bluuebunny/crossref_metadata_2025 huggingface dataset:
Diversity of Malignancies in Patients with Different Types of Inborn Errors of Immunity
Authors: Tavakol Marzieh , Ansari Sarina , Delavari Samaneh , Rasouli Seyed Erfan , chavoshzadeh Zahra , Sherkat Roya , Ahanchian Hamid , Aleyasin Soheila , Esmaeilzadeh Hossein , Moazzen Nasrin , Shafiei Alireza , Abolnezhadian Farhad , Iranparast Sara , Ebrahimi Sareh sadat , shad Tannaz Moeini , Pashangzadeh Salar , Nazari Farzad , Rezaei Arezou , saeedi-Boroujeni Ali , Nabavi Mohammad , Arshi Saba , Fallahpour Morteza , Bemanian Mohammad hassan , Sharafian Samin , Shokri Sima , Eshaghi Sarvin , Nazari Shiva , Shamsian Bibi Shahin , Malamir Mehrdad Dargahi , Khazaei Roya , Ashkevari Pooya , Khavandegar Armin , Haghi Sabahat , Abolhassani Hassan , Rezaei Nima
Published: May 2022

Genetic defects in development, maturation, and/or function of immune cells can lead to Inborn errors of immunity (IEI) which may predispose patients to malignancies. Overall risk for cancer in children with IEI ranges from 4-25% and the type of malignancy is highly dependent on the specific mutant gene underlying IEI.We investigated 3056 IEI patients registered in the Iranian national registry between the years 1999 and 2020 in this retrospective cohort study. Frequency of malignancy and its association with type of IEI in these patients were evaluated.A total of 82 IEI patients with malignancy were enrolled in this study. Among them, predominantly lymphoma was the most common type of malignancy (65.8%), followed by leukemia (11%), and cancers of head and neck (7.3%). Among identified lymphoma cancers, Hodgkin’s lymphomas were the most frequent type (45.1%) followed by different subtypes of non-Hodgkin lymphoma (20.7%). Solid tumors (19.5%) appeared to be very heterogeneous by type and localization. The correlation between the type of malignancy and survival status and association between type of malignancy and IEI entities were unremarkable. The awareness of the association between presence of IEI and cancer highlights the importance of a synergistic effort by oncologists and immunologists in the early diagnosis of malignancy and personalized therapeutic strategies in IEI patients. Therefore, we investigated the frequency of different types of malignancy and also evaluated the correlation of type of IEI and type of malignancy in these 82 patients.
The relationship between fronto-striatal tractography and cortical morphometry changes in Huntington's Disease: Image-HD
Authors: Tan Brendan , Shishegar Rosita , Oldham Stuart , Fornito Alex , Poudel Govinda , Georgiou-Karistianis Nellie
Published: May 2022

This paper aimed to investigate the relationship between cortical folding and white matter integrity changes in Huntington’s disease. Cortical morphometry and tractography changes in three gyral based regions of interest (i.e., precentral, rostral middle frontal and superior frontal gyri) were examined. Neuroimaging data from the IMAGE-HD database comprised of 25 pre-symptomatic, 27 symptomatic and 25 healthy control individuals at three separate time points (baseline, 18-months, 30-months). Cortical morphometry measures of local gyrification index and cortical thickness were derived using Freesurfer 6.0’s longitudinal pipeline. Tractography integrity measures of fractional anisotropy, axial diffusivity and radial diffusivity were obtained using MRTrix3. Gyral-based regions of interest were identified using the Desikan-Killiany Atlas. A hierarchical regression analysis was conducted to investigate whether baseline white matter tractography could predict cortical morphometry changes. We found baseline white matter integrity measures did not predict tractography changes in any of the regions of interest. A hierarchical regression analysis was conducted to investigate whether tractography or cortical morphometry changes could predict change in clinical measures (i.e., disease burden score and the Unified Huntington’s Disease Rating Scale – total motor score) over and above group (i.e., clinical diagnosis) in the pre-symptomatic and symptomatic groups. Tractography and cortical morphometry changes did not significantly predict change in clinical measures over and above group. These findings suggest cortical morphometry changes in these brain regions may occur independently to the health of the cortico-striatal tracts leading to them. Furthermore, these changes appear to have no significant relationship to motor symptoms in HD or life-time disease exposure.
Diagnostic accuracy of atopy patch test in children with cow’s milk allergy
Authors: Kulalert Prapasri , Pongcharoen Padcha , Sritipsu Paskorn , Intraakhao Sukkrawan , Piriyanon Punnapat , Thaweekul Patcharapa , Nanthapisal Sira , Poachanukoon Orapan
Published: May 2022

