bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative efficacy and safety of ciprofol, propofol, and propofol and etomidate mixture, and ciprofol and etomidate mixture in patients undergoing painless gastroscopy: A randomized, double-blind controlled clinical trial
Authors: Liu Yanlong , Qian Yihong , Zhang Lilan , Guo Shanliang , Fan Longcheng , Zhang Mingsheng , Liu Zhongyu
Published: November 2024

Background:

To compare the efficacy and safety of ciprofol, propofol, propofol and etomidate mixture or ciprofol and etomidate mixture in patients undergoing painless gastroscopic anesthesia, and to explore the optimal plan to relieve the patient’s discomfort.

Methods:

A total of 120 patients scheduled for painless gastroscopy were randomly assigned to 4 groups: propofol (Group P), ciprofol (Group C), propofol-etomidate mixture (Group P-E), and ciprofol-etomidate mixture (Group C-E). The success rate of gastroscopy examination, patient satisfaction, incidence of injection pain, hemodynamic parameters, induction time, procedure time, the consumption of drugs, awakening time, and incidence of adverse events were evaluated.

Results:

All patients in the study successfully completed the gastroscopy. The satisfaction of patients in Group C-E was significantly higher than that in Group P (P < .05), but there was no statistical significance in the patient satisfaction among the other groups. Compared with Group P, the incidence of injection pain in Groups C and C-E significantly decreased (P < .05). There were no significant differences in the SBP, diastolic blood pressure, HR, and SpO2 among the 4 groups (P > .05). The awakening time of Group C was significantly longer than that of Groups P and P-E (P < .05), but there was no statistically significant difference in the awakening time of other groups.

Conclusion:

Ciprofol demonstrated efficacy in inducing sedation or anesthesia during painless gastroscopy that was similar to propofol, while exhibiting a comparable safety profile. Moreover, the combination of propofol and etomidate, as well as the combination of ciprofol and etomidate, were both shown to be equally safe and effective for this clinical application. These findings suggest that ciprofol can be considered as a safe and effective alternative for painless gastroscopy, and the ciprofol-etomidate mixture may be a better choice.
Prevalence of cognitive impairment and its associated factors in middle-aged and elderly people in Anhui Province, China: An observational study
Authors: Cui Can , Yu Tianyun , Zhai Yujia , Zhang Shan , Su Zengfeng
Published: November 2024

To understand the prevalence of cognitive impairment (CI) in middle-aged and elderly individuals in Anhui Province and to develop a CI risk prediction model. From May to June 2022, a multistage, stratified cluster-sampling method was used to select 3200 middle-aged and elderly people over 45 years old in Anhui Province for a questionnaire survey, and the Chinese version of the Mini-Mental State Examination (MMSE) was used to assess cognitive function. SPSS 25.0 was used for univariate and multivariate analyses, and R software was used to establish and validate the nomogram. A total of 3059 valid questionnaires were included, of which 384 were from participants who were diagnosed with CI, and the prevalence rate was 12.6%. Multivariate logistic analysis showed that female sex, advanced age, family history, etc., were closely related to the occurrence of CI. The area under curve (AUC) values in the modeling and validation groups were 0.845 (95% CI: 0.822–0.868) and 0.868 (95% CI: 0.835–0.902), respectively, indicating that the predictive ability of the model was good. The Hosmer–Lemeshow test suggested that the model had good goodness-of-fit, and the decision-curve evaluation nomogram had a high benefit within the threshold, which had a certain clinical importance. The prevalence rate of CI among middle-aged and elderly individuals in Anhui Province was 12.6%. Female sex, elderly age, family history, low educational status, current smoking status, sleep disorders, hypertension, stroke, and diabetes were shown to be risk factors for CI, while exercise was shown to be a protective factor.
The application of wing-shaped window decompression device in the treatment of large odontogenic keratocyst: An observational study
Authors: Liu Haifeng , Zhou Nuo , Huang Xuanping
Published: November 2024

To enhance the decompression and drainage effects after marsupialization of large odontogenic keratocysts (OKCs) in the jawbone, a novel cyst plug was designed, and its clinical feasibility was investigated. A total of 42 patients with large OKCs requiring decompression were divided into 2 groups: the control group (n = 21), which underwent traditional drainage tube insertion, and the experimental group (n = 21), which received a personalized wing-shaped plug. The clinical efficacy of the wing-shaped plug was assessed, and postoperative recovery times were compared between the 2 groups. The average duration of use for the wing-shaped plug was approximately 14 months. Compared to the control group, the treatment duration in the experimental group was reduced by about 3 months. The wing-shaped plug demonstrated superior fit, comfort, reduced food residue, minimal irritation to surrounding tissues, a more aesthetically pleasing appearance, and less reported pain. The adaptive wing-shaped plug offers improved prognosis for patients undergoing decompression of OKCs and shows significant potential for clinical application.
A case report of diet elimination guided by food specific IgG4 achieved clinical cure for eczematous external otitis with finger paronychia
Authors: Du Yuteng , Yang Boyun , Yao Wo , Zhu Yongbin , Tang Xuxia , Wang Huiying
Published: November 2024

Rationale:

Eczematous external otitis (EEO) is the most difficult-to-treat otitis externa, and characterized by the symptoms of inflammation with hypersensitivity of the external ear canal skin. It is acknowledged as a chronic skin inflammation primarily caused by dermatological and allergic reactions. Food allergens are also considered a cause to induce the inflammation. However, the role of food specific IgG4 in this disease is unclear yet.

