bluuebunny/crossref_metadata_2025 huggingface dataset:
Re-scaling and small area estimation of behavioral risk survey guided by social vulnerability data
Authors: Stacy Shaina L. , Chandra Hukum , Guha Saurav , Gurewitsch Raanan , Brink Lu Ann L. , Robertson Linda B. , Wilson David O. , Yuan Jian-Min , Pyne Saumyadipta
Published: January 2023

Background

Local governments and other public health entities often need population health measures at the county or subcounty level for activities such as resource allocation and targeting public health interventions, among others. Information collected via national surveys alone cannot fill these needs. We propose a novel, two-step method for rescaling health survey data and creating small area estimates (SAEs) of smoking rates using a Behavioral Risk Factor Surveillance System survey administered in 2015 to participants living in Allegheny County, Pennsylvania, USA.

Methods

The first step consisted of a spatial microsimulation to rescale location of survey respondents from zip codes to tracts based on census population distributions by age, sex, race, and education. The rescaling allowed us, in the second step, to utilize available census tract-specific ancillary data on social vulnerability for small area estimation of local health risk using an area-level version of a logistic linear mixed model. To demonstrate this new two-step algorithm, we estimated the ever-smoking rate for the census tracts of Allegheny County.

Results

The ever-smoking rate was above 70% for two census tracts to the southeast of the city of Pittsburgh. Several tracts in the southern and eastern sections of Pittsburgh also had relatively high (> 65%) ever-smoking rates.

Conclusions

These SAEs may be used in local public health efforts to target interventions and educational resources aimed at reducing cigarette smoking. Further, our new two-step methodology may be extended to small area estimation for other locations and health outcomes.
Balance training benefits chronic ankle instability with generalized joint hypermobility: a prospective cohort study
Authors: Hou Zong-chen , Ao Ying-fang , Hu Yue-lin , Jiao Chen , Guo Qin-wei , Li Nan , Jiang Yan-fang , Jiang Dong
Published: January 2023

Background

Balance training is the first choice of treatment for chronic ankle instability (CAI). However, there is a lack of research on the effects of balance training in CAI with generalized joint hypermobility (GJH). This study is to compare the outcomes of balance training in CAI patients with and without GJH.

Methods

Forty CAI patients were assigned into the GJH group (Beighton ≥ 4, 20) and non-GJH group (Beighton < 4, 20) and they received same 3-month supervised balance training. Repeated measure ANOVA and independent t test were used to analyze self-reported questionnaires (Foot and ankle ability measure, FAAM), the number of patients experiencing ankle sprain, isokinetic muscle strength and postural control tests (Star excursion balance test, SEBT and Balance errors system, BES) before training, post-training immediately, and post-training 3 months, respectively.

Results

At baseline, no differences were found between groups with except for GJH group having poorer SEBT in the posteromedial direction (83.6 ± 10.1 vs 92.8 ± 12.3, %) and in the posterolateral direction (84.7 ± 11.7 vs 95.7 ± 8.7, %). Following the balance training, GJH group demonstrated lower re-sprain ratio (immediately after training, 11.1% vs 23.5%, 3 month after training, 16.7% vs 29.4%) than non-GJH group, as well as greater FAAM-S score, plantarflexion strength and dorsiflexion strength at post-training immediately and 3 months, and both groups improved similarly in the FAAM-A score, muscle strength and balance control (SEBT in the posterior-lateral and posterior-medial directions, and BES scores) compared with baseline.

Conclusions

CAI patients with GJH gained equally even better postural stability and muscle strength after the balance training than the non-GJH patients. Balance training could still be an effective treatment for CAI patients with GJH before considering surgery.

Trial registration

ChiCTR1900023999, June 21st, 2019.
Three nervous system-specific expressed genes are potential biomarkers for the diagnosis of sporadic amyotrophic lateral sclerosis through a bioinformatic analysis
Authors: Liao Yifu , Cai Haiping , Luo Feifei , Li Dongcheng , Li Hao , Liao Geng , Duan Jinhai , Xu Renshi , Zhang Xiong
Published: January 2023

Background

Amyotrophic lateral sclerosis (ALS) is the most common neurodegenerative disease in adults. However, ALS, especially sporadic ALS (sALS), is difficult to diagnose due to the lack of biomarkers.

Results

We used the bioinformatics technology to find the potential biomarker and we found that two hundred seventy-four DEGs were identified and enrichment analysis showed DEGs were involved in nervous system activity, like axon_guidance and the neurotrophin_signaling_pathway. Five nervous system-specific expressed hub genes were further validated by three GEO datasets. APP, LRRK2, and PSEN1 might be potential diagnostic and prognostic biomarkers of sALS, and NEAT1-miR-373-3p/miR-302c-3p/miR-372-3p-APP, circ_0000002-miR-302d-3p/miR-373-3p-APP and XIST-miR-9-5p/miR-30e-5p/miR-671-5p might be potential ceRNA regulatory pathways. APP SNP analysis showed subjects harboring the minor G allele of rs463946, minor G allele of rs466433 and minor C allele of rs364048 had an increased risk of sALS development.

