bluuebunny/crossref_metadata_2025 huggingface dataset:
Genomic Evolution of ST11 Carbapenem-Resistant Klebsiella pneumoniae from 2011 to 2020 Based on Data from the Pathosystems Resource Integration Center
Authors: Zhang Na , Tang Yue , Yang Xiaojing , Jin Meiling , Chen Jiali , Qin Shiyu , Liu Fangni , Liu Xiong , Guo Jinpeng , Wang Changjun , Chen Yong
Published: September 2022

(1) Objective: ST11 carbapenem-resistant Klebsiella pneumoniae (CRKP) is widespread throughout the world, and the mechanisms for the transmission and evolution of major serotypes, ST11-KL47 and ST11-KL64, were analyzed to investigate the global distribution and evolutionary characteristics of ST11 CRKP; (2) Methods: The Pathosystems Resource Integration Center (PATRIC) database was downloaded and all K. pneumoniae from 2011 to 2020 were screened to obtain ST11 CRKP genome assemblies with basic information. The relationship of serotype evolution between KL47 and KL64 was then investigated using statistical and bioinformatic analysis; (3) Results: In total, 386 ST11 CRKP isolates were included for analysis. Blood (31.09%, 120/386), respiratory tract (23.06%, 89/386), and feces (20.21%, 78/386) were the major sources of samples. China was the leading country where ST11 CRKP was isolated. KL47 and KL64 were found to be the most prevalent serotypes. ST11-KL64 CRKP [median 78(P25~P75: 72~79.25)] had remarkably more virulence genes than the KL47 [median 63(P25~P75: 63~69)], and the distinction was statistically significant (p < 0.001). A differential comparison of virulence genes between KL47 and KL64 revealed 35 differential virulence genes, including rmpA/rmpA2, iucABCD, iutA, etc. The comparison of the recombination of serotype-determining regions between the two serotypes revealed that KL64 CRKP carried more nucleotide sequences in the CD1-VR2-CD2 region than KL47 CRKP. More nucleotide sequences added approximately 303 base pairs (bp) with higher GC content (58.14%), which might facilitate the evolution of the serotype toward KL64; (4) Conclusions: KL47 and KL64 have become the predominant serotypes of ST11 CRKP. KL64 CRKP carries more virulence genes than KL47 and has increased by approximately 303 bp through recombinant mutations, thus facilitating the evolution of KL47 to KL64. Stricter infection prevention and control measures should be developed to deal with the epidemic transmission of ST11-KL64 CRKP.
Enhanced Resolution of Evolution and Phylogeny of the Moths Inferred from Nineteen Mitochondrial Genomes
Authors: Zheng Xiaofeng , Zhang Rusong , Yue Bisong , Wu Yongjie , Yang Nan , Zhou Chuang
Published: September 2022

The vast majority (approximately 90%) of Lepidoptera species belong to moths whose phylogeny has been widely discussed and highly controversial. For the further understanding of phylogenetic relationships of moths, nineteen nearly complete mitochondrial genomes (mitogenomes) of moths involved in six major lineages were sequenced and characterized. These mitogenomes ranged from 15,177 bp (Cyclidia fractifasciata) to 15,749 bp (Ophthalmitis albosignaria) in length, comprising of the core 37 mitochondrial genes (13 protein-coding genes (PCGs) + 22 tRNAs + two rRNAs) and an incomplete control region. The order and orientation of genes showed the same pattern and the gene order of trnM-trnI-trnQ showed a typical rearrangement of Lepidoptera compared with the ancestral order of trnI-trnQ-trnM. Among these 13 PCGs, ATP8 exhibited the fastest evolutionary rate, and Drepanidae showed the highest average evolutionary rate among six families involved in 66 species. The phylogenetic analyses based on the dataset of 13 PCGs suggested the relationship of (Notodontidae + (Noctuidae + Erebidae)) + (Geometridae + (Sphingidae + Drepanidae)), which suggested a slightly different pattern from previous studies. Most groups were well defined in the subfamily level except Erebidae, which was not fully consistent across bayesian and maximum likelihood methods. Several formerly unassigned tribes of Geometridae were suggested based on mitogenome sequences despite a not very strong support in partial nodes. The study of mitogenomes of these moths can provide fundamental information of mitogenome architecture, and the phylogenetic position of moths, and contributes to further phylogeographical studies and the biological control of pests.
C-to-U RNA Editing: A Site Directed RNA Editing Tool for Restoration of Genetic Code
Authors: Bhakta Sonali , Tsukahara Toshifumi
Published: September 2022

The restoration of genetic code by editing mutated genes is a potential method for the treatment of genetic diseases/disorders. Genetic disorders are caused by the point mutations of thymine (T) to cytidine (C) or guanosine (G) to adenine (A), for which gene editing (editing of mutated genes) is a promising therapeutic technique. In C-to-Uridine (U) RNA editing, it converts the base C-to-U in RNA molecules and leads to nonsynonymous changes when occurring in coding regions; however, for G-to-A mutations, A-to-I editing occurs. Editing of C-to-U is not as physiologically common as that of A-to-I editing. Although hundreds to thousands of coding sites have been found to be C-to-U edited or editable in humans, the biological significance of this phenomenon remains elusive. In this review, we have tried to provide detailed information on physiological and artificial approaches for C-to-U RNA editing.
An Integrated Analysis of Lactation-Related miRNA and mRNA Expression Profiles in Donkey Mammary Glands
Authors: Fei Yaqi , Gai Yedan , Liao Qingchao , Zhang Linxi , Li Zheng , Li Bojiang , Bai Man , Li Na , Deng Liang
Published: September 2022

