bluuebunny/crossref_metadata_2025 huggingface dataset:
Endovascular treatment strategies for simultaneous bilateral anterior circulation occlusions in acute ischemic stroke: A single-center experience and systematic review of the literature
Authors: Bernava Gianmarco , Botti Paul , Rosi Andrea , Hofmeister Jeremy , Yilmaz Hasan , Carrera Emmanuel , Brina Olivier , Reymond Philippe , Muster Michel , Kulcsar Zsolt , Lovblad Karl-Olof , Machi Paolo
Published: May 2023

Background

Bilateral and simultaneous occlusion of the anterior circulation is a rare event in patients with acute ischemic stroke. Although endovascular treatment is feasible and safe, the endovascular strategy to be used remains a subject of debate.

Objective

To assess the different endovascular strategies proposed for the treatment of a bilateral, simultaneous anterior circulation occlusion following acute ischemic stroke.

Methods

We present a retrospective study of the clinical and radiological records of all patients with a bilateral, simultaneous anterior circulation occlusion treated at our center between January 2019 and December 2022. Following the PRISMA guidelines, we also conducted a systematic review of the literature.

Results

Two patients with a bilateral and simultaneous middle cerebral artery occlusion were treated at our center during the study period. A TICI score ≥2b was obtained in 4 out of 4 occlusions. Modified Rankin Scale (mRS) at 90 days was 0 and 4, respectively. The literature review retrieved reports on 22 patients. The most frequent bilateral occlusion sites were internal carotid artery-middle cerebral artery. The clinical presentation was severe in most patients. A combined thrombectomy technique proved to have the highest number of first-pass recanalization. A TICI ≥2b was obtained in 95% of patients and an mRS ≤2 was found in 31.8% of patients.

Conclusions

In patients with bilateral and simultaneous occlusion of the anterior circulation, endovascular treatment using a combined technique appears to be rapid and effective. The clinical evolution of this patient population strongly depends on the severity of the onset symptoms.
Real-world outcomes associated with vonoprazan-based versus proton pump inhibitor-based therapy for Helicobacter pylori infection in Japan
Authors: Howden Colin W. , Cook Erin E. , Swallow Elyse , Yang Karen , Guo Helen , Pelletier Corey , Jacob Rinu , Sugano Kentaro
Published: May 2023

Background:

Japanese guidelines recommend triple therapy with vonoprazan or a proton pump inhibitor (PPI) in combination with antibiotics to treat Helicobacter pylori ( H. pylori) infection. While studies have shown improved eradication rates and reduced costs with vonoprazan versus PPIs, there is little data describing healthcare resource use (HCRU) and treatment patterns.

Objectives:

To compare patients treated with a vonoprazan-based or PPI-based regimen for H. pylori infection in Japan in terms of their characteristics, HCRU, healthcare costs, clinical outcomes, and treatment patterns.

Design:

Retrospective matched cohort.

Methods:

We used data from the Japan Medical Data Center claims database (July 2014–January 2020) to identify adult patients with H. pylori infection and a first observed use of vonoprazan or a PPI in 2015 or later (index date). Patients prescribed a vonoprazan-based or a PPI-based regimen were matched 1:1 using propensity score matching. HCRU, healthcare costs, diagnostic tests, a proxy for H. pylori eradication (i.e. no triple therapy with amoxicillin in combination with metronidazole or clarithromycin >30 days after the index date), and second-line treatment were described during the 12-month follow-up period.

Results:

Among 25,389 matched pairs, vonoprazan-treated patients had fewer all-cause and H. pylori-related inpatient stays and outpatient visits than PPI-treated patients, resulting in lower all-cause healthcare costs [185,378 Japanese yen (JPY) versus 230,876 JPY, p < 0.001]. Over 80% of patients received a post-treatment test for H. pylori. Fewer vonoprazan-treated than PPI-treated patients subsequently received an additional triple regimen for H. pylori infection (7.1% versus 20.0%, p < 0.001) or a prescription for vonoprazan or a PPI as monotherapy (12.4% versus 26.4%, p < 0.001) between 31 days and 12 months after the index date.

Conclusion:

Patients with H. pylori infection who were treated with vonoprazan-based therapy had lower rates of subsequent H. pylori treatment, lower overall and H. pylori-related HCRU, and lower healthcare costs than patients treated with PPI-based therapy.
Rationale and value of consolidative cranial local therapy in EGFR-mutant non-small cell lung cancer patients with baseline brain metastasis treated with first-line EGFR-TKIs
Authors: Zeng Ya , Su Xi , Zhao Yang , Zhou Yue , Guo Tiantian , Chu Xiao , Chu Li , Yang Xi , Ni Jianjiao , Zhu Zhengfei
Published: May 2023

Objectives:

To explore the rationale and value of consolidative cranial local therapy (CLT) in epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC) patients with brain metastases (BMs).

Methods:

EGFR-mutant NSCLC patients with baseline BMs who received first-line EGFR-tyrosine kinase inhibitors (TKIs) at two academic centers from May 2015 to June 2020 were retrospectively enrolled. Patterns of tumor response and treatment failure were extensively analyzed in order to explore the rationale of CLT. Cranial lesions with number ⩽3 and largest tumor size ⩽3 cm at baseline and best response to EGFR-TKIs were defined as oligo-BMs and oligo-residual cranial disease (ORCD), respectively. To provide preliminary data supporting CLT, survival outcomes were compared in patients with ORCD, stratified by CLT status.

