bluuebunny/crossref_metadata_2025 huggingface dataset:
Refractory serositis in Gorham–Stout syndrome
Authors: Di Hong , Zhang Bingqing , Xu Na , Yin Yue , Han Xinxin , Zhang Yun , Zeng Xuejun
Published: April 2022

Background

Gorham–Stout syndrome (GSS) is a rare disorder with various presentations and unpredictable prognoses. Previous understandings of GSS mainly focused on progressive bone destruction, while we identified a group of GSS patients with serous effusion as the first symptom. This study aimed to investigate the clinical characteristics of patients with GSS having serous effusion as the first symptom.

Methods

Patients diagnosed with GSS were identified through the Peking Union Medical College Hospital Medical Record System. The demographic, clinical, laboratory, and imaging data were collected. Patients who first presented with serous effusion were recruited into the serous group, while those with bone destruction were recruited into the bone group.

Results

Of the 23 patients with GSS enrolled, 13 were in the bone group and 10 in the serous group. The median disease duration was shorter and exercise tolerance was lower in the serous group. Despite less frequent bone pain in the serous group, the frequency of bone involvement was similar to that in the bone group. Patients in the serous group had higher rates of bilateral pleural effusion and multiple serous effusion. However, serous effusion also developed with disease progression in the bone group. Of the 17 patients treated with bisphosphonates, 14 reached bone-stable state. However, 5 out of 10 patients with serous effusion still had refractory effusions after bisphosphonates treatment. Three patients received sirolimus treatment, with an improvement in serous effusion. Seventeen patients were followed up; three patients died, two in the bone group and one in the serous group.

Conclusions

This study discovered that GSS could first be presented with serous effusion. We believe that this may be a new phenotype of the disease. Sirolimus might help in controlling serous effusion and improving prognosis.
Gender-based violence experiences among Palestinian women during the COVID-19 pandemic: mental health professionals’ perceptions and concerns
Authors: Mahamid Fayez , Veronese Guido , Bdier Dana
Published: April 2022

Background

In a geopolitically at-risk environment, such as Palestine, gender-based violence (GBV) is still a crucial problem rooted in discriminatory laws and traditional habits exacerbated by the ongoing Israeli military occupation. Moreover, the lack of updated data makes it difficult to grasp the magnitude of the phenomenon entirely; the purpose of the current study was to explore mental health professionals’ perceptions and concerns on GBV among Palestinian women during the COVID-19 pandemic.

Methods

Participants in the study were 30 Mental Health Professionals (MHP) selected using convenience and snowball sampling techniques from among MHP in northern West Bank, Palestine.

Results

A thematic content analysis revealed seven main themes of GBV during the pandemic. Palestinian MHP reported that the increased number of GBV cases among women during the COVID-19, quarantine, physical distancing measures, and closure of non-essential services significantly heightened the risks of GBV among Palestinian women. Moreover, Palestinian women involved with or married to older men or married at a very young age were at risk of GBV more than others. Results of qualitative analysis also showed that Israeli occupation and the political violence characterizing the area for decades (including restriction of movement, house demolitions, separation of family members, etc.) have also exacerbated and increased GBV in the occupied Palestinian territories.

Conclusions

Improving intervention skills and supervision services among Palestinian MHP to help women who face GBV is recommended. Moreover, additional research should be conducted to explore the risk and potential factors of GBV, agency, and coping strategies to deal with GBV.
Could termites be hiding a goldmine of obscure yet promising yeasts for energy crisis solutions based on aromatic wastes? A critical state-of-the-art review
Authors: Ali Sameh S. , Al-Tohamy Rania , Mohamed Tarek M. , Mahmoud Yehia A.-G. , Ruiz Héctor A. , Sun Lushan , Sun Jianzhong
Published: April 2022

Biodiesel is a renewable fuel that can be produced from a range of organic and renewable feedstock including fresh or vegetable oils, animal fats, and oilseed plants. In recent years, the lignin-based aromatic wastes, such as various aromatic waste polymers from agriculture, or organic dye wastewater from textile industry, have attracted much attention in academia, which can be uniquely selected as a potential renewable feedstock for biodiesel product converted by yeast cell factory technology. This current investigation indicated that the highest percentage of lipid accumulation can be achieved as high as 47.25% by an oleaginous yeast strain,Meyerozyma caribbicaSSA1654, isolated from a wood-feeding termite gut system, where its synthetic oil conversion ability can reach up to 0.08 (g/l/h) and the fatty acid composition in yeast cells represents over 95% of total fatty acids that are similar to that of vegetable oils. Clearly, the use of oleaginous yeasts, isolated from wood-feeding termites, for synthesizing lipids from aromatics is a clean, efficient, and competitive path to achieve "a sustainable development" towards biodiesel production. However, the lacking of potent oleaginous yeasts to transform lipids from various aromatics, and an unknown metabolic regulation mechanism presented in the natural oleaginous yeast cells are the fundamental challenge we have to face for a potential cell factory development. Under this scope, this review has proposed a novel concept and approach strategy in utilization of oleaginous yeasts as the cell factory to convert aromatic wastes to lipids as the substrate for biodiesel transformation. Therefore, screening robust oleaginous yeast strain(s) from wood-feeding termite gut system with a set of the desirable specific tolerance characteristics is essential. In addition, to reconstruct a desirable metabolic pathway/network to maximize the lipid transformation and accumulation rate from the aromatic wastes with the applications of various “omics” technologies or a synthetic biology approach, where the work agenda will also include to analyze the genome characteristics, to develop a new base mutation gene editing technology, as well as to clarify the influence of the insertion position of aromatic compounds and other biosynthetic pathways in the industrial chassis genome on the expressional level and genome stability. With these unique designs running with a set of the advanced biotech approaches, a novel metabolic pathway using robust oleaginous yeast developed as a cell factory concept can be potentially constructed, integrated and optimized, suggesting that the hypothesis we proposed in utilizing aromatic wastes as a feedstock towards biodiesel product is technically promising and potentially applicable in the near future.
Structure–property–degradability relationships of varisized lignocellulosic biomass induced by ball milling on enzymatic hydrolysis and alcoholysis
Authors: Chen Xueli , He Dingping , Hou Tao , Lu Minsheng , Mosier Nathan S. , Han Lujia , Xiao Weihua
Published: April 2022

