bluuebunny/crossref_metadata_2025 huggingface dataset:
SSEP N20 and P25 amplitudes predict poor and good neurologic outcomes after cardiac arrest
Authors: Benghanem Sarah , Nguyen Lee S. , Gavaret Martine , Mira Jean-Paul , Pène Frédéric , Charpentier Julien , Marchi Angela , Cariou Alain
Published: March 2022

Background

To assess in comatose patients after cardiac arrest (CA) if amplitudes of two somatosensory evoked potentials (SSEP) responses, namely, N20-baseline (N20-b) and N20–P25, are predictive of neurological outcome.

Methods

Monocentric prospective study in a tertiary cardiac center between Nov 2019 and July-2021. All patients comatose at 72 h after CA with at least one SSEP recorded were included. The N20-b and N20–P25 amplitudes were automatically measured in microvolts (µV), along with other recommended prognostic markers (status myoclonus, neuron-specific enolase levels at 2 and 3 days, and EEG pattern). We assessed the predictive value of SSEP for neurologic outcome using the best Cerebral Performance Categories (CPC1 or 2 as good outcome) at 3 months (main endpoint) and 6 months (secondary endpoint). Specificity and sensitivity of different thresholds of SSEP amplitudes, alone or in combination with other prognostic markers, were calculated.

Results

Among 82 patients, a poor outcome (CPC 3–5) was observed in 78% of patients at 3 months. The median time to SSEP recording was 3(2–4) days after CA, with a pattern “bilaterally absent” in 19 patients, “unilaterally present” in 4, and “bilaterally present” in 59 patients. The median N20-b amplitudes were different between patients with poor and good outcomes, i.e., 0.93 [0–2.05]µV vs. 1.56 [1.24–2.75]µV, respectively (p < 0.0001), as the median N20–P25 amplitudes (0.57 [0–1.43]µV in poor outcome vs. 2.64 [1.39–3.80]µV in good outcome patients p < 0.0001). An N20-b > 2 µV predicted good outcome with a specificity of 73% and a moderate sensitivity of 39%, although an N20–P25 > 3.2 µV was 93% specific and only 30% sensitive. A low voltage N20-b < 0.88 µV and N20–P25 < 1 µV predicted poor outcome with a high specificity (sp = 94% and 93%, respectively) and a moderate sensitivity (se = 50% and 66%). Association of “bilaterally absent or low voltage SSEP” patterns increased the sensitivity significantly as compared to “bilaterally absent” SSEP alone (se = 58 vs. 30%, p = 0.002) for prediction of poor outcome.

Conclusion

In comatose patient after CA, both N20-b and N20–P25 amplitudes could predict both good and poor outcomes with high specificity but low to moderate sensitivity. Our results suggest that caution is needed regarding SSEP amplitudes in clinical routine, and that these indicators should be used in a multimodal approach for prognostication after cardiac arrest.
Role of hard X-ray emission in ionospheric D-layer disturbances during solar flares
Authors: Briand Carine , Clilverd Mark , Inturi Srivani , Cecconi Baptiste
Published: March 2022

Any disturbance of the ionosphere may affect operational activities based on HF communication. The electron density is a critical parameter that controls levels of HF-signal absorption. A significant part of the HF absorption takes place in the D-layer. The increase of X radiations during solar flares generates noticeable perturbations of the electron density of the D-layer. However, the ionosphere reacts with some delay to the solar forcing. Several studies have addressed this question of ionospheric sluggishness from the time delay between VLF narrow-band transmissions and soft X-ray emissions during solar flares. Our study initially considers the interpretation of the VLF amplitude time profile. In particular, we show that the maximum of X-ray emission can be associated with a reversal in the VLF amplitude variation with time, i.e. exhibiting a peak or a trough. Then, building on this insight, we perform estimates of the time delay between VLF and soft X-rays during 67 events between 2017 and 2021, thus including the major flares of 2017. We show that the time delay can become negative for flares above X2, proving that soft X-rays are not the initial source of ionization in the case of major flares. From a careful analysis of RHESSI data for some events of September 2017, we demonstrate that radiation above 40 keV (i.e. hard X-rays) is an important forcing source of the ionosphere. This is of crucial interest in the frame of space weather forecasting since the hard X-rays are produced several minutes before the peak of soft X-rays.

Graphical Abstract
Decreased myostatin in response to a controlled DASH diet is associated with improved body composition and cardiometabolic biomarkers in older adults: results from a controlled-feeding diet intervention study
Authors: Perry Cydne A. , Van Guilder Gary P. , Butterick Tammy A.
Published: March 2022

Background

Elevated concentrations of myostatin inhibit muscle growth, function and strength. Myostatin is a mediator of sarcopenia and is associated with insulin resistance. For this study we tested the response of a calorie-restricted Dietary Approaches to Stop Hypertension (DASH) diet on changes in myostatin, follistatin, and mystatin:follistatin ratio levels after 12 weeks in comparison to basline in adults aged 65 years and older. Furthermore we evaluated correlations between changes in myostatin, body composition and cardiometabolic biomarkers in this cohort of older adults.

Methods

This was a controlled-feeding diet intervention study in which females (n = 17) and males (n = 11) aged 65 years and older consumed either 85 g (n = 15) or 170 g (n = 13) of fresh lean beef within a standardized DASH diet for 12-weeks. Myostatin and follistatin concentrations were measured from fasted blood samples collected at 5 timepoints throughout the 12-week feeding intervention period. Correlations were assessed between changes in myostatin and follistatin levels and measures of body composition and cardiometabolic biomarkers.

