Cases In Group Research Articles

Health Disparities in Acidosis Risks

Background: Health disparities in acidosis risk are entangled with a range of factors including clinical conditions, genomic traits, and demographic features. Current clinical guidelines and policies on the safety of metformin have not yet taken holistic considerations of health disparities and other risk factors. The All of Us (AoU) research dataset provides comprehensive information including longitudinal real-world data for diseases and treatments, genetic data, and surveys for social determinants of health, with a focus on minority groups and the underserved population. This study leverages the AoU data to understand the health disparities in acidosis risk and provides real-world evidence to support clinical decisions.
 Methods: A case-control design was used to identify risk factors associated with emergent acidosis events, with a 1:4 matching using propensity scores specified by enrollment date, number of diagnoses, and length of medical history. Risk factors were sex, age, race, ethnicity, metformin use, Charlson comorbidities, and insurance status. Adjusted odds ratios (aOR) were estimated using conditional logistic regression.
 Results: The study includes the case group (n=2,666) and the control group (n=10,664). Health disparities were observed among participants. Compared with those who did not have health insurance, those with employer provided insurance (aOR: 0.49, 95%CI: 0.40 – 0.61), Medicare (aOR: 0.62, 95%CI: 0.52 – 0.74), or Medicaid (aOR: 0.80, 95%CI: 0.66 – 0.97) were less likely to develop acidosis. African Americans (aOR: 1.35, 95%CI: 1.15 – 1.58) showed higher acidosis risk. Other major risk factors include liver disease, renal disease, diabetes, and metformin use.
 Conclusion: Health insurance coverage is a major determinant of acidosis risk. Patients with kidney and liver diseases or diabetes should be monitored carefully for signs of acidosis, especially if they have been prescribed metformin. In future work, for diabetes patients with both kidney and liver diseases, pharmacogenomics analysis will be performed for precision management of metformin-related acidosis risks.

Foods and nutrients consumption and the risk of gallstone disease: A nested case-control study in Rosario, Argentina

The etiology of Gallstone Disease (GD) is multivariate and it involves genetics and environmental factors. Nutritional exposure is considered the main environmental influence that contributes to gallstone formation. The aim of this study was to assess the association between diet and GD. A nested case-control study based on a previous representative screening of asymptomatic subjects living in Rosario, Argentina, was carried out. Participants underwent a personal interview. Food and nutrient intake were estimated by applying a food-frequency questionnaire, a food photography atlas, and software for food composition. Logistic regression analysis was used to estimate Odds Ratios (OR) and 95% confidence intervals, adjusted by potential confounders. A total of 120 patients, 51 cases and 69 controls, were studied. Statistically significant differences in average daily energy intake were found between cases and controls (p = 0.002). Total fats, chicken with skin, sausages, and cold cuts intakes were higher in the cases group. However, the control group was characterized by a statistically significant higher consumption of vegetables, fresh fruits, nuts, chicken without skin, and skimmed dairy products. Multiple logistic regression showed that GD risk diminished with red and yellow vegetables (OR = 0.037; p = 0,0004) and nuts consumption (OR = 0.201; p = 0.019). Instead, GD risk increases with total fats (OR = 7.959; ρ = 0.0205), fatty cattle meat (OR = 18.163; p = 0.0063), and chicken with skin consumption (OR: 10.595; p = 0.0050). Phosphorus consumption decreases GD risk (OR = 0.055; p = 0.0035). A number of meals also acted as a protective factor. Also, caloric intake was a risk factor. Each 100 kilocalories daily consumed; the risk increases by 12%.

Pregnancy Outcomes in Diabetic Mothers with Controlled Glycemia: A Case-Control Study

