bluuebunny/crossref_metadata_2025 huggingface dataset:
Repair and care: Locating the work of climate crisis
Authors: Carr Chantel
Published: June 2022

Climate crisis has arrived, and as predicted it has brought with it high levels of uncertainty. More frequent and extreme weather events expose infrastructural shortcomings, signalling a future characterised by profound disruption. It is time to turn our attention to the tangible work of climate crisis. Work is fundamental to embodied, material and spatial understandings of the world, yet it remains largely overlooked in social and cultural geography. What does the work of climate crisis look like, and who will do it? In this paper I argue that climate crisis demands more attention be paid to the deeply interwoven labours of repair and care. Reflecting on fieldwork across a range of carbon-intensive sectors and places, I locate the work of repair and care within the context of adaptation and mitigation action. Capacities to repair and care for our world and each other are profoundly important for adapting to the conditions of planetary breakdown. But the work of repair and care is also crucial for transitioning to low-carbon futures. A focus on this vital work suggests a deeply pragmatic and inclusive environmental politics and scholarship, bringing into dialogue rich veins of work within and beyond geography, on labour and everyday life.
The prevalence of concurrent pulmonary and extrapulmonary tuberculosis in Uganda: a retrospective study
Authors: Kyagulanyi Eddy , Mirembe Joy , Nantaayi Brandy , Nalukenge Sonita , Mukasa David , Tamale Jaffar , Oriekot Anthony , Kamya Moses R. , Baluku Joseph Baruch
Published: June 2022

Background:

Concurrent pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB) is associated with poor treatment outcomes yet its epidemiology in Uganda is unknown. The purpose of this study was to determine the prevalence, associated factors, and treatment outcomes of concurrent PTB and EPTB among patients at a national tuberculosis (TB) treatment center located at Mulago National Referral Hospital in Kampala, Uganda.

Methods:

We conducted a retrospective review of charts for people with TB who were enrolled in care between January 2015 and December 2019. Eligible charts were for people with pulmonary bacteriologically confirmed TB enrolled into care in the period under study. Concurrent PTB and EPTB was defined as PTB and bacteriological, histopathological, and/or radiological features of TB at another noncontiguous sites.

Results:

Overall, 400 patient charts were eligible, of whom 240 (60.0%) were aged 15–34 years and 205 (51.3%) were female. The prevalence of concurrent PTB and EPTB was 8.5% (34/400) [95% confidence interval (CI): 6.0–11.7%]. People with concurrent PTB and EPTB were more likely to have at least one comorbidity (82.4% versus 37.2%, p < 0.001), of which HIV was the most frequent. Furthermore, people with concurrent PTB and EPTB were more likely to have empyema (15% versus 2.6%, p = 0.028) but less likely to have bronchopneumonic opacification (0.0% versus 15.3%, p = 0.043) on chest x-ray imaging. People with concurrent PTB and EPTB had higher mortality (26.5% versus 6.37%) and a lower cure rate (41.2% versus 64.8%), p = 0.002.

Conclusion:

Our findings highlight the need for early detection of TB before dissemination particularly among people who use alcohol and people with HIV.
Magnitude of central obesity and associated factors among adults working in government offices in Bedele town, Buno Bedele zone, Southwest Ethiopia
Authors: Tefera Workineh , Shuremu Muluneh , Tadelle Amanuel , Abdissa Daba , Banjaw Zelalem
Published: June 2022

Objective:

Central obesity is an emerging public health problem globally and an independent risk factor for heart, blood vessels, and metabolic disorder. This study aimed to assess the central obesity and associated factors among adults working in government offices in Bedele town, Southwest Ethiopia, 2021.

Methods:

An institutional survey was conducted among randomly selected government offices. Anthropometric measurements were carried out. Face-to-face interview using standard questionnaires were also used to collect data. A total of 403 respondents were selected from the list of public office workers employed in Bedele Town. Data were entered into Epi data 3.1 then exported to SPSS version 20 for analysis. Each variable with a p value less than 0.25 in the bivariate analysis was entered into logistic regression and p value 0.05 was considered as statistically significant.

Results:

The response rate was 373 respondents (92.6%). The overall prevalence of central obesity among public office workers of Bedele town was 54.7%. Sitting for more than 5 h at workplace adjusted odds ratio = 2.911 (95% confidence interval = 1.644, 5.156), being a female adjusted odds ratio = 3.258 (95% confidence interval = 1.744, 6.047), age range of 40–49 (adjusted odds ratio = 4.520, 95% confidence interval = 1.798, 11.363), age ⩾ 50 years (adjusted odds ratio = 5.907, 95% confidence interval = 1.808, 19.297), being physically inactive (adjusted odds ratio = 4.594, 95% confidence interval = 2.313, 9.125), consumption of snack (adjusted odds ratio = 4.521, 95% confidence interval = 2.583, 7.913), and alcohol consumption (adjusted odds ratio = 2.324 95% confidence interval = 1.210, 4.463) were factors significantly associated with central obesity among office workers in Bedele town.

