bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnostic value of multiple b-value diffusion-weighted imaging in discriminating the malignant from benign breast lesions
Authors: Lin Chu-Xin , Tian Ye , Li Jia-Min , Liao Shu-Ting , Liu Yu-Tao , Zhan Run-Gen , Du Zhong-Li , Yu Xiang-Rong
Published: January 2023

Objective

The conventional breast Diffusion-weighted imaging (DWI) was subtly influenced by microcirculation owing to the insufficient selection of the b values. However, the multiparameter derived from multiple b-value exhibits more reliable image quality and maximize the diagnostic accuracy. We aim to evaluate the diagnostic performance of stand-alone parameter or in combination with multiparameter derived from multiple b-value DWI in differentiating malignant from benign breast lesions.

Methods

A total of forty-one patients diagnosed with benign breast tumor and thirty-eight patients with malignant breast tumor underwent DWI using thirteen b values and other MRI functional sequence at 3.0 T magnetic resonance. Data were accepted mono-exponential, bi-exponential, stretched-exponential, aquaporins (AQP) model analysis. A receiver operating characteristic curve (ROC) was used to evaluate the diagnostic performance of quantitative parameter or multiparametric combination. The Youden index, sensitivity and specificity were used to assess the optimal diagnostic model. T-test, logistic regression analysis, and Z-test were used.Pvalue < 0.05 was considered statistically significant.

Result

The ADCavg, ADCmax, f, and α value of the malignant group were lower than the benign group, while the ADCfastvalue was higher instead. The ADCmin, ADCslow, DDC and ADCAQPshowed no statistical significance. The combination (ADCavg-ADCfast) yielded the largest area under curve (AUC = 0.807) with sensitivity (68.42%), specificity (87.8%) and highest Youden index, indicating that multiparametric combination (ADCavg-ADCfast) was validated to be a useful model in differentiating the benign from breast malignant lesion.

Conclusion

The current study based on the multiple b-value diffusion model demonstrated quantitatively multiparametric combination (ADCavg-ADCfast) exhibited the optimal diagnostic efficacy to differentiate malignant from benign breast lesions, suggesting that multiparameter would be a promising non-invasiveness to diagnose breast lesions.
Risk model and factors for prediction of response to neoadjuvant chemotherapy in patients with advanced gastric cancer-a two-center cohort study
Authors: Liang Xian-Wen , Xiao Wei-Sheng , Lei Hao , Huag Qian-Cheng , Dong Yu-Lan , Wang Fang , Qing Wei-Peng
Published: January 2023

Objective

Due to inconsistency in neoadjuvant chemotherapy (NACT) response in advanced gastric cancer (GC), the indications remain the source of controversy. This study focused on identifying factors related to NACT chemosensitivity and providing the best treatment for GC cases.

Methods

Clinical data in 867 GC cases treated with neoadjuvant chemotherapy were downloaded from two medical centers between January 2014 and December 2020, and analyzed by logistic regression and the least absolute shrinkage and selection operator (LASSO) for identifying potential factors that predicted NACT response and might be incorporated in constructing the prediction nomogram.

Results

After the inclusion and exclusion criteria were applied, totally 460 cases were enrolled, among which, 307 were males (66.74%) whereas 153 were females (33.26%), with the age of 24–77 (average, 59.37 ± 10.60) years. Consistent with RECIST standard, 242 patients were classified into effective group (PR or CR) while 218 were into ineffective group (PD or SD), with the effective rate of 52.61%. In training set, LASSO and logistic regression analysis showed that five risk factors were significantly associated with NACT effectiveness, including tumor location, Smoking history, T and N stages, and differentiation. In terms of our prediction model, its C-index was 0.842. Moreover, calibration curve showed that the model-predicted results were in good consistence with actual results. Validation based on internal and external validation sets exhibited consistency between training set results and ours.

Conclusions

This study identified five risk factors which were significantly associated with NACT response, including smoking history, clinical T stage, clinical N stage, tumor location and differentiation. The prediction model that exhibited satisfying ability to predict NACT effectiveness was constructed, which may be adopted for identifying the best therapeutic strategy for advanced GC by gastrointestinal surgeons.
Terminal ileitis and cytotoxic lesion of corpus callosum as the presenting features of Multisystem inflammatory syndrome in children (MIS-C): a case report
Authors: Davoodi Marzieh , Pouladfar Gholamreza , Kadivar Mohammad Rahim , Dehghan Alireza , Askarisarvestani Aida , Hamzavi Seyedeh Sedigheh
Published: January 2023

Background

Multisystem inflammatory syndrome in children (MIS-C) is a post-viral inflammatory vasculopathy characterized by persistent fever, multiorgan dysfunction, significant laboratory markers of inflammation, lack of an alternative diagnosis, and prior SARS-CoV-2 infection or exposure in children and adolescents. The most common early symptoms include a prolonged fever, as well as dermatologic, mucocutaneous, and gastrointestinal symptoms such abdominal pain, vomiting, and diarrhea.

Case presentation

We present a pediatric patient with multisystem inflammatory syndrome with the development of abdominal pain and seizure who was found to have a circumferential wall thickening of the terminal ileum and ileocecal junction in abdominal CT scan. The brain MRI of the patient showed cytotoxic lesions of the corpus callosum (CLOCC) which had hypersignal intensity with a few diffusion restrictions in the splenium of the corpus callosum.

