bluuebunny/crossref_metadata_2025 huggingface dataset:
A case report of pseudoaneurysm of coronary artery within a month of percutaneous coronary intervention
Authors: Sharma Raghav , Ruia Aditya Vikram
Published: April 2022

Background

Coronary artery pseudoaneurysms (PSAs) are uncommon and have poorly understood natural history. Unlike true aneurysms, PSAs do not have all the three layers of the vessel in the aneurysmal wall. The PSAs are most commonly seen after an overzealous percutaneous coronary intervention (PCI) which causes damage to the vessel wall. They usually develop slowly after PCI and PSAs within a month of a PCI are not so common. The PSA may be asymptomatic or present with recurrent angina.

Case summary

Here, we report a case of symptomatic PSA to right coronary artery (RCA). The patient had a myocardial infarction for which a PCI was performed to deploy a drug-eluting stent (DES) in the RCA. The patient had in-stent restenosis (ISR) within a week of PCI for which plain old balloon angioplasty (POBA) was performed. The patient continued to have unstable angina and within a month of POBA was diagnosed as a case of PSA by intravascular ultrasound. A covered stent was deployed which effectively sealed off the PSA and resumed normal blood flow to distal vessel. Patient has been doing well on medication [aspirin 75 mg once daily, atorvastatin 80 mg once daily, and P2Y12 platelet inhibitor (Ticagrelor) 90 mg twice daily].

Discussion

The PSAs usually take 6–9 months to develop. However, PSAs have been reported within 1–2 months of PCI. This case also shows that PSAs can occur within a month of PCI. It is possible that over-aggressive and/or high-pressure dilatation and/or deep engagement during POBA performed to open up the ISR could have damaged the struts of the DES and compressed it against the vascular wall. The resultant vascular wall injury could have been the cause of early PSA formation in this case. Hence, cardiologists should be vigilant enough to suspect PSA, especially in a patient presenting with angina. The case also shows that covered stents are a viable option to treat early presentations of PSA.
Transradial versus transfemoral approach for percutaneous coronary intervention in patients with ST-elevation myocardial infarction complicated by cardiogenic shock: a systematic review and meta-analysis
Authors: Ahsan Muhammad Junaid , Ahmad Soban , Latif Azka , Lateef Noman , Ahsan Mohammad Zoraiz , Abusnina Waiel , Nathan Sandeep , Altin S Elissa , Kolte Dhaval S , Messenger John C , Tannenbaum Mark , Goldsweig Andrew M
Published: April 2022

Background

In ST-elevation myocardial infarction (STEMI), transradial access (TRA) for percutaneous coronary intervention (PCI) is associated with less bleeding and mortality than transfemoral access (TFA). However, patients in cardiogenic shock (CS) are more often treated via TFA. The aim of this meta-analysis is to compare the safety and efficacy of TRA vs. TFA in CS.

Methods

Systematic review was performed querying PubMed, Google Scholar, Cochrane, and clinicaltrials.gov for studies comparing TRA to TFA in PCI for CS. Outcomes included in-hospital, 30-day and ≥1-year mortality, major and access site bleeding, TIMI3 (thrombolytics in myocardial infarction) flow, procedural success, fluoroscopy time, and contrast volume. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated using random effects models.

Results

Six prospective and eight retrospective studies (TRA, n = 8032; TFA, n = 23 031) were identified. TRA was associated with lower in-hospital (RR 0.59, 95% CI 0.52–0.66, P < 0.0001), 30-day and ≥1-year mortality, as well as less in-hospital major (RR 0.41, 0.31–0.56, P < 0.001) and access site bleeding (RR 0.42, 0.23–0.77, P = 0.005). There were no statistically significant differences in post-PCI coronary flow grade, procedural success, fluoroscopy time, and contrast volume between TRA vs. TFA.

Conclusions

In PCI for STEMI with CS, TRA is associated with significantly lower mortality and bleeding complications than TFA while achieving similar TIMI3 flow and procedural success rates.
Factors predicting recurrence in thymic epithelial neoplasms
Authors: Alkaaki Aroub , Abo Al-Saud Ali , Di Lena Élise , Ramirez-GarciaLuna Jose Luis , Najmeh Sara , Spicer Jonathan , Ferri Lorenzo , Mulder David , Sirois Christian , Cools-Lartigue Jonathan
Published: April 2022

OBJECTIVES

Thymic epithelial neoplasms (TENs) represent a heterogeneous group of rare thoracic malignancies. We analysed the clinicopathological features, survival outcomes, risk factors, and patterns of recurrence in patients undergoing resection.

METHODS

Records were reviewed for adult patients with TEN who underwent resection from 2006 to 2019. Survival rates were assessed using the Kaplan–Meier method. Univariable and multivariable analyses were performed using the log-rank test and Cox proportional hazards model.

