bluuebunny/crossref_metadata_2025 huggingface dataset:
Measles outbreak investigation in Kasoshekumer kebele, Sinana district, South-Eastern Oromia, Ethiopia: A case–control study
Authors: Mebrate Milkessa , Hailu Cherinet , Alemu Soresa
Published: May 2023

Objective:

This study aimed at verifying the outbreak, preventing further transmission, and identifying the risk factors for the outbreak.

Method:

A case–control study design was conducted from March 4, 2020 to April 30, 2020, in Kasoshekumer kebele of Sinana district. Thirty-seven carer–patient pairs and 74 controls were recruited in a 1:2 case–control ratio. Patients were selected using a national standard case definition of the Ministry of Health. Controls were selected from neighbors of patients and interviewed after the second incubation period from the last patient of the outbreak by a structured questionnaire similar to patients. All cases were included while controls were selected purposively for their exposure status. Vaccine efficacy, attack rate, and case fatality rate were conducted as a descriptive epidemiology. Multivariate analysis was used to identify associated factors.

Result:

Out of 109 study participants, there were 37 cases and 72 controls. The mean age was 58.8 months with ±54 standard deviation. Thirty-one (83.8%) of the cases had a known contact history and 23 (62.2%) were unvaccinated. The age-specific attack rate was 36/1000 in <5 years and 53/100,000 in >15 years. The estimated vaccine efficacy was 73.7%. Having any type of socialization behavior (adjusted odds ratio = 6.8, confidence interval: 4.25, 11.4), maternal poor knowledge of measles prevention (adjusted odds ratio = 4.152, confidence interval: 1.226, 8.058), and being unvaccinated (adjusted odds ratio = 7.79, confidence interval: 2.281, 12.63) were associated factors for measles infection.

Conclusion:

Poor knowledge of the parents on vaccination and the less effort taken to deliver good attitude toward vaccination are resulting in measles outbreak. However, herd immunity can prevent the outbreak; if not, the community will continue to suffer from mortality and morbidity. A resilient immunization program with sustainable and equitable supply, delivery, monitoring, and evaluation is a fundamental action in prevention of measles outbreak. Increased awareness of vaccination and other prevention measures are also crucial to end the outbreaks.
A comprehensive systematic review and content analysis of active video game intervention research
Authors: Moller Arlen C , Sousa Caio V , Lee Kelly J , Alon Dar , Lu Amy S
Published: May 2023

Objective

Intervention research using digital games to promote physical activity has proliferated. Yet few studies have attempted to systematically catalog features that characterize this research. To address this gap, we undertook a systematic review and content analysis of active video game interventions, examining only published longitudinal interventions that prominently featured active video game technology (≥50% of the intervention).

Methods

Our protocol was registered in the International Prospective Register of Systematic Reviews (CRD42020204191). For inclusion, an active video game intervention had to require gross movement beyond finger movement, and target improvement, maintenance, or recovery of health. The intervention design had to include at least two conditions, within- or between-subjects, with ≥10 participants per condition to examine the chronic effects of active video game exposure.

Results

The search resulted in 232 studies published in English between 1996 and 2020. The majority of active video game interventions (69.8%) targeted physical fitness (physiological functioning as a consequence of physical activity), followed by cognitive performance (11.3%), physical activity (5.5%), or a mixture of those outcomes (13.4%). Total enrollment across all studies was 14,849 participants ( MParticipants = 62, SD = 106; MAge = 50.2, SD = 25.2 years; 47.3% men). A strong majority of the samples (69.8%) were recruited from medical subpopulations, and only 30.2% were recruited from the general (healthy) population. A strong majority of active video games (72.0%) were developed by industry for the commercial market, and only 13.3% were funded by government or foundation grants.

Conclusions

Suggested directions for improving future active video game development and intervention research include greater consideration of promising features (social connectedness, novelty, narrative, rhythmic movement to music) and new models for productive collaboration between industry and academia.
Digital technology use, technological self-efficacy, and subjective well-being among North Korean migrants during the COVID-19 pandemic: Moderated moderation
Authors: Yoo Nari , Jang Sou Hyun
Published: May 2023

Using digital technology to adapt to their host country is an integral part of social inclusion for migrant and refugee populations. However, researchers have not empirically examined how digital technology use may affect subjective well-being among migrant populations. This study aimed to examine the association between increased digital technology use, technological self-efficacy, and subjective well-being. Using the 2020 Digital Divide Survey in Korea, our sample consists of 6520 native South Koreans and 699 North Korean migrants aged 18 years and older. We examined the three-way interaction of technological self-efficacy and being North Korean migrants in the relationship between the increase in the use of five types of digital technology, technological self-efficacy, and subjective well-being, using hierarchical linear regressions. North Korean migrants were statistically lower than South Korean natives in all types of increased digital technology use. Moderation analysis showed that technological self-efficacy positively moderated the relationship between increased digital technology use and subjective well-being. A three-way interaction showed that this relationship was stronger in North Korean migrants for three types of utilization, networking, information sharing, and life services. A psychosocial approach needs to be taken to digital technology education for North Korean migrants, in light of the potential benefits of technological self-efficacy.
Romantic Relationships from Adolescence to Established Adulthood
Authors: Boisvert Stéphanie , Poulin François , Dion Jacinthe
Published: May 2023

