bluuebunny/crossref_metadata_2025 huggingface dataset:
Preliminary image findings of lower limb stress fractures to aid ultrasonographic diagnoses: A systematic review and narrative synthesis
Authors: Schaper Madeleine , Harcus James
Published: March 2021

Introduction

This systematic review investigates which image appearances are most common when diagnosing lower limb stress fractures using ultrasound imaging, with the aim of outlining an image critique guideline for operators to support confident diagnoses.

Method

A comprehensive literature search of medical databases and handsearching was undertaken to identify relevant studies. All studies were critically examined for quality using the CASP critical appraisal tool. Results from eight studies were combined and interpreted using a narrative synthesis.

Findings

A clear outline of common stress fracture appearances using ultrasound were identified in a combined total of 119 participants. Each finding was ranked according to its popularity. Periosteal thickening (78/119) and cortical disruption/irregularity (83/119) were noted in all eight studies. Hypervascularity of the periosteum visualised by colour Doppler imaging (66/119) was reported in six of the eight studies. Soft tissue hypervascularity (13/119), bony callus formation (5/119) and cortical break (22/119) were seen in three studies.

Conclusions

Based on the findings, we offer a guideline of the most significant preliminary image findings to be utilised by operators when examining athletes suspected of having lower limb stress fractures. The results show a gap in research for evaluating changes in appearance depending on the injury severity. Further research into distinguishing stress fractures from pathological involvement may in future reduce reliance on plain film radiography.
Challenges in management of gastrointestinal cancers in pregnancies: A report of three cases
Authors: Thain Serene , McMicking Jess , de Naurois Julien , Nelson-Piercy Catherine
Published: March 2021

Gastrointestinal cancer occurs in approximately 1 in 13,000 pregnancies, making up 4% of malignancies detected in pregnancy. It is a complex and challenging condition to diagnose and manage and is often only detected in its more advanced stages. This is partly due to symptoms of gastrointestinal cancer being incorrectly attributed to physiological symptoms of pregnancy, as well as concerns about the safety of diagnostic investigations in pregnancy, both of which may delay diagnosis and lead to disease progression. Challenges in management also arise from under-treatment in pregnancy due to concerns about the impact of surgery or chemotherapy on the pregnancy. We present here three cases of gastrointestinal cancer diagnosed in pregnancy in our centre and discuss the challenges and pitfalls one may encounter in the diagnosis and management of gastrointestinal malignancies in pregnancy.
Acute severe heart failure in pregnancy: A clinical challenge and review of the literature
Authors: Ellison Lili , Sundaram Ash , Coroyannikis Christina , Cauldwell Matthew
Published: March 2021

Pregnancy-associated myocarditis is uncommon and remains poorly described. The spectrum of the disorder is wide, with the severe cases culminating in heart failure, cardiogenic shock and even maternal death. Diagnosis is typically made on imaging, serology and endocardiac biopsy findings with treatment being directed towards the underlying cause. We describe a case of likely peripartum myocarditis associated with severe early-onset pre-eclampsia.
How Does Service Climate Influence Hotel Employees’ Brand Citizenship Behavior? A Social Exchange and Social Identity Perspective
Authors: Hoang Hung Trong
Published: March 2021

By integrating social exchange and social identity theories, this article examines the mechanism through which employee perceived service climate enhances employee brand citizenship behavior (BCB). Specifically, we propose that this relationship is mediated by perceived brand image and moderated by employees’ power distance orientation. Using data from hotel employees in Vietnam, the findings show that service climate positively affects employee BCB. Furthermore, the mediating effect of perceived brand image and the negative moderating effect of employees’ power distance orientation on the linkage between service climate and employee BCB are found to be significant. This article enriches the existing knowledge by incorporating both social exchange and social identity perspectives in explaining an underexplored linkage between service climate and employee BCB. We suggest that hotel providers should put an emphasis on fostering a supportive service climate and should take into account the role of employee’s power distance orientation in promoting employee BCB.
The Expression of Anger Enhances Perceived Competence Following Corporate Social Irresponsibility
Authors: Septianto Felix
Published: March 2021

Although prior research acknowledges the significant role of emotions in response to corporate social irresponsibility (CSI), such research typically examines emotions as mediators that explain how consumers respond to CSI. The present research tests a novel perspective by examining how the expression of anger (vs. sadness) in a company’s apology can influence consumer responses following CSI. Across two experimental studies in different CSI contexts, this research demonstrates that a company’s expression of anger (vs. sadness) enhances consumers’ perceived competence of the company, leading to higher purchase intentions. Furthermore, consumers’ mindset acts as a boundary condition such that the effect is attenuated among consumers with a growth (but not fixed) mindset. Thus, the findings of these studies have important theoretical and practical implications for the CSI literature.
Multi-Timescale Rhythmicity of Blood Glucose and Insulin Delivery Reveals Key Advantages of Hybrid Closed Loop Therapy
Authors: Grant Azure D. , Lewis Dana M. , Kriegsfeld Lance J.
Published: March 2021

Background:

Blood glucose and insulin exhibit coordinated daily and hourly rhythms in people without diabetes (nonT1D). Although the presence and stability of these rhythms are associated with euglycemia, it is unknown if they (1) are preserved in individuals with type 1 diabetes (T1D) and (2) vary by therapy type. In particular, Hybrid Closed Loop (HCL) systems improve glycemia in T1D compared to Sensor Augmented Pump (SAP) therapies, but the extent to which either recapitulates coupled glucose and insulin rhythmicity is not well described. In HCL systems, more rapid modulation of glucose via automated insulin delivery may result in greater rhythmic coordination and euglycemia. Such precision may not be possible in SAP systems. We hypothesized that HCL users would exhibit fewer hyperglycemic event, superior rhythmicity, and coordination relative to SAP users.

