bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between nutrient patterns and hyperuricemia: mediation analysis involving obesity indicators in the NHANES
Authors: Wang Juping , Chen Shuting , Zhao Junkang , Liang Jie , Gao Xue , Gao Qian , He Simin , Wang Tong
Published: October 2022

Background

Diet has long been hypothesized to play an important role in hyperuricemia, and weight gain is a factor that is strongly associated with the rise in serum urate. We aimed to clarify the mediating role of obesity in the relationship between diet and hyperuricemia and to determine whether a weight-loss diet is an effective way to prevent hyperuricemia.

Methods

This cross-sectional study analysed representative samples of United States (n = 20,081; NHANES 2007–2016) adults. Nutrient patterns were derived with two methods: principal component analysis (PCA) and reduced rank regression (RRR) with obesity. Logistic regression and multivariable linear regression were applied to analyse the association between nutrient patterns in obesity and hyperuricemia. Mediation analyses were used to determine whether four obesity indicators, including body mass index (BMI), waist circumference (WC), visceral adiposity index (VAI) and lipid accumulation product index (LAP), mediated the relationship between nutrient patterns and hyperuricemia.

Results

PCA revealed three nutrient patterns (including “Low energy diet”, “Lower vitamin A, C, K pattern” and “Vitamin B group”), and only Vitamin B group had a total effect on hyperuricemia. RRR revealed one main nutrient pattern associated with obesity, which was characterized by High fat and low vitamin levels and was significantly associated with hyperuricemia. Mediation analysis showed that obesity mostly or even completely mediated the relationship between nutrient patterns and hyperuricemia, especially traditional obesity indicators, which played a key intermediary effect. The proportions of indirect effects for BMI and WC were as high as 53.34 and 59.69, respectively.

Conclusions

Our findings suggest that the direct effect of diet on hyperuricemia is weak, and obesity plays a critical mediating role in the relationship between diet and hyperuricemia, which confirms that a weight-loss diet such as a “Low fat and high vitamin diet” may be useful in preventing hyperuricemia.
Association between statins and progression of osteoarthritis features on magnetic resonance imaging in a predominantly pre-radiographic cohort: the Vancouver Longitudinal Study of Early Knee Osteoarthritis (VALSEKO): a cohort study
Authors: Gill Jagdeep , Sayre Eric C. , Guermazi Ali , Nicolaou Savvas , Cibere Jolanda
Published: October 2022

Background

To evaluate the effect of statin use on osteoarthritis (OA) incidence/progression using magnetic resonance imaging (MRI) in a population-based cohort with predominantly pre-radiographic knee OA.

Methods

A cohort aged 40–79 years with knee pain was recruited using random population sampling and followed for 7 years. Baseline exclusions were inflammatory arthritis, recent knee surgery/injury, and inability to undergo MRI. At baseline, current statin use was ascertained. Baseline and follow-up MRIs were read semi-quantitatively for cartilage damage (grade 0–4, 0/1 collapsed, 6 regions), osteophytes (grade 0–3, 8 regions), bone marrow lesions (BML) (grade 0–3, 6 regions) and effusion (grade 0–3). The primary outcome was cartilage damage incidence/progression, while secondary outcomes were incidence/progression of osteophytes, BML, and effusion, each defined as an increase by ≥1 grade at any region. To ensure population representative samples, sample weights were used. Logistic regression was used to assess the association of statin use at baseline with incidence/progression of MRI outcomes. Analyses were adjusted for sex, age, BMI, and multiple comorbidities requiring statin therapy.

Results

Of 255 participants evaluated at baseline, 122 completed the 7-year follow-up. Statin use was not significantly associated with progression of cartilage damage (OR 0.82; 95% CI 0.17, 4.06), osteophytes (OR 3.48; 95% CI 0.40, 30.31), BML (OR 0.61; 95% CI 0.12, 3.02), or effusion (OR 2.38; 95% CI 0.42, 13.63), after adjusting for confounders.

Conclusion

In this population-based cohort of predominantly pre-radiographic knee OA, statins did not affect MRI incidence/progression of cartilage damage, BML, osteophytes or effusion. Therefore, statin use does not appear to affect people with pre-radiographic stages of knee OA.
Preoperative serum CA19-9 predicts postoperative pancreatic fistula in PDAC patients: retrospective analysis at a single institution
Authors: Sugita Hiroki , Okabe Hirohisa , Ogawa Daisuke , Hirao Hiroki , Kuroda Daisuke , Taki Katsunobu , Tomiyasu Shinjiro , Hirota Masahiko
Published: October 2022

Background

Postoperative pancreatic fistula (POPF) is a critical complication of pancreatectomy in patients with pancreatic ductal adenocarcinoma (PDAC). Recent papers reported that serum carbohydrate antigen (CA)19-9 levels predicted long-term prognosis. We investigated whether preoperative serum CA19-9 levels were associated with POPF in PDAC patients.

Methods

This cohort study was conducted at a single institution retrospectively. Clinicopathologic features were determined using medical records.