This 15-year longitudinal study investigated with follow-up data how romantic patterns from ages 16 to 24 are associated with romantic involvement and turnover (ages 25–30), romantic dispositions (age 30) and romantic relationships characteristics (age 30). A sample of 255 individuals (60.8% women) identified all their romantic partners between the ages of 16 and 24. Between ages 25 and 30, participants identified all their romantic partners and the length of each relationship. At age 30, they also completed a series of questionnaires regarding romantic dispositions and if it applied, characteristics of their current romantic relationship. Results indicated continuity in the romantic sphere from adolescence to established adulthood. At age 30, romantic patterns were associated with: avoidance of intimacy, jealousy, global romantic satisfaction, relationship status and the duration of the current romantic relationship. Together, these results bring new information on romantic development from adolescence to established adulthood.
Making a Case for Teaching Caste and Gender in Law Schools
Authors: Dalwai Sameena
Published: May 2023

This article argues for mainstreaming of caste and gender as subject matter in legal education in India. Justice education in any country ought to introduce students to the main axis of oppression, historical patterns of discrimination in their society—in the United States, it is race and patriarchy; in India, it is caste patriarchy. The article connects the denial of justice in caste crimes to the invisibility of caste in the legal discourse and insists that legal education is the key to making caste and gender visible within the legal machinery. For this purpose, the article examines how critical race and feminist theory informed law school education in the United States. It also elucidates the efforts of making legal education inclusive and reflective through the national law schools experiment in India. Lastly, it suggests ways in which caste and gender can be included in law school curricula.
Unilateral Variant of NGT Syndrome: An Uncommon Complication of a Very Common Intervention
Authors: Paul Theresa , Shdid Reham Kama Abo , Khan Shafi Hashmath Ulla
Published: May 2023

The common complications of nasogastric tube placement include gastrointestinal—tube malposition, coiling, or knotting, impaired function of the lower esophageal sphincter leading to reflux of gastric contents, esophagitis, gastrointestinal bleeding, and aspiration pneumonia. Sofferman et al. in 1990, described a clinical entity constituted by life-threatening bilateral vocal cord paralysis, presenting as throat pain, stridor and respiratory compromise as Nasogastric syndrome (NGTS). There are fewer than 50 cases of NGTS described in the literature, till date, let alone a unilateral variant of the same. Here we have described two cases of unilateral variant of NGTS, the management, outcome, and a detailed literature review of the previous reported cases. The two cases described were identified in the same year, highlighting the fact that, the entity might be more common, and needs more clinical attention than previously estimated.
Road network distances and detours in Europe: Radial profiles and city size effects
Authors: Mennicken Estelle , Lemoy Rémi , Caruso Geoffrey
Published: May 2023

The form and the size of cities influence their social, economic and environmental outcomes. The form of a city is itself influenced by the shape of its road network, but this relationship and how it is affected by city size are unclear. We analyse how road distances to the main centre vary across 300 European cities and how radial physical detours (i.e. the distance on the road network compared to the Euclidean distance) are affected by city size and extent. We use landuse and population data to sample potential residences and compute the fastest routes to the main centre. We find a linear relationship between road and Euclidean distances, and for the first time document an average radial physical detour of 1.343 across Europe. We then rescale distance bands so to make cities of different population size comparable and show the effect of different urban delineations. We find that physical detour ratios increase when core cities only are considered without suburbs. At the urban region scale, radial physical detours increase with city size, especially when other significant geographical factors (latitude, longitude, elevation change and proximity to coast) are controlled for. When the central part of cities only is considered, larger cities have smaller radial physical detours.
A New Trend in Social Media and Medicine: The Poor Quality of Videos Related to Ankle Sprain Exercises on TikTok
Authors: Anastasio Albert T. , Tabarestani Troy Q. , Bagheri Kian , Bethell Mikhail A. , Prado Isabel , Taylor Joshua R. , Adams Samuel B.
Published: May 2023

Background:

Social media platforms, like TikTok, have become popular options for the distribution of health care information. Because of the lack of scientific oversight, the quality of health care–related videos has become a focus of the current literature. However, orthopaedic surgery has lagged behind other fields in acknowledging the widespread utilization of TikTok videos for medical information consumption. This study aims to assess the quality and educational benefits of ankle sprain–related TikTok videos.

Methods:

TikTok was queried using the hashtag “#anklesprainexercises.” One hundred videos were included after applying the exclusion criteria. The number of views, likes, shares, comments, and favorites was recorded. The content was graded using DISCERN (a well-validated informational analysis tool) and ASEES (a self-designed tool for exercise evaluation). We hypothesized that information on TikTok related to ankle sprain exercises would be poor in quality.

Results:

The total number of views of the 100 videos was 6 483 412, with a median of 5377.5 (IQR = 1074-20 275). The videos collectively received 385 847 likes, 3642 comments, 55 574 favorites, and 14 918 shares with a median of 267.5 (IQR = 41.5-1678.0), 4.0 (IQR = 0.0-23.0), 42.0 (IQR = 4.8-264.5), and 13.0 (IQR = 1.8-67.8), respectively. General users had a higher percentage of their videos graded as “very poor” (61.8%) in comparison to the number of videos uploaded by health care professionals deemed “very poor” (34.4%). Neither general user nor health care professionals had videos graded as “good” or “excellent.” There were significant differences between the 2 groups for DISCERN 1, 3, and ASSES scores.