Background

Valorization of lignocellulosic biomass to obtain clean fuels and high-value chemicals is attractive and essential for sustainable energy and chemical production, but the complex structure of biomass is recalcitrant to catalytic processing. This recalcitrance can be overcome by pretreating biomass into deconstructable components, which involves altering the structural complexities and physicochemical properties. However, the impact of these alterations on biomass deconstruction varies considerably, depending on the pretreatment and subsequent conversion type. Here, we systematically describe the changes in structure and properties of corn stover after ball milling as well as their influence on the following enzymatic saccharification and acid-catalyzed alcoholysis, with the aim of elucidating the relationships between structures, properties and deconstructable potential of lignocellulosic biomass.

Results

Ball milling causes dramatic structural changes, since the resistant plant cell walls are destroyed with size reduction to a cellular scale, leading to the increase in surface area and reducing ends, and decrease in crystallinity and thermal stability. As a result, ball-milled corn stover is more susceptible to enzymatic saccharification to fermentable sugars and provides more industrially viable processing approaches, as it is effective at high solids loading and minor enzyme loading, without any other pretreatment. Acid-catalyzed alcoholysis of corn stover to biofuels, on the other hand, is also enhanced by ball milling, but additional processing parameters should be tailored to the needs of efficient conversion. Further, a detailed examination of process variables coupled with a kinetic study indicates that acid-catalyzed alcoholysis is limited by the process variables rather than by the substrate parameters, whereas ball milling facilitates this reaction to some extent, especially under mild conditions, by lowering the activation energy of corn stover decomposition.

Conclusions

The efficient catalytic conversion of biomass is closely related to its structure and properties, an understanding of which offers prospects for the rational improvement of methods aimed at more economic commercial biorefineries.
Inter-species geographic signatures for tracing horizontal gene transfer and long-term persistence of carbapenem resistance
Authors: Salamzade Rauf , Manson Abigail L. , Walker Bruce J. , Brennan-Krohn Thea , Worby Colin J. , Ma Peijun , He Lorrie L. , Shea Terrance P. , Qu James , Chapman Sinéad B. , Howe Whitney , Young Sarah K. , Wurster Jenna I. , Delaney Mary L. , Kanjilal Sanjat , Onderdonk Andrew B. , Bittencourt Cassiana E. , Gussin Gabrielle M. , Kim Diane , Peterson Ellena M. , Ferraro Mary Jane , Hooper David C. , Shenoy Erica S. , Cuomo Christina A. , Cosimi Lisa A. , Huang Susan S. , Kirby James E. , Pierce Virginia M. , Bhattacharyya Roby P. , Earl Ashlee M.
Published: April 2022

Background

Carbapenem-resistant Enterobacterales (CRE) are an urgent global health threat. Inferring the dynamics of local CRE dissemination is currently limited by our inability to confidently trace the spread of resistance determinants to unrelated bacterial hosts. Whole-genome sequence comparison is useful for identifying CRE clonal transmission and outbreaks, but high-frequency horizontal gene transfer (HGT) of carbapenem resistance genes and subsequent genome rearrangement complicate tracing the local persistence and mobilization of these genes across organisms.

Methods

To overcome this limitation, we developed a new approach to identify recent HGT of large, near-identical plasmid segments across species boundaries, which also allowed us to overcome technical challenges with genome assembly. We applied this to complete and near-complete genome assemblies to examine the local spread of CRE in a systematic, prospective collection of all CRE, as well as time- and species-matched carbapenem-susceptible Enterobacterales, isolated from patients from four US hospitals over nearly 5 years.

Results

Our CRE collection comprised a diverse range of species, lineages, and carbapenem resistance mechanisms, many of which were encoded on a variety of promiscuous plasmid types. We found and quantified rearrangement, persistence, and repeated transfer of plasmid segments, including those harboring carbapenemases, between organisms over multiple years. Some plasmid segments were found to be strongly associated with specific locales, thus representing geographic signatures that make it possible to trace recent and localized HGT events. Functional analysis of these signatures revealed genes commonly found in plasmids of nosocomial pathogens, such as functions required for plasmid retention and spread, as well survival against a variety of antibiotic and antiseptics common to the hospital environment.

