bluuebunny/crossref_metadata_2025 huggingface dataset:
Plant-based diets, genetic predisposition and risk of non-alcoholic fatty liver disease
Authors: Lv Yanling , Rong Shuang , Deng Yan , Bao Wei , Xia Yang , Chen Liangkai
Published: September 2023

Background

Diets rich in plant-based foods are associated with lower risks of non-alcoholic fatty liver disease (NAFLD), while the prospective evidence is limited. We aimed to examine longitudinal associations of plant-based diets and genetic susceptibility with NAFLD risk.

Methods

This longitudinal cohort study included 159,222 participants (58.0 ± 8.0 years old, 55.7% female) free of NAFLD in the UK Biobank. We calculated the overall plant-based diet index (PDI), the healthful plant-based diet index (hPDI), and the unhealthful plant-based diet index (uPDI). New-onset NAFLD was the primary outcome. The weighted polygenic risk score was calculated based on risk variants associated with NAFLD. Hazard ratios (HR) and 95% confidential intervals (CI) were estimated by Cox proportional hazards model. Magnetic resonance imaging-derived proton density fat fraction (MRI-PDFF) measured liver fat content in a subsample of 20,692 participants (57.5 ± 7.4 years old, 52.6% female) was the secondary outcome. The associations between plant-based diet indices and MRI-PDFF were evaluated using generalized linear models.

Results

During a median follow-up of 9.5 years, 1541 new-onset NAFLD cases were documented. Compared to the lowest quintile, multivariable-adjusted hazard ratios (HRs) of NAFLD in the highest quintile were 0.78 (95% confidential intervals [CI], 0.66–0.93, p-trend =0.02), 0.74 (95% CI, 0.62–0.87, p-trend <0.0001), and 1.24 (95% CI, 1.05–1.46, p-trend = 0.02) for overall PDI, hPDI, and uPDI, respectively. For liver fat content, higher overall PDI and hPDI were associated with lower MRI-PDFF, while higher uPDI was associated with higher liver fat content. We observed a significant interaction between hPDI and PRS (p-interaction =0.03), and the NAFLD risk was lowest among participants with the highest hPDI and low genetic risk.

Conclusions

Higher intake of plant-based diets especially healthful plant-based diets was associated with lower NAFLD risk and liver fat content regardless of genetic susceptibility, whereas an unhealthful plant-based diet was associated with higher NAFLD risk and intrahepatic steatosis. These results suggest that the quality of plant-based foods should be highlighted when adopting a plant-based diet.
Knowledge, attitude and practices of malaria preventive measures among mothers with children under five years in a rural setting of Ghana
Authors: Adum Prince , Agyare Veronica Adwoa , Owusu-Marfo Joseph , Agyeman Yaa Nyarko
Published: September 2023

Background

Malaria remains a major public health concern around the world, particularly in resource-constrained countries. Malaria still accounts for 40% of all Out-Patient Department (OPD) cases in Ghana, with children under the age of five being the most vulnerable group. The study assessed the knowledge, attitudes, and practices of malaria preventive measures among mothers with children under 5 years old in a rural setting in Ghana.

Methods

A cross-sectional study design with a quantitative approach was used in this study. The study was facility based and involved the use of interviewer administered questionnaires to collect data from 281 mothers with children under the age of five. Simple random sampling method was used to select the respondents. The data collected was analysed using the statistical package for the social sciences (SPSS) version 22 and results presented in tables.

Results

There were 281 mothers, with 59.4% having children at the age of a year. The findings revealed that the majority of participants have a high level of knowledge about malaria’s causes, signs, and symptoms. Again, the majority of participants demonstrated a positive attitude toward malaria prevention, such as seeking treatment at a hospital within 24 h of suspecting their children had malaria and demonstrating good knowledge of malaria prevention practices. Despite this, 35.5% of respondents were not actively engaged in malaria prevention practices in a day prior to the interview. Respondents’ occupation, level of education, and religion had a statistically significant association with mothers’ attitude towards prevention (p-values < 0.05 and 0.01).

Conclusion

The study’s findings clearly demonstrate that the majority of mothers were knowledgeable about the causes, signs and symptoms, and preventive measures of malaria in children under the age of five. There was also statistically significant association between mothers’ demographic information, including level of education, occupation, religion, and their attitude towards malaria prevention. A keen interest should be directed toward the consistent application of low-cost preventive measures.
Subcutaneous tocilizumab in the management of non-infectious uveitis in children: a brief report
Authors: Burlo Francesca , Tumminelli Cristina , Pastore Serena , Stocco Gabriele , Curci Debora , Lucafò Marianna , Tommasini Alberto , Taddio Andrea
Published: September 2023

Background

Tocilizumab is a humanized monoclonal antibody that acts as an IL-6 receptor antagonist. Intravenous tocilizumab is considered an option for children with anti-TNF refractory juvenile idiopathic arthritis-associated uveitis. In contrast, the potential of subcutaneous drug use with this indication is more controversial. Due to the decreased availability of intravenous tocilizumab during the COVID-19 pandemic, we started using the subcutaneous formulation of the drug in children with anti-TNF refractory uveitis. The study analyzes the serum concentration of tocilizumab and its clinical response in patients with anti-TNF refractory uveitis who started or switched to subcutaneous administration from intravenous use.

Methods

Five patients with non-infectious uveitis were treated with subcutaneous tocilizumab. Ocular inflammation was evaluated on slit lamp examination during clinical control. Serum tocilizumab concentrations were determined by ELISA.

Results

The mean blood concentration of tocilizumab was 61.4 µg/mL (range 2.7–137.0.), with higher values than levels recorded in adult patients with rheumatoid arthritis treated with intravenous tocilizumab. Three patients entered clinical remission. One patient developed a mild relapse and was treated with topical steroids. Only one patient did not respond to therapy. The medication was well tolerated without severe infection or other adverse events.

