bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of hyperinflation: comparison of Global Lung Function Initiative and European Community for Steel and Coal lung volume reference equations
Authors: Roodenburg Sharyn A. , van Dijk Marlies , Augustijn Sonja W.S. , Klooster Karin , Slebos Dirk-Jan , Hartman Jorine E.
Published: February 2024

Background

Assessment of static hyperinflation severity is crucial to identify COPD patients eligible for lung volume reduction. The current recommendation of residual volume ≥175% predicted may need to be reconsidered owing to potential differences between the Global Lung Function Initiative (GLI) and the European Community for Steel and Coal (ECSC) reference equations for residual volume and concerns about using percentage of predicted.

Methods

We compared the residual volume reference values derived from the GLI and ECSC equations using mathematically simulated data and used a receiver operating characteristic curve to establish a new GLI-derived z-score cut-off for residual volume using body plethysmography data from patients with severe COPD.

Results

The GLI reference equation for residual volume consistently yields a lower predicted residual volume for individuals with an average or below-average height (females ≤163 cm and males ≤177 cm). Our clinical cohort consisted of 1011 patients with COPD (graded using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria as 38% GOLD 3 and 59% GOLD 4). In this cohort, a GLI-derived residual volume z-score of ≥2.9 could accurately replace the ECSC-derived 175% predicted cut-off and a z-score of ≥3.5 was established for the 200% predicted cut-off.

Conclusion

There are substantial differences in predicted residual volume values between the GLI and ECSC equations, with the GLI generally yielding a lower predicted residual volume in the majority of individuals. A GLI-derived residual volume z-score of ≥2.9 could be used to replace the currently used cut-off of ≥175% predicted to identify potential lung volume reduction candidates.
Association between upper and lower respiratory disease among patients with primary ciliary dyskinesia: an international study
Authors: Lam Yin Ting , Papon Jean-François , Alexandru Mihaela , Anagiotos Andreas , Armengot Miguel , Boon Mieke , Burgess Andrea , Calmes Doriane , Crowley Suzanne , Dheyauldeen Sinan Ahmed D. , Emiralioglu Nagehan , Erdem Eralp Ela , van Gogh Christine , Gokdemir Yasemin , Haarman Eric G. , Harris Amanda , Hayn Isolde , Ismail-Koch Hasnaa , Karadag Bülent , Kempeneers Céline , Kieninger Elisabeth , Kim Sookyung , Lorent Natalie , Ozcelik Ugur , Pioch Charlotte , Raidt Johanna , Reula Ana , Roehmel Jobst , Sperstad Kennelly Synne , Yiallouros Panayiotis ,   on behalf of the EPIC-PCD team, Goutaki Myrofora
Published: February 2024

Introduction

Nearly all patients with primary ciliary dyskinesia (PCD) report ear–nose–throat (ENT) symptoms. However, scarce evidence exists about how ENT symptoms relate to pulmonary disease in PCD. We explored possible associations between upper and lower respiratory disease among patients with PCD in a multicentre study.

Methods

We included patients from the ENT Prospective International Cohort (EPIC-PCD). We studied associations of several reported ENT symptoms and chronic rhinosinusitis (defined using patient-reported information and examination findings) with reported sputum production and shortness of breath, using ordinal logistic regression. In a subgroup with available lung function results, we used linear regression to study associations of chronic rhinosinusitis and forced expiratory volume in 1 s (FEV1) accounting for relevant factors.

Results

We included 457 patients (median age 15 years, interquartile range 10–24 years; 54% males). Shortness of breath associated with reported nasal symptoms and ear pain of any frequency, often or daily hearing problems, headache when bending down (OR 2.1, 95% CI 1.29–3.54) and chronic rhinosinusitis (OR 2.3, 95% CI 1.57–3.38) regardless of polyp presence. Sputum production associated with daily reported nasal (OR 2.2, 95% CI 1.20–4.09) and hearing (OR 2.0, 95% CI 1.10–3.64) problems and chronic rhinosinusitis (OR 2.1, 95% CI 1.48–3.07). We did not find any association between chronic rhinosinusitis and FEV1.

Conclusion

Reported upper airway symptoms and signs of chronic rhinosinusitis associated with reported pulmonary symptoms, but not with lung function. Our results emphasise the assessment and management of upper and lower respiratory disease as a common, interdependent entity among patients with PCD.
Effects of square dance exercise on cognitive function in elderly individuals with mild cognitive impairment: the mediating role of balance ability and executive function
Authors: Wang Heng , Pei Zhengguo , Liu Yangyang
Published: February 2024

Background

Square dancing is a kind of aerobic fitness exercise without environmental restrictions that yields many benefits for physical and mental health; this exercise is popular among middle-aged and elderly people in China and in these populations in other countries. This study aimed to evaluate the effects of square dance exercise on the overall cognitive function of elderly individuals with mild cognitive impairment (MCI) and to research its mechanisms.

Methods

A total of 60 elderly people with MCI (60–69 years old) without square dance experience were selected and randomly divided into an experimental group (n = 30) and a control group (n = 30). The experimental group participated in square dance exercise for 12 weeks, while the control group maintained their original lifestyle habits. One week before and after the intervention period, the overall cognitive function, physical fitness, and executive function of both groups were measured.

Results

According to the results, square dance exercise directly improved the overall cognitive function of elderly individuals with MCI and indirectly affected overall cognitive function through the mediating effects of balance ability and executive function.