Results

There were no differences (p > 0.05) in circulating myostatin or follistatin levels between the beef intake groups. However, with beef groups combined myostatin decreased by 17.6% (p = 0.006) and the myostatin-to-follistatin ratio decreased by 16.5% (p < 0.001) in response to the study diet. Decreased myostatin was positively correlated with reductions in waist circumference (R2 = 0.163; p = 0.033) and fat mass (R2 = 0.233; p = 0.009). There was an inverse relationship between decreased myostatin and increased strength-to-weight ratio (R2 = 0.162; p = 0.034). The change in myostatin-to-follistatin ratio was associated with the change in skeletal muscle mass-to-fat mass ratio (R2 = 0.176; p = 0.026). Decreased myostatin was positively correlated with reductions in total cholesterol (R2 = 0.193; p = 0.012), LDL-C (R2 = 0.163; p = 0.031), insulin (R2 = 0.234; p = 0.009), and HOMA-IR (R2 = 0.248; P = 0.007). There was no change (p > 0.05) in circulating follistatin concentrations in response to the diet intervention.

Conclusions

The outcomes from this study suggest that a calorie-restricted DASH diet has the potential to reduce myostatin concentrations in older adults. Furthermore these outcomes support interrelationships between myostatin, body composition and cardiometabolic health in adults aged 65 years and older.

Trial registration

ClinicalTrials.gov; Identifier: NCT04127240; Registration Date: 15/10/ 2019.
Evaluation of the quality of online patient information at the intersection of complementary and alternative medicine and hypertension
Authors: Ng Jeremy Y. , Jomy Jane , Vacca Alexandra
Published: March 2022

Background

Hypertension impacts 1.1 billion people globally; many patients seek complementary and alternative medicine (CAM), as a result of adverse side effects from antihypertensive medications or because they believe natural options are safer. The internet is increasingly playing a role in patient health information-seeking behavior, however, the variability of information quality across websites is unclear. Thus, the purpose of this study was to assess the quality of websites providing consumer health information at the intersection of hypertension and CAM.

Methods

Four unique terms were searched on Google, across Australia, Canada, the US, and the UK. The first 20 webpages resulting from each search were screened for eligibility, and were included if they contained consumer health information relating to CAM therapies for the treatment/management of hypertension. To assess the quality of health information on eligible websites, we used the DISCERN instrument, a standardized quality index of consumer health information.

Results

Of 90 unique webpages, 40 websites were deemed eligible and quality assessed. The 40 eligible websites were classified into seven categories: professional (n = 15), news (n = 11), non-profit (n = 5), health portal (n = 3), commercial (n = 2), government (n = 1), and other (n = 3). The mean summed DISCERN score was 52.34 (standard deviation [SD] = 10.69) out of 75 and the mean overall score was 3.49 (SD = 0.08) out of 5. A total of 10 websites had a total DISCERN score of 60.00 and above with an average rating of 4.33. Among these, Medicine Net (69.00) and WebMD (69.00) were determined to have the highest quality information. Websites generally scored well with respect to providing their aims, identifying treatment benefits and options, and discussing shared-decision making; websites generally lacked references and provided inadequate information surrounding treatment risks and impact on quality of life.

Conclusions

While some websites provided high-quality consumer health information, many others provided information of suboptimal quality. A need exists to better educate patients about identifying misinformation online. Healthcare providers should also inquire about their patients’ health information-seeking behavior, and provide them with the guidance necessary to identify high-quality resources which they can use to inform shared-decision making.
Objectively-measured sleep patterns and cardiometabolic health in a rural South African setting: a cross sectional analysis
Authors: Cook Ian , Mohlabe Matlawa
Published: March 2022

Background

To investigate the relationship between objectively-measured, free-living sleep patterns, and cardiometabolic health, in a rural South African health and demographic surveillance site.

Methods

Wrist-mounted actigraphy data was collected over nine days from 167 adults (≥ 40 years). Sleep patterns were constructed from tertiles of sleep quantity and quality parameters (TST: total sleep time, AC: activity counts during sleep) from valid minute-by-minute data. The reference category was Moderate TST/Low-to-Moderate AC. Self-reported data included behavioural, health and socio-demographic variables. Biological data included anthropometry, resting blood pressure and fasting blood glucose, insulin and lipids. Binary and ordinal logistic regression models were constructed to determine the association between TST and AC, the factors associated with sleeping patterns, and the association between sleeping patterns and Insulin resistance (HOMA-IR) and Metabolic Syndrome (MetS). HOMA-IR and MetS were also examined across sleep patterns using analysis of variance models.

Results

A total of 139 adults (71.2% female) had a complete dataset. In unadjusted analyses, females had poorer sleep quality, were more physically active, and displayed poorer cardiometabolc health and greater adiposity than males (p ≤ 0.017). There were no sex differences in TST or sleep pattern distribution (p ≤ 0.901). Not being classified as Low TST/High AC or exposed to ≥ 1 bout of Low TST/High AC sleep was associated with lower physical activity, longer sleep duration, better sleep quality and lower IR (p ≤ 0.0452). In multivariate analyses, there was no association between TST and AC (p = 0.921), while increasing age and people-to-bedroom density, and lower physical activity where significantly associated with increasing TST (p ≤ 0.027). Participants classified as Low TST/High AC had significantly higher HOMA-IR, but not MetS, compared with Moderate TST/Low AC (p = 0.021). Being exposed to ≥ 1 bout of Low TST/High AC sleep was significantly associated with hypertension (OR = 2.31, 95%CI: 1.00, 5.34), but not for HOMA-IR or MetS (p ≥ 0.227).

