bluuebunny/crossref_metadata_2025 huggingface dataset:
Bombesin receptor-activated protein exacerbates cisplatin-induced AKI by regulating the degradation of SIRT2
Authors: Peng Liang , Liu Di , Liu Haiyang , Xia Ming , Wan Lili , Li Mei , Zhao Junyong , Tang Chengyuan , Chen Guochun , Qu Xiangpin , Dong Zheng , Liu Hong
Published: April 2022

Background

Acute kidney injury (AKI) is a public health problem with no specific therapies in the clinic and the underlying pathogenesis of AKI remains obscure. Bombesin receptor-activated protein (BRAP, C6ORF89 protein) was initially discovered as a ligand for a previously orphan G-protein-coupled receptor bombesin-like receptor-3. At present, accepted biological effects of BRAP include cell cycle progression, wound repair and the activation of histone deacetylases. However, its role in kidney disease is unknown. In this study we have investigated the role of BRAP and underlying mechanisms involved in cisplatin (CP)-induced AKI.

Methods

Here we used Bc004004 (homologous of C6ORF89 in mice) knockout mice and HK2 cells to investigate the effect of BRAP on AKI in vitro and in vivo. We analyzed ChIP-Seq and RNA-Seq data to search for the upstream regulators of BRAP and downstream mediators of BRAP action in AKI. Immunostaining, real-time polymerase chain reaction (PCR), co-immunoprecipitation, a dual-luciferase reporter assay and ChIP-PCR assay were applied to reveal the upstream and downstream regulation mechanism of BRAP during cisplatin-induced AKI.

Results

BRAP was downregulated in mice and human kidneys with AKI. Global Bc004004 deletion alleviated tubular cell apoptosis and necroptosis in CP-induced AKI mice, whereas local overexpression of BRAP in kidneys aggravated them. Pan-caspase inhibitor Z-VAD pretreatment attenuated CP-induced blood creatinine increase and kidney injury in wild-type mice but not in BRAP -/- mice. The activation of mixed lineage kinase like-domain was magnified by Z-VAD in CP-treated mice, especially in BRAP -/- mice. The cytoprotective effect of Z-VAD was more substantial than necrostatin-1 (Nec-1, an inhibitor of necroptosis) in CP-treated human kidney proximal tubular epithelial (HK2) cells. Furthermore, Nec-1 pretreatment reduced the CP-induced cell death in BRAP overexpression HK2 cells but did not work in cells with normal BRAP levels. We determined that CP treatment activated the nuclear factor-κB subunit P65 and inhibition of P65 increased the messenger RNA (mRNA) levels of BRAP in HK2 cells. The chromatin immunoprecipitation assay and dual-luciferase reporter gene assay verified P65 binding to the C6ORF89 promoter and reduced its mRNA expression upon CP treatment. Next we found that sirtuin 2 (SIRT2) was downregulated in CP-induced AKI and BRAP levels directly impacted the protein levels of SIRT2. Our findings further confirmed that BRAP regulates the SIRT2 protein levels by affecting SIRT2’s interactions with E3 ubiquitin ligase HRD1 and subsequent proteasomal degradation.

Conclusions

Our results demonstrated that BRAP played an important role in tubular cell apoptosis and necroptosis during CP-induced AKI. Safe and efficient BRAP inhibitors might be effective therapeutic options for AKI.
Time to Mammographic Density Decrease After Exposure to Tamoxifen
Authors: Bäcklund Magnus , Eriksson Mikael , Hammarström Mattias , Thoren Linda , Bergqvist Jenny , Margolin Sara , Hellgren Roxanna , Wengström Yvonne , Gabrielson Marike , Czene Kamila , Hall Per
Published: April 2022

Mammographic density change has proven to be a reliable proxy for tamoxifen therapy response. The primary aim of this study was to identify time to tamoxifen-induced mammographic density change. We also analyzed side effects and adherence to therapy. In all, 42 women were randomized to 10 or 20 mg of daily oral tamoxifen. Mammograms were taken at baseline, 3, 6, and 9 months. Mammographic density change was measured using the automated STRATUS tool. Adverse events were monitored through a web-based questionnaire based on the FACT-ES tool. Nine out of the 42 (21%) participants discontinued therapy due to adverse events leaving 33 women in the study. A significant decrease in density was seen after 3 months of therapy. Dose did not seem to affect density change, side effects or adherence. Given the size of the study, additional studies are needed to confirm our data.
Interpreting Convergences and Divergences in Multi-Informant, Multimethod Assessment
Authors: De Los Reyes Andres , Makol Bridget A.
Published: April 2022

Individuals often vary in how they display signs and symptoms of personality disturbances and psychopathology. As such, comprehensive assessments of these signs and symptoms should capture how they manifest within and across time and contexts (e.g., community, home, and work). Contexts may vary in the degree to which they influence personality and psychopathology concerns. Thus, practitioners and researchers often rely on multiple informants and methodologies to characterize intervention targets, monitor intervention progress, and inform the selection of evidence-based services. Across research teams and assessment domains, researchers commonly observe diverging outcomes among assessments, depending on the informant and/or method. This chapter reviews theory and research that demonstrate how patterns of divergence observed in multi-informant, multimethod assessments represent valid individual differences in clinical presentations. This divergence may inform interpretations of personality and psychopathology functioning clinically; the chapter advances a research agenda to improve their use when assessing and diagnosing adult personality and psychopathology.
The Core Self–Other Dimension of Personality Functioning
Authors: Hopwood Christopher J. , Fox Sydney , Bender Donna S. , Zimmermann Johannes
Published: April 2022

