bluuebunny/crossref_metadata_2025 huggingface dataset:
Stent placement to prevent strictures after esophageal endoscopic submucosal dissection: a systematic review and meta-analysis
Authors: Zhang Bao-zhen , Zhang Yue , Wang Yi-dan , Liao Ye , Zhang Jing-jing , Wu Yu-fan , Xiao Ting-yue , Sun Si-yu , Guo Jin-tao
Published: March 2021

Endoscopic submucosal dissection (ESD) is an important method for the treatment of early esophageal cancer. However, post-procedure stenosis is one of the most common long-term complications. This meta-analysis aimed to investigate whether stent placement is effective in the stenosis prevention, and which type of stent would be more effective. A systematic and electronic search of clinical trials and observational studies conducted before March 2020 on the efficacy of stent placement in preventing esophageal stricture after ESD was performed. Search terms included “ESD,” “esophageal stenosis,” “esophageal stricture,” and “stents.” We conducted a bias risk assessment of the eligible reports and a meta-analysis of the data using Revman 5.3 software. We included two randomized controlled trials (RCTs) and a prospective cohort study involving 163 patients with esophageal mucosal defects encompassing at least three-quarters of the esophagus circumference after ESD. The meta-analysis results showed that post-ESD stenosis rates (RR, 0.37; 95% CI, 0.22–0.64; P = 0.0003) and the number of endoscopic balloon dilations (EBDs) (MD, −1.74; 95% CI, −2.46 to −1.01; P < 0.00001) were reduced in the pooled analysis of three studies, indicating that stent placement was effective for stenosis prevention, especially a polyglycolic acid (PGA) sheet combined with stent placement can prevent stenosis (RR, 0.41; 95% CI, 0.23–0.74; P = 0.003) and reduce the number of EBDs (MD, −1.65; 95% CI, −2.40 to −0.90; P < 0.0001) significantly. Stent placement can reduce the rate of esophageal stenosis after ESD, especially when stents are covered with PGA sheets. However, more high-quality, low-bias RCTs with a sufficient sample size are needed to demonstrate its effectiveness.
Blood culture negative infective endocarditis in adult congenital heart disease patients with prosthetic grafts: a case series
Authors: Lwin Myo Thidar , Tsoi Victor , Yam Tat , Carroll Aisling , Salmon Tony , Harden Stephen , Smith Lindsay
Published: March 2021

Background

Blood culture negative infective endocarditis (BCNIE) is often a diagnostic challenge in adult congenital heart disease patients leading to misdiagnosis, treatment delay and associated high mortality. Studies of BCNIE in adult congenital heart disease patients repaired with prosthetic cardiovascular grafts are limited.

Case summary

We report two cases of BCNIE where serology testing, multiple polymerase chain reaction testing of explanted valve material and multi-modality imaging including 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) were utilized not only to confirm the diagnosis but also to guide management strategy and inform prognosis. Both patients were treated successfully with cardiac surgery and prolonged anti-microbial therapy.

Discussion

Clinical presentation of BCNIE in repaired CHD patients is highly variable. The symptoms are often non-specific with subacute or chronic presentation. This may mislead initial diagnosis and subsequent management. Multi-modality imaging including PET/CT should be considered to support the diagnosis, define the extent of infection, decide the management strategy and inform prognosis in patients. A thorough history of animal exposure, and consideration of serology and multiple molecular testing to identify the causative organism, is critical in the management of BCNIE.
Rapid reviews: the pros and cons of an accelerated review process
Authors: Moons Philip , Goossens Eva , Thompson David R.
Published: March 2021

Although systematic reviews are the method of choice to synthesize scientific evidence, they can take years to complete and publish. Clinicians, managers, and policy-makers often need input from scientific evidence in a more timely and resource-efficient manner. For this purpose, rapid reviews are conducted. Rapid reviews are performed using an accelerated process. However, they should not be less systematic than standard systematic reviews, and the introduction of bias must be avoided. In this article, we describe what rapid reviews are, present their characteristics, give some examples, highlight potential pitfalls, and draw attention to the importance of evidence summaries in order to facilitate adoption in clinical decision-making.
Atrial fibrillation burden during the coronavirus disease 2019 pandemic
Authors: O’Shea Catherine J , Middeldorp Melissa E , Thomas Gijo , Harper Curtis , Elliott Adrian D , Ray Noemi , Campbell Kevin , Lau Dennis H , Sanders Prashanthan
Published: March 2021

Aims

The aim of this study is to determine the association between the coronavirus disease 2019 (COVID-19) pandemic and atrial fibrillation (AF) occurrence in individuals with cardiac implantable electronic devices (CIEDs).

Method and results

Multi-centre, observational, cohort study over a 100-day period during the COVID-19 pandemic (COVID-19) in the USA. Remote monitoring was used to assess AF episodes in patients with a CIED (pacemaker or defibrillator; 20 centres, 13 states). For comparison, the identical 100-day period in 2019 was used (Control). The primary outcomes were the AF burden during the COVID-19 pandemic, and the association of the pandemic with AF occurrence, as compared with 1 year prior. The secondary outcome was the association of AF occurrence with per-state COVID-19 prevalence. During COVID-19, 10 346 CIEDs with an atrial lead were monitored. There were 16 570 AF episodes of ≥6 min transmitted (16 events per 1000 patient days) with a significant increase in proportion of patients with AF episodes in high COVID-19 prevalence states compared with low prevalence states [odds ratio 1.34, 95% confidence interval (CI) 1.21–1.48, P < 0.001]. There were significantly more AF episodes during COVID-19 compared with Control [incident rate ratio (IRR) 1.33, 95% CI 1.25–1.40, P < 0.001]. This relationship persisted for AF episodes ≥1 h (IRR 1.65, 95% CI 1.53–1.79, P < 0.001) and ≥6 h (IRR 1.54, 95% CI 1.38–1.73, P < 0.001).

