bluuebunny/crossref_metadata_2025 huggingface dataset:
Plasma calprotectin as an indicator of need of transfer to intensive care in patients with suspected sepsis at the emergency department
Authors: Parke Åsa , Unge Christian , Yu David , Sundén-Cullberg Jonas , Strålin Kristoffer
Published: February 2023

Background

Deciding whether to transfer patients with sepsis from the emergency department (ED) to intensive care units (ICUs) is challenging. We hypothesised that the new biomarker plasma calprotectin (p-calprotectin) could be used to aid the selection of patients for intensive care transfer, since it has been shown to be a promising tool for the determination of sepsis severity in critical care.

Methods

This prospective study was performed on consecutive sepsis alert patients in the ED of Karolinska University Hospital Huddinge. The sepsis alert mandates clinical assessment and decisions regarding treatment, disposition, and level of care by physicians from the ED, the Department of Infectious Diseases, and the ICU. Blood sample analysis for C-reactive protein, procalcitonin, neutrophils, and lymphocytes was routinely performed. P-calprotectin was analysed from frozen plasma samples, using a specific turbidimetric assay.

Results

Three-hundred fifty-one patients who triggered the sepsis alert were available for the study. Among 319 patients who were considered to have an infection, 66 patients (26%) were immediately transferred to the ICU or high-dependency unit (HDU), and 253 patients (74%) were transferred to ordinary wards.

Median p-calprotectin was 2.2 mg/L (IQR 1.2–3.9 mg/L) for all patients with infection, it was 3.3 (IQR 1.6–5.2) for those transferred to ICU/HDU and 2.1 (IQR 1.1–3.5) for those transferred to ward units (p = 0.0001).

Receiver operating characteristic curve analysis for transfer to the ICU/HDU showed superiority for p-calprotectin compared with procalcitonin and neutrophil–lymphocyte ratio, regarding both all sepsis alert cases and the patients with infection (p < 0.001 for all comparisons). The best p-calprotectin cut-off, 4.0 mg/L, showed a sensitivity of 42.5% and specificity of 83% for transfer to the ICU/HDU among patients with infection.

Conclusions

In sepsis alert patients, p-calprotectin was significantly elevated in patients who were subject to immediate ICU/HDU transfer after assessment by a multidisciplinary team. P-calprotectin was superior to traditional biomarkers in predicting the need for transfer to the ICU/HDU.
Frailty index and its association with the onset of postoperative delirium in older adults undergoing elective surgery
Authors: Steenblock Janina , Braisch Ulrike , Brefka Simone , Thomas Christine , Eschweiler Gerhard W. , Rapp Michael , Metz Brigitte , Maurer Christoph , von Arnim Christine A. F. , Herrmann Matthias. L. , Wagner Sören , Denkinger Michael , Dallmeier Dhayana
Published: February 2023

Background

The association of frailty based on the accumulation of deficits with postoperative delirium (POD) has been poorly examined. We aimed to analyze this association in older patients undergoing elective surgery.

Methods

Preoperative data was used to build a 30-item frailty index (FI) for participants of the PAWEL-study. Delirium was defined by a combination of I-CAM and chart review. Using logistic regressions models we analysed the association between frailty and POD adjusting for age, sex, smoking, alcohol consumption, education and type of surgery.

Results

Among 701 participants (mean age 77.1, 52.4% male) median FI was 0.27 (Q1 0.20| Q3 0.34), with 528 (75.3%) frail participants (FI ≥ 0.2). Higher median FI were seen in orthopedic than cardiac surgery patients (0.28 versus 0.23), and in women (0.28 versus 0.25 in men). Frail participants showed a higher POD incidence proportion (25.4% versus 17.9% in non-frail). An increased odds for POD was observed in frail versus non-frail participants (OR 2.14 [95% CI 1.33, 3.44], c-statistic 0.71). A 0.1 increment of FI was associated with OR 1.57 [95% CI 1.30, 1.90] (c-statistic 0.72) for POD. No interaction with sex or type of surgery was detected. Adding timed-up-and-go-test and handgrip strength to the FI did not improve discrimination.

Conclusion

Our data showed a significant association between frailty defined through a 30-item FI and POD among older adults undergoing elective surgery. Adding functional measures to the FI did not improve discrimination. Hence, our preoperative 30-item FI can help to identify patients with increased odds for POD.

Trial registration

PAWEL and PAWEL-R (sub-) study were registered on the German Clinical Trials Register (number DRKS00013311 and DRKS00012797).
NT-proBNP as predictor of major cardiac events after renal transplantation in patients with preserved left ventricular ejection fraction
Authors: Schwab Sebastian , Pörner Daniel , Kleine Carola-Ellen , Werberich Roxana , Werberich Louisa , Reinhard Stephan , Bös Dominik , Strassburg Christian P. , von Vietinghoff Sibylle , Lutz Philipp , Woitas Rainer P.
Published: February 2023

Background

For the improvement of outcome after renal transplantation it is important to predict future risk of major adverse cardiac events as well as all-cause mortality. We aimed to determine the relationship of pre-transplant NT-proBNP with major adverse cardiac events and all-cause mortality after transplant in patients on the waiting-list with preserved left ventricular ejection fraction.

Patients and methods

We included 176 patients with end-stage renal disease and preserved left ventricular ejection fraction who received a kidney transplant. MACE was defined as myocardial infarction (ST-segment elevation [STEMI] or non-ST-segment elevation [NSTEMI]), stroke or transient ischemic attack), coronary artery disease requiring intervention or bypass or death from cardiovascular causes.

