bluuebunny/crossref_metadata_2025 huggingface dataset:
Using the R = MC2 heuristic to understand barriers to and facilitators of implementing school-based physical activity opportunities: a qualitative study
Authors: Craig Derek W. , Walker Timothy J. , Cuccaro Paula , Sharma Shreela V. , Heredia Natalia I. , Robertson Michael C. , Fernandez Maria E.
Published: January 2024

Background

Schools are a key setting for supporting youth physical activity, given their broad reach and diverse student populations. Organizational readiness is a precursor to the successful implementation of school-based physical activity opportunities. The R = MC2 heuristic (Readiness = Motivation x Innovation-Specific Capacity x General Capacity) describes readiness as a function of an organization’s motivation and capacity to implement an innovation and can be applied to better understand the implementation process. The purpose of this study was to explore the barriers to and facilitators of implementing school-based physical activity opportunities in the context of organizational readiness.

Methods

We analyzed interview data from 15 elementary school staff (principals, assistant principals, physical education teachers, and classroom teachers) from a school district in Texas. We focused on factors related to adopting, implementing, and sustaining a variety of school-based physical activity opportunities. We used the Framework Method to guide the analysis and coded data using deductive (informed by the R = MC2 heuristic) and inductive approaches. Themes were generated using the frequency, depth, and richness of participant responses.

Results

Four themes emerged from the data: (1) implementation is aided by the presence of internal and external relationships; (2) physical activity opportunities compete with other school priorities; (3) seeing the benefits of physical activity opportunities motivates school staff toward implementation; and (4) staff buy-in is critical to the implementation process. Themes 1–3 aligned with subcomponents of the R = MC2 heuristic (intra- and inter-organizational relationships, priority, and observability), whereas Theme 4 (staff buy-in) related to multiple subcomponents within the Motivation component but was ultimately viewed as a distinct construct.

Conclusion

Our results highlight and explain how key readiness constructs impact the implementation of school-based physical activity opportunities. They also highlight the importance of obtaining staff buy-in when implementing in the school setting. This information is critical to developing readiness-building strategies that help schools improve their capacity to deliver physical activity opportunities effectively.

Trial registration

Not applicable.
Clinical profile analysis and nomogram for predicting in-hospital mortality among elderly severe community-acquired pneumonia patients: a retrospective cohort study
Authors: Wei Chang , Wang Xinyu , He Dingxiu , Huang Dong , Zhao Yue’an , Wang Xinyuan , Liang Zong’an , Gong Linjing
Published: January 2024

Background

Severe community-acquired pneumonia is one of the most lethal forms of CAP with high mortality. For rapid and accurate decisions, we developed a mortality prediction model specifically tailored for elderly SCAP patients.

Methods

The retrospective study included 2365 elderly patients. To construct and validate the nomogram, we randomly divided the patients into training and testing cohorts in a 70% versus 30% ratio. The primary outcome was in-hospital mortality. Univariate and multivariate logistic regression analyses were used in the training cohort to identify independent risk factors. The robustness of this model was assessed using the C index, ROC and AUC. DCA was employed to evaluate the predictive accuracy of the model.

Results

Six factors were used as independent risk factors for in-hospital mortality to construct the prediction model, including age, the use of vasopressor, chronic renal disease, neutrophil, platelet, and BUN. The C index was 0.743 (95% CI 0.719–0.768) in the training cohort and 0.731 (95% CI 0.694–0.768) in the testing cohort. The ROC curves and AUC for the training cohort and testing cohort (AUC = 0.742 vs. 0.728) indicated a robust discrimination. And the calibration plots showed a consistency between the prediction model probabilities and observed probabilities. Then, the DCA demonstrated great clinical practicality.

Conclusions

The nomogram incorporated six risk factors, including age, the use of vasopressor, chronic renal disease, neutrophil, platelet and BUN, which had great predictive accuracy and robustness, while also demonstrating clinical practicality at ICU admission.
Effects of Curcumin on the treatment of oral lichen planus symptoms: a systematic review and meta-analysis study
Authors: Moayeri Hanie , Rajabi Abdolhalim , Mohammadi Masoud , Moghaddam Sudabeh Bagheri
Published: January 2024

Background and objectives

Oral lichen planus (OLP) is a relatively common chronic T-cell–mediated disease that can cause significant pain, particularly in its erosive or ulcerative forms. This study aimed to examine the therapeutic impact of curcumin on symptoms of OLP.

Materials and methods

This meta-analysis was performed according to the PRISMA guidelines. All related English documents indexed in electronic databases (including PubMed, Web of Science, Scopus, Embase, Wiley, Cochrane, and ProQuest databases [updated to August 15, 2023]) were retrieved. Data were double-extracted into a predefined worksheet, and quality analysis was performed using the Joanna Briggs Institute (JBI) scale. We carried out meta-analyses, and the random effects model was used to estimate the differences in erythema, lesion size, and pain between the curcumin control groups.

Results

The search identified 289 studies, of which 10 were found to meet the inclusion criteria. The overall findings of the meta-analysis revealed that curcumin did not have a significant effect on erythema of OLP (standardized mean difference [SMD] = -0.14; 95% CI, -0.68 to 0.40; P = 0.61; I2 = 57.50%), lesion size of OLP (SMD = -0.15; 95% CI, -0.45 to 0.15; P = 0.33; I2 = 28.42%), and pain of OLP (SMD = -0.38; 95% CI, -0.97 to 0.22; P = 0.22; I2 = 86.60%). However, subgroup analysis based on treatment duration indicated that 2-week treatment duration was significantly associated with a reduction in OLP pain (n = 3; SMD = -1.21; 95% CI, -2.19 to -0.23; P = 0.01).

