bluuebunny/crossref_metadata_2025 huggingface dataset:
Applying Psychiatry and Psychology Principles to Lifestyle Approaches for Mental and Behavioral Health
Authors: Merlo Gia , Vela Alyssa
Published: June 2021

Research suggests that mental health symptoms and disorders are historically underdiagnosed and undertreated, in part due to the siloed nature of medicine. Yet, approximately 50 million American adults experience a mental health disorder. As the field of lifestyle medicine continues to emerge and grow, there is an important opportunity to address mental health from a lifestyle medicine perspective, as well as to ensure that lifestyle medicine can be utilized for all patients, including those with mental health conditions. To effectively address mental health, the field of lifestyle medicine would benefit from understanding and leveraging the decades of science and practice from the fields of psychiatry and psychology, as well as the expertise of psychiatrists and psychologists who are familiar with the science and trained in lifestyle medicine. Incorporating empirical literature from other areas, utilizing well-established conceptual frameworks, and addressing the overlap between lifestyle medicine and mental health early in, and throughout, training and education, are important steps to move toward addressing mental and behavioral health with a lifestyle medicine approach.
Processing symbolic magnitude information conveyed by number words and by scalar adjectives
Authors: Kochari Arnold R , Schriefers Herbert
Published: June 2021

Humans not only process and compare magnitude information such as size, duration, and number perceptually, but they also communicate about these properties using language. In this respect, a relevant class of lexical items are so-called scalar adjectives like “big,” “long,” “loud,” and so on which refer to magnitude information. It has been proposed that humans use an amodal and abstract representation format shared by different dimensions, called the generalised magnitude system (GMS). In this paper, we test the hypothesis that scalar adjectives are symbolic references to GMS representations, and, therefore, GMS gets involved in processing their meaning. Previously, a parallel hypothesis on the relation between number symbols and GMS representations has been tested with the size congruity paradigm. The results of these experiments showed interference between the processing of number symbols and the processing of physical (font-) size. In the first three experiments of the present study (total N = 150), we used the size congruity paradigm and the same/different task to look at the potential interaction between physical size magnitude and numerical magnitude expressed by number words. In the subsequent three experiments (total N = 149), we looked at a parallel potential interaction between physical size magnitude and scalar adjective meaning. In the size congruity paradigm, we observed interference between the processing of the numerical value of number words and the meaning of scalar adjectives, on the one hand, and physical (font-) size, on the other hand, when participants had to judge the number words or the adjectives (while ignoring physical size). No interference was obtained for the reverse situation, i.e., when participants judged the physical font size (while ignoring numerical value or meaning). The results of the same/different task for both number words and scalar adjectives strongly suggested that the interference that was observed in the size congruity paradigm was likely due to a response conflict at the decision stage of processing rather than due to the recruitment of GMS representations. Taken together, it can be concluded that the size congruity paradigm does not provide evidence in support the hypothesis that GMS representations are used in the processing of number words or scalar adjectives. Nonetheless, the hypothesis we put forward about scalar adjectives is still is a promising potential line of research. We make a number of suggestions for how this hypothesis can be explored in future studies.
Scoping health literacy in Latin America
Authors: Arrighi E. , Ruiz de Castilla E. M. , Peres F. , Mejía R. , Sørensen K. , Gunther C. , Lopez R. , Myers L. , Quijada J. G. , Vichnin M. , Pleasant A.
Published: June 2021

Studies evaluating the influence of health literacy on patient behavior and outcomes suggest a positive relationship between health literacy and health knowledge, health behaviors, and health status. In Latin American countries, studies assessing health literacy are few, regional, and demonstrate considerable variation, with reported rates of adequate health literacy ranging from 5.0% to 73.3%. In this paper, we examine and explore the state of health literacy and efforts to promote it in Latin America. Key challenges to those efforts include socioeconomic inequality, social/geographic isolation, and cultural-, language-, and policy-related barriers, many of which disproportionately affect indigenous populations and others living in rural areas. Greater use of infographics, videos, and mobile apps may enhance health literacy and patient empowerment, especially when language barriers exist. This paper provides strategies and tools for tailored programming, examples of successful health literacy interventions, and policy recommendations to improve health literacy in Latin America, intending to spur additional discussion and action. Centrally organized collaboration across multiple sectors of society, with community involvement, will enhance health literacy and improve health and well-being across Latin America.
Advanced magnetic resonance imaging and spectroscopy in a case of neurocysticercosis from North America
Authors: Chawla Sanjeev , Asadollahi Shadi , Gupta Pradeep Kumar , Nath Kavindra , Brem Steven , Mohan Suyash
Published: June 2021

Neurocysticercosis (NCC) is a parasitic infection caused by Cysticercus cellulosae, the metacestode of pork tapeworm ( Taenia solium). NCC is one of the most common public health problems worldwide. We present a patient harboring a bilobed ring-enhancing lesion with a presumed diagnosis of brain metastasis, who returned to the USA after traveling to an endemic region. The diagnosis of NCC was established based on a characteristic resonance of succinate on proton magnetic resonance spectroscopy. Also, higher mean diffusivity and lower fractional anisotropy along with relative cerebral blood volume were observed from the lesion compared to contralateral normal brain regions. Multiparametric analysis may improve the differential diagnosis of ring-enhancing intracranial lesions such as NCC.
Chronic subdural hemorrhage predisposes to development of cerebral venous thrombosis and associated retinal hemorrhages and subdural rebleeds in infants
Authors: Vaslow Dale F
Published: June 2021

