bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and validation of a structured survey questionnaire on knowledge, attitude, preventive practice, and treatment-seeking behaviour regarding dengue among the resident population of Sabah, Malaysia: an exploratory factor analysis
Authors: Guad Rhanye Mac , Mangantig Ernest , Low Wah Yun , Taylor-Robinson Andrew W. , Azzani Meram , Sekaran Shamala Devi , Sim Maw Shin , Azizan Nornazirah
Published: August 2021

Background

Several studies have reported a significant association of knowledge, attitude and preventive practice (KAP) regarding dengue infection among community’s resident in endemic areas. In this study we aimed to assess and develop a reliable and valid KAP survey on the subject of dengue that is suitable for the resident population of Sabah, Malaysia.

Methods

A community-based cross-sectional study was conducted from October 2019 to February 2020 involving 468 respondents. Information on the socio-demographic characteristics of the participants (six items), their KAP (44, 15 and 18 items on knowledge, attitude and practice, respectively) and treatment-seeking behaviour (five items) towards dengue was collected using a structured questionnaire. Data analysis was performed using SPSS and R software in the R Studio environment. The knowledge section was analysed by two-parameter logistic item response theory (2-PL IRT) using ltm package. The construct validity and reliability of items for sections on attitude, practice and treatment-seeking behaviour were analysed using psy package.

Results

For the knowledge section, only 70.5% (31/44) of items were within or close to the parameter acceptable range of −3 to + 3 of difficulty. In terms of discrimination, 65.9% (29/44) of items were within or close to the acceptable range of 0.35 to 2.5, and 24 items (54.5%) failed to fit the 2-PL IRT model (P < 0.05) after assessing by goodness-of-fit analysis. Only eight items were reliable and retained in the attitude section with a Kaiser–Meyer–Olkin (KMO) test value of > 0.7, while based on the communalities, 11 items in the attitude section were excluded due to very low h2, factor loading values and low correlation with the total (< 0.5). The practice section was found suitable for factor analysis because the KMO value was > 0.7. The communalities of the practice section showed that seven items had low h2 values (< 0.3), which were therefore excluded from further analysis, and only 11 items were retained.

Conclusions

The KAP items retained in the final version of the survey were reliable and valid to be use as a questionnaire reference when conducting future similar studies among the population of Sabah.
Negative effects of iodine-based contrast agent on renal function in patients with moderate reduced renal function hospitalized for COVID-19
Authors: Kistner Anna , Tamm Chen , Svensson Ann Mari , Beckman Mats O. , Strand Fredrik , Sköld Magnus , Nyrén Sven
Published: August 2021

Background

Kidney disease and renal failure are associated with hospital deaths in patients with COVID − 19. We aimed to test if contrast enhancement affects short-term renal function in hospitalized COVID − 19 patients.

Methods

Plasma creatinine (P-creatinine) was measured on the day of computed tomography (CT) and 24 h, 48 h, and 4–10 days after CT. Contrast-enhanced (n = 142) and unenhanced (n = 24) groups were subdivided, based on estimated glomerular filtration rates (eGFR), > 60 and ≤ 60 ml/min/1.73 m2. Contrast-induced acute renal failure (CI-AKI) was defined as ≥27 μmol/L increase or a > 50% rise in P-creatinine from CT or initiation of renal replacement therapy during follow-up. Patients with renal replacement therapy were studied separately. We evaluated factors associated with a > 50% rise in P-creatinine at 48 h and at 4–10 days after contrast-enhanced CT.

Results

Median P-creatinine at 24–48 h and days 4–10 post-CT in patients with eGFR> 60 and eGFR≥30–60 in contrast-enhanced and unenhanced groups did not differ from basal values. CI-AKI was observed at 48 h and at 4–10 days post contrast administration in 24 and 36% (n = 5/14) of patients with eGFR≥30–60. Corresponding figures in the eGFR> 60 contrast-enhanced CT group were 5 and 5% respectively, (p < 0.037 and p < 0.001, Pearson χ2 test). In the former group, four of the five patients died within 30 days. Odds ratio analysis showed that an eGFR≥30–60 and 30-day mortality were associated with CK-AKI both at 48 h and 4–10 days after contrast-enhanced CT.

Conclusion

Patients with COVID − 19 and eGFR≥30–60 had a high frequency of CK-AKI at 48 h and at 4–10 days after contrast administration, which was associated with increased 30-day mortality. For patients with eGFR≥30–60, we recommend strict indications are practiced for contrast-enhanced CT. Contrast-enhanced CT had a modest effect in patients with eGFR> 60.
Postoperative results of ventilation tube insertion: a retrospective multicenter study for suggestion of grading system of otitis media with effusion
Authors: Song Chan Il , Kang Byung Chul , Shin Chol Ho , An Yun Suk , Kim Tae Su , Lim Hyun Woo , Shim Hyun Joon , Yoo Myung Hoon , Ahn Joong Ho
Published: August 2021

Background

In otitis media with effusion (OME), it is important to know when to surgically intervene and when careful monitoring is more appropriate. This study aimed to visualize and classify the clinical manifestations of OME and the correlation between the new grading system and postoperative results after ventilation tube insertion (VTI).

Methods

We classified the collective 1,012 ears from 506 patients into six groups: grade 0 (no effusion), grade I (scant effusion, but abnormal), grade II (effusion less than half of the tympanic cavity), grade III (effusion over half of the tympanic cavity, with air bubbles), grade IV (complete effusion), and grade V (retracted tympanic membrane or hemotympanum without air bubbles).