Conclusions

Long sleep was not associated with increased sleep fragmentation. Short, fragmented sleep was associated with insulin resistance. Exposure to at least one bout of short, fragmented sleep increased the likelihood of hypertension. Further studies are required to identify the factors associated with short, fragmented sleep in this setting.
Clinical experience with 18F-JK-PSMA-7 when using a digital PET/CT
Authors: Vierasu Irina , Trotta Nicola , Albisinni Simone , Mathey Céline , Leurquin-Sterk Gil , Lacroix Simon , Van Simaeys Gaetan , Quackels Thierry , Roumeguère Thierry , Goldman Serge
Published: March 2022

Background

Digital PET/CT systems make use of a new technology with higher sensitivity and other better technological features than the analog ones. They require adaptation of the trade-off between performance, tracer dose and acquisition time. The aim of the study was to explore the performance of 18F-JK-PSMA-7 imaging when performed on a digital PET/CT with an adapted protocol, in a population of patients with prostate cancer patients (PCa). Influence of previous therapy on PET/CT performance is generally disregarded in PSMA-based imaging, despite potential influence of hormono-chemotherapy on the target expression. This potential influence was also tested in this work.

Methods

A total of 54 PCa patients experiencing biochemical recurrence were included in the study, in which we analysed the diagnostic performance of digital 18F-JK-PSMA-7 PET/CT. Compared to our protocol applied for acquisition on an analog system, administered dose and acquisition time were reduced by 20% and 50% respectively. We specifically took into consideration the influence of previous treatments on recurrence detection.

Results

We detected overall 18F-JK-PSMA-7-positive lesions in 38/54 patients (70.3%). There was no statistically significant difference regarding the detection rate between the groups of patients who had hormono-chemotherapy any time after initial diagnosis and those who never got any hormonal or chemotherapeutic treatment. Regarding the SUV max values, there was not significant difference between the two groups of patients neither in pelvic ganglions nor in other metastatic sites or the prostate region.

Conclusion

18F-JK-PSMA7 PET/CT with administered dose and acquisition time adapted to the digital technology provides valuable information in PCa patients with biochemical recurrence.
Comparative suitability of different nutrients for feeding the predaceous mite, Amblyseius swirskii Athias-Henriot (Acari: Phytoseiidae), in the laboratory
Authors: Elshazly Mohamed Mahrous Youssef
Published: March 2022

Background

The attractiveness, the stickiness and the edibility span of 29 nutrients were assessed to reveal the comparative suitability of each nutrient for feeding the predaceous mite Amblyseius swirskii Athias-Henriot (Acari: Phytoseiidae).

Results

Baker's yeast generally was the most attractive-food source. The mixture of skim milk, honey, yolk, baker's yeast and amino acid solution 10% at a volume ratio of 100:1:1:20:1, respectively, was the most attractive mixture. No mite individual fed on honey, the three nutrients containing amino acid solution at high concentrations, chicken blood, smashed cow liver, living drosophila stages, or cotton pollen. Over two minutes, no mite individual stuck to honey, baker's yeast, the three nutrients containing amino acid solution at high concentrations, chicken blood, smashed cow liver, or drosophila types. On the contrary, all the mite individuals exposed to cotton pollen stuck to it on touching. Grape juice was the most adhesive of the rest of the nutrients. The mixture of skim milk, honey, yolk, baker's yeast, and amino acid solution 10% at the volume ratio of 100: 20: 1: 1: 1, respectively, was the most adhesive mixture. The mixture containing the same components at a volume ratio of 100: 1: 20: 1: 1, respectively, was the least adhesive mixture. By examining each of the 19 edible nutrients individually, water was found to be edible until evaporation. Amongst the rest of the edible nutrients, maize pollen had the longest edibility span; it continued valid for feeding for about four days. On the contrary, the yolk continued to be edible for just seven minutes. As regards the edible mixtures, the mixture containing skim milk, honey, yolk, baker's yeast and amino acid solution 10% at a volume ratio of 100:20:1:1:1, respectively, had the longest edibility span. On the contrary, the mixture containing the same components at a volume ratio of 100:1:20:1:1, respectively, had the shortest edibility span. As regards the components of the edible mixtures, honey percentage showed a negative correlation with the number of the attracted mites, whereas it showed positive correlations with each of the number of the stuck mites and edibility span. Compared with honey, yolk and baker's yeast showed opposite trends.

Conclusions

Each of the examined edibles had its good points as a food for A. swirskii.
High fidelity numerical simulations on the unsteady flow field of low-pressure turbine cascades with and without upstream disturbance at moderate Reynolds number
Authors: Zhu Hongbo , Pang Xiyuan , Wu Feng , Zhang Chunxiao , Bao Yan , Xu Hui
Published: March 2022

This paper numerically investigates the aerodynamic performance of the T106A low-pressure turbine based with different inflow conditions at moderate Reynolds number by using high performance computing based on high order unstructured methods. Two different inflow conditions respectively of uniform and disturbed are considered, while for the latter a small circular cylinder is placed upstream of the cascade to generate wake turbulence as a long-standing disturbance. A high order Fourier-spectral/hp element method is employed to solve the flow dynamics in the cascade of high complex geometries. Flow transition characteristics are quantified in terms of the distribution of cascade wall surface pressure and friction coefficient, the distribution of wake profile pressure loss and the evolution characteristics of boundary layer flow structures as well. The numerical results show that the current numerical simulations accurately predict the flow transition performance of low-pressure turbine cascades and capture the effects of wake-generated disturbance on the cascade, which is shown to effectively modify the flow transition performance as compared with the uniform inflow case.
Diagnosing the environmental impacts of typical fatliquors in leather manufacture from life cycle assessment perspective
Authors: Yu Yue , Sun Qingyong , Zeng Yunhang , Lin Yirui , Wang Ya-nan , Shi Bi
Published: March 2022

