bluuebunny/crossref_metadata_2025 huggingface dataset:
Association Between Platelet Indices and Preoperative Deep Vein Thrombosis in Elderly Patients Undergoing Total Joint Arthroplasty: A Retrospective Study
Authors: Xiong Xiaojuan , Li Ting , Yu Shuang , Cheng Bo
Published: January 2023

To investigate the association between platelet (PLT) indices and preoperative deep vein thrombosis (DVT) in elderly patients undergoing total joint arthroplasty (TJA). A total of 1391 patients were enrolled. We created receiver operator characteristic (ROC) curve using the ratio of PLT indices to DVT before TJA, divided the enrolled patients into groups based on the cut-off value, and then analyzed risk factors for DVT before TJA in the multivariate binary logistic regression analysis. Preoperative DVT occurred in 103 cases. Based on the ROC curve, we determined that the cut-off values for PLT, mean platelet volume (MPV), platelet distribution width (PDW), platelet large cell ratio (P-LCR), and plateletcrit (PCT) were 202 × 109/L, 11.4 fL, 13.2 fL, 34.6%, and 0.228%. And the areas under the curve were 0.606, 0.605, 0.617, 0.616, and 0.598. Multivariate binary regression analysis revealed that the risk of preoperative DVT in TJA patients with PLT≥202 × 109/L, MPV≤11.4 fL, PDW≤13.2 fL, P-LCR≤34.6%, and PCT≥0.228% increased by 2.32 ( P < .001, 95% confidence interval [CI] [1.50-3.60]), 1.86 ( P < .001, 95% CI [1.22-2.83]), 2.17 ( P < .001, 95% CI [1.43-3.31]), 2.27 ( P < .001, 95% CI [1.50-3.45]), and 1.76 times ( P = .013, 95% CI [1.13-2.76]), respectively. Age, P < .001, odds ratio (OR) = 1.08, 95% CI [1.04-1.11]; corticosteroid use, P = .011, OR = 3.66, 95% CI [1.34-9.96]. We found that increased PLT count and PCT, decreased MPV, PDW, and P-LCR, old age, and corticosteroid use were independent risk factors for preoperative DVT in elderly TJA patients.
Perinatal Health Profiles Associated With Removal From the Home and Subsequent Child Protective Services Report in Maltreated Infants
Authors: Buek Katharine W. , Mandell Dorothy J.
Published: January 2023

Infants face the highest risk of abuse and neglect nationally. There is a compelling need to understand the individual risk factors and needs of families of maltreated infants so that prevention efforts can be tailored for optimal effectiveness. Using linked birth certificate and CPS records data, we employed latent class analysis to identify distinct profiles of perinatal health factors associated with infant maltreatment. Classes were then regressed onto two key child welfare outcomes—removal from the home and re-report. Results indicated 10 latent classes primarily associated with supervisory neglect and presumed prenatal substance exposure. Rapid repeat pregnancy, smoking during pregnancy and inadequate prenatal care emerged as key risk factors. Presumed substance exposure was associated with high risk of removal from the home and low risk of re-report. The opposite was found for supervisory neglect. Substantial variation existed across classes and types of maltreatment, suggesting a need for tailored prevention strategies.
Biomimetic torene shells
Authors: Bazmara Maziyar , Sauer Roger A , Agrawal Ashutosh
Published: January 2023

The genome inside the eukaryotic cells is guarded by a unique shell structure, called the nuclear envelope (NE), made of lipid membranes. This structure has an ultra torus topology with thousands of torus-shaped holes that imparts the structure a high flexural stiffness. Inspired from this biological design, here we present a novel “torene” architecture to design lightweight shell structures with ultra-stiffness for engineering applications. We perform finite element analyses on classic benchmark problems to investigate the mechanics of torene shells. This study reveals that the torene shells can achieve one order of magnitude or higher flexural stiffness than traditional shells with the same amount of material. This novel geometric strategy opens new avenues to exploit additive manufacturing to design lightweight shell structures for extreme mechanical environments.
Exercise-Induced Ischemia after Successful Percutaneous Coronary Intervention is Related to Distal Coronary Endothelial Dysfunction
Authors: Monnink Stefan H. J. , Tio Rene A. , Veeger Nic J. G. M. , Amoroso Giovanni , van Boven Ad J. , van Gilst Wiek H.
Published: January 2023

Background

As endothelial dysfunction can be responsible for myocardial ischemia even in the absence of significant coronary lesions, we aimed to assess the correlation between endothelium-dependent vasomotor function and inducible ischemia late after successful coronary angioplasty.

Methods

In 30 patients without angiographic restenosis or coronary disease progression, coronary endothelial function was determined by acetylcholine infusion 6 months after elective single-vessel stenting of the left coronary artery. Acetylcholine-induced diameter changes were assessed in the proximal and distal segments of both the stented and the contralateral vessels by means of quantitative coronary angiography. A maximal workload ergometric test was also performed prior to endothelial function testing.

Results

Acetylcholine induced significant vasoconstrictive responses in the distal but not in the proximal segments of both the stented (-11 ± 7% versus baseline; p < .01) and the contralateral vessels (-11 ± 6%; p < .01), which were significantly correlated ( R = .48; p < .05) and were completely reverted by nitroglycerine. Inducible ischemia was the only predictive factor for distal vasoconstriction in the stented vessel ( p < .01) but not in the contralateral vessel (p = .06). Patients with minor signs of ischemia at the ergometric test showed a greater vasoconstriction than those with a completely normal test (-16 ± 7% versus -7 ± 6%; p < .01).