Results

The mean age at VTI was 5.2 (±2.9) years and mean duration between diagnosis and operation was 4.1 (±1.8) months. Between the grades, the nature of the middle ear effusion was also significantly different (p < 0.001). The duration of ventilation tube retention after VTI was significantly different when compared between two groups: grade I-IV and grade V (p = 0.019). Our results showed that the recurrence rate, as well as rate of revision VTI, increased as the grade increased (p < 0.001).

Conclusions

The new grading system of OME using endoscopic otoscope evaluation had a significant correlation with the age at VTI, the nature of middle ear effusion, the recurrence rate of OME, and the rate of revision VTI.
Correlates of transitions from alcohol use to disorder diagnosed by DSM-5 in China
Authors: Zhang Tingting , Liu Zhaorui , Li Guohua , Huang Yueqin , Li Yanxiang , Geng Hongchun , Cheng Hui G.
Published: August 2021

Background

This study aimed to describe the prevalence and lifetime criteria profiles of DSM-5 alcohol use disorder (AUD) and the transitions from alcohol use to disorder in Chifeng, China.

Methods

Face-to-face interviews were conducted using Composite International Diagnostic Interview-3.0 (CIDI-3.0) among 4528 respondents in Chifeng.

Results

The weighted lifetime and 12-month prevalence of DSM-5 AUD were 3.03 and 1.05%, respectively. Mild lifetime AUD was the most prevalent severity level (69.53%). The two most common criteria were “failure to quit/cutdown” and “drinking more or for longer than intended.” Lifetime prevalence was 65.59% for alcohol use, and 22.97% for regular drinking. Male and domestic violence were risk factors for the transition from alcohol use to regular drinking or AUD and from regular drinking to AUD. Younger age was risk factor for the transition to AUD from alcohol use or regular drinking. Poverty (OR = 2.49) was risk factor for the transition from alcohol use to regular drinking. The earlier drinkers were more likely to develop to regular drinking (OR = 2.11).

Conclusion

AUD prevalence in Chifeng was not as high as that in Western countries. The study revealed that multiple risk factors might contribute to the transition across different stages of alcohol use. Further research should explore the underlying mechanisms.
A national survey of ambient air pollution health literacy among adult residents of Taiwan
Authors: Hou Wen-Hsuan , Huang Yi-Chin , Lu Chien-Yeh , Chen I-Chen , Lee Pei-Chen , Lin Ming-Yeng , Wang Yu-Chen , Sulistyorini Lilis , Li Chung-Yi
Published: August 2021

Objective

To investigate the level of and covariates associated with ambient air pollution health literacy (AAPHL) among adult residents of Taiwan.

Methods

With a cross-sectional study design, we conducted telephone interviews using a Chinese version AAPHL scale, which consisted of 24 items assessing 12 subdomains of AAPHL formed by 4 information processing competence matrices (i.e., access, understand, appraise, and apply) and 3 health contexts (i.e., healthcare, disease prevention, and health promotion). The AAPHL was with the lowest and highest score at 1 to 4, respectively. Between September and November 2020, a sample of 1017 and 280 adults was successfully interviewed via home phones and mobile phones, respectively. We employed multiple linear regression models to identify covariates significantly associated with overall and 4 matric-specific AAPHL scores.

Results

The mean and standard deviation (±SD) of overall AAPHL score was considered as moderate at 2.90 (±0.56), with the highest and lowest metric-specific score for “apply” (3.07 ± 0.59) and “appraise” (2.75 ± 0.66). Lower education was significantly associated with a lower overall score; and living with children < 12 years and single were both significantly associated with higher overall scores. We also noted a significant geographic variation in overall score in which people living in the east/remote islands had highest scores.

Conclusions

People in Taiwan had only moderate level of AAPHL; and covariates including education, living arrangement, marital status, and area of living were significantly associated with AAPHL. These covariates should be considered in future educational interventions aiming to improve the AAPHL in the community.
Effects of valsartan combined with α-lipoic acid on renal function in patients with diabetic nephropathy: a systematic review and meta-analysis
Authors: Sun Fangfang , Jiang Deqi , Cai Juanjuan
Published: August 2021

Background

Diabetic nephropathy (DN) is one of the most serious microvascular complications of diabetes, valsartan and α-lipoic acid alone or in combination has been used for the treatment of patients with DN. However, some results in these clinical reports were still controversial. The purpose of this study was to evaluate the efficacy of valsartan combined with α-lipoic acid on renal function in patients with DN.

Methods

We searched the electronic databases including PubMed, Sciencedirect, EMBASE, Cochrane library, Chinese national knowledge infrastructure (CNKI) and Wanfang databases, and the publication deadline was limited to January 2020. Randomized controlled trials (RCTs) evaluating the effects of valsartan combined with α-lipoic acid in DN patients were included. Pooled estimates were conducted using a fixed or random effect model. The outcomes included urinary albumin excretion rate (UAER), and the level of urinary albumin, β2-microglobulin (β2-MG), hypersensitive C-reactive protein (hs-CRP) and oxidative stress.

