bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of the immune system in amyotrophic lateral sclerosis. Analysis of the natural killer cells and other circulating lymphocytes in a cohort of ALS patients
Authors: Piccoli Tommaso , Castro Francesca , La Bella Vincenzo , Meraviglia Serena , Di Simone Marta , Salemi Giuseppe , Dieli Francesco , Spataro Rossella
Published: June 2023

Aims

Neuroinflammation might be involved in the degeneration and progression of Amyotrophic Lateral Sclerosis (ALS). Here, we studied the role of the circulating lymphocytes in ALS, in particular the NK cells. We focused on the relationship between blood lymphocytes, ALS clinical subtype and disease severity.

Subjects and Methods

Blood samples were collected from 92 patients with sporadic ALS, 21 patients with Primary Lateral Sclerosis (PLS) and 37 patients affected by primary progressive multiple sclerosis (PPMS) with inactive plaques. Blood was taken from ALS and controls at the time of diagnosis/referral. Circulating lymphocytes were analyzed by flow cytometry with specific antibodies. Values were expressed as absolute number (n°/µl) of viable lymphocytes subpopulations in ALS were compared with controls. Multivariable analysis was made using site of onset, gender changes in ALSFRS-R and disease progression rate (calculated as ΔFS score).

Results

Age at onset was 65y (58–71) in ALS (spinal 67.4%; bulbar, 32.6%), 57y (48–78) in PLS and 56y (44–68) PPMS. Absolute blood levels of the lymphocytes in the different cohorts were within normal range. Furthermore, while levels of lymphocytes T and B were not different between disease groups, NK cells were increased in the ALS cohort (ALS = 236 [158–360] vs. Controls = 174[113–240], p < 0.001). In ALS, blood levels of NK cells were not related with the main clinical-demographic variables, including the rate of disease progression. Multivariable analysis suggested that male gender and bulbar onset were independently associated with a risk of high blood NK cells levels.

Conclusions

We show that blood NK cells are selectively increased in ALS, though their level appear unaffected in patients with an estimated rapidly progressing disease. Being of a male gender and with a bulbar onset seems to confer higher susceptibility to have increased NK lymphocytes levels at diagnosis/referral. Our experiments provides a further clear-cut evidence of the role of the NK lymphocytes as a significant player in ALS pathogenesis.
Secondary polycythaemia from chronic hypoxia is a risk for cerebral thrombosis: a case report
Authors: Zhou Min , Liu Xiaoxia , Li Li
Published: June 2023

Background

Secondary polycythemia is considered the usual complication of chronic hypoxia. It can theoretically increase the oxygen-carrying capacity, but this adaptive trait has a deleterious effect because the blood viscosity increases, which can induce significant morbidity and mortality, such as stroke and myocardial infarction.

Case presentation

A 55-year-old man with a history of a congenitally small main pulmonary artery presented to the emergency department with sustained unsteady walking, dizziness and vertigo. Evaluation revealed elevated hemoglobin and superior posterior circulation cerebral artery thrombosis. The patient was treated with high flux inhalation of oxygen and anti-platelet aggregation.

Conclusions

The involvement of cerebral vessels has rarely been reported in chronic hypoxia cases. The present case is the first case of superior posterior circulation cerebral artery thrombosis due to chronic hypoxia in a patient with a congenitally small main pulmonary artery. This case demonstrates the importance of recognizing some chronic diseases that can lead to hypoxia and secondary polycythemia thereby leading to hypercoagulable state and subsequent thrombosis.
Prognostic value of tumor necrosis based on the evaluation of frequency in invasive breast cancer
Authors: Chen Jianhua , Li Zhijun , Han Zhonghua , Kang Deyong , Ma Jianli , Yi Yu , Fu Fangmeng , Guo Wenhui , Zheng Liqin , Xi Gangqin , He Jiajia , Qiu Lida , Li Lianhuang , Zhang Qingyuan , Wang Chuan , Chen Jianxin
Published: June 2023

Background

Tumor necrosis (TN) was associated with poor prognosis. However, the traditional classification of TN ignored spatial intratumor heterogeneity, which may be associated with important prognosis. The purpose of this study was to propose a new method to reveal the hidden prognostic value of spatial heterogeneity of TN in invasive breast cancer (IBC).

Methods

Multiphoton microscopy (MPM) was used to obtain multiphoton images from 471 patients. According to the relative spatial positions of TN, tumor cells, collagen fibers and myoepithelium, four spatial heterogeneities of TN (TN1-4) were defined. Based on the frequency of individual TN, TN-score was obtained to investigate the prognostic value of TN.

Results

Patients with high-risk TN had worse 5-year disease-free survival (DFS) than patients with no necrosis (32.5% vs. 64.7%; P < 0.0001 in training set; 45.8% vs. 70.8%; P = 0.017 in validation set), while patients with low-risk TN had a 5-year DFS comparable to patients with no necrosis (60.0% vs. 64.7%; P = 0.497 in training set; 59.8% vs. 70.8%; P = 0.121 in validation set). Furthermore, high-risk TN “up-staged” the patients with IBC. Patients with high-risk TN and stage I tumors had a 5-year DFS comparable to patients with stage II tumors (55.6% vs. 62.0%; P = 0.565 in training set; 62.5% vs. 66.3%; P = 0.856 in validation set), as well as patients with high-risk TN and stage II tumors had a 5-year DFS comparable to patients with stage III tumors (33.3% vs. 24.6%; P = 0.271 in training set; 44.4% vs. 39.3%; P = 0.519 in validation set).

