bluuebunny/crossref_metadata_2025 huggingface dataset:
Tumor-associated microbiota in colorectal cancer with vascular tumor-thrombus and neural invasion and association with clinical prognosis
Authors: Li Mingjie , Jin Min , Zhao Lei , Yu Dandan , Li Yan , Shi Linli , Zhou Bin , Liu Li , Cao Yinghao , Cai Kailin , Nie Xiu , Zhang Tao , Liu Hongli
Published: January 2023

Background
Neural invasion (NI) and vascular tumor thrombus (VT) are associated with poor prognosis in patients with colorectal cancer (CRC). But little is known about the changes of gut microbiota in CRC tissues with invasion. In this study, we applied 16S rRNA amplicon sequencing to tumor tissues and adjacent normal tissues in patients with CRC to determine the microbial differences.
Results
A discovery cohort (n = 88), including 30 patients with NI, 23 with VT, and 35 with double-negative CRC tissue, was utilized. We analyzed the relationship between the differential bacterial taxa and survival prognosis in an analysis cohort (n = 82) and explored the association of the special microorganisms with the clinical characteristics in an expanded cohort (n = 286) as well as their association with the survival prognosis in the overall cohort (n = 329). In the discovery cohort, the diversity, composition, and metabolic pathways of the gut microbiome distinctly differed between the tumor and non-tumor tissues in the NI and VT groups. Compared with the species richness of the microbiota communities of the noninvasive tumor tissues of the double-negative group, that of the tumor tissues of the NI and VT groups decreased. At the genus level, the four dominant bacteria in the NI and VT groups were Cupriavidus, Acinetobacter, Sphingobium, and Thermus. A high abundance of Cupriavidus was found to be related to a short survival time of NI CRC in the Kaplan–Meier analysis. Simultaneously, Herbaspirillum was a potential microbial biomarker predicting the prognosis of patients with CRC with NI or VT. Moreover, an abundance of Cupriavidus was associated with the NI status, pN stage, and clinical stage, while that of Herbaspirillum was related to the tumor diameter, NI status, pN stage, distant metastasis, and clinical stage. In the overall cohort, a high abundance of Cupriavidus and Herbaspirillum also indicated a poor prognosis.
Conclusion
This study is the first to comprehensively elaborate the differences in the gut microbiota of patients with CRC with different invasion statuses and to prove the relationship between some gut microbiota and clinical patient characteristics.
Development and evaluation of Novel krill oil based Clomiphene Microemulsion as a therapeutic strategy for PCOS treatment
Authors: PANCHAL DARSHITA , PANDYA TOSHA , KEVLANI VIJAY , SHAH SHREERAJ , Acharya Sheetal
Published: January 2023

Polycystic ovary syndrome (PCOS) is frequently diagnosed
hormonal disorder with reproductive and metabolic complications.
The most common symptoms include cyst in ovaries, anovulation,
insulin resistance, and obesity. Clomiphene citrate, an ovulating
agent, is the first-line drug used to treat PCOS. We hypothesized
that clomiphene citrate, by stimulating ovarian function, with
krill oil used as an oil phase to improve solubility, by addressing
PCOS-associated symptoms might be effective in PCOS. Hence, our
goal was to target hormonal imbalance along with PCOS-associated
symptoms using single formulation. The concentration of water (X1),
oil (X2) and Smix(surfactant-cosurfactant mixture) (X3) were
selected as independent variables, in a simplex lattice design,
from microemulsion area derived from pseuodoternary phase diagram
while the globule size (Y1) was selected as dependent parameter.
The optimized microemulsion showed good sphericity having 41 nm
globule size, 0.32 Poly dispersibility index and + 31mV zeta
potential. The optimized microemulsion was further evaluated
in-vivo using letrozole induced PCOS rats. Formulation
treated group reversed the effect of letrozole on body weight and
oestrus cycle in comparison to disease control group
(p < 0.001). The formulation was also effective in reducing
insulin resistance, cholesterol and serum testosterone level
(p < 0.001). The in-vivo results were supported by
histopathological studies where formulation treated group showed a
marked decrease in the number of cystic follicles and a remarkable
increase in the number of growing follicles at variable stages,
similar to the normal control group. Thus, the results confirmed
that novel krill oil based clomiphene microemulsion may become
promising therapeutic choice for treatment of PCOS.
Exploring the Role of HaTIPs Genes in Enhancing Drought Tolerance in Sunflower
Authors: Safdar Tania , Tahir Muhammad Hammad Nadeem , Ali Zulfiqar , Rahman Muhammad Habib ur
Published: January 2023

