bluuebunny/crossref_metadata_2025 huggingface dataset:
The Estimated Carbon Cost of Concrete Building Demolitions following the Canterbury Earthquake Sequence
Authors: Gonzalez Rosa E , Stephens Max T , Toma Charlotte , Dowdell David
Published: March 2022

The 2010/2011 Canterbury Earthquake Sequence caused severe economic impacts and community disruption in Christchurch, New Zealand due to damage from liquefaction and strong shaking. Following the earthquake, approximately 7500 dwellings and 1400 commercial properties were demolished, resulting in 4 million tons of building debris. Using the Canterbury event, and the subsequent building demolitions in Christchurch as a case study, this research quantifies the embodied carbon and energy costs associated with the post-earthquake demolition of buildings prior to the end of their intended design life. A building data set consisting of 142 reinforced concrete buildings that were demolished following the event was used to estimate the total amount of structural and non-structural debris resulting from the demolitions. A framework was developed to calculate the global warming potential of the demolished buildings considering embodied CO2 and energy in the building materials, impacts of the processes used in construction of the building, and CO2 emissions of the transport and waste management processes. A life cycle assessment tool was used to calculate the environmental costs in the production and transport module, the spatial distribution of the waste based on the building locations was calculated to determine transport distances to disposal facilities, and the waste disposal and recycling benefits were calculated using values from a life cycle inventory database. The results of the research revealed the demolition of concrete buildings had staggering environmental costs in terms of embodied CO2 and energy, which make the case for both resilient design strategies that reduce waste and pollution following earthquakes, and incorporating environmental impacts into demolition decisions.
Characterization of the wheat VQ protein family and expression of candidate genes associated with seed dormancy and germination
Authors: Cheng Xinran , Gao Chang , Liu Xue , Xu Dongmei , Pan Xu , Gao Wei , Yan Shengnan , Yao Hui , Cao Jiajia , Min Xiaoyu , Lu Jie , Chang Cheng , Zhang Haiping , Ma Chuanxi
Published: March 2022

Background

Seed dormancy and germination determine wheat resistance to pre-harvest sprouting and thereby affect grain yield and quality. Arabidopsis VQ genes have been shown to influence seed germination; however, the functions of wheat VQ genes have not been characterized.

Results

We identified 65 TaVQ genes in common wheat and named them TaVQ1–65. We identified 48 paralogous pairs, 37 of which had Ka/Ks values greater than 1, suggesting that most TaVQ genes have experienced positive selection. Chromosome locations, gene structures, promoter element analysis, and gene ontology annotations of the TaVQs showed that their structures determined their functions and that structural changes reflected functional diversity. Transcriptome-based expression analysis of 62 TaVQ genes and microarray analysis of 11 TaVQ genes indicated that they played important roles in diverse biological processes. We compared TaVQ gene expression and seed germination index values among wheat varieties with contrasting seed dormancy and germination phenotypes and identified 21 TaVQ genes that may be involved in seed dormancy and germination.

Conclusions

Sixty-five TaVQ proteins were identified for the first time in common wheat, and bioinformatics analyses were used to investigate their phylogenetic relationships and evolutionary divergence. qRT-PCR data showed that 21 TaVQ candidate genes were potentially involved in seed dormancy and germination. These findings provide useful information for further cloning and functional analysis of TaVQ genes and introduce useful candidate genes for the improvement of PHS resistance in wheat.
Association between early elevated phosphate and mortality among critically ill elderly patients: a retrospective cohort study
Authors: Yang Jie , Cheng Yisong , Wang Ruoran , Wang Bo
Published: March 2022

Background

Phosphate disturbances are relatively common in hospitalized patients, especially in critically ill patients. The abnormal phosphate levels may indicate an abnormal body condition. However, little is known about the association between elevated serum phosphate and outcome in critically ill elderly patients. Therefore, the purpose of the present study was to investigate the association between early elevated phosphate and mortality in critically ill elderly patients.

Methods

The present study was a retrospective cohort study based on the medical information mart for intensive care IV (MIMIC-IV) database. Patients with age ≥60 years old were enrolled in the present study. The primary outcome in the present study was ICU mortality. Univariate and multivariate Cox proportional hazard regression analyses were used to evaluate the association between early elevated phosphate and ICU mortality in critically ill elderly patients.

Results

Twenty-four thousand two hundred eighty-nine patients were involved in this analysis and 2,417 patients died in ICU. The median age of involved patients was 78.4 (67.5, 82.9) years old. The median level of serum phosphate in the survivor group was 3.6 (3.0, 4.3) mg/dL, and the median level of serum phosphate in the non-survivor group was 4.4 (3.4, 5.8) mg/dL. The level of serum phosphate in the non-survivor group was significantly higher than the survivor group (4.4 vs. 3.6, P<0.001). The multivariate Cox proportional hazard regression demonstrated that elevated phosphate was an independent risk factor for ICU mortality, after adjustment for other covariates (HR=1.056, 95%CI: 1.028-1.085, P<0.001).

Conclusions

In critically ill elderly patients, early elevated phosphate was significantly associated with increased ICU mortality.
Serum creatinine/cystatin C ratio as a screening tool for sarcopenia and prognostic indicator for patients with esophageal cancer
Authors: Zheng Chao , Wang Ellen , Li Jiang-Shan , Xie Kai , Luo Chao , Ge Qi-Yue , Hu Li-Wen , Shen Yi
Published: March 2022

Background & aims

Sarcopenia is associated with poor clinical outcomes of patients who underwent esophagectomy. The current diagnostic criteria for sarcopenia are complex and laborious. We aimed to employ the simple and economic indicator sarcopenia index (SI = creatinine/cystatin C ×100) to screen for sarcopenia and to evaluate its prognostic value in patients with esophageal cancer (EC).

