bluuebunny/crossref_metadata_2025 huggingface dataset:
SELE Downregulation Suppresses Mast Cell Accumulation to Protect against Inflammatory Response in Chronic Idiopathic Urticaria
Authors: Wang Hong , Xu Yangchun , Jin Meishan , Yuan Wen
Published: December 2020

Background:Chronic idiopathic urticaria (CIU) represents a common skin disorder often characterized by mast cell activation and secretion of histamine and other proinflammatory factors. E-selectin (SELE) has been implicated in the pathogenesis of common inflammatory cutaneous disorders, while the role of SELE in CIU is yet to be fully understood. Thus, we aimed to investigate the mechanism by which SELE influences CIU in connection with the involvement of mast cells. Methods: SELE expression was measured in blood samples obtained from CIU patients and normal individuals. A CIU mouse model was subsequently established by intradermally injecting a normal saline solution with ovalbumin IgE antiserum into the mice. Loss- and gain-of-function investigations were conducted on the mouse models. The number of degranulated mast cells and the amount of histamine release in vitro were determined. The levels of SELE, tumor necrosis factor (TNF)-α, homologous restriction factor (HRF), and interleukin (IL)-6 levels were determined. Results: The CIU clinical samples exhibited upregulated SELE, while the CIU mice showed increased mast cell degranulation and an increased rate of histamine directional release, as well as an elevated expression of SELE, TNF-α, HRF, and IL-6. SELE silencing was found to decrease the number of degranulated mast cells and reduce the rate of histamine directional release, along with suppressed TNF-α, HRF, and IL-6 expression, in the serum of CIU mice. Ketotifen was observed to rescue the increased expression of TNF-α, HRF, and IL-6 caused by SELE overexpression. Conclusions:This study highlights the potential of SELE downregulation to repress inflammatory factor secretion caused by the accumulation of mast cells, which ultimately inhibits the development of CIU.
Resolution of Refractory Corneal Neovascularization with Subconjunctival Bevacizumab
Authors: Britton Anna Krystyna , Crayford Basil Bamford
Published: December 2020

Corneal neovascularization (CNV) has a variety of causes and threatens corneal clarity, thus optimal visual acuity. Conventional medical management includes topical steroids and matrix metalloproteinase inhibitors like doxycycline. Anti-vascular endothelial growth factor (anti-VEGF) agents have demonstrated promise but remain off-label for this indication. However, these agents hold value in cases refractory to first-line medical management. We report the case of a 63-year-old woman who presented with ocular rosacea and CNV affecting vision, on a background of acne rosacea. She was initially treated with fluorometholone and doxycycline, yet continued to deteriorate. Eventually she received two 1.5-mg subconjunctival injections of bevacizumab 2 months apart. CNV completely resolved and results were maintained at 4-year follow-up. This case demonstrates that refractory CNV can be effectively treated with subconjunctival injection of anti-VEGF bevacizumab. The resolution of CNV was also maintained years after injection with minimal adjunctive therapy during this period, and to our knowledge there are no other studies reporting a follow-up period of 4 years after treatment. This is a pertinent case for other clinicians treating patients in a similar situation.
Psych-APP-Therapie: Smartphonebasierte Interventionen in der Psychotherapie – Eine systematische Übersichtsarbeit
Authors: Neumayr Christina , Voderholzer Ulrich , Schlegl Sandra
Published: December 2020

Hintergrund: Technologiebasierte Interventionen haben in der Psychotherapie an Bedeutung gewonnen. Ein versorgungsrelevanter Ansatz sind Mental Health Apps. Ziel dieser systematischen Übersichtsarbeit ist es (1) international eva­luierte Apps zu den Störungsbildern Depressionen, Angststörungen und Essstörungen zu identifizieren, (2) deren Verfügbarkeit in deutschen App-Stores sowie (3) in deutscher Sprache zu prüfen und (4) ihre Effektivitätsergebnisse aus randomisiert-kontrollierten (Pilot-)Studien (RCTs) darzustellen. Methode: Die Übersichtsarbeit wurde in Anlehnung an das PRISMA Statement durchgeführt und ausgewertet. Eine systematische Recherche (2007–2018) der Datenbanken PubMed, PsychINFO sowie PSYNDEX wurde durchgeführt. Zudem fand eine Beurteilung der methodischen Qualität sowie der Effektivitätsergebnisse der (Pilot-)RCTs statt. Ergebnisse: Es wurden 2’571 Abstracts identifiziert und 47 Publikationen eingeschlossen (N = 32 unterschiedliche Apps; N = 24 [Pilot-]RCTs). Die Qualität der (Pilot-)RCTs ist überwiegend als gut bis moderat einzustufen. Die Ergebnisse waren heterogen (keine bis große Effekte [Cohens d] zwischen den Gruppen: –0,01; KI [–0,36; 0,34] bis 1,49; KI [1,00; 1,99]). Vier Apps mit einer Evaluation durch (Pilot-)RCTs sind in den deutschen App-Stores verfügbar – eine in deutscher Sprache. Schlussfolgerungen: Es liegt international eine Vielzahl von ersten App-Evaluationen zu den Störungsbildern vor, die Verfügbarkeit ausreichend evalu­ierter deutschsprachiger Apps in den deutschen App-Stores ist aber extrem limitiert. Englischsprachige, bereits evalu­ierte Apps könnten in das Deutsche übersetzt und – genauso wie schon verfügbare, aber nicht evaluierte deutschsprachige Apps – in RCTs inkl. Katamnesedaten evaluiert werden. So könnten smartphonebasierte Interventionen im Rahmen des “Digitalen-Versorgungs-Gesetzes” als ergänzendes Element in der Psychotherapie an Bedeutung gewinnen.
Frequency of leptospirosis in horses in Manaus and metropolitan region in Amazonas State, Brazil
Authors: Sousa Isadora Karolina Freitas de , Silva Rebeca Larissa Castro , Sousa Rejane dos Santos , Vieira Claudia Elisa Martins , Melo Sérgio de , Quevedo Geórgea Portella , Von Laer Ana Eucares , Lovato Luciane Teresinha , Tonin Alexandre Alberto
Published: December 2020

