bluuebunny/crossref_metadata_2025 huggingface dataset:
Hydration and nutrition care practices in stroke: findings from the UK and Australia
Authors: Miller Colette , Jones Stephanie P. , Bangee Munirah , Martinez-Garduno Cintia Mayel , Brady Marian C. , Cadilhac Dominique A. , Dale Simeon , McInnes Elizabeth , Middleton Sandy , Watkins Caroline L. , Lightbody C. Elizabeth
Published: October 2023

Background

Dehydration and malnutrition are common in hospitalised patients following stroke leading to poor outcomes including increased mortality. Little is known about hydration and nutrition care practices in hospital to avoid dehydration or malnutrition, and how these practices vary in different countries. This study sought to capture how the hydration and nutrition needs of patients’ post-stroke are assessed and managed in the United Kingdom (UK) and Australia (AUS).

Aim

To examine and compare current in-hospital hydration and nutrition care practice for patients with stroke in the UK and Australia.

Methods

A cross-sectional survey was conducted between April and November 2019. Questionnaires were mailed to stroke specialist nurses in UK and Australian hospitals providing post-stroke inpatient acute care or rehabilitation. Non-respondents were contacted up to five times.

Results

We received 150/174 (86%) completed surveys from hospitals in the UK, and 120/162 (74%) in Australia. Of the 270 responding hospitals, 96% reported undertaking assessment of hydration status during an admission, with nurses most likely to complete assessments (85%). The most common methods of admission assessment were visual assessment of the patient (UK 62%; AUS 58%), weight (UK 52%; AUS 52%), and body mass index (UK 47%; AUS 42%). Almost all (99%) sites reported that nutrition status was assessed at some point during admission, and these were mainly completed by nurses (91%). Use of standardised nutrition screening tools were more common in the UK (91%) than Australia (60%). Similar proportions of hydration management decisions were made by physicians (UK 84%; AUS 83%), and nutrition management decisions by dietitians (UK 98%; AUS 97%).

Conclusion

Despite broadly similar hydration and nutrition care practices after stroke in the UK and Australia, some variability was identified. Although nutrition assessment was more often informed by structured screening tools, the routine assessment of hydration was generally not. Nurses were responsible for assessment and monitoring, while dietitians and physicians undertook decision-making regarding management. Hydration care could be improved through the development of standardised assessment tools. This study highlights the need for increased implementation and use of evidence-based protocols in stroke hydration and nutrition care to improve patient outcomes.
Identifying reasons for non-acceptance of influenza vaccine in healthcare workers: an observational study using declination form data
Authors: Challenger Aimee , Sumner Petroc , Powell Eryl , Bott Lewis
Published: October 2023

Background

Healthcare workers are sometimes required to complete a declination form if they choose not to accept the influenza vaccine. We analysed the declination data with the goal of identifying barriers to vaccination uptake across seasons, staff groups, and pre- and post- arrival of COVID-19.

Methods

Reasons for declining the vaccine were gathered from N = 2230 declination forms, collected over four influenza seasons, 2017/2018, 2018/2019, 2019/2020 and 2020/2021, from a single health board in the UK. Reasons were classified according to ten categories and the resulting distribution analysed across year and staff groups. A further analysis considered the two most prevalent categories in more detail.

Results

Fear of adverse reactions and Lack of perception of own risk were identified as primary reasons for not accepting the vaccine across time and across staff groups. However, there was no evidence that Lack of concern with influenza, or Doubts about vaccine efficacy was prevalent, contrary to previous findings. Overall, reasons fitted a pattern of underestimating risk associated with influenza and overestimating risk of minor adverse reactions. There were also differences across years, χ2(24) = 123, p < .001. In particular, there were relatively fewer Lack of perception of own risk responses post-COVID-19 arrival than before, χ2(8) = 28.93, p = .002.

Conclusion

This study shows that data collected from declination forms yields sensible information concerning vaccine non-acceptance without the difficulties of retrospective or pre-emptive reasoning suffered by questionnaires. Our findings will aid messaging campaigns designed to encourage uptake of the influenza vaccine in healthcare workers. In particular, we argue for an approach focused on risk perception rather than correction of straightforward misconceptions.
The triglyceride-glucose index predicts 1-year major adverse cardiovascular events in end-stage renal disease patients with coronary artery disease
Authors: Xie Enmin , Ye Zixiang , Wu Yaxin , Zhao Xuecheng , Li Yike , Shen Nan , Gao Yanxiang , Zheng Jingang
Published: October 2023

Background

The triglyceride-glucose (TyG) index has been suggested as a dependable indicator for predicting major adverse cardiovascular events (MACE) in individuals with cardiovascular conditions. Nevertheless, there is insufficient data on the predictive significance of the TyG index in end-stage renal disease (ESRD) patients with coronary artery disease (CAD).

Methods

This study, conducted at multiple centers in China, included 959 patients diagnosed with dialysis and CAD from January 2015 to June 2021. Based on the TyG index, the participants were categorized into three distinct groups. The study’s primary endpoint was the combination of MACE occurring within one year of follow-up, including death from any cause, non-fatal myocardial infarction, and non-fatal stroke. We assessed the association between the TyG index and MACE using Cox proportional hazard models and restricted cubic spline analysis. The TyG index value was evaluated for prediction incrementally using C-statistics, continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI).

