bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors related to HIV testing frequency in MSM based on the 2011–2018 survey in Tianjin, China: a hint for risk reduction strategy
Authors: Liu Zhongquan , Chen Yang , Yao Tingting , Zhang Tiantian , Song Desheng , Liu Yuanyuan , Yu Maohe , Xu Jie , Li Zhijun , Yang Jie , Cui Zhuang , Li Changping , Ma Jun
Published: October 2021

Abstracts

Background

In recent years, HIV testing has become one of the effective strategies to reduce the risk of the infection. Frequent quarterly HIV testing can be cost effective. Therefore, an in-depth study of factors related to the testing behavior of men who have sex with men (MSM) were analyzed to optimize intervention strategies.

Methods

From March 2011 to October 2018, the project was implemented in a Tianjin (China) bathhouse, and 5165 MSM were surveyed using snowball sampling. Factors related to HIV testing behavior were analyzed by ordinal logistic regression analysis after grouping according to testing frequency, and comprehensive analysis was performed.

Results

The multivariate logistic analysis showed that 6 variables including young MSM (OR = 0.67, 95% CI: 0.49–0.92, p = 0.01), low-educated MSM (OR = 0.60, 95% CI: 0.48–0.77, p < 0.0001), low HIV/AIDS knowledge (95% CI: 0.57–0.83, p < 0.0001), marital status (OR = 1.30, 95% CI: 1.07–1.57, p = 0.007), acceptance of condom promotion and distribution (OR = 14.52, 95% CI: 12.04–17.51, p < 0.0001), and frequency of condom use (p < 0.05) could link to HIV testing behaviors.

Conclusions

In order to achieve the 95–95-95 goal, target publicity, HIV/AIDS education and promotion of HIV self-testing kits should be carried out to encourage frequent HIV testing among MSM who are young (especially students), married to women, poorly educated and who are reluctant to always use condoms.
Usefulness of intraoperative C-arm image intensifier in reducing errors of acetabular component during primary total hip arthroplasty: an application of Widmer’s method
Authors: Song Joo-Hyoun , Kim Yong-Sik , Kwon Soon-Yong , Lim Young-Wook , Jung Jiyoung , Oh Seungbae
Published: October 2021

Background

Acetabular prosthesis positioning in total hip arthroplasty (THA) is crucial in reducing the risk of dislocation. There has been minimal research on the proper way to put the acetabular components into the safe zone intraoperatively. Assessment of version by intraoperative imaging intensifier is very valuable. The value of Widmer’s method, using the intraoperative C-arm available to determine cup anteversion was assessed.

Methods

One hundred one hips in 91 patients who underwent primary THA were eligible for inclusion. Utilizing intraoperative C-arm images, measurement was performed using the technique described by Widmer. The values obtained using 3D computed tomography postoperatively, which determined the anteversion of the acetabular component, were regarded as the reference standard.

Results

The method of Widmer obtained values similar to those obtained using 3D computed tomography and was considered accurate (n.s.). All 101 hips were positioned in the set target zone. Among the 101 hips, the cup position in nine hips (8.9%) was changed. The dislocation rate in our study was 1.0% with all dislocations occurring in hips placed in the target zone. The mean Harris hip score after THA in 1 year was 94.2 (82-98).

Conclusions

The method of Widmer was accurate using intraoperative imaging intensifier for the measurement of the anteversion of the acetabular component during THA, with reference to the anteversion obtained from the 3D computed tomography. Also, utilizing intraoperative C-arm imaging was very useful because it allowed for correction of the position of the acetabular cup.
Experience with modified radical mastectomy in a low-income country: a multi-center prospective observational study
Authors: Bawoke Giziew , Kejela Segni , Alemayehu Abebe , Bogale Girmaye Tamirat
Published: October 2021

Background

Modified radical mastectomy is the procedure of choice in centers with little to no radiotherapy services. Studying the in-hospital outcome and complications associated with the procedure is important in low-income countries.

Methods

This is a multi-center prospective observational study involving all patients operated with modified radical mastectomy with curative intent.

Results

A total of 87 patients were studied with 10.3% of which were male and 54% were between the age of 30–49 years. Clinical stage IIB and IIIA were reported in 33 (37.9%) and 25 (28.7%) respectively and 62.1% had clinically positive lymph nodes at presentation. All of the studied patients underwent curative surgery, with an average lymph node dissection of 10.2 ± 0.83. Seroma rate was 17.2% and was significantly associated with diabetes (AOR: 6.2 (CI 1.5–8.7)) and neoadjuvant chemotherapy (AOR: 8.9 (CI 1.2–14.2)). Surgical site infection occurred in 14.9% and was significantly associated with Retroviral infections (AOR: 4.2 (CI 2.1–5.8)) and neoadjuvant chemotherapy (AOR: 1.8 (CI 1.3–3.9)). No in-hospital mortality occurred during the course of the study.

