bluuebunny/crossref_metadata_2025 huggingface dataset:
Pulmonary Vascular Reverse Remodeling After Left Ventricular Assist Device Implantation in Patients With Pulmonary Hypertension
Authors: Anegawa Eiji , Seguchi Osamu , Mochizuki Hiroki , Kuroda Kensuke , Doi Nakajima Seiko , Watanabe Takuya , Yanase Masanobu , Tadokoro Naoki , Fukushima Satsuki , Fujita Tomoyuki , Fukushima Norihide
Published: January 2023

Prevalence of combined pre- and post-capillary (Cpc) pulmonary hypertension (PH) in patients with PH due to left heart disease (PH-LHD) and the long-term impact of left ventricular assist device (LVAD) implantation in patients with Cpc-PH are not fully elucidated. Eighty-nine patients with PH-LHD who underwent LVAD implantation were retrospectively analyzed. Patients were divided into two groups according to their preoperative pulmonary vascular resistance (PVR) and diastolic pressure gradient (DPG) values (Cpc-PH group, PVR >3 wood units [WU], or DPG ≥7 mmHg; isolated postcapillary [Ipc]-PH group, PVR ≤3 WU, and DPG <7 mmHg). There were 50 patients with Cpc-PH (PVR >3 WU [group A, n = 41]; PVR >3 WU and DPG ≥7 mmHg [group B, n = 8]; DPG ≥7 mmHg [group C, n = 1]), and 39 patients with Ipc-PH. Despite a successful LVAD implantation in all participants, 13 and two patients remained in groups A and B, respectively, early after LVAD implantation, whereas two patients each remained in groups A and B 1 year postoperatively. Values of PVR and DPG in the Cpc-PH group returned to normal levels by 3 years postoperatively. Over 50% of patients with PH-LHD had Cpc-PH, and PVR and DPG normalized in all participants within 3 years after LVAD implantation.
ST elevation myocardial infarction – national trend analysis with mortality differences in outcomes based on day of hospitalization
Authors: Jha Anil , Ojha Chandra P. , Bhattad Pradnya Brijmohan , Sharma Ashish , Thota Ajit , Mishra Ajay Kumar , Krishnan Anand M. , Roumia Mazen
Published: January 2023

Background

Patientswho present with acute ST elevation myocardial infarction (STEMI) need emergent revascularization. Our study aims to investigate the outcomes in patients with STEMI admitted during weekends versus weekdays.

Methods

We conducted a retrospective analysis of the nationwide inpatient sample database. Patients with an admitting diagnosis of STEMI identified by the International Classification of Disease code for the year 2016 were analyzed. A weighted descriptive analysis was performed to generate national estimates. Patients admitted over the weekend were compared to those admitted over the weekday. Patients were stratified by demographic and clinical factors including the Elixhauser comorbidity index. The primary outcome was in-hospital mortality and secondary outcomes were percutaneous coronary intervention (PCI) utilization rate, rate of transfer-out, length of stay (LOS), and total hospital charges. Statistical analysis including linear and logistic regression was performed using STATA.

Results

A total of 163 715 adult patients were admitted with STEMI, of which 27.9% (45 635) were admitted over the weekend. There were 76.2% Caucasians, 9.3% African Americans, and 8.0% Hispanics. Mean age of the patients was 63.2 years (95% CI, 62.9–63.5) for the weekend group and 63.7 years (95% CI, 63.5–63.9) for weekday admissions. The majority of the patients in both groups had Medicare (43.7% and 45.8% on weekends and weekdays, respectively; P = 0.0047). After adjusting for age, sex, race, income, Elixhauser comorbidity index, PCI use, hospital location, teaching status, and bed size, mortality was not significantly different in weekend versus weekday admissions (odds ratios 1.04; P = 0.498; 95% CI, 0.93–1.16). There was no significant difference in mean total charge per admission during the weekend versus weekday admissions ($107 093 versus $106 869; P = 0.99.) Mean LOS was 4.1 days for both groups (P = 0.81).

Conclusions

There were no significant differences in mortality, LOS, or total hospital charge in STEMI patients being admitted during the weekend versus weekdays.
Clinical implication of totally occluded infarct-related coronary artery in non-ST-segment elevation myocardial infarction: the TOTAL-NSTEMI study
Authors: Güner Ahmet , Çörekçioğlu Büşra , Uzun Fatih , Kalçik Macit , Ulutaş Ahmet Emir , Akman Cemalettin , Can Cemil , Keten Mustafa Ferhat , Küp Ayhan , Gürsoy Mustafa Ozan , Kalkan Semih , Çizgici Ahmet Yaşar , Kahraman Serkan , Güner Ezgi Gültekin , Külahçioğlu Şeyhmus , Yalçin Ahmet Arif , Ertürk Mehmet
Published: January 2023

Background

A subset ofpatients found to have total occlusion of the culprit artery (TOCA), present with non-ST-segment elevation myocardial infarction (NSTEMI) and elevated biomarkers. The aim of this study is to assess the effect of the TOCA in patients presenting with NSTEMI.

Methods

This multicenter observational study was retrospectively conducted between 2015 and 2019. Thrombolysis in myocardial infarction (TIMI) flow grades 0–1 was defined as the TOCA. The primary end point included a combination of all-cause death, myocardial infarction, target vessel revascularization, stent thrombosis, and stroke.

