bluuebunny/crossref_metadata_2025 huggingface dataset:
Information needs of parents of children with congenital anomalies across Europe: a EUROlinkCAT survey
Authors: Marcus Elena , Latos-Bielenska Anna , Jamry-Dziurla Anna , Barišić Ingeborg , Cavero-Carbonell Clara , Den Hond Elly , Garne Ester , Genard Lucas , Santos Ana João , Lutke LRenée , Matias Dias Carlos , Neergaard Pedersen Christina , Neville Amanda J. , Niemann Annika , Odak Ljubica , Pierini Anna , Rico Juan , Rissmann Anke , Rankin Judith , Morris Joan K.
Published: November 2022

Background

Parents of children who have a congenital anomaly can experience significant worry about their child’s health. Access to clear, helpful, and trustworthy information can provide a valuable source of support. In this study the aim was to explore the information needs of parents/carers of children with congenital anomalies across Europe.

Method

A cross-sectional online survey was developed in nine languages to measure parents’ information needs, including: (1) the ‘helpfulness’/’trustworthiness’ of information received from eight relevant sources, and (2) overall satisfaction with information received. Parents/carers of children (0–10 years) with cleft lip, spina bifida, congenital heart defect [CHD] requiring surgery, and/or Down syndrome were recruited online via relevant organisations in 10 European countries from March-July 2021. Quantitative analyses using multivariable logistic regressions were performed.

Results

One thousand seventy parents/carers of children with a cleft lip (n = 247), spina bifida (n = 118), CHD (n = 366), Down syndrome (n = 281), and Down syndrome with CHD (n = 58) were recruited in Poland (n = 476), the UK (n = 120), Germany (n = 97), the Netherlands/Belgium (n = 74), Croatia (n = 68), Italy (n = 59), other European countries (n = 92), and not specified/non-European countries (n = 84). Most participants were mothers (92%) and aged 31–40 years (71%). Participants were most likely to rate support groups (63%), patient organisations (60%), specialist doctors/nurses (58%), and social media (57%) as ‘very helpful’ information sources. ‘Very trustworthy’ ratings remained high for specialist doctors/nurses (61%), however, they declined for support groups (47%), patient organisations (48%), and social media (35%). Germany had the highest proportion of participants who were ‘very satisfied’ (44%, 95% CI = 34%-54%) with information, whereas this percentage was lowest in Croatia (11%, 95% CI = 3%-19%) and Poland (15%, 95% CI = 11%-18%). Parents of children with Down syndrome had significantly lower satisfaction ratings than parents of children with CHD; 13% (95% CI = 8%-18%) reported being ‘very satisfied’ compared to 28% (95% CI = 23%-33%) in the CHD group.

Conclusions

Findings suggest that informal sources of information (e.g. support groups) are of value to parents, however, they are not deemed as trustworthy as specialist medical sources. Satisfaction ratings differed across countries and by anomaly, and were particularly low in Croatia and Poland, as well as for parents of children with Down syndrome, which warrants further investigation.
Congenital anomalies during the 2015–2018 Zika virus epidemic: a population-based cross-sectional study
Authors: Venancio Fabio Antonio , Quilião Maria Eulina , de Almeida Moura Danielli , de Azevedo Micael Viana , de Almeida Metzker Sahra , Mareto Lisany Krug , de Medeiros Márcio José , Santos-Pinto Cláudia Du Bocage , de Oliveira Everton Falcão
Published: November 2022

Background

Congenital anomalies are associated with several clinical and epidemiological complications. Following the Zika epidemic onset in Latin America, the incidence of congenital anomalies increased in Brazil. This study aimed to determine the frequency of congenital anomalies in one Brazilian state and assess potential factors associated with them.

Methods

This cross-sectional descriptive study was based on data concerning congenital anomalies recorded in the Brazilian Live-Born Information System during the Zika epidemic in Mato Grosso do Sul state from 2015 to 2018. Congenital anomalies were stratified according to year of birth and classified using ICD-10 categories.

Results

In total, 1,473 (0.85%) anomalies were registered. Within the number of cases recorded, microcephaly showed the greatest frequency and variations, with a 420% increase observed in the number of cases from 2015 to 2016. We identified an increase in the incidence of central nervous system anomalies, with the highest peak observed in 2016 followed by a subsequent decrease. Musculoskeletal, nervous, and cardiovascular system anomalies, and eye, ear, face, and neck anomalies represented 73.9% of all recorded anomalies. There was an increased chance of congenital anomalies in uneducated (odds ratio [OR] 5.56, 95% confidence interval [CI] 2.61–11.84) and Indigenous (OR 1.32, 95% CI 1.03–1.69) women, as well as among premature births (OR 2.74, 95% CI 2.39–3.13).

Conclusions

We estimated the incidence of congenital anomalies during the Zika epidemic. Our findings could help to support future research and intervention strategies in health facilities to better identify and assist children born with congenital anomalies.
Acute effect of fine particulate matter and respiratory mortality in Changsha, China: a time-series analysis
Authors: Feng Qi , Chen Yan , Su Sha , Zhang Xixing , Lin Xijian
Published: November 2022

Background

Previous studies have confirmed that exposure to fine particulate matter (PM2.5) is associated with respiratory disease mortality. However, due to the differences in PM2.5 concentration, composition and population susceptibility within different regions, the estimates of the association between PM2.5 concentration and mortality are different. Moreover, few studies have examined the potential hazard of excessive PM2.5 exposure in terms of respiratory disease mortality.

