bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract 79: The Impact Of Left Atrial And Left Ventricular Size On TAVR Outcomes
Authors: Ambalavanan Manoj , Patel Keshav , Nasrollahi Farrah , Dohse Carlos , Twing Aamir , Ramsis Ramsis , Tiu David , Sreepathy Pranati , Zayyad Zaid , Cho Nicole , Ibrahim Khalil , Kansal Mayank M , Shroff Adhir R
Published: May 2022

Introduction:
In severe aortic stenosis, left atrium (LA) and left ventricle (LV) enlargement are common physiologic sequelae but their prognostic value in transcatheter aortic valve replacement (TAVR) outcomes is still being investigated. The purpose of this study is to look at the effect of left atrial and ventricular size on major adverse cardiac events (MACE) following TAVR.

Methods:
Retrospective analysis of electronic medical records from 2018-2020 at the University of Illinois at Chicago and affiliated Veterans Affairs identified TAVR patients. The cutoff for normal LA diameter was <4.0 cm. Normal LV systolic diameter was <4.1 cm and an enlarged LV based on dilated systolic LV diameter. Primary outcomes included composite MACE (all-cause mortality, myocardial infarction, or cerebrovascular accident) at 6- and 12- months post TAVR. MACE was then stratified based on the number of dilated left-sided chambers.

Results:
We included 134 patients in the analysis. The study population was 81% (109 of 134) male, 56% (75 of 134) non-white, and 74 ± 12 years old. Patients that experienced MACE at 6 months were found to have a larger systolic LV diameter (3.9 vs 3.3 cm, p=0.02). MACE was stratified based on the number of dilated chambers (neither, LA or LV, both) and was found to be significant at 6 months (4.1% to 10.4% and 35.3% p=0.002) but not at 12 months (12.2% vs 19.1% vs 35.3% p=0.11). Patients with increased LA size (4.8 vs. 4.1 cm; p=0.001) had higher rates of MACE, specifically with respect to mortality (p=0.007). When comparing patients with an enlarged LA (4.8 cm) to normal-sized LA (<4.0 cm), there was no statistically significant difference in ejection fraction <50% (16.7% vs 14.5% of patients, respectively; p=0.8) or enlarged diastolic LV diameter (4.5 vs. 4.6 cm; p=0.7).

Conclusion:
Our results suggest that patients with an enlarged LA or LV may have an increased risk for mortality and composite MACE following procedure at either 6- or 12-months even when controlling for confounding factors such as depressed LV or enlarged diastolic LV diameter. Our study suggests LA and LV size should be considered in risk stratifying patients prior to TAVR.
Beyond the Golden Hour: Treating Acute Stroke in the Platinum 30 Minutes
Authors: Randhawa Anantbir S. , Pariona-Vargas Fatima , Starkman Sidney , Sanossian Nerses , Liebeskind David S. , Avila Gilda , Stratton Samuel , Gornbein Jeffrey , Sharma Latisha , Restrepo-Jimenez Lucas , Valdes-Sueiras Miguel , Kim-Tenser May , Villablanca Pablo , Conwit Robin , Hamilton Scott , Saver Jeffrey L.
Published: May 2022

Background:

To emphasize treatment speed for time-sensitive conditions, emergency medicine has developed not only the concept of the golden hour, but also the platinum half-hour. Patients with acute stroke treated within the first half-hour of onset have not been previously characterized.

Methods:

In this cohort study, we analyzed patients enrolled in the FAST-MAG (Field Administration of Stroke Therapy–Magnesium) trial, testing paramedic prehospital start of neuroprotective agent ≤2 hours of onset. The features of all acute cerebral ischemia, and intracranial hemorrhage patients with treatment starting at ≤30 m of last known well were compared with later-treated patients.

Results:

Among 1680 patients, 203 (12.1%) received study agents within 30 minutes of last known well. Among platinum half-hour patients, median onset-to-treatment time was 28 minutes (interquartile range, 25–30), and final diagnoses were acute cerebral ischemia in 71.8% (ischemic stroke, 61.5%, TIA 10.3%); intracranial hemorrhage in 26.1%; and mimic in 2.5%. Clinical features among platinum half-hour patients were largely similar to later-treated patients and included age 69 (interquartile range, 57–79), 44.8% women, prehospital Los Angeles Motor Scale median 4 (3–5), and early-postarrival National Institutes of Health Stroke Scale deficit 8 (interquartile range, 3–18). Platinum half-hour acute cerebral ischemia patients did have more severe prehospital motor deficits and younger age; platinum half-hour intracranial hemorrhage patients had more severe motor deficits, were more often female, and less often of Hispanic ethnicity. Outcomes at 3 m in platinum half-hour patients were comparable to later-treated patients and included freedom-from-disability (modified Rankin Scale score, 0–1) in 35.5%, functional independence (modified Rankin Scale score, 0–2) in 53.2%, and mortality in 17.7%.

