bluuebunny/crossref_metadata_2025 huggingface dataset:
Genome-wide identification, new classification, expression analysis and screening of drought & heat resistance related candidates in the RING zinc finger gene family of bread wheat (Triticum aestivum L.)
Authors: Li Yongliang , Qin Pai , Sun Aolong , Xiao Wenjun , Chen Fenglin , He Yang , Yu Keyao , Li You , Zhang Meng , Guo Xinhong
Published: October 2022

Background

RING (Really Interesting New Gene) zinc finger (RING-zf) proteins belong to an important subclass of zinc fingers superfamily, which play versatile roles during various developmental stages and in abiotic stress responses. Based on the conserved cysteine and histidine residues, the RING-zf domains are classified into RING-HC (C3HC4), RING-H2 (C3H2C3), RING-v, RING-D, RING-S/T, RING-G, and RING-C2. However, little is known about the function of the RING-zfs of wheat.

Results

In this study, 129 (93.5%) of 138 members were found in nucleus, indicating TaRING-zf were primarily engaged in the degradation of transcription factors and other nuclear-localized proteins. 138 TaRING-zf domains can be divided into four canonical or modified types (RING-H2, RING-HC, RING-D, and RING-M). The RING-M was newly identified in T. aestivum, and might represent the intermediate other states between RING-zf domain and other modified domains. The consensus sequence of the RING-M domain can be described as M-X2-R-X14-Cys-X1-H-X2-Cys-X2-Cys-X10-Cys-X2-Cys. Further interspecies collinearity analyses showed that TaRING-zfs were more closely related to the genes in Poaceae. According to the public transcriptome data, most of the TaRING-zfs were expressed at different 15 stages of plant growth, development, and some of them exhibited specific responses to drought/heat stress. Moreover, 4 RING-HC (TraesCS2A02G526800.1, TraesCS4A02G290600.1, TraesCS4B02G023600.1 and TraesCS4D02G021200.1) and 2 RING-H2 (TraesCS3A02G288900.1 and TraesCS4A02G174600.1) were significantly expressed at different development stages and under drought stress. These findings provide valuable reference data for further study of their physiological functions in wheat varieties.

Conclusions

Taken together, the characterization and classifications of the TaRING-zf family were extensively studied and some new features about it were revealed. This study could provide some valuable targets for further studies on their functions in growth and development, and abiotic stress responses in wheat.
Effect of three water-regimes on morpho-physiological, biochemical and yield responses of local and foreign olive cultivars under field conditions
Authors: Gholami Rahmatollah , Fahadi Hoveizeh Narjes , Zahedi Seyed Morteza , Gholami Hojattollah , Carillo Petronia
Published: October 2022

Background

Drought stress is among the most serious threats jeopardizing the economic yield of crop plants in Iran. In particular, in response to withholding irrigation, the reduction in performance and quality of a precious plant such as the olive tree is remarkable. Therefore, the selection of cultivars that are resistant or tolerant to drought has been recognized as one of the most effective long-term strategies for sustainably alleviating the adverse effects of this stress. In this view, our study evaluated the response of 8 olive cultivars including 4 elite native cultivars (Zard Aliabad, Roughani, Dezful, and Shengeh) and 4 foreign cultivars (Manzanilla, Sevillana, Konservolia, and Mission) to water shortage in the Dallaho Olive Research station of Sarpole-Zahab in Kermanshah province in 2020. Olive trees underwent 3 levels of irrigation treatment including 100% full irrigation (control), 75%, and 50% deficit irrigation.

Results

Based on the results, 50% deficit irrigation decreased both growth and pomological traits, but determined the highest dry matter percentage. As the severity of drought stress increased, with an accumulation of sodium and malondialdehyde, an incremental increase in osmolytes was observed, as well as an enhancement of the activity of antioxidant enzymes (peroxidase and catalase). In contrast, full irrigation led to an increase in photosynthetic pigments, calcium, and potassium. Dezful and Konservolia cultivars revealed a significantly higher growth rate, correlated in the former to higher levels of chlorophyll, compatible compounds, total phenolic content, relative water content, potassium to sodium ratio, catalase, and peroxidase activities compared with other cultivars. Konservolia showed the best yield parameters under 75% and 100% irrigation regimes, correlated to higher chlorophyll, potassium, and total phenolic content (in particular at 75% ET).

Conclusions

Generally, the selection of more resilient or tolerant cultivars to sustain water scarcity stress is a widely operative solution to extend rainfed orchards in semi-arid environments. Our study showed that Dezful and Konservolia had the best adaptive mechanisms to cope with the detrimental effects of drought stress.
Groningen Frailty Indicator–Chinese (GFI-C) for pre-frailty and frailty assessment among older people living in communities: psychometric properties and diagnostic accuracy
Authors: Huang Emma Yun Zhi , Cheung Jasmine , Liu Justina Yat Wa , Kwan Rick Yiu Cho , Lam Simon Ching
Published: October 2022

Background

The early identification of pre-frailty and frailty among older people is a global priority because of the increasing incidence of frailty and associated adverse health outcomes. This study aimed to validate the Groningen Frailty Indicator-Chinese (GFI-C), a widely used screening instrument, and determine the optimal cut-off value in Chinese communities to facilitate pre-frailty and frailty screening.