Results:

Of the 216 patients enrolled, 57.1% had oligo-BMs and 24.5% received first-line osimertinib. At best response to the first-line EGFR-TKIs, intracranial complete response, partial response, and stable disease occurred in 18.5, 31.9, and 44.4% of the whole population, respectively. For patients without CLT ( n = 193), ORCD was observed in 78.1% of the 105 patients with baseline oligo-BMs and 10.2% of the 88 patients with baseline multiple-BMs. With a median follow-up of 22.8 months, 107 patients had cranial first progressive disease (PD); more than 60% developed their first PD solely from the residual tumor sites at best response to EGFR-TKIs. Moreover, among patients with ORCD ( n = 108), patients who received CLT ( n = 17) achieved significantly longer progression-free survival (13.4 versus 8.5 months, p = 0.001) and overall survival (58.9 versus 28.8 months, p = 0.021) than those without CLT. Meanwhile, CLT remained as an independent prognostic factor associated with improved survival after Cox regression analyses.

Conclusions:

Cranial progressive disease developed mostly at the residual cranial lesions in EGFR-mutant NSCLC patients with baseline BMs who received first-line EGFR-TKIs. Consolidative cranial local therapy targeting the oligo-residual cranial tumor lesions may provide survival benefit, which warrants future validation.
Magnetic resonance relaxometry in quantitative imaging of brain gliomas: A literature review
Authors: Chekhonin Ivan V , Cohen Ouri , Otazo Ricardo , Young Robert J , Holodny Andrei I , Pronin Igor N
Published: May 2023

Magnetic resonance (MR) relaxometry is a quantitative imaging method that measures tissue relaxation properties. This review discusses the state of the art of clinical proton MR relaxometry for glial brain tumors. Current MR relaxometry technology also includes MR fingerprinting and synthetic MRI, which solve the inefficiencies and challenges of earlier techniques. Despite mixed results regarding its capability for brain tumor differential diagnosis, there is growing evidence that MR relaxometry can differentiate between gliomas and metastases and between glioma grades. Studies of the peritumoral zones have demonstrated their heterogeneity and possible directions of tumor infiltration. In addition, relaxometry offers T2* mapping that can define areas of tissue hypoxia not discriminated by perfusion assessment. Studies of tumor therapy response have demonstrated an association between survival and progression terms and dynamics of native and contrast-enhanced tumor relaxometric profiles. In conclusion, MR relaxometry is a promising technique for glial tumor diagnosis, particularly in association with neuropathological studies and other imaging techniques.
Collective regulation of algorithmic management
Authors: Adams Zoe , Wenckebach Johanna
Published: May 2023

This article sets out the case for co-determination in the context of work, with a particular emphasis on why this is mandated in relation to algorithmically managed work and workplaces in particular. Having set out the theoretical case for collective regulation of algorithmic management that includes extensive rights of co-determination, focusing on the power relations implied by algorithmic management for this purpose, the article goes on to explore the current state of collective regulation of algorithmic management in the UK and in Germany. From here, it explores existing EU law mechanisms relating to algorithmic management, highlighting their limits and potential, and identifying how, and in what ways, the blueprint outlined by Adams-Prassl et al in this Special Issue might be further elaborated and improved. The article then presents certain proposals for how to establish conditions conducive to the introduction of co-determination in the EU, both generally and in relation to algorithmic technologies more specifically, while engaging critically with the potential and the limitations of legal, top-down—as opposed to bottom-up—mechanisms to achieve this end.
Time-domain full-field optical coherence tomography (TD-FF-OCT) in ophthalmic imaging
Authors: Zhang Jinze , Mazlin Viacheslav , Fei Keyi , Boccara Albert Claude , Yuan Jin , Xiao Peng
Published: May 2023

Ocular imaging plays an irreplaceable role in the evaluation of eye diseases. Developing cellular-resolution ophthalmic imaging technique for more accurate and effective diagnosis and pathogenesis analysis of ocular diseases is a hot topic in the cross-cutting areas of ophthalmology and imaging. Currently, ocular imaging with traditional optical coherence tomography (OCT) is limited in lateral resolution and thus can hardly resolve cellular structures. Conventional OCT technology obtains ultra-high resolution at the expense of a certain imaging range and cannot achieve full field of view imaging. In the early years, Time-domain full-field OCT (TD-FF-OCT) has been mainly used for ex vivo ophthalmic tissue studies, limited by the low speed and low full-well capacity of existing two-dimensional (2D) cameras. The recent improvements in system design opened new imaging possibilities for in vivo applications thanks to its distinctive optical properties of TD-FF-OCT such as a spatial resolution almost insensitive to aberrations, and the possibility to control the curvature of the optical slice. This review also attempts to look at the future directions of TD-FF-OCT evolution, for example, the potential transfer of the functional-imaging dynamic TD-FF-OCT from the ex vivo into in vivo use and its expected benefit in basic and clinical ophthalmic research. Through non-invasive, wide-field, and cellular-resolution imaging, TD-FF-OCT has great potential to be the next-generation imaging modality to improve our understanding of human eye physiology and pathology.
The Multilayered Atrium: An Unusual Case of a Life-Threatening Cor Triatriatum With Persistent Levotrial Cardinal Vein in a 2-Month-Old Infant
Authors: Esiemoghie Akhigbe , Munes Fares , Jeffrey Harris , Jack Stines
Published: May 2023