Background: Overt Diabetes mellitus and Gestational diabetes mellitus (GDM) can complicate pregnancy. Early detection and management of the disease should be done to ensure better maternal and foetal outcomes. Our goal is to compare treatment-controlled diabetic women with non-diabetic women to evaluate the pregnancy-related unfavourable outcomes. Methods and Materials: This is a single-centre case-control study with women, from Nellore, Andhra Pradesh, who gave birth between September 2022 and February 2023. A total of 144 patients, including 72 women with diabetes and controlled glycemia (case group, n=72), were compared with non-diabetic women (control group, n=72). Various pregnancy-related outcomes were observed. The student t-test and SPSS were used for statistical analysis to compare Results: Average ages were 24±4.9 years and 27.83±6.24 years in controls and cases, respectively. Mean pregnancy duration was 268.15±7.1 days in controls and 257.1±31.2 days in cases. The cases had a mean HbA1C of 6.05%, indicating controlled levels. Caesarean births were observed in 75% of cases and 51.3% of controls. While macrosomia (>4 kg) was not observed, 25% of cases had low birth weight (<2.5 kg). Family history, gravidity, consanguinity, newborn sex, APGAR score, nuchal cord, asphyxia, and need for respiratory support did not significantly differ between the cases and controls. However, there was a significant difference (p<0.05) in the gestation period, previous neonatal loss, type of previous deliveries, caesarean delivery, baby weight, hyperbilirubinemia, and present neonatal loss between diabetic mothers and non-diabetic mothers. Conclusion: A well-managed chronic hyperglycaemia was thought to prevent multiple pregnancy-related problems for both the mother and the baby. This study aimed to investigate this point. Though many complications were avoided with controlled glycemia in our study, complications such as caesarean deliveries, preterm births, low birth weight, hyperbilirubinemia, and neonatal loss were more prevalent in cases. This highlights the need for further research, especially in understanding and possibly intensifying glycaemic goals for diabetic mothers.

Evaluation of relation between vitamin D serum level and community acquired pneumonia in children between 1 to 60 months

Background: Community-acquired pneumonia is the leading cause of hospitalization and death in children under five, particularly in developing countries. Low UV B exposure during winter can decrease serum vitamin D levels, which is a defense factor against microbial agents. This study aims to investigate the relationship between serum vitamin D levels and community-acquired pneumonia in children at Motahari Hospital in Urmia, despite the limited number of studies in this field. The findings could help improve the management of pneumonia in children. Methods: In the present study, 45 children admitted to Motahhari Hospital in Urmia with a diagnosis of pneumonia and 45 children without respiratory symptoms referred to health centers have been performed as evidence. Results: The mean of vitamin D in the case group was 31.28 ± 24.28 and less than the control group (34.43 ± 25.65), but no statistically significant difference was observed. Vitamin D deficiency is common in both groups. Community-based interventions for vitamin D deficiency appear necessary. Conclusion: Various studies have shown several effects of vitamin D on health. The results of this study showed that vitamin D deficiency is common in both groups under study and of course in the case group this deficiency is more than it is recommended to take preventive interventions.

Observational studies in orthodontics

Randomized controlled trials (RCTs) are generally considered the highest level of evidence and the preferred approach to comparing the effectiveness of different treatments. However, the cost of an RCT can be very high, and it may be considered unethical to randomly assign patients to treatments that have no real benefits or even may cause harm. For rare events, it may take a long time and require a large number of patients to observe a sufficient number of outcomes. RCTs may have low external validity or generalizability. Observational studies provide valuable alternatives, particularly for developing predictive models and assessing the effectiveness of interventions. This article aims to provide a general introduction to the advantages and disadvantages of two major observational study designs, namely cohort and case-control studies. Cohort studies compare the outcomes of exposed and unexposed groups over time. However, the nonrandom allocation may lead to confounding bias. Propensity score matching and statistical adjustment are often used to address this problem, but they cannot deal with unmeasured confounders. Case-control studies select participants based on their outcomes and retrospectively collect information on the exposure levels of the case and control groups. We will discuss methods to minimize or adjust for confounding bias, such as propensity score matching and statistical adjustment.

PIK3CA regulates development of diabetes retinopathy through the PI3K/Akt/mTOR pathway.

