bluuebunny/crossref_metadata_2025 huggingface dataset:
Mapping an Observation-Based Global Solar Irradiance Climatology across the Conterminous United States
Authors: Rupp David E. , Daly Christopher , Doggett Matthew K. , Smith Joseph I. , Steinberg Ben
Published: April 2022

The exponential growth in solar radiation measuring stations across the conterminous United States permits the generation of gridded solar irradiance data that capture the spatiotemporal variability of solar irradiance far more accurately than was previously possible from ground-based observations. Taking advantage of these observations, we generated a 30-yr climatology (1991–2020) of mean monthly global irradiance at a resolution of 30 arc s (∼800 m) on both a horizontal surface and a sloped ground surface. This paper describes the methods used to generate the gridded data, which include extensive quality control of station data, spatial interpolation of effective cloud transmittance using the “PRISM” method, and simulation of the effects of elevation, shading, and reflection from nearby terrain on solar irradiance. A comparison of the new dataset with several other solar radiation products reveals some spatial features in solar radiation that are either lacking or underresolved in some or all of the other datasets. Examples of these features include strong gradients near foggy coastlines and along mountain ranges where there is persistent orographically driven cloud formation. The workflow developed to create the long-term means will be used as a template for generating time series of monthly and daily solar radiation grids up to the present.
Aligning Trends in Climatic Parameters and Nomads’ Indigenous Knowledge about Climate Change in Central Iran (Case Study: Semirom Town)
Authors: Saboohi Razieh , Barani Hossein , Khodagholi Morteza , Sarvestani Ahmad Abedi , Tahmasebi Asghar , Feuer Hart Nadav
Published: April 2022

Nomadic pastoral communities are considered some of the most vulnerable to climate change. While Indigenous knowledge can play an effective role in mitigating or responding to some impacts of climate change, the extent of their capacity to adapt their livestock and rangeland management is under question. This research aims to assess the scope and applicability of climate change–related knowledge acquired in the management of summer rangeland, with a case study in Semirom, Isfahan Province, Iran. To do so, objective weather conditions (precipitation, minimum temperatures, and maximum temperatures) were evaluated using the Mann–Kendall nonparametric test and compared with subjective evaluations by nomad community members. Specifically, the study targeted a community of 7700 members of the Qashqai, a conglomeration of nomadic tribes in Iran. Their understanding of the weather was evaluated using focus groups and self-administered questionnaires, with a descriptive approach to data analysis. The findings of the climatic investigation revealed a possible shift in the climate in the study area, particularly in winter and autumn. The findings of subjective evaluation showed similar changes in wind, precipitation, and temperature to be the main characteristics of climate change in the region, with about 90% of informants directly citing decreasing precipitation and increasing temperature and wind speeds. The community evaluation also highlighted some adaptations to climate change, such as delays in beginning the seasonal migration, increased reliance on concrete homes, reservoir construction, decreasing livestock yields, and increasing diversification of resources to feed livestock. Understanding the perceptions of nomadic pastoralists, their meteorological basis, and ongoing climate adaptations can facilitate governmental planning.
Platelet-targeted thrombolysis for treatment of acute ischemic stroke
Authors: Palazzolo Jason S. , Ale Anukreity , Ho Heidi , Jagdale Shweta , Broughton Brad R. S. , Medcalf Robert L. , Wright David K. , Alt Karen , Hagemeyer Christoph E. , Niego Be’eri
Published: April 2022

Thrombolysis with tissue-type plasminogen activator (tPA) remains the main treatment for acute ischemic stroke. Nevertheless, tPA intervention is limited by a short therapeutic window, low recanalization rates, and a risk of intracranial hemorrhage (ICH), highlighting the clinical demand for improved thrombolytic drugs. We examined a novel thrombolytic agent termed “SCE5-scuPA,” comprising a single-chain urokinase plasminogen activator (scuPA) fused with a single-chain antibody (SCE5) that targets the activated glycoprotein IIb/IIIa platelet receptor, for its effects in experimental stroke. SCE5-scuPA was first tested in a whole blood clot degradation assay to show the benefit of platelet-targeted thrombolysis. The tail bleeding time, blood clearance, and biodistribution were then determined to inform the use of SCE5-scuPA in mouse models of photothrombotic stroke and middle cerebral artery occlusion against tenecteplase. The impacts of SCE5-scuPA on motor function, ICH, blood–brain barrier (BBB) integrity, and immunosuppression were evaluated. Infarct size was measured by computed tomography imaging and magnetic resonance imaging. SCE5-scuPA enhanced clot degradation ex vivo compared with its nonplatelet-targeting control. The maximal SCE5-scuPA dose that maintained hemostasis and a rapid blood clearance was determined. SCE5-scuPA administration both before and 2 hours after photothrombotic stroke reduced the infarct volume. SCE5-scuPA also improved neurologic deficit, decreased intracerebral blood deposits, preserved the BBB, and alleviated immunosuppression poststroke. In middle cerebral artery occlusion, SCE5-scuPA did not worsen stroke outcomes or cause ICH, and it protected the BBB. Our findings support the ongoing development of platelet-targeted thrombolysis with SCE5-scuPA as a novel emergency treatment for acute ischemic stroke with a promising safety profile.
Effects of 3 months of detraining following cardiac rehabilitation in patients with atrial fibrillation
Authors: Borland Maria , Bergfeldt Lennart , Cider Åsa , Rosenkvist Agneta , Jakobsson Marika , Olsson Kristin , Lundwall Adam , Andersson Lars , Nordeman Lena
Published: April 2022

Background

Atrial fibrillation negatively impacts physical fitness and health-related quality of life. We recently showed that 3 months of physiotherapist-led exercise-based cardiac rehabilitation improves physical fitness and muscle function in elderly patients with permanent atrial fibrillation and concomitant diseases. Little is, however, known about the consequences for physical fitness, physical activity level, and health-related quality of life after ending the rehabilitation period.