Cor triatriatum sinister (CTS) is a rare congenital cardiac malformation. In CTS, a fibromuscular membrane subdivides the left atrium into 2 chambers. The communication between the 2 chambers is through 1 or more orifices in the dividing membrane. We present an interesting case of a 2-month-old infant with obstructed CTS membrane who first presented on account of poor feeding and failure to thrive. Echocardiography showed a persistent levoatrial cardinal vein (LACV) connecting the left atrium and the innominate vein. This allowed the proximal left atrial chamber to decompress its blood volume into the innominate vein and subsequently the superior vena cava. There was minimal prograde blood flow across the Cor triatriatum membrane, so the majority of pulmonary venous blood ultimately returned to the heart by way of the decompressing vertical vein into the systemic venous circulation. Surgical repair was performed with an uneventful postoperative course. The specific anatomical variant of Cor triatriatum found in our subject has rarely been reported.
The Patient With Right Atrial Thrombus With a Previous History of Double-Chambered Right Ventricular Surgery and Atrial Fibrillation: A Rare Association
Authors: Xu Yanhan , Gao Mingcheng , Zhang Yajun , Shi Zhan , Chang Huiwen , Jianxiang Song
Published: May 2023

Right atrial thrombosis, which occurs alone, is rare in clinical practice. Its incidence and mechanism are unclear, but susceptibility factors are usually present at its occurrence: ischemic heart disease, heart failure, atrial fibrillation, and chronic kidney disease. Complete isolated right atrial thrombosis rarely occurs. We report here a 47-year-old male patient with a right atrial mass on cardiac ultrasound and chest computed tomography (CT) and a history of previous right heart surgery with type 2 diabetes mellitus and atrial fibrillation, complaining of “chest tightness and shortness of breath after activity for half a month.” The patient was admitted to the hospital and underwent right atrial mass resection, and the postoperative pathology showed “right atrial thrombus.” As right atrial thrombus is very rare and can be a serious threat to life when it occurs in the heart, the prevention and treatment of right atrial thrombus are very important. Based on the analysis of this case, we believe that for patients with special medical history such as “post right heart surgery and atrial fibrillation,” we need to be vigilant for atrial thrombosis.
Difficulties in Adapting at School Among Nepalese Immigrant Children in Japan
Authors: Banstola Ratna Shila , Inoue Sachiko
Published: May 2023

Introduction

Japan has experienced a shift toward a multicultural society, and an increasing number of immigrant children have enrolled in its educational systems. Unforeseen experiences may affect the mental well-being of these children and undermine their holistic development; however, research is scarce. This article explores parents’ concern on Nepalese children's experiences in Japanese schools. We aim to reveal the issues that may inform healthcare professionals and schools in best supporting immigrant students.

Methods

Qualitative survey methods were adopted in an online survey tool to access and collect data from 13 Nepalese parents whose children (age 6–18 years) attended the schools (elementary or junior high school) in four prefectures of Japan. Thematic analysis was used to analyze the data.

Results

The following four themes were identified: (i) interaction and relationship; (ii) feeling different and meals at school; (iii) academic exclusion—lack of assistance/review at home; and (iv) emotional distress, peer exclusion, and bullying.

Conclusion

Our findings suggest that because of the linguistic and cultural differences, children had difficulty communicating, leading to poor interpersonal relationships. Subjects reported changes in daily living patterns at home and school, and children felt different, shy, and unable to make friends or get involved. There were problems with school meals as well, and parents expressed concern over a lack of academic assistance. Some noteworthy emotional aspects were inability to be happy at school and bullying or exclusion from peers. They did, however, express the impression that Japanese students and teachers are cooperative. Overall, these findings have implications for schoolteachers, nurses, health personnel, parents, and others who promote the mental well-being and holistic development of children. This study provides a basis for mental health educational programs targeting the relationship between migrant and native students to create an inclusive society for all.
The role of oxidative damage in cataract etiopathogenesis
Authors: Atalay Enes , Oğurel Tevfik , Derici Mehmet Kürşat
Published: May 2023

Background:

Cataract usually occurs due to age and diabetes, but the mechanisms of cataract formation have not yet been fully elucidated. In this study, the relationship between cataract and oxidative stress was evaluated by examining the aqueous humor reflecting lens metabolism.

Objective:

In this study, the effect of oxidative stress on the etiopathogenesis of cataract was investigated through the total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI), and arylesterase (ARE) levels in aqueous humor samples of patients with cataract.

Design:

A prospective cohort study.

Methods:

This study was conducted on patients who were scheduled for cataract surgery between June 2020 and March 2021. The patients were divided into four groups according to their cataract density as grades 1, 2, 3, and 4. TOS, TAS, and ARE levels of aqueous humor samples were measured spectrophotometrically, and comparisons were made between groups.

Results:

A total of 100 eyes of 100 patients were included in this study. TAS levels were found significantly higher in the grade 2 group compared with the grade 4 group ( p = 0.006). In addition, a significant negative correlation was present between cataract grade and TAS level ( r = −0.237; p = 0.018). There was no significant difference between diabetic and nondiabetic patients in terms of TAS, TOS, OSI, and ARE levels.

