bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of Recycling-Reflection Color-Purity Enhancement Film to Improve Color Purity of Full-Color Micro-LEDs
Authors: Ye Zhi Ting , Wu Jun-Yi
Published: January 2022

A common full-color method involves combining micro-light-emitting diodes (LEDs) chips with color conversion materials such as quantum dots (QDs) to achieve full color. However, during color conversion between micro-LEDs and QDs, QDs cannot completely absorb incident wavelengths cause the emission wavelengths that including incident wavelengths and converted wavelength through QDs, which compromises color purity. The present paper proposes the use of a recycling-reflection color-purity-enhancement film (RCPEF) to reflect the incident wavelength multiple times and, consequently, prevent wavelength mixing after QDs conversion. This RCPEF only allows the light of a specific wavelength to pass through it, exciting blue light is reflected back to the red and green QDs layer. The prototype experiment indicated that with an excitation light source wavelength of 445.5 nm, the use of green QDs and RCPEFs increased color purity from 77.2% to 97.49% and light conversion efficiency by 1.97 times and the use of red QDs and RCPEFs increased color purity to 94.68% and light conversion efficiency by 1.46 times. Thus, high efficiency and color purity were achieved for micro-LEDs displays.

Graphical Abstract
High genetic heterogeneity of Mycobacterium intracellulare isolated from respiratory specimens
Authors: Lari Nicoletta , Rindi Laura
Published: January 2022

Background

M. intracellulare is a frequent causative pathogen of nontuberculous mycobacteria infection that causes infections in the respiratory tract, whose incidence is increasing in many countries. This study aimed at determining the VNTR-based genetic diversity of a collection of 39 M. intracellulare human strains isolated from respiratory specimens over the last 5 years.

Results

The VNTR analysis showed that M. intracellulare strains displayed a high genetic diversity, indicating that the M. intracellulare genotypes are quite heterogeneous in our geographical area. Moreover, a comparison with VNTR profiles of strains from other countries confirmed that genotypes of clinical strains of M. intracellulare are not related to geographical origin.

Conclusions

VNTR typing has proved to be a highly discriminatory method for better understanding the molecular epidemiology of M. intracellulare.
Analysis of risk factors and preventive strategies for intracranial infection after neuroendoscopic transnasal pituitary adenoma resection
Authors: Huang Xin , Zhang Xuejun , Zhou Jian , Li Gang , Zheng Gang , Peng Lei , Yan Ziwei , Chen Shaojun
Published: January 2022

Objective

To analyse the risk factors for intracranial infection after neuroendoscopic transnasal pituitary adenoma resection (NTPAR) to provide a reference for the prevention and treatment of postoperative intracranial infection.

Methods

The clinical data of 387 patients who underwent NTPAR in the Department of Neurosurgery of the First People’s Hospital of Yichang from March 2013 to March 2021 were retrospectively analysed. The patients were divided into an infected group and a noninfected group according to the occurrence of intracranial infection. The detailed clinical data of the two groups were collected. Univariate and multivariate logistic regression was used to analyse the risk factors for intracranial infection after NTPAR.

Results

Among the 387 surgical patients, 32 patients (8.27%) were in the intracranially infected group and 355 patients (91.73%) were in the noninfected group. The results of the univariate analysis suggested that age > 45 years, tumour size > 1 cm, operation time > 240 min, blood loss > 400 ml, Kelly Grade of cerebrospinal fluid (CSF) leakage > Grade 2, postoperative CSF leakage, lumbar cistern drainage and blood transfusion were the influencing factors for postoperative intracranial infection, while the results of multivariate logistic regression analysis implied that intraoperative CSF leakage (Kelly Grade > 2) and postoperative CSF leakage were independent influencing factors for intracranial infection after NTPAR, and perioperative use of antibiotics was an independent protective factor for postoperative intracranial infection.

Conclusions

There are a variety of risk factors for intracranial infection after NTPAR, which indicates that it is necessary to develop different repair strategies for CSF leakage according to the Kelly Grade, timely treatment of postoperative CSF leakage and perioperative use of antibiotics. These measures have been shown to effectively reduce the probability of intracranial infection after NTPAR.
Poly-γ-glutamic acid enhanced the drought resistance of maize by improving photosynthesis and affecting the rhizosphere microbial community
Authors: Ma Haizhen , Li Panpan , Liu Xingwang , Li Can , Zhang Shengkui , Wang Xiaohan , Tao Xia
Published: January 2022

Background

Compared with other abiotic stresses, drought stress causes serious crop yield reductions. Poly-γ-glutamic acid (γ-PGA), as an environmentally friendly biomacromolecule, plays an important role in plant growth and regulation.

Results

In this project, the effect of exogenous application of γ-PGA on drought tolerance of maize (Zea mays. L) and its mechanism were studied. Drought dramatically inhibited the growth and development of maize, but the exogenous application of γ-PGA significantly increased the dry weight of maize, the contents of ABA, soluble sugar, proline, and chlorophyll, and the photosynthetic rate under severe drought stress. RNA-seq data showed that γ-PGA may enhance drought resistance in maize by affecting the expression of ABA biosynthesis, signal transduction, and photosynthesis-related genes and other stress-responsive genes, which was also confirmed by RT–PCR and promoter motif analysis. In addition, diversity and structure analysis of the rhizosphere soil bacterial community demonstrated that γ-PGA enriched plant growth promoting bacteria such as Actinobacteria, Chloroflexi, Firmicutes, Alphaproteobacteria and Deltaproteobacteria. Moreover, γ-PGA significantly improved root development, urease activity and the ABA contents of maize rhizospheric soil under drought stress. This study emphasized the possibility of using γ-PGA to improve crop drought resistance and the soil environment under drought conditions and revealed its preliminary mechanism.

