1
|
Cao LC, Ha LNN, Giang TT, Tiep VM, Chau NTM, Phuong Anh TN, Duy PK, Nhan LP, Hoai NTT, Linh LTK, Hafza N, Bock CT, My TN, Sy BT, Toan NL, Song LH, Velavan TP. Characterization of zoonotic hepatitis E virus in domestic pigs and wild boar in Vietnam: Implications for public health. One Health 2024; 19:100857. [PMID: 39077329 PMCID: PMC11284544 DOI: 10.1016/j.onehlt.2024.100857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 07/08/2024] [Accepted: 07/08/2024] [Indexed: 07/31/2024] Open
Abstract
Vietnam's unprecedented demand for meat from livestock, including pigs and farmed wildlife, underscores the importance of understanding zoonotic reservoirs for hepatitis E virus (HEV). This study aimed to identify and characterize circulating zoonotic HEV in domestic pigs and wild boar to understand genotype frequencies, transmission dynamics, and associated human health burdens. Rectal swabs, feces, and liver samples from 415 pigs and 102 wild boars were collected across various farms and slaughterhouses in central and southern Vietnam and screened for HEV RNA using nested PCR. HEV RNA-positive samples underwent sanger sequencing and genotyping. Overall, 10% (n = 54/517) of samples were HEV RNA-positive, with wild boars exhibiting the highest HEV positivity rate at 25%, followed by domestic pigs at 7%. Southern Vietnam showed a higher HEV RNA positivity rate (20%) compared to central Vietnam (7%). Notably, rectal swabs demonstrated the highest positivity rate (15%), followed by feces (8%) and liver (4%). HEV-3a was the predominant genotype at 85%, followed by HEV-4b at 9% and HEV-3f at 6%. While HEV-3a was distributed across both central and southern Vietnam, HEV-3f was exclusively detected in central Vietnam, and HEV-4b was identified in wild boar in southern Vietnam. These findings underscore the substantial prevalence of HEV in wild boars, emphasizing their potential as crucial zoonotic reservoirs alongside domestic pigs. Further investigations involving occupationally exposed individuals in high-prevalence areas are warranted to evaluate the human health impact of zoonotic hepatitis E and inform preventive measures. Regular epidemiological studies are imperative for assessing the prevalence and transmission of zoonotic HEV infections among common reservoirs, thereby aiding in the prevention of spillover events within the community.
Collapse
Affiliation(s)
- Le Chi Cao
- Institute of Tropical Medicine, University of Tübingen, 72074, Tübingen, Germany
- Department of Parasitology, Hue University of Medicine and Pharmacy (HUMP), Hue University, 49000 Hue, Viet Nam
| | - Le Nguyen Nhat Ha
- School of Biotechnology, International University, Vietnam National University Ho Chi Minh City, 70000 Ho Chi Minh City, Viet Nam
| | - Tran Thi Giang
- Department of Parasitology, Hue University of Medicine and Pharmacy (HUMP), Hue University, 49000 Hue, Viet Nam
| | - Vo Minh Tiep
- Department of Parasitology, Hue University of Medicine and Pharmacy (HUMP), Hue University, 49000 Hue, Viet Nam
| | - Ngo Thi Minh Chau
- Department of Parasitology, Hue University of Medicine and Pharmacy (HUMP), Hue University, 49000 Hue, Viet Nam
| | - Ton Nu Phuong Anh
- Department of Parasitology, Hue University of Medicine and Pharmacy (HUMP), Hue University, 49000 Hue, Viet Nam
| | - Pham Khanh Duy
- School of Biotechnology, International University, Vietnam National University Ho Chi Minh City, 70000 Ho Chi Minh City, Viet Nam
| | - Le Phuc Nhan
- School of Biotechnology, International University, Vietnam National University Ho Chi Minh City, 70000 Ho Chi Minh City, Viet Nam
| | - Nguyen Thi Thu Hoai
- School of Biotechnology, International University, Vietnam National University Ho Chi Minh City, 70000 Ho Chi Minh City, Viet Nam
- Research Center for Infectious Diseases, International University, Vietnam National University Ho Chi Minh City, 70000, Ho Chi Minh City, Viet Nam
| | - Le Thi Kieu Linh
- Institute of Tropical Medicine, University of Tübingen, 72074, Tübingen, Germany
| | - Nourhane Hafza
- Institute of Tropical Medicine, University of Tübingen, 72074, Tübingen, Germany
| | - C. Thomas Bock
- Division of Viral Gastroenteritis and Hepatitis Pathogens and Enteroviruses, Department of Infectious Diseases, Robert Koch Institute, 13353 Berlin, Germany
| | - Truong Nhat My
- Vietnamese-German Center for Medical Research (VG-CARE), 10000 Hanoi, Viet Nam
- 108 Military Central Hospital, 10000 Hanoi, Viet Nam
| | - Bui Tien Sy
- Vietnamese-German Center for Medical Research (VG-CARE), 10000 Hanoi, Viet Nam
- 108 Military Central Hospital, 10000 Hanoi, Viet Nam
| | - Nguyen Linh Toan
- Vietnamese-German Center for Medical Research (VG-CARE), 10000 Hanoi, Viet Nam
- Vietnam Military Medical University, 10000 Hanoi, Viet Nam
| | - Le Huu Song
- Vietnamese-German Center for Medical Research (VG-CARE), 10000 Hanoi, Viet Nam
- 108 Military Central Hospital, 10000 Hanoi, Viet Nam
| | - Thirumalaisamy P. Velavan
- Institute of Tropical Medicine, University of Tübingen, 72074, Tübingen, Germany
- Vietnamese-German Center for Medical Research (VG-CARE), 10000 Hanoi, Viet Nam
- Faculty of Medicine, Duy Tan University, 55000 Da Nang, Viet Nam
| |
Collapse
|
2
|
Ahern Z, Corry P, Rabbani W, Paz A. Multi-objective extensive hypothesis testing for the estimation of advanced crash frequency models. ACCIDENT; ANALYSIS AND PREVENTION 2024; 206:107690. [PMID: 38968865 DOI: 10.1016/j.aap.2024.107690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 05/24/2024] [Accepted: 06/21/2024] [Indexed: 07/07/2024]
Abstract
Analyzing crash data is a complex and labor-intensive process that requires careful consideration of multiple interdependent modeling aspects, such as functional forms, transformations, likely contributing factors, correlations, and unobserved heterogeneity. Limited time, knowledge, and experience may lead to over-simplified, over-fitted, or misspecified models overlooking important insights. This paper proposes an extensive hypothesis testing framework including a multi-objective mathematical programming formulation and solution algorithms to estimate crash frequency models considering simultaneously likely contributing factors, transformations, non-linearities, and correlated random parameters. The mathematical programming formulation minimizes both in-sample fit and out-of-sample prediction. To address the complexity and non-convexity of the mathematical program, the proposed solution framework utilizes a variety of metaheuristic solution algorithms. Specifically, Harmony Search demonstrated minimal sensitivity to hyperparameters, enabling an efficient search for solutions without being influenced by the choice of hyperparameters. The effectiveness of the framework was evaluated using two real-world datasets and one synthetic dataset. Comparative analyses were performed using the two real-world datasets and the corresponding models published in literature by independent teams. The proposed framework showed its capability to pinpoint efficient model specifications, produce accurate estimates, and provide valuable insights for both researchers and practitioners. The proposed approach allows for the discovery of numerous insights while minimizing the time spent on model development. By considering a broader set of contributing factors, models with varied qualities can be generated. For instance, when applied to crash data from Queensland, the proposed approach revealed that the inclusion of medians on sharp curved roads can effectively reduce the occurrence of crashes, when applied to crash data from Washington, the simultaneous consideration of traffic volume and road curvature resulted in a notable reduction in crash variances but an increase in crash means.
Collapse
Affiliation(s)
- Zeke Ahern
- School of Civil & Environment Engineering, Queensland University of Technology, 2 George Street, Brisbane, 4000 QLD, Australia.
| | - Paul Corry
- School of Mathematical Sciences, Queensland University of Technology, 2 George Street, Brisbane, 4000 QLD, Australia
| | - Wahi Rabbani
- Department of Transport and Main Roads, Brisbane, 4000 QLD, Australia
| | - Alexander Paz
- School of Civil & Environment Engineering, Queensland University of Technology, 2 George Street, Brisbane, 4000 QLD, Australia
| |
Collapse
|
3
|
Zhang L, Wu HD, Qian YF, Xu HY. Prevalence of nonalcoholic fatty liver disease in patients with hepatitis B: A meta-analysis. World J Clin Cases 2024; 12:5749-5760. [DOI: 10.12998/wjcc.v12.i25.5749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 06/27/2024] [Accepted: 07/03/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND The prevalence of nonalcoholic fatty liver disease (NAFLD) in patients with chronic hepatitis B (CHB) has increased in recent clinical practice; however, the relationship between CHB and hepatic steatosis (HS) remains controversial.
AIM To shed light on the potential association between NAFLD and hepatitis B virus (HBV) infection.
METHODS We conducted a systematic literature search using multiple databases, including PubMed, the Cochrane Library, Web of Science, and EMBASE, to identify relevant studies. Predefined inclusion criteria were used to determine the eligibility of the studies for further analysis.
RESULTS Comprehensive meta-analysis software was used for statistical analysis, which covered 20 studies. The results indicated a lower NAFLD susceptibility in HBV-infected individuals (pooled OR = 0.87; 95%CI = 0.69-1.08; I2 = 91.1%), with diabetes (P = 0.015), body mass index (BMI; P = 0.010), and possibly age (P = 0.061) as heterogeneity sources. Of note, in four studies (6197 HBV patients), HBV-infected individuals had a reduced NAFLD risk (OR = 0.68, 95%CI = 0.51-0.89, P = 0.006). A positive link between hyperlipidemia and metabolic syndrome emerged in hepatitis B patients, along with specific biochemical indicators, including BMI, creatinine, uric acid, fasting blood glucose, and homeostasis model assessment of insulin resistance.
CONCLUSION HBV infection may provide protection against HS; however, the occurrence of HS in patients with HBV infection is associated with metabolic syndrome and specific biochemical parameters.
Collapse
Affiliation(s)
- Li Zhang
- Department of Infectious Diseases, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang Province, China
| | - Hong-Di Wu
- Department of Infectious Diseases, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang Province, China
| | - Yuan-Fang Qian
- Department of Nursing, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang Province, China
| | - Hong-Yan Xu
- Department of Nursing, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang Province, China
| |
Collapse
|
4
|
Muñoz-Labrador A, Hernandez-Hernandez O, Moreno FJ. A review of the state of sweeteners science: the natural versus artificial non-caloric sweeteners debate. Stevia rebaudiana and Siraitia grosvenorii into the spotlight. Crit Rev Biotechnol 2024; 44:1080-1102. [PMID: 39103281 DOI: 10.1080/07388551.2023.2254929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 05/08/2023] [Accepted: 07/13/2023] [Indexed: 08/07/2024]
Abstract
The rapid increase in the worldwide prevalence of obesity and certain non-communicable diseases (NCDs), such as: cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes, has been mainly attributed to an excess of sugar consumption. Although the potential benefits of the synergetic use of sweeteners have been known for many years, recent development based on synthesis strategies to produce sucrose-like taste profiles is emerging where biocatalyst approaches may be preferred to produce and supply specific sweetener compounds. From a nutritional standpoint, high-intensity sweeteners have fewer calories than sugars while providing a major sweet potency, placing them in the spotlight as valuable alternatives to sugar. Due to the modern world awareness and incidence of metabolic diseases, both food research and growing markets have focused on two generally regarded as safe (GRAS) groups of compounds: the sweet diterpenoid glycosides present on the leaves of Stevia rebaudiana and, more recently, on the cucurbitane triterpene glycosides present on the fruits of Siraitia grosvenorii. In spite of their flavor advantages, biological benefits, including: antidiabetic, anticancer, and cardiovascular properties, have been elucidated. The present bibliographical review dips into the state-of-the-art of sweeteners and their role in human health as sugar replacements, as well as the biotransformation methods for steviol gylcosides and mogrosides apropos of enzymatic technology to update and locate the discoveries to date in the scientific literature to help boost the continuity of research efforts of the ongoing sweeteners.
Collapse
Affiliation(s)
| | | | - F Javier Moreno
- Institute of Food Science Research, CIAL (CSIC-UAM), Madrid, Spain
| |
Collapse
|
5
|
Han H, Letourneau ID, Abate YH, Abdelmasseh M, Abu-Gharbieh E, Adane TD, Ahinkorah BO, Ahmad A, Ahmadi A, Ahmed A, Alhalaiqa FN, Al-Sabah SK, Al-Worafi YM, Amu H, Andrei CL, Anoushiravani A, Arabloo J, Aravkin AY, Ashraf T, Azadnajafabad S, Baghcheghi N, Bagherieh S, Bantie BB, Bardhan M, Basile G, Bayleyegn NS, Behnoush AH, Bekele A, Bhojaraja VS, Bijani A, Biondi A, Burkart K, Chu DT, Chukwu IS, Cruz-Martins N, Dai X, Demessa BH, Dhali A, Diaz D, Do TC, Dodangeh M, Dongarwar D, Dsouza HL, Ekholuenetale M, Ekundayo TC, El Sayed I, Elhadi M, Fagbamigbe AF, Fakhradiyev IR, Ferrara P, Fetensa G, Fischer F, Gebrehiwot M, Getachew M, Golechha M, Gupta VK, Habib JR, Hadi NR, Haep N, Haile TG, Hamilton EB, Hasan I, Hasani H, Hassanzadeh S, Haubold J, Hay SI, Hayat K, Ilesanmi OS, Inamdar S, Iwu CCD, Iyasu AN, Jayarajah U, Jayaram S, Jokar M, Jomehzadeh N, Joseph A, Joseph N, Joshua CE, Kabir A, Kandel H, Kauppila JH, Kemp Bohan PM, Khajuria H, Khan M, Khatatbeh H, Kim MS, Kisa A, Kompani F, Koohestani HR, Kumar R, Le TTT, Lee M, Lee SW, Li MC, Lim SS, Lo CH, Lunevicius R, Malhotra K, Maugeri A, Mediratta RP, Meretoja TJ, Mestrovic T, Mirza-Aghazadeh-Attari M, Mohamed NS, Mokdad AH, Monasta L, Moni MA, Moradi M, Mougin V, Mukoro GD, Murillo-Zamora E, Murray CJL, Naimzada MD, Najmuldeen HHR, Natto ZS, Negoi I, Nguyen HQ, Nikolouzakis TK, Olufadewa II, Padubidri JR, Pandey A, Parikh RR, Pham HT, Pollok RCG, Rahimi M, Rahimi-Movaghar V, Rahman M, Rahmani S, Rashidi MM, Rawaf S, Rickard J, Rouientan H, Roy S, Saddik BA, Saeed U, Saleh MA, Salehi S, Samy AM, Sanabria J, Sankararaman S, Schumacher AE, Senthilkumaran S, Shah PA, Shool S, Sibhat MM, Sidamo NB, Singh JA, Socea B, Solomon Y, Sreeram S, Tabatabaei SM, Tan KK, Tavangar SM, Tefera YM, Thomas NK, Ticoalu JHV, Tsegay GM, Tsegaye D, Ullah S, Usman AN, Valizadeh R, Veroux M, Verras GI, Vos T, Wang M, Wang S, Wickramasinghe DP, Yahya G, Zare I, Zarrintan A, Zhang ZJ, Dirac MA. Trends and levels of the global, regional, and national burden of appendicitis between 1990 and 2021: findings from the Global Burden of Disease Study 2021. Lancet Gastroenterol Hepatol 2024; 9:825-858. [PMID: 39032499 PMCID: PMC11306195 DOI: 10.1016/s2468-1253(24)00157-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/02/2024] [Accepted: 05/10/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND Appendicitis is a common surgical emergency that poses a large clinical and economic burden. Understanding the global burden of appendicitis is crucial for evaluating unmet needs and implementing and scaling up intervention services to reduce adverse health outcomes. This study aims to provide a comprehensive assessment of the global, regional, and national burden of appendicitis, by age and sex, from 1990 to 2021. METHODS Vital registration and verbal autopsy data, the Cause of Death Ensemble model (CODEm), and demographic estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) were used to estimate cause-specific mortality rates (CSMRs) for appendicitis. Incidence data were extracted from insurance claims and inpatient discharge sources and analysed with disease modelling meta-regression, version 2.1 (DisMod-MR 2.1). Years of life lost (YLLs) were estimated by combining death counts with standard life expectancy at the age of death. Years lived with disability (YLDs) were estimated by multiplying incidence estimates by an average disease duration of 2 weeks and a disability weight for abdominal pain. YLLs and YLDs were summed to estimate disability-adjusted life-years (DALYs). FINDINGS In 2021, the global age-standardised mortality rate of appendicitis was 0·358 (95% uncertainty interval [UI] 0·311-0·414) per 100 000. Mortality rates ranged from 1·01 (0·895-1·13) per 100 000 in central Latin America to 0·054 (0·0464-0·0617) per 100 000 in high-income Asia Pacific. The global age-standardised incidence rate of appendicitis in 2021 was 214 (174-274) per 100 000, corresponding to 17 million (13·8-21·6) new cases. The incidence rate was the highest in high-income Asia Pacific, at 364 (286-475) per 100 000 and the lowest in western sub-Saharan Africa, at 81·4 (63·9-109) per 100 000. The global age-standardised rates of mortality, incidence, YLLs, YLDs, and DALYs due to appendicitis decreased steadily between 1990 and 2021, with the largest reduction in mortality and YLL rates. The global annualised rate of decline in the DALY rate was greatest in children younger than the age of 10 years. Although mortality rates due to appendicitis decreased in all regions, there were large regional variations in the temporal trend in incidence. Although the global age-standardised incidence rate of appendicitis has steadily decreased between 1990 and 2021, almost half of GBD regions saw an increase of greater than 10% in their age-standardised incidence rates. INTERPRETATION Slow but promising progress has been observed in reducing the overall burden of appendicitis in all regions. However, there are important geographical variations in appendicitis incidence and mortality, and the relationship between these measures suggests that many people still do not have access to quality health care. As the incidence of appendicitis is rising in many parts of the world, countries should prepare their health-care infrastructure for timely, high-quality diagnosis and treatment. Given the risk that improved diagnosis may counterintuitively drive apparent rising trends in incidence, these efforts should be coupled with improved data collection, which will also be crucial for understanding trends and developing targeted interventions. FUNDING Bill and Melinda Gates Foundation.