Conclusion

Our results support a possible role of subcutaneous tocilizumab in anti-TNF refractory uveitis.
Murine leukemia virus (MLV) P50 protein induces cell transformation via transcriptional regulatory function
Authors: Akkawi Charbel , Feuillard Jerome , Diaz Felipe Leon , Belkhir Khalid , Godefroy Nelly , Peloponese Jean-Marie , Mougel Marylene , Laine Sebastien
Published: September 2023

Background

The murine leukemia virus (MLV) has been a powerful model of pathogenesis for the discovery of genes involved in cancer. Its splice donor (SD’)-associated retroelement (SDARE) is important for infectivity and tumorigenesis, but the mechanism remains poorly characterized. Here, we show for the first time that P50 protein, which is produced from SDARE, acts as an accessory protein that transregulates transcription and induces cell transformation.

Results

By infecting cells with MLV particles containing SDARE transcript alone (lacking genomic RNA), we show that SDARE can spread to neighbouring cells as shown by the presence of P50 in infected cells. Furthermore, a role for P50 in cell transformation was demonstrated by CCK8, TUNEL and anchorage-independent growth assays. We identified the integrase domain of P50 as being responsible for transregulation of the MLV promoter using luciferase assay and RTqPCR with P50 deleted mutants. Transcriptomic analysis furthermore revealed that the expression of hundreds of cellular RNAs involved in cancerogenesis were deregulated in the presence of P50, suggesting that P50 induces carcinogenic processes via its transcriptional regulatory function.

Conclusion

We propose a novel SDARE-mediated mode of propagation of the P50 accessory protein in surrounding cells. Moreover, due to its transforming properties, P50 expression could lead to a cellular and tissue microenvironment that is conducive to cancer development.
Situating commercial determinants of health in their historical context: a qualitative study of sugar-sweetened beverages in Jamaica
Authors: Barnett-Naghshineh Olivia , Warmington Sheray , Altink Henrice , Govia Ishtar , Morrissey Karyn , Smith Matthew J. , Thurstan Ruth H. , Unwin Nigel , Guell Cornelia
Published: September 2023

Background

Non-communicable diseases (NCDs) are the leading cause of mortality across the Caribbean and similar regions. Structural determinants include a marked increase in the dependency on food imports, and the proliferation of processed foods, including sugar-sweetened beverages (SSBs). We focused on Jamaica as a case study and the health challenge of SSBs, and situated contemporary actions, experiences and policies within their historical context to investigate underlying drivers of commercial determinants of health and attempts to counter them. We asked: how can a historical perspective of the drivers of high level SSB consumption in Jamaica contribute to an enhanced understanding of the context of public health policies aimed at reducing their intake?

Methods

An ethnographic approach with remote data collection included online semi-structured interviews and workshops with 22 local experts and practitioners of health, agriculture and nutrition in Jamaica and attending relevant regional public webinars on SSBs and NCD action in the Caribbean. Our analysis was situated within a review of historical studies of Caribbean food economies with focus on the twentieth century. Jamaican and UK-based researchers collected and ethnographically analysed the data, and discussed findings with the wider transdisciplinary team.

Results

We emphasise three key areas in which historical events have shaped contextual factors of SSB consumption. Trade privileged sugar as a cash crop over food production during Jamaica’s long colonial history, and trade deregulation since the 1980s through structural adjustment opened markets to transnational companies. These changes increased Jamaican receptiveness to the mass advertisement and marketing of these companies, whilst long-standing power imbalances hampered taxation and regulation in contemporary public health actions. Civil society efforts were important for promoting structural changes to curb overconsumption of SSBs and decentring such entrenched power relations.

Conclusion

The contemporary challenge of SSBs in Jamaica is a poignant case study of commercial determinants of health and the important context of global market-driven economies and the involvement of private sector interests in public health policies and governance. Historically contextualising these determinants is paramount to making sense of the sugar ecology in Jamaica today and can help elucidate entrenched power dynamics and their key actors.
Association of psychosocial factors with physical activity among Japanese adults aged 65 and older: a 6-year repeated cross-sectional study from the Nakanojo Study
Authors: Dhakal Amrit , Kurisu Ken , Park Sungjin , Yoshiuchi Kazuhiro , Aoyagi Yukitoshi
Published: September 2023

Background

Physical activity (PA) provides substantial mental and physical health benefits for individuals of all ages. A limited number of long-term or longitudinal studies have investigated the association between psychosocial factors and PA in healthy older adults aged 65 and above. This study aimed to determine the long-term relationship between psychosocial factors, such as vitality, mental health, anxiety, and depression, and objectively measure PA in older adults.

Methods

Healthy participants from Nakanojo, Japan, aged 65–90, capable of walking, were included in this study and were followed up from 2008 to 2013. Those diagnosed with dementia and depression were excluded. Using a repeated cross-sectional dataset, a multilevel model was developed with psychosocial variables as independent variables and an average daily duration of PA volume of > 3 metabolic equivalents (METs) as the outcome. The Akaike information criterion was used to select the final model.

Results

This study included 1108 records from 319 participants. In the multilevel model, age (coefficient = -0.106, 95% confidence interval [CI] = -0.127 to -0.086, p < 0.001) and the Hospital Anxiety and Depression Scale depression scores (coefficient = -0.019, 95% CI = -0.036 to -0.002, p = 0.026) were negatively associated with the duration of PA volume > 3 METs, whereas male sex (coefficient = 0.343, 95% CI = 0.115 to 0.571, p = 0.003) was positively associated with PA volume.