Methods

Daily recorded data on meteorological indices, environmental pollutants, and causes of death data in Changsha from January 2015 to December 2018 were obtained. The potential relationship between PM2.5 concentrations and respiratory disease mortality was determined using distributed lag nonlinear model (DLNM), which includes the relative risk (RR) and cumulative relative risk (CRR) of the lagged effect. The synergistic effects of other air pollutants were also considered.

Results

A total of 8,825 cases of respiratory disease mortality occurred in Changsha between 2015 and 2018. The acute effect of PM2.5 concentration was associated with an increased risk of respiratory disease mortality. Regarding the lag specific effect, a 10 μg/m3 increase in PM2.5 concentration on respiratory disease mortality was statistically significant at lag day 0 and lag day 7 with a relative risk of 1.019 (95% CI 1.007- 1.031) and 1.013(95%CI: 1.002-1.024). As for the cumulative lag effect, a 4-day moving average of PM2.5 concentrations was significantly associated with a cumulative relative risk of 1.027 (95%CI: 1.011-1.031). The single-day lag effect and cumulative 4-day lag effect for male individuals were more significant than those observed in females. The effect of PM2.5 concentrations and respiratory disease mortality remained statistically significant in the multi-pollutant models (SO2, NO2, and O3). A higher risk was observed in the cold season than in the warm season.

Conclusions

Our findings show a potential association between exposure to PM2.5 concentration and respiratory disease mortality in Changsha, with male individuals observed to have particularly higher risk.
Association of Underlying Comorbidities and Sites of tuberculosis: an analysis using surveillance data
Authors: Jeong Yun-Jeong , Kang Ji Young , Kim Hyung Woo , Min Jinsoo , Ko Yousang , Oh Jee Youn , Kang Hyeon Hui , Lim Sung Chul , Hwang Hun-Gyu , Shin Kyeong-Cheol , Lee Heung Bum , Kim Ju Sang , Park Jae Seuk , Lee Sung Soon , Koo Hyeon-Kyoung
Published: November 2022

Background

Tuberculosis (TB) is a highly heterogeneous disease that can affect any organ. Extrapulmonary TB (EPTB) is more difficult to diagnose due to various clinical presentations. Depending on the characteristics of the patient, the involved site of TB may vary. However, data on clinical characteristics of EPTB are inconsistent and insufficient. This study aimed to identify the characteristics of patients with pulmonary TB (PTB) and EPTB and describe characteristic differences for each involved site.

Methods

We systemically collected data of TB patients included in the national surveillance system in South Korea from July 2018 to June 2019 and compared the characteristics of patients with EPTB with that of PTB.

Results

A total of 7674 patients with a mean age of 60.9 years were included. Among them, 6038 (78.7%) patients were diagnosed with PTB and 1636 (21.3%) with EPTB. In PTB group, the mean age (61.7 ± 18.7 vs. 57.8 ± 19.9) and proportion of male sex (63.3% vs. 50.1%) were higher, but the body mass index was lower (21.2 ± 3.4 vs. 22.7 ± 3.5) than that of the EPTB group. Prevalence of diabetes (20.5% vs. 16.9%) and chronic lung disease (5.1% vs. 2.9%) were higher in PTB group, meanwhile, those of chronic kidney disease (CKD) (2.7% vs. 5.4%) and long-term steroid use (0.4% vs. 1.0%) were higher in EPTB group. Abdominal TB was more prevalent in patients with chronic liver disease (odds ratio [OR]: 2.69, 95% CI: 1.52–4.74), and urogenital TB was more prevalent in patients with CKD (OR: 2.75, 95% CI: 1.08–6.99).

Conclusions

We found that underlying comorbidities were closely associated with the location of TB development, and therefore, the possibility of EPTB should be carefully evaluated while monitoring for underlying disease in TB-endemic areas.
Pronator teres nerve branch transfer to the extensor carpi radialis brevis nerve branch for wrist extension reconstruction in proximal radial nerve injury following humeral shaft fractures
Authors: Tian Jia , Leng Minghao , Wang Kun , Huang Qishun
Published: November 2022

Background

Tendon and nerve transfers are used for functional reconstruction in cases of proximal radial nerve injury complicated by humeral fractures in patients who do not show functional recovery after primary nerve repair. The effectiveness of pronator teres (PT) nerve branch transfer to the extensor carpi radialis brevis (ERCB) nerve branch for wrist extension reconstruction was investigated and compared to the results of tendon transfer.

Methods

This study included 10 patients with proximal radial nerve injury, who did not show functional recovery after primary nerve repair at our hospital between April 2016 and May 2019. The nerve transfer procedure included PT nerve branch transfer to the ECRB nerve branch to restore wrist extension and the flexor carpi radialis (FCR) nerve branch to the posterior interosseous nerve (PIN) to restore thumb and finger extension. Tendon transfer procedures included PT transfer to the ECRB for wrist extension, FCR transfer to the extensor digitorum communis (EDC) for finger extension and palmaris longus (PL) transfer to the extensor pollicis longus (EPL) for thumb extension.