Conclusion

During the first 100 days of COVID-19, a 33% increase in AF episodes occurred with a 34% increase in the proportion of patients with AF episodes observed in states with higher COVID-19 prevalence. These findings suggest a possible association between pandemic-associated social disruptions and AF in patients with CIEDs.

Clinical TRIAL registration

Australian New Zealand Clinical Trial Registry: ACTRN12620000692932.
Identifying landslides from continuous seismic surface waves: a case study of multiple small-scale landslides triggered by Typhoon Talas, 2011
Authors: Okuwaki Ryo , Fan Wenyuan , Yamada Masumi , Osawa Hikaru , Wright Tim J
Published: March 2021

Landslides can cause devastating damage. In particular, heavy rainfall-triggered landslides pose a chain of natural hazards. However, such events are often difficult to detect, leaving the physical processes poorly understood. Here we apply a novel surface-wave detector to detect and locate landslides during the transit of Typhoon Talas 2011. We identify multiple landslides triggered by Typhoon Talas, including a landslide in the Tenryu Ward, Shizuoka prefecture, Japan, $\sim 400\, {\rm km}$ east from the typhoon track. The Tenryu landslide displaced a total volume of $1.2\!-\!1.5 \times 10^{6}\, {\rm m}^3$ . The landslide is much smaller than those detected by using globally recorded surface waves, yet the event generated coherent seismic signals propagating up to 3000 km away. Our observations show that attributes of small and large landslides may follow the same empirical scaling relationships, indicating possible invariant failure mechanisms. Our results also suggest an alerting technology to detect and locate landslides with a sparse seismic network.
A primer for initiation of commercialization of glycobiological discoveries
Authors: DeAngelis Paul L
Published: March 2021

In this age of translational science, blossoming biotechnology and increasingly elusive federal funding, a working knowledge of commercialization beyond typical academic training is necessary. Here, some issues and initial strategies to help principal investigators, postdoctoral fellows and students considering the route from discovery to invention to commercialization in the glycobiology field. Common myths are addressed, and tips and resources are provided to help start down this path.
Health sciences and inclusive pedagogy: a qualitative study exploring educational practices for students with disabilities at Spanish universities
Authors: Mori�a Anabel , Orozco Inmaculada
Published: March 2021

The number of people with disabilities who study at university is rising. Previous studies have revealed that it is not enough simply to provide these students with access to university, it is also important to guarantee their retention and success. This article explores participants’ actions and their appraisals of their teaching practice in relation to disability in campus-based education. The study was conducted with 19 Spanish faculty members from the Health Sciences who were nominated by their students with disabilities for having contributed to their inclusion. We carried out a qualitative study based on individual, in-depth, semi-structured interviews. We analysed the data progressively, using a system of categories and codes. The results section outlines the actions taken by faculty members upon learning that they were going to be teaching a student with disabilities, analysing what specific measures they took in accordance with the type of disability in question, and what they found most rewarding and most difficult or unpleasant about their experience with these students in the classroom. The study concludes that the voices of these faculty members may encourage other colleagues to rethink their actions in the classroom and engage in more inclusive practices.
Adult exposure to ocean acidification and warming leads to limited beneficial responses for oyster larvae
Authors: Gibbs Mitchell C , Parker Laura M , Scanes Elliot , Byrne Maria , O’Connor Wayne A , Ross Pauline M
Published: March 2021

There is a need to understand the responses of marine molluscs in this era of rapid climate change. Transgenerational plasticity that results in resilient offspring provides a mechanism for rapid acclimation of marine organisms to climate change. This study tested the hypothesis that adult parental exposure to elevated pCO2 and warming will have transgenerational benefits for offspring in the oysters Saccostrea glomerata and Crassostrea gigas. Adult S. glomerata and C. gigas were exposed to orthogonal treatments of ambient and elevated pCO2, and ambient and elevated temperature for 8 weeks. Gametes were collected and fertilized, larvae were then reared for 9 days under ambient and elevated pCO2. Egg lipidome and larval morphology and lipidome were measured. Parental exposure to warming and elevated pCO2 led to limited beneficial transgenerational responses for eggs and larvae of S. glomerata and C. gigas. Overall, larvae of S. glomerata were more sensitive than C. gigas, and both species had some capacity for transgenerational plasticity. This study supports the idea that transgenerational plasticity acts as an acclimatory mechanism for marine organisms to cope with the stress of climate change, but there are limitations, and it may not be a panacea or act equally in different species.
Status of Indian marine fish stocks: modelling stock biomass dynamics in multigear fisheries
Authors: Sathianandan T V , Mohamed Kolliyil Sunil , Jayasankar Jayaraman , Kuriakose Somy , Mini K G , Varghese Eldho , Zacharia P U , Kaladharan P , Najmudeen T M , Koya Mohammed K , Sasikumar Geetha , Bharti Vivekanand , Rohit Prathibha , Maheswarudu G , Sindhu K Augustine , Sreepriya V , Alphonsa Joseph , Deepthi A
Published: March 2021

