Effects of prophylactic nebulized antibiotics on the prevention of ICU-acquired pneumonia: a systematic review and meta-analysis
Objective To evaluate the efficacy and safety of prophylactic nebulized antibiotics in preventing intensive care unit (ICU)-acquired pneumonia through a meta-analysis. Methods Randomized controlled trials (RCTs) investigating the potential reduction in the incidence of ICU-acquired pneumonia through prophylactic nebulized antibiotics were collected by searching the PubMed, Embase, and Cochrane Library databases from their inception to January 23, 2024. The primary endpoint was the incidence of ICU-acquired pneumonia, while the secondary endpoints included mortality, length of ICU stay, mechanical ventilation days, and nebulization-related side effects. Statistical analyses were performed using RevMan 5.3 and STATA 14.0 software. Results A total of six RCTs were included in the analysis, involving 1,287 patients (636 patients in the study group received prophylactic antibiotic therapy, including Polymyxin B, Tobramycin, Ceftazidime, Colistimethate sodium, and amikacin; 651 patients in the control group primarily received saline). The results indicated that prophylactic nebulized antibiotic therapy significantly reduced the incidence of ICU-acquired pneumonia compared to that in the control group (odds ratio (OR) = 0.57, 95% confidence interval (CI) [0.43–0.74], P < 0.0001). No significant difference was observed in the mortality rate between the treatment and control groups (OR = 0.86, 95% CI [0.68–1.10], P = 0.24). Prophylactic nebulized antibiotic therapy also did not significantly reduce the length of ICU stay (MD = 0.2 days; 95% CI [−0.81 to 1.20], P = 0.70) or the number of mechanical ventilation days (MD = 0.43 days; 95% CI [−0.47 to 1.33], P = 0.35). Additionally, there was no evidence that prophylactic nebulized antibiotic therapy contributed to the development of multiple drug-resistant (MDR) bacterial pneumonia or increased the incidence of associated side effects, such as airway spasms. Conclusions This meta-analysis suggests that ICU-acquired pneumonia can be prevented by prophylactic nebulized antibiotic therapy in critically ill patients without increasing the risk of MDR bacterial infections or airway spasms. However, the reduction in the incidence of ICU-acquired pneumonia did not result in significant improvements in mortality or length of ICU stay.
Gao et al. (2024) Effects of prophylactic nebulized antibiotics on the prevention of ICU-acquired pneumonia: a systematic review and meta-analysis. PeerJ 12:e18686 https://doi.org/10.7717/peerj.18686
Identification of immunogenic cell death gene-related subtypes and risk model predicts prognosis and response to immunotherapy in ovarian cancer
Background Immunogenic cell death (ICD) has been associated with enhanced anti-tumor immunotherapy by stimulating adaptive immune responses and remodeling the immune microenvironment in tumors. Nevertheless, the role of ICD-related genes in ovarian cancer (OC) and tumor microenvironment remains unexplored. Methods In this study, high-throughput transcriptomic data from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases as training and validation sets separately were obtained and proceeded to explore ICD-related clusters, and an ICD-related risk signature was conducted based on the least absolute shrinkage and selection operator (LASSO) Cox regression model by iteration. Multiple tools including CIBERSORT, ESTIMATE, GSEA, TIDE, and immunohistochemistry were further applied to illustrate the biological roles of ICD-related genes as well as the prognostic capacity of ICD risk signature in OC. Results Two ICD-related subtypes were identified, with the ICD-high subtype showing more intense immune cell infiltration and higher activities of immune response signaling, along with a favorable prognosis. Additionally, four candidate ICD genes (IFNG, NLRP3, FOXP3, and IL1B) were determined to potentially impact OC prognosis, with an upregulated expression of NLRP3 in OC and metastatic omental tissues. A prognostic model based on these genes was established, which could predict overall survival (OS) and response to immunotherapy for OC patients, with lower-risk patients benefiting more from immunotherapy. Conclusion Our research conducted a prognostic and prediction of immunotherapy response model based on ICD genes, which could be instrumental in assessing prognosis and assigning immunotherapeutic strategies for OC patients. NLRP3 is a promising target for prognosis in OC.