Results

Five patients recovered Medical Research Council grade M4 muscle strength in the ECRB and EPL in both tendon and nerve groups. Two patients recovered grade M3 strength and three patients recovered grade M4 strength in the EDC in the tendon transfer group, and all five patients recovered grade M4 strength in the EDC in the nerve transfer group. Limited wrist flexion was observed only in one patient in the tendon transfer group.

Conclusion

PT nerve branch transfer to the ECRB nerve branch combined with FCR nerve branch transfer to PIN is a useful strategy for wrist and fingers extension reconstruction in patients with proximal radial nerve injuries.
15-item Roland-Morris Disability Questionnaire (RMDQ-15): structural and criterion validity on patients with chronic low back pain
Authors: Frota Natália Teixeira , Fidelis-de-Paula-Gomes Cid André , Pontes-Silva André , Pinheiro Jocassia Silva , de Jesus Sulamizia Filomena Costa , Apahaza Gabriel Henrique Santin , da Silva Souza Cesário , Avila Mariana Arias , Dibai-Filho Almir Vieira
Published: November 2022

Background

The Roland-Morris Disability Questionnaire (RMDQ) is one of the most used instruments to measure self-reported disability in patients with low back pain, however, the uncertainty on which version to use may lead to inadequate disability measurement and consequently, improper management of patients with chronic low back pain.

Objective

To propose a short version of the RMDQ, compare it with the other short versions presented by the specialized literature, and identify the best internal structure of the RMDQ for the Brazilian population.

Methods

This is a cross-sectional study in which we used confirmatory factor analysis to identify the best structure of the RMDQ. We assessed 545 participants, most of which were women, aged ≥ 30 years old, single, with mean low back pain intensity ~ 5 points, and mean pain chronicity ~ 72 months. We used lavaan and semPlot packages, with implementation of a tetrachoric matrix and the robust diagonally weighted least squares extraction method. We also used fit indices chi-square/degree of freedom, comparative fit index, Tucker-Lewis index, root mean square error of approximation, and standardized root mean squared residual. For the comparison between models, we considered the structure with the lowest values of the Akaike information criterion and Bayesian information criterion. In addition, we assessed criterion validity via Spearman’s correlation coefficient to correlate the long and short versions. In this study, the 15-item structure was created through the use of modification indices to identify redundant items (9 items were excluded).

Results

RMDQ structure with one domain and 15 items and the structure with two domains and 16 items showed all fit indices with adequate values, but the one-dimensional version showed the lowest Akaike information criterion and Bayesian information criterion values. Regarding criterion validity, correlation between the RMDQ with 24 items and 15 items is adequate (rho = 0.954, p < 0.001).

Conclusion

The RMDQ-15 is a short version of the RMDQ instrument with the most adequate internal structure and satisfactorily correlated with the long version of the instrument.
Magnitude and attributed reasons for adult weight gain amongst women at increased risk of breast cancer
Authors: Pegington Mary , Harkness Elaine F. , Howell Anthony , Evans D. Gareth , Harvie Michelle
Published: November 2022

Background

Excess weight (BMI ≥25.0 kg/m2) and weight gain during adult life increase the risk of postmenopausal breast cancer in women who are already at increased risk of the disease. Reasons for weight gain in this population can inform strategies for weight gain prevention.

Methods

Baseline data from six weight loss studies for women at increased risk of breast cancer (age 31–74 years) were collated. Self-reported patterns of adult weight gain and attributed reasons for weight gain before joining the weight loss study were reported for the whole population and secondary analyses reported the different reasons given by women with/without children, pre−/peri- or postmenopausal, and moderate/high risk of breast cancer.

Results

Five hundred and one women with a mean age of 47.6 (SD 8.4) years and median BMI of 29.9 (IQR 27.0–34.7) kg/m2 were included in the analyses. The median weight gain since young adulthood (18–20 years) was 20.5 (IQR 14.0–29.7) kg or 33.7 (23.4–50.2) % and median annual weight gain was 0.73 (IQR 0.51–1.08) kg. Four hundred and one women were included in analysis of weight gain reasons. The main five self-reported reasons for weight gain were children / childcare / pregnancy (stated by 55.9% of participants), followed by inactivity (41.9%), comfort or boredom eating (38.2%), portion size (32.4%), and stress (27.4%). Reasons appeared broadly similar between the different groups in the secondary analyses.

Conclusions

We have highlighted common reasons for weight gain in women at increased risk of breast cancer. This will inform future interventions to support women to avoid weight gain in adulthood which would reduce the burden of breast cancer.

Trial registration

NIHR NRR N0226132725, ISRCTN52913838, ISRCTN77916487, ISRCTN91372184, ISRCTN10803394 and ISRCTN16431108.
Challenges associated with the integration of immuno-oncology agents in clinical practice
Authors: Lazure Patrice , Parikh Aparna R. , Ready Neal E. , Davies Marianne J. , Péloquin Sophie , Caterino Jeffrey M. , Lewandowski Robert , Lazar Alexander J. , Murray Suzanne
Published: November 2022

Background

The availability of new immuno-oncology therapeutics markedly impacts oncology clinicians’ treatment decision-making. To effectively support healthcare professionals (HCPs) in their practice, it is important to better understand the challenges and barriers that can accompany the introduction of these agents. This study aimed to establish the types and causes of clinical challenges posed by the introduction of new immuno-oncology agents.