Methods:

Wavelet and coherence analyses were used to compare glucose and insulin delivery rate (IDR) within-day and daily rhythms, and their coordination, in 3 datasets: HCL (n = 150), SAP (n = 89), and nonT1D glucose (n = 16).

Results:

Glycemia, correlation between normalized glucose and IDR, daily coherence of glucose and IDR, and amplitude of glucose oscillations differed significantly between SAP and HCL users. Daily glucose rhythms differed significantly between SAP, but not HCL, users and nonT1D individuals.

Conclusions:

SAP use is associated with greater hyperglycemia, higher amplitude glucose fluctuations, and a less stably coordinated rhythmic phenotype compared to HCL use. Improvements in glucose and IDR rhythmicity may contribute to the overall effectiveness of HCL systems.
A Comparison of Artificial Intelligence and Human Diabetic Retinal Image Interpretation in an Urban Health System
Authors: Mokhashi Nikita , Grachevskaya Julia , Cheng Lorrie , Yu Daohai , Lu Xiaoning , Zhang Yi , Henderer Jeffrey D.
Published: March 2021

Introduction:

Artificial intelligence (AI) diabetic retinopathy (DR) software has the potential to decrease time spent by clinicians on image interpretation and expand the scope of DR screening. We performed a retrospective review to compare Eyenuk’s EyeArt software (Woodland Hills, CA) to Temple Ophthalmology optometry grading using the International Classification of Diabetic Retinopathy scale.

Methods:

Two hundred and sixty consecutive diabetic patients from the Temple Faculty Practice Internal Medicine clinic underwent 2-field retinal imaging. Classifications of the images by the software and optometrist were analyzed using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and McNemar’s test. Ungradable images were analyzed to identify relationships with HbA1c, age, and ethnicity. Disagreements and a sample of 20% of agreements were adjudicated by a retina specialist.

Results:

On patient level comparison, sensitivity for the software was 100%, while specificity was 77.78%. PPV was 19.15%, and NPV was 100%. The 38 disagreements between software and optometrist occurred when the optometrist classified a patient’s images as non-referable while the software classified them as referable. Of these disagreements, a retina specialist agreed with the optometrist 57.9% the time (22/38). Of the agreements, the retina specialist agreed with both the program and the optometrist 96.7% of the time (28/29). There was a significant difference in numbers of ungradable photos in older patients (≥60) vs younger patients (<60) (p=0.003).

Conclusions:

The AI program showed high sensitivity with acceptable specificity for a screening algorithm. The high NPV indicates that the software is unlikely to miss DR but may refer patients unnecessarily.
Physical and mental health of older people with disabilities in residential homes in Switzerland
Authors: Wicki Monika T
Published: March 2021

Objectives:

People with disabilities are underserved in terms of health care and prevention, and special health conditions exist among older people with intellectual disabilities. The Swiss Health Survey only covers people over the age of 15 years living in private households. Therefore, this study aims to assess the health status of older persons living in residential facilities for adults with disabilities.

Methods:

A cross-sectional survey with written questionnaires was conducted in six cantons in Switzerland to capture context factors and the physical health status of persons aged between 50 and 65 years in residential homes in Switzerland. The survey collected data on physical and mental health from 241 persons aged 50–65 years living in residential homes for people with disabilities. This was compared with data from the 2012 Swiss Health Survey comprising a sample of 2261 persons of the same age with chronic morbidities living in their own apartments.

Results:

Regarding their health, 94.1% of the survey respondents rated it as being very good, good or moderate. Although higher limitations on activities of daily living, higher levels of psychological distress and lower energy and vitality were reported by all respondents, a lower level of health issues was assessed than in the sample of persons with chronic morbidities living in their own apartment.

Conclusion:

Low energy and vitality, high limitations on activities of daily living, high psychological distress, high obesity rates and the assessment of health issues and pain should be specifically addressed in residential homes for people with disabilities.
Marijuana: A systems-based primer of adverse effects associated with use and an overview of its therapeutic utility
Authors: Kichloo Asim , Albosta Michael , Aljadah Michael , El-Amir Zain , Goldar Ghazaleh , Khan Muhammed Zatmar , Dahiya Dushyant Singh , Vallabhaneni Srilakshmi , Wani Farah , Singh Jagmeet
Published: March 2021

Marijuana use is on the rise in the United States. By the end of 2019, 33 states have legalized marijuana use and marijuana byproduct use for medical purposes. However, marijuana use does not come without side effects. This manuscript reviews the increasing usage of marijuana and the different forms (natural and synthetic) that patients may use when presenting to clinicians. It also addresses the biochemical and behavioral changes observed with marijuana use, including the location and changes associated with cannabinoid receptors (abbreviated CB1 and CB2). These two topics lead into an extensive review of the side effects of marijuana use. This manuscript discusses gastrointestinal side-effects, such as Cannabinoid Hyperemesis Syndrome, pancreatitis, and hepatotoxicity. It also briefly reviews cardiovascular, neurologic, and pulmonary side effects. This article provides an overview of therapeutic effects of marijuana including the antiemetic effect, its medical utility as an appetite stimulant, and usefulness in cancer patients post-chemotherapy. A thorough social history pertaining to marijuana use is an important consideration for clinicians in patients presenting with a variety of symptoms, including those effecting the gastrointestinal, cardiovascular, pulmonary, or neurologic systems.
Increased COVID-19-related fear and subjective risk perception regarding COVID-19 affects behavior in individuals with internal high-risk diseases
Authors: Kohler Hannah , Bäuerle Alexander , Schweda Adam , Weismüller Benjamin , Fink Madeleine , Musche Venja , Robitzsch Anita , Pfeiffer Corinna , Benecke Anke-Verena , Dörrie Nora , Führer Dagmar , Taube Christian , Rassaf Tienush , Teufel Martin , Skoda Eva-Maria
Published: March 2021

