bluuebunny/crossref_metadata_2025 huggingface dataset:
Independent and joint effect of relative telomere length and type 2 diabetes on all-cause mortality in American adults
Authors: Lan Beidi , Bai Yuan , Chang Xiaoyi , Zhang Xiaoxia
Published: November 2022

Objective

The joint effect of leukocyte telomere length (LTL) and type 2 diabetes (T2D) on the risk of all-cause death has been sparsely explored. The study designed to examine the joint effect of T2D and LTL on the probability of death in American adults.

Methods

A cohort of 6862 adults with LTL measurements and with or without T2D from the NHANES 1999-2002 with follow-up information until 2015 was studied. Quantitative PCR was used to measure the length of telomeres relative to standard reference DNA (T/S ratio). Individuals were grouped into three tertiles according to the LTL levels, with the first tertile demonstrating the lowest one and used as the reference group. The effects of LTL and T2D status on death were evaluated using Kaplan–Meier curves along with log-rank test. Three Cox proportional hazards models with adjustment for various confounders were used to examine the links between TL and all-cause death possibility using adjusted hazard ratios (HRs).

Results

Adults in the sample averaged 45.54 years of age, with 49.51% being male. After a median follow-up period of 14.4 years, 1543 (22.5%) individuals died from all cause. The probability of all-cause mortality was higher among individuals with LTL in the highest tertile than individuals in the lowest tertile (aHR = 0.89; 95%CI: 0.77-1.03); however, the difference did not reach the level of statistical significance (P = 0.11). Conversely, the individuals with T2D had a higher probability of death than individuals without (aHR = 1.26; 95%CI: 1.06-1.50; P = 0.0092). When LTL and T2D status were investigated jointly, subjects in the highest TLT tertile and with T2D had the highest probability of mortality compared with their counterparts (aHR = 1.34; 95%CI: 1.07-1.68; P = 0.0101). However, there was no independent effect of low TLT on mortality as demonstrated among individuals with diabetes (aHR = 1.14; 95%CI: 0.95-1.38; P = 0.1662).

Conclusion

The joint effect of TLT and T2D was larger than the sum of the independent effects on the risk of all-cause death. Participants with high TLT and diabetes showed the highest possibility of death compared with other groups.
From conceptual model to conceptual framework: A sustainable business framework for community water supply businesses
Authors: Sukma Narongsak , Leelasantitham Adisorn
Published: November 2022

Businesses must do more than safeguard their financial interests to survive in today’s market. Sustainability, or long-term viability, requires consideration of society, the environment, and the global community. However, community-based businesses cannot use some of the current components of the sustainable business framework because they were created for large corporations. Both quantitative and qualitative approaches are used in this study. First, quantitative methods were used to develop a conceptual model for the organization’s current needs using the PPT, the TOE, and an Expectation Confirmation Theory (ECT). A simple random sampling method was used to gather the data, with a sample size of 14 villages. Using a five-point Likert scale, the researcher gathered data from 2,584 households and collected 627 valid responses. After that, descriptive statistics were used to describe the data (frequency distributions, percentages, averages, medians, and standard deviations), and PLS-SEM was used to investigate the interactions between variables and launch the conceptual model using partial least squares (PLS) path modeling. First and foremost, qualitative through Interactive Qualitative Analysis (IQA). There are two ways to create a congested SID and an uncluttered SID: the Affinity Relationship Table (ART), the mapping of the Inter-Relationship Diagram (IRD), and the system influence diagram. According to the study, sustainable community water supply businesses are the primary driver. The conceptual framework presented in this paper is consistent with the results of the combination of quantitative and qualitative methods and the current constraints placed on community water supply businesses to thrive.
Correlation analysis and application investigation of multi-angle simultaneous polarization measurement data and concentration of suspended particulate matter in the atmosphere
Authors: Yuan Xuan , Song Jiawei , Zeng Nan , Guo Jun , Ma Hui
Published: November 2022

Determining the composition, particle size distribution and concentration changes of suspended particulate matter in the atmosphere is important for evaluating the quality of air and its impact on public health. The scattering and absorption of light by suspended particulate matter can change the polarization state of light, which can be used to extract characteristic information of measured particles. Firstly, we use our previously developed multi-angle simultaneous polarization measurement device to monitor the particulate matter around Dianshan Lake, Shanghai, and obtain high-throughput, high-dimensional Stokes data for nearly 1 month. The correlation between the Stokes data measured and the reference concentrations of five suspended particulate matter (Si, K, Fe, Ca, and Zn) was analyzed using the Periodical canonical correlation analysis (PCCA) method. The study shows a strong correlation between the three Stokes vectors and the concentrations of two types of suspended particulate matter in the atmosphere. Moreover, a prediction model for the concentration change of suspended particles was proposed by combining the locally weighted linear regression (LWLR) and the auto regressive moving average (ARMA) model. The prediction results on the concentration change of K and Fe in the atmosphere verified the validity of our method. The research in this work offers the possibility of continuous analysis and prediction of atmospheric suspended particulate matter in real environments.
Influence of the upper gravity-wave damping layer on precipitation over complex terrain
Authors: Duan H. X. , Zhang T. J. , Gong C. S. , Zhou G. L. , Zhu WeiWei
Published: November 2022