Conclusions

Collectively, the framework we developed provides a clearer, high-resolution picture of the epidemiology of antibiotic resistance importation, spread, and persistence in patients and healthcare networks.
Simultaneous improvement of lincomycin A production and reduction of lincomycin B levels in Streptomyces lincolnensis using a combined medium optimization approach
Authors: Zheng Xiu-hong , Ye Rui-fang , Ding Qi-hang , Hu Feng-xian , Zhang Hong-zhou , Lai Shen
Published: April 2022

Purpose

The current study aimed to optimize the culture and production parameters of industrial production of lincomycin A by Streptomyces lincolnensis using a statistical approach that could also reduce unwanted by-products.

Methods

The Plackett-Burman design, steepest ascent method, and response surface design were used to evaluate different factors that affect lincomycin A production.

Results

Using an optimized S. lincolnensis fermentation medium, lincomycin A production was increased up to 4600 mg/L in shaking flasks, which indicated a 28.3% improvement over previous production in an un-optimized medium (3585 mg/L). Additionally, the concentration of lincomycin B by-product was reduced to 0.8%, which was 82.2% lower than that in the un-optimized medium. Further, quantitative real-time PCR analysis revealed the optimized medium improved lincomycin A production by stimulating key genes in the lincomycin A biosynthesis pathway, as well as an osmotic stress gene.

Conclusions

Based on the results, the sequential optimization strategy in this study provides powerful means for the enhancement of lincomycin A with less by-product. We found that osmotic stress reduced the concentration of lincomycin B, which could also help reduce fermentation by-product yields in other actinobacteria.
Honorary authorship in health sciences: a protocol for a systematic review of survey research
Authors: Meursinge Reynders Reint , ter Riet Gerben , Di Girolamo Nicola , Malički Mario
Published: April 2022

Background

Honorary authorship refers to the practice of naming an individual who has made little or no contribution to a publication as an author. Honorary authorship inflates the output estimates of honorary authors and deflates the value of the work by authors who truly merit authorship. This manuscript presents the protocol for a systematic review that will assess the prevalence of five honorary authorship issues in health sciences.

Methods

Surveys of authors of scientific publications in health sciences that assess prevalence estimates will be eligible. No selection criteria will be set for the time point for measuring outcomes, the setting, the language of the publication, and the publication status. Eligible manuscripts are searched from inception onwards in PubMed, Lens.org, and Dimensions.ai. Two calibrated authors will independently search, determine eligibility of manuscripts, and conduct data extraction. The quality of each review outcome for each eligible manuscript will be assessed with a 14-item checklist developed and piloted for this review. Data will be qualitatively synthesized and quantitative syntheses will be performed where feasible. Criteria for precluding quantitative syntheses were defined a priori. The pooled random effects double arcsine transformed summary event rates of five outcomes on honorary authorship issues with the pertinent 95% confidence intervals will be calculated if these criteria are met. Summary estimates will be displayed after back-transformation. Stata software (Stata Corporation, College Station, TX, USA) version 16 will be used for all statistical analyses. Statistical heterogeneity will be assessed using Tau2 and Chi2 tests and I2 to quantify inconsistency.

Discussion

The outcomes of the planned systematic review will give insights in the magnitude of honorary authorship in health sciences and could direct new research studies to develop and implement strategies to address this problem. However, the validity of the outcomes could be influenced by low response rates, inadequate research design, weighting issues, and recall bias in the eligible surveys.

Systematic review registration

This protocol was registered a priori in the Open Science Framework (OSF) link: https://osf.io/5nvar/.
Improving hand hygiene practices in two regional hospitals in Kenya using a continuous quality improvement (CQI) approach
Authors: Kibira Jemima , Kihungi Loyce , Ndinda Mary , Wesangula Evelyn , Mwangi Catherine , Muthoni Faith , Augusto Orvalho , Owiso George , Ndegwa Linus , Luvsansharav Ulzii-Orshikh , Bancroft Elizabeth , Rabinowitz Peter , Lynch John , Njoroge Anne
Published: April 2022

Background

Hand hygiene (HH) is central in prevention of health care-associated infections. In low resource settings, models to improve HH compliance are needed. We implemented a continuous quality improvement (CQI) program targeting HH in two hospitals in Kenya.

Objective

To determine the impact of the HH CQI program and identify factors associated with HH compliance between 2018 and 2019.

Methods

A CQI project targeting the improvement of hand hygiene was implemented, including training and mentorship. Data were collected monthly between April 2018 and December 2019 in Thika and Kitale Hospitals. Healthcare workers trained on Infection Prevention and Control (IPC) observed and recorded HH opportunities and subsequent compliance among staff, including nurses, clinicians, and auxiliary staff, using the World Health Organization’s “My Five Moments for Hand Hygiene” tool. Covariates were explored using mixed-effects logistic regression with random department-level intercepts.

Results

Hand hygiene compliance improved from 27% at baseline to 44% after 21 months. Indication/moment for HH was significantly associated with compliance. Adjusting for site, professional category and department, compliance was higher after a moment of body fluid exposure (aOR 1.43, 95% CI 1.17–1.74, p value < 0.001) and lower before an aseptic procedure (aOR 0.12, 95% CI 0.08–0.17, p value < 0.001) compared to after patient contact. Wearing of gloves often replaced proper HH in surgical departments, which although not significant, had lower compliance compared to departments for internal medicine (aOR 0.93, 95% CI 0.85–1.02). Adjusted HH compliance from all quarters improved from baseline, but comparing each quarter to the previous quarter, the improvement fluctuated over time.

