bluuebunny/crossref_metadata_2025 huggingface dataset:
Sex differences in early transcriptomic responses to oxidative stress in the copepod Tigriopus californicus
Authors: Li Ning , Flanagan Ben A. , Partridge MacKenzie , Huang Elaine J. , Edmands Suzanne
Published: November 2020

Background

Patterns of gene expression can be dramatically different between males and females of the same species, in part due to genes on sex chromosomes. Here we test for sex differences in early transcriptomic response to oxidative stress in a species which lacks heteromorphic sex chromosomes, the copepodTigriopus californicus.

Results

Male and female individuals were separately exposed to control conditions and pro-oxidant conditions (hydrogen peroxide and paraquat) for periods of 3 hours and 6 hours. Variance partitioning showed the greatest expression variance among individuals, highlighting the important information that can be obscured by the common practice of pooling individuals. Gene expression variance between sexes was greater than that among treatments, showing the profound effect of sex even when males and females share the same genome. Males exhibited a larger response to both pro-oxidants, differentially expressing more than four times as many genes, including up-regulation of more antioxidant genes, heat shock proteins and protease genes. While females differentially expressed fewer genes, the magnitudes of fold change were generally greater, indicating a more targeted response. Although females shared a smaller fraction of differentially expressed genes between stressors and time points, expression patterns of antioxidant and protease genes were more similar between stressors and more GO terms were shared between time points.

Conclusions

Early transcriptomic responses to the pro-oxidants H2O2and paraquat in copepods revealed substantial variation among individuals and between sexes. The finding of such profound sex differences in oxidative stress response, even in the absence of sex chromosomes, highlights the importance of studying both sexes and the potential for developing sex-specific strategies to promote optimal health and aging in humans.
Gut microbiota: effect of pubertal status
Authors: Yuan Xin , Chen Ruimin , Zhang Ying , Lin Xiangquan , Yang Xiaohong
Published: November 2020

Background

The make-up of gut microbiota at different puberty stages has not been reported. This cross-sectional study analyzed the bio-diversity of gut microbiota at different puberty stages.

Result

The subjects (aged 5–15 years) were divided into non-pubertal (n = 42, male%: 66.7%) or pubertal groups (n = 47, male%:44.68); in both groups, Firmicutes, Bacteroidetes and Proteobacteria were the dominant phylum. There was no difference of alpha- and beta-diversity among disparate puberty stages. Non-pubertal subjects had members of the order Clostridiales, family Clostridiaceae, genus Coprobacillus which were significantly more prevalent than puberty subjects. Also, the pubertal subjects had members of class Betaproteobacteria, order Burkholderiales which were significantly more prevalent than the non-pubertal subjects. Their relative abundance was independent of BMI-Z. In the pubertal subjects, the abundance of genus Adlercreutzia, Ruminococcus, Dorea, Clostridium and Parabacteroides was associated with the level of testosterone.

Conclusions

This is the first report of the diversity of gut microbiota at different puberty stages. The various species of gut microbiota changed gradually associated with puberty stages. Differences in gut microflora at different pubertal status may be related to androgen levels.
Comprehensive evaluation of physiological traits under nitrogen stress and participation of linolenic acid in nitrogen-deficiency response in wheat seedlings
Authors: Liu Xiaoxiao , Wang Shiwen , Deng Xiping , Zhang Zhiyong , Yin Lina
Published: November 2020

Background

Nitrogen (N) deficiency is a major constraint for plant production in many areas. Developing the new crop genotypes with high productivity under N deficiency is an important approach to maintain agricultural production. Therefore, understanding how plant response to N deficiency and the mechanism of N-deficiency tolerance are very important for sustainable development of modern crop production.

Results

In this study, the physiological responses and fatty acid composition were investigated in 24 wheat cultivars under N-deficient stress. Through Pearson’s correlation analysis and principal component analysis, the responses of 24 wheat cultivars were evaluated. The results showed that the plant growth and carbohydrate metabolism were all differently affected by N deficiency in all tested wheat cultivars. The seedlings that had high shoot biomass also maintained high level of chlorophyll content under N deficiency. Moreover, the changes in fatty acid composition, especially the linolenic acid (18:3) and the double bond index (DBI), showed close positive correlations with the shoot dry weight and chlorophyll content alterations in response to N-deficient condition. These results indicated that beside the chlorophyll content, the linolenic acid content and DBI may also contribute to N-deficiency adaptation, thus could be considered as efficient indicators for evaluation of different response in wheat seedlings under N-deficient condition.

Conclusions

The alteration in fatty acid composition can potentially contribute to N-deficiency tolerance in plants, and the regulation of fatty acid compositions maybe an effective strategy for plants to adapt to N-deficient stress.
Late diagnosis of coarctation of the aorta in a 44-year-old male: a case report
Authors: Luo Weijian , Li Jilin , Huang Xiaojun , Cai Xiangna
Published: November 2020

Background

Coarctation of the aorta is a rare congenital disease. In adults, the main manifestations include hypertension, weak or absent femoral pulses, heart failure, and left ventricular hypertrophy.

Case presentation

We present a case involving a late diagnosis of coarctation of the aorta detected during aortography in a 44-year-old man. The patient underwent stent implantation and aortoplasty. After 2 years of follow-up, the patient was in good condition.

