bluuebunny/crossref_metadata_2025 huggingface dataset:
Global, regional, and national health inequalities of Alzheimer’s disease and Parkinson’s disease in 204 countries, 1990–2019
Authors: Ji Zixiang , Chen Qi , Yang Jing , Hou Jiazhe , Wu Hengjing , Zhang Lijuan
Published: June 2024

Background

Alzheimer’s disease and related dementias (ADRD) and Parkinson’s disease (PD), pose growing global health challenges. Socio-demographic and economic development acts paradoxically, complicating the process that determines how governments worldwide designate policies and allocate resources for healthcare.

Methods

We extracted data on ADRD and PD in 204 countries from the Global Burden of Disease 2019 database. Health disparities were estimated using the slope index of inequality (SII), and concentration index (CIX) based on the socio-demographic index. Estimated annual percentage changes (EAPCs) were employed to evaluate temporal trends.

Results

Globally, the SII increased from 255.4 [95% confidence interval (CI), 215.2 to 295.5)] in 1990 to 559.3 (95% CI, 497.2 to 621.3) in 2019 for ADRD, and grew from 66.0 (95% CI, 54.9 to 77.2) in 1990 to 132.5 (95% CI, 118.1 to 147.0) in 2019 for PD; CIX rose from 33.7 (95% CI, 25.8 to 41.6) in 1990 to 36.9 (95% CI, 27.8 to 46.1) in 2019 for ADRD, and expanded from 22.2 (95% CI, 21.3 to 23.0) in 1990 to 29.0 (95% CI, 27.8 to 30.3) in 2019 for PD. Age-standardized disability-adjusted life years displayed considerable upward trends for ADRD [EAPC = 0.43 (95% CI, 0.27 to 0.59)] and PD [0.34 (95% CI, 0.29 to 0.38)].

Conclusions

Globally, the burden of ADRD and PD continues to increase with growing health disparities. Variations in health inequalities and the impact of socioeconomic development on disease trends underscored the need for targeted policies and strategies, with heightened awareness, preventive measures, and active management of risk factors.
Unmet needs and harm reduction preferences of syringe services program participants: differences by co-use of illicit opioids and methamphetamine
Authors: Sun Rachel , Sauda Tonazzina H. , Hoopsick Rachel A.
Published: June 2024

Background

The current fourth wave of the United States opioid overdose epidemic is characterized by the co-use of opioids and stimulants, including illicit opioids and methamphetamine. The co-use of these two drugs, known as “goofballing,” is associated with higher risk for several adverse outcomes, including more frequent injections, greater health risks, and higher morbidity. Considering these differences, this unique subpopulation of people who inject drugs (PWID) may also have unique unmet needs and harm reduction preferences.

Methods

We collected self-reported data from participants (N = 50) of a syringe services program (SSP), including basic needs and harm reduction preferences. Using bivariate analyses, we examined differences between SSP participants who do and do not co-use illicit opioids and methamphetamine. Co-use was defined as reporting the use of both drugs, which may or may not have been used simultaneously.

Results

In the overall sample, the mean level of need was highest for bus passes or other transportation, a person who can help you get the services you need, medication for opioid use disorder, and a job or job training. Additionally, all participants reported being either interested or very interested in fentanyl test strips, safe consumption sites, delivery of syringe service supplies, and delivery of naloxone. Those who endorsed co-use had a greater need for food, healthcare, substance use disorder treatment, a support person to help them access needed services, and bus passes or transportation.

Conclusions

Unmet needs were prevalent, and the desire for more harm reduction services was high among these PWID. Results also suggest people who co-use illicit opioids and methamphetamine may have the greatest unmet needs and desire for additional harm reduction services.
The role of KLRG1: a novel biomarker and new therapeutic target
Authors: Zhang Yakun , Chen Shuang , Tang Xinyi , Peng Yu , Jiang Tingting , Zhang Xiaomei , Li Jun , Liu Yao , Yang Zailin
Published: June 2024

Killer cell lectin-like receptor G1 (KLRG1) is an immune checkpoint receptor expressed predominantly in NK and T-cell subsets that downregulates the activation and proliferation of immune cells and participates in cell-mediated immune responses. Accumulating evidence has demonstrated the importance of KLRG1 as a noteworthy disease marker and therapeutic target that can influence disease onset, progression, and prognosis. Blocking KLRG1 has been shown to effectively mitigate the effects of downregulation in various mouse tumor models, including solid tumors and hematologic malignancies. However, KLRG1 inhibitors have not yet been approved for human use, and the understanding of KLRG1 expression and its mechanism of action in various diseases remains incomplete. In this review, we explore alterations in the distribution, structure, and signaling pathways of KLRG1 in immune cells and summarize its expression patterns and roles in the development and progression of autoimmune diseases, infectious diseases, and cancers. Additionally, we discuss the potential applications of KLRG1 as a tool for tumor immunotherapy.
Estrogen-immuno-neuromodulation disorders in menopausal depression
Authors: Zhang Yuling , Tan Xiying , Tang Chaozhi
Published: June 2024