Background: Activity of plant aquaporins (AQPs) is extremely sensitive to environmental variables such as temperature, drought atmospheric vapor pressure deficit, cell water status and also appears to be closely associated to expressions of plant tolerance to various stresses. The spatial and temporal expression patterns of genes of Tonoplast Intrinsic Proteins (TIPs) in various crops indicates the complex and diverse regulation of these proteins and are important in understanding their key role in plant growth, development and stress responses.
Methods and Results: Based on phylogenetic analysis, six distinct HaTIPs were selected for studying their spatial and temporal expression in sunflower (Helianthus annuus). In this study semi quantitative polymerase chain reaction (semi q-PCR) and real time polymerase chain reaction (q-PCR) analysis were used to study the spatial and temporal expression of HaTIPsin sunflower. The results indicated that all of HaTIPs showed differential expression specific to both the tissues and the accessions. Moreover, the expression of all HaTIPs was higher in cross compared to the parents. Results of semi q-PCR and real time PCR indicated an upregulation of expression of HaTIP-RB7 and HaTIP7 in drought tolerant entries at 12 hours of 20 % polyethylene glycol (PEG) treatment compared to 0 hour.
Conclusion: Hence these genes can be utilized as potential target in improving water use efficiency and for further genetic manipulation for the development of drought tolerant sunflower. This study may further contribute to our better understanding regarding the precise role of HaTIPsthrough their spatial and temporal expression analysis and their application in sunflower drought stress responses.
Cost aware strategies for sensitivity enhancement in a SARS-CoV-2 antigen test prototype: insertion of a cotton intermembrane doubles analytical sensitivity
Authors: Nicollete Diego Rinaldi Pavesi , Benedetti Rafael , Valença Beatriz Arruda , Kuniyoshi Keyla Kaori , de Jesus Thainá Caroline Schuartz , Gevaerd Ava , Santiago Erika Bergamo , de Almeida Bernardo Montesanti Machado , Júnior Sérgio Renato Rogal , Figueredo Marcus Vinícius Mazega
Published: January 2023

Lateral flow antigen tests have been widely used in the Covid-19 pandemic, allowing faster diagnostic test results and preventing further viral spread through isolation of infected individuals. Accomplishment of this screening must be performed with tests that show satisfactory sensitivity in order to successfully detect the target protein and avoid false negatives. The aim of this study was to create a lateral flow test that could detect SARS-CoV-2 nucleocapsid protein in low concentrations that were comparable to the limits of detection claimed by existing tests from the market. To do so, several adjustments were necessary during research and development of the prototypes until they were consistent with these criteria. The proposed alternatives of increasing the test line antibody concentration and addition of an intermembrane between the conjugate pad and the nitrocellulose membrane were able to increase the sensitivity four-fold and generate a new rapid test prototype called “lateral flow intermembrane immunoassay test” (LFIIT). This prototype showed an adequate limit of detection (2.0 ng mL− 1) while maintaining affordability and simplicity in manufacturing processes.
Treatment persistence of bictegravir/emtricitabine/tenofovir alafenamide and efavirenz+lamivudine+tenofovir disoproxil among HIV-1 patients newly starting treatment in China
Authors: Jing Cao , Wei Tang , Ning Wang , Fang Zheng , Gang Xiao , Wang Xingzhi , Guoqiang Zhou , Min Wang
Published: January 2023

Background: Though bictegravir/emtricitabine/tenofovir (BIC/TAF/TAF) have been regulatory approved and included in the National Reimbursement Drug List in China, due to the affordability concern, generic version of efavirenz+lamivudine+tenofovir (EFV+3TC+TDF) is still recommended as the 1st-line therapy in the clinical guideline and widely used in clinical practice. The aim of the study is to assess the persistence with 1st-line BIC/TAF/TAF and EFV+3TC+TDF in newly treated HIV-1 patients in the real-world setting in China.
Methods: A retrospective analysis of the medical records of HIV patients initiating 1st-line antiretroviral therapy in the First Hospital of Changsha in January 1st, 2021-July 31st, 2022 was conducted. Persistence was assessed as the number of days on the therapy from the index until treatment discontinuation or end of data availability. Kaplan-Meier Curves and Cox Proportional Hazard models were used to evaluate the discontinuation rates. Subgroup analysis was performed excluding BIC/FTC/TAF patients with treatment discontinuation due to economic reason, and EFV+3TC+TDF patients with a viral load >500,000 copies/mL.
Results: A total of 310 eligible patients were included in the study, with 244 and 66 patients in the BIC/FTC/TAF group and EFV+3TC+TDF group, respectively. Compared with EFV+3TC+TDF patients, BIC/FTC/TAF patients were significantly younger and had significantly higher total cholesterol and low-density level (all p<0.05). No significant difference was shown in the time to discontinuation between BIC/FTC/TAF patients and EFV+3TC+TDF patients. After excluding BIC/FTC/TAF patients with treatment discontinuation due to economic reason, EFV+3TC+TDF group were shown to have a significantly higher risk of discontinuation than BIC/FTC/TAF group (hazard ratio [HR] = 9.6, 95% confidence interval [CI]=1.2-74.2). After further removing the EFV+3TC+TDF patients with a viral load>500,000 copies/mL, the analysis showed similar results (HR=9.7, 95% CI = 1.2 - 76.9). 79.4% of the EFV+3TC+TDF patients discontinued treatment due to clinical reasons, while 83.3% of the BIC/FTC/TAF patients discontinued treatment due to economic reasons.
Conclusions: Compared with BIC/FTC/TAF, EFV+TDF+3TC patients were significantly more likely to discontinue the 1st-line treatment.
Measuring Ecological Vulnerability Status of Chongqing Using Deep Learning Algorithms
Authors: Wu Junyi , Liu Hong , Li Tong , Ou-Yang Yuan , Zhang Jing-Hua , Zhang Teng-Jiao , Huang Yong , Gao Wen-Long , Shao Lu
Published: January 2023

