bluuebunny/crossref_metadata_2025 huggingface dataset:
Occupational Happiness of Civilian Nurses in China: a cross-sectional study
Authors: Meng Ying , Luo Xue , Sun Peng , Luo Yu , Wang Zonghua , Wang Lihua , Ge Yuhong , Lin Li
Published: July 2023

Background

Civilian nurses have gradually become the main body of military nurses. Our study aimed to understand their occupational happiness and its influencing factors.

Methods

This descriptive study was conducted with 319 civilian nurses working in 15 military hospitals in China. Based on literature review, expert consultation and combined with the characteristics of civilian positions, this study developed a questionnaire on occupational happiness of civilian nurses in military hospitals. The questionnaire includes 7 dimensions as follows: work emotion, salary, work environment, professional identity, work output, interpersonal relationship, well‑being. The demographic questionnaire and occupational well-being questionnaire of civilian nurses in military hospitals were analysed by t-test, analysis of variance and Pearson correlation analysis.

Results

The occupational happiness score (3.83 ± 0.56, upper limit score: 5) was at the upper middle level. There were significant differences in occupational well-being by gender (t = -2.668, p = 0.008), age (F = 5.085, p = 0.007) and the type of city where the hospital was located (F = 15.959, p < 0.0001). The happiness score of females (3.94 ± 0.60) was higher than that of males (3.47 ± 0.54). Nurses who were over 41 years old had the highest occupational happiness. Compared with nurses younger than 30 years old, the p value was 0.004. The occupational happiness of nurses in hospitals in a “prefecture-level city” (p < 0.0001) and a “sub-provincial city” (p < 0.0001) was significantly higher than that of nurses in hospitals in a “municipality directly under the central government”. Correlation analysis showed that the higher the nurses’ satisfaction with professional identity, work output, work environment, salary, and interpersonal relationships, the higher their occupational happiness.

Conclusion

Occupational happiness of civilian nurses in Chinese military hospitals was above the medium level. Gender, age, and the type of city where the hospital was located had a very significant impact on the level of occupational happiness. In addition, “professional identity”, “work output”, “work environment”, “salary”, and “interpersonal relationships” were significantly correlated with the occupational happiness of civilian nurses. They can be improved with some future lines of research.
The Full Value of Vaccine Assessments (FVVA): a framework for assessing and communicating the value of vaccines for investment and introduction decision-making
Authors: Hutubessy Raymond , Lauer Jeremy A. , Giersing Birgitte , Sim So Yoon , Jit Mark , Kaslow David , Botwright Siobhan
Published: July 2023

Background

Several economic obstacles can deter the development and use of vaccines. This can lead to limited product options for some diseases, delays in new product development, and inequitable access to vaccines. Although seemingly distinct, these obstacles are actually interrelated and therefore need to be addressed through a single over-arching strategy encompassing all stakeholders.

Methods

To help overcome these obstacles, we propose a new approach, the Full Value of Vaccines Assessments (FVVA) framework, to guide the assessment and communication of the value of a vaccine. The FVVA framework is designed to facilitate alignment across key stakeholders and to enhance decision-making around investment in vaccine development, policy-making, procurement, and introduction, particularly for vaccines intended for use in low- and middle-income countries.

Results

The FVVA framework has three key elements. First, to enhance assessment, existing value-assessment methods and tools are adapted to include broader benefits of vaccines as well as opportunity costs borne by stakeholders. Second, to improve decision-making, a deliberative process is required to recognize the agency of stakeholders and to ensure country ownership of decision-making and priority setting. Third, the FVVA framework provides a consistent and evidence-based approach that facilitates communication about the full value of vaccines, helping to enhance alignment and coordination across diverse stakeholders.

Conclusions

The FVVA framework provides guidance for stakeholders organizing global-level efforts to promote investment in vaccines that are priorities for LMICs. By providing a more holistic view of the benefits of vaccines, its application also has the potential to encourage greater take-up by countries, thereby leading to more sustainable and equitable impacts of vaccines and immunization programmes.
Analysis of phase III clinical trials in metastatic NSCLC to assess the correlation between QoL results and survival outcomes
Authors: Servetto Alberto , Di Maio Massimo , Salomone Fabio , Napolitano Fabiana , Paratore Chiara , Di Costanzo Fabrizio , Viscardi Giuseppe , Santaniello Antonio , Formisano Luigi , Bianco Roberto
Published: July 2023

Background

In addition to improving survival outcomes, new oncology treatments should lead to amelioration of patients’ quality of life (QoL). Herein, we examined whether QoL results correlated with PFS and OS outcomes in phase III randomized controlled trials (RCTs) investigating new systemic treatments in metastatic non-small cell lung cancer (NSCLC).

Methods

The systematic search of PubMed was conducted in October 2022. We identified 81 RCTs testing novel drugs in metastatic NSCLC and published in the English language in a PubMed-indexed journal between 2012 and 2021. Only trials reporting QoL results and at least one survival outcome between OS and PFS were selected. For each RCT, we assessed whether global QoL was “superior,” “inferior,” or with “non-statistically significant difference” in the experimental arm compared to the control arm.