Conclusions

This case shows that coarctation of the aorta can be cured and that hypertension caused by the condition can be controlled to some extent with medication. Based on our findings, we recommend a detailed physical examination for all patients suspected of having coarctation of the aorta; the examination should include blood pressure measurements of both the upper and lower extremities. The case of coarctation of the aorta is not common or easy to be found in medium-aged population. Better BP control, earlier repair, and transcatheter intervention may result in a good outcome in that case.
Blood group A: a risk factor for heart rupture after acute myocardial infarction
Authors: Fu Yuan , Chen Mulei , Sun Hao , Guo Zongsheng , Gao Yuanfeng , Yang Xinchun , Li Kuibao , Wang Lefeng
Published: November 2020

Introduction

Studies have been performed to identify the association between ABO blood groups and coronary artery disease. However, data is scarce about the impact of ABO blood groups on heart rupture (HR) after acute myocardial infarction (AMI).

Methods

We conducted a retrospective case–control study that included 61 consecutive patients with HR after AMI during a period from 1 January 2012 to 1 December 2019. The controls included 600 patients who were selected randomly from 8143 AMI patients without HR in a ratio of 1:10. Univariate and multivariate logistic regression analysis were used to identify the association between ABO blood groups and HR.

Results

Patients with blood group A had a greater risk of HR after AMI than those with non-A blood groups (12.35% vs 7.42%, P < 0.001). After adjusting for age, gender, heart rate at admission, body mass index (BMI), and systolic blood pressure (SBP), blood group A was independently related to the increased risk of HR after AMI (OR = 2.781, 95% CI 1.174–7.198, P = 0.035), and remained as an independent risk factor of HR after AMI in different multivariate regression models.

Conclusion

Blood group A is significantly associated with increased HR risk after AMI.
Features of patient-education websites for patients with chronic kidney disease: an analysis of recommended websites
Authors: Singh Rohanit , Jaar Bernard G. , Kazi Gibran , Appel Lawrence J.
Published: November 2020

Background

Chronic kidney disease (CKD) requires lifelong self-management. With the rise in access to the Internet, many CKD patients and their caregivers increasingly use the internet for information on CKD self-management. A recent environmental scan by Smekal et al. identified 11 CKD-related websites that covered the greatest number of content areas. This paper aims to evaluate these 11 selected websites in order to identify those that most effectively address content areas relevant to patients with CKD.

Methods

Each website was assessed for information to 6 content areas: diet, physical activity, financial information, emotional support, general CKD information, and medication adherence. A three-tiered scoring metric was used in which a 0 was given if a content area was completely unaddressed, a (+) was given for a category that was generally addressed, and a (++) was given for a category that was addressed with actionable guidance.

Results

While CKD information and diet were very comprehensively covered with scores of 11 (++) and 8 (++), respectively; physical activity, emotional support and medication adherence received the fewest (++) scores (3 for physical activity and five for both emotional support and medication adherence). For each content area, recommendations are made for websites that are particularly useful. Common themes for these highlighted websites include specific instructions, multiple modalities of information, downloadable and printable resources, and contact references for personal inquiries.

Conclusion

The recommended websites can help CKD patients and caregivers utilize the most applicable information for their specific self-management needs. Website improvements related to physical activity, emotional support, and financial information for persons with CKD are warranted.
High proportion of anergic B cells in the bone marrow defined phenotypically by CD21(−/low)/CD38- expression predicts poor survival in diffuse large B cell lymphoma
Authors: Rijal Sewa , Kok Johanna , Coombes Caitlin , Smyth Lillian , Hourigan Jayde , Jain Sanjiv , Talaulikar Dipti
Published: November 2020

Background

Diffuse large B cell lymphoma (DLBCL) is the commonest lymphoma that is highly aggressive where one-third of the patients relapse despite effective treatment. Interaction between the lymphoma cells and the non-clonal immune cells within the bone marrow microenvironment is thought to play a critical role in the pathogenesis of DLBCL.

Methods

We used flow cytometry to characterize the proportion of B cell subpopulations in the bone marrow (N = 47) and peripheral blood (N = 54) of 75 DLBCL patients at diagnosis and study their impact on survival.

Results

Anergic B cells in the bone marrow (BM), characterized as having CD21(−/low)/CD38- expression, influenced survival with high numbers (defined as > 13.9%) being associated with significantly shorter overall survival (59.7 months vs 113.6 months, p = 0.0038). Interestingly, low numbers of anergic B cells in the BM (defined as ≤13.9%) was associated with germinal center B cell type of DLBCL (p = 0.0354) that is known to have superior rates of survival when compared to activated B cell type. Finally, Cox regression analysis in our cohort of patients established that the inferior prognosis of having high numbers of anergic B cells in the bone marrow was independent of the established Revised International Prognostic Index (R-IPI) score.

