bluuebunny/crossref_metadata_2025 huggingface dataset:
Convergence of two serotypes within the epidemic ST11 KPC-producing Klebsiella pneumoniae creates the “Perfect Storm” in a teaching hospital
Authors: Liu Chao , Yang Ping , Zheng Jiajia , Yi Juan , Lu Ming , Shen Ning
Published: October 2022

Objectives

ST11 KPC-producing Klebsiella pneumoniae (Kp) is highly prevalent in China. We investigated the inter- and intra- host transmission and evolution characteristics of ST11 KPC-producing Kp.

Methods

A retrospective study was conducted in a hospital. The clinical data and antimicrobial resistance (AMR) phenotypes were collected. Whole genome sequencing was performed. The transmission route was reconstructed by combining single nucleotide polymorphisms (SNPs) with the clinical information. Hypervirulent Kp (HvKp) was defined as the presence of some combination of peg-344, iroB, iucA, rmpA, or rmpA2.

Results

Fifty-eight Kp strains isolated from thirty-five patients were enrolled. The information of one isolate was missing. The mean age of the patients was 74.3 ± 18.0 years, and 18 (50.0%) were female. Fifteen patients (41.7%, 15/36) presented with poor prognosis. All the strains were identified as ST11, and 57 strains harbored blaKPC-2. Two distinguished clades were identified based on the 1,325 high quality SNPs. In clade 1, carbapenem-resistant (CR)-hvKp accounted for 48.3% of the strains (28/58), which mostly presented as KL64 subclones, whereas CR-classical Klebsiella pneumoniae (cKp) commonly possessing KL47 were clustered in Clade 2. One CR-hvKp strain might have originated from the CR-cKp strain from within-host evolution. Even worse, a prolonged transmission of CR-hvKp has led to its spread into healthcare institutes.

Conclusion

Two endemic subclones of ST11 KPC-producing Kp, KL64-CR-hvKp and KL47-CR-cKp, were transmitted in parallel within the hospital and/or the healthcare institute, suggesting that the ongoing genomic surveillance should be enhanced.
Transcriptomic analysis provides insight into defensive strategies in response to continuous cropping in strawberry (Fragaria × ananassa Duch.) plants
Authors: Chen Peng , Li He-qin , Li Xing-yue , Zhou Xian-hong , Zhang Xiu-xia , Zhang An-sheng , Liu Qi-zhi
Published: October 2022

Background

Strawberries are an important economic fruit crop world-wide. In strawberry cultivation, continuous cropping (CC) can seriously threaten yield and quality. However, our understanding of the gene expression changes in response to CC and during subsequent defense processes is limited. In this study, we analyzed the impact of CC on the transcriptome of strawberry roots using RNA-Seq technology to elucidate the effect of CC and the subsequent molecular changes.

Results

We found that CC significantly affects the growth of strawberry plants. The transcriptome analysis identified 136 differentially expressed genes (DEGs), including 49 up-regulated and 87 down-regulated DEGs. A Gene Ontology (GO) analysis indicated that the up-regulated DEGs were mainly assigned to defense-related GO terms, and most down-regulated DEGs were assigned to nutrient-related GO terms. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis revealed that the responsive DEGs were classified in a large number of important biological pathways, such as phenylalanine metabolism, starch and sucrose metabolism, phenylpropanoid biosynthesis, glutathione metabolism and plant-pathogen interaction. We also found that four WRKY transcription factors and three peroxidase genes involved in plant defense pathways were up-regulated in the roots of strawberry plants subjected to CC.

Conclusion

Several unigenes involved in plant defense processes, such as CNGCs, WRKY transcription factors, PR1, and peroxidase genes with highly variable expression levels between non-CC and CC treatments may be involved in the regulation of CC in strawberry. These results indicate that strawberry roots reallocate development resources to defense mechanisms in response to CC. This study will further deepen our understanding of the fundamental regulatory mechanisms of strawberry resource reallocation in response to CC.
The bacterial consortia promote plant growth and secondary metabolite accumulation in Astragalus mongholicus under drought stress
Authors: Lin Yixian , Zhang Hui , Li Peirong , Jin Juan , Li Zhefei
Published: October 2022

Astragalus mongholicus is a widely used Traditional Chinese Medicine. However, cultivated A. mongholicus is often threatened by water shortage at all growth stage, and the content of medicinal compounds of cultivated A. mongholicus is much lower than that of wild plants. To alleviate drought stress on A. mongholicus and improve the accumulation of medicinal components in roots of A. mongholicus, we combined different bacteria with plant growth promotion or abiotic stress resistance characteristics and evaluated the role of bacterial consortium in helping plants tolerate drought stress and improving medicinal component content in roots simultaneously. Through the determination of 429 bacterial strains, it was found that 97 isolates had phosphate solubilizing ability, 63 isolates could release potassium from potash feldspar, 123 isolates could produce IAA, 58 isolates could synthesize ACC deaminase, and 21 isolates could secret siderophore. Eight bacterial consortia were constructed with 25 bacterial isolates with more than three functions or strong growth promoting ability, and six out of eight bacterial consortia significantly improved the root dry weight. However, only consortium 6 could increase the root biomass, astragaloside IV and calycosin-7-glucoside content in roots simultaneously. Under drought challenge, the consortium 6 could still perform these functions. Compared with non-inoculated plants, the root dry weight of consortium inoculated-plants increased by 120.0% and 78.8% under mild and moderate drought stress, the total content of astragaloside IV increased by 183.83% and 164.97% under moderate and severe drought stress, calycosin-7-glucoside content increased by 86.60%, 148.56% and 111.45% under mild, moderate and severe drought stress, respectively. Meanwhile, consortium inoculation resulted in a decrease in MDA level, while soluble protein and proline content and SOD, POD and CAT activities increased. These findings provide novel insights about multiple bacterial combinations to improve drought stress responses and contribute to accumulate more medicinal compounds.
Estimation of myocardial infarction death in Iran: artificial neural network
Authors: Asghari-Jafarabadi Mohammad , Gholipour Kamal , Khodayari-Zarnaq Rahim , Azmin Mehrdad , Alizadeh Gisoo
Published: October 2022

