bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in physical activity and sleep habits among adults in Russian Federation during COVID-19: a cross-sectional study
Authors: Kontsevaya Anna V. , Mukaneeva Dinara K. , Myrzamatova Azaliia O. , Okely Anthony D. , Drapkina Oxana M.
Published: May 2021

Background

The aim of this study was to evaluate the impact of COVID-19 on the levels of physical activity (PA) and sleep and to examine specific COVID-19 factors that may be associated with changes in PA and sleep among adults in Russia.

Methods

Cross-sectional data were collected during the period of tightest restrictions between 26 April 2020 and 6 June 2020. Eligible participants included all Russian adults aged 18 years and over. Participants reported their sleep patterns and problems, frequency and duration of walking, moderate- and vigorous-intensity PA, and muscle strengthening activities before COVID-19 and during the past 7 days. Access to an outdoor green space and fitness centres, use of online resources, adherence to self-isolation recommendations and other preventive measures from Ministry of Health were self-reported.

Results

The sample included 2432 participants from 62 regions, 83% of who were female. There was a significant decline in the number of days per week participants reported not getting enough sleep (3.21 ± 2.44 to 2.86 ± 2.57; P < 0.001); participants also reported an increase in the number of days per week they had trouble falling asleep (1.70 ± 2.24 to 2.13 ± 2.48; P < 0.001). The proportion of participants who met the WHO Guidelines for PA declined from 68 to 49% (P < 0.001). The proportion who participated in muscle strengthening activities for 2 or more days per week declined from 53 to 45% (P < 0.001).

Conclusion

Compared with before COVID-19, PA and sleep hygiene were adversely affected during COVID-19. Awareness of factors associated with these declines will assit policymakers in developing strategies to mitigate the negative lifestyle behaviours that have manifested during the COVID-19 confinement.
Incidence, characteristics, and outcomes of delirium in patients with noninvasive ventilation: a prospective observational study
Authors: Zhang Rui , Bai Linfu , Han Xiaoli , Huang Shicong , Zhou Lintong , Duan Jun
Published: May 2021

Background

Factors that may increase the risk for delirium and the firm knowledge around mechanism for delirium in noninvasive ventilation (NIV) patients is lacking. We investigated the incidence, characteristics, and outcomes of delirium in NIV patients.

Methods

A prospective observational study was performed in an intensive care unit (ICU) of a teaching hospital. Patients in whom NIV was used as a first-line intervention were enrolled. During NIV intervention, delirium was screened using the Confusion Assessment Method for the ICU each day. The association between delirium and poor outcomes (e.g., NIV failure, ICU and hospital mortality) was investigated using forward stepwise multivariate logistic regression analyses.

Results

We enrolled 1083 patients. Of these, 196 patients (18.1%) experienced delirium during NIV intervention. Patients with delirium had higher NIV failure rates (37.8% vs. 21.0%, p < 0.01), higher ICU mortality (33.2% vs. 14.3%, p < 0.01), and higher hospital mortality (37.2% vs. 17.0%, p < 0.01) than subjects without delirium. They also had a longer duration of NIV (median 6.3 vs. 3.7 days, p < 0.01), and stayed longer in the ICU (median 9.0 vs. 6.0 days, p < 0.01) and the hospital (median 14.5 vs. 11.0 days, p < 0.01). These results were confirmed in COPD and non-COPD cohorts. According to subtype, compared to hyperactive delirium patients, hypoactive and mixed delirium patients spent more days and many more days on NIV (median 3.4 vs. 6.5 vs. 10.1 days, p < 0.01). Similar outcomes were found for length of stay in the ICU and hospital. However, NIV failure, ICU mortality, and hospital mortality did not differ among the three subtypes.

Conclusions

Delirium is associated with increases in poor outcomes (NIV failure, ICU mortality, and hospital mortality) and the use of medical resources (duration of NIV, and lengths of stay in the ICU and hospital). Regarding subtype, hypoactive and mixed delirium are associated with higher, and much higher, consumption of medical resources, respectively, compared to hyperactive delirium.
Breastfeeding history and the risk of overweight and obesity in middle-aged women
Authors: Cieśla Elżbieta , Stochmal Ewa , Głuszek Stanisław , Suliga Edyta
Published: May 2021

Background

The increased metabolic activity required to sustain breastfeeding and its associated milk production helps to reduce maternal fat stores accumulated during pregnancy. This study aims to assess the association between breastfeeding duration and fatness indices in middle-aged women.

Methods

The analysis was carried out in a group of 7500 parous 55.5 ± 5.3 year old women included body mass index, body fat percentage, and waist-to-height ratio. The likelihood of excessive weight or obesity in relation to total breastfeeding time using multivariate logistic regression analyses.

Results

An analysis of adjusted odds ratios did not show significant associations between breastfeeding duration and the risk of excessive weight and obesity in premenopausal women. After menopause, women who gave birth to 2 children and breastfed 1–6 and > 12 months had a lower risk of abdominal obesity (OR 0.70; 95% CI 0.50–0.99; p = 0.042; and OR 0.68; 95% CI 0.47–0.98; p = 0.039). Women who gave birth to 3 or more children and breastfed for 1–6 months, also showed a lower risk of overweight (OR 0.52; 95% CI 0.27–0.99; p = 0.047), compared to those ones that have never breastfed. There was no relationship found between the duration of lactation and the risk of excessive body fat.