Methods

Prospective 3 months follow-up study of 38 patients out of 40 eligible (10 women) who, as part of a randomized controlled trial, had completed a 3 months physiotherapist-led cardiac rehabilitation resulting in improved physical fitness,. In the current study, the participants were instructed to refrain from exercise for 3 months after completion of the rehabilitation period. Primary outcome measure was physical fitness measured as highest achieved workload using an exercise tolerance test. Secondary outcome measures were muscle function (muscle endurance tests), physical activity level (questionnaire and accelerometer), and health-related quality of life, (Short Form-36), as in the preceding intervention study. We used the Wilcoxon Signed Rank test to analyse differences between the end of rehabilitation and at follow-up. The effect size was determined using Cohen’s d .

Results

Exercise capacity and exercise time significantly decresead between end of rehabilitation and at follow-up (p < .0001 for both). A significant reduction in shoulder flexion repetitions (p = .006) was observed as well as reduced health-related quality of life in the Short Form-36 dimensions Physical Function (p = .042), Mental Health (p = .030), and Mental Component Score (p = .035). There were, however, no changes regarding objective and subjective physical activity measurements.

Conclusion

In older patients with permanent atrial fibrillation, previously achieved improvements from physiotherapist-led exercise-based cardiac rehabilitation in physical fitness and muscle function were lost, and health-related quality of life was impaired after ending the rehabilitation period. A strategy for conserving improvements after a rehabilitation period is essential.
Effects of situated learning and clarification of misconceptions on contextual reasoning about natural selection
Authors: Aptyka Helena , Fiedler Daniela , Großschedl Jörg
Published: April 2022

Background

Natural selection is a core principle of evolution. Understanding natural selection enables students to think about the evolution and the variability of life. Despite its great importance, understanding natural selection is challenging for students. This is evident in the phenomenon of contextual reasoning, showing that students can often explain natural selection in one context (e.g., trait gain) but not in another (e.g., trait loss). The study pursues the following aims: First, to examine the link between contextual reasoning and situated learning. Second, to explore whether different instructional strategies differ in their associated cognitive load. Third, to investigate whether clarifying common misconceptions about natural selection (no vs. yes) is an effective strategy to regular instructions when aiming to increase key concepts and reduce misconceptions. Fourth, to exploratively examine the effectiveness of different instructional strategies.

Method

In a 2 × 2 factorial intervention study with a total of N = 373 secondary school students, we varied the instructional material of a 90-min intervention in terms of the evolutionary context (trait gain vs. trait loss) and the availability of additional support in the form of a clarification of misconceptions (no vs. yes). We measured students’ cognitive load immediately after instruction and assessed their ability to reason about natural selection (i.e., use of key concepts and misconceptions) later.

Results

We documented low knowledge about evolution in the pre-test and persisting misconceptions in the post-test. The results showed that the intervention context of trait loss elicited a higher intrinsic and extraneous cognitive load than trait gain. Moreover, when the clarification of misconceptions is analyzed in connection to the intervention context, it reveals a potential for reducing misconceptions in some contexts. Students who have learned in trait gain contexts with a clarification used significantly fewer misconceptions in later reasoning than students who learned in trait gain contexts without a clarification of misconceptions.

Conclusion

Our study creates new insights into learning about natural selection by outlining the complex interplay between situated learning, cognitive load, clarification of misconceptions, and contextual reasoning. Additionally, it advises researchers and educators on potential instructional strategies.
Analgesic effects of sufentanil in combination with flurbiprofen axetil and dexmedetomidine after open gastrointestinal tumor surgery: a retrospective study
Authors: Liu Fei , Li Ting-Ting , Yin Lu , Huang Jin , Chen Yan-Jun , Xiong Liu-Lin , Wang Ting-Hua
Published: April 2022

Background

To investigated the effects of sufentanil in combination with flurbiprofen axetil and dexmedetomidine for patient-controlled intravenous analgesia (PCIA) on patients after open gastrointestinal tumor surgery, and compared this combination with traditional PCIA with pure opioids or epidural analgesia (PCEA).

Methods

Patients (n = 640) who underwent open gastrointestinal tumor surgery and received patient-controlled analgesia (PCA) were included. According to the type of PCA, patients were assigned to three groups: MPCIA (PCIA with sufentanil, flurbiprofen axetil, dexmedetomidine and metoclopramide), OPCIA (PCIA with sufentanil, tramadol and metoclopramide) and PCEA group (PCEA with sufentanil and ropivacaine). The characteristics of patients, intraoperative use of analgesics, postoperative visual analogue scale (VAS), postoperative adverse reactions and postoperative recovery were collected. The primary outcome was postoperative VAS score. One-way ANOVA, Kruskal-Wallis H test, Fisher exact probability method, and binary logistic regression analysis were used for analysis.

