bluuebunny/crossref_metadata_2025 huggingface dataset:
Pattern of antibiotic resistance in surgical site infections in a tertiary care hospital of Nepal
Authors: Dahal Krishna , Rawal Laba , Shah Sangam , Pokharel Shristy , Dahal Mahesh , Shrestha Sahira , Mishra Shyam K. , Maharjan Sujina , Baidya Sujata
Published: February 2024

Background:

Surgical site infection (SSI) is the second most common hospital-acquired infection. The identification of bacterial pathogens and their antibiotic susceptibility pattern is required for the successful treatment of SSI and curb antimicrobial resistance, which is a major threat globally. This study aimed to assess the microbial profile of the organisms causing SSI and their antibiogram in a tertiary care hospital.

Methods:

This cross-sectional study was conducted at Microbiology Laboratory of tertiary care hospital, from March 2023 to August 2023. Swab or aspirate specimens were collected aseptically from the surgical site and processed for bacterial isolation following standard bacteriological techniques. Gram’s staining and biochemical tests were performed to identify the organisms at the species level. Antimicrobial susceptibility tests were done following Kirby–Bauer’s disc diffusion method. Statistical analysis was performed using SPSS software version16.0.

Results:

Out of 405 samples, 92 (22.7%) yielded bacterial growth. Eighty-three culture positive cases (90.2%) were monomicrobial while nine (15.7%) had mixed growth of at least two different bacteria. Out of 108 isolates, 43 (39.8%) were gram-positive and 65 (60.2%) were gram-negative bacteria. Escherichia coli (39.8%) was the most commonly isolated organism. All gram-negative isolates were resistant to ceftriaxone followed by amoxicillin-clavulanic acid (94.0%), amoxicillin (94.0%), cefixime (90.7%), and cefepime (89.8%). Similarly, none of the gram-positive isolates were susceptible to ampicillin, amoxicillin, and ampicillin/sulbactam. The most effective drugs against E. coli were imipenem (100%), followed by tigecycline (96%), meropenem (95.1%), chloramphenicol (84%), amikacin (81.5%), and gentamicin (81.5%). Overall prevalence of MDR was 59.3%.

Conclusion:

Our study demonstrates increased resistance of both gram-positive and gram-negative organisms to commonly used drugs like cephalosporins and even quinolones. Continued surveillance of antimicrobial susceptibility results at local level, dissemination of data, and prescribing the antibiotics accordingly based on culture and sensitivity results are necessary to ameliorate antimicrobial resistance.
Spontaneous heterotopic pregnancy resulting in tubal rupture and complete spontaneous abortion: a case report in Tiko, Cameroon
Authors: Takoutsing Berjo D. , Endalle Geneviève , Sow Aissatou , Nyoh Derek O. , Fontem Vera A.
Published: February 2024

Introduction and importance:

A heterotopic pregnancy (HP) following spontaneous conception is a rare and potentially life-threatening condition. Its diagnosis can be overlooked, hence remaining one of the challenging gyneco-obstetrical emergencies, especially in the low-resource setting.

Case presentation:

A 24-year-old G2P0010 at 11 weeks of gestation with a history of one induced abortion and a family history of twin pregnancies presented with an acute abdomen, associated with vaginal spotting in an afebrile context. An abdominopelvic ultrasound showed retained products of conception, and the presence of a left adnexal mass suggestive of an extrauterine gestational sac at ~6 weeks of gestation. There was spontaneous expulsion of retained products of conception. The deterioration of the hemodynamic stability of the patient prompted an emergency laparotomy to be done. The patient was transfused, postsalpingectomy counseling done and was discharged on oral analgesics, blood tonics, and antibiotics on day 6 postoperation.

Clinical discussion:

HP following spontaneous conception is a rare and potentially life-threatening condition. This case reports on the management of spontaneous HP resulting in a ruptured ectopic pregnancy (EP) and a complete spontaneous abortion managed in a low-resource setting. This case emphasizes the importance of a systematic ultrasound to be done for all patients with a clinically confirmed abortion to rule out an associated EP.

Conclusion:

A spontaneous abortion without signs of peritoneal irritation can be associated with an EP. Ultrasound can help in the early diagnosis, and laparotomy can be life-saving.
Association Between Idiopathic Thrombocytopenic Purpura and Hemorrhagic and Nonhemorrhagic Stroke
Authors: Guntu Rachna , Patel Aamir , Movahed Mohammad Reza , Hashemzadeh Mehrtash , Hashemzadeh Mehrnoosh
Published: February 2024

Background:

Idiopathic thrombocytopenic purpura (ITP) is characterized by a low platelet count. This may lead to an increased risk of hemorrhagic stroke but a lower rate of nonhemorrhagic stroke. The goal of this study was to evaluate the association between ITP and both hemorrhagic and nonhemorrhagic strokes using a large database.

Methods:

We used the Nationwide Inpatient Sample (NIS) database to analyze the occurrence of hemorrhagic and nonhemorrhagic stroke in patients with and without a diagnosis of ITP from 2005 to 2014.

Results:

Univariate analysis revealed a higher incidence of hemorrhagic stroke in patients with ITP in the year studied. (for example, in 2005: OR, 1.75; 95% CI, 1.57–1.94; P < 0.001; 2014: OR, 2.19; 95% CI, 2.03–2.36; P < 0.001). After adjusting for age, gender, race, and hypertension, hemorrhagic stroke remained significantly associated with ITP (in 2005: OR, 1.85; 95% CI, 1.49–1.89; P < 0.001; 2014: OR, 2.01; 95% CI, 1.86–2.18; P < 0.001) for all the years studied. Nonhemorrhagic stroke occurred at a lower rate in patients with ITP in most years (2006: OR, 0.91; 95% CI, 0.85–0.97; P = 0.004; 2014: OR, 0.88; 95% CI, 0.83–0.93; P < 0.001). Multivariate analysis confirmed a higher rate of nonhemorrhagic stroke in ITP patients.