Collapse
|
6
|
Muro S, Kawayama T, Sugiura H, Seki M, Duncan EA, Bowen K, Marshall J, Megally A, Patel M. Benefits of budesonide/glycopyrronium/formoterol fumarate dihydrate on lung function and exacerbations of COPD: a post-hoc analysis of the KRONOS study by blood eosinophil level and exacerbation history. Respir Res 2024; 25:297. [PMID: 39103901 DOI: 10.1186/s12931-024-02918-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 07/17/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND Japanese guidelines recommend triple inhaled corticosteroid (ICS)/long-acting muscarinic antagonist (LAMA)/long-acting β2-agonist (LABA) therapy in patients with chronic obstructive pulmonary disease (COPD) and no concurrent asthma diagnosis who experience frequent exacerbations and have blood eosinophil (EOS) count ≥ 300 cells/mm3, and in patients with COPD and asthma with continuing/worsening symptoms despite receiving dual ICS/LABA therapy. These post-hoc analyses of the KRONOS study in patients with COPD and without an asthma diagnosis, examine the effects of fixed-dose triple therapy with budesonide/glycopyrronium/formoterol fumarate dihydrate (BGF) versus dual therapies on lung function and exacerbations based on blood EOS count - focusing on blood EOS count 100 to < 300 cells/mm3 - as a function of exacerbation history and COPD severity. METHODS In KRONOS, patients were randomized to receive treatments that included BGF 320/14.4/10 µg, glycopyrronium/formoterol fumarate dihydrate (GFF) 14.4/10 µg, or budesonide/formoterol fumarate dihydrate (BFF) 320/10 µg via metered dose inhaler (two inhalations twice-daily for 24 weeks). These post-hoc analyses assessed changes from baseline in morning pre-dose trough forced expiratory volume in 1 s (FEV1) over 12-24 weeks and moderate or severe COPD exacerbations rates over 24 weeks. The KRONOS study was not prospectively powered for these subgroup analyses. RESULTS Among patients with blood EOS count 100 to < 300 cells/mm3, least squares mean treatment differences for lung function improvement favored BGF over BFF in patients without an exacerbation history in the past year and in patients with moderate and severe COPD, with observed differences ranging from 62 ml to 73 ml across populations. In this same blood EOS population, moderate or severe exacerbation rates were reduced for BGF relative to GFF by 56% in patients without an exacerbation history in the past year, by 47% in patients with moderate COPD, and by 50% in patients with severe COPD. CONCLUSIONS These post-hoc analyses of patients with moderate-to-very severe COPD from the KRONOS study seem to indicate clinicians may want to consider a step-up to triple therapy in patients with persistent/worsening symptoms with blood EOS count > 100 cells/mm3, even if disease severity is moderate and there is no recent history of exacerbations. TRIAL REGISTRATION ClinicalTrials.gov registry number NCT02497001 (registration date, 13 July 2015).
Collapse
Affiliation(s)
- Shigeo Muro
- Department of Respiratory Medicine, Nara Medical University, 840 Shijo-cho, Nara, 634-8522, Japan.
| | - Tomotaka Kawayama
- Division of Respirology, Neurology and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Hisatoshi Sugiura
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Munehiro Seki
- Respiratory Inhalation, Medical Department, AstraZeneca K.K. Kita-ku, Osaka, Japan
| | | | - Karin Bowen
- Late RIA Biometrics, AstraZeneca, Gaithersburg, MD, USA
| | | | - Ayman Megally
- Late RIA, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA
| | - Mehul Patel
- Late RIA, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
| |
Collapse
|
7
|
Li X, Gu Y, Liao C, Ma X, Bi Y, Lian Y, Huang Y. A comprehensive model to better screen out antiviral treatment candidates for chronic hepatitis B patients. Int Immunopharmacol 2024; 140:112848. [PMID: 39096876 DOI: 10.1016/j.intimp.2024.112848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 04/03/2024] [Accepted: 07/29/2024] [Indexed: 08/05/2024]
Abstract
BACKGROUND Chronic hepatitis B virus (HBV) infection is a serious human health threat given its high morbidity and mortality. Timely and effective antiviral treatment can postpone liver disease progression and reduce the occurrence of HBV-related end-stage liver disease. At present, the antiviral treatment criteria are mainly based on alanine transaminase (ALT) levels, HBV DNA levels and HBV e antigen levels according to the American Association for the Study of Liver Diseases treatment guidelines. However, some chronic hepatitis B (CHB) patients not meeting the above criteria still experience liver disease progression without antiviral treatment. It is urgent to identify a more comprehensive tool to screen out more antiviral treatment candidates as soon as possible. METHODS Considering the vital role of the immune response in the development of HBV infection and CHB cure, we collected data from 335 treatment-naïve CHB patients and comprehensively analysed their clinical and immune traits (including innate and adaptive responses). The immune parameters were obtained by flow cytometry. Finally, we established a model that can better distinguished CHB patients who need treatment through machine learning and LASSO regression of serological and immune parameters. RESULTS Through a series of analyses, we selected four important clinical parameters (ALT, HBV DNA, the Fibroscan value, and the A/G ratio) and four immune indicators (NKbright + NKp44+, NKbright + NKG2A+, NKT+GranzymeB+, and CD3 + CD107a + ) from more than 200 variables and then successfully established a mathematical model with high sensitivity and specificity to better screen out antiviral treatment candidates from all CHB patients. CONCLUSIONS Our results developed a refined model to better screen out antiviral treatment candidates from all CHB patients by combining common clinical parameters and important immune indicators, including innate and adaptive immunity. These findings provide more information for improving treatment guidelines and have potential implications for the timing of antiviral therapy to achieve better virus control and reduce the occurrence of end-stage liver disease.
Collapse
Affiliation(s)
- Xiaoyan Li
- Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Yurong Gu
- Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Chunhong Liao
- Guangdong Provincial Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Xinyi Ma
- Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Yanhua Bi
- Guangdong Provincial Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Yifan Lian
- Guangdong Provincial Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
| | - Yuehua Huang
- Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
| |
Collapse
|
8
|
Jiang Y, Xu Y, Wang Q, Chen Z, Liu C. Significance of serum NLRP3 as a potential predictor of 5-year death in hemodialysis patients: A prospective observational cohort study. Medicine (Baltimore) 2024; 103:e39185. [PMID: 39093762 PMCID: PMC11296485 DOI: 10.1097/md.0000000000039185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Accepted: 07/15/2024] [Indexed: 08/04/2024] Open
Abstract
Nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3 (NLRP3) is involved in inflammatory response. This study was done to explore the role of serum NLRP3 as a predictive biomarker of death after hemodialysis. In this prospective observational study of 331 patients undergoing maintenance hemodialysis, serum NLRP3 levels were measured. Univariate analysis and multivariate analysis were sequentially performed to determine predictors of 5-year death after hemodialysis. Age, major adverse cardiac and cerebral events (MACCE), and serum NLRP3 levels independently predicted 5-year mortality and overall survival (all P < .05). No interactions were found between serum NLRP3 levels and other variables, such as age, gender, hypertension, diabetes mellitus, primary renal diseases, and MACCE (all P interaction > .05). Serum NLRP3 levels were linearly correlated with risk of death and overall survival under restricted cubic spline (both P > .05) and substantially discriminated patients at risk of death under receiver operating characteristic curve (P < .001). Two models, in which age, MACCE, and serum NLRP3 were combined, were built to predict 5-year mortality and overall survival. The mortality prediction model had significantly higher predictive ability than age, AMCCE, and serum NLRP3 alone under receiver operating characteristic curve (all P < .05). The models, which were graphically represented by nomograms, performed well under calibration curve and decision curve. Serum NLRP3 levels are independently related to 5-year mortality and overall survival of patients after hemodialysis, suggesting that serum NLRP3 may be a potential prognostic biomarker of hemodialysis patients.
Collapse
Affiliation(s)
- Yi Jiang
- Department of Nephrology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, China
| | - Yandan Xu
- Department of Nephrology, Quzhou KeCheng People’s Hospital, Quzhou, China
| | - Qiuli Wang
- Traditional Chinese Medicine Department, Quzhou Hospital of Zhejiang Medical and Health Group, Quzhou, China
| | - Zhiwei Chen
- Department of Nephrology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, China
| | - Chunya Liu
- Department of Nephrology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, China
| |
Collapse
|
9
|
Joshi N, Hosen SKY, Fahad M, Narooka AR, Gourinath S, Tiwari S. The 26 S proteasome in Entamoeba histolytica: divergence of the substrate binding pockets from host proteasomes. BMC Res Notes 2024; 17:216. [PMID: 39095914 PMCID: PMC11295364 DOI: 10.1186/s13104-024-06848-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 06/26/2024] [Indexed: 08/04/2024] Open
Abstract
OBJECTIVE Proteasomes are conserved proteases crucial for proteostasis in eukaryotes and are promising drug targets for protozoan parasites. Yet, the proteasomes of Entamoeba histolytica remain understudied. The study's objective was to analyse the differences in the substrate binding pockets of amoeba proteasomes from those of host, and computational modelling of β5 catalytic subunit, with the goal of finding selective inhibitors. RESULTS Comparative sequence analysis revealed differences in substrate binding sites of E. histolytica proteasomes, especially in the S1 and S3 pockets of the catalytic beta subunits, implying differences in substrate preference and susceptibility to inhibitors from host proteasomes. This was strongly supported by significantly lower sensitivity to MG132 mediated inhibition of amoebic proteasome β5 subunit's chymotryptic activity compared to human proteasomes, also reflected in lower sensitivity of E. histolytica to MG132 for inhibition of proliferation. Computational models of β4 and β5 subunits, and a docked β4-β5 model revealed a binding pocket between β4-β5, similar to that of Leishmania tarentolae. Selective inhibitors for visceral leishmaniasis, LXE408 and compound 8, docked well to this pocket. This functional and sequence-based analysis predicts differences between amoebic and host proteasomes that can be utilized to develop rationally designed, selective inhibitors against E. histolytica.
Collapse
Affiliation(s)
- Nidhi Joshi
- Department of Pharmacology, University of Minnesota, Minneapolis, USA
- Molecular Cell Biology Laboratory, School of Biotechnology, Jawaharlal Nehru University, New Delhi, 110067, India
| | - S K Yasir Hosen
- Tata Institute of Fundamental Research, Hyderabad, 500046, India
- Molecular Cell Biology Laboratory, School of Biotechnology, Jawaharlal Nehru University, New Delhi, 110067, India
| | - Mohd Fahad
- Molecular Cell Biology Laboratory, School of Biotechnology, Jawaharlal Nehru University, New Delhi, 110067, India
| | - Anil Raj Narooka
- Proteomics Department, Advanced Enzymes Technologies Ltd, Thane, 400604, India
- School of Life Sciences, Jawaharlal Nehru University, New Delhi, 110067, India
- Molecular Cell Biology Laboratory, School of Biotechnology, Jawaharlal Nehru University, New Delhi, 110067, India
| | - S Gourinath
- School of Life Sciences, Jawaharlal Nehru University, New Delhi, 110067, India
| | - Swati Tiwari
- Molecular Cell Biology Laboratory, School of Biotechnology, Jawaharlal Nehru University, New Delhi, 110067, India.
| |
Collapse
|
10
|
Thapa L, Katwal S, Thapa BR. Association between gallstone disease and carotid intima-media thickness: a prospective observational cross-sectional study in a tertiary care center. Ann Med Surg (Lond) 2024; 86:4410-4415. [PMID: 39118692 PMCID: PMC11305746 DOI: 10.1097/ms9.0000000000002269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 06/03/2024] [Indexed: 08/10/2024] Open
Abstract
Background and objectives Gallstone disease (GD) is a prevalent health issue globally, particularly in developed nations, and has notable associations with cardiovascular disease (CVD). This prospective observational cross-sectional study aimed to investigate the association between gallstone disease and carotid intima-media thickness (CIMT), a marker of carotid atherosclerosis, in a tertiary care setting. Method Conducted at a tertiary care center, the study included 96 participants (48 with gallstone disease and 48 age and sex-matched controls). Data collection involved demographic information, BMI calculation, abdominal ultrasonography for gallstone detection, and carotid ultrasonography for CIMT measurement. Statistical analysis was performed using SPSS version 26. Results The study revealed higher CIMT values in GD patients compared to controls (P<0.001). Additionally, a positive correlation was observed between CIMT and age (r=0.450, P<0.001) and BMI (r=0.550, P<0.001). The Cohen's d-test indicated a clinically significant difference in CIMT between GD patients and controls (d=1.47). Conclusion This study revealed a significant association between gallstone disease and elevated CIMT, correlating with higher BMI indicating a potential link between gallstone disease and increased risk of carotid atherosclerosis. These findings highlight the importance of assessing cardiovascular risk in patients with gallstone disease, highlighting the potential utility of carotid ultrasonography as a non-invasive screening tool. Early intervention strategies may be warranted to mitigate cardiovascular risks associated with gallstone disease.
Collapse
Affiliation(s)
- Lokendra Thapa
- Department of Radiology, National Academy of Medical Sciences, Kathmandu
| | - Shailendra Katwal
- Department of Radiology, Dadeldhura Subregional Hospital, Dadeldhura, Nepal
| | - Bikash Raj Thapa
- Department of Radiology, National Academy of Medical Sciences, Kathmandu
| |
Collapse
|
11
|
Asiltürk AY, Atalık K. Computational Pulsatile Flow and Efficiency Analysis of Biocompatible Microfluidic Artificial Lungs for Different Fiber Configurations. J Biomech Eng 2024; 146:081002. [PMID: 38376443 DOI: 10.1115/1.4064793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 02/09/2024] [Indexed: 02/21/2024]
Abstract
Average-sized microfluidic artificial lungs consisting of rows and columns of fiber bundles with different column to row aspect ratios (AR) are numerically analyzed for flow characteristics, maximum gas transfer performance, minimum pressure drop, and proper wall shear stress (WSS) values in terms of biocompatibility. The flow is fully laminar and assumed to be incompressible and Newtonian. The transport analysis is performed using a combined convection-diffusion model, and the numerical simulations are carried out with the finite element method. The inlet volumetric flow is modeled as a sinusoidal wave function to simulate the cardiac cycle and its effect on the device performance. The model is first validated with experimental studies in steady-state condition and compared with existing correlations for transient conditions. Then, the validated model is used for a parametric study in both steady and pulsatile flow conditions. The results show that increasing the aspect ratio in fiber configuration leads to converging gas transfer, higher pressure drop, and higher WSS. While determining the optimum configuration, the acceptable shear stress levels play a decisive role to ensure biocompatibility. Also, it is observed that the steady analysis underestimates the gas transfer for higher aspect ratios.
Collapse
Affiliation(s)
- Ahmet Yusuf Asiltürk
- Mechanical Engineering Department, Boğaziçi University, Bebek, İstanbul 34342, Turkey
| | - Kunt Atalık
- Mechanical Engineering Department, Boğaziçi University, Bebek, İstanbul 34342, Turkey
| |
Collapse
|
12
|
Merrell KW, Konney TO, Acheamfour O, Lucido J, Aduse-Poku AY, Kumar A, Ansah MB, Amankwa AT, Shumway D, Awittor FK, Badu-Peprah A, Fonkoua LAAK, Hendrickson AEW, Boakye E, Adjei EK, Kyei I, Kemper K, Rank M, Peethambaram PP, Spangenberg K, Sorenson K, Hearrold M, Garda A, Graham R, Lang K, Adom J, Achiaa R, Jakub J, Amo BD, Osei-Bonsu E, Camacho R, Addison ECDK. Participant Evaluation of a Multi-disciplinary Oncology Preceptorship Training Program for Oncology Health Professionals from Kumasi, Ghana. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2024; 39:360-367. [PMID: 38506985 PMCID: PMC11219391 DOI: 10.1007/s13187-024-02417-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/26/2024] [Indexed: 03/22/2024]
Abstract
A critical shortage of skilled healthcare workers is a primary cause of disparate global cancer outcomes. We report participant evaluation of a multidisciplinary preceptorship program. In collaboration with the city of Kumasi, Ghana, Mayo Clinic and the City Cancer Challenge hosted a preceptorship program for comprehensive multidisciplinary breast and cervix cancer training. A total of 14 healthcare workers from Kumasi received two weeks of training at Mayo Clinic in November and December 2021. Each participant and preceptor were requested to complete an anonymous post-participation survey. Of the 14 trainee participants, 10 (71%) completed the survey. All respondents found the program "valuable and applicable to their clinical practice." Ninety percent reported they were able to "review effective and critical elements in the development and expansion of the multidisciplinary team" and able to "solve practical clinical cases as a team". General themes of satisfaction included: (1) organization and administration, (2) clinical observations and demonstrations, (3) guidelines development, and (4) recognizing the central importance of cultivating a team-based approach. Of the 40 preceptors, 16 (40%) completed the survey. All respondents reported they felt the training would meaningfully "influence patient care in Ghana", that participation "added value or joy to their clinical practice," and all wished to "participate in future preceptorship programs". After a focused two-week program, trainees reported high satisfaction, usefulness from observing specialized cancer care, and value in closely observing a multidisciplinary oncology team. Preceptors reported the experience added joy and perspective to their clinical practice and wished to participate in future programs.
