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Metabolism Open Jun 2024'Vision 2020, the Right to Sight', jointly coordinated by the World Health Organization's program for the prevention of blindness and deafness and the international...
INTRODUCTION
'Vision 2020, the Right to Sight', jointly coordinated by the World Health Organization's program for the prevention of blindness and deafness and the international agency for the prevention of blindness, was launched in 1999, however, the initiative faces many challenges to hitting its target. One of the challenges for this is, the absence of comprehensive data regarding eye care service utilization among diabetes mellitus patients in Africa. Therefore, this study was aimed at assessing the prevalence of eye care service utilization and associated factors among adult diabetes mellitus patients in Africa.
METHODS
This systematic review and meta-analysis was conducted as per the international preferred reporting items for systematic review and meta-analysis protocols (PRISMA) guidelines. Published articles were searched using reputable databases (PubMed, Cochrane Library) and Web searches (Science Direct, African Journals Online, and Google Scholar). Quality appraisal was assessed based on the Joanna Briggs Institute's (JBI) critical appraisal checklist. The extracted data was exported to STATA version 11 (STATA Corp., LLC) for further analysis. Heterogeneity between the results of primary studies was assessed using Cochran's Q chi-square test and quantified with the I statistics. Publication bias was assessed by visual inspection of the funnel plot and Egger's regression tests.
RESULTS
The database search found 26,966 articles. The pooled prevalence of eye care service utilization among diabetic patients in Africa is found to be 40.92 % (95 % CI: 27.14-54.70, P < 0.001). Good knowledge (POR = 3.57, 95 % CI: 2.67-4.76), good attitude (POR = 5.68, 95 % CI: 4.20-7.68), age greater than 65 years old (POR = 7.11, 95 % CI: 3.86-13.10), urban residence (POR = 5.03, 95 % CI: 2.12-11.96), and disease duration greater than 6 years (POR = 3.81, 95 % CI: 2.25-6.45) were factors associated with eye care service utilization.
CONCLUSION
This meta-analysis revealed that a high proportion of people with diabetes failed to use eye care services. Older age, good knowledge, urban residence and longer duration of illness were found to be the contributing factors for the utilization of eye care services in diabetes mellitus patients. Therefore, by considering the negative impact of low eye care service utilization, it is important to improve the habit of regular screening of the eye into routine assessment of diabetes mellitus follow up targeting patients with older age and longer duration of illness to reduce the magnitude of the problem.
PubMed: 38957624
DOI: 10.1016/j.metop.2024.100293 -
Frontiers in Immunology 2024Enteric glial cells (EGCs) are an essential component of the enteric nervous system (ENS) and play key roles in gastrointestinal development, homeostasis, and disease.... (Review)
Review
Enteric glial cells (EGCs) are an essential component of the enteric nervous system (ENS) and play key roles in gastrointestinal development, homeostasis, and disease. Derived from neural crest cells, EGCs undergo complex differentiation processes regulated by various signalling pathways. Being among the most dynamic cells of the digestive system, EGCs react to cues in their surrounding microenvironment and communicate with various cell types and systems within the gut. Morphological studies and recent single cell RNA sequencing studies have unveiled heterogeneity among EGC populations with implications for regional functions and roles in diseases. In gastrointestinal disorders, including inflammatory bowel disease (IBD), infections and cancer, EGCs modulate neuroplasticity, immune responses and tumorigenesis. Recent evidence suggests that EGCs respond plastically to the microenvironmental cues, adapting their phenotype and functions in disease states and taking on a crucial role. They exhibit molecular abnormalities and alter communication with other intestinal cell types, underscoring their therapeutic potential as targets. This review delves into the multifaceted roles of EGCs, particularly emphasizing their interactions with various cell types in the gut and their significant contributions to gastrointestinal disorders. Understanding the complex roles of EGCs in gastrointestinal physiology and pathology will be crucial for the development of novel therapeutic strategies for gastrointestinal disorders.
Topics: Humans; Neuroglia; Enteric Nervous System; Animals; Gastrointestinal Diseases
PubMed: 38957473
DOI: 10.3389/fimmu.2024.1408744 -
Frontiers in Immunology 2024Targeted therapy and immunotherapy are both important in the treatment of non-small-cell lung cancer (NSCLC). Accurate diagnose and precise treatment are key in...