Methods

Older participants in the National health and nutrition examination survey (NHANES) database (1999–2002) were divided into three groups according to tertiles of the SI value to explore the feasibility of SI in the diagnosis of sarcopenia. Restricted cubic spline (RCS) was utilized to show the non-linear relationship between all-cause mortality and SI. Patients with EC admitted to Jinling Hospital were enrolled to validate the efficacy and prognostic value of SI. Cut-off values of SI were determined using receiver operating characteristic curves. Multivariable logistic analyses and Cox analyses were used to identify the independent factors of postoperative complications and long-term survival, respectively.

Results

A total of 989 participants were identified from the NHANES database. SI showed the diagnostic value of sarcopenia (tertile 1 vs. tertile 3: odds ratio [OR]=3.67, 95% confidence interval [CI]: 1.52–8.87, p=0.004; tertile 2 vs. tertile 3: OR=1.79, 95% CI: 0.75–4.28, p=0.191) adjusted for race, gender, and body mass index (BMI). Individuals with SI ≤ 68 had a poorer overall survival (OS) (hazard ratio [HR]=2.14, 95% CI: 1.71–2.68, p<0.001), and the RCS plot showed that the all-cause mortality risk gradually decreased with the increase in SI. Then, 203 patients with EC were enrolled, of which 76 patients were diagnosed with sarcopenia. There was a linear correlation between SI and skeletal muscle index and prealbumin, indicating that SI was reliable for diagnosing sarcopenia. Patients in the high sarcopenia risk group (Male: SI < 62; Female: SI < 55) showed a higher incidence of complications (OR=3.50, 95% CI: 1.85–6.61, p<0.001) and poorer long-term survival (HR=2.62, 95% CI: 1.02–6.77, p=0.046).

Conclusion

SI could be used to identify sarcopenia in patients with EC, and it is a useful prognostic factor of postoperative complications and long-term survival.
Immunotactoid glomerulopathy – an enigmatic case in the setting of nodal marginal zone lymphoma and systemic sclerosis sine scleroderma
Authors: Mohamed Mohamed Wael , Al-Hammadi Mariam , Hussein Ali Mohammad , Alarab Daher , Albreak Hisham Ahmad , Tungekar Mohammad Fahim , Dandi Balaji
Published: March 2022

Background

Immunotactoid Glomerulopathy (ITG) is an exceedingly rare type of glomerulopathy characterised by distinctive electron microscopic features. ITG has been linked to lymphoproliferative or autoimmune disorders. The clinical manifestations are diverse including nephrotic syndrome (NS), haematuria, acute kidney injury and end stage renal failure (ESRD). We present a case with a stage 3 Nodal Marginal Zone Lymphoma (NMZL) and systemic sclerosis sine scleroderma (SSSS), where the evolution of ITG was documented in 2 renal biopsies 19 months apart. To the best of our knowledge, no cases have been reported linking ITG to NMZL. Furthermore, there is only one non-peer reviewed report linking ITG to scleroderma. We discuss the implications of our findings and highlight the satisfactory management of the case.

Case presentation

A 79-year-old female with history of systemic sclerosis sine scleroderma and stage 3 NMZL presented with acute kidney injury and NS on a background of chronic kidney disease. Her first kidney biopsy showed a diffuse proliferative glomerulonephritis and her serum protein electrophoresis showed no abnormalities. She was managed satisfactorily with conservative measures. She returned 19 months later with features of fluid overload, increasing proteinuria and rising serum creatinine. A repeat serum protein electrophoresis showed excess free kappa light chains and ITG was detected in the repeat kidney biopsy. Her kidney function and proteinuria showed a good and sustained response to rituximab administered after the second biopsy.

Conclusion

ITG is a rare type of glomerulopathy, associated with underlying haematological malignancies and autoimmune disorders that may result in ESRD.

Rituximab is one of the effective agents used in the management of ITG with haematological malignancies.
Boston cognitive assessment (BOCA) — a comprehensive self-administered smartphone- and computer-based at-home test for longitudinal tracking of cognitive performance
Authors: Vyshedskiy Andrey , Netson Rebecca , Fridberg Elisabeth , Jagadeesan Priyanka , Arnold Matthew , Barnett Sophie , Gondalia Anjali , Maslova Victoria , de Torres Lauren , Ostrovsky Simone , Durakovic Danijel , Savchenko Andrei , McNett Sienna , Kogan Mikhail , Piryatinsky Irene , Gold Dov
Published: March 2022

