bluuebunny/crossref_metadata_2025 huggingface dataset:
Neurobrucellosis (Brucella ceti) in striped dolphins (Stenella coeruleoalba): Immunohistochemical studies on immune response and neuroinflammation
Authors: Rebollada-Merino Agustín , Giorda Federica , Pumarola Martí , Martino Laura , Gomez-Buendia Alberto , Romani-Cremaschi Umberto , Casalone Cristina , Mattioda Virginia , Di Nocera Fabio , Lucifora Giuseppe , Petrella Antonio , Domínguez Lucas , Domingo Mariano , Grattarola Carla , Rodríguez-Bertos Antonio
Published: May 2024

Neurobrucellosis is a shared condition of cetaceans and humans. However, the pathogenesis and immune response in cetacean neurobrucellosis has not been extensively studied. In this multicentric investigation, 21 striped dolphin ( Stenella coeruleoalba) neurobrucellosis ( Brucella ceti) cases diagnosed over a 10-year period (2012-2022) were retrospectively evaluated. For each case, morphological changes were assessed by evaluating 21 histological parameters. Furthermore, the immunohistochemical expression of Brucella antigen, glial fibrillary acid protein (GFAP), and a selection of inflammatory cell (IBA-1, CD3, and CD20) and cytokine (tumor necrosis factor-alpha [TNF-α], interferon-gamma [IFN-γ], interleukin [IL]-1β, IL-2, and IL-6) markers were investigated. Inflammation of the leptomeninges, ependyma, and/or choroid plexus was lymphohistiocytic, containing macrophages/microglia (IBA-1+), T-cells (CD3+), and B-cells (CD20+) in equal proportion. B-cells occasionally formed tertiary follicles. GFAP expression showed astrocytosis in most cases. Expression of TNF-α, IFN-γ, and IL-2 indicated an intense proinflammatory response, stimulating both macrophages and T-cells. Our results showed that the inflammation and neuroinflammation in neurobrucellosis of striped dolphins mimic human neurobrucellosis and in vitro and in vivo studies in laboratory animals. Cetacean disease surveillance can be exploited to expand the knowledge of the pathogenesis and immunology of infectious diseases, particularly brucellosis, under a One Health approach.
Does remote ischemic preconditioning affect the systemic inflammatory response by modulating presepsin levels?
Authors: Bayram Barıs , Senarslan Dilsad Amanvermez , Sengel Arife , Ozturk Tulun , Onur Ece , Iskesen Ihsan
Published: May 2024

Objective:

We investigated the effect of Remote Ischemic Preconditioning (RIPC) on the inflammatory response during CPB by means of serum presepsin levels at preoperative and postoperative 1st and 24th h.

Methods:

In this prospective, randomized, cross-sectional study we included 81 patients undergoing coronary artery bypass graft surgery with cardiopulmonary bypass (CPB). Patients were randomized and RIPC was applied to 40 patients in the study group before anesthesia. The remaining 41 patients were determined as the control group. The relationships between RIPC and factors such as presepsin, C-reactive protein (CRP), and leukocyte levels were investigated.

Results:

There was no significant difference between the groups in postoperative leukocyte and CRP values ( p = 0.52, p = 0.13, respectively). When the preoperative and postoperative first hour presepsin values of the patients were compared, no significant difference was found in the control group ( p = 0.17), but a significant difference was found in the study group ( p < 0.05). When the presepsin values were compared between the groups, a significant difference was found only in the postoperative first hour value ( p < 0.05).

Conclusions:

It was observed that RIPC application caused to increase the presepsin levels in the postoperative first hour significantly in the study group ( p < 0.05).
Etiological Subclassification of Stroke in Older People ≥80 Years Compared to Younger People: A Systematic Review and Meta-Analysis
Authors: Sanner Johan , Ström Jakob O. , von Euler Mia , Thommessen Bente , Fure Brynjar
Published: May 2024

Background

Due to the rapid growth of the world´s oldest population, the number of older persons with stroke is expected to rise. Knowledge of stroke etiology is essential to offer personalized and equal health care across age groups. The present systematic review aimed to investigate the prevalence of etiological subtypes of ischemic and hemorrhagic stroke in older compared to younger people.

Methods

MEDLINE, Embase, Cochrane, Epistemonikos, and Cinahl were systematically searched for studies regarding etiological classification in people ≥80 years compared to those <80 years with ischemic or hemorrhagic stroke.

Results

Out of 28 441 identified articles, eight met the inclusion criteria. In total, 8223 individuals were included in meta-analyses, of whom 2997 were 80 years or older. We demonstrated a higher prevalence of cardioembolic stroke in people ≥80 years OR 1.68 (95% CI, 1.12-2.53). Small vessel disease was significantly less common in older people OR .64 (95% CI, .50-.81). Regarding large vessel disease, no statistically significant difference between the two groups was shown OR 1.05 (95% CI, .77-1.43).

