bluuebunny/crossref_metadata_2025 huggingface dataset:
Finite element analysis of intraosseous distal radioulnar joint prosthesis
Authors: Gholamian Farzaneh , Ashrafi Mehran , Moradi Ali
Published: August 2022

Background

Joint replacement is one of the options to retrieve the interosseous distal radioulnar joint (DRUJ) function. DRUJ prosthesis has recently been introduced clinically to treat DRUJ instability. This article analyzes the biomechanical behavior of the prosthesis during different loadings by the finite element method.

Methods

CT images of a healthy 33 years old man were used to construct the three-dimensional geometry of the forearm bone. Then two models, a healthy foreman (Model A) and a damaged model with an inserted interosseous prosthesis (Model B), were constructed to analyze and compare the foreman's biomechanical behavior under different loading conditions using the finite element method. Both models were examined during pronation and supination with 500, 1000, 2000, and 5000 N.mm values. Also, both models were subjected to volar and dorsal loads with values of 10, 30, and 50 N and traction force with 100, 150, and 200 N.

Results

Maximum and minimum principal stresses were evaluated for bones in all conditions, and von Mises stress was considered for the prosthesis and fixing screws. In supination, the maximum stress in Model A is significantly higher than the Model B. However, the maximum principal stress of both models is similar during volar and dorsal loading. In Model A, the maximum principal stress in traction is much smaller than in Model B. The absolute value of minimum principal stress in pronation and supination in Model B is higher than in Model A. The prostheses and screws are subjected to higher stresses during pronation than supination. Also, the amount of stress created in prostheses and screws during volar and dorsal loading is almost equal. In traction loading, screws are subjected to significantly high stresses.

Conclusion

Our study indicates that the interosseous DRUJ prosthesis can perform the foreman's normal daily activities. This prosthesis provides the ability similar to a normal hand.

Level of evidence

IV.
Anaerobic spondylodiscitis: a retrospective analysis
Authors: Chen Chien-Ting , Wu Meng-Huang , Huang Tsung-Yu , Li Yen-Yao , Huang Tsung-Jen , Lee Chien-Yin , Lin Che-Han , Lee Ching-Yu
Published: August 2022

Background

This retrospective study analyzed the clinical characteristics and outcomes of patients with anaerobic spondylodiscitis.

Methods

From a total of 382 patients with infectious spondylodiscitis, nine patients (2.4%; two male and seven female with an average age of 67 years) with anaerobic spondylodiscitis between March 2003 and March 2017 were analyzed.

Results

Most of the patients (77.8%) initially presented with afebrile back pain. Hematogenous spread occurred in seven patients and postoperative infection in two patients.Bacteroid fragiliswas the most common pathogen isolated from three patients. Atypical radiographic characteristics, including a vertebral fracture with the preservation of disk height or coexisting spondylolytic spondylolisthesis, occurred in four patients with hematogenous anaerobic spondylodiscitis. The eradication rate of anaerobic infection was significantly higher in the patients with hematogenous infection than in those with postoperative infection (100% vs. 0%,p = 0.0476). Anaerobic spondylodiscitis accounted for 2.4% of cases of infectious spondylodiscitis and predominantly affected the female patients.

Conclusions

Diagnostic delay may occur because of atypical spinal radiographs if the patient reports only back pain but no fever. Anaerobic infection following elective spinal instrumentation has a higher recurrence rate.
Refractory ascites after laparoscopic cholecystectomy: a case report
Authors: Cheng Xiaoyun , Huang Jin , Yang Aiming , Wang Qiang
Published: August 2022

Background

Laparoscopic cholecystectomy is a common surgical option for gallstone disease with minimal trauma and rapid recovery. Ascites is a relatively uncommon complication after laparoscopic cholecystectomy and is more frequently observed in patients with preoperative abnormal liver function. However, patients without underlying liver disease develop refractory ascites after laparoscopic cholecystectomy are rare. We report a case of massive ascites caused by lymphatic injury after laparoscopic cholecystectomy.

Case presentation

A 63-year-old woman complained of abdominal discomfort and distension at the twelfth day after a laparoscopic cholecystectomy for gallbladder stones. Subsequently, the patient developed spontaneous bacterial peritonitis and a decreased output of urine. Abdominal computed tomography (CT) identified abdominal effusion. The patient received abdominocentesis and the volume of slightly turbid yellow ascites averaged 1500–2000 ml per day. The results of laboratory analysis of ascitic fluid showed the following: serum-ascites albumin-gradient (SAAG), 11–12 g/L; albumin, 11–14 g/L; triglycerides, 0.91 mmol/L. After the diuretic therapy, repeated large-volume paracentesis with albumin supplementation, administration of antibiotics and renal vasodilating medications, the patient’s symptoms did not relieve. Lymphoscintigraphy found a small amount of radioactive filling in the abdominal cavity. The patient finally received surgery with detection and ligation of the lymphatic leak. The ascites disappeared and the patient recovered well.