The ecological environment is the welfare of human survival. With the global climate change in recent years, the deterioration of the ecological environment has exceeded any time. The purpose of this study is to evaluate the ecological vulnerability of Chongqing, China, and draw an ecological vulnerability map. The study screened the impact factors by information gain ratio, and finally considered 16 ecological vulnerability impact factors, using multilayer perception (DNN) and convolutional neural network (CNN) methods to model vulnerability. A total of 1200 ecological points were recorded by remote sensing images, field survey and local data, and divided into training set and test set according to the ratio of 7: 3. Finally, two ecological vulnerability status maps were produced. The DNN and CNN models were evaluated by receiver operating characteristic curve (ROC), area under curve (AUC), mean absolute error (MAE) and root mean square error (RMSE). The results showed that the ecological vulnerability evaluation effect of CNN (AUC = 0.926) was better than that of DNN (AUC = 0.888). Calculate the contribution rate of vulnerability impact factors to different model results by random forests. The results show that the highest contribution rate of the two models are geological factors. It can be understood that the relative ecological vulnerability of Chongqing is mainly affected by its own karst landform. The areas with high vulnerability in the study area are the northeast and southeast regions, as well as the mountain valleys and urban in the central and western regions. The main ecological problems are low forest quality and unreasonable structure caused by its own geological factors, and serious rocky desertification and soil erosion. Human activities, including deforestation, over-reclamation and stone mining, are also important factors contributing to the ecological vulnerability of the study area. The machine learning method of this study creates an appropriate and accurate ecological vulnerability status map, which can support the future ecological environment protection and governance decisions in the study area.
Effectiveness of a community-based intervention in improving cardio-metabolic risk factors in adults with Metabolic Syndrome: A Randomized Controlled Trial.
Authors: Okube Okubatsion Tekeste , Kimani Samuel Thou , Waithira Mirie
Published: January 2023

Background Cardiovascular diseases (CVDs) are disproportionately burdened the low- and middle-income countries (LMICs), where awareness and detection rates remain low. Community-based approaches addressing health behaviors including diet, regular physical activity and not smoking cigarettes have all been proved to substantially reduce the risk of CVDs in the high-income countries. However, their effects in improving cardio-metabolic risk factors in adults with Metabolic Syndrome in the LMICs remains unknown. Objective This study aimed to evaluate the effectiveness of community-based lifestyle intervention in improving cardio-metabolic risk factors among adults with MetS. Methods This was a randomized controlled trial study conducted for a period of 15-months among adults with MetS. Eligible individuals (n = 352) were randomly allocated to either the control or the intervention group on 1:1 ratio. The treatment arm received World Health Organization recommended lifestyle intervention that encouraged physical activity and healthy diet through face-to-face contacts. The control group received usual medical care involved drug treatment and general medical advice. Anthropometric, clinical and biochemical measurements as well as lifestyle characteristics were assessed before and 12-months after the intervention. The measurements were compared between and within the groups during analyses using chi-square test, independent t-test and paired t-test. Results The changes in lifestyle characteristics have been reported elsewhere [31]. Relative to the baseline values and the control group, the intervention group experienced significant average reductions in body weight (-4.6 vs -0.4 kgs, p = 0.027), body mass index (-1.6 vs -0.14, p = 0.012), waist circumference (-2.29 vs -0.12 cm, p = 0.019), waist hip ratio (-0.02 vs -0.0, P = 0.003), waist height ratio (-0.01 vs 0.0, p = 0.015), systolic BP (-4.06 vs + 0.24 mmHg, p = 0.025), diastolic BP (-2.4 vs – 0.23 mmHg, p = 0.033), fasting blood glucose (− 0.5 vs + 0.08 mmol/L; p < 0.001), Triglycerides (-0.33 vs -0.01 mmol/L, p = 0.006), and an increase in high-density lipoprotein cholesterol (+ 0.25 vs + 0.02 mmol/L; p < 0.001) at the end-line. Conclusion Community-based lifestyle intervention comprised diet and physical activity significantly improved cardio-metabolic risk factors in adults with MetS. Population-based screening and adoption of a healthy lifestyle should be considered for the prevention, reduction, and treatment of cardio-metabolic risk factors in the LMICs. The strategy could be implemented through nurses and community health workers.
Prevalence of Visual Impairment and Substance Use Disorders and, Their Association with Road Traffic Accident among Drivers of Public Transportation In Jimma Zone, South West Ethiopia
Authors: Debebe Wondwosen , Berhanu Hiwot , Reta Wondu , Bariso Moyeta , Mulat Elias , Kenenisa Chala , Sadik Mohammed Ibrahim , Alenko Arefayne , Tolesa Kumale , Girma Betemariam , Tareke Amare Abera
Published: January 2023

Introduction:Around 4500 Ethiopians die every year due to Road Traffic Accidents (RTAs). Various factors contributed for high prevalence as well as fatality of RTAs in Ethiopia including the road safety, the vehicles condition, the driver’s condition, the legislation and its implementation. Driver related factors collectively including visual impairment and substance use contribute for 82% RTAs. Although there are various measures to intervene RTAs, the magnitude of visual impairment and substance use disorders among drivers of public transportation in Jimma Zone are not known objectively.Objective: The main aim of the present study was to assess magnitude of visual impairment and substance use disorders and, their association with road traffic accident among drivers of public transportation in Jimma Zone.Methodology:Cross sectional study design was employed among 398 licensed drivers. Drivers were approached while waiting their turn using systematic random sampling technique. Interviewer-administered questionnaire and measurement of visual functions were used for data collection. Data were entered toEpi-data 4.4.1 and exported to Statistical Package for Social sciences (SPSS) version 25 for statistical analysis. Both descriptive and inferential statistics were used.Results:In the present study prevalence of self-reported road traffic accident (RTA) for the last one year was 35.7% (95% CI=31.02% to 40.38%). Among drivers, sixteen (4%) and 28 (7%) of them had color vision abnormality and subnormal depth perception respectively.Conclusion and Recommendation: In conclusion, the present study revealed that there were statistically significant association between RTA and, severe khat use disorder, moderate alcohol use disorder, stereopsis abnormality, work schedule, color vision and marital status of drivers. There were also statistically significant association between age of drivers and occurrence of road traffic accident.We suggest eye examination in drivers whose age is greater than fifty years. We recommend transport authority officials to use efforts to tackle the use of substances among drivers and night driving.
Levels, trends and predictors of unintended pregnancy among adolescents and young women aged 15-14 in India: An analysis from NFHS-4 and 5 Survey
Authors: Sharma Himani , Singh Shrikant
Published: January 2023