Conclusion

Seroma rate was lower than published studies while surgical site infections rate was higher. Neoadjuvant chemotherapy was associated with increase in seroma and surgical site infection rates. Additionally, diabetes increased the rate of seroma. Surgical site infections were higher in patients with retroviral infections.
Impact of the Affordable Care Act Medicaid expansion on oral surgery delivery at community health centers: an observational study
Authors: Goldstein Evan V. , Xu Wendy Yi , Seiber Eric E.
Published: October 2021

Background

Unmet oral health needs routinely affect low-income communities. Lower-income adults suffer a disproportionate share of dental disease and often cannot access necessary oral surgery services. The Affordable Care Act (ACA) Medicaid expansion created new financial opportunities for community health centers (CHCs) to provide mission-relevant services in low-income areas. However, little is understood in the literature about how the ACA Medicaid expansion impacted oral surgery delivery at CHCs. Using a large sample of CHCs, we examined whether the ACA Medicaid expansion increased the likelihood of oral surgery delivery at expansion-state CHCs compared to non-expansion-state CHCs.

Methods

Exploiting a natural experiment, we estimated Poisson regression models examining the effects of the Medicaid expansion on the likelihood of oral surgery delivery at expansion-state CHCs relative to non-expansion-state CHCs. We merged data from multiple sources spanning 2012–2017. The analytic sample included 2054 CHC-year observations.

Results

Compared to the year prior to expansion, expansion-state CHCs were 13.5% less likely than non-expansion-state CHCs to provide additional oral surgery services in 2016 (IRR = 0.865;P = 0.06) and 14.7% less likely in 2017 (IRR = 0.853;P = 0.02). All else equal, and relative to non-expansion-state CHCs, expansion-state CHCs included in the analytic sample were 8.7% less likely to provide oral surgery services in all post-expansion years pooled together (IRR = 0.913;P = 0.01).

Conclusions

Medicaid expansions can provide CHCs with opportunities to expand their patient revenue and services. However, whether because of known dental treatment capacity limitations, new competition, or coordination with other providers, expansion-state CHCs in our study sample were less likely to provide oral surgery services on the margin relative to non-expansion-state CHCs following Medicaid expansion.
Factors associated with prolonged post-operative acute care length of stay in limb amputation patients in Saskatchewan, Canada
Authors: Essien Samuel Kwaku , Zucker-Levin Audrey
Published: October 2021

Background

The effect of predisposing factors on post-operative acute care length of stay (POALOS) after lower extremity amputation (LEA) has been sparsely studied with reports largely focused on major (through/proximal to the ankle) LEA specifically due to diabetes mellitus (DM). Although valuable, the narrow focus disregards the impact of other causes and minor levels (distal to the ankle) of LEA. To address this gap, this study aimed to identify predisposing factors associated with prolonged POALOS after index LEA stratified by amputation level in Saskatchewan.

Methods

The study used Saskatchewan’s provincial linked administrative health data and demographic factors between 2006 and 2019. Amputation levels, identified as major or minor, were derived from the amputation procedure codes. POALOS was calculated by subtracting patients’ intervention date from discharge date, recorded in days, and categorized as short (< 7 days) or prolonged (> 7 days). Multivariable logistic regression was performed to identify predictors associated with prolonged POALOS.

Results

Of the 3123 LEA cases 1421 (45.5%) had prolonged POALOS. The median POALOS for the entire cohort was 7 days (IQR 3 to 16 days); 5 days (IQR 1 to 10 days) for minor LEA and 11 days (IQR 5 to 23 days) for major LEA. Predictors of prolonged POALOS after minor LEA were diabetes (AOR = 2.47, 95% CI: 1.87–3.27) and general surgeon (AOR = 1.52, 95% CI: 1.21–1.91). Minor LEA performed by orthopedic surgeons were half (AOR = 0.49, 95% CI: 0.35–0.70) as likely to experience prolonged POALOS. Predictors of prolonged POALOS after major LEA were diabetes (AOR = 1.34, 95% CI: 1.04–1.71), general surgeon (AOR = 1.91, 95% CI: 1.45–2.49), urban residence (AOR = 1.58, 95% CI: 1.25–1.99), Resident Indian (RI) status (AOR = 1.57, 95% CI: 1.15–2.15), and age with the likelihood of prolonged POALOS after LEA attenuating with increasing age: 35–54 years (AOR = 2.73, 95% CI: 1.56–4.76); 55–69 years (AOR = 2.65, 95% CI: 1.54–4.58); and 70+ years (AOR = 1.81, 95% CI: 1.05–3.11).

Conclusion

This study identified only diabetes and surgical specialty predicted prolonged POALOS after both major and minor LEA in Saskatchewan while residence, RI status, and age were predictors of POALOS after major LEA. These findings shed light on the need for further research to identify confounding factors. It is not clear if general surgeons care for more unplanned, emergent cases with poor entry-level health while specialty surgeons perform more scheduled procedures.
Estimating intervention effectiveness in trials of malaria interventions with contamination
Authors: Multerer Lea , Vanobberghen Fiona , Glass Tracy R. , Hiscox Alexandra , Lindsay Steven W. , Takken Willem , Tiono Alfred , Smith Thomas
Published: October 2021

Background

In cluster randomized trials (CRTs) or stepped wedge cluster randomized trials (SWCRTs) of malaria interventions, mosquito movement leads to contamination between trial arms unless buffer zones separate the clusters. Contamination can be accounted for in the analysis, yielding an estimate of the contamination range, the distance over which contamination measurably biases the effectiveness.

Methods

A previously described analysis for CRTs is extended to SWCRTs and estimates of effectiveness are provided as a function of intervention coverage. The methods are applied to two SWCRTs of malaria interventions, the SolarMal trial on the impact of mass trapping of mosquitoes with odor-baited traps and the AvecNet trial on the effect of adding pyriproxyfen to long-lasting insecticidal nets.