Conclusions

High proportion of anergic B cells in the BM characterized by CD21(−/low)/CD38- expression predicts poor survival outcomes in DLBCL.
The study protocol of the evaluation for the preventive efficacy of the HPV vaccine for persistent HPV16/18 infection in Japanese adult women: the HAKUOH study
Authors: Kurokawa Tetsuji , Yamamoto Makoto , Onuma Toshimichi , Tsuyoshi Hideaki , Shinagawa Akiko , Chino Yoko , Yoshida Yoshio
Published: November 2020

Background

In general, human papillomavirus (HPV) vaccines have demonstrated efficacy in young women worldwide, but there is limited evidence on the efficacy of the quadrivalent HPV6/11/16/18 vaccine in adult women and no evidence of its effectiveness in Japanese adult women in particular. This study aims to evaluate the efficacy of the quadrivalent HPV6/11/16/18 vaccine for persistent HPV16/18 infection in Japanese women aged 27–45 years.

Methods

This is an interventional, nonrandomized, non-double-blind prospective cohort study designed to compare the rates of persistent HPV16/18 infection between the vaccinated arm and unvaccinated arm. The subjects will consist of all women aged 27–45 years who have normal cytology results confirmed by cervical cancer screening from May 2019 to March 2021. The follow-up time is two years. The subjects will be divided into two groups: the vaccinated group and the unvaccinated group. The study will need to enroll 600 vaccinated participants (experimental arm) and 2200 unvaccinated participants (control arm).

Discussion

The findings of this trial (HAKUOH study) might provide the first local evidence on the subject and be significantly useful not only to medical academia but also to the Japanese Ministry of Health, Labour and Welfare. The findings could contribute to public health improvement by providing local supportive knowledge on the prevention of HPV infection through HPV vaccination in young adult women in Japan, where active recommendations have been suspended for a long time due to adverse effects.

Trial registration

Trial registration number: NCT04022148.

Registration began on December 1, 2019.
Anti-tumor efficacy of CKD-516 in combination with radiation in xenograft mouse model of lung squamous cell carcinoma
Authors: Kim Min-Young , Shin Jung-Young , Kim Jeong-Oh , Son Kyoung-Hwa , Kim Yeon Sil , Jung Chan Kwon , Kang Jin-Hyoung
Published: November 2020

Background

Hypoxic tumors are known to be highly resistant to radiotherapy and cause poor prognosis in non-small cell lung cancer (NSCLC) patients. CKD-516, a novel vascular disrupting agent (VDA), mainly affects blood vessels in the central area of the tumor and blocks tubulin polymerization, thereby destroying the aberrant tumor vasculature with a rapid decrease in blood, resulting in rapid tumor cell death. Therefore, we evaluated the anti-tumor efficacy of CKD-516 in combination with irradiation (IR) and examined tumor necrosis, delayed tumor growth, and expression of proteins involved in hypoxia and angiogenesis in this study.

Methods

A xenograft mouse model of lung squamous cell carcinoma was established, and the tumor was exposed to IR 5 days per week. CKD-516 was administered with two treatment schedules (day 1 or days 1 and 5) 1 h after IR. After treatment, tumor tissues were stained with hematoxylin and eosin, and pimonidazole. HIF-1α, Glut-1, VEGF, CD31, and Ki-67 expression levels were evaluated using immunohistochemical staining.

Results

Short-term treatment with IR alone and CKD-516 + IR (d1) significantly reduced tumor volume (p = 0.006 andp = 0.048, respectively). Treatment with CKD-516 + IR (d1 and d1, 5) resulted in a marked reduction in the number of blood vessels (p < 0.005). More specifically, CKD-516 + IR (d1) caused the most extensive tumor necrosis, which resulted in a significantly large hypoxic area (p = 0.02) and decreased HIF-1α, Glut-1, VEGF, and Ki-67 expression. Long-term administration of CKD-516 + IR reduced tumor volume and delayed tumor growth. This combination also greatly reduced the number of blood vessels (p = 0.0006) and significantly enhanced tumor necrosis (p = 0.004). CKD-516 + IR significantly increased HIF-1α expression (p = 0.0047), but significantly reduced VEGF expression (p = 0.0046).

Conclusions

Taken together, our data show that when used in combination, CKD-516 and IR can significantly enhance anti-tumor efficacy compared to monotherapy in lung cancer xenograft mice.
Central retinal artery and vein occlusion as a complication of persistent hyaloid artery – a case report
Authors: Bjeloš Mirjana , Križanović Ana , Bušić Mladen , Kuzmanović Elabjer Biljana
Published: November 2020

Background

In this case report, we present for the first time central retinal artery occlusion (CRAO) and central retinal vein occlusion (CRVO) as a complication of persistent hyaloid artery (PHA).

Case presentation

In August 2019, a six-year-old male patient manifested right eye (RE) excessive tearing, conjunctival injection and pain. On examination, RE demonstrated light perception and intraocular pressure of 36 mmHg. The diagnoses of neovascular glaucoma, CRVO and CRAO were established as affirmed with fluorescein angiography (FA). PHA was not reported. Extensive work-up and family history were unremarkable. The child was born on term after uncomplicated twin pregnancy. In December 2019, he was referred to our Centre. Transillumination revealed fully dilated, non-reactive RE pupil, clear lens and tubular remnant of HA containing blood cells in its lumen freely rotating in the anterior vitreous.