The environmental impacts of typical fatliquors were diagnosed by the life cycle assessment of industrial production and use (post-tanning) processes. Life cycle impact assessment and sensitivity analysis showed that fatliquor and fatliquoring operation were the major contributors to the environmental impacts of post-tanning because a large amount of fatliquors was consumed during fatliquoring operation. The environmental impacts of fatliquors decreased in the following order: chlorinated paraffin (CP) > sulfonated rape oil (SNR) > sulfated rape oil (SR) > phosphated rape oil (PR) > oxidized–sulfited rape oil (OSR). Sulfuric acid, fuming sulfuric acid, and chlorine used for fatliquor modification gave the main contribution to most impact categories for SR, SNR, and CP production, whereas rape oil contributed the most for PR and OSR production. OSR use process reduced the primary energy demand, abiotic depletion potential, and global warming potential by 38.5%, 56.0%, and 48.5%, respectively, compared with CP use process. These results suggested that biomass-derived fatliquors, especially oxidized–sulfited and phosphate modified fatiliquors, helped reduce the environmental burdens in leather manufacturing.

Graphical Abstract
Comparison of computed tomography and magnetic resonance imaging in evaluation of skull lesions
Authors: Arora Vijinder , Sidhu Bikramjit Singh , Singh Kunwarpal
Published: March 2022

Background

Computed tomography (CT) and magnetic resonance imaging (MRI) have been incorporated into the basic imaging tools for evaluation of skull lesions. Despite the known advantages and disadvantages of CT and MRI in various aspects of evaluating skull lesions, it is not always feasible to perform both CT and MRI in evaluation of the same patient. The purpose of this study is to compare CT and MRI in evaluation of various skull lesions and to determine which imaging modality out of the two is more appropriate in evaluation of skull lesions and their characterization.

Results

There was no statistically significant difference between CT and MRI for detection of number of lesions, distribution of lesions, margins of the lesions, nature of the lesions, zone of transition, cortical breach, intralesional calcification, intralesional hemorrhage, associated soft tissue, and invasion into brain parenchyma (p value > 0.05 in all these parameters). Dural involvement was picked up better on MRI as compared to CT (p value 0.031). Another advantage of MRI over CT was better characterization of lesions by diffusion weighted imaging.

Conclusion

CT and MRI are equally efficient in providing adequate diagnostic information in various skull lesions and each of them can be used independent of the other to characterize and diagnose the lesions of skull. The slight advantage of MRI over CT is detection of dural involvement.
The extended range phase shift method for broadband surface wave dispersion measurement from ambient noise and its application in ore deposit characterization
Authors: Deng Bao , Li Junlun , Liu Jiangshan , Shen Changming , Suwen Junliu , Chen Qi-Fu
Published: March 2022

Surface wave tomography using seismic ambient noise has been applied widely in subsurface characterization, the depth of which ranges from a few meters in urban underground engineering to tens of kilometers in delineation of crustal heterogeneities. Currently, multichannel analysis of surface waves with active and passive sources together with some similar techniques has been widely applied to obtain fine near-surface structures. However, it is still difficult to retrieve accurate dispersion curves at low frequencies with those methods to constrain structures at greater depths. To better retrieve surface wave dispersion data at lower frequencies using ambient noise data acquired by dense linear arrays, we use the extended range phase shift (ERPS) method, which can extract broadband dispersions from the ambient noise crosscorrelation functions (CFs). A broadband dispersion curve is obtained by merging a dispersion curve of medium-to-high frequencies with a dispersion curve of low-to-medium frequencies measured using receivers with different combinations, whereas both curves reflect the local property of the subsurface structure under a subarray with a relatively small aperture. Thus, the horizontal resolution of the inverted models is not compromised, whereas the inverted depth is improved considerably. We first perform a synthetic test to validate the ERPS method, and then apply the method in characterizing the Woxi polymetallic deposit in Hunan, China, where eight 10 km linear arrays using 467 seismic nodes were deployed to record ambient noise. The dispersion data within 0.5–10 Hz are extracted from the CFs using ERPS and then used to invert for the [Formula: see text] models down to at least 2 km. The inverted structures are found to be consistent with the previous geologic studies and known structures from underground mining, and the proposed passive-source imaging method is considered to be economical and practical for ore deposit explorations.
Noniterative least-squares reverse time migration based on an efficient asymptotic Hessian/point-spread function estimation
Authors: Xu Peng , Feng Bo , Wang Huazhong , Liu Shaoyong
Published: March 2022

Although reverse time migration (RTM) is a powerful imaging method, it uses only the adjoint of the wave-propagation operator and produces only a blurred image. Through linearized inversion, least-squares RTM (LSRTM) reduces migration artifacts, balances the amplitudes, and improves the resolution of the imaging results. Compared to data-domain LSRTM, image-domain LSRTM (ID-LSRTM) is a more practical choice because it typically requires one round of RTM and subsequently solves the deblurring problem of the conventional RTM image involving the Hessian matrix. The Hessian matrix can be effectively replaced by a set of point-spread functions (PSFs). PSFs are traditionally obtained through one round of demigration-migration; hence, the traditional PSF estimation has a computational cost that is twice that of the RTM. We have deduced an analytic expression of the Hessian/PSF by using an asymptotic Green’s function and derived an efficient estimation strategy for the Hessian/PSF. The proposed method significantly reduces the computational cost and allows more flexible spatial sampling of PSFs without interference. Based on the explicitly calculated PSFs, ID-LSRTM can be achieved by solving an optimization problem with combined total-variation and curvelet-domain [Formula: see text] regularizations. The total computational cost of the proposed LSRTM is approximately the same as that of the conventional RTM. Numerical examples of synthetic and field data find that the proposed LSRTM significantly improves image quality while being highly efficient.
Reflection residual statics estimated using a high-resolution neural network
Authors: Duan Xudong , Zhang Jie
Published: March 2022