Collapse
Affiliation(s)
- Kenneth W Merrell
- Department of Radiation Oncology, Global Bridges, Mayo Clinic, Rochester, MN, USA.
| | | | | | - Joseph Lucido
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
| | | | - Amanika Kumar
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, USA
| | | | | | - Dean Shumway
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | | | - Ernest Boakye
- Ernphil Laboratory and Diagnostic Services, Kumasi, Ghana
| | | | | | | | | | | | | | - Kasie Sorenson
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
| | - Miranda Hearrold
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
| | - Allison Garda
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
| | - Rondell Graham
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Karen Lang
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
| | - Joseph Adom
- Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | | | - James Jakub
- General Surgery, Mayo Clinic, Jacksonville, FL, USA
| | | | | | | | | |
Collapse
|
13
|
Kumar A, Sahu U, Agnihotri G, Dixit A, Khare P. A novel multi-epitope peptide vaccine candidate targeting hepatitis E virus: An in silico approach. J Viral Hepat 2024; 31:446-456. [PMID: 38727597 DOI: 10.1111/jvh.13949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 04/05/2024] [Accepted: 04/29/2024] [Indexed: 07/25/2024]
Abstract
Hepatitis E virus (HEV) is a foodborne virus transmitted through the faecal-oral route that causes viral hepatitis in humans worldwide. Ever since its discovery as a zoonotic agent, HEV was isolated from several species with an expanding range of hosts. HEV possesses several features of other RNA viruses but also has certain HEV-specific traits that make its viral-host interactions inimitable. HEV leads to severe morbidity and mortality in immunocompromised people and pregnant women across the world. The situation in underdeveloped countries is even more alarming. Even after creating a menace across the world, we still lack an effective vaccine against HEV. Till date, there is only one licensed vaccine for HEV available only in China. The development of an anti-HEV vaccine that can reduce HEV-induced morbidity and mortality is required. Live attenuated and killed vaccines against HEV are not accessible due to the lack of a tolerant cell culture system, slow viral replication kinetics and varying growth conditions. Thus, the main focus for anti-HEV vaccine development is now on the molecular approaches. In the current study, we have designed a multi-epitope vaccine against HEV through a reverse vaccinology approach. For the first time, we have used viral ORF3, capsid protein and polyprotein altogether for epitope prediction. These are crucial for viral replication and persistence and are major vaccine targets against HEV. The proposed in silico vaccine construct comprises of highly immunogenic and antigenic T-cell and B-cell epitopes of HEV proteins. The construct is capable of inducing an effective and long-lasting host immune response as evident from the simulation results. In addition, the construct is stable, non-allergic and antigenic for the host. Altogether, our findings suggest that the in silico vaccine construct may be useful as a vaccine candidate for preventing HEV infections.
Collapse
Affiliation(s)
- Anoop Kumar
- National Institute of Biologicals (NIB), Noida, Uttar Pradesh, India
| | - Utkarsha Sahu
- Department of Microbiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Geetanjali Agnihotri
- School of Chemical Technology, Kalinga Institute of Industrial Technology (KIIT) Deemed to be University, Bhubaneswar, Odisha, India
| | | | - Prashant Khare
- Department of Microbiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| |
Collapse
|
14
|
Edwards TH, Venn EC, Le TD, Grantham LE, Hogen T, Ford R, Ewer N, Gunville R, Carroll C, Taylor A, Hoareau GL. Comparison of shelf-stable and conventional resuscitation products in a canine model of hemorrhagic shock. J Trauma Acute Care Surg 2024; 97:S105-S112. [PMID: 38706102 DOI: 10.1097/ta.0000000000004332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
BACKGROUND Treatment of severe hemorrhagic shock typically involves hemostatic resuscitation with blood products. However, logistical constraints often hamper the wide distribution of commonly used blood products like whole blood. Shelf-stable blood products and blood substitutes are poised to be able to effectively resuscitate individuals in hemorrhagic shock when more conventional blood products are not readily available. METHODS Purpose-bred adult dogs (n = 6) were anesthetized, instrumented, and subjected to hemorrhagic shock (mean arterial pressure <50 mm Hg or 40% blood volume loss). Then each dog was resuscitated with one of five resuscitation products: (1) lactated ringers solution and hetastarch (LRS/Heta), (2) canine chilled whole blood (CWB), (3) fresh frozen plasma (FFP) and packed red blood cells (pRBC), (4) canine freeze-dried plasma (FDP) and hemoglobin-based oxygen carrier (HBOC), or (5) HBOC/FDP and canine lyophilized platelets (LyoPLT). Each dog was allowed to recover after the hemorrhage resuscitation event and was then subjected to another hemorrhage event and resuscitated with a different product until each dog was resuscitated with each product. RESULTS At the time when animals were determined to be out of shock as defined by a shock index <1, mean arterial pressure (mmHg) values (mean ± standard error) were higher for FFP/pRBC (n = 5, 83.7 ± 4.5) and FDP/HBOC+LyoPLT (n = 4, 87.8 ± 2.1) as compared with WB (n = 4, 66.0 ± 13.1). A transient increase in creatinine was seen in dogs resuscitated with HBOC and FDP. Albumin and base excess increased in dogs resuscitated with HBOC and FDP products compared with LRS/heta and CWB ( p < 0.01). CONCLUSION Combinations of shelf-stable blood products compared favorably to canine CWB for resolution of shock. Further research is needed to ascertain the reliability and efficacy of these shelf-stable combinations of products in other models of hemorrhage that include a component of tissue damage as well as naturally occurring trauma.
Collapse
Affiliation(s)
- Thomas H Edwards
- From the US Army Institute of Surgical Research (T.H.E., E.C.V., T.D.L., L.E.G.II), JBSA Fort Sam Houston; Department of Veterinary Small Animal Clinical Sciences (T.H.E.), School of Veterinary Medicine, Texas A&M University, College Station; Department of Epidemiology and Biostatistics (T.D.L.), University of Texas Tyler School of Medicine, Tyler, Texas; Oak Ridge Institute for Science and Education (L.E.G.II), Oak Ridge, Tennessee; Nora Eccles-Harrison Cardiovascular Research and Training Institute (T.H., G.L.H.); Biomedical Engineering Department (G.L.H.), and Department of Emergency Medicine (R.F., N.E., R.G., C.C., A.T., G.L.H.), University of Utah Health, Salt Lake City, Utah
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Behl T, Kaur I, Sehgal A, Khandige PS, Imran M, Gulati M, Khalid Anwer M, Elossaily GM, Ali N, Wal P, Gasmi A. The link between Alzheimer's disease and stroke: A detrimental synergism. Ageing Res Rev 2024; 99:102388. [PMID: 38914265 DOI: 10.1016/j.arr.2024.102388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 05/05/2024] [Accepted: 05/06/2024] [Indexed: 06/26/2024]
Abstract
Being age-related disorders, both Alzheimer's disease (AD) and stroke share multiple risk factors, such as hypertension, smoking, diabetes, and apolipoprotein E (APOE) Ɛ4 genotype, and coexist in patients. Accumulation of amyloid-β plaques and neurofibrillary tangled impair cognitive potential, leading to AD. Blocked blood flow in the neuronal tissues, causes neurodegeneration and cell death in stroke. AD is commonly characterized by cerebral amyloid angiopathy, which significantly elevates the risk of hemorrhagic stroke. Patients with AD and stroke have been both reported to exhibit greater cognitive impairment, followed by multiple pathophysiological mechanisms shared between the two. The manuscript aims to elucidate the relationship between AD and stroke, as well as the common pathways and risk factors while understanding the preventive therapies that might limit the negative impacts of this correlation, with diagnostic modalities and current AD treatments. The authors provide a comprehensive review of the link and aid the healthcare professionals to identify suitable targets and risk factors, that may retard cognitive decline and neurodegeneration in patients. However, more intricate research is required in this regard and an interdisciplinary approach that would target both the vascular and neurodegenerative factors would improve the quality of life in AD patients.
Collapse
Affiliation(s)
- Tapan Behl
- Amity School of Pharmaceutical Sciences, Amity University, Mohali, Punjab, India.
| | - Ishnoor Kaur
- University of Glasgow, College of Medical, Veterinary and Life Sciences, Glasgow, United Kingdom
| | - Aayush Sehgal
- GHG Khalsa College of Pharmacy, Gurusar Sadhar, Ludhiana, Punjab, India
| | - Prasanna Shama Khandige
- NITTE (Deemed to be University), NGSM Institute of Pharmaceutical Sciences, Department of Pharmacology, Mangaluru, Karnataka, India
| | - Mohd Imran
- Department of Pharmaceutical Chemistry, College of Pharmacy, Northern Border University, Rafha 91911, Saudi Arabia
| | - Monica Gulati
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab 1444411, India; ARCCIM, Faculty of Health, University of Technology Sydney, Ultimo, NSW 20227, Australia
| | - Md Khalid Anwer
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Gehan M Elossaily
- Department of Baisc Medical Sciences, College of Medicine, AlMaarefa University, P.O. Box 71666, Riyadh 11597, Saudi Arabia
| | - Nemat Ali
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia
| | - Pranay Wal
- PSIT Kanpur, Department of Pharmacy, Uttar Pradesh, India
| | - Amin Gasmi
- Societe Francophone de Nutritherapie et de Nutrigenetique Appliquee, Villeurbanne, France; International Institute of Nutrition and Micronutrition Sciences, Saint Etienne, France
| |
Collapse
|
16
|
Tain YL, Li LC, Kuo HC, Hsu CN. Gestational Exposure to Maternal Systemic Glucocorticoids and Childhood Risk of CKD. Am J Kidney Dis 2024; 84:215-223.e1. [PMID: 38479460 DOI: 10.1053/j.ajkd.2024.01.523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 01/02/2024] [Accepted: 01/13/2024] [Indexed: 07/23/2024]
Abstract
RATIONALE & OBJECTIVE The potential effects of antenatal glucocorticoid exposure on the health of children are unclear. We examined the association of gestational exposure to maternal systemic glucocorticoids and the risk of developing chronic kidney disease (CKD) in childhood. STUDY DESIGN Retrospective cohort study. SETTING & PARTICIPANTS Newborns cared for at the largest health care delivery system in Taiwan between 2004 and 2018. EXPOSURE Maternal prescriptions for systemic glucocorticoids between the last menstrual period and birth as a proxy for gestational exposure. OUTCOME Incidence of childhood CKD, including congenital anomalies of the kidney and urinary tract (CAKUT) and other kidney diseases (non-CAKUT), over 10 years. ANALYTICAL APPROACH Cox proportional hazards models with stabilized inverse probability of treatment weighting and robust sandwich estimator were used to estimate the average association between systemic glucocorticoids and incident CKD after adjustment for offspring characteristics (adjusted HR: AHR). RESULTS Among 23,363 singleton-born children, gestational systemic glucocorticoid exposure was significantly associated with a higher risk of childhood CKD (AHR, 1.69 [95% CI, 1.01-2.84]). Stratified analyses showed stronger associations between systemic glucocorticoids and childhood CKD within the strata of birth<37 weeks' gestational age (AHR, 2.38 [95% CI, 1.19-4.78]), male sex (AHR, 1.89 [95% CI, 1.00-3.55]), gestational exposure in the second trimester (AHR, 6.70 [95% CI, 2.17-20.64]), and total dose of>24mg hydrocortisone equivalent (AHR, 1.91 [95% CI, 1.05-3.47]). LIMITATIONS Study was limited to the Taiwan health care delivery system and childhood CKD events through the age of 10 years. CONCLUSIONS The findings of this study suggest that gestational exposure to systemic glucocorticoids is associated with the occurrence of kidney disease in childhood. If these findings are confirmed, they may inform clinicians who are considering prescribing systemic glucocorticoids during pregnancy. PLAIN-LANGUAGE SUMMARY In a singleton-born cohort of neonates, maternal exposure to antenatal systemic glucocorticoids was significantly associated with a 1.7-fold increased risk of the children developing chronic kidney disease over the first 10 years of life. Children of mothers who received>24mg of hydrocortisone equivalent, systemic glucocorticoid treatment in second trimester of gestation, and children born at<37 weeks of gestational age had a higher risk of childhood kidney disease after gestational systemic glucocorticoid exposure. If these findings are confirmed, they may inform clinicians who are considering prescribing systemic glucocorticoids during pregnancy.
Collapse
Affiliation(s)
- You-Lin Tain
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine; Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine
| | - Lung-Chih Li
- Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine; Department of Internal Medicine, Division of Nephrology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine
| | - Hsiao-Ching Kuo
- Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chien-Ning Hsu
- Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan.
| |
Collapse
|
17
|
Hashmi SB, Ahmed S, Hashmi S, Bux R, Siddiqui I. Choosing the right equation for calculating indirect LDL-Cholesterol (LDL-C) in adult Pakistani population: Evaluation of seven equations using big data analytics. Pract Lab Med 2024; 41:e00418. [PMID: 39119471 PMCID: PMC11304068 DOI: 10.1016/j.plabm.2024.e00418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 06/02/2024] [Accepted: 07/08/2024] [Indexed: 08/10/2024] Open
Abstract
Objective Cardiovascular diseases (CVDs) are a leading cause of mortality worldwide. Low density lipoprotein cholesterol (LDL-C) contributes to the atherogenic process. However, direct LDL-C (d-LDL) has rarely been estimated by the gold standard method because it is cumbersome and expensive. We aim to evaluate calculated low density lipoprotein (LDL-c) by various equations with reference to directly measured LDL-C in the Pakistani adult population as a cost-effective alternative. Methods We retrospectively evaluated the validity of seven equations for estimating calculated LDL-C by computing correlation coefficients (r) and Bland Altman plots to assess agreement (mean %) for (d-LDL) and calculated (LDL-c) on all seven equations. Statistical analysis was performed in Stata Statistical Software: Release 17, College Station, TX: StataCorp LLC. Results We analyzed 247082 direct assays of lipid profiles of adults aged ≥18 years. The mean LDL-C levels computed on Friedewald, de Cordova, Chen, Hattori, Vujovic, Teerakanchana, Sampson equations were 106.8 ± 31.4, 103.7 ± 25.0, 108.6 ± 28.2, 100.1 ± 29.5, 115.2 ± 31.2, 113.1 ± 28.3 and 110.3 ± 30.6 respectively. Friedewald and Hattori equations correlated strongly with direct LDL-C (r = 0.937) for each followed by Sampson (r = 0.935) and Vujovic (r = 0.931). However, the median bias was least for the Friedwald equation (-1.6) compared to the other equations. Conclusion In contrast to the global literature advocating for the use of newer equations, although the conventional and widely utilized Friedewald equation remains the best alternative for calculated LDL-C estimation in adult Pakistani population.
Collapse
Affiliation(s)
- Syed Bilal Hashmi
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Sibtain Ahmed
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Shiraz Hashmi
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Rasool Bux
- Department of Pediatrics, Division of Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Imran Siddiqui
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| |
Collapse
|
18
|
Smith RA, Desai A, Barnes EL, Hayney M, Kochhar GS, Hashash JG, Farraye FA, Caldera F. Patients With Inflammatory Bowel Disease Are at Increased Risk of Hospitalization Due to Respiratory Syncytial Virus. Am J Gastroenterol 2024; 119:1545-1554. [PMID: 38318981 DOI: 10.14309/ajg.0000000000002682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 01/23/2024] [Indexed: 02/07/2024]
Abstract
INTRODUCTION Patients with inflammatory bowel disease (IBD) are at increased risk of developing respiratory infections. Respiratory syncytial virus (RSV) is a common respiratory virus with adverse outcomes in older adults. This study aimed to determine whether patients with IBD are at increased risk of a serious infection due to RSV. METHODS We conducted a retrospective study using the multi-institutional research network TriNetX to assess the risk of hospitalization in a cohort of patients with IBD compared with that in a non-IBD control cohort with RSV infection from January 1, 2007, to February 27, 2023. One-to-one (1:1) propensity score matching was performed for demographic variables and RSV risk factors between the 2 cohorts. Risk was expressed as adjusted odds ratio (aOR) with 95% confidence interval (CI). RESULTS There were 794 patients in the IBD-RSV cohort and 93,074 patients in the non-IBD-RSV cohort. The mean age of the IBD-RSV cohort was 55.6 ± 20 years, 59% were female, 80% were White, and 56.9% had Crohn's disease. The IBD-RSV cohort was at an increased risk of hospitalization (aOR 1.30, 95% CI 1.06-1.59). There was no difference in the risk (aOR 0.83, 95% CI 0.58-1.19) of a composite outcome of hospitalization-related complications between the 2 cohorts. Recent systemic corticosteroid use (<3 months) was associated with an increased risk of hospitalization (aOR 1.86, 95% CI 1.30-2.59) in the IBD-RSV cohort. DISCUSSION We found that adult patients with IBD and RSV infection are at an increased risk of hospitalization and may benefit from the new RSV vaccine recommended for adults aged 60 years and older.