Results

Experimental treatments led to superior QoL in 30 (37.0%) RCTs and inferior QoL in 3 (3.7%) RCTs. In the remaining 48 (59.3%) RCTs, a statistically significant difference between the experimental and control arms was not found. Of note, we found a statistically significant association between QoL and PFS improvements (X2 = 3.93, p = 0.0473). In more detail, this association was not significant in trials testing immunotherapy or chemotherapy. On the contrary, in RCTs testing target therapies, QoL results positively correlated with PFS outcomes (p = 0.0196). This association was even stronger in the 32 trials testing EGFR or ALK inhibitors (p = 0.0077). On the other hand, QoL results did not positively correlate with OS outcomes (X2 = 0.81, p = 0.368). Furthermore, we found that experimental treatments led to superior QoL in 27/57 (47.4%) trials with positive results and in 3/24 (12.5%) RCTs with negative results (p = 0.0028). Finally, we analyzed how QoL data were described in publications of RCTs in which QoL outcomes were not improved (n = 51). We found that a favorable description of QoL results was associated with sponsorship by industries (p = 0.0232).

Conclusions

Our study reveals a positive association of QoL results with PFS outcomes in RCTs testing novel treatments in metastatic NSCLC. This association is particularly evident for target therapies. These findings further emphasize the relevance of an accurate assessment of QoL in RCTs in NSCLC.
Adherence to healthy diet and risk of cardiovascular disease in adult survivors of childhood cancer in the St. Jude Lifetime Cohort: a cross-sectional study
Authors: Lan Tuo , Wang Mei , Ehrhardt Matthew J. , Jiang Shu , Lanctot Jennifer Q. , Armstrong Gregory T. , Hudson Melissa M. , Colditz Graham A. , Robison Leslie L. , Park Yikyung
Published: July 2023

Background

Whether diet has beneficial effects on cardiovascular disease (CVD) in childhood cancer survivors as in the general population is unknown. Therefore, we examined associations between dietary patterns and risk of CVD in adult survivors of childhood cancer.

Methods

Childhood cancer survivors, 18–65 years old in the St Jude Lifetime Cohort (1882 men and 1634 women) were included in the analysis. Dietary patterns were defined by the adherence to the Healthy Eating Index (HEI)–2015, Dietary Approaches to Stop Hypertension (DASH), and alternate Mediterranean diet (aMED) based on a food frequency questionnaire at study entry. CVD cases (323 in men and 213 in women) were defined as participants with at least one grade 2 or higher CVD-related diagnosis at baseline. Multivariable logistic regression adjusted for confounders was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of CVD.

Results

Greater adherence to HEI-2015 (OR=0.88, 95% CI: 0.75–1.03, per 10 score increment), DASH (OR=0.85, 95% CI: 0.71–1.01, per 10 score increment), and aMED (OR=0.92, 95% CI: 0.84–1.00, each score increment) were, albeit trending towards significance, associated with a lower risk of CVD in women. HEI-2015 was associated with a non-significantly lower risk of CVD in men (ORQ5 vs. Q1=0.80, 95% CI: 0.50–1.28). These dietary patterns were also associated with a lower risk of CVD in survivors with high underlying CVD risk.

Conclusions

As recommended to the general population, a diet rich in plant foods and moderate in animal foods needs to be a part of CVD management and prevention in childhood cancer survivors.
The impact of fasting stress hyperglycemia ratio, fasting plasma glucose and hemoglobin A1c on in-hospital mortality in patients with and without diabetes: findings from the China acute myocardial infarction registry
Authors: Cui Kongyong , Fu Rui , Yang Jingang , Xu Haiyan , Yin Dong , Song Weihua , Wang Hongjian , Zhu Chenggang , Feng Lei , Wang Zhifang , Wang Qingsheng , Lu Ye , Dou Kefei , Yang Yuejin ,   the CAMI Registry Investigators
Published: July 2023

Background

Stress hyperglycemia was positively associated with poor prognosis in individuals with acute myocardial infarction (AMI). However, admission glucose and stress hyperglycemia ratio (SHR) may not be the best indicator of stress hyperglycemia. We performed this study to evaluate the comparative prognostic value of different measures of hyperglycemia (fasting SHR, fasting plasma glucose [FPG], and hemoglobin A1c [HbA1c]) for in-hospital mortality in AMI patients with or without diabetes.

Methods

In this prospective, nationwide, multicenter China Acute Myocardial Infarction (CAMI) registry, 5,308 AMI patients including 2081 with diabetes and 3227 without diabetes were evaluated. Fasting SHR was calculated using the formula [(first FPG (mmol/l))/(1.59×HbA1c (%)-2.59)]. According to the quartiles of fasting SHR, FPG and HbA1c, diabetic and non-diabetic patients were divided into four groups, respectively. The primary endpoint was in-hospital mortality.

Results

Overall, 225 (4.2%) patients died during hospitalization. Individuals in quartile 4 had a significantly higher rate of in-hospital mortality compared with those in quartile 1 in diabetic cohort (9.7% vs. 2.0%; adjusted odds ratio [OR] 4.070, 95% CI 2.014–8.228) and nondiabetic cohort (8.8% vs. 2.2%; adjusted OR 2.976, 95% CI 1.695–5.224). Fasting SHR was also correlated with higher in-hospital mortality when treated as a continuous variable in diabetic and nondiabetic patients. Similar results were observed for FPG either as a continuous variable or a categorical variable. In addition, fasting SHR and FPG, rather than HbA1c, had a moderate predictive value for in-hospital mortality in patients with diabetes (areas under the curve [AUC] for fasting SHR: 0.702; FPG: 0.689) and without diabetes (AUC for fasting SHR: 0.690; FPG: 0.693). The AUC for fasting SHR was not significantly different from that of FPG in diabetic and nondiabetic patients. Moreover, adding fasting SHR or FPG to the original model led to a significant improvement in C-statistic regardless of diabetic status.