Background
Unintended pregnancy is an important reproductive health issue among women. Little is known about the prevalence of unintended pregnancy and its associated factors among Indian adolescents and young women in India. The present study aims to determine the prevalence of unintended pregnancy, its association with sociodemographic and behavioural characteristics and identify the important determinants among female adolescents and young women aged 15–24 in India from NFHS-4 to 5.
Methods
Data from the fourth and fifth rounds of the National Family Health Survey conducted in 2015-16 and 2019–2021 are used for the analysis. Ever-married adolescents and young women of age 15–24 who have given at least one birth in the last 5 years were taken into the analysis with a finalized sample of 62,079 women in NFHS-4 and 53,635 women in NFHS-5. Univariate and bivariate analysis was used to examine the association of unintended pregnancy with the explanatory variables. Further, a binary logistic regression analysis was employed to identify the predictors of unintended pregnancy among adolescents and young women aged 15–24 from NFHS-4 to 5.
Results
The results revealed that at least seven per cent of the pregnancies during both surveys (NFHS-4 & 5) were unintended in India. The trend shows a slight increase (7.29–7.52%) in unintended pregnancy among adolescents and young women aged 15–24 from NFHS-4 to NFHS-5. Covariates like age, religion, education, region, birth in last five years, the ideal number of children, knowledge of the ovulatory cycle, heard about family planning, interaction with family planning worker, age at birth and unmet need put forth a strong influence upon unintended pregnancy in India. In contrast, factors like wealth index, media exposure, body mass index and caste were not significant predictors of unintended pregnancy in India.
Conclusions
The present study discloses that unintended pregnancy among adolescents and young women is a significant obstacle to achieving commendable reproductive health in India. The study reports important findings which can be beneficial for the policymakers and health care providers to formulate target-based programmes to reduce unintended pregnancy among the young population in India.
Application of bayesian networks in web services: a scoping review
Authors: Guinhouya Kouami A.
Published: January 2023

Context. Web services (WSs) are the preferred approach in realizing the service-oriented computing paradigm. However, this comes with challenges like complexity and uncertainty. Bayesian networks (BNs) are one of the techniques used to deal with these challenges.
Objective. This study aims to determine and describe what is known about the use of BNs in WSs research.
Methods. Using the scoping review method, we selected 69 (among the 532 identified) articles published on the subject (2001-2021). These articles were classified by research themes (What), research objectives (Why), and the types of bayesian network used (How).
Results. The research themes explored are, in order of importance, Service composition, Service management, and Service engineering. In terms of research objectives, the articles mainly focused on Prediction, Description, and Prescription. Finally, the types of BNs used are Basic, Combined, and Extended BNs.
Conclusion. This review offers a first structured picture of the use of BNs in WSs. Its results can help researchers and practitioners interested in the subject.
Effects of anterior approach to quadratus lumborum block on postoperative cognitive function following hip surgery in elderly patients: A randomized controlled clinical trial
Authors: Zhu Manhua , Mei Yuliu , Zhou Ruifen , Wang Lingzhi , Zhang Xiaoyan
Published: January 2023

Background: Peripheral nerve block, including the quadratus lumborum block (QLB), has been used for postoperative analgesia in hip surgery. However, the effects of QLB on cognitive function after hip surgery remain unknown. This study aimed to assess the effects of the anterior approach to QLB on postoperative cognitive function in elderly patients undergoing hip surgery.
Methods: Sixty elderly patients who underwent hip surgery from May 2021 to May 2022 were randomly divided into the QLB (n = 30) and control groups (n = 30). The Montreal Cognitive Assessment (MoCA) score was measured one day preoperatively and seven and 30 days postoperatively. The incidence of postoperative cognitive dysfunction (POCD) was examined seven and 30 days postoperatively. The visual analog scale (VAS) scores at rest and Bruggrmann comfort scale (BCS) scores 6 h (t1), 12 h (t2), 24 h (t3), and 48 h (t4) after surgery were assessed. The plasma high mobility group box protein 1 (HMGB1) and levels of interleukin-6 (IL-6) were evaluated 1 h preoperatively (baseline) and 24 h postoperatively (day 1). The requirement for rescue analgesia, time to first off-bed activity, and adverse effects after surgery were also recorded.
Results: Compared with the control group, the incidence of POCD was significantly lower in the QLB group seven days postoperatively (10.7% vs. 34.5%, P = 0.033), but no difference at 30 days postoperatively (3.6% vs. 10.3%, P = 0.317). There was no significant difference in MoCA scores between the two groups at one day preoperatively and 30 days postoperatively. However, the MoCA scores at seven days postoperatively were higher in the QLB group than in the control group (P < 0.05). In the QLB group, the VAS scores at t1, t2, and t3 were lower, and the BCS scores at t1, t2, and t3 were higher than those in the control group (P < 0.05). The patients in the QLB group reported significantly fewer requirements for rescue analgesia (P < 0.05). The plasma levels of HMGB1 and IL-6 at 24 h postoperatively in the QLB group were significantly lower than in the control group (P < 0.05). The time to first off-bed activity was shorter in the QLB group (P < 0.05). There was no significant difference in the incidence of postoperative complications between the two groups.
Conclusions: Anterior QLB given to elderly patients undergoing hip surgery could promote early postoperative cognitive function recovery, provide adequate postoperative analgesia, and inhibit the release of inflammatory factors.
Trial registration: Chictr.org.cn identifier ChiCTR2000040724 (Date of registry: 08/12/2020, prospectively registered).
Postgraduate OB-GYN Training Programme Evaluation in Lao PDR Using the CIPP Model
Authors: CHANTHALANGSY Panima , Yeh Byung-il , Choi Sung Jin , Park Yon Chul
Published: January 2023

