bluuebunny/crossref_metadata_2025 huggingface dataset:
HIV self-testing adoption and post-test linkage to care among men who have sex with men in China: a nationwide cross-sectional survey
Authors: Yang Fan , Zhao Peizhen , Tang Weiming , Tucker Joseph D. , Xu Wenqian , Wang Cheng
Published: May 2024

Background

HIV self-testing (HIVST) was recommended to improve HIV testing services. China initiated some of the first HIVST pilots in the world, providing a unique opportunity for implementation research. We aim to investigate HIVST adoption and its following linkage to care among Chinese men who have sex with men (MSM).

Methods

Data were collected using an online questionnaire distributed on major social media platforms in 2018, one year after HIVST was officially endorsed and allowed for sale. MSM who were at least 16 years old, assigned as male at birth, and ever tested for HIV were eligible. Primary outcome, adoption was defined as ever use of HIVST. Bivariate and multivariable logistic regressions were performed to explore the association between HIVST adoption and sociodemographic and behavioral factors. Linkage to care was also described via the following sequential events as indicators: (1) receiving result after recent test (2), seeking care from healthcare facility if test result was positive or indeterminate, and (3) delayed time before seeking care.

Results

A total of 540 participants were included with an average age of 27.4 ± 6.6. Most were never married (87.4%) and half completed college (52.2%). Overall, 75.2% had adopted HIVST. Self-test kits were commonly obtained from community-based organizations (54.4%) and from online (46.6%). HIVST adoption was positively associated with having college or higher education (OR = 1.66, 95%CI: 1.07–2.57), and negatively associated with age older than 30 (AOR = 0.52, 95%CI: 0.32–0.84). Adoption was not associated with other socio-demographic or behavioral factors. After receiving HIV-positive or indeterminate results, 25/25 of HIVST adopters sought care while 3 out of 7 (42.9%) non-adopters sought care (p < 0.001). Delays before seeking care were not significantly different between HIVST adopters compared to non-adopters (P = 0.366).

Conclusion

Many MSM adopted HIVST shortly after its launch. Our findings suggested that HIVST linkage to care is promising among MSM in China. Integration of HIVST with other essential sexual health services is needed.
Malignant tumor increases the risk of all causes in-hospital mortality in critically ill patients with ischemic stroke: analysis of the MIMIC-IV database
Authors: Wang Qiwei , Fu Wang , Wang Feng
Published: May 2024

Background

Ischemic stroke (IS) and malignant tumor (MT) have high morbidity and mortality rates worldwide, and several associations exist between them. This study aimed to determine the effect of MT on hospital mortality in patients with IS.

Methods

Based on their MT status, participants with IS in the Medical Information Mart for Intensive Care IV (MIMIC-IV) were divided into two groups. The primary outcome was in-hospital all causes mortality. Kaplan-Meier survival analysis was performed to evaluate the intergroup in-hospital mortality, and three Cox regression models were used to determine the association between MT and in-hospital mortality.

Results

A total of 1605 participants (749 males and 856 females) were included in the study. The mean age was 72.030 ± 15.463 years. Of these, 257 (16%) patients died in the hospital. Kaplan-Meier analysis showed that the MT group had a significantly lower possibility of in-hospital survival than the non-MT group. In the unadjusted model, in-hospital mortality among MT patients had a higher odds ratio (OR) of 1.905 (95% CI, 1.320–2.748; P < 0.001) than the non-MT group. After adjusting for basic information, vital signs, and laboratory data, MT was also associated with increased in-hospital mortality (OR = 1.844, 95% CI: 1.255–2.708; P = 0.002).

Conclusions

Among the patients with IS, the risk of all causes in-hospital mortality was higher for MT than for patients non-MT. This finding can assist clinicians in more accurately assessing prognosis and making informed treatment decisions.
Patients’ satisfaction with cancer pain treatment at adult oncologic centers in Northern Ethiopia; a multi-center cross-sectional study
Authors: Amsalu Molla , Ashagrie Henos Enyew , Getahun Amare Belete , Berhe Yophtahe Woldegerima
Published: May 2024

Background

Patient satisfaction is an important indicator of the quality of healthcare. Pain is one of the most common symptoms among cancer patients that needs optimal treatment; rather, it compromises the quality of life of patients.

Objective

To assess the levels and associated factors of satisfaction with cancer pain treatment among adult patients at cancer centers found in Northern Ethiopia in 2023.

Methods

After obtaining ethical approval, a multi-center cross-sectional study was conducted at four cancer care centers in northern Ethiopia. The data were collected using an interviewer-administered structured questionnaire that included the Lubeck Medication Satisfaction Questionnaire (LMSQ). The severity of pain was assessed by a numerical rating scale from 0 to 10 with a pain score of 0 = no pain, 1–3 = mild pain, 4–6 = moderate pain, and 7–10 = severe pain Binary logistic regression analysis was employed, and the strength of association was described in an adjusted odds ratio with a 95% confidence interval.

Result

A total of 397 cancer patients participated in this study, with a response rate of 98.3%. We found that 70.3% of patients were satisfied with their cancer pain treatment. Being married (AOR = 5.6, CI = 2.6–12, P < 0.001) and being single (never married) (AOR = 3.5, CI = 1.3–9.7, P = 0.017) as compared to divorced, receiving adequate pain management (AOR = 2.4, CI = 1.1–5.3, P = 0.03) as compared to those who didn’t receive it, and having lower pain severity (AOR = 2.6, CI = 1.5–4.8, P < 0.001) as compared to those who had higher level of pain severity were found to be associated with satisfaction with cancer pain treatment.