Results

There were no significant differences in the characteristics of patients, operation time, tumor site and the use of postoperative rescue analgesics among the groups. In the first two days after open gastrointestinal tumor surgery, the VAS (expressed by median and interquartile range) of MPCIA (24th h, resting: 1,1; movement: 3,2. 48th h, resting: 0,1; movement: 2,1.) and PCEA (24th h, resting: 0,1; movement: 2,1. 48th h, resting: 0,1; movement: 2,2.) groups were significantly lower than those of OPCIA group (24th h, resting: 2.5,2; movement: 4,2. 48th h, resting: 1.5,1.75; movement: 3,1.) (all p <  0.01). The incidence of postoperative nausea and vomiting in MPCIA group was 13.6% on the first day after surgery, which was significantly higher than that in PCEA group. There was no significant difference in the incidence of other postoperative adverse events. Higher intraoperative sufentanil dosage (OR (95%CI) = 1.017 (1.002–1.031), p = 0.021), lower body mass index (OR (95%CI) = 2.081 (1.059–4.089), p = 0.033), and tumor location above duodenum (OR (95%CI) = 2.280 (1.445–3.596), p <  0.001) were associated with poor postoperative analgesia.

Conclusions

The analgesic effects of PCIA with sufentanil in combination with flurbiprofen axetil and dexmedetomidine on postoperative analgesia was better than that of traditional pure opioids PCIA, and similar with that of PCEA.
Safety assessment of a redirection program using an electronic application for low-acuity patients visiting an emergency department
Authors: Feral-Pierssens Anne-Laure , Morris Judy , Marquis Martin , Daoust Raoul , Cournoyer Alexis , Lessard Justine , Berthelot Simon , Messier Alexandre
Published: April 2022

Background

Emergency departments (EDs) are operating at or above capacity, which has negative consequences on patients in terms of quality of care and morbi-mortality. Redirection strategies for low-acuity ED patients to primary care practices are usually based on subjective eligibility criteria that sometimes necessitate formal medical assessment. Literature investigating the effect of those interventions is equivocal. The aim of the present study was to assess the safety of a redirection process using an electronic clinical support system used by the triage nurse without physician assessment.

Methods

A single cohort observational study was performed in the ED of a level 1 academic trauma center. All low-acuity patients redirected to nearby clinics through a clinical decision support system (February–August 2017) were included. This system uses different sets of medical prerequisites to identify patients eligible to redirection. Data on safety and patient experience were collected through phone questionnaires on day 2 and 10 after ED visit. The primary endpoint was the rate of redirected patients returning to any ED for an unexpected visit within 48 h. Secondary endpoints were the incidence of 7-day return visit and satisfaction rates.

Results

A total of 980 redirected low-acuity patients were included over the period: 18 patients (2.8%) returned unexpectedly to an ED within 48 h and 31 patients (4.8%) within 7 days. No hospital admission or death were reported within 7 days following the first ED visit. Among redirected patients, 81% were satisfied with care provided by the clinic staff.

Conclusion

The implementation of a specific electronic-guided decision support redirection protocol appeared to provide safe deferral to nearby clinics for redirected low-acuity patients. EDs are pivotal elements of the healthcare system pathway and redirection process could represent an interesting tool to improve the care to low-acuity patients.
The impact of retirement on inpatient healthcare utilization in Guangzhou, China: a regression discontinuity analysis of 189,031 health insurance claims
Authors: Zhao Xintong , Liu Yuehua , Zhang Xin , Bärnighausen Till , Chen Simiao
Published: April 2022

Background

Previous studies suggest that retirement, a major life event, affects overall healthcare utilization. We examine, the effects of retirement on inpatient healthcare utilization, including effect heterogeneity by gender, disease category, and type of health service.

Methods

We used routine health insurance claims data (N= 87,087) spanning the period 2021 - September 2013 from the Urban Employee Basic Medical Insurance (UEBMI), a mandatory social health insurance for working and retired employees in urban China. We applied a non-parametric fuzzy regression discontinuity design using the statutory retirement age in urban China as an exogenous instrument to measure the causal effect of retirement on six measures of inpatient healthcare utilization.

Results

Retirement reduced total hospital costs (-84.71 Chinese Yuan (CNY), 95% confidence interval (CI) -172.03 – 2.61), shortened length of hospital stays (-44.59, 95% CI -70.50 – -18.68), and increased hospital readmissions (0.06, 95% CI 0.00 – 0.12) and primary hospital visits (0.06, 95% CI 0.02 – 0.09) among women. Retirement did not significantly change inpatient healthcare utilization among men. The retirement effects among women varied by disease category. Specifically, retirement substantially increased hospitalizations for non-communicable diseases (NCDs), yet had only modest or no effect on hospitalizations for communicable diseases or injuries. Retirement effects among women also varied by the type of services. For relatively inexpensive services, such as nonoperative treatment, there were surges in the extensive margin (hospital readmission). For relatively expensive and invasive services, such as surgeries, retirement reduced the intensive margin (out-of-pocket expenditures and length of stay).