Results

MACE occurred in 28/176 patients. Patients with NT-proBNP levels above 4350 pg/ml had 1- and 5-year survival rates of 90.67% and 68.20%, whereas patients with NT-proBNP levels below 4350 pg/ml had 1- and 5-year survival rates of 100% and 90.48% (p < 0.01). 1- and 5-year MACE-free survival rates were calculated as 78.82% and 74.68% for patients with NT-proBNP > 4350 pg/ml and 93.33% and 91.21% for patients with NT-proBNP < 4350 pg/ml (p < 0.01).

Conclusions

Pre-transplant NT-proBNP might identify renal transplant candidates at risk for MACE after transplant.
TAP1, a potential immune-related prognosis biomarker with functional significance in uveal melanoma
Authors: Zhu Ru , Chen Yu-Ting , Wang Bo-Wen , You Ya-Yan , Wang Xing-Hua , Xie Hua-Tao , Jiang Fa-Gang , Zhang Ming-Chang
Published: February 2023

Background

TAP1 is an immunomodulation-related protein that plays different roles in various malignancies. This study investigated the transcriptional expression profile of TAP1 in uveal melanoma (UVM), revealed its potential biological interaction network, and determined its prognostic value.

Methods

CIBERSORT and ESTIMATE bioinformatic methods were used on data sourced from The Cancer Genome Atlas database (TCGA) to determine the correlation between TAP1 expression, UVM prognosis, biological characteristics, and immune infiltration. Gene set enrichment analysis (GSEA) was used to discover the signaling pathways associated with TAP1, while STRING database and CytoHubba were used to construct protein–protein interaction (PPI) and competing endogenous RNA (ceRNA) networks, respectively. An overall survival (OS) prognostic model was constructed to test the predictive efficacy of TAP1, and its effect on the in vitro proliferation activity and metastatic potential of UVM cell line C918 cells was verified by RNA interference.

Results

There was a clear association between TAP1 expression and UVM patient prognosis. Upregulated TAP1 was strongly associated with a shorter survival time, higher likelihood of metastasis, and higher mortality outcomes. According to GSEA analysis, various immunity-related signaling pathways such as primary immunodeficiency were enriched in the presence of elevated TAP1 expression. A PPI network and a ceRNA network were constructed to show the interactions among mRNAs, miRNAs, and lncRNAs. Furthermore, TAP1 expression showed a significant positive correlation with immunoscore, stromal score, CD8+ T cells, and dendritic cells, whereas the correlation with B cells and neutrophils was negative. The Cox regression model and calibration plots confirmed a strong agreement between the estimated OS and actual observed patient values. In vitro silencing of TAP1 expression in C918 cells significantly inhibited cell proliferation and metastasis.

Conclusions

This study is the first to demonstrate that TAP1 expression is positively correlated with clinicopathological factors and poor prognosis in UVM. In vitro experiments also verified that TAP1 is associated with C918 cell proliferation, apoptosis, and metastasis. These results suggest that TAP1 may function as an oncogene, prognostic marker, and importantly, as a novel therapeutic target in patients with UVM.
Evaluation of health-related quality of life in children with postoperative delirium after surgical repair of ventricular septal defect: short- and mid-term follow-up
Authors: Huang Jiang-Shan , Lin Wen-Hao , Chen Yu-Kun
Published: February 2023

Background

To investigate health-related quality of life (HRQOL) in children with postoperative delirium (POD) after surgical repair of ventricular septal defects (VSDs).

Methods

A total of 109 patients were enrolled and assigned to the POD group (n = 47) and the non-POD group (n = 62). HRQOL was assessed by the PedsQLTM 3.0 Cardiac Module at discharge, and at the three- and six-month postoperative follow.

Results

Significant differences were detected in age, operation time, CPB time, mechanical ventilation duration, and length of ICU stay between the two groups, whereas sex and the VSD size did not significantly differ between groups. In terms of “cardiac heart problems and treatment” and “treatment-II”, the HRQOL scores of the non-POD group were significantly better than those of the POD group. In terms of “perceived physical appearance” and “treatment anxiety”, the POD group had significantly higher scores than the non-POD group at discharge and at the three-month postoperative follow-up. In terms of “cognitive problems” and “communication”, the occurrence of POD still affected HRQOL at three months postoperatively, but the effect was significantly reduced at six months postoperatively. In terms of “total scores”, both groups scored increasingly higher over time. The non-POD group had higher scores at discharge and three months postoperatively than the POD group, but no significant difference persisted at six months postoperatively.

Conclusion

During the follow-up period, the HRQOL of the children with POD after surgical repair of VSD was inferior to that of the children without POD at discharge and three months postoperatively. However, the HRQOL did not differ between the two groups at six months postoperatively.
Survey on human milk feeding and enteral feeding practices for very-low-birth-weight infants in NICUs in China Neonatal Network
Authors: Hu Xiaoshan , Lu Junjie , Zhang Jun , Zhang Min , Yu Zhangbin , Lee Shoo K. , Han Shuping , Chen Xiaohui
Published: February 2023

Background

The breastfeeding rate in China is lower than that in many other countries and the extent of adoption of the “Feeding Recommendations for Preterm Infants and Low Birth Weight Infants” guideline in NICUs remains unclear.