For infants presenting with subdural hemorrhage, retinal hemorrhage, and neurological decline the “consensus” opinion is that this constellation represents child abuse and that cerebral venous sinus thrombosis and cortical vein thrombosis is a false mimic. This article contends that this conclusion is false for a subset of infants with no evidence of spinal, external head, or body injury and is the result of a poor radiologic evidence base and misinterpreted data. Underdiagnosis of thrombosis is the result of rapid clot dissolution and radiologic under recognition. A pre-existing/chronic subdural hemorrhage predisposes to development of venous sinus thrombosis/cortical vein thrombosis, triggered by minor trauma or an acute life-threatening event such as dysphagic choking, variably leading to retinal and subdural hemorrhages and neurologic decline. These conclusions are based on analysis of the neuroradiologic imaging findings in 11 infants, all featuring undiagnosed cortical vein or venous sinus thrombosis. Subtle neuroradiologic signs of and the mechanisms of thrombosis are discussed. Subarachnoid hemorrhage from leaking thrombosed cortical veins may be confused with acute subdural hemorrhage and probably contributes to the development of retinal hemorrhage ala Terson’s syndrome. Chronic subdural hemorrhage rebleeding from minor trauma likely occurs more readily than bleeding from traumatic bridging vein rupture. Radiologists must meet the challenge of stringent evaluation of neuro imaging studies; any infant with a pre-existing subdural hemorrhage presenting with neurologic decline must be assumed to have venous sinus or cortical vein thrombosis until proven otherwise.
Association between the risk of death and serum calcium, phosphate, and intact parathyroid hormone levels in older patients undergoing maintenance hemodialysis: a cohort study in Beijing
Authors: Li Dishan , Liu Wenhu , Huang Hongdong , Guo Wang , Diao Zongli , Chen Xinpan , Wangs Weiwei
Published: June 2021

Background:

The number of patients ⩾65 years who require maintenance hemodialysis (MHD) is increasing. Although reduced bone turnover in older patients receiving hemodialysis, as reflected by lower serum intact parathyroid hormone (iPTH) and phosphate (P) levels, has been reported, focus on the association between abnormal bone metabolism and the risk of death in older patients receiving MHD has been limited.

Methods:

We retrospectively examined data from the Beijing Hemodialysis Quality Control and Improvement Center for 1410 older patients who underwent hemodialysis from 1 January 2012 to 31 December 2016. Baseline, time-dependent (TD) Cox proportional hazards models and Kaplan–Meier analyses were used to evaluate the association between the markers of mineral and bone disorder (MBD) [calcium (Ca), P, and iPTH] and survival. The Kidney Disease: Improving Global Outcomes (KDIGO) target ranges were included as reference values.

Results:

Serum P levels >2.49 mmol/l increased the risk of all-cause death [hazard ratio (HR): 1.46; 95% confidence interval (CI): 1.04–2.07; p = 0.030] and cardiovascular death (HR: 2.01; 95%CI: 1.21–3.34; p = 0.007); iPTH levels >600 pg/ml increased the risk of cardiovascular death (HR: 1.95; 95%CI: 1.20–3.15; p = 0.007). Baseline results and TD Cox analyses were similar. All three MBD parameters were within the respective target ranges at least once during the follow-up period in 399 (28.3%) patients, and these patients had better survival rates than those who achieved two of the three target ranges (715/1410 patients; 50.7%); those who achieved one or no target range (296/1410; 21.0%) had the lowest survival rate (all-cause death: log-rank chi square = 83.96, p < 0.001; cardiovascular death: log-rank chi square = 47.06, p < 0.001).

Conclusion:

Older patients undergoing MHD who achieved the KDIGO target levels for any two or three MBD parameters had lower risks of all-cause and cardiovascular death.
From virtual to participatory learning with technology during COVID-19
Authors: Squire Kurt D
Published: June 2021

During COVID-19, schools around the world rapidly went online. Examining youth technology use reveals sharp inequities within the United States’ education system and incongruencies between the technologies used in virtual schooling and those in the lives of students outside of school. In affluent communities, virtual schooling is supported by a distributed schooling infrastructure that coordinates students’ knowledge work. This home and school technology infrastructure features material, human, and structural capital that facilitates youth development as nascent knowledge workers. Technology use during virtual schooling keeps youth activity grounded within the “walls” of school; during virtual schooling, students have little voice in setting learning goals or contributing “content.” Technology use at home for learning or entertainment stems from their own goals and features them as active inquisitors seeking out information and extending their social networks, and crucially, using participatory learning technologies such as Discord for communications. An extended period of virtual schooling could enable a rethinking of the role of technology in schools, including an embrace of play, emotional design, participatory communications, place-based learning, embodied understandings, and creative construction.
The Strength of Weak Ties Revisited: Further Evidence of the Role of Strong Ties in the Provision of Online Social Support
Authors: Krämer Nicole C. , Sauer Vera , Ellison Nicole
Published: June 2021