Conclusions:

Prehospital initiation permits treatment start within the platinum half-hour after last known well in a substantial proportion of acute ischemic and hemorrhagic stroke patients, accounting for more than 1 in 10 enrolled in a multicenter trial. Hyperacute platinum half-hour patients were largely similar to later-treated patients and are an attainable target for treatment in prehospital stroke trials.
Pier Competitor: China's Power Position in Global Ports
Authors: Kardon Isaac B. , Leutert Wendy
Published: May 2022

China is a leader in the global transportation industry, with an especially significant position in ocean ports. A mapping of every ocean port outside of China reveals that Chinese firms own or operate terminal assets in ninety-six ports in fifty-three countries. An original dataset of Chinese firms' overseas port holdings documents the geographic distribution, ownership, and operational characteristics of these ports. What are the international security implications of China's global port expansion? An investigation of Chinese firms' ties to the Party-state reveals multiple mechanisms by which the Chinese leadership may direct the use of commercial port assets for strategic purposes. International port terminals that Chinese firms own and operate already provide dual-use capabilities to the People's Liberation Army during peacetime, establishing logistics and intelligence networks that materially enable China to project power into critical regions worldwide. But this form of networked state power is limited in wartime because it depends on commercial facilities in non-allied states. By providing evidence that overseas bases are not the sole index of global power projection capabilities, findings advance research on the identification and measurement of sources of national power. China's leveraging of PRC firms' transnational commercial port network constitutes an underappreciated but consequential form of state power projection.
Toward a Social History of Modern Chinese Warlordism
Authors: McCord Edward A.
Published: May 2022

The social impact of modern Chinese warlordism on China’s modern development has attracted little attention in past scholarship, which generally has been more interested in warlordism as a military-political system. This article argues, however, that warlordism developed within a social context and had a major impact on Chinese society, and this in turn suggests the usefulness of applying a social history approach to the study of the warlord period. This article makes a preliminary effort to advance this goal by identifying three main areas that could provide a framework for research on the social history of Chinese warlordism. First, the article examines debates over the social (or class) foundations of warlord power. Second, the article explores the ways in which warlordism changed the social status of military men and created opportunities for social mobility. Finally, the article emphasizes the need to look beyond the political impact of Chinese warlordism to show the social and economic effects that arose from the military conflicts of the warlord era.
On Characterizing Ocean Kinematics from Surface Drifters
Authors: Essink Sebastian , Hormann Verena , Centurioni Luca R. , Mahadevan Amala
Published: May 2022

Horizontal kinematic properties, such as vorticity, divergence, and lateral strain rate, are estimated from drifter clusters using three approaches. At submesoscale horizontal length scales , kinematic properties become as large as planetary vorticity f, but challenging to observe because they evolve on short time scales . By simulating surface drifters in a model flow field, we quantify the sources of uncertainty in the kinematic property calculations due to the deformation of cluster shape. Uncertainties arise primarily due to (i) violation of the linear estimation methods and (ii) aliasing of unresolved scales. Systematic uncertainties (iii) due to GPS errors, are secondary but can become as large as (i) and (ii) when aspect ratios are small. Ideal cluster parameters (number of drifters, length scale, and aspect ratio) are determined and error functions estimated empirically and theoretically. The most robust method—a two-dimensional, linear least squares fit—is applied to the first few days of a drifter dataset from the Bay of Bengal. Application of the length scale and aspect-ratio criteria minimizes errors (i) and (ii), and reduces the total number of clusters and so computational cost. The drifter-estimated kinematic properties map out a cyclonic mesoscale eddy with a surface, submesoscale fronts at its perimeter. Our analyses suggest methodological guidance for computing the two-dimensional kinematic properties in submesoscale flows, given the recently increasing quantity and quality of drifter observations, while also highlighting challenges and limitations.