This chapter describes the core self–other dimension of personality functioning that has a long history in psychiatric taxonomy and which defines personality disorder in the Alternative Model of Personality Disorders in the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders. The chapter first summarizes theoretical models of personality function/dysfunction. It then reviews empirical evidence regarding personality dysfunction and appraises assessment instruments designed to assess personality dysfunction. Given the variability in how personality dysfunction has been measured and conceptualized in research, the chapter next highlights the most pressing questions for ongoing research. The chapter concludes with a case that demonstrates the clinical importance of personality dysfunction.
FIRST CARDIAC COMPUTED TOMOGRAPHY TYPICAL RADIATION DOSE VALUES FROM A SINGLE CENTRE IN NIGERIA: A PILOT STUDY
Authors: Garba I , Fatima A M , Mansur Y , Ismail A , Abubakar A
Published: April 2022

Concern regarding radiation dose associated with cardiac computed tomography (CT) still exists and requires the use of diagnostic reference levels for dose optimisation. Typical median doses were established for 58 consented adult patients from a single centre for coronary artery calcium score (CACS) as volume computed tomography dose index (CTDIvol): 5.9 mGy; dose length product (DLP): 86.6 mGy*cm and cardiac CT angiography (CCTA) as CTDIvol: 11.1 mGy; DLP: 190.8 mGy*cm. Wide radiation dose variability in terms of CTDIvol was noted for CACS: 2.7–15.9 mGy, a 6-fold, whereas for CCTA it ranges from 3.8 to 52.8 mGy, a 14-fold. The DLP values for CACS range from 33.2 to 344.2 mGy*cm, which is 10-fold, whereas for CCTA it ranges from 32.8 to 834.9 mGy*cm, a 25-fold. The typical values compared lower than the radiation dose from other countries; however, the wide variability in dose remains a call for concern.
Emerging computational technologies in human leishmaniasis: where are we?
Authors: Tuon Felipe Francisco , Amato Valdir Sabagga , Zequinao Tiago , Cruz June Alisson Westarb
Published: April 2022

Human leishmaniasis is a neglected tropical disease (NTD) with high morbidity and is endemic in low- to middle-income countries. Its diagnosis, treatment and epidemiological control methods are outdated and obsolete, which has become a challenge for health practitioners in controlling the disease. Computational methods have proven to be beneficial and have become popular in many fields of medicine, especially in affluent countries. However, they have not been widely used for NTDs. To date, few computational technologies have been employed for leishmaniasis. Although new technologies in leishmaniasis are theorized, they have only been minimally applied and have not been updated, even in other infections. Research and development on NTDs suffers from the inherent difficulties of the demographic regions the diseases afflict. In this narrative review we described the e-tools available in managing leishmaniasis, ranging from drug discovery to treatment.
Imaging and Management of Unusual Breast Neoplasms
Authors: Iorfido Suzanne M. Smith , Makariou Erini , Crane Erin P. , Willey Shawna C. , Jeon Janice Y.
Published: April 2022

Unusual breast neoplasms encompass a host of heterogeneous benign, borderline, and malignant entities, which often pose a management challenge when encountered on pathologic analysis after image-guided biopsy. Entities to be discussed in this article include select lesions of fibroepithelial, mesenchymal, and myoepithelial origin and nonneoplastic inflammatory lesions. Our objective is to discuss the imaging characteristics of these uncommon lesions and review management guidelines to facilitate radiologic-pathologic correlation and postbiopsy recommendations.
A rare case of dual congenital coronary cameral fistula and myocardial bridge
Authors: Shen Yong
Published: April 2022

Rationale:

A coronary artery fistula (CAF) is an anomalous communication between a coronary artery and a cardiac chamber or great vessel. It is a rare congenital anomaly that is often small and asymptomatic, occurring in only 0.002% of the general population. Most CAFs originate from the right coronary artery and flow into the right cardiac system. Although extremely rare, some cases may originate from the bilateral coronary arteries and flow into the left ventricle.

Patient concerns:

Herein, we report a rare case of a 55-year-old male smoker with no history of heart disease or cardiac surgery, who presented with a 5-year history of recurrent chest congestion, palpitations, and shortness of breath. On physical examination, his heart and lungs revealed normal findings without cardiac murmurs and no systemic or pulmonary edema. Moreover, 24-hour ambulatory electrocardiography showed no signs of ischemia but exhibited a short array of ventricular tachycardia and short atrial tachycardia. Chest computed tomography showed left apical emphysema without cardiomegaly and pulmonary congestion. Furthermore, coronary angiography revealed dual congenital coronary cameral fistula, a complex CAF with a left circumflex artery–left ventricle fistula and a right coronary artery–left ventricle fistula, complicated with a myocardial bridge.

Diagnosis and interventions:

A diagnosis of left circumflex artery–left ventricle fistula complicated with a right coronary artery–left ventricle fistula and myocardial bridge was made. Since the patient refused surgery, medical management with enteric-coated aspirin, sustained-release metoprolol, and atorvastatin calcium was initiated.

Outcomes and lesson:

Currently, the patient is now asymptomatic and in good condition since 6 months after undergoing conservative treatment with β-blockers.
Thrombolysis after cardiopulmonary resuscitation in myocardial infarction with abdominal pain as the first presentation
Authors: Zheng Yang-Jian , Wang Wen-na , Lin Han-li , Wu Ya-nan
Published: April 2022

Rationale:

Thrombolysis after cardiopulmonary resuscitation in patients with acute ST-segment elevation myocardial infarction (STEMI) is controversial. This case report describes a successful thrombolysis after resuscitation in delayed-diagnosis STEMI.