Conclusions

TN-score was an independent prognostic factor for 5-year DFS. Only high-risk TN was associated with poor prognosis. High-risk TN “up-staged” the patients with IBC. Incorporating TN-score into staging category could improve its performance to stratify patients.
The significance of the best puncture side bone cement/vertebral volume ratio to prevent paravertebral vein leakage of bone cement during vertebroplasty: a retrospective study
Authors: Gao Tao , Chen Zhi-Yu , Li Tao , Lin Xu , Hu Hai-Gang , Wang Xiang-Yu , Zeng Jun , Wu Chao
Published: June 2023

Objectives

To verify the clinical significance of the best puncture-side bone cement/vertebral volume ratio (PSBCV/VV%) and bone cement leakage in paravertebral veins during vertebroplasty.

Methods

This was a retrospective analysis of a total of 210 patients from September 2021 to December 2022, who were divided into an observation group (110 patients) and a control group (100 patients). In the observation group, patients’ preoperative computed tomography (CT) data were imported into Mimics software, and the VV was calculated using the three-dimensional (3D) reconstruction function. Then, based on the best PSBCV/VV% of 13.68% determined in a previous study, the optimal PSBCV to be injected during vertebroplasty was calculated. In the control group, vertebroplasty was performed directly using the conventional method. The incidence of cement leakage into paravertebral veins was observed postoperatively in both groups.

Results

There were no statistically significant differences (P > 0.05) in the evaluated indicators between the two groups pre- or postoperatively, including the anterior vertebral margin height, mid-vertebral height, injured vertebral Cobb angle, visual analogue scale (VAS) score, and Oswestry Disability Index (ODI). Intragroup comparisons showed improvements in the anterior vertebral height, mid-vertebral height, injured vertebral Cobb angle, VAS score, and ODI after surgery compared with before surgery (P < 0.05). In the observation group, there were 3 cases of cement leakage into the paravertebral veins, for a leakage rate of 2.7%. In the control group, there were 11 cases of cement leakage into the paravertebral veins, for a leakage rate of 11%. The difference in the leakage rate between the two groups was statistically significant (P = 0.016).

Conclusion

In vertebroplasty, preoperative VV calculations using Mimics software, combined with calculation of the PSBCV according to the best PSBCV/VV% (13.68%), can effectively prevent leakage of bone cement into paravertebral veins and further prevent serious life-threatening complications such as pulmonary embolism.
Clinical efficacy of adjunctive methods for the non-surgical treatment of peri-implantitis: a systematic review and meta-analysis
Authors: Barbato Luigi , Cavalcanti Raffaele , Rupe Cosimo , Scartabelli Daniele , Serni Lapo , Chambrone Leandro , Cairo Francesco
Published: June 2023

Background

The aim of this systematic review (SR) was to evaluate the clinical efficacy of different adjunctive methods/therapies to the non-surgical treatment (NST) of peri-implantitis.

Materials and methods

The protocol of the review was registered in PROSPERO database (CRD42022339709) and was designed according to PRISMA statement. Electronic and hand searches were performed to identify randomized clinical trials (RCTs) comparing non-surgical treatment of peri-implantitis alone versus NST plus any adjunctive method/treatment. The primary outcome was probing pocket depth (PPD) reduction.

Results

Sixteen RCTs were included. Only 2 out of 1189 implants were lost and follow-up ranged from 3 to 12 months. PPD reduction across the studies varied from 0.17 to 3.1 mm, while defect resolution from 5.3% to 57.1%. Systemic antimicrobials were associated to higher PPD reduction (1.56 mm; [95% CI 0.24 to 2.89]; p = 0.02) with high heterogeneity, and treatment success (OR = 3.23; [95% CI 1.17 to 8.94]; p = 0.02), compared to NST alone. No differences were found with adjunctive local antimicrobials and lasers for PPD and bleeding on probing (BoP) reduction.

Conclusions

Non-surgical treatment with or without adjunctive methods may reduce PPD and BoP even if complete resolution of the pocket is unpredictable. Among possible adjunctive methods, only systemic antibiotics seems to provide further benefits, but their usage should be considered with caution.
Relationship between vitamin D status and caries experience in a group of Egyptian children: a cross-sectional study
Authors: El Shiekh Manal Ahmed , Hanafy Rasha Mohamed Hatem
Published: June 2023

Background

Dental caries is one of the most common diseases of childhood. Evidence suggests that malnutrition and vitamin deficiency may increase the risk to dental caries.

Aim

This study aimed to determine the relationship between vitamin D and dental caries experience in children and whether vitamin D deficiency is a risk factor for tooth decay.

Participants and methods

A cross-sectional study was performed on 51 Egyptian children, aged from three to five years and diagnosed from Abo El-Resh Children’s Hospital as ‘Sufficient’, ‘Insufficient’ or ‘Deficient’ in vitamin D. Children were divided into 3 equal groups. A structured questionnaire, formed of four sections, was answered by the parents. Dental examination was performed under natural daylight. Caries index (dmf), for each group, was calculated then compared. The study was conducted from July 2019 to January 2020. Associations between dmf and different variables were assessed using independent t-test. Correlation between age and dmf was assessed using Spearman’s rank order correlation coefficient. Multiple linear regression model was used to study the effect of different variables on caries.

