bluuebunny/crossref_metadata_2025 huggingface dataset:
Time in range, assessed with continuous glucose monitoring, is associated with brachial-ankle pulse wave velocity in type 2 diabetes: A retrospective single-center analysis
Authors: Zhou Hui , Wang Wei , Shen Qiuyue , Feng Zhouqin , Zhang Zhen , Lei Haiyan , Yang Xinyi , Liu Jun , Lu Bin , Shao Jiaqing , Gu Ping
Published: October 2022

Aims

The aim of this retrospective single-center is to research the relationship between time in range(TIR), an important novel metric of glycemic control, assessed with continuous glucose monitoring(CGM) and brachial-ankle pulse wave velocity(BaPWV), a unique index of systemic arterial stiffness in type 2 diabetes.

Methods

Study participants included 469 hospitalized patients with type 2 diabetes and no history of serious cardiovascular disease who underwent CGM and BaPWV measurements. TIR of 3.9-10.0 mmol/L was evaluated with CGM. BaPWV was measured by non-invasive arteriosclerosis detector and high baPWV was defined as a mean baPWV≧1800m/s. The spearman correlation and the partial correlation analysis were applied to analyze the correlation between TIR and baPWV. The binary logistic regression was used to examine the independent association of TIR and high BaPWV.

Results

The presence of high baPWV was 32.2%. Compared with patients of low baPWV, those with high baPWV had significantly reduced TIR(P<0.001). With the increase of TIR tertiles, the prevalence of high BaPWV progressively decreased. Correlation analysis showed that TIR is inversely correlated with BaPWV. In a fully adjusted model controlling for traditional risk factor of CVD, TIR is associated with the presence of high BaPWV independent of HbA1c.

Conclusion

TIR is correlated with BaPWV independent of HbA1c in patients with type 2 diabetes, confirming a link between TIR and arterial stiffness.
Global research trends of steroid-induced osteonecrosis of the femoral head: A 30-year bibliometric analysis
Authors: Lu Chao , Qi Haodong , Xu Hanbo , Hao Yangquan , Yang Zhi , Yu Wenxing , Xu Peng
Published: October 2022

Objective

To explore the global research trends and hotspots of steroid-induced osteonecrosis of the femoral head (SONFH) through qualitative and quantitative analysis of bibliometrics.

Methods

All publications on SONFH published from 1992 to 2021 were extracted from the Web of Science Core Collection database. CiteSpace was used for the visualization analysis of major countries, active institutions, productive authors, and the burst of keywords. VOSviewer was used for coupling analysis of countries/regions, institutions, and authors. Microsoft Excel 2017 was used for statistical analysis, drawing bar charts, pie charts, and cumulative area charts. The software of MapInfo was used to draw the distribution map of the publications.

Results

A total of 780 publications were included for analyses. The most productive year was 2020 with 98 records. China was the most influential country with 494 publications, an H-index of 59, and total citations of 16820. The most prolific institution was Shanghai Jiaotong University in China with 53 publications and 998 citations. Clinical Orthopaedics and Related Research (IF = 4.755, 2021) was the most active journal with 26 articles. The hot keywords were “osteonecrosis”, “avascular necrosis”, “osteogenic differentiation”, “proliferation”, “PPAR gamma”, “apoptosis”, “oxidative stress”, “genetic polymorphism” and “mesenchymal stem cells”. The keywords like “proliferation”, “PPAR gamma” and “genome-wide” have emerged in recent years.

Conclusion

The number of publications in SONFH has increased significantly in the last three decades. The pathologic mechanism of SONFH gathered most research interests. Genomics and cell molecular biology of SONFH are the research frontiers.
Parathyroid adenoma in pregnancy: A case report and systematic review of the literature
Authors: Pliakos I. , Chorti A. , Moysidis Moysis , Kotsovolis G. , Kaltsas T. , Pana A. , Ioannidis A. , Papavramidis TS.
Published: October 2022

Objective

Primary hyperparathyroidism is a common disorder of the parathyroid glands. Parathyroid adenoma (PA) in pregnancy is a relatively rare disease, whose diagnosis and treatment is a challenging task. The aim of the present study is to present a new case of parathyroid adenoma during pregnancy and to give a detailed account of all reported cases of parathyroid adenoma during pregnancy in the literature.

Study design

A bibliographic research was performed, and characteristics of parathyroid adenomas in pregnancy such as age, gestational week at diagnosis, ionized calcium levels, genetic testing result, symptomatology, radiological method of localization, treatment method, gestational week at operation, and maternal/fetal complications were recorded.

Results

A 34-year-old woman at her 25 weeks’ gestation was diagnosed with parathyroid adenoma and was referred to our Surgical Department due to contraindication for conservative treatment. A parathyroidectomy was performed, and the maternal and fetal postoperative period was uneventful. Two hundred eleven cases of parathyroid adenoma in pregnancy were recorded in the literature, and statistical analysis was performed. The median gestational week at diagnosis was 21 ± 9.61 weeks. The mean level of ionized calcium was 2.69 mmol/l [SD = 0.75 (2.55–2.84 95% CI)]. Most cases were familiar (72.4%), while surgery was the preferred treatment option (67.3%). The majority of cases were asymptomatic (21.7%), and the main radiological method applied for localization was ultrasound (63.4%).