Results

Of 3272 patients, TIMI 0–1 flow in the culprit artery was present in 488 (14.9%) patients. TOCA was more likely to be of thrombotic origin (54.1% vs. 10.3%; P < 0.001) and visible collaterals (22.5% vs. 4.4%; P < 0.001). The rates of 30-day (14.3% vs. 7.2%; P < 0.001) and 2-year (25% vs. 19.1%; P = 0.003) primary end points were significantly higher in TOCA patients. Fatal arrhythmias were remarkably higher at 30-day (8.6% vs. 4%; P < 0.001) and 2-year (9% vs. 5.2%; P = 0.001) follow-ups. Mechanical complications were also higher in patients with TOCA at 30 days (0.8% vs. 0.2%; P = 0.013). Moreover, TOCA (OR, 1.379; P = 0.001) was one of the independent predictors of MACCE in NSTEMI patients.

Conclusion

The current data suggest that patients with TOCA in the context of NSTEMI are at higher risk of MACCE, fatal arrhythmias, and mechanical complications.
Burning mouth syndrome and pelvodynia: A literature review
Authors: Hamon Bérenger , Orliaguet Marie , Misery Laurent , Boisramé Sylvie
Published: January 2023

Burning mouth syndrome (BMS) and pelvodynia are chronic pain still poorly understood and the links between them are all the more so. Health professionals therefore have few resources to understand, diagnose and treat these pains. They may consider and treat these ailments individually, which does not represent optimal care management for the patient and leads to overmedication. This article aims to highlight their contiguity from epidemiological, etiological, diagnostic, and therapeutic perspectives. This study was based on articles which were found using databases such as PubMed and Web of Science. No exclusion criteria were used. Fourteen studies were reviewed. This present work shows that the clinical presentations of these syndromes are similar, as exemplified by their strong association with anxiety and depression. The neurophysiological mechanisms involved in these conditions are similar to those in patients. The diagnosis is essentially based on visual examination and an elimination of all other possible causes. In addition, this work promotes the fact that a common therapy can be implemented when BMS and pelvodynia co-occur. However, the literature on the subject is still very limited. This can be deepened by exploring all the effective treatments in BMS and vulvodynia for penoscrotodynia. Finally, for all these pains, there is a therapeutic order to respect starting with a psychological approach, then topical treatments, systemic therapy and surgical. This therapeutic gradient assists practitioner in their patient’s pain management. This article also allows health care providers to quickly find an effective systemic treatment for a patient with both BMS and pelvodynia.
A challenging case of lumbar vertebral burst fracture with alcohol withdrawal delirium: A case report
Authors: Koizumi Keisuke , Uehara Masashi , Oba Hiroki , Ikegami Shota , Kamanaka Takayuki , Hatakenaka Terue , Miyaoka Yoshinari , Fukuzawa Takuma , Hayashi Koji , Takahashi Jun
Published: January 2023

Background:

Delirium tremens is a symptom of alcohol withdrawal syndrome that occurs 48 to 96 hours after the last drink in 5% of withdrawing patients.

Methods:

This report describes the clinical progression of a case of lumbar vertebral burst fracture with alcohol withdrawal delirium that was difficult to manage.

Results:

A 47-year-old man was rushed to our hospital complaining of lumbar back pain and numbness in both lower extremities resulting from a 6-m fall during civil engineering work. Computed tomography (CT) revealed a L1 burst fracture with a highly protruding bone fragment in the spinal canal. Magnetic resonance imaging disclosed significant compression of the conus and intramedullary signal changes. We immediately performed posterior spinal fusion and vertebroplasty using instrumentation. On the 4th postoperative day, he became severely agitated, as diagnosed as having delirium tremens related to alcohol withdrawal syndrome, and soon began appropriate medication with diazepam. Although his symptoms persisted until 6 days postoperatively, follow-up CT detected no evidence of screw loosening or breakage.

Conclusion:

We encountered a patient with severe delirium tremens developing several days after thoraco-lumbar fusion surgery. Prompt internal fixation successfully treated the spinal injury and prevented neurological damage. It may also be necessary to consider treatment strategies for patients with a background of heavy alcohol consumption in consideration of delirium tremens and other symptoms of alcohol withdrawal.
Past, present and future of genomics for kidney stone disease
Authors: Jahrreiss Victoria , Özsoy Mehmet , Seitz Christian , Somani Bhaskar
Published: January 2023

Purpose of review

To summarize the latest findings and developments in genomics for kidney stone disease (KSD) that help to understand hereditary pathomechanisms, identify high risk stone formers, provide early treatment and prevent recurrent kidney stone formation.

Recent findings

Several gene loci associated to KSD have presently been discovered in large Genome-wide association studies. Monogenic causes are rare, but are thought to have higher penetrance, while polygenic causes are more frequent with less penetrance. Although there is a great effort identifying genetic causes of KSD, targeted therapies are scarce.