Conclusions

Square dance exercise represents a nonpharmacological intervention for the prevention and treatment of MCI. Importantly, it is best to combine this exercise with other forms of physical exercise and comprehensive treatment programs such as cognitive training, social interaction, and psychological intervention to realize its maximum effect.
Prevalence of Rifampicin resistance tuberculosis among presumptive tuberculosis patients in Egypt-2021: a national health facility-based survey
Authors: Amin Wagdy , Gadallah Mohsen , Salah Amal , Rady Mervat
Published: February 2024

Background

The magnitude of MDR-TB cases was noticeable in Egypt. However, the last national survey was 11-years ago. The current survey was conducted to determine the prevalence of rifampicin resistance among sputum smear-positive pulmonary tuberculosis patients in Egypt.

Methods

A national health facility-based cross-sectional study was conducted in 14 randomly selected governorates in Egypt between August 2020 and September 2021. All presumptive TB cases, either new or previously treated according to WHO definitions, with no gender, age, or nationality limitations, and provided informed consent were included in the study. Each patient completed a case report form (CRF). The CRF included socio-demographic and clinical data. Sputum samples were collected according to standard techniques and cultured on Lowenstein-Jensen (L-J) medium. Gene X-pert test was carried out first on the samples for simultaneous identification of MTB and rifampicin resistance. The prevalence of RR was calculated using crude, cluster, and weighted methods. Factors associated with RR were analyzed by bivariate and multivariate techniques.

Results

Among the total 849 presumptive TB patients enrolled in the study, 710 (83.6%) patients were subjected to Gene X-pert testing (MTB/RIF). The crude prevalence of RR was 3.32% (95% CI: 1.89–4.76%) among the new cases and 9.46% (95% CI: 2.63–16.29%) among the retreated cases with an overall estimate of 3.99%; (95% CI: 2.51–5.47%). By cluster analysis the overall prevalence of RR was 5.01% (95% CI: 2.90–7.13). Factors associated with the prevalence of RR were co-morbidity with bronchial asthma, drug abuse and history of contact with a family member with TB.

Conclusion

The prevalence of RR among either new or retreated cases TB patients was lower than the previous Egyptian rates in 2010–2012. The strongest predictor associated with RR was comorbidity with bronchial asthma.
Geographic differences in pharmacotherapy patterns and outcomes of acute ischemic stroke in China
Authors: Li Ying , Ou Qianhua , Lu Yuxuan , Shen Zhiyuan , Li Jieyu , Zhang Zhuangzhuang , Tai Liwen , Li Guozhong , Chen Huisheng , Zhang Guiru , Zhang Lei , Sun Xuwen , Qiu Jinhua , Wei Yan , Zhu Sainan , Wang Zhaoxia , Sun Weiping , Huang Yining
Published: February 2024

Background

Vast economic and healthcare status discrepancies exist among regions in China, contributing to different treatment patterns. This study was aimed to investigate the current status of pharmacotherapy for acute ischemic stroke (AIS) and outcomes in China and explore the geographic variation in stroke care.

Methods

This study was a multicenter prospective registry study, which collected the data of patients with AIS from 80 hospitals in 46 cities in 2015–2017 across China. Poor functional outcome defined as a modified Rankin Scale score of 3–6 was assessed at 3 and 12 months. Multivariate logistic regression was used.

Results

Among 9973 eligible patients, the number of receiving intravenous thrombolysis (IVT), antiplatelet agents, anticoagulants, statin and human urinary kallidinogenase was 429 (4.3%), 9363 (93.9%), 1063 (10.7%), 6828 (74.7%) and 5112 (51.2%), respectively. Multivariable analysis showed IVT use in northeastern was significantly more frequent than in eastern region (OR = 3.17, 95% CI, 2.53–3.99), while the antiplatelets agents use were less frequent (OR = 0.46, 95%CI: 0.38–0.57). The proportions of poor outcomes at 3 and 12 months were 20.7% and 15.8%, respectively. Multivariate analysis showed AIS patients from northeastern and central region had significantly lower risk of poor outcome at month 3 and 12 than those from eastern region (all P < 0.05).

Conclusions

There was a low IVT use and a high antiplatelet agent and statin use for AIS in China. The pharmacotherapy and prognosis of AIS had variation by geographic region.

Trial registration

This study was registered with ClinicalTrials.gov (NCT02470624).
SIRT7 promotes the proliferation and migration of anaplastic thyroid cancer cells by regulating the desuccinylation of KIF23
Authors: Wu Yongkang , Chen Weijie , Miao Huilai , Xu Tuo
Published: February 2024

Objective

This study was designed to investigate the regulatory effects of kinesin family member (KIF) 23 on anaplastic thyroid cancer (ATC) cell viability and migration and the underlying mechanism.

Methods

Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was used to analyze the levels of KIF23 in ATC cells. Besides, the effects of KIF23 and sirtuin (SIRT) 7 on the viability and migration of ATC cells were detected using cell counting kit-8, transwell and wound healing assays. The interaction between SIRT7 and KIF23 was evaluated by co-immunoprecipitation (Co-IP) assay. The succinylation (succ) of KIF23 was analyzed by western blot.