Conclusions

This study indicated that, in individuals with AMI, fasting SHR as well as FPG was strongly associated with in-hospital mortality regardless of glucose metabolism status. Fasting SHR and FPG might be considered as a useful marker for risk stratification in this population.

Trial registration: ClinicalTrials.gov NCT01874691.
Mode of transport, genetic susceptibility, and incidence of coronary heart disease
Authors: Jiesisibieke Zhu Liduzi , Panter Jenna , Wang Mengyao , Au Yeung Shiu Lun , Luo Shan , Jang Haeyoon , Wan Eric Yuk Fai , Brage Soren , Kim Youngwon
Published: July 2023

Background

Car use has been associated with higher risk of coronary heart disease (CHD). However, whether the associations of transport modes with CHD vary by genetic susceptibility to CHD are unknown. This study aims to investigate the associations of genetic susceptibility and modes of transport with incidence of CHD.

Methods

We included 339,588 white British participants from UK Biobank with no history of CHD or stroke at baseline or within two years of follow-up (52.3% in work). Genetic susceptibility to CHD was quantified through weighted polygenic risk scores derived from 300 single-nucleotide polymorphisms related to CHD risk. Categories of transport mode included exclusive car use and alternatives to the car (e.g., walking, cycling and public transport), separately for non-commuting (e.g., getting about [n=339,588] excluding commuting for work), commuting (in the sub-set in work [n=177,370] who responded to the commuting question), and overall transport (transport mode for both commuting and non-commuting [n=177,370]). We used Cox regression with age as the underlying timescale to estimate hazard ratios (HR) of CHD (n=13,730; median 13.8-year follow-up) and tested the interaction between genetic susceptibility and travel modes with adjustment for confounders.

Results

Compared to those using alternatives to the car, hazards of CHD were higher for exclusive use of cars for overall transport (HR: 1.16, 95% confidence interval (CI): 1.08-1.25), non-commuting (HR: 1.08, 95% CI: 1.04-1.12) and commuting (HR: 1.16, 95% CI: 1.09-1.23), after adjusting for confounders plus genetic susceptibility. HRs of CHD were 1.45 (95% CI: 1.38-1.52) and 2.04 (95% CI: 1.95-2.12) for the second and third tertile of genetic susceptibility to CHD, respectively, compared to the first. There was, in general, no strong evidence of interactions between genetic susceptibility and categories of overall, non-commuting and commuting transport. Estimated 10-year absolute risk of CHD was lower for the alternatives to the car across strata of genetic susceptibility, compared with exclusive use of cars for overall, non-commuting and commuting transport.

Conclusion

Exclusive use of cars was associated with a relatively higher risk of CHD across all strata of genetic susceptibility. Using alternatives to the car should be encouraged for prevention of CHD for the general population including individuals at high genetic risk.
Initial analysis of the synergy of programmed cell death-1 (PD-1) inhibitor and concurrent chemoradiotherapy treatment for recurrent/metastatic head and neck squamous cell carcinoma patients
Authors: Li Lu , Chen Lu , Yan Lu , Guo Yueqian , Li Fang , Fan Ming , Lan Mei , Lai Xin , Zhou Jie , Huang Yecai , Xu Peng , Lang Jinyi , Feng Mei
Published: July 2023

Background

Programmed cell death-1 (PD-1) inhibitor was proven to be useful for the recurrent/metastatic head and neck squamous carcinoma (R/M HNSCC) patients. Though both PD-1 inhibitor alone and combination with chemotherapy showed some benefit for PFS and OS, the survival outcome was still not satisfactory. Some studies showed the possible benefit for PD-1 inhibitors combination with radiation for head and neck squamous carcinoma, however there was few studies concerned about synergy of concurrent PD-1 inhibitor combination with chemoradiotherapy for R/M HNSCC. So, we aimed to explore the potential effect and toxicity of the concurrent PD-1 inhibitor and chemoradiotherapy for R/M HNSCC.

Methods

We consecutively enrolled the R/M HNSCC patients treated with concurrent PD-1 inhibitor and chemoradiotherapy from August 2018 to April 2022 in Sichuan Cancer hospital. All the patients received the combination of PD-1 inhibitor and chemotherapy, and followed with synergy of concurrent PD-1 inhibitor and chemoradiotherapy, then maintenance PD-1 inhibitor. ORR and DCR was calculated by immune-related Response Evaluation Criteria in Solid Tumors (irRECIST-1.1), and Common terminology criteria for adverse events (CTCAE-4.0) was used to evaluate the toxicity.The Kaplan–Meier method was used to analyze OS and PFS.

Results

40 R/M HNSCC patients were enrolled in our stuty. The median follow up time was 14 months. 22 patients had recurrent disease only, 16 patients had metastatic disease only, and 2 patients had both recurrence and metastasis disease. For the recurrent lesions, 23 patients received a median radiation dose of 64 Gy (range 50–70 Gy). 18 patients received a median dose of 45 Gy (range 30–66 Gy) for metastatic lesions. The median courses of PD-1 inhibitors and chemotherapy were 8 and 5 respectively. After the treatment, the ORR and DCR were 70.0% and 100%. The median OS was 19 months (range 6.3–31.7 months), with 1 and 2-years OS rates of 72.8% and 33.3%. The median PFS was 9 months (range 3.1–14.9 months), with 6 and 12 months PFS rates of 75.5% and 41.4% respectively. The PFS had no statistical significance in PD-L1 negative and positive group (7 vs 12 months, p = 0.059). The most common grade 3 or 4 adverse events(AE) were leucopenia (25.0%), neutropenia (17.5%), anemia (10.0%), thrombocytopenia (5.0%), hyponatremia (2.5%), and pneumonia(2.5%). No grade 5 AE was observed.

