bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of Proton Pump Inhibitors in Cardiac Patients: Guideline Recommendations Versus Practical Approach
Authors: Kahali Dhiman , Desai Shashank , Pebbili Kranthi Kiran
Published: June 2024

Dual-antiplatelet therapy (DAPT) is a cornerstone treatment for patients diagnosed with acute coronary syndrome (ACS) and coronary artery disease (CAD). Although DAPT effectively reduces the occurrence of thrombotic events, it also substantially increases the likelihood of gastrointestinal (GI) bleeding. Proton pump inhibitors (PPIs) are essential for mitigating the GI bleeding risk, yet concerns persist regarding their prolonged use and potential adverse effects. Apart from rabeprazole, PPIs share the hepatic metabolism pathway with clopidogrel, resulting in unfavorable cardiovascular outcomes. The pairing of rabeprazole with clopidogrel emerges as a prudent recommendation, displaying superior efficacy in mitigating major adverse cardiovascular events (MACE) when juxtaposed with other PPIs. This narrative review underscores the complexity of managing PPIs in cardiac patients and emphasizes the importance of tailored approaches based on emerging evidence while providing valuable insights to clinicians navigating this challenging therapeutic landscape.
Association of Food and Housing Insecurity on Outcomes in Pregnant Patients With Substance Use Disorder
Authors: Chilukuri Pranaya , Patel Neil , Cockerham Cynthia , Su Leon , Stromberg Arnold , O’Brien John , Parilla Barbara
Published: June 2024

Objectives:

Food insecurity (FI) may be associated with worsened neonatal abstinence syndrome severity in infants born to individuals with substance use disorder. This study evaluates FI and housing insecurity (HI) influence on maternal and neonatal outcomes.

Methods:

This was a cohort study of patients receiving obstetric care through a multispecialty program in Kentucky from 2015 to 2023. Inclusion criteria were: (1) program participants over age 18 consenting to observational research, (2) delivering at University of Kentucky, and (3) not withdrawing from research at any time. Initially, a subset of patients for whom FI and HI concerns were heightened were screened. In 2019, FI and HI screening became standard of care at the clinic. Housing was assessed on enrollment. A validated 2-question Hunger Vital Sign FI screen was utilized for a subset of patients. Maternal and neonatal outcomes, including adverse delivery outcomes, maternal comorbidities, and birth complications, were observed. Fisher’s exact and 2 sample t tests were performed.

Results:

Of 494 participants, 188 (38%) identified at risk for HI. At enrollment, 221 (45%) individuals reported owning their primary residence, 85 (17%) were in group residential treatment, 34 (6.9%) had no housing, and 134 (27%) lived at another’s residence. Disposition of a child to a relative or not the patient’s own care was greater with HI, 51% versus 47%. Of 155 respondents, 96 (62%) reported FI, associated with increased neonatal intensive care unit (NICU) admission, 86% versus 74%. Using the validated tool, Abuse Assessment Screen, abuse was significantly greater with FI, 76% versus 58%. Edinburgh Postpartum Depression Scales >12 indicating depression were more common with FI, 63% versus 32%, P < .05. Anxiety scores were also higher with FI, P < .05. Patients with FI were more likely to experience abuse.

Conclusions:

FI and HI were health-related needs associated with increased anxiety, depression, infant NICU admission, and loss of child custody.
GWAS and Transcriptomic Analysis Identify OsRING315 as a New Candidate Gene Controlling Amylose Content and Gel Consistency in Rice
Authors: Nie Shuai , Chen Luo , Zheng Minhua , Dong Jingfang , Ma Yamei , Zhou Lian , Wang Jian , Chen Jiansong , Hu Haifei , Yang Tifeng , Zhao Junliang , Zhang Shaohong , Yang Wu
Published: June 2024

Cooking quality is the main factor determining the market value of rice. Although several major genes and a certain number of QTLs controlling cooking quality have been identified, the genetic complexity and environmental susceptibility limit the further improvement for cooking quality by molecular breeding. This research conducted a genome-wide association study to elucidate the QTLs related to cooking quality including amylose content (AC), gel consistency (GC) and alkali spreading value (ASV) by using 450 rice accessions consisting of 300 indica and 150 japonica accessions in two distinct environments. A total of 54 QTLs were identified, including 25 QTLs for AC, 12 QTLs for GC and 17 QTLs for ASV. Among them, 10 QTLs were consistently observed by the same population in both environments. Six QTLs were co-localized with the reported QTLs or cloned genes. The Wx gene for AC and GC, and the ALK gene for ASV were identified in every population across the two environments. The qAC9-2 for AC and the qGC9-2 for GC were defined to the same interval. The OsRING315 gene, encoding an E3 ubiquitin ligase, was considered as the candidate gene for both qAC9-2 and qGC9-2. The higher expression of OsRING315 corresponded to the lower AC and higher GC. Three haplotypes of OsRING315 were identified. The Hap 1 mainly existed in the japonica accessions and had lower AC. The Hap 2 and Hap 3 were predominantly present in the indica accessions, associated with higher AC. Meanwhile, the GC of accessions harboring Hap 1 was higher than that of accessions harboring Hap 3. In addition, the distribution of the three haplotypes in several rice-growing regions was unbalanced. The three traits of cooking quality are controlled by both major and minor genes and susceptible to environmental factors. The expression level of OsRING315 is related to both AC and GC, and this gene can be a promising target in quality improvement by using the gene editing method. Moreover, the haplotypes of OsRING315 differentiate between indica and japonica, and reveal the differences in GC and AC between indica and japonica rice.
Diagnosis and multidisciplinary management of a large primary retroperitoneal hydatid cyst: report of a sporadic case
Authors: Nedjim Saleh Abdelkerim , Bencherki Youssef , Daghdagh Yassine , Nachid Abdellah , Tmiri Anas , El Badr Mouad , Moataz Amine , Dakir Mohamed , Adil Debbagh , Aboutaieb Rachid
Published: June 2024

