bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between higher triglyceride glucose index and increased risk of osteoarthritis: data from NHANES 2015–2020
Authors: Huang Jie , Rozi Rigbat , Ma Jingbo , Fu Bensheng , Lu Zhengcao , Liu Jiang , Ding Yu
Published: March 2024

Background

The relationship between the triglyceride glucose (TyG) index and osteoarthritis (OA) remains unclear. The objective of this study was to examine potential associations between an elevated TyG index and an increased risk of OA prevalence.

Methods

3,921 participants with OA from the National Health and Nutrition Examination Survey (2015–2020) were included in this study. Participants were categorized into quartiles based on TyG index, which was determined using the formula: Ln [triglyceride (mg/dL) fasting blood glucose (mg/dL)/2]. Weighted multivariable regression, subgroup analyses, and threshold effect analyses were performed to calculate the independent association between TyG index and OA.

Results

A total of 25,514 people were enrolled, with a mean TyG index of 8.48 ± 0.65. The results of multivariable logistic regression analysis after full adjustment showed a significant association between higher TyG index values and an increased risk of OA. Specifically, each incremental unit increase in the TyG index was associated with a 634% higher risk of OA [OR = 7.34; 95% CI: 2.25, 23.93; p = 0.0010]. Based on interaction tests, age, gender, BMI, and smoking status did not significantly affect the relationship between the TyG index and OA, while diabetes showed a stronger positive correlation between the TyG index and OA.

Conclusion

An increased risk of OA was associated with a higher TyG index. TyG could be a valuable predictor of OA and offer novel perspectives on the assessment and treatment of OA.
Evaluation of mechanical properties of anatomically customized fiber posts using E-glass short fiber-reinforced composite to restore weakened endodontically treated premolars
Authors: Alshetiwi Dawood Salman Dawood , Muttlib Nor Aidaniza Abdul , El-Damanhoury Hatem M. , Alawi Rabihah , Rahman Normastura Abd , Elsahn Nesrin Aly , Karobari Mohmed Isaqali
Published: March 2024

Objective

This study was conducted to assess the influence of combining different forms of fiber-reinforced composites (FRC) on the mechanical behavior and bond strength of compromised endodontically treated teeth (ETT).

Materials and methods

Eighty extracted human premolar teeth were randomly divided into five experimental groups according to the type of intra-radicular restoration and the canal preparation design which was either non-flared (Group 1), flared (Groups 2–5), closed-apex (Groups 1,3,5) or open-apex (Groups 2,4). Standard prefabricated fiber posts were used as intra-radicular restoration for Groups 1–3 while Groups 4–5 were restored with anatomically customized relined fiber posts. After composite core fabrication, all samples were sent for an artificial aging process. Fracture resistance and push-out bond strength tests were then carried out through a universal testing machine followed by mode of failure analysis via a stereomicroscope and scanning electron microscope.

Results

Pairwise Log-Rank comparisons revealed that the survival rate of Group 2 and Group 3 was significantly lower than all other groups after artificial aging. The highest fracture resistance value (1796 N) was recorded in Group 5 and was significantly higher than that of the other groups (p < 0.05), while Group 2 exhibited the lowest fracture resistance (758 N), which was significantly lower compared to the other groups. Group 5 and Group 4 demonstrated a significantly higher push-out bond strength, at all root thirds, than Group 3, Group 2, and Group 1 (p < 0.05). The most frequently observed failure mode in the tested groups occurred between the resin cement and radicular dentin.

Conclusion

The use of short fiber-reinforced composite (SFRC) to reline the prefabricated FRC post has been proven to have superior fracture resistance with favorable failure patterns and increased push-out bond strength values compared to standard prefabricated FRC posts.
Catastrophic health expenditure and health-related quality of life among older adults in Shandong, China: the moderation effect of daily care by adult children
Authors: Li Jiayan , Gao Tingting , Zhao Dan , Chai Shujun , Luo Jingjing , Wang Xuehong , Wang Xueqing , Sun Jingjie , Li Peilong , Zhou Chengchao
Published: March 2024

Background

Catastrophic health expenditure (CHE) has a considerable impact on older people in later life, but little is known about the relationship between catastrophic health expenditure and health-related quality of life (HRQOL). The aim of this study was to examine the relationship between catastrophic health expenditure and health-related quality of life in older people, and to explore whether the daily care provided by adult children is a moderator in this relationship.

Methods

Data from the sixth National Health Services Survey in Shandong Province, China. The sample consisted of 8599 elderly people (age ≥ 60 years; 51.7% of female). Health-related quality of life was measured by the health utility value of EQ-5D-3 L. Interaction effects were analyzed using Tobit regression models and marginal effects analysis.

Results

The catastrophic health expenditure prevalence was 60.5% among older people in Shandong, China. catastrophic health expenditure was significantly associated with lower health-related quality of life (β= − 0.142, P < 0.001). We found that adult children providing daily care services to their parents mitigated the effect of catastrophic health expenditure on health-related quality of life among older people (β = 0.027, P = 0.040).