Method

A web-based survey about the current status of human milk feeding and enteral feeding practices at NICUs was sent to all China Neonatal Network’s cooperation units on September 7, 2021, and the respondents were given a month to send their responses.

Results

All sixty NICUs responded to the survey, the reply rate was 100%. All units encouraged breastfeeding and provided regular breastfeeding education. Thirty-six units (60.0%) had a dedicated breastfeeding/pumping room, 55 (91.7%) provided kangaroo care, 20 (33.3%) had family rooms, and 33 (55.0%) routinely provided family integrated care. Twenty hospitals (33.3%) had their own human milk banks, and only 13 (21.7%) used donor human milk. Eight units (13.3%) did not have written standard nutrition management guidelines for infants with body weight < 1500 g. Most units initiated minimal enteral nutrition with mother’s milk for infants with birth weight ˂1500 g within 24 h after birth. Fifty NICUs (83.3%) increased the volume of enteral feeding at 10–20 ml/kg daily. Thirty-one NICUs (51.7%) assessed gastric residual content before every feeding session. Forty-one NICUs (68.3%) did not change the course of enteral nutrition management during drug treatment for patent ductus arteriosus, and 29 NICUs (48.3%) instated NPO for 1 or 2 feeds during blood transfusion.

Conclusion

There were significant differences in human milk feeding and enteral feeding strategies between the NICUs in CHNN, but also similarities. The data obtained would be useful in the establishment of national enteral feeding guidelines for preterm infants and quality improvement of cooperation at the national level.
Exploring the influence of food labels and advertisements on eating habits of children: a cross-sectional study from Punjab, India
Authors: Verma Madhur , Aggarwal Ramnika , Nath Bhola , Kakkar Rakesh
Published: February 2023

Background

Maintaining healthy eating habits among children is challenging due to industrial tactics. There is little research on the effect of nutritional labels and tv ads on the eating habits of children. So the primary aim of the study was to explore the noticeability of the food packaging labels by the children, the information retrieved from the food nutrition labels, and their role in increased frequency of eating out in addition to the perceptions of their parents about the television ads.

Methods

A cross-sectional study was conducted at schools in Punjab, India. Using multi-stage stratified random sampling, we included 722 school-going children aged 14–18 and their parents. A structured predefined questionnaire collected data using a four-point Likert scale. Descriptive statistics and binary logistic regression were used to draw our inferences.

Results

About 46% of children were eating out > 3 times a week. Nearly 49% said they never looked at the expiry dates on the food packet, and 40% have yet to notice the quality certification. Nearly half do not understand the components of the food label, and 59% said they never changed their buying behavior because of the label. Only 37% of parents expressed their concerns about the timing of the ads when children watch television, while only 25.5% were concerned about the accuracy of the information. Concerns of the parents regarding the timing of the ads, and celebrity endorsements, were potential predictors for the increased frequency of eating out by the children.

Conclusions

Low awareness regarding the utility of nutrition labels and minimal concerns of the parents increase the frequency of eating out. Unification of our existing policies regarding food labels and tv advertisements to develop family-centric interventions will bring us one step closer to improving the enabling environment to curb the growing menace of childhood obesity.
Generalized anxiety disorder among rural primary and middle school students during the outbreak of COVID-19: a multicenter study in three southern Chinese cities
Authors: Yang Zidan , Zhang Yongxin , Xu Haijie , Gan Menglai , Ma Jianrui , Liu Jiarong , Tan Xiner , Hou Wenjing , Ye Wanbao , Li Liping
Published: February 2023

Background

The major public health crisis caused by the rapid spread of the coronavirus disease 2019 (COVID-19) and the large-scale public health measures such as social isolation and school closures enforced by some countries have severely affected on the physical and mental wellbeing of children and adolescents globally. This study aimed to estimate the prevalence of the psychological impact and investigate the similarities and differences in the influential factors for generalized anxiety disorder among rural adolescents as a relatively lesser noticed population the outbreak of COVID-19.

Methods

From May 11 to 22, 2020, a total of 1,179 adolescents, including Grade 5–6 in primary school and Grade 7–8 in middle school, were selected by multistage sampling in three Southern Chinese cities (Shantou, Guangdong Province; Hezhou, Guangxi Province; Nanchong, Sichuan Province), and completed the questionnaires including sociodemographic, generalized anxiety disorder, academic stress, coronaphobia, knowledge of COVID-19, and precautionary measures. ANOVA, Chi-square test, Kruskalwallis H test and multivariate linear regression were performed in the statistical analysis.

Results

The average scores of generalized anxiety disorder during the past two weeks were 3.43 (SD 4.46), 4.47 (SD 5.15), and 4.10 (SD 4.94) in Shantou, Hezhou and Nanchong, respectively. For the pooled data, academic stress (P < 0.001), coronaphobia (P < 0.001), and precautionary measures (P = 0.002) contributed to the prediction of anxiety scores. Academic stress was significantly associated to anxiety symptoms in all cities (P all < 0.001). Coronaphobia was also significantly associated to anxiety symptoms in all cities (P all < 0.001).