Conclusion

Breastfeeding may have some beneficial, long-term effect on the risk of excessive weight and abdominal obesity in women.
Could existing infrastructure for using patient‐reported outcomes as quality measures also be used for individual care in patients with colorectal cancer?
Authors: Breidenbach Clara , Kowalski Christoph , Wesselmann Simone , Sibert Nora Tabea
Published: May 2021

Background

There has been increasing interest in integrating patient-reported outcomes (PROs) into routine oncological practice. To date, however, PROs have rarely been implemented in Germany. Currently, PROs are being used as performance measures in colorectal cancer centers in Germany. This content analysis identified factors that may inhibit or facilitate the additional use of PROMs for individual patient management.

Methods

The analysis follows an exploratory approach. Out of 103 centers that participated in a multicentric PRO quality management and benchmarking program in Germany, twelve oncological health-care providers from eight certified colorectal cancer centers were interviewed using a semi-structured interview guide. The interviewees were clinicians (physicians, nurses, psycho-oncologist and physician assistant) who care for colorectal cancer patients. This analysis evaluated whether and how PROs that are primarily collected for quality management/benchmarking reasons could also be used for the management of individual patients. The data was analyzed using a content-analysis approach.

Results

The interviewees were not using PRO in their routine clinical work, but they recognized its added value and pointed out potential example uses. Identified inhibiting factors for the use of PROs in clinical routine work were effortful access to PRO reports, lacking coordinating structures, time delays and time points of measurements as well as redundancy with other instruments. Facilitating factors for the use of PROs in clinical routine work that were identified included access via electronic patient records, implementation of coordinating structures for PRO processes in the center, clear PRO reports that are easy to interpret, and measurements at relevant time points.

Discussion

Clinicians had quite a positive attitude toward PROs and recognized their added value. Inhibiting and facilitating factors of an organizational and technical nature were identified.

Conclusions

These findings indicate how PROs used for quality management purposes may also be used for the management of individual patients. Therefore, existing structures and processes in the certified colorectal cancer centers, as well as lessons learned from the literature on the implementation of PROs monitoring individual patients need to be taken into account.
A National Consensus Forum on improving cornea donation and transplantation access in Canada
Authors: Bae Steven S. , Rocha Guillermo , Humphreys Christine , Chan Clara C. , Yeung Sonia N.
Published: May 2021

A consensus meeting was held in Toronto on February 9–10, 2020 to discuss ways to improve cornea donation and transplantation access in Canada. The meeting brought together eye and tissue bank representatives, health authority and hospital leadership, transplant ophthalmologists, organ donation organizations, transplant recipients, donor families and several national organizations. Through facilitated discussions in multidisciplinary, gender-balanced, and geographically balanced small groups, participants identified opportunities for improvement in the Canadian cornea donation and transplantation system. Discussion occurred around broad themes of donor tissue demand, supply, access, utilization, interprovincial sharing and cost recovery, interprovincial knowledge sharing and research. This event marked the first time in 10 years in which the Canadian cornea transplantation community came together.
Medication risk management and health equity in New Zealand general practice: a retrospective cross-sectional study
Authors: Leitch Sharon , Zeng Jiaxu , Smith Alesha , Stokes Tim
Published: May 2021

Background

Despite an overt commitment to equity, health inequities are evident throughout Aotearoa New Zealand. A general practice electronic alert system was developed to notify clinicians about their patient’s risk of harm due to their pre-existing medical conditions or current medication. We aimed to determine whether there were any disparities in clinician action taken on the alert based on patient ethnicity or other demographic factors.

Methods

Sixty-six New Zealand general practices from throughout New Zealand participated. Data were available for 1611 alerts detected for 1582 patients between 1 and 2018 and 1 July 2019. The primary outcome was whether action was taken following an alert or not. Logistic regression was used to assess if patients of one ethnicity group were more or less likely to have action taken. Potential confounders considered in the analyses include patient age, gender, ethnicity, socio-economic deprivation, number of long term diagnoses and number of long term medications.

Results

No evidence of a difference was found in the odds of having action taken amongst ethnicity groups, however the estimated odds for Māori and Pasifika patients were lower compared to the European group (Māori OR 0.88, 95 %CI 0.63–1.22; Pasifika OR 0.88, 95 %CI 0.52–1.49). Females had significantly lower odds of having action taken compared to males (OR 0.76, 95 %CI 0.59–0.96).

Conclusions

This analysis of data arising from a general practice electronic alert system in New Zealand found clinicians typically took action on those alerts. However, clinicians appear to take less action for women and Māori and Pasifika patients. Use of a targeted alert system has the potential to mitigate risk from medication-related harm. Recognising clinician biases may improve the equitability of health care provision.
Dose adjustment of follicle-stimulating hormone (FSH) during ovarian stimulation as part of medically-assisted reproduction in clinical studies: a systematic review covering 10 years (2007–2017)
Authors: Fatemi Human , Bilger Wilma , Denis Deborah , Griesinger Georg , La Marca Antonio , Longobardi Salvatore , Mahony Mary , Yin Xiaoyan , D’Hooghe Thomas
Published: May 2021

Background

Individualization of the follicle-stimulating hormone (FSH) starting dose is considered standard clinical practice during controlled ovarian stimulation (COS) in patients undergoing assisted reproductive technology (ART) treatment. Furthermore, the gonadotropin dose is regularly adjusted during COS to avoid hyper- or hypo-ovarian response, but limited data are currently available to characterize such adjustments. This review describes the frequency and direction (increase/decrease) of recombinant-human FSH (r-hFSH) dose adjustment reported in clinical trials.

