bluuebunny/crossref_metadata_2025 huggingface dataset:
Feasibility and Performance of Hemoglobin A1C Self-Testing During COVID-19 Among African Americans With Type 2 Diabetes
Authors: Woo Jihun , Whyne Erum Z. , Wright Jaylen I. , Lehrer H. Matthew , Alhalimi Taha A. , Wang Tianyu , Saba Victoria C. , Dubois Susan K. , Tanaka Hirofumi , Brown Sharon A. , Steinhardt Mary A.
Published: June 2022

Purpose:

The purpose of the study was to determine the feasibility of implementing A1C self-testing at home using the A1CNow® Self Check and to compare the accuracy of the A1CNow to a reference standard in African Americans with type 2 diabetes (T2D).

Methods:

African American adults with T2D were recruited from 13 different churches (N = 123). Phase 1, conducted during the early phase of the COVID-19 pandemic, examined the feasibility of A1C assessment using the A1CNow performed at home by untrained participants. Phase 2, conducted when in-person research resumed, compared A1C values concurrently measured using the A1CNow and the DCA Vantage™ Analyzer (reference standard) collected by research staff at church testing sites.

Results:

In Phase 1, 98.8% of participants successfully completed at least 1 at-home A1C test; the overall failure rate was 24.7%. In Phase 2, the failure rate of staff-performed A1CNow testing was 4.4%. The Bland-Altman plot reveals that A1CNow values were 0.68% lower than DCA values, and the mean differences (A1CNow minus DCA) ranged from −2.6% to 1.2% with a limit of agreement between −1.9% to 0.5%.

Conclusions:

A1C self-testing is feasible for use in community settings involving African American adults with T2D. The A1CNow Self-Check underestimated A1C values when compared with the reference standard. Ongoing improvements in point-of-care devices have the potential to expand research and clinical care, especially in underserved communities.
Impact of a Digitally Enhanced Diabetes Self-Management Program on Glycemia and Medical Costs
Authors: Chen Fang , Jasik Carolyn B. , Dall Timothy M. , Siego Cynthia Veronica
Published: June 2022

Objective:

To analyze economic savings and health impacts associated with a virtual digitally enhanced diabetes self-management education and support (DSMES) program.

Research design and methods:

Participants (n = 1,494) were nonpregnant adults with diagnosed type 2 diabetes and baseline body mass index (BMI) of 25 kg/m2 (23 kg/m2 if of Asian descent) or higher who enrolled in virtual DSMES between February 2019 and April 2020 for at least 4 months. Participants’ changes in glycated hemoglobin (A1C) and body weight were calculated as the difference between program start and last recorded values between months 4 and 6. Outcomes for all participants were analyzed; subanalyses were done on 628 participants with starting A1C >7% (53 mmol/mol), who could benefit most from DSMES. Markov-based microsimulation approach was used to model the potential reductions in diabetes sequalae and medical expenditures if observed improvements in A1C and BMI were maintained.

Results:

DSMES participants with starting A1C >7% experienced average reductions of 0.9% A1C and 2.1 kg of body weight (−1.7% of BMI) within 6 months. If these improvements were maintained, simulated outcomes include reduced 5-year onset of ischemic heart disease by 9.2%, myocardial infarction by 10.6%, stroke by 12.1%, chronic kidney disease by 16.5%, and reduced onset of other sequelae. Simulated cumulative reduction in medical expenditures is $1160 after 1 year, $4150 after 3 years, $7790 after 5 years, and $18 020 after 10 years.

Conclusions:

Participation in virtual DSMES improves A1C and body weight, with the potential to slow onset of diabetes sequelae and reduce medical expenditures.
Understanding Hypoglycemia in the Real World
Authors: Dickinson Jane K. , Litchman Michelle L.
Published: June 2022

Purpose:

The purpose of this study was to gain a better understanding of real-world hypoglycemia experiences from people living with diabetes.

Methods:

An exploratory cross-sectional study of a convenience sample of 374 English-speaking adults affected by diabetes using an online survey was conducted.

Results:

Participant mean age was 37 years with an average diabetes duration of 21 years. On average, participants reported feeling hypoglycemia at 64 mg/dL (3.6 mmol/L), worrying about hypoglycemia at 63 mg/dL (3.5 mmol/L), and treating hypoglycemia at 72 mg/dL (4 mmol/L). Terminology used by study participants did not match the current classifications of hypoglycemia used in clinical research. Participants who have been told they have hypoglycemia unawareness treat at a significantly lower level compared to those without hypoglycemia unawareness. Only 58% always carry hypoglycemia treatment; there was a relationship with increasing age and always carrying hypoglycemia treatment. Thirty-eight percent of participants treat hypoglycemia with the recommended 15 g of carbohydrate (CHO). Survey respondents who wore continuous glucose monitors reported using significantly less CHO to treat hypoglycemia.