Results

Among of 196 consecutive patients who underwent pancreatectomy against PDAC, 180 patients whose CA19-9 levels were above the measurement sensitivity, were registered in this study. The patients consisted of 122 patients who underwent pancreaticoduodenectomy and 58 patients who underwent distal pancreatectomy. Several clinicopathological factors, including CA 19-9 level, as well as surgical factors were determined retrospectively based on the medical records. Patients with high CA19-9 levels had a significantly higher incidence of POPF than those with low levels (43.9 vs. 13.0%, P < 0.0001). The receiver operating characteristic curves calculated that the cutoff CA19-9 value to predict POPF was 428 U/mL. CA19-9, BMI, curability, and histology were statistically significant risk factors for POPF by univariate analysis. Multivariate analysis showed that CA19-9 and BMI levels were statistically significant independent risk factors for POPF. CA19-9 levels were correlated with both histology and curability. Disease free survival and overall survival of patients with higher levels of CA19-9 were significantly shorter than that of patients with lower levels of preoperative serum CA19-9.

Conclusions

In patients undergoing pancreatectomy for PDAC, higher preoperative CA19-9 levels are a significant predictor for POPF.
Exploring the identity development of the budding neuroscientist at postgraduate level: a mixed-method study with perspectives from alumni and academics
Authors: Sandrone Stefano , Ntonia Iro
Published: October 2022

Introduction

Neuroscience represents one of the most exciting frontiers in scientific research. However, given the recency of neuroscience as a discipline, its inter- and multi-disciplinary nature, the lack of educational research on brain science training, the absence of a national or global benchmark and the numerous neuroscience subfields, the development of the academic neuroscientist identity across career stages remains obfuscated. Neuroscience is not predominantly taught at the undergraduate level but presents as a postgraduate specialism, accepting graduates from a wide range of primary disciplines.

Methods

This work represents the first mixed-method study exploring the development of the neuroscientist identity at the postgraduate level at a high-ranking, research-intensive UK University. It combines responses from standardised self-efficacy and professional identity questionnaires and qualitative data from nineteen semi-structured interviews with alumni and academics.

Results

Key findings on influences, identity transitions, curricular skills and sense of belonging have been discussed. The results obtained can be mapped against the theoretical framework proposed by Laudel and Gläser in 2008, although some minor changes to the model have been suggested.

Discussion

Implementing active learning strategies and experiential assessments, designing mentoring opportunities and creating spaces for interaction can favour the transition from students to neuroscientists and contribute to an inclusive and diverse neuroscientific community.
Enabling mental health task-sharing: a collective case study of undergraduate clinical associate training programmes in South Africa
Authors: Moodley Saiendhra Vasudevan , Wolvaardt Jacqueline , Grobler Christoffel
Published: October 2022

Background

There is a shortage of the human resources needed to deliver mental health services which is likely to be exacerbated by COVID-19. Due to mental health workforce shortages, task-shifting and task-sharing approaches have been implemented in a number of countries. Clinical associates, a mid-level cadre working under the supervision of medical practitioners, could play a role in delivering mental health services but it is not clear if they are adequately prepared. This study explored the mental health curriculum content of the undergraduate clinical associate training programmes in South Africa and the views of key informants of the adequacy of training in mental health.

Methods

A qualitative collective case study approach was utilised for this multisite study at the three universities in South Africa offering clinical associate degrees. The study consisted of in-depth interviews utilising videoconferencing of individuals involved in each programme and a document review. Thematic analysis of the data was conducted.

Results

Nineteen interviews were conducted. Mental health formed part of the curriculum in all three programmes with the bulk of the training taking place in the final year of the three-year degree. Facility-based training ranged from two weeks to four weeks with one university only using hospitals with mental health units while two universities used hospitals at which the students were based for the year regardless of potential mental health exposure they would receive. The list of curricula inclusions extended to seldom-seen conditions. The quality of training and supervision appeared site-dependant and only one university set minimum experiential targets.

Conclusion

There is a basis on which to build the competencies and skills regarding mental health in this cadre. A training model that integrates mental health early in the undergraduate curriculum, focuses on common conditions and those with high disease burden, includes time in a mental health unit, provides facility-based trainers with detailed guidance to improve standardisation, and includes specific experiential targets that are monitored will enhance the potential utility of this cadre.
What can healthcare systems learn from looking at tensions in innovation processes? A systematic literature review
Authors: Haring Malte , Freigang Felix , Amelung Volker , Gersch Martin
Published: October 2022

Background

Until now, scholarship on innovation processes in healthcare systems lack an in-depth appreciation of tensions. Tensions often revolve around barriers and result from individual assessments and prioritizations that guide actions to eventually overcome these barriers. In order to develop a more differentiated understanding of tensions’ role in healthcare innovation processes, this paper aims to shed light on the multifaceted ways in which tensions emerge, are being dealt with, and how they hinder or, at times, facilitate innovation processes.