Results

For the SolarMal trial, the contamination range was estimated to be 146 m ($$95\%$$

95
%

credible interval $$[0.052,\,0.923]$$

[
0.052
,

0.923
]

 km), together with a $$31.9\%$$

31.9
%

($$95\%$$

95
%

credible interval $$[15.3,\,45.8]\%$$

[
15.3
,

45.8
]
%

) reduction of Plasmodium infection, compared to the $$30.0\%$$

30.0
%

reduction estimated without accounting for contamination. The estimated effectiveness had an approximately linear relationship with coverage. For the AvecNet trial, estimated contamination effects were minimal, with insufficient data from the cluster boundary regions to estimate the effectiveness as a function of coverage.

Conclusions

The contamination range in these trials of malaria interventions is much less than the distances Anopheles mosquitoes can fly. An appropriate analysis makes buffer zones unnecessary, enabling the design of more cost-efficient trials. Estimation of the contamination range requires information from the cluster boundary regions and trials should be designed to collect this.
The contributions of public health policies and healthcare quality to gender gap and country differences in life expectancy in the UK
Authors: Allel Kasim , Salustri Franceso , Haghparast-Bidgoli Hassan , Kiadaliri Ali
Published: October 2021

Background

In many high-income countries, life expectancy (LE) has increased, with women outliving men. This gender gap in LE (GGLE) has been explained with biological factors, healthy behaviours, health status, and sociodemographic characteristics, but little attention has been paid to the role of public health policies that include/affect these factors. This study aimed to assess the contributions of avoidable causes of death, as a measure of public health policies and healthcare quality impacts, to the GGLE and its temporal changes in the UK. We also estimated the contributions of avoidable causes of death into the gap in LE between countries in the UK.

Methods

We obtained annual data on underlying causes of death by age and sex from the World Health Organization mortality database for the periods 2001–2003 and 2014–2016. We calculated LE at birth using abridged life tables. We applied Arriaga’s decomposition method to compute the age- and cause-specific contributions into the GGLE in each period and its changes between two periods as well as the cross-country gap in LE in the 2014–2016 period.

Results

Avoidable causes had greater contributions than non-avoidable causes to the GGLE in both periods (62% in 2001–2003 and 54% in 2014–2016) in the UK. Among avoidable causes, ischaemic heart disease (IHD) followed by injuries had the greatest contributions to the GGLE in both periods. On average, the GGLE across the UK narrowed by about 1.0 year between 2001–2003 and 2014–2016 and three avoidable causes of IHD, lung cancer, and injuries accounted for about 0.8 years of this reduction. England & Wales had the greatest LE for both sexes in 2014–2016. Among avoidable causes, injuries in men and lung cancer in women had the largest contributions to the LE advantage in England & Wales compared to Northern Ireland, while drug-related deaths compared to Scotland in both sexes.

Conclusion

With avoidable causes, particularly preventable deaths, substantially contributing to the gender and cross-country gaps in LE, our results suggest the need for behavioural changes by implementing targeted public health programmes, particularly targeting younger men from Scotland and Northern Ireland.
Prevalence, characteristics, and distribution of HPV genotypes in women from Zhejiang Province, 2016–2020
Authors: Yan Xiaotian , Shen Lingwei , Xiao Yufei , Wang Qi , Li Fugang , Qian Yun
Published: October 2021

Objective

To evaluate and understand the prevalence of HPV genotypes and characteristics of female populations in specific areas and the relationship with cervical lesions, which can effectively guide cervical cancer screening and formulate HPV vaccine prevention strategies.

Methods

A total of 77,443 women who visited gynecological clinics and underwent health examinations in the Second Affiliated Hospital of Zhejiang University School of Medicine during 2016–2020 were enrolled in this survey. Cervical samples were collected for HPV DNA genotyping and cervical cytology testing. Cervical biopsies were performed for patients with visible cervical abnormality or abnormal cytological results.

Results

The results showed the 5-year overall positive rate was 22.3%, of which the gynecology clinic group had significantly more positive results compared with the health examination group (P < 0.001). The five most common genotypes in Zhejiang Province were HPV 52, 58, CP8304, 16, and 51 (23.9%, 12.7%, 11.7%, 11.7% and 9.3%). HPV infection was age-specific, with the highest infection rate in the age group ≤ 20 compared to other age groups (P < 0.001). HPV infection was also season-specific, with the highest infection rate in spring or winter. The main HPV infection mode was single infection (P = 0.004), but patients ≤ 20 years old were more likely to develop multiple infections (51.0%). HPV 16, 52 and 58 were the main genotypes that caused cytological abnormalities and HPV16, 18, 56, 58 and 66 were independent risk factors for cervical lesions (OR = 2.352, 1.567, 2.000, 1.694, 1.889; all P < 0.05). Further analysis found HPV 16 and 18 were the main genotypes that cause cervical cancer histological abnormalities and were independent risk factors for cervical cancer (OR = 5.647, P < 0.001; OR = 3.495, P = 0.036).