Conclusions

For patients with atypical characteristics of chylous ascites, lymphoscintigraphy could help to localize and qualify the diagnosis. Surgical treatment could be considered when conservative treatment fails.
Predictors of physical activity promotion in clinical practice: a cross-sectional study among medical doctors
Authors: Silva Catarina Santos , Mendes Romeu , Godinho Cristina , Monteiro-Pereira Ana , Pimenta-Ribeiro Jaime , Martins Helena Silva , Brito João , Themudo-Barata José Luís , Fontes-Ribeiro Carlos , Teixeira Pedro J. , Freitas Graça , Silva Marlene Nunes
Published: August 2022

Background

Physical activity is a major determinant of physical and mental health. International recommendations identify health professionals as pivotal agents to tackle physical inactivity. This study sought to characterize medical doctors’ clinical practices concerning the promotion of patients’ physical activity, while also exploring potential predictors of the frequency and content of these practices, including doctors’ physical activity level and sedentary behaviours.

Methods

A cross-sectional study assessed physical activity promotion in clinical practice with a self-report questionnaire delivered through the national medical prescription software (naturalistic survey). Physical activity and sedentary behaviours were estimated using the International Physical Activity Questionnaire (short form). Indicators of medical doctors’ attitudes, knowledge, confidence, barriers, and previous training concerning physical activity promotion targeting their patients were also assessed. Multiple regression analysis was performed to identify predictors of physical activity promotion frequency by medical doctors, including sociodemographic, attitudes and knowledge-related variables, and physical activity behaviours as independent variables.

Results

A total of 961 medical doctors working in the Portuguese National Health System participated (59% women, mean age 44 ± 13 years) in the study. The majority of the participants (84.6%) reported to frequently promote patients’ physical activity. Five predictors of physical activity promotion frequency emerged from the multiple regression analysis, explaining 17.4% of the dependent variable (p < 0.001): working in primary healthcare settings (p = 0.037), having a medical specialty (p = 0.030), attributing a high degree of relevance to patients’ physical activity promotion in healthcare settings (p < 0.001), being approached by patients to address physical activity (p < 0.001), and having higher levels of physical activity (p = 0.001).

Conclusions

The sample of medical doctors approached reported a high level of engagement with physical activity promotion. Physical activity promotion frequency seems to be influenced by the clinical practice setting, medical career position and specialty, attitudes towards physical activity, and perception of patients´ interest on the topic, as well as medical doctors’ own physical activity levels.
Programs to encourage working as a general practitioner in rural areas: why do medical students not want to participate? A cross-sectional study
Authors: Sapoutzis Nikolaos , Schneider Antonius , Brandhuber Tom , Berberat Pascal O. , Wijnen-Meijer Marjo
Published: August 2022

Background

In many countries, not enough students are interested to work as general practitioners in rural areas. To solve this problem, several, sometimes partly extracurricular, programs have been developed. Most of these programs are based on continuity, which means that students stay in a rural region for an extended period of time, by completing clerkships. Although the effects of these programs are positive, it is often difficult to motivate students to participate. The purpose of the present study is to get insight into the reasons why students choose not to participate in these programs.

Methods

We carried out a questionnaire study among medical students in the clinical phase of the Technical University of Munich in Germany. First, we asked the students whether they actively informed themselves about the program which aims to reduce the shortage of general practitioners in rural areas in Bavaria. Furthermore, the questionnaire focused on the reasons for not participating in this program.

Results

Based on the answers of 442 students from study years 3–6, the most frequently chosen reason for not participating in the program is “identification with another discipline” with 61.0%, directly followed by “not willing to commit long-term” (56.1%). In third place is “personal connections to another region” with 30.5%. In the open comments, we find the same reasons: many students do not want to commit to a certain direction too early. In addition, students indicate that the number of regions where this program is offered is too limited for them.

Conclusions

Offering programs to prepare and motivate students for work as general practitioners in rural areas can contribute to increasing the pool of future general practitioners. To encourage students to participate in such a program, it is important to consider the motives of students. Many students who might be interested in general practice do not choose to take part in such a program because they do not want to commit to a particular specialty or region at an early stage. It is important to take these insights into account when designing and implementing these programs.
Visual oscillation effects on dynamic balance control in people with multiple sclerosis
Authors: Riem Lara , Beardsley Scott A. , Obeidat Ahmed Z. , Schmit Brian D.
Published: August 2022

Background

People with multiple sclerosis (PwMS) have balance deficits while ambulating through environments that contain moving objects or visual manipulations to perceived self-motion. However, their ability to parse object from self-movement has not been explored. The purpose of this research was to examine the effect of medial–lateral oscillations of the visual field and of objects within the scene on gait in PwMS and healthy age-matched controls using virtual reality (VR).

Methods

Fourteen PwMS (mean age 49 ± 11 years, functional gait assessment score of 27.8 ± 1.8, and Berg Balance scale score 54.7 ± 1.5) and eleven healthy controls (mean age: 53 ± 12 years) participated in this study. Dynamic balance control was assessed while participants walked on a treadmill at a self-selected speed while wearing a VR headset that projected an immersive forest scene. Visual conditions consisted of (1) no visual manipulations (speed-matched anterior/posterior optical flow), (2) 0.175 m mediolateral translational oscillations of the scene that consisted of low pairing (0.1 and 0.31 Hz) or (3) high pairing (0.15 and 0.465 Hz) frequencies, (4) 5 degree medial–lateral rotational oscillations of virtual trees at a low frequency pairing (0.1 and 0.31 Hz), and (5) a combination of the tree and scene movements in (3) and (4).