There have been great advancements in genetic research in identifying genetic variants associated with KSD. Identifying these variants and understanding the underlying pathophysiology will not only provide individual risk assessment but open the way for new treatment targets and preventive care strategies.
Robotic radical cystectomy – more precision needed?
Authors: Walz Simon , Aslani Valese , Sawodny Oliver , Stenzl Arnulf
Published: January 2023

Purpose of review

Recently, several trials as well as registry-data analyses investigating the role of robot-assisted radical cystectomy with extra or intracorporal urinary diversion were completed and follow up matured. This review aims to comment on the current evidence-based findings and interpret the future role of the robotic approach as a part of the treatment of bladder cancer.

Recent findings

Numerous trials and registry-data analyses revealed no significant differences in progression-free and overall survival after open radical cystectomy or robot-assisted radical cystectomy irrespective of urinary diversion. Perioperative parameters, especially intraoperative blood loss, transfusions, thromboembolic events, wound infections and hospitalization were significantly increased in open radical cystectomy. Patients’ convalescence, and especially early postsurgical quality of life, was improved by the robotic approach. The highly demanding surgery itself displayed by a flat learning curve required more than 130 surgeries per institution to reach a stable plateau of complications. The performance of high-quality radical cystectomy irrespective of the approach was significantly increased in high-volume centres. Local recurrence occurs in 11% after radical cystectomy. Current research focuses on intraoperatively usable detection methods and instruments to minimize the risk of residual tumour cells.

Taken together, the total intracorporal approach in radical cystectomy holds the potential to improve perioperative parameters and reduces hospitalization without impairing oncological performance of the procedure. To provide best results for the patient radical cystectomy and especially the technically challenging total intracorporal procedure will gain importance in bladder cancer treatment but should be limited to high-volume centres.
Side Effects With a Focus on Lymphadenopathy Following COVID-19 Vaccination in Pediatric and AYA Oncology Patients
Authors: Belsky Jennifer A. , Carroll Whitney R. , Xu Guang , Jacob Seethal A.
Published: January 2023

The Coronavirus Disease 2019 (COVID-19) pandemic led to the swift development of multiple vaccinations. Vaccine side effects were well-documented in the healthy adult cohort and included fever and lymphadenopathy, however, side effects in the pediatric immunocompromised population have not been reported. This retrospective study investigated vaccine-eligible children and adolescent young adult oncology patients 12 to 35 years old. We found uncommon, mild, and self-limiting side effects among pediatric cancer patients and survivors. This data will help guide pediatric and AYA oncologists in providing anticipatory guidance and serve as a guide to managing lymphadenopathy as a potential confounder of malignancy.
Stroke in Pediatric Cancer Patients: A Systematic Review
Authors: Catueno Samanta , Ali Sara , Barrientos Ricardo , Valdez Marcos , Mba Nkechi , Sherani Farha , Bhalala Utpal
Published: January 2023

Objective:

Pediatric cancer patients have an increased risk of stroke. However, there is a knowledge gap regarding stroke in early stages of pediatric cancer. The objective of this project is to describe the current knowledge on stroke in pediatric cancer patients.

Design:

Systematic review.

Materials and Methods:

After Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, literature search was conducted in PubMed, Cochrane, and Google Scholar from January 1, 1995, up to February 1, 2022.

Results:

A total of 3499 studies were identified, of which 8 met inclusion criteria. The incidence of stroke in pediatric cancer patients varied between 0.47% and 2.9%, and prevalence between 1% and 3%. The risk factors identified were leukemia diagnosis, cranial radiation, thrombocytopenia, coagulopathy, and infection. There was a higher rate of diagnosis with magnetic resonance imaging than with computed tomography scan. Treatment was inconsistent, and patients with cancer were less likely to receive antithrombotic treatment when compared with patients without cancer. The highest mortality was among hemorrhagic stroke. Recurrence rate was 5% to 19%.

Conclusions:

The risk for stroke is increased in the pediatric cancer population and can lead to devastating results. The available reports include few patients, with heterogeneous cancer diagnoses and outcomes. Large-scale multicenter studies are needed, focusing on early diagnosis, risk factors, and management strategies of stroke in children with underlying cancer.
Do Children With an Allergic Transfusion Reaction Require Premedication For All Blood Products?
Authors: Bahabri Aban , Barty Rebecca , Li Na , Liu Yang , Kovalova Tanya , Chan Anthony K.C.
Published: January 2023

Background:

Children with a history of allergic transfusion reactions (ATRs) receive antihistamine premedication with or without hydrocortisone to prevent subsequent reactions. We aim to examine the frequency of developing ATRs to subsequent different blood product type transfusions.

Methods:

A retrospective chart review of children who received blood product transfusions (packed red blood cells, platelets, frozen plasma, intravenous immunoglobin, albumin, and cryoprecipitate) and developed ATRs. Cases were identified through Transfusion Transmitted Injuries Surveillance System- Ontario database with a complementary chart review. Demographics and subsequent transfusions records were described.

Results:

During this period, 35,925 blood products were transfused to 4153 patients. Thirty-eight ATRs were reported in 30 patients. All ATRs were minor except 1 anaphylaxis to albumin transfusion. Seven patients (23%) developed multiple ATRs, and all of them were of the same blood product type. A total of 60 subsequent different blood product types were transfused to the 7 patients who had multiple ATRs; none of those transfusions caused ATR.