Background

Hydatid cysts, a parasite caused by infestation with Echinococcosis granulose, are rarely found in isolation in the retroperitoneum. Diagnosis is based on clinical and paraclinical criteria, and the symptoms are often aspecific. In large, symptomatic forms, surgical excision is the mainstay of treatment. However, a multidisciplinary approach, including infectious diseases specialists, can improve results and reduce the risk of recurrence.

Case presentation

We report the case of a 38-year-old woman presenting with a large primary retroperitoneal hydatid cyst. After 13 years of asymptomatic evolution, she developed lumbar pain and a sensation of heaviness. The diagnosis was confirmed by a battery of biological and radiological tests. Due to the size of the cyst, open surgery was performed. Follow-up revealed no clinical complaints or recurrences.

Conclusion

Considered a rare condition, hydatid cyst requires special attention when evaluating lumbar masses or cystic masses, particularly in endemic areas. In addition to surgery, it is essential to take into account the risk of contamination of other sites during surgery. Collaboration with specialists in infectious diseases is therefore essential.
Regulating “forever chemicals”: social data are necessary for the successful implementation of the essential use concept
Authors: Suffill Ellise , White Mathew P. , Hale Sarah , Pahl Sabine
Published: June 2024

Per- and polyfluoroalkyl substances (PFAS) are a large class of synthetic compounds, many of which are persistent, mobile and toxic (PMT). The sheer number of PFAS makes a substance-by-substance based approach to regulating this group unfeasible. Given the known risks of many PFAS, a precautionary approach (i.e., the Essential Use Concept; EUC) has been called for, whereby any substance is assumed to be harmful and should be phased out, unless it is shown that: (a) the use of this substance is necessary for health and safety, or is critical for the functioning of society and (b) there are no available technically and economically feasible alternatives. While experts, including chemists and toxicologists, are well-placed to assess the second criteria, determining what is necessary for the “functioning of society” requires a wider consideration of societal beliefs and preferences and greater involvement of various interested and affected parties, especially those whose voices are less heard but may be most vulnerable. The aim of the current paper is to provide a preliminary framework and research agenda outlining why and at what points in the essential use decision-making process broader societal perspectives are required, and how such ‘social data’ can be collected. The ultimate goal is to improve chemicals management by supporting citizens in becoming more informed and engaged participants in relevant debates and policies, including in how to operationalise the EUC.
The impact of global value chains on wages, employment, and productivity: a survey of theoretical approaches
Authors: Szymczak Sabina
Published: June 2024

This study presents a systematic literature review to provide a collection of theories explaining the impact of global value chains (GVCs) on labour market outcomes. Due to the complex nature of GVCs and the interconnectedness of wages, employment, and productivity, many direct and indirect effects are at play. To ensure a transparent and systematic flow of the review process, I follow the PRISMA guide. Eventually, 36 records out of 1221 results from Scopus database were selected. This review may be useful for theorists, empirical economists, and policy makers as an overview of theoretical developments and convenient map of potential outcomes expected from involvement in GVCs. It identifies and systematizes a number of effects existing in the literature under various names. The results show that the predictions from the theory are ambiguous. The positive effects which may emerge regardless the characteristics of the GVC are the productivity-enhancing effect and the cross-effect, especially important considering growing servicification of manufacturing. Here lies the critical role of the state and policies to assure that the losses will not exceed the gains in the aggregate terms. One of the main factors shaping the outcome is the power distribution among the GVC’s firms. Additionally, this paper shows the shortcomings of the existing theories. Less aggregated levels of analysis could be a great input to the discussion, as well as addressing different GVCs’ dimensions and types of organisation. The understanding of relation between GVC position and labour market is especially worth exploration as the existing evidence adopt different and even contradicting perspectives on the definition of upgrading the GVC position.
Integrating transformers and many-objective optimization for drug design
Authors: Aksamit Nicholas , Hou Jinqiang , Li Yifeng , Ombuki-Berman Beatrice
Published: June 2024

Background

Drug design is a challenging and important task that requires the generation of novel and effective molecules that can bind to specific protein targets. Artificial intelligence algorithms have recently showed promising potential to expedite the drug design process. However, existing methods adopt multi-objective approaches which limits the number of objectives.

Results

In this paper, we expand this thread of research from the many-objective perspective, by proposing a novel framework that integrates a latent Transformer-based model for molecular generation, with a drug design system that incorporates absorption, distribution, metabolism, excretion, and toxicity prediction, molecular docking, and many-objective metaheuristics. We compared the performance of two latent Transformer models (ReLSO and FragNet) on a molecular generation task and show that ReLSO outperforms FragNet in terms of reconstruction and latent space organization. We then explored six different many-objective metaheuristics based on evolutionary algorithms and particle swarm optimization on a drug design task involving potential drug candidates to human lysophosphatidic acid receptor 1, a cancer-related protein target.