Conclusion:

The aqueous humor of patients with a high degree of cataract is characterized by low antioxidant capacity. Decreased antioxidant capacity has a role in cataract formation and progression.
Characterization of the biochemical and behavioral effects of cannabidiol: implications for migraine
Authors: Greco Rosaria , Francavilla Miriam , Demartini Chiara , Zanaboni Anna Maria , Sodergren Mikael H. , Facchetti Sara , Pacchetti Barbara , Palmisani Michela , Franco Valentina , Tassorelli Cristina
Published: May 2023

Cannabidiol (CBD) is the main pharmacologically active phytocannabinoid. CBD exerts an analgesic effect in several pain models, does not have side effects and has low toxicity. The data about CBD mechanisms of action in pain and its therapeutic potential in this area are limited. Here, we tested CBD effects in animal models specific for migraine. We assayed CBD distribution in plasma and in cranial areas related to migraine pain in male Sprague Dawley rats treated chronically (5 days). Successively, we tested CBD activity on the behavioral and biochemical effects induced in the acute and the chronic migraine animal models by nitroglycerin (NTG) administration. In the acute migraine model, rats received CBD (15 mg or 30 mg/kg, i.p) 3 h after NTG (10 mg/kg i.p.) or vehicle injection. In the chronic migraine model, rats were treated with CBD and NTG every other day over nine days with the following doses: CBD 30 mg/kg i.p., NTG 10 mg/kg i.p. We evaluated behavioral parameters with the open field and the orofacial formalin tests. We explored the fatty acid amide hydrolase gene expression, cytokines mRNA and protein levels in selected brain areas and CGRP serum level. CBD levels in the meninges, trigeminal ganglia, cervical spinal cord, medulla pons, and plasma were higher 1 h after the last treatment than after 24 h, suggesting that CBD penetrates but does not accumulate in these tissues. In the acute model, CBD significantly reduced NTG-induced trigeminal hyperalgesia and CGRP and cytokine mRNA levels in peripheral and central sites. In the chronic model, CBD caused a significant decrease in NTG-induced IL-6 protein levels in the medulla–pons, and trigeminal ganglion. It also reduced CGRP serum levels. By contrast, CBD did not modulate TNF-alpha protein levels and fatty acid amide hydrolase (FAAH) gene expression in any of investigated areas. In both experimental conditions, there was no modulation of anxiety, motor/exploratory behavior, or grooming. These findings show that CBD reaches brain areas involved in migraine pain after systemic administration. They also show for the first time that CBD modulates migraine-related nociceptive transmission, likely via a complex signaling mechanism involving different pathways.
MBECS: Microbiome Batch Effects Correction Suite
Authors: Olbrich Michael , Künstner Axel , Busch Hauke
Published: May 2023

Despite the availability of batch effect correcting algorithms (BECA), no comprehensive tool that combines batch correction and evaluation of the results exists for microbiome datasets. This work outlines the Microbiome Batch Effects Correction Suite development that integrates several BECAs and evaluation metrics into a software package for the statistical computation framework R.
Dosage balance acts as a time-dependent selective barrier to subfunctionalization
Authors: Wilson Amanda E. , Liberles David A.
Published: May 2023

Background

Gene duplication is an important process for genome expansion, sometimes allowing for new gene functions to develop. Duplicate genes can be retained through multiple processes, either for intermediate periods of time through processes such as dosage balance, or over extended periods of time through processes such as subfunctionalization and neofunctionalization.

Results

Here, we built upon an existing subfunctionalization Markov model by incorporating dosage balance to describe the interplay between subfunctionalization and dosage balance to explore selective pressures on duplicate copies. Our model incorporates dosage balance using a biophysical framework that penalizes the fitness of genetic states with stoichiometrically imbalanced proteins. These imbalanced states cause increased concentrations of exposed hydrophobic surface areas, which cause deleterious mis-interactions. We draw comparison between our Subfunctionalization + Dosage-Balance Model (Sub + Dos) and the previous Subfunctionalization-Only (Sub-Only) Model. This comparison includes how the retention probabilities change over time, dependent upon the effective population size and the selective cost associated with spurious interaction of dosage-imbalanced partners. We show comparison between Sub-Only and Sub + Dos models for both whole-genome duplication and small-scale duplication events.

Conclusion

These comparisons show that following whole-genome duplication, dosage balance serves as a time-dependent selective barrier to the subfunctionalization process, by causing an overall delay but ultimately leading to a larger portion of the genome retained through subfunctionalization. This higher percentage of the genome that is ultimately retained is caused by the alternative competing process, nonfunctionalization, being selectively blocked to a greater extent. In small-scale duplication, the reverse pattern is seen, where dosage balance drives faster rates of subfunctionalization, but ultimately leads to a smaller portion of the genome retained as duplicates. This faster rate of subfunctionalization is because the dosage balance of interacting gene products is negatively affected immediately after duplication and the loss of a duplicate restores the stoichiometric balance. Our findings provide support that the subfunctionalization of genes that are susceptible to dosage balance effects, such as proteins involved in complexes, is not a purely neutral process. With stronger selection against stoichiometrically imbalanced gene partners, the rates of subfunctionalization and nonfunctionalization slow; however, this ultimately leads to a greater proportion of subfunctionalized gene pairs.
Promising biotherapeutic prospects of different probiotics and their derived postbiotic metabolites: in-vitro and histopathological investigation
Authors: El Far Mona S. , Zakaria Azza S. , Kassem Mervat A. , Wedn Abdalla , Guimei Maha , Edward Eva A.
Published: May 2023