Collapse
Affiliation(s)
- Ryan A Smith
- Division of Gastroenterology and Hepatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Aakash Desai
- Division of Gastroenterology and Hepatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Edward L Barnes
- Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Mary Hayney
- School of Pharmacy, University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin, USA
| | - Gursimran S Kochhar
- Division of Gastroenterology, Hepatology & Nutrition, Allegheny Health Network, Pittsburgh, Pennsylvania, USA
| | - Jana G Hashash
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA
| | - Francis A Farraye
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA
| | - Freddy Caldera
- Division of Gastroenterology and Hepatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| |
Collapse
|
19
|
Khan S, Khan MA, Noor A, Fareed K. SASAN: ground truth for the effective segmentation and classification of skin cancer using biopsy images. Diagnosis (Berl) 2024; 11:283-294. [PMID: 38487874 DOI: 10.1515/dx-2024-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 02/27/2024] [Indexed: 08/09/2024]
Abstract
OBJECTIVES Early skin cancer diagnosis can save lives; however, traditional methods rely on expert knowledge and can be time-consuming. This calls for automated systems using machine learning and deep learning. However, existing datasets often focus on flat skin surfaces, neglecting more complex cases on organs or with nearby lesions. METHODS This work addresses this gap by proposing a skin cancer diagnosis methodology using a dataset named ASAN that covers diverse skin cancer cases but suffers from noisy features. To overcome the noisy feature problem, a segmentation dataset named SASAN is introduced, focusing on Region of Interest (ROI) extraction-based classification. This allows models to concentrate on critical areas within the images while ignoring learning the noisy features. RESULTS Various deep learning segmentation models such as UNet, LinkNet, PSPNet, and FPN were trained on the SASAN dataset to perform segmentation-based ROI extraction. Classification was then performed using the dataset with and without ROI extraction. The results demonstrate that ROI extraction significantly improves the performance of these models in classification. This implies that SASAN is effective in evaluating performance metrics for complex skin cancer cases. CONCLUSIONS This study highlights the importance of expanding datasets to include challenging scenarios and developing better segmentation methods to enhance automated skin cancer diagnosis. The SASAN dataset serves as a valuable tool for researchers aiming to improve such systems and ultimately contribute to better diagnostic outcomes.
Collapse
Affiliation(s)
- Sajid Khan
- Department of Computer Science, School of Engineering, Central Asian University, Tashkent, Uzbekistan
| | - Muhammad Asif Khan
- Department of Computer Science, 66972 Sukkur IBA University , Sukkur, Pakistan
| | - Adeeb Noor
- Department of Information Technology, Faculty of Computing and Information Technology, 37848 King Abdulaziz University , Jeddah, Saudi Arabia
| | - Kainat Fareed
- Department of Computer Science, 66972 Sukkur IBA University , Sukkur, Pakistan
| |
Collapse
|
20
|
Cao H, Chen Y, Ge L, Kwong JSW, Lai H, Hu F, Zhang R, Zhao H, Hu L, He R, Zheng W, Zhang J. An umbrella review of the diagnostic value of next-generation sequencing in infectious diseases. Int J Clin Pharm 2024; 46:780-794. [PMID: 38570474 DOI: 10.1007/s11096-024-01704-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 01/18/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND An increasing number of systematic reviews (SRs) have evaluated the diagnostic values of next-generation sequencing (NGS) in infectious diseases (IDs). AIM This umbrella analysis aimed to assess the potential risk of bias in existing SRs and to summarize the published diagnostic values of NGS in different IDs. METHOD We searched PubMed, Embase, and the Cochrane Library until September 2023 for SRs assessing the diagnostic validity of NGS for IDs. Two investigators independently determined review eligibility, extracted data, and evaluated reporting quality, risk of bias, methodological quality, and evidence certainty in the included SRs. RESULTS Eleven SRs were analyzed. Most SRs exhibited a moderate level of reporting quality, while a serious risk of bias was observed in all SRs. The diagnostic performance of NGS in detecting pneumocystis pneumonia and periprosthetic/prosthetic joint infection was notably robust, showing excellent sensitivity (pneumocystis pneumonia: 0.96, 95% CI 0.90-0.99, very low certainty; periprosthetic/prosthetic joint infection: 0.93, 95% CI 0.83-0.97, very low certainty) and specificity (pneumocystis pneumonia: 0.96, 95% CI 0.92-0.98, very low certainty; periprosthetic/prosthetic joint infection: 0.95, 95% CI 0.92-0.97, very low certainty). NGS exhibited high specificity for central nervous system infection, bacterial meningoencephalitis, and tuberculous meningitis. The sensitivity to these infectious diseases was moderate. NGS demonstrated moderate sensitivity and specificity for multiple infections and pulmonary infections. CONCLUSION This umbrella analysis indicates that NGS is a promising technique for diagnosing pneumocystis pneumonia and periprosthetic/prosthetic joint infection with excellent sensitivity and specificity. More high-quality original research and SRs are needed to verify the current findings.
Collapse
Affiliation(s)
- Hong Cao
- School of Pharmaceutical Sciences, Guizhou University, 2708 South of Huaxi Avenue Road, Guiyang, Guizhou Province, China
- Department of Pharmacy, Guizhou Provincial People's Hospital, No.83 Zhongshandong Road, Guiyang, Guizhou Province, China
| | - Yan Chen
- School of Pharmaceutical Sciences, Guizhou University, 2708 South of Huaxi Avenue Road, Guiyang, Guizhou Province, China
- Department of Pharmacy, Guizhou Provincial People's Hospital, No.83 Zhongshandong Road, Guiyang, Guizhou Province, China
| | - Long Ge
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, No. 199, Donggang West Road, Chengguan District, Lanzhou City, Gansu Province, China
| | - Joey Sum-Wing Kwong
- Global Health Nursing, Graduate School of Nursing Science, St. Luke's International University, 10-1 Akashi-Cho, Chuo-Ku, Tokyo, 104-0044, Japan
| | - Honghao Lai
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, No. 199, Donggang West Road, Chengguan District, Lanzhou City, Gansu Province, China
| | - Fangfang Hu
- Department of Laboratory, Guizhou Provincial People's Hospital, No.83 Zhongshandong Road, Guiyang, 550002, Guizhou Province, China
| | - Rui Zhang
- Department of Pharmacy, Guizhou Provincial People's Hospital, No.83 Zhongshandong Road, Guiyang, Guizhou Province, China
| | - Huaye Zhao
- Department of Pharmacy, Guizhou Provincial People's Hospital, No.83 Zhongshandong Road, Guiyang, Guizhou Province, China
| | - Linfang Hu
- Department of Pharmacy, Guizhou Provincial People's Hospital, No.83 Zhongshandong Road, Guiyang, Guizhou Province, China
| | - Rui He
- Experimental Cancer Medicine, Department of Laboratory Medicine, Karolinska Institute, Room 601, Novum PI 6, Hälsovägen 7, Huddinge, 14157, Stockholm, Sweden
| | - Wenyi Zheng
- Experimental Cancer Medicine, Department of Laboratory Medicine, Karolinska Institute, Room 601, Novum PI 6, Hälsovägen 7, Huddinge, 14157, Stockholm, Sweden
| | - Jiaxing Zhang
- Department of Pharmacy, Guizhou Provincial People's Hospital, No.83 Zhongshandong Road, Guiyang, Guizhou Province, China.
| |
Collapse
|
21
|
Kalbas Y, Kumabe Y, Karl-Ludwig F, Halvachizadeh S, Teuben MPJ, Weisskopf M, Cesarovic N, Hülsmeier AJ, Märsmann S, Hierholzer C, Hildebrand F, Hornemann T, Pfeifer R, Cinelli P, Pape HC. Systemic acylcarnitine levels are affected in response to multiple injuries and hemorrhagic shock: An analysis of lipidomic changes in a standardized porcine model. J Trauma Acute Care Surg 2024; 97:248-257. [PMID: 38556639 DOI: 10.1097/ta.0000000000004328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
INTRODUCTION Along with recent advances in analytical technologies, tricarboxylic acid-cycle intermediates are increasingly identified as promising makers for cellular ischemia and mitochondrial dysfunction during hemorrhagic shock. For traumatized patients, the knowledge of the role of lipid oxidation substrates is sparse. In this study, we aimed to analyze the dynamics of systemic acylcarnitine (AcCa) release in a standardized polytrauma model with hemorrhagic shock. METHODS Fifty-two male pigs (50 ± 5 kg) were randomized into two groups: group isolated fracture was subject to a standardized femur shaft fracture, and group polytrauma was subject to a femur fracture, followed by blunt chest trauma, liver laceration, and a pressure-controlled hemorrhagic shock for 60 minutes. Resuscitation was performed with crystalloids. Fractures were stabilized by intramedullary nailing. Venous samples were collected at six time points (baseline, trauma, resuscitation, 2 hours, 4 hours, and 6 hours). Lipidomic analysis was performed via liquid chromatography coupled mass spectrometry. Measurements were collated with clinical markers and near-infrared spectrometry measurements of tissue perfusion. Longitudinal analyses were performed with linear mixed models, and Spearman's correlations were calculated. A p value of 0.05 was defined as threshold for statistical significance. RESULTS From a total of 303 distinct lipids, we identified two species of long-chain AcCas. Both showed a highly significant ( p < 0.001) twofold increase after hemorrhagic shock in group polytrauma that promptly normalized after resuscitation. This increase was associated with a significant decrease of the base excess ( p = 0.005), but recovery after resuscitation was faster. For both AcCas, there were significant correlations with decreased muscle tissue oxygen delivery ( p = 0.008, p = 0.003) and significant time-lagged correlations with the increase of creatine kinase ( p < 0.001, p < 0.001). CONCLUSION Our results point to plasma AcCas as a possible indicator for mitochondrial dysfunction and cellular ischemia in hemorrhagic shock. The more rapid normalization after resuscitation in comparison with acid base changes may warrant further investigation.
Collapse
Affiliation(s)
- Yannik Kalbas
- From the Department of Trauma Surgery (Y. Kalbas, F.K.-L., S.H., M.P.J.T., R.P., P.C., H.-C.P.), University Hospital Zurich, Harald-Tscherne Laboratory for Orthopaedic and Trauma Research (Y. Kalbas, Y. Kumabe, F.K.-L., S.H., M.P.J.T., S.M., C.H., R.P., P.C., H.-C.P.), Center for Preclinical Development (M.W.), University Hospital of Zurich, University of Zurich; Department of Health Sciences and Technology (N.C.), Swiss Federal Institute of Technology; Institute of Clinical Chemistry (A.J.H., T.H.), University Hospital Zurich, University of Zurich, Zurich, Switzerland; and Department of Orthopaedic Trauma and Reconstructive Surgery (F.H.), University Hospital RWTH, Aachen, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Gwin JC, Rangnekar N, Murray GP, Byerly S, Fleming AM, Easterday TS, Kerwin AJ, Howley IW. O blood type is not associated with worse coagulopathy or outcome in exsanguinating trauma. Am J Surg 2024; 234:117-121. [PMID: 38553336 DOI: 10.1016/j.amjsurg.2024.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/18/2024] [Accepted: 03/22/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Despite improving understanding of trauma-induced coagulopathy (TIC), mortality and morbidity due to exsanguinating trauma remain high. Increased complications due to hemorrhage have been reported in blood group O, possibly due to reduced levels of von Willebrand factor (vWF). METHODS An urban level 1 adult trauma center registry was retrospectively queried. Patients receiving ≥6 units of pRBC within 4 h of presentation were included. Patient demographics, admission labs and outcomes were obtained. Univariate and multiple logistic regression analyses were performed. RESULTS 562 patients were identified. There were no significant differences in demographics, admission labs, or outcome between different ABO groups. After adjustment, Type A patients were more likely to be hypocoagulable compared to Type O patients (p = 0.014). No mortality differences were seen between ABO types in multiple regression analysis. CONCLUSIONS No outcome or mortality differences were seen between ABO types, therefore factors other than vWF expression should be considered to explain coagulopathy in trauma patients.
Collapse
Affiliation(s)
- J Cole Gwin
- College of Medicine, University of Tennessee Health Science Center, Memphis, USA.
| | - Niyati Rangnekar
- Department of Obstetrics, Gynecology and Reproductive Sciences, Temple University, Philadelphia, PA, USA
| | - Glenn P Murray
- College of Medicine, University of Tennessee Health Science Center, Memphis, USA
| | - Saskya Byerly
- Department of Surgery, University of Tennessee Health Science Center, Memphis, USA
| | - Andrew M Fleming
- Department of Surgery, University of Tennessee Health Science Center, Memphis, USA
| | - Thomas S Easterday
- Department of Surgery, University of Tennessee Health Science Center, Memphis, USA
| | - Andrew J Kerwin
- Department of Surgery, University of Tennessee Health Science Center, Memphis, USA
| | - Isaac W Howley
- Department of Surgery, University of Tennessee Health Science Center, Memphis, USA
| |
Collapse
|
23
|
Tian Y, Liu YF, Wang YY, Li YZ, Ding WY, Zhang C. Molecular mechanisms of PTEN in atherosclerosis: A comprehensive review. Eur J Pharmacol 2024; 979:176857. [PMID: 39094923 DOI: 10.1016/j.ejphar.2024.176857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 07/17/2024] [Accepted: 07/24/2024] [Indexed: 08/04/2024]
Abstract
Atherosclerosis is a chronic inflammatory disease of the arterial wall caused by an imbalance of lipid metabolism and a maladaptive inflammatory response. A variety of harmful cellular changes associated with atherosclerosis include endothelial dysfunction, the migration of circulating inflammatory cells to the arterial wall, the production of proinflammatory cytokines, lipid buildup in the intima, local inflammatory responses in blood vessels, atherosclerosis-associated apoptosis, and autophagy. PTEN inhibits the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (PKB/AKT)/mammalian target of rapamycin (mTOR) pathway through its lipid phosphatase activity. Previous studies have shown that PTEN is closely related to atherosclerosis. This article reviews the role of PTEN in atherosclerosis from the perspectives of autophagy, apoptosis, inflammation, proliferation, and angiogenesis.
Collapse
Affiliation(s)
- Yuan Tian
- Institute of Cardiovascular Disease, Key Lab for Arteriosclerology of Hunan province, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, People's Republic of China
| | - Yi-Fan Liu
- Research Laboratory of Translational Medicine, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, People's Republic of China
| | - Yan-Yue Wang
- Institute of Cardiovascular Disease, Key Lab for Arteriosclerology of Hunan province, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, People's Republic of China
| | - Yong-Zhen Li
- Department of Pathology, The First People's Hospital of Zigong, Zigong, China, 643099, People's Republic of China
| | - Wen-Yan Ding
- Institute of Cardiovascular Disease, Key Lab for Arteriosclerology of Hunan province, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, People's Republic of China
| | - Chi Zhang
- Institute of Cardiovascular Disease, Key Lab for Arteriosclerology of Hunan province, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, People's Republic of China.
| |
Collapse
|
24
|
Wu S, Zhang H, Liu C, Yang Q, Sun J, Yuan C, Xiang H, Zhang J, Lu E, Guo J, Shao Q, Zhao B, Yang G. Impact of surface ultraviolet radiation intensity on hospital admissions for ischemic and hemorrhagic stroke: A large-scale database study using distributed lag nonlinear analysis, 2015-2022, in Harbin, China. J Stroke Cerebrovasc Dis 2024; 33:107908. [PMID: 39094717 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 07/27/2024] [Accepted: 07/30/2024] [Indexed: 08/04/2024] Open
Abstract
OBJECTIVES Our aim is to evaluate the impact of surface ultraviolet radiation intensity on hospital admissions for stroke and to compare the correlation and differences among different subtypes of strokes. MATERIALS AND METHODS We collected daily data on surface ultraviolet radiation intensity, temperature, air pollution, and hospital admissions for stroke in Harbin from 2015 to 2022. Using a distributed lag non-linear model, we determined the correlation between daily surface ultraviolet radiation intensity and the stroke admission rate. Relative risks (RR) with 95% confidence intervals (CI) and attributable fractions (AF) with 95% CI were calculated based on stroke subtypes, gender, and age groups. RESULTS A total of 132,952 hospitalized stroke cases (including hemorrhagic and ischemic strokes) were included in the study. We assessed the non-linear effects of ultraviolet intensity on hospitalized patients with ischemic and hemorrhagic strokes. Compared to the maximum morbidity benchmark ultraviolet intensity (19.2 × 10^5 for ischemic stroke and 20.25 for hemorrhagic stroke), over the 0-10 day lag period, the RR for extreme low radiation (1st percentile) was 0.86 (95% CI: 0.77, 0.96), and the RR for extreme high radiation (99th percentile) was 0.86 (95% CI: 0.77, 0.96). In summary, -4.842% (95% CI: -7.721%, -2.167%) and -1.668% (95% CI: -3.061%, -0.33%) of ischemic strokes were attributed to extreme low radiation intensity with a lag of 0 to 10 days and extreme high radiation intensity with a lag of 0 to 5 days, respectively. The reduction in stroke hospitalization rates due to low or high ultraviolet intensity was more pronounced in females and younger individuals compared to males and older individuals. None of the mentioned ultraviolet intensity intensities and lag days had a statistically significant impact on hemorrhagic stroke. CONCLUSIONS Our study fundamentally suggests that both lower and higher levels of surface ultraviolet radiation intensity in Harbin, China, contribute to a reduced incidence of ischemic stroke, with this effect lasting approximately 10 days. This finding holds significant potential for public health and clinical relevance.