Results

The three groups showed notable variations in the risk of MACE (16.3% in tertile 1, 23.5% in tertile 2, and 27.2% in tertile 3; log-rank P = 0.003). Following complete adjustment, patients with the highest TyG index exhibited a notably elevated risk of MACE in comparison to those in the lowest tertile (hazard ratio [HR] 1.63, 95% confidence interval [CI] 1.14–2.35, P = 0.007). Likewise, each unit increase in the TyG index correlated with a 1.37-fold higher risk of MACE (HR 1.37, 95% CI 1.13–1.66, P = 0.001). Restricted cubic spline analysis revealed a connection between the TyG index and MACE (P for nonlinearity > 0.05). Furthermore, incorporating the TyG index to the Global Registry of Acute Coronary Events risk score or baseline risk model with fully adjusted factors considerably enhanced the forecast of MACE, as demonstrated by the C-statistic, continuous NRI, and IDI.

Conclusions

The TyG index might serve as a valuable and dependable indicator of MACE risk in individuals with dialysis and CAD, indicating its potential significance in enhancing risk categorization in clinical settings.
Systematic analysis of integrated bioinformatics to identify upregulated THBS2 expression in colorectal cancer cells inhibiting tumour immunity through the HIF1A/Lactic Acid/GPR132 pathway
Authors: Liu Ye , Jiang Chunhui , Xu Chunjie , Gu Lei
Published: October 2023

Background

THBS2, a member of the extracellular matrix glycoprotein family, can effectively inhibit tumour growth and angiogenesis. This study aimed to investigate the biological role of THBS2 in various types of cancers and the mechanisms underlying the malignant progression of colorectal cancer (CRC).

Methods

THBS2 expression in pan-cancer tissues and cell lines was assessed using the HPA, TISCH and CCLE databases. The CIBERSORT, ESTIMATE, TIMER, xCell and ssGSEA (implemented using the IOBR R package) algorithms were used to calculate the proportion of tumour-infiltrating immune cells based on the expression profile of THBS2 in TCGA-COAD cohort. The clusterprofiler R package was used to implement GO and KEGG pathway enrichm SNVs were compared between the high- and low-THBS2-expression groups using the maftools R package. Additionally, immunotherapy responses were compared between the high- and low-THBS2-expression groups based on immunophenoscores (IPSs). CT26 cells were engineered to overexpress THBS2 (CT26-THBS2) to investigate its regulatory effects on HIF1 and cellular metabolism. The conditioned medium from CT26-THBS2 cells was collected to examine its effect on the M2 polarisation of RAW264.7 macrophages. Subsequently, in vitro experiments were performed to validate the inhibitory effects of M2-polarised macrophages on T-cell proliferation and cytotoxicity. A CT26-THBS2 tumour-bearing mouse model was constructed to validate the impact of high THBS2 expression in tumour cells on the tumour microenvironment in vivo.

Results

THBS2 expression was upregulated in a majority of tumours, including COAD, and was positively associated with ESTIMATEScore, ImmuneScore and StromalScore. Furthermore, THBS2 expression was positively associated with angiogenesis and epithelial–mesenchymal transition and negatively associated with DNA repair, cell cycle and DNA replication in most tumours. THBS2 expression was considerably associated with progression-free interval (PFI) and positively associated with MSI in COAD. THBS2 methylation levels were remarkably lower in COAD tissues than in healthy tissues. The high expression of THBS2 in CT26 cells remarkably promoted the nuclear translocation of HIF1 and consequently enhanced lactate metabolism in cells. In vitro and in vivo experiments revealed that lactate released by tumour cells promoted M2 polarisation of macrophages, leading to inhibition of T-cell proliferation and cytotoxicity.

Conclusions

THBS2 expression is associated with PFI, immune cell infiltration, immune regulation, cell death, cell migration, epithelial–mesenchymal transition, angiogenesis and genomic variations in COAD. THBS2 may serve as a biomarker for immunotherapy in COAD. Upregulated THBS2 expression in CRC cells inhibits anti-tumour immunity through the HIF1A/lactic acid/GPR132 pathway.
TiO2 nanoparticles promote tumor metastasis by eliciting pro-metastatic extracellular vesicles
Authors: Mu Xupeng , Hu Kebang , Wei Anhui , Bai Jinping , Feng Li , Jiang Jinlan
Published: October 2023

The development of nanotechnology has provided numerous possibilities for the diagnosis and treatment of cancer. Paradoxically, some in vivo experimental studies have also shown that nanoparticles (NPs) could promote tumor progression, but the specific mechanism is not yet clear. Primary tumors can release extracellular vesicles (EVs) which can promote the inoculation and growth of tumor cells that have metastasized to distant organs. So, whether nanomaterials can promote tumor progression through tumor-derived EVs deserves further research. Here, we showed that TiO2 NPs, widely used in nanomedicine, could trigger tumor-derived EVs with enhanced pro-metastatic capacity in vitro and in vivo. Mechanically, miR-301a-3p derived from NPs-elicited EVs could be delivered into vascular endothelial cells, which inhibited the expression of VEGFR2 and VE-cadherin by targeting S1PR1, leading to disrupt the tight junctions of vascular endothelial cells, thus to promote vascular permeability and angiogenesis, and induce the formation of pre-metastasis niches in vivo. This study emphasizes that it is urgent to consider the effect of NPs on EVs under long-term use conditions when designing nanodrugs for cancer treatment.