Conclusion

The majority of cancer patients were satisfied with cancer pain treatment. Being married, being single (never married), lower pain severity, and receiving adequate pain management were found to be associated with satisfaction with cancer pain treatment. It would be better to enhance the use of multimodal analgesia in combination with strong opioids to ensure adequate pain management and lower pain severity scores.
Immune cell patterns before and after neoadjuvant immune checkpoint blockade combined with chemoradiotherapy in locally advanced esophageal squamous cell carcinoma
Authors: Zheng Dan-Dan , Li Yu-Ying , Yuan Xiao-Yi , Lu Jiang-Li , Zhang Mei-Fang , Fu Jia , Zhang Chris Zhiyi
Published: May 2024

Background

Neoadjuvant immune checkpoint blockade (ICB) combined with chemoradiotherapy offers high pathologic complete response (pCR) rate for patients with locally advanced esophageal squamous cell carcinomas (ESCC). But the dynamic tumor immune microenvironment modulated by such neoadjuvant therapy remains unclear.

Patients and methods

A total of 41 patients with locally advanced ESCC were recruited. All patients received neoadjuvant toripalimab combined with concurrent chemoradiotherapy. Matched pre- and post-treatment tissues were obtained for fluorescent multiplex immunohistochemistry (mIHC) and IHC analyses. The densities and spatial distributions of immune cells were determined by HALO modules. The differences of immune cell patterns before and after neoadjuvant treatment were investigated.

Results

In the pre-treatment tissues, more stromal CD3 + FoxP3 + Tregs and CD86+/CD163 + macrophages were observed in patients with residual tumor existed in the resected lymph nodes (pN1), compared with patients with pCR. The majority of macrophages were distributed in close proximity to tumor nest in pN1 patients. In the post-treatment tissues, pCR patients had less CD86 + cell infiltration, whereas higher CD86 + cell density was significantly associated with higher tumor regression grades (TRG) in non-pCR patients. When comparing the paired pre- and post-treatment samples, heterogeneous therapy-associated immune cell patterns were found. Upon to the treatment, CD3 + T lymphocytes were slightly increased in pCR patients, but markedly decreased in non-pCR patients. In contrast, a noticeable increase and a less obvious decrease of CD86 + cell infiltration were respectively depicted in non-pCR and pCR patients. Furthermore, opposite trends of the treatment-induced alterations of CD8 + and CD15 + cell infiltrations were observed between pN0 and pN1 patients.

Conclusions

Collectively, our data demonstrate a comprehensive picture of tumor immune landscape before and after neoadjuvant ICB combined with chemoradiotherapy in ESCC. The infiltration of CD86 + macrophage may serve as an unfavorable indicator for neoadjuvant toripalimab combined with chemoradiotherapy.
Association of CYP2D6 and CYP2C19 metabolizer status with switching and discontinuing antidepressant drugs: an exploratory study
Authors: Brouwer Jurriaan M. J. L. , Wardenaar Klaas J. , Nolte Ilja M. , Liemburg Edith J. , Bet Pierre M. , Snieder Harold , Mulder Hans , Cath Danielle C. , Penninx Brenda W. J. H.
Published: May 2024

Background

Tailoring antidepressant drugs (AD) to patients’ genetic drug-metabolism profile is promising. However, literature regarding associations of ADs’ treatment effect and/or side effects with drug metabolizing genes CYP2D6 and CYP2C19 has yielded inconsistent results. Therefore, our aim was to longitudinally investigate associations between CYP2D6 (poor, intermediate, and normal) and
CYP2C19 (poor, intermediate, normal, and ultrarapid) metabolizer-status, and switching/discontinuing of ADs. Next, we investigated whether the number of perceived side effects differed between metabolizer statuses.

Methods

Data came from the multi-site naturalistic longitudinal cohort Netherlands Study of Depression and Anxiety (NESDA). We selected depression- and/or anxiety patients, who used AD at some point in the course of the 9 years follow-up period (n = 928). Medication use was followed to assess patterns of AD switching/discontinuation over time. CYP2D6 and CYP2C19 alleles were derived using genome-wide data of the NESDA samples and haplotype data from the PharmGKB database. Logistic regression analyses were conducted to investigate the association of metabolizer status with switching/discontinuing ADs. Mann–Whitney U-tests were conducted to compare the number of patient-perceived side effects between metabolizer statuses.

Results

No significant associations were observed of CYP metabolizer status with switching/discontinuing ADs, nor with the number of perceived side effects.

Conclusions

We found no evidence for associations between CYP metabolizer statuses and switching/discontinuing AD, nor with side effects of ADs, suggesting that metabolizer status only plays a limited role in switching/discontinuing ADs. Additional studies with larger numbers of PM and UM patients are needed to further determine the potential added value of pharmacogenetics to guide pharmacotherapy.
Prevalence and factors associated with dyslipidemia in patients with first hospitalization for major depressive disorder: a large sample cross-sectional study
Authors: Yin Huimin , Lu Baili , Zeng Kuan , Li Yi , Ma Jun
Published: May 2024

Background

Major depressive disorder (MDD) is a severe mental illness with high relapse rates and high mortality. Depression not only severely limits psychosocial functioning but also reduces quality of life. It can also negatively affect patients’ clinical parameters, including lipid metabolism markers. This study aimed to investigate the prevalence and risk factors of hyperlipidemia (HL) in patients with MDD who were hospitalized for the first time.

