bluuebunny/crossref_metadata_2025 huggingface dataset:
Right ventricle to pulmonary artery coupling after transcatheter aortic valve implantation—Determinant factors and prognostic impact
Authors: Parasca Catalina A. , Calin Andreea , Cadil Deniz , Mateescu Anca , Rosca Monica , Botezatu Simona Beatrice , Enache Roxana , Beladan Carmen , Ginghina Carmen , Deleanu Dan , Chioncel Ovidiu , Bubenek-Turconi Serban , Iliescu Vlad A. , Popescu Bogdan A.
Published: April 2023

Introduction

Right ventricular (RV) dysfunction and pulmonary hypertension (PH) have been previously associated with unfavorable outcomes in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI), but little is known about the effect of right ventricle (RV) to pulmonary artery (PA) coupling. Our study aimed to evaluate the determinant factors and the prognostic value of RV-PA coupling in patients undergoing TAVI.

Methods

One hundred sixty consecutive patients with severe AS were prospectively enrolled, between September 2018 and May 2020. They underwent a comprehensive echocardiogram before and 30 days after TAVI, including speckle tracking echocardiography (STE) for myocardial deformation analysis of the left ventricle (LV), left atrium (LA), and RV function. Complete data on myocardial deformation was available in 132 patients (76.6 ± 7.5 years, 52.5% men) who formed the final study population. The ratio of RV free wall longitudinal strain (RV-FWLS) to PA systolic pressure (PASP) was used as an estimate of RV-PA coupling. Patients were analyzed according to baseline RV-FWLS/PASP cut-off point, determined through time-dependent ROC curve analysis, as follows: normal RV-PA coupling group (RV-FWLS/PASP ≥0.63, n = 65) and impaired RV-PA coupling group (RV-FWLS/PASP < 0.63, n = 67).

Results

A significant improvement of RV-PA coupling was observed early after TAVI (0.75 ± 0.3 vs. 0.64 ± 0.3 before TAVI, p < 0.001), mainly due to PASP decrease (p < 0.001). LA global longitudinal strain (LA-GLS) is an independent predictor of RV-PA coupling impairment before and after TAVI (OR = 0.837, p < 0.001, OR = 0.848, p < 0.001, respectively), while RV diameter is an independent predictor of persistent RV-PA coupling impairment after TAVI (OR = 1.174, p = 0.002). Impaired RV-PA coupling was associated with a worse survival rate (66.3% vs. 94.9%, p-value < 0.001) and emerged as an independent predictor of mortality (HR = 5.97, CI = 1.44–24.8, p = 0.014) and of the composite endpoint of death and rehospitalization (HR = 4.14, CI = 1.37–12.5, p = 0.012).

Conclusion

Our results confirm that relief of aortic valve obstruction has beneficial effects on the baseline RV-PA coupling, and they occur early after TAVI. Despite significant improvement in LV, LA, and RV function after TAVI, RV-PA coupling remains impaired in some patients, it is mainly related to persistent pulmonary hypertension and is associated with adverse outcomes.
Estimated pulse wave velocity is associated with all-cause mortality and cardiovascular mortality among adults with diabetes
Authors: Wu Li-Da , Chu Peng , Kong Chao-Hua , Shi Yi , Zhu Ming-Hui , Xia Yi-Yuan , Li Zheng , Zhang Jun-Xia , Chen Shao-Liang
Published: April 2023

Aims

We aim to examine the association of estimated pulse wave velocity (ePWV) with all-cause and cardiovascular mortality in patients with diabetes.

Methods

All of adult participants with diabetes from the National Health and Nutrition Examination Survey (NHANES) (1999–2018) were enrolled. ePWV was calculated according to the previously published equation based on age and mean blood pressure. The mortality information was obtained from the National Death Index database. Weighted Kaplan-Meier (KM) plot and weighted multivariable Cox regression was used to investigate the association of ePWV with all-cause and cardiovascular mortality risks. Restricted cubic spline was adopted to visualize the relationship between ePWV and mortality risks.

Results

8,916 participants with diabetes were included in this study and the median follow-up duration was ten years. The mean age of study population was 59.0 ± 11.6 years, 51.3% of the participants were male, representing 27.4 million patients with diabetes in weighted analysis. The increment of ePWV was closely associated with increased risks of all-cause mortality (HR: 1.46, 95% CI: 1.42–1.51) and cardiovascular mortality (HR: 1.59, 95% CI: 1.50–1.68). After adjusting for cofounding factors, for every 1 m/s increase in ePWV, there was a 43% increased risk of all-cause mortality (HR: 1.43, 95% CI: 1.38–1.47) and 58% increased of cardiovascular mortality (HR: 1.58, 95% CI: 1.50–1.68). ePWV had positive linear associations with all-cause and cardiovascular mortality. KM plots also showed that the risks of all-cause and cardiovascular mortality were significantly elevated in patients with higher ePWV.