Conclusions

Exogenous application of poly-γ-glutamic acid could significantly enhance the drought resistance of maize by improving photosynthesis, and root development and affecting the rhizosphere microbial community.
Effect of general anesthesia with thoracic paravertebral block on postoperative delirium in elderly patients undergoing thoracoscopic lobectomy: a randomized-controlled trial
Authors: Wei Wei , Zheng Xi , Gu Yu , Fu Wenting , Tang Chunlin , Yao Yonghua
Published: January 2022

Background

Postoperative delirium (POD) is characterized by acute brain dysfunction, especially in elderly patients. Postoperative pain is an important factor in the development of delirium, and effective pain management can reduce the risk of POD. Thoracic paravertebral block (TPVB) can effectively relieve postoperative pain and inhibit the perioperative stress and inflammatory response. We investigated whether the combination of TPVB with general anesthesia reduced the occurrence of POD following thoracoscopic lobectomy.

Methods

A total of 338 elderly patients, aged 65–80 years, who underwent elective surgery for video-assisted thoracoscopic lobectomy (VATS) were randomly assigned to either a patient-controlled intravenous analgesia group (PIA) or a patient-controlled paravertebral-block analgesia group (PBA). POD was evaluated using the 3-min diagnostic confusion assessment method (3D-CAM). The postoperative quality of recovery (QoR) was assessed with Chinese version of QoR-40 scale. Pain intensity was measured using the visual analog scale (VAS) score. Tumor necrosis factor-α (TNF-α) and neurofilament light (NFL) levels were determined using enzyme-linked immunosorbent assay (ELISA) kits.

Results

Delirium occurred in 47 (28%) of 168 cases in the PIA group and 28 (16.5%) of 170 cases in the PBA group (RR 1.7, p = 0.03). PBA was also associated with a higher rate of overall recovery quality at day 7 after surgery (27.1% vs. 17.3%, P = 0.013) compared with PIA. The incremental change in surgery-induced TNF-α and NFL was greater in the PIA group than PBA group (p < 0.05).

Conclusion

Thoracic paravertebral block analgesia is associated with lower incidence of postoperative delirium, probably due to its anti-neuroinflammatory effects. Furthermore, as a component of multimodal analgesia, TPVB provides not only superior analgesic but also opioid-sparing effects.

Trial registration

The study was registered on the Chinese Clinical Trial Registry Center (www.chictr.org.cn; registration number: ChiCTR 2,000,033,238) on 25/05/2018.
Preliminary evaluation of SaCoVLM™ video laryngeal mask airway in airway management for general anesthesia
Authors: Yan Chun-ling , Chen Ying , Sun Pei , Qv Zong-yang , Zuo Ming-zhang
Published: January 2022

Background

To preliminary evaluate the application of SaCoVLM™ video laryngeal mask airway in airway management of general anesthesia.

Methods

We recruited 100 adult patients (ages 18–78 years, male 19, female 81, weight 48–90 kg) with normal predicted airway (Mallampati I ~ II, unrestricted mouth opening, normal head and neck mobility) and ASA I-II who required general anaesthesia. The SaCoVLM™ was inserted after anesthesia induction and connected with the anesthesia machine for ventilation. Our primary outcome was glottic visualization grades. Secondary outcomes included seal pressure, success rate of insertion, intraoperative findings (gastric reflux and contraposition), gastric drainage and 24-h complications after operation.

Results

The laryngeal inlet was exposed in all the patients and shown on the video after SaCoVLM™ insertion. The status of glottic visualization was classified: grade 1 in 55 cases, grade 2 in 23 cases, grade 3 in 14 cases and grade 4 in 8 cases. The first-time success rate of SaCoVLM™ insertion was 95% (95% CI = 0.887 to 0.984), and the total success rate was 96% (95% CI = 0.901 to 0.989). The sealing pressure of SaCoVLM™ was 34.1 ± 6.2 cmH2O and the gastric drainage were smooth. Only a small number of patients developed mild complications after SaCoVLM™ was removed (such as blood stains on SaCoVLM™ and sore throat).

Conclusions

The SaCoVLM™ can visualize partial or whole laryngeal inlets during the surgery, with a high success rate, a high sealing pressure and smooth gastroesophageal drainage. SaCoVLM™ could be a promise new effective supraglottic device to airway management during general anesthesia.

Trial registration

ChiCTR,ChiCTR2000028802.Registered 4 January 2020.
Postoperative delirium prediction using machine learning models and preoperative electronic health record data
Authors: Bishara Andrew , Chiu Catherine , Whitlock Elizabeth L. , Douglas Vanja C. , Lee Sei , Butte Atul J. , Leung Jacqueline M. , Donovan Anne L.
Published: January 2022

Background

Accurate, pragmatic risk stratification for postoperative delirium (POD) is necessary to target preventative resources toward high-risk patients. Machine learning (ML) offers a novel approach to leveraging electronic health record (EHR) data for POD prediction. We sought to develop and internally validate a ML-derived POD risk prediction model using preoperative risk features, and to compare its performance to models developed with traditional logistic regression.

