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Double tract reconstruction improves the quality of life and better maintain the BMI of patients with proximal gastric cancer

BMC Surg. 2024 May 31;24(1):171. doi: 10.1186/s12893-024-02454-8.

ABSTRACT

PURPOSE: The aim of this study is to investigate the effect of double-tract reconstruction on short-term clinical outcome, quality of life and nutritional status of patients after proximal gastrectomy by comparing with esophagogastrostomy and total gastrectomy with Roux-en-Y reconstruction.

METHODS: The clinical data of patients who underwent double tract reconstruction (DTR), esophagogastrostomy (EG), total gastrectomy with Roux-en-Y reconstruction (TG-RY) were retrospectively collected from May 2020 to May 2022. The clinical characteristics, short-term surgical outcomes, postoperative quality of life and nutritional status were compared among the three groups.

RESULTS: Compared with the DTR group, the operation time in the TG group was significantly shorter (200(180,240) minutes vs. 230(210,255) minutes, p < 0.01), and more lymph nodes were removed (28(22, 25) vs. 22(19.31), p < 0.01), there were no significant differences in intraoperative blood loss, first flatus time, postoperative hospital stay and postoperative complication rate among the three groups. Postoperative digestive tract angiography was completed in 36 patients in the DTR group, of which 21 (58.3%) showed double-tract type of food passing. The incidence of postoperative reflux symptoms was 9.2% in the DTR group, 43.8% in the EG group and 23.2% in the TG group, repectively (P < 0.01). EORTCQLQ-STO22 questionnaire survey showed that compared with EG group, DTR group had fewer reflux symptoms (P < 0.05), fewer anxiety symptoms (P < 0.05) and more swallowing symptoms (P < 0.05). Compared with TG group, DTR group had fewer reflux symptoms (P < 0.05). There were no other significant differences between the two groups. Compared with TG group and EG group, DTR can better maintain postoperative BMI, and there is no statistical difference between the three groups in terms of hemoglobin and albumin.

CONCLUSIONS: Although partial double-tract reconstruction approach does not always ensure food to enter the distal jejunum along the two pathways as expected, it still shows satisfactory anti-reflux effect. Moreover, it might improve patients’ quality of life and maintain better nutritional status comparing with gastroesophageal anastomosis and total gastrectomy with Roux-en-Y reconstruction.

PMID:38822305 | DOI:10.1186/s12893-024-02454-8

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The impact of intimate partner violence on PrEP adherence among U.S. Cisgender women at risk for HIV

BMC Public Health. 2024 May 31;24(1):1461. doi: 10.1186/s12889-024-18946-4.

ABSTRACT

BACKGROUND: Cisgender women account for 1 in 5 new HIV infections in the United States, yet remain under-engaged in HIV prevention. Women experiencing violence face risk for HIV due to biological and behavioral mechanisms, and barriers to prevention, such as challenges to Pre-Exposure Prophylaxis for HIV Prevention (PrEP) adherence. In this analysis, we aim to characterize intimate partner violence (IPV) among cisgender heterosexual women enrolled in a PrEP demonstration project and assess the associations with PrEP adherence.

METHODS: Adherence Enhancement Guided by Individualized Texting and Drug Levels (AEGiS) was a 48-week single-arm open-label study of PrEP adherence in HIV-negative cisgender women in Southern California (N = 130) offered daily tenofovir disoproxil fumarate/emtricitabine (TDF/FTC). From 6/2016 to 10/2018, women completed a survey reporting HIV risk behavior and experiences of any IPV (past 90-days) and IPV sub-types (past-year, lifetime) and biological testing for HIV/STIs at baseline, and concentrations of tenofovir-diphosphate (TFV-DP) in dried blood spots at weeks 4, 12, 24, 36, and 48. Outcomes were TFV-DP concentrations consistent with ≥ 4 or ≥ 6 doses/week at one or multiple visits. Multivariable logistic regression models were conducted to examine associations.

RESULTS: Past-90-day IPV was reported by 34.4% of participants, and past-year and lifetime subtypes reported by 11.5-41.5%, and 21.5-52.3%, respectively. Women who engaged in sex work and Black women were significantly more likely to report IPV than others. Lifetime physical IPV was negatively associated with adherence at ≥ 4 doses/week at ≥ 3 of 5 visits, while other relationships with any IPV and IPV sub-types were variable.

CONCLUSION: IPV is an indication for PrEP and important indicator of HIV risk; our findings suggest that physical IPV may also negatively impact long-term PrEP adherence.

