bluuebunny/crossref_metadata_2025 huggingface dataset:
Lower socioeconomic status associated with higher tuberculosis rate in South Korea
Authors: Choi Seong-Woo , Im Jeong-Ja , Yoon Sang-Eun , Kim Seo-Hee , Cho Jun-Hwi , Jeong So-Jung , Park Kyung-Ae , Moon Young-Sung
Published: October 2023

Background

Tuberculosis is an infectious disease influenced by social factors rather than a simple infectious disease. In this study, we investigated the relationship between tuberculosis rates and socioeconomic status.

Methods

This study was conducted using data of the 49,483 participants of the Korean National Health and Nutrition Examination Survey (KNHANES) VI–VIII (2013–2021). The relationships between tuberculosis rates and the quartiles of monthly household income and education level were examined using a multivariate logistic regression analysis.

Results

The KNHANES data revealed that the prevalence of tuberculosis as substantially related to monthly household income (odds ratio [OR], 6.0; 95% confidence interval [CI], 1.1–32.0 for lowest vs. highest incomes) and education level (OR, 3.8; 95% CI, 1.2–12.0 for 10–12 years vs. ≥13 years; OR, 4.1; 95% CI, 1.2–14.8 for ≤ 6 years vs. ≥13 years). Furthermore, current tuberculosis treatment was significantly related to monthly household income and education level.

Conclusion

There were substantial correlations between tuberculosis rates and socioeconomic status in South Korea.
Estimating the cure proportion of stage IA lung adenocarcinoma: a population-based study
Authors: Huang Zhixin , Chen Dinghang , Hong Zhinuan , Kang Mingqiang
Published: October 2023

Background

We aimed to investigate the factors influencing the cure, recurrence, and metastasis rates of stage IA lung adenocarcinoma, using a mixed cure model.

Methods

A total of 1,064 patients who underwent video-assisted thoracoscopic pulmonectomy were included. Variable screening was performed using the random forest algorithm and least absolute shrinkage and selection operator approaches. The mixed cure model was used to identify factors affecting patient cure and survival, and a sequential analysis was performed on 5%, 10%, and 20% of the presentational subtype concurrently. A receiver operating characteristics curve was used to determine the best model and construct a nomogram to predict the cure rate.

Results

The median follow-up time was 58 (range: 3–115) months. Results from the cure part of the mixed model indicated that the predominant subtype, presentational subtype, and tumor diameter were the main prognostic factors affecting cure rate. Therefore, the nomogram to predict the cure rate was constructed based on these factors. The survival part indicated that the predominant subtype was the only factor that influenced recurrence and metastasis. A sequential analysis of the presentational subtype showed it had no significant effect on survival (P > 0.05). Regardless of the recording mode, no significant improvement was observed in the model's discriminative ability. Only a few postoperative pathological specimens showed lymphovascular invasion (LVI); however, the survival curve suggested a significant effect on patient survival.

Conclusions

After excluding the existence of long-term survivors, the predominant tumor subtype was determined to be the only factor influencing recurrence and metastasis. Although LVI is rare in stage IA lung adenocarcinoma, its significance cannot be discounted in terms of determining patient prognosis.
Construct validity, test–retest reliability, and responsiveness of the Arabic version of the upper limb functional index
Authors: Albahrani Yousef A. , Alshami Ali M.
Published: October 2023

Background

The upper limb functional index (ULFI) is a widely used self-report outcome measure questionnaire with robust psychometric properties to assess the upper limb musculoskeletal disorders (UL-MSDs). This study aimed to investigate the psychometric properties of the Arabic version of ULFI (ULFI-Ar).

Methods

In this observational study, 139 patients (87 male, 52 females with mean age of 38.67 ± 13.04 year) with various UL-MSD’s, completed the ULFI-Ar, Disability of Arm, Shoulder, and Hand questionnaire (DASH-Arabic), and numeric pain rating scale (NPRS-Arabic). All participants determined the factor structure, and the construct validity. A subgroup of the participants determined test–retest reliability (n = 46) and responsiveness (n = 27).

Results

The ULFI-Ar construct validity obtained by the expletory factor analysis as one-factor structure, demonstrated an excellent test–retest reliability [intraclass correlation coefficient (ICC2:1) = 0.95], measurement error [standard error of measurement (SEM) = 4.43%; minimal detectable change at 90% confidence interval (MDC90) = 10.34%], medium internal responsiveness [Cohen’s d = 0.62 and standard response of mean (SRM) = 0.67], strong external responsiveness DASH-Arabic (r =—0.90; p < 0.001), and negative strong correlation with NPRS-Arabic (r =—0.75, p < 0.001).

Conclusions

The ULFI-Ar is a valid, reliable, and responsive self-report questionnaire to assess UL-MSDs in Arabic speaking patients.
Informing a national rare disease registry strategy in Australia: a mixed methods study
Authors: Ruseckaite Rasa , Caruso Marisa , Mudunna Chethana , Helwani Falak , Millis Nicole , Ahern Susannah
Published: October 2023

Background

Rare disease registries (RDRs) facilitate monitoring of rare diseases by pooling small datasets to increase clinical and epidemiological knowledge of rare diseases and promote patient centred best practice. The aim of this study was to understand the current state of RDRs in Australia, data captured, impact on patient outcomes, funding models, and barriers and enablers regarding their establishment and maintenance.