Conclusion

We show that multi-objective evolutionary algorithm based on dominance and decomposition performs the best in terms of finding molecules that satisfy many objectives, such as high binding affinity and low toxicity, and high drug-likeness. Our framework demonstrates the potential of combining Transformers and many-objective computational intelligence for drug design.
De novo transcriptome assembly of the oak processionary moth Thaumetopoea processionea
Authors: Zicola Johan , Dasari Prasad , Hahn Katharina Klara , Ziese-Kubon Katharina , Meurer Armin , Buhl Timo , Scholten Stefan
Published: June 2024

Objectives

The oak processionary moth (OPM) (Thaumetopoea processionea) is a species of moth (order: Lepidoptera) native to parts of central Europe. However, in recent years, it has become an invasive species in various countries, particularly in the United Kingdom and the Netherlands. The larvae of the OPM are covered with urticating barbed hairs (setae) causing irritating and allergic reactions at the three last larval stages (L3-L5). The aim of our study was to generate a de novo transcriptomic assembly for OPM larvae by including one non-allergenic stage (L2) and two allergenic stages (L4 and L5). A transcriptomic assembly will help identify potential allergenic peptides produced by OPM larvae, providing valuable information for developing novel therapeutic strategies and allergic immunodiagnostic assays.

Data

Transcriptomes of three larval stages of the OPM were de novo assembled and annotated using Trinity and Trinotate, respectively. A total of 145,251 transcripts from 99,868 genes were identified. Bench-marking universal single-copy orthologues analysis indicated high completeness of the assembly. About 19,600 genes are differentially expressed between the non-allergenic and allergenic larval stages. The data provided here contribute to the characterization of OPM, which is both an invasive species and a health hazard.
Molecular prevalence and phylogenetic analysis of hemotropic Mycoplasma species in cats in different regions of Iran
Authors: Hoseinpoor Elham , Goudarztalejerdi Ali , Sazmand Alireza
Published: June 2024

Background

Hemotropic Mycoplasma species (hemoplasmas) cause hemolytic anemia in cats worldwide and are recognized as emerging zoonotic pathogens. There is no comprehensive study on the prevalence and species diversity of hemoplasmas in domestic cat populations in different regions in Iran. Thus, the aims of the present study were to provide data on the prevalence and molecular characterization of hemotropic Mycoplasma species in apparently healthy cats from six Iranian provinces with different climates. In addition, potential risk factors associated with hemoplasmosis in cats were assessed.

Results

Mycoplasma spp. DNA was detected in the blood of 56 / 361 cats (15.5%) using genus-specific PCR. Further examinations with species-specific PCR and Sanger sequencing showed that 38 cats (10.5%) tested positive for Candidatus Mycoplasma haemominutum (CMhm), 8 cats (2.2%) tested positive for Mycoplasma haemofelis (Mhf), and 2 cats (0.6%) tested positive for Candidatus Mycoplasma turicensis (CMt). Co-infection with CMhm, and Mhf was observed in 7 cats (1.9%). One cat (0.3%) showed mixed infection with CMhm, Mhf, and CMt. There were statistically significant relationships between Mycoplasma positivity and being female, living in shelter (cattery), and being over 3 years old (P < 0.05). No significant association was observed for the cat breed and sampling localities.

Conclusions

Current study findings revealed that hemoplasma infections are common among Iran cat populations. Considering the impact of such emerging zoonotic pathogens on the One Health, routine screenings, increasing public awareness, effective control, and prophylactic strategies for minimizing infection in cats and subsequently in human are strongly recommended.
CRISPR/Cas9-induced knockout of an amino acid permease gene (AAP6) reduced Arabidopsis thaliana susceptibility to Meloidogyne incognita
Authors: Dutta Tushar K. , Rupinikrishna Katakam , Akhil Voodikala S. , Vashisth Neeraj , Phani Victor , Pankaj  , Sirohi Anil , Chinnusamy Viswanathan
Published: June 2024

Background

Plant-parasitic root-knot nematode (Meloidogyne incognita) causes global yield loss in agri- and horticultural crops. Nematode management options rely on chemical method. However, only a handful of nematicides are commercially available. Resistance breeding efforts are not sustainable because R gene sources are limited and nematodes have developed resistance-breaking populations against the commercially available Mi-1.2 gene-expressing tomatoes. RNAi crops that manage nematode infection are yet to be commercialized because of the regulatory hurdles associated with transgenic crops. The deployment of the CRISPR/Cas9 system to improve nematode tolerance (by knocking out the susceptibility factors) in plants has emerged as a feasible alternative lately.

Results

In the present study, a M. incognita-responsive susceptibility (S) gene, amino acid permease (AAP6), was characterized from the model plant Arabidodpsis thaliana by generating the AtAAP6 overexpression line, followed by performing the GUS reporter assay by fusing the promoter of AtAAP6 with the β-glucuronidase (GUS) gene. Upon challenge inoculation with M. incognita, overexpression lines supported greater nematode multiplication, and AtAAP6 expression was inducible to the early stage of nematode infection. Next, using CRISPR/Cas9, AtAAP6 was selectively knocked out without incurring any growth penalty in the host plant. The ‘Cas9-free’ homozygous T3 line was challenge inoculated with M. incognita, and CRISPR-edited A. thaliana plants exhibited considerably reduced susceptibility to nematode infection compared to the non-edited plants. Additionally, host defense response genes were unaltered between edited and non-edited plants, implicating the direct role of AtAAP6 towards nematode susceptibility.