Methods

A systematic review of published and grey literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline. The review involved searching three databases for original research articles and manually searching citations. Twenty-nine original full texts were identified, evaluated, and coded. These include papers on innovation in healthcare systems that investigated innovation-related organizational tensions. The findings were synthesized into different types of tensions in healthcare system innovation and the descriptions of the conflicting elements. We also analyzed the investigated innovations by type, process stages, and across different countries and healthcare systems.

Results

A total of forty-two tensions were identified and grouped into nine categories. Organizing tensions were predominant, followed by learning/belonging, performing, and performing/organizing tensions. Tensions most frequently occurred in the implementation phase and in the form of a dilemma. Included studies were conducted mainly in government-funded healthcare systems.

Conclusion

Our data suggest that innovation processes in healthcare systems are impaired by conflicts between contradictory elements, working cultures, and convictions and the organizational and regulatory context. Since the majority of the tensions we collected in our study can be addressed, future policy-making and research should take advantage of this fact and develop strategies that significantly influence the successful management of tensions and thus improve the implementation of innovations.
Improving perioperative management of surgical sets for trauma surgeries: the 4S approach
Authors: Ribes-Iborra Julio , Segarra Borja , Cortés-Tronch Victor , Quintana Javier , Galvain Thibaut , Muehlendyck Christian , Escalona Elena , Battaglia Suzanne , Navarrete-Dualde Jorge
Published: October 2022

Background

The perioperative management of the surgical instruments and implants that comprise sets for trauma surgeries has been identified as a complex and resource-intensive activity due to non-standardized inventories, redundant surgical instruments and unnecessary sterilization cycles. The 4S Intelligent Trauma Care program aims to improve perioperative management and thereby reduce environmental impact by utilizing standardized inventories, a sterile implant portfolio, a barcode that enables a digital safety certification, and a digitized restocking service.

Objective

The objective of this study was to investigate the impact of the introduction of the 4S program for the management of surgical sets in open reduction internal fixation (ORIF) trauma surgeries.

Methods

This was a single-center, quality improvement study of ORIF trauma surgeries, comparing the current practice (30 procedures) to the procedure following the introduction of the 4S program (30 procedures). The primary outcome was the proportion of procedures requiring only one sterilization cycle. Secondary outcomes were the number of sterilization cycles per procedure, set processing time across departments, total set processing costs, number of missing or damaged implants, number of cleaning cycles per procedure, time taken to assemble containers for sterilization, number of containers entering the autoclave per procedure, environmental impact, number of baskets entering the cleaning machine per procedure, and staff satisfaction.

Results

Introduction of the 4S program resulted in a reduction in the mean number of sterilization cycles required from 2.1 to 1.0 (p < 0.001). In the current practice, only 30.0% of procedure sets were sterilized within one cycle, compared to 100.0% following introduction of the 4S program (p < 0.001). A reduction in the mean set processing time of 24.1% in the OR and 35.3% in the sterilization department was observed. Mean set processing costs for the current practice were €81.23, compared to €50.30 following introduction of the 4S program. Furthermore, following the introduction of the 4S program, procedures were associated with significant reductions in water and electricity usage, and increased staff satisfaction.

Conclusions

This quality improvement study demonstrates the substantial time and cost savings, positive environmental impact and staff satisfaction that could be achieved by streamlining surgical set management through the 4S program. To our knowledge, this is the first study of this type and our findings may be instructive to other hospitals and surgical specialties.
Psychometric evidence of a perception scale about covid-19 vaccination process in Peruvian dentists: a preliminary validation
Authors: Cayo-Rojas César F. , Córdova-Limaylla Nancy , Briceño-Vergel Gissela , Ladera-Castañeda Marysela , Cachay-Criado Hernán , López-Gurreonero Carlos , Cornejo-Pinto Alberto , Cervantes-Ganoza Luis
Published: October 2022

Background

In the current pandemic context, dental professionals have greater occupational risks due to their healthcare activity, placing their expectations on the vaccine as a means of protection and at the same time hoping that the immunization process will be safe, reliable and comfortable, giving them greater peace of mind when they return to work. Therefore, the aim of the present study was to develop and provide a preliminary validation of a scale to measure perception of the COVID-19 vaccination process in Peruvian dental professionals.

Methods

Cross-sectional study with instrumental design. The scale was self-administered virtually. It was distributed through social networks to 220 dental professionals from two universities in the Peruvian capital between June and August 2021. The Aiken V was used for content analysis, while descriptive statistics such as mean, variance, kurtosis and skewness were used for construct validation, in addition to Pearson’s correlation matrix for analysis of the 18 items. Subsequently, a Parallel Analysis based on minimum rank factor analysis was performed. Finally, the reliability of the total scale and its dimensions was evaluated with Cronbach’s alpha.

Results

The Aiken V coefficient values were favorable for all items. Parallel analysis indicated the existence of three dimensions. Principal component analysis with rotation suggested grouping eight items for the first dimension, six items for the second dimension and four items for the third dimension. These dimensions showed good reliability, as Cronbach’s alpha was 0.87, (95% confidence interval [CI]: 0.84–0.90), 0.80 (95% CI: 0.75–0.84) and 0.82 (95% CI: 0.78–0.86), respectively. In addition, the overall reliability of the scale was 0.89 (95% CI: 0.86–0.91), being acceptable.