Background

Probiotics and their derived postbiotics, as cell-free supernatants (CFS), are gaining a solid reputation owing to their prodigious health-promoting effects. Probiotics play a valuable role in the alleviation of various diseases among which are infectious diseases and inflammatory disorders. In this study, three probiotic strains,Lactiplantibacillus plantarum,Lacticaseibacillus rhamnosus, andPediococcus acidilactici, were isolated from marketed dietary supplements. The antimicrobial activity of the isolated probiotic strains as well as their CFS was investigated. The neutralized CFS of the isolated probiotics were tested for their antibiofilm potential. The anti-inflammatory activity of the isolatedLactobacillusspp., together with their CFS, was studied in the carrageenan-induced rat paw edema model in male Wistar rats. To the best of our knowledge, such a model was not previously experimented to evaluate the anti-inflammatory activity of the CFS of probiotics. The histopathological investigation was implemented to assess the anti-inflammatory prospect of the isolatedL. plantarumandL. rhamnosusstrains as well as their CFS.

Results

The whole viable probiotics and their CFS showed variable growth inhibition of the tested indicator strains using the agar overlay method and the microtiter plate assay, respectively. When tested for virulence factors, the probiotic strains were non-hemolytic lacking both deoxyribonuclease and gelatinase enzymes. However, five antibiotic resistance genes,blaZ,ermB,aac(6’)- aph(2”), aph(3’’)-III, andvanX, were detected in all isolates. The neutralized CFS of the isolated probiotics exhibited an antibiofilm effect as assessed by the crystal violet assay. This effect was manifested by hindering the biofilm formation of the testedStaphylococcus aureusandPseudomonas aeruginosaclinical isolates in addition toP. aeruginosaPAO1 strain. Generally, the cell cultures of the two tested probiotics moderately suppressed the acute inflammation induced by carrageenan compared to indomethacin. Additionally, the studied CFS relatively reduced the inflammatory changes compared to the inflammation control group but less than that observed in the case of the probiotic cultures treated groups.

Conclusions

The tested probiotics, along with their CFS, showed promising antimicrobial and anti-inflammatory activities. Thus, their safety and their potential use as biotherapeutics for bacterial infections and inflammatory conditions are worthy of further investigation.
Molecular characterization of a flavanone 3-hydroxylase gene from citrus fruit reveals its crucial roles in anthocyanin accumulation
Authors: Ma Gang , Zhang Lancui , Yamamoto Risa , Kojima Nami , Yahata Masaki , Kato Masaya
Published: May 2023

Background

Flavanone 3-hydroxylase (F3H), a key enzyme in the flavonoid biosynthetic pathway, plays an important role in the regulation of flavonols and anthocyanidins accumulation. Citrus fruit is a rich source of flavonoids with varied flavonoid compositions among different varieties. To date, the study onF3His limited in citrus, and its roles in regulating flavonoid accumulation in citrus fruit are still unclear.

Results

In this study, we isolated aCitF3Hfrom three different citrus varieties, Satsuma mandarin (Citrus unshiuMarc.), Ponkan mandarin (C.reticulataBlanco) and blood orange ‘Moro’ (C.sinensisOsbeck). Functional analysis showed thatCitF3Hencoded a functional flavanone 3-hydroxylase. It catalyzed the hydroxylation of naringenin to yield dihydrokaempferol, which was a precursor of anthocyanins in flavonoid biosynthetic pathway. In the juice sacs,CitF3Hwas differentially expressed among the three citrus varieties, and its expression level was positively correlated with the accumulation of anthocyanins during the ripening process. In the juice sacs of Satsuma mandarin and Ponkan mandarin the expression ofCitF3Hkept constant at an extremely low level, and no anthocyanin was accumulated during the ripening process. In contrast, the expression ofCitF3Hincreased rapidly along with the accumulation of anthocyanin in the juice sacs of blood orange ‘Moro’ during the ripening process. In addition, we found that blue light irradiation was effective to up-regulate the expression ofCitF3Hand improve anthocyanin accumulation in the juice sacs of blood orange ‘Moro’ in vitro.

Conclusion

CitF3Hwas a key gene regulating anthocyanin accumulation in the juice sacs of citrus fruit. The results presented in this study will contribute to elucidating anthocyanin biosynthesis in citrus fruit, and provide new strategies to improve the nutritional and commercial values of citrus fruit.
The role of routine first-trimester ultrasound screening for central nervous system abnormalities: a longitudinal single-center study using an unselected cohort with 3-year experience
Authors: Hu Yu , Sun Lijuan , Feng Li , Wang Jingjing , Zhu Yantong , Wu Qingqing
Published: May 2023

Background

To evaluate the role of a standardized first-trimester scan in screening different kinds of central nervous system malformations and to report a 3-year experience from a tertiary center using an unselected cohort.

Methods

This was a retrospective analysis of prospectively collected data from a single center evaluating first-trimester scans with predesigned standardized protocols performed between 1 May 2017 and 1 May 2020, involving 39,526 pregnancies. All pregnant women underwent a series of prenatal ultrasound scans at 11–14, 20–24, 28–34 and 34–38 weeks of gestation. Abnormalities were confirmed by magnetic resonance imaging, postmortem examination or trained ultrasound professionals. Pregnancy outcomes and some postnatal follow-up were obtained from maternity medical records and telephone calls.