Conclusion

Parathyroid adenoma in pregnancy is a rare condition. The early diagnosis is of great importance as surgical treatment at the second trimester of pregnancy outweighs the maternal and fetal risks.
The resilience of pioneer crops in the highlands of Central Asia: Archaeobotanical investigation at the Chap II site in Kyrgyzstan
Authors: Motuzaite Matuzeviciute Giedre , van Unen Manon , Karaliute Ruta , Tabaldiev Kubatbek
Published: October 2022

This paper presents archaeobotanical research results from an occupation horizon of the Chap II site left by the earliest known farming community in the Central Tien Shan mountains in the current territory of Kyrgyzstan. The archaeobotanical samples were recovered from well-defined contexts in domestic waste pits, house floors, fireplaces, and an oven, all of which date to a narrow period of occupation between 2474 and 2162 cal BCE (based on n-14 AMS dates). The archaeobotanical assemblage is dominated by the SW package crops of bread wheat and naked barley. Those are the only species to have progressed further east across the mountain ranges of Central Asia during the earliest wave of crop dispersal. However, other species in small quantities were also identified at the Chap II site, such asT. durum/turgidumandT. carthlicum, possibly glume wheats and hulled barley. Here, we argue that the dominant compact morphotypes seen only in bread wheat and naked barley caryopses hint toward a selection for the specific adaptive traits of cultigens that enabled successful agriculture in high-altitude ecogeographies. Large variations in cereal caryopses size possibly indicate that crops endured stress (e.g., insufficient nutrients, water, or other) during plant development. More research is needed for a better understanding of the developmental plasticity between different crop species and the formation of unique landraces in diverse environmental niches in the past.
Applying differential network analysis to longitudinal gene expression in response to perturbations
Authors: Xue Shuyue , Rogers Lavida R.K. , Zheng Minzhang , He Jin , Piermarocchi Carlo , Mias George I.
Published: October 2022

Differential Network (DN) analysis is a method that has long been used to interpret changes in gene expression data and provide biological insights. The method identifies the rewiring of gene networks in response to external perturbations. Our study applies the DN method to the analysis of RNA-sequencing (RNA-seq) time series datasets. We focus on expression changes: (i) in saliva of a human subject after pneumococcal vaccination (PPSV23) and (ii) in primary B cells treatedex vivowith a monoclonal antibody drug (Rituximab). The DN method enabled us to identify the activation of biological pathways consistent with the mechanisms of action of the PPSV23 vaccine and target pathways of Rituximab. The community detection algorithm on the DN revealed clusters of genes characterized by collective temporal behavior. All saliva and some B cell DN communities showed characteristic time signatures, outlining a chronological order in pathway activation in response to the perturbation. Moreover, we identified early and delayed responses within network modules in the saliva dataset and three temporal patterns in the B cell data.
Regulatory mechanism of fibrosis-related genes in patients with heart failure
Authors: Tao Yijing , Gao ChengJie , Qian Da , Cao Donglai , Han Leng , Yang Ling
Published: October 2022

Background: Heart failure (HF) is a complex clinical syndrome characterized by the inability to match cardiac output with metabolic needs. Research on regulatory mechanism of fibrosis-related genes in patients with HF is very limited. In order to understand the mechanism of fibrosis in the development and progression of HF, fibrosis -related hub genes in HF are screened and verified.

Methods: RNA sequencing data was obtained from the Gene Expression Omnibus (GEO) cohorts to identify differentially expressed genes (DEGs). Thereafter, fibrosis-related genes were obtained from the GSEA database and that associated with HF were screened out. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways analysis was carried out to analyze the biological function of fibrosis-related DEGs. The protein-protein interaction (PPI) network of hub genes was constructed via the STRING database. Moreover, the diagnostic value of hub genes for HF was confirmed using ROC curves and expression analysis. Finally, quantitative real time PCR was used to detect the expression levels of mRNAs.

Results: A total of 3, 469 DEGs were identified closely related to HF, and 1, 187 fibrosis-related DEGs were obtained and analyzed for GO and KEGG enrichment. The enrichment results of fibrosis-related DEGs were consistent with that of DEGs. A total of 10 hub genes (PPARG, KRAS, JUN, IL10, TLR4, STAT3, CXCL8, CCL2, IL6, IL1β) were selected via the PPI network. Receiver operating characteristic curve analysis was estimated in the test cohort, and 6 genes (PPARG, KRAS, JUN, IL10, TLR4, STAT3) with AUC more than 0.7 were identified as diagnosis genes. Moreover, miRNA-mRNA and TF-mRNA regulatory networks were constructed. Finally, quantitative real time PCR revealed these 6 genes may be used as the potential diagnostic biomarkers of HF.

Conclusion: In this study, 10 fibrosis-related hub genes in the HF were identified and 6 of them were demonstrated as potential diagnostic biomarkers for HF.
Construction and analysis of a lncRNA–miRNA–mRNA competing endogenous RNA network from inflamed and normal synovial tissues after anterior cruciate ligament and/or meniscus injuries
Authors: Xiao Xiling , Yang Xiaofan , Ren Sen , Meng Chunqing , Yang Zhaohui
Published: October 2022

Background: Despite ample evidence demonstrating that anterior cruciate ligament (ACL) and meniscus tears are associated with posttraumatic osteoarthritis (PTOA) development, the contributing factors remain unknown. Synovial inflammation has recently been recognized as a pivotal factor in the pathogenesis of OA. However, there is a lack of data on synovial profiles after ACL or meniscus injuries, which may contribute to PTOA.