Conclusions

The perception scale of the COVID-19 vaccination process in dental professionals proved preliminarily to be a valid and reliable scale that can be used for research purposes. However, it is recommended to extend its application and evaluate its metric properties in other health professionals.
Study of knowledge, attitude and practice regarding patient education in hypertension among community pharmacists in China
Authors: Chen Lei , Liu Yueyue , Xi Xiaoyu
Published: October 2022

Background

In the prevention and treatment of hypertension, patient education is an important measure to improve the awareness rate and control rate of patients. The professional and geographical advantages of community pharmacists enable them to play an important role in the patient education in hypertension. The purpose of this study was to understand the situation of patient education in hypertension conducted in Chinese community pharmacies, and put forward measures according to the problems.

Methods

A multi-stage competitive sampling by convenience was used to select community pharmacists working in community pharmacies in China for the study. Based on KAP theory, the first draft of the questionnaire was designed and the Delphi method was used to improve the questionnaire and a pre-study was conducted to test the reliability of the questionnaire. In January 2020, electronic questionnaires were distributed to 143 community pharmacists in Chinese community pharmacies. SPSS24 software was used for descriptive statistics and subgroup analysis of data.

Results

One hundred and eight valid questionnaires were collected, and the efficiency rate was 75.5%. Most of the respondents were younger than 30 years old (98.1%), and had bachelor’s degree (95.4%). In terms of knowledge, only 15.7% considered themselves "very good" and even 10.2% considered themselves "very bad". Only 35%-55% of respondents answered correctly for patient education content that requires more specialized knowledge, such as treatment and medication. Respondents generally had a positive attitude on the effect of hypertension patient education, but slightly less recognition of their role in patient education. In terms of practice, programs related to patient education have been conducted to different degrees. More than 30% of the community pharmacists interviewed implemented them occasionally or never.

Conclusions

Despite a positive attitude, most of the respondents did not have a high level of knowledge or practice. In China, more research evidence and new guidelines are needed to emphasize the importance and responsibilities of community pharmacists. Continuing education should be certificated at the national level and meet the various needs of community pharmacists. And salary incentives can be tried to motivate them.
Genetic mechanisms underlying increased microalgal thermotolerance, maximal growth rate, and yield on light following adaptive laboratory evolution
Authors: Barten Robin , van Workum Dirk-Jan M. , de Bakker Emma , Risse Judith , Kleisman Michelle , Navalho Sofia , Smit Sandra , Wijffels Rene H. , Nijveen Harm , Barbosa Maria J.
Published: October 2022

Background

Adaptive laboratory evolution (ALE) is a powerful method for strain optimization towards abiotic stress factors and for identifying adaptation mechanisms. In this study, the green microalgaPicochlorumsp.BPE23was cultured under supra-optimal temperature to force genetic adaptation. The robustness and adaptive capacity ofPicochlorumstrains turned them into an emerging model for evolutionary studies on abiotic stressors such as temperature, salinity, and light.

Results

Mutant strains showed an expanded maximal growth temperature of 44.6 °C, whereas the maximal growth temperature of the wild-type strain was 42 °C. Moreover, at the optimal growth temperature of 38 °C, the biomass yield on light was 22.3% higher, and the maximal growth rate was 70.5% higher than the wild type. Genome sequencing and transcriptome analysis were performed to elucidate the mechanisms behind the improved phenotype. A de novo assembled phased reference genome allowed the identification of 21 genic mutations involved in various processes. Moreover, approximately half of the genome contigs were found to be duplicated or even triplicated in all mutants, suggesting a causal role in adaptation.

Conclusions

The developed tools and mutant strains provide a strong framework from whereuponPicochlorumsp.BPE23can be further developed. Moreover, the extensive strain characterization provides evidence of how microalgae evolve to supra-optimal temperature and to photobioreactor growth conditions. With this study, microalgal evolutionary mechanisms were identified by combining ALE with genome sequencing.
Is there crosstalk between circadian clocks in plants and the rhizomicrobiome?
Authors: Xu Xinming , Dodd Antony N.
Published: October 2022

Circadian clocks occur across the kingdoms of life, including some fungi and bacteria present in the root-associated soil known as the rhizosphere. Recent work from Amy Newman and colleagues, published in BMC Biology, has discovered that the circadian clock in Arabidopsis plants affects the rhythmicity of rhizosphere microbial communities This brings into play the exciting question of whether there is a bidirectional rhythmic interaction between plants and their rhizomicrobiome. Here, we discuss how the findings of Newman et al. suggest that soil microbiomes can have both self-sustained and plant-imposed rhythmicity, and the challenges of plant-microbiome circadian clock research.
The causal associations of circulating amino acids with blood pressure: a Mendelian randomization study
Authors: Lin Chenhao , Sun Zhonghan , Mei Zhendong , Zeng Hailuan , Zhao Manying , Hu Jianying , Xia Mingfeng , Huang Tao , Wang Chaolong , Gao Xin , Zheng Yan
Published: October 2022

Background

Circulating levels of amino acids were associated with blood pressure (BP) in observational studies. However, the causation of such associations has been hypothesized but is difficult to prove in human studies. Here, we aimed to use two-sample Mendelian randomization analyses to evaluate the potential causal associations of circulating levels of amino acids with BP and risk of hypertension.