Conclusion:

Our analysis showed that there was a higher rate of hemorrhagic stroke but a lower rate of ischemic stroke in ITP patients, suggesting an important role of platelets in the occurrence of stroke.
Impact of Therapeutic Education on the Management of High Blood Pressure: A Quasi-experimental Survey From Southern Tunisia
Authors: Baklouti Mouna , Mejdoub Yosra , Tombohindy Maurisse Guamilah , Ketata Nouha , Jdidi Jihen , Triki Faten , Yaich Sourour , Abid Leila
Published: February 2024

Introduction:

The prevalence of arterial hypertension (HTA) was continuously increased with a low percentage of pressure control blood pressure among treated patients. Therapeutic education (TE) was one of the inventive methods in the management of high blood pressure (HBP) worldwide. The objective was to assess the impact of TE on the control and management of HBP.

Methods:

This was a quasi-experimental study consisting of an intervention, a pretest, and a post-test evaluation. This study was conducted in the external consultation service of cardiology CHU HEDI CHAKER of Sfax during over a period of 4 months (November 2021–March 2022).

Results:

In total, 35 of the patients (50%) were women with a sex ratio of 1. The mean age was 63.33 ± 8.91 years. We noted a statistically significant decrease on both systolic and diastolic blood pressure blood pressure values after TE among educated patients (135.3 ± 9.77 vs. 141.9 ± 10.9; P = 0.010) and (75 [70–80] vs. 80 [75–80]; P = 0.002), respectively. We found a significantly good knowledge about HBP definition (Odds ratio [OR] = 3.4; P = 0.022), HBP symptoms (OR = 9.1; P < 0.001), and HBP complications (OR = 12.3; P < 0.001) among educated patients. A significant association was noted between educated patients and low daily salt consumption after TE (OR = 2.7; P = 0.048). Powered by Editorial Manager and ProduXion Manager from Aries Systems Corporation Educated patients had significantly more adequate auto-control devise use (OR = 1.01; P = 0.028). Moreover, the respect of therapeutic compliance was statistically more important among educated patients (OR = 3.7; P = 0.028).

Conclusions:

Our results showed that the TE training session is an operative intervention to improve HBP management. Thus, integrating TE therapy in daily care should be continuous and should be exhaustive to all cardiovascular and all chronic diseases.
The Benefit of an Extensive Cancer Screening Strategy After the First Episode of Unprovoked Pulmonary Embolism
Authors: Bouchlarhem Amine , Lahmidi Ismahane , Bazid Zakaria , Ismaili Nabila , El Ouafi Noha
Published: February 2024

Introduction:

The etiological assessment after an acute unprovoked pulmonary embolism (PE) represents an essential step in the overall management of the patient, with the aim of adapting the duration and type of anticoagulant to be used, avoiding recurrence and thus improving overall morbidity and mortality, but this is not such a simple question to answer.

Purpose:

The main objective of this work is to know the benefit of a limited etiology strategy versus an extensive strategy after a first episode of acute non-provoked PE, first on all-cause mortality, and then the superiority of one strategy over another on the diagnosis of cancer at 1 year in patients admitted to a cardiac intensive care unit.

Methods:

This is a single-center, retrospective study from 2014 to 2021, which includes all patients, admitted to a cardiac intensive care unit for a first episode, at high or high intermediate risk of mortality at day 30. The included patients were divided into 2 groups: those who received a limited cancer screening strategy, and those who received, in addition to the latter, an injected cerebral and cervical-thoracic-abdominal scan, and the determination of tumor markers. All data were extracted from the medical hospital files.

Results:

In total, we included 130 patients. The mean age of our patients was 87.19 (SD = 6.1), with a female predominance with a percentage of 55.4%. Eighty-seven patients benefited from an extensive cancer screening strategy, versus 43 patients who benefited from a limited strategy. First, for mortality at 1 year, 27 deaths were found between the 2 groups but without significant difference (hazard ratio; 0.53; P = 0.16), and for the mean duration from embolic episode to death, there was a mean of 20 weeks for the limited strategy group and 24 weeks for the extensive strategy group, with a nonsignificant difference (P = 0.106). For the diagnosis of cancer at 1 year, 28 patients were diagnosed with cancer: 13 patients in the limited strategy group versus 15 in the extensive strategy group, with no significant difference (hazard ratio, 1.983; P = 0.082). The mean time to diagnosis was 22 weeks in the limited strategy group and 20 weeks in the extensive strategy, with no significant difference (P = 0.729).

Conclusion:

To date, no scientific evidence has been established for the extensive versus the limited strategy, therefore, a minimal etiological workup is also effective in the detection of cancer after unprovoked PE.
Routine Abdominal Aortic Examination During Echocardiographic Studies Detects Significant Numbers of Abdominal Aortic Aneurysm and Should be a Part of Routine Echocardiographic Examinations
Authors: Movahed Mohammad Reza , Soltani Moghaddam Arman , Dodge Melisa
Published: February 2024

Background:

Early detection and follow-up of abdominal aortic aneurysm (AAA) are important and can be lifesaving. The goal of this study was to evaluate if routine abdominal aorta screenings during echocardiograms can be helpful in detecting asymptomatic abdominal aortic aneurysm.