Conclusion

In people ≥80 years, cardioembolic stroke is more common, and small vessel disease less common compared to people <80 years. Overall, the results have to be interpreted with caution due to few studies. Large studies using validated classification systems are needed.
Structural, linear/non-linear optical, and optoelectrical properties of PVB/Bi2WO6 nanocomposite for industrial applications
Authors: Alziyadi Mohammed O , Alkabsh Asma , Said Basmat Amal M , Shalaby Mustafa S
Published: May 2024

Nanocomposite films composed of polyvinyl butyral (PVB) and Bi2WO6 were produced through solution casting. The goal of this investigation was to examine the effects of different Bi2WO6 concentrations (0%, 2%, and 4% wt.) on the linear/non-linear optical and optoelectrical properties, as well as the structure and dispersion of films of PVB/Bi2WO6 nanocomposite. The direct band gap Eg1 value falls from 5.1 eV to 3.83 eV with the progressive increase in Bi2WO6 content from 0% to 4% wt., while indirect band gap Eg2 decreased from 4.1 eV to 2.89 eV. Conversely, the PVB + 4% Bi2WO6 nanocomposite increased Urbach’s energy (EU) from 1.00 eV for pure PVB to 1.97 eV. Moreover, our research has documented the impact of different concentrations of Bi2WO6 on a range of optical properties, including the refractive index ( n), extinction coefficient ( k), and other pertinent parameters. Utilizing the real and imaginary components of the dielectric constants εr and εi, an investigation was carried out into the dielectrics’ behavior and the optoelectrical parameters’ calculation. Furthermore, investigations were performed on the linear optical susceptibility, the non-linear refractive index, and the third-order non-linear optical susceptibility concerning the concentrations of Bi2WO6. In addition, the results indicated that varying Bi2WO6 concentrations substantially affect the oscillator strength, average oscillator wavelength, and optical conductivity. The nanocomposite films of PVB/Bi2WO6 concentrations exhibited favorable associations between their optoelectrical and non-linear/linear optical parameters, rendering them viable candidates for implementation in flexible electronic devices and radiation shielding.
The optimal design of composite overwrapped pressure vessels based on geodesic dome trajectories using population-based techniques
Authors: Coskun Taner , Sahin Omer Sinan , Sen Muhammed Arif , Kalyoncu Mete
Published: May 2024

Pressure vessels are frequently fabricated using composite materials which stand out with their high strength-to-weight ratio, and provide considerable advantages compared to conventional steel ones. In our previous study, the impacts of Polar Opening Radius (POR) on the mechanical characteristics of Composite Overwrapped Pressure Vessels COPVs were numerically examined, and it was determined that effective volume and structural weight responses improved with higher POR, but significant deterioration took place in first-ply interlaminar shear stress (ILSS) responses after 20 mm POR. Therefore, to achieve the best possible mechanical and structural behaviors, the present study aimed to discover an optimum POR that provides maximum internal volume as well as minimum weight and ILSS responses. In this regard, the optimum geodesic dome trajectory based on the 10–30 mm POR range was determined using the Bees Algorithm (BA) and the Particle Swarm Optimization (PSO). According to the findings, the optimum POR was found as 17.9643 and 17.9671 mm due to the BA and PSO algorithms, respectively. Moreover, first-ply ILSS, structural weight and effective internal volume for the optimal COPVs design were achieved as 52.444 MPa, 1070.81 g, and 2721.94 cm3 from the BA, and thus COPVs with maximum strength and minimum structural weight has been designed. In this way, thanks to the optimization studies, an approximately 18.31% improvement in ILSS responses was achieved despite the negligible deterioration in weight and volume compared to the COPVs with a 30 mm POR.
Antimicrobial resistance determinants in the oropharyngeal microbiome of ‘men having sex with men’ attending an sexually transmitted infection clinic
Authors: Djusse Marielle Ezekielle , Gaspari Valeria , Morselli Sara , Rapparini Luca , Foschi Claudio , Ambretti Simone , Lazzarotto Tiziana , Piraccini Bianca Maria , Marangoni Antonella
Published: May 2024

Background

‘Men having sex with men’ (MSM) represent a key population with a significant prevalence of pharyngeal Neisseria gonorrhoeae (NG) infections and a high rate of antimicrobial resistance genes in the pharyngeal microbiome. As NG can acquire antibiotic resistance genes from other commensal oropharyngeal bacteria, monitoring the prevalence of these resistance determinants is critical to curtail the spread of NG-resistant strains.

Purpose and Research Design

Here, we assessed the distribution of five resistance genes ( pen (A), mtr (R), gyr (A), par (C), msr (D)) in the oropharynx of 164 MSM, attending an Outpatient clinic for STI screening.

Results

The most frequently detected resistance gene was msr (D) (88.4%), followed by gyr (A) (67.1%). The distribution of resistance genes was not influenced by pharyngeal gonorrhea nor by the HIV status, whereas a younger age was associated with mtr (R) presence ( p = .008). Subjects using mouthwash exhibited significantly lower levels of mtr (R) ( p = .0005). Smoking habit was associated with a higher prevalence of par (C) ( p = .02). A noteworthy association was observed between the presence of msr (D) gene and the use of antibiotics ( p = .014).

Conclusions

Our findings reveal an enrichment of antimicrobial resistance genes in the oropharynx of MSM. These insights could aid in the development of screening programs and antimicrobial stewardship initiatives targeting populations at heightened risk of pharyngeal gonorrhea.
Explaining mobilization for revolts by private interests and kinship relations. A comment on Armandola, Doehne and Rost
Authors: Nieva Ricardo
Published: May 2024