Methods

This methodological study employed a cross-sectional and correlational design to examine the psychometric properties of GFI-C, namely, internal consistency, stability, and concurrent and construct validities. The appropriate cut-off values for pre-frailty and frailty screening in the receiver-operating characteristic (ROC) curve were determined through sensitivity and specificity analysis.

Results

A total of 350 community older people had been assessed and interviewed by a nurse. The GFI-C showed satisfactory internal consistency (Cronbach’s α = 0.87) and two-week test-retest reliability (intra-class correlation coefficient = 0.87). Concurrent validity (r = 0.76,p < 0.001) showed a moderate correlation with Fried’s frailty phenotype. The known-groups method, hypothesis testing and confirmatory factory analysis (three-factor model; χ2/df = 2.87, TLI = 0.92, CFI = 0.93, GFI = 0.92, RMR = 0.014; RMSEA = 0.073) were suitable for the establishment of construct validity. Based on the ROC and Youden’s index, the optimal cut-off GFI-C values were 2 (sensitivity, 71.5%; specificity, 84.7%) for pre-frailty and 3 for frailty (sensitivity, 88.2%; specificity, 79.6%).

Conclusions

The result indicated that GFI-C is a reliable and valid instrument for pre-frailty and frailty screening among older Chinese people in communities. For optimal diagnostic accuracy, the cut-off values of 3 for frailty and 2 for pre-frailty are recommended.
The prevalence and risk factors of sarcopenia among Thai community-dwelling older adults as defined by the Asian Working Group for Sarcopenia (AWGS-2019) criteria: a cross-sectional study
Authors: Sri-on Jiraporn , Fusakul Yupadee , Kredarunsooksree Thiti , Paksopis Thitiwan , Ruangsiri Rasida
Published: October 2022

Background

This study aimed to determine the prevalence and risk factors for sarcopenia and severe sarcopenia among urban community-dwelling adults in Thailand, using the Asian Working Group for Sarcopenia (AWGS-2019) criteria.

Methods

This cross-sectional study comprising 892 older adults aged > 60 years analyzed data from a cohort study (Bangkok Falls study; 2019–2021). The appendicular skeletal muscle mass was evaluated using the Bioelectrical Impedance Analysis (BIA) method. Physical performance and muscle strength were evaluated using the five-time sit-to-stand and handgrip strength tests, respectively. Logistic regression was used to determine the factors associated with sarcopenia.

Results

The prevalence rates of sarcopenia and severe sarcopenia were 22.2% and 9.4%, respectively. Age ≥ 70 years (adjusted odds ratio (aOR), 2.40; 95% confidence interval (CI), 1.67–3.45), body mass index (BMI) of < 18.5 kg/m2 (aOR, 8.79; 95% CI, 4.44–17.39), Mini Nutritional Assessment (MNA) score of < 24 (aOR, 1.75; 95% CI, 1.24–2.48), and a six-item cognitive screening test score of ≥ 8 (aOR, 1.52; 95% CI, 1.08–12.15) were associated with sarcopenia. Likewise, age ≥ 70 years, BMI < 18.5 kg/m2, and an MNA score of < 24 predicted severe sarcopenia.

Conclusion

One-third of the urban community-dwelling older Thai adults had sarcopenia or severe sarcopenia. The age ≥ 70 years, low BMI, and inadequate nutrition increased the risk of both sarcopenia and severe sarcopenia while impaired cognitive functions predicted only sarcopenia in this population.
Efficacy and safety of high-intensity focused ultrasound cyclo-plasty in glaucoma
Authors: Chen Di , Guo Xiu-Juan , Luo Shu-Ke , Lu Yan , Tang Xiu-Rong
Published: October 2022

Background

High-intensity focused ultrasound cyclo-plasty (UCP) is a recently developed glaucoma surgery. This study collected and analysed the clinical data of patients who underwent UCP to observe the efficacy and safety of this surgery in Chinese glaucoma patients.

Methods

This was a retrospective study. The clinical data of all the patients who underwent UCP at Affiliated Foshan Hospital, Southern Medical University, were collected and analysed to evaluate the efficacy and safety of UCP. The main outcome measure was intraocular pressure, and the secondary outcome measures were best corrected visual acuity (logMAR) and complications.

Results

Fifty-eight patients (61 eyes) were recruited for this study. IOP was dramatically decreased during the 12 months after UCP (p<0.05). The median IOP reduction during the 18 months post-procedure was more than 30%. The greatest reduction was at 1 month post-UCP (60.86%). The qualified success rate was more than 60% during the 18-month follow-up (Fig. 1). Poor follow up was found after 6-month post-UCP. The highest success rate was obtained at 7 days post-UCP (94.55%). No statistically significant decrease in BCVA in the vison group was observed at the follow-up visits, except for 1 day post-UCP. There was a statistically significant reduction in the use of IOP lowering medications during the 6 months post-UCP. No severe complications occurred.

Conclusion

UCP is a safe and effective procedure for primary and refractive glaucoma at least during the 6 months post-UCP procedure. Studies with longer follow-up time and better follow up are needed to further confirm the long-term efficacy and safety of UCP in Chinese glaucoma patients.
Proportion and risk factors of diabetic retinopathy by stage in less-developed rural areas of Hunan province of China: A multi-site cross-sectional study
Authors: Chen Yao , Jiang Yuanyuan , Yao Xiaoxi , Li Yimeng , Liu Ruisi , Lv Wencong , Zhong Qinyi , Yan Bin , Meng Yongan , Luo Jing , Wu Mengbo , Guo Jia
Published: October 2022

Aims

To investigate the proportion and risk factors of diabetic retinopathy (DR) by stages in less-developed rural areas in Hunan Province of China.