Conclusions

The synergy of concurrent PD-1 inhibitor treatment with chemoradiotherapy shows promise as a treatment strategy and an acceptable toxicity for the R/M HNSCC patients.
Overexpression of human alpha-Synuclein leads to dysregulated microbiome/metabolites with ageing in a rat model of Parkinson disease
Authors: Singh Yogesh , Trautwein Christoph , Romani Joan , Salker Madhuri S. , Neckel Peter H. , Fraccaroli Isabel , Abeditashi Mahkameh , Woerner Nils , Admard Jakob , Dhariwal Achal , Dueholm Morten K. D. , Schäfer Karl-Herbert , Lang Florian , Otzen Daniel E. , Lashuel Hilal A. , Riess Olaf , Casadei Nicolas
Published: July 2023

Background

Braak’s hypothesis states that sporadic Parkinson’s disease (PD) follows a specific progression of pathology from the peripheral to the central nervous system, and this progression can be monitored by detecting the accumulation of alpha-Synuclein (α-Syn) protein. Consequently, there is growing interest in understanding how the gut (commensal) microbiome can regulate α-Syn accumulation, as this could potentially lead to PD.

Methods

We used 16S rRNA and shotgun sequencing to characterise microbial diversity. 1H-NMR was employed to understand the metabolite production and intestinal inflammation estimated using ELISA and RNA-sequencing from feces and the intestinal epithelial layer respectively. The Na+ channel current and gut permeability were measured using an Ussing chamber. Immunohistochemistry and immunofluorescence imaging were applied to detect the α-Syn protein. LC-MS/MS was used for characterization of proteins from metabolite treated neuronal cells. Finally, Metascape and Ingenuity Pathway Analysis (IPA) bioinformatics tools were used for identification of dysregulated pathways.

Results

We studied a transgenic (TG) rat model overexpressing the human SNCA gene and found that a progressive gut microbial composition alteration characterized by the reduction of Firmicutes to Bacteroidetes ratio could be detected in the young TG rats. Interestingly, this ratio then increased with ageing. The dynamics of Lactobacillus and Alistipes were monitored and reduced Lactobacillus and increased Alistipes abundance was discerned in ageing TG rats. Additionally, the SNCA gene overexpression resulted in gut α-Syn protein expression and increased with advanced age. Further, older TG animals had increased intestinal inflammation, decreased Na+ current and a robust alteration in metabolite production characterized by the increase of succinate levels in feces and serum. Manipulation of the gut bacteria by short-term antibiotic cocktail treatment revealed a complete loss of short-chain fatty acids and a reduction in succinate levels. Although antibiotic cocktail treatment did not change α-Syn expression in the enteric nervous system of the colon, however, reduced α-Syn expression was detected in the olfactory bulbs (forebrain) of the TG rats.

Conclusion

Our data emphasize that the gut microbiome dysbiosis synchronous with ageing leads to a specific alteration of gut metabolites and can be modulated by antibiotics which may affect PD pathology.
Unexplained bacterial meat spoilage during the moose hunting in northern Norway – a review of cases 2008–2021
Authors: Josefsen Terje Domaas , Mørk Torill , Ims Anders Aarthun
Published: July 2023

Background

Sudden and unexpected spoilage of moose (Alces alces) carcasses has incidentally been reported in northern Norway. Hunters describe a strong foul odour and greenish discolouration of moose carcasses, hence the nickname “green moose”. Finnmark Estate has registered all reported cases of “green moose” in Finnmark county in the period 2008–2021. In 2013, a questionnaire was introduced to gather more detailed information. Bacteriological and histological examinations were performed on submitted samples of spoiled moose meat. The aim of the present report is to summarize the data gathered about the “green moose” cases, and to discuss possible causes.

Results

Ninety-three valid cases of “green moose” meat spoilage were registered in Finnmark county, giving this form of meat spoilage a prevalence of 0.85% of hunted moose. The carcass weights of spoiled carcasses were within normal weights for moose carcasses in Finnmark. Adult bulls were significantly more, and calves were less frequently affected by meat spoilage. No distinct geographical pattern or “hotspots” could be identified, but multiple cases in the same hunting area same year were reported. The meat spoilage was detected within 5 h after shooting in five cases, and 53% of cases were detected within 2 days after shooting. The meat spoilage was primarily found in deep muscle groups. Bacteriological analyses of 13 samples of spoiled meat were not conclusive. A mixture of aerobic bacteria was detected in 12 samples, and swarming clostridia in 10 samples. Histological examination of seven samples showed abundance of bacteria in fasciae and connective tissue surrounding blood vessels. Injury shootings were not more frequent in “green moose” cases than in moose hunting in general. Other possibly predisposing events to meat spoilage were evisceration later than 60 min after shooting, delayed skinning and contamination by ruminal content. Whether these events occurred more often in “green moose” than normal moose was difficult to determine, due to lack of reference data.

Conclusions

Based on the bacteriological results and the characteristics of the meat spoilage we suggest that clostridia are a main factor involved. How and why clostridia are spread to the muscles and causing the often rapid meat spoilage, is unexplained.
Independent prescribing in the UK: insights from the Department of Health Allied Health Professions Medicines Project team
Authors: Bristow Ivan , Bowen Catherine , Wilson Nicky , Borthwick Alan
Published: July 2023

Background

The UK medicines legislation was amended ten years ago (2013) to allow podiatrists and physiotherapists independent prescribing rights, the first of the allied health professions to do so. Non‐medical prescribing formed one part of a broader policy agenda promoting role flexibility in response to the challenge of an ageing population and the need to maintain effective health provision in the face of a contracting workforce.