Results

We found that both PwMS and controls exhibited greater instability and visuomotor entrainment to simulated mediolateral translation of the visual field (scene) during treadmill walking. This was demonstrated by significant (p < 0.05) increases in mean step width and variability and center of mass sway. Visuomotor entrainment was demonstrated by high coherence between center of mass sway and visual motion (magnitude square coherence = ~ 0.5 to 0.8). Only PwMS exhibited significantly greater instability (higher step width variability and center of mass sway) when objects moved within the scene (i.e., swaying trees).

Conclusion

Results suggest the presence of visual motion processing errors in PwMS that reduced dynamic stability. Specifically, object motion (via tree sway) was not effectively parsed from the observer’s self-motion. Identifying this distinction between visual object motion and self-motion detection in MS provides insight regarding stability control in environments with excessive external movement, such as those encountered in daily life.
Postnatal women’s breastfeeding beliefs, practices, and support during the COVID-19 pandemic: a cross-sectional comparative study across five countries
Authors: Coca K. P. , Lee E. Y. , Chien L. Y. , Souza A. C. P. , Kittikul P. , Hong S. A. , Chang Y. S.
Published: August 2022

Background

Women with COVID-19 experienced numerous concerns and doubts about the safety of breastfeeding their babies, and lack of support may have impacted breastfeeding practices. This study aims to compare breastfeeding beliefs, practices, and contact with healthcare professionals regarding the level of postnatal feeding support provided during the COVID-19 pandemic in Brazil, South Korea, Taiwan, Thailand, and the United Kingdom.

Methods

A multi-country cross-sectional study was conducted with postnatal women in five countries. Women up to six months postpartum were invited to complete an online survey concerning the transmission of preventative measures, beliefs toward breastfeeding, infant feeding practices in the last 24 hours and experiences of postnatal infant feeding support between July to November 2021. Bivariate and multivariate analyses were performed to identify the association.

Results

Of the 3,253 eligible responses received, 39.5% of children were aged between one and two months, but in Taiwan (36%) and South Korea (42.8%) they were between three and four months. The mean of the belief score was significantly different among countries (p< 0.0001). Women in Brazil and the UK had a higher rate of breastfeeding at the breast (90.7% and 85.4%, respectively) compared to the three Asian countries (p< 0.0001) while feeding with expressed breastmilk in Thailand (59.9%), Taiwan (52.6%), and South Korea (50.4%) was higher than the others (p< 0.0001). Brazil and UK mothers (mean = 16.0 and 14.5 respectively) had a higher mean score for belief toward breastfeeding during the COVID-19 than the others. These results are inversely associated with breastfeeding but positively related to formula feeding practice. Postnatal feeding support during the COVID-19 pandemic was mainly provided by healthcare professionals (67.1%) and peers / family through face-to-face personal contact (51.6%) in all countries.

Conclusion

Some differences were found in breastfeeding beliefs during the COVID-19 pandemic in Asian countries. A positive breastfeeding belief was associated with the practice of breastfeeding at the breast. Women from all countries received postpartum infant feeding support from health professionals and peers / family through personal contacts. Governments need to emphasize and disseminate the importance of breastfeeding safety, especially in Asian countries.
Analysis of risk factors progression of preterm delivery using electronic health records
Authors: Safi Zeineb , Venugopal Neethu , Ali Haytham , Makhlouf Michel , Farooq Faisal , Boughorbel Sabri
Published: August 2022

Background

Preterm deliveries have many negative health implications on both mother and child. Identifying the population level factors that increase the risk of preterm deliveries is an important step in the direction of mitigating the impact and reducing the frequency of occurrence of preterm deliveries. The purpose of this work is to identify preterm delivery risk factors and their progression throughout the pregnancy from a large collection of Electronic Health Records (EHR).

Results

The study cohort includes about 60,000 deliveries in the USA with the complete medical history from EHR for diagnoses, medications and procedures. We propose a temporal analysis of risk factors by estimating and comparing risk ratios and variable importance at different time points prior to the delivery event. We selected the following time points before delivery: 0, 12 and 24 week(s) of gestation. We did so by conducting a retrospective cohort study of patient history for a selected set of mothers who delivered preterm and a control group of mothers that delivered full-term. We analyzed the extracted data using logistic regression and random forests models. The results of our analyses showed that the highest risk ratio and variable importance corresponds to history of previous preterm delivery. Other risk factors were identified, some of which are consistent with those that are reported in the literature, others need further investigation.

Conclusions

The comparative analysis of the risk factors at different time points showed that risk factors in the early pregnancy related to patient history and chronic condition, while the risk factors in late pregnancy are specific to the current pregnancy. Our analysis unifies several previously reported studies on preterm risk factors. It also gives important insights on the changes of risk factors in the course of pregnancy. The code used for data analysis will be made available on github.
Treatment shortening of drug-sensitive pulmonary tuberculosis using high-dose rifampicin for 3 months after culture conversion (Hi-DoRi-3): a study protocol for an open-label randomized clinical trial
Authors: Kwak Nakwon , Jeon Doosoo , Park Youngmok , Kang Young Ae , Kim Kyung Jong , Kim Young Ran , Kwon Byoung Soo , Kwon Yong-Soo , Kim Hyung-Jun , Lee Jae Ho , Lee Ji Yeon , Lee Jung-Kyu , Mok Jeongha , Cheon Minkyoung , Park Jiwon , Hahn Seokyung , Yim Jae-Joon
Published: August 2022

Background

The standard treatment regimen for drug-sensitive tuberculosis (TB), comprising four companion drugs, requires a minimum duration of 6 months, and this lengthy treatment leads to poor adherence and increased toxicity. To improve rates of adherence, reduce adverse events, and lower costs, a simplified and shortened treatment regimen is warranted.