Conclusion:

In children with a history of ATR, developing a reaction to a different blood product type is rare. Hence, premedicating those transfusions is not warranted.
Ontological Adaptation in Transition to Adulthood
Authors: Chiappelli Joshua , Beason Tiffany
Published: January 2023

In this theoretical review, the neurodevelopmental model of psychotic disorders is considered within the framework of ontological development, referring to the individual-level construction of a sense of reality regarding identity and worldview. Following Erikson's theory of development, the challenge of forging a personal and social identity is a developmental process typical of late adolescence and early adulthood. Accompanying this process is a developmentally normal increase in exploratory and risk-taking behavior, which sometimes includes challenging and defying cultural norms. Although many aspects of ontological adaptation are developmentally appropriate, we argue that psychopathology such as psychosis can be rooted in an abnormal deviation of this process, in which aberrant salience accelerates the typical drive to develop a meaningful sense of identity, leading to delusion formation. By placing psychosis onset within a broader context of normal development, this model offers a humanistic approach for understanding experiences of new onset of psychotic disorders.
Case Report: Recurrent Acute Macular Neuroretinopathy—Monitoring Recovery with Multimodal Imaging
Authors: Oliver Joshua C. , DePoe Scott A.
Published: January 2023

Significance

Acute macular neuroretinopathy (AMN) is a rare, non-progressive condition affecting the outer retina that can be diagnosed clinically utilizing widely available multimodal imaging techniques. This case report presents an exceedingly rare same eye recurrence of AMN and describes the characteristic imaging findings of this unique, not fully understood clinical entity.

Purpose

The following report provides a detailed account of recurrent AMN from four hours of symptom onset through four months with repeat multimodal imaging captured at different visits. This report also devotes some discussion to the current understanding of its pathophysiology, associations, management, and imaging characteristics.

Case Report

A 32-year-old female with unilateral recurrent AMN was monitored frequently with various multimodal imaging from four hours after onset of new scotoma through four months. The primary finding in the acute stage was a hyperreflective lesion of the outer nuclear (ONL) and outer plexiform layers followed by disruption of underlying external limiting membrane, ellipsoid zone, and photoreceptors. This resolved into stable ONL thinning and subtle disruption of the deeper layers after one week. Fundus photography revealed a red-brown petaloid lesion adjacent to the fovea, and optical coherence tomography angiography revealed subtle decreased perfusion of the choriocapillaris layer throughout follow up.

Conclusions

AMN is a rare non-progressive condition of the outer retina most often affecting otherwise healthy young females and is most associated with recent flu-like illness and oral contraceptives. The underlying mechanism of AMN remains unknown, but modern imaging techniques have elucidated the disease locus to be choroidal and/or deep capillary plexus. It is important for eye care providers to recognize AMN as a clinical entity distinct from other retinal conditions that require different management.
The Impact of Donor Preparation for Tissue Procurement on Postmortem Vitreous Isopropanol Concentration
Authors: Avedschmidt Sarah E. , Melton Annamaria , Turner Katherine A. , Sommer Stephanie , Olden Nick K. , Cohle Stephen
Published: January 2023

Volatile chemicals can be relevant in the determination of the cause and manner of death by forensic pathologists. Isopropanol is a secondary alcohol that is occasionally seen on postmortem toxicology testing. A series of 11 forensic autopsy cases was previously reported in which the presence of isopropanol in the vitreous humor was suspected to be due to postmortem contamination from the body preparation process for tissue procurement.

In collaboration with a tissue procurement agency, donor vitreous humor was collected from one eye before body preparation for procurement and from the other eye postpreparation. The specimens underwent testing for volatile substances by headspace gas chromatography.

Of the 50 cases, 8 (16%) showed statistically significant changes in the prepreparation and postpreparation isopropanol concentrations. Postpreparation isopropanol concentrations ranged from 5 to 104 mg/dL (median, 18 mg/dL). Seven of the 8 cases had undetectable prepreparation isopropanol, whereas the remaining case had a detectable prepreparation isopropanol.

In conclusion, surface contamination of the decedent's body with chemicals used in body preparation can lead to the passive absorption into the body, resulting in the presence of isopropanol in postmortem toxicology samples. Forensic pathologists need to be aware of this when interpreting postmortem samples after tissue procurement.
Enhancing and Leveraging the West Virginia's Prescription Drug Monitoring Program (PDMP) for Public Health Surveillance and Clinical Decision Making: A Case Study
Authors: Wood Nathan , Mells Jamie , Dotson Timothy , Jeffries James E.
Published: January 2023

West Virginia has struggled with an overdose epidemic for many years and continues to have the highest overdose death rate in the nation. However, through successful collaboration between the West Virginia Board of Pharmacy and the West Virginia Department of Health via its Violence and Injury Prevention Program, West Virginia has improved data quality, enhanced program development and implementation, and developed strategies to address the overdose epidemic. This multiagency collaboration plays an important role in addressing the overdose epidemic and promotes lasting interagency relationships. One strategy is overcoming barriers to maximizing and utilizing the Prescription Drug Monitoring Program, or PDMP. This strategy allows for a better understanding of a patient's prescription history and ensures safer prescribing practices. In addition, this strategic partnership facilitates the use of PDMP data for epidemiologic studies and public health surveillance, which results in sustainable analyses and dissemination of actionable data that are now driving public health action in West Virginia.
Overweight and Obesity in Adult Birth by Cesarean Section: A Systematic Review With Meta-analysis
Authors: Chiavarini Manuela , De Socio Benedetta , Giacchetta Irene , Fabiani Roberto
Published: January 2023

Context:

Overweight/obesity is one of the most important health problems. Birth by cesarean section has been shown to influence long-term health outcomes including obesity.