Conclusion

Training and mentorship on the importance of HH for all moments is needed to improve overall HH compliance. CQI with regular monitoring and feedback of HH performance can be an effective approach in improving HH compliance in public hospitals in Kenya.
Routes of transmission of VIM-positive Pseudomonas aeruginosa in the adult intensive care unit-analysis of 9 years of surveillance at a university hospital using a mathematical model
Authors: Pham Thi Mui , Büchler Andrea C. , Voor in ‘t holt Anne F. , Severin Juliëtte A. , Bootsma Martin C. J. , Gommers Diederik , Kretzschmar Mirjam E. , Vos Margreet C.
Published: April 2022

Background

Hospital outbreaks of multidrug resistant Pseudomonas aeruginosa are often caused by Pseudomonas aeruginosa clones which produce metallo-β-lactamases, such as Verona Integron-encoded Metallo-β-lactamase (VIM). Although different sources have been identified, the exact transmission routes often remain unknown. However, quantifying the role of different transmission routes of VIM-PA is important for tailoring infection prevention and control measures. The aim of this study is to quantify the relative importance of different transmission routes by applying a mathematical transmission model using admission and discharge dates as well as surveillance culture data of patients.

Methods

We analyzed VIM-PA surveillance data collected between 2010 and 2018 of two intensive-care unit (ICU) wards for adult patients of the Erasmus University Medical Center Rotterdam using a mathematical transmission model. We distinguished two transmission routes: direct cross-transmission and a persistent environmental route. Based on admission, discharge dates, and surveillance cultures, we estimated the proportion of transmissions assigned to each of the routes.

Results

Our study shows that only 13.7% (95% CI 1.4%, 29%) of the transmissions that occurred in these two ICU wards were likely caused by cross-transmission, leaving the vast majority of transmissions (86.3%, 95% CI 71%, 98.6%) due to persistent environmental contamination.

Conclusions

Our results emphasize that persistent contamination of the environment may be an important driver of nosocomial transmissions of VIM-PA in ICUs. To minimize the transmission risk from the environment, potential reservoirs should be regularly and thoroughly cleaned and disinfected, or redesigned.
Serum levels of vitamin D, retinol, zinc, and CRP in relation to obesity among children and adolescents
Authors: Zou Yan , Zhang Ronghua , Huang Lichun , Zhao Dong , Su Danting , Meng Jia , Fang Yueqiang
Published: April 2022

Background

The aim of this study was to examine the possible association between serum micronutrients (vitamin D, retinol, zinc), C-reactive protein (CRP), and obesity among children and adolescents.

Methods

Weight and height were measured and serum 25-hydroxy vitamin D, serum retinol, serum zinc, and CRP were measured in 2818 children and adolescents (6–17 years of age), and the data of 10 investigation sites in Zhejiang Province were used. The difference of micronutrients (vitamin D, retinol, zinc) and CRP among different nutritional status were explored by ANOVA and Chi-square test. The associated factors of micronutrients and CRP of overweight and obesity were explored by multifactor analysis.

Results

There were significant differences between male students and female students on BMI, 25(OH)D3, and CRP, and there were significant differences between children and adolescents and between students living in urban area and rural area on BMI, 25(OH)D3, retinol, and zinc(t > 1.96, p < 0.05). There were significant differences on 25(OH)D3 and CRP level among children and adolescents with different nutritional conditions (F = 2.612, 15.022, p < 0.05). In multifactor analysis, we found that female [odds ratio (OR) = 0.68, 95% CI 0.49–0.81], living in rural area (OR = 0.68, 95% CI 0.56–0.82), age (OR = 0.95, 95% CI 0.92–0.98), high CRP concentration (OR = 1.08, 95% CI 1.04–1.12) and appropriate retinol level (OR = 1.32, 95% CI 1.09–1.59) were associated with obesity compared to low/normal BMI.

Conclusion

Gender, living area, age, CRP concentration, and vitamin A status were associated with children and adolescents with overweight and obesity compared to low/normal BMI. More attention in the intervention of overweight and obesity should be paid to boys living in urban areas, and high serum concentration of CRP should also be concerned.
Adversity, attachment and emotion recognition in BPD adolescents: the distinct roles of disengaged and controlling environment
Authors: Robin Marion , Belbèze Jean , Pham-Scottez Alexandra , Speranza Mario , Shadili Gérard , Silva Jerôme , Corcos Maurice
Published: April 2022

Background

Literature data about emotion perception in patients with borderline personality disorders (BPD) revealed some discrepancies between some patients that are vigilant and accurate to detect their emotional environment and others that are impaired at identifying emotions of others. Even if some links between childhood adversity and facial affect recognition have been established, there is a need to understand the heterogeneous psychobiological mechanisms underlying this association. The aim is to distinguish in a BPD sample, the links between facial emotion recognition (FER) and adversity types (maltreatment and parental bonding), by evaluating two dimensions of disengaged and controlling environment.

Method

The study includes BPD adolescents (n = 45) and healthy controls (HC, n = 44): two scores of disengaged environment (parental low care; emotional and physical neglect) and controlling environment (high level of parenting control; emotional, physical and sexual abuse) were established and correlated to FER, as well as to attachment dimensions. Multiple linear regression analyzes were conducted to evaluate the effect of disengaged and controlling dimensions, on FER scores of sensitivity and accuracy, including anxious and avoidant attachment as covariables.

