bluuebunny/crossref_metadata_2025 huggingface dataset:
Allogeneic, donor-derived, second-generation, CD19-CAR-T cell for the treatment of pediatric relapsed/refractory BCP-ALL
Authors: del Bufalo Francesca , Becilli Marco , Rosignoli Chiara , De Angelis Biagio , Algeri Mattia , Hanssens Linda , Gunetti Monica , Iacovelli Stefano , Li Pira Giuseppina , Girolami Elia , Leone Giovanna , Lazzaro Stefania , Bertaina Valentina , Sinibaldi Matilde , Di Cecca Stefano , Iaffaldano Laura , Künkele Annette , Boccieri Emilia , Del Baldo Giada , Pagliara Daria , Merli Pietro , Carta Roberto , Quintarelli Concetta , Locatelli Franco
Published: May 2023

Autologous CD19-directed chimeric antigen receptor (CAR)-T cells have shown unprecedented efficacy in children with relapsed/refractory B-cell-precursor acute lymphoblastic leukemia (BCP-ALL). However, patients either relapsing after allogeneic hematopoietic stem cell transplantation (allo-HSCT), or displaying profound lymphopenia and/or with rapidly progressing disease often cannot access autologous products. These hurdles may be overcome by allogeneic, donor-derived CAR-T cells. We tested donor-derived T-cells transduced with a 2nd-generation (4.1BB) CD19-CAR for treatment of patients with BCP-ALL, in a hospital exemption setting. Two constructs were tested: a retroviral construct incorporating the suicide gene inducible caspase-9 (CD19-CAR-Retro_ALLO) first and then a lentiviral construct and an automated, Prodigy®-based, manufacturing process (CD19-CAR-Lenti_ALLO). Thirteen children/young adults received ALLO-CAR T-cells between 03/2021 and 10/2022. Doses ranged between 1,0×106 and 3,0×106 CAR T-cells/kg. The toxicity profile was comparable to that of autologous CAR-T cells, characterized mainly by cytopenia, CRS (maximum grade 1) and grade 2 ICANS. One case of acute graft-versus-host disease (GvHD) occurred and was rapidly controlled by steroids and ruxolitinib. None of the other patients, including 3 infused with ALLO-CAR T cells from an HLA-haplo-identical donor, experienced GvHD. Two patients received ALLO-CAR T-cells before HSCT and showed a significant expansion of CAR T cells, without any sign of GvHD. All patients obtained complete remission (CR) with negativity of minimal residual disease in the BM; with a median follow-up of 12 months (range 5-21), 8/13 patients maintain CR. Allogeneic anti-CD19 CAR-T cells can effectively treat highly-refractory BCP-ALL relapsing after alloHSCT, without showing increased toxicity as compared to autologous CAR T cells.
Factors associated with non-invasive positive pressure ventilation failure in a COVID-19 intermediate care unit
Authors: Farinha Inês , da Cunha Alexandra Tenda , Nogueira Ana Rita , Ribeiro André , Silva Carlos , Rua João , Trêpa João , Mateus José Eduardo , Costa Filipa
Published: May 2023

Background

The use of non-invasive positive pressure ventilation (NIPPV) in COVID-19 patients with hypoxaemia is still under debate. The aim was to evaluate the efficacy of NIPPV (CPAP, HELMET-CPAP or NIV) in COVID-19 patients treated in the dedicated COVID-19 Intermediate Care Unit of Coimbra Hospital and University Centre, Portugal, and to assess factors associated with NIPPV failure.

Methods

Patients admitted from December 1st 2020 to February 28th 2021, treated with NIPPV due to COVID-19 were included. Failure was defined as orotracheal intubation (OTI) or death during hospital stay. Factors associated with NIPPV failure were included in a univariate binary logistic regression analysis; those with a significance level of p < 0.001 entered a multivariate logistic regression model.

Results

A total of 163 patients were included, 64.4% were males (n = 105). The median age was 66 years (IQR 56–75). NIPPV failure was observed in 66 (40.5%) patients, 26 (39.4%) were intubated and 40 (60.6%) died during their hospital stay. The highest CRP (OR 1.164; 95%CI 1.036–1.308) and morphine use (OR 24.771; 95%CI 1.809–339.241) were identified as predictors of failure after applying multivariate logistic regression. Adherence to prone positioning (OR 0.109; 95%CI 0.017–0.700) and a higher value of the lowest platelet count during hospital stay (OR 0.977; 95%CI 0.960–0.994) were associated with a favorable outcome.

Conclusions

NIPPV was successful in over half of patients. Highest CRP during hospital stay and morphine use were predictors of failure. Adherence to prone positioning and a higher value of the lowest platelet count during hospital stay were associated with a favourable outcome.
Atypical presentation of bilateral Epstein-Barr virus dacryoadenitis: a case report of corticosteroid resistant orbital inflammation
Authors: Tan Charissa H. , Tauchi-Nishi Pamela S. , Sweeney Adam R.
Published: May 2023