Conclusions

Our results identified three nervous system-specific expressed hub genes that might be diagnostic and prognostic markers of sALS and APP might be a genetic susceptibility factor contributing to sALS development.
Deletion of Tbc1d4/As160 abrogates cardiac glucose uptake and increases myocardial damage after ischemia/reperfusion
Authors: Binsch C. , Barbosa D. M. , Hansen-Dille G. , Hubert M. , Hodge S. M. , Kolasa M. , Jeruschke K. , Weiß J. , Springer C. , Gorressen S. , Fischer J. W. , Lienhard M. , Herwig R. , Börno S. , Timmermann B. , Cremer A. L. , Backes H. , Chadt A. , Al-Hasani H.
Published: January 2023

Background

Type 2 Diabetes mellitus (T2DM) is a major risk factor for cardiovascular disease and associated with poor outcome after myocardial infarction (MI). In T2DM, cardiac metabolic flexibility, i.e. the switch between carbohydrates and lipids as energy source, is disturbed. The RabGTPase-activating protein TBC1D4 represents a crucial regulator of insulin-stimulated glucose uptake in skeletal muscle by controlling glucose transporter GLUT4 translocation. A human loss-of-function mutation in TBC1D4 is associated with impaired glycemic control and elevated T2DM risk. The study’s aim was to investigate TBC1D4 function in cardiac substrate metabolism and adaptation to MI.

Methods

Cardiac glucose metabolism of male Tbc1d4-deficient (D4KO) and wild type (WT) mice was characterized using in vivo [18F]-FDG PET imaging after glucose injection and ex vivo basal/insulin-stimulated [3H]-2-deoxyglucose uptake in left ventricular (LV) papillary muscle. Mice were subjected to cardiac ischemia/reperfusion (I/R). Heart structure and function were analyzed until 3 weeks post-MI using echocardiography, morphometric and ultrastructural analysis of heart sections, complemented by whole heart transcriptome and protein measurements.

Results

Tbc1d4-knockout abolished insulin-stimulated glucose uptake in ex vivo LV papillary muscle and in vivo cardiac glucose uptake after glucose injection, accompanied by a marked reduction of GLUT4. Basal cardiac glucose uptake and GLUT1 abundance were not changed compared to WT controls. D4KO mice showed mild impairments in glycemia but normal cardiac function. However, after I/R D4KO mice showed progressively increased LV endsystolic volume and substantially increased infarction area compared to WT controls. Cardiac transcriptome analysis revealed upregulation of the unfolded protein response via ATF4/eIF2α in D4KO mice at baseline. Transmission electron microscopy revealed largely increased extracellular matrix (ECM) area, in line with decreased cardiac expression of matrix metalloproteinases of D4KO mice.

Conclusions

TBC1D4 is essential for insulin-stimulated cardiac glucose uptake and metabolic flexibility. Tbc1d4-deficiency results in elevated cardiac endoplasmic reticulum (ER)-stress response, increased deposition of ECM and aggravated cardiac damage following MI. Hence, impaired TBC1D4 signaling contributes to poor outcome after MI.
Interventions to reduce cancer screening inequities: the perspective and role of patients, advocacy groups, and empowerment organizations
Authors: Richardson-Parry Afua , Baas Carole , Donde Shaantanu , Ferraiolo Bianca , Karmo Maimah , Maravic Zorana , Münter Lars , Ricci-Cabello Ignacio , Silva Mitchell , Tinianov Stacey , Valderas Jose M. , Woodruff Seth , van Vugt Joris
Published: January 2023

Background

Health inequities lead to low rates of cancer screening in certain populations, such as low-income and ethnic minority groups. Different interventions to address this have been developed with mixed results. However, interventions are not always developed in collaboration with the people they target. The aim of our article is to present the viewpoint of patients, survivors, advocates, and lay persons on interventions to increase cancer screening from a health inequity perspective.

Methods

We prepared talking points to guide discussions between coauthors, who included representatives from nine patient and survivor advocacy groups, organizations working for citizen/patient empowerment, and health equity experts. Perspectives and opinions were first collected through video conferencing meetings and a first draft of the paper was prepared. All authors, read through, revised, and discussed the contents to reach an agreement on the final perspectives to be presented.

Results

Several themes were identified: it is important to not view screening as a discrete event; barriers underlying an individual’s access and willingness to undergo screening span across a continuum; individually tailored interventions are likely to be more effective than a one-size fits-all approach because they may better accommodate the person’s personal beliefs, knowledge, behaviors, and preferences; targeting people who are unknown to medical services and largely unreachable is a major challenge; including professional patient advocacy groups and relevant lay persons in the cocreation of interventions at all stages of design, implementation, and evaluation is essential along with relevant stakeholders (healthcare professionals, researchers, local government and community organizations etc).

Conclusions

Interventions to address cancer screening inequity currently do not adequately solve the issue, especially from the viewpoint of patients, survivors, and lay persons. Several core pathways should be focused on when designing and implementing interventions: advancing individually tailored interventions; digital tools and social media; peer-based approaches; empowerment; addressing policy and system barriers; better design of interventions; and collaboration, including the involvement of patients and patient advocacy organizations.
Supplementation with sesame oil suppresses genotoxicity, hepatotoxicity and enterotoxicity induced by sodium arsenite in rats
Authors: Akinrinde Akinleye Stephen , Oyewole Stephen Oluwasemilore , Ola-Davies Olufunke Eunice
Published: January 2023

Background

Sesame oil, an edible essential oil, is known to be rich in unsaturated fatty acids, vitamins and lignans with several reported health-promoting benefits. Acute arsenic poisoning produces toxic hepatitis, bone marrow depression and adverse gastrointestinal responses. In this study, we investigated the protective effect of sesame seed oil (SSO) against genotoxicity, hepatotoxicity and colonic toxicity induced by sodium arsenite (SA) in Wistar rats.

