bluuebunny/crossref_metadata_2025 huggingface dataset:
The effectiveness of neurorehabilitation in inpatient department
Authors: Manysheva K. B. , Alieva B. B. , Emirgamzaev Sh. S.
Published: August 2024

The objective of the study is to evaluate the effectiveness of rehabilitation treatment in patients with neurological pathology in inpatient department.Materials and methods. The study included 101 patients undergoing hospital treatment due to an existing neurological disease. The mean age was 52.41 ± 13.49 years. The condition of each patient upon admission and after the course of inpatient treatment was assessed using special tools – scales, tests, indices and questionnaires, such as the Rehabilitation Routing Scale and the modified Rankin scale, and according to the clinical specifics and needs of rehabilitation treatment – the Ashworth scale, Caprini Scale, Muscle Strength Grading Scale, National Institutes of Health Stroke Scale, HAS-BLED Scale, Berg Scale, Functional Independence Measure, Waterlow Score, Numeric Pain Rating Scale, Frenchay Arm Test, Rivermead Mobility Index, Hauser Index, EQ-5D, Barthel Index. The dynamics of recovery were calculated by comparing scores obtained using special instruments upon admission to rehabilitation treatment and after it.Results. By analyzing the results of the study, a positive dynamic of recovery was established, confirming the effectiveness of an inpatient course of neurorehabilitation, which is expressed in an improvement in the condition of patients when assessed using the designated tools for its objectification.Conclusions. The study confirms the effectiveness of an inpatient course of medical rehabilitation in restoring neurological deficits, increasing the activity of daily living, reducing the degree of social maladjustment and improving the rehabilitation prognosis.
Late diagnosis of chronic inflammatory demyelinating polyneuropathy on the background of misdiagnosed alcoholic polyneuropathy: a clinical case
Authors: Shtaimets S. V. , Mineeva A. A. , Lalov Ju. V. , Filatenkova T. V.
Published: August 2024

Chronic inflammatory demyelinating polyneuropathy is a rare immune-mediated polyneuropathy pathology of the peripheral nervous system. The presence of etiological factors in the patient, such as type 1 and 2 diabetes mellitus, alcohol intoxication in the anamnesis or other causes of polyneuropathy, which are often found in practice, can disguise chronic inflammatory demyelinating polyneuropathy and lead to delayed diagnosis of potentially curable polyneuropathy, which further increases the likelihood of disability of the patient and a significant decrease in the quality of his life. The clinical case under consideration is a demonstration of such diagnostic difficulties, which led to a delayed diagnosis of chronic inflammatory demyelinating polyneuropathy against the background of alcohol abuse in the debut of neurological disorders.
Prognostic role of NT-proBNP and ultrasound assessment of venous congestion according to the VEXUS protocol in patients with acute decompensation of heart failure in the intensive care unit
Authors: Vatsik-Gorodetskaya M. V. , Petrikov S. S. , Tolkacheva V. V. , Kobalava Z. D.
Published: August 2024

Aim. To determine the prognostic value of NT-proBNP and ultrasound assessment of venous congestion according to the VEXUS protocol in patients hospitalized with acute decompensation of heart failure (ADHF) in the intensive care unit (ICU) in relation to adverse outcomes for HF during a year of follow-up.

Materials and methods. A prospective observational study included 150 patients hospitalized with ADHF in the ICU. All patients included in the study at admission and discharge underwent standard physical, laboratory and instrumental examinations, including NT-proBNP, lung ultrasound, assessment of venous congestion according to the VExUS protocol. The assessment of long-term clinical events was carried out by a structured telephone survey 1, 3, 6, 12 months after discharge. The total rate of total mortality and repeated hospitalizations for HF was estimated as the endpoint.

Results. During 1 year of follow–up, 58 events (38 %) were detected, 50 deaths (33 %), 8 repeated hospitalizations (5 %). Patients with events were significantly older, characterized by more pronounced laboratory and instrumental assessment of congestion, diameter of the inferior vena cava, and venous congestion. The following threshold values were identified by ROC curves for predicting outcomes (total mortality + re–hospitalization) − the degree of venous congestion according to the VExUS GRADE protocol >2 and the level of NT-proBNP>10806 pg/ml at admission, the diameter of the inferior vena cava >2.3 cm at discharge.

Conclusion: NT-proBNP>10806 pg/ml and GRADE>2 of venous congestion according to the VExUS protocol in patients admitted to the ICU with ADHF, have prognostic value in relation to the risk of adverse outcomes (total mortality and repeated hospitalizations) during a year of follow-up.
Ischemic stroke in cancer patients: possibilities of reperfusion therapy in elderly patients
Authors: Komarova A. G. , Krivosheeva N. M. , Zhuravlev V. S. , Chekini A. K. , Arablinskiy A. V. , Rodionov E. P. , Levin O. S.
Published: August 2024

Globally, stroke and malignancies represent a major public health burden. Cancer and stroke are two clinical manifestations that are related: cancer patients have twice the risk of stroke than the general population [1]. Types of cancer most commonly associated with ischemic stroke are lung cancer, pancreatic cancer, breast cancer and prostate cancer [2]. An analysis of patients with ischemic stroke and concomitant cancer who underwent inpatient treatment at the regional vascular center in Botkin Hospital. A total of 199 patients with ischemic stroke and malignancy were analyzed. 68 patients received reperfusion therapy and 131 patients did not receive reperfusion therapy. As a result of the analysis, it was concluded that reperfusion therapy is possible and necessary for patients with malignant tumors. The risk of developing extracranial hemorrhages associated with the oncological process is extremely low, and the development of intracranial hemorrhagic complications does not significantly worsen the outcome of the disease. The severity of stroke in the presence of cancer was for the most part due to the stroke itself, its size and location, and depended less on the stage of cancer.
Effects of different adding methods of fermentation medium on the quality of cigar
Authors: Wen Cai , Shuanghong Yang , Wanrong Hu , Ran Chen , Zhishun Chai , Danqun Huo , Changjun Hou , Dongliang Li , Qianying Zhang
Published: August 2024

Background: To investigate the effects of different media and media addition methods on the fermentation of tobacco.