CLINICAL TRIALS REGISTRATION: NCT02584140 (ClinicalTrials.gov), registered 15/10/2015.

PMID:38822300 | DOI:10.1186/s12889-024-18946-4

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Pathways linking workplace violence and suicidal ideation/non-suicidal self-injury among nurse staff: the mediating role of loneliness and depressive symptoms

BMC Nurs. 2024 May 31;23(1):363. doi: 10.1186/s12912-024-02044-2.

ABSTRACT

BACKGROUND: Nurses face disproportionately high rates of suicidal ideation and non-suicidal self-injury (NSSI). The role of workplace violence, loneliness, and depressive symptoms in exacerbating these issues is poorly understood. This study aims to explore these relationships to inform interventions for improving nurses’ mental health.

METHODS: A cross-sectional study involving 1,774 Chinese nurse staff selected through convenient sampling methods was conducted. Workplace violence, depressive symptoms, and loneliness were assessed using the Chinese versions of the Workplace Violence Scale (WVS), the 9-item Patient Health Questionnaire (PHQ-9), and a three-item loneliness scale, respectively. Participants completed self-report questionnaires anonymously to ensure adherence to ethical standards. Statistical analysis utilized structural equation modeling (SEM) to examine the intricate relationships among variables, thereby elucidating the impact of workplace violence, loneliness, and depressive symptoms on nurses’ suicidal ideation/NSSI outcomes.

RESULTS: Nurse staff 165 (7.8%) were reported different level of suicidal ideation and 139 (7.8%) participants were reported different level of NSSI. And the final model of workplace violence on suicidal ideation shown a good model fit index (CMIN/DF = 3.482 NFI = 0.969 CFI = 0.977 TLI = 0.955 RFI = 0.938, RMSEA = 0.037 SRMR = 0.035). The pathway of workplace violence to loneliness (β = 0.163, P < 0.001), the indirect effect of workplace violence on suicidal ideation via loneliness and depressive symptoms were 0.100 (95%CI = 0.085, 0.121), the indirect effect of loneliness on suicidal ideation via depressive symptoms were 0.128 (95%CI = 0.100, 0.158). Similarly, the final model of workplace violence on NSSI shown a good model fit index (CMIN/DF = 3.482 NFI = 0.967 CFI = 0.976 TLI = 0.953 RFI = 0.935, RMSEA = 0.037 SRMR = 0.034), the pathways of workplace violence to NSSI (β = 0.115, P < 0.001), the indirect effect of workplace violence on NSSI via loneliness and depressive symptoms were 0.075 (95%CI = 0.055, 0.096), the indirect effect of loneliness on NSSI via depressive symptoms were 0.102 (95%CI = 0.076, 0.130).

CONCLUSION: Our study unveils the role of workplace violence in nurses’ suicidal ideation and NSSI, mediated by loneliness and depressive symptoms. Interventions targeting workplace violence are crucial for nurses’ well-being, potentially reducing loneliness and depressive symptoms and lowering the risk of suicidal ideation and NSSI. However, further research is needed to explore additional mediators and pathways, employing longitudinal designs to establish causality and develop tailored interventions for nurses affected by workplace violence.

PMID:38822294 | DOI:10.1186/s12912-024-02044-2

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Evaluation and clinical significance of serum neurospecific enolase in children with pneumonia: a case-control study

BMC Pediatr. 2024 May 31;24(1):379. doi: 10.1186/s12887-024-04852-6.

ABSTRACT

BACKGROUND: Neurospecific Enolase (NSE), a multifunctional protein, is present in various tissues of the body and plays an important role in many disease processes, such as infection, inflammation, tumours, injury, and immunity. In recent years, the application of NSE in respiratory diseases has become increasingly widespread and a research hotspot.

OBJECTIVE: This study aims to explore the relationship between NSE and childhood pneumonia, providing assistance for the diagnosis and assessment of pneumonia.

METHODS: Using prospective research and case-control methods, We selected 129 children with pneumonia hospitalised in Weifang People’s Hospital from September 2020 to April 2022 as the case group. Among them were 67 cases of Mycoplasma pneumoniae pneumonia (MP+), 62 cases of non-Mycoplasma pneumoniae pneumonia (MP -), and 21 cases of severe pneumonia. At the same time, 136 children who underwent outpatient health examinations were selected as the control group. The levels of NSE, ESR, CRP in cases group and NSE in control group were measured separately.