Conclusion:

The magnitude of central obesity was high among office workers in Bedele town and being female gender, older age, physical inactivity, consumption of snacks, and alcohol were associated with it. Physical exercise and a healthy lifestyle should be promoted to minimize the problem.
Concomitant Mitral Valve Re-Repair for Mixed Congenital and Degenerative Mitral Disease, Tricuspid Repair, and Cox-Maze Procedure in a College Athlete
Authors: Gupta Sohini , Karamlou Tara , Salim Hammoud Miza , Ghobrial Joanna , Aziz Peter , Najm Hani K.
Published: June 2022

A significant proportion of patients undergoing repair of congenital mitral valve disease will require a subsequent reoperation. During somatic growth, mitral valve repair is preferable to replacement as it allows for annular growth, preservation of ventricular function, and avoidance of lifelong anticoagulation. Techniques to facilitate successful re-repairs for congenital and non-rheumatic mixed degenerative mitral valve disease are not well-described in the literature. Description of the encountered pathology and surgical maneuvers utilized in this case provides real-world tools to help surgeons deal with limited orifice availability, fibrosis, and multilevel lesions. We describe a mitral valve re-repair in a young athlete for a rare cleft posterior mitral leaflet, with a simultaneous tricuspid valve repair and Cox-Maze procedure. We focus on technical pearls that address specific anatomic challenges within our surgical approach.
The Impact of the Fascia Iliaca Block Beyond Perioperative Pain Control in Hip Fractures: A Retrospective Review
Authors: Houserman David J. , Raszewski Jesse A. , Palmer Brandi , Chavan Bhakti , Sferrella Abby , Campbell Melody , Santanello Steven
Published: June 2022

Background

Geriatric hip fractures are common injuries that are associated with high morbidity and mortality. Adequate pain control remains a challenge as the altered physiology in elderly patients makes use of traditional analgesics challenging. The use of regional anesthetics, specifically the fascia iliaca compartment block (FICB), in the perioperative period has been shown to decrease opioid use in this population. This study aimed to investigate the effect the FICB had on pain control, length of stay, readmissions, and complications in a 30-day postoperative period.

Methods

This was a retrospective cohort study comparing patients who sustained hip fractures; one cohort (110 patients) received a preoperative fascia iliaca block with continuous infusion (FICB), whereas the other cohort (110 patients) did not receive a block (NO-FICB). Both cohorts were from level II trauma centers. Data were collected between 2016 and 2019. Descriptive statistics was performed to describe and summarize the data. Bivariate analysis was performed using chi-square test, with 2 tailed P-values ≤ .05 were considered statistically significant.

Results

The FICB group had a lower length of stay (3.9 days vs 4.8 days; P < .001), and lower pain scores on post-operative days 2 and 3 ( P = .019). There was no difference in time from admission to surgery ( P = .112) or narcotic use between cohorts ( P = .304). However, the FICB group was more likely to discharge to a skilled nursing facility (P=.002), and more likely to be readmitted within 30 days ( P = .047). There were no differences in medical complications or mortality between the 2 groups.

Conclusions

The primary study endpoint, length of stay, was found to be significantly shorter in the patients who underwent the FICB vs the group who did not undergo the FICB. Pain scores on POD2 and POD3 were lower in patients who received a FICB. This study adds to the body of evidence that the FICB is an effective addition to a multimodal pain pathway.

Level of Evidence

Level III Evidence – Retrospective Cohort Study
We Choose to Call it ‘Degenerative Cervical Myelopathy’: Findings of AO Spine RECODE-DCM, an International and Multi-Stakeholder Partnership to Agree a Standard Unifying Term and Definition for a Disease
Authors: Davies Benjamin M. , Khan Danyal Z , Barzangi Kara , Ali Ahmad , Mowforth Oliver D. , Nouri Aria , Harrop James S. , Aarabi Bizhan , Rahimi-Movaghar Vafa , Kurpad Shekar N , Guest James D. , Tetreault Lindsay , Kwon Brian K. , Boerger Timothy F , Rodrigues-Pinto Ricardo , Furlan Julio C. , Chen Robert , Zipser Carl Moritz , Curt Armin , Milligan James , Kalsi-Rayn Sukhivinder , Sarewitz Ellen , Sadler Iwan , Widdop Shirley , Fehlings Michael G. , Kotter Mark R.N.
Published: June 2022

Study Design

Modified DELPHI Consensus Process

Objective

To agree a single unifying term and definition. Globally, cervical myelopathy caused by degenerative changes to the spine is known by over 11 different names. This inconsistency contributes to many clinical and research challenges, including a lack of awareness.

Method

AO Spine RECODE-DCM (Research objectives and Common Data Elements Degenerative Cervical Myelopathy). To determine the index term, a longlist of candidate terms and their rationale, was created using a literature review and interviews. This was shared with the community, to select their preferred terms (248 members (58%) including 149 (60%) surgeons, 45 (18%) other healthcare professionals and 54 (22%) People with DCM or their supporters) and finalized using a consensus meeting. To determine a definition, a medical definition framework was created using inductive thematic analysis of selected International Classification of Disease definitions. Separately, stakeholders submitted their suggested definition which also underwent inductive thematic analysis (317 members (76%), 190 (59%) surgeons, 62 (20%) other healthcare professionals and 72 (23%) persons living with DCM or their supporters). Using this definition framework, a working definition was created based on submitted content, and finalized using consensus meetings.