Methods

An exploratory sequential mixed methods study design was adopted. First, a list of Australian RDRs, primary contacts and data custodians was generated through online and consumer group (Rare Voices Australia (RVA)) contacts. A cross-sectional, anonymous online survey was distributed to registry custodians, managers, or principal investigators of 74 identified Australian RDRs, 88 RVA Partners, 17 pharmaceutical organizations and 12 RVA Scientific and Medical Advisory Committee members. Next, managers and coordinators of RDRs and databases who participated in the survey were invited to participate in semi-structured interviews. Quantitative and qualitative data were analysed using basic descriptive statistics and content analysis, respectively.

Results

Forty RDRs responded to the survey; nine were national, five were based in Australia and New Zealand, and the remaining were global. Of the 40 survey respondents, eight were interviewed. Most of the RDRs captured similar information regarding patient characteristics, comorbidities and clinical features, diagnosis, family history, genetic testing, procedures or treatment types, response to treatments and complications of treatments. Better treatment outcomes, changes in process of care and changes in quality of care were the most frequently reported benefits of the RDRs. The main challenges proved to be cost/funding of data collection, data completeness, and patient consent. When asked, the participants identified opportunities and challenges regarding potential options to streamline RDRs in Australia in the future.

Conclusion

Findings from this study highlighted significant dataset heterogeneity based on the individual disease, and current lack of interoperability and coordination between different existing RDRs in Australia. Nevertheless, a nationally coordinated approach to RDRs should be investigated given the particular benefits RDRs offer, such as access to research and the monitoring of new disease-modifying treatments.
Data completeness and consistency in individual medical records of institutional births: retrospective crossectional study from Northwest Ethiopia, 2022
Authors: Taye Biniam Kefyalew , Gezie Lemma Derseh , Atnafu Asmamaw , Mengiste Shegaw Anagaw , Tilahun Binyam
Published: October 2023

Background

Ensuring the data quality of Individual Medical Records becomes a crucial strategy in mitigating maternal and newborn morbidity and mortality during and around childbirth. However, previous research in Ethiopia primarily focused on studying data quality of institutional birth at the facility level, overlooking the data quality within Individual Medical Records. This study examined the data completeness and consistency within Individual Medical Records of the institutional birth service and associated factors.

Methods

An institution-based retrospective cross-sectional study was conducted in two districts of Northwest Ethiopia. Data were obtained by reviewing three sets of Individual Medical Records of 651 women: the delivery register, Integrated Individual Folder, and integrated card. The proportions of completeness and consistency were computed. A multilevel binary logistic regression was used to identify factors of completeness and consistency. An odds ratio with a 95% confidence interval was used to assess the level of significance.

Results

Overall, 74.0% of women’s Individual Medical Records demonstrated good data completeness ( > = 70%), 95%CI (70.5, 77.3), while 26% exhibited good consistency, 95%CI (22.9, 29.7). The presence of trained providers in data quality (AOR = 2.9, 95%CI: (1.5, 5.7)) and supportive supervision (AOR = 11.5, 95%CI: (4.8, 27.2)) were found to be associated with completeness. Health facilities’ practice of root cause analysis on data quality gaps (AOR = 8.7, 9%CI: (1.5, 50.9)) was statistically significantly associated with the consistency.

Conclusions

Most medical records were found to have good completeness, but nearly only a quarter of them found to contain consistent data. Completeness and consistency varied on the type of medical record. Health facility’s root cause analysis of data quality gaps, the presence of trained providers in data quality, and supportive supervision from higher officials were identified as factors affecting data quality in institutional birth service. These results emphasize the importance of focused efforts to enhance data completeness and consistency within Individual Medical Records, particularly through consideration of Individual Medical Records in future provider training, supervision, and the implementation of root cause analysis practices.
Physician perspective on the implementation of risk mitigation strategies when prescribing opioid medications: a qualitative analysis
Authors: Tata Vaishnavi , Al Saadi Randa , Cho Sang Kyu , Varisco Tyler J. , Wanat Matthew , Thornton J. Douglas
Published: October 2023

Objective

To understand the physician perspective on the barriers and facilitators of implementing nine different opioid risk mitigation strategies (RMS) when prescribing opioid medications.

Methods

We created and dispersed a cross-sectional online survey through the Qualtrics© data collection platform among a nationwide sample of physicians licensed to practice medicine in the United States who have prescribed an opioid medication within the past year. The responses were analyzed using a deductive thematic analysis approach based on the Consolidated Framework for Implementation Research (CFIR) to ensure a holistic approach to identifying the barriers and facilitators for each RMS assessed. In concordance with this method, the themes and codes for the thematic analysis were defined prior to the analysis. The five domains within the CFIR were used as themes and the 39 nested constructs were treated as the codes. Two members of the research team independently coded the transcripts and discussed points of disagreement until consensus was reached. All analyses were conducted in ATLAS.ti© V7.