Epstein-Barr virus is a known cause of dacryoadenitis that is typically sensitive to corticosteroid treatment. When affecting the orbit, particularly the lacrimal gland, Epstein-Barr virus may cause chronic proptosis and a bilateral lacrimal mass effect. We provide a case of bilateral Epstein-Barr virus associated dacryoadenitis initially resistant to corticosteroid treatment requiring biopsy and confirmation by polymerase chain reaction of lacrimal tissue. Herein, we discuss the presentation with associated magnetic resonance imaging and histopathologic images, diagnostic dilemma, and treatment of an atypical case.
Perovskite quantum dots modulating upconversion nanomaterials for cancer early detections
Authors: He Yue , Rao Hongtao , Wang JingJing , Wu Ying , Han Caiqin , Yan Changchun , Temple Hunter , Zhang Le , Chen Wei , Liu Ying
Published: May 2023

The accurate diagnosis and treatment of cancer cell lesions need a high standard of detection technology. Fluorescent probes to perform cancer biomarker detection have become a popular research issue. However, fluorescent probes still face enormous challenges of complex design and difficult detection. In this work, we propose a novel composite material UCNP@SiO2 + QDs based on the combination of rare earth upconversion (UCNPs) and perovskite quantum dots (QDs) and design a new fluorescent probe MB-UCNP@SiO2 + QDs with molecular beacon (MB) as the carrier, that can be excited by near-infrared light, emitted in the visible wavelength, specifically identified and highly sensitive. Under the excitation of 980 nm near-infrared light, the UCNPs and QDs in the composite produced the maximum efficiency of energy transfer through fluorescence resonance, and the multi-emission light of UCNPs synergistically excited the re-emission of QDs, and the energy transfer efficiency is 70.6%. By changing the doping ratio of QDs halogen elements in UCNP@SiO2 + QDs, it is possible to modulate the precise luminescence of UCNP@SiO2 + QDs in the entire wavelength range of visible light at different positions. The novel fluorescent probe is obtained using UCNP@SiO2 + QDs and Black Hole Quencher-1 (BHQ1) quenching groups linked to the two respective sides of MB, selecting as the target of detection the myeloma cancer biomarker miRNA-155, a difficult diagnostic and complex developmental type, and have achieved specific recognition and low concentration of miRNA-155 and a detection limit of 73.5 pM. This fluorescent probe design can provide new ideas for the early diagnosis and treatment of cancer, tumors, and cardiovascular diseases.

Graphical Abstract
Improving variant calling using population data and deep learning
Authors: Chen Nae-Chyun , Kolesnikov Alexey , Goel Sidharth , Yun Taedong , Chang Pi-Chuan , Carroll Andrew
Published: May 2023

Large-scale population variant data is often used to filter and aid interpretation of variant calls in a single sample. These approaches do not incorporate population information directly into the process of variant calling, and are often limited to filtering which trades recall for precision. In this study, we develop population-aware DeepVariant models with a new channel encoding allele frequencies from the 1000 Genomes Project. This model reduces variant calling errors, improving both precision and recall in single samples, and reduces rare homozygous and pathogenic clinvar calls cohort-wide. We assess the use of population-specific or diverse reference panels, finding the greatest accuracy with diverse panels, suggesting that large, diverse panels are preferable to individual populations, even when the population matches sample ancestry. Finally, we show that this benefit generalizes to samples with different ancestry from the training data even when the ancestry is also excluded from the reference panel.
Congenital absence of the left pericardium: a case report
Authors: Li Xiang-Yi , Jiang Yan , Li Hao-Wen , Liu Yong-Kang , Bai Jing
Published: May 2023

Background

Congenital absence of the pericardium (CAP) is rare in clinical practice, the symptoms vary among patients, and most doctors do not have enough knowledge of the condition. Most reported CAP cases are incidental findings. Therefore, this case report aimed to present a rare case of left partial CAP that presented with non-specific, possibly cardiac-related symptoms.

Case presentation

The patient, male, 56 years old, Asian, was admitted on March 2, 2021. The patient complained of occasional dizziness in the past week. The patient was suffering from hyperlipidemia and hypertension (stage 2), both untreated. The patient reported chest pain, palpitations, discomfort in the precordium, and dyspnea in the lateral recumbent position after strenuous activities, all of which started when he was about 15 years old. ECG showed sinus rhythm, 76 bpm, premature ventricular beats, incomplete right bundle branch block, and clockwise rotation of the electrical axis. Most of the ascending aorta could be detected in the parasternal intercostal space 2–4 by transthoracic echocardiography in the left lateral position. Chest computed tomography revealed the absence of pericardium between the aorta and the pulmonary artery, and part of the left lung was extending into the space. No changes in his condition have been reported up to now (March 2023).

Conclusions

CAP should be considered when multiple examinations suggest heart rotation and a large moving range of the heart in the thoracic cavity.
Sleep duration affects the sequential change of body mass index and muscle strength: a contribution to dynapenic obesity
Authors: Zhang Zeyi , Wang Jingjing , Wang Jingyi , Ma Bin , Jia Yuanmin , Chen Ou
Published: May 2023

Background

With aging, body mass index (BMI) increases and muscle strength declines, resulting in dynapenic obesity. It remains unknown whether and how sleep duration contributes to the sequence of BMI and muscle strength change in the progression of dynapenic obesity.

Methods

Data were derived from the first two waves of China Health and Retirement Longitudinal Study. Sleep duration was self-reported. BMI was calculated and grip strength (GS) was measured to reflect muscle strength. The effect of baseline sleep duration on the sequential change of BMI and GS was assessed using two mediation models considering the nonlinear associations between them. The moderating effect of metabolic disorder was also tested.