Methods:

We retrospective studied consecutive patients who were sent for outpatient routine echocardiograms for various clinical reasons in 2015–2017 until we reached a total of 1000 patients. Starting from the subcostal and then proceeding to the abdomen, a long-axis screening of the abdominal aorta was attempted on all of the patients after the echocardiogram was completed. No patient preparation was given. Imaging began from the subcostal view and proceeded caudally with images obtained every 1–2 cm. Measurement of the aortic diameter was performed from the longitudinal plane using the leading-edge-to-leading-edge method.

Results:

The age range was 33–96 years with a median age of 72.4. A total of 273 (27.3%) patients did not have an appropriate window to evaluate AAA. Among the remaining 727 screenings, 18 (2.4%) had dilatation of abdominal aorta or AAA. The dilatation and aneurysms ranged between 2.5 and 4.5 cm in size. Abnormal aortic diameters were as follows: 5 (27.7%) were between 2.5 and 2.9 cm, 6 (33.3%) between 3 and 3.4 cm, 1 (5.5%) between 3.5 and 3.9, 5 (27.7%) between 4.0 and 4.4 cm, and 1 (5.5%) between 4.5 and 4.9 cm.

Conclusions:

Performing routine abdominal aortic examinations during routine echocardiographic exams can detect a significant amount of abdominal aortic aneurysm which can be lifesaving. We suggest adding abdominal aortic assessment to routine echocardiographic examination.
Prevalence and association of early onset severe hyperbilirubinemia in newborn in the East China region: Retrospective medical record analyses
Authors: Gao Ke , Zhao Wu , Chen Lijun , Zeng Ke , Wang Jichao , Yu Xiping , Li Zhifei
Published: February 2024

Research on the prevalence and association of hyperbilirubinemia is controversial because of different cultures, demographics, and clinical conditions. The etiology of hyperbilirubinemia is affected by the environment and other factors in the newborn. The World Health Organization recommended a 1-day hospital stay after uncomplicated delivery, jaundice assessment before discharge, and screening on 3rd and 7th days after birth for hyperbilirubinemia. However, the implementation of these recommendations is difficult in China. The objective of this study was to evaluate the prevalence and association of early onset severe hyperbilirubinemia in newborns in East China. Retrospective medical record analyses for 250 cesarean sections or vaginal deliveries, ≥2 kg body weight, and negative for Hepatitis B surface antigen by birth newborns were performed. A biochemical analyzer, quantitative assay, and quantitative polymerase chain reaction were used to evaluate total serum bilirubin, glucose-6-phosphate dehydrogenase (G6PD) deficiency, and gene variant phenotyping, respectively. A total in 33 (13%) newborns were reported with early onset severe hyperbilirubinemia (according to the American Academy of Pediatrics, total serum bilirubin ≥ 342 μmol/L within 6 hours of birth). All newborns with severe hyperbilirubinemia were hospitalized and underwent phototherapy. The mothers of all newborns had a gestational age ≥ 35 weeks. Hospitalization included artificial feeding, and breastfeeding was rare (P < .0001). ABO incompatibility (“O” blood type for mother and either “A” or “AB” or “B” blood type for newborn, P = .0411), G6PD deficiency (G6PD/6-phosphogluconate dehydrogenase ≤ 1.0 in quantitative assay, P = .0422), Rh incompatibility (the mother’s blood type was Rh negative and newborn blood type was Rh positive, P = .0416), fewer genotype rs4149056 frequencies (P = .0452), higher genotype rs2306283 frequencies (P = .0461), and higher genotype rs1805173 frequencies (P = .0471) were independent parameter for early onset severe hyperbilirubinemia of newborns. The prevalence of early onset severe hyperbilirubinemia in Chinese newborns is 13% in the East China region. Blood incompatibility, G6PD deficiency, fewer genotype rs4149056 frequencies, higher genotype rs2306283 frequencies, and higher genotype rs1805173 frequencies were independent predictors of early onset severe hyperbilirubinemia among newborns in the East China region (Level of Evidence: IV; Technical Efficacy: Stage 5).
Sanji Peiyuan decoction combined with dydrogesterone in the treatment of massive subchorionic hematoma: A case report
Authors: Yang Yi , Zheng Huiling , Ye Huijun , Lin Yunxia , Liu Jiali , Li Ruilan , Jin Lihua
Published: February 2024

Rationale:

Subchorionic Hematoma, often referred to as Bruce hematoma, can lead to serious obstetric complications such as intrauterine growth restriction and fetal death, as well as early and late pregnancy miscarriage, placental abruption, and premature rupture of membranes, posing great harm to both mother and fetus.

Patient concerns:

At present, Western medical treatments have not shown satisfactory results, necessitating the discovery of more effective clinical treatment methods.

Diagnoses:

Threatened miscarriage, Subchorionic hematoma, Iron deficiency anemia (mild).

Interventions:

Sanji Peiyuan decoction combined with dydrogesterone.

Outcomes:

Following 17 days of treatment with Sanji Peiyuan decoction and oral dydrogesterone tablets, the hematoma was no longer detectable by ultrasound. The patient experienced no symptoms such as abdominal pain, bloating, or vaginal bleeding. She successfully gave birth around her due date, with both the mother and child in good health.