Background
The accuracy of an atopy patch test (APT) for fresh cow’s milk allergy is controversial. Few studies have focused on commercial extract solutions. We aimed to evaluate the diagnostic performance of the APT in cow’s milk allergic children using fresh cow’s milk and commercial extracts of cow’s milk and its components including casein, α-lactalbumin, and β-lactoglobulin.
Methods
A prospective study was carried out in children with a history of cow’s milk allergy. Children underwent the skin prick test (SPT) and APT with fresh cow’s milk, powdered cow’s milk, and commercial extracts of cow’s milk, casein, α-lactalbumin, and β-lactoglobulin. Oral food challenge (OFC) was confirmed in all children.
Results
A total of 37 patients participated (mean age 13.14 ± 7.26 months). Only 5 (13.51%) patients had positive OFC to cow’s milk. The sensitivity of the APT using fresh cow’s milk was 40%, specificity was 65.6%, PPV was 15.4%, and NPV was 87.5%. The sensitivity of the APT using powdered cow’s milk was 40%, 60.7% for specificity, 15.4% for PPV, and 58% for NPV. The sensitivity and PPV of the APT using commercial solutions of cow’s milk, casein, α-lactalbumin, and β-lactoglobulin were zero. The specificities were 90.6%, 93.8%, 100%, and 100% for α-lactalbumin, cow’s milk, casein, and β-lactoglobulin, respectively. ​
Conclusions
APT using commercial solutions showed higher specificity than fresh milk. The specificity increased using a protein component allergen.
Antimicrobial Stewardship and Infection Prevention and Control Programs across Three Healthcare Levels: A Qualitative Study
Authors: Aika Isabel Naomi , Enato Ehijie
Published: May 2022

Introduction: Antimicrobial stewardship (AMS) and infection prevention control (IPC) programs are proposed to address antimicrobial resistance. Nigeria’s 5-year action plan for these programs is due for implementation by 2022. The objective of this study was to examine the perspectives, barriers and facilitators of these programs among health care managers and the current state of these programs in the three levels of healthcare facilities in Benin City, Nigeria. Methods: Fourteen in-depth interviews were conducted among hospital manager across primary, secondary and tertiary healthcare facilities. The interviews were guided by semi-structured questionnaire. Responses were audio-taped and hand written. Data were analyzed by transcribing recorded tapes into major themes. Results: Most of the participants viewed inappropriate prescribing as a problem both in the country and their facilities. None of the institutions have a formal AMS program (AMS), but participants believed that the presence of drug and therapeutic committee is a foundation for such a program. A majority of the participants acknowledged barriers to AMS to include lack of management backing, interprofessional rivalry, and poor laboratories. Only the tertiary institution has a formal IPC program. Some challenges to IPC across the healthcare institutions are inadequate waste disposal, lack of personal protective equipment and behavioral change among healthcare providers.Conclusion: There is no AMS program across all facilities studied, although some forms of IPC activities are present in all healthcare institutions, only the tertiary facility has a formal IPC program. Effort should be made to strengthen AMS and IPC in the study facilities.
Socio-economic disparities in female genital circumcision: finding from a case- control study
Authors: Laleh Shahla Shafaati , Roshanaei Ghodratollah , Soltani Farzaneh , Ghamari Fatemeh
Published: May 2022

Background
Female genital circumcision is still one of the challenges in reproductive health. This study was conducted to investigate the socio-economic disparities in female genital circumcision in a Kurdish region of Iran.
Methods
We conducted a case-control study to assess the socio-economic factors associated with female genital circumcision. Using the available sampling method, 130 cases of circumcised girls and 130 controls without history of circumcision were enrolled. The demographic and circumcision information questionnaires were completed by self-report method. Data were analyzed using descriptive statistics, chi-square statistical methods as well as univariate and multivariate logistic regression models with a backward method at 95% confidence level.
Results
The chances of genital circumcision in girls under the age of 20 and then in the age group of 20 to 30 years were 5.77 and 8.55 times higher than those over 30 years, respectively. This chance in girls with elementary education was 6.6 times higher than those with a college education. The chances of girls being circumcised with mothers with elementary education were 5.75 times higher than girls with university-educated mothers. Also, the family history of circumcision increased the chance of female genital circumcision by 9.90 times.
Conclusion
The present study highlighted the importance of modifiable variable such as girls’ education as well as parents' education as predictors of female genital circumcision. Empowering women by creating opportunities for their education can lead to the success of global efforts to reduce and eradicate this health problem.
A unified Lyapunov function for optimizing synchronization of coupled heterogeneous oscillators
Authors: Lei Yong , Xu Xin-Jian , Wang Xiaofan , Zou Yong , Kurths Jürgen
Published: May 2022

Synchronization of coupled oscillators is important for understanding collective dynamics of a variety of natural and artificial systems including Josephson junctions, neuronal networks, and power grids. Despite this ubiquity, it remains unclear how the interaction between oscillator’s dynamics and coupled structure either promotes or inhibits synchrony. Here, we introduce a unified Lyapunov function to Kuramoto systems such that it can be readily optimized to enhance synchrony of even heterogeneous oscillators on sparse networks. We demonstrate its efficacy in frequency allocation and network design on both synthetic network models and empirical power grids. This new criterion circumventes the calculation of the eigenvalues and eigenvectors of the network Laplacian, and thus is a high efficient framework for optimizing synchronization of large oscillator networks.
Association between visceral adiposity index and bone mineral density: an NHANES study
Authors: Chen Shuai , Zhou Guowei , Sun Xiaohe , Jin Jie , Li Zhiwei
Published: May 2022