Results

Analyzes revealed that a disengaged environment was positively correlated to sensitivity in BPD patients, and the correlation was negative in the HC group. Controlling environment was negatively associated to accuracy of emotion in BPD. Avoidant and anxious attachment did not influence these associations.

Conclusions

These results suggest that distinct adverse experiences account for the heterogeneity observed in emotion regulation in BPD patients.
Development and validation of COVID-19 Impact Scale
Authors: Min Haewon , Kim Jinwon , Moon Kibum , Lee Seungjin , Kim Jin-young , Ko Young-gun
Published: April 2022

Background

As the COVID-19 (Coronavirus disease 2019) pandemic is prolonged, psychological responses to the pandemic have changed, and a new scale to reflect these changes needs to be developed. In this study, we attempt to develop and validate the COVID-19 Impact Scale (CIS) to measure the psychological stress responses of the COVID-19 pandemic, including emotional responses and difficulty with activities of daily living.

Methods

We recruited 2152 participants. Participants completed the CIS, the Fear of COVID-19 Scale (FCV-19S), and other mental health related measures. The factor structure, reliability, and validity of the CIS were analyzed. In addition, the validity of the scale was confirmed by its relationships to the existing measures assessing fear of COVID-19, depression, anxiety, subjective well-being, and suicidal ideation.

Results

Using exploratory factor analysis (N1 = 1076), we derived a one-factor structure. In confirmatory factor analysis (N2 = 1076), the one-factor model showed good to excellent fitness. The CIS was positively correlated with depression, anxiety, suicidal ideation, fear of COVID-19 and negatively correlated with subjective well-being. The FCV-19S did not show significant correlations with subjective well-being or suicidal ideation, and FCV-19S’s explanatory powers on depression and anxiety were lower than those of the CIS.

Conclusions

These results support that the CIS is a valid assessment of emotional problems and deterioration of the quality of life caused by the COVID-19 pandemic. Finally, the limitations of this study and future research directions are discussed.
Differential vulnerability of hippocampal CA3-CA1 synapses to Aβ
Authors: Shipton Olivia A. , Tang Clara S. , Paulsen Ole , Vargas-Caballero Mariana
Published: April 2022

Amyloid-beta (Aβ) and tau protein are both involved in the pathogenesis of Alzheimer’s disease. Aβ produces synaptic deficits in wild-type mice that are not seen in Mapt−/− mice, suggesting that tau protein is required for these effects of Aβ. However, whether some synapses are more selectively affected and what factors may determine synaptic vulnerability to Aβ are poorly understood. Here we first observed that burst timing-dependent long-term potentiation (b-LTP) in hippocampal CA3-CA1 synapses, which requires GluN2B subunit-containing NMDA receptors (NMDARs), was inhibited by human Aβ1–42 (hAβ) in wild-type (WT) mice, but not in tau-knockout (Mapt−/−) mice. We then tested whether NMDAR currents were affected by hAβ; we found that hAβ reduced the postsynaptic NMDAR current in WT mice but not in Mapt−/− mice, while the NMDAR current was reduced to a similar extent by the GluN2B-selective NMDAR antagonist Ro 25–6981. To further investigate a possible difference in GluN2B-containing NMDARs in Mapt−/− mice, we used optogenetics to compare NMDAR/AMPAR ratio of EPSCs in CA1 synapses with input from left vs right CA3. It was previously reported in WT mice that hippocampal synapses in CA1 that receive input from the left CA3 display a higher NMDAR charge transfer and a higher Ro-sensitivity than synapses in CA1 that receive input from the right CA3. Here we observed the same pattern in Mapt−/− mice, thus differential NMDAR subunit expression does not explain the difference in hAβ effect on LTP. Finally, we asked whether synapses with left vs right CA3 input are differentially affected by hAβ in WT mice. We found that NMDAR current in synapses with input from the left CA3 were reduced while synapses with input from the right CA3 were unaffected by acute hAβ exposure. These results suggest that hippocampal CA3-CA1 synapses with presynaptic axon originating in the left CA3 are selectively vulnerable to Aβ and that a genetic knock out of tau protein protects them from Aβ synaptotoxicity.
Long-term survival of implant-based oral rehabilitation following maxillofacial reconstruction with vascularized bone flap
Authors: Ma Hongyang , Van Dessel Jeroen , Shujaat Sohaib , Bila Michel , Sun Yi , Politis Constantinus , Jacobs Reinhilde
Published: April 2022

Aim

The aim of the study was to assess the 5-year cumulative survival rate of implant-based dental rehabilitation following maxillofacial reconstruction with a vascularized bone flap and to investigate the potential risk factors which might influence the survival rate.

Materials and methods

A retrospective cohort study was designed. Inclusion criteria involved 18 years old or above patients with the availability of clinical and radiological data and a minimum follow-up 1 year following implant placement. The cumulative survival rate was analyzed by Kaplan–Meier curves and the influential risk factors were assessed using univariate log-rank tests and multivariable Cox-regression analysis.

Results

151 implants were assessed in 40 patients with a mean age of 56.43 ± 15.28 years at the time of implantation. The mean number of implants placed per patient was 3.8 ± 1.3 with a follow-up period of 50.0 ± 32.0 months. The cumulative survival at 1-, 2- and 5-years was 96%, 87%, and 81%. Patients with systemic diseases (HR = 3.75, 95% CI 1.65–8.52;p = 0.002), irradiated flap (HR = 2.27, 95% CI 1.00–5.17;p = 0.05) and poor oral hygiene (HR = 11.67; 95% CI 4.56–29.88;p < 0.0001) were at a significantly higher risk of implant failure.