Methods

This was a retrospective analysis of preoperative EHR data from 24,885 adults undergoing a procedure requiring anesthesia care, recovering in the main post-anesthesia care unit, and staying in the hospital at least overnight between December 2016 and December 2019 at either of two hospitals in a tertiary care health system. One hundred fifteen preoperative risk features including demographics, comorbidities, nursing assessments, surgery type, and other preoperative EHR data were used to predict postoperative delirium (POD), defined as any instance of Nursing Delirium Screening Scale ≥2 or positive Confusion Assessment Method for the Intensive Care Unit within the first 7 postoperative days. Two ML models (Neural Network and XGBoost), two traditional logistic regression models (“clinician-guided” and “ML hybrid”), and a previously described delirium risk stratification tool (AWOL-S) were evaluated using the area under the receiver operating characteristic curve (AUC-ROC), sensitivity, specificity, positive likelihood ratio, and positive predictive value. Model calibration was assessed with a calibration curve. Patients with no POD assessments charted or at least 20% of input variables missing were excluded.

Results

POD incidence was 5.3%. The AUC-ROC for Neural Net was 0.841 [95% CI 0. 816–0.863] and for XGBoost was 0.851 [95% CI 0.827–0.874], which was significantly better than the clinician-guided (AUC-ROC 0.763 [0.734–0.793], p < 0.001) and ML hybrid (AUC-ROC 0.824 [0.800–0.849], p < 0.001) regression models and AWOL-S (AUC-ROC 0.762 [95% CI 0.713–0.812], p < 0.001). Neural Net, XGBoost, and ML hybrid models demonstrated excellent calibration, while calibration of the clinician-guided and AWOL-S models was moderate; they tended to overestimate delirium risk in those already at highest risk.

Conclusion

Using pragmatically collected EHR data, two ML models predicted POD in a broad perioperative population with high discrimination. Optimal application of the models would provide automated, real-time delirium risk stratification to improve perioperative management of surgical patients at risk for POD.
Qualitative and quantitative gastric ultrasound assessment in highly skilled regional anesthesiologists
Authors: Tankul Rattanaporn , Halilamien Pathom , Tangwiwat Suwimon , Dejarkom Sukanya , Pangthipampai Pawinee
Published: January 2022

Background

Pulmonary aspiration is a major complication in anesthesia, and various studies have shown that gastric sonography can reliably provide valuable information relative to both the qualitative and quantitative aspects of gastric content. This study aimed to determine the accuracy of ultrasound assessment of gastric content compared between two novice anesthesiologist gastric sonographers.

Methods

This prospective cohort study of two anesthesiologists learning to perform qualitative and quantitative ultrasound assessment of gastric content on healthy volunteers was conducted at Siriraj Hospital (Bangkok, Thailand). This trial was registered with ClinicalTrials.gov (reg. no. NCT04760106).

Results

Of the 50 enrolled participants, three were excluded due to study protocol violation. Each anesthesiologist performed a qualitative assessment on 47 participants for an overall total of 94 scans. There were 15 males and 32 females (age 42 ± 11.7 years, weight 61.2 ± 13.1 kg, height 160.7 ± 7.3 cm, and BMI 23.6 ± 4.3 kg/m2). The overall success rate for all gastric content categories was approximately 96%. From antral cross-sectional area measurement, as the ingested volume increased, there was a tendency toward increased deviation from the actual ingested volume. Interrater agreement between anesthesiologists was analyzed using intraclass correlation coefficients (ICCs). A larger fluid volume was found to be associated with a lower level of agreement between the two anesthesiologists. The ICCs were 0.706 (95% CI: −0.125 to 0.931), 0.669 (95% CI: −0.254 to 0.920), 0.362 (95% CI: −0.498 to 0.807) for the 100 ml, 200 ml, and 300 ml fluid volumes, respectively. The mean duration to perform an ultrasound examination for each gastric content category and for the entire examination did not differ significantly between anesthesiologists (p > 0.05).

Conclusion

Our results indicate that qualitative ultrasound assessment of gastric content is highly accurate and can be easily learned. In contrast, quantification of gastric volume by novice gastric sonographers is more complex and requires more training.

Trial registration

ClinicalTrials.gov no. NCT04760106 Date registered on Feb 11, 2021. Prospectively registered.
Phosphoserine phosphatase as a prognostic biomarker in patients with gastric cancer and its potential association with immune cells
Authors: Huang Ma-Yan , Liu Xiao-Yun , Shao Qiong , Zhang Xu , Miao Lei , Wu Xiao-Yan , Xu Yu-Xia , Wang Fang , Wang Hai-Yun , Zeng Liang , Deng Ling
Published: January 2022

Background

Because of dismal prognosis in gastric cancer, identifying relevant prognostic factors is necessary. Phosphoserine phosphatase (PSPH) exhibits different expression patterns in many cancers and has been reported to affect the prognosis of patients with cancer. In this study, we examined the prognostic role of metabolic gene PSPH in gastric cancer based on the TCGA dataset and our hospital–based cohort cases.

Methods

We collected and analysed RNA-seq data of Pan-cancer and gastric cancer in the TCGA dataset and PSPH expression data obtained from immunohistochemical analysis of 243 patients with gastric cancer from Sun Yat-sen University cancer center. Further, Kaplan–Meier survival analysis and Cox analysis were used to assess the effect of PSPH on prognosis. The ESTIMATE and Cibersort algorithms were used to elucidate the relationship between PSPH and the abundance of immune cells using the TCGA dataset.