Since December 2019, the coronavirus disease-2019 (COVID-19) has been keeping the world in suspense. Proven risk factors for a severe course of COVID-19 are common diseases like diabetes, hypertension, cardiovascular or respiratory disorders. Until today, little is known about the psychological burden of individuals suffering from these high-risk diseases regard to COVID-19. The aim of the study was to define the impact of the coronavirus pandemic on behavior and mental health in individuals at high risk for developing a severe COVID-19 course. Items assessed generalized anxiety (GAD-7), COVID-19-related fear, adherent/dysfunctional safety behavior, and the subjective risk perception of regarding symptoms, having a severe course and dying because of COVID-19. Data were compared between participants with the high risk diseases and individuals without any of those diseases. 16,983 respondents completed the study. Generalized anxiety, COVID-19-related fear, adherent/dysfunctional safety behavior and subjective risk perception were elevated in participants with high-risk diseases. The increased COVID-19-related fear as a functional concern is a conclusion on the increased risk of a severe course. The functionality of the fear is reflected in people’s increased need for security and includes an increase in both adherent and dysfunctional safety behavior that underlines the need for psychological support strategies.
The Rural/Nonrural Divide? K–12 District Spending and Implications of Equity-Based School Funding
Authors: Dhaliwal Tasminda K. , Bruno Paul
Published: March 2021

In the 2013–2014 school year, the state of California implemented a new equity-minded funding system, the Local Control Funding Formula (LCFF). LCFF increased minimum per-pupil funding for educationally underserved students and provided greater autonomy in allocating resources. We use the implementation of LCFF to enrich our understanding of rural school finance and explore the implications of equity-based school finance reform across urbanicity (i.e., between rural, town, suburban, and urban districts) and between rural areas of different remoteness. Drawing on 15 years of financial data from California school districts, we find variation in the funding levels of rural districts but few differences in the ways resources are allocated and only modest evidence of constrained spending in rural areas. Our results suggest that spending progressivity (i.e., spending advantage of higher-poverty districts) has increased since LCFF, although progressivity is lowest in rural districts by the end of the data panel.
Atypical Presentations among Older Adults with COVID-19 Disease: A Need for Broadening the Differential Diagnosis
Authors: Ohuabunwa Ugochi , Turner Joyce , Johnson Ted
Published: March 2021

Typical presenting symptoms of COVID-19 have been reported to be common in older adults. Current guidelines by the World Health Organization (WHO) and Centers for Disease Control (CDC) for testing and diagnosis are based on the presence of these typical symptoms. Several older adults seen at our hospital have presented atypically with symptoms such as delirium, falls, increasing the need for attention to diagnostic protocols since this has significant implications for early detection and patient outcomes, infection control and promotion of safety among healthcare providers. With the increased risk of fatality among older adults with COVID-19, appropriate diagnostic protocols are needed to ensure early diagnosis and management. Recognizing these atypical presentations in nursing homes would also facilitate early screening and cohorting in these congregate living facilities where older adults have had disproportionately high morbidity and mortality rates. We present two patients who presented with delirium and falls, found to have COVID-19 infection.
Social, Psychological, and Behavioral Predictors of Salivary Bacteria, Yeast in Caries-Free Children
Authors: Kopycka-Kedzierawski D.T. , Scott-Anne K. , Ragusa P.G. , Cvetanovska M. , Flint K. , Feng C. , Watson G.E. , Wong C.L. , Billings R.J. , Quivey R.J. , O’Connor T.G.
Published: March 2021

Introduction:

Early childhood caries (ECC) is a complex, multifactorial oral disease that is a major public health concern because it is prevalent, profoundly alters a child’s quality of life, is difficult to treat effectively, and has a distressing tendency to recur following treatment.

Objectives:

The purpose of the study was to examine social, psychological, and behavioral predictors of salivary bacteria and yeast in young children at risk for ECC.

Methods:

A sample of 189 initially caries-free preschool children was assessed for child stress physiology from salivary cortisol, child and family stress exposure, diet, oral health behaviors, and sociodemographic risks. Multiple logistic regression analysis was implemented to examine the associations between these risk factors and cariogenic microorganisms: mutans streptococci (MS), lactobacilli (LB), and Candida species.

Results:

Higher baseline salivary cortisol (odds ratio [OR] = 6.26; 95% confidence level [CL], 1.69–23.16) and a blunted response to an acute laboratory stressor (OR = .56; 95% CL, .37–.83) were associated with an increased likelihood of elevated salivary MS (≥105 colony-forming units/mL) in caries-free children. Sociodemographic risk for cariogenic microorganisms was also found. Specifically, lower education attainment of the parent/primary caregiver was associated with children being more likely to carry salivary Candida species and elevated salivary MS; in addition, children from households with an unemployed parent/primary caregiver were more likely (OR = 3.13; 95% CL, 1.2–8.05) to carry salivary Candida species and more likely (OR = 3.03; 95% CL, 1.25–7.33) to carry elevated levels of MS and/or salivary Candida and/or LB.