Methods

We evaluated the proportion of patients undergoing ART treatment who received ≥ 1 r-hFSH dose adjustments. The inclusion criteria included studies (published Sept 2007 to Sept 2017) in women receiving ART treatment that allowed dose adjustment within the study protocol and that reported ≥ 1 dose adjustments of r-hFSH; studies not allowing/reporting dose adjustment were excluded. Data on study design, dose adjustment and patient characteristics were extracted. Point-incidence estimates were calculated per study and overall based on pooled number of cycles with dose adjustment across studies. The Clopper–Pearson method was used to calculate 95% confidence intervals (CI) for incidence where adjustment occurred in < 10% of patients; otherwise, a normal approximation method was used.

Results

Initially, 1409 publications were identified, of which 318 were excluded during initial screening and 1073 were excluded after full text review for not meeting the inclusion criteria. Eighteen studies (6630 cycles) reported dose adjustment: 5/18 studies (1359 cycles) reported data for an unspecified dose adjustment (direction not defined), in 10/18 studies (3952 cycles) dose increases were reported, and in 11/18 studies (5123 cycles) dose decreases were reported. The studies were performed in women with poor, normal and high response, with one study reporting in oocyte donors and one in obese women. The median day that dose adjustment was permitted was Day 6 after the start of treatment. The point estimates for incidence (95% CI) for unspecified dose adjustment, dose increases, and dose decreases were 45.3% (42.7, 48.0), 19.2% (18.0, 20.5), and 9.5% (8.7, 10.3), respectively.

Conclusions

This systematic review highlights that, in studies in which dose adjustment was allowed and reported, the estimated incidence of r-hFSH dose adjustments during ovarian stimulation was up to 45%.
Extracellular vesicle-derived miRNA as a novel regulatory system for bi-directional communication in gut-brain-microbiota axis
Authors: Zhao Liang , Ye Yingze , Gu Lijuan , Jian Zhihong , Stary Creed M. , Xiong Xiaoxing
Published: May 2021

The gut-brain-microbiota axis (GBMAx) coordinates bidirectional communication between the gut and brain, and is increasingly recognized as playing a central role in physiology and disease. MicroRNAs are important intracellular components secreted by extracellular vesicles (EVs), which act as vital mediators of intercellular and interspecies communication. This review will present current advances in EV-derived microRNAs and their potential functional link with GBMAx. We propose that EV-derived microRNAs comprise a novel regulatory system for GBMAx, and a potential novel therapeutic target for modifying GBMAx in clinical therapy.
Capsazepine decreases corneal pain syndrome in severe dry eye disease
Authors: Fakih Darine , Guerrero-Moreno Adrian , Baudouin Christophe , Réaux-Le Goazigo Annabelle , Parsadaniantz Stéphane Mélik
Published: May 2021

Background

Dry eye disease (DED) is a multifactorial disease of the ocular surface accompanied by neurosensory abnormalities. Here, we evaluated the effectiveness of transient receptor potential vanilloid-1 (TRPV1) blockade to alleviate ocular pain, neuroinflammation, and anxiety-like behavior associated with severe DED.

Methods

Chronic DED was induced by unilateral excision of the Harderian and extraorbital lacrimal glands of adult male mice. Investigations were conducted at 21 days after surgery. The mRNA levels of TRPV1, transient receptor potential ankyrin-1 (TRPA1), and acid-sensing ion channels 1 and 3 (ASIC1 and ASIC3) in the trigeminal ganglion (TG) were evaluated by RNAscope in situ hybridization. Multi-unit extracellular recording of ciliary nerve fiber activity was used to monitor spontaneous and stimulated (cold, heat, and acid) corneal nerve responsiveness in ex vivo eye preparations. DED mice received topical instillations of the TRPV1 antagonist (capsazepine) twice a day for 2 weeks from d7 to d21 after surgery. The expression of genes involved in neuropathic and inflammatory pain was evaluated in the TG using a global genomic approach. Chemical and mechanical corneal nociception and spontaneous ocular pain were monitored. Finally, anxiety-like behaviors were assessed by elevated plus maze and black and white box tests.

Results

First, in situ hybridization showed DED to trigger upregulation of TRPV1, TRPA1, ASIC1, and ASIC3 mRNA in the ophthalmic branch of the TG. DED also induced overexpression of genes involved in neuropathic and inflammatory pain in the TG. Repeated instillations of capsazepine reduced corneal polymodal responsiveness to heat, cold, and acidic stimulation in ex vivo eye preparations. Consistent with these findings, chronic capsazepine instillation inhibited the upregulation of genes involved in neuropathic and inflammatory pain in the TG of DED animals and reduced the sensation of ocular pain, as well as anxiety-like behaviors associated with severe DED.

Conclusion

These data provide novel insights on the effectiveness of TRPV1 antagonist instillation in alleviating abnormal corneal neurosensory symptoms induced by severe DED, opening an avenue for the repositioning of this molecule as a potential analgesic treatment for patients suffering from chronic DED.
Birth weight and childhood obesity: effect modification by residence and household wealth
Authors: Andriani Helen
Published: May 2021

Background

There are both genetic and environmental factors which contribute to a child’s chances of being obese. When low birth weight (LBW) has been specifically evaluated relative to its association with childhood obesity, the results have produced conflicting findings. This study aims to describe the relationship between birth weight and childhood obesity and investigate the influence that residence and household wealth has on this relationship.