Patient concerns:

A 54-year-old woman complained of recurrent itching of the external auditory meatus for 3 years and nails chapping of hands for 2 years.

Diagnoses and Interventions:

She was diagnosed with EEO and underwent the therapeutic strategy as food elimination of egg, milk and wheat, guided by the result of food specific IgG4 together with probiotics on the basis of previous symptom controlling therapy.

Outcomes:

After 17 months’ treatment, she was finally free of all the symptoms and the serum IgG4 specific to all foods are under normal limit.

Lessons:

To the best of our knowledge, it is the first report revealing the clinical significance of food specific IgG4 in EEO, and the successful treatment with diet elimination guided by food specific IgG4 threw a new light on the clinical management of refractory EEO.
Association between depression severity and trouble sleeping: A population-based study
Authors: Tu Yating , Qing Guangwei , Chen Meiying , Chen Haibo
Published: November 2024

This study investigates the association between insomnia and depression severity, exploring sleep disturbances in individuals with depression. The aim is to establish a new foundation for managing patients with co-occurring depression and insomnia, using 2015 to 2016 National Health and Nutrition Examination Survey (NHANES) data. We employed a cross-sectional design, using NHANES data from 2015 to 2018. The study included 11,261 participants after excluding incomplete data. Depression severity, assessed using Patient Health Questionnaire-9 (PHQ-9) scores, served as the exposure variable. We considered various demographic and lifestyle factors as covariates in the multivariate adjustment model. Statistical analyses adhered to CDC recommendations, with sample weights incorporated to account for NHANES’ complex sample design. Our study, encompassing 19,225 participants, revealed that higher PHQ-9 scores correlated with an increased likelihood of sleep disorders. In the fully adjusted model, a positive association emerged between PHQ-9 scores and trouble sleeping (OR = 3.95, 95% CI: 3.35–4.66, P < .0001). This relationship displayed an inverted U-shaped curve, with an inflection point at 28. Subgroup analysis and interaction tests indicated no reliance on factors such as gender, age, marital status, or BMI for the connection between depression severity and trouble sleeping (all P for interaction > .05). We identified a significant inverted U-shaped correlation between sleep disturbances and depression severity. This underscores the crucial importance of assessing sleep disorder risks in individuals with varying degrees of depression severity, facilitating personalized therapeutic interventions.
Comparison of clinical outcomes between ticagrelor and clopidogrel in patients with acute coronary syndrome and left ventricle dysfunction undergoing percutaneous coronary intervention: An observational study
Authors: Zhao Caitong , Fei Changdong , Chen Renzheng , Liu Yupeng , Zhang Hualin
Published: November 2024

Patients with acute coronary syndrome (ACS) and left ventricular (LV) dysfunction undergoing percutaneous coronary intervention (PCI) need adequate antithrombotic protection. We aim to compare the clinical outcomes between ticagrelor and clopidogrel in these patients. In total, 336 patients with ACS and LV dysfunction who undergoing PCI were included in this retrospective observational study. Of these, 137 received clopidogrel and 199 received ticagrelor. There was a 6-month follow-up period during which clinical outcomes were monitored. The incidence of the composite endpoint (23.1% vs 13.9%, P = .041) and bleeding events (6.5% vs 1.5%, P = .027) in the ticagrelor group were significantly higher compared to the clopidogrel group. Multivariate logistic regression analysis revealed that age (P = .006), hypertension (P = .007), liver insufficiency (P = .022), previous MI (P = .014) and ticagrelor (P = .044) were independent risk factors that affect the efficacy outcome. Age (P = .027) and ticagrelor (P = .016) were the independent risk factors for the safety outcome. Furthermore, in Cox survival regression analysis model, the survival rate of the efficacy endpoint in the clopidogrel group was seemingly higher than in the ticagrelor group (HR = 1.68, 95% CI: 0.97–2.90, P = .065). The survival rate of the bleeding endpoint in the clopidogrel group was higher than in the ticagrelor group (HR = 2.00, 95% CI: 1.17–3.40, P = .011). Compared to clopidogrel, ticagrelor showed increased risk of efficacy outcome and major bleeding events during 6-month follow-up in patients with ACS and LV dysfunction undergoing PCI.
Investigation of functional constipation in elderly inpatients and analysis of its influencing factors: A cross-sectional study
Authors: Xian Xuejiao , Wang Xiaobin , Liu Jie , Yang Hongjun
Published: November 2024

To investigate the prevalence of functional constipation (FC) in elderly hospitalized patients and analyze the influencing factors. This was a cross-sectional study in which 506 patients hospitalized in general surgery from February to June 2020 were selected. Information on patients’ age, gender, ethnicity, body mass index, intake of vegetables, fruits, meat, and spicy foods, sleep, smoking, alcohol consumption, time of defecation, and mode of defecation was collected through questionnaires, and the factors affecting functional constipation were analyzed using binary logistic regression models; among 506 patients, 254 had FC, with a prevalence of 50.19%. Among the clinical symptoms of FC, the most common ones were straining to defecate (83.85%) and lumpy or hard stools (81.80%). Univariate analysis revealed statistically significant differences in family history of constipation (P = .033), sedentary (P = .004), self-care ability (P = .001), body mass index (P = .013), defecation time (P < .0001), spicy food intake in dietary preference (P = .001), age (P = .004), and education level (P = .016), and binary logistic regression analysis showed that defecation time and spicy food consumption were independent influencing factors of FC. For hospitalized elderly people, regular morning defecation and not eating spicy foods can more helpful to slow the occurrence of functional constipation.
Comparison of treatment results between microvascular decompression and gamma knife radiosurgery in primary trigeminal neuralgia
Authors: Yang Moon Seok , Choi Chang Hwa , Lee Jae Meen
Published: November 2024