The authors study the role of kinship relationships in explaining mobilization for a revolt in Basel, Switzerland, in 1691; rebels consisted of a weaker fraction of the elite and individuals with citizen rights. The empirical section shows that revolts are mainly driven by the elite’s distant kin rather than the rebels’ close kin. Allowing for coalition formation, as in the new theory of corruption, conflict, and inequality proposed in this comment, can give an alternative explanation. In the first formal model, we assume “elite” corresponds to the term “enforcer” in the new theory. This is a nonproductive individual who is the strongest in terms of fighting against peasants over a prize in a contest. In this simple model, there are no other players. Thus, this framework predicts that the only rebels would come from within the elite. Historical evidence shows that the marginal elite got stronger relatively and, thus, excluded the oligarchy from the winning coalition to take over the government. The direct application of this model would imply that non-elite members were not part of the rebellion. However, the historical facts presented by Armandola et al. show that non-elite citizens also participated in the revolt. To match these facts in Armandola et al., we allow informally individuals with citizen rights to participate in the rebellion. Peasants, a term also used in the new theory, and marginalized groups (a term only used in the commented paper) in the cities did not participate. Kinship effects are discussed.
Patterns of Palliative Care Consultation in Neurosurgical Patients
Authors: Kieffer Sawyer , Arce John , Ogilvie Amy , Oya Hiroyuki , Hagiwara Yuya
Published: May 2024

Numerous neurosurgical (NSG) conditions entail high morbidity, mortality, and prolonged ICU stays. Palliative care (PC) serves to alleviate suffering, align treatment with patient preferences, and is linked to enhanced patient and family outcomes as well as reduced care costs. Notably, no studies have addressed demographic and clinical factors associated with PC receipt in NSG patients. Our aim is to identify characteristics and outcomes, particularly end of life outcomes, of hospitalized NSG patients associated with a PC consult compared with usual NSG care. A retrospective chart review was performed of patients admitted to the NSG service from January 1, 2017 to December 31, 2018 at the University of Iowa Hospitals & Clinics. Data regarding demographics, clinical outcomes, and GOC and ACP documentation were collected. The most common reasons for a PC consult were goals of care, end of life issues, and comfort care. Of 121 total decedent patients, 97 (80.2%) had PC referrals. Patients with a PC referral had longer hospital stays (10.3 days vs 4 days) and had the majority of care in the ICU (90.7% vs 83.3%). However, fewer PC patients died in the ICU (42.3% vs 75%) and more had PCA/NCA use (51.5% vs 8.3%), code status changes to DNR (90.7% vs 62.5%), GOC documented (78.4% vs 0%) and ACP documentation (35.1% vs 16.7%). In conclusion, in NSG patients, the integration of PC may contribute to improved end-of-life care.
Integrating Network Pharmacology and Molecular Docking Approach to Elucidate the Mechanism of Commiphora wightii for the Treatment of Rheumatoid Arthritis
Authors: Abdel-Maksoud Mostafa A , Askar Mostafa A , Abdel-rahman Ibrahim Y , Gharib Mustafa , Aufy Mohammed
Published: May 2024

Background:

Rheumatoid arthritis (RA) is considered a notable prolonged inflammatory condition with no proper cure. Synovial inflammation and synovial pannus are crucial in the onset of RA. The “tumor-like” invading proliferation of new arteries is a keynote of RA. Commiphora wightii ( C wightii) is a perennial, deciduous, and trifoliate plant used in several areas of southeast Asia to cure numerous ailments, including arthritis, diabetes, obesity, and asthma. Several in vitro investigations have indicated C wightii’s therapeutic efficacy in the treatment of arthritis. However, the precise molecular action is yet unknown.

Material and methods:

In this study, a network pharmacology approach was applied to uncover potential targets, active therapeutic ingredients and signaling pathways in C wightii for the treatment of arthritis. In the groundwork of this research, we examined the active constituent-compound-target-pathway network and evaluated that (Guggulsterol-V, Myrrhahnone B, and Campesterol) decisively donated to the development of arthritis by affecting tumor necrosis factor (TNF), PIK3CA, and MAPK3 genes. Later on, docking was employed to confirm the active components’ efficiency against the potential targets.

Results:

According to molecular-docking research, several potential targets of RA bind tightly with the corresponding key active ingredient of C wightii. With the aid of network pharmacology techniques, we conclude that the signaling pathways and biological processes involved in C wightii had an impact on the prevention of arthritis. The outcomes of molecular docking also serve as strong recommendations for future research. In the context of this study, network pharmacology combined with molecular docking analysis showed that C wightii acted on arthritis-related signaling pathways to exhibit a promising preventive impact on arthritis.

Conclusion:

These results serve as the basis for grasping the mechanism of the antiarthritis activity of C wightii. However, further in vivo/ in vitro study is needed to verify the reliability of these targets for the treatment of arthritis.
A resiliency intervention adapted for older women with HIV: Results from a pilot randomized controlled trial in the northeastern US
Authors: Psaros Christina , Stanton Amelia M , Goodman Georgia R , Blyler Abigail , Vangel Mark , Labbe Allison K , Robbins Gregory K , Park Elyse R
Published: May 2024

Aging with HIV often results in psychosocial and health-related challenges for women; however, no resiliency interventions exist for older women with HIV (WWH). WWH aged ≥50 were randomized to 10 group sessions of an adapted resiliency intervention or time-matched supportive psychotherapy. Assessments were conducted at three timepoints. Feasibility and acceptability metrics were defined a priori; differences in resilience, stress coping, anxiety, and depression across timepoints were assessed. Overall, 44 WWH enrolled; participants were 58 years old on average, and 56.4% identified as Black/African American. Among those who attended any sessions, all feasibility metrics were met, and the intervention was acceptable. The interaction of study arm and time was associated with significant decreases in depression and a trend toward significant decreases in anxiety. The intervention was not associated with changes in resilience or stress coping. Adjusting delivery modality may further reduce barriers to attendance, improving feasibility and clinical outcomes.
Impact of inflammatory bowel disease on women’s reproductive life: a questionnaire-based study
Authors: Zingone Fabiana , Borsato Alessandro , Maniero Daria , Della Loggia Francesco , Lorenzon Greta , Zanini Annalisa , Canova Cristina , Barberio Brigida , Savarino Edoardo Vincenzo
Published: May 2024

Background:

Inflammatory bowel diseases (IBDs) have a peak incidence between the second and fourth decades of life and can affect women’s reproductive life.

