from hospital and health care structure impact on outcome after arthroplasty of the hip for proximal fractures of the femur
Authors: Levaillant Mathieu , Rony Louis , Hamel-Broza Jean-François , Soula Julien , Vallet Benoît , Lamer Antoine
Published: June 2023

Background

Hip arthroplasty is a frequently performed procedure in orthopedic surgery, carried out in almost all health structures for two main issues: fracture and coxarthrosis. Even if volume–outcome relationship appeared associated in many surgeries recently, data provided are not sufficient to set surgical thresholds neither than closing down low-volumes centers.

Question

With this study, we wanted to identify surgical, health care-related and territorial factors influencing patient’ mortality and readmission after a HA for a femoral fracture in 2018 in France.

Patients and methods

Data were anonymously collected from French nationwide administrative databases. All patients who underwent a hip arthroplasty for a femoral fracture through 2018 were included. Patient outcome was 90-day mortality and 90-day readmission rate after surgery.

Results

Of the 36,252 patients that underwent a HA for fracture in France in 2018, 0.7% died within 90-day year and 1.2% were readmitted. Male and Charlson comorbidity index were associated with a higher 90-day mortality and readmission rate in multivariate analysis. High volume was associated with a lower mortality rate. Neither time of travel nor distance upon health facility were associated with mortality nor with readmission rate in the analysis.

Conclusion

Even if volume appears to be associated with lower mortality rate even for longer distance and time of travel, the persistence of exogenous factors not documented in the French databases suggests that regionalization of hip arthroplasty should be organized with caution.

Clinical relevance

As volume–outcome relationship must be interpreted with caution, policy makers should not regionalize such surgery without further investigation.