Conclusions:

The impact of sociodemographic risk and stress physiology on cariogenic disease processes are evident prior to ECC onset. The findings provide novel data on the early onset of cariogenic processes in children and the importance of considering sociodemographic, psychosocial, and behavioral factors when judging ECC risk.

Knowledge Transfer Statement:

The findings provide valuable and novel findings that, pre-ECC onset, the caries disease process is explicable from a detailed assessment of behavioral, sociodemographic, and psychosocial stress variables.
Urban resilience in the aftermath of tropical storm Washi in the Philippines: The role of autonomous household responses
Authors: Maquiling Karl Sam M , De La Sala Safira , Rabé Paul
Published: March 2021

Existing knowledge regarding the role of household adaptation in pursuing urban resilience, especially in developing countries, is limited. Upon this rationale, the study provides in-depth empirical evidence on how resilience is framed, pursued, and realized from the perspective of low-income households in the Philippines. The study adopted a mixed-methods strategy to expound on the dynamics that affect resilience-building measures at the household level. The quantitative tools were chosen to provide empirical evidence on how residents in selected areas understand resilience and the actions undertaken to realize desired outcomes. The findings were further examined through analysis of data gathered from key informant interviews, relevant local policies, and regulations. Key findings show that autonomous household responses are intended, albeit intuitively, as resilience-building measures from the need to address risks immediately. These measures are undertaken independently and can provide direct benefits to the household. However, they may become counterproductive when analyzed from the point of view of collective resilience. The key to addressing this is institutional interventions that allow flexible modes of resilience that could enable households to pursue better resilience-building measures. Autonomous household responses, transitioning to a more collective level approach, challenge the distribution of decision-making processes and could result in framing appropriate urban resilience policies, strategies, and measures.
Context-specificity of violence: Physical, psychological, and social dimensions of harm during the Taliban’s insurgency (2007–2009) in Pakistan
Authors: Sanaullah
Published: March 2021

This article explores the Taliban’s insurgency (2007–2009) in Swat Valley (northern Pakistan) and the multiple meanings of violence in this context. A thematic analysis of data collected through qualitative fieldwork finds that the violence experienced by the victims was understood in three ways: physically as bodily harm, psychologically as terror and fear, and socially in the form of humiliation and dishonor. By delving into the experiences of civilians, the article offers a victim-centered approach and argues that instances of violence were characterized by harm as a “core referent.” It further argues for a context-specific understanding of harm and explicates that this notion is also determined by the local culture of Swat Valley, Pashtunwali.
IL-17 deficiency aggravates the streptozotocin‐induced diabetic nephropathy through the reduction of autophagosome formation in mice
Authors: Kim Kyung-Hyun , Hong Geum-Lan , Jung Da-Young , Karunasagara Shanika , Jeong Won-Il , Jung Ju-Young
Published: March 2021

Background

Diabetic nephropathy (DN) is one of the most important medical complications of diabetes mellitus. Autophagy is an important mediator of pathological response and plays a critical role in inflammation during the progression of diabetic nephropathy. Interleukin (IL)-17A favorably modulates inflammatory disorders including DN. In this study, we examined whether IL-17A deficiency affected the autophagy process in the kidneys of mice with streptozotocin (STZ)-induced DN.

Methods

The autophagic response of IL-17A to STZ-induced nephrotoxicity was evaluated by analyzing STZ-induced functional and histological renal injury in IL-17A knockout (KO) mice.

Results

IL-17A KO STZ-treated mice developed more severe nephropathy than STZ-treated wild-type (WT) mice, with increased glomerular damage and renal interstitial fibrosis at 12 weeks. IL-17A deficiency also increased the up-regulation of proinflammatory cytokines and fibrotic gene expression after STZ treatment. Meanwhile, autophagy-associated proteins were induced in STZ-treated WT mice. However, IL-17A KO STZ-treated mice displayed a significant decrease in protein expression. Especially, the levels of LC3 and ATG7, which play crucial roles in autophagosome formation, were notably decreased in the IL-17A KO STZ-treated mice compared with their WT counterparts.

Conclusions

IL-17 deficiency aggravates of STZ-induced DN via attenuation of autophagic response. Our study demonstrated that IL-17A mediates STZ-induced renal damage and represents a potential therapeutic target in DN.
E2F1 copy number variations in germline and breast cancer: a retrospective study of 222 Italian women
Authors: Rocca Maria Santa , Benna Clara , Goldin Elena , Di Nisio Andrea , De Toni Luca , Cosci Ilaria , Marchet Alberto , Nitti Donato , Foresta Carlo
Published: March 2021

Background

Breast cancer is the most common neoplasia among women in developed countries. The risk factors of breast cancer can be distinguished in modifiable and unmodifiable factors and, among the latter, genetic factors play a key role. Copy number variations (CNVs) are genetic variants that are classified as rare when present in less than 1% of the healthy population. Since rare CNVs are often cause of diseases, over the last years, their contribution in carcinogenesis has become a relevant matter of study. E2F1 is a transcriptional factor that plays an important role in regulating cell cycle and apoptosis. Its double and conflicting role is the reason why it acts both as oncogene and as tumour suppressor, depending on cell context. Since anomalies in expression or in number of copies of E2F1 have been related to several cancers, we aimed to study number of germline copies of E2F1 in women with breast cancer in order to better elucidate their contribution as predisposing factor to this tumour.