Pan et al. (2024) Identification of immunogenic cell death gene-related subtypes and risk model predicts prognosis and response to immunotherapy in ovarian cancer. PeerJ 12:e18690 https://doi.org/10.7717/peerj.18690
Efficacy of different dietary therapy strategies in active pediatric Crohn’s disease: a systematic review and network meta-analysis
Background Dietary therapy strategies play an important role in the treatment of pediatric patients with Crohn’s disease (CD), but the relative efficacy of different dietary therapy strategies for Crohn’s remission is unknown. This study aims to compare the effectiveness and tolerance of these dietary therapy strategies for active pediatric CD. Methods We searched the medical literature up to August 30, 2024 to identify randomized controlled trials (RCTs) of dietary therapy strategies for pediatric CD. The primary outcomes were clinical remission rate and tolerance, secondary outcomes included differences between pre- and post-treatment levels of albumin, C-reactive protein (CRP), and fecal calprotectin levels. A network meta-analysis (NMA) was performed by using the frequentist model. For binary outcome variables and continuous outcome variables, odds ratios (OR) and mean differences (MD) with corresponding 95% confidence intervals (CI) were utilized, respectively. The ranking of dietary therapy strategies was determined based on the surface under the cumulative ranking area (SUCRA) for each comparison analyzed. Results Overall, 14 studies involving 564 participants were included. In terms of clinical remission rate, the partial enteral nutrition (PEN) plus Crohn’s disease exclusion diet (PEN+CDED) (OR = 7.86, 95% CI [1.85–33.40]) and exclusive enteral nutrition (EEN) (OR = 3.74, 95% CI [1.30–10.76]) exhibited significant superiority over PEN alone. The tolerance of PEN+CDED was significantly higher than that of EEN (OR = 0.07, 95% CI [0.01–0.61]). According to the surface under the cumulative ranking area (SUCRA) values, the PEN+CDED intervention (90.5%) achieved the highest ranking in clinical remission rate. In terms of tolerance, PEN+CDED ranked first (88.0%), while EEN ranked last (16.3%). Conclusions In conclusion, PEN+CDED was associated with the highest clinical remission rate and tolerance among the various dietary therapy strategies evaluated. Despite limitations in the studies, this systematic review provides evidence that PEN+CDED can be used as an alternative treatment to exclusive enteral nutrition and is more suitable for long-term management in children.
Ma et al. (2024) Efficacy of different dietary therapy strategies in active pediatric Crohn’s disease: a systematic review and network meta-analysis. PeerJ 12:e18692 https://doi.org/10.7717/peerj.18692
Adiposity and body fat distribution based on skinfold thicknesses and body circumferences in Czech preschool children, secular changes
Background The long-standing widespread prevalence of obesity includes issues of its evaluation. Nutritional status may be assessed using various tools and methods; among others simple anthropometric measurements are well established. Widely used body mass index (BMI), presents an obstacle of needing to calculate a standard deviation score (SD) for correct use in the child population. As BMI overlooks body composition, it is necessary to evaluate fat and muscle mass with different methods. Established skinfolds and circumferences are used in many variations and equations to accomplish that goal; however, the parameters used in these methods also undergo secular changes. Furthermore, secular changes have been documented in fat mass distribution. The aim of the study is to assess secular changes of skinfolds thickness and body circumferences and evaluate their validity for use in clinical practice and population research. Methods and sample Our database consisted of a recent (2016–2022) sample with 594 participants (298 males) and a reference sample (from 1990) with 2,910 participants (1,207 males). Both cohorts comprised Czech preschool children, aged 4.00 to 6.99 years. With standard methodology, anthropometric parameters were obtained for 13 skinfolds and eight circumferences, by trained staff. The equations of Slaughter, Durnin and Deurenberg were correspondingly calculated. Statistical evaluation was conducted in the R programming language, using Welch’s test, Cohen’s d and the Bland–Altman method. Results Our study found significant increases in skinfold thickness on the abdomen, chest I. and forearm, with high clinical relevance (p ≥ 0.01; d = range from 0.20 to 0.70). Contrastingly, apart from the abdominal area, a decrease of circumferences was observed. The body fat percentage estimation equations were tested for bias in the recent sample in the context of bioimpedance analysis with the Bland–Altman method. All equations are suitable for application in clinical use. Discussion Documented secular changes in fat mass distribution are only part of a contemporary accelerating trend of obesity prevalence. Our findings support the trend of a decline of circumferences and rise of skinfold thickness in corresponding areas, especially on the limbs, that is evidenced by the trend of latent obesity. The results of the study show the need to complement established diagnostic procedures in childhood obesitology with abdominal and midthigh circumferences and optionally even the maximal circumference of the forearm. These circumferences should always be measured alongside the skinfold thickness of the region. Only in this way can the overall adiposity of an individual with regard to secular changes, including the detection of latent obesity, be objectively evaluated.