A significant decrease in estrogen levels puts menopausal women at high risk for major depression, which remains difficult to cure despite its relatively clear etiology. With the discovery of abnormally elevated inflammation in menopausal depressed women, immune imbalance has become a novel focus in the study of menopausal depression. In this paper, we examined the characteristics and possible mechanisms of immune imbalance caused by decreased estrogen levels during menopause and found that estrogen deficiency disrupted immune homeostasis, especially the levels of inflammatory cytokines through the ERα/ERβ/GPER-associated NLRP3/NF-κB signaling pathways. We also analyzed the destruction of the blood-brain barrier, dysfunction of neurotransmitters, blockade of BDNF synthesis, and attenuation of neuroplasticity caused by inflammatory cytokine activity, and investigated estrogen-immuno-neuromodulation disorders in menopausal depression. Current research suggests that drugs targeting inflammatory cytokines and NLRP3/NF-κB signaling molecules are promising for restoring homeostasis of the estrogen-immuno-neuromodulation system and may play a positive role in the intervention and treatment of menopausal depression.
Paternal care plasticity: males care more for early- than late-developing embryos in an arboreal breeding treefrog
Authors: Cheng Yuan-Cheng , Xie Cai-Han , Chen Yu-Chen , Fuh Nien-Tse , Chuang Ming-Feng , Kam Yeong-Choy
Published: June 2024

Background

Parental care benefits offspring but comes with costs. To optimize the trade-off of costs and benefits, parents should adjust care based on intrinsic and/or extrinsic conditions. The harm to offspring hypothesis suggests that parents should invest more in younger offspring than older offspring because younger offspring are more vulnerable. However, this hypothesis has rarely been comprehensively tested, as many studies only reveal an inverse correlation between parental care and offspring age, without directly testing the effects of offspring age on their vulnerability. To test this hypothesis, we studied Kurixalus eiffingeri, an arboreal treefrog with paternal care. We first performed a field survey by monitoring paternal care during embryonic development. Subsequently, we conducted a field experiment to assess the prevalence of egg predators (a semi-slug, Parmarion martensi) and the plasticity of male care. Finally, we conducted a laboratory experiment to assess how embryo age affects predation by P. martensi.

Results

Our results showed that (1) male attendance and brooding frequency affected embryo survival, and (2) males attended and brooded eggs more frequently in the early stage than in the late stage. The experimental results showed that (3) males increased attendance frequency when the predators were present, and (4) the embryonic predation by the semi-slug during the early was significantly higher than in the late stage.

Conclusions

Our findings highlight the importance of paternal care to embryo survival, and the care behavior is plastic. Moreover, our results provide evidence consistent with the predictions of the harm to offspring hypothesis, as males tend to care more for younger offspring which are more vulnerable.
Pumilio-1 mediated translational control of claudin-5 at the blood-brain barrier
Authors: Hashimoto Yosuke , Greene Chris , Hanley Nicole , Hudson Natalie , Henshall David , Sweeney Kieron J. , O’Brien Donncha F. , Campbell Matthew
Published: June 2024

Claudin-5 is one of the most essential tight junction proteins at the blood-brain barrier. A single nucleotide polymorphism rs10314 is located in the 3’-untranslated region of claudin-5 and has been shown to be a risk factor for schizophrenia. Here, we show that the pumilio RNA-binding protein, pumilio-1, is responsible for rs10314-mediated claudin-5 regulation. The RNA sequence surrounding rs10314 is highly homologous to the canonical pumilio-binding sequence and claudin-5 mRNA with rs10314 produces 25% less protein due to its inability to bind to pumilio-1. Pumilio-1 formed cytosolic granules under stress conditions and claudin-5 mRNA appeared to preferentially accumulate in these granules. Added to this, we observed granular pumilio-1 in endothelial cells in human brain tissues from patients with psychiatric disorders or epilepsy with increased/accumulated claudin-5 mRNA levels, suggesting translational claudin-5 suppression may occur in a brain-region specific manner. These findings identify a key regulator of claudin-5 translational processing and how its dysregulation may be associated with neurological and neuropsychiatric disorders.

Graphical Abstract
Zero-profile implant system versus novel plate systems after ACDF for comparison of sagittal balance parameters and clinical efficacy analysis
Authors: Gong Yan , Zhuo Hang , Zhou Zelin , Cheng Zhaojun , Gan Yanchi , He Jiahui , Song Zefeng , Liu Hao , Liu Yu , Liang De , Jiang Xiaobing , Ren Hui
Published: June 2024

Background

The zero-profile implant system (Zero-P) and conventional plates have been widely used in anterior cervical discectomy and fusion (ACDF) to treat cervical spondylosis. The purpose of this study was to compare the effects of the application of Zero-P and new conventional plates (ZEVO, Skyline) in ACDF on the sagittal imaging parameters of cervical spondylosis patients and to analyze their clinical efficacy.

Methods

We conducted a retrospective study on 119 cervical spondylosis patients from January 2018 to December 2021, comparing outcomes between those receiving the Zero-P device (n = 63) and those receiving a novel conventional plate (n = 56, including 46 ZEVO and 10 Skyline plates) through ACDF. Cervical sagittal alignment was assessed pre- and postoperatively via lateral radiographs. The Japanese Orthopedic Association (JOA), Neck Disability Index (NDI), and visual analog scale (VAS) scores were recorded at baseline, after surgery, and at the 2-year follow-up to evaluate patient recovery and intervention success.

Results

There were significant differences in the postoperative C0-C2 Cobb angle and postoperative sagittal segmental angle (SSA) between patients in the novel conventional plate group and those in the Zero-P group (P < 0.05). Postoperatively, there were significant changes in the C2‒C7 Cobb angle, C0‒C2 Cobb angle, SSA, and average surgical disc height (ASDH) compared to the preoperative values in both patient groups (P < 0.05). Dysphagia in the immediate postoperative period was lower in the Zero-P group than in the new conventional plate group (0% in the Zero-P group, 7.14% in the novel conventional plate group, P = 0.046), and the symptoms disappeared within 2 years in both groups. There was no statistically significant difference between the two groups in terms of complications of adjacent spondylolisthesis (ASD) at 2 years postoperatively (3.17% in the Zero-P group, 8.93% in the novel conventional plate group; P = 0.252). According to the subgroup analysis, there were significant differences in the postoperative C2‒C7 Cobb angle, C0‒C2 Cobb angle, T1 slope, and ASDH between the ZEVO group and the Skyline group (P < 0.05). Compared with the preoperative scores, the JOA, NDI, and VAS scores of all groups significantly improved at the 2-year follow-up (P < 0.01). According to the subgroup analysis, the immediate postoperative NDI and VAS scores of the ZEVO group were significantly better than those of the Skyline group (P < 0.05).