The upper boundary condition of a numerical model can significantly influence the model prediction results. This study used the Weather Research and Forecasting model to introduce the Rayleigh damping layer in the complex terrain of southern Gansu, China. Sensitivity tests are conducted for a strong precipitation process that occurred in 2016. Meanwhile, the effects of the upper gravity-wave damping layer and vertical velocity damping term of different schemes are explored. The results show that the upper gravity-wave damping layer can effectively reduce the error caused by false gravity waves in the complex terrain of southern Gansu Province. Moreover, the applicability of this model in the complex terrain of northwestern China is discussed. Overal, prediction of the precipitation area and intensity is improved. Specifically, the introduction of an implicit gravity-wave damping layer has a more significant damping effect on the upwardly propagating gravity-wave.
Characteristics and source profiles of atmospheric volatile organic compounds (VOCs) in the heavy industrial province of Northeast China with cruise monitoring
Authors: Shang Yijing , Chen Weiwei , Bao Qiuyang , Yu Yang , Pang Xiaobing , Zhang Yanli , Guo Li , Fu Jing , Feng Wei
Published: November 2022

As key precursors of tropospheric ozone (O3) pollution, volatile organic compound (VOC) pollution and related studies in China are mainly concentrated in developed regions or metropolises, while there are few studies on VOC pollution in the heavy industrial base in Northeast China. This study conducted a systematic survey of VOCs’ information for the first time in Jilin Province, covering eight prefecture-level cities, ten major industries (e.g., petrochemical, chemical), and 130 major factories, based on cruise monitoring for 2 months. The concentrations and compositions (i.e., 65 species) of VOC were measured in real-time. The emission characteristics of VOC, local source profiles, and the ozone formation potential (OFP) were further analyzed to support O3 pollution control in Northeast China. On the provincial scale, the concentrations of total VOC during the monitoring period ranged from 0.03 to 18321.5 μg/m3, and averaged at 607.9 ± 2051.8 μg/m3. Among the prefecture-level cities, Jilin City had the highest concentration level (1938.0 ± 3811.3 μg/m3) given the largest numbers of petrochemical factories, and the lowest level (85.5 ± 48.9 μg/m3) was found in Liaoyuan City. At the industrial scale, the highest (1915.2 ± 1842.6 μg/m3) was detected in the petrochemical industry with a major species of 1,1,2,2-tetrachloroethane. The lowest VOC emission concentration levels were found in the textile industry (57.8 ± 44.6 μg/m3; major species: xylene/ethylbenzene). Local source profiles in various industries were established, and normalized OFP of corresponding species was calculated, which are important parameters to evaluate the contribution of different VOC sources to O3 pollution. Combined with provincial industrial structure and future planning, we suggest two major industries including the chemical industry and petrochemical industry in Changchun City and Jilin City are prior to being optimized to reduce O3 pollution. This study contributes to the knowledge of the characteristics and source profiles of VOC emissions, providing an important reference for the management or control of O3 pollution in Northeast China.
Probabilistic edge inference of gene networks with markov random field-based bayesian learning
Authors: Huang Yu-Jyun , Mukherjee Rajarshi , Hsiao Chuhsing Kate
Published: November 2022

Current algorithms for gene regulatory network construction based on Gaussian graphical models focuses on the deterministic decision of whether an edge exists. Both the probabilistic inference of edge existence and the relative strength of edges are often overlooked, either because the computational algorithms cannot account for this uncertainty or because it is not straightforward in implementation. In this study, we combine the Bayesian Markov random field and the conditional autoregressive (CAR) model to tackle simultaneously these two tasks. The uncertainty of edge existence and the relative strength of edges can be measured and quantified based on a Bayesian model such as the CAR model and the spike-and-slab lasso prior. In addition, the strength of the edges can be utilized to prioritize the importance of the edges in a network graph. Simulations and a glioblastoma cancer study were carried out to assess the proposed model’s performance and to compare it with existing methods when a binary decision is of interest. The proposed approach shows stable performance and may provide novel structures with biological insights.
College students’ screening early warning factors in identification of suicide risk
Authors: Han Ke , Ji Lei , Chen Changfeng , Hou Binyin , Ren Decheng , Yuan Fan , Liu Liangjie , Bi Yan , Guo Zhenming , Wu Na , Feng Mofan , Su Kai , Wang Chenliu , Yang Fengping , Wu Xi , Li Xingwang , Liu Chuanxin , Zuo Zhen , Zhang Rong , Yi Zhenghui , Xu Yifeng , He Lin , Shi Yi , Yu Tao , He Guang
Published: November 2022

This study aimed to explore the main influencing factors of suicide risk among Chinese students and establish an early warning model to provide interventions for high-risk students. We conducted surveys of students in their first and third years from a cohort study at Jining Medical College. Logistic regression models were used to screen the early warning factors, and four machine learning models were used to establish early warning models. There were 8 factors related to suicide risk that were eventually obtained through screening, including age, having a rough father, and CES-D, OHQ, ASLEC-4, BFI-Neuroticism, BFI-Openness, and MMC-AF-C scores. A random forest model with SMOTE was adopted, and it verified that these 8 early warning signs, for suicide risk can effectively predict suicide risk within 2 years with an AUC score of 0.947. Among the factors, we constructed a model that indicated that different personality traits affected suicide risk by different paths. Moreover, the factors obtained by screening can be used to identify college students in the same year with a high risk of suicide, with an AUC score that reached 0.953. Based on this study, we suggested some interventions to prevent students going high suicide risk.
Peripheral ulcerative keratitis, nodular episcleritis, and pulmonary nodules as the initial signs of rheumatic arthritis: A Case Report
Authors: Wang Jingting , Zhang Qin , Shi Weiyun , Pang Yilin , Li Suxia
Published: November 2022

Background

Rheumatoid vasculitis (RV) is a rare but potentially devastating complication of rheumatoid arthritis (RA). It typically occurs in patients with extra-articular manifestations. Here we reported a case of PUK with nodular episcleritis and pulmonary nodules that occurred in the same patient without joint involvement.