Conclusions

Curcumin had no significant effect on erythema, lesion size, and pain of OLP compared to the control groups. However, subgroup analysis revealed that curcumin was more effective in reducing pain in non-randomized trials and in trials with a treatment duration of 2 weeks.
A systematic scoping review of medicine availability and affordability in Africa
Authors: Lane Jeff , Nakambale Hilma , Kadakia Asha , Dambisya Yoswa , Stergachis Andy , Odoch Walter Denis
Published: January 2024

Background

The most recent World Medicines Situation Report published in 2011 found substantial medicine availability and affordability challenges across WHO regions, including Africa. Since publication of the 2011 report, medicine availability and affordability has risen on the international agenda and was included in the Sustainable Development Goals as Target 3.8. While numerous medicine availability and affordability studies have been conducted in Africa since the last World Medicines Situation Report, there has not been a systematic analysis of the methods used in these studies, measures of medicine availability and affordability, categories of medicines studied, or geographic distribution. Filling this knowledge gap can help inform future medicine availability and affordability studies, design systems to monitor progress toward Sustainable Development Goal Target 3.8 in Africa and beyond, and inform policy and program decisions to improve medicine availability and affordability.

Methods

We conducted a systematic scoping review of studies assessing medicine availability or affordability conducted in the WHO Africa region published from 2009–2021.

Results

Two hundred forty one articles met our eligibility criteria. 88% of the articles (213/241) reported descriptive studies, while 12% (28/241) reported interventional studies. Of the 198 studies measuring medicine availability, the most commonly used measure of medicine availability was whether a medicine was in stock on the date of a survey (124/198, 63%). We also identified multiple other availability methods and measures, including retrospective stock record reviews and self-reported medicine availability surveys. Of the 59 articles that included affordability measures, 32 (54%) compared the price of the medicine to the daily wage of the lowest paid government worker. Other affordability measures were patient self-reported affordability, capacity to pay measures, and comparing medicines prices with a population-level income standard (such as minimum wage, poverty line, or per capita income). The most commonly studied medicines were antiparasitic and anti-bacterial medicines. We did not identify studies in 22 out of 48 (46%) countries in the WHO Africa Region and more than half of the studies identified were conducted in Ethiopia, Kenya, Tanzania, and/or Uganda.

Conclusion

Our results revealed a wide range of medicine availability and affordability assessment methodologies and measures, including cross-sectional facility surveys, population surveys, and retrospective data analyses. Our review also indicated a need for greater focus on medicines for certain non-communicable diseases, greater geographic diversity of studies, and the need for more intervention studies to identify approaches to improve access to medicines in the region.
Does integration with national registers improve the data completeness of local COVID-19 contact tracing tools? A register-based study in Norway, May 2020 - September 2021
Authors: Meijerink Hinta , Shelil Mohamed , Jani-Bølstad Jagrati , Dvergsdal Evy Therese , Madslien Elisabeth Henie , Wilberg Madeleine , Gundersen Ragnhild Bassøe , Sæbø Johan Ivar , Thorseng Anne Asmyr , Iversen Bjørn Gunnar
Published: January 2024

Background

During the COVID-19 response in Norway, many municipalities used the Fiks contact tracing tool (FiksCT) to register positive individuals and follow-up contacts. This tool is based on DHIS2, an open source, web-based platform. In this study we examined if data completeness in FiksCT improved after integration with national registers between May 2020 and September 2021.

Methods

Data from municipalities using FiksCT was extracted from the Norwegian Emergency Preparedness Register for COVID-19 (Beredt C19). We linked FiksCT data to the Norwegian Surveillance System for Communicable Diseases (MSIS), the National Population Register (FREG), and the Norwegian Vaccine Registry (SYSVAK) using unique identification numbers (ID). Completeness for each variable linked with a national register was calculated before and after integration with these registers.

Results

Of the 125 municipalities using FiksCT, 87 (69.6%) agreed to share and upload their data to Beredt C19. Data completeness for positive individuals improved after integration with national registers. After integration with FREG, the proportion of missing values decreased from 12.5 to 1.6% for ID, from 4.5 to 0.9% for sex, and from 1.2 to 0.4% for date of birth. Missing values for vaccine type decreased from 63.0 to 15.2% and 39.3–36.7% for first and second dose, respectively. In addition, direct reporting from FiksCT to MSIS increased the proportion of complete records in MSIS (on the selected variables) from 68.6% before to 77.0% after integration.

Conclusion

The completeness of local contact tracing data can be improved by enabling integration with established national registers. In addition, providing the option to submit local data to the national registers could ease workload and reduce the need to collect duplicate data.
Nine dietary habits and risk of colorectal cancer: a Mendelian randomization study
Authors: He Mengyang , Huan Luyao , Wang Xuan , Fan Yingyi , Huang Jinchang
Published: January 2024

Background

Epidemiological studies have provided evidence that there is an association between diet and colorectal cancer. However, the causal relationship between dietary habits and colorectal cancer remains unknown.

Methods

The UK Biobank provided summary-level genome-wide association study data for nine dietary habits, including alcohol consumption (n = 549,703), instant coffee consumption (n = 250,308), fruit consumption (n = 210,947), meat consumption (n = 210,947), full cream milk consumption (n = 41,306), sweets consumption (n = 25,521), tea consumption (n = 501,494), vegetable consumption (n = 210,947), and yogurt/ice cream consumption (n = 210,947). Additionally, data on colorectal cancer were collected, consisting of 5,567 cases and 372,016 controls. The MR analysis employed inverse variance weighted, weighted median, MR-Egger regression, and MR multivariate residuals tests.

