bluuebunny/crossref_metadata_2025 huggingface dataset:
Using a Non-Wearable Actigraphy in Nursing Care for Dementia With Lewy Bodies
Authors: Fukuda Chiaki , Higami Yoko , Shigenobu Kazue , Kanemoto Hideki , Yamakawa Miyae
Published: March 2022

People who have dementia with Lewy bodies often have sleep disorders. We used non-wearable devices to record and categorize the sleep patterns of patients with Lewy body dementia. Individual sleep data at a dementia–care unit in Japan were recorded using non-wearables. One week’s worth of data from 18 patients was analyzed. Median metrics for all participants were the following: sleep efficiency, 68% (23-89); sleep duration at night, 6.8 hours (1.6-11.1); times getting out of bed at night, 3.5 (0-13). We identified three types of abnormal sleep: extremely short sleep duration, excessive sleep duration at night, and excessive number of times getting out of bed at night. Sleep disturbances in Lewy body dementia patients are treated using various practices; staff must choose the most effective plan for each patient’s situation. Monitoring patient sleep using non-wearable provides more objective data that can help staff better personalize nursing care.
Temporal and Spectral Properties of the Auditory Mismatch Negativity and P3a Responses in Schizophrenia
Authors: Lundin Nancy B. , Burroughs Leah P. , Kieffaber Paul D. , Morales Jaime J. , O’Donnell Brian F. , Hetrick William P.
Published: March 2022

The mismatch negativity (MMN) event-related potential (ERP) indexes relatively automatic detection of changes in sensory stimuli and is typically attenuated in individuals with schizophrenia. However, contributions of different frequencies of electroencephalographic (EEG) activity to the MMN and the later P3a attentional orienting response in schizophrenia are poorly understood and were the focus of the present study. Participants with a schizophrenia-spectrum disorder ( n = 85) and non-psychiatric control participants ( n = 74) completed a passive auditory oddball task containing 10% 50 ms “deviant” tones and 90% 100 ms “standard” tones. EEG data were analyzed using spatial principal component analysis (PCA) applied to wavelet-based time-frequency analysis and MMN and P3a ERPs. The schizophrenia group compared to the control group had smaller MMN amplitudes and lower deviant-minus-standard theta but not alpha event-related spectral perturbation (ERSP) after accounting for participant age and sex. Larger MMN and P3a amplitudes but not latencies were correlated with greater theta and alpha time-frequency activity. Multiple linear regression analyses revealed that control participants showed robust relationships between larger MMN amplitudes and greater deviant-minus-standard theta inter-trial coherence (ITC) and between larger P3a amplitudes and greater deviant-minus-standard theta ERSP, whereas these dynamic neural processes were less tightly coupled in participants with a schizophrenia-spectrum disorder. Study results help clarify frequency-based contributions of time-domain (ie, ERP) responses and indicate a potential disturbance in the neural dynamics of detecting change in sensory stimuli in schizophrenia. Overall, findings add to the growing body of evidence that psychotic illness is associated with widespread neural dysfunction in the theta frequency band.
Evaluation of an Innovative Device for Mitral Valve Regurgitation: Experimental Acute In Vivo Results
Authors: Zeitani Jacob , Chiariello Giovanni A. , Shofti Rona , Sabbag Latif , Bruno Piergiorgio , Massetti Massimo , Alfieri Ottavio
Published: March 2022

Objective: Currently, mitral prosthetic rings are intended only to reshape the annulus. We present in vivo results of an innovative device characterized by an intraventricular segment designed to enable artificial chordae implantation and simplify leaflets and subvalvular apparatus correction. Methods: Eight sheep were employed. The first 4 underwent solely device implantation. In the last 4, primary chordae of the anterior leaflet (A2) were torn to induce severe mitral regurgitation. The severed chordae were replaced by 2 pairs of 5-0 Gore-Tex artificial chordae previously measured and anchored to the device bridge. Ease of device and chordae implantation were evaluated, and postprocedural valve competence was verified by postoperative echocardiogram. Results: The procedure was completed in all 8 sheep. In the 4 sheep with induced severe mitral regurgitation, repair could be achieved by means of artificial chordae implantation. Length of the 2 chordae implanted was 21.6 ± 2 mm and 22 ± 3 mm, respectively. The time required to suture the artificial chordae was 2.5 ± 1.2 min. Postoperative echocardiograms showed normal left ventricular ejection fraction and free motion of the mitral leaflets. Mitral regurgitation was absent in 5 cases and trivial in 3. The transvalvular peak pressure gradient was 9.5 ± 6 mm Hg, and mean gradient was 3.7 ± 4 mm Hg. Postprocedural evaluation of the heart and mitral valve showed no damage to the left ventricle wall, valve leaflets, chordae, and papillary muscles. Conclusions: In vivo tests confirm safety of the device, ease of chordal length estimation prior to implantation, short operative time, and no negative impact of the device on mitral leaflet motion, function, and structure.
Resintonizar roles profesionales para la acción comunitaria en tiempos de la COVID-19. Reflexiones desde el Observatorio de Salud Comunitaria
Authors: Blanco Daniel García , Munera Adrián Carrasco , Plaza Cristina Sanz , Llanes Jara Cubillo , García Mariano Hernán
Published: March 2022

Introducción:

La pandemia de la COVID-19 ha generado nuevas barreras a la acción comunitaria en salud, pero también ha potenciado el desarrollo de iniciativas ciudadanas para responder colectivamente a la crisis social y sanitaria. En este contexto se crea el Observatorio de Salud Comunitaria y COVID-19 (OBSCOMCOVID), un espacio en el que personas vinculadas a la salud comunitaria se encuentran para reflexionar sobre las claves de la acción comunitaria en el contexto actual y desarrollar modelos de trabajo para el futuro.