Results

Degenerative Cervical Myelopathy was selected as the unifying term, defined in short, as a progressive spinal cord injury caused by narrowing of the cervical spinal canal

Conclusion

A consistent term and definition can support education and research initiatives. This was selected using a structured and iterative methodology, which may serve as an exemplar for others in the future.
Digital environment: An evolutionary component in environmental health
Authors: Syamimi Masrani Afiqah , Nik Husain Nik Rosmawati
Published: June 2022

The COVID-19 pandemic has hastened the progress of digitalization where the public is forced to embrace paradigm shifts on how we function in a digital society. The way we work, learn, live, and play daily has drastically changed with the revolution of digital systems from their analog predecessor. This transformation warrants the digital environment as a social determinant of health. It comprises the whole continuum from the tangible aspects of the computing devices, their programing and information system, the network technologies connecting them, and the product of interactivity between people to people and people to the digital interface. Despite permeating the everyday life of each level of society, the digital environment has yet to be scrutinized comprehensively in terms of health. A review of the literature produces fragmented results where different specialties within and beyond the medical field lay claim to the various aspects of digitalization. We proposed five domains within the digital environment namely digital transformation, digital health, digital technology, digital identity, and digital media that exerts diversified pressure on the digital environment through human activities. Their subjacent linkage to human health and environmental impact is further discussed by using the DPSEEA framework. Challenges that crossed all domains were discussed including the widening gap of inequalities secondary to the limited availability of, and accessibility to digitalization. Considering the rapid speed at which we propel to a fully immersive virtual world, a timely transformation of environmental health to include the digital environment as part of its main components is inevitable.
The Co-Creation of a Patient Information Leaflet for Patients With the Rare Eye Infection Acanthamoeba keratitis
Authors: Ekkeshis Irenie , Mason Melanie , Watson Martin , Rowan Bryony , Carnt Nicole
Published: June 2022

Acanthamoeba keratitis (AK) is a rare but severe eye disease. A research engagement event, “The Cornea Day,” in London, UK in 2013, identified the lack of credible information about AK and a need for practical day to day management strategies. Experiences of 15 AK patients attending The Cornea Day were distilled into a survey that was administered to a wider group of 76 patients, carers, researchers, and clinicians. A Patient Information Leaflet was cocreated and then represented to additional patients for final modification. The AK Patient Leaflet (revised 2019) is available in several languages and used globally.
Smell and Taste Symptoms Among Patients With Mild and Moderately Severe COVID‐19 Infection in Uganda
Authors: Byaruhanga Richard , Kabagenyi Fiona , Kagga Douglas Ssenyonjo , Ndoleriire Christopher , Kamulegeya Adriane , Ssemwogerere Lamech , Kiguba Ronald , Kirenga Bruce , Kakande Emily
Published: June 2022

Objective

Patients with coronavirus disease 2019 (COVID‐19) may present with smell/taste dysfunctions in addition to the most frequent symptoms (fever, cough, and shortness of breath) or as the first symptom or even the only symptom. There is paucity of documentation of prevalence and characteristics of smell/taste dysfunction in COVID‐19 in sub‐Saharan Africa. The aim of this study was to determine the prevalence of smell/taste symptoms in our setting to institute local evidence‐based practice.

Study Design

Cross‐sectional study.

Setting

COVID‐19 treatment centers in Uganda.

Methods

Patients hospitalized for COVID‐19 at 3 treatment sites from November 2020 to March 2021 were recruited. Following written informed consent, their demographics, comorbidities, and smell/taste symptoms data were collected using a questionnaire.

Results

Of 614 patients recruited, 409 (63.8%) had mild symptoms and 232 (36.2%) had moderate to severe symptoms; 64.3% were male, and the mean age was 48.6 ± 15.51 years. In total, 23.1% were health responders and 12.2% had contact with a positive case. Smell and taste impairment was seen in 425 (66.3%) patients, second to cough (71.6%). Smell and taste impairment was seen in 162 (38.1%) as the first symptom, in 128 (30%) as the only symptom, and significantly more in those with mild COVID‐19 symptoms (P <. 001).

Conclusion

COVID‐19 manifests with various symptoms, including impairment of smell and taste. This study shows that smell and taste impairment is common and can be the first and only symptom in less severe COVID‐19 infections. Therefore, inclusion in the Ministry of Health guidelines is strongly recommended.
Regulation of mi-RNAs Target Cancer Genes Between Exercise and Non-exercise in Rat Rheumatoid Arthritis Induction: Pilot Study
Authors: Tansathitaya Vimolmas , Sarasin Witchana , Phakham Tanapati , Sawaswong Vorthon , Chanchaem Prangwalai , Payungporn Sunchai
Published: June 2022

Introduction:

Rheumatoid arthritis is associated with various cancers. Many studies have investigated physical exercise interventions as health improvements to ameliorate the risk of cancer during rheumatoid arthritis diagnosis. Recently, microRNAs were used as biomarkers for health assessment and cancer prediction in rheumatoid arthritis patients.

Methods:

The effects of exercise interventions on serum microRNAs were investigated in pristane-induced arthritis (PIA) rat models. Twelve Sprague-Dawley male rats were divided into 4 groups including non-exercise without PIA (N-EX), non-exercise with PIA (N-EX + PIA), exercise without PIA (EX) and exercise with PIA (EX + PIA). Blood samples were collected at the end of the study period to analyze miRNA biomarkers and target cancer gene predictions.

Results:

Four significant Rattus norvegicus (rno-microRNAs) may purpose as tumor suppressors were identified as potential target cancer gene candidate expressions within the 4 comparative interventional exercise groups. One rno-microRNA and target cancer gene candidate was up-regulated and 3 rno-microRNAs and their target cancer genes were down-regulated.