Patient concerns:

A 58-year-old man presented with acute abdominal pain as the first symptom of a subsequent STEMI diagnosis. When he returned to the clinic after having been assisted with abdominal pain relief, he suffered a sudden cardiac arrest. Cardiopulmonary resuscitation was performed immediately, and thrombolysis was carried out for his anterior STEMI. He was successfully resuscitated in a short period of time.

Diagnosis:

The patient was diagnosed with acute and extensive anterior STEMI. The D-dimer level was normal, and pericardial effusion was ruled out.

Interventions:

After successful resuscitation, the patient received half-dose alteplase thrombolytic therapy. After a few days, the patient was transferred to a general ward. Coronary angiography revealed unobstructed flow in the left anterior descending artery.

Outcomes:

The ST segment of the patient gradually declined after thrombolytic therapy, and the myocardial injury marker levels increased. A small amount of pleural fluid in the lungs and pulmonary infection were observed. With effective diuretic, anti-infective, and other treatments, the patient's condition gradually improved, the ventilator was removed, and vasoactive drugs were successfully discontinued. Coronary angiography revealed that the flow of the culprit artery was unobstructed, and a drug-coated balloon was implanted. No wall motion abnormalities were detected on echocardiography, and the patient recovered well.

Conclusions:

In patients with abdominal pain as the first presentation, a simple initial electrocardiogram may help reduce the risk of missed STEMI diagnosis. Thrombolysis after successful resuscitation is an effective treatment for these patients. However, the effects of thrombolysis after resuscitation remain unclear. The point of dispute lies in the effectiveness and safety of thrombolysis (primarily for bleeding). Prompt thrombolysis would lead to a better prognosis if spontaneous circulation can be restored within 10 minutes.
Intensity-modulated radiotherapy with more than 60 Gy improved the survival of inoperable patients with locally advanced esophageal squamous cell carcinoma
Authors: Zhang Wei , Xie Qing , Zhu Bifa , Wang Xiaokang , He Ling , Zhang Yong
Published: April 2022

Intensity-modulated radiotherapy (IMRT) is widely applied during the treatment of esophageal squamous cell carcinoma (ESCC), but the optimal radiation dose still lacks a consensus. The aim of this study was to explore the optimal radiation dose for inoperable locally advanced ESCC patients treated with IMRT in a real-world clinical setting.

A total of 90 inoperable ESCC patients with locally advanced stages of II-IVA treated with IMRT in our institute between February 1, 2014 and June 30, 2019 were included in this retrospective study. Sixty patients had received >60 Gy (high dose group) and 30 patients had received ≤60 Gy (low dose group). The median radiation dose was 66 Gy (range: 61–70 Gy) and 50.2 Gy (range: 40–60 Gy), respectively. Concurrent chemotherapies were platinum-based regimens.

The median progression free survival (PFS) and overall survival (OS) of all patients were 7.6 and 14.1 months, respectively. Patients in the high dose group exhibited a significantly better PFS (1-year PFS 34.6% vs 22.8%; 2-year PFS 11.9% vs 0%, P = .008) and OS (1-year OS 57.5% vs 39.5%; 2-year OS 31.4% vs 15.8%, P = .007). The median PFS in the high and low dose groups were 8.1 and 6.1 months, and the median OS were 15.4 and 8.5 months, respectively. Multivariate Cox analysis showed that radiation dose (>60 Gy vs ≤60 Gy) was independently prognostic factor for OS (HR: 0.44; 95% CI: 0.22–0.89; P = .021), but not for PFS (HR: 0.56; 95% CI: 0.31–1.02; P = .058). There was no significant difference in treatment-related toxicities of grade ≥3 between the 2 groups (P = .402).

This retrospective study confirmed that higher radiation dose (>60 Gy) resulted in better survival outcomes for inoperable patients with locally advanced ESCC treated with IMRT.
Acute flaccid paralysis of a new surfer
Authors: Loh Yee Leng , Atresh Sridhar , Ferguson Kylie
Published: April 2022

Rationale:

Surfer's myelopathy is a rare atraumatic spinal cord injury most frequently experienced by novice surfers. Patients often experience back pain, followed by motor, sensory, bowel, and bladder involvement. Here, we report a case of surfer's myelopathy.

Patient concerns:

The patient presented with acute low back pain associated with lower limb weakness, sensory loss, urinary retention, and perineal paraesthesia 1 hour after her first surf lesson.

Diagnosis:

On arrival at the emergency department, she was noted to have flaccid paralysis with flickers in both lower limbs, reduced sensation in the midthoracic region, reduced anal tone, and saddle anesthesia. Magnetic resonance imaging of the spine revealed evidence of restricted diffusion from T6 to the level of the conus. Extensive investigations, including cerebrospinal fluid analysis, vasculitides/paraneoplastic screening, and further imaging, were unremarkable. She was diagnosed with complete T7 spinal cord injury secondary to surfer's myelopathy.

Interventions:

She subsequently received methylprednisolone and was transferred to the spinal injury unit for rehabilitation. As she experienced persistent neuropathic pain at the level of the injury, she received input from the local pain team. One month after the injury, the patient developed swelling of the right thigh associated with reduced internal and external rotation of the right hip, impacting rehabilitation. The patient was diagnosed with heterotopic ossification following a triple-phase bone scan. She then received intravenous zolendronic acid, which had a good effect.