Conclusion:

Although TikTok is a powerful tool for information distribution, the educational value of the videos related to ankle sprain injury exercises was poor. With only 2% of videos receiving a grade of “fair,” and no videos reaching a score of “good” or “excellent,” health care professionals should be aware of the low-quality content easily accessible on TikTok.

Level of Evidence:

Level III, cross-sectional study.
Valsalva Retinopathy Associated With COVID-19: Diagnosis and Surgical Management
Authors: Han Wesley , Adrean Sean D.
Published: May 2023

Purpose: To report a case of severe Valsalva retinopathy secondary to intense coughing and vomiting as symptoms of COVID-19 and describe the presentation, diagnosis, and surgical management. Methods: The patient’s subjective findings, examination, fundus photography, optical coherence tomography (OCT) examinations, and laboratory results were used to diagnose the patient. Results: Surgical management was required to remove a vitreous hemorrhage (VH) and a sub-internal limiting membrane (sub-ILM) hemorrhage. Another foveal hemorrhage was determined to be intraretinal with intraoperative OCT. The patient’s visual acuity improved from hand motions to 20/20 OD at postoperative week 6. Conclusions: The related COVID-19 symptoms of severe coughing and vomiting led to the Valsalva retinopathy. The VH and sub-ILM hemorrhage were successfully removed surgically. On intraoperative OCT, a foveal hemorrhage was determined to be intraretinal; thus, the decision was made to monitor it and allow it to resolve over time.
Twitter-generated Moral Panic and Its Effect on Pretrial Incarceration/ Bail: Contextualizing the Tale of ‘Folk Devil’ Aryan Khan
Authors: Gautam Upma , Das Priya
Published: May 2023

The Narcotic Drugs and Psychotropic Substances (NDPS) Act, which was enacted with an intent to control drug abuse and prohibit its trade, has blurred the line between the offender and the victim, particularly in cases of addicts. Nonetheless, the focus of this study is the multifarious victimization of the offender: overcriminalization in terms of measures, lengthy pretrial incarceration and increased sensationalism in cases of offenders belonging to high strata of society, thus creating a moral panic. Incident of victimization is juxtaposed with public concern solicited by the reporting of cases. The stigmatization endured and the trauma suffered by the accused owing to the full media glare strike on their innocence and violate their right to life and dignity.

Aim and Objective:

A criminal justice system is an institutionalized means of rendering justice. One of the virtuous traits of a criminal justice system modelled on the ethos of due process is its attempt to achieve certainty and transparency in its process and the outcomes. However, no institution is infallible as manifested by the misuse of draconian provisions of the NDPS Act 1985. This study first evaluates whether disposal of bail matters in NDPS cases is a classic case of overcriminalization leading to the victimization of the offender; second, it gauges the impact of public reaction depicting ‘moral panic’ of the offender in the disposal of bail matters.

Methodology:

The study was conducted through a detailed content analysis of the public reaction in the Aryan Khan drug case on the micro-blogging site Twitter with the help of the content analysis tool NVivo.

Findings:

The outcome of the study manifests positive interrelationship between moral panic and public perception, positive interrelationship between moral panic and status of the person arrested which consequentially affects the period of pretrial incarceration (denial of bail).
‘I do enjoy the work, but I think the wages in the jails are shocking’: Analysing prisoner wages as a pain of imprisonment using Foucault's artifice
Authors: Maycock Matthew , McGregor Daniel
Published: May 2023

Until now, wages in prison and the meanings associated with them have been relatively overlooked within penology. This study analyses findings from a research project conducted between 2019 and 2021 that explores multiple meanings attached to prisoner wages. Through the analysis of 29 semi-structured interviews were conducted with a cohort of purposely selected people in custody across three prisons in Scotland, this study provides unique and rich insights into prison wages. Themes analysed include comments relating to wage rates and what emerges as a particularly tenuous link between wages within and outside prison. Receiving a weekly wage close to the hourly UK minimum wage was seen as an integral part of the life in prison and compounded feelings of detachment to life outside of prison. Our findings also indicate that sentiments associated with prison wages are significantly shaped by pre-prison experience of wages. The impact of imprisonment in relation to prison wages are stratified by income, given the differences in experience related to pre-prison employment and wage levels. Our paper also situates prison wages within a wider context through engaging with Foucault's notion of ‘artifice’ which served to develop an understanding of the logic behind the low levels of remuneration for prison work. Our study has relevance in all prison jurisdictions where people in custody receive wages significantly less than local minimum wage legislation or sectoral tariffs would normally dictate.
Gulf War Illness: A Randomized Controlled Trial Combining Mindfulness Meditation and Auricular Acupuncture
Authors: Breneman Charity B. , Reinhard Matthew J. , Allen Nathaniel , Belouali Anas , Chun Timothy , Crock Lucas , Duncan Alaine D. , Dutton Mary Ann
Published: May 2023

Background

Many Gulf War (GW) Veterans report chronic symptoms including pain, fatigue, and cognitive impairment, commonly defined as Gulf War Illness (GWI). Complementary and integrative health (CIH) therapies may potentially improve multiple symptoms of GWI.