Methods

Twenty-eight male Wistar albino rats were randomly allocated into four groups: control, SA only (2.5 mg/kg), SA + SSO (4 ml/kg) and SSO alone for eight consecutive days. Liver function and morphology, bone marrow micronuclei induction, colonic histopathology, mucus production and immune expression of Bcl-2, carcinoembryonic antigen (CEA), MUC1 and cytokeratins AE1/AE3 were evaluated.

Results

SA provoked increased serum activities of liver enzymes, including alanine aminotransferase (ALT) and aspartate aminotransferase (AST), and caused severely altered morphology of hepatic and colonic tissues with increased frequency of micronucleated polychromatic erythrocytes (MnPCEs/1000PCE) in the bone marrow. In addition, SA triggered increased expression of colonic CEA and MUC1 but weak Bcl-2 immunoexpression. However, cotreatment with SSO demonstrated protective activities against SA-induced damage, as indicated by significantly reduced serum ALT and AST, fewer micronucleated bone marrow erythrocytes and well-preserved hepatic and colonic morphologies compared to the SA-treated rats. Furthermore, SSO protected the colonic mucosa by boosting mucus production, elevating anti-apoptotic Bcl-2 expression and reducing CEA expression. GC–MS analysis of SSO revealed that it was predominated by linoleic acid, an omega-3 fatty acid, and tocopherols.

Conclusions

Our data indicated that SSO protected the liver, colon and bone marrow potentially via anti-inflammatory and anti-apoptotic activities. The data suggest that sesame oil has potential therapeutic applications against chemical toxicities induced by arsenic.
Identification and validation of pyroptosis-related gene landscape in prognosis and immunotherapy of ovarian cancer
Authors: Gao Lingling , Ying Feiquan , Cai Jing , Peng Minggang , Xiao Man , Sun Si , Zeng Ya , Xiong Zhoufang , Cai Liqiong , Gao Rui , Wang Zehua
Published: January 2023

Background

Emerging evidence has highlighted the biological significance of pyroptosis in tumor tumorigenesis and progression. Nonetheless, the potential roles of pyroptosis in tumor immune microenvironment and target therapy of ovarian cancer (OC) remain unknown.

Methods

In this study, with a series of bioinformatic and machine learning approaches, we comprehensively evaluated genetic alterations and transcriptome profiles of pyroptosis-associated genes (PYAGs) with TCGA-OV datasets. Consensus molecular clustering was performed to determine pyroptosis-associated clusters (PACs) and gene clusters in OC. Subsequently, component analysis algorithm (PCA) was employed to construct Pyrsig score and a highly accurate nomogram was established to evaluate its efficacy. Meanwhile, we systematically performed association analysis for these groups with prognosis, clinical features, TME cell-infiltrating characteristics, drug response and immunotherapeutic efficacy. Immunohistochemistry was conducted to verify molecular expression with clinical samples.

Results

The somatic mutations and copy number variation (CNV) of 51 PYRGs in OC samples were clarified. Two distinct PACs (PAC1/2) and three gene clusters (A/B/C) were identified based on 1332 OC samples, PAC1 and gene cluster A were significantly associated with favorable overall survival (OS), clinicopathological features and TME cell-infiltrating characteristics. Subsequently, Pyrsig score was successfully established to demonstrate the prognostic value and immune characteristics of pyroptosis in OC, low Pyrsig score, characterized by activated immune cell infiltration, indicated prolonged OS, increased sensitivity of some chemotherapeutic drugs and enhanced efficacy of anti-PD-L1 immunotherapy, Consequently, a nomogram was successfully established to improve the clinical applicability and stability of Pyrsig score. With clinical OC samples, GSDMD and GZMB proteins were validated highly expressed in OC and associated with immune infiltration and Pyrsig score, GZMB and CD8 proteins were regarded as independent prognostic factors of OC.

Conclusion

This work revealed pyroptosis played a non-negligible role in prognosis value, clinicopathological characteristics and tumor immune infiltration microenvironment in OC, which provided novel insights into identifying and characterizing landscape of tumor immune microenvironment, thereby guiding more effective prognostic evaluation and tailored immunotherapy strategies of OC.
LH level on ovulation trigger day has a different impact on the outcomes of agonist and antagonist regimens during in vitro fertilization
Authors: Luo Xi , Deng Bo , Li Lei , Ma Rui , Mai Xuancheng , Wu Ze
Published: January 2023

Background

To assess the impact of the luteinizing hormone level on ovulation trigger day (LHOTD) on in vitro fertilization (IVF) outcomes in gonadotropin-releasing hormone (GnRH) agonist and antagonist regimens during fresh embryo transfer cycles.

Methods

A stepwise, progressive multivariate regression model was introduced to assess the effect of the LHOTD on clinical pregnancy and live birth rates. Mantel‒Haenszel stratification analysis was used to examine the association between the LHOTD and clinical outcomes with the antagonist regimen.