Results

We observed that PSPH expression displayed considerably high in gastric cancer and it was significantly associated with inferior prognosis (P = 0.043). Surprisingly, there was a significant relationship between lower immune scores and high expression of PSPH (P < 0.05). Furthermore, patients with a low amount of immune cells exhibited poor prognosis (P = 0.046). The expression of PSPH significantly increased in activated memory CD4 T cells, resting NK cells and M0 macrophages (P = 0.037, < 0.001, and 0.005, respectively).

Conclusions

This study highlighted that PSPH influences the prognosis of patients with gastric cancer, and this is associated with the infiltration of tumour immune cells, indicating that PSPH may be a new immune-related target for treating gastric cancer.
Association between single nucleotide polymorphism of rs1937 in TFAM gene and longevity among the elderly Chinese population: based on the CLHLS study
Authors: Chen Qing , Li Zhi-Hao , Song Wei-Qi , Yao Yao , Zhang Yu-Jie , Zhong Wen-Fang , Zhang Pei-Dong , Liu Dan , Zhang Xi-Ru , Huang Qing-Mei , Zhao Xiao-Yang , Shi Xiao-Ming , Mao Chen
Published: January 2022

Background

To investigate whether the mitochondrial transcription factor A (TFAM) rs1937 single nucleotide polymorphism (SNP) is associated with longevity.

Methods

We conducted a case-control study among Chinese long-lived individuals (≥90 years). Data were obtained on 3294 participants who were able to voluntarily provided a saliva sample during 2008–2009 from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). In this study, 1387 young elderly (65–74 years) were allocated to the control group, and 1907 long-lived individuals were recruited as the case group. SNP rs1937 on TFAM were genotyped. Logistic regression models were applied to evaluate the association between rs1937 SNP and longevity.

Results

The genotype frequency of the SNP of rs1937 in the two groups had a significant difference (p = 0.003). Binary logistic regression analysis showed that compared to younger elderly, the long-lived individuals with “CC genotype” of rs1937 were more closely related to increased longevity than those with “GG genotype” (OR: 1.989, 95% CI: 1.160–3.411). The positive association between rs1937 SNP and longevity was robust in stratified analyses and sensitivity analyses.

Conclusions

We found the SNP of rs1937 may be a potential biomarker for longer human life span. Further studies are necessary to elucidate the biological mechanism of rs1937 on TFAM with promoting longevity.
Associations of fruit & vegetable intake and physical activity with poor self-rated health among Chinese older adults
Authors: Guan Ming
Published: January 2022

Background

Despite the existing literature highlights the central roles of sociodemographic factors, fruit & vegetable (F&V) intake, and physical activities for maintaining good health, less is known about the associations in the Chinese context. This study attempted to explore the associations of servings of F&V intake and levels of physical activities with poor self-rated health (SRH) among Chinese older adults.

Methods

Data were drawn from the Study on Global Ageing and Adult Health-China (SAGE-China) issued by the World Health Organization and included 7560 respondents aged ≥60 years in China. After screening out the potential confounding factors, multiple logistic regression models were adopted to explore the associations of sociodemographic factors, servings of F&V intake, and levels of physical activities with poor SRH.

Results

Among the sample, nearly a quarter reported poor health status. There were significant gender differences in the case of servings of F&V intake and levels of physical activities. Logistic regressions indicated that higher fruit intake was associated with lower likelihood of vigorous level of physical activity as compared to zero intake. Likewise, higher vegetable intake (≥10 servings) was associated with a higher likelihood of vigorous & moderate level of physical activity when compared to lower intake (≤ 4 servings). Higher fruit intake was associated with a lower likelihood of poor SRH. Similarly, vegetable intake (5 servings: AOR = 0.69, 95%CI: 0.58–0.83; 6–9 servings: AOR = 0.72, 95%CI: 0.59–0.87) was significantly associated with poor SRH. Additionally, vigorous level of physical activity (AOR = 0.79, 95%CI: 0.65–0.97) and vigorous fitness/leisure (AOR = 0.57, 95%CI: 0.39–0.84) were significantly associated with poor SRH.

Conclusion

This study suggested that older adults with high fruit intake had lower probability of performing vigorous & moderate level of physical activity, while those with high vegetable intake had higher probability of performing vigorous & moderate level of physical activity. Likewise, the older adults with high F&V intake and higher probability of performing vigorous level of physical activity, walk/bike activity, and vigorous/moderate fitness/leisure had less likelihood to face the risk for poor SRH outcomes. The appropriate servings of F&V intake and levels of physical activity should be highlighted.
The impact of socioeconomic status, general health and oral health on Health-Related Quality of Life, Oral Health-Related Quality of Life and mental health among Polish older adults
Authors: Malicka Barbara , Skośkiewicz-Malinowska Katarzyna , Kaczmarek Urszula
Published: January 2022

Background

The study aims to evaluate the impact of socioeconomic status, general health and oral health parameters on Health-Related Quality of Life (HRQoL), Oral Health-Related Quality of Life (OHRQoL) and mental health in elderly urban residents of South-Western Poland.

Methods

The 500 residents of Wroclaw, aged 65 and older provided demographic and personal information as well as their medical history. A patient's oral condition were determined based on the clinical oral examination.Quality of Life was assessed using Euro-Quality of Life (EQ-5D), Oral Health Impact Profile-14 (OHIP-14) and Patient Health Questionnaire (PHQ-9).The association between exposure (socioeconomic status, general health and oral health) and outcome (HRQoL, OHRQoL and mental health variables) were analyzed with the use of four models: P – Poisson model, NB-Negative Binomial model, ZIP – Zero Inflated Poisson model, ZINB – Zero Inflated Negative Binomial model.