Conclusions:

In the real world, experiences related to feeling, worrying about, and treating hypoglycemia trend higher than what is noted in the standardized hypoglycemia classifications. Study findings have implications for teaching and supporting people with diabetes who experience hypoglycemia. Consuming less CHO to treat hypoglycemia could lead to fewer episodes of rebound hyperglycemia and less weight gain. Increased support for continuous glucose monitoring is warranted.
Utility of On-Treatment Viral Loads During Treatment With Direct-Acting Antivirals in Patients Infected With Chronic Viral Hepatitis C
Authors: Mortazavi Shila , Hynicka Lauren M.
Published: June 2022

Background: Direct-acting antiviral (DAA) agents have revolutionized the treatment of chronic hepatitis C virus (HCV) infection. Current data regarding the utility of on-treatment HCV viral load (VL) monitoring are conflicting and limited data are available in HIV-coinfected patients. Objective: The objective of the study was to determine whether on-treatment VLs are predictive of HCV cure in a real-world population. Method: A single-center, retrospective cohort study was conducted using patients who received a prescription for DAA therapy for HCV treatment at a large, tertiary ambulatory care clinic. Results: A total of 219 patients were included in the final analysis. The average age was 56 years. Most patients were male (64.4%), African American (73.1%), and insured by Medicaid (61.6%). Most patients were treatment-naive, noncirrhotic, and infected with HCV genotype 1a (73.1%). About 22.4% of patients were coinfected with HIV. The most common regimen was 12 weeks of ledipasvir/sofosbuvir (53.9%). On-treatment VLs were most commonly obtained at treatment week 4 (42.5%), of which 45.2% of patients were detectable. Sustained virologic response (SVR) was achieved in 96.8% of the total population and 95.9% of HIV-coinfected patients. Of the 7 patients who did not achieve SVR, 3 patients had undetectable on-treatment VLs in the first 8 weeks of therapy. Conclusion: Sustained virologic response rates were similar between HCV-monoinfected patients and HCV-HIV-coinfected patients. This research further supports that on-treatment VLs may not be a valuable indicator of treatment failure but may be helpful to engage patients in care and ensure treatment adherence and ultimately cure.
“Press On, Continue On”: Rural Parents’ Experiences of Transitions Within Early Intervention
Authors: Decker Kalli B. , Feigel Alexandra J. , Foster Tricia D. , Kepl Rachel L.
Published: June 2022

Although all families experience a variety of transitions over time, families of children with exceptionalities tend to encounter more transitions during their children’s earliest years. Transitions can be stressful and often include changes as part of early intervention or special education services. It is important to understand these transitions because the support families receive can influence child and family well-being. Therefore, we interviewed parents ( N = 28) across a rural U.S. state about their experiences of transition over time. Using thematic analysis, three common themes emerged: (a) change is constant, (b) positive relationships support changing needs and priorities, and (c) parents need more support, information, or access to services or providers. Parents reported relationships and collaboration with providers to be important, yet insufficient, in supporting transitions. Rurality added some challenges to parents’ experiences with transition. Recommendations include empowering families, providing more access and/or removing barriers to services, and building family efficacy through family-focused services.
A Brief Review of Carbon Dots–Silica Nanoparticles Synthesis and their Potential Use as Biosensing and Theragnostic Applications
Authors: Ornelas-Hernández Luis Fernando , Garduno-Robles Angeles , Zepeda-Moreno Abraham
Published: June 2022

Carbon dots (CDs) are carbon nanoparticles with sizes below 10 nm and have attracted attention due to their relatively low toxicity, great biocompatibility, water solubility, facile synthesis, and exceptional photoluminescence properties. Accordingly, CDs have been widely exploited in different sensing and biomedical applications, for example, metal sensing, catalysis, biosensing, bioimaging, drug and gene delivery, and theragnostic applications. Similarly, the well-known properties of silica, such as facile surface functionalization, good biocompatibility, high surface area, and tunable pore volume, have allowed the loading of diverse inorganic and organic moieties and nanoparticles, creating complex hybrid nanostructures that exploit distinct properties (optical, magnetic, metallic, mesoporous, etc.) for sensing, biosensing, bioimaging, diagnosis, and gene and drug delivery. In this context, CDs have been successfully grafted into diverse silica nanostructures through various synthesis methods (e.g., solgel chemistry, inverse microemulsion, surfactant templating, and molecular imprinting technology (MIT)), imparting hybrid nanostructures with multimodal properties for distinct objectives. This review discusses the recently employed synthesis methods for CDs and silica nanoparticles and their typical applications. Then, we focus on combined synthesis techniques of CD–silica nanostructures and their promising biosensing operations. Finally, we overview the most recent potential applications of these materials as innovative smart hybrid nanocarriers and theragnostic agents for the nanomedical field.

Graphical abstract
Improving Agricultural Traits While Maintaining High Resistant Starch Content in Rice
Authors: Miura Satoko , Narita Maiko , Crofts Naoko , Itoh Yuki , Hosaka Yuko , Oitome Naoko F. , Abe Misato , Takahashi Rika , Fujita Naoko
Published: June 2022

Background

Resistant starch (RS) is beneficial for human health. Loss of starch branching enzyme IIb (BEIIb) increases the proportion of amylopectin long chains, which greatly elevates the RS content. Although high RS content cereals are desired, an increase in RS content is often accompanied by a decrease in seed weight. To further increase the RS content, genes encoding active-type starch synthase (SS) IIa, which elongates amylopectin branches, and high expression-type granule-bound SSI (GBSSI), which synthesizes amylose, were introduced into the be2b mutant rice. This attempt increased the RS content, but further improvement of agricultural traits was required because of a mixture of indica and japonica rice phonotype, such as different grain sizes, flowering times, and seed shattering traits. In the present study, the high RS lines were backcrossed with an elite rice cultivar, and the starch properties of the resultant high-yielding RS lines were analyzed.