Conclusion

In ACDF, both novel conventional plates and Zero-P can improve sagittal parameters and related scale scores. Compared to the Zero-P plate, the novel conventional plate has a greater advantage in correcting the curvature of the surgical segment, but the Zero-P plate is less likely to produce postoperative dysphagia.
Nrf2 mediates the effects of shionone on silica-induced pulmonary fibrosis
Authors: Wang Guiyun , Xie Weixi , Deng Lang , Huang Xiaoting , Sun Mei , Liu Wei , Tang Siyuan
Published: June 2024

Background

Extended contact with silica particles can lead to Silicosis, a chronic lung condition lacking established treatment protocols or clear mechanisms of development. The urgency for innovative treatments arises from the unavailability of effective treatment methodologies. The origin of silica-induced pulmonary fibrosis includes essential processes such as macrophage activation and the conversion of fibroblasts into myofibroblasts, with oxidative stress playing a pivotal role. Shionone (SHI), a triterpenoid extracted from the Aster tataricus plant, is recognized for its extensive health benefits. This study explores the capability of SHI to alleviate the effects of silica-induced lung fibrosis in mice.

Methods

This investigation explored the impact of SHI on lung inflammation and fibrosis at different stages (early and late) triggered by silica in mice, focusing specifically on the initial and more developed phases. It comprised an analysis of isolated peritoneal macrophages and fibroblasts extracted from mice to elucidate SHI's therapeutic potential and its underlying mechanism. The methodology employed encompassed quantitative PCR, immunofluorescence, flow cytometry, and western blotting to examine macrophage activity and their transition into myofibroblasts. The activation of the nuclear factor erythroid 2-related factor 2 (Nrf2) pathway by SHI was confirmed via immunofluorescence and western blot studies. SHI's antioxidative properties were evidenced by the measurement of reactive oxygen species (ROS) and mitochondrial ROS within both macrophages and fibroblasts, using 2′, 7′-dichlorodihydrofluorescein diacetate and MitoSOX, respectively. The relevance of SHI was further underscored by applying ML385 and Nrf2 siRNA to gauge its effectiveness.

Results

Starting SHI treatment early countered the harmful effects of lung inflammation and fibrosis caused by silica, while initiating SHI at a later phase decelerated the advancement of fibrosis. SHI's action was linked to the activation of the Nrf2 signaling pathway, a boost in antioxidant enzyme levels, and a decrease in oxidative stress and inflammation in macrophages affected by silica. Furthermore, SHI prevented the conversion of fibroblasts into myofibroblasts prompted by TGF-β, along with the resultant oxidative stress. The beneficial outcomes of SHI were negated when ML385 and Nrf2 siRNA were applied, highlighting the pivotal role of the Nrf2 pathway in SHI's efficacy.

Conclusion

SHI plays a significant role in stimulating the Nrf2 pathway, thereby defending against silica-induced oxidative stress and inflammatory reactions in macrophages, and inhibiting the conversion of fibroblasts to myofibroblasts due to TGF-β. This suggests that SHI is a viable option for treating lung inflammation and fibrosis in mice suffering from silicosis.
Needle fasciotomy versus limited fasciectomy for the treatment of Dupuytren’s contractures of the fingers (Hand-2): study protocol for a randomised controlled trial
Authors: Harrison Samantha , Ogollah Reuben , Hollingworth William , Mills Nicola , Karantana Alexia , Blazeby Jane , Montgomery Alan , Shafayat Aisha , Jarrett Hugh , Davis Tim
Published: June 2024

Background

Dupuytren’s contractures (DC) are fibrous cords under the skin of the hand that cause one or more fingers to curl gradually and irreversibly towards the palm. These contractures are usually painless but can cause a loss of hand function. Two treatments for Dupuytren’s contractures are widely used within the National Health Service (NHS) in the UK: removal of the contractures via surgery (limited fasciectomy) and division of the contractures via a needle inserted through the skin (needle fasciotomy).

This study aims to establish the clinical and cost-effectiveness of needle fasciotomy (NF) versus limited fasciectomy (LF) for the treatment of DC in the NHS, in terms of patient-reported hand function and resource utilisation.

Methods/design

Hand-2 is a national multi-centre, two-arm, parallel-group randomised, non-inferiority trial. Patients will be eligible to join the trial if they are aged 18 years or older, have at least one previously untreated finger with a well-defined Dupuytren’s contracture of 30° or greater that causes functional problems and is suitable for treatment with either LF or NF. Patients with a contracture of the distal interphalangeal joint only are ineligible. Eligible consenting patients will be randomised 1:1 to receive either NF or LF and will be followed up for 24 months post-treatment. A QuinteT Recruitment Intervention will be used to optimise recruitment. The primary outcome measure is the participant-reported assessment of hand function, assessed by the Hand Health Profile of the Patient Evaluation Measure (PEM) questionnaire at 12 months post-treatment. Secondary outcomes include other patient-reported measures, loss of finger movement, and cost-effectiveness, reported over the 24-month post-treatment. Embedded qualitative research will explore patient experiences and acceptability of treatment at 2 years post-surgery.

Discussion

This study will determine whether treatment with needle fasciotomy is non-inferior to limited fasciectomy in terms of patient-reported hand function at 12 months post-treatment.