Background

Examining past trends and predicting the future helps policymakers to design effective interventions to deal with myocardial infarction (MI) with a clear understanding of the current and future situation. The aim of this study was to estimate the death rate due to MI in Iran by artificial neural network (ANN).

Methods

In this ecological study, the prevalence of diabetes, hypercholesterolemia over 200, hypertension, overweight and obesity were estimated for the years 2017–2025. ANN and Linear regression model were used. Also, Specialists were also asked to predict the death rate due to MI by considering the conditions of 3 conditions (optimistic, pessimistic, and probable), and the predicted process was compared with the modeling process.

Results

Death rate due to MI in Iran is expected to decrease on average, while there will be a significant decrease in the prevalence of hypercholesterolemia 1.031 (− 24.81, 26.88). Also, the trend of diabetes 10.48 (111.45, − 132.42), blood pressure − 110.48 (− 174.04, − 46.91) and obesity and overweight − 35.84 (− 18.66, − 5.02) are slowly increasing. MI death rate in Iran is higher in men but is decreasing on average. Experts' forecasts are different and have predicted a completely upward trend.

Conclusion

The trend predicted by the modeling shows that the death rate due to MI will decrease in the future with a low slope. Improving the infrastructure for providing preventive services to reduce the risk factors for cardiovascular disease in the community is one of the priority measures in the current situation.
Defining the concepts of a smart nursing home and its potential technology utilities that integrate medical services and are acceptable to stakeholders: a scoping review
Authors: Zhao Yuanyuan , Rokhani Fakhrul Zaman , Sazlina Shariff-Ghazali , Devaraj Navin Kumar , Su Jing , Chew Boon-How
Published: October 2022

Background and objectives

Smart technology in nursing home settings has the potential to elevate an operation that manages more significant number of older residents. However, the concepts, definitions, and types of smart technology, integrated medical services, and stakeholders’ acceptability of smart nursing homes are less clear. This scoping review aims to define a smart nursing home and examine the qualitative evidence on technological feasibility, integration of medical services, and acceptability of the stakeholders.

Methods

Comprehensive searches were conducted on stakeholders’ websites (Phase 1) and 11 electronic databases (Phase 2), for existing concepts of smart nursing home, on what and how technologies and medical services were implemented in nursing home settings, and acceptability assessment by the stakeholders. The publication year was inclusive from January 1999 to September 2021. The language was limited to English and Chinese. Included articles must report nursing home settings related to older adults ≥ 60 years old with or without medical demands but not bed-bound. Technology Readiness Levels were used to measure the readiness of new technologies and system designs. The analysis was guided by the Framework Method and the smart technology adoption behaviours of elder consumers theoretical model. The results were reported according to the PRISMA-ScR.

Results

A total of 177 literature (13 website documents and 164 journal articles) were selected. Smart nursing homes are technology-assisted nursing homes that allow the life enjoyment of their residents. They used IoT, computing technologies, cloud computing, big data and AI, information management systems, and digital health to integrate medical services in monitoring abnormal events, assisting daily living, conducting teleconsultation, managing health information, and improving the interaction between providers and residents. Fifty-five percent of the new technologies were ready for use in nursing homes (levels 6–7), and the remaining were proven the technical feasibility (levels 1–5). Healthcare professionals with higher education, better tech-savviness, fewer years at work, and older adults with more severe illnesses were more acceptable to smart technologies.

Conclusions

Smart nursing homes with integrated medical services have great potential to improve the quality of care and ensure older residents’ quality of life.
A community-based health–social partnership program for community-dwelling older adults: a hybrid effectiveness–implementation pilot study
Authors: Wong Arkers Kwan Ching , Wong Frances Kam Yuet , Wong Martin Chi Sang , Chow Karen Kit Sum , Kwan Dilys Kwai Sin , Lau Dubby Yun Sang
Published: October 2022

Background

A growing body of literature supports the efficacy of the health–social approach for the implementation of complex interventions to enhance self-care health management among community-dwelling older adults. However, there is little research on how interventions with this approach are implemented and disseminated in a real community setting.