Outcomes:

Four months after the initial presentation, she was discharged to the community. Despite no improvement in her neurological status, she was independent of transfers and mobility with a wheelchair. In addition, she managed her neurogenic bowel and bladder independently with intermittent self-catheterization and a transanal irrigation system. At 6 months, she engaged well with returning to drive program and vocational rehabilitation.

Lessons:

Neurological recovery from surfer's myelopathy has been shown to vary from complete recovery to minimal recovery. With a spinal-specific rehabilitation program, this patient remains independent of her activities of daily living. Surfer's myelopathy often occurs in inexperienced surfers; therefore, it is crucial to provide education to surfers and instructors.
Misdiagnosis of Pediatric Concussions in the Emergency Department
Authors: Wazir Adonis , Tamim Hani , Wakil Cynthia , Sawaya Rasha Dorothy
Published: April 2022

Objective

We aimed to determine the rate and predictors of correctly diagnosed concussions in the pediatric emergency department and to describe the characteristics, presentation, and management of concussions in children presenting for minor head injury.

Methods

We included 186 patients aged 5 to 18 years presenting within 24 hours of minor head injuries and met our diagnostic criteria for concussion. We compared patients correctly diagnosed with a concussion with those who were not. Our main outcome was the rate and predictors of misdiagnoses.

Results

Of the patients, 5.4% were correctly diagnosed. Amnesia was the only variable associated with correct diagnoses (40.0% vs 10.2%,P= 0.02). The most common mechanism of injury was fall (8.4%); the most frequent symptoms were nausea/vomiting (42.5%), and 48.4% had a brain computed tomography scan done.

Conclusions

The high rate of concussion misdiagnosis puts into question the usability of current concussion guidelines, their accuracy, and barriers to translation into clinical practice.
Diagnostic Value of Lactate Dehydrogenase and Uric Acid as Screening Tools for Malignancies in Children
Authors: Oriaifo Irene A. , Gerard James M. , Thomas Scott M.
Published: April 2022

Objective

The aim of this study was to determine the diagnostic value of lactate dehydrogenase (LDH) and uric acid (UA) in children undergoing evaluation for possible malignancies.

Methods

This was a retrospective chart review of patients aged 0 to 18 years presenting to an urban, tertiary care, pediatric hospital between July 1, 2011, and July 1, 2016. Patients were included if they had an LDH and/or UA level drawn, and they were excluded if they had a known cancer diagnosis. Sensitivity, specificity, and receiver operating characteristic curves were calculated for each biomarker.

Results

Six hundred five subjects were included in this study; 579 and 384 subjects had LDH and UA levels drawn, respectively; 15.7% had a final diagnosis of malignancy (49 leukemia, 46 nonleukemia).

Conclusion

The specificities of both biomarkers for all types of malignancies were lower than their respective sensitivities. Comparing leukemic versus nonleukemic malignancies, the areas under the curve were 0.848 and 0.719, respectively, for LDH and 0.681 and 0.555, respectively, for UA.
Multicolor Imaging of Optic Disc Drusen
Authors: Yan Yan , Pugazhendhi Sangeethabalasri , Beres Shannon J , Liao Yaping Joyce
Published: April 2022

Optic disc drusen (ODD) are calcified deposits at the anterior optic nerve that are often detectable by ophthalmic imaging, including optical coherence tomography and fundus autofluorescence imaging. Multicolor (MC) imaging is a novel modality that captures reflectance of blue, green, and near-infrared laser lights with confocal scanning laser ophthalmoscopy to rapidly acquire high-resolution reflectance images of the optic disc and retina. Here, we show an eye with 3 MC imaging features of ODD, including prominent green hyperreflectance of the optic disc, green sheathing of the papillary and peripapillary vasculature (arterioles > venules), and presence of orange superficial ODD. MC imaging can provide rapid high-resolution assessment of eyes with optic nerve head elevation to help distinguish pseudopapilledema vs papilledema in children and adults without dilation, and future large studies incorporating MC imaging will help determine its contribution in the diagnosis and monitoring of ODD and assessment of other causes of optic nerve head elevation.
Partial ORF1ab Gene Target Failure with Omicron BA.2.12.1
Authors: Rodino Kyle G. , Peaper David R. , Kelly Brendan J. , Bushman Frederic , Marques Andrew , Adhikari Hriju , Tu Zheng Jin , Rolon Rebecca Marrero , Westblade Lars F. , Green Daniel A. , Berry Gregory J. , Wu Fann , Annavajhala Medini K. , Uhlemann Anne-Catrin , Parikh Bijal A. , McMillen Tracy , Jani Krupa , Babady N. Esther , Hahn Anne M. , Koch Robert T. , Grubaugh Nathan D. ,   Yale SARS-CoV-2 Genomic Surveillance Initiative, Rhoads Daniel D.
Published: April 2022