Conclusions

PHA results from failure of apoptosis during gestation. It can easily be observed during the red reflex screening at neonatal wards. We hypothesized that PHA twisting led to torsion of the residual primordial common bulb, branching off to HA and CRA with CRAO occurring first. The consequential CRVO presumably advanced by venous stasis due to decrease in arterial inflow. Liquid vitreous appears as early as 4 years of age enabling PHA to whirl more freely. Thus, in case of PHA, we advocate FA to be performed and if connection with retinal artery is proven, parents should be informed on the possible devastating complications and prompt surgical treatment should be considered.
Optic nerve Hemangioblastoma with bilateral frontal lobe Oedema: a case report
Authors: Xu Shujia , Li Qian , Bian Bingyang , Zhou Hongli , Li Dan
Published: November 2020

Background

Hemangioblastomas are rare benign tumours that are most commonly detected in the subtentorium or spinal cord. Optic nerve hemangioblastoma is very rare and is most commonly associated with Von Hippel-Lindau (VHL) syndrome.

Case presentation

Here, we report a case of hemangioblastoma of the optic nerve with bilateral frontal lobe oedema without VHL syndrome, which has not yet been reported. A 51-year-old woman presented with progressive and painless deteriorating vision in the left eye. Magnetic resonance imaging showed a mass at the back of the left orbital optic nerve. Endoscopic-assisted intraorbital tumour resection was performed successfully. The pathological diagnosis was left optic nerve hemangioblastoma.

Conclusions

This is the first reported case of optic nerve hemangioblastoma (HBL) with bilateral frontal lobe oedema.
Access to care for childhood cancers in India: perspectives of health care providers and the implications for universal health coverage
Authors: Faruqui Neha , Bernays Sarah , Martiniuk Alexandra , Abimbola Seye , Arora Ramandeep , Lowe Jennifer , Denburg Avram , Joshi Rohina
Published: November 2020

Background

There are multiple barriers impeding access to childhood cancer care in the Indian health system. Understanding what the barriers are, how various stakeholders perceive these barriers and what influences their perceptions are essential in improving access to care, thereby contributing towards achieving Universal Health Coverage (UHC). This study aims to explore the challenges for accessing childhood cancer care through health care provider perspectives in India.

Methods

This study was conducted in 7 tertiary cancer hospitals (3 public, 3 private and 1 charitable trust hospital) across Delhi and Hyderabad. We recruited 27 healthcare providers involved in childhood cancer care. Semi-structured interviews were audio recorded after obtaining informed consent. A thematic and inductive approach to content analysis was conducted and organised using NVivo 11 software.

Results

Participants described a constellation of interconnected barriers to accessing care such as insufficient infrastructure and supportive care, patient knowledge and awareness, sociocultural beliefs, and weak referral pathways. However, these barriers were reflected upon differently based on participant perception through three key influences: 1) the type of hospital setting: public hospitals constituted more barriers such as patient navigation issues and inadequate health workforce, whereas charitable trust and private hospitals were better equipped to provide services. 2) the participant’s cadre: the nature of the participant’s role meant a different degree of exposure to the challenges families faced, where for example, social workers provided more in-depth accounts of barriers from their day-to-day interactions with families, compared to oncologists. 3) individual perceptions within cadres: regardless of the hospital setting or cadre, participants expressed individual varied opinions of barriers such as acceptance of delay and recognition of stakeholder accountabilities, where governance was a major issue. These influences alluded to not only tangible and structural barriers but also intangible barriers which are part of service provision and stakeholder relationships.

Conclusion

Although participants acknowledged that accessing childhood cancer care in India is limited by several barriers, perceptions of these barriers varied. Our findings illustrate that health care provider perceptions are shaped by their experiences, interests and standpoints, which are useful towards informing policy for childhood cancers within UHC.
Suicide by self-immolation in southern Iran: an epidemiological study
Authors: Mohammadi Ali Akbar , Karoobi Mohammadreza , Erfani Amirhossein , Shahriarirad Reza , Ranjbar Keivan , Zardosht Mitra , Modarresi Mahboobeh-Sadat , Afrasiabi Zari
Published: November 2020

Background

Self-immolation, as a method of suicide, is one of the most violent and extreme ways which is usually attempted by the ignition of inflammable materials, with more than 70% fatality rate. In the literature, Iran has been reported to have a high rate of self-immolation; therefore, this study aimed to evaluate the prevalence and epidemiological features of self-immolated patients.

Methods

In this retrospective cross-sectional multicenter study, data from burn patients from 2007 till 2017 due to self-immolation and suicide were enrolled in our study.

Results

Based on our data, 657 out of 3530 burn patients (18.6%) with a mean age of 31.15 (SD = 0.452) were documented as suicidal attempts; the majority were female (63.2%) and married (66.3%). Most of the patients were from rural areas (58.3%) with an education level of under diploma (63.2%). Of the patients in our study, 22 (8.7%) had comorbid systemic diseases and 115 (50.5%) had psychiatric disorders.

Conclusion

Due to the high prevalence of suicide by self-immolation among the Iranian population, further studies to evaluate the risk factors and clarify the high-risk group for more targeted approaches are recommended.
Resistance to fracture of intraradicular posts made of biological materials
Authors: Tavano Karine Taís Aguiar , Botelho Adriana Maria , Douglas-de-Oliveira Dhelfeson Willya , Avila Antonio Ferreira , Huebner Rudolf
Published: November 2020

Background

The aim was to analyze the fracture resistance of human teeth treated endodontically and restored with posts made of bovine dentin, human dentin, or glass fiber, and to evaluate the fracture pattern.