Methods

This pilot study adopted an effectiveness–implementation hybrid design to 1) evaluate the effectiveness of a community-based Health–Social Partnership Program (HSPP) and 2) explore the reach, adoption, implementation, and maintenance of the HSPP in the community. Potential participants were recruited if they were aged 60 or above, owned a smartphone, and were cognitively competent. The participants received nurse-led case management with support from a social service team. Factors that hindered or facilitated the program delivery were examined to determine the implementation outcomes and sustained effects of the program. Data were collected at pre-intervention (T1), immediately post-intervention (T2), and 3 months post-intervention (T3).

Results

Ninety-two older adults joined and completed the program. The recruitment rate was 76.7%. A significant interaction effect was found for the mean self-efficacy scores from T1 to T2 (Wald χ2 = 12.28,p ≤ .001). Barriers to widespread program implementation included manpower shortage, lack of experienced staff, and unpredictable environment, whereas facilitators, as suggested by the older adults, providers, and community staff members, included regular communication between the research and service teams, recruitment of participants through community centers with the support of the research team, and seamless partnership among the health–social partnership team members. Strong implementation fidelity was achieved with zero attrition rate.

Conclusion

Most conventional randomized controlled trials investigating the effects of community-based programs have tended to control the contextual factors rather than incorporate the program in a real setting. This pilot study was the first to use a hybrid model to test the effectiveness and outcomes of HSPP implementation. The results imply that the program has a high potential sustainability in the real-life context.

Trial registration

This study was registered atclinicaltrials.gov(NCT04442867; date of first registration 23/06/2020).
Localized versus 360-degree laser photocoagulation with limited pars plana vitrectomy in the management of primary rhegmatogenous retinal detachment
Authors: Ryoo Na-Kyung , Kim So Yeon , Woo Se Joon , Park Kyu Hyung
Published: October 2022

Background

To compare the efficacy of intraoperative localized and 360-degree laser photocoagulation in 23-gauge limited pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD).

Methods

This retrospective, comparative, consecutive, interventional study included 155 eyes of 155 patients who underwent primary repair of RRD utilizing 23-gauge PPV with at least six months of follow up. Medical records were retrospectively reviewed, and the corresponding demographic data, preoperative ophthalmic features, surgical management, and postoperative course were recorded. Main outcome measures included single surgery anatomical success, pre- and post-operative visual acuity, and complications.

Results

Eighty-three patients (group A) received localized laser photocoagulation in PPV, while the remaining 72 patients (group B) received underwent circumferential 360-degree laser photocoagulation in PPV. Two skilled-surgeons performed all the surgeries, and 23-gauge PPV instrumentation, a wide-angle viewing system, endolaser photocoagulation, and gas tamponade were used in each case. No significant difference was identified in baseline characteristics. The single surgery anatomical success rate was 96.4 % in group A, and 95.8 % in group B, showing no significant difference (p = 1.00). Primary anatomical failure was caused by re-detachment due to break in 2 eyes in each group (no new break 1 eye, new break 1eye in group A, 2 eyes with no new break in group B), and proliferative vitreoretinopathy in 1 eye in each group. Other complications were epiretinal membrane in 7 eyes (3 in group A, 4 in group B), and macular hole in 1 eye in group B. There were no differences in pre- and post-operative best-corrected visual acuity (BCVA) as well as BCVA improvement (p=0.144, p=0.866 and p=0.263, respectively).

Conclusion

Localized laser photocoagulation showed no difference in anatomic and visual outcome in RRD patients, when compared with 360-degree laser photocoagulation in limited PPV. Routine circumferential 360-degree laser photocoagulation may not be necessary in vitrectomy surgery for primary rhegmatogenous retinal detachment without severe PVR.
The contagious leader: a panel study on occupational stress transfer in a large Danish municipality
Authors: Bonnesen Lærke , Pihl-Thingvad Signe , Winter Vera
Published: October 2022

Occupational stress has immense economic and health-related consequences for individuals, organizations, and societies. In this context, the question of whether and how stress among managers transmits to their subordinates is highly interesting, yet not profoundly researched. This study aims to empirically investigate the effect of manager occupational stress on the development of subordinate stress and for how long such effects last in time. We exploit a unique panel dataset based on three different surveys among employees from a large Danish municipality, covering 5,688 employees and their 473 immediate managers between 2016 and 2020. We analyze this data using a fixed effects estimator with clustered robust standard errors, allowing us to significantly reduce potential endogeneity issues. The study shows that managers do in fact ‘transmit’ stress onto their employees, that the relationship is detectable a full year after the initial transmission of stress occurred, and that such an effect fades within additional two years. Our study serves to emphasize the great importance of the psychosocial wellbeing of managers as ‘nerve centers’ for entire job teams and urges organizations to treat stress among personnel on management levels with a high degree of concern.
Socio-economic disparities in female genital circumcision: finding from a case-control study in Mahabad, Iran
Authors: Laleh Shahla Shafaati , Roshanaei Ghodratollah , Soltani Farzaneh , Mehran Fatemeh Ghamari
Published: October 2022

Background

Female genital circumcision (FGC) is still a challenge in reproductive health. This study investigated socioeconomic disparities in FGC in the Kurdish region of Mahabad, Iran.