Case presentation

A 43-year-old Chinese woman, exhibited a partial crescent-shaped marginal corneal ulcer in the right eye at admission and the ulcer developed rapidly into nearly 360-degree ulcers in both eyes within one week. Nodular episcleritis was observed in the right eye. Conjunctival biopsy revealed vasculitis. Her rheumatoid factor (RF) and anti-cyclic citrullinated protein antibody were positive, while anti-neutrophilic cytoplasmic antibody (c-ANCA) and anti-protease 3 were negative. Pulmonary nodules were found, without joint involvement. The ocular condition did not relieve under the topical and systemic use of corticosteroids, or under other immunosuppressive agents until the infliximab therapy. PUK recurrence was observed after the discontinuation of infliximab.

Conclusions

Rapidly deteriorated PUK with nodular episcleritis and pulmonary nodules occurred in the same patient is a special case of RA without joint involvement. This case reinforces the concept that RV may be the initial sign of RA. Infliximab can be used to prevent further progress of RA-related PUK in some refractory cases.
TriTECM: A tetrafunctional T-cell engaging antibody with built-in risk mitigation of cytokine release syndrome
Authors: Carrara Stefania C. , Harwardt Julia , Grzeschik Julius , Hock Björn , Kolmar Harald
Published: November 2022

Harnessing the innate power of T cells for therapeutic benefit has seen many shortcomings due to cytotoxicity in the past, but still remains a very attractive mechanism of action for immune-modulating biotherapeutics. With the intent of expanding the therapeutic window for T-cell targeting biotherapeutics, we present an attenuated trispecific T-cell engager (TCE) combined with an anti- interleukin 6 receptor (IL-6R) binding moiety in order to modulate cytokine activity (TriTECM). Overshooting cytokine release, culminating in cytokine release syndrome (CRS), is one of the severest adverse effects observed with T-cell immunotherapies, where the IL-6/IL-6R axis is known to play a pivotal role. By targeting two tumour-associated antigens, epidermal growth factor receptor (EGFR) and programmed death ligand 1 (PD-L1), simultaneously with a bispecific two-in-one antibody, high tumour selectivity together with checkpoint inhibition was achieved. We generated tetrafunctional molecules that contained additional CD3- and IL-6R-binding modules. Ligand competition for both PD-L1 and IL-6R as well as inhibition of both EGF- and IL-6-mediated signalling pathways was observed. Furthermore, TriTECM molecules were able to activate T cells and trigger T-cell-mediated cytotoxicity through CD3-binding in an attenuated fashion. A decrease in pro-inflammatory cytokine interferon γ (IFNγ) after T-cell activation was observed for the TriTECM molecules compared to their respective controls lacking IL-6R binding, hinting at a successful attenuation and potential modulation via IL-6R. As IL-6 is a key player in cytokine release syndrome as well as being implicated in enhancing tumour progression, such molecule designs could reduce side effects and cytotoxicity observed with previous TCEs and widen their therapeutic windows.
Crosslinking of membrane CD13 in human neutrophils mediates phagocytosis and production of reactive oxygen species, neutrophil extracellular traps and proinflammatory cytokines
Authors: Pérez-Figueroa Erandi , Álvarez-Carrasco Pablo , Ortega Enrique
Published: November 2022

Aminopeptidase N, or CD13, is a cell membrane ectopeptidase highly expressed in myeloid cells. Through its enzymatic activity, CD13 regulates the activity of several bioactive peptides, such as endorphins and enkephalins, chemotactic peptides like MCP-1 and IL-8, angiotensin III, bradikinin, etc. In recent years, it has been appreciated that independently of its peptidase activity, CD13 can activate signal transduction pathways and mediate effector functions such as phagocytosis and cytokine secretion in monocytes and macrophages. Although neutrophils are known to express CD13 on its membrane, it is currently unknown if CD13 can mediate effector functions in these cells. Here, we show that in human neutrophils CD13 can mediate phagocytosis, which is dependent on a signaling pathway that involves Syk, and PI3-K. Phagocytosis mediated by CD13 is associated with production of reactive oxygen species (ROS). The level of phagocytosis and ROS production mediated by CD13 are similar to those through FcγRIII (CD16b), a widely studied receptor of human neutrophils. Also, CD13 ligation induces the release of neutrophil extracellular traps (NETs) as well as cytokine secretion from neutrophils. These results support the hypothesis that CD13 is a membrane receptor able to activate effector functions in human neutrophils.
High resolution geomorphological classification of benthic structure on the Western Pacific Seamount
Authors: Fan Miao , Shi Suixiang , Ma Yong , Wang Hu , Zhai Jingsheng , Zhang Xuefeng , Ning Pengfei
Published: November 2022