A biomass dynamics modelling study to derive biological reference points and management requirements of 223 commercially important fish stocks in different maritime states of India was conducted. Two decades (1997–2016) of fishery-related data on the harvest of resources by different types of fishing fleets formed the input. The multigear nature of the fishery situation was solved by introducing a gear standardization parameter into the biomass dynamics model. The relative positions of the fish stocks were depicted through Kobe plots generated for the ten maritime states/union territory, and the fish stocks were categorized, based on the status, into sustainable, overfished, recovering, and overfishing. The results indicate that 34.1% of the assessed fish stocks in the country are sustainable, 36.3% are overfished, 26.5% are recovering, and 3.1% are in the overfishing status. Regionally, the percentage of sustainable fish stocks were high along the southwest coast (51.6%), overfished stocks were high along the northwest coast (54.2%), and recovering fish stocks were high along the northeast coast (47.8%). The national mean B/BMSY was estimated as 0.86, which is a strong reason for strengthening fisheries management. Fishing fleets harvesting overfished stocks were examined for each maritime state, and recommendations regarding reduction in annual fishing hours are made.
The personal is political: The feminist critique of liberalism and the challenge of right-wing populism
Authors: Stopler Gila
Published: March 2021

The recent democratic backsliding and the decline of liberal hegemony have generated different explanations for the turn away from liberal democracy. This article offers an explanation based on the feminist critique of structural and theoretical flaws within liberalism and argues that these flaws are used effectively by right-wing populism to endanger liberal democracy. Using feminist critiques of political liberalism, including critiques of the public/private and political/non-political distinctions, the article claims that the liberal choice to allow the flourishing of bigotry and intolerance in the private sphere and to require respect for equality only in the public sphere has made liberalism vulnerable to the right-wing populist attack. Political liberalism has rejected the feminist call to recognize that the personal is political and has relied on political institutions and processes as barriers against illiberalism. Liberal states applying these principles are therefore ill equipped to fight right-wing populists who rally their supporters around the promise to do away with political institutions and to let the populist leaders turn their private prejudices into public policy. The article calls for a redrawing of the lines between the political and non-political, and between the public and the private, to meet the challenge of right-wing populism.
Coupling kinetic models and advection–diffusion equations. 1. Framework development and application to sucrose translocation and metabolism in sugarcane
Authors: Uys Lafras , Hofmeyr Jan-Hendrik S , Rohwer Johann M
Published: March 2021

The sugarcane stalk, besides being the main structural component of the plant, is also the major storage organ for carbohydrates. Previous studies have modelled the sucrose accumulation pathway in the internodal storage parenchyma of sugarcane using kinetic models cast as systems of ordinary differential equations. To address the shortcomings of these models, which did not include subcellular compartmentation or spatial information, the present study extends the original models within an advection–diffusion–reaction framework, requiring the use of partial differential equations to model sucrose metabolism coupled to phloem translocation. We propose a kinetic model of a coupled reaction network where species can be involved in chemical reactions and/or be transported over long distances in a fluid medium by advection or diffusion. Darcy’s law is used to model fluid flow and allows a simplified, phenomenological approach to be applied to translocation in the phloem. Similarly, generic reversible Hill equations are used to model biochemical reaction rates. Numerical solutions to this formulation are demonstrated with time-course analysis of a simplified model of sucrose accumulation. The model shows sucrose accumulation in the vacuoles of stalk parenchyma cells, and is moreover able to demonstrate the upregulation of photosynthesis in response to a change in sink demand. The model presented is able to capture the spatio-temporal evolution of the system from a set of initial conditions by combining phloem flow, diffusion, transport of metabolites between compartments and biochemical enzyme-catalysed reactions in a rigorous, quantitative framework that can form the basis for future modelling and experimental design.
Retrospective Analysis of Quality Control Data Using Pooled Blood to Compare Agreement within Two Models of Blood Gas Analyzers
Authors: Toffaletti John G , Buckner Kelly A , Liu Beiyu , Green Cynthia L
Published: March 2021

Background

Two previous reports from the same group concluded that the analytical reliability of Instrumentation Laboratory GEM4000 analyzers (GEM4K) deteriorated during a 24-hour period, based on results between samples from the same patient but collected at different times. Our routine blood gas Between-Laboratory Survey is done every 2 weeks using a freshly pooled heparinized blood sample taken to each analyzer location to verify comparability among our GEM4K and Radiometer ABL90 (Rad90) blood gas analyzers. Because another report found a few very large differences in glucose results between the GEM4K and central laboratory analyzers, we reviewed the glucose results on plasma from our Chemistry Between-Laboratory Surveys that includes comparisons between our central laboratory analyzers (Beckman DxC800; DxC800) and our GEM4K and Rad90 blood gas analyzers.

Method

Using data from our Blood Gas and Chemistry Surveys over a 55-week period, we calculated the mean, standard deviation (SD), and concentration intervals of the 27 sets of results by the GEM4K or Rad90 analyzers. Agreement in plasma glucose between DxC800 and blood gas analyzers was evaluated by the limits of agreement and intraclass correlation coefficient analysis.

Results

For each analyte, the Rad90 had lower average SD than the GEM4K for the 55-week period, although both brands of analyzers showed acceptable performance. For plasma glucose results on our Chemistry Survey, the GEM4K results agreed more closely with the DxC800 results than the Rad90 results.