Conclusion

The present findings enrich the existing literature on CRISPR/Cas9 research in plant-nematode interactions, which is quite limited currently while compared with the other plant-pathogen interaction systems.
Population differentiation and dynamics of five pioneer species of Gaultheria from the secondary forests in subtropical China
Authors: Li Yi-Rong , Fritsch Peter W. , Zhao Gui-Gang , Cheng Xiao-Juan , Ding Zhao-Li , Lu Lu
Published: June 2024

Background

The influence of native secondary succession associated with anthropogenic disturbance on the biodiversity of the forests in subtropical China remains uncertain. In particular, the evolutionary response of small understory shrubs, particularly pioneer species inhabiting continuously disturbed habitats, to topographic heterogeneity and climate change is poorly understood. This study aimed to address this knowledge gap by focusing on the Gaultheria crenulata group, a clade of small pioneer shrubs in subtropical China.

Results

We examined the genetic structure and demographic history of all five species of the G. crenulata group with two maternally inherited chloroplast DNA (cpDNA) fragments and two biparentally inherited low-copy nuclear genes (LCG) over 89 natural populations. We found that the genetic differentiation of this group was influenced by the geomorphological boundary between different regions of China in association with Quaternary climatic events. Despite low overall genetic diversity, we observed an isolation-by-distance (IBD) pattern at a regional scale, rather than isolation-by-environment (IBE), which was attributed to ongoing human disturbance in the region.

Conclusion

Our findings suggest that the genetic structure of the G. crenulata group reflects the interplay of geological topography, historical climates, and anthropogenic disturbance during the Pliocene–Pleistocene-Holocene periods in subtropical China. The observed IBD pattern, particularly prominent in western China, highlights the role of limited dispersal and gene flow, possibly influenced by physical barriers or decreased connectivity over geographic distance. Furthermore, the east-to-west trend of gene flow, potentially facilitated by the East Asian monsoon system, underscores the complex interplay of biotic and abiotic factors shaping the genetic dynamics of pioneer species in subtropical China’s secondary forests. These findings can be used to assess the impact of environmental changes on the adaptation and persistence of biodiversity in subtropical forest ecosystems.
Characteristics of duplicated gene expression and DNA methylation regulation in different tissues of allopolyploid Brassica napus
Authors: Sun Weiqi , Li Mengdi , Wang Jianbo
Published: June 2024

Plant polyploidization increases the complexity of epigenomes and transcriptional regulation, resulting in genome evolution and enhanced adaptability. However, few studies have been conducted on the relationship between gene expression and epigenetic modification in different plant tissues after allopolyploidization. In this study, we studied gene expression and DNA methylation modification patterns in four tissues (stems, leaves, flowers and siliques) of Brassica napusand its diploid progenitors. On this basis, the alternative splicing patterns and cis-trans regulation patterns of four tissues in B. napus and its diploid progenitors were also analyzed. It can be seen that the number of alternative splicing occurs in the B. napus is higher than that in the diploid progenitors, and the IR type increases the most during allopolyploidy. In addition, we studied the fate changes of duplicated genes after allopolyploidization in B. napus. We found that the fate of most duplicated genes is conserved, but the number of neofunctionalization and specialization is also large. The genetic fate of B. napus was classified according to five replication types (WGD, PD, DSD, TD, TRD). This study also analyzed generational transmission analysis of expression and DNA methylation patterns. Our study provides a reference for the fate differentiation of duplicated genes during allopolyploidization.
Non-targeted GC–MS metabolomics-based differences in Indica rice seeds of different varieties
Authors: Zhou Dahu , Jing Hao , Yuan Jun , Zhou Mingming , Liu Lin , Fu Junru , Ouyang Linjuan , Xu Jie , Bian Jianmin , Fu Haihui , He Haohua
Published: June 2024

Rice seeds of different varieties exhibited distinct metabolic profiles in our study. We analyzed the metabolites in seeds of six rice varieties (CH, HM, NX, YX, HY, and MX) using non-targeted GC–MS. Our findings revealed that amino acids, sugars, and organic acids were predominant in all varieties, with significant differences observed in CH compared to the others. Specifically phenylalanine and glycine content differed notably in NX and YX, respectively. Additionally, 1,5-anhydroglucitol content in NX, and glutamate, aspartate, and lactulose in NX, YX, HM, HY, and MX were up-regulated. Due to the biological functions of these amino acids and sugars, these indicated that compared to CH, rice of NX were more conducive to metabolism of carbohydrate and fat, and healthy growth maintenance in the human body, but mightThese variations suggest that NX rice may be more beneficial for carbohydrate and fat metabolism and overall health maintenance compared to CH. However, it may not be suitable for diabetic patients. YX rice may not be an ideal glycine supplement, rice ofwhile HM, HY, and MX rice could serve as potential lactulose sources. Furthermore, NX and YX rice exhibited higher levels of main storage proteins compared to CH. This study offers valuable insights into the metabolic differences among various rice varieties.
Remimazolam anaphylaxis in a patient not allergic to brotizolam: a case report and literature review
Authors: Nakai Toshihiro , Kako Eisuke , Ota Haruko , So MinHye , Sobue Kazuya
Published: June 2024

Background

Remimazolam is a recently developed, ultrashort-acting benzodiazepine that is used as a general anesthetic. Some cases of remimazolam anaphylaxis have been reported, but its characteristics are not fully understood. We present an interesting case report and review of the literature to better understand remimazolam anaphylaxis.