To explore their association with the development of diabetes retinopathy (DR), single nucleotide polymorphism (SNP) mutations were screened out by high-throughput sequencing and validated in patients diagnosed with DR. To understand the role of PIK3CA in the pathogenesis of DR and explore the relationship between PIK3CA,phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR),and DR, the effect of PIK3CA.rs17849079 mutation was investigated in a DR cell model. Twelve patients diagnosed with DR at the Qinghai Provincial People's Hospital from September 2020 to June 2021 were randomly selected as the case group, while 12 healthy subjects of similar age and gender who underwent physical examination in Qinghai Provincial People's Hospital physical examination center during the same period were randomly selected as the control group. Blood samples (2 mL) were collected from both groups using EDTA anticoagulant blood collection vessels and frozen at -20°C for future analysis. SNP mutations were detected by high-throughput sequencing, and the shortlisted candidates were subjected by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses. The detected SNP candidates were verified by expanding the sample size (first validation: 56 patients in the case group and 58 controls; second validation: 157 patients in the case group and 96 controls). A lentivirus vector carrying mutated or wild-type PIK3CA.rs17849079 was constructed. ARPE-19 cells were cultured in a medium supplemented with 10% fetal bovine serum (FBS) to establish a DR cell model. PIRES2-PIK3CA-MT and PIRES2-PIK3CA-WT vectors were transfected into DR model cells, which were categorized into control, mannitol, model, empty vector, PIK3CA wild-type, and PIK3CA mutant-type groups. Cell activity was detected by the cell counting kit (CCK)-8 assay, and cellular apoptosis was evaluated by flow cytometry. Glucose concentration and levels of cytokines tumor necrosis factor (TNF)-α and interleukin (IL)-1β were detected using enzyme-linked immunosorbent assay kits. The expression of PIK3CA, AKT1, mTOR, and VEGF genes was detected by real-time quantitative polymerase chain reaction (RT-qPCR), while the expression of PI3K, p-PI3K, AKT1, p-AKT1, mTOR, p-mTOR, and VEGF proteins was detected by western blotting. The mutated SNPs were mainly enriched in the PI3K/AKT pathway, calcium ion pathway, and glutamatergic synaptic and cholinergic synaptic signaling pathways. Seven SNPs, including PRKCE.rs1533476, DNAH11.rs10485983, ERAP1.rs149481, KLHL1.rs1318761, APOBEC3C.rs1969643, FYN.rs11963612, and KCTD1.rs7240205, were not related to the development of DR. PIK3CA.rs17849079 was prone to C/T mutation. The risk of DR increased with the presence of the C allele and decreased in the presence of the T allele. High glucose induced the expression of PIK3CA and VEGF mRNAs as well as the expression of PI3K, p-PI3K, p-AKT1, p-mTOR, and VEGF proteins in ARPE-19 cells, which led to secretion of inflammatory factors TNF-αand IL-1, cell apoptosis, and inhibition of cell proliferation. The PIK3CA.rs17849079 C allele accelerated the progression of DR. These biological effects were inhibited when the C allele of PIK3CA.rs17849079 was mutated to T allele. The mutated SNP sites in patients with DR were mainly enriched in PI3K/AKT, calcium ion, and glutamatergic synaptic and cholinergic synaptic signaling pathways. The rs17849079 allele of PIK3CA is prone to C/T mutation where the C allele increases the risk of DR. High glucose activates the expression of PIK3CA and promotes the phosphorylation of PI3K, which leads to the phosphorylation of AKT and mTOR. These effects consequently increase VEGF expression and accelerate the development of DR. The C to T allele mutation in PIK3CA.rs17849079 can play a protective role and reduce the risk of DR.

Judging the relative trustworthiness of research results: How to do it and why it matters

AbstractThis paper describes, and lays out an argument for, the use of a procedure to help groups of reviewers to judge the quality of prior research reports. It argues why such a procedure is needed, and how other existing approaches are only relevant to some kinds of research, meaning that a review or synthesis cannot successfully combine quality judgements of different types of research. The proposed procedure is based on four main factors: the fit between the research question(s) for any study and its design(s); the size of the smallest group of cases used in the headline analyses; the amount and skewness of missing data; and the quality of the data collected. This simple procedure is now relatively widely used, and has been found to lead to widespread agreement between reviewers. It can fundamentally change the findings of a review of evidence, compared to the conclusions that would emerge from a more traditional review that did not include genuine quality rating of prior evidence. And powerfully, because it is not technical, it permits users to help judge research findings. This is important as there is a growing demand for evidence‐led approaches in areas of social science such as education, wherein summaries of evidence must be as trustworthy as possible.