The occurrence of leptospirosis is significantly higher in the tropical climate than in temperate regions, especially in periods with high rainfall levels. In horses, leptospirosis can range from subclinical to asymptomatic but maintains an important role in the transmission of leptospirosis by eliminating the agent in the environment. Regarding horses, the Amazonas herd increased by 30% between 2004 and 2013. Thus, the study aimed to determine the serological prevalence of leptospirosis in horses in Manaus and metropolitan regions, in the State of Amazonas, Brazil as well as to assess the main serogroups involved in the infections of these animals. For this purpose, from August 2018 to July 2019, serum from 198 horses was evaluated through the microscopic agglutination test with a panel of 10 serogroups. As a result, 92 horses (44.46%) were found to be positive for one or more Leptospira serovars, with the highest prevalence of serogroups Icterohaemorrhagiae and Pyrogenes. Therefore, with the increase in the equine herd in the region and, consequently, greater interaction between breeders and animals, the identification of reagents to at least one serovar of Leptospira spp. signals the possible existence of reservoirs of pathogenic strains for other animals and man.
Systemic Inflammatory Response Syndrome Is Associated With Increased Mortality Across the Spectrum of Shock Severity in Cardiac Intensive Care Patients
Authors: Jentzer Jacob C , Lawler Patrick R. , van Diepen Sean , Henry Timothy D. , Menon Venu , Baran David A. , Džavík Vladimír , Barsness Gregory W. , Holmes David R. , Kashani Kianoush B.
Published: December 2020

Background:

The systemic inflammatory response syndrome (SIRS) frequently occurs in patients with cardiogenic shock and may aggravate shock severity and organ failure. We sought to determine the association of SIRS with illness severity and survival across the spectrum of shock severity in cardiac intensive care unit (CICU) patients.

Methods:

We retrospectively analyzed 8995 unique patients admitted to the Mayo Clinic CICU between 2007 and 2015. Patients with ≥2/4 SIRS criteria based on admission laboratory and vital sign data were considered to have SIRS. Patients were stratified by the 2019 Society for Cardiovascular Angiography and Interventions (SCAI) shock stages using admission data. The association between SIRS and mortality was evaluated across SCAI shock stage using logistic regression and Cox proportional-hazards models for hospital and 1-year mortality, respectively.

Results:

The study population had a mean age of 67.5±15.2 years, including 37.2% women. SIRS was present in 33.9% of patients upon CICU admission and was more prevalent in advanced SCAI shock stages. Patients with SIRS had higher illness severity, worse shock, and more organ failure, with an increased risk of mortality during hospitalization (16.8% versus 3.8%; adjusted odds ratio, 2.1 [95% CI, 1.7–2.5];
P
<0.001) and at 1 year (adjusted hazard ratio, 1.4 [95% CI, 1.3–1.6];
P
<0.001). After multivariable adjustment, SIRS was associated with higher hospital and 1-year mortality among patients in SCAI shock stages A through D (all
P
<0.01) but not SCAI shock stage E.

Conclusions:

One-third of CICU patients meet clinical criteria for SIRS at the time of admission, and these patients have higher illness severity and worse outcomes across the spectrum of SCAI shock stages. The presence of SIRS identified CICU patients at increased risk of short-term and long-term mortality. Further study is needed to determine whether systemic inflammation truly drives SIRS in this population and whether patients with SIRS respond differently to supportive therapies for shock.
Creative Connections: Computational Semantic Distance Captures Individual Creativity and Resting-State Functional Connectivity
Authors: Orwig William , Diez Ibai , Vannini Patrizia , Beaty Roger , Sepulcre Jorge
Published: December 2020

Recent studies of creative cognition have revealed interactions between functional brain networks involved in the generation of novel ideas; however, the neural basis of creativity is highly complex and presents a great challenge in the field of cognitive neuroscience, partly because of ambiguity around how to assess creativity. We applied a novel computational method of verbal creativity assessment—semantic distance—and performed weighted degree functional connectivity analyses to explore how individual differences in assembly of resting-state networks are associated with this objective creativity assessment. To measure creative performance, a sample of healthy adults ( n = 175) completed a battery of divergent thinking (DT) tasks, in which they were asked to think of unusual uses for everyday objects. Computational semantic models were applied to calculate the semantic distance between objects and responses to obtain an objective measure of DT performance. All participants underwent resting-state imaging, from which we computed voxel-wise connectivity matrices between all gray matter voxels. A linear regression analysis was applied between DT and weighted degree of the connectivity matrices. Our analysis revealed a significant connectivity decrease in the visual-temporal and parietal regions, in relation to increased levels of DT. Link-level analyses showed higher local connectivity within visual regions was associated with lower DT, whereas projections from the precuneus to the right inferior occipital and temporal cortex were positively associated with DT. Our results demonstrate differential patterns of resting-state connectivity associated with individual creative thinking ability, extending past work using a new application to automatically assess creativity via semantic distance.
Integrating Philosophy of Science into Research on Ethical, Legal and Social Issues in the Life Sciences
Authors: Lohse Simon , Wasmer Martin S. , Reydon Thomas A. C.
Published: December 2020