Collapse
Affiliation(s)
- Shouyue Wu
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China; Heilongjiang Province Neuroscience Institute, Harbin, China
| | - Hongli Zhang
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China; Heilongjiang Province Neuroscience Institute, Harbin, China
| | - Chunyang Liu
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China; Heilongjiang Province Neuroscience Institute, Harbin, China
| | - Qiunan Yang
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China; Heilongjiang Province Neuroscience Institute, Harbin, China
| | - Jianda Sun
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China; Heilongjiang Province Neuroscience Institute, Harbin, China
| | - Chao Yuan
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China; Heilongjiang Province Neuroscience Institute, Harbin, China
| | - Huan Xiang
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China; Heilongjiang Province Neuroscience Institute, Harbin, China
| | - Jian Zhang
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China; Heilongjiang Province Neuroscience Institute, Harbin, China
| | - Enzhou Lu
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China; Heilongjiang Province Neuroscience Institute, Harbin, China
| | - Jinyi Guo
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China; Heilongjiang Province Neuroscience Institute, Harbin, China
| | - Qi Shao
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China; Heilongjiang Province Neuroscience Institute, Harbin, China
| | - Boxian Zhao
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China; Heilongjiang Province Neuroscience Institute, Harbin, China
| | - Guang Yang
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China; Heilongjiang Province Neuroscience Institute, Harbin, China.
| |
Collapse
|
25
|
Wu Y, Zhou J, Shu T, Li W, Shang S, Du L. Epidemiological study of post-pandemic pediatric common respiratory pathogens using multiplex detection. Virol J 2024; 21:168. [PMID: 39080730 PMCID: PMC11290110 DOI: 10.1186/s12985-024-02441-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Accepted: 07/18/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND The burden and characteristics of respiratory viral infections in children hospitalized for acute respiratory tract infections (ARTIs) during the post-COVID-19 pandemic era are unclear. We analyzed the epidemiological and clinical characteristics of pediatric patients hospitalized with common respiratory virus infections before and after relaxation of non-pharmaceutical interventions in Hangzhou, China and evaluated the diagnostic value of the six-panel respiratory pathogen detection system. METHODS Six types of respiratory viruses were detected in respiratory samples from children with suspected ARTIs by multiplex real-time quantitative polymerase chain reaction (RT-qPCR). Changes in virus detection rates and epidemiological and clinical characteristics, obtained from electronic health records, were analyzed. Binary logistic regression was used to identify respiratory tract infections risk factors. Multiplex RT-qPCR and targeted next-generation sequencing results were compared in random samples. RESULTS Among the 11,056 pediatric samples, 3228 tested positive for one or more of six common respiratory pathogens. RSV and PIV-3 detection rates differed significantly across age groups (both P < 0.001), and were more common in younger children. PIV-1 was more common in infants, toddlers, and preschoolers than in school-age children (P < 0.001). FluB was predominantly detected in school-age children (P < 0.001). RSV-, ADV-, and PIV-1-positivity rates were higher in 2022 than in 2023. Seasonal viral patterns differed across years. RSV (OR 9.156. 95% CI 5.905-14.195) and PIV-3 (OR 1.683, 95% CI 1.133-2.501) were risk factors for lower respiratory tract infections. RSV-positivity was associated with severe pneumonia (P = 0.044). PIV-3 (OR 0.391, 95% CI 0.170-0.899), summer season (OR 1.982, 95% CI 1.117-3.519), and younger age (OR 0.938, 95% CI 0.893-0.986) influenced pneumonia severity. Multiplex RT-qPCR showed good diagnostic performance. CONCLUSION After changes in COVID-19 prevention and control strategies, six common respiratory viruses in children were prevalent in 2022-2023, with different seasonal epidemic characteristics and age proclivities. RSV and PIV-3 cause lower, and FluA, FluB, and ADV more typically cause upper respiratory tract infections. Infancy and summer season influence severe pneumonia risk. Multiplex RT-qPCR is valuable for accurate and timely detection of respiratory viruses in children, which facilitates management, treatment, and prevention of ARTIs.
Collapse
Affiliation(s)
- Yidong Wu
- Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, Zhejiang, China
- Department of Clinical Laboratory, Hangzhou Ninth People's Hospital, Hangzhou, Zhejiang, China
| | - Jun Zhou
- Department of Clinical Laboratory, Hangzhou Children's Hospital, Hangzhou, Zhejiang, China
| | - Ting Shu
- Department of Clinical Laboratory, Hangzhou Children's Hospital, Hangzhou, Zhejiang, China
| | - Wei Li
- Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, Zhejiang, China
| | - Shiqiang Shang
- Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, Zhejiang, China
| | - Lizhong Du
- Department of Neonatology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China.
| |
Collapse
|
26
|
Kyaw KLS, Pana TA, Bettencourt-Silva JH, Metcalf AK, Myint PK, Potter JF. The individual and combined impacts of pre-existing diabetes and dementia on ischemic stroke outcomes: a registry-based cohort study. BMC Cardiovasc Disord 2024; 24:396. [PMID: 39080558 PMCID: PMC11290225 DOI: 10.1186/s12872-024-04050-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 07/15/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Individually, diabetes mellitus and dementia are associated with poorer outcomes after stroke. However, the combined impact of these pre-existing factors on acute ischemic stroke (AIS) outcomes has not been examined. METHODS All consecutive patients with AIS admitted to Norfolk and Norwich University Hospitals between 2003 and 2016 (catchment population ~ 900,000) were divided into four groups: those with neither diabetes nor dementia (reference), with diabetes without dementia, with dementia without diabetes, and with both co-morbidities. In-hospital mortality, length of hospital stay (LoS), and disability outcomes were analysed using logistic regressions. Post-discharge mortality and recurrence were assessed using Cox regressions. Additionally, interaction terms were added to the models for the short-term outcomes and long-term mortality to test for synergistic effects of diabetes and dementia. Models were adjusted for age, sex, Oxfordshire Community Stroke Project classification, comorbidities, hematological and biochemical measures, and antithrombotic medications. RESULTS The cohort was 10,812 patients with 52% females and a median age of 80. The median follow-up was 3.8 years for stroke recurrence and 5.5 years for mortality. No significant differences between the four groups existed for in-hospital mortality and post-stroke disability. Patients with dementia had significantly longer LoS (OR 2.25 [95% CI: 1.34-3.77] and 1.31 [1.02-1.68] with and without diabetes, respectively). Patients with both comorbidities had the highest risk of stroke recurrence (HR 2.06 [1.12-3.77]), followed by those with only dementia (1.59 [1.15-2.20]) and only diabetes (1.25 [1.06-1.49]). Similarly, the patient group with both diabetes and dementia had the highest long-term mortality risk (1.76 [1.33-2.37]). The hazard ratios for patients with only dementia and only diabetes were 1.71 [1.46-2.01] and 1.19 [1.08-1.32], respectively. No significant interactions were seen between diabetes and dementia with regards to their effects on the outcomes. CONCLUSION Individual and cumulative impacts of the two conditions on long-term mortality and stroke recurrence were notable. However, no synergistic impact of the two comorbidities were seen on the stroke outcomes tested in our study. Therefore, tailoring the management of stroke patients based on additional requirements associated with each pre-existing condition will be more impactful towards improving outcomes.
Collapse
Affiliation(s)
- Kyi Lae Shune Kyaw
- Edinburgh Medical School, University of Edinburgh, Edinburgh, Scotland, UK
| | - Tiberiu A Pana
- Aberdeen Cardiovascular & Diabetes Centre, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, Scotland, UK
- Ageing Clinical and Experimental Research Team, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, UK
| | - Joao H Bettencourt-Silva
- Norfolk & Norwich University Hospitals NHS Foundation Trust, Norwich, UK
- Healthcare and Life Sciences, IBM Research, Norwich, UK
| | - Anthony K Metcalf
- Norfolk & Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Phyo K Myint
- Aberdeen Cardiovascular & Diabetes Centre, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, Scotland, UK
- Ageing Clinical and Experimental Research Team, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, UK
- Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, Scotland, UK
| | - John F Potter
- Norwich Medical School, University of East Anglia, Norwich, UK.
| |
Collapse
|
27
|
Nigussie EW, Abera EG, Woldemariam MB. Burden and determinants of renal dysfunction and in-hospital mortality among acute stroke patients in Ethiopia: A hospital-based observational study. Medicine (Baltimore) 2024; 103:e39140. [PMID: 39058854 PMCID: PMC11272293 DOI: 10.1097/md.0000000000039140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024] Open
Abstract
Stroke, a leading global cause of mortality and neurological impairment, is often complicated by renal failure, exacerbating in-hospital risks and mortality. Limited understanding exists regarding renal failure prevalence in Ethiopian acute stroke patients. This study examines renal function abnormalities in acute stroke patients at Jimma Medical Center (JMC). A hospital-based cross-sectional study was conducted at JMC from December 5, 2023, to March 15, 2024. A structured data collection tool was developed after comprehensive review of pertinent literature, encompassing variables pertinent to the study objectives. Following data quality assurance, information was coded and inputted into EpiData version 3.1, subsequently analyzed using Statistical Package for Social Sciences (SPSS) version 26.0. Multivariable logistic regression analysis was performed to adjust for confounding variables, with statistical significance set at P < .05. The mean age of participants was 60.5 ± 15.5 years, with 129 (64.5%) being male. Forty-five participants (22.5%, 95% confidence interval [CI] = 16.9, 28.9) exhibited renal dysfunction. Advanced age (≥70 years), hypertension, diabetes mellitus (DM), cardiac disease, history of transient ischemic attack (TIA)/stroke, and hemorrhagic stroke type were identified as significant predictors of renal dysfunction among hospitalized stroke patients. The mortality rate was 3.7 times higher in stroke patients with renal dysfunction compared to those with normal renal function (adjusted odds ratio [AOR] = 3.7, 95% CI: 1.41, 6.22). Renal function abnormalities were prevalent among hospitalized acute stroke patients, emphasizing the significance of renal dysfunction as a frequent comorbidity. Older age, hypertension, DM, cardiac disease, history of TIA/stroke, and hemorrhagic stroke type emerged as statistically significant predictors of renal dysfunction. Furthermore, renal dysfunction was identified as a significant predictor of in-hospital mortality following stroke.
Collapse
Affiliation(s)
| | - Eyob Girma Abera
- Department of Public Health, Jimma University, Jimma, Oromia, Ethiopia
- Jimma University Clinical Trial Unit, Jimma, Oromia, Ethiopia
| | | |
Collapse
|
28
|
Ghareghomi S, Arghavani P, Mahdavi M, Khatibi A, García-Jiménez C, Moosavi-Movahedi AA. Hyperglycemia-driven signaling bridges between diabetes and cancer. Biochem Pharmacol 2024; 229:116450. [PMID: 39059774 DOI: 10.1016/j.bcp.2024.116450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 07/21/2024] [Accepted: 07/23/2024] [Indexed: 07/28/2024]
Abstract
Growing epidemiological evidence indicates an association between obesity, type 2 diabetes, and certain cancers, suggesting the existence of common underlying mechanisms in these diseases. Frequent hyperglycemias in type 2 diabetes promote pro-inflammatory responses and stimulate intracellular metabolic flux which rewires signaling pathways and influences the onset and advancement of different types of cancers. Here, we review the provocative impact of hyperglycemia on a subset of interconnected signalling pathways that regulate (i) cell growth and survival, (ii) metabolism adjustments, (iii) protein function modulation in response to nutrient availability (iv) and cell fate and proliferation and which are driven respectively by PI3K (Phosphoinositide 3-kinase), AMPK (AMP-activated protein kinase), O-GlcNAc (O-linked N-acetylglucosamine) and Wnt/β-catenin. Specifically, we will elaborate on their involvement in glucose metabolism, inflammation, and cell proliferation, highlighting their interplay in the pathogenesis of diabetes and cancer. Furthermore, the influence of antineoplastic and antidiabetic drugs on the unbridled cellular pathways will be examined. This review aims to inspire the next molecular studies to understand how type 2 diabetes may lead to certain cancers. This will contribute to personalized medicine and direct better prevention strategies.
Collapse
Affiliation(s)
- Somayyeh Ghareghomi
- Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran; Department of Biotechnology, Faculty of Biological Sciences, Alzahra University, Tehran, Iran
| | - Payam Arghavani
- Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran
| | - Majid Mahdavi
- Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran
| | - Ali Khatibi
- Department of Biotechnology, Faculty of Biological Sciences, Alzahra University, Tehran, Iran.
| | - Custodia García-Jiménez
- Department of Basic Health Sciences, Faculty of Health Sciences, University Rey Juan Carlos. Alcorcón, Madrid, Spain.
| | - Ali A Moosavi-Movahedi
- Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran; UNESCO Chair on Interdisciplinary Research in Diabetes, University of Tehran, Tehran, Iran.
| |
Collapse
|
29
|
Assogba CO, Ale BM, Youm E, Houehanou YC, Sinsin AS, Assiongbon SJE, Ale OAJ, Noubiap JJ, Amidou SA, Houinato DS. Prevalence and associated factors of hypertension among people living with HIV/AIDS on antiretroviral therapy in Benin's National Teaching Hospital. Sci Rep 2024; 14:17035. [PMID: 39043662 PMCID: PMC11266684 DOI: 10.1038/s41598-024-64212-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 06/06/2024] [Indexed: 07/25/2024] Open
Abstract
Antiretroviral therapy (ART) has extended the lifespan of people living with HIV/AIDS (PLHIV), exposing them to a higher risk of cardiovascular diseases (CVD). Hypertension (HTN), the primary contributor to CVD burden, is increasingly concerning for PLHIV. This study aimed to assess the prevalence and associated factors of hypertension in PLHIV on ART at the National Teaching Hospital Hubert Koutoukou Maga (HKM) of Benin using a prospective cross-sectional study conducted between October and December 2021. Patients who had a systolic blood pressure ≥ 140 mmHg or/and diastolic blood pressure ≥ 90 mmHg or/and current use of antihypertensive medication from medical records were considered to have HTN. A total of 352 patients, including 260 women with a sex ratio of 0.3 were included. The mean age was 42.9 ± 11.9 years. Most patients were educated and did not use tobacco. 42.0% were current alcohol drinkers. The duration of ART treatment ranged from 0 to 22 years, with a median duration of 5.0 years. 14.2% were hypertensives with 3.1% newly diagnosed and 11.1% known with hypertension. Age above 40 years, living with a partner, alcohol consumption and body mass index greater than 25 were significantly associated with HTN. HTN in PLHIV is associated with numerous factors. Reducing the burden of the disease in target people in Benin requires a wide range of actions that need to be implemented.
Collapse
Affiliation(s)
- Calixte Oswald Assogba
- Ecole Doctorale des Sciences de la Santé (EDSS), University of Abomey Calavi, Abomey Calavi, Benin
- Laboratoire ses Maladies Chroniques et Neurologiques (LEMACEN), Abomey Calavi, Benin
| | - Boni Maxime Ale
- Holo Global Health Research Institute, Cotonou, Benin.
- Health Data Acumen, Cotonou, Benin.
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya.
| | - Eric Youm
- Holo Global Health Research Institute, Cotonou, Benin
| | - Yessito Corine Houehanou
- Ecole Nationale de Formation des Techniciens Supérieurs en Santé Publique et Surveillance Epidémiologique (ENATSE), University of Parakou, Parakou, Benin
| | - Amen Sèminvo Sinsin
- Faculty of Health Sciences, University of Abomey Calavi, Abomey Calavi, Benin
| | | | | | - Jean Jacques Noubiap
- Holo Global Health Research Institute, Cotonou, Benin
- Division of Cardiology, Department of Medicine, University of San Francisco, San Francisco, USA
| | - Salmane Ariyoh Amidou
- Ecole Doctorale des Sciences de la Santé (EDSS), University of Abomey Calavi, Abomey Calavi, Benin
- Laboratoire ses Maladies Chroniques et Neurologiques (LEMACEN), Abomey Calavi, Benin
| | - Dismand Stephan Houinato
- Ecole Doctorale des Sciences de la Santé (EDSS), University of Abomey Calavi, Abomey Calavi, Benin
- Laboratoire ses Maladies Chroniques et Neurologiques (LEMACEN), Abomey Calavi, Benin
| |
Collapse
|
30
|
Hussain Z, Habib A, Sajjad Z. Prevalence of metabolic syndrome and its association with CT-based central adiposity measures: a cross-sectional study at a tertiary care hospital in Pakistan. BMJ Open 2024; 14:e082095. [PMID: 39043597 PMCID: PMC11268048 DOI: 10.1136/bmjopen-2023-082095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 06/30/2024] [Indexed: 07/25/2024] Open
Abstract
OBJECTIVES To assess the prevalence of metabolic syndrome (MS) and association of central obesity measures such as body mass index (BMI), visceral fat adiposity (VFA) and superficial fat adiposity (SFA) with MS, diabetes (DM) and hypertension (HTN). DESIGN Cross-sectional study design. SETTING Tertiary care hospital in Pakistan. PARTICIPANTS 165 participants. There were 124 male participants and 41 female participants of Pakistani population. All participants above 18 years, who had unenhanced CT abdomen examination and relevant blood workup, were included. Patients with a known clinical history of coronary artery disease, HTN and DM as well as pregnant patients were excluded. INTERVENTIONS VFA and SFA were estimated, at the level of the umbilicus. Data of BMI, MS, DM and HTN were extracted from patient files. Data for MS, DM and HTN were recorded as binary variables. OUTCOME MEASURES The primary outcome measures were the prevalence of MS and the association of MS, DM and HTN with gender, VFA, SFA and BMI. P value of <0.05 was taken as significant with CI of 95%. RESULTS The prevalence of MS was 29.7%. There was a significant association of MS, DM and HTN with VFA, SFA and BMI. In gender-based analysis 48.7% of the female participants had MS. In subset analysis, 47% of male subjects in the third tertile of VFA revealed significant association with MS (p value <0.05) while only 32.7% of subjects in the obesity category of BMI had MS. SFA revealed a significant association with DM only (p value <0.5). CONCLUSION In conclusion, VFA shows a significant association with MS, DM and HTN. Considering these results, further studies with a larger sample size are warranted to generate gender-based cut-offs for VFA for obesity screening purposes.