Methods

I performed a secondary analysis on the 2013 Riskesdas (or Basic Health Research), a cross-sectional, nationally representative survey of the Indonesian population. Height, weight, information regarding child’s birth weight, and basic characteristics of the study population were collected from parents with children aged 0 to 5 years (n = 63,237) in 2013. The exposure was child’s birth weight and the outcomes were child’s current weight, BMI z-score, and obesity. Data were analyzed by using multiple linear regression and multiple logistic regression.

Results

I found a significant increase in the weight, BMI z-score, and risk of childhood obesity to be associated with LBW. LBW children in rural area were associated with higher BMI z-score (mean ± standard error: 1.44 ± 0.02) and higher odds (odds ratio (95% confidence interval): 7.46 (6.77–8.23)) of obesity than those in urban area. LBW children from low class families were associated with higher BMI z-score (1.79 ± 0.04) and had higher odds (14.79 (12.47–17.54)) of obesity than those from middle class and wealthy families.

Conclusions

Effective prevention and intervention to childhood obesity as early as possible are imperative. As far as this study was concerned, efforts, policies, and targets are required to reduce the prevalence of LBW. Children born of LBW, who live in a rural area and from low income families, should be emphatically intervened as early as possible.
COVID-19 and periodontitis: reflecting on a possible association
Authors: Campisi Giuseppina , Bizzoca Maria Eleonora , Lo Muzio Lorenzo
Published: May 2021

Recent studies have demonstrated a relationship between the severe clinical course of COVID-19 and other chronic diseases such as: cardiovascular disease, hypertension, diabetes mellitus, obesity and chronic renal disease. It may be possible to extend this association to a common and chronic oral disease in adults: periodontitis. Alternatively, the latter could be simply related to the systemic chronic diseases cited above, as already observed in the non-COVID-19 literature. In order to provide an overview and their opinion, the authors in this perspective article will report and discuss the most recent references of interest relating to COVID-19 and periodontitis pathophysiology. Within such a narrative review, the authors will hypothesize that the association between chronic periodontitis and COVID-19 could exist via two pathways: a direct link, through the ACEII and CD147 receptors used by the virus to infect the cells, which would occur in greater numbers in cases of periodontitis (thereby favoring a SARS-CoV-2 infection); and/or an indirect pathway involving the overexpression of inflammatory molecules, especially IL-6 and IL-17. An expression of the latter has been found to play a role in periodontitis, in addition to severe cases of COVID-19, although it is still unclear if it plays a direct role in the worsening of the clinical course.
Warburg effect-promoted exosomal circ_0072083 releasing up-regulates NANGO expression through multiple pathways and enhances temozolomide resistance in glioma
Authors: Ding Chenyu , Yi Xuehan , Chen Xiangrong , Wu Zanyi , You Honghai , Chen Xiaoyong , Zhang Gaoqi , Sun Yong , Bu Xingyao , Wu Xiyue , Lin Zhangya , Gu Jianjun , Lin Yuanxiang , Kang Dezhi
Published: May 2021

Background

Temozolomide (TMZ) resistance limits its application in glioma. Exosome can carry circular RNAs (circRNAs) to regulate drug resistance via sponging microRNAs (miRNAs). miRNAs can control mRNA expression by regulate the interaction with 3’UTR and methylation. Nanog homeobox (NANOG) is an important biomarker for TMZ resistance. Hitherto, it is unknown about the role of exosomal hsa_circ_0072083 (circ_0072083) in TMZ resistance in glioma, and whether it is associated with NANOG via regulating miRNA sponge and methylation.

Methods

TMZ-resistant (n = 36) and sensitive (n = 33) patients were recruited. The sensitive cells and constructed resistant cells were cultured and exposed to TMZ. circ_0072083, miR-1252-5p, AlkB homolog H5 (ALKBH5) and NANOG levels were examined via quantitative reverse transcription polymerase chain reaction and western blot. The half maximal inhibitory concentration (IC50) of TMZ, cell proliferation, apoptosis, migration and invasion were analyzed via Cell Counting Kit-8, colony formation, flow cytometry, wound healing and transwell assays. The in vivo function was assessed using xenograft model. The N6-methyladenosine (m6A) level was analyzed via methylated RNA immunoprecipitation (MeRIP). Target relationship was investigated via dual-luciferase reporter assay and RNA immunoprecipitation. Warburg effect was investigated via lactate production, glucose uptake and key enzymes expression. Exosome was isolated and confirmed via transmission electron microscopy and specific protein expression.

Results

circ_0072083 expression was increased in TMZ-resistant glioma tissues and cells. circ_0072083 knockdown restrained the resistance of resistant cells via decreasing IC50 of TMZ, proliferation, migration, invasion and xenograft tumor growth and increasing apoptosis. circ_0072083 silence reduced NANOG expression via blocking ALKBH5-mediated demethylation. circ_0072083 could regulate NANOG and ALKBH5 via targeting miR-1252-5p to control TMZ resistance. Warburg effect promoted the release of exosomal circ_0072083 in resistant cells. Exosomal circ_0072083 from resistant cells increased the resistance of sensitive cells to TMZ in vitro and xenograft model. Exosomal circ_0072083 level was enhanced in resistant patients, and it had a diagnostic value and indicated a lower overall survival in glioma.