Methods: Twelve patients with ACL tears and/or meniscus injuries were recruited. During surgery, synovial tissues were obtained from the injured knees. The inflammation status of the synovium was characterized according to macroscopic criteria and histological synovitis grades. Then the synovial tissues were classified as control group or inflamed group. High-throughput RNA sequencing of the synovial samples (3 vs. 3) was conducted to identify differentially expressed (DE) RNAs. Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway, and protein–protein interaction (PPI) analyses were performed to investigate DE mRNAs. Next, competing endogenous RNA (ceRNA) networks were constructed based on bioinformatics analyses. Associations of the identified DE genes (DEGs) with infiltrating immune cells were explored using Pearson correlation analysis.

Results: The results showed that 2793 mRNAs, 3392 lncRNAs and 211 miRNAs were significantly DE between two groups. The top 3 significantly upregulated GO terms and KEGG pathways were immune response, adaptive immune response and immune system process, systemic lupus erythematosus, haematopoietic cell lineage and cytokine–cytokine receptor interaction, respectively. In PPI networks, the top 10 hub genes were IL6, CCR7, C3, CCR5, CXCR3, CXCL8, IL2, CCR3, CCR2 and CXCL1. Seven mRNAs (EPHA5, GSN, ORC1, TLN2, SOX6, NKD2 and ADAMTS19), 4 lncRNAs (MIR4435-2HG, TNXA, CEROX1 and TMEM92-AS1) and 3 miRNAs (miR-486-5p, miR-199a-3p and miR-21-3p) were validated by quantitative real-time polymerase chain reaction and sub-networks were constructed. In correlation analysis, MMP9 correlated positively with M0 macrophages and plasma cells, NKD2 positively with CD8 T cells, and CCR7 and IL2RB positively with naive B cells.

Conclusion: Our study provides foundational synovial inflammation profiles following knee trauma. The ceRNA and PPI networks provide new insight into the biological processes and underlying mechanisms of PTOA. The differential infiltration profiles of immune cells in synovium may contribute to PTOA development. This study also highlights immune-related DEGs as potential PTOA treatment biomarkers.
Innovative, complementary and alternative therapy in inflammatory bowel diseases: A broad 2020s update
Authors: Masi Letizia , Ciuffini Cristina , Petito Valentina , Pisani Laura Francesca , Lopetuso Loris Riccardo , Graziani Cristina , Pugliese Daniela , Laterza Lucrezia , Puca Pierluigi , Di Vincenzo Federica , Pizzoferrato Marco , Napolitano Daniele , Turchini Laura , Amatucci Valeria , Schiavoni Elisa , Privitera Giuseppe , Minordi Laura Maria , Mentella Maria Chiara , Papa Alfredo , Armuzzi Alessandro , Gasbarrini Antonio , Scaldaferri Franco
Published: October 2022

Inflammatory bowel diseases (IBD) are chronic disabling conditions with a complex and multifactorial etiology, which is still not completely understood. In the last 20 years, anti-TNF-α antagonists have revolutionized the treatment of IBD, but many patients still do not respond or experience adverse events. Therefore, new biological therapies and small molecules, targeting several different pathways of gut inflammation, have been developed of which some have already been introduced in clinical practice while many others are currently investigated. Moreover, therapeutic procedures such as leukocytapheresis, fecal microbiota transplant and stem cell transplantation are currently being investigated for treating IBD. Lastly, complementary and alternative medicine has become a field of interest for gastroenterologist to reduce symptom burden in IBD patients. In this comprehensive and updated review, a novel classification of current and developing drugs is provided.
Identification of the immunosuppressive effect of γδ T cells correlated to bone morphogenetic protein 2 in acute myeloid leukemia
Authors: Liang Shuang , Dong Tianhui , Yue Keli , Gao Haitao , Wu Ning , Liu Ruoyang , Chang Yan , Hao Le , Hu Lijuan , Zhao Ting , Jiang Qian , Huang Xiao-Jun , Liu Jiangying
Published: October 2022

Description of immune landscapes in malignant microenvironment is critical to the improvement of therapeutic strategies for various tumors. Acute myeloid leukemia (AML) remains a severe life-threatening malignancy and often confronts treatment dilemma in clinic. Although γδ T cells exhibit independent and potent cytotoxicity against leukemic cells in vitro and in the mouse models, efficacy of γδ T cell-based immunotherapy on AML patients has seemed unsatisfying so far. How the anti-AML capacity of γδ T cells is suppressed in vivo remains elusive. Herein, we found an aberrant γδ T cells subset expressing CD25+CD127lowVδ2+ in the bone marrows of patients with newly diagnosed AML. The emergence of this subset was significantly associated with disease status and risk stratification as well as with the abnormally increased bone morphogenetic protein 2 (BMP2). Mechanistically, BMP2 could directly induce CD25+CD127lowVδ2+ γδ T cells (named as Reg-Vδ2) in vitro. The immunosuppressive features of Reg-Vδ2 cells were identified by combining immunophenotypical and functional data. Furthermore, inhibition of BMP2 pathway significantly blocked the emergence of Reg-Vδ2 cells and enhanced the anti-AML immunity in humanized mice. These findings not only provide a novel insight into the mechanisms of immunosuppression in the context of leukemia, but also suggest potential targets for the treatment of AML and other hematopoietic malignancies.
The role of macrophage scavenger receptor 1 (MSR1) in inflammatory disorders and cancer
Authors: Gudgeon Jack , Marín-Rubio José Luis , Trost Matthias
Published: October 2022