Methods

In this study, we enrolled 981 patients with MDD who were hospitalized for the first time, collected their demographic data and biochemical indicators, and evaluated their clinical symptoms. We divided the patients into HL and non-HL subgroups based on whether they had co-morbid HL. We compared whether there were significant differences between the two groups regarding demographics and general clinical information.

Results

A total of 708 of 981 MDD patients were described as being in the hyperlipidemic group, with an incidence of 72.17%. Clinical Global Impression Scale-Severity of Illness (CGI-SI) score and Hamilton Depression Scale (HAMD) score are risk factors for co-morbid HL in patients with MDD. The area under the ROC curve for the CGI-SI and HAMD score and their combined discriminatory ability was approximately 63%, 67%, and 68%, respectively.

Conclusion

The prevalence of HL was high in patients with MDD who were first hospitalized; Higher HAMD score and CGI-SI score were risk factors for the development of HL in MDD; The HAMD score and the CGI-SI score are predictive of the severity of HL.
The effect of social anxiety on teenagers’ internet addiction: the mediating role of loneliness and coping styles
Authors: Dong Wanglin , Tang Haishan , Wu Sijia , Lu Guangli , Shang Yanqing , Chen Chaoran
Published: May 2024

Background & Aim

There is a lack of understanding of how social anxiety may affect Internet addiction among adolescents. Based on several theories, the purpose of this study was to investigate the multiple mediating roles of loneliness and coping styles in the association between social anxiety and Internet addiction in Chinese adolescents.

Methods

This study used the Social Anxiety Scale, Internet Addiction Test, Loneliness Scale, and Simple Coping Style Questionnaire to investigate 1188 students in two junior high schools and senior high schools in Henan Province, China. We adopted Pearson’s correlation analysis and the PROCESS Macro Model 81 in regression analysis to explore the relationships among social anxiety, loneliness, coping styles, and Internet addiction.

Results

We found that social anxiety not only directly affects teenagers' Internet addiction, but also affects teenagers' Internet addiction through loneliness and coping styles.

Conclusions

These results emphasize the importance of improving social anxiety to reduce Internet addiction among adolescents. At the same time, it also emphasizes the need to reduce adolescents' loneliness and cultivating positive coping styles. In addition, this study has certain theoretical significance for teenagers' mental health and intervention studies on Internet addiction.
Enhancing colorectal cancer prevention: a national assessment of public awareness in Egypt
Authors: Yehia Sania Ali , Alboraie Mohamed , Ashour Reham , Hassan Dalia , Ezzat Reem , El-Raey Fathiya , Tag-Adeen Mohammed , Abdelaziz Mohamed , Asfour Sabry , Abdellatef Abeer , Abdeen Nermeen , Elsayed Rasha , Elkhadry Sally Waheed
Published: May 2024

Background

Despite the increasing incidence of colorectal cancer (CRC) in the Egyptian population, it still seems that there is a significant lack of awareness regarding the disease. This study aimed to assess the Egyptian population's awareness of CRC regarding its risk factors, the screening procedures, and the appropriate responses to its diagnosis.

Method

A cross-sectional study was conducted in Egypt between July 2022 and March 2023 and recruited a convenient sample of adults from seven governorates representing different geographic areas, and socioeconomic and educational backgrounds with the help of the validated Bowel Cancer Awareness Measure (CAM) version 2.1. The modified Arabic questionnaire was validated through a pilot study including 30 patients. Then it was presented through a Google form before being shared via online methods and face-to-face interviews. The questionnaire provided both numerical and categorical data, which were analyzed accordingly. The Chi-square, the Fisher exact, and the Man-Whitney test were used to compare colorectal cancer poor and good knowledge groups. Logistic regression analysis was conducted to predict the factors that affected the awareness level of the study population.

Results

Nine hundred forty individuals participated in the survey. Their ages ranged from 18 to 86 years old, with an average of 37.38 ± 12.22 years. The mean Knowledge score was 14.29 ± 7.05 out of 37 with most of our participants (71%) having poor knowledge about CRC. Most of the participants (64.1%) chose colonoscopy as the best screening modality, followed by an abdominal CT (27.8%), and fecal occult blood (15.5%). The study revealed significant differences between participants with good and poor knowledge of colorectal cancer. (78.5%) of participants with good CRC knowledge lived in cities, (85.4%) attained university or higher educational level, and (87.2%) of them were nonsmokers (p < 0.05%).

Conclusion

In general, there was a lack of awareness about Colorectal cancer among the Egyptian population especially among rural and lower educational levels, and more health education campaigns are required to enhance CRC prevention efforts in Egypt.
Trends in socio-demographic characteristics and substance use among high school learners in a selected district in Limpopo Province, South Africa
Authors: Shuro Linda , Waggie Firdouza
Published: May 2024

Background

Substance use is an escalating public health problem in South Africa resulting in risky behaviours and poor educational attainment among adolescents. There is a huge battle to overcome substance use among learners as more drugs become easily available with the mean age of drug experimentation reported to be at 12 years of age. It is important to continuously understand the trends in substance use in order to assess if there are positive changes and provide evidence for the development of context-specific effective interventions. This paper outlines the prevalence of substance use among selected high schools in a district in Limpopo province.