This study aims to analyze and evaluate the comparative clinical outcomes associated with microvascular decompression (MVD) and gamma knife radiosurgery (GKRS), focusing on pain relief, pain recurrence, and complications encountered in the treatment of trigeminal neuralgia (TN). Among 155 surgical procedures performed for TN (90 GKRS, and 65 MVD) between March 1997 and December 2020, the exclusion criteria encompassed prior surgical interventions, the presence of other pathological conditions such as tumors, vascular diseases, and multiple sclerosis, as well as patients who were lost to follow-up. Ultimately, 101 patients received their initial treatment for primary TN (47 GKRS, and 54 MVD) and were followed up for more than 1 year. The MVD procedures utilized the suboccipital retrosigmoid sinus approach, whereas GKRS was conducted with MR imaging guidance, employing a single 4mm isocenter, with median GKRS doses of 80 Gy. We retrospectively analyzed patient characteristics, including sites of divisions, distributions of pain, and clinical outcomes. The assessment of outcomes was performed utilizing the Barrow Neurological Institute Pain Intensity Score and the Visual Analog Scale (VAS), with evaluations taking place preoperatively and after 1, 3, 6 and 12 months. Postoperative VAS scores for patients undergoing either MVD or GKRS demonstrated a significant improvement when compared with their preoperative counterparts. The reduction in postoperative VAS scores within the MVD group was significantly more substantial than that observed in patients who underwent GKRS at the initial postoperative evaluations (P = .037). The maintenance of pain relief after MVD proved significantly superior to that following GKRS (P < .01). Both MVD and GKRS present as safe and efficacious therapeutic options for individuals diagnosed with primary TN, though MVD displayed superior initial outcomes in terms of pain relief and its maintenance. However, for older patients or those with medical contraindications to invasive procedures, GKRS emerges as a viable and less invasive alternative for initial treatment in cases of primary TN.
Association of MCP-4, NRTN, and PD-L1 with the risk of hepatic fibrosis: A Mendelian randomization study
Authors: Li Liqun , Yan Jing , Liu Qian , Ge Laian , Pan Yifeng , Han Bingjie , Wang Chunmei , Tang Xiaomei , Liu Lijian , Xie Sheng
Published: November 2024

Previous studies have confirmed the affiliation between specific inflammatory cytokines and Hepatic fibrosis (HF); however, contradictions remain in the causality. The study implemented a bidirectional two-sample Mendelian randomization (MR) analysis with published statistics derived from Genome-wide Association Studies (GWAS) to investigate casualties between inflammatory cytokines and HF. Additionally, MR analysis was also introduced to consider if 1400 blood metabolites act as the key mediators in this process. Single nucleotide polymorphisms (SNPs) with strong correlations to inflammatory factors were selected for multiple MR analyses in this study. The inverse variance weighted method (IVW) was chosen as the principal analysis, and the others as the supportive. Besides, sensitivity tests were involved to identify potential heterogeneity and pleiotropic level. IVW methods revealed that a relatively high level of prediction-based monocyte chemoattractant protein-4 (MCP-4) (95% CI: 1.014–3.336, P = .045), along with neurturin (NRTN) (95% CI: 1.204–4.004, P = .010), may increase the risk of HF; while programmed cell death 1 ligand 1 (PD-L1) (95% CI: 0.223–0.928, P = .030), showed a protective effect on HF. No significant statistical differences were detected on any other inflammatory cytokines, nor did the impact of HF genetic predisposition on the 91 circulating inflammatory cytokines-related characteristics.
Efficacy and safety of hyperbaric oxygen therapy for diabetes peripheral neuropathy: A systematic review and meta-analysis
Authors: Weng Jiyan , Ren Haiyong , Guo Qiaofeng , Huang Kai , Ding Liqing
Published: November 2024

Background:

Diabetes peripheral neuropathy (DPN) is mainly treated with diabetes as a whole, and there is no targeted treatment. Some studies have reported that adjuvant hyperbaric oxygen therapy (HBOT) for DPN has achieved a good effect, our study aimed to evaluate the clinical efficacy and safety of HBOT for DPN and provide reference for the clinic by using a systematic review and meta-analysis.

Methods:

A comprehensive search was conducted across several databases, including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Internet Database, Chinese BioMedical Database, China Scientific Journal Database, and Wanfang Database, for relevant randomized controlled trials published before July 2022. The population, intervention, comparison, outcomes, study design criteria were used to guide the selection of studies. Meta-analysis was performed using RevMan 5.4 and STATA 14.0, with odds ratios and mean differences along with 95% confidence intervals serving as measures of effect size.