Results

There was a weak positive correlation between age and dmf scores (β = 2.00; 95%CI, 0.73:3.26). Children playing outside experienced higher dmf (β = 1.29; 95%CI, -0.35:2.94) than those with no outside play. Children with 25(OH) D below 20 ng / ml had the highest dmfs (β = 1.01; 95%CI, -0.74:2.76). There was a significant association with teeth brushing; children not brushing their teeth showed significantly higher dmf (β = -2.21; 95%CI, -4.14:-0.28) than their counterparts. There were no significant associations of sex (β = -1.05; 95%CI, -2.68:0.59), fluoride tablets intake (β = 2.19; 95%CI, -1.25:5.63), dental visits (β = -1.43; 95%CI, -3.09:0.23), mothers’ vitamin D intake during pregnancy (β = 0.71; 95%CI, -1.13:2.56), snacking (β = -1.18; 95%CI, -4.62:2.26) and parental education (β = 0.62; 95%CI, -1.18:2.42) with caries experience among the study population.

Conclusion

Vitamin D deficiency does not seem to be associated with dental caries experience of 3–5 years old Egyptian children. Out of the indicator variables, age and tooth brushing contributed significantly to the occurrence of dental caries among the study population.
The value of a specialized second-opinion pathological diagnosis for oral and maxillofacial lesions
Authors: Binmadi Nada O. , Alhindi Areej A. , Alsharif Maha T. , Jamal Basem T. , Mair Yasmin H.
Published: June 2023

Objectives

An error in the diagnosis of an oral or maxillofacial lesion could potentially be detrimental to a patient’s prognosis and management. Major discrepancies between the initial and subsequent diagnoses of head and neck pathologies range from 7 to 53%. This study determined the rate of discrepancies found in the diagnoses of oral and maxillofacial lesions after a second opinion in Saudi Arabia.

Methods

A retrospective single-center study was conducted by oral and maxillofacial pathology consultants to review all cases referred for a second opinion to the oral and maxillofacial pathology laboratory between January 2015 and December 2020. If the second-opinion diagnosis matched the original diagnosis, this was described as “agreement.” If the second-opinion diagnosis did not match the original diagnosis but would not change the management or prognosis of a patient, this was classified as a “minor disagreement.” If the second-opinion diagnosis resulted in the changing of a patient’s management or prognosis, this was categorized as a “major disagreement.” Chi-square test and Fisher’s exact test were used to compare data between original and second-opinion diagnoses. A p-value of less than 0.05 was considered significant.

Results

Of 138 cases, 59 (43%) had an initial diagnosis and a second-opinion diagnosis that were in major disagreement. The most common tumor for which there was a major disagreement was squamous cell carcinoma. No single factor influenced the occurrence of major disagreements.

Conclusions

Our evaluation reiterates the importance of obtaining a second opinion from a specialist in oral and maxillofacial pathology to improve the diagnostic accuracy for lesions. A formal system for this step, in addition to the obtaining of adequate clinical and radiographic information about a patient, is mandatory for the review of difficult cases.
Safety climate in the surgical center during the Covid-19 pandemic: mixed-method study
Authors: Azevedo Ana Regina Ramos , Fassarella Cintia Silva , de Andrade Lourenção Daniela Campos , Camerini Flavia Giron , de Mendonça Henrique Danielle , da Silva Renata Flavia Abreu
Published: June 2023

Context

The gradual impact of the Covid-19 pandemic had important effects on routines in surgical environments. In order to cope with the impact and re-establish anaesthesiology and surgery procedures, it was imperative to pursue in-depth studies with a view to ensuring safe surgical care, reducing hazards, as well as protecting the health, safety and wellbeing of the health personnel involved. The purpose of this study was to evaluate quantitative and qualitative approaches to domains of safety climate among multi-professional staffs of surgical centres during the Covid-19 pandemic and to identify intersections.

Methods

This mixed-method project employed a concomitant triangulation strategy on a quantitative approach in an exploratory, descriptive, cross-sectional study, as well as a qualitative approach by way of a descriptive study. Data were collected using the validated, self-applicable Safety Attitudes Questionnaire/Operating Room (SAQ/OR) questionnaire and a semi-structured interview script. The 144 participants were the surgical, anaesthesiology, nursing and support teams working in the surgical centre during the Covid-19 pandemic.

Results

The study found an overall safety climate score of 61.94, the highest-scoring domain being ‘Communication in the surgical environment’ (77.91) and the lowest, ‘Perception of professional performance’ (23.60). On integrating the results, a difference was found between the domains ‘Communication in the surgical environment’ and ‘Working conditions’. However, there was intersection by the ‘Perception of professional performance’ domain, which permeated important categories of the qualitative analysis.

Conclusions

For care practice, it is hoped to encourage improved patient safety, educational interventions to strengthen the patient safety climate and promote in-job wellbeing on the job for health personnel working in surgical centres. It is suggested that further studies explore the subject in greater depth among several surgical centres with mixed methods, so as to permit future comparisons and to monitor the evolving maturity of safety climate.
Impact of PSA testing on secondary care costs in England and Wales: estimates from the Cluster randomised triAl of PSA testing for Prostate cancer (CAP)
Authors: Thorn Joanna C. , Turner Emma L. , Walsh Eleanor I. , Donovan Jenny L. , Neal David E. , Hamdy Freddie C. , Martin Richard M. , Noble Sian M.
Published: June 2023

Background

Screening men for prostate cancer using prostate-specific antigen (PSA) testing remains controversial. We aimed to estimate the likely budgetary impact on secondary care in England and Wales to inform screening decision makers.