Conclusion

Depressive symptoms were related to a reduced duration of PA volume of > 3 METs among these adults aged 65 and above.
Prevention of cardiac surgery-associated acute kidney injury: a systematic review and meta-analysis of non-pharmacological interventions
Authors: Hariri Geoffroy , Collet Lucie , Duarte Lucie , Martin Guillaume L. , Resche-Rigon Matthieu , Lebreton Guillaume , Bouglé Adrien , Dechartres Agnès
Published: September 2023

Background

Cardiac surgery-associated acute kidney injury (CSA-AKI) is frequent. While two network meta-analyses assessed the impact of pharmacological interventions to prevent CSA-AKI, none focused on non-pharmacological interventions. We aim to assess the effectiveness of non-pharmacological interventions to reduce the incidence of CSA-AKI.

Methods

We searched PubMed, Embase, Central and clinical trial registries from January 1, 2004 (first consensus definition of AKI) to July 1, 2023. Additionally, we conducted manual screening of abstracts of major anesthesia and intensive care conferences over the last 5 years and reference lists of relevant studies. We selected all randomized controlled trials (RCTs) assessing a non-pharmacological intervention to reduce the incidence of CSA-AKI, without language restriction. We excluded RCTs of heart transplantation or involving a pediatric population. The primary outcome variable was CSA-AKI. Two reviewers independently identified trials, extracted data and assessed risk of bias. Random-effects meta-analyses were conducted to calculate risk ratios (RRs) with 95% confidence intervals (CIs). We used the Grading of Recommendations Assessment, Development, and Evaluation to assess the quality of evidence.

Results

We included 86 trials (25,855 patients) evaluating 10 non-pharmacological interventions to reduce the incidence of CSA-AKI. No intervention had high-quality evidence to reduce CSA-AKI. Two interventions were associated with a significant reduction in CSA-AKI incidence, with moderate quality of evidence: goal-directed perfusion (RR, 0.55 [95% CI 0.40–0.76], I2 = 0%; Phet = 0.44) and remote ischemic preconditioning (RR, 0.86 [0.78–0.95]; I2 = 23%; Phet = 0.07). Pulsatile flow during cardiopulmonary bypass was associated with a significant reduction in CSA-AKI incidence but with very low quality of evidence (RR = 0.69 [0.48; 0.99]; I2 = 53%; Phet < 0.01). We found high quality of evidence for lack of effect of restrictive transfusion strategy (RR, 1.02 [95% CI 0.92; 1.12; Phet = 0.67; I2 = 3%) and tight glycemic control (RR, 0.86 [95% CI 0.55; 1.35]; Phet = 0.25; I2 = 26%).

Conclusions

Two non-pharmacological interventions are likely to reduce CSA-AKI incidence, with moderate quality of evidence: goal-directed perfusion and remote ischemic preconditioning.
A treatment strategy with nifedipine versus labetalol for women with pregnancy hypertension: study protocol for a randomised controlled trial (Giant PANDA)
Authors: Ashworth Danielle , Battersby Cheryl , Bick Debra , Green Marcus , Hardy Pollyanna , Leighton Lisa , Magee Laura A. , Maher Alisha , McManus Richard J. , Moakes Catherine , Morris R. Katie , Nelson-Piercy Catherine , Sparkes Jenie , Rivero-Arias Oliver , Webb Andrew , Wilson Hannah , Myers Jenny , Chappell Lucy C.
Published: September 2023

Background

Approximately one in ten women have high blood pressure during pregnancy. Hypertension is associated with adverse maternal and perinatal outcomes, and as treatment improves maternal outcomes, antihypertensive treatment is recommended. Previous trials have been unable to provide a definitive answer on which antihypertensive treatment is associated with optimal maternal and neonatal outcomes and the need for robust evidence evaluating maternal and infant benefits and risks remains an important, unanswered question for research and clinical communities.

Methods

The Giant PANDA study is a pragmatic, open-label, multicentre, randomised controlled trial of a treatment initiation strategy with nifedipine (calcium channel blocker), versus labetalol (mixed alpha/beta blocker) in 2300 women with pregnancy hypertension. The primary objective is to evaluate if treatment with nifedipine compared to labetalol in women with pregnancy hypertension reduces severe maternal hypertension without increasing fetal or neonatal death or neonatal unit admission. Subgroup analyses will be undertaken by hypertension type (chronic, gestational, pre-eclampsia), diabetes (yes, no), singleton (yes, no), self-reported ethnicity (Black, all other), and gestational age at randomisation categories (11 + 0 to 19 + 6, 20 + 0 to 27 + 6, 28 + 0 to 34 + 6 weeks). A cost-effectiveness analysis using an NHS perspective will be undertaken using a cost-consequence analysis up to postnatal hospital discharge and an extrapolation exercise with a lifetime horizon conditional on the results of the cost-consequence analysis.

Discussion

This trial aims to address the uncertainty of which antihypertensive treatment is associated with optimal maternal and neonatal outcomes. The trial results are intended to provide definitive evidence to inform guidelines and linked, shared decision-making tools, thus influencing clinical practice.

Trial registration

EudraCT number: 2020–003410-12, ISRCTN: 12,792,616 registered on 18 November 2020.
‘Forest malaria’ in Myanmar? Tracking transmission landscapes in a diversity of environments
Authors: Legendre Eva , Girond Florian , Herbreteau Vincent , Hoeun Sokeang , Rebaudet Stanislas , Thu Aung Myint , Rae Jade Dean , Lehot Laurent , Dieng Sokhna , Delmas Gilles , Nosten François , Gaudart Jean , Landier Jordi
Published: September 2023

Background

In the Greater Mekong Subregion, case–control studies and national-level analyses have shown an association between malaria transmission and forest activities. The term ‘forest malaria’ hides the diversity of ecosystems in the GMS, which likely do not share a uniform malaria risk. To reach malaria elimination goals, it is crucial to document accurately (both spatially and temporally) the influence of environmental factors on malaria to improve resource allocation and policy planning within given areas. The aim of this ecological study is to characterize the association between malaria dynamics and detailed ecological environments determined at village level over a period of several years in Kayin State, Myanmar.