Results

The seed weight of high RS lines was greatly improved after backcrossing, increasing up to 190% compared with the seed weight before backcrossing. Amylopectin structure, gelatinization temperature, and RS content of high RS lines showed almost no change after backcrossing. High RS lines contained longer amylopectin branch chains than the wild type, and lines with active-type SSIIa contained a higher proportion of long amylopectin chains compared with the lines with less active-SSIIa, and thus showed higher gelatinization temperature. Although the RS content of rice varied with the cooking method, those of high RS lines remained high after backcrossing. The RS contents of cooked rice of high RS lines were high (27–35%), whereas that of the elite parental rice was considerably low (< 0.7%). The RS contents of lines with active-type SSIIa and high-level GBSSI expression in be2b or be2b ss3a background were higher than those of lines with less-active SSIIa.

Conclusions

The present study revealed that backcrossing high RS rice lines with elite rice cultivars could increase the seed weight, without compromising the RS content. It is likely that backcrossing introduced loci enhancing seed length and width as well as loci promoting early flowering for ensuring an optimum temperature during RS biosynthesis.
Establishment and Fractionation of Metastatic Axillary Lymph Node Cell Suspension for Determination of Protein Expression Levels of Nuclear cFOS and Cytosolic TGFβ1 from Breast Cancer Patients
Authors: Ivanović Vesna , Dedović-Tanić Nasta , Milovanović Zorka , Stojiljković Bratislav , Demajo Miroslav , Mandušić Vesna
Published: June 2022

Background

Metastatic Axillary Lymph Node (mALN) status is currently the most important prognostic factor in the management of primary breast cancer (BC). Thus, development of specimens which enable identification of new mALN markers, involved in the progression of the disease, are of considerable interest. The specific aim of this work was to describe the method of establishment of Metastatic Axillary Nodal Cell Suspension and its fractionation, termed Fractionated Nodal Cell Suspension (FNCS), into nuclear and cytosolic extracts to enable determination of protein expression levels of nuclear cFOS and cytosolic Transforming Growth Factor β1 (TGFβ1) in BC patients.

Results

To standardize the procedure, HeLa cells were successfully fractionated into nuclear/cytosolic extracts with confirmed presence of nuclear cFOS and cytosolic TGFβ1 proteins. Subsequently, the ALN Cell Suspension specimens were obtained and further fractionated from a pilot sample of six ALN tissue pairs, mALN versus autologous normal ALN (nALN), dissected from invasive BC patients. The mALN/nALN results revealed overexpression of both nuclear cFOS and cytosolic TGFβ1 protein levels. However, only the TGFβ1 data exhibited statistically significant overexpression, which was proportional to the respective values of mALN diameter of tumor deposits.

Conclusions

Detailed protocol for establishment and fractionation of mALN cell suspension specimens, termed FNCS, into nuclear and cytosolic extracts is here described for the first time. This approach might be a convenient ex vivo model for simultaneous analysis of protein, RNA and DNA biomarkers from nuclear/cytosolic extracts of the same mALN tissue sample. It might have potential to enable, in the age of genomics and personalized medicine, an identification of novel mALN biomarkers and thus improve the screening, diagnosis and prognosis of invasive BC.
Antagonistic regulatory effects of a single cis-acting expression quantitative trait locus between transcription and translation of the MRPL43 gene
Authors: Han Jooyeon , Lee Chaeyoung
Published: June 2022

Background

Heterogeneity of expression quantitative trait locus (eQTL) effects have been shown across gene expression processes. Knowledge on how to produce the heterogeneity is quite limited. This study aims to examine fluctuations in differential gene expression by alleles of sequence variants across expression processes.

Results

Genome-wide eQTL analyses with transcriptome-wide gene expression data revealed 20 cis-acting eQTLs associated simultaneously with mRNA expression, ribosome occupancy, and protein abundance. A 97 kb-long eQTL signal for mitochondrial ribosomal protein L43 (MRPL43) covered the gene, showing a heterogeneous effect size on gene products across expression stages. One allele of the eQTL was associated with increased mRNA expression and ribosome occupancy but decreased protein abundance. We examined the heterogeneity and found that the eQTL can be attributed to the independent functions of three nucleotide variants, with a strong linkage. NC_000010.11:g.100987606G > T, upstream of MRPL43, may regulate the binding affinity of transcription factors. NC_000010.11:g.100986746C > G, 3 bp from an MRPL43 splice donor site, may alter the splice site. NC_000010.11:g.100978794A > G, in the isoform with a long 3′-UTR, may strengthen the binding affinity of the microRNA. Individuals with the TGG haplotype at these three variants had higher levels of mRNA expression and ribosome occupancy than individuals with the GCA haplotype but lower protein levels, producing the flipped effect throughout the expression process.

Conclusions

These findings suggest that multiple functional variants in a linkage exert their regulatory functions at different points in the gene expression process, producing a complexity of single eQTLs.
Temperature regulation of carotenoid accumulation in the petals of sweet osmanthus via modulating expression of carotenoid biosynthesis and degradation genes
Authors: Wang Yiguang , Zhang Chao , Xu Bin , Fu Jianxin , Du Yanxia , Fang Qiu , Dong Bin , Zhao Hongbo
Published: June 2022

Background

Temperature is involved in the regulation of carotenoid accumulation in many plants. The floral color of sweet osmanthus (Osmanthus fragrans Lour.) which is mainly contributed by carotenoid content, is affected by temperature in autumn. However, the mechanism remains unknown. Here, to reveal how temperature regulates the floral color of sweet osmanthus, potted sweet osmanthus ‘Jinqiu Gui’ were treated by different temperatures (15 °C, 19 °C or 32 °C). The floral color, carotenoid content, and the expression level of carotenoid-related genes in petals of sweet osmanthus ‘Jinqiu Gui’ under different temperature treatments were investigated.