Conclusion

Exosomal circ_0072083 promoted TMZ resistance via increasing NANOG via regulating miR-1252-5p-mediated degradation and demethylation in glioma.
What are the applications of single-cell RNA sequencing in cancer research: a systematic review
Authors: Li Lvyuan , Xiong Fang , Wang Yumin , Zhang Shanshan , Gong Zhaojian , Li Xiayu , He Yi , Shi Lei , Wang Fuyan , Liao Qianjin , Xiang Bo , Zhou Ming , Li Xiaoling , Li Yong , Li Guiyuan , Zeng Zhaoyang , Xiong Wei , Guo Can
Published: May 2021

Single-cell RNA sequencing (scRNA-seq) is a tool for studying gene expression at the single-cell level that has been widely used due to its unprecedented high resolution. In the present review, we outline the preparation process and sequencing platforms for the scRNA-seq analysis of solid tumor specimens and discuss the main steps and methods used during data analysis, including quality control, batch-effect correction, normalization, cell cycle phase assignment, clustering, cell trajectory and pseudo-time reconstruction, differential expression analysis and gene set enrichment analysis, as well as gene regulatory network inference. Traditional bulk RNA sequencing does not address the heterogeneity within and between tumors, and since the development of the first scRNA-seq technique, this approach has been widely used in cancer research to better understand cancer cell biology and pathogenetic mechanisms. ScRNA-seq has been of great significance for the development of targeted therapy and immunotherapy. In the second part of this review, we focus on the application of scRNA-seq in solid tumors, and summarize the findings and achievements in tumor research afforded by its use. ScRNA-seq holds promise for improving our understanding of the molecular characteristics of cancer, and potentially contributing to improved diagnosis, prognosis, and therapeutics.
Deconvolution of cell type-specific drug responses in human tumor tissue with single-cell RNA-seq
Authors: Zhao Wenting , Dovas Athanassios , Spinazzi Eleonora Francesca , Levitin Hanna Mendes , Banu Matei Alexandru , Upadhyayula Pavan , Sudhakar Tejaswi , Marie Tamara , Otten Marc L. , Sisti Michael B. , Bruce Jeffrey N. , Canoll Peter , Sims Peter A.
Published: May 2021

Background

Preclinical studies require models that recapitulate the cellular diversity of human tumors and provide insight into the drug sensitivities of specific cellular populations. The ideal platform would enable rapid screening of cell type-specific drug sensitivities directly in patient tumor tissue and reveal strategies to overcome intratumoral heterogeneity.

Methods

We combine multiplexed drug perturbation in acute slice culture from freshly resected tumors with single-cell RNA sequencing (scRNA-seq) to profile transcriptome-wide drug responses in individual patients. We applied this approach to drug perturbations on slices derived from six glioblastoma (GBM) resections to identify conserved drug responses and to one additional GBM resection to identify patient-specific responses.

Results

We used scRNA-seq to demonstrate that acute slice cultures recapitulate the cellular and molecular features of the originating tumor tissue and the feasibility of drug screening from an individual tumor. Detailed investigation of etoposide, a topoisomerase poison, and the histone deacetylase (HDAC) inhibitor panobinostat in acute slice cultures revealed cell type-specific responses across multiple patients. Etoposide has a conserved impact on proliferating tumor cells, while panobinostat treatment affects both tumor and non-tumor populations, including unexpected effects on the immune microenvironment.

Conclusions

Acute slice cultures recapitulate the major cellular and molecular features of GBM at the single-cell level. In combination with scRNA-seq, this approach enables cell type-specific analysis of sensitivity to multiple drugs in individual tumors. We anticipate that this approach will facilitate pre-clinical studies that identify effective therapies for solid tumors.
Correction to: Infrapatellar fat pad-derived mesenchymal stem cell-based spheroids enhance their therapeutic efficacy to reverse synovitis and fat pad fibrosis
Authors: Kouroupis Dimitrios , Willman Melissa A. , Best Thomas M. , Kaplan Lee D. , Correa Diego
Published: May 2021

An amendment to this paper has been published and can be accessed via the original article.
Gambogic acid protects LPS-induced apoptosis and inflammation in a cell model of neonatal pneumonia through the regulation of TrkA/Akt signaling pathway
Authors: Gao Xu , Dai Jingya , Li Guifang , Dai Xinya
Published: May 2021

Objective

In this work, we investigated the effects of gambogic acid (GA) on lipopolysaccharide (LPS)-induced apoptosis and inflammation in a cell model of neonatal pneumonia.

Method

Human WI-38 cells were maintained in vitro and incubated with various concentrations of GA to examine WI-38 survival. GA-preincubated WI-38 cells were then treated with LPS to investigate the protective effects of GA on LPS-induced death, apoptosis and inflammation. Western blot assay was utilized to analyze the effect of GA on tropomyosin receptor kinase A (TrkA) signaling pathway in LPS-treated WI-38 cells. In addition, human AKT serine/threonine kinase 1 (Akt) gene was knocked down in WI-38 cells to further investigate the associated genetic mechanisms of GA in protecting LPS-induced inflammation and apoptosis.