Methods

We generated genetic instruments for circulating levels of nine amino acids by conducting meta-analyses of genome-wide association study (GWAS) in UK Biobank participants with metabolomic data (n = 98,317) and another published metabolomics GWAS (n = 24,925). Data on the associations of the genetic variants with BP and hypertension were obtained in the UK Biobank participants without metabolomic data (n = 286,390). The causal effects were estimated using inverse-variance weighted method.

Results

Significant evidence consistently supported the causal effects of increased branched-chain amino acids (BCAAs, i.e., leucine, isoleucine, and valine) levels on higher BP and risk of hypertension (allP < 0.006 after Bonferroni correction except forPleucine-on-diastolicBP = 0.008). For example, per standard deviation higher of genetically predicted isoleucine levels were associated with 2.71 ± 0.78 mmHg higher systolic BP and 1.24 ± 0.34 mmHg higher diastolic BP, as well as with 7% higher risk of hypertension (odds ratio: 1.07, [95% CI: 1.04–1.10]). In addition, per standard deviation higher of genetically predicted glycine level was associated with lower systolic BP (− 0.70 ± 0.17 mmHg,P = 4.04 × 10−5) and a lower risk of hypertension (0.99 [0.98–0.99],P = 6.46 × 10−5). In the reverse direction, genetically predicted higher systolic BP was associated with lower circulating levels of glycine (− 0.025±0.008,P = 0.001).

Conclusions

This study provides evidence for causal impacts of genetically predicted circulating BCAAs and glycine levels on BP. Meanwhile, genetically predicted higher BP was associated with lower glycine levels. Further investigations are warranted to clarify the underlying mechanisms.
Combination of an autophagy inhibitor with immunoadjuvants and an anti-PD-L1 antibody in multifunctional nanoparticles for enhanced breast cancer immunotherapy
Authors: Cheng Yibin , Wang Caixia , Wang Huihui , Zhang Zhiwei , Yang Xiaopeng , Dong Yanming , Ma Lixin , Luo Jingwen
Published: October 2022

Background

The application of combination therapy for cancer treatment is limited due to poor tumor-specific drug delivery and the abscopal effect.

Methods

Here, PD-L1- and CD44-responsive multifunctional nanoparticles were developed using a polymer complex of polyethyleneimine and oleic acid (PEI-OA) and loaded with two chemotherapeutic drugs (paclitaxel and chloroquine), an antigen (ovalbumin), an immunopotentiator (CpG), and an immune checkpoint inhibitor (anti-PD-L1 antibody).

Results

PEI-OA greatly improved the drug loading capacity and encapsulation efficiency of the nanoplatform, while the anti-PD-L1 antibody significantly increased its cellular uptake compared to other treatment formulations. Pharmacodynamic experiments confirmed that the anti-PD-L1 antibody can strongly inhibit primary breast cancer and increase levels of CD4+ and CD8+ T cell at the tumor site. In addition, chloroquine reversed the “immune-cold” environment and improved the anti-tumor effect of both chemotherapeutics and immune checkpoint inhibitors, while it induced strong immune memory and prevented lung metastasis.

Conclusions

Our strategy serves as a promising approach to the rational design of nanodelivery systems for simultaneous active targeting, autophagy inhibition, and chemotherapy that can be combined with immune-checkpoint inhibitors for enhanced breast cancer treatment.
Lycium barbarum polysaccharide improves dopamine metabolism and symptoms in an MPTP-induced model of Parkinson’s disease
Authors: Song Jiangbo , Liu Lian , Li Zhiquan , Mao Ting , Zhang Jianfei , Zhou Lei , Chen Xin , Shang Yunzhu , Sun Tao , Luo Yuxin , Jiang Yu , Tan Duan , Tong Xiaoling , Dai Fangyin
Published: October 2022

Background

Parkinson’s disease (PD) is the second most common neurodegenerative disease in middle-aged and elderly populations, whereas there is no cure for PD so far. Novel animal models and medications await development to elucidate the aetiology of PD and attenuate the symptoms, respectively.

Methods

A neurotoxin, 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), was used in the current study to establish a PD pathologic model in silkworms. The time required to complete specific behaviours was recorded. Dopamine content was detected by ultra-performance liquid chromatography (UPLC). The activity of insect tyrosine hydroxylase (TH) was determined using a double-antibody sandwich method. Oxidative stress was assessed by changes in antioxidant enzyme activity and the content of oxidative products.