Results

A total of 38,586 pregnancies included in the study. The detection rates of CNS anomalies by ultrasound in the first, second, third and late third trimester were 32%, 22%, 25%, and 16%, respectively. And there were 5% of CNS anomalies missed by prenatal ultrasound. In the first-trimester scan, we diagnosed all cases of exencephaly, anencephaly, alobar holoprosencephaly and meningoencephalocele, and some cases of posterior cranial fossa anomalies (20%), open spina bifida (67%), semilobar holoprosencephaly (75%) and severe ventriculomegaly (8%). Vein of Galen aneurysmal malformation, closed spina bifida, lobar holoprosencephaly, intracranial infection, arachnoid cyst, agenesis of the corpus callosum, cysts of the septum pellucidum and isolated absence of the septum pellucidum were never detected during the first trimester. The abortion rates of fetal CNS anomalies detected by first-trimester scan, second-trimester scan, and third- trimester scan were 96%, 84% and 14%, respectively.

Conclusions

The study showed that almost 1/3 of central nervous system anomalies were detected by the standard first-trimester scan and these cases were associated with a high rate of abortion. Early screening for fetal abnormalities gives parents more time for medical advice and safer abortion if needed. It is therefore recommended that some major CNS anomalies should be screened in the first trimester. The standardized anatomical protocol, consisting of four fetal brain planes, were recommended for routine first trimester ultrasound screening.
Laparoscopic versus open surgery for perihilar cholangiocarcinoma: a multicenter propensity score analysis of short- term outcomes
Authors: Wang Min , Qin Tingting , Zhang Hang , Li Jingdong , Deng Xiaxing , Zhang Yuhua , Zhao Wenxing , Fan Ying , Li Dewei , Chen Xuemin , Feng Yechen , Zhu Siwei , Xing Zhongqiang , Yu Guangsheng , Xu Jian , Xie Junjie , Dou Changwei , Ma Hongqin , Liu Gangshan , Shao Yue , Chen Weibo , Liu Jun , Liu Jianhua , Yin Xinmin , Qin Renyi
Published: May 2023

Background

Laparoscopic surgery (LS) has been increasingly applied in perihilar cholangiocarcinoma (pCCA). In this study, we intend to compare the short-term outcomes of LS versus open operation (OP) for pCCA in a multicentric practice in China.

Methods

This real-world analysis included 645 pCCA patients receiving LS and OP at 11 participating centers in China between January 2013 and January 2019. A comparative analysis was performed before and after propensity score matching (PSM) in LS and OP groups, and within Bismuth subgroups. Univariate and multivariate models were performed to identify significant prognostic factors of adverse surgical outcomes and postoperative length of stay (LOS).

Results

Among 645 pCCAs, 256 received LS and 389 received OP. Reduced hepaticojejunostomy (30.89% vs 51.40%, P = 0.006), biliary plasty requirement (19.51% vs 40.16%, P = 0.001), shorter LOS (mean 14.32 vs 17.95 d, P < 0.001), and lower severe complication (CD ≥ III) (12.11% vs. 22.88%, P = 0.006) were observed in the LS group compared with the OP group. Major postoperative complications such as hemorrhage, biliary fistula, abdominal abscess, and hepatic insufficiency were similar between LS and OP (P > 0.05 for all). After PSM, the short-term outcomes of two surgical methods were similar, except for shorter LOS in LS compared with OP (mean 15.19 vs 18.48 d, P = 0.0007). A series subgroup analysis demonstrated that LS was safe and had advantages in shorting LOS.

Conclusion

Although the complex surgical procedures, LS generally seems to be safe and feasible for experienced surgeons.

Trial registration

NCT05402618 (date of first registration: 02/06/2022).
Urinary tract infection after radiation therapy or radical prostatectomy on the prognosis of patients with prostate cancer: a population-based study
Authors: Hyun Jihye , Ha Moon Soo , Oh Seung Young , Tae Jong Hyun , Chi Byung Hoon , Chang In Ho , Kim Tae-Hyoung , Myung Soon Chul , Nguyen Tuan Thanh , Kim Jung Hoon , Kim Jin Wook , Lee Yong Seong , Lee Jooyoung , Choi Se Young
Published: May 2023

Background

We aimed to assess the trends in urinary tract infections (UTIs) and prognosis of patients with prostate cancer after radical prostatectomy (RP) and radiation therapy (RT) as definitive treatment options.

Methods

The data of patients diagnosed with prostate cancer between 2007 and 2016 were collected from the National Health Insurance Service database. The incidence of UTIs was evaluated in patients treated with RT, open/laparoscopic RP, and robot-assisted RP. The proportional hazard assumption test was performed using the scaled Schoenfeld residuals based on a multivariable Cox proportional hazard model. Kaplan–Meier analysis were performed to assess survival.

Results

A total of 28,887 patients were treated with definitive treatment. In the acute phase (< 3 months), UTIs were more frequent in RP than in RT; in the chronic phase (> 12 months), UTIs were more frequent in RT than in RP. In the early follow-up period, the risk of UTIs was higher in the open/laparoscopic RP group (aHR, 1.63; 95% CI, 1.44–1.83; p < 0.001) and the robot-assisted RP group (aHR, 1.26; 95% CI, 1.11–1.43; p < 0.001), compared to the RT group. The robot-assisted RP group had a lower risk of UTIs than the open/laparoscopic RP group in the early (aHR, 0.77; 95% CI, 0.77–0.78; p < 0.001) and late (aHR, 0.90; 95% CI, 0.89–0.91; p < 0.001) follow-up periods. In patients with UTI, Charlson Comorbidity Index score, primary treatment, age at UTI diagnosis, type of UTI, hospitalization, and sepsis from UTI were risk factors for overall survival.