Results

The KIF23 expression was upregulated in ATC cells. Silencing of KIF23 suppressed the viability and migration of 8505C and BCPAP cells. The KIF23-succ level was decreased in ATC cells. SIRT7 interacted with KIF23 to inhibit the succinylation of KIF23 at K537 site in human embryonic kidney (HEK)-293T cells. Overexpression of SIRT7 enhanced the protein stability of KIF23 in HEK-293T cells. Besides, overexpression of KIF23 promoted the viability and migration of 8505C and BCPAP cells, which was partly blocked by silenced SIRT7.

Conclusions

SIRT7 promoted the proliferation and migration of ATC cells by regulating the desuccinylation of KIF23.
Household factors and prevalence of squalor: meta-analysis and meta-regression
Authors: Norton Mike , Kellett Stephen , Huddy Vyv , Simmonds-Buckley Melanie
Published: February 2024

Background

Severe domestic squalor occurs when a person lives in a dwelling that is significantly unclean, disorganised and unhygienic. The limited previous research has primarily focused on the characteristics of those who live in squalor and the associated risk factors. Robust and reliable studies of squalor prevalence have not been conducted. This study sought to produce a reliable estimate of the point prevalence of squalor.

Methods

Using data from 13-years of the English Housing Survey, N = 85,681 households were included in a prevalence meta-analysis. Squalor prevalence over time, subgroup analysis and logistic regression investigated the role played by household and community characteristics.

Results

The point prevalence of squalor was estimated to be 0.85% and squalor was seen to decrease significantly over time. More significant community deprivation, a rented dwelling, lower income and high numbers of people in the home was associated with a greater risk of squalor.

Conclusions

Squalor prevalence was higher than previous estimates and supports community care services in associated service planning. The results regarding household characteristics help to inform which households and individuals may be at a higher risk of living in squalid conditions.
The effectiveness and pharmacoeconomic study of using different corticosteroids in the treatment of hypersensitivity pneumonitis
Authors: Elhennawy Marwa G. , Akl Yosri , Abbassi Maggie , Sabry Nirmeen A.
Published: February 2024

Purpose

Interstitial lung diseases (ILDs) are caused by inflammation and/or fibrosis of alveolar walls resulting in impaired gas exchange. Hypersensitivity pneumonitis (HP) is the third most common type of ILDs. Corticosteroids are the mainstay treatment for HP. The use of intramuscular (IM) betamethasone or intravenous (IV) dexamethasone as weekly pulse doses has shown higher benefit than daily oral prednisolone for HP patients. The aim of this study is to directly compare different corticosteroids in terms of effectiveness and in monetary values and perform an economic evaluation.

Methods

One hundred and seven patients were tested for pulmonary function tests (PFTs) and inflammatory markers to assess the treatment effectiveness. A cost-effectiveness analysis (CEA) was performed. ICERs between 3 treatment groups were calculated.

Results

Post treatment, Krebs von den Lungen-6 (KL-6) levels significantly improved in betamethasone group from 723.22 ± 218.18 U/ml to 554.48 ± 129.69 U/ml (p = 0.001). A significant improvement in erythrocyte sedimentation rate (ESR) occurred in the dexamethasone group from 56.12 ± 27.97 mm to 30.06 ± 16.04 mm (p = 0.048). A significant improvement in forced expiratory volume (FEV1), forced vital capacity (FVC) and six-minute walk distance (6MWD) was observed within the three treatment groups. A significant improvement in oxygen desaturation percentage (SpO2) occurred within dexamethasone and betamethasone groups. Betamethasone and dexamethasone were found more cost-effective than prednisolone as their ICERs fell in quadrant C. Furthermore, ICER between betamethasone and dexamethasone was performed; a small difference in cost was found compared to the higher benefit of betamethasone.

Conclusion

Betamethasone and dexamethasone were found to be more effective than prednisolone in improving the inflammatory reaction and the clinical features of HP patients. Betamethasone was found to be the best intervention in terms of cost against the effect.
Association of per- and polyfluoroalkyl substances (PFAS) with periodontitis: the mediating role of sex hormones
Authors: Wu Yuxuan , Qiu Yu , Wu Yuying , Li Husheng , Yang Han , Deng Qingrong , He Baochang , Yan Fuhua , Li Yanfen , Chen Fa
Published: February 2024

Objectives

To investigate the association between serum per- and polyfluoroalkyl substances (PFAS) and periodontitis, and further explore the possible mediating role of sex hormones in this association.

Methods

We extracted data from National Health and Nutrition Examination Survey (NHANES) 2009–2014. Univariable and multivariable logistic regression models were performed to investigate the association between serum levels of seven PFASs and periodontitis. Bayesian kernel machine regression (BKMR) was conducted to assess the joint effect of PFASs in mixtures. Mediation analyses were used to explore the potential mediating role of sex hormones.

Results

Participants with periodontitis had higher concentrations of serum perfluorooctane sulfonate (PFOS) and perfluorononanoic acid (PFNA) than those without periodontitis (both P < 0.05). In fully adjusted models, high serum concentrations of PFOS and PFNA were positively associated with periodontitis (tertile 3 vs. tertile 1: prevalence ratio (PR) = 1.19 for PFOS, 95% CI: 1.01–1.39; PR = 1.17 for PFNA, 95% CI: 1.02–1.34). The results from the BKMR models consistently showed a positive association between PFAS mixtures and periodontitis. Of note, testosterone and the ratio of testosterone to estradiol significantly mediated the relationship between high level of PFOS and periodontitis, accounting for 16.5% and 31.7% of the total effect, respectively. Sensitivity analyses yielded similar results when using periodontal clinical indices (mean loss of attachment, mean periodontal probing depth, and the number of teeth) as dependent variables.