Targeted therapy and immunotherapy are both important in the treatment of non-small-cell lung cancer (NSCLC). Accurate diagnose and precise treatment are key in achieving long survival of patients. fusion is a rare oncogenic factor, whose optimal detection and treatment are not well established. Here, we report on a 32-year-old female lung adenocarcinoma patient with positive PD-L1 and negative driver gene detected by DNA-based next-generation sequencing (NGS). A radical resection of the primary lesion after chemotherapy combined with PD-1 checkpoint inhibitor administration indicated primary immuno-resistance according to her pathological response and rapid relapse. A rare was detected by RNA-based NGS, which was confirmed by fluorescence hybridization. Multiplex immunofluorescence revealed a PD-L1 related heterogeneous immunosuppressive microenvironment with little distribution of CD4+ T cells and CD8+ T cells. Savolitinib therapy resulted in a progression-free survival (PFS) of >12 months, until a new secondary resistance mutation in p.D1228H was detected by re-biopsy and joint DNA-RNA-based NGS after disease progression. In this case, fusion NSCLC was primarily resistant to immunotherapy, sensitive to savolitinib, and developed secondary p.D1228H mutation after targeted treatment. DNA-RNA-based NGS is useful in the detection of such molecular events and tracking of secondary mutations in drug resistance. To this end, DNA-RNA-based NGS may be of better value in guiding precise diagnosis and individualized treatment in this patient population.
Topics: Humans; Female; Adenocarcinoma of Lung; Adult; Lung Neoplasms; High-Throughput Nucleotide Sequencing; Proto-Oncogene Proteins c-met; Oncogene Proteins, Fusion; Drug Resistance, Neoplasm; Immune Checkpoint Inhibitors
PubMed: 38957460
DOI: 10.3389/fimmu.2024.1386561 -
PNAS Nexus Jul 2024In this paper, we examine how different governance types impact prosocial behaviors in a heterogenous society. We construct a general theoretical framework to examine a...
In this paper, we examine how different governance types impact prosocial behaviors in a heterogenous society. We construct a general theoretical framework to examine a game-theoretic model to assess the ease of achieving a cooperative outcome. We then build a dynamic agent-based model to examine three distinct governance types in a heterogenous population: monitoring one's neighbors, despotic leadership, and influencing one's neighbors to adapt strategies that lead to better fitness. In our research, we find that while despotic leadership may lead towards high prosociality and high returns it does not exceed the effects of a local individual who can exert positive influence in the community. This may suggest that greater individual gains can be had by cooperating and that global hierarchical leadership may not be essential as long as influential individuals exert their influence for public good and not for public ill.
PubMed: 38957450
DOI: 10.1093/pnasnexus/pgae224 -
Frontiers in Medicine 2024Mild cognitive impairment (MCI) is a heterogeneous condition definable as the intermediate clinical state between normal aging and dementia. As a pre-dementia condition,... (Review)
Review
Mild cognitive impairment (MCI) is a heterogeneous condition definable as the intermediate clinical state between normal aging and dementia. As a pre-dementia condition, there is a recent growing interest in the identification of non-invasive markers able to predict the progression from MCI to a more advanced stage of the disease. Previous evidence showed the close link between gut microbiota and neurodegenerative diseases, such as Alzheimer's (AD) and Parkinson's disease (PD). Conversely, the actual relationship between gut microbiota and MCI is yet to be clarified. In this work, we provide an overview about the current knowledge regarding the role of gut microbiota in the context of MCI, also assessing the potential for microbiota-targeted therapies. Through the review of the most recent studies focusing on this topic, we found evidence of an increase of Bacteroidetes at phylum level and Bacteroides at genus level in MCI subjects with respect to healthy controls and patients with AD. Despite such initial evidence, the definitive identification of a typical microbiota profile associated with MCI is still far from being achieved. These preliminary results, however, are growingly encouraging research on the role of gut microbiota modulation in improving the cognitive status of pre-dementia subjects. To date, few studies evaluated the role of probiotics in MCI subjects, and they showed favorable results, although still biased by small sample size, heterogeneity of study design and short follow-up.
PubMed: 38957302
DOI: 10.3389/fmed.2024.1410246 -
Journal of Tropical Medicine 2024Neglected tropical diseases (NTDs) are a heterogeneous group of medical conditions that commonly occur in underprivileged populations. NTDs are primarily diagnosed in...