Methods

We characterized malaria incidence profiles at village scale based on intra- and inter-annual variations in amplitude, seasonality, and trend over 4 years (2016–2020). Environment was described independently of village localization by overlaying a 2-km hexagonal grid over the region. Specifically, hierarchical classification on principal components, using remote sensing data of high spatial resolution, was used to assign a landscape and a climate type to each grid cell. We used conditional inference trees and random forests to study the association between the malaria incidence profile of each village, climate and landscape. Finally, we constructed eco-epidemiological zones to stratify and map malaria risk in the region by summarizing incidence and environment association information.

Results

We identified a high diversity of landscapes (n = 19) corresponding to a gradient from pristine to highly anthropogenically modified landscapes. Within this diversity of landscapes, only three were associated with malaria-affected profiles. These landscapes were composed of a mosaic of dense and sparse forest fragmented by small agricultural patches. A single climate with moderate rainfall and a temperature range suitable for mosquito presence was also associated with malaria-affected profiles. Based on these environmental associations, we identified three eco-epidemiological zones marked by later persistence of Plasmodium falciparum, high Plasmodium vivax incidence after 2018, or a seasonality pattern in the rainy season.

Conclusions

The term forest malaria covers a multitude of contexts of malaria persistence, dynamics and populations at risk. Intervention planning and surveillance could benefit from consideration of the diversity of landscapes to focus on those specifically associated with malaria transmission.

Graphical Abstract
Diversity and geographic distribution of haplotypes of Dirofilaria immitis across European endemic countries
Authors: Alsarraf Mustafa , Carretón Elena , Ciuca Lavinia , Diakou Anastasia , Dwużnik-Szarek Dorota , Fuehrer Hans-Peter , Genchi Marco , Ionică Angela Monica , Kloch Agnieszka , Kramer Laura Helen , Mihalca Andrei D. , Miterpáková Martina , Morchón Rodrigo , Papadopoulos Elias , Pękacz Mateusz , Rinaldi Laura , Alsarraf Mohammed , Topolnytska Mariia , Vismarra Alice , Zawistowska-Deniziak Anna , Bajer Anna
Published: September 2023

Background

Dirofilaria immitis, also known as heartworm, is one of the most important parasitic nematodes of domestic dogs, causing a potentially serious disease, cardiopulmonary dirofilariosis, which can be lethal. This species seems to be less 'expansive' than its sister species Dirofilaria repens, and it is believed that climate change facilitates the spread of this parasite to new non-endemic regions.

Methods

In total, 122 heartworm isolates were analysed from nine endemic countries in Europe (Portugal, Spain, Italy, Greece, Hungary, Romania, Slovakia, and Ukraine) and a single isolate from Bangladesh by amplification and sequencing of two mitochondrial (mt) DNA markers: cytochrome c oxidase subunit 1 (COI) and dehydrogenase subunit 1 (NADH). The main aim of the current study was to determine the genetic diversity of D. immitis and compare it with D. repens haplotype diversity and distribution. DNA was extracted from adult heartworms or microfilariae in blood. Most isolates originated from dogs (Canis lupus familiaris) while 10 isolates originated from wildlife species from Romania, including eight isolates from golden jackals (Canis aureus), one isolate from a Eurasian otter (Lutra lutra) and one isolate from a red fox (Vulpes vulpes).

Results

Median spanning network analysis was based on the combined sequence (1721 bp) obtained from two mt markers and successfully delineated nine haplotypes (Di1-Di9). Haplotype Di1 was the dominant haplotype encompassing 91 out of the 122 sequences (75%) from all nine countries and four host species. Haplotype Di2 was the second most common haplotype, formed solely by 13 isolates from Italy. The remaining sequences were assigned to Di3-Di9 haplotypes, differing by 1–4 SNPs from the dominant Di1 haplotype. There was evidence for geographical segregation of haplotypes, with three unique haplotypes associated with Italy and four others associated with certain countries (Di4 and Di7 with Slovakia; Di8 with Greece; Di6 with Hungary).

Conclusion

Diversity in D. immitis mt haplotypes was lower by half than in D. repens (9 vs. 18 haplotypes in D. immitis and D. repens, respectively), which may be associated with the slower expansion of heartworm in Central and NE Europe. NADH gene appears to be conserved in Dirofilaria sp. by showing lower genetic diversity than the analysed COI gene.

Graphical Abstract
Diaporthe cotoneastri and Ilyonectria cyclaminicola endophytes promote the growth, development, and accumulation of active components of Epimedium koreanum Nakai host plants in field experiments
Authors: Chen Jiawen , Hu Xing , Bai Yang , Liu Hanning , Zhuang Xin , Guo Junjie , Xiao Jinglei
Published: September 2023

Purpose

This study aims to explore the effects of two endophytes of Epimedium koreanum Nakai on host plant growth and development and medicinal material quality and to promote the growth and development of ingredients derived from Epimedium koreanum Nakai.

Methods

The effects on the biomass, photosynthesis parameters, chlorophyll fluorescence parameters, activity of key enzymes, and active components in the process of growth and development in Korea were examined.