Performing reflection statics corrections for improving seismic imaging is an important step in land and shallow marine data processing. The reflection residual statics solution is commonly derived from stack power maximization with hyperbolic assumptions that are valid for normal moveout (NMO) correction and stacking. We have developed a deep learning method for deriving surface-consistent reflection residual statics directly from common-shot, common-receiver, or common-midpoint gathers without velocity analysis and NMO correction. To mitigate overfitting and improve generalization ability, we augment training data by using only a few gathers but massive synthetic statics values. Because the magnitude of residual statics is often small, we apply a high-resolution neural network as a backbone to learn detailed features. We also design the head of the neural network to allow multiscale training and multiscale testing, which enables different acquisition geometries for prediction. Training with labeled samples from synthetic or real data has been tested with new real data as prediction inputs. In both cases, residual statics help improve stacked sections. If the NMO assumption is valid, our method produces results comparable to stack power maximization with much less computation time. If the NMO assumption is invalid, our method produces better results than stack power maximization.
Breaking out of the citadel: social theory and psychiatry
Authors: Poole Rob , Robinson Catherine A.
Published: March 2022

British psychiatry has tended to hold itself aloof from social theory. Nonetheless, these ideas have influenced the development of mental health services. Alongside this, the biopsychosocial model cannot reconcile contradictions in the scientific evidence regarding mental illness. We need to develop a more constructive understanding of the implications of social theory.
The Association of Consumption Time for Food With Cardiovascular Disease and All-Cause Mortality Among Diabetic Patients
Authors: Jiang Wenbo , Song Qingrao , Zhang Jia , Chen Yunyan , Jiang Hongyan , Long Yujia , Li Ying , Han Tianshu , Sun Hongru , Wei Wei
Published: March 2022

Aims

This study aims to investigate whether food intake time across 3 meals is associated with long-term survival among the people with diabetes.

Materials and Methods

This study included 4642 diabetic patients participating in the National Health and Nutrition Examination Survey from 2003 to 2014. Food consumed across a day including the forenoon, afternoon, and evening was divided into quantiles based on their distribution. Cox proportional hazards regression models were used to analyze the survival relationship between food intakes time and mortality.

Results

In the forenoon, compared to the participants in the lowest quantile of potato and starchy vegetable, participants in the highest quantile had lower mortality risk of cardiovascular disease (CVD) [hazard ratio (HR)potato = 0.46, 95% CI 0.24-0.89; HRstarchy-vegetable = 0.32, 95% CI 0.15-0.72]. In the afternoon, participants who consumed whole grain had lower mortality of CVD (HRwhole grain = 0.67, 95% CI 0.48-0.95). In the evening, the highest quantile of dark vegetable and milk intake is related to lower mortality risk of CVD (HRdark vegetable = 0.55, 95% CI 0.35-0.87; HRmilk = 0.56, 95% CI 0.36-0.88) and all-cause mortality (HRmilk = 0.71, 95% CI 0.54-0.92), whereas participants in the highest quantile of intakes of processed meat are more likely to die due to CVD (HRprocessed-meat = 1.74, 95% CI 1.07-2.82). Isocalorically switching 0.1 serving potato or starchy vegetable consumed in the afternoon or evening to the forenoon, 0.1 serving dark vegetable consumed in the afternoon to the evening, and 0.1 serving whole grain consumed in the forenoon to the afternoon reduced the risk of CVD mortality.

Conclusions

Higher intake of potato or starchy vegetable in forenoon, whole grain in the afternoon, and dark vegetable and milk in the evening and lower intake of processed meat in the evening was associated with better long-term survival in people with diabetes.
Variation in Glycemic Outcomes in Focal Forms of Congenital Hyperinsulinism—The UK Perspective
Authors: Dastamani Antonia , Yau Daphne , Gilbert Clare , Morgan Kate , De Coppi Paolo , Craigie Ross J , Bomanji Jamshed , Biassoni Lorenzo , Sajjan Rakesh , Flanagan Sarah E , Houghton Jayne A L , Senniappan Senthil , Didi Mohammed , Dunne Mark J , Banerjee Indraneel , Shah Pratik
Published: March 2022

Context

In focal congenital hyperinsulinism (CHI), localized clonal expansion of pancreatic β-cells causes excess insulin secretion and severe hypoglycemia. Surgery is curative, but not all lesions are amenable to surgery.

Objective

We describe surgical and nonsurgical outcomes of focal CHI in a national cohort.

Methods

Patients with focal CHI were retrospectively reviewed at 2 specialist centers, 2003-2018.

Results

Of 59 patients with focal CHI, 57 had heterozygous mutations in ABCC8/KCNJ11 (51 paternally inherited, 6 de novo). Fluorine-18 L-3,4 dihydroxyphenylalanine positron emission tomography computed tomography scan identified focal lesions in 51 patients. In 5 patients, imaging was inconclusive; the diagnosis was established by frozen section histopathology in 3 patients, a lesion was not identified in 1 patient, and 1 declined surgery. Most patients (n = 56) were unresponsive to diazoxide, of whom 33 were unresponsive or partially responsive to somatostatin receptor analog (SSRA) therapy. Fifty-five patients underwent surgery: 40 had immediate resolution of CHI, 10 had persistent hypoglycemia and a focus was not identified on biopsy in 5. In the 10 patients with persistent hypoglycemia, 7 underwent further surgery with resolution in 4 and ongoing hypoglycemia requiring SSRA in 3. Nine (15% of cohort) patients (1 complex surgical access; 4 biopsy negative; 4 declined surgery) were managed conservatively; medication was discontinued in 8 children at a median (range) age 2.4 (1.5-7.7) years and 1 remains on SSRA at 16 years with improved fasting tolerance and reduction in SSRA dose.