Results

In the predominantly European population, a positive association was observed between vegetables (OR = 1.014, 95% CI = 1.000-1.029, p = 0.048) and an increased risk of colorectal cancer. The results for vegetable did not survive correction for multiple comparisons. However, no strong evidence was found for other dietary factors, such as alcohol (OR = 1.012, 95% CI = 0.974–1.051, p = 0.556), fruit (OR = 1.007, 95% CI = 0.986–1.029, p = 0.512), meat (OR = 1.000, 95% CI = 0.987–1.026, p = 0.968), full cream milk (OR = 1.019, 95% CI = 0.979–1.061, p = 0.357), sweets (OR = 0.998, 95% CI = 0.991–1.004, p = 0.524), and tea (OR = 1.002, 95% CI = 0.994–1.009, p = 0.672), with regards to colorectal cancer risk in the European population.

Conclusions

Our study highlights the need for a more nuanced approach to dietary recommendations for CRC prevention, with greater emphasis adherence to the Mediterranean dietary pattern.
Engineered EVs with pathogen proteins: promising vaccine alternatives to LNP-mRNA vaccines
Authors: Zhang Bin , Sim Wei Kian , Shen Tang-Long , Lim Sai Kiang
Published: January 2024

Extracellular vesicles (EVs) are tiny, lipid membrane-bound structures that are released by most cells. They play a vital role in facilitating intercellular communication by delivering bioactive cargoes to recipient cells and triggering cellular as well as biological responses. EVs have enormous potential for therapeutic applications as native or engineered exosomes. Native EVs are naturally released by cells without undergoing any modifications to either the exosomes or the cells that secrete them. In contrast, engineered EVs have been deliberately modified post-secretion or through genetic engineering of the secreting cells to alter their composition. Here we propose that engineered EVs displaying pathogen proteins could serve as promising alternatives to lipid nanoparticle (LNP)-mRNA vaccines. By leveraging their unique characteristics, these engineered EVs have the potential to overcome certain limitations associated with LNP-mRNA vaccines.
Bioproduction and optimization of newly characterized melanin pigment from Streptomyces djakartensis NSS-3 with its anticancer, antimicrobial, and radioprotective properties
Authors: El-Zawawy Nessma A. , Kenawy El-Refaie , Ahmed Sara , El-Sapagh Shimaa
Published: January 2024

Background

Melanin is a natural pigment that is considered a promising biomaterial for numerous biotechnological applications across several industries. Melanin has biomedical applications as antimicrobial, anticancer, and antioxidant properties. Additionally, in the pharmaceutical and cosmetic industries, it is used in drug delivery and as a radioprotective agent. Also, melanin has environmental uses in the fields of bioremediation and the food industry. The biosynthesis of melanin pigment is an area of interest for researchers due to its multifunctionality, high compatibility, and biodegradability. Therefore, our present work is the first attempt to characterize and optimize the productivity of melanin pigment from Streptomyces djakartensis NSS-3 concerning its radioprotection and biological properties.

Results

Forty isolates of soil actinobacteria were isolated from the Wadi Allaqui Biosphere Reserve, Egypt. Only one isolate, ACT3, produced a dark brown melanin pigment extracellularly. This isolate was identified according to phenotypic properties and molecular phylogenetic analysis as Streptomyces djakartensis NSS-3 with accession number OP912881. Plackett–Burman experimental design (PBD) and response surface methodology (RSM) using a Box-Behnken design (BBD) were performed for optimum medium and culturing conditions for maximum pigment production, resulting in a 4.19-fold improvement in melanin production (118.73 mg/10 mL). The extracted melanin pigment was purified and characterized as belonging to nitrogen-free pyomelanin based on ultraviolet–visible spectrophotometry (UV–VIS), Fourier transform infrared (FT-IR), Raman spectroscopy, scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDX), and NMR studies. Purified melanin demonstrated potent scavenging activity with IC50 values of 18.03 µg/mL and revealed high potency as sunscreens (in vitro SPF = 18.5). Moreover, it showed a nontoxic effect on a normal cell line (WI38), while it had a concentration-dependent anticancer effect on HCT116, HEPG, and MCF7 cell lines with IC50 = 108.9, 43.83, and 81.99 µg/mL, respectively. Also, purified melanin had a detrimental effect on the tested MDR bacterial strains, of which PA-09 and SA-04 were clearly more susceptible to melanin compared with other strains with MICs of 6.25 and 25 µg/mL, respectively.

Conclusion

Our results demonstrated that the newly characterized pyomelanin from Streptomyces djakartensis NSS-3 has valuable biological properties due to its potential photoprotective, antioxidant, anticancer, antimicrobial, and lack of cytotoxic activities, which open up new prospects for using this natural melanin pigment in various biotechnological applications and avoiding chemical-based drugs.
USP29 activation mediated by FUBP1 promotes AURKB stability and oncogenic functions in gastric cancer
Authors: Tu Rongfu , Kang Ye , Pan Yiwen , Da Yanyan , Ren Doudou , Zhang Ru , Cai Zeqiong , Liu Yijia , Xu Jiao , Ma Junpeng , Zhou Zhiyong , Yin Shupeng , Li Xiaozhuang , Zhang Peng , Zhang Qi , Wang Jingchao , Lu Xinlan , Zhang Chengsheng
Published: January 2024

Background

Gastric cancer is a highly prevalent cancer type and the underlying molecular mechanisms are not fully understood. Ubiquitin-specific peptidase (USP) 29 has been suggested to regulate cell fate in several types of cancer, but its potential role in gastric carcinogenesis remains unclear.