Results

11 studies with 1294 participants were included in this study. The pooled analysis indicated that α-lipoic acid combined with valsartan could remarkably reduce UAER (P < 0.00001, SMD = -1.95, 95%CI = -2.55 to − 1.20; P = 0.03, SMD = -0.85, 95%CI = -1.59 to − 0.1) and the level of urinary albumin (P = 0.001, SMD = -1.48, 95%CI = − 2.38 to − 0.58; P = 0.01, SMD = -1.67, 95%CI = -3.00 to − 0.33), β2-MG (P < 0.001,SMD = − 2.59, 95%CI = -3.78 to − 1.40; P = 0.03, SMD = -0.48, 95%CI = -0.93 to − 0.04) when compared with valsartan or lipoic acid monotherapy in patients with DN. However, there was no significant difference in the level of hs-CRP among the three therapies (P = 0.06, SMD = -2.80, 95%CI = -5.67 to 0.07; P = 0.10, SMD = -0.42, 95%CI = − 0.92 to 0.08). In addition, α-lipoic acid combined with valsartan markedly increased the level of SOD (P = 0.03, SMD = 1.24, 95%CI = 0.32 to 1.03; P = 0.0002, SMD = 0.68, 95%CI = 0.32 to 1.03) and T-AOC (P < 0.00001, SMD = 0.89, 95%CI = 0.62 to 1.16; P = 0.02, SMD = 0.58, 95%CI = 0.10 to1.07), and reduced the level of MDA(P = 0.0002, SMD = -1.99, 95%CI = -3.02 to − 0.96; P = 0.0001, SMD = -0.69, 95%CI = -1.04 to − 0.34).

Conclusions

α-lipoic acid combined with valsartan could significantly reduce the level of urinary albumin and oxidative stress, increase antioxidant capacity and alleviate renal function damage in patients with DN, and this will provide a reference for the selection of treatment drugs for DN.
Remote interviews for medical residency selection during the initial COVID-19 crisis: a national survey
Authors: Temsah Mohamad-Hani , Alkhattabi Fadiah , Aljamaan Fadi , Alhasan Khalid , Alherbish Adi , Philby Mona , Alsohime Fahad , Alobaylan Mohamad , Alabdulkarim Hayfa , Almosned Badr , Gashgarey Deema , Felimban Ghadah , Alkathiri Ziyad , Almaghrabi Randa , Jamal Amr , Barry Mazin , Alhaider Sami A. , Alsaywid Basim , Bashiri Fahad A.
Published: August 2021

Background

Medical training programs candidate’s interview is an integral part of the residency matching process. During the coronavirus disease 2019 (COVID-19) pandemic, conducting these interviews was challenging due to infection prevention restrains (social distancing, namely) and travel restrictions. E-interviews were implemented by the Saudi Commission for Healthcare Specialties (SCFHS) since the matching cycle of March 2020 to hold the interviews in a safer virtual environment while maintaining the same matching quality and standards.

Aim

This study was conducted to assess the medical training residency program applicants’ satisfaction, stress, and other perspectives for the (SCFHS) March 2020 Matching-cycle conducted through an urgently implemented E-interviews process.

Method

A cross-sectional, nationwide survey (Additional file 1) was sent to 4153 residency-nominated applicants to the (SCFHS) March 2020 cycle.

Results

Among the 510 candidates who responded, 62.2% applied for medical specialties, 20.2% applied for surgical specialties, and 17.6% applied for critical care and emergency specialties. Most respondents (61.2%) never had previous experience with web-based video conferences. Most respondents (80.2%) used the Zoom application to conduct the current E-interviews, whereas only 15.9% used the FaceTime application. 63.3% of the respondents preferred E-interviews over in-person interviews, and 60.6% rated their experience as very good or excellent. 75.7% of the respondents agreed that all their residency program queries were adequately addressed during the E-interviews. At the same time, 52.2% of them agreed that E-interviews allowed them to represent themselves accurately. 28.2% felt no stress at all with their E-interviews experience, while 41.2% felt little stressed and only 8.2% felt highly stressed. The factors that were independently and inversely associated with applicants’ level of stress with E-interviews experience were their ability to represent themselves during the interviews (p = 0.001), cost-savings (p < 0.001), their overall rating of the E-interviews quality (p = 0.007) and the speed of the internet connection (p < 0.006).

Conclusion

Videoconferencing was implemented on an urgent basis during the COVID-19 pandemic in the medical residency application process in Saudi Arabia. It was perceived as an adequate and promising tool to replace in-person interviews in the future. Applicants’ satisfaction was mainly driven by good organization, cost-saving, and their ability to present themselves. Future studies to enhance this experience are warranted.
Identifying associations between health services operational factors and health experience for patients with type 2 diabetes in Iran
Authors: Mahdavi Mahdi , Parsaeian Mahboubeh , Borzouei Shiva , Majdzadeh Reza
Published: August 2021

Background

Facing limited health resources, healthcare providers need to rely on health service delivery models that produce the best clinical outcomes and patient experience. We aimed to contribute to developing a patient experience-based type 2 diabetes service delivery model by identifying operational structures and processes of care that were associated with clinical outcome, health experience, and service experience.

Methods

We conducted a cross-sectional survey of type 2 diabetes patients between January 2019 to February 2020. Having adjusted for demand variables, we examined relationships between independent variables (behaviours, services/processes, and structures) and three categories of dependent variables; clinical outcomes (HbA1c and fasting blood glucose), health experience (EuroQol quality of life (EQ-5D), evaluation of quality of life (visual analgene scale of EQ-5D), and satisfaction with overall health status), and service experience (evaluation of diabetes services in comparison with worst and best imaginable diabetes services and satisfaction with diabetes services). We analysed data using multivariate linear regression models using Stata software.