Aim

The aim of this study was to outline the experiences of the Department of Health AHP medicines project board team in working towards independent prescribing for podiatry and physiotherapy, with a particular focus on the challenges encountered.

Methods

In depth, open‐ended interviews were conducted with eight of the core members of the project team, drawn from those individuals who served throughout the duration of the project (2010–2013). Included were the former Department of Health Chief and Deputy Chief Allied Health Professions Officers; the Department of Health Engagement and Communications Officer; representatives of the Health and Care Professions Council; the Medicines and Healthcare products Regulatory Agency; the Council of Deans of Health; the Royal College of Podiatry and the Chartered Society of Physiotherapy (The team also included the representative of the Allied Health Professions Federation. However, as that representative is also a researcher in this study, he has recused himself from any role as a participant.). Data were transcribed and subject to a thematic analysis.

Results

A complex picture of the project emerged revealing a range of obstacles and challenges, including inter‐professional role boundary tensions and negative prior assumptions about the two professions. Success hinged upon the adoption of a dual strategy involving submission of a robust case of need focused on patient benefit coupled with the careful management of professional expectations. Underpinning theory from the sociology of the professions offers a supportive explanatory framework for understanding the relationships between the various stakeholders involved.

Conclusions

Ultimately, success depended upon aligning the project aims with healthcare policy through a clear focus on patient benefit. Balancing competing professional and policy demands through a continual emphasis on improved patient care laid the foundations for future projects by other allied health professions.
Potential effects of assisted reproductive technology on telomere length and telomerase activity in human oocytes and early embryos
Authors: Tire Betul , Ozturk Saffet
Published: July 2023

Telomeres are repetitive DNA sequences at eukaryotic chromosome ends and function in maintaining genome integrity and stability. These unique structures undergo shortening due to various factors including biological aging, consecutive DNA replication, oxidative stress, and genotoxic agents. Shortened telomeres can be lengthened by the enzyme telomerase and alternative lengthening of telomeres in germ cells, early embryos, stem cells, and activated lymphocytes. If telomeres reach to critical length, it may lead to genomic instability, chromosome segregation defects, aneuploidy, and apoptosis. These phenotypes also occur in the oocytes and early embryos, produced using assisted reproductive technologies (ARTs). Thus, a number of studies have examined the potential effects of ART applications such as ovarian stimulation, culture conditions, and cryopreservation procedures on telomeres. Herein, we comprehensively reviewed impacts of these applications on telomere length and telomerase activity in ART-derived oocytes and embryos. Further, we discussed use of these parameters in ART centers as a biomarker in determining oocyte and embryo quality.
Long noncoding RNA PSMA3-AS1 functions as a competing endogenous RNA to promote gastric cancer progression by regulating the miR-329-3p/ALDOA axis
Authors: Kan Liang , Yang Meiqi , Zhang Huijing
Published: July 2023

LncRNA PSMA3-AS1 functions as an oncogene in several cancers, including ovarian cancer, lung cancer, and colorectal cancer. However, its role in gastric cancer (GC) progression remains unclear. In this study, the levels of PSMA3-AS1, miR-329-3p, and aldolase A (ALDOA) in 20 paired human GC tissues and adjacent nontumorous tissues were measured by real-time PCR. GC cells were transfected with recombinant plasmid carrying full-length PSMA3-AS1 or shRNA targeting PSMA3-AS1. The stable transfectants were selected by G418. Then, the effects of PSMA3-AS1 knockdown or overexpression on GC progression in vitro and in vivo were evaluated. The results showed that PSMA3-AS1 was highly expressed in human GC tissues. Stable knockdown of PSMA3-AS1 significantly restrained proliferation/migration/invasion, enhanced cell apoptosis, and induced oxidative stress in vitro. Tumor growth and matrix metalloproteinase expression in tumor tissues were markedly inhibited, while oxidative stress was enhanced in nude mice after stable PSMA3-AS1 knockdown. Additionally, PSMA3-AS1 negatively regulated miR-329-3p while positively regulated ALDOA expression. MiR-329-3p directly targeted ALDOA-3′UTR. Interestingly, miR-329-3p knockdown or ALDOA overexpression partially attenuated the tumor-suppressive effects of PSMA3-AS1 knockdown. Conversely, PSMA3-AS1 overexpression exhibited the opposite effects. PSMA3-AS1 promoted GC progression by regulating the miR-329-3p/ALDOA axis. PSMA3-AS1 might serve as a promising and effective target for GC treatment.
Seasonal variations of intensity of avian malaria infection in the Thousand Island Lake System, China
Authors: Han Yuxiao , Hellgren Olof , Wu Qiang , Liu Juan , Jin Tinghao , Bensch Staffan , Ding Ping
Published: July 2023

Background

Migratory birds play an important part in the spread of parasites, with more or less impact on resident birds. Previous studies focus on the prevalence of parasites, but changes in infection intensity over time have rarely been studied. As infection intensity can be quantified by qPCR, we measured infection intensity during different seasons, which is important for our understanding of parasite transmission mechanisms.

Methods

Wild birds were captured at the Thousand Island Lake with mist nets and tested for avian hemosporidiosis infections using nested PCR. Parasites were identified using the MalAvi database. Then, we used qPCR to quantify the infection intensity. We analyzed the monthly trends of intensity for all species and for different migratory status, parasite genera and sexes.