Methods

The mixed-methods design included qualitative in-depth interviews and group discussions with HCPs, in which participants discussed clinical challenges and potential underlying reasons for these challenges. Qualitative findings informed a quantitative survey. This survey investigated the extent and distribution of challenges using HCPs’ self-rating of knowledge, skill, confidence, and exposure to system-level effects. These two phases were conducted sequentially with distinctly stratified samples of oncologists, nurse practitioners (NPs), physician assistants (PAs), pathologists, clinical pharmacists, interventional radiologists, rheumatologists, pulmonologists, and emergency department physicians. Participants were from the United States and had various levels of clinical experience and represented both academic and community-based settings.

Results

The final sample included 107 HCPs in the qualitative phase and 554 in the quantitative phase. Analyses revealed clinical challenges related to the use of pharmacodiagnostics. For example, 47% of pathologists and 42% of oncologists reported skill gaps in identifying the appropriate marker and 46% of oncologists, 61% of PAs, 66% of NPs, 74% of pulmonologists and 81% of clinical pharmacists reported skill gaps in selecting treatment based on test results. Challenges also emerged regarding the integration of immuno-oncology agents, as oncologists, rheumatologists, pulmonologists, clinical pharmacists, PAs, and NPs reported knowledge gaps (74-81%) of the safety profiles of recently approved agents. In addition, 90% of clinical pharmacists reported skill gaps weighing the risks and benefits of treating patients with immuno-oncology agents while affected by lupus. Finally, patient communication challenges were identified: HCPs reported difficulties discussing essential aspects of immunotherapy to patients as well as how they might compare to other types of therapies.

Conclusion

The challenges highlighted in this study reveal substantial educational gaps related to the integration of immuno-oncology agents into practice for various groups of HCPs. These findings provide a strong base of evidence for future educational initiatives.
Measuring rurality in health services research: a scoping review
Authors: Danek Robin , Blackburn Justin , Greene Marion , Mazurenko Olena , Menachemi Nir
Published: November 2022

Purpose

This study is a scoping review of the different methods used to measure rurality in the health services research (HSR) literature.

Methods

We identified peer-reviewed empirical studies from 2010–2020 from seven leading HSR journals, including the Journal of Rural Health, that used any definition to measure rurality as a part of their analysis. From each study, we identified the geographic unit (e.g., county, zip code) and definition (e.g., Rural Urban Continuum Codes, Rural Urban Commuting Areas) used to classify categories of rurality. We analyzed whether geographic units and definitions used to classify rurality differed by focus area of studies, including costs, quality, and access to care. Lastly, we examined the number of rural categories used by authors to assess rural areas.

Findings

In 103 included studies, five different geographic units and 11 definitions were used to measure rurality. The most common geographic units used to measure rurality were county (n = 59, 57%), which was used most frequently in studies examining cost (n = 12, 75%) and access (n = 33, 57.9%). Rural Urban Commuting Area codes were the most common definition used to measure rurality for studies examining access (n = 13, 22.8%) and quality (n = 10, 44%). The majority of included studies made rural versus urban comparisons (n = 82, 80%) as opposed to focusing on rural populations only (n = 21, 20%). Among studies that compared rural and urban populations, most studies used only one category to identify rural locations (n = 49 of 82 studies, 60%).

Conclusion

Geographic units and definitions to determine rurality were used inconsistently within and across studies with an HSR focus. This finding may affect how health disparities by rural location are determined and thus how resources and federal funds are allocated. Future research should focus on developing a standardized system to determine under what circumstances researchers should use different geographic units and methods to determine rurality by HSR focus area.
Histological and biochemical evaluation of plasma rich in growth factors treatment for grade II muscle injuries in sheep
Authors: Aguilar-García Daniel , Fernández-Sarmiento J. Andrés , del Mar Granados Machuca María , Rodríguez Juan Morgaz , Rascón Pilar Muñoz , Calvo Rocío Navarrete , Ruiz Yolanda Millán , Poveda José María Carrillo , Castañeda Juan Muñoz , Bertomeu Ramón Cugat , Domínguez Pérez Juan Manuel
Published: November 2022

The purpose of this study was to perform a histological and biochemical evaluation of the influence of plasma rich in growth factors (PRGF) on muscle regeneration process after a surgically induced grade II muscle laceration. A randomized, single blind, controlled experimental research was conducted including twenty-one adult healthy sheep, randomly divided in three groups (n = 7). A grade II surgical section was performed in the biceps femoris muscle of both hindlimbs. After two days (basal time), intralesional infiltration of autologous PRGF or Saline solution was randomly administered in both hindlimbs. Treatment was repeated once a week. Animal groups were euthanized at 1 (T1), 2 (T2) or 4 (T4) weeks. Histological assessment showed that PRGF intralesional injection induced a significant decrease of inflammatory cells density, significant higher centrally nucleated fibers percentage and significantly smaller fibrotic areas compared to Saline-treated muscles at T1, T2 and T4. Also, lower vascular density, with lower capillaries cross-sectional area, in PRGF group compared to Saline was observed. Biochemical analysis revealed a significant higher expression level ofMYOD1,MYF5andMYOGgenes in PRGF groups at T1 compared to Saline treated muscles. At ultrastructural level, PRGF groups presented scarce edema and loss of connective tissue structure, as well as higher mitochondrial density adequately associated to the sarcomere unit in contrast to the Saline group. In conclusion, histological, biochemical, and ultrastructural results showed that PRGF treatment improved muscle regeneration process leading to more mature histological aspect in newly formed muscle tissue after a surgically induced grade II muscle injury.
An unexpected cause of dysuria in a cat in Poland
Authors: Miszczak Marta , Wyleżoł Oliwia , Prorok Paulina , Bierowiec Karolina
Published: November 2022