Conclusion

This study highlights the urgent need for researchers and policymakers to focus on the mental health of rural children and adolescents during the COVID-19 epidemic. The adolescents with academic stress and coronaphobia, the greater the risk that adolescents will suffer from anxiety, suggesting mental health counseling and professional family support are needed.
Investigating significant health trends in progressive fibrosing interstitial lung disease (INSIGHTS-ILD): rationale, aims and design of a nationwide prospective registry
Authors: Behr Juergen , Bonella Francesco , Günther Andreas , Koschel Dirk , Prasse Antje , Pittrow David , Klotsche Jens , Kreuter Michael ,   INSIGHTS-ILD Study Group, Andreica Ioana , Behr Jürgen , Biller Heike , Claussen Martin , Budweiser Stephan , Eisenmann Stephan , Ewert Ralf , Gesierich Wolfgang , Gläser Sven , Grohé Christian , Grund Daniel , Grünewaldt Achim , Hagmeyer Lars , Held Matthias , Kabitz Hans-Joachim , Kirschner Joachim , Markart Philipp , Neff Ulrich , Neurohr Claus , Reichenberger Frank , Schramm Peter , Schwaiblmair Martin , Seese Bernd , Skowasch Dirk , Wälscher Julia , Weber Michael , Westhoff Michael , Wilkens Heinrike , Wirtz Hubert
Published: February 2023

Background

The progressive course of pulmonary fibrosis (PPF) is observed with variable prevalence in different entities of fibrosing interstitial lung disease (fILD). PPF is characterised by worsening respiratory symptoms, declining lung function and increasing extent of fibrosis on high-resolution computer tomography. In Germany, data are limited on the characteristics and management of such patients.

Methods/Design

INSIGHTS-ILD is a prospective observational longitudinal registry designed to describe characteristics, management and course of newly diagnosed (incident) and prevalent patients with fILD on the long term. The registry uses a non-probability sampling approach to collect data on characteristics, therapeutic interventions, health-related quality of life and health economic parameters. It is planned to include 900 patients in ambulatory care in about 30 expert sites over three years. The study has been initiated in December 2021, and currently (January 2023) follows 360 patients.

Discussion

The registry is expected to provide much-needed data on the characteristics, management, and trajectories of patients fILD in Germany. The start of the study comes at a time when new treatment options are available for PPF. We hypothesize that PPF represents a broad clinical phenotype that is differentially influenced by inflammatory and fibrotic pathomechanisms that need to be treated with anti-inflammatory and/or anti-fibrotic treatment strategies. This registry will allow comparisons with other countries. Gap analyses based on current guidelines for management of these patients will be possible.

Trial registration DRKS00027389 (registered on 7.12.2021), BfArM NIS 7562.
Effect of multidisciplinary team (MDT) centred on pregnant women with pulmonary hypertension on treatment and outcomes of pregnancy
Authors: Chen Wenjie , Luo Jun , Chen Jingyuan , Chen Yusi , Li Zilu , Qiu Haihua , Li Jiang
Published: February 2023

Background

The importance of multidisciplinary team (MDT) centred on pregnant women with pulmonary hypertension (PH) has been highlighted. However, rare studies have explored its effects on pregnancy outcomes. This study seeks to investigate whether and how the MDT has an effect on the treatment and outcomes of PH pregnant women.

Methods

A pre- and post-intervention study was conducted based on an interrupted time series design to compare the treatment and outcomes of patients with PH before (pre-MDT) and after (post-MDT) implementation of the MDT. PH was defined as pulmonary artery systolic pressure (sPAP) ≥ 35 mmHg measured by echocardiography or right heart catheterization and sPAP at 35–60 mmHg and over 60 mmHg was defined as mild and severe PH, respectively. All results were analyzed by T-tests, Chi square tests or Fisher exact test and two-sided p value < 0.05 was set to be statistically significant.

Results

149 pregnancies were found in 143 women with PH. Overall, 46 pregnancies were elective abortions, remaining 49 and 54 pregnancies completing delivery in the pre-MDT group and post-MDT group, respectively. Five (10.2%) mother and seven (8.6%) neonatal died in the former, while no maternal deaths but 1.9% neonatal death occurred in the latter. In subgroup analysis, maternal and fetal/neonatal complications were higher in patients with severe PH and World Health Organization functional class (WHO FC) III/IV and all maternal deaths occurred in class III/IV women. In pre-MDT and post-MDT groups, there were 8 and 22 pregnant women receiving the pulmonary-specific therapy and completing delivery, respectively. The percentage of heart failure and urgent cesarean of pre-MDT group was higher than the post-MDT group (30.6% vs. 12.9%, p = 0.02; 40.8% vs. 14.8%, p = 0.01, respectively).

Conclusion

Implementing the MDT decreased the rate of urgent caesarean section and heart failure in patients with PH and no maternal deaths occurred in the post-MDT group. Pregnant women with severe PH and WHO FC III/IV might have a poor prognosis, whereas the use of pulmonary-specific therapy might improve outcomes of pregnancy.
Radiographic markers of hip dysplasia in young adults: predictive effect of factors in early life
Authors: Laborie Lene B. , Lie Stein Atle , Rosendahl Karen
Published: February 2023

Abstrac

Background and objectives

Acetabular dysplasia in young adults occurs, despite screening for developmental hip dysplasia (DDH) in the neonatal period. We aimed to examine how early life factors predict radiographic measurements of acetabular dysplasia at 18–19 years of age.

Methods

From a previous randomized trial (n = 12,014; 1988–90) evaluating the role of hip ultrasound in newborn screening of DDH, 4469 participants (2193 males) were invited to a follow-up 18 years later (2007–09), of which 2370 (53% attendance; 932 males) met. We examined associations between early life factors and four radiographic measurements for acetabular dysplasia at skeletal maturity. Hierarchical regressions, with addition of variables observed/measured consecutively in time, were analyzed using mixed effects models considering hip as the unit in the analyses. The study is approved by the Regional Ethics Committee.

