Tag: pubmed

BMC Microbiol. 2022 Oct 5;22(1):240. doi: 10.1186/s12866-022-02652-5.

ABSTRACT

BACKGROUND: The Bacillus cereus group, also known as B. cereus sensu lato (s.l.) contains ubiquitous spore-forming bacteria found in the environment including strains from the B. cereus sensu stricto (s.s.) species. They occur naturally in a wide range of raw materials and in consumer products. Characterizing isolates that have survived in consumer products allows us to better understand the mechanisms that permit spores to persist and potentially cause illness. Here we characterize the draft genome sequence of B. cereus s. s. 3A-ES, originally isolated from eye shadow and since investigated in several cosmetic studies and compared it to other top ten published complete genome sequences of B. cereus s.l. members.

RESULTS: The draft genome sequence of B. cereus s.s. 3A ES consisted of an average of 90 contigs comprising approximately 5,335,727 bp and a GC content of 34,988%, and with 5509 predicted coding sequences. Based on the annotation statistics and comparison to other genomes within the same species archived in the Pathosystems Resource Integration Center (PATRIC), this genome “was of good quality. Annotation of B. cereus s.s. 3A ES revealed a variety of subsystem features, virulence factors and antibiotic resistant genes. The phylogenetic analysis of ten B. cereus group members showed B. cereus s.s. 3A-ES to be a closely related homolog of B. cereus s.s. ATCC 14,579, an established reference strain that is not adapted for cosmetic microbiological studies. Survival of 3A-ES in eye shadow could be linked to predicted stress-response genes and strengthened by additional stress-response genes such as VanB-type, VanRB, CAT15/16, BcrA, BcrB, Lsa(B), and recA that are lacking in B. cereus s.s. ATCC 14,579.

CONCLUSION: Our genomic analysis of B. cereus s.s. 3A-ES revealed genes, which may allow this bacterium to withstand the action of preservatives and inhibitors in cosmetics, as well as virulence factors that could contribute to its pathogenicity. Having a well-characterized strain obtained from eye-shadow may be useful for establishing a reference strain for cosmetics testing.

PMID:36199032 | DOI:10.1186/s12866-022-02652-5

BMC Infect Dis. 2022 Oct 5;22(1):774. doi: 10.1186/s12879-022-07752-1.

ABSTRACT

BACKGROUND: Neonatal bacterial meningitis is a common neonatal disease with high morbidity, and can cause serious sequelae when left untreated. Escherichia coli is the common pathogen, and its endotoxin, lipopolysaccharide (LPS) can damage the endothelial cells, increasing the permeability of the blood-brain barrier (BBB), leading to intracranial inflammation. However, the specific mechanism of bacterial meningitis induced by LPS damaging BBB remains unclear. In this study, the mouse brain microvascular endothelial (bEND.3) cells were used as a research object to investigate whether LPS damage BBB through the PI3K/Akt pathway.

METHODS: The bEND.3 cells were stimulated with different concentrations of LPS for 12 h, and the expression of tight junction proteins (ZO-1, claudin-5, occludin) was detected using western blotting. The cells were challenged with the same concentration of LPS (1ug/ml) across different timepoints (0, 2 h, 4 h, 6 h, 12 h, 24 h). Expression of TJ proteins and signal pathway molecules (PI3K, p-PI3K, Akt, p-Akt) were detected. The distribution of ZO-1 in bEND.3 cells were detected by immunofluorescence staining.

RESULTS: A negative correlation is observed between ZO-1 and LPS concentration. Moreover, a reduced expression of ZO-1 was most significant under 1 ug/ml of LPS, and the difference was statistically significant (P < 0.05). Additionally, there is a negative correlation between ZO-1 and LPS stimulation time. Meanwhile, the expression of claudin-5 and occludin did not change significantly with the stimulation of LPS concentration and time. The immunofluorescence assay showed that the amount of ZO-1 on the surface of bEND.3 cells stimulated with LPS was significantly lower than that of the control group. After LPS stimulation, p-Akt protein increased at 2 h and peaked at 4 h. The titer of p-PI3K did not change significantly with time.

CONCLUSION: LPS can downregulate the expression of ZO-1; however, its effect on claudin-5 and occludin is minimal. Akt signal pathway may be involved in the regulation of ZO-1 expression induced by LPS in bEND.3 cells.