Conclusion

This case is being reported to raise awareness of MIS-C presenting characteristics. Given the rising number of MIS-C patients and a lack of understanding regarding early diagnostic clinical characteristics and therapy, further research into clinical presentations, treatment, and outcomes is urgently needed.
The Precision in Psychiatry (PIP) study: Testing an internet-based methodology for accelerating research in treatment prediction and personalisation
Authors: Lee Chi Tak , Palacios Jorge , Richards Derek , Hanlon Anna K. , Lynch Kevin , Harty Siobhan , Claus Nathalie , Swords Lorraine , O’Keane Veronica , Stephan Klaas E , Gillan Claire M
Published: January 2023

Background

Evidence-based treatments for depression exist but not all patients benefit from them. Efforts to develop predictive models that can assist clinicians in allocating treatments are ongoing, but there are major issues with acquiring the volume and breadth of data needed to train these models. We examined the feasibility, tolerability, patient characteristics, and data quality of a novel protocol for internet-based treatment research in psychiatry that may help advance this field.

Methods

A fully internet-based protocol was used to gather repeated observational data from patient cohorts receiving internet-based cognitive behavioural therapy (iCBT) (N = 600) or antidepressant medication treatment (N = 110). At baseline, participants provided > 600 data points of self-report data, spanning socio-demographics, lifestyle, physical health, clinical and other psychological variables and completed 4 cognitive tests. They were followed weekly and completed another detailed clinical and cognitive assessment at week 4. In this paper, we describe our study design, the demographic and clinical characteristics of participants, their treatment adherence, study retention and compliance, the quality of the data gathered, and qualitative feedback from patients on study design and implementation.

Results

Participant retention was 92% at week 3 and 84% for the final assessment. The relatively short study duration of 4 weeks was sufficient to reveal early treatment effects; there were significant reductions in 11 transdiagnostic psychiatric symptoms assessed, with the largest improvement seen for depression. Most participants (66%) reported being distracted at some point during the study, 11% failed 1 or more attention checks and 3% consumed an intoxicating substance. Data quality was nonetheless high, with near perfect 4-week test retest reliability for self-reported height (ICC = 0.97).

Conclusions

An internet-based methodology can be used efficiently to gather large amounts of detailed patient data during iCBT and antidepressant treatment. Recruitment was rapid, retention was relatively high and data quality was good. This paper provides a template methodology for future internet-based treatment studies, showing that such an approach facilitates data collection at a scale required for machine learning and other data-intensive methods that hope to deliver algorithmic tools that can aid clinical decision-making in psychiatry.
The prevalence and mental health correlates of exposure to offensive behaviours at work in Hungary: results of a national representative survey
Authors: Szusecki Tyler , Konkolÿ Thege Barna , Stauder Adrienne
Published: January 2023

Background

Within the last decades, a substantial number of reports have established bullying behaviours as a severe risk to the health and safety of workers. However, in Hungary, the severity of this issue remains largely unknown. Therefore, the current study aimed to 1) determine the prevalence of offensive workplace behaviours in the Hungarian working population and 2) examine the relationship between exposure to these offensive behaviours and certain mental health indicators.

Methods

The cross-sectional analyses of the present study are based on a sample of 13,104 active workers being representative of the Hungarian working population according to gender, age, educational level, and 18 occupational sectors. The mid-length version of the Copenhagen Psychosocial Questionnaire II (COPSOQ II) was used to measure workplace offensive behaviours (bullying, sexual harassment, threats of violence, and physical violence) in the 12 months preceding the survey. Examined mental health correlates included depressive symptomatology (Beck Depression Inventory), functional somatic symptoms (PHQ-15), perceived stress (Perceived Stress Scale), and general well-being (WHO Well-being Index).

Results

Almost half (48.7%) of the sample reported exposure to some form of offensive behaviour; 37.6% of participants reported occasional-, while 11.1% reported weekly or daily exposure. More women than men were exposed to offensive workplace behaviours, and those targeted the most were individuals aged 18–29 and in companies employing 20–49 employees. Top managers reported the lowest amount of bullying, while unskilled labourers reported the most frequent exposure. A moderately strong relationship was discovered between exposure to workplace offensive behaviours and all indicators of mental health.

Conclusion

Workplace bullying was revealed to be a significant public health concern according to this large, representative data set from Hungary. Strategies to reduce the occurrence and impact of these behaviours on employee health should be a priority for occupational health and safety interventions.
Does China’s Equalization of Basic Public Health Services policy improve delivery care for migrant women?
Authors: Zou Hong , Xiao Han , Xu Hongwei
Published: January 2023

Background

As of 2020, 1 in 4 people in China is a domestic migrant. However, their lack of access to health care in destination cities has been largely neglected by the Chinese government until recently.

Methods

Drawing on data from the 2010–2016 China Migrants Dynamic Survey, this study evaluated the impact of a pilot program of the Equalization of Basic Public Health Services launched in 2014 and focused on place of childbirth, an important indicator of delivery care. A difference-in-differences design was employed for statistical inference.

Results

The migrant pilot program increased the likelihood of a migrant childbirth at a migration destination by about 4 to 8 percentage points, depending on the model specification. Further analyses revealed that this positive effect was short-term and benefited relatively better-off migrant families.