Results:

Fourteen randomized controlled trials were included in the final analysis, comprising 675 patients in the HBOT group and 648 in the standard therapy (ST) group. The HBOT group demonstrated a significantly higher effective treatment rate compared to the ST group (P < .001). Additionally, the HBOT group showed significant improvements in motor nerve conduction velocity (MNCV) and sensory nerve conduction velocity (SNVC) across multiple nerves: median nerve (PMNCV < 0.001, PSNCV = 0.001), ulnar nerve (PMNCV = 0.02, PSNCV < 0.001), peroneal nerve (PMNCV < 0.001, PSNCV < 0.001), and tibial nerve (PMNCV = 0.001, PSNCV = 0.008). Six adverse events were reported in the HBOT group, while no adverse events occurred in the ST group, with no significant difference between the 2 groups. Publication bias was identified in some outcome variables through funnel plots, Begger test, and Egger test.

Conclusions:

HBOT significantly enhances treatment efficacy and nerve conduction velocity in patients with DPN, with few adverse events, making it a safe and effective adjunctive therapy for DPN.
Systematic vitamin K antagonist reversal with prothrombin complex concentrate in patients with mild traumatic brain injury: randomized controlled trial
Authors: Douillet Delphine , Tazarourte Karim , Dehours Emilie , Brice Christian , Andrianjafy Hery , Trinh-Duc Albert , Lasocki Sigismond , Labriffe Matthieu , Riou Jérémie , Roy Pierre-Marie
Published: November 2024

Background and importance

Traumatic brain injury (TBI) in patients on vitamin K antagonists (VKAs) is linked to a high rate of intracranial hemorrhage (ICH). Rapid reversal can reduce ICH progression and mortality, but its effectiveness depends on the time between bleeding onset and coagulation normalization.

Objective

The PREVACT study aimed to assess the efficacy and safety of prompt systematic reversal of anticoagulation in patients presenting to emergency departments (EDs) for recent mild-TBI while receiving a VKA.

Intervention

A randomized, open-label, blinded-endpoint clinical trial was conducted in 21 French EDs. Patients receiving a VKA, having experienced a TBI within the last 6 h, and presenting a Glasgow Coma Score ≥13 were included. Patients were randomized to systematic immediate VKA reversal with 25 IU/kg of four-factor prothrombin complex concentrate (4f-PCC) before any investigation (intervention group) or standard-of-care signifying reversal only if the initial cranial computed tomography (CT) scan indicated ICH (control group). The primary outcome was the rate of ICH detected on a cranial CT scan 24 h post-inclusion.

Results

The study was prematurely stopped for logistic reasons after the randomization of 202 patients (101 and 101 in the intervention and control groups, respectively, mean age 90; 51.8% female). On the 24-h cranial CT scan, 6 of 98 patients (6.1%) in the intervention group manifested ICH vs. 12 of 99 patients (12.1%) in the control group [odds ratio: 0.47 (95% confidence interval: 0.14–1.44); P = 0.215].

Conclusion

In patients with recent mild-TBI receiving a VKA, systematic prompt reversal with 4f-PCC did not statistically significantly reduce ICH rate at 24 h. However, the study was prematurely stopped and does not exclude a clinically relevant benefit of the strategy tested.

Trial registration

Clinicaltrials.gov (NCT01961804).
A Comparison of Pumping Infusion-Induced Contamination With Different Syringe Types
Authors: Kawakami Yutaka , Tagami Takashi
Published: November 2024

Health care providers use several types of syringes in their daily routine to provide or safely deliver therapeutic agents to patients. Pump infusion with a syringe (PIS) are used for the rapid delivery of large amounts of fluid or blood to patients in critical conditions, such as hypovolemic shock. Patients often experience bacterial infections, such as catheter-related bloodstream infections, specifically when they are in critical condition in the intensive care unit (ICU) after surgery or undergoing resuscitation in an emergency department. A previous study has shown that PIS may cause intraluminal contamination. This study compared PIS-induced contamination among different types of available syringes, including disposable plastic syringes produced by several companies, glass syringes, and syringes with plastic covers. The authors found that plastic syringes caused approximately equivalent PIS-induced contamination and that glass syringes caused substantially more contamination than plastic syringes. However, syringes equipped with a plastic cover exhibited no contamination. Furthermore, disinfection with ethanol completely prevented PIS-induced contamination. This study supports the evidence that PIS may cause bacterial contamination and that a thorough aseptic technique is needed, especially when using glass syringes. These findings highlight the need to develop alternative devices for rapid infusion.
Patient Blood Management
Authors: Sarver Mary Jo , McManus Monica , Toler John , Johnson Bethany
Published: November 2024

A quasi-experimental study comparing the mixing and discard methods of laboratory specimen techniques in an adult acute care setting was conducted over a 30-month period. Primary end points were delta hemoglobin (Hgb) and transfusion rates. Secondary end points were redraws related to hemolysis and erroneous results, noting central venous access device (CVAD) type. Primary objectives included the comparison of hospital-acquired anemia and transfusion rates utilizing Hgb and venous sampling methods as part of a patient blood management (PBM) program. Secondary objectives tracked the type of CVAD used to acquire venous specimens and the impact on hemolysis rates or erroneous results. Considerations include exploring the benefits of utilizing the mixing method related to cost savings. In summary, the mixing versus discard method eliminates wasting blood to reduce hospital-acquired anemia as part of a PBM program. CVAD type did not influence hemolysis rates or impact erroneous results. The mixing method is easy to implement in any health care setting. Cost savings are feasible by elimination of external venous or arterial blood management protection devices. Removal of add-on devices supports standards by decreasing access points to reduce infection risk. Results, although inconclusive to superiority, demonstrated noninferiority and encouraged consideration of the mixing method for laboratory specimen collection.
Epidemiology of Emergency Department Visits for Children With Clinically Significant Cardiovascular Disease
Authors: Abid Zaynah , Neuman Mark I. , Hall Matt , Anderson Brett R. , Dayan Peter S.
Published: November 2024

Objective

The aim of the study is to determine the epidemiology, cost, and factors associated with hospital admission, deterioration if hospitalized, and mortality for children with a history of clinically significant cardiovascular disease (CVD) presenting to pediatric emergency departments (EDs).

