bluuebunny/crossref_metadata_2025 huggingface dataset:
Process and costs for readiness to safely implement immediate kangaroo mother care: a mixed methods evaluation from the OMWaNA trial at five hospitals in Uganda
Authors: Medvedev Melissa M. , Tumukunde Victor , Kirabo-Nagemi Charity , Greco Giulia , Mambule Ivan , Katumba Kenneth , Waiswa Peter , Tann Cally J. , Elbourne Diana , Allen Elizabeth , Ekirapa-Kiracho Elizabeth , Pitt Catherine , Lawn Joy E.
Published: June 2023

Background

Preterm birth complications result in > 1 million child deaths annually, mostly in low- and middle-income countries. A World Health Organisation (WHO)-led trial in hospitals with intensive care reported reduced mortality within 28 days among newborns weighing 1000–1799 g who received immediate kangaroo mother care (iKMC) compared to those who received standard care. Evidence is needed regarding the process and costs of implementing iKMC, particularly in non-intensive care settings.

Methods

We describe actions undertaken to implement iKMC, estimate financial and economic costs of essential resources and infrastructure improvements, and assess readiness for newborn care after these improvements at five Ugandan hospitals participating in the OMWaNA trial. We estimated costs from a health service provider perspective and explored cost drivers and cost variation across hospitals. We assessed readiness to deliver small and sick newborn care (WHO level-2) using a tool developed by Newborn Essential Solutions and Technologies and the United Nations Children’s Fund.

Results

Following the addition of space to accommodate beds for iKMC, floor space in the neonatal units ranged from 58 m2 to 212 m2. Costs of improvements were lowest at the national referral hospital (financial: $31,354; economic: $45,051; 2020 USD) and varied across the four smaller hospitals (financial: $68,330-$95,796; economic: $99,430-$113,881). In a standardised 20-bed neonatal unit offering a level of care comparable to the four smaller hospitals, the total financial cost could be in the range of $70,000 to $80,000 if an existing space could be repurposed or remodelled, or $95,000 if a new unit needed to be constructed. Even after improvements, the facility assessments demonstrated broad variability in laboratory and pharmacy capacity as well as the availability of essential equipment and supplies.

Conclusions

These five Ugandan hospitals required substantial resource inputs to allow safe implementation of iKMC. Before widespread scale-up of iKMC, the affordability and efficiency of this investment must be assessed, considering variation in costs across hospitals and levels of care. These findings should help inform planning and budgeting as well as decisions about if, where, and how to implement iKMC, particularly in settings where space, devices, and specialised staff for newborn care are unavailable.

Trial registration

ClinicalTrials.gov, NCT02811432. Registered: 23 June 2016.
NIR/pH-triggered aptamer-functionalized DNA origami nanovehicle for imaging-guided chemo-phototherapy
Authors: Li Mengyue , Yang Geng , Zheng Yue , Lv Jiazhen , Zhou Wanyi , Zhang Hanxi , You Fengming , Wu Chunhui , Yang Hong , Liu Yiyao
Published: June 2023

Targeted chemo-phototherapy has received widespread attention in cancer treatment for its advantages in reducing the side effects of chemotherapeutics and improving therapeutic effects. However, safe and efficient targeted-delivery of therapeutic agents remains a major obstacle. Herein, we successfully constructed an AS1411-functionalized triangle DNA origami (TOA) to codeliver chemotherapeutic drug (doxorubicin, DOX) and a photosensitizer (indocyanine green, ICG), denoted as TOADI (DOX/ICG-loaded TOA), for targeted synergistic chemo-phototherapy. In vitro studies show that AS1411 as an aptamer of nucleolin efficiently enhances the nanocarrier’s endocytosis more than 3 times by tumor cells highly expressing nucleolin. Subsequently, TOADI controllably releases the DOX into the nucleus through the photothermal effect of ICG triggered by near-infrared (NIR) laser irradiation, and the acidic environment of lysosomes/endosomes facilitates the release. The downregulated Bcl-2 and upregulated Bax, Cyt c, and cleaved caspase-3 indicate that the synergistic chemo-phototherapeutic effect of TOADI induces the apoptosis of 4T1 cells, causing ~ 80% cell death. In 4T1 tumor-bearing mice, TOADI exhibits 2.5-fold targeted accumulation in tumor region than TODI without AS1411, and 4-fold higher than free ICG, demonstrating its excellent tumor targeting ability in vivo. With the synergetic treatment of DOX and ICG, TOADI shows a significant therapeutic effect of ~ 90% inhibition of tumor growth with negligible systemic toxicity. In addition, TOADI presents outstanding superiority in fluorescence and photothermal imaging. Taken together, this multifunctional DNA origami-based nanosystem with the advantages of specific tumor targeting and controllable drug release provides a new strategy for enhanced cancer therapy.
‘A recipe for cultural disaster!’– a case study of Woolworths Group’s proposal to build an alcohol megastore in Darwin, Northern Territory
Authors: Crocetti Alessandro Connor , Cubillo Beau , Walker Troy , Mitchell Fiona , Paradies Yin , Backholer Kathryn , Browne Jennifer
Published: June 2023

Background

The health and wellbeing impacts of commercial activity on Indigenous populations is an emerging field of research. The alcohol industry is a key driver of health and social harms within Australia. In 2016 Woolworths, the largest food and beverage retailer in Australia, proposed to build a Dan Murphy’s alcohol megastore in Darwin, near three ‘dry’ Aboriginal communities. This study examines the tactics used by Woolworths to advance the Dan Murphy’s proposal and understand how civil society action can overcome powerful commercial interests to protect Aboriginal and Torres Strait Islander health and wellbeing.