Objetivos:

Recopilar los aprendizajes adquiridos sobre salud comunitaria en el contexto de la pandemia por profesionales implicados en el OBSCOMCOVID. Clarificar el rol profesional en el desarrollo de la Acción Comunitaria en tiempos de la COVID-19. Identificar líneas prioritarias de actuación en relación con la acción comunitaria en salud a futuro.

Método:

El material base de este estudio son los cuatro conversatorios realizados por el OBSCOMCOVID entre julio y agosto del 2020. En ellos participaron 21 profesionales de Atención Primaria, Salud Pública e Intervención Social. Se realizó un análisis temático del contenido manifiesto y significados subyacentes en las narrativas de las personas participantes, triangulando posteriormente los resultados entre el equipo investigador.

Resultados:

Se reconoce la dimensión colectiva y social como elemento esencial en el abordaje de la emergencia, priorizando las situaciones de vulnerabilidad como elemento fundamental. Se detectan algunas barreras para la acción comunitaria en salud: enfoque biomédico y de emergencia, medidas de distanciamiento y sobrecarga de profesionales. Se identifican claves desde el rol profesional: capacidad de escucha y de vinculación con la población, legitimidad y capacidad de acción tanto dentro como fuera de lo institucional que se pueden potenciar y poner al servicio de la Acción Comunitaria.

Conclusiones:

La reorientación del rol profesional debe priorizar las dinámicas de abogacía, potenciar las redes comunitarias y promover la formación.
Digital health interventions for osteoporosis and post-fragility fracture care
Authors: Gupta Amit , Maslen Christina , Vindlacheruvu Madhavi , Abel Richard L. , Bhattacharya Pinaki , Bromiley Paul A. , Clark Emma M. , Compston Juliet E. , Crabtree Nicola , Gregory Jennifer S. , Kariki Eleni P. , Harvey Nicholas C. , McCloskey Eugene , Ward Kate A. , Poole Kenneth E.S.
Published: March 2022

The growing burden from osteoporosis and fragility fractures highlights a need to improve osteoporosis management across healthcare systems. Sub-optimal management of osteoporosis is an area suitable for digital health interventions. While fracture liaison services (FLSs) are proven to greatly improve care for people with osteoporosis, such services might benefit from technologies that enhance automation. The term ‘Digital Health’ covers a variety of different tools including clinical decision support systems, electronic medical record tools, patient decision aids, patient apps, education tools, and novel artificial intelligence (AI) algorithms. Within the scope of this review are AI solutions that use algorithms within health system registries to target interventions. Clinician-targeted, patient-targeted, or system-targeted digital health interventions could be used to improve management and prevent fragility fractures. This review was commissioned by The Royal Osteoporosis Society and Bone Research Academy during the production of the 2020 Research Roadmap ( https://theros.org.uk ), with the intention of identifying gaps where targeted research funding could lead to improved patient health. We explore potential uses of digital technology in the general management of osteoporosis. Evidence suggests that digital technologies can support multidisciplinary teams to provide the best possible patient care based on current evidence and to support patients in self-management. However, robust randomised controlled studies are still needed to assess the effectiveness and cost-effectiveness of these technologies.
Autologous hematopoietic stem cell transplantation modifies specific aspects of systemic sclerosis-related microvasculopathy
Authors: Santana-Gonçalves Maynara , Zanin-Silva Djúlio , Henrique-Neto Álvaro , Moraes Daniela A. , Kawashima- Vasconcelos Marianna Y. , Lima-Júnior João R. , Dias Juliana B. E. , Bragagnollo Vinícius , de Azevedo Júlia T. C. , Covas Dimas T. , Malmegrim Kelen C. R. , Ramalho Leandra , Oliveira Maria Carolina
Published: March 2022

Objective:

Autologous hematopoietic stem cell transplantation (AHSCT) is a therapeutic option for patients with severe and progressive systemic sclerosis (SSc). Here, we aimed to investigate how AHSCT affects the vasculopathy of SSc patients.

Methods:

Twenty-seven SSc patients were retrospectively assessed, before and after AHSCT, for vessel morphology (nailfold capillaroscopy), skin expression of endothelial markers and serum levels of markers of inflammation, angiogenesis and endothelial activation. Skin biopsies were analyzed by immunohistochemistry (IHC) for expression of CD31, VE-cadherin, E-selectin, angiopoietin-1 (Ang1), angiopoietin-2 (Ang2), Tie-2, vascular endothelial growth factor A (VEGFA), vascular endothelial growth factor receptor 2 (VEGFR2), and endothelin-1 before and 12 months post-AHSCT. Serum samples from SSc patients were assessed before and up to 36 months after AHSCT for IL-6, von Willebrand factor (vWF), CXC Motif Chemokine Ligand 8 (CXCL8), Endothelin-1, epidermal growth factor (EGF), VEGFA, Pentraxin-3, Intercellular Adhesion Molecule 1 (ICAM-1), E-selectin, P-selectin, Thrombomodulin and IL-18 levels, and compared to healthy control samples.