Methods

This study is a multicenter, open-label randomized clinical trial of non-inferiority design that compares a new regimen with the conventional regimen for drug-sensitive pulmonary TB. The investigational group will use a regimen of high-dose rifampicin (30 mg/kg/day) with isoniazid and pyrazinamide, and the treatment will be maintained for 12 weeks after the achievement of negative conversion of sputum culture. The control group will be treated for 6 months with a World Health Organization-endorsed regimen consisting of isoniazid, rifampicin (10 mg/kg/day), ethambutol, and pyrazinamide. The primary endpoint is the proportion of unfavorable outcomes at 18 months after randomization. Secondary outcomes include time to unfavorable treatment outcome, time to culture conversion on liquid medium, treatment success rate at the end of treatment, proportion of recurrence at 18 months after randomization, time to recurrence after treatment completion, and adverse events of grade 3 or higher during the treatment. We predict a 10% unfavorable outcome for the control group, and 0% difference from the investigational group. Based on 80% verification power and a 2.5% one-sided significance level for a non-inferiority margin of 6%, 393 participants per group are required. Considering the 15% dropout rate, a total of 926 participants (463 in each group) will be recruited.

Discussion

This study will inform on the feasibility of the treatment regimen using high-dose rifampicin with a shortened and individualized treatment duration for pulmonary TB.

Trial registration

ClinicalTrials.gov NCT04485156. Registered on July 24, 2020.
Access to unpublished protocols and statistical analysis plans of randomised trials
Authors: Campbell David , McDonald Cassandra , Cro Suzie , Jairath Vipul , Kahan Brennan C.
Published: August 2022

Background

Access to protocols and statistical analysis plans (SAPs) increases the transparency of randomised trial by allowing readers to identify and interpret unplanned changes to study methods, however they are often not made publicly available. We sought to determine how often study investigators would share unavailable documents upon request.

Methods

We used trials from two previously identified cohorts (cohort 1: 101 trials published in high impact factor journals between January and April of 2018; cohort 2: 100 trials published in June 2018 in journals indexed in PubMed) to determine whether study investigators would share unavailable protocols/SAPs upon request. We emailed corresponding authors of trials with no publicly available protocol or SAP up to four times.

Results

Overall, 96 of 201 trials (48%) across the two cohorts had no publicly available protocol or SAP (11/101 high-impact cohort, 85/100 PubMed cohort). In total, 8/96 authors (8%) shared some trial documentation (protocol only [n = 5]; protocol and SAP [n = 1]; excerpt from protocol [n = 1]; research ethics application form [n = 1]). We received protocols for 6/96 trials (6%), and a SAP for 1/96 trial (1%). Seventy-three authors (76%) did not respond, 7 authors responded (7%) but declined to share a protocol or SAP, and eight email addresses were invalid (8%). A total of 329 emails were sent (an average of 41 emails for every trial which sent documentation). After emailing authors, the total number of trials with an available protocol increased by only 3%, from 52% in to 55%.

Conclusions

Most study investigators did not share their unpublished protocols or SAPs upon direct request. Alternative strategies are needed to increase transparency of randomised trials and ensure access to protocols and SAPs.
Long-term effects of intensive multifactorial treatment on aortic stiffness and central hemodynamics after 13 years with screen-detected type 2 diabetes: the ADDITION-Denmark trial
Authors: Bjerg Lasse , Laugesen Esben , Andersen Signe Toft , Rosborg Jonas Frey , Charles Morten , Vistisen Dorte , Witte Daniel R.
Published: August 2022

Background

Peripheral and central hemodynamic indices are modifiable by lifestyle and medical intervention. We aimed to determine the long-term effect of intensive multifactorial treatment on peripheral and central hemodynamic indices among people with screen-detected diabetes.

Methods

Between 2001 and 2006, people with screen-detected type 2 diabetes were included in the Anglo-Danish-Dutch study of Intensive Treatment of Diabetes in Primary Care (ADDITION) trial (NCT00237549, ClinicalTrials.gov). In the Danish arm, participants were invited to a clinical examination in 2015–2016, 13 years after inclusion and 8 years after trial-end. Out of 586 eligible participants who attended the clinical examination, 411 had a valid examination of central and peripheral hemodynamic indices (242 received intensive treatment and 169 received routine care). Carotid-femoral pulse wave velocity (cfPWV), central blood pressure and augmentation index were assessed by applanation tonometry. We used mixed-effect models to examine the intervention effect adjusting for cluster randomization and heart rate.

Results

Randomization to intensive treatment during the trial-period was associated with a 0.58 m/s lower cfPWV (95% CI − 1.09 to − 0.06) at follow-up. Adjustment for blood pressure attenuated the association. Differences between intervention groups for central augmentation index were − 1.25% (95% CI: − 3.28 to 0.78), central pulse pressure − 1.74 mmHg (95% CI − 4.79 to 1.31), central systolic blood pressure − 3.06 mmHg (− 7.08 to 0.96), and central diastolic blood pressure − 1.70 mmHg (− 3.74 to 0.34).

