bluuebunny/crossref_metadata_2025 huggingface dataset:
Metabolic and Bariatric Surgery in Adolescents: For Whom, When, and How?
Authors: Janson Annika , Järvholm Kajsa , Sjögren Lovisa , Dahlgren Jovanna , Beamish Andrew J. , Gronowitz Eva , Olbers Torsten
Published: March 2022

Severe obesity in adolescence profoundly impacts health and social well-being. Lifestyle modifications are seldom successful in maintaining sufficient weight loss to mitigate the risk of complications. Metabolic and bariatric surgery (MBS) is a standard treatment for adult patients and has emerged as an option for adolescent patients. Several high-quality studies of adolescent MBS show substantial and sustained improvements both in weight and cardiometabolic parameters, as well as a safety profile similar to that seen in adult patients. Patients report improvements in health- and weight-related quality of life. Concerns around adolescent MBS can be attributed to a fear of side effects on growth and puberty, risk of nutritional deficiencies and osteoporosis, alcohol abuse, psychosocial vulnerability, and the ability to consent in the decision process. Guidelines give somewhat different recommendations, but the most comprehensive guidelines from the American Society for Metabolic and Bariatric Surgery recommend MBS for class III obesity or class II obesity with comorbidity. This mini-review aimed to pre­sent published data on MBS in adolescents. We discuss indications for MBS and the optimal timing in the young person’s life, the choice of surgical method, and MBS in relation to the new anti-obesity medications. Based on data primarily from the USA and Sweden, we conclude that MBS is a valuable treatment option for adolescents with severe obesity that appears underutilized against the backdrop of the poor prognosis of severe obesity. We argue for continued research, development of guidelines, multi-professional teamwork, long-term follow-up, and centralization of adolescent MBS.
Do espaço cibernético à Guerra do Canaimés: imagens que ganham vida e a arte como armadilha
Authors: Bergamaschi Alessandra
Published: March 2022

O artigo introduz algumas reflexões sobre os efeitos das interações cotidianas no ambiente cibernético, intensificadas durante a pandemia. Um deles é que a mediação constante da tecnologia na geração e arquivo de nossas memórias esteja diluindo as demarcações fixas entre seres humanos e máquinas. Propomos então um percurso especulativo através de teorias recentes, no campo da estética e da antropologia, que procuram dar conta dessas hibridizações, repensando radicalmente os dualismos centrais para o nosso pensamento (natureza e cultura, humano e não humano, masculino e feminino, o eu e o outro). Ao longo do artigo, serão abordados objetos díspares, como as perspectivas parciais da filósofa Donna Haraway e as armadilhas poéticas de Jaider Esbell, artista, ativista e escritor.
Blood Pressure Management After Intracerebral and Subarachnoid Hemorrhage: The Knowns and Known Unknowns
Authors: Minhas Jatinder S. , Moullaali Tom J. , Rinkel Gabriel J.E. , Anderson Craig S.
Published: March 2022

Blood pressure (BP) elevations often complicate the management of intracerebral hemorrhage and aneurysmal subarachnoid hemorrhage, the most serious forms of acute stroke. Despite consensus on potential benefits of BP lowering in the acute phase of intracerebral hemorrhage, controversies persist over the timing, mechanisms, and approaches to treatment. BP control is even more complex for subarachnoid hemorrhage, where there are rationales for both BP lowering and elevation in reducing the risks of rebleeding and delayed cerebral ischemia, respectively. Efforts to disentangle the evidence has involved detailed exploration of individual patient data from clinical trials through meta-analysis to determine strength and direction of BP change in relation to key outcomes in intracerebral hemorrhage, and which likely also apply to subarachnoid hemorrhage. A wealth of hemodynamic data provides insights into pathophysiological interrelationships of BP and cerebral blood flow. This focused update provides an overview of current evidence, knowledge gaps, and emerging concepts on systemic hemodynamics, cerebral autoregulation and perfusion, to facilitate clinical practice recommendations and future research.
Spain’s Loss of Human Capital after the Civil War: Spanish Refugees in Mexico
Authors: Sánchez-Alonso Blanca , Santiago-Caballero Carlos
Published: March 2022

Among the important consequences of non-voluntary migration due to forced exile is the loss of human capital in the country of origin. Quantitative measurement of the human capital represented by the Spanish refugees who migrated to Mexico after the Spanish Civil War is largely missing from the economic-history literature. The use of multivariate regression models, focusing on occupation, height, and foreign-language facility as proxies of human capital, finds that the Spanish Republican refugees to Mexico presented a premium of human capital exceeding that of traditional economic migrants from Spain to Mexico, who were already considered “privileged.” The data sources also allow the analysis to isolate the human capital of the exiled women, thereby overcoming the traditional invisibility of women in recorded economic history.
Race Unity, World Peace, and the Perfectability of Humankind
Authors: Rotberg Robert I.
Published: March 2022

Utopianism, wild optimism, and a spreading conviction that the many ills of the world could be remedied with just the right formulas punctuated the final decades of the Victorian era. Given the absence of outright global conflicts and pandemics, the seeming triumph of industrialism, the conquest and occupation by Europe of remote areas of the globe, and a communications revolution that knit distant regions more easily to mother countries, leading figures of the period thought that they could confidently succeed in making the planet a much better and much more humanly rewarding enterprise.
Common Public Life Values: A Roadmap to Inclusivity and Understanding – the Case of Lebanon
Authors: Daou Ana Maria
Published: March 2022