Methods

A case-control study was conducted in three comprehensive health centers on 130 circumcised girls as the case group and 130 girls without a history of circumcision as the control group, according to the residential area and the religious sect. The participants completed a previously validated demographic and circumcision information questionnaire. A multivariate logistic regression model with a backward method at a 95% confidence level was used to determine the relationship between socioeconomic variables and FGC.

Results

Multivariate logistic regression showed that a family history of FGC (AOR 9.90; CI 95%: 5.03–19.50), age ranging between 20 and 30 years (AOR 8.55; CI 95%: 3.09–23.62), primary education (AOR 6.6; CI 95%: 1.34–33.22), and mothers with primary education (AOR 5.75; CI 95%: 1.23–26.76) increased the chance of FGC.

Conclusion

The present study provided evidence on socioeconomic factors related to FGC in girls. A family history of FGC, age ranging between 20 and 30 years, and girls’ and their mothers’ education level were strong predictors of FGC. The findings indicate the need to design effective interventions to address these factors to help eradicate FGC.
“Such conversations are not had in the families”: a qualitative study of the determinants of young adolescents’ access to sexual and reproductive health and rights information in Rwanda
Authors: Mbarushimana Valens , Conco Daphney Nozizwe , Goldstein Susan
Published: October 2022

Background

Access to sexual and reproductive health and rights (SRHR) information during adolescence has become a global concern. This study explored factors that enable or prevent young adolescents from accessing to SRHR information from the perspective of the key informants in Rwanda.

Methods

We conducted a qualitative study using semi-structured interviews with 16 purposively selected key informants from public and private institutions in Rwanda. This selection was based on their positions and expertise in delivering SRHR information to adolescents. The interview guide questions were designed based on the social-ecological theoretical framework of adolescent health. The interview transcripts were recorded, transcribed, translated and thematically analysed in Nvivo 11.

Results

The study reflected that multiple enablers and barriers at the individual, relationship, community and societal levels determined young adolescents’ access to SRHR information. These determinants include information-seeking behaviour and age of starting sexuality education at the individual level; and parents’ limited communication with young adolescents due to taboos, lack of skills, limited parental availability, beliefs, lack of appropriate language and peer norms at the relationships level. Enablers and barriers at the community level were the diversity of SRHR sources, the scope of sexuality education programmes, and cultural and religious beliefs. Finally, the perceived enablers and barriers at the societal level consisted of inadequate resources, inappropriate SRHR policy-making processes and unfriendly SRHR laws.

Conclusion

Enabling access to SRHR information requires addressing multiple factors within the social-ecological environment of young adolescents. Addressing these factors may facilitate improved access to SRHR information for this age group.
Disability status, partner behavior, and the risk of sexual intimate partner violence in Uganda: An analysis of the demographic and health survey data
Authors: Kwagala Betty , Galande Johnstone
Published: October 2022

Background

Women with disabilities in developing countries experience significant marginalization, which negatively affects their reproductive health. This study examined the association between disability status and sexual intimate partner violence; the determinants of sexual intimate partner violence by disability status; and the variations in the determinants by disability status.

Methods

The study, which was based on a merged dataset of 2006, 2011 and 2016 Uganda Demographic Surveys, used a weighted sample of 9689 cases of married women selected for the domestic violence modules. Data were analyzed using frequency distributions and chi-squared tests and multivariable logistic regressions. Other key explanatory variables included partner’s alcohol consumption and witnessing parental violence. A model with disability status as an interaction term helped to establish variations in the determinants of sexual intimate partner violence by disability status.

Results

Sexual IPV was higher among women with disabilities (25% compared to 18%). Disability status predicted sexual intimate partner violence with higher odds among women with disabilities (aOR = 1.51; 95% CI 1.10–2.07). The determinants of sexual intimate partner violence for women with disabilities were: partner’s frequency of getting drunk, having witnessed parental violence, occupation, and wealth index. The odds of sexual intimate partner violence were higher among women whose partners often or sometimes got drunk, that had witnessed parental violence, were involved in agriculture and manual work; and those that belonged to the poorer and middle wealth quintiles. Results for these variables revealed similar patterns irrespective of disability status. However, women with disabilities in the agriculture and manual occupations and in the poorer and rich wealth quintiles had increased odds of sexual intimate partner violence compared to nondisabled women in the same categories.

Conclusion

Determinants of sexual intimate partner violence mainly relate to partners’ behaviors and the socialization process. Addressing sexual intimate partner violence requires prioritizing partners’ behaviors, and gender norms and proper childhood modelling, targeting men, women, families and communities. Interventions targeting women with disabilities should prioritize women in agriculture and manual occupations, and those above the poverty line.
Antioxidative, anticancer, and antibacterial activities of a nanogel containing Mentha spicata L. essential oil and electrospun nanofibers of polycaprolactone-hydroxypropyl methylcellulose
Authors: Rasti Fatemeh , Yousefpoor Yaser , Abdollahi Abbas , Safari Mojdeh , Roozitalab Ghazaal , Osanloo Mahmoud
Published: October 2022

Background

As the largest organ, the skin has been frequently affected by trauma, chemical materials, toxins, bacterial pathogens, and free radicals. Recently, many attempts have been made to develop natural nanogels that, besides hydrating the skin, could also be used as antioxidant or antibacterial agents.