PMID:36199030 | DOI:10.1186/s12879-022-07752-1

BMC Med Res Methodol. 2022 Oct 5;22(1):261. doi: 10.1186/s12874-022-01733-3.

ABSTRACT

BACKGROUND: Count data from the national survey captures healthcare utilisation within a specific reference period, resulting in excess zeros and skewed positive tails. Often, it is modelled using count data models. This study aims to identify the best-fitting model for outpatient healthcare utilisation using data from the Malaysian National Health and Morbidity Survey 2019 (NHMS 2019) and utilisation factors among adults in Malaysia.

METHODS: The frequency of outpatient visits is the dependent variable, and instrumental variable selection is based on Andersen’s model. Six different models were used: ordinary least squares (OLS), Poisson regression, negative binomial regression (NB), inflated models: zero-inflated Poisson, marginalized-zero-inflated negative binomial (MZINB), and hurdle model. Identification of the best-fitting model was based on model selection criteria, goodness-of-fit and statistical test of the factors associated with outpatient visits.

RESULTS: The frequency of zero was 90%. Of the sample, 8.35% of adults utilized healthcare services only once, and 1.04% utilized them twice. The mean-variance value varied between 0.14 and 0.39. Across six models, the zero-inflated model (ZIM) possesses the smallest log-likelihood, Akaike information criterion, Bayesian information criterion, and a positive Vuong corrected value. Fourteen instrumental variables, five predisposing factors, six enablers, and three need factors were identified. Data overdispersion is characterized by excess zeros, a large mean to variance value, and skewed positive tails. We assumed frequency and true zeros throughout the study reference period. ZIM is the best-fitting model based on the model selection criteria, smallest Root Mean Square Error (RMSE) and higher R2. Both Vuong corrected and uncorrected values with different Stata commands yielded positive values with small differences.

CONCLUSION: State as a place of residence, ethnicity, household income quintile, and health needs were significantly associated with healthcare utilisation. Our findings suggest using ZIM over traditional OLS. This study encourages the use of this count data model as it has a better fit, is easy to interpret, and has appropriate assumptions based on the survey methodology.

PMID:36199028 | DOI:10.1186/s12874-022-01733-3

J Neurodev Disord. 2022 Oct 5;14(1):54. doi: 10.1186/s11689-022-09462-w.

ABSTRACT

BACKGROUND: Anxiety symptomatology is common in individuals with intellectual disability (ID). Symptomatology includes both traditional Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) anxiety disorders and autism spectrum disorder (ASD)-related anxiety traits. Some genetic disorders such as Cornelia de Lange (CdLS) and fragile X syndromes (FXS) are at very high risk of anxiety and afford the opportunity to examine prevalence, profiles and associated person characteristics. However, prevalence and associated characteristics of anxiety in these high-risk groups remain poorly described and understood. The aim of the current study was to examine the prevalence and profile of DSM-5 and ASD-related anxiety symptomatology in individuals with CdLS and FXS and associated behavioural and cognitive characteristics.

METHODS: Questionnaires and interviews assessing DSM-5 and ASD-related anxiety were conducted with caregivers of individuals with CdLS (n = 49) and FXS (n = 36).

RESULTS: DSM-5 anxiety symptomatology was present in both groups with high co-morbidity across anxiety diagnoses. ASD-related anxiety was also prevalent with specific difficulties related to intolerance of uncertainty identified in both groups. Symptomatology was persistent over the lifespan for both groups. Anxiety type was partially associated with repetitive behaviour but not measures of overall ASD phenomenology in CdLS.

CONCLUSIONS: DSM-5 and ASD-related anxiety are common in these high-risk syndromes associated with ID. Prospective syndrome specific presentations and associations, which may implicate specific underlying mechanisms, are discussed. Clinicians should be aware of the risk and difficulties involved in assessment of anxiety in individuals with ID, including atypical types, to ensure these individuals do not “miss” diagnoses and support in general clinical practice.

PMID:36199025 | DOI:10.1186/s11689-022-09462-w

Acta Med Port. 2022 Oct 4. doi: 10.20344/amp.18284. Online ahead of print.

ABSTRACT

INTRODUCTION: The benefits of the multimodal Enhanced Recovery After Surgery® (ERAS) program have been described all over the world. The adoption of several perioperative strategies translates into an improvement in the quality of the healthcare provided. The aim of this study was to report the results of the implementation of the ERAS® program for colorectal surgery in a tertiary hospital.