Conclusions

These findings provide evidence to support a positive association between certain PFASs and periodontitis, which might be partially mediated by sex hormones.
Evaluation of the amount of residual monomer released from different flowable composite resins
Authors: Odabasi Didem , Guler Cigdem , Kucukaslan Didem
Published: February 2024

Today, resin materials are used in the restoration of permanent and deciduous teeth or as fissure sealants. The materials can contain different types of monomers (Bis-GMA, UDMA, TEGDMA). These monomers can be released into the oral cavity after polymerization. Residual monomers released from resin-containing restorative materials after polymerization have been reported to have negative effects on mechanical properties. The aim of our study is to evaluate the amount of residual monomers released after polymerization of different flowable composite resin materials using two different modes of LED light source. Composite disc samples (8 mm diameter/2 mm depth) prepared for each material group were polymerized using two different modes of the LED light device (Standard mode and extra power mode). HPLC (High Performance Liquid Chromatography) device was used to measure the amount of residual monomer release at 1 h, 1 day, 3 days and 7 days periods. Pairwise comparison of the differences between the materials was performed by Post-hoc test. For each residual monomer, the Kruskal Wallis test was used to analyze the difference between the materials in standard mode and the difference between the materials in extra power mode. According to the results of the study; Grandio flow flowable composite showed the highest release of TEGDMA and Bis-GMA while SDR® Flow flowable composite showed the lowest release of TEGDMA, Bis-GMA and UDMA. For all materials, the extra power mode resulted in more residual monomer release. TEGDMA and Bis-GMA release was detected in all tested flowable composites at all time periods.
Exploring spirituality, religion and life philosophy among parents of children receiving palliative care: a qualitative study
Authors: Miquel Pau , Clemente Ignasi , Ciccorossi Mario
Published: February 2024

Background

Few studies have examined the spiritual environment of parents of children receiving palliative care in Southern European countries, which are mostly characterized by secularization (or the abandonment of traditional religiosity) and an increase of cultural and religious diversities resulting in a much broader spectrum of spiritual and religious beliefs. This study aimed to explore the parents’ own spirituality, religiosity, and philosophy of life in coping with the care of their child with palliative needs.

Methods

Qualitative interviews of 14 parents of children included in a palliative care program in a pediatric hospital in Barcelona, Spain. Inclusion criteria were parents of children who have been cared for the palliative care program for a minimum of 3 months and who displayed a willingness to talk about their personal experiences and gave written consent. Interviews were audio-recorded, transcribed by an independent service, and analyzed on a case-by-case basis using Interpretative Phenomenological Analysis.

Results

The three domains identified were life philosophy, relational, and transcendent. Life philosophy included principles that guided parents’ decision-making, and how the onset of their child’s serious illness had promoted a change in their values. Relational was focused on how they perceived themselves (e.g. motherhood), others (e.g. one’s own child exceptionality), and the way they believed others perceived and supported them (e.g. relatives, friends, and healthcare providers). The transcendent domain involved God-related concepts, divinity and divine intervention (e.g. a miracle as an interpretive framework for that which cannot be explained within scientific knowledge limitations).

Conclusions

Inflexible categories identifying parents as having a particular religious faith tradition are not sufficient to capture the interrelation of knowledges (ethical, religious, scientific) that each parent generates when faced with their child receiving palliative care. Clinicians should explore parents’ spirituality in an individualized way that responds to the uniqueness of their experiential process.
The effect of Oenothera biennis (Evening primrose) oil on inflammatory diseases: a systematic review of clinical trials
Authors: Sharifi Melika , Nourani Nasim , Sanaie Sarvin , Hamedeyazdan Sanaz
Published: February 2024

Background

Evening primrose oil (EPO), extracted from the seeds of Oenothera biennis, has gained attention for its therapeutic effects in various inflammatory conditions.

Method

We performed a systematic search in multiple databases and defined the inclusion criteria based on the following PICOs: P: Patients with a form of inflammatory condition, I: EPO, C: Placebo or other therapeutic interventions, O: changes in inflammatory markers or patients’ symptoms; S: randomized controlled trials. The quality of the RCTs was evaluated using Cochrane’s RoB tool.

Results

Several conditions were investigated in the literature. In rheumatoid arthritis, mixed results were observed, with some studies reporting significant improvements in symptoms while others found no significant impact. EPO showed some results in diabetes mellitus, atopic eczema, menopausal hot flashes, and mastalgia. However, it did not demonstrate effectiveness in chronic hand dermatitis, tardive dyskinesia, psoriatic arthritis, cystic fibrosis, hepatitis B, premenstrual syndrome, contact lens-associated dry eyes, acne vulgaris, breast cyst, pre-eclampsia, psoriasis, or primary Sjogren's syndrome. Some results were reported from multiple sclerosis after EPO consumption. Studies in healthy volunteers indicated no significant effect of EPO on epidermal atrophy, nevertheless, positive effects on the skin regarding hydration and barrier function were achieved.