Conclusion

The migrant pilot program improved delivery care for migrant women. The Chinese government needs to expand this pilot program to more cities and improve its benefits to better serve the massive migrant population.
Prevalence of married women’s decision-making autonomy on contraceptive use and its associated factors in high fertility regions of Ethiopia: a multilevel analysis using EDHS 2016 data
Authors: Belachew Tadele Biresaw , Negash Wubshet Debebe , Bitew Desalegn Anmut , Asmamaw Desale Bihonegn
Published: January 2023

Background

Women's independence in reproductive health is crucial to the health of mothers and children. Couples are, however, restricted from discussing their relationship openly. Regarding this, information about women’s decision-making autonomy is low in developing countries including Ethiopia. Therefore, this study was aimed to assess married women’s decision-making autonomy on contraceptive use in high fertility regions of Ethiopia.

Methods

The study was based on secondary data analysis of the Ethiopian Demographic and Health Survey 2016 data. A total weighted sample of 1157 reproductive age women was included. A multilevel mixed-effect binary logistic regression model was fitted to identify the significant associated factors of decision making autonomy on contraceptive use. Statistical significance was determined using Adjusted Odds Ratio (AOR) with 95% confidence interval.

Results

Overall prevalence of decision making autonomy on contraceptive use was observed to be 17.2% (15.1, 19.5). Women's age 25–34 (AOR = 3.19; 95% CI:1.55, 6.54), and 35–49 (AOR = 3.59; 95% CI: 1.5, 8.36), secondary and above educational level (AOR = 3.38; 95% CI: 1.07, 10.67), being married before 18 years (AOR = 0.42; 95% CI:0.26, 0.68), being Muslim in religion (AOR = 0.47; 95% CI: 0.23, 0.98), women being in urban area (AOR = 2.73; 95% CI: 1.97, 6.35), and community media exposure (AOR = 1.85; 95% CI: 1.15, 2.48) were associated with decision making autonomy on contraceptive use.

Conclusion

Women’s decision-making autonomy on contraceptive use in this study was low. Age of mothers, educational status of mothers, age at first marriage, residence, religion, and community media exposure were significant factors. Therefore, the government should promote women’s autonomy on contraceptive use as an essential component of reproductive health rights through mass media, educating, with particular attention for, youth women, and women living in rural settings.
Synovial biopsy for establishing a definite diagnosis in undifferentiated chronic knee monoarthritis
Authors: Soroosh Soosan G , Ghatfan Ali , Farbod Abolfazl , Meftah Elahe
Published: January 2023

Background

Undifferentiated arthritis is a condition in which the problem cannot be classified into any definite diagnosis category. Various methods have been suggested to clarify the definite diagnosis in this class. The synovial biopsy is suggested as the last diagnostic approach to determine the precise histopathological diagnosis. In this study, we aimed to evaluate the efficacy of synovial biopsy for establishing a definite diagnosis in patients with undifferentiated chronic knee monoarthritis.

Methods

The present retrospective case series was conducted in 2005 in the rheumatology research center of Shariati hospital and the 501 hospital in Tehran, Iran. The study included the synovial biopsy of patients with chronic knee monoarthritis who did not have a definite diagnosis after all the diagnostic steps before the synovial biopsy. Pathology slides of the patients’ synovial biopsy were reevaluated with a senior expert pathologist.

Results

Eighty patients with a mean age of 37.6 ± 17.32 years (range: 6–68) were included, of whom 50% were female. The gap time between the onset of knee monoarthritis and the decision-making for synovial biopsy was 14.34 ± 19.61 months. Histopathologic evaluations revealed non-specific synovitis in 65% of the patients and a definite diagnosis in 35%. The most common definite diagnosis was rheumatoid arthritis (9%), followed by septic arthritis (5%). The most common pathologic findings were endothelial proliferation (89%) and synovial proliferation (88%), and the most common infiltrating cell was lymphocyte (54%). Patients with non-specific synovitis were more likely to have neovascularization, cellular infiltration (p-value < 0.001), synovial proliferation, endothelial proliferation (p-value = 0.001), pannus formation (p-value = 0.009), and fibrosis (p-value = 0.022) compared to the patients with a definite pathologic diagnosis. However, age, gender, and the gap time between disease symptoms to synovial biopsy were not significantly different between the different groups of diagnosis (p-value > 0.05).

Conclusion

Non-specific synovitis remains the most common histopathologic finding, highlighting the importance of physician expert opinion for most of the patients with undifferentiated chronic knee monoarthritis. Studies with larger samples and immunohistochemistry analyses are needed to clarify this uncategorized entity further.
Impact of apparent diffusion coefficient on prognosis of early hepatocellular carcinoma: a case control study
Authors: Yamada Shinichiro , Morine Yuji , Ikemoto Tetsuya , Saito Yu , Teraoku Hiroki , Waki Yuhei , Nakasu Chiharu , Shimada Mitsuo
Published: January 2023

Background

We investigated the usefulness of apparent diffusion coefficients (ADC) from diffusion-weighted images (DWI) obtained using magnetic resonance imaging (MRI) for prognosis of early hepatocellular carcinoma (HCC): Barcelona Clinic Liver Cancer (BCLC) stage 0 and A.

Methods

We enrolled 102 patients who had undergone surgical resection for early HCC: BCLC stage 0 and A, and calculated their minimum ADC using DWI-MRI. We divided patients into ADCHigh (n = 72) and ADCLow (n = 30) groups, and compared clinicopathological factors between the two groups.