MATERIAL AND METHODS: In this single-center observational study, 534 patients who underwent colorectal surgery between December 2018 and May 2021 were included. Two groups were considered: before and after the implementation of the ERAS® program. The primary outcome measure was 30-day morbidity. The length of hospital stay, readmission rate, reintervention and mortality among the two groups were also evaluated.

RESULTS: The pre-ERAS group included 102 patients and the ERAS group included 432 patients. There was a statistically significant reduction in morbidity at 30 days (37.3% vs 26.5%, p < 0.05), length of stay (7 days vs 5 days, p < 0.001) and readmission rate (12.9% vs 6%, p < 0.05) after the implementation of the ERAS program.

CONCLUSION: The ERAS® protocol for colorectal surgery was successfully and safely implemented in our hospital, contributing to an improvement in perioperative care provided to patients.

PMID:36198199 | DOI:10.20344/amp.18284

Acad Med. 2022 Oct 1;97(10):1546-1553. doi: 10.1097/ACM.0000000000004761. Epub 2022 Sep 23.

ABSTRACT

PURPOSE: To assess the impact of virtual interviewing during the COVID-19 pandemic on the residency application process and to compare applicant costs and time spent interviewing during the 2020-2021 application cycle with prior years.

METHOD: Fourth-year medical students at the University of Kansas School of Medicine applying for first-year residency positions via the National Resident Matching Program Match completed an electronic 46-item survey after submitting their rank lists during each application cycle from 2015-2016 to 2020-2021. The authors used descriptive statistics and t tests to analyze and compare responses to demographics questions and questions regarding number of submitted applications, offered and completed interviews, ranked programs, costs, and time spent interviewing. They used thematic analysis to code respondents’ narrative comments about the virtual interviewing experience.

RESULTS: From 2015-2016 to 2020-2021, 994 (of 1,190; 83.5%) respondents completed the survey. From 2019-2020 to 2020-2021, the average total cost of applying to residency per applicant dropped by $3,566 (P < .001) and the average time spent interviewing dropped by 13.3 days (P < .001). At the same time, the average number of applications per applicant dropped by 3.4, and applicants completed the same number of interviews and ranked 2.3 fewer programs, none of which were statistically significant differences. Narrative comments from 113 (79%) respondents in 2020-2021 revealed 4 themes related to virtual interviewing: convenience of time and cost, positive aspects of the process, negative aspects of the process, and overall impressions of the program.

CONCLUSIONS: Virtual interviewing during the 2020-2021 application cycle resulted in an approximately 80% reduction in cost for applicants and an approximately 50% decrease in time spent interviewing compared with previous years but was not associated with large increases in number of submitted applications, completed interviews, or ranked programs. Applicants generally perceived virtual interviewing as positive although they raised notable concerns.

PMID:36198163 | DOI:10.1097/ACM.0000000000004761

Acad Med. 2022 Oct 1;97(10):1427-1428. doi: 10.1097/ACM.0000000000004910. Epub 2022 Sep 23.

NO ABSTRACT

PMID:36198148 | DOI:10.1097/ACM.0000000000004910

Egypt J Immunol. 2022 Oct;29(4):94-105.

ABSTRACT

Psoriasis is a chronic debilitating skin disease with an estimated prevalence reaching 2% of the worldwide population. Psoriatic disease is driven by the interactions among innate and adaptive immune systems with structural components of the skin. Interleukin (IL)-22 mediates keratinocyte proliferation and epidermal hyperplasia, and changes in the structure of skin flora can play a role in the secretion of IL-22. The aim of this study was to correlate serum levels of IL-22 and Staphylococcus aureus toxins with disease activity in plaque psoriasis. The study group included 50 patients with mild, moderate, and severe psoriasis. The control group comprised 20 sex- and age-matched apparently healthy volunteers. IL-22 concentration was assessed in sera of patients and the control group by using the ELISA technique. The serum levels of IL-22 in patients were higher than in the control group, but the difference was statistically insignificant (P=0.413). Serum IL-22 levels were positively correlated with the Psoriasis Area and Severity Index (PASI) score of psoriasis patients (P=0.0003). The IL-22 serum levels in patients colonized with toxigenic strains of S. aureus were significantly higher than in patients colonized with non-toxigenic strains (P= 0.028). In conclusion, IL-22 plays a role in the pathogenesis of psoriasis, and its secretion can be triggered by the toxins produced by S. aureus colonizing the skin of patients.