This paper argues that research on normative issues in the life sciences will benefit from a tighter integration of philosophy of science. We examine research on ethical, legal and social issues in the life sciences (“ELSI”) and discuss three illustrative examples of normative issues that arise in different areas of the life sciences. These examples show that important normative questions are highly dependent on epistemic issues which so far have not been addressed sufficiently in ELSI, RRI and related areas of research. Accordingly, we argue for the integration of research on the epistemic aspects of the relevant areas of science into ELSI research to provide a better basis for addressing normative questions.
Integrating Heather Douglas’ Inductive Risk Framework with an Account of Scientific Evidence: Why and How?
Authors: Dede O. Çağlar
Published: December 2020

I examine how Heather Douglas’ account of values in science applies to the assessment of actual cases of scientific practice. I focus on the case of applied toxicologists’ acceptance of molecular evidence-gathering methods and evidential sources. I demonstrate that a set of social and institutional processes plays a philosophically significant role in changing toxicologists’ inductive risk judgments about different kinds of evidence. I suggest that Douglas’ inductive risk framework can be integrated with a suitable account of evidence, such as Helen Longino’s contextual empiricism, to address the role of social context in the cases like the one examined here. I introduce such an integrated account and show how Longino’s contextual empiricism and inductive risk framework fruitfully complement each other in analyzing the novel aspects of the toxicology case.
Applications of Dynamic Land Surface Information for Passive Microwave Precipitation Retrieval
Authors: Ringerud Sarah , Peters-Lidard Christa , Munchak Joe , You Yalei
Published: December 2020

Accurate, physically based precipitation retrieval over global land surfaces is an important goal of the NASA/JAXA Global Precipitation Measurement Mission (GPM). This is a difficult problem for the passive microwave constellation, as the signal over radiometrically warm land surfaces in the microwave frequencies means that the measurements used are indirect and typically require inferring some type of relationship between an observed scattering signal and precipitation at the surface. GPM, with collocated radiometer and dual-frequency radar, is an excellent tool for tackling this problem and improving global retrievals. In the years following the launch of the GPM Core Observatory satellite, physically based passive microwave retrieval of precipitation over land continues to be challenging. Validation efforts suggest that the operational GPM passive microwave algorithm, the Goddard profiling algorithm (GPROF), tends to overestimate precipitation at the low (<5 mm h−1) end of the distribution over land. In this work, retrieval sensitivities to dynamic surface conditions are explored through enhancement of the algorithm with dynamic, retrieved information from a GPM-derived optimal estimation scheme. The retrieved parameters describing surface and background characteristics replace current static or ancillary GPROF information including emissivity, water vapor, and snow cover. Results show that adding this information decreases probability of false detection by 50% and, most importantly, the enhancements with retrieved parameters move the retrieval away from dependence on ancillary datasets and lead to improved physical consistency.
Sequential bilateral Behçet’s neuroretinitis associated with prepapillary vitreous exudate: case report
Authors: Ksiaa Imen , Ben Aoun Safa , Zina Sourour , Nefzi Dhouha , Khochtali Sana , Khairallah Moncef
Published: December 2020

Objective

To describe a case of Behçet disease (BD) uveitis manifesting with sequential bilateral neuroretinitis associated with prepapillary inflammatory vitreous exudate (PIVE).

Material and methods

A single case report documented with multimodal imaging.

Results

A 37-year-old man developed neuroretinitis with associated PIVE in the left eye. He was diagnosed with ocular toxoplasmosis and treated accordingly based on positive serologic testing and negative work-up for other entities, including BD. The disease course was favorable, but 1 year later a similar neuroretinitis developed in the right eye. Extraocular features of BD became evident only at the time of the second eye involvement, and the patient received corticosteroid and immunosuppressive therapy.

Swept source (SS) OCT showed at the acute phase in both eyes a typical “mushroom-shaped” prepapillary hyperreflectivity of the PIVE. SS OCT angiography (OCTA) demonstrated a corresponding prepapillary hypointense area due to shadowing effect, decreasing in size while scanning deeper layers. It also detected peripapillary retinal hypervascularity in both eyes and a sectoral area of flow signal loss in the first involved left eye. Visual acuity improved following the resolution of the PIVE and associated acute inflammatory changes in both eyes. The left eye showed residual optic disc pallor and retinal nerve fiber layer defects.

Conclusion

Sequential bilateral neuroretinitis associated with PIVE may occur before other clinical features of BD become evident. SS OCT and OCTA can provide useful information for the diagnosis and management of this rare, but typical, ocular manifestation of BD uveitis.
New insights into the evolution and functional divergence of the CIPK gene family in Saccharum
Authors: Su Weihua , Ren Yongjuan , Wang Dongjiao , Huang Long , Fu Xueqin , Ling Hui , Su Yachun , Huang Ning , Tang Hanchen , Xu Liping , Que Youxiong
Published: December 2020

Background

Calcineurin B-like protein (CBL)-interacting protein kinases (CIPKs) are the primary components of calcium sensors, and play crucial roles in plant developmental processes, hormone signaling transduction, and in the response to exogenous stresses.