Conclusions

Our findings suggested that catastrophic health expenditure was associated with health-related quality of life and the caring role of older adult children moderated this relationship. Reducing the damage caused by catastrophic health expenditure helps to improve health-related quality of life in older people. Adult children should increase intergenerational contact, provide timely financial and emotional support to reduce the negative impact of catastrophic health expenditure on health-related quality of life.
3D-printed bredigite scaffolds with ordered arrangement structures promote bone regeneration by inducing macrophage polarization in onlay grafts
Authors: Xuan Yaowei , Guo Yibo , Li Lin , Yuzhang  , Zhang Chenping , RuiJin  , Yin Xuelai , Zhang Zhen
Published: March 2024

Bone tissue engineering scaffolds may provide a potential strategy for onlay bone grafts for oral implants. For determining the fate of scaffold biomaterials and osteogenesis effects, the host immune response is crucial. In the present study, bredigite (BRT) bioceramic scaffolds with an ordered arrangement structure (BRT-O) and a random morphology (BRT-R) were fabricated. The physicochemical properties of scaffolds were first characterized by scanning electron microscopy, mechanical test and micro-Fourier transform infrared spectroscopy. In addition, their osteogenic and immunomodulatory properties in an onlay grafting model were investigated. In vitro, the BRT-O scaffolds facilitated the macrophage polarization towards a pro-regenerative M2 phenotype, which subsequently facilitated the migration and osteogenic differentiation of bone marrow-derived mesenchymal stem cells. In vivo, an onlay grafting model was successfully established in the cranium of rabbits. In addition, the BRT-O scaffolds grafted on rabbit cranium promoted bone regeneration and CD68 + CD206 + M2 macrophage polarization. In conclusion, the 3D-printed BRT-O scaffold presents as a promising scaffold biomaterial for onlay grafts by regulating the local immune microenvironment.

Graphical Abstract
Finding maximal exact matches in graphs
Authors: Rizzo Nicola , Cáceres Manuel , Mäkinen Veli
Published: March 2024

Background

We study the problem of finding maximal exact matches (MEMs) between a query stringQand a labeled graphG. MEMs are an important class of seeds, often used in seed-chain-extend type of practical alignment methods because of their strong connections to classical metrics. A principled way to speed up chaining is to limit the number of MEMs by considering only MEMs of length at least$$\kappa$$κ($$\kappa$$κ-MEMs). However, on arbitrary input graphs, the problem of finding MEMs cannot be solved in truly sub-quadratic time under SETH (Equi et al., TALG 2023) even on acyclic graphs.

Results

In this paper we show an$$O(n\cdot L \cdot d^{L-1} + m + M_{\kappa ,L})$$O(n·L·dL-1+m+Mκ,L)-time algorithm finding all$$\kappa$$κ-MEMs betweenQandGspanning exactlyLnodes inG, wherenis the total length of node labels,dis the maximum degree of a node inG,$$m = |Q|$$m=|Q|, and$$M_{\kappa ,L}$$Mκ,Lis the number of output MEMs. We use this algorithm to develop a$$\kappa$$κ-MEM finding solution on indexable Elastic Founder Graphs (Equi et al., Algorithmica 2022) running in time$$O(nH^2 + m + M_\kappa )$$O(nH2+m+Mκ), whereHis the maximum number of nodes in a block, and$$M_\kappa$$Mκis the total number of$$\kappa$$κ-MEMs. Our results generalize to the analysis of multiple query strings (MEMs betweenGand any of the strings). Additionally, we provide some experimental results showing that the number of graph MEMs is an order of magnitude smaller than the number of string MEMs of the corresponding concatenated collection.

Conclusions

We show that seed-chain-extend type of alignment methods can be implemented on top of indexable Elastic Founder Graphs by providing an efficient way to produce the seeds between a set of queries and the graph. The code is available inhttps://github.com/algbio/efg-mems.
Seven-chain adaptive immune receptor repertoire analysis in rheumatoid arthritis reveals novel features associated with disease and clinically relevant phenotypes
Authors: Aterido Adrià , López-Lasanta María , Blanco Francisco , Juan-Mas Antonio , García-Vivar María Luz , Erra Alba , Pérez-García Carolina , Sánchez-Fernández Simón Ángel , Sanmartí Raimon , Fernández-Nebro Antonio , Alperi-López Mercedes , Tornero Jesús , Ortiz Ana María , Fernández-Cid Carlos Marras , Palau Núria , Pan Wenjing , Byrne-Steele Miranda , Starenki Dmytro , Weber Daniel , Rodriguez-Nunez Ivan , Han Jian , Myers Richard M. , Marsal Sara , Julià Antonio
Published: March 2024

Background

In rheumatoid arthritis (RA), the activation of T and B cell clones specific for self-antigens leads to the chronic inflammation of the synovium. Here, we perform an in-depth quantitative analysis of the seven chains that comprise the adaptive immune receptor repertoire (AIRR) in RA.

Results

In comparison to controls, we show that RA patients have multiple and strong differences in the B cell receptor repertoire including reduced diversity as well as altered isotype, chain, and segment frequencies. We demonstrate that therapeutic tumor necrosis factor inhibition partially restores this alteration but find a profound difference in the underlying biochemical reactivities between responders and non-responders. Combining the AIRR with HLA typing, we identify the specific T cell receptor repertoire associated with disease risk variants. Integrating these features, we further develop a molecular classifier that shows the utility of the AIRR as a diagnostic tool.