Conclusions

Retirement decreases overall use of inpatient healthcare for women. The examination on the disease-related heterogeneous effects helps with the introduction and implementation of integrated healthcare delivery and appropriate incentive schemes to encourage better use of healthcare resources among older adults.
Health outcomes and implementation barriers and facilitators of comprehensive geriatric assessment in community settings: a systematic integrative review [PROSPERO registration no.: CRD42021229953]
Authors: Sum Grace , Nicholas Sean Olivia , Nai Ze Ling , Ding Yew Yoong , Tan Woan Shin
Published: April 2022

Background

Comprehensive geriatric assessment (CGA) addresses the bio-psycho-social needs of older adults through multidimensional assessments and management. Synthesising evidence on quantitative health outcomes and implementation barriers and facilitators would inform practice and policy on CGA for community-dwelling older adults.

Methods

We systematically searched four medical and social sciences electronic databases for quantitative, qualitative, and mixed methods studies published from 1 January 2000 to 31 October 2020. Due to heterogeneity of articles, we narratively reviewed the synthesis of evidence on health outcomes and implementation barriers and facilitators.

Results

We screened 14,151 titles and abstracts and 203 full text articles, and included 43 selected articles. Study designs included controlled intervention studies (n = 31), pre-post studies without controls (n = 4), case-control (n = 1), qualitative methods (n = 3), and mixed methods (n = 4). A majority of articles studied populations aged ≥75 years (n = 18, 42%). CGAs were most frequently conducted in the home (n = 25, 58%) and primary care settings (n = 8, 19%). CGAs were conducted by nurses in most studies (n = 22, 51%). There was evidence of improved functional status (5 of 19 RCTs, 2 of 3 pre-post), frailty and fall outcomes (3 of 6 RCTs, 1 of 1 pre-post), mental health outcomes (3 of 6 RCTs, 2 of 2 pre-post), self-rated health (1 of 6 RCTs, 1 of 1 pre-post), and quality of life (4 of 17 RCTs, 3 of 3 pre-post). Barriers to implementation of CGAs involved a lack of partnership alignment and feedback, poor acceptance of preventive work, and challenges faced by providers in operationalising and optimising CGAs. The perceived benefits of CGA that served to facilitate its implementation included the use of highly skilled staff to provide holistic assessments and patient education, and the resultant improvements in care coordination and convenience to the patients, particularly where home-based assessments and management were performed.

Conclusion

There is mixed evidence on the quantitative health outcomes of CGA on community-dwelling older adults. While there is perceived positive value from CGA when carried out by highly skilled staff, barriers such as bringing providers into a partnership, greater acceptance of preventive care, and operational issues could impede its implementation.
Diagnostic value of metagenomic next-generation sequencing of bronchoalveolar lavage fluid for the diagnosis of suspected pneumonia in immunocompromised patients
Authors: Lin Pengcheng , Chen Yi , Su Shanshan , Nan Wengang , Zhou Lingping , Zhou Ying , Li Yuping
Published: April 2022

Background

To evaluate the diagnostic value of metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF) in immunocompromised patients for the diagnosis of suspected pneumonia in comparison with that of conventional microbiological tests (CMTs).

Methods

Sixty-nine immunocompromised patients with suspected pneumonia received both CMTs and mNGS of BALF were analyzed retrospectively. The diagnostic value was compared between CMTs and mNGS, using the clinical composite diagnosis as the reference standard.

Results

Sixty patients were diagnosed of pneumonia including fifty-two patients with identified pathogens and eight patients with probable pathogens. Taking the composite reference standard as a gold standard, 42 pathogens were identified by CMTs including nine bacteria, 17 fungi, 8 virus, 6 Mycobacterium Tuberculosis, and two Legionella and 19(45%) of which were detected by BALF culture. As for mNGS, it identified 76 pathogens including 20 bacteria, 31 fungi, 14 virus, 5 Mycobacterium Tuberculosis, four Legionella and two Chlamydia psittaci. The overall detection rate of mNGS for pathogens were higher than that of CMTs. However, a comparable diagnostic accuracy of mNGS and CMTs were found for bacterial and viral infections. mNGS exhibited a higher diagnostic accuracy for fungal detection than CMTs (78% vs. 57%, P < 0.05), which mainly because of the high sensitivity of mNGS in patients with Pneumocystis jirovecii pneumonia (PJP) (100% vs. 28%, P < 0.05). Nineteen patients were identified as pulmonary co-infection, mNGS test showed a higher detection rate and broader spectrum for pathogen detection than that of CMTs in co-infection. Moreover, Pneumocystis jirovecii was the most common pathogen in co-infection and mNGS have identified much more co-pathogens of PJP than CMTs.

Conclusions

mNGS of BALF improved the microbial detection rate of pathogens and exhibited remarkable advantages in detecting PJP and identifying co-infection in immunocompromised patients.
Extremely high levels of central nervous system involvement in miliary tuberculosis
Authors: Wang Guirong , Liang Ruixia , Sun Qing , Liao Xinlei , Wang Chenqian , Huang Hairong
Published: April 2022

Background

Miliary tuberculosis (TB) is one of the severest manifestations of TB that can be lethal when concomitant with the central nervous system (CNS) involvement. Bacteriological, biochemical and radiological methods for find CNS comorbidity in miliary TB was evaluated in this study.

Methods

Consecutive miliary TB adults were retrospectively enrolled from two designated TB hospitals in China. The capacities of examinations of cerebrospinal fluid (CSF), cerebral computed tomography (CT) and magnetic resonance imaging (MRI) for diagnosis of CNS involvement were assessed.