Conclusions:

Exercise interventions affected rno-miRNAs regulated target cancer gene candidates ITPR3, SOCS6, ITGA6, and NKX2-1 as biomarkers for cancer prognosis in rheumatoid arthritis diagnosis.
Corporate E-Learning Initiatives: A New Paradigm for Employee Development
Authors: Banerjee Pratyush
Published: June 2022

In today’s world, change is the only constant. Organisations must become more agile and proactive to stay relevant. The nature of knowledge has become extremely volatile and new developments are making older insights obscure and obsolete at an alarming speed. Hence, managers are faced with the uphill task of bringing their human resources up to speed. One way of helping employees equip themselves with new paradigm shifts is through e-learning initiatives, which help in making the learning self-paced and convenient. However, implementing such initiatives can be a challenging task. This article provides a brief overview of key benefits of such initiatives, followed by three case studies: a public sector enterprise, an IT consultancy firm and a business analytics consultancy firm.
Future of Work and the Importance of Upskilling in India
Authors: Chakrabarti Diganta
Published: June 2022

Speculations and predictions about the ‘future of work’ have been around for more than two decades. We present crucial research findings on the changing job roles and the anticipated skill gap we would be facing by 2025. We underline how upskilling initiatives can prepare us for tomorrow. Finally, we offer our perspectives on the roles of the key stakeholders in the upskilling process.
Physioxia-induced downregulation of Tet2 in hematopoietic stem cells contributes to enhanced self-renewal
Authors: Aljoufi Arafat , Zhang Chi , Ropa James , Chang Wennan , Palam Lakshmi Reddy , Cooper Scott , Ramdas Baskar , Capitano Maegan L. , Broxmeyer Hal E. , Kapur Reuben
Published: June 2022

Hematopoietic stem cells (HSCs) manifest impaired recovery and self-renewal with a concomitant increase in differentiation when exposed to ambient air as opposed to physioxia. Mechanism(s) behind this distinction are poorly understood but have the potential to improve stem cell transplantation. Single-cell RNA sequencing of HSCs in physioxia revealed upregulation of HSC self-renewal genes and downregulation of genes involved in inflammatory pathways and HSC differentiation. HSCs under physioxia also exhibited downregulation of the epigenetic modifier Tet2. Tet2 is α-ketoglutarate, iron- and oxygen-dependent dioxygenase that converts 5-methylcytosine to 5-hydroxymethylcytosine, thereby promoting active transcription. We evaluated whether loss of Tet2 affects the number and function of HSCs and hematopoietic progenitor cells (HPCs) under physioxia and ambient air. In contrast to wild-type HSCs (WT HSCs), a complete nonresponsiveness of Tet2−/− HSCs and HPCs to changes in oxygen tension was observed. Unlike WT HSCs, Tet2−/− HSCs and HPCs exhibited similar numbers and function in either physioxia or ambient air. The lack of response to changes in oxygen tension in Tet2−/− HSCs was associated with similar changes in self-renewal and quiescence genes among WT HSC-physioxia, Tet2−/− HSC-physioxia and Tet2−/− HSC-air. We define a novel molecular program involving Tet2 in regulating HSCs under physioxia.
Abnormal metaphase cytogenetics predicts venous thromboembolism in myeloma: derivation and validation of the PRISM score
Authors: Chakraborty Rajshekhar , Rybicki Lisa , Wei Wei , Valent Jason , Faiman Beth M. , Samaras Christy J. , Anwer Faiz , Khorana Alok A.
Published: June 2022

Although venous thromboembolism (VTE) is an important treatment and disease-related complication in myeloma, a validated risk prediction model including disease-specific variables such as cytogenetics or tumor burden is lacking. The aim of this study was to develop a new risk prediction model for VTE in the context of modern antimyeloma therapy. All consecutive patients diagnosed at the Cleveland Clinic between 2008 and 2018 and with available data on baseline candidate risk factors constituted the derivation cohort. The primary outcome was VTE (deep venous thrombosis/pulmonary embolism) within 1 year of treatment initiation. A multivariable model was used, and weights were derived from subdistribution hazard ratios to construct a risk score. The model was validated both by internal bootstrap validation and in an external validation cohort. The derivation cohort consisted of 783 patients. A 5-component risk prediction tool, named the PRISM score, was developed, including the following variables: prior VTE, prior surgery, immunomodulatory drug use, abnormal metaphase cytogenetics, and Black race. The c-statistic of the model was 0.622 (95% confidence interval [CI], 0.567-0.674). The model stratified patients into low, intermediate, and high risk, with 12-month cumulative VTE incidence of 2.7%, 10.8%, and 36.5%, respectively. Risk of VTE increased significantly with increasing score in both the derivation and the external validation data sets, with a subdistribution hazard ratio per 1-point increase of 1.28 (95% CI, 1.19-1.39; P < .001) and 1.23 (95% CI, 1.07-1.41; P = .004) respectively. Although the PRISM score can guide clinicians in identifying patients at a high risk of VTE, additional external validation is necessary for incorporation into routine clinical practice.
ICH in primary or metastatic brain cancer patients with or without anticoagulant treatment: a systematic review and meta-analysis
Authors: Giustozzi Michela , Proietti Giulia , Becattini Cecilia , Roila Fausto , Agnelli Giancarlo , Mandalà Mario
Published: June 2022