Methods

Data from 11 interviews with Aboriginal and non-Aboriginal informants were combined with data extracted from media articles and government, non-government and industry documents. Thematic analysis was informed by an adapted corporate health impact assessment framework.

Results

Woolworths employed several strategies including lobbying, political pressure, litigation, and divisive public rhetoric, while ignoring the evidence suggesting the store would increase alcohol-related harm. The advocacy campaign against the proposal highlighted the importance of Aboriginal and non-Aboriginal groups working together to counter commercial interests and the need to champion Aboriginal leadership. Advocacy strategies included elevating the voices of community Elders in the media and corporate activism via Woolworths’ investors.

Conclusions

The strategies used by the coalition of Aboriginal and non-Aboriginal groups may be useful in future advocacy campaigns to safeguard Aboriginal and Torres Strait Islander health and wellbeing from commercial interests.
Clinical examination, ultrasound assessment and aspiration of knee effusion in primary knee osteoarthritis patients
Authors: Elsawy Noha Abdelhalim , Ibrahiem Aya Hanafy , Younis Gihan Abdellatif , Meheissen Marwa Ahmed , Abdel-Fattah Yousra Hisham
Published: June 2023

Background

To assess the diagnostic performance of clinical examination and ultrasound (US) assessment of knee effusion in primary knee osteoarthritis (KOA) patients. Furthermore, the success rate for effusion aspiration and the factors related to it were investigated.

Methods

This cross-sectional study included patients diagnosed with primary KOA-induced knee effusion clinically or sonographically. The affected knee of each patient was subjected to clinical examination and US assessment using the ZAGAZIG effusion and synovitis ultrasonographic score. Patients with confirmed effusion and consented to aspiration were prepared for direct US-guided aspiration under complete aseptic techniques.

Results

One hundred and nine knees were examined. During visual inspection, swelling was detected in 80.7% of knees and effusion was confirmed by US in 67.8% of knees. Visual inspection was the most sensitive at 90.54% while bulge sign was the most specific at 65.71%. Only 48 patients (61 knees) consented to aspiration procedure; 47.5% had grade III effusion, and 45.9% had grade III synovitis. Successful aspiration was achieved in 77% of knees. Two needle types were used; a 22 gauge / 3.5-inch spinal needle in 44 knees and an 18 gauge/ 1.5-inch needle in 17 knees, with a success rate of 90.9% and 41.2%, respectively. Aspirated amount of synovial fluid correlated positively with effusion grade (rs=0.455, p < 0.001) and negatively with synovitis grade on US (rs = − 0.329, p = 0.01).

Conclusions

The superiority of the US over clinical examination in detecting knee effusion suggests that US should be used routinely to confirm the presence of effusion. Long needles (spinal needle) may have a higher success rate of aspiration than shorter needles.
Mechanisms of glabridin inhibition of integrin αIIbβ3 inside-out signals and NF-κB activation in human platelets
Authors: Huang Wei-Chieh , Jayakumar Thanasekaran , Sheu Joen-Rong , Hsia Chih-Wei , Hsia Chih-Hsuan , Yen Ting-Lin , Chang Chao-Chien
Published: June 2023

Background

Platelets play a crucial role in cardiovascular diseases (CVDs) and are activated by endogenous agonists like collagen. These agonists initiate signal transduction through specific platelet receptors, resulting in platelet aggregation. Glabridin, a prenylated isoflavonoid found in licorice root, is known for its significance in metabolic abnormalities. Glabridin has been observed to inhibit collagen-induced platelet aggregation, but the precise mechanisms, specifically concerning NF-κB activation and integrin αIIbβ3 signaling, are not yet fully understood.

Methods

In this study, platelet suspensions were prepared from healthy human blood donors, and the aggregation ability was observed using a lumi-aggregometer. The inhibitory mechanisms of glabridin in human platelets were evaluated through immunoblotting and confocal microscopy. The anti-thrombotic effects of glabridin were assessed by histological analysis of lung sections in acute pulmonary thromboembolism and by examining fluorescein-induced platelet plug formation in mesenteric microvessels in mice.

Results

Glabridin inhibited integrin αIIbβ3 inside-out signals such as Lyn, Fyn, Syk, and integrin β3 activation and NF-κB-mediated signal events, with similar potency to classical inhibitors BAY11-7082 and Ro106-9920. Glabridin and BAY11-7082 inhibited IKK, IκBα, and p65 phosphorylation and reversed IκBα degradation, while Ro106-9920 only reduced p65 phosphorylation and reversed IκBα degradation. BAY11-7082 reduced Lyn, Fyn, Syk, integrin β3, phospholipase Cγ2 and protein kinase C activation. Glabridin reduced platelet plug formation in mesenteric microvessels and occluded vessels in thromboembolic lungs of mice.