Background

DR is common among people with diabetes but not well recognized in less-developed rural areas. There is insufficient evidence on the risk factors of DR by stages, making it challenging to develop targeted prevention and intervention programs for DR in primary care settings.

Methods

A multi-site cross-sectional survey was conducted among people with type 2 diabetes mellitus (T2DM) from four less-developed counties in Hunan Province of China. All participants underwent the screening of DR via digital fundus photography and completed self-reported questionnaires on their socio-demographic and clinical characteristics, diabetes self-efficacy, diabetes self-care behaviors, social support, family function, and health service accessibility. The multinomial logistic regression models were employed to explore the risk factors of DR by stage, which were selected based on the socio-ecological model, literature, and clinical experience.

Results

A total of 196 participants were included in this study with an average age of 57.43 ± 10.26. 59.6% (117/196) of the participants were identified as DR, including 37.2% (73/196) non-proliferative DR and 22.4% (44/196) proliferative DR. Compared to the non-DR group, the risk factors of non-proliferative DR and proliferative DR were diabetes duration (OR: 1.10, 95 CI%: 1.04–1.17; OR: 1.14, 95 CI% 1.06–1.22) and self-monitoring of blood glucose (OR: 1.09, 95 CI% 1.01–1.17; OR: 1.11, 95 CI%: 1.02–1.20); the protective factors of non-proliferative DR was accessible complication prevention and management education (OR: 0.37, 95 CI% 0.14–0.94) while the protective factors of proliferative DR were physical activities (OR: 0.89, 95 CI%: 0.80–0.98). Compared to the non-proliferative DR group, the protective factors of proliferative DR were physical activities (OR: 0.89, 95 CI% 0.02–0.89) and family function (OR: 0.84, 95 CI%: 0.04–0.84).

Conclusion

DR was prevalent among people with T2DM in less-developed rural areas, indicating the need of strengthening DR screening. Risk factors of DR varied by stage while sharing some common factors. Future DR prevention and intervention programs may benefit from improving these factors to reduce the risk of DR by stage.
Sociodemographic predictors of and main reasons for COVID-19 vaccine hesitancy in eastern Oslo: a cross-sectional study
Authors: Steinmetz Lara
Published: October 2022

Background

Vaccines are an essential public health strategy to curb viral infection spreading that hinge on vaccine uptake which may be threatened by vaccine hesitant individuals. This study aims to identify sociodemographic predictors of vaccine hesitancy, main reasons for vaccine hesitancy, and how these reasons are explained by sociodemographic characteristics during the COVID-19 pandemic.

Methods

A cross-sectional study (N = 5 442) was carried out in June 2021. A web-based survey was conducted among six eastern districts in Oslo with high infection pressure. Sociodemographic variables included gender, age, country of birth, education, and household income. Binary logistic regression models were used to explore predictors of both vaccine hesitancy and specific reasons for hesitancy.

Results

Vaccine hesitancy was low overall (5.8%). Findings indicate that participants with younger ages, lower education, and lower household income, and those born outside of Norway were prone to vaccine hesitancy. Over half of the vaccine hesitant sample cited barriers relating to confidence in the vaccines. Women and participants born in Norway were more likely hesitant due to fear of side effects and there being little experience with the vaccines. Otherwise, complacency barriers such as not feeling that they belonged to a risk group (46.1%), not needing the vaccines (39.1%), and wanting the body to develop natural immunity (29.3%) were frequently selected by participants.

Conclusion

Different determinants of vaccine hesitancy among population groups demonstrate the need for clear public health communication about the risks, benefits, and importance of vaccines. Future studies with a larger sample should verify current findings and further explore the role of convenience barriers in health literacy and language. Health authorities should take these results into account and develop different public health strategies targeted at vulnerable population groups during the current and future pandemics to increase vaccine uptake and reach sufficient immunization.
Psychosocial factors related to sleep in adolescents and their willingness to participate in the development of a healthy sleep intervention: a focus group study
Authors: Vandendriessche Ann , Verloigne Maïté , Boets Laura , Joriskes Jolien , DeSmet Ann , Dhondt Karlien , Deforche Benedicte
Published: October 2022

Background

Over the last decades, adolescents’ sleep has deteriorated, suggesting the need for effective healthy sleep interventions. To develop such interventions, it is important to first gather insight into the possible factors related to sleep. Moreover, previous research has indicated that chances of intervention effectivity could be increased by actively involving adolescents when developing such interventions. This study examined psychosocial factors related to sleep in adolescents and investigated adolescents’ willingness to participate in the development of a healthy sleep intervention.

Methods

Nine focus group interviews were conducted with seventy-two adolescents (63.9% girls, 14.8 (± 1.0) years) using a standardized interview guide. Interviews were audio-recorded and thematic content analysis was performed using Nvivo 11.