Longitudinal cognitive testing is essential for developing novel preventive interventions for dementia and Alzheimer’s disease; however, the few available tools have significant practice effect and depend on an external evaluator. We developed a self-administered 10-min at-home test intended for longitudinal cognitive monitoring, Boston Cognitive Assessment or BOCA. The goal of this project was to validate BOCA. BOCA uses randomly selected non-repeating tasks to minimize practice effects. BOCA evaluates eight cognitive domains: 1) Memory/Immediate Recall, 2) Combinatorial Language Comprehension/Prefrontal Synthesis, 3) Visuospatial Reasoning/Mental rotation, 4) Executive function/Clock Test, 5) Attention, 6) Mental math, 7) Orientation, and 8) Memory/Delayed Recall. BOCA was administered to patients with cognitive impairment (n = 50) and age- and education-matched controls (n = 50). Test scores were significantly different between patients and controls (p < 0.001) suggesting good discriminative ability. The Cronbach’s alpha was 0.87 implying good internal consistency. BOCA demonstrated strong correlation with Montreal Cognitive Assessment (MoCA) (R = 0.90, p < 0.001). The study revealed strong (R = 0.94, p < 0.001) test-retest reliability of the total BOCA score one week after participants’ initial administration. The practice effect tested by daily BOCA administration over 10 days was insignificant (β = 0.03, p = 0.68). The effect of the screen size tested by BOCA administration on a large computer screen and re-administration of the BOCA to the same participant on a smartphone was insignificant (β = 0.82, p = 0.17; positive β indicates greater score on a smartphone). BOCA has the potential to reduce the cost and improve the quality of longitudinal cognitive tracking essential for testing novel interventions designed to reduce or reverse cognitive aging. BOCA is available online gratis at www.bocatest.org.
Vulvar cancer during pregnancy and/or breastfeeding: a report of five cases from a single center study at the University Hospital of Düsseldorf
Authors: Winarno Andreas Suhartoyo , Fehm Tanja Natascha , Hampl Monika
Published: March 2022

Background

The incidence of vulvar cancer (VC) in pregnancy is unknown due to its rarity; between 1955 and 2014 only 36 case reports were reported worldwide. Underreporting may also be a contributing factor to the unknown incidence of VC in pregnancy. The aim of this study was to analyze the diagnosis, treatment and outcome of vulvar cancer cases diagnosed during pregnancy and/or breastfeeding.

Case presentation

Patient 1 was diagnosed at 18 weeks’ gestation (WG) with Grade 2 VC (pT1a, pN0, 0/4 sentinel lymph nodes biopsy (SLNB) involved) and was treated by having the tumor resected (R0). She is currently recurrence-free at 4 years post-diagnosis.

Patient 2 was diagnosed at 7 WG with Grade 2 VC (pT1b, pN1a, 1/17 SLNB, R0) and was treated during the first trimester and during the second trimester with SLNB. She is currently recurrence-free at 5 years post-diagnosis.

Patient 3 was diagnosed at 30 WG with Grade 2 VC (pT1b, pN0, 0/5 SLNB, R0). She subsequently experienced a number of local recurrences postpartum that were managed by resection and is currently recurrence-free at 3 years post-diagnosis.

Patient 4 was diagnosed a VL later, at 14 months during breastfeeding, that was diagnosed as Grade 3 VC (pT1b, pN1a, 1/14 SLNB, R0). The patient is currently recurrence-free at 9 years post-diagnosis.

Patient 5 was not diagnosed during pregnancy, but was diagnosed with G3 VC (pT2, pN2c, 2/17 SLNB, R0) 8 months postpartum. The patient due to the extent of tumor involvement and lymph node metastasis, underwent chemoradiation therapy post-surgery. Despite adjuvant therapy, the patient progressed and developed bone metastases. Analysis of the tumour tissue revealed increased expression of PD-L1 (programmed cell death protein 1) indicating that the patient may have benefited from treatment with nivolumab to block the PD-L1 interaction; unfortunately the patient passed away at 24 months post-diagnosis before immunotherapy treatment could commence.

Conclusion

Surgical resection and simultaneous SLNB in VC cases are considered safe during pregnancy, with comparable outcomes to non-pregnant women. Prompt diagnostic workup and treatment should never be delayed during pregnancy as delayed diagnosis could lead to tumour progression with fatal consequences.
Assessment of transparency and selective reporting of interventional trials studying colorectal cancer
Authors: Pellat Anna , Boutron Isabelle , Ravaud Philippe
Published: March 2022

Background

Colorectal cancer (CRC) is currently one of the most frequently diagnosed cancers. Our aim was to evaluate transparency and selective reporting in interventional trials studying CRC.

Methods

First, we assessed indicators of transparency with completeness of reporting, according to the CONSORT statement, and data sharing. We evaluated a selection of reporting items for a sample of randomized controlled trials (RCTs) studying CRC with published full-text articles between 2021–03-22 and 2018–03-22. Selected items were issued from the previously published CONSORT based peer-review tool (COBPeer tool). Then, we evaluated selective reporting through retrospective registration and primary outcome(s) switching between registration and publication. Finally, we determined if primary outcome(s) switching favored significant outcomes.

Results

We evaluated 101 RCTs with published full-text articles between 2021–03-22 and 2018–03-22. Five trials (5%) reported all selected CONSORT items completely. Seventy-four (73%), 53 (52%) and 13 (13%) trials reported the primary outcome(s), the allocation concealment process and harms completely. Twenty-five (25%) trials were willing to share data. In our sample, 49 (49%) trials were retrospectively registered and 23 (23%) trials had primary outcome(s) switching. The influence of primary outcome(s) switching could be evaluated in 16 (16/23 = 70%) trials, with 6 (6/16 = 38%) trials showing a discrepancy that favored statistically significant results.

Conclusions

Our results highlight a lack of transparency as well as frequent selective reporting in interventional trials studying CRC.
Decomposing urban-rural differences in multimorbidity among older adults in India: a study based on LASI data
Authors: Chauhan Shekhar , Srivastava Shobhit , Kumar Pradeep , Patel Ratna
Published: March 2022

Background

Multimorbidity is defined as the co-occurrence of two or more than two diseases in the same person. With rising longevity, multimorbidity has become a prominent concern among the older population. Evidence from both developed and developing countries shows that older people are at much higher risk of multimorbidity; however, urban-rural differential remained scarce. Therefore, this study examines urban-rural differential in multimorbidity among older adults by decomposing the risk factors of multimorbidity and identifying the covariates that contributed to the change in multimorbidity.

