Tag: pubmed

J Clin Pathol. 2023 Jul 11:jclinpath-2021-207975. doi: 10.1136/jcp-2021-207975. Online ahead of print.

ABSTRACT

AIMS: Microbial flora of dental plaque trigger innate and adaptive immune responses. The function of antigen-presenting cells (APCs) is to bridge the innate and adaptive immune systems. The human immune system contains three main types of APCs: dendritic cells (DC) (Langerhans cells (LCs) and interstitial DCs, IDCs), macrophages and B lymphocytes. In this study, the distribution and density of all APCs in healthy and inflamed human gingival tissue were comparatively analysed.

METHODS: Research was conducted on gingival biopsy specimens obtained from 55 patients and classified in three groups: healthy gingiva (control group, n=10), moderate periodontal disease (PD) (n=21) and severe PD (n=24). For APCs’ identification antibodies raised against CD_1a (for LCs), S₁₀₀ protein (for iDCs), CD₆₈ (for macrophages) and CD₂₀ (for B lymphocytes) were used.

RESULTS: Increased density of IDCs, macrophages and B lymphocytes in lamina propria and reduced density of LCs in the gingival epithelium were found in patients with periodontitis. Simultaneously, it was noticed an increased concentration of macrophages and B cells in the gingival epithelium in patients with PD. No statistically significant difference in the distribution and density of APC was found among patients with moderate and advanced periodontitis.

CONCLUSIONS: It was hypothesised that in the periodontitis the role of antigen presentation was largely taken from LCs by the DCs, macrophages and B cells. These APCs are thought to have less protective and tolerogenic potential than LCs and this is a significant reason for alveolar bone destruction in periodontitis.

PMID:37433669 | DOI:10.1136/jcp-2021-207975

Chaos. 2023 Jul 1;33(7):073123. doi: 10.1063/5.0145079.

ABSTRACT

Urban road networks (URNs), as simplified views and important components of cities, have different structures, resulting in varying levels of transport efficiency, accessibility, resilience, and many socio-economic indicators. Thus, topological characteristics of URNs have received great attention in the literature, while existing studies have used various boundaries to extract URNs for analysis. This naturally leads to the question of whether topological patterns concluded using small-size boundaries keep consistent with those uncovered using commonly adopted administrative boundaries or daily travel range-based boundaries. This paper conducts a large-scale empirical analysis to reveal the boundary effects on 22 topological metrics of URNs across 363 cities in mainland China. Statistical results show that boundaries have negligible effects on the average node degree, edge density, orientation entropy of road segments, and the eccentricity for the shortest or fastest routes, while other metrics including the clustering coefficient, proportion of high-level road segments, and average edge length together with route-related metrics such as average angular deviation show significant differences between road networks extracted using different boundaries. In addition, the high-centrality components identified using varied boundaries show significant differences in terms of their locations, with only 21%-28% of high-centrality nodes overlapping between the road networks extracted using administrative and daily travel range-based boundaries. These findings provide useful insights to assist urban planning and better predict the influence of a road network structure on the movement of people and the flow of socio-economic activities, particularly in the context of rapid urbanization and the ever-increasing sprawl of road networks.

PMID:37433653 | DOI:10.1063/5.0145079

Genome Res. 2023 Jul 11. doi: 10.1101/gr.277490.122. Online ahead of print.