Significance Statement

The purpose of this study is to provide insights and guidance for computing horizontal velocity gradients from clusters (i.e., three or more) of Lagrangian surface ocean drifters. The uncertainty in velocity gradient estimates depends strongly on the shape deformation of drifter clusters by the ocean currents. We propose criteria for drifter cluster length scales and aspect ratios to reduce uncertainties and develop ways of estimating the magnitude of the resulting errors. The findings are applied to a real ocean dataset from the Bay of Bengal.
Stratospheric Observations of Corona Current from Loon’s Superpressure Balloons
Authors: Reid Beth , Swanson Tom
Published: May 2022

Loon LLC collected 794 000 h of corona current observations between 15 and ∼20 km above sea level with time resolution between 1 and 30 min. We are publicly releasing this dataset to enable the research community’s understanding of electrical activity in the stratosphere. We validate the reliability of these measurements by aligning our flight data with both nearby Geostationary Lightning Mapper (GLM) events and the Convective Diagnostic Oceanic (CDO) indicator. Corona current observations that exceeded the sensor maximum of 10 μA were associated with high GLM optical flux accumulations along the flight trajectory. Using the CDO indicator as a persistence forecast for future electrical activity was effective at predicting corona current events, and so we highly recommend this data source for real-time stratospheric navigation for vehicles sensitive to the harsh electrical environment of the stratosphere.

Significance Statement

Loon LLC operated a fleet of balloons in the stratosphere, between 15 and 20 km above sea level. The balloons were instrumented with a sensor that measured the current flowing through a wire dangling from the flight vehicle. The observed currents were caused by the motion of nearby charged particles that are often associated with thunderstorms and lightning activity. In this paper we show that Loon’s sensor registered current at the same time lightning was recorded near the balloon by other instruments like the Geostationary Lightning Mapper satellite. This is the first dataset of its kind and size, reaching 794 000 flight hours. We are publicly releasing these data in hopes of aiding scientific discovery by researchers and to help future stratospheric vehicle operators better understand and plan for the electrical environment.
Examining Strategy Improvements in Hospitals: Linking Trade-Offs to Performance Frontiers
Authors: Nand Alka , ONeill Peter
Published: May 2022

The notion of trade-offs has long been recognized by operations management scholars as a necessary constraint to operations strategy. The increasing importance of this concept is reflected in numerous scholarly works, all seeking an understanding on how firms compete with their limited set of resources. A large majority of the past studies have primarily focused on the empirical validation of trade-offs mainly in manufacturing, with few that have visualized trade-offs as a result of performance frontiers in service sectors. In this article, using longitudinal data, we test and validate trade-offs in a public healthcare service-based setting through a performance frontier lens. Our analyses show that better performing hospitals on the basis of quality and cost-efficiency are those that are closer to their performance frontiers and exhibit a cost trade-off. Those that are situated further away demonstrate a trend for quality and cost improvements. However, despite the positions on the frontier, quality always seemed to be the prerequisite dimension for all hospitals. We believe this reaffirms the logic surrounding the sand cone model, albeit in old industry not known for quality.
Monocytosis and its association with clonal hematopoiesis in community-dwelling individuals
Authors: van Zeventer Isabelle A. , de Graaf Aniek O. , Koorenhof-Scheele Theresia N. , van der Reijden Bert A. , van der Klauw Melanie M. , Dinmohamed Avinash G. , Diepstra Arjan , Schuringa Jan Jacob , Malcovati Luca , Huls Gerwin , Jansen Joop H.
Published: May 2022

Monocytosis may occur in numerous inflammatory conditions but is also the defining feature of chronic myelomonocytic leukemia (CMML). Clonal somatic mutations detectable in CMML may occur with aging in otherwise healthy individuals, so-called “clonal hematopoiesis” (CH). We investigated whether the combination of CH and monocytosis would represent an early developmental stage of CMML. We studied community-dwelling individuals with monocytosis (≥1 × 109/L and ≥10% of leukocytes) in the population-based Lifelines cohort (n = 144 676 adults). The prevalence and spectrum of CH were evaluated for individuals ≥60 years with monocytosis (n = 167 [0.8%]), and control subjects 1:3 matched for age and sex (n = 501). Diagnoses of hematological malignancies were retrieved by linkage to the Netherlands Cancer Registry (NCR). Monocyte counts and the prevalence of monocytosis increased with advancing age. Older individuals with monocytosis more frequently carried CH (50.9% vs 35.5%; P < .001). Monocytosis is associated with enrichment of multiple gene mutations (P = .006) and spliceosome mutations (P = .007) but not isolated mutated DNMT3A, TET2, or ASXL1. Persistent monocytosis over 4 years was observed in 30/102 evaluable individuals and associated with a higher prevalence of CH (63%). Myeloid malignancies, including 1 case of CMML, developed in 4 individuals with monocytosis who all carried CH. In conclusion, monocytosis and CH both occur at an older age and do not necessarily reflect clonal monocytic proliferation. In a fraction of older subjects with monocytosis, CH might constitute early clonal dominance in developing malignant myelomonocytic disease. Mutational spectra deviating from age-related CH require attention.
The Growth of Polarization Domains in Ultrathin Ferroelectric Films Seeded by the Tip of an Atomic Force Microscope
Authors: Zamani-Alavijeh Mohammad , Morgan Timothy A. , Kuchuk Andrian V. , Salamo Gregory J.
Published: May 2022