Conclusions

Intensive multifactorial treatment of screen-detected type 2 diabetes has a sustained positive effect on aortic stiffness measured by cfPWV. Although all estimates pointed in favor of intensive treatment, we observed no clear beneficial effect on other hemodynamic indices.
Quality assurance for automatically generated contours with additional deep learning
Authors: Isaksson Lars Johannes , Summers Paul , Bhalerao Abhir , Gandini Sara , Raimondi Sara , Pepa Matteo , Zaffaroni Mattia , Corrao Giulia , Mazzola Giovanni Carlo , Rotondi Marco , Lo Presti Giuliana , Haron Zaharudin , Alessi Sara , Pricolo Paola , Mistretta Francesco Alessandro , Luzzago Stefano , Cattani Federica , Musi Gennaro , De Cobelli Ottavio , Cremonesi Marta , Orecchia Roberto , Marvaso Giulia , Petralia Giuseppe , Jereczek-Fossa Barbara Alicja
Published: August 2022

Objective

Deploying an automatic segmentation model in practice should require rigorous quality assurance (QA) and continuous monitoring of the model’s use and performance, particularly in high-stakes scenarios such as healthcare. Currently, however, tools to assist with QA for such models are not available to AI researchers. In this work, we build a deep learning model that estimates the quality of automatically generated contours.

Methods

The model was trained to predict the segmentation quality by outputting an estimate of the Dice similarity coefficient given an image contour pair as input. Our dataset contained 60 axial T2-weighted MRI images of prostates with ground truth segmentations along with 80 automatically generated segmentation masks. The model we used was a 3D version of the EfficientDet architecture with a custom regression head. For validation, we used a fivefold cross-validation. To counteract the limitation of the small dataset, we used an extensive data augmentation scheme capable of producing virtually infinite training samples from a single ground truth label mask. In addition, we compared the results against a baseline model that only uses clinical variables for its predictions.

Results

Our model achieved a mean absolute error of 0.020 ± 0.026 (2.2% mean percentage error) in estimating the Dice score, with a rank correlation of 0.42. Furthermore, the model managed to correctly identify incorrect segmentations (defined in terms of acceptable/unacceptable) 99.6% of the time.

Conclusion

We believe that the trained model can be used alongside automatic segmentation tools to ensure quality and thus allow intervention to prevent undesired segmentation behavior.
The use of ICU resources in CAR-T cell recipients: a hospital-wide study
Authors: Valade Sandrine , Darmon Michael , Zafrani Lara , Mariotte Eric , Lemiale Virginie , Bredin Swann , Dumas Guillaume , Boissel Nicolas , Rabian Florence , Baruchel André , Madelaine Isabelle , Larghero Jérôme , Brignier Anne , Lengliné Etienne , Harel Stéphanie , Arnulf Bertrand , Di Blasi Roberta , Thieblemont Catherine , Azoulay Elie
Published: August 2022

Background

CAR-T cell (chimeric antigen receptor T) therapy has emerged as an effective treatment of refractory hematological malignancies. Intensive care management is intrinsic to CAR-T cell therapy. We aim to describe and to assess outcomes in critically ill CAR-T cell recipients.

Study design and methods

Hospital-wide retrospective study. Consecutive CAR-T cell recipients requiring ICU admission from July 2017 and December 2020 were included.

Results

71 patients (median age 60 years [37–68]) were admitted to the ICU 6 days [4–7] after CAR-T cell infusion. Underlying malignancies included diffuse large B cell lymphoma (n = 53, 75%), acute lymphoblastic leukemia (17 patients, 24%) and multiple myeloma (n = 1, 1.45%). Performance status (PS) was 1 [1–2]. Shock was the main reason for ICU admission (n = 40, 48%). Isolated cytokine release syndrome (CRS) was the most common complication (n = 33, 46%), while 21 patients (30%) had microbiologically documented bacterial infection (chiefly catheter-related infection). Immune effector cell-associated neurotoxicity syndrome was reported in 26 (37%) patients. At ICU admission, vasopressors were required in 18 patients (25%) and invasive mechanical ventilation in two. Overall, 49 (69%) and 40 patients (56%) received tocilizumab or steroids, respectively.

Determinant of mortality were the reason for ICU admission (disease progression vs. sepsis or CRS (HR 4.02 [95%CI 1.10–14.65]), Performance status (HR 1.97/point [95%CI 1.14–3.41]) and SOFA score (HR 1.16/point [95%CI 1.01–1.33]).

Conclusions

Meaningful survival could be achieved in up to half the CAR-T cell recipients. The severity of organ dysfunction is a major determinant of death, especially in patients with altered performance status or disease progression.
IL-1β promotes A7r5 and HASMC migration and invasion via the p38-MAPK/Angpt-2 pathway
Authors: Xu Anyu , Pei Jingchun , Yang Yunhong , Hua Baotong , Wang Jing
Published: August 2022