Results

The ADCLow group showed higher protein induced by vitamin K absence-II (PIVKA-II) levels (p = 0.02) compared with the ADCHigh group. In overall survival, the ADCLow group showed significantly worse prognosis than the ADCHigh group (p < 0.01). Univariate analysis identified multiple tumors, infiltrative growth, high PIVKA-II, and low ADC value as prognostic factors. Multivariate analysis identified infiltrative growth and low ADC value as an independent prognostic factor.

Conclusion

ADC values can be used to estimate the prognosis of early HCC.
Risk factor analysis and prediction of postoperative clinically relevant pancreatic fistula after distal pancreatectomy
Authors: He Chenchen , Zhang Yibing , Li Longfei , Zhao Mingda , Wang Chunhui , Tang Yufu
Published: January 2023

Objective

Postoperative pancreatic fistula (POPF) following distal pancreatectomy (DP) is a serious complication. In the present study, we aimed to identify the risk factors associated with clinically relevant postoperative pancreatic fistula (CR-POPF) and establish a nomogram model for predicting CR-POPF after DP.

Methods

In total, 115 patients who underwent DP at the General Hospital of Northern Theater Command between January 2005 and December 2020 were retrospectively studied. Univariate and multivariable logistic regression analyses were used to identify the independent risk factors associated with CR-POPF. Then, a nomogram was formulated based on the results of multivariable logistic regression analysis. The predictive performance was evaluated with receiver operating characteristic (ROC) curves. Decision curve and clinical impact curve analyses were used to validate the clinical application value of the model.

Results

The incidence of CR-POPF was 33.0% (38/115) in the present study. Multivariate logistic regression analysis identified the following variables as independent risk factors for POPF: body mass index (BMI) (OR 4.658, P = 0.004), preoperative albumin level (OR 7.934, P = 0.001), pancreatic thickness (OR 1.256, P = 0.003) and pancreatic texture (OR 3.143, P = 0.021). We created a nomogram by incorporating the above mentioned risk factors. The nomogram model showed better predictive value, with a concordance index of 0.842, sensitivity of 0.710, and specificity of 0.870 when compared to each risk factor. Decision curve and clinical impact curve analyses also indicated that the nomogram conferred a high clinical net benefit.

Conclusion

Our nomogram could accurately and objectively predict the risk of postoperative CR-POPF in individuals who underwent DP, which could help clinicians with early identification of patients who might develop CR-POPF and early development of a suitable fistula mitigation strategy and postoperative management.
Can teaching serious illness communication skills foster multidimensional empathy? A mixed-methods study
Authors: Yuen Jacqueline K. , See Christopher , Cheung Johnny T. K. , Lum Chor Ming , Lee Jenny SW , Wong Wai Tat
Published: January 2023

Background

To investigate the impact of a serious illness communication skills training course on medical students’ attitudes regarding clinical empathy, self-efficacy in empathic communication, and learning on different dimensions of empathy.

Methods

A mixed-methods design was used. A blended learning Serious Illness Communication Skills Training (SI-CST) course was delivered to sixth-year medical students. Students (n=185) completed questionnaires with the 20-item Jefferson Scale of Empathy (JSE) and self-rated preparedness level for five empathic communication tasks at baseline (T1), six weeks (T2), and three-to-six months post-training (T3). Written reflections on key lessons learned were analyzed using inductive thematic analysis.

Results

Total JSE scores significantly improved from T1 to T2 (111.4 vs 113.9, P=.01) and from T1 to T3 (111.4 vs 113.9, P=.01). There was an increase in Standing in Patient’s Shoes subscale of the JSE with an effect size of 0.56 whereas the Perspective-Taking and Compassionate Care subscales showed no significant changes. Self-rated preparedness for all five empathic communication tasks significantly improved from T1 to T2 (P ≤ .001) and from T1 to T3 (P ≤ .001) with large effect sizes (1.09-1.41). Four key themes emerged from the qualitative analysis. They were appreciating the important role of empathy in clinical care (moral empathy), learning skills in detecting and understanding patient emotions (cognitive empathy), learning skills in responding to emotion with empathy (behavioral empathy), and appreciating that communication skills can be improved with continual practice and self-reflection.

Conclusions

Our results revealed that SI-CST improved medical students’ empathic attitudes and self-efficacy in empathic communication. Qualitative results found learning on the cognitive, behavioral and moral dimensions of empathy.
Lentiviral in situ targeting of stem cells in unperturbed intestinal epithelium
Authors: Garside George B. , Sandoval Madeline , Beronja Slobodan , Rudolph K. Lenhard
Published: January 2023

Background

Methods for the long-term in situ transduction of the unperturbed murine intestinal epithelium have not been developed in past research. Such a method could speed up functional studies and screens to identify genetic factors influencing intestinal epithelium biology. Here, we developed an efficient method achieving this long-sought goal.