Results

Totally 4986 participants aged ≥ 50 years (50.8% females) with complete information on variables were included. Baseline BMI fully mediated the nonlinear association between sleep duration and follow-up GS change, but baseline GS did not mediate between sleep duration and follow-up BMI change for older men and women. Short sleep duration positively affected BMI-induced GS change (β = 0.038; 95%CI, 0.015–0.074), while this favorable effect became nonsignificant for moderate sleep duration (β = 0.008; 95% CI, -0.003–0.024) and turned negative with prolonged sleep duration (β =  − 0.022; 95%CI, − 0.051 to − 0.003). This nonlinear mediation effect was more pronounced in older women who are relatively metabolically healthy at baseline.

Conclusion

For older adults in China, the influence of sleep duration on BMI-induced GS change but not the GS-induced BMI change suggested the contribution of sleep duration to the sequential course in the progression of dynapenic obesity. Sleep duration deviated either above or below normal range may confer adverse impact on GS through BMI. Strategies addressing sleep and obesity jointly to improve muscle function and delay the progression of dynapenic obesity are required.
Indirect effects of the COVID-19 pandemic on risk of gestational diabetes and factors contributing to increased risk in a multiethnic population: a retrospective cohort study
Authors: Rhou Yoon Ji Jina , Elhindi James , Melov Sarah J. , Cheung N. Wah , Pasupathy Dharmintra ,   the Western Sydney COVID-19 Pregnancy Study Group
Published: May 2023

Background

The COVID-19 pandemic has had indirect effects on pregnancy outcomes. There is limited data on the impact on gestational diabetes (GDM) in diverse populations and the possible underlying mediators. This study aimed to assess the risk of GDM pre-COVID-19 and in two distinct pandemic exposure periods, and to determine the potential factors contributing to increased risk in a multiethnic population.

Methods

A multicentre, retrospective cohort study was performed of women with singleton pregnancy receiving antenatal care at three hospitals two years pre-COVID-19 (January 2018 – January 2020), first year of COVID-19 with limited pandemic-mitigating restrictions (February 2020 – January 2021) and second year of COVID-19 with stringent restrictions (February 2021 – January 2022). Baseline maternal characteristics and gestational weight gain (GWG) were compared between cohorts. The primary outcome was GDM, assessed using univariate and multivariate generalised estimating equations models.

Results

28,207 pregnancies met the inclusion criteria, 14,663 pregnancies two years pre-COVID-19, 6,890 in COVID-19 Year 1 and 6,654 in COVID-19 Year 2. Maternal age increased across exposure periods (30.7 ± 5.0 years pre-COVID-19 vs 31.0 ± 5.0 years COVID-19 Year 1 vs 31.3 ± 5 years COVID-19 Year 2; p < 0.001). There were increases in pre-pregnancy body mass index (BMI) (25.5 ± 5.7 kg/m2 vs 25.7 ± 5.6 kg/m2 vs 26.1 ± 5.7 kg/m2; p < 0.001), proportion who were obese (17.5% vs 18.1% vs 20.7%; p < 0.001) and proportion with other traditional risk factors for GDM including South Asian ethnicity and prior history of GDM. Rate of GWG and proportion exceeding recommended GWG increased with pandemic exposure (64.3% vs 66.0% vs 66.6%; p = 0.009). GDM diagnosis increased across exposure periods (21.2% vs 22.9% vs 24.8%; p < 0.001). Both pandemic exposure periods were associated with increased risk of GDM on univariate analysis, only COVID-19 Year 2 remaining significantly associated after adjusting for maternal baseline characteristics and GWG (OR 1.17 [1.06, 1.28], p = 0.01).

Conclusions

Diagnosis of GDM increased with pandemic exposure. Progressive sociodemographic changes and greater GWG may have contributed to increased risk. However, exposure to the second year of COVID-19 remained independently associated with GDM after adjusting for shifts in maternal characteristics and GWG.
Serum fatty acid profiles in breast cancer patients following treatment
Authors: Pakiet Alicja , Jędrzejewska Agata , Duzowska Katarzyna , Wacławska Alina , Jabłońska Patrycja , Zieliński Jacek , Mika Adriana , Śledziński Tomasz , Słomińska Ewa
Published: May 2023

Background

Breast cancer is associated with alterations in lipid metabolism. The treatment of breast cancer can also affect serum lipid composition. The purpose of this study was the examination of serum fatty acids (FAs) profiles in breast cancer survivors to assess if the FA levels normalize.

Methods

Serum levels of FAs were determined by gas chromatography–mass spectrometry in a group of breast cancer patients at baseline (before treatment, n = 28), at two follow-up visits at 12 months (n = 27) and 24 months (n = 19) after the breast cancer resection, and in the group of healthy controls (n = 25). Multivariate analysis was performed to assess how FA serum profile changes following treatment.

Results

Breast cancer patients’ serum FA profiles at follow-ups did not normalize to the levels of control group. The greatest differences were found for levels of branched-chain (BCFA), odd-chain (OCFA) and polyunsaturated (PUFAs) FAs, all of which were significantly increased 12 months after the surgery.