Conclusion

The cumulative implant survival rate was highest at 1st year followed by 2nd and 5th year, indicating that the risk of implant failure increased over time. Risk indicators that seem to be detrimental to long-term survival include poor oral hygiene, irradiated flap and systemic diseases.
Adherence to Cancer Survivorship Care Guidelines and Health Care Utilization Patterns Among Nonmetastatic Breast Cancer Survivors in Singapore
Authors: Ke Yu , Tan Chia Jie , Yeo Hui Ling Angie , Chan Alexandre
Published: April 2022

PURPOSE

Currently, limited information is available on care provided to breast cancer survivors in Singapore. This study aims to assess the quality of post-treatment cancer survivorship care among breast cancer survivors on the basis of compliance with international guidelines up to 5 years post-primary treatment.

METHODS

This study analyzed a cohort of 189 nonmetastatic breast cancer survivors recruited from the National Cancer Centre Singapore, Changi General Hospital, and KK Women's and Children's Hospital between November 2011 and September 2015. Data were retrieved from electronic medical records in 6-month intervals. Adherence to guidelines was assessed in four areas: (1) recurrent cancer surveillance, (2) monitoring and detecting late effects, (3) health care resource utilization, and (4) preventive care. Descriptive statistics, Kaplan-Meier, and regression analyses were conducted.

RESULTS

Annual surveillance mammogram adherence rates were ≥ 83% consistently. The most common new diagnosis was osteoporosis at an incidence rate of 102 (95% CI, 77.6 to 135) cases per 1,000 person-years. Overall, ≤ 10.1% of survivors had an emergency department or hospitalization visit. Oncologist services were overutilized, with a median of 6 (interquartile range: 4-10) visits in the first 6 months before reducing to a median of 2 (interquartile range: 1-3) visits biannually 3 years post-treatment. Bone mineral density test utilization rate adhered to guidelines for 92.2% of aromatase inhibitor recipients but only for 36.4% of premenopausal tamoxifen recipients.

CONCLUSION

Overall, adherence rates to surveillance and osteoporosis preventive care were high. Extensive utilization of oncologist services up to 5 years post-primary treatment could be reversed with strategies to engage and coordinate survivorship care with primary care providers, leveraging their strengths to improve adherence to health promotion and chronic disease management.
Two-body hadronic decay of K+ in the presence of a circularly polarized laser field
Authors: Baouahi M. , Dahiri I. , Ouali M. , Manaut B. , Benbrik R. , Taj S.
Published: April 2022

In this study, we have investigated the two-body hadronic decay of the charged kaon,

, in the presence of a laser field with circular polarization. We have derived, by analytical techniques, the laser-assisted decay width and the branching ratio of the charged kaon decay via the two-body hadronic channel. We have also taken into consideration the impressive results obtained for the laser-assisted charged kaon decay via the leptonic mode in order to understand more clearly the effect of the laser field on the quantities related to the charged kaon decay such as the decay width, the branching ratio and lifetime. A precise comparison of the ratios of hadronic-to-muonic decay in the presence of the laser field is made to show that the hadronic mode becomes slightly more important by increasing the laser field intensity.
The importance of considering regulatory domains in genome-wide analyses – the nearest gene is often wrong!
Authors: Chua Ellora Hui Zhen , Yasar Samen , Harmston Nathan
Published: April 2022

The expression of a large number of genes is regulated by regulatory elements that are located far away from their promoters. Identifying which gene is the target of a specific regulatory element or is affected by a non-coding mutation is often accomplished by assigning these regions to the nearest gene in the genome. However, this heuristic ignores key features of genome organisation and gene regulation; in that the genome is partitioned into regulatory domains, which at some loci directly coincide with the span of topologically associated domains (TADs), and that genes are regulated by enhancers located throughout these regions, even across intervening genes. In this review, we examine the results from genome-wide studies using chromosome conformation capture technologies and from those dissecting individual gene regulatory domains, to highlight that the phenomenon of enhancer skipping is pervasive and affects multiple types of genes. We discuss how simply assigning a genomic region of interest to its nearest gene is problematic and often leads to incorrect predictions and highlight that where possible information on both the conservation and topological organisation of the genome should be used to generate better hypotheses.

The article has an associated Future Leader to Watch interview.
The genomic basis of host and vector specificity in non-pathogenic trypanosomatids
Authors: Oldrieve Guy R. , Malacart Beatrice , López-Vidal Javier , Matthews Keith R.
Published: April 2022

Trypanosoma theileri, a non-pathogenic parasite of bovines, has a predicted surface protein architecture that likely aids survival in its mammalian host. Their surface proteins are encoded by genes which account for ∼10% of their genome. A non-pathogenic parasite of sheep, Trypanosoma melophagium, is transmitted by the sheep ked and is closely related to T. theileri. To explore host and vector specificity between these species, we sequenced the T. melophagium genome and transcriptome and an annotated draft genome was assembled. T. melophagium was compared to 43 kinetoplastid genomes, including T. theileri. T. melophagium and T. theileri have an AT biased genome, the greatest bias of publicly available trypanosomatids. This trend may result from selection acting to decrease the genomic nucleotide cost. The T. melophagium genome is 6.3Mb smaller than T. theileri and large families of proteins, characteristic of the predicted surface of T. theileri, were found to be absent or greatly reduced in T. melophagium. Instead, T. melophagium has modestly expanded protein families associated with the avoidance of complement-mediated lysis. We propose that the contrasting genomic features of these species is linked to their mode of transmission from their insect vector to their mammalian host.