Methods: A plant extract and a bacterial agent are used for fermenting cigar tobacco leaves in a different order of addition. The chemical composition, cellulose, and pectin content, as well as changes in the microbial community, were measured.

Results: The addition method of the fermentation medium affects the quality of fermented tobacco. The optimal medium formula and addition method involve first adding plant extracts and then microbial agents. The medium formula and addition method can significantly reduce cellulose in tobacco, with a reduction rate of 46%, and significantly increase the content of β-carotene, thereby enhancing the aroma of cigarettes. There is an increase in aroma components, such as alcohols, alkanes, and olefins, in tobacco. By reducing the proportion of Aspergillus, it can alter the microbial community structure of tobacco.

Conclusion: Adding plant extracts before introducing microbial agents can significantly improve the quality and alter the microbial community structure of Dexue No.1 tobacco.
NOX4-reactive oxygen species axis: critical regulators of bone health and metabolism
Authors: Dzubanova Martina , Bond Jacob M. , Craige Siobhan M. , Tencerova Michaela
Published: August 2024

Bone marrow stromal cells (BMSCs) play a significant role in bone metabolism as they can differentiate into osteoblasts, bone marrow adipocytes (BMAds), and chondrocytes. BMSCs chronically exposed to nutrient overload undergo adipogenic programming, resulting in bone marrow adipose tissue (BMAT) formation. BMAT is a fat depot transcriptionally, metabolically, and morphologically distinct from peripheral adipose depots. Reactive oxygen species (ROS) are elevated in obesity and serve as important signals directing BMSC fate. ROS produced by the NADPH oxidase (NOX) family of enzymes, such as NOX4, may be responsible for driving BMSC adipogenesis at the expense of osteogenic differentiation. The dual nature of ROS as both cellular signaling mediators and contributors to oxidative stress complicates their effects on bone metabolism. This review discusses the complex interplay between ROS and BMSC differentiation in the context of metabolic bone diseases.Special attention is paid to the role of NOX4-ROS in regulating cellular processes within the bone marrow microenvironment and potential target in metabolic bone diseases.
Cellular metabolism changes in atherosclerosis and the impact of comorbidities
Authors: Dai Yusang , Junho Carolina Victoria Cruz , Schieren Luisa , Wollenhaupt Julia , Sluimer Judith C. , van der Vorst Emiel P. C. , Noels Heidi
Published: August 2024

Cell activation and nutrient dysregulation are common consequences of atherosclerosis and its preceding risk factors, such as hypertension, dyslipidemia, and diabetes. These diseases may also impact cellular metabolism and consequently cell function, and the other way around, altered cellular metabolism can impact disease development and progression through altered cell function. Understanding the contribution of altered cellular metabolism to atherosclerosis and how cellular metabolism may be altered by co-morbidities and atherosclerosis risk factors could support the development of novel strategies to lower the risk of CVD. Therefore, we briefly review disease pathogenesis and the principles of cell metabolic pathways, before detailing changes in cellular metabolism in the context of atherosclerosis and comorbidities. In the hypoxic, inflammatory and hyperlipidemic milieu of the atherosclerotic plaque riddled with oxidative stress, metabolism shifts to increase anaerobic glycolysis, the pentose-phosphate pathway and amino acid use. We elaborate on metabolic changes for macrophages, neutrophils, vascular endothelial cells, vascular smooth muscle cells and lymphocytes in the context of atherosclerosis and its co-morbidities hypertension, dyslipidemia, and diabetes. Since causal relationships of specific key genes in a metabolic pathway can be cell type-specific and comorbidity-dependent, the impact of cell-specific metabolic changes must be thoroughly explored in vivo, with a focus on also systemic effects. When cell-specific treatments become feasible, this information will be crucial for determining the best metabolic intervention to improve atherosclerosis and its interplay with co-morbidities.
Feasibility of deescalating postoperative care in enhanced recovery after cardiac surgery
Authors: Stock Sina , Berger Veith Sarah , Holst Theresa , Erfani Sahab , Pochert Julia , Dumps Christian , Girdauskas Evaldas
Published: August 2024

Introduction

Enhanced Recovery After Surgery (ERAS) prioritizes faster functional recovery after major surgery. An important aspect of postoperative ERAS is decreasing morbidity and immobility, which can result from prolonged critical care. Using current clinical data, our aim was to analyze whether a six-hour monitoring period after Minimally Invasive Cardiac Surgery (MICS) might be sufficient to recognize major postoperative complications in a future Fast Track pathway. Additionally, we sought to investigate whether it could be possible to deescalate the setting of postoperative monitoring.