Objectives:

Our study aimed to assess the impact of IBD on the reproductive life of female patients with this condition.

Design:

Cross-sectional study.

Methods:

Women with IBD followed at our IBD Unit and a group of healthy controls were enrolled. Data on reproductive life were collected using a dedicated questionnaire.

Results:

The study included 457 women, of whom 228 had IBD, and 229 age-matched healthy controls. No differences were found in the use of contraceptives, infertility, and endometriosis. The risk of spontaneous and voluntary abortions was significantly higher in IBD patients than in healthy controls [odds ratio (OR) 2 and 3.62, respectively]. The risk of obstetrical complications in the IBD population was more than six times higher in patients who experienced disease reactivations during pregnancy than in those with persistent remission [OR 6.9, 95% confidence interval (CI) 1.51–31.28]. Finally, we found that the chances of breastfeeding were 66% lower in patients with IBD than in controls (OR 0.44, 95% CI 0.22–0.91).

Conclusion:

Our study underlines the negative impact of IBD on women’s reproductive life, supporting the need for proactive preconception counseling.
Vasa previa Type 3: Advocating for universal screening and investigation of risk factors: A case report
Authors: Mohamad Hawraa , Yared Georges , Al Hassan Jihad , Nakib Hamza , El Hajjar Charlotte , Ghazal Kariman
Published: May 2024

Vasa previa is a critical obstetric condition marked by unprotected fetal vessels near the cervical os, traditionally divided into Types 1 and 2, based on its association with velamentous cord insertion and accessory placental lobes, respectively. The recent introduction of Type 3 vasa previa addresses atypical cases. We report a unique intrapartum diagnosis of Type 3 vasa previa in a 39-year-old at 38 weeks of gestation, identified during labor induction without prior risk indicators. Despite lacking traditional risk factors, advanced imaging and clinical vigilance led to a primary cesarean delivery, confirming the diagnosis through intraoperative findings of three aberrant vessels with marginal cord insertion. This case emphasizes the critical importance of considering vasa previa in prenatal and intrapartum care to prevent adverse outcomes, advocating for universal screening practices to identify this rare but significant condition.
Factors Affecting Sustainable Tourism Development: Evidence from the Central Highlands of Vietnam
Authors: Nguyen Thang Duc , Nguyen Nam Thanh , Thanh Nguyen Nghi
Published: May 2024

Tourism is a very important part of Vietnam’s economy, and the country’s central highlands offer a lot of chances to grow tourism. However, due to the challenging terrain, remote location, and diverse ethnic populations, creating sustainable tourism in this area poses a significant challenge. To address this issue, our study employs quantitative research methodologies, including questionnaire surveys conducted with local stakeholders. Our research identifies cultural, economic, infrastructural, policy, and regulatory factors as critical drivers of long-term tourism growth in the region. The results show that sustainable tourism growth in Vietnam’s central highlands needs a complete plan that considers the area’s unique natural and cultural environment. In addition, our research gives policymakers and people in the tourism industry important information they can use to promote sustainable tourism development in this region.
Team Cohesion in Records/Martial Arts Sport Athletes: Transformational Leadership and the Role of Narcissism
Authors: Oh Youngtaek
Published: May 2024

This study aimed to determine the relationship between narcissism and team cohesion of transformational leadership and individual sports athletes interactions. In particular, individual sports can present a model to verify the level of perception of team cohesion according to the type of record sports and martial arts sports. Transformational leadership, narcissism, and team cohesion were measured among 225 college athletes. SPSS 24.0, Amos 24.0, PROCESS Macro programs (Model No. 5) were used for data analysis. The analysis includes frequency analysis, Cronbach’s alpha values, confirmatory factor analysis (CFA), Pearson’s correlation, and moderating effect. Transformational leadership significantly positively affected team cohesion and narcissism. Non-narcissism also significantly positively affected team cohesion. The interaction between transformational leadership and individual athletes was significantly higher for martial arts sports. Team cohesion was also important for athletes in individual sports, thus expanding the boundaries of transformational leadership theory. To cultivate a sports team (organization), strategic sports management will be necessary to enhance team cohesion.
Major Selection as Iteration: Observing Gendered Patterns of Major Selection Under Elective Curriculums
Authors: Dalberg Tobias , Cortes Kalena E. , Stevens Mitchell L.
Published: May 2024

Social scientists have long recognized field of study as an important mechanism of gender differentiation and stratification in U.S. higher education, but they have rarely attended to how elective curriculums mediate gender differentiation in major selection. Under elective curriculums, major selection is an iterative process, in which students select courses in stepwise fashion at the beginning of each academic term, and are able to change majors early in their undergraduate careers. We observe how an elective curriculum mediates gendered patterns of major selection, using a novel data set describing 11,730 students at a large public research university. We find (a) gender and intended major are strongly correlated upon college entry; (b) large proportions of students change majors between entry and declaration; (c) because most changes are to academically adjacent fields, gendered patterns in field of study persist through the undergraduate career. Findings suggest the value of an iterative conception of major selection and offer tractable means for intervening in the process through which students select majors.