Results

MPTP-treated silkworms were characterized by impaired motor ability, reduced dopamine content, and elevated oxidative stress level. The expression of TH, a dopamine biosynthetic enzyme within dopaminergic neurons in the brain, was significantly reduced, indicating that dopaminergic neurons were damaged. Moreover, MPTP-induced motility impairment and reduced dopamine level in the silkworm PD model could be rescued after feeding a combination of levodopa (L-dopa [LD]) and carbidopa (CD). MPTP-induced oxidative damage was also alleviated, in ways consistent with other PD animal models. Interestingly, administration of Lycium barbarum polysaccharide (LBP) improved the motor ability, dopamine level, and TH activity, and the oxidative damage was concomitantly reduced in the silkworm PD model.

Conclusions

This study provides a promising animal model for elucidating the pathogenesis of PD, as well as a relevant preliminary drug screening (e.g., LBP) and evaluation.
One-year outcomes of polymer-free amphilimus-eluting stents versus durable polymer zotarolimus-eluting stents in patients with diabetes mellitus: a meta-analysis
Authors: Wang Hong , Xie Xiaoya , Zu Quannan , Lu Ming , Chen Rongfa , Yang Zhiren , Gao Yongqiang
Published: October 2022

Background

Diabetes mellitus (DM) and cardiovascular diseases often co-exist. Today, percutaneous coronary intervention (PCI) is the preferred revascularization procedure for majority of patients with coronary artery disease. Polymer-free amphilimus-eluting stents (AES) represent a novel elution technology in the current era of drug-eluting stents. In this analysis, we aimed to systematically compare the cardiovascular outcomes which are associated with polymer-free amphilimus-eluting stents (AES) versus the durable polymer zotarolimus-eluting stents (ZES) for the treatment of patients with DM.

Methods

Http://www.ClinicalTrials.gov, EMBASE, Web of Science, MEDLINE, Cochrane database and Google Scholar were searched for publications comparing polymer-free AES versus durable polymer ZES in patients with DM. Selective cardiovascular outcomes were assessed. Statistical analysis was carried out by the latest version of the RevMan software. Risk ratio (RR) with 95% confidence interval (CI) was used to represent the data analysis.

Results

Four studies with a total number of 1795 participants with DM whereby 912 patients were assigned to be revascularized by the polymer-free AES and 883 patients were assigned to be revascularized by the durable polymer ZES were included in this analysis. In patients with DM, at one year, polymer-free AES were associated with significantly lower risk of major adverse cardiac events (MACEs) (RR: 0.69, 95% CI: 0.54–0.88; P = 0.002) and target lesion failure (TLF) (RR: 0.66, 95% CI: 0.48–0.91; P = 0.01) compared to durable polymer ZES. However, there was no significant change in all-cause mortality (RR: 0.79, 95% CI: 0.51–1.22; P = 0.28), cardiac death and the other cardiovascular outcomes. Similar risk of total stent thrombosis (RR: 1.13, 95% CI: 0.60–2.13; P = 0.70), including definite stent thrombosis (RR: 1.12, 95% CI: 0.38–3.31; P = 0.84), probable stent thrombosis (RR: 0.87, 95% CI: 0.37–2.09; P = 0.76), possible stent thrombosis (RR: 1.19, 95% CI: 0.50–2.87; P = 0.69) and late stent thrombosis (RR: 1.00, 95% CI: 0.17–5.72; P = 1.00) as between polymer-free AES and durable polymer ZES in patients with DM.

Conclusions

At 1 year follow-up, polymer-free AES were associated with significantly lower MACEs and TLF compared to durable polymer ZES in these patients with DM, without any increase in mortality, stent thrombosis and other cardiovascular outcomes. However, this analysis is only based on a follow-up time period of one year, therefore, future research should focus on the long term follow-up time period.
Transcriptomic and metabolomic analyses for providing insights into the influence of polylysine synthetase on the metabolism of Streptomyces albulus
Authors: Lian Congcong , Zhang Min , Mao Jiaqi , Liu Yuanyu , Wang Xiuwen , Kong Linghui , Yao Qingshou , Qin Jiayang
Published: October 2022

ε-poly-l-lysine (ε-PL) is the main secondary metabolite of Streptomyces albulus, and it is widely used in the food industry. Polylysine synthetase (Pls) is the last enzyme in the ε-PL biosynthetic pathway. Our previous study revealed that Pls overexpressed in S. albulus CICC11022 result in the efficient production of ε-PL. In this study, a Pls gene knockout strain was initially constructed. Then, genomic, transcriptomic and metabolomic approaches were integrated to study the effects of the high expression and knockout of Pls on the gene expression and metabolite synthesis of S. albulus. The high expression of Pls resulted in 598 significantly differentially expressed genes (DEGs) and 425 known differential metabolites, whereas the inactivation of Pls resulted in 868 significant DEGs and 374 known differential metabolites. The expressions of 8 and 35 genes were negatively and positively associated with the Pls expression, respectively. Subsequently, the influence mechanism of the high expression and inactivation of Pls on the ε-PL biosynthetic pathway was elucidated. Twelve metabolites with 30% decreased yield in the high-expression strain of Pls but 30% increased production in the Pls knockout strain were identified. These results demonstrate the influence of Pls on the metabolism of S. albulus. The present work can provide the theoretical basis for improving the production capacity of ε-PL by means of metabolic engineering or developing bioactive substances derived from S. albulus.
The global inequity in COVID-19 vaccination coverage among health and care workers
Authors: Nabaggala Maria Sarah , Nair Tapas Sadasivan , Gacic-Dobo Marta , Siyam Amani , Diallo Khassoum , Boniol Mathieu
Published: October 2022

Background

Health and care workers (HCWs) are at the forefront of COVID-19 response, at high risk of infection, and as a result they are a priority group for COVID-19 vaccination. This paper presents the global patterns in COVID-19 vaccination coverage among HCWs in 2021, how HCWs were prioritized, and identifies factors associated with the early vaccination coverage.