BACKGROUND
Neglected tropical diseases (NTDs) are a heterogeneous group of medical conditions that commonly occur in underprivileged populations. NTDs are primarily diagnosed in tropical areas. Although South Africa is not situated in a tropical region, the high poverty rate makes the country susceptible to some NTDs. Limited data are available on the burden of NTDs in the Free State province of South Africa. This study aimed to determine the number of NTDs diagnosed on histopathological specimens in the public sector of the Free State province over a six-year period and to evaluate the patient demographics.
METHODS
A retrospective, descriptive study was performed. All NTDs diagnosed in histopathological specimens from public sector hospitals in the province submitted to the Department of Anatomical Pathology, National Health Laboratory Service, and University of the Free State between 1 January 2015 and 31 December 2020 were included in the study. The demographic information, biopsy site, and referring hospital were noted for each case identified.
RESULTS
A total of 72 NTDs were diagnosed. The five most common diagnoses were echinococcosis ( = 33; 45.8%), bilharzia ( = 13; 18.1%), leprosy ( = 9; 12.5%), mycetoma ( = 8; 11.1%), and intestinal worms ( = 5; 6.9%). Ten (30.3%) patients diagnosed with echinococcosis came from the Free State's neighbouring country, Lesotho.
CONCLUSION
Echinococcosis was the most prevalent NTD diagnosed in central South Africa. We recommend that the South African Department of Health add echinococcosis to the principal NTDs of significance in South Africa, alongside soil-transmitted helminths, schistosomiasis, leprosy, and rabies.
PubMed: 38957266
DOI: 10.1155/2024/5076288 -
Cureus Jun 2024Type 2 diabetes mellitus is a metabolic condition where vascular inflammation and oxidative stress contribute to disease progression and associated complications.... (Review)
Review
A Comparison of Rosuvastatin Monotherapy and Rosuvastatin Plus Ezetimibe Combination Therapy in Patients With Type 2 Diabetes: A Meta-Analysis of Randomized Controlled Trials.
Type 2 diabetes mellitus is a metabolic condition where vascular inflammation and oxidative stress contribute to disease progression and associated complications. Although statins are recommended for managing dyslipidemia in diabetes, additional therapies are often required to achieve target lipid levels. This meta-analysis aimed to evaluate the efficacy of rosuvastatin monotherapy versus combination therapy with ezetimibe in patients with type 2 diabetes. A systematic literature search was conducted across multiple databases until April 2024, identifying six randomized controlled trials meeting the inclusion criteria. The meta-analysis revealed that the rosuvastatin plus ezetimibe combination resulted in significantly greater reductions in total cholesterol (mean difference, or MD: 19.49; 95% CI: 13.99 to 24.99), triglycerides (MD: 13.44; 95% CI: 2.04 to 24.85), and low-density lipoprotein cholesterol (MD: -17.68; 95% CI: 12.85 to 22.51) compared to rosuvastatin monotherapy. Conversely, rosuvastatin monotherapy achieved a greater reduction in HbA1c levels (MD: -0.11; 95% CI: -0.17 to -0.04). Subgroup analysis demonstrated that using the same dose of rosuvastatin in both groups led to more significant improvements in lipid parameters with lower heterogeneity. The findings suggest that the rosuvastatin-ezetimibe combination may be a more effective lipid-lowering strategy for patients with type 2 diabetes, though larger studies are needed to assess long-term safety and optimal dosing. Additionally, while rosuvastatin monotherapy provided modest HbA1c reductions, the clinical relevance remains uncertain, and potential risks with high-dose statins should be considered.
PubMed: 38957250
DOI: 10.7759/cureus.61526 -
Cureus Jun 2024Metaplastic breast cancer (MBC) is a rare type of breast carcinoma with clinicopathological differences. The prognosis and treatment strategies for MBC are usually...
BACKGROUND
Metaplastic breast cancer (MBC) is a rare type of breast carcinoma with clinicopathological differences. The prognosis and treatment strategies for MBC are usually conflicting. In this study, we aim to present the clinicopathologic features, treatment strategies, and prognosis of our MBC patients.