Conclusions

ePWV had a close association with all-cause and cardiovascular mortality risks in patients with diabetes.
Network experiment designs for inferring causal effects under interference
Authors: Fatemi Zahra , Zheleva Elena
Published: April 2023

Current approaches to A/B testing in networks focus on limiting interference, the concern that treatment effects can “spill over” from treatment nodes to control nodes and lead to biased causal effect estimation. In the presence of interference, two main types of causal effects are direct treatment effects and total treatment effects. In this paper, we propose two network experiment designs that increase the accuracy of direct and total effect estimations in network experiments through minimizing interference between treatment and control units. For direct treatment effect estimation, we present a framework that takes advantage of independent sets and assigns treatment and control only to a set of non-adjacent nodes in a graph, in order to disentangle peer effects from direct treatment effect estimation. For total treatment effect estimation, our framework combines weighted graph clustering and cluster matching approaches to jointly minimize interference and selection bias. Through a series of simulated experiments on synthetic and real-world network datasets, we show that our designs significantly increase the accuracy of direct and total treatment effect estimation in network experiments.
Biomedical heterogeneous data categorization and schema mapping toward data integration
Authors: Deshpande Priya , Rasin Alexander , Tchoua Roselyne , Furst Jacob , Raicu Daniela , Schinkel Michiel , Trivedi Hari , Antani Sameer
Published: April 2023

Data integration is a well-motivated problem in the clinical data science domain. Availability of patient data, reference clinical cases, and datasets for research have the potential to advance the healthcare industry. However, the unstructured (text, audio, or video data) and heterogeneous nature of the data, the variety of data standards and formats, and patient privacy constraint make data interoperability and integration a challenge. The clinical text is further categorized into different semantic groups and may be stored in different files and formats. Even the same organization may store cases in different data structures, making data integration more challenging. With such inherent complexity, domain experts and domain knowledge are often necessary to perform data integration. However, expert human labor is time and cost prohibitive. To overcome the variability in the structure, format, and content of the different data sources, we map the text into common categories and compute similarity within those. In this paper, we present a method to categorize and merge clinical data by considering the underlying semantics behind the cases and use reference information about the cases to perform data integration. Evaluation shows that we were able to merge 88% of clinical data from five different sources.
Discovery of the Qinghe fault, the inner part of the Weihe graben, central China, and its geological significance
Authors: Li Wei , Feng Xijie
Published: April 2023

The Weihe graben is an active Cenozoic continental rift with frequent seismic activity. The previous work focused on the graben boundary faults, but less work has been conducted on the faults in the internal graben. The Weihe basin is an economically developed and densely populated area. Therefore, identifying these potential risks is significant for the evaluation of regional seismic hazards and to understand the evolution of continental rifts. Prior work used oil exploration methods to document a fault (we named it “Qinghe fault”) in the Qinghe river area of Sanyuan County, north of Xi’an. But the shallow structure and activity was not clear. Therefore, we carried out shallow seismic detection and borehole exploration, as well as a geological survey in the area. Based on seismic reflection profile and boreholes, the Qinghe fault is the main fault and with other secondary faults, together they constitute a typical Y-shaped structure, with a fracture zone width ∼4 km. Combined with the field survey, we provide evidence that the Qinghe fault is a Holocene active fault and capable of earthquakes of magnitude 5.2–5.5. The discovery of the Qinghe fault shows that the Weihe rift is active, and the faults inside the rift play an important role in tectonic deformation.
Deep well new data in the area of the 2022 Mw 5.5 earthquake, Adriatic Sea, Italy: In situ stress state and P-velocities
Authors: Montone Paola , Mariucci Maria Teresa
Published: April 2023

Following the Mw 5.5 earthquake of 9 November 2022 that occurred along the Adriatic coast of Italy and the related seismic sequence, we analysed new data from deep wells drilled in recent years by ENI S.p.A. Specifically, we calculated the horizontal stress orientations from breakouts recognized in three wellbores, determined the P-wave velocities for the first 5 km of crust from 12 well sonic records, and then calculated the vertical stress values in the area. Our results, indicating orientations of the present-day stress field of ∼N130 and ∼N040 for minimum and maximum horizontal stress, respectively, are consistent with the seismic sequence focal solutions. Thrust faulting focal solutions occurring at a hypocentral depth between 5 and 10 km, show minimum horizontal stress oriented at ∼N140, which is also in agreement with the compressive tectonics of the area and the known seismogenic sources. The crustal P-wave velocities vary as a function of both the lithology crossed and the geological-structural location of the wells, suggesting several velocity patterns in a confined area. The average vertical stress for the investigated area, inferred from the velocity-derived density, shows values of ∼100 MPa at a depth of 4.5 km, with a gradient varying from 21 to 23 MPa/km. The obtainedin situstress measurements indicate that no stress regime changes or temporal rotations have been observed in the past 50 years throughout the entire area. The new stress indicators fill a geographical gap between the northern and southernmost existing data coherently with a compressive stress regime.
Association analysis between the TLR9 gene polymorphism rs352140 and type 1 diabetes
Authors: Wang Yimeng , Xia Ying , Chen Yan , Xu Linling , Sun Xiaoxiao , Li Jiaqi , Huang Gan , Li Xia , Xie Zhiguo , Zhou Zhiguang
Published: April 2023

Background

To a great extent, genetic factors contribute to the susceptibility to type 1 diabetes (T1D) development, and by triggering immune imbalance, Toll-like receptor (TLR) 9 is involved in the development of T1D. However, there is a lack of evidence supporting a genetic association between polymorphisms in the TLR9 gene and T1D.