ABSTRACT

Approximately 13% of the human genome at certain motifs have the potential to form noncanonical (non-B) DNA structures (e.g., G-quadruplexes, cruciforms, and Z-DNA), which regulate many cellular processes but also affect the activity of polymerases and helicases. Because sequencing technologies use these enzymes, they might possess increased errors at non-B structures. To evaluate this, we analyzed error rates, read depth, and base quality of Illumina, Pacific Biosciences (PacBio) HiFi, and Oxford Nanopore Technologies (ONT) sequencing at non-B motifs. All technologies showed altered sequencing success for most non-B motif types, although this could be owing to several factors, including structure formation, biased GC content, and the presence of homopolymers. Single-nucleotide mismatch errors had low biases in HiFi and ONT for all non-B motif types but were increased for G-quadruplexes and Z-DNA in all three technologies. Deletion errors were increased for all non-B types but Z-DNA in Illumina and HiFi, as well as only for G-quadruplexes in ONT. Insertion errors for non-B motifs were highly, moderately, and slightly elevated in Illumina, HiFi, and ONT, respectively. Additionally, we developed a probabilistic approach to determine the number of false positives at non-B motifs depending on sample size and variant frequency, and applied it to publicly available data sets (1000 Genomes, Simons Genome Diversity Project, and gnomAD). We conclude that elevated sequencing errors at non-B DNA motifs should be considered in low-read-depth studies (single-cell, ancient DNA, and pooled-sample population sequencing) and in scoring rare variants. Combining technologies should maximize sequencing accuracy in future studies of non-B DNA.

PMID:37433640 | DOI:10.1101/gr.277490.122

Neuropsychopharmacol Rep. 2023 Jul 11. doi: 10.1002/npr2.12367. Online ahead of print.

ABSTRACT

AIMS: The means of suicide vary, but in cases of impaired consciousness, it is often difficult to determine the initial treatment because it is not known whether a patient has overdosed or used pesticides or poisons. Therefore, we investigated the clinical characteristics of suicide by medication in patients with suicide attempts who were brought to the emergency department, especially the influence of age.

METHODS: Patients with suicide attempts were transported to the two hospitals. There were 96 males (38.4%) and 154 females (61.6%). The mean age was 43.5 ± 20 years, and both males and females were most often in their 20s. Data on sex, age, motive for suicide, means of suicide attempt, psychiatric diagnosis, length of hospital stay, and place of discharge were retrospectively analyzed.

RESULTS: The average age of the patients by means of suicide attempt was 40.5 years for “prescription drugs,” 30.2 years for “over-the-counter drugs,” and 63.5 years for “pesticide/poison.” For each means of suicide attempt, there was a significant difference in age among patients with suicide attempts using “prescription drugs,” “over-the-counter drugs” and “pesticides/poisons.” There was a statistical bias in the means and reasons for each suicide attempt.

CONCLUSION: The results showed that the age of patients who used over-the-counter medicines and pesticides and poisons varied significantly. It was thought that pesticide use should be considered first, especially when patients aged 50 years and over are brought to the hospital with impaired consciousness due to suicide attempts.

PMID:37433639 | DOI:10.1002/npr2.12367

BMJ. 2023 Jul 11;382:p1434. doi: 10.1136/bmj.p1434.

NO ABSTRACT

PMID:37433610 | DOI:10.1136/bmj.p1434

Nephrol Dial Transplant. 2023 Jul 11:gfad151. doi: 10.1093/ndt/gfad151. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with kidney replacement therapy (KRT) have been identified as a vulnerable group during the COVID-19 pandemic. This study reports the outcomes of COVID-19 in KRT patients in Sweden, a country where patients on KRT were prioritized early in the vaccination campaign.

METHODS: Patients with KRT between January 2019 and December 2021 in the Swedish Renal Registry were included. Data were linked to national healthcare registries. The primary outcome was monthly all-cause mortality over three-years follow-up. The secondary outcomes were monthly COVID-19 related deaths and hospitalizations. The results were compared with the general population using standardized mortality ratios. The difference in risk for COVID-19 related outcomes between dialysis and kidney transplant recipients was assessed in multivariable logistic regression models before and after vaccinations started.

RESULTS: On January 1, 2020, there were 4097 patients on dialysis (median age 70) and 5905 kidney transplant recipients (median age 58). Between March 2020 and February 2021, mean all-cause mortality rates increased by 10% (from 720 to 804 deaths) and 22% (from 158 to 206 deaths) in dialysis and kidney transplant recipients respectively compared with the same period 2019. After vaccinations started, all-cause mortality rates during the third wave (April 2021) returned to pre COVID-19 mortality rates among dialysis patients, while mortality rates remained increased among transplant recipients. Dialysis patients had a higher risk for COVID-19 hospitalizations and death before vaccinations started aOR 2.1 (95% CI 1.7-2.5), but a lower risk after vaccination, aOR 0.5 (95% CI 0.4-0.7) compared to kidney transplant recipients.