Methods

The expression of USP29 in normal and gastric cancer tissues was analyzed by bioinformatics analysis, immunohistochemistry and immunoblot. Gene overexpression, CRISPR-Cas9 technology, RNAi, andUsp29knockout mice were used to investigate the roles of USP29 in cell culture, xenograft, and benzo[a]pyrene (BaP)-induced gastric carcinogenesis models. We then delineated the underlying mechanisms using mass spectrometry, co-immunoprecipitation (Co-IP), immunoblot, ubiquitination assay, chromatin immunoprecipitation (ChIP), quantitative real-time PCR (qRT-PCR), and luciferase assays.

Results

In this study, we found that USP29 expression was significantly upregulated in gastric cancers and associated with poor patient survival. Ectopic expression of USP29 promoted, while depletion suppressed the tumor growth in vitro and in vivo mouse model. Mechanistically, transcription factor far upstream element binding protein 1 (FUBP1) directly activates USP29 gene transcription, which then interacts with and stabilizes aurora kinase B (AURKB) by suppressing K48-linked polyubiquitination, constituting a FUBP1-USP29-AURKB regulatory axis that medicates the oncogenic role of USP29. Importantly, systemic knockout ofUsp29in mice not only significantly decreased the BaP-induced carcinogenesis but also suppressed the Aurkb level in forestomach tissues.

Conclusions

These findings uncovered a novel FUBP1-USP29-AURKB regulatory axis that may play important roles in gastric carcinogenesis and tumor progression, and suggested that USP29 may become a promising drug target for cancer therapy.
Recent advances in the potential role of RNA N4-acetylcytidine in cancer progression
Authors: Zhang Shujun , Liu Yafeng , Ma Xiao , Gao Xiaohui , Ru Yi , Hu Xinjun , Gu Xinyu
Published: January 2024

N4-acetylcytidine (ac4C) is a highly conserved chemical modification widely found in eukaryotic and prokaryotic RNA, such as tRNA, rRNA, and mRNA. This modification is significantly associated with various human diseases, especially cancer, and its formation depends on the catalytic activity of N-acetyltransferase 10 (NAT10), the only known protein that produces ac4C. This review discusses the detection techniques and regulatory mechanisms of ac4C and summarizes ac4C correlation with tumor occurrence, development, prognosis, and drug therapy. It also comments on a new biomarker for early tumor diagnosis and prognosis prediction and a new target for tumor therapy.
Shih-Tzu dogs show alterations in ocular surface homeostasis despite adequate aqueous tear production
Authors: Vitor Rebeca Costa , de Carvalho Teixeira Jamille Bispo , dos Santos Katharine Costa , Oliveira Gabriela Mota Sena de , Guedes Paula Elisa Brandão , da Paixão Sevá Anaiá , Gomes Junior Deusdete Conceição , Veloso Jéssica Fontes , Carlos Renata Santiago Alberto
Published: January 2024

Background

Shih-Tzu dogs are frequently affected by ocular surface disorders such as corneal ulceration and dry eye disease (DED). The aim of this study was to evaluate ocular surface homeostasis in Shih-Tzu dogs that have adequate aqueous production. Twenty-eight dogs were subjected to eyelid blink counting, Schirmer tear test (STT-1), ophthalmic evaluation, tear film break-up time (TBUT), fluorescein test and Masmali tear ferning (TF) grading scale.

Results

Of the 28 animals evaluated, the median value of incomplete eyelid blinks/min (median = 15.0 blinks/min; Interquartil interval - IQR = 8.7 blinks/min − 19.5 blinks/min) was higher than the complete blinks/min (median = 2.5 blinks/min; IQR = 1.6 blinks/min − 4.3 blinks/min), with statistically significant difference. The Schirmer tear test had a median value of 25.0 mm/min (IQR = 22.7 mm/min − 27.5 mm/min), considered within the normal range for the species. On ophthalmic examination, all dogs had trichiasis of the caruncle and medial lower eyelid entropion. Lagophthalmos was the third most common alteration observed (71.4%; 20/28). The median of TBUT was 4.0 s; (IQR = 3.0 – 6.0 s). All the animals were negative to the fluorescein test and the TFT indicated that the majority of the eyes (51.8%; 29/56) were classified in abnormal grades 3 and 4 according to the Masmali tear ferning (TF) grading scale.

Conclusions

Although the Shith-Tzu dogs had STT-1 values within the normal range for the species there was high prevalence of abnormal TFT grades and low TBUT in all dogs, showing that despite adequate aqueous production, these dogs have poor precorneal tear film quality. In addition, the dogs showed few complete eyelid blinks and ophthalmic alterations, promoting poor tear film diffusion. All these findings, isolated or together, can result in DED.
Application of bacteria and bacteriophage cocktails for biological control of houseflies
Authors: Zhang Kexin , Wang Shumin , Li Ying , Yin Yansong , Zhang Xinyu , Zhang Qian , Kong Xinxin , Liu Wenjuan , Yao Dawei , Zhang Ruiling , Zhang Zhong
Published: January 2024

Background

Houseflies, Musca domestica L., are an ubiquitous pest that can transmit numerous diseases and threaten human health. Increasing insecticide resistance shown by houseflies necessitates the develop new control alternatives. The housefly gut is densely colonized with microorganisms that interact with each other dynamically and benefit the host’s health. However, the impact of multiple symbiotic bacteria on the composition of housefly gut microbiota and the host’s activities remains unclear.