Objective

To examine the effectiveness of combining 2 commonly available CIH therapies, mindfulness meditation and auricular acupuncture, in improving health-related functioning and multiple symptom domains of GWI (e.g., pain, fatigue).

Methods

This study was a randomized controlled trial in which Veterans with GWI were randomly assigned to either the intervention group (n = 75), wherein they received 2 distinct CIH therapies – mindfulness meditation and auricular acupuncture, or the active control group, wherein they received a GW Health Education (GWHE) program (n = 74), each lasting 8 weeks. Self-report health measures were assessed at baseline, endpoint, and 3 month follow-up.

Results

In the intention-to-treat analyses, there were significant between-group differences for mental-health related functioning, fatigue, depression symptoms, and Kansas total severity scores for symptoms in which the CIH group had improved scores for these outcomes at endpoint compared to the GWHE group (all P ≤ .05). The CIH group also had significant reductions in pain interference at endpoint and follow-up compared to baseline (estimated marginal mean difference: −2.52 and −2.22, respectively; all P = .01), whereas no significant changes were observed in the GWHE group. For pain characteristics, the GWHE group had a worsening of pain at endpoint compared to baseline (estimated marginal mean difference: +2.83; P = .01), while no change was observed in the CIH group.

Conclusion

Findings suggest a possible beneficial effect of combining 2 CIH therapies, mindfulness meditation and auricular acupuncture, in reducing overall symptom severity and individual symptom domains of fatigue, musculoskeletal, and mood/cognition in Veterans with GWI.

Trial Registration

Clinical Trials identifier NCT02180243
European Respiratory Society statement on airway clearance techniques in adults with bronchiectasis
Authors: Herrero-Cortina Beatriz , Lee Annemarie L. , Oliveira Ana , O'Neill Brenda , Jácome Cristina , Dal Corso Simone , Poncin William , Muñoz Gerard , Inal-Ince Deniz , Alcaraz-Serrano Victoria , Reychler Gregory , Bellofiore Angela , Posthumus Annette ,   Patient representative, Tonia Thomy , Chalmers James D. , Spinou Arietta
Published: May 2023

Airway clearance techniques (ACTs) are part of the main management strategy for patients with bronchiectasis. Despite being a priority for patients, accessibility, implementation and reporting of ACTs are variable in clinical settings and research studies. This European Respiratory Society statement summarises current knowledge about ACTs in adults with bronchiectasis and makes recommendations to improve the future evidence base. A task force of 14 experts and two patient representatives (10 countries) determined the scope of this statement through consensus and defined six questions. The questions were answered based on systematic searches of the literature. The statement provides a comprehensive review of the physiological rationale for ACTs in adults with bronchiectasis, and the mechanisms of action along with the advantages and disadvantages of each ACT. Evidence on ACTs in clinical practice indicates that the most frequently used techniques are active cycle of breathing techniques, positive expiratory pressure devices and gravity-assisted drainage, although there is limited evidence on the type of ACTs used in specific countries. A review of 30 randomised trials for the effectiveness of ACTs shows that these interventions increase sputum clearance during or after treatment, reduce the impact of cough and the risk of exacerbations, and improve health-related quality of life. Furthermore, strategies for reducing the risk of bias in future studies are proposed. Finally, an exploration of patients’ perceptions, barriers and enablers related to this treatment is also included to facilitate implementation and adherence to ACTs.
Whole‐genome sequencing identifies interferon-induced protein IFI6/IFI27-like as a strong candidate gene for VNN resistance in European sea bass
Authors: Delpuech Emilie , Vandeputte Marc , Morvezen Romain , Bestin Anastasia , Besson Mathieu , Brunier Joseph , Bajek Aline , Imarazene Boudjema , François Yoannah , Bouchez Olivier , Cousin Xavier , Poncet Charles , Morin Thierry , Bruant Jean-Sébastien , Chatain Béatrice , Haffray Pierrick , Phocas Florence , Allal François
Published: May 2023

Background

Viral nervous necrosis (VNN) is a major disease that affects European sea bass, and understanding the biological mechanisms that underlie VNN resistance is important for the welfare of farmed fish and sustainability of production systems. The aim of this study was to identify genomic regions and genes that are associated with VNN resistance in sea bass.

Results

We generated a dataset of 838,451 single nucleotide polymorphisms (SNPs) identified from whole-genome sequencing (WGS) in the parental generation of two commercial populations (A: 2371 individuals and B: 3428 individuals) of European sea bass with phenotypic records for binary survival in a VNN challenge. For each population, three cohorts were submitted to a red-spotted grouper nervous necrosis virus (RGNNV) challenge by immersion and genotyped on a 57K SNP chip. After imputation of WGS SNPs from their parents, quantitative trait loci (QTL) were mapped using a Bayesian sparse linear mixed model (BSLMM). We found several QTL regions that were specific to one of the populations on different linkage groups (LG), and one 127-kb QTL region on LG12 that was shared by both populations and included the genes ZDHHC14, which encodes a palmitoyltransferase, and IFI6/IFI27-like, which encodes an interferon-alpha induced protein. The most significant SNP in this QTL region was only 1.9 kb downstream of the coding sequence of the IFI6/IFI27-like gene. An unrelated population of four large families was used to validate the effect of the QTL. Survival rates of susceptible genotypes were 40.6% and 45.4% in populations A and B, respectively, while that of the resistant genotype was 66.2% in population B and 78% in population A.