Conclusions

Based on both our Blood Gas and Chemistry Surveys, we conclude that both brands of analyzers performed within analytically and clinically acceptable limits throughout the year, with no evidence for the type of errors reported previously.
Transient performance of a solar humidification–dehumidification desalination system based on hollow fiber membrane
Authors: Zhang Ning , Yin Shao-You , Vafai Kambiz
Published: March 2021

Solar humidification–dehumidification desalination system based on hollow fiber membrane is a promising method to produce drinkable water from brine due to its abilities for low primary energy consumption and pollution prevention for the liquid seawater droplets. As operating conditions change with temporal weather conditions, a dynamic model of this desalination system is developed and experimentally validated in this study. Transient performance is investigated and a regulation strategy is proposed. It is found that the startup time can be reduced substantially by decreasing the mean pore diameter, porosity of the membrane, solar collector area, and volume of the seawater in the storage tank, and increasing the packing fractions of the humidifier. The specific freshwater production (SWP) rate at the equilibrium state grows with longer mean pore diameter, higher porosity of the membrane, more solar collector areas, and less packing fractions of the humidifier. SWP is basically constant with different volumes of the seawater in the storage tank. Variations of solar radiation cause the low freshwater production and high energy consumption especially in the morning and afternoon. Utilizing our model, the hour-by-hour adjustment is also established. The accumulated water production in 1 day can be increased by 13.5% and the energy consumption can decrease by over 23% based on decreasing flow rates of the seawater in the morning and increasing flow rates of the cooling water in the afternoon. The proposed dynamic model will be helpful for the daily regulation of the seawater desalination system and a better performance can be realized.
Knowledge-based relational search in cultural heritage linked data
Authors: Hyvönen Eero , Rantala Heikki
Published: March 2021

This article presents a new knowledge-based approach for finding interesting semantic relations between resources in a knowledge graph (KG). The idea is to characterize the notion of ‘interesting connection’ in terms of generic ontological explanation patterns that are applied to an underlying linked data repository to instantiate connections. In this way, (1) semantically uninteresting connections can be ruled out effectively and (2) natural language explanations about the connections can be created for the end-user. The idea has been implemented and tested based on a KG of biographical data extracted from the life stories of 13,144 prominent historical persons in Finland, enriched by data linking to collection databases of museums, libraries, and archives. The demonstrator is in use as part of the BiographySampo portal of interlinked biographies.
Stark broadening of Fe V spectral lines: 4s–4p transitions
Authors: Hamdi Rafik , Ben Nessib Nabil , Sahal-Bréchot Sylvie , Dimitrijević Milan S
Published: March 2021

Using the impact semiclassical perturbation approach, widths and shifts of the 4s–4p configuration of Fe V spectral line profiles due to collisions with electrons, H+, He+, and He2 + ions, have been calculated in the physical conditions of hot white dwarfs. Energy levels and oscillator strengths needed for the calculation have been obtained by using the Hartree–Fock method with relativistic corrections. The results may be of interest not only for spectroscopic diagnostics in astrophysics, but also for laboratory plasmas, and technological plasmas. The obtained results will enter the STARK-B data base which is in free access and which is a node of the Virtual Atomic and Molecular Data Center – VAMDC.
Report of National Brain Tumor Society roundtable workshop on innovating brain tumor clinical trials: building on lessons learned from COVID-19 experience
Authors: Lee Eudocia Q , Selig Wendy , Meehan Clair , Bacha Jeffrey , Barone Amy , Bloomquist Erik , Chang Susan M , de Groot John F , Galanis Evanthia , Hassan Islam , Kalidas Chitkala , Khasraw Mustafa , Kvedar Joseph C , Lassman Andrew B , Puduvalli Vinay , Sahebjam Solmaz , Schwamm Lee H , Tamir Sharon , Welch Mary , Yung W K Alfred , Zadeh Gelareh , Arons David , Wen Patrick Y
Published: March 2021

On July 24, 2020, a workshop sponsored by the National Brain Tumor Society was held on innovating brain tumor clinical trials based on lessons learned from the COVID-19 experience. Various stakeholders from the brain tumor community participated including the US Food and Drug Administration (FDA), academic and community clinicians, researchers, industry, clinical research organizations, patients and patient advocates, and representatives from the Society for Neuro-Oncology and the National Cancer Institute. This report summarizes the workshop and proposes ways to incorporate lessons learned from COVID-19 to brain tumor clinical trials including the increased use of telemedicine and decentralized trial models as opportunities for practical innovation with potential long-term impact on clinical trial design and implementation.
Over-projected Pacific warming and extreme El Niño frequency due to CMIP5 common biases
Authors: Tang Tao , Luo Jing-Jia , Peng Ke , Qi Li , Tang Shaolei
Published: March 2021

Extreme El Niño events severely disrupt the global climate, causing pronounced socio-economic losses. A prevailing view is that extreme El Niño events, defined by total precipitation or convection in the Niño3 area, will increase 2-fold in the future. However, this projected change was drawn without removing the potential impacts of Coupled Model Intercomparison Project phase 5 (CMIP5) models’ common biases. Here, we find that the models’ systematic biases in simulating tropical climate change over the past century can reduce the reliability of the projected change in the Pacific sea surface temperature (SST) and its related extreme El Niño frequency. The projected Pacific SST change, after removing the impacts of 13 common biases, displays a ‘La Niña-like’ rather than ‘El Niño-like’ change. Consequently, the extreme El Niño frequency, which is highly linked to the zonal distribution of the Pacific SST change, would remain mostly unchanged under CMIP5 warming scenarios. This finding increases confidence in coping with climate risks associated with global warming.
Psychiatric Comorbidity and Multimorbidity in the EAGLES Trial: Descriptive Correlates and Associations With Neuropsychiatric Adverse Events, Treatment Adherence, and Smoking Cessation
Authors: Correa John B , Lawrence David , McKenna Benjamin S , Gaznick Natassia , Saccone Phillip A , Dubrava Sarah , Doran Neal , Anthenelli Robert M
Published: March 2021

Introduction

Psychiatric and substance use disorders represent barriers to smoking cessation. We sought to identify correlates of psychiatric comorbidity (CM; 2 diagnoses) and multimorbidity (MM; 3+ diagnoses) among smokers attempting to quit and to evaluate whether these conditions predicted neuropsychiatric adverse events (NPSAEs), treatment adherence, or cessation efficacy (CE).