Methods

Cylindrical posts of 1.5 mm in diameter cemented to the roots of human maxillary canines presented a length of 15 mm, cervical diameter of 5–5.5 mm in the mesiodistal direction, and 7–7.5 mm in the vestibule-palatal direction. The groups studied were: Group I—10 glass fiber posts; Group II—10 human dentin posts; Group III—10 bovine dentin posts (self-adhesive resin cement); and Group IV—10 bovine dentin posts (resin-modified glass-ionomer cements). The coronal part of tooth was restored with a standardized core build-up using composite. All of the groups were submitted to a compression force test and the resistance to fracture was verified using a universal testing machine. The fracture pattern was likewise evaluated.

Results

The values of resistance to fracture were: 723.3N in group I, 561.5N in group II, 556.6N in group III, and, 613.27N in group IV. However, no statistically significant difference was observed among the groups. The fractures in groups I and II were most commonly found in the middle/apical third and were considered irreparable. For restored teeth in group III, half of the fractures appeared in the cervical third and were reparable. In group IV, all of the fractures were reparable, with the majority in the cervical thirds.

Conclusion

Bovine dentin can be used as intraradicular post to substitute human dentin and glass fiber posts. The greater the malleability of the post, the greater the chances of survival of the teeth when subjected to fracture testing.
Evaluating the feasibility and impact of case rate payment for recovery support navigator services: a mixed methods study
Authors: Torres Maria E. , Brolin Mary , Panas Lee , Ritter Grant , Hodgkin Dominic , Lee Margaret , Merrick Elizabeth , Horgan Constance , Hopwood Jonna C. , Gewirtz Andrea , De Marco Natasha , Lane Nancy
Published: November 2020

Background

Acute 24-h detoxification services (detox) are necessary but insufficient for many individuals working towards long-term recovery from opiate, alcohol or other drug addiction. Longer engagement in substance use disorder (SUD) treatment can lead to better health outcomes and reductions in overall healthcare costs. Connecting individuals with post-detox SUD treatment and supportive services is a vital next step. Toward this end, the Massachusetts Medicaid program reimburses Community Support Program staff (CSPs) to facilitate these connections. CSP support services are typically paid on a units-of-service basis. As part of a larger study testing health care innovations, one large Medicaid insurer developed a new cadre of workers, called Recovery Support Navigators (RSNs). RSNs performed similar tasks to CSPs but received more extensive training and coaching and were paid an experimental case rate (a flat negotiated reimbursement). This sub-study evaluates the feasibility and impact of case rate payments for RSN services as compared to CSP services paid fee-for-service.

Methods

We analyzed claims data and RSN service data for a segment of the Massachusetts Medicaid population who had more than one detox admission in the last year and also engaged in post-discharge CSP or RSN services. Qualitative data from key informant interviews and Learning Collaboratives with CSPs and RSNs supplemented the findings.

Results

Clients receiving RSN services under the case rate utilized the service significantly longer than clients receiving CSP services under unit-based billing. This resulted in a lower average cost per member per month for RSN clients. However, when calculating total SUD treatment costs per member, RSN client costs were 50% higher than CSP client costs. Provider organizations employing RSNs successfully implemented case rate billing. Benefits included allowing time for outreach efforts and training and coaching, activities not paid under the unit-based system. Yet, RSNs identified staffing and larger systems level challenges to consider when using a case rate payment model.

Conclusions

Addiction is a chronic disease that requires long-term investments. Case rate billing offers a promising option for payers and providers as it promotes continued engagement with service providers. To fully realize the benefits of case rate billing, however, larger systems level changes are needed.
Considering the APOE locus in Alzheimer’s disease polygenic scores in the Health and Retirement Study: a longitudinal panel study
Authors: Ware Erin B. , Faul Jessica D. , Mitchell Colter M. , Bakulski Kelly M.
Published: November 2020

Background

Polygenic scores are a strategy to aggregate the small, additive effects of single nucleotide polymorphisms across the genome. With phenotypes like Alzheimer’s disease, which have a strong and well-established genomic locus (APOE), the cumulative effect of genetic variants outside of this area has not been well established in a population-representative sample.

Methods

Here we examine the association between polygenic scores for Alzheimer’s disease both with and without the APOE region (chr19: 45,384,477 to 45,432,606, build 37/hg 19) at different P value thresholds and dementia. We also investigate the addition of APOE-ε4 carrier status and its effect on the polygenic score—dementia association in the Health and Retirement Study using generalized linear models accounting for repeated measures by individual and use a binomial distribution, logit link, and unstructured correlation structure.

Results

In a large sample of European ancestry participants of the Health and Retirement Study (n = 9872) with an average of 5.2 (standard deviation 1.8) visit spaced two years apart, we found that including the APOE region through weighted variants in a polygenic score was insufficient to capture the large amount of risk attributed to this region. We also found that a polygenic score with a P value threshold of 0.01 had the strongest association with the odds of dementia in this sample (odds ratio = 1.10 95%CI 1.0 to 1.2).