Methods

To determine the prevalence of substance use among selected high school learners in a district in Limpopo Province, a cross-sectional school survey of 768 learners was conducted. Data was analysed using SPSS v 26. Descriptive analysis was used to describe the independent and dependent variables and Chi-Square test was used to investigate associations between demographic characteristics and substance use among high school learners.

Results

The most abused substances by learners were alcohol (49%), cigarettes (20.8%) and marijuana (dagga/cannabis) (16.8%). In a lifetime, there was a significant difference (P < 0.05) in cigarette smoking with gender, school, and grade; with more use in males (14.2%) than females (7.6%); in urban schools (14.6) than peri-urban (6.7%) and more in Grade 12 (6.4%). There was a significant difference (P < 0.05) in alcohol use with more use in Grade 10 (12.6%) and varied use among male and female learners but cumulatively more alcohol use in females (27.7%). Drug use varied, with an overall high drug use in urban schools (20.7%).

Conclusions

Substance use is rife among high school learners in the district and health promotion initiatives need to be tailored within the context of socio-demographic characteristics of learners including the multiple levels of influence such as peer pressure, poverty, unemployment and child headed families. Additional research is required to investigate the factors leading to a notable gradual increase in use among female learners and into the environmental and family settings of learners in influencing substance use.
Developing a novel causal inference algorithm for personalized biomedical causal graph learning using meta machine learning
Authors: Wu Hang , Shi Wenqi , Wang May D.
Published: May 2024

Background

Modeling causality through graphs, referred to as causal graph learning, offers an appropriate description of the dynamics of causality. The majority of current machine learning models in clinical decision support systems only predict associations between variables, whereas causal graph learning models causality dynamics through graphs. However, building personalized causal graphs for each individual is challenging due to the limited amount of data available for each patient.

Method

In this study, we present a new algorithmic framework using meta-learning for learning personalized causal graphs in biomedicine. Our framework extracts common patterns from multiple patient graphs and applies this information to develop individualized graphs. In multi-task causal graph learning, the proposed optimized initial guess of shared commonality enables the rapid adoption of knowledge to new tasks for efficient causal graph learning.

Results

Experiments on one real-world biomedical causal graph learning benchmark data and four synthetic benchmarks show that our algorithm outperformed the baseline methods. Our algorithm can better understand the underlying patterns in the data, leading to more accurate predictions of the causal graph. Specifically, we reduce the structural hamming distance by 50-75%, indicating an improvement in graph prediction accuracy. Additionally, the false discovery rate is decreased by 20-30%, demonstrating that our algorithm made fewer incorrect predictions compared to the baseline algorithms.

Conclusion

To the best of our knowledge, this is the first study to demonstrate the effectiveness of meta-learning in personalized causal graph learning and cause inference modeling for biomedicine. In addition, the proposed algorithm can also be generalized to transnational research areas where integrated analysis is necessary for various distributions of datasets, including different clinical institutions.
Recommended data elements for health registries: a survey from a German funding initiative
Authors: Harkener Sonja , Jenetzky Ekkehart , Rupp Rüdiger , Dell Jennifer , Engel Christoph , von Bargen Maximilian Ferry , Finger Robert , Glienke Maximilian , Heinz Carsten , Jersch Patrick , Martin David , Schmutzler Rita , Schönthaler Martin , Suwelack Barbara , Wegner Jeannine , Stausberg Jürgen
Published: May 2024

Background

The selection of data elements is a decisive task within the development of a health registry. Having the right metadata is crucial for answering the particular research questions. Furthermore, the set of data elements determines the registries’ readiness of interoperability and data reusability to a major extent. Six health registries shared and published their metadata within a German funding initiative. As one step in the direction of a common set of data elements, a selection of those metadata was evaluated with regard to their appropriateness for a broader usage.

Methods

Each registry was asked to contribute a 10%-selection of their data elements to an evaluation sample. The survey was set up with the online survey tool „LimeSurvey Cloud”. The registries and an accompanying project participated in the survey with one vote for each project. The data elements were offered in content groups along with the question of whether the data element is appropriate for health registries on a broader scale. The question could be answered using a Likert scale with five options. Furthermore, “no answer” was allowed. The level of agreement was assessed using weighted Cohen’s kappa and Kendall’s coefficient of concordance.

Results

The evaluation sample consisted of 269 data elements. With a grade of “perhaps recommendable” or higher in the mean, 169 data elements were selected. These data elements belong preferably to groups’ demography, education/occupation, medication, and nutrition. Half of the registries lost significance compared with their percentage of data elements in the evaluation sample, one remained stable. The level of concordance was adequate.

Conclusions

The survey revealed a set of 169 data elements recommended for health registries. When developing a registry, this set could be valuable help in selecting the metadata appropriate to answer the registry’s research questions. However, due to the high specificity of research questions, data elements beyond this set will be needed to cover the whole range of interests of a register. A broader discussion and subsequent surveys are needed to establish a common set of data elements on an international scale.
Knowledge of gendered needs among the planners and policy makers for prevention of NCDs in Bangladesh: a qualitative exploration
Authors: Akhter Sadika , Kamruzzaman Mohammed , Anwar Iqbal , Banu Mahmuda Shaila , Reidpath Daniel D , Cameron Adrian J
Published: May 2024

Background

Globally, non-communicable diseases (NCDs) are increasingly the primary cause of mortality and morbidity among women. Like many developing countries, Bangladesh also faces a growing burden of NCDs. The “Multisectoral Action Plan for Prevention and Control of Non-communicable Diseases, 2018–2025” signifies Bangladesh’s commitment to comprehensively combating the rising burden of NCDs. This study investigates the perceptions of those involved in developing the action plan and if/how a gender lens was incorporated into its implementation.