Conclusion

Our study revealed a new pathway for activating integrin αIIbβ3 inside-out signals and NF-κB, which contributes to the antiplatelet aggregation effect of glabridin. Glabridin could be a valuable prophylactic or clinical treatment option for CVDs.
Laboratory performance of genome-wide cfDNA for copy number variants as compared to prenatal microarray
Authors: Soster Erica , Tynan John , Gibbons Clare , Meschino Wendy , Wardrop Jenna , Almasri Eyad , Schwartz Stuart , McLennan Graham
Published: June 2023

Background

Noninvasive prenatal testing (NIPT) allows for screening of fetal aneuploidy and copy number variants (CNVs) from cell-free DNA (cfDNA) in maternal plasma. Professional societies have not yet embraced NIPT for fetal CNVs, citing a need for additional performance data. A clinically available genome-wide cfDNA test screens for fetal aneuploidy and CNVs larger than 7 megabases (Mb).

Results

This study reviews 701 pregnancies with “high risk” indications for fetal aneuploidy which underwent both genome-wide cfDNA and prenatal microarray. For aneuploidies and CNVs considered ‘in-scope’ for the cfDNA test (CNVs ≥ 7 Mb and select microdeletions), sensitivity and specificity was 93.8% and 97.3% respectively, with positive and negative predictive values of 63.8% and 99.7% as compared to microarray. When including ‘out-of-scope’ CNVs on array as false negatives, the sensitivity of cfDNA falls to 48.3%. If only pathogenic out-of-scope CNVs are treated as false negatives, the sensitivity is 63.8%. Of the out-of-scope CNVs identified by array smaller than 7 Mb, 50% were classified as variants of uncertain significance (VUS), with an overall VUS rate in the study of 2.29%.

Conclusions

While microarray provides the most robust assessment of fetal CNVs, this study suggests that genome-wide cfDNA can reliably screen for large CNVs in a high-risk cohort. Informed consent and adequate pretest counseling are essential to ensuring patients understand the benefits and limitations of all prenatal testing and screening options.
ScInfoVAE: interpretable dimensional reduction of single cell transcription data with variational autoencoders and extended mutual information regularization
Authors: Pan Weiquan , Long Faning , Pan Jian
Published: June 2023

Single-cell RNA-sequencing (scRNA-seq) data can serve as a good indicator of cell-to-cell heterogeneity and can aid in the study of cell growth by identifying cell types. Recently, advances in Variational Autoencoder (VAE) have demonstrated their ability to learn robust feature representations for scRNA-seq. However, it has been observed that VAEs tend to ignore the latent variables when combined with a decoding distribution that is too flexible. In this paper, we introduce ScInfoVAE, a dimensional reduction method based on the mutual information variational autoencoder (InfoVAE), which can more effectively identify various cell types in scRNA-seq data of complex tissues. A joint InfoVAE deep model and zero-inflated negative binomial distributed model design based on ScInfoVAE reconstructs the objective function to noise scRNA-seq data and learn an efficient low-dimensional representation of it. We use ScInfoVAE to analyze the clustering performance of 15 real scRNA-seq datasets and demonstrate that our method provides high clustering performance. In addition, we use simulated data to investigate the interpretability of feature extraction, and visualization results show that the low-dimensional representation learned by ScInfoVAE retains local and global neighborhood structure data well. In addition, our model can significantly improve the quality of the variational posterior.
MiR-494 induces metabolic changes through G6pc targeting and modulates sorafenib response in hepatocellular carcinoma
Authors: Bergamini Christian , Leoni Ilaria , Rizzardi Nicola , Melli Mattia , Galvani Giuseppe , Coada Camelia Alexandra , Giovannini Catia , Monti Elisa , Liparulo Irene , Valenti Francesca , Ferracin Manuela , Ravaioli Matteo , Cescon Matteo , Vasuri Francesco , Piscaglia Fabio , Negrini Massimo , Stefanelli Claudio , Fato Romana , Gramantieri Laura , Fornari Francesca
Published: June 2023

Background

Metabolic reprogramming is a well-known marker of cancer, and it represents an early event during hepatocellular carcinoma (HCC) development. The recent approval of several molecular targeted agents has revolutionized the management of advanced HCC patients. Nevertheless, the lack of circulating biomarkers still affects patient stratification to tailored treatments. In this context, there is an urgent need for biomarkers to aid treatment choice and for novel and more effective therapeutic combinations to avoid the development of drug-resistant phenotypes. This study aims to prove the involvement of miR-494 in metabolic reprogramming of HCC, to identify novel miRNA-based therapeutic combinations and to evaluate miR-494 potential as a circulating biomarker.

Methods

Bioinformatics analysis identified miR-494 metabolic targets. QPCR analysis of glucose 6-phosphatase catalytic subunit (G6pc) was performed in HCC patients and preclinical models. Functional analysis and metabolic assays assessed G6pc targeting and miR-494 involvement in metabolic changes, mitochondrial dysfunction, and ROS production in HCC cells. Live-imaging analysis evaluated the effects of miR-494/G6pc axis in cell growth of HCC cells under stressful conditions. Circulating miR-494 levels were assayed in sorafenib-treated HCC patients and DEN-HCC rats.

Results

MiR-494 induced the metabolic shift of HCC cells toward a glycolytic phenotype through G6pc targeting and HIF-1A pathway activation. MiR-494/G6pc axis played an active role in metabolic plasticity of cancer cells, leading to glycogen and lipid droplets accumulation that favored cell survival under harsh environmental conditions. High miR-494 serum levels associated with sorafenib resistance in preclinical models and in a preliminary cohort of HCC patients. An enhanced anticancer effect was observed for treatment combinations between antagomiR-494 and sorafenib or 2-deoxy-glucose in HCC cells.