In this work, we challenge the assumption that weak ties play uniquely important social support roles on social network sites, particularly regarding informational support. To overcome methodological limitations of earlier research, we present a mixed-methods study. Forty-one participants were interviewed and asked to identify five weak, medium, and strong ties each and to report on perceived and actually received social support (emotional, informational, instrumental, and appraisal) associated with each. Complicating traditional understandings of “the strength of weak ties,” the qualitative analyses of actual support events show that both emotional and informational support is provided by strong ties. In an additional quantitative between-subjects study design, 352 participants were asked about various aspects of a weak, medium, or strong tie. These results indicate that participants valued their strong ties more regarding every form of support. Although there were only weak correlations between perceived and recalled actually received support, people also report actual support events with strong ties to be more helpful—overall suggesting the strength of strong ties.
Social Media in and Around a Temporary Large-Scale Refugee Shelter in the Netherlands
Authors: Smets Peer , Younes Younes , Dohmen Marinka , Boersma Kees , Brouwer Lenie
Published: June 2021

During the 2015 refugee crisis in Europe, temporary refugee shelters arose in the Netherlands to shelter the large influx of asylum seekers. The largest shelter was located in the eastern part of the country. This shelter, where tents housed nearly 3,000 asylum seekers, was managed with a firm top-down approach. However, many residents of the shelter—mainly Syrians and Eritreans—developed horizontal relations with the local receiving society, using social media to establish contact and exchange services and goods. This case study shows how various types of crisis communication played a role and how the different worlds came together. Connectivity is discussed in relation to inclusion, based on resilient (non-)humanitarian approaches that link society with social media. Moreover, we argue that the refugee crisis can be better understood by looking through the lens of connectivity, practices, and migration infrastructure instead of focusing only on state policies.
Legacy of Honor and Violence: An Analysis of Factors Responsible for Honor Killings in Afghanistan, Canada, India, and Pakistan as Discussed in Selected Documentaries on Real Cases
Authors: Singh Deler , Bhandari Dipali S.
Published: June 2021

The present study scrutinizes the cases of honor killings in Afghanistan, India, Pakistan, and Canada through selected documentary films. The case focuses on the social, moral, and religious aspects that coerce some people to take the lives of their own family members in case they defy norms. The documentaries chosen as case studies provide the perspectives of both the victims and the victimizers regarding the concepts of honor, dishonor, and honor killings. People in certain societies reject progressive new thought as attempts to contaminate their perceived cultural purity. People from these communities who try to assimilate liberal ideas are often shunned, especially when the emancipation of women is concerned. Even the seemingly progressive males are very unforgiving about the female members of their families embracing the modern ways of life. The women who try to defy set traditions are branded as being rebellious and are punished to serve as a precedent for future rebellions by women and to save society from their alleged bad influence. In some patriarchal societies, women are seen as the preservers of the family’s honor, and their conduct often reflects the family’s culture, morality, and ethics. Any lapse on a woman’s part allegedly taints the family’s name, and punishment must be given to the erring party to restore the family’s honor. The case also studies the influence of society as a compelling factor in honor killings.
Complementary and Integrative Health Knowledge and Practice in Primary Care Settings: A Survey of Primary Care Providers in the Northwestern United States
Authors: Schwartz Malaika R , Cole Allison M , Keppel Gina A , Gilles Ryan , Holmes John , Price Cynthia
Published: June 2021

Background

The demand for complementary and integrative health (CIH) is increasing by patients who want to receive more CIH referrals, in-clinic services, and overall care delivery. To promote CIH within the context of primary care, it is critical that providers have sufficient knowledge of CIH, access to CIH-trained providers for referral purposes, and are comfortable either providing services or co-managing patients who favor a CIH approach to their healthcare.

Objective

The main objective was to gather primary care providers’ perspectives across the northwestern region of the United States on their CIH familiarity and knowledge, clinic barriers and opportunities, and education and training needs.

Methods

We conducted an online, quantitative survey through an email invitation to all primary care providers (n = 483) at 11 primary care organizations from the WWAMI (Washington, Wyoming, Alaska, Montana and Idaho) region Practice and Research Network (WPRN). The survey questions covered talking about CIH with patients, co-managing care with CIH providers, familiarity with and training in CIH modalities, clinic barriers to CIH integration, and interest in learning more about CIH modalities.

Results

218 primary care providers completed the survey (45% response rate). Familiarity with individual CIH methods ranged from 73% (chiropracty) to 8% (curanderismo). Most respondents discussed CIH with their patients (88%), and many thought that their patients could benefit from CIH (41%). The majority (89%) were willing to co-manage a patient with a CIH provider. Approximately one-third of respondents had some expertise in at least one CIH modality. Over 78% were interested in learning more about the safety and efficacy of at least one CIH modality.

Conclusion

Primary care providers in the Northwestern United States are generally familiar with CIH modalities, are interested in referring and co-managing care with CIH providers, and would like to have more learning opportunities to increase knowledge of CIH.
A Quality Improvement Project to Improve Influenza Vaccination Rates Among Employees at an Onsite Employer-Based Health Clinic
Authors: Landwehr Karen , Trees W. Jeff , Reutman Susan
Published: June 2021

Background

In the United States, millions of people contract the flu each year. Immunization has been shown to provide the best protection against the flu. Increasing flu vaccination rates can reduce the number of patients who get the flu and seek care for non-specific symptoms thus making detection of the coronavirus more efficient.