Results

Compared to the control (19 °C), high temperature (32 °C) changed the floral color from yellow to yellowish-white with higher lightness (L*) value and lower redness (a*) value, while low temperature (15 °C) turned the floral color from yellow to pale orange with decreased L* value and increased a* value. Total carotenoid content and the content of individual carotenoids (α-carotene, β-carotene, α-cryptoxanthin, β-cryptoxanthin, lutein and zeaxanthin) were inhibited by high temperature, but were enhanced by low temperature. Lower carotenoid accumulation under high temperature was probably attributed to transcriptional down-regulation of the biosynthesis gene OfPSY1, OfZ-ISO1 and OfLCYB1, and up-regulation of degradation genes OfNCED3, OfCCD1-1, OfCCD1-2, and OfCCD4-1. Up-regulation of OfLCYB1, and down-regulation of OfNCED3 and OfCCD4-1 were predicted to be involved in low-temperature-regulated carotenoid accumulation. Luciferase assays showed that the promoter activity of OfLCYB1 was activated by low temperature, and repressed by high temperature. However, the promoter activity of OfCCD4-1 was repressed by low temperature, and activated by high temperature.

Conclusions

Our study revealed that high temperature suppressed the floral coloration by repressing the expression of carotenoid biosynthesis genes, and activating the expression of carotenoid degradation genes. However, the relative low temperature had opposite effects on floral coloration and carotenoid biosynthesis in sweet osmanthus. These results will help reveal the regulatory mechanism of temperature on carotenoid accumulation in the petals of sweet osmanthus.
Transcriptomic analysis provides insights into molecular mechanisms of thermal physiology
Authors: Drown Melissa K. , Crawford Douglas L. , Oleksiak Marjorie F.
Published: June 2022

Physiological trait variation underlies health, responses to global climate change, and ecological performance. Yet, most physiological traits are complex, and we have little understanding of the genes and genomic architectures that define their variation. To provide insight into the genetic architecture of physiological processes, we related physiological traits to heart and brain mRNA expression using a weighted gene co-expression network analysis. mRNA expression was used to explain variation in six physiological traits (whole animal metabolism (WAM), critical thermal maximum (CTmax), and four substrate specific cardiac metabolic rates (CaM)) under 12 °C and 28 °C acclimation conditions. Notably, the physiological trait variations among the three geographically close (within 15 km) and genetically similarF. heteroclituspopulations are similar to those found among 77 aquatic species spanning 15–20° of latitude (~ 2,000 km). These large physiological trait variations among genetically similar individuals provide a powerful approach to determine the relationship between mRNA expression and heritable fitness related traits unconfounded by interspecific differences. Expression patterns explained up to 82% of metabolic trait variation and were enriched for multiple signaling pathways known to impact metabolic and thermal tolerance (e.g., AMPK, PPAR, mTOR, FoxO, and MAPK) but also contained several unexpected pathways (e.g., apoptosis, cellular senescence), suggesting that physiological trait variation is affected by many diverse genes.
The Kandelia obovata transcription factor KoWRKY40 enhances cold tolerance in transgenic Arabidopsis
Authors: Fei Jiao , Wang You-Shao , Cheng Hao , Su Yu-Bin , Zhong Yong-Jia , Zheng Lei
Published: June 2022

Background

WRKY transcription factors play key roles in plant development processes and stress response. Kandelia obovata is the most cold-resistant species of mangrove plants, which are the important contributors to coastal marine environment. However, there is little known about the WRKY genes in K. obovata.

Results

In this study, a WRKY transcription factor gene, named KoWRKY40, was identified from mangrove plant K. obovata. The full-length cDNA of KoWRKY40 gene was 1420 nucleotide bases, which encoded 318 amino acids. The KoWRKY40 protein contained a typical WRKY domain and a C2H2 zinc-finger motif, which were common signatures to group II of WRKY family. The three-dimensional (3D) model of KoWRKY40 was formed by one α-helix and five β-strands. Evolutionary analysis revealed that KoWRKY40 has the closest homology with a WRKY protein from another mangrove plant Bruguiera gymnorhiza. The KoWRKY40 protein was verified to be exclusively located in nucleus of tobacco epidermis cells. Gene expression analysis demonstrated that KoWRKY40 was induced highly in the roots and leaves, but lowly in stems in K. obovata under cold stress. Overexpression of KoWRKY40 in Arabidopsis significantly enhanced the fresh weight, root length, and lateral root number of the transgenic lines under cold stress. KoWRKY40 transgenic Arabidopsis exhibited higher proline content, SOD, POD, and CAT activities, and lower MDA content, and H2O2 content than wild-type Arabidopsis under cold stress condition. Cold stress affected the expression of genes related to proline biosynthesis, antioxidant system, and the ICE-CBF-COR signaling pathway, including AtP5CS1, AtPRODH1, AtMnSOD, AtPOD, AtCAT1, AtCBF1, AtCBF2, AtICE1, AtCOR47 in KoWRKY40 transgenic Arabidopsis plants.