Lessons:

The combination of Sanji Peiyuan decoction and oral dydrogesterone tablets shows promising clinical efficacy in treating Massive Subchorionic Hematomas. This method merits further clinical research.
Spontaneous mutation in the COL6A2 gene causing Ullrich congenital muscular dystrophy type 1 in a Chinese child: A case report
Authors: Li Jiayi , Lin Shuangzhu , Wu Qiong , Feng Jinhua , Chen Qiandui , Jiang Kai
Published: February 2024

Rationale:

Mutations in the gene encoding type VI collagen cause Bethlem myopathy (MIM 158810) and Ullrich congenital muscular dystrophy (MIM 254090); 2 diseases previously recognized as completely independent, and have been increasingly recognized. However, collagen-related myopathy caused by intron variation in the COL6 gene is rarely reported in China. Ullrich congenital muscular dystrophy is an autosomal recessive disorder that leads to severe muscle weakness with early onset. Thus, children may never walk independently, with proximal joint contractures and significant hyperelastic distal joints, and have early respiratory failure. Therefore, timely diagnosis and treatment are important. We report a spontaneous mutation in the COL6A2 gene causing Ullrich congenital muscular dystrophy type 1 in a pediatric patient.

Patient concerns:

A boy aged 4 years was unable to walk independently, could sit alone for a short time, and his motor development was delayed and had regressed after 1 year of age. He had a high palatal arch and a through palm with localized transverse lines running laterally from the palm. Electromyography showed an impaired neurogenic source, and whole-exon gene sequencing revealed a spontaneous heterozygous mutation in the COL6A2 gene (c.955-2A>G), which was determined to be a pathogenic mutation according to the American Guidelines of the College of Medical Genetics.

Diagnoses:

This child has a delayed motor development, high osprey arch and a through palm with localized transverse lines running laterally from the palm, and regression of motor development after the age of 1 year. Whole exon examination showed spontaneous mutation of the COL6A2 gene; thus, the child was diagnosed with UCMD type 1.

Interventions:

At present, there is no special treatment for this disease, and treatment is mainly symptomatic and supportive. The child underwent home massage, rehabilitation training, oral folic acid tablets, vitamins and coenzyme Q10.

Outcomes:

During the subsequent follow-up period, the patient can now sit alone for a short period of time.

Lessons:

We report a case of spontaneous mutation in the COL6A2 gene causing Ullrich congenital muscular dystrophy type 1 in a pediatric patient, expanding the phenotypic spectrum of the disease and enriching the human gene pool.
Diagnosis and treatment of right ventricular metastasis from esophageal squamous cell carcinoma: An unusual case report and a literature review
Authors: Luo Lingyun , Luo Xuelian
Published: February 2024

Background:

Right ventricular metastasis from esophageal squamous cell carcinoma is very rare and only seen in few case reports. Patients with cardiac metastasis have a poor prognosis with a median survival period of 4 weeks due to the lack of standardized and effective treatment guidelines. Therefore, we aimed to clarify the feature and treatment of cardiac metastasis through literature review and reporting of an unusual case.

Case:

We reported a case of a 67 years-old man diagnosed as right ventricular metastasis from esophageal squamous cell with the help of echocardiography and pathological biopsy. Moreover, the patient survival period reached an astonishing 6 months, which far exceeded 4 weeks reported in previous literature.

Methods:

We searched for relevant literature in the past decade on PUBMED and summarized the content of the literature to better clarify cardiac metastasis.

Conclusion:

Cardiac metastatic likely to occur in the elderly and in the right side of heart which related to hemodynamics. Surgical resection of metastatic tumors is the main treatment method, but patients usually die during the perioperative period due to its complexity and difficulty. Meanwhile, we have proposed some potentially effective treatment measures.
Socioeconomic status, obesity, individual behaviors, diabetes, and risk for frozen shoulder: A Mendelian randomization study
Authors: Yang Wenwen , Yang Yanjiang , Han Biao
Published: February 2024

There are few studies on risk factors for frozen shoulder, and even fewer Mendelian randomization (MR) studies on frozen shoulder. Therefore, we conducted a two-sample MR study to explore whether socioeconomic status (years of schooling, average total household income before tax), obesity (body mass index and waist circumference), individual behaviors (smoking initiation, alcohol intake frequency, coffee intake, nonoily fish intake, tea intake, beef intake, bread intake, cheese intake, oily fish intake, and fresh fruit intake), and diabetes (type 1 and type 2 diabetes) are associated with frozen shoulder. The exposure datasets and the outcome dataset were extracted from the MRC Integrative Epidemiology Unit at the University of Bristol Open genome-wide association studies project (https://gwas.mrcieu.ac.uk/). We conducted MR analyses using the inverse variance weighted (primary method), MR-Egger, and weighted median methods and conducted heterogeneity and pleiotropy analyses. Type 1 diabetes (OR: 1.103; 95% CI: 1.053–1.156; P = .0000410) was associated with an increased risk of frozen shoulder. Cheese intake (OR: 0.490; 95% CI: 0.267–0.899; P = .0213), non-oily fish intake (OR: 0.0993; 95% CI: 0.0220–0.448; P = .00267), years of schooling (OR: 0.453; 95% CI: 0.349–0.588; P = .00000000277), and average total household income before tax (OR: 0.434; 95% CI: 0.253–0.743; P = .00236) were discovered as protective factors. No horizontal pleiotropy was found in all analyzes we performed (P > .05). Our study indicated that type 1 diabetes was a risk factor for frozen shoulder while cheese intake, non-oily fish intake, years of schooling, and average total household income before tax were considered as protective factors for frozen shoulder.
Research progress of intra-aortic balloon counterpulsation in the treatment of acute myocardial infarction with cardiogenic shock: A review
Authors: Li Mengxian , Hu Liqun , Li Lei
Published: February 2024