Conclusions

Simultaneous sequencing of the seven chains of the human AIRR reveals novel features associated with the disease and clinically relevant phenotypes, including response to therapy. These findings show the unique potential of AIRR to address precision medicine in immune-related diseases.
Streamlined, single-step non-viral CRISPR-Cas9 knockout strategy enhances gene editing efficiency in primary human chondrocyte populations
Authors: Ponta Simone , Bonato Angela , Neidenbach Philipp , Bruhin Valentino F. , Laurent Alexis , Applegate Lee Ann , Zenobi-Wong Marcy , Barreto Goncalo
Published: March 2024

Background

CRISPR-Cas9-based genome engineering represents a powerful therapeutic tool for cartilage tissue engineering and for understanding molecular pathways driving cartilage diseases. However, primary chondrocytes are difficult to transfect and rapidly dedifferentiate during monolayer (2D) cell culture, making the lengthy expansion of a single-cell-derived edited clonal population not feasible. For this reason, functional genetics studies focused on cartilage and rheumatic diseases have long been carried out in cellular models that poorly recapitulate the native molecular properties of human cartilaginous tissue (e.g., cell lines, induced pluripotent stem cells). Here, we set out to develop a non-viral CRISPR-Cas9, bulk-gene editing method suitable for chondrocyte populations from different cartilaginous sources.

Methods

We screened electroporation and lipid nanoparticles for ribonucleoprotein (RNP) delivery in primary polydactyly chondrocytes, and optimized RNP reagents assembly. We knocked out RELA (also known as p65), a subunit of the nuclear factor kappa B (NF-κB), in polydactyly chondrocytes and further characterized knockout (KO) cells with RT-qPCR and Western Blot. We tested RELA KO in chondrocytes from diverse cartilaginous sources and characterized their phenotype with RT-qPCR. We examined the chondrogenic potential of wild-type (WT) and KO cell pellets in presence and absence of interleukin-1β (IL-1β).

Results

We established electroporation as the optimal transfection technique for chondrocytes enhancing transfection and editing efficiency, while preserving high cell viability. We knocked out RELA with an unprecedented efficiency of ~90%, confirming lower inflammatory pathways activation upon IL-1β stimulation compared to unedited cells. Our protocol could be easily transferred to primary human chondrocytes harvested from osteoarthritis (OA) patients, human FE002 chondroprogenitor cells, bovine chondrocytes, and a human chondrocyte cell line, achieving comparable mean RELA KO editing levels using the same protocol. All KO pellets from primary human chondrocytes retained chondrogenic ability equivalent to WT cells, and additionally displayed enhanced matrix retention under inflamed conditions.

Conclusions

We showcased the applicability of our bulk gene editing method to develop effective autologous and allogeneic off-the-shelf gene therapies strategies and to enable functional genetics studies in human chondrocytes to unravel molecular mechanisms of cartilage diseases.
Forkhead box O proteins: steering the course of stem cell fate
Authors: Cheng Mengdi , Nie Yujie , Song Min , Chen Fulin , Yu Yuan
Published: March 2024

Stem cells are pivotal players in the intricate dance of embryonic development, tissue maintenance, and regeneration. Their behavior is delicately balanced between maintaining their pluripotency and differentiating as needed. Disruptions in this balance can lead to a spectrum of diseases, underscoring the importance of unraveling the complex molecular mechanisms that govern stem cell fate. Forkhead box O (FOXO) proteins, a family of transcription factors, are at the heart of this intricate regulation, influencing a myriad of cellular processes such as survival, metabolism, and DNA repair. Their multifaceted role in steering the destiny of stem cells is evident, as they wield influence over self-renewal, quiescence, and lineage-specific differentiation in both embryonic and adult stem cells. This review delves into the structural and regulatory intricacies of FOXO transcription factors, shedding light on their pivotal roles in shaping the fate of stem cells. By providing insights into the specific functions of FOXO in determining stem cell fate, this review aims to pave the way for targeted interventions that could modulate stem cell behavior and potentially revolutionize the treatment and prevention of diseases.
Comparative analysis on root exudate and rhizosphere soil bacterial assembly between tomatoes and peppers infected by Ralstonia
Authors: Yan Mengyuan , Wu Meng , Liu Ming , Li Guilong , Liu Kai , Qiu Cunpu , Bao Ying , Li Zhongpei
Published: March 2024

Background

The rhizosphere environment regulated by root secretory activity and rhizosphere microbial interactions plays an essential role in resisting soil-borne diseases, while the host species is an important factor that affects the composition of root exudates and rhizosphere microbiomes. However, few studies have been done on the characteristics of root exudates and bacterial communities in terms of composition, diversity, and functional potential when host plants of different species are subjected to the same disease.

Results

In this study, we examined the rhizosphere soil bacteria and root exudates of both healthy and diseased tomatoes and peppers employing metabolomics and amplicon techniques. Our findings indicated that variations existed in both root exudates and the bacterial community among different host species and health states. The diversities of both rhizosphere metabolites and bacterial communities were significantly reduced in different diseased plants. Although pepper and tomato resisted the invasion of Ralstonia by recruiting different potentially beneficial bacteria, their rhizosphere bacterial communities had the same functional potential. In comparison to diseased rhizosphere soil, healthy rhizosphere soil had many more functional pathways associated with disease suppression and plant growth.

Conclusions

This study highlighted the crucial role of host plants in shaping the rhizosphere environment and revealed the variation characteristics of root exudates and rhizosphere bacteria of different host plants induced by the same disease.