Objectives:With the improvement of living standards and changes in dietary structure, the number of individuals with central obesity is increasing. Recent studies have indicated that visceral fat accumulation is closely linked to osteoporosis. Therefore, we aimed to explore the relationship between obesity status and bone density mineral (BMD) from a novel perspective of visceral adiposity.MethodsThe study included 9,016 participants from the National Health and Nutrition Examination Survey (NHANES) 2007-2010. The visceral adiposity index (VAI) was calculated by anthropometry parameters (body mass index and waist circumference) and functional parameters (triglycerides and high-density lipoprotein cholesterol). Considering the complex survey design and sample weights, we employed multivariate linear regression models and smooth curve fittings to evaluate the correlation between VAI and BMD. For addressing the nonlinear relationship, we employed a two-piecewise regression to calculate the inflection points.ResultsAfter adjusting for multiple covariates, there was a significant positive correlation between VAI and lumbar spine, total femur, and femoral neck BMD. After converting VAI to a categorical variable (quartiles), participants in the highest VAI quartile had a 0.049g/cm2 higher BMD than those in the lowest VAI quartile (β =0.049, 95%CI: 0.040-0.057, P＜0.001). In subgroup analyses stratified by age, the relationship between VAI and lumbar BMD was an inverted U-shaped curve in the age ≤18 groups, with a point of inflection at 4.86. ConclusionsVAI was significantly positively correlated with lumbar BMD, demonstrating the complex relationship between visceral fat and bone metabolism. In addition, VAI may be used as a useful predictor of osteoporosis and provide new ideas for the evaluation and screening of osteoporosis.
MiRNA signatures related to invasiveness and recurrence in patients with non-functioning pituitary adenomas
Authors: Nikolova Emiliya , Nankova Anelia , Kalenderova Silvia , Georgieva Bilyana , Hadzhiyanev Asen , Bichev Stoyan , Savov Alexey , Todorova Albena , Mitev Vanyo , Elenkova Atanaska
Published: May 2022

Purpose: The aim of the present work was to analyse and identify differentially expressed miRNAs in Bulgarian patients with non-functioning pituitary adenomas (NFPA). The relationship between deregulated miRNAs and tumor size, invasiveness, and recurrence was determined.Methods: Twenty patients with NFPAs were selected and fresh pituitary tumor tissues were collected. RNA containing miRNAs were isolated using miRNAeasy mini kit and analysed with LNA miRNA Cancer Focus PCR Panel (Qiagen) by quantitative real-time PCR. Results: Three miRNAs (miR-210-3p, miR-149-3p and miR-29b-3p) were deregulated in invasive compared to non-invasive NFPAs. Differential expression of 4-miRNA signature - miRNA-17, miR-19, miR-106a and miR-20 was informative as a recurrence biomarker. ROC analysis showed that the selected miRNAs could be used as potential biomarkers for the diagnosis, prognosis and therapy monitoring of NFPAs.Conclusion: In this pilot study, we selected a unique miRNA expression profile correlating with NFPA invasiveness and recurrence. Moreover, some of the selected miRNAs are reported for the first time in patients with NFPAs and might elucidate the molecular mechanisms involved in pituitary pathogenesis. The selected miRNAs showed a promising biomarker potential and could be studied for future miRNAs-based anti-NFPAs therapy.
Nurses' perception of the quality of procedural sedation in children comparing different pharmacological regimens
Authors: Curatola Antonietta , D’Agostin Martina , Favaretto Elena , Vittori Giada , Vidonis Viviana , Strajn Tamara , De Vita Nicole , Saccari Alessia , Barbi Egidio , Wiel Luisa Cortellazzo
Published: May 2022

Purpose
Nurses play a pivotal role during pediatric procedural sedation and their perspective is an important indicator of the quality of care. The aim of this study is to examine nurses’ satisfaction comparing four different pharmacological regimens used for pediatric sedation outside of the operating room.
Methods
A prospective observational study was conducted in a third level pediatric teaching hospital, involving all the nurses with experience in the field of pediatric procedural sedation. A 13-items survey was used to assess the level of nurses’ satisfaction for the quality of sedation with four different analgesic-sedative drugs.
Results
Fifty-one questionnaires were completed by pediatric nurses with a median length of experience of 10 years. Regarding the overall quality of the sedation, the highest median satisfaction scores were observed for propofol (8, IQR 7–9), dexmedetomidine (8, IQR 6–8) and midazolam (8, IQR 7–9). Ketamine (5, IQR 3–7) displayed the lowest score. When asked to rate their level of perceived safety, nurses gave high scores to all the four drugs studied, with no statistically significant difference between them. Non-pharmacological techniques during procedural sedation were judged as important by 38 (74.5%) nurses.
Conclusions
According to this sample of pediatric nurses, the best quality of procedural sedation in children outside of the operating room is obtained with propofol, dexmedetomidine and midazolam. During procedural sedation, nurses feel overall safe regardless of the pharmacological regimen used. Moreover, they highlighted the relevance on non-pharmacological approaches in the preparation of the child for the procedure.
Color Stability and Surface Roughness of Ormocer- vs Methacrylate- Based Single Shade Composite in Anterior Restoration
Authors: Ebaya Maha Mohamed , El-Haliem Huda Abed , Ali Ashraf Ibrahim , Mahmoud Salah Hasab
Published: May 2022