Conclusion

This article analyzed the prevalence of distribution characteristics of HPV infection and revealed the corelation between HPV infection and cytological and histological abnormalities. Comprehensive results of this survey will help Zhejiang Province to formulate public health policies and provide evidence for future selection of specific HPV vaccines.
Governing industry involvement in the non-communicable disease response in Kenya
Authors: Bünder Tobias , Karekezi Catherine , Wirtz Veronika
Published: October 2021

Background

In low- and middle-income countries (LMICs), multinational companies have become increasingly involved in addressing public health challenges. Dealing with companies as partners in health sector development creates new challenges for governments. We sought to develop an approach to assess the existence and effectiveness of governance structures that can ensure that industry-led public health initiatives contribute to development.

Methods

We developed a governance assessment tool based on the principles of the Paris Declaration for Aid Effectiveness and other related agreements. We applied it to the case of pharmaceutical companies’ involvement in the Kenyan response to non-communicable diseases (NCDs). We gathered data for analysis through 46 stakeholder interviews and reviewing documents.

Results

The Kenyan government has informal norms in place regarding program governance and strategy, but it has yet to issue formal regulations. While enabling elements exist that support initiatives to develop in alignment with these norms, implementation is often hindered by a lack of resources. Currently, broad stakeholder support for filling these gaps has created a window of opportunity for action.

Conclusion

The application of the proposed assessment tool illustrates its viability for assisting companies and governments alike in defining governance needs for industry-led public health initiatives. Our findings in Kenya provide example considerations for LMICs working to integrate industry-led public health programs into the health system. Bilateral and multilateral donors also have important roles in strengthening LMICs’ capacities to govern multinational corporations’ contributions to NCDs in particular, and development in general.
Exploring perception and usage of narrative medicine by physician specialty: a qualitative analysis
Authors: Fox Daniel A. , Hauser Joshua M.
Published: October 2021

Background

Narrative medicine is a well-recognized and respected approach to care. It is now found in medical school curricula and widely implemented in practice. However, there has been no analysis of the perception and usage of narrative medicine across different medical specialties and whether there may be unique recommendations for implementation based upon specialty. The aims of this study were to explore these gaps in research.

Methods

Fifteen senior physicians who specialize in internal medicine, pediatrics, or surgery (5 physicians from each specialty) were interviewed in a semi-structured format about the utilization, benefits, drawbacks (i.e., negative consequences), and roles pertaining to narrative medicine. Qualitative content analysis of each interview was then performed.

Results

Three themes emerged from our analysis: roles, practice, and outcomes. Through these themes we examined the importance, utilization, barriers, benefits, and drawbacks of narrative medicine. There was consensus that narrative medicine is an important tool in primary care. Primary care physicians (general internists and general pediatricians) also believed that narrative medicine is not as important for non-primary care providers. However, non-primary care providers (surgeons) generally believed narrative medicine is valuable in their practice as well. Within specialties, providers’ choice of language varied when trying to obtain patients’ narratives, but choice in when to practice narrative medicine did not differ greatly. Among specialties, there was more variability regarding when to practice narrative medicine and what barriers were present. Primary care physicians primarily described barriers to eliciting a patient’s narrative to involve trust and emotional readiness, while surgeons primarily described factors involving logistics and patient data as barriers to obtaining patients’ narratives. There was broad agreement among specialties regarding the benefits and drawbacks of narrative medicine.

Conclusions

This study sheds light on the shared and unique beliefs in different specialties about narrative medicine. It prompts important discussion around topics such as the stereotypes physicians may hold about their peers and concerns about time management. These data provide some possible ideas for crafting narrative medicine education specific to specialties as well as future directions of study.
1H-NMR-based metabolic profiling identifies non-invasive diagnostic and predictive urinary fingerprints in 5q spinal muscular atrophy
Authors: Saffari Afshin , Cannet Claire , Blaschek Astrid , Hahn Andreas , Hoffmann Georg F. , Johannsen Jessika , Kirsten Romy , Kockaya Musa , Kölker Stefan , Müller-Felber Wolfgang , Roos Andreas , Schäfer Hartmut , Schara Ulrike , Spraul Manfred , Trefz Friedrich K. , Vill Katharina , Wick Wolfgang , Weiler Markus , Okun Jürgen G. , Ziegler Andreas
Published: October 2021

Background

5q spinal muscular atrophy (SMA) is a disabling and life-limiting neuromuscular disease. In recent years, novel therapies have shown to improve clinical outcomes. Yet, the absence of reliable biomarkers renders clinical assessment and prognosis of possibly already affected newborns with a positive newborn screening result for SMA imprecise and difficult. Therapeutic decisions and stratification of individualized therapies remain challenging, especially in symptomatic children. The aim of this proof-of-concept and feasibility study was to explore the value of 1H-nuclear magnetic resonance (NMR)-based metabolic profiling in identifying non-invasive diagnostic and prognostic urinary fingerprints in children and adolescents with SMA.

Results

Urine samples were collected from 29 treatment-naïve SMA patients (5 pre-symptomatic, 9 SMA 1, 8 SMA 2, 7 SMA 3), 18 patients with Duchenne muscular dystrophy (DMD) and 444 healthy controls. Using machine-learning algorithms, we propose a set of prediction models built on urinary fingerprints that showed potential diagnostic value in discriminating SMA patients from controls and DMD, as well as predictive properties in separating between SMA types, allowing predictions about phenotypic severity. Interestingly, preliminary results of the prediction models suggest additional value in determining biochemical onset of disease in pre-symptomatic infants with SMA identified by genetic newborn screening and furthermore as potential therapeutic monitoring tool.