Conclusion

Some evidence regarding the potential benefits of EPO in inflammatory disorders were reported however caution is due to the limitations of the current survey. Overall, contemporary literature is highly heterogeneous and fails to provide strong recommendations regarding the efficacy of EPO on inflammatory disorders. Further high-quality studies are necessitated to draw more definite conclusions and establish O. biennis oil effectiveness as an assuring treatment option in alleviating inflammatory conditions.
Patients’ perceptions of use, needs, and preferences related to a telemedicine solution for HIV care in a Norwegian outpatient clinic: a qualitative study
Authors: Johnsen Hege Mari , Øgård-Repål Anita , Martinez Santiago Gil , Fangen Kim , Bårdsen Aas Kristin , Ersfjord Ellen Margrete Iveland
Published: February 2024

Background

Telemedicine in outpatient services for people living with human immunodeficiency virus (PLHIV) was scaled up during the COVID-19 pandemic as services transitioned to remote care. Many studies have reported on the challenges and advantages of telemedicine care during the pandemic. However, there is limited research on the provision of telemedicine human immunodeficiency virus (HIV) care beyond the COVID-19 pandemic, which entails different telemedicine components and focuses on ways to improve the telemedicine experience for patients. This study aimed to explore PLHIV’s perceptions of use, needs, and preferences related to a telemedicine solution for HIV care in an outpatient clinic in Norway. The telemedicine solution included a pre-consultation questionnaire, asynchronous digital messages, and video consultation.

Methods

Qualitative interviews were conducted with 12 PLHIV. The interviews were analysed using thematic analysis.

Results

We identified four main themes that covered the participants’ perceptions, needs, and preferences: (1) perceived usability, (2) maintaining confidentiality, (3) accommodating personal preferences, and (4) perceived usefulness. Some participants had difficulty logging into the telemedicine solution. Other participants suggested additional functionalities, such as picture sharing and access to test result. Telemedicine care enabled the avoidance of stigmatising clinic experiences, although a few participants reported concerns about confidentiality and data security. Accommodating personal preferences and needs in terms of the type of consultations (in-person or video) and frequency of visits was essential to the participants. With telemedicine care, participants felt more in control of their own lives, perceiving that it increased their perceived quality of life and saved them both time and money for travelling to the clinic.

Conclusions

Our study identified several specific needs and preferences related to the assessed technical solution and the provision of current and future telemedicine care services. Nevertheless, the telemedicine solution was perceived as a usable, flexible, and person-centred approach to HIV care, contributing to accommodating the participants’ personal preferences. However, healthcare professionals need to ensure that individual requirements and preferences are consistent with evidence-based follow-up and supported by person-centred care. Thus, the practice of shared decision making is important in telemedicine care.
Application of the Weighted-Incidence Syndromic Combination Antibiogram (WISCA) to guide the empiric antibiotic treatment of febrile neutropenia in oncological paediatric patients: experience from two paediatric hospitals in Northern Italy
Authors: Liberati Cecilia , Donà Daniele , Maestri Linda , Petris Maria Grazia , Barbieri Elisa , Gallo Elisa , Gallocchio Jacopo , Pierobon Marta , Calore Elisabetta , Zin Annachiara , Brigadoi Giulia , Mariani Marcello , Mesini Alessio , Saffioti Carolina , Ugolotti Elisabetta , Gregori Dario , Giaquinto Carlo , Castagnola Elio , Biffi Alessandra
Published: February 2024

Background

Guidelines about febrile neutropenia in paediatric patients are not homogeneous; the best empiric treatment of this condition should be driven by local epidemiology. The Weighted-Incidence Syndromic Combination Antibiogram (WISCA) addresses the need for disease-specific local susceptibility evidence that could guide empiric antibiotic prescriptions based on outcome estimates of treatment regimens obtained as a weighted average of pathogen susceptibilities. This study developed a WISCA model to inform empirical antibiotic regimen selection for febrile neutropenia (FN) episodes in onco-haematological paediatric patients treated at two Italian paediatric tertiary centres.

Methods

We included blood cultures from patients with a bloodstream infection and neutropenia admitted to the Paediatric Haematology-Oncology wards in Padua and Genoa Hospitals from 2016 to 2021. WISCAs were developed by estimating the coverage of 20 antibiotics as monotherapy and of 21 combined regimens with a Bayesian probability distribution.

Results

We collected 350 blood cultures, including 196 g-negative and 154 g-positive bacteria. Considering the most used antibiotic combinations, such as piperacillin–tazobactam plus amikacin, the median coverage for the pool of bacteria collected in the study was 78%. When adding a glycopeptide, the median coverage increased to 89%, while the replacement of piperacillin–tazobactam with meropenem did not provide benefits. The developed WISCAs showed that no monotherapy offered an adequate coverage rate for the identified pathogens.

Conclusions

The application of WISCA offers the possibility of maximizing the clinical utility of microbiological surveillance data derived from large hospitals to inform the choice of the best empiric treatment while contributing to spare broad-spectrum antibiotics.
A neuromechanical model characterizing the motor planning and posture control in the voluntary lean in Parkinson’s disease
Authors: Jasimi Zindashti Niromand , Rahmati Zahra , Mohebbi Abolfazl , Behzadipour Saeed
Published: February 2024