Results

In this study, 48CIPKgenes (SsCIPKs) were identified from the genome ofSaccharum spontaneum. Phylogenetic reconstruction suggested that theSsCIPKgene family may have undergone six gene duplication events from the last common ancestor (LCA) ofSsCIPKs. Whole-genome duplications (WGDs) served as the driving force for the amplification ofSsCIPKs. The Nonsynonymous to synonymous substitution ratio (Ka/Ks) analysis showed that the duplicated genes were possibly under strong purifying selection pressure. The divergence time of these duplicated genes had an average duplication time of approximately 35.66 Mya, suggesting that these duplication events occurred after the divergence of the monocots and eudicots (165 Mya). The evolution of gene structure analysis showed that theSsCIPKfamily genes may involve intron losses. TenScCIPKgenes were amplified from sugarcane (Saccharum spp. hybrids). The results of real-time quantitative polymerase chain reaction (qRT-PCR) demonstrated that these tenScCIPKgenes had different expression patterns under abscisic acid (ABA), polyethylene glycol (PEG), and sodium chloride (NaCl) stresses. Prokaryotic expression implied that the recombinant proteins of ScCIPK3, − 15 and − 17 could only slightly enhance growth under salinity stress conditions, but the ScCIPK21 did not. TransientN. benthamianaplants overexpressingScCIPKsdemonstrated that theScCIPKgenes were involved in responding to external stressors through the ethylene synthesis pathway as well as to bacterial infections.

Conclusions

In generally, a comprehensive genome-wide analysis of evolutionary relationship, gene structure, motif composition, and gene duplications ofSsCIPKfamily genes were performed inS. spontaneum. The functional study of expression patterns in sugarcane and allogenic expressions inE. coliandN. benthamianashowed thatScCIPKsplayed various roles in response to different stresses. Thus, these results improve our understanding of the evolution of theCIPKgene family in sugarcane as well as provide a basis for in-depth functional studies ofCIPKgenes in sugarcane.
The patterns of admixture, divergence, and ancestry of African cattle populations determined from genome-wide SNP data
Authors: Gebrehiwot N. Z. , Strucken E. M. , Aliloo H. , Marshall K. , Gibson J. P.
Published: December 2020

Background

HumplessBos tauruscattle are one of the earliest domestic cattle in Africa, followed by the arrival of humpedBos indicuscattle. The diverse indigenous cattle breeds of Africa are derived from these migrations, with most appearing to be hybrids betweenBos taurusandBos indicus. The present study examines the patterns of admixture, diversity, and relationships among African cattle breeds.

Methods

Data for ~ 40 k SNPs was obtained from previous projects for 4089 animals representing 35 African indigenous, 6 EuropeanBos taurus, 4Bos indicus,and 5 African crossbred cattle populations. Genetic diversity and population structure were assessed using principal component analyses (PCA), admixture analyses, and Wright’sFstatistic. The linkage disequilibrium and effective population size (Ne) were estimated for the pure cattle populations.

Results

The first two principal components differentiatedBos indicusfrom EuropeanBos taurus, and AfricanBos taurusfrom other breeds. PCA and admixture analyses showed that, except for recently admixed cattle, all indigenous breeds are either pure AfricanBos taurusor admixtures of AfricanBos taurusandBos indicus.The African zebu breeds had highest proportions ofBos indicusancestry ranging from 70 to 90% or 60 to 75%, depending on the admixture model. Other indigenous breeds that were not 100% AfricanBos taurus, ranged from 42 to 70% or 23 to 61%Bos indicusancestry. The AfricanBos tauruspopulations showed substantial genetic diversity, and other indigenous breeds show evidence of having more than one African taurine ancestor.Neestimates based onr2andr2adjshowed a decline inNefrom a large population at 2000 generations ago, which is surprising for the indigenous breeds given the expected increase in cattle populations over that period and the lack of structured breeding programs.

Conclusion

African indigenous cattle breeds have a large genetic diversity and are either pure AfricanBos taurusor admixtures of AfricanBos taurusandBos indicus.This provides a rich resource of potentially valuable genetic variation, particularly for adaptation traits, and to support conservation programs. It also provides challenges for the development of genomic assays and tools for use in African populations.
Genomic targets for high-resolution inference of kinship, ancestry and disease susceptibility in orang-utans (genus: Pongo)
Authors: Banes Graham L. , Fountain Emily D. , Karklus Alyssa , Huang Hao-Ming , Jang-Liaw Nian-Hong , Burgess Daniel L. , Wendt Jennifer , Moehlenkamp Cynthia , Mayhew George F.
Published: December 2020

Background

Orang-utans comprise three critically endangered species endemic to the islands of Borneo and Sumatra. Though whole-genome sequencing has recently accelerated our understanding of their evolutionary history, the costs of implementing routine genome screening and diagnostics remain prohibitive. Capitalizing on a tri-fold locus discovery approach, combining data from published whole-genome sequences, novel whole-exome sequencing, and microarray-derived genotype data, we aimed to develop a highly informative gene-focused panel of targets that can be used to address a broad range of research questions.

Results

We identified and present genomic co-ordinates for 175,186 SNPs and 2315 Y-chromosomal targets, plus 185 genes either known or presumed to be pathogenic in cardiovascular (N = 109) or respiratory (N = 43) diseases in humans – the primary and secondary causes of captive orang-utan mortality – or a majority of other human diseases (N = 33). As proof of concept, we designed and synthesized ‘SeqCap’ hybrid capture probes for these targets, demonstrating cost-effective target enrichment and reduced-representation sequencing.