Results

From the analysis of biomass and photosynthesis data, both the S3 (Diaporthe cotoneastri) and S10 (Ilyonectria cyclaminicola) strains promoted the growth of Epimedium koreanum Nakai. Redundancy analysis (RDA) showed that the activity of S3 and the content of epimedin A were negatively correlated and that the peroxidase (POD) activity was positively correlated with the total flavonoid content.

Conclusion

The application of the S3 (Diaporthe cotoneastri) and S10 (Ilyonectria cyclaminicola) strains can significantly increase the biomass and contents of total flavonoids, icariin, epimedin B, and epimedin C, but not epimedin A, in Epimedium koreanum Nakai host plants grown in field conditions. The S10 strain promotes faster growth of Epimedium koreanum Nakai than the S3 strain, and flavonoid 3-hydroxylase (F3H) catalyzes the synthesis of epimedin A and icariin by different pathways using the same substrate. POD plays a key role in total flavonoid synthesis in Epimedium koreanum Nakai.
The quality of care index for low back pain: a systematic analysis of the global burden of disease study 1990–2017
Authors: Ghafouri Mohammad , Ghasemi Erfan , Rostami Mohsen , Rouhifard Mahtab , Rezaei Negar , Nasserinejad Maryam , Danandeh Khashayar , Nakhostin-Ansari Amin , Ghanbari Ali , Borghei Alireza , Ahmadzadeh Amiri Ali , Teymourzadeh Azin , Taylor Jeffrey B. , Moghadam Navid , Kordi Ramin
Published: September 2023

Background

. Low back pain is one of the major causes of morbidity worldwide. Studies on low back pain quality of care are limited. This study aimed to evaluate the quality of care of low back pain worldwide and compare gender, age, and socioeconomic groups.

Methods

. This study used GBD data from 1990 to 2017 from the Institute for Health Metrics and Evaluation (IHME) website. Extracted data included low back pain incidence, prevalence, disability-adjusted life years (DALYs), and years lived with disability (YLDs). DALYs to prevalence ratio and prevalence to incidence ratio were calculated and used in the principal component analysis (PCA) to make a proxy of the quality-of-care index (QCI). Age groups, genders, and countries with different socioeconomic statuses regarding low back pain care quality from 1990 to 2017 were compared.

Results

The proxy of QCI showed a slight decrease from 36.44 in 1990 to 35.20 in 2017. High- and upper-middle-income countries showed a decrease in the quality of care from 43.17 to 41.57 and from 36.37 to 36.00, respectively, from 1990 to 2017. On the other hand, low and low-middle-income countries improved, from a proxy of QCI of 20.99 to 27.89 and 27.74 to 29.36, respectively.

Conclusion

. Despite improvements in the quality of care for low back pain in low and lower-middle-income countries between 1990 and 2017, there is still a large gap between these countries and higher-income countries. Continued steps must be taken to reduce healthcare barriers in these countries.
Influence of age on voice quality after transoral CO2 laser microsurgery
Authors: Lechien Jerome R. , Hans Stephane , Crevier-Buchman Lise
Published: September 2023

Objective

To study the post-operative evolution of voice quality of patients treated by transoral CO2 laser microsurgery (TLM) according to the age.

Methods

Patients treated by type I to VI TLM and post-operative speech therapy were prospectively recruited from our hospital. The voice quality was assessed pre-, 1-, 3- 6- and 12-month posttreatment with voice handicap index (VHI), dysphonia, roughness, breathiness, asthenia, strain (GRBAS), maximal phonation time (MPT), F0, F0 standard deviation (STD), percent jitter, percent shimmer, noise-to-harmonic ratio (NHR), vocal fold vibration assessment and speech fluency. Evolution of voice outcomes was analyzed considering age of patients (< 60 vs. ≥ 60 years).

Results

Seventy-five patients completed the evaluations. Thirty-four and forty-one patients were < 60 or ≥ 60 yo, respectively. Subjective and objective voice parameters (VHI, G, R, B), jitter and fluency significantly improved from 1- to 6-month post-TLM in < 60 yo individuals. The voice parameters improved 12-month post-TLM in the ≥ 60 yo group at the exception of VHI that improved 3-month post-TLM. There were positive associations between age and 12-month NHR, G and A parameters.

Conclusion

The post-operative evolution of voice quality parameters may vary between patients according to the age. Preoperative VHI is predictive of 12-month subjective and objective voice outcomes.

Graphical Abstract
High-throughput sequencing in plant disease management: a comprehensive review of benefits, challenges, and future perspectives
Authors: Nizamani Mir Muhammad , Zhang Qian , Muhae-Ud-Din Ghulam , Wang Yong
Published: September 2023

High-throughput sequencing (HTS) has instigated a paradigm shift in plant pathology, showcasing its transformative role in the management of plant diseases. As a powerful tool, HTS aids in identifying pathogens and enhances disease management strategies by detecting novel and emerging pathogens, tracking disease outbreaks, and contributing to developing disease-resistant cultivars. Despite these benefits, the implementation of HTS faces obstacles due to the complexity of data interpretation and economic factors that affect its widespread adoption. This comprehensive review summarizes the strengths, limitations, and opportunities associated with using HTS in managing plant diseases. The article also delves into the prospects of HTS, incorporating technological advancements, synergy with complementary methodologies, capacity-building initiatives, and the development of best practices and guidelines. By acknowledging and addressing these obstacles while harnessing the full capabilities of HTS, we advocate for a refined approach to managing plant diseases. This approach is critical for ensuring global food security, especially in the context of a growing global population and climate change.
Efficient degradation of various recalcitrant azo dyes in aqueous medium by immobilized Origanum vulgare peroxidase
Authors: Golbabaie Mahsa , Gharahchei Behzad , Mirazizi Fatemeh , Baharanchi Alireza Abbasi , Khosronejad Ali , Karkhanie Ali Asghar , Haghbeen Kamahldin
Published: September 2023