Macrophage scavenger receptor 1 (MSR1), also named CD204, holds key inflammatory roles in multiple pathophysiologic processes. Present primarily on the surface of various types of macrophage, this receptor variably affects processes such as atherosclerosis, innate and adaptive immunity, lung and liver disease, and more recently, cancer. As highlighted throughout this review, the role of MSR1 is often dichotomous, being either host protective or detrimental to the pathogenesis of disease. We will discuss the role of MSR1 in health and disease with a focus on the molecular mechanisms influencing MSR1 expression, how altered expression affects disease process and macrophage function, the limited cell signalling pathways discovered thus far, the emerging role of MSR1 in tumour associated macrophages as well as the therapeutic potential of targeting MSR1.
Progress in the application of body fluid and tissue level mRNAs-non-coding RNAs for the early diagnosis and prognostic evaluation of systemic lupus erythematosus
Authors: Liang Jiabin , Xie Fangmei , Feng Jie , Huang Chen , Shen Jian , Han Zeping , Luo Wenfeng , He Jinhua , Chen Hanwei
Published: October 2022

The diagnosis and differential classification of systemic lupus erythematosus (SLE) is difficult, especially in patients with early-onset SLE who are susceptible to systemic multi-organ damage and serious complications and have difficulties in individualized treatment. At present, diagnosis is based mainly on clinical manifestations and the detection of serological antinuclear antibodies. The pathogenesis of SLE involves multiple factors, is clinically heterogeneous, and lacks specific biomarkers. Therefore, it is necessary to identify new biomarkers for the diagnosis and subtype classification of SLE. Non-coding RNAs (ncRNAs) are composed of microRNAs, long non-coding RNAs, small nucleolar RNAs, circular RNAs, and transfer RNAs. They play an important role in the occurrence and development of diseases and are used widely in the early diagnosis and prognosis of autoimmune diseases. In this review, we focus on the research progress in the diagnosis and prognostic assessment of SLE using humoral to tissue level ncRNAs.
Characteristics of cerebral blood flow in an Eastern sample of multiple sclerosis patients: A potential quantitative imaging marker associated with disease severity
Authors: Zhou Qinming , Zhang Tianxiao , Meng Huanyu , Shen Dingding , Li Yao , He Lu , Gao Yining , Zhang Yizongheng , Huang Xinyun , Meng Hongping , Li Biao , Zhang Min , Chen Sheng
Published: October 2022

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system that is rare in China. At present, there are no widespread quantitative imaging markers associated with disease severity in MS. Despite several previous studies reporting cerebral blood flow (CBF) changes in MS, no consensus has been reached. In this study, we enrolled 30 Eastern MS patients to investigate CBF changes in different brain regions using the arterial spin labeling technique and their relationship with disease severity. The average CBF in MS patients were higher than those in health controls in various brain regions except cerebellum. The results indicated that MS patients with strongly increased CBF showed worse disease severity, including higher Expanded Disability Status Scale (EDSS) scores and serum neurofilament light chain (sNfL) values than those with mildly increased CBF in the parietal lobes, temporal lobes, basal ganglia, and damaged white matter (DWM). From another perspective, MS patients with worse disease severity (higher EDSS score and sNfL values, longer disease duration) showed increased CBF in parietal lobes, temporal lobes, basal ganglia, normal-appearing white matter (NAWM), and DWM. Correlation analysis showed that there was a strong association among CBF, EDSS score and sNfL. MS patients with strongly increased CBF in various brain regions had more ratio in relapsing phase than patients with mildly increased CBF. And relapsing patients showed significantly higher CBF in some regions (temporal lobes, left basal ganglia, right NAWM) compared to remitting patients. In addition, MS patients with cognitive impairment had higher CBF than those without cognitive impairment in the right parietal lobe and NAWM. However, there were no significant differences in CBF between MS patients with and without other neurologic dysfunctions (e.g., motor impairment, visual disturbance, sensory dysfunction). These findings expand our understanding of CBF in MS and imply that CBF could be a potential quantitative imaging marker associated with disease severity.
The affinity of antigen-binding domain on the antitumor efficacy of CAR T cells: Moderate is better
Authors: Mao Rui , Kong Wanqing , He Yukai
Published: October 2022

The overall efficacy of chimeric antigen receptor modified T cells (CARTs) remain limited in solid tumors despite intensive studies that aim at targeting multiple antigens, enhancing migration, reducing tonic signaling, and improving tumor microenvironment. On the other hand, how the affinity and engaging kinetics of antigen-binding domain (ABD) affects the CART’s efficacy has not been carefully investigated. In this article, we first analyzed 38 published solid tumor CART trials and correlated the response rate to their ABD affinity. Not surprisingly, majority (25 trials) of the CARTs utilized high-affinity ABDs, but generated merely 5.7% response rate. In contrast, 35% of the patients treated with the CARTs built from moderate-affinity ABDs had clinical responses. Thus, CARTs with moderate-affinity ABDs not only have less off-target toxicity, but also are more effective. We then reviewed the effects of ABD affinity on the biology and function of CARTs, providing further evidence that moderate-affinity ABDs may be better in CART development. In the end, we propose that a fast-on/fast-off (high Kon and Koff) kinetics of CART-target engagement in solid tumor allow CARTs to generate sufficient signaling to kill tumor cells without being driven to exhaustion. We believe that studying the ABD affinity and the kinetics of CART-tumor interaction may hold a key to designing effective CARTs for solid tumors.
Small-scale benthic faunal activities may lead to large-scale morphological change- A model based assessment
Authors: Arlinghaus Peter , Zhang Wenyan , Schrum Corinna
Published: October 2022