Methods

In-depth interviews were conducted with 25 key individuals involved in a high-level committee to develop and implement Bangladesh’s multisectoral action plan to address the burden of NCDs. Data were collected between July and November 2021, and thematic analysis was conducted.

Results

The findings revealed that interviewees believed the multisectoral action plan adopted a population-wide approach without considering gender-specific needs. This study presents the explanations for this inattention under five themes: (1) A population-level approach to NCD prevention; (2) Understanding women’s health beyond reproductive health; (3) Absence of gender-specific programs; (4) Lack of consideration of gender constraints on physical activity; and (5) Lack of collaborative efforts to address NCDs beyond the health ministry.

Conclusion

In conclusion, governments in countries like Bangladesh can develop more effective strategies to reduce the disease burden of NCDs among women by recognizing and addressing the gendered nature of preventive health. This can be achieved by promoting gender-responsive research, programs, and policy initiatives that consider women’s specific health concerns, ultimately leading to better health outcomes for all.
Interfaces of ‘being healthy and being Ill’: how is health being perceived by individuals with non-communicable chronic conditions?
Authors: Bhor Nilanjan , Nadh P Omkar
Published: May 2024

Background

Accommodating chronic care into the everyday lives of individuals diagnosed with non-communicable chronic conditions often poses significant challenges. Several studies in public health literature that addressed the question of non-adherence to treatment by turning their gaze towards individual’s perception of their own health restricted the use of perception exploration to visceral states and corporeality without adequately acknowledging the mutual permeance of socio-biological worlds. This study explored the socio-economic genealogies of individuals, to understand the role of structural and intermediate factors that determine health perceptions, by attempting to answer the question ‘how do individuals with non-communicable chronic conditions perceive their health as healthy or ill’?.

Methods

This study was conducted in a low-income neighbourhood called Kadugondanahalli in India using qualitative research methods. A total of 20 in-depth interviews were conducted with individuals diagnosed with non-communicable chronic conditions. Individuals were recruited through purposive and snowball sampling.

Results

The participants predominantly perceived their health as being healthy and ill in an episodic manner while adhering to their treatment and medications for chronic conditions. This was strongly determined by the factors such as presence of family support and caregiving, changes in work and occupation, changes in lifestyle, psychological stress from being diagnosed, and care-seeking practices. This episodic perception of illness led to the non-adherence of prescribed chronic care.

Conclusions

Due to the episodic manner in which the participants experienced their illness, the paper recommends considering health and illness as two different entities while researching chronic conditions. It is important for the health system to understand and fix the healthy and ill episodes, which often lead to switching between controlled and uncontrolled states of diabetes and hypertension. To do so, it is important to consider the social, economic, behavioural and psychological factors in an individual’s health outcome. The interplay between these factors has socialized health perception and various related practices from the individual to the community level. Therefore, the health system needs to re-strategize its focus from individual to community level interventions to address the determinants of health and NCD risk factors by strengthening the NCD prevention approach.
Potential antivirulence activity of sub-inhibitory concentrations of ciprofloxacin against Proteus mirabilis isolates: an in-vitro and in-vivo study
Authors: Elhosseini Mohamed A. , El-Banna Tarek E. , Sonbol Fatma I. , El-Bouseary Maisra M.
Published: May 2024

Background

Proteus mirabilisis a significant nosocomial pathogen that is frequently associated with a wide range of infections, necessitating heightened attention to mitigate potential health risks. Hence, this study was performed to investigate the impact of sub-minimum inhibitory concentrations (MICs) of ciprofloxacin (CIP) onProteus mirabilisclinical isolates.

Methods

The sub-MICs of CIP were selected using the growth curve approach. The untreated and treated isolates with sub-MICs of CIP were assessed for their biofilm development, motilities on agar, and other virulence factors. The cell morphology of untreated and treated isolates with sub-MIC of CIP was explored using electron microscope. Moreover, the expression levels of the virulence genes in isolates were measured using quantitative real-time PCR.

Results

Data revealed that sub-MICs of CIP significantly (p < 0.05), in a concentration-dependent manner, inhibited biofilm formation and other virulence factors in the selected isolates. Electron microscope analysis showed cell enlargement and various abnormalities in the cell wall and membrane integrity.

Conclusion

Sub-MICs of CIP exhibited inhibition of virulence and alterations in morphological integrity againstP. mirabilisisolates.
Developing a competency model for Chinese general practitioners: a mixed-methods study
Authors: Gong Xue , Zhang Xu , Zhang Xinyan , Li Yixuan , Zhang Yang , Yu Xiaosong
Published: May 2024

Background

The Chinese government has formulated a series of policies and strengthened training of general practitioners (GPs) to support their role as “gatekeepers” of residents’ health. This study aimed to explore the core competencies of Chinese GPs and develop a competency framework in line with China’s actual conditions, which can provide a more scientific basis for the education, training, and evaluation of GPs.