Risk Factors Of Ovarian Cancer Among The Postmenopausal Women

Background: Ovarian cancer ranks 5thin cancer deaths among women. A woman’s risk of getting ovarian cancer during her lifetime is about 1 in 75. Cancer mainly develops in older women.
 Methods: The case control study was carried out among 154 respondents in medical oncology department, NIRCH, Dhaka from July 2016 to June 2017. Among the participants, 77 were cases who had ovarian cancer and another 77 were controls who had no ovarian cancer. Convenient sampling technique was used and data were collected by face-to-face interview using a pretested semi-structured questionnaire. Data were entered on to the template of SPSS and analysis was done.
 Results: The mean age of case and control group were 60.06±7.00 and 59.89±6.96 years respectively. Highest number of respondents were illiterate. Majority came from rural area and had no personal monthly income. Most of them were taken high fiber diet, 83.1% in case and 77.9% in control group. About 80.5% in case and 66.2% in control group had BMI ≥25 kg/m2. Sedentary workers 40.3% in case and 13.0% in control group; moderate workers were 31.2% in case and 20.8% in control group and hard workers were 28.5% and 66.2% in case and control group respectively. The mean age of menarche 12.02±1.19 years and 12.87±1.30 years in case and control group respectively and mean age of menopause in case and in control groups respectively 51.54±2.39 and 49.61±1.29 years. In case group 49.3% had early term pregnancy whereas in control group 9.5% had early term pregnancy; in case group 82.1% and in control group 86.5% had breast feeding history. Around 16.9% in case group and 27.3% in control group used to take OCP. Significantly more respondents 6.5% in case group had personal H/O breast cancer than control group. Positive family history of breast and ovarian cancer was found 16.9% in case group and 2.6% in control group. In binary logistic regression analysis for risk factors of OC was found that sedentary activity was associated with increased risk, increased BMI (≥25 kg/m2), early age of menarche (≤12 years), late age of menopause (>51 years), nullipara and early term pregnancy. Family H/O breast or ovarian cancer significantly associated with development of ovarian cancer.
 Conclusion: Ovarian cancer observed more in older age group (≥60 years) among sedentary worker with high body mass index (≥25 kg/m2). Early age of menarche (≤12 years), late menopause (>50 years), never having given birth to a child in life time, early term of pregnancy and family history of breast and ovarian cancer were significantly associated with ovarian cancer among post-menopausal women.
 JOPSOM 2021; 41(2):28-35

Risk Factors for Severe Maternal Morbidity Among Women Enrolled in Mississippi Medicaid

Mississippi has one of the highest rates of severe maternal morbidity (SMM) in the US, and SMMs have been reported to be more frequent among Medicaid-insured women. A substantial proportion of pregnant women in Mississippi are covered by Medicaid; hence, there is a need to identify potential risk factors for SMM in this population. To examine the associations of health care access and clinical and sociodemographic characteristics with SMM events among Mississippi Medicaid-enrolled women who had a live birth. A nested case-control study was conducted using 2018 to 2021 Mississippi Medicaid administrative claims database. The study included Medicaid beneficiaries aged 12 to 55 years who had a live birth and were continuously enrolled throughout their pregnancy period and 12 months after delivery. Individuals in the case group had SMM events and were matched to controls on their delivery date using incidence density sampling. Data analysis was performed from June to September 2022. Risk factors examined in the study included sociodemographic factors (age and race), health care access (distance from delivery center, social vulnerability index, and level of maternity care), and clinical factors (maternal comorbidity index, first-trimester pregnancy-related visits, and postpartum care). The main outcome of the study was an SMM event. Adjusted odds ratio (aORs) and 95% CIs were calculated using conditional logistic regression. Among 13 485 Mississippi Medicaid-enrolled women (mean [SD] age, 25.0 [5.6] years; 8601 [63.8%] Black; 4419 [32.8%] White; 465 [3.4%] other race [American Indian, Asian, Hispanic, multiracial, and unknown]) who had a live birth, 410 (3.0%) were in the case group (mean [SD] age, 26.8 [6.4] years; 289 [70.5%] Black; 112 [27.3%] White; 9 [2.2%] other race) and 820 were in the matched control group (mean [SD] age, 24.9 [5.7] years; 518 [63.2%] Black; 282 [34.4%] White; 20 [2.4%] other race). Black individuals (aOR, 1.44; 95% CI, 1.08-1.93) and those with higher maternal comorbidity index (aOR, 1.27; 95% CI, 1.16-1.40) had higher odds of experiencing SMM compared with White individuals and those with lower maternal comorbidity index, respectively. Likewise, an increase of 100 miles (160 km) in distance between beneficiaries' residence to the delivery center was associated with higher odds of experiencing SMM (aOR, 1.14; 95% CI, 1.07-1.20). The study findings hold substantial implications for identifying high-risk individuals within Medicaid programs and call for the development of targeted multicomponent, multilevel interventions for improving maternal health outcomes in this highly vulnerable population.

Oculomotor Rehabilitation Improves Reading Abilities in Dyslexic Children With Concurrent Eye Movement Abnormalities.