Results

After adjusting for demand variables; structures, diabetes-specific health behaviours, and processes explained up to 22, 12, and 9% of the variance in the outcomes, respectively. Based on significant associations between the diabetes service operations and outcomes, the components of an experience-based service delivery model included the structural elements (continuity of care, redistribution of task to low-cost resources, and improved access to provider), behaviours (improved patient awareness and adherence), and process elements (reduced variation in service utilization, increased responsiveness, caring, comprehensiveness of care, and shared decision-making).

Conclusions

Based on the extent of explained variance and identified significant variables, health services operational factors that determine patient-reported outcomes for patients with type 2 diabetes in Iran were identified, which focus on improving continuity of care and access to providers at the first place, improving adherence to care at the second, and various operational process variables at the third place.
Single-cell analysis of cell fate bifurcation in the chordate Ciona
Authors: Winkley Konner M. , Reeves Wendy M. , Veeman Michael T.
Published: August 2021

Background

Inductive signaling interactions between different cell types are a major mechanism for the further diversification of embryonic cell fates. Most blastomeres in the model chordate Ciona robusta become restricted to a single predominant fate between the 64-cell and mid-gastrula stages. The deeply stereotyped and well-characterized Ciona embryonic cell lineages allow the transcriptomic analysis of newly established cell types very early in their divergence from sibling cell states without the pseudotime inference needed in the analysis of less synchronized cell populations. This is the first ascidian study to use droplet scRNAseq with large numbers of analyzed cells as early as the 64-cell stage when major lineages such as primary notochord first become fate restricted.

Results and conclusions

We identify 59 distinct cell states, including new subregions of the b-line neural lineage and the early induction of the tail tip epidermis. We find that 34 of these cell states are directly or indirectly dependent on MAPK-mediated signaling critical to early Ciona patterning. Most of the MAPK-dependent bifurcations are canalized with the signal-induced cell fate lost upon MAPK inhibition, but the posterior endoderm is unique in being transformed into a novel state expressing some but not all markers of both endoderm and muscle. Divergent gene expression between newly bifurcated sibling cell types is dominated by upregulation in the induced cell type. The Ets family transcription factor Elk1/3/4 is uniquely upregulated in nearly all the putatively direct inductions. Elk1/3/4 upregulation together with Ets transcription factor binding site enrichment analysis enables inferences about which bifurcations are directly versus indirectly controlled by MAPK signaling. We examine notochord induction in detail and find that the transition between a Zic/Ets-mediated regulatory state and a Brachyury/FoxA-mediated regulatory state is unexpectedly late. This supports a “broad-hourglass” model of cell fate specification in which many early tissue-specific genes are induced in parallel to key tissue-specific transcriptional regulators via the same set of transcriptional inputs.
Inhibition of HDAC1 alleviates monocrotaline-induced pulmonary arterial remodeling through up-regulation of miR-34a
Authors: Li Fangwei , Wang Dan , Wang Hong , Chen Lijun , Sun Xilu , Wan Yixin
Published: August 2021

Background

It has been found that up-regulation of histone deacetylases 1 (HDAC1) is involved in the development of pulmonary arterial hypertension (PAH). However, it is still unclear whether inhibition of HDAC1 suppresses the development of PAH via restoring miR-34a level in monocrotaline (MCT)-induced PAH rats.

Methods

PAH rat models were induced by intraperitoneal injection of MCT. HDAC1 was suppressed by intraperitoneal injection of the class I HDAC inhibitor MS-275, and miR-34a was over-expressed via tail vein injection of miR-34a agomiR.

Results

HDAC1 protein was significantly increased in MCT-induced PAH rats; this was accompanied with down-regulation of miR-34a and subsequent up-regulation of matrix metalloproteinase 9 (MMP-9)/tissue inhibitor of metalloproteinase 1 (TIMP-1) and MMP-2/TIMP-2. Administration of PAH rats with MS-275 or miR-34a agomiR dramatically abolished MCT-induced reduction of miR-34a and subsequent up-regulation of MMP-9/TIMP-1 and MMP-2/TIMP-2, finally reduced extracellular matrix (ECM) accumulation, pulmonary arterial remodeling, right ventricular systolic pressure (RVSP) and right ventricle hypertrophy index (RVHI) in PAH rats.

Conclusions

HDAC1 contributes to the development of MCT-induced rat PAH by suppressing miR-34a level and subsequently up-regulating the ratio of MMP-9/TIMP-1 and MMP-2/TIMP-2. Inhibition of HDAC1 alleviates pulmonary arterial remodeling and PAH through up-regulation of miR-34a level and subsequent reduction of MMP-9/TIMP-1 and MMP-2/TIMP-2, suggesting that inhibition of HDAC1 might have potential value in the management of PAH.
Asthmatic allergen inhalation sensitises carotid bodies to lysophosphatidic acid
Authors: Jendzjowsky Nicholas G. , Roy Arijit , Wilson Richard J. A.
Published: August 2021