Hybrid xerogels, constructed from organic and inorganic silanes, have emerged as materials with versatile applications. They have shown promising potential for immobilization as their chemical structures encompass the mechanical, thermal, and structural stability of inorganic compounds in synergy with the functionality and flexibility of organic compounds. Incorporating a magnetic core and preparation at the nanoscale multiply their attraction for enzyme immobilization. To evaluate how efficiently this technology works for the immobilization of a plant peroxidase, a novel peroxidase (POXov) from a famous medicinal herb, Origanum vulgare, was immobilized on magnetic nanoparticles of a hybrid xerogel obtained from tetraethyl orthosilicate and (3-aminopropyl)triethoxysilane. Immobilization boosted the physicochemical properties of the enzyme so that the immobilized POXov (I.POXov) could tolerate lower pHs and higher temperatures. It oxidized all types of the examined phenolic, catecholic, guaiacolic, and aniline diazo dyes, while the free POXov (F.POXov) failed to oxidize the last group. These improvements also made I.POXov capable of oxidizing the recalcitrant azo dyes carrying electron-withdrawing groups much faster than F.POXov. I.POXov was employed in 7 successive cycles of oxidation of both phenolic and guaiacolic dyes with an average efficiency of 69%. The efficacy of the immobilization method and I.POXov competency for the enzymatic remediation of polluted water resources have been quantitatively demonstrated.
“Cheerios in the lung” as first metastases from endometrial endometrioid adenocarcinoma with adequate response to immunotherapy
Authors: De Nardo Chiara , Landini Nicholas , Massaro Michele , Pernazza Angelina , Arienzo Francesca , Bicchetti Marco , Panebianco Valeria , Catalano Carlo
Published: September 2023

Background

Metastases from endometrial carcinoma to the lungs are uncommon and cavitating metastases are even rarer. In some cases, lung cavitating metastases may resemble diffuse “Cheerios in the lung.”

Case presentation

A 58-year-old woman, smoker, with a history of hysteroannessiectomy and pelvic lymphadenectomy for a low stage endometrial endometrioid adenocarcinoma, came under our attention for dry cough without fever that persisted for over three months, and computed tomography (CT) revealed diffuse cavitating lung metastases resembling "Cheerios in the lung".

After standard chemotherapy proved ineffective, Lenvatinib plus Pembrolizumab (immunotherapy) was administrated, leading to the disappearance of all lung nodules, leaving behind a diffuse emphysematous-like pattern.

Conclusions

This case is a rare example of metastatic endometrioid adenocarcinoma, manifested with chronic dry cough, with “Cheerios in the lung” appearence. The metastases responded well to immunotherapy, resulting in the regression of nodules into areas of diffuse emphysematous-like changes.
Splinting in carpal tunnel syndrome—should we use it during the daytime?
Authors: Kirac Unal Zeynep , Umay Ebru , Unlu Akyuz Ece
Published: September 2023

Background

Splinting is frequently used in the treatment of CTS (carpal tunnel syndrome) and is mostly preferred at night. On the other hand, there are some studies suggesting the use of splint throughout the day. However, there is still no consensus. The aim of this randomized controlled study was to evaluate the effects of day and night splinting in terms of pain, symptom severity, functional status, and quality of life in patients with CTS.

Results

Seventy wrists of 46 patients with CTS were evaluated. In the day-night splint group, according to without splint group and night-only splint group, a statistically significant improvement was found in terms of pain level assessed by Visual Analogue Scale (p = 0.001, p = 0.015, respectively), Boston Carpal Tunnel Questionnaire-Functional Severity Scale (p = 0.004, p = 0.020, respectively), The Nottingham Health Profile-pain (p = 0.001, p = 0.003, respectively), The Nottingham Health Profile-social isolation (p = 0.001, p = 0.001, respectively), and The Nottingham Health Profile-total score (p = 0.001, p = 0.012, respectively). In addition, it was found that even the use of splint only at night resulted in a significant reduction in pain compared to the control group (p = 0.018).

Conclusions

Continuation of splinting as much as possible during the daytime in addition to night splinting is beneficial in terms of pain, nocturnal symptoms, functionality, and quality of life.
Reconstruction and rehabilitation of the Grand Al-Nouri Mosque dated to the twelfth century: a case of study
Authors: Aboelhassan Mohamed Gamal , Tarabia Ahmed Mokhtar , Hassan Sherif Farag
Published: September 2023

This paper aims to present the structural design and the rehabilitation process as well as the site assessment of the reconstruction and rehabilitation of the twelfth-century Grand Al-Nouri Mosque in Al-Nouri Complex, which is a part of the project Revive the Spirit of Mosul in Iraq. UNESCO launched the project Revive the Spirit of Mosul in February 2018 in order to reconstruct the old city after the destruction and looting from the wars with ISIS (Daesh) in 2017. Al-Nouri Complex includes the Great Al-Nouri Mosque and the 45-m-high Al-Hadba Minaret, which are the iconic historic landmarks of the old city of Mosul on the western side of the Tigris River, and it was built by Nur Al-Din Zengi during the twelfth century. Al-Nouri Mosque was reconstructed in 1942 using the original 40 octagonal Moslawi marble columns, and alabaster arches, the mihrab brought from the Ummayad Mosque in Mosul dates back to 956 AD, masonry stones, and a reinforced concrete roof. In this paper, the structural performance of Al-Nouri Mosque has been investigated through site observations, experimental tests, and structural analyses. Due to the several destructive earthquakes recorded around Mosul, a 3D finite element model of the whole mosque using a commercial finite element program has been developed considering the actual material properties and the effect of wind and seismic actions. Generally, the output results of the structural analysis models showed that the obtained compressive stress values did not exceed the compressive strength values defined for the original footing stones and Moslawi marble. Also, the recommended rehabilitation methodology was proposed to enhance the structural characteristics of the dome, the original Moslawi marble columns, and the old stone footings under the marble columns.
Impact of symptomatic menopausal transition on the occurrence of depression, anxiety, and sleep disorders: A real-world multi-site study
Authors: Lee Dong Yun , Andreescu Carmen , Aizenstein Howard , Karim Helmet , Mizuno Akiko , Kolobaric Antonija , Yoon Seokyoung , Kim Yerim , Lim Jaegyun , Hwang Ein Jeong , Ouh Yung-Taek , Kim Hyung Hoi , Son Sang Joon , Park Rae Woong
Published: September 2023