Results

The LHOTD had different distributions in the agonist and antagonist regimens. The cycles were assigned into three LHOTD tertile groups. In the agonist regimen, compared with the 1st tertile (T1), in the 2nd (T2) and 3rd (T3) tertiles, the adjusted odds ratios (ORs) (95% confidence intervals [CIs], P value) were 1.187 (1.047–1.345, 0.007) and 1.420 (1.252–1.610, < 0.001) for clinical pregnancy, respectively, and 1.149 (1.009–1.309, 0.036) and 1.476 (1.296–1.681, < 0.001) for live birth. In the antagonist regimen, there was no significant difference in clinical pregnancy and live birth rates among the tertiles. However, in the stratified group of patients aged less than 35 years, the ORs (95% CIs, P value) of T2 and T3 were 1.316 (1.051–1.648, 0.017) and 1.354 (1.077–1.703, 0.009) for clinical pregnancy, respectively, and 1.275 (1.008–1.611, 0.043) and1.269 (0.999–1.611, 0.051) for live birth. Moreover, there was a discrepancy in the results among the subdivided LHOTD T1 groups adopting the antagonist regimen. Compared with that of the < 1.06 mIU/mL subgroup, the ORs (95% CIs, P value) of the > 1.5 mIU/mL subgroup were 1.693 (1.194–2.400, 0.003) for clinical pregnancy and 1.532 (1.057–2.220, 0.024) for live birth after eliminating potential confounders.

Conclusions

The LHOTD was profoundly suppressed in the agonist regimen, and its level was positively correlated with clinical pregnancy and live birth rates. In contrast, in the flexible antagonist regimen, the LHOTD was significantly higher than that in the agonist regimen and did not correlate with the outcome, except for women in the nonadvanced age group and those with an excessively suppressed LHOTD. Further investigation is required to determine the rationale for these findings.
Invasion of intestinal cells by Staphylococcus warneri, a member of the human gut microbiota
Authors: Louail Robin , Florin Franklin , Bernard Sophie , Michaud Jean-Baptiste , Breton Jonathan , Achamrah Najate , Tavolacci Marie-Pierre , Coëffier Moïse , Ribet David
Published: January 2023

Coagulase negative staphylococci (CoNS) are a heterogeneous group of bacteria that colonize different types of human epithelia. These bacteria have a highly variable pathogenic potential ranging from avirulent species to major nosocomial pathogens. Staphylococcus warneri is a CoNS species considered to be nonpathogenic. Here, we identify that S. warneri is a natural member of both human and mouse gut microbiota. In addition, we demonstrate that this bacterium is able to get internalized into human cells. We show that S. warneri efficiently invades several human cell types and, more specifically, intestinal epithelial cells, using actin-dependent mechanisms. In contrast to bona fide pathogens, S. warneri does not actively replicate within intestinal cells or resist killing by macrophages. Together, our results highlight that bacteria from the human gut microbiota that are not associated with a high pathogenic potential, can actively invade intestinal cells and may, in this way, impact intestinal physiology.
Clinical and financial impacts of abnormal liver biochemistry after liver transplantation
Authors: Lim Dee Zhen , Low Nicholas , Jackett Louise , Ma Ronald , Jones Robert , Testro Adam , Weinberg Laurence , Vijayaragavan Muralidharan
Published: January 2023

Objective

After liver transplant (LT), many investigations are needed to evaluate abnormal liver function test (LFT), which has poor specificity for graft function and complication. A single center retrospective audit of all adult single organ LT from 1/1/2015 to 31/12/2017 was performed. Demographic, clinical and investigation data from the LT database and electronic medical records and cost data from the hospital’s Business Intelligence Unit were analyzed. Patients were classified into uncomplicated or complicated LFT by 2 independent investigators and the number, type, and cost of investigations in the first 30 post-operative days were analyzed. Investigations prior to liver biopsy was sub-analyzed.

Results

There was 170 LT with 87 cases of uncomplicated LFT (51.2%) and 83 cases of complicated LFT (48.8%). Most patients with complicated LFT had additional investigations (97.6%), most commonly cholangiogram (55.4%) and liver biopsy (LBx) (50.6%). The additional investigations cost was $1863.3 (95% CI 1289.0–2437.6). Although most LBx (73.8%) showed evidence of rejection, LBx was often not the initial investigation of choice. Current LFT based post-transplant monitoring is inefficient. It remains difficult to determine which patient will benefit from an early invasive procedure like LBx, using LFT alone without further imaging investigations.
How does apolipoprotein E genotype influence the relationship between physical activity and Alzheimer’s disease risk? A novel integrative model
Authors: de Frutos Lucas Jaisalmer , Sewell Kelsey R. , García-Colomo Alejandra , Markovic Shaun , Erickson Kirk I. , Brown Belinda M.
Published: January 2023

Background

Wide evidence suggests that physical activity (PA) confers protection against Alzheimer’s disease (AD). On the other hand, the apolipoprotein E gene (APOE) ε4 allele represents the greatest genetic risk factor for developing AD. Extensive research has been conducted to determine whether frequent PA can mitigate the increased AD risk associated with APOE ε4. However, thus far, these attempts have produced inconclusive results. In this context, one possible explanation could be that the influence of the combined effect of PA and APOE ε4 carriage might be dependent on the specific outcome measure utilised.

Main body.

In order to bridge these discrepancies, the aim of this theoretical article is to propose a novel model on the interactive effects of PA and APOE ε4 carriage on well-established mechanisms underlying AD. Available literature was searched to investigate how PA and APOE ε4 carriage, independently and in combination, may alter several molecular pathways involved in AD pathogenesis. The reviewed mechanisms include amyloid beta (Aβ) and tau deposition and clearance, neuronal resilience and neurogenesis, lipid function and cerebrovascular alterations, brain immune response and glucose metabolism. Finally, combining all this information, we have built an integrative model, which includes evidence-based and theoretical synergistic interactions across mechanisms. Moreover, we have identified key knowledge gaps in the literature, providing a list of testable hypotheses that future studies need to address.