Background

Urinary tract infestation byCapillariaspp. in domestic cats is rather rare, but can cause clinical symptoms and affect behaviour. To our knowledge, this report is the first to describe a case of urinary capillariosis in a cat in Poland.

Case presentation

A female formerly stray cat aged about 1.5 years showing dysuria, stranguria, periuria and lethargy was presented at the veterinary clinic. Urinalysis revealed the presence ofCapillaria plicaeggs in the sediment. The cat was treated successfully with three topical doses of Broadline (Merial, Toulouse, France).

Conclusions

C. plicais a nematode whose definitive hosts are carnivores, which are infected by eating earthworms (the intermediate hosts). Thus,C. plicainfestation is more frequent in wild carnivores and dogs, and rare in cats. Symptomatic bladder capillariosis in cats is very rarely diagnosed and described.
Calcium chloride diluted in ethanol 95% as female sterilizing agent: effect of transcutaneous delivery in rats
Authors: Gomes Etiele Maldonado , dos Santos Endreo Alan Pail , Trost Maria Elisa , de Souza Campos Gabrielle Christine , Thiesen Roberto , da Exaltação Pascon João Paulo , Machado Ingrid Rios Lima , de Arruda Mestieri Maria Ligia
Published: November 2022

Background

Different fertility control methods are investigated as a tool for population control of free-roaming animals. Chemical castration using calcium chloride has been widely studied over the years in males, but there are few studies related to its use in females. Therefore, we aimed to evaluate the local effects, as a potential chemosterilant, of two concentrations of calcium chloride diluted in 95% ethanol when administered by transcutaneous ultrasound-guided intraovarian injection in rats. In this study, 30 female Wistar rats were randomly divided into three treatment groups, which consisted of transcutaneous ultrasound-guided intraovarian injection of: 0.9% sodium chloride solution (GC); 10% calcium chloride diluted in 95% ethanol (G10); 20% calcium chloride diluted in 95% ethanol (G20). The animals were subdivided into two evaluation times, 15 days (n = 5 of each group) and 30 days (n = 5 of each group) after the intraovarian injection. The ovarian diameter was measured using ultrasound image prior and immediately after the injection and after the treatment period. Furthermore, animals’ clinical evaluation, estrous cycles assessment, macroscopic examination of the abdominal cavity and histological evaluation of the ovaries were performed.

Results

Ovarian ultrasound measurement revealed changes (p < 0.05) between ovarian diameters before and immediately after the injection in all treatments. Three animals in G20 had a small focal skin lesion at the injection site that evolved to total healing. Extended and abnormal estrous cycles were observed in G10 and G20. At gross examination, adhesions and ovarian cysts were noticed in both groups, G10 and G20. Also, the histopathology analysis revealed changes in ovarian architecture and vessel congestion in G10 and G20, but ovarian tissue damage was greater in the ovaries treated with the highest concentration (G20).

Conclusions

The results indicate that 20% calcium chloride diluted in 95% ethanol may be a potential agent for inducing sterilization in females and was possible to be minimally invasively delivered.
Adrenocorticotropic hormone-producing pituitary adenoma with pituitary apoplexy treated by surgical decompression: a case report
Authors: Tanaka Sachiyo , Suzuki Shuji , Oishi Mana , Soeta Satoshi , Namiki Ryosuke , Hara Yasushi
Published: November 2022

Background

Pituitary-dependent hypercortisolism (PDH) is one of the most common endocrine disorders in veterinary medicine. However, there are few reports on pituitary tumor apoplexy (PTA) in dogs and no reports on its surgical intervention in veterinary medicine. Accordingly, the appropriate treatment is unknown. Herein, a case of PDH and PTA in a dog treated surgically is described.

Case presentation

A mongrel female dog (spayed; age, 8 years and 8 months; weight, 6.1 kg) with persistently elevated alkaline phosphatase underwent adrenocorticotropic hormone (ACTH) stimulation testing (post-stimulation cortisol: 20.5 μg/dL), abdominal ultrasonography (adrenal gland thickness: left, 5.7 mm; right, 8.1 mm), and brain magnetic resonance imaging (MRI) (pituitary-to-brain ratio [PBR], 0.61) at the referral hospital, resulting in a diagnosis of PDH (day 0). On day 9, the dog visited XXXX for the preparation of pituitary surgery to treat PDH. However, on days 10–15, the dog developed a loss of energy and appetite, bloody diarrhea, vomiting, and a decreased level of consciousness. However, on day 16, the dog’s condition recovered. A preoperative MRI scan performed on day 52 (the day of surgery) showed apoplexy in the dorsal pituitary region (PBR, 0.68). Based on the PTA findings, the risks of surgery were described to the owner, and approval was obtained. At the time of trans-sphenoidal surgery, a partial pituitary resection was performed with preservation of the PTA area due to adhesions between the PTA area of the right side of the pituitary and surrounding tissues. The resected pituitary tissue was diagnosed as an ACTH-producing adenoma, with necrotic and hemorrhagic findings. As of day 290, endogenous ACTH and cortisol levels did not exceed the reference range.