Conclusions

This study provides preliminary evidence for the use of 1H-NMR-based urinary metabolic profiling as diagnostic and prognostic biomarker in spinal muscular atrophy.
The association of sleep duration and metabolic syndrome in the Bandare-Kong cohort study, a cross-sectional survey (finding from PERSIAN cohort study)
Authors: Rafati Shideh , Isheh Maryam , Azarbad Abnoos , Ghadiri Soufi Farhad , Rahimi Arash , Kheirandish Masoumeh
Published: October 2021

Background

A variety of health problems, such as metabolic syndrome (MetS), have been linked to sleep disorders. While numerous epidemiological studies have shown a U-shaped relationship between sleep duration and poor health outcomes, the results were limited and inconsistent. This study was designed to evaluate the relationship between sleep duration and MetS.

Methods

This population-based study was conducted on the participants aged 35–70 of Bandare-Kong Non-Communicable Diseases (BKNCD) Cohort Study, a part of Prospective Epidemiological Research Studies in IrAN (PERSIAN). MetS was diagnosed according to the National Cholesterol Education Program (NCEP) criteria and the Iranian-specific cut-off for waist circumference (≥ 95 cm). Sleep information was extracted through a standard questionnaire based on self-reported information. Data were analyzed by R software using generalized additive models (GAMs). A statistically significant level was considered as P < 0.05.

Results

A total of 3695 participants were included in the analyses. The mean age was 48.05 years (SD 9.36), and 2067 (55.9%) were female. The estimated Prevalence of MetS was 35.9%, and women appeared to be more likely to have MetS than men (P < 0.001). There was a non-linear and linear association between sleep duration and the risk of MetS in women and men, respectively. The lowest risk was observed among those with 7–7.5 h of sleep duration per night.

Conclusion

Long sleep duration was associated with increased risk of MetS and higher MetS severity score in both genders, while the short sleep duration increased the risk of Mets as well as MetS severity score just in women. The longitudinal studies would be suggested to assess the relationship between sleep quality and quantity components and MetS.
Perceived social and built environment associations of leisure-time physical activity among adults in Sri Lanka
Authors: De Silva Weliange Shreenika , Perera Madhawa , Gunatilake Jagath
Published: October 2021

Objective

Although perceived neighbourhood environment is considered a predictor of leisure-time physical activity (LTPA), evidence for this is limited in South Asia. Thus, the aim was to determine the association between neighbourhood social and built environment features in carrying out LTPA among adults in Colombo District, Sri Lanka. A cross-sectional study among 1320 adults was carried out using validated questionnaires for physical activity (PA) and built environment data collection. Multiple logistic regression analysis was conducted to assess the associations between environment characteristics and LTPA after adjusting for gender, age, employment status, income level and sector of residence.

Results

A total of 21.7% of adults participated in some LTPA. The commonest type of LTPA was walking; carried out by 14.5%. Moderate and vigorous activity at leisure was carried out by 10.3% and 3.9% respectively. Perceived social acceptance for PA was positively associated with LTPA. Out of the built environment characteristics perceived infrastructure for walking, and recreational facilities for PA were negatively associated with LTPA. Self-efficacy emerged as an important positive correlate of LTPA. The participants were positively influenced by the self-efficacy and perceived social environment which should be addressed when promoting LTPA.
Gut–microbiota–microglia–brain interactions in Alzheimer’s disease: knowledge-based, multi-dimensional characterization
Authors: Wang QuanQiu , Davis Pamela B. , Qi Xin , Chen Shu G. , Gurney Mark E. , Perry George , Doraiswamy P. Murali , Xu Rong
Published: October 2021

Background

Interactions between the gut microbiota, microglia, and aging may modulate Alzheimer’s disease (AD) pathogenesis but the precise nature of such interactions is not known.

Methods

We developed an integrated multi-dimensional, knowledge-driven, systems approach to identify interactions among microbial metabolites, microglia, and AD. Publicly available datasets were repurposed to create a multi-dimensional knowledge-driven pipeline consisting of an integrated network of microbial metabolite–gene–pathway–phenotype (MGPPN) consisting of 34,509 nodes (216 microbial metabolites, 22,982 genes, 1329 pathways, 9982 mouse phenotypes) and 1,032,942 edges.

Results

We evaluated the network-based ranking algorithm by showing that abnormal microglia function and physiology are significantly associated with AD pathology at both genetic and phenotypic levels: AD risk genes were ranked at the top 6.4% among 22,982 genes, P < 0.001. AD phenotypes were ranked at the top 11.5% among 9982 phenotypes, P < 0.001. A total of 8094 microglia–microbial metabolite–gene–pathway–phenotype–AD interactions were identified for top-ranked AD-associated microbial metabolites. Short-chain fatty acids (SCFAs) were ranked at the top among prioritized AD-associated microbial metabolites. Through data-driven analyses, we provided evidence that SCFAs are involved in microglia-mediated gut–microbiota–brain interactions in AD at both genetic, functional, and phenotypic levels.