JEL codes: I21, I24, I26, J16.
Analysis of the intestinal microbiota and profiles of blood amino acids and acylcarnitines in neonates with hyperbilirubinemia
Authors: Li Junguo , Ye Shenglin , Huang Xinyuan , Yang Guolong , Wang Yijin , Zeng Jianghui , Lai Chunhui
Published: May 2024

Objective

This study aimed to discuss the distinctive features of the intestinal microbiota in neonates with hyperbilirubinemia and to comprehensively analyse the composition of the intestinal microbiota as well as the levels of free amino acids and acylcarnitines in the peripheral blood of neonates experiencing hyperbilirubinemia.

Results

At the phylum level, Proteobacteria, Firmicutes, Actinobacteria, Bacteroidetes, and Chloroflexi were the five predominant microbial groups identified in both the hyperbilirubinemia and control groups. Alpha diversity analysis, encompassing seven indices, showed no statistically significant differences between the two groups. However, Beta diversity analysis revealed a significant difference in intestinal microbiota structure between the groups. Linear discriminant analysis effect size (LEfSe) indicated a significant reduction in the abundance of Gammaproteobacteria and Enterobacteriaceae within the hyperbilirubinemia group compared to that in the control group. The heatmap revealed that the control group exhibited increased abundances of Escherichia and Bifidobacterium, while the hyperbilirubinemia group exhibited increased levels of Enterococcus and Streptococcus. Regarding blood amino acids and acylcarnitines, there were greater concentrations of citrulline (Cit), arginine (Arg), ornithine (Orn), and valine (Val) in the hyperbilirubinemia group than in the control group. The hyperbilirubinemia group also exhibited significant increases in medium-chain fatty acids (C6, C8), long-chain fatty acids (C18), and free carnitine (C0).

Conclusion

By comparing neonates with hyperbilirubinemia to those without, a significant disparity in the community structure of the intestinal microbiota was observed. The intestinal microbiota plays a crucial role in the bilirubin metabolism process. The intestinal microbiota of neonates with hyperbilirubinemia exhibited a certain degree of dysbiosis. The abundances of Bacteroides and Bifidobacterium were negatively correlated with the bilirubin concentration. Therefore, the fact that neonates with hyperbilirubinemia exhibit some variations in blood amino acid and acylcarnitine levels may provide, to a certain degree, a theoretical basis for clinical treatment and diagnosis.
The effect of deep and awake extubation on emergence agitation after nasal surgery: a randomized controlled trial
Authors: Suo Lulu , Lu Lu , Li Jingjie , Qiu Lin , Liu Jinxing , Shi Jinya , Sun Zhujie , Lao Wei , Zhou Xuhui
Published: May 2024

Background

Post-anesthetic emergence agitation is common after general anesthesia and may cause adverse consequences, such as injury as well as respiratory and circulatory complications. Emergence agitation after general anesthesia occurs more frequently in nasal surgery than in other surgical procedures. This study aimed to assess the occurrence of emergence agitation in patients undergoing nasal surgery who were extubated under deep anesthesia or when fully awake.

Methods

A total of 202 patients (18–60 years, American Society of Anesthesiologists classification: I–II) undergoing nasal surgery under general anesthesia were randomized 1:1 into two groups: a deep extubation group (group D) and an awake extubation group (group A). The primary outcome was the incidence of emergence agitation. The secondary outcomes included number of emergence agitations, sedation score, vital signs, and incidence of adverse events.

Results

The incidence of emergence agitation was lower in group D than in group A (34.7% vs. 72.8%; p < 0.001). Compared to group A, patients in group D had lower Richmond Agitation-Sedation Scale scores, higher Ramsay sedation scores, fewer agitation episodes, and lower mean arterial pressure when extubated and 30 min after surgery, whereas these indicators did not differ 90 min after surgery. There was no difference in the incidence of adverse events between the two groups.

Conclusions

Extubation under deep anesthesia can significantly reduce emergence agitation after nasal surgery under general anesthesia without increasing the incidence of adverse events.

Trial registration

Registered in Clinicaltrials.gov (NCT04844333) on 14/04/2021.
Dental caries prevalence in children during temporary protective care according to type of abuse
Authors: Nakamura Yuki , Nogami Yukiko , Iwase Yoko , Hozawa Mio , Sotome Tetsuya , Saitoh Issei , Ohuchi Akitsugu , Hayasaki Haruaki
Published: May 2024

Background

This study investigated the correlation between the prevalence of dental caries and the presence and type of abuse.

Methods

Participants were 534 children admitted for care at two child guidance centers (CGCs) in Niigata, Japan. Data pertaining to abuse, including the reason for temporary protective care and the type of abuse, and the oral examination results of the children, were collected. These results were then compared with those of a national survey and analyzed in relation to the presence and type of abuse.

Results

The odds ratio for decayed teeth was 4.1, indicating a higher risk in children admitted to the CGCs. However, no significant association was found between the presence of decayed, filled, or caries-experienced teeth and the presence of abuse. A significant positive association was observed between dental caries and one type of abuse, indicating a greater prevalence of dental caries in cases of neglect. The findings of this study suggest that the type of abuse, rather than its presence, is associated with dental caries.