Conclusions

Our targets are of broad utility in studies of orang-utan ancestry, admixture and disease susceptibility and aetiology, and thus are of value in addressing questions key to the survival of these species. To facilitate comparative analyses, these targets could now be standardized for future orang-utan population genomic studies. The targets are broadly compatible with commercial target enrichment platforms and can be utilized as published here to synthesize applicable probes.
Target detection in healthy 4-week old piglets from a passive two-tone auditory oddball paradigm
Authors: Oeur R. Anna , Margulies Susan S.
Published: December 2020

Background

Passive auditory oddball tests are effort independent assessments that evaluate auditory processing and are suitable for paediatric patient groups. Our goal was to develop a two-tone auditory oddball test protocol and use this clinical assessment in an immature large animal model. Event-related potentials captured middle latency P1, N1, and P2 responses in 4-week old (N = 16, female) piglets using a custom piglet 32- electrode array on 3 non-consecutive days. The effect of target tone frequency (250 Hz and 4000 Hz) on middle latency responses were tested in a subset of animals.

Results

Results show that infrequent target tone pulses elicit greater N1 amplitudes than frequent standard tone pulses. There was no effect of day. Electrodes covering the front of the head tend to elicit greater waveform responses. P2 amplitudes increased for higher frequency target tones (4000 Hz) than the regular 1000 Hz target tones (p < 0.05).

Conclusions

Two-tone auditory oddball tests produced consistent responses day-to-day. This clinical assessment was successful in the immature large animal model.
Lung ultrasound in the emergency department - a valuable tool in the management of patients presenting with respiratory symptoms during the SARS-CoV-2 pandemic
Authors: Schmid Bonaventura , Feuerstein Doreen , Lang Corinna N. , Fink Katrin , Steger Rebecca , Rieder Marina , Duerschmied Daniel , Busch Hans-Jörg , Damjanovic Domagoj
Published: December 2020

Background

Typical lung ultrasound (LUS) findings in patients with a COVID-19 infection were reported early on. During the global SARS-CoV-2 pandemic, LUS was propagated as a useful instrument in triage and monitoring. We evaluated LUS as a rapid diagnostic triage tool for the management of patients with suspected COVID-19 in the emergency department (ED).

Methods

The study retrospectively enrolled patients with suspected COVID-19, who were admitted from 1st April to 25th of April 2020 to the ED of a tertiary care center in Germany. During clinical work-up, patients underwent LUS and polymerase chain reaction (PCR) testing for SARS-CoV-2. The recorded ultrasound findings were analyzed and judged regarding typical signs of viral pneumonia, blinded for clinical information of the patients. The results were compared with PCR test and chest computed tomography (CT).

Results

2236 patients were treated in the ED during the study period. 203 were tested for SARS-CoV-2 using PCR, 135 (66.5%) underwent LUS and 39 (28.9%) of the patients were examined by chest CT scan. 39 (28.9%) of the 135 patients were tested positive for SARS-CoV-2 with PCR.

In 52 (38.5%) COVID-19 was suspected from the finding of the LUS, resulting in a sensitivity of 76.9% and a specificity of 77.1% compared with PCR results. The negative predictive value reached 89.2%. The findings of the LUS had - compared to a positive chest CT scan for COVID-19 - a sensitivity of 70.6% and a specificity of 72.7%.

Conclusions

LUS is a rapid and useful triage tool in the work-up of patients with suspected COVID-19 infection during a pandemic scenario. Still, the results of the LUS depend on the physician’s experience and skills.
Slow radiological improvement and persistent low-grade inflammation after chemotherapy in tuberculosis patients with type 2 diabetes
Authors: Mily Akhirunnesa , Sarker Protim , Taznin Inin , Hossain Delwar , Haq Md. Ahsanul , Kamal S. M. Mostofa , Agerberth Birgitta , Brighenti Susanna , Raqib Rubhana
Published: December 2020

Background

Diabetes mellitus type 2 (DM) may impede immune responses in tuberculosis (TB) and thus contribute to enhanced disease severity. In this study, we aimed to evaluate DM-mediated alterations in clinical, radiological and immunological outcomes in TB disease.

Methods

Newly diagnosed pulmonary TB patients with or without DM (TB n = 40; TB-DM n = 40) were recruited in Dhaka, Bangladesh. Clinical symptoms, sputum smear and culture conversion as well as chest radiography were assessed. Peripheral blood and sputum samples were collected at the time of diagnosis (baseline) and after 1, 2 and 6 months of standard anti-TB treatment. Blood samples were also obtained from healthy controls (n = 20). mRNA expression of inflammatory markers in blood and sputum samples were quantified using real-time PCR.

Results

The majority of TB-DM patients had poor glycemic control (HbA1c > 8%) and displayed elevated pulmonary pathology (P = 0.039) particularly in the middle (P < 0.004) and lower lung zones (P < 0.02) throughout the treatment period. However, reduction of clinical symptoms and time to sputum smear and culture conversion did not differ between the groups. Transcripts levels of the pro-inflammatory cytokines IL-1β (P = 0.003 at month-1 and P = 0.045 at month-2) and TNF-α (P = 0.005 at month-1) and the anti-inflammatory cytokine IL-10 (P = 0.005 at month-2) were higher in peripheral blood after anti-TB treatment in TB-DM compared to TB patients. Conversely in sputum, TB-DM patients had reduced CD4 (P < 0.009 at month-1) and IL-10 (P = 0.005 at month-1 and P = 0.006 at month-2) transcripts, whereas CD8 was elevated (P = 0.016 at month-2). At 1- and 2-month post-treatment, sputum IL-10 transcripts were inversely correlated with fasting blood glucose and HbA1c levels in all patients.