Conclusions

After treatment for breast cancer, the patients’ serum FA profile differs from the profile before treatment and from controls, especially 12 months after treatment. Some changes may be beneficial – increased BCFA and OCFA levels, and improved n-6/n-3 PUFA ratio. This may reflect lifestyle changes in breast cancer survivors and have an impact on the risk of recurrence.
Cogan’s syndrome is more than just keratitis: a case-based literature review
Authors: Wang Yanqing , Tang Shichao , Shao Chong , Liu Yu
Published: May 2023

Background

Cogan's syndrome (CS) is a rare autoimmune disorder characterized by non-syphilitic interstitial keratitis (IK) and Menière-like cochlear vestibular symptoms, which may also have systemic effects. Corticosteroids are first-line treatment. DMARDs and biologics have been used to treat ocular and systemic symptoms of CS.

Case presentation

This is a case of a 35-year-old female who reported hearing loss, eye redness and photophobia. Her condition progressed to a sudden sensorineural hearing loss, tinnitus, and constant vertigo accompanied by cephalea. CS was diagnosed after excluding other diseases. The patient still developed bilateral sensorineural hearing loss after receiving hormone, methotrexate, cyclophosphamide, and a variety of biological agents. Joint symptoms were relieved after treatment with a JAK inhibitor (tofacitinib), and hearing did not deteriorate further.

Conclusions

CS should be involved in the differential diagnosis of keratitis. Early identification and intervention of this autoimmune disease can minimize disability and irreversible damage.
Real-life instability in ADHD from young to middle adulthood: a nationwide register-based study of social and occupational problems
Authors: Ahlberg Rickard , Du Rietz E. , Ahnemark E. , Andersson L. M. , Werner-Kiechle T. , Lichtenstein P. , Larsson H. , Garcia-Argibay M.
Published: May 2023

Background

Studies using self-reports indicate that individuals with ADHD are at increased risk for functional impairments in social and occupational settings, but evidence around real-life instability remains limited. It is furthermore unclear if these functional impairments in ADHD differ across sex and across the adult lifespan.

Method

A longitudinal observational cohort design of 3,448,440 individuals was used to study the associations between ADHD and residential moves, relational instability and job shifting using data from Swedish national registers. Data were stratified on sex and age (18–29 years, 30–39 years, and 40–52 years at start of follow up).

Results

31,081 individuals (17,088 males; 13,993 females) in the total cohort had an ADHD-diagnosis. Individuals with ADHD had an increased incidence rate ratio (IRR) of residential moves (IRR 2.35 [95% CI, 2.32–2.37]), relational instability (IRR = 1.07 [95% CI, 1.06–1.08]) and job shifting (IRR = 1.03 [95% CI, 1.02–1.04]). These associations tended to increase with increasing age. The strongest associations were found in the oldest group (40–52 years at start of follow). Women with ADHD in all three age groups had a higher rate of relational instability compared to men with ADHD.

Conclusion

Both men and women with a diagnosis of ADHD present with an increased risk of real-life instability in different domains and this behavioral pattern was not limited to young adulthood but also existed well into older adulthood. It is therefore important to have a lifespan perspective on ADHD for individuals, relatives, and the health care sector.
The association between mental health and Bulimia Nervosa among a sample of Lebanese young adults: the indirect effect of difficulties in emotion regulation
Authors: Azzi Reine , Samaha Serena , Malaeb Diana , Akel Marwan , Azzi Vanessa , Hallit Souheil , Obeid Sahar
Published: May 2023

Background

Bulimia nervosa (BN) is defined as repeated episodes of binge eating, followed by compensatory behaviors such as self-induced vomiting. BN has been shown to be associated with many co-morbidities including depression and anxiety. BN has also been associated with stress, which was shown to trigger binge eating episodes in BN. Furthermore, difficulties in emotion regulation have been seen to play an important role in the psychopathology of eating disorders, including BN. Seeing that BN is the most prevalent eating disorder in Lebanon, which is linked to the stressful events the country has been through, the study aims to examine the indirect effect of emotional dysregulation on this relationship between mental health issues (stress, anxiety and depression) and bulimia nervosa among young adults. We hypothesize that difficulties in emotion regulation would have an indirect effect in the relationship between mental health and BN.

Methods

This was a cross-sectional observational study, based on an online anonymous survey, which was carried out between September and December of 2020. Participants were all 18 years and above, recruited from all Lebanese governorates (n = 1175).

Results

Difficulties in emotion regulation mediated the association between anxiety/stress/depression and bulimia. Higher mental health issues were significantly associated with more difficulties in emotion regulation; higher difficulties in emotion regulation were significantly associated with more bulimia. Finally, higher anxiety and higher stress, but not depression, were significantly and directly associated with higher bulimia.

Conclusion

Results of this study could be used by mental health professional to shed light on the difficulties in emotion regulation in patients with BN and try to use therapeutic strategies to help them better regulate their emotions.
Reliability and validity evaluation of the chinese revision of the attitude towards adult vaccination scale
Authors: Kong Jie , Liang Chunguang , Fu Dongmei , Wang Liying , Yan Xiangru , Li Sisi , Zhang Hui
Published: May 2023

Background

Although vaccination is one of the critical interventions to address global health issues, inadequate vaccination rates has become an international challenge. Vaccine hesitancy is the key to affecting inadequate vaccination rates. According to the WHO SAGE working group’s definition, vaccine hesitancy refers to delaying or refusing vaccination and has been ranked as one of the top 10 health threats. There has yet to be a scale that evaluates vaccination attitudes among Chinese adults. However, an attitude quantity, the adult vaccination attitude scale, has been developed to assess adult vaccination attitudes and reasons for vaccine hesitancy.