Aims and Methods

Data were collected from November 2011 to January 2015 across sixteen countries and reflect the psychiatric cohort of the EAGLES trial. Participants were randomly assigned to receive varenicline, bupropion, nicotine replacement therapy, or placebo for 12 weeks and were followed for an additional 12 weeks posttreatment. NPSAE outcomes reflected 16 moderate-to-severe neuropsychiatric symptom categories, and CE outcomes included continuous abstinence at weeks 9–12 and 9–24.

Results

Of the 4103 participants included, 36.2% were diagnosed with multiple psychiatric conditions (20.9% CM, 15.3% MM). Psychiatric CM and MM were associated with several baseline factors, including male gender, nonwhite race or ethnicity, more previous quit attempts, and more severe mental health symptoms. The incidence of moderate-to-severe NPSAEs was significantly higher (p < .01) in participants with MM (11.9%) than those with CM (5.1%) or primary diagnosis only (4.6%). There were no significant (ps > .05) main effects or interactions with treatment condition for diagnostic grouping on treatment adherence or CE outcomes.

Conclusions

While having multiple psychiatric diagnoses increased risk of developing moderate-to-severe NPSAEs during a quit attempt, neither CM nor MM were associated with treatment adherence or odds of quitting. These findings reassure providers to advise smokers with multiple stable psychiatric conditions to consider using Food and Drug Administration (FDA)-approved medications when trying to quit.

Implications

Psychiatric MM may be associated with development of NPSAEs when smokers make a medication-assisted quit attempt, but it does not appear to be differentially associated with medication compliance or efficacy. Prescribing healthcare professionals are encouraged to not only promote use of FDA-approved pharmacotherapies by smokers with complex psychiatric presentations, but also to closely monitor such smokers for neuropsychiatric side effects that may be related to their mental health conditions.

NCT #

NCT01456936.
Vitamin D Levels in Mother–Baby Pairs: A Cross-Sectional Prospective Study in a Rwandan Tertiary Hospital
Authors: Rutagarama Florent , Muganga Raymond , Konrad Katja , Teteli Raissa , Semakula Muhammed , Musafili Aimable , Laigong Paul , Mutesa Leon
Published: March 2021

Background

Exposure to the sunlight contributes largely to the production of vitamin D. However, vitamin D deficiency is a reality in tropical countries, despite enjoying enough sunlight, especially bearing women in their last trimester whose foetuses exclusively depend on their reserves. This work aimed at demonstrating the state of vitamin D in mother–baby pairs and associated factors in one of the University Hospitals in Rwanda.

Methods

This cross-sectional prospective study was performed on mother–baby pairs at Kigali University Hospital. Mother’s serum 25-hydroxyvitamin D levels were considered as outcomes compared with demographic, clinical and biological markers. Correlation analysis was conducted in order to assess the association between serum 25-hydroxyvitamin D levels for the couple mothers–babies.

Results

Approximately 38% of women and 65% of neonates had deficiency in 25-hydroxyvitamin D (<20 ng/ml). The use of a vitamin D rich diet within 24 h recall (p < 0.01) or 1 week recall (p < 0.001) before delivery was associated with appropriate vitamin D levels in mothers. Interestingly, a strong positive correlation was found between maternal and neonatal serum 25-hydroxyvitamin D levels (r = 0.760).

Conclusions

There was a high rate of vitamin D deficiency in mothers and their babies. Babies born from women with deficiency were likely to develop low levels of vitamin D. This stresses on the need to strengthen the interventions for preventing vitamin D deficiency in the couple mothers–babies such as supplement in vitamin D before and after delivery, improving the quality of meals and regular contact with sunlight.
The Molecular Mechanisms of Phytophthora infestans in Response to Reactive Oxygen Species Stress
Authors: Luo Xiumei , Tian Tingting , Bonnave Maxime , Tan Xue , Huang Xiaoqing , Li Zhengguo , Ren Maozhi
Published: March 2021