Vážná et al. (2024) Adiposity and body fat distribution based on skinfold thicknesses and body circumferences in Czech preschool children, secular changes. PeerJ 12:e18695 https://doi.org/10.7717/peerj.18695
Virtual reality therapy in managing cancer pain in middle-aged and elderly: a systematic review and meta-analysis
Background Virtual reality technology has been proposed to rehabilitate cancer patients. This study aimed to summarize the effectiveness of virtual reality (VR)--based therapies for pain management in middle-aged and elderly cancer patients. Methods This meta-analysis was registered in PROSPERO (CRD42023400432). We searched the randomized controlled trials (RCTs) in PubMed, Scopus, the Cochrane Library, Web of Science, and Embase, conducted from construction until November 1, 2024. The study examined the effects of VR treatment on pain levels in middle-aged and elderly cancer patients using RCTs as primary or secondary outcome measures. Articles were evaluated for eligibility according to predetermined criteria, and each of the three researchers independently collected the data. The researchers used the heterogeneous selection effects model to calculate the mean effect sizes. Results This meta-analysis included seven RCTs involving 476 patients. The meta-analysis confirmed the significant effect of VR therapy on the management of pain, anxiety, and depression in the middle-aged and elderly cancer population. Conclusions Our research shows that VR could be a significant device for cancer pain management in the middle-aged and elderly and that VR scene therapy may be more effective. Nevertheless, it is essential to use caution when interpreting the findings since the number of research included is small.
Chen et al. (2024) Virtual reality therapy in managing cancer pain in middle-aged and elderly: a systematic review and meta-analysis. PeerJ 12:e18701 https://doi.org/10.7717/peerj.18701
Pepper power: short-term impact of pepper consumption on the gut bacteriome composition in healthy volunteers
Background Pepper from Capsicum species is a well-established spice with a rich history of culinary use. Some observations have linked its consumption to gastrointestinal discomfort and alterations in stool patterns while it is considered beneficial in some cultures. However, there is lack of information on the direct effect of pepper consumption on human gut microbiota, we conducted dietary intervention studies to assess the impact of pepper on gut bacteriome composition in humans. Methods Ten healthy volunteers were recruited, and each person received 200 ml of 0.14 g/ml fresh Habanero Pepper (Capsicum chinense) daily over a 4-day period after which they abstained from pepper consumption for the subsequent 4 days before resumption of their normal diet. Stool samples were collected at baseline, after pepper consumption, after 4 days without pepper and after 4- and 6-days resumption of normal diet. We sequenced the V3-V4 region of the 16S rRNA gene and analyzed microbial diversity and composition using the QIIME2 pipeline and relevant R packages. Results Consumption of pepper over a 4-day period led to a higher abundance of Verrucomicrobia, a phylum rarely found in significant proportions at other time points. There was a gradual depletion of Shigella and Staphylococcus spp. from baseline untill the end of the study. Other taxa showed timepoint specific associations, emphasizing the potential impact of short-term dietary interventions on the relative abundance of these genera. Conclusions Our study adds nuance to the understanding of diet-microbiota interactions, highlighting the intricate relationship between pepper consumption and gut bacteriome composition. Further exploration of these dynamics holds promise for personalized dietary recommendations and targeted interventions to support gut microbial health.