Method

A quality improvement project was implemented to increase the number of influenza vaccines received by employees at an onsite employer-based health clinic. Anonymous pre- and post-surveys were used to assess the flu knowledge of employees. Employees from a large financial group, who voluntarily participated, received an educational handout at the onsite health fair or at a lunch and learn. Full-time employees who carried their employer’s health insurance were eligible to participate, whereas, dependents and contract employees were excluded.

Findings

The number of employees who received the vaccination increased during the fall of 2019 ( n = 406) when compared with the previous year ( n = 337). Nineteen percent ( n = 170) of employees completed surveys. There were statistically significantly more post- than pre-survey responses reflecting the participants’ perceived knowledge of influenza and the flu vaccine. The majority of participants in both the pre- and post-surveys reported that they learned “a lot” about both influenza and the flu vaccine.

Conclusion

Providing education and access to the vaccine in the workplace may improve flu knowledge, reduce barriers, and increase flu vaccine uptake among employees.
The Device Capability Dataset: A Descriptive Approach to Laboratory Automation System Integration Standards
Authors: Staab Torsten A. , Kramer Gary W.
Published: June 2021

A Device Capability Dataset (DCD) describes the idiosyncratic characteristics of laboratory equipment, such as the equipment's identity, physical dimensions, location, supported command set, generated events, input-output (I/O) ports, and other resources. The DCD concept provides a means for standardizing the interfacing of laboratory automation devices in a descriptive rather than a prescriptive manner.
The System Capability Dataset for Laboratory Automation System Integration
Authors: Piotrowski Christian , Richter Thorsten , Schäfer Reinhold , Kramer Gary W.
Published: June 2021

A System Capability Dataset (SCD) is a tool for stylizing the way the unique characteristics and attributes of an automation environment are represented in a systematic, computer-usable fashion. Device Capability Datasets (DCDs) that describe the characteristics and behaviors of the constituent devices in a system are central components of an SCD. However, an SCD is more than just the sum of its DCDs, since the SCD must contain information about the logical and physical dependencies and relationships of the all devices and other components in the system. By stylizing the idiosyncratic characteristics of devices, the capability dataset approach permits the construction of standard integration interfaces and can eliminate custom programming for devices, facilitate integrating different types of devices, and enable centralized control and error handling for laboratory automation systems.
The Unsustainable State: Greenhouse Gas Emissions, Inequality, and Human Well-Being in the United States, 1913 to 2017
Authors: Kelly Orla , Thombs Ryan P. , Jorgenson Andrew
Published: June 2021

A central premise of development strategies is that nations use natural resources, such as fossil fuels, to raise population living standards and enhance well-being. However, research shows that the relationship among human well-being, resource use, and the associated emissions is complex and context specific. To better understand if natural resource use plays a historic role in generating human well-being in the United States, the authors conduct a time-series analysis of greenhouse gas emissions and average life expectancy from 1913 to 2017. The results show that increases in greenhouse gas emissions per capita have an instantaneous, negative effect on life expectancy. The authors also find evidence that income inequality has a long-run negative effect on life expectancy. Additional analyses provide mixed results regarding whether and how the effects of emissions on life expectancy are conditional on income inequality. These findings contradict the assumption that reductions in emissions necessitate trade-offs in human well-being in high-income contexts.
Examining the Links Between Heritage Use and Identity Building Through a Narrative Approach: A Case Study of Dadaocheng, Taipei City, in Taiwan
Authors: Liu Tu-Chung
Published: June 2021

This article is intended to explore where narrative stands in the interconnection between heritage use and identity building. To achieve this goal, both heritage use and identity building are understood as the process of connection with a physical place for meaning-making of self-identification. This also means that while heritage use is related to discursive practices with historical legacies, narrative is the discursive structure for heritage users to receive its temporal meanings between time, person and place. Accordingly, with a case study of the historic district of Dadaocheng, Taipei City, in Taiwan, this article would like to suggest that heritage really benefits the shaping of our imagination with a physical place, particularly for building urban imaginaries and place uniqueness. Moreover, historical legacies and urban imaginaries are defined and chosen to strengthen the quality of a person, and then each narrated story of heritage use seems like an illustration of the strategic ways of living and/or working with historical legacies in a specific place. Consequently, the linkage between heritage and narrative here denotes an ongoing doing–saying–being approach to make time and place more humanized; meanwhile, ongoing storytelling is a possible way to reflect people’s perspectives and envision a sustainable historic environment.
Data set from shake table tests of free-standing rocking bodies
Authors: Vassiliou Michalis F , Cengiz Cihan , Dietz Matt , Dihoru Luiza , Broccardo Marco , Mylonakis George , Sextos Anastasios , Stojadinovic Bozidar
Published: June 2021