Results

Assessment of CNS involvement with a lumbar puncture and/or neuroimaging was undertaken in 282 out of 392 of acute miliary TB. Of these 282 patients, 87.59% (247/282) had CNS involvement. Cerebral contrast-enhanced MRI (96.05%, 170/177) and MRI (93.15%, 204/219) yielded significantly higher sensitivities over CSF examination (71.92%, 146/203, P < 0.001) and CT (34.69%, 17/49, P < 0.001). The sensitivity of CSF examination was superior to CT scan (P < 0.001). Although 59.65% (134/225) miliary TB patients acquired bacteriological evidence with sputum examination, the positivity was only 8.82% (21/238) for CSF examination by conventional and molecular tests.

Conclusion

Almost all miliary TB had CNS involvement and MRI demonstrated outstanding potential over other methods. Therefore, a routinely screening of CNS TB should be strongly suggested in miliary TB and MRI could be used as the initial approach in resources rich settings.
Circulating vaccine derived polio virus type 1 outbreak, Saadah governorate, Yemen, 2020
Authors: Al-Qassimi Mutahar Ahmed , Al Amad Mohammed , Anam Labiba , Almoayed Khaled , Al-Dar Ahmed , Ezzadeen Faten
Published: April 2022

Background

Yemen has faced one of the worst humanitarian crises in the world since the start of the war in 2015. In 2020; 30 Vaccine Derived Polio Virus type 1 (VDPV1) isolates were detected in Saadah governorate. The aims are to characterize the outbreak and address the gaps predisposing the emergence and circulation of VDPV1 in Saadah governorate, Yemen.

Method

A retrospective descriptive study of confirmed cases of VDPV1 between January and December 2020 was performed. Surveillance staff collected data from patient cases, contacts, as well as stool specimens that shipped to WHO accredited polio labs. Data of population immunity was also reviewed. The difference in days between the date of sample collection, shipment, and receiving lab result was used to calculate the average of delayed days for lab confirmation.

Results

From January to December 2020, a total of 114 cases of acute flaccid paralysis (AFP) were reported from 87% (13/15) districts, and cVDPV1 was confirmed among 26% (30) AFP cases. 75% (21) were < 5 years, 73% (20) had zero doses of Oral Polio Vaccine (OPV). The first confirmed case (3%) was from Saadah city, with paralysis onset at the end of January 2020 followed by 5 cases (17%) in March from another four districts, 8 cases (27%) in April, and 13 (43%) up to December 2020 were from the same five districts in addition to 3 (10%) form three new districts. The lab confirmation was received after an average of 126 days (71–196) from sample collection. The isolates differ from the Sabin 1 type by 17- 30 VP1 nucleotides (nt) and were linked to VDPV1 with 13 (nt) divergence that isolated in July 2020 from stool specimens collected before one year from contacts of an inadequate AFP case reported from Sahar district.

Conclusion

The new emerging VDPV1 was retrospectively confirmed after one year of sample collection from Sahar district. Delayed lab confirmation, as well as the response and low immunization profile of children against polio, were the main predisposing factors for cVDPV1 outbreak. This outbreak highlights the need to maintain regular biweekly shipments to referral polio labs in the short-term, and the exploration of other options in the longer-term to enable the Yemen National Lab to fully process national samples itself.
Sustained circulation of yellow fever virus in Cameroon: an analysis of laboratory surveillance data, 2010–2020
Authors: Nemg Fredy Brice Simo , Abanda Ngu Njei , Yonga Martial Gide , Ouapi Diane , Samme Ivis Ewang , Djoumetio Marlise Dontsop , Endegue-Zanga Marie Claire , Demanou Maurice , Njouom Richard
Published: April 2022

Background

The re-emergence of yellow fever poses a serious public health risk to unimmunized communities in the tropical regions of Africa and South America and unvaccinated travelers visiting these regions. This risk is further accentuated by the likely spread of the virus to areas with potential for yellow fever transmission such as in Asia, Europe, and North America. To mitigate this risk, surveillance of yellow fever is pivotal. We performed an analysis of laboratory-based surveillance of yellow fever suspected cases in Cameroon during 2010–2020 to characterize the epidemiology of yellow fever cases and define health districts at high risk.

Method

We reviewed IgM capture ELISA and plaque reduction neutralization test (PRNT) test results of all suspected yellow fever patients analyzed at Centre Pasteur of Cameroon, the national yellow fever testing laboratory, during 2010–2020.

Results

Of the 20,261 yellow fever suspected patient’s samples that were tested, yellow fever IgM antibodies were detected in 360 patients representing an annual average of 33 cases/year. A major increase in YF IgM positive cases was observed in 2015 and in 2016 followed by a decrease in cases to below pre-2015 levels. The majority of the 2015 cases occurred during the latter part of the year while those in 2016, occurred between February and May. This trend may be due to an increase in transmission that began in late 2015 and continued to early 2016 or due to two separate transmission events. In 2016, where the highest number of cases were detected, 60 health districts in the 10 regions of Cameroon were affected with the Littoral, Northwest and, Far North regions being the most affected. After 2016, the number of detected yellow fever IgM positive cases dropped.