The carotid bodies are multimodal sensors that regulate various autonomic reflexes. Recent evidence demonstrates their role in immune reflex regulation. Our previous studies using the allergen (ovalbumin) sensitised and exposed Brown Norway rat model of asthma suggest that carotid bodies mediate asthmatic bronchoconstriction through a lysophosphatidic acid (LPA) receptor (LPAr)-protein kinase C epsilon (PKCε)-transient receptor potential vanilloid one channel (TRPV1) pathway. Whilst naïve carotid bodies respond to LPA, whether their response to LPA is enhanced in asthma is unknown. Here, we show that asthmatic sensitisation of Brown Norway rats involving repeated aerosolised allergen challenges over 6 days, results in an augmentation of the carotid bodies’ acute sensitivity to LPA. Increased expression of LPAr in the carotid bodies and petrosal ganglia likely contributed to this sensitivity. Importantly, allergen sensitisation of the carotid bodies to LPA did not alter their hypoxic response, nor did hypoxia augment LPA sensitivity acutely. Our data demonstrate the ability of allergens to sensitise the carotid bodies, highlighting the likely role of the carotid bodies and blood-borne inflammatory mediators in asthma.
Efficacy of wrist robot-aided orthopedic rehabilitation: a randomized controlled trial
Authors: Albanese Giulia Aurora , Taglione Elisa , Gasparini Cecilia , Grandi Sara , Pettinelli Foebe , Sardelli Claudio , Catitti Paolo , Sandini Giulio , Masia Lorenzo , Zenzeri Jacopo
Published: August 2021

Background

In recent years, many studies focused on the use of robotic devices for both the assessment and the neuro-motor reeducation of upper limb in subjects after stroke, spinal cord injuries or affected by neurological disorders. Contrarily, it is still hard to find examples of robot-aided assessment and rehabilitation after traumatic injuries in the orthopedic field. However, those benefits related to the use of robotic devices are expected also in orthopedic functional reeducation.

Methods

After a wrist injury occurred at their workplace, wrist functionality of twenty-three subjects was evaluated through a robot-based assessment and clinical measures (Patient Rated Wrist Evaluation, Jebsen-Taylor and Jamar Test), before and after a 3-week long rehabilitative treatment. Subjects were randomized in two groups: while the control group (n = 13) underwent a traditional rehabilitative protocol, the experimental group (n = 10) was treated replacing traditional exercises with robot-aided ones.

Results

Functionality, assessed through the function subscale of PRWE scale, improved in both groups (experimental p = 0.016; control p < 0.001) and was comparable between groups, both pre (U = 45.5, p = 0.355) and post (U = 47, p = 0.597) treatment. Additionally, even though groups’ performance during the robotic assessment was comparable before the treatment (U = 36, p = 0.077), after rehabilitation the experimental group presented better results than the control one (U = 26, p = 0.015).

Conclusions

This work can be considered a starting point for introducing the use of robotic devices in the orthopedic field. The robot-aided rehabilitative treatment was effective and comparable to the traditional one. Preserving efficacy and safety conditions, a systematic use of these devices could lead to decrease human therapists’ effort, increase repeatability and accuracy of assessments, and promote subject’s engagement and voluntary participation. Trial Registration ClinicalTrial.gov ID: NCT04739644. Registered on February 4, 2021—Retrospectively registered, https://www.clinicaltrials.gov/ct2/show/study/NCT04739644.
Still a place for aortic counterpulsation in cardiac surgery and patients with cardiogenic shock?
Authors: Heringlake Matthias , Berggreen Astrid Ellen , Paarmann Hauke
Published: August 2021

This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2021. Other selected articles can be found online at https://www.biomedcentral.com/collections/annualupdate2021. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from https://link.springer.com/bookseries/8901.
Monitoring and modifying brain oxygenation in patients at risk of hypoxic ischaemic brain injury after cardiac arrest
Authors: Skrifvars Markus Benedikt , Sekhon Mypinder , Åneman Erik Anders
Published: August 2021

This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2021. Other selected articles can be found online at https://www.biomedcentral.com/collections/annualupdate2021. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from https://link.springer.com/bookseries/8901.
Impact of the HLA-DRB1 shared epitope on responses to treatment with tofacitinib or abatacept in patients with rheumatoid arthritis
Authors: Hirose Wataru , Harigai Masayoshi , Amano Koichi , Hidaka Toshihiko , Itoh Kenji , Aoki Kazutoshi , Nakashima Masahiro , Nagasawa Hayato , Komano Yukiko , Nanki Toshihiro ,   for the TOF-ABT Study Group, Akiyama Yuji , Ando Souichirou , Hashiba Yayoi , Kaneko Motohide , Kawagoe Mitsuhiro , Kondo Tsuneo , Kubo Kazuyoshi , Masuda Ikuko , Matsumoto Mitsuyo , Okada Yusuke , Shibata Akiko , Suzuki Kimihiro , Takamatsu Ko , Takei Hirofumi
Published: August 2021

Objectives

The aim of this study was to compare the clinical effectiveness of tofacitinib and abatacept and clarify the impact of the HLA-DRB1 shared epitope (SE) on responses to these treatments in patients with rheumatoid arthritis (RA).

Methods

After adjustments by propensity score matching, 70 out of 161 patients receiving tofacitinib and 70 out of 131 receiving abatacept were extracted. The clinical effectiveness of both drugs over 24 weeks and the impact of the copy numbers of SE on effectiveness outcomes were investigated.