The migration, proliferation, and inflammatory factor secretion of vascular smooth muscle cells (VSMCs) are involved in the important pathological processes of several vascular occlusive diseases, including coronary atherosclerosis (CAS). Interleukin 1β(IL-1β), as a bioactive mediator of VSMC synthesis and secretion, can promote the pathological progress of CAS. In this study, we further explored the underlying molecular mechanisms by which IL-1β regulates VSMC migration, invasion. We pretreated A7r5 and HASMC with IL-1β for 24 h, and measured the expression of IL-1β, proliferating cell nuclear antigen (PCNA), cyclin D1, matrix metalloproteinase 2 (MMP2) and matrix metalloproteinase 2 (MMP9) in the cells by Western blotting. Cell migration and invasion ability were measured by Transwell and wound healing assays. Cell viability was measured by an MTT assay. We found that IL-1β upregulated the expression of proliferation-related proteins (PCNA and Cyclin D1) in A7r5 and HASMC, and induces the secretion of MMP2 and MMP9, promotes cell invasion and migration. In addition, in A7r5 and HASMCs treated with IL-1β, the expression of Angiopoietin-2 (Angpt-2) increased in a time-dependent manner, transfection with si-Angpt-2 suppressed cell migration and invasion, with downregulated MMP2 and MMP9 expression. Parallelly, we further found that the p38-MAPK pathway is activated in cells induced by IL-1β, p38-MAPK inhibitors can down-regulate the expression of Angpt-2. Collectively, these data demonstrated that IL-1β promotes A7r5 and HASMC migration and invasion via the p38-MAPK/Angpt-2 pathway.
Effects of topography and sea surface temperature anomalies on heavy rainfall induced by Typhoon Chaba in 2016
Authors: Cho Woojin , Park Jinyoung , Moon Jihong , Cha Dong-Hyun , Moon Yu-min , Kim Hyeon-Sung , Noh Kyoung-jo , Park Sang-Hwan
Published: August 2022

Typhoon Chaba made landfall on the Korean Peninsula in the fall of 2016, resulting in record-breaking rainfall in southeastern Korea. In particular, the Ulsan metropolitan region experienced the most severe floods due to heavy rainfall of 319 mm for just 3 h. The heavy rainfall was possibly associated with the mountainous southeastern Korea topography and the warm sea surface temperature (SST) anomaly in the East China Sea. In this study, the Weather Research and Forecasting (WRF) model was used to investigate the effects of topography and SST anomalies through high-resolution numerical experiments. Simulation using original topography showed more rainfall on the windward and less on the leeward slope compared to the experiment with reduced topography around Ulsan. The moist flow in the typhoon was raised by orographic uplift, enhancing precipitation on the windward side and summits of the mountains. The orographically induced updraft extended to the mid-troposphere and contributed to the upward vertical moisture flux associated with rainfall. Therefore, the mountainous topography around Ulsan affected the local change in rainfall induced by the simulated typhoon. In addition, SST on the track of the typhoon controlled storm intensity and caused extreme precipitation changes. The experiment using the original SST in the East China Sea simulated less decayed typhoons and produced more precipitation compared to the experiment wherein the positive SST anomaly in the East China Sea was removed. The warm SST anomaly hindered the weakening of the typhoon moving northward to the mid-latitudes. At landfall, the stronger typhoon contained more water vapor, transported more moisture inland, and generated increased precipitation.
Numerical experiments on tsunami flow depth prediction for clustered areas using regression and machine learning models
Authors: Kamiya Masato , Igarashi Yasuhiko , Okada Masato , Baba Toshitaka
Published: August 2022

Emergency responses during a massive tsunami disaster require information on the flow depth of land for rescue operations. This study aims to predict tsunami flow depth distribution in real time using regression and machine learning. Training data of 3480 earthquake-induced tsunamis in the Nankai Trough were constructed by numerical simulations. Initially, the k-means method was used to discriminate the areas with approximately the same flow depth. The number of clustered areas was 18, and the standard deviation of the flow depth data in a cluster was 0.46 m on average. The objective variables were the mean and standard deviation of the flow depth in the clustered areas. The explanatory variables were the maximum deviation of the water pressure at the seafloor observation points of the DONET observatory. We generated multiple regression equations for a power law using these datasets and the conjugate gradient method. Further, we employed the multilayer perceptron method, a machine learning technique, to evaluate the prediction performance. Both methods accurately predicted the tsunami flow depth calculated by testing 11 earthquake scenarios in the cabinet office of the government of Japan. The RMSE between the predicted and the true (via forward tsunami calculations) values of the mean flow depth ranged from 0.34–1.08 m. In addition to large-scale tsunami prediction systems, prediction methods with a robust and light computational load as used in this study are essential to prepare for unforeseen situations during large-scale earthquakes and tsunami disasters.

Graphical Abstract
The influence of gluteal muscle strength deficits on dynamic knee valgus: a scoping review
Authors: Rinaldi Vito Gaetano , Prill Robert , Jahnke Sonja , Zaffagnini Stefano , Becker Roland
Published: August 2022

Anterior cruciate ligament (ACL) injuries are caused by both contact and non-contact injuries. However, it can be claimed that non-contact ones account approximately for 70% of all cases. Thus, several authors have emphasized the role of reduction of muscle strength as a modifiable risk factor referred to non-contact ACL injury, with the latter being targeted by specific training interventions.

The present paper wants to review the available literature specifically on the relationship between dynamic knee valgus, gluteal muscles (GM) strength, apart from the potential correlation regarding ACL injury.

After a research based on MEDLINE via PubMed, Google scholar, and Web of Science, a total of 29 articles were collected and thus included.