Background: The blending ability of universal shade composites and their stability in the oral environment are of great concern in restoring anterior teeth. This study aims to evaluate and compare the color stability and surface roughness of two single-shade composite restorations, ormocer-based composite (OBC) and methacrylate resin-based composite (RBC), after storing them in different staining media.Materials and Methods: In this study, two universal shade composite restorative materials were tested: a nanohybrid OBC (Admira fusion X-tra, Voco) and a supra-nanofilled RBC (Omnichroma, Toukyama). In total, 60 cylindrical centralized cavities (diameter: 5 mm, depth: 2 mm) were prepared in sound extracted-human central incisors and divided into two equal groups according to the restorative material used (n=30). According to the storage media, the teeth of each group were divided into three subgroups (n=10): artificial saliva, black tea, and cola. The restoration color was evaluated for all teeth at baseline and after four weeks of storage. The color stability (∆ E) was measured using a reflective spectrophotometer (X-Rite, model RM200QC, Neu-Isenburg, Germany). The surface roughness (Ra) was evaluated using three-dimensional optical profilometry (Wyko, Model NT 1100, Veeco, Tucson, USA). Additionally, the extracted data were analyzed using two-way analysis of variance (ANOVA), one-way ANOVA and Student's t- test. Results: In the baseline evaluation, there were no statistically significant differences with respect to color matching or surface roughness results between the two studied restorative materials. However, the differences were statistically significant after storing them in different media. Conclusion: Universal composites showed satisfactory color matching with different teeth colors and accepted surface smoothness, whereas the aging procedure exerted a negative effect on their color stability and surface characteristics.
Clonal integration facilitates the invasion of two root-suckering plants (Rorippa amphibia and Rorippa sylvestris) in a water-heterogeneous environment
Authors: Shao MeiNi , Wang QiuLi , Yan Biyu , Xu YuFeng , Ma Yongsheng , Xu ShuJun , Qu Bo
Published: May 2022

Environmental heterogeneity is common in nature. Clonal integration is an important trait that allows clonal plants to grow in resource-heterogeneous environments. The aim of this work was to study the effects of clonal integration on the growth and propagation of two root-suckering plant species under water-heterogeneous conditions and to elucidate their adaptive strategy to water stress. Two root-suckering plants of the genus Brassicaceae, Rorippa amphibia and Rorippa sylvestris, have invaded Liaoning Province, China. The greenhouse pot experiments were performed in the research center of the Shenyang Agricultural University. Mother and daughter fragments collected from these two plants were grown under either well-watered or water-limited conditions to mimic the homogeneous and heterogeneous water condition. Morphological traits (root-shoot ratio, the number of new shoots, etc.) and the biomass of mother and daughter fragments were measured. The results showed that clonal integration did not occur under water-homogeneous conditions. However, under water-heterogeneous conditions, clonal integration transported the resources from resource-rich environments to resource-defficient environments. When the resources were re-allocated, clonal integration increased the root-shoot ratio and the number of new shoots on daughter fragments, which facilitated the spread of the plants. At low water availability, R. sylvestris had higher root-shoot ratios and more new shoots on daughter fragments than R. amphibia, suggesting that R. sylvestris had higher invasibility than R. amphibia. The findings enhanced our understanding of how clonal integration facilitates the invasion of root-suckering plants in resource-heterogeneous environments and provided insights into management measures for invasive alien species.
Optimization of Neoadjuvant Chemotherapy for Rectal Cancer Using the Deep Learning Approach
Authors: Kubota Shunsuke , Wakiya Taiichi , Morohashi Hajime , Miura Takuya , Kanda Taishu , Ichiyama Sotaro , Soma Kenji , Matsuzaka Masashi , Sasaki Yoshihiro , Sakamoto Yoshiyuki , Hakamada Kenichi
Published: May 2022

To optimize the use of neoadjuvant chemotherapy (NAC), this study aimed to develop a therapeutic response prediction model with NAC for rectal cancer (RC). Three courses of S-1 and oxaliplatin (SOX) NAC were administered before rectal surgery. We prospectively collected the dataset for the prechemotherapy arterial phase of enhanced computed tomography (CT) images from 57 RC patients undergoing rectal surgery after NAC. The therapeutic response to NAC had been pathologically confirmed. We established three prediction labels: poor response, marked response, and complete response (CR). We built a CT patch-based predictive model using a residual convolutional neural network and used 3-fold cross-validation. Of the 57 patients, pathological CR was observed in 9 (15.8%). A total of 4,607 patches were extracted from the segmented tumor area of each patient. The accuracy of the model for predicting pathological CR was 99.9% for the training dataset. In the validation dataset, the accuracy was 94.9%. Furthermore, the area under the curve (AUC) was 0.949. Likewise, in the prediction of marked and poor response, the models demonstrated high accuracy (93.6% and 93.3%, respectively) and high AUC (0.966 and 0.976, respectively). Our CT-based deep learning model exhibited high predictive performance in projecting therapeutic response to SOX NAC.
Public Cord Blood Banks as a source of starting material for clinical grade HLA-homozygous induced pluripotent stem cells.
Authors: Alvarez-Palomo Belen , Veiga Anna , Raya Angel , Codinach Margarita , Torrents Silvia , Verdugo Laura Ponce , Rodriguez-Aierbe Clara , Cuellar Leopoldo , Alenda Raquel , Arbona Cristina , Hernández-Maraver Dolores , Fusté Cristina , Querol Sergi
Published: May 2022