Conclusion

We recommend removing the APOE region from polygenic score calculation and treating the APOE locus as an independent covariate when modeling dementia. We also recommend using a moderately conservative P value threshold (e.g. 0.01) when creating polygenic scores for Alzheimer’s disease on dementia. These recommendations may help elucidate relationships between polygenic scores and regions of strong significance for phenotypes similar to Alzheimer’s disease.
RETRACTED ARTICLE: Prevalence and predictors of timely initiation of breastfeeding in Ghana: an analysis of 2017–2018 multiple indicator cluster survey
Authors: Apanga Paschal Awingura , Kumbeni Maxwell Tii
Published: November 2020

Background

Timely initiation of breastfeeding is putting the newborn to the breast within 1 h of birth. Its practice can prevent neonatal and under-5 mortality. This study aims to assess the prevalence and factors associated with timely initiation of breastfeeding among mothers in Ghana.

Methods

We used data from the 2017–2018 Ghana multiple indicator cluster survey and our analysis was restricted to 15,305 mothers who had a live birth within 2 years. Multivariable logistic regression was used to estimate the factors associated with timely initiation of breastfeeding whilst adjusting for potential confounders, and accounted for clustering, stratification, and sample weights.

Results

The prevalence of timely initiation of breastfeeding was 51.3% (95% CI 48.1, 54.6%). Mothers who received antenatal care were twice as likely to timely initiate breastfeeding compared to mothers who did not receive antenatal care (Adjusted prevalence odds ratios [aPOR] 2.01, 95% CI 1.03, 3.95). Mothers who were assisted by a skilled attendant at birth had 90% higher odds of timely initiation of breastfeeding compared to mothers who were not assisted by a skilled attendant (aPOR 1.90, 95% CI 1.41, 2.55). Mothers who delivered by caesarean section had 76% lower odds of timely initiation of breastfeeding compared to mothers who had a vaginal delivery (aPOR 0.24, 95, 95% CI 0.16, 0.36). Mothers who had planned their pregnancy had 45% higher odds of timely initiation of breastfeeding compared to mothers who had an unplanned pregnancy (aPOR 1.45, 95% CI 1.09, 1.92). There were also 84% and 55% higher odds of timely initiation of breastfeeding among mothers who perceived their baby was large (aPOR 1.84, 95% CI 1.32, 2.58), and of average size (aPOR 1.55, 95% CI 1.11, 2.17) at birth respectively, compared to mothers who perceived their baby was small.

Conclusions

Interventions to increase timely initiation of breastfeeding should provide breastfeeding support to mothers who have had a caesarean section or small sized babies, prevent unplanned pregnancies, and promote antenatal care attendance among pregnant women.
Efficacy of proprioceptive training on the recovery of total joint arthroplasty patients: a meta-analysis
Authors: Zhang Wen-chao , Xiao Deng
Published: November 2020

Background

Optimal balance control is of paramount importance for function recovery after total joint arthroplasty (TJA). The study objective of this meta-analysis was to assess the short- and mid-term effects of proprioceptive and balance training for patients undergoing TJA.

Methods

Electronic searches were conducted from PubMed, Cochrane library, and Embase databases to identify eligible RCTs through May 2020. Standard mean difference (SMD) with 95% confidence interval (95%CI) was applied to calculate pooled effect estimates between proprioceptive and balance training and control group. Main outcomes were self-reported functionality, balance, pain, quality of life, and function (range of motion).

Results

Seven randomized controlled trials were finally included in this meta-analysis. Pooled results found that balance and proprioceptive trainings have a positive role in improving self-reported functionality at short-term after TJA. Moreover, balance and proprioceptive trainings were associated with an increase of the balance at short- and mid-term after TJA. These results were further confirmed by subgroup analysis between preoperative and postoperative administration of balance and proprioceptive trainings.

Conclusion

Our meta-analysis suggests that balance and proprioceptive trainings after TJA improved self-reported functionality and balance. These improvements were maintained at mid-terms. More research is needed to confirm balance and proprioceptive trainings for pain and quality of life for TJA.
Non-invasive detection of endometrial cancer by DNA methylation analysis in urine
Authors: van den Helder Rianne , Wever Birgit M. M. , van Trommel Nienke E. , van Splunter Annina P. , Mom Constantijne H. , Kasius Jenneke C. , Bleeker Maaike C. G. , Steenbergen Renske D. M.
Published: November 2020

Background

The incidence of endometrial cancer is rising, and current diagnostics often require invasive biopsy procedures. Urine may offer an alternative sample type, which is easily accessible and allows repetitive self-sampling at home. Here, we set out to investigate the feasibility of endometrial cancer detection in urine using DNA methylation analysis.

Results

Urine samples of endometrial cancer patients (n = 42) and healthy controls (n = 46) were separated into three fractions (full void urine, urine sediment, and urine supernatant) and tested for three DNA methylation markers (GHSR,SST,ZIC1). Strong to very strong correlations (r = 0.77–0.92) were found amongst the different urine fractions. All DNA methylation markers showed increased methylation levels in patients as compared to controls, in all urine fractions. The highest diagnostic potential for endometrial cancer detection in urine was found in full void urine, with area under the receiver operating characteristic curve values ranging from 0.86 to 0.95.