Methods

The study utilized information from 31,464 older adults (rural-20,725 and urban-10,739) aged 60 years and above from the recent release cross-sectional data of the Longitudinal Ageing Study in India (LASI). Descriptive, bivariate, and multivariate decomposition analysis techniques were used.

Results

Overall, significant urban-rural differences were found in the prevalence of multimorbidity among older adults (difference: 16.3; p < 0.001). The multivariate decomposition analysis revealed that about 51% of the overall differences (urban-rural) in the prevalence of multimorbidity among older adults was due to compositional characteristics (endowments). In contrast, the remaining 49% was due to the difference in the effect of characteristics (Coefficient). Moreover, obese/overweight and high-risk waist circumference were found to narrow the difference in the prevalence of multimorbidity among older adults between urban and rural areas by 8% and 9.1%, respectively. Work status and education were found to reduce the urban-rural gap in the prevalence of multimorbidity among older adults by 8% and 6%, respectively.

Conclusions

There is a need to substantially increase the public sector investment in healthcare to address the multimorbidity among older adults, more so in urban areas, without compromising the needs of older adults in rural areas.
Incarcerated workers: overlooked as essential workers
Authors: Segule Marjorie Naila , LeMasters Katherine , Peterson Meghan , Behne Michael Forrest , Brinkley-Rubinstein Lauren
Published: March 2022

Objective

To use the example of COVID-19 vaccine prioritization for incarcerated workers to call attention to the need to prioritize incarcerated workers’ health.

Methods

From November to December 2020, we searched publicly available information (e.g. Department Of Corrections websites and press releases) for 53 US prison systems, including all states, Immigration and Customs Enforcement, the Federal Bureau of Prisons, and Puerto Rico. Coders reviewed if states had prison labor policies, if states had COVID-19 specific prison labor policies, the location of work, industries both pre- and during the COVID-19 pandemic, the scope of work, and hourly wage. Findings were compared to the Centers for Disease Control and Prevention’s occupational vaccine prioritization recommendations.

Results

Every facility has incarcerated individuals working in some capacity with some resuming prison labor operations to pre-pandemic levels. All but one prison system has off-site work locations for their incarcerated population and many incarcerated workers have resumed their off-site work release assignments. Additionally, every state has incarcerated workers whose job assignments are considered frontline essential workers (e.g. firefighters). In at least five states, incarcerated workers are participating in frontline health roles that put them at higher risk of acquiring COVID-19. Yet, no state followed the Centers for Disease Control and Prevention recommended vaccination plan for its incarcerated population given their incarcerated workers’ essential worker status.

Conclusion

The Centers for Disease Control and Prevention recommended that incarcerated people be prioritized for vaccination primarily due to the risk present in congregate style prison and jail facilities. Furthermore, our review found that many incarcerated people perform labor that should be considered “essential”, which provides another reason why they should have been among the first in line for COVID-19 vaccine allocation. These findings also highlight the need for incarcerated workers’ health to be prioritized beyond COVID-19.
Are all domains created equal? An exploration of stakeholder views on the concept of physical literacy
Authors: Belton Sarahjane , Connolly Sinead , Peers Cameron , Goss Hannah , Murphy Marie , Murtagh Elaine , Kavanagh Jennifer , Corr Méabh , Ferguson Kyle , O’Brien Wesley
Published: March 2022

Background

Developing physical literacy at population levels provides a transformative appeal for those working in sport, health, education, recreation and physical activity settings. Interdisciplinary approaches to development of policy in this area is recommended. The purpose of this study was to gather empirical data from key stakeholders working with young people in areas related to physical literacy across the Republic of Ireland and Northern Ireland, to capture their current understanding and awareness of the physical literacy to help inform the development of the first all-island consensus statement for physical literacy.

Methods

A total of 1,241 participants (52% male), from a range of stakeholder groups (health, physical activity, sport, recreation and education) completed a researcher developed physical literacy questionnaire. A one-way MANOVA was carried out to investigate differences across stakeholder grouping in terms of perceived importance of three domains of physical literacy. Overlap of independent confidence intervals was analysed to determine importance of the physical literacy domains within stakeholder grouping.

Results

A majority (63%) of respondents indicated they were aware of an existing definition of physical literacy, but this varied by stakeholder group (e.g. 86% for higher education, versus 47% of coaches). Participants working in higher education (69%), or working as physical education specialists (67%), were more likely to rate themselves as experts or near experts in physical literacy, while coaches, education generalists, and decision makers were more likely rate themselves as having no expertise (9%, 12% and 12% respectively). Non-specialist teachers and physical education teachers rated the importance of all domains of physical literacy significantly higher than decision makers, and significantly higher than coaches in the cognitive and affective domains. All stakeholders significantly rated the importance of the physical/psychomotor domain of physical literacy higher than the affective or cognitive domains of physical literacy.