Background: The obstetrics and gynaecology (OB-GYN) residency training programme in Lao People’s Democratic Republic (PDR) began in 2003 based on the Millennium Development Goals (MDGs) and ‘Reproductive, maternal, newborn, and child health interventions (RMNCH) strategies and action plan’. However, a proper evaluation of the training programme was not conducted previously. This study aims to evaluate the postgraduate OB-GYN residency training programme in Lao PDR and identify the current problems and suggest a future plan.
Method: The context, input, process and product classification was used to develop criteria and indicators. A mixed research method was adopted for this study. To capture instructional material for quantitative analysis, a Google survey with 38 items and a t-test was used to determine a significant difference in responses between residents and lecturers(N = 120). Based on qualitative analysis, in depth interview was done (four questions based on study outcomes, including satisfaction, strengths and weaknesses and future opportunities) with six interviews provided different viewpoints on the course. The SPSS software program was used to measure validity and p-values = 0.05.
Results: The overall average response rate was 97.5%. Two significant differences in the programme perspectives were revealed between lecturers and residents, difficulties in maintaining the course (professors 3.66 ± 1.03 and residents 3.27 ± 0.98, p = 0.04) and learning outcomes achieved (professors 3.57 ± 0.85 and residents 3.14 ± 0.95, p = 0.01).
overall average under 3.00 on the questionnaire of the context part included the overlapped learning outcome and the difficulties in maintaining the course. The input part, lack of the classroom, skills lab and staff; the process part, lecturer to collect student opinions and the product part on learning outcomes.
Conclusion: Curriculum improvement based on the programme evaluation results, i.e. regular evaluation and feedback, will advance the residency training programme based on the RMNCH strategy and will contribute to the promotion of maternal health in the Lao PDR.
CTLA4 protects against maladaptive cytotoxicity during differentiation of effector and follicular CD4+ T cells
Authors: Cook Matthew , Hao Yuwei , Miraghazadeh Bahar , Chand Rochna , Davies Ainsley , Cardinez Chelisa , Kwong Kristy , Downes Morgan , Sweet Rebecca , Cañete Pablo , D’Orsogna Lloyd , Fulcher David , Choo Sharon , Yip Desmond , Peters Geoffrey , Yip Sonia , Witney Matthew , Nekrasov Maxim , Feng Zhi-Ping , Tscharke David , Vinuesa Carola
Published: January 2023

As chronic antigenic stimulation from infection and autoimmunity are features of primary antibody deficiency (PAD), analysis of affected patients could yield insights into T cell differentiation, and explain how environmental exposures modify clinical phenotypes conferred by single gene defects. CD57 marks dysfunctional T cells that have differentiated after antigenic stimulation. Indeed, while CD57+ CD4+ T cells are normally rare in the circulation, we found that they are increased in patients with PAD, and markedly by CTLA4 haploinsufficiency or blockade. We performed single-cell RNA-seq analysis of matched CD57+ CD4+ T cells from blood and tonsil. Circulating CD57+ CD4+ T cells (CD4cyt) exhibit a cytotoxic transcriptome similar to CD8+ effectors, can kill B cells, and inhibit B cell responses. CTLA4 restrains the formation of CD4cyt. While CD57 also marks an abundant subset of follicular helper T cells, which is consistent with their antigen-driven differentiation, this subset has a precursor of exhaustion transcriptomic signature marked by TCF7, TOX, ID3, and constitutive expression of CTLA4, and are robust to becoming cytotoxic even after CTLA4 inhibition. Thus, CD57+ CD4+ T cell phenotypes of cytotoxicity and exhaustion are compartmentalized between blood and germinal centres. CTLA4 is a key modifier of CD4+ T cell cytotoxicity, and the pathological CD4cyt phenotype is accentuated in CTLA4 deficiency by the environmental stimulus of infection.
Perspectives of adults living with HIV attending the opportunistic infections clinic at Chitungwiza Central Hospital in Zimbabwe towards Physical activity: -A Cross- sectional study
Authors: Kaseke Farayi , Pamire Precious R , Mlambo Tecla , Nhunzvi Clement
Published: January 2023