Conclusions

MiR-494/G6pc axis is critical for the metabolic rewiring of cancer cells and associates with poor prognosis. MiR-494 deserves attention as a candidate biomarker of likelihood of response to sorafenib to be tested in future validation studies. MiR-494 represents a promising therapeutic target for combination strategies with sorafenib or metabolic interference molecules for the treatment of HCC patients who are ineligible for immunotherapy.
Further considerations for placebo controls in surgical trials
Authors: Campbell Marion K. , Beard David J. , Blazeby Jane M. , Cousins Sian ,   the ASPIRE group, Ahmed Ahmed , Al-Lamee Rasha , Anderson David B. , Blencowe Natalie , Cook Jonathan , Cuthbertson Brian H. , Ferreira Manuela , Gardiner Matt , Gillies Katie , Miola José , Norrie John , Pinkney Tom , Pugh Jonathan , Rovers Maroeska , Stocken Deborah , Westmore Matt
Published: June 2023

The use of invasive placebo controls in surgical trials can be challenging. The ASPIRE guidance, published in the Lancet in 2020, provided advice for the design and conduct of surgical trials with an invasive placebo control. Based on a more recent international expert workshop in June 2022, we now provide further insights into this topic. These include the purpose and design of invasive placebo controls, patient information provision and how findings from these trials may be used to inform decision-making.
A short, animated storytelling video about sodium intake as a major cardiovascular risk factor and recommendations for a healthy diet: an online, randomized, controlled trial
Authors: Supady A , Nguyen K , Aziz M Abd El , Überreiter C , Bärnighausen T , Adam M
Published: June 2023

Background

Increased uptake of sodium is a major cause for cardiovascular disease and mortality. Reduction of daily salt intake below a reference level of 2 g per day (the equivalent to 5 g salt/day) is known to effectively reduce cardiovascular mortality. The widespread use of social media, with a constant increase in video consumption, is opening new avenues for the dissemination of innovative and scalable approaches to health-related information and recommendations for a healthy diet, such as via video interventions with short animated stories (SAS).

Objective

This study will evaluate the effect of a sodium intake-SAS video intervention on immediate and medium-term knowledge about dietary sodium. Beyond that, immediate and medium-term effects on behavioral expectation to reduce sodium intake as well as voluntary post-trial engagement with the video content will be examined.

Methods

In this 4-armed, parallel, randomized controlled trial, 10,000 adult, US participants will be randomly assigned to (1) a short, animated storytelling intervention video on sodium as a cardiovascular disease risk factor followed by surveys assessing the facts on sodium and cardiovascular disease conveyed in the video (2) the surveys only, (3) an attention placebo control video followed by the before mentioned surveys, and (4) an arm that is exposed to neither the video nor the surveys. Two weeks later, participants in all four arms will complete all of the surveys.

Results

Primary outcomes are the immediate and medium-term effects of the short, animated storytelling intervention video on knowledge about dietary sodium. Secondary outcomes are immediate and medium-term effects of the short, animated storytelling intervention on behavioral expectation to reduce sodium intake as well as voluntary post-trial engagement with the video content.

Conclusion

This study will extend the knowledge on the effects of short, animated storytelling for the containment of the global cardiovascular disease burden. Knowledge on the groups that may be more likely to voluntarily engage with SAS video content will help to improve targeting of future interventions towards audiences at risk.

Trial registration {2a}

ClinicalTrials.gov NCT05735457. Registered on February 21, 2023.
Serratia marcescens in the intestine of housefly larvae inhibits host growth by interfering with gut microbiota
Authors: Li Ying , Wang Shumin , Zhang Kexin , Yin Yansong , Zhang Xinyu , Zhang Qian , Kong Xinxin , Tang Luyao , Zhang Ruiling , Zhang Zhong
Published: June 2023

Background

The structure of gut microbiota is highly complex. Insects have ubiquitous associations with intestinal symbiotic bacteria, which play essential roles. Thus, understanding how changes in the abundance of a single bacterium interfere with bacterial interactions in the insect’s gut is important.

Methods

Here, we analyzed the effects of Serratia marcescens on the growth and development of housefly larvae using phage technology. We used 16S rRNA gene sequencing technology to explore dynamic diversity and variation in gut bacterial communities and performed plate confrontation assays to study the interaction between S. marcescens and intestinal microorganisms. Furthermore, we performed phenoloxidase activity assay, crawling assay, and trypan blue staining to explore the negative effects of S. marcescens on housefly larvae’s humoral immunity, motility, and intestinal organization.

Results

The growth and development of housefly larvae were inhibited after feeding on S. marcescens, and their intestinal bacterial composition changed with increasing abundance of Providencia and decreasing abundance of Enterobacter and Klebsiella. Meanwhile, the depletion of S. marcescens by phages promoted the reproduction of beneficial bacteria.

Conclusions

In our study, using phage as a tool to regulate the abundance of S. marcescens, we highlighted the mechanism by which S. marcescens inhibits the growth and development of housefly larvae and illustrated the importance of intestinal flora for larval development. Furthermore, by studying the dynamic diversity and variation in gut bacterial communities, we improved our understanding of the possible relationship between the gut microbiome and housefly larvae when houseflies are invaded by exogenous pathogenic bacteria.