RESULTS

A total of 100 patients were analysed (51 females, median age 58 years). Thymoma was the most common histology (n = 92), followed by thymic carcinoma (n = 5) and thymic neuroendocrine tumour (n = 3). Stage II (Masaoka) tumours were most common (n = 51), followed by stage I (n = 27). World Health Organization B2/B3 was the most prominent histological subtype (n = 34). Complete resection (R0) was achieved in 91 patients: 86/92 thymoma, 4/5 thymic carcinoma and 1/3 neuroendocrine tumour. The most common treatment modality was surgery alone in 72 patients, followed by surgery and radiation therapy in 24, and adjuvant chemoradiotherapy in 3 patients. Only one patient with thymic carcinoma received neoadjuvant chemotherapy. The 10-year overall and disease-free survival rates were 86.6% and 83.9%, respectively. Recurrence was most common in neuroendocrine tumours (3/3). Risk factors for recurrence identified on multivariable analyses were: R1/2 resection (hazard ratio 9.30; 95% confidence interval 1.82–36.1), TEN subtype (hazard ratio 8.08; 95% confidence interval 1.24–34.6), and presence of lymphovascular invasion (hazard ratio 9.56; 95% confidence interval 2.56–25.8).

CONCLUSIONS

Complete resection remains critical in patients with TEN. Incomplete resection, high-risk histology, and lymphovascular invasion highlight the need for effective adjuvant modalities. Given the rarity of these diseases, emphasis must be placed on collaborative research conducted on TEN.
International Investment Law and Discipline for the Indebted
Authors: Schneiderman David
Published: April 2022

The object of the article is to recover the institutional memory of the 1980s debt crisis, when the decolonized world experienced forms of tutelage at the hands of international financial institutions, so as to sketch out material and discursive continuities with investment law’s present. The paper asks whether damage awards in investment arbitration serve functions analogous to state indebtedness in the 1980s. As during the 1980–1989 debt crisis, states are expected to generate the conditions for investor confidence by, among other things, guaranteeing rights to property and to contract. State indebtedness, in both periods, places stress on government budgets and reduces the living standards of poor people, contributing to heightened inequality within and between states. The article begins with a social-theoretical discussion of how debt serves to curb the possibilities for political action. This is followed by a review of IMF borrowing practices in the 1980s and a discussion of the merits of comparison with contemporary investment law. The narrative frames arising during the 1980s debt crisis that continue to have resonance in the era of investment law are taken up in subsequent sections, focusing on the refrains of mismanagement, the missing development angle, shrunken policy space and irrelevance of ability to pay. The method is predominantly qualitative, although reference is made to relevant empirical work. In the course of the discussion, the Tethyan Copper v. Pakistan (2019) ruling is periodically revisited as a specimen of how tribunals arrive at damages assessments in investment arbitration. The upshot is that indebtedness in the contemporary world serves functions similar to that in the 1980s: principally to constrain policy capacity in a wide range of sectors. These binding constraints serve the interests of only a small set of actors, while those rendered most vulnerable by these constraints are relegated to the margins.
Single versus multiple arterial grafting in diabetic patients at 10 years: the Arterial Revascularization Trial
Authors: Taggart David P , Audisio Katia , Gerry Stephen , Robinson N Bryce , Rahouma Mohamed , Soletti Giovanni Jr , Cancelli Gianmarco , Benedetto Umberto , Lees Belinda , Gray Alastair , Stefil Maria , Flather Marcus , Gaudino Mario , Investigators A R T
Published: April 2022

Aims

To evaluate the impact of multiple arterial grafting (MAG) vs. single arterial grafting (SAG) in a post hoc analysis of 10-year outcomes in patients with diabetes mellitus (DM) from the Arterial Revascularization Trial (ART).

Methods and results

The primary endpoint was all-cause mortality and the secondary endpoint was a composite of major adverse cardiac events (MACE) at 10-year follow-up. Patients were stratified by diabetes status (non-DM and DM) and grafting strategy (MAG vs. SAG). A total of 3020 patients were included in the analysis; 716 (23.7%) had DM. Overall, 55.8% non-DM patients received MAG and 44.2% received SAG, while 56.6% DM patients received MAG and 43.4% received SAG. The use of MAG compared with SAG was associated with lower 10-year mortality for both non-DM [17.7 vs. 21.0%, adjusted hazard ratio (HR) 0.87, 95% confidence interval (CI) 0.72–1.06] and DM patients (21.5 vs. 29.9%, adjusted HR 0.65, 95% CI 0.48–0.89; P for interaction = 0.12). For both groups, the rate of 10-year MACE was also lower for MAG vs. SAG. Overall, deep sternal wound infections (DSWIs) were uncommon but more frequent in the MAG vs. SAG group in both non-DM (3.3 vs. 2.1%) and DM patients (7.9 vs. 4.8%). The highest rates of DSWI were in insulin-treated patients receiving MAG (9.6 vs. 6.3%, when compared with SAG).

Conclusion

In this post hoc analysis of the ART, MAG was associated with substantially lower mortality rates at 10 years after coronary artery bypass grafting in patients with DM. Patients with DM receiving MAG had a higher incidence of DSWI, especially if insulin dependent.
The collateral damage of COVID-19 to cardiovascular services: a meta-analysis
Authors: Nadarajah Ramesh , Wu Jianhua , Hurdus Ben , Asma Samira , Bhatt Deepak L , Biondi-Zoccai Giuseppe , Mehta Laxmi S , Ram C Venkata S , Ribeiro Antonio Luiz P , Van Spall Harriette G C , Deanfield John E , Lüscher Thomas F , Mamas Mamas , Gale Chris P
Published: April 2022

Aims

The effect of the COVID-19 pandemic on care and outcomes across non-COVID-19 cardiovascular (CV) diseases is unknown. A systematic review and meta-analysis was performed to quantify the effect and investigate for variation by CV disease, geographic region, country income classification and the time course of the pandemic.