The benthic structure of seamounts is critical for understanding the ecological environment and for assessing the influence of resource exploitation. However, the characteristics of the benthic structure of the seamount, especially for guyot, are still far from being clearly understood. For the first time, we carried out detailed hydroacoustic mapping in conjunction with surficial sediment sampling and underwater video recording to investigate the geomorphical and biological characteristics of Pallada Guyot in the Western Pacific Ocean (WPO). We utilized the Benthic Terrain Modeler (BTM) as an initial step to describe the detailed benthic structures and then classify the textural seabed according to backscatter images and sediment samples. We further discussed the relationship between geomorphology and the occurrence of benthic megafauna from video images. The results revealed that 13 classes of benthic structural zones were differentiated, and the dominant zones were flat abyssal plains, where the number and size of megafauna were smaller than those on the flank and flat-topped areas. The second most notable feature is the flat top, where sea cucumbers, starfish, fish, and shrimp have higher biomass and diversity. In the flank region, which is characterized by complex and extensive current-scoured ridges and depressions, sponges and corals are distributed in high-relief bedrocks. We also found that the maximum water depth where cold-water corals develop is 2,250 m. The sponge grounds appear in a marked bathymetric belt (1,800–2,150 m), which is shallower than that on a tropical seamount (2,500–3,000 m) located in the northeastern Atlantic. The findings of this study contribute to understanding the geomorphological drivers and biogeography of WPO seamounts and provide a reference for identifying priority areas for improved marine mineral planning in WPO areas.
Deep learning-based DOA estimation using CRNN for underwater acoustic arrays
Authors: Li Xiaoqiang , Chen Jianfeng , Bai Jisheng , Ayub Muhammad Saad , Zhang Dongzhe , Wang Mou , Yan Qingli
Published: November 2022

In the marine environment, estimating the direction of arrival (DOA) is challenging because of the multipath signals and low signal-to-noise ratio (SNR). In this paper, we propose a convolutional recurrent neural network (CRNN)-based method for underwater DOA estimation using an acoustic array. The proposed CRNN takes the phase component of the short-time Fourier transform of the array signals as the input feature. The convolutional part of the CRNN extracts high-level features, while the recurrent component captures the temporal dependencies of the features. Moreover, we introduce a residual connection to further improve the performance of DOA estimation. We train the CRNN with multipath signals generated by the BELLHOP model and a uniform line array. Experimental results show that the proposed CRNN yields high-accuracy DOA estimation at different SNR levels, significantly outperforming existing methods. The proposed CRNN also exhibits a relatively short processing time for DOA estimation, extending its applicability.
Effects of wetland, tide, and season on benthic biofilms and related sediment properties in mangrove ecosystems
Authors: Yang Lihua , Yang Qian , Lin Li , Luan Tiangang , Yang Qiong , Li Pu , Tam Nora F. Y.
Published: November 2022

Sediment biofilms, mainly composed of diatoms, bacteria, and related extracellular polymeric substances (EPS), play important roles in mangrove ecosystems. In order to better understand the microbial biodiversity in marine environment, this study aims to clarify the effects of wetland, season, and tide on benthic biofilms and related sediment properties based on in situ investigation in two mangrove wetlands (Futian and Qi’ao) in the Pearl River Estuary, South China. Owing to the tide current, the northeastern Futian is more influenced by seawater than the southwestern Qi’ao. As a consequence of the salinity-driven accumulation of nutrients in sediments, Futian is more eutrophic than Qi’ao. Compared to Qi’ao, the higher nutrimental condition in Futian conserves higher abundance of eutrophic indicators of Nitzschia and Cyclotella, which results in higher values of all pigments and bound polysaccharide with varied monosaccharide composition. Compared to the seaward site, the landward site has higher abundance of benthic (pennate) diatoms but lower abundance of planktonic (centric) diatoms due to the varied settling velocity by tidal disturbance. This varied diatom composition leads to higher levels of bound polysaccharide and more monosaccharides in the landward site than in the seaward site. Compared to late spring (March), early summer (May) appears to have similar diatom abundance but more EPS fractions (except bound protein) and monosaccharides due to the higher level of light intensity and temperature. The observed lower bacterial abundance in May than in March might be due to the higher predation pressure. The baseline data on biofilm compositions in mangrove ecosystems from this study can improve the understanding of microbial biodiversity in response to the tidal, temporal, and spatial changes.
Modeling Spray C and Spray D with FGM within the framework of RANS and LES
Authors: Di Matteo Andrea , Bao Hesheng , Somers Bart
Published: November 2022