Reactive oxygen species (ROSs) are critical for the growth, development, proliferation, and pathogenicity of microbial pathogens; however, excessive levels of ROSs are toxic. Little is known about the signaling cascades in response to ROS stress in oomycetes such as Phytophthora infestans, the causal agent of potato late blight. Here, P. infestans was used as a model system to investigate the mechanism underlying the response to ROS stress in oomycete pathogens. Results showed severe defects in sporangium germination, mycelium growth, appressorium formation, and virulence of P. infestans in response to H2O2 stress. Importantly, these phenotypes mimic those of P. infestans treated with rapamycin, the inhibitor of target of rapamycin (TOR, 1-phosphatidylinositol-3-kinase). Strong synergism occurred when P. infestans was treated with a combination of H2O2 and rapamycin, suggesting that a crosstalk exists between ROS stress and the TOR signaling pathway. Comprehensive analysis of transcriptome, proteome, and phosphorylation omics showed that H2O2 stress significantly induced the operation of the TOR-mediated autophagy pathway. Monodansylcadaverine staining showed that in the presence of H2O2 and rapamycin, the autophagosome level increased in a dosage-dependent manner. Furthermore, transgenic potatoes containing double-stranded RNA of TOR in P. infestans (PiTOR) displayed high resistance to P. infestans. Therefore, TOR is involved in the ROS response and is a potential target for control of oomycete diseases, because host-mediated silencing of PiTOR increases potato resistance to late blight.
Yu ping feng san for pediatric allergic rhinitis
Authors: Liao Yong , Zhong Juan , Liu Shuqin , Dai Menglin , Liu Yang , Li Xinrong , Yang Yepeng , Zhang Dazheng , Lai Dan , Lu Tao , Zhang Qinxiu , Zhao Yu
Published: March 2021

Background:

The potential treatment effects and safety of Yu ping feng san (YPFS) for pediatric allergic rhinitis (PAR) patients have yet to be studied systematically.

Objectives:

To assess the effects and safety of YPFS for treat pediatric patients, allergic rhinitis.

Methods:

We systematically searched PubMed, EMBASE (Excerpta Medical Database), Cochrane library, Chinese Cochrane Centre's Controlled Trials Register platform, Wanfang Chinese Digital Periodical and Conference Database, China National Knowledge Infrastructure Database, and VIP Chinese Science, from inception dates to November 1, 2019. Randomized controlled trials (RCTs) were included. The risk of bias in the trials was assessed in accordance with the Cochrane Handbook, version 5.1.0. RevMan 5.3 software was used to perform a meta-analysis. Grading of Recommendations Assessment, Development and Evaluation methodology was applied to evaluate the evidence quality for each outcome. The quality of evidence for each outcome measurement was low for 4 outcomes and very low for 5 outcomes.

Results:

A total of 10 RCTs involving 1069 participants (3–15 years old) fulfilled the inclusion criteria. After exclusion, 8 RCTs were pooled for efficacy assessment. The overall efficacy evaluation result did not show benefit for the experimental group (relative risk 0.32, CI 95% 0.24–0.45; P = .98;) Investigation of variation of serum IgA, immunoglobulin E, IgG in three studies in 2 groups returned no statistical significance. YPFS gave relatively better safety (relative risk 0.29, CI 95% 0.14–0.58; P = .0005; Fig. S8, http://links.lww.com/MD/F751) and lower recurrence rates than did Western medical therapy.

Conclusions:

Current evidence cannot support the routine use of YPFS for treatment of PAR. This may be due to poor-quality study-design limitations of the included YPFS studies. Our data showed that the use of YPFS for PAR is relatively safe compared to Western medical therapy, but a conclusion could not be drawn because only 5 studies were analyzed. Every study suffered from some methodological limitation. Therefore, further large, rigorously-designed studies are necessary to determine conclusively the utility of YPFS in PAR.
Vitamin D supplementation and improvement of pneumonic children at a tertiary pediatric hospital in Egypt
Authors: Labib John Rene , Ibrahem Sally Kamal , Ismail Mohamed M. , Fatah Shaimaa A.M. Abd El , Sedrak Amal Samir , Attia Mona Adel Soliman , El-Hanafi Hadeel Mohammad , Kamel Mai Hamed
Published: March 2021

Background:

Despite the well-recognized effect of vitamin D in metabolism and homeostasis, there is now growing interest in its probable association with pneumonia. This study aims to supply vitamin D3 (Cholecalciferol) (100,000 IU) to pneumonic children to minimize the duration of illness and improve their outcome.

Methods:

A double-blinded, randomized, placebo-controlled trial was conducted in a Pediatric Cairo University affiliated hospital. An intervention arm (93 children) and a control arm (98 children), who had pneumonia with an insufficient or deficient level of vitamin D and whose parental permission was obtained, were enrolled in the trial. All children were treated with antibiotics according to WHO guidelines. Children were given a single injection of 1 mL of 100,000 IU of vitamin D3 or placebo. Clinical data were recorded every eight hours for all children. Outcomes were assessed 7 days after vitamin D injection.

The primary outcome variable was the change in serum level of 25(OH)D, while the secondary outcomes were the medical state of the assigned cases (improvement or death) and duration between enrollment and hospital discharge for improved cases.

Results:

In the supplementation group, the percentage of patients who suffered either deficient (38.7%) or insufficient levels (61.3%) of 25 (OH)D at day one had significantly decreased in the seventh day to (11.8%) and (52.7%), respectively. Kaplan--Meier plots highlighted that the median time to recover of the placebo group was significantly longer than that of the supplementation group (Log Rank P value < .001).

Conclusion:

VDD was detected in pediatric critical care children. In pneumonic children with high VDD, it is illustrated that Vitamin D supplementation is accompanied by lowered mortality risk and pSOFA scores, reduced time to recover, and improved PaO2/FiO2.

Trial registration:

Trial Identifier number: NCT04244474. Registered on 27 January 2020- Retrospectively registered at ClinicalTrials.gov https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0009JXO&selectaction=Edit&uid=U0004UO8&ts=152&cx=9cceq6
The impact of exercise training for chronic heart failure patients with cardiac resynchronization therapy
Authors: Guo Ran , Wen Yi , Xu Ying , Jia Ruikun , Zou Song , Lu Sijie , Liu Guobin , Cui Kaijun
Published: March 2021

Background and objective:

Systematically review the current published literature on the impact of exercise training (ET) in chronic heart failure (CHF) patients who were conducted cardiac resynchronization therapy (CRT).