Graphical Abstract
Comparisons of EQ-5D-Y and PedsQL in pediatric patients with mild-to-moderate chronic kidney disease in longitudinal analyses
Authors: Hsu Chien-Ning , Tain You-Lin , Lu Pei-Chen , Lin Hsiang-Wen
Published: October 2023

Objective

To characterize longitudinal changes and correlations between the measures of EQ-5D-Y and generic PedsQL and their associations with clinical changes in children and adolescents with mild-to-moderate chronic kidney disease (CKD).

Methods

Participants were recruited from January 2017 to September 2021 in a medical center in Taiwan. Both instruments were administered in their initial visits and every 6-month subsequent visits. Spearman’s Rho (ρ) was used to assess correlations between the scores of EQ-5D-Y and PedsQL measures in longitudinal changes. Cohen’s effect size (ES) was used to evaluate the changes of scores/subscales over time. In addition, factors associated with longitudinal changes in the score/subscales were explored.

Results

A total of 121 participants were enrolled, and 83 with ≥ 3 HRQOL measures during the 3.5 years follow-up were assessed their changes of HRQOL measures. The correlations (ρ > 0.3) appeared between the changes in the visual analog scale (VAS) of EQ-5D-Y and emotional and social subscales of PedsQL. ES was small (< 0.5) in the VAS and level-sum-score (LSS) of EQ-5D-Y scores for the clinical changes in comorbidities, while some PedsQL subscales were medium to high (0.5–0.8 or > 0.8). Hypertension, mineral bone disorder/anemia, and hyperuricemia associated with the changes in both HRQOL scores were varied by their various domains.

Conclusion

Both EQ-5D-Y and PedsQL of HRQOL measures were responsive to worsened childhood CKD-related comorbidities during the follow-up; however, convergent validity between them was limited in some domains. The LSS of EQ-5D-Y showed greater changes than the VAS by comorbidity status; further comparison with utility weight is needed to determine the better performance of EQ-5D-Y.
Cross-border utilization of cancer care by patients in the US and Mexico – a survey of Mexican oncologists
Authors: LaPelusa Michael , Verduzco-Aguirre Haydeé , Diaz Fernando , Aldaco Fernando , Soto-Perez-de-Celis Enrique
Published: October 2023

Background

The US-Mexico border is the busiest in the world, with millions of people crossing it daily. However, little is known about cross-border utilization of cancer care, or about the reasons driving it. We designed a cross sectional online survey to understand the type of care patients with cancer who live in the US and Mexico seek outside their home country, the reasons why patients traveled across the border to receive care, and the barriers faced when seeking cross-border care.

Results

The online survey was sent to the 248 cancer care providers working in the six Mexican border states who were registered members of the Mexican Society of Oncology. Responses were collected between September-November 2022. Sixty-six providers (response rate 26%) completed the survey. Fifty-nine (89%) reported interacting with US-based patients traveling to Mexico to receive various treatment modalities, with curative surgery (n = 38) and adjuvant chemotherapy (n = 31) being the most common. Forty-nine (74%) reported interacting with Mexico-based patients traveling to the US to receive various treatment modalities, with immunotherapy (n = 29) and curative surgery (n = 27) being the most common. The most frequently reported reason US-based patients sought care in Mexico was inadequate health insurance (n = 45). The most frequently reported reason Mexico-based patients sought care in the US was patients’ perception of superior healthcare (n = 38).

Conclusions

Most Mexican oncologists working along the Mexico-US border have interacted with patients seeking or receiving binational cancer care. The type of care sought, as well as the reasons for seeking it, differ between US and Mexico-based patients. These patterns of cross-border healthcare utilization highlight unmet needs for patients with cancer in both countries and call for policy changes to improve outcomes in border regions.
Medicinal plants of the upper Aswa River catchment of northern Uganda - a cultural crossroads
Authors: Masters Eliot T.
Published: October 2023

Background

This paper presents a comparative inventory of medicinal plant taxa and their uses by smallholder farming communities of four cultures in the Aswa River catchment of northern Uganda, situated in the eastern Sudanian savanna parkland ecotype of sub-Saharan Africa. The purpose of the study was to document the ethnobotanical use of medicinal plants by the Lango, Acholi, Teso (Atesot) and Ethur (jo Abwor), in an historical moment before civil conflict and mass displacement of the respondent communities disrupted the inter-generational transmission of traditional technical knowledge within the study area.

Methods

Following community consultations in four districts of northern Uganda during 1999–2000, interviews were conducted with holders of specialist knowledge on plants used as medicine on basis of a plant specimen allocated a voucher number and identified by the national herbarium. Use reports reflecting specific medicinal applications were compiled in aggregate to obtain a Relative Importance Index ranking. The commonality of medicinal taxa cited between each cultural interface was assessed by the Jaccard Index of Similarity, and the similarity of specific medicinal usage by taxon using Rahman’s Similarity Index.

Results

The data collected from 112 respondents comprise 280 medicinal use reports describing 263 applications for 62 medical conditions, citing 108 taxa from 44 botanical families of which Fabaceae comprised 20% of all use reports. No earlier mention could be found to corroborate 72 use reports (27% of the total), representing medicinal indications as yet undocumented, and potentially worthy of investigation. The RI values ranged between 15 and 94%, with 13 taxa having RI values above 50%. The JI ratios indicate the highest degree of similarity in the plant taxa used as medicine (21%) between the Lango and Teso cultures who share a common origin; however, Rahman’s Similarity Index indicates the highest similarity of specific medicinal usage by taxon between the Lango and Acholi, who share a common language group through cultural assimilation over time.