Conclusions

Differences observed across stakeholder groups underline the importance of developing a shared vision for physical literacy, and the need to clarify and gain consensus on a definition of the term and its domains. Engaging and understanding the voice of stakeholders is critical in ensuring the relevance, ownership of and commitment to physical literacy statement operationalisation.
An enhanced recovery after surgery pathway: LOS reduction, rapid discharge and minimal complications after anterior cervical spine surgery
Authors: Leng Xue , Zhang Yaqing , Wang Guanzhong , Liu Libangxi , Fu Jiawei , Yang Minghui , Chen Yu , Yuan Jiawei , Li Changqing , Zhou Yue , Feng Chencheng , Huang Bo
Published: March 2022

Background

Enhance recovery after surgery (ERAS) is a new and promising paradigm for spine surgery. The purpose of this study is to investigate the effectiveness and safety of a multimodal and evidence-based ERAS pathway to the patients undergoing anterior cervical discectomy and fusion (ACDF).

Methods

The patients treated with the ACDF-ERAS pathway were compared with a historical cohort of patients who underwent ACDF before ERAS pathway implementation. Primary outcome was length of stay (LOS). Secondary outcomes included cost, MacNab grading, complication rates and 90-day readmission and reoperation. And perioperative factors and postoperative complications were reviewed.

Results

The ERAS protocol was composed of 21 components. More patients undergoing multi-level surgery (n ≥ 3) were included in the ERAS group. The ERAS group showed a shorter LOS and a lower cost than the conventional group. The postoperative satisfaction of patients in ERAS group was better than that in conventional group. In addition, the rate of overall complications was significantly higher in the conventional group than that in the ERAS group. There were no significant differences in operative time, postoperative drainage, or 90-day readmission and reoperation.

Conclusions

The ACDF-tailored ERAS pathway can reduce LOS, cost and postoperative complications, and improve patient satisfaction without increasing 90-day readmission and reoperation.
The impact of organisational characteristics of staff and facility on infectious disease outbreaks in care homes: a systematic review
Authors: Liljas A. E. M. , Morath L. P. , Burström B. , Schön P. , Agerholm J.
Published: March 2022

Background

Infectious disease outbreaks are common in care homes, often with substantial impact on the rates of infection and mortality of the residents, who primarily are older people vulnerable to infections. There is growing evidence that organisational characteristics of staff and facility might play a role in infectious disease outbreaks however such evidence have not previously been systematically reviewed. Therefore, this systematic review aims to examine the impact of facility and staff characteristics on the risk of infectious disease outbreaks in care homes.

Methods

Five databases (MEDLINE, EMBASE, ProQuest, Web of Science, CINAHL) were searched. Studies considered for inclusion were of any design reporting on an outbreak of any infectious disease in one or more care homes providing care for primarily older people with original data on: facility size, facility location (urban/rural), facility design, use of temporary hired staff, staff compartmentalizing, residence of staff, and/or nursing aides hours per resident. Retrieved studies were screened, assessed for quality using CASP, and analysed employing a narrative synthesis.

Results

Sixteen studies (8 cohort studies, 6 cross-sectional studies, 2 case-control) were included from the search which generated 10,424 unique records. COVID-19 was the most commonly reported cause of outbreak (n = 11). The other studies focused on influenza, respiratory and gastrointestinal outbreaks. Most studies reported on the impact of facility size (n = 11) followed by facility design (n = 4), use of temporary hired staff (n = 3), facility location (n = 2), staff compartmentalizing (n = 2), nurse aides hours (n = 2) and residence of staff (n = 1). Findings suggest that urban location and larger facility size may be associated with greater risks of an infectious disease outbreak. Additionally, the risk of a larger outbreak seems lower in larger facilities. Whilst staff compartmentalizing may be associated with lower risk of an outbreak, staff residing in highly infected areas may be associated with greater risk of outbreak. The influence of facility design, use of temporary staff, and nurse aides hours remains unclear.

Conclusions

This systematic review suggests that larger facilities have greater risks of infectious disease outbreaks, yet the risk of a larger outbreak seems lower in larger facilities. Due to lack of robust findings the impact of facility and staff characteristics on infectious disease outbreaks remain largely unknown.

Prospero

CRD42020213585.
Combining faecal immunochemical testing with blood test results for colorectal cancer risk stratification: a consecutive cohort of 16,604 patients presenting to primary care
Authors: Withrow Diana R. , Shine Brian , Oke Jason , Tamm Andres , James Tim , Morris Eva , Davies Jim , Harris Steve , East James E. , Nicholson Brian D.
Published: March 2022

Background

Faecal immunochemical tests (FITs) are used to triage primary care patients with symptoms that could be caused by colorectal cancer for referral to colonoscopy. The aim of this study was to determine whether combining FIT with routine blood test results could improve the performance of FIT in the primary care setting.

Methods

Results of all consecutive FITs requested by primary care providers between March 2017 and December 2020 were retrieved from the Oxford University Hospitals NHS Foundation Trust. Demographic factors (age, sex), reason for referral, and results of blood tests within 90 days were also retrieved. Patients were followed up for incident colorectal cancer in linked hospital records. The sensitivity, specificity, positive and negative predictive values of FIT alone, FIT paired with blood test results, and several multivariable FIT models, were compared.

Results

One hundred thirty-nine colorectal cancers were diagnosed (0.8%). Sensitivity and specificity of FIT alone at a threshold of 10 μg Hb/g were 92.1 and 91.5% respectively. Compared to FIT alone, blood test results did not improve the performance of FIT. Pairing blood test results with FIT increased specificity but decreased sensitivity. Multivariable models including blood tests performed similarly to FIT alone.