Background: The increasing number of clinical trials for induced pluripotent stem cell (iPSC)-derived cell therapy products makes the production on clinical grade iPSC more and more relevant and necessary. Cord blood banks (CBB) are an ideal source of young, HLA-typed and virus screened starting material to produce HLA-homozygous iPSC lines for wide immune-compatibility allogenic cell therapy approaches. The production of such clinical grade iPSC lines (haplolines) involves particular attention to all steps since donor informed consent, cell procurement and a GMP-compliant cell isolation process.Methods: Homozygous cord blood (CB) units were identified and quality verified before recontacting donors for informed consent. CD34+ cells were purified from the mononuclear fraction isolated in a cell processor, by magnetic microbeads labelling and separation columns.Results: We obtained a median recovery of 20.0% of the collected pre-freezing CD34+, with a final product median viability of 99.1% and median purity of 83.5% of the post-thawed purified CD34+ population.Conclusions: Here we describe our own experience, from unit selection and donor reconsenting, in generating a CD34+ cell product as a starting material to produce HLA-homozygous iPSC following a cost-effective and clinical grade-compliant procedure. These CD34+ cells are the basis for the Spanish bank of haplolines envisioned to serve as a source of cell products for clinical research and therapy.
Higher Education's Influence on Social Networks and Entrepreneurship in Brazil
Authors: Reddy Michelle , Nardelli Júlio C. , Pereira Yuri L. , Oliveira Leonardo B. , Silva Thiago H. , Vasconcelos Marisa , Horowitz Mark
Published: May 2022

Developing and middle-income countries increasingly emphasize higher education and entrepreneurship in their long-term development strategy. Thus, our work focuses on the influence of higher education institutions (HEIs) on startup ecosystems in Brazil, an emerging economy. As traditional data to perform this type of study, such as surveys, are challenging to get, we propose an alternative approach. Given the growing capability of social media databases such as Crunchbase and LinkedIn to provide startup and individual-level data, we draw on computational methods to mine data for social network analysis. Our approach enables different types of analysis. First, we describe regional variability in entrepreneurial network characteristics. Then we examine the influence of elite HEIs in economic hubs on entrepreneur networks. Second, we investigate the influence of the academic trajectories of startup founders, including their courses of study and HEIs of origin, on the fundraising capacity of startups. We find that HEI quality and the maturity of the ecosystem influence startup success. We also observe that elite HEIs have a powerful influence on local entrepreneur ecosystems. Surprisingly, while the most nationally prestigious HEIs in the South and Southeast have the longest geographical reach, their network influence remains local. Our approach can be helpful, especially in countries with limited studies of the interaction between startups and institutional factors supporting them.
Bovine campylobacteriosis in bulls: insights in the conventional and molecular diagnosis
Authors: García Juan A. , Farace Pablo , Gioffré Andrea K. , Morsella Claudia , Méndez María A. , Acuña Joaquín , Aller Juan F. , Signorini Marcelo , Paolicchi Fernando A.
Published: May 2022

Campylobacter fetus is a gram-negative motile bacterium, with two subspecies relevant for cattle health: C. fetus subsp. venerealis (Cfv) and C. fetus subsp. fetus (Cff). Both subspecies are associated with reproductive losses in cattle. Herein, the C. fetus infection of three Angus bulls naturally challenged with Cfv, Cfv biovar intermedius (Cfvi) or Cff were assessed through conventional and molecular diagnosis of preputial smegma (PS) samples collected with different devices. The Cfv- and Cfvi-bulls were positive until at least 9 months. Although Cff is not considered a venereal strain, this study demonstrated its transmission to bull from heifers experimentally infected, with evidence of colonization and persistence in the preputial cavity for 5 to 6 months. This finding suggests a potential risk of dissemination of the bacteria within herds. The results obtained by bacteriological culture or direct immunofluorescence (DIF) showed no significant differences, regardless the sampling device used (aspiration with Cassou pipette, metal and plastic scraper). On the other hand, the qPCR for C. fetus detection yielded better results with an in-house DNA extraction method than with a commercial kit (75% vs 66.6%). Furthermore, the molecular diagnosis by qPCR was more efficient than culture (66.6%) or DIF (56%). Bacteremia in whole blood samples was negative by qPCR and bacteriological culture in all samples. PCR-based methods are promising for the diagnosis of Bovine Genital Campylobacteriosis from clinical samples of PS. This study demonstrated the transmission of Cff from heifers to bull.
Microbial Quality and Antimicrobial Residue of Local and Industrial Processed Fruit Juice Sold in Tamale, Ghana
Authors: Jimma Fidaus Iddrisu , Mohammed Amina , Adzaworlu Emmanuel Gameli , Nzeh Joseph , Quansah Lydia , Dufailu Osman Adamu
Published: May 2022

Fruits are essential part of human nutrition that provides numerous health benefits. When processed into juice, they are either packaged and stored or consumed immediately. There are reports on contraction of foodborne illness due to consumption of these natural beverages possibly from contamination by pathogenic microbes. Also, concerns of antimicrobial resistance due to antimicrobial residues in fruit juices has been raised. Thus, this study assessed the microbial quality of fruit juice by determining the microbial load of E. coli and Salmonella spp., and the presence of antimicrobial residues in locally processed fruit juices (n= 25) and industrially (n= 3) processed fruit juices sold in Tamale, Ghana. Spread plate technique was adopted for isolation and enumeration of bacteria. Whereas the presence of antimicrobial residue was determined using the Premi® test kit. Neither E. coli nor Salmonella spp. is recorded in all three industrially processed juice samples. However, the locally processed juice samples recorded 88 % E. coli and 40 % Salmonella spp. with microbial load above the acceptable limits. Antimicrobial residues were absent in all 28 samples analyzed. The incidence of high microbial load found in the locally processed fruit juice is of concern to avert possible foodborne illness linked with the consumption of fruit juices within Tamale.
Structural stigma and its impact on healthcare for borderline personality disorder: a scoping review
Authors: Klein Pauline , Fairweather A. Kate , Lawn Sharon
Published: May 2022