Conclusions

The acute signs that occurred on days 10–15 were most likely caused by PTA. Therefore, when signs similar to those detected in acute hypoadrenocorticism are observed in dogs with PDH, it is necessary to include PTA as a differential diagnosis. Trans-sphenoidal surgery may be effective in PDH-affected dogs that develop PTA, but careful attention should be paid to tissue adhesions secondary to hemorrhage that may occur after PTA.
Expression profile and prognostic values of LSM family in skin cutaneous melanoma
Authors: Sun Xiaofang , Zhang Jianping , Xiao Can , Ge Zili
Published: November 2022

Background

The like-Smith (LSM) family is a group of RNA-binding proteins involved in RNA metabolism. However, their involvement in tumors, particularly skin cutaneous melanoma (SKCM), is not fully understood. In this study, we focused on the expression profiles and prognostic values of the LSM family in SKCM.

Methods

Raw data were downloaded from The Cancer Genome Atlas. The expression profile and prognostic value of LSM genes in SKCM were explored using the GEPIA, cBioPortal, and HPA databases. Protein–protein and gene–gene interaction analyses were performed using STRING and GeneMANIA. Enrichment and Cox regression analysis were conducted using R software. The TISIDB database was used to explore the relationship between LSMs and immunomodulators. Receiver operating characteristic curves and nomogram models were constructed to validate prognostic values.

Results

mRNA and protein expression levels of LSM2, LSM4, and LSM12 were significantly elevated in SKCM. The upregulated mRNA expression of LSM2 (p = 0.0013) and LSM4 (p = 0.0043) was significantly correlated with poor overall survival in patients with SKCM, whereas only LSM2 (p = 0.049) overexpression was markedly associated with worse disease-free survival. LSM2 overexpression was an independent risk factor (p = 0.013) and was confirmed to have a high prognostic value in SKCM using the receiver operating characteristic curve (AUC = 0.942) and nomogram models. All LSM genes were identified as genomic mutations, whereas alteration of LSM2 (p = 0.0153) significantly affected the overall survival in patients with SKCM. Significant correlations were observed between LSM family expression, immune cell infiltration, and immunomodulator. Furthermore, function and pathway enrichment analysis showed that the LSM family was mainly RNA binding proteins and involved in RNA splicing and degradation.

Conclusion

Expression profiles and prognostic values of LSM in SKCM were inconsistent. Among the LSM family, only LSM2 may serve as a potential poor prognosticator and immunotherapeutic target of SKCM.
SWI/SNF complex gene variations are associated with a higher tumor mutational burden and a better response to immune checkpoint inhibitor treatment: a pan-cancer analysis of next-generation sequencing data corresponding to 4591 cases
Authors: Li Yue , Yang Xinhua , Zhu Weijie , Xu Yuxia , Ma Jiangjun , He Caiyun , Wang Fang
Published: November 2022

Background

Genes related to the SWItch/sucrose nonfermentable (SWI/SNF) chromatin remodeling complex are frequently mutated across cancers. SWI/SNF-mutant tumors are vulnerable to synthetic lethal inhibitors. However, the landscape of SWI/SNF mutations and their associations with tumor mutational burden (TMB), microsatellite instability (MSI) status, and response to immune checkpoint inhibitors (ICIs) have not been elucidated in large real-world Chinese patient cohorts.

Methods

The mutational rates and variation types of six SWI/SNF complex genes (ARID1A, ARID1B, ARID2, SMARCA4, SMARCB1, and PBRM1) were analyzed retrospectively by integrating next-generation sequencing data of 4591 cases covering 18 cancer types. Thereafter, characteristics of SWI/SNF mutations were depicted and the TMB and MSI status and therapeutic effects of ICIs in the SWI/SNF-mutant and SWI/SNF-non-mutant groups were compared.

Results

SWI/SNF mutations were observed in 21.8% of tumors. Endometrial (54.1%), gallbladder and biliary tract (43.4%), and gastric (33.9%) cancers exhibited remarkably higher SWI/SNF mutational rates than other malignancies. Further, ARID1A was the most frequently mutated SWI/SNF gene, and ARID1A D1850fs was identified as relatively crucial. The TMB value, TMB-high (TMB-H), and MSI-high (MSI-H) proportions corresponding to SWI/SNF-mutant cancers were significantly higher than those corresponding to SWI/SNF-non-mutant cancers (25.8 vs. 5.6 mutations/Mb, 44.3% vs. 10.3%, and 16.0% vs. 0.9%, respectively; all p  < 0.0001). Furthermore, these indices were even higher for tumors with co-mutations of SWI/SNF genes and MLL2/3. Regarding immunotherapeutic effects, patients with SWI/SNF variations showed significantly longer progression-free survival (PFS) rates than their SWI/SNF-non-mutant counterparts (hazard ratio [HR], 0.56 [95% confidence interval {CI} 0.44–0.72]; p < 0.0001), and PBRM1 mutations were associated with relatively better ICI treatment outcomes than the other SWI/SNF gene mutations (HR, 0.21 [95% CI 0.12–0.37]; p = 0.0007). Additionally, patients in the SWI/SNF-mutant + TMB-H (HR, 0.48 [95% CI 0.37–0.54]; p  < 0.0001) cohorts had longer PFS rates than those in the SWI/SNF-non-mutant + TMB-low cohort.