Methods

In total, 1513 individuals, including T1D patients (n=738) and healthy control individuals (n=775), from the Han Chinese population were recruited for an association analysis of the rs352140 polymorphism of the TLR9 gene and T1D. rs352140 was genotyped by MassARRAY. The allele and genotype distributions of rs352140 in the T1D and healthy groups and those in different T1D subgroups were analyzed by the chi-squared test and binary logistic regression model. The chi-square test and Kruskal−Wallis H test were performed to explore the association between genotype and phenotype in T1D patients.

Results

The allele and genotype distributions of rs352140 were significantly different in T1D patients and healthy control individuals (p=0.019, p=0.035). Specifically, the T allele and TT genotype of rs352140 conferred a higher risk of T1D (OR=1.194, 95% CI=1.029-1.385, p=0.019, OR=1.535, 95% CI=1.108-2.126, p=0.010). The allele and genotype distributions of rs352140 were not significantly different between childhood-onset and adult-onset T1D and between T1D with a single islet autoantibody and T1D with multiple islet autoantibodies (p=0.603, p=0.743). rs352140 was associated with T1D susceptibility according to the recessive and additive models (p=0.015, p=0.019) but was not associated with T1D susceptibility in the dominant and overdominant models (p=0.117, p=0.928). Moreover, genotype-phenotype association analysis showed that the TT genotype of rs352140 was associated with higher fasting C-peptide levels (p=0.017).

Conclusion

In the Han Chinese population, the TLR9 polymorphism rs352140 is associated with T1D and is a risk factor for susceptibility to T1D.
Machine learning-based multimodal MRI texture analysis for assessing renal function and fibrosis in diabetic nephropathy: a retrospective study
Authors: Chen Wenbo , Zhang Lu , Cai Guanhui , Zhang Bin , Lian Zhouyang , Li Jing , Wang Wenjian , Zhang Yuxian , Mo Xiaokai
Published: April 2023

Introduction

Diabetic nephropathy (DN) has become a major public health burden in China. A more stable method is needed to reflect the different stages of renal function impairment. We aimed to determine the possible practicability of machine learning (ML)-based multimodal MRI texture analysis (mMRI-TA) for assessing renal function in DN.

Methods

For this retrospective study, 70 patients (between 1 January 2013 and 1 January 2020) were included and randomly assigned to the training cohort (n1 = 49) and the testing cohort (n2 = 21). According to the estimated glomerular filtration rate (eGFR), patients were assigned into the normal renal function (normal-RF) group, the non-severe renal function impairment (non-sRI) group, and the severe renal function impairment (sRI) group. Based on the largest coronal image of T2WI, the speeded up robust features (SURF) algorithm was used for texture feature extraction. Analysis of variance (ANOVA) and relief and recursive feature elimination (RFE) were applied to select the important features and then support vector machine (SVM), logistic regression (LR), and random forest (RF) algorithms were used for the model construction. The values of area under the curve (AUC) on receiver operating characteristic (ROC) curve analysis were used to assess their performance. The robust T2WI model was selected to construct a multimodal MRI model by combining the measured BOLD (blood oxygenation level-dependent) and diffusion-weighted imaging (DWI) values.

Results

The mMRI-TA model achieved robust and excellent performance in classifying the sRI group, non-sRI group, and normal-RF group, with an AUC of 0.978 (95% confidence interval [CI]: 0.963, 0.993), 0.852 (95% CI: 0.798, 0.902), and 0.972 (95% CI: 0.995, 1.000), respectively, in the training cohort and 0.961 (95% CI: 0.853, 1.000), 0.809 (95% CI: 0.600, 0.980), and 0.850 (95% CI: 0.638, 0.988), respectively, in the testing cohort.

Discussion

The model built from multimodal MRI on DN outperformed other models in assessing renal function and fibrosis. Compared to the single T2WI sequence, mMRI-TA can improve the performance in assessing renal function.
Unique safety features and licensing requirements of the NuScale small modular reactor
Authors: Welter Kent , Reyes José N. , Brigantic Adam
Published: April 2023

Small modular reactors (SMR) offer a novel approach to the construction and operation of nuclear power plants. The NuScale VOYGR™ plant uses a simplified SMR design that is based on proven light-water reactor technology with substantial improvements in nuclear safety. It consists of a 250 MWt reactor core housed with other primary system components in an integral reactor pressure vessel surrounded by a steel containment vessel, all of which is immersed in a large pool of water that also serves as the ultimate heat sink. At the core of the NuScale safety case are three primary safety systems: the decay heat removal system, the emergency core cooling system, and the containment. The ability of the NuScale Power Module (NPM) passive safety systems to remove core decay heat for an unlimited duration is demonstrated through analysis of a beyond-design-basis extended loss of AC power with no replenishment of water to the ultimate heat sink or operator actions. The NuScale methodology to evaluate an indefinite loss of AC power uses the proprietary NRELAP5 systems analysis computer code. Analysis results show that the reactor coolant system liquid level above the core is maintained and that containment pressure remains below the vessel design pressure. Once full passive air cooling is established, containment pressure and temperature will decrease over time with decreasing core decay heat. NuScale received standard design approval in September 2020 and design certification in January 2023 for its 50 MWe NPM configured as a 12 module plant. NuScale is currently seeking standard design approval to increase its core power to 250 MWt, nominally 77 MWe per module, in a 6-module plant (VOYGR™-6) configuration. The high-level safety of NuScale’s SMR technology is foundational to a new standard of nuclear power plant resilience.
Distribution and sources of particulate organic matter from the anthropogenically disturbed Iyidere River to the Black Sea coast
Authors: Kaymak Nehir , Mutlu Tanju , Verep Bulent
Published: April 2023