Results

Pre-incubating WI-38 cells with low and medium concentrations GA protected LPS-induced cell death, apoptosis and inflammatory protein productions of IL-6 and MCP-1. Using western blot assay, it was demonstrated that GA promoted TrkA phosphorylation and Akt activation in LPS-treated WI-38 cells. Knocking down Akt gene in WI-38 cells showed that GA-associated protections against LPS-induced apoptosis and inflammation were significantly reduced.

Conclusions

GA protected LPS-induced apoptosis and inflammation, possibly through the activations of TrkA and Akt signaling pathway. This work may broaden our understanding on the molecular mechanisms of human neonatal pneumonia.
Variations in vertical mucosal thickness at edentulous ridge according to site and gender measured by cone-beam computed tomography
Authors: Munakata Motohiro , Nagata Koudai , Sanda Minoru , Kawamata Ryota , Sato Daisuke , Yamaguchi Kikue
Published: May 2021

Background

The vertical thickness of the peri-implant mucosa is associated with the amount of post treatment marginal bone loss. However, the variations in mucosal thickness at the different edentulous sites have been sparsely documented. The purpose of the study was to conduct a survey of the frequency distribution of variations in mucosal thickness at the different sites of the edentulous alveolar ridge and to compare them according to gender.

Our study included 125 partially edentulous patients having a total of 296 implant sites. Cone-beam computed tomography (CBCT) scans were obtained by placing a diagnostic template with a radiopaque crown indicator on the ridge to determine the mucosal thickness at the crest of the alveolar ridge.

Results

The mucosal thickness was 3.0±1.3 mm in the maxilla, which was significantly greater than the mucosal thickness of 2.0±1.0 mm in the mandible (p<0.001). In both the maxilla and the mandible, the mucosa was the thickest in the anterior region, followed by the premolar and molar regions. Sites were further classified into two groups based on whether the mucosal thickness was greater than 2 mm. In the mandible, more than half of the sites showed a mucosal thickness of 2 mm or less.

Conclusions

Although this study was a limited preoperative study, the vertical mucosal thickness at the edentulous ridge differed between the maxillary and mandibular regions. The majority of sites in the mandibular molar region had a mucosal thickness of less than 2 mm. Practitioners might be able to develop an optimal dental implant treatment plan for long-term biologic and esthetic stability by considering these factors.
Elastic FWI for orthorhombic media with lithologic constraints applied via machine learning
Authors: Singh Sagar , Tsvankin Ilya , Zabihi Naeini Ehsan
Published: May 2021

Full-waveform inversion (FWI) of 3D wide-azimuth data for elastic orthorhombic media suffers from parameter trade-offs which cannot be overcome without constraining the model-updating procedure. We present an FWI methodology that incorporates geologic constraints to reduce the inversion nonlinearity and increase the resolution of parameter estimation for orthorhombic models. These constraints are obtained from well logs, which can provide rock-physics relationships for different geologic facies. Because the locations of the available well logs are usually sparse, a supervised machine-learning (ML) algorithm (Support Vector Machine) is employed to account for lateral heterogeneity in building the lithologic constraints. The advantages of the facies-based FWI are demonstrated on the modified SEG-EAGE 3D overthrust model, which is made orthorhombic with the symmetry planes that coincide with the Cartesian coordinate planes. We employ a velocity-based parameterization, whose suitability for FWI was studied using the radiation-pattern analysis. Application of the facies-based constraints substantially increases the resolution of the P- and S-wave vertical velocities ([Formula: see text], [Formula: see text], and [Formula: see text]) and, therefore, of the depth scale of the model. Improvements are also observed for the P-wave horizontal and normal-moveout velocities ([Formula: see text], [Formula: see text], [Formula: see text], and [Formula: see text]) and the S-wave horizontal velocity [Formula: see text]. However, the velocity [Formula: see text] that depends on Tsvankin’s parameter [Formula: see text] defined in the horizontal plane is not well recovered from the surface data. On the whole, the developed algorithm achieves a much higher spatial resolution compared to unconstrained FWI, even in the absence of recorded frequencies below 2 Hz.
Prognostic Factors in De Novo Metastatic Renal Cell Carcinoma: A Report From the Latin American Renal Cancer Group
Authors: Abreu Diego , Carvalhal Gustavo , Gueglio Guillermo , Tobia Ignacio , Garcia Patricio , Zuñiga Alvaro , Meza Luis , Bengió Rubén , Scorticati Carlos , Castillejos Ricardo , Rodriguez Francisco , Autran Ana María , Gonzales Carmen , Gadu Jose , Nolazco Alejandro , Ameri Carlos , Zampolli Hamilton , Langenhin Raúl , Muguruza Diego , Machado Marcos Tobías , Mingote Pablo , Yandian Juan , Clavijo Jorge , Nogueira Lucas , Clark Omar , Secin Fernando , Rovegno Agustín , Vilas Ana , Barrios Enrique , Decia Ricardo , Guimarães Gustavo , Glina Sidney , Pal Sumanta K. , Rodriguez Oscar , Palou Joan , Spiess Philippe , Lara Primo N. , Linehan W. Marston , Pastore Antonio Luigi , Zequi Stenio C.
Published: May 2021

PURPOSE

To assess the effect of clinical and pathological variables on cancer-specific and overall survival (OS) in de novo metastatic patients from a collaborative of primarily Latin American countries.