Results

In total, 2340 participants (921 boys), mean age 18.7 years, (SD 0.6) had hip radiographs performed at follow-up and were included. Early life factors significantly predicting radiographic acetabular dysplasia at age 18–19-years included female gender, breech, low acetabular inclination (alpha) angle and sonographic instability, abduction treatment, as well as the velocity of growth during childhood. A positive family history of DDH was not associated with acetabular dysplasia at skeletal maturity.

Conclusion

The acetabular inclination (alpha) angle as measured on ultrasound at birth turned out to be a significant predictor of dysplasia at 18–19 years of age. The discordant role of a positive family history in early versus adult hip dysplasia is intriguing, warranting further studies on the genetic mechanisms of DDH.
A novel modified McLaughlin surgery for treating locked chronic posterior shoulder dislocation
Authors: Xiong Fei , Yin Qin , Wang Jian , Wei Changbao , Gu Sanjun , Liu Yu
Published: February 2023

Background

Posterior shoulder dislocation is an uncommon orthopaedics injury and is frequently missed or misdiagnosed, accounting for 2%-4% of all shoulder dislocations, and is associated with the reverse Hill-Sachs lesion. Once posterior shoulder dislocation develops into a chronic disease, it will bring a lot of trouble to the treatment, especially in repairing the humeral defects. Surgical strategies are also developing and innovating to deal with this injury, including transfer of subscapularis tendon or lesser tubercle, humeral rotational osteotomy, autogenous bone graft or allograft. Shoulder replacement seems to be the ultimate and only option when the injury becomes irreparable, although some studies have shown unsatisfactory follow-up results. Considering no gold-standard treatment for locked posterior shoulder dislocation, we described a novel modified McLaughlin procedure for locked chronic posterior shoulder dislocation and evaluated the functional outcomes.

Methods

This study included five locked chronic posterior shoulder dislocation patients with an associated reverse Hill-Sachs lesion, in which the compression surface covered 30–40% of the humeral head. The mean period from injury to receiving surgery was 11.6 weeks (6–24 weeks). All five patients underwent the modified McLaughlin procedure, mainly divided into three steps, including open reduction, transfer of the partial lesser tuberosity and artificial bone to repair the reverse Hill-Sachs defects. The kernel technique was to fix the transferred tuberosity with two lag screws and strengthen it with two Ethibond sutures. The Constant-Murley score (CMS), the range of shoulder motion and the complications were recorded to assess and compare the functional situation of the shoulder postoperatively and postoperatively.

Results

After an average of 19.8 months (12–30) of follow-up, the mean CMS improved to 85.8 ± 4.9 (79–91) compared with 46.0 ± 4.5 (40–52) preoperatively, which showed a significant difference (p = 0.001). In the final follow-up, all five patients showed no symptoms of shoulder instability, and there was no pain or limited activity in daily life, thus all patients were satisfied with the results.

Conclusion

Repairing the reverse Hill-Sachs lesion by transferring the partial lesser tuberosity combined with artificial bone fixed by lag screws and sutures can ensure shoulder stability and provide pain relief and good function in patients with locked chronic posterior shoulder dislocation associated with the humeral head defect.
Pseudocysts of the jaw: a retrospective study of 41 cases from a single institution
Authors: Wang Yahui , Tang Fan , Li Zhiyong , Chen Qianming
Published: February 2023

Objective

The purpose of this retrospective study was to investigate and compare the clinical, radiographic, pathological, pathogenesis, and therapeutic features of simple bone cysts (SBCs) and aneurysmal bone cysts (ABCs) of the jaw.

Methods

35 patients with SBCs and 6 patients with ABCs who received treatment at the Department of Oral and Maxillofacial Surgery, Zhejiang University School of Medicine from 2017 to 2022 were followed up and reviewed retrospectively.

Results

The study included 41 patients, accounting for 2.14% of all jaw pathologies, with 35 patients having SBCs and 6 patients having ABCs; their average ages were 26.63 ± 13.62 years and 17.83 ± 7.88 years, respectively. The prevalence of SBC and ABC did not differ significantly by sex. The mandible was the most vulnerable area to be involved. Only 5.71% (2/35) of patients with SBCs and 16.7% (1/6) of patients with ABCs reported histories of previous trauma in the same region of the pseudocysts. A total of 42.86% (15/35) of SBC cases and 66.67% (4/6) of ABC cases had malocclusions. The radiographic features of pseudocysts varied in shape, were associated with the root, and unilocular or multilocular. All patients had curettage with or without bone graft or substitute implantation, and recurrences did not occur in 94.29% (33/35) of SBC patients and 100% (6/6) of ABC patients after a mean follow-up time of 26.23 ± 15.47 months and 21.67 ± 19.75 months, respectively.