Conclusions

SWI/SNF complex genes are frequently mutated and are closely associated with TMB-H status, MSI-H status, and superior ICI treatment response in several cancers, such as colorectal cancer, gastric cancer, and non-small cell lung cancer. These findings emphasize the necessity and importance of molecular-level detection and interpretation of SWI/SNF complex mutations.
The association between preventive health and outpatient spending and life expectancy by income quartile
Authors: Barnard Mason S. , Hagos Rama M.
Published: November 2022

Background

To describe the relationship between longevity and local access to preventive healthcare at the county level.

Methods

We used Medicare outpatient reimbursement data from the 2010 Dartmouth Health Atlas and longevity data from Chetty et al. (2016) to identify the cross-sectional associations between county longevity, access to outpatient care, and the quality of primary care.

Results

We find that the cost of outpatient care is inversely correlated with area life expectancy for individuals in the bottom income quartile. Much of this correlation is driven by men in the bottom income quartile. We also find that disaggregating a preventive care index produces significant relationships between components of the index and longevity where none were previously found.

Conclusions

These results counter prior assertions that local health costs are not associated with life expectancy. Additionally, the results also suggest that the local cost of outpatient care and the quality of that care may influence the longevity of low-income populations, especially for low-income men.
Phthalates and bone mineral density: a systematic review
Authors: Heilmann Nina Z. , Reeves Katherine W. , Hankinson Susan E.
Published: November 2022

Background

Exposure to endocrine disruptors, such as phthalates, may impact bone mineral density (BMD) through a variety of mechanisms. Studies of phthalate exposure and BMD in humans are scarce.

Objectives

To synthesize published data on the association between phthalate metabolites and BMD in humans and to provide methodological suggestions for future research.

Methods

A single investigator searched PubMed for relevant studies, including observational studies of phthalate exposure and BMD in children and postmenopausal women. Twelve studies were screened with 5 meeting the eligibility criteria and included for review. A quality assessment form was used as a quality measure and key information was extracted from the included studies.

Results

In one prospective study among postmenopausal women, higher levels of monocarboxyoctyl phthalate (MCOP) and monocarboxynonyl phthalate (MCNP) were significantly associated with lower BMD among nonusers of hormone therapy (HT). In cross-sectional studies of postmenopausal women, monoethyl phthalate (MEP), mono-n-butyl phthalate (MnBP), mono (3-carboxypropyl) phthalate (MCPP), and mono-benzyl phthalate (MBzP) were negatively associated with BMD, and MCNP was positively associated with BMD, but these results were not replicated across studies. In studies of fetal exposure to phthalates and childhood BMD, significant positive associations between MCPP and BMD in children at age 12 years were found in 1 study, while associations were null in the other study.

Conclusions

Studies among postmenopausal women provide suggestive evidence of an association between urinary phthalate metabolite concentration and decreased BMD. Results from studies of childhood BMD are inconclusive given the limited data and their limitations. More research is needed to address limitations and further investigate the association between phthalate exposure and human BMD.
Spatial accessibility to health facilities in Sub-Saharan Africa: comparing existing models with survey-based perceived accessibility
Authors: Bihin Jérémie , De Longueville Florence , Linard Catherine
Published: November 2022

Background

Mapping geographical accessibility to health services is essential to improve access to public health in sub-Saharan Africa. Different methods exist to estimate geographical accessibility, but little is known about the ability of these methods to represent the experienced accessibility of the population, and about the added-value of sophisticated and data-demanding methods over simpler ones. Here we compare the most commonly used methods to survey-based perceived accessibility in different geographical settings.

Methods

Modelled accessibility maps are computed for 12 selected sub-Saharan African countries using four methods: Euclidean distance, cost-distance considering walking and motorized speed, and Kernel density. All methods are based on open and large-scale datasets to allow replication. Correlation coefficients are computed between the four modelled accessibility indexes and the perceived accessibility index extracted from Demographic and Health Surveys (DHS), and compared across different socio-geographical contexts (rural and urban, population with or without access to motorized transports, per country).

Results

Our analysis suggests that, at medium spatial resolution and using globally-consistent input datasets, the use of sophisticated and data-demanding methods is difficult to justify as their added value over a simple Euclidian distance method is not clear. We also highlight that all modelled accessibilities are better correlated with perceived accessibility in rural than urban contexts and for population who do not have access to motorized transportation.

Conclusions

This paper should guide researchers in the public health domain for knowing strengths and limits of different methods to evaluate disparities in health services accessibility. We suggest that using cost-distance accessibility maps over Euclidean distance is not always relevant, especially when based on low resolution and/or non-exhaustive geographical datasets, which is often the case in low- and middle-income countries.
Automatic segmentation of the gross target volume in radiotherapy for lung cancer using transresSEUnet 2.5D Network
Authors: Xie Hui , Chen Zijie , Deng Jincheng , Zhang Jianfang , Duan Hanping , Li Qing
Published: November 2022

Objective

This paper intends to propose a method of using TransResSEUnet2.5D network for accurate automatic segmentation of the Gross Target Volume (GTV) in Radiotherapy for lung cancer.