CONCLUSIONS: The COVID-19 pandemic in Sweden resulted in increased mortality and hospitalization rates among KRT patients. After vaccinations started, a distinct reduction in hospitalization and mortality rates was observed among dialysis patients, but not in kidney transplant recipients. Early and prioritized vaccinations of KRT patients in Sweden probably saved many lives.

PMID:37433606 | DOI:10.1093/ndt/gfad151

Radiol Technol. 2023 Jul;94(6):409-418.

ABSTRACT

PURPOSE: This study investigated several determinants of radiation safety culture among radiologic technologists to determine whether factors related to work shifts or workday length affect the perception of workplace radiation safety.

METHODS: The secondary analysis used de-identified data from 425 radiologic technologists collected with the Radiation Actions and Dimensions of Radiation Safety (RADS) questionnaire, a 35-item survey with valid and reliable psychometric properties. Respondents included radiologic technologists working in radiography, computed tomography (CT), mammography, and hospital radiology administration. Descriptive statistics were used to report RADS survey item outcomes, and analysis of variance (ANOVA) tests with Games-Howell post hoc tests were conducted to analyze the hypotheses.

RESULTS: Mean differences in perception of teamwork across imaging stakeholders (P < .001) and leadership actions (P = .001) were found across shift-length groups. In addition, mean differences in perception of teamwork across imaging stakeholders (P = .007) were found across work-shift groups.

DISCUSSION: Longer shifts (≥ 12 hours) and night shifts are related to a diminished perception of the importance of radiation safety among radiologic technologists. The study showed a significant effect of these shift factors on the perception of teamwork and leadership actions concerning radiation safety.

CONCLUSION: These results underscore the importance of leadership actions and messaging, teamwork-building, and in-service training on radiation safety for technologists who frequently work long, after-hours shifts.

PMID:37433604

Radiol Technol. 2023 Jul;94(6):397-408.

ABSTRACT

PURPOSE: To investigate the effects of patient-induced artifacts on the diagnostic performance of the COVID-19 Reporting and Data System (CO-RADS) and the computed tomography chest severity score (CT-SS).

METHODS: A single-center retrospective analysis of patients aged 18 years and older who were admitted to the authors’ hospital with laboratory-confirmed COVID-19 and underwent chest CT between July and November 2021 was conducted. Patients’ chest CT scans were examined by 3 radiologists for CT-SS and CO-RADS classifications. Patient-based artifacts, including metal artifacts, incomplete projection artifacts, motion artifacts, and insufficient inspiration, were identified by 3 readers who were unaware of each other. For statistical analysis, interreader agreement was investigated using Fleiss kappa () agreement analysis.

RESULTS: The study population included 549 patients with a median age of 66 years (IQR, 55-75 years), 321 (58.5%) of whom were men. According to the overall CO-RADS classification, the highest interreader agreement was in patients without CT artifacts ( = 0.924), while the lowest interreader agreement was in patients with motion artifacts ( = 0.613). For the CO-RADS 1 and 2 patient groups, insufficient inspiration decreased the interreader agreement most ( = 0.712 and = 0.250, respectively). For the CO-RADS 3, 4, and 5 patient groups, motion artifacts reduced the interreader agreement most ( = 0.464, = 0.453, and = 0.705, respectively). For total CT-SS, the highest kappa value was in patients without artifacts ( = 0.574), while the lowest kappa value was in patients with motion artifacts ( = 0.374).

DISCUSSION: The CT technologist can avoid patient-induced artifacts by placing patients carefully on the CT table, giving patients necessary instructions before CT acquisition, and selecting optimal scanning parameters. The authors are not aware of another study in the literature investigating the effects of patient-based artifacts on interreader agreement of CO-RADS classification and CT-SS for COVID-19.

CONCLUSION: CT artifacts degrade image quality and might lead to interreader disagreement of CO-RADS classification and CT-SS for patients with COVID-19.