Piezoresponse force microscopy is used to study the velocity of the polarization domain wall in ultrathin ferroelectric barium titanate (BTO) films grown on strontium titanate (STO) substrates by molecular beam epitaxy. The electric field due to the cone of the atomic force microscope tip is demonstrated as the dominant electric field for domain expansion in thin films at lateral distances greater than about one tip diameter away from the tip. The velocity of the domain wall under the applied electric field by the tip in BTO for thin films (less than 40 nm) followed an expanding process given by Merz’s law. The material constants in a fit of the data to Merz’s law for very thin films are reported as about 4.2 KV/cm for the activation field, $$E_{\mathrm{a}}$$

E
a

, and 0.05 nm/s for the limiting velocity, $$v_{\infty }$$

v
∞

. These material constants showed a dependence on the level of strain in the films, but no fundamental dependence on thickness.
Biomarker interaction selection and disease detection based on multivariate gain ratio
Authors: Chu Xiao , Jiang Mao , Liu Zhuo-Jun
Published: May 2022

Background

Disease detection is an important aspect of biotherapy. With the development of biotechnology and computer technology, there are many methods to detect disease based on single biomarker. However, biomarker does not influence disease alone in some cases. It’s the interaction between biomarkers that determines disease status. The existing influence measure I-score is used to evaluate the importance of interaction in determining disease status, but there is a deviation about the number of variables in interaction when applying I-score. To solve the problem, we propose a new influence measure Multivariate Gain Ratio (MGR) based on Gain Ratio (GR) of single-variate, which provides us with multivariate combination called interaction.

Results

We propose a preprocessing verification algorithm based on partial predictor variables to select an appropriate preprocessing method. In this paper, an algorithm for selecting key interactions of biomarkers and applying key interactions to construct a disease detection model is provided. MGR is more credible than I-score in the case of interaction containing small number of variables. Our method behaves better with average accuracy $$93.13\%$$

93.13
%

than I-score of $$91.73\%$$

91.73
%

in Breast Cancer Wisconsin (Diagnostic) Dataset. Compared to the classification results $$89.80\%$$

89.80
%

based on all predictor variables, MGR identifies the true main biomarkers and realizes the dimension reduction. In Leukemia Dataset, the experiment results show the effectiveness of MGR with the accuracy of $$97.32\%$$

97.32
%

compared to I-score with accuracy $$89.11\%$$

89.11
%

. The results can be explained by the nature of MGR and I-score mentioned above because every key interaction contains a small number of variables in Leukemia Dataset.

Conclusions

MGR is effective for selecting important biomarkers and biomarker interactions even in high-dimension feature space in which the interaction could contain more than two biomarkers. The prediction ability of interactions selected by MGR is better than I-score in the case of interaction containing small number of variables. MGR is generally applicable to various types of biomarker datasets including cell nuclei, gene, SNPs and protein datasets.
Convolutional neural network-based system for endocytoscopic diagnosis of early gastric cancer
Authors: Noda Hiroto , Kaise Mitsuru , Higuchi Kazutoshi , Koizumi Eriko , Yoshikata Keiichiro , Habu Tsugumi , Kirita Kumiko , Onda Takeshi , Omori Jun , Akimoto Teppei , Goto Osamu , Iwakiri Katsuhiko , Tada Tomohiro
Published: May 2022

Background

Endocytoscopy (ECS) aids early gastric cancer (EGC) diagnosis by visualization of cells. However, it is difficult for non-experts to accurately diagnose EGC using ECS. In this study, we developed and evaluated a convolutional neural network (CNN)