Mutations in the viral genome of SARS-CoV-2 can impact the performance of molecular diagnostic assays. In some cases, such as S gene target failure, the impact can serve as a unique indicator of a particular SARS-CoV-2 variant and provide a method for rapid detection. Here we describe partial ORF1ab gene target failure (pOGTF) on the cobas® SARS-CoV-2 assays, defined by a ≥2 thermocycles delay in detection of the ORF1ab gene compared to the E gene. We demonstrate that pOGTF is 97% sensitive and 99% specific for SARS-CoV-2 lineage BA.2.12.1, an emerging variant in the United States with spike L452Q and S704L mutations that may impact transmission, infectivity, and/or immune evasion. Increasing rates of pOGTF closely mirrored rates of BA.2.12.1 sequences uploaded to public databases, and, importantly increasing local rates of pOGTF also mirrored increasing overall test positivity. Use of pOGTF as a proxy for BA.2.12.1 provides faster tracking of the variant than whole-genome sequencing and can benefit laboratories without sequencing capabilities.
Human Germline Heterozygous Gain-of-Function STAT6 Variants Cause Severe Allergic Disease
Authors: Sharma Mehul , Lu Henry Y. , Vaseghi-Shanjani Maryam , Del Bel Kate L. , Fornes Oriol , van der Lee Robin , Richmond Phillip A. , Lin Susan , Dalmann Joshua , Lee Jessica J. , Matthews Allison , Blanchard-Rohner Géraldine , van Karnebeek Clara D M , Bedford H. Melanie , Wasserman Wyeth W. , Seear Michael , McKinnon Margaret L. , Ahmed Hanan , Turvey Stuart E.
Published: April 2022

STAT6 (Signal transducer and activator of transcription 6) is a transcription factor that plays a central role in the pathophysiology of allergic inflammation. STAT6 mediates the biological effects of IL-4, a cytokine necessary for type 2 differentiation of T cells and B cell survival, proliferation and class switching to IgE. We have identificated two unrelated patients with a phenotype notable for their early-life onset of profound allergic immune dysregulation, widespread treatment-resistant atopic dermatitis, hypereosinophilia with esosinophilic esophagitis, elevated serum IgE, IgE-mediated food allergies, and vascular anomalies of the brain. Both patients harbored heterozygous de novo missense variants in the DNA binding domain of STAT6 (c.1144G>C, p.E382Q; and c.1256A>G, p.D419G). Functional studies established that both variants caused a gain-of-function (GOF) phenotype associated with enhanced phosphorylation and transcriptional activity of STAT6, in addition to increased transcript abundance of known STAT6 target genes and other genes implicated in allergic disease. JAK inhibitors decreased the enhanced STAT6 responses associated with both these STAT6 GOF variants. This study identifies heterozygous GOF variants in STAT6 as a novel autosomal dominant allergic disorder. We anticipate that our discovery of the first humans with germline STAT6 GOF variants will facilitate the recognition of more affected individuals and the full definition of this new primary atopic disorder.
The Helping Older People Engage (HOPE) Study: Protocol & COVID Modifications for a Randomized Trial
Authors: Van Orden Kimberly A. , Conwell Yeates , Chapman Benjamin P. , Buttaccio April , VanBergen Alexandra , Beckwith Ellen , Santee Angela , Rowe Jody , Palumbos Deborah , Williams Geoffrey , Messing Susan , Sörensen Silvia , Tu Xin
Published: April 2022

Objectives

Evidence-based strategies to reduce loneliness in later life are needed because loneliness impacts all domains of health, functioning, and quality of life. Volunteering is a promising strategy, as a large literature of observational studies documents associations between volunteering and better health and well-being. However, relatively few studies have used randomized controlled trials (RCTs) to examine benefits of volunteering, and none have examined loneliness. The primary objective of the Helping Older People Engage (HOPE) study is to examine the social-emotional benefits of a social volunteering program for lonely older adults. This manuscript describes the rationale and design of the trial.

Design

Randomized controlled trial examining an existing community volunteering program available nationwide. We are randomly assigning adults aged 60 or older (up to 300) who report loneliness to 12 months of either AmeriCorps Seniors volunteering program or an active control (self-guided life review). Co-primary outcomes are assessed via self-report—loneliness (UCLA Loneliness Scale) and quality of life (WHOQOL-Bref). This trial is registered at clinicaltrials.gov (NCT03343483)

Setting

Lifespan of Greater Rochester, a non-medical, community-based aging services agency (volunteering) and participants’ homes (control).

Participants

Adult ages ≥60 years who endorsed feelings of loneliness (score of 6 or greater on the 3-item UCLA Loneliness Scale).

Intervention

The interventions are 12-months of volunteer service with the AmeriCorps Seniors program or self-guided life review writing (active control).

Measurements

Data were collected at baseline, 3-, 6-, and 12-months (loneliness) and baseline and 12-months (quality of life).

Timeline

Enrollment for this trial is underway and expected to finish by May 2022, with completion of follow-up assessments through April, 2023, and completion of primary outcomes soon thereafter.
Factors affecting oral health problems among school children in Kaski District, Nepal
Authors: Chapain Kamal Prasad , Rampal Krishna Gopal , Pokhrel Kalpana Gaulee , Adhikari Chiranjivi , Hamal Deependra , Pokhrel Khem Narayan
Published: April 2022

Introduction

School children have a high prevalence of oral health problems in Nepal. Socio-demographic factors such as gender, parents’ socioeconomic status, and individual awareness of oral health may have an influence on the occurrence of oral health problems. However, little evidence is available about the oral health problems and their associated factors among school children. Therefore, this study aimed to assess the factors associated with oral health problems among school children in Nepal.

Methodology

A cross-sectional study was conducted among school children of grade 7 in 12 schools of Kaski district, Gandaki Province, Nepal. The schools were randomly chosen from urban and semi-urban areas in the district. A total of 669 students participated in the study. Data were collected using a set of questionnaires covering dental health knowledge, socio-demographic characteristics, oral health condition and practices. The factors of poor oral health condition and practices were examined using t-test, one-way Anova, and multiple linear regression.