Trial registration

International Standard Registered Clinical/soCial sTudy ISRCTN12525655. Registered on 18th September 2020.
Hormonal contraceptive use among women living with hypertension in sub-Saharan Africa: insights from 12 countries
Authors: Okyere Joshua , Aboagye Richard Gyan , Ayebeng Castro , Dosoo Abigail Kabukie , Salu Samuel , Dickson Kwamena Sekyi
Published: June 2024

Objectives

Given the well-established link between hormonal contraceptives and hypertension risk, and the paucity of research on hormonal contraceptive use dynamics in this particular demographic, we hypothesize that there is a likelihood of low utilization of high-risk hormonal contraceptives among women living with hypertension in SSA. This study investigates the prevalence and factors associated with hormonal contraceptive use among women living with hypertension in the SSA.

Results

Only 18.5% of women living with hypertension used hormonal contraceptives. Hormonal contraceptive use was high among women with a higher level of education (aOR = 2.33; 95%CI: 1.73–3.14), those currently working (aOR = 1.38; 95%CI: 1.20–1.59), those who have heard about family planning on the radio (aOR = 1.27, 95%CI: 1.09–1.47), listened to the radio at least once a week (aOR = 1.29, 95%CI: 1.10–1.51), and those residing in rural areas (aOR = 1.32; 95%CI: 1.14–1.54). Conversely, women aged 45–49 exhibited a substantial decrease in the odds of hormonal contraceptive use (aOR = 0.23, 95%CI: 0.14–0.38) compared to younger women (15–19 years). Likewise, the odds of HCU were low among cohabiting (aOR = 0.66; 95%CI: 0.48–0.89) and previously married women (aOR = 0.67; 95%CI: 0.50–0.91) than never married women.
Associations of computer gaming with incident dementia, cognitive functions, and brain structure: a prospective cohort study and Mendelian randomization analysis
Authors: Jia Yiming , Shi Mengyao , Yang Pinni , Wang Ruirui , Sun Lulu , Wang Yinan , Xu Qingyun , Zhang Jing , Zhang Qilu , Guo Daoxia , Zheng Xiaowei , Liu Yi , Chang Xinyue , He Yu , Hui Li , Chen Guo-Chong , Zhang Yonghong , Zhu Zhengbao
Published: June 2024

Background

Computer gaming has recently been suggested to be associated with benefits for cognition, but its impact on incident dementia remains uncertain. We aimed to investigate the observational associations of playing computer games with incident dementia, cognitive functions, and brain structural measures, and further explore the genetic associations between computer gaming and dementia.

Methods

We included 471,346 White British participants without dementia at baseline based on the UK Biobank, and followed them until November 2022. We estimated the risk of dementia using Cox proportional hazard models, and assessed the changes of cognitive functions and brain structural measures using logistic regression models and linear regression models. Mendelian randomization (MR) analyses were performed to examine the association between genetically determined computer gaming and dementia.

Results

High frequency of playing computer games was associated with decreased risk of incident dementia (HR, 0.81 [95% CI: 0.69, 0.94]). Individuals with high frequency of playing computer games had better performance in prospective memory (OR, 1.46 [1.26, 1.70]), reaction time (beta, -0.195 [-0.243, -0.147]), fluid intelligence (0.334 [0.286, 0.382]), numeric memory (0.107 [0.047, 0.166]), incorrect pairs matching (-0.253 [-0.302, -0.203]), and high volume of gray matter in hippocampus (0.078 [0.023, 0.134]). Genetically determined high frequency of playing computer games was associated with a low risk of dementia (OR, 0.37 [0.15, 0.91]).

Conclusions

Computer gaming was associated with a decreased risk of dementia, favorable cognitive function, and better brain structure, suggesting that computer gaming could modulate cognitive function and may be a promising target for dementia prevention.
Schistosomal appendicitis: a case report
Authors: Khalifa Mohanad , Elhassan Eman , Abdel Rahim Sawsan
Published: June 2024

Background

Schistosomiasis is one of the endemic parasitic diseases in many developing countries. Despite this, appendicitis secondary to schistosomiasis is an uncommon condition even in some endemic areas. Schistosomal appendicitis, an incidentally discovered appendicitis associated with schistosomiasis histological findings, affects young males predominantly. Timely diagnosis and treatment, including appendectomy and anti-helminthic therapy, are crucial.

Case report

A 24-year-old Sudanese male patient presented with abdominal pain. Diagnosed with acute appendicitis, he underwent appendectomy, revealing appendix inflammation with Schistosoma ova in histopathology. Abdominal ultrasound detected no complications. Weakly positive Schistosoma serology was noted, but stool and urine analysis showed no infection evidence. Prescribed praziquantel, patient had 3-year post-op follow-up without complications.

Conclusions

This case report underscores the significance of including schistosomiasis in the differential diagnosis of appendicitis, particularly in regions where the disease is endemic. It underscores the necessity of histopathological evaluations for accurate diagnosis, emphasizing the potential implications for clinical practice in similar settings.
Sex-specific differences in the mechanisms for enhanced thromboxane A2-mediated vasoconstriction in adult offspring exposed to prenatal hypoxia
Authors: Graton Murilo E. , Spaans Floor , He Rose , Chatterjee Paulami , Kirschenman Raven , Quon Anita , Phillips Tom J. , Case C. Patrick , Davidge Sandra T.
Published: June 2024

Background

Prenatal hypoxia, a common pregnancy complication, leads to impaired cardiovascular outcomes in the adult offspring. It results in impaired vasodilation in coronary and mesenteric arteries of the adult offspring, due to reduced nitric oxide (NO). Thromboxane A2 (TxA2) is a potent vasoconstrictor increased in cardiovascular diseases, but its role in the impact of prenatal hypoxia is unknown. To prevent the risk of cardiovascular disease by prenatal hypoxia, we have tested a maternal treatment using a nanoparticle-encapsulated mitochondrial antioxidant (nMitoQ). We hypothesized that prenatal hypoxia enhances vascular TxA2 responses in the adult offspring, due to decreased NO modulation, and that this might be prevented by maternal nMitoQ treatment.