In the recent past, many religious and secular organisations worked on developing declarations that called for the celebration of all forms of diversity, the protection of Freedom of Religion or Belief, the inclusion of marginalised groups in decision-making, and the promotion of active citizenship. However, the rise of populist movements worldwide increased the propagation of hate speech and violent narratives. This article explores how common public life values in Christianity and Islam could contribute to the development of peaceful and inclusive societies and studies the added layer this provides to practical interfaith dialogue. The article draws on real-life examples from the Lebanese context – especially from the experiences of members of the Forum for Religious Social Responsibility at Adyan Foundation.
‘Clinical Christianity’ as Philanthropy
Authors: Palanki Satheesh
Published: March 2022

This study looks into the role of Protestant Missionary groups in disseminating western medicine and medical practices in Travancore during the colonial period. The institutionalisation of Western Medicine in Travancore was filliped and completed by the process of a triangular patronage. It was not only due to the state’s patronage (both the British and the Princely rulers) that Western medicine was institutionalised in Travancore but also due to the keenness shown by the missionaries to dispense it, particularly among the lower classes. Hence, this study also examines how the missionaries functioned as promoters of western medicine to popularise Christianity in Travancore during the colonial period. As in the case of education, missionaries viewed western medicine as a tool for evangelisation through charity. Missionaries developed Medical Philanthropy to elevate the lower sections of the society in Travancore.
Assessment of SCoT and ISSR molecular markers in genetic diversity of rigid ryegrass (Lolium rigidum Gaud.) in Iran
Authors: KESHAVARZI MARYAM , TABARIPOUR RAHELEH , ULLAH FAZAL
Published: March 2022

Lolium rigidum (Poaceae) is important forage and weed species grown in different habitats of Iran. Rigid ryegrass originated from the Mediterranean region. They are very resistant to common herbicides. To investigate the genetic variability of L. rigidum, we studied 81 individuals of 18 natural populations from Iran; four ISSR and four SCoT primers were used. These are reproducible and highly polymorphic markers. We examined their gene flow and genetic variation. Genetic diversity among and within populations was determined through different methods. The Mantel test indicated a significant correlation between these populations’ genetic distance and geographical distance and a high correlation between ISSR and SCoT markers. Analyses of molecular variance (AMOVA) produced high genetic differences among the studied populations for both markers. Structure analysis showed population genetic stratification and identified three genetic groups through ISSR molecular markers for L. rigidum in Iran and indicated restricted gene flow. The current investigation revealed the productivity of ISSR and SCoT molecular markers in evaluating genetic variation and grouping of wild populations of L. rigidum and provides detailed data concerning the genetic structure of its populations. The present finding provided useful information for further conservation, selection, and breeding plans.
One new species of Achnanthidium Kützing (Bacillariophyta, Achnanthidiaceae) from Tibet, China
Authors: GE DANYANG , ZHANG SIMENG , LIU HONGYAN , LIU YAN , KOCIOLEK PATRICK JOHN , ZHU HUAN , LIU GUOXIANG , FAN YAWEN
Published: March 2022

Tibet is a very important biodiversity hot spot in China and the diatom flora of this region has drawn a lot of attention. Diatom samples were collected from several places across Tibet. During research on the biodiversity of diatoms from Tibet, one Achnanthidium species showed unique features compared with other known taxa. It has linear-lanceolate valves with rounded apices, tear-drop shaped proximal raphe ends and ?-shaped distal raphe ends. The most distinctive character of this species, however, is the shape of areolae; since this species has nearly round external areolar openings on the valve face but more typical slit-like areolae present on the mantle. Here we describe it as new to science as Achnanthidium tibeticum Y. Liu & Kociolek. We compare this new species with other, similar taxa within the genus.
The RIG-I–NRF2 axis regulates the mesenchymal stromal niche for bone marrow transplantation
Authors: Lou Qi , Jiang Kaizheng , Xu Quanhui , Yuan Lisha , Xie Siyu , Pan Yuan , Chen Jian , Wu Jun , Zhu Jiang , Jiang Linjia , Zhao Meng
Published: March 2022

Bone marrow–derived mesenchymal stem cells (BMSCs) support bone formation and constitute the stromal niche in regulating hematopoietic stem cells (HSCs). Stromal niche dysfunction affects HSC engraftment during transplantation; however, the underlying mechanisms remain elusive. In the present study, we found that all-trans retinoic acid (ATRA) and inflammation stress upregulated retinoic acid–inducible gene I (RIG-I) in BMSCs. Excess RIG-I expression damaged the clonogenicity, bone-forming ability of BMSCs and particularly their stromal niche function that supports HSC expansion in vitro and engraftment in vivo. Mechanistically, RIG-I elevation promoted the degradation of NRF2, a checkpoint for antioxidant cellular response, by altering the RIG-I-Trim25-Keap1-NRF2 complex, leading to reactive oxygen species (ROS) accumulation and BMSC damage. Genetic inhibition of RIG-I sustained NRF2 protein levels and reduced ROS levels in ATRA-treated BMSCs, thus preserving their clonogenicity, bone-forming ability, and stromal niche function in supporting HSC engraftment in mice. More importantly, RIG-I inhibition recovered the ATRA-treated stromal niche function to enhance HSC engraftment and emergency myelopoiesis for innate immunity against the bacterium Listeria monocytogenes during transplantation. Overall, we identified a noncanonical role of RIG-I in the regulation of the stromal niche for HSC transplantation.
A new role for the SRC family kinase HCK as a driver of SYK activation in MYD88 mutated lymphomas
Authors: Munshi Manit , Liu Xia , Kofides Amanda , Tsakmaklis Nickolas , Guerrera Maria Luisa , Hunter Zachary R. , Palomba M. Lia , Argyropoulos Kimon V. , Patterson Christopher J. , Canning Alexa G. , Meid Kirsten , Gustine Joshua , Branagan Andrew R. , Flynn Catherine A. , Sarosiek Shayna , Castillo Jorge J. , Wang Jinhua , Buhrlage Sara J. , Gray Nathanael S. , Munshi Nikhil C. , Anderson Kenneth C. , Treon Steven P. , Yang Guang
Published: March 2022