Results

Adolescents showed limited knowledge concerning sleep guidelines, sleep hygiene and the long-term consequences of sleep deficiency, but they demonstrated adequate knowledge of the short-term consequences. Positive attitudes towards sleep were outweighed by positive attitudes towards other behaviors such as screen time. In addition, adolescents reported leisure activities, the use of smartphones and television, high amounts of schoolwork, early school start time and excessive worrying as barriers for healthy sleep. Perceived behavioral control towards changing sleep was reported to be low and norms about sufficient sleep among peers were perceived as negative. Although some adolescents indicated that parental rules provoke feelings of frustration, others indicated these have a positive influence on their sleep. Finally, adolescents emphasized that it would be important to allow students to participate in the development process of healthy sleep interventions at school, although adult supervision would be necessary.

Conclusion

Future interventions promoting healthy sleep in adolescents could focus on enhancing knowledge of sleep guidelines, sleep hygiene and the consequences of sleep deficiency, and on enhancing perceived behavioral control towards changing sleep. Interventions could also focus on prioritizing positive sleep attitudes over positive attitudes towards screen time, finding solutions for barriers towards healthy sleep and creating a positive perceived norm regarding healthy sleep. Involving adolescents in intervention development could lead to intervention components that match their specific needs and are more attractive for them.
Relationship between the expression of ARHGAP25 and RhoA in non-small cell lung cancer and vasculogenic mimicry
Authors: Shi Fan , Wu Jiatao , Jia Qianhao , Li Kairui , Li Wenjuan , Shi Yuqi , Wang Yufei , Wu Shiwu
Published: October 2022

Background

Vasculogenic mimicry (VM) is a recently identified pattern of blood supply to tumor tissue. It has long been considered a functional element in the metastasis and prognosis of malignant tumors. Both Rho GTPase-activating protein 25 (ARHGAP25) and Ras homolog family member A (RhoA) are effective predictors of tumor metastasis. In this study, we examined the expression levels of ARHGAP25 and RhoA and the structure of VM in non-small cell lung cancer (NSCLC). At the same time, we used cytology-related experiments to explore the effect of ARHGAP25 on the migration ability of tumor cells. Furthermore, we analyzed the interaction between the three factors and their association with clinicopathological characteristics and the five-year survival time in patients using statistical tools.

Methods

A total of 130 well-preserved NSCLC and associated paracancerous tumor-free tissues were obtained. Cell colony formation, wound healing, and cytoskeleton staining assays were used to analyze the effect of ARHGAP25 on the proliferation and migration ability of NSCLC cells. Immunohistochemical staining was used to determine the positivity rates of ARHGAP25, RhoA, and VM. Statistical software was used to examine the relationships between the three factors and clinical case characteristics, overall survival, and disease-free survival.

Results

Cell colony formation, wound healing, and cytoskeleton staining assays confirmed that ARHGAP25 expression affects the proliferation and migratory abilities of NSCLC cells. ARHGAP25 positivity rates in NSCLC and paracancerous tumor-free tissues were 48.5% and 63.1%, respectively, whereas RhoA positivity rates were 62.3% and 18.5%, respectively. ARHGAP25 had a negative relationship with RhoA and VM, whereas RhoA and VM had a positive relationship (P < 0.05). ARHGAP25, RhoA, and VM affected the prognosis of patients with NSCLC (P < 0.05) according to Kaplan–Meier of survival time and Cox regression analyses. Furthermore, lowering ARHGAP25 expression increased NSCLC cell proliferation and migration.

Conclusions

ARHGAP25 and RhoA expression is associated with VM and may be of potential value in predicting tumor metastasis, prognosis, and targeted therapy.
Prevalence and surgical outcomes of stage 3 and 4 pelvic organs prolapse in Jimma university medical center, south west Ethiopia
Authors: Sori Demisew Amenu , Bretones Stephan , Mellier Georges , de Rochambeau Bertrand
Published: October 2022

Background

Pelvic organ prolapse (POP) affects about half of the women and affects their quality of life. The current study is, therefore, aimed at determining the prevalence and surgical outcomes of severe stage POP at Jimma University medical center from November 2016 to May 2018.

Method

A Hospital-based cross-sectional study was conducted on all patients with stage 3 and 4 POP, who were admitted, and had surgery. Data were collected from the patient’s chart, and logbooks, which were filled up from entry till her discharge. A Simplified POPQ(S-POPQ) was used to stage the prolapse at admission, at discharge, and three months follow-ups.

Results

Among 92 patients who were analyzed, POP accounts for 10.6% of all gynecologic admissions, and 43.8% of all gynecologic surgeries. The mean age of patients is 46 (± 12) years, and nearly 34% of the patients had stage 3 and 66% had stage 4 POP. Based on the type of prolapse, 93.5% of patients had stage 3 and more anterior vaginal wall prolapse (AVWP) and apical prolapse, while 57.6% had stage 3 or more posterior vaginal wall prolapse.

Out of 72 patients who had anterior colporrhaphy, 58.7% had anterior colporrhaphy with colposuspension. Out of 83 patients who had apical suspension, 48.2%, 39.8%, and 12% had uterosacral, sacrospinous, and Richardson respectively.

Ninety-seven patients had stage 0 or 1 POP at discharge while 90% of 20 patients who returned for follow-up at three months had stage 0 or 1 POP. Eight patients had surgery-related complications; bladder injury, urinary retention, Hemorrhage during SSLF, and rectal injury.