Methods

358 patients received MICS and were deemed suitable for an ERAS protocol between 01/2021 and 03/2023 at our institution. Of these, 297 patients could be successfully extubated on-table, were transferred to IMC or ICU in stable condition and therefore served as study cohort. Outcomes of interest were incidence and timing of Major Adverse Cardiac Events (MACE; death, myocardial infarction requiring revascularization, stroke), bleeding requiring reexploration and Fast Track-associated complications (reintubation and readmission to ICU).

Results

Patients' median age was 63 years (IQR 55–70) and 65% were male. 189 (64%) patients received anterolateral mini-thoracotomy, primarily for mitral and/or tricuspid valve surgery (n = 177). 108 (36%) patients had partial upper sternotomy, primarily for aortic valve repair/replacement (n = 79) and aortic surgery (n = 17). 90% of patients were normotensive without need for vasopressors within 6 h postoperatively, 82% of patients were transferred to the general ward on postoperative day 1 (POD). Two (0.7%) MACE events occurred, as well as 4 (1.3%) postoperative bleeding events requiring reexploration. Of these complications, only one event occurred before transfer to the ward - all others took place on or after POD 1. There was one instance of reintubation and two of readmission to ICU.

Conclusions

If MICS patients can be successfully extubated on-table and are hemodynamically stable, major postoperative complications were rare in our single-center experience and primarily occurred after transfer to the ward. Therefore, in well selected MICS patients with uncomplicated intraoperative course, monitoring for six hours, possibly outside of an ICU, followed by transfer to the ward appears to be a feasible theoretical concept without negative impact on patient safety.
Minimally invasive vs. conventional mitral valve surgery: a meta-analysis of randomised controlled trials
Authors: Amin Aamir , Kumar Rajanikant , Mokhtassi Shiva Seyed , Alassiri Abdullah K. , Odaman Agatha , Khan Muhammad Ahmad Raza , Lakshmana Shashi , Din Zahir Ud , Acharya Pawan , Cheema Huzaifa Ahmad , Nashwan Abdulqadir J. , Khan Arsalan Ali , Hussain Awab , Bhudia Sunil , Vincent Royce P.
Published: August 2024

Objective

The evidence underlying the efficacy and safety of minimally invasive mitral valve surgery (MIMVS) is inconclusive. We conducted a meta-analysis to evaluate whether MIMVS improves clinical outcomes compared with conventional sternotomy.

Methods

We searched MEDLINE (via PubMed), Embase, the Cochrane Library, and ClinicalTrials.gov from inception to January 2024 for all randomised controlled trials (RCTs), comparing MIMVS with conventional mitral valve surgery. RevMan 5.4 was used to analyse the data with risk ratio (RR) and mean difference (MD) as the effect measures.

Results

Eight studies reporting data on 7 RCTs were included in our review. There was no significant difference in all-cause mortality, the number of patients requiring blood product transfusion, and the change from baseline in the SF-36 physical function scores between the MIMVS and conventional sternotomy groups. MIMVS reduced the length of hospital stay (MD −2.02 days, 95% CI: −3.66, −0.39) but did not affect the length of ICU stay, re-operation for bleeding, and the incidence of renal injury, wound infection, neurological events, and postoperative moderate or severe mitral regurgitation. MIMVS was associated with a trend toward lower postoperative pain scores (MD −1.06; 95% CI: −3.96 to 0.75).

Conclusions

MIMVS reduced the number of days spent in the hospital and showed a trend toward lower postoperative pain scores, but it did not decrease the risk of all-cause mortality or the number of patients needing blood product transfusions. Further large-scale RCTs are required to inform definitive conclusions, particularly with regard to quality-of-life outcomes investigating functional recovery.

Systematic Review Registration

PROSPERO (CRD42023482122).
Does academic motivation contribute to the self-esteem of students at the graduate level? A case study of universities in the southern districts of Khyber Pakhtunkhwa, Pakistan
Authors: Ullah Hikmat , Shahzada Gulap , Khan Habib Nawaz
Published: August 2024

This study explored the impact of students' academic motivation on self-esteem at the graduate level. The respondents of this study were 375 university students enrolled in a Bachelor of Science (BS) program in nine disciplines from all four public sector universities in the southern districts of Khyber Pakhtunkhwa. Two standardized questionnaires, i.e., the Academic Motivation Scale, a tool consisting of 28 items for measuring academic motivation, and Rosenberg's Scale for measuring self-esteem, consisting of 10 items that measure self-respect by assessing both positive and negative emotional states about the self, were used. In light of the objectives and hypotheses, mean, and standard deviation (SD) were used to find out the level of academic motivation and self-esteem of the students. Linear regression was applied to find out the impact of students' academic motivation on their self-esteem. Moreover, an independent t-test was used to explore the difference in academic motivation and self-esteem between male and female students. There was no significant difference in the academic motivation and self-esteem of the students at the graduate level. The results showed that the university students at the graduate level had a high level of academic motivation and self-esteem. A unit change in overall academic motivation, knowledge, and stimulation parts of intrinsic motivation and identified and external regulation of extrinsic motivation bring 0.678, 0.218, 0.223, 0.122 and 0.172 change in self-esteem, respectively, while the constructs i.e., accomplishment (intrinsic motivation), introjected (extrinsic motivation), and amotivation are non-significant as p > 0.05.
The involvement of peritoneal GATA6+ macrophages in the pathogenesis of endometriosis
Authors: Shi Mingxin , MacLean James A. , Hayashi Kanako
Published: August 2024