Methods and results

From January 2019 to December 2021, Medline and Embase databases were searched for observational studies comparing a pandemic and pre-pandemic period with relation to CV disease hospitalisations, diagnostic and interventional procedures, outpatient consultations, and mortality. Observational data were synthesised by incidence rate ratios (IRR) and risk ratios (RR) for binary outcomes and weighted mean differences for continuous outcomes with 95% confidence intervals. The study was registered with PROSPERO (CRD42021265930). A total of 158 studies, covering 49 countries and 6 continents, were used for quantitative synthesis. Most studies (80%) reported information for high-income countries (HICs). Across all CV disease and geographies there were fewer hospitalisations, diagnostic and interventional procedures, and outpatient consultations during the pandemic. By meta-regression, in low-middle income countries (LMICs) compared to HICs the decline in ST-segment elevation myocardial infarction (STEMI) hospitalisations (RR 0.79, 95% confidence interval [CI] 0.66–0.94) and revascularisation (RR 0.73, 95% CI 0.62–0.87) was more severe. In LMICs, but not HICs, in-hospital mortality increased for STEMI (RR 1.22, 95% CI 1.10–1.37) and heart failure (RR 1.08, 95% CI 1.04–1.12). The magnitude of decline in hospitalisations for CV diseases did not differ between the first and second wave.

Conclusions

There was substantial global collateral CV damage during the COVID-19 pandemic with disparity in severity by country income classification.
Development and validation of a prediction model for unemployment and work disability among 55 950 Dutch workers
Authors: Ots Patricia , Oude Hengel Karen M , Burdorf Alex , Robroek Suzan J W , Nieboer Daan , Schram Jolinda L D , van Zon Sander K R , Brouwer Sandra
Published: April 2022

Background

This study developed prediction models for involuntary exit from paid employment through unemployment and disability benefits and examined if predictors and discriminative ability of these models differ between five common chronic diseases.

Methods

Data from workers in the Lifelines Cohort Study (n = 55 950) were enriched with monthly information on employment status from Statistics Netherlands. Potential predictors included sociodemographic factors, chronic diseases, unhealthy behaviours and working conditions. Data were analyzed using cause-specific Cox regression analyses. Models were evaluated with the C-index and the positive and negative predictive values (PPV and NPV, respectively). The developed models were externally validated using data from the Study on Transitions in Employment, Ability and Motivation.

Results

Being female, low education, depression, smoking, obesity, low development possibilities and low social support were predictors of unemployment and disability. Low meaning of work and low physical activity increased the risk for unemployment, while all chronic diseases increased the risk of disability benefits. The discriminative ability of the models of the development and validation cohort were low for unemployment (c = 0.62; c = 0.60) and disability benefits (c = 0.68; c = 0.75). After stratification for specific chronic diseases, the discriminative ability of models predicting disability benefits improved for cardiovascular disease (c = 0.81), chronic obstructive pulmonary disease (c = 0.74) and diabetes mellitus type 2 (c = 0.74). The PPV was low while the NPV was high for all models.

Conclusion

Taking workers’ particular disease into account may contribute to an improved prediction of disability benefits, yet risk factors are better examined at the population level rather than at the individual level.
Higher risk, higher protection: COVID-19 risk among immigrants in France—results from the population-based EpiCov survey
Authors: Gosselin Anne , Warszawski Josiane , Bajos Nathalie ,   for the EpiCov Study Group, Bajos Nathalie , Warszawski Josiane , Bagein Guillaume , Beck François , Counil Emilie , Jusot Florence , Lydié Nathalie , Martin Claude , Meyer Laurence , Raynaud Philippe , Rouquette Alexandra , Pailhé Ariane , Rahib Delphine , Sillard Patrick , Slama Rémy , Spire Alexis
Published: April 2022

Background

Immigrants and ethnic/racialized minorities have been identified as being at higher risk of coronavirus disease-19 (COVID-19) infection, but few studies report on their exposures and prevention behaviours. This study aims to examine the social distribution of COVID-19 exposure (overcrowding, working outside the home, use of public transport to go to work) and prevention behaviours (use of face masks, washing hands, respect for physical distance) in France during the first wave of the epidemic.

Methods

We used the EpiCov population-based survey from a random sample of individuals aged 15 years or more. We determined the distribution of the self-reported outcomes according to migratory status and sex, using χ2 tests. We modelled the probability of outcomes with logistic regression. Finally, we focused the analysis on the Greater Paris area and accounted for neighbourhood characteristics.

Results

A total of 111 824 participants were included in the study. Overall, immigrant groups from non-European countries were more exposed to COVID-19-related factors and more respectful of prevention measures. The probability of overcrowding and the use of public transport was higher for immigrants from sub-Saharan Africa [adjusted odds ratio (aOR) = 3.71 (3.19; 4.32), aOR = 6.36 (4.86; 8.32)] than for the majority population. Immigrant groups were less likely to have a non-systematic use of face masks and to breach physical distancing than the majority population [for immigrants from sub-Saharan Africa, aOR = 0.32 (0.28; 0.37) and aOR = 0.71 (0.61; 0.81), respectively]. Living in a neighbourhood with a higher share of immigrants was associated with higher exposure and better prevention behaviours.