The SRC family kinase (SFK) HCK is transcriptionally upregulated and activated by mutated MYD88 (MYD88Mut), a key adaptor for Toll-receptor signaling. HCK activates BTK, AKT, and ERK in MYD88Mut lymphomas. SYK, a B-cell receptor (BCR) component, is activated in MYD88Mut lymphoma cells. Although the SFK LYN serves as a trigger for SYK activation in MYD88Mut ABC DLBCL cells, LYN activity is muted in MYD88Mut Waldenstrom macroglobulinemia (WM) cells. We therefore investigated a role for HCK in mediating SYK activation. Overexpression of wild-type (WT) (HCKWT) or gatekeeper mutated (HCKThr333Met) HCK in MYD88Mut lymphoma cells triggered SYK activation. Conversely, HCK knockdown reduced p-SYK in MYD88Mut lymphoma cells. Coimmunoprecipitation experiments showed that HCK was complexed with p-SYK in MYD88Mut BCWM.1 and TMD8 cells, but not in MYD88 WT Ramos cells. Rescue experiments in MYD88Mut lymphoma cells expressing HCKThr333Met led to persistent HCK and SYK activation and resistance to the HCK inhibitor A419259. Treatment of primary MYD88Mut WM cells with A419259 reduced p-HCK and p-SYK expression. Taken together, our findings show that SYK is activated by HCK in MYD88Mut B-cell lymphomas cells, broaden the prosurvival signaling generated by aberrant HCK expression in response to MYD88Mut, and help define HCK as an important therapeutic target in MYD88Mut B-cell lymphomas.
ROR2 increases the chemoresistance of melanoma by regulating p53 and Bcl2-family proteins via ERK hyperactivation
Authors: Castro María Victoria , Barbero Gastón Alexis , Máscolo Paula , Ramos Rocío , Quezada María Josefina , Lopez-Bergami Pablo
Published: March 2022

Background

ROR2 is a tyrosine-kinase receptor whose expression is dysregulated in many human diseases. In cancer, ROR2 stimulates proliferation, survival, migration, and metastasis, and is associated with more aggressive tumor stages. The purpose of this work is to study the role of ROR2 in the chemoresistance of melanoma.

Methods

Gain- and loss-of-function experiments were used to study the biological function of ROR2 in melanoma. Cell death induced by chemotherapeutic drugs and BH-3 mimetics was evaluated using crystal violet cytotoxicity assays and annexin V/propidium iodide staining. Western blots were used to evaluate the expression of proteins implicated in cell death. The differences observed between cells with manipulation of ROR2 levels and control cells were evaluated using both Student’s t-test and ANOVA.

Results

We describe that ROR2 contributes to tumor progression by enhancing the resistance of melanoma cells to both chemotherapeutic drugs and BH-3 mimetics. We demonstrate that ROR2 reduced cell death upon treatment with cisplatin, dacarbazine, lomustine, camptothecin, paclitaxel, ABT-737, TW-37, and venetoclax. This effect was mediated by the inhibition of apoptosis. In addition, we investigated the molecular mechanisms implicated in this role of ROR2. We identified the MDM2/p53 pathway as a novel target of ROR2 since ROR2 positively regulates MDM2 levels, thus leading to p53 downregulation. We also showed that ROR2 also upregulates Mcl-1 and Bcl2-xL while it negatively regulates Bax and Bid expression. The effect of ROR2 on the expression of these proteins is mediated by the hyperactivation of ERK.

Conclusions

These results demonstrate that ROR2 contributes to melanoma progression by inhibiting apoptosis and increasing chemoresistance. These results not only position ROR2 as a marker of chemoresistance but also support its use as a novel therapeutic target in cancer.
A Facile Preparation of Multicolor Carbon Dots
Authors: Yu Risheng , Liang Sen , Ru Yi , Li Lu , Wang Zhikun , Chen Junlang , Chen Liang
Published: March 2022

Carbon dots (CDs) have raised broad interest because of their great potential in the fluorescence related fields, such as photocatalysis and bioimaging. CDs exhibit different optical properties when dissolved in various solvents. However, the effects of solvents during the process of preparation on the fluorescence emission of CDs are still unclear. In this work, CDs were prepared by a simple one-pot solvothermal route. Typical critic acid and thiourea were used as precursors. Through changing the volume ratio of water to N,N-dimethylformamide (DMF), we have obtained color tunable CDs, with the emission wavelength from 450 to 640 nm. TEM images, Raman and XPS spectra indicate that the particle size of CDs and the content of surface functional groups (C–N/C–S and C≡N bonds) increase with the increasing ratio of DMF to water, which results in the optimal emission wavelength red-shifted. The prepared multicolor CDs may have prospects in the lighting applications.