Endometriosis is a chronic inflammatory disease that causes debilitating pelvic pain in women. Macrophages are considered to be key players in promoting disease progression, as abundant macrophages are present in ectopic lesions and elevated in the peritoneum. In the present study, we examined the role of GATA6+ peritoneal macrophages on endometriosis-associated hyperalgesia using mice with a specific myeloid deficiency of GATA6. Lesion induction induced the disappearance of TIM4hi MHCIIlo residential macrophages and the influx of increased Ly6C+ monocytes and TIM4lo MHCIIhi macrophages. The recruitment of MHCIIhi inflammatory macrophages was extensive in MacGata6 KO mice due to the severe disappearance of TIM4hi MHCIIlo residential macrophages. Ki67 expression confirmed GATA6-dependent proliferative ability, showing different proliferative phenotypes of TIM4+ residential macrophages in Gata6f/f and MacGata6 KO mice. Peritoneal proinflammatory cytokines were elevated after lesion induction. When cytokine levels were compared between Gata6f/f and MacGata6 KO mice, TNFα at day 21 in Gata6f/f mice was higher than in MacGata6 KO mice. Lesion induction increased both abdominal and hind paw sensitivities. Gata6f/f mice tended to show higher sensitivity in the abdomen after day 21. Elevated expression of TRPV1 and CGRP was observed in the dorsal root ganglia after ELL induction in Gata6f/f mice until days 21 and 42, respectively. These results support that peritoneal GATA6+ macrophages are involved in the recruitment and reprogramming of monocyte-derived macrophages. The extensive recruitment of monocyte-derived macrophages in MacGata6 KO mice might protect against inflammatory stimuli during the resolution phase, whereas GATA6 deficiency did not affect lesion initiation and establishment at the acute phase of inflammation. GATA6+ residential macrophages act to sustain local inflammation in the peritoneum and sensitivities in the neurons, reflecting endometriosis-associated hyperalgesia.
Nano-based formulations of thymoquinone are new approaches for psoriasis treatment: a literature review
Authors: Modarresi Chahardehi Amir , Ojaghi Hamid Reza , Motedayyen Hossein , Arefnezhad Reza
Published: August 2024

Psoriasis, a persistent immune-mediated inflammatory skin condition, affects approximately 2-3% of the global population. Current treatments for psoriasis are fraught with limitations, including adverse effects, high costs, and diminishing efficacy over time. Thymoquinone (TQ), derived from Nigella sativa seeds, exhibits promising anti-inflammatory, antioxidant, and immunomodulatory properties that could prove beneficial in managing psoriasis. However, TQ’s hydrophobic nature and poor bioavailability have hindered its usefulness as a therapeutic agent. Recent research has strategically addressed these challenges by developing nano-thymoquinone (nano-TQ) formulations to enhance delivery and efficacy in treating psoriasis. Preclinical studies employing mouse models have demonstrated that nano-TQ effectively mitigates inflammation, erythema, scaling, epidermal thickness, and cytokine levels in psoriatic lesions. Various nano-TQ formulations, including nanoemulsions, lipid vesicles, nanostructured lipid carriers, and ethosomes, have been explored to improve solubility, facilitate skin penetration, ensure sustained release, and achieve site-specific targeting. Although clinical trials are currently scarce, the outcomes from in vitro and animal models are promising. The potential co-delivery of nano-TQ with other anti-psoriatic agents also presents avenues for further investigation.
Obesity-compromised immunity in post-COVID-19 condition: a critical control point of chronicity
Authors: Jang Soonwoo , Hong Wooyoung , Moon Yuseok
Published: August 2024

Post-COVID-19 condition is recognized as a multifactorial disorder, with persistent presence of viral antigens, discordant immunity, delayed viral clearance, and chronic inflammation. Obesity has emerged as an independent risk factor for both SARS-CoV-2 infection and its subsequent sequelae. In this study, we aimed to predict the molecular mechanisms linking obesity and post-COVID-19 distress. Viral antigen-exposed adipose tissues display remarkable levels of viral receptors, facilitating viral entry, deposition, and chronic release of inflammatory mediators and cells in patients. Subsequently, obesity-associated inflammatory insults are predicted to disturb cellular and humoral immunity by triggering abnormal cell differentiation and lymphocyte exhaustion. In particular, the decline in SARS-CoV-2 antibody titers and T-cell exhaustion due to chronic inflammation may account for delayed virus clearance and persistent activation of inflammatory responses. Taken together, obesity-associated defective immunity is a critical control point of intervention against post-COVID-19 progression, particularly in subjects with chronic metabolic distress.
Rejuvenating bone marrow hematopoietic reserve prevents regeneration failure and hepatic decompensation in animal model of cirrhosis
Authors: Nautiyal Nidhi , Maheshwari Deepanshu , Kumar Dhananjay , Rao E. Pranshu , Tripathi Dinesh Mani , Kumar Sandeep , Diwakar Sunidhi , Bhardwaj Manisha , Mohanty Sujata , Baligar Prakash , Kumari Anupama , Bihari Chhagan , Biswas Subhrajit , Sarin S. K. , Kumar Anupam
Published: August 2024

Background and aim

Bone marrow stem cells (BM-SCs) and their progeny play a central role in tissue repair and regeneration. In patients with chronic liver failure, bone marrow (BM) reserve is severally compromised and they showed marked defects in the resolution of injury and infection, leading to liver failure and the onset of decompensation. Whether BM failure is the cause or consequence of liver failure during cirrhosis is not known. In this study, we aimed to determine the underlying relationship between BM failure and regeneration failure in cirrhosis.