Conclusions

In France, immigrants had a higher exposure to COVID-19-related factors and more systematic prevention behaviours.
Comparative Study of Protein Aggregation Propensity and Mutation Tolerance Between Naked Mole-Rat and Mouse
Authors: Besse Savandara , Poujol Raphaël , Hussin Julie G.
Published: April 2022

The molecular mechanisms of aging and life expectancy have been studied in model organisms with short lifespans. However, long-lived species may provide insights into successful strategies for healthy aging, potentially opening the door for novel therapeutic interventions in age-related diseases. Notably, naked mole-rats, the longest-lived rodent, present attenuated aging phenotypes compared with mice. Their resistance toward oxidative stress has been proposed as one hallmark of their healthy aging, suggesting their ability to maintain cell homeostasis, specifically their protein homeostasis. To identify the general principles behind their protein homeostasis robustness, we compared the aggregation propensity and mutation tolerance of naked mole-rat and mouse orthologous proteins. Our analysis showed no proteome-wide differential effects in aggregation propensity and mutation tolerance between these species, but several subsets of proteins with a significant difference in aggregation propensity. We found an enrichment of proteins with higher aggregation propensity in naked mole-rat, and these are functionally involved in the inflammasome complex and nucleic acid binding. On the other hand, proteins with lower aggregation propensity in naked mole-rat have a significantly higher mutation tolerance compared with the rest of the proteins. Among them, we identified proteins known to be associated with neurodegenerative and age-related diseases. These findings highlight the intriguing hypothesis about the capacity of the naked mole-rat proteome to delay aging through its proteomic intrinsic architecture.
DnaA and SspA Regulation of the iraD gene of E. coli: an alternative DNA damage response independent of LexA/RecA
Authors: Sass Thalia H , Ferrazzoli Alexander E , Lovett Susan T
Published: April 2022

The transcription factor RpoS (σS) of Escherichia coli controls many genes important for tolerance of a variety of stress conditions. IraD promotes the post-translation stability of RpoS by inhibition of RssB, an adaptor protein for ClpXP degradation. We have previously documented DNA damage induction of iraD expression, independent of the SOS response. Both iraD and rpoS are required for tolerance to DNA damaging treatments such as H2O2 and the replication inhibitor azidothymidine (AZT) in the log phase of growth. Using luciferase gene fusions to the 672 bp iraD upstream region, we show here that both promoters of iraD are induced by AZT. Genetic analysis suggests that both promoters are repressed by DnaA-ATP, partially dependent on a putative DnaA box at -81 bp and are regulated by RIDA (regulatory inactivation of DnaA), dependent on the DnaN processivity clamp. By electrophoretic mobility shift assays we show that purified DnaA protein binds to the iraD upstream region, so DnaA regulation of IraD is likely to be direct. DNA damage induction of iraD during log phase growth is abolished in the dnaA-T174P mutant, suggesting that DNA damage, in some way, relieves DnaA repression, possibly through the accumulation of replication clamps and enhanced RIDA. We also demonstrate that the RNA-polymerase associated factor, SspA (stringent starvation protein A), induced by the accumulation of ppGpp, also affects iraD expression, with a positive effect on constitutive expression and a negative effect on AZT-induced expression.
Atypical strategies for cuticle pigmentation in the blood-feeding hemipteran Rhodnius prolixus
Authors: Berni Mateus , Lima Leonardo , Bressan Daniel , Julio Alison , Bonfim Larissa , Simão Yasmin , Pane Attilio , Ramos Isabela , Oliveira Pedro L , Araujo Helena
Published: April 2022

Pigmentation in insects has been linked to mate selection and predator evasion, thus representing an important aspect for natural selection. Insect body color is classically associated to the activity of tyrosine pathway enzymes, and eye color to pigment synthesis through the tryptophan and guanine pathways, and their transport by ATP-binding cassette proteins. Among the hemiptera, the genetic basis for pigmentation in kissing bugs such as Rhodnius prolixus, that transmit Chagas disease to humans, has not been addressed. Here, we report the functional analysis of R. prolixus eye and cuticle pigmentation genes. Consistent with data for most insect clades, we show that knockdown for yellow results in a yellow cuticle, while scarlet and cinnabar knockdowns display red eyes as well as cuticle phenotypes. In addition, tyrosine pathway aaNATpreto knockdown resulted in a striking dark cuticle that displays no color pattern or UV reflectance. In contrast, knockdown of ebony and tan, that encode N-beta-alanyl dopamine hydroxylase branch tyrosine pathway enzymes, did not generate the expected dark and light brown phenotypes, respectively, as reported for other insects. We hypothesize that R. prolixus, which requires tyrosine pathway enzymes for detoxification from the blood diet, evolved an unusual strategy for cuticle pigmentation based on the preferential use of a color erasing function of the aaNATpreto tyrosine pathway branch. We also show that genes classically involved in the generation and transport of eye pigments regulate red body color in R. prolixus. This is the first systematic approach to identify the genes responsible for the generation of color in a blood-feeding hemiptera, providing potential visible markers for future transgenesis.
Approximation of SPDE covariance operators by finite elements: a semigroup approach
Authors: Kovács Mihály , Lang Annika , Petersson Andreas
Published: April 2022

The problem of approximating the covariance operator of the mild solution to a linear stochastic partial differential equation is considered. An integral equation involving the semigroup of the mild solution is derived and a general error decomposition is proven. This formula is applied to approximations of the covariance operator of a stochastic advection-diffusion equation and a stochastic wave equation, both on bounded domains. The approximations are based on finite element discretizations in space and rational approximations of the exponential function in time. Convergence rates are derived in the trace class and Hilbert–Schmidt norms with numerical simulations illustrating the results.
Modelling the effect of COVID-19 mass vaccination on acute hospital admissions
Authors: Booton Ross D , Powell Anna L , Turner Katy M E , Wood Richard M
Published: April 2022

Background

Managing high levels of acute COVID-19 bed occupancy can affect the quality of care provided to both affected patients and those requiring other hospital services. Mass vaccination has offered a route to reduce societal restrictions while protecting hospitals from being overwhelmed. Yet, early in the mass vaccination effort, the possible impact on future bed pressures remained subject to considerable uncertainty.