Conclusions

Exercise-induced ischemia late after successful percutaneous coronary intervention is related to distal coronary endothelial dysfunction.
Angiotensin-Converting Enzyme Genotype in Blacks with Diabetic Nephropathy: Effects on Risk of Diabetes and Its Complications
Authors: Crook Errol D. , Genous Lori , Oliver Bonnie
Published: January 2023

Objective

Among blacks, we have observed that diabetic nephropathy (DN) is a more frequent primary cause of end-stage renal disease (ESRD) in women (∼ 50%) than in men (< 20%). In this study, we consider the role of the angiotensin-converting enzyme (ACE) polymorphism in determining this gender discrepancy and its role in the course of DN.

Methods

ACE genotype (I = insertion, D = deletion) was determined in consecutive consenting patients with type 2 diabetes mellitus and DN. Charts were subsequently reviewed for renal survival and its determinants (end point: time to ESRD from first clinic visit).

Results

Fifty-four patients (46 blacks) who had DN and were pre-ESRD consented: II = 6, ID = 31, and DD = 17. The allele frequency for D was ∼. 61 versus .39 for the I allele and did not differ by gender. Renal disease at presentation to the renal clinic was significantly worse in II. Twenty-one patients reached ESRD (II = 4, ID = 13, DD = 4; χ2 not significant), but ACE genotype had no significant effect on renal survival. Initial serum creatinine and blood pressure over follow-up independently predicted renal survival. Among blacks reaching ESRD, the presence of the D allele was associated with higher blood pressures. Patients without a family history of diabetes (χ2, p = .01) or diabetic retinopathy (χ2, p = .02) were more likely to have the DD genotype.

Conclusions

The gender discrepancy observed in rates of ESRD owing to DN in blacks is not likely dependent on ACE genotype. The effects of ACE genotype on renal disease progression were not significant; however, patients with diabetic nephropathy and DD genotype were less likely to have traditional risk factors for diabetes or diabetic nephropathy.
Oxidative Stress in Nonalcoholic Fatty Liver Disease: Pathogenesis and Antioxidant Therapies
Authors: Gawrieh Samer , Opara Emmanuel C. , Koch Timothy R.
Published: January 2023

Nonalcoholic fatty liver disease is a common cause of chronic liver disease, a common finding on liver biopsy in those patients with abnormal blood transaminase levels, and a common cause of cryptogenic cirrhosis in the United States. The prevalence of this disorder is expected to rise with the increase in obesity, and the clinical spectrum can range from simple steatosis (fatty liver) to cirrhosis of the liver. Insulin resistance is thought to be pivotal for the development of steatosis, and oxidative stress may be a potential factor that can promote hepatic necroinflammation and fibrosis. Preliminary studies have examined the role of oxidative stress and antioxidants in animal and human studies of this disorder. Efforts to improve the hepatic antioxidant system could be achieved by optimizing the patient's diet, by supplementation with precursors for antioxidants, or by supplementation with essential metals and/or antioxidants. Randomized, controlled trials are required to examine these potential approaches using patients with this disorder.
Corneal stem cells niche and homeostasis impacts in regenerative medicine; concise review
Authors: Tavakkoli Fatemeh , Eleiwa Taher K , Elhusseiny Abdelrahman M , Damala Mukesh , Rai Amit K , Cheraqpour Kasra , Ansari Mohammad H , Doroudian Mohammad , H Keshel Saeed , Soleimani Mohammad , Djalilian Ali R , Sangwan Virender S , Singh Vivek
Published: January 2023

The limbal stem cells niche (LSCN) is an optimal microenvironment that provides the limbal epithelial stem cells (LESCs) and strictly regulates their proliferation and differentiation. Disturbing the LSCN homeostasis can lead to limbal stem cell dysfunction (LSCD) and subsequent ocular surface aberrations, such as corneal stromal inflammation, persistent epithelial defects, corneal neovascularisation, lymphangiogenesis, corneal opacification, and conjunctivalization. As ocular surface disorders are considered the second main cause of blindness, it becomes crucial to explore different therapeutic strategies for restoring the functions of the LSCN. A major limitation of corneal transplantation is the current shortage of donor tissue to meet the requirements worldwide. In this context, it becomes mandatory to find an alternative regenerative medicine, such as using cultured limbal epithelial/stromal stem cells, inducing the production of corneal like cells by using other sources of stem cells, and using tissue engineering methods aiming to produce the three-dimensional (3D) printed cornea. Limbal epithelial stem cells have been considered the magic potion for eye treatment. Epithelial and stromal stem cells in the limbal niche hold the responsibility of replenishing the corneal epithelium. These stem cells are being used for transplantation to maintain corneal epithelial integrity and ultimately sustain optimal vision. In this review, we summarised the characteristics of the LSCN and their current and future roles in restoring corneal homeostasis in eyes with LSCD.
Development and validation of a new reduced diesel/natural gas mechanism under engine-relevant conditions
Authors: Zhou Song , Zhou Weijian , Xi Hongyuan , Shreka Majed , Zhang Zhao
Published: January 2023