Graphical Abstract
Successful removal of an intra-pericardic Kirschner wire via fluoroscopy-guided minimal invasive approach: a case report
Authors: Georges Olivier , De Dominicis Florence , Rahal Malek Ben , Le Pessot Jules , Berna Pascal , Arab Osama Abou , Beyls Christophe
Published: March 2024

Background

Kirschner wires are widely used in trauma surgery. Their migration into the pericardium is a rare but often fatal phenomenon, requiring urgent management.

Case presentation

We describe the case of a 65-year-old patient who underwent Kirschner wire placement to treat a humeral head fracture. Three months after the operation, pleural and pericardial effusions with cardiac tamponade were observed, leading to the diagnosis of wire migration within the pericardium. A minimally invasive approach guided by fluoroscopy allowed emergency wire extraction without needing a median sternotomy. The postoperative clinical course was uncomplicated.

Conclusions

The use of pre- and per-operative multimodal imaging allowed for the safe extraction of an intra-pericardial Kirschner wire through a minimally invasive approach.
Pulmonary cyst newly formed after lobectomy in various underlying lung conditions
Authors: Tanaka Satona , Date Naoki , Imamura Yoshito , Kabuto Takafumi , Kayawake Hidenao , Motoyama Hideki , Aoyama Akihiro , Date Hirohi
Published: March 2024

Background

It has been recently recognized that pulmonary cyst may develop after pulmonary resection, causing various symptoms. Most previously reported cases were after upper lobectomy in patients with chronic obstructive lung disease (COPD).

Case presentation

Case 1 was a man in his 70 s with interstitial pneumonia (IP). Right lower lobectomy was performed for metastatic lung tumor using video-assisted thoracoscopic surgery (VATS). On postoperative day (POD) 19, computed tomography (CT) revealed a large cyst at the upper interlobular surface of the middle lobe, with pneumoderma and pneumomediastinum. The cyst was incised, polyglycolic acid (PGA) sheet and fibrin glue were applied, and the cyst was sutured. The sutured line was covered again with PGA sheet and fibrin glue. Case 2 was a man in his 70 s with COPD. Right upper lobectomy for primary lung cancer was performed using VATS. On POD 17, CT revealed a large pulmonary cyst at the apex of S6 and massive air leakage was observed. The same surgical procedure as that used in case 1 was performed. Cases 3 and 4 were healthy donors for living-donor lung transplantation. Two months after the right lower lobectomy in Case 3 and 3 months after the left lower lobectomy in Case 4, the patients had respiratory symptoms such as dyspnea and hemosputum. CT revealed a large cyst on the diaphragmatic surface of the right middle lobe in Case 3 and on the posterior mediastinal surface of the left upper lobe in Case 4. Cyst incision, soft coagulation, and application of PGA sheet with fibrin glue were performed in both cases. CT performed 1 year after surgery showed no development of a pulmonary cyst or air space in these four cases.

Conclusions

Pulmonary cysts newly formed after lobectomy can develop not only in COPD or IP but also in healthy lungs. Our findings suggest that incision of the cyst and application of fibrin glue and PGA sheet with or without suturing the cyst wall is effective for management.
An innovative machine learning workflow to research China’s systemic financial crisis with SHAP value and Shapley regression
Authors: Wang Da , Zhou YingXue
Published: March 2024

This study proposed a cutting-edge, multistep workflow and upgraded it by addressing its flaw of not considering how to determine the index system objectively. It then used the updated workflow to identify the probability of China’s systemic financial crisis and analyzed the impact of macroeconomic indicators on the crisis. The final workflow comprises four steps: selecting rational indicators, modeling using supervised learning, decomposing the model’s internal function, and conducting the non-linear, non-parametric statistical inference, with advantages of objective index selection, accurate prediction, and high model transparency. In addition, since China’s international influence is progressively increasing, and the report of the 19th National Congress of the Communist Party of China has demonstrated that China is facing severe risk control challenges and stressed that the government should ensure that no systemic risks would emerge, this study selected China’s systemic financial crisis as an example. Specifically, one global trade factor and 11 country-level macroeconomic indicators were selected to conduct the machine learning models. The prediction models captured six risk-rising periods in China’s financial system from 1990 to 2020, which is consistent with reality. The interpretation techniques show the non-linearities of risk drivers, expressed as threshold and interval effects. Furthermore, Shapley regression validates the alignment of the indicators. The final workflow is suitable for categorical and regression analyses in several areas. These methods can also be used independently or in combination, depending on the research requirements. Researchers can switch to other suitable shallow machine learning models or deep neural networks for modeling. The results regarding crises could provide specific references for bank regulators and policymakers to develop critical measures to maintain macroeconomic and financial stability.
Learning from the implementation of a surgical opioid reduction initiative in an integrated health system: a qualitative study among providers and patients
Authors: Schäfer Willemijn L. A. , Johnson Julie K. , Ager Meagan S. , Iroz Cassandra B. , Huang Reiping , Balbale Salva N. , Stulberg Jonah J.
Published: March 2024

Background

Surgical opioid overprescribing can result in long-term use or misuse. Between July 2018 and March 2019, the multicomponent intervention, Minimizing Opioid Prescribing in Surgery (MOPiS) was implemented in the general surgery clinics of five hospitals and successfully reduced opioid prescribing. To date, various studies have shown a positive outcome of similar reduction initiatives. However, in addition to evaluating the impact on clinical outcomes, it is important to understand the implementation process of an intervention to extend sustainability of interventions and allow for dissemination of the intervention into other contexts. This study aims to evaluate the contextual factors impacting intervention implementation.