A novel 3-dimensional numerical model resolving dynamic interactions between environmental drivers and benthic fauna was applied to an idealized domain as analogous to typical tidal embayments. The aim is to derive insights into the role of benthic fauna in guiding long-term (decadal to centennial) coastal morphological evolution at a system scale. Three major functions by benthic fauna on sediment dynamics, namely bio-destabilization, bio-deposition and bio-stabilization, were incorporated. Results indicate that each of the three functions is able to guide a unique and profound long-term change of the embayment morphology. Bioturbation-induced sediment mixing and bio-destabilization may result in net sediment export out of the embayment, whilst bio-deposition and bio-stabilization tend to alter the embayment toward a net sediment import environment. Benthic fauna is able to modify large-scale hydro-morphology toward a state favorable for living. A combined effect of the three functions is not just a simple neutralization of the opposing impacts between sediment stabilization and destabilization. Rather, it leads to a unique response of the embayment morphology due to interactions between different benthic functional groups. Comparison with a real tidal embayment (Jade Bay from the Wadden Sea) justified a general validity of the model results in terms of statistics in both morphology and benthic fauna, and suggested an equal importance of interactions between benthic fauna and bed morphology and between different benthic functional groups in guiding morphological development of complex coastal systems.
Insignificant effects of eddies and typhoons on the biogeochemistry of the tropical northwest Pacific Ocean
Authors: Seo Junhyeong , Hahm Doshik , Kim Guebuem , Lee Inhee , Park Jihyun , Na Taehee , Park Jae-Hyoung , Kang Sok Kuh , Hwang Jeomshik
Published: October 2022

We investigated the effects of eddies and typhoons on the biogeochemistry of the tropical northwest Pacific by examining the distribution of nutrients, dissolved oxygen (DO), chlorophyll-a (Chl-a), gross primary production (GPP), dissolved organic carbon (DOC), and fluorescent dissolved organic matter (FDOM). Water samples were collected from anticyclonic and cyclonic eddies in September 2019 and 2020, and before and after the passage of a Category 2 typhoon in 2019. The study region was characterized by a deep nitracline (~150 m), which was deeper than both the pycnocline (~50 m) and the FDOM-depleted layer (~75 m). A subsurface chlorophyll maximum layer was observed at 100–150 m depth. No clear differences in Chl-a, DO, GPP, DOC, and FDOM were observed for the anticyclonic and cyclonic eddies, indicating that the eddies did not have a significant influence on biological production. Similarly, there were no discernable changes in Chl-a concentrations or other biogeochemical parameters after the passage of the typhoon, which induced water mixing to a depth of ~60 m. We conjecture that the nutrient-depleted layer was too deep for any eddy- or typhoon-induced vertical mixing to cause upwelling of nutrients to the euphotic zone. Our results imply that the disturbances caused by mesoscale processes in the upper layer of the highly oligotrophic northwest Pacific may have a smaller effect than in oceans in other parts of the world.
A phased intervention bundle to decrease the mortality of patients with extracorporeal membrane oxygenation in intensive care unit
Authors: Jing Yajun , Yuan Zhiyong , Zhou Weigui , Han Xiaoning , Qi Qi , Song Kai , Xing Jinyan
Published: October 2022

Aim

To evaluate whether a phased multidimensional intervention bundle would decrease the mortality of patients with extracorporeal membrane oxygenation (ECMO) and the complication incidence.

Materials and methods

We conducted a prospective observational study in comparison with a retrospective control group in six intensive care units (ICUs) in China. Patients older than 18 years supported with ECMO between March 2018 to March 2022 were included in the study. A phased intervention bundle to improve the outcome of patients with ECMO was developed and implemented. Multivariable logistic regression modeling was used to compare the mortality of patients with ECMO and the complication incidence before, during, and up to 18 months after implementation of the intervention bundle.

Results

The cohort included 297 patients in 6 ICUs, mostly VA ECMO (68.7%) with a median (25th–75th percentile) duration in ECMO of 9.0 (4.0–15.0) days. The mean (SD) APECHII score was 24.1 (7.5). Overall, the mortality of ECMO decreased from 57.1% at baseline to 21.8% at 13–18 months after implementation of the study intervention (P < 0.001). In multivariable analysis, even after excluding the confounding factors, such as age, APECHII score, pre-ECMO lactate, and incidence of CRRT during ECMO, the intervention bundle still can decrease the mortality independently, which also remained true in the statistical analysis of V-V and V-A ECMO separately. Among all the ECMO-related complications, the incidence of bloodstream infection and bleeding decreased significantly at 13–18 months after implementation compared with the baseline. The CUSUM analysis revealed a typical learning curve with a point of inflection during the implementation of the bundle.

Conclusion

A phased multidimensional intervention bundle resulted in a large and sustained reduction in the mortality of ECMO that was maintained throughout the 18-month study period.

Clinical trial registration

[ClinicalTrials.gov], identifier [NCT05024786].
A protocol on the effects of interactive digital assistance on engagement and perceived quality of care of surgery patients and self-efficacy and workload of staff
Authors: Plohl Nejc , Flis Vojko , Bergauer Andrej , Kobilica Nina , Kampič Tadej , Horvat Samo , Vidovič Damjan , Musil Bojan , Smrke Urška , Mlakar Izidor
Published: October 2022

Introduction

The workforce shortage in the healthcare context is a growing issue that exerts detrimental effects on employees (e.g., higher workload) and patients (e.g., suboptimal patient care). Since traditional approaches alone may not be enough to solve this problem, there is a need for complementary innovative digital health solutions, such as socially assistive robots. Hence, the proposed study aims to investigate the effects of gamified nursing education and physiotherapy delivered by a socially assistive robot on patient- (engagement, perceived quality of care) and employee-related outcomes (perceived self-efficacy, workload).