Conclusions

As a comparative study, the results imply that cultural exchange and assimilation may be a greater driver of inter-cultural similarity of ethnopharmacological use of a given taxon, as compared to shared historical origins.
An ethnobotanical study of wild edible plants used by the Tibetan in the Rongjia River Valley, Tibet, China
Authors: Wang Jin , Ding Xiaoyong , Guo Chang-An , Zhang Xiong , Feng Haowen , Yang Huizhao , Wang Yuhua
Published: October 2023

Background

Wild edible plants (WEPs) play a crucial role in communities with limited communication with the outside world, where unstable factors, such as poor food supply and insufficient access to timely nutritional supplementation, are common, as in the Himalayan region. To document the traditional knowledge of WEPs and explore their significance for communities with minimal global economic exchange, an ethnobotanical study was conducted in the town of Rongjia, which lies in a narrow valley near Mount Everest, Tibet, China.

Methods

This ethnobotanical study was conducted in three villages in the Rongjia River Valley between August 2021 and June 2023. Semi-structured interviews and participatory observations were used to collect information on WEPs. The fieldwork was performed with the assistance of local guides. Voucher specimens were collected from each documented plant species for taxonomic identification. We used the use report (UR) and relative frequency of citations (RFC) to evaluate the comprehensive utilization value of WEPs.

Results

We interviewed 161 informants who provided us with 2499 use reports. We collected 50 WEPs belonging to 28 families and 42 genera used by the Tibetan people in the Rongjia River Valley. WEPs are used in vegetables, fruits, seasonings, healthcare foods, substitute grains, and beverages. Wild vegetables were the most commonly used, followed by wild fruits. Leaves were the most commonly consumed part of the plant. The three most important WEPs ordered by RFC values were Rosa sericea var. glandulosa Osmaston (RFC = 0.76), Zanthoxylum bungeanum Maxim. (RFC = 0.75), and Urtica hyperborea Jacquem. ex Wedd. (RFC = 0.71). Other than that, we also document some of WEPs used in the past. Arisaema erubescens Schott, Pinellia ternata (Thunb.) Makino, and Satyrium nepalense var. ciliatum (Lindl.) Hook. f. used to serve as important substitute grains, are no longer in use, however, they remain vivid in the memories of older people.

Conclusions

WEPs included wild vegetables, fruits, seasonings, healthcare food, and substitute grains for Tibetan people in the Rongjia River Valley. Some WEPs have become important cultural symbols for older people, which can help in understanding the relationship between plants and local people in the past. In addition, WEPs can increase the resilience of local people living in remote areas when facing sudden destabilizing events in future. This is the significance of WEPs for communities with minimal global economic exchange. Therefore, we suggest that future studies focus more on WEPs in communities with limited communication with the world to improve their resilience.
Detection and characterization of spike architecture based on deep learning and X-ray computed tomography in barley
Authors: Ling Yimin , Zhao Qinlong , Liu Wenxin , Wei Kexu , Bao Runfei , Song Weining , Nie Xiaojun
Published: October 2023

Background

Spike is the grain-bearing organ in cereal crops, which is a key proxy indicator determining the grain yield and quality. Machine learning methods for image analysis of spike-related phenotypic traits not only hold the promise for high-throughput estimating grain production and quality, but also lay the foundation for better dissection of the genetic basis for spike development. Barley (Hordeum vulgare L.) is one of the most important crops globally, ranking as the fourth largest cereal crop in terms of cultivated area and total yield. However, image analysis of spike-related traits in barley, especially based on CT-scanning, remains elusive at present.

Results

In this study, we developed a non-invasive, high-throughput approach to quantitatively measuring the multitude of spike architectural traits in barley through combining X-ray computed tomography (CT) and a deep learning model (UNet). Firstly, the spikes of 11 barley accessions, including 2 wild barley, 3 landraces and 6 cultivars were used for X-ray CT scanning to obtain the tomographic images. And then, an optimized 3D image processing method was used to point cloud data to generate the 3D point cloud images of spike, namely ‘virtual’ spike, which is then used to investigate internal structures and morphological traits of barley spikes. Furthermore, the virtual spike-related traits, such as spike length, grain number per spike, grain volume, grain surface area, grain length and grain width as well as grain thickness were efficiently and non-destructively quantified. The virtual values of these traits were highly consistent with the actual value using manual measurement, demonstrating the accuracy and reliability of the developed model. The reconstruction process took 15 min approximately, 10 min for CT scanning and 5 min for imaging and features extraction, respectively.

Conclusions

This study provides an efficient, non-invasive and useful tool for dissecting barley spike architecture, which will contribute to high-throughput phenotyping and breeding for high yield in barley and other crops.
A blinded-endpoint, randomized controlled trial of Sanyrene with natural active ingredient for prophylaxis of radiation dermatitis in patients receiving radiotherapy
Authors: Long Xiaoli , Guo Jing , Yin Yutian , Cheng Ming , Zhang Xiao , Zhang Jing , Wang Pengyuan , Zang Jian , Zhao Lina
Published: October 2023

Background

Randomized controlled study was conducted to evaluate the efficacy of Sanyrene® vs. control intervention (DaBao®, a complex of hyaluronic acid and Vitamin E) for acute radiation dermatitis in patients receiving radiotherapy.