Donkey milk is consumed by humans for its nutritional and therapeutic properties. MicroRNAs (miRNAs) and messenger RNAs (mRNAs) have been implicated in the regulation of milk component synthesis and mammary gland development. However, the regulatory profile of the miRNAs and mRNAs involved in lactation in donkeys is unclear. We performed mRNA-seq and miRNA-seq and constructed coexpression regulatory networks for the mammary glands during the lactating and nonlactating period of jennies. We identified 3144 differentially expressed (DE) mRNAs (987 upregulated mRNAs and 2157 downregulated mRNAs) and 293 DE miRNAs (231 upregulated miRNAs and 62 downregulated miRNAs) in the lactating group compared to the nonlactating group. The DE miRNA target mRNA were significantly associated with pathways related to RNA polymerase, glycosphingolipid biosynthesis, mRNA surveillance, ribosome biogenesis in eukaryotes, glycerophospholipid metabolism, Ras signaling, and the fly hippo signaling pathway. The mRNA–miRNA coregulation analysis showed that novel-m0032-3p, miR-195, miR-26-5p, miR-23-3p, miR-674-3p, and miR-874-3p are key miRNAs that target mRNAs involved in immunity and milk lipid, protein, and vitamin metabolism in the jenny mammary gland. Our results improve the current knowledge of the molecular mechanisms regulating bioactive milk component metabolism in the mammary glands and could be used to improve milk production in donkeys.
Scale-Dependent Transport of Saharan Dust by African Easterly Waves
Authors: Nathan Terrence R. , Grogan Dustin F. P.
Published: September 2022

The scale-dependent transport of Saharan dust aerosols by African easterly waves (AEWs) is examined analytically and numerically. The analytical analysis shows that the meridional and vertical wave transports of dust are modulated by the Doppler-shifted frequency, ωd, and the wave growth rate, ωi, both of which are functions of the zonal wave scale. The analytical analysis predicts that the AEW dust transports, which are driven by the Reynolds stresses acting on the mean dust gradients, are largest for the twin limits: ωd→0, which corresponds to flow near a critical surface, a local effect; and ωi→0, which corresponds to the slowest growing waves, a global effect. The numerical analysis is carried out with the Weather Research and Forecasting (WRF) model, which is radiatively coupled to the dust field. The model simulations are based on an AEW spectrum consistent with observations. The simulations agree with the theoretical predictions: the slowest growing waves have the strongest transports, which are as much as ~40% larger than the transports of the fastest growing wave. Although the transports are highly scale-dependent, largely due to the scale dependence of ωi, the location of the critical surface and thus the location of the maximum dust transports are not.
Main Aspects of Preparing Diabetic Patients in Poland for Self-Care
Authors: Pluta Agnieszka , Marzec Alicja , Kobus Edyta , Sulikowska Beata
Published: September 2022

Diabetes is a lifestyle disease which can cause many complications and organ-related disorders. The aim of the study was to analyze selected aspects of preparing patients with diabetes for self-care. The study group consisted of 190 people diagnosed with type 1 and type 2 diabetes, including 101 women and 89 men. The mean age of the respondents was 42.2 ± 13.4 years. The study was conducted using an anonymous self-designed questionnaire containing 50 questions. Among the respondents, 23.2% did not control their glucose levels at home. The respondents most often measured glucose once a day (33.6%) or three times a day (26.7%). A total of 64.7% of the respondents declared that they kept a self-monitoring diary. The knowledge of the symptoms of hypoglycemia and the ability to properly manage it was declared by 64.8% of the respondents. A total of 52.1% of the patients did not undertake any activity lasting more than 30 min at least 3 times a week, and 75.2% described their condition as very good and good. Independent participation in therapy, i.e., taking hypoglycemic drugs or insulin, was declared by 63.7% of the respondents. Despite undergoing therapeutic education, the study population diagnosed with diabetes still shows deficiencies in terms of awareness of proper health behaviors. Objective results showed that the patients had insufficient knowledge and skills in terms of self-care and self-observation, blood glucose and blood pressure measurements, physical activity, diet therapy as well as adherence to pharmacotherapy recommendations. Despite the good general preparation for self-care as declared by the respondents, these patients require further systematic, individual educational activities. The results of the present study have implications for nursing practice, patient therapeutic education, and the functioning of the public health and healthcare systems. The number of diabetic patients is constantly increasing. Patients require coordinated care and individualized therapeutic education in order to be prepared for self-care and self-management, thus reducing the risk of complications. Delaying the occurrence of potential complications provides patients with a chance to live an active private and professional life, and protects the health care system from carrying the cost burden of expensive highly specialized services.
Fake News Spreaders Detection: Sometimes Attention Is Not All You Need
Authors: Siino Marco , Di Nuovo Elisa , Tinnirello Ilenia , La Cascia Marco
Published: September 2022

Guided by a corpus linguistics approach, in this article we present a comparative evaluation of State-of-the-Art (SotA) models, with a special focus on Transformers, to address the task of Fake News Spreaders (i.e., users that share Fake News) detection. First, we explore the reference multilingual dataset for the considered task, exploiting corpus linguistics techniques, such as chi-square test, keywords and Word Sketch. Second, we perform experiments on several models for Natural Language Processing. Third, we perform a comparative evaluation using the most recent Transformer-based models (RoBERTa, DistilBERT, BERT, XLNet, ELECTRA, Longformer) and other deep and non-deep SotA models (CNN, MultiCNN, Bayes, SVM). The CNN tested outperforms all the models tested and, to the best of our knowledge, any existing approach on the same dataset. Fourth, to better understand this result, we conduct a post-hoc analysis as an attempt to investigate the behaviour of the presented best performing black-box model. This study highlights the importance of choosing a suitable classifier given the specific task. To make an educated decision, we propose the use of corpus linguistics techniques. Our results suggest that large pre-trained deep models like Transformers are not necessarily the first choice when addressing a text classification task as the one presented in this article. All the code developed to run our tests is publicly available on GitHub.
Global Metabolomics of Fireflies (Coleoptera: Lampyridae) Explore Metabolic Adaptation to Fresh Water in Insects
Authors: Yang Linyu , Zhao Zishun , Luo Dan , Liang Mingzhong , Zhang Qilin
Published: September 2022