Objective:

The aim of this systematic review-meta-analysis is to update acknowledgment of the increased risk of cesarean section on offspring's overweight/obesity.

Methods:

This study follows the PRISMA guidelines. A systematic literature search was conducted on Scopus, PubMed, and Web of Science; we have selected all the articles published until January 2, 2022. For inclusion, studies must have reported either (i) both birth by cesarean section and adult (≥18 years) offspring's body mass index; (ii) cohort or case-control study design; and (iii) a risk estimate. Heterogeneity testing was performed using Cochran's Q and I
2 statistics. Publication bias was assessed by the Egger test and the Begg test. Meta-analysis was performed through a random-effects model.

Results:

Twelve studies with a combined population of 180 065 subjects were included in the meta-analysis. The overall analysis (N = 19) yielded a combined risk estimate for overweight/obesity of 1.19 (95% CI, 1.08-1.30) and the test of heterogeneity resulted into Q = 57.44 (I
2 = 68.67%, P ≤ .001). The risk of offspring obesity is 1.23 (95% CI, 1.09-1.39) and the test of heterogeneity resulted into Q = 39.55 (I
2 = 69.66%, P ≤ .001). Children born by cesarean section have an increased risk of obesity in adulthood.
Near-Miss Events Detected Using the Emergency Department Trigger Tool
Authors: Griffey Richard T. , Schneider Ryan M. , Todorov Alexandre A.
Published: January 2023

Objectives

Near misses include conditions with potential for harm, intercepted medical errors, and events requiring monitoring or intervention to prevent harm. Little is reported on near misses or their importance for quality and safety in the emergency department (ED).

Methods

This is a secondary evaluation of data from a retrospective study of the ED Trigger Tool (EDTT) at an urban, academic ED (data from October 1, 2014, to October 31, 2015; 92,859 eligible visits). All patients 18 years and older completing a visit were eligible. We ran the EDTT, a computerized query for triggers on 13 months of ED visit data, reviewing 5582 selected records using a 2-tiered approach. Events were categorized by occurrence (ED vs present on arrival [POA]), severity, omission/commission, and type, using a taxonomy with categories, subcategories, and cross-cutting modifiers.

Results

We identified 1458 ED near misses in 1269 of 5582 records (22.7%) and 80 near misses that were POA. Patient care events represented most ED near misses, including delays in diagnosis, treatment, and failure to monitor, primarily driven by ED boarding and crowding. Medication events were second most common (17%), including 80 medication administration errors. Of 80 POA events, 42% were related to overanticoagulation. We estimate that 19.3% of all ED visits include a near miss.

Conclusions

Near-miss events are relatively common (22.7% of our sample, 19.3% in the population) and are associated with an increased risk for an adverse event. Most events were patient care related (77%) involving delays due to crowding and ED boarding followed by medication administration errors. The EDTT is a high-yield approach for detecting important near misses and latent system deficiencies that impact patient safety.
Physicochemical characteristics of frankfurter sausage made with
venison
Authors: Kim Jong-Uk , Lee Nan-Hee , Choi Ung-Kyu
Published: January 2023

To revitalize the meat processing industry, the physicochemical properties of
frankfurter sausage prepared using venison were confirmed in this study. The pH
values of all sausages were within the range of 5.6-6.1. The yield after heat
treatment showed a significant increase pattern in proportion with the deer meat
added. The L and b values were significantly decreased with the addition of
venison. The ΔE value showed a pattern similar to that of the L value.
The a value was increased with the addition of venison. Hardness, adhesiveness,
and chewiness tended to increase depending on the amount of venison added,
whereas elasticity decreased. The total amino acid content increased depending
on the venison content. The content of essential amino acids compared to total
amino acids was 40% in all test groups. The content of glutamic acid was
the highest in all test groups, followed by that of aspartic acid, lysine, and
leucine. Among the amino acid compounds, sweet, savory, bitter and other
ingredients all showed the highest in FSV (frankfurter sausage made with
venison), followed by FSM (frankfurter sausage made with mixed meat) and FSP
(frankfurter sausage made with pork meat).
Colorimetric Detector for Hydrogen Sulfide Detection in Industrial Environments Based on Silver Nanoparticles Synthesized in Streptomyces Bacteria
Authors: Souri Nika , Abbaszadeh Maedeh , Ghorbanzadeh Sadegh
Published: January 2023