Methods

Patients with breast cancer or head and neck cancer undergoing radiotherapy (≥ 50 Gy) were eligible. Participants were randomly assigned to either Sanyrene arm or control intervention arm in a ratio of 1:1. The primary endpoint was incidence rate of ≥ grade 2 radiation induced dermatitis. (Trial Registration: ChiCTR2100050910, registration date: 9/7/2021)

Results

A total of 102 eligible patients were randomly assigned into the study. The rate of ≥ grade 2 radiation dermatitis was 22% in Sanyrene group, as compared with 67.3% in the control intervention group (P<0.001). The incidence of grade 3 radiation dermatitis was 20.4% and 8.0% in control intervention group and Sanyrene group, respectively (P = 0.076). Patients in Sanyrene group had a longer median time to reach ≥ grade 2 radiation dermatitis compared to these in control intervention group, with hazard ratio of 0.231 (95%CI:0.116–0.458, p < 0.001). Mean score of SD-16 were much higher in control intervention group than Sanyrene group at end of radiotherapy (25 vs.8.3), 2 weeks after radiotherapy (22.9 vs. 0.5) and 4 weeks after radiotherapy (4.2 vs.0), with significantly statistical difference between two groups.

Conclusions

This trial suggests that Sanyrene is effective on preventing serious radiation dermatitis and improving skin related quality of life in patients with breast cancer or head and neck cancer receiving radiotherapy.
Rosmarinic acid treatment protects against lethal H1N1 virus-mediated inflammation and lung injury by promoting activation of the h-PGDS-PGD2-HO-1 signal axis
Authors: Zhou Beixian , Wang Linxin , Yang Sushan , Liang Yueyun , Zhang Yuehan , Pan Xiping , Li Jing
Published: October 2023

Background

Rosmarinic acid (RosA) is a natural phenolic compound that possesses a wide-range of pharmacological properties. However, the effects of RosA on influenza A virus-mediated acute lung injury remain unknown. In this study, we aimed to explore whether RosA could protect against H1N1 virus-mediated lung injury and elucidate the underlying mechanisms.

Methods

Mice were intragastrically administered with RosA for 2 days before intranasal inoculation of the H1N1 virus (5LD50) for the establishment of an acute lung injury model. At day 7 post-infection (p.i.), gross anatomic lung pathology, lung histopathologic, and lung index (lung weight/body weight) were examined. Luminex assay, multiple immunofluorescence and flow cytometry were performed to detect the levels of pro-inflammatory cytokines and apoptosis, respectively. Western blotting and plasmid transfection with hematopoietic-type PGD2 synthase (h-PGDS) overexpression were conducted to elucidate the mechanisms.

Results

RosA effectively attenuated H1N1 virus-triggered deterioration of gross anatomical morphology, worsened lung histopathology, and elevated lung index. Excessive pro-inflammatory reactions, aberrant alveolar epithelial cell apoptosis, and cytotoxic CD8+ T lung recruitment in the lung tissues induced by H1N1 virus infection were observed to be reduced by RosA treatment. In vitro experiments demonstrated that RosA treatment dose-dependently suppressed the increased levels of pro-inflammatory mediators and apoptosis through inhibition of nuclear factor kappa B (NF-κB) and P38 MAPK signaling pathways in H1N1 virus-infected A549 cells, which was accompanied by promoting activation of the h-PGDS-PGD2-HO-1 signal axis. Furthermore, we strikingly found that h-PGDS inhibition significantly abrogated the inhibitory effects of RosA on H1N1 virus-mediated activation of NF-κB and P38 MAPK signaling pathways, resulting in diminishing the suppressive effects on the increased levels of pro-inflammatory cytokines and chemokines as well as apoptosis. Finally, suppressing h-PGDS prominently abolished the protective effects of RosA on H1N1 virus-mediated severe pneumonia and lung injury.

Conclusions

Taken together, our study demonstrates that RosA is a promising compound to alleviate H1N1 virus-induced severe lung injury through prompting the h-PGDS-PGD2-HO-1 signal axis.
A unicentric cross-sectional observational study on chronic intestinal inflammation in total colonic aganglionosis: beware of an underestimated condition
Authors: Erculiani M , Poluzzi F , Mottadelli G , Felici E , ML Novi , Caraccia M , Grandi A , Casella S , Giacometti L , Montobbio G , Ceccherini I , Di Marco E , Bonaretti C , Biassoni R , Squillario M , Pietrantoni A , Villanacci V , Pini Prato A
Published: October 2023

Background

Inflammatory Bowel Diseases (IBD) are known to occur in association with Hirschsprung disease (HSCR). Most of cases are represented by Crohn Disease (CD) occurring in patients with Total Colonic Aganglionosis (TCSA) with an estimated prevalence of around 2%. Based on these considerations and on a number of provisional data belonging to our Center for Digestive Diseases, we developed a unicentric cross-sectional observational study aimed at describing phenotype, genotype, pathology and metagenomics of all patients with TCSA and Crohn-like lesions.