Conclusion

Despite a unifying genetic basis of disease, we report inherent heterogeneity in focal CHI patients impacting outcomes of both surgical and medical management.
Clinical Characteristics, Outcomes, and Pathology Analysis in Patients With Dorsal Arachnoid Web
Authors: Delgardo Mychael , Higgins Dominique , McCormick Kyle L. , Reid Patrick , Canoll Peter , McCormick Paul C.
Published: March 2022

BACKGROUND:

Dorsal arachnoid webs (DAWs) are rare pathological abnormalities of the arachnoid layer of the spinal cord that can result in pain and myelopathy.

OBJECTIVE:

To present clinical, imaging, and pathological characteristics of patients diagnosed with DAW, case illustrations, and a review of the literature.

METHODS:

Seventeen cases of DAW between 2015 and 2019 at a tertiary medical center were retrospectively identified through a case log search. Patient characteristics, preoperative imaging, operative notes, and pathology reports were collected. Our main outcome assessed was postoperative resolution of symptoms. Odds ratios were used to determine associations between preoperative signs and symptoms with postoperative symptom resolution.

RESULTS:

The mean age of the cohort was 50.5 years (IQR = 16) and presented primarily with back pain (64.7%). On imaging, all patients were found to have the “scalpel sign,” and nearly half had a syrinx present (41.2%). All DAWs were located in the thoracic spine, with the most common location being the midthoracic (70.6%). The mean follow-up length for all patients was 4.3 months. There were no preoperative symptoms significantly associated with postoperative symptom resolution; however, a trend was noted with the presence of a preoperative syrinx. Pathology samples consistently demonstrated fibroconnective or collagenous tissue with no evidence of inflammation or neoplasm.

CONCLUSION:

DAW is a rare pathology that can result in myelopathy or inappropriate interventions if misdiagnosed. Surgical intervention using laminectomy with intradural exploration should be considered in symptomatic patients with DAW because it is curative with a strong chance of preoperative symptom resolution with relatively low complication rates.
Engrailed, Suppressor of fused and Roadkill modulate the Drosophila GLI transcription factor Cubitus interruptus at multiple levels
Authors: Roberto Nicole , Becam Isabelle , Plessis Anne , Holmgren Robert A.
Published: March 2022

Morphogen gradients need to be robust, but may also need to be tailored for specific tissues. Often this type of regulation is carried out by negative regulators and negative feedback loops. In the Hedgehog (Hh) pathway, activation of patched (ptc) in response to Hh is part of a negative feedback loop limiting the range of the Hh morphogen. Here, we show that in the Drosophila wing imaginal disc two other known Hh targets genes feed back to modulate Hh signaling. First, anterior expression of the transcriptional repressor Engrailed modifies the Hh gradient by attenuating the expression of the Hh pathway transcription factor cubitus interruptus (ci), leading to lower levels of ptc expression. Second, the E-3 ligase Roadkill shifts the competition between the full-length activator and truncated repressor forms of Ci by preferentially targeting full-length Ci for degradation. Finally, we provide evidence that Suppressor of fused, a negative regulator of Hh signaling, has an unexpected positive role, specifically protecting full-length Ci but not the Ci repressor from Roadkill.
Bridging the muscle genome to phenome across multiple biological scales
Authors: Sundar SaiLavanyaa , Rimkus Barbora , Meemaduma Prabath S. , deLap Samuel , LaFave Nicholas , Racca Alice W. , Hettige Pabodha , Moore Jeffrey , Gage Matthew , Shehaj Andrea , Konow Nicolai
Published: March 2022

Muscle is highly hierarchically organized, with functions shaped by genetically controlled expression of protein ensembles with different isoform profiles at the sarcomere scale. However, it remains unclear how isoform profiles shape whole muscle performance. We compared two mouse hind limb muscles, the slow, relatively parallel-fibered soleus (SOL) and the faster, more pennate-fibered tibialis anterior (TA), across scales: from gene regulation, isoform expression and translation speed, to force-length-velocity-power for intact muscles. Expression of myosin heavy-chain (MHC) isoforms directly corresponded with contraction velocity. The fast-twitch TA with fast MHC isoforms had faster unloaded velocities (actin sliding velocity, VACTIN; peak fiber velocity, VMAX) than slow-twitch SOL. For SOL, VACTIN was biased towards VACTIN for purely slow MHC I, despite this muscle's even fast and slow MHC isoform composition. Our multi-scale results clearly identified a consistent and significant dampening in fiber shortening velocities for both muscles, underscoring an indirect correlation between VACTIN and fiber VMAX that may be influenced by differences in fiber architecture, along with internal loading due to both passive and active effects. These influences correlate with the increased peak force and power in the slightly more pennate TA, leading to a broader length range of near-optimal force production. Conversely, a greater force-velocity curvature in the near-parallel fibered SOL highlights the fine-tuning by molecular-scale influences including myosin heavy and light chain expression along with whole muscle characteristics. Our results demonstrate that the individual gene, protein, and whole fiber characteristics do not directly reflect overall muscle performance but that intricate fine-tuning across scales shapes specialized muscle function.
Análise do modelo logístico aplicado à primeira onda da Covid-19 nos países com os 20 maiores PIB’S
Authors: Souza Lucas Cardoso , Kock Kelser De Souza
Published: March 2022