Results

School children who visited health institutions for oral health services and those with parents having higher level education had higher dental health knowledge scores. Total decayed score was higher among those who did not have knowledge that fluoride prevents decay compared to those who had knowledge about it (Have knowledge about fluoride prevents decay: Mean=1.21 (SD=1.54) Vs No knowledge: mean=2.13 (SD=2.13). Females were more likely to have higher DMFT score compared to males (β-coefficient=0.43, 95% CI=0.13, 0.73, P value=0.005) and increase in knowledge score was associated a with a decrease in DMFT score (β-coefficient=-0.09, 95% CI= -0.20, -0.10, P value=0.047).

Conclusion

This study found that gender, knowledge score, and parent’s socioeconomic status were the major factors contributing to higher DMFT scores. School children should be provided with regular oral health counseling and promotion activities in schools and oral health screening in schools.
Predictors of Survival among 6-59 Months Old Children with Severe Acute Malnutrition: A Retrospective Cohort
Authors: Abate Mohammed , Gebre Abel , Bekele Bisrat Tamene , Dinkashe Fantaye Teka
Published: April 2022

Background

Undernutrition among children is a significant contributor to the global disease burden and a leading cause of child mortality. Ethiopia, home to more than 16 million children under 5 years old, is one of the countries that have high levels of wasting. The aim of this study was to assess survival status and predictors of mortality among children with severe acute malnutrition admitted to Dubti Zonal Referral hospital from January 1/2017 to September 30/2019.

Methods

Facility-based retrospective cohort was conducted among 331 severely acutely malnourished children. Data were collected from SAM management registration, individual patient cards and multi-charts admitted from January 1/2017 to September 30/2019. Cox-regression was used to characterize survival within the cohort and to estimate the effect of specific variables while controlling for potential confounders. The hazard ratio was used as a measure of the outcome. P-value less than 0.05 was considered statistically significant to identify independent predictors in multivariable analysis.

Result

The median age of study participants was 18 months and males were 187(56%). About half of 160 (48.3%) respondents were with co-morbidities during admission: diarrhea (44%) and pneumonia (26%) were the major co-morbidities. From a total of 331 SAM children, 255(77%) were recovered, 34(10%) died, and 40(12%) have defaulted from treatment. The main risk factors for earlier death of severely malnourished children were rural residence (AHR=1.6, 95% CI= 0.745-3.493), being on IV Infusion (AHR=2.5, 95% CI= 1.12-4.18), anemia during admission (AHR= 6.27, 95% CI =2.41-16.36) & pneumonia (AHR=0.27, 95% CI = 0.11-0.68)

Conclusions

The death rate was 10% which is close to the minimum SPHERE standard & national management protocol for SAM. Predictors for earlier hospital deaths were rural residence, IV infusion, Anemia, and Pneumonia.
Effects of boosted mRNA and adenoviral-vectored vaccines on immune responses to omicron BA.1 and BA.2 following the heterologous CoronaVac/AZD1222 vaccination
Authors: Suntronwong Nungruthai , Kanokudom Sitthichai , Auphimai Chompoonut , Assawakosri Suvichada , Thongmee Thanunrat , Vichaiwattana Preeyaporn , Duangchinda Thaneeya , Chantima Warangkana , Pakchotanon Pattarakul , Chansaenroj Jira , Puenpa Jiratchaya , Nilyanimit Pornjarim , Srimuan Donchida , Thatsanatorn Thaksaporn , Sudhinaraset Natthinee , Wanlapakorn Nasamon , Poovorawan Yong
Published: April 2022

Background

The coronavirus 2019 omicron variant has surged rapidly and raises concerns about immune evasion because it harbors mutations even in individuals with complete vaccination. Here, we examine the capability of the booster vaccination to induce neutralizing antibodies (NAbs) against omicron (BA.1 and BA.2) and T-cell responses.

Methods

A total of 167 participants primed with heterologous CoronaVac/AZD1222 were enrolled to receive AZD1222, BNT162b2, or mRNA-1273 as a booster dose. Reactogenicity was recorded. Binding antibody, neutralizing antibody (NAb) titers against omicron BA.1 and BA.2, and total interferon gamma (IFN-γ) post-booster responses were measured.

Results

A substantial loss in neutralizing potency to omicron variant was found at 4 to 5 months after receiving the heterologous CoronaVac/AZD1222. Following booster vaccination, a significant increase in binding antibodies and neutralizing activities toward delta and omicron variants was observed. Neutralization to omicron BA.1 and BA.2 were comparable, showing the highest titers after boosted mRNA-1273 followed by BNT162b2 and AZD1222. Notably, boosted individuals with mRNA vaccines could induce T cell response. Reactogenicity was mild to moderate without serious adverse events.