Conclusions

Our findings suggest that proactive support should be provided to children in problematic nurturing environments, regardless of whether they have been subjected to abuse.
Identification of hub genes and therapeutic siRNAs to develop novel adjunctive therapy for Duchenne muscular dystrophy
Authors: Li Na , Xiahou Zhikai , Li Zhuo , Zhang Zilian , Song Yafeng , Wang Yongchun
Published: May 2024

Objective

Duchenne muscular dystrophy (DMD) is a devastating X-linked neuromuscular disorder caused by various defects in the dystrophin gene and still no universal therapy. This study aims to identify the hub genes unrelated to excessive immune response but responsible for DMD progression and explore therapeutic siRNAs, thereby providing a novel treatment.

Methods

Top ten hub genes for DMD were identified from GSE38417 dataset by using GEO2R and PPI networks based on Cytoscape analysis. The hub genes unrelated to excessive immune response were identified by GeneCards, and their expression was further verified in mdx and C57 mice at 2 and 4 months (M) by (RT-q) PCR and western blotting. Therapeutic siRNAs were deemed as those that could normalize the expression of the validated hub genes in transfected C2C12 cells.

Results

855 up-regulated and 324 down-regulated DEGs were screened from GSE38417 dataset. Five of the top 10 hub genes were considered as the candidate genes unrelated to excessive immune response, and three of these candidates were consistently and significantly up-regulated in mdx mice at 2 M and 4 M when compared with age-matched C57 mice, including Col1a2, Fbn1 and Fn1. Furthermore, the three validated up-regulated candidate genes can be significantly down-regulated by three rational designed siRNA (p < 0.0001), respectively.

Conclusion

COL1A2, FBN1 and FN1 may be novel biomarkers for DMD, and the siRNAs designed in our study were help to develop adjunctive therapy for Duchenne muscular dystrophy.
Comparison of efficacy of nadroparin and fondaparinux sodium for prevention of deep vein thromboembolism in lower extremities after total hip arthroplasty and total knee arthroplasty: a retrospective study of 592 patients
Authors: Gao Xiang , Jin Xiaowei , Huang Rui , Li Zhenxing , Zhang Hanle , Fan Pei
Published: May 2024

Objectives

To compare the efficacy of nadroparin and fondaparinux sodium for prevention of deep vein thromboembolism (DVT) in lower extremities after total hip arthroplasty (THA) and total knee arthroplasty (TKA).

Methods

A total of 592 patients were enrolled in the study. Clinical data of patients who underwent total hip arthroplasty (THA) and total knee arthroplasty (TKA) in our hospital from December 2021 to September 2022 were retrospectively collected, which mainly included patients’ general information, surgery-related information, and DVT-related information. The patients were categorized into the nadroparin group(n = 278) and the fondaparinux sodium group(n = 314) according to the types of anticoagulants used. Anticoagulant therapy began 12–24 h after operation and continued until discharge. DVT prevalence between two groups was compared. The Statistical Package for Social Sciences (SPSS) software version 25 (SPSS, Armonk, NY, USA) was used for statistical analysis.

Results

The prevalence of DVT in the nadroparin group and the fondaparinux sodium group was 8.3% (23/278) and 15.0% (47/314), respectively(p = 0.012). Statistical analysis showed that nadroparin group showed a lower prevalence of thrombosis than fondaparinux group (OR = 1.952, P = 0.012). Subgroup analyses showed that nadroparin group had a lower prevalence of DVT than fondaparinux group in some special patients groups such as female patients (OR = 2.258, P = 0.007), patients who are 65–79 years old (OR = 2.796, P = 0.004), patients with hypertension (OR = 2.237, P = 0.042), patients who underwent TKA (OR = 2.091, P = 0.011), and patients who underwent combined spinal-epidural anesthesia (OR = 2.490, P = 0.003) (P < 0.05).

Conclusion

Nadroparin may have an advantage over fondaparinux sodium in preventing DVT in lower extremities after THA and TKA.
A rare case of spontaneous bladder wall abscess mimicking bladder tumour in young women
Authors: Alfarizi Zico Yusuf , Subekti Eko , Danarto  , Yuri Prahara
Published: May 2024

Introduction

Abscess of the bladder wall is a rare urological disorder, with a few cases recorded in the literature. The finding of a bladder wall mass via computed tomography (CT) imaging in a visiting patient is the subject of this report.

Case discussion

A 37-year-old woman with persistent pain in the suprapubic area and lower urinary tract symptoms was examined as a case study. Through a CT scan revealed an inhomogeneous structure in the anteroinferior part of the right bladder. A cystoscopy procedure followed by transurethral resection was performed to remove the mass, which was found to be an abscess. A Foley catheter with irrigation was administered after surgery, and the patient goes home in three days.

Conclusion

the patient had no symptoms or discomfort in the lower urinary tract after follow-up. Despite the rarity of bladder wall abscesses, cystoscopy can be used to aid diagnosis. Transurethral resection of bladder wall can reduce the mass and eliminate the possibility of malignancy.
Prognostic factors and overall survival of breast cancer in Benin: a hospital-based study
Authors: Gnangnon Freddy Houéhanou Rodrigue , Parenté Alexis , Aboubakar Moufalilou , Kiki-migan Yannick , Totah Terence , Gbessi Dansou Gaspard , Tonato-Bagnan Josiane Angéline , Laleye Anatole , Preux Pierre-Marie , Denakpo Justin Lewis , Blanquet Véronique , Houinato Dismand Stephan
Published: May 2024

Background

In Benin, a country in West Africa, breast cancer is the leading cancer in women, both in terms of incidence and mortality. However, evidence on the mortality of breast cancer and its associated factors is lacking in this country. Our aim was to describe and analyze the clinical, histopathological, and prognostic aspects of breast cancer in Benin.