Methodology

C57Bl/6(J) mice were used to develop chronic liver injury through intra-peritoneal administration of carbon tetrachloride (CCl4) for 15 weeks (0.1-0.5 ml/kg). Animals were sacrificed to study the transition of cirrhosis and BM defects. To restore the BM-SC reserve; healthy BM cells were infused via intra-BM infusion and assessed for changes in liver injury, regeneration, and BM-SC reserve.

Results

Using a CCl4-induced animal - model of cirrhosis, we showed the loss of BM-SCs reserve occurred before regeneration failure and the onset of non-acute decompensation. Intra-BM infusion of healthy BM cells induced the repopulation of native hematopoietic stem cells (HSCs) in cirrhotic BM. Restoring BM-HSCs reserve augments liver macrophage-mediated clearance of infection and inflammation dampens neutrophil-mediated inflammation, accelerates fibrosis regression, enhances hepatocyte proliferation, and delays the onset of non-acute decompensation.

Conclusion

These findings suggest that loss of BM-HSCs reserve underlies the compromised innate immune function of the liver, drives regeneration failure, and the onset of non-acute decompensation. We further provide the proof-of-concept that rejuvenating BM-HSC reserve can serve as a potential therapeutic approach for preventing regeneration failure and transition to decompensated cirrhosis.
Identification of crosstalk genes and immune characteristics between Alzheimer’s disease and atherosclerosis
Authors: An Wenhao , Zhou Jiajun , Qiu Zhiqiang , Wang Peishen , Han Xinye , Cheng Yanwen , He Zi , An Yihua , Li Shouwei
Published: August 2024

Background

Advancements in modern medicine have extended human lifespan, but they have also led to an increase in age-related diseases such as Alzheimer’s disease (AD) and atherosclerosis (AS). Growing research evidence indicates a close connection between these two conditions.

Methods

We downloaded four gene expression datasets related to AD and AS from the Gene Expression Omnibus (GEO) database (GSE33000, GSE100927, GSE44770, and GSE43292) and performed differential gene expression (DEGs) analysis using the R package “limma”. Through Weighted gene correlation network analysis (WGCNA), we selected the gene modules most relevant to the diseases and intersected them with the DEGs to identify crosstalk genes (CGs) between AD and AS. Subsequently, we conducted functional enrichment analysis of the CGs using DAVID. To screen for potential diagnostic genes, we applied the least absolute shrinkage and selection operator (LASSO) regression and constructed a logistic regression model for disease prediction. We established a protein-protein interaction (PPI) network using STRING (https://cn.string-db.org/) and Cytoscape and analyzed immune cell infiltration using the CIBERSORT algorithm. Additionally, NetworkAnalyst (http://www.networkanalyst.ca) was utilized for gene regulation and interaction analysis, and consensus clustering was employed to determine disease subtypes. All statistical analyses and visualizations were performed using various R packages, with a significance level set at p<0.05.

Results

Through intersection analysis of disease-associated gene modules identified by DEGs and WGCNA, we identified a total of 31 CGs co-existing between AD and AS, with their biological functions primarily associated with immune pathways. LASSO analysis helped us identify three genes (C1QA, MT1M, and RAMP1) as optimal diagnostic CGs for AD and AS. Based on this, we constructed predictive models for both diseases, whose accuracy was validated by external databases. By establishing a PPI network and employing four topological algorithms, we identified four hub genes (C1QB, CSF1R, TYROBP, and FCER1G) within the CGs, closely related to immune cell infiltration. NetworkAnalyst further revealed the regulatory networks of these hub genes. Finally, defining C1 and C2 subtypes for AD and AS respectively based on the expression profiles of CGs, we found the C2 subtype exhibited immune overactivation.

Conclusion

This study utilized gene expression matrices and various algorithms to explore the potential links between AD and AS. The identification of CGs revealed interactions between these two diseases, with immune and inflammatory imbalances playing crucial roles in their onset and progression. We hope these findings will provide valuable insights for future research on AD and AS.
Microbiological culture versus 16S/18S rRNA gene PCR-sanger sequencing for infectious keratitis: a three-arm, diagnostic cross-sectional study
Authors: Hammoudeh Yasmeen , Suresh Lakshmi , Ong Zun Zheng , Lister Michelle M. , Mohammed Imran , Thomas D. John I. , Cottell Jennifer L. , Holden Jennifer M. , Said Dalia G. , Dua Harminder S. , Ting Darren Shu Jeng
Published: August 2024

Background

To compare the diagnostic performance of microbiological culture and 16S/18S rRNA gene polymerase chain reaction (PCR)-Sanger sequencing for infectious keratitis (IK) and to analyse the effect of clinical disease severity on test performance and inter-test concordance.

Methods

This was a three-arm, diagnostic cross-sectional study. We included all eligible patients who presented with presumed bacterial/fungal keratitis to the Queen's Medical Centre, Nottingham, UK, between June 2021 and September 2022. All patients underwent simultaneous culture (either direct or indirect culture, or both) and 16S (pan-bacterial)/18S (pan-fungal) ribosomal RNA (rRNA) PCR-Sanger sequencing. The bacterial/fungal genus and species identified on culture were confirmed using matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry. Relevant clinical data were also collected to analyze for any potential clinico-microbiological correlation. Main outcome measures included the diagnostic yield, test accuracy (including sensitivity and specificity), and inter-test agreement [including percent agreement and Cohen's kappa (k)].