Study Design

Using the Pediatric Health Information System, we performed a retrospective analysis of ED encounters of children ≤17 years old with clinically significant CVD between 2016 and 2021. Patients were included if they had a cardiovascular complex chronic condition, defined by ICD diagnosis, and procedure codes. We assessed the primary diagnosis, admission rate, ICU transfer rate (as a marker of disease progression), mortality, resource utilization, and costs. We conducted multivariable analyses to identify risk factors for admission, ICU transfer, and mortality.

Results

There were 201,551 ED visits (mean 33,592 ± 3354 per year) among 129,938 children with clinically significant CVD. Most ED encounters had a primary diagnosis of a circulatory (21.1%) or respiratory (19.7%) illness. Seventy-six percent of visits had at least one blood test or imaging study conducted. The overall admission rate was 59.7%, with 28.7% admitted to the ICU, and 6.2% transferred to the ICU after the first 24 hours. The median costs for encounters resulting in admission were $13,605 in US 2023 dollars. In multivariable analyses, younger age, a greater number of noncardiac complex chronic conditions, and CVD type were associated with increased odds of admission, ICU transfer after 24 hours, and mortality (all P < 0.05).

Conclusions

ED visits for children with clinically significant CVD lead to substantial resource utilization, including frequent hospitalization, ICU level of care, and costs. This baseline data aids in the development of prospective studies to inform the appropriate ED management for children with clinically significant CVD.
Do kea parrots infer the weight of objects from their movement in a breeze?
Authors: Temeroli Elizabeth , Jelbert Sarah A. , Lambert Megan L.
Published: November 2024

Weight, though it cannot be seen directly, pervades nearly every aspect of an animal’s life. However, the extent to which non-human animals reason about the property of weight remains poorly understood. Recent evidence highlights birds as a promising group for testing this ability: for example, New Caledonian crows can infer the weight of objects after observing their movements in a breeze. Here, we tested for similar weight inference abilities in kea (
Nestor notabilis
), a parrot species known for its sophisticated problem-solving skills. Subjects were trained to exchange objects of a target weight (light or heavy) for a food reward. They were then allowed to observe pairs of novel objects (one light and one heavy) hung in front of an electric fan in both an experimental condition (fan on, light object moving) and a control condition (fan off, both objects motionless). The birds were subsequently presented with test trials in which they could use the information from the demonstration to select an object of their target weight. We found that, unlike New Caledonian crows, kea did not perform significantly better on trials in which they observed the objects’ movements and discussed our findings within the context of the kea’s highly explorative nature.
Axon demyelination and degeneration in a zebrafish
spastizin
model of hereditary spastic paraplegia
Authors: Garg Vranda , André Selina , Heyer Luisa , Kracht Gudrun , Ruhwedel Torben , Scholz Patricia , Ischebeck Till , Werner Hauke B. , Dullin Christian , Engelmann Jacob , Möbius Wiebke , Göpfert Martin C. , Dosch Roland , Geurten Bart R. H.
Published: November 2024

Hereditary spastic paraplegias (HSPs) are a diverse set of neurological disorders characterized by progressive spasticity and weakness in the lower limbs caused by damage to the axons of the corticospinal tract. More than 88 genetic mutations have been associated with HSP, yet the mechanisms underlying these disorders are not well understood. We replicated the pathophysiology of one form of HSP known as spastic paraplegia 15 (SPG15) in zebrafish. This disorder is caused in humans by mutations in the
ZFYVE26
gene, which codes for a protein called SPASTIZIN. We show that, in zebrafish, the significant reduction of Spastizin caused degeneration of large motor neurons. Motor neuron degeneration is associated with axon demyelination in the spinal cord and impaired locomotion in the
spastizin
mutants. Our findings reveal that the reduction in Spastizin compromises axonal integrity and affects the myelin sheath, ultimately recapitulating the pathophysiology of HSPs.
Vertical Variability in morphology, chemistry and optical properties of the transported Saharan air layer measured from Cape Verde and the Caribbean
Authors: Aryasree Sudharaj , Kandler Konrad , Benker Natalie , Walser Adrian , Tipka Anne , Dollner Maximillian , Seibert Petra , Weinzierl Bernadett
Published: November 2024

The structural properties of the Saharan air layer (SAL) including chemical, morphological and optical properties were measured during the Saharan Aerosol Longrange TRansport and Aerosol Cloud interaction Experiment (SALTRACE- June/July 2013). Flight measurements were done from Cape Verde and the Caribbean. Changes happening with the chemical composition, mixing, shape and absorption of aerosol single particles (particle diameter range 0.5–3.0 µm) inside SAL during its transport are detailed. Dust-dominated SAL (relative number abundance >90%) and generally low mixing (<1% with sea-salt and sulphates) are observed at both locations. The change in shape (determined as aspect ratio (AR)) after transatlantic transport was statistically not significant. The iron oxide fraction, important for light absorption, contributed 6.0–6.8% to SAL dust. A lower amount of Fe oxides was observed in transported SAL, especially for the size range 0.5–1.5 µm. This reduction in Fe oxide content resulted in a 4% decrease (0.0046–0.0044) in dust imaginary refractive index and a 1% decrease in single scattering albedo (0.802–0.809) at 520 nm. Our work suggests including the size distribution of iron oxides and their particular behaviour in future experiment/model studies.
The logic of conventional and reversed Bateman gradients
Authors: Lehtonen Jussi , Parker Geoff A. , Whittington Camilla M.
Published: November 2024