Objective

The aim of this study was to model the effect of vaccination on projections of acute and intensive care bed demand within a 1 million resident healthcare system located in South West England.

Methods

An age-structured epidemiological model of the susceptible–exposed–infectious–recovered type was fitted to local data up to the time of the study, in early March 2021. Model parameters and vaccination scenarios were calibrated through a system-wide multidisciplinary working group, comprising public health intelligence specialists, healthcare planners, epidemiologists and academics. Scenarios assumed incremental relaxations to societal restrictions according to the envisaged UK Government timeline, with all restrictions to be removed by 21 June 2021.

Results

Achieving 95% vaccine uptake in adults by 31 July 2021 would not avert the third wave in autumn 2021 but would produce a median peak bed requirement ∼6% (IQR: 1–24%) of that experienced during the second wave (January 2021). A 2-month delay in vaccine rollout would lead to significantly higher peak bed occupancy, at 66% (11–146%) of that of the second wave. If only 75% uptake was achieved (the amount typically associated with vaccination campaigns), then the second wave peak for acute and intensive care beds would be exceeded by 4% and 19%, respectively, an amount which would seriously pressure hospital capacity.

Conclusion

Modelling influenced decision-making among senior managers in setting COVID-19 bed capacity levels, as well as highlighting the importance of public health in promoting high vaccine uptake among the population. Forecast accuracy has since been supported by actual data collected following the analysis, with observed peak bed occupancy falling comfortably within the inter-quartile range of modelled projections.
The association between women’s empowerment and reproductive health care utilization in Cameroon
Authors: Mokam Blandine , Zamo Akono Christian
Published: April 2022

Background

The context related to maternal mortality has improved over the past decade in Cameroon. However, the demand for reproductive health care use remains insufficient with regard to public health policy targets, and women’s empowerment is identified as a catalyst with a great potential.

Objective

This study aims to analyse the association between the dimensions of women’s empowerment and the utilization of adequate reproductive health care.

Method

The data comes from the fifth demographic and health survey of Cameroon carried out in 2018. Women’s empowerment is measured through two indices: the economic status index and the decision-making index. Given the dichotomous nature of reproductive health outcomes, namely the use of at least four antenatal visits during pregnancy, the timing from the first antenatal visit and the place of delivery, a logistic regression model is adopted.

Results

The results suggest that an increase in the decision-making index was significantly associated with higher chances of having at least four antenatal visits during pregnancy (odds ratio [OR]: 1.25; 95% confidence interval [CI]: 1.20, 1.29), of making the first prenatal visit during the first 3 months of pregnancy (OR: 1.03; 95% CI: 1.01, 1.07) and delivery in a hospital (OR: 1.34; 95% CI: 1.29, 1.39). However, a better economic status of the woman in the household was associated with lower chances of making the first prenatal visit during the first 3 months of pregnancy (OR: 0.65; 95% CI: 0.60, 0.71) and giving birth in a hospital (OR: 0.92; 95% CI: 0.83, 1.01); but no significant association was found with the number of antenatal visits. These different associations do not remain the same when mother and household characteristics are controlled. In addition, the results illustrate the key role that education, household wealth and media exposure played in the use of reproductive health care.

Conclusion

One of the strategic objectives of the Health Sector Strategy 2016–2027, the framework document for the public health policy in force, is to reduce maternal mortality rates by improving access to reproductive health care. To achieve this objective, this study suggests that policymakers should emphasize social policies favourable to women’s empowerment in Cameroon by pointing out access to income-generating activities and decision-making within the household.
Long Noncoding RNA lncR17454 Regulates Metamorphosis of Silkworm Through let-7 miRNA Cluster
Authors: Fu Yu , Wang Yi , Huang Qunxia , Zhao Chenyue , Li Xinmei , Kan Yunchao , Li Dandan
Published: April 2022

A number of long noncoding RNAs (lncRNAs) have been identified in silkworm, but little is known about their functions. Recent study showed that the let-7 miRNA cluster (contains let-7, miR-2795, and miR-100) was transcribed from the last exon of lncRNA lncR17454 in silkworm. To investigate the functional role of lncR17454, dsRNAs of lncR17454 were injected into the hemolymph of 1-d-old third-instar larvae of Bombyx mori, repression of lncR17454 led to molting arrestment during the larval–larval and larval–pupal transition of silkworm, which was consistent to the result as let-7 knockdown in other studies. The expression level of mature let-7, miR-100, and miR-2795 decreased 40%, 36%, and 40%, respectively, while the mRNA level of two predicted target genes of let-7, the Broad Complex isoform 2 (BR-C-Z2) and the BTB-Zinc finger transcription repression factor gene Abrupt (Ab), increased significantly after lncR17454 knockdown. In contrast, when adding the 20-Hydroxyecdysone (20E) to silkworm BmN4 cell lines, the expression level of lncR17454 and let-7 cluster all increased significantly, but the expression of Abrupt, the predicted target gene of let-7, was repressed. Dual-luciferase reporter assays confirmed Abrupt was the real target of let-7. Here we found that the lncRNA lncR17454 can play regulator roles in the metamorphosis of silkworm through let-7 miRNA cluster and the ecdysone signaling pathway, which will provide new clues for lepidopteran pest control.
Feasibility of control of particle assembly by dielectrophoresis in liquid-cell transmission electron microscopy
Authors: Yamazaki Tomoya , Niinomi Hiromasa , Kimura Yuki
Published: April 2022