PMID:36198107

Clin J Pain. 2022 Oct 3. doi: 10.1097/AJP.0000000000001076. Online ahead of print.

ABSTRACT

OBJECTIVES: People living with chronic pain may use wearable health technology (WHT) in conjunction with an expert-directed pain management program for up to one year. WHT use may be associated with improvements in key patient outcomes.

METHODS: A 12-month study of WHT use among people with chronic pain was conducted, consisting of iPhone and Apple Watch applications to measure movement, sleep, and self-reported pain. Clinical outcomes among 105 patients enrolled in a multidisciplinary pain program that included WHT use were compared to 146 patients in the same program but without WHT, and to 161 patients receiving medical pain management without WHT.

RESULTS: Participants used the WHT on average 143.0 (SD 117.6) out of 365 days. Mixed-effects models revealed participants who used WHT had decreases in depression scores (-7.83, P<0.01) and prescribed morphine milligram equivalents (-21.55, P=0.04) over one year. Control groups also showed decreases in depression scores (-5.08, P=0.01; -5.68, P<0.01) and morphine milligram equivalents (-18.67, P=0.01; -10.99, ns). The estimated slope of change among the WHT was not statistically different than control groups.

DISCUSSION: Patients who used WHT as part of their pain management program demonstrated a willingness to do so for extended periods of time despite living with chronic pain and other comorbidities. Data trends suggest that WHT use may positively impact depression and prescribed medication. Additional research is warranted to investigate the potential of WHT to improve the negative consequences of chronic pain.

PMID:36198095 | DOI:10.1097/AJP.0000000000001076

Echocardiography. 2022 Oct 5. doi: 10.1111/echo.15445. Online ahead of print.

ABSTRACT

BACKGROUND: Coronary vasomotion abnormalities have been described in small studies but not studied systematically. We aimed to review the present literature and analyze it to improve our understanding of chronic kidney disease (CKD) related-coronary microvascular dysfunction.

OBJECTIVE: Coronary flow reserve (CFR) is a well-known measure of coronary vasomotion. We aimed to assess the difference in CFR among participants with and without CKD.

METHODS: PubMed, Embase, and Cochrane CENTRAL were systematically reviewed to identify studies that compared CFR in participants with and without CKD. We estimated standardized mean differences in mean CFR reported in these studies. We performed subgroup analyses according to imaging modality, and the presence of significant epicardial coronary artery disease.

RESULTS: In 14 observational studies with 5966 and 1410 patients with and without CKD, the mean estimated glomerular filtration rate (eGFR) was 29 ± 04 and 87 ± 25 ml/min/1.73 m² , respectively. Mean CFR was consistently lower in patients with CKD in all studies and the cumulative mean difference was statistically significant (2.1 ± .3 vs. 2.7 ± .5, standardized mean difference -.8, 95% CI -1.1, -.6, p < .05). The lower mean CFR was driven by both significantly higher mean resting flow velocity (.58 cm/s, 95% CI .17, .98) and lower mean stress flow velocity (-.94 cm/s, 95% CI -1.75, -.13) in studies with CKD. This difference remained significant across diagnostic modalities and even in absence of epicardial coronary artery disease. In meta-regression, there was a significant positive relationship between mean eGFR and mean CFR (p < .05).

CONCLUSION: Patients with CKD have a significantly lower CFR versus those without CKD, even in absence of epicardial coronary artery disease. There is a linear association between eGFR and CFR. Future studies are required to understand the mechanisms and therapeutic implications of these findings.

KEY POINTS: In this meta-analysis of observational studies, there was a significant reduction in coronary flow reserve in studies with chronic kidney disease versus those without. This difference was seen even in absence of epicardial coronary artery disease. In meta-regression, a lower estimate glomerular filtration rate was a significant predictor of lower coronary flow reserve. Coronary microvascular dysfunction, rather than atherosclerosis-related epicardial disease may underly increase cardiovascular risk in a patient with chronic kidney disease.

PMID:36198077 | DOI:10.1111/echo.15445