Methods

Literature analysis and behaviour event interviews were conducted to build the competency dictionary and the initial version of the competency model. Two rounds of Delphi were performed to gain consensus on the final model. The questionnaire survey was carried out in 10 provinces (municipalities, autonomous regions) of China, and GPs were invited to score the importance of each competency item. The total sample was randomly divided into two groups. One group was for exploratory factor analysis (EFA), and the other was for confirmatory factor analysis (CFA) to examine the scale’s reliability and validity.

Results

The dictionary of general practitioners’ competency including 107 competency items was constructed. After two rounds of Delphi, a consensus was reached on 60 competencies in 6 domains. A total of 1917 valid questionnaires were obtained in the nationwide survey. The average importance score of all second-level indicators is 4.53 ± 0.45. The Cronbach’s α coefficient is 0.984. The results of the five factors extracted by EFA showing the 68.16% cumulative explained variance variation is considered to be consistent with the six dimensions obtained by Delphi after thorough discussion. The model fitness indexes obtained by CFA were acceptable (χ2/df = 4.909, CFI = 0.869, NFI = 0.841, RMSEA = 0.065). The values of the composite reliability (CR) of the six dimensions were all greater than 0.7 (0.943, 0.927, 0.937, 0.927, 0.943, 0.950), and the average of variance extracted (AVE) were all greater than 0.5 (0.562, 0.613, 0.649, 0.563, 0.626, 0.635). The results showed that the model has good reliability and validity.

Conclusion

A competency model for GPs suited to China has been developed, which may offer guidance for future training and medical licensing examinations of GPs.
First identification and isolation of equine herpesvirus type 1 in aborted fetal lung tissues of donkeys
Authors: Tong Panpan , Pan Juanjuan , Dang Yueyi , Yang Enhui , Jia Chenyang , Duan Ruli , Tian Shuyao , Palidan Nuerlan , Kuang Ling , Wang Chuanfeng , Lu Gang , Xie Jinxin
Published: May 2024

Background

Equine herpesvirus type 1 (EHV-1) is commonly associated with horse abortion. Currently, there are no reported cases of abortion resulting from EHV-1 infection in donkeys.

Results

This was the first survey-based study of Chinese donkeys. The presence of EHV-1 was identified by PCR. This survey was conducted in Chabuchar County, North Xinjiang, China, in 2020. A donkey EHV-1 strain (Chabuchar/2020) was successfully isolated in MDBK cells. Seventy-two of 100 donkey sera were able to neutralize the isolated EHV-1. Moreover, the ORF33 sequence of the donkey-origin EHV-1 Chabuchar/2020 strain showed high levels of similarity in both its nucleotide (99.7‒100%) and amino acid (99.5‒100%) sequences, with those of horse EHV-1 strains. EHV-1 Chabuchar/2020 showed significant consistency and was classified within cluster 1 of horse EHV-1 strains. Further, analysis of the expected ORF30 nucleotide sequence revealed that donkey EHV-1 strains contained guanine at position 2254, resulting in a change to aspartic acid at position 752 of the viral DNA polymerase. Therefore, these strains were classified as horse neuropathogenic strains. Lastly, a phylogenetic tree was constructed using the partial ORF68 nucleotide sequences, showing that the identified donkey EHV-1 strain and the EHV-1 strain found in aborted Yili horses in China comprised a novel independent VIII group.

Conclusion

This study showed the first isolation and identification of EHV-1 as an etiological agent of abortions in donkeys. Further analysis of the ORF33, ORF30, and ORF68 sequences indicated that the donkey EHV-1 contained the neuropathogenic genotype of strains in the VIII group. It is thus important to be aware of EHV-1 infection in the donkey population, even though the virus has only been identified in donkey abortions in China.
Molecular determinants for brain targeting by peptides: a meta-analysis approach with experimental validation
Authors: Cavaco Marco , Fraga Patrícia , Valle Javier , Silva Ruben D. M. , Gano Lurdes , Correia João D. G. , Andreu David , Castanho Miguel A. R. B. , Neves Vera
Published: May 2024

Blood–brain barrier (BBB) peptide-shuttles (BBBpS) are able to translocate the BBB and reach the brain. Despite the importance of brain targeting in pharmacology, BBBpS are poorly characterized. Currently, their development relies on the empiric assumption that cell-penetrating peptides (CPPs), with proven ability to traverse lipid membranes, will likewise behave as a BBBpS. The relationship between CPPs/BBBpS remains elusive and, to the best of our knowledge, has not hitherto been subject to thorough experimental scrutiny. In this work, we have identified/quantified the main physicochemical properties of BBBpS and then searched for CPPs with these properties, hence potential BBBpS. The specific features found for BBBpS are: (i) small size, (ii) none or few aromatic residues, (iii) hydrophobic, and (iv) slight cationic nature. Then, we selected the 10 scoring best in an ordinary least squares analysis, and tested them in vitro and in vivo. Overall, we identified the molecular determinants for brain targeting by peptides, devised a methodology that can be used to assist in the design of peptides with potential brain penetration from amino acid residue sequences, and found four new BBBpS within the CPP library.