Results

The completion rate for this survey was 85.1% with 273 participant responses eligible for analysis. Intercoder reliability was calculated to be 82%. Deductive thematic analysis yielded 2,077 descriptions of factors affecting implementation of the nine RMS. The most salient code across all RMS was Knowledge and Beliefs about the Intervention, which refers to individuals’ attitudes towards and value placed on the intervention. Patient Needs and Resources, a code referring to the extent to which patient needs are known and prioritized by the organization, also emerged as a salient code. The physicians agreed that the patient perspective on the issue is vital to the uptake of each of the RMS.

Conclusions

This deductive thematic analysis identified key points for actionable intervention across the nine RMS assessed and established the importance of patient concordance with physicians when deciding on a course of treatment.
The current and future costs of colorectal cancer attributable to red and processed meat consumption in Brazil
Authors: Rezende Leandro F. M. , Malhão Thainá Alves , da Silva Barbosa Rafael , Schilithz Arthur Orlando Correa , da Silva Ronaldo Corrêa Ferreira , Moreira Luciana Grucci Maya , Ferrari Gerson , Machado Paula Aballo Nunes , Diogenes Maria Eduarda Leão
Published: October 2023

Background

Compelling evidence supports the association between red and processed meat consumption and increased risk of colorectal cancer. Herein, we estimated the current (2018) and future (2030) federal direct healthcare costs of colorectal cancer in the Brazilian Unified Health System attributable to red and processed meat consumption. Considering reduced red and processed meat consumption, we also projected attributable costs of colorectal cancer in 2040.

Methods

We retrieved information on red and processed meat consumption from two nationally representative dietary surveys, the Household Budget Survey 2008–2009 and 2017–2018; relative risks for colorectal cancer from a meta-analysis; direct healthcare costs of inpatient and outpatient procedures in adults ≥ 30 years with colorectal cancer (C18-C20) from 2008–2019 by sex.

Results

Attributable costs of colorectal cancer were calculated via comparative risk assessment, assuming a 10-year lag. In 2018, US$ 20.6 million (8.4%) of direct healthcare costs of colorectal cancer were attributable to red and processed meat consumption. In 2030, attributable costs will increase to US$ 86.6 million (19.3%). Counterfactual scenarios of reducing red and processed meat consumption in 2030 suggested that US$ 2.2 to 11.9 million and US$ 13 to 74 million could be saved in 2040, respectively.

Conclusion

Red and processed meat consumption has an escalating economic impact on the Brazilian Unified Health System. Our findings support interventions and policies focused on primary prevention and cancer.
Primary Care Behavioral Health in Sweden – a protocol of a cluster randomized trial evaluating outcomes related to implementation, organization, and patients (KAIROS)
Authors: Farnsworth von Cederwald Anneli , Lilja Josefine L. , Hentati Isacsson Nils , Kaldo Viktor
Published: October 2023

Background

Providing comprehensive and continuous care for patients whose conditions have mental or behavioral components is a central challenge in primary care and an important part of improving universal health coverage. There is a great need for high and routine availability of psychological interventions, but traditional methods for delivering psychotherapy often result in low reach and long wait times. Primary Care Behavioral Health (PCBH) is a method for organizing primary care in which behavioral health staff provide brief, flexible interventions to a large part of the population in active collaboration with other providers. While PCBH holds promise in addressing important challenges, it has not yet been thoroughly evaluated.

Methods

This cluster randomized trial will assess 17 primary care centers (PCCs) that are starting a PCBH implementation process. The PCCs will be divided into two groups, with one starting immediate implementation and the other acting as a control, implementing six months later. The purpose of the study is to strengthen the evidence base for PCBH regarding implementation-, organization-, and patient-level outcomes, taking into consideration that there is a partially dependent relationship between the three levels. Patient outcomes (such as increased daily functioning and reduction of symptoms) may be dependent on organizational changes (such as availability of treatment, waiting times and interprofessional teamwork), which in turn requires change in implementation outcomes (most notably, model fidelity). In addition to the main analysis, five secondary analyses will compare groups based on different combinations of randomization and time periods, specifically before and after each center achieves sufficient PCBH fidelity.

Discussion

A randomized comparison of PCBH and traditional primary care has, to our knowledge, not been made before. While the naturalistic setting and the intricacies of implementation pose certain challenges, we have designed this study in an effort to evaluate the causal effects of PCBH despite these complex aspects. The results of this project will be helpful in guiding decisions on how to organize the delivery of behavioral interventions and psychological treatment within the context of primary care in Sweden and elsewhere.

Trial registration

ClinicalTrials.gov: NCT05335382. Retrospectively registered on March 13th, 2022.
The Queensland Virtual Integrated Practice (VIP) partnership program pilot study: an Australian-first model of care to support rural general practice
Authors: Lepre Breanna , Job Jennifer , Martin Zena , Kerrigan Natalie , Jackson Claire
Published: October 2023

Background

There is a critical lack of medical workforce internationally, and this is particularly notable in rural and remote Australia where strategies to address workforce shortages are urgently required. This pilot study aimed to implement and evaluate a Virtual Integrated Practice (VIP) Program in the Australian rural primary care setting.

Methods

The VIP model was developed using co-creation methodology and involves an urban GP joining a rural general practice team to provide ongoing care to patients remotely via secure telehealth. The pilot study was conducted in two western Queensland general practices, commencing in October 2021 with one rural practice and extending to an additional rural practice from November 2022. Evaluation included a retrospective review of service, billing and cost data, and an online survey for patients. Ethical approval was obtained from the University of Queensland Human Research Ethics Committee (Project number: 2021/HE002434).