Results

Of 1101 individuals, 407 were infected (37.0%) of which 95 were newly identified and mainly from the genus Leucocytozoon. The total intensity trend shows peaks at the start of summer, during the breeding season of hosts and during the over-winter season. Different parasite genera show different monthly trends. Plasmodium causes high prevalence and infection intensity of winter visitors. Female hosts show significant seasonal trends of infection intensity.

Conclusions

The seasonal changes of infection intensity is consistent with the prevalence. Peaks occur early and during the breeding season and then there is a downward trend. Spring relapses and avian immunity are possible reasons that could explain this phenomenon. In our study, winter visitors have a higher prevalence and infection intensity, but they rarely share parasites with resident birds. This shows that they were infected with Plasmodium during their departure or migration and rarely transmit the disease to resident birds. The different infection patterns of different parasite species may be due to vectors or other ecological properties.

Graphical abstract
Comorbidity in incident osteoarthritis cases and matched controls using electronic health record data
Authors: Kamps Anne , Runhaar Jos , de Ridder Maria A. J. , de Wilde Marcel , van der Lei Johan , Zhang Weiya , Prieto-Alhambra Daniel , Englund Martin , de Schepper Evelien I. T. , Bierma-Zeinstra Sita M. A.
Published: July 2023

Background

Comorbidities are common in patients with osteoarthritis (OA). This study aimed to determine the association of a wide range of previously diagnosed comorbidities in adults with newly diagnosed OA compared with matched controls without OA.

Methods

A case–control study was conducted. The data were derived from an electronic health record database that contains the medical records of patients from general practices throughout the Netherlands. Incident OA cases were defined as patients with one or more diagnostic codes recorded in their medical records that correspond to knee, hip, or other/peripheral OA. Additionally, the first OA code had to be recorded between January 1, 2006, and December 31, 2019. The date of cases’ first OA diagnosis was defined as the index date. Cases were matched (by age, sex, and general practice) to up to 4 controls without a recorded OA diagnosis. Odds ratios were derived for each 58 comorbidities separately by dividing the comorbidity prevalence of cases by that of their matched controls at the index date.

Results

80,099 incident OA patients were identified of whom 79,937 (99.8%) were successfully matched with 318,206 controls. OA cases had higher odds for 42 of the 58 studied comorbidities compared with matched controls. Musculoskeletal diseases and obesity showed large associations with incident OA.

Conclusions

Most of the comorbidities under study had higher odds in patients with incident OA at the index date. While previously known associations were confirmed in this study, some associations were not described earlier.
Adipose-derived stem cell exosomes regulate Nrf2/Keap1 in diabetic nephropathy by targeting FAM129B
Authors: Ren Peiyao , Qian Fengmei , Fu Lanjun , He Wenfang , He Qiang , Jin Juan , Zheng Danna
Published: July 2023

Background

Exosomes from adipose-derived stem cells (ADSCs-Exos) have exhibited a therapeutic role in diabetic nephropathy (DN). Further studies are needed to investigate how ADSCs-Exos regulate oxidative stress and inflammation in high glucose-induced podocyte injury.

Methods

An enzyme-linked immunosorbent assay (ELISA) was used to detect cellular inflammation. Reactive oxygen species (ROS) levels were assessed using flow cytometry in podocytes with different treatments. A malondialdehyde (MDA) kit was used to evaluate the lipid peroxidation levels in podocytes and kidney tissues of mice. Western blotting and co-immunoprecipitation were performed to detect protein expression and protein-protein interactions.

Results

ADSCs-Exos reversed oxidative stress and inflammation in podocytes and kidney tissues of DN mice induced by high glucose levels in vitro and in vivo. Interference with heme oxygenase-1 expression could reverse the improvement effect of ADSCs-Exos on oxidative stress induced by high glucose levels. Furthermore, high glucose inhibited nuclear factor erythroid 2-related factor 2 (Nrf2) protein expression and promoted Kelch-like ECH-associated protein 1 (Keap1) protein expression in podocytes, as well as their binding ability. As a potential target for Nrf2/Keap1 pathway regulation, FAM129B expression in podocytes is regulated by high glucose and ADSCs-Exos. Moreover, FAM129B siRNA blocked the inhibitory effect of ADSCs-Exos on intracellular ROS and MDA upregulation induced by high glucose in podocytes.

Conclusion

ADSCs-Exos regulate the Nrf2/Keap1 pathway to alleviate inflammation and oxidative stress in DN by targeting FAM129B, which may provide a potential therapeutic strategy for DN.
Effect of static magnetic field therapy on diabetic neuropathy and quality of life: a double-blind, randomized trial
Authors: Nazeri Armin , Mohammadpour Ali , Modaghegh Mohammad-Hadi Saeed , Kianmehr Mojtaba
Published: July 2023

Background

Diabetic peripheral neuropathy (DPN) is a common complication of diabetes mellitus (DM) that can cause annoying symptoms. To address this condition, several treatment approaches have been proposed, including static magnetic field (SMF) therapy, which has shown promise in treating neurological conditions. Therefore, this study aimed to investigate the effects of SMF therapy on symptomatic DPN and the quality of life (QoL) in patients with type 2 diabetes.

Methods

A double-blind, randomized, placebo-controlled trial was conducted from April to October 2021. Sixty-four DPN patients (20 males, 44 females) were recruited for the study via invitation. The participants were divided into two groups: the magnet group, which used magnetic ankle bracelets (155 mT) for 12 weeks, and the sham group, which used non-magnetic ankle bracelets for the same duration. Neuropathy Symptom Score (NSS), Neuropathic Disability Score (NDS), and Visual Analogue Scale (VAS) were used to assess neuropathy symptoms and pain. In addition, the Neuropathy Specific Quality of Life Questionnaire (Neuro-QoL) tool was used to measure the patients’ quality of life.