Results

Out of a series of 62 eligible TCSA patients, 48 fulfilled inclusion criteria and were enrolled in the study. Ten patients did not complete the study due to non-compliance or withdrawal of consent and were subsequently dropped out. A total of 38 patients completed the study. All patients were tested for chronic intestinal inflammation by a combination of fecal calprotectine (FC) or occult fecal blood (OFB) and underwent fecal metagenomics. Nineteen (50%) tested positive for FC, OFB, or both and subsequently underwent retrograde ileoscopy. Fourteen patients (36.8%) presented Crohn-like lesions, occurring after a median of 11.5 years after surgery (range 8 months − 21.5 years). No statistically significant differences regarding demographic, phenotype and genotype were observed comparing patients with and without lesions, except for need for blood transfusion that was more frequent in those with lesions. Faecal microbiome of patients with lesions (not that of caregivers) was less biodiverse and characterized by a reduction of Bacteroidetes, and an overabundance of Proteobacteria. FC tested negative in 3/14 patients with lesions (21%).

Conclusions

Our study demonstrated an impressive 10-folds higher incidence of chronic inflammation in TCSA. Up to 50% of patients may develop IBD-like lesions postoperatively. Nonetheless, we failed in identifying specific risk factors to be used to implement prevention strategies. Based on the results of our study, we suggest screening all TCSA patients with retrograde ileoscopy regardless of FC/OFB values. The frequency of endoscopic assessments and the role of FC/OFB screening in prompting endoscopy is yet to be determined.
First identification of Strongyloides stercoralis infection in a pet dog in Argentina, using integrated diagnostic approaches
Authors: Borrás Pablo , Pérez Matías Gastón , Repetto Silvia , Barrera Juan Pedro , Risso Marikena Guadalupe , Montoya Ana , Miró Guadalupe , Fernandez Federico , Telesca Laura , Britton Collette , Ruybal Paula
Published: October 2023

Background

Strongyloides stercoralis is a soil-transmitted intestinal nematode with a complex life cycle that primarily affects humans, non-human primates, dogs, and occasionally cats. This study presents, to the best of our knowledge, the first case of S. stercoralis infection and its genotyping in a domestic dog from Argentina.

Methods

The patient was a female wired-haired Teckel dog exhibiting recurrent coughing. Coproparasitological analysis using the Baermann technique revealed the presence of rhabditiform larvae morphologically compatible with S. stercoralis. To confirm this finding, molecular diagnosis (18S ribosomal RNA) and analysis of the cox1 gene were performed.

Results

We identified a haplotype (HP20) that has previously only been related to S. stercoralis infection in dogs, but was found in the present study to be highly related to the haplotype (HP16) of a zoonotic variant and divergent from those previously described from human patients in Argentina. Furthermore, unlike in human cases following treatment with ivermectin, the dog was negative after moxidectin treatment according to polymerase chain reaction of the sampled faeces.

Conclusions

This case report shows the importance of further investigation into potential transmission events and prevalences of S. stercoralis in dogs and humans in South America. The results reported here should also encourage future work that examines different scenarios of infection with S. stercoralis in dogs and humans with the aim of integrating clinical management, diagnosis, treatment and follow-up strategies in the quest for new approaches for the treatment of this disease in animals and humans. The findings support the adoption of a One Health approach, which recognizes the interconnectedness between animal and human health, in addressing parasitic infections such as strongyloidiasis.

Graphical Abstract
Total marrow lymphoid irradiation IMRT treatment using a novel CT-linac
Authors: Jiang Dazhen , Deng Di , Xiong Yu , Wang Dajiang , Gong Jian , Zhao Hongli , Bao Zhirong , Wei Yongchang , Xie Conghua , Jia Lecheng , Liao Can , Liu Shuo , Liu Hui , Wang Xiaoyong
Published: October 2023

Background

A novel CT-linac (kilovolt fan-beam CT-linac) has been introduced into total marrow and lymphoid irradiation (TMLI) treatment. Its integrated kilovolt fan-beam CT (kV FBCT) can be used not only for image guidance (IGRT) but also to re-calculate the dose.

Purpose

This study reported our clinical routine on performing TMIL treatment on the CT-linac, as well as dose distribution comparison between planned and re-calculated based on IGRT FBCT image sets.

Methods

11 sets of data from 5 male and 6 female patients who had underwent the TMLI treatment with uRT-linac 506c were selected for this study. The planning target volumes consist of all skeletal bones exclusion of the mandible and lymphatic sanctuary sites. A planned dose of 10 Gy was prescribed to all skeletal bones exclusion of the mandible in two fractions and 12 Gy in two fractions was prescribed to lymphatic sanctuary sites. Each TMLI plan contained two sub-plans, one dynamic IMRT for the upper body and the other VMAT for the lower extremity. Two attempts were made to obtain homogeneous dose in the overlapping region, i.e., applying two plans with different isocenters for the treatment of two fractions, and using a dose gradient matching scheme. The CT scans, including planning CT and IGRT FBCT, were stitched to a whole body CT scan for dose distribution evaluation.

Results

The average beam-on time of Planupper is 30.6 min, ranging from 24.9 to 37.5 min, and the average beam-on time of Planlower is 6.3 min, ranging from 5.7 to 8.2 min. For the planned dose distribution, the 94.79% of the PTVbone is covered by the prescription dose of 10 Gy (V10), and the 94.68% of the PTVlymph is covered by the prescription dose of 12 Gy (V12). For the re-calculated dose distribution, the 92.17% of the PTVbone is covered by the prescription dose of 10 Gy (V10), and the 90.07% of the PTVlymph is covered by the prescription dose of 12 Gy (V12). The results showed that there is a significant difference (p < 0.05) between planning V10, V12 and delivery V10, V12. There is no significant difference (p > 0.05) between planned dose and re-calculated dose on selected organs, except for right lens (p < 0.05, Dmax). The actual delivered maximum dose of right lens is apparently larger than the planned dose of it.