Collapse
Affiliation(s)
- Zainab Hussain
- Department of Radiology, Aga Khan University Hospital, Karachi, Pakistan
| | - Aysha Habib
- Department of Pathology, Aga Khan University Hospital, Karachi, Pakistan
| | - Zafar Sajjad
- Department of Radiology, Aga Khan University Hospital, Karachi, Pakistan
| |
Collapse
|
31
|
Woytinek K, Glitscher M, Hildt E. Antagonism of epidermal growth factor receptor signaling favors hepatitis E virus life cycle. J Virol 2024; 98:e0058024. [PMID: 38856640 PMCID: PMC11265270 DOI: 10.1128/jvi.00580-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 05/09/2024] [Indexed: 06/11/2024] Open
Abstract
Hepatitis E virus (HEV) poses a global threat, which currently remains understudied in terms of host interactions. Epidermal growth factor receptor (EGFR) plays multifaceted roles in viral pathogenesis, impacting host-cell entry, viral replication, and host-defense modulation. On the one hand, EGFR signaling emerged as a major driver in innate immunity; on the other hand, a crosstalk between HEV and EGFR requires deeper analysis. We therefore aimed to dissect the receptor's involvement in the HEV life cycle. In persistently HEV-infected cells, the EGFR amount is decreased alongside with enhanced receptor internalization. As compared with the control ligand-induced EGFR, activation revealed an early receptor internalization and degradation in HEV-replicating cells, resulting in a notable EGFR signaling delay. Interestingly, inhibition or silencing of EGFR increased viral replication, extracellular and intracellular viral transcripts, and released infectious particles. The pro-viral impact of EGFR inhibition was attributed to (i) impaired expression of interferon-stimulated genes, (ii) activation of the autophagosomal system, (iii) virus-induced inhibition of lysosomal acidification, and (iv) a decrease of the cellular cholesterol level. IMPORTANCE This study identifies epidermal growth factor receptor (EGFR) as a novel host factor affecting hepatitis E virus (HEV): EGFR downregulation promotes viral replication, release, and evasion from the innate immune response. The discovery that EGFR inhibition favors viral spread is particularly concerning for HEV patients undergoing EGFR inhibitor treatment.
Collapse
Affiliation(s)
| | - Mirco Glitscher
- Division of Virology, Paul Ehrlich Institute, Langen, Germany
| | - Eberhard Hildt
- Division of Virology, Paul Ehrlich Institute, Langen, Germany
| |
Collapse
|
32
|
Makiuchi T, Saito-Nakano Y, Nozaki T. Evidence of γ-secretase complex involved in the regulation of intramembrane proteolysis in Entamoeba histolytica. Parasitol Int 2024; 103:102925. [PMID: 39048023 DOI: 10.1016/j.parint.2024.102925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Accepted: 07/14/2024] [Indexed: 07/27/2024]
Abstract
Presenilins (PSNs) are multifunctional membrane proteins involved in signal transduction, lysosomal acidification, and certain physiological processes related to mitochondria. The aspartic protease activity of PSN and the formation of a γ-secretase complex with other subunits such as nicastrin (NCT) are required for the biological functions. Although PSN is widely conserved in eukaryotes, most studies on PSN were conducted in metazoans. Homologous genes for PSN and NCT (EhPSN and EhNCT, respectively) are encoded in the genome of Entamoeba histolytica, however, their functions remain unknown. In this study, we showed that EhPSN and EhNCT form a complex on the cell membrane, demonstrating that the parasite possesses γ-secretase. The predicted structure of EhPSN was similar to the human homolog, demonstrated by the crystal structure, and phylogenetic analysis indicated good conservation between EhPSN and human PSN, supporting the premise that EhPSN functions as a subunit of γ-secretase. By contrast, EhNCT appears to have undergone remarkable structural changes during its evolution. Blue native-polyacrylamide gel electrophoresis combined with western blotting indicated that a 150-kDa single band contains both EhPSN (estimated molecular size: 47-kDa) and EhNCT (64-kDa), suggesting that the complex also contains other unknown components or post-translational modifications. Coimmunoprecipitation from amebic lysates also confirmed that EhPSN and EhNCT formed a complex. Indirect immunofluorescence analysis revealed that the complex localized to the plasma membrane. Moreover, EhPSN exhibited protease activity, which was suppressed by a γ-secretase inhibitor. This is the first report of a γ-secretase complex in protozoan parasites.
Collapse
Affiliation(s)
- Takashi Makiuchi
- Department of Infectious Diseases, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
| | - Yumiko Saito-Nakano
- Department of Parasitology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan
| | - Tomoyoshi Nozaki
- Department of Biomedical Chemistry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| |
Collapse
|
33
|
Yin Y, Liu J, Yu J, Dong D, Gao F, Yu L, Du X, Wu S. ASGR1 is a promising target for lipid reduction in pigs with PON2 as its inhibitor. iScience 2024; 27:110288. [PMID: 39055948 PMCID: PMC11269292 DOI: 10.1016/j.isci.2024.110288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 05/17/2024] [Accepted: 06/13/2024] [Indexed: 07/28/2024] Open
Abstract
Although the role of asialoglycoprotein receptor 1 (ASGR1) in lowering lipid levels is well established, recent studies indicate that ASGR1 inhibition can cause unexpected liver damage in pigs, raising a serious issue about whether ASGR1 can be a good target for treating ASCVD. Here, we utilized the CRISPR-Cas9 system to regenerate ASGR1-knockout pigs, who displayed decreased lipid profiles without observable liver damage. This was confirmed by the lower levels of serum ALT and AST, reduced expression of inflammation markers, and normal histological morphology. Also, we implemented immunoprecipitation combined with mass spectrometry (IP-MS) and discovered that paraoxonase-2 (PON2) can interact with and significantly degrade ASGR1 in a dose-dependent manner. This degradation reduced lipid levels in mice, accompanied by little inflammation. Our study highlights the effectiveness and safety of degrading ASGR1 to reduce lipid levels in pigs and provides a potential inhibitor of ASGR1.
Collapse
Affiliation(s)
- Yunjun Yin
- State Key Laboratory of Animal Biotech Breeding, College of Biological Sciences, China Agricultural University, Beijing 100193, China
| | - Jun Liu
- State Key Laboratory of Animal Biotech Breeding, College of Biological Sciences, China Agricultural University, Beijing 100193, China
| | - Jia Yu
- State Key Laboratory of Animal Biotech Breeding, College of Biological Sciences, China Agricultural University, Beijing 100193, China
| | - Dingcai Dong
- State Key Laboratory of Animal Biotech Breeding, College of Biological Sciences, China Agricultural University, Beijing 100193, China
| | - Fei Gao
- State Key Laboratory of Animal Biotech Breeding, College of Biological Sciences, China Agricultural University, Beijing 100193, China
- Sanya Institute of China Agricultural University, Sanya 572024, China
| | - Libao Yu
- The Eighth Medical Center of PLA General Hospital, Beijing 100094, China
| | - Xuguang Du
- State Key Laboratory of Animal Biotech Breeding, College of Biological Sciences, China Agricultural University, Beijing 100193, China
- Sanya Institute of China Agricultural University, Sanya 572024, China
| | - Sen Wu
- State Key Laboratory of Animal Biotech Breeding, College of Biological Sciences, China Agricultural University, Beijing 100193, China
- Sanya Institute of China Agricultural University, Sanya 572024, China
| |
Collapse
|
34
|
Yan R, Liu X, Peng Y, Peng X. Preconception underweight and the risk of offspring congenital heart diseases in young pregnant women: Evidence from the China Birth Cohort Study. Int J Gynaecol Obstet 2024. [PMID: 39022861 DOI: 10.1002/ijgo.15795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 07/02/2024] [Accepted: 07/06/2024] [Indexed: 07/20/2024]
Abstract
OBJECTIVE Maternal obesity is a highly suggestive risk factor of offspring congenital heart diseases (CHD). However, the risk of offspring CHD associated with maternal underweight has rarely been mentioned. Therefore, this study aimed to explore the effect of preconception underweight on offspring CHD. METHODS From November 2017 to August 2021, 132 386 pregnant women were enrolled in a birth cohort study in China in early pregnancy, and completed follow-up until delivery (or miscarriage/termination). Offspring CHD was diagnosed by prenatal ultrasound examination in both live births and stillbirths. Log-binomial regression and restricted cubic spline were used to estimate the risk of offspring CHD associated with preconception body mass index (BMI). A generalized additive model was used to explore the modification effect of maternal age on the association between preconception BMI and offspring CHD. RESULTS A total of 129 096 pregnant women were included in the analysis. The incidence of CHD in the underweight, normal weight, overweight, and obesity groups were 117/17 313 (0.68%), 556/85 695 (0.65%), 128/19 936 (0.64%), 47/6152 (0.76%), respectively. Both underweight and obesity before pregnancy marginally increased the risk of offspring CHD. The association between preconception BMI and offspring CHD varied by maternal age, with low preconception BMI associated with a significantly higher risk of offspring CHD in women <24 years (RR 2.32, 95% CI: 1.07-5.01 for 17 vs 21 kg/m2). CONCLUSION Preconception underweight was associated with an increased risk of offspring CHD in young pregnant women. Therefore, weight gain is important to prevent offspring CHD, especially for young women with low preconception BMI.
Collapse
Affiliation(s)
- Ruohua Yan
- Center for Clinical Epidemiology and Evidence-based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children Health, Beijing, China
| | - Xiaohang Liu
- Center for Clinical Epidemiology and Evidence-based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children Health, Beijing, China
| | - Yaguang Peng
- Center for Clinical Epidemiology and Evidence-based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children Health, Beijing, China
| | - Xiaoxia Peng
- Center for Clinical Epidemiology and Evidence-based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children Health, Beijing, China
| |
Collapse
|
35
|
Cagnin S, Pontisso P, Martini A. SerpinB3: A Multifaceted Player in Health and Disease-Review and Future Perspectives. Cancers (Basel) 2024; 16:2579. [PMID: 39061218 PMCID: PMC11274807 DOI: 10.3390/cancers16142579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 07/10/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024] Open
Abstract
SerpinB3, a member of the serine-protease inhibitor family, has emerged as a crucial player in various physiological and pathological processes. Initially identified as an oncogenic factor in squamous cell carcinomas, SerpinB3's intricate involvement extends from fibrosis progression and cancer to cell protection in acute oxidative stress conditions. This review explores the multifaceted roles of SerpinB3, focusing on its implications in fibrosis, metabolic syndrome, carcinogenesis and immune system impairment. Furthermore, its involvement in tissue protection from oxidative stress and wound healing underscores its potential as diagnostic and therapeutic tool. Recent studies have described the therapeutic potential of targeting SerpinB3 through its upstream regulators, offering novel strategies for cancer treatment development. Overall, this review underscores the importance of further research to fully elucidate the mechanisms of action of SerpinB3 and to exploit its therapeutic potential across various medical conditions.
Collapse
Affiliation(s)
| | - Patrizia Pontisso
- Department of Medicine, University of Padova, 35123 Padova, Italy; (S.C.); (A.M.)
| | | |
Collapse
|
36
|
Song W, Wu M, Wang H, Pang R, Zhu L. Prevalence, risk factors, and outcomes of dysphagia after stroke: a systematic review and meta-analysis. Front Neurol 2024; 15:1403610. [PMID: 39087010 PMCID: PMC11288910 DOI: 10.3389/fneur.2024.1403610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 07/02/2024] [Indexed: 08/02/2024] Open
Abstract
Background Dysphagia is a common complication after stroke, which not only brings adverse outcomes but also greatly affects the quality of life of patients. At present, there is no systematic review or meta-analysis to comprehensively evaluate the epidemiological characteristics of post-stroke dysphagia (PSD). A systematic review of the prevalence, risk factors, and prognosis of PSD is essential. Methods Through 31 December 2022, a comprehensive literature search was performed for observational studies related to PSD. Five databases were retrieved. Random-effects models were used to estimate the pooled prevalence, odds ratio (OR), and 95% CIs. Results A total of 34 studies were included, and the results showed that the overall prevalence of PSD was 46.6% (95% CI, 0.405-0.528). The prevalence of dysphagia in ischemic stroke and hemorrhagic stroke was 43.6% (95% CI 0.370-0.501) and 58.8% (95% CI 0.519-0.654), respectively. The prevalence of PSD in Africa was 49.4% (95% CI, 0.196-0.792), in Asia was 40.1% (95% CI, 0.348-0.454), in Europe was 45.8% (95% CI, 0.327-0.590), in North America was 44.3% (95% CI, 0.370-0.517), in South America was 57.5% (95% CI, 0.441-0.708), and in Oceania was 64.1% (95%CI, 0.558, 0.724). In risk factor analysis, hypertension, previous stroke, and atrial fibrillation were significantly associated with the occurrence of PSD, pooled OR = 1.179 [(95% CI, 1.002-1.386), p < 0.05], pooled OR = 1.514 [(95% CI, 1.204-1.905), p < 0.001], and pooled OR = 1.980 [(95% CI, 1.580-2.481), p < 0.001]. In outcome studies, the prevalence of aphasia and dysarthria in PSD was 35.6% (95% CI, 0.213-0.499) and 54.5% (95% CI, 0.293-0.798), respectively. The prevalence of respiratory tract infection was 27.1% (95%CI, -0.038-0.579), and the prevalence of pneumonitis was 32.1% (95% CI, 0.224-0.418). Persistence of dysphagia at discharge and at 1 month was 74.5% (95% CI, 0.621-0.869) and 50.9% (95% CI, 0.142-0.876), respectively. Mortality rates for PSD patients during admission and discharge at 1 month, 3 months, and 1 year were 11.8% (95% CI, 0.083-0.152), 26.5% (95% CI, 0.170-0.359), 25.7% (95% CI, 0.19-0.324), and 31.3% (95% CI, 0.256-0.369), respectively. Conclusion This study found that the overall prevalence of PSD was 46.6%. Prevalence is most influenced by the diagnosis method. Hypertension, history of stroke, atrial fibrillation, patient age, and stroke severity were risk factors significantly associated with PSD. The prevalence of aphasia, dysarthria, respiratory tract infection, and pneumonitis in PSD patients is 2-4 times that of patients without PSD.Systematic review registration: www.crd.york.ac.uk/PROSPERO, PROSPERO, CRD42021252967.
Collapse
Affiliation(s)
- Wenjing Song
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Minmin Wu
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Haoran Wang
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Ruifeng Pang
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Luwen Zhu
- The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| |
Collapse
|
37
|
Kumschier T, Thalhammer J, Schmid C, Haeusele J, Koehler T, Pfeiffer F, Lasser T, Schaff F. Streak artefact removal in x-ray dark-field computed tomography using a convolutional neural network. Med Phys 2024. [PMID: 39012833 DOI: 10.1002/mp.17305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 06/24/2024] [Accepted: 07/01/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND Computed tomography (CT) relies on the attenuation of x-rays, and is, hence, of limited use for weakly attenuating organs of the body, such as the lung. X-ray dark-field (DF) imaging is a recently developed technology that utilizes x-ray optical gratings to enable small-angle scattering as an alternative contrast mechanism. The DF signal provides structural information about the micromorphology of an object, complementary to the conventional attenuation signal. A first human-scale x-ray DF CT has been developed by our group. Despite specialized processing algorithms, reconstructed images remain affected by streaking artifacts, which often hinder image interpretation. In recent years, convolutional neural networks have gained popularity in the field of CT reconstruction, amongst others for streak artefact removal. PURPOSE Reducing streak artifacts is essential for the optimization of image quality in DF CT, and artefact free images are a prerequisite for potential future clinical application. The purpose of this paper is to demonstrate the feasibility of CNN post-processing for artefact reduction in x-ray DF CT and how multi-rotation scans can serve as a pathway for training data. METHODS We employed a supervised deep-learning approach using a three-dimensional dual-frame UNet in order to remove streak artifacts. Required training data were obtained from the experimental x-ray DF CT prototype at our institute. Two different operating modes were used to generate input and corresponding ground truth data sets. Clinically relevant scans at dose-compatible radiation levels were used as input data, and extended scans with substantially fewer artifacts were used as ground truth data. The latter is neither dose-, nor time-compatible and, therefore, unfeasible for clinical imaging of patients. RESULTS The trained CNN was able to greatly reduce streak artifacts in DF CT images. The network was tested against images with entirely different, previously unseen image characteristics. In all cases, CNN processing substantially increased the image quality, which was quantitatively confirmed by increased image quality metrics. Fine details are preserved during processing, despite the output images appearing smoother than the ground truth images. CONCLUSIONS Our results showcase the potential of a neural network to reduce streak artifacts in x-ray DF CT. The image quality is successfully enhanced in dose-compatible x-ray DF CT, which plays an essential role for the adoption of x-ray DF CT into modern clinical radiology.