Objective

The Adult Attitudes to Vaccination Scale (ATAVAC) was initially developed by Professor Zoi Tsimtsiou et al. This study aimed to analyze the structure of the Chinese version of the ATAVAC and explore the relationship between adult vaccination attitudes, e-health literacy, and medical distrust.

Methods

After obtaining author permission for the initial scales, the study was translated using the Brislin back-translation method. 693 adults were enrolled to the study. To validate this hypothesis, participants finished the socio-demographic questionnaire, the Chinese version of the ATAVAC, the electronic Health Literacy Scale (e-HEALS) and the Medical Mistrust Index (MMI). The exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to examine the underlying structure of the factors of the Chinese version of the Adult Vaccination Attitude Scale and to measure its reliability and validity.

Results

The Cronbach’s alpha coefficient for the Chinese version of the ATAVAC was 0.885, with Cronbach’s alpha coefficients ranging from 0.850 to 0.958 for each dimension. The content validity index was 0.90, and the retest reliability was 0.943. The exploratory factor analysis (EFA) supported the 3-factor structure of the translation instrument, and the scale had good discriminant validity. The confirmatory factor analysis (CFA) revealed a degree of freedom of 1.219, a model fit index (GFI) of 0.979, a normative fit index (NFI) of 0.991, a Tucker-Lewis index (TLI) of 0.998, a comparability index (CFI) of 0.998 and a root mean square error of approximation (RMSEA) of 0.026.

Conclusion

The results show that the Chinese version of the ATAVAC has demonstrated good reliability and validity. Hence, it can be used as an effective tool to assess vaccination attitudes among Chinese adults.
The association between parental risks and childhood development: findings from a community-based survey in East China
Authors: Zheng Shuangshuang , Fang Jianing , Bai Guannan , He Xinyu , Hua Mengdi , Zhu Bingquan , Chen Weijun , Dong Wenhong , Wang Lei , Huang Xiaona , Wang Huishan , Shao Jie
Published: May 2023

Background

Nurturing care is necessary for optimal early childhood development. This study aimed to investigate the prevalence of parental risks in rural East China and assess their impacts on early development in children younger than three years old.

Methods

This community-based cross-sectional survey was conducted among 3852 caregiver-child pairs in Zhejiang Province from December 2019 to January 2020. Children aged 0 to 3 years were recruited from China’s Early Childhood Development Program (ECD). Local child health care providers conducted face-to-face interviews with the primary caregivers. Demographic information of the participants was collected by questionnaire. Each child was screened for parental risk through the Parental Risk Checklist designed by the ECD program. The Ages and Stages Questionnaire (ASQ) was used to identify children with potential developmental delays. Multinomial logistic regression model and linear trend test were applied to assess the association between parental risks and suspected developmental delays.

Results

Among the 3852 children included in the analyses, 46.70% had at least one parental risk and 9.01% presented suspected developmental delays in any domain of ASQ. Parental risk was statistically associated with the overall suspected developmental delay in young children (Relative Risk Ratio (RRR): 1.36; 95% confidence interval (CI): 1.08, 1.72; P = 0.010) after adjusting potential confounders. Compared with children with no parental risk, children exposed to 3 or more parental risks had 2.59, 5.76, 3.95, and 2.84 times higher risk of the suspected developmental delay in overall ASQ, communication, problem-solving, and personal-social domain, respectively (P values < 0.05). The linear trend tests found that the more parental risks, the higher possibility of developmental delay (P values < 0.05).

Conclusions

Parental risks are prevalent among children under three years in rural East China, which may increase the risk of developmental delays in children. Meanwhile, parental risk screening can be used to recognize poor nurturing care in primary health care settings. Targeted interventions are warranted to improve nurturing care for optimal early childhood development.
Butyrate inhibits iILC2-mediated lung inflammation via lung-gut axis in chronic obstructive pulmonary disease (COPD)
Authors: Jiang Min , Li Zhiwei , Zhang Fengbo , Li Zheng , Xu Dan , Jing Jing , Li Fengsen , Wang Jing , Ding Jianbing
Published: May 2023

Background

The study investigated the effects and underlying mechanisms of intestinal flora metabolite butyrate on inflammatory ILC2 cells (iILC2s)-mediated lung inflammation in chronic obstructive pulmonary disease (COPD).

Methods

Mouse models of COPD and acute exacerbation of COPD (AECOPD) were established. Flow cytometry was used to detect natural ILC2 cells (nILC2s) and iILC2s in lung and colon tissues. The 16s rRNA and GC-MS were used to detect microbial flora and short chain fatty acids (SCFAs) in feces. ELISA was used to detect IL-13 and IL-4. Western blot and qRT-PCR were used to detect the relative protein and mRNA levels, respectively. In vitro experiments were performed with sorted ILC2s from colon tissues of control mice. Mice with AECOPD were treated with butyrate.

Results

The nILC2s and iILC2s in lung and colon tissues of AECOPD mice were significantly higher than control groups. The abundance of the flora Clostridiaceae was significantly reduced, and the content of SCFAs, including acetate and butyrate, was significantly reduced. The in vitro experiments showed that butyrate inhibited iILC2 cell phenotype and cytokine secretion. Butyrate treatment reduced the proportion of iILC2 cells in the colon and lung tissues of mice with AECOPD.