In this study, two different diesel-like igniting sprays are investigated: Engine Combustion Network (ECN) Spray C and D. In particular, this study focuses on the respective performances of the RANS and LES models to predict a turbulent, igniting spray using the OpenFOAM platform. The breakup model, discretization schemes, and case setups, including the combustion model, are kept constant in order to mitigate any potential effect on the simulation apart from intrinsic differences due to turbulence modeling. A classic κ-ε model is applied for the RANS approach, while a dynamic structure model is used to solve the momentum equation in the LES approach. The κ-ε model constants are tuned to obtain a suitable prediction of inert experiments. Both approaches exhibit a reasonable agreement with the inert experiments regarding the global spray characteristics, the liquid length, and the vapor penetration. However, the transient local properties, including the spatial distribution of mixture fraction variance and the species distributions, are not identical. For reacting conditions, the Flamelet Generate Manifold (FGM) model is adopted in both the LES and RANS simulations, using several enthalpy levels as the fourth dimension in the tabulation to account for local heat loss. The results show good agreement between the two turbulence models, in terms of liquid length, vapor penetration, and lift-off length, while a short ignition delay is registered for both sprays and turbulence frameworks. Turbulence–chemistry interaction (TCI) is considered by applying a presumed probability density function (β-PDF) to the mixture fraction, and is found to play a key role in the reproduction of species distribution in the domain.
Caregiver perspectives on barriers and facilitators to primary care for autistic adults: A qualitative study
Authors: Stein Duker Leah I. , Goodman Elizabeth , Pomponio Davidson Amber , Mosqueda Laura
Published: November 2022

Background

Primary care is associated with greater access to healthcare services and improved health outcomes. However, autistic adults report challenges accessing and utilizing primary care, in addition to unmet healthcare needs. The need to minimize existing barriers and identify strategies to facilitate successful healthcare encounters is increasingly important as autistic adults represent a growing segment of society. Minimal research has examined primary healthcare encounters for this population.

Methods

As part of a larger convergent parallel design mixed-methods study that recruited autistic adults, caregivers of autistic adults, and primary care providers treating autistic adults, interviews were conducted with 31 caregivers of autistic adults. Caregivers were predominantly female (94%), and the autistic adult they cared for were primarily male (87%), with a mean age of 24 years. Thematic analysis was employed to elucidate the barriers to care, suggestions to mitigate challenges, and/or successful strategies implemented during care encounters for autistic adults, as reported by their caregivers.

Results

Reported here are the results only from the caregiver interviews, in which seven themes emerged: (1) finding a primary care provider; (2) patient-provider communication; (3) anxiety due to unpredictability, an overstimulating sensory environment, and waiting time; (4) participation of consumers in the healthcare process; (5) stigma and assumptions about autism; (6) caregiver experiences; and (7) the impact of culture and ethnicity on care.

Conclusion

Findings from this study have the potential to inform the development of, or improve existing, client-centered interventions to improve primary healthcare services for autistic adults.
Efficacy and adverse effects of peripheral nerve blocks and local infiltration anesthesia after arthroscopic shoulder surgery: A Bayesian network meta-analysis
Authors: Liu Zheng , Li Yi-bo , Wang Ji-hua , Wu Guang-han , Shi Peng-cai
Published: November 2022

Study objective

To quantitatively assess and compare the efficacy and adverse effects of six different peripheral nerve block techniques after arthroscopic shoulder surgery (ASS).

Design

Bayesian network meta-analysis.

Methods

The PubMed, Embase, Web of Science, the Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure database, Chinese Scientific Journal database, Wan Fang databases were searched to retrieve randomized clinical trials comparing interscalene brachial plexus block, continuous interscalene brachial plexus block, supraclavicular brachial plexus block, suprascapular nerve block, combined suprascapular and axillary nerve block and local infiltration analgesia on postoperative pain, opioid consumption, and adverse effects (defined as Horner’s syndrome, dyspnea, hoarseness, vomiting, and nausea) after ASS under general anesthesia (GA). Two reviewers independently screened the literature, extracted data, and evaluated the risk of bias in the included studies.

Results

A total of 1,348 articles were retrieved initially and 36 randomized clinical trials involving 3,124 patients were included in the final analysis. The network meta-analysis showed that interscalene brachial plexus block was superior in reducing pain and opioid consumption compared to the five other interventions. However, adverse effects were reduced using suprascapular nerve block and combined suprascapular and axillary nerve block compared to interscalene brachial plexus block.

Conclusion

Interscalene brachial plexus block was superior in reducing pain and opioid consumption compared to other peripheral nerve blocks but had a higher frequency of adverse events.
Short-term outcomes of near-infrared imaging using indocyanine green in laparoscopic lateral pelvic lymph node dissection for middle-lower rectal cancer: A propensity score-matched cohort analysis
Authors: Dai Jin-Yu , Han Zhi-Jun , Wang Jing-Dong , Liu Bao-Shuang , Liu Jian-Yu , Wang Yan-Cheng
Published: November 2022