Conclusions

Our findings highlight that the booster vaccination could overcome immunity wanes and provide adequate NAbs coverage against omicron BA.1 and BA.2.
If Research is Not the Evidence, What is it? Egyptian Physicians’ Explanations of the Lack of Research Citations in their Health Vlogs
Authors: Atef Noha
Published: April 2022

Doctor-influencers have the knowledge needed to understand scientific research, and they have the social media popularity to share it with large audiences. In this article, I explore the treatment of evidence in vlogs by Egyptian doctor-influencers: how they present it and what they use instead of it. I answer the following questions: 1) How do doctor-influencers present evidence on social media? 2) If evidence is not the research, then what is it? The data was collected through in-depth interviews with 12 Egyptian doctor-influencers from different specializations; two focus groups; and a critical discourse analysis of 48 of the influencers’ most popular and most engaging videos. I found that the doctor-influencers cited academic research only in the videos about medical controversies, new treatments, misinformation, or common medical mistakes. In most of their videos, the Egyptian doctor-influencers scarcely referred to medical research. This is because they believe that their audiences would not understand evidence due to their low educational attainment, weak research skills, and the language barrier (as most medical research is published in English rather than Arabic). These findings highlight the challenges of communicating science in societies with a low level of education. In these settings, communicators may need to move beyond mediating research studies on social media and instead focus on simplifying, translating, and connecting evidence-based information to the cultural context.
Trends in non-COVID-19 hospitalizations prior to and during the COVID-19 pandemic period, United States, 2017 – 2021
Authors: Cassell Kelsie , Zipfel Casey M , Bansal Shweta , Weinberger Daniel M.
Published: April 2022

COVID-19 pandemic-related shifts in healthcare utilization, in combination with trends in non-COVID-19 disease transmission and NPI use, had clear impacts on infectious and chronic disease hospitalization rates. Using a national healthcare billing database (C19RDB), we estimated the monthly incidence rate ratio of hospitalizations between March 2020 and June 2021 according to 19 ICD-10 diagnostic chapters and 189 subchapters. The majority of hospitalization causes showed an immediate decline in incidence during March 2020. Hospitalizations for diagnoses such as reproductive neoplasms, hypertension, and diabetes returned to pre-pandemic norms in incidence during late 2020 and early 2021, while others, like those for infectious respiratory disease, never returned to pre-pandemic norms. These results are crucial for contextualizing future research, particularly time series analyses, utilizing surveillance and hospitalization data for non-COVID-19 disease. Our assessment of subchapter level primary hospitalization codes offers new insight into trends among less frequent causes of hospitalization during the COVID-19 pandemic.
Factors Influencing Health Impacts among Smartphone Users in New Normal Situation: A Case Study among University Students in Thailand
Authors: Siriwong Wattasit , Frost Eric G. , Wilaiwan Wachiraporn
Published: April 2022

Background

Nowadays, smartphone users are increasing across the world. Smartphones have become a necessary thing in people’s life. Using smartphones have both benefits and health effects. Therefore, this study mainly aims to develop an appropriate mobile application to be the tool for health effects and finding factors associated with a health risk from smartphone usage.

Methods

This study was a cross-sectional descriptive study. The data was conducted in Thailand. The sample size was 500 university students. The Smartphone U Health mobile application was developed and shown in the Play Store and App Store. The self-administration was used for data collection throughout the Smart U Health. Data were entered and analyzed with licensed SPSS version 22.

Results

The participants, including 328 females (65.6%) and 172 males (34.4%) with an average age was 20.3±1.5 years old. The average period of using smartphones was 7.9±2.0 years. The average time spent was 8.6±3.4 hours/day. The primary physical, mental, and social health effects from smartphone usage over three months were eye pain (93.8%), feeling bored (90.4%), the participants had a communication problem with other people (84.0%), respectively. In the multivariate analysis, the significant factors associated with a health risk from smartphone usage were faculty, income, using smartphones in the classroom, experience of resting their eyes before continuing. Moreover, knowledge and practice levels were significantly associated with health risk levels from smartphone usage.

Conclusion

Overuse of smartphones had many health effects. The Smart U Health mobile application might be the appropriate tool to assess smartphone users’ health risk levels. In the future, it may consider an intervention study to reduce health risks from smartphone usage.
Does greater longevity come with lower life disparity in India? A comparative study between Kerala and Delhi
Authors: Akhtar Saddaf Naaz , Anson Jon
Published: April 2022

Background

Life expectancy and life disparity are two important measures for determining society’s health condition. Over last decades, Indian life expectancy has increased, reaching 69.4 years in 2018, with highest life expectancies being registered in Kerala and Delhi, with 75.3 years for both-sexes. Delhi has overtaken Kerala and is now top-ranking state in life expectancy. However, whether Delhi also has a lower disparity than Kerala is still unknown.

Objectives

To assess age-at death distributions, trends in life expectancy and life disparity for Delhi and Kerala from 2010-2018; to assess patterns of life disparity and their relation to rising longevity; to show that, despite having similar life expectancies, life disparity varies between Delhi and Kerala.

Methods

Abridged-life table from Sample Registration System from 2010-18 for Kerala and Delhi. Decomposition approach is performed to calculate age-specific contribution to changes in life expectancy and life disparity for each population.

Results

Kerala showed inverse relationship between life expectancy and life disparity but not Delhi. Despite having a better Delhi’s life expectancy than Kerala during the study period, Delhi’s life disparity is still higher than Kerala’s. Disparities in life expectancy and life disparity between the two groups are closely related to their differences in age-specific mortality.

Conclusions

Given the ongoing demographic transition in India and spatial variations in it, this study is a welcome contribution to our understanding of India’s mortality decline. Our study has revealed that the life disparity in Delhi is higher than that in Kerala. This is because infant mortality in Delhi is higher than in Kerala whereas old age mortality is higher in Kerala than in Delhi.

Contribution

Beneficial in allocating healthcare resources to minimize both infants and old deaths and to attain equality in longevity and health.
Artificial Intelligence Model for Detecting Duodenal Endoscopic Changes on Images of Functional Dyspepsia
Authors: Mihara Hiroshi , Nanjo Sohachi , Motoo Iori , Ando Takayuki , Fujinami Haruka , Yasuda Ichiro
Published: April 2022

Introduction and Aims

Recently, it has been suggested that the duodenum may be the pathological locus of functional dyspepsia (FD), but there are few reports on the presence of duodenal changes on imaging in FD.