Methods

A descriptive and analytical study was carried out at the CNHU-HKM and the CHU-MEL, two major tertiary referral hospitals for breast cancer management located in Cotonou, the capital city of Benin. All breast cancer medical records with histological evidence and immunohistochemistry studies were retrospectively collected between January 1, 2014, and September 30, 2020, in these two tertiary referral hospitals and analyzed in the current study.

Results

Finally, 319 medical records were included. The mean age at diagnosis was 48.74 years. The tumors were most frequently classified as T4 (47.6%) with lymph node involvement N2 (34.5%), and metastases were clinically noted in 21.9% of cases. Stage was reported in the medical records of 284 patients. Tumors were diagnosed at very late AJCC stages: stage III (47.5%) and stage IV (24.7%). Grades SBR 2 (49.2%) and SBR 3 (32.6%) were the most frequent grades. Triple-negative breast cancer (31.3%) was the most common molecular type. The overall 5-year survival was 48.49%. In multivariable analysis, the poor prognostic factors were lymph node invasion (HR = 2.63; p = 0.026; CI: [1.12, 6.17]), the presence of metastasis (HR = 3.64; p < 0.001); CI: [2.36, 5.62] and the immunohistochemical profile (HR = 1.29; p < 0.001; CI: [1.13, 1.48]).

Conclusions

Breast cancer in Beninese is predominant in young adults and is often diagnosed at a late stage. The survival of breast cancer patients in Benin can be improved by enhancing early diagnosis and multidisciplinary management.
YAP/TAZ activation mediates PQ-induced lung fibrosis by sustaining senescent pulmonary epithelial cells
Authors: Yu Youjia , Chu Chunyan , Wang Kang , Li Yan , Mao Zhengsheng , Hu Li , Wang Jie , Yu Yanfang , Sun Hao , Chen Feng
Published: May 2024

Paraquat (PQ) is a widely used herbicide and a common cause of poisoning that leads to pulmonary fibrosis with a high mortality rate. However, the underlying mechanisms of PQ-induced pulmonary fibrosis and whether pulmonary epithelial cell senescence is involved in the process remain elusive. In this study, PQ-induced pulmonary epithelial cell senescence and Hippo-YAP/TAZ activation were observed in both C57BL/6 mice and human epithelial cells. PQ-induced senescent pulmonary epithelial cells promoted lung fibroblast transformation through secreting senescence-associated secretory phenotype (SASP) factors. Yap/Taz knockdown in mice lungs significantly decreased the expression of downstream profibrotic protein Ctgf and senescent markers p16 and p21, and alleviated PQ-induced pulmonary fibrosis. Interfering YAP/TAZ in senescent human pulmonary epithelial cells resulted in decreased expression of the anti-apoptosis protein survivin and elevated level of apoptosis. In conclusion, our findings reveal a novel mechanism by which the involvement of Hippo-YAP/TAZ activation in pulmonary epithelial cell senescence mediates the pathogenesis of PQ-induced pulmonary fibrosis, thereby offering novel insights and potential targets for the clinical management of PQ poisoning as well as providing the mechanistic insight of the involvement of Yap/Taz activation in cell senescence in pulmonary fibrosis and its related pulmonary disorders. The YIN YANG balance between cell senescence and apoptosis is important to maintain the homeostasis of the lung, the disruption of which will lead to disease.
Comparative microbiome analysis in cystic fibrosis and non-cystic fibrosis bronchiectasis.
Authors: Motta Heryk , Reuwsaat Júlia Catarina Vieira , Lopes Fernanda Cortez , Viezzer Graciele , Volpato Fabiana Caroline Zempulski , Barth Afonso Luís , de Tarso Roth Dalcin Paulo , Staats Charley Christian , Vainstein Marilene Henning , Kmetzsch Lívia
Published: May 2024

Background

Bronchiectasis is a condition characterized by abnormal and irreversible bronchial dilation resulting from lung tissue damage and can be categorized into two main groups: cystic fibrosis (CF) and non-CF bronchiectasis (NCFB). Both diseases are marked by recurrent infections, inflammatory exacerbations, and lung damage. Given that infections are the primary drivers of disease progression, characterization of the respiratory microbiome can shed light on compositional alterations and susceptibility to antimicrobial drugs in these cases compared to healthy individuals.

Methods

To assess the microbiota in the two studied diseases, 35 subjects were recruited, comprising 10 NCFB and 13 CF patients and 12 healthy individuals. Nasopharyngeal swabs and induced sputum were collected, and total DNA was extracted. The DNA was then sequenced by the shotgun method and evaluated using the SqueezeMeta pipeline and R.

Results

We observed reduced species diversity in both disease cohorts, along with distinct microbial compositions and profiles of antimicrobial resistance genes, compared to healthy individuals. The nasopharynx exhibited a consistent microbiota composition across all cohorts. Enrichment of members of the Burkholderiaceae family and an increased Firmicutes/Bacteroidetes ratio in the CF cohort emerged as key distinguishing factors compared to NCFB group. Staphylococcus aureus and Prevotella shahii also presented differential abundance in the CF and NCFB cohorts, respectively, in the lower respiratory tract. Considering antimicrobial resistance, a high number of genes related to antibiotic efflux were detected in both disease groups, which correlated with the patient’s clinical data.