Methods

We performed, hence, a retrospective study on 222 Italian women with breast cancer recruited from October 2002 to December 2007. TaqMan CNV assay and Real-Time PCR were carried out to analyse, respectively, E2F1 CNV and E2F1 expression in the subjects of the study. Chi square test or Fisher’s exact test and Student's t‐test were used to calculate the frequency of CNVs and differences in continuous variables between groups, respectively.

Results

Intriguingly, we found that 10/222 (4.5%) women with breast cancer had more copies than controls (0/200, 0%), furthermore, the number of copies positively correlated with E2F1 gene expression in breast cancer tissue, suggesting that the constitutive gain of the gene could translate into an increased risk of genomic instability. Additionally, we found that altered E2F1 copies were present prevalently in the patients with contralateral breast cancer (20%) and all of them had a positive family history, both typically associated with hereditary cancer.

Conclusions

Our findings suggest that copy number variations of E2F1 might be a susceptibility factor for breast cancer, however, further studies on large cohorts are to be performed in order to better delineate the phenotype linked to the gain of E2F1 copies.
Shear strength properties of hybrid (hinoki cypress and Japanese cedar) cross-laminated timber
Authors: Ukyo Seiichiro , Miyatake Atsushi , Shindo Kenta , Hiramatsu Yasushi
Published: March 2021

In this study, the out-of-plane shear strength of hybrid cross-laminated timber (CLT) with outer layers of hinoki (hinoki cypress, Chamaecyparis obtusa) and inner layers of sugi (Japanese cedar, Cryptomeria japonica) is investigated for four different layer configurations. To investigate the influence from rolling shear properties of cross layers on the shear strength of CLT, stress analysis was conducted using the shear analogy method. The nominal shear strength, the maximum shear force divided by the cross-section of CLT, was in the 1.0–2.1 MPa range. Using the shear analogy method, the rolling shear modulus in the cross layer was determined as 72.9 MPa, which was comparable with the value obtained for laminae in previous study as well as the value confirmed by strain measurements in the present study. The magnitude of rolling shear stress in the cross layer was 0.9–1.1 times the average shear stress, which was negatively correlated with the nominal shear strength. From the regression line between the nominal shear strength and the magnitude of the shear stress in the cross layer, the mean shear strength of the cross layer was estimated to be 1.33 MPa.
Rice FLOURY SHRUNKEN ENDOSPERM 5 Encodes a Putative Plant Organelle RNA Recognition Protein that Is Required for cis-Splicing of Mitochondrial nad4 Intron 1
Authors: Wang Liang , Zhang Wenwei , Liu Shijia , Tian Yunlu , Liu Xi , Yan Haigang , Cai Yue , Teng Xuan , Dong Hui , Chen Rongbo , Jiang Xiaokang , Wang Yihua , Wan Jianmin
Published: March 2021

Background

The sequences of several important mitochondrion-encoded genes involved in respiration in higher plants are interrupted by introns. Many nuclear-encoded factors are involved in splicing these introns, but the mechanisms underlying this splicing remain unknown.

Results

We isolated and characterized a rice mutant namedfloury shrunken endosperm 5(fse5). In addition to having floury shrunken endosperm, thefse5seeds either failed to germinate or produced seedlings which grew slowly and died ultimately.Fse5encodes a putative plant organelle RNA recognition (PORR) protein targeted to mitochondria. Mutation ofFse5hindered the splicing of the first intron ofnad4, which encodes an essential subunit of mitochondrial NADH dehydrogenase complex I. The assembly and NADH dehydrogenase activity of complex I were subsequently disrupted by this mutation, and the structure of the mitochondria was abnormal in thefse5mutant. The FSE5 protein was shown to interact with mitochondrial intron splicing factor 68 (MISF68), which is also a splicing factor fornad4intron 1 identified previously via yeast two-hybrid (Y2H) assays.

Conclusion

Fse5which encodes a PORR domain-containing protein, is essential for the splicing ofnad4intron 1, and loss ofFse5function affects seed development and seedling growth.
Inferring the number and position of changes in selective regime in a non-equilibrium mutation-selection framework
Authors: Ritchie Andrew M. , Stark Tristan L. , Liberles David A.
Published: March 2021

Background

Recovering the historical patterns of selection acting on a protein coding sequence is a major goal of evolutionary biology. Mutation-selection models address this problem by explicitly modelling fixation rates as a function of site-specific amino acid fitness values.However, they are restricted in their utility for investigating directional evolution because they require prior knowledge of the locations of fitness changes in the lineages of a phylogeny.

Results

We apply a modified mutation-selection methodology that relaxes assumptions of equlibrium and time-reversibility. Our implementation allows us to identify branches where adaptive or compensatory shifts in the fitness landscape have taken place, signalled by a change in amino acid fitness profiles. Through simulation and analysis of an empirical data set of$$\beta $$β-lactamase genes, we test our ability to recover the position of adaptive events within the tree and successfully reconstruct initial codon frequencies and fitness profile parameters generated under the non-stationary model.