Conclusion

The prevalence of pelvic organ prolapse is high and the majority of patients presented with advanced-stage pelvic organ prolapse, with a long duration of symptoms and associated problems. The surgical techniques used have resulted in a high immediate success rate of 97% and 90% at discharge and three months follow up respectively. Therefore, awareness creation activities are important to facilitate an early presentation for treatment to improve the quality of life and the current surgical technique; native tissue vaginal repair (NTVR), being practiced in the setup has had better success.
Advances in e-learning in undergraduate clinical medicine: a systematic review
Authors: Delungahawatta T. , Dunne S. S. , Hyde S. , Halpenny L. , McGrath D. , O’Regan A. , Dunne C. P.
Published: October 2022

Background

E-learning is recognised as a useful educational tool and is becoming more common in undergraduate medical education. This review aims to examine the scope and impact of e-learning interventions on medical student learning in clinical medicine, in order to aid medical educators when implementing e-learning strategies in programme curricula.

Methods

A systematic review compliant with PRISMA guidelines that appraises study design, setting and population, context and type of evaluations. Specific search terms were used to locate articles across nine databases: MEDLINE/PubMed, ScienceDirect, EMBASE, Cochrane Library, ERIC, Academic Search Complete, CINAHL, Scopus and Google Scholar. Only studies evaluating e-learning interventions in undergraduate clinical medical education between January 1990 and August 2021 were selected. Of the 4,829 papers identified by the search, 42 studies met the inclusion criteria.

Results

The 42 studies included varied in scope, cognitive domain, subject matter, design, quality and evaluation. The most popular approaches involved multimedia platforms (33%) and case-based approaches (26%), were interactive (83%), asynchronous (71%) and accessible from home (83%). Twelve studies (29%) evaluated usability, all of which reported positive feedback. Competence in use of technology, high motivation and an open attitude were key characteristics of successful students and preceptors.

Conclusions

Medical education is evolving consistently to accommodate rapid changes in therapies and procedures. In today’s technologically adept world, e-learning is an effective and convenient pedagogical approach for the teaching of undergraduate clinical medicine.
Assessment of life support skills of resident dentists using OSCE: cross-sectional survey
Authors: Yang Fan , Zheng Chen , Zhu Tianer , Zhang Denghui
Published: October 2022

Background

The aim of this cross-sectional survey was to apply the Objective Structured Clinical Examination (OSCE) to evaluate the cardiopulmonary resuscitation (CPR) and endotracheal intubation skills of resident dentists for stage assessment in standardized training.

Methods

A total of 146 third-year resident dentists were recruited and randomly assigned to perform either CPR or endotracheal intubation. Their performance was scored by experienced anesthesiologists with standardized scoring criteria. Participants were also asked to rated their self-assessed competence, willingness, and perceptions on training status using Likert-type scales in a questionnaire. Student’s ttest was applied to compare scores for CPR and endotracheal intubation performed by resident dentists with different characteristics. The results of the questionnaires were analyzed and visualized by the R package ‘Likert’. Significance was set at the P < 0.05 level.

Results

The mean OSCE score for endotracheal intubation (59.1 ± 12.5) was lower than that of CPR (72.4 ± 8.8). Participants with Master’s degrees scored higher than those with Bachelor’s degrees and Doctor of Philosophy (PhD) degrees in the assessment of CPR and endotracheal intubation. Low scores of self-assessed competence and willingness were observed, especially for endotracheal intubation. Resident dentists showed poor satisfaction on training volume and frequency of CPR and endotracheal intubation.

Conclusion

Resident dentists showed poor performance on CPR and endotracheal intubation assessed by the OSCE. Relatively low self-assessed competence and willingness were reported in endotracheal intubation. The medical emergency curriculum for resident dentists should be more consistent and standardized to help resident dentists enhance the proficiency of life support skills.
Multi-dimensional relationships among dementia, depression and prescribed drugs in England and Wales hospitals
Authors: Joshi Alok , Todd Stephen , Finn David P. , McClean Paula L. , Wong-Lin KongFatt
Published: October 2022

Background

 Dementia is a group of symptoms that largely affects older people. The majority of patients face behavioural and psychological symptoms (BPSD) during the course of their illness. Alzheimer’s disease (AD) and vascular dementia (VaD) are two of the most prevalent types of dementia. Available medications provide symptomatic benefits and provide relief from BPSD and associated health issues. However, it is unclear how specific dementia, antidepressant, antipsychotic, antianxiety, and mood stabiliser drugs, used in the treatment of depression and dementia subtypes are prescribed in hospital admission, during hospital stay, and at the time of discharge. To address this, we apply multi-dimensional data analytical approaches to understand drug prescribing practices within hospitals in England and Wales.

Methods

We made use of the UK National Audit of Dementia (NAD) dataset and pre-processed the dataset. We evaluated the pairwise Pearson correlation of the dataset and selected key data features which are highly correlated with dementia subtypes. After that, we selected drug prescribing behaviours (e.g. specific medications at the time of admission, during the hospital stay, and upon discharge), drugs and disorders. Then to shed light on the relations across multiple features or dimensions, we carried out multiple regression analyses, considering the number of dementia, antidepressant, antipsychotic, antianxiety, mood stabiliser, and antiepileptic/anticonvulsant drug prescriptions as dependent variables, and the prescription of other drugs, number of patients with dementia subtypes (AD/VaD), and depression as independent variables.