Aquatic insects are well-adapted to freshwater environments, but metabolic mechanisms of such adaptations, particularly to primary environmental factors (e.g., hypoxia, water pressure, dark light, and abundant microbes), are poorly known. Most firefly species (Coleoptera: Lampyridae) are terrestrial, but the larvae of a few species are aquatic. We generated 24 global metabolomic profiles of larvae and adults of Aquatica leii (freshwater) and Lychnuris praetexta (terrestrial) to identify freshwater adaptation-related metabolites (AARMs). We identified 110 differentially abundant metabolites (DAMs) in A. leii (adults vs. aquatic larvae) and 183 DAMs in L. praetexta (adults vs. terrestrial larvae). Furthermore, 100 DAMs specific to aquatic A. leii larvae were screened as AARMs via interspecific comparisons (A. leii vs. L. praetexta), which were primarily involved in antioxidant activity, immune response, energy production and metabolism, and chitin biosynthesis. They were assigned to six categories/superclasses (e.g., lipids and lipid-like molecules, organic acids and derivatives, and organoheterocyclic compound). Finally, ten metabolic pathways shared between KEGG terms specific to aquatic fireflies and enriched by AARMs were screened as aquatic adaptation-related pathways (AARPs). These AARPs were primarily involved in energy metabolism, xenobiotic biodegradation, protection of oxidative/immune damage, oxidative stress response, and sense function (e.g., glycine, serine and threonine metabolism, drug metabolism-cytochrome P450, and taste transduction), and certain aspects of morphology (e.g., steroid hormone biosynthesis). These results provide evidence suggesting that abundance changes in metabolomes contribute to freshwater adaptation of fireflies. The metabolites identified here may be vital targets for future work to determine the mechanism of freshwater adaptation in insects.
Effect of Parental Age and Mating Status on Reproductive Performance of Orius laevigatus (Hemiptera: Anthocoridae)
Authors: Rodríguez-Gómez Amador , Balanza Virginia , Donate Alberto , Abelaira Ana Belén , Reche María del Carmen , Sánchez-Martínez Isabel , Bielza Pablo
Published: September 2022

The reproductive potential of biological control agents (BCAs) is crucial for efficient mass-rearing and field performance, and it all begins with mating. Fecundity can be strongly influenced by intrinsic conditions, such as female age and, often neglected, male age and mating status. However, little is known about the impact of parental status at mating on female reproductive outcomes in BCAs. Orius laevigatus (Fieber) (Hemiptera: Anthocoridae) is widely used to control thrips in protected crops. We evaluated how many consecutive females a male could successfully mate and the effect on a female’s reproductive output. In addition, we studied the effects of male and female age on mating. In the multiple mating experiment, the males showed a high capacity to fertilize females successively, not reducing fecundity until the sixth mated female. In the delayed mating experiment, copulation duration and fecundity increased with male age but decreased with female age. In contrast, fertility followed an opposite pattern, increasing with female age but decreasing with male age. However, fecundity gains outweighed fertility declines in both sexes. Therefore, reproductive capacity is increased when mating newly emerged females with males a few days old. The implications of our results for mass rearing and field performance are discussed.
COVID-19 Therapeutics: Improvise—Adapt—Learn
Authors: Abraham Joseph , Palaiodimos Leonidas , Arora Shitij
Published: September 2022

“In the midst of chaos, there is also opportunity”—Sun Tzu, The Art of War [...]
Tweenager Computer Visual Syndrome Due to Tablets and Laptops during the Postlockdown COVID-19 Pandemic and the Influence on the Binocular and Accommodative System
Authors: De-Hita-Cantalejo Concepción , Sánchez-González José-María , Silva-Viguera Carmen , Sánchez-González María Carmen
Published: September 2022

The aim of our study was to compare computer visual syndrome (CVS) in a tweenager student population who use tablets and laptops only to play versus CVS in tweenagers who use these digital devices at school to study, in addition to playing. The tests performed were a validated survey for children for the detection of CVS and accommodative and vergence tests. The CVS item questionnaire was divided into four main groups based on questions concerning the following: (I) the digital device usage time, (II) musculoskeletal and ergonomic nature, (III) visual symptoms, and (IV) ocular surface symptoms. The high-demand digital device group showed worse punctuation in all item groups. From the optometric perspective, when the subjects were classified according to the CVS, high-demand participants presented a clear tendency to exophoria with statistically significant differences in distance vision (−1.94 ± 4.48 Δ) and near vision (−5.78 ± 8.62 Δ) (p < 0.01). Our results establish a relationship between the increased use of electronic devices and computer vision syndrome in the preadolescent population. In addition, this situation is related to the presence of visual, accommodative, and binocular dysfunctions that could affect the efficiency of the visual system.
Italian Candidates for the XEN Implant: An Overview from the Glaucoma Treatment Registry (XEN-GTR)
Authors: Posarelli Chiara , Figus Michele , Roberti Gloria , Giammaria Sara , Ghirelli Giorgio , Quercioli Pierpaolo , Micelli Ferrari Tommaso , Pace Vincenzo , Mastropasqua Leonardo , Agnifili Luca , Sacchi Matteo , Scuderi Gianluca , Perdicchi Andrea , Altafini Romeo , Uva Maurizio , D’Andrea Dino , Covello Giuseppe , Maglionico Maria Novella , Fea Antonio Maria , Carnevale Carmela , Oddone Francesco
Published: September 2022