Methods

The Cluster randomised triAl of PSA testing for Prostate cancer study (CAP) compared a single invitation to men aged 50–69 for a PSA test with usual care (no screening). Routinely collected hospital care data were obtained for all men in CAP, and NHS reference costs were mapped to each event via Healthcare Resource Group (HRG) codes. Secondary-care costs per man per year were calculated, and cost differences (and population-level estimates) between arms were derived annually for the first five years following randomisation.

Results

In the first year post-randomisation, secondary-care costs averaged across all men (irrespective of a prostate cancer diagnosis) in the intervention arm (n = 189279) were £44.80 (95% confidence interval: £18.30-£71.30) higher than for men in the control arm (n = 219357). Extrapolated to a population level, the introduction of a single PSA screening invitation could lead to additional secondary care costs of £314 million.

Conclusions

Introducing a single PSA screening test for men aged 50–69 across England and Wales could lead to very high initial secondary-care costs.
Does using the sociodental approach in oral health care influence use of dental services and oral health of adolescents living in deprived communities? a one-year follow up study
Authors: Gomes Andressa Coelho , Vettore Mario Vianna , Quadros Larissa Neves , Rebelo Maria Augusta Bessa , Rebelo Vieira Janete Maria
Published: June 2023

Background

Oral health needs assessment is important for oral health care planning. This study compared dental treatment needs between normative and sociodental needs. We also longitudinally examined the relationships of baseline sociodental needs measures and socioeconomic status with one-year follow up measures of use of dental services, dental caries, filled teeth, and oral health-related quality of life (OHRQoL).

Methods

A prospective study was conducted with 12-year-old adolescents from public schools in deprived communities in the city of Manaus, Brazil. Validated questionnaires were used to collect adolescents’ sex and socioeconomic status, OHRQoL (CPQ11 − 14) and behaviours (sugar intake, frequency of toothbrushing, regular use of fluoridated toothpaste and pattern of dental attendance). Normative need was assessed according to decayed teeth, clinical consequences of untreated dental caries, malocclusion, dental trauma, and dental calculus. The relationships between variables were tested thorough Structural equation modelling.

Results

Overall 95.5% of adolescents had normative dental treatment needs. Of these, 9.4% were classified as high level of propensity. Higher normative/impact need and greater propensity-related need directly predicted use of dental services at one-year follow up. The latter mediated the association of normative/impact need and propensity-related need with incidence of dental caries and filled teeth. Normative/impact need and use of dental services were directly associated with filled teeth at one-year follow up. Poor OHRQoL at one-year follow-up was directly predicted by higher normative/impact need at baseline and less filled teeth at one-year follow up. Greater socioeconomic status was directly associated with better propensity-related need. Socioeconomic status indirectly predicted incidence of dental caries and filled teeth via propensity-related need and use of dental services.

Conclusions

Sociodental needs measures were related to use of dental services, dental caries, filled teeth and OHRQoL after one year among adolescents living in deprived communities. Adolescents with dental needs treatment priorities according to the sociodental approach had more filled teeth via use of dental services. Dental services utilisation did not attenuate the impact of normative and impact-related need on dental caries incidence and poor OHRQoL after one year. Our findings suggest the importance of developing oral health promotion and enhancing access to dental care to improve oral health of adolescents living in deprived communities.
Prospective application of theoretical implementation frameworks to improve health care in hospitals — a systematic review
Authors: Barnden Rebecca , Snowdon David A. , Lannin Natasha A. , Lynch Elizabeth , Srikanth Velandai , Andrew Nadine E.
Published: June 2023

Background

Health Service implementation projects are often guided by theoretical implementation frameworks. Little is known about the effectiveness of these frameworks to facilitate change in processes of care and patient outcomes within the inpatient setting. The aim of this review was to assess the effectiveness of the application of theoretical implementation frameworks in inpatient healthcare settings to change processes of care and associated patient outcomes.

Method

We conducted a search in CINAHL, MEDLINE, EMBASE, PsycINFO, EMCARE and Cochrane Library databases from 1st January 1995 to 15th June 2021. Two reviewers independently applied inclusion and exclusion criteria to potentially eligible studies. Eligible studies: implemented evidence-based care into an in-patient setting using a theoretical implementation framework applied prospectively; used a prospective study design; presented process of care or patient outcomes; and were published in English. We extracted theoretical implementation frameworks and study design against the Workgroup for Intervention Development and Evaluation Research (WIDER) Checklist and implementation strategies mapped to the Cochrane Effective Practice and Organisation of Care (EPOC) taxonomy. We summarised all interventions using the Template for Intervention Description and Replication (TIDieR) checklist. We appraised study quality using the Item bank on risk of bias and precision of observational studies and the revised Cochrane risk of bias tool for cluster randomised trials. We extracted process of care and patient outcomes and described descriptively. We conducted meta-analysis for process of care and patient outcomes with reference to framework category.

Results

Twenty-five studies met the inclusion criteria. Twenty-one used a pre-post (no comparison), two a pre-post with a comparison, and two a cluster randomised trial design. Eleven theoretical implementation frameworks were prospectively applied: six process models; five determinant frameworks; and one classic theory. Four studies used two theoretical implementation frameworks. No authors reported their justification for selecting a particular framework and implementation strategies were generally poorly described. No consensus was reached for a preferred framework or subset of frameworks based on meta-analysis results.

Conclusions

Rather than the ongoing development of new implementation frameworks, a more consistent approach to framework selection and strengthening of existing approaches is recommended to further develop the implementation evidence base.