Laparoscopic lateral pelvic lymph node dissection (LPND) is limited by complex neurovascular bundles in the narrow pelvic sidewall and various post-operative complications. Indocyanine green (ICG) has been applied to increase the number of harvested lymph nodes and reduce the injury of irrelevant vessels in patients with rectal cancer. However, few studies on the recurrence rate of ICG fluorescence imaging-guided laparoscopic LPND were reported. This retrospective study enrolled 50 middle- low rectal cancer patients who were treated by LPND. After propensity score matching, 20 patients were matched in each of the indocyanine green (ICG) guided imaging group (ICG group) and non-ICG guided imaging group (non-ICG group). The average follow-up time was 13.5 months (12–15 months). Our results showed that the total number of harvested lymph nodes in the ICG group was significantly higher than that in the non-ICG group (P < 0.05), and intraoperative blood loss and post-operative hospital stay times in the ICG group were less than those in the non-ICG group (P < 0.05). After 12 months of follow-up, no residual lymph node and local tumor recurrence were found for patients in the ICG group. Four patients in the non-ICG group detected residual lymph nodes at the 3-month visit. Our findings highlighted the importance of ICG fluorescence-guided imaging in LPND because it has unique advantages in improving the number of lymph node dissections, surgical accuracy, and decreasing the residual lymph nodes and local tumor recurrence. In addition, ICG fluorescence guidance technology can effectively shorten the operation time, and it is simple to operate, which is worth popularizing.
Cost-accuracy and patient experience assessment of blood pressure monitoring methods to diagnose hypertension: A comparative effectiveness study
Authors: González-de Paz Luis , Kostov Belchin , Freixa Xavier , Herranz Carmen , Lagarda Elena , Ortega María , Pérez Elisa , Porcar Silvia , Sánchez Eva , Serrato Montserrat , Vidiella Ingrid , Sisó-Almirall Antoni
Published: November 2022

Objectives

Studies of the diagnosis of hypertension have emphasized long-term cost-effectiveness analysis, but the patient experience and costs of blood pressure monitoring methods at the diagnosis stage remain unclear. We studied four diagnostic methods: a new 1 h-automated office blood pressure (BP) monitoring, office BP measurement, home BP monitoring, and awake-ambulatory BP monitoring.

Methods

We carried out a comparative effectiveness study of four methods of diagnosing hypertension in 500 participants with a clinical suspicion of hypertension from three primary healthcare (PHC) centers in Barcelona city (Spain). We evaluated the time required and the intrinsic and extrinsic costs of the four methods. The cost-accuracy ratio was calculated and differences between methods were assessed using ANOVA and Tukey’s honestly significant difference (HSD) post-hoc test. Patient experience data were transformed using Rasch analysis and re-scaled from 0 to 10.

Results

Office BP measurement was the most expensive method (€156.82, 95% CI: 156.18–157.46) and 1 h-automated BP measurement the cheapest (€85.91, 95% CI: 85.59–86.23). 1 h-automated BP measurement had the best cost-accuracy ratio (€ 1.19) and office BP measurement the worst (€ 2.34). Home BP monitoring (8.01, 95% CI: 7.70–8.22), and 1 h-automated BP measurement (7.99, 95% CI: 7.80–8.18) had the greatest patient approval: 66.94% of participants would recommend 1 h-automated BP measurement as the first or second option.

Conclusion

The relationship between the cost-accuracy ratio and the patient experience suggests physicians could use the new 1 h-automated BP measurement as the first option and awake-ambulatory BP monitoring in complicated cases and cease diagnosing hypertension using office BP measurement.
Chinese herbal medicine for migraine management: A hospital-based retrospective analysis of electronic medical records
Authors: Lyu Shaohua , Zhang Claire Shuiqing , Sun Jingbo , Weng Heng , Xue Charlie Changli , Guo Xinfeng , Zhang Anthony Lin
Published: November 2022

Background

Migraine is a chronic neurological disease causing significant socioeconomic burden and impaired quality of life. Chinese medicine is commonly used for migraine in China. Clinical trials have generated evidence of the effectiveness of Chinese medicine therapies for migraine. However, little is known about how to use these therapies to treat migraine in real-world clinical settings.

Methods

In this retrospective study, we analyzed data from the electronic medical records (EMRs) of 2,023 migraine patients who attended the Guangdong Provincial Hospital of Chinese Medicine (GPHCM) between July 2018 and July 2020.

Results

More than three-quarters (77.21%) of the patients were female. Most (78.20%) of the patients were aged between 18 and 50 years, 18.49% were aged above 50 years, and the remaining 3.31% were under 18 years. Sleep disorders were the most documented comorbidity occurring in 27.29% of patients, and more common in females (29.77%) than male (18.87%). Fatigue was the most frequently reported trigger of migraine attacks among all patients (9.39%), while menstruation was the most common trigger for female patients (10.24%). Less than a quarter of patients (21.01%) reported a history of taking analgesic medication for their migraine. The median treatment duration reported by the patients was 10 days. Chinese herbal medicine (CHM) was the predominant treatment for migraine at the hospital (88.48%), while pharmacotherapies were prescribed to 28.97% of the patients. CHM was prescribed more often as a sole treatment (53.58% of patients) than combined with pharmacotherapies (27.39% of patients). Among patients who reported improvements after taking CHM, the most frequently used herbs were fu ling and chuan xiong, the most frequent patented CHM product was tong tian oral solution, and the main herbal formulae were chuan xiong cha tiao san and yi qi cong ming tang.