Conclusion

These results demonstrated that KoWRKY40 conferred cold tolerance in transgenic Arabidopsis by regulating plant growth, osmotic balance, the antioxidant system, and ICE-CBF-COR signaling pathway. The study indicates that KoWRKY40 is an important regulator involved in the cold stress response in plants.
Effects of structured involvement of the primary care team versus standard care after a cancer diagnosis on patient satisfaction and healthcare use: the GRIP randomised controlled trial
Authors: Perfors I. A. A. , Helsper C. W. , Noteboom E. A. , Visserman E. A. , van Dorst E. B. L. , van Dalen T. , Verhagen M. A. M. T. , Witkamp A. J. , Koelemij R. , Flinterman A. E. , Pruissen-Peeters K. A. B. M. , Schramel F. M. N. H. , van Rens M. T. M. , Ernst M. F. , Moons L. M. G. , van der Wall E. , de Wit N. J. , May A. M.
Published: June 2022

Background

The growing number of cancer survivors and treatment possibilities call for more personalised and integrated cancer care. Primary care seems well positioned to support this. We aimed to assess the effects of structured follow-up of a primary care team after a cancer diagnosis.

Methods

We performed a multicentre randomised controlled trial enrolling patients curatively treated for breast, lung, colorectal, gynaecologic cancer or melanoma. In addition to usual cancer care in the control group, patients randomized to intervention were offered a “Time Out consultation” (TOC) with the general practitioner (GP) after diagnosis, and subsequent follow-up during and after treatment by a home care oncology nurse (HON). Primary outcomes were patient satisfaction with care (questionnaire: EORTC-INPATSAT-32) and healthcare utilisation. Intention-to-treat linear mixed regression analyses were used for satisfaction with care and other continuous outcome variables. The difference in healthcare utilisation for categorical data was calculated with a Pearson Chi-Square or a Fisher exact test and count data (none versus any) with a log-binomial regression.

Results

We included 154 patients (control n = 77, intervention n = 77) who were mostly female (75%), mainly diagnosed with breast cancer (51%), and had a mean age of 61 (SD ± 11.9) years. 81% of the intervention patients had a TOC and 68% had HON contact. Satisfaction with care was high (8 out of 10) in both study groups. At 3 months after treatment, GP satisfaction was significantly lower in the intervention group on 3 of 6 subscales, i.e., quality (− 14.2 (95%CI -27.0;-1.3)), availability (− 15,9 (− 29.1;-2.6)) and information provision (− 15.2 (− 29.1;-1.4)). Patients in the intervention group visited the GP practice and the emergency department more often ((RR 1.3 (1.0;1.7) and 1.70 (1.0;2.8)), respectively).

Conclusions

In conclusion, the GRIP intervention, which was designed to involve the primary care team during and after cancer treatment, increased the number of primary healthcare contacts. However, it did not improve patient satisfaction with care and it increased emergency department visits. As the high uptake of the intervention suggests a need of patients, future research should focus on optimizing the design and implementation of the intervention.

Trial registration

GRIP is retrospectively (21/06/2016) registered in the ‘Netherlands Trial Register’ (NTR5909).
Is multimorbidity associated with higher risk of falls among older adults in India?
Authors: Barik Manish , Panda Sushree Nibedita , Tripathy Sweta Sulagna , Sinha Abhinav , Ghosal Shishirendu , Acharya Ardhendhu Sekhar , Kanungo Srikanta , Pati Sanghamitra
Published: June 2022

Background

Fall, a multifaceted health condition, is one of the major causes of mortality among older adults. Rapid ageing and increased multimorbidity in low-and middle-income countries (LMICs), including India, might elevate the risk of fall. Although, fall is associated with significant healthcare utilization, it still remains an under-recognized public health issue. This accentuates a need for evidence on fall to integrate it into existing healthcare programs, a gap in geriatric care. The present study aimed to assess the association of fall with multimorbidity among older adults in India.

Methods

We included 28,567 participants aged ≥ 60 years from Longitudinal Ageing Study in India (LASI), wave-1 conducted during 2017–19. Descriptive statistics were used to compute the prevalence of self-reported falls along with 95% confidence interval as a measure of uncertainty. The association between falls and multimorbidity was assessed by multivariable logistic regression and presented as an adjusted odds ratio (AOR).

Results

The prevalence of falls was 12.5%, being higher among women (13.6% vs. 11.4%) than men. The major determinants of fall were females, rural residents and smokeless tobacco use. We observed multimorbidity [AOR: 1.29 (1.14–1.46)] to be significantly associated with falls.

Conclusion

Falls are commonly prevalent among older adults having multimorbidity as its important predictor. Existing health programs should incorporate falls as an important part of geriatric care. Additionally, primary health care facilities should be strengthened to provide comprehensive care for injuries sustained due to falls.
A case of recurrent acute cholecystitis caused by Actinomyces odontolyticus, rare actinomycosis
Authors: Furuya Kento , Ito Kenta , Sugiyama Kyohei , Fujita Akitsugu , Kanemoto Hideyuki , Shimada Toshio
Published: June 2022

Backgrounds

Actinomyces species are gram-positive, obligate anaerobic rods and are rare causes of cholecystitis. Because Actinomyces species are anaerobic bacteria, it is difficult for Actinomyces to survive in bile apart from A. naeslundii. We experienced a case of recurrent acute cholecystitis caused by A. odontolyticus.

Case presentation

A patient had been diagnosed with acute cholecystitis and treated one month before and after that, admitted to our hospital because of recurrent cholecystitis. Gram stain of the bile revealed gram-positive rods and gram-positive cocci. We found A. odontolyticus and MRSA in bile culture and MRSA in blood culture. We administered piperacillin-tazobactam and then changed it to ampicillin-sulbactam and vancomycin. The patient underwent laparoscopic cholecystectomy and was discharged safely.