Conclusions

We conclude that PA influences a wide array of molecular targets involved in AD neuropathology. A deeper understanding of where, when and, most importantly, how PA decreases AD risk even in the presence of the APOE ε4 allele will enable the creation of new protocols using exercise along pharmaceuticals in combined therapeutic approaches.
Heparanase is the possible link between monkeypox and Covid-19: robust candidature in the mystic and present perspective
Authors: Al-Kuraishy Hayder M. , Al-Gareeb Ali I. , Hetta ‏Helal F. , Alexiou Athanasios , Papadakis Marios , Batiha Gaber El-Saber
Published: January 2023

Heparanase (HPSE) is an endoglycosidase cleaves heparan sulfate (HS) and this contributes to the degradation and remodeling of the extracellular matrix. HS cleaved by HPSE induces activation of autophagy and formation of autophagosommes which facilitate binding of HPSE to the HS and subsequent release of growth factors. The interaction between HPSE and HS triggers releases of chemokines and cytokines which affect inflammatory response and cell signaling pathways with development of hyperinflammation, cytokine storm (CS) and coagulopathy. HPSE expression is induced by both SARS-CoV-2 and monkeypox virus (MPXV) leading to induction release of pro-inflammatory cytokines, endothelial dysfunction and thrombotic events. Co-infection of MPX with SARS-CoV-2 may occur as we facing many outbreaks of MPX cases during Covid-19 pandemic. Therefore, targeting of HPSE by specific inhibitors may reduce the risk of complications in both SARS-CoV-2 and MPXV infections. Taken together, HPSE could be a potential link between MPX with SARS-CoV-2 in Covid-19 era.
Current advances in noninvasive methods for the diagnosis of oral squamous cell carcinoma: a review
Authors: Wang Shan , Yang Mao , Li Ruiying , Bai Jie
Published: January 2023

Oral squamous cell carcinoma (OSCC), one of the most common types of cancers worldwide, is diagnosed mainly through tissue biopsy. However, owing to the tumor heterogeneity and other drawbacks, such as the invasiveness of the biopsy procedure and high cost and limited usefulness of longitudinal surveillance, there has been a focus on adopting more rapid, economical, and noninvasive screening methods. Examples of these include liquid biopsy, optical detection systems, oral brush cytology, microfluidic detection, and artificial intelligence auxiliary diagnosis, which have their own strengths and weaknesses. Extensive research is being performed on various liquid biopsy biomarkers, including novel microbiome components, noncoding RNAs, extracellular vesicles, and circulating tumor DNA. The majority of these elements have demonstrated encouraging clinical outcomes in early OSCC detection. This review summarizes the screening methods for OSCC with a focus on providing new guiding strategies for the diagnosis of the disease.
Comparison of the effect of oral and vaginal misoprostol on labor induction: updating a systematic review and meta-analysis of interventional studies
Authors: Rahimi Maryam , Haghighi Ladan , Baradaran Hamid Reza , Azami Mobin , Larijani Samaneh Saghafian , Kazemzadeh Paniz , Moradi Yousef
Published: January 2023

Objectives

This study is aimed to compare the effect of oral misoprostol with vaginal misoprostol to induce labor as a systematic review and meta-analysis.

Methods

Electronic databases including PubMed [Medline], Scopus, Web of science, Embase, Ovid, Cochrane library, and ClinicalTrials.gov were searched using the relevant keywords. All RCTs comparing the effect of oral vs vaginal misoprostol on labor induction were considered. The Cochrane Risk of Bias checklist was used for assessing quality of included RCTs. All statistical analyses were completed using STATA (Version 16) and Revman (Version 5).

Results

Thirty-three RCTs with 5162 patients (1560 in oral and 2602 in vaginal groups) were included in this meta-analysis. Labor induction length did differ significantly between the two routes of misoprostol administration [Standardized Mean Difference: 0.40 h, 95% confidence interval (CI) 0.34, 0.46; I2: 66.35%; P = 0.04]. In addition, the risk of neonatal death, tachysystole, uterine hyperstimulation, preeclampsia, non-FHR and abortion was lower in the oral misoprostol group and the risk of hypertonus, PROM, oxytocin need and cesarean fever was higher in this group than the vaginal misoprostol group.

Conclusions

Based on results of this meta-analysis, it can be inferred that currently, clinical specialists can decide to use this drug orally or vaginally on a case-by-case basis, depending on the condition of the pregnant mother and the baby.
Therapeutic potential of mesenchymal stem/stromal cells (MSCs)-based cell therapy for inflammatory bowel diseases (IBD) therapy
Authors: Saadh Mohamed J. , Mikhailova Maria V. , Rasoolzadegan Soheil , Falaki Mojgan , Akhavanfar Roozbeh , Gonzáles José Luis Arias , Rigi Amir , Kiasari Bahman Abedi
Published: January 2023