Conclusion

Our analysis produces a novel framework to offer insights into the mechanistic links between gut microbial metabolites, microglia, and AD, with the overall goal to facilitate disease mechanism understanding, therapeutic target identification, and designing confirmatory experimental studies.
Vertebral artery dissection in term pregnancy after cervical spine manipulation: a case report and review the literature
Authors: Monari Francesca , Busani Stefano , Imbrogno Maria Giovanna , Neri Isabella , Girardis Massimo , Ghirardini Annamaria , Cavalleri Francesca , Facchinetti Fabio
Published: October 2021

Background

Vertebral artery dissection is an uncommon, but potentially fatal, vascular event. This case aimed to describe the pathogenesis and clinical presentation of vertebral artery dissection in a term pregnant patient. Moreover, we focused on the differential diagnosis, reviewing the available evidence.

Case presentation

A 39-year-old Caucasian woman presented at 38 + 4 weeks of gestation with a short-term history of vertigo, nausea, and vomiting. Symptoms appeared a few days after cervical spine manipulation by an osteopathic specialist. Urgent magnetic resonance imaging of the head was obtained and revealed an ischemic lesion of the right posterolateral portion of the brain bulb. A subsequent computed tomography angiographic scan of the head and neck showed a right vertebral artery dissection. Based on the correlation of the neurological manifestations and imaging findings, a diagnosis of vertebral artery dissection was established. The patient started low-dose acetylsalicylic acid and prophylactic enoxaparin following an urgent cesarean section.

Conclusion

Vertebral artery dissection is a rare but potential cause of neurologic impairments in pregnancy and during the postpartum period. It should be considered in the differential diagnosis for women who present with headache and/or vertigo. Women with a history of migraines, hypertension, or autoimmune disorders in pregnancy are at higher risk, as well as following cervical spine manipulations. Prompt diagnosis and management of vertebral artery dissection are essential to ensure favorable outcomes.
Transcriptional differentiation driving Cucumis sativus–Botrytis cinerea interactions based on the Skellam model and Bayesian networks
Authors: Zhang Qi , Li Kaihang , Yang Yan , Li Beibei , Jiang Libo , He Xiaoqing , Jin Yi , Zhao Guozhu
Published: October 2021

Robust statistical tools such as the Skellam model and Bayesian networks can capture the count properties of transcriptome sequencing data and clusters of genes among treatments, thereby improving our knowledge of gene functions and networks. In this study, we successfully implemented a model to analyze a transcriptome dataset ofCucumis sativusandBotrytis cinereabefore and after their interaction. First, 4200 differentially expressed genes (DEGs) fromC. sativuswere clustered into 17 distinct groups, and 670 DEGs fromB. cinereawere clustered into 12 groups. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were applied on these DEGs to assess the interactions betweenC. sativusandB. cinerea. InC. sativus, more DEGs were divided into terms in the molecular function and biological process domains than into cellular components, and 277 DEGs were allocated to 19 KEGG pathways. InB. cinerea, more DEGs were divided into terms in the biological process and cellular component domains than into molecular functions, and 150 DEGs were allocated to 26 KEGG pathways. In this study, we constructed networks of genes that interact with each other to screen hub genes based on a directed graphical model known as Bayesian networks. Through a detailed GO analysis, we excavated hub genes which were biologically meaningful. These results verify that availability of Skellam model and Bayesian networks in clustering gene expression data and sorting out hub genes. These models are instrumental in increasing our knowledge of gene functions and networks in plant–pathogen interaction.
Effect of organic acids on growth performance, intestinal morphology, and immunity of broiler chickens with and without coccidial challenge
Authors: Mustafa Ahsan , Bai Shiping , Zeng Qiufeng , Ding Xuemei , Wang Jianping , Xuan Yue , Su Zhuowei , Zhang Keying
Published: October 2021

A total of 360-day-old broiler chicks were allocated into six groups in 2 (Coccidial challenge or not) × 3 (dietary treatments) factorial design. Three dietary treatments including: basic diet, basic diet plus organic acids (OAs) in drinking water, and basic diet plus OAs in the feed with and without coccidial challenge. The OAs in water or feed improved (P < 0.01) average body weight (ABW), average body weight gain (ABWG), and feed conversion ratio (FCR) as compared with the control diet during starter, grower, and whole experimental period. Coccidial challenge decreased BW, ABWG, and average feed intake (AFI), as well as resulted in poor FCR during the starter and whole experimental period (P < 0.05). Though there was no interaction between OAs supplementation and coccidial challenge, the OAs supplementation improved the overall performance with and without coccidial challenge birds on 21 d and 35 d. IgG was found higher (P = 0.03) in broilers fed OAs in feed without the coccidial challenge group. On 18 d, OAs supplementation in feed increased TNF-γ (P = 0.006), whereas the coccidial challenge decreases TNF-γ (P = 0.01) and IL-10 (P =  < .0001), and increases IgM (P = 0.03), IgG (P = 0.04) and IgA (P = 0.02). On 29 d, the coccidial challenge increases IgM and IgA. On 18 d, jejunal lesion score was found significantly higher in the coccidial challenged group as compared to OAs supplementation with coccidial challenged groups on 18 d (P < 0.0001) and 29 d (P = 0.03). Crypt depth was higher, and Villus-height to Crypt depth ratio was lower in the coccidial challenge group on 18 and 29 d. The Goblet cells were found higher in the non-coccidial challenge on 18 d. After 18 d, 16S rDNA gene sequence analysis of ileal chyme has shown that coccidial challenge decreases Lactobacillus_reuteri species as compared to the non-challenged group (P = 0.02). After 29, Cyanobacteria abundance reduced (P = 0.014) in the challenged group than the non-challenged group at the phylum level. At the genus level, Lactobacillus (P = 0.036) and unidentified Cyanobacteria (P = 0.01) were found higher in the non-challenged group than the coccidial challenge group. The results indicate that the OAs supplementation showed improved responses in a pattern similar to the non-challenged control group by neutralizing the negative effects of the coccidial challenge.
Interventions for improving outcomes in patients with multimorbidity in primary care and community setting: a systematic review
Authors: Smith Susan M. , Wallace Emma , Clyne Barbara , Boland Fiona , Fortin Martin
Published: October 2021