Conclusions

To our knowledge, this is the first case of cholecystitis caused by A. odontolyticus. Cholecystitis caused by Actinomyces species is rare. In addition, we may overlook it with the low positivity of bile cultures of Actinomyces. Whenever the cholecystitis recurs without any obstruction of the biliary tract, we should search for the gram-positive rods hidden in the bile, such as A. odontolyticus, as the causative organism, even if the bile culture is negative.
Catheter-related bloodstream Mycobacterium wolinskyi infection in an umbilical cord blood transplant recipient: a case report
Authors: Muranaka Emiri , Hase Ryota , Utsu Yoshikazu , Watari Tomohisa , Otsuka Yoshihito , Hosokawa Naoto
Published: June 2022

Background

Catheter-related bloodstream infection (CRBSI), caused by rapidly growing mycobacteria (RGM), is a rare infectious complication in hematopoietic stem cell transplant (HSCT) recipients and can often be misdiagnosed as Gram-positive rod (GPR) bacteremia.

Case presentation

We present a case of CRBSI caused by Mycobacterium wolinskyi, a rare RGM, in a 44-year-old female patient who received an umbilical cord blood transplant.

Conclusions

Rapidly growing mycobacteria can stain as GPRs and may grow in routine blood culture media after 3–4 days of incubation. These features are not widely known to clinicians, and acid-fast staining is therefore recommended when unidentifiable GPRs are detected in blood cultures, especially in immunocompromised patients, such as those with hematologic malignancies or intravascular devices.
Impact of COVID-19 pandemic on the epidemiology of STDs in China: based on the GM (1,1) model
Authors: Yan Jingmin , Li Yanbo , Zhou Pingyu
Published: June 2022

Background

COVID-19 and Sexually Transmitted Diseases (STDs) are two very important diseases. However, relevant researches about how COVID-19 pandemic has impacted on the epidemiological trend of STDs are limited in China. This study aimed to analyze the impact of COVID-19 on STDs in China and proposed relevant recommendations to be used in bettering health.

Methods

The incidence of HIV infection, syphilis and gonorrhea in China from 2008 to 2020 were collected. Grey Model (1,1) were established to predict the incidence of STDs with the incidence data of these three STDs from 2013 to 2018 considering the impact of policies in China, respectively. We then calculated the predictive incidence of each STD in 2019, 2020 and 2021 by the established Model. And we estimated the extent of the impact of COVID-19 on the epidemiological changes of STDs by analyzing the difference between the absolute percentage error (APE) of the predictive incidence and actual rate in 2019 and 2020.

Results

The incidence of HIV infection and syphilis showed a trend of increase from 2008 to 2019 in China, but that for gonorrhea was fluctuant. Of note, the incidence of these three STDs decreased significantly in 2020 compared with that in 2019. The APE of HIV infection, syphilis and gonorrhea in 2020 (20.54%, 15.45% and 60.88%) were about 7 times, 4 times and 2 times of that in 2019 (2.94%, 4.07% and 30.41%). The incidence of HIV infection, syphilis and gonorrhea would be 5.77/100,000, 39.64/100,000 and 13.19/100,000 in 2021 based on our model.

Conclusions

The epidemiological trend of STDs in China was significant influenced by COVID-19 pandemic. It is important to balance the control of COVID-19 and timely management of STDs during the COVID-19 epidemic to prevent or reduce the poor outcome among COVID-19 patients with STDs. New management strategies on STDs, such as leveraging social media, online medical care, rapid self-testing, timely diagnosis and treatment guarantee and balance of medical resources for STDs management should be adapted in the context of the long-term effects of COVID-19.
Impact of delayed processing of positive blood cultures on organism detection: a prospective multi-centre study
Authors: Roberts Tamalee , Chandna Arjun , Watthanaworawit Wanitda , Thaiprakong Areerat , Soeng Sona , Simmalavong Manivone , Phoumin Phonelavanh , Saengchun Weerawut , Khatta Nongyao , Hinfonthong Pattaraporn , Kaewpundoem Napaporn , Lee Sue J. , Perrone Carlo , Amos Ben , Turner Paul , Ashley Elizabeth A. , Ling Clare L.
Published: June 2022

Background

Blood cultures remain the gold standard investigation for the diagnosis of bloodstream infections. In many locations, quality-assured processing of positive blood cultures is not possible. One solution is to incubate blood cultures locally, and then transport bottles that flag positive to a central reference laboratory for organism identification and antimicrobial susceptibility testing. However, the impact of delay between the bottle flagging positive and subsequent sub-culture on the viability of the isolate has received little attention.

Methods

This study evaluated the impact of delays to sub-culture (22 h to seven days) in three different temperature conditions (2–8 °C, 22–27 °C and 35 ± 2 °C) for bottles that had flagged positive in automated detection systems using a mixture of spiked and routine clinical specimens. Ninety spiked samples for five common bacterial causes of sepsis (Escherichia coli, Haemophilus influenzae, Staphylococcus aureus, Streptococcus agalactiae and Streptococcus pneumoniae) and 125 consecutive positive clinical blood cultures were evaluated at four laboratories located in Cambodia, Lao PDR and Thailand. In addition, the utility of transport swabs for preserving organism viability was investigated.

Results

All organisms were recoverable from all sub-cultures in all temperature conditions with the exception of S. pneumoniae, which was less likely to be recoverable after longer delays (> 46–50 h), when stored in hotter temperatures (35 °C), and from BacT/ALERT when compared with BACTEC blood culture bottles. Storage of positive blood culture bottles in cooler temperatures (22–27 °C or below) and the use of Amies bacterial transport swabs helped preserve viability of S. pneumoniae.