Methods and analysis

Approximately 90 vascular and thoracic surgery patients will receive either standard care or standard care with additional robot interactions over the course of 3–5 days. Additionally, approximately 34 nursing and physiotherapeutic employees will fill out self-report questionnaires after weeks of not using a social robot and weeks of using a social robot. The main hypotheses will be tested with mixed-design analyses of variance and paired-samples t-tests.

Discussion

While the proposed study has some limitations, the results will provide high-quality and comprehensive evidence on the effectiveness of socially assistive robots in healthcare.

Ethics and dissemination

The study was approved by the Medical Ethics Commission of the University Medical Center and registered in the ISRCTN registry (ISRCTN96689284). The study findings will be summarized in international peer-reviewed scientific journals and meetings and communicated to relevant stakeholders.
Molecular characterization and virulence gene profiling of methicillin-resistant Staphylococcus aureus associated with bloodstream infections in southern China
Authors: Zhao Rui , Wang Xing , Wang Xinhui , Du Bingyu , Xu Kexin , Zhang Faming , Jiang Changhong , Zhao Yanfeng , Zhu Yefei
Published: October 2022

Methicillin-resistant Staphylococcus aureus (MRSA) causes an enormous illness burden, including skin and soft tissue infections (SSTIs), pneumonia, bloodstream infections (BSI), and sepsis. BSI are associated with significant patient morbidity and mortality worldwide. However, limited information is available on MRSA-related BSI in China. This study aimed to investigate the molecular characterization of 77 MRSA isolates recovered from hospitalized patients with BSI between 2012 and 2020 at three first-class tertiary hospitals in southern China based on multilocus sequence typing (MLST), spa typing, and staphylococcal cassette chromosome mec (SCCmec) typing. Overall, 13 clonal complexes (CCs) were identified, with CC59 and CC5 being the largest clusters, indicating high genetic diversity among BSI-causing MRSA isolates. ST59 was the most prevalent MLST type (22.1%). ST5/ST764-MRSA SCCmec II was the predominant adult MRSA clone, whereas ST59-MRSA SCCmec IV was the most common pediatric MRSA clone. ST5-t2460, ST764-t1084, and ST59-t437 were the most common types of adult MRSA isolates, whereas ST59-t437 and ST59-t172 were the predominant types of children’s MRSA isolates. ST59-SCCmec IV/V represented the most common clone among community acquired-MRSA isolates. ST5/ST764-SCCmec II was the most common type of hospital-associated MRSA isolate. The most prevalent toxin-encoding genes detected were hla, hld, icaA, and clfA (96.1–100%). Forty-three (100%, 43/43) isolates harbored more than 18 of the tested virulence genes in adults and eight virulence genes (23.5%, 8/34) in children. Virulence gene analysis revealed diversity among different clones: the positivity rates for the Panton-Valentine leukocidin (PVL) gene were 55.8 and 35.3% in adult and pediatric MRSA isolates, respectively; the genes seb–sei were present in all adult strains; seb–seg–sei–seo were present in all ST5, ST59, ST15, ST45, and ST22 adult strains; and seg–sei–sem–sen–seo were present in different clones, including ST15, ST45, and ST22 adult MRSA isolates and ST25, ST30, ST546, and ST72 children’s MRSA isolates. Adult MRSA isolates had significantly higher antibiotic resistance rates and virulence gene prevalence than pediatric MRSA isolates. For 8 years, this study provided epidemiological data on the molecular characteristics and virulence genes in different groups of MRSA BSI in China. Our findings may provide critical information for a better understanding of MRSA BSI.
A novel therapeutic concern: Antibiotic resistance genes in common chronic diseases
Authors: Pan Xiaxia , Zhou Ziyuan , Liu Bowen , Wu Zhongwen
Published: October 2022

Infections caused by multidrug-resistant bacteria carrying antibiotic resistance genes pose a severe threat to global public health and human health. In clinical practice, it has been found that human gut microbiota act as a “reservoir” of antibiotic resistance genes (ARGs) since gut microbiota contain a wide variety of ARGs, and that the structure of the gut microbiome is influenced by the profile of the drug resistance genes present. In addition, ARGs can spread within and between species of the gut microbiome in multiple ways. To better understand gut microbiota ARGs and their effects on patients with chronic diseases, this article reviews the generation of ARGs, common vectors that transmit ARGs, the characteristics of gut microbiota ARGs in common chronic diseases, their impact on prognosis, the current state of treatment for ARGs, and what should be addressed in future research.
A pilot study to show that asymptomatic sexually transmitted infections alter the foreskin epithelial proteome
Authors: Chigorimbo-Murefu Nyaradzo T. L. , Potgieter Matthys , Dzanibe Sonwabile , Gabazana Zikhona , Buri Gershom , Chawla Aditya , Nleya Bokani , Olivier Abraham J. , Harryparsad Rushil , Calder Bridget , Garnett Shaun , Maziya Lungile , Lewis David A. , Jaspan Heather , Wilson Doug , Passmore Jo-Ann S. , Mulder Nicola , Blackburn Jonathan , Bekker Linda-Gail , Gray Clive M.
Published: October 2022