Results

In terms of antidepressant drugs prescribed in hospital admission, during stay and discharge, the number of sertraline and venlafaxine prescriptions were associated with the number of VaD patients whilst the number of mirtazapine prescriptions was associated with frontotemporal dementia patients. During admission, the number of lamotrigine prescriptions was associated with frontotemporal dementia patients, and with the number of valproate and dosulepin prescriptions. During discharge, the number of mirtazapine prescriptions was associated with the number of donepezil prescriptions in conjunction with frontotemporal dementia patients. Finally, the number of prescriptions of donepezil/memantine at admission, during hospital stay and at discharge exhibited positive association with AD patients.

Conclusion

Our analyses reveal a complex, multifaceted set of interactions among prescribed drug types, dementia subtypes, and depression.
Adaptation and validation of a coding algorithm for the Charlson Comorbidity Index in administrative claims data using the SNOMED CT standardized vocabulary
Authors: Fortin Stephen P. , Reps Jenna , Ryan Patrick
Published: October 2022

Objectives

The Charlson comorbidity index (CCI), the most ubiquitous comorbid risk score, predicts one-year mortality among hospitalized patients and provides a single aggregate measure of patient comorbidity. The Quan adaptation of the CCI revised the CCI coding algorithm for applications to administrative claims data using the International Classification of Diseases (ICD). The purpose of the current study is to adapt and validate a coding algorithm for the CCI using the SNOMED CT standardized vocabulary, one of the most commonly used vocabularies for data collection in healthcare databases in the U.S.

Methods

The SNOMED CT coding algorithm for the CCI was adapted through the direct translation of the Quan coding algorithms followed by manual curation by clinical experts. The performance of the SNOMED CT and Quan coding algorithms were compared in the context of a retrospective cohort study of inpatient visits occurring during the calendar years of 2013 and 2018 contained in two U.S. administrative claims databases. Differences in the CCI or frequency of individual comorbid conditions were assessed using standardized mean differences (SMD). Performance in predicting one-year mortality among hospitalized patients was measured based on the c-statistic of logistic regression models.

Results

For each database and calendar year combination, no significant differences in the CCI or frequency of individual comorbid conditions were observed between vocabularies (SMD ≤ 0.10). Specifically, the difference in CCI measured using the SNOMED CT vs. Quan coding algorithms was highest in MDCD in 2013 (3.75 vs. 3.6; SMD = 0.03) and lowest in DOD in 2018 (3.93 vs. 3.86; SMD = 0.02). Similarly, as indicated by the c-statistic, there was no evidence of a difference in the performance between coding algorithms in predicting one-year mortality (SNOMED CT vs. Quan coding algorithms, range: 0.725–0.789 vs. 0.723–0.787, respectively). A total of 700 of 5,348 (13.1%) ICD code mappings were inconsistent between coding algorithms. The most common cause of discrepant codes was multiple ICD codes mapping to a SNOMED CT code (n = 560) of which 213 were deemed clinically relevant thereby leading to information gain.

Conclusion

The current study repurposed an important tool for conducting observational research to use the SNOMED CT standardized vocabulary.
Application of information-intelligence technologies in pharmacy intravenous admixture services in a Chinese third-class a hospital
Authors: Wang Xu , Gu Ming , Gao Xueqin , Xiong Xiang , Wang Nanxi , Li Qiuqi , Ge Miaomiao , Luo Miao , Zhang Yu , Hua Xiaoli , Shi Chen
Published: October 2022

Background

Pharmacy intravenous admixture service (PIVAS) center has emerged as an important department of hospital as it can improve occupational protection and ensure the safety and effectiveness of intravenous infusions. However, medication errors were considered to be a significant challenge in PIVAS, so information-intelligence technologies were introduced to optimize the management of PIVAS. Our article summarized the application of information-intelligence technologies in PIVAS of a large third-class A hospital in China, and provided an example for PIVAS in other hospitals at home and abroad.

Methods

Prescription-reviewing rules containing intravenous medications and infusion solution guideline were recorded in the database of prescription-cheking system. Drugs information were recorded in the PIVAS management system with special identification and warning labels to reduce intravenous infusion errors. Automatic labeling device was used to label the infusion bags, and the quality control program database of intelligent compounding robot for cytotoxic drugs was established ingeniously. Automatic sorting devices were applied for the third batch of finished infusion admixtures, and intelligent logistics robots were used to transport the infusion to the ward.

Results

After establishing and implementing of prescription-reviewing rules in the prescription-cheking system database, the number of prescriptions checked by pharmacists increased from 18 to 43 per minute. The success rate of intervention with irrational medical orders increased from 85.89% to 99.06% (P < 0.05). By introducing various intelligent devices, automatic labeling significantly enhanced work efficiency and reduced the error rate (P < 0.001). Furthermore, the use of intelligent intravenous compounding robots significantly reduced the risk of errors (P < 0.001).