Trial registration

CRD42019119429.
Understanding collaborative implementation between community and academic partners in a complex intervention: a qualitative descriptive study
Authors: Clark Rebecca , Gaber Jessica , Datta Julie , Talat Samina , Bomze Sivan , Marentette-Brown Sarah , Gagnon Cherie , Oliver Doug , Lamarche Larkin , Forsyth Pamela , Carr Tracey , Price David , Mangin Dee
Published: June 2023

Background

Community-academic partnerships (CAPs) can improve the relevance, sustainability, and uptake of new innovations within the community. However, little is known about what topics CAPs focus on and how their discussions and decisions impact implementation at ground level. The objectives of this study were to better understand the activities and learnings from implementation of a complex health intervention by a CAP at the planner/decision-maker level, and how that compared to experiences implementing the program at local sites.

Methods

The intervention, Health TAPESTRY, was implemented by a nine-partner CAP including academic, charitable organizations, and primary care practices. Meeting minutes were analyzed using qualitative description, latent content analysis, and a member check with key implementors. An open-answer survey about the best and worst elements of the program was completed by clients and health care providers and analyzed using thematic analysis.

Results

In total, 128 meeting minutes were analyzed, 278 providers and clients completed the survey, and six people participated in the member check. Prominent topics of discussion categories from the meeting minutes were: primary care sites, volunteer coordination, volunteer experience, internal and external connections, and sustainability and scalability. Clients liked that they learned new things and gained awareness of community programs, but did not like the volunteer visit length. Clinicians liked the regular interprofessional team meetings but found the program time-consuming.

Conclusions

An important learning was about who had “voice” at the planner/decision-maker level: many of the topics discussed in meeting minutes were not identified as issues or lasting impacts by clients or providers; this may be due to differing roles and needs, but may also identify a gap. Overall, we identified three phases that could serve as a guide for other CAPs: Phase (1) recruitment, financial support, and data ownership; Phase (2) considerations for modifications and adaptations; Phase (3) active input and reflection.
Multimetallic nanoparticles decorated metal-organic framework for boosting peroxidase-like catalytic activity and its application in point-of-care testing
Authors: Wu Pian , Gong Fangjie , Feng Xiangling , Xia Yong , Xia Lehuan , Kai Tianhan , Ding Ping
Published: June 2023

Metal-organic frameworks (MOFs) are a sort of promising peroxidase-like nanozyme but face the challenge that the inorganic nodes in most of the MOF structures are generally blocked by the organic linkers. Further enhancement or activation of their peroxidase-like activity plays an important role in developing MOF-based nanozymes. Herein, a multimetallic nanoparticle (NP) decorated-MOF, Cu/Au/Pt NP decorated-Cu-TCPP(Fe) nanozyme (CuAuPt/Cu-TCPP(Fe)) was synthesized in situ and served as a peroxidase-like nanozyme. The peroxidase-like activity of this stable CuAuPt/Cu-TCPP(Fe) nanozyme was enhanced due to the decreased potential barriers for *OH generation in the catalytic process. Owing to the remarkable peroxidase-like activity, a CuAuPt/Cu-TCPP(Fe)-based colorimetric assay was established for the sensitive determination of H2O2 and glucose with the limit of detection (LOD) of 9.3 µM and 4.0 µM, respectively. In addition, a visual point-of-care testing (POCT) device was developed by integrating the CuAuPt/Cu-TCPP(Fe)-based test strips with a smartphone and was employed for a portable test of 20 clinical serum glucose samples. The results determined by this method agree well with the values deduced by clinical automatic biochemical analysis. This work not only represents an inspiration for the usage of MNP/MOF composite as a novel nanozyme for POCT diagnosis, but also provides a deeper insight and understanding into the enhanced enzyme-mimic effect of MNP-hybrid MOF composites, which in turn will guide the engineering of MOF-based functional nanomaterials.

Graphical Abstract
Exploring the impact of the COVID-19 pandemic on healthcare and substance use service access among women who inject drugs: a qualitative study
Authors: Cooper Lyra , Rosen Joseph G. , Zhang Leanne , Pelaez Danielle , Olatunde Praise F. , Owczarzak Jill , Park Ju Nyeong , Glick Jennifer L.
Published: June 2023

Background

The COVID-19 pandemic disrupted healthcare and substance use services engagement, including primary and mental health services as well as residential and outpatient drug treatment. Women who inject drugs (WWID) face known barriers to healthcare and substance use service engagement, which pre-date the COVID-19 pandemic. The impact of COVID-19 on WWID’s engagement with healthcare and substance use services, however, remains understudied.

Methods

To explore the impact of the COVID-19 pandemic on service-seeking and utilization, we conducted in-depth interviews with 27 cisgender WWID in Baltimore, Maryland, in April–September 2021. Iterative, team-based thematic analysis of interview transcripts identified disruptions and adaptations to healthcare and substance use services during the COVID-19 pandemic.

Results

The COVID-19 pandemic disrupted service engagement for WWID through service closures, pandemic safety measures restricting in-person service provision, and concerns related to contracting COVID-19 at service sites. However, participants also described various service adaptations, including telehealth, multi-month prescriptions, and expanded service delivery modalities (e.g., mobile and home delivery of harm reduction services), which overwhelmingly increased service engagement.