Methods

Using monthly data reported to the World Health Organization, the percentages of partially and fully vaccinated HCWs were computed. The rates of vaccination of HCWs for the first and second half of 2021 were compared in a stratified analysis using several factors. A multivariate analysis was used to investigate the independent associations of these factors with the percentage of HCWs fully vaccinated.

Results

Based on data from 139 Member States, as of end of 2021, 82% HCWs were reported as fully vaccinated with important variations by income groups: 33% for low income countries, 83% for lower-middle income countries, 79% for upper-middle income countries and 88% for high income countries. Overall 76% of countries did not achieve 70% vaccination coverage of their HCWs in the first half of 2021, and 38% of countries by end of 2021. Compared with the general population, the rate of HCWs full vaccination was 3.5 times higher, in particular for low income countries (RR = 5.9). Stratified analysis showed that beyond income group, the availability of vaccine doses was a critical factor of HCWs vaccination coverage with medians of 59.1% and 88.6% coverage in the first and second half of 2021, respectively for countries with enough doses to cover 70% of their population, compared with 0.8% and 47.5% coverage, respectively for countries with doses to cover 40% of their population. The multivariate analysis confirmed this observation with a 35.9% overall difference (95%CI 15.1%; 56.9%) between these two groups.

Conclusion

Despite being considered a priority group, more than a third of countries did not achieve 70% vaccination coverage of their HCWs at the end of 2021. Large inequities were observed with low income countries lagging behind. Additional efforts should be dedicated to ensure full protection of HCWs through vaccination.
Antioxidants in brain tumors: current therapeutic significance and future prospects
Authors: Qi Xuchen , Jha Saurabh Kumar , Jha Niraj Kumar , Dewanjee Saikat , Dey Abhijit , Deka Rahul , Pritam Pingal , Ramgopal Kritika , Liu Weiting , Hou Kaijian
Published: October 2022

Brain cancer is regarded among the deadliest forms of cancer worldwide. The distinct tumor microenvironment and inherent characteristics of brain tumor cells virtually render them resistant to the majority of conventional and advanced therapies. Oxidative stress (OS) is a key disruptor of normal brain homeostasis and is involved in carcinogenesis of different forms of brain cancers. Thus, antioxidants may inhibit tumorigenesis by preventing OS induced by various oncogenic factors. Antioxidants are hypothesized to inhibit cancer initiation by endorsing DNA repair and suppressing cancer progression by creating an energy crisis for preneoplastic cells, resulting in antiproliferative effects. These effects are referred to as chemopreventive effects mediated by an antioxidant mechanism. In addition, antioxidants minimize chemotherapy-induced nonspecific organ toxicity and prolong survival. Antioxidants also support the prooxidant chemistry that demonstrate chemotherapeutic potential, particularly at high or pharmacological doses and trigger OS by promoting free radical production, which is essential for activating cell death pathways. A growing body of evidence also revealed the roles of exogenous antioxidants as adjuvants and their ability to reverse chemoresistance. In this review, we explain the influences of different exogenous and endogenous antioxidants on brain cancers with reference to their chemopreventive and chemotherapeutic roles. The role of antioxidants on metabolic reprogramming and their influence on downstream signaling events induced by tumor suppressor gene mutations are critically discussed. Finally, the review hypothesized that both pro- and antioxidant roles are involved in the anticancer mechanisms of the antioxidant molecules by killing neoplastic cells and inhibiting tumor recurrence followed by conventional cancer treatments. The requirements of pro- and antioxidant effects of exogenous antioxidants in brain tumor treatment under different conditions are critically discussed along with the reasons behind the conflicting outcomes in different reports. Finally, we also mention the influencing factors that regulate the pharmacology of the exogenous antioxidants in brain cancer treatment. In conclusion, to achieve consistent clinical outcomes with antioxidant treatments in brain cancers, rigorous mechanistic studies are required with respect to the types, forms, and stages of brain tumors. The concomitant treatment regimens also need adequate consideration.
GelMA-MXene hydrogel nerve conduits with microgrooves for spinal cord injury repair
Authors: Cai Jiaying , Zhang Hui , Hu Yangnan , Huang Zhichun , Wang Yan , Xia Yu , Chen Xiaoyan , Guo Jiamin , Cheng Hong , Xia Lin , Lu Weicheng , Zhang Chen , Xie Jingdun , Wang Huan , Chai Renjie
Published: October 2022