In earthquake engineering, structural models are validated by performing a time history analysis and comparing its maximum to the maximum response obtained by a shake table test. It has been shown that this is a sufficient (but not a necessary) precondition to accept a numerical model. Numerical models can fail to predict the planar rocking response of a rigid block, but may succeed in predicting the statistics of the response to an ensemble of ground motions. As seismic response is inherently stochastic, comparison of the statistics of the numerically simulated response to the statistics of the experimentally obtained benchmark response for the same ensemble of earthquake excitation is a sufficient (and easier to pass) model validation test. This article describes the publicly available data of a set of 12 free rocking vibration and 115 shake table tests of six three-dimensional rocking and sliding columns, designed at ETH Zurich and performed at EQUALS Laboratory, University of Bristol. The data can be used to statistically validate different approaches that aim to model three-dimensional rocking structures.
Treatment of cystic fibrosis airway cells with CFTR modulators reverses aberrant mucus propertiesviahydration
Authors: Morrison Cameron B. , Shaffer Kendall M. , Araba Kenza C. , Markovetz Matthew R. , Wykoff Jason A. , Quinney Nancy L. , Hao Shuyu , Delion Martial F. , Flen Alexis L. , Morton Lisa C. , Liao Jimmy , Hill David B. , Drumm Mitchell L. , O'Neal Wanda K. , Kesimer Mehmet , Gentzsch Martina , Ehre Camille
Published: June 2021

Question

Cystic fibrosis (CF) is characterised by the accumulation of viscous adherent mucus in the lungs. While several hypotheses invoke a direct relationship with cystic fibrosis transmembrane conductance regulator (CFTR) dysfunction (i.e.acidic airway surface liquid (ASL) pH, low bicarbonate (HCO3−) concentration, airway dehydration), the dominant biochemical alteration of CF mucus remains unknown.

Materials/methods

We characterised a novel cell line (CFTR-KO Calu3 cells) and the responses of human bronchial epithelial (HBE) cells from subjects with G551D or F508del mutations to ivacaftor and elexacaftor-tezacaftor-ivacaftor. A spectrum of assays such as short-circuit currents, quantitative PCR, ASL pH, Western blotting, light scattering/refractometry (size-exclusion chromatography with inline multi-angle light scattering), scanning electron microscopy, percentage solids and particle tracking were performed to determine the impact of CFTR function on mucus properties.

Results

Loss of CFTR function in Calu3 cells resulted in ASL pH acidification and mucus hyperconcentration (dehydration). Modulation of CFTR in CF HBE cells did not affect ASL pH or mucin mRNA expression, but decreased mucus concentration, relaxed mucus network ultrastructure and improved mucus transport. In contrast with modulator-treated cells, a large fraction of airway mucins remained attached to naïve CF cells following short apical washes, as revealed by the use of reducing agents to remove residual mucus from the cell surfaces. Extended hydration, but not buffers alkalised with sodium hydroxide or HCO3−, normalised mucus recovery to modulator-treated cell levels.

Conclusion

These results indicate that airway dehydration, not acidic pH and/or low [HCO3−], is responsible for abnormal mucus properties in CF airways and CFTR modulation predominantly restores normal mucin entanglement.
Associations of genetic risk and smoking with incident COPD
Authors: Zhang Pei-Dong , Zhang Xi-Ru , Zhang Ao , Li Zhi-Hao , Liu Dan , Zhang Yu-Jie , Mao Chen
Published: June 2021

Background

Genetic factors and smoking contribute to chronic obstructive pulmonary disease (COPD), but whether a combined polygenic risk score (PRS) is associated with incident COPD and whether it has a synergistic effect on smoking remains unclear. We aimed to investigate the association of the PRS with COPD and explore whether smoking behaviours could modify such association.

Methods

Multivariable Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals for the association of the PRS and smoking with COPD.

Results

The study included 439 255 participants (mean age 56.5 years; 53.9% female), with a median follow-up of 9.0 years. PRSlassocontaining 2.5 million variants showed better discrimination and a stronger association for incident COPD than PRS279containing 279 genome-wide significance variants. Compared with low genetic risk, the HRs of medium and high genetic risk were 1.39 (95% CI 1.31–1.48) and 2.40 (95% CI 2.24–2.56), respectively. The HR of high genetic risk and current smoking was 11.62 (95% CI 10.31–13.10) times that of low genetic risk and never smoking. There were significant interactions between PRSlassoand smoking status for incident COPD (pinteraction<0.001). From low genetic risk to high genetic risk, the HRs of current smoking increased from 4.32 (95% CI 3.69–5.06) to 6.89 (95% CI 6.21–7.64) and the population-attributable risks of smoking increased from 42.7% to 61.1%.

Conclusions

The PRS constructed from millions of variants below genome-wide significance showed significant associations with incident COPD. Participants with a high genetic risk may be more susceptible to developing COPD when exposed to smoking.
Particle flow rate from the airways as fingerprint diagnostics in mechanical ventilation in the intensive care unit: a randomised controlled study
Authors: Hallgren Filip , Stenlo Martin , Niroomand Anna , Broberg Ellen , Hyllén Snejana , Malmsjö Malin , Lindstedt Sandra
Published: June 2021

Introduction

Mechanical ventilation can be monitored by analysing particles in exhaled air as measured by particle flow rate (PFR). This could be a potential method of detecting ventilator-induced lung injury (VILI) before changes in conventional parameters can be detected. The aim of this study was to investigate PFR during different ventilation modes in patients without lung pathology.