PMID:37433603

BJU Int. 2023 Jul 11. doi: 10.1111/bju.16124. Online ahead of print.

ABSTRACT

BACKROUND: Kidney is an essential regulator of arterial blood pressure (BP) via the renin-angiotensin system. The impact of kidney surgery on BP is unclear.

OBJECTIVE: To evaluate the consequences of kidney surgery for renal tumor on BP.

DESIGN, SETTING AND PARTICIPANTS: In a multicenter prospective study, we evaluated 200 patients who underwent nephrectomy for renal tumor between 2018 and 2020 at 7 departments of the UROCCR network. All patients had localized cancer without pre-existing hypertension.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: BP was measured the week before nephrectomy, one month and six months after nephrectomy, according to the recommendations for home blood pressure measurement. Plasmatic renin was measured one week before surgery and 6 months after surgery. The primary endpoint was the occurrence of de novo hypertension (HTN). The secondary endpoint was a clinically significant increase in BP at six months defined by an increase in systolic and / or diastolic ABP ≥10 mmHg or if medical anti-hypertensive treatment was required RESULTS AND LIMITATIONS: BP and renin measurements were available for 182 (91%) and 136 (68%) patients, respectively. We excluded from the analysis 18 patients who had undeclared HTN detected on preoperative measurements. At six months, 31 (19.2%) patients had de novo HTN and 43 (26.3%) patients had a significant increase in their BP. The type of surgery was not associated with an increased risk of HTN (21.7% PN vs 15.7% RN; p=0.59). There was no difference between plasmatic renin levels before and after surgery (18.5 vs. 16, p=0.46). In multivariable analysis, age (O.R 1.07; CI-95 1.02-1.12; p=0.03) and BMI (O.R. 1.14; CI-95 1.03-1.26; p=0.01) were the only predictors of de novo HTN.

CONCLUSION: Surgical treatment of renal tumors is associated with significant changes in BP. These changes are not impacted by the type of surgery (PN vs RN).

PATIENT SUMMARY: In this study we evaluated blood pressure changes after surgery for renal tumors. We found that 19% of the patients developed de novo hypertension 6 months after surgery. We feel that patients who are scheduled to undergo kidney cancer surgery should be informed of these findings and have their blood pressure closely monitored after the operation.

PMID:37433580 | DOI:10.1111/bju.16124

Ann Rheum Dis. 2023 Jul 10:ard-2023-224416. doi: 10.1136/ard-2023-224416. Online ahead of print.

ABSTRACT

OBJECTIVE: To develop evidence-based recommendations for the non-pharmacological management of systemic lupus erythematosus (SLE) and systemic sclerosis (SSc).

METHODS: A task force comprising 7 rheumatologists, 15 other healthcare professionals and 3 patients was established. Following a systematic literature review performed to inform the recommendations, statements were formulated, discussed during online meetings and graded based on risk of bias assessment, level of evidence (LoE) and strength of recommendation (SoR; scale A-D, A comprising consistent LoE 1 studies, D comprising LoE 4 or inconsistent studies), following the European Alliance of Associations for Rheumatology standard operating procedure. Level of agreement (LoA; scale 0-10, 0 denoting complete disagreement, 10 denoting complete agreement) was determined for each statement through online voting.

RESULTS: Four overarching principles and 12 recommendations were developed. These concerned common and disease-specific aspects of non-pharmacological management. SoR ranged from A to D. The mean LoA with the overarching principles and recommendations ranged from 8.4 to 9.7. Briefly, non-pharmacological management of SLE and SSc should be tailored, person-centred and participatory. It is not intended to preclude but rather complement pharmacotherapy. Patients should be offered education and support for physical exercise, smoking cessation and avoidance of cold exposure. Photoprotection and psychosocial interventions are important for SLE patients, while mouth and hand exercises are important in SSc.

CONCLUSIONS: The recommendations will guide healthcare professionals and patients towards a holistic and personalised management of SLE and SSc. Research and educational agendas were developed to address needs towards a higher evidence level, enhancement of clinician-patient communication and improved outcomes.

PMID:37433575 | DOI:10.1136/ard-2023-224416