Results

The best model turned out to be the ZINB model, in which a negative binomial distribution in the count equation is assumed. In this model, only 13 independent variables had a significant effect on HRQoL, OHRQoL, and mental health. HRQoL assessed with the EQ-5D is significantly influenced by: living conditions 0.133 (95% CI: 0.001, 0.267, p = 0.049), income -0.348 (95%CI: -0.466, -0.230, p < 0.001), diabetes mellitus 0.437 (95%CI: 0.250, 0.624, p < 0.001), myocardial infarction 0.454 (95% CI: 0.151, 0.757, p = 0.003), stroke 0.543 (95%CI: 0.094, 0.992, p = 0.018) and renal disease 0.466 (95% CI: 0.206, 0.726, p < 0.001). Factors negatively affecting OHRQOL are: the need for oral treatment 0.278 (95%CI: 0.104, 0.452, p = 0.002), the number of missing teeth 0.053 (95%CI: 0.039, 0.067, p < 0.001) and gender 0.271 (95%CI: 0.015, 0.527, p = 0.038) and age -0.025 (95%CI: -0.042, -0.008, p = 0.003). An important factor influencing the level of depression assessed by the PHQ-9 questionnaire may be the material condition -0.225 (95%CI: -0.349, -0.101, p < 0.001). It should be emphasized that living with other people may be a factor that significantly increases the probability of avoiding the occurrence of depression symptoms.

Conclusion

The study concerning elderly residents of the macroregion in Poland found the impact of socioeconomic, general health and oral health parameters on Health-Related Quality of Life, Oral Health-Related Quality of Life and mental health. Research on the quality of life of the elderly at the local level allowed to assess the factors linked to quality of life of older adults.
A method for improving semantic segmentation using thermographic images in infants
Authors: Asano Hidetsugu , Hirakawa Eiji , Hayashi Hayato , Hamada Keisuke , Asayama Yuto , Oohashi Masaaki , Uchiyama Akira , Higashino Teruo
Published: January 2022

Background

Regulation of temperature is clinically important in the care of neonates because it has a significant impact on prognosis. Although probes that make contact with the skin are widely used to monitor temperature and provide spot central and peripheral temperature information, they do not provide details of the temperature distribution around the body. Although it is possible to obtain detailed temperature distributions using multiple probes, this is not clinically practical. Thermographic techniques have been reported for measurement of temperature distribution in infants. However, as these methods require manual selection of the regions of interest (ROIs), they are not suitable for introduction into clinical settings in hospitals. Here, we describe a method for segmentation of thermal images that enables continuous quantitative contactless monitoring of the temperature distribution over the whole body of neonates.

Methods

The semantic segmentation method, U-Net, was applied to thermal images of infants. The optimal combination of Weight Normalization, Group Normalization, and Flexible Rectified Linear Unit (FReLU) was evaluated. U-Net Generative Adversarial Network (U-Net GAN) was applied to thermal images, and a Self-Attention (SA) module was finally applied to U-Net GAN (U-Net GAN + SA) to improve precision. The semantic segmentation performance of these methods was evaluated.

Results

The optimal semantic segmentation performance was obtained with application of FReLU and Group Normalization to U-Net, showing accuracy of 92.9% and Mean Intersection over Union (mIoU) of 64.5%. U-Net GAN improved the performance, yielding accuracy of 93.3% and mIoU of 66.9%, and U-Net GAN + SA showed further improvement with accuracy of 93.5% and mIoU of 70.4%.

Conclusions

FReLU and Group Normalization are appropriate semantic segmentation methods for application to neonatal thermal images. U-Net GAN and U-Net GAN + SA significantly improved the mIoU of segmentation.
Association of accelerometer-measured physical activity with kidney function in a Japanese population: the DOSANCO Health Study
Authors: Sasaki Sachiko , Nakamura Koshi , Ukawa Shigekazu , Okada Emiko , Amagasa Shiho , Inoue Shigeru , Kimura Takashi , Yoshimura Aya , Tanaka Aya , Nakagawa Takafumi , Imae Akihiro , Tamakoshi Akiko
Published: January 2022

Background

Sedentary behavior and decreased physical activity are associated with reduced kidney function, yet most evidence is based on self-reported physical activity. This study investigated the association between accelerometer-based physical activity level and kidney function in a general Japanese population.

Methods

A cross-sectional study was conducted in 440 community-dwelling Japanese participants, aged 35–79 years. Time (min/d) was assessed for the following types of physical activity: sedentary behavior, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA). Kidney function was assessed using estimated glomerular filtration rate (eGFR). A linear regression model was employed to calculate the β coefficient of eGFR for a 60-min/d increase in sedentary behavior and LPA and a 10-min/d increase in MVPA. A logistic regression model was used to calculate the odds ratio for low eGFR (< 60 versus ≥60 mL/min/1.73m2) for a 60-min/d or 10-min/d increase in each physical activity type.

Results

MVPA time and eGFR were positively associated in both men and women, after adjusting for age, body mass index, and other clinical characteristics (Men: β, 0.91; P = 0.021; Women: β, 0.70; P = 0.034). In women, sedentary behavior and eGFR were inversely associated after adjusting for the same factors (β, − 1.06; P = 0.048). The odds ratio (95% confidence interval) for low eGFR associated with a 60-min increase in sedentary behavior was 1.65 (1.07–2.55) after adjusting for the same factors in women.