Conclusion

CHM formulae, such as chuan xiong cha tiao san and yi qi cong ming tang, patented CHM product tong tian oral solution, and some herbs are potentially effective treatments for migraine. As such, CHM can be used as an alternative to conventional pharmacotherapies for migraine and is worth further evaluation in randomized controlled trials.
Case report: Desmoid fibromatosis diagnosed in a 27-year-old male after being mistaken for a gastrointestinal stromal tumour
Authors: Albino Larissa , Guo Yimeng , Bacani Julinor , Mather Cheryl , Nilsson Jan-Erick , Dieleman Levinus A.
Published: November 2022

Despite being distinct lesions, gastrointestinal stromal tumours (GISTs) and desmoid fibromatosis may appear similar on imaging when they involve the stomach wall or bowel. As a result, they may be confused with one another when initially diagnosed. This report aims to present a case where a desmoid tumour was mistaken for a gastric GIST in a 27-year-old gentleman despite extensive investigation prior to exploratory laparotomy, and why differentiation through pathology, with a focus on the immunohistochemistry profile, is key for proper prognostication and appropriate management, including timely investigation for associated diseases such as Familial Adenomatous Polyposis in patients with desmoid tumours.
Fecal indicators and antibiotic resistance genes exhibit diurnal trends in the Chattahoochee River: Implications for water quality monitoring
Authors: Nguyen Karena. H. , Smith Shanon , Roundtree Alexis , Feistel Dorian J. , Kirby Amy E. , Levy Karen , Mattioli Mia Catharine
Published: November 2022

Water bodies that serve as sources of drinking or recreational water are routinely monitored for fecal indicator bacteria (FIB) by state and local agencies. Exceedances of monitoring thresholds set by those agencies signal likely elevated human health risk from exposure, but FIB give little information about the potential source of contamination. To improve our understanding of how within-day variation could impact monitoring data interpretation, we conducted a study at two sites along the Chattahoochee River that varied in their recreational usage and adjacent land-use (natural versus urban), collecting samples every 30 min over one 24-h period. We assayed for three types of microbial indicators: FIB (total coliforms and Escherichia coli); human fecal-associated microbial source tracking (MST) markers (crAssphage and HF183/BacR287); and a suite of clinically relevant antibiotic resistance genes (ARGs; blaCTX-M, blaCMY, MCR, KPC, VIM, NDM) and a gene associated with antibiotic resistance (intl1). Mean levels of FIB and clinically relevant ARGs (blaCMY and KPC) were similar across sites, while MST markers and intI1 occurred at higher mean levels at the natural site. The human-associated MST markers positively correlated with antibiotic resistant-associated genes at both sites, but no consistent associations were detected between culturable FIB and any molecular markers. For all microbial indicators, generalized additive mixed models were used to examine diurnal variability and whether this variability was associated with environmental factors (water temperature, turbidity, pH, and sunlight). We found that FIB peaked during morning and early afternoon hours and were not associated with environmental factors. With the exception of HF183/BacR287 at the urban site, molecular MST markers and intI1 exhibited diurnal variability, and water temperature, pH, and turbidity were significantly associated with this variability. For blaCMY and KPC, diurnal variability was present but was not correlated with environmental factors. These results suggest that differences in land use (natural or urban) both adjacent and upstream may impact overall levels of microbial contamination. Monitoring agencies should consider matching sample collection times with peak levels of target microbial indicators, which would be in the morning or early afternoon for the fecal associated indicators. Measuring multiple microbial indicators can lead to clearer interpretations of human health risk associated with exposure to contaminated water.
Differences in gene expression patterns between cultured and natural Haloquadratum walsbyi ecotypes
Authors: Rosselli Riccardo , López-Pérez Mario , Martin-Cuadrado Ana-Belen , Rodriguez-Valera Francisco , Bolhuis Henk
Published: November 2022

Solar crystallizer ponds are characterized by high population density with a relatively simple community structure in terms of species composition. The microbial community in the solar saltern of Santa Pola (Alicante, Spain), is largely dominated by the hyperhalophilic square archaeon Haloquadratum walsbyi. Here we studied metatranscriptomes retrieved from a crystallizer pond during the winter of 2012 and summer of 2014 and compared Hqr. walsbyi’s transcription patterns with that of the cultured strain Hqr. walsbyi HBSQ001. Significant differences were found between natural and the cultured grown strain in the distribution of transcript levels per gene. This likely reflects the adaptation of the cultured strain to the relative homogeneous growth conditions while the natural species, which is represented by multiple ecotypes, is adapted to heterogeneous environmental conditions and challenges of nutrient competition, viral attack, and other stressors. An important consequence of this study is that expression patterns obtained under artificial cultivation conditions cannot be directly extrapolated to gene expression under natural conditions. Moreover, we found 195 significantly differential expressed genes between the seasons, with 140 genes being higher expressed in winter and mainly encode proteins involved in energy and carbon source acquiring processes, and in stress responses.
Microbiological characteristics and risk factors on prognosis associated with Acinetobacter baumannii bacteremia in general hospital: A single-center retrospective study
Authors: Wei Zhiyong , Zhou Shuai , Zhang Ying , Zheng Lin , Zhao Lina , Cui Yan , Xie Keliang
Published: November 2022

Objective

Acinetobacter baumannii is one of the most important pathogenic bacteria causing nosocomial infections and has a high mortality rate. Assessment of the microbiological characteristics and risk factors on prognosis associated with A.baumannii is essential. In this study, we aimed to investigate the clinical characteristics and prognostic risk factors of patients with A.baumannii bacteremia.

Patients and Methods

This study retrospectively analyzed the antibiotic resistance of pathogens based on the clinical data of A.baumannii bacteremia patients presented in a tertiary teaching hospital from 2017 to 2022. Logistic regression and decision tree identified the prognostic risk factors for patients with baumannemia. Kaplan-Meier method was used for survival analysis between MDR and Non-MDR groups. The area under receiver-operating characteristic curve (ROC curve) was used to compare the predictive value of the APACHE II score and Sequential Organ Failure Assessment (SOFA) score.