Conclusions

We have identified a genomic region that carries a major QTL for resistance to VNN and includes the ZDHHC14 and IFI6/IFI27-like genes. The potential involvement of the interferon pathway, a well-known anti-viral defense mechanism in several organisms (chicken, human, or fish), in survival to VNN infection is of particular interest. Our results can lead to major improvements for sea bass breeding programs through marker-assisted genomic selection to obtain more resistant fish.
Telomere-to-Telomere genome assemblies of human-infecting Encephalitozoon species
Authors: Mascarenhas dos Santos Anne Caroline , Julian Alexander Thomas , Liang Pingdong , Juárez Oscar , Pombert Jean-François
Published: May 2023

Background

Microsporidia are diverse spore forming, fungal-related obligate intracellular pathogens infecting a wide range of hosts. This diversity is reflected at the genome level with sizes varying by an order of magnitude, ranging from less than 3 Mb in Encephalitozoon species (the smallest known in eukaryotes) to more than 50 Mb in Edhazardia spp. As a paradigm of genome reduction in eukaryotes, the small Encephalitozoon genomes have attracted much attention with investigations revealing gene dense, repeat- and intron-poor genomes characterized by a thorough pruning of molecular functions no longer relevant to their obligate intracellular lifestyle. However, because no Encephalitozoon genome has been sequenced from telomere-to-telomere and since no methylation data is available for these species, our understanding of their overall genetic and epigenetic architectures is incomplete.

Methods

In this study, we sequenced the complete genomes from telomere-to-telomere of three human-infecting Encephalitozoon spp. —E. intestinalis ATCC 50506, E. hellem ATCC 50604 and E. cuniculi ATCC 50602— using short and long read platforms and leveraged the data generated as part of the sequencing process to investigate the presence of epigenetic markers in these genomes. We also used a mixture of sequence- and structure-based computational approaches, including protein structure prediction, to help identify which Encephalitozoon proteins are involved in telomere maintenance, epigenetic regulation, and heterochromatin formation.

Results

The Encephalitozoon chromosomes were found capped by TTAGG 5-mer telomeric repeats followed by telomere associated repeat elements (TAREs) flanking hypermethylated ribosomal RNA (rRNA) gene loci featuring 5-methylcytosines (5mC) and 5-hemimethylcytosines (5hmC), themselves followed by lesser methylated subtelomeres and hypomethylated chromosome cores. Strong nucleotide biases were identified between the telomeres/subtelomeres and chromosome cores with significant changes in GC/AT, GT/AC and GA/CT contents. The presence of several genes coding for proteins essential to telomere maintenance, epigenetic regulation, and heterochromatin formation was further confirmed in the Encephalitozoon genomes.

Conclusion

Altogether, our results strongly support the subtelomeres as sites of heterochromatin formation in Encephalitozoon genomes and further suggest that these species might shutdown their energy-consuming ribosomal machinery while dormant as spores by silencing of the rRNA genes using both 5mC/5hmC methylation and facultative heterochromatin formation at these loci.
Resequencing of Rosa rugosa accessions revealed the history of population dynamics, breed origin, and domestication pathways
Authors: Zang Fengqi , Ma Yan , Wu Qichao , Tu Xiaolong , Xie Xiaoman , Huang Ping , Tong Boqiang , Zheng Yongqi , Zang Dekui
Published: May 2023

Background

Rosa rugosa is a shrub that originated in China and has economic and ecological value. However, during the development of R. rugosa, the genetic background was chaotic, and the genetic structure among different wild populations was unclear, as well as wild and cultivated accessions. Here, we report whole-genome resequencing of wild and cultivated R. rugosa accessions.

Results

A total of 19,041,284 SNPs were identified in 188 R. rugosa accessions and 3 R. chinensis accessions by resequencing. Population genetic analysis revealed that cultivated and wild groups were separated very early. All R. rugosa accessions were divided into 8 categories based on genetic structure: (1) Weihai, Yantai, and Liaoning category, (2) Jilin category, and (3) Hammonasset category (above three are wild); (4) traditional varieties, (5) hybrids between R. rugosa and R. chinensis, (6) Zizhi Rose, (7) Kushui Rose, (8) hybrids between R. rugosa and R. multiflora. We found that the heterozygosity and genetic diversity of wild accessions were generally lower than those of cultivated individuals. The genes that were selected during cultivation were identified, and it was found that these genes were mainly related to environmental adaptation and growth.