A simplified mechanism of diesel/natural gas blend was developed for a dual fuel engine built from a previously reported detailed mechanism of a n-dodecane and natural gas. In the model, n-dodecane was selected as the representative substance of diesel and the mixture of methane, ethane and propane was selected as the representative substance of natural gas. The simplified mechanism was obtained by using the direct relation graph, the directed relation graph with error propagation, and the sensitivity analysis simplification method. On this basis, a simplified n-dodecane-natural gas mechanism with 141 species and 739 reactions was established. In addition, the experimental data and detailed mechanism are used to compare with the n-dodecane-natural gas dual fuel simplified mechanism established in this paper, and have been widely verified in 0-D and 1-D combustion systems for the first time, including ignition delay time, laminar flame velocity, premixed flame species, HCCI combustion, which verify the rationality of the new simplified mechanism. Then the mechanism is coupled to CFD software to simulate the spray combustion of constant volume spray under engine like conditions. The results show that the mechanism has high reliability and can be coupled with CFD.
Needs of Children With Incarcerated Parents in Their Own Voice
Authors: Navrátilová Jitka , Navrátil Pavel , Punová Monika , Smutná Veronika
Published: January 2023

Even though Czech social policy cites child protection as one of its main priorities, there continue to be groups of children whose needs remain unnoticed. As many as forty thousand Czech children with at least one incarcerated parent have failed to gain public attention, find no support in the national legislative framework, and are only slowly attracting the attention of helping professionals. Guided by our research question—“What are the needs of children whose parent leaves the household due to incarceration?”—we describe the individual needs of children of incarcerated parents in their own voices through phenomenological optics. These needs, recorded via individual interviews and focus groups, contextualized using the theoretical methodology of the capability approach, which serves as the framework for assessing the relationship between the stated needs of these children and their overall well-being.
A lightweight deep learning network based on knowledge distillation for applications of efficient crack segmentation on embedded devices
Authors: Chen Jun , Liu Ye , Hou Jia-ao
Published: January 2023

Timely crack detection of pavement helps inspectors access road conditions and determine the maintenance strategy, which can reduce repair costs and safety risks. Deep learning has greatly advanced the development of automated crack detection, but there are still challenges that hinder the application of crack segmentation networks in engineering practice such as the bloated models, the class imbalance problem, and the high-performance device dependency. For efficient crack segmentation tasks, this paper proposes a novel high-performance lightweight network termed multi-path convolution feature fusion lightweight network (MCFF-L Net) and utilize the concept of knowledge distillation. The MCFF-L Net with only 1.18 M parameters achieves F1 score of 85.70% and intersection over union (IoU) of 78.22%, which surpasses the popular heavyweight networks and lightweight networks. The proposed network is further implemented on an embedded device of Jetson Xavier NX and the detection speed of pavement cracks can reach 9.71 frames per second (FPS). The combination of embedded device and proposed lightweight networks is suitable for application scenarios where the portable and efficient crack segmentation is needed and the reliable data transmission through network is not accessible.
Promising Clinical Applications of Hydrogels Associated With Precise Cancer Treatment: A Review
Authors: Wang Qian-qian , Tan Chang , Qin Geng , Yao Shu-kun
Published: January 2023

Gastrointestinal cancer is one of the most malignant tumors with high morbidity and mortality, especially colorectal cancer, which has become the second leading cause of cancer-related deaths worldwide. Targeted drug treatment and precise endoscopic resection can significantly improve the overall survival rate and greatly extend the life span. Promising biomedical applications of hydrogels would represent hopeful therapeutic alternatives for patients with different kinds of diseases, particularly providing precise therapy for cancer patients. Although the intersection field of material science and biomedical science has made tremendous advances, major challenges remain. In this review, the application of hydrogel-based technology in cancer precision medicine is the focus of attention, which is the development trend of multidisciplinary cooperation in the future. First, we provide the current clinical landscape of hydrogel applications, and then we highlight precision oncology, including personalized drug treatment and accurate endoscopic intervention. Finally, we discuss major challenges for their clinical translation that have not yet been overcome and future perspectives on cancer precision medicine.
Role of Traditional Chinese Medicine Syndrome Type, Gut Microbiome, and Host Immunity in Predicting Early and Advanced Stage Colorectal Cancer
Authors: Yan Yunzi , Yang Yufei , Ning Chunhui , Wu Na , Yan Shaohua , Sun Lingyun
Published: January 2023

Objective:

To investigate the role of Traditional Chinese Medicine (TCM) syndrome type, gut microbiome distribution, and host immunity function in predicting the early and advanced clinical stages of colorectal cancer (CRC).

Methods:

A cross-sectional case-control study was performed which included 48 early stage and 48 advanced patients with CRC enrolled from March 2018 to December 2020. 16S rRNA gene sequencing was performed to analyze the gut microbiomes of the patients, while T and B lymphocyte subsets in peripheral blood were assessed using flow cytometry. TCM syndrome type was measured using the spleen deficiency syndrome (SDS) scale.