The mortality rate of patients with acute myocardial infarction complicated with cardiogenic shock is very high, and in recent years, intra-aortic balloon counterpulsation has been used more and more. It plays a very important role in improving left ventricular ejection, increasing coronary artery perfusion pressure and reducing myocardial oxygen consumption. This article reviews the development of intra-aortic balloon counterpulsation in the treatment of acute myocardial infarction with cardiogenic shock in recent years.
Pretreatment controlling nutritional status (CONUT) score and carcinoembryonic antigen level provide tumor progression and prognostic information in gastric cancer: A retrospective study
Authors: Chen Xiuqing , Chen Chen , Huang Linjing , Wu Peiwen
Published: February 2024

This study explores the role of combining the controlling nutritional status (CONUT) score and the carcinoembryonic antigen (CEA) level on predicting tumor stage and prognosis in gastric cancer (GC) patients. A total of 682 GC patients were included in this retrospective study. CONUT scores and CEA levels were combined to establish a new scoring system: CONUT-CEA score. cutoff values for distinguishing patients between stage IV and non-stage IV were established by receiver operating characteristic curves. cutoff values for predicting prognosis were determined by maximum χ2 method. The CONUT and CEA cutoff values for discriminating stage IV patients from non-stage IV patients were 2.0 and 5.58 ng/mL, respectively. Logistic regression model demonstrated that high CONUT-CEA score was related to advanced tumor stage. Among non-stage IV patients, CONUT and CEA cutoff values of 2.0 and 9.50 ng/mL predicted overall survival (OS), respectively. The Cox proportional risk model revealed that high CONUT-CEA score was notable related to decreased OS (2 vs 0: hazard ratios (HR) = 2.358, 95% confidence intervals (CI) = 1.412–3.940, P = .001) and decreased disease-free survival (2 vs 0: HR = 1.980, 95% CI = 1.072–3.656, P = .003). The CONUT-CEA score may be a good biomarker for predicting tumor stage and prognosis in GC patients.
Bone Marrow Stromal Cells inhibited the growth and metastasis of human U87 cells through delivering exosomal miR-506
Authors: Zhang Liexiang , Ding Yu , Zhou Wei , Xu Xiaohong , Zheng Jing
Published: February 2024

Glioma is one of the malignancy brain tumors, which deeply threaten the health of patients. Although the traditional therapies for glioma have improved, the outcome is still far from satisfactory. Bone Marrow Stromal Cells (BMSC)-based therapy provided novel insight in the treatment for glioma. However, the detailed molecular mechanism is still not clear. The aim of present study is to discover the novel factor in BMSC-based therapy for glioma. The cell proliferation and apoptosis were identified by using CCK-8 and flow cytometry. The invasion of glioma cells was examined by using Transwell assay and wound-healing assay respectively. qRT-PCR was used to examine the expression of miR-506. Western blot was used to examine the protein levels of CD63, TSG101, NUR77 and CXCR4. Our data suggested that BMSC-derived exosome inhibited the proliferation and contributed to apoptosis of human U87 cells after culturing with miR-506 mimic. Overexpression of miR-506 in BMSC-derived exosome inhibited the invasion of human glioma U87 cells, while these effects were deeply suppressed in the presence GW4869. Our present study demonstrated that BMSC inhibited the growth and metastasis of human glioma U87 cells through delivering exosomal miR-506, and provided the evidences to develop the BMSC-based therapy for glioma.
Effect of the Home to Hospital to Home nutrition management program on postoperative liver cancer patients: A single-center randomized controlled study
Authors: Zhao Runan , Hou Xiaohong , Niu Yushuo , Wang Jianlu
Published: February 2024

Background:

Malnutrition is the most common complication in postoperative liver cancer patients. This study aimed to investigate the effects of the Home to Hospital to Home nutrition management program on postoperative liver cancer patients.

Methods:

A total of 184 liver cancer patients were randomly assigned to either an intervention group (treated under the Home to Hospital to Home nutrition management program) or a control group (treated with the general nutritional method). Nutrition-related indicators, such as prealbumin (PA) and albumin, were assessed before and after treatment in both groups. The incidence of complications (e.g., nausea or vomiting, bloating, difficulty defecating, ascites), length of hospital stay, first time to anal exhaust and out-of-bed activity, and patient satisfaction were recorded.

Results:

A total of 184 liver cancer patients were randomly assigned to either an intervention group (treated under the Home to Hospital to Home nutrition management program) or a control group (treated with the general nutritional method). Nutrition-related indicators, such as prealbumin (PA) and albumin, were assessed before and after treatment in both groups. The incidence of complications (e.g., nausea or vomiting, bloating, difficulty defecating, ascites), length of hospital stay, first time to anal exhaust and out-of-bed activity, and patient satisfaction were recorded.