Conclusion

Insufficient up-regulation of IL-10 in the lung may fuel persistent local inflammation thereby promoting lung pathology in TB-DM patients with poorly controlled DM.
Molecular epidemiology of SARS-CoV-2 clusters caused by asymptomatic cases in Anhui Province, China
Authors: Yuan Yuan , He Jun , Gong Lei , Li Weiwei , Jiang Liangliang , Liu Jiang , Chen Qingqing , Yu Junling , Hou Sai , Shi Yonglin , Lu Siqi , Zhang Zhuhui , Ge Yinglu , Sa Nan , He Lan , Wu Jiabing , Sun Yong , Liu Zhirong
Published: December 2020

Background

COVID-19 is a newly emerging disease caused by a novel coronavirus (SARS-CoV-2), which spread globally in early 2020. Asymptomatic carriers of the virus contribute to the propagation of this disease, and the existence of asymptomatic infection has caused widespread fear and concern in the control of this pandemic.

Methods

In this study, we investigated the origin and transmission route of SARS-CoV-2 in Anhui’s two clusters, analyzed the role and infectiousness of asymptomatic patients in disease transmission, and characterized the complete spike gene sequences in the Anhui strains.

Results

We conducted an epidemiological investigation of two clusters caused by asymptomatic infections sequenced the spike gene of viruses isolated from 12 patients. All cases of the two clusters we investigated had clear contact histories, both from Wuhan, Hubei province. The viruses isolated from two outbreaks in Anhui were found to show a genetically close link to the virus from Wuhan. In addition, new single nucleotide variations were discovered in the spike gene.

Conclusions

Both clusters may have resulted from close contact and droplet-spreading and asymptomatic infections were identified as the initial cause. We also analyzed the infectiousness of asymptomatic cases and the challenges to the current epidemic to provided information for the development of control strategies.
Perception of childbirth experiences of Japanese women in Bali, Indonesia: a qualitative study
Authors: Tanaka Kazuko , Kurniasari Ni Made Dian , Widyanthini Desak Nyoman , Suariyani Ni Luh Putu , Listyowati Rina , Urayama Akimi , Wirawan I. Made Ady , Yoshimura Koichi
Published: December 2020

Background

Maternal healthcare services in Indonesia have seen dramatic improvements over the past 25 years and yet there is still room for improvement. The perception, by the women, of the perinatal care provided, is a vital input to further improving these services. This study examines how the perinatal care provided is experienced by Japanese women in Bali, using an interview survey.

Methods

We conducted semi-structured interviews, from August to October 2017, with 14 Japanese women living in Badung Regency and Denpasar City in Bali Province, Indonesia to report their perception of the perinatal care they experienced during their pregnancies. The interview guide included among others, the reasons for choosing specific (perinatal care) health facilities and their satisfaction with their experience of using the antenatal, delivery, and postnatal care services. The data were analysed using the qualitative content analysis method.

Results

From the interview data, 12 categories across five themes were extracted. Participants reported experiencing various concerns during their pregnancies such as difficulty in obtaining perinatal care related information. From the beginning of their pregnancies, participants gradually established trusting relationships with midwives, but in many situations, they were disappointed with their childbirth experiences, as they felt that the care provided was not woman-centred. Through their own efforts and with the support of family members and other Japanese residents, many women were able to eventually regard their childbirth experiences as positive. Nevertheless, some women could not overcome their negative impressions even years after childbirth.

Conclusions

Participants desired close attention and encouragement from nurses and midwives. Our results suggest that Japanese women in Bali expected a woman-centred perinatal care and active support from nursing/midwifery staff during their pregnancies and postnatal care.
O6-methylguanine DNA methyltransferase and glucose transporter 2 in foregut and hindgut gastrointestinal neuroendocrine neoplasms
Authors: Watanabe Hirofumi , Yamazaki Yuto , Fujishima Fumiyoshi , Izumi Komoto , Imamura Masayuki , Hijioka Susumu , Toriyama Kazuhiro , Yatabe Yasushi , Kudo Atsushi , Motoi Fuyuhiko , Unno Michiaki , Sasano Hironobu
Published: December 2020

Background

Streptozocin (STZ) is used for treating both pancreatic (PanNET) and gastrointestinal (GI-NET) neuroendocrine tumors but its therapeutic efficacy is relatively low in GI-NETs. Therefore, it has become pivotal to select GI-NET patients who could benefit from STZ treatment. STZ is transported via the glucose transporter 2 (GLUT2) into the cells and the loss of O6-methylguanine DNA methyltransferase (MGMT) also increases its therapeutic efficacy. Therefore, GLUT2 high and MGMT low status could be the surrogate markers of STZ.

Methods

In this study, we examined the MGMT and GLUT2 status in gastrointestinal neuroendocrine neoplasm (NEN). We studied 84 NEN cases: 33 foregut and 37 hindgut GI-NETs and 14 gastrointestinal neuroendocrine carcinomas (GI-NECs).