Results:

On nailfold capillaroscopy, the number of capillaries increased at 1 year, while giant capillaries decreased at 6 months and 1 year after AHSCT. In the skin biopsies, expression of E-selectin notably decreased and Ang1 increased after AHSCT. At baseline, all vascular markers evaluated in the serum were significantly higher in SSc patients when compared to healthy controls, except for ICAM-1. When compared at different time points after AHSCT, Thrombomodulin, Pentraxin-3, vWF, and IL-18 levels remained generally stable at high levels until 36 months after AHSCT.

Conclusion:

Our results suggest that AHSCT contributes to improvements of the vessel morphology and dermal microvasculopathy, but does not normalize elevated levels of serum vascular markers in SSc patients. Additional vascular therapeutic approaches might contribute to more effectively treat the endothelial injury.
Study on Collision Detection Techniques for the Informed Design of Natural Views in Healthcare Environments
Authors: Ban Qichao , Lyu Min , Gao Weijun , Chen Yulin , Yao Jiawei
Published: March 2022

Background:

Natural views are an important design strategy for the application of ecological resources in built environments. Numerous clinical studies have indicated that views of nature—for example, plants—can effectively promote patient recovery by relieving their postoperative pains and negative emotions during hospitalization.

Aims:

This study demonstrates an intelligent method that develops algorithms of using collision detection techniques in Building Information Modeling to evaluate outdoor plant visibility for patients.

Methods:

These algorithms are digitized into a Revit plug-in program, which can be viewed as a design-aided tool for architects with the purpose of informing healthcare environment design in the decision-making process.

Results:

Its acceptability and effectiveness are evaluated based on the consultations in beta tests.

Conclusions:

It is believed that this method can improve the work efficiency of evaluating natural views in wards and help architects implement an informed design of built environments for better health performance. All findings in this study can contribute to the development of computational intelligence and social sustainability in the near future.
Racial and Social Determinants of Civilian Gunshot Wounds to the Head
Authors: Rolle Myron L. , McLellan Rachel M. , Nanda Pranav , Patel Aman B. , Sacks Chana A. , Masiakos Peter T. , Stapleton Christopher J.
Published: March 2022

Objective

To assess the clinical, racial, and social characteristics of victims of Gunshot wounds (GSWs) to the head and assess for associations between these factors and outcomes.

Summary Background Data

Previous literature has not focused on the association of race and socioeconomic factors with these specific injuries.

Methods

We identified patients with GSWs to the head who presented to 2 urban academic medical centers between 1998 and 2020, and extracted patient-level demographic data, information about the clinical and surgical course, and outcomes at discharge and follow-up.

Results

The cohort included 250 patients, 90% (n = 226) of whom were male, with a mean age of 28 years. Forty-five percent were white (n = 112), 19% Black (n = 48), 18% Latinx (n = 45), with 6% “other” (n = 16), and 12% “unknown” (n = 29). The majority of patients presented with assault-related trauma (n = 153, 61%) as compared to self-inflicted injuries (n = 97, 39%). Across the entire cohort, sex, age, race, and median income by ZIP code were not significant predictors of outcome. Victims of assault by GSW to the head were more likely to be age 18 or younger (OR 5.26, P = 0.01), between the ages of 19 and 33 years (OR 4.7, P = 0.001), Black (OR 6.66, P < .001), and Latinx (OR 2.65, P = 0.03). Most patients (n = 155, 63%) had a poor functional outcome (modified Rankin Score 3–6) at discharge.

Conclusion

Age, race, and income status were not independent predictors of mortality or functional outcome at discharge in our population. Assault-related GSWs to the head mostly involved young Black or Latinx men of lower socioeconomic status, while self-inflicted injuries were largely seen in older white men.
Delayed oleoma formation with injection of oil-suspended testosterone: A case report and review of pathogenesis
Authors: Hamm Camille , Azad Sanjay
Published: March 2022

This is the case report of a 51-year-old man who was seen in consult with plastic surgery presenting with painful, disfiguring, submuscular nodules in the bilateral deltoids and right gluteal regions. Pre-operative investigations confirmed the presence of multiple heterogeneous, complex non-vascular fluid collections in the subcutaneous and intramuscular layers. The origin of these lesions was unknown until the post-operative follow-up appointment where the patient revealed that he had injected those areas with testosterone suspended in oil 9 years prior. Later, pathology reports confirmed the presence of numerous granulomas containing yellow viscous fluid and focal areas of calcification consistent with the diagnosis of oleomas. This case presents an important differential in the diagnosis of subcutaneous nodules and a review of pathophysiology of granuloma formation, and highlights some of the complications of oil injection use by bodybuilders.
Associations Between Spousal Relationship, Husband Involvement, and Postpartum Depression Among Postpartum Mothers in West Java, Indonesia
Authors: Pebryatie Elit , Paek Seung Chun , Sherer Penchan , Meemon Natthani
Published: March 2022

Introduction:

Indonesia is actively promoting husband involvement in maternal health care, since it has been claimed to impact the wellbeing of mothers. This study aims to investigate the extent to which spousal relationship, husband involvement, and maternal health behavior affect postpartum depression among Indonesian mothers.

Method:

A survey was carried out among 336 postpartum mothers who received maternal care in 27 independent midwifery clinics in 7 regions of West Java Province, Indonesia. The measurement model of husband involvement comprising 4 dimensions, namely maternity care engagement, instrumental support, emotional support, and informational support were developed and validated using confirmatory factor analysis. The Quality of Marriage Index (QMI) and the Edinburgh Postnatal Depression Scale (EPDS) were also validated and used to measure spousal relationship and postpartum depressive symptoms. A structural equation model was specified to examine the association between spousal relationship, husband involvement, maternal healthy behavior, and postpartum depression.