Parkinson’s disease targets patients’ cognitive and motor abilities, including postural control. Many studies have been carried out to introduce mathematical models for a better understanding of postural control in such patients and the relation between the model parameters and the clinical assessments. So far, these studies have addressed this connection merely in static tests, such as quiet stance. The aim of this study is to develop a model for voluntary lean, and as such, identify the model parameters for both PD patients and healthy subjects from experimental data. The proposed model comprises planning and control sections. The model parameters for the planning section were extracted from the time response characteristics. Parameters for the control section were identified based on the spatial characteristics of the center-of-pressure (COP) response using an optimization process. 24 PD patients along with 24 matched healthy subjects participated in the study. The results showed a significant difference between the two groups in terms of temporal parameters for the planning section. This difference emphasizes bradykinesia as an essential symptom of PD. Also, differences were found for the postural control section. In all directions, the proportional gain of the feedback controller was significantly larger in PD patients; however, the gain of the feedforward controller was significantly smaller in PD patients. Furthermore, the control gains were strongly correlated with the clinical scales (Functional Reach Test and Unified Parkinson's Disease Rating Scale) in certain directions. In conclusion, the new model helps to better understand and quantify some PD symptoms in voluntary lean tasks.
Cultivation of microalgae–bacteria consortium by waste gas–waste water to achieve CO2 fixation, wastewater purification and bioproducts production
Authors: Kong Wenwen , Kong Jia , Feng Shuo , Yang TianTian , Xu Lianfei , Shen Boxiong , Bi Yonghong , Lyu Honghong
Published: February 2024

The cultivation of microalgae and microalgae–bacteria consortia provide a potential efficient strategy to fix CO2 from waste gas, treat wastewater and produce value-added products subsequently. This paper reviews recent developments in CO2 fixation and wastewater treatment by single microalgae, mixed microalgae and microalgae–bacteria consortia, as well as compares and summarizes the differences in utilizing different microorganisms from different aspects. Compared to monoculture of microalgae, a mixed microalgae and microalgae–bacteria consortium may mitigate environmental risk, obtain high biomass, and improve the efficiency of nutrient removal. The applied microalgae include Chlorella sp., Scenedesmus sp., Pediastrum sp., and Phormidium sp. among others, and most strains belong to Chlorophyta and Cyanophyta. The bacteria in microalgae–bacteria consortia are mainly from activated sludge and specific sewage sources. Bioengineer in CBB cycle in microalgae cells provide effective strategy to achieve improvement of CO2 fixation or a high yield of high-value products. The mechanisms of CO2 fixation and nutrient removal by different microbial systems are also explored and concluded, the importance of microalgae in the technology is proven. After cultivation, microalgae biomass can be harvested through physical, chemical, biological and magnetic separation methods and used to produce high-value by-products, such as biofuel, feed, food, biochar, fertilizer, and pharmaceutical bio-compounds. Although this technology has brought many benefits, some challenging obstacles and limitation remain for industrialization and commercializing.

Graphical Abstract
Comparison of the level of physical activity after the COVID-19 pandemic in Poland, Slovakia and the Czech Republic
Authors: Líška D. , Rutkowski S. , Oplatková L. , Sýkora J. , Pupiš M. , Novák J. , Urbářová E. , Rutkowska A. , Busch A. , Kobesova Alena
Published: February 2024

Background

The COVID-19 pandemic was associated with limited physical activity (PA) of most of the world’s population. This cross-sectional prospective study aimed to assess the levels of PA of university students in Poland, Czech Republic and Slovakia after COVID-19 using the International Physical Activity Questionnaire Short Form (IPAQ-SF).

Methods

A total of 2635 students completed questionnaires regarding their PA levels using the IPAQ-SF between September and December 2022.

Results

PA measured by metabolic equivalent of task (MET) scores, varied between the three countries: Slovakia median MET-minutes/week score 4459.9; Czech Republic 3838.8 Poland 3567.1. The results of the post hoc analysis revealed there were significant differences in MET-minutes/week values between the Czech Republic and Poland (p < 0.035) as well as between the Czech Republic and Slovakia (p < 0.037). The analysis of energetic expenditure during walking revealed that students from the Czech Republic and Slovakia had higher median MET-min/weeks values (Czech 2284.1; Slovak 2467.1) compared to their Polish (1536.1) peers (p < 0.001). Polish cohort presented with significantly higher body mass index (BMI) (p < 0.001) than Czech and Slovak groups (BMI Czech: 22.3; Slovak 22.8; Polish 23.8).

Conclusions

Significant differences in PA levels between the Czech Republic, Poland, and Slovakia university students were identified. Slovakia showed the highest median PA measured as a MET score, and Poland showed the lowest. Compared to available pre-COVID studies it seems the total level of PA in the observed cohorts has not returned to the pre-COVID levels and students remain less active.
Prediction of esophagogastroduodenoscopy therapeutic usefulness for in-ICU suspected upper gastrointestinal bleeding: the SUGIBI score study
Authors: Penaud Victor , Vieille Thibault , Urbina Tomas , Bonny Vincent , Gabarre Paul , Missri Louai , Gasperment Maxime , Baudel Jean-Luc , Carbonell Nicolas , Beurton Alexandra , Chaibi Sayma , Retbi Aurélia , Fartoukh Muriel , Piton Gaël , Guidet Bertrand , Maury Eric , Ait-Oufella Hafid , Joffre Jérémie
Published: February 2024

Background

Suspected upper gastrointestinal bleeding (SUGIB) is a common issue during ICU stay. In the absence of specific guidelines on the indication and timing of esophagogastroduodenoscopy (EGD), there is substantial variability in EGD indication depending on accessibility and clinical presentation. This study aimed to investigate factors associated with the need for per-EGD hemostatic therapy and to create a score predicting therapeutic benefit of emergency bedside EGD in ICU patients with SUGIB.

Methods

We conducted a retrospective study in our ICU to identify factors associated with the need for hemostatic procedure during EGD performed for SUGIB. From this observational cohort, we derived a score predicting the need for hemostasis during EGD, the SUGIBI score. This score was subsequently validated in a retrospective multicenter cohort.