Case presentation

A 75-year-old man scheduled for robot-assisted gastrectomy was administered remimazolam for the induction of general anesthesia. After intubation, low end-expiratory CO2, high airway pressure and concurrent circulatory collapse were observed. Bronchoscopy revealed marked tracheal and bronchial edema, which we diagnosed as anaphylaxis. The patient suffered cardiac arrest after bronchoscopy but recovered immediately with intravenous adrenaline administration and chest compressions. We performed skin prick tests for the drugs used during induction except for remimazolam, considering the high risk of systemic adverse reactions to remimazolam. We diagnosed remimazolam anaphylaxis because the skin prick test results for the other drugs used during anesthesia were negative, and these drugs could have been used without allergic reactions during the subsequent surgery. Furthermore, this patient had experienced severe anaphylactic-like reactions when he underwent cardiac surgery a year earlier, in which midazolam had been used, but it was not thought to be the allergen at that time. Based on these findings, cross-reactivity to remimazolam and midazolam was suspected. However, the patient had previously received another benzodiazepine, brotizolam, to which he was not allergic, suggesting that cross-reactivity of remimazolam may vary among benzodiazepines. In this article, we reviewed the 11 cases of remimazolam anaphylaxis that have been described in the literature.

Conclusions

Remimazolam is an ultrashort-acting sedative; however, it can cause life-threatening anaphylaxis. In addition, its cross-reactivity with other benzodiazepines is not fully understood. To increase the safety of this drug, further research and more experience in its use are needed.
The role of triglyceride-glucose index in the differential diagnosis of atherosclerotic stroke and cardiogenic stroke
Authors: Liu Mengqian , Yang Xiaoyun , Jiang Yi , Zhong Wen , Xu Yiwen , Zhang Guanghui , Fang Qi , Shen Xiaozhu
Published: June 2024

Objective

This study aims to investigate the role of the triglyceride glucose (TyG) index in differentiating cardiogenic stroke (CE) from large atherosclerotic stroke (LAA).

Method

In this retrospective study, patients with acute ischemic stroke were recruited from the First Affiliated Hospital of Soochow University, Lianyungang Second People’s Hospital and Lianyungang First People’s Hospital. Their general data, medical history and laboratory indicators were collected and TyG index was calculated. Groups were classified by the TyG index quartile to compare the differences between groups. Logistic regression was utilized to assess the relationship between the TyG index and LAA. The receiver operating characteristic curve (ROC) curve was used to evaluate the diagnostic efficiency of the TyG index in differentiating LAA from CE.

Result

The study recruited 1149 patients. After adjusting for several identified risk factors, groups TyG-Q2, TyG-Q3, and TyG-Q4 had a higher risk of developing LAA compared to group TyG-Q1(odds ratio (OR) = 1.63,95% confidence interval (CI) = 1.11–2.39, OR = 1.72,95%CI = 1.16–2.55, OR = 2.06,95%CI = 1.36–3.09). TyG has certain diagnostic value in distinguishing LAA from CE(AUC = 0.595, 95%CI0.566–0.623;P<0.001).

Conclusion

Summarily, the TyG index has slight significance in the identification of LAA and CE; it is particularly a marker for their preliminary identification.
The Hospital Burden of Flu in Italy: a retrospective study on administrative data from season 2014–2015 to 2018–2019
Authors: Cipelli Riccardo , Falato Serena , Lusito Eleonora , Maifredi Giovanni , Montedoro Michele , Valpondi Paola , Zucchi Alberto , Azzi Maria Vittoria , Zanetta Laura , Gualano Maria Rosaria , Xoxi Entela , Marchisio Paola Giovanna , Castaldi Silvana
Published: June 2024

Background

Every year in Italy, influenza affects about 4 million people. Almost 5% of them are hospitalised. During peak illness, enormous pressure is placed on healthcare and economic systems. This study aims to quantify the clinical and economic burden of severe influenza during 5 epidemic seasons (2014–2019) from administrative claims data.

Methods

Patients hospitalized with a diagnosis of influenza between October 2014, and April 2019, were analyzed. Clinical characteristics and administrative information were retrieved from health-related Administrative Databases (ADs) of 4 Italian Local Health Units (LHUs). The date of first admission was set as the Index Date (ID). A follow-up period of six months after ID was considered to account for complications and re-hospitalizations, while a lookback period (2 years before ID) was set to assess the prevalence of underlying comorbidities.

Results

Out of 2,333 patients with severe influenza, 44.1% were adults ≥ 65, and 25.6% young individuals aged 0–17. 46.8% had comorbidities (i.e., were at risk), mainly cardiovascular and metabolic diseases (45.3%), and chronic conditions (24.7%). The highest hospitalization rates were among the elderly (≥ 75) and the young individuals (0–17), and were 37.6 and 19.5/100,000 inhabitants/year, respectively. The average hospital stay was 8 days (IQR: 14 − 4). It was higher for older individuals (≥ 65 years, 11 days, [17 − 6]) and for those with comorbidities (9 days, [16 − 6]), p-value < 0.001. Similarly, mortality was higher in elderly and those at risk (p-value < 0.001). Respiratory complications occurred in 12.7% of patients, and cardiovascular disorders in 5.9%. Total influenza-related costs were €9.7 million with hospitalization accounting for 95% of them. 47.3% of hospitalization costs were associated with individuals ≥ 65 and 52.9% with patients at risk. The average hospitalisation cost per patient was € 4,007.