Anticoagulant treatment in patients with primary and metastatic brain cancer is a concern due to risk of intracranial hemorrhage (ICH). We performed a systematic review and meta-analysis to evaluate the risk of ICH in patients with primary or metastatic brain cancer treated with or without anticoagulants. Articles on ICH in patients with primary or metastatic brain cancer treated with or without anticoagulants published up to September 2021 were identified by searching PubMed, EMBASE, and Cochrane Library databases. The primary outcome of this analysis was ICH. Thirty studies were included. Rate of ICH was 13.0% in 1009 patients with metastatic brain cancer and 6.4% in 2353 patients with primary brain cancer (relative risk [RR], 3.26; 95% confidence interval [CI], 2.69-3.94; I2 = 92.8%). In patients with primary brain cancer, ICH occurred in 12.5% and 4.4% of patients treated with or without anticoagulants, respectively (11 studies, 659 treated and 1346 not treated patients; RR, 2.63; 95% CI, 1.48-4.67; I2 = 49.6%). In patients with metastatic brain cancer, ICH occurred in 14.7% and 15.4% (5 studies, 265 treated and 301 not treated patients; RR, 0.92; 95% CI, 0.43-1.93; I2 = 0%). ICH occurred in 8.3% of 172 treated with direct oral anticoagulants (DOACs) and in 11.7% of 278 treated with low-molecular weight heparin (LMWH) (5 studies; RR, 0.44; 95% CI, 0.25-0.79; I2 = 0%). Patients with metastatic brain cancer have a particularly high risk of ICH. Patients with primary brain cancer have an increased risk of ICH during anticoagulation. DOACs are associated with a lower risk of ICH than LMWH.
Focusing on individual morphological fracture characteristics of pelvic ring fractures in elderly patients can support clinical decision making
Authors: Ramser Michaela , Cadosch Dieter , Vach Werner , Strub Nathalie , Saxer Franziska , Eckardt Henrik
Published: June 2022

Introduction

Pelvic ring fractures in the elderly are often caused by minor trauma. Treatment of these patients is currently based on fracture classification, clinical course, and ability to mobilize. Our aim was to identify morphological fracture characteristics with potential prognostic relevance and evaluate their association with clinical decision making and outcome, as well as their interobserver reliability.

Methods

Five fracture characteristics were investigated as potential variables: 1. Extent of the dorsal pelvic ring fracture (absent, unilateral, bilateral); 2. Extent of the ventral pelvic ring fracture (absent, unilateral, bilateral); 3. Presence of a horizontal sacral fracture; 4. Ventral dislocation; 5. Ventral comminution.

These characteristics were assessed retrospectively in a series of 548 patients. The association of their presence with the decision to perform surgery, failure of conservative treatment and the length of hospital stay (LOS) was determined. Further, the inter-observer reliability for the specific characteristics was calculated and the relation with survival assessed.

Results

Four of the five evaluated characteristics showed an association with clinical decision making and patient management. In particular the extent of the dorsal fractures (absent vs. unilateral vs. bilateral) (OR = 7.0; p < 00.1) and the presence of ventral comminution/dislocation (OR = 2.4; p = 0.004) were independent factors for the decision to perform surgery. Both the extent of the dorsal fracture (OR = 1.8; p < 0.001) and the presence of ventral dislocation (OR = 1.7; p = 0.003) were independently associated with a prolonged overall LOS.

The inter-observer agreement for the fracture characteristics ranged from moderate to substantial.

A relevant association with increased mortality was shown for horizontal sacral and comminuted ventral fractures with hazard ratios (HR) of 1.7 (95% CI: 1.1, 2.5; p = 0.008) and HR = 1.5 (95% CI: 1.0, 2.2; p = 0.048).

Conclusion

In the elderly, the extent of the dorsal fractures and the presence of ventral comminution/dislocation were associated to the decision to undergo surgery, failure of conservative treatment and length of stay. Survival was related to horizontal sacral fractures and ventrally comminuted fractures. These characteristics thus represent a simplified but highly informative approach for the evaluation of pelvic ring fractures in the elderly. This approach can support clinical decision making, promote patient-centred treatment algorithms and thus improve the outcome of individualized care.
Risk factors for campylobacteriosis in Australia: outcomes of a 2018–2019 case–control study
Authors: Cribb Danielle M. , Varrone Liana , Wallace Rhiannon L. , McLure Angus T. , Smith James J. , Stafford Russell J. , Bulach Dieter M. , Selvey Linda A. , Firestone Simon M. , French Nigel P. , Valcanis Mary , Fearnley Emily J. , Sloan-Gardner Timothy S. , Graham Trudy , Glass Kathryn , Kirk Martyn D.
Published: June 2022

Background

We aimed to identify risk factors for sporadic campylobacteriosis in Australia, and to compare these for Campylobacter jejuni and Campylobacter coli infections.

Methods

In a multi-jurisdictional case–control study, we recruited culture-confirmed cases of campylobacteriosis reported to state and territory health departments from February 2018 through October 2019. We recruited controls from notified influenza cases in the previous 12 months that were frequency matched to cases by age group, sex, and location. Campylobacter isolates were confirmed to species level by public health laboratories using molecular methods. We conducted backward stepwise multivariable logistic regression to identify significant risk factors.

Results

We recruited 571 cases of campylobacteriosis (422 C. jejuni and 84 C. coli) and 586 controls. Important risk factors for campylobacteriosis included eating undercooked chicken (adjusted odds ratio [aOR] 70, 95% CI 13–1296) or cooked chicken (aOR 1.7, 95% CI 1.1–2.8), owning a pet dog aged < 6 months (aOR 6.4, 95% CI 3.4–12), and the regular use of proton-pump inhibitors in the 4 weeks prior to illness (aOR 2.8, 95% CI 1.9–4.3). Risk factors remained similar when analysed specifically for C. jejuni infection. Unique risks for C. coli infection included eating chicken pâté (aOR 6.1, 95% CI 1.5–25) and delicatessen meats (aOR 1.8, 95% CI 1.0–3.3). Eating any chicken carried a high population attributable fraction for campylobacteriosis of 42% (95% CI 13–68), while the attributable fraction for proton-pump inhibitors was 13% (95% CI 8.3–18) and owning a pet dog aged < 6 months was 9.6% (95% CI 6.5–13). The population attributable fractions for these variables were similar when analysed by campylobacter species. Eating delicatessen meats was attributed to 31% (95% CI 0.0–54) of cases for C. coli and eating chicken pâté was attributed to 6.0% (95% CI 0.0–11).