The Bateman gradient is a central concept in sexual selection theory that relates reproductive success to mate number, with important consequences for sex-specific selection. The conventional expectation is that Bateman gradients are steeper in males than females, implying that males benefit more from multiple mating than females do. This claim is supported by much empirical evidence as well as mathematical modelling. However, under some reproductive systems, reversed Bateman gradients are observed, perhaps most notably in syngnathid fishes with male pregnancy. Unlike conventional Bateman gradients, the causal basis of such reversed Bateman gradients has never been modelled mathematically. Here, we present a sex-neutral mathematical model demonstrating how restrictions in capacity for carrying or incubating gametes and embryos (brooding) interact with anisogamy, generating both conventional and reversed Bateman gradients from a single mathematical model. The results clearly demonstrate how anisogamy tends to cause conventional Bateman gradients, but diminishing male brooding capacity under male pregnancy or nesting causes a gradual reversal from conventional to fully ‘reversed’ Bateman gradients.
Erysipelothrix rhusiopathiae-associated bloodstream infection in a patient with systemic lupus erythematosus: a case report and literature review
Authors: Lo Calvin Ka-Fung , Schonhofer Cole , Mina Neil , Masud Shazia , Wong Patrick Ho Pun , Chapman Michael G.
Published: November 2024

Introduction. Systemic human infections caused by Erysipelothrix rhusiopathiae have been increasingly reported especially within immunocompromised hosts and those with significant occupational exposure to livestock and aquatic animals. We report a case of E. rhusiopathiae bacteraemia in a patient with systemic lupus erythematosus (SLE) and present a literature review on clinical outcomes and microbiologic diagnosis for this organism.

Case presentation. A 43-year-old female patient was reporting a 1-month history of intermittent fevers. She recently increased her immunosuppression medication for her underlying SLE on the advice of her rheumatologist. The patient sustained a finger laceration from butchering cattle meat 2 weeks after the onset of her initial symptoms, with worsening index finger swelling and increased febrile episodes. Two weeks post-injury, multiple blood cultures were drawn, and each isolated Gram-positive bacilli. Given her recurrent intermittent fevers, there was a concern for ongoing infection, and therefore, intravenous vancomycin was started with prompt referral to an outpatient parenteral antibiotic therapy clinic. The Gram-positive bacillus was confirmed as E. rhusiopathiae via matrix-assisted laser desorption/ionization-time of flight analysis. Given intrinsic resistance to vancomycin, vancomycin was switched to intravenous ceftriaxone as targeted antimicrobial therapy for 2 weeks. Reassuringly, there was no echocardiographic evidence of infective endocarditis, warranting the prolonged treatment course. Post-treatment, she remained symptom-free with the resolution of joint symptoms and fevers.

Conclusion. Our report illustrates a case of E. rhusiopathiae bacteraemia from an immunodeficient host, with prompt microbiologic diagnosis and intervention with appropriate antimicrobial coverage. Literature reflects the rarity of this infection, predilections to specific susceptible hosts and the importance of raising awareness of zoonotic infections.
A Modular Bacteriophage T4 Nanoparticle Platform Enables Rapid Design of Dual COVID-19-Flu Mucosal Vaccines
Authors: Zhu Jingen , Sha Jian , Batra Himanshu , Jain Swati , Wu Xiaorong , Hendrix Emily K. , Kilgore Paul B. , Sun Keer , Plante Kenneth S. , Plante Jessica A. , Walker Jordyn , Tao Pan , Chopra Ashok K. , Rao Venigalla B.
Published: November 2024

A multivalent, rapidly deployable, mucosal vaccine platform is desperately needed to prevent the acquisition and transmission of respiratory infections during epidemics and pandemics. We present one such bacteriophage T4-based platform, and design of dual COVID-19-Flu mucosal vaccines by exploiting its unique architecture. These include: T4’s natural affinity for nasal mucosa, flexible engineering to incorporate multiple antigens, and repeat and symmetric epitope presentation for enhanced B cell responses. Hundreds of SARS-CoV-2 spike trimers and nucleocapsid proteins, and influenza hemagglutinin trimers and M2e peptides, were incorporated into a single phage, creating the highest density nanoparticle presentation yet reported. Intranasal administration of adjuvant-free vaccine induced robust mucosal immunity in mice including, neutralizing antibody and secretory IgA, lung-resident CD4+/CD8+T cells, diverse memory B cells, and complete protection against SARS-CoV-2 and influenza challenges. The noninfectious T4 phage offers an extraordinary platform to rapidly design potent mucosal vaccines against emerging bacterial and viral threats.
Improved heritability partitioning and enrichment analyses using summary statistics with graphREML
Authors: Li Hui , Kamath Tushar , Mazumder Rahul , Lin Xihong , O’Connor Luke
Published: November 2024