Conclusions

FIT is a highly sensitive tool for identifying higher risk individuals presenting to primary care with lower risk symptoms. Combining blood test results with FIT does not appear to lead to better discrimination for colorectal cancer than using FIT alone.
Evaluation of factors influencing expression and extraction of recombinant bacteriophage endolysins in Escherichia coli
Authors: Balaban Cecilia Lucía , Suárez Cristian Alejandro , Boncompain Carina Andrea , Peressutti-Bacci Natalia , Ceccarelli Eduardo Augusto , Morbidoni Héctor Ricardo
Published: March 2022

Background

Endolysins are peptidoglycan hydrolases with promising use as environment-friendly antibacterials mainly when used topically. However, in general, endolysin expression is hampered by its low solubility. Thus, a critical point in endolysin industrial production is optimizing their expression, including improvement of solubility and recovery from cell extracts.

Results

We report the expression of two endolysins encoded in the genome of phages infecting Staphylococcus aureus. Expression was optimized through changes in the concentration of the inducer and growth temperature during the expression. Usually, only 30–40% of the total endolysin was recovered in the soluble fraction. Co-expression of molecular chaperones (DnaK, GroEL) or N-term fusion tags endowed with increased solubility (DsbC, Trx, Sumo) failed to improve that yield substantially. Inclusion of osmolytes (NaCl, CaCl2, mannitol, glycine betaine, glycerol and trehalose) or tensioactives (Triton X-100, Tween 20, Nonidet P-40, CHAPS, N-lauroylsarcosine) in the cell disruption system (in the absence of any molecular chaperone) gave meager improvements excepted by N-lauroylsarcosine which increased recovery to 54% of the total endolysin content.

Conclusion

This is the first attempt to systematically analyze methods for increasing yields of recombinant endolysins. We herein show that neither solubility tags nor molecular chaperones co-expression are effective to that end, while induction temperature, (His)6-tag location and lysis buffer additives (e.g.N-lauroylsarcosine), are sensible strategies to obtain higher levels of soluble S. aureus endolysins.
Establishment and validation of a novel invasion-related gene signature for predicting the prognosis of ovarian cancer
Authors: Liang Leilei , Li Jian , Yu Jing , Liu Jing , Xiu Lin , Zeng Jia , Wang Tiantian , Li Ning , Wu Lingying
Published: March 2022

Background

Ovarian cancer (OC) is an invasive gynaecologic cancer with a high cancer-related death rate. The purpose of this study was to establish an invasion-related multigene signature to predict the prognostic risk of OC.

Methods

We extracted 97 invasion-related genes from The Cancer Genome Atlas (TCGA) database. Then, the ConsensusClusterPlus and limma packages were used to calculate differentially expressed genes (DEGs). To calculate the immune scores of the molecular subtypes, we used ESTIMATE to evaluate the stromal score, immune score and ESTIMATE score. MCP-counter and the GSVA package ssgsea were used to evaluate the types of infiltrating immune cells. Survival and nomogram analyses were performed to explore the prognostic value of the signature. Finally, qPCR, immunohistochemistry staining and functional assays were used to evaluate the expression and biological abilities of the signature genes in OC.

Results

Based on the consistent clustering of invasion-related genes, cases in the OC datasets were divided into two subtypes. A significant difference was observed in prognosis between the two subtypes. Most genes were highly expressed in the C1 group. Based on the C1 group genes, we constructed an invasion-related 6-gene prognostic risk model. Furthermore, to verify the signature, we used the TCGA-test and GSE32062 and GSE17260 chip datasets for testing and finally obtained a good risk prediction effect in those datasets. Moreover, the results of the qPCR and immunohistochemistry staining assays revealed that KIF26B, VSIG4 and COL6A6 were upregulated and that FOXJ1, MXRA5 and CXCL9 were downregulated in OC tissues. The functional study showed that the expression of KIF26B, VSIG4, COL6A6, FOXJ1, MXRA5 and CXCL9 can regulate the migration and invasion abilities of OC cells.

Conclusion

We developed a 6-gene prognostic stratification system (FOXJ1, MXRA5, KIF26B, VSIG4, CXCL9 and COL6A6) that is independent of clinical features. These results suggest that the signature could potentially be used to evaluate the prognostic risk of OC patients.
Engineered extracellular vesicles: potentials in cancer combination therapy
Authors: Chen Jiangbin , Tan Qi , Yang Zimo , Jin Yang
Published: March 2022

Extracellular vesicles (EVs) are a group of secretory vesicles with cell-derived membrane and contents. Due to the cargo delivery capability, EVs can be designed as drug delivery platforms for cancer therapy. Biocompatibility and immune compatibility endow EVs with unique advantages compared with other nanocarriers. With the development of this field, multiple ingenious modification methods have been developed to obtain engineered EVs with desired performance. Application of engineered EVs in cancer therapy has gradually shifted from monotherapy to combinational therapy to fight against heterogeneous cancer cells and complex tumor microenvironment. In addition, the strong plasticity and load capacity of engineered EV make it potential to achieve various combinations of cancer treatment methods. In this review, we summarize the existing schemes of cancer combination therapy realized by engineered EVs, highlight the mechanisms and representative examples of these schemes and provide guidance for the future application of engineered EVs to design more effective cancer combination treatment plans.