Methods

Pregnant Sprague–Dawley rats received a single intravenous injection (100 µL) of vehicle (saline) or nMitoQ (125 µmol/L) on gestational day (GD)15 and were exposed to normoxia (21% O2) or hypoxia (11% O2) from GD15 to GD21 (term = 22 days). Coronary and mesenteric arteries were isolated from the 4-month-old female and male offspring, and vasoconstriction responses to U46619 (TxA2 analog) were evaluated using wire myography. In mesenteric arteries, L-NAME (pan-NO synthase (NOS) inhibitor) was used to assess NO modulation. Mesenteric artery endothelial (e)NOS, and TxA2 receptor expression, superoxide, and 3-nitrotyrosine levels were assessed by immunofluorescence.

Results

Prenatal hypoxia resulted in increased U46619 responsiveness in coronary and mesenteric arteries of the female offspring, and to a lesser extent in the male offspring, which was prevented by nMitoQ. In females, there was a reduced impact of L-NAME in mesenteric arteries of the prenatal hypoxia saline-treated females, and reduced 3-nitrotyrosine levels. In males, L-NAME increased U46619 responses in mesenteric artery to a similar extent, but TxA2 receptor expression was increased by prenatal hypoxia. There were no changes in eNOS or superoxide levels.

Conclusions

Prenatal hypoxia increased TxA2 vasoconstrictor capacity in the adult offspring in a sex-specific manner, via reduced NO modulation in females and increased TP expression in males. Maternal placental antioxidant treatment prevented the impact of prenatal hypoxia. These findings increase our understanding of how complicated pregnancies can lead to a sex difference in the programming of cardiovascular disease in the adult offspring.

Graphical Abstract
Gerbode defect resulting from Group B Streptococcus infective endocarditis: a case report
Authors: Hisatomi Kazuki , Miyanaga Tatsuya , Miura Takashi , Eishi Kiyoyuki
Published: June 2024

Background

Gerbode defect is an unusual abnormal communication between the left ventricle and the right atrium and is a serious complication of aortic infective endocarditis. Group B Streptococcus is an uncommon cause of infective endocarditis and has a markedly destructive effect on valvular tissue. Acute fistulation between the left ventricle and the right atrium associated with this form of infective endocarditis is a life-threatening, aggressive complication that often requires urgent surgical intervention. However, the identification of actual communication is often extremely difficult. Herein, we describe an unusual case of Gerbode defect resulting from Group B Streptococcus infective endocarditis and discuss the issues surrounding such a rare cardiac defect and such an infection.

Case presentation

A 60-year-old man with underlying uncontrolled diabetes mellitus underwent endoscopic retrograde biliary drainage for acute cholangitis. On the 10th postoperative day, the patient developed multiple acute cerebral embolisms. Transthoracic echocardiography demonstrated severe aortic regurgitation and a large mobile vegetation near the tricuspid annulus. No obvious fistula between the left ventricle and the right atrium could be demonstrated. The blood culture examination was positive for Group B Streptococcus. The patient was diagnosed with Group B Streptococcus infective endocarditis, and antibiotic therapy was initiated. Transesophageal echocardiogram performed after referral to our hospital confirmed detachment of the right coronary cusp of the aortic valve from the annulus and an abnormal cavity immediately below the right coronary cusp. Color Doppler imaging finally revealed systolic blood flows from the left ventricle into the right atrium through the cavity. Therefore, we diagnosed the patient with Gerbode defect resulting from Group B Streptococcus infective endocarditis. In addition to aortic valve replacement, defect closure and left ventricular outflow tract repair were successfully performed urgently for severely complicated and uncommon infective endocarditis. The patient was uneventfully discharged without any complications.

Conclusions

We reported successful surgical treatment of unusual active IE and Gerbode defect caused by GBS. Careful preoperative echocardiographic work-up is imperative for accurate early diagnosis and successful repair.
Dietary risk factors for colorectal cancer in Uganda: a case-control study
Authors: Wismayer Richard , Kiwanuka Julius , Wabinga Henry , Odida Michael
Published: June 2024

Introduction

Low-income countries in East Africa have a lower incidence of colorectal cancer (CRC) than high-income countries; however, the incidence has steadily increased in the last few decades. In Uganda, the extent to which genetic and environmental factors, particularly dietary factors, contribute to the aetiology of CRC is unclear. Therefore, the objective of our study was to determine the relationship between dietary factors and CRC in Uganda.

Methods

We conducted a case-control study and recruited 128 cases and 256 controls, matched for age (± 5 years) and sex. Data regarding the frequency of consumption of the dietary factors were obtained from all the participants using an interview-based questionnaire. The potential dietary risk factors and protective factors evaluated included the type and frequency of meat consumed and the type and frequency of high-fibre foods consumed. The frequency was either 4 or more times/week, 2–3 times/week, once/week or never. Conditional logistic regression analyses were used to determine the odds ratios associated with the different risk and protective factors.