Conclusion

Longer sedentary behavior and shorter MVPA time were associated with lower kidney function in the Japanese population.
Serum Galectin-3 levels and all-cause and cardiovascular mortality in maintenance hemodialysis patients: a prospective cohort study
Authors: Liu Shuxin , Wu Qijun , Zhang Shuang , Wang Zhihong , Liu Hong , Teng Lanbo , Xiao Ping , Lu Yan , Wang Xuena , Dong Cui , Xiao Jia , Zhang Jiayu
Published: January 2022

Background

Higher serum galectin-3 levels are related to adverse outcomes in different disease states. However, the association of galectin-3 with mortality in the maintenance hemodialysis (HD) population has not been fully described. Thus, we aimed to assess the predictive significance of galectin-3 for all-cause and cardiovascular (CV) mortality through a Chinese maintenance HD population.

Methods

A prospective cohort study was conducted in five hundred and six patients with end-stage renal disease who underwent hemodialysis at Dalian Central Hospital before December 31, 2014. Serum galectin-3 levels were measured at baseline and classified as high (> 8.65 ng/ml) or low (≤ 8.65 ng/ml) according to the “X-tile” program. Primary and secondary outcomes were all-cause and CV mortality, respectively. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated by the Cox proportional hazards regression models.

Results

During the median follow-up of 60 months, there were 188 all-cause deaths and 125 CV deaths. Compared with maintenance HD population with galectin-3 ≤ 8.65 ng/ml, the adjusted HR for all-cause mortality among those with galectin-3 >  8.65 ng/ml was 1.59 (CI: 0.96–2.65, p = 0.07). Furthermore, multivariable analysis showed that maintenance HD patients with galectin-3 >  8.65 ng/ml had a 2.13-fold higher risk of CV death than those with galectin-3 ≤ 8.65 ng/ml (HR = 2.13, 95% CI 1.07–4.26).

Conclusion

Galectin-3 is an independent predictor of CV mortality in maintenance HD patients.
Success of small-dose fractionated sodium thiosulfate in the treatment of calciphylaxis in a peritoneal dialysis patient
Authors: Lu Yuan , Shen Lei , Zhou Ling , Xu Deyu
Published: January 2022

Background

Calciphylaxis, or calcific uremic arteriolopathy (CUA), is a rare, fatal disorder of microvascular calcification and thrombosis that typically affects patients with end-stage renal disease (ESRD) receiving long-term dialysis. Fewer reports describe calciphylaxis in peritoneal dialysis patients than hemodialysis patients as per a literature review. To date, there are no clear guidelines for CUA diagnosis and treatment. While sodium thiosulfate (STS) has been increasingly used for treatment in recent years, there have also been reports of severe side effects. There is no uniform standard for its usage and dosage, especially for peritoneal dialysis patients.

Case presentation

We present a case of a 40-year-old Chinese male patient with ESRD on peritoneal dialysis who developed calciphylaxis with severe painful cutaneous ulcers on the fingers and toes that were managed successfully for 6 months with comprehensive treatment composed mainly of small-dose fractionated sodium thiosulfate.

Conclusions

Our experience suggests that the treatment of calciphylaxis requires timely and multi-angle intervention. Treatment with small-dose fractionated sodium thiosulfate has proven effective and tolerated in this patient.
Association between bone mineral metabolism and vascular calcification in end-stage renal disease
Authors: Aaltonen Louise , Koivuviita Niina , Seppänen Marko , Kröger Heikki , Tong Xiaoyu , Löyttyniemi Eliisa , Metsärinne Kaj
Published: January 2022

Background

Development of vascular calcification is accelerated in patients with end-stage renal disease. In addition to traditional risk factors of cardiovascular disease (CVD) abnormal bone and mineral metabolism together with many other factors contribute to the excess cardiovascular burden in patients on dialysis. Aortic calcification score and coronary calcification score are predictive of CVD and mortality. The aim of this study was to evaluate the possible relationship between arterial calcification and bone metabolism.

Methods

Thirty two patients on dialysis were included. All patients underwent a bone biopsy to assess bone histomorphometry and a 18F-NaF PET scan. Fluoride activity was measured in the lumbar spine (L1 – L4) and at the anterior iliac crest. Arterial calcification scores were assessed by computerized tomography for quantification of coronary artery calcification score and lateral lumbar radiography for aortic calcification score.

Results

This study group showed high prevalence of arterial calcification and 59% had verified CVD. Both CAC and AAC were significantly higher in patients with verified CVD. Only 22% had low turnover bone disease. There was a weak association between fluoride activity, which reflects bone turnover, measured in the lumbar spine, and CAC and between PTH and CAC. There was also a weak association between erosion surfaces and AAC. No significant association was found between calcification score and any other parameter measured.

Conclusions

The results in this study highlight the complexity, when evaluating the link between bone remodeling and vascular calcification in patients with multiple comorbidities and extensive atherosclerosis. Several studies suggest an impact of bone turnover on development of arterial calcification and there is some evidence of reduced progression of vascular calcification with improvement in bone status. The present study indicates an association between vascular calcification and bone turnover, even though many parameters of bone turnover failed to show significance. In the presence of multiple other factors contributing to the development of calcification, the impact of bone remodeling might be diminished.