RESULT: The NSE levels in the MP + group were 17.86 (14.29-22.54) ng/mL, while those in the MP- group were 17.89 (14.10-21.66) ng/mL, both of which were higher than the control group’s NSE levels of 13.26(12.18,14.44) ng/mL (H = 46.92, P = 0.000). There was no statistically significant difference in NSE levels between the MP + and MP – groups (P > 0.05). The NSE level in the severe pneumonia group was 27.38 (13.95-34.06) ng/mL, higher than that in the mild pneumonia group, which was 17.68 (14.27-21.04) ng/mL, (P = 0.024). The AUC values for diagnosing pneumonia are NSE0.714, CRP0.539, and ESR0.535, with NSE having the highest diagnostic value.

CONCLUSION: Serum NSE can serve as an inflammatory indicator for paediatric pneumonia, which has important clinical guidance significance for the diagnosis, condition evaluation, and prognosis of paediatric pneumonia.

PMID:38822291 | DOI:10.1186/s12887-024-04852-6

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Proteome profiling of Campylobacter jejuni 81-176 at 37 °C and 42 °C by label-free mass spectrometry

BMC Microbiol. 2024 May 31;24(1):191. doi: 10.1186/s12866-024-03348-8.

ABSTRACT

BACKGROUND: The main natural reservoir for Campylobacter jejuni is the avian intestinal tract. There, C. jejuni multiplies optimally at 42 °C – the avian body temperature. After infecting humans through oral intake, the bacterium encounters the lower temperature of 37 °C in the human intestinal tract. Proteome profiling by label-free mass spectrometry (DIA-MS) was performed to examine the processes which enable C. jejuni 81-176 to thrive at 37 °C in comparison to 42 °C. In total, four states were compared with each other: incubation for 12 h at 37 °C, for 24 h at 37 °C, for 12 h at 42 °C and 24 h at 42 °C.

RESULTS: It was shown that the proteomic changes not only according to the different incubation temperature but also to the length of the incubation period were evident when comparing 37 °C and 42 °C as well as 12 h and 24 h of incubation. Altogether, the expression of 957 proteins was quantifiable. 37.1 – 47.3% of the proteins analyzed showed significant differential regulation, with at least a 1.5-fold change in either direction (i.e. log2 FC ≥ 0.585 or log2 FC ≤ -0.585) and an FDR-adjusted p-value of less than 0.05. The significantly differentially expressed proteins could be arranged in 4 different clusters and 16 functional categories.

CONCLUSIONS: The C. jejuni proteome at 42 °C is better adapted to high replication rates than that at 37 °C, which was in particular indicated by the up-regulation of proteins belonging to the functional categories “replication” (e.g. Obg, ParABS, and NapL), “DNA synthesis and repair factors” (e.g. DNA-polymerase III, DnaB, and DnaE), “lipid and carbohydrate biosynthesis” (e.g. capsular biosynthesis sugar kinase, PrsA, AccA, and AccP) and “vitamin synthesis, metabolism, cofactor biosynthesis” (e.g. MobB, BioA, and ThiE). The relative up-regulation of proteins with chaperone function (GroL, DnaK, ClpB, HslU, GroS, DnaJ, DnaJ-1, and NapD) at 37 °C in comparison to 42 °C after 12 h incubation indicates a temporary lower-temperature proteomic response. Additionally the up-regulation of factors for DNA uptake (ComEA and RecA) at 37 °C compared to 42 °C indicate a higher competence for the acquisition of extraneous DNA at human body temperature.

PMID:38822261 | DOI:10.1186/s12866-024-03348-8

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Changes in patient profiles in the cardiology department of the University Hospital Gabriel Touré (UH-GT) : results of two cross-sectional studies of 2010 and 2022

BMC Cardiovasc Disord. 2024 Jun 1;24(1):290. doi: 10.1186/s12872-024-03890-3.

ABSTRACT

BACKGROUND: Little is known about patient profile changes in medical facilities in our country, leading to this study to describe and compare patient profiles in 2010 and 2022.

PATIENTS AND METHODS: This was a cross-sectional study with new outpatients aged 15 years and more seen in the cardiology department of the UH-GT. Measurements included height, weight and body mass index (BMI). Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded. Quantitative data are presented as the mean with standard deviation, and categorical one as proportions. Statistical tests were the t test to compare means and chi-test for categorical variables. The level of significance was set to 0.05.