Graphical abstract
Co-expression network analyses of anthocyanin biosynthesis genes in Ruellia (Wild Petunias; Acanthaceae)
Authors: Zhuang Yongbin , Manzitto-Tripp Erin A.
Published: March 2022

Background

Anthocyanins are major pigments contributing to flower coloration and as such knowledge of molecular architecture underlying the anthocyanin biosynthetic pathway (ABP) is key to understanding flower color diversification. To identify ABP structural genes and associated regulatory networks, we sequenced 16 transcriptomes generated from 10 species of Ruellia and then conducted co-expression analyses among resulting data.

Results

Complete coding sequences for 12 candidate structural loci representing eight genes plus nine candidate regulatory loci were assembled. Analysis of non-synonymous/synonymous (dn/ds) mutation rates indicated all identified loci are under purifying selection, suggesting overall selection to prevent the accumulation of deleterious mutations. Additionally, upstream enzymes have lower rates of molecular evolution compared to downstream enzymes. However, site-specific tests of selection yielded evidence for positive selection at several sites, including four in F3'H2 and five in DFR3, and these sites are located in protein binding regions. A species-level phylogenetic tree constructed using a newly implemented hybrid transcriptome–RADseq approach implicates several flower color transitions among the 10 species. We found evidence of both regulatory and structural mutations to F3′5'H in helping to explain the evolution of red flowers from purple-flowered ancestors.

Conclusions

Sequence comparisons and co-expression analyses of ABP loci revealed that mutations in regulatory loci are likely to play a greater role in flower color transitions in Ruellia compared to mutations in underlying structural genes.
A DasA family sugar binding protein Ste2 links nutrient and oxidative stress to exopolysaccharides production in Streptomyces sp. 139
Authors: Geng Mengxin , Ai Limei , Ma Ming , Li Panpan , Guo Lianhong , Shan Guangzhi , Bai Liping
Published: March 2022

Background

Ebosin is an exopolysaccharide produced by Streptomyces sp. 139, and its biosynthetic gene cluster (ste) has been previously described. Ste234 has high homology to the well-known ATP-binding cassette transport system DasABC, which has been linked to the regulation of morphological differentiation, antibiotics biosynthesis and aminosugars utilization in Streptomycetes. This study was conducted to evaluate the effect of the DasA family sugar binding protein Ste2 on Streptomyces sp. 139.

Results

The disruption of ste2 results in the upregulation of transcription of genes within Ebosin biosynthetic gene cluster and a two-fold increase in Ebosin production. RNA sequencing data suggests that the disruption of ste2 results in the decreased utilization of carbon and nitrogen sources, increased sensitivity to oxidative stress, as well as differed strain morphology, all of which have been experimentally proven.

Conclusions

Taken together, Ste2 controls Ebosin yields, aminosugars uptake, sensitivity to oxidative stress, and morphological differentiation of Streptomyces sp. 139.
Breaking the limits - multichromosomal structure of an early eudicot Pulsatilla patens mitogenome reveals extensive RNA-editing, longest repeats and chloroplast derived regions among sequenced land plant mitogenomes
Authors: Szandar Kamil , Krawczyk Katarzyna , Myszczyński Kamil , Ślipiko Monika , Sawicki Jakub , Szczecińska Monika
Published: March 2022

Background

The mitogenomes of vascular plants are one of the most structurally diverse molecules. In the present study we characterize mitogenomes of a rare and endangered speciesPulsatilla patens. We investigated the gene content and its RNA editing potential, repeats distribution and plastid derived sequences.

Results

The mitogenome structure of early divergent eudicot, endangeredPulsatilla patensdoes not support the master chromosome hypothesis, revealing the presence of three linear chromosomes of total length 986 613 bp. The molecules are shaped by the presence of extremely long, exceeding 87 kbp repeats and multiple chloroplast-derived regions including nearly complete inverted repeat. Since the plastid IR content of Ranunculales is very characteristic, the incorporation into mitogenome could be explained rather by intracellular transfer than mitochondrial HGT. The mitogenome contains almost a complete set of genes known from other vascular plants with exception ofrps10 andsdh3, the latter being present but pseudogenized. Analysis of long ORFs enabled the identification of genes which are rarely present in plant mitogenomes, including RNA and DNA polymerases, albeit their presence even at species level is variable. Mitochondrial transcripts ofP. patenswere edited with a high frequency, which exceeded the level known in other analyzed angiosperms, despite the strict qualification criteria of counting the editing events and taking into analysis generally less frequently edited leaf transcriptome. The total number of edited sites was 902 andnad4 was identified as the most heavily edited gene with 65 C to U changes. Non-canonical, reverse U to C editing was not detected. Comparative analysis of mitochondrial genes of threePulsatillaspecies revealed a level of variation comparable to chloroplast CDS dataset and much higher infrageneric differentiation than in other known angiosperm genera. The variation found in CDS of mitochondrial genes is comparable to values found amongPulsatillaplastomes. Despite the complicated mitogenome structure, 14 single copy regions of 329 kbp, not splitted by repeats or plastid-derived sequences (MTPT), revealed the potential for phylogenetic, phylogeographic and population genetics studies by revealing intra- and interspecific collinearity.