Liquid-cell transmission electron microscopy (LC-TEM) is a useful technique for observing phenomena in liquid samples with spatial and temporal resolutions similar to those of conventional transmission electron microscopy (TEM). This method is therefore expected to permit the visualization of phenomena previously inaccessible to conventional optical microscopy. However, dynamic processes such as nucleation are difficult to observe by this method because of difficulties in controlling the condition of the sample liquid in the observation area. To approach this problem, we focused on dielectrophoresis, in which electrodes are used to assemble particles, and we investigated the phenomena that occurred when an alternating-current signal was applied to an electrode in an existing liquid cell by using a phase-contrast optical microscope (PCM) and TEM. In PCM, we observed that colloidal particles in a solution were attracted to the electrodes to form assemblies, that the particles aligned along the electric field to form pearl chains and that the pearl chains accumulated to form colloidal crystals. However, these phenomena were not observed in the TEM study because of differences in the design of the relevant holders. The results of our study imply that the particle assembly by using dielectrophoretic forces in LC-TEM should be possible, but further studies, including electric device development, will be required to realize this in practice.
Intestinal tuberculosis masquerading as carcinoma colon: a case report of diagnostic quandary in low-resource setting
Authors: Panthi Sagar , Khatiwada Pradeep , Adhikari Seema , Acharya Rochana , Neupane Durga , Sharma Ananta , Yadav Pramodman Singh , Yadav Padmini , Bhattarai Raksha , Khanal Bhawani
Published: April 2022

Intestinal tuberculosis (TB) is a rare condition comprising a majority of the extra-pulmonary TB cases. Owing to a similar clinical presentation, ultrasonographic and biopsy findings of intestinal TB with that of other abdominal pathologies such as carcinoma colon, their clinical delineation is very difficult unless aided with other modalities of investigations such as colonoscopy, culture of the biopsy material, etc. and even advanced methods such as polymerase chain reaction and gene X-pert of the biopsy material. Having all these investigations may not even lead to a correct diagnosis of intestinal TB as evidenced in the reported cases in the literature, advocating the need of diagnostic laparoscopy in the diagnosis of intestinal TB to eliminate extensive and unnecessary surgeries. Here, we present a case of intestinal TB in a 51-year-gentleman who got diagnosed in the course of treatment for a suspected carcinoma colon.
Energy law in crisis: an energy justice revolution needed
Authors: Heffron Raphael J
Published: April 2022

Energy research has been growing in a holistic way whereby researchers are connecting their research to the bigger picture of an ‘energy system’. Energy law scholarship has lacked this direction and traditionally has focused too narrowly on specific topics such as electricity markets or extraction. A major limitation has permeated through scholarship in the area and relatively no connection is made to the energy system. Energy law scholarship did not for example, state where the energy system can improve and deliver a just outcome. The lack of identifying such a connection has permitted energy law scholars to fall under the radar and continue to work on issues that in essence support the continued development of traditional energy sources, ie, fossil fuels. Only a minority of researchers have shifted their focus in a real and impactful way to ensuring energy law delivers just outcomes for society. Energy justice scholarship has allowed scholars to do that. It has emerged as a major interdisciplinary energy research topic yet there remain remarkably few energy law scholars interacting with it. Many scholars remain reluctant to read beyond traditional research in energy law not to mention engage in interdisciplinary energy journals which increasingly publish legal scholarship. This article calls for the further development of the modern energy law scholar. For such scholars to exist, there needs to be a revolution in energy law scholarship to ensure law contributes to the ongoing global climate emergency.
Is PTSD an Evolutionary Survival Adaptation Initiated by Unrestrained Cytokine Signaling and Maintained by Epigenetic Change?
Authors: Rudzki Stephan
Published: April 2022

Introduction

Treatment outcomes for PTSD with current psychological therapies are poor, with very few patients achieving sustained symptom remission. A number of authors have identified physiological and immune disturbances in Post Traumatic Stress Disorder (PTSD) patients, but there is no unifying hypothesis that explains the myriad features of the disorder.

Materials and Methods

The medical literature was reviewed over a 6-year period primarily using the medical database PUBMED.