Method

A prospective study was conducted on patients on mechanical ventilation in the cardiothoracic intensive care unit (ICU). A PExA 2.0 device was connected to the expiratory limb on the ventilator for continuous measurement of PFR in 30 patients randomised to either volume-controlled ventilation (VCV) or pressure-controlled ventilation (PCV) for 30 min including a recruitment manoeuvre. PFR measurements were continued as the patients were transitioned to pressure-regulated volume control (PRVC) and then pressure support ventilation (PSV) until extubation.

Results

PRVC resulted in significantly lower PFR, while those on PSV had the highest PFR. The distribution of particles differed significantly between the different ventilation modes.

Conclusions

Measuring PFR is safe after cardiac surgery in the ICU and may constitute a novel method of continuously monitoring the small airways in real time. A low PFR during mechanical ventilation may correlate to a gentle ventilation strategy. PFR increases as the patient transitions from controlled mechanical ventilation to autonomous breathing, which most likely occurs as recruitment by the diaphragm opens up more distal airways. Different ventilation modes resulted in unique particle patterns and could be used as a fingerprint for the different ventilation modes.
A synbiotic intervention modulates meta-omics signatures of gut redox potential and acidity in elective caesarean born infants
Authors: Lay Christophe , Chu Collins Wenhan , Purbojati Rikky Wenang , Acerbi Enzo , Drautz-Moses Daniela I. , de Sessions Paola Florez , Jie Song , Ho Eliza , Kok Yee Jiun , Bi Xuezhi , Chen Shuwen , Mak Shi Ya , Chua Mei Chien , Goh Anne E. N. , Chiang Wen Chin , Rao Rajeshwar , Chaithongwongwatthana Surasith , Khemapech Nipon , Chongsrisawat Voranush , Martin Rocio ,   the JULIUS Study Group, Koh Yanqing , Lohar Sachin R. , Tan Ivan Chin Hin , Anng Wong Anng , Jie Chen , Bartke Nana , Ben-Amor Kaouther , Renes Ingrid B. , Wong Fiona , Roeselers Guus , Ho Ying Swan , Hibberd Martin L. , Schuster Stephan C. , Knol Jan
Published: June 2021

Background

The compromised gut microbiome that results from C-section birth has been hypothesized as a risk factor for the development of non-communicable diseases (NCD). In a double-blind randomized controlled study, 153 infants born by elective C-section received an infant formula supplemented with either synbiotic, prebiotics, or unsupplemented from birth until 4 months old. Vaginally born infants were included as a reference group. Stool samples were collected from day 3 till week 22. Multi-omics were deployed to investigate the impact of mode of delivery and nutrition on the development of the infant gut microbiome, and uncover putative biological mechanisms underlying the role of a compromised microbiome as a risk factor for NCD.

Results

As early as day 3, infants born vaginally presented a hypoxic and acidic gut environment characterized by an enrichment of strict anaerobes (Bifidobacteriaceae). Infants born by C-section presented the hallmark of a compromised microbiome driven by an enrichment of Enterobacteriaceae. This was associated with meta-omics signatures characteristic of a microbiome adapted to a more oxygen-rich gut environment, enriched with genes associated with reactive oxygen species metabolism and lipopolysaccharide biosynthesis, and depleted in genes involved in the metabolism of milk carbohydrates. The synbiotic formula modulated expression of microbial genes involved in (oligo)saccharide metabolism, which emulates the eco-physiological gut environment observed in vaginally born infants. The resulting hypoxic and acidic milieu prevented the establishment of a compromised microbiome.

Conclusions

This study deciphers the putative functional hallmarks of a compromised microbiome acquired during C-section birth, and the impact of nutrition that may counteract disturbed microbiome development.

Trial registration

The study was registered in the Dutch Trial Register (Number:2838) on 4th April 2011.
Effect of drought on photosynthesis, total antioxidant capacity, bioactive component accumulation, and the transcriptome of Atractylodes lancea
Authors: Zhang Aqin , Liu Mengxue , Gu Wei , Chen Ziyun , Gu Yuchen , Pei Lingfeng , Tian Rong
Published: June 2021

Background

Atractylodes lancea(Thunb.) DC, a medicinal herb belonging to the Asteraceae family, often faces severe drought stress during its growth. Until now, there has been no research on the effect of drought stress on the quality formation ofA. lancea. Therefore, the present study aimed to study the effects of drought stress onA. lanceathrough physical and chemical analysis, and to reveal the related molecular mechanisms via transcriptome analysis.

Results

The photosynthesis was markedly inhibited under drought stress. There were alterations to photosynthetic parameters (Pn, Gs, Ci) and chlorophyll fluorescence (Fv/Fm, NPQ), and the chlorophyll content decreased. Twenty genes encoding important regulatory enzymes in light and dark reactions, including the Rubisco gene of the Calvin cycle, were significantly downregulated. After exposure to drought stress for more than 4 days, the activities of four antioxidative enzymes (SOD, POD CAT and APX) began to decrease and continued to decrease with longer stress exposure. Meanwhile, most of the genes encoding antioxidative enzymes were downregulated significantly. The downregulation of 21 genes related to the respiratory electron transport chain indicated that the blocked electron transfer accelerated excessive ROS.The MDA content was significantly elevated. The above data showed that 15 days of drought stress caused serious oxidative damage toA. lancea. Drought stress not only reduced the size and dry weight ofA. lancea, but also lowered the amount of total volatile oil and the content of the main bioactive components. The total volatile oil and atractylodin content decreased slightly, whereas the content of atractylon and β-eudesmol decreased significantly. Moreover, ten significantly downregulated genes encoding sesquiterpene synthase were mainly expressed in rhizomes.