Conclusions

This study provides valuable new information about mitochondrial genome of early divergent eudicots,Pulsatilla patens, revealed multi-chromosomal structure and shed new light on mitogenomics of early eudicots.
Perspectives on Telehealth for older adults during the COVID-19 pandemic using the quadruple aim: interviews with 48 physicians
Authors: Goldberg Elizabeth M. , Lin Michelle P. , Burke Laura G. , Jiménez Frances N. , Davoodi Natalie M. , Merchant Roland C.
Published: March 2022

Background

Telehealth delivery expanded quickly during the COVID-19 pandemic after the reduction of payment and regulatory barriers, but older adults are the least likely to benefit from this expansion. Little is known about physician experiences initiating telehealth and factors that fostered or discouraged adoption during the COVID-19 pandemic with older adult patients. Therefore, our objective was to understand experiences of frontline physicians caring for older adults via telehealth during the COVID-19 pandemic.

Methods

We conducted semi-structured interviews from September 2020 to November 2020 with 48 physicians. We recruited a diverse sample of geriatricians (n = 18), primary care (n = 15), and emergency (n = 15) physicians from all United Stated (US) regions, rural-urban settings, and academic-community practices who cared for older adult patients during the pandemic using purposive sampling methods. We completed framework analysis of the transcribed interviews to identify emerging themes and used the Quadruple Aim to organize themes.

Results

Frontline physicians described telehealth as a more flexible, value-based, and patient-centered mode of health care delivery. Benefits of using telehealth to treat older adults included reducing deferred care and increasing timely care, improving efficiency for physicians, enhancing communication with caregivers and patients, reducing patient travel burdens, and facilitating health outreach and education. Challenges included unequal access for rural, older, or cognitively impaired patients. Physicians noted that payment parity with in-person visits, between video and telephone visits, and relaxation of restrictive regulations would enhance their ability to continue to offer telehealth.

Conclusions

Frontline physicians who treated older adults during the COVID-19 pandemic were largely in favor of continuing telehealth use beyond the pandemic; however, they noted that sustainability would depend on enacting policies that address access inequities and reimbursement concerns. Our data provide policy insights that if placed into action could facilitate the long-term success of telehealth and encourage a more flexible healthcare delivery system in the US.
A deep learning framework for automated detection and quantitative assessment of liver trauma
Authors: Farzaneh Negar , Stein Erica B. , Soroushmehr Reza , Gryak Jonathan , Najarian Kayvan
Published: March 2022

Background

Both early detection and severity assessment of liver trauma are critical for optimal triage and management of trauma patients. Current trauma protocols utilize computed tomography (CT) assessment of injuries in a subjective and qualitative (v.s. quantitative) fashion, shortcomings which could both be addressed by automated computer-aided systems that are capable of generating real-time reproducible and quantitative information. This study outlines an end-to-end pipeline to calculate the percentage of the liver parenchyma disrupted by trauma, an important component of the American Association for the Surgery of Trauma (AAST) liver injury scale, the primary tool to assess liver trauma severity at CT.

Methods

This framework comprises deep convolutional neural networks that first generate initial masks of both liver parenchyma (including normal and affected liver) and regions affected by trauma using three dimensional contrast-enhanced CT scans. Next, during the post-processing step, human domain knowledge about the location and intensity distribution of liver trauma is integrated into the model to avoid false positive regions. After generating the liver parenchyma and trauma masks, the corresponding volumes are calculated. Liver parenchymal disruption is then computed as the volume of the liver parenchyma that is disrupted by trauma.

Results

The proposed model was trained and validated on an internal dataset from the University of Michigan Health System (UMHS) including 77 CT scans (34 with and 43 without liver parenchymal trauma). The Dice/recall/precision coefficients of the proposed segmentation models are 96.13/96.00/96.35% and 51.21/53.20/56.76%, respectively, in segmenting liver parenchyma and liver trauma regions. In volume-based severity analysis, the proposed model yields a linear regression relation of 0.95 in estimating the percentage of liver parenchyma disrupted by trauma. The model shows an accurate performance in avoiding false positives for patients without any liver parenchymal trauma. These results indicate that the model is generalizable on patients with pre-existing liver conditions, including fatty livers and congestive hepatopathy.

Conclusion

The proposed algorithms are able to accurately segment the liver and the regions affected by trauma. This pipeline demonstrates an accurate performance in estimating the percentage of liver parenchyma that is affected by trauma. Such a system can aid critical care medical personnel by providing a reproducible quantitative assessment of liver trauma as an alternative to the sometimes subjective AAST grading system that is used currently.
A study on spinal level, length, and branch type of the inferior mesenteric artery and the position relationship between the inferior mesenteric artery, left colic artery, and inferior mesenteric vein
Authors: Zhou Jie , Chen Jinghao , Wang Meirong , Chen Feixiang , Zhang Kun , Cong Ruochen , Fan Xiaole , Yang Jushun , He Bosheng
Published: March 2022

Background

This study was aimed to explore the clinical application of dual-energy computed tomography (DECT) monoenergetic plus (mono+) imaging to evaluate anatomical variations in the inferior mesenteric artery (IMA).

Methods

The clinical and imaging data of 212 patients who had undergone total abdominal DECT were retrospectively analyzed. The post-processing mono+ technique was used to obtain 40-keV single-level images in the arterial phase. Three-dimensional reconstruction was performed to evaluate the relationship between the IMA root position and the spinal level, IMA length, and IMA branch type, as well as the position of the left colic artery (LCA) and inferior mesenteric vein (IMV) at the IMA root level.