MATERIAL AND METHODS
In our retrospective study, 18 metaplastic breast cancer patients treated in our institution between January 2005 and December 2022 were evaluated. Demographic and clinicopathological characteristics, surgical and systemic treatment options, locoregional recurrences, distant metastases, and overall survival (OS) of the MBC patients were retrieved from the patient files.
RESULTS
All patients were female; the median age was 54.42 ± 12.37 years. Most of the patients (n = 15, 83.33%) presented with palpable masses. Tumors were mostly triple-negative, with a high grade and a high Ki‑67 proliferation index. Spindle cell carcinoma and MBC with mesenchymal differentiation were the most common subtypes. Most of the patients underwent mastectomy (n = 11, 61.11%); breast-conserving surgery (BCS) was performed on seven (38,88%) patients. Lymph node positivity was detected in six of 18 patients (33.33%). Fewer patients (n = 4, 22.22%) received neoadjuvant chemotherapy. While local recurrence developed in two out of seven patients (28.57%) who underwent BCS, there was no local recurrence in patients who had mastectomy. The OS time varied according to tumor size and the presence of lymph node metastases (p <0.001; p = 0.005).
CONCLUSION
Metaplastic breast cancer is genetically heterogeneous and resistant to conventional treatment strategies. Mastectomy is still the surgical treatment method that is performed more frequently and provides better local control for patients with metaplastic breast cancer.
PubMed: 38957239
DOI: 10.7759/cureus.61517 -
Frontiers in Neuroscience 2024The incidence of neurological disorders, particularly age-related neurodegenerative pathologies, exhibits an alarming upward trend, while current pharmacological... (Review)
Review
The incidence of neurological disorders, particularly age-related neurodegenerative pathologies, exhibits an alarming upward trend, while current pharmacological interventions seldom achieve curative outcomes. Despite their diverse clinical presentations, neurological diseases often share a common pathological thread: the aberrant accumulation of misfolded proteins within the endoplasmic reticulum (ER). This phenomenon, known as ER stress, arises when the cell's intrinsic quality control mechanisms fail to cope with the protein-folding burden. Consequently, misfolded proteins accumulate in the ER lumen, triggering a cascade of cellular stress responses. Recognizing this challenge, researchers have intensified their efforts over the past two decades to explore natural compounds that could potentially slow or even reverse these devastating pathologies. Flavonoids constitute a vast and heterogeneous class of plant polyphenols, with over 10,000 identified from diverse natural sources such as wines, vegetables, medicinal plants, and organic products. Flavonoids are generally divided into six different subclasses: anthocyanidins, flavanones, flavones, flavonols, isoflavones, and flavonols. The diverse family of flavonoids, featuring a common phenolic ring backbone adorned with varying hydroxyl groups and additional modifications, exerts its antioxidant activity by inhibiting the formation of ROS, as evidenced by research. Also, studies suggest that polyphenols such as flavonoids can regulate ER stress through apoptosis and autophagy. By understanding these mechanisms, we can unlock the potential of flavonoids as novel therapeutic agents for neurodegenerative disorders. Therefore, this review critically examines the literature exploring the modulatory effects of flavonoids on various steps of the ER stress in neurological disorders.
PubMed: 38957188
DOI: 10.3389/fnins.2024.1348151 -
Journal of the American Chemical Society Jul 2024High-entropy alloys (HEAs) or multi-principal element alloys (MPEAs) have found extensive applications in high-precision devices. While the increased configurational...
High-entropy alloys (HEAs) or multi-principal element alloys (MPEAs) have found extensive applications in high-precision devices. While the increased configurational entropy for HEAs favors more elemental diversity, it also increases the possibility of phase separation into multiple heterogeneous systems. This article reports that these two mutually competing effects are balanced for 3- and 4-component alloys. Analysis of all of the n-component ABCD···-type (∼5 × 10) available compounds in the materials' database shows that more than 70% are either 3- or 4-component ones. Their high propensity is explained on the basis of their optimal average difference of electronegativity (EN) ∼0.5-1.0 and the average sum of electronegativity (EN) ∼5.0-6.5 between the constituent atoms in the Oganov scale. Effectively, these 3- and 4-component alloys lie in the intermediate (centroid) region of the van Arkel-Ketelaar triangle, indicating their metalloid nature.
PubMed: 38957138
DOI: 10.1021/jacs.4c04342