Conclusion

To build upon service adaptations occurring during the pandemic and maximize expanded access for WWID, it is vital for healthcare and substance use service providers to continue prioritizing expansion of service delivery modality options, like telehealth and the provision of existing harm reduction services through alternative platforms (e.g., mobile services), that facilitate care continuity and increase coverage.
HPV-positive murine oral squamous cell carcinoma: development and characterization of a new mouse tumor model for immunological studies
Authors: Modic Ziva , Cemazar Maja , Markelc Bostjan , Cör Andrej , Sersa Gregor , Kranjc Brezar Simona , Jesenko Tanja
Published: June 2023

Background

Infection with high-risk human papillomavirus (HPV) strains is one of the risk factors for the development of oral squamous cell carcinoma (OSCC). Some patients with HPV-positive OSCC have a better prognosis and respond better to various treatment modalities, including radiotherapy or immunotherapy. However, since HPV can only infect human cells, there are only a few immunocompetent mouse models available that enable immunological studies. Therefore, the aim of our study was to develop a transplantable immunocompetent mouse model of HPV-positive OSCC and characterize it in vitro and in vivo.

Methods

Two monoclonal HPV-positive OSCC mouse cell lines were established by inducing the expression of HPV-16 oncogenes E6 and E7 in the MOC1 OSCC cell line using retroviral transduction. After confirming stable expression of HPV-16 E6 and E7 with quantitative real-time PCR and immunofluorescence staining, the cell lines were further characterized in vitro using proliferation assay, wound healing assay, clonogenic assay and RNA sequencing. In addition, tumor models were characterized in vivo in C57Bl/6NCrl mice in terms of their histological properties, tumor growth kinetics, and radiosensitivity. Furthermore, immunofluorescence staining of blood vessels, hypoxic areas, proliferating cells and immune cells was performed to characterize the tumor microenvironment of all three tumor models.

Results

Characterization of the resulting MOC1-HPV cell lines and tumor models confirmed stable expression of HPV-16 oncogenes and differences in cell morphology, in vitro migration capacity, and tumor microenvironment characteristics. Although the cell lines did not differ in their intrinsic radiosensitivity, one of the HPV-positive tumor models, MOC1-HPV K1, showed a significantly longer growth delay after irradiation with a single dose of 15 Gy compared to parental MOC1 tumors. Consistent with this, MOC1-HPV K1 tumors had a lower percentage of hypoxic tumor area and a higher percentage of proliferating cells. Characteristics of the newly developed HPV-positive OSCC tumor models correlate with the transcriptomic profile of MOC1-HPV cell lines.

Conclusions

In conclusion, we developed and characterized a novel immunocompetent mouse model of HPV-positive OSCC that exhibits increased radiosensitivity and enables studies of immune-based treatment approaches in HPV-positive OSCC.
Staged osteotomy in lateral position for the treatment of severe kyphotic deformity secondary to ankylosing spondylitis: a retrospective study
Authors: Hu Zhengjun , Zhong Rui , Zhao Deng , Wang Fei , Huang Huaqiang , Jiang Dengxu , Zhang Zhong , Liang Yijian
Published: June 2023

Background

Patients with severe kyphotic deformity (Cobb > 100°) secondary to ankylosing spondylitis (AS) occasionally cannot undergo corrective surgery in the prone position. Osteotomy in the lateral position might provide a possible solution. In this study, we aim to evaluate the clinical efficacy and safety of staged osteotomy in the lateral position for the treatment of AS-related severe kyphosis with a minimum of 2-year follow-up.

Methods

In total, 23 patients who underwent staged osteotomy in the lateral position from October 2015 to June 2017 were analyzed. In the first stage of surgery, all but one patient underwent a single-level Ponte osteotomy, which was followed by a pedicle subtraction osteotomy in the second stage. Mean follow-up was 30.8 ± 4.6 months. Global kyphosis (GK), thoracic kyphosis (TK), lumbar lordosis (LL), sagittal vertical axis (SVA), osteotomized vertebra intervertebral angle (OVI), chin-brow vertical angle (CBVA), Oswestry Disability Index (ODI) score and Scoliosis Research Society-22 Patient Questionnaire (SRS-22) were all compared pre- and postoperation.

Results

All kyphosis parameters were significantly improved (all P < 0.05). GK was corrected from 115.0 ± 13.4° to 46.5 ± 9.0° postoperatively, with a mean correction of 68.5°. SVA was improved from 21.2 ± 5.1 cm to 5.1 ± 1.8 cm postoperatively. After surgery, CBVA was adjusted from 64.1 ± 23.2° to 5.7 ± 10.6° and OVI was changed from 9.0 ± 2.7° to − 20.1 ± 5.6°. Both the ODI and SRS-22 showed substantial improvements (all P < 0.05). Four patients with mild complications were observed perioperatively.

Conclusion

In AS patients with severe kyphosis, satisfactory correction can be safely achieved with staged osteotomy in the lateral position, which can not only correct the sagittal imbalance of the spine with acceptable complications but also facilitate the placement of the intraoperative position.
Root causes and preventability of unintentionally retained foreign objects after surgery: a national expert survey from Switzerland
Authors: Schwappach David , Pfeiffer Yvonne
Published: June 2023

Background

Retained foreign objects (RFO) after surgery are rare, serious patient safety events. In international comparisons based on routine data, Switzerland had remarkably high RFO rates. The objectives of this study were to 1) explore national key stakeholders’ views on RFO as a safety problem, its preventability and need for action in Switzerland; and 2) to assess their interpretation of Switzerland’s RFO incidence compared to other countries.