Background The Italian XEN Glaucoma Treatment Registry (XEN-GTR) was created to acquire a comprehensive prospective dataset that includes the patient characteristics, intraoperative variables, and postoperative management of glaucoma patients undergoing the XEN gel stent implantation. Methods This was a prospective observational, longitudinal clinical study involving 10 centres throughout Italy. The baseline examination included a comprehensive evaluation of demographic parameters (age, sex, ethnicity, and systemic condition), specific ophthalmological parameters, and quality of life questionnaire score collection. Results The baseline data of 273 patients were analysed. The median (IQR) age was 72 (65.0 to 78.0) years. Of the 273 patients, 123 (45%) were female and 150 (55%) were male. A total of 86% of the patients had open-angle glaucoma with a mean intraocular pressure of 24 ± 6 (range 12.0–60.0) mmHg. The mean number of medications was 2.7 ± 0.9 at baseline for the patients with a prevalence of prostaglandin analogues combined with a beta-blocker and anhydrase carbonic inhibitor (31.8%). The mean scores of the NEI-VFQ 25 and GSS questionnaires were 78 ± 18 (range 26.5–100) and 85 ± 14 (range 79–93), respectively. Combined XEN/cataract surgeries were scheduled in 73.7% of the patients. The preferred place for the XEN implant was the supero-nasal quadrant (91.6%). Conclusions Observing the baseline characteristics of the typical Italian candidates for the XEN gel implant shows that they are patients affected by POAG and cataracts, with moderate to severe glaucoma damage, all of which has an impact on their quality of life.
Direct-Acting Antiviral Drugs Reduce Fibromyalgia Symptoms in Patients with Chronic Hepatitis C
Authors: Tang Kuo-Tung , Lin Ching-Chun , Chen Yi-Hsing , Liao Tsai-Ling , Chen Der-Yuan , Yang Sheng-Shun , Chen Chia-Chang
Published: September 2022

Background Fibromyalgia (FM) is a complex disorder characterized by chronic widespread pain and significant patient burden. Patients with chronic hepatitis C are reportedly predisposed to the development of FM. Direct-acting antiviral drugs (DAA) achieved a remarkable therapeutic efficacy in CHC patients. We therefore investigated the impact of DAA on FM symptoms in CHC patients. Methods We enrolled consecutive CHC patients who received DAA. FM symptoms were evaluated based on the 2016 American College of Rheumatology (ACR) fibromyalgia scale at baseline and 12 and 24 weeks after cessation of DAA therapy. Logistic regression was performed to determine the influence of HCV on FM at baseline. We also recruited individuals who underwent a health checkup examination as the control group, and calculated the standardized prevalence ratio of FM in CHC patients. Comparisons of fibromyalgia in different time points were undertaken using the Wilcoxon signed-rank test. Results A total of 33 CHC patients (15 males and 18 females) and 402 controls were recruited. All CHC patients achieved sustained virological response. Two (6%) patients and two (0.5%) controls fulfilled the diagnostic criteria for FM, and the standardized prevalence ratio was 23.9 in CHC patients. Logistic regression also showed increased odds for FM in CHC patients after adjusting for age and sex (OR: 14.4; 95%CI: 1.6, 128.0). In addition, their fibromyalgianess scale decreased at 12 and 24 weeks after DAA therapy. In conclusion, CHC patients were more likely to develop FM. Implementation of DAA therapy might improve FM symptoms in these patients.
Precision Medicine in Sepsis and Septic Shock
Authors: Suarez-de-la-Rica Alejandro , Maseda Emilio
Published: September 2022

Sepsis is defined as a potentially fatal organ dysfunction induced by a dysregulated host response to infection [...]
Glycemic Variability in Subjects with Diabetes and Hypogonadism during Testosterone Replacement Treatment: A Pilot Study
Authors: Defeudis Giuseppe , Maddaloni Ernesto , Rossini Giovanni , Di Tommaso Alfonso Maria , Mazzilli Rossella , Di Palma Paolo , Pozzilli Paolo , Napoli Nicola
Published: September 2022

Background: This is a proof of concept, as a pilot study, with the aim to evaluate continuous glucose monitoring metrics (CGM) in subjects with type 2 diabetes (T2DM), treated with nutritional therapy and metformin, before and after testosterone replacement therapy (TRT). Methods: In this longitudinal observational study, subjects affected by T2DM and starting TRT for documented ED and hypogonadism were enrolled. All subjects mounted a CGM system during the v0 visit, one week before the beginning of the TRT (week−1), during v2, four weeks after the start of TRT (week 4), and v4 (week 12). CGM was worn for about 144 h after each visit. Results: A total of seven patients, referring to our clinic for erectile dysfunction (ED), were studied (aged 63.3 ± 2.3 years). Mean (± standard deviation) total testosterone level was 2.3 ± 0.6 ng/mL at baseline. After TRT, total testosterone level was 4.6 ± 3.04 ng/mL at week 4 and 3.93 ± 4.67 ng/mL at week 12. No significant differences were observed in TIR, TAR, TBR, estimated HbA1c, AUC below, and AUC above limit during the intervention period. Conclusions: This is the first study evaluating the effects of TRT on daily glucose excursions in subjects with T2DM and hypogonadism. Though we did not find any significant difference in key CGM metrics during the 12 weeks of TRT, this study confirms the glycometabolic safety of the TRT even on the most novel standardized glycemic targets.
Dual- vs. Single-Plane Ultrasonic Scan-Assisted Positioning during Lumbar Spinal Puncture in Elderly Patients: A Randomized Controlled Trial
Authors: Huang Fang , Li Huili , Liu Shaopeng , Zong Mingjiang , Wang Yun
Published: September 2022