Understanding the biogeochemical processes of particulate organic matter occurring in the river under anthropogenic disturbances and its transport to the coastal system is important for environmental resource management. In this study, we investigated the sources and distribution of particulate organic matter (POM) from the upper reaches of the Iyidere River, Türkiye, to the coastal water of the Black Sea during the fall and spring seasons using the elemental (POC and PON (%), C/N), isotopic (δ13C and δ15N), and Bayesian mixing model (MixSIAR) analysis. The POC (%), PON (%), and C/N of POM varied seasonally, indicating that the composition of POM varied with river hydrology, which varies depending on the climate of the region. Both the mixing model and the isotopic and elemental ratios of POM have revealed that the organic matter sources contributing to the riverine of POM, during the fall season, when the precipitation is severe, exhibited a uniform distribution. Heavy rain increased soil erosion along the high-slope land, and as a result, soil and bacteria were identified as the main contributor of POM along the Iyidere River. The results showed that the organic matter sources contributing to POM in the spring season showed significant spatial variation. Terrestrial vegetation, soil OM, and bacteria were the main contributors of POM depending on sites, and these contributions did not show a regular trend along the river. δ15N of POM had significant spatial variation in both seasons that was likely caused by nitrogen inputs derived from anthropogenic activities along the river. The anthropogenic activities and cascade dams causing variations in the contribution of organic matter to the POM are the likely important driving factors in this river-coastal system.
The estimation of young water fraction based on isotopic signals: challenges and recommendations
Authors: Xia Chengcheng , Zuecco Giulia , Chen Ke , Liu Li , Zhang Zhiliang , Luo Jian
Published: April 2023

Young water fraction (Fyw) is defined as the fraction of water in a stream with a transit time of less than 2–3 months. Fyw is a metric used to quantify the proportion of precipitation input converted into the runoff in the form of fast flow, which provides new insights for characterizing the mechanisms of water storage and release, understanding the time-scale of ecohydrological processes and indicating water-related risks. However, Fyw has been advanced for a relatively short time, and the research on its applicability conditions and main drivers is still ongoing. Studies estimating Fyw are still very few and this index has not been reported in many landscapes and climate backgrounds, limiting its further application in hydrological studies. On the basis of summarizing the progresses of Fyw in previous studies, this paper provides a preliminary analysis of the potential uncertainties in the Fyw estimation, which can be due to temporal trends in the isotopic composition of precipitation, uneven sampling interval of stream water, and complex hydrological systems. Finally, this paper provides some recommendations for the optimization of the sampling design and the methods used for the Fyw estimation.
Microalgal diversity enhances water purification efficiency in experimental microcosms
Authors: Zhou Songlin , Li Wei , He Shuqiang
Published: April 2023

The losses of biodiversity have impaired functioning and provision of ecosystem services, and the relationship between biodiversity and ecosystem functioning has emerged as a central issue in environmental sciences. However, the majority of relevant studies are conducted in terrestrial ecosystems, and they focus predominantly on the relationship between community diversity and biomass production of terrestrial vegetation. At present, water eutrophication represents an increasingly serious problem worldwide, and the use of aquatic organisms for improving water quality represents a promising approach. However, more focus is placed on the selection of certain aquatic organisms with good performance, but neglects the effects of biodiversity in the process of water purification and the underlying mechanisms. In the present study, five microalgal species commonly found in freshwater ecosystems were used to assembly experimental microcosms with varying microalgal richness and composition. We analyzed the relationship between microalgal diversity and nitrogen removal efficiency based on mixed-effect models, and further explored the underlying mechanism of microalgal diversity in the process of water quality improvement. The results showed that with an increase in microalgal diversity, nitrogen removal efficiency of microalgal communities also increased. A further analysis of the impacts of microalgal diversity showed that the complementarity effect increased while the selection effect decreased with an increase in microalgal diversity. Meanwhile, there was a significantly positive relationship between microalgal diversity and the total abundance of microalgae. On the one hand, the present study clearly demonstrates two positive diversity-ecosystem functioning relationships. On the other hand, the present study also reveals the underlying mechanism by which microalgal diversity influences nitrogen removal efficiency, namely, high-diversity microalgal communities could use limiting nutrients such as nitrogen in a more efficient and complementary manner (e.g., stronger complementarity effect in high-diversity communities), convert them into higher aggregate community properties (e.g., higher total abundance of microalge in high-diversity communities), and thus exhibit higher purification capacity (e.g., higher nitrogen removal efficiency in high-diversity communities). Under the scenario that global ecosystems are experiencing high rates of anthropogenic nutrient inputs, the use of diverse microalgal species with proper management may help provide a promising approach for improving water quality.
Regulation of NDVI and ET negative responses to increased atmospheric vapor pressure deficit by water availability in global drylands
Authors: Wen Rihong , Jiang Peng , Qin Meiou , Jia Qingyu , Cong Nan , Wang Xiaoying , Meng Ying , Yang Feiyun , Liu Bin , Zhu Mengyuan , Zu Jiaxing , Chen Ning
Published: April 2023