Results

In GI-NETs, MGMT scores of ≥2 and ≥ 3 were 77% (54/70) and 56% (39/70), respectively, and GLUT2 scores of ≥4 and ≥ 6 were 30% (21/70) and 4.3% (3/70), respectively. Methylation-specific polymerase chain reaction revealed that MGMT promoter methylation was detected only in 2/14 GI-NECs but none of the included GI-NETs. GLUT2 (GLUT2 score) and MGMT immunoreactivity (MGMT and H-scores) were both significantly correlated with Ki-67 labeling index (GLUT2 score: P = 0.0045, ρ = − 0.4570; MGMT score: P = 0.0064, ρ = − 0.4399; H-score: P = 0.0110, ρ = − 0.4135) and MGMT immunoreactivity were significantly correlated with GLUT2 immunoreactivity (MGMT score: P = 0.0198; H-score, P = 0.0004, ρ = 0.5483) in hindgut NETs, but not in foregut NETs. However, discrepancies from the above correlation between GLUT2 and MGMT immunoreactivity were detected in several GI-NET cases which could be potential candidates for STZ therapy.

Conclusion

The evaluation of MGMT and GLUT2 status could provide an important information in planning STZ therapy in GI-NET patients.
Dynamic changes of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio predicts breast cancer prognosis
Authors: Kim Ju-Yeon , Jung Eun Jung , Kim Jae-Myung , Lee Han Shin , Kwag Seung-Jin , Park Ji-Ho , Park Taejin , Jeong Sang-Ho , Jeong Chi-Young , Ju Young-Tae
Published: December 2020

Background

We aimed to identify whether neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are more useful predictors after initial intention to treat than at the time of diagnosis.

Methods

We collected the medical data of 533 patients. The results of the peripheral blood sampling before the primary treatments were labeled as initial cohort, and those obtained between 24 and 36 months after initial treatment were defined as the 2nd cohort. Delayed metastasis has been defined as distant metastasis 2 years after treatment, and survival outcome was estimated and compared across groups.

Results

Median follow-up duration was 74 months (24–162 months), and 53 patients experienced delayed metastasis. In univariate analysis, metastasis-free survival, patient age at diagnosis, tumor size, axillary lymph node metastasis, HER-2 status, initial NLR and PLR, and 2nd NLR and PLR were found to be significantly associated with delayed metastasis. However, in multivariate analysis, only the 2nd NLR and PLR were found to be significantly associated with delayed metastasis, excluding initial NLR and PLR. Metastasis-free survival was analyzed through the pattern changes of NLR or PLR. The results revealed that patients with continued low NLR and PLR values at pre- and post-treatment (low initial values and 2nd values) showed a significantly better prognosis than those with a change in value or continued high NLR and PLR.

Conclusions

We identified that patients with persistent high NLR and PLR after initial treatment have significant worse prognosis in terms of late metastasis. Therefore, these results suggest that NLR and PLR are more useful in predicting prognosis post-treatment.
A white circular-spot pattern of iridian atrophy associated with Varicella-zoster virus and Toxoplasma gondii coinfection: a case report
Authors: Muñoz-Ortiz Juliana , Rubio-Romero Olga Lorena , Cedeño Maria Cecilia , Arteaga-Rivera Karla , de-la-Torre Alejandra
Published: December 2020

Background

We report a case of white circular spots of iridian atrophy, which we will call “polka dots” pattern, as a rare ophthalmological finding associated with uveitis secondary to varicella-zoster virus and Toxoplasma gondii coinfection in a male patient in Bogotá, Colombia.

Case presentation

We present de case of a 53-year-old Colombian male patient with a diagnosis of anterior uveitis in his left eye due to varicella-zoster virus and Toxoplasma gondii coinfection documented by polymerase chain reaction analysis. He presented with multiple areas of superficial white circular spots of iridian atrophy in 360º, some with deeper atrophy where the stroma fibers were visualized and only a small punctate defect of transillumination was evident. This rare pattern of iridian atrophy has not been previously described in cases of uveitis in the literature.

Conclusions

This is the first case reporting the findings of superficial “polka dots” pattern iridian atrophy in 360° secondary to anterior uveitis due to the coinfection of a virus and a parasite. The identification of similar clinical cases may lead to early initiation of systemic treatment in these patients.
Influence of measurement differences of anterior chamber depth and axial length on lens thickness evaluation in cataract patients: a comparison of two tests
Authors: Xu Jiayi , Li Chen , Wang Lijun , Li Caixin , Li Xin , Lu Peirong
Published: December 2020

Background

The purpose of this study was to investigate the agreement of lens thickness (LT) measurements made by contact A-scan ultrasonography and Lenstar LS900 as well as the influence of anterior chamber depth (ACD) and axial length (AL) measurement differences on LT measurement in cataract patients in the two techniques.

Methods

1247 cataract patients (1247 eyes) participated in this retrospective cross-sectional study. Ocular biometric measurements were performed with Lenstar LS900 and A-scan ultrasonography respectively, and the measured results of AL, ACD and LT were compared using Pearson correlation coefficients (r) and Bland-Altman analyses.

Results

Bland-Altman analyses showed poor agreement between the A-scan ultrasonography and Lenstar LS900 in measuring AL and ACD. The average difference of LT was 0.01 mm; the consistency limit was − 0.86 mm, 0.88 mm; and 95.27% of datapoints were within the 95% consistency limit. The consistency of LT measurements between the two techniques was poor for those subjects whose ACD or AL values were beyond the 95% consistency limit. Among the subjects whose AL or ACD values measured by A-scan ultrasonography were greater than those measured by Lenstar LS900, 93.33% of them were within the 95% consistency limit, suggesting that the consistency of LT measurement between the two techniques was poor. Of patients whose ACD or AL measured by A-scan ultrasonography were smaller than that of Lenstar LS900, 96.01% of them were within the 95% consistency limit.