Conclusions

In patients treated with RP or RT, the incidence of UTIs was higher than that in the general population. RP posed a higher risk of UTIs than RT did in early follow-up period. Robot-assisted RP had a lower risk of UTIs than open/laparoscopic RP group in total period. UTI characteristics might be related to poor prognosis.
Characterization of gut microbiota associated with metabolic syndrome and type-2 diabetes mellitus in Mexican pediatric subjects
Authors: Carrizales-Sánchez Ana K. , Tamez-Rivera Oscar , Rodríguez-Gutiérrez Nora A. , Elizondo-Montemayor Leticia , Gradilla-Hernández Misael Sebastián , García-Rivas Gerardo , Pacheco Adriana , Senés-Guerrero Carolina
Published: May 2023

Background

Childhood obesity is a serious public health concern that confers a greater risk of developing important comorbidities such as MetS and T2DM. Recent studies evidence that gut microbiota may be a contributing factor; however, only few studies exist in school-age children. Understanding the potential role of gut microbiota in MetS and T2DM pathophysiology from early stages of life might contribute to innovative gut microbiome-based interventions that may improve public health. The main objective of the present study was to characterize and compare gut bacteria of T2DM and MetS children against control subjects and determine which microorganisms might be potentially related with cardiometabolic risk factors to propose gut microbial biomarkers that characterize these conditions for future development of pre-diagnostic tools.

Results

Stool samples from 21 children with T2DM, 25 with MetS, and 20 controls (n = 66) were collected and processed to conduct 16S rDNA gene sequencing. α- and β-diversity were studied to detect microbial differences among studied groups. Spearman correlation was used to analyze possible associations between gut microbiota and cardiometabolic risk factors, and linear discriminant analyses (LDA) were conducted to determine potential gut bacterial biomarkers. T2DM and MetS showed significant changes in their gut microbiota at genus and family level. Read relative abundance of Faecalibacterium and Oscillospora was significantly higher in MetS and an increasing trend of Prevotella and Dorea was observed from the control group towards T2DM. Positive correlations were found between Prevotella, Dorea, Faecalibacterium, and Lactobacillus with hypertension, abdominal obesity, high glucose levels, and high triglyceride levels. LDA demonstrated the relevance of studying least abundant microbial communities to find specific microbial communities that were characteristic of each studied health condition.

Conclusions

Gut microbiota was different at family and genus taxonomic levels among controls, MetS, and T2DM study groups within children from 7 to 17 years old, and some communities seemed to be correlated with relevant subjects’ metadata. LDA helped to find potential microbial biomarkers, providing new insights regarding pediatric gut microbiota and its possible use in the future development of gut microbiome-based predictive algorithms.
Anemia and associated factors among 6 to 59 months age children attending health facilities in Kombolcha town, Northeast Ethiopia: a facility-based cross-sectional study
Authors: Fentaw Wubshet , Belachew Tefera , Andargie Assefa
Published: May 2023

Background

Childhood anemia is an important public health problem in Ethiopia. The northeast part of the country is among the areas affected by recurrent drought. Despite its significance, studies are scarce on childhood anemia particularly, in the study area. This study aimed to assess the proportion and factors associated with anemia among under-five children in Kombolcha town.

Methods

A facility-based cross-sectional study was conducted among 409 systematically selected 6 to 59 months aged children visited health institutions in Kombolcha town. Data were collected using structured questionnaires from mothers/caretakers. The data entry and analysis were done using EpiData version 3.1 and SPSS version 26 respectively. Binary logistic regression was fitted to identify factors associated with anemia. Statistical significance was declared at p-value ≤ 0.05. The effect size was reported using the adjusted odds ratio with its 95% confidence interval.

Results

Of the participants, 213(53.9%) were males with a mean age of 26 months (SD ± 15.2). The proportion of anemia was 52.2% (95% CI, 46.8-57%). Being in the age of 6–11 months (AOR = 6.23, 95% CI: 2.44, 15.95), 12–23 months (AOR = 3.74, 95%CI: 1.63, 8.60), having low dietary diversity score (AOR = 2.61, 95% CI: 1.55, 4.38), having a history of diarrhea (AOR = 1.87, 95% CI: 1.12, 3.12) and having the lowest family monthly income (AOR = 16.97, 95% CI: 4.95, 58.20) were positively associated with anemia. Whereas, maternal age ≥ 30 years (AOR = 0.37 (0.18, 0.77) and exclusive breastfeeding until six months (AOR = 0.27, 95% CI: 0.16, 0.45) were negatively associated with anemia.

Conclusions

Childhood anemia was a public health problem in the study area. Child age, maternal age, exclusive breastfeeding, dietary diversity score, diarrhea, and family income were significantly associated with anemia.
Inequality in quality-adjusted life expectancy by educational attainment in Norway: an observational study
Authors: Gutacker Nils , Kinge Jonas Minet , Olsen Jan Abel
Published: May 2023

Background

Health inequalities are often assessed in terms of life expectancy or health-related quality of life (HRQoL). Few studies combine both aspects into quality-adjusted life expectancy (QALE) to derive comprehensive estimates of lifetime health inequality. Furthermore, little is known about the sensitivity of estimated inequalities in QALE to different sources of HRQoL information. This study assesses inequalities in QALE by educational attainment in Norway using two different measures of HRQoL.