Conclusions

The main risk factor for campylobacteriosis in Australia is consumption of chicken meat. However, contact with young pet dogs may also be an important source of infection. Proton-pump inhibitors are likely to increase vulnerability to infection.
Mutations of 1p genes do not consistently abrogate tumor suppressor functions in 1p-intact neuroblastoma
Authors: Kuick Chik Hong , Tan Jia Ying , Jasmine Deborah , Sumanty Tohari , Ng Alvin Y. J. , Venkatesh Byrrappa , Chen Huiyi , Loh Eva , Jain Sudhanshi , Seow Wan Yi , Ng Eileen H. Q. , Lian Derrick W. Q. , Soh Shui Yen , Chang Kenneth T. E. , Chen Zhi Xiong , Loh Amos H. P.
Published: June 2022

Background

Deletion of 1p is associated with poor prognosis in neuroblastoma, however selected 1p-intact patients still experience poor outcomes. Since mutations of 1p genes may mimic the deleterious effects of chromosomal loss, we studied the incidence, spectrum and effects of mutational variants in 1p-intact neuroblastoma.

Methods

We characterized the 1p status of 325 neuroblastoma patients, and correlated the mutational status of 1p tumor suppressors and neuroblastoma candidate genes with survival outcomes among 100 1p-intact cases, then performed functional validation of selected novel variants of 1p36 genes identified from our patient cohort.

Results

Among patients with adverse disease characteristics, those who additionally had 1p deletion had significantly worse overall survival. Among 100 tumor-normal pairs sequenced, somatic mutations of 1p tumor suppressors KIF1Bβ and CHD5 were most frequent (2%) after ALK and ATRX (8%), and BARD1 (3%). Mutations of neuroblastoma candidate genes were associated with other synchronous mutations and concurrent 11q deletion (P = 0.045). In total, 24 of 38 variants identified were novel and predicted to be deleterious or pathogenic. Functional validation identified novel KIF1Bβ I1355M variant as a gain-of-function mutation with increased expression and tumor suppressive activity, correlating with indolent clinical behavior; another novel variant CHD5 E43Q was a loss-of-function mutation with decreased expression and increased long-term cell viability, corresponding with aggressive disease characteristics.

Conclusions

Our study showed that chromosome 1 gene mutations occurred frequently in 1p-intact neuroblastoma, but may not consistently abrogate the function of bonafide 1p tumor suppressors. These findings may augment the evolving model of compounding contributions of 1p gene aberrations toward tumor suppressor inactivation in neuroblastoma.
Potential association of bone mineral density loss with cognitive impairment and central and peripheral amyloid-β changes: a cross-sectional study
Authors: Zhang Peng , Zhou Yi , Chen Gang , Li Jun , Wang Bangjun , Lu Xinyan
Published: June 2022

Background

There is some evidence in the literature that older adults with cognitive impairments have a higher risk for falls and osteoporotic hip fractures. Currently, the associations between bone health and cognitive health have not been extensively studied. Thus, the present cross-sectional study aims to investigate the relationship between markers of bone loss and cognitive performance in older adults with and without osteopenia as well as older adults with cognitive impairments (i.e., Alzheimer’s disease [AD]).

Methods

Sixty-two non-osteopenia participants and one hundred three osteopenia participants as the cohort 1 and 33 cognitively normal non-AD participants and 39 AD participants as the cohort 2 were recruited. To assess cognitive and bone health, hip bone mineral density (BMD) and cognitive performance (via Minimal Mental State Examination [MMSE] and/or Auditory Verbal Learning Test-delayed recall [AVLT-DR]) were assessed. Furthermore, in cohort 1, plasma amyloid-β (Aβ) levels, and in cohort 2, cerebrospinal fluid (CSF) Aβ levels were determined.

Results

We observed that (1) compared with non-osteopenia participants, BMD values (t = − 22.806; 95%CI: − 1.801, − 1.484;p < 0.001), MMSE scores (t = − 5.392; 95%CI: − 3.260, − 1.698;p < 0.001), and AVLT-DR scores (t = − 4.142; 95%CI: − 2.181, − 0.804;p < 0.001), plasma Aβ42 levels (t = − 2.821; 95%CI: − 1.737, − 0.305;p = 0.01), and Aβ42/40 ratio (t = − 2.020; 95%CI: − 0.009, − 0.001;p = 0.04) were significantly lower in osteopenia participants; (2) plasma Aβ42/40 ratio showed a mediate effect for the association between BMD values and the performance of cognitive function in osteopenia participants by mediation analysis, adjusting age, sex, years of education, and body mass index (BMI); (3) BMD values (95%CI: − 1.085, 0.478;p < 0.001) were significantly reduced in AD participants as compared with cognitively normal non-AD participants; (4) in AD participants, the interactive effects of BMD and CSF Aβ42/40 ratio on MMSE scores was found by regression analysis, controlling age, sex, years of education, and BMI; (5) BMD can distinguish AD participants from cognitively normal non-AD participants with AUC of 0.816 and distinguish participants with the cognitive impairment from cognitively normal participants with AUC of 0.794.