Results

Before treatment, there were no significant differences between the magnet and sham groups in terms of the NSS scores (P = 0.50), NDS scores (P = 0.74), VAS scores (P = 0.17), and Neuro-QoL scores (P = 0.82). However, after 12 weeks of treatment, the SMF exposure group showed a significant reduction in NSS scores (P < 0.001), NDS scores (P < 0.001), VAS scores (P < 0.001), and Neuro-QoL scores (P < 0.001) compared to the baseline. The changes in the sham group, on the other hand, were not significant.

Conclusion

According to obtained data, SMF therapy is recommended as an easy-to-use and drug-free method for reducing DPN symptoms and improving QoL in diabetic type-2 patients.

Trial registration Registered at Iranian Registry of Clinical Trials: IRCT20210315050706N1, 2021/03/16.
Treatment patterns of antidiabetic and kidney protective therapies among patients with type 2 diabetes mellitus and chronic kidney disease in Colombia. The KDICO descriptive study
Authors: Machado-Duque Manuel E , Gaviria-Mendoza Andres , Valladales-Restrepo Luis F , Franco Juan Sebastian , de Rosario Forero Maria , Vizcaya David , Machado-Alba Jorge E
Published: July 2023

Background

Type 2 diabetes mellitus is one of the most common causes of chronic kidney disease (CKD) worldwide and prevalence of 1.75 per 100 inhabitants in Colombia. The aim of this study was to describe the treatment patterns of a group of patients with type 2 diabetes mellitus and CKD in an outpatient setting from Colombia.

Methods

A cross-sectional study in adult patients with type 2 diabetes mellitus and CKD identified in the Audifarma S.A. administrative healthcare database between April 2019 and March 2020 was performed. Sociodemographic, clinical and pharmacological variables were considered and analyzed.

Results

A total of 14,722 patients with type 2 diabetes mellitus and CKD were identified, predominantly male (51%), with a mean age of 74.7 years. The most common treatment patterns of type 2 diabetes mellitus included the use of metformin monotherapy (20.5%), followed by the combination of metformin + dipeptidyl peptidase-4 inhibitor (13.4%). Regarding the use of drugs with nephroprotective properties, the most prescribed treatments were angiotensin receptor blockers (67.2%), angiotensin converting enzyme inhibitors (15.8%), sodium glucose cotransporter 2 inhibitors (SGLT2i) (17.0%) and glucagon-like peptide-1 analogs (GLP1a) (5.2%).

Conclusion

In Colombia, the majority of patients with type 2 diabetes mellitus and CKD identified in this study were treated with antidiabetic and protective medications to ensure adequate metabolic, cardiovascular, and renal control. The management of type 2 diabetes mellitus and CKD may be improved if the beneficial properties of new groups of antidiabetics (SGLT2i, GLP1a), as well as novel mineralocorticoid receptor antagonists, are considered.
Chronic uterine inversion presenting with severe anemia 7 years after a home delivery and the subsequent successful pregnancy: a case report
Authors: Tolcha Fekata Defere , Dale Tufa Bube , Anbessie Tilahun Tufa
Published: July 2023

Background

Uterine inversion is a clinical condition characterized by the folding of the uterine fundus into the uterine cavity or beyond the cervix. Chronic uterine inversions that manifest seven years after delivery are extremely rare, despite the fact that both acute and chronic uterine inversions are infrequent. Unlike uterine inversion during parturition, which can be promptly managed, chronic uterine inversion poses a diagnostic and management challenge. We, herein, report a patient who was managed and followed at our institution for chronic uterine inversion.

Case presentation

A 28-year-old African female who was referred to our institution with complaints of secondary infertility for seven years, abnormal vaginal bleeding, and lower abdominal pain for 12 months with a mass-like sensation in the vagina. At presentation, she had pale conjunctiva and a protruded, rubbery mass in the cervix with indistinguishable cervical OS on vaginal examination. The patient was resuscitated with intravenous fluids and three units of blood, after which Haultain’s procedure was performed. After 16 months on a contraceptive, she was able to conceive and deliver a healthy neonate.

Conclusion

Severe anemia can rarely be a presenting symptom of chronic uterine inversion. Following a surgical procedure for chronic uterus inversion, a successful delivery is possible if thorough follow-up is carried out.
Regenerative potential of multinucleated cells: bone marrow adiponectin-positive multinucleated cells take the lead
Authors: Moein Shiva , Ahmadbeigi Naser , Adibi Rezvan , Kamali Sara , Moradzadeh Kobra , Nematollahi Pardis , Nardi Nance Beyer , Gheisari Yousof
Published: July 2023

Background

Polyploid cells can be found in a wide evolutionary spectrum of organisms. These cells are assumed to be involved in tissue regeneration and resistance to stressors. Although the appearance of large multinucleated cells (LMCs) in long-term culture of bone marrow (BM) mesenchymal cells has been reported, the presence and characteristics of such cells in native BM and their putative role in BM reconstitution following injury have not been fully investigated.

Methods

BM-derived LMCs were explored by time-lapse microscopy from the first hours post-isolation to assess their colony formation and plasticity. In addition, sub-lethally irradiated mice were killed every other day for four weeks to investigate the histopathological processes during BM regeneration. Moreover, LMCs from GFP transgenic mice were transplanted to BM-ablated recipients to evaluate their contribution to tissue reconstruction.