Conclusion

Our study shows that yellow fever transmission continues to persist and seems to be occurring all over Cameroon with all 10 regions under surveillance reporting a case. Preventive measures such as mass vaccination campaigns and routine childhood immunizations are urgently needed to increase population immunity. The diagnostic limitations in our analysis highlight the need to strengthen laboratory capacity and improve case investigations.
Association of gut microbiota with idiopathic membranous nephropathy
Authors: Li Mengfei , Wei Lixue , Sun Jing , Zhu Qianshen , Yang He , Zhang Yu , Zhang Chao , Xi Lin , Zhao Rong , Du Xuanyi
Published: April 2022

Background

The prevalence of idiopathic membranous nephropathy (IMN) is increasing worldwide and the gut microbiota is recognized to play a role in its pathology. The aim of this study was to understand the involvement of the gut–kidney axis in IMN by analyzing the composition of the gut microbiota of biopsy-proven IMN patients compared with healthy controls (HC).

Methods

Fecal samples from 30 patients with IMN diagnosed by renal biopsy and 30 healthy co-residents (control group) were collected for analysis in the Nephrology Department of the Second Affiliated Hospital of Harbin Medical University. The microbiota composition was analyzed by a 16S rRNA microbial profiling approach.

Results

The results indicated that the α- and β-diversity of IMN patients differed significantly from those of the HC groups (P < 0.05). At the phylum level, IMN patients showed an increased abundance of Proteobacteria but a reduced abundance of Bacteroidota compared with the HC group. Actinobacteriota abundance showed a strong negative correlation with the estimated glomerular filtration rate. At the genus level, Faecalibacterium, Agathobacter, and Bacteroides were less abundant in the IMN group than in the HC group (LDA score > 2). Abundant bacterial functions related to lipid metabolism were observed among IMN group.

Conclusion

Patients with IMN appear to have an altered gut microbiome, which could provide reference for future research on the interaction mechanism between the intestinal flora and IMN.
Trends in hospitalization for pediatric hip arthroplasty: an epidemiological Nationwide study in Italy from 2001 to 2015
Authors: Longo Umile Giuseppe , Papalia Rocco , De Salvatore Sergio , Ruzzini Laura , Piergentili Ilaria , Salvatore Giuseppe , Candela Vincenzo , Denaro Vincenzo
Published: April 2022

Background

The epidemiology of Pediatric Hip Arthroplasty (PHA) is unclear. Prevalence of PHA in Europe was reported in Scandinavian registries, but data on this procedure are not described in other countries. Therefore, it is challenging to redact a complete and valid epidemiological report on PHA in Europe. Nevertheless, national health statistics for PHA are helpful for an international audience, as different treatments are reported between countries. Moreover, sharing national statistics and correlating those to other countries’ protocols could be helpful to compare outcomes for different procedures internationally. The principal purpose is to evaluate the yearly hospital admission for PHA in Italy.

Methods

Data of this study were collected from the National Hospital Discharge Reports (SDO) reported at the Italian Ministry of Health.

Results

From 2001 to 2015, 770 PHA hospitalizations were performed in Italy, with an incidence of 0.5 procedures for every 100,000 pediatric Italian inhabitants. The average age of patients was 15.2 ± 4.6 years. The mean length of days of hospitalization was 10.9 ± 8.6 days. The majority of patients were male of 15–19 years old age group. A progressive decrease in days of hospitalizations was found during the years of the study.

Conclusions

In Europe, the incidence of hospital admission for PHA is not fully described. There is a lack of consensus on the best type of surgery to perform on young patients. Epidemiological studies are helpful to understand the national variation of a specific surgical procedure and compare them with other countries.
Prevalence of smartphone addiction and its effects on subhealth and insomnia: a cross-sectional study among medical students
Authors: Liu Huan , Zhou Zhiqing , Huang Long , Zhu Ergang , Yu Liang , Zhang Ming
Published: April 2022

Objective

This study aimed to assess Chinese medical students’ smartphone addiction and its effects on subhealth and insomnia.

Methods

A cross-sectional survey was conducted from October 14, 2020 to November 14, 2020 by administering an online questionnaire to Wannan Medical College students.

Results

Of 2741 students who completed the survey, 1,447 (52.8%) had smartphone addiction. Medical specialty (p = 0.004), alcohol consumption (p = 0.001), smartphone use in bed (p = 0.000), depression (p = 0.000) and anxiety (p = 0.000) were strongly associated with smartphone addiction. The impacts of smartphone addiction on subhealth (p = 0.000) and insomnia (p = 0.000) were significant.

Conclusion

This survey shows that the smartphone addiction detection rate among medical students was 52.8%. Students who did not like their medical specialty, consumed alcohol, used their smartphones in bed, and suffered from depression and anxiety had a higher smartphone addiction detection rate. The subhealth and insomnia of medical students are adversely associated with smartphone addiction.
Oral health needs of U.S. children with developmental disorders: a population-based study
Authors: Obeidat Raghad , Noureldin Amal , Bitouni Anneta , Abdellatif Hoda , Lewis-Miranda Shirley , Liu Shuling , Badner Victor , Timothé Peggy
Published: April 2022

Background

Children with Special Health Care Needs (CSHCN) have higher rates of oral diseases and tooth decay compared with the general population. Children with developmental disorders/ disabilities (DD) are a subset of CSHCN whose oral health has not been specifically addressed. Therefore, this study had two objectives: to describe the oral health needs (OHN) of children with DD compared with children without DD; and to assess barriers to access to care, utilization of dental services, and their association with oral health needs for children with DD.