The oculomotor abnormalities have been reported in some dyslexic children. The purpose of the study was to evaluate the effects of oculomotor rehabilitation on the reading performance of dyslexic children. Subjects were 50 dyslexic children. Those with oculomotor abnormalities (n = 30) were randomly assigned into 2 groups matched for age. The case group received oculomotor rehabilitation. The rehabilitation program consists of 3 different exercises. The reading and dyslexia tests were performed before and after the intervention. The correct scores of reading tests in the case group posttest increased significantly compared with the control group, and there is a significant difference between the two groups (P = .001). The positive effects of oculomotor rehabilitation on the reading performance of dyslexic children confirmed that the oculomotor program could be a practical tool for improving reading performance in dyslexic children.

Metabolic alterations in urine among the patients with severe fever with thrombocytopenia syndrome

BackgroundThe pathogenesis of severe fever with thrombocytopenia syndrome (SFTS) remained unclear. We aimed to profile the metabolic alterations in urine of SFTS patients and provide new evidence for its pathogenesis.MethodsA case–control study was conducted in the 154th hospital in China. Totally 88 cases and 22 controls aged ≥ 18 years were enrolled. The cases were selected from laboratory-confirmed SFTS patients. The controls were selected among SFTSV-negative population. Those with diabetes, cancer, hepatitis and other sexually transmitted diseases were excluded in both groups. Fatal cases and survival cases were 1:1 matched. Inter-group differential metabolites and pathways were obtained, and the inter-group discrimination ability was evaluated.ResultsTryptophan metabolism and phenylalanine metabolism were the top one important metabolism pathway in differentiating the control and case groups, and the survival and fatal groups, respectively. The significant increase of differential metabolites in tryptophan metabolism, including 5-hydroxyindoleacetate (5-HIAA), L-kynurenine (KYN), 5-hydroxy-L-tryptophan (5-HTP), 3-hydroxyanthranilic acid (3-HAA), and the increase of phenylpyruvic acid and decrease of hippuric acid in phenylalanine metabolism indicated the potential metabolic alterations in SFTSV infection. The increase of 5-HIAA, KYN, 5-HTP, phenylpyruvic acid and hippuric acid were involved in the fatal progress of SFTS patients.ConclusionsTryptophan metabolism and phenylalanine metabolism might be involved in the pathogenesis of SFTSV infection. These findings provided new evidence for the pathogenesis and treatment of SFTS.

Association between ischemic heart disease and dietary intake of lycopene: a case-control study.

The effect of dietary lycopene on ischemic heart disease (IHD) is not clear. Hence, this study aimed to determine the association between dietary lycopene and IHD. This case-control study was conducted on 443 patients with physician confirmed diagnosis of IHD as the case group and 443 healthy individuals as the control group. Data on demographic, medical history, anthropometric, and physical activity of the participants were collected. Food intake was evaluated using a 237-item semi-quantitative food frequency questionnaire (FFQ). The dietary intake of lycopene was assessed using Nutritionist IV software. A negative association was found between IHD and lycopene (OR: 0.98, CI 95%: 0.963-0.996, p = 0.02). The results remained significant after adjustment for age and sex, additional adjustment for dietary intake of calorie and fat, further adjustments for BMI, and additional adjustment for smoking, drinking alcohol, and physical activity. The risk of IHD in people with the highest quartile of dietary intake of lycopene was significantly lower than those with the lowest quartile (OR = 0.67, CI 95%: 0.46-0.97, p = 0.036). There was a significant inverse relationship between intake of lycopene and IHD. Further prospective studies in different populations are required to elucidate the roles of lycopene against IHD.

Cutaneous Leishmaniasis Hampers COVID-19: A Controlled Cross-Sectional Study in High-Burden Endemic Areas of Iran.