Trial registration

The study is registered in ClinicalTrials.gov protocol registration and result system, ID is NCT02967042. Date of registration is 17/11/2016.
Campylobacter coli infection causes spinal epidural abscess with Guillain–Barré syndrome: a case report
Authors: Fujita Masako , Ueno Tatsuya , Horiuchi Michiru , Mitsuhashi Tatsuro , Yamamoto Shouji , Arai Akira , Tomiyama Masahiko
Published: January 2022

Background

Guillain–Barré syndrome (GBS) and spinal epidural abscess (SEA) are known as mimics of each other because they present with flaccid paralysis following an infection; however, they differ in the main causative bacteria. Nevertheless, the two diseases can occur simultaneously if there is a preceding Campylobacter infection. Here, we report the first case of SEA with GBS following Campylobacter coli infection.

Case presentation

A 71-year-old Japanese man presented with progressive back pain and paralysis of the lower limbs following enteritis. Magnetic resonance imaging showed a lumbar epidural abscess that required surgical decompression; therefore, surgical drainage was performed. Blood cultures revealed the presence of C. coli. Despite surgery, the paralysis progressed to the extremities. Nerve conduction studies led to the diagnosis of GBS. Anti-ganglioside antibodies in the patient suggested that GBS was preceded by Campylobacter infection. Intravascular immunoglobulin therapy attenuated the progression of the paralysis.

Conclusions

We report a case of SEA and GBS following Campylobacter infection. A combination of the two diseases is rare; however, it could occur if the preceding infection is caused by Campylobacter spp. If a cause is known but the patient does not respond to the corresponding treatment, it is important to reconsider the diagnosis based on the medical history.
Options for improving low birthweight and prematurity birth outcomes of indigenous and culturally and linguistically diverse infants: a systematic review of the literature using the social-ecological model
Authors: Karger Shae , Bull Claudia , Enticott Joanne , Callander Emily J.
Published: January 2022

Background

Prematurity and low birthweight are more prevalent among Indigenous and Culturally and Linguistically Diverse infants.

Methods

To conduct a systematic review that used the social-ecological model to identify interventions for reducing low birthweight and prematurity among Indigenous or CALD infants. Scopus, PubMed, CINAHL, and Medline electronic databases were searched. Studies included those published in English between 2010 and 2021, conducted in high-income countries, and reported quantitative results from clinical trials, randomized controlled trials, case-control studies or cohort studies targeting a reduction in preterm birth or low birthweight among Indigenous or CALD infants. Studies were categorized according to the level of the social-ecological model they addressed.

Findings

Nine studies were identified that met the inclusion criteria. Six of these studies reported interventions targeting the organizational level of the social-ecological model. Three studies targeted the policy, community, and interpersonal levels, respectively. Seven studies presented statistically significant reductions in preterm birth or low birthweight among Indigenous or CALD infants. These interventions targeted the policy (n = 1), community (n = 1), interpersonal (n = 1) and organizational (n = 4) levels of the social-ecological model.

Interpretation

Few interventions across high-income countries target the improvement of low birthweight and prematurity birth outcomes among Indigenous or CALD infants. No level of the social-ecological model was found to be more effective than another for improving these outcomes.
Plasma circN4BP2L2 is a promising novel diagnostic biomarker for epithelial ovarian cancer
Authors: Ning Li , Lang Jinghe , Wu Lingying
Published: January 2022

Background

Circular RNAs (circRNAs) are more stable than linear RNA molecules, which makes them promising diagnostic biomarkers for diseases. By circRNA-sequencing analysis, we previously found that circN4BP2L2 was significantly decreased in epithelial ovarian cancer (EOC) tissues, and was predictive of disease progression. The aim of this study was to evaluate the diagnostic value of plasma circN4BP2L2 in EOC.

Methods

Three hundred seventy-eight plasma samples were acquired prior to surgery. Samples were obtained from 126 EOC patients, 126 benign ovarian cyst patients, and 126 healthy volunteers. CircN4BP2L2 was assessed using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Cancer antigen 125 (CA125) and human epididymis protein 4 (HE4) were assessed using enzyme-linked immunosorbent assay (ELISA). EOC cells were transfected with small interference RNAs (siRNAs) and cell proliferation, migration, invasion, cell cycle and cell apoptosis were performed to assess the effect of circN4BP2L2 in EOC. Receiver operating curve (ROC), the area under the curve (AUC), sensitivity and specificity were estimated.

Results

Plasma circN4BP2L2 was significantly downregulated in EOC patients. Decreased circN4BP2L2 was significantly associated with advanced tumor stage, worse histological grade, lymph node metastasis and distant metastasis in EOC. CircN4BP2L2 inhibited tumor cell migration and invasion in vitro. CircN4BP2L2 could significantly separate EOC from benign (AUC = 0.82, P <  0.01) or normal (AUC = 0.90, P <  0.01) cohort. Early stage EOC vs benign (AUC = 0.81, P <  0.01) or normal (AUC = 0.90, P <  0.01) cohort could also be distinguished by circN4BP2L2. In discrimination between EOC cohort and benign or normal cohort, circN4BP2L2 performed equally well in both pre- and post-menopausal women. The combination of circN4BP2L2, CA125 and HE4 showed high sensitivity and specificity in detecting EOC cases.