Methods

We conducted a qualitative study with semi-structured interviews held with providers and patients of the general surgery clinics of five hospitals of a single health system between March and November of 2019. Interview questions focused on how contextual factors affected implementation of the intervention. We coded interview transcripts deductively, using the Consolidated Framework for Implementation Research (CFIR) to identify the relevant contextual factors. Content analyses were conducted using a constant comparative approach to identify overarching themes.

Results

We interviewed 15 clinicians (e.g., surgeons, nurses), 1 quality representative, 1 scheduler, and 28 adult patients and identified 3 key themes. First, we found high variability in the responses of clinicians and patients to the intervention. There was a strong need for intervention components to be locally adaptable, particularly for the format and content of the patient and clinician education materials. Second, surgical pain management should be recognized as a team effort. We identified specific gaps in the engagement of team members, including nurses. We also found that the hierarchical relationships between surgical residents and attendings impacted implementation. Finally, we found that established patient and clinician views on opioid prescribing were an important facilitator to effective implementation.

Conclusion

Successful implementation of a complex set of opioid reduction interventions in surgery requires locally adaptable elements of the intervention, a team-centric approach, and an understanding of patient and clinician views regarding changes being proposed.
Classification of Congenital Leptin Deficiency
Authors: von Schnurbein Julia , Zorn Stefanie , Nunziata Adriana , Brandt Stephanie , Moepps Barbara , Funcke Jan-Bernd , Hussain Khalid , Farooqi I Sadaf , Fischer-Posovszky Pamela , Wabitsch Martin
Published: March 2024

Purpose

Biallelic pathogenic leptin gene variants cause severe early-onset obesity usually associated with low or undetectable circulating leptin levels. Recently, variants have been described resulting in secreted mutant forms of the hormone leptin with either biologically inactive or antagonistic properties.

Methods

We conducted a systematic literature research supplemented by unpublished data from patients at our center as well as new in vitro analyses to provide a systematic classification of congenital leptin deficiency based on the molecular and functional characteristics of the underlying leptin variants and investigated the correlation of disease subtype with severity of the clinical phenotype.

Results

A total of 28 distinct homozygous leptin variants were identified in 148 patients. The identified variants can be divided into 3 different subtypes of congenital leptin deficiency: classical hormone deficiency (21 variants in 128 patients), biologically inactive hormone (3 variants in 12 patients), and antagonistic hormone (3 variants in 7 patients). Only 1 variant (n = 1 patient) remained unclassified. Patients with biological inactive leptin have a higher percentage of 95th body mass index percentile compared to patients with classical hormone deficiency. While patients with both classical hormone deficiency and biological inactive hormone can be treated with the same starting dose of metreleptin, patients with antagonistic hormone need a variant-tailored treatment approach to overcome the antagonistic properties of the variant leptin.

Main Conclusion

Categorization of leptin variants based on molecular and functional characteristics helps to determine the most adequate approach to treatment of patients with congenital leptin deficiency.
Artificial Intelligence in Endocrinology: On Track Toward Great Opportunities
Authors: Assié Guillaume , Allassonnière Stéphanie
Published: March 2024

In endocrinology, the types and quantity of digital data are increasing rapidly. Computing capabilities are also developing at an incredible rate, as illustrated by the recent expansion in the use of popular generative artificial intelligence (AI) applications. Numerous diagnostic and therapeutic devices using AI have already entered routine endocrine practice, and developments in this field are expected to continue to accelerate. Endocrinologists will need to be supported in managing AI applications. Beyond technological training, interdisciplinary vision is needed to encompass the ethical and legal aspects of AI, to manage the profound impact of AI on patient/provider relationships, and to maintain an optimal balance between human input and AI in endocrinology.
Cardiovascular Risk in Women With Nonclassical Congenital Adrenal Hyperplasia
Authors: Costa Fernanda Cavalieri , Gomes Larissa Garcia , de Lima Thais Martins , Bortolotto Luiz Aparecido , Hong Valeria , Verardino Renata , de Souza Rocha Manoel , Ueda Serli Kiyomi Nakao , de Miranda Mirela Costa , de Souza Heraldo Possolo , Latronico Ana Claudia , Mendonca Berenice Bilharinho , Bachega Tania A S S
Published: March 2024

Context

The outcomes related to cardiovascular risk (CVR) in patients with the nonclassical form of congenital adrenal hyperplasia (NCAH) are unknown, especially those related to therapeutic options, including low doses of glucocorticoids or oral contraceptive pills.

Objectives

To analyze CVR by markers of atherosclerosis in females with the nonclassical form according to therapeutic options.

Design and Setting

A cross-sectional study at a tertiary center.

Patients and Methods

Forty-seven females with NCAH (33.4 ± 10 years) were subdivided into group 1 (G1) (n = 28) treated with dexamethasone (0.14 ± 0.05 mg/m2/day), group 2 (G2) (n = 19) treated with oral contraceptive pills, and group 3 (G3) (30 matched controls). CVR was analyzed through serum lipids, the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), inflammatory cytokines levels, and quantitative image evaluations [pulse wave velocity (PWV), endothelial function by flow-mediated dilatation (FMD), carotid intima media thickness (CIMT), and visceral fat (VAT) by abdominal tomography].