Methods:

PubMed, EMBASE, and the Cochrane Library of Controlled Trails databases were searched for trials comparing the additional effects of ET in CHF patients after CRT implantation with no exercise or usual care control up until 2020.03.07. We independently screened the literature, extracted data, employed the tool for the assEssment of Study qualiTy and reporting in EXercise (TESTEX) to evaluate study quality and risk of bias, and performed meta-analysis with Revman 5.3 software.

Results:

Eight trials were identified for qualitative analysis and 7 randomized controlled trails (RCTs) included 235 participants (120 ET; 115 controls) for quantitative analysis. The results showed that the maximal workload (mean difference [MD] 26.32 W, 95% CI 19.41–33.23; P < .00001, I
2 = 0%) and the exercise duration (MD 68.95 seconds, 95% CI 15.41–122.48; P = .01, I
2 = 76%) had significant improvement in the ET group versus control. Subgroup analysis showed that compared with control, the change in peak oxygen uptake (VO2) (MD 3.05 ml/kg/minute, 95% CI 2.53–3.56; P < .00001, I
2 = 0%), left ventricular ejection fraction (LVEF) (MD 4.97%, 95% CI 1.44–8.49; P = .006, I
2 = 59%), and health related quality of life (HRQoL) (the change in Minnesota living with heart failure questionnaire [MLHFQ]: MD −19.96, 95% CI −21.57 to −18.34; P < .00001, I
2 = 0%) were significantly improved in the light to moderate intensity training (non-HIT) group, while there seemed no statistical difference of above endpoints in the high intensity training (HIT) group.

Conclusion:

During the short term (up to 6 months), non-HIT could improve exercise capacity, cardiac function, and HRQoL in CHF patients with CRT. However, due to the small number of participants, a high-quality large-sample multicenter trial is demanded.
Physical health and emotional and behavioral problems in maltreated children according to family economic status
Authors: Jung Jin Hee , Kwak Young Ho
Published: March 2021

Low family income is a risk factor for child maltreatment. However, there has been no comparative study on the association between child maltreatment and family income. The objective of this study was to investigate the physical health and emotional and behavioral problems of maltreated children according to the economic status of their family.

Cross-sectional nationwide study

Data from 2012 to 2014 was extracted from the Korean National Child Abuse Registry (age <18 years) operated by the National Child Protection Agency (NCPA). Demographic characteristics and 34 physical health and emotional/behavioral problems of maltreated children were compared by family economic status. Family economic status was classified into 2 groups: families receiving the National Basic Livelihood Guarantee (NBLG) and those not receiving the guarantee (non-NBLG group).

A total of 17,128 children were registered in the system. Mean age was 9.3 years (SD 4.8 years), 44.4% were females, and 29.2% were in the NBLG group. Poor hygiene, anxiety, and attention deficit were frequently reported physical and emotional health problems. Common behavioral problems included running away, rebelliousness/impulsivity/aggressiveness, maladjustment in school, learning problems at school, and frequent unauthorized absenteeism and truancy. Physical health problems (7 of 8 items) occurred more often in the NBLG group, and behavioral problems (6 of 17 items) occurred more often in the non-NBLG group.

Children in Korea who are maltreated have different physical health, emotional, and behavioral problems depending on their family income level. These results can be useful in approaching the recognition of and interventions for child maltreatment.
Iron chelators reverse organ damage in type 4B hereditary hemochromatosis
Authors: Wu Ling-yan , Song Zhen-ya , Li Qing-hai , Mou Li-jun , Yu Ying-ying , Shen Si-si , Song Xiao-xiao
Published: March 2021

Rationale:

Hereditary hemochromatosis (HH) is a hereditary disorder of iron metabolism. It is classified into 4 main types depending on the underlying genetic mutation: human hemochromatosis protein (HFE) (type 1), hemojuvelin (HJV) (type 2A), HAMP (type 2B), transferrin receptor-2 (TFER2) (type 3), and ferroportin (type 4). Type 4 HH is divided into 2 subtypes according to different mutations: type 4A (classical ferroportin disease) and type 4B (non-classical ferroportin disease). Type 4B HH is a rare autosomal dominant disease that results from mutations in the Solute Carrier Family 40 member 1 (SLC40A1) gene, which encodes the iron transport protein ferroportin.

Patient concerns:

Here we report 2 elderly Chinese Han men, who were brothers, presented with liver cirrhosis, diabetes mellitus, skin hyperpigmentation, hyperferritinaemia as well as high transferrin saturation.

Diagnosis:

Subsequent genetic analyses identified a heterozygous mutation (p. Cys326Tyr) in the SLC40A1 gene in both patients.

Interventions:

We treated the patient with iron chelator and followed up for 3 years.

Outcomes:

Iron chelator helped to reduce the serum ferritin and improve the condition of target organs, including skin, pancreas, liver as well as pituitary.

Lessons:

Type 4B HH is rare but usually tends to cause multiple organ dysfunction and even death. For those patients who have difficulty tolerating phlebotomy, iron chelator might be a good alternative.
Risk factors for postoperative pneumonia and prognosis in lung cancer patients after surgery
Authors: Yao Lijun , Luo Jun , Liu Lu , Wu Qingchen , Zhou Ruiqin , Li Linjun , Zhang Cheng
Published: March 2021

Postoperative pneumonia (POP) is one of the most frequent complications following lung surgery. The aim of this study was to identify the risk factors for developing POP and the prognostic factors in lung cancer patients after lung resection.