RESULTS: The sample consisted of 515 new patients (199 in 2010 and 316 in 2022) with 59.1% female in 2010 and 60.1% in 2022 (p = 0.821). We noticed an increase in hypertension (59.1-71.8%, p = 0.003) and a decrease in tobacco smoking (from 13 to 05.4%, p = 0.002) and stroke (from 05.8 to 02.2%, p = 0.033). Height increased significantly from 1.59 m to 1.66 m, p = 0.002. SBP and DBP showed significant decreases in their means from 155.43 to 144.97 mmHg, p = < 0.001 for SBP and from 95.53 to 89.02 mmHg, p = < 0.001 for DBP.

CONCLUSIONS: Cardiovascular risk factors showed different trends with decreasing tobacco smoking, similar to systolic and diastolic blood pressure, albeit with an increase in hypertension prevalence. Other CVrf values increased. Awareness campaigns must be reinforced and maintained to obtain their decrease.

PMID:38822250 | DOI:10.1186/s12872-024-03890-3

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Effect of a juggling-based physical activity on postural stability, reaction time, and attention focus in older adults: a randomized crossover study

Eur Rev Aging Phys Act. 2024 May 31;21(1):15. doi: 10.1186/s11556-024-00351-w.

ABSTRACT

BACKGROUND: In the aging society, more attention is paid to the promotion of forms of physical activity that can improve postural stability and cognitive functioning. In this context, the importance of combined exercises, requiring simultaneous physical and cognitive involvement, is emphasized. Juggling seems to be a form of activity that is both cognitively and physically demanding. The purpose of this study was to determine the effect of additional juggling exercise on postural stability and cognitive abilities in healthy, physically active older adults.

METHODS: Twenty-six healthy and physically active older adults (70.08±4.40 years old) were included in a randomized crossover study. The addition of juggling three times a week during four weeks was the main intervention (one period), while the control phase included four weeks with no addition of juggling (second period). Measurements of postural stability and cognitive abilities were performed before and after each period. For the purpose of postural stability assessment, a velocity of center of pressure with root mean square, area 95 percentile, medio-lateral and anterior-posterior range of motion were measured. Center of pressure signals were obtained using an AccuGait™ System force plate in three conditions: free standing, dual-task and limits of stability. The Vienna Test System was used for the assessment of selected cognitive abilities. A battery of reaction time tests and Cognitrone test were used for this purpose.

RESULTS: A significant interaction effect of intervention and time was observed in the postural stability dual-task condition in the root mean square of the center of pressure velocity in the advantage of the juggling period (medio-lateral: F=14.83, p<.01, ƞp2=.37; anterior-posterior: F=26.30, p<.01, ƞp2=.51). Additionally, moderate effect sizes were observed in the velocity of the center of pressure and variability of simple reaction time measurements, but without statistical significance.

CONCLUSIONS: The results of this study indicate that the implementation of juggling activity in everyday life may have positive effects on cognitive abilities and postural stability in healthy, physically active older adults, but the true effect may be low to moderate.

TRIAL REGISTRATION: The study was registered retrospectively (30.10.2023) at ClinicalTrials.gov (NCT06108713).

PMID:38822245 | DOI:10.1186/s11556-024-00351-w

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The prognostic value of combined uric acid and neutrophil-to-lymphocyte ratio in acute ischemic stroke patients treated with intravenous thrombolysis

BMC Neurol. 2024 May 31;24(1):183. doi: 10.1186/s12883-024-03628-w.

ABSTRACT

BACKGROUND: Serum uric acid (UA) and the neutrophil-to-lymphocyte ratio (NLR) have been reported to be associated with outcomes in acute ischemic stroke (AIS). However, whether UA is related to the prognosis of AIS patients undergoing intravenous thrombolysis (IVT) remains inconclusive. We sought to explore the combined effect of UA and NLR on the prognosis of AIS treated with IVT.

METHODS: A total of 555 AIS patients receiving IVT treatment were enrolled. Patients were categorized into four groups according to the levels of UA and NLR: LNNU (low NLR and normal UA), LNHU (low NLR and high UA), HNNU (high NLR and normal UA), and HNHU (high NLR and high UA). Multivariable logistic regression analysis was used to evaluate the value of serum UA level and NLR in predicting prognosis. The primary outcomes were major disability (modified Rankin scale (mRS) score 3-5) and death within 3 months.