Results

The percentage of patients in remission in the 28-joint count disease activity score using the erythrocyte sedimentation rate (DAS28-ESR) did not significantly differ between patients receiving tofacitinib and abatacept at week 24 (32% vs 37%,p= 0.359). The mean change at week 4 in DAS28-ESR from baseline was significantly greater in patients receiving tofacitinib than in those receiving abatacept (− 1.516 vs − 0.827,p= 0.0003). The percentage of patients in remission at week 4 was 30% with tofacitinib and 15% with abatacept (p= 0.016). When patients were stratified by the copy numbers of SE alleles, differences in these numbers did not affect DAS28-ESR scores of patients receiving tofacitinib. However, among patients receiving abatacept, DAS28-ESR scores were significantly lower in patients carrying 2 copies of SE alleles than in those carrying 0 copies at each time point throughout the 24-week period. Furthermore, the percentage of patients in remission with DAS28-ESR at week 24 was not affected by the copy numbers of SE alleles in patients receiving tofacitinib (p= 0.947), whereas it significantly increased as the copy numbers became higher in patients receiving abatacept (p= 0.00309). Multivariable logistic regression analyses showed a correlation between the presence of SE and DAS28-ESR remission in patients receiving abatacept (OR = 25.881, 95% CI = 3.140–213.351,p= 0.0025), but not in those receiving tofacitinib (OR = 1.473, 95% CI = 0.291–7.446,p= 0.639).

Conclusions

Although the clinical effectiveness of tofacitinib and abatacept was similar at week 24, tofacitinib was superior to abatacept for changes from baseline in DAS28-ESR and the achievement of remission at week 4. SE positivity was associated with the achievement of DAS28-ESR remission by week 24 in patients receiving abatacept, but not in those receiving tofacitinib.
Detection of dementia on voice recordings using deep learning: a Framingham Heart Study
Authors: Xue Chonghua , Karjadi Cody , Paschalidis Ioannis Ch. , Au Rhoda , Kolachalama Vijaya B.
Published: August 2021

Background

Identification of reliable, affordable, and easy-to-use strategies for detection of dementia is sorely needed. Digital technologies, such as individual voice recordings, offer an attractive modality to assess cognition but methods that could automatically analyze such data are not readily available.

Methods and findings

We used 1264 voice recordings of neuropsychological examinations administered to participants from the Framingham Heart Study (FHS), a community-based longitudinal observational study. The recordings were 73 min in duration, on average, and contained at least two speakers (participant and examiner). Of the total voice recordings, 483 were of participants with normal cognition (NC), 451 recordings were of participants with mild cognitive impairment (MCI), and 330 were of participants with dementia (DE). We developed two deep learning models (a two-level long short-term memory (LSTM) network and a convolutional neural network (CNN)), which used the audio recordings to classify if the recording included a participant with only NC or only DE and to differentiate between recordings corresponding to those that had DE from those who did not have DE (i.e., NDE (NC+MCI)). Based on 5-fold cross-validation, the LSTM model achieved a mean (±std) area under the receiver operating characteristic curve (AUC) of 0.740 ± 0.017, mean balanced accuracy of 0.647 ± 0.027, and mean weighted F1 score of 0.596 ± 0.047 in classifying cases with DE from those with NC. The CNN model achieved a mean AUC of 0.805 ± 0.027, mean balanced accuracy of 0.743 ± 0.015, and mean weighted F1 score of 0.742 ± 0.033 in classifying cases with DE from those with NC. For the task related to the classification of participants with DE from NDE, the LSTM model achieved a mean AUC of 0.734 ± 0.014, mean balanced accuracy of 0.675 ± 0.013, and mean weighted F1 score of 0.671 ± 0.015. The CNN model achieved a mean AUC of 0.746 ± 0.021, mean balanced accuracy of 0.652 ± 0.020, and mean weighted F1 score of 0.635 ± 0.031 in classifying cases with DE from those who were NDE.

Conclusion

This proof-of-concept study demonstrates that automated deep learning-driven processing of audio recordings of neuropsychological testing performed on individuals recruited within a community cohort setting can facilitate dementia screening.
Aggrandizement of fermented cucumber through the action of autochthonous probiotic cum starter strains of Lactiplantibacillus plantarum and Pediococcus pentosaceus
Authors: Ahmed Sadia , Ashraf Fatima , Tariq Muhammad , Zaidi Arsalan
Published: August 2021

Purpose

Cucumber fermentation is traditionally done using lactic acid bacteria. The involvement of probiotic cultures in food fermentation guarantees enhanced organoleptic properties and protects food from spoilage.

Methods

Autochthonous lactic acid bacteria were isolated from spontaneously fermented cucumber and identified to species level. Only strains adjudged as safe for human consumption were examined for their technological and functional characteristics. Strain efficiency was based on maintaining high numbers of viable cells during simulated GIT conditions and fermentation, significant antioxidant activity, EPS production, nitrite degradation, and antimicrobial ability against Gram-positive and Gram-negative foodborne pathogens.

Result

Two strains, Lactiplantibacillus plantarum NPL 1258 and Pediococcus pentosaceus NPL 1264, showing a suite of promising functional and technological attributes, were selected as a mixed-species starter for carrying out a controlled lactic acid fermentations of a native cucumber variety. This consortium showed a faster lactic acid-based acidification with more viable cells, at 4% NaCl and 0.2% inulin (w/v) relative to its constituent strains when tested individually. Sensory evaluation rated the lactofermented cucumber acceptable based on texture, taste, aroma, and aftertaste.