Conclusions

The nILC2s and iILC2s in the colon tissues are involved in the course of COPD. Decreased Clostridiaceae and butyrate in AECOPD mice caused the accumulation of iILC2 cells in the intestines and lungs. Supplementation of butyrate can reduce iILC2 in the intestine and lung tissues. Our data may provide new ideas for prevention and treatment of COPD.
Prevalence and clinical impact of frailty in COPD: a systematic review and meta-analysis
Authors: Wang Lina , Zhang Xiaolin , Liu Xinmin
Published: May 2023

Background

Frailty has been increasingly identified as a risk factor of adverse outcomes in chronic obstructive pulmonary disease (COPD). The prevalence and impact of frailty on health outcomes in people with COPD require clarification.

Methods

PubMed, Embase, The Cochrane Library and Web of Science (January 1, 2002, to July 1, 2022) were comprehensively searched to identify studies related to frailty and COPD. Comparisons were made between people who did and did not have frailty for pulmonary function, dyspnea severity, 6-minute walking distance, activities of daily life, and mortality.

Results

Twenty studies (9 cross-sectional, 10 cohort studies,1 clinical trial) from Europe (9), Asia (6), and North and South America (4), Oceania (1) involving 11, 620 participants were included. The prevalence of frailty was 32.07% (95% confidence interval (CI) 26.64–37.49) with a range of 6.43–71.70% based on the frailty tool used. People with frailty had lower predicted forced expiratory volume in the first second (mean difference − 5.06%; 95%CI -6.70 to -3.42%), shorter 6-minute walking distance (mean difference − 90.23 m; 95%CI -124.70 to -55.76), poorer activities of daily life (standardized mean difference − 0.99; 95%CI -1.35 to -0.62), higher CAT(COPD Assessment Test) score(mean difference 6.2; 95%CI 4.43 to 7.96) and mMRC (modified Medical Research Council) grade (mean difference 0.93; 95%CI 0.85 to 1.02) compared with those who did not (P < 0.001 for all). Meta-analysis showed that frailty was associated with an increased risk of long-term all-cause mortality (HR 1.68; 95% CI 1.37–2.05; I2 = 0%, P < 0.001).

Conclusion

Frailty is prevalent in people with COPD and linked with negative clinical outcomes including pulmonary function, dyspnea severity, exercise capacity, quality of life and mortality.
Sensory analysis of formulations containing whey protein to individuals undergoing bariatric and metabolic surgery
Authors: Alvarez Tatiana Souza , Von Atzingen Maria Carolina Batista Campos , Sarni Roseli Oselka Saccardo
Published: May 2023

Background

Individuals undergoing bariatric surgery often have inadequate protein intake, which can cause loss of lean body mass, low level of physical activity and sarcopenia. The whey protein supplement is the most suitable in this situation, however there is a low adherence to long-term use due to the palatability and monotony of the recipes. The aim this study was to analyze the acceptability of recipes containing whey-based protein supplements in individuals undergoing bariatric and metabolic surgery.

Methods

An on-demand sampling was performed, through a prospective, experimental study, with individuals undergoing bariatric surgery, treated by a multidisciplinary team, in a clinic located in São Paulo, Brazil. The study excluded: individuals with possible changes in taste during the sensory testing period. The study was divided into selection of recipes containing whey proteins, recruitment of tasters, sensory and chemical analysis of the recipes.

Results

The sample consisted of 40 tasters, adults, and elderly, who underwent bariatric and metabolic surgery, with a median of eight years of surgery, who had previously consumed a supplement. These individuals were subjected to sensory analysis of six recipes with fresh and minimally processed foods, plus protein supplement. All recipes had food acceptance above 78% and the chemical analysis of the recipes showed an average of 13 g of protein per serving.

Conclusion

There was favorable acceptance of recipes with whey proteins, which places them as good dietary alternatives for the prevention of sarcopenia and weight relapse in individuals undergoing bariatric and metabolic surgery.
Laser doppler flowmetry to detect pulp vitality, clinical reference range and coincidence rate for pulpal blood flow in permanent maxillary incisors in Chinese children: a clinical study
Authors: Yang Kuan , Guo Feifei , Zhou Zhifei , Hui Zeming , Wang Zirui , Wang Junhui , Chen Yujiang , Ge Xin , Huang Ruizhe , Wang Xiaojing
Published: May 2023

Background

A laser doppler flowmetry (LDF) test can reflect the pulp vitality caused by the change in pulp blood flow (PBF). This study aimed to investigate the PBF of the permanent maxillary incisors using LDF and to calculate the clinical reference range and coincidence rate for pulp vitality using PBF as an indicator.

Methods

School-age children (7–12 years) were recruited randomly. A total of 455 children (216 female and 239 male) were included in this study. An additional 395 children (7–12 years) who attended the department due to anterior tooth trauma from October 2015 to February 2018 were included to assess the clinical occurrence rate. The PBF was measured using LDF equipment and an LDF probe.

Results

The clinical reference range of PBF values for the permanent maxillary incisors (teeth 11, 12, 21, and 22) in children were from 7 to 14 perfusion units (PU), 11 (6.016; 11.900 PU), 12 (6.677; 14.129 PU), 21 (6.043;11.899 PU), and 22 (6.668; 14.174 PU). There was a statistically significant correlation between PBF and children’s age (p < 0.000) without any significant gender discrimination (p = 0.395). For all incisors, for any age group, the PBF detection value of the lateral incisors was significantly higher than that of the central incisors (p < 0.05). The clinical coincidence rate of detecting PBF in the traumatic teeth was 90.42% and the sensitivity and specificity were 36.99% and 99.88%, respectively.