Results

There were 1468 services provided through to December 2022, including general consults (n = 1197), therapeutic procedures (n = 68), mental health treatment plans (n = 68) and chronic disease management plans (n = 59). Patients were predominantly female (73.1%) and did not have their appointment at the practice (57.8%). Among 1282 occasions of service, less than 20% of consultations (n = 224) required support from staff (e.g., a nurse), and more than half were repeat patient encounters (53.0%). Survey respondents (n = 45) indicated that they were satisfied (9.3%) or highly satisfied (90.7%) with the care provided, and importantly, 95.5% of respondents reported that the service improved their access to the GP. More than 20% of respondents indicated that they would attend the Emergency Department if virtual care was not available.

Conclusions

Data from this pilot study has informed translation to an additional 20 vulnerable rural general practices in three further rural regions in Queensland in 2023 and evaluation is ongoing. This pilot study demonstrates the feasibility and acceptability of an innovative, digitally supported community-focussed, healthcare initiative to arrest the decline in rural general practice workforce, improve patient care access and support rural practice viability.
Engineered extracellular vesicles for ischemic stroke: a systematic review and meta-analysis of preclinical studies
Authors: Li Pengtao , Yin Rui , Chen Yihao , Chang Jianbo , Yang Lang , Liu Xiaoyu , Xu Houshi , Zhang Xiao , Wang Shihua , Han Qin , Wei Junji
Published: October 2023

Background

This systematic review and meta-analysis aimed to evaluate the efficacy of engineered extracellular vesicles (EEVs) in the treatment of ischemic stroke (IS) in preclinical studies and to compare them with natural extracellular vesicles (EVs). The systematic review provides an up-to-date overview of the current state of the literature on the use of EEVs for IS and informs future research in this area.

Methods

We searched PubMed, EMBASE, Web of Science, Cochrane Library, and Scopus databases for peer-reviewed preclinical studies on the therapeutic effect of EEVs on IS.Databases ranged from the inception to August 1, 2023. The outcome measures included infarct volumes, neurological scores, behavioral scores, apoptosis rates, numbers of neurons, and levels of IL-1β, IL-6, and TNF-α. The CAMARADES checklist was used to assess the quality and bias risks of the studies. All statistical analyses were performed using RevMan 5.4 software.

Results

A total of 28 studies involving 1760 animals met the inclusion criteria. The results of the meta-analysis showed that compared to natural EVs, EEVs reduced infarct volume (percentage: SMD = -2.33, 95% CI: -2.92, -1.73; size: SMD = -2.36, 95% CI: -4.09, -0.63), improved neurological scores (mNSS: SMD = -1.78, 95% CI: -2.39, -1.17; Zea Longa: SMD = -2.75, 95% CI: -3.79, -1.71), promoted behavioral recovery (rotarod test: SMD = 2.50, 95% CI: 1.81, 3.18; grid-walking test: SMD = -3.45, 95% CI: -5.15, -1.75; adhesive removal test: SMD = -2.60, 95% CI: -4.27, -0.93; morris water maze test: SMD = -3.91, 95% CI: -7.03, -0.79), and reduced the release of proinflammatory factors (IL-1β: SMD = -2.02, 95% CI: -2.77, -1.27; IL-6: SMD = -3.01, 95% CI: -4.47, -1.55; TNF-α: SMD = -2.72, 95% CI: -4.30, -1.13), increasing the number of neurons (apoptosis rate: SMD = -2.24, 95% CI: -3.32, -1.16; the number of neurons: SMD = 3.70, 95% CI: 2.44, 4.96). The funnel plots for the two main outcome measures were asymmetric, indicating publication bias. The median score on the CAMARADES checklist was 7 points (IQR: 6–9).

Conclusions

This meta-analysis shows that EEVs are superior to natural EVs for the treatment of IS. However, research in this field is still at an early stage, and more research is needed to fully understand the potential therapeutic mechanism of EEVs and their potential use in the treatment of IS.

PROSPERO registration number

CRD42022368744.
Comparison of the measurement properties of the EQ-5D-5L and SF-6Dv2 among overweight and obesity populations in China
Authors: Xie Shitong , Li Meixuan , Wang Dingyao , Hong Tianqi , Guo Weihua , Wu Jing
Published: October 2023

Objective

To evaluate and compare the measurement properties of the EQ-5D-5L and SF-6Dv2 among Chinese overweight and obesity populations.

Methods

A representative sample of Chinese overweight and obesity populations was recruited stratified by age, gender, body mass index (BMI), and area of residence. Social-demographic characteristics and self-reported EQ-5D-5L and SF-6Dv2 responses were collected through the online survey. The agreement was assessed using intraclass correlation coefficients (ICC). Convergent validity and known-group validity were examined using Spearman’s rank correlation and effect sizes, respectively. The test-retest reliability was assessed using among a subgroup of the total sample. Sensitivity was compared using relative efficiency and receiver operating characteristic.