Results

A total of 81 patients (86 episodes of IK) were included in this study. All organisms identified were of bacterial origin. Diagnostic yields were similar among direct culture (52.3%), indirect culture (50.8%), and PCR (43.1%; p = 0.13). The addition of PCR enabled a positive diagnostic yield in 3 (9.7%) direct culture-negative cases. Based on composite reference standard, direct culture had the highest sensitivity (87.5%; 95% CI, 72.4–95.3%), followed by indirect culture (85.4%; 95% CI, 71.6–93.5%) and PCR (73.5%; 95% CI, 59.0–84.6%), with 100% specificity noted in all tests. Pairwise comparisons showed substantial agreement among the three tests (percent agreement = 81.8–86.2%, Cohen's k = 0.67–0.72). Clinico-microbiological correlation demonstrated higher culture-PCR concordance in cases with greater infection severity.

Conclusions

This study highlights a similar diagnostic performance of direct culture, indirect culture and 16S rRNA PCR for bacterial keratitis, with substantial inter-test concordance. PCR serves as a useful diagnostic adjuvant to culture, particularly in culture-negative cases or those with lesser disease severity (where culture-PCR concordance is lower).
Developing leadership competencies for genomics integration through globally networked learning and education
Authors: Limoges Jacqueline , Halkoaho Arja , Laaksonen Mari , Karwal Muskaan
Published: August 2024

Aim

To describe the implementation and evaluation of an education strategy called the globally networked learning-genomics (GNL-G) used in Master’s courses in Canada and Finland. The study focused on the feasibility and effectiveness of GNL-G in developing leadership competencies for integrating genomics into practice.

Methods

Interpretive description qualitative methodology was used to explore how GNL-G, global exchanges and assignments standardized with the Assessment of Strategies to Integrate Genomics in Nursing (ASIGN) tool influenced competency development. The Reporting Item Standards for Education and its Evaluation in Genomics (RISE2 Genomics) framework guided the design, implementation, evaluation, and reporting of GNL-G. Data included one-to-one interviews, written assignments, and reflections.

Results

Interviews and assignment data from three cohorts of students for a total of ten Canadian and 11 Finnish master’s students participated in this study. The ASIGN Tool played a crucial role in facilitating students’ analysis of their practice context and the development of leadership strategies. Participation in GNL-G enhanced students’ confidence to lead efforts to integrate genomics, irrespective of their genomics expertise. Engagement with global peers emphasized the importance of incorporating equity, ethics, and social justice into leadership strategies for genomics integration.

Conclusion

The GNL-G strategy enhanced leadership competencies for genomics integration in graduate students from Canada and Finland. The ASIGN Tool and global peer collaboration highlight the importance of innovative educational methods in preparing leaders for the complexities of genomics in healthcare.
Relationship between intraoperative hypothermia and hyperthermia with postoperative pulmonary infection and surgical site infection in major non-cardiac surgery
Authors: Pang Qian-Yun , Yang Ya-Jun , Feng Yu-Mei , Sun Shu-Fang , Liu Hong-Liang
Published: August 2024

Background

Surgical patients often experience intraoperative hypothermia or hyperthermia. However, the relationship of intraoperative hypothermia and hyperthermia with postoperative pulmonary infection (PPI) and surgical site infection (SSI) is unclear. Here, we conducted a retrospective cohort study to address these issues.

Methods

Adult patients who underwent major non-cardiac surgery under general anesthesia were eligible for the study and were recruited. Three indices of core body temperature under hypothermia (<36°C) and hyperthermia (>37.3°C) were calculated as mentioned in the following: absolute value (0C), duration of exposure (min), and area under the curve (AUC,°C× min). The outcomes were in-hospital PPI and SSI. The risk-adjusted association of intraoperative hypothermia and hyperthermia with PPI and SSI was determined.

Results

The absolute value (the nadir value of hypothermia and the peak value of hyperthermia) was not associated with PPI and SSI. PPI was associated with (1) duration: hypothermia >90 min [adjusted odds ratio (aOR): 1.425, 95% confidence interval (CI): 1.131–1.796] and hyperthermia >75 min (aOR: 1.395, 95%CI: 1.208–1.612) and (2) AUC: hypothermia >3,198 (aOR: 1.390, 95%CI: 1.128–1.731) and hyperthermia >7,945 (aOR: 2.045, 95%CI: 1.138–3.676). SSI was associated with (1) duration: hypothermia > 195 min (aOR: 2.900, 95%CI: 1.703–4.937) and hyperthermia >75 min (aOR: 1.395, 95%CI: 1.208–1.612) and (2) AUC: hypothermia >6,946 (aOR: 2.665, 95%CI: 1.618–4.390), hyperthermia >7,945 (aOR: 2.619, 95%CI: 1.625–4.220). Interactions were not observed between hyperthermia and hypothermia on the outcomes.

Conclusions

It was observed that intraoperative hypothermia and hyperthermia are associated with postoperative pulmonary infection and surgical site infection in major non-cardiac surgery.
A study on the correlation between hyperuricemia and TG/HDL-c ratio in the Naxi ethnic group at high-altitude regions of Yunnan
Authors: Han Dongmei , Yao Yaqi , Wang Fengshuang , He Wenjing , Sun Tianbao , Li Han
Published: August 2024

Objective

The study aimed to explore the risk factors for hyperuricemia (HUA) in the Naxi ethnic population residing in high-altitude areas of Yunnan, China, and assess the clinical value of the triglyceride/high-density lipoprotein cholesterol (TG/HDL-c) ratio as a diagnostic marker.