Conclusion

We demonstrate successful detection of selective shifts and identification of the affected branch on partitions of 300 codons or more. We successfully reconstruct fitness parameters and initial codon frequencies in simulated data and demonstrate that failing to account for non-equilibrium evolution can increase the error in fitness profile estimation. We also demonstrate reconstruction of plausible shifts in amino acid fitnesses in the bacterial$$\beta $$β-lactamase family and discuss some caveats for interpretation.
Natural hybridization between two butterfly bushes in Tibet: dominance of F1 hybrids promotes strong reproductive isolation
Authors: Liao Rongli , Sun Weibang , Ma Yongpeng
Published: March 2021

Background

It has been recognized that a certain amount of habitat disturbance is a facilitating factor for the occurrence of natural hybridization, yet to date we are unaware of any studies exploring hybridization and reproductive barriers in those plants preferentially occupying disturbed habitats.Buddlejaplants (also called butterfly bush) generally do grow in disturbed habitats, and several species with hybrid origin have been proposed, based solely on morphological evidence.

Results

In the present study, we test the hypothesis thatB. × wardiiis of natural hybridization origin in two sympatric populations of three taxa includingB. × wardiiand its parents (B. alternifoliaandB. crispa) plus 4 referenced parental populations, using four nuclear genes and three chloroplast intergenic spacers, as well as with 10 morphological characters. Our results suggest that at both sitesB. × wardiiis likely to be a hybrid betweenB. alternifoliaandB. crispa, and moreover, we confirm that most of the hybrids examined are F1s. That these plants are F1s is further supported by morphology, as no transgressive characters were detected.B. crispawas found to be the maternal parent in the Bahe (BH) population, from cpDNA evidence. However, in the Taji (TJ) population, the direction of hybridization was difficult to establish due to the shared cpDNA haplotypes betweenB. alternifoliaandB. crispa, however we still predicted a similar unidirectional hybridization pattern due to results from cross-specific pollination treatments which supported the “SI × SC rule”.

Conclusions

The presence of mainly F1hybrids can successfully impede gene flow and thus maintain species boundaries in parental species in a typical distribution ofBuddleja, i.e. in disturbed habitats.
Improvement of analgesic efficacy for total hip arthroplasty by a modified ultrasound‐guided supra‐inguinal fascia iliaca compartment block
Authors: Zheng Ting , Hu Bin , Zheng Chun-ying , Huang Feng-yi , Gao Fei , Zheng Xiao-chun
Published: March 2021

Background

Fascia iliaca compartment block (FICB) is an anterior approach to the lumbar plexus block and provides the effective adjunctive analgesia for total hip arthroplasty (THA).

Methods

As a case series study, 28 patients (≥ 65 years old) with THA were received a modified in-plane ultrasound-guided supra-inguinal (S-FICB) as an analgesic adjunct to evaluate the analgesic effectiveness and the local anesthetic diffusion with magnetic resonance imaging (MRI). A combination of propofol and sufentanil was administered to conduct target-controlled infusion.

Results

The pain scores were 1 (0–4), 2 (1–5), 3 (1–6) and 3 (1–6) at 4, 8, 12, and 24 h. The cumulative opioids were 8 (8–12), 18 (16–32), 28 (24–54) and 66 (48–104) mg of i.v. morphine equivalents at 4, 8, 12, and 24 h. The patient-controlled analgesia (PCA) times were 0 (0–1), 1 (0–2), 2 (0–5) and 5 (3–8) at 4, 8, 12, and 24 h. In lateral, anterior and medial part of thigh, the sensory blockade in 28 patients was 23 (82 %), 21 (75 %) and 19 (68 %) at 5 min; 28 (100 %) at 10 and 20 min. Motor blockade of femoral nerve (FN) and obturator nerve (ON) was present in 13 (46 %) and 3 (11 %) patients at 5 min, 24 (86 %) and 9 (32 %) at 10 min, 26 (93 %) and 11 (39 %) at 20 min. Injectate permeated to the FN and extended superiorly over the surface of iliac muscle (IM) and pectineus muscle (PM) in all patients.

Conclusions

The modified S-FICB has provided an effective postoperative analgesic adjunct after THA with the satisfactory blockade of femoral (FN), obturator (ON) and sciatic (SN) nerves, especially for ON, when compared with the existing techniques.
Refractory pharyngeal ulceration due to cytomegalovirus in a patient with HIV infection: a case report and literature review
Authors: Osa Morichika , Sato Akihiro , Sakagami Maki , Machida Masaki , Sato Takao , Tsukimori Ayaka , Fukushima Shinji , Nakamura Itaru , Akai Ryo , Tsukahara Kiyoaki , Watanabe Hidehiro
Published: March 2021

Background

Cytomegalovirus (CMV) is an important pathogen among immunocompromised hosts. Typically, CMV in human immunodeficiency virus (HIV) infection causes diseases of the retina, digestive tract, lungs and liver, but there are few cases of CMV infection of the pharynx and larynx.

Case presentation

A 57-year-old man with HIV infection was admitted because of pharyngeal pain. Before and after admission, pharyngeal biopsies guided by laryngeal endoscopy were performed four times, but pathological examination showed nonspecific inflammation, and the cause of pharyngeal ulceration was unclear. Additionally, the ulceration deteriorated after initiation of retroviral therapy. Laryngomicrosurgery was conducted under general anesthesia to remove tissue, and pathological diagnosis confirmed CMV infection. Pathological features included enlargement of the cytoplasm and nucleus in infected cells, and intranuclear bodies called owl’s eye inclusions. Ganciclovir dramatically improved the symptoms and laryngoscopic findings.