Recently, mesenchymal stem/stromal cells (MSCs) therapy has become an emerging therapeutic modality for the treatment of inflammatory bowel disease (IBD), given their immunoregulatory and pro-survival attributes. MSCs alleviate dysregulated inflammatory responses through the secretion of a myriad of anti-inflammatory mediators, such as interleukin 10 (IL-10), transforming growth factor-β (TGFβ), prostaglandin E2 (PGE2), tumor necrosis factor-stimulated gene-6 (TSG-6), etc. Indeed, MSC treatment of IBD is largely carried out through local microcirculation construction, colonization and repair, and immunomodulation, thus alleviating diseases severity. The clinical therapeutic efficacy relies on to the marked secretion of various secretory molecules from viable MSCs via paracrine mechanisms that are required for gut immuno-microbiota regulation and the proliferation and differentiation of surrounding cells like intestinal epithelial cells (IECs) and intestinal stem cells (ISCs). For example, MSCs can induce IECs proliferation and upregulate the expression of tight junction (TJs)-associated protein, ensuring intestinal barrier integrity. Concerning the encouraging results derived from animal studies, various clinical trials are conducted or ongoing to address the safety and efficacy of MSCs administration in IBD patients. Although the safety and short-term efficacy of MSCs administration have been evinced, the long-term efficacy of MSCs transplantation has not yet been verified. Herein, we have emphasized the illumination of the therapeutic capacity of MSCs therapy, including naïve MSCs, preconditioned MSCs, and also MSCs-derived exosomes, to alleviate IBD severity in experimental models. Also, a brief overview of published clinical trials in IBD patients has been delivered.
How temperatures derived from fluid flow and heat transport models impact predictions of deep geothermal potentials: the “heat in place” method applied to Hesse (Germany)
Authors: Koltzer Nora , Bott Judith , Bär Kristian , Scheck-Wenderoth Magdalena
Published: January 2023

One key aspect in the energy transition is to use the deep geothermal energy stored in sedimentary basins as well as in igneous and metamorphic basement rocks. To estimate the variability of deep geothermal potentials across different geological domains as encountered in the Federal State of Hesse (Germany), it is necessary to understand the driving processes of fluid flow and heat transport affecting subsurface temperature variations. In this study, we quantify the stored energy in a set of geological units in the subsurface of Hesse with the method of “heat in place” (HIP, sensu Muffler and Cataldi in Geothermics 7:53–89, 1978)—HIP is one proxy for the geothermal potential of these units controlled by their temperature configuration as derived from a series of coupled 3D thermo-hydraulic numerical models. We show how conductive, advective and convective heat transport mechanisms influence the thermal field and thereby the HIP calculations. The heterogeneous geology of the subsurface of Hesse ranges from locally outcropping Paleozoic basement rocks to up to 3.8 km thick Cenozoic, porous sedimentary deposits in the tectonically active northern Upper Rhine Graben. The HIP was quantified for five sedimentary layers (Cenozoic, Muschelkalk, Buntsandstein, Zechstein, Rotliegend) as well as for the underlying basement. We present a set of maps allowing to identify geothermally prospective subregions of Hesse based on the laterally varying thermal energy stored within the units. HIP is predicted to be highest in the area of the northern Upper Rhine Graben in the Cenozoic unit with up to 700 GJ $$\text {m}^{-2}$$

m

-
2

and in the Rotliegend with up to 617 GJ $$\text {m}^{-2}$$

m

-
2

. The calculations account for the variable thicknesses and temperatures of the layers, density and heat capacity of the solid and fluid parts of the rocks as well as porosity.
Thermophilic bacteria and their thermozymes in composting processes: a review
Authors: Finore Ilaria , Feola Antonio , Russo Ludovica , Cattaneo Andrea , Di Donato Paola , Nicolaus Barbara , Poli Annarita , Romano Ida
Published: January 2023

In this review, the composting process of organic waste is discussed through an in-depth exploring of its thermophilic phase. It starts with the highlight on the thermodynamic evolution, which needs to be assessed when deciding to use reactors for composting, also in the context of energy generation. The composting process is mediated by different types of microorganisms, and the bacteria that play key roles are evaluated. The roles of the generaBacillusandThermusare considered, often described as the main components of the microbiota of compost. Due to their adaptation to the composting processes, they are candidates for technological purposes. Subsequentially, the focus is moved on the thermostable enzymes that can be isolated from them and their succession during the composting processes. Experimental examples of enzyme-related literature are reviewed, for example investigating proteases and ureases, which are found at the beginning of the process. In addition, cellulases, hemicellulases, lignin-modifying enzymes, and esterases have been described for their activities during the thermophilic phase, giving them great potential for biotechnological and industrial applications. Following, the composition of the microbial community is analyzed through the description of approaches of metagenomics. Despite it being a relatively new but fast-growing field within biology, it is intended to be a priority analysis to acquire knowledge on genomes of environmental microorganisms and communities. Finally, a space is dedicated to the description of the composting plant which treats olive oil wastes within the LIFE TIRSAV PLUS project (LIFE05 ENV/IT/00845). Through two plant solutions, being the Dynamic and the Static Composting, it provides a high-quality compost with an effective, flexible and economical process.