Conclusion

Our findings suggest a relationship between bone health and cognitive health. Given the correlations between BMD and important markers of cognitive health (e.g.,central and peripheral pathological change of Aβ), BMD might serve as a promising and easy-accessible biomarker. However, more research is needed to further substantiate our findings.
The effect of LDL-C status on the association between increased coronary artery calcium score and compositional plaque volume progression in statins-treated diabetic patients: evaluated using serial coronary CTAs
Authors: Shi Rui , Gao Yue , Shen Li-Ling , Shi Ke , Wang Jin , Jiang Li , Li Yuan , Yang Zhi-Gang
Published: June 2022

Background

In statins-treated diabetic mellitus (DM) patients, longitudinal coronary CTA (CCTA) evidence is scarce regarding the relationship between coronary Agatston artery calcification scores (CACs) and coronary plaque progression. This study was designed to investigate whether the association between CACs progression and compositional plaque volumes (PVs) progression differed between follow-up low-density lipoprotein cholesterol (LDL-C) controlled and uncontrolled groups in statins-treated DM patients.

Methods

From January 2015 to June 2021, 208 patients who submitted serial clinically indicated CCTAs in our hospital were included in this study. Participants were further subdivided into LDL-C controlled (n = 75) and LDL-C uncontrolled (n = 133) groups according to whether the LDL-C reached the treatment goals at follow-up. Baseline and follow-up CCTA image datasets were quantified analysis at per-patient and per-plaque levels. The annual change of total PV (TPV), calcific PV(CPV), non-calcific PV (NCPV), low-density non-calcific PV (LD-NCPV), and CACs were assessed and further compared according to follow-up LDL-C status. The effect of CACs progression on the annual change of componential PVs was evaluated according to follow-up LDL-C status at both per-patient and per-plaque levels.

Results

The annual change of CACs was positively associated with the annual change of TPV (β = 0.43 and 0.61, both p < 0.001), CPV (β = 0.23 and β = 0.19, p < 0.001 and p = 0.004, respectively), NCPV (β = 0.20 and β = 0.42, p < 0.001 and p = 0.006, respectively), and LD-NCPV (β = 0.08 and 0.13, p < 0.001 and p = 0.001, respectively) both on per-patients and per-plaque levels. LDL-C status had no effect on the annual change of TPV, CPV, NCPV, and LD-NCPV (all p > 0.05). After adjusting for confounding factors, on the per-patient level, the increase in CACs was independently associated with annual change of TPV (β = 0.650 and 0.378, respectively, both p < 0.001), CPV (β = 0.169 and 0.232, respectively, p = 0.007 and p < 0.001), NCPV (β = 0.469 and 0.144, respectively, both p = 0.001), and LD-NCPV (β = 0.082 and 0.086, respectively, p = 0.004 and p = 0.006) in LDL-C controlled and LDL-C uncontrolled group. On the per-plaque level, the increase in CACs was independently associated with the annual change of NCPV and LD-NCPV in LDL-C uncontrolled patient (β = 0.188 and 0.106, p < 0.001), but not in LDL-C controlled group (β = 0.268 and 0.056, p = 0.085 and 0.08).

Conclusions

The increase of CACs in statins-treated DM patients indicates the progression of compositional PVs. From a per-plaque perspective, there might be increased instability of individual plaques concomitant with CACs increase in LDL-C uncontrolled patients.
The potential impact of allied health professional telehealth consultations on health inequities and the burden of treatment
Authors: Eddison Nicola , Leone Enza , Healy Aoife , Royse Carolyn , Chockalingam Nachiappan
Published: June 2022

Background

The COVID-19 pandemic resulted in a rapid shift to remote consultations. The study aimed to explore the prevalence of telehealth consultations amongst allied health professional (AHP) services in the UK National Health Service (NHS), and the potential impact on health inequities and burden of treatment for patients.

Methods

Cross-sectional online survey. Participants were practising UK registered AHP and/or AHP service manager in an NHS/social care/local authority service. Data was collected between May – June 2021.

Results

658 participants took part in this study, including 119 AHP service managers, managing a total of 168 AHP services, and 539 clinicians. 87.4% of clinicians and 89.4% of services represented were using telehealth consultations as a method of delivering healthcare, the majority reported their services were planning to continue using telehealth post COVID-19 restrictions. Participants reported a lack of technological skills for patients as the most prevalent barrier affecting the patient’s ability to conduct a telehealth consultation, followed by a lack of technology for patients. These were also reported as the biggest disadvantages of telehealth for patients. The majority of clinicians reported a reduction in the cost of parking/transport to attend hospital appointments as a patient benefit of telehealth consultations. Reported benefits for clinicians included saving travel time/costs and allowing flexible working, while benefits to the AHP service included patient flexibility in how their appointments are conducted and reducing the potential exposure of staff to communicable diseases.

Conclusions

The current large-scale implementation of telehealth in NHS AHP services may increase disparities in health care access for vulnerable populations with limited digital literacy or access. Consequently, there is a danger that telehealth will be considered inappropriate and thus, underutilised, negating the potential benefits of sustainability, patient empowerment and the reduction in the burden of treatment.
Evaluation the reactivity of a peptide-based monoclonal antibody derived from OmpA with drug resistant pulsotypes of Acinetobacter baumannii as a potential therapeutic approach
Authors: Yeganeh Omid , Shabani Mahdi , Pakzad Parviz , Mosaffa Nariman , Hashemi Ali
Published: June 2022

Background

Acinetobacter baumanniiis an opportunistic and antibiotic-resistant pathogen that predominantly causes nosocomial infections. There is urgent need for development nonantibiotic-based treatment strategies. We developed a novel monoclonal antibody (mAb) against a peptide of conserved outer membrane protein A (OmpA) and evaluated its reactivity with different pulsotypes ofA. baumannii.