Objetivo: aplicar a modelagem logística da primeira onda da COVID-19, com índice nos países com 20 maiores Produto Interno Bruto (PIB). Métodos: foi utilizada a modelagem matemática de crescimento logístico, considerando os seguintes parâmetros: número cumulativo de casos (C), tamanho final da epidemia na onda única de um surto (K), taxa intrínseca de crescimento (y) e tempo de inflexão (τ). Resultados: o Brasil apresentou maior número de casos e mortalidade, e os Estados Unidos da América (EUA) maior número de casos absolutos. A Coreia do Sul evidenciou o menor ponto de inflexão de 15,3 dias, enquanto o maior foi da Indonésia, com 213,9 dias. Na análise entre o ponto de inflexão e casos acumulados (/100 mil habitantes), observou-se correlação positiva moderada significativa (r=0,629 e p=0,003); (r=0,532 e p=0,016). Conclusão: o reconhecimento do comportamento de uma epidemia por meio da modelagem matemática torna possível determinar a propagação de uma epidemia, visto que, com a possibilidade de captar a dinâmica de uma epidemia, torna-se possível prever a necessidade de medidas públicas antecipadas e, consequentemente, diminuição da mortalidade global.
Εκτελεστικές λειτουργίες, μαθηματική και λεκτική συλλογιστική κατά τη σχολική ηλικία
Authors: Μιχαλακούδη Αποστολία
Published: March 2022

Θεωρώντας κρίσιμους παράγοντες για τη γνωστική ανάπτυξη του ατόμου τόσο την ενσυνειδησία, όσο και τις εκτελεστικές λειτουργίες, η παρούσα μελέτη στοχεύει στη διερεύνηση, μέσω ενός προγράμματος παρέμβασης στις μεταγνωστικές διεργασίες, του ρόλου της ενσυνειδησίας στις εκτελεστικές λειτουργίες της αναστολής, μετατόπισης και εργαζόμενης μνήμης, αλλά και της επίλυσης προβλημάτων. Στην έρευνα συμμετείχαν 137 μαθητές, ηλικίας 10 και 12 ετών. Εξετάστηκαν ατομικά, σε τρεις φάσεις. Στην πρώτη φάση εξετάστηκαν με τα εξής έργα: α) μία συστοιχία γλωσσικών και μαθηματικών έργων που διέφεραν ως προς την πολυπλοκότητά τους, ενώ τους ζητήθηκε να περιγράψουν, μέσω της μεθόδου της εκφωνούμενης σκέψης, τον τρόπο που ακολούθησαν για την επεξεργασία των έργων, β) μία σειρά από έργα σε ηλεκτρονική μορφή, που αφορούν στην αναστολή, τη μετατόπιση και την εργαζόμενη μνήμη, και γ) τις μήτρες RAVEN για τον προσδιορισμό της ρέουσας νοημοσύνης. Με βάση την επίδοση στο RAVEN test, οι συμμετέχοντες χωρίστηκαν σε τρεις ισοδύναμες ως προς τη νοημοσύνη τους, υποομάδες: την ομάδα ελέγχου (ΟΕ) και δύο πειραματικές ομάδες (ΠΟ). Κατά τη 2η φάση οι δύο ΠΟ πειραματικές ομάδες ασκήθηκαν στην καλλιέργεια των μεταγνωστικών δεξιοτήτων τους. Χρησιμοποιώντας τη μέθοδο της εκφωνούμενης σκέψης, η μία ΠΟ ασκήθηκε μέσω των έργων λεκτικού συλλογισμού (ΠΟΓΛ, Ν=44), ενώ η δεύτερη ασκήθηκε μέσω των έργων μαθηματικού συλλογισμού (ΠΟΜαθ, Ν=43). Οι συμμετέχοντες της ΟΕ (Ν=50) δεν συμμετείχαν στο εκπαιδευτικό πρόγραμμα, αλλά ακολουθούσαν το τυπικό σχολικό πρόγραμμα. Στην τρίτη φάση, όλοι συμμετέχοντες εξετάστηκαν, ατομικά, με όλα τα έργα που χρησιμοποιήθηκαν στην 1η φάση. Τα αποτελέσματα έδειξαν, πρώτον, ότι ανεξάρτητα από το πεδίο (λεκτική ή μαθηματική συλλογιστική) στο οποίο πραγματοποιήθηκε η άσκηση, οι συμμετέχοντες και των δύο ΠΟ βελτίωσαν την επίδοσή τους και στα δύο πεδία συλλογισμού. Δεύτερον, ότι οι δύο ΠΟ βελτιώσαν την επίδοσή τους σε έργα της ΕΜ, την αποτελεσματικότητά τους στα έργα αναστολής και μετατόπισης, αλλά και την ακρίβεια στην περιγραφή του τρόπου που ακολούθησαν για την επεξεργασία των γνωστικών έργων. Τρίτον, παρά την άσκηση στις γνωστικές δεξιότητες, οι σχέσεις μεταξύ των διαφόρων γνωστικών διεργασιών παραμένουν αμετάβλητες. Ωστόσο, οι αναλύσεις παλινδρόμησης έδειξαν ότι οι επιδόσεις σε διαφορετικά πεδία συλλογισμού ερμηνεύονται από διαφορετικές γνωστικές διεργασίες. Τα αποτελέσματα συζητιούνται σε σχέση με τις αρχές των σύγχρονων θεωριών γνωστικής ανάπτυξης και, ιδιαίτερα, τη θεωρία των αναπτυξιακών προτεραιοτήτων. Συζητιούνται, επίσης, οι εκπαιδευτικές προεκτάσεις αυτών των αποτελεσμάτων.
Transmission of yellow fever vaccine virus from breast feeding mothers to their infants: reporting of yellow fever virus (YFV) RNA detection in milk specimens
Authors: Hassan Tarteel , Bashir Razan A. , Abdelrahman Dina N. , Madni Hassan , M El Hussein Abdel Rahim , Elkidir Isam M. , Enan Khalid A.
Published: March 2022