Graphical Abstract
Deep learning-enhanced nuclear medicine SPECT imaging applied to cardiac studies
Authors: Apostolopoulos Ioannis D. , Papandrianos Nikolaos I. , Feleki Anna , Moustakidis Serafeim , Papageorgiou Elpiniki I.
Published: January 2023

Deep learning (DL) has a growing popularity and is a well-established method of artificial intelligence for data processing, especially for images and videos. Its applications in nuclear medicine are broad and include, among others, disease classification, image reconstruction, and image de-noising. Positron emission tomography (PET) and single-photon emission computerized tomography (SPECT) are major image acquisition technologies in nuclear medicine. Though several studies have been conducted to apply DL in many nuclear medicine domains, such as cancer detection and classification, few studies have employed such methods for cardiovascular disease applications. The present paper reviews recent DL approaches focused on cardiac SPECT imaging. Extensive research identified fifty-five related studies, which are discussed. The review distinguishes between major application domains, including cardiovascular disease diagnosis, SPECT attenuation correction, image denoising, full-count image estimation, and image reconstruction. In addition, major findings and dominant techniques employed for the mentioned task are revealed. Current limitations of DL approaches and future research directions are discussed.
Neuropathology of yellow fever autopsy cases
Authors: Frassetto Fernando Pereira , Rosemberg Sergio
Published: January 2023

Background

Yellow fever is a viral hemorrhagic fever caused by yellow fever virus, a mosquito-borne flavivirus. Despite an effective vaccine, major outbreaks continue to occur around the world. Even though it is not a proven neurotropic virus, neurological symptoms in more severe clinical forms are frequent. The understanding of this apparent paradox is still rarely addressed in literature.

Methods

The brains of thirty-eight patients with yellow fever confirmed by RT-PCR, who underwent autopsy, were analyzed morphologically to identify and characterize neuropathological changes. The data were compared with brains collected from individuals without the disease, as a control group. Both cases and controls were subdivided according to the presence or absence of co-concurrent septic shock, to exclude changes of the sepsis associated encephalopathy. To verify possible morphological differences between the yellow fever cases groups, between the control groups, and between the cases and the controls, we applied the statistical tests Fisher's exact test and chi-square, with p values < 0.05 considered statistically significant.

Results

All cases and controls presented, at least focally, neuropathological changes, which included edema, meningeal and parenchymal inflammatory infiltrate and hemorrhages, and perivascular inflammatory infiltrate. We did not find an unequivocal aspect of encephalitis. The only parameter that, after statistical analysis, can be attributed to yellow fever was the perivascular inflammatory infiltrate.

Conclusions

The neuropathological findings are sufficient to justify the multiple clinical neurologic disturbances detected in the YF cases. Since most of the parameters evaluated did not show statistically significant difference between cases and controls, an explanation for most of the neuropathological findings may be the vascular changes, consequent to shock induced endotheliopathy, associated with stimulation of the immune system inherent to systemic infectious processes. The statistical difference obtained in yellow fever cases regarding perivascular infiltrate can be can be explained by the immune activation inherent to the condition.
A case report: extracorporeal membrane oxygenation for multitrauma patient with pneumorrhagia
Authors: Meng Qiang , Ji Changwei , Ma Zhen , Chen Bo wang , Zhang Hao , Li Jun , Cong Lin , Qu Feng , Gao Shuhong
Published: January 2023

Background

Extracorporeal membrane oxygenation (ECMO) can be used as salvage therapy for multitrauma patients with acute respiratory distress syndrome (ARDS) when conventional treatment fails to maintain oxygenation. However, controversy exists between ECMO application and the risk of bleeding due to systemic anticoagulation during the treatment. Non-heparin introduction seems to be a possible solution for this dilemma, owing to technical improvements in the device and management methods of ECMO.

Case presentation

A 58-year-old woman suffered from blunt thoracic, pelvic, and right lower limb fractures due to a falling accident, which resulted in acute respiratory distress syndrome (ARDS). Although the patient received intubation and mechanical ventilation (MV), respiratory failure was not alleviated. Venous-venous (V-V) ECMO was used as a salvage therapy. With the support of V-V ECMO, we safely cleared blood clots in the bronchus and avoided secondary lung injury caused by pressure trauma and oxygen poisoning of the MV. We introduced heparin-free ECMO management as a solution to reduce the risk of bleeding associated with pulmonary contusion and other organ injuries. To prevent thrombosis, we set the blood rate of ECMO to 4.0 L/min, which is much higher than the usual parameter. During ECMO, coagulation factors, such as prothrombin time, activated partial thromboplastin time, and D-dimer, were examined. ECMO was maintained for 5 days without any complications; MV was stopped on the 13th day, extubated on the 24th day, and discharged from ICU on the 28th day.

Conclusion

ECMO with non-heparin could be an optimal treatment for multitrauma patients with ARDS when traditional treatment cannot sustain oxygenation. High blood flow rate could prevent thrombosis through ongoing ECMO therapy without systemic anticoagulation. In addition, monitoring D-dimer value change (Δ D-dimer) may be better than D-dimer value in predicting clot formation in the membrane oxygenator.
Clinician Perspectives on Barriers and Enablers to Implementing an Inpatient Oncology Early Warning System: A Mixed-Methods Study
Authors: Lyons Patrick G. , Chen Vanessa , Sekhar Tejas C. , McEvoy Colleen A. , Kollef Marin H. , Govindan Ramaswamy , Westervelt Peter , Vranas Kelly C. , Maddox Thomas M. , Geng Elvin H. , Payne Philip R.O. , Politi Mary C.
Published: January 2023

PURPOSE

To elicit end-user and stakeholder perceptions regarding design and implementation of an inpatient clinical deterioration early warning system (EWS) for oncology patients to better fit routine clinical practices and enhance clinical impact.