Conclusions

This feasibility study demonstrates, for the first time, that DNA methylation analysis in urine could provide a non-invasive alternative for the detection of endometrial cancer. Further investigation is warranted to validate its clinical usefulness. Potential applications of this diagnostic approach include the screening of asymptomatic women, triaging women with postmenopausal bleeding symptoms, and monitoring women with increased endometrial cancer risk.
Acute generalized exanthematous pustulosis and Stevens-Johnson syndrome overlap due to hydroxychloroquine: a case report
Authors: Coleman Ivorie , Ruiz Gabriel , Brahmbhatt Sumir , Ackerman Lindsay
Published: November 2020

Background

Since the World Health Organization declared a global pandemic due to the novel coronavirus disease2019, there have been targeted efforts to establish management modalities. Hydroxychloroquine has been suggested as a possible treatment; however, it is associated with multiple adverse reactions. We report a rare case of a patient with acute generalized exanthematous pustulosis with Stevens-Johnson syndrome due to hydroxychloroquine. Acute generalized exanthematous pustulosis is characterized by acute onset of a generalized rash that is pustular and erosive in nature, affecting limbs; trunk; face; and, less often, mucosal membranes. Although rare, it is important to be mindful of this side effect because the diagnosis is often delayed, and the disease has the potential to be life-threatening.

Case presentation

A 68-year-old American woman presented to our hospital with a painful, rapidly spreading rash. Its morphologic features included erythema multiforme–like lesions with extensive skin sloughing in various regions of the head, neck, and trunk and mucosal involvement. Her Nikolsky sign was negative, and she had no evidence of lesions on areas of skin trauma. Four weeks prior, she had been initiated on hydroxychloroquine for a presumed diagnosis of cutaneous sarcoidosis. Three punch biopsies of the head and neck area revealed subcorneal pustules consistent with acute generalized exanthematous pustulosis. Treatment began with high doses of methylprednisolone, leading to only minimal improvement of existing areas and ongoing spread to new areas. Treatment with intravenous immunoglobulin was initiated, at which point disease stability was achieved. The patient’s rash ultimately resolved, as did her cutaneous pain and pruritus.

Conclusions

Among many potential adverse reactions involving hydroxychloroquine, cutaneous side effects are varied and can lead to significant morbidity or even death. The drug is currently being investigated in a multitude of trials for coronavirus disease2019 treatment, prevention, and prophylaxis after exposure to severe acute respiratory syndrome coronavirus 2. Acute generalized exanthematous pustulosis is a rare side effect of hydroxychloroquine, and even fewer cases demonstrate histologic evidence of acute generalized exanthematous pustulosis while clinically presenting with Stevens-Johnson syndrome. Patients who develop Stevens-Johnson syndrome/toxic epidermal necrolysis require best supportive care with aggressive fluid and electrolyte replacement and prevention of further breakdown of the skin barrier. With the potential of widespread hydroxychloroquine use, it is important that providers be aware of its potential severe adverse drug reactions.
Castleman disease and SLE in a G6PD-deficient Marfan patient: a case report and literature review
Authors: Alhoulaiby Sami , Okar Lina , Samaan Haya , Qalaani Hisham
Published: November 2020

Introduction

Marfan syndrome, G6PD deficiency, systemic lupus erythematosus (SLE), and Castleman disease are four distinctive, thoroughly investigated entities whose coincidence was never reported. However, occurrence in pairs was sporadically mentioned in literature.

Case presentation

We report a 15-year-old Caucasian G6PD deficient Marfan male patient, who presented with tonic–clonic seizures, fever, a hemolytic episode, and general symptoms. After the discovery of hepatosplenomegaly, malar rash, and painless lymphadenopathy, further testing diagnosed a multifocal Castleman disease of the hyaline vascular subtype and systemic lupus erythematosus with lupus nephritis that got 35 points on the 2019 EULAR/ACR criteria. G6PD deficiency, SLE & Castleman disease, and seizures were handled medically with eventual improvement in the patient’s condition.

Discussion and conclusion

It is extremely rare to discover the gathering of these four diseases in the same patient. Marfan syndrome and G6PD deficiency were proven by respective clinical and laboratory examinations. Castleman disease that tends to occur in older age groups was confirmed via pathological study of a lymph node biopsy, which was compatible with the HHV-8 negative type reported in Asian countries. SLE is part of the differential diagnosis for Castleman disease, yet the newest evidence strongly supports its presence as a distinct entity. However, no concrete proof is available to suggest a causative relationship between the four of them, rather than a coincidental occurrence.
Fully nonlinear stochastic and rough PDEs: Classical and viscosity solutions
Authors: Buckdahn Rainer , Keller Christian , Ma Jin , Zhang Jianfeng
Published: November 2020

We study fully nonlinear second-order (forward) stochastic PDEs. They can also be viewed as forward path-dependent PDEs and will be treated as rough PDEs under a unified framework. For the most general fully nonlinear case, we develop a local theory of classical solutions and then define viscosity solutions through smooth test functions. Our notion of viscosity solutions is equivalent to the alternative using semi-jets. Next, we prove basic properties such as consistency, stability, and a partial comparison principle in the general setting. If the diffusion coefficient is semilinear (i.e, linear in the gradient of the solution and nonlinear in the solution; the drift can still be fully nonlinear), we establish a complete theory, including global existence and a comparison principle.
Improved model predictive load frequency control of interconnected power system with synchronized automatic generation control loops
Authors: Kunya Abdullahi Bala , Argin Mehmet , Jibril Yusuf , Shaaban Yusuf Abubakar
Published: November 2020

Background

Automatic generation control (AGC) of multi-area interconnected power system (IPS) is often designed with negligible cross-coupling between the load frequency control (LFC) and automatic voltage regulation (AVR) loops. This is because the AVR loop is considerably faster than that of LFC. However, with the introduction of slow optimal control action on the AVR, positive damping effect can be achieved on the LFC loop thereby improving the frequency control. In this paper, LFC synchronized with AVR in three-area IPS is proposed. Model predictive controller (MPC) configured in a dense distributed pattern, due to its online set-point tacking is used as the supplementary controller. The dynamics of the IPS subjected to multi-area step and random load disturbances are studied. The efficacy of the developed scheme is ascertained by simulating the disturbed system in MATLAB/Simulink.