Results

The median age (IQR) for the case participants was 55.5 (43-67.5) years, and that of the control participants was 54 (42–65) years. The male-to-female ratio was 1:1 for all the participants. Factors significantly associated with CRC cases included:- the consumption of boiled beef 2–3 times/week (aOR:3.24; 95% CI: 1.08–9.69; p < 0.035). Consumption of high-fibre foods, including:- millet for ≥ 4 times/week (aOR: 0.23; 95% CI: 0.09–0.62; p = 0.003)), spinach for ≥ 4 times/week (aOR:0.32; 95% CI: 0.11–0.97; p = 0.043), and potatoes 2–3 times/week (aOR: 0.30; 95% CI: 0.09–0.97; p = 0.044), were protective against CRC. Boiled cassava showed a tendency to reduce the likelihood of CRC when consumed ≥ 4 times/week (aOR:0.38; 95% CI: 0.12–1.18) however this did not reach statistical significance (p = 0.093).

Conclusions

The consumption of boiled beef increases the risk of CRC, while the intake of high-fibre foods may reduce the risk of CRC among Ugandans. We recommend nutritional educational programmes to increase public awareness regarding the protective role of a high-fibre diet and to limit the intake of cooked meat in our Ugandan population.
Knockdown of ATRX enhances radiosensitivity in glioblastoma
Authors: Zhao Yue , Chen Yifei , Liu Ruoyu , Liu Minghang , You Na , Zhao Kai , Zhang Jiashu , Xu Bainan
Published: June 2024

Background

Glioblastoma are highly malignant type of primary brain tumors. Treatment for glioblastoma multiforme (GBM) generally involves surgery combined with chemotherapy and radiotherapy. However, the development of tumoral chemo- and radioresistance induces complexities in clinical practice. Multiple signaling pathways are known to be involved in radiation-induced cell survival. However, the role of alpha-thalassemia X-linked mutant retardation syndrome (ATRX), a chromatin remodeling protein, in GBM radioresistance remains unclear.

Methods

In the present study, the ATRX mutation rate in patients with glioma was obtained from The Cancer Genome Atlas, while its expression analyzed using bioinformatics. Datasets were also obtained from the Gene Expression Omnibus, and ATRX expression levels following irradiation of GBM were determined. The effects of ATRX on radiosensitivity were investigated using a knockdown assays.

Results

The present study demonstrated that the ATRX mutation rate in patients with GBM was significantly lower than that in patients with low-grade glioma, and that patients harboring an ATRX mutation exhibited a prolonged survival, compared with to those harboring the wild-type gene. Single-cell RNA sequencing demonstrated that ATRX counts increased 2 days after irradiation, with ATRX expression levels also increasing in U-251MG radioresistant cells. Moreover, the results of in vitro irradiation assays revealed that ATRX expression was increased in U-251MG cells, while ATRX knockdown was associated with increased levels of radiosensitivity.

Conclusions

High ATRX expression levels in primary GBM may contribute to high levels of radioresistance. Thus ATRX is a potential target for overcoming the radioresistance in GBM.
Physical activity information-seeking behaviour and barriers in a sample of university undergraduate emerging adults: a cross-sectional survey
Authors: Idowu Opeyemi A. , Omoijahe Benedicta , Fawole Henrietta O. , Adeagbo Inioluwa , Akinola Bolarinwa I.
Published: June 2024

Background

Access to physical activity information provides opportunities for enduring and relevant messaging regarding physical activity. This may be a potential vehicle to optimise physical activity participation among emerging adults. This study aimed to characterise the physical activity information-seeking behaviour in a sample of university undergraduate emerging adults.

Methods

Five hundred and seventy-five undergraduate students (age = 21.7 ± 1.9 years) participated in the study. Respondents’ physical activity information-seeking behaviour was obtained using an adapted instrument, while physical activity and barriers were assessed using the International Physical Activity Questionnaire and the Exercise Benefits and Barrier Scale.

Results

Three hundred and fifty-one respondents (61%) of respondents sought physical activity information. The majority of these individuals (73.8%) sought physical activity information using social media. After identifying and controlling for confounders including engaging in physical activity programmes and faculty of study, having low physical activity levels was associated with a < 1 likelihood of seeking physical activity information compared to having high physical activity levels (odds ratio = 0.5, 95% confidence interval 0.27–0.87; p = 0.015). However, there was no association between barriers to physical activity and physical activity information-seeking behaviour (odds ratio = 1.17, 95% confidence interval 0.81–1.69; p = 0.40).

Conclusion

Undergraduate emerging adults seek physical activity information using social media to enhance their physical appearance and health.
Impact of frailty on patients hospitalized with myelodysplastic syndrome: A nationwide analysis.
Authors: Del Castillo Olivia , Javaid Saad , Frasier Kelly , Li Vivian , Vinagolu-Baur Julia , Rodriguez Evadne , Ortega Yaguachi Nataly , Batista Raquel , Jonas Kenlee , Palma Laura
Published: June 2024