Emerging infectious diseases such as SARS-CoV-2 can cause pandemics and create a critical risk for humans. In a previous pilot study, we reported that the immunological responses induced bycutaneous leishmaniasis (CL) could decrease the incidence and severity of COVID-19. In this large-scale case-control study, we assessed the possible relationship between mortality and morbidity of COVID-19 in healed CL persons suffering scars compared to cases without CL history. This controlled cross-sectional study was conducted between July 2020 and December 2022 in the endemic and high-burden areas of CL in southeastern Iran. In the study, 1400 previous CL cases with scars and 1,521,329 subjects who had no previous CL were analyzed. We used R 4.0.2 to analyze the data. Firth's bias reduction approach corresponding to the penalization of likelihood logistic regression by Jeffreys was also employed to influence the variables in the dataset. Also, a Bayesian ordinal logistic regression model was performed to explore the COVID-19 severity in both case and referent groups. The occurrence and severity rate of COVID-19 in CL scar cases are significantly less than in the non-CL control group, while in the CL scar subjects, patients with critical conditions and mortality were not observed. The morbidity (OR = 0.11, CI 0.06-0.20 and P < 0.001) and severity of COVID-19 in previous cases with CL scars were significantly diminished than that in the control group (credible interval - 2.57, - 1.62). The results represented a durable negative relationship between cured CL and COVID-19 incidence and severity. Additional studies seem necessary and should be designed to further validate the true impact and underlying mechanistic action of CL on COVID-19.

MTHFR (C677T) polymorphism and its association with cytogenetic and clinical profile in individuals with primary amenorrhea

BackgroundAbnormal folate metabolism is a risk factor for DNA hypomethylation and chromosomal nondisjunction. MTHFR is a candidate gene for folliculogenesis and ovarian development. In the present study, we aimed to investigate the distribution of the MTHFR C677T polymorphism in individuals with primary amenorrhea and it’s association with the cytogenetic and clinical profile. The MTHFR polymorphism (C677T) was checked in 45 females with PA and 45 control females (age-matched) with regular menstrual cycles using polymerase chain reaction-restriction fragment length polymorphism.ResultsWe observed the CC genotype in 84.4% (n = 38) of the control group females and 48.9% (n = 22) of the case group females, CT genotype in 13.3% (n = 6) in the control group females and 24.4% (n = 11) in the case group females (p = 0.039; χ2 value 4.253; odd ratio 0.316, 95%CI 0.103–0.973) and TT genotype in 2.2% (n = 1) in the control group females and 26.7% (n = 12) in the case group females (p = 0.000266; χ2 value 13.294; odd ratio 0.048, 95%CI 0.006–0.397). Out of 45 case group females, 26 females showed 46,XX karyotype, 4 females showed male karyotype, 3 females showed pure Turner karyotype, 2 females were mosaic Turner and the rest of the females showed structural abnormalities like deletion, isochromosome and normal variants. The serum values revealed significantly lower levels (p = 0.032) of progesterone in the individuals with the TT genotype as compared to the CC genotype and the radiology profile showed a significant role of the MTHFR gene in ovarian development (p = 0.024).ConclusionWe suggest that the MTHFR polymorphism (C677T) might be responsible for the chromosomal nondisjunction in monosomy X females. It also influences the progesterone level and ovarian development, thus affecting folliculogenesis and the ovarian reserve responsible for primary amenorrhea.

Study on transcriptome characteristics of respiratory syncytial virus bronchiolitis in children by RNA sequencing

To explore the biological characteristics related to the pathogenesis and severity of respiratory syncytial virus (RSV) bronchiolitis by RNA sequencing of white blood cells in children with RSV bronchiolitis. This study is a case-control study. A total of 87 children diagnosed with bronchiolitis and RSV antigen positive and/or RSV nucleic acid positive in the pediatric respiratory department of the Second Affiliated Hospital of Wenzhou Medical University from October 2019 to April 2022 were selected as the case group. The case group was divided into three groups based on the condition: mild, moderate, and severe, and there were two groups according to the presence or absence of atopic symptoms: the atopic group and the non-atopic group, forty healthy children in the same period were selected as the control group. The whole blood leukocyte RNA of the children in the case group and the control group was extracted for RNA sequencing, and the data were analyzed to obtain differentially expressed genes (DEGs). Then, the immunobiological pathways and genes related to the pathogenesis, disease condition, and atopy were screened through Gene Ontology (GO) annotation, Kyoto Gene and Genome Encyclopedia (KEGG) annotation, and protein interaction network (PPI) construction methods. Construct the weighted gene co-expression network analysis (WGCNA) module to identify potential biological indicators related to disease severity.Compared with the control group, the case group had a total of 1 782 DEGs, including 1 586 upregulated genes and 196 downregulated genes. The GO pathway enrichment of DEGs is mainly enriched in molecular functions such as peroxidase activity and oxidoreductase activity. In the cytological components, it is mainly enriched in cytoplasmic vesicle lumen and secretory granule lumen. In biological processes, it is mainly enriched in processes such as neutrophil activation involved in immune responses, neutrophil degranulation, and neutrophil activation. KEGG analysis is mainly concentrated in the signal pathway of the viral protein interaction with cytokine and cytokine receptor. A PPI network was constructed to screen four genes at the core position, including CCL2, IL-10, MMP9 and JUN. The DEGs obtained by comparing different disease groups with the control group are mainly enriched in retrograde endocannabinoid signaling and cell apoptosis pathways. WGCNA analysis showed that the brown module related to oxygen saturation was most closely related to the disease, and its gene was mainly enriched in the RNA helicase retinoic acid inducible gene-I (RIG-I) like receptor signal pathway. There are 230 specific DEGs in the atopic group and 444 in the non-atopic group. KEGG enrichment analysis results show that both groups are enriched to NF-κB signaling pathway, the characteristic does not cause significant changes in immune response and transcriptome characteristics in children with RSV bronchiolitis. In conclusion, neutrophil activation, degranulation pathway and signal pathway of interaction between viral protein and cytokine and cytokine receptor are involved in the immune response of RSV bronchiolitis host. CCL2, IL-10, MMP9 and JUN genes may be associated with the pathogenesis. They might be potential biomarkers related to disease severity in RIG-I like receptors, cell apoptosis, and endogenous cannabinoid related signaling pathways.