Methods

Duodenal images acquired at our hospital with the presence or absence of the term “functional dyspepsia” on the electronic medical record, and H. pylori (HP) infection status on the Japan Endoscopy Database were obtained. The Google Cloud Platform AutoML Vision (single-label classification) was used to classify FD/HP current infection, versus FD/HP uninfected patients. We constructed an AI model to distinguish four groups, which included FD/HP current infection, FD/HP uninfected, non-FD/current infection, and non-FD/HP uninfected, and calculated the sensitivity, specificity, and AUC. Patient images with other organic diseases such as gastrointestinal cancer, peptic ulcer, postoperative abdominal organs, and gastroesophageal reflux disease were excluded. Narrow band imaging and dye-spread images were also excluded.

Results

The overall AUC of the four groups was 0.47 (FD/HP current infection 0.20, FD/HP uninfected 0.35, non-FD/current infection 0.46, non-FD/HP uninfected 0.74). Next, using the same images, we constructed a model to determine the presence or absence of FD in HP infected patients only. The sensitivity, specificity, positive predictive value, negative predictive value, and AUC were 71.4%, 66.7%, 50.0%, 83.3%, and 0.84, respectively. However, when we constructed a model to determine the presence of FD only in uninfected HP patients, the sensitivity, specificity, positive predictive value, negative predictive value, and AUC were 58.3%, 100%, 100%, 77.3%, and 0.85, respectively.

Conclusion

The results suggest that the duodenal imaging AL model may be able to determine the presence or absence of FD to a certain degree in HP-infected or uninfected patients.
Cancer-associated Lactobacillus iners are genetically distinct and associated with chemoradiation resistance in cervical cancer
Authors: Colbert Lauren E. , Karpinets Tatiana , El Alam Molly B. , Lynn Erica J. , Sammouri Julie , Lo David , Elnaggar Jacob H , Wang Rui , Harris Timothy A , Yoshida-Court Kyoko , Tomasic Katarina , Bronk Julianna K. , Yanamandra Ananta V. , Olvera Adilene V. , Carlin Lily G. , Sims Travis , Delgado Medrano Andrea Y. , Solley Travis , Eifel Patricia J. , Jhingran Anuja , Joyner Melissa , Lin Lilie , Ramondetta Lois M. , Futreal Andrew M. , Schmeler Kathleen M. , Mathew Geena , Dorta-Estremera Stephanie , Zhang Jianhua , Wu Xiaogang , Ajami Nadim J. , Taniguchi Cullen , Petrosino Joseph F. , Wargo Jennifer , Sastry K. Jagannadha , Okhuysen Pablo C. , Klopp Ann H.
Published: April 2022

This study identifies a novel pathotype of cervical cancer-associated Lactobacillus iners (L. iners) that results in chemoradiation resistance in vitro and is associated with poor patient survival. Cervical cancer affects over half a million women a year around the world. Treatment for women with locally advanced cancer is delivered with definitive chemoradiation (CRT) but is curative for only 60% of patients. There are few validated molecular markers to identify patients who will respond poorly to treatment. Tumor microbiome features are associated with treatment resistance in patients with colon and pancreatic cancers, and thus we investigated their role in the response of cervical cancer to therapy. We identified a strong association between poor clinical response to CRT and tumors dominated by L. iners. Cancer-associated L. iners promoted in vitro resistance of cervical cancer cells and modified the local tumor immunologic microenvironment, while non-cancer-associated L. iners did not. Assembly of genomes from cancer-derived L. iners also demonstrated pathogenic, metabolic, and immune functions not found in healthy patients.
Early Carotid Revascularization Rates, Procedural Distribution, and Hospital Density
Authors: Russeau Andrew , Bidare Deeksha , Walker Kyle E. , Kougias Panos , Mills Joseph L. , Barshes Neal R.
Published: April 2022

Early carotid revascularization (i.e. during the index hospitalization) may help reduce the risk of additional neurologic events without excess perioperative morbidity. We evaluated the relationship between rates of early carotid endarterectomy (CEA) or stenting (CAS) and hospital density/distribution within metropolitan areas of Texas. Patients with extracranial carotid artery stenosis and either stroke, transient ischemic attacks, or amaurosis were identified among all patients admitted from 2009 to 2013 to non-federal Texas hospitals within all 24 Texas metropolitan statistical areas (MSAs). Early CEA/CAS was defined as occurring during the index hospitalization. A Gini coefficient with bias correction factor was calculated to quantify the distribution of carotid procedures within an MSA. In total, 3,330 (15.4%) of the 21,665 metropolitan patients admitted to Texas hospitals with symptomatic carotid stenosis received early CEA/CAS. Only 263 (44%) of the 600 total hospitals where patients were admitted performed early CEA/CAS. An increasing proportion receiving early carotid CEA/CAS was inversely correlated with the procedural Gini coefficient (p=0.002) and directly correlated with the number of hospitals per 100K population (p=0.01). These two factors accounted for 51% of the variability among MSAs. Early CEA/CAS rates did not correlate with hospital volume or with level 1or 2 stroke centers within an MSA. Increasing the number of hospitals performing early carotid revascularization procedures (i.e. avoiding regionalization/concentration) may help increase the number of patients receiving early carotid revascularization for symptomatic carotid artery disease.