Background
People with Borderline Personality Disorder (BPD) and their carers/families continue to experience structural stigma when accessing health services. Structural stigma involves societal-level conditions, cultural norms, and organizational policies that inhibit the opportunities, resources, and wellbeing of people living with attributes that are the object of stigma. BPD is a serious mental illness characterized by pervasive psychosocial dysfunction including, problems regulating emotions and suicidality. This scoping review aimed to identify, map, and explore the international literature on structural stigma associated with BPD and its impact on healthcare for consumers with BPD, their carers/families, and health practitioners.
Methods
A comprehensive search of the literature encompassed MEDLINE, CINAHL, PsycINFO, Scopus, Cochrane Library, and JBI Evidence-Based databases (from inception to February 28th 2022). The search strategy also included grey literature searches and handsearching the references of included studies. Eligibility criteria included citations relevant to structural stigma associated with BPD and health and crisis care services. Quality appraisal of included citations were completed using the Mixed Methods Appraisal Tool 2018 version (MMAT v.18), the Joanna Briggs Institute (JBI) Checklist for Systematic Reviews and Research Syntheses Tool, or the AGREE II: advancing guideline development, reporting, and evaluation in health care tool. Thematic Analysis was used to inform data extraction, analysis, interpretation, and synthesis of the data.
Results
A total of fifty-seven citations were included in the review comprising empirical peer-reviewed articles (n = 55), and reports (n = 2). Studies included quantitative, qualitative, mixed methods, and systematic review designs. Review findings identified several extant macro- and micro-level structural mechanisms, challenges, and barriers contributing to BPD-related stigma in healthcare systems. These structural factors have a substantial impact on health service access and care for BPD. Key themes that emerged from the data comprised: structural stigma and the BPD diagnosis; structural stigma surrounding health and crisis care services; and practitioner-patient interactions.
Conclusion
Narrative synthesis of the findings provide evidence about the impact of structural stigma on healthcare for BPD. Results of this review are anticipated to inform future research, policy, and practice in addressing BPD-related stigma in healthcare systems, as well as approaches for improving responsive care delivery for consumers with BPD and their carers/families.
Capturing Critical Data Elements in Juvenile Idiopathic Arthritis: Variations between In-person and Virtual Visits and Initiatives to Improve Data Capture
Authors: Ryan Meghan E. , Warmin Andrew , Binstadt Bryce A. , Correll Colleen K. , Hause Emily , Hobday Patricia , Lerman Alison , Mahmud Shawn A. , Riskalla Mona M. , Shaheen Zachary , Vehe Richard K. , Bullock Danielle R.
Published: May 2022

Background: Documentation of critical data elements is a focus of the Pediatric Rheumatology Care and Outcomes Improvement Network to aid in clinical care and research for patients with juvenile idiopathic arthritis. We aimed to increase data capture for arthritis pain score, patient/parent global assessment of wellbeing, provider global assessment, and active joint count. We hypothesized that data capture for all critical data elements would be lower for virtual visits compared to in-person visits. Methods: All visits for patients with JIA between 9/14/2020 and 12/31/2021 at the University of Minnesota were included. Sixteen interventions with providers were conducted, including email reminders, individual discussions, group meetings, and feedback reports. We used statistical process control charts to evaluate change over time.Results: Baseline included 355 patient-visits: 221 (62%) in-person and 134 (38%) virtual with critical data elements entry ranging between 50-60%. Post-intervention included 1,596 patient-visits: 1,350 (85%) in-person and 246 (15%) virtual with critical data elements entry of 91%. In-person visits had significantly higher data capture rates than virtual visits for all 4 critical data elements.Conclusion: We achieved our aim to increase critical data element documentation and found that collection of critical data elements occurred significantly less often with virtual visits than with in-person visits. We inferred that critical data element capture for virtual visits was lower for multiple reasons, including the lack of intake forms and provider uncertainty about scoring certain elements. Now that we improved capture of critical data elements, we can shift the focus to efforts aimed at improving outcomes for patients with juvenile arthritis.
Associations of left renal vein entrapment with IgA nephropathy and glomerular galactose-deficient-IgA1 deposition
Authors: Wang Fengmei , Zhu Huizi , Bao Shougang , Qi Hengtao , Xu Liang , Liu Xiang , Zhai Chunjuan , Wang Rong , Yang Xiaowei
Published: May 2022