Graphical Abstract
DNA methylation alterations at RE1-silencing transcription factor binding sites and their flanking regions in cancer
Authors: Vega-Benedetti Ana Florencia , Loi Eleonora , Moi Loredana , Zavattari Patrizia
Published: June 2023

Background

DNA methylation changes, frequent early events in cancer, can modulate the binding of transcription factors. RE1-silencing transcription factor (REST) plays a fundamental role in regulating the expression of neuronal genes, and in particular their silencing in non-neuronal tissues, by inducing chromatin modifications, including DNA methylation changes, not only in the proximity of its binding sites but also in the flanking regions. REST has been found aberrantly expressed in brain cancer and other cancer types. In this work, we investigated DNA methylation alterations at REST binding sites and their flanking regions in a brain cancer (pilocytic astrocytoma), two gastrointestinal tumours (colorectal cancer and biliary tract cancer) and a blood cancer (chronic lymphocytic leukemia).

Results

Differential methylation analyses focused on REST binding sites and their flanking regions were conducted between tumour and normal samples from our experimental datasets analysed by Illumina microarrays and the identified alterations were validated using publicly available datasets. We discovered distinct DNA methylation patterns between pilocytic astrocytoma and the other cancer types in agreement with the opposite oncogenic and tumour suppressive role of REST in glioma and non-brain tumours.

Conclusions

Our results suggest that these DNA methylation alterations in cancer may be associated with REST dysfunction opening the enthusiastic possibility to develop novel therapeutic interventions based on the modulation of this master regulator in order to restore the aberrant methylation of its target regions into a normal status.
Clinical pointers in Prevotella septic arthritis of the hip: a case report
Authors: Kgagudi M. P. , Mogane M. G. , Ramokgopa M. T. , Jingo M.
Published: June 2023

Background

Infective arthritis is an orthopaedic surgical emergency. Staphylococcus aureus remains the commonest causative bacteria across all age groups. Prevotella spp. as a cause of infective arthritis is extremely rare.

Case report

We present our case of a 30-year-old African male patient who presented with mild signs of infective arthritis of the left hip. His risk factors were his background retroviral disease, intravenous drug abuse, and a previous episode of left hip arthrotomy which healed expectantly with intervention. The current presentation was treated with arthrotomy of the hip, fluid lavage, and skeletal traction based on our clinical findings and the rarity of the presentation was seen to be mobilising non-weight bearing with crutches, and pain-free on the left hip.

Conclusion

A high index of suspicion for Prevotella Septic Arthritis (PSA) should be exercised when treating infective arthritis patients with background joint arthropathies, and intravenous drug abuse, especially in individuals with significant immunosuppression and/or recent tooth extraction. Fortunately, although rare an entity, good outcomes can be expected with early diagnosis and classic treatment principles of joint decompression and lavage as well as guided antibiotic therapy.
Terminal microdeletion of chromosome 18 in a Malaysian boy characterized with few features of typical 18q- deletion syndrome: a case report
Authors: Ismail Azli , Ahid Fadly , Thong Meow-Keong , Zakaria Zubaidah
Published: June 2023

Background

The 18q- deletion syndrome is a rare congenital chromosomal disorder caused by a partial deletion of the long arm of chromosome 18. The diagnosis of a patient with this syndrome relies on the family medical history, physical examination, developmental assessment, and cytogenetic findings. However, the phenotype of patients with 18q- deletion syndrome can be highly variable, ranging from almost normal to severe malformations and intellectual disability, and normal cytogenetic findings are common, thus complicating the diagnosis. Interestingly, only few characteristic features of typical 18q- deletion syndrome were found in the patient, despite sharing the same critical region. To our knowledge, this is the first report of a Malaysian individual with 18q- terminal microdeletion diagnosed with microarray-based technology.

Case presentation

Here we report a 16-year-old Malaysian Chinese boy, a product of a non-consanguineous marriage, who presented with intellectual disability, facial dysmorphism, high arched palate, congenital talipes equinovarus (clubfoot), congenital scoliosis, congenital heart defect, and behavioral problems. A routine chromosome analysis on 20 metaphase cells showed a normal 46, XY G-banded karyotype. Array-based comparative genomic hybridization was performed using a commercially available 244 K 60-mer oligonucleotide microarray slide according to the manufacturer’s protocol. This platform allows genome-wide survey and molecular profiling of genomic aberrations with an average resolution of about 10 kB. In addition, multiplex ligation-dependent probe amplification analysis was carried out using SALSA MLPA kit P320 Telomere-13 to confirm the array-based comparative genomic hybridization finding. Array-based comparative genomic hybridization analysis revealed a 7.3 MB terminal deletion involving chromosome band 18q22.3-qter. This finding was confirmed by multiplex ligation-dependent probe amplification, where a deletion of ten probes mapping to the 18q22.3-q23 region was detected, and further multiplex ligation-dependent probe amplification analysis on his parents showed the deletion to be de novo.

Conclusion

The findings from this study expand the phenotypic spectrum of the 18q- deletion syndrome by presenting a variation of typical 18q- deletion syndrome features to the literature. In addition, this case report demonstrated the ability of the molecular karyotyping method, such as array-based comparative genomic hybridization, to assist in the diagnosis of cases with a highly variable phenotype and variable aberrations, such as 18q- deletion syndrome.
A simple ANN-MLP model for estimating 60-GHz PDP inside public and private vehicles
Authors: Shukla Rajeev , Sarkar Abhishek Narayan , Chandra Aniruddha , Kelner Jan M. , Ziolkowski Cezary , Mikulasek Tomas , Prokes Ales
Published: June 2023