Heritability enrichment analysis using data from Genome-Wide Association Studies (GWAS) is often used to understand the functional basis of genetic architecture. Stratified LD score regression (S-LDSC) is a widely used method-of-moments estimator for heritability enrichment, but S-LDSC has low statistical power compared with likelihood-based approaches. We introduce graphREML, a precise and powerful likelihood-based heritability partition and enrichment analysis method. graphREML operates on GWAS summary statistics and linkage disequilibrium graphical models (LDGMs), whose sparsity makes likelihood calculations tractable. We validate our method using extensive simulations and in analyses of a wide range of real traits. On average across traits, graphREML produces enrichment estimates that are concordant with S-LDSC, indicating that both methods are unbiased; however, graphREML identifies 2.5 times more significant trait-annotation enrichments, demonstrating greater power compared to the moment-based S-LDSC approach. graphREML can also more flexibly model the relationship between the annotations of a SNP and its heritability, producing well-calibrated estimates of per-SNP heritability.
Polymicrobial interactions betweenStaphylococcus aureusandPseudomonas aeruginosapromote biofilm formation and persistence in chronic wound infections
Authors: Keim Klara , Bhattacharya Mohini , Crosby Heidi A. , Jenul Christian , Mills Krista , Schurr Michael , Horswill Alexander
Published: November 2024

Chronic, non-healing wounds are a leading cause of prolonged patient morbidity and mortality due to biofilm-associated, polymicrobial infections.Staphylococcus aureusandPseudomonas aeruginosaare the most frequently co-isolated pathogens from chronic wound infections. Competitive interactions between these pathogens contribute to enhanced virulence, persistence, and antimicrobial tolerance.P. aeruginosautilizes the extracellular proteases LasB, LasA, and AprA to degradeS. aureussurface structures, disrupt cellular physiology, and induce cell lysis, gaining a competitive advantage during co-infection.S. aureusevadesP. aeruginosaby employing aggregation mechanisms to form biofilms. The cell wall protein SasG is implicated inS. aureusbiofilm formation by facilitating intercellular aggregation upon cleavage by an extracellular protease. We have previously shown that proteolysis by a host protease can induce aggregation. In this study, we report thatP. aeruginosaproteases LasA, LasB, and AprA cleave SasG to induceS. aureusaggregation. We demonstrate that SasG contributes toS. aureusbiofilm formation in response to interactions withP. aeruginosaproteases by quantifying aggregation, SasG degradation, and proteolytic kinetics. Additionally, we assess the role of SasG in influencingS. aureusbiofilm architecture during co-infectionin vivo,chronic wound co-infections. This work provides further knowledge of some of the principal interactions that contribute toS. aureuspersistence within chronic wounds co-infected withP. aeruginosa,and their impact on healing and infection outcomes.
Prospective study of the behavior of totally implantable long-term catheters in patients with mammary hypertrophy.
Authors: Portugal Maria Fernanda , Ponte Bruno J , Sorbello Carolina Carvalho Jansen , Souza Thulio Fernandes , Indig Pinheiro Amanda , Louzada Andressa Cristina Sposato , Leiderman Dafne Braga Diamante , Wolosker Nelson , Mendes Cynthia de Almeida
Published: November 2024

Background: The aim of this study was to evaluate the change in the position of totally implantable central venous catheters(TIVC) tips in patients with mammary hypertrophy, comparing them to patients without this condition in both the supine and upright position. Methods: This was a prospective study involving consecutive patients who underwent the implantation of totally implantable central venous catheters (TIVC) in internal jugular or subclavian veins with reservoir placement on the thoracic wall. Data were collected with regard to demographic and clinical features of the included patients, including: age (years), height (cm), weight (Kg), BMI, malignancy type, occurrence of previous non-deforming procedures to the breasts, presence of a Peripherally Inserted Central Catheter (PICC) during TIVC implantation, and history of DVT (punctured vein and laterality). The catheter tip's position in an upright stance was documented through a routine postoperative chest X-ray, using a posterior-to-anterior incidence technique, also including a radiopaque ruler permitting the measuring of its distance from the carina in centimetres. The intraclass correlation coefficient between the intraoperative and postoperative distance variation recorded by Observers 1 and 2 was excellent (r =0.773). Results: Significant caudal TIVC tip displacement was determined by previous nondeforming surgery to the chest wall (p=0.002); and significant proximal displacement was calculated by the presence of PICC during TIVC implantation (p =0.042). The Sacchini index did not exhibit a significant association with changes in catheter tip locations after surgery. Conclusion: Significant caudal TIVC tip displacement was determined by previous non-deforming surgery to the thoracic wall (p=0.002); and significant proximal displacement was determined by the presence of a PICC during TIVC implantation (p=0.042). Mammary hypertrophy, as assessed by the Sacchini index, was not statistically correlated to catheter tip displacement (p=0.612).
Vigorous exercise associates with the abundance of gut bacterial species reflecting energy pathways: an epidemiological cross-sectional analysis within the Lifelines Dutch Microbiome Project
Authors: Morwani-Mangnani Jordi , Ducarmon Quinten R. , Zeller Georg , Deelen Joris , Beekman Marian , Slagboom P. Eline
Published: November 2024

Background

Regular physical activity (PA) is vital for proper organ functions including the gut. Despite existing research, it remains unclear how the gut microbiome is affected by different intensities of PA, and how other lifestyle factors influence this relationship. Here we study the relation between PA intensity and gut microbiome composition and function in a large Lifelines Dutch Microbiome Project dataset.