Graphical Abstract
The influence of operation time for hip hemiarthroplasty on complication rates and mortality in patients with femoral neck fracture: a retrospective data analysis
Authors: Ramadanov Nikolai , Salzmann Mikhail , Voss Maximilian , Hable Robert , Hakam Hassan Tarek , Prill Robert , Dimitrov Dobromir , Becker Roland
Published: May 2024

Background

The aim of the present study was to investigate the influence of various factors, in particular operation time, on mortality and complication rates in patients with femoral neck fractures who have undergone hip hemiarthroplasty (HHA) and to determine a cut-off value above which mortality and complication rates increase significantly.

Methods

Cases of patients with femoral neck fracture treated with HHA between 1 January 2017 and 31 December 2023 were screened for eligibility. Multiple logistic regressions were calculated to determine which factors (patient age, experience of surgeon, patient sex, ASA score, time to surgery, operation time) influenced the incidence of complications and mortality. The exact cut-off value for complications and mortality was determined using the Youden index of the ROC curve (sensitivity vs. specificity) of logistic regression.

Results

A total of 552 patients were considered eligible for this study. During the 90-day follow-up period after HHA, 50 deaths and 34 complications were recorded, giving a mortality rate of 9.1%, and a complication rate of 6.2%. Of the 34 complications recorded, 32.3% were infections, 14.7% dislocations, 20.7% trochanteric avulsions, 11.8% periprosthetic fractures, 11.8% nerve injuries, and 8.8% deep vein thrombosis. The odds ratio (OR) of a patient experiencing a complication is 2.2% higher for every minute increase in operation time (Exponential Beta − 1 = 0.022; p = 0.0363). The OR of a patient dying is 8.8% higher for each year increase in age (Exponential Beta − 1 = 0.088; p = 0.0007). When surgery was performed by a certified orthopaedic surgeon the mortality rate lowered by 61.5% in comparison to the surgery performed by a trainee (1 – Exponential Beta = 0.594; p = 0.0120). Male patients have a 168.7% higher OR for mortality than female patients (Exponential Beta − 1 = 1.687; p = 0.0017). Patients with an operation time of ≥ 86 min. have a 111.8% higher OR for mortality than patients with an operation time of < 86 min. (Exponential Beta – 1 = 1.118).

Conclusion

This retrospective data analysis found that the risk of a patient experiencing a complication was 2.2% higher for every minute increase in operation time. Patients with an operation time above the cut-off of 86 min had a 111.8% higher risk of mortality than those with an operation time below the cut-off. Other influencing factors that operators should be aware of include patient age, male sex, and operator experience.
Value of estrogen pretreatment in patients with diminished ovarian reserve and elevated FSH on a line antagonist regimen: a retrospective controlled study
Authors: Lin Lin , Chen Guoyong , Liu Yun
Published: May 2024

Background

The key to enhancing the efficacy of antagonistic regimens in pregnancy is to better synchronize follicular growth during cycles of controlled ovarian stimulation (COS), especially in patients with diminished ovarian reserve (DOR). During in vitro fertilization-embryo transfer (IVF-ET) treatment, luteal phase estrogen pretreatment may enhance follicular development synchronization and yield of mature oocytes. However, the effect of estrogen pretreatment in DOR patients with elevated basal follicle-stimulating hormone (FSH) levels has not been well studied.

Methods

We retrospectively analyzed the clinical data of patients with elevated basal FSH levels and DOR (401 cycles) who underwent IVF/intracytoplasmic monosperm injection (ICSI)-assisted conception. Both groups were treated with a flexible gonadotropin-releasing hormone (GnRH) antagonist regimen and were further divided into two groups according to whether they received luteal estrogen pretreatment. There were 79 patients in the estrogen pretreatment group and 322 patients in the control group. On the second day of the menstrual cycle, gonadotropin (Gn) stimulation of the ovaries was initiated. The general characteristics, clinical, biological parameters and outcomes of the two groups were compared.

Results

The basic profiles of the two groups were similar (P > 0.05). More patients in the pretreatment group showed FSH rebound after gonadotropin (Gn) initiation, resulting in a significantly higher number of Gn days and total Gn than those in the control group (P < 0.05). There was no statistically significant difference in the number of days of antagonist use, follicle output rate (FORT), number of metaphase II(MII)eggs obtained, number of Two pronuclei (2PN) fertilized, number of D3 quality embryos, blastocyst formation rate, fresh embryo clinical pregnancy rate, cumulative pregnancy rate, and non-transferable embryo rate between the two groups (P > 0.05).

Conclusions

The use of luteal phase estrogen pretreatment in patients with elevated basal FSH combined with DOR resulted in high FSH levels after the release of negative feedback, which was detrimental to early follicular growth, did not increase the follicular output rate, may have increased the use and duration of controlled ovarian stimulation drugs, and did not increase the number of eggs gained or improve clinical outcomes.
Contributions to our knowledge on avian louse flies (Hippoboscidae: Ornithomyinae) with the first European record of the African species Ornithoctona laticornis
Authors: Keve Gergő , Csörgő Tibor , Kováts Dávid , Benke Anikó , Bende Attila Tibor , Ágoston Hunor , Mórocz Attila , Németh Ákos , Tamás Enikő Anna , Huber Attila , Gyurácz József , Keve Gábor , Kontschán Jenő , Németh Anna , Hornok Sándor
Published: May 2024

Background

Louse flies (Diptera, Hippoboscidae) are important blood-sucking parasites of birds and mammals with a worldwide distribution. The aim of our study was to collect louse flies from birds across multiple sites in Hungary and evaluate the effects of avian traits on louse fly–host relationships.