Results:

The abundance levels of Prevotella, Escherichia-Shigella, and Faecalibacterium in the gut microbiota were significantly increased in the advanced group, while Bacteroides was significantly decreased. Phascolarctobacterium was detectable only in the early metaphase group, whereas Alistipes was detectable only in the advanced group. The lymphocyte ( P = .006), T helper cell (TH) ( P = .002), cytotoxic T cell (TC) ( P = .003), double positive T cell (DPT) ( P = .02), and total T counts ( P = .001) were significantly higher in the early metaphase group than in the advanced metaphase group. Compared with patients with early stage CRC, the advanced group had a higher SDS score. After adjusting for clinical stage, Spearman’s correlation analysis showed interactions among gut microbiome abundance, T cell level, and SDS score. Multivariate logistic analysis showed that after controlling for the SDS score, abundance of Alistipes and Faecalibacterium, and double negative T cell (DNT) level, DPT was significantly associated with a lower risk of advanced-stage disease (hazard ratio, 0.918; P = .022).

Conclusion:

Our study suggested associations between clinical stage, SDS, gut microbiota, and T lymphocytes, which provided insights for a potential prediction model for the disease progression of CRC.
The Medium and the Message in Argentina's Presidential Campaigns
Authors: Pallister Kevin , Fitzpatrick Erin
Published: January 2023

Do campaigns message to voters consistently across different media? And do competing candidates tend to converge over time on a single national style of campaign messaging? To address these questions, this article employs novel data from a content analysis of campaign spots and candidate tweets from the 2015 and 2019 presidential elections in Argentina. We find that the policy orientation of candidate messaging is similar across different media, with spots and tweets addressing specific issues in similar proportions. We also find that, consistent with the theory of success contagion, campaign messaging across candidates and election cycles varies along a wide range of variables as candidates have failed to converge on a similar campaigning style. Contrary to expectations drawn from prior research, we find that candidate tweets contain policy content and attacks on opponents just as often as do campaign spots.
Construction of a pancreatic cancer nerve invasion system using brain and pancreatic cancer organoids
Authors: Song Chenyun , Chen Xinyu , Ma Jixin , Buhe Hada , Liu Yang , Saiyin Hexige , Ma Lixiang
Published: January 2023

Pancreatic cancer (PC) is a fatal malignancy in the human abdominal cavity that prefers to invade the surrounding nerve/nerve plexus and even the spine, causing devastating and unbearable pain. The limitation of available in vitro models restricts revealing the molecular mechanism of pain and screening pain-relieving strategies to improve the quality of life of end-stage PC patients. Here, we report a PC nerve invasion model that merged human brain organoids (hBrO) with mouse PC organoids (mPCO). After merging hBrOs with mPCOs, we monitored the structural crosstalk, growth patterns, and mutual interaction dynamics of hBrO with mPCOs for 7 days. After 7 days, we also analyzed the pathophysiological statuses, including proliferation, apoptosis and inflammation. The results showed that mPCOs tend to approximate and intrude into the hBrOs, merge entirely into the hBrOs, and induce the retraction/shrinking of neuronal projections that protrude from the margin of the hBrOs. The approximating of mPCOs to hBrOs accelerated the proliferation of neuronal progenitor cells, intensified the apoptosis of neurons in the hBrOs, and increased the expression of inflammatory molecules in hBrOs, including NLRP3, IL-8, and IL-1β. Our system pathophysiologically replicated the nerve invasions in mouse GEMM (genetically engineered mouse model) primary and human PCs and might have the potential to be applied to reveal the molecular mechanism of nerve invasion and screen therapeutic strategies in PCs.
Psychotherapists’ perspective of the use of eHealth services to enhance positive mental health promotion
Authors: Seow Lee Seng Esmond , Chang Sherilyn , Sambasivam Rajeswari , Subramaniam Mythily , Lu Sharon Huixian , Assudani Hanita , Tan Chern-Yee Geoffrey , Vaingankar Janhavi Ajit
Published: January 2023

Objective

Keyes’s two-continua model of mental health proposes that mental illness and positive mental health are two separate, correlated, unipolar dimensions. eHealth services have been used to deliver mental health care, though the focus remained largely on symptom reduction and management of negative aspects of mental health. The potential of eHealth services to promote positive mental well-being, however, has not been tapped sufficiently. The present study aims to explore psychotherapists’ perspective on the feasibility of eHealth services to enhance positive mental health promotion.

Methods

Seven focus group discussions were conducted among professionals ( n = 38) who delivered psychotherapy to examine positive mental health in their practice. Responses related to the use of e-psychotherapy to promote mental well-being were extracted for use in a secondary analysis of data in this study. Thematic analysis of data via inductive approach was conducted to allow emergence of common themes.

Results

Three main themes related to psychotherapists’ perspective on the feasibility of eHealth intervention in enhancing positive mental health were identified: (1) use of eHealth to educate and improve positive mental health; (2) concerns on incorporating psychotherapy into online services; (3) other factors that affect uptake or effectiveness of eHealth intervention for positive mental health.

Conclusions

The study generally found support among psychotherapists for the feasibility of eHealth intervention in promoting positive mental health among clients. Potential difficulties in implementation and practicality concerns were discussed.
Assessment of Spiritual Care Practices Among Nurses Caring for Cancer Patients in a Tertiary Hospital in Nigeria
Authors: Bolarinwa Falilat Idowu , Esan Deborah Tolulope , Bolarinwa Oladimeji Akeem
Published: January 2023

Introduction

The importance of spirituality in health and wellness has been documented in the literature. While the developed countries have reported robust evidence of spirituality in nursing practices, there is scant evidence in low- and middle-income countries like Nigeria.

Objectives

This study assessed the spiritual care practices of the nurses attending to cancer patients in a tertiary health institution in Ilorin. It further determined factors associated with spiritual caring practices among nurses.