Owolo et al. (2024) Pepper power: short-term impact of pepper consumption on the gut bacteriome composition in healthy volunteers. PeerJ 12:e18707 https://doi.org/10.7717/peerj.18707
Prognostic value of serum Mrp 8/14 in sepsis-induced acute respiratory distress syndrome patients: a retrospective cohort study
Background Mrp 8/14 is abundantly secreted by activated neutrophils during infection and inflammation. However, its prognostic value in acute respiratory distress dyndrome (ARDS) induced by sepsis is poorly understood. Our aim was to investigate the relationship between serum Mrp 8/14 and the prognosis in sepsis-induced ARDS patients admitted to the intensive care unit (ICU). Methods Serum Mrp 8/14 concentrations were analyzed in 118 ARDS patients induced by sepsis included in the analytical study. Patients were enrolled upon admission to the ICU of Nanjing Hospital affiliated to Nanjing Medical University. The baseline information and clinical outcomes were obtained. Patients were divided into survivor group and non-survivor group according to whether they died during ICU hospitalization. Results The serum Mrp 8/14 levels were significantly increased in the non-survivor group compared to the survivor group (P < 0.05). Logistic regression analysis showed that serum Mrp 8/14, albumin and APACHE II were the independent factors for predicting the prognosis of sepsis-induced ARDS during ICU hospitalization after adjustment. Additionally, the area under the receiver operating characteristic curve for Mrp 8/14 combined with albumin was associated with ICU mortality and was higher than that of Mrp 8/14, albumin, APACHE II and Mrp 8/14 combined with APACHE II (all P < 0.05). A nomogram was constructed to predict ICU mortality and the c-indexes of predictive accuracy was 0.830 in the cohort (P < 0.05). Conclusions The serum Mrp 8/14 upon ICU admission in septic patients may be useful for predicting mortality in sepsis-induced ARDS patients during ICU hospitalization.
Sun et al. (2024) Prognostic value of serum Mrp 8/14 in sepsis-induced acute respiratory distress syndrome patients: a retrospective cohort study. PeerJ 12:e18718 https://doi.org/10.7717/peerj.18718
Phylogeography of the Mesa Silverside fish Chirostoma jordani (Woolman, 1894) throughout the Mexican Plateau
Background Understanding the processes that influence distribution of organisms is a major goal in evolutionary biology. Speciation in freshwater fishes is mainly associated with the “island-like” model of evolution, in which the formation of land barriers between different hydrographic basins interrupts gene flow and promotes isolation. Freshwater fish therefore provide an excellent model system for macro- and micro-evolutionary studies. The Mesa Silverside, Chirostoma jordani, is one of the most widespread freshwater fish species in the Mexican Plateau, a geologically complex physiographic region with a long history of genesis, destruction and compartmentalization of hydrographic basins that has promoted the dispersal and isolation of freshwater fishes. Methods We used mitochondrial (Cytb and D-loop) and nuclear (first intron of the ribosomal protein S7) data and used phylogeographic and coalescent based methods to elucidate the evolutionary history of C. jordani throughout its distributional range on the Mexican Plateau. Results The results obtained in the present study revealed that C. jordani consists of two main genetic groups with geographical correspondence. Clade I occur exclusively in north-western basin and shows population structure. Clade II is widely distributed across the west, central and eastern basins without population structure. The split between these two main clades was estimated at 1.4 Mya. This cladogenetic event may be associated with the allopatric process promoted by the fragmentation and compartmentalization of hydrographic basins induced by the geological and climatic history of the Mexican Plateau.