There is limited data on the role of asymptomatic STIs (aSTIs) on the risk of human immunodeficiency virus (HIV) acquisition in the male genital tract (MGT). The impact of foreskin removal on lowering HIV acquisition is well described, but molecular events leading to HIV acquisition are unclear. Here, in this pilot study, we show that asymptomatic urethral infection with Chlamydia trachomatis (CT) significantly impacts the foreskin proteome composition. We developed and optimized a shotgun liquid chromatography coupled tandem mass spectrometry (MS)-based proteomics approach and utilized this on foreskins collected at medical male circumcision (MMC) from 16 aSTI+ men and 10 age-matched STI- controls. We used a novel bioinformatic metaproteomic pipeline to detect differentially expressed (DE) proteins. Gene enrichment ontology analysis revealed proteins associated with inflammatory and immune activation function in both inner and outer foreskin from men with an aSTI. Neutrophil activation/degranulation and viral-evasion proteins were significantly enriched in foreskins from men with aSTI, whereas homotypic cell–cell adhesion proteins were enriched in foreskin tissue from men without an aSTI. Collectively, our data show that asymptomatic urethral sexually transmitted infections result in profound alterations in epithelial tissue that are associated with depletion of barrier integrity and immune activation.
Abnormal static and dynamic functional network connectivity in stable chronic obstructive pulmonary disease
Authors: Tang Fuqiu , Li Lan , Peng Dechang , Yu Jingjing , Xin Huizhen , Tang Xuan , Li Kunyao , Zeng Yaping , Xie Wei , Li Haijun
Published: October 2022

Objective

Many studies have explored the neural mechanisms of cognitive impairment in chronic obstructive pulmonary disease (COPD) patients using the functional MRI. However, the dynamic properties of brain functional networks are still unclear. The purpose of this study was to explore the changes in dynamic functional network attributes and their relationship with cognitive impairment in stable COPD patients.

Materials and methods

The resting-state functional MRI and cognitive assessments were performed on 19 stable COPD patients and 19 age-, sex-, and education-matched healthy controls (HC). We conducted the independent component analysis (ICA) method on the resting-state fMRI data, and obtained seven resting-state networks (RSNs). After that, the static and dynamic functional network connectivity (sFNC and dFNC) were respectively constructed, and the differences of functional connectivity (FC) were compared between the COPD patients and the HC groups. In addition, the correlation between the dynamic functional network attributes and cognitive assessments was analyzed in COPD patients.

Results

Compared to HC, there were significant differences in sFNC among COPD patients between and within networks. COPD patients showed significantly longer mean dwell time and higher fractional windows in weaker connected State I than that in HC. Besides, in comparison to HC, COPD patients had more extensive abnormal FC in weaker connected State I and State IV, and less abnormal FC in stronger connected State II and State III, which were mainly located in the default mode network, executive control network, and visual network. In addition, the dFNC properties including mean dwell time and fractional windows, were significantly correlated with some essential clinical indicators such as FEV1, FEV1/FVC, and c-reactive protein (CRP) in COPD patients.

Conclusion

These findings emphasized the differences in sFNC and dFNC of COPD patients, which provided a new perspective for understanding the cognitive neural mechanisms, and these indexes may serve as neuroimaging biomarkers of cognitive performance in COPD patients.
First-principles calculations of the optical response of single-layer and bilayer armchair graphene nanoribbons
Authors: Ge Yijun , Fisher Timothy S.
Published: October 2022

Electronic and optical properties of single-layer and bilayer armchair graphene nanoribbons are investigated using a first-principles method. Increased nanoribbon width reduces the band gap and causes a red shift in photon absorption energy. The 3n + 2 family of nanoribbons has the smallest band gaps and lowest onset photon absorption energy among the three families considered due to high π-conjugation indicated by exciton wavefunctions. We also compare the bilayer α and β alignments of armchair graphene nanoribbons with their single-layer counterparts. The extra layer of graphene reduces the band gap and onset photon absorption energy, and the difference between the α alignment and the single-layer configuration is more significant than that of the β alignment and the single layer. Our calculations indicate that the optical properties of graphene nanoribbons depend on the details of atomic structures, including nanoribbon width, edge alignment and number of layers. These characteristics are expected to be important in the design of optoelectronic devices.
Fixed/Predefined-time synchronization of memristor-based complex-valued BAM neural networks for image protection
Authors: Liu Aidi , Zhao Hui , Wang Qingjie , Niu Sijie , Gao Xizhan , Su Zhen , Li Lixiang
Published: October 2022

This paper investigates the fixed-time synchronization and the predefined-time synchronization of memristive complex-valued bidirectional associative memory neural networks (MCVBAMNNs) with leakage time-varying delay. First, the proposed neural networks are regarded as two dynamic real-valued systems. By designing a suitable feedback controller, combined with the Lyapunov method and inequality technology, a more accurate upper bound of stability time estimation is given. Then, a predefined-time stability theorem is proposed, which can easily establish a direct relationship between tuning gain and system stability time. Any predefined time can be set as controller parameters to ensure that the synchronization error converges within the predefined time. Finally, the developed chaotic MCVBAMNNs and predefined-time synchronization technology are applied to image encryption and decryption. The correctness of the theory and the security of the cryptographic system are verified by numerical simulation.
Case report: A compound heterozygous mutations in ARSA associated with adult-onset metachromatic leukodystrophy
Authors: Wang Bing-lei , Lu Fen-lei , Sun Yu-chen , Wang Hui-juan
Published: October 2022