Conclusions

The application of information-intelligence technologies in PIVAS can improve work efficiency and reduce error risk. However, some intelligent devices have failed to achieve the expected effect in practical use, and further improvements are needed to meet the demands of PIVAS in the future.
Ensuring vaccine potency and availability: how evidence shaped Gavi's Immunization Supply Chain Strategy
Authors: Prosser Wendy , Sagar Karan , Seidel Michelle , Alva Soumya
Published: October 2022

Background

In 2014, Gavi and partners developed a global Immunization Supply Chain (iSC) Strategy, 2015–2020, which prioritized functioning cold chain equipment (CCE) and additional storage capacity. In 2016, Gavi launched the Cold Chain Equipment Optimization Platform (CCEOP) as a funding mechanism to improve CCE availability. In 2018, Gavi commissioned an evaluation of CCEOP in Guinea, Kenya and Pakistan. The global iSC Strategy has recently been revised, drawing on findings from effective vaccine management assessments and practical experiences. This case study presents the CCEOP evaluation and how its findings reinforced the revision of the iSC strategy.

Methods

The CCEOP evaluation used a prospective mixed-methods research design in all three countries involving key informant interviews at multiple levels of the health system, document reviews, direct observation (as and when possible), and a health facility assessment.

Results

Results show that CCEOP was effective at increasing the number of available and reliable CCE, and establishing improved management processes using the project management team (PMT) approach for country management systems and the service bundle provider approach for installation and maintenance. CCEOP also extended the iSC and immunization services in countries. The evaluation results also show gaps in the overall supply chain system, including CCE maintenance.

Discussion

Gavi has recently revised its iSC strategy, which has addressed gaps identified through assessments and practical experiences from stakeholders. Results of the CCEOP evaluation reinforce many of these findings. The strategy now provides more emphasis on supporting the fundamental infrastructure and establishing strong processes for maintenance. It also emphasizes strategic planning and forward thinking for iSC decisions, building on the processes established for the PMT through CCEOP. The original iSC strategy was an impetus for the establishment of CCEOP. The new strategy reflects shifting trends and priorities to fill gaps identified through practical experience, advocated for by stakeholders and thought leaders engaged in the iSC, and validated by the evaluation. It demonstrates the importance of aligning stakeholders with clear objectives and a sound strategy.
The duration of protection against clinical malaria provided by the combination of seasonal RTS,S/AS01E vaccination and seasonal malaria chemoprevention versus either intervention given alone
Authors: Cairns Matthew , Barry Amadou , Zongo Issaka , Sagara Issaka , Yerbanga Serge R. , Diarra Modibo , Zoungrana Charles , Issiaka Djibrilla , Sienou Abdoul Aziz , Tapily Amadou , Sanogo Koualy , Kaya Mahamadou , Traore Seydou , Diarra Kalifa , Yalcouye Hama , Sidibe Youssoufa , Haro Alassane , Thera Ismaila , Snell Paul , Grant Jane , Tinto Halidou , Milligan Paul , Chandramohan Daniel , Greenwood Brian , Dicko Alassane , Ouedraogo Jean Bosco
Published: October 2022

Background

A recent trial of 5920 children in Burkina Faso and Mali showed that the combination of seasonal vaccination with the RTS,S/AS01Emalaria vaccine (primary series and two seasonal boosters) and seasonal malaria chemoprevention (four monthly cycles per year) was markedly more effective than either intervention given alone in preventing clinical malaria, severe malaria, and deaths from malaria.

Methods

In order to help optimise the timing of these two interventions, trial data were reanalysed to estimate the duration of protection against clinical malaria provided by RTS,S/AS01Ewhen deployed seasonally, by comparing the group who received the combination of SMC and RTS,S/AS01Ewith the group who received SMC alone. The duration of protection from SMC was also estimated comparing the combined intervention group with the group who received RTS,S/AS01Ealone. Three methods were used: Piecewise Cox regression, Flexible parametric survival models and Smoothed Schoenfeld residuals from Cox models, stratifying on the study area and using robust standard errors to control for within-child clustering of multiple episodes.

Results

The overall protective efficacy from RTS,S/AS01Eover 6 months was at least 60% following the primary series and the two seasonal booster doses and remained at a high level over the full malaria transmission season. Beyond 6 months, protective efficacy appeared to wane more rapidly, but the uncertainty around the estimates increases due to the lower number of cases during this period (coinciding with the onset of the dry season). Protection from SMC exceeded 90% in the first 2–3 weeks post-administration after several cycles, but was not 100%, even immediately post-administration. Efficacy begins to decline from approximately day 21 and then declines more sharply after day 28, indicating the importance of preserving the delivery interval for SMC cycles at a maximum of four weeks.

Conclusions

The efficacy of both interventions was highest immediately post-administration. Understanding differences between these interventions in their peak efficacy and how rapidly efficacy declines over time will help to optimise the scheduling of SMC, malaria vaccination and the combination in areas of seasonal transmission with differing epidemiology, and using different vaccine delivery systems.

Trial registration

The RTS,S-SMC trial in which these data were collected was registered at clinicaltrials.gov: NCT03143218
Possible step-up in prevalence for Escherichia coli ST131 from fecal to clinical isolates: inferred virulence potential comparative studies within phylogenetic group B2
Authors: Kudinha Timothy , Kong Fanrong
Published: October 2022

Background

Escherichia coli sequence type (ST)131 is an important urinary tract pathogen, and is responsible for considerable healthcare-associated problems and costs worldwide. A better understanding of the factors that contribute to its rapid worldwide spread may help in arresting its continual spread. We studied a large collection of fecal and urinary E. coli ST131 and E. coli non-ST131 phylogenetic group B2 isolates, from women, men and children, in regional NSW, Australia.