Methods

A semi-structured expert survey was conducted among national key representatives, including clinician experts, patient advocates, health administration representatives and other relevant stakeholders (n = 21). Data were coded and analyzed to generate themes related to the study questions following a deductive approach.

Results

Experts in this study unequivocally emphasized the tragedy for individual patients affected by RFOs. Productivity pressure and the strong economization of operating rooms were perceived as detrimental to safety culture, which was seen as essential for RFO prevention, specifically by those working in the OR. RFOs were seen as “maximally minimizable” but not completely preventable. There was strong agreement that within country differences in RFO risk between Swiss hospitals existed. On the systems level and compared to other safety issues, RFO were having less urgency for most experts. The international comparison of RFO incidences raised serious skepticism across all groups of experts. The validity of the data was questioned and the dominant interpretation of Switzerland’s high RFO incidence compared to other countries was a “reporting artifact” based on high coding quality in Swiss hospitals. While most experts thought that the published RFO incidence warrants in-depth analysis of the data, there was little agreement about who’s role it was to initiate any further activities.

Conclusions

This investigation offers valuable insights into the perspectives of significant stakeholders concerning RFOs, their root causes, and preventability. The findings demonstrate how international comparative safety data are perceived, interpreted, and utilized by national experts to derive conclusive insights.
Alignment of CCI total ankle replacements in relation to midterm functional outcome and complication incidence
Authors: Hermus Joris P. S. , van Kuijk Sander M. , Witlox Marianne A. , Poeze Martijn , van Rhijn Lodewijk W. , Arts Jacobus J.
Published: June 2023

Background

Total ankle arthroplasty is increasingly used as a treatment for end stage ankle arthropathy. The aim of this study was to report the mid‐term clinical function and survival results of Ceramic Coated Implant (CCI) ankle replacements and assess the association between the alignment of the CCI total ankle replacements and early functional outcome and complication incidence.

Methods

Data of 61 patients, who received 65 CCI implants between 2010 and 2016, were obtained from a prospectively documented database. Mean follow‐up time was 85.2 months (range 27–99 months). Clinical function was assessed with AOFAS questionnaire and passive range of motion (ROM). Survival analysis and elaborate radiographic analysis was performed. Furthermore, complications and reoperations were recorded for all patients.

Results

Progression in ROM was most seen in the first 10 months from 21.8 degrees of passive range of motion preoperative to 27.6 degrees postoperative (p < 0.001), while the mean AOFAS gradually increased during follow‐up postoperative from a mean of 40.9 points preoperative to an average of 82.5 but shows a small decline towards the end of follow‐up (p < 0.001). During follow‐up we recorded 8 failures (12.3%) resulting in a Kaplan‐Meier survival analysis of 87.7% with a median follow‐up of 85.2 months.

Conclusion

We observed excellent clinical results and survival after TAA with the CCI implant with only a low mid‐term complication rate.

Level of evidence

Level III, prospective cohort study.
Effect of propranolol and clonidine after severe traumatic brain injury: a pilot randomized clinical trial
Authors: Nordness Mina F. , Maiga Amelia W. , Wilson Laura D. , Koyama Tatsuki , Rivera Erika L. , Rakhit Shayan , de Riesthal Michael , Motuzas Cari L. , Cook Madison R. , Gupta Deepak K. , Jackson James C. , Williams Roberson Shawniqua , Meurer William J. , Lewis Roger J. , Manley Geoffrey T. , Pandharipande Pratik P. , Patel Mayur B.
Published: June 2023

Objective

To evaluate the safety, feasibility, and efficacy of combined adrenergic blockade with propranolol and clonidine in patients with severe traumatic brain injury (TBI).

Background

Administration of adrenergic blockade after severe TBI is common. To date, no prospective trial has rigorously evaluated this common therapy for benefit.

Methods

This phase II, single-center, double-blinded, pilot randomized placebo-controlled trial included patients aged 16–64 years with severe TBI (intracranial hemorrhage and Glasgow Coma Scale score ≤ 8) within 24 h of ICU admission. Patients received propranolol and clonidine or double placebo for 7 days. The primary outcome was ventilator-free days (VFDs) at 28 days. Secondary outcomes included catecholamine levels, hospital length of stay, mortality, and long-term functional status. A planned futility assessment was performed mid-study.

Results

Dose compliance was 99%, blinding was intact, and no open-label agents were used. No treatment patient experienced dysrhythmia, myocardial infarction, or cardiac arrest. The study was stopped for futility after enrolling 47 patients (26 placebo, 21 treatment), per a priori stopping rules. There was no significant difference in VFDs between treatment and control groups [0.3 days, 95% CI (− 5.4, 5.8), p = 1.0]. Other than improvement of features related to sympathetic hyperactivity (mean difference in Clinical Features Scale (CFS) 1.7 points, CI (0.4, 2.9), p = 0.012), there were no between-group differences in the secondary outcomes.

Conclusion

Despite the safety and feasibility of adrenergic blockade with propranolol and clonidine after severe TBI, the intervention did not alter the VFD outcome. Given the widespread use of these agents in TBI care, a multi-center investigation is warranted to determine whether adrenergic blockade is of therapeutic benefit in patients with severe TBI.