Radio wave propagation in an intra-vehicular (IV) environment is markedly different from other well-studied indoor scenarios, such as an office or a factory floor. While millimetre wave (mmWave)-based intra-vehicular communications promise large bandwidth and can achieve ultra-high data rates with lower latency, exploiting the advantages of mmWave communications largely relies on adequately characterising the propagation channel. Channel characterisation is most accurately done through an extensive channel sounding, but due to hardware and environmental constraints, it is impractical to test channel conditions for all possible transmitter and receiver locations. Artificial neural network (ANN)-based channel sounding can overcome this impediment by learning and estimating the channel parameters from the channel environment. We estimate the power delay profile in intra-vehicular public and private vehicle scenarios with a high accuracy using a simple feedforward multi-layer perception-based ANN model. Such artificially generated models can help extrapolate other relevant scenarios for which measurement data are unavailable. The proposed model efficiently matches the taped delay line samples obtained from real-world data, as shown by goodness-of-fit parameters and confusion matrices.
Nutritional composition, antioxidant activity and gossypol level of Nazilli glandless cottonseed, cottonseed kernel and their cold-pressed meal
Authors: Canikli Ali , Yıldırım Arda , Erdem Halil , Genç Nusret
Published: June 2023

Background

The study was conducted to determine the nutrient composition and gossypol levels of glandless cottonseed (GCS), glandless cottonseed kernel (GCSK) glandless cottonseed meal (GCSM) and cottonseed kernel meal (GCSKM) obtained by cold pressing of cotton seeds and kernels (Glandless Nazilli variety) as a raw material of compound feed industry.

Result

Feed and dry matter (DM)-based nutrient analyses showed significant differences (p < 0.05) in DM, OM (organic matter), CP (crude protein), EE (ether extract), ash and NFE (nitrogen-free extract) contents between GCS and GCSK. The DM-based K, P, S, Mg, Ca, Na, Fe, Cu, Zn and Al contents were significantly different (p < 0.05) between GCS and GCSK. The concentrations of nonessential heavy metals (Cd, Pb, Ni and Al) in GCS, GCSK, GCSM and GCSKM samples were below the permissible limits. The linoleic acid (C18:2; ω6) was the main component (55.55%) among the 20 fatty acids identified in GCS oil. The level of unsaturated fatty acids (70.78%) was higher than that of saturated fatty acids (29.22%). Total phenolics concentrations of GCS, GCSK, GCSM and GCSKM samples were 7.87, 2.18, 5.86 and 1.91 mg gallic acid equivalents (GAE)/g, respectively. Free and total gossypol levels of GCS and GCSK were 294 and 440, and 521 and 706 mg/kg, respectively.

Conclusion

The results revealed that nutritional properties of Nazilli GCS with low gossypol and high linoleic acid content were relatively higher compared to the other meals investigated. The antioxidant activity of phenolic compounds, albeit at low levels in Nazilli GCS and GCSM, may contribute to animal health and production efficiency when used in animal rations.
Fulminant Type 1 Diabetes—East and West
Authors: Imagawa Akihisa , Hanafusa Toshiaki
Published: June 2023

Fulminant type 1 diabetes is a subtype of type 1 diabetes in which beta cells are destroyed within days or a few weeks. The first criterion indicates a rise in blood glucose levels shown in the patient’s history. The second suggests that the increase occurs suddenly within a very short period, as shown by the laboratory findings of the discrepancy between the glycated hemoglobin concentration and plasma glucose level. The third indicates a marked reduction in endogenous insulin secretion, which indicates almost complete destruction of beta cells. Fulminant type 1 diabetes is a common subtype in East Asian countries, including Japan, but rare in Western countries. Class II human leukocyte antigen and other genetic factors may have contributed to the skewed distribution. Environmental factors may also be involved including entero and herpes viruses and immune regulation during drug-induced hypersensitivity syndrome; pregnancy may also affect it. In contrast, treatment with an immune checkpoint inhibitor of the anti-programmed cell death 1 antibody induces similar characteristics and incidence of diabetes as fulminant type 1 diabetes. Further studies are needed to clarify the etiology and clinical characteristics of fulminant type 1 diabetes. Although the incidence of this disease differs between the East and West, it is life-threatening; thus, it is important to diagnose fulminant type 1 diabetes without delay and treat it appropriately.
Associations Between Fatigue and Endocrine and Non-endocrine Health Problems in Turner Syndrome: Cohort Study and Review
Authors: Rosenberg Anna G W , Dingemans Veerle D A , Bos-Roubos Anja G , Luijks Sanne , Dessens Arianne B , Dykgraaf Ramon , Roos-Hesselink Jolien W , Van Rossum Elisabeth F C , Van Der Lely Aart J , De Graaff Laura C G
Published: June 2023

Context

Turner syndrome (TS) is a rare chromosomal disorder characterized by gonadal dysfunction, short stature, and heart defects, among other features. Women with TS often suffer from severe fatigue, for which they are typically referred to endocrinologists. The diagnostic work-up is generally time-consuming and invasive, and it rarely solves the problem. To prevent the personal and financial burden of unnecessary diagnostic procedures, it is crucial to understand fatigue in TS.

Objective

To explore the association between fatigue and endocrine and non-endocrine comorbidities in a—for rare disorders—large group of women with TS.

Methods

170 genetically confirmed women with TS who attended the TS Reference Center underwent a systematic health screening, including a structured interview, complete physical examination, biochemical measurements, perceived stress and fatigue questionnaires, and additional tests when indicated.