Conclusions

The determination of the PBF clinical reference range and clinical coincidence rate for the permanent maxillary incisors in children using LDF provided a promising theoretical basis for clinical applications.
Facilitators and barriers to engaging with the DREAMS initiative among young women who sell sex aged 18–24 in Zimbabwe: a qualitative study
Authors: Machingura Fortunate , Busza Joanna , Jamali Gracious Madimutsa , Makamba Memory , Mushati Phillis , Chiyaka Tarisai , Hargreaves James , Hensen Bernadette , Birdthistle Isolde , Cowan Frances Mary
Published: May 2023

Background

Adolescent girls and young women (AGYW) are at high risk of contracting HIV and exchanging sex for financial or material support heightens their risk. In Zimbabwe, the DREAMS initiative integrated education and employment opportunities within HIV health promotion and clinical services for vulnerable young women, including those who sell sex. While most participants accessed health services, fewer than 10% participated in any social programmes.

Methods

We conducted semi-structured qualitative interviews with 43 young women aged 18–24 to understand their experiences of engaging with the DREAMS programme. We purposively sampled participants for diversity in level of education, type and location of selling sex. We analysed the data by applying the Theoretical Domains Framework to explore facilitators and barriers to engaging with DREAMS.

Results

Eligible women were motivated by hopes of escaping poverty, and their longer-term engagement was sustained through exposure to new social networks, including friendships with less vulnerable peers. Barriers included opportunity costs and expenses such as transport or equipment required for job placements. Participants also described pervasive stigma and discrimination related to their involvement in selling sex. Interviews highlighted the young women’s struggles in a context of entrenched social and material deprivation and structural discrimination that hindered their ability to take up most of the social services offered.

Conclusions

This study demonstrates that while poverty was a key driver of participation in an integrated package of support, it also constrained the ability of highly vulnerable young women to benefit fully from the DREAMS initiative. Multi-layered HIV prevention approaches such as DREAMS that seek to alter complex and longstanding social and economic deprivation address many of the challenges faced by YWSS but will only succeed if the underlying drivers of HIV risk among YWSS are also addressed.
Predicting cervical cancer screening behavior among women in southern Iran: a cross-sectional study with PEN-3 model
Authors: Hosseini Zahra , Seyrafi Niloofar , Homayuni Atefeh , Mouseli Ali , Homayuni Atefeh
Published: May 2023

Introduction

Despite the fact that the Pap smear test is a simple, affordable, painless and relatively reliable method to diagnose cervical cancer in women, the majority of women are unaware of the value of this valuable diagnostic method. There are many cultural and social barriers to this diagnostic method. The present study was conducted to predict cervical cancer screening behavior with PEN-3 model among women residents of Bandar Abbas.

Methods

The present descriptive-analytical study was conducted on 260 women aged 18 years and above who visited the comprehensive health centers of Bandar Abbas. The data were collected online using a demographic information questionnaire and a researcher-made questionnaire based on the PEN-3 model constructs and analyzed using Mann-Whitney U test, Pearson correlation test and logistic regression analysis in SPSS-23.

Results

The participants’ age ranged between 18 and 52 years with an average of 30.95 ± 5.47 years. 27.7% of the participants had done their last pap smear test less than 1 year before the study and 26.2% had not done a pap smear test until the time of study. The results showed that the mean scores of knowledge (11.28 ± 2.87), attitude (64.96 ± 4.96), enablers (44.66 ± 5.8), and nurturers (36.02 ± 8.83) in women who had done the cervical cancer screening behavior was more than those who had not done the behavior. Also, the results of logistic regression analysis showed that knowledge, attitude and nurturers were the major predictors of cervical cancer screening behavior.

Conclusion

The present findings showed that knowledge, attitude, enablers and nurturers play a major role in women’s participation in Pap smear test. These findings should be considered in the development and implementation of educational interventions.
Spanish psychometric properties of the moral distress scale—revised: a study in healthcare professionals treating COVID-19 patients
Authors: Galiana L , Moreno-Mulet C , Carrero-Planells A , López-Deflory C , García-Pazo P , Nadal-Servera M , Sansó N
Published: May 2023

Background

Moral distress appears when a healthcare professional is not able to carry out actions in accordance with their professional ethical standards. The Moral Distress Scale-Revised is the most widely used to assess levels of moral distress, but it is not validated in Spanish. The aim of the study is to validate the Spanish version of the Moral Distress Scale – utilised within a sample of Spanish healthcare professionals treating COVID–19 patients.

Methods

The original (english) and the portuguese and french versions of the scale were translated into spanish by native or bilingual researchers and reviewed by an academic expert in ethics and moral philosophy as well as by a clinical expert. Research design: Descriptive cross-sectional study carried out using a self-reporting online survey. The data was collected between June- November 2020. A total of 661 professionals responded to the survey (N = 2873). Participants: healthcare professionals with more than two weeks of experience treating COVID–19 patients at the end of their life and working in the public sector of the Balearic Islands Health Service (Spain). Analyses included descriptive statistics, competitive confirmatory factor analysis, evidence on criterion-related validity and estimates of reliability. The study was approved by the Research Ethics Committee at the University of Balearic Islands.