Conclusions

After exposed to drought stress, the process of assimilation was affected by the destruction of photosynthesis; stress tolerance was impaired because of the inhibition of the antioxidative enzyme system; and bioactive component biosynthesis was hindered by the downregulation of sesquiterpene synthase-related gene expression. All these had negative impacts on the quality formation ofA. lanceaunder drought stress.
Trends in incidence and long-term prognosis of acute kidney injury following coronary angiography in Chinese cohort with 11,943 patients from 2013 to 2017: an observational study
Authors: Liu Jin , Li Qiang , Lai Disheng , Chen Guoqin , Wang Bo , Liu Liwei , Huang Haozhang , Lun Zhubin , Ying Ming , Chen Guanzhong , Huang Zhidong , Xu Danyuan , Meng Liangguang , Yan Xiaoming , Qiu Weiyan , Tan Ning , Chen Jiyan , Liu Yong , Chen Shiqun
Published: June 2021

Background

Contrast-associated acute kidney injury (CA-AKI) is a common complication with poor prognosis after coronary angiography (CAG). With the prevention methods widely being implemented, the temporal trends of incidence and mortality of CA-AKI are still unknown over the last five years. The study aims to determine the incidence and prognosis of CA-AKI in China.

Methods

This retrospective cohort study was based on the registry at Guangdong Provincial People’s Hospital in China (ClinicalTrials.gov NCT04407936). We analyzed data from hospitalization patients who underwent CAG and with preoperative and postoperative serum creatinine (Scr) values from January 2013 to December 2017.

Results

11,943 patients were included in the study, in which the mean age was 63.01 ± 10.79 years and 8,469 (71.1 %) were male. The overall incidence of CA-AKI was 11.2 %. Compared with 2013, the incidence of CA-AKI in 2017 was significantly increased from 9.7 to 13.0 % (adjusted odds ratios [aOR], 1.38; 95 %CI, 1.13–1.68; P-value < 0.01, P for trend < 0.01). The temporal trends of incidence among patients of different ages and genders yielded similar findings. During a standardized follow-up of 1 year, 178 (13.7 %) CA-AKI patients died in total, which showed no obvious decreased trend in this 5 five years from 21.1 to 16.5 (adjusted hazard ratio [aHR], 0.72; 95 %CI, 0.36–1.45; P-value = 0.35, P for trend = 0.24).

Conclusions

Our Chinese cohort showed that the incidence of CA-AKI increased significantly, while CA-AKI associated mortality showed no obvious decreased trend in the last five years. Our findings support more active measures to prevent CA-AKI and improve the prognosis of CA-AKI patients.
Maternal mortality ratio in Jiangsu Province, China: recent trends and associated factors
Authors: Li Donghua , Yu Chengxiao , Song Ci , Ning Weiqing , Xu Yan , Ge Huan , Lin Song , Zhou Wenjie , Lu Yajun , Wang Xudong , Hu Zhibin , Lin Yuan , Wu Jie
Published: June 2021

Background

In recent years, births to older mothers and multiparous mothers have increased rapidly with the change of birth policy in China. And mothers of advanced age are more likely to have maternal complications and poor birth outcomes. We aimed to estimate the recent trends and underlying risk factors of maternal mortality.

Methods

In this systematic assessment, we used data from the National Maternal and Child Health Routine Reporting System (2013–2018), Jiangsu Provincial Maternal Mortality Surveillance System (2017–2018), the Integrated National Mortality Surveillance System (2018), City Statistical Yearbooks (2018), City Health Statistical Yearbooks (2018). The factors associated with maternal mortality ratio (MMR) were explored using the stepwise regression analysis and cluster analysis.

Results

The MMR maintained at low levels between 2013 and 2016 and there was a slight increase in maternal mortality after 2016 in Jiangsu province. With the implementation of the China’s universal two child policies, the percentage of multiparous mothers ascended from 34.2% (95% confidence interval (CI) = 34.1–34.3%) in 2013 to 51.4% (95% CI = 51.3–51.6%) in 2018 (beta = 3.88, P < 0.001). Consistently, the percentage of advanced maternal age (≥ 35) increased from 8.4% (95% CI = 8.4–8.5%) in 2013 to 10.4% (95% CI = 10.3–10.4%) in 2018 (beta = 0.50, P = 0.012). And we found that the percentage of multiparous mothers and advanced maternal age among maternal deaths were higher than all pregnant women (P < 0.001). In the stepwise regression analysis, four risk factors were significantly associated with maternal mortality ratio (primary industry of gross domestic product (GDP), rate of delivery in maternal and child health hospital, rate of cesarean section and rate of low birth weight). As the results derived from cluster analysis, the relatively developed regions had lower preventable maternal mortality ratio (43.5% (95% CI = 31.2–56.7%) vs. 62.6% (95% CI = 52.3–72.0%), P = 0.027).