Hydrogen sulfide is a colorless, foul-odor pollutant with corrosive properties. This gas is one of the important pollutants released from food factories, fertilizer manufacturing factories, sewage treatment plants, and well drilling. Considering the dangers of being exposed to hydrogen sulfide gas, this article provides a cost-effective, simple, life-saving efficient solution. In this study, Streptomyces bacterium was used for biological production of silver nanoparticles, due to its resistance to the antimicrobial properties of silver. The synthesis and the size range of nanoparticles were confirmed using validation methods. For preparing biocomposite that entraps biological agents, microencapsulation of bacteria was adopted using gellan gum and alginate. In order to validate the final product, the viscosity and porosity of the biocomposite were determined. These tests aimed to investigate the mechanical properties affecting the behaviour and the response time of the final detector. In the end, the detector was exposed to hydrogen sulfide gas, and the color changes of the detector were recorded by time. According to the results, the control sample remained unchanged in all concentrations. However, the color of the test sample, changed faster with the increase in the input gas concentration. Moreover, no color change was observed in concentrations less than 20 mg/l. Therefore, the designed biodetector can be used for qualitative and semi-quantitative measurement of Hydrogen sulfide, in concentrations higher than 20 mg/l.
A Case Report of a COVID-19 Infection with Positive Sputum and Negative Nasopharyngeal Rapid Antigen-Based Testing: A Practical Method to Explore Sputome
Authors: Guzman Norberto A. , Guzman Daniel E.
Published: January 2023

Current COVID-19 antigen testing is primarily carried out by obtaining a specimen via nasopharyngeal swab and performing a rapid lateral flow immunoassay (LFIA) or related immunoassays. On average, a nasopharyngeal antigen-based LFIA for COVID-19 remains positive for approximately one week from symptom onset, and levels of infectivity and duration of the symptoms may depend primarily on carrying a high viral load enough to infect others. It has been proposed that patients with long-COVID, a syndrome in which patients continue to have complications of COVID with ongoing symptoms, may have occurring viral replication, despite testing negative via rapid COVID antigen testing.

We therefore propose a modified antigen-based method that exposes hidden or masked antigenic sites of viral specimens, or lingering fragments of viral proteins, present in sputum using a home-based rapid immunoassay for COVID-19. Almost all protocols for testing were performed according to LFIA kit manufacturer’s instructions for the detection of SARS-CoV-2 nucleocapsid protein antigen, one of the most predominant proteins encoded by the SARS-CoV-2 virus. However, in challenging the manufacturer instructions, one or more digestive enzymes and a detergent were added to the collected biosamples (nasopharyngeal, oropharyngeal, saliva, buccal, gargle, and sputum); this modified procedure expose hidden or masked antigenic sites of the coronavirus or cross-reactant antigenic sites of related or non-related viruses, or some of the plethora of epitopes generated by the sample corresponding microbiota to accomplish an optimal binding to the commercial antibody used in the diagnostic test. The modified protocol can enhance detection sensitivity by making the resultant test band in sputum samples visible, that would otherwise not be seen, and consequently may generate a false negative result, in a nasopharyngeal sample from a patient with mild symptoms of COVID-19 and/or low viral load. Therefore, a need exists for an improved sample pre-treatment extraction procedure that allows optimization of sample preparation to attain a more accurate test result. Although the experiments described here were performed using commercial platforms, with antibodies directed to SARS-CoV-2 nucleocapsid antigen, this method may also be viable for the detection of any other pathogen in sputum by using antibodies directed to the key antigens present in the pathogen of interest. Furthermore, this modified method to expose the content of sputum can be used as a simple protocol to study the sputome, the proteome of sputum, and other omics (sputomics). In summary, this simple method is non-invasive, rapid, inexpensive, accurate, and may provide increased sensitivity and specificity in the detection of COVID-19 antigens for several weeks or even months.
Using Artificial Intelligence to Learn Optimal Regimen Plan for Alzheimer’s Disease
Authors: Bhattarai Kritib , Das Trisha , Kim Yejin , Chen Yongbin , Dai Qiying , Li Xiaoyang , Jiang Xiaoqian , Zong Nansu
Published: January 2023

Background

Alzheimer’s Disease (AD) is a progressive neurological disorder with no specific curative medications. While only a few medications are approved by FDA (i.e., donepezil, galantamine, rivastigmine, and memantine) to relieve symptoms (e.g., cognitive decline), sophisticated clinical skills are crucial to optimize the appropriate regimens given the multiple coexisting comorbidities in this patient population.

Objective

Here, we propose a study to leverage reinforcement learning (RL) to learn the clinicians’ decisions for AD patients based on the longitude records from Electronic Health Records (EHR).

Methods

In this study, we withdraw 1,736 patients fulfilling our criteria, from the Alzheimer’s Disease Neuroimaging Initiative(ADNI) database. We focused on the two most frequent concomitant diseases, depression, and hypertension, thus resulting in five main cohorts, 1) whole data, 2) AD-only, 3) AD-hypertension, 4) AD-depression, and 5) AD-hypertension-depression. We modeled the treatment learning into an RL problem by defining the three factors (i.e., states, action, and reward) in RL in multiple strategies, where a regression model and a decision tree are developed to generate states, six main medications extracted (i.e., no drugs, cholinesterase inhibitors, memantine, hypertension drugs, a combination of cholinesterase inhibitors and memantine, and supplements or other drugs) are for action, and Mini-Mental State Exam (MMSE) scores are for reward.

Results

Given the proper dataset, the RL model can generate an optimal policy (regimen plan) that outperforms the clinician’s treatment regimen. With the smallest data samples, the optimal-policy (i.e., policy iteration and Q-learning) gained a lesser reward than the clinician’s policy (mean -2.68 and -2.76vs. -2.66, respectively), but it gained more reward once the data size increased (mean -3.56 and -2.48vs. -3.57, respectively).