Atmospheric vapor pressure deficit (VPD, indicative of atmospheric water conditions) has been identified as a major driver of global vegetation dynamics. Drylands, including deserts, temperate grasslands, savannas, and dry forests, are more sensitive to water conditions and affect carbon, nitrogen, and water cycles. However, our knowledge is limited on the way increasing VPD affects vegetation growth and evapotranspiration (ET) in global drylands. In this study, we used long-term satellite datasets combined with multiple statistical analyses to examine the relationship between the satellite-derived normalized difference vegetation index (NDVI), a proxy for vegetation growth, and ET to VPD across global drylands. We found that significant decreases in NDVI and ET predominantly influenced the NDVI (RVPD − NDVI) and ET (RVPD − ET) responses to VPD in both the savannas and dry forests of South American, African, and Australian savannas and dry forests, as well as in temperate grasslands (e.g., Eurasian steppes and American prairies). Notably, more than 60% of global drylands exhibited significantly negative RVPD − NDVI and RVPD − ET values. In contrast, the percentage of significantly negative RVPD − NDVI and RVPD − ET decreased to <10% in cold drylands (>60° N). In predominantly warm drylands (60° N~60° S), negative VPD effects were significantly and positively regulated by soil water availability, as determined by multiple linear regression models. However, these significant regulatory effects were not observed in cold drylands. Moving-window analyses further revealed that temporal changes in RVPD − NDVI and RVPD − ET were positively correlated with changes in the Standardized Precipitation Evapotranspiration Index (SPEI). In warm drylands, areas with increasing RVPD − NDVI and RVPD − ET over time showed an increasing trend in the SPEI, whereas areas with a decreasing SPEI showed a negative trend in RVPD − NDVI and RVPD − ET values over time. Given the increasing atmospheric dryness due to climate change, this study highlighted the importance of re-evaluating the representation of the role of water availability in driving the response of the carbon-water cycle to increased VPD across global drylands.
Analysis of basic pentacysteine6 transcription factor involved in abiotic stress response in Arabidopsis thaliana
Authors: Zhang Zhijun , Zhang Tingting , Ma Lei
Published: April 2023

Background: Abiotic stress is a significant environmental factor that limits plant growth. Plants have complex and diverse mechanisms for dealing with abiotic stress, and different response mechanisms are interconnected. Our research aims to find key transcription factors that can respond to multiple non -biological stress.

Methods: We used gene expression profile data of Arabidopsis in response to abiotic stress, constructed a weighted gene co-expression network, to obtain key modules in the network. The functions and pathways involved in these modules were further explored by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses. Through the enrichment analysis of transcription factor, the transcription factor that plays an important regulatory role in the key module. Through gene difference expression analysis and building protein interaction networks, the important role of key transcription factors is verified.

Result: In weighted gene co-expression network, identified three gene modules that are primarily associated with cold stress, heat stress, and salt stress. Functional enrichment analysis indicated that the genes in these modules participate in biological processes such as protein binding, stress response, and others. Transcription factor enrichment analysis revealed that the transcription factor Basic Pentacysteine6 (BPC6) plays a crucial regulatory role in these three modules. The expression of the BPC6 gene is dramatically affected under a variety of abiotic stress treatments, according to an analysis of Arabidopsis gene expression data under abiotic stress treatments. Differential expression analysis showed that there were 57 differentially expressed genes in bpc4 bpc6 double mutant Arabidopsis relative to normal Arabidopsis samples, including 14 BPC6 target genes. Protein interaction network analysis indicated that the differentially expressed genes had strong interactions with BPC6 target genes within the key modules.

Conclusion: Our findings reveal that the BPC6 transcription factor plays a key regulatory function in Arabidopsis coping with a variety of abiotic stresses, which opens up new ideas and perspectives for us to understand the mechanism of plants coping with abiotic stresses.
A phenomenological study of the lived experiences of partner relationship breakup during pregnancy: Psychosocial effects, coping mechanisms, and the healthcare providers' role
Authors: Negussie Abel , Girma Eshetu , Kaba Mirgissa
Published: April 2023

Background

Pregnancy is a state of continuous changes in feelings and emotions, and highly stressful experiences such as a relationship breakup during this period may result in additional stress for the woman, making pregnancy and motherhood challenging. This study aimed to investigate pregnant women's lived experiences of partner relationship breakup during pregnancy, their coping mechanisms, and the role of healthcare providers in breakup cases during their Antenatal care visits.

Methods

A phenomenological study approach was followed to seek an understanding of the lived experiences of pregnant women who encountered partner relationship breakup. The study was carried out in Hawassa, Ethiopia, and eight pregnant women were involved in in-depth interviews. The data meanings found from participants' experiences were described in a meaningful text and organized into themes. Key themes were developed in reference to the research objectives, and thematic analysis was used to analyze the data.

Results

Pregnant women in such situations faced serious psychological and emotional distress, feelings of shame/embarrassment, prejudice and discrimination, and severe economic struggles. To cope with this multifaceted situation, pregnant women sought social support from family/relatives or close friends, and if they had no other options, from supporting organizations. The participants also revealed that they received no counseling from healthcare providers during their Antenatal care visits, and there was no further discussion to address their psychosocial problems.