Results

We used ultrasound-guided microinjections to transduce the embryonic endoderm at day 8 (E8.0) in utero. The injection procedure can be completed in 20 min and had a 100% survival rate. By injecting a small volume (0.1–0.2 μl) of concentrated virus, single shRNA constructs as well as lentiviral libraries can successfully be transduced. The new method stably and reproducibly targets adult intestinal epithelium, as well as other endoderm-derived organs such as the lungs, pancreas, liver, stomach, and bladder. Postnatal analysis of young adult mice indicates that single transduced cells at E8.0 gave rise to crypt fields that were comprised of 20–30 neighbouring crypts per crypt-field at 90 days after birth. Lentiviral targeting of ApcMin/+ mutant and wildtype mice revealed that heterozygous loss of Apc function suppresses the developmental normal growth pattern of intestinal crypt fields. This suppression of crypt field sizes did not involve a reduction of the crypt number per field, indicating that heterozygous Apc loss impaired the growth of individual crypts within the fields. Lentiviral-mediated shRNA knockdown of p53 led to an approximately 20% increase of individual crypts per field in both Apc+/+ and ApcMin/+ mice, associating with an increase in crypt size in ApcMin/+ mice but a slight reduction in crypt size in Apc+/+ mice. Overall, p53 knockdown rescued the reduction in crypt field size in Apc-mutant mice but had no effect on crypt field size in wildtype mice.

Conclusions

This study develops a novel technique enabling robust and reproducible in vivo targeting of intestinal stem cells in situ in the unperturbed intestinal epithelium across different regions of the intestine. In vivo somatic gene editing and genetic screening of lentiviral libraries has the potential to speed up discoveries and mechanistic understanding of genetic pathways controlling the biology of the intestinal epithelium during development and postnatal life. The here developed method enables such approaches.
Cord blood epigenome-wide meta-analysis in six European-based child cohorts identifies signatures linked to rapid weight growth
Authors: Alfano Rossella , Zugna Daniela , Barros Henrique , Bustamante Mariona , Chatzi Leda , Ghantous Akram , Herceg Zdenko , Keski-Rahkonen Pekka , de Kok Theo M. , Nawrot Tim S , Relton Caroline L , Robinson Oliver , Roumeliotaki Theano , Scalbert Augustin , Vrijheid Martine , Vineis Paolo , Richiardi Lorenzo , Plusquin Michelle
Published: January 2023

Background

Rapid postnatal growth may result from exposure in utero or early life to adverse conditions and has been associated with diseases later in life and, in particular, with childhood obesity. DNA methylation, interfacing early-life exposures and subsequent diseases, is a possible mechanism underlying early-life programming.

Methods

Here, a meta-analysis of Illumina HumanMethylation 450K/EPIC-array associations of cord blood DNA methylation at single CpG sites and CpG genomic regions with rapid weight growth at 1 year of age (defined with reference to WHO growth charts) was conducted in six European-based child cohorts (ALSPAC, ENVIRONAGE, Generation XXI, INMA, Piccolipiù, and RHEA, N = 2003). The association of gestational age acceleration (calculated using the Bohlin epigenetic clock) with rapid weight growth was also explored via meta-analysis. Follow-up analyses of identified DNA methylation signals included prediction of rapid weight growth, mediation of the effect of conventional risk factors on rapid weight growth, integration with transcriptomics and metabolomics, association with overweight in childhood (between 4 and 8 years), and comparison with previous findings.

Results

Forty-seven CpGs were associated with rapid weight growth at suggestive p-value <1e−05 and, among them, three CpGs (cg14459032, cg25953130 annotated to ARID5B, and cg00049440 annotated to KLF9) passed the genome-wide significance level (p-value <1.25e−07). Sixteen differentially methylated regions (DMRs) were identified as associated with rapid weight growth at false discovery rate (FDR)-adjusted/Siddak p-values < 0.01. Gestational age acceleration was associated with decreasing risk of rapid weight growth (p-value = 9.75e−04). Identified DNA methylation signals slightly increased the prediction of rapid weight growth in addition to conventional risk factors. Among the identified signals, three CpGs partially mediated the effect of gestational age on rapid weight growth. Both CpGs (N=3) and DMRs (N=3) were associated with differential expression of transcripts (N=10 and 7, respectively), including long non-coding RNAs. An AURKC DMR was associated with childhood overweight. We observed enrichment of CpGs previously reported associated with birthweight.

Conclusions

Our findings provide evidence of the association between cord blood DNA methylation and rapid weight growth and suggest links with prenatal exposures and association with childhood obesity providing opportunities for early prevention.
Brain endothelial CXCL12 attracts protective natural killer cells during ischemic stroke
Authors: Wang Shuaiwei , de Fabritus Lauriane , Kumar Praveen Ashok , Werner Yves , Ma Minglu , Li Dan , Siret Carole , Simic Milesa , Li Bin , Kerdiles Yann M. , Hou Lei , Stumm Ralf , van de Pavert Serge A.
Published: January 2023

Background

The innate lymphoid cell (ILC) family consists of NK cells, ILC type 1, 2, 3 and lymphoid tissue inducer cells. They have been shown to play important roles in homeostasis and immune responses and are generally considered tissue resident. Not much is known about the presence of ILC members within the central nervous system and whether they are tissue resident in this organ too. Therefore, we studied the presence of all ILC members within the central nervous system and after ischemic brain insult.

Methods

We used the photothrombotic ischemic lesion method to induce ischemic lesions within the mouse brain. Using whole-mount immunofluorescence imaging, we established that the ILCs were present at the rim of the lesion. We quantified the increase of all ILC members at different time-points after the ischemic lesion induction by flow cytometry. Their migration route via chemokine CXCL12 was studied by using different genetic mouse models, in which we induced deletion of Cxcl12 within the blood–brain barrier endothelium, or its receptor, Cxcr4, in the ILCs. The functional role of the ILCs was subsequently established using the beam-walk sensorimotor test.