Results

Two hundred fifty-five patients not primarily admitted for GI bleeding who underwent a bedside EGD for SUGIB during their ICU stay were analyzed. The preeminent EGD indication were anemia (79%), melena (19%), shock (14%), and hematemesis (13%). EGD was normal in 24.7% of cases, while primary lesions reported were ulcers (23.1%), esophagitis (18.8%), and gastritis (12.5%). Only 12.9% of patients underwent hemostatic endotherapy during EGD. A SUGIBI score < 4 had a negative predictive value of 95% (91–99) for hemostatic endotherapy [AUC of 0.81; 0.75–0.91 (p < 0.0001)]. The SUGIBI score for predicting the need for an EGD-guided hemostatic procedure was next validated in a multicenter cohort with an AUC of 0.75 (0.66–0.85) (p < 0.0001), a score < 4 having a negative predictive value of 95% (92–97).

Conclusions

Our study shows that the therapeutic usefulness of bedside emergency EGD for SUGIB in critically ill patients is limited to a minority of patients. The SUGIBI score should help clinicians stratify the probability of a therapeutic EGD.
The paradoxical role of cytokines and chemokines at the tumor microenvironment: a comprehensive review
Authors: Abdul-Rahman Toufik , Ghosh Shankhaneel , Badar Sarah M. , Nazir Abubakar , Bamigbade Gafar Babatunde , Aji Narjiss , Roy Poulami , kachani Hajar , Garg Neil , Lawal Lukman , Bliss Zarah Sophia Blake , Wireko Andrew Awuah , Atallah Oday , Adebusoye Favour Tope , Teslyk Tetiana , Sikora Kateryna , Horbas Viktoriia
Published: February 2024

Tumor progression and eradication have long piqued the scientific community's interest. Recent discoveries about the role of chemokines and cytokines in these processes have fueled renewed interest in related research. These roles are frequently viewed as contentious due to their ability to both suppress and promote cancer progression. As a result, this review critically appraised existing literature to discuss the unique roles of cytokines and chemokines in the tumor microenvironment, as well as the existing challenges and future opportunities for exploiting these roles to develop novel and targeted treatments. While these modulatory molecules play an important role in tumor suppression via enhanced cancer-cell identification by cytotoxic effector cells and directly recruiting immunological effector cells and stromal cells in the TME, we observed that they also promote tumor proliferation. Many cytokines, including GM-CSF, IL-7, IL-12, IL-15, IL-18, and IL-21, have entered clinical trials for people with advanced cancer, while the FDA has approved interferon-alpha and IL-2. Nonetheless, low efficacy and dose-limiting toxicity limit these agents' full potential. Conversely, Chemokines have tremendous potential for increasing cancer immune-cell penetration of the tumor microenvironment and promoting beneficial immunological interactions. When chemokines are combined with cytokines, they activate lymphocytes, producing IL-2, CD80, and IL-12, all of which have a strong anticancer effect. This phenomenon opens the door to the development of effective anticancer combination therapies, such as therapies that can reverse cancer escape, and chemotaxis of immunosuppressive cells like Tregs, MDSCs, and TAMs.
Outcomes of acute myeloid leukemia patients undergoing allogeneic hematopoietic stem cell transplantation: validation, comparison and improvement of 2022 ELN genetic risk system
Authors: Zhang Haixiao , Zheng Xinhui , Guo Wenwen , Xia Yonghui , Zhang Rongli , Zhai Weihua , Chen Xin , Ma Qiaoling , Yang Donglin , Wei Jialin , Pang Aiming , He Yi , Feng Sizhou , Wang Jianxiang , Han Mingzhe , Jiang Erlie
Published: February 2024

The 2022 European LeukemiaNet (ELN) updated the previous risk classification published in 2017 but the prognostic significance for allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains unclear. We enrolled 600 acute myeloid leukemia (AML) patients who underwent allo-HSCT to validate ELN-2022 genetic risk system and compared it with ELN-2017. There were 214 (35.67%), 162 (27.0%), and 224 (37.33%) patients in ELN-2022 favorable-, intermediate-, and adverse-risk group respectively and 86 patients (14.33%) experienced a shift in risk stratification compared to ELN-2017. Median and maximum follow-up time were 2.89 (95% CI 2.67 to 3.03) years and 8.78 years. The median overall survival (OS) was 73.8% (95% CI 67.5% to 80.3%), 63.9% (95% CI 56.7% to 72.0%) and 57.6% (95% CI 50.4% to 65.9%) in ELN-2022 favorable-, intermediate-, and adverse-risk group (P < 0.001). OS shortened significantly as the ELN-2022 risk stratification increased but didn’t significantly in ELN-2017 intermediate-risk compared to favorable-risk. Both ELN-2022 and ELN-2017 adverse-risk were associated with increased cumulative incidence of relapse (CIR). Time-dependent receiver operating characteristic (ROC) analysis showed that both ELN-2017 and ELN-2022 risk systems had limited prognostic ability for OS. We modified ELN-2022 risk system with pre-transplant minimal residual disease (MRD) and the modified risk system performed a significantly superior efficacy to ELN-2022 system.
Early weight gain as a predictor of weight restoration in avoidant/restrictive food intake disorder
Authors: Perry Taylor R. , Cai Kelly , Freestone David , Steinberg Dori M. , Bohon Cara , Menzel Jessie E. , Baker Jessica H.
Published: February 2024

Background

Previous research has demonstrated that early weight gain in family-based treatment (FBT) is predictive of remission for adolescents with anorexia nervosa (AN). However, no published data has addressed if early weight gain is also predictive of reaching weight restoration (i.e., 95% EBW) in patients with avoidant/restrictive food intake disorder (ARFID). Furthermore, no studies have evaluated the performance of the statistical models used to predict weight restoration at the end of treatment. This study sought to examine whether early weight gain in ARFID is predictive of weight restoration at 20 weeks using ROC analysis. Additionally, this study assessed how accurately the model classified patients and what types of misclassifications occurred.