Methods

In this study, the chemical composition of the Mentha spicata essential oil was first investigated using GC–MS analysis. Its nanoemulsion-based nanogel was then investigated; successful loading of the essential oil in the nanogel was confirmed using FTIR analysis. Besides, nanogel’s antioxidative, anticancer, and antibacterial activities were investigated.

Results

Carvone (37.1%), limonene (28.5%), borneol (3.9%), β-pinene (3.3%), and pulegone (3.3%) were identified as five major compounds in the essential oil. By adding carboxymethylcellulose (3.5% w/v) to the optimal nanoemulsion containing the essential oil (droplet size of 196 ± 8 nm), it was gelified. The viscosity was fully fitted with a common non-Newtonian viscosity regression, the Carreau-Yasuda model. The antioxidant effect of the nanogel was significantly more potent than the essential oil (P < 0.001) at all examined concentrations (62.5–1000 µg/mL). Furthermore, the potency of the nanogel with an IC50 value of 55.0 µg/mL was substantially more (P < 0.001) than the essential oil (997.4 µg/mL). Also, the growth of Staphylococcus aureus and Escherichia coli after treatment with 1000 µg/mL nanogel was about 50% decreased compared to the control group. Besides, the prepared electrospun polycaprolactone-hydroxypropyl methylcellulose nanofibers mat with no cytotoxic, antioxidant, or antibacterial effects was proposed as lesion dressing after treatment with the nanogel. High potency, natural ingredients, and straightforward preparation are advantages of the prepared nanogel. Therefore, it could be considered for further consideration in vivo studies.
Selective gene expression profiling contributes to a better understanding of the molecular pathways underlying the histological changes observed after RHMVL
Authors: Arlt Janine , Vlaic Sebastian , Feuer Ronny , Thomas Maria , Settmacher Utz , Dahmen Uta , Dirsch Olaf
Published: October 2022

Background

In previous studies, five vasoactive drugs were investigated for their effect on the recovery process after extended liver resection without observing relevant improvements. We hypothesized that an analysis of gene expression could help to identify potentially druggable pathways and could support the selection of promising drug candidates.

Methods

Liver samples obtained from rats after combined 70% partial hepatectomy and right median hepatic vein ligation (n = 6/group) sacrificed at 0 h, 24 h, 48 h, and 7days were selected for this study. Liver samples were collected from differentially perfused regions of the median lobe (obstruction-zone, border-zone, normal-zone). Gene expression profiling of marker genes regulating hepatic hemodynamics, vascular remodeling, and liver regeneration was performed with microfluidic chips. We used 3 technical replicates from each sample. Raw data were normalized using LEMming and differentially expressed genes were identified using LIMMA.

Results

The strongest differences were found in obstruction-zone at 24 h and 48 h postoperatively compared to all other groups. mRNA expression of marker genes from hepatic hemodynamics pathways (iNOS,Ptgs2,Edn1) was most upregulated.

Conclusion

These upregulated genes suggest a strong vasoconstrictive effect promoting arterial hypoperfusion in the obstruction-zone. Reducing iNOS expression using selective iNOS inhibitors seems to be a promising approach to promote vasodilation and liver regeneration.
Cirsiliol regulates mitophagy in colon cancer cells via STAT3 signaling
Authors: Jiang Tao , Peng Lulu , Wang Qian , Huang Bingyu , Peng Dewei , Men Lintong , Jiang Yue , Zhu Mengying , Wang Moran , Lin Li , Lv Jiagao , Li Sheng
Published: October 2022

Background

Mitophagy is a type of selective autophagy for dysfunctional mitochondria and plays a key role in tumorigenesis and cancer progression. However, whether mitophagy plays a role in colon cancer remains unclear. Cirsiliol is a natural product and has been found to exert anti-cancer effects in multiple tumors. The effects of cirsiliol in the tumorigenesis and progression of colon cancer remain unknown.

Methods

CCK8 assay, plate cloning assay, and cell scratch assay were performed to determine cell viability, colony formation, and wound healing abilities of HCT116 and SW480 cells. JC-1 staining, H2DCFDA staining, and Mito-Tracker Red staining were carried out to evaluate mitochondrial membrane potential (Δψm), intracellular reactive oxygen species (ROS) level, and mitochondrial morphology. Molecular docking technology was utilized to predict interaction of cirsiliol and signal transducer and activator of transcription 3 (STAT3). Immunofluorescence staining was used to measure nuclear translocation of STAT3. The protein levels of phosphorylated STAT3 (Y705), total STAT3, and mitophagy proteins were detected by western blot.

Results

In this study, we first found that cirsiliol inhibited cell viability, colony formation, and wound healing abilities of HCT116 and SW480 colon cancer cells. Moreover, cirsiliol suppressed Δψm, increased ROS production, and disrupted mitochondrial morphology via inhibiting the levels of mitophagy proteins including PINK1, Parkin, BNIP3, and FUNDC1. Application of mitophagy activator improved the levels of mitophagy-related proteins, and ameliorated Δψm and ROS levels. According to the result of molecular docking, we found that cirsiliol potentially bound to the SH2 domain of STAT3, the key domain for the functional activation of STAT3. Moreover, it was found that cirsiliol inhibited constitutive and IL‑6‑induced STAT3 phosphorylation and nuclear translocation by western blot and immunofluorescence analysis. Comparing with cirsiliol group, we found that overexpression of STAT3 restored the expressions of mitophagy proteins.