Results:

The study confirms the assumption that the quality of the spousal relationship could determine husband’s involvement during pregnancy, childbirth, and postpartum (γ = .60, P < .001), eventually leading to better maternal healthy behavior (γ = .015, P < .001) and a decrease in postpartum depressive symptoms among mothers (γ = −.21, P < .001).

Conclusions:

The study results suggest the needs to promote comprehensive husband involvement to enhance the wellbeing of mothers. This can be achieved through couple interventions at the community level and the inclusion of a supportive role for husbands in the maternal and childcare guidebook offered during ANC visits.
Does the Peer Group Matter? Assessing Frog Pond Effects in Transition to Secondary Schooling
Authors: Skov Peter Rohde
Published: March 2022

Peers are considered important for adolescents’ educational achievement and attainment, though little conclusive evidence demonstrate peer comparison effects. Using school and year fixed-effects models to account for peer group selection and comprehensive Danish administrative data on more than 260,000 students, across six cohorts, this study provides evidence of the so-called frog pond effect on the choice of secondary education among adolescents in Denmark. The frog pond effect is based upon a social comparison mechanism with heterogeneous effects. Through peer achievement, the author investigates the heterogeneous effects and show that peer achievement has different effects for low- and high-achieving students on choice of secondary education. The results shows that low-achieving students benefit from having high-achieving peers, while high-achieving students are negatively affected by their high-achieving peers, although only to a small extent. These findings lend support to the frog pond effect for high-achieving students.
BarWare: efficient software tools for barcoded single-cell genomics
Authors: Swanson Elliott , Reading Julian , Graybuck Lucas T. , Skene Peter J.
Published: March 2022

Background

Barcode-based multiplexing methods can be used to increase throughput and reduce batch effects in large single-cell genomics studies. Despite advantages in flexibility of sample collection and scale, there are additional complications in the data deconvolution steps required to assign each cell to their originating samples.

Results

To meet computational needs for efficient sample deconvolution, we developed the tools BarCounter and BarMixer that compute barcode counts and deconvolute mixed single-cell data into sample-specific files, respectively. Together, these tools are implemented as the BarWare pipeline to support demultiplexing from large sequencing projects with many wells of hashed 10x Genomics scRNA-seq data.

Conclusions

BarWare is a modular set of tools linked by shell scripting: BarCounter, a computationally efficient barcode sequence quantification tool implemented in C; and BarMixer, an R package for identification of barcoded populations, merging barcoded data from multiple wells, and quality-control reporting related to scRNA-seq data. These tools and a self-contained implementation of the pipeline are freely available for non-commercial use athttps://github.com/AllenInstitute/BarWare-pipeline.
Widely used, short 16S rRNA mitochondrial gene fragments yield poor and erratic results in phylogenetic estimation and species delimitation of amphibians
Authors: Chan Kin Onn , Hertwig Stefan T. , Neokleous Dario N. , Flury Jana M. , Brown Rafe M.
Published: March 2022

Background

The 16S mitochondrial rRNA gene is the most widely sequenced molecular marker in amphibian systematic studies, making it comparable to the universalCO1barcode that is more commonly used in other animal groups. However, studies employ different primer combinations that target different lengths/regions of the 16S gene ranging from complete gene sequences (~ 1500 bp) to short fragments (~ 500 bp), the latter of which is the most ubiquitously used. Sequences of different lengths are often concatenated, compared, and/or jointly analyzed to infer phylogenetic relationships, estimate genetic divergence (p-distances), and justify the recognition of new species (species delimitation), making the 16S gene region, by far, the most influential molecular marker in amphibian systematics. Despite their ubiquitous and multifarious use, no studies have ever been conducted to evaluate the congruence and performance among the different fragment lengths.

Results

Using empirical data derived from both Sanger-based and genomic approaches, we show that full-length 16S sequences recover the most accurate phylogenetic relationships, highest branch support, lowest variation in genetic distances (pairwisep-distances), and best-scoring species delimitation partitions. In contrast, widely used short fragments produce inaccurate phylogenetic reconstructions, lower and more variable branch support, erratic genetic distances, and low-scoring species delimitation partitions, the numbers of which are vastly overestimated. The relatively poor performance of short 16S fragments is likely due to insufficient phylogenetic information content.

Conclusions

Taken together, our results demonstrate that short 16S fragments are unable to match the efficacy achieved by full-length sequences in terms of topological accuracy, heuristic branch support, genetic divergences, and species delimitation partitions, and thus, phylogenetic and taxonomic inferences that are predicated on short 16S fragments should be interpreted with caution. However, short 16S fragments can still be useful for species identification, rapid assessments, or definitively coupling complex life stages in natural history studies and faunal inventories. While the full 16S sequence performs best, it requires the use of several primer pairs that increases cost, time, and effort. As a compromise, our results demonstrate that practitioners should utilize medium-length primers in favor of the short-fragment primers because they have the potential to markedly improve phylogenetic inference and species delimitation without additional cost.
High-flow nasal cannula in nonlaser microlaryngoscopic surgery: a prospective study of 19 cases in a chinese population
Authors: Ma Bo , Liu Fei , Wang Dandan , Zhong Ruihan , Lin Kaihao , Li Shuo , Zhang Jie , Li Chaoyang
Published: March 2022

Background

High-flow nasal cannula (HFNC) is a new type of oxygen therapy, but its application in surgery remains unclear, we tried to describe the application of HFNC in microlaryngoscopic surgery for the Chinese population.