Additionally, this review highlights the crucial role of gluteal muscles in maintaining a correct knee position in the coronal plane during different exercises, namely walking, running, jumping and landing.
Characterization of water masses around the southern Ryukyu Islands based on isotopic compositions
Authors: Cruz Salmeron Andros Daniel , Takayanagi Hideko , Wakaki Shigeyuki , Ishikawa Tsuyoshi , Miyajima Toshihiro , Wakaki Hitomi , Itaki Takuya , Iryu Yasufumi
Published: August 2022

We investigated the water-mass structure on the Okinawa Trough and Pacific sides of the southern Ryukyu Island Arc (Yonaguni, Iriomote, and Ishigaki subareas) using the Nd isotope composition (143Nd/144Nd ratios; expressed as εNd values) of benthic foraminiferal tests in surface sediments, which reflect bottom-water composition, along with hydrogen and oxygen isotope compositions (δD and δ18O values, respectively) and physical properties (temperature and salinity) of seawater. The Okinawa Trough side has lower εNd values than the Pacific side due to continental/island material inputs characterized by relatively low εNd values. Moreover, within the Okinawa Trough, other processes control the Nd behavior of seawater and primarily affect the Yonaguni and Iriomote subareas, as follows. (1) Surface and subsurface waters are influenced by Taiwanese river discharge combined with temporospatial variations in oceanographic conditions including Kuroshio Current meandering. (2) Intermediate water is characterized by low εNd values (down to − 8.2), possibly attributable to sediment plumes and turbiditic fluxes. (3) The εNd values of bottom water indicate upwelling and vertical mixing, with composition therefore being similar to those of intermediate water. The εNd profiles are better defined on the Pacific side. High εNd values occur in surface and subsurface (< 300 m depth, potential density < 25.0 kg m−3) waters, and low values (down to − 7.0) occur in subsurface–core-intermediate water (400–600 m depth, 26–27 kg m−3). εNd values increase slightly to − 4.0 below 750 m depth and remain constant down to about 2000 m depth, below which deep water shows a slight decrease in εNd values. Intermediate and bottom/deep waters are distinguished from upper layers by their lower δD and δ18O values.
Sequencing introduced false positive rare taxa lead to biased microbial community diversity, assembly, and interaction interpretation in amplicon studies
Authors: Jia Yangyang , Zhao Shengguo , Guo Wenjie , Peng Ling , Zhao Fang , Wang Lushan , Fan Guangyi , Zhu Yuanfang , Xu Dayou , Liu Guilin , Wang Ruoqing , Fang Xiaodong , Zhang He , Kristiansen Karsten , Zhang Wenwei , Chen Jianwei
Published: August 2022

Background

Increasing studies have demonstrated potential disproportionate functional and ecological contributions of rare taxa in a microbial community. However, the study of the microbial rare biosphere is hampered by their inherent scarcity and the deficiency of currently available techniques. Sample-wise cross contaminations might be introduced by sample index misassignment in the most widely used metabarcoding amplicon sequencing approach. Although downstream bioinformatic quality control and clustering or denoising algorithms could remove sequencing errors and non-biological artifact reads, no algorithm could eliminate high quality reads from sample-wise cross contaminations introduced by index misassignment, making it difficult to distinguish between bona fide rare taxa and potential false positives in metabarcoding studies.

Results

We thoroughly evaluated the rate of index misassignment of the widely used NovaSeq 6000 and DNBSEQ-G400 sequencing platforms using both commercial and customized mock communities, and observed significant lower (0.08% vs. 5.68%) fraction of potential false positive reads for DNBSEQ-G400 as compared to NovaSeq 6000. Significant batch effects could be caused by stochastically introduced false positive or false negative rare taxa. These false detections could also lead to inflated alpha diversity of relatively simple microbial communities and underestimated that of complex ones. Further test using a set of cow rumen samples reported differential rare taxa by different sequencing platforms. Correlation analysis of the rare taxa detected by each sequencing platform demonstrated that the rare taxa identified by DNBSEQ-G400 platform had a much higher possibility to be correlated with the physiochemical properties of rumen fluid as compared to NovaSeq 6000 platform. Community assembly mechanism and microbial network correlation analysis indicated that false positive or negative rare taxa detection could lead to biased community assembly mechanism and identification of fake keystone species of the community.

Conclusions

We highly suggest proper positive/negative/blank controls, technical replicate settings, and proper sequencing platform selection in future amplicon studies, especially when the microbial rare biosphere would be focused.
Competition-cooperation in the chemoautotrophic ecosystem of Movile Cave: first metagenomic approach on sediments
Authors: Chiciudean Iulia , Russo Giancarlo , Bogdan Diana Felicia , Levei Erika Andrea , Faur Luchiana , Hillebrand-Voiculescu Alexandra , Moldovan Oana Teodora , Banciu Horia Leonard
Published: August 2022

Background

Movile Cave (SE Romania) is a chemoautotrophically-based ecosystem fed by hydrogen sulfide-rich groundwater serving as a primary energy source analogous to the deep-sea hydrothermal ecosystems. Our current understanding of Movile Cave microbiology has been confined to the sulfidic water and its proximity, as most studies focused on the water-floating microbial mat and planktonic accumulations likely acting as the primary production powerhouse of this unique subterranean ecosystem. By employing comprehensive genomic-resolved metagenomics, we questioned the spatial variation, chemoautotrophic abilities, ecological interactions and trophic roles of Movile Cave’s microbiome thriving beyond the sulfidic-rich water.