Conclusion

The results suggest that the autochthonous LAB starter cultures can shorten the fermentation cycle and reduce pathogenic organism’ population, thus improving the shelf life and quality of fermented cucumber. The development of these new industrial starters would increase the competitiveness of production and open the country’s frontiers in the fermented vegetable market.
Biodegradation of p-nitrophenol by engineered strain
Authors: Xu Jing , Wang Bo , Zhang Wen-hui , Zhang Fu-Jian , Deng Yong-dong , Wang Yu , Gao Jian-Jie , Tian Yong-Sheng , Peng Ri-He , Yao Quan-Hong
Published: August 2021

p-Nitrophenol (PNP) is an important environmental pollutant and can causes significant environmental and health risks. Compared with the traditional methods, biodegradation is a useful one to completely remove the harmful pollutants from the environment. Here, an engineered strain was first constructed by introducing PNP biodegradation pathway via the hydroquinone (HQ) pathway into Escherichia coli. In the engineered strain BL-PNP, PNP was completely degraded to β-ketoadipate and subsequently enter the metabolites of multiple anabolic pathways. The high tolerance and rapid degradation ability to PNP enable the engineered strain to have the potential to degrade toxic substances. The engineered strain created in this study can be used as a functional strain for bioremediation of PNP and potential toxic intermediates, and the method of assembling aromatic hydrocarbons metabolic pathway can be used to eradicate nitroaromatic pollutants in the environment.
Mathematical model of survival of fractional calculus, critics and their impact: How singular is our world?
Authors: Atangana Abdon
Published: August 2021

Fractional calculus as was predicted by Leibniz to be a paradox, has nowadays evolved to become a centre of interest for many researchers from various backgrounds. As a result, multiple innovative ideas had emerged, which caused significant divisions regarding fractional calculus in the past three years. Therefore, this work is aimed at developing a mathematical model that could be used to depict the survival of fractional calculus. Six classes are herein considered to construct a mathematical model with six ordinary differential equations. All elementary analysis have been performed. Additionally, a new analysis including strength number that accounts for the accelerative information of nonlinear and linear parts of a given epidemiological model is introduced. An analysis of the second derivative of the Lyapunov function as well as an analysis of the second derivative of each class is applied to assess how a wave could be detected. It is strongly believed that this new analysis will particularly open new doors within the field of epidemiological modelling, which will aid researchers to better understand the spread of infectious diseases. The stochastic version of the suggested model was also investigated, and numerical simulations were performed. The obtained reproductive number, strength number, extinction of criticism together with numerical simulation, revealed that the field of fractional calculus will be stable will therefore have no significant effect soon.
Predictability of polygenic risk score for progression to dementia and its interaction with APOE ε4 in mild cognitive impairment
Authors: Pyun Jung-Min , Park Young Ho , Lee Keon-Joo , Kim SangYun , Saykin Andrew J. , Nho Kwangsik ,   for the Alzheimer’s Disease Neuroimaging Initiative
Published: August 2021

Background

The combinatorial effect of multiple genetic factors calculated as a polygenic risk score (PRS) has been studied to predict disease progression to Alzheimer’s disease (AD) from mild cognitive impairment (MCI). Previous studies have investigated the performance of PRS in the prediction of disease progression to AD by including and excluding single nucleotide polymorphisms within the region surrounding the APOE gene. These studies may have missed the APOE genotype-specific predictability of PRS for disease progression to AD.

Methods

We analyzed 732 MCI from the Alzheimer’s Disease Neuroimaging Initiative cohort, including those who progressed to AD within 5 years post-baseline (n = 270) and remained stable as MCI (n = 462). The predictability of PRS including and excluding the APOE region (PRS+APOE and PRS−APOE) on the conversion to AD and its interaction with the APOE ε4 carrier status were assessed using Cox regression analyses.

Results

PRS+APOE (hazard ratio [HR] 1.468, 95% CI 1.335–1.615) and PRS−APOE (HR 1.293, 95% CI 1.157–1.445) were both associated with a significantly increased risk of MCI progression to dementia. The interaction between PRS+APOE and APOE ε4 carrier status was significant with a P-value of 0.0378. The association of PRSs with the progression risk was stronger in APOE ε4 non-carriers (PRS+APOE: HR 1.710, 95% CI 1.244–2.351; PRS−APOE: HR 1.429, 95% CI 1.182–1.728) than in APOE ε4 carriers (PRS+APOE: HR 1.167, 95% CI 1.005–1.355; PRS−APOE: HR 1.172, 95% CI 1.020–1.346).

Conclusions

PRS could predict the conversion of MCI to dementia with a stronger association in APOE ε4 non-carriers than APOE ε4 carriers. This indicates PRS as a potential genetic predictor particularly for MCI with no APOE ε4 alleles.
Signs of a new geomagnetic jerk between 2019 and 2020 from Swarm and observatory data
Authors: Pavón-Carrasco F. Javier , Marsal Santiago , Campuzano Saioa A. , Torta J. Miquel
Published: August 2021

Following the observed pattern of a new geomagnetic jerk every 3–4 years, certain predictions suggested that a new event should occur around 2020 after the one observed around 2017.5. In this work, we explore this scenario by analysing the secular variation of the East geomagnetic field component in both ground and satellite geomagnetic data. At ground, we use the available data from 2015 to 2021 in 10 observatories worldwide distributed. This analysis shows the occurrence of the mentioned jerk in mid-2017 at observatories located in the Pacific region, but also reveals a new jerk between mid-2019 and early 2020 with a clear global character. Swarm satellite data also corroborate these findings by means of the secular variation estimated using virtual observatories at 440 km altitude. In addition, a general view using the most recent CHAOS geomagnetic model confirms the global character of the 2020-jerk with V-shaped secular variation changes in meridional sectors covering the Eastern Pacific, America, Asia and the Indian Ocean; and Λ-shapes in Europe, Africa and Western Pacific. The radial geomagnetic field at the core–mantle boundary is investigated as the origin of the new jerk. Results show that the global-average secular acceleration of the radial field exhibits a new pulse at mid-2018, establishing the starting epoch of the 2020-jerk.
Investigations on the occurrence of a muscular disorder in Austrian slaughter pigs
Authors: Schwarz Lukas , Schöner Carolin , Brunthaler Rene , Weissenböck Herbert , Bernreiter-Hofer Tanja , Wallner Barbara , Ladinig Andrea
Published: August 2021