Results

An unidimensional model in which a general factor of moral distress explained by 11 items of the Spanish version of the MDS–R scale was an adequate representation of the data: χ2(44) = 113.492 (p 0.001); Comparative Fit Index = 0.965; Root Mean Square Error of Approximation = 0.079[0.062,0.097]; and Standarized Root Mean-Square = 0.037. Evidence of reliability was excellent: Cronbach’s alpha = 0.886 and McDonald’s omega = 0.910. Moral distress was related to discipline, with nurses having statistically significant higher levels than physicians. Additionally, moral distress successfully predicted professional quality of life, with higher levels of moral distress being related to poorer quality of life.

Conclusions

The Spanish version of Moral Distress Scale–Revised can be used as a reliable and valid measurement tool for the evaluation of moral distress experienced by health professionals. This tool will be highly useful for managers and applicable to a variety of healthcare professionals and settings.
Change in habitual intakes of flavonoid-rich foods and mortality in US males and females
Authors: Bondonno Nicola P. , Liu Yan Lydia , Zheng Yan , Ivey Kerry , Willett Walter C. , Stampfer Meir J. , Rimm Eric B. , Cassidy Aedín
Published: May 2023

Background

Higher baseline intakes of flavonoid-rich foods and beverages are associated with a lower risk of chronic disease and mortality in observational studies. However, associations between changes in intakes and mortality remain unclear. We aimed to evaluate associations between 8-year changes in intakes of (1) individual flavonoid-rich foods and (2) a composite measure (termed the ‘flavodiet’) of foods and beverages that are known to be main contributors to flavonoid intake and subsequent total and cause-specific mortality.

Methods

We evaluated associations between 8-year changes in intakes of (1) individual flavonoid-rich foods and (2) a novel ‘flavodiet’ score and total and cause-specific mortality. We included 55,786 females from the Nurses’ Health Study (NHS) and 29,800 males from the Health Professionals Follow-up Study (HPFS), without chronic disease at baseline in our analyses. Using multivariable-adjusted Cox proportional hazard models, we examined associations of 8-year changes in intakes of (1) flavonoid-rich foods and (2) the flavodiet score with subsequent 2-year lagged 6-year risk of mortality adjusting for baseline intakes. Data were pooled using fixed-effects meta-analyses.

Results

We documented 15,293 deaths in the NHS and 8988 deaths in HPFS between 1986 and 2018. For blueberries, red wine and peppers, a 5%, 4% and 9% lower risk of mortality, respectively, was seen for each 3.5 servings/week increase in intakes while for tea, a 3% lower risk was seen for each 7 servings/week increase [Pooled HR (95% CI) for blueberries; 0.95 (0.91, 0.99); red wine: 0.96 (0.93, 0.99); peppers: 0.91 (0.88, 0.95); and tea: 0.97 (0.95, 0.98)]. Conversely, a 3.5 servings/week increase in intakes of onions and grapefruit plus grapefruit juice was associated with a 5% and 6% higher risk of total mortality, respectively. An increase of 3 servings per day in the flavodiet score was associated with an 8% lower risk of total mortality [Pooled HR: 0.92 (0.89, 0.96)], and a 13% lower risk of neurological mortality [Pooled HR: 0.87 (0.79, 0.97)], after multivariable adjustments.

Conclusions

Encouraging an increased intake of specific flavonoid-rich foods and beverages, namely tea, blueberries, red wine, and peppers, even in middle age, may lower early mortality risk.
LINC00963-FOSB-mediated transcription activation of UBE3C enhances radioresistance of breast cancer cells by inducing ubiquitination-dependent protein degradation of TP73
Authors: Wang Yansu , Liu Ming , Liu Xiaoqian , Guo Xianling
Published: May 2023

Background

The ubiquitin protein ligase E3C (UBE3C) has been reported to play an oncogenic role in breast cancer (BRCA). This work further investigates the effect of UBE3C on the radioresistance of BRCA cells.

Methods

Molecules linking to radioresistance in BRCA were identified by analyzing two GEO datasets, GSE31863 and GSE101920. UBE3C overexpression or knockdown was induced in parental or radioresistant BRCA cells, followed by irradiation treatment. The malignant properties of cells in vitro, and the growth and metastatic activity of cells in nude mice, were analyzed. Downstream target proteins, as well as upstream transcriptional regulators of UBE3C, were predicted by bioinformatics tools. Molecular interactions were confirmed by immunoprecipitation and immunofluorescence assays. Furthermore, artificial alterations of TP73 and FOSB were induced in the BRCA cells for functional rescue assays.

Results

According to bioinformatics analyses, UBE3C expression was linked to radioresistance in BRCA. UBE3C knockdown in radioresistant BRCA cells reduced while its overexpression in parental BRCA cells increased the radioresistance of cells in vitro and in vivo. UBE3C, which induced ubiquitination-dependent protein degradation of TP73, was transcriptionally activated by FOSB. The radioresistance of cancer cells was blocked by TP73 overexpression or FOSB knockdown. Additionally, LINC00963 was found to be responsible for the recruitment of FOSB to the UBE3C promoter for transcription activation.

Conclusion

This work demonstrates that LINC00963 induces nuclear translocation of FOSB and the consequent transcription activation of UBE3C, which enhances radioresistance of BRCA cells by inducing ubiquitination-dependent protein degradation of TP73.

Graphical Abstract