Conclusions

These results have practical implications for the optimal workflow for blood culture bottles that have flagged positive in automated detection systems located remotely from a central processing laboratory, particularly in tropical resource-constrained contexts.
Magnetic resonance imaging findings among young adults with low back pain at Nsambya hospital
Authors: Lukecha Komakech Richard , Geoffrey Erem , Gonzaga Mubuuke A. , Sam Bugeza
Published: June 2022

Background

Studies on MRI findings among patients with LBP have been conducted; especially among adolescents and young adult population in developed countries. However, MRI lumbar spine evaluation findings in young adult patients with low back pain in Uganda is not known. The purpose of this study was to determine the MRI findings and their correlation to clinical features in young adult patients with low back pain in Nsambya hospital.

Methods

This was a descriptive cross sectional study. One hundred and fifty-seven patients with low back pain in the 18–39 year age group underwent MRI lumbar spine evaluation. The MRI changes in the lumbar spine and correlation to clinical features were determined. Correlation was assessed by Pearson chi square tests (Fisher’s exact test) and p values reported at 0.05 level of significance.

Results

Of the 157 patients 129 (82.2%) had severe pain, whereas ninety (57.3%) had pain that had lasted more than 10 weeks. Sixty-five (41.4%) patients were found to have MRI evidence of disc desiccation, majority (61%) of whom had multiple level disease, mostly involving the lowest 2 disc levels. Facet joint arthropathy (47.8%), marginal osteophyte (31.8%) and disc contour irregularity [disc bulge] (31.2%) were other common MRI features seen. There was an association between duration of pain and limb weakness, and development of marginal osteophytes. There was also association between clinical presentation and disc bulge.

Conclusions

The MRI finding of disc degeneration among young adult patients with LBP is higher than reported. Age and pain distribution are predictors of developing disc desiccation.
A stratification model of hepatocellular carcinoma based on expression profiles of cells in the tumor microenvironment
Authors: Zeng Chunting , Zhang Linmeng , Luo Chanhua , Yang Chen , Huang Xiaowen , Fan Linfeng , Li Jiarong , Chen Fengsheng , Luo Zelong
Published: June 2022

Background

A malignancy of the liver, hepatocellular carcinoma (HCC) is among the most common and second-leading causes of cancer-related deaths worldwide. A reliable prognosis model for guidance in choosing HCC therapies has yet to be established.

Methods

A consensus clustering approach was used to determine the number of immune clusters in the Cancer Genome Atlas and Liver Cancer-RIKEN, JP (LIRI_JP) datasets. The differentially expressed genes (DEGs) among these groups were identified based on RNA sequencing data. Then, to identify hub genes among signature genes, a co-expression network was constructed. The prognostic value and clinical characteristics of the immune clusters were also explored. Finally, the potential key genes for the immune clusters were determined.

Results

After conducting survival and correlation analyses of the DEGs, three immune clusters (C1, C2, and C3) were identified. Patients in C2 showed the longest survival time with the greatest abundance of tumor microenvironment (TME) cell populations. MGene mutations in Ffibroblast growth factor-19 (FGF19) and catenin (cadherin-associated protein),β1(CTNNB1) were mostly observed in C2 and C3, respectively. The signature genes of C1, C2, and C3 were primarily enriched in 5, 23, and 26 pathways, respectively.

Conclusions

This study sought to construct an immune-stratification model for the prognosis of HCC by dividing the expression profiles of patients from public datasets into three clusters and discovering the unique molecular characteristics of each. This stratification model provides insights into the immune and clinical characteristics of HCC subtypes, which is beneficial for the prognosis of HCC.
A predictive model for advanced oropharyngeal cancer patients treated with chemoradiation
Authors: Lo Wu-Chia , Chang Chih-Ming , Wu Chia-Yun , Hsieh Chen-Hsi , Shueng Pei-Wei , Cheng Po-Wen , Liao Li-Jen
Published: June 2022

Background

To analyze clinical characteristics in the prediction of death within 1 year in advanced oropharyngeal cancer patients treated with chemoradiation.

Methods

One hundred forty-seven advanced oropharyngeal cancer patients who underwent curative-intent chemoradiation treatment were retrospectively enrolled. The pre-treatment clinical parameters including inflammatory markers were reviewed.

Results

The 1-year death rate for all patients was 29% [95% confidence interval (CI): 23–37%]. In multivariate logistic regression analysis, hemoglobulin (Hb) < 13.5 g/dl was an independent indicator of death within 1-year [Odds ratio (OR) 5.85, 95% CI 2.17–15.75, p < 0.001]. Systemic immune inflammation (SII) ≥ 1820 was also a significant factor for prediction of death within 1 year (OR 4.78, 95% CI 1.44–15.85, p = 0.011). We further used gander, age, Hb and SII to develop a nomogram to predict death within 1 year. The c-index of the model was 0.75 (95%CI 0.66–0.83). For patients with low nomogram score (< 14) versus high nomogram score (≥ 14), the 1-year and 2-year OS rates were 91 and 71% versus 53 and 29%, respectively. (p < 0.001). A difference in the disease persistence or recurrence rate between patients with high and low nomogram score was significant (73 and 28%, respectively; p < 0.001).