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Background: Myelodysplastic Syndrome (MDS) is a complex group of neoplasms that arises from abnormalities in the bone marrow's hematopoietic stem cells, leading to ineffective blood cell production. Frailty signifies increased vulnerability to internal and external stressors, with its impact on survival in MDS gaining recognition. We conducted a retrospective analysis to explore the impact of frailty on hospitalized MDS patients and its association with unfavorable hospital outcomes. Methods: National Inpatient Sample (NIS) 2019 and 2020 was utilized to identify the patients admitted with a primary diagnosis of MDS and had a concurrent diagnosis of Frailty. The Primary outcome was Mortality, and secondary outcomes included length of stay, total cost of hospitalization, and other adverse in-hospital outcomes. Multivariate logistic regression analysis was used to calculate the outcomes after adjusting for baseline sociodemographic characteristics. Results: A total of 17,000 patients were admitted with a primary diagnosis of MDS, among whom 4,285 (25.20%) patients had a concurrent diagnosis of Frailty. The mean age of patients with and without Frailty was 75.75 (+/-14.01) and 71.54 (+/-14.68), respectively, p<0.001. After adjusting for confounding variables, Frailty was considered an independent predictor of mortality in MDS patients (OR=1.80 (1.22-2.64); p=0.003). Patients with Frailty had a prolonged length of stay in the hospital (8.62 days(3.2-9.6) without and 11.56 days (4.6-12.1) with Frailty, P<0.001), as well as an increased total cost of hospitalization ($ 132159 (3256-23651) without and $173898 (5317-389146) with Frailty, p<0.001). Additionally, Frailty was associated with an increased likelihood of sepsis (OR=2.02 (1.33-3.06); p=0.001), acute kidney injury (OR=1.22 (1.02-1.50); p=0.04), major depressive disorder (OR=1.51 (1.19-1.91); p=0.001), and a higher association with chemotherapy (OR=3.46 (1.21-9.91); p=0.021) and palliative care (OR=2.23 (1.72-2.90); p<0.001). However, frail patients were less likely to receive blood transfusions (OR=0.73 (0.61-0.88); p=0.001), and no difference was noted in the risk of platelet transfusions (OR=0.95 (0.73-1.25); p=0.763). Conclusions: Frailty is considered an independent predictor of mortality and is associated with increased healthcare resource utilization along with other adverse in-hospital outcomes. Careful and thorough identification of frailty and its effective management is crucial for improving outcomes, reducing mortality, and enhancing the quality of life for patients with debilitating MDS. [Table: see text]
Disparities in the prevalence of acute pulmonary embolism in patients with ovarian cancer: A nationwide analysis.
Authors: Rodriguez Evadne , Javaid Saad , Frasier Kelly , Li Vivian , Vinagolu-Baur Julia , Ortega Yaguachi Nataly , Del Castillo Olivia , Batista Raquel , Jonas Kenlee , Palma Laura
Published: June 2024

e17560

Background: Ovarian cancer is the leading cause of death among gynecological cancers. It is highly thrombogenic and is associated with increased venous thromboembolism events. We conducted a retrospective analysis to study the prevalence and disparities in the association of Acute Pulmonary embolism(PE) with ovarian cancer. Methods: National Inpatient Sample (2017-2020) was used to identify the patients with primary diagnosis of Acute PE and was stratified into those with and without concurrent diagnosis of Ovarian cancer ( regional and advanced metastatic disease). Basic demographic variables were analyzed to identify disparities in the prevalence of Acute PE among ovarian cancer patients.Multivariate logistic regression analysis was conducted to examine the association between Acute PE and Ovarian cancer. Results: A total of 651435 patients were hospitalized with a primary diagnosis of Acute PE, and 2980 (0.46%) had a secondary diagnosis of Ovarian cancer. The ovarian cancer group had a greater percentage of white (73.4% vs.71.93%), Hispanics (7.98% vs. 6.04%), and fewer Black patients (15.78% vs. 19.86), p=0.021. Compared to the white, Black population with ovarian cancer (OR=0.77(0.6-0.9); p=0.04) had a decreased likelihood of developing Acute PE without any difference noted in the Hispanics (OR=1.13 (0.81-1.58); p=0.44) and other races (OR=1.11 (0.67-1.83); p=0.67). Patients in the high income groups were more likely to be admitted due to acute PE ($65,000-$85,999: OR=1.35 (1.05-1.73), p=0.018; >$86,000: OR=1.24 (1.14-1.62), p=0.01). A greater percentage of patients with ovarian cancer had private insurance (35.2% vs. 28.91%), while a greater percentage of patients without ovarian cancer had Medicare (54.38% vs. 50.34%) and Medicaid (11.9% vs. 12.5%), p=0.003. Patients with private insurance were more likely to be admitted due to acute PE (OR=1.73(1.36-2.22); p<0.001). Patients with a Charlson comorbidity index of 3 or more had higher odds of Acute PE (OR=1.3(1.12-3.4); p=0.02). A greater percentage of Acute PE patients with ovarian cancer were admitted to large (54.03% vs. 47.86%; p=0.014), urban (95.3% vs. 90.35%; p<0.001), and teaching hospitals (79.87% vs. 69.15%; p<0.001). Teaching hospitals had higher odds of admissions due to acute PE in ovarian cancer patients (OR=1.37(1.07-1.75); p=0.01). On multivariate regression analysis, Ovarian cancer patients had higher odds of Acute PE (OR=1.88 (1.73-2.05); p<0.001). Conclusions: Ovarian cancer patients with Black race and private insurance showed a significantly increased likelihood of admissions due to acute pulmonary embolism. Additionally, urban and teaching hospitals demonstrated higher odds of encountering cases of acute pulmonary embolism. Further prospective studies are necessary to validate the findings presented in our study.
The spectrum consistency of fractional quantum Hall effect model
Authors: Del Cima O. M. , Lima L. S. , Miranda E. S.
Published: June 2024

The spectrum consistency of the three-fermion family

quantum electrodynamics in three space-time dimensions is analyzed. It has been verified that the originally proposed action violates the unitarity consistency condition in the gauge field sector by exhibiting negative norm states in the spectrum. However, the cure came through the fundamental gauge fields properly settled, consequently, the action rewritten in terms of those fundamental fields shows to be free from any spurious degrees of freedom, and the model now becomes safe for further quantization.
Novel complexiton solutions to the new extended (3+1)-dimensional Boiti-Leon-Manna-Pempinelli equation for incompressible fluid
Authors: Wang Kang-Jia , Li Shuai
Published: June 2024