RESULTS: After multivariate adjustment, a high NLR (≥ 3.94) increased the risk of 3-month death or major disability (OR, 2.23; 95% CI, 1.42 to 3.55, p < 0.001). However, there was no statistically significant association between a high UA level (≥ 313.00 µmol/L) and clinical outcome. HNHU was associated with a 5.09-fold increase in the risk of death (OR, 5.09; 95% CI, 1.31-19.83; P value = 0.019) and a 1.98-fold increase in the risk of major disability (OR, 1.98; 95% CI 1.07-3.68; P value = 0.030) in comparison to LNNU.

CONCLUSIONS: High serum UA levels combined with high NLR were independently associated with 3-month death and major disability in AIS patients after IVT.

PMID:38822243 | DOI:10.1186/s12883-024-03628-w

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Rotavirus vaccines in Africa and Norovirus genetic diversity in children aged 0 to 5 years old: a systematic review and meta-analysis : Rotavirus vaccines in Africa and Norovirus genetic diversity

BMC Infect Dis. 2024 May 31;24(1):547. doi: 10.1186/s12879-024-09434-6.

ABSTRACT

Noroviruses are the second leading cause of death in children under the age of 5 years old. They are responsible for 200 million cases of diarrhoea and 50,000 deaths in children through the word, mainly in low-income countries. The objective of this review was to assess how the prevalence and genetic diversity of noroviruses have been affected by the introduction of rotavirus vaccines in Africa. PubMed, Web of Science and Science Direct databases were searched for articles. All included studies were conducted in Africa in children aged 0 to 5 years old with gastroenteritis. STATA version 16.0 software was used to perform the meta-analysis. The method of Dersimonian and Laird, based on the random effects model, was used for the statistical analyses in order to estimate the pooled prevalence’s at a 95% confidence interval (CI). Heterogeneity was assessed by Cochran’s Q test using the I2 index. The funnel plot was used to assess study publication bias. A total of 521 studies were retrieved from the databases, and 19 were included in the meta-analysis. The pooled norovirus prevalence’s for pre- and post-vaccination rotavirus studies were 15% (95 CI, 15-18) and 13% (95 CI, 09-17) respectively. GII was the predominant genogroup, with prevalence of 87.64% and 91.20% respectively for the pre- and post-vaccination studies. GII.4 was the most frequently detected genotype, with rates of 66.84% and 51.24% respectively for the pre- and post-vaccination studies. This meta-analysis indicates that rotavirus vaccination has not resulted in a decrease in norovirus infections in Africa.

PMID:38822241 | DOI:10.1186/s12879-024-09434-6

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Daily compared with alternate-day levamisole in pediatric nephrotic syndrome: an open-label randomized controlled study

Pediatr Nephrol. 2024 Jun 1. doi: 10.1007/s00467-024-06402-9. Online ahead of print.

ABSTRACT

BACKGROUND: Levamisole is less expensive and has a better toxicity profile compared to other steroid sparing agents used in nephrotic syndrome. It has a plasma half-life of 2.0 to 5.6 hours, but is conventionally administered on alternate days. We aimed to assess whether daily levamisole is safe and more effective than standard alternate-day therapy in maintaining remission in children with frequently relapsing or steroid-dependent nephrotic syndrome (FR/SDNS).

METHODS: An open-label randomized controlled trial was conducted in children with FR/SDNS. Group A received daily while Group B received alternate-day levamisole (2-3 mg/kg/dose) for 12 months. Prednisolone was tapered off by 3 months. Patients were monitored for relapses, further steroid requirement, and adverse effects.

RESULTS: A total of 190 children with FR/SDNS (94 in Group A and 96 in Group B) were analyzed. Sustained remission for 12 months was observed in 36% of Group A and 27% of Group B patients (p = 0.18). Numbers completing 12 months in the study were 67% in Group A and 56% in Group B (p = 0.13). Time to first relapse, persistent FR/SDNS, and withdrawal due to poor compliance were statistically similar in both groups, while relapse rate and cumulative steroid dosage were significantly lower in Group A compared to Group B (p = 0.03 and p = 0.02, respectively). The incidence of adverse effects was comparable in both groups, with reversible leucopenia and hepatic transaminitis being the commonest.

CONCLUSIONS: Daily levamisole therapy was not superior to alternate-day therapy in maintaining sustained remission over 12 months. Nevertheless, relapse rate and cumulative steroid dosage were significantly lower without increased adverse effects.

PMID:38822220 | DOI:10.1007/s00467-024-06402-9