Results

A total of 110 patients with positive A. Baumannii blood cultures were included. Most of the patients were from intensive care unit (ICU) wards. The drug sensitivity results showed that the resistance rate of A. baumannii to colistin was the lowest (1.1%), followed by tigecycline (3.6%).

The survival time of MDR group was significantly shorter than that of Non-MDR group. Multivariate analysis showed that, APACHE II score and SOFA score were independent risk factors affecting the prognosis of 28 days of A.baumannii bacteremia. And both scores displayed excellent AUROCs (SOFA: 0.909, APACHE II: 0.895 in predicting 28-day mortality). The two scoring systems were highly correlated and predicted no significant difference (r2 = 0.4410, P < 0.001). We found that SOFA > 7 and APACHE II > 21 are associated with significantly higher mortality rates.

Conclusion

A.baumannii bacteremia have the highest incidence in the ICU, with high drug resistance and mortality rates. The survival time of patients with MDR A. Baumannii bacteremia was significantly shortened. The SOFA score and APACHE II score can reflect the severity of A.baumannii bacteremia patients and evaluate the 28-day prognosis. In addition, for the convenience of calculation, the SOFA score may be more clinically useful than the APACHE II score in predicting the mortality rate of A.baumannii bacteremia.
Salivary inflammatory biomarkers are predictive of mild cognitive impairment and Alzheimer’s disease in a feasibility study
Authors: McNicholas Kym , François Maxime , Liu Jian-Wei , Doecke James D. , Hecker Jane , Faunt Jeff , Maddison John , Johns Sally , Pukala Tara L. , Rush Robert A. , Leifert Wayne R.
Published: November 2022

Alzheimer’s disease (AD) is an insidious disease. Its distinctive pathology forms over a considerable length of time without symptoms. There is a need to detect this disease, before even subtle changes occur in cognition. Hallmark AD biomarkers, tau and amyloid-β, have shown promising results in CSF and blood. However, detecting early changes in these biomarkers and others will involve screening a wide group of healthy, asymptomatic individuals. Saliva is a feasible alternative. Sample collection is economical, non-invasive and saliva is an abundant source of proteins including tau and amyloid-β. This work sought to extend an earlier promising untargeted mass spectrometry study in saliva from individuals with mild cognitive impairment (MCI) or AD with age- and gender-matched cognitively normal from the South Australian Neurodegenerative Disease cohort. Five proteins, with key roles in inflammation, were chosen from this study and measured by ELISA from individuals with AD (n = 16), MCI (n = 15) and cognitively normal (n = 29). The concentrations of Cystatin-C, Interleukin-1 receptor antagonist, Stratifin, Matrix metalloproteinase 9 and Haptoglobin proteins had altered abundance in saliva from AD and MCI, consistent with the earlier study. Receiver operating characteristic analysis showed that combinations of these proteins demonstrated excellent diagnostic accuracy for distinguishing both MCI (area under curve = 0.97) and AD (area under curve = 0.97) from cognitively normal. These results provide evidence for saliva being a valuable source of biomarkers for early detection of cognitive impairment in individuals on the AD continuum and potentially other neurodegenerative diseases.
Bioinformatics analysis of gene expression profile and functional analysis in periodontitis and Parkinson’s disease
Authors: Wang Xiaofeng , Shi Naixu , Wu Baiao , Yuan Lin , Chen Jiapeng , Ye Cong , Hao Miao
Published: November 2022

Periodontitis is a chronic inflammatory disease inextricably linked to both the innate and acquired immune systems of the body. Parkinson’s disease (PD) is a neurodegenerative disease caused by immune system dysfunction. Although recent studies suggest that a clinical relationship exists between PD and periodontitis, the pathogenesis of this relationship is unclear. Therefore, in the present study, we obtained datasets of periodontitis and PD from the Gene Expression Omnibus (GEO) database and extracted 785 differentially expressed genes (DEGs), including 15 common upregulated genes and four common downregulated genes. We performed enrichment analyses of these DEGs using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes analyses. We found that the genes were mainly enriched in keratinocyte differentiation, neuronal cell bodies, and structural constituents of epidermis terms, and pathways such as immune response and synaptic pathways. In addition, we screened matching hub genes by constructing a protein–protein interaction (PPI) network map and a Molecular Complex Detection (MCODE) map using the Cytoscape software. The hub genes were then subjected to GO enrichment analysis, which revealed that the dopamine biosynthetic process, dopaminergic synapse and dopamine-binding terms, and dopaminergic synapse and serotonergic synapse pathways were primarily where they were expressed. Finally, we selected four of these genes for validation in the periodontitis and PD datasets, and we confirmed that these hub genes were highly sensitive and specific for diagnosing and monitoring PD and periodontitis. In conclusion, the above experimental results indicate that periodontitis is a high-risk factor for PD, and the association between these two conditions is mainly manifested in immune and dopamine-related pathways. Hub genes, such as the CDSN, TH, DDC, and SLC6A3 genes, may serve as potential biomarkers for diagnosing or detecting PD.