Conclusions

Since the universal two child policy has been associated with changes in health related birth characteristics: women giving birth have been more likely to be multiparous, and more likely to be aged 35 and over. This somewhat magnifies the impact of differences in economic development and obstetric services on MMR. The findings based on prefecture level data suggest that interventions must target economic development, the health system and maternal risk factors in synergy. These approaches will be of great benefit to control or diminish environmental factors associated with preventable deaths and will effectively reduce MMR and narrow the gap among the different regions.
The role of postmastectomy radiation in patients with ypN0 breast cancer after neoadjuvant chemotherapy: a meta-analysis
Authors: Wang Ke , Jin Xiaoyan , Wang Weilan , Yu Xiuyan , Huang Jian
Published: June 2021

Background

It has been demonstrated that postmastectomy radiation therapy (PMRT) was beneficial for breast cancer patients who are axillary lymph node-positive. However, the effectiveness of radiotherapy in pathological negative nodes (ypN0) after neoadjuvant chemotherapy (NAC) remains open to considerable debate. Here, we aim to evaluate whether PMRT improves loco-regional control and survival for such patients.

Methods

The literature from January 2004 to June 2019 was searched. The effects of PMRT on local-regional recurrence (LRR) and survival was evaluated in a meta-analysis. Pooled relative risk (RR) values with 95% confidence intervals (CIs) were computed using random and fixed-effect model. Subgroup and heterogeneity analyses were also conducted.

Results

Twelve studies that included 17,747 patients met the inclusion criteria. Pooled results showed that PMRT was associated with reduced LRR (RR, 0.38; 95% CI, 0.19–0.77, P = 0.007), particularly in patients with stage III breast cancer (RR, 0.16; 95% CI, 0.07–0.37, P < 0.001). However, no significant difference in disease-free survival were observed with the addition of PMRT for ypN0 patients (RR, 0.70; 95% CI, 0.21–2.27, P = 0.55). Also, there was no statistically significant association between radiotherapy with overall survival (RR, 0.81; 95% CI, 0.64–1.04, P = 0.10).

Conclusions

Our meta-analysis indicated that PMRT might reduce local-regional recurrence for ypN0 patients after NAC, but lack of benefit for survival outcomes. Prospective randomized clinical trial data will be needed to confirm our results.
Globulin, the albumin-to-globulin ratio, and fibrinogen perform well in the diagnosis of Periprosthetic joint infection
Authors: Wang Huhu , Zhou Haikang , Jiang Rendong , Qian Zhenhao , Wang Fei , Cao Li
Published: June 2021

Background

Although periprosthetic joint infection (PJI) is a severe complication of total joint arthroplasty (TJA), the diagnosis of PJI remains challenging. Albumin (ALB), globulin (GLB), the albumin-to-globulin ratio (AGR), and fibrinogen could be indicators of the body’s inflammatory state. This study aimed to compare the diagnostic accuracy of these biomarkers with that of other inflammatory biomarkers in PJI patients.

Methods

We conducted a retrospective cohort study that included a consecutive series of patients undergoing debridement antibiotic irrigation and implant retention (DAIR), one-stage or the first stage of a two-stage revision total knee arthroplasty (TKA) or total hip arthroplasty (THA) for acute (n = 31) or chronic (n = 51) PJI, or revision TKA or THA for aseptic failures (n = 139) between January 2017 and December 2019 in our hospital. The 2013 criteria of the Musculoskeletal Infection Society (2013 MSIS) were used as the reference standard for the diagnosis of PJI. The preoperative ALB, GLB, AGR, fibrinogen, D-dimer, platelet count, fibrin degradation product (FDP), platelet-to-lymphocyte (PLR), platelet count to mean platelet volume ratio (PVR), neutrophil-to-lymphocyte ratio (NLR), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were assessed. The receiver operating characteristic curve (ROC), sensitivity, and specificity were utilized to compare different biomarkers.

Results

Compared with the aseptic patients, the GLB, D-dimer, fibrinogen, FDP, platelet count, PVR, PLR, NLR, ESR, and CRP levels of PJI patients were significantly higher (P < 0.01); however, the ALB and AGR levels were significantly lower (P < 0.01). The area under the curve (AUC), sensitivity and specificity were 0.774, 67.50, 77.54% for ALB; 0.820, 57.50, 89.86% for GLB; 0.845, 66.25, 93.48% for AGR; 0.832, 78.48, 78.95% for fibrinogen; 0.877, 81.48, 85.07% for ESR; 0.909, 83.95, 88.89% for CRP; 0.683, 55.22, 75.83% for D-dimer; 0.664, 38.81, 88.33% for FDP; 0.678, 52.44, 79.86% for platelet count; 0.707, 48.78, 86.33% for PVR; 0.700, 51.22, 80.58% for PLR; and 0.678, 52.44, 81.30% for NLR, respectively. In the clinic, GLB, AGR and fibrinogen could be used for diagnosis of patients suspected of having PJI.

Conclusion

Our study demonstrated that GLB, AGR, and fibrinogen were promising biomarkers in the diagnosis of PJI.