Methods

Nineteen adults, American society of anesthesiology class (ASA) 1–2 patients with body mass index < 30 kg.m−2 underwent microlaryngoscopic surgery using HFNC for airway management. Outcomes included apnoea time, intraoperative oxygenation, carbon dioxide value, lactate value, and the relationship between the duration of apnoea time and carbon dioxide levels.

Results

A total of 19 patients underwent vocal cord tumor resection under a microlaryngoscope with HFNC as the sole method of ventilation. The mean age was 39.7 years old, and the mean BMI was 23.9 kg.m−2. The mean apnea time was 21.5 min. The SpO2 of 18 patients remained above 90%, and only 1 patient dropped to 88%. The average basal lactate and highest lactate value was 0.58 mmol. L−1 and 0.68 mmol.L−1. The difference between basal and highest lactate values was statistically significant (P < 0.05). The average highest PaCO2 value was 79.4 mmHg. The PaCO2 increased by 1.68 ± 0.12 mmHg every minute linearly.

Conclusions

In the case series we have observed that HFNC would be safe and effective oxygenation and ventilation technique for selected Chinese patients undergoing non-laser microlaryngoscopic surgery within 30 min. The tubeless technology reduces the complications of tracheal intubation and jet ventilation and clears the surgical field of vision.

Trial registration

Chinese Clinical Trial Registry (ChiCTR100049144).
MedMinas project: design and use of mixed methods in the evaluation of pharmaceutical services in primary health care in Minas Gerais, Brazil
Authors: Luz Tatiana Chama Borges , Tavares Noemia Urruth Leão , de Castro Ana Karine Sarvel , Marques Isabela Cristina , dos Santos Elizabeth Moreira , Cota Betania Barros
Published: March 2022

Background

The main purposes of primary care-based pharmaceutical services (PHCPS) in Brazil are to provide free access to medicines and pharmaceutical care to patients. Several obstacles hinder achieving their goals; thus, MedMinas Project aimed to evaluate the PHCPS, the supply system, and the use of medicines. This paper reflects on our experience designing, planning, and conducting the project, describing the issues yielded in the field and lessons learned.

Methods

This work consists of a mixed-methods study conducted in Minas Gerais, Southeastern Brazil. We adopted the principles of Rapid Evaluation Methods, employing a multistage stratified sampling for the quantitative and a purposeful sampling for the qualitative components, respectively, and a documentary research. Data sources included individuals (patients and professionals), prescriptions, dispensed medicines, and policy documents collected between April and October 2019. The quantitative data described in this paper were analysed by descriptive statistics and the qualitative by Thematic Content Analysis.

Results

A total of 26 municipalities varying from 37,784 to 409,341 inhabitants were included. The field team spent, on average, 16 days in each location. We interviewed 1019 respondents, of which 127 were professionals and 892 patients. The participation rate varied from 92 to 100%, depending on the respondent subgroup. Most interviews lasted between 45 min and one hour. Fieldwork challenges included participants’ enrolment, field team, interview processes, and project budget. The participants provided positive feedback and five main themes emerged from the interview experience (self-awareness, sense of gratitude, research value, access to findings, and benefits of the research). Additionally, we collected copies of 1072 documents and 2070 pieces of data from prescriptions filled and medicines dispensed at the PCP.

Conclusion

We demonstrated the viability of conducting the MedMinas Project in an extensive geographic area within effective time frames that provided meaningful, high-quality data from multiple actors. The methods and lessons learned are valuable for researchers across various disciplines in similar urban settings in Brazil and other countries of low- and middle-income (LMIC).
Anti-NMDAR encephalitis with bilateral basal ganglia MRI lesions at a distance of time: a case report
Authors: Son Dong Keun , Cho Seong Min , Ryu Han Uk , Shin Byoung-Soo , Kang Hyun Goo
Published: March 2022

Background

Approximately half (55%) of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is known to show abnormal brain images, including high signal intensity in T2 or fluid attenuated inversion recovery (FLAIR) images. In a minority of anti-NMDAR encephalitis cases, high signal intensity on diffusion-weighted imaging (DWI) has been reported, a finding that is highly suggestive of a stroke.

Case presentation

We present the case of a 66-year-old man who experienced two separate focal seizure events, which involved first the right and then the left upper extremity in a short period of time. The patient showed focal clonic seizures involving right arm and hand, which sometimes evolved to bilateral tonic-clonic seizures on his first admission. Brain magnetic resonance imaging (MRI) showed high signal intensity on DWI and low signal intensity on the apparent diffusion coefficient (ADC) map of the left caudate nucleus and putamen. The patient was discharged symptom-free with anti-epileptic drugs for 2 weeks. The second admission occurred 4 days after the discharge. He exhibited a new symptom of focal clonic seizures involving left arm and hand while showing a brain lesion on the opposite side which is hyperintense on DWI image and hypointense on ADC map. The patient was eventually diagnosed with anti-NMDAR encephalitis according to the cerebrospinal fluid (CSF) antibody test.