Methods

This cross-sectional study utilized a sample of 30,530 noninstitutionalized children from the 2018 National Survey of Children’s Health (NSCH). Analysis was conducted using descriptive and inferential statistics.

Results

The analysis identified 6501 children with DD and 24,029 children without DD. Children with DD had significantly higher prevalence of OHN (20.3% vs. 12.2%, respectively), unmet dental needs (3.5% vs 1.2%), and utilization of any dental visits (86.1% vs 76.1%), (P-value < . 001). The adjusted logistic model identified four factors that contributed to the higher odds of OHN among children with DD: poverty (< 100% of the Federal Poverty Level (AOR = 2.27, CI: 1.46–3.51), being uninsured (AOR = 2.12, 95% CI: 1.14–3.95), a high level of disability (AOR = 1.89, CI: 1.23–2.78), and living in the western United States (AOR = 1.61, CI: 1.09–2.37.

Conclusion

Despite higher utilization of dental services, children with DD had poorer oral health and more unmet dental needs than children without DD. Advocacy efforts and policy changes are needed to develop affordable access that assesses, as early as possible, children with DD whose conditions impact their ability a great deal so that their potential OHN may be alleviated more effectively.
Diagnostic value of miRNA expression and right ventricular echocardiographic functional parameters for chronic thromboembolic pulmonary hypertension with right ventricular dysfunction and injury
Authors: Miao Ran , Gong Juanni , Guo Xiaojuan , Guo Dichen , Zhang Xinyuan , Hu Huimin , Zhong Jiuchang , Yang Yuanhua , Li Yidan
Published: April 2022

Background

We aimed to establish the relationships between the expression of microRNAs (miRNAs) and echocardiographic right ventricular (RV) function parameters, and to explore the effectiveness and clinical value of miRNA expression in predicting RV injury and dysfunction in patients with chronic thromboembolic pulmonary hypertension (CTEPH).

Methods

In this retrospective study, clinical data were collected from eight CTEPH patients and eight healthy individuals. RV parameters on echocardiography were analyzed, and the expression levels of specific miRNAs were measured by quantitative real-time PCR. Correlation analysis was performed on structural and functional RV parameters and five candidate miRNAs (miR-20a-5p, miR-17-5p, miR-93-5p, miR-3202 and miR-665). The diagnostic value of RV functional parameters and miRNAs expression was assessed by receiver operating characteristic (ROC) curve analysis and C statistic.

Results

Among the tested miRNAs, miR-20a-5p expression showed the best correlation with echocardiographic RV functional parameters (P < 0.05), although the expression levels of miR-93-5p, miR-17-5p and miR-3202 showed positive associations with some RV parameters. ROC curve analysis demonstrated the ability of miR-20a-5p expression to predict RV dysfunction, with a maximum area under the curve of 0.952 (P = 0.003) when the predicted RV longitudinal strain was less than –20%. The C index for RV dysfunction prediction by the combination of miRNAs (miR-20a-5p, miR-93-5p and miR-17-5p) was 1.0, which was significantly larger than the values for miR-93-5p and miR-17-5p individually (P = 0.0337 and 0.0453, respectively).

Conclusion

Among the tested miRNAs, miR -20a-5p, miR -93-5p and miR -17-5p have potential value in the diagnosis of CTEPH based on the correlation between the abnormal expression of these miRNAs and echocardiographic parameters in CTEPH patients. miR-20a-5p showed the strongest correlation with echocardiographic RV functional parameters. Moreover, expression of a combination of miRNAs seemed to show excellent predictive power for RV dysfunction.
FOXO3a-ROS pathway is involved in androgen-induced proliferation of prostate cancer cell
Authors: Tao Yan , Liu Shanhui , Lu Jianzhong , Fu Shengjun , Li Lanlan , Zhang Jing , Wang Zhiping , Hong Mei
Published: April 2022

Background

Although FOXO3a can inhibit the cell proliferation of prostate cancer, its relationship with reactive oxygen species (ROS) in prostate cancer (PCa) has not been reported.

Methods

We analyzed the correlation between the expression of FOXO3a and the antioxidant enzyme catalase in prostate cancer with the TCGA and GEPIA databases. We also constructed a PPI network of FOXO3a via the STRING database. The mRNA and protein expression of FOXO3a and catalase were detected by qRT-PCR or western blotting in LNCaP and 22RV1 cells treated with DHT, R1881, or Enzalutamide. The effects of FOXO3a on catalase expression were tested by over-expressing or knocking down FOXO3a in LNCaP cells. Furthermore, the catalase activity and ROS level were detected in LNCaP cells treated with DHT. Cell proliferation and ROS were also analyzed in LNCaP which was treated with antioxidant.

Results

Results showed that the catalase expression was down-regulated in prostate cancer. A positive correlation between FOXO3a and catalase existed. DHT treatment could significantly reduce FOXO3a and catalase expression at mRNA and protein level in LNCaP cells. Catalase expression partly depended on FOXO3a as over-expression and knockdown of FOXO3a could result in the expresssion change of catalase. DHT treatment was found to inhibit catalase activity and increase ROS level in prostate cancer cell. Our study also demonstrated that antioxidant treatment reduced DHT-induced proliferation and ROS production in prostate cancer cell.