Conclusions

Our results highlight the potential of using RL to generate the optimal treatment based on the patients’ longitude records. Our work can lead the path toward the development of RL-based decision support systems which could facilitate the daily practice to manage Alzheimer’s disease with comorbidities.
Assessing eligibility for lung cancer screening: Parsimonious multi-country ensemble machine learning models for lung cancer prediction
Authors: Callender Thomas , Imrie Fergus , Cebere Bogdan , Pashayan Nora , Navani Neal , van der Schaar Mihaela , Janes Sam M
Published: January 2023

Background

Ensemble machine learning could support the development of highly parsimonious prediction models that maintain the performance of more complex models whilst maximising simplicity and generalisability, supporting the widespread adoption of personalised screening. In this work, we aimed to develop and validate ensemble machine learning models to determine eligibility for risk-based lung cancer screening.

Methods

For model development, we used data from 216,714 ever-smokers in the UK Biobank prospective cohort and 26,616 high-risk ever-smokers in the control arm of the US National Lung Screening randomised controlled trial. We externally validated our models amongst the 49,593 participants in the chest radiography arm and amongst all 80,659 ever-smoking participants in the US Prostate, Lung, Colorectal and Ovarian Screening Trial (PLCO). Models were developed to predict the risk of two outcomes within five years from baseline: diagnosis of lung cancer, and death from lung cancer. We assessed model discrimination (area under the receiver operating curve, AUC), calibration (calibration curves and expected/observed ratio), overall performance (Brier scores), and net benefit with decision curve analysis.

Results

Models predicting lung cancer death (UCL-D) and incidence (UCL-I) using three variables – age, smoking duration, and pack-years – achieved or exceeded parity in discrimination, overall performance, and net benefit with comparators currently in use, despite requiring only one-quarter of the predictors. In external validation in the PLCO trial, UCL-D had an AUC of 0.803 (95% CI: 0.783-0.824) and was well calibrated with an expected/observed (E/O) ratio of 1.05 (95% CI: 0.95-1.19). UCL-I had an AUC of 0.787 (95% CI: 0.771-0.802), an E/O ratio of 1.0 (0.92-1.07). The sensitivity of UCL-D was 85.5% and UCL-I was 83.9%, at 5-year risk thresholds of 0.68% and 1.17%, respectively 7.9% and 6.2% higher than the USPSTF-2021 criteria at the same specificity.

Conclusions

We present parsimonious ensemble machine learning models to predict the risk of lung cancer in ever-smokers, demonstrating a novel approach that could simplify the implementation of risk-based lung cancer screening in multiple settings.
A large-scale machine learning study of sociodemographic factors contributing to COVID-19 severity
Authors: Tumbas Marko , Markovic Sofija , Salom Igor , Djordjevic Marko
Published: January 2023

Understanding sociodemographic factors behind COVID-19 severity relates to significant methodological difficulties, such as differences in testing policies and epidemics phase, as well as a large number of predictors that can potentially contribute to severity. To account for these difficulties, we assemble 115 predictors for more than 3000 US counties and employ a well-defined COVID-19 severity measure derived from epidemiological dynamics modeling. We then use a number of advanced feature selection techniques from machine learning to determine which of these predictors significantly impact the disease severity. We obtain a surprisingly simple result, where only two variables are clearly and robustly selected - population density and proportion of African Americans. Possible causes behind this result are discussed. We argue that the approach may be useful whenever significant determinants of disease progression over diverse geographic regions should be selected from a large number of potentially important factors.
Influence of soil-transmitted helminth infections on physical activity, physical fitness, and cardiovascular disease risk in primary schoolchildren in Gqeberha, South Africa
Authors: Nqweniso Siphesihle , Walter Cheryl , Randt Rosa du , Adams Larissa , Beckmann Johanna , Coulibaly Jean T. , Degen Jan , Dolley Danielle , Gall Stefanie , Joubert Nandi , Long Kurt Z. , Müller Ivan , Nienaber Madeleine , Pühse Uwe , Seelig Harald , Steinmann Peter , Utzinger Jürg , Gerber Markus , Lang Christin
Published: January 2023

Objective

School-aged children in low- and middle-income countries carry the highest burden of intestinal helminth infections, such as soil-transmitted helminths (STH). STH infections have been associated with negative consequences for child physical and cognitive development and wellbeing. Thus, the aim of this study was to determine the association of STH infections in schoolchildren from Gqeberha, focusing on physical activity, physical fitness, and clustered cardiovascular disease (CVD) risk score.

Methods

This cross-sectional study involved 680 schoolchildren (356 girls and 324 boys; mean age 8.19 years, SD±1.4) from disadvantaged communities in Gqeberha (formerly, Port Elizabeth), South Africa. Stool samples were collected and examined for STH infections using the Kato-Katz method. Physical activity (accelerometer) and physical fitness (grip strength, 20 m shuttle run) were measured using standard procedures. Furthermore, anthropometry, blood pressure, as well as glycated haemoglobin and lipid profile from capillary blood samples were assessed. We employed one-way ANOVAs to identify the associations of STH infections in terms of species and infection intensity with physical activity, physical fitness, and clustered CVD risk score.