Conclusions

This is the case of anti-NMDAR encephalitis patient whose DWI/ADC images revealed sequential involvement on the left and right basal ganglia with a short time interval. When stroke-like brain lesions on DWI are found in a patient with a focal seizure, a CSF study could help rule out autoimmune encephalitis. We also suggest that DWI/ADC map images may be useful for the early detection of anti-NMDAR encephalitis.
N-glycolylneuraminic acid serum biomarker levels are elevated in breast cancer patients at all stages of disease
Authors: Shewell Lucy K. , Day Christopher J. , Kutasovic Jamie R. , Abrahams Jodie L. , Wang Jing , Poole Jessica , Niland Colleen , Ferguson Kaltin , Saunus Jodi M. , Lakhani Sunil R. , von Itzstein Mark , Paton James C. , Paton Adrienne W. , Jennings Michael P.
Published: March 2022

Background

Normal human tissues do not express glycans terminating with the sialic acid N-glycolylneuraminic acid (Neu5Gc), yet Neu5Gc-containing glycans have been consistently found in human tumor tissues, cells and secretions and have been proposed as a cancer biomarker. We engineered a Neu5Gc-specific lectin called SubB2M, and previously reported elevated Neu5Gc biomarkers in serum from ovarian cancer patients using a Surface Plasmon Resonance (SPR)-based assay. Here we report an optimized SubB2M SPR-based assay and use this new assay to analyse sera from breast cancer patients for Neu5Gc levels.

Methods

To enhance specificity of our SPR-based assay, we included a non-sialic acid binding version of SubB, SubBA12, to control for any non-specific binding to SubB2M, which improved discrimination of cancer-free controls from early-stage ovarian cancer. We analysed 96 serum samples from breast cancer patients at all stages of disease compared to 22 cancer-free controls using our optimized SubB2M-A12-SPR assay. We also analysed a collection of serum samples collected at 6 monthly intervals from breast cancer patients at high risk for disease recurrence or spread.

Results

Analysis of sera from breast cancer cases revealed significantly elevated levels of Neu5Gc biomarkers at all stages of breast cancer. We show that Neu5Gc serum biomarker levels can discriminate breast cancer patients from cancer-free individuals with 98.96% sensitivity and 100% specificity. Analysis of serum collected prospectively, post-diagnosis, from breast cancer patients at high risk for disease recurrence showed a trend for a decrease in Neu5Gc levels immediately following treatment for those in remission.

Conclusions

Neu5Gc serum biomarkers are a promising new tool for early detection and disease monitoring for breast cancer that may complement current imaging- and biopsy-based approaches.
Safety and efficacy study of laparoscopic or robotic radical surgery using an endoscopic stapler for inhibiting tumour spillage of cervical malignant neoplasms evaluating survival (SOLUTION): a multi-centre, open-label, single-arm, phase II trial protocol
Authors: Park Soo Jin , Kong Tae Wook , Kim Taehun , Lee Maria , Choi Chel Hun , Shim Seung-Hyuk , Yim Ga Won , Lee Seungmee , Lee Eun Ji , Lim Myong Cheol , Chang Suk-Joon , Lee Sung Jong , Lee San Hui , Song Taejong , Lee Yoo-Young , Kim Hee Seung , Nam Eun Ji
Published: March 2022

Background

The Laparoscopic Approach to Cervical Cancer trial and Surveillance, Epidemiology, and End Results program database study demonstrated that minimally invasive radical hysterectomy was inferior to abdominal radical hysterectomy in terms of disease recurrence and survival. Among risk factors related to poor prognosis after minimally invasive surgery (MIS), tumour spillage during intracorporeal colpotomy became a significant issue. Thus, we designed this trial to evaluate the efficacy and safety of minimally invasive radical hysterectomy using an endoscopic stapler for early-stage cervical cancer.

Methods

This trial is a prospective, multi-centre, open-label, single-arm, non-inferiority phase II study. The nine organisations will participate in this trial after the approval of the institutional review board. Major eligibility criteria include women aged 20 years or older with cervical cancer stage IB1 squamous cell carcinoma, adenocarcinoma, or adenosquamous carcinoma according to the revised 2009 FIGO staging system who will undergo type B2 or C hysterectomy by MIS. The primary endpoint is the 4.5-year disease-free survival (DFS) rate between abdominal radical hysterectomy and MIS using an endoscopic stapler. For calculating the sample size, we hypothesised that the 4.5-year DFS rate after MIS using an endoscopic stapler is assumed to be the same after abdominal radical hysterectomy at 90.9%, and the non-inferiority margin was 7.2%. When we consider a three-year accrual and 4.5-year follow-up, at least 13 events must happen, requiring a total of 111 patients assuming a statistical power of 80% and the one-tailed test of 5% significance. A total of 124 patients is needed, considering a drop-out rate of 10%.

Discussion

We expect intracorporeal colpotomy using an endoscopic stapler may prevent tumour spillage during MIS for stage IB1 cervical cancer, showing a comparable prognosis with abdominal radical surgery.

Trial registration

ClinicalTrials.gov; NCT04370496; registration date, May 2020.
The trend of 10-year cardiovascular risk among diabetic and non-diabetic participants in Tehran Lipid and glucose study: 1999–2018
Authors: Koohi Fatemeh , Kohansal Karim , Naz Marzieh Saei Ghare , Derakhshan Somayeh , Azizi Fereidoun , Khalili Davood
Published: March 2022

Background

Assessing the risk of cardiovascular disease (CVD) is crucial in preventive cardiology. We aimed to determine the trend of CVD risk among individuals with and without diabetes during two decades of follow-up in a Middle Eastern cohort.