Betancourt-Resendes et al. (2024) Phylogeography of the Mesa Silverside fish Chirostoma jordani (Woolman, 1894) throughout the Mexican Plateau. PeerJ 12:e18256 https://doi.org/10.7717/peerj.18256
A polyphasic approach in the identification and biochemical characterization of Dunaliella tertiolecta with biodiesel potential from a saltern in Mauritius
Bioprospecting robust and oleaginous strain is crucial for the commercialization of microalgae-based biodiesel. In this study, a microalgal strain SCH18 was isolated from a solar saltern located in Mauritius. This isolate was identified as Dunaliella tertiolecta based on a polyphasic approach that combined molecular, physiological, and morphological analyses. Furthermore, the effect of different salinities on the biochemical composition and fatty acid profile of this microalga was investigated to explore its potential in producing biodiesel. Results from the growth studies showed that salinity of 1.0 M NaCl was optimal for achieving a high growth rate. Under this salt concentration, the growth rate and the doubling time were calculated as 0.39 ± 0.003 day−1 and 1.79 ± 0.01 days, respectively. In terms of biochemical composition, a substantial amount of carbohydrate (42.02 ± 5.20%), moderate amount of protein (30.35 ± 0.18%) and a low lipid content (17.81 ± 2.4%) were obtained under optimal NaCl concentration. The fatty acid analysis indicated the presence of palmitic acid, stearic acid, palmitoleic acid, oleic acid, linoleic acid, gamma, and alpha-linolenic acids, which are suitable for biodiesel synthesis. The predicted biodiesel properties were in accordance with the standard of ASTM 6751, indicating that the microalgal isolate D. tertiolecta SCH18 is a potential candidate for use in biodiesel production.
Ramdhony et al. (2024) A polyphasic approach in the identification and biochemical characterization of Dunaliella tertiolecta with biodiesel potential from a saltern in Mauritius. PeerJ 12:e18325 https://doi.org/10.7717/peerj.18325
Study of TRAF3IP3 for prognosis and immune infiltration in hepatocellular carcinoma
Background Tumor necrosis factor receptor-associated factor 3 (TRAF3)-interacting protein 3 (TRAF3IP3) expressed in various tumor cell. However, its role in hepatocellular carcinoma (HCC) was unclear. We aimed to demonstrate the relationship between TRAF3IP3 and HCC and explore the potential role of TRAF3IP3 in HCC. Methods The Cancer Genome Atlas (TCGA), Gene Expression Omnibus (GEO), Genotype-Tissue Expression (GTEx), KM-Plotter, University of Alabama at Birmingham Cancer data analysis Portal (UALCAN), and Xiantao Academic Online Website were utilized for the systematic analysis of TRAF3IP3. This analysis included mRNA expression, protein expression, prognostic value, enrichment analysis, and immune cell infiltration in HCC. Subsequently, immunohistochemistry was performed to assess the expression levels of TRAF3IP3 in both cancer and non-cancer tissues of patients with HCC. Results Analysis of public databases and immunohistochemical staining on 20 pairs of samples confirmed a decrease in TRAF3IP3 expression in HCC. Both the TCGA database and GSE14520 indicated that patients with high TRAF3IP3 expression had a more favorable prognosis in terms of overall survival (OS) and progression-free interval (PFI), as shown by KM curve results. Multivariate Cox regression analysis further demonstrated that high TRAF3IP3 expression was an independent protective factor for HCC prognosis (hazard ratio (HR): 0.619, 95% confidence interval (CI) [0.399–0.959]; p < 0.05). In the high TRAF3IP3 expression group, various immune response-related molecular pathways, particularly B lymphocyte-mediated pathways, were activated. The level of TRAF3IP3 expression showed a significant correlation with the presence of tumor-infiltrating CD8+ T cells. Additionally, a positive correlation was observed between immunophenoscore (IPS) and TRAF3IP3 expression. Notably, the half-maximal inhibitory concentration (IC50) of commonly used chemotherapeutic drugs, such as lapatinib and mitomycin, was inversely associated with TRAF3IP3 expression in HCC patients. Conclusion TRAF3IP3 may be as a novel and promising biomarker for prognosis prediction and immunological evaluation of HCC.
Wang et al. (2024) Study of TRAF3IP3 for prognosis and immune infiltration in hepatocellular carcinoma. PeerJ 12:e18538 https://doi.org/10.7717/peerj.18538