Background

Multimorbidity, defined as the co-existence of two or more chronic conditions, presents significant challenges to patients, healthcare providers and health systems. Despite this, there is ongoing uncertainty about the most effective ways to manage patients with multimorbidity. This review updated and narrowed the focus of a previous Cochrane review and aimed to determine the effectiveness of interventions designed to improve outcomes in people with multimorbidity in primary care and community settings, compared to usual care.

Methods

We searched eight databases and two trials registers up to 9 September 2019. Two review authors independently screened potentially eligible titles and selected studies, extracted data, evaluated study quality and judged the certainty of the evidence (GRADE). Interventions were grouped by their predominant focus into care-coordination/self-management support, self-management support and medicines management. Main outcomes were health-related quality of life (HRQoL) and mental health. Meta-analyses were conducted, where possible, but the synthesis was predominantly narrative.

Results

We included 16 RCTs with 4753 participants, the majority being older adults with at least three conditions. There were eight care-coordination/self-management support studies, four self-management support studies and four medicines management studies. There was little or no evidence of an effect on primary outcomes of HRQoL (MD 0.03, 95% CI −0.01 to 0.07,I2= 39%) and mental health or on secondary outcomes with a small number of studies reporting that care coordination may improve patient experience of care and self-management support may improve patient health behaviours. Overall, the certainty of the evidence was graded as low due to significant variation in study participants and interventions.

Conclusions

There are remaining uncertainties about the effectiveness of interventions for people with multimorbidity, despite the growing number of RCTs conducted in this area. Our findings suggest that future research should consider patient experience of care, optimising medicines management and targeted patient health behaviours such as exercise.
Using the QI Maturity Tool – Modified Ontario Version to assess the state of QI maturity in Ontario’s public health units
Authors: Law Madelyn P. , Berry Alex , Clarke Nicole , Hay Graham , Muhl Caitlin , Pilato Kelly , Hunter Danielle , Larson Anna
Published: October 2021

Background

Implementation of quality improvement (QI) practices varies considerably among public health units (PHUs) in Ontario. With the emphasis on continuous quality improvement (CQI) in the revised Ontario Public Health Standards (OPHS), there is a need to understand the level of QI maturity in Ontario’s PHUs. The objective of this research was to establish a baseline understanding of QI maturity in Ontario’s PHUs.

Methods

The QI Maturity Tool - Modified Ontario Version was used to assess the state of QI maturity in 34 PHUs across Ontario. QI maturity was assessed through 23 questions across three dimensions: QI Organizational Culture; QI Capacity and Competency; and QI Perceived Value. QI maturity scores were classified into five stages: Beginning; Emerging; Progressing; Achieving; and Excelling. QI maturity scores were calculated for each of the 34 participating PHUs to determine their stage of QI maturity. Each PHU’s score was then used to determine the provincial average for QI maturity. Participants were also asked to answer three questions related to core CQI organizational structures.

Results

Across the 34 PHUs, 3503 staff participated in the survey. A review of individual PHU scores indicates that Ontario’s PHUs are at varying stages of QI maturity. The average QI maturity score of 4.94 for the 34 participating PHUs places the provincial average in the “Emerging” stage of QI maturity. By QI dimensions, the participating PHUs scored in the “Emerging” stage for QI Organizational Culture (5.09), the “Beginning” stage for QI Competency and Capacity (4.58), and the “Achieving” stage for QI Perceived Value (6.00).

Conclusion

There is an urgent need for Ontario’s PHUs to progress to higher stages of QI maturity. Participants place a high value on QI, but collectively are at less “mature” stages of QI in relation to QI organizational culture and the competency and capacity to engage in QI activities. PHUs should leverage the value that staff place on QI to foster the development of a culture of QI and provide staff with relevant knowledge and skills to engage in QI activities.
Amelioration of complete Freund’s adjuvant-induced arthritis by Calotropis procera latex in rats
Authors: Patel Roshni , Kadri Shahrukh , Gohil Priyanshee , Deshpande Shrikalp , Shah Gaurang
Published: October 2021

Background

Rheumatoid arthritis is the most common cause of disability, affecting 0.3–1% of the adult population worldwide. The latex of Calotropis procera possesses potent anti-inflammatory as well as analgesic properties. In light above facts, the present study was designed to evaluate anti-arthritic activity of Calotropis procera latex in complete Freund's adjuvant (CFA)-induced arthritis in Wistar albino rats. Complete Freund's adjuvant was injected into the left hind paw on day 0, and treatment of prednisolone and Calotropis procera latex was given from day 0 to 28. Various biochemical, hematological and functional parameters as well as radiological and histopathological changes of joint along with body weight and paw volume were measured.