Conclusions

This retrospective study showed that during the 2014–2019 influenza seasons in Italy, individuals of extreme ages and those with pre-existing medical conditions, were more likely to be hospitalized with severe influenza. Together with complications and ageing, they worsen patient’s outcome and may lead to a prolonged hospitalization, thus increasing healthcare utilization and costs. Our data generate real-world evidence on the burden of influenza, useful to inform public health decision-making.
The efficacy and safety of PARP inhibitors in mCRPC with HRR mutation in second-line treatment: a systematic review and bayesian network meta-analysis
Authors: Zhu Qiyu , Chen Junru , Liu Haoyang , Zhao Jinge , Xu Chenhao , Sun Guangxi , Zeng Hao
Published: June 2024

Background

Poly (ADP- ribose) polymerase inhibitors (PARPi) has been increasingly adopted for metastatic castration-resistance prostate cancer (mCRPC) patients with homologous recombination repair deficiency (HRD). However, it is unclear which PARPi is optimal in mCRPC patients with HRD in 2nd -line setting.

Method

We conducted a systematic review of trials regarding PARPi- based therapies on mCRPC in 2nd -line setting and performed a Bayesian network meta-analysis (NMA). Radiographic progression-free survival (rPFS) was assessed as primary outcome. PSA response and adverse events (AEs) were evaluated as secondary outcomes. Subgroup analyses were performed according to specific genetic mutation.

Results

Four RCTs comprised of 1024 patients (763 harbored homologous recombination repair (HRR) mutations) were identified for quantitative analysis. Regarding rPFS, olaparib monotherapy, rucaparib and cediranib plus olaparib showed significant improvement compared with ARAT. Olaparib plus cediranib had the highest surface under cumulative ranking curve (SUCRA) scores (87.5%) for rPFS, followed by rucaparib, olaparib and olaparib plus abiraterone acetate prednisone. For patients with BRCA 1/2 mutations, olaparib associated with the highest probability (98.1%) of improved rPFS. For patients with BRCA-2 mutations, olaparib and olaparib plus cediranib had similar efficacy. However, neither olaparib nor rucaparib showed significant superior effectiveness to androgen receptor-axis-targeted therapy (ARAT) in patients with ATM mutations. For safety, olaparib showed significantly lower ≥ 3 AE rate compared with cediranib plus olaparib (RR: 0.72, 95% CI: 0.51, 0.97), while olaparib plus cediranib was associated with the highest risk of all-grade AE.

Conclusion

PARPi-based therapy showed considerable efficacy for mCRPC patients with HRD in 2nd -line setting. However, patients should be treated accordingly based on their genetic background as well as the efficacy and safety of the selected regimen.

Trial registration

: CRD42023454079.
Validity of central pain processing biomarkers for predicting the occurrence of oncological chronic pain: a study protocol
Authors: Carrillo-de-la-Peña M. T. , Fernandes C. , Castro C. ,   PAINLESS Consortium, Rubal Lara , Samartin-Veiga Noelia , Yarnitzsky David , Arendt-Nielsen Lars , Dahl Carsten , Medeiros R.
Published: June 2024

Background

Despite recent improvements in cancer detection and survival rates, managing cancer-related pain remains a significant challenge. Compared to neuropathic and inflammatory pain conditions, cancer pain mechanisms are poorly understood, despite pain being one of the most feared symptoms by cancer patients and significantly impairing their quality of life, daily activities, and social interactions. The objective of this work was to select a panel of biomarkers of central pain processing and modulation and assess their ability to predict chronic pain in patients with cancer using predictive artificial intelligence (AI) algorithms.

Methods

We will perform a prospective longitudinal cohort, multicentric study involving 450 patients with a recent cancer diagnosis. These patients will undergo an in-person assessment at three different time points: pretreatment, 6 months, and 12 months after the first visit. All patients will be assessed through demographic and clinical questionnaires and self-report measures, quantitative sensory testing (QST), and electroencephalography (EEG) evaluations. We will select the variables that best predict the future occurrence of pain using a comprehensive approach that includes clinical, psychosocial, and neurophysiological variables.

Discussion

This study aimed to provide evidence regarding the links between poor pain modulation mechanisms at precancer treatment in patients who will later develop chronic pain and to clarify the role of treatment modality (modulated by age, sex and type of cancer) on pain. As a final output, we expect to develop a predictive tool based on AI that can contribute to the anticipation of the future occurrence of pain and help in therapeutic decision making.
Necrotizing enterocolitis in a term newborn after spontaneous cerebral parenchymal hemorrhage: a case report
Authors: Zhang Lijuan , Lu Weifeng
Published: June 2024

Background

Necrotizing enterocolitis (NEC) and intracranial hemorrhage are severe emergencies in the neonatal period. The two do not appear to be correlated. However, our report suggests that parenchymal brain hemorrhage in full-term newborns may put patients at risk for NEC by altering intestinal function through the brain-gut axis.

Case presentation

We present a case of spontaneous parenchymal cerebral hemorrhage in a full-term newborn who developed early-stage NEC on Day 15.