Conclusions

Cirsiliol targets STAT3 to inhibit colon cancer cell proliferation by regulating mitophagy.
Evaluation of left ventricular systolic function in patients with systemic lupus erythematosus using ultrasonic layer-specific strain technology and its association with cardiovascular events: a long-term follow-up study
Authors: Zhang Hebin , Yang Cunxin , Gao Feng , Hu Shanting , Ma Hui
Published: October 2022

Background

Systemic lupus erythematosus (SLE) is a multisystem, autoimmune disease with potential cardiovascular involvement. Layer-specific strain (LSS) analysis is a new method that allows early detection of subtle left ventricular (LV) systolic dysfunction. The aim of this study was to evaluate LV systolic function in patients with SLE using conventional echocardiographic measurements and longitudinal strain (LS) and circumferential strain (CS) by LSS. Furthermore, the association between echocardiographic parameters and the occurrence of cardiovascular events was assessed.

Methods

A total of 162 patients with SLE (the SLE group) who underwent a dedicated multidisciplinary assessment, including echocardiography, were analyzed at the time of their first visits. The control group consisted of 68 age- and sex-matched healthy subjects. LS and CS on endocardial, mid-myocardial, and epicardial layers at 17 cardiac segments were measured. Transmural strain gradient was calculated as the differences in systolic strain between the endocardial and epicardial layers.

Results

Compared with control subjects, patients with SLE had significantly lower LV ejection fraction, LS, and CS values in all layers (P < 0.05); LV LS and CS gradient were all lower than control subjects (P < 0.05). During a median follow-up period of 83 months (interquartile range: 64–95 months), 59 patients (36.4%) developed cardiovascular events. Using multivariate Cox regression analysis, we found that LV endocardial LS (hazard ratio, 1.014; 95% CI, 1.002–1.035; P = 0.025) and CS (hazard ratio, 1.051; 95% CI, 1.027–1.077; P < 0.001) demonstrated independent associations with cardiovascular events; whereas LV ejection fraction was not significantly associated with cardiovascular events. The Kaplan–Meier survival curves showed that patients with SLE with lower LV endocardial LS and CS (based on the cutoff values of -21.5% and -29.0%, respectively) experienced higher cumulative rates of cardiovascular events compared with those with higher LV endocardial LS and CS.

Conclusions

In patients with SLE, LV systolic function measured by LV endocardial LS and CS were significantly lower than that of the control group and were associated with cardiovascular events, potentially representing a new technology to improve risk stratification in these patients
TIMM8A is associated with dysfunction of immune cell in BRCA and UCEC for predicting anti-PD-L1 therapy efficacy
Authors: Zhu Xiaoyu , Yuan Zile , Cheng Sheng , Wang Hongyi , Liao Yuxuan , Zhou Dawei , Wu Zhiqiang
Published: October 2022

Background

TIMM8A is a protein-coding gene located on the X chromosome. There is evidence that TIMM8A plays an important role in mitochondrial morphology and fission. Studies have shown that mitophagy and fission could affect the function of immune cells. However, there is currently no research on this gene’s role in cancer occurrence and progression.

Methods

TIMM8A expression was analyzed via the Tumor Immune Estimation Resource (TIMER) site and UALCAN database. We evaluated the influence of TIMM8A on clinical prognosis using Kaplan-Meier plotter, the PrognoScan database, and Human Protein Atlas (HPA). The correlations between TIMM8A and cancer immune infiltrates were investigated via TIMER. Tumor Immune Dysfunction and Exclusion (TIDE) was used to evaluate the potential of tumor immune evasion. Functions of TIMM8A mutations and 50 genes significantly associated with TIMM8A mutations in breast cancer (BRCA) and uterine corpus endometrial cancer (UCEC) were analyzed by GO and KEGG in LinkedOmics database.

Results

We investigated the role of TIMM8A in multiple cancers and found that it was significantly associated with poor prognosis in BRCA and UCEC. After analyzing the effect of TIMM8A on immune infiltration, we found Th2 CD4+ T cells might be a common pathway by which TIMM8A contributed to poor prognosis in BRCA and UCEC. Our results suggested that myeloid-derived suppressor cells (MDSC) and tumor-associated M2 macrophages (TAM M2) might be important factors in immune evasion through T cell rejection in both cancers, and considered TIMM8A as a biomarker to predict the efficacy of this therapy in BRCA and UCEC. The results of TIMM8A enrichment analysis showed us that abnormally expressed TIMM8A might affect the mitochondrial protein in BRCA and UCEC.