Conclusions

We discovered a novel mechanism by which DHT promotes prostate cancer cell proliferation via suppressing catalase activity and activating ROS signaling via a FOXO3a dependent manner.
Clinicopathological study of 1000 biopsied gingival lesions among dental outpatients: a 22-year retrospective study
Authors: Montazer Lotf-Elahi Mohammad-Salar , Farzinnia Golnoush , Jaafari-Ashkavandi Zohreh
Published: April 2022

Background

Up to now, limited research has been done on a significant number of cases with all types of gingival lesion. Besides, the available literature does not provide reliable data on the epidemiology of gingival lesions, especially non-reactive lesions. Thus, the present study aimed to analyze the frequency and distribution of gingival lesions in an Iranian population.

Methods

This retrospective study was conducted on 1000 gingival biopsy samples during 22 years. All lesion types were evaluated in terms of location, clinical signs and symptoms, and patients’ age and gender. The data were analyzed using descriptive statistics and chi-square test.

Results

Out of the 5284 oral lesions, 1000 (18.92%) gingival lesions were detected, with a female dominance (64.06%). The incidence peak (35.6%) was observed in the third and fourth decades. Non-neoplastic lesions accounted for 92.4% of the cases. The most common reports were related to reactive lesions (71.8%), with the highest prevalence being related to pyogenic granuloma. Additionally, oral squamous cell carcinoma (OSCC) was the most common neoplasm, and exophytic changes and color changes were the most frequent clinical signs.

Conclusions

The study findings indicated the high prevalence of gingival pathological lesions. Although most biopsies were reactive in nature, a few cases were malignant, which must be considered by practitioners. Further research is needed to achieve a clear impression about non-neoplastic lesions so as to develop more helpful oral health planning.
How can we compare multispecies livestock rearing households? – an analysis of the impact of health and production parameters on multispecies livestock rearing outcomes
Authors: Win Tu Tu Zaw , Campbell Angus , Soares Magalhaes Ricardo J. , Oo Kyaw Naing , Henning Joerg
Published: April 2022

Background

The Central Dry Zone (CDZ) of Myanmar is a critical region of livestock production. This region supports 10 million people whose livelihoods depend on small-scale, dry-land agriculture, but it is also one of the poorest regions of Myanmar. Little is known about the constraints to animal health in multi-species livestock farms in this region or the relationships between husbandry practices and measures of the success of livestock rearing such as income, and successful health management.

Results

In this study, we describe associations between husbandry practices and animal health problems affecting different body systems. We also develop a biosecurity and livestock disease prevention index by taking account of different activities (i.e. treatment, vaccination, reducing disease transmission practice, sanitation) that can be compared between livestock species, estimate the income generated from livestock production, and identify factors influencing these parameters. Cross-sectional study was used to collect data on livestock production and health from cattle (N = 382), sheep, goat (N = 303) and village chicken (N = 327) farmers in 40 villages of the CDZ. Survey-design based techniques and F-statistics, ordinal, and binomial regression were used for data analysis. Our results indicate that a significant proportion of farmers’ income in the CDZ comes from crop production (43.2%) and livestock production (23.1%) and the rest of the farmers’ income is derived from trading, supported by other relatives and employment. Our results indicate that animal health management practices, herd/flock size, and experience of farmers contributed significantly to the presence of animal health problems, in particular related to the physical, respiratory and digestive systems. Animal health management was usually conducted in traditional ways. Among different livestock species farms, cattle farms (cattle median BDPI: 45; IQR: 35–55) practised better biosecurity than other livestock species farms (i.e. small ruminant and village chicken farms) (small ruminant and village chicken BDPI: 10; IQR: 0–20). Interestingly, the ownership groups (i.e. rearing singly or multispecies) did not show any impact on biosecurity and disease prevention index of the farms.

Conclusions

This study identified good practice households and these findings will be useful for designing intervention trials to improve the production and health outcomes evaluated in this study.
Biological causes of immunogenic cancer cell death (ICD) and anti-tumor therapy; Combination of Oncolytic virus-based immunotherapy and CAR T-cell therapy for ICD induction
Authors: Mardi Amirhossein , Shirokova Anastasia V. , Mohammed Rebar N. , Keshavarz Ali , Zekiy Angelina O. , Thangavelu Lakshmi , Mohamad Talar Ahmad Merza , Marofi Faroogh , Shomali Navid , Zamani Amir , Akbari Morteza
Published: April 2022

Chimeric antigen receptor (CAR) T-cell therapy is a promising and rapidly expanding therapeutic option for a wide range of human malignancies. Despite the ongoing progress of CAR T-cell therapy in hematologic malignancies, the application of this therapeutic strategy in solid tumors has encountered several challenges due to antigen heterogeneity, suboptimal CAR T-cell trafficking, and the immunosuppressive features of the tumor microenvironment (TME). Oncolytic virotherapy is a novel cancer therapy that employs competent or genetically modified oncolytic viruses (OVs) to preferentially proliferate in tumor cells. OVs in combination with CAR T-cells are promising candidates for overcoming the current drawbacks of CAR T-cell application in tumors through triggering immunogenic cell death (ICD) in cancer cells. ICD is a type of cellular death in which danger-associated molecular patterns (DAMPs) and tumor-specific antigens are released, leading to the stimulation of potent anti-cancer immunity. In the present review, we discuss the biological causes of ICD, different types of ICD, and the synergistic combination of OVs and CAR T-cells to reach potent tumor-specific immunity.