The purpose of this study was to investigate the ability of single- versus dual-plane ultrasound scan-assisted spinal anesthesia techniques to improve the success rate and efficacy of spinal anesthesia in elderly patients undergoing lower extremity surgery. A total of 120 elderly patients undergoing lower extremity surgery were randomly assigned to either receive single-plane (Group A) or dual-plane ultrasonic scan-assisted spinal anesthesia (Group B). The primary outcome analyzed by this study was first-attempt success rate. Secondary outcomes analyzed included number of needle insertion attempts, needle redirections, locating time, procedural time, total time, puncture depth, quality of ultrasound images, level of block, adverse reactions, and complications. The first-attempt success rate was significantly higher in Group B compared to Group A (88.3% vs. 68.3%, p = 0.008). In comparison with Group A, the number of needle insertion attempts (1 (1–2) vs. 1 (1–1), p = 0.005) and needle redirections (2 (1–3) vs. 1 (0–2), p < 0.001) were both significantly lower in Group B; Group B also had a shorter procedural time (249.2 ± 30.1 vs. 380.4 ± 39.4 s, p < 0.001) but a longer locating time (250.1 ± 26.2 vs. 137.8 ± 13.5 s, p < 0.001). The dual-plane ultrasonic scan-assisted spinal anesthesia technique warrants consideration for application in elderly patients.
Therapeutic Efficacy and Safety of Intense Pulsed Light for Refractive Multiple Recurrent Chalazia
Authors: Arita Reiko , Fukuoka Shima
Published: September 2022

To evaluate the efficacy and safety of intense pulsed light (IPL) combined with meibomian gland expression (MGX) for the treatment of refractory multiple and recurrent chalazia without surgery or curettage. This was a retrospective controlled study. Patients with multiple and recurrent chalazia, who had performed the conventional treatment at least 2 months without any surgery or curettage, were enrolled in this study. Twenty-nine consecutive multiple recurrent chalazia (12 patients) were assigned to receive either the combination of IPL and MGX or MGX alone as a control. Each eye underwent one to four treatment sessions with 2-week intervals. Parameters were evaluated before and 1 month after the final treatment session. Clinical assessments included symptom, size of each chalazion, lid margin abnormalities, corneal and conjunctival fluorescein staining, meibum grade, the number of Demodex mites, the Schirmer value and meiboscore. All parameters except meiboscore and the Schirmer value were significantly improved with IPL-MGX therapy, whereas only meibum grade was significantly improved with MGX alone. There were no adverse events which occurred in either group. IPL-MGX was safe and effective for multiple and recurrent chalazia without surgery or curettage by reducing the size of chalazion and improving lid margin abnormalities and meibum grade.
Alterations in Glomerular Filtration Rates Using Different Algorithms in the Korean Population Visiting Local Clinics and Hospitals
Authors: Choi Rihwa , Lee Sang Gon , Lee Eun Hee
Published: September 2022

We retrospectively reviewed the estimated glomerular filtration rates (eGFR) calculated by three equations: (1) Modification of Diet in Renal Disease Study (MDRD), (2) Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) using serum creatinine in 2009 (CKD-EPI 2009), and (3) CKD-EPI suggested in 2021 (CKD-EPI 2021), in an adult Korean population visiting local clinics and hospitals for health check-ups between 2019 and 2021 to investigate the effect of changes in the prevalence of chronic kidney diseases using those equations. During the study period, serum creatinine tests were performed on 442,566 subjects (205,236 men and 237,330 women). The overall prevalence rates of decreased eGFR (<60 mL/min/1.73 m2) at baseline measurement were as follows: 3.4% using MDRD, 2.8% using CKD-EPI 2009, and 2.1% using CKD-EPI 2021. The prevalence of decreased eGFR increased with age. Among 442,566 tests, specimens having simultaneously measured random urine dipstick tests for proteinuria represented 6.0% of the population, and the albumin-creatinine ratio (ACR) was 0.3%. The prevalence of specimens having both decreased eGFR and proteinuria was significantly different among equations (p < 0.05). Among the three equations, MDRD and CKD-EPI 2009 had a similar specimen prevalence of decreased eGFR and proteinuria (≥1+) using a dipstick test or albuminuria (urine ACR > 30 mg/g creatinine), while those based on CKD-EPI 2021 were about half of those based on MDRD and CKD-EPI 2009. Future studies are needed to clarify the clinical impact of the changes in the calculations for eGFR.
Deep Ensemble Learning for the Automatic Detection of Pneumoconiosis in Coal Worker’s Chest X-ray Radiography
Authors: Devnath Liton , Luo Suhuai , Summons Peter , Wang Dadong , Shaukat Kamran , Hameed Ibrahim A. , Alrayes Fatma S.
Published: September 2022

Globally, coal remains one of the natural resources that provide power to the world. Thousands of people are involved in coal collection, processing, and transportation. Particulate coal dust is produced during these processes, which can crush the lung structure of workers and cause pneumoconiosis. There is no automated system for detecting and monitoring diseases in coal miners, except for specialist radiologists. This paper proposes ensemble learning techniques for detecting pneumoconiosis disease in chest X-ray radiographs (CXRs) using multiple deep learning models. Three ensemble learning techniques (simple averaging, multi-weighted averaging, and majority voting (MVOT)) were proposed to investigate performances using randomised cross-folds and leave-one-out cross-validations datasets. Five statistical measurements were used to compare the outcomes of the three investigations on the proposed integrated approach with state-of-the-art approaches from the literature for the same dataset. In the second investigation, the statistical combination was marginally enhanced in the ensemble of multi-weighted averaging on a robust model, CheXNet. However, in the third investigation, the same model elevated accuracies from 87.80 to 90.2%. The investigated results helped us identify a robust deep learning model and ensemble framework that outperformed others, achieving an accuracy of 91.50% in the automated detection of pneumoconiosis.
A Novel Suturing Technique for Choroidal Avulsion
Authors: Iwase Takeshi , Nishiyama Shungo , Sato Mariko
Published: September 2022