Results

A total of 1000 respondents (52.0% male, mean age 51.7 years, 67.7% overweight, 32.3% obesity) were included in this study. A higher ceiling effect was observed in EQ-5D-5L than in SF-6Dv2 (30.6% vs. 2.1%). The mean (SD) utility was 0.851 (0.195) for EQ-5D-5L and 0.734 (0.164) for SF-6Dv2, with the ICC of the total sample was 0.639 (p < 0.001). The Spearman’s rank correlation (range: 0.186–0.739) indicated an acceptable convergent validity between the dimensions of EQ-5D-5L and SF-6Dv2. The EQ-5D-5L showed basically equivalent discriminative capacities with the SF-6Dv2 (ES: 0.517–1.885 vs. 0.383–2.329). The ICC between the two tests were 0.939 for EQ-5D-5L and 0.972 for SF-6Dv2 among the subgroup (N = 150). The SF-6Dv2 had 3.7–170.1% higher efficiency than the EQ-5D-5L at detecting differences in self-reported health status, while the EQ-5D-5L was found to be 16.4% more efficient at distinguishing between respondents with diabetes and non-diabetes.

Conclusions

Both the EQ-5D-5L and SF-6Dv2 showed comparable reliability, validity, and sensitivity when used in Chinese overweight and obesity populations. The two measures may not be interchangeable given the systematic difference in utility values between the EQ-5D-5L and SF-6Dv2. More research is needed to compare the responsiveness.
Lessons learnt while designing and conducting a longitudinal study from the first Italian COVID-19 pandemic wave up to 3 years
Authors: Palese Alvisa , Chiappinotto Stefania , Fonda Federico , Visintini Erica , Peghin Maddalena , Colizzi Marco , Balestrieri Matteo , De Martino Maria , Isola Miriam , Tascini Carlo
Published: October 2023

Background

Several scientific contributions have summarized the “lessons learnt” during the coronavirus disease 2019 (COVID-19) pandemic, but only a few authors have discussed what we have learnt on how to design and conduct research during a pandemic. The main intent of this study was to summarize the lessons learnt by an Italian multidisciplinary research group that developed and conducted a longitudinal study on COVID-19 patients infected during the first wave in March 2020 and followed-up for 3 years.

Methods

A qualitative research approach embedded into the primary CORonavirus MOnitoRing study (CORMOR) study was developed, according to the the consolidated criteria for reporting qualitative research. Multiple data collection strategies were performed: each member was invited to report the main lessons learnt according to his/her perspective and experience from the study design throughout its conduction. The narratives collected were summarized and discussed in face-to-face rounds. The narratives were then thematically analysed according to their main topic in a list that was resent to all members to check the content and their organization. The list of the final “lessons learnt” has been agreed by all members, as described in a detailed fashion.

Results

Several lessons were learnt while designing and conducting a longitudinal study during the COVID-19 pandemic and summarised into ten main themes: some are methodological, while others concern how to conduct research in pandemics/epidemics/infectious disease emergencies.

Conclusions

The multidisciplinary approach, which also included patients’ perspective, helped us to protect the consistency and quality of the research provided in pandemic times. The lesson learnt suggest that our research approach may benefit from changes in education, clinical practice and policies.
Knowledge management tools and mechanisms for evidence-informed decision-making in the WHO European Region: a scoping review
Authors: El-Jardali Fadi , Bou-Karroum Lama , Hilal Nadeen , Hammoud Maya , Hemadi Nour , Assal Michelle , Kalach Nour , Harb Aya , Azzopardi-Muscat Natasha , Sy Tyrone Reden , Novillo-Ortiz David
Published: October 2023

Background

Knowledge management (KM) emerged as a strategy to promote evidence-informed decision-making. This scoping review aims to map existing KM tools and mechanisms used to promote evidence-informed health decision-making in the WHO European Region and identify knowledge gaps.

Methods

Following the Joanna Briggs Institute (JBI) guidance for conducting scoping reviews, we searched Medline, PubMed, EMBASE, the Cochrane library, and Open Grey. We conducted a descriptive analysis of the general characteristics of the included papers and conducted narrative analysis of the included studies and categorized studies according to KM type and phase.

Results

Out of 9541 citations identified, we included 141 studies. The KM tools mostly assessed are evidence networks, surveillance tools, observatories, data platforms and registries, with most examining KM tools in high-income countries of the WHO European region. Findings suggest that KM tools can identify health problems, inform health planning and resource allocation, increase the use of evidence by policymakers and stimulate policy discussion.

Conclusion

Policymakers and funding agencies are called to support capacity-building activities, and future studies to strengthen KM in the WHO European region particularly in Eastern Europe and Central Asia. An updated over-arching strategy to coordinate KM activities in the WHO European region will be useful in these efforts.
Human isogenic cells of the neurovascular unit exert transcriptomic cell type-specific effects on a blood-brain barrier in vitro model of late-onset Alzheimer disease
Authors: Haferkamp Undine , Hartmann Carla , Abid Chaudhry Luqman , Brachner Andreas , Höchner Alevtina , Gerhartl Anna , Harwardt Bernadette , Leckzik Selin , Leu Jennifer , Metzger Marco , Nastainczyk-Wulf Marina , Neuhaus Winfried , Oerter Sabrina , Pless Ole , Rujescu Dan , Jung Matthias , Appelt-Menzel Antje
Published: October 2023

Background

The function of the blood-brain barrier (BBB) is impaired in late-onset Alzheimer disease (LOAD), but the associated molecular mechanisms, particularly with respect to the high-risk APOE4/4 genotype, are not well understood. For this purpose, we developed a multicellular isogenic model of the neurovascular unit (NVU) based on human induced pluripotent stem cells.