The association between ambient air pollution exposure and connective tissue sarcoma risk: a nested case-control study using a nationwide population-based database.

A nationwide population-based database was utilized in a nested case-control study to explore the association between ambient air pollution exposure and the likelihood of developing connective tissue sarcoma. The study examined 280 cases of connective tissue sarcoma diagnosed between 2000 and 2012. A random sample of 1120 control subjects was selected from a subpopulation of claim records without a connective tissue sarcoma diagnosis in a 1:4 ratio. The control subjects were selected based on similar characteristics as the connective tissue sarcoma patients, including gender, birth year, and the year of diagnosis of the case group with medical records. Risk factors for connective tissue sarcoma were collected for analysis. Our data on exposure to air pollutants was collected from Taiwan's Air Quality Monitoring Network, which has been gathering air quality data from a growing network of sampling stations (now 76) throughout the country since 1997. It was discovered that the risk of connective tissue sarcoma was significantly increased by the Charlson comorbidity index (CCI), elevated levels of specific air pollution indices (e.g., total hydrocarbons (THC), fine particulate matter (PM2.5), and O3_8 (the annual mean of the daily maximum 8-h average concentration of O3), the High Pollutant Standards Index (hPSI) (the percentage of days in a given year in Taiwan where the PSI exceeds 100), and an insurable monthly wage over US$1100. Further investigation is needed to explore the involvement of these air pollutants in the formation of connective tissue sarcoma.

Effect of Cognitive-Behavioral Therapy ‎on the Oxidative Balance of Fibromyalgia ‎Patients: A Randomized Controlled Trial

Background: Cognitive-behavioral therapy (CBT) is acknowledged as an efficient therapeutic modality in fibromyalgia. However, its effect on the oxidative balance of fibromyalgia patients has not been investigated. Objectives: We investigated whether CBT intervention could influence serum markers of oxidative balance. Methods: Forty fibromyalgia patients were randomly assigned to either the intervention (CBT) or control (waiting list) group. For the intervention group, traditional face-to-face CBT was performed for 20 sessions over two months. Sixteen patients in the CBT group and 17 patients in the control group completed the study. Outcomes were the serum total oxidant status (TOS) and total antioxidant capacity (TAC) that were assessed before the intervention and at the end of the intervention by an oxidation-reduction colorimetric assay. Within-group and between-group analyses were performed using the Wilcoxon signed-rank test and Mann–Whitney U test, respectively. Results: Baseline characteristics showed no significant difference between the participants of the two groups. At the end of the study, mean TOS significantly reduced in the case group (P &lt; 0.001) but not in the control group (P = 0.61), and mean TAC showed no significant change in the case and control groups (P = 0.1 and P = 0.09, respectively). The mean change in TOS was 0.43 ± 0.3 mM in the CBT group and 0.03 ± 0.2 mM in the control group (P &lt; 0.001). The mean change in TAC was 0.015 ± 0.03 mM in the CBT group and 0.01 ± 0.02 mM in the control group (P = 0.57). Conclusions: Cognitive-behavioral therapy improves the oxidative balance of fibromyalgia patients. Our results further support the benefits of CBT implication in the treatment of fibromyalgia.