Results

A customized bioinformatics pipeline led to the recovery of 106 high-quality metagenome-assembled genomes from 7 cave sediment metagenomes. Assemblies’ taxonomy spanned 19 bacterial and three archaeal phyla withAcidobacteriota,Chloroflexota,Proteobacteria,Planctomycetota,Ca.Patescibacteria,Thermoproteota,Methylomirabilota,andCa.Zixibacteria as prevalent phyla. Functional gene analyses predicted the presence of CO2fixation, methanotrophy, sulfur and ammonia oxidation in the explored sediments. Species Metabolic Coupling Analysis of metagenome-scale metabolic models revealed the highest competition-cooperation interactions in the sediments collected away from the water. Simulated metabolic interactions indicated autotrophs and methanotrophs as major donors of metabolites in the sediment communities. Cross-feeding dependencies were assumed only towards 'currency' molecules and inorganic compounds (O2, PO43−, H+, Fe2+, Cu2+) in the water proximity sediment, whereas hydrogen sulfide and methanol were assumedly traded exclusively among distant gallery communities.

Conclusions

These findings suggest that the primary production potential of Movile Cave expands way beyond its hydrothermal waters, enhancing our understanding of the functioning and ecological interactions within chemolithoautotrophically-based subterranean ecosystems.
Melphalan intra-arterial chemotherapy for choroidal melanoma chemoreduction
Authors: Jorge Rodrigo , Coelho Igor , Viani Gustavo , Vieira Amanda Alexia R. , Chahud Fernando , Abud Daniel G. , Correa Zelia M.
Published: August 2022

Background

Intra-arterial chemotherapy (IAC) has been used to treat multiple cancers including liver metastasis from uveal and cutaneous melanoma but not as primary tumor treatment. We report the compassionate use of chemoreduction with intra-arterial melphalan before ruthenium brachytherapy to salvage an eye with choroidal melanoma.

Case presentation

A 61-year-old female patient complained of decreased vision and central-temporal scotoma in OS (left eye) for 1 month. Visual acuity was 20/20 in right eye (OD) and 20/125 OS. Anterior segment examination and intraocular pressure were unremarkable in both eyes, as was fundus examination of the OD. Fundus examination of OS revealed a brown, solid tumor partially obscuring the temporal optic disc margin and extending to the equatorial fundus midzone. Serous retinal detachment was present over the lesion and around it. Ultrasonography revealed a solid choroidal tumor with a largest basal diameter (LBD) of 13.0 mm and thickness of 10.4 mm. The tumor presented acoustic hollowness and a superimposing retinal detachment. After metastatic screening was negative, the patient underwent intra-arterial chemotherapy with melphalan. Three weeks later, her visual acuity was 20/200 and there was noticeable tumor regression to 11.9 mm (LBD) by 7.9 mm (thickness) allowing brachytherapy to be performed. Ten weeks after brachytherapy (13 weeks after IAC), visual acuity was HM due to biopsy-related vitreous hemorrhage (VH). Tumor dimensions were 9.9 (LBD) mm and 6.5 mm (thickness) and PPV was performed to remove VH. Six weeks after PPV (20 weeks after IAC), her visual acuity was 20/200 and further reduction of tumor dimensions was observed: largest basal diameter was 8.9 mm and thickness was 4.9 mm.

Conclusion

This case illustrates the feasibility of combining induction IAC prior to ruthenium brachytherapy for large choroidal melanoma. More studies are warranted to confirm these early preliminary findings.
Validity of foetal Doppler indices in predicting postnatal respiratory distress syndrome: a prospective study
Authors: Keshuraj Veena , Prakash Arjun , Boruah Deb K. , Ramanna H. C. , Sowmyashree A. R. , Mithun S. K.
Published: August 2022

Background

Respiratory distress syndrome (RDS) is a potentially fatal condition of neonate occurring due to alveolar surfactant deficiency causing inefficient gaseous exchange and leading to hampered respiratory function. Purpose of our study is to investigate the role of Doppler indices in antenatal prediction of clinical Respiratory Distress Syndrome (RDS) in late preterm and early term foetuses using Main pulmonary artery (MPA) Doppler indices. The current study was conducted on 342 pregnant women between 34 and 39 weeks of gestational age, who came for routine third trimester ultrasound examination. The standard foetal biometric parameters, gestational age and estimated foetal weight were first obtained. The MPA Doppler indices like pulsatility index (PI), resistivity index (RI), peak systolic velocity (PSV), systolic/diastolic ratio and acceleration time/ejection time (At/Et) were recorded and correlated with the postnatal development of RDS.

Results

Of the 342 foetuses, neonatal RDS was diagnosed in 47 foetuses. Foetuses diagnosed with RDS had statistically higher PI and RI values, whereas At/Et ratio and PSV were lower. At/Et ratio, PI and RI, PSV showed significant correlation with gestational age and the most statistically significant correlation was found with At/Et ratio. A cut-off value of 0.2865 (sensitivity 89.45%, specificity 94.79%) and 0.3155 (sensitivity 93.22%, specificity 96.78%) correlated strongly with development of RDS in late preterm foetuses and early term infants.

Conclusion

Foetal MPA indices like PSV, RI, PI and especially Foetal At/Et ratio is a promising non-invasive tool which helps in identifying foetuses at risk and may be very useful to plan delivery in complicated pregnancies and also for better post-natal care of the neonate.