Conclusions

Bronchiectasis is associated with reduced microbial diversity and a shift in microbial and resistome composition compared to healthy subjects. Despite some similarities, CF and NCFB present significant differences in microbiome composition and antimicrobial resistance profiles, suggesting the need for customized management strategies for each disease.
Circulating total and H-specific GDF15 levels are elevated in subjects with MASLD but not in hyperlipidemic but otherwise metabolically healthy subjects with obesity
Authors: Boutari Chrysoula , Stefanakis Konstantinos , Simati Stamatia , Guatibonza-García Valentina , Valenzuela-Vallejo Laura , Anastasiou Ioanna A. , Connelly Margery A. , Kokkinos Alexander , Mantzoros Christos S.
Published: May 2024

Background

Growth differentiation factor 15 (GDF15) is a mitokine, the role of which, total or H-specific, in modulating energy metabolism and homeostasis in obesity-related diseases, such as metabolic dysfunction associated steatotic liver disease (MASLD), has not been fully elucidated in adult humans. We aimed to investigate the fasting and stimulated levels of GDF15, total and H-specific, glucose-dependent insulinotropic polypeptide (GIP) and C-peptide, in two physiology interventional studies: one focusing on obesity, and the other on MASLD.

Methods

Study 1 investigated individuals with normal weight or with obesity, undergoing a 3-h mixed meal test (MMT); and study 2, examined adults with MASLD and controls undergoing a 120-min oral glucose tolerance test (OGTT). Exploratory correlations of total and H-specific GDF15 with clinical, hormonal and metabolomic/lipidomic parameters were also performed.

Results

In study 1, 15 individuals were included per weight group. Fasting and postprandial total and H-specific GDF15 were similar between groups, whereas GIP was markedly higher in leaner individuals and was upregulated following a MMT. Baseline and postprandial C-peptide were markedly elevated in people with obesity compared with lean subjects. GIP was higher in leaner individuals and was upregulated after a MMT, while C-peptide and its overall AUC after a MMT was markedly elevated in people with obesity compared with lean subjects. In study 2, 27 individuals were evaluated. Fasting total GDF15 was similar, but postprandial total GDF15 levels were significantly higher in MASLD patients compared to controls. GIP and C-peptide remained unaffected. The postprandial course of GDF15 was clustered among those of triglycerides and molecules of the alanine cycle, was robustly elevated under MASLD, and constituted the most notable differentiating molecule between healthy and MASLD status. We also present robust positive correlations of the incremental area under the curve of total and H-specific GDF15 with a plethora of lipid subspecies, which remained significant after adjusting for confounders.

Conclusion

Serum GDF15 levels do not differ in relation to weight status in hyperlipidemic but otherwise metabolically healthy individuals. In contrast, GDF15 levels are significantly increased in MASLD patients at baseline and they remain significantly higher compared to healthy participants during OGTT, pointing to a role for GDF15 as a mitokine with important roles in the pathophysiology and possibly therapeutics of MASLD.

Trial registration ClinicalTrials.gov NCT03986684, NCT04430946.
Acute kidney injury after out-of-hospital cardiac arrest
Authors: Jeppesen Karoline Korsholm , Rasmussen Sebastian Buhl , Kjaergaard Jesper , Schmidt Henrik , Mølstrøm Simon , Beske Rasmus Paulin , Grand Johannes , Ravn Hanne Berg , Winther-Jensen Matilde , Meyer Martin Abild Stengaard , Hassager Christian , Møller Jacob Eifer
Published: May 2024

Background

Acute kidney injury (AKI) is a significant risk factor associated with reduced survival following out-of-hospital cardiac arrest (OHCA). Whether the severity of AKI simply serves as a surrogate measure of worse peri-arrest conditions, or represents an additional risk to long-term survival remains unclear.

Methods

This is a sub-study derived from a randomized trial in which 789 comatose adult OHCA patients with presumed cardiac cause and sustained return of spontaneous circulation (ROSC) were enrolled. Patients without prior dialysis dependent kidney disease and surviving at least 48 h were included (N = 759). AKI was defined by the kidney disease: improving global outcome (KDIGO) classification, and patients were divided into groups based on the development of AKI and the need for continuous kidney replacement therapy (CKRT), thus establishing three groups of patients—No AKI, AKI no CKRT, and AKI CKRT. Primary outcome was overall survival within 365 days after OHCA according to AKI group. Adjusted Cox proportional hazard models were used to assess overall survival within 365 days according to the three groups.

Results

In the whole population, median age was 64 (54–73) years, 80% male, 90% of patients presented with shockable rhythm, and time to ROSC was median 18 (12–26) min. A total of 254 (33.5%) patients developed AKI according to the KDIGO definition, with 77 requiring CKRT and 177 without need for CKRT. AKI CKRT patients had longer time-to-ROSC and worse metabolic derangement at hospital admission. Overall survival within 365 days from OHCA decreased with the severity of kidney injury. Adjusted Cox regression analysis found that AKI, both with and without CKRT, was significantly associated with reduced overall survival up until 365 days, with comparable hazard ratios relative to no AKI (HR 1.75, 95% CI 1.13–2.70 vs. HR 1.76, 95% CI 1.30–2.39).

Conclusions

In comatose patients who had been resuscitated after OHCA, patients developing AKI, with or without initiation of CKRT, had a worse 1-year overall survival compared to non-AKI patients. This association remains statistically significant after adjusting for other peri-arrest risk factors.

Trial registration: The BOX trial is registered at ClinicalTrials.gov: NCT03141099.