Methods

A cross-sectional design was performed on 5409 adults aged 40 to 60 from the community-based Lifelines Dutch Microbiome Project and from all these participants metagenomic shotgun data was available. Participants were categorized into sedentary (N=2501), moderate (N=1915), and vigorous (N=993) PA groups, based on self-reported activity levels. We investigated association between PA intensity and microbial diversity, bacterial species, and metabolic pathways by multiple regression models sequentially adjusted for the covariates age/sex, BMI, stool consistency and diet quality/alcohol intake.

Results

Vigorous PA, but not moderate PA, was significantly associated with higher gut microbiome alpha diversity (i.e., species richness, Shannon diversity, and Simpson diversity) as compared to sedentary PA. Compared to the sedentary group, the vigorous PA group showed a lower abundance of the bacterial speciesLawsonibacter asaccharolyticus(β = −0.003, p = 0.042), even after extensive covariate adjustments and correction for multiple testing. Other species were initially also significantly associated with vigorous PA, but they disappeared after adjusting for covariates resulting in a loss of significance. Pathway analysis showed significant enrichment of two distinct metabolic pathways related to cellular energy recycling (Pyruvate fermentation to acetate and lactate II,β = 8.11×10−05, p = 0.035) and purine metabolism (Purine ribonucleosides degradation, β = 3.36×10−04, p = 0.039) in participants engaging in vigorous PA as compared to sedentary PA.

Conclusions

Vigorous PA is associated with higher gut microbiome diversity and with specific alterations of microbial composition. The lower abundance ofLawsonibacter asaccharolyticuswithin the vigorous PA group may be linked to increased gut permeability. The identified enrichment of microbial fermentation and purine metabolism in vigorous PA hints at a potential role of PA in affecting gut microbiome functionality and host health. The results of our modeling strategy highlight the importance of adjusting for dietary covariates to understand how PA may impact the gut microbiome independently from other influences.
Do viral-associated pathways underlie the immune activation during the acute phase of severe major depression?
Authors: Maes Michael , Zhang Yingqian , Plaimas Kitiporn , Suratanee Apichat , Li Jing , Almulla Abbas F.
Published: November 2024

Background

Major depressive disorder (MDD) and its most severe phenotype, major dysmood disorder (MDMD), are distinguished by the activation of the immune-inflammatory response system, T cell activation, and a relative T regulatory cell suppression. Nevertheless, these immune data were not used to characterize the features of the immune protein-protein interaction (PPI) network of MDMD.

Objectives

To identify the network’s nodes and bottlenecks as well as the biological processes that are overrepresented in the PPI network, we conducted PPI network, annotation, and enrichment analyses.

Results

The PPI network analysis has identified the following backbone genes: tumor necrosis factor-α (TNF), interleukin (IL)6, CXCL12, CXCL10, CCL5, cluster of differentiation (CD)4, CD8A, human leukocyte antigen (HLA)-DR, and FOXP3. A “cellular and defense response”, an “immune response system response”, and “a viral process that involves viral protein interaction with cytokines and cytokine receptors” were all highly associated with the network. The chemokine network and TNF and nuclear factor-κB (NFKB) pathways are additional biological pathways that are enriched in the PPI network. Molecular complex detection extracted one component from the data, including viral protein interaction with cytokine and cytokine receptors and “regulated by RELA” (an NFKB subunit).

Conclusions

Viral processes may underlie the activation of T cells and the cytokine and chemokine networks that are associated with MDMD. Future research on the pathogenesis of MDMD and MDD should examine whether and which viral infections are associated with the onset of these conditions, or whether viral reactivation is associated with the recurrence of illness.
Determinants of antenatal care service utilization among adolescent mothers of (10-19) years of age at Kanyama level one hospital in Lusaka district
Authors: Saka Kenny , Hazemba Alice Ngoma , Bwembya Phoebe
Published: November 2024

Introduction

The provision of adequate antenatal care services is crucial for promoting maternal and child health. Therefore, it is necessary to understand the factors influencing the use of these services, especially among special groups such as adolescents. Adolescents, defined as individuals between the ages of 10 and 19 years, face specific challenges and vulnerabilities during pregnancy and childbirth. Hence, it is vital to develop targeted interventions to improve their reproductive health outcomes. This study analyzed the factors associated with antenatal care utilization among adolescent mothers in Zambia.

Methodology

The study used a cross sectional study design. Data was collected using a structured questionnaire from adolescents who were 8 months pregnant or more and adolescents who were already mothers at Kanyama level one hospital in Lusaka. Descriptive statistics of individual characteristics were developed to describe the data. Associations between ANC utilization and independent variables was tested using the Chi-Square test and multivariate logistic regression.

Results

The proportion of antenatal care utilization in this study was 39.37%. At multivariate analysis, factors that were significantly associated with antenatal care utilization were past pregnant experience (OR = 0.35; 95% CI: 0.14 to 0.85) and partners education (OR = 1.38; 95% CI: 1.02 to 1.87). However, Partner education did not have a statistical significance between levels of education and ANC utilization. This could have been due to a small sample size. Other studies however, reviewed a significant statistical relationship between levels of education and adolescent ANC utilization.

Conclusion

The findings underscore a low proportion of antenatal care utilization among adolescent mothers. Particularly low proportion of ANC utilization was found in adolescents mothers who had never experienced pregnancy in the past.