Conclusions

The pre-treatment Hb < 13.5 g/dl and SII ≥ 1820 are associated with higher risks of death within 1-year in patients with advanced oropharyngeal cancers. Nomogram can aid in patient counseling and treatment modality adjustment. The development of a more effective treatment protocol for patients with high nomogram score will be essential.
Association of polymorphisms in the erythropoietin gene with diabetic retinopathy: a case–control study and systematic review with meta-analysis
Authors: Sesti Luís Fernando Castagnino , Sbruzzi Renan Cesar , Polina Evelise Regina , dos Santos Soares Douglas , Crispim Daisy , Canani Luís Henrique , dos Santos Kátia Gonçalves
Published: June 2022

Background

Diabetic retinopathy (DR) is characterized by ischemia, hypoxia, and angiogenesis. Erythropoietin (EPO), an angiogenic hormone, is upregulated in DR, and the association of EPO genetic variants with DR is still uncertain, as conflicting results have been reported. Therefore, we performed a case–control study followed by a meta-analysis to investigate whether the rs1617640, rs507392, and rs551238 polymorphisms in EPO gene are associated with DR.

Methods

The case–control study included 1042 Southern Brazilians with type 2 diabetes (488 without DR and 554 with DR). Eligible studies for the meta-analysis were searched from electronic databases up to June 1, 2021. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for five genetic inheritance models.

Results

The minor alleles of the EPO polymorphisms had nearly the same frequency in all groups of patients (35%), and no association was detected with DR in the case–control study. The meta-analysis included 14 independent sets of cases and controls with 9117 subjects for the rs1617640 polymorphism and nine independent sets with more than 5000 subjects for the rs507392 and rs551238 polymorphisms. The G allele of the rs1617640 polymorphism was suggestively associated with DR under the dominant (OR = 0.82, 95% CI: 0.68–0.98), heterozygous additive (OR = 0.82, 95% CI: 0.69–0.97), and overdominant (OR = 0.88, 95% CI: 0.79–0.97) models. In the subgroup analyses, the G allele was also suggestively associated with proliferative DR (PDR), non-proliferative DR (NPDR), and DR (PDR + NPDR) among patients with type 1 diabetes (T1DM) or non-Asian ancestry. After considering the Bonferroni correction for multiple comparisons, the G allele remained associated with NPDR and DR in T1DM. Regarding the rs507392 and rs551238 polymorphisms, no association was found between these variants and DR.

Conclusion

Our findings provide additional support to EPO as a susceptibility gene for DR, with the rs1617640 polymorphism deserving further investigation.
Intravitreal ranibizumab improves macular sensitivity in patients with central retinal vein occlusion and macula edema
Authors: Otawa Taro , Noma Hidetaka , Yasuda Kanako , Narimatsu Akitomo , Asakage Masaki , Tanaka Akina , Goto Hiroshi , Shimura Masahiko
Published: June 2022

Background

Patients with central retinal vein occlusion (CRVO) and macular edema often are treated by intravitreal ranibizumab injection (IRI). The role of changes in macular sensitivity in the positive effects of IRI on visual functions is unclear. Therefore, we assessed the relationship between macular sensitivity and improvement of visual functions.

Methods

We included 15 eyes of 15 patients with treatment-naïve CRVO and followed patients for 6 months after pro re nata IRI. IRI was repeated if the central macular thickness was greater than or equal to 300 µm. Microperimetry-3 was used to measure macular sensitivity within the central 1-mm, 3-mm, and 6-mm fields before and monthly for 6 months after IRI.

Results

IRI significantly improved mean macular sensitivity over time within the central 1-mm, 3-mm, and 6-mm fields (all P < 0.001). None of the fields showed significant differences in the change of mean macular sensitivity between patients with little improvement in best corrected visual acuity (BCVA; i.e., in patients with a change in logarithm of the minimum angle of resolution [logMAR] BCVA < 0.3) and those with marked improvement in BCVA (change in logMAR BCVA > 0.3). The mean macular sensitivity before IRI showed correlations with the improvement of macular sensitivity in every field.

Conclusion

These findings suggest that IRI improves macular sensitivity in patients with CRVO and macular edema independent of any improvement in BCVA and that macular sensitivity before treatment is associated with improvement of macular sensitivity after treatment.
A study protocol to evaluate the impact of a personal and domestic hygiene intervention on lead exposure in a community next to a mine dump
Authors: Mokoatle Charlotte , Mathee Angela , Street Renee , Nkosi Vusumuzi
Published: June 2022

Background

Lead has been associated with adverse health effects, especially neurocognitive and behavioural effects, in children. Communities living close to mining land are at risk of elevated exposure to lead.

Methods

This paper outlines a before and after intervention study protocol to evaluate the impact of a personal and domestic hygiene intervention on lead exposure in a community located adjacent to a mine dump. In each participating household, parents or guardians will be interviewed using a structured questionnaire to obtain information on socio-demographic characteristics, living conditions, domestic hygiene practices and potential alternative sources of exposure to lead. A registered nurse will collect hand wipe samples from children aged one to five years, for whom parental consent and where possible child assent has been obtained. Environmental dust samples will be collected from the floors and/or windowsills of children’s dwellings for lead content analysis. Soil samples will be collected from yards to determine lead content. An educational intervention will then be applied to the intervention group, including the engagement of households or guardians in an educational discussion on the sources, pathways of exposure, health effects of lead exposure and protective measures, with the aid of a specially designed educational brochure. Data will be analysed for descriptive and inferential statistics using Stata version 16.

Discussion

The study will determine whether the intervention led to a reduction in indoor dust lead levels, and if shown to be effective, will inform the development of an awareness campaign to reduce lead exposure in communities located in close proximity to mine dumps.

Trial registration

The study is retrospectively registered on ClinicalTrials.gov Protocol Registration and Results System with registration number NCT05265572 and first release date of 18th February 2022.