Background
Regular physical activity and exercise have been shown to be of benefit in managing the HIV disease, its complications and the side effects of HAART. The perceptions of those living with HIV toward physical activity and exercises is a key factor in advocating for participation of rehabilitation personnel in the management of this disease. However, this domain remains underexplored in Zimbabwe
Methods
A descriptive cross-sectional quantitative study was conducted with 327 people living with HIV. participants. Participants were consecutively sampled from Chitungwiza Central Hospital Opportunistic Clinic. The International Physical Activity Questionnaire (IPAQ) and the Exercise Benefits/Barriers Scale (EBBS) were respectively used to measure the physical activity level and perceived benefits/barriers of physical exercise among adults living with HIV. The tools were self-administered. The analyses were done for 323 participants using the Statistical Package for the Social Sciences (SPSS) version 21.
Results
The mean age was 41.1 ± 11.0. Females constituted n = 225; (69.7%) of the sample. The majority of participants (n = 184; 57%) described themselves as being highly physically active (3204(IQR = 2139–4441 MET-minutes/week). Most of the participants agreed that physical activity prevented heart attacks with a mean value of 3.34 ± 0.65. The majority perceived psychological outlook as the greatest benefit from physical activity among the benefit sub-scales. Furthermore, most of the participants agreed that it cost too much for them to exercise which had a mean of 3.00 ± 0.88. Family discouragement was the most agreed perceived barrier to physical activity with a mean of 2.91 ± 0.67. Those who perceived physical activity as being beneficial reported less barriers. A statistically significant association was found between level of physical activity and CD4 (p = 0.035) cell count as well as with employment status (p = 0.000). No statistically significant association was reported between the perceived benefits and the level of physical activity (p = 0.214). A statistically significant association was reported between the perceived barriers and age (p = 0.000) as well as with employment status (p = 0.006).
Conclusion
Adults living with HIV receiving HAART at Chitungwiza Central Hospital are highly active when compared to other studies done in Sub-Saharan Africa. It is also important to create interventions that promote physical activity considering what this population considers as perceived benefits and barriers to physical activity.
Clustering of Physical Activity, Sedentary Behavior, and Diet Associated With Social Isolation Among Brazilian Adolescents
Authors: MATIAS THIAGO SOUSA , Alves Julianne Fic , Nienov Gislaine Terezinha Amaral , Lopes Marcus Vinicius Veber , Vasconcellos Diego Itibere Cunha
Published: January 2023

Backgound: Although obesogenic behaviors have been found to be related to social isolation, evidence-based person-centered approaches are lacking. This study investigated the association between clusters of obesogenic behavior – derived from a data-driven process – and social isolation among Brazilian adolescents.
Methods: Data from the National Adolescent School-based Health Survey (PeNSE) 2015 Cohort were analyzed. A total of 100,794 9th-grade students (51.3% females; 14.3 ± 0.1 years old) enrolled in 3,040 public and private high schools participated in the study. Social isolation was assessed by two outcomes (i.e., perceived loneliness and lack of close friends). A two-step cluster analysis was conducted to identify patterns of obesogenic behaviors with the input of leisure-time physical activity (PA), sitting time as a proxy of sedentary behavior (SB), and the weekly consumption of healthy and unhealthy food. Crude and adjusted binary logistic regression models were applied to evaluate the associations between the clusters of obesogenic behaviors and social isolation variables in adolescents. Results: Three clusters were identified. Adolescents in the “Health-promoting SB and diet” (32.6%; OR = 0.69; 95% CI=0.62-0.76) and “Health-promoting PA and diet” (44.9%; OR = 0.73; 95% CI = 0.67-0.79) clusters had lower odds of loneliness compared to those in the “Health-risk” cluster (22.5%). Those belonging to the “Health-promoting PA and diet” cluster were more likely to report having close friends (OR=1.19; 95% CI = 1.00-1.41) than those in the “Health-risk” cluster.
Conclusion: Adolescents in clusters where positive behaviors outweighed negative ones were less likely to perceive themselves as lonely and without close connections.
The balance between lung regulatory T cells and Th17 cells is a risk indicator for the acute exacerbation of interstitial lung disease after surgery: a case control study
Authors: Fukui Mariko , Harada Norihiro , Takamochi Kazuya , Hayashi Takuo , Matsunaga Takeshi , Hattori Aritoshi , Kawagoe Izumi , Suzuki Kenji
Published: January 2023

Background: Acute exacerbation (AE) of interstitial lung disease (ILD) (AE-ILD) is a life-threatening condition and the leading cause of 30-day mortality among patients who underwent pulmonary resection for lung cancer in Japan. This study was conducted to clarify the characteristics of the immune environment of lung tissue before the onset of AE-ILD.
Methods: This retrospective matched case-control study comparing the immune phenotype of helper T cells in the lung from patients with and without AE-ILD after surgery was conducted in 135 patients who underwent surgical resection for lung cancer and were pathologically diagnosed with ILD at our institute between 2009 and 2018. Thirteen cases of AE-ILD and 122 cases without AE (non-AE) were matched using a propensity score analysis, and 12 cases in each group were compared. We evaluated the percentage of T helper (Th)1, Th2, Th17, regulatory T cells (Treg), and CD8 cells in CD3+ T cells and the Th1:Th2, Th17: Treg, and CD8: Treg ratios in AE patients by immunostaining of lung tissue in the non-tumor area.
Results: We found a significant difference in the lung Th17: Treg ratio between the AE and non-AE groups (1.47 and 0.79, p = 0.041). However, we detected no significant differences in the percentages of lung Th1 (21.3% and 29.0%), Th2 (34.2% and 42.7%), Th17 (22.3% and 21.6%), Treg (19.6% and 29.1%), and CD8+ T cells (47.2% and 42.2%) of CD3+ T cells between the AE and non-AE groups.
Conclusion: The ratios of Th17: Treg cells in the lung from the AE group were higher than those in the non-AE group.
Clinical Trial Registration: This study was approved by the ethics committee of our institute (2016095).
Developing a Training Program Based on the CIPP Model for Junior Caregivers in Nursing Homes: A Modified Delphi Study
Authors: Wang Lingling , Chen Mengxia , Dou Yinxia , Wang Gaoxia , Zhang Lingjuan , Qiao Mengting
Published: January 2023