Results

Here, we report that ILCs are not resident within the mouse brain parenchyma during steady-state conditions, but are attracted towards the ischemic stroke. Specifically, we identify NK cells, ILC1s, ILC2s and ILC3s within the lesion, the highest influx being observed for NK cells and ILC1s. We further show that CXCL12 expressed at the blood–brain barrier is essential for NK cells and NKp46+ ILC3s to migrate toward the lesion. Complementary, Cxcr4-deficiency in NK cells prevents NK cells from entering the infarct area. Lack of NK cell migration results in a higher neurological deficit in the beam-walk sensorimotor test.

Conclusions

This study establishes the lack of ILCs in the mouse central nervous system at steady-state and their migration towards an ischemic brain lesion. Our data show a role for blood–brain barrier-derived CXCL12 in attracting protective NK cells to ischemic brain lesions and identifies a new CXCL12/CXCR4-mediated component of the innate immune response to stroke.
The influence of share buybacks on ill-health and health inequity: an exploratory analysis using a socio-ecological determinants of health lens
Authors: Wood Benjamin , Sacks Gary
Published: January 2023

Introduction

Share buybacks, when a corporation buys back its own shares, are recognised as having potentially harmful impacts on society. This includes by contributing to economic inequalities, and by impeding investments with the potential to protect and promote the welfare of various stakeholders. Share buybacks, however, have received minimal analytical attention in the public health literature. This paper aimed to explore the potential influence of share buybacks on population health and health inequity using a socio-ecological determinants of health lens.

Methods

We conducted a descriptive analysis of share buybacks made by corporations listed on United States (US) stock exchanges between 1982 and 2021, using quantitative data sourced from Compustat. We examined annual trends in share buyback expenditure, including comparisons to dividend, net income, capital expenditure, and research and development expenditure data. We then purposively sampled a set of corporations to provide illustrative examples of how share buybacks potentially influence key socio-ecological determinants of health. The examples were: i) three COVID-19 vaccine manufacturers; ii) five of the world’s largest fossil fuel corporations; and iii) US car manufacturer General Motors. For these, we conducted an analysis of data from Compustat, company reports and grey literature materials, focusing on key sources of profits and their allocation to share buybacks and particular investments.

Results

US-listed corporations spent an estimated US$9.2 trillion in real terms on share buybacks between 2012 and 2021 (nearly 12 times more than from 1982 to 1991). The contribution of share buybacks to total shareholder ‘returns’ increased from 11% in 1982 to 55% in 2021, with expenditure on shareholder returns increasing considerably relative to capital, research and development expenditure over this period. The three examples illustrated how some corporations have prioritised the short-term financial interests of their shareholders, including via implementing large share buyback programs, over investments with considerable potential to protect and promote the public’s health.

Conclusion

The potentially substantial impacts of share buybacks on health warrant increased research and policy attention. Arguably, more must be done to regulate share buybacks as part of efforts to address the corporate drivers of ill-health and inequity.
Anemia and formation of deep vein thrombosis before operation in patients with knee osteoarthritis: a cross-sectional study
Authors: Xiong Xiaojuan , Li Ting , Cheng Bo
Published: January 2023

Background

Preoperative anemia is a common complication in knee osteoarthritis (KOA) patients. However, the association between anemia and preoperative deep vein thrombosis (DVT) in osteoarthritis patients remains unknown. The aim of this study was to investigate such association.

Methods

In this retrospective study, we included 1005 KOA patients undergoing total knee arthroplasty (TKA) in our hospital. According to preoperative hemoglobin levels, the patients were divided into anemia group and non-anemia group. According to the results of Doppler ultrasonography for the lower extremities, the patients were divided into DVT group and non-DVT group. A logistic model was established through propensity score matching (PSM), with anemia before TKA as the dependent variable, DVT-related variable as the covariate, and 0.03 as the Caliper value. The anemia group and non-anemia group were matched at a 1:1 ratio and 310 successfully matched. After matching, logistic regression analysis was used to evaluate the correlation between preoperative anemia and DVT in KOA patients.

Results

In this study, 342 cases (33.6%) had preoperative anemia and 73 cases (7.2%) had DVT before TKA. After matching, 46 DVT cases (7.42%) were found. By using binary logistic regression after PSM, we found that the risk for preoperative DVT formation in TKA patients with preoperative anemia increased by 1.97 times [95% (CI 1.05–3.69)], P = 0.035.

Conclusion

Preoperative anemia is considered as an independent risk factor for the formation of preoperative DVT in KOA patients.

Trial registration: ChiCRT2100054844.
Postoperative health-related quality of life in children with congenital heart disease: a short-term follow-up study
Authors: Dai Wang-Sheng , Lin Wen-Hao , Lin Shi-Hao , Chen Qiang , Cao Hua
Published: January 2023

Objective

This study aimed to explore changes in health-related quality of life in children with congenital heart disease from pre-surgery to 6 months after surgery.

Methods

A total of 87 children aged 2–12 years who underwent cardiac surgery in a provincial hospital in China from January 2021 to June 2021 were selected. After 6 months, the quality of life of all children was retrospectively analyzed. The Chinese version of the Pediatric Quality of Life Inventory 4.0 Scale was used to assess the quality of life of children before and after surgery.