PATIENTS AND METHODS

Of 4,060 patients with renal cell carcinoma diagnosed between 1990 and 2015, a total of 530 (14.5%) had metastasis at clinical presentation. Relationships between clinical and pathological parameters and treatment-related outcomes were analyzed by Cox regression and the log-rank method.

RESULTS

Of 530 patients, 184 (90.6%) had died of renal cell carcinoma. The median OS of the entire cohort was 24 months. American Society of Anesthesiology classification 3-4 (hazard ratio [HR]: 1.64), perirenal fat invasion (HR: 2.02), and ≥ 2 metastatic organ sites (HR: 2.19) were independent prognostic factors for 5-year OS in multivariable analyses. We created a risk group stratification with these variables: no adverse risk factors (favorable group), median OS not reached; one adverse factor (intermediate group), median OS 33 months (HR: 2.04); and two or three adverse factors (poor risk group), median OS 14 months (HR: 3.58).

CONCLUSION

Our study defines novel prognostic factors that are relevant to a Latin American cohort. With external validation, these easily discerned clinical variables can be used to offer prognostic information across low- and middle-income countries.
Increasing Incidence of Primary Aldosteronism in Western Sweden During 3 Decades – Yet An Underdiagnosed Disorder
Authors: Gkaniatsa Eleftheria , Ekerstad Eva , Gavric Manuela , Muth Andreas , Trimpou Penelope , Olsson Daniel S , Johannsson Gudmundur , Ragnarsson Oskar
Published: May 2021

Context

Primary aldosteronism (PA) is the most common cause of secondary hypertension. Yet, the incidence of PA in the general population has not been studied.

Objective

To estimate the incidence of PA in the general population.

Design and methods

Patients who had received a diagnostic code for PA between 1987 and 2016 were identified in the Swedish National Patient Registry. Assessment of clinical and biochemical data was used to validate the diagnosis. The annual incidence of PA was calculated by using the number of inhabitants in the Västra Götaland County as a reference.

Results

Of 570 identified patients, 473 (83%) had confirmed PA. Eligible for the incidence analysis were 416 patients, 248 (60%) men and 168 (40%) women, diagnosed with PA between 1987 and 2016. The mean (± standard deviation) age at diagnosis was 56 ± 12 years. The median (interquartile range) annual incidence was 2 (1-2) cases per million between 1987 and 1996, 6 (4-9) cases per million between 1997 and 2006 and 17 (12-24) cases per million between 2007 and 2016. At the end of the study (December 31, 2016), 386 patients with confirmed PA were alive and living in the Västra Götaland County, giving a prevalence of 231 cases per million (0.022%).

Conclusions

Despite increasing incidence, the proportion of patients identified with PA is lower than expected. Given the serious consequences of untreated PA, the noticeably low prevalence at the end of the study stresses the need to increase the awareness of PA among health care providers.
Hemodynamic Changes via the Lung Recruitment Maneuver Can Predict Fluid Responsiveness in Stroke Volume and Arterial Pressure During One-Lung Ventilation
Authors: Kimura Aya , Suehiro Koichi , Juri Takashi , Fujimoto Yohei , Yoshida Hisako , Tanaka Katsuaki , Mori Takashi , Nishikawa Kiyonobu
Published: May 2021

BACKGROUND:

We aimed to evaluate the ability of lung recruitment maneuver–induced hemodynamic changes to predict fluid responsiveness in patients undergoing lung-protective ventilation during one-lung ventilation (OLV).

METHODS:

Thirty patients undergoing thoracic surgery with OLV (tidal volume: 6 mL/kg of ideal body weight and positive end-expiratory pressure: 5 cm H2O) were enrolled. The study protocol began 30 minutes after starting OLV. Simultaneous recordings were performed for hemodynamic variables of heart rate, mean arterial pressure (MAP), stroke volume (SV), pulse pressure variation (PPV), and stroke volume variation (SVV) were recorded at 4 time points: before recruitment maneuver (continuous airway pressure: 30 cm H2O for 30 seconds), at the end of recruitment maneuver, and before and after volume loading (250 mL over 10 minutes). Patients were recognized as fluid responders if the increase in SV or MAP was >10%. Receiver operating characteristic curves for percent decrease in SV and MAP by recruitment maneuver (ΔSVRM and ΔMAPRM, respectively) were generated to evaluate the ability to discriminate fluid responders from nonresponders. The gray-zone approach was applied for ΔSVRM and ΔMAPRM.

RESULTS:

Of 30 patients, there were 17 SV-responders (57%) and 12 blood pressure (BP)-responders (40%). Area under the curve (AUC) for ΔSVRM to discriminate SV-responders from nonresponders was 0.84 (95% confidence interval [CI], 0.67-0.95; P < .001). The best threshold for ΔSVRM to discriminate the SV-responders was –23.7% (95% CI, –41.2 to –17.8; sensitivity, 76.5% [95% CI, 50.1-93.2]; specificity, 84.6% [95% CI, 54.6-98.1]). For BP-responders, AUC for ΔMAPRM was 0.80 (95% CI, 0.61-0.92, P < .001). The best threshold for ΔMAPRM was –17.3% (95% CI, –23.9 to –5.1; sensitivity, 75.0% [95% CI, 42.8-94.5]; specificity, 77.8% [95% CI, 52.4-93.6]). With the gray-zone approach, the inconclusive range of ΔSVRM for SV-responders was –40.1% to –13.8% including 13 (43%) patients, and that of ΔMAPRM was –23.9% to –5.1%, which included 16 (53%) patients.