Background

The menopause transition is a vulnerable period that can be associated with changes in mood and cognition. The present study aimed to investigate whether a symptomatic menopausal transition increases the risks of depression, anxiety, and sleep disorders.

Methods

This population-based, retrospective cohort study analysed data from five electronic health record databases in South Korea. Women aged 45–64 years with and without symptomatic menopausal transition were matched 1:1 using propensity-score matching. Subgroup analyses were conducted according to age and use of hormone replacement therapy (HRT). A primary analysis of 5-year follow-up data was conducted, and an intention-to-treat analysis was performed to identify different risk windows over 5 or 10 years. The primary outcome was first-time diagnosis of depression, anxiety, and sleep disorder. We used Cox proportional hazard models and a meta-analysis to calculate the summary hazard ratio (HR) estimates across the databases.

Results

Propensity-score matching resulted in a sample of 17,098 women. Summary HRs for depression (2.10; 95% confidence interval [CI] 1.63–2.71), anxiety (1.64; 95% CI 1.01–2.66), and sleep disorders (1.47; 95% CI 1.16–1.88) were higher in the symptomatic menopausal transition group. In the subgroup analysis, the use of HRT was associated with an increased risk of depression (2.21; 95% CI 1.07–4.55) and sleep disorders (2.51; 95% CI 1.25–5.04) when compared with non-use of HRT.

Conclusions

Our findings suggest that women with symptomatic menopausal transition exhibit an increased risk of developing depression, anxiety, and sleep disorders. Therefore, women experiencing a symptomatic menopausal transition should be monitored closely so that interventions can be applied early.
Differentiation of Idiopathic Central Precocious Puberty From Premature Thelarche Using Principal Component Analysis
Authors: Cleemann Wang Amanda , Hagen Casper P , Johannsen Trine Holm , Madsen Andre Greger , Cleemann Line Hartvig , Christiansen Peter , Main Katharina M , Juul Anders , Jensen Rikke Beck
Published: September 2023

Context

Nonprogressive premature thelarche (PT) is a self-limiting variant of early puberty, while idiopathic central precocious puberty (ICPP) is a disorder that causes progressive development of secondary sexual characteristics and often requires treatment. The diagnostic differentiation between these conditions is important but can be challenging since they often both initially present clinically with isolated breast development.

Objective

To describe relevant clinical variables in a large cohort of girls referred for early puberty, and to evaluate clinical and biochemical parameters to distinguish between girls with ICPP and PT.

Methods

This retrospective study included 1361 girls referred with signs of early puberty to a single, tertiary center from 2009 to 2019. We evaluated clinical presentation, medical history, growth velocity, bone age, hormonal serum concentrations, and gonadotropin-releasing hormone (GnRH) test results.

Results

Central precocious puberty was diagnosed in 11% (ICPP: n = 143, organic CPP: n = 11) girls, whereas 8% (n = 91 girls) presented with PT. Receiver operating characteristic (ROC) analysis showed several biochemical and anthropometric markers as potential parameters to differentiate between ICPP and PT; however, none were individually adequate. Principal component analysis (PCA)–derived clinical and hormone profiles could predict girls with ICPP from girls with PT with a specificity of 90% and sensitivity of 84%, outperforming any single marker.

Conclusion

Differentiation of girls with ICPP and PT can be supported by individual clinical and biochemical parameters. However, dimension reduction of clinical and hormonal profiles by PCA improved the diagnostic value, which in the future may support the diagnostic process as a supplement to the GnRH test in evaluation of pubertal disorders.
A Prospective, Multicenter, Observational Study of Surgical vs Nonsurgical Management for Pituitary Apoplexy
Authors: Mamelak Adam N , Little Andrew S , Gardner Paul A , Almeida João Paulo , Recinos Pablo , Soni Pranay , Kshettry Varun R , Jane John A , Barkhoudarian Garni , Kelly Daniel F , Dodd Robert , Mukherjee Debraj , Gersey Zachary C , Fukuhara Noriaki , Nishioka Hiroshi , Kim Eui-Hyun , Litré Claude-Fabien , Sina Elliott , Mazer Mia W , Cui Yujie , Bonert Vivien
Published: September 2023

Context

Pituitary apoplexy (PA) has been traditionally considered a neurosurgical emergency, yet retrospective single-institution studies suggest similar outcomes among patients managed medically.

Objective

We established a multicenter, international prospective registry to compare presentation and outcomes in PA patients treated with surgery or medical management alone.

Methods

A centralized database captured demographics, comorbidities, clinical presentation, visual findings, hormonal status, and imaging features at admission. Treatment was determined independently by each site. Key outcomes included visual, oculomotor, and hormonal recovery, complications, and hospital length of stay. Outcomes were also compared based on time from symptom onset to surgery, and from admission or transfer to the treating center. Statistical testing compared treatment groups based on 2-sided hypotheses and P less than .05.