Methods

Between 2015 and 2022, 237 louse flies were collected from birds at multiple locations in Hungary. The louse flies were identified to species level by morphological and molecular methods. Louse fly species and their seasonal dynamics were analyzed.

Results

Six louse fly species were identified: Ornithomya avicularia, Ornithomya fringillina, Ornithomya biloba, Ornithomya chloropus, Ornithoica turdi and Ornithoctona laticornis. Results of statistical analyses indicated that habitat, migration habits and the feeding places of birds have significant effects on their possible role as hosts of O. avicularia, O. fringillina and O. turdi. Analysis of the temporal distribution of avian louse flies showed different seasonal patterns according to species. Phylogenetic analyses highlighted that O. turdi clustered separately from other members of the subfamily Ornithomyinae which thus did not form a monophyletic group.

Conclusions

This study presents one of the longest continuous collections of ornithophilic louse fly species in Europe so far. Avian traits were shown to influence louse-fly infestation. To our best knowledge, this is the first report on O. laticornis in Europe. The ability of this African louse fly species to survive in Europe, as demonstrated in the present study, may be an indication of its future establishment. Our findings, in accordance with previous reports, also indicated that the subfamily Ornithomyinae should be taxonomically revised.

Graphical Abstract
Correlation between the radial artery resistance index and the systemic vascular resistance index: a cross-sectional study
Authors: Rodríguez Aparicio Edith Elianna , Almanza Hernández David Fernando , Rubio Ramos Cristhian , Moreno Knudsen María Paula , Rodriguez Lima David Rene
Published: May 2024

Introduction

Ultrasound measurement of the radial resistance index (RRI) in the anatomical snuffbox has been proposed as a useful method for assessing the systemic vascular resistance index (SVRI). This study aims to establish the correlation between SVRI measured by pulmonary artery catheter (PAC) and RRI.

Methods

A cross-sectional study included all consecutive patients undergoing postoperative (POP) cardiac surgery with hemodynamic monitoring using PAC. Hemodynamic assessment was performed using PAC, and RRI was measured with ultrasound in the anatomical snuffbox. The Pearson correlation test was used to establish the correlation between RRI and SVRI measured using PAC. Hemodynamic behavior concerning RRI with a cutoff point of 1.1 (described to estimate under SVRI) was examined. Additionally, consistency between two evaluators was assessed for RRI using the intraclass correlation coefficient and Bland-Altman analysis.

Results

A total of 35 measurements were obtained. The average cardiac index (CI) was 2.73 ± 0.64 L/min/m², and the average SVRI was 1967.47 ± 478.33 dyn·s·m²/cm5. The correlation between RRI and SVRI measured using PAC was 0.37 [95% CI 0.045–0.62]. The average RRI was 0.94 ± 0.11. RRI measurements > 1.1 had a mean SVRI of 2120.79 ± 673.48 dyn·s·m²/cm5, while RRI measurements ≤ 1.1 had a mean SVRI of 1953.1 ± 468.17 dyn·s·m²/cm5 (p = 0.62). The consistency between evaluators showed an intraclass correlation coefficient of 0.88 [95% CI 0.78–0.93], and Bland-Altman analysis illustrated adequate agreement of RRI evaluators.

Conclusions

For patients in cardiac surgery POP, the correlation between the SVRI measured using PAC and the RRI measured in the anatomical snuffbox is low. Using the RRI as a SVRI estimator for patients is not recommended in this clinical scenario.
No association between peripheral serotonin-gene-related DNA methylation and brain serotonin neurotransmission in the healthy and depressed state
Authors: Bruzzone S. E. P. , Ozenne B. , Fisher P. M. , Ortega G. , Jensen P. S. , Dam V. H. , Svarer C. , Knudsen G. M. , Lesch K. P. , Frokjaer V. G.
Published: May 2024

Background

Methylation of serotonin-related genes has been proposed as a plausible gene-by-environment link which may mediate environmental stress, depressive and anxiety symptoms. DNA methylation is often measured in blood cells, but little is known about the association between this peripheral epigenetic modification and brain serotonergic architecture. Here, we evaluated the association between whole-blood-derived methylation of four CpG sites in the serotonin transporter (SLC6A4) and six CpG sites of the tryptophan hydroxylase 2 (TPH2) gene and in-vivo brain levels of serotonin transporter (5-HTT) and serotonin 4 receptor (5-HT4) in a cohort of healthy individuals (N = 254) and, for 5-HT4, in a cohort of unmedicated patients with depression (N = 90). To do so, we quantified SLC6A4/TPH2 methylation using bisulfite pyrosequencing and estimated brain 5-HT4 and 5-HTT levels using positron emission tomography. In addition, we explored the association between SLC6A4 and TPH2 methylation and measures of early life and recent stress, depressive and anxiety symptoms on 297 healthy individuals.

Results

We found no statistically significant association between peripheral DNA methylation and brain markers of serotonergic neurotransmission in patients with depression or in healthy individuals. In addition, although SLC6A4 CpG2 (chr17:30,236,083) methylation was marginally associated with the parental bonding inventory overprotection score in the healthy cohort, statistical significance did not remain after accounting for blood cell heterogeneity.

Conclusions

We suggest that findings on peripheral DNA methylation in the context of brain serotonin-related features should be interpreted with caution. More studies are needed to rule out a role of SLC6A4 and TPH2 methylation as biomarkers for environmental stress, depressive or anxiety symptoms.