Methods

A descriptive cross-sectional study was conducted between November 2021 and December 2021 to assess spiritual care practices among nurses caring for cancer patients. During the study period, 66 nurses were recruited randomly from the hospital's medical and surgical clinics, palliative care department, and Obstetrics and Gynecology department. Twelve items validated Nurses’ spiritual care practices questionnaire was adapted for this study. Data were analyzed using IBM SPSS version 23.

Results

The mean age of the respondents was 36.5 years ( + 10.1) while female respondents made up 83.3%. About 48% of the nurses had good spiritual caring practices while 52% had poor spiritual caring practices. Nurses with training in oncology (96%) with p = .001 and those with spirituality training (86.2%) with p = .017 showed significant association with spiritual care practices. This study concluded that spiritual care practices among nurses are sub-optimal with training as a significantly associated factor with spiritual care practices.

Conclusion

It is, therefore, suggested that spiritual care practices should be incorporated into all nursing training and curriculum. This will allow them to better support the spiritual needs of the patients, especially those with chronic diseases like cancer.
Reconciling UES, GEP and NCP in Chinese cities
Authors: Yang Jun
Published: January 2023

China is developing a new strategy to achieve harmony between nature and economic growth. In order to ensure the conformity of policies and actions in this new strategy, Chinese cities need tools to evaluate the change in nature and its contribution to human well-being. The rapid development of theories and methodologies in the valuation of nature provides many options. The potential of three frameworks — urban ecosystem services, nature’s contribution to people, and gross ecosystem products — for meeting Chinese cities’ needs was analyzed through a comprehensive literature review. The results show that the gross ecosystem products framework actively brings nature’s values into Chinese cities’ political agenda. The urban ecosystem services framework has been extensively used in scientific studies, while the nature’s contribution to people framework is gradually gaining researchers’ attention. The three frameworks complement each other due to their unique strengths in the social context of Chinese cities. Based on those discoveries, I recommend that Chinese cities adopt the three frameworks simultaneously to assess urban ecosystems and their contributions to residents’ well-being. To achieve this goal, I call for more studies to address the theoretical and methodological barriers to integrating the three frameworks.
Antenatal gut microbiome profiles and effect on pregnancy outcome in HIV infected and HIV uninfected women in a resource limited setting
Authors: Chandiwana Panashe , Munjoma Privilege Tendai , Mazhandu Arthur John , Li Jiaqi , Baertschi Isabel , Wyss Jacqueline , Jordi Sebastian Bruno Ulrich , Mazengera Lovemore Ronald , Yilmaz Bahtiyar , Misselwitz Benjamin , Duri Kerina
Published: January 2023

Background

Human immunodeficiency virus (HIV) severely damages the epithelial cells of the gut lining leading to an inflamed leaky gut, translocation of microbial products, and dysbiosis resulting in systemic immune activation. Also, microbiota composition and maternal gut function can be altered in pregnancy through changes in the immune system and intestinal physiology. The aim of this study was to investigate the gut microbiota in HIV-infected and HIV-uninfected pregnant women and to compare and identify the association between gut microbial composition and adverse birth outcomes.

Results

A total of 94 pregnant women (35 HIV-infected and 59 HIV-uninfected controls) were recruited in Harare from 4 polyclinics serving populations with relatively poor socioeconomic status. Women were of a median age of 28 years (interquartile range, IQR: 22.3–32.0) and 55% of women were 35 weeks gestational age at enrolment (median 35.0 weeks, IQR: 32.5–37.2). Microbiota profiling in these participants showed that species richness was significantly lower in the HIV-infected pregnant women compared to their HIV-uninfected peers and significant differences in β-diversity using Bray–Curtis dissimilarity were observed. In contrast, there was no significant difference in α-diversity between immune-compromised (CD4+  < 350 cells/µL) and immune-competent HIV-infected women (CD4+  ≥ 350 cells/µL) even after stratification by viral load suppression. HIV infection was significantly associated with a reduced abundance of Clostridium, Turicibacter, Ruminococcus, Parabacteroides, Bacteroides, Bifidobacterium, Treponema, Oscillospira, and Faecalibacterium and a higher abundance of Actinomyces, and Succinivibrio. Low infant birth weight (< 2500 g) was significantly associated with high abundances of the phylum Spirochaetes, the families Spirochaeteceae, Veillonellaceae, and the genus Treponema.

Conclusion

The results reported here show that the species richness and taxonomy composition of the gut microbiota is altered in HIV-infected pregnant women, possibly reflecting intestinal dysbiosis. Some of these taxa were also associated with low infant birth weight.
Comparative activities of ampicillin and teicoplanin against Enterococcus faecalis isolates
Authors: Zacharopoulos Georgios V. , Manios Georgios A. , Papadakis Marios , Koumaki Dimitra , Maraki Sofia , Kassotakis Dimitrios , De Bree Eelco , Manios Andreas
Published: January 2023

Background

Enterococcus faecalis remains one of the most common pathogens causing infection in surgical patients. Our goal was to evaluate the antibiotic resistance of E. faecalis, causing infections in a surgical clinic, against two antibacterial drugs, ampicillin and teicoplanin. One commonly administered in the past for such infections, ampicillin, and another newer, teicoplanin, which demonstrated exceptionally good efficacy.