Methods

We studied 8,450 individuals (55.5% women) aged 40–75 years who participated in the Tehran Lipid and Glucose Study (TLGS). Diabetes status and CVD risk factors were evaluated in six examinations from 1999 to 2018. The individual 10-year CVD risk score was calculated using the ACC/AHA recommended risk equation. We used generalized estimating equation models (GEE) to assess the time trends of CVD risk factors and CVD risk scores in diabetic and non-diabetic groups separately.

Results

The age-adjusted ACC/AHA risk score significantly decreased in non-diabetic women and men (from 3.2% to 1.6% in women and 6.8% to 5.0% in men; p for trend < 0.001). Whereas the risk significantly decreased among diabetics men (from 13.8% to 11.5%), it increased somehow among diabetics women (from 5.3% to 5.5%). Furthermore, in both sexes, diabetic individuals compared to non-diabetic ones had better control on their systolic blood pressure, total cholesterol, and fasting plasma glucose during the last two decades.

Conclusions

The CVD risk and most CVD risk factors improved in individuals with and without diabetes in the past two decades; however, they have not reached the targets yet. So, more stringent lifestyle modifications and treatment strategies are needed, especially for primary prevention in the general population.
Interaction between posaconazole and flucloxacillin in a lung transplant patient: decrease in plasma exposure of posaconazole and possible undertreatment of invasive aspergillosis: case report
Authors: Verfaillie Saartje , Godinas Laurent , Spriet Isabel , Vos Robin , Verleden Geert M.
Published: March 2022

Background

Variability in triazole plasma concentrations by drug interactions is well known. An interaction between voriconazole and flucloxacillin has already been described. In our case we observed a similar interaction between posaconazole and flucloxacillin, which in our knowledge has not ever been reported in literature.

Case presentation

A 60-year-old male who had a double lung transplantation for end-stage chronic obstructive pulmonary disease was being treated with voriconazole for invasive pulmonary aspergillosis (IPA). During this treatment he presented at the emergency room and was diagnosed with endocarditis for which a combination of amoxicillin, flucloxacillin and gentamicin was initiated. A known interaction between voriconazole and flucloxacillin was observed, with a drop of the voriconazole levels, and treatment for IPA was switched to posaconazole. After ending the treatment for endocarditis, the patient had a catheter infection for which flucloxacillin was reinitiated. Unexpectedly we saw a similar immediate drop in posaconazole levels, recovering after ending treatment with flucloxacillin.

Conclusions

We describe a new interaction between posaconazole and flucloxacillin. Presumably the underlying mechanism is activation of the pregnane X receptor by flucloxacillin, which can induce cytochrome P450, uridine glucuronosyl transferase (UGT1A4) and P-glycoprotein. We advise caution when combining flucloxacillin and triazoles, because interactions may lead to undertreatment of invasive aspergillosis.
The zinc transporter ZIP12 regulates monocrotaline-induced proliferation and migration of pulmonary arterial smooth muscle cells via the AKT/ERK signaling pathways
Authors: Ye Chaoyi , Lian Guili , Wang Tingjun , Chen Ai , Chen Weixiao , Gong Jin , Luo Li , Wang Huajun , Xie Liangdi
Published: March 2022

Background

The zinc transporter ZIP12 is a membrane-spanning protein that transports zinc ions into the cytoplasm from the extracellular space. Recent studies demonstrated that upregulation of ZIP12 is involved in elevation of cytosolic free zinc and excessive proliferation of pulmonary arterial smooth muscle cells (PASMCs) induced by hypoxia. However, the expression of ZIP12 and its role in pulmonary arterial hypertension (PAH) induced by monocrotaline (MCT) in rats have not been evaluated previously. The aim of this study was to investigate the effect of ZIP12 on the proliferation and migration of PASMCs and its underlying mechanisms in MCT-induced PAH.

Methods

A PAH rat model was generated by intraperitoneal injection of 20 mg/kg MCT twice at one-week intervals. PASMCs were isolated from the pulmonary arteries of rats with MCT-induced PAH or control rats. The expression of ZIP12 and related molecules was detected in the lung tissues and cells. A ZIP12 knockdown lentivirus and an overexpressing lentivirus were constructed and transfected into PASMCs derived from PAH and control rats, respectively. EdU assays, wound healing assays and Western blotting were carried out to explore the function of ZIP12 in PASMCs.

Results

Increased ZIP12 expression was observed in PASMCs derived from MCT-induced PAH rats. The proliferation and migration of PASMCs from PAH rats were significantly increased compared with those from control rats. These results were corroborated by Western blot analysis of PCNA and cyclin D1. All these effects were significantly reversed by silencing ZIP12. Comparatively, ZIP12 overexpression resulted in the opposite effects as shown in PASMCs from control rats. Furthermore, selective inhibition of AKT phosphorylation by LY294002 abolished the effect of ZIP12 overexpression on enhancing cell proliferation and migration and partially suppressed the increase in ERK1/2 phosphorylation induced by ZIP12 overexpression. However, inhibition of ERK activity by U0126 resulted in partial reversal of this effect and did not influence an increase in AKT phosphorylation induced by ZIP12 overexpression.