Results

There were no statistically significant differences in BMI, HOMA-IR, high-density lipoprotein-cholesterol, or triglyceride levels among groups (P > .05). Serum interleukin 6 (IL-6) levels were higher in G1 than in G2 (P = .048), and interleukin 8 (IL-8) levels were higher in G1 than in G2/3 (P = .008). There were no statistically significant differences in VAT, PWV, FMD, or CIMT among groups (P > .05). In multivariable regression analysis, there was no statistically significant association between glucocorticoid dose and evaluated outcomes.

Conclusion

Adult females with NCAH did not show increased CVR using methodologies for detection of precocious atherosclerosis. Although patients receiving dexamethasone therapy had increased IL-6 and IL-8 levels, these data were not associated with radiological markers of atherosclerosis. Our cohort was composed of young adults and should be reevaluated in a long-term follow-up.
Impaired polyamine metabolism causes behavioral and neuroanatomical defects in a mouse model of Snyder–Robinson syndrome
Authors: Akinyele Oluwaseun , Munir Anushe , Johnson Marie A. , Perez Megan S. , Gao Yuan , Foley Jackson R. , Nwafor Ashley , Wu Yijen , Murray-Stewart Tracy , Casero Robert A. , Bayir Hülya , Kemaladewi Dwi U.
Published: March 2024

Snyder–Robinson syndrome (SRS) is a rare X-linked recessive disorder caused by a mutation in the SMS gene, which encodes spermine synthase, and aberrant polyamine metabolism. SRS is characterized by intellectual disability, thin habitus, seizure, low muscle tone/hypotonia and osteoporosis. Progress towards understanding and treating SRS requires a model that recapitulates human gene variants and disease presentations. Here, we evaluated molecular and neurological presentations in the G56S mouse model, which carries a missense mutation in the Sms gene. The lack of SMS protein in the G56S mice resulted in increased spermidine/spermine ratio, failure to thrive, short stature and reduced bone density. They showed impaired learning capacity, increased anxiety, reduced mobility and heightened fear responses, accompanied by reduced total and regional brain volumes. Furthermore, impaired mitochondrial oxidative phosphorylation was evident in G56S cerebral cortex, G56S fibroblasts and Sms-null hippocampal cells, indicating that SMS may serve as a future therapeutic target. Collectively, our study establishes the suitability of the G56S mice as a preclinical model for SRS and provides a set of molecular and functional outcome measures that can be used to evaluate therapeutic interventions for SRS.
Clinical and seasonal pattern of dengue in a tertiary care hospital of South West India
Authors: BB Darshan , Holla Ramesh , Unnikrishnan Bhaskaran , Achappa Basavaprabhu , Poovattil Robin , Sharma Ashir , Simmy Shawna , Prateek Suryansh
Published: March 2024

Background Dengue is an emerging global viral disease with an increase 30-fold in incidence in the past fifty years. In the past decade it was restricted to only few a states of South and Northern India but in the recent past it has affected almost all the states in India. The objective of this study was to assess the clinical profile, trends and outcome of dengue cases. Methods This retrospective record based cross-sectional study was conducted in tertiary hospital, Mangaluru in Southern India. The study population included all dengue positive cases diagnosed either by IgM Capture ELISA or Dengue Non-structural Protein NS1 antigen over a period of five years. Information from pre-recorded case sheets were used for data collection. The data was analyzed using SPSS Version 20. Results from the analysis have been expressed in percentages, means and graphs. Results The study included 401 dengue cases. Most cases were in the age range of 20-40 years with a male to female ratio of 3:2. Overall seropositivity rate was 23.94% with High IgM prevalence. Monthly distribution showed a maximum cases were in the months of June and July and minimum were in January and February. Among the study participants, 91.5% of patients recovered completely and 1.7% of patients had died. 6.8% of patients were discharged against medical advice. Conclusions Dengue continues to be major public health problem in this part of the globe affecting mainly the working age group. Low seropositivity with High IgM prevelance makes dengue an important differential for febrile illness of vague nature and invokes the need for robust public health response to curb the hyper-endemicity.
Handling missingness and specify the dropout models in haematocrit levels over time in patients who received renal graft
Authors: Teklezgi Mehari Gebre , Asres Abebech Abera , Debale Gutu Adugna , Matope Agnes
Published: March 2024

Chronic Kidney Disease (CKD) or renal failure is a public global health problem with an estimated prevalence of as 8 to 16% worldwide. This study was conducted in order to Specify Dropout Models the haematocrit levels over time in renal patients after their transplant. This is a longitudinal study that consisted of 1160 patients who received a renal transplant. Level of Haematocrit level as a response, time (log (years)), gender and age of the patients just to mention a few were as a covariate. Different statistical methods, such as dropout models were employed. Direct likelihood and MI based approach of Linear Mixed Model revealed that all the covariates included in the final models were significant. It was observed that the evolution of haematocrit levels follows a quartic time trend and the effect of time on the evolution varies according to gender and age. The effect of time followed a significant 5th power time trend under MI GEE and quadratic time trend under WGEE. However, both models are valid under MAR. In addition, age, gender and rejection symptoms have a significant effect on the evolution of haematocrit levels in renal patients, however their effect varies with time.
Effectiveness of multi-component modular intervention on screen-based and non-screen-based sedentary time among adolescents in an urban area of Mangalore: a school-based cluster randomised controlled trial-protocol
Authors: Janani S Soundarya , Kumar Nithin , Rao Mithun , T Rekha , Mithra Prasanna , Unnikrishnan Bhaskaran , Holla Ramesh , Vikraman Saraswathy M , Kotian Himani
Published: March 2024