Results

We found out that there was a step up in ST131 prevalence (and possibly in virulence) from fecal to clinical (urinary) isolates in general, and specifically among ciprofloxacin resistant isolates, in the 3 host groups. Furthermore, our results revealed that the inferred virulence potential of the ST131 isolates (as measured by VF gene scores) was much higher than that of non-ST131 phylogenetic group B2 isolates, and this was much more pronounced amongst the urinary isolates. This finding suggests presence of possible E. coli phylogenetic B2 subgroups with varying levels of virulence, with ST131 being much more virulent compared to others. A strong association between ST131 and fluoroquinolone (FQ) resistance was also demonstrated, suggesting that FQ use is related to ST131 emergence and spread. Specifically, about 77% of ST131 isolates from women and men, and 47% from children, were extended spectrum β- lactamase (ESBL) producers. Moreover, FQ resistant ST131 ESBL isolates on average harbored more VF genes than all other isolates.

Conclusions

The strong association between ST131 prevalence and FQ resistance amongst the studied isolates suggests that FQ use is related to ST131 emergence and spread. Furthermore, our results demonstrate that FQ resistance and a plurality of VF genes can exist together in ST131, something that has traditionally been regarded as being inversely related. This may partly contribute to the emergence and worldwide spread of ST131.
Mesoporous silica nanoparticle-encapsulated Bifidobacterium attenuates brain Aβ burden and improves olfactory dysfunction of APP/PS1 mice by nasal delivery
Authors: Liu Ni , Yang Changwen , Liang Xiaohan , Cao Kai , Xie Jun , Luo Qingming , Luo Haiming
Published: October 2022

Background

Dysbiosis or imbalance of gut microbiota in Alzheimer's disease (AD) affects the production of short-chain fatty acids (SCFAs), whereas exogenous SCFAs supplementation exacerbates brain Aβ burden in APP/PS1 mice. Bifidobacterium is the main producer of SCFAs in the gut flora, but oral administration of Bifidobacterium is ineffective due to strong acids and bile salts in the gastrointestinal tract. Therefore, regulating the levels of SCFAs in the gut is of great significance for AD treatment.

Methods

We investigated the feasibility of intranasal delivery of MSNs-Bifidobacterium (MSNs-Bi) to the gut and their effect on behavior and brain pathology in APP/PS1 mice.

Results

Mesoporous silica nanospheres (MSNs) were efficiently immobilized on the surface of Bifidobacterium. After intranasal administration, fluorescence imaging of MSNs-Bi in the abdominal cavity and gastrointestinal tract revealed that intranasally delivered MSNs-Bi could be transported through the brain to the peripheral intestine. Intranasal administration of MSNs-Bi not only inhibited intestinal inflammation and reduced brain Aβ burden but also improved olfactory sensitivity in APP/PS1 mice.

Conclusions

These findings suggested that restoring the balance of the gut microbiome contributes to ameliorating cognitive impairment in AD, and that intranasal administration of MSNs-Bi may be an effective therapeutic strategy for the prevention of AD and intestinal disease.
Whole-genome analysis of human papillomavirus 67 isolated from Japanese women with cervical lesions
Authors: Kogure Gota , Onuki Mamiko , Hirose Yusuke , Yamaguchi-Naka Mayuko , Mori Seiichiro , Iwata Takashi , Kondo Kazunari , Sekizawa Akihiko , Matsumoto Koji , Kukimoto Iwao
Published: October 2022

Background

Human papillomavirus (HPV) type 67 is phylogenetically classified intoAlphapapillomavirusspecies 9 (alpha-9) together with other carcinogenic types (HPV16, 31, 33, 35, 52 and 58), but is the only alpha-9 type defined as possibly carcinogenic. This study aimed to determine whole-genome sequences of HPV67 isolated from Japanese women with cervical cancer or cervical intraepithelial neoplasia (CIN) to better understand the genetic basis of the oncogenic potential of HPV67.

Methods

Total cellular DNA isolated from cervical exfoliated cells that were single positive for HPV67 (invasive cervical cancer, n = 2; CIN3, n = 6; CIN 2, n = 1; CIN1, n = 2; the normal cervix, n = 1) was subjected to PCR to amplify HPV67 DNA, followed by next generation sequencing to determine the complete viral genome sequences. Variant lineages/sublineages were assigned through viral whole-genome phylogenetic analysis. The transcriptional activity of the virus early promoter was assessed by luciferase reporter assays in cervical cancer cell lines.

Results

Phylogenetic analyses of HPV67 genomes from Japan (n = 12) revealed that 11 belonged to lineage A (sublineage A1, n = 9; sublineage A2, n = 2) and one belonged to lineage B. All cancer cases contained sublineage A1 variants, and one of these contained an in-frame deletion in theE2gene. The long control region of the HPV67 genome did not induce transcription from the virus early promoter in HeLa cells, but showed weak transcriptional activity in CaSki cells.

Conclusions

The single detection of HPV67 in cervical cancer and precancer specimens strongly suggests the carcinogenic potential of this rare genotype. The phylogenetic analysis indicates a predominance of lineage A variants among HPV67 infections in Japan. Since only 23 complete genome sequences of HPV67 had been obtained until now, the newly determined genome sequences in this study are expected to contribute to further functional and evolutionary studies on the genetic diversity of HPV67.