Ocular trauma has been one of the leading causes of visual impairment, and choroidal avulsion is especially devastating. Surgical treatment of choroidal avulsion is challenging, and very few surgical techniques have been reported. We experienced two cases of globe rupture with 360-degree avulsion of the choroid-ciliary body from the peripheral section. After vitrectomy for a globe rupture, the choroid gradually slid down to the posterior pole over time and vision deteriorated even though the retina was attached. We treated the choroidal avulsion using two surgical methods: a mattress suturing technique using a 10-0 proline long needle and a 7-0 nylon single suture technique. In both methods, the retina-choroid, which had slipped down to the posterior pole, was suspended and fixed to the sclera assisted by a wide-angle viewing system, improving visual acuity. These two methods are considered to be useful surgical procedures for the treatment of an avulsed choroid.
Severe Impairment of Left Ventricular Regional Strain in STEMI Patients Is Associated with Post-Infarct Remodeling
Authors: Luisi Giovanni Andrea , Pestelli Gabriele , Lorenzoni Giulia , Trevisan Filippo , Smarrazzo Vittorio , Fiorencis Andrea , Flamigni Filippo , Ferrari Roberto , Mele Donato
Published: September 2022

Background: Measures of global left ventricular (LV) systolic function have limitations for the prediction of post-infarct LV remodeling (LVR). Therefore, we tested the association between a new measure of regional LV systolic function—the percentage of severely altered strain (%SAS)- and LVR after acute ST-elevation myocardial infarction (STEMI). As a secondary objective, we also evaluated the association between %SAS and clinical events during follow-up. Methods: Of 177 patients undergoing echocardiography within 24 h from primary percutaneous coronary angioplasty, 172 were studied for 3 months, 167 for 12 months, and 10 died. The %SAS was calculated by dividing the number of LV myocardial segments with ≥−5% peak systolic longitudinal strain by the total number of segments. LVR was defined as the increase in end-diastolic volume >20% at its first occurrence compared to baseline. Results: LVR percentage was 10.2% and 15.8% at 3 and 12 months, respectively. Based on univariable analysis, a number of clinical, laboratory, electrocardiographic and echocardiographic variables were associated with LVR. Based on multivariable analysis, %SAS and TnI peak remained associated with LVR (for %SAS 5% increase, OR 1.226, 95% CI 1.098–1.369, p < 0.0005; for TnI peak, OR 1.025, 95% CI 1.004–1.047, p = 0.022). %SAS and LVR were also associated with occurrence of clinical events at a median follow-up of 43 months (HR 1.02, 95% CI 1.0–1.04, p = 0.0165). Conclusions: In patients treated for acute STEMI, acute %SAS is associated with post-infarct LVR. Therefore, we suggest performing such evaluations on a routine basis to identify, as early as possible, STEMI patients at higher risk.
Adherence to Medication in Neurogeriatric Patients: Insights from the NeuroGerAd Study
Authors: Schönenberg Aline , Mühlhammer Hannah M. , Lehmann Thomas , Prell Tino
Published: September 2022

Nonadherence to medication is associated with increased morbidity, mortality, and healthcare costs, especially in older adults with higher chances of multimorbidity. However, comprehensive data on factors influencing adherence in this patient group are rare. Thus, data for 910 patients were acquired, including demographic data, nonadherence (Stendal Adherence to Medication), depression (Beck Depression Inventory), cognition (Montreal Cognitive Assessment), personality (Big Five Inventory), satisfaction with healthcare (Health Care Climate Questionnaire), quality of life (36-item Short Form Survey), mobility, diagnoses, and medication. Elastic net regularization was used to analyze the predictors of adherence. Principal component and general estimation equations were calculated to analyze the underlying patterns of adherence. Only 21.1% of patients were fully adherent. Nonadherence was associated with male gender, higher number of medications, diagnosis, depression, poor patient–physician relationship, personality, impaired cognition, and impaired mobility. Nonadherence was classified into three sub-factors: forgetting (46.2%), missing knowledge about medication (29%), and intentional modification of medication (24.8%). While depression exerted the strongest influence on modification, a high number of medications was associated with missing knowledge. The different patterns of nonadherence (i.e., modification, missing knowledge, and forgetting) are influenced differently by clinical factors, indicating that specific approaches are needed for interventions targeting adherence.
Simultaneous Motor and Visual Intraoperative Neuromonitoring in Asleep Parietal Lobe Surgery: Dual Strip Technique
Authors: Rajashekar Devika , Lavrador Jose Pedro , Ghimire Prajwal , Keeble Hannah , Harris Lauren , Pereira Noemia , Patel Sabina , Beyh Ahmad , Gullan Richard , Ashkan Keyoumars , Bhangoo Ranjeev , Vergani Francesco
Published: September 2022