Results

Based on the comparative analysis on the system responses, it is established that by cross-coupling the LFC loop with AVR, reductions of 66.45% and 59.09% in the frequency and tie-line power maximum deviations respectively are observed, while the respective settling times are found to be reduced by 29.68% and 22.77% when compared with the uncoordinated control scheme. In addition, the standard deviation and variance of the integral time absolute error of the system’s responses have reduced by 23.21% and 20.83% respectively compared to those obtained in a similar study.

Conclusions

The reduction in the maximum deviations and settling times in the system states indicates that introducing the voltage control via AVR loop has improved the frequency control significantly. While the lower standard deviation and variance of the integral time absolute error signify improvement in the robustness of the developed algorithm. However, this improvement is at the detriment of the controller size and computational complexity. In the uncoordinated control scheme, the control vector is one-dimensional, while in the coordinated scheme, the control vector is two-dimensional for each CA.
A novel biomarker of chronic allograft dysfunction in renal transplant recipients (serum calreticulin and CD47)
Authors: Gawish Rasha Ibrahim Abdel Razek , El Aggan Hayam Abdel Meguid , Mahmoud Sabah Abdel Hady , Mortada Sara Ahmed Mohamed
Published: November 2020

Background

Chronic allograft dysfunction (CAD) is considered the leading cause of late allograft loss. The cluster of differentiation 47 (CD47) and calreticulin (CRT) are involved in many and diverse cellular processes. The present study was designed to study the role of the pro-phagocytic CRT and anti-phagocytic CD47 signals in patients with renal transplantation in relation to graft function.

Thirty renal transplantation recipients (RTR) for more than 6 months [15 with stable renal function and 15 with chronic allograft dysfunction (CAD)] and 15 healthy controls were enrolled in the study. Quantification of CRT, CD47, and high-sensitivity C-reactive protein (hsCRP) levels in serum was done using standardized enzyme-linked immunosorbent assay (ELISA) kits. Measurement of renal function and urinary alkaline phosphatase (U.ALP) was done. Renal interstitial fibrosis (IF) was graded in renal biopsies of CAD.

Results

Serum CRT and urinary ALP levels were statistically significant higher (P < 0.001) while serum CD47 level was statistically significant lower (P < 0.001) in patients with CAD than patients with stable graft function and controls. There was statistically insignificant difference between controls and patients with stable graft function. Serum CRT and serum CD47 levels were positively correlated with each other and with worsening renal and tubular function, serum hsCRP in RTR and with degree of renal IF in patients with CAD (P < 0.05).

Conclusions

The activation and dysregulation of CRT and CD47 could play a role in the development of CAD and could be a potential biomarker for renal allograft dysfunction.
Deriving symptom networks from digital phenotyping data in serious mental illness
Authors: Hays Ryan , Keshavan Matcheri , Wisniewski Hannah , Torous John
Published: November 2020

Background

Symptoms of serious mental illness are multidimensional and often interact in complex ways. Generative models offer value in elucidating the underlying relationships that characterise these networks of symptoms.

Aims

In this paper we use generative models to find unique interactions of schizophrenia symptoms as experienced on a moment-by-moment basis.

Method

Self-reported mood, anxiety and psychosis symptoms, self-reported measurements of sleep quality and social function, cognitive assessment, and smartphone touch screen data from two assessments modelled after the Trail Making A and B tests were collected with a digital phenotyping app for 47 patients in active treatment for schizophrenia over a 90-day period. Patients were retrospectively divided up into various non-exclusive subgroups based on measurements of depression, anxiety, sleep duration, cognition and psychosis symptoms taken in the clinic. Associated transition probabilities for the patient cohort and for the clinical subgroups were calculated using state transitions between adjacent 3-day timesteps of pairwise survey domains.

Results

The three highest probabilities for associated transitions across all patients were anxiety-inducing mood (0.357, P < 0.001), psychosis-inducing mood (0.276, P < 0.001), and anxiety-inducing poor sleep (0.268, P < 0.001). These transition probabilities were compared against a validation set of 17 patients from a pilot study, and no significant differences were found. Unique symptom networks were found for clinical subgroups.

Conclusions

Using a generative model using digital phenotyping data, we show that certain symptoms of schizophrenia may play a role in elevating other schizophrenia symptoms in future timesteps. Symptom networks show that it is feasible to create clinically interpretable models that reflect the unique symptom interactions of psychosis-spectrum illness. These results offer a framework for researchers capturing temporal dynamics, for clinicians seeking to move towards preventative care, and for patients to better understand their lived experience.