Collapse
Affiliation(s)
- Tom Kumschier
- Chair of Biomedical Physics, Department of Physics, School of Natural Sciences, Technical University of Munich, Garching, Germany
- Munich School of BioEngineering, Technical University of Munich, Garching, Germany
| | - Johannes Thalhammer
- Chair of Biomedical Physics, Department of Physics, School of Natural Sciences, Technical University of Munich, Garching, Germany
- Munich School of BioEngineering, Technical University of Munich, Garching, Germany
- Institute for Advanced Study, Technical University of Munich, Garching, Germany
| | - Clemens Schmid
- Chair of Biomedical Physics, Department of Physics, School of Natural Sciences, Technical University of Munich, Garching, Germany
- Munich School of BioEngineering, Technical University of Munich, Garching, Germany
| | - Jakob Haeusele
- Chair of Biomedical Physics, Department of Physics, School of Natural Sciences, Technical University of Munich, Garching, Germany
- Munich School of BioEngineering, Technical University of Munich, Garching, Germany
| | - Thomas Koehler
- Institute for Advanced Study, Technical University of Munich, Garching, Germany
- Philips Research, Hamburg, Germany
| | - Franz Pfeiffer
- Chair of Biomedical Physics, Department of Physics, School of Natural Sciences, Technical University of Munich, Garching, Germany
- Munich School of BioEngineering, Technical University of Munich, Garching, Germany
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Tobias Lasser
- Munich School of BioEngineering, Technical University of Munich, Garching, Germany
- Computational Imaging and Inverse Problems, Department of Computer Science, School of Computation, Information and Technology, Technical University of Munich, Garching, Germany
| | - Florian Schaff
- Chair of Biomedical Physics, Department of Physics, School of Natural Sciences, Technical University of Munich, Garching, Germany
- Munich School of BioEngineering, Technical University of Munich, Garching, Germany
| |
Collapse
|
38
|
Zhou Q, Chang C, Wang Y, Gai X, Chen Y, Gao X, Liang Y, Sun Y. Comparative analysis of lysophospholipid metabolism profiles and clinical characteristics in patients with high vs. low C-reactive protein levels in acute exacerbations of chronic obstructive pulmonary disease. Clin Chim Acta 2024; 561:119816. [PMID: 38885755 DOI: 10.1016/j.cca.2024.119816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 06/09/2024] [Accepted: 06/12/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND The precise role of lysophospholipids (LysoPLs) in the pathogenesis of acute exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD) remains unclear. In this study, we sought to elucidate the differences in serum LysoPL metabolite profiles and their correlation with clinical features between patients with low versus high CRP levels. METHODS A total of 58 patients with AECOPD were enrolled in the study. Patients were classified into two groups: low CRP group (CRP < 20 mg/L, n = 34) and high CRP group (CRP ≥ 20 mg/L, n = 24). Clinical data were collected, and the LysoPL metabolite profiles were analyzed using Liquid Chromatography-Mass Spectrometry (LC-MS) and identified by matching with the LipidBlast library. RESULTS Nineteen differential LysoPLs were initially identified through Student's t-test (p < 0.05 and VIP > 1). Subsequently, four LysoPLs, LPC(16:0), LPE(18:2), LPC(22:0), and LPC(24:0), were identified by FDR adjustment (adjusted p < 0.05). These four lysoPLs had a significant negative correlation with CRP. Integrative analysis revealed that LPC (16:0) and LPC (22:0) correlated with less hypercapnic respiratory failure and ICU admission. CONCLUSION AECOPD patients with high CRP levels demonstrated a distinctive LysoPL metabolism profile, with LPC (16:0), LPE(18:2), LPC(22:0), and LPC(24:0) being the most significantly altered lipid molecules. These alterations were associated with poorer clinical outcomes.
Collapse
Affiliation(s)
- Qiqiang Zhou
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, China
| | - Chun Chang
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, China; Research Center for Chronic Airway Diseases, Peking University Health Science Center, Beijing, China
| | - Yating Wang
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, China
| | - Xiaoyan Gai
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, China; Research Center for Chronic Airway Diseases, Peking University Health Science Center, Beijing, China
| | - Yahong Chen
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, China; Research Center for Chronic Airway Diseases, Peking University Health Science Center, Beijing, China
| | - Xu Gao
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Ying Liang
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, China; Research Center for Chronic Airway Diseases, Peking University Health Science Center, Beijing, China.
| | - Yongchang Sun
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, China; Research Center for Chronic Airway Diseases, Peking University Health Science Center, Beijing, China
| |
Collapse
|
39
|
Niyoyita JC, Ndayisenga J, Omolo J, Niyompano H, Bimenyimana PC, Dzinamarira T, Nsekuye O, Chavez I, Hakizayezu F. Factors associated with neonatal sepsis among neonates admitted in Kibungo Referral Hospital, Rwanda. Sci Rep 2024; 14:15961. [PMID: 38987637 PMCID: PMC11236976 DOI: 10.1038/s41598-024-66818-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 07/04/2024] [Indexed: 07/12/2024] Open
Abstract
More than one million neonatal deaths occur every year worldwide, of which 99% take place in low-income countries. In Rwanda, nearly 71% of neonatal deaths are preventable and among these, 10% are due to neonatal sepsis. Nevertheless, limited information exists on neonatal sepsis and its associated factors in Rwanda. The objectives of the study were to find prevalence and factors associated with neonatal sepsis among neonates admitted in Kibungo Referral Hospital, Ngoma District, Rwanda. We used a retrospective cross-sectional study design reviewing a subset of neonatal, maternal and laboratory records from Kibungo Hospital in 2017. Data were reviewed and collected from March to May, 2018. Logistic regression and odds ratios were calculated to identify the factors associated with neonatal sepsis at 95% CI, p < 0.05. Of the 972 total neonates' medical records from 2017, we randomly selected 422 of which 12.8% (n = 54) had neonatal sepsis. When blood cultures were positive, 62% grew Klebsiella pneumoniae. Among neonates with sepsis, 38 (70%) recovered while 16 (30%) died. Neonatal sepsis was strongly associated with neonatal age less than or equal to three days (aOR: 2.769, 95% CI 1.312-5.843; p = 0.008); and gestational age less than 37 weeks (aOR: 4.149; CI 1.1878-9.167; p ≤ 0.001). Increased use of blood cultures including sensitivity testing, routine surface cultures of the neonatology and maternity wards facilities, and systematic ward cleaning are all important approaches to prevent and treat neonatal infections in additional to regular neonatal sepsis evaluations.
Collapse
Affiliation(s)
- Jean Claude Niyoyita
- Rwanda Field Epidemiology and Laboratory Training Program, Department of Biostatistics and Epidemiology, School of Public Health, University of Rwanda, P.O. Box 3286, Kigali, Rwanda.
- African Research and Community Health Initiative, Kigali, Rwanda.
| | - Jerome Ndayisenga
- African Research and Community Health Initiative, Kigali, Rwanda
- Rwanda Biomedical Centre, Kigali, Rwanda
| | - Jared Omolo
- Rwanda Field Epidemiology and Laboratory Training Program, Department of Biostatistics and Epidemiology, School of Public Health, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
| | - Hosee Niyompano
- Rwanda Field Epidemiology and Laboratory Training Program, Department of Biostatistics and Epidemiology, School of Public Health, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
- Rwanda Biomedical Centre, Kigali, Rwanda
| | - Pierre Celestin Bimenyimana
- Rwanda Field Epidemiology and Laboratory Training Program, Department of Biostatistics and Epidemiology, School of Public Health, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
| | | | | | - Isabella Chavez
- University of California, Los Angeles (UCLA), Los Angeles, USA
| | - François Hakizayezu
- Rwanda Field Epidemiology and Laboratory Training Program, Department of Biostatistics and Epidemiology, School of Public Health, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
| |
Collapse
|
40
|
Nayak S, Amin A, Reghunath SR, Thunga G, Acharya U D, Shivashankara KN, Prabhu Attur R, Acharya LD. Development of a machine learning-based model for the prediction and progression of diabetic kidney disease: A single centred retrospective study. Int J Med Inform 2024; 190:105546. [PMID: 39003788 DOI: 10.1016/j.ijmedinf.2024.105546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 07/02/2024] [Accepted: 07/08/2024] [Indexed: 07/16/2024]
Abstract
BACKGROUND Diabetic kidney disease (DKD) is a diabetic microvascular complication often characterized by an unpredictable progression. Hence, early detection and recognition of patients vulnerable to progression is crucial. OBJECTIVE To develop a prediction model to identify the stages of DKD and the factors contributing to progression to each stage using machine learning. METHODOLOGY A retrospective study was conducted in a South Indian tertiary care hospital and collected the details of patients diagnosed with DKD from January 2017 to January 2022. Bayesian optimization-based machine learning techniques such as classification and regression were employed. The model was developed with the help of an optimization framework that effectively balances classification, prediction accuracy, and explainability. RESULTS Of the 311 patients diagnosed with DKD, 227 were selected for the study. A system for predicting DKD has been created for a patient dataset utilizing a variety of machine-learning approaches. The eXtreme gradient (XG) Boost method excelled, achieving 88.75% accuracy, 88.57% precision, 91.4% sensitivity,100% specificity, and 89.49% F1-score. An interpretable data-driven method highlights significant features for early DKD diagnosis. The best explainable prediction model uses the XG Boost classifier, revealing serum uric acid, urea, phosphorous, red blood cells, calcium, and absolute eosinophil count as the major predictors influencing the progression of DKD. In the case of regression models, the gradient boost regressor performed the best, with an R2 score of 0.97. CONCLUSION Machine learning algorithms can effectively predict the stages of DKD and thus help physicians in providing patients with personalized care at the right time.
Collapse
Affiliation(s)
- Sandhya Nayak
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Udupi District, Karnataka 576 104, India.
| | - Ashwini Amin
- Department of Computer Science and Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Udupi District, Karnataka 576 104, India.
| | - Swetha R Reghunath
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Udupi District, Karnataka 576 104, India.
| | - Girish Thunga
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Udupi District, Karnataka 576 104, India.
| | - Dinesh Acharya U
- Department of Computer Science and Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Udupi District, Karnataka 576 104, India.
| | - K N Shivashankara
- Department of General Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Udupi District, Karnataka 576 104, India.
| | - Ravindra Prabhu Attur
- Department of Nephrology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Udupi District, Karnataka 576 104, India.
| | - Leelavathi D Acharya
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Udupi District, Karnataka 576 104, India.
| |
Collapse
|
41
|
Kim S, Kang H, Excler JL, Kim JH, Lee JS. The Economic Burden of Non-Typhoidal Salmonella and Invasive Non-Typhoidal Salmonella Infection: A Systematic Literature Review. Vaccines (Basel) 2024; 12:758. [PMID: 39066396 PMCID: PMC11281589 DOI: 10.3390/vaccines12070758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2024] [Revised: 06/25/2024] [Accepted: 06/28/2024] [Indexed: 07/28/2024] Open
Abstract
Non-typhoidal Salmonella (NTS) infection and invasive non-typhoidal Salmonella (iNTS) infection cause a significant global health and economic burden. This systematic review aims to investigate the reported economic burden of NTS and iNTS infection, identify research gaps, and suggest future research directions. Data from PubMed and Embase databases up to April 2022 were reviewed, and articles were screened based on predefined criteria. Cost data were extracted, categorized into direct medical costs (DMCs), direct non-medical costs (DNMCs), and indirect costs (ICs), and converted into US dollars (year 2022). Data primarily originated from high-income countries (37 out of 38), with limited representation from Africa and resource-limited settings. For inpatients, DMCs were the primary cost driver for both NTS and iNTS illnesses, with estimates ranging from USD 545.9 (Taiwan, a region of China) to USD 21,179.8 (Türkiye) for NTS and from USD 1973.1 (Taiwan, a region of China) to USD 32,507.5 (United States of America) for iNTS per case. DNMCs and ICs varied widely across studies. Although study quality improved over time, methodological differences persisted. This review underscores the lack of economic data on NTS and iNTS in resource-limited settings. It also highlights the need for economic burden data in resource-limited settings and a standardized approach to generate global datasets, which is critical for informing policy decisions, especially regarding future vaccines.
Collapse
Affiliation(s)
- Sol Kim
- International Vaccine Institute, Seoul 08826, Republic of Korea; (S.K.); (H.K.); (J.-L.E.); (J.H.K.)
| | - Hyolim Kang
- International Vaccine Institute, Seoul 08826, Republic of Korea; (S.K.); (H.K.); (J.-L.E.); (J.H.K.)
| | - Jean-Louis Excler
- International Vaccine Institute, Seoul 08826, Republic of Korea; (S.K.); (H.K.); (J.-L.E.); (J.H.K.)
| | - Jerome H. Kim
- International Vaccine Institute, Seoul 08826, Republic of Korea; (S.K.); (H.K.); (J.-L.E.); (J.H.K.)
- College of Natural Sciences, Seoul National University, Seoul 08826, Republic of Korea
| | - Jung-Seok Lee
- International Vaccine Institute, Seoul 08826, Republic of Korea; (S.K.); (H.K.); (J.-L.E.); (J.H.K.)
| |
Collapse
|
42
|
Aksak-Wąs B, Karasińska-Cieślak M, Parczewski M. Overcoming Geographical Constraints: A Diagnostic and Therapeutic Challenge of Amebic Liver Abscess in a Non-Endemic Region. Clin Exp Gastroenterol 2024; 17:185-190. [PMID: 39006393 PMCID: PMC11246073 DOI: 10.2147/ceg.s459696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 06/20/2024] [Indexed: 07/16/2024] Open
Abstract
This case report provides data on unique challenges related to amoebiasis diagnostics and treatment in non-endemic regions. The presented case report is focused a 28-year-old male patient of Indian origin, temporarily living in Poland, who was diagnosed with an amoebic liver abscess. The patient presented with a range of non-specific symptoms including shortness of breath, chest pain, and fever. The differential diagnosis included cardio-pulmonary diseases, a range of tropical diseases such as malaria or typhoid fever, bacterial abscesses, and malignancies, necessitating a comprehensive, multi-modal diagnostic approach. This approach included an extensive review of patient history, physical examination, and various laboratory and imaging investigations. A further challenge in this case was the unavailability of standard cysticidal treatments in Poland, which required individualized therapeutic strategy. Despite these obstacles, the patient was successfully treated using an alternative regimen of intravenous metronidazole, ceftriaxone, doxycycline, chloroquine, and finally, trimethoprim/sulfamethoxazole (treatment with metronidazole was used as a base drug, due to the lack of typical cysticidal treatment, an alternative treatment was added: chloroquine is a recommended drug used in the treatment of pregnant patients, in addition, doxycycline showed in vitro activity against Entamoeba histolytica). This therapeutic journey underscored the value of adaptability in treatment protocols, particularly in regions where certain resources may not be readily available. This case report underlines the importance of broadening the differential diagnosis in non-endemic regions to include tropical diseases, particularly in the context of increasing global travel and migration. It also highlights the significance of employing comprehensive diagnostic strategies and adaptable treatment protocols in such scenarios. In addition, the report reiterates the need for global collaboration and education among healthcare providers to effectively manage tropical diseases, especially in non-endemic regions. Through its exploration of the complexities associated with diagnosing and managing amebiasis in a non-endemic region, this report offers valuable insights to clinicians worldwide.
Collapse
Affiliation(s)
- Bogusz Aksak-Wąs
- Department of Infectious, Tropical Diseases and Acquired Immunodeficiency, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Malwina Karasińska-Cieślak
- Department of Infectious, Tropical Diseases and Acquired Immunodeficiency, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Miłosz Parczewski
- Department of Infectious, Tropical Diseases and Acquired Immunodeficiency, Pomeranian Medical University in Szczecin, Szczecin, Poland
| |
Collapse
|
43
|
Li Q, Feng M, Zhang H, Zhou H, Cheng X. Entamoeba moshkovskii as a potential model organism for Gal/GalNAc lectin intermediate subunit exhibition and functional identification. Drug Discov Ther 2024; 18:178-187. [PMID: 38777764 DOI: 10.5582/ddt.2024.01031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
In humans, Entamoeba histolytica is the main pathogen causing various amoebiases, while E. moshkovskii falls between being a pathogen and non-pathogen. The two species have similar behavior patterns but differ significantly in pathogenicity, with previous studies and clinical data indicating that E. moshkovskii has a low level of pathogenicity. Meaningfully, the biological characteristics of E. moshkovskii make it a potential model organism and a protein display platform for studying the functions of important Entamoeba proteins. Here, an Amoeba-pcDNA3.1 vector capable of overexpressing E. histolytica-sourced Igl-C protein was constructed and successfully transfected into E. moshkovskii. High levels of expression of the Igl-C, EGFP, and NeoR genes were identified in Igl-C-transfected trophozoites using qRT-PCR, and they were subsequently confirmed using immunoblotting. Transfection of Igl-C protein improved the adherence and phagocytosis of E. moshkovskii, demonstrating that E. histolytica Igl mediated amoebic adhesion. Moreover, as a manifestation of protein virulence, the ability of post-transfected trophozoites to induce inflammation in host macrophages was also enhanced. In conclusion, this study utilizing the characteristics of E. moshkovskii confirmed its potential to serve as a model organism. E. moshkovskii could replace E. histolytica as the target of gene editing, allowing more efficient study of amoebic pathogenicity.