Methods

Data from 1882 isolates were retrieved from the microbiology department database during two 5-year periods. Standard biochemical methods were employed for the identification of the isolates. The prevalence of E. faecalis among patients with clinical evidence of infection in a surgical oncology ward was assessed. Confidence interval (CI) as well as standard error (SE) were calculated. Moreover, the annual incidence of E. faecalis infections in this surgical ward was recorded. The susceptibility of E. faecalis to ampicillin and teicoplanin was studied and compared using Fisher’s exact test.

Results and conclusion

Results showed that the incidence of E. faecalis infections in the surgical clinic was increasing. Ampicillin, in the later year period, was not statistically different from teicoplanin in treating E. faecalis infections. Consequently, ampicillin seems currently to be an effective antibiotic against such infections that could be used as empiric therapy.
The relationship between the modified frailty index score (mFI-5), malnutrition, body composition, systemic inflammation and short-term clinical outcomes in patients undergoing surgery for colorectal cancer
Authors: McGovern Josh , Grayston Alexander , Coates Dominic , Leadbitter Stephen , Hounat Adam , Horgan Paul G. , Dolan Ross D. , McMillan Donald C
Published: January 2023

Background

While the current literature suggests an association with frailty and clinical outcomes in patients undergoing surgery for colorectal cancer (CRC), the basis of this relationship is unclear.

Aim

Examine the relationship between frailty, malnutrition, body composition, systemic inflammation and short-term clinical outcomes in patients undergoing surgery for colorectal cancer.

Methods

Consecutive patients who underwent potentially curative resection for colorectal cancer, between April 2008 and April 2018, were identified from a prospectively maintained database. Frailty was defined using the modified five-item frailty index (mFI-5). Body composition measures included CT-derived skeletal muscle index (SMI) and density (SMD). Systemic inflammatory status was determined using Systemic Inflammatory Grade (SIG). Outcomes of interest were the incidence of post-operative complications and thirty-day mortality. Associations between categorical variables were examined using χ2 test and binary logistics regression analysis.

Results

1002 patients met the inclusion criteria. 28% (n = 221) scored 2 or more on the mFI-5. 39% (n = 388) of patients had a post-operative complication (Clavien-Dindo I-IV) and 1% (n = 11) died within thirty days of surgery. On univariate analysis, mFI-5 frailty score, was significantly associated with advanced age (p < 0.001), colonic tumours (p < 0.001), reduced use of neo-adjuvant chemotherapy (p < 0.05), higher BMI (p < 0.05), low SMD (p < 0.001), elevated NLR (p < 0.05), elevated mGPS (p < 0.05), elevated SIG (p < 0.05), incidence of post-operative complications (p < 0.001) and thirty-day mortality (p < 0.05). On multivariate analysis, male sex (p < 0.05), elevated SIG (p < 0.05) and mFI-5 score (p < 0.01) remained significantly associated with the incidence of post-operative complications. mFI-5 frailty was found to remain significantly associated with the incidence post-operative complications in patients who were SIG 0 (p < 0.05).

Conclusion

mFI-5 frailty score was found to be significantly associated with age, systemic inflammation and post-operative outcomes in patients undergoing potentially curative resections for CRC. Incorporation of an assessment of systemic inflammatory status in future frailty screening tools may improve their prognostic value.
COVID arm as a common cutaneous manifestation after mRNA-1273 vaccination: a systematic review
Authors: Agustin Maulidina , Trifitriana Monica , Danarti Retno
Published: January 2023

Background

By August 2022, CoronaVirus Disease-2019 (COVID-19) had caused 600 million illnesses and 6.5 million fatalities globally. A massive vaccination program is being implemented worldwide to suppress this condition. Several works of literature stated that mRNA COVID-19 vaccination, specifically with the mRNA-1273 vaccine, is followed by clear evidence of the COVID arm effects associated with this vaccine.

Objective

To analyze the latest evidence of COVID arm as a common effect of mRNA-1273 vaccination with the ultimate goal of improving vaccine counseling to help healthcare professionals and reassure patients.

Methods

A comprehensive search was performed on topics that assess the COVID arm as a cutaneous manifestation following mRNA-1273 vaccination from inception up until July 2022.

Results

Eighteen studies with a total of 1129 participants after the first and second dose of mRNA-1273 vaccination reported that most participants had COVID arm following the first dose administration. The characteristics of the patients were a mean age of 43.8 years old, and females represented ≥ 50% in most studies, with a mean onset of 6.9 days after the first dose administration. Symptoms resolved within seven days following the treatment and were harmless.

Conclusions

This study found that the COVID arm condition is most common following the first mRNA-1273 vaccination in the female and middle-aged group. The correlation between demographic variables and COVID arm risk elucidates that the reaction is a type IV allergic skin reaction.
The anti-estrogen receptor drug, tamoxifen, is selectively Lethal to P-glycoprotein-expressing Multidrug resistant tumor cells
Authors: Bakadlag Rowa , Limniatis Georgia , Georges Gabriel , Georges Elias
Published: January 2023

Background

P-glycoprotein (P-gp), a member of the ATP Binding Cassette B1 subfamily (ABCB1), confers resistance to clinically relevant anticancer drugs and targeted chemotherapeutics. However, paradoxically P-glycoprotein overexpressing drug resistant cells are “collaterally sensitive” to non-toxic drugs that stimulate its ATPase activity.