Methods

We combine full population life tables from Statistics Norway with survey data from the Tromsø study, a representative sample of the Norwegian population aged ≥ 40. HRQoL is measured using the EQ-5D-5L and EQ-VAS instruments. Life expectancy and QALE at 40 years of age are calculated using the Sullivan-Chiang method and are stratified by educational attainment. Inequality is measured as the absolute and relative gap between individuals with lowest (i.e. primary school) and highest (university degree 4 + years) educational attainment.

Results

People with the highest educational attainment can expect to live longer lives (men: + 17.9% (95%CI: 16.4 to 19.5%), women: + 13.0% (95%CI: 10.6 to 15.5%)) and have higher QALE (men: + 22.4% (95%CI: 20.4 to 24.4%), women: + 18.3% (95%CI: 15.2 to 21.6%); measured using EQ-5D-5L) than individuals with primary school education. Relative inequality is larger when HRQoL is measured using EQ-VAS.

Conclusion

Health inequalities by educational attainment become wider when measured in QALE rather than LE, and the degree of this widening is larger when measuring HRQoL by EQ-VAS than by EQ-5D-5L. We find a sizable educational gradient in lifetime health in Norway, one of the most developed and egalitarian societies in the world. Our estimates provide a benchmark against which other countries can be compared.
Assessing the relationship between food insecurity and lifestyle behaviors among university students: a comparative study between Lebanon and Germany
Authors: Rizk Rana , Haddad Chadia , Sacre Hala , Malaeb Diana , Wachten Hanna , Strahler Jana , Salameh Pascale
Published: May 2023

Background

Food insecurity is a common public health problem in both developed and developing countries. This study aimed to profile food insecurity among university students in a developed country with stable economic circumstances (Germany) and a developing Mediterranean country undergoing a severe economic and financial crisis (Lebanon) and examine the associations between food insecurity and lifestyle behaviors (i.e., physical activity, sleep, and adherence to a healthy eating pattern, such as the Mediterranean diet), stress, and financial well-being.

Method

This online cross-sectional study was conducted between September 2021 and March 2022. Subjects were recruited through social media platforms (Facebook, WhatsApp, Instagram, and personal email) and in-class announcements by several university professors of various majors and from different universities in Lebanon and Germany. The final sample included 547 participants (197 from Lebanon and 350 from Germany).

Results

Our findings showed a higher food insecurity rate in Lebanon compared with Germany (59% versus 33%). In the bivariate analysis, food insecurity was associated with insomnia (r = 0.230; p < 0.001) and stress (r = 0.225; p = 0.001); German university students had higher physical activity (p < 0.001), better diet quality (p < 0.001), and lower adherence to the Mediterranean diet (p < 0001) than Lebanese students. In the multivariable analyses, more stress was related to insomnia (B = 0.178; p < 0.001), while financial well-being was not associated with any of the lifestyle behaviors. Physical activity, insomnia, and Mediterranean diet adherence were not associated with the country or food insecurity (p > 0.05); however, living in Germany was associated with better diet quality (B = -7.85; p < 0.001).

Conclusion

The high prevalence of food insecurity reported in this study is alarming, particularly among Lebanese students; German students had better diet quality and higher physical activity but worse adherence to the Mediterranean diet. Moreover, food insecurity was also associated with worse sleep and stress. Further studies are necessary to assess the role of food insecurity as a mediating factor between sociodemographic characteristics and lifestyle behaviors.
Cervical cancer screening and vaccination: knowledge, awareness, and attitude of female staff in a Nigerian University
Authors: Ogundipe Laofe , Ojo Tolulope , Oluwadare Tunrayo , Olayemi Eniola , Oluwafemi Funmilayo , Oni Olawale , Kukoyi Olasumbo , Orok Edidiong
Published: May 2023

Background

Poor knowledge and awareness of cervical cancer screening and vaccination are significant barriers to effective cervical cancer prevention in developing countries. Knowledge of cervical cancer and vaccination against cervical cancer remains low in Nigeria. The purpose of this study was to assess the knowledge, awareness, and attitude of female staff of Afe Babalola University towards cervical cancer screening and vaccinations.

Methods

This study was a cross-sectional study conducted using a semi-structured questionnaire among female staff of Afe Babalola University, Ado-Ekiti, Ekiti State, Nigeria. The workers’ knowledge and awareness were assessed using yes and no questions while the attitude was assessed using Likert scale questions. The workers’ knowledge was ranked as good (≥ 50%) and poor (< 50%) while attitude was ranked as positive (≥ 50%) and negative (< 50%). The relationship between demographics, attitude and knowledge of cervical cancer screening and vaccination was carried out using the Chi-square test. Analyses were conducted using SPSS software version 20.

Results

A total of 200 staff consented to participate in the study out of which 64% were married with mean age 32.81 ± 8.164 years. Majority (60.5%) of the participants knew the causes of cervical cancer while 7.5% strongly agreed that they do not see the need for cervical screening. Majority (63.5%) of the participants showed good knowledge while 46% had a positive attitude towards cervical cancer screening and vaccination.

Conclusions

The study participants showed good knowledge and awareness but poor attitude towards cervical cancer screening and vaccinations. Interventions and continuous education are needed to improve the population’s attitude and eliminate misconceptions.