Conclusions

This case was diagnosed as pharyngitis and pharyngeal ulceration caused by CMV infection, related to immune reconstitution inflammatory syndrome. In previous reports of CMV-induced pharyngeal or laryngeal ulceration in HIV infection, we found six cases similar to our present case. All cases were diagnosed by biopsy. The present case indicates the importance of biopsy for definitive diagnosis. CMV infection should be considered as a differential diagnosis of pharyngeal ulceration in patients with HIV infection.
A novel nonsense variant of the AGXT identified in a Chinese family: special variant research in the Chinese reference genome
Authors: Xu Chang Bao , Zhou Xu Dong , Xu Hong En , Zhao Yong Li , Zhao Xing Hua , Liu Dan Hua , Tian Yong An , Hu Xin Xin , Guan Jing Yuan , Guo Jian Cheng , Tang Wen Xue , Xue Xia
Published: March 2021

Background

Primary hyperoxaluria(PH)is a rare autosomal recessive genetic disease that contains three subtypes (PH1, PH2 and PH3). Approximately 80% of PH patients has been reported as subtype PH1, this subtype of PH has been related to a higher risk of renal failure at any age. Several genetic studies indicate that the variants in gene AGXT are responsible for the occurrence of PH1. However, the population heterogeneity of the variants in AGXT makes the genetic diagnosis of PH1 more challenging as it is hard to locate each specific variant. It is valuable to have a complete spectrum of AGXT variants from different population for early diagnosis and clinical treatments of PH1.

Case presentation

In this study, We performed high-throughput sequencing and genetic analysis of a 6-year-old male PH1 patient from a Chinese family. Two variants (c.346G > A: p.Gly116Arg; c.864G > A: p.Trp288X) of the gene AGXT were identified. We found a nonsense variant (c.864G > A: p.Trp288X) that comes from the proband’s mother and has never been reported previously. The other missense variant (c.346G > A: p.Gly116Arg) was inherited from his father and has been found previously in a domain of aminotransferase, which plays an important role in the function of AGT protein. Furthermore, we searched 110 pathogenic variants of AGXT that have been reported worldwide in healthy local Chinese population, none of these pathogenic variants was detected in the local genomes.

Conclusions

Our research provides an important diagnosis basis for PH1 on the genetic level by updating the genotype of PH1 and also develops a better understanding of the variants in AGXT by broadening the variation database of AGXT according to the Chinese reference genome.
Association between physical performance and incidence of end-stage renal disease in older adults: a national wide cohort study
Authors: Jung Hee-won , Choi In Young , Shin Dong Wook , Han Kyungdo , Yoo Jung Eun , Chun Sohyun , Yi Yongjin
Published: March 2021

Background

Physical frailty has previously been associated with adverse clinical outcomes in patients with end-stage renal disease (ESRD). This study aimed to determine whether impaired physical performance at baseline is associated with the incidence of ESRD, using a nationwide database.

Methods

The timed up-and-go (TUG) test was used to assess physical frailty in 1,552,781 66-year-old individuals, using health examination database records from the Korean National Health Insurance Service. As a primary endpoint, incident ESRD was defined operationally using healthcare claims data from the Korean Health Insurance Review and Assessment Service.

Results

Our results showed that baseline kidney function was significantly worse in individuals with TUG results of > 10 s compared to individuals with an intact TUG performance (≤10 s). Kaplan-Meier analysis showed a stepwise dose-response relationship between baseline physical performance and the incidence rate of ESRD (log-rank test P-value of < 0.001). An increasing ESRD incidence rate trend with poor physical performance remained significant after adjusting for characteristics such as baseline glomerular filtration rate and proteinuria.

Conclusion

Poor baseline physical performance was associated with an increased risk of ESRD, suggesting possible interactions between systemic frailty and vascular aging processes.
Beam complexity and monitor unit efficiency comparison in two different volumetric modulated arc therapy delivery systems using automated planning
Authors: Li Chengqiang , Tao Cheng , Bai Tong , Li Zhenjiang , Tong Ying , Zhu Jian , Yin Yong , Lu Jie
Published: March 2021

Background

To investigate the beam complexity and monitor unit (MU) efficiency issues for two different volumetric modulated arc therapy (VMAT) delivery technologies for patients with left-sided breast cancer (BC) and nasopharyngeal carcinoma (NPC).

Methods

Twelve left-sided BC and seven NPC cases were enrolled in this study. Each delivered treatment plan was optimized in the Pinnacle3treatment planning system with the Auto-Planning module for the Trilogy and Synergy systems. Similar planning dose objectives and beam configurations were used for each site in the two different delivery systems to produce clinically acceptable plans. The beam complexity was evaluated in terms of the segment area (SA), segment width (SW), leaf sequence variability (LSV), aperture area variability (AAV), and modulation complexity score (MCS) based on the multileaf collimator sequence and MU. Plan delivery and a gamma evaluation were performed using a helical diode array.

Results

With similar plan quality, the average SAs for the Trilogy plans were smaller than those for the Synergy plans: 55.5 ± 21.3 cm2vs. 66.3 ± 17.9 cm2(p < 0.05) for the NPC cases and 100.7 ± 49.2 cm2vs. 108.5 ± 42.7 cm2(p < 0.05) for the BC cases, respectively. The SW was statistically significant for the two delivery systems (NPC: 6.87 ± 1.95 cm vs. 6.72 ± 2.71 cm,p < 0.05; BC: 8.84 ± 2.56 cm vs. 8.09 ± 2.63 cm,p < 0.05). The LSV was significantly smaller for Trilogy (NPC: 0.84 ± 0.033 vs. 0.86 ± 0.033,p < 0.05; BC: 0.89 ± 0.026 vs. 0.90 ± 0.26,p < 0.05). The mean AAV was significantly larger for Trilogy than for Synergy (NPC: 0.18 ± 0.064 vs. 0.14 ± 0.037,p < 0.05; BC: 0.46 ± 0.15 vs. 0.33 ± 0.13,p < 0.05). The MCS values for Trilogy were higher than those for Synergy: 0.14 ± 0.016 vs. 0.12 ± 0.017 (p < 0.05) for the NPC cases and 0.42 ± 0.106 vs. 0.30 ± 0.087 (p < 0.05) for the BC cases. Compared with the Synergy plans, the average MUs for the Trilogy plans were larger: 828.6 ± 74.1 MU and 782.9 ± 85.2 MU (p > 0.05) for the NPC cases and 444.8 ± 61.3 MU and 393.8 ± 75.3 MU (p > 0.05) for the BC cases. The gamma index agreement scores were never below 91% using 3 mm/3% (global) distance to agreement and dose difference criteria and a 10% lower dose exclusion threshold.