Results

The IMA root was located at the L3 level in 78.3% of cases and at the L2/L3 level in 3.3%. The highest vertebral level of IMA origin was L2 (4.2%), and the lowest was L4 (7.1%). The distance from the IMA root to the level of the sacral promontory was 99.58 ± 13.07 mm, which increased with the elevation of the IMA root at the spinal level. Of the patients, 53.8% demonstrated Type I IMA, 23.1% Type II, 20.7% Type III, and 2.4% Type IV. The length of the IMA varied from 13.6 to 66.0 mm. 77.3% of the IMAs belonged to Type A, the adjacent type, and 22.7% to Type B, the distant type.

Conclusion

DECT mono+ can preoperatively evaluate the anatomical characteristics of the IMA and the positional relationship between the LCA and IMV at the IMA root level, which would help clinicians plan individualized surgery for patients.
Patient-reported gastrointestinal symptoms in patients with peritoneal dialysis: the prevalence, influence factors and association with quality of life
Authors: Yi Chunyan , Wang Xin , Ye Hongjian , Lin Jianxiong , Yang Xiao
Published: March 2022

Background

The aims of this study were to investigate the prevalence and the influence factors of gastrointestinal symptoms, and its association with the quality of life (QOL) in peritoneal dialysis (PD) patients.

Methods

Continuous ambulatory PD patients (CAPD) who followed up in our PD center between March 2016 and December 2017 were enrolled in this cross-sectional study. Gastrointestinal symptom rating scale (GSRS) was used to evaluate gastrointestinal symptoms. The related clinical data were also collected. Multiple linear regression analysis was test for the influence factors associated with score of GSRS and QOL.

Results

This study included 471 CAPD patients. The mean age was 48.5±13.9 years, 53.9% were male and 15.1% with diabetic nephropathy. The median duration of PD was 37.3 (17.5~66.5) months. The median score of GSRS was 1.2(1.1~1.3) scores. Totally 82.2% (n=387) CAPD patients had at least one gastrointestinal symptom. Higher glycosylated hemoglobin, higher score of depression, lower diastolic blood pressure, urine output, score of instrumental activities of daily living scale and more amount of pills per day were independently associated with higher score of GSRS (all P<0.05). Score of dyspepsia and eating dysfunction were independently associated with worse score of QOL and physical health (all P<0.05).

Conclusions

Gastrointestinal symptoms were common but not serious in CAPD patients. Glycemic control, depression, blood pressure, urine output, activity of daily life and amount of pills were all associated with gastrointestinal symptoms. Moreover, gastrointestinal symptoms were correlated with QOL of PD patients.
The mediating role of coping styles in the relationship between perceived social support and antenatal depression among pregnant women: a cross-sectional study
Authors: Chen Zhonglan , Li Youping , Chen Juan , Guo Xiujing
Published: March 2022

Background

Antenatal depression (AD) is common in pregnant women and is associated with adverse outcomes for the mother, fetus, infant and child. The influencing factors of AD among pregnant women have been studied; however, the mechanisms of these factors remain unclear. This study was designed to examine the direct and serial mediating roles of coping styles in the relationship between perceived social support and AD among pregnant women.

Methods

A cross-sectional study was conducted among 1486 pregnant women who registered to give birth at a tertiary hospital. A self-developed questionnaire was administered to obtain sociodemographic and obstetric data. The Perceived Social Support Scale (PSSS), Simplified Coping Style Questionnaire (SCSQ), and Edinburgh Postnatal Depression Scale (EPDS) were administered to measure the perceived social support, coping styles, and depressive symptoms of pregnant women, respectively. Multiple linear stepwise regression analysis was used, and then, the specific relationships among influencing factors were determined through structural equation modelling (SEM).

Results

The prevalence of AD was 24.02%. The average scores of intrafamily support, extrafamily support, positive coping styles, negative coping styles and EPDS reported by pregnant women were 24.16 ± 3.09, 44.52 ± 6.16, 27.34 ± 4.89, 9.79 ± 3.82, and 7.44 ± 3.56, respectively. Multiple regression analysis showed that pregnant women with a higher level of intrafamily support exhibited a positive coping style and a decreased risk of AD. Compared with extrafamily support, the direct effect (-0.16 vs. -0.10, P < 0.05) and indirect effect of intrafamily support through coping styles (-0.028 vs. -0.027, P < 0.05) on AD were stronger. Two indirect pathways explained 17.46% of the variance in the EPDS scores.

Conclusion

Higher social support decreased the likelihood of AD, not only directly but also through the mediating roles of coping styles. Social support should be strengthened, and positive coping styles should be advocated in every stage of pregnancy. Specifically, intrafamily support should be given more attention for pregnant Chinese women.
Factors associated with home delivery in rural Sindh, Pakistan: results from the global network birth registry
Authors: Sadia Afreen , Mahmood Shafaq , Naqvi Farnaz , Naqvi Seemab , Soomro Zahid , Saleem Sarah
Published: March 2022

Background

According to global estimates for 2017, nearly 295,000 maternal deaths occurred worldwide. Thus, approximately 810 women die every day due to pregnancy-related complications. This burden of maternal deaths in LMICs is primarily due to poor healthcare service utilization, as indicated by relatively low rates of institutional deliveries and skilled-birth attendance (SBA). We conducted this study with an aim to assess the factors associated with home delivery and its subsequent effect on the pregnancy outcome in rural Sindh, Pakistan.