Results

Median (interquartile range) age was 32.6 (23.9-41.4) years. Severe fatigue was experienced by 1 in 3 women with TS. Liver enzyme disturbances and body mass index were significantly associated with higher fatigue scores. Perceived stress was highly correlated with fatigue.

Conclusion

There was no association between fatigue and most endocrine and non-endocrine disorders, which implies that fatigue is only partly explained by somatic disorders. The high correlation between perceived stress and fatigue suggests that TS-related neuropsychological processes may play an important role in the etiology of fatigue in women with TS. We provide a practical algorithm for the endocrine, non-endocrine, and psychological approach to fatigue in women with TS.
Longitudinal Mediating Effect of Fat Mass and Lipids on Sedentary Time, Light PA, and MVPA with Inflammation in Youth
Authors: Agbaje Andrew O
Published: June 2023

Context

Inflammation has been associated with atherosclerosis and metabolic disorders in youth. Preventing inflammation through exposure to different accelerometer-based movement behaviors has not been longitudinally examined.

Objective

This work aimed to examine the mediating role of fat mass, lipids, and insulin resistance on the associations of cumulative sedentary time (ST), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) with inflammation.

Methods

From the Avon Longitudinal Study of Parents and Children, United Kingdom, 792 children with data on at least 2 time-point measures of accelerometer-based ST, LPA, and MVPA during age 11, 15, and 24 years follow-up clinic visits with complete high-sensitivity C-reactive protein (hsCRP) measures at age 15, 17, and 24 years were studied. Mediating associations were examined using structural equation models. When the magnitude of the association between the exposure and outcome is increased after including a third variable, suppression occurred but mediation if decreased.

Results

Among 792 (58% female; mean [SD] age at baseline, 11.7 [0.2] years), ST increased, LPA decreased, and MVPA had a U-shaped increase while hsCRP increased during 13-year follow-up. Insulin resistance partly suppressed (23.5% suppression) the positive associations of ST with hsCRP among participants who were overweight/obese. Fat mass partly mediated (30% mediation) the negative associations of LPA with hsCRP. Fat mass had a 77% mediation effect on the negative associations of MVPA with hsCRP.

Conclusion

ST worsens inflammation, but increased LPA had a 2-fold inflammatory-lowering effect and was more resistant to the attenuating effect of fat mass compared with MVPA, and hence should be targeted in future interventions.
Percutaneous cholecystostomy as a definitive treatment for acute acalculous cholecystitis: clinical outcomes and risk factors for recurrent cholecystitis
Authors: Do Yoon Ah , Yoon Chang Jin , Lee Jae Hwan , Choi Won Seok , Lee Chong-ho
Published: June 2023

Objective:

To investigate the outcomes of percutaneous cholecystostomy (PC) as a definitive treatment for acute acalculous cholecystitis (AAC) and to identify the risk factors for cholecystitis recurrence after catheter removal.

Methods:

Between January 2008 and December 2017, 124 patients who had undergone PC as definitive treatment for moderate or severe AAC. The initial clinical success, complications, and recurrent cholecystitis after PC removal were retrospectively assessed. Twenty-one relevant variables were analyzed to identify risk factors for recurrent cholecystitis.

Results:

Clinical effectiveness was achieved in 107 patients (86.3%) at 3 days and in all patients (100%) at 5 days after PC placement. Six Grade 2 adverse events occurred, including catheter dislodgement (n = 3) and clogging (n = 3), which required catheter exchange. The PC catheter was removed in 123 patients (99.2%), with a median indwelling duration of 18 days (range 5–116 days). During the follow-up period (median, 1624 days; range, 40–4945 days), five patients experienced recurrent cholecystitis (4.1%). The cumulative recurrence rates were 3.3%, 4.1%, and 4.1% at 6 months, 1 year, and 5 years, respectively. Multivariate analysis revealed that an age-adjusted Charlson comorbidity index (aCCI)≥7 positively correlated with recurrence (OR, 1.97; 95% confidence interval, 1.07–3.64; p = 0.029).

Conclusions:

Definitive PC is a safe and effective treatment option for patients with AAC. The PC catheters can be safely removed in most patients. An aCCI≥7 was a risk factor for cholecystitis recurrence after catheter removal.

Advances in knowledge:

1. Percutaneous cholecystostomy (PC) is a safe and effective as a definitive treatment in patients with acute acalculous cholecystitis (AAC). 2. PC can be safely removed after recover from AAC in the majority of patients (99.2%) with low rate of recurrence of cholecystitis (4.1%). 3. Age-adjusted Charlson comorbidity index ≥7 was a risk factor for recurrence of cholecystitis after PC removal.
Considerations for an ideal post-surgical wound dressing aligned with antimicrobial stewardship objectives: a scoping review
Authors: Ousey Karen , Rippon Mark G , Rogers Alan A , Totty Joshua P
Published: June 2023

Objective:

Most surgical wounds heal by primary or secondary intention. Surgical wounds can present specific and unique challenges including wound dehiscence and surgical site infection (SSI), either of which can increase risk of morbidity and mortality. The use of antimicrobials to treat infection in these wounds is prevalent, but there is now an imperative to align treatment with reducing antimicrobial resistance and antimicrobial stewardship (AMS). The aim of this review was to explore the published evidence identifying general considerations/criteria for an ideal post-surgical wound dressing in terms of overcoming potential wound healing challenges (including infection) while supporting AMS objectives.

Method:

A scoping review examining evidence published from 1954–2021, conducted by two authors acting independently. Results were synthesised narratively and have been reported in line with PRISMA Extension for Scoping Reviews.