CONCLUSIONS:

ΔSVRM and ΔMAPRM could predict hemodynamic responses after volume expansion during OLV.
Using Lean Six Sigma to Decrease Delivery Time of Blood Products to the Operating Room
Authors: Garvanovic Samantha H. , Gatling Jason W. , Wang Annie T. , Wong Christine M. , Stevens Wesley T. , Lauer Ryan E. , Ramsingh Davinder
Published: May 2021

Lean Six Sigma (LSS) is a process improvement strategy used in many industries. Its goal is to improve performance and quality by eliminating waste, optimizing flow, and reducing variability. This article describes LSS methods and their application in health care. We detail a successful quality improvement (QI) initiative in which we tested LSS tools to evaluate and enhance our institution’s blood product delivery to the operating room (OR). Incorporating LSS-driven changes resulted in a revised workflow, which decreased personnel workload and significantly reduced delivery time. We hope this article will encourage other health care institutions to integrate LSS strategies into their workflows.
Critical Reading in a Screen Paradigm
Authors: Downs Doug
Published: May 2021

An important step in teaching critical reading for online civic reasoning is building teachers’ own acceptance of and comfort with screen literacies, understanding them not as alternative to gold-standard book literacies but as normative. To do so, teachers must better understand how web-based texts, and the reading of them, differ from the “classical” critical reading most teachers are used to. This article examines the “quantum” nature of web-based texts—their fundamental instability, their reader constructedness, and their nature as processes rather than objects—and relates these features to hyper-reading and other reading strategies that research shows allow engaged readers to screen-read critically.
Critical Thinking, Identity, and Performance
Authors: Clark Irene L.
Published: May 2021

Referencing current research in neuroscience, this article argues that although knowledge about logic and evidence are important for helping students become critical thinkers, teachers should devote attention to the nonrational biases currently being evoked for persuasion, plan additional class time for students to reflect on their own emotional biases, and encourage students to self-identify as critical thinkers, so that they will continue to think critically in other courses and contexts. To attain this goal, approaches involving performance and reflection should be given further attention to help students develop the habit of questioning the credibility of information.
Assessing the Impact on Critical Reading and Critical Thinking
Authors: Johnson Anna Maria , Jahan Nusrat
Published: May 2021

Although much has been written about the history of commonplacing, there is a lack of evidence-based research to show the extent to which this historical practice may still be valuable today as a pedagogy that educates citizens in critical reading for democracy. This article describes an institutional-review-board-approved, experimental study to answer this question. Three sections of the same first-year reading and writing course were compared: one section did not use commonplace books, a second section used commonplace books that included quotations only, and a third section used commonplace books with reflective writing. We expected to find that students who used commonplace books would perform better in end-of-study assessments than those who did not. Instead, we were surprised to find that many of the students who were not required to use commonplace books created their own note-taking methods that performed a similar function. In essence, they developed their own commonplace book culture and methodology using Google Docs and other social reading practices. Their performance was as strong as the students who used commonplace books.
“Writing Back to the News”
Authors: King-O'Brien Kelly
Published: May 2021

As online content has rapidly proliferated in recent years, college teachers may find teaching students how to navigate their way to reputable sources both more challenging and more crucial. When we integrate reading the news into our curricula, we can engage our students, cultivate their critical reading and writing skills, harness digital tools and sources, and teach students how to transfer those skills to academic writing and other endeavors. To fight fake news, students must learn to interrogate sources and writing in the news, thereby empowering them to read, discuss, and engage with contemporary and real-world problems with compassion, complexity, and nuance.
Alligators employ intermetatarsal reconfiguration to modulate plantigrade ground contact
Authors: Turner Morgan L. , Gatesy Stephen M.
Published: May 2021

Feet must mediate substrate interactions across an animal's entire range of limb poses used in life. Metatarsals, the ‘bones of the sole’, are the dominant pedal skeletal elements for most tetrapods. In plantigrade species that walk on the entirety of their sole, such as living crocodylians, intermetatarsal mobility offers the potential for a continuum of reconfiguration within the foot itself. Alligator hindlimbs are capable of postural extremes from a belly sprawl to a high walk to sharp turns – how does the foot morphology dynamically accommodate these diverse demands? We implemented a hybrid combination of marker-based and markerless X-ray reconstruction of moving morphology (XROMM) to measure 3D metatarsal kinematics in three juvenile American alligators (Alligator mississippiensis) across their locomotor and maneuvering repertoire on a motorized treadmill and flat-surfaced arena. We found that alligators adaptively conformed their metatarsals to the ground, maintaining plantigrade contact throughout a spectrum of limb placements with non-planar feet. Deformation of the metatarsus as a whole occurred through variable abduction (twofold range of spread) and differential metatarsal pitching (45 deg arc of skew). Internally, metatarsals also underwent up to 65 deg of long-axis rotation. Such reorientation, which correlated with skew, was constrained by the overlapping arrangement of the obliquely expanded metatarsal bases. Such a proximally overlapping metatarsal morphology is shared by fossil archosaurs and archosaur relatives. In these extinct taxa, we suggest that intermetatarsal mobility likely played a significant role in maintaining ground contact across plantigrade postural extremes.