Objectives: To identify whether left renal vein (LRV) entrapment was more prevalent in IgA nephropathy (IgAN) and Henoch-Schönlein purpura (HSPN) compared with other types of renal diseases, and the association of LRV entrapment with glomerular incidental IgA and galactose-deficient-IgA1 (Gd-IgA1) deposition.Methods: 797 patients with biopsy-proven kidney diseases have been screened for LRV entrapment by color Doppler ultrasound, and the prevalence of LRV entrapment in different types of renal diseases were then analyzed. Propensity score matching analysis was used to adjust for age, gender and body mass index. Immunostaining of Gd-IgA1 with KM55 was performed in paraffin-embedded sections of renal biopsy specimens.Results: LRV entrapment was diagnosed in 47 patients (6%) with several kinds of renal diseases in our cohort. 32 (68%) LRV entrapments were combined with expanded IgAN (idiopathic IgAN and HSPN). The prevalence of LRV entrapment in expanded IgAN was significantly higher than that in non-expanded IgAN (17% vs. 2%, P<0.001), even after adjustment for age, gender and body mass index by propensity score matching analysis (13% vs. 2%, P<0.001). Removing expanded IgAN and LN, glomerular incidental IgA deposition was observed to be significantly more common in patients with LRV entrapment compared with patients without it (43% vs. 9%, P<0.001). Furthermore, in glomerular diseases with incidental IgA deposits, significantly much larger proportion of patients with LRV entrapment were positive for glomerular Gd-IgA1 in contrast to patients without LRV entrapment (5/5 vs. 5/17, P=0.01).Conclusion: LRV entrapment might be associated with glomerular Gd-IgA1 deposition and the development of IgAN.
Effective Arterial Elastance as The Best Predictor of Mean Arterial Pressure in Patients with Sepsis or Septic Shock Receiving Fluid Expansion: A Validation Study by Regression Analysis
Authors: Theerawit Pongdhep , Tengsirikomol Tanawat , Sutherasan Yuda
Published: May 2022

Backgroundwe conducted this study to compare four arterial load parameters and determine which arterial load parameters directly impacted arterial pressure regarding pressure, flow, and arterial system relationship.MethodsWe conducted a cross-sectional study in patients with sepsis who underwent volume expansion (VE). Hemodynamic parameters were recorded before and after VE. The relationship between the change of mean arterial pressure (%MAP) and that of the dynamic arterial elastance (EaDyn), effective arterial elastance (Eaeff), net arterial elastance (EaNet), and net arterial resistance (RaNet) was analyzed.ResultsSixty-two patients were included. The DEaDyn(%) was not correlated with DMAP(%) (r=0.048, P=0.826). Meanwhile, DEaeff(%), DEaNet(%), and DRaNet(%) were correlated with DMAP(%) (r=0.495, P<0.001; r=0.453, P<0.001; and r=0.485, P<0.001, respectively). A multiple linear regression model was analyzed for identifying predictors of DMAP(%) by including DCO(%) and each %change of arterial parameters. The best-fit model was found by including DCO(%) and DEaeff(%) in the regression equation (R2=0.823, adjusted R2=0.817). The model was adjusted by age, sex, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score, arterial lactate level, norepinephrine dosage, ventilator setting, method of VE, and fluid responsiveness and found that DCO(%) and DEaeff(%) remained statistically significant predictors of DMAP(%) (P<0.001 and P<0.001, respectively).ConclusionThe Eaeff was the best AL parameter that correlated with the changes in MAP. Furthermore, the model that included the ∆Eaeff(%) provided the best predictive performance for ∆MAP(%) induced by VE, independent of the fluid responsiveness and norepinephrine dosage.
Delay in Diagnosis of Common Cancers among Women – A Scoping review
Authors: R Maanasa , S Jayashree , Srijaya Parameswari , PR Karthikeyan , Govindarajulu Srinivas
Published: May 2022

Introduction
As majority of these cancers are only diagnosed at advanced stages, it has become the reason for increased mortality rates and poor prognosis affecting the quality of life of patients. The delay in cancer diagnosis especially among women may be attributed to various factors both from patients and the healthcare sector. This study thus aims to conduct a comprehensive review of the literature on the factors behind the delay in case detection, that are common and specific for both the cancers, the reasons for the delay and the average time duration and reasons for the delay.
Materials and methods
A systematic search was conducted over several databases to identify relevant peer-reviewed studies. From eligible studies, data were extracted to summarize, collate, appraise the quality and make a narrative account of the findings.
Results
Of 581 studies, 29 were reviewed which revealed the commonest factors for delay were patient (presentation delay) followed by the health provider and healthcare sector, and the average time duration of delay was 6 months. Reasons for delay in the presentation were misconception about the disease, perceived stigma and fear of cancer. Poor knowledge of general practitioners, misclassification of disease severity, and long waiting queues in public health facilities were the commonest reasons for healthcare sector delay.
Conclusion:
Disease awareness among healthy women followed by widespread screening and appropriate interpretation of early clinical presentation by healthcare providers can be improved to reduce delay in cancer diagnosis and ensure better prognosis and quality of life of patients.
Research on the driving effect of Eco-economic Zones on urban coordinated development and its effect mechanism
Authors: Liu Jiaqi , Gong Bibang , Hu Zongyi , Li Jianjun
Published: May 2022

The core goal of Eco-economic Zone planning is to enhance the coordinated development of cities in the basin in terms of main function realization and livelihood development and achieve coordinated and high-quality development in the basin. Using a double-difference approach, this paper uses panel data from 2004 to 2019 for 49 prefecture-level cities in Jiangxi, Hunan, Hubei, and Jiangsu provinces to test the proposed theoretical hypotheses and empirically examine the driving effects and mechanisms of the three Eco-economic Zones on the coordinated development of cities along the river basin. The study finds that the three zones significantly enhance the coordinated development of cities along the zones. The dimension of livelihood development is more significant in strengthening cities' coordinated development along the three zones. At the same time, there is substantial regional individual heterogeneity and temporal dynamic heterogeneity in the driving effect of the plan. The Eco-economic Zone Plan is designed to enhance the coordinated development of cities along the Great Lakes Basin through green economic development and ecological environment improvement. The above findings help explore new experiences in the protection, management, and development of the Great Lakes Basin. They have important policy implications for cities in the Eco-economic Zone to develop a “new path” of collaborative ecological and economic development.
Development and validation of two redox-related genes associated with prognosis and immune microenvironment in endometrial carcinoma
Authors: He Yan , Cao Nannan , Tian Yanan , Wang Xuelin , Xiao Qiaohong , Tang Xiaojuan , Huang Jiaolong , Zhu Tingting , Hu Chunhui , Zhang Ying , Deng Jie , Yu Han , Duan Peng
Published: May 2022