Methods

The human NVU was modeled in vitro using isogenic co-cultures of astrocytes, brain capillary endothelial-like cells (BCECs), microglia-like cells, neural stem cells (NSCs), and pericytes. Physiological and pathophysiological properties were investigated as well as the influence of each single cell type on the characteristics and function of BCECs. The barriers established by BCECs were analyzed for specific gene transcription using high-throughput quantitative PCR.

Results

Co-cultures were found to tighten the barrier of BCECs and alter its transcriptomic profile under both healthy and disease conditions. In vitro differentiation of brain cell types that constitute the NVU was not affected by the LOAD background. The supportive effect of NSCs on the barrier established by BCECs was diminished under LOAD conditions. Transcriptomes of LOAD BCECs were modulated by different brain cell types. NSCs were found to have the strongest effect on BCEC gene regulation and maintenance of the BBB. Co-cultures showed cell type-specific functional contributions to BBB integrity under healthy and LOAD conditions.

Conclusions

Cell type-dependent transcriptional effects on LOAD BCECs were identified. Our study suggests that different brain cell types of the NVU have unique roles in maintaining barrier integrity that vary under healthy and LOAD conditions.

Graphical abstract

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Alcohol consumption and associated factors among pregnant women attending antenatal care at governmental hospitals in Harari regional state, Eastern, Ethiopia
Authors: Bete Tilahun , Asfaw Henock , Nigussie Kabtamu , Alemu Addisu , Eyeberu Gebrie Addis , Dechasa Deribe Bekele , Gemechu Kabtamu , Arkew Mesay , Daniel Beniam , Gelaye Habtam , Wolde Asrat , Kassa Mulat Awoke , Anbesaw Tamrat
Published: October 2023

Background

Alcohol consumption during the pregnancy period is high despite the well-established evidence of its harmful effects on pregnancy and infant development. Early identification and behavioral modification are of great significance. This study aimed to assess the prevalence and associated factors of alcohol consumption among pregnant women attending antenatal care at governmental hospitals in the Harari regional state, Eastern Ethiopia.

Method

From April 1/2022-May 1/2022, an institutional-based cross-sectional survey was conducted among 589 pregnant women attending antenatal care governmental hospitals in Harari regional state. A systematic random sampling technique was used to select study participants during the study period. Data were collected through face-to-face interview methods using AUDIT-C. The collected data were coded, entered into Epi-data data version 3.1, and analyzed by SPSS Version 26. Binary logistic regression was carried out to identify independent predictors of alcohol consumption at a 95% confidence level.

Results

From a total of 617 eligible participants, 589 participated in the study with a response rate of 95.46%. The overall prevalence of alcohol consumption among pregnant women in Harari regional state governmental hospitals was 21.2% (95% CI:17.8, 24.4). In multivariate analysis, single marital status (AOR = 5.18;95% CI (2.66,10.11), previous history of abortion(AOR = 4.07;95% CI(2.06,8.04), family history of mental illness (AOR = 4.79;95% CI (1.94,11.83), depression (AOR 2.79; 95%CI(1.35,5.76), and anxiety(AOR = 2.51; 95% CI (1.23, 5.12) were variables found to have a statistically significant association with alcohol consumption during pregnancy in Harari regional state governmental hospitals.

Conclusion

In comparison to the majority of other research, the prevalence of alcohol usage during pregnancy was high in this study. This study observed that single marital status, previous history of abortion, family history of mental illness, depression, and anxiety were highly associated with alcohol consumption during pregnancy. Hence, responsible bodies working on mother and child health should try to mitigate or remove the above-mentioned risks when developing interventions.
Muti-factor analysis of sport activity level after high tibial osteotomy
Authors: Huang Teng , Kang Kai , Qiao Qi , Li Tong , Liu Tao , Ji Chenni , Gao Shijun
Published: October 2023

Background

Although many studies have shown that high tibial osteotomy is appropriate for active patients, there are limited multifactorial studies on patients’ sport activity level after HTO in general population.

Methods

158 patients who underwent HTO for knee osteoarthritis between January 2016 and December 2019 are included, with a 36-month follow-up. Information was collected from X-rays and questionnaire. The independent variables were age, sex, breadwinner (provide more than 50% income), sport activity level when the knee was pain-free before and after surgery, concomitant meniscal treatment history, Lysholm knee score, desire level for returning to sports. The 158 cases are divided into three groups according to their sports participation before and after operation, Chi-square tests and ANOVA analysis were adopted to identify the effect of these variables on sport activity level after HTO, and factors with statistical differences and clinical relevancies, or provided by previous research were assessed with the ordinal logistic regression analysis.

Results

According to sport activity level analysis, 28(17.7%) patients were categorized into the sport level-reduced group, 97(61.4%) patients into the sport level-unchanged group, and 33(20.9%) patients into the sport level-improved group. Upon ordinal logistic regression analysis, postoperative MA%, age, BMI, and preoperative Lysholm knee score were statistically significant.