Conclusions

Community-level information, education, and communication should be initiated to aware communities about the psychosocial consequences of relationship breakup during pregnancy, address cultural norms and discrimination, and promote supportive environments. Women's empowerment activities and psychosocial support services should also be strengthened. In addition, the need for more comprehensive Antenatal care to address such unique risk conditions is indicated.
Immune-related mechanisms and immunotherapy in extragonadal germ cell tumors
Authors: Xiu Weigang , Pang Jiyun , Hu Yang , Shi Huashan
Published: April 2023

Purpose of review

Extragonadal germ cell tumors (EGCTs) are relatively rare tumors, accounting for 1%–5% of all GCTs. In this review, we summarize the current research progress regarding the pathogenesis, diagnosis, and treatment of EGCTs from an immunology perspective.

Recent findings

The histological origin of EGCTs is related to a gonadal origin, but they are located outside the gonad. They show great variation in morphology and can occur in the cranium, mediastinum, sacrococcygeal bone, and other areas. The pathogenesis of EGCTs is poorly understood, and their differential diagnosis is extensive and challenging. EGCT behavior varies greatly according to patient age, histological subtype, and clinical stage.

This review provides ideas for the future application of immunology in the fight against such diseases, which is a hot topic currently.
Succinylation modification provides new insights for the treatment of immunocompromised individuals with drug-resistant Aspergillus fumigatus infection
Authors: Chen Xianzhen , Lei Wenzhi , Meng Hui , Jiang Yi , Zhang Sanli , Chen Huyan , Du Mingwei , Xue Xiaochun
Published: April 2023

Invasive Aspergillus fumigatus infection poses a serious threat to global human health, especially to immunocompromised individuals. Currently, triazole drugs are the most commonly used antifungals for aspergillosis. However, owing to the emergence of drug-resistant strains, the effect of triazole drugs is greatly restricted, resulting in a mortality rate as high as 80%. Succinylation, a novel post-translational modification, is attracting increasing interest, although its biological function in triazole resistance remains unclear. In this study, we initiated the screening of lysine succinylation in A. fumigatus. We discovered that some of the succinylation sites differed significantly among strains with unequal itraconazole (ITR) resistance. Bioinformatics analysis showed that the succinylated proteins are involved in a broad range of cellular functions with diverse subcellular localizations, the most notable of which is cell metabolism. Further antifungal sensitivity tests confirmed the synergistic fungicidal effects of dessuccinylase inhibitor nicotinamide (NAM) on ITR-resistant A. fumigatus. In vivo experiments revealed that treatment with NAM alone or in combination with ITR significantly increased the survival of neutropenic mice infected with A. fumigatus. In vitro experiments showed that NAM enhanced the killing effect of THP-1 macrophages on A. fumigatus conidia. Our results suggest that lysine succinylation plays an indispensable role in ITR resistance of A. fumigatus. Dessuccinylase inhibitor NAM alone or in combination with ITR exerted good effects against A. fumigatus infection in terms of synergistic fungicidal effect and enhancing macrophage killing effect. These results provide mechanistic insights that will aid in the treatment of ITR-resistant fungal infections.
Reprogramming tumor-associated macrophages as a unique approach to target tumor immunotherapy
Authors: Khan Safir Ullah , Khan Munir Ullah , Azhar Ud Din Muhammad , Khan Ibrar Muhammad , Khan Muhammad Imran , Bungau Simona , Hassan Syed Shams ul
Published: April 2023

In the last ten years, it has become increasingly clear that tumor-infiltrating myeloid cells drive not just carcinogenesis via cancer-related inflammatory processes, but also tumor development, invasion, and metastasis. Tumor-associated macrophages (TAMs) in particular are the most common kind of leucocyte in many malignancies and play a crucial role in establishing a favorable microenvironment for tumor cells. Tumor-associated macrophage (TAM) is vital as the primary immune cell subset in the tumor microenvironment (TME).In order to proliferate and spread to new locations, tumors need to be able to hide from the immune system by creating an immune-suppressive environment. Because of the existence of pro-tumoral TAMs, conventional therapies like chemotherapy and radiotherapy often fail to restrain cancer growth. These cells are also to blame for the failure of innovative immunotherapies premised on immune-checkpoint suppression. Understanding the series of metabolic changes and functional plasticity experienced by TAMs in the complex TME will help to use TAMs as a target for tumor immunotherapy and develop more effective tumor treatment strategies. This review summarizes the latest research on the TAMs functional status, metabolic changes and focuses on the targeted therapy in solid tumors.
Combination of anti-C1qA08 and anti-mCRP a.a.35-47 antibodies is associated with renal prognosis of patients with lupus nephritis
Authors: Liu Xiao-Ling , Tan Ying , Yu Feng , Ji Shang-Rong , Zhao Ming-Hui
Published: April 2023

Objective

The aim of this study is to explore the prevalence and clinicopathological associations between anti-C1qA08 antibodies and anti-monomeric CRP (mCRP) a.a.35-47 antibodies and to explore the interaction between C1q and mCRP.