Results

BM-isolated LMCs produced mononucleated cells with characteristics of mesenchymal stromal cells. Time-series inspections of BM sections following irradiation revealed that LMCs are highly resistant to injury and originate mononucleated cells which reconstitute the tissue. The regeneration process was synchronized with a transient augmentation of adipocytes suggesting their contribution to tissue repair. Additionally, LMCs were found to be adiponectin positive linking the observations on multinucleation and adipogenesis to BM regeneration. Notably, transplantation of LMCs to myeloablated recipients could reconstitute both the hematopoietic system and BM stroma.

Conclusions

A population of resistant multinucleated cells reside in the BM that serves as the common origin of stromal and hematopoietic lineages with a key role in tissue regeneration. Furthermore, this study underscores the contribution of adipocytes in BM reconstruction.

Graphical Abstract
Hepatitis B vaccination status among health workers in Nigeria: a nationwide survey between January to June 2021
Authors: Issa Amudalat , Ayoola Yekeen Ayodele , Abdulkadir Mohammed Baba , Ibrahim Rasheed Olayinka , Oseni Tijani Idris Ahmad , Abdullahi Musa , Ibraheem Rasheedat Mobolaji , Lawal Aishat Funmi , Dele-ojo Bolade Folasade , Owolabi Bilkis Iyabo , Echieh Chidiebere Peter
Published: July 2023

Background

Hepatitis B vaccination is the most important preventive measure against Hepatitis B viral (HBV) infection. Vaccination against HBV infection among healthcare workers is important because of their daily exposure to patients’ body fluids and the possible risk of transmission to other patients. Hence, this study assessed the risk of hepatitis B infection, vaccination status and associated factors among healthcare workers in six geopolitical zones of Nigeria.

Methods

A nationwide cross-sectional study was conducted between January and June 2021 using electronic data capture techniques to enroll 857 healthcare workers (HCWs) in regular contact with patients and their samples through a multi-stage sampling method.

Results

The participants’ mean (SD) age was 38.7 (8.0) years, and 453 (52.9%) were female. Each of the six geopolitical zones in Nigeria had a fair representation, with a range of 15.3 to 17.7% of the study population. The majority (83.8%) of healthcare workers in Nigeria knew that they were at an increased risk of being infected by their work. Also, 72.2% knew that if infected, there was a high risk of liver cancer in later life. Many participants (642 [74.9%]) responded that they consistently applied standard precautions, such as hand washing, gloves, and face masks while attending to patients. Three hundred and sixty (42.0%) participants were fully vaccinated. Of the 857 respondents, 248 (28.9%) did not receive any dose of the hepatitis B vaccine. Factors that were associated with not being vaccinated included age less than 25 [adjusted odds ratio (AOR) 4.796, 95% CI 1.119 to 20.547, p = 0.035], being a nurse (AOR 2.346, 95% CI 1.446 to 3.808, p = 0.010), being a health attendant (AOR 9.225, 95% CI 4.532 to 18.778, p = 0.010), and being a healthcare worker from the Southeast (AOR 2.152, 95% CI 1.186 to 3.904, p = 0.012) in Nigeria.

Conclusion

This study showed a high level of awareness of the risks associated with hepatitis B infection and suboptimal uptake of the hepatitis B vaccine among healthcare workers in Nigeria.
Different COVID-19 treatments’ impact on hospital length of stay
Authors: Iwamoto Satori , Muhar Bahaar Kaur , Chen Hao , Chu Harrison , Johnstone Mason , Sidhu Ashwin , Chu Hillary , Fischer Joseph , Chu Gary
Published: July 2023

Importance

COVID-19 has adversely affected global healthcare infrastructure since 2019. Currently, there are no large-scale published reports on the efficacy of combination therapy of dexamethasone, remdesivir, and tocilizumab on COVID-19 patients.

Objectives

Is the combination therapy of dexamethasone, remdesivir, and tocilizumab superior to other treatments on hospitalized COVID-19 patients?

Design

This is a retrospective, comparative effectiveness study.

Setting

Single-center study

Participants/interventions

We analyzed different inpatient COVID-19 treatment options available in the United States and their impact on hospital length of stay (LOS) and mortality. Hospitalized COVID-19 were categorized as “mild,” “moderate” and “severe'' based on the highest level of oxygen required; room air, nasal cannula, or high flow/PAP/intubation, respectively. Patients were treated in accordance with the availability of medications and the latest treatment guidelines.

Main outcomes

The endpoints of the study are hospital discharges and death during hospitalization.

Results

1233 COVID-19 patients were admitted from 2020 to 2021. No treatment combinations showed a statistically significant decrease in hospital LOS in mild COVID-19 patients (p = 0.186). In moderate patients, the combination of remdesivir and dexamethasone slightly decreased LOS by 1 day (p = 0.007). In severe patients, the three-drug combination of remdesivir, dexamethasone, and tocilizumab decreased LOS by 8 days (p = 0.0034) when compared to nonviable treatments, such as hydroxychloroquine and convalescent plasma transfusion. However, it did not show any statistically significant benefit when compared to two-drug regimens (dexamethasone plus remdesivir) in severe COVID-19 (p = 0.116). No treatment arm appeared to show a statistically significant decrease in mortality for severe COVID-19 patients.

Conclusions

Our findings suggest that three-drug combination may decrease LOS in severe COVID-19 patients when compared to two-drug therapy. However, the trend was not supported by statistical analysis. Remdesivir may not be clinically beneficial for mild hospitalized COVID-19 patients; considering its cost, one could reserve it for moderate and severe patients. Triple drug therapies, while potentially reducing LOS for severe patients, do not affect overall mortality. Additional patient data may increase statistical power and solidify these findings.