Results

Calotropis procera treatment significantly lowered paw volume in CFA-induced arthritic rats. Significant improvement was observed in functional, biochemical and hematological parameters in Calotropis procera-treated rats. However, the body weight remained unaffected. Histological and radiographical examination of synovial joints in Calotropis procera-treated animals exhibited less synovial hyperplasia, infiltration and accumulation of inflammatory cell in synovial fluid, cartilage and bone erosion and joint space narrowing.

Conclusion

Calotropis procera latex possesses anti-arthritic activity, which is facilitated by modulation in the level of inflammatory mediators and oxidative stress. The improvement in hematological as well as biochemical parameters might be reflected on functional, histopathological, radiological changes and thereby disease progression.
Role of SIRT1 and Progesterone Resistance in Normal and Abnormal Endometrium
Authors: Kim Tae Hoon , Young Steven L , Sasaki Tsutomu , Deaton Jeffrey L , Schammel David P , Palomino Wilder Alberto , Jeong Jae-Wook , Lessey Bruce A
Published: October 2021

Context

Progesterone resistance, a known pathologic condition associated with a reduced cellular response to progesterone and heightened estrogen responses, appears to have a normal physiologic role in mammalian reproduction. The molecular mechanism responsible for progesterone resistance in normal and abnormal endometrium remains unclear.

Objective

To examine the roles of sirtuin-1 (SIRT1) in normal endometrium as well as endometrium associated with infertility and endometriosis, as an epigenetic modulator associated with progesterone resistance.

Methods

SIRT1 expression was examined by Western blot, quantitative real-time polymerase chain reaction, and immunohistochemistry in mouse uterus and human endometrium. Mice with uterine specific Sirt1 overexpression were developed to examine SIRT1’s role in endometrial function and endometriosis development. EX-527, a SIRT1 inhibitor, and SRT1720, a SIRT1 agonist, were also used to evaluate SIRT1 effect on endometriosis.

Results

In normal healthy women, endometrial SIRT1 is expressed only during menses. SIRT1 was dramatically overexpressed in the endometrium from women with endometriosis in both the epithelium and stroma. In mice, SIRT1 is expressed at the time of implantation between day 4.5 and 5.5 of pregnancy. Overexpression of SIRT1 in the mouse uterus leads to subfertility due to implantation failure, decidualization defects and progesterone resistance. SIRT1 overexpression in endometriotic lesions promotes worsening endometriosis development. EX-527 significantly reduced the number of endometriotic lesions in the mouse endometriosis model.

Conclusions

SIRT1 expression and progesterone resistance appears to play roles in normal endometrial functions. Aberrant SIRT1 expression contributes to progesterone resistance and may participate in the pathophysiology of endometriosis. SIRT1 is a novel and targetable protein for the diagnosis as well as treatment of endometriosis and the associated infertility seen in this disease.
Nondeterministic nature of sensorineural outcomes following noise trauma
Authors: Guthrie O'neil W. , Bhatt Ishan S.
Published: October 2021

Over 1.1 billion individuals are at risk for noise induced hearing loss yet there is no accepted therapy. A long history of research has demonstrated that excessive noise exposure will kill outer hair cells (OHCs). Such observations have fueled the notion that dead OHCs underlie hearing loss. Therefore, previous and current therapeutic approaches are based on preventing the loss of OHCs. However, the relationship between OHC loss and hearing loss is at best a modest correlation. This suggests that in addition to the death of OHCs, other mechanisms may regulate the type and degree of hearing loss. In the current study, we tested the hypothesis that permanent noise-induced-hearing loss is consequent to additional mechanisms beyond the noise dose and the death of OHCs. Hooded male rats were randomly divided into noise and control groups. Morphological and physiological assessments were conducted on both groups. The combined results suggest that beyond OHC loss, the surviving cochlear elements shape sensorineural outcomes, which can be nondeterministic. These findings provide the basis for individualized ototherapeutics that manipulate surviving cellular elements in order to bias cochlear function towards normal hearing even in the presence of dead OHCs.
Dynamic remodeling of ribosomes and endoplasmic reticulum in axon terminals of motoneurons
Authors: Deng Chunchu , Moradi Mehri , Reinhard Sebastian , Ji Changhe , Jablonka Sibylle , Hennlein Luisa , Lüningschrör Patrick , Doose Sören , Sauer Markus , Sendtner Michael
Published: October 2021

In neurons, the endoplasmic reticulum (ER) forms a highly dynamic network that enters axons and presynaptic terminals and plays a central role in Ca2+ homeostasis and synapse maintenance; however, the underlying mechanisms involved in regulation of its dynamic remodeling as well as its function in axon development and presynaptic differentiation remain elusive. Here, we used high-resolution microscopy and live-cell imaging to investigate rapid movements of the ER and ribosomes in axons of cultured motoneurons after stimulation with brain-derived neurotrophic factor. Our results indicate that the ER extends into axonal growth cone filopodia, where its integrity and dynamic remodeling are regulated mainly by actin and the actin-based motor protein myosin VI (encoded by Myo6). Additionally, we found that in axonal growth cones, ribosomes assemble into 80S subunits within seconds and associate with the ER in response to extracellular stimuli, which describes a novel function of axonal ER in dynamic regulation of local translation.

This article has an associated First Person interview with Chunchu Deng, joint first author of the paper.