Methods

Ninety patients with biopsy-proven lupus nephritis were included from a Chinese cohort. Plasma samples collected on the day of renal biopsy were tested for anti-C1qA08 antibodies and anti-mCRP a.a.35-47 antibodies. The associations between these two autoantibodies and clinicopathologic features and long-term prognosis were analyzed. The interaction between C1q and mCRP was further investigated by ELISA, and the key linear epitopes of the combination of cholesterol binding sequence (CBS; a.a.35-47) and C1qA08 were tested by competitive inhibition assays. The surface plasmon resonance (SPR) was used to further verify the results.

Results

The prevalence of anti-C1qA08 antibodies and anti-mCRP a.a.35-47 antibodies were 50/90 (61.1%) and 45/90 (50.0%), respectively. Levels of anti-C1qA08 antibodies and anti-mCRP a.a.35-47 antibodies were negatively correlated with serum C3 concentrations ((0.5(0.22-1.19) g/L vs. 0.39(0.15-1.38) g/L, P=0.002) and (0.48(0.44-0.88) g/L vs. 0.41(0.15-1.38) g/L, P=0.028), respectively. Levels of anti-C1qA08 antibodies were correlated with the score of fibrous crescents and tubular atrophy (r=-0.256, P=0.014 and r=-0.25, P=0.016, respectively). The patients with double positive antibodies showed worse renal prognosis than that of the double negative group (HR 0.899 (95% CI: 0.739-1.059), P=0.0336). The binding of mCRP to C1q was confirmed by ELISA. The key linear epitopes of the combination were a.a.35-47 and C1qA08, which were confirmed by competitive inhibition experiments and SPR.

Conclusion

The combination of anti-C1qA08 and anti-mCRP a.a.35-47 autoantibodies could predict a poor renal outcome. The key linear epitopes of the combination of C1q and mCRP were C1qA08 and a.a.35-47. A08 was an important epitope for the classical pathway complement activation and a.a.35-47 could inhibit this process.
An effective trap for spotted lanternfly egg masses
Authors: Lewis Phillip , Davila-Flores Amanda , Wallis Emily
Published: April 2023

Spotted lanternfly (SLF) (Lycorma delicatula (White)), an invasive planthopper discovered in Pennsylvania, USA in 2014, continues to spread and is now present in 14 states with substantial infestations present in seven states. Population projections using adult SLF trapping or visual counts are not reliable due to the transient, migratory behavior of the adults which make population forecasts difficult. Another approach to population monitoring is utilization of the stationary egg mass stage, but counting small cryptic egg masses throughout the canopy of large trees in dense woodlots is arduous and prone to error. After several field seasons testing various trapping configurations and materials, we have identified an efficient, simple, low-cost trap termed a ‘lamp shade trap’ that is attached to the lower trunk area of an SLF host tree. SLF females readily enter the trap and lay eggs on the thin, flexible trap surface. A vertical trap orientation was superior, and the most productive woodlots yielded an average of 47 and 54 egg masses per trap, and several traps had over 100 egg masses. There were 1,943 egg masses tallied from 105 traps placed at six locations in two states. Egg mass counts in the area above and below the traps and on nearby control trees yielded very few egg masses in comparison. Selection of trees 15 to 20 cm in diameter for trap placement is most efficient, yielding good egg mass abundance while minimizing the amount of trap material used. The lamp shade trap has potential as an effective tool to identify SLF in new areas, gauge SLF population levels in woodlots and can also be used to collect and monitor egg masses for research purposes.
Application issues of compulsory conciliation in the settlement of fishery disputes in the Yellow Sea
Authors: Pan Xiaolin
Published: April 2023

China and South Korea have made great efforts to settle their fishery disputes in the Yellow Sea through political negotiations. The results of the bilateral treaty, which was concluded around 2001, have been very limited. The Law of the Sea’s compulsory conciliation procedure can become an alternative choice for two countries to settle fishery disputes. This article starts with a comparative study of fishery disputes in the Yellow Sea that should be subject to compulsory conciliation. Based on the similarities among these disputes, it is argued that compulsory conciliation is applicable to the settlement of fishery disputes in the Yellow Sea. This article also pays attention to some essential issues related to the application of compulsory conciliation, including the jurisdiction and powers of the Conciliation Commission and the implementation of the report concluded by the Conciliation Commission.
Density functional modeling of the binding energies between aluminosilicate oligomers and different metal cations
Authors: Gong Kai , Yang Kengran , White Claire E.
Published: April 2023