Background Behavioural risk factors may often present during adolescence and account for 70% of premature deaths during adulthood. Excessive sedentary behaviour and screen time have become significant concerns, especially among adolescents, due to their potential negative impact on physical and mental health. Adolescents with a high screen-based sedentary time are more likely to be physically inactive, have unhealthy body structure and poor academic performance. The objective of our study is to assess the effect of multi-component modular educational intervention on screen-based sedentary time (SST) and non-screen-based Sedentary time (NSST) among adolescents. Methods Ethical approval for the study has been obtained from the institutional Ethics Committee of Kasturba Medical College in Mangalore, India. This cluster randomized control trial will be carried out in schools located in the urban area of Mangalore. Using simple randomization, the eligible schools will be randomized into intervention and control arms, each consisting of 10 clusters. A multi-component modular educational intervention will be administered to participants in the intervention group at baseline, second and fourth month. The control group will receive the standard curriculum. Both the groups will be assessed at baseline and at second month, fourth month and sixth month of follow up for SST, NSST and level of physical activity. Anthropometric measurements like height, weight, waist circumference and hip circumference will be taken at baseline and sixth month of follow up. Results A comprehensive school-based modular educational intervention can have cumulative advantages by reducing screen- and non-screen-based sedentary time, and encouraging physical activity. Similar modular teaching can be incorporated into the curriculum, which will promote healthy life-style among the adolescents.
Case Report: Ofloxacin-induced fixed drug eruption
Authors: Varma Anuj R. , Varma Ashish R. , Arora Sakshi P. , Naqvi Waqar M.
Published: March 2024

Background Fixed Drug Eruption (FDE) is a rare form of drug-induced dermatoses that appears as well-defined, erythematous patches occurring within hours of medication’s administration with or without blistering and resolves with post-inflammatory residual hyperpigmentation. Case presentation A 50-year-old male patient visited the outpatient department with chief complaints of burning micturition, increased urine frequency, and high-grade fever with chills lasting three days. Blood and urine investigations indicated leukocytosis and remnants of pus cells, respectively, confirming the diagnosis of urinary tract infection intervened with a tablet ofloxacin. Two hours after drug consumption, intense itching was noticed over the body, which soon progressed to blackening discoloration; blisters developed with a burning sensation over the webs of the palm and on the arm, with hyperpigmentation of the lower lip. Furthermore, painful patches with serous discharge developed in the oral cavity and penile tip. He had encountered a similar episode seven years before, which confirmed the diagnosis of fixed drug eruption (FDE). Immediate treatment included injectable steroids, antihistamines, cephalosporin antibiotics, and intravenous fluids with discontinuation of the ofloxacin drug. He adhered well to the treatment and had a remarkable improvement after 72 hours with residual hyperpigmentation, following which, the patient was advised to avoid similar medicine in the future to prevent a recurrence. Conclusions This case report concludes that the adverse drug reactions should be considered mandatorily with antibiotic audits on a regular basis to ensure that the course of treatment is appropriate and adequate, and any inappropriate reaction should be reported immediately. The rationality of the treatment and inappropriate prescriptions must be reported.
A prospective observational study of red cell distribution width (RDW) as an outcome marker in Critically ill children admitted to a Pediatric Intensive Care Unit in a tertiary care hospital in central India
Authors: nagaraju nimmanagoti , Verma Ashish , TAKSANDE DR AMAR
Published: March 2024

Background Critically ill pediatric patients often present with a broad spectrum of conditions, and early prognostic markers are essential for guiding clinical decisions. Red Cell Distribution Width (RDW), a measure of the variability in red blood cell size, has been associated with various health conditions. Methods The study will be conducted over two years at a tertiary care hospital in Central India. Critically ill children between the ages of 1 month and 18 years admitted to the PICU will be consecutively enrolled after obtaining informed consent. Demographic data, vital signs, diagnoses, laboratory results, and relevant scores (PELOD-2 and SOFA) will be recorded. Outcome variables will be documented, including ICU stay duration, mechanical ventilation days, ionotrope usage, development of Acute Kidney Injury (AKI), renal replacement therapy, and outcome (death or discharge). Statistical analysis will involve t-tests, chi-square tests, ROC curve analysis, sensitivity, specificity, positive predictive value, and negative predictive value calculations. Expected results The study aims to provide insights into the potential of RDW as a predictor of morbidity and mortality in critically ill pediatric patients. Comparison with established scoring systems will contribute to understanding the practical significance of RDW in clinical decision-making.
A prospective study on health seeking behaviour and post exposure prophylaxis received by animal bite victims at the anti-rabies clinic in a tertiary care centre of urban Bangalore
Authors: Surendran Jithin , HS Ravish , Kumari Nitu , M Prasanth Ramya , Fotedar Nidhi
Published: March 2024