Methods

Cell viability assays were used to determine the effect of low concentrations of tamoxifen on the proliferation of multidrug resistant cells (CHORC5 and MDA-Doxo400), expressing P-gp, their parental cell lines (AuxB1 and MDA-MB-231) or P-gp-CRISPR knockout clones of AuxB1 and CHORC5 cells. Western blot analysis was used to estimate P-gp expression in different cell lines. Apoptosis of tamoxifen-induced cell death was estimated by flow cytometry using Annexin-V-FITC stained cells. Oxidative stress of tamoxifen treated cells was determined by measuring levels of reactive oxygen species and reduced thiols using cell-permeant 2',7'-dichlorodihydrofluorescein diacetate (H2DCFDA) and 5,5-dithio-bis-(2-nitrobenzoic acid) DTNB, respectively.

Results

In this report, we show that P-gp-expressing drug resistant cells (CHORC5 and MDA-Doxo400) are collaterally sensitive to the anti-estrogen tamoxifen or its metabolite (4-hydroxy-tamoxifen). Moreover, P-gp-knockout clones of CHORC5 cells display complete reversal of collateral sensitivity to tamoxifen. Drug resistant cells exposed to low concentrations of tamoxifen show significant rise in reactive oxygen species, drop of reduced cellular thiols and increased apoptosis. Consistent with the latter, CHORC5 cells expressing high levels of human Bcl-2 (CHORC5-Bcl-2) show significant resistance to tamoxifen. In addition, the presence of the antioxidant N-acetylcysteine or P-gp ATPase inhibitor, PSC-833, reverse the collateral sensitivity of resistant cells to tamoxifen. By contrast, the presence of rotenone (specific inhibitor of mitochondria complex I) synergizes with tamoxifen.

Conclusion

This study demonstrates the use of tamoxifen as collateral sensitivity drug that can preferentially target multidrug resistant cells expressing P-gp at clinically achievable concentrations. Given the widespread use of tamoxifen in the treatment of estrogen receptor-positive breast cancers, this property of tamoxifen may have clinical applications in treatment of P-gp-positive drug resistant breast tumors.

Graphical Abstract
Predictors of surgery choices in women with early-stage breast cancer in China: a retrospective study
Authors: Huang Sijia , Yang Qingmo , Zheng Xujuan , Chow Ka Ming , Wu Junhua , Zhu Jiemin
Published: January 2023

Background

The breast-conserving surgery and reconstruction rate in China is relatively low when compared with those in Western countries. Moreover, predictors of surgical choices for women with breast cancer in China have not yet been explored. This study aims to explore differences in the surgical choices of women with different demographic and clinical characteristics and the predictors that influence surgical choices of women with early-stage breast cancer.

Methods

This retrospective study included women with early-stage (0-II) breast cancer who underwent surgeries at one of two Xiamen University-affiliated hospitals between 2009 and 2017. Using medical records, eleven variables were collected: the woman's age, year of diagnosis, hospital, marital status, payment method, cancer stage, presence of positive axillary lymph node, histology, neoadjuvant chemotherapy, radiotherapy, and the type(s) of surgery they chose. Binary logistic regression was used to analyse predictors of surgical choice.

Results

A total of 1,787 cases were included in this study. Of the total number of women with breast cancer, 61.3% underwent mastectomy without breast reconstruction, 26.4% underwent mastectomy with breast reconstruction, and the remaining 12.2% chose breast-conserving surgery. Women with different demographic and clinical characteristics underwent different types of surgery. Cancer stage, neoadjuvant chemotherapy, radiotherapy, and the choice of hospital were found to be predictors of breast-conserving surgery. Meanwhile, age, year of diagnosis, payment method, neoadjuvant chemotherapy, and the choice of hospital were found to be predictors of reconstruction after mastectomy in women with early-stage breast cancer.

Conclusions

In China, surgical choices for women with breast cancer have diversified. Healthcare workers should understand the surgical preferences of women of different ages. For early detection of breast cancer, knowledge of breast self-examination and breast cancer screening should be provided. Adequate information about the safety of reconstruction and advocacy for medical insurance coverage of reconstruction should be offer. Breast surgeons need specialised training and standardising protocols towards different types of breast surgery. These actions will help women make better, well-informed decisions about their breast surgeries.
Delivering the Thinking Healthy Programme as a universal group intervention integrated into routine antenatal care: a randomized-controlled pilot study
Authors: Boran Perran , Dönmez Melike , Barış Ezgi , Us Mahmut Caner , Altaş Zeynep Meva , Nisar Anum , Atif Najia , Sikander Siham , Hıdıroğlu Seyhan , Save Dilşad , Rahman Atif
Published: January 2023

Background

Women with perinatal depression and their children are at increased risk of poor health outcomes. There is a need to implement non-stigmatizing interventions into existing health systems which reduce psychosocial distress during pregnancy and prevent perinatal depression. We adapted the WHO-endorsed Thinking Healthy Programme (THP) to be delivered universally to all women attending routine online pregnancy schools in Istanbul, Turkey. This study aimed to evaluate the feasibility and acceptability of this intervention.