Interactions between negatively charged aluminosilicate species and positively charged metal cations are critical to many important engineering processes and applications, including sustainable cements and aluminosilicate glasses. In an effort to probe these interactions, here we have calculated the pair-wise interaction energies (i.e., binding energies) between aluminosilicate dimer/trimer and 17 different metal cations Mn+ (Mn+ = Li+, Na+, K+, Cu+, Cu2+, Co2+, Zn2+, Ni2+, Mg2+, Ca2+, Ti2+, Fe2+, Fe3+, Co3+, Cr3+, Ti4+ and Cr6+) using a density functional theory (DFT) approach. Analysis of the DFT-optimized structural representations for the clusters (dimer/trimer + Mn+) shows that their structural attributes (e.g., interatomic distances) are generally consistent with literature observations on aluminosilicate glasses. The DFT-derived binding energies are seen to vary considerably depending on the type of cations (i.e., charge and ionic radii) and aluminosilicate species (i.e., dimer or trimer). A survey of the literature reveals that the difference in the calculated binding energies between different Mn+ can be used to explain many literature observations associated with the impact of metal cations on materials properties (e.g., glass corrosion, mineral dissolution, and ionic transport). Analysis of all the DFT-derived binding energies reveals that the correlation between these energy values and the ionic potential and field strength of the metal cations are well captured by 2nd order polynomial functions (R2 values of 0.99–1.00 are achieved for regressions). Given that the ionic potential and field strength of a given metal cation can be readily estimated using well-tabulated ionic radii available in the literature, these simple polynomial functions would enable rapid estimation of the binding energies of a much wider range of cations with the aluminosilicate dimer/trimer, providing guidance on the design and optimization of sustainable cements and aluminosilicate glasses and their associated applications. Finally, the limitations associated with using these simple model systems to model complex interactions are also discussed.
Term breech presentation vaginal births in Tibet: A retrospective analysis of 451 cases
Authors: Long Fang , Yan Keqing , Guo Dongxing , Zhaxi Duoji , Xu Xiaoguang , Sun Zhigang , Xiao Zhen
Published: April 2023

Background

In high altitude areas, like Tibet, most fetuses in breech presentation at term are delivered vaginally owing to a variety of reasons, but this has not been published.

Objective

This study aimed to provide references and evidence for the delivery of breach presentation term fetuses in high altitude areas, through comparing and analyzing the data of full-term singleton fetuses with breech or cephalic presentation in Naqu People’s Hospital, Tibet.

Study design

We retrospectively analyzed the clinical data of 451 breech presentation fetuses mentioned above over a period of 5  years (2016–2020). A total of 526 cephalic presentation fetuses’ data within 3  months (1 June to 1 September 2020) of the same period were collected too. Statistics were compared and assembled on fetal mortality, Apgar scores, and severe neonatal complications for both planned cesarean section (CS) and vaginal delivery. In addition, we also analyzed the types of breech presentation, the second stage of labor, and damage to the maternal perineum during vaginal delivery.

Results

Among the 451 cases of breech presentation fetuses, 22 cases (4.9%) elected for CS and 429 cases (95.1%) elected for vaginal delivery. Of the women who chose vaginal trial labor, 17 cases underwent emergency CSs. The perinatal and neonatal mortality rate was 4.2% in the planned vaginal delivery group and the incidence of severe neonatal complications was 11.7% in the transvaginal group, no deaths were detected in the CS group. Among the 526 cephalic control groups with planned vaginal delivery, the perinatal and neonatal mortality was 1.5% (p = 0.012), and the incidence of severe neonatal complications was 1.9%. Among vaginal breech deliveries, most of them were complete breech presentation (61.17%). Among the 364 cases, the proportion of intact perinea was 45.1%, and first degree lacerations accounted for 40.7%.

Conclusion

In the Tibetan Plateau region, vaginal delivery was less safe than cephalic presentation fetuses for full-term breech presentation fetuses delivered in the lithotomy position. However, if dystocia or fetal distress can be identified in time and then encouraged to convert to cesarean, its safety will be greatly improved.
Training in psychosomatic medicine and psychotherapy for medical doctors in China: A field report
Authors: Wei Jing , Fritzsche Kurt , Shi Lili , Cao Jinya , Bassler Markus , Müller Anne-Maria , Zhang Ying , Lüdemann Hannah-Theresa , Leonhart Rainer
Published: April 2023

Background

The high prevalence rates of mental disorders in China contrast a comparatively low care capacity from qualified trained medical doctors in the mental health field. The main objective of our cooperation project was to develop and implement advanced postgraduate training for medical doctors for their acquisition of knowledge, skills, and attitudes in the field of psychosomatic medicine and psychotherapy in China.

Methods

Monitoring and evaluation as part of the advanced training in Beijing were conducted following the Kirkpatrick training approach using four levels of evaluation: reaction, learning, behavior and results. We performed a continuous course evaluation, assessed the respective learning goal attainment, conducted a pre-post evaluation of reasons and goals for participation in the training, and measured the treatment effects on the patient side.

Results

The implementation of training standards in the field of psychosomatic medicine and psychotherapy for medical doctors and the transfer of didactic knowledge and skills for Chinese lecturers were achieved. A total of 142 mainly medical doctors attended the 2-year training. Ten medical doctors were trained as future teachers. All learning goals were reached. The content and didactics of the curriculum were rated with an overall grade of 1.23 (1 = very good to 5 = very bad). The highest rated elements were patient life interviews, orientation on clinical practice and communication skills training. The achievement of learning objectives for each block (depression, anxiety disorders, somatic symptom disorder, coping with physical diseases) was rated between 1 and 2 (1 = very well achieved to 5 = not achieved) for all items from participants’ perspectives. On the patient side (n = 415), emotional distress decreased and quality of life and the doctor–patient alliance improved significantly.

Discussion

Advanced training in psychosomatic medicine and psychotherapy was successfully implemented. The results of the evaluation show high participant satisfaction and the successful achievement of all learning objectives. A more detailed and extensive evaluation of the data, such as an analysis of the development of the participants as psychotherapists, is in preparation. The continuation of the training under Chinese guidance is guaranteed.