Conclusions

It is possible to consider brain parenchymal hemorrhage as a risk factor for the appearance of NEC. Clinicians should be highly cautious about NEC in infants who have experienced parenchymal hemorrhage. This article is the first to discuss the relationship between parenchymal hemorrhage and NEC in full-term newborns.
Factors associated with changes in the quality of life and family functioning scores of primary caregivers of children and young people with primary brain tumors in Karachi, Pakistan: a prospective cohort study
Authors: Zahid Nida , Enam Syed Ather , Mårtensson Thomas , Azam Iqbal , Mushtaq Naureen , Moochhala Mariya , Kausar Faiza , Hassan Aneesa , Kamran Bakhshi Saqib , Javed Farrukh , Rehman Lal , Mughal Muhammad Nouman , Altaf Sadaf , Kirmani Salman , Brown Nick
Published: June 2024

Background

There are limited data available, particularly in low- and middle-income countries (LMICs), on the long-term quality of life (QoL) and family functioning of primary caregivers of children and young people (CYPs) affected by primary brain tumors (PBTs). This study aimed to assess the factors associated with the mean change in QoL and family functioning scores of primary caregivers of CYP patients with PBTs 12 months posttreatment.

Methods

This prospective cohort study enrolled CYPs aged 5–21 years with newly diagnosed PBTs and their primary caregivers. The study was carried out between November 2020 and July 2023. The primary caregivers of CYPs were recruited from two major tertiary care centers in Karachi, Pakistan. The primary caregivers QoL were assessed by the Pediatric Quality of Life Inventory (PedsQL) Family Impact Module. The assessment was undertaken by a psychologist at the time of diagnosis and 12 months posttreatment. The data were analyzed with STATA version 12.

Results

Forty-eight CYPs with newly diagnosed PBTs and their primary caregivers (46 mothers and 2 fathers) were enrolled. At 12 months posttreatment, 25 (52%) CYPs and their primary caregivers (mothers) were reassessed, and 23 (48%) were lost to follow-up. On multivariable analysis, a significant decrease in mothers’ mean 12-month posttreatment QoL and family functioning scores was associated with CYP having posttreatment seizures (beta= -10.2; 95% CI: -18.4 to -2.0) and with the financial burden associated with the CYP’s illness (beta= -0.3; 95% CI: -0.4 to -0.1). However, in those cases where CYP had higher posttreatment quality of life scores (beta = 0.4; 95% CI = 0.1, 0.6) and posttreatment higher verbal intelligence scores (beta = 0.1; 95% CI = 0.01, 0.3), the mothers’ QoL and family functioning scores were significantly greater.

Conclusion

We found a significant decrease in QoL of mothers who had a high financial burden and whose CYP had posttreatment seizures. However, those whose CYPs had higher posttreatment verbal intelligence scores and quality of life scores had significantly greater QoL scores. Identification of the factors that influence primary caregivers QoL has the potential to aid in the development of targeted strategies to alleviate stressors and improve the overall quality of life for primary caregivers and their children who are at high risk.
Esophageal button battery impactions in children: an analysis of 89 cases
Authors: Xu Guo , Jia Desheng , Chen Jing , Pan Hongguang , Wu Zebin
Published: June 2024

Objective

To analyze the clinical characteristics of esophageal button battery impactions in children and explore safe and effective treatment methods.

Methods

This retrospective cohort study was conducted at a single tertiary care center, Shenzhen Children’s Hospital, encompassing 89 children diagnosed with esophageal button battery impactions between January 2013 and January 2023. To minimize esophageal mucosal corrosion, prompt removal of the button battery with a first-aid fast track rigid esophagoscopy under general anesthesia was performed within thirty minutes of diagnosis. The clinical features and complications were recorded and analyzed.

Results

Button battery as esophageal foreign body was prevalent among children under 3 years old (79.8%), with boys exhibiting a higher incidence rate (56.2%) compared to girls (43.8%), and an average age of 25.8 months. The median duration from ingestion to hospital admission was 3 h (range: 0.5 h to 3 months). Common symptoms included vomiting and dysphagia, with early stage vomiting of brown foamy secretions being a characteristic presentation of esophageal button battery impactions. The majority (77.5%) of batteries were lodged in the upper esophagus. The larger batteries were verified to be more prone to complications. All 89 cases exhibited varying degrees of esophageal mucosal erosion, with 31 cases (34.8%) experiencing severe complications, including esophageal stenosis in 11 cases (35.5%), esophageal perforation in 9 cases (29%) with 4 cases of tracheoesophageal fistula, vocal cord paralysis in 6 cases (19.4%), hemorrhage in 2 cases (6.5%), mediastinitis in 2 cases (6.5%), and periesophageal abscess in 1 case (3.2%). Despite the severity of these complications, none of the patients died after emergency surgery.

Conclusion

Esophageal button battery impactions can lead to significant damage to the esophageal mucosa due to its strong corrosiveness. Prompt action is crucial to mitigate the risk of complications. For the first time, we implement a first-aid fast track surgical intervention following diagnosis is imperative to minimize the incidence of adverse outcomes.
Effect of different ulnar osteotomies on loading of the distal radioulnar joint: a finite element analysis
Authors: Tan Jiyang , Zhang Fei , Liu Qianyuan , Fang Xiaodong , Jiang Hong , Qian Jun , Mi Jingyi , Zhao Gang
Published: June 2024

Background

Ulnar impingement syndrome is a prevalent source of ulnar carpal pain; however, there is ongoing debate regarding the specific location of shortening, the method of osteotomy, the extent of shortening, and the resulting biomechanical alterations.