Conclusions

The Jilin population was the oldest population and later migrated to Liaoning and then migrated to Yantai and Weihai by sea regression in the Bohai Basin. The Hammonasset naturalized population probably originated from the Jilin population and then experienced separate differentiation. The long-term asexual reproduction pattern of R. rugosa decreased genetic diversity in the wild population. During R. rugosa cultivation, the ancestors of the Jilin population were involved in breeding traditional varieties, after which almost no wild individuals were engaged in breeding. However, in recent decades, cross breeding of R. rugosa started the utilization of wild germplasms. In comparison, some other species play important roles in variety formation. Few genes related to economic traits were selected, suggesting no directional domestication in the R. rugosa cultivation process.
Quantitative bias analysis in practice: review of software for regression with unmeasured confounding
Authors: Kawabata Emily , Tilling Kate , Groenwold Rolf H. H. , Hughes Rachael A.
Published: May 2023

Background

Failure to appropriately account for unmeasured confounding may lead to erroneous conclusions. Quantitative bias analysis (QBA) can be used to quantify the potential impact of unmeasured confounding or how much unmeasured confounding would be needed to change a study’s conclusions. Currently, QBA methods are not routinely implemented, partly due to a lack of knowledge about accessible software. Also, comparisons of QBA methods have focused on analyses with a binary outcome.

Methods

We conducted a systematic review of the latest developments in QBA software published between 2011 and 2021. Our inclusion criteria were software that did not require adaption (i.e., code changes) before application, was still available in 2022, and accompanied by documentation. Key properties of each software tool were identified. We provide a detailed description of programs applicable for a linear regression analysis, illustrate their application using two data examples and provide code to assist researchers in future use of these programs.

Results

Our review identified 21 programs with$$62\%$$62%created post 2016. All are implementations of a deterministic QBA with$$81\%$$81%available in the free software R. There are programs applicable when the analysis of interest is a regression of binary, continuous or survival outcomes, and for matched and mediation analyses. We identified five programs implementing differing QBAs for a continuous outcome: treatSens, causalsens, sensemakr, EValue, and konfound. When applied to one of our illustrative examples, causalsens incorrectly indicated sensitivity to unmeasured confounding whereas the other four programs indicated robustness.sensemakrperforms the most detailed QBA and includes a benchmarking feature for multiple unmeasured confounders.

Conclusions

Software is now available to implement a QBA for a range of different analyses. However, the diversity of methods, even for the same analysis of interest, presents challenges to their widespread uptake. Provision of detailed QBA guidelines would be highly beneficial.
Complex association of self-rated health, depression, functional ability with loneliness in rural community-dwelling older people
Authors: Cao Wenwen , Cao Chenglin , Ren Bohua , Yang Jing , Chen Ruoling , Hu Zhi , Bai Zhongliang
Published: May 2023

Background

This study aimed to explore whether and how self-rated health, depression and functional ability interactively associated with loneliness using a sample group of older adults residing in China rural communities.

Methods

Data on socio-demographic information, self-rated health, depressive symptoms, functional ability and loneliness (quantified via a single question) were collected from 1009 participants. Cross-tabulations with chi-square test, bivariate correlations, and Classification and Regression Tree (CART) models were employed for analysis.

Results

We found that 45.1% of the participants were classified as lonely. Our results gain insight into the hierarchical order of predictors for the presence of loneliness, suggesting that there was a significant interaction between functional ability and depressive symptoms while self-rated health was not a significant factor. The probability of loneliness increased with the combination of limited functional ability and depression, and varied with different interaction of functional ability, depressive symptoms, and marital status, respectively. Notably, while there were some differences, similar associations were observed among older male and female respondents.

Conclusion

To delay or reduce loneliness, early detection which focuses on older people who report limitations in functional ability, depression, and being female, offers opportunities to start early interventions. Our findings might be helpful not only in designing and implementing loneliness prevention programs but also in improving healthcare for older rural community-dwelling people.
Association of serum uric acid and fasting plasma glucose with cognitive function: a cross-sectional study
Authors: Yuan Zelin , Liu Huamin , Zhou Rui , Gu Shanyuan , Wu Keyi , Huang Zhiwei , Zhong Qi , Huang Yining , Chen Haowen , Wu Xianbo
Published: May 2023

Background

The combined effect of serum uric acid (SUA) and blood glucose on cognition has not been explored. This study aimed to examine the separate and combined association of SUA and fasting plasma glucose (FPG) or diabetes mellitus (DM) with cognition in a sample of Chinese middle-aged and elderly population.

Methods

A total of 6,509 participants aged 45 years or older who participated in the China Health and Retirement Longitudinal Study (CHARLS, 2011) were included. The three cognitive domains assessed were episodic memory, mental status, and global cognition (the sum of the first two terms). Higher scores indicated better cognition. SUA and FPG were measured. The participants were grouped based on SUA and FPG quartiles to evaluate their combined associations of cognition with SUA Q1–Q3 only (Low SUA), with FPG Q4 only (High FPG), without low SUA and high FPG levels (Non), and with low SUA and high FPG levels (Both), multivariate linear regression models were used to analyze their association.

Results

Lower SUA quartiles were associated with poorer performance in global cognition and episodic memory compared with the highest quartile. Although no association was found between FPG or DM and cognition, high FPG or DM combined with low SUA levels in women (βFPG = -0.983, 95% CI: -1.563–-0.402; βDM = -0.800, 95% CI: -1.369–-0.232) had poorer cognition than those with low SUA level only (βFPG = -0.469, 95% CI: -0.926–-0.013; βDM = -0.667, 95% CI: -1.060–-0.275).