Conclusion

TMLI treatment can be performed on the CT-linac with clinical acceptable quality and high efficiency. Evaluation of the recalculated dose on IGRT FBCT suggests the treatment was delivered with adequate target coverage.
Exploring the influence of climatic variables on mycobiome composition and community diversity in lichens: insights from structural equation modeling analysis
Authors: Yang Jiho , Woo Jung-Jae , Kim Wonyong , Oh Seung-Yoon , Hur Jae-Seoun
Published: October 2023

Background

Lichens are symbiotic organisms composed of a fungus and a photosynthetic partner, which are key ecological bioindicators due to their sensitivity to environmental changes. The endolichenic fungi (ELF) living inside lichen thalli, are an important but understudied component of playing crucial ecological roles such as nutrient cycling and protection against environmental stressors. Therefore ELF community investigation is vital for fostering sustainable ecosystems and leveraging their ecological benefits. Deciphering the intricate relationships between ELF and their lichen hosts, alongside the influence of environmental factors on these communities, presents a significant challenge in pinpointing the underlying drivers of community structure and diversity.

Results

Our research demonstrated that locational factors were the main drivers of the ELF community structure, rather than host haplotype. Several climatic factors affected the diversity of the ELF community and contributed to the prevalence of different types of fungal residents within the ELF community. A decrease in isothermality was associated with a greater prevalence of pathotrophic and saprotrophic fungi within the ELF community, resulting in an overall increase in community diversity. By conducting a structural equation modeling analysis, we identified a robust link between climatic variables, fungal trophic mode abundance, and the species diversity of the ELF community.

Conclusion

This study’s discoveries emphasize the significance of examining climate-related factors when investigating ELF’s structure and function. The connection between fungi and climate is intricate and complex, and can be influenced by various other factors. Investigating the potential for ELF to adapt to changing climatic conditions, as well as the potential effects of changes in ELF communities on lichen function, would be valuable research areas. We anticipate that our research results will establish a basis for numerous future ELF research projects and have a significant impact on the field.
Factors associated with the utilization of diagnostic tools among countries with different income levels during the COVID-19 pandemic
Authors: Zhou Shuduo , Feng Xiangning , Hu Yunxuan , Yang Jian , Chen Ying , Bastow Jon , Zheng Zhi-Jie , Xu Ming
Published: October 2023

Background

Disparities in the utilization of essential medical products are a key factor contributing to inequality in health outcomes. We aimed to analyze the trends and influencing factors in using Coronavirus disease 2019 (COVID-19) diagnostic tools and disparities in countries with different income levels.

Methods

We conducted a cross-sectional study using open and publicly available data sources. Data were mainly collected from the Foundation for Innovative New Diagnostics, "Our World in Data," and the Global Burden of Disease databases. Negative binomial regression model and generalized linear mixed model were employed to investigate into five sets of factors associated with the usage of diagnostics: severity of COVID-19, socioeconomic status, health status, medical service capacity, and rigidity of response. Dominance analysis was utilized to compare the relative importance of these factors. The Blinder–Oaxaca decomposition was used to decompose the difference in the usage of diagnostics between countries.

Results

The total COVID-19 testing rate ranged from 5.13 to 22,386.63 per 1000 people from March 2020 to October 2022 and the monthly testing rate declined dramatically from January 2022 to October 2022 (52.37/1000 vs 5.91/1000).. The total testing rate was primarily associated with socioeconomic status (37.84%), with every 1 standard deviation (SD) increase in Gross Domestic Product per capita and the proportion of people aged ≥ 70, the total testing rate increased by 88% and 31%. And so is the medical service capacity (33.66%), with every 1 SD increase in health workforce density, the number increased by 38%. The monthly testing rate was primarily associated with socioeconomic status (34.72%) and medical service capacity (28.67%), and the severity of COVID-19 (21.09%). The average difference in the total testing rates between high-income and low-income countries was 2726.59 per 1000 people, and 2493.43 (91.45%) of the differences could be explained through the five sets of factors.

Conclusions

Redoubling the efforts, such as local manufacturing, regulatory reliance, and strengthening the community health workforce and laboratory capacity in low- and middle-income countries (LMICs) cannot be more significant for ensuring sustainable and equitable access to diagnostic tools during pandemic.
Antirheumatoid arthritis and cellular uptake study of cefuroxime axetil-loaded boswellic acids nanoparticles on RAW 264.7 cells
Authors: Rani Gitika , Rohilla Seema , Rohilla Ankur , Kumar Vanish , Kumar Ishab
Published: October 2023

Background

The present study revealed the grafting of extracted oleo gum resin of Boswellia serrata with polyacrylamide by conventional method with a principle of radical polymerization by using potassium per sulfate/ascorbic acid as redox initiator. A series of copolymer were synthesized using varying concentration of acrylamide at varying temperature. The optimum ratio for grafting was selected (1:2.5), on the basis of percent grafting and grafting efficiency. The grafted gum was further used as a nanocarrier to encapsulate cefuroxime axetil for their sustained release. Then, the nanoparticles were further analyzed by FT-IR, scanning electron microscopy, and DLS. The encapsulation efficiency (%), loading capacity (%) and drug content (%) was also calculated.