Tic disorder in allergic rhinitis children and adolescents: a case-control study

BackgroundAllergic rhinitis is the most common allergic disease. It can accompany psychological disorders such as tic disorders due to the prolonged course of the symptoms of allergic rhinitis. This pioneer case-control study aims to investigate tic disorders in children and adolescents under 18 years of age diagnosed with allergic rhinitis.MethodThe case group in this study consisted of patients who had both allergic rhinitis and tic disorders. Patients with allergic rhinitis without tic disorders were also enrolled as the control group with matched gender and age. Demographic characteristics, tic classifications, and contributing factors for allergic rhinitis and tic disorders were studied among the cases. Tic disorders were evaluated using DSM-5 criteria for the classification of tic disorders.Results47 patients in the case group and 47 patients in the control group were included in this study. 53.2% and 46.8% were males and females in the case group, respectively. The mean age of the patients was 10.46 ± 3.97 years old. Sound tics were more common among the patients compared to motor tics. Patients with concomitant AR and tic disorders had more days per week with AR symptoms (P-value ≤ 0.001; OR (every day vs. three days a week = 11.02(2.98, 40.76))). Most patients with sound tick were women (p: 0.026), and most patients with motion tic were in the Provisional tic disorder group (p: 0.001). The history of infantile eczema was seen more in patients without sound tic (p: 0.025), and otitis media was significantly less common among patients with sound tics (p: 0.026). Provisional tic disorder was the most common class among the patients. In the case group (coexistence between allergic rhinitis and tic) compared to the control group, patients had significantly more days with AR symptoms per week.ConclusionThis preliminary study indicates that Provisional tic disorder was the most common classification of tic among patients with allergic rhinitis, especially in patients with motor tics. Asthma in motor tics, a history of food allergy in infancy, and a history of infantile eczema were also common among patients with vocal tics. Also, patients with allergic rhinitis and tic had more severe disease (more symptoms per week) than those with rhinitis alone. These findings emphasize the association of tic disorders with immunological pathways.

The Effect of Psychoactive Substances Used on Clinical Outcomes in Injured Drivers Referred to Emergency Medicine; Case-Control Study

Objective: The use of psychoactive substances increases the risk of accidents. This study evaluated the relationship between the type of psychoactive substances among traffic injured admitted to the medical center. Methods: Injured drivers (100 used drugs), (260 control group), who were transferred to 7-Tir Hospital from April 2021 to March 2022 were studied. The information related to the accident scene, personal characteristics, and the substance used was collected from the police and the medical center documents. We used multiple logistic regression to find the important factor in outcomes. Results: The mean age of the case group (37.49 ±13.61) compared to the control group (34.18 ±14.05) was significant (p=0.044). The most common substances in the case group were opioids which had the highest mean age (41.90 ± 13.541). Injured who used sedatives had higher signs of head trauma than the others. Also, being guilty had a remarkable difference in the groups (94.6 vs 62.4 p= &lt;0.001). Motorcyclist drivers were 185(65%) as responsible for the accident, in addition, 69(69%) were in the case group. Head trauma, type of accident, and level of triage had a significant effect on the death of the injured. Conclusion: Using sedatives causes increased head trauma. Driving under the effect of psychoactive drugs is more common among motorcycle drivers, and a large percentage of them were guilty of accidents.

Students and Academics Perception of Flexible Learning Tools and their Effectiveness in Developing Employability Skills within UK Business Schools

With the growth and acceptance of flexible learning after the COVID-19 pandemic, it is crucial to identify the pedagogical tools which are effective in developing employability skills among the undergraduate business students. The paper is the second in the series to investigate the effective pedagogical tools to develop the employability skills. This study seeks to provide an insight into the most effective flexible pedagogical tool especially in the context of UK Business Schools. Indeed, the use of resourceful pedagogical tools are vital in developing the key 21st century employability skills among the business students. In order to ensure that organizations have the right skills to support and sustain their hard-earned success, and people have a relevant set of skills they need to be both employable and individually fulfilled. For this study, a single case study was selected; where a business school in central London was selected which provided both face to face and flexible learning to students in the UK. The study critically reviewed students’ and academics perspectives on the issue of pedagogical tools. Both data strands agreed that case studies, class debates, lectures, group projects, role play, and internships are effective flexible learning tools for the development of 21st century skills or in gaining employability for life values.