Background

In slaughterhouse, veterinarians responsible for meat inspection are often confronted with abnormalities in carcasses, not only in pigs but in all livestock species. In 2017, a veterinarian responsible for meat inspection in a slaughterhouse in Styria, Austria, observed gluteal muscles infiltrated by fat and muscle tissue obviously being replaced by fat in two different slaughter pigs. These muscles were sent for further diagnostics to the University Clinic for Swine.

Results

The two muscle samples were investigated histopathologically and diagnosed with fatty muscular dystrophy. The results of routine histopathology were confirmed by dystrophin-specific immunohistochemistry. Sex of the two affected animals was determined retrospectively using a PCR-based protocol and resulted in one male and one female pig. A survey to determine the prevalence of fatty muscular disorders of pork revealed that this phenomenon gets frequently observed in Styria, but also occurs in Upper Austria and Lower Austria. Mostly gluteal and lumbal muscles were affected and approximately 20–40% of the affected muscles were replaced by fat.

Conclusions

Fatty muscular dystrophy or muscular steatosis, as it was sometimes called in early literature, seems not to be an uncommon and rare event and is known to have several different causes. As it was detected in both sexes, our observations are different to the described case in Japan, where only one male individual was affected. To avoid further increase of such cases (fatty muscular dystrophy), it would be useful to clarify the cause. First, whether the cause is environmental or genetic, and in case it is genetic it would be key to disentangle the underlying genomic architecture. Having causal variants described—one could think about integrating this information (depending on the mode of inheritance and the number of loci involved) in the breeding program of pigs. Furthermore, the proportion of non-Austrian pig genetics used for commercial pig production in Austria should be reviewed in order to be able to make reliable statements about the spread of the disease not only in Austrian pig breeds, but also in pig breeds worldwide.
Contrast-enhanced mammography in comparison with dynamic contrast-enhanced MRI: which modality is appropriate for whom?
Authors: Kamal Rasha , Mansour Sahar , Farouk Amr , Hanafy Mennatallah , Elhatw Ahmed , Goma Mohammed Mohammed
Published: August 2021

Background

Dynamic contrast-enhanced MRI (DCE-MRI) is a revolution regarding screening and diagnosis of breast cancer. Yet, sometimes it is not the appropriate choice of imaging since the examination needs to be scheduled and may take place in another department. Contrast-enhanced mammography (CEM) is contrast-based digital mammogram, and consequently, it has emerged as a potential and promising replacer to DCE-MRI.

Main body of the abstract

There is a frequently asked question during the multidisciplinary breast cancer tumor boards is: which modality is more appropriate to be used in each clinical scenario? This article provided a detailed understanding of these two modalities in order to achieve a successful implementation of them into the clinical practice. Which modality to start with, in the context of thedetection(screening) followed by characterization ordiagnosisof the identified lesions? What is the appropriate application of both modalities inlocal stagingandfollow-up? All of these issues would be discussed in this article.

Short conclusion

MRI is a safe tool for breast imaging and has a superior diagnostic performance compared to CEM. However, CEM is getting close: this lies in its accessibility, short-time procedure, requirement of less training and feasibility to standardize.
Hyperspectral fluorescence imaging: Robust detection of petroleum in porous sedimentary rock formations
Authors: Gadea Otto Charles Anthony , Khan Shuhab Danishwar
Published: August 2021

Examining hand samples can be a necessary step for geologic studies, and effective mapping of such samples can be achieved through the high spectral and spatial resolutions of ground-based hyperspectral imaging (HSI) at the millimeter to centimeter scale. We have developed a simple approach to crude oil identification and characterization — feasible in 16 h — based on hyperspectral data collected under ultraviolet (UV) lighting and normalized with respect to the fluorescence patterns of the Spectralon diffuse reflectance material. The samples under consideration were extracted from a core acquired from an Early Cretaceous bituminous sandstone formation in the Athabasca Basin located near Fort McMurray, Alberta, Canada. This basin contains the largest natural bitumen deposit in the world, where surface mining operations currently are viable only for approximately 20% of the estimated 164 billion barrels of total recoverable oil reserves. This deposit is unique in that its tar sands are water-wet, which facilitates the separation of bitumen from the sandstone via water-based gravity separation. However, large amounts of water are still required for oil recovery; therefore, a fast and reliable way to mark portions of the deposit where ample petroleum has accumulated and assess its extractability based on its physical characteristics prior to mining can be helpful for optimizing resource usage. For this reason, we test and visually develop the ability of three classification methods — the spectral angle mapper, support vector machine, and supervised neural network — to distinguish among bitumen, Spectralon, and a nonfluorescent slate background based on the emission of visible light in response to absorbing UV light of different wavelengths. We also adopt spectral indices useful for indicating concentrated bitumen in tar sands. Errors inherent to the methodology are discussed along with ways to mitigate them. After accounting for these, HSI can be a valuable asset alongside other techniques used for production economics evaluation.