Conclusion

Maintaining an appropriate level of SUA may be important to prevent cognitive impairment in women with high FPG.
Design of effective outpatient sentinel surveillance for COVID-19 decision-making: a modeling study
Authors: Toh Kok Ben , Runge Manuela , Richardson Reese AK , Hladish Thomas J , Gerardin Jaline
Published: May 2023

Background

Decision-makers impose COVID-19 mitigations based on public health indicators such as reported cases, which are sensitive to fluctuations in supply and demand for diagnostic testing, and hospital admissions, which lag infections by up to two weeks. Imposing mitigations too early has unnecessary economic costs while imposing too late leads to uncontrolled epidemics with unnecessary cases and deaths. Sentinel surveillance of recently-symptomatic individuals in outpatient testing sites may overcome biases and lags in conventional indicators, but the minimal outpatient sentinel surveillance system needed for reliable trend estimation remains unknown.

Methods

We used a stochastic, compartmental transmission model to evaluate the performance of various surveillance indicators at reliably triggering an alarm in response to, but not before, a step increase in transmission of SARS-CoV-2. The surveillance indicators included hospital admissions, hospital occupancy, and sentinel cases with varying levels of sampling effort capturing 5, 10, 20, 50, or 100% of incident mild cases. We tested 3 levels of transmission increase, 3 population sizes, and conditions of either simultaneous transmission increase or lagged increase in the older population. We compared the indicators’ performance at triggering alarm soon after, but not prior, to the transmission increase.

Results

Compared to surveillance based on hospital admissions, outpatient sentinel surveillance that captured at least 20% of incident mild cases could trigger an alarm 2 to 5 days earlier for a mild increase in transmission and 6 days earlier for a moderate or strong increase. Sentinel surveillance triggered fewer false alarms and averted more deaths per day spent in mitigation. When transmission increase in older populations lagged the increase in younger populations by 14 days, sentinel surveillance extended its lead time over hospital admissions by an additional 2 days.

Conclusions

Sentinel surveillance of mild symptomatic cases can provide more timely and reliable information on changes in transmission to inform decision-makers in an epidemic like COVID-19.
Vogesella urethralis-induced aspiration pneumonia and bacteremia in an elderly man: a first case report and literature review
Authors: Matsuda Hironari , Katayama Isana , Watanabe Takayasu , Komatsu Arisa , Iwakami Naoko , Goto Yukiko , Suzuki Misako , Iwakami Shin-ichiro , Takahashi Kazuhisa
Published: May 2023

Background

Vogesella species are common aquatic Gram-negative rods that were first reported in 1997. Vogesella urethralis bacterium was first isolated from human urine in 2020. Only two cases of disease caused by Vogesella species have been reported with no case of Vogesella urethralis-caused disease being reported as yet. Herein, we report a case of aspiration pneumonia and bacteremia caused by Vogesella urethralis.

Case presentation

An 82-year-old male patient was admitted with dyspnea, increased sputum production, and hypoxia. Gram-negative rods were isolated from the blood and sputum cultures of the patient. He was diagnosed with aspiration pneumonia and bacteremia. Initially, Vogesella urethralis was wrongly identified as Comamonas testosteroni based on fully automated susceptibility testing; however, additional 16S rRNA gene sequencing identified the causative as Vogesella urethralis. The patient was treated with piperacillin and tazobactam. Unfortunately, he developed aspiration pneumonia again and died during hospitalization.

Conclusions

Since no database exists for rare bacteria in traditional clinical microbiology laboratories, 16S rRNA gene sequence analysis is useful. We report the first case of Vogesella urethralis-induced aspiration pneumonia and bacteremia.
Neoadjuvant Chemoradiation for Rectal Cancer Achieves Satisfactory Tumour Regression and Local Recurrence – Result of a Dedicated Multi-disciplinary Approach from a South Asian Centre
Authors: Deen Raeed , Ediriweera Dileepa S , Thillakaratne Suchintha , Hewavissenthi Janaki , Kumarage Sumudu K , Chandrasinghe Pramodh C.
Published: May 2023

Background

Pre-operative long-course chemoradiotherapy (CRT) for rectal cancer has resulted in improvement in rates of restorative rectal resection and local recurrence by inducing tumour downstaging and downsizing. Total mesorectal excision (TME) is a standardised surgical technique of low anterior resection aimed at the prevention of local tumour recurrence. The purpose of this study was to evaluate tumour response following CRT in a standardised group of patients with rectal cancer.

Methods

One hundred and thirty-one patients (79 male; 52 female, median age 57; interquartile range 47–62 years) of 153 with rectal cancer who underwent pre-operative long-course CRT were treated by standardised open low anterior resection at a median of 10 weeks post-CRT. Sixteen of 131 (12%) were 70 years or older. Median follow-up at the time of analysis was 15 months (interquartile range 6–45 months). Pathology reports were analysed based on AJCC-UICC classification using the TNM system. Data recorded were overall/subgrades of tumour regression; good, moderate or poor, lymph node harvest, local recurrence, disease-free and overall survival using standard statistical methods.