Results

A total of 100 consecutive PA patients from 12 hospitals were enrolled, and 97 (67 surgical and 30 medical) were evaluable. Demographics, clinical features, presenting symptoms, hormonal deficits, and imaging findings were similar between groups. Severe temporal visual field deficit was more common in surgical patients. At 3 and 6 months, hormonal, visual, and oculomotor outcomes were similar. Stratifying based on severity of visual fields demonstrated no difference in any outcome at 3 months. Timing of surgery did not affect outcomes.

Conclusion

We found that medical and surgical management of PA yield similar 3-month outcomes. Although patients undergoing surgery had more severe visual field deficits, we could not clearly demonstrate that surgery led to better outcomes. Even without surgery, apoplectic tumor volumes regress substantially within 2 to 3 months, indicating that surgery is not always needed to reduce mass effect.
AI pitfalls and what not to do: mitigating bias in AI
Authors: Gichoya Judy Wawira , Thomas Kaesha , Celi Leo Anthony , Safdar Nabile , Banerjee Imon , Banja John D , Seyyed-Kalantari Laleh , Trivedi Hari , Purkayastha Saptarshi
Published: September 2023

Various forms of artificial intelligence (AI) applications are being deployed and used in many healthcare systems. As the use of these applications increases, we are learning the failures of these models and how they can perpetuate bias. With these new lessons, we need to prioritize bias evaluation and mitigation for radiology applications; all the while not ignoring the impact of changes in the larger enterprise AI deployment which may have downstream impact on performance of AI models. In this paper, we provide an updated review of known pitfalls causing AI bias and discuss strategies for mitigating these biases within the context of AI deployment in the larger healthcare enterprise. We describe these pitfalls by framing them in the larger AI lifecycle from problem definition, data set selection and curation, model training and deployment emphasizing that bias exists across a spectrum and is a sequela of a combination of both human and machine factors.
Cross-linking mass spectrometric analysis of the endogenous TREX complex fromSaccharomyces cerevisiae
Authors: Kern Carina , Radon Christin , Wende Wolfgang , Leitner Alexander , Sträßer Katja
Published: September 2023

The conserved TREX complex has multiple functions in gene expression such as transcription elongation, 3′ end processing, mRNP assembly and nuclear mRNA export as well as the maintenance of genomic stability. InSaccharomyces cerevisiae, TREX is composed of the pentameric THO complex, the DEAD-box RNA helicase Sub2, the nuclear mRNA export adaptor Yra1, and the SR-like proteins Gbp2 and Hrb1. Here, we present the structural analysis of the endogenous TREX complex ofS. cerevisiaepurified from its native environment. To this end, we used cross-linking mass spectrometry to gain structural information on regions of the complex that are not accessible to classical structural biology techniques. We also used negative-stain electron microscopy to investigate the organization of the cross-linked complex used for XL-MS by comparing our endogenous TREX complex with recently published structural models of recombinant THO–Sub2 complexes. According to our analysis, the endogenous yeast TREX complex preferentially assembles into a dimer.
Aξιόποινη παραμέληση εποπτείας εκ μέρους διευθυντικών στελεχών για την αποτροπή αξιοποίνων πράξεων υφισταμένων τους
Authors: Αποστολάκης Εμμανουήλ
Published: September 2023

Η συγκρότηση μιας ΑΕ, η οποία επιτελεί, διά της εσωτερικής κατανομής ρόλων και της μεταβίβασης αρμοδιοτήτων, σύνθετες δράσεις, αποτελεί μια κοινωνικά πρόσφορη αλλά κινδυνώδη δραστηριότητα. Αυτός ο ήδη ενυπάρχων κίνδυνος επιτείνεται, όταν τα επιφορτισμένα με την εξουσία διευθύνσεως και εποπτείας πρόσωπα εκπληρώνουν πλημμελώς το καθήκον εποπτείας της δράσης των υφισταμένων τους και κατά τούτο διευκολύνουν ή καθιστούν εφικτή την αξιόποινη δράση των τελευταίων, χωρίς να έχουν απαραιτήτως γνώση και θέληση ως προς την πραγμάτωσή της. Αντικείμενο διερεύνησης της εργασίας είναι το καθήκον εποπτείας των εταιρικών διοικητών και των διευθυντικών στελεχών στο πλαίσιο της ΑΕ και η δυνατότητα στοιχειοθέτησης ποινικής ευθύνης εξαιτίας της μη προσήκουσας εκπλήρωσής του, όταν κάποιο ιεραρχικά υφιστάμενο πρόσωπο πραγμάτωσε τελικώς κάποια αξιόποινη συμπεριφορά. Υπό την έννοια αυτή εξετάζεται, μεταξύ άλλων, το ερώτημα αν σε ιδιώτες που βαρύνονται με ένα ιδιωτικό καθήκον, όπως είναι το καθήκον εποπτείας, μπορούν να ανατεθούν (δημόσια) καθήκοντα αντεγκληματικής πολιτικής. Για την εξέταση του ανωτέρω ερωτήματος, η εργασία διέρχεται τόσο από την προβληματική του εγκλήματος που τελείται με παράλειψη κατ’ άρθρο 15 ΠΚ όσο και από ειδικές ποινικές διατάξεις, με τις οποίες τιμωρείται η παραμέληση του καθήκοντος εποπτείας και η μη αποτροπή αξιόποινων πράξεων υφισταμένων στο πλαίσιο συλλογικών οντοτήτων της ιδιωτικής οικονομίας (λ.χ. στο πεδίο της διαφθοράς, της προστασίας του περιβάλλοντος, του ελεύθερου ανταγωνισμού), καταλήγοντας σε de lege ferenda προτάσεις.