Conclusions

There was good agreement of the LT measurements between A-scan ultrasonography and Lenstar LS900, except for the axis deviating from the apparent axis during A-scan ultrasonography. If this error can be avoided, A-scan ultrasonography can replace Lenstar LS900 in LT measurement in cataract patients.
Differences in course of illness between patients with bipolar II disorder with and without epileptiform discharges or other sharp activity on electroencephalograms: a cross-sectional study
Authors: Drange O. K. , Sæther S. G. , Finseth P. I. , Morken G. , Vaaler A. E. , Arntsen V. , Henning O. , Andreassen O. A. , Elvsåshagen T. , Malt U. F. , Bøen E.
Published: December 2020

Background

A diagnosis of bipolar II disorder requires that the symptoms cannot be better explained by a medical condition. Epilepsy is in some cases associated with an affective syndrome mimicking an unstable bipolar II disorder. Epileptiform discharges on electroencephalograms (EEGs) are typical, but not pathognomonic, for epilepsy. A previous study has found a high frequency of epileptiform discharges and other sharp activity among patients with bipolar disorder. The aim of the study was to identify if epileptic discharges or other sharp activity per se are associated with an altered course of illness among patients with bipolar II disorder.

Methods

Eighty six patients diagnosed with bipolar II disorder at two psychiatric departments were interviewed about prior course of illness and assessed with EEGs. The patients were split into two groups based on the presence (n = 12) or absence (n = 74) of epileptiform discharges or other sharp activity. Wilcoxon rank sum test, Fisher’s exact test, and Pearson’s chi squared test were used to assess differences between the groups on six variables of course of illness.

Results

Patients with epileptiform discharges or other sharp activity had a history of more hypomanic episodes per year (median (interquartile range (IQR)) 1.5 (3.2) vs. 0.61 (1.1), p = 0.0090) and a higher hypomania:depression ratio (median (IQR) 3.2 (16) vs. 1.0 (1.0), p = 0.00091) as compared to patients without. None of the patients with epileptiform discharges or other sharp activity had self-reported epileptic seizures in their history.

Conclusions

Epileptiform discharges or other sharp activity on EEGs are associated with more hypomanic episodes and an increased hypomania:depression ratio. Our results warrant replication in prospective studies, but suggest that EEG findings could be of prognostic importance for patients diagnosed with bipolar II disorder in psychiatric care.

Trial registration

ClinicalTrials.gov (NCT00201526).
Is cycle network expansion cost-effective? A health economic evaluation of cycling in Oslo
Authors: Lamu Admassu N. , Jbaily Abdulrahman , Verguet Stéphane , Robberstad Bjarne , Norheim Ole Frithjof
Published: December 2020

Background

Expansion of designated cycling networks increases cycling for transport that, in turn, increases physical activity, contributing to improvement in public health. This paper aims to determine whether cycle-network construction in a large city is cost-effective when compared to the status-quo. We developed a cycle-network investment model (CIM) for Oslo and explored its impact on overall health and wellbeing resulting from the increased physical activity.

Methods

First, we applied a regression technique on cycling data from 123 major European cities to model the effect of additional cycle-networks on the share of cyclists. Second, we used a Markov model to capture health benefits from increased cycling for people starting to ride cycle at the age of 30 over the next 25 years. All health gains were measured in quality-adjusted life years (QALYs). Costs were estimated in US dollars. Other data to populate the model were derived from a comprehensive literature search of epidemiological and economic evaluation studies. Uncertainty was assessed using deterministic and probabilistic sensitivity analyses.

Results

Our regression analysis reveals that a 100 km new cycle network construction in Oslo city would increase cycling share by 3%. Under the base-case assumptions, where the benefits of the cycle-network investment relating to increased physical activity are sustained over 25 years, the predicted average increases in costs and QALYs per person are $416 and 0.019, respectively. Thus, the incremental costs are $22,350 per QALY gained. This is considered highly cost-effective in a Norwegian setting.

Conclusions

The results support the use of CIM as part of a public health program to improve physical activity and consequently avert morbidity and mortality. CIM is affordable and has a long-term effect on physical activity that in turn has a positive impact on health improvement.
A systematic review of interventions to increase attendance at health and fitness venues: identifying key behaviour change techniques
Authors: Rand Matthew , Norman Paul , Goyder Elizabeth
Published: December 2020

Background

Members’ attendance at health and fitness venues typically declines over the course of their membership, with a likely negative impact on physical activity and health outcomes. This systematic review sought to examine the effectiveness of interventions to increase attendance at health and fitness venues and identify the behaviour change techniques (BCTs) included in effective interventions.

Methods

A systematic search of seven databases was conducted. The Behaviour Change Technique Taxonomy was used to code the interventions. Cohen’s d was used to assess the effectiveness of the interventions.

Results

Fourteen papers reporting 20 interventions were included in the review. Most interventions were found to have trivial or small effects on attendance, although one had a medium effect (d = 0.60) and three had a large effect (ds = 1.00, 1.37, 1.45). The interventions used a limited range of BCTs, with “Prompts/Cues” being the most frequently used. Of the interventions with large effect sizes, two used “Problem solving” and “Pros and cons” and one used “Goal setting (behaviour)” and “Review behaviour goals”.

Conclusions

Only a small number of studies have tested interventions to increase attendance at health and fitness venues, with predominantly trivial or small effects. With the possible exception of problem solving alongside decisional balance and goal setting alongside reviewing behaviour goals, there is little evidence for the effectiveness of specific BCTs. Further research is required to identify the key components of effective interventions to increase attendance at health and fitness venues.