Result

The optimized nanoparticles have shown spherical morphology with dimension of 209.4 ± 20.46 nm along with entrapment efficiency (62.47 ± 4.23%), loading capacity (33.57 ± 3.01%) and drug content (89.35 ± 6.47%). The prepared nanoparticles had found to be more stable at 4 °C. The experiential results rationalize the effectiveness of cefuroxime axetil-loaded boswellic acid nanoparticles owing to higher cellular uptake, nonstop intercellular drug withholding and improved antiproliferative effect by initiating apoptosis.

Conclusion

The significant anti-arthritic effect of developed nanoparticles may be endorsed due to its dimension, encapsulation efficiency, and long-lasting drug release profile. Thus, the developed nanoparticles may assume to be a hopeful formulation for rheumatoid arthritis, which requires further investigation and may recommend a novel track to arthritis patients.
Optimization of African indigenous vegetables production in sub Saharan Africa: a review
Authors: Kodzwa Jefline J. , Madamombe Godwil , Masvaya Esther N. , Nyamangara Justice
Published: October 2023

The numerous types of African Indigenous Vegetables (AIVs) in sub-Saharan Africa are not extensively cultivated, even after the realization of their superior nutritional, health benefits, and higher resistance to climate change. The recent increase in demand for AIVs brings about the need to match cultivation with consumption to prevent the extinction of these nutritious vegetables through overexploitation. This review aims to assess the most common AIVs and the associated agronomic practices in their production by smallholder farmers in Zimbabwe and SSA in general for potential commercialization. Amaranthus, Cleome gynandra, Bidens pilosa, Abelmoschus esculentus, Vigna unguiculata, Cucurbita spp. and Corchorus molitorius are some of the most consumed AIVs in sub-Saharan Africa. Plant density should balance between leaf quality and leaf and seed yield per unit area. Transplanting and sowing AIVs in lines as pure stand can optimize production when compared to broadcasting. Nutrient application whether organic or inorganic is crucial together with harvesting leaves in 1 to 2 weeks interval and removing flowers to increase budding for optimized AIVs production. There is vast information on the indigenous vegetables found and preferred in SSA but scarce information on their performance under different plant nutrition management regimes and different agroecological regions. Research is required to increase production and to improve the nutrient content of AIVs.
Early Efficacy End Points in Neoadjuvant Rectal Cancer Trials: Surrogacy Revisited
Authors: Fokas Emmanouil , Smith J. Joshua , Garcia-Aguilar Julio , Glynne-Jones Robert , Buyse Marc , Rödel Claus
Published: October 2023

Trial-level surrogacy is critical before early response endpoints are used to approve new therapies.
High Incidence of Diabetes Mellitus After Distal Pancreatectomy and Its Predictors: A Long-term Follow-up Study
Authors: Imamura Shuzo , Niwano Fumimaru , Babaya Naru , Hiromine Yoshihisa , Matsumoto Ippei , Kamei Keiko , Yoshida Yuta , Taketomo Yasunori , Yoshida Sawa , Takeyama Yoshifumi , Noso Shinsuke , Maeda Norikazu , Ikegami Hiroshi
Published: October 2023

Context

Glucose tolerance worsens after distal pancreatectomy (DP); however, the long-term incidence and factors affecting interindividual variation in this worsening are unclear.

Objective

To investigate the changes in diabetes-related traits before and after DP and to clarify the incidence of diabetes and its predictors.

Methods

Among 493 registered patients, 117 underwent DP. Among these, 56 patients without diabetes before surgery were included in the study. Glucose and endocrine function were prospectively assessed using a 75-g oral glucose tolerance test preoperatively, 1 month after DP, and every 6 months thereafter for up to 36 months. Pancreatic volumetry was performed using multidetector row computed tomography before and after surgery.

Results

Insulin secretion decreased and blood glucose levels worsened after DP. Residual pancreatic volume was significantly associated with the reserve capacity of insulin secretion but not with blood glucose levels or the development of diabetes. Among 56 patients, 33 developed diabetes mellitus. The cumulative incidence of diabetes at 36 months after DP was 74.1%. Multivariate Cox regression analysis showed that impaired glucose tolerance as a preoperative factor as well as a decreased insulinogenic index and impaired glucose tolerance at 1 month postoperatively were identified as risk factors for diabetes following DP.

Conclusion

Impaired glucose tolerance and reduced early-phase insulin response to glucose are involved in the development of new-onset diabetes after DP; the latter is an additional factor in the development of diabetes and becomes apparent when pancreatic beta cell mass is reduced after DP.
Monitor Reputation and Transparency
Authors: Marinovic Iván , Szydlowski Martin
Published: October 2023

We study the disclosure policy of a regulator overseeing a monitor with reputation concerns. The monitor faces a manager, who chooses how much to manipulate based on the monitor’s reputation. Reputational incentives are strongest for intermediate reputations. Instead of providing transparency, the regulator’s disclosure policy aims to keep the monitor’s reputation intermediate, even at the cost of diminished incentives. Beneficial schemes feature random delay or noisy information. Schemes that feature verifiable disclosure destroy reputational incentives. The regulator discloses more aggressively when she has better enforcement tools. (JEL D82, D83, G21, G28, G38, M42)
Comment on “Frontiers: The Interplay of User-Generated Content, Content Industry Revenues, and Platform Regulation: Quasi-Experimental Evidence from YouTube”
Authors: Tushnet Rebecca
Published: October 2023

The paper provides useful information about music consumption, but not about legal safe harbors, whose effects it cannot test because they did not change between periods.