Graphical Abstract
Lanthanide europium MOF nanocomposite as the theranostic nanoplatform for microwave thermo-chemotherapy and fluorescence imaging
Authors: Zhao Lirong , Zhang Wei , Wu Qiong , Fu Changhui , Ren Xiangling , Lv Kongpeng , Ma Tengchuang , Chen Xudong , Tan Longfei , Meng Xianwei
Published: March 2022

Backgrounds

Microwave sensitization nanoplatform, integrating multiple functional units for improving tumor selectivity, is of great significance for clinical tumor microwave treatment. Lanthanide europium metal organic framework (EuMOF) is expected to be a theranostic nanoplatform owing to its unique luminescent and microwave sensitization properties. However, it is difficult to be applied to complicated biological systems for EuMOF due to its rapid degradation induced by the solvent molecular and ionic environment. In this work, a luminescent EuMOF nanocomposite (EuMOF@ZIF/AP-PEG, named EZAP) was designed, which brought the multifunctional characteristics of microwave sensitization, fluorescence imaging and drug loading.

Results

Lamellar EuMOF was synthesized by a hydrothermal method. Through the charge adsorption mechanism, the zeolite imidazole framework (ZIF) structure was intensively assembled on the surface of EuMOF to realize the protection. Then, through in-situ Apatinib drug loading and PEG modification, EZAP nanocomposite was finally obtained. Apatinib (AP) was a kind of chemotherapy drug approved by Food and Drug Administration for targeted therapy of tumors. PEG modification increased long-term circulation of EZAP nanocomposite. The physical and chemical structure and properties of EuMOF@ZIF (EZ) were systematically represented, indicating the successful synthesis of the nanocomposite. The toxic and side effects were negligible at a safe dose. The growth of human liver cancer cells and murine liver cancer cells in vitro was significantly inhibited, and the combined microwave-thermal therapy and chemotherapy in vivo achieved high anti-cancer efficacy. Moreover, EZAP nanocomposite possessed bright red fluorescence, which can be applied for tumor imaging in tumor-bearing mice in vivo.

Conclusion

Therefore, EZAP nanocomposite showed high microwave sensitization, excellent fluorescence properties and outstanding drug loading capacity, establishing a promising theranostic nanoplatform for tumor therapy and fluorescence imaging. This work proposes a unique strategy to design for the first time a multifunctional nanoplatform with lanthanide metal organic frameworks for biological applications in tumor therapy and diagnosis.

Graphical Abstract
Which NK cell populations mark the high burden of CMV present in all HIV patients beginning ART in Indonesia?
Authors: Ariyanto Ibnu A. , Estiasari Riwanti , Karim Birry , Wijaya Ika Praseya , Bela Budiman , Soebandrio Amin , Price Patricia , Lee Silvia
Published: March 2022

Background

Cytomegalovirus (CMV) has been linked with cardiovascular disease (CVD) in populations where some individuals are seronegative. However, effects of CMV are unclear in HIV patients who all have high levels of CMV antibodies. Other metrics of their CMV burden are needed. Amongst transplant recipients, CMV drives the expansion of NK cell populations expressing NKG2C and/or LIR1 and lacking FcRγ.

Methods

Indonesian HIV patients (n = 40) were tested before ART and after 6 months, with healthy local controls (n = 20). All patients had high CMV antibody titres. 52% started therapy with CMV DNA detectable by qPCR, providing a crude measure of CMV burden. Proportions of CD56Hi or CD56Lo NK cells expressing FcRγ, NKG2C or LIR1 were determined flow cytometrically. CVD was predicted using carotid intimal media thickness (cIMT). Values were correlated with levels of CMV antibodies on ART.

Results

Patients had low proportions of CD56Lo and more CD56Hi NK cells. However proportions of FcRγ− NK cells were lowest in patients with CMV DNA, and cIMT values related inversely with FcRγ− NK cells in these patients. Percentages of NKG2C+CD56Lo NK cells were similar in patients and controls, but rose in patients with CMV DNA. Proportions of NKG2C+ CD56Hi NK cells correlated with levels of CMV antibodies in CMV DNA-negative patients.

Conclusions

We show that the very high burdens of CMV in this population confound systems developed to study effects of CMV in other populations. FcRγ− NK cells may be depleted by very high CMV burdens, but NKG2C and antibody levels may be informative in patients on ART.
Oncolytic therapy with vaccinia virus carrying IL-24 for hepatocellular carcinoma
Authors: Deng Lili , Yang Xue , Ding Yuedi , Fan Jun , Peng Ying , Xu Dong , Huang Biao , Hu Zhigang
Published: March 2022

Background

Hepatocellular carcinoma (HCC) is a highly refractory cancer associated with increasing mortality, which currently lacks effective treatment options. Interleukin-24 (IL-24) is a novel tumor suppressor cytokine that can selectively induce cancer cell apoptosis, and it has been utilized as a cancer gene therapy strategy. The vaccinia virus is a promising strategy for cancer therapy, owing to its direct viral lytic effects, as well as a vehicle to overexpress therapeutic transgenes.

Methods

We constructed a recombinant oncolytic vaccinia viruse (VG9-IL-24) based on vaccinia virus Guang9 (VG9) harboring the IL-24 gene. In vitro, we assessed the replication of VG9-IL-24 in HCC cell lines and normal liver cells and evaluated the cytotoxicity in different cell lines; then, we determined the expression of IL-24 by RT-PCR and ELISA. We examined apoptosis and cell cycle progression in SMMC-7721 cells treated with VG9-IL-24 by flow cytometry. In vivo, we established the SMMC-7721 xenograft mouse model to evaluate the antitumor effects of VG9-IL-24.