Methods

This mixed-methods study incorporated a two-arm pilot randomized controlled trial and qualitative evaluation of the feasibility and acceptability of the adapted THP – Brief Group version (THP-BGV) to a range of stakeholders. We recruited pregnant women at 12-30 weeks’ gestation through pregnancy schools within the University Hospital’s catchment area. Women in the intervention arm received five online sessions of the THP-BGV delivered by antenatal nurses. The intervention employed principles of cognitive behaviour therapy to provide psychoeducation, behaviour activation, problem-solving strategies and group support to participants. In the control arm, women received usual care consisting of routine online educational pregnancy classes aided by the antenatal nurses. The women were assessed for depressive symptoms with the Edinburgh Postnatal Depression Scale at baseline and 4-6 weeks post-intervention and also evaluated for anxiety, perceived social support, partner relationship, level of disability and sleep quality. In-depth interviews were conducted with women and other key stakeholders.

Results

Of the 99 consecutive women referred to the pregnancy schools, 91 (91.9%) were eligible and 88 (88.8%) consented to participate in the study and were randomized. Eighty-two (83%) completed the final assessments. Our main findings were that this preventive group intervention was feasible to be integrated into routine antenatal educational classes and it was valued by the women and delivery-agents. While the study was not powered to detect differences between intervention and control conditions, we found small trends towards reduction in anxiety and depressive symptoms favoring the intervention arm. No serious adverse events were reported.

Conclusions

Given the paucity of preventive interventions for perinatal depression in low and middle-income countries, a fully powered definitive randomized controlled trial of this feasible and acceptable intervention should be conducted.

Trial registration

The study was registered at Clinical Trails.gov (NCT04819711) (Registration Date: 29/03/2021).
Caregiving: a risk factor of poor health and depression among informal caregivers in India- A comparative analysis
Authors: Chakraborty Ruchira , Jana Arjun , Vibhute Viraj Mahesh
Published: January 2023

Abstract

Background

In an ageing society, the provision of long-term care is the prime need. In Indian cultural setting, family members are the informal, albeit primary caregivers to the elderly. Caregiving demands intense emotional and financial involvement. While taking care of elderly persons’ health and wellbeing, these family members, acting as informal caregivers, may themselves become vulnerable to poor health due to additional stress and burden. Using a nationally representative survey, the study tried to identify how health condition varies within caregivers and a comparative analysis of how in similar socio-economic background health condition varies between caregivers and non-caregivers.

Method

The data, used for the analysis, is taken from Longitudinal Ageing Study in India (LASI), Wave I. Both descriptive and multivariable regression analysis are done in different models along with interaction effect of caregiving to understand the difference in health status between caregiver and non-caregivers.

Results

Nearly 29% and 11% of the informal caregivers, reported to have depressive symptoms and poor self-rated health (SRH), respectively. Almost half of the caregivers, who provide care for more than 40 h a week, are diagnosed to have depressive symptoms. They are also at higher risk of having depressive symptoms (AOR 1.59 CI 1.16–2.18) and poor SRH (AOR 1.73 CI 1.11–2.69) than those who invest less than 40 h in a week. In almost every socio-economic condition, caregivers are at a higher risk of having depression and poor health than non-caregivers. Caregivers, who are widowed, live in rural areas or are not satisfied with current living arrangement are more vulnerable to have depressive symptoms. On the other hand, caregivers of age 45–59 years, widowed, male and who live only with their children with spouse absent, have almost 2 times higher odds of poor SRH than non-caregivers.

Conclusion

Caregivers are more susceptible to depression and poor self-rated health compared to non-caregivers irrespective of their socio-economic characteristics, only the magnitude of vulnerability varies.
Urodynamic changes before and after endoscopic valve ablation in boys diagnosed with the posterior urethral valve without chronic renal failure
Authors: Mo Zhiqiang , Li Minglei , Xie Xianghui , Sun Ning , Zhang Weiping , Tian Jun , Song Hongcheng
Published: January 2023

Introduction

Current research on the posterior urethral valve (PUV) mainly focuses on the follow-up of bladder function after valve ablation. However, few studies exist on the changes in bladder function before and after valve ablation.

Objectives

To investigate the urodynamic changes before and after PUV ablation and determine the effect of operation on bladder function, in patients.

Materials and methods

The clinical records of 38 boys diagnosed with PUV and undergone urodynamic exams before and after valve ablation were retrospectively reviewed. In addition, differences in patients’ radiographic studies and urodynamic characteristics between pre- and post-operation were evaluated. Moreover, the urodynamic data was compared using the paired t-test and all the data was expressed as means ± SEM. Additionally, p values less than 0.05 were considered to be statistically significant.

Results

All the patients were diagnosed with PUV and the follow-up period after operation ranged between 9 and 114 months. The urodynamic exams were performed about 6 months after operation. The results revealed that bladder compliance improved from 8.49 ± 4.73 to 13.31 ± 6.78 ml/cmH2O while the maximum detrusor pressure decreased from 95.18 ± 37.59 to 50.71 ± 21.71 cmH2O, after valve ablation. Additionally, there were significant differences in the pre- and post-operation values of bladder compliance and maximum detrusor pressure (p < 0.05). However, there were no significant differences in the pre- and post-operation values with regard to the residual urine volume, maximum bladder volume and maximum urinary flow rate (p > 0.05).

Conclusions

The adequacy of the COPUM incision is necessary. But the study showed that endoscopic valve ablation couldn’t by itself completely improve the bladder function of patients diagnosed with PUV. However, it was able to improve bladder compliance and decrease maximum detrusor pressure to a certain extent. However, bladder compliance still couldn’t reach the normal level.