Conclusion:

The Home to Hospital to Home nutrition management program improves the nutritional status of postoperative liver cancer patients, lowers the incidence of complications, shortens hospital stays, increases patient satisfaction, and promotes the early recovery of patients.
Pharmacist as vaccinators: the way forward for pharmacist-administered vaccinations in Low-Resource settings: Editorial
Authors: Bekele Firomsa , Samuel Dagim , Tafese Lalise
Published: February 2024

Despite the availability of effective vaccinations, inadequate vaccine uptake continues to be a significant public health concern. Pharmacists can play a significant role in disease prevention by promoting and providing vaccines. Despite this, various obstacles that prevent community pharmacists from providing vaccinations include a patient, health care workers, and government related factors. Therefore, the facilitators and barriers of Pharmacist administered vaccination should be studied more widely in low-resource settings.
Molecular assembly indices of mineral heteropolyanions: some abiotic molecules are as complex as large biomolecules
Authors: Hazen Robert M. , Burns Peter C. , Cleaves H. James , Downs Robert T. , Krivovichev Sergey V. , Wong Michael L.
Published: February 2024

Molecular assembly indices, which measure the number of unique sequential steps theoretically required to construct a three-dimensional molecule from its constituent atomic bonds, have been proposed as potential biosignatures. A central hypothesis of assembly theory is that any molecule with an assembly index ≥15 found in significant local concentrations represents an unambiguous sign of life. We show that abiotic molecule-like heteropolyanions, which assemble in aqueous solution as precursors to some mineral crystals, range in molecular assembly indices from 2 for H
2
CO
3
or Si(OH)
4
groups to as large as 21 for the most complex known molecule-like subunits in the rare minerals ewingite and ilmajokite. Therefore, values of molecular assembly indices ≥15 do not represent unambiguous biosignatures.
Analysis of fibrocalcific aortic valve stenosis: computational pre-and-post TAVR haemodynamics behaviours
Authors: Morany Adi , Bardon Ricardo Gomez , Lavon Karin , Hamdan Ashraf , Bluestein Danny , Haj-Ali Rami
Published: February 2024

Fibro-calcific aortic valve (AV) diseases are characterized by calcium growth or accumulation of fibrosis in the AV tissues. Fibrocalcific aortic stenosis (FAS) rises specifically in females, like calcification-induced aortic stenosis (CAS), may eventually necessitate valve replacement. Fluid-structure-interaction (FSI) computational models for severe CAS and FAS patients were developed using lattice Boltzmann method and multi-scale finite elements (FE). Three parametric AV models were introduced: pathology-free of non-calcified tri-and-bicuspid AVs with healthy collagen fibre network (CFN), a FAS model incorporated a thickened CFN with embedded small calcification volumes, and a CAS model employs healthy CFN with embedded high calcification volumes. The results indicate that the interaction between calcium deposits, adjacent tissue and fibres crucially influences haemodynamics and structural reactions. A fourth model of transcatheter aortic valve replacement (TAVR) post-procedure outcomes was created to study both CAS and FAS. TAVR-CAS had a higher maximum contact pressure and lower anchoring area than TAVR-FAS, making it prone to aortic tissue damage and migration. Finally, although the TAVR-CAS offered a larger opening area, its paravalvular leakage was higher. This may be attributed to a similar thrombogenicity potential characterizing both models. The computational framework emphasizes the significance of mechanobiology in FAS and underscores the requirement for tissue modelling at multiple scales.
Attention deficits linked with proclivity to explore while foraging
Authors: Barack David L. , Ludwig Vera U. , Parodi Felipe , Ahmed Nuwar , Brannon Elizabeth M. , Ramakrishnan Arjun , Platt Michael L.
Published: February 2024

All mobile organisms forage for resources, choosing how and when to search for new opportunities by comparing current returns with the average for the environment. In humans, nomadic lifestyles favouring exploration have been associated with genetic mutations implicated in attention deficit hyperactivity disorder (ADHD), inviting the hypothesis that this condition may impact foraging decisions in the general population. Here we tested this pre-registered hypothesis by examining how human participants collected resources in an online foraging task. On every trial, participants chose either to continue to collect rewards from a depleting patch of resources or to replenish the patch. Participants also completed a well-validated ADHD self-report screening assessment at the end of sessions. Participants departed resource patches sooner when travel times between patches were shorter than when they were longer, as predicted by optimal foraging theory. Participants whose scores on the ADHD scale crossed the threshold for a positive screen departed patches significantly sooner than participants who did not meet this criterion. Participants meeting this threshold for ADHD also achieved higher reward rates than individuals who did not. Our findings suggest that ADHD attributes may confer foraging advantages in some environments and invite the possibility that this condition may reflect an adaptation favouring exploration over exploitation.
Mesophotic corals in Hawai‘i maintain autotrophy to survive low-light conditions
Authors: Backstrom Callum H. , Padilla-Gamiño Jacqueline L. , Spalding Heather L. , Roth Melissa S. , Smith Celia M. , Gates Ruth D. , Rodrigues Lisa J.
Published: February 2024

In mesophotic coral ecosystems, reef-building corals and their photosynthetic symbionts can survive with less than 1% of surface irradiance. How depth-specialist corals rely upon autotrophically and heterotrophically derived energy sources across the mesophotic zone remains unclear. We analysed the stable carbon (
δ
13
C) and nitrogen (
δ
15
N) isotope values of a
Leptoseris
community from the ‘Au‘au Channel, Maui, Hawai‘i (65–125 m) including four coral host species living symbiotically with three algal haplotypes. We characterized the isotope values of hosts and symbionts across species and depth to compare trophic strategies. Symbiont
δ
13
C was consistently 0.5‰ higher than host
δ
13
C at all depths. Mean colony host and symbiont
δ
15
N differed by up to 3.7‰ at shallow depths and converged at deeper depths. These results suggest that both heterotrophy and autotrophy remained integral to colony survival across depth. The increasing similarity between host and symbiont
δ
15
N at deeper depths suggests that nitrogen is more efficiently shared between mesophotic coral hosts and their algal symbionts to sustain autotrophy. Isotopic trends across depth did not generally vary by host species or algal haplotype, suggesting that photosynthesis remains essential to
Leptoseris
survival and growth despite low light availability in the mesophotic zone.
Impacts of behaviour and acclimation of metabolic rate on energetics in sheltered ectotherms: a climate change perspective
Authors: Enriquez-Urzelai Urtzi , Gvoždík Lumír
Published: February 2024