This article has an associated First Person interview with the first author of the paper.
Age-Independent Preoperative Chemosensitivity and 5-Year Outcome Determined by Combined 70- and 80-Gene Signature in a Prospective Trial in Early-Stage Breast Cancer
Authors: Whitworth Pat , Beitsch Peter D. , Pellicane James V. , Baron Paul L. , Lee Laura A. , Dul Carrie L. , Nash Charles H. , Murray Mary K. , Richards Paul D. , Gittleman Mark , Budway Raye , Rahman Rakhshanda Layeequr , Kelemen Pond , Dooley William C. , Rock David T. , Cowan Ken , Lesnikoski Beth-Ann , Barone Julie L. , Ashikari Andrew Y. , Dupree Beth , Wang Shiyu , Menicucci Andrea R. , Yoder Erin B. , Finn Christine , Corcoran Kate , Blumencranz Lisa E. , Audeh William ,   NBRST Investigators Group
Published: April 2022

Background

The Neoadjuvant Breast Symphony Trial (NBRST) demonstrated the 70-gene risk of distant recurrence signature, MammaPrint, and the 80-gene molecular subtyping signature, BluePrint, precisely determined preoperative pathological complete response (pCR) in breast cancer patients. We report 5-year follow-up results in addition to an exploratory analysis by age and menopausal status.

Methods

The observational, prospective NBRST (NCT01479101) included 954 early-stage breast cancer patients aged 18–90 years who received neoadjuvant chemotherapy and had clinical and genomic data available. Chemosensitivity and 5-year distant metastasis-free survival (DMFS) and overall survival (OS) were assessed. In a post hoc subanalysis, results were stratified by age (≤ 50 vs. > 50 years) and menopausal status in patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2−) tumors.

Results

MammaPrint and BluePrint further classified 23% of tumors to a different subtype compared with immunohistochemistry, with more precise correspondence to pCR rates. Five-year DMFS and OS were highest in MammaPrint Low Risk, Luminal A-type and HER2-type tumors, and lowest in MammaPrint High Risk, Luminal B-type and Basal-type tumors. There was no significant difference in chemosensitivity between younger and older patients with Low-Risk (2.2% vs. 3.8%; p = 0.64) or High-Risk tumors (14.5% vs. 11.5%; p = 0.42), or within each BluePrint subtype; this was similar when stratifying by menopausal status. The 5-year outcomes were comparable by age or menopausal status for each molecular subtype.

Conclusion

Intrinsic preoperative chemosensitivity and long-term outcomes were precisely determined by BluePrint and MammaPrint regardless of patient age, supporting the utility of these assays to inform treatment and surgical decisions in early-stage breast cancer.
Novel behavioral model in evaluating initiation and sustenance of teeth brushing behavior among students pursuing health sciences: a cross-sectional study
Authors: Panjwani Dhiraj , Pai Mithun , Yellapurkar Shweta , Poddar Aayush Anand , Rajesh Gururagavendra
Published: April 2022

Background: Oral hygiene maintenance is a crucial and integral feature in determining the overall wellbeing of a person. It has been established that interventions for health promotion at the public health level derived from theoretical models based on social and behavioural sciences have a superior effectiveness as compared to the ones without a theoretical background. Hence a novel behavioral model known as the multi-theory model (MTM) was used to understand two important aspects of health behavior change: (i) Initiation and (ii) Sustenance in twice daily teeth brushing in a university setting with objectives to identify factors effecting MTM in initiation and sustenance of twice daily brushing behavior among students pursuing health sciences and correlating the MTM theory with socio-demographic and behavioral patterns.

Methods: The study is an analytical cross-sectional study. Students pursuing Medicine and Dentistry in a University setting were included. A validated questionnaire was designed for this study. Questions were framed to evaluate the constructs of initiation and sustenance of MTM, personality, sleeping habits and demographic corelates of participants. Multiple means between the groups were compared using analysis of variance and a post hoc test. Correlation was established between different domains, the items were then entered for hierarchical multiple regression.

Results: Of the 235 participants in the study, 229 completed the questionnaire. There was a significant association between brushing quartiles, professional streams (p<0.001) and academic performance (p<0.001). The hierarchical multiple regression revealed that at stage one, behavioral confidence contributed significantly to the regression model (F (1,227) = 33.227, p<0.001) and accounted for 12.4% of the variation in twice daily brushing.

Conclusion: MTM is a good tool in predicting the initiation and sustenance of twice daily brushing behavior among young adults and can form a useful tool in assessing the patterns of brushing behavior in a population.
Case Report: Identification of likely recurrent CEP290 mutation in a child with Joubert syndrome and cerebello-retinal-renal features.
Authors: Spahiu Lidvana , Sayer John A , Behluli Emir , Liehr Thomas , Temaj Gazmend
Published: April 2022

Background. Joubert syndrome (JS) is a rare autosomal recessive ciliopathy with an estimated prevalence of 1 in 100,000. JS is characterized by hyperpnoea, hypotonia, ataxia, developmental delay and various neuropathological abnormalities in the brain including cerebellar hypoplasia and cerebellar vermis aplasia. JS can also have variable multi-organ involvement, including the retina, kidneys, liver, and musculoskeletal system.