Background Rabies is 100% preventable by administering early and complete post exposure prophylaxis (PEP). Animal bite victims must have the knowledge and attitude necessary to seek appropriate medical care at the earliest to receive the required PEP. Objectives The present study sought to ascertain the health-seeking behavior of animal bite victims, their knowledge and attitude regarding rabies prophylaxis, the PEP they received, and their level of compliance with the full course of anti-rabies vaccination. Methods The study included animal bite cases that presented to the anti-rabies clinic and matched the eligibility criteria. All the required details were recorded using an internally validated structured questionnaire. All participants were followed up for six months to ensure their health conditions and compliance with the vaccination schedule. Results Out of 1058 respondents, 57.9% were adults, with 46.6% belonging to middle socioeconomic class. 91.1% of them were informed biting animals as dogs. Before arriving at the anti-rabies clinic, 93.3% of the study subjects washed their wounds, and 62.4% visited to another health facility. Rabies knowledge was inadequate among the study participants, only 54.8% being mindful about the disease and its prevention. The compliance with the full course of antirabies vaccination was found to be 77.9%. All subjects were healthy, confirming that PEP is safe and effective. Conclusion Regular social and behavioral change communication (SBCC) needs to be implemented with regard to health-seeking behavior.
The genome sequence of the European shag, Gulosus aristotelis (previously Phalacrocorax aristotelis) (Linnaeus, 1761)
Authors: Ravenswater Hannah M. , Greco Fiona , Burthe Sarah J. , Cunningham Emma J. A. ,   Darwin Tree of Life Barcoding collective,   Wellcome Sanger Institute Tree of Life Management, Samples and Laboratory team,   Wellcome Sanger Institute Scientific Operations: Sequencing Operations,   Wellcome Sanger Institute Tree of Life Core Informatics team,   Tree of Life Core Informatics collective,   Darwin Tree of Life Consortium
Published: March 2024

We present a genome assembly from an individual female Gulosus aristotelis, previously known as Phalacrocorax aristotelis, (the European shag; Chordata; Aves; Pelecaniformes; Phalacrocoracidae). The genome sequence is 1,279.1 megabases in span. Most of the assembly is scaffolded into 36 chromosomal pseudomolecules, including the Z and W sex chromosomes. The mitochondrial genome has also been assembled and is 18.61 kilobases in length. Gene annotation of this assembly on Ensembl identified 16,474 protein coding genes.
Działania wojenne oraz reakcje mocarstw na bitwę pod Cuszimą w czasie wojny japońsko-rosyjskiej na łamach „Kuriera Warszawskiego”
Authors: Wegner Marek
Published: March 2024

W niniejszym artykule zostały przedstawione i omówione wybrane fragmenty „Kuriera Warszawskiego” z końca maja 1905 r., odnoszące się do działań wojennych w czasie bitwy pod Cuszimą, planów dotyczących tej batalii oraz reakcji kilku mocarstw europejskich i Stanów Zjednoczonych.
Tirzepatide-induced ketoacidosis in non-diabetic patients
Authors: Iqbal Pathan Mohamad Rafe , Maadarani Ossama Sajeh , Bitar Zouheir Ibrahim
Published: March 2024

Background: Tirzepatide is a novel glucagon-like peptide 1/glucose-dependent insulinotropic peptide (GLP-1/GIP) receptor agonist. It was recently approved for diabetes control and weight reduction in non-diabetic patients. Case description: We report the first case of ketoacidosis after the use of tirzepatide in an obese non-diabetic patient, secondary to the possibility of starvation ketoacidosis and insulin resistance. Conclusion: The dual-acting GLP-1 and GIP receptor agonists, tirzepatide, can induce ketoacidosis in obese non-diabetic patients.
Alimentação da população em situação de rua no contexto da Covid-19 no Brasil: debate qualitativo a partir do jornal O Trecheiro
Authors: Torres Thifany Helena , Scagliusi Fernanda Baeza , Sabatini Fernanda
Published: March 2024

Introdução: A insegurança alimentar e nutricional da população em situação de rua perpassa a negação de direitos básicos, como moradia, e abrange a incerteza do que, quando, onde e como se alimentar. Assim, dar voz às vulnerabilidades e reivindicações dessa população é essencial. Objetivo: Descrever e discutir as principais questões que permearam a temática da alimentação e da comida nas matérias do jornal O Trecheiro, focado nas realidades sociais da população em situação de rua no Brasil, durante um período da pandemia de Covid-19 (março de 2020 a fevereiro de 2021). Métodos: Tratou-se de pesquisa qualitativa genérica com produção de dados a partir de análise documental; adotou-se o método de análise de conteúdo para categorizar o corpus documental e discutir os temas construídos a partir dos dados. Resultados: A "alimentação enquanto direito" surgiu como parte dos saberes e lutas da pessoa em situação de rua. Os temas e subtemas construídos abrangeram alimentação enquanto um direito não assegurado, vinculando-se à não garantia de outras necessidades (terra e trabalho); às saídas para a garantia do alimento e de outros insumos (solidariedade, luta popular); e aos sentidos e significados que a alimentação e os rituais em torno dela possuem para a pessoa em situação de rua. Conclusão: Pensar sobre o cuidado e a alimentação dessa população exige um olhar integral e multifatorial que considere a complexidade do grupo estudado, assim como os diversos aspectos que atravessam as vivências desses indivíduos, como questões estruturais, sociopolíticas e experiências individuais discutidas neste artigo.