Conclusions

Pseudocysts, including SBCs and ABCs, are benign osteolytic lesions without an epithelial lining that occur occasionally in the jaw, mostly in adolescents and young adults, and their incidence did not significantly differ by sex. The most vulnerable site of involvement is the mandible, and they are generally not overtly aggressive. Trauma has a less significant role in pseudocysts, but minor trauma, such as malocclusion, has the potential to influence pseudocyst development. The clinical presentation of pseudocysts lacks specificity, and most patients are asymptomatic and found incidentally during radiographs. Dental panoramic radiographs and CBCT cannot accurately distinguish between SBC and ABC, and the final diagnosis depends on pathological diagnosis. Curettage combined with bone grafting is currently the best treatment for both, with a 5.71% (2/35) recurrence rate for SBC and no recurrence found for ABC.
Knowledge on human papilloma virus and experience of getting positive results: a qualitative study among women in Kilimanjaro, Tanzania
Authors: Swai Patricia , Mgongo Melina , Leyaro Beatrice J. , Mwaiselage Julius , Mchome Bariki L. , Kjaer Susanne K. , Rasch Vibeke , Manongi Rachel , Msuya Sia E.
Published: February 2023

Background

Human papilloma virus (HPV) is a sexually transmitted infection causing more than 80% of cervical cancers. WHO recommends using of sensitive screening methods like HPV-testing to timely prevent future morbidity and mortality from cervical cancer. Pilot studies have shown that HPV-testing is feasible and can be scaled in developing country like Tanzania. However, there is limited information on women understanding, reactions and psychological challenges following diagnosis of high risk HPV (HR-HPV). This study explored the knowledge of women on HPV and their experience after HPV positive results in Kilimanjaro, Tanzania.

Methods

The study was part of a larger study that assessed incidence and persistence of HR-HPV among women aged 18 years and above in Kilimanjaro. This was a cross sectional study conducted in Moshi municipal council among women who had HR-HPV positive results at enrollment. In-depth interviews were conducted with 13 randomly selected women who were attending for follow-up after enrollment. Interviews were conducted at the health facility and Atlas.ti.8 was used to analyze the data using thematic framework analysis.

Results

Women had knowledge on HPV infection but they had different reactions following receiving positive HPV results. Reaction toward the positive HPV results had two extremes; some women had psychological effect (hopeless, death sentence, having cancer, being shocked, failure to disclose and psychosexual effects) while others women explained positive results is good as they are identified earlier, will be followed up and it has made them plan to continue with cervical cancer screening in future.

Conclusion

Women had knowledge on HPV, but positive results lead to negative and positive experiences by women. Clinicians and programs need to develop interventions and good strategies to minimize the psychological and social burden of testing positive for HPV.
Decision makers perceptions and experiences of developing population-level interventions targeting risk factors for hypertension and diabetes in South Africa: a qualitative study
Authors: Hendricks Lynn , Uwimana-Nicol Jeannine , Young Taryn
Published: February 2023

Background

People in low- and middle-income countries are disproportionately affected by Noncommunicable diseases (NCDs). NCD’s such as heart disease, cancer, chronic respiratory disease, and diabetes, are the leading cause of premature death worldwide and represent an emerging global health threat. The purpose of this qualitative study was to explore decision makers perceptions of developing population-level interventions (policies and programmes), targeting risk factors for hypertension and diabetes, in South Africa.

Methods

Using purposive sampling we recruited fifteen participants, who were well informed about the policies, programs or supportive environment for prevention and management of diabetes and hypertension in South Africa. We conducted 12 individual interviews and 1 group interview (consisting of 3 participants). Data was analysed thematically in NVivo. The results were shared and discussed in two consultative stakeholder workshops, with participants, as part of a member validation process in qualitative research. All communication with participants was done virtually using MS Teams or ZOOM.

Results

For development of population-level interventions, key enablers included, stakeholders’ engagement and collaboration, contextualization of policies and programs, and evaluation and organic growth. Challenges for supportive policy and program formulation, and to enable supportive environments, included the lack of time and resources, lack of consultation with stakeholders, regulations and competing priorities, and ineffective monitoring and evaluation. The main drivers of population-level interventions for diabetes and hypertension were perceived as the current contextual realities, costs, organizational reasons, and communication between various stakeholders.

Conclusion

To address the risk factors for hypertension and diabetes in South Africa, policies and programs must account for the needs of the public and the historical and socio-economic climate. Feasibility and sustainability of programs can only be ensured when the resources are provided, and environments enabled to promote behavior change on a population-level. A holistic public health approach, which is contextually relevant, and evidence informed, is considered best practice in the formulation of population-level interventions.
Malaria Frontline Project: strategic approaches to improve malaria control program leveraging experiences from Kano and Zamfara States, Nigeria, 2016–2019
Authors: Adewole Adefisoye , Ajumobi Olufemi , Waziri Ndadilnasiya , Umar Amina Abdullahi , Bala Usaini , Gidado Saheed , Ugbenyo Gideon , Simple Edwin , Igbaver Isaac , Attahiru Adam , Michael Charles A. , Uba Belinda , Nguku Patrick , Uhomoibhi Perpetua , Muhammad Basheer , Ismael Munira , Cash Shelby , Williamson John , McElroy Peter , Kachur Stephen Patrick , Asamoa Kwame
Published: February 2023

Background

The Malaria Frontline Project (MFP) supported the National Malaria Elimination Program for effective program implementation in the high malaria-burden states of Kano and Zamfara adapting the National Stop Transmission of Polio (NSTOP) program elimination strategies.

Project implementation

The MFP was implemented in 34 LGAs in the two states (20 out of 44 in Kano and all 14 in Zamfara). MFP developed training materials and job aids tailored to expected service delivery for primary and district health facilities and strengthened supportive supervision. Pre- and post-implementation assessments of intervention impacts were conducted in both states.