Results

We found a low STH infection prevalence (7.2%) in our study, with participants infected with at least one intestinal helminth species. In comparison to their non-infected peers, children infected with STH had lower mean grip strength scores, but higher mean VO2max estimation and higher levels of MVPA (p<.001). When considering type and intensity of infection, a positive association ofA. lumbricoidesinfection and MVPA was found. In contrast, lightT. trichiura-infected children had significantly lower grip strength scores compared to non-infected children. VO2max and MVPA were positively associated with lightT. trichiurainfection. No significant association between the clustered CVD risk score and infection with any STH species was evident.

Conclusions

STH-infected children had lower grip strength scores than their non-infected peers, yet, achieved higher VO2max and MVPA scores. Our study highlights that the type and intensity of STH infection is relevant in understanding the disease burden of STH infections on children’s health. The findings of our study must be interpreted cautiously due to the low infection rate, and more research is needed in samples with higher prevalence rates or case-control designs.
Omicron BA.1/BA.2 infections in triple-vaccinated individuals enhance a diverse repertoire of mucosal and blood immune responses
Authors: Hornsby Hailey , Nicols Alexander R. , Longet Stephanie , Liu Chang , Tomic Adriana , Angyal Adrienn , Kronsteiner Barbara , Tyerman Jessica K. , Tipton Tom , Zhang Peijun , Ramalho Marta Gallis , Supasa Piyada , Selvaraj Muneeswaran , Abraham Priyanka , Neale Isabel , Ali Mohammad , Barratt Natalie A. , Nell Jeremy M. , Gustafsson Lotta , Strickland Scarlett , Grouneva Irina , Rostron Timothy , Moore Shona C. , Hering Luisa M. , Dobson Susan L. , Bibi Sagida , Mongkolsapaya Juthathip , Lambe Teresa , Wootton Dan , Hall Victoria , Hopkins Susan , Dong Tao , Barnes Eleanor , Screaton Gavin , Richter Alex , Turtle Lance , Rowland-Jones Sarah L. , Carroll Miles , Duncan Christopher J.A. , Klenerman Paul , Dunachie Susanna J. , Payne Rebecca P. , de Silva Thushan I.
Published: January 2023

Pronounced immune escape by the SARS-CoV-2 Omicron variant has resulted in large numbers of individuals with hybrid immunity, generated through a combination of vaccination and infection. Based primarily on circulating neutralizing antibody (NAb) data, concerns have been raised that omicron breakthrough infections in triple-vaccinated individuals result in poor induction of omicron-specific immunity, and that a history of prior SARS-CoV-2 in particular is associated with profound immune dampening. Taking a broader and comprehensive approach, we characterized mucosal and blood immunity to both spike and non-spike antigens following BA.1/BA.2 infections in triple mRNA-vaccinated individuals, with and without a history of previous SARS-CoV-2 infection. We find that the majority of individuals increase BA.1/BA.2/BA.5-specific NAb following infection, but confirm that the magnitude of increase and post-omicron titres are indeed higher in those who were infection-naive. In contrast, significant increases in nasal antibody responses are seen regardless of prior infection history, including neutralizing activity against BA.5 spike. Spike-specific T cells increase only in infection-naive vaccinees; however, post-omicron T cell responses are still significantly higher in previously-infected individuals, who appear to have maximally induced responses with a CD8+ phenotype of high cytotoxic potential after their 3rdmRNA vaccine dose. Antibody and T cell responses to non-spike antigens also increase significantly regardless of prior infection status, with a boost seen in previously-infected individuals to immunity primed by their first infection. These findings suggest that hybrid immunity induced by omicron breakthrough infections is highly dynamic, complex, and compartmentalised, with significant immune enhancement that can help protect against COVID-19 caused by future omicron variants.
Migrant healthcare workers during COVID-19: bringing an intersectional health system-related approach into pandemic protection. A German case study
Authors: Kuhlmann Ellen , Ungureanu Marius-Ionut , Behrens Georg MN , Cossmann Anne , Fehr Leonie Mac , Klawitter Sandra , Mikuteit Marie , Müller Frank , Thilo Nancy , Brînzac Monica Georgina , Dopfer-Jablonka Alexandra
Published: January 2023

Introduction

Migrant healthcare workers played an important role during the COVID-19 pandemic, but data are lacking especially for high-resourced European healthcare systems. This study aims to research migrant healthcare workers through an intersectional health system-related approach, using Germany as a case study.

Methods

An intersectional research framework was created and a rapid scoping study performed. Secondary analysis of selected items taken from two COVID-19 surveys was undertaken to compare perceptions of national and foreign-born healthcare workers, using descriptive statistics.

Results

Available research is focused on worst-case pandemic scenarios of Brazil and the United Kingdom, highlighting racialised discrimination and higher risks of migrant healthcare workers. The German data did not reveal significant differences between national-born and foreign-born healthcare workers for items related to health status including SARS-CoV-2 infection and vaccination, and perception of infection risk, protective workplace measures, and government measures, but items related to social participation and work conditions with higher infection risk indicate a higher burden of migrant healthcare workers.

Conclusions

COVID-19 pandemic policy must include migrant healthcare workers, but simply adding the migration status is not enough. We introduce an intersectional health systems-related approach to understand how pandemic policies create social inequalities and how the protection of migrant healthcare workers may be improved.