Metachromatic Leukodystrophy (MLD) is a rare autosomal recessive disease, which is caused by mutations in the arylsulfatase A (ARSA) gene. The ARSA gene is located on chromosome 22q13, containing eight exons. According to the age of onset, MLD can be divided into late infantile type, juvenile type, and adult type. Adult MLD has an insidious onset after the age of 16 years. Additionally, intellectual as well as behavioral changes, such as memory deficits or emotional instability, are commonly the first presenting symptoms. There is a study that reported an adult-onset MLD manifested cognitive impairment progressively due to compound heterozygous mutations of NM_000487: c.[185_186dupCA], p.(Asp63GlnfsTer18), and NM_000487: c.[154G>T], p.(Gly172Cys), rs74315271 in the ARSA gene, finding that the c.[154G>T], p.(Gly172Cys) is a novel missense mutation. Brain magnetic resonance imaging (MRI) revealed symmetrical demyelination of white matter. The activity of ARSA enzymatic in leukocytes decreased. Nerve conduction studies displayed that evidence of polyneuropathy was superimposed upon diffuse, uniform demyelinating, and sensorimotor polyneuropathy. Family genes revealed that each family member carried one of two heterozygous mutant genes. She has been discharged and is currently being followed up. This study found a compound heterozygous mutation in the ARSA gene associated with MLD and identified a novel missense mutation NM_000487: c.[154G>T], p.(Gly172Cys), rs74315271. This will provide a critical clue for prenatal diagnosis of the offspring in this family, and expand the mutation spectrum of MLD-related ARSA.
Hippocampal atrophy in neurofunctional subfields in insomnia individuals
Authors: Yang Yang , Liang Wei , Wang Yongjun , Peng Dechang , Gong Liang , Wang Na , Huang Zhongjie , Yang Weikang
Published: October 2022

Objective

The aim of this study was to investigate the pattern of volume changes in neurofunctional hippocampal subfields in patients with insomnia and their associations with risk of development of insomnia.

Methods

A total of 120 patients with insomnia (78 females, 42 males; mean age ± standard deviation, 43.74 ± 13.02 years) and 120 good sleepers (67 females, 53 males; mean age, 42.69 ± 12.24 years) were recruited. The left hippocampus was segmented into anterior (L1), middle (L2), and posterior (L3) subregions. The right hippocampus was segmented into top anterior (R1), second top anterior (R2), middle (R3), posterior (R4), and last posterior (R5) subregions. Multivariate logistic regression was used to evaluate the associations of hippocampal volume (HV) of each subfield with the risk of the development of insomnia. Mediation analyses were performed to evaluate mediated associations among post-insomnia negative emotion, insomnia severity, and HV atrophy. A visual easy-to-deploy risk nomogram was used for individual prediction of risk of development of insomnia.

Results

Hippocampal volume atrophy was identified in the L1, R1, and R2 subregions. L1 and R2 volume atrophy each predisposed to an ~3-fold higher risk of insomnia (L1, odds ratio: 2.90, 95% confidence intervals: [1.24, 6.76], p = 0.014; R2, 2.72 [1.19, 6.20], p = 0.018). Anxiety fully mediates the causal path of insomnia severity leading to R1 volume atrophy with a positive effect. We developed a practical and visual competing risk-nomogram tool for individual prediction of insomnia risk, which stratifies individuals into different levels of insomnia risk with the highest prediction accuracy of 97.4% and an average C-statistic of 0.83.

Conclusion

Hippocampal atrophy in specific neurofunctional subfields was not only found to be associated with insomnia but also a significant risk factor predicting development of insomnia.
Sanghuangporus vaninii fruit body polysaccharide alleviates hyperglycemia and hyperlipidemia via modulating intestinal microflora in type 2 diabetic mice
Authors: Huang Zi-Rui , Huang Qi-Zhen , Chen Ke-Wen , Huang Zi-Feng , Liu Yun , Jia Rui-Bo , Liu Bin
Published: October 2022

The disease of type 2 diabetes mellitus (T2DM) is principally induced by insufficient insulin secretion and insulin resistance. In the current study, Sanghuangporus vaninii fruit body polysaccharide (SVP) was prepared and structurally characterized. It was shown that the yield of SVP was 1.91%, and SVP mainly contains small molecular weight polysaccharides. Afterward, the hypoglycemic and hypolipidemic effects and the potential mechanism of SVP in T2DM mice were investigated. The results exhibited oral SVP could reverse the body weight loss, high levels of blood glucose, insulin resistance, hyperlipidemia, and inflammation in T2DM mice. Oral SVP increased fecal short-chain fatty acids (SCFAs) concentrations of T2DM mice. Additionally, 16S rRNA sequencing analysis illustrated that SVP can modulate the structure and function of intestinal microflora in T2DM mice, indicating as decreasing the levels of Firmicutes/Bacteroidetes, Flavonifractor, Odoribacter, and increasing the levels of Weissella, Alloprevotella, and Dubosiella. Additionally, the levels of predicted metabolic functions of Citrate cycle, GABAergic synapse, Insulin signaling pathway were increased, and those of Purine metabolism, Taurine and hypotaurine metabolism, and Starch and sucrose metabolism were decreased in intestinal microflora after SVP treatment. These findings demonstrate that SVP could potentially play hypoglycemic and hypolipidemic effects by regulating gut microflora and be a promising nutraceutical for ameliorating T2DM.