Conclusions

Contributed to illustrating the value of TIMM8A as a prognostic biomarker, our findings suggested that TIMM8A was correlated with prognosis and immune infiltration, including CD8+ T cells, Th2 CD4+ T cells, and macrophages in BRCA and UCEC. In addition, TIMM8A might affect immune infiltration and prognosis in BRCA and UCEC by affecting mitophagy. We believed it could also be a biomarker to predict the efficacy of anti-PD-L1 therapy and proposed to improve the efficacy by eliminating MDSC and TAM M2.
Estimating disability-adjusted life years for breast cancer and the impact of screening in female populations in China, 2015–2030: an exploratory prevalence-based analysis applying local weights
Authors: Yan Xin-Xin , Zhu Juan , Li Yan-Jie , Cao Meng-Di , Wang Xin , Wang Hong , Liu Cheng-Cheng , Wang Jing , Li Yang , Shi Ju-Fang
Published: October 2022

Background

Most cancer disability-adjusted life year (DALY) studies worldwide have used broad, generic disability weights (DWs); however, differences exist among populations and types of cancers. Using breast cancer as example, this study aimed to estimate the population-level DALYs in females in China and the impact of screening as well as applying local DWs.

Methods

Using multisource data, a prevalence-based model was constructed. (1) Overall years lived with disability (YLDs) were estimated by using numbers of prevalence cases, stage-specific proportions, and local DWs for breast cancer. Numbers of females and new breast cancer cases as well as local survival rates were used to calculate the number of prevalence cases. (2) Years of life lost (YLLs) were estimated using breast cancer mortality rates, female numbers and standard life expectancies. (3) The prevalence of and mortality due to breast cancer and associated DALYs from 2020 to 2030 were predicted using Joinpoint regression. (4) Assumptions considered for screening predictions included expanding coverage, reducing mortality due to breast cancer and improving early-stage proportion for breast cancer.

Results

In Chinese females, the estimated number of breast cancer DALYs was 2251.5 thousand (of 17.3% were YLDs) in 2015, which is predicted to increase by 26.7% (60.3% among those aged ≥ 65 years) in 2030 (2852.8 thousand) if the screening coverage (25.7%) stays unchanged. However, if the coverage can be achieved to 40.7% in 2030 (deduced from the “Healthy China Initiative”), DALYs would decrease by 1.5% among the screened age groups. Sensitivity analyses found that using local DWs would change the base-case values by ~ 10%.

Conclusion

Estimates of DALYs due to breast cancer in China were lower (with a higher proportion of YLDs) than Global Burden of Disease Study numbers (2527.0 thousand, 8.2% were YLDs), suggesting the importance of the application of population-specific DWs. If the screening coverage remains unchanged, breast cancer-caused DALYs would continue to increase, especially among elderly individuals.
Feasibility and psychophysical effects of immersive virtual reality-based mirror therapy
Authors: Heinrich Chris , Morkisch Nadine , Langlotz Tobias , Regenbrecht Holger , Dohle Christian
Published: October 2022

Background

Virtual reality (VR) has been used as a technological medium to deliver mirror therapy interventions with people after stroke in numerous applications with promising results. The recent emergence of affordable, off-the-shelf head-mounted displays (like the Oculus Rift or HTC Vive) has opened the possibility for novel and cost-effective approaches for immersive mirror therapy interventions. We have developed one such system, ART-VR, which allows people after stroke to carry out a clinically-validated mirror therapy protocol in an immersive virtual environment and within a clinical setting.

Methods

A case cohort of 11 people with upper limb paresis following first time stroke at an in-patient rehabilitation facility received three interventions over a one week period. Participants carried out the BeST mirror therapy protocol using our immersive VR system as an adjunct therapy to their standard rehabilitation program. Our clinical feasibility study investigated intervention outcomes, virtual reality acceptance and user experience.

Results

The results show that the combination of an immersive VR system and mirror therapy protocol is feasible for clinical use. 9 out of 11 participants showed some improvement of their affected hand after the intervention. The vast majority of the participants (9/11) reported experiencing some psycho-physical effects, such as tingling or paraesthesia, in the affected limb during the intervention.

Conclusions

Our findings show that immersive VR-based mirror therapy is feasible and shows effects comparable to those of conventional mirror therapy.

Trial RegistrationTrial was registered with the ISRCTN Registry (ISRCTN34011164) on December 3, 2021, retrospectively
Investigation and analysis of four countries’ recalls of osteosynthesis implants and joint replacement implants from 2011 to 2021
Authors: Wang Yang , Xu Kai , Wang Yuchen , Ye Weijie , Hao Xinyi , Wang Shouli , Li Kun , Du Jun
Published: October 2022

Background

Medical devices are used in almost all orthopedic surgical subspecialties, and the frequency of adverse events is increasing, which should not be ignored. To provide suggestions on how to avoid implant recalls from the perspective of manufacturers, medical institutions and supervisions, as well as how to respond promptly to adverse events.

Methods

The research extracted recalls of osteosynthesis implants and joint replacement implants from January 1, 2011, to June 30, 2021, in the CNMPA, FDA, HC and ATGA websites and collected the information on device name, recall time, recall class, recall manufacturer, device classification and affected areas. Moreover, the McKinsey 7S model and fishbone diagram were used to analyze recall reasons.

Results

A total of 315 cases of osteosynthesis implants and 286 cases of joint replacement implants were reported in China, the USA, Canada and Australia. The recalls number from 2016 to 2021 was more than that from 2011 to 2015 for osteosynthesis implant (p = 0.012) and joint replacement implant (p = 0.002), and both mainly focused on class II (76.19% and 78.32%). There were statistical differences in the four countries for both implants (p = 0.000), especially osteosynthesis implant between China and the USA (p = 0.000), China and Canada (p = 0.001), the USA and Australia (p = 0.002), and joint replacement implant between China and Australia (p = 0.000).