Background: To alleviate the burden of aging, China has built many nursing homes and hired many people with no prior caregiving experience. However, there is little professional training program for junior caregivers, and standard programs are required to train those new to improve the quality of care. This study aims to develop and implement a training program for junior elderly caregivers based on the Context, Input, Process, and Product (CIPP) model.
Objectives: This study aimed to develop a standardized training program based on the CIPP model for junior elderly caregivers in nursing homes.
Methods:
A literature review, interviews with 208 junior elderly caregivers in 6 nursing homes, and semi-structured interviews with 8 clinical experts were conducted to develop an initial training framework. Then, the two-round Delphi method was employed to get a consensus on the framework through an online questionnaire.
Results:
A two-round Delphi expert consultation was done, and a consensus on four domains and 14 secondary items, and 66 tertiary training items of the professional framework were achieved. The framework domains included training objectives (3 secondary items and 20 tertiary items), training management (5 secondary items and 13 tertiary items), training content(3 secondary items and 27 tertiary items) and training evaluation(3 secondary items and 6 tertiary items).
Conclusion:
This CIPP-based training program offers guidelines for junior caregivers in nursing homes. Future research should focus on the length of the program and its long-term effects to prepare qualified junior elderly caregivers.
Construction and Validation of a Coagulation Factor-Related Prognostic Model for Colorectal Cancer Based on the Public Database
Authors: Xu Hong-kai , Han Shao-liang , Lu Hao-feng , Dai Rui-shuai , Han Sai-yi , Xie Wei-dong
Published: January 2023

Background:Colorectal cancer is one of the most common malignant cancers in the world, which is a serious threat to human health with increasingly diagnosed cases every year.It has been reported that coagulation factors play an important role in various cancer. However, the role of coagulation factor-related genes in colorectal cancer remains unknown.
Methods: Gene expression data with clinical information of colorectal cancer samples were downloaded from the TCGA (The Cancer Genome Atlas) database and Gene Expression Omnibus (GEO) database, respectively. The coagulation factor-related prognostic model was constructed based on univariate, LASSO, and multivariate Cox regression analysis. In addition, colorectal cancer patients were classified into different subtypes according to non-negative matrix factorization (NMF) analysis. The nomogram and calibration curves were plotted to validate the accuracy of the coagulation factor-related prognostic model.Finally, the proportion of the infiltrating immune cells in different risk groups was analyzed by using immune cell infiltration
Results: Seven coagulation factor-related genes were screened out to establish a prognostic model. The risk score of each colorectal cancer sample was calculated by the product of each prognostic coagulation factor-related gene with prognostic value and the corresponding gene expression of each prognostic coagulation factor-related gene. Patients with colorectal cancer were classified into high- and low-risk groups according to the median risk score. Survival curves indicated that colorectal cancer patients in the high-risk group had a worse prognosis both in the training set, internal validation set, and external validation set. Colorectal cancer patients were divided into three subtypes (subtype C1, subtype C2, and subtype C3) according to the optimal number of clusters. The nomogram we established was accurate to predict the overall survival of colorectal cancer patients. The Sankey plot suggested that colorectal cancer patients in the subtype C2 and low-risk group had a better prognosis. Finally, immune cell infiltration analysis indicated that macrophages might play an important role in the development of colorectal cancer.
Conclusion: The coagulation factor-related prognostic model was established based on STIM1, PLCB1, MAPK12, F2RL2, C8G, C9, and ADCY5. The colorectal cancer patients were divided into three subtypes, including subtype C1, subtype C2, and subtype C3. These findings might provide novel therapeutic strategies for the treatment of patients with colorectal cancer.
Regional variations in distribution, diagnosis and treatment of chronic pancreatitis in the mainland China: a systematic review of case articles over 40 years
Authors: Wang Wei , Jiang Weisong , Shu Meng , Luo Liying , Liu Ao , Pan Xunke , Liu Jingjing , Wang Chong , Cao Yizhi , Wu TungChing , Liu Pengyi , Xv Junyao , Zhou Yiran
Published: January 2023