Methods and Results. Here we report a clinical description of two-year-old girl presenting with breathing difficulties, hyperechoic kidneys with loss of corticomedullary differentiation. Brain magnetic resonance imaging revealed the typical molar tooth sign consistent with a clinical diagnosis of JS and retinal examination showed severe retinal dystrophy leading to blindness. Molecular genetic analysis using whole exome sequencing and Sanger sequence confirmation demonstrated a homozygous mutation (c.5493delA, p.(A1832fs*19) in CEP290 which segregated from either parent and was consistent with the multisystem ciliopathy phenotype. This precise variant has been described previously in 2 families from the Kosovar-Albanian region suggesting this allele is a recurrent mutation in this population.

Conclusions. Mutations in CEP290 lead to multisystem ciliopathy syndromes and molecular genetic diagnostics of such cases allows precise diagnosis, screening of at risk relatives and appropriate management.
Evaluation of the rapid, multi-country, parallel process, multi-tasking approach to startup of short-term technical assistance to improve service delivery in newborn and child health in the context of USAID’s Zika response in four Eastern and Southern Caribbean countries
Authors: Aumakhan Bulbul , Coly Astou , Hager Salwan , Chitashvili Tamar , Massoud M. Rashad
Published: April 2022

Background: In 2018, the USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project started a new partnership with four Eastern and Southern Caribbean countries impacted by the Zika virus: Antigua and Barbuda, Dominica, St. Kitts and Nevis, and St. Vincent and the Grenadines.  The goal of the project was to provide short-term technical assistance (STTA) to strengthen the health systems’ capacity to detect newborns and young children potentially affected by Zika and to address their health needs.  To meet these objectives, ASSIST developed an innovative approach based on its existing model for service delivery improvement. This novel approach is known as Rapid, Multi-country, Parallel Process, Multi-tasking Approach for a Project Startup (RMPP-MAPS).  An evaluation was conducted to document the STTA startup activities, to identify enabling and constraining factors, and to capture lessons learned.

Methods: An external consultant conducted remote in-depth interviews with individuals involved in the startup using semi-structured interview guides and retrieved data from the review of project documents.

Results: Using RMPP-MAPS, the ASSIST Project successfully implemented the startup for complex STTA in four countries within less than four months, spanning mid-May to early September 2018. Project milestones included achieving buy-in from stakeholders, co-developing the technical scope and materials, and rapidly executing critical operational functions.  Dedicated project teams, country leaderships, and local champions were essential to overcoming the main challenges, which included a condensed timeframe, lack of in-country offices, and country-level factors such as a shortage of health care workers and a weak health infrastructure. 

Conclusions: The RMPP-MAPS is a feasible and resource-efficient mechanism of interest to implementers, donors, and low and middle-income countries facing temporal and financial limitations to rapidly addressing public health priorities.
Asymptomatic COVID-19 in the elderly: dementia and viral clearance as risk factors for disease progression.
Authors: Esteban Ignacio , Bergero Georgina , Alves Camila , Bronstein Micaela , Ziegler Valeria , Wood Cristian , Caballero Mauricio T. , Wappner Diego , Libster Romina , Perez Marc Gonzalo , Polack Fernando P.
Published: April 2022

Background:

SARS-CoV-2 infected individuals ≥60 years old have the highest hospitalization rates and represent >80% fatalities. Within this population, those in long-term facilities represent >50% of the total COVID-19 related deaths per country. Among those without symptoms, the rate of pre-symptomatic illness is unclear, and potential predictors of progression for symptom development are unknown.

Our objective was to delineate the natural evolution of asymptomatic SARS-CoV-2 infection in elders and identify determinants of progression.

Methods:

We established a medical surveillance team monitoring 63 geriatric institutions in Buenos Aires, Argentina during June-July 2020. When an index COVID-19 case emerged, we tested all other eligible asymptomatic elders ≥75 or >60 years old with at least 1 comorbidity. SARS-CoV-2 infected elders were followed for 28 days. Disease was diagnosed when any COVID-19 manifestation occurred. SARS-CoV-2 load at enrollment, shedding on day 15, and antibody responses were also studied.

Results:

After 28 days of follow-up, 74/113(65%) SARS-CoV-2-infected elders remained asymptomatic. 54% of pre-symptomatic patients developed hypoxemia and ten pre-symptomatic patients died.

Dementia was the only clinical risk factor associated with disease(OR 2.41(95%CI=1.08, 5.39). In a multivariable logistic regression model, dementia remained as risk factor for COVID-19 severe disease. Furthermore, dementia status showed a statistically significant different trend when assessing the cumulative probability of developing COVID-19 symptoms(log-rank p=0.027).

On day 15, SARS-CoV-2 was detectable in 30% of the asymptomatic group while in 61% of the pre-symptomatic(p=0.012).

No differences were observed among groups in RT-PCR mean cycle threshold at enrollment(p=0.391) and in the rates of antibody seropositivity(IgM and IgG against SARS-CoV-2).

Conclusions:

In summary, 2/3 of our cohort of SARS-CoV-2 infected elders from vulnerable communities in Argentina remained asymptomatic after 28 days of follow-up with high mortality among those developing symptoms. Dementia and persistent SARS-CoV-2 shedding were associated with progression from asymptomatic to symptomatic infection.