Methods

In this cross-sectional study, clinical data were collected from the health checkup population in the People's Hospital of Yulong Naxi Autonomous County, Yunnan Province, from January 2021 to January 2023. Participants were divided into quartiles based on the TG/HDL-c ratio (Q1, Q2, Q3, and Q4) for group analysis using chi-square tests, t-tests, and rank sum tests. Logistic regression analysis and linear regression models were employed to further investigate the correlation between the prevalence of hyperuricemia and TG/HDL-c ratio in this high-altitude Naxi population.

Results

A total of 714 participants from the health checkup population were included in the study, of whom 61.5% were male participants and 38.5% were female participants, and the average age was 41.21 ± 11.69 years. The mean uric acid level was 388.51 ± 99.24. After correcting for confounding factors, TG/HDL-c, serum creatinine (Scr), blood urea nitrogen (BUN), triglyceride (TG), high-density lipoprotein cholesterol (HDL-c), red blood cells (RBCs), and hemoglobin (Hb) showed a positive correlation with blood uric acid. Further analysis involved categorizing the TG/HDL-c ratio from a continuous variable to a categorical variable using quartiles. The fully adjusted model showed results that were consistent with the trend observed in the continuous variable analysis when considering the TG/HDL-c ratio as a categorical variable. In addition, in all unadjusted and adjusted models, the serum uric acid (SUA) levels in the high TG/HDL-c ratio group were significantly higher than those in the low TG/HDL-c ratio group (trend p < 0.001). Further linear relationship analysis indicated that after adjusting for covariates, there was an approximate linear relationship between the TG/HDL-c and SUA levels, with a coefficient (β) of 5.421.

Conclusion

The prevalence of hyperuricemia is greater in high-altitude areas of Yunnan, showing a nearly linear positive correlation with the TG/HDL-c ratio. Monitoring TG/HDL-c levels may benefit patients with hyperuricemia.
Erythrocytosis in congenital heart defects: hints for diagnosis and therapy from a clinical case
Authors: Borsani Oscar , Varettoni Marzia , Riccaboni Giacomo , Rumi Elisa
Published: August 2024

Erythrocytosis is one of the most common abnormalities that clinical hematologists, general practitioners, and internal medicine specialists could have to face off in their routine clinical practice. While diagnostic criteria for primary erythrocytosis (i.e., polycythemia vera) are well known and characterized, there are several causes of secondary erythrocytosis that should be kept in mind to avoid misdiagnosis. Congenital heart defects are rarely cause of secondary erythrocytosis as they are normally recognized and treated at an early stage. Eisenmenger syndrome is a complex clinical syndrome that arise as consequence of an untreated congenital heart defect associated with large intracardiac shunt. The clinical picture of this syndrome usually includes a severe erythrocytosis that could tempt clinicians to start an intensive phlebotomy (or venesection) program. However, clinicians should be aware that erythrocytosis in Eisenmenger syndrome is a compensatory mechanism aimed at improving blood oxygen-carrying capacity; accordingly, phlebotomies should be reserved for those cases complaining hyperviscosity symptoms. Here we present a case of an adult female patient with Eisenmenger syndrome that has been evaluated because of severe and persistent erythrocytosis. In this case we present a step-by-step approach by which clinical hematologist could proceed to reach the definitive diagnosis. We will also provide some hints that could help clinicians when choosing the best treatment strategy to avoid unnecessary and potentially harmful procedures.
Impact of pulmonary rehabilitation on exercise capacity, health-related quality of life, and cardiopulmonary function in lung surgery patients: a retrospective propensity score-matched analysis
Authors: Niu Chunlai , Lin Huan , Zhang Zinan , Wang Qing , Wei Yingjun
Published: August 2024

Background

Pulmonary rehabilitation is considered beneficial for patients undergoing lung surgery, yet its specific impacts on exercise capacity, health-related quality of life (HRQL), and cardiopulmonary function require further elucidation. This study aimed to evaluate the effect of PR on these outcomes in patients undergoing lung surgery using a retrospective propensity score-matched analysis.

Methods

We retrospectively analyzed 420 patients with non-small cell lung cancer (NSCLC) who underwent lung surgery from January 2022 to May 2024. Among these, 84 patients received PR while 336 did not (control group). Propensity score matching (PSM) at a 1:1 ratio yielded 46 patients in each group. Baseline characteristics, spirometry, cardiopulmonary exercise testing, respiratory muscle strength, HRQL, and muscle measurements were assessed pre-and post-surgery.

Results

Before PSM, significant differences existed between groups, with the PR group being older and having different pulmonary function baselines. After PSM, groups were well-balanced. Postoperatively, the PR group showed significant improvements in FEV1/FVC (64.17% vs. 50.87%, p < 0.001), FEV1 (2.31 L/min vs. 1.75 L/min, p < 0.001), and predicted FVC percentage (88.75% vs. 68.30%, p < 0.001). Cardiovascular responses showed a lower CI during exercise in the PR group post-PSM (6.24 L/min/m2 vs. 7.87 L/min/m2, p < 0.001). In terms of exercise capacity, the PR group had higher maximal WR percentage (104.76% vs. 90.00%, p = 0.017) and peak VO2 (1150.70 mL/min vs. 1004.74 mL/min, p = 0.009). PR also resulted in less leg soreness and lower total CAT scores postoperatively. Muscle measurements indicated significantly smaller reductions in ΔHUESMCSA and percentage change in the PR group.