METHODS

In an explanatory-sequential mixed-methods study, we evaluated a stakeholder-informed oncology early warning system (OncEWS) using surveys and semistructured interviews. Stakeholders were physicians, advanced practice providers (APPs), and nurses. For qualitative data, we used grounded theory and thematic content analysis via the constant comparative method to identify determinants of OncEWS implementation.

RESULTS

Survey respondents generally agreed that an oncology-focused EWS could add value beyond clinical judgment, with nurses endorsing this notion significantly more strongly than other clinicians (nurse: median 5 on a 6-point scale [6 = strongly agree], interquartile range 4-5; doctors/advanced practice providers: 4 [4-5]; P = .005). However, some respondents would not trust an EWS to identify risk accurately (n = 36 [42%] somewhat or very concerned), while others were concerned that institutional culture would not embrace such an EWS (n = 17 [28%]). Interviews highlighted important aspects of the EWS and the local context that might facilitate implementation, including (1) a model tailored to the subtleties of oncology patients, (2) transparent model information, and (3) nursing-centric workflows. Interviewees raised the importance of sepsis as a common and high-risk deterioration syndrome.

CONCLUSION

Stakeholders prioritized maximizing the degree to which the OncEWS is understandable, informative, actionable, and workflow-complementary, and perceived these factors to be key for translation into clinical benefit.
Hypofractionation in Breast Cancer Radiotherapy Across World Bank Income Groups: Results of an International Survey
Authors: Mushonga Melinda , Weiss Jessica , Liu Zhihui Amy , Nyakabau Anna-Mary , Mohamad Osama , Tawk Bouchra , Moraes Fabio Y. , Grover Surbhi , Yap Mei Ling , Zubizarreta Eduardo , Lievens Yolande , Rodin Danielle
Published: January 2023

PURPOSE

Hypofractionated breast radiotherapy has been found to be equivalent to conventional fractionation in many clinical trials. Using data from the European Society for Radiotherapy and Oncology Global Impact of Radiotherapy in Oncology survey, we identified preferences for hypofractionation in breast cancer across World Bank income groups and the perceived facilitators and barriers to its use.

MATERIALS AND METHODS

An international, electronic survey was administered to radiation oncologists from 2018 to 2019. Demographics, practice characteristics, preferred hypofractionation regimen for specific breast cancer scenarios, and facilitators and barriers to hypofractionation were reported and stratified by World Bank income groups. Variables associated with hypofractionation were assessed using multivariate logistic regression models.

RESULTS

One thousand four hundred thirty-four physicians responded: 890 (62%) from high-income countries (HICs), 361 (25%) from upper-middle–income countries (UMICs), 183 (13%) from low- and lower-middle–income countries (LLMICs). Hypofractionation was preferred most frequently in node-negative disease after breast-conserving surgery, with the strongest preference reported in HICs (78% from HICs, 54% from UMICs, and 51% from LLMICs, P < .001). Hypofractionation for node-positive disease postmastectomy was more frequently preferred in LLMICs (28% from HICs, 15% from UMICs, and 35% from LLMICs, P < .001). Curative doses of 2.1 to < 2.5 Gy in 15-16 fractions were most frequently reported, with limited preference for ultra-hypofractionation, but significant variability in palliative dosing. In adjusted analyses, UMICs were significantly less likely than LLMICs to prefer hypofractionation across all curative clinical scenarios, whereas respondents with > 1 million population catchments and with intensity-modulated radiotherapy were more likely to prefer hypofractionation. The most frequently cited facilitators and barriers were published evidence and fear of late toxicity, respectively.

CONCLUSION

Preference for hypofractionation varied for curative indications, with greater acceptance in earlier-stage disease in HICs and in later-stage disease in LLMICs. Targeted educational interventions and greater inclusivity in radiation oncology clinical trials may support greater uptake.
Long-Term Cangrelor Administration in Neurology Intensive Care: A Case Series
Authors: Duranteau Olivier , Abdennour Lamine , Drir Mehdi , Clarencon Frederic , Frère Corinne , Jacquens Alice , Degos Vincent
Published: January 2023

Cangrelor is a P2Y12 inhibitor antiplatelet agent, with a rapid onset and offset. The available literature only reviews short-term administration over a few hours. We describe 5 patients who received cangrelor for >1 month in a neurosurgical intensive care unit due to a very high likelihood of requiring emergency revision surgery. Despite multiple therapeutic interruptions for surgical procedures, no hemorrhagic events occurred, and there was only one transient ischemic event, which occurred during transition from cangrelor to ticagrelor. Cangrelor can be a therapeutic option for patients with a high likelihood of requiring revision neurosurgery after intracranial stenting.
Telescoping Nasal Intubation for Carotid Endarterectomy: A Case Series
Authors: McDowell Brittany J. , Sharma Sonal
Published: January 2023

Systemic anticoagulation is a relative contraindication for performing nasal intubation due to the risk of hazardous bleeding. However, nasal intubation may sometimes be the only way to facilitate surgical exposure. There are currently no recommendations in the literature to safely perform nasal intubation in anticoagulated patients. This case series describes 4 patients, all receiving systemic anticoagulation for carotid endarterectomy, who received nasal intubation using a telescoping approach. None of them had any epistaxis. Telescoping the endotracheal tube using a red rubber catheter may be an effective and safe method for nasal intubation when there is a high risk of epistaxis.