Results

A total of 158 (Kano:83; Zamfara:75) and 180 (Kano:100; Zamfara:80) healthcare workers (HCWs), were interviewed for pre-and post-implementation assessments, respectively. The proportions of HCWs with correct knowledge on diagnostic criteria were Kano: 97.5% to 92.0% and Zamfara: 94.7% to 98.8%; and knowledge of recommended first line treatment of uncomplicated malaria were Kano: 68.7% to 76.0% and Zamfara: 69.3% to 65.0%. The proportion of HCWs who adhered to national guidelines for malaria diagnosis and treatment increased in both states (Kano: 36.1% to 73.0%; Zamfara: 39.2% to 67.5%) and HCW knowledge to confirm malaria diagnosis slightly decreased in Kano State but increased in Zamfara State (Kano: 97.5% to 92.0%; Zamfara: 94.8% to 98.8%). HCWs knowledge of correct IPTp drug increased in both states (Kano: 81.9% to 94.0%; Zamfara: 85.3% to 97.5%).

Conclusion

MFP was successfully implemented using tailored training materials, job aids, supportive supervision, and data use. The project strategy can likely be adapted to improve the effectiveness of malaria program implementation in other Nigerian states, and other malaria endemic countries.
β-1,3-glucan improved the health and immunity of juvenile African catfish (Clarias gariepinus) and neutralized the histological changes caused by lead and fipronil pollutants
Authors: Elmowalid Gamal A. , Ghonimi Wael A. M. , Abd Allah Hossam M. , Abdallah Haytham , El-Murr Abdelhakeem , Abdelwahab Ashraf M.
Published: February 2023

Background

Water pollutants cause adverse effects in aquatic ecosystems. The immunomodulatory and mitigating effects of dietary 1,3-glucan on fipronil and lead-induced intoxication in African catfish (Clarias gariepinus) were investigated. Two hundred forty catfish were randomly divided into four equal groups: those in the first group were fed basic diet and served as controls; those in the second group were supplemented with β-1,3-glucan (0.1%); those in the third group were exposed to combination of lead nitrate at 0.041 mg/L (1/10 96 h LC50) and fipronil at 2.8 mg/l (1/10 96 h LC50); and those in the fourth group were exposed to combination of fipronil, lead, and β-1,3-glucan. The health status, haematological, immunological, and histological changes were all evaluated.

Result

Swelling on the dorsolateral side, spinal column deviation, sluggish movement, skin bleaching, excessive mucus secretion, significant variations in blood indices-related measures, and a 45% death rate were observed in the third group. There was a significant reduction in interleukin-1 (IL-1) and interleukin-6 (IL-6) and immunoglobulin M (IgM) concentrations, as well as decrease in their corresponding gene expression, indicating that fipronil and lead had immunosuppressive activity. Severe catarrhal enteritis and mucinous degeneration of the lining epithelium, and notable depletion of white pulp, congested red pulp and hemosiderosis were common pathological findings in the spleen. β-1,3-glucan alone or in combination with fipronil and lead provoked physical activity, blood indices, with elevations in IL-1β, IL-2, IL-6, and IgM concentrations, as well as up-regulation in their genes’ expression in splenic tissues, when compared to the third group. The spleen and intestine had normal histological architecture with 5% mortalities. There were no fish deaths in the β-1,3-glucan-alone or control groups.

Conclusion

The use of β-1,3-glucan (0.1%) as dietary supplement could be implemented to protect against the toxic effects of fipronil and lead toxicity by improving the health and immunological parameters of intoxicated catfish.
Development of an enzyme-linked immunosorbent assay based on viral antigen capture by anti-spike glycoprotein monoclonal antibody for detecting immunoglobulin A antibodies against porcine epidemic diarrhea virus in milk
Authors: Li Rui , Wen Ying , Yang Lei , Qian Qi-sheng , Chen Xin-xin , Zhang Jia-qing , Li Xuewu , Xing Bao-song , Qiao Songlin , Zhang Gaiping
Published: February 2023

Background

Porcine epidemic diarrhea (PED), caused by PED virus (PEDV), is a severe enteric disease burdening the global swine industry in recent years. Especially, the mortality of PED in neonatal piglets approaches 100%. Maternal antibodies in milk, particularly immunoglobulin A (IgA) antibodies, are of great importance for protection neonatal suckling piglets against PEDV infection as passive lactogenic immunity. Therefore, appropriate detection methods are required for detecting PEDV IgA antibodies in milk. In the current study, we prepared monoclonal antibodies (mAbs) against PEDV spike (S) glycoprotein. An enzyme-linked immunosorbent assay (ELISA) was subsequently developed based on PEDV antigen capture by a specific anti-S mAb.

Results

The developed ELISA showed high sensitivity (the maximum dilution of milk samples up to 1:1280) and repeatability (coefficient of variation values < 10%) in detecting PEDV IgA antibody positive and negative milk samples. More importantly, the developed ELISA showed a high coincidence rate with a commercial ELISA kit for PEDV IgA antibody detection in clinical milk samples.