Results

The literature contains numerous papers that have identified a range of physiological and immune dysfunction in association with PTSD. This paper proposes that unrestrained cytokine signaling induces epigenetic changes that promote an evolutionary survival adaptation, which maintains a defensive PTSD phenotype. The brain can associate immune signaling with past threat and initiate a defensive behavioral response. The sympathetic nervous system is pro-inflammatory, while the parasympathetic nervous system is anti-inflammatory. Prolonged cholinergic withdrawal will promote a chronic inflammatory state. The innate immune cytokine IL-1β has pleiotropic properties and can regulate autonomic, glucocorticoid, and glutamate receptor functions, sleep, memory, and epigenetic enzymes. Changes in epigenetic enzyme activity can potentially alter phenotype and induce an adaptation. Levels of IL-1β correlate with severity and duration of PTSD and PTSD can be prevented by bolus administration of hydrocortisone in acute sepsis, consistent with unrestrained inflammation being a risk factor for PTSD. The nervous and immune systems engage in crosstalk, governed by common receptors. The benefits of currently used psychiatric medication may arise from immune, as well as synaptic, modulation. The psychedelic drugs (3,4-Methylenedioxymethamphetamine (MDMA), psilocybin, and ketamine) have potent immunosuppressive and anti-inflammatory effects on the adaptive immune system, which may contribute to their reported benefit in PTSD. There may be distinct PTSD phenotypes induced by innate and adaptive cytokine signaling.

Conclusion

In order for an organism to survive, it must adapt to its environment. Cytokines signal danger to the brain and can induce epigenetic changes that result in a persistent defensive phenotype. PTSD may be the price individuals pay for the genomic flexibility that promotes adaptation and survival.
Blister Beetle Dermatitis Outbreaks in Mali
Authors: Velut Guillaume , Grau Martin , Valois Aude , Holterbach Lise , François Mickaël , Le Gall Philippe , Aigle Luc , Pommier de Santi Vincent , Bologna Marco A
Published: April 2022

Introduction

Meloidae are distributed in temperate and arid regions but are also common in subtropical and tropical savannahs. These insects contain cantharidin, a vesicant substance that can cause poisoning by ingestion and dermatitis by direct contact.

Material and Methods

We describe recurrent Meloidae-related dermatitis outbreaks and their health impact by analyzing medical consultation records and meteorological data.

Results

Between 2015 and 2019, dermatitis outbreaks took place at a French military base at the end of the rainy season, from July to August, with 100 cases reported in 2015, 74 in 2017, 100 in 2018, and 36 in 2019. In 2017, the incidence rate was 4.4% for the base’s population. Initial medical consultations represented 31.5% of total medical care activity. Meloidae were identified as Cyaneolytta fryi.

Conclusions

These outbreaks of burn-like lesions, although clinically benign, can place a considerable burden on the medical activity of health care facilities. The diagnosis of Meloidae dermatitis is exclusively anamnestic and clinical and requires reported contact with the insect. The treatment protocol is that of standard burn care, and the best preventive measure is to avoid bright white lights. Military personnel, foreign workers, and travelers venturing into the Sahel should be warned of the risks associated with these beetles.
Opioid Prescription Reduction after Dentoalveolar Surgery—A Success Story in the Recruit Training Environment
Authors: Tang Clarence , Buckley James , Burcal Robert
Published: April 2022

Given the public health toll exacted by the Opioid Crisis, it is important for providers in all disciplines to examine their opioid prescribing patterns to see where opioid reduction strategies can be effectively employed. Limiting the impact of the Opioid Crisis on active duty service members is a critical component of maintaining a ready fighting force. One avenue for reducing the potential for opioid diversion and abuse is developing and implementing non-opioid postsurgical pain management strategies that both provide adequate pain relief and also ensure an expedient return to full duty. Dentoalveolar surgeries performed by oral and maxillofacial surgeons to maintain operational dental readiness are a good example of common procedures necessitating post-procedural pain medications and convalescent days impacting availability for full duty. The providers at US Navy Recruit Training Command’s oral surgery clinic undertook a process improvement initiative to reduce opioid prescriptions after dentoalveolar surgery. This change was accompanied by a concerted education effort aimed at both providers and patients on the benefits of avoiding opioids as well as the importance of strict adherence to a standardized medication dosing regimen for efficacious non-opioid pain control consisting of maximum doses of ibuprofen and acetaminophen taken every six hours. No increase in convalescent time off and no increase in postoperative visits related to pain control were noted. In our experience, eliminating routine post-procedure opioids for dentoalveolar surgery was a viable strategy for reducing the potential for opioid diversion and abuse among our patients with no negative impact on the operational and training tempo of the associated command.
A Cross-sectional Cohort Study to Assess Long-term Neurocognitive and Psychiatric Symptoms of Mefloquine Use in Veterans
Authors: Reinhard Matthew J , Chester Jeremy E , Breneman Charity B , Samuel Immanuel B H , Prisco Michelle K , Vincent Terra D , Rumm Peter D , Smith Shanna R , Barrett John P
Published: April 2022

Introduction

To evaluate the associations between neurocognitive and psychiatric health outcomes with mefloquine or any antimalarial exposure.

Materials and Methods

Medical records were systematically reviewed to identify veterans that indicated antimalarial medication use. Linear regression was performed to examine associations between mefloquine/antimalarial exposure and health outcomes. The mefloquine-exposed group was further compared with normative populations for the same health outcomes.

Results

In the adjusted models, no significant differences were noted between the two exposure groups and the unexposed group for any of the health measures (P-value > 0.05). When compared to normative population samples, the mefloquine-exposed group had poorer health and greater neurobehavioral symptom severity or cognitive complaints.