Background: The role played by the non-dominant parietal lobe in motor cognition, attention and spatial awareness networks has potentiated the use of awake surgery. When this is not feasible, asleep monitoring and mapping techniques should be used to achieve an onco-functional balance. Objective: This study aims to assess the feasibility of a dual-strip method to obtain direct cortical stimulation for continuous real-time cortical monitoring and subcortical mapping of motor and visual pathways simultaneously in parietal lobe tumour surgery. Methods: Single-centre prospective study between 19 May–20 November of patients with intrinsic non-dominant parietal-lobe tumours. Two subdural strips were used to simultaneously map and monitor motor and visual pathways. Results: Fifteen patients were included. With regards to motor function, a large proportion of patients had abnormal interhemispheric resting motor threshold ratio (iRMTr) (71.4%), abnormal Cortical Excitability Score (CES) (85.7%), close distance to the corticospinal tract—Lesion-To-Tract Distance (LTD)—4.2 mm, Cavity-To-Tract Distance (CTD)—7 mm and intraoperative subcortical distance—6.4 mm. Concerning visual function, the LTD and CTD for optic radiations (OR) were 0.5 mm and 3.4 mm, respectively; the mean intensity for positive subcortical stimulation of OR was 12 mA ± 2.3 mA and 5/6 patients with deterioration of VEPs > 50% had persistent hemianopia and transgression of ORs. Twelve patients remained stable, one patient had a de-novo transitory hemiparesis, and two showed improvements in motor symptoms. A higher iRMTr for lower limbs was related with a worse motor outcome (p = 0.013) and a longer CTD to OR was directly related with a better visual outcome (p = 0.041). At 2 weeks after hospital discharge, all patients were ambulatory at home, and all proceeded to have oncological treatment. Conclusion: We propose motor and visual function boundaries for asleep surgery of intrinsic non-dominant parietal tumours. Pre-operative abnormal cortical excitability of the motor cortex, deterioration of the VEP recordings and CTD < 2 mm from the OR were related to poorer outcomes.
Association of Inflammatory and Metabolic Biomarkers with Mitral Annular Calcification in Type 2 Diabetes Patients
Authors: Grigorescu Elena-Daniela , Lăcătușu Cristina-Mihaela , Floria Mariana , Cazac Georgiana-Diana , Onofriescu Alina , Ceasovschih Alexandr , Crețu Ioana , Mihai Bogdan-Mircea , Șorodoc Laurențiu
Published: September 2022

(1) Background: Type 2 diabetes mellitus (T2DM) contributes to cardiovascular disease and related mortality through the insidious effects of insulin resistance and chronic inflammation. Mitral annular calcification (MAC) is one such degenerative process promoted by T2DM. (2) Methods: This is a post hoc analysis of insulin resistance, inflammation, and hepatic steatosis markers in T2DM patients without atherosclerotic manifestations, but with incidental echocardiographic detection of mild MAC. (3) Results: 138 consenting patients were 49.3% men, 57.86 years old, with a history of T2DM of 6.16 years and HbA1c 8.06%, of whom sixty had mild MAC (43.47%). The statistically significant differences between patients with/without MAC were higher HOMA C-peptide and C-peptide index for insulin resistance, higher TNF-α for inflammation, and lower estimated glomerular filtration rate. High-sensitive C-reactive protein (hsCRP) was significantly associated with insulin resistance and the strength of the relationship was higher in the MAC group. Predictive of MAC were TNF-α, HOMA C-peptide, and especially hepatic steatosis and hypertension. (4) Conclusions: MAC was more prevalent than reported in the literature. Insulin resistance and inflammation were predictive of MAC, but significant markers differ across studies. Widely available routine tests and echocardiographic assessments are useful in the early identification of mitral annular calcifications in diabetes patients.
Impact of the COVID-19 Pandemic on Breast Cancer Stage at Diagnosis in a Regional Cancer Center in Poland between 2019 and 2021
Authors: Trojanowski Maciej , Radomyski Piotr , Matuszewski Krzysztof , Litwiniuk Maria , Wierzchosławska Ewa , Kycler Witold
Published: September 2022

The COVID-19 pandemic had a negative effect on oncology healthcare services in Poland, with a reduction in the national breast cancer (BC) screening program coverage rates. This article analyzes the impact of the pandemic on BC stage at diagnosis in a regional cancer center in Poland. Records from BC multidisciplinary team (MDT) meetings that took place in the years 2019–2021 were gathered. BC clinical staging was compared. Age-related subgroups were additionally analyzed to reflect possible screening program disruptions. The total number of BC cases fell by 8% in 2020 compared with 2019, with a 14% fall in the screening age group. In 2021, a stage shift was observed, with stage II BC becoming most frequently diagnosed (as opposed to stage I BC in 2019 and 2020). A statistically significant increase in the number of stage III BC cases was observed in 2021.
Effects of Vitamin D Receptor Genotype on Lipid Profiles and Retinopathy Risk in Type 2 Diabetes Patients: A Pilot Study
Authors: Alhawari Hussam , Jarrar Yazun , Abulebdah Dina , Abaalkhail Sara J. , Alkhalili Marah , Alkhalili Sura , Alhawari Hussein , Momani Munther , Obeidat Mohammed N. , Fram Rand K. , Salahat Mohammad A. , Lee Su-Jun
Published: September 2022