Conclusions

ZIP12 is involved in MCT-induced pulmonary vascular remodeling and enhances the proliferation and migration of PASMCs. The mechanism of these effects was partially mediated by enhancing the AKT/ERK signaling pathways.
Unusual manifestations of young woman with MODY5 based on 17q12 recurrent deletion syndrome
Authors: Cheng Ying , Zhong Da-Peng , Ren Li , Yang Hang , Tian Chen-Fu
Published: March 2022

Background

Maturity-onset diabetes of the young type 5 (MODY5) is a rare subtype of MODYs. It is caused by mutations of the hepatocyte nuclear factor 1 homeobox b gene (HNF1B). 17q12 recurrent deletion syndrome usually results in MODY5 because of the deletion of HNF1B. These patients often have other clinical manifestations besides diabetes. Refractory hypomagnesemia was a clue for further examination in this patient. But she lacked structural abnormalities of the genitourinary system and neurodevelopmental disorders that are common manifestations in patients with 17q12 recurrent deletion syndrome. Some atypical patients deserved attention.

Case presentation

A 21-year-old young woman was admitted to our hospital for severe malnutrition and gastrointestinal symptoms. At age 20, she was diagnosed with type 2 diabetes mellitus (T2DM) and was administered oral antidiabetic drugs. Soon afterward, the patient discontinued the medication on her own accord and then went to the hospital again due to diabetic ketoacidosis. After insulin treatment, diabetic ketoacidosis was cured and blood glucose was controlled satisfactorily. But intractable nausea, vomiting, and persistent weight loss were stubborn. Further examination revealed that the patient had hypokalemia and hard rectification hypomagnesemia. Genetic testing revealed about 1.85 Mb heterozygous fragment deletion on chromosome 17 and deletion of exons 1–9 of HNF1B heterozygosity missing was approved. Finally, the patient was diagnosed MODY5.

Discussion and Conclusions

The 17q12 recurrent deletion syndrome is characterized by MODY5, structural or functional abnormalities of the kidney and urinary tract, and neurodevelopmental or neuropsychiatric disorders. This patient did not have any structural abnormalities of the genitourinary system and neuropsychiatric disorders, which is rare. She had experienced a period of misdiagnosis before being diagnosed with 17q12 recurrent deletion syndrome, and hypomagnesemia was an important clue for her diagnosis. Therefore, diabetic physicians should be alert to a special type of diabetes if patients have unexplained signs and symptoms. The absence of well-known features of HNF1B disease does not exclude MODY5.
Effect of staining beverages and bleaching on optical properties of a CAD/CAM nanohybrid and nanoceramic restorative material
Authors: Elsaka Shaymaa , Taibah Salwa , Elnaghy Amr
Published: March 2022

Background

The purpose of this study was to evaluate the optical properties of nanohybrid Grandio (GR) and nanoceramic Lava Ultimate (LU) CAD/CAM restorative materials subjected to different beverage solutions and subsequently bleached.

Methods

Five groups of each restorative material (n = 20/group, shade A2-high translucent) were immersed in distilled water, coffee, tea, cola, and ginger for one week. Changes in whiteness index, translucency parameter, and color changes of the specimens were evaluated. The data of color measurements after staining, bleaching, and the residual differences were statistically analyzed using Kruskal–Wallis and Mann–Whitney U tests at the significance level of P < 0.05.

Results

LU and GR revealed the highest differences in whiteness index after coffee staining (P < 0.001). GR revealed lower translucency parameter differences after staining with coffee than LU (P = 0.007). There were no significant differences in translucency changes between LU and GR after staining with tea, cola, or ginger (P > 0.05). LU revealed significantly greater color changes than GR after staining (P < 0.001).

Conclusions

LU nanoceramic CAD/CAM restorative material revealed higher color changes than GR nanohybrid material. Staining beverage solutions had a distinct influence on the optical properties of the tested CAD/CAM restorative materials.
Identifying priorities, directions and a vision for Indigenous mental health using a collaborative and consensus-based facilitation approach
Authors: Montesanti Stephanie , Fitzpatrick Kayla , Fayant Bryan , Pritchard Caillie
Published: March 2022

Background

Mental health disparities between Indigenous and non-Indigenous people in Canada are related to underlying economic, social, and political inequities that are legacies of colonization and the oppression of Indigenous cultures. It also widely acknowledged that mental health services currently available may not be culturally appropriate in supporting the health needs of Indigenous Canadians. A two-day Indigenous mental health forum examined mental health needs and gaps among Indigenous communities across the Regional Municipality of Wood Buffalo (RMWB) on Treaty 8 territory, in northern Alberta, Canada. This paper outlines the insights generated by stakeholder engagement at the forum to identify and prioritize directions for Indigenous mental health and build a vision and strategy for improving mental health services and programs for the region’s diverse Indigenous population.

Methods

We applied a modified nominal group technique (NGT) consensus method embedded within Indigenous knowledge to determine key priorities and directions for Indigenous-focused mental health and synthesize information from discussions that occurred at the forum. Following the NGT, a participatory community visioning exercise was conducted with participants to develop a vision, guiding principles, and components of an action plan for an Indigenous mental health strategy for the RMWB.

Results

Four key themes for setting priorities and directions for Indigenous mental health emerged from roundtable group discussions: 1) understand the realities of mental health experiences for Indigenous peoples, 2) design a holistic and culturally rooted mental health system, 3) foster cross-sectoral engagement and collaboration on mental health service delivery, and 4) focus on children and youth. The community visioning exercise helped stakeholders to visualize a direction or path forward for addressing existing gaps in the mental health system and opportunities for strengthening Indigenous mental health in the region.

Conclusions

Forum participants described mental health and well-being around holistic concepts of social and emotional well-being. Addressing Indigenous mental health and wellness involves multi-sectoral action in various settings including community and school through programs, policies, and other interventions that promote mental health for all Indigenous peoples, as well as for those at greater risk such as children and youth.