Results

78% showed tumour regression post-CRT; 43% displayed good tumour regression/response while 22% had poor tumour regression/response. All patients had a pre-operative T-stage of either T3 or T4. Post-operation, good responders had a median T stage of T2 vs. T3 in poor responders (P = 0.0002). Overall, the median lymph node harvest was < 12. There was no difference in the number of nodes harvested in good vs. poor responders (Good/moderate-6 nodes vs. Poor- 8; P = 0.31). Good responders tended to have a lesser number of malignant nodes vs. poor responders (P = 0.31). Overall, local recurrence was 6.8% and the anal sphincter preservation rate was 89%. Predicted 5-year disease-free and overall survival were similar between good and poor responders.

Conclusion

Long-course CRT resulted in satisfactory tumour regression and enabled consideration for safe, sphincter-saving resection in rectal cancer. A dedicated multi-disciplinary team approach achieved a global benchmark for local recurrence in a resource-limited setting.
Elevated LILRB1 expression predicts poor prognosis and is associated with tumor immune infiltration in patients with glioma
Authors: Zou Renheng , Zhong Xunlong , Liang Kairong , Zhi Cheng , Chen Danmin , Xu Zhichao , Zhang Jingbai , Liao Degui , Lai Miaoling , Weng Yuhao , Peng Huaidong , Pang Xiao , Ji Yunxiang , Ke Yanbin , Zhang Hongri , Wang Zhaotao , Wang Yezhong
Published: May 2023

Background

Leukocyte immunoglobulin-like receptor subfamily B1 (LILRB1) is regarded as an inhibitory molecule. However, the importance of LILRB1 expression in glioma has not yet been determined. This investigation examined the immunological signature, clinicopathological importance and prognostic value of LILRB1 expression in glioma.

Methods

We used data from the UCSC XENA database, the Cancer Genome Atlas (TCGA) database, the Chinese Glioma Genome Atlas (CGGA) database, the STRING database, the MEXPRESS database and our clinical glioma samples to perform bioinformatic analysis and used vitro experiments to examine the predictive value and potential biological roles of LILRB1 in glioma.

Results

Higher LILRB1 expression was considerably present in the higher WHO grade glioma group and was linked to a poorer prognosis in patients with glioma. Gene set enrichment analysis (GSEA) revealed that LILRB1 was positively correlated with the JAK/STAT signaling pathway. LILRB1 combined with tumor mutational burden (TMB) and microsatellite instability (MSI) may be a promising indicator for the effectiveness of immunotherapy in patients with glioma. Increased LILRB1 expression was positively linked with the hypomethylation, M2 macrophage infiltration, immune checkpoints (ICPs) and M2 macrophage makers. Univariate and multivariate Cox regression analyses determined that increased LILRB1 expression was a standalone causal factor for glioma. Vitro experiments determined that LILRB1 positively enhanced the proliferation, migration and invasion in glioma cells. MRI images demonstrated that higher LILRB1 expression was related with larger tumor volume in patients with glioma.

Conclusion

Dysregulation of LILRB1 in glioma is correlated with immune infiltration and is a standalone causal factor for glioma.
Purtscher-like retinopathy following coronary artery bypass grafting in an antiphospholipid syndrome patient: a case report
Authors: Ameen Ismail Ahmed , Tolba Heba Eid , Sadek Sherin Hassan , Hatata Ragai Magdy
Published: May 2023

Background

Purtscher retinopathy is a rare occlusive microangiopathy comprising a constellation of retinal signs including cotton wool spots, retinal hemorrhages and Purtscher flecken. While classical Purtscher must be antedated by a traumatic incident, Purtscher-like retinopathy is used to refer to the same clinical syndrome in the absence of trauma. Various non-traumatic conditions have been associated with Purtscher-like retinopathy e.g. acute pancreatitis, preeclampsia, parturition, renal failure and multiple connective tissue disorders. In this case study, we report the occurrence of Purtscher-like retinopathy following coronary artery bypass grafting in a female patient with primary antiphospholipid syndrome (APS).

Case presentation

A 48-year-old Caucasian female patient presented with a complaint of acute painless diminution of vision in the left eye (OS) that occurred approximately two months earlier. Clinical history revealed that the patient underwent coronary artery bypass grafting (CABG) two months earlier and that visual symptoms started 4 days thereafter. Furthermore, the patient reported undergoing percutaneous coronary intervention (PCI) one year before for another myocardial ischemic event. Ophthalmological examination revealed multiple yellowish-white superficial retinal lesions i.e. cotton-wool spots, exclusively in the posterior pole and predominantly macular within the temporal vascular arcades only OS. Fundus examination of the right eye (OD) was normal and the anterior segment examination of both eyes (OU) was unremarkable. A diagnosis of Purtscher-like retinopathy was made based on clinical signs, suggestive history and consolidated by fundus fluorescein angiography (FFA), spectral domain optical coherence tomography (SD-OCT) and optical coherence tomography angiography (OCTA) of macula, optic nerve head (ONH) according to the diagnostic guidelines of Miguel. The patient was referred to a rheumatologist to identify the underlying systemic cause and was diagnosed with primary antiphospholipid syndrome (APS).

Conclusions

We report a case of Purtscher-like retinopathy complicating primary antiphospholipid syndrome (APS) following coronary artery bypass grafting. This conveys a message to clinicians that patients presenting with Purtscher-like retinopathy should undergo meticulous systemic work-up in order to identify potentially life-threatening underlying systemic diseases.