Many ectothermic organisms counter harsh abiotic conditions by seeking refuge in underground retreats. Variations in soil hydrothermal properties within these retreats may impact their energy budget, survival and population dynamics. This makes retreat site choice a critical yet understudied component of their strategies for coping with climate change. We used a mechanistic modelling approach to explore the implications of behavioural adjustments and seasonal acclimation of metabolic rate on retreat depth and the energy budget of ectotherms, considering both current and future climate conditions. We used a temperate amphibian, the alpine newt (
Ichthyosaura alpestris
), as a model species. Our simulations predict an interactive influence of different thermo- and hydroregulatory strategies on the vertical positioning of individuals in underground refuges. The adoption of a particular strategy largely determines the impact of climate change on retreat site choice. Additionally, we found that, given the behavioural thermoregulation/hydroregulation and metabolic acclimation patterns considered, behaviour within the retreat has a greater impact on ectotherm energetics than acclimation of metabolic rate under different climate change scenarios. We conclude that further empirical research aimed at determining ectotherm behavioural strategies during both surface activity and inactivity is needed to understand their population dynamics and species viability under climate change.
Macroevolutionary drivers of morphological disparity in the avian quadrate
Authors: Kuo Pei-Chen , Navalón Guillermo , Benson Roger B. J. , Field Daniel J.
Published: February 2024

In birds, the quadrate connects the mandible and skull, and plays an important role in cranial kinesis. Avian quadrate morphology may therefore be assumed to have been influenced by selective pressures related to feeding ecology, yet large-scale variation in quadrate morphology and its potential relationship with ecology have never been quantitatively investigated. Here, we used geometric morphometrics and phylogenetic comparative methods to quantify morphological variation of the quadrate and its relationship with key ecological features across a wide phylogenetic sample. We found non-significant associations between quadrate shape and feeding ecology across different scales of phylogenetic comparison; indeed, allometry and phylogeny exhibit stronger relationships with quadrate shape than ecological features. We show that similar quadrate shapes are associated with widely varying dietary ecologies (one-to-many mapping), while divergent quadrate shapes are associated with similar dietary ecologies (many-to-one mapping). Moreover, we show that the avian quadrate evolves as an integrated unit and exhibits strong associations with the morphologies of neighbouring bones. Our results collectively illustrate that quadrate shape has evolved jointly with other elements of the avian kinetic system, with the major crown bird lineages exploring alternative quadrate morphologies, highlighting the potential diagnostic value of quadrate morphology in investigations of bird systematics.
ViromeFlowX: a Comprehensive Nextflow-based Automated Workflow for Mining Viral Genomes from Metagenomic Sequencing Data
Authors: Wang Xiaokai , Ding Zhimin , Yang Ying , Liang Lifeng , Sun Yingshuai , Hou Chaojian , Zheng Yuning , Xia Yan , Dong Lixin
Published: February 2024

Understanding the link between the human gut virome and diseases has garnered significant interest in the research community. Extracting virus-related information from metagenomic sequencing data is crucial for unravelling virus composition, host interactions, and disease associations. However, current metagenomic analysis workflows for viral genomes vary in effectiveness, posing challenges for researchers seeking the most up-to-date tools. To address this, we present ViromeFlowX, a user-friendly Nextflow workflow that automates viral genome assembly, identification, classification, and annotation. This streamlined workflow integrates cutting-edge tools for processing raw sequencing data for taxonomic annotation and functional analysis. Application to a dataset of 200 metagenomic samples yielded high-quality viral genomes. ViromeFlowX enables efficient mining of viral genomic data, offering a valuable resource to investigate the gut virome’s role in virus-host interactions and virus-related diseases.
Characterization of gelling agents in callus inducing media: Physical properties and their effect on callus development
Authors: Sadot Muzika Noy , Kamai Tamir , Williams Leor Eshed , Kleiman Maya
Published: February 2024

In plant tissue culture, callus formation serves as a crucial mechanism for regenerating entire plants, enabling the differentiation of diverse tissues. Researchers have extensively studied the influence of media composition, particularly plant growth regulators, on callus behavior. However, the impact of the physical properties of the media, a well-established factor in mammalian cell studies, has received limited attention in the context of plant tissue culture. Previous research has highlighted the significance of gelling agents in affecting callus growth and differentiation, with agar, Phytagel, and Gelrite being the most used options. Despite their widespread use, a comprehensive comparison of their physical properties and their subsequent effects on callus behavior remains lacking. Our study seeks to bridge this gap by providing a thorough analysis of the physical properties of these gelling agents and their influence on callus induction and differentiation, offering valuable insights for researchers seeking to optimize plant tissue culture media for diverse applications.
Human iPSC-derived Committed Cardiac Progenitors Generate Cardiac Tissue Grafts in a Swine Ischemic Cardiomyopathy Model without Triggering Ventricular Arrhythmias
Authors: Raval Amish N. , Schmuck Eric G. , Roy Sushmita , Saito Yukihiro , Zhou Tianhua , Conklin James , Hacker Timothy A. , Koonce Chad , Boyer Meghan , Stack Kristin , Hebron Ellen , Nagle Scott K. , Hsieh Patrick C.H. , Kamp Timothy J
Published: February 2024