Methods

A total of 11,370 computed tomograms (CT), deriving from 137 cases, of lung cancer patients under radiotherapy developed by radiotherapists were used as the training set; 1642 CT images in 20 cases were used as the validation set, and 1685 CT images in 20 cases were used as the test set. The proposed network was tuned and trained to obtain the best segmentation model and its performance was measured by the Dice Similarity Coefficient (DSC) and with 95% Hausdorff distance (HD95). Lastly, as to demonstrate the accuracy of the automatic segmentation of the network proposed in this study, all possible mirrors of the input images were put into Unet2D, Unet2.5D, Unet3D, ResSEUnet3D, ResSEUnet2.5D, and TransResUnet2.5D, and their respective segmentation performances were compared and assessed.

Results

The segmentation results of the test set showed that TransResSEUnet2.5D performed the best in the DSC (84.08 ± 0.04) %, HD95 (8.11 ± 3.43) mm and time (6.50 ± 1.31) s metrics compared to the other three networks.

Conclusions

The TransResSEUnet 2.5D proposed in this study can automatically segment the GTV of radiotherapy for lung cancer patients with more accuracy.
Aging beyond menopause selectively decreases CD8+ T cell numbers but enhances cytotoxic activity in the human endometrium
Authors: Shen Zheng , Patel Mickey V. , Rodriguez-Garcia Marta , Wira Charles R.
Published: November 2022

Background

Regulation of endometrial (EM) CD8+ T cells, which provide protection through cell-mediated cytotoxicity, is essential for successful reproduction, and protection against sexually transmitted infections and potential tumors. We have previously demonstrated that EM CD8+ T cell cytotoxicity is suppressed directly and indirectly by sex hormones and enhanced after menopause. What remains unclear is whether CD8+ T cell protection and the contribution of tissue-resident (CD103+) and non-resident (CD103-) T cell populations in the EM change as women age following menopause.

Results

Using hysterectomy EM tissues, we found that EM CD8+ T cell numbers declined significantly in the years following menopause. Despite an overall decline in CD8+ T cells, cytotoxic activity per cell for both CD103- and CD103 + CD8+ T cells increased with age. Investigation of the underlying mechanisms responsible for cytotoxicity indicated that the percentage of total granzyme A and granzyme B positive CD8+ T cells, but not perforin, increased significantly after menopause and remained high and constant as women aged. Additionally, baseline TNFα production by EM CD8+ T cells increased significantly in the years following menopause, and estradiol suppressed TNFα secretion. Moreover, in response to PMA activation, TNFα and IFNγ were significantly up-regulated, and CD103-CD8+ T cells up-regulation of TNFα, IFNγ and IL-6 increased as women aged.

Conclusions

Understanding the underlying factors involved in regulating cell-mediated protection of the EM by CD8+ T cells will contribute to the foundation of information essential for developing therapeutic tools to protect women against gynecological cancers and infections as they age.
Tissue dissociation for single-cell and single-nuclei RNA sequencing for low amounts of input material
Authors: Wiegleb Gordon , Reinhardt Susanne , Dahl Andreas , Posnien Nico
Published: November 2022

Background

Recent technological advances opened the opportunity to simultaneously study gene expression for thousands of individual cells on a genome-wide scale. The experimental accessibility of such single-cell RNA sequencing (scRNAseq) approaches allowed gaining insights into the cell type composition of heterogeneous tissue samples of animal model systems and emerging models alike. A major prerequisite for a successful application of the method is the dissociation of complex tissues into individual cells, which often requires large amounts of input material and harsh mechanical, chemical and temperature conditions. However, the availability of tissue material may be limited for small animals, specific organs, certain developmental stages or if samples need to be acquired from collected specimens. Therefore, we evaluated different dissociation protocols to obtain single cells from small tissue samples of Drosophila melanogaster eye-antennal imaginal discs.

Results

We show that a combination of mechanical and chemical dissociation resulted in sufficient high-quality cells. As an alternative, we tested protocols for the isolation of single nuclei, which turned out to be highly efficient for fresh and frozen tissue samples. Eventually, we performed scRNAseq and single-nuclei RNA sequencing (snRNAseq) to show that the best protocols for both methods successfully identified relevant cell types. At the same time, snRNAseq resulted in less artificial gene expression that is caused by rather harsh dissociation conditions needed to obtain single cells for scRNAseq. A direct comparison of scRNAseq and snRNAseq data revealed that both datasets share biologically relevant genes among the most variable genes, and we showed differences in the relative contribution of the two approaches to identified cell types.

Conclusion

We present two dissociation protocols that allow isolating single cells and single nuclei, respectively, from low input material. Both protocols resulted in extraction of high-quality RNA for subsequent scRNAseq or snRNAseq applications. If tissue availability is limited, we recommend the snRNAseq procedure of fresh or frozen tissue samples as it is perfectly suited to obtain thorough insights into cellular diversity of complex tissue.