Conclusions

Higher postoperative MA%, younger age, lower BMI, and lower Lysholm score are associate with improvement on activity level after HTO. This finding provides valuable references in operation option and rehabilitation planning.
High incidence of catheter-associated urinary tract infections and related antibiotic resistance in two hospitals of different geographic regions of Sierra Leone: a prospective cohort study
Authors: Lakoh Sulaiman , Yi Le , Russell James B.W. , Zhang Juling , Sevalie Stephen , Zhao Yongkun , Kanu Joseph Sam , Liu Peng , Conteh Sarah K. , Williams Christine Ellen Elleanor , Barrie Umu , Adekanmbi Olukemi , Jiba Darlinda F. , Kamara Matilda N. , Sesay Daniel , Deen Gibrilla F. , Okeibunor Joseph Chukwudi , Yendewa George A. , Guo Xuejun , Firima Emmanuel
Published: October 2023

Objective

Catheter-associated urinary tract infections (CAUTI) are common worldwide, but due to limited resources, its actual burden in low-income countries is unknown. Currently, there are gaps in knowledge about CAUTI due to lack of surveillance activities in Sierra Leone. In this prospective cohort study, we aimed to determine the incidence of CAUTI and associated antibiotic resistance in two tertiary hospitals in different regions of Sierra Leone.

Results

The mean age of the 459 recruited patients was 48.8 years. The majority were females (236, 51.3%). Amongst the 196 (42.6%) catheterized patients, 29 (14.8%) developed CAUTI. Bacterial growth was reported in 32 (84%) patients. Escherichia coli (14, 23.7%), Klebsiella pneumoniae (10, 17.0%), and Klebsiella oxytoca (8, 13.6%) were the most common isolates. Most isolates were ESBL-producing Enterobacteriaceae (33, 56%) and WHO Priority 1 (Critical) pathogens (38, 71%). Resistance of K. pneumoniae, K. oxytoca, E. coli, and Proteus mirabilis was higher with the third-generation cephalosporins and penicillins but lower with carbapenems, piperacillin-tazobactam and amikacin. To reduce the high incidence of CAUTI and multi-drug resistance organisms, urgent action is needed to strengthen the microbiology diagnostic services and develop and implement catheter bundles that provide clear guidance for catheter insertion, care and removal.
Functional reconstruction of elbow flexion with latissimus dorsi muscle rotational transfer: two case reports
Authors: Kobayashi Yuka , Uchiyama Yoshiyasu , Yoshida Shinji , Saito Ikuo , Ishii Takayuki , Nakajima Daisuke , Yanagisawa Shou , Watanabe Masahiko
Published: October 2023

Background

We report two cases of biceps brachii and brachialis paralysis due to musculocutaneous nerve injury in which elbow joint flexion was reconstructed using rotational transfer of the latissimus dorsi muscle with sutures to the radial and ulnar tuberosities, thereby enabling flexion by simultaneous activation of the humeroradial and humeroulnar joints. In cases of associated brachialis paralysis, weaker flexion strength can be expected when the forearm is in a pronated position than when it is in a supinated state. To the best of our knowledge, no previous study has reported the rotational position of the forearm during elbow joint flexion reconstruction.

Case presentation

Case 1 involved a 30-year-old Asian male who presented with a rupture of the musculocutaneous, median, radial, and ulnar nerves. Reconstruction was performed by rotational transfer of the latissimus dorsi muscle. In this case, the supination and pronation flexion forces were equal. Case 2 involved a 50-year-old Asian man who presented with partial loss of the musculocutaneous nerve, biceps brachii, and pectoralis major due to debridement. Reconstruction was performed by rotational transfer of the latissimus dorsi muscle. In this case, supination and pronation flexion strengths were demonstrated to be equal. Our reconstruction method used the rotational transfer of the latissimus dorsi muscle; the distal muscle flap was divided into radial and ulnar sides to allow elbow joint flexion by simultaneously activating the humeroradial and humeroulnar joints. These sides were then fixed to the anchors at the radial and ulnar tuberosities. Finally, they were wrapped around the myotendinous junction of the biceps brachii or brachialis and secured using sutures.

Conclusions

Although larger studies are required to verify these methods, this case study successfully demonstrates the following: (1) the flexion strength in the supinated position was equal to that in the pronated position; (2) the stability of the humeroradial and humeroulnar joints was unaffected by the forearm's rotational position; and (3) a satisfactory range of motion of the elbow joint was obtained, with no complications.
Primary explants of the postnatal thymus allow the expansion of clonogenic thymic epithelial cells that constitute thymospheres
Authors: Ocampo-Godinez Juan M. , Gonzalez-Quiroz Jose L. , Cote-Palafox Hector , George Elizabeth , Vergara-Lope Nuñez Jael A. , Villagomez-Olea Guillermo , Vazquez-Vazquez Febe C. , Lopez-Villegas Edgar O. , Leon-Avila Gloria , Dominguez-Lopez Maria L. , Alvarez-Perez Marco A.
Published: October 2023

Background

Thymic epithelial cells (TECs) are responsible for shaping the repertoires of T cells, where their postnatal regeneration depends on a subset of clonogenic TECs. Despite the implications for regenerative medicine, their cultivation and expansion remain challenging. Primary explant cell culture is a technique that allows the seeding and expansion of difficult-to-culture cells. Here, we report a reliable and simple culture system to obtain functional TECs and thymic interstitial cells (TICs).