Methods

We isolated and cultured 12 bacterial species from the intestines of housefly larvae. We also isolated seven bacteriophages to precisely target the regulation of certain bacterial species. Using 16S rRNA high-throughput gene sequencing, we analyzed the bacterial diversity after orally administering bacteria/phage cocktails to houseflies.

Results

Our results showed that larval growth was promoted, the abundance of beneficial bacteria, such as Klebsiella and Enterobacter, was increased and the abundance of harmful bacteria, such as Providencia, Morganella and Pseudomonas, was decreased in housefly larvae fed with the beneficial bacteria cocktail. However, oral administration of both beneficial and harmful bacterial phage cocktails inhibited larval growth, probably due to the drastic alteration of gut flora. Untargeted metabolomics using liquid chromatography–mass spectrometry showed that disturbances in gut microbiota changed the larval metabolite profiles. Feeding experiments revealed that disrupting the intestinal flora suppressed the beneficial bacteria and increased the harmful bacteria, causing changes in the metabolites and inhibiting larval growth.

Conclusions

Based on our results, bacteria/phage cocktails are effective tools for regulating the intestinal flora of insects and have a high potential as a biological control agent for incorporation into an integrated pest management program.

Graphical abstract
CXCL9 may serve as a potential biomarker for primary Sjögren’s syndrome with extra-glandular manifestations
Authors: Hong Jingwei , Cheng Hui , Wang Ping , Wu Yanzhi , Lu Saisai , Zhou Yan , Wang Xiao bing , Zhu Xiaofang
Published: January 2024

Background

Primary Sjögren's syndrome (pSS) is an autoimmune condition that causes harm to exocrine glands and also has extra-glandular manifestations (EGM). pSS patients with EGM have a worse prognosis than those with only sicca symptoms. Previous studies have shown that the minor salivary glands (MSG) of pSS patients exhibit a unique profile of cytokines and chemokines compared to healthy controls. However, there is a lack of research comparing pSS with EGM (pSS-EGM) and pSS without EGM (pSS-non-EGM). This study aims to explore potential biomarkers associated with pSS, particularly pSS with EGM.

Methods

By utilizing RNA sequencing, we conducted an analysis on the gene expression profiles of MSG in 63 patients diagnosed with pSS, as well as 12 non-pSS individuals. Furthermore, we also investigated the MSG of pSS patients, both with and without EGM. Through bioinformatics analysis, we identified genes with differential expression (DEGs) and determined the core hub genes using PPI network. We then analyzed the top 20 DEGs and their correlation with the patients' clinical characteristics, and validated our findings using peripheral blood plasma.

Results

A total of 725 differentially expressed genes (DEGs) were identified in the comparison between pSS and non-pSS groups, and 727 DEGs were observed between pSS-EGM and pSS-non-EGM. It is noteworthy that the expression levels of CXCL9 were higher in both pSS patients and pSS-EGM when compared to the control group. Taking into consideration the significance of the top 20 DEGs in relation to clinical parameters and the central hub genes, we ultimately chose CXCL9. In comparison to the non-pSS group, pSS patients exhibited notably greater expression of the CXCL9 gene in the MSG, as well as higher levels of CXCL9 protein in their plasma (p < 0.001). Furthermore, the expression of the CXCL9 gene and levels of CXCL9 protein were notably higher in pSS patients accompanied by EGM and those with SSA antibodies. Additionally, a correlation was found between the expression of the CXCL9 gene and the EULAR Sjogren’s Syndrome Disease Activity Index (ESSDAI), as well as with immunoglobulin G (IgG) levels and erythrocyte sedimentation rate (ESR). Meanwhile, the protein levels of CXCL9 were found to be correlated with IgG levels and ESSDAI.

Conclusion

CXCL9 proves to be a valuable biomarker in pSS, specifically due to its strong ability to differentiate between pSS patients with EGM and those without EGM. There is a significant correlation between CXCL9 and various clinical parameters both at the gene and protein level. Therefore, CXCL9 could be a potential target for future treatment of pSS.
Liver indicators affecting the relationship between BMI and hypertension in type 2 diabetes: a mediation analysis
Authors: Yao Xuelin , Hu Keyan , Wang Zhen , Lu Fangting , Zhang Jie , Miao Yahu , Feng Qing , Jiang Tian , Zhang Yi , Tang Songtao , Zhang Nan , Dai Fang , Hu Honglin , Zhang Qiu ,   the China National Diabetic Chronic Complications Study Group
Published: January 2024

Background

Body mass index (BMI) is an important risk factor for hypertension in diabetic patients. However, the underlying mechanisms remain poorly understood. Although liver-derived biological intermediates may play irreplaceable roles in the pathophysiology of diabetes, few studies have explored them in the association between BMI and hypertension in diabetes.

Objective

To investigate the role of liver enzymes in mediating the relationship between BIM exposure and hypertension in type 2 diabetes mellitus (T2DM).

Methods

We included a total of 1765 participants from the China National Diabetic Chronic Complications Study Cohort. Associations between liver enzymes and hypertension were estimated using multivariable regression models. The function of liver indicators in the relationship between BMI and hypertension was assessed using mediation analysis. Mediation analysis was conducted, taking into account age, diabetes duration, current smoking, fasting plasma glucose level, glycated hemoglobin, anti-diabetic therapy, and family history of diseases, including diabetes, hypertension, obesity, and hyperlipidemia.