Repair of spinal cord injury (SCI) depends on microenvironment improvement and the reconnection between injured axons and regenerated neurons. Here, we fabricate a GelMA-MXene hydrogel nerve conduit with electrical conductivity and internal-facing longitudinal grooves and explore its function in SCI repair. It is found that the resultant grooved GelMA-MXene hydrogel could effectively promote the neural stem cells (NSCs) adhesion, directed proliferation and differentiation in vitro. Additionally, when the GelMA-MXene conduit loaded with NSCs (GMN) is implanted into the injured spinal cord site, effective repair capability for the complete transection of SCI was demonstrated. The GMN group shows remarkable nerve recovery and significantly higher BBB scores in comparison to the other groups. Therefore, GMN with the microgroove structure and loaded with NSCs is a promising strategy in treating SCI.
Using nominal group technique to identify barriers and facilitators to preventing HIV using combination same-day pre-exposure prophylaxis and medications for opioid use disorder
Authors: Eger William H. , Altice Frederick L. , Lee Jessica , Vlahov David , Khati Antoine , Osborne Sydney , Wickersham Jeffrey A. , Bohonnon Terry , Powell Lindsay , Shrestha Roman
Published: October 2022

Background

Preventing HIV transmission among people who inject drugs (PWID) is a key element of the US Ending the HIV Epidemic strategy and includes both pre-exposure prophylaxis (PrEP) and medications for opioid use disorder (MOUD). While both lead to decreases in HIV transmission, MOUD has other social and health benefits; meanwhile, PrEP has additional HIV prevention advantages from sexual risk and the injection of stimulants. However, these medications are often prescribed in different settings and require multiple visits before initiation. Strategies to integrate these services (i.e., co-prescription) and offer same-day prescriptions may reduce demands on patients who could benefit from them.

Methods

Nominal group technique, a consensus method that rapidly generates and ranks responses, was used to ascertain barriers and solutions for same-day delivery of PrEP and MOUD as an integrated approach among PWID (n = 14) and clinical (n = 9) stakeholders. The qualitative portion of the discussion generated themes for analysis, and the ranks of the proposed barriers and solutions to the program are presented.

Results

The top three barriers among PWID to getting a same-day prescription for both PrEP and MOUD were (1) instability of insurance (e.g., insurance lapses); (2) access to a local prescriber; and (3) client-level implementation factors, such as lack of personal motivation. Among clinical stakeholders, the three greatest challenges were (1) time constraints on providers; (2) logistics (e.g., coordination between providers and labs); and (3) availability of providers who can prescribe both medications. Potential solutions identified by both stakeholders included pharmacy delivery of the medications, coordinated care between providers and health care systems (e.g., case management), and efficiencies in clinical care (e.g., clinical checklists), among others.

Conclusions

Implementing and sustaining a combined PrEP and MOUD strategy will require co-training providers on both medications while creating efficiencies in systems of care and innovations that encourage and retain PWID in care. Pilot testing the co-prescribing of PrEP and MOUD with quality performance improvement is a step toward new practice models.
What the policy and stewardship landscape of a national health research system looks like in a developing country like Iran: a qualitative study
Authors: Poursheikhali Atousa , Alkhaldi Mohammed , Dehnavieh Reza , Haghdoost AliAkbar , Masoud Ali , Noorihekmat Somayeh , Cheshmyazdan Mohammad Reza , Bamir Mousa
Published: October 2022

Background

The health research system (HRS) is an important national priority that requires a systematic and functional approach. Evaluating the HRS of Iran as a developing country and identifying its challenges reveals the stewardship-related role in how the whole system is operating well. This study aims to assess the HRS in terms of stewardship functions and highlight the enhancement points.

Methods

This study was carried out between March 2020 and April 2021 using a systematic review and meta-synthesis of evidence to examine the Iranian HRS stewardship challenges and interview 32 stakeholders, using a critical case sampling and snowballing approach which included both semi-structured and in-depth interviews. The interviewees were selected based on criteria covering policy-makers, managers, research bodies and nongovernmental organizations (NGOs) in health research-related fields like higher education, research, technology, innovation and science. All data were analysed using content analysis to determine eight main groups of findings under three levels: macro, meso, and micro.

Results

Analysis of the findings identified eight main themes. The most critical challenges were the lack of an integrated leadership model and a shared vision among different HRS stakeholders. Their scope and activities were often contradictory, and their role was not clarified in a predetermined big picture. The other challenges were legislation, priority-setting, monitoring and evaluation, networking, and using evidence as a decision support base.

Conclusions

Stewardship functions are not appropriately performed and are considered the root causes of many other HRS challenges in Iran. Formulating a clear shared vision and a work scope for HRS actors is critical, along with integrating all efforts towards a unified strategy that assists in addressing many challenges of HRS, including developing strategic plans and future-oriented and systematic research, and evaluating performance. Policy-makers and senior managers need to embrace and use evidence, and effective networking and communication mechanisms among stakeholders need to be enhanced. An effective HRS can be achieved by redesigning the processes, regulations and rules to promote transparency and accountability within a well-organized and systematic framework.