Method

To investigate the biomechanical changes in the distal radioulnar joint (DRUJ) resulting from different osteotomy methods, a cadaveric specimen was dissected, and the presence of a stable DRUJ structure was confirmed. Subsequently, three-dimensional data of the specimen were obtained using a CT scan, and finite element analysis was conducted after additional processing.

Results

The DRUJ stress did not change significantly at the metaphyseal osteotomy of 2–3 mm but increased significantly when the osteotomy length reached 5 mm. When the osteotomy was performed at the diaphysis, the DRUJ stress increased with the osteotomy length, and the increase was greater than that of metaphyseal osteotomy. Stress on the DRUJ significantly increases when the position is changed to pronation dorsi-extension. Similarly, the increase in stress in diaphyseal osteotomy was greater than that in metaphyseal osteotomy. When the model was subjected to a longitudinal load of 100 N, neither osteotomy showed a significant change in DRUJ stress at the neutral position. However, the 100 N load significantly increased stress on the DRUJ when the position was changed to pronation dorsi-extension, and the diaphyseal osteotomy significantly increased stress on the DRUJ.

Conclusions

For patients with distal oblique bundle, metaphyseal osteotomy result in a lower increase in intra-articular pressure in the DRUJ compared to diaphyseal osteotomy. However, it is crucial to note that regardless of the specific type of osteotomy employed, it is advisable to avoid a shortening length exceeding 5 mm.
Risk factors of poor mid-term shoulder functional outcomes of osteosynthesis using antegrade intramedullary nailing for humeral shaft fractures: a retrospective study with a minimum 5-year follow-up
Authors: Furuhata Ryogo , Tanji Atsushi , Nakamura Soichiro
Published: June 2024

Background

Osteosynthesis using antegrade intramedullary nailing for humeral shaft fractures yields satisfactory bone union rates; however, it may adversely affect postoperative shoulder function. To date, factors affecting mid- or long-term shoulder functional outcomes following intramedullary nail fixation have not been clarified. In this study, we aimed to identify the risk factors for poor mid-term functional outcomes over 5 years postoperatively following antegrade intramedullary nail osteosynthesis for humeral shaft fractures.

Methods

We retrospectively identified 33 patients who underwent surgery using an antegrade intramedullary nail for acute traumatic humeral shaft fractures and were followed up for at least 5 years postoperatively. We divided the patients into clinical failure and no clinical failure groups using an age- and sex-adjusted Constant score of 55 at the final follow-up as the cutoff value. We compared preoperative, perioperative, and postoperative factors between the two groups.

Results

Five of the 33 patients had poor shoulder functional outcomes (adjusted Constant score < 55) at a mean follow-up of 7.5 years postoperatively. Proximal protrusion of the nail at the time of bone union (P = 0.004) and older age (P = 0.009) were significantly associated with clinical failure in the univariate analyses. Multivariate analysis showed that proximal protrusion of the nail (P = 0.031) was a risk factor for poor outcomes.

Conclusions

The findings of this study provide new information on predictive factors affecting mid-term outcomes following osteosynthesis using antegrade nails. Our results demonstrated that proximal protrusion of the nail was significantly associated with poor mid-term functional shoulder outcomes. Therefore, particularly in older adults, it is essential to place the proximal end of the intramedullary nail below the level of the articular cartilage.
Evaluation of masticatory performance and patient satisfaction for conventional and 3D-printed implant overdentures: a randomized crossover study
Authors: Nabil Mohamed Shady , Mahanna Fatma Fathe , Said Mohamed Moustafa
Published: June 2024

Background

This crossover clinical study aimed to evaluate and compare masticatory performance and patient satisfaction for patients rehabilitated with conventional heat-cured acrylic resin and 3D-printed mandibular implant overdentures retained with bar attachment.

Materials and methods

Sixteen completely edentulous healthy participants received new conventional dentures. In the mandible, four interforaminal implants were inserted. Following the stage of osseointegration, the bar was constructed in a trapezoidal configuration. Each patient randomly received the following overdentures using a crossover design: (1) conventional heat-cured acrylic resin overdenture and (2) 3D-printed overdenture (developed by scanning of mandibular conventional overdenture). The masticatory performance was assessed by conducting a two-colour mixing ability test at 5, 10, 20, 30, and 50 masticatory cycles. Moreover, the McGill Denture Satisfaction Questionnaire (MDSQ) was employed to assess patient satisfaction. Evaluation was performed after 3 months of using each overdenture. Paired sample t tests were used to compare the masticatory performance and MDSQ scores of patients for both prostheses.

Results

No significant difference in masticatory performance was reported between the two types of overdentures. Regarding patient satisfaction, only the esthetic aspect was significantly better for conventionally processed overdentures than for printed overdentures. Insignificant differences were observed regarding other MDSQ items between the two overdentures.

Conclusion

Within this clinical study, 3D-printed implant overdentures showed promising results in terms of chewing efficiency and patient satisfaction compared to conventionally fabricated implant overdentures.

Trial registration

Retrospectively registered at www.clinicaltrials.gov: NCT06148727.(28/11/2023).