Trial Registration Number NCT01322048.
Matchtigs: minimum plain text representation of k-mer sets
Authors: Schmidt Sebastian , Khan Shahbaz , Alanko Jarno N. , Pibiri Giulio E. , Tomescu Alexandru I.
Published: June 2023

We propose a polynomial algorithm computing a minimum plain-text representation of k-mer sets, as well as an efficient near-minimum greedy heuristic. When compressing read sets of large model organisms or bacterial pangenomes, with only a minor runtime increase, we shrink the representation by up to 59% over unitigs and 26% over previous work. Additionally, the number of strings is decreased by up to 97% over unitigs and 90% over previous work. Finally, a small representation has advantages in downstream applications, as it speeds up SSHash-Lite queries by up to 4.26× over unitigs and 2.10× over previous work.
Retrospective study of the epidemiological risk and serological diagnosis of human babesiosis in Asturias, Northwestern Spain
Authors: Montero Estrella , Folgueras María , Rodriguez-Pérez Mercedes , Pérez-ls Laura , Díaz-Arias Javier , Meana Maria , Revuelta Belén , Haapasalo Karita , Collazos Julio , Asensi Víctor , Gonzalez Luis Miguel
Published: June 2023

Background

Babesiosis is a globally growing tick-borne disease in humans. Severe babesiosis caused by Babesia divergens has been reported in two patients from Asturias (Northwestern Spain), suggesting an undetected risk for the disease. To analyze this risk, we retrospectively evaluated the seroprevalence of babesiosis in the Asturian population from 2015 through 2017, a period covering the intermediate years in which these two severe cases occurred.

Methods

Indirect fluorescent assay (IFA) and Western blot (WB) were performed to detect B. divergens IgG antibodies in 120 serum samples from Asturian patients infected with the tick-transmitted spirochete Borrelia burgdorferi sensu lato, a condition that indicates exposure to tick bites.

Results

This retrospective study confirmed a B. divergens seroprevalence rate of 39.2% according to IFA results. B. divergens incidence was 7.14 cases/100,000 population, exceeding previously reported seroprevalence rates. No differences in epidemiology and risk factors were found between patients infected solely with B. burgdorferi s.l. and those infected with B. burgdorferi s.l. and with IgG antibodies against B. divergens. This last group of patients lived in Central Asturias, had a milder clinical course and, according to WB results, developed different humoral responses against B. divergens.

Conclusions

Babesia divergens parasites have circulated for several years in Asturias. Epidemiological evidence of babesiosis makes Asturias an emerging risk area for this zoonosis. Human babesiosis could also be relevant in other Spanish and European regions affected by borreliosis. Hence, the potential risk of babesiosis on human health in Asturias and other European forest regions needs to be addressed by the health authorities.

Graphical Abstract
Expression of a deep-sea bacterial laccase from Halomonas alkaliantartica and its application in dyes decolorization
Authors: Wang Jingjing , Zhang Ran , Zhu Guilan , Wang Lingling , Bai Han , Qian Yong , Zhou Xiazhen , Yin Qiang , Zhang Yan
Published: June 2023

Introduction

Laccase is a copper-containing polyphenolic oxidase widely found in bacteria, archaea, fungi, animals, and plants. As a green biocatalyst with considerable potential for numerous environmental and industrial applications, the enzyme production efficiency of laccase in nature is low, and the cost is high.

Purpose

To examine the characterization and potential applications of laccase in this study, a novel laccase from Halomonas alkaliantartica (LacHa) was cloned and heterologously expressed it in Escherichia coli.

Results

To achieve heterologous and efficient laccase expression, a bacterial laccase gene designed as LacHa from Halomonas alkaliantartica of deep sea was cloned and expressed in E. coli. The results showed that the optimum temperature and pH of the enzyme reaction were 45 °C and 7.5. The 100 μM Cu2+ and Fe2+ ions had the strongest stimulatory effect on laccase activity, the surface-active agent SDS and organic solvent 5% ethanol had opposite effect. EDTA, and 5% DMSO have no effect on LacHa activity.

The activity of LacHa was enhanced 1.5-fold by chloride at concentrations lower than 500 mM, and 57.6% of its initial activity remained in the reaction system containing 1000 mM.

NaCl. Furthermore, LacHa showed decolorization rates ranging from 90.28 to 100% for indigo carmine and two azo dyes without mediators, with wide pH (5.0–9.0) and temperature (25–65 °C) ranges.

Conclusions

In this study, LacHa was expressed and showed unusual properties, indicating its great application potential in textile industries or environmental fields.
The determination of epidermal growth factor in Edible bird's nest by enzyme-linked immunosorbent assay
Authors: Bai Weijuan , Deng Fenghong , Zhang Xiaojiang , Han Yanping , Xiao Yue’e , Wang Nan , Liu Xuncai , Fan Qunyan , Guo Baozhong
Published: June 2023

Edible bird's nest (EBN) is a traditional food which was nourishing and functional. Particularly, there is the epidermal growth factor (EGF) in EBN, which is thought to play an important role in promoting skin repair. However, the type and content of EGF in EBN were not determined yet. In this study, the type of EGF in EBN was identified as bird EGF by enzyme-linked immunosorbent assay and this method was validated to be accurate and precise. Moreover, it was found that the content of EGF in raw-unclean EBN, raw-clean EBN and stewed EBN was 3000 pg/g–4000 pg/g and there were no significant differences, which suggested that the batches, origins, forms, stewing temperatures and stewing times of EBN had no effect on the content of EGF in EBN. However, it was due to that enzyme destroyed the primary structure of EGF, the EGF content of neutral protease and trypsin hydrolysates of EBN was lower than that of flavor enzymes, alkaline protease and pepsin hydrolysates of EGF. This study was the first to determine the type and content of EGF in EBN, and provided a theoretical basis for the selection and processing of EBN and using EBN as a source of EGF.