BACKGROUND: Epidemiological data regarding the regional differences in chronic pancreatitis (CP) from the mainland of China is lacking. We aimed to gather and combine the information concerning the regional distribution and the risk factors associated with pancreatic cancer (PaCa) and death from published articles.
METHODSː:Case articles on CP published in seven databases from January 1979 to December 2018 were analysed.
RESULTS: A total of 4,452 cases articles (containing 161,243 CP cases) were included. Since the mid-1990s, the number of published articles grew rapidly, which was significantly related to the gross domestic product of the region. In recent years, the number of CP cases of idiopathic etiology, those receiving endoscopic treatment, those with comorbid diabetes mellitus and the number of Science Citation Index (SCI) case articles have increased. Surgical treatment (37.4%) was closely associated to alcoholic CP (r = 0.55, P = 0.000), idiopathic CP (r = 0.52, P = 0.000), wasting (r = 0.21, P = 0.000), jaundice (r = 0.27, P = 0.000), PaCa and death detected during hospitalization and follow-up, and was more common in underdeveloped areas. Endoscopic therapy (27.9%) was mainly concentrated in developed areas, associated with non-alcoholic CP and a higher incidence of death (r = 0.48, P = 0.000) and PaCa (r = 0.3, P = 0.000) during follow-up. The total number of PaCa in CP cases was significantly related to the number of PaCa cases in each region (r = 0.94, P = 0.002). PaCa detected during hospitalization was mainly related to jaundice, pain, diabetes, biliary diseases, alcoholic CP, conservative treatment and surgical treatment.
CONCLUSIONS: The distribution of clinical features and management treasures showed obvious regional characteristics, which closely related to the local detection level of CP and PaCa, showing that there were likely to be many cases of misdiagnosis or delayed diagnosis of CP and PaCa. The problem of uneven distribution of medical resources, which related to the imbalance of economic and social development, needs to be resolved.
Bromocriptine for Central Hyperthermia after Acute Brain Injury: A Retrospective Cohort Study
Authors: Amin Suneri , Aghajan Yasmin , Webb Andrew
Published: January 2023

Introduction

Bromocriptine is a dopamine receptor agonist used in clinical practice for central hyperthermia with limited published data. We sought to describe the patient population treated with bromocriptine for central hyperthermia and report the most common dosing regimens, efficacy, and reasons for discontinuation of therapy.

Methods

This was a retrospective cohort study conducted at a single academic Level 1 Trauma Center and advanced comprehensive stroke center. Patients were 18 years and older, admitted to the neurocritical or surgical/trauma intensive care units for acute neurological emergencies, and were administered bromocriptine to manage central fevers between April 2016 and September 2022. Baseline characteristics, disease severity markers, and bromocriptine doses during ICU admission were collected. The highest body temperature in the 8 hours prior to the first dose of bromocriptine as well as at the time of dose and every hour for up to 6 hours after each dose were recorded. Hyperthermia was defined as a recorded temperature of ≥ 38.3°C. Potential bromocriptine responsiveness was defined as resolution of hyperthermia at 1- or 2-hours post-bromocriptine administration. Coadministration of additional therapies for fever management or paroxysmal sympathetic hyperactivity (PSH) and confounding therapies were noted.

Results

30 patients were included with a mean age of 45 (± 17.3) years. Patients were 70% male and 67% Caucasian. The most common diagnosis was TBI (N = 14) followed by SAH (N = 6), and median admission GCS was 5.5 (IQR 3.0-10.8). Median cumulative daily dose was 8mg (IQR 5–15, range 2.5–60). There was a paired mean difference of -0.37°C (p = 0.005) between the average temperature prior to bromocriptine initiation and after initiation. Potential responsiveness was observed after 41% of doses at 1 hour and 62% of doses at 2 hours. All patients received at least one other therapy for management of fevers or PSH and at least one potentially confounding therapy. The most common reason for discontinuation was resolution of indication (N = 14). Discontinuation due to mild adverse effects occurred in 4 patients.

Conclusion

Bromocriptine is a potential therapy for management of central hyperthermia in patients with acute neurologic emergencies for severely critically ill patients who have failed other therapies. There was a small but statistically significant decrease in average temperature pre- and post-administration of bromocriptine. Results may have been confounded by administration of additional medications and other antipyretics.
Dna Barcoding: Efficiency of Rbcl Gene for Sequence Characterisation of Cyperus Esculentus in Nigeria
Authors: Bello Ridwan Opeyemi , Ojokoh Anthony Okhonlaye , Babalola Deborah , Shonde. Temitope Esther , Towobola Funmilayo Mary
Published: January 2023

Background Plants have been classified based on morphological traits. However, there are biases associated with this classification. The limitation can be prevented by using DNA barcoding. Therefore, the efficiency of the Ribulose -bisphosphate carboxylase (rbcL) marker was investigated to identify Tiger Nut (Cyperus esculentus), which belongs to the family of Cyperaceae. In this study,C. esculentussamples were collected from two villages in northern Nigeria. For DNA barcoding, the rbcL region ofC. esculentussamples were amplified, sequenced in both directions, and subsequently analysed. The amplified sequences' biological sequence homology, sequence divergence, and phylogenetic tree construction were studied using Basic Local Alignment Tool (BLAST), Codon Code Aligner and MEGA X respectively. Results A 100% identity of rbcL locus with several other Cyperus species was obtained from BLAST result. The region seems highly conserved among several Cyperus species as variation within this marker locus’s sequence is minimal. However, a G/T variation at a nucleotide position could differentiate the tested samples from 40% of the other data bank species. The phylogenetic tree analysis clustered the 20 samples and the retrieved sequences based on the very few sequence variations without distinctly separatingC. esculentussamples from other Cyperus species. Conclusions These findings showed that rbcL marker could only identify our samples up to genius level. Therefore, other DNA barcoding markers are needed to identify and characteriseC. esculentussince the characterization based on rbcL gene sequences conducted in this work could not identifyC. esculentusup to the species level.