This letter focuses on exploring some novel exact solutions to the new extended (3+1)-dimensional Boiti-Leon-Manna-Pempinelli equation (BLMPE) that has a major role in incompressible fluid. Adopting the Cole-Hopf transformation, the bilinear form of the considered equation is successfully constructed. Then the singular complexiton solutions (SCSs) are developed by applying the ansatz function method with a novel functional form. Additionally, we also find the non-singular complexiton solutions (NCSs) via imposing the restrictive conditions. To unveil the behaviors of the attained solutions better, the corresponding outlines are plotted via Maple.
Learning performance and GABAergic pathway link to deformed wing virus in the mushroom bodies of naturally infected honey bees
Authors: Szymański Szymon , Baracchi David , Dingle Lauren , Bowman Alan S. , Manfredini Fabio
Published: June 2024

Viral infections can be detrimental to the foraging ability of the western honey bee, Apis mellifera. The deformed wing virus (DWV) is the most common honey bee virus and has been proposed as a possible cause of learning and memory impairment. However, evidence for this phenomenon so far has come from artificially infected bees, while less is known about the implications of natural infections with the virus. Using the proboscis extension reflex (PER), we uncovered no significant association between a simple associative learning task and natural DWV load. However, when assessed through a reversal associative learning assay, bees with higher DWV load performed better in the reversal learning phase. DWV is able to replicate in the honey bee mushroom bodies, where the GABAergic signalling pathway has an antagonistic effect on associative learning but is crucial for reversal learning. Hence, we assessed the pattern of expression of several GABA-related genes in bees with different learning responses. Intriguingly, mushroom body expression of selected genes was positively correlated with DWV load, but only for bees with good reversal learning performance. We hypothesise that DWV might improve olfactory learning performance by enhancing the GABAergic inhibition of responses to unrewarded stimuli, which is consistent with the behavioural patterns that we observed. However, at higher disease burdens, which might be induced by an artificial infection or by a severe, natural Varroa infestation, this DWV-associated increase in GABA signalling could impair associative learning as previously reported by other studies.
Διαχείριση κρίσεων και κινδύνων σε οργανισμούς
Authors: Μαντάς Νικόλαος
Published: June 2024

Η εργασία αυτή αποτελεί συμβολή στην ανάλυση κινδύνου στις σχολικές μονάδες πρωτοβάθμιας και δευτεροβάθμιας εκπαίδευσης στην Ελλάδα υπό το πρίσμα της πανδημίας Covid-19 και της συνεπακόλουθης ψηφιακής στροφής της εκπαίδευσης. Παρουσιάζεται αρχικά η Ανάλυση Κινδύνου ως επιστημονικό πεδίο έρευνας και συζητείται διεξοδικά η σύνδεσή της με την μείωση των επιδόσεων των μαθητών και τις αρνητικές επιδράσεις στην ευεξία τους λόγω της τελευταίας πανδημίας. Στη συνέχεια αναλύονται οι κίνδυνοι που προέκυψαν από την ψηφιακή στροφή στην εκπαίδευση λόγω της πανδημίας, με έμφαση στο λεγόμενο «ψηφιακό χάσμα». Με βάση το προαναφερθέν θεωρητικό πλαίσιο, διενεργήθηκε δημοσκοπική έρευνα σε 1010 εκπαιδευτικούς δημόσιων ελληνικών σχολείων πρωτοβάθμιας και δευτεροβάθμιας εκπαίδευσης. Το φαινόμενο της ψηφιακής φτώχειας εμφανίστηκε και στην Ελλάδα, ενώ εκτιμήθηκε ότι η οργανωτική υποστήριξη και η συνεργασία της διοίκησης και των εκπαιδευτικών δεν ήταν πολύ καλή. Οι ελλείψεις σε αναγκαίο εξοπλισμό για εξ αποστάσεως εκπαίδευση, καθώς και η ελλιπής επιμόρφωση των εκπαιδευτικών είναι στοιχεία που ενέτειναν το πρόβλημα. Προτείνεται η αγορά τεχνολογικού εξοπλισμού, η αύξηση της επαφής των μαθητών με τις νέες τεχνολογίες στο σχολείο και η υλοποίηση προγραμμάτων επιμόρφωσης των εκπαιδευτικών και εκπαιδευτών για τη χρήση ψηφιακών εκπαιδευτικών εργαλείων.
Satisfaction of patients treated in a Physical Medicine and Rehabilitation department during the Covid-19 pandemic: a cross-sectional study
Authors: Hamadou Leila , Moncer Rihab , Ghammam Rim , Ouanes Walid , Jemni Sonia
Published: June 2024

Background Patients treated in Physical Medicine and Rehabilitation (PM&R) departments benefit from global and multidisciplinary long-term care. The study of satisfaction represents an important element in the evaluation of the quality of the healthcare provided. The aim of this study is to assess the level of satisfaction of patients treated in the PM&R department of Sahloul university hospital of Sousse Tunisia as well as the associated factors during the year 2020. Methods We conducted a cross-sectional study, including patients treated in the hospitalization and the outpatient units of the PM&R department. Monnin and Perneger scale validated in Arabic was used to measure satisfaction in its different dimensions. Medical data were completed from patients’ records. Results A total of 240 patients were included in our study. The level of satisfaction was significantly higher with the admission procedures for inpatients compared to outpatients (87.9% vs. 60.0%, p<0.001). Regarding the global assessment, 82.1% of patients were satisfied. Multivariate analysis showed that for administrative procedures, consultation for outpatients was a factor of dissatisfaction (aOR=0.18, p<0.001). Patients’ physiotherapy treatment during the Covid-19 period was negatively associated with satisfaction for logistics (aOR= 0.44, p=0.011) and for the global assessment of health care provided in our department (aOR= 0.46, p=0.04). Conclusion Our study showed overall good levels of satisfaction in the department of PM&R of Sahloul. However, more studies should follow to determine other factors that can influence satisfaction.