Results

For men, the association of BMI with hypertension was partially mediated by alanine aminotransferase (ALT), with a proportion of mediation was 68.67%, by aspartate aminotransferase (AST) was 27.02%, and by γ-glutamyltransferase (GGT) was 38.58%, by AST/ALT was 63.35%; for women, the proportion mediated by ALT was 36.93%, and by AST was 37.47%, and GGT was 44.60%, and AST/ALT was 43.73% for BMI (all P < 0.05).

Conclusion

The effect of BMI on hypertension is partly mediated by liver indicators (ALT, AST, GGT, and AST/ALT) in diabetic patients. Our results may provide opportunities to identify new targets for hypertension interventions.
Difference in composition and functional analysis of bacterial communities between Mytilus galloprovincialis gills and surrounding water in a brackish inshore bay, analyzed by 16S rDNA multi-amplicon sequencing
Authors: Zardinoni Giulia , Deb Saptarathi , Ravi Samathmika , Giagnoni Lucia , Fumelli Piergiorgio , Tondello Alessandra , Dacasto Mauro , Squartini Andrea , Spanu Carlo , Trocino Angela , Stevanato Piergiorgio
Published: January 2024

Background

Lagoons are important natural systems, with attractive favorable conditions for aquaculture production, such as shellfish cultivation. Despite their socio-economic relevance for human activity, information on the microbial diversity, community composition, and putative functions of gill-associated microbiota and seawater is still limited, particularly as regards the extent of specific taxa enrichment within the gills and the relative effects of the temporal and spatial variables. In this study, we used a 16S rDNA multi-amplicon sequencing approach using an Ion GeneStudio S5 System and a function prediction method (Functional Annotation of Prokaryotic Taxa (FAPROTAX), to inspect the springtime dynamics of microbial communities and their inferred metabolic features in an Adriatic lagoon (Po Delta, Italy).

Results

Mussels and surrounding seawater were sampled in two rearing areas three times between April and June 2021. Sequencing results showed significant (p ≤ 0.05) differences in bacterial community composition and diversity between gills and seawater. Gills were dominated by the Methylobacterium-Methylorubrum and Burkholderia-Caballeronia-Paraburkholderia genera, while in seawater samples Izamaplasma, Planktomarina, and Candidatus Aquiluna were detected as being dominant. The microbiota composition did not differ significantly between the two rearing areas. The sampling time, although limited to a 3-month timeframe, instead revealed a structural variation of the bacterial profile both in gills and seawater for alpha and beta diversities respectively. The functional prediction analysis highlighted an overexpression of human gut-associated bacteria in relation to the season-related increase in seawater temperature.

Conclusions

These findings enhance our understanding of the differences between gill-associated and seawater microbiota composition and provide novel insights into the functions carried out by bacteria inhabiting these niches, as well as on the key host-symbiont relationships of bivalves in lagoon environments.
Inborn errors of immunity in adulthood
Authors: Wang Joanne J. F. , Dhir Arün , Hildebrand Kyla J. , Turvey Stuart E. , Schellenberg Robert , Chen Luke Y. C. , Pourshahnazari Persia , Biggs Catherine M.
Published: January 2024

Inborn errors of immunity (IEIs) are a group of conditions whereby parts of the immune system are missing or dysfunctional. Once thought to primarily be a pediatric disorder, it is now estimated that more than 50% of worldwide incident IEI cases are accounted for by adults. Delayed diagnosis, late symptom onset, and IEI phenocopies can all lead to adult-onset recognition of IEIs. Lack of awareness regarding the diversity of IEI manifestations in adults contributes to diagnostic and treatment delays. Prompt referral to immunology is critical so that patients can receive a precise molecular diagnosis and targeted therapy when available. This article serves as a primer on IEIs in adulthood, highlighting the pathophysiology, epidemiology and clinical features. We present clinical vignettes of three key IEIs to assist clinicians in building illness scripts on their presentations. We provide a framework for the laboratory evaluation of IEIs and their initial treatment, with the aim of improving recognition and management of these conditions.
Low dose lofexidine for medically directed outpatient opioid tapering in adults with chronic pain: a prospective case series
Authors: Ellis Megan M. , Eberhart Nathan D. , Warner Nafisseh S. , Hooten W. Michael
Published: January 2024

Background

In adults with chronic pain, mild-to-moderate withdrawal symptoms during medically directed opioid tapering in the outpatient setting may not be accompanied by hypertension or tachycardia. This clinical scenario could limit the use of lofexidine at dosages reported in clinical trials of opioid withdrawal precipitated by abrupt opioid discontinuation. Thus, the primary aim of this prospective case series is to describe the use of low dose lofexidine for opioid withdrawal in patients with chronic pain undergoing medically directed opioid tapering in an outpatient setting.

Methods

Six patients (white 5, Latino 1) admitted to an outpatient interdisciplinary pain rehabilitation program met inclusion and exclusion criteria. Patients self-selected to undergo medically directed opioid tapering, and the medication the patients were prescribed upon admission was used in the taper schedule. Upon initiation of the opioid taper, patients received 0.18 mg of lofexidine every 6 hours.

Results

Five of the six patients were women, and the median morphine milligram equivalents at baseline were 36.9. The median taper duration was 15 days, and the median duration of lofexidine administration was 14 days. Withdrawal scores were mild throughout the taper in four patients, and two patients with fibromyalgia experienced single episodes of moderately severe withdrawal symptoms at the median morphine milligram equivalent midpoint of the taper. No hypotension or sustained bradycardia were observed, and no adverse effects related to lofexidine were reported.