Methods

Data for this study were taken from The Global Network’s Maternal Newborn Health Registry (MNHR), which is a prospective, population-based observational cohort study. Registry data for 2018–2019 for District Thatta, Pakistan was retrieved for the analysis. Multivariable logistic regression models were used to determine the effect of each independent variable on the place of delivery by including all predictors and covariates. Results of the regression analyses are presented with crude odds ratios (OR) and adjusted odds ratios (aOR) with 95% confidence intervals (CIs).

Results

A total of 4649 women were included in the study, of these, 1286 (27.7%) women had delivered at home. Of those who delivered at home, a larger proportion was illiterate (90%), had a BMI of less than 18.5 kg/m2 (26.0%), had parity of 3 or more (48.1%), and had a history of pregnancy loss as compared to women who had institutional delivery. In addition, two-thirds of women (63.4%) who had delivered at home had less than 4 ANC visits, whereas 15.6% did not receive any ANC. On multivariable logistic regression we found that home delivery was significantly associated with being illiterate (aOR = 1.60; [95% CI: 1.34, 2.04]), having high parity (aOR = 1.91; [95% CI: 1.58, 2.32]), and no ANC visit (aOR = 14.8; [95% CI: 10.2, 21.5]).

Conclusions

More than a quarter of our study sample women delivered at home. These women were illiterate, multiparous, and did not receive antenatal care during pregnancy. It is essential to conduct extensive educational interventions for the women and their family members regarding the potential benefits of delivering in a safe and skilled environment. Moreover, the provision of comprehensive and quality antenatal care should be ensured as it improves the mothers' health-seeking behavior and helps them make informed decisions about their health and well-being.
Antenatal depressive symptoms in rwanda: rates, risk factors, and social support
Authors: Umuziga Marie Providence , Gishoma Darius , Hynie Michaela , Nyirazinyoye Laetitia
Published: March 2022

Background

Prevalence of perinatal depression is high in Rwanda and has been found to be associated with the quality of relationship with partner. This study extends this work to examine the relationship between antenatal depressive symptoms and social support across several relationships among women attending antenatal care services.

Methods

Structured survey interviews were conducted with 396 women attending antenatal care services in 4 health centres in the Southern Province of Rwanda. The Edinburgh Postnatal Depression Scale (EPDS) and Maternity Social Support Scale (MSSS) were used to assess antenatal depressive symptoms and the level of support respectively. Socio-demographic and gestational information, pregnancy intentions, perceived general health status, and experience of violence were also collected. Univariate, bivariate analyses and a multivariate logistic regression model were performed to determine the relationship between social support and risk factors for antenatal depressive symptoms.

Results

More than half of respondents were married (55.1%) or living with a partner in a common-law relationship (28.5%). About a third (35.9%) were in their 6th month of pregnancy; the rest were in their third term. The prevalence of antenatal depressive symptoms was 26.6% (EPDS ≥ 12). Bivariate analyses suggested that partner and friend support negatively predict depression level symptoms. Adjusting for confounding variables such as unwanted pregnancy (AOR: 0.415, CI: 0.221- 0.778), parity (AOR: 0.336, CI: 0.113–1.000) and exposure to extremely stressful life events (AOR: 2.300, CI: 1.263- 4.189), partner support (AOR: 4.458, CI: 1.833- 10.842) was strongly significantly associated with antenatal depressive symptoms; women reporting good support were less likely to report depressive symptoms than those reporting poor support or those with no partner. Friend support was no longer significant.

Conclusion

The study revealed that social support may be a strong protector against antenatal depressive symptoms but only support from the partner. This suggests that strengthening support to pregnant women may be a successful strategy for reducing the incidence or severity of maternal mental health problems, but more work is required to assess whether support from the broader social network can compensate for absent or unsupportive partners.
Combining gene expression analysis of gastric cancer cell lines and tumor specimens to identify biomarkers for anti-HER therapies—the role of HAS2, SHB and HBEGF
Authors: Ebert Karolin , Haffner Ivonne , Zwingenberger Gwen , Keller Simone , Raimúndez Elba , Geffers Robert , Wirtz Ralph , Barbaria Elena , Hollerieth Vanessa , Arnold Rouven , Walch Axel , Hasenauer Jan , Maier Dieter , Lordick Florian , Luber Birgit
Published: March 2022

Background

The standard treatment for patients with advanced HER2-positive gastric cancer is a combination of the antibody trastuzumab and platin-fluoropyrimidine chemotherapy. As some patients do not respond to trastuzumab therapy or develop resistance during treatment, the search for alternative treatment options and biomarkers to predict therapy response is the focus of research. We compared the efficacy of trastuzumab and other HER-targeting drugs such as cetuximab and afatinib. We also hypothesized that treatment-dependent regulation of a gene indicates its importance in response and that it can therefore be used as a biomarker for patient stratification.

Methods

A selection of gastric cancer cell lines (Hs746T, MKN1, MKN7 and NCI-N87) was treated with EGF, cetuximab, trastuzumab or afatinib for a period of 4 or 24 h. The effects of treatment on gene expression were measured by RNA sequencing and the resulting biomarker candidates were tested in an available cohort of gastric cancer patients from the VARIANZ trial or functionally analyzed in vitro.