Background: Because of yellow fever’s serious impact on health, vaccination is the principal strategy to control the disease. Administration of the yellow fever vaccine to breastfeeding women should be before they complete 9 months post-delivery, in order to prevent transmission of the yellow fever vaccine virus to their infants through breast feeding. This study aimed to confirm whether the excretion of yellow fever vaccine virus is in milk of vaccinated breastfeeding mothers and to confirm the probable transmission to their infants through breast milk.

Methods: Samples were taken as follows: one serum specimen was taken 3-14 days after the date of the vaccination, and breast milk specimens were taken at four different time points between 3-4 days apart. Specimens were obtained from eight nursing mothers, who received the YVF vaccine (17DD). Mothers were asymptomatic before and after the vaccine administration but their infants developed symptoms after administration. Maternal serum samples were tested for YFV specific IgM antibodies through immuno-fluorescent assay (IFA). RNA was extracted from serum and breast milk specimens and YFV RNA screened using real-time polymerase chain reaction (RT-PCR).

Results: In total, five mothers (62.5%) were positive for YFV IgM and two mothers (25%) had YFV RNA in serum. Among milk specimens, YFV RNA was detected during the four different mentioned collection times as follows (positive milk specimens/total milk specimens): 3/8 (37.5 %), 4/6 (66.6%) and 1/4(25%). RNA was completely undetectable in the last collection time.

Conclusions: YFV transmission from mothers to their babies through breast-feeding was highly probable indicated by the temporal relationship to mother’s YF vaccination.
Efficacy and safety of chimeric antigen receptor T-cell (CAR-T) therapy in hematologic malignancies: a living systematic review (protocol)
Authors: Leache Leire , Gutiérrez Valencia Marta , Saiz Luis Carlos , Erviti Juan , Rojas Reyes Maria Ximena
Published: March 2022

Objective: To determine the efficacy and safety of CAR-T therapy in the treatment of patients with hematologic malignancies, in comparison with other current therapies. 

Design: A living systematic review.

Methods: We will include randomized trials evaluating the effect of CAR-T therapy versus other active treatments, hematopoietic stem cell transplantation, best supportive care or any other intervention in patients with hematologic malignancies. Non-randomized primary studies will be searched in case we found no direct evidence from randomized controlled trials. Two reviewers will independently screen each study for eligibility, extract data, and assess the risk of bias. Efficacy measures will include overall survival rate, overall response rate, complete response/remission (CR) rate, partial response/remission (PR) rate, relapse from CR, progression-free survival, and time from CAR-T infusion to transplantation. Safety measures will include serious adverse events, the incidence of cytokine release syndrome, graft-versus-host disease, neurotoxicity, and total adverse events. Quality of life will also be assessed. Meta-analyses will be carried out to summarize the results. We will apply the GRADE approach to assess the certainty of the evidence for each outcome. A living, web-based version of this review will be openly available until there is solid evidence to respond to the review objective. We will resubmit it for publication every time the conclusions change or whenever there are substantial updates.
Gale’s Fixed Tax for Exchanging Houses
Authors: Andersson Tommy , Ehlers Lars , Svensson Lars-Gunnar , Tierney Ryan
Published: March 2022

We consider taxation of exchanges among a set of agents in which each agent owns one object. Agents may have different valuations for the objects, and they need to pay taxes for exchanges. We show that, if a rule satisfies individual rationality, strategy-proofness, constrained efficiency, weak anonymity, and weak consistency, then it is either the no-trade rule or a fixed-tax core rule. For the latter rules, whenever any agent exchanges an object, the agent pays the same fixed tax (a lump sum payment that is identical for all agents) independently of which object the agent consumes. Gale’s top trading cycles algorithm finds the final assignment using the agents’ valuations adjusted with the fixed tax if the induced preferences are strict.
Optimal Policies for a Multi-Echelon Inventory Problem with Service Time Target and Expediting
Authors: Shen Xiaobei , Yu Yimin , Song Jing-Sheng
Published: March 2022

Problem definition: We study the optimal inventory ordering, expediting, and allocation decisions in a multiechelon supply chain over a finite horizon, in which customer orders are quoted with a fixed fulfillment time window, termed the service time target (STT). Academic/practical relevance: Service time target is commonly used as a marketing strategy to increase customer satisfaction and strengthen firms’ competitive edge. However, how to efficiently manage a multistage supply chain to meet the target has received relatively scant attention in the literature. Our study fills this gap. Methodology: We use dynamic programming to characterize the optimal policy. Results: We show that an echelon base stock policy and a rationing policy are optimal for inventory ordering and inventory allocation/expediting, respectively. We also develop a polynomial-time algorithm to compute the optimal policy. To derive these results, we uncover a new functional property named the decomposable of degree 2 property, which is a nontrivial generalization of the celebrated Clark-Scarf decomposition. This property further allows us to derive induced penalty and compensation to coordinate a decentralized serial system with STT and expediting. Managerial implications: Our result provides an efficient decision tool for managing centralized and decentralized serial supply chains with STT and expediting. Our model can be used to quantify the tradeoff between marketing and operational decisions, such as the impact of a marginal reduction in STT on system cost and expedition frequency, as explored in our numerical studies.