Conclusion

This study suggests that mefloquine use by veterans referred for intensive evaluation of their military deployment exposures and health was not associated with increased, long-term, neurocognitive/psychiatric symptoms compared to unexposed veterans.
Evaluation of Posttraumatic Stress Disorder and Acute Stress Disorder VA/DoD Clinical Practice Guidelines Training
Authors: Edwards Shelby , Edwards-Stewart Amanda , Dean Christina , Reddy Madhavi K
Published: April 2022

Introduction

This study evaluated the use of an online learning platform [Joint Knowledge Online (JKO)] for dissemination of the Veterans Affairs and Department of Defense Clinical Practice Guidelines for Management of Posttraumatic Stress Disorder (PTSD) and Acute Stress Disorder (ASD). User satisfaction with the training program was assessed, users were asked to estimate their knowledge base about PTSD and ASD, and users provided comments about how they might use the course material in their clinical practice.

Materials and Methods

A total of 4,442 users took at least one of three courses offered via JKO related to the PTSD Clinical Practice Guidelines (CPG) between July 1, 2019 and June 25, 2020. A total of 1,663 users took the post-test after the JKO courses and 235 applied to a second website (J7) which granted Continuing Education (CE) credits. Data were gathered from the JKO post-course survey, as well as the J7 course survey, which also asked for respondents’ written comments.

Results

User satisfaction was analyzed using the JKO survey Likert scale data for each course, and results found most users rated the courses as “good” or “great.” Users were also asked to evaluate their knowledge about PTSD management before and after the course. Results from all three courses showed a statistically significant change in pre-post knowledge with a medium effect size. Thematic analysis was performed on the write-in comments from each course. Comments indicated participants found the assessment tools provided in the courses to be of particular value.

Conclusions

The VA/DoD’s online learning platform (JKO) was a user-friendly, effective tool for training users on PTSD and ASD clinical practice guidelines. Users were satisfied with their experience of the trainings on JKO and improved their knowledge base about the CPG. This study did not evaluate patient data for CPG compliance, but the future study may benefit from these outcomes to demonstrate provider adherence to the guidelines.
Nano2NGS-Muta: a framework for converting nanopore sequencing data to NGS-liked sequencing data for hotspot mutation detection
Authors: Lang Jidong , Sun Jiguo , Yang Zhi , He Lei , He Yu , Chen Yanmei , Huang Lei , Li Ping , Li Jialin , Qin Liu
Published: April 2022

Nanopore sequencing, also known as single-molecule real-time sequencing, is a third/fourth generation sequencing technology that enables deciphering single DNA/RNA molecules without the polymerase chain reaction. Although nanopore sequencing has made significant progress in scientific research and clinical practice, its application has been limited compared with next-generation sequencing (NGS) due to specific design principle and data characteristics, especially in hotspot mutation detection. Therefore, we developed Nano2NGS-Muta as a data analysis framework for hotspot mutation detection based on long reads from nanopore sequencing. Nano2NGS-Muta is characterized by applying nanopore sequencing data to NGS-liked data analysis pipelines. Long reads can be converted into short reads and then processed through existing NGS analysis pipelines in combination with statistical methods for hotspot mutation detection. Nano2NGS-Muta not only effectively avoids false positive/negative results caused by non-random errors and unexpected insertions-deletions (indels) of nanopore sequencing data, improves the detection accuracy of hotspot mutations compared to conventional nanopore sequencing data analysis algorithms but also breaks the barriers of data analysis methods between short-read sequencing and long-read sequencing. We hope Nano2NGS-Muta can serves as a reference method for nanopore sequencing data and promotes higher application scope of nanopore sequencing technology in scientific research and clinical practice.
Population-Based Assessment of Contact Tracing Operations for Coronavirus Disease 2019 in Pirkanmaa Hospital District, Finland
Authors: Rannikko Juha , Viskari Hanna , Sirkeoja Simo , Tamminen Pekka , Kaila Ville , Ala-Mursula Anni , Huttunen Reetta , Laine Janne , Syrjänen Jaana , Nuorti J Pekka
Published: April 2022

Background

The coronavirus disease 2019 (COVID-19) epidemic overwhelmed local contact tracing (CT) efforts in many countries. In Finland, severe acute respiratory syndrome coronavirus 2 incidence and mortality were among the lowest in Europe during 2020–2021. We evaluated CT efficiency, effectiveness, and transmission settings.

Methods

Polymerase chain reaction (PCR) test–positive COVID-19 cases and high-risk contacts in the population-based CT database of Pirkanmaa Hospital District (population 540 000) during June 2020–May 2021 were interviewed.

Results

Altogether 353 926 PCR tests yielded 4739 (1.3%) confirmed cases (average 14-day case notification rate, 34 per 100 000 population); about 99% of confirmed cases and high-risk contacts were reached by a CT team. Of 26 881 high-risk contacts who were placed in quarantine, 2275 subsequently tested positive (48% of new cases), 825 (17%) had been in quarantine ≥48 hours before symptoms, and 3469 (77%) of locally acquired cases were part of transmission chains with an identified setting. The highest secondary attack rates were seen in households (31%), healthcare patients (18%), and private functions (10%). Among the 311 hospitalized patients, COVID-19 diagnosis or exposure was known in 273 (88%) before emergency room admission (identified patients). Healthcare workers had the highest proportion of work-related infections (159 cases [35%]). The source of infection was classifiable in 65% and was most commonly a coworker (64 cases [62%]).

Conclusions

Our data demonstrate the role of effective testing and CT implementation during the cluster phase of COVID-19 spread. Although half of newly diagnosed cases were already in quarantine, targeted public health measures were needed to control transmission. CT effectiveness during widespread community transmission should be assessed.