Conclusions

The developed ELISA in the current study is applicable for PEDV IgA antibody detection in milk samples, which is beneficial for evaluating vaccination efficacies and neonate immune status against the virus.
Effect of itaconic acid production on Neurospora crassa in consolidated bioprocessing of cellulose
Authors: Zhao Jiajia , Ma Caihong , Mei Yaojie , Han Jingjing , Zhao Chen
Published: February 2023

A system for itaconic acid synthesis from cellulose by Neurospora crassa was established, resulting in the highest yield of itaconic acid was 354.08 + 35.99 mg/L. Meanwhile, cellulase activity increased significantly, without any strain modifications for improved cellulase production. Multi-omics analyses showed that itaconic acid synthesis reduced energy production, leading to decreases in trehalose, cell wall, fatty acids synthesis and downregulations in MAPK signaling pathway, cell cycle and meiosis. More importantly, the low-energy environment enhanced the energy-efficient cellobionic acid/gluconic acid pathway, and the cellulase composition also changed significantly, manifested as the up-regulation of LPMOs and the down-regulation of β-glucosidases. Enhancing LPMOs-cellobionic acid/gluconic acid system has the potential to reduce energy consumption of the consolidated bioprocessing. These findings offer an overview of resource allocations by N. crassa in response to itaconic acid synthesis and highlight a series of intriguing connections between itaconic acid synthesis and cellulase synthesis in consolidated bioprocessing.
Low muscle mass in lung cancer is associated with an inflammatory and immunosuppressive tumor microenvironment
Authors: Cury Sarah Santiloni , de Moraes Diogo , Oliveira Jakeline Santos , Freire Paula Paccielli , dos Reis Patricia Pintor , Batista Miguel Luiz , Hasimoto Érica Nishida , Carvalho Robson Francisco
Published: February 2023

Background

Computed tomographies (CT) are useful for identifying muscle loss in non-small lung cancer (NSCLC) cachectic patients. However, we lack consensus on the best cutoff point for pectoralis muscle loss. We aimed to characterize NSCLC patients based on muscularity, clinical data, and the transcriptional profile from the tumor microenvironment to build a cachexia classification model.

Methods

We used machine learning to generate a muscle loss prediction model, and the tumor's cellular and transcriptional profile was characterized in patients with low muscularity. First, we measured the pectoralis muscle area (PMA) of 211 treatment-naive NSCLC patients using CT available in The Cancer Imaging Archive. The cutoffs were established using machine learning algorithms (CART and Cutoff Finder) on PMA, clinical, and survival data. We evaluated the prediction model in a validation set (36 NSCLC). Tumor RNA-Seq (GSE103584) was used to profile the transcriptome and cellular composition based on digital cytometry.

Results

CART demonstrated that a lower PMA was associated with a high risk of death (HR = 1.99). Cutoff Finder selected PMA cutoffs separating low-muscularity (LM) patients based on the risk of death (P-value = 0.003; discovery set). The cutoff presented 84% of success in classifying low muscle mass. The high risk of LM patients was also found in the validation set. Tumor RNA-Seq revealed 90 upregulated secretory genes in LM that potentially interact with muscle cell receptors. The LM upregulated genes enriched inflammatory biological processes. Digital cytometry revealed that LM patients presented high proportions of cytotoxic and exhausted CD8+ T cells.

Conclusions

Our prediction model identified cutoffs that distinguished patients with lower PMA and survival with an inflammatory and immunosuppressive TME enriched with inflammatory factors and CD8+ T cells.
Spermatogenesis associated serine rich 2 like plays a prognostic factor and therapeutic target in acute myeloid leukemia by regulating the JAK2/STAT3/STAT5 axis
Authors: Li Fenglin , Ye Wenle , Yao Yiyi , Wei Wenwen , Lin Xiangjie , Zhuang Haihui , Li Chenying , Li Xia , Ling Qing , Hu Chao , Huang Xin , Qian Yu , Mao Shihui , Huang Jiansong , Lu Ying , Jin Jie
Published: February 2023

Background

Spermatogenesis associated serine rich 2 like (SPATS2L) was highly expressed in homoharringtonine (HHT) resistant acute myeloid leukemia (AML) cell lines. However, its role is little known in AML. The present study aimed to investigate the function of SPATS2L in AML pathogenesis and elucidate the underlying molecular mechanisms.

Methods

Overall survival (OS), event-free survival (EFS), relapse-free survival (RFS) were used to evaluate the prognostic impact of SPATS2L for AML from TCGA database and ourcohort. ShRNA was used to knockdown the expression of SPATS2L. Apoptosis was assessed by flow cytometry. The changes of proteins were assessed by Western blot(WB). A xenotransplantation mice model was used to evaluate in vivo growth and survival. RNA sequencing was performed to elucidate the molecular mechanisms underlying the role of SPATS2L in AML.

Results

SPATS2L expression increased with increasing resistance indexes(RI) in HHT-resistant cell lines we had constructed. Higher SPATS2L expression was observed in intermediate/high-risk patients than in favorable patients. Meanwhile, decreased SPATS2L expression was observed in AML patients achieving complete remission (CR). Multivariate analysis showed high SPATS2L expression was an independent poor predictor of OS, EFS, RFS in AML. SPATS2L knock down (KD) suppressed cell growth, induced apoptosis, and suppressed key proteins of JAK/STAT pathway, such as JAK2, STAT3, STAT5 in AML cells. Inhibiting SPATS2L expression markedly enhanced the pro-apoptotic effects of traditional chemotherapeutics (Ara-c, IDA, and HHT).

Conclusions

High expression of SPATS2L is a poor prognostic factor in AML, and targeting SPATS2L may be a promising therapeutic strategy for AML patients.