Background: The adult human heart following a large myocardial infarction is unable to regenerate heart muscle and instead forms scar with the risk of progressive heart failure. Large animal studies have shown that intramyocardial injection of human pluripotent stem cell-derived cardiomyocytes (hPSC-CMs) following a myocardial infarction result in cell grafts but also ventricular arrhythmias. We hypothesized that intramyocardial injection of committed cardiac progenitor cells (CCPs) derived from iPSCs, combined with cardiac fibroblast-derived extracellular matrix (cECM) to enhance cell retention will: i) form cardiomyocyte containing functional grafts, ii) be free of ventricular arrhythmias and iii) restore left ventricular contractility in a post-myocardial infarction (MI) cardiomyopathy swine model. Methods: hiPSCs were differentiated using bioreactors and small molecules to produce a population of committed cardiac progenitor cells (CCPs). MI was created using a coronary artery balloon occlusion and reperfusion model in Yucatan mini pigs. Four weeks later, epicardial needle injections of CCPs+cECM were performed in a small initial feasibility cohort, and then transendocardial injections (TEI) of CCPs+cECM, CCPs alone, cECM alone or vehicle control into the peri-infarct region in a larger randomized cohort. A 4-drug immunosuppression regimen was administered to prevent rejection of human CCPs. Arrhythmias were evaluated using implanted event recorders. Magnetic resonance imaging (MRI) and invasive pressure volume assessment were used to evaluate left ventricular anatomic and functional performance, including viability. Detailed histology was performed on the heart to detect human grafts. Results: A scalable biomanufacturing protocol was developed generating CCPs which can efficiently differentiate to cardiomyocytes or endothelial cells in vitro. Intramyocardial delivery of CCPs to post-MI porcine hearts resulted in engraftment and differentiation of CCPs to form ventricular cardiomyocyte rich grafts. There was no significant difference in cardiac MRI-based measured cardiac volumes or function between control, CCP and CCP+cECM groups; however, dobutamine stimulated functional reserve was improved in CCP and CCP+cECM groups. TEI delivery of CCPs with or without cECM did not result in tumors or trigger ventricular arrhythmias. Conclusions: CCPs are a promising cell source for post-MI heart repair using clinically relevant TEI with a low risk of engraftment ventricular arrhythmias.
Global genetic rewiring during compensatory evolution in the yeast polarity network
Authors: Kingma Enzo , Laan Liedewij
Published: February 2024

Functional defects resulting from deleterious mutations can often be restored during evolution by compensatory mutations elsewhere in the genome. Importantly, this process can generate the genetic diversity seen in networks regulating the same biological function in different species. How the options for compensatory evolution depend on the molecular interactions underlying these functions is currently unclear. In this study, we investigate how gene deletions compensating for a defect in the polarity pathway ofSaccharomyces cerevisiaeimpact the fitness landscape. Using a transposon mutagenesis screen, we demonstrate that gene fitness has changed on a genome-wide scale in the compensated strain. An analysis of the functional associations between the affected genes reveals that compensation impacts cellular processes that have no clear connection to cell polarity. Moreover, genes belonging to the same process tend to show the same direction of gene fitness change, indicating that compensation rewires the fitness contribution of cellular processes rather than of individual genes. In conclusion, our results strongly suggest that functional overlap between modules and the interconnectedness of the molecular interaction network play major roles in mediating compensatory evolution.
Validity of a novel excessive daytime sleepiness’ screening stool : the Yaoundé Sleepiness Score.
Authors: MASSONGO MASSONGO , Duthoit Louise , Balkissou Adamou Dodo , Ngah Komo Marie Elisabeth , Kuaban Alain , Fry Stéphanie , Pefura Yone Eric Walter , Mallart Anne
Published: February 2024

Background The subjective assessment of excessive daytime sleepiness (EDS) using Epworth sleepiness scale (ESS) has shown some limits. This study aimed to assess the validity of the Yaoundé Sleepiness Scale (YSS), a new tool for EDS screening, using ESS as reference.  Methodology A 6-item questionnaire was assessed for validity features. The content validity was based on sleep physiology. Four sleep specialists approved the initial draft for face validity. A cross-sectional study was led in Lille University Hospital to assess the criterion and construct validity. Baseline data,  full night recording, and sleepiness scales (YSS, ESS) were recorded. The criterion validity was assessed using the Pearson correlation between YSS and ESS and the area under the receiver operator characteristics (AUROC) curve. A graphical method was used to find the YSS threshold. We used a simple linear regression to seek the association between YSS and EDS predictors for construct validity. Results A total of 566 patients (mean age ± standard deviation = 53.1 ± 14.6 years, female = 47%) were enrolled. The mean ± standard deviation YSS and ESS were 9.8 ± 4.7 and 9.1 ± 5.3, respectively. The Pearson correlation between YSS and ESS was 0.74% (p<0.0001). The AUROC curves (95% confidence interval, 95CI) for ESS-based EDS and severe EDS prediction were 0.856 (0.829 – 0.889) and 0.871 (0.829 – 0.913), respectively. The YSS thresholds for EDS and severe EDS were 9 and 15, respectively. Using ESS as gold standard, the sensitivity and specificity for EDS and severe EDS were 92.3 (88.7 - 95.9)% and 60.6 (55.3 - 65.9)%, and 60.3 (49.0 - 71.5)%  and 90.2 (87.5 - 92.9)%. The YSS significantly increased with the use of psychotropic drugs and psychiatric conditions, and significantly decreased with age. Conclusion We found a good criterion validity and an acceptable construct validity of the YSS compared with ESS. This questionnaire could be proposed as an alternative to ESS. However, these data should be confirmed by other studies, notably based on objective sleepiness tests.