Conclusion

Pulmonary rehabilitation significantly enhances exercise capacity, HRQL, and cardiopulmonary function in patients undergoing lung surgery. It also mitigates postoperative muscle loss, underscoring its importance in the postoperative management of lung surgery patients.
Investigating acoustic startle habituation and prepulse inhibition with silent functional MRI and electromyography in young, healthy adults
Authors: Naysmith Laura F. , O’Daly Owen , Solana Ana Beatriz , Wiesinger Florian , Hill Simon , Williams Steven C. R. , Kumari Veena
Published: August 2024

Introduction

Startle habituation and prepulse inhibition (PPI) are distinct measures of different sensory information processes, yet both result in the attenuation of the startle reflex. Identifying startle habituation and PPI neural mechanisms in humans has mostly evolved from acoustic-focused rodent models. Human functional magnetic resonance imaging (fMRI) studies have used tactile startle paradigms to avoid the confounding effects of gradient-related acoustic noise on auditory paradigms and blood-oxygen-level-dependent (BOLD) measures. This study aimed to examine the neurofunctional basis of acoustic startle habituation and PPI in humans with silent fMRI.

Methods

Using silent fMRI and simultaneous electromyography (EMG) to measure startle, the neural correlates of acoustic short-term startle habituation and PPI [stimulus onset asynchronies (SOA) of 60 ms and 120 ms] were investigated in 42 healthy adults (28 females). To derive stronger inferences about brain-behaviour correlations at the group-level, models included EMG-assessed measures of startle habituation (regression slope) or PPI (percentage) as a covariate. A linear temporal modulator was modelled at the individual-level to characterise functional changes in neural activity during startle habituation.

Results

Over time, participants showed a decrease in startle response (habituation), accompanied by decreasing thalamic, striatal, insula, and brainstem activity. Startle habituation was associated with the linear temporal modulation of BOLD response amplitude in several regions, with thalamus, insula, and parietal lobe activity decreasing over time, and frontal lobe, dorsal striatum, and posterior cingulate activity increasing over time. The paradigm yielded a small amount of PPI (9–13%). No significant neural activity for PPI was detected.

Discussion

Startle habituation was associated with the thalamus, putamen, insula, and brainstem, and with linear BOLD response modulation in thalamic, striatal, insula, parietal, frontal, and posterior cingulate regions. These findings provide insight into the mediation and functional basis of the acoustic primary startle circuit. Instead, whilst reduced compared to conventional MRI, scanner noise may have disrupted prepulse detection and processing, resulting in low PPI and impacting our ability to map its neural signatures. Our findings encourage optimisation of the MRI environment for acoustic PPI-based investigations in humans. Combining EMG and functional neuroimaging methods shows promise for mapping short-term startle habituation in healthy and clinical populations.
Using mid-upper arm circumference z-score measurement to support youth malnutrition screening as part of a global sports and wellness program and improve access to nutrition care
Authors: Sharn Amy R. , Sorgho Raissa , Sulo Suela , Molina-Molina Emilio , Rojas Montenegro Clara , Villa-Real Guno Mary Jean , Abdel-Rahman Susan
Published: August 2024

Objective

Historically, mid-upper arm circumference (MUAC) has been instrumental to identifying malnutrition in children under 5 years living in resource restricted settings. Less attention is directed to at-risk, school-aged youth. Updated and validated pediatric age- and gender-specific MUAC growth curves expand malnutrition screening opportunities (2 months-18 years) including overweight/obesity. An innovative partnership was created to integrate MUAC z-score measurement trainings and screenings in the Real Madrid Foundation's (RMF) Social Sports Schools (S3) program, which provide sports and wellness programming to under-resourced communities. This work aimed to investigate the feasibility of leveraging non-healthcare professionals (non-HCPs) to identify malnutrition risk as part of RMF S3.

Methods

This global, two-part program on malnutrition risk identification included training adult facilitators and screening children attending RMF S3. RMF facilitators were trained with didactic lectures on malnutrition, and practical hands-on learning of proper MUAC z-score tape measurement. Aggregate data on facilitators and the number of times to correctly administer the MUAC z-tape were recorded. Aggregate data on child malnutrition risk screenings were collected.

Results

Nine countries participated representing Europe, Pacific Asia, Africa, Latin America, and North America. In total, 143 RMF facilitators were trained, and 318 children were screened across 11 sites. More than half of facilitators were male (56%, n = 80), and majority were coaches (41.3%, n = 59), followed by staff (25.2%, n = 36), and volunteers (16.1%, n = 23). Facilitator attempts ranged from 1 to 4 times for proper MUAC z-score administration with mean 2.12 (± 0.86). There were no significant differences for attempts among RMF facilitator types (p = 0.10). Sixteen percent (n = 51) of children screened were recommended for HCP referral, with concentrations in Pacific Asia (68%, n = 35), Latin America (24%, n = 12), and Africa (8%, n = 4).

Conclusions

Findings from our sample demonstrate that integration of MUAC z-score based malnutrition risk screening within community sports and wellness programming among non-HCPs is feasible, and that some regions with less frequent access to routine health care may experience greater benefit from these programs. Equipping non-HCP facilitators in community sports and wellness programs with training on malnutrition screening provides a means to meet under-resourced families where they live to begin conversations around malnutrition risk with the hope of establishing additional pathways to care.