Methods

Participants (n = 130, 57.7% cisgender female 70.0% white) received virtual outpatient FBT. Receiver operating characteristics (ROC) were used to predict successful weight restoration at end of treatment, using early weight gain as the predictor. Twenty weeks was considered as the end of treatment, to align with the definition of end of treatment in FBT clinical trials. ROC analyses demonstrated that gaining at least 6.2 pounds by week 5 of treatment was the strongest predictor of achieving 95% EBW at 20 weeks (AUC = 0.72 [0.63, 0.81]). ROC analyses misclassified 35% of patients; the most common misclassification was predicting that a patient would not achieve 95% EBW when they actually did (61.6%). A logistical regression model, which included the patients’ %EBW at admission in addition to early weight gain as a predictor, outperformed the ROC analyses (AUC = 0.90 [0.85, 0.95]) and provided additional context by showing the probability that a patient would succeed.

Conclusion

Taken together, research demonstrates that early weight gain is a useful predictor of 95% EBW at 20 weeks of treatment for patients with ARFID who require weight restoration. Furthermore, results suggest that statistical models need to take into account additional information, such as %EBW at admission, along with early weight gain in order to more accurately predict which patients will reach weight restoration at week 20.
The attitude of contemporary Iranian directors and screenwriters toward patients with mental disorders in comparison with general population
Authors: Kamalinejad Kiandokht , Shariat Seved Vahid , Eissazade Negin , Shalbafan Mohammadreza
Published: February 2024

Background

Mental disorders are accountable for 16% of global disability-adjusted life years (DALYs). Therefore, accessible, cost-effective interventions are needed to help provide preventive and therapeutic options. As directors and screenwriters can reach a great audience, they can use their platform to either promote stigma or educate the public with the correct definition and conception of mental disorders. Therefore, we aimed to measure the stigmatizing attitude of contemporary Iranian directors and screenwriters toward patients with mental disorders in comparison with a general population group.

Methods

In this comparative study, we included 72 directors and screenwriters between 18 and 65 years of age with a minimum involvement in at least one movie/television show, and 72 age and educationmatched controls. We collected the demographic data of the participants, and used the Persian version of the Level of Contact Report (LCR) to measure their familiarity with mental disorders, and used the Persian version of Social Distance Scale (SDS) and Dangerousness Scale (DS) to measure their attitude toward them.

Results

Compared to the general population group, directors and screenwriters had significantly lower SDS (12.51 ± 3.8 vs. 13.65 ± 3.73) and DS (12.51 ± 3.8 vs. 13.65 ± 3.73) scores (P < 0.001), indicating a more positive attitude toward patients with mental disorders. Familiarity with mental disorders was not significantly different between the groups. Female sex was associated with a more negative attitude among the directors and screenwriters group. Additionally, among the SDS items, ‘How would you feel about someone with severe mental disorder marrying your children?’ and ‘How would you feel about someone with severe mental disorder taking care of your children for a couple of hours?’ received the most negative feedback in both groups. And among the DS items, ‘there should be a law forbidding a former mental patient the right to obtain a hunting license’ received the most negative feedback in both groups.

Conclusions

Iranian contemporary directors and screenwriters had a more positive attitude toward patients with mental disorders, compared to general population. Due to this relatively positive attitude, this group of artists can potentially contribute to anti-stigma initiatives by offering educational materials and resources, promoting mental health care, and improving access to mental health care.
Early maladaptive schema, attachment style, and parenting style in a clinical population with personality disorder and normal individuals: a discriminant analysis model
Authors: Emami Maryam , Moghadasin Maryam , Mastour Haniye , Tayebi Afshin
Published: February 2024

Introduction

Researchers have shown various variables’ role in forming personality disorders (PD). This study aimed to assess the role of early maladaptive schema (EMS), attachment style (AS), and parenting style (PS) in discriminating between personality disorders and normal individuals.

Methods

In this study, 78 personality disorder patients and 360 healthy volunteers aged 18–84 were selected using convenience sampling. They completed the Schema Questionnaire-Short Form (SQ-SF), Revised Adult Attachment Scale (RAAS), and Baumrind’s Parenting Styles Questionnaire (PSI). Data were analyzed using discriminant analysis with IBM SPSS 25.

Results

The results showed higher mean scores in all early maladaptive schema domains, insecure attachment styles, and authoritarian parenting in the personality disorder group than in the normal group. Also, discriminant analyses revealed that the function was statistically significant and could distinguish between the two groups and a compound of essential variables, disconnection, impaired autonomy, and secure attachment, respectively, discriminating two groups. Given that all components were able to distinguish between the two groups.

Conclusion

Therefore, intervention based on these factors early in life may help reduce the characteristics of personality disorders. Also, considering the role of these factors, treatment protocols can be prepared.