Conclusion

The observations from this prospective case series suggest that low-dose lofexidine may be a feasible adjunct medication to attenuate withdrawal symptoms in adults with chronic pain undergoing outpatient opioid tapering.
Efficacy of an antimicrobial stewardship intervention for early adaptation of antibiotic therapy in high-risk neutropenic patients
Authors: Durand Claire , Risso Karine , Loschi Michael , Retur Nicolas , Emery Audrey , Courjon Johan , Cluzeau Thomas , Carles Michel
Published: January 2024

Background

The 4th European Conference on Infections in Leukemia recommends early adaptation of empirical antibiotic therapy (EAT) for febrile neutropenia in stable patients.

Objectives

To assess the efficacy of an antimicrobial stewardship (AMS) intervention promoting early de-escalation and discontinuation of EAT in high-risk neutropenic patients.

Methods

This before-after study was conducted in the hematology department of the University Hospital of Nice, France. The AMS intervention included the development of clinical decision support algorithms, a twice-weekly face-to-face review of all antibiotic prescriptions and monthly feedback on the intervention. The primary endpoint was overall antibiotic consumption during hospital stay, expressed as days of therapy (DOT).

Results

A total of 113 admissions were included: 56 during the pre-intervention period and 57 during the intervention period. Induction chemotherapy and conditioning for allogeneic stem cell transplantation were the most frequent reasons for admission. In the intervention period, there was a significant decrease in overall antibiotic consumption (median DOT 20 vs. 28 days, p = 0.006), carbapenem consumption (median DOT 5.5 vs. 9 days, p = 0.017) and anti-resistant Gram-positive agents consumption (median DOT 8 vs. 11.5 days, p = 0.017). We found no statistical difference in the rates of intensive care unit admission (9% in each period) and 30-day mortality (5% vs. 0%, p = 0.243). Compliance with de-escalation and discontinuation strategies was significantly higher in the intervention period (77% vs. 8%, p < 0.001).

Conclusion

A multifaceted AMS intervention led to high compliance with early de-escalation and discontinuation of EAT and lower overall antibiotic consumption, without negatively affecting clinical outcomes.
Movement ecology of an endangered mesopredator in a mining landscape
Authors: Cowan M. A. , Dunlop J. A. , Gibson L. A. , Moore H. A. , Setterfield S. A. , Nimmo D. G.
Published: January 2024

Background

Efficient movement and energy expenditure are vital for animal survival. Human disturbance can alter animal movement due to changes in resource availability and threats. Some animals can exploit anthropogenic disturbances for more efficient movement, while others face restricted or inefficient movement due to fragmentation of high-resource habitats, and risks associated with disturbed habitats. Mining, a major anthropogenic disturbance, removes natural habitats, introduces new landscape features, and alters resource distribution in the landscape. This study investigates the effect of mining on the movement of an endangered mesopredator, the northern quoll (Dasyurus hallucatus). Using GPS collars and accelerometers, we investigate their habitat selection and energy expenditure in an active mining landscape, to determine the effects of this disturbance on northern quolls.

Methods

We fit northern quolls with GPS collars and accelerometers during breeding and non-breeding season at an active mine site in the Pilbara region of Western Australia. We investigated broad-scale movement by calculating the movement ranges of quolls using utilisation distributions at the 95% isopleth, and compared habitat types and environmental characteristics within observed movement ranges to the available landscape. We investigated fine-scale movement by quolls with integrated step selection functions, assessing the relative selection strength for each habitat covariate. Finally, we used piecewise structural equation modelling to analyse the influence of each habitat covariate on northern quoll energy expenditure.

Results

At the broad scale, northern quolls predominantly used rugged, rocky habitats, and used mining habitats in proportion to their availability. However, at the fine scale, habitat use varied between breeding and non-breeding seasons. During the breeding season, quolls notably avoided mining habitats, whereas in the non-breeding season, they frequented mining habitats equally to rocky and riparian habitats, albeit at a higher energetic cost.

Conclusion

Mining impacts northern quolls by fragmenting favoured rocky habitats, increasing energy expenditure, and potentially impacting breeding dispersal. While mining habitats might offer limited resource opportunities in the non-breeding season, conservation efforts during active mining, including the creation of movement corridors and progressive habitat restoration would likely be useful. However, prioritising the preservation of natural rocky and riparian habitats in mining landscapes is vital for northern quoll conservation.
Simultaneous resection of a neuroendocrine tumor in an incidental Meckel’s diverticulum with transabdominal preperitoneal hernial repair: a case report
Authors: Kato Shoko , Saito Takuya , Kurahashi Shintaro , Fukami Yasuyuki , Komatsu Shunichiro , Kaneko Kenitiro , Sano Tsuyoshi
Published: January 2024

Background

As laparoscopic surgery becomes more prevalent worldwide, Meckel’s diverticula are increasingly being discovered incidentally during surgery. There is no consensus on whether to follow up or resect such diverticula, which are usually asymptomatic. In cases of transabdominal preperitoneal inguinal hernia repair, resection of such a diverticulum might add the risk of mesh infection. Thus, it is unclear whether simultaneous intestinal resection is advisable.

Case presentation

A 64-year-old man diagnosed with a left indirect inguinal hernia underwent laparoscopic inguinal hernia repair, during which a 2-cm Meckel’s diverticulum located contralateral to the mesentery of the ileum approximately 30 cm from Bauhin’s valve was detected incidentally. Because of the potential risk of future complications such as hemorrhage, diverticulitis, or tumor development, wedge resection of the ileum was performed extracorporeally through an extended umbilical port site after completion of the hernia repair. Pathological examination revealed a neuroendocrine tumor (G1) in Meckel’s diverticulum, which was successfully resected without any mesh infection or postoperative complications.