Background: In recent studies, tumourigenesis and development of endometrial carcinoma (EC) have been correlated significantly with redox. We aimed to develop and validate a redox-related prognostic model of patients with EC to predict the prognosis and the efficacy of immunotherapy.Methods: We downloaded gene expression profiles and clinical information of patients with EC from the Cancer Genome Atlas (TCGA) and the Gene Ontology (GO) dataset. We identified two key differentially expressed redox genes (CYBA and SMPD3) by univariate Cox regression and utilised them to calculate the risk score of all samples. Based on median of risk scores, we composed low-and high-risk groups and performed correlation analysis with immune cell infiltration and immune checkpoints. Finally, we constructed a nomogram of the prognostic model based on clinical factors and the risk score. We verified the predictive performance by using receiver operating characteristic (ROC) and calibration curves.Results: CYBA and SMPD3 were significantly related to prognosis of patients with EC and used to construct a risk model. There were significant differences in survival, immune cell infiltration and immune checkpoints between the low-and high-risk groups. The nomogram developed with clinical indicators and the risk scores was effective in predicting the prognosis of patients with EC.Conclusion: Our novel prognostic model based on CYBA and SMPD3 accurately predicted the prognosis and immunotherapy outcomes of patients with EC. Our results provide a new direction to study tumourgenesis and development, as well as guidance for clinical diagnosis and therapy of EC.
Clinical teaching practices in maternal mental health nursing. An integrated review
Authors: Hussein Chrissie , Baluwa Masumbuko , Bvumbwe Thokozani
Published: May 2022

Background
Clinical teaching of nursing and midwifery is critical for acquiring necessary competencies and developing confidence in students to make them ready for practice. Such competencies are especially important in midwifery practice in Malawi as there is a significant increase in maternal mental health problems in the country. Most cases are reported in the primary healthcare level maternity units where qualified nurse-midwives practise. However, reports show that maternal mental health has not been given adequate consideration and there is a huge service gap among nursing and midwifery personnel globally and in Malawi. This integrative review examined the literature on clinical teaching practices in maternal mental health to inform nursing and midwifery educators on the competencies taught in nursing colleges to improve the quality, quantity, and relevance of nursing and midwifery education
Method
PubMed, MEDLINE, Research4life, HINARI, Google scholar, and EBSCOhost were searched using clinical teaching, clinical practices, perinatal mental health, maternal mental health, clinical skills, and clinical education as keywords. Published works from 2014 to 2022 were reviewed.
Results
Six themes emerged; core curriculum, regulation of professional standards, clinical teaching strategies, a collaboration between educators and staff, capacity building, and availability of resources.
Conclusion
Nursing and midwifery training institutions should review their curriculum to maximize student learning opportunities in maternal mental health practice by creating more clinical-based learning opportunities that meet the students’ needs and those of the public.
Skin aseptic abscess secondary to dermatomyositis for 8 years follow-up: A case report and literature review
Authors: Ma Ke , Liu Zhihe , Shao Shihong , Wen Dawei , Zhao Lei , Liu Jingxuan , Zhu Fangyi , Liang Hongda
Published: May 2022

Background Dermatomyositis occurs with aseptic purulent changes in the skin is relatively rare. T he purpose of this report is to explore the clinical characteristics, etiology, diagnosis a nd treatment of dermatomyositis combined with skin aseptic abscess.Case presentation We report a case of dermatomyositis and skin aseptic abscess. After combined treatm ent with hormones, cyclosporine and cyclophosphamide, the skin aseptic abscess was effectively controlled.Conclusion Dermatomyositis and skin aseptic abscess are rare, and active treatment of the primar y disease is an alternative treatment strategy.
The relationship of GDF-15 with renal damage and dyslipidemia in non-albuminuric and albuminuric Type-2 Diabetes Mellitus
Authors: Yücel Hasan Esat , İlanbey Bilal
Published: May 2022

Aim: To investigate the correlation of GDF-15 with renal damage and dyslipidemia in Type-2 Diabetes Mellitus.Material and Method: The study was conducted prospectively with patients diagnosed with Type-2 Diabetes Mellitus. Two groups were formed as non-albuminuric (n:47) and albuminuric (n:24). Age, gender, comorbidities, GDF-15, glycemic index, lipid panel, GFR, urine albumin/creatin (ACR) and urine protein/creatin (PCR) ratios of the groups were compared and their correlations were examined.Results: GDF-15, age and hemoglobin A1c were found to be higher in the albuminuric group, and hemoglobin and hematocrit levels were found to be lower. A positive correlation of GDF-15 with urine ACR/PCR was observed in the albuminuric group. In the non-albuminuric group, was observed positive correlation with Triglyceride and negative correlation with HDL. Negative correlation of GDF-15 and GFR was detected in all participants.Conclusions: In type-2 DM, GDF-15 is positively correlated albuminuria and TRG elevation and negatively correlated with GFR and HDL