Conclusions

To avoid the recalls of such implants, manufacturers should strictly select implant materials and components, develop detailed labels and instructions, severely control the packaging process and establish the integrity of medical device data. Medical institutions should standardize procurement procedures, use qualified equipment and train medical workers. It also requires supervisions to conduct premarket safety assessments. In addition, regulators should strengthen supervision and establish reporting systems to deal with the occurrence of adverse events promptly.
Relationship between children with neurodevelopmental disorders and their caregivers and friends during early phase of COVID-19 school closure in Japan: Association with difficulty in implementing infection prevention measures
Authors: Yamamoto Tomoka , Tanaka Sanae , Yoshizaki Arika , Yoshimura Yuko , Fauzi Aishah Ahmad , Syarinaz Aida , Adlan Ahmad , Jayanath Subhashini , Hamzah Norhamizan , Fujino Haruo , Tachibana Masaya
Published: October 2022

Background

Due to the COVID-19 pandemic people had to implement various infection prevention measures. Researchers have reported the difficulties experienced by children with neurodevelopmental disorders in implementing these measures and their caregivers’ resultant anxiety and stress. This study examined the relationship between these difficulties and the deterioration of the children’s relationships with their caregivers and friends during school closure and after school reopened.

Methods

A total of 150 caregivers of children with neurodevelopmental disorders answered a questionnaire asking about parent‒child relationships, their child’s friendships, and the presence or absence of difficulty in implementing infection prevention measures at three time points: before the pandemic, while schools were closed, and after school reopened. The frequency and percentages of the child’s behavioral problems, deterioration in their relationships, and difficulty implementing infection control measures were calculated. Using the relationship deterioration scores, independent and multiple regression analyses were performed for the presence or absence of difficulty implementing infection control measures, presence or absence of caregivers’ mental health concerns, and the presence or absence of deterioration of one or more problematic behaviors.

Results

Overall, 84.1% of the children displayed difficulties implementing infection prevention measures. No relationship was observed between difficulty with infection prevention measures and deterioration in their relationships with parents and friends when schools were closed. After school reopened, however, deterioration in parent‒child relationships correlated positively with difficulty in hand-washing, and deterioration of friendships correlated positively with the maintenance of social distancing and difficulty in hand-washing. Deterioration of friendships correlated negatively with difficulty in voluntarily complying with stay-at-home requests.

Conclusion

Difficulty in implementing infection prevention measures was related to deterioration in social relationships with parents and friends of children with neurodevelopmental disorders during the school reopening period, following COVID-19 school closure in Japan. Under a condition requiring heightened infection control, close monitoring may be necessary for the social relationships in children with neurodevelopmental disorders.
Patient and provider perspectives on polygenic risk scores: implications for clinical reporting and utilization
Authors: Lewis Anna C. F. , Perez Emma F. , Prince Anya E. R. , Flaxman Hana R. , Gomez Lizbeth , Brockman Deanna G. , Chandler Paulette D. , Kerman Benjamin J. , Lebo Matthew S. , Smoller Jordan W. , Weiss Scott T. , Blout Zawatksy Carrie L. , Meigs James B. , Green Robert C. , Vassy Jason L. , Karlson Elizabeth W.
Published: October 2022

Background

Polygenic risk scores (PRS), which offer information about genomic risk for common diseases, have been proposed for clinical implementation. The ways in which PRS information may influence a patient’s health trajectory depend on how both the patient and their primary care provider (PCP) interpret and act on PRS information. We aimed to probe patient and PCP responses to PRS clinical reporting choices

Methods

Qualitative semi-structured interviews of both patients (N=25) and PCPs (N=21) exploring responses to mock PRS clinical reports of two different designs: binary and continuous representations of PRS.

Results

Many patients did not understand the numbers representing risk, with high numeracy patients being the exception. However, all the patients still understood a key takeaway that they should ask their PCP about actions to lower their disease risk. PCPs described a diverse range of heuristics they would use to interpret and act on PRS information. Three separate use cases for PRS emerged: to aid in gray-area clinical decision-making, to encourage patients to do what PCPs think patients should be doing anyway (such as exercising regularly), and to identify previously unrecognized high-risk patients. PCPs indicated that receiving “below average risk” information could be both beneficial and potentially harmful, depending on the use case. For “increased risk” patients, PCPs were favorable towards integrating PRS information into their practice, though some would only act in the presence of evidence-based guidelines. PCPs describe the report as more than a way to convey information, viewing it as something to structure the whole interaction with the patient. Both patients and PCPs preferred the continuous over the binary representation of PRS (23/25 and 17/21, respectively). We offer recommendations for the developers of PRS to consider for PRS clinical report design in the light of these patient and PCP viewpoints.

Conclusions

PCPs saw PRS information as a natural extension of their current practice. The most pressing gap for PRS implementation is evidence for clinical utility. Careful clinical report design can help ensure that benefits are realized and harms are minimized.