Conclusions

Plasma circN4BP2L2 is significantly downregulated in EOC and might serve as a promising novel diagnostic biomarker for EOC patients, especially in early stage EOC cases. CircN4BP2L2 might act as an adjunct to CA125 and HE4 in detecting EOC. Further large-scale studies are warranted to verify our results.
Clinical features as potential prognostic factors in patients treated with nivolumab for highly pretreated metastatic gastric cancer: a multicenter retrospective study
Authors: Sano Akihiko , Sohda Makoto , Nakazawa Nobuhiro , Ubukata Yasunari , Kuriyama Kengo , Kimura Akiharu , Kogure Norimichi , Hosaka Hisashi , Naganuma Atsushi , Sekiguchi Masanori , Saito Kana , Ogata Kyoichi , Sakai Makoto , Ogawa Hiroomi , Shirabe Ken , Saeki Hiroshi
Published: January 2022

Background

Although nivolumab (anti-programmed cell death-1 antibody) is a promising approach for advanced gastric cancer (AGC), the response rate remains limited. The aim of this multicenter retrospective study was to determine if clinical features could serve as prognostic factors of the efficacy of nivolumab in patients with AGC.

Methods

Fifty-eight patients with AGC who were treated with nivolumab as a third or later line from October 2017 to December 2018 at any of five clinical sites were enrolled in the study. The correlation between the best overall response and clinical features was investigated. Overall survival and progression-free survival after initiation of nivolumab were calculated and clinical features that could be predictors of the prognosis were sought.

Results

The disease control rate (DCR) for nivolumab was 36.2% and was significantly correlated with performance status (p = 0.021), metastasis to one organ (p = 0.006), and grade 2 or higher immune-related adverse events (p = 0.027). There was also a significant association between response to nivolumab and ability to receive subsequent chemotherapy (p = 0.022). In the analysis of overall survival, the following variables were identified as being significantly associated with a poor outcome: Eastern Cooperative Oncology Group performance status ≥1, prior treatment with trastuzumab, no immune-related adverse events, lack of a response to nivolumab, and inability to receive subsequent chemotherapy.

Conclusion

The findings of this study suggest that nivolumab may be ineffective for AGC in patients with poor performance status and those with a history of treatment with trastuzumab.
Eribulin improved the overall survival from the initiation of first-line chemotherapy for HER2-negative advanced breast cancer: a multicenter retrospective study
Authors: Nakamoto Shogo , Watanabe Junichiro , Ohtani Shoichiro , Morita Satoshi , Ikeda Masahiko
Published: January 2022

Background

Eribulin methylate (eribulin) improved the overall survival (OS) of eribulin-treated patients with HER2-negative advanced breast cancer (ABC) in prospective and retrospective studies. However, the effect of eribulin on OS as first-line chemotherapy and the characteristics of the patients who benefited from eribulin remain unclear.

Methods

Between January 2011 and December 2016, 301 patients with HER2-negative ABC who started first-line chemotherapy at 3 institutions were retrospectively evaluated for OS from the initiation of first-line chemotherapy.

Results

We identified 172 patients (119 estrogen receptor-positive [ER+], 47 ER−, 6 unknown) who received eribulin (eribulin group) and 129 patients (92 ER+, 31 ER−, 6 unknown) who did not receive eribulin (non-eribulin group). The median OS from the initiation of first-line chemotherapy in the two groups was not statistically significant (869 vs. 744 days, P = 0.47, log-rank); however, in patients who received eribulin in later lines (≥3rd-line) and who had a history of perioperative chemotherapy with anthracycline- and/or taxane-based regimens, the median OS improved (1001 vs. 744 days, P = 0.037; and 834 vs. 464 days, respectively P = 0.032, respectively; Wilcoxon). Multivariate analyses revealed that a history of perioperative chemotherapy with anthracycline- and/or taxane-based regimens was a predictive factor (hazard ratio, 0.39; 95% confidence interval, 0.21–0.70) for OS.

Conclusions

This study successfully identified subgroups of HER2− ABC patients with improved OS by eribulin therapy. Selecting patients according to their background and line of treatment will maximize the efficacy of eribulin therapy.
Factors associated with response to compression-based physical therapy for secondary lower limb lymphedema after gynecologic cancer treatment: a multicenter retrospective study
Authors: Yoshihara Masato , Kitamura Kaoru , Tsuru Satoko , Shimono Ryoko , Sakuda Hiromi , Mayama Michinori , Tano Sho , Uno Kaname , Ukai Mayu Ohno , Kishigami Yasuyuki , Oguchi Hidenori , Hirota Akio
Published: January 2022

Background

Lower limb lymphedema (LLL) is one of the most refractory and debilitating complications related to gynecological cancer treatment. We investigated factors associated with response to compression-based physical therapy (CPT) for secondary LLL after gynecologic cancer treatment.

Methods

We performed a multicenter retrospective study using the records of seven medical institutions from 2002 and 2014. Patients who developed LLL after gynecological cancer treatment were included. Limb volumes were calculated from the lengths of the limb circumferences at four points. All participants underwent compression-based physical therapy for LLL. Factors, including MLD, indicative of circumference reductions in LLL were determined.

Results

In total, 1,034 LLL met the required criteria of for the study. A multivariate linear regression analysis identified age; body mass index (BMI); endometrial cancer; radiotherapy; and initial limb circumference as significant independent prognostic factors related to improvement in LLL. In analysis of covariance for improvement in LLL adjusted by the initial limb circumference and stratified by BMI and radiotherapy, patients with BMI 28 kg/m2or higher and receiving radiation rarely responded to CPT.

Conclusions

Improvements in the lower limb circumference correlated with clinical histories and physical characteristics, which may be used as independent prognostic factors for successful CPT for LLL after gynecological cancer treatment.