Results

After treatment of the cell lines with afatinib, the highest number of regulated genes was observed, followed by cetuximab and trastuzumab. Although trastuzumab showed only relatively small effects on gene expression, BMF, HAS2 and SHB could be identified as candidate biomarkers for response to trastuzumab. Subsequent studies confirmed HAS2 and SHB as potential predictive markers for response to trastuzumab therapy in clinical samples from the VARIANZ trial. AREG, EREG and HBEGF were identified as candidate biomarkers for treatment with afatinib and cetuximab. Functional analysis confirmed that HBEGF is a resistance factor for cetuximab.

Conclusion

By confirming HAS2, SHB and HBEGF as biomarkers for anti-HER therapies, we provide evidence that the regulation of gene expression after treatment can be used for biomarker discovery.

Trial registration.

Clinical specimens of the VARIANZ study (NCT02305043) were used to test biomarker candidates.
Coats plus syndrome: a rare cause of severe gastrointestinal tract bleeding in children – a case report
Authors: Bozkurt Selcen , Usta Ayse Merve , Urganci Nafiye , Kalay Nida Gulderen , Kose Gulsen , Ozmen Evrim
Published: March 2022

Background

Coats plus syndrome, cerebroretinal microangiopathy with calcifications and cysts, is a rare disease with autosomal recessive pattern occurring due to a mutation in CTC1, encoding conserved telomere maintenance component 1, gene. Besides retinal involvement, abnormalities in brain and osteopenia, serious life-threatening bleeding in gastrointestinal tract and portal hypertension can be observed.

Case presentation

A 6-year-old girl with Coats plus syndrome presented to the pediatric emergency department with vomiting blood and blood in stool. An upper and lower gastrointestinal endoscopy revealed esophageal varices and vascular telangiectasia in the pyloric antrum, duodenum, and colon. She received palliative care and the bleeding was stopped after receiving intravenous octreotide. She then was followed in the pediatric gastroenterology, neurology, and ophthalmology clinics. She was later hospitalized and admitted to the intensive care unit as she continued to have intermittent gastrointestinal system bleeding. She eventually died due to severe gastrointestinal system bleeding.

Conclusions

Coats plus syndrome can lead to life-threatening gastrointestinal bleeding and portal hypertension. As Coats plus syndrome is quite rare, there is little published data on this syndrome. This report presents a case of Coats plus syndrome as a rare cause of gastrointestinal bleeding and portal hypertension.
Analysis of hydration and subchondral bone density on the viscoelastic properties of bovine articular cartilage
Authors: Crolla Joseph P. , Lawless Bernard M. , Cederlund Anna A. , Aspden Richard M. , Espino Daniel M.
Published: March 2022

Background

Articular cartilage is known to be a viscoelastic material, however little research has explored the impact of cartilage water content and bone density on its viscoelasticity. This study aimed to isolate subchondral bone density and hydration of articular cartilage and analyse their effects on the viscoelastic properties of articular cartilage.

Methods

Dynamic mechanical analysis was used to test samples at frequencies of 1, 8, 12, 29, 49, 71, and 88 Hz. Synthetic bone material with densities of 663.7 kg/m3 and 156.8 kg/m3 were used to mimic the bone mineral density (BMD). Dehydration occurred in a stepwise manner at relative humidity (RH) levels of 100%, 30%, and 1%. These relative humidity levels led to water contents of approximately 76%, 8.5%, and ≈ 0% by mass, respectively.

Results

Samples from eight bovine femoral heads were tested under a sinusoidal load. Storage stiffness was lower on the lower substrate density. Storage stiffness, though, increased as cartilage samples were dehydrated from a water content of 76% to 8.5%; decreasing again as the water content was further reduced. Loss stiffness was lower on a lower density substrate and decreased as the water content decreased.

Conclusions

In conclusions, a decrease in hydration decreases the loss stiffness, but a non-linear relationship between hydration and storage stiffness may exist. Additionally, higher BMD values led to greater storage and loss stiffnesses.
A realist evaluation of a home-based end of life care service for children and families: what works, for whom, how, in what circumstances and why?
Authors: Malcolm Cari , Knighting Katherine
Published: March 2022

Background

Children’s palliative and end of life care is underpinned internationally by a commitment to provide care and support in the family’s preferred place, which may include home, hospital or hospice. Limited evidence on models of best practice for the provision of children’s end of life care at home is available. This realist evaluation of a novel, home-based end of life care service explored what works for whom, how, in what circumstances and why.

Methods

Adopting principles of realist evaluation, an initial programme theory (IPT) was developed from multiple data sources including a scoping review, service documentation review, audit of service data, and qualitative data gathered from stakeholder (n = 6) and family interviews (n = 10). Three families who had used the service were identified as case studies and interviews with professionals involved in their care (n = 20) were conducted to test the IPT. The findings informed the revised CMOs illustrating the contexts and mechanisms which underpin how and why the service works and for whom.

Results

CMO configurations were identified explaining how and why the service works for families across five core components: anticipatory approach to care planning and delivery, advance care planning, service responsiveness and flexibility, 24/7 nurse-led service with 24-h medical support, and partnership working. Key mechanisms include establishing trusting relationships, building skills and parent confidence to deliver care, early advance care planning discussions with clear documentation, providing a single point of contact for families, workforce planning and resources to deliver the service as intended, effective communication and leadership within and between providers of the service, and use of joint policies and procedures. Recommendations for future development and expansion of the service are also discussed.

Conclusions

The findings highlight core components making this service a success and areas of challenge which continue to be addressed as the service develops. With increasing demand for home-based end of life care for children these components provide a structure which can help to guide service development to meet the needs of these families in other regions to ensure that children and families receive good quality care in their place of choice.