Results

Parents of 85 children and 33 children aged 5–12 years completed the questionnaires. After surgical treatment, the quality of life scores reported by parents of children of all ages were significantly higher than those before surgery, the P value < 0.05; the self-evaluated quality of life scores of children of different ages were significantly higher than those before surgery, the P value < 0.05.

Conclusion

Surgical treatment can improve the health-related quality of life of children with congenital heart disease.
Efficacy and safety of corticosteroids in cardiac arrest: a systematic review, meta-analysis and trial sequential analysis of randomized control trials
Authors: Penn Jeremy , Douglas Will , Curran Jeffrey , Chaudhuri Dipayan , Dionne Joanna C. , Fernando Shannon M. , Granton David , Mathew Rebecca , Rochwerg Bram
Published: January 2023

Background

Post-cardiac arrest, outcomes for most patients are poor, regardless of setting. Many patients who do achieve spontaneous return of circulation require vasopressor therapy to maintain organ perfusion. There is some evidence to support the use of corticosteroids in cardiac arrest.

Research question

Assess the efficacy and safety of corticosteroids in patients following in- and out-of-hospital cardiac arrest.

Study design and methods

We searched databases CINAHL, EMBASE, LILACS, MEDLINE, Web of Science, CENTRAL, ClinicalTrails.gov, and ICTRP. We included randomized controlled trials (RCTs) that examined the efficacy and safety of corticosteroids, as compared to placebo or usual care in patients post-cardiac arrest. We pooled estimates of effect size using random effects meta-analysis and report relative risk (RR) with 95% confidence intervals (CIs). We assessed risk of bias (ROB) for the included trials using the modified Cochrane ROB tool and rated the certainty of evidence using Grading of Recommendations Assessment, Development and Evaluation methodology.

Results

We included 8 RCTs (n = 2213 patients). Corticosteroids administered post-cardiac arrest had an uncertain effect on mortality measured at the longest point of follow-up (RR 0.96, 95% CI 0.90–1.02, very low certainty, required information size not met using trial sequential analysis). Corticosteroids probably increase return of spontaneous circulation (ROSC) (RR 1.32, 95% CI 1.18–1.47, moderate certainty) and may increase the likelihood of survival with good functional outcome (RR 1.49, 95% CI 0.87–2.54, low certainty). Corticosteroids may decrease the risk of ventilator associated pneumonia (RR 0.76, 95% CI 0.46–1.09, low certainty), may increase renal failure (RR 1.29, 95% CI 0.84–1.99, low certainty), and have an uncertain effect on bleeding (RR 2.04, 95% CI 0.53–7.84, very low certainty) and peritonitis (RR 10.54, 95% CI 2.99–37.19, very low certainty).

Conclusions

In patients during or after cardiac arrest, corticosteroids have an uncertain effect on mortality but probably increase ROSC and may increase the likelihood of survival with good functional outcome at hospital discharge. Corticosteroids may decrease ventilator associated pneumonia, may increase renal failure, and have an uncertain effect on bleeding and peritonitis. However, the pooled evidence examining these outcomes was sparse and imprecision contributed to low or very low certainty of evidence.
Incentivizing COVID-19 vaccination among racial/ethnic minority adults in the United States: $209 per dose could convince the hesitant
Authors: Chen Kevin , Wilson-Barthes Marta , Harris Jeffrey E. , Galárraga Omar
Published: January 2023

Background

More than two years into the coronavirus disease (COVID-19) pandemic, it remains unclear whether financial incentives can reduce vaccine hesitancy and improve uptake among key unvaccinated populations. This study estimated the willingness of racial/ethnic minority adults in the United States to accept financial incentives for COVID-19 vaccination and the minimum amount needed to vaccinate a sufficiently high percentage of this population.

Methods

From August through September 2021, we conducted an online survey of 367 Black/African American and Hispanic patients, age ≥ 18 years, from 8 community health centers in Rhode Island. Contingent valuation questions assessed respondents’ willingness-to-accept (WTA) incentives for COVID-19 vaccination using random-starting-points and iterative incentive offers of $5 to $50 per dose. Ordered logistic regression models examined associations between respondent characteristics and WTA. Predictive probabilities were modeled using both within-survey range and out-of-survey range incentive offer amounts and compared against vaccination thresholds needed to reach herd immunity.

Results

Less than 30% of unvaccinated survey respondents were WTA an incentive of $50/dose for vaccination. Models using out-of-survey incentive offer amounts greater than $50 suggested that 85% of respondents would agree $140/dose (95% CI: $43-$236) could convince other people to accept vaccination, while $209/dose (95% CI: -$91-$509) would be needed for 85% of respondents to accept vaccination themselves.