Results:

A total of 819 articles were initially identified and subsequently filtered to 178 for inclusion in the assessment. The search highlighted six key outcomes of interest associated with post-surgical wound dressings: wound infection; wound healing; physical attributes related to comfort, conformability and flexibility; fluid handling (e.g., blood and exudate); pain; and skin damage.

Conclusion:

There are several challenges that can be overcome when treating a post-surgical wound with a dressing, not least the prevention and treatment of SSIs. However, it is imperative that the use of antimicrobial wound dressings is aligned with AMS programmes and alternatives to active antimicrobials investigated.
Clinical correlates of pain in adults with hard-to-heal leg ulcers: a cross-sectional study
Authors: Schmidt Luke J , Parker Christina N , Parker Tony J , Finlayson Kathleen J
Published: June 2023

Objective:

Pain is a complex symptom associated with hard-to-heal (chronic) leg ulcers that is often poorly managed. The objective of this study was to gain greater understanding by investigating relationships between physical and psychosocial factors, and pain severity in adults with hard-to-heal leg ulcers.

Method:

A secondary analysis of data collected for a longitudinal, observational study of adults with hard-to-heal leg ulcers was undertaken. Data were collected over a 24-week period, including variables relating to sociodemographics, clinical variables, medical status, health, ulcer and vascular histories, and psychosocial measures. Multiple linear regression modelling was used to determine the independent influences of these variables on pain severity, as measured with a Numerical Rating Scale (NRS).

Results:

Of 142 participants who were recruited, 109 met the inclusion criteria for this study, of whom: 43.1% had venous ulcers; 41.3% had mixed ulcers; 7.3% had arterial ulcers; and 8.3% had ulcers from some other cause. The final model explained 37% (adjusted r2=0.370) of the variation in the pain NRS scores. Controlling for analgesic use, salbutamol use (p=0.005), clinical signs of infection (p=0.027) and ulcer severity (p=0.001) were significantly associated with increased pain, while the presence of diabetes (p=0.007) was significantly associated with a decrease in pain.

Conclusion:

Pain is a highly complex and pervasive symptom associated with hard-to-heal leg ulcers. Novel variables were identified as being associated with pain in this population. The model also included wound type as a variable; however, despite being significantly correlated to pain at the bivariate level of analysis, in the final model, the variable did not reach significance. Of the variables included in the model, salbutamol use was the second most significant. This is a unique finding that, to the authors' knowledge, has not been previously reported or studied. Further research is required to better understand these findings and pain in general.
Professional development and academic satisfaction from a wound programme in Latin America: 10 years of experience
Authors: Chico-Barba Gabriela , Jiménez-Limas Karime , López-Hernández Blanca , Murad-Robles Yolanda , González-Mier María José , Bonilla Alejandra , Vila-Zepeda Alejandra , Rubilar Ximena
Published: June 2023

Objective:

Latin America had only one Spanish-speaking postgraduate academic programme on managing wounds and ostomies until 2021. Since then, two more programmes have been developed; one in Colombia and another in Mexico. Therefore, studying alumni outcomes becomes highly relevant. We aimed to describe the alumni's professional development and academic satisfaction from a Wound, Ostomy and Burn Therapy postgraduate programme in Mexico City, Mexico.

Method:

An electronic survey was sent to all alumni from January–July 2019 from the School of Nursing of Universidad Panamericana. Employability, academic development and satisfaction following completion of the academic programme were evaluated.

Results:

From 88 respondents, 77 of whom were nurses, 86 (97.7%) answered that they were working, and 86.4% were working in an area related to the studied programme. Regarding general satisfaction, 88% were totally satisfied/satisfied with the programme and 93.2% would recommend it.

Conclusion:

Alumni from the Wound, Ostomy and Burn Therapy postgraduate programme are satisfied with the academic curriculum and have good professional development, demonstrated by a high employment rate.
Prescribing intravenous fluids: a review
Authors: Rowberry Rowena , Mortimore Gerri
Published: June 2023

This article highlights the multitude of considerations when prescribing intravenous fluids from the perspective of a trainee advanced practitioner, and emphasises that reassessment of the patient is key to safe fluid administration. Having identified that the practice of prescribing intravenous fluids is commonplace in acute care, this article will explore the level of training and education provided to clinicians, and highlights the importance of undertaking a systematic approach in assessing and decision making. In addition, this article will discuss the complexities of prescribing fluids and examine the considerations required for the assessment of fluid status, methods of determining the most appropriate fluid regime and selection of fluid for the patient, and the available evidence and guidance to aid decision making.
An overview of prescribing practice and non-pharmacological treatments in COPD
Authors: Ray Emma , Astles Carla
Published: June 2023

Chronic obstructive pulmonary disease (COPD) is a common heterogenous disease with significant personal implications, responsible for substantial healthcare costs. The goal of treatment and management in COPD is to control symptoms, and reduce risk and frequency of exacerbations and hospitalisations using a patient-centred approach. This article summarises the main current pharmaceutical and non-pharmaceutical management strategies in COPD, drawing on contemporaneous clinical guidelines and evidence, and highlight how emerging COPD endotypes and phenotypes are enhancing our understanding. An overview of inhaled medications, the mainstay of COPD treatment, is discussed, as well as the significance of device selection related to personal and physical considerations. Acute and long-term treatment and the criteria for specialist referral and medical management in complex patients is also presented.