Conclusions

The Pinnacle3Auto-Planning system can optimize BC and NPC plans to achieve the same plan quality using both the Trilogy and Synergy systems. We found that these two systems resulted in different SAs, SWs, LSVs, AAVs and MCSs. As a result, we suggested that the beam complexity should be considered in the development of further methodologies while optimizing VMAT autoplanning.
A new rapid diagnostic system with ambient mass spectrometry and machine learning for colorectal liver metastasis
Authors: Kiritani Sho , Yoshimura Kentaro , Arita Junichi , Kokudo Takashi , Hakoda Hiroyuki , Tanimoto Meguri , Ishizawa Takeaki , Akamatsu Nobuhisa , Kaneko Junichi , Takeda Sen , Hasegawa Kiyoshi
Published: March 2021

Background

Probe electrospray ionization-mass spectrometry (PESI-MS) can rapidly visualize mass spectra of small, surgically obtained tissue samples, and is a promising novel diagnostic tool when combined with machine learning which discriminates malignant spectrum patterns from others. The present study was performed to evaluate the utility of this device for rapid diagnosis of colorectal liver metastasis (CRLM).

Methods

A prospectively planned study using retrospectively obtained tissues was performed. In total, 103 CRLM samples and 80 non-cancer liver tissues cut from surgically extracted specimens were analyzed using PESI-MS. Mass spectra obtained by PESI-MS were classified into cancer or non-cancer groups by using logistic regression, a kind of machine learning. Next, to identify the exact molecules responsible for the difference between CRLM and non-cancerous tissues, we performed liquid chromatography-electrospray ionization-MS (LC-ESI-MS), which visualizes sample molecular composition in more detail.

Results

This diagnostic system distinguished CRLM from non-cancer liver parenchyma with an accuracy rate of 99.5%. The area under the receiver operating characteristic curve reached 0.9999. LC-ESI-MS analysis showed higher ion intensities of phosphatidylcholine and phosphatidylethanolamine in CRLM than in non-cancer liver parenchyma (P < 0.01, respectively). The proportion of phospholipids categorized as monounsaturated fatty acids was higher in CRLM (37.2%) than in non-cancer liver parenchyma (10.7%;P < 0.01).

Conclusion

The combination of PESI-MS and machine learning distinguished CRLM from non-cancer tissue with high accuracy. Phospholipids categorized as monounsaturated fatty acids contributed to the difference between CRLM and normal parenchyma and might also be a useful diagnostic biomarker and therapeutic target for CRLM.
A prediction model based on DNA methylation biomarkers and radiological characteristics for identifying malignant from benign pulmonary nodules
Authors: Xing Wenqun , Sun Haibo , Yan Chi , Zhao Chengzhi , Wang Dongqing , Li Mingming , Ma Jie
Published: March 2021

Background

Lung cancer remains the leading cause of cancer deaths across the world. Early detection of lung cancer by low-dose computed tomography (LDCT) can reduce the mortality rate. However, making a definitive preoperative diagnosis of malignant pulmonary nodules (PNs) found by LDCT is a clinical challenge. This study aimed to develop a prediction model based on DNA methylation biomarkers and radiological characteristics for identifying malignant pulmonary nodules from benign PNs.

Methods

We assessed three DNA methylation biomarkers (PTGER4, RASSF1A, and SHOX2) and clinically-relevant variables in a training cohort of 110 individuals with PNs. Four machine-learning-based prediction models were established and compared, including the K-nearest neighbors (KNN), random forest (RF), support vector machine (SVM), and logistic regression (LR) algorithms. Variables of the best-performing algorithm (LR) were selected through stepwise use of Akaike’s information criterion (AIC). The constructed prediction model was compared with the methylation biomarkers and the Mayo Clinic model using the non-parametric approach of DeLong et al. with the area under a receiver operator characteristic curve (AUC) analysis.

Results

A prediction model was finally constructed based on three DNA methylation biomarkers and one radiological characteristic for identifying malignant from benign PNs. The developed prediction model achieved an AUC value of 0.951 in malignant PNs diagnosis, significantly higher than the three DNA methylation biomarkers (0.912, 95% CI:0.843–0.958, p = 0.013) or Mayo Clinic model (0.823, 95% CI:0.739–0.890, p = 0.001). Validation of the prediction model in the testing cohort of 100 subjects with PNs confirmed the diagnostic value.

Conclusion

We have shown that integrating DNA methylation biomarkers and radiological characteristics could more accurately identify lung cancer in subjects with CT-found PNs. The prediction model developed in our study may provide clinical utility in combination with LDCT to improve the over-all diagnosis of lung cancer.