Conclusions

Findings from this analysis may inform the design of incentive schemes aiming to reduce racial/ethnic disparities in vaccine and booster uptake, which will continue to be important as new variants of SARS-CoV-2 emerge.
Bull spermatozoa selected by thermotaxis exhibit high DNA integrity, specific head morphometry, and improve ICSI outcome
Authors: Ruiz-Díaz Sara , Mazzarella Rosane , Navarrete-López Paula , Fernández-González Raúl , de Frutos Celia , Maroto María , Cucala Claudia , Beltrán-Breña Paula , Lombó Marta , Rizos Dimitrios , Gutiérrez-Adán Alfonso
Published: January 2023

Background

Sperm migration by thermotaxis is a guidance mechanism that operates along the oviduct and it has proved to be a valid method for selecting spermatozoa with low DNA fragmentation (SDF) in mice, humans, and stallions. This study aimed to analyse if bull spermatozoa could be selected by thermotaxis and to assess their quality in terms of SDF as well as determine the presence of a specific sperm subpopulation based on sperm morphometry and assess their fertilizing capacity by ICSI.

Methods

We used frozen-thawed sperm from 6 bulls and sperm selection by thermotaxis was performed with TALP medium supplemented with 25 mmol/L of HEPES and 5 mmol/L of caffeine. In these conditions, sperm selection was achieved, obtaining a net thermotaxis of 3.6%. Subsequently, we analysed the SDF of the migrated and not-migrated spermatozoa using the neutral COMET assay, and we evaluated the size of the sperm head using Hemacolor® staining with Motic Images Plus 3 software. Additionally, migrated and not-migrated spermatozoa by thermotaxis were used to fertilize bovine in vitro matured (IVM) oocytes by ICSI, a very inefficient procedure in cattle that is only successful when the oocyte is artificially activated.

Results

The results showed lower SDF (χ², P < 0.001, 13.3% reduction, n = 8) and lower head size parameters (length and width, P < 0.01; and perimeter and area, P < 0.001; n = 4) in those spermatozoa migrated in comparison to those not-migrated. The distribution of sperm subpopulations structure varied between groups, highlighting cluster 2, characterized by spermatozoa with small head size, and high ellipticity and elongated heads, as the most abundant in the thermotaxis migrated group. When performed ICSI (without oocyte artificial activation) with the thermotactic sperm, the blastocyst rate was 32.2% ± 9.3% in the group microinjected with the thermotactic spermatozoa vs. 8.3% ± 7.8% in the group of not-migrated sperm (χ², P < 0.05).

Conclusion

Our results showed that bull sperm selection by thermotaxis has a much higher DNA integrity, small and elongated head size parameters, and different sperm subpopulation structure than the not-selected spermatozoa. Additionally, we evidenced that thermotactic spermatozoa improve ICSI success rates.
Screening and confirmation tests for SARS-CoV-2: benefits and drawbacks
Authors: Shafie Muhammad Hakimin , Antony Dass Marie , Ahmad Shaberi Hazlam Shamin , Zafarina Zainuddin
Published: January 2023

Background

Coronavirus disease 2019 is a pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection that emerged in late 2019 and has activated an ongoing international public health emergency. SARS-CoV-2 was discovered in Wuhan, China, in December 2019 and rapidly spread to other cities and countries. Currently, SARS-CoV-2 diagnostic tests have relied heavily on detecting viral genes, antigens, and human antibodies. Hence, this review discusses and analyses the existing screening and confirmation tests for SARS-CoV-2, including the real-time reverse transcriptase polymerase chain reaction (RT-PCR), lateral flow immunoassay (LFIA), and enzyme-linked immunosorbent assay (ELISA).

Main body

The illustrations of each testing were presented to provide the readers with an understanding of the scientific principles behind the testing methods. The comparison was made by highlighting the advantages and disadvantages of each testing. ELISA is ideal for performing the maximum population screening to determine immunological capacity, although its inability to provide reliable results on the status of the infection. Recently, LFIA has been approved as a quicker way of determining whether a patient is infected at the analysis time without using particular instruments and non-laboratory settings. RT-PCR is the gold-standard approach in terms of sensitivity and specificity.

Conclusion

However, the combination of LFIA or ELISA with RT-PCR is also proposed in this review to obtain an adequate level of sensitivity and specificity.

Graphic Abstract
A Forest, a Maze, a Garden, a City
Authors: Fitzgerald Des
Published: January 2023

This article argues for a mutation in how mental health is conceived in the early twenty-first century. In this mutation, physical environments, in the form of homes, workplaces, and streetscapes, are understood as central to the production and maintenance of good mental health. Much writing on this topic has taken place within a rhetorical division between stereotypically urban buildings or spaces (tower blocks, for example), which are said to be harmful to the human mind, and idealized rural or green spaces, such as parks or small hamlets, understood to be psychologically restorative. This discourse, which has its roots in both cultural and scientific developments, has rendered mental disorder as, at least in part, a spatial problem—which is to say, as a problem that might be both understood through but also treated by spatial practices. The goal of the article is to establish the ground of this claim and to make some of its epistemic roots visible. The article begins with an ethnographic account of a contemporary intellectual movement aimed at populating urban spaces with trees in the name of global mental health. Then the discussion turns to a series of critical developments in the psychological and neurobiological sciences—the article demonstrates how these, in turn, are efflorescing into new links between the architectural and psychological sciences. The article shows how this scientific discussion is paralleled by developments in urban planning—Ebenezer Howard's program of the early twentieth century, set out in Garden Cities of To-Morrow, is taken as exemplary here. The article ends with a reading of Clive Barker's 1985 short story “The Forbidden” and of the film Candyman, which it gave rise to, whose shared sense of horror at the visceral consequences of failed urban experiments, I argue, should be read as a critical inflection point for the contemporary relationship between psychology and architecture.