Discussion

Our patient’s clinical course raises two important issues. First, a Meckel’s diverticulum detected incidentally during laparoscopic surgery should be resected promptly because malignant tumors within such diverticula have frequently been reported. Second, simultaneous resection with hernia repair using mesh seems to be as safe as other clean-contaminated surgery.

Conclusions

Management of incidental Meckel’s diverticula should be selected by appropriate assessment for the risk of malignancy and complications.
Slowness vectors in viscoelastic anisotropic media and their physical interpretation and significance
Authors: Wang Di , Zhou Bing , Greenhalgh Stewart , Bai Chao-Ying , Li Xing-Wang
Published: January 2024

Under the high-frequency assumption, the slowness vector in a viscoelastic anisotropic medium is often defined by a complex-valued vector, whose direction is given by a complex unit vector that can hardly ever be explained by the intuitive physical reasoning related to the actual seismic wave propagation direction. We extend the existing conjugate real ray-tracing (C-RRT) method to compute the ray velocity vectors and then apply it to determine the slowness vectors for three body waves (qP, qSV, and qSH) in a viscoelastic anisotropic medium. Moreover, we dissect the slowness vector with two physical specifications — traveltime gradient and inhomogeneity components, to reveal the physical significance of the slowness vector and give illustrative examples of these components and the phase propagation (real traveltime) and wave-energy attenuation (imaginary traveltime) wavefronts of seismic waves. We also display the homogeneous and inhomogeneous components, as well as the inhomogeneity angles (or deviation angles between these two wavefronts) for the three body waves (qP, qSV, and qSH) in shale with different quality factors ( Q-factors). These results reveal the elusive link between the homogeneous slowness vector and the Q-factors of the medium. The theoretical and numerical dissections of the slowness vector and the extended C-RRT method are extremely helpful in understanding seismic wave propagation and offer a ray-tracing method for wave-energy compensation in seismic migration and reconstruction of subsurface images through seismic ray tomography in viscoelastic anisotropic media.
Υψηλή στρατηγική και διαχείριση κρίσεων από τους Κομνηνούς αυτοκράτορες (1081-1180)
Authors: Σαραντίδης Ιωάννης
Published: January 2024

Η παρούσα διδακτορική διατριβή στοχεύει στην εξέταση της υψηλής στρατηγικής των Κομνηνών αυτοκρατόρων, Αλέξιου Α΄ (1081-1118), Ιωάννη Β΄ (1118-1143) και Μανουήλ Α΄ (1143-1180), και τη διαχείριση των κρίσεων που αυτοί αντιμετώπισαν την περίοδο 1081-1180. Στα τέλη του 11ου αι. το Βυζάντιο αντιμετώπισε μια από τις σοβαρότερες κρίσεις ασφάλειας στη μακραίωνη ιστορία του. Οι σοβαρές στρατιωτικές ήττες από τους εξωτερικούς εχθρούς (Τούρκους, Νορμανδούς κ.ά.) και η πολιτική αστάθεια που ξέσπασε στο εσωτερικό τη δεκαετία του 1070 προκάλεσαν όχι μόνο την εδαφική συρρίκνωση αλλά και τη γεωπολιτική υποχώρηση του Βυζαντίου. Οι πρωτοβουλίες των Κομνηνών τόσο σε στρατιωτικό όσο και σε διπλωματικό επίπεδο επέτρεψαν στο Βυζάντιο όχι μόνο να αντιμετωπίσει τις εξωτερικές απειλές και να ανακτήσει εκτεταμένα εδάφη στη χερσόνησο του Αίμου και την Ανατολή αλλά και να αναδειχθεί σε μία από τις ισχυρότερες δυνάμεις στην Ευρώπη και τη Μέση Ανατολή στα τέλη του 11ου αι. και τον 12ο αι.
Anesthetic Strategies in Cerebral Edema: Navigating Neurological Challenges Amid Trauma, Tumors and Therapeutic Advances
Authors: Świercz Maciej , Markowiak Szymon , Wardęszkiewicz Marta , Jabłońska Wiktoria , Kasprzak Amelia , Truchta Monika , Mańkowska Aleksandra , Kolano Agata , Pejas Anna
Published: January 2024

Cerebral edema, characterized by abnormal fluid accumulation in brain tissue leading to increased intracranial pressure, poses significant challenges for anesthesiologists. This review delves into the pathophysiology, clinical manifestations, diagnostic approaches, pharmacological strategies, and anesthesiological considerations associated with cerebral edema. Disruptions in the blood-brain barrier, alterations in cerebral blood flow, cellular swelling, and aquaporin dysregulation contribute to the complexity of cerebral edema. Clinical presentations vary, encompassing cognitive changes, seizures, and neurological deficits. Accurate diagnosis relies on clinical assessments and neuroimaging, with MRI and CT scans playing pivotal roles. Pharmacological interventions, including osmotic agents, corticosteroids, diuretics, and barbiturates, target specific causes and symptoms. Anesthesiological challenges encompass ICP monitoring, choice of anesthetic agents, maintenance of cerebral perfusion, fluid management, temperature control, and collaboration with neurosurgical teams. This multidisciplinary approach ensures optimal patient care and emphasizes ongoing research collaboration for refining therapeutic strategies. This comprehensive review provides valuable insights for clinicians managing cerebral edema, offering a roadmap for tailored interventions and highlighting the need for continued advancements in understanding and treating this critical condition.

Material and method: ​​

The literature review applied standard criteria and focused on PubMed articles using keywords: cerebral edema, pathophysiology, aquaporin, blood-brain barrier, anesthesiology, cerebral edema treatment, corticosteroids