Methods

To establish primary thymic explants, we harvested 1 mm cleaned fragments of thymus from 5-week-old C57/BL6 mice. Tissue fragments of a complete thymic lobe were placed in the center of a Petri dish with 1 mL of DMEM/F-12 medium supplemented with 20% fetal bovine serum (FBS) and 1% penicillin‒streptomycin. To compare, thymic explants were also cultivated by using serum-free DMEM/F-12 medium supplemented with 10% KnockOut™.

Results

We obtained high numbers of functional clonogenic TECs and TICs from primary thymic explants cultivated with DMEM/F-12 with 20% FBS. These cells exhibited a highly proliferative and migration profile and were able to constitute thymospheres. Furthermore, all the subtypes of medullary TECs were identified in this system. They express functional markers to shape T-cell and type 2 innate lymphoid cells repertoires, such as Aire, IL25, CCL21 and CD80. Finally, we also found that ≥ 70% of lineage negative TICs expressed high amounts of Aire and IL25.

Conclusion

Thymic explants are an efficient method to obtain functional clonogenic TECs, all mTEC subsets and different TICs Aire+IL25+ with high regenerative capacity.
Autologous mesenchymal stromal cells embedded with Tissucol Duo® for prevention of air leak after anatomical lung resection: results of a prospective phase I/II clinical trial with long-term follow-up
Authors: Jiménez Marcelo F. , Gómez-Hernández María Teresa , Villarón Eva M. , López-Parra Miriam , Sánchez-Guijo Fermín
Published: October 2023

Background

Prolonged air leak (PAL) is the most frequent complication after pulmonary resection. Several measures have been described to prevent the occurrence of PAL in high-risk patients, however, the potential role of mesenchymal stem cells (MSCs) applied in the parenchymal suture line to prevent postoperative air leak in this setting has not been fully addressed.

Objective

To analyse the feasibility, safety and potential clinical efficacy of the implantation of autologous MSCs embedded in Tissucol Duo® as a prophylactic alternative to prevent postoperative prolonged air leak after pulmonary resection in high-risk patients.

Study design

Phase I/II single-arm prospective clinical trial.

Methods

Six patients with high risk of PAL undergoing elective pulmonary resection were included. Autologous bone marrow-derived MSCs were expanded at our Good Manufacturing Practice (GMP) Facility and implanted (embedded in a Tissucol Duo® carrier) in the parenchymal suture line during pulmonary resection surgery. Patients were monitored in the early postoperative period and evaluated for possible complications or adverse reactions. In addition, all patients were followed-up to 5 years for clinical outcomes.

Results

The median age of patients included was 66 years (range: 55–70 years), and male/female ratio was 5/1. Autologous MSCs were expanded in five cases, in one case MSCs expansion was insufficient. There were no adverse effects related to cell implantation. Regarding efficacy, median air leak duration was 0 days (range: 0–2 days). The incidence of PAL was nil. Radiologically, only one patient presented pneumothorax in the chest X-ray at discharge. No adverse effects related to the procedure were recorded during the follow-up.

Conclusions

The use of autologous MSCs for prevention of PAL in patients with high risk of PAL is feasible, safe and potentially effective.

Trial registration No. EudraCT: 2013-000535-27. Clinicaltrials.gov idenfier: NCT02045745.
Principal component analysis: development and initial validation of the mirror effects inventory
Authors: Ho Wing W. Y.
Published: October 2023

Background

Mirroring is a specific phenomenon that occurs in groups. People observe others enacting different roles in given situations, whereby concretizing the role of the observing aspect of their self as if looking in a mirror. Individuals could acquire emotional, cognitive, imaginative, behavioral, and interpersonal experiences through this process of mirroring; that is, “mirror effects.” Given that there are very few comprehensive scales capable of evaluating mirror effects, the Mirror Effects Inventory (MEI) was developed to measure experiences after participating in counseling education. This study describes the development of the MEI based on an interpersonal perspective and aimed to validate this scale.

Methods

The development and validation of the MEI involved a seven-stage process that utilized both qualitative and quantitative methods. Former students who studied counseling (N = 24) were surveyed via semi-structured telephone interviews. A subjective perceived scale (the MEI) was then constructed. The MEI was administered to part-time university students (N = 221) studying counseling courses. Psychometric tests were performed to examine its validity and reliability. Validation of the MEI included examining correlations between three types of mirror effects and age differences and educational attainment.

Results

The PCA revealed three types of mirror effects: general, positive, and negative. These components accounted for 53.82% of the total variance. Reliability estimates measured using Cronbach’s alpha of .88 indicated that the items were internally consistent. The findings showed that as the general mirror effect increased, there was a corresponding increase in the positive mirror effect and a decrease in the negative mirror effect. However, an increase in positive mirror effects was associated with an increase in negative mirror effects.

Conclusions

The development of a reliable and valid measure of mirror effects has benefits and implications for counseling education and clinical practice. Further empirical research could contribute to resolving the controversies concerning the basic conceptual understanding of MEI.