Methods

Peptide derived fromA. baumanniiOmpA was conjugated to keyhole limpet hemocyanin and injected into BALB/c mice. Splenocytes of immunized mice were fused with SP2/0 myeloma cells followed by selection of antibody-producing hybridoma cells. After screening of different hybridoma colonies by ELISA, one monoclone was selected as 3F10-C9 and the antibody was tested for reaction with five differentAcinetobacterpulsotypes that were resistant to carbapenem antibiotics. The affinity constant was measured by ELISA. The ELISA, western blotting, indirect immunofluorescence (IFA), and in vitro opsonophagocytosis assays were used to evaluate the reactivity of generated mAb.

Results

The anti-OmpA antibody reacted with the immunizing peptide and had a high affinity (1.94 × 10−9 M) for its antigen in the ELISA. Specific binding of mAb to OmpA was confirmed in Western blot. IFA assays revealed that mAb recognized specific OmpA on the pulsotypes. Opsonophagocytosis assays showed that the mAb increased the bactericidal activity of macrophage cells. The antibody function was higher in the presence of serum complement.

Conclusions

The peptide-based mAb demonstrated optimal performance in laboratory experiments which may be appropriate in investigation on OmpA inAcinetobacterpathogenesis and development of passive immunization as a novel therapeutic approach.
3,3′-Diindolylmethane improves antitumor immune responses of PD-1 blockade via inhibiting myeloid-derived suppressor cells
Authors: Sun Qi , Xiao Lin , Cui Zhiying , Yang Yaping , Ma Junting , Huang Zhen , Zhang Junfeng , Chen Jiangning
Published: June 2022

Background

Immune checkpoint inhibitors that target programmed cell death protein 1 (PD-1) have obtained encouraging results, but a fraction of tumor patients failed to respond to anti-PD-1 treatment due to the existence of multiple immune suppressive elements such as myeloid-derived suppressor cells (MDSCs). Traditional Chinese medicine or natural products from medicinal plants could enhance immunity and may be helpful for cancer immunotherapy. As a digestive metabolite from cruciferous plants, 3,3′-diindolylmethane (DIM) has been widely used in chemotherapy, but its influence on cancer immunotherapy remains unclear. Here we investigate the function of DIM on MDSCs and examine the therapeutic effects of DIM in conjunction with PD-1 antibody against mouse tumors.

Methods

Flow cytometry analysis, Western blot analysis and qRT-PCR assay were used to examine the inhibitory effects and mechanisms of DIM on MDSCs in vitro and in vivo. The therapeutic effects of DIM on cancer immunotherapy by PD-1 antibody were evaluated in mouse models of breast cancer and melanoma tumor.

Results

DIM exerted the inhibitory effect on MDSCs via downregulating miR-21 level and subsequently activating PTEN/PIAS3-STAT3 pathways. Adoptive transfer of MDSCs impaired the therapeutic effects of DIM, indicating that the antitumor activity of DIM might be due to the suppression of MDSCs. Furthermore, in mouse models of breast cancer and melanoma tumor, the addition of DIM can enhance the therapeutic effect of PD-1 antibody through promoting T cells responses, and thereby inhibiting tumor growth.

Conclusions

Overall, the strategy based on the combination treatment of anti-PD-1 antibody and DIM may provide a new approach for cancer immunotherapy. Cruciferae plants-rich diet which contains high amount of DIM precursor may be beneficial for cancer patients that undergo the anti-PD-1 treatment.
Enhanced procedures for mosquito identification by MALDI-TOF MS
Authors: Bamou Roland , Costa Monique Melo , Diarra Adama Zan , Martins Ademir Jesus , Parola Philippe , Almeras Lionel
Published: June 2022

Background

In the last decade, an innovative approach has emerged for arthropod identification based on matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS). Increasing interest in applying the original technique for arthropod identification has led to the development of a variety of procedures for sample preparation and selection of body parts, among others. However, the absence of a consensual strategy hampers direct inter-study comparisons. Moreover, these different procedures are confusing to new users. Establishing optimized procedures and standardized protocols for mosquito identification by MALDI-TOF MS is therefore a necessity, and would notably enable the sharing of reference MS databases. Here, we assess the optimal conditions for mosquito identification using MALDI-TOF MS profiling.

Methods

Three homogenization methods, two of which were manual and one automatic, were used on three distinct body parts (legs, thorax, head) of two mosquito laboratory strains, Anopheles coluzzii and Aedes aegypti, and the results evaluated. The reproducibility of MS profiles, identification rate with relevant scores and the suitability of procedures for high-throughput analyses were the main criteria for establishing optimized guidelines. Additionally, the consequences of blood-feeding and geographical origin were evaluated using both laboratory strains and field-collected mosquitoes.

Results

Relevant score values for mosquito identification were obtained for all the three body parts assayed using MALDI-TOF MS profiling; however, the thorax and legs were the most suitable specimens, independently of homogenization method or species. Although the manual homogenization methods were associated with a high rate of identification on the three body parts, this homogenization mode is not adaptable to the processing of a large number of samples. Therefore, the automatic homogenization procedure was selected as the reference homogenization method. Blood-feeding status did not hamper the identification of mosquito species, despite the presence of MS peaks from original blood in the MS profiles of the three body parts tested from both species. Finally, a significant improvement in identification scores was obtained for field-collected specimens when MS spectra of species from the same geographical area were added to the database.

Conclusion

The results of the current study establish guidelines for the selection of mosquito anatomic parts and modality of sample preparation (e.g. homogenization) for future specimen identification by MALDI-TOF MS profiling. These standardized operational protocols could be used as references for creating an international MS database.