We performed a retrospective review of 726 patients who underwent surgery for stages I–III lung cancer at a single institution between August 2017 and July 2018 by conducting logistic regression analysis of the risk factors for POP. The Cox risk model was used to analyze the factors influencing the survival of patients with lung cancer.

We identified 112 patients with POP. Important risk factors for POP included smoking (odds ratio [OR], 2.672; 95% confidence interval [CI], 1.586–4.503; P < .001), diffusing capacity for carbon monoxide (DLCO) (40–59 vs ≥80%, 4.328; 95% CI, 1.976–9.481; P < .001, <40 vs ≥80%, 4.725; 95% CI, 1.352–16.514; P = .015), and the acute physiology and chronic health evaluation (APACHE) II score (OR, 2.304; 95% CI, 1.382–3.842; P = .001). In the Cox risk model, we observed that age (hazard ratios (HR), 1.633; 95% CI, 1.062–2.513; P = .026), smoking (HR, 1.670; 95% CI, 1.027–2.716; P = .039), POP (HR, 1.637; 95% CI, 1.030–2.600; P = .037), etc were predictor variables for patient survival among the factors examined in this study.

The risk factors for POP and the predictive factors affecting overall survival (OS) should be taken into account for effective management of patients with lung cancer undergoing surgery.
Survival analysis and treatment strategies for limb liposarcoma patients with metastasis at presentation
Authors: Wang Shicheng , Zhou Yuanxi , Wang Haifeng , Ling Jing
Published: March 2021

Limited data exist on patients with limb liposarcoma (LLS) with metastasis at presentation Moreover, the potential prognostic factors of this patient population are poorly documented because of its rarity. Therefore, we conducted this study to evaluate the clinicopathologic characteristics and prognostic factors for patients with metastatic LLS.

All patients with LLS with metastasis at presentation from 1975 to 2016 were identified by using the Surveillance, Epidemiology, and End Results (SEER) database. The following clinical data were derived from this clinical database: age, sex, histologic grade, subtype, size of tumor, surgery, radiotherapy, chemotherapy, vital status, cause of death, and survival duration. The Kaplan-Meier method was performed to calculate median survival time and draw survivorship curves. Cox-proportional hazards regression model was used to reveal the statistical independence between various variables.

The present study collected 184 cases from SEER database for survival analysis. Mean age was 57.8 years with 63.6% (n = 117) men. The 3-year overall survival (OS) and cancer-specific survival (CSS) rates of this population were 27.8% and 30.1%, respectively. Univariate analysis revealed that age, tumor grade, and surgery were significantly correlated with survival. Sex and tumor size did not reach significant predictor status of survival. Multivariate analysis revealed that age at diagnosis <60, low tumor grade, and local surgery were significantly correlated with improved OS and CSS.

Patients with LLS with metastasis at diagnosis experienced quite poor prognosis. Currently, surgery for the primary tumor significantly prolonged the survival of those patients, whereas chemotherapy and radiotherapy need to be further confirmed.
Clinical and laboratory features of patients with focal lymphocytic sialadenitis on minor salivary gland biopsy for sicca symptoms
Authors: Ayesha Bibi , Fernandez-Ruiz Ruth , Shrock Devin , Snyder Brittney M. , Lieberman Scott M. , Tuetken Rebecca , Field Elizabeth , Singh Namrata
Published: March 2021

Minor salivary gland biopsy (MSGB) is often used in patients lacking specific autoantibodies (seronegative patients) to confirm the presence of focal lymphocytic sialadenitis (FLS), which would suggest a diagnosis of Sjogren syndrome. There are no current guidelines indicating when to refer patients for MSGB. The objective of our study was to ascertain distinguishing clinical and laboratory features among individuals with sicca symptoms based on their serologic and histopathologic status, and to identify factors associated with FLS.

Using a cross-sectional study design, patients ages 18 years or older with sicca symptoms who had MSGB performed at the University of Iowa from January 2000 to December 2016 were selected for chart reviews. The clinical and laboratory features of patients with and without FLS were analyzed using exact univariate and multivariable logistic regression, with Bonferroni correction for multiple comparisons.

We identified 177 patients who had MSGB performed and available clinical data. A total of 133 patients had FLS, 37 (27.8%) were seropositive (positive-anti-Sjogren syndrome type A [SSA] and/or anti-Sjogren syndrome type B) and 96 (72.2%) were seronegative. Dry eyes (unadjusted odds ratio [OR]: 5.17, 95% confidence interval [CI]: 1.16–26.30; adjusted odds ratio [aOR]: 12.58, 95% CI: 1.70–167.77) and the presence of anti-SSA (OR: 7.16, 95% CI: 1.70–64.24; aOR: 8.82, 95% CI: 1.73–93.93) were associated with FLS. Smoking (aOR 0.27, 95% CI: 0.11–0.63) and antihistamine use (aOR 0.23, 95% CI: 0.08–0.63) were associated with lower odds of FLS.

Our study suggests that dry eyes and anti-SSA positivity are associated with FLS. Smoking and antihistamine use were associated with lower odds of FLS. In the appropriate clinical context, seronegative patients with sicca symptoms and no smoking history could be considered for MSGB. A thorough medication and smoking history should be performed in all patients before referral for MSGB.