Results

In vitro, VG9-IL-24 efficiently infected HCC cell lines, but not normal liver cells, and resulted in a high level of IL-24 expression and significant cytotoxicity. Moreover, VG9-IL-24 induced an increase in the proportion of apoptotic cells and blocked the SMMC-7721 cell cycle in the G2/M phase. In vivo, tumor growth was significantly suppressed and the survival was prolonged in VG9-IL-24-treated mice.

Conclusions

Vaccinia virus VG9-mediated gene therapy might be an innovative treatment for cancer with tumor-specific lysis and apoptosis-inducing effects. VG9-IL-24 exhibited enhanced antitumor effects and is a promising candidate for HCC therapy.
Monitoring population salt intake using casual urinary sodium: Tehran Lipid and Glucose Study
Authors: Bahadoran Zahra , Mirmiran Parvin , Norouzirad Reza , Ghasemi Asghar , Azizi Fereidoun
Published: March 2022

Background

We aimed to estimate salt intake among an Iranian population using spot urine-based equations and a dietary-based method.

Methods

Adult men and women (n = 2069) were recruited from the Tehran Lipid and Glucose Study (2014–2017). Urinary sodium (Na), potassium (K), and creatinine (Cr) concentrations were measured in the morning spot urine samples. The 24-h urinary Na excretion and predicted salt intake was estimated using five equations, i.e., Kawasaki, Tanaka, Intersalt, Toft, and Whitton. A validated food frequency questionnaire (FFQ) was used to obtain dietary intake of salt. The agreement of each urinary- and FFQ-based salt estimation with the overall mean of the methods, considered as the gold standard, was assessed using the Bland–Altman method.

Results

Mean age of the participants was 45.6 ± 14.8 y, and 45.4% were men. Mean (SD) estimated salt intake, derived from the overall mean of the methods, was 9.0 ± 2.2 g/d (10.2 ± 2.1 and 7.9 ± 1.7 g/d in men and women, respectively). Mean bias of the estimations from the overall mean ranged from − 0.2.42 to 2.75 g/d, with the Tanaka equation having the least bias (mean bias = 0.13 ± 1.10, 95% CI − 2.37, 2.30 g/d). Tanaka estimated a mean salt intake of 8.9 g/d (range 2.1 to 18.7 g/d); accordingly, only 5.1% of participants adhered to the recommendation (< 5 g/d salt intake), whereas 26.8% and 2.4% exceeded the recommendation by 2- and threefold.

Conclusion

The Tanaka equation could provide a more accurate mean-population estimated salt intake from casual urinary Na concentration in our population. About 95% of the Iranian population exceeded the current recommendations of salt intake.
Thoracoscopic giant lung bullaectomy: our initial experience
Authors: Kolodii Marina , Azzam Sharbel , Peer Michael
Published: March 2022

Background

Giant lung bullae (GLB) are rare, and the only currently available management involves either an open surgical resection (thoracotomy) or the newer minimally invasive resection consisting of video-assisted thoracoscopic surgery (VATS). The aim of our study was to evaluate the possible influence of GLBs pulmonary attachment on patient's post-operative complications.

Methods

A retrospective analysis included all consecutive patients with GLBs who underwent bullae's surgical resection from 7/2007 to 12/2018. GLBs patient's individual characteristics, including demographics, comorbidities, and clinical pre-operative, surgical intra-operative and post-operative data were evaluated.

Results

20 patients with GLBs, 15 males and 5 females with average age of 48.9 years (range, 22–67 years) underwent 21 surgical procedures. The GLBs were located in the right lung in 12 patients, in the left lung in seven patients, and in both lungs in one patient. Fifteen patients (75%) were symptomatic on admission and underwent urgent surgery. Five asymptomatic patients (25%) were operated on electively. Thirteen from 21 surgical procedures (61.9%) were VATS bullectomy, while the other eight were thoracotomies (38.1%). Complications included pneumonia successfully treated with intravenous antibacterial therapy in two thoracotomy patients and in one VATS patient (three patients, 14.2%) and a prolonged air leak in two thoracotomy and four VATS patients (six patients, 28.5%). Out of 21 GLBs, eight had a wide attachment with lung parenchyma (wide-based bullae's) and 13 had a short attachment (short-based bullae's). Two re-operated patients, with prolonged air leak complicated with empyema, had a wide-based GLBs. The median hospital stay was nine days. All patients completed the 24-month follow-up.

Conclusions

Minimally invasive video-assisted thoracoscopic surgery as an open thoracotomy surgery is a safe and effective for giant lung bullae (GLB). Patients with wide-based GLBs were more likely to develop postoperative prolonged air leak that requiring re-operation.
Target-oriented prioritization: targeted selection strategy by integrating organismal and molecular traits through predictive analytics in breeding
Authors: Yang Wenyu , Guo Tingting , Luo Jingyun , Zhang Ruyang , Zhao Jiuran , Warburton Marilyn L. , Xiao Yingjie , Yan Jianbing
Published: March 2022

Genomic prediction in crop breeding is hindered by modeling on limited phenotypic traits. We propose an integrative multi-trait breeding strategy via machine learning algorithm, target-oriented prioritization (TOP). Using a large hybrid maize population, we demonstrate that the accuracy for identifying a candidate that is phenotypically closest to an ideotype, or target variety, achieves up to 91%. The strength of TOP is enhanced when omics level traits are included. We show that TOP enables selection of inbreds or hybrids that outperform existing commercial varieties. It improves multiple traits and accurately identifies improved candidates for new varieties, which will greatly influence breeding.