Genetic polymorphisms affect lipid profiles and are associated with disease complications. Genetic variants in the vitamin D receptor (VDR) gene are associated with type 2 diabetes mellitus (T2DM). In this study, we investigated the effects of VDR genotypes on the lipid profile and disease complications of T2DM patients in a Jordanian population. Ninety T2DM patients were genotyped for four major functional VDR genetic variants, rs2228570 C > T (FokI), rs7975232 A > C (ApaI), rs731236 T > C (TaqI), and rs1544410 C > T (BsmI), using the polymerase chain reaction–restriction fragment length polymorphism method. Lipid profiles and diabetes complications were analyzed and correlated with VDR genotypes. We found that the VDR rs7975232 and rs1544410 alleles were significantly (p = 0.008–0.04) associated with high-density lipoprotein (HDL) levels and retinopathy among patients. Carriers of the rs7975232 A/A genotype exhibited higher levels (49.68 ± 15.86 mg/dL) of HDL than patients with the A/C (44.73 ± 13.38 mg/dL) and C/C (37.93 ± 9.22 mg/dL) genotypes. Moreover, carriers of the rs1544410 T/T genotype had higher levels of HDL (54.31 ± 16.45 mg/dL) than patients with the C/T (43.57 ± 13.24 mg/dL) and C/C (43.98 ± 13.17 mg/dL) genotypes. T2DM patients who carry the rs7975232 C/C genotype were at higher risk (odds ratio [OR] = 7.88) of developing retinopathy compared with carriers of the rs7975232 C/A and A/A genotypes. In addition, T2DM patients with the rs1544410 C/C genotype had a higher risk (OR = 4.21) of developing retinopathy than patients with the rs1544410 C/T and T/T genotypes. Therefore, we concluded that the VDR rs7975232 and rs1544410 alleles were associated with HDL levels and retinopathy and can be considered as potential genetic biomarkers for the lipid profile and retinopathy complication among T2DM patients in a Jordanian population of Arabic origin. Further studies with larger sample sizes are needed to confirm our findings.
Bioradiotherapy with Cetuximab May Reduce the Risk of Neck Node Relapse in Locoregionally Advanced Laryngeal Glottic Carcinoma: May HER1-Profile Be Useful in the Bioselection of Patients?
Authors: Almadori Giovanni , Coli Antonella , De Corso Eugenio , Settimi Stefano , Mele Dario Antonio , Brigato Francesca , Scannone Domenico , Galli Jacopo , Valentini Vincenzo , Paludetti Gaetano , Lauriola Libero , Ranelletti Franco Oreste
Published: September 2022

The aim of the study was to evaluate survival in patients with advanced glottic laryngeal squamous cell carcinoma treated by bioradiotherapy (BioRT) with cetuximab and eventual salvage surgery (group A, n = 66) or upfront surgery (total laryngectomy or near-total laryngectomy) with or without postoperative radiotherapy (PORT) (group B, n = 66). The predictive role of HER1 expression in the bioselection of tumors was evaluated. Relapse-free (RFS), metastasis-free (MFS), overall (OS) survivals, salvageability, and rates of larynx preservation were analyzed. The two groups were balanced by propensity score method on their baseline characteristics. No significant differences in RFS and OS were found, while MFS results were significantly higher in group A (p = 0.04). Group A showed a 22% reduction in the probability of nodal metastasis (p = 0.0023), mostly in tumors with higher HER1 expression. The salvageability with TL at 3 years was 54% after prior BioRT and 18% after prior upfront NTL (p < 0.05). BioRT with cetuximab showed a reduction in the risk of lymph node relapse, particularly in the case of HER1 positive tumors, and it allowed to achieve a higher rate of functional larynx preservation and a higher salvageability compared with upfront surgery. HER1 analysis could be clinically useful in the bioselection of tumors that may benefit from BioRT with cetuximab, particularly in those with neck node metastatic propensity.
The Doctor Is In(ternet): The Mediating Role of Health Anxiety in the Relationship between Somatic Symptoms and Cyberchondria
Authors: Santoro Gianluca , Starcevic Vladan , Scalone Andrea , Cavallo Josephin , Musetti Alessandro , Schimmenti Adriano
Published: September 2022

Cyberchondria is a dysfunctional behavioral pattern characterized by an excessive and anxiety-amplifying engagement in searching for reassuring health information on the Internet. Research demonstrated that somatic symptoms and health anxiety might foster maladaptive health-related behaviors, such as cyberchondria. However, the relationships between somatic symptoms, health anxiety, and cyberchondria have been scarcely examined. Accordingly, this study aimed to test the mediating effect of health anxiety on the association between somatic symptoms and cyberchondria. Four hundred and thirty-one adults from the community (158 males, 36.66%), aged between 18 and 74, were recruited via an online survey. Participants completed self-report measures of somatic symptoms, health anxiety, and cyberchondria. A mediation analysis demonstrated that the severity of somatic symptoms predicted increased levels of cyberchondria and that health anxiety partially mediated this association. Therefore, interventions aimed at decreasing health anxiety may also play a role in decreasing the risk of developing cyberchondria.
Barriers to Prescribed Fire in the US Great Plains, Part I: Systematic Review of Socio-Ecological Research
Authors: Clark Autumn S. , McGranahan Devan Allen , Geaumont Benjamin A. , Wonkka Carissa L. , Ott Jacqueline P. , Kreuter Urs P.
Published: September 2022

Prescribed fire is increasingly being considered as a viable management tool by public and private land managers. Fully expanding prescribed fire use in a land management context, where it is an ecologically effective but not commonly applied tool, requires a comprehensive understanding of barriers that limit prescribed fire, especially in working rangelands of the North American Great Plains. While there is an emerging body of work on the perceptions of prescribed fire, there has yet to be a compilation of the research. We present a systematic review of the published literature on the perceptions and attitudes of land managers towards prescribed fire in the Great Plains in an effort to provide a social-ecological perspective on the issue. The aim is to share the methods used to assess social perceptions of prescribed fire in the Great Plains and regional distribution of these studies as well as to identify perceived barriers and limitations that restrict the use of prescribed fire by reviewing studies primarily located in the Great Plains ecoregion and focused on perceptions of fire. Surveys were the most commonly used method to assess social perceptions, with most research concentrated in the southern Great Plains. Barriers included a range of social, informational, practical, and regulatory concerns. This compilation of research synthesizes the current knowledge regarding social perceptions of and potential barriers to prescribed fire use so that fire practitioners and communities considering prescribed fire use for rangeland management have the most current information to make sound decisions.