Collapse
Affiliation(s)
- Qingshan Li
- Department of Medical Microbiology and Parasitology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Meng Feng
- Department of Medical Microbiology and Parasitology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Hongze Zhang
- Department of Medical Microbiology and Parasitology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Hang Zhou
- Department of Medical Microbiology and Parasitology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Xunjia Cheng
- Department of Medical Microbiology and Parasitology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| |
Collapse
|
44
|
Nziza N, Jung W, Mendu M, Chen T, Julg B, Graham B, Ramilo O, Mejias A, Alter G. Longitudinal humoral analysis in RSV-infected infants identifies pre-existing RSV strain-specific G and evolving cross-reactive F antibodies. Immunity 2024; 57:1681-1695.e4. [PMID: 38876099 DOI: 10.1016/j.immuni.2024.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 01/16/2024] [Accepted: 05/20/2024] [Indexed: 06/16/2024]
Abstract
Respiratory syncytial virus (RSV) is among the most common causes of lower respiratory tract infection (LRTI) and hospitalization in infants. However, the mechanisms of immune control in infants remain incompletely understood. Antibody profiling against attachment (G) and fusion (F) proteins in children less than 2 years of age, with mild (outpatients) or severe (inpatients) RSV disease, indicated substantial age-dependent differences in RSV-specific immunity. Maternal antibodies were detectable for the first 3 months of life, followed by a long window of immune vulnerability between 3 and 6 months and a rapid evolution of FcγR-recruiting immunity after 6 months of age. Acutely ill hospitalized children exhibited lower G-specific antibodies compared with healthy controls. With disease resolution, RSV-infected infants generated broad functional RSV strain-specific G-responses and evolved cross-reactive F-responses, with minimal maternal imprinting. These data suggest an age-independent RSV G-specific functional humoral correlate of protection, and the evolution of RSV F-specific functional immunity with disease resolution.
Collapse
Affiliation(s)
- Nadège Nziza
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA
| | - Wonyeong Jung
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA
| | - Maanasa Mendu
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA; Harvard University, Cambridge, MA, USA
| | - Tina Chen
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA
| | - Boris Julg
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA
| | - Barney Graham
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Octavio Ramilo
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, USA; Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, OH, USA.
| | - Asuncion Mejias
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, USA; Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, OH, USA.
| | - Galit Alter
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA.
| |
Collapse
|
45
|
Howell K, Garvan C, Amini S, Kamyszek RW, Tighe P, Price CC, Spiess BD. Association Between Preoperative Anemia and Cognitive Function in a Large Cohort Study of Older Patients Undergoing Elective Surgery. Anesth Analg 2024:00000539-990000000-00859. [PMID: 38985884 DOI: 10.1213/ane.0000000000006998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2024]
Abstract
BACKGROUND The etiology of anemia has tremendous overlap with the disease states responsible for cognitive decline. We used data from a perioperative database of older adults undergoing elective surgery with anesthesia to (1) examine relationships among preoperative anemia blood markers, preoperative screeners of cognitive function, and chronic disease status; and (2) examine the relationship of these factors with operative outcomes. The primary goal of this study was to investigate the association between preoperative anemia blood markers and cognition measured by a preoperative cognitive screener. Secondary goals were to (1) examine the relationship between preoperative anemia blood markers and chronic disease states (ie, American Society of Anesthesiologists [ASA] and frailty), and (2) investigate the relationship of preoperative anemia blood markers and cognition with operative outcomes (ie, discharge disposition, 1-year mortality, number of surgical complications, length of hospital stay, and length of intensive care unit [ICU] stay). METHODS Data were collected at the University of Florida Health Shands Presurgical Center and the Perioperative Cognitive Anesthesia Network clinic within the electronic medical record. Patients 65 years of age or older were included if they had a preoperative hemoglobin (Hgb) value and a preoperative screening. Nonparametric methods were used for bivariate analysis. Logistic regression was used for the simultaneous examination of variables associated with nonhome discharge and 1-year mortality. Primary outcomes were discharge disposition and 1-year mortality. Secondary outcomes were number of surgical complications and length of hospital and ICU stay. RESULTS Of 14,795 patients cognitively assessed, 8643 met the inclusion criteria. Of these, 26.7% were anemic, with 16.8%, 9.5%, and 0.4% having mild, moderate, and severe anemia, respectively. The Spearman correlation coefficient [95% confidence interval, CI] between the Hgb level and the clock drawing time (CDT) was -.15 [-.17 to -.13] (P < .0001) indicating that a lower Hgb level was associated with cognitive vulnerability. Hgb was also negatively correlated with the ASA physical status classification, patient Fried Frailty Index, and hospital and ICU length of stay. In the multivariable model, age, surgical service, ASA and Fried Frailty Index significantly predicted nonhome discharge. Furthermore, age, surgical service, ASA, Fried Frailty Index, and Hgb independently predicted death within 1 year of surgery. The odds of death, adjusted for ASA, Fried Frailty, and covariates, were 2.7 times higher for those in the mild anemic group compared to those who were not anemic (odds ratio [OR], 2.7, 95% CI, [2.1-3.5]). The odds of death, adjusted for ASA, Fried Frailty, and covariates, were 3.6 times higher for those in the moderate/severe anemic group compared to those who were not anemic (OR, 3.6, 95% CI, [2.7-4.9]). CONCLUSIONS In this first medicine study, we established relationships among anemia, preoperative markers of frailty and cognition, and chronic disease states in a large cohort of older patients undergoing elective surgery in a large tertiary medical center. We found that anemia, cognitive vulnerability, and chronic health disease states predicted death within 1 year of surgery, and that these preoperative factors negatively contribute to surgical outcomes such as time in the ICU, length of hospital stay, nonhome discharge, and 1-year mortality. The World Health Organization (WHO) and many academic medical societies have urged the adoption of patient blood management (PBM) disciplines, yet anemia is not routinely optimized as a preoperative risk factor. Given the well-defined association between preoperative anemia and postoperative morbidity and mortality, performing elective surgery on an untreated anemic patient should be considered substandard care. With established safe and effective treatment regimens, iron deficiency anemia is a modifiable preoperative risk factor that should be addressed before elective surgery.
Collapse
Affiliation(s)
- Keith Howell
- From the Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida
| | - Cynthia Garvan
- From the Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida
| | - Shawna Amini
- Department of Neurosurgery, University of Florida College of Medicine, Gainesville, Florida
| | - Reed W Kamyszek
- From the Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida
| | - Patrick Tighe
- From the Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida
| | - Catherine C Price
- Department of Neurosurgery, University of Florida College of Medicine, Gainesville, Florida
| | - Bruce D Spiess
- From the Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida
| |
Collapse
|
46
|
Wei N, Zheng B, Cai H, Li N, Yang J, Liu M. Systematic review and meta-analysis: de novo combination of nucleos(t)ide analogs and pegylated interferon alpha versus pegylated interferon alpha monotherapy for the functional cure of chronic hepatitis B. Front Pharmacol 2024; 15:1403805. [PMID: 39035984 PMCID: PMC11259969 DOI: 10.3389/fphar.2024.1403805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 06/10/2024] [Indexed: 07/23/2024] Open
Abstract
Introduction: Chronic hepatitis B (CHB) is a worldwide infectious disease caused by hepatitis B virus (HBV). Optimizing antiviral treatment strategies could improve the functional cure (FC) rate of patients with CHB. This study aims to systematically review the FC rate of the de novo combination of nucleos(t)ide analogs (NAs) and pegylated interferon α (PEG-IFNα) versus that of PEG-IFNα monotherapy for CHB. Methods: Databases were searched until 31 December 2023. Selected studies included randomized controlled trials on the de novo combination of NAs and PEG-IFNα versus PEG-IFNα monotherapy for 48 weeks in patients with CHB to achieve FC, which was defined as hepatitis B surface antigen (HBsAg) loss and/or HBsAg seroconversion. Meta-analysis was conducted in accordance with the efficacy at the end of treatment and different time points during follow-up. Results: A total of 10 studies, encompassing 2,339 patients in total, were included. Subgroup analysis was conducted in accordance with whether first-line NAs were used. It found no statistically significant difference between HBsAg loss and HBsAg seroconversion at the end of treatment. Serum HBV DNA <500 copies/mL significantly differed between the two groups at the end of treatment and did not significantly differ during follow-up. Meanwhile, HBsAg loss and HBsAg seroconversion showed statistically significant differences at 24 weeks of follow-up. By contrast, no statistically significant difference was found in HBsAg loss at 48 weeks of follow-up. Discussion: Without distinguishing the eligible preponderant population, the efficacy of the de novo combination of NAs and PEG-IFNα in treating patients with CHB was not superior to that of PEG-IFNα monotherapy. Systematic Review Registration: PROSPERO, identifier CRD42022325239.
Collapse
Affiliation(s)
| | | | | | | | | | - Maobai Liu
- Department of Pharmacy, Fujian Medical Union Hospital, Fuzhou, China
| |
Collapse
|
47
|
Fan J, Tan X, Smith AP, Wang J. Work-related musculoskeletal disorders, fatigue and stress among gas station workers in China: a cross-sectional study. BMJ Open 2024; 14:e081853. [PMID: 38969368 PMCID: PMC11227785 DOI: 10.1136/bmjopen-2023-081853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 06/20/2024] [Indexed: 07/07/2024] Open
Abstract
INTRODUCTION Work-related musculoskeletal disorders (WMSDs) are disorders of the musculoskeletal system that have the highest prevalence among workers worldwide. Workers in gas stations usually work in poor ergonomic working conditions, including prolonged standing and repetitive posturing. OBJECTIVE The study aimed to investigate the prevalence of WMSDs and fatigue and to identify the predictors of WMSDs among gas station workers. DESIGN The present study was a cross-sectional study. SETTING AND PARTICIPANTS 2962 gas station workers from an oil and gas company in China, with ages ranging from 17 to 75 years old, 55.47% female. RESULTS The prevalence of WMSDs within the 12 months prior to the study was 73.23%, with the highest prevalence in the neck, shoulders, ankles and feet. Furthermore, a correlation was observed between fatigue, stress and WMSDs. Fatigue and job role were the strongest predictors of WMSDs, with an OR range of 2.211-3.413. CONCLUSIONS This research identified the detrimental impact of WMSDs and fatigue on gas station workers, indicating the critical need for interventions to reduce WMSDs and relieve fatigue.
Collapse
Affiliation(s)
- Jialin Fan
- School of Psychology, Shenzhen University, Shenzhen, China
- Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, Shenzhen, China
| | - Xiaotong Tan
- School of Psychology, Shenzhen University, Shenzhen, China
| | | | - Jing Wang
- School of Psychology, Shenzhen University, Shenzhen, China
| |
Collapse
|
48
|
Liu H, Fan D, Wang J, Wang Y, Li A, Wu S, Zhang B, Liu J, Wang S. Lactobacillus rhamnosus NKU FL1-8 Isolated from Infant Feces Ameliorates the Alcoholic Liver Damage by Regulating the Gut Microbiota and Intestinal Barrier in C57BL/6J Mice. Nutrients 2024; 16:2139. [PMID: 38999886 PMCID: PMC11243132 DOI: 10.3390/nu16132139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 06/28/2024] [Accepted: 07/02/2024] [Indexed: 07/14/2024] Open
Abstract
Alcoholic liver damage is caused by long-term or heavy drinking, and it may further progress into alcoholic liver diseases (ALD). Probiotic supplements have been suggested for the prevention or improvement of liver damage. This study was designed to consider the ameliorative effects of Lactobacillus rhamnosus NKU FL1-8 isolated from infant feces against alcoholic liver damage. The mice were gavaged with a 50% ethanol solution and treated with 109 CFU of L. rhamnosus NKU FL1-8 suspension. The factors for liver function, oxidative stress, inflammation, gut microbiota composition, and intestinal barrier integrity were measured. The results showed that L. rhamnosus NKU FL1-8 could decrease the levels of aspartate aminotransferase (AST) to 61% and alanine aminotransferase (ALT) to 50% compared with ethanol given by gavage. It could inhibit the expression level of malondialdehyde (MDA), increase superoxide dismutase (SOD), glutathione (GSH) to relieve oxidative stress, and down-regulate the cytokines to decrease hepatic inflammation. After treatment, the level of triglycerides was reduced, and the expression levels of adenosine 5'-monophosphate (AMP)-activated protein kinase (AMPK) and the peroxisome proliferators-activated receptor-α (PPAR-α) pathway were up-regulated. Additionally, the 16S rRNA sequencing analysis showed that L. rhamnosus NKU FL1-8 increased the relative abundance of Lactobacillus, Ruminococcaceae, etc. At the same time, L. rhamnosus NKU FL1-8 could significantly reduce lipopolysaccharides (LPS) and enhance intestinal tight junction proteins. These results demonstrated that L. rhamnosus NKU FL1-8 could reduce the level of oxidative stress, fat accumulation, and liver inflammation caused by alcohol in the host. The underlying mechanism could be that L. rhamnosus NKU FL1-8 inhibits LPS by regulating the gut microbiota and repairing the intestinal barrier. Thereby, these findings support L. rhamnosus NKU FL1-8 as a potential functional food for the relief of ALD.
Collapse
Affiliation(s)
- Haiwei Liu
- Tianjin Key Laboratory of Food Science and Health, School of Medicine, Nankai University, Tianjin 300350, China
| | - Dancai Fan
- Tianjin Key Laboratory of Food Science and Health, School of Medicine, Nankai University, Tianjin 300350, China
| | - Jin Wang
- Tianjin Key Laboratory of Food Science and Health, School of Medicine, Nankai University, Tianjin 300350, China
| | - Yuanyifei Wang
- Tianjin Key Laboratory of Food Science and Health, School of Medicine, Nankai University, Tianjin 300350, China
| | - Ang Li
- Tianjin Key Laboratory of Food Science and Health, School of Medicine, Nankai University, Tianjin 300350, China
| | - Sihao Wu
- Tianjin Key Laboratory of Food Science and Health, School of Medicine, Nankai University, Tianjin 300350, China
| | - Bowei Zhang
- Tianjin Key Laboratory of Food Science and Health, School of Medicine, Nankai University, Tianjin 300350, China
| | - Jingmin Liu
- Tianjin Key Laboratory of Food Science and Health, School of Medicine, Nankai University, Tianjin 300350, China
| | - Shuo Wang
- Tianjin Key Laboratory of Food Science and Health, School of Medicine, Nankai University, Tianjin 300350, China
| |
Collapse
|
49
|
Baldi S, Amer B, Alnadari F, Al-Mogahed M, Gao Y, Gamallat Y. The Prognostic and Therapeutic Potential of Fragile X Mental Retardation 1 ( FMR1) Gene Expression in Prostate Adenocarcinoma: Insights into Survival Outcomes and Oncogenic Pathway Modulation. Int J Mol Sci 2024; 25:7290. [PMID: 39000397 PMCID: PMC11242135 DOI: 10.3390/ijms25137290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 06/22/2024] [Accepted: 06/24/2024] [Indexed: 07/16/2024] Open
Abstract
Prostate adenocarcinoma (PRAD) is the second most common tumor associated with death. The role and mechanisms of the fragile X mental retardation 1 (FMR1) gene in PRAD remain unknown. We conducted an analysis of FMR1 expression in PRAD to determine its prognostic importance and connection to carcinogenic pathways such as PI3K_AKT_mTOR. Survival analyses were utilized to establish a correlation between FMR1 expression and patient outcomes. We used the integration of genomic data with bioinformatic predictions to predict the regulatory factors of the FMR1 gene in PRAD. Our data revealed that individuals with higher levels of FMR1 expression experience worse survival outcomes compared to those with lower expression (hazard ratio [HR] = 5.08, 95% confidence interval [CI] = 1.07 - 24, p = 0.0412). FMR1 expression was significantly higher in patients with advanced pathological tumor stages, particularly in the pT3 and pT4 combined stages and the pN1 nodal stage. Furthermore, patients with high Gleason scores (GSs) (combined GSs 8 and 9) exhibited increased levels of FMR1 expression. Our results further identify a possible regulatory link between FMR1 and key oncogenic pathways, including PI3K_AKT_mTOR, and predict the possible mechanism by which FMR1 is regulated in PRAD. Our data suggest that the FMR1 gene could serve as a biomarker for PRAD progression. However, in-depth investigations, including those with large patient samples and in vitro studies, are needed to validate this finding and understand the mechanisms involved.
Collapse
Affiliation(s)
- Salem Baldi
- Department of Medical Laboratory Diagnostics, School of Medical Technology, Shaoyang University, Shaoyang 422000, China
| | - Bushra Amer
- Department of Family Medicine, Michigan State University, East Lansing, MI 49684, USA
| | - Fawze Alnadari
- Research and Development Center of Jiangsu Tianmeijian Nature Bioengineering Co., Ltd., Nanjing 210046, China
| | - Maged Al-Mogahed
- Department of Surgery, The First Bethune Hospital of Jilin University, Changchun 130012, China
| | - Yaqin Gao
- Department of Ultrasound Diagnosis, Zhongda Hospital Southeast University, Nanjing 210009, China
| | - Yaser Gamallat
- Department of Oncology, Biochemistry and Molecular Biology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1M4, Canada
| |
Collapse
|
50
|
Labeur-Iurman L, Harker JA. Mechanisms of antibody mediated immunity - Distinct in early life. Int J Biochem Cell Biol 2024; 172:106588. [PMID: 38768890 DOI: 10.1016/j.biocel.2024.106588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 05/08/2024] [Accepted: 05/10/2024] [Indexed: 05/22/2024]
Abstract
Immune responses in early life are characterized by a failure to robustly generate long-lasting protective responses against many common pathogens or upon vaccination. This is associated with a reduced ability to generate T-cell dependent high affinity antibodies. This review highlights the differences in T-cell dependent antibody responses observed between infants and adults, in particular focussing on the alterations in immune cell function that lead to reduced T follicular helper cell-B cell crosstalk within germinal centres in early life. Understanding the distinct functional characteristics of early life humoral immunity, and how these are regulated, will be critical in guiding age-appropriate immunological interventions in the very young.
Collapse
Affiliation(s)
- Lucia Labeur-Iurman
- National Heart & Lung Institute, Imperial College London, London, United Kingdom.
| | - James A Harker
- National Heart & Lung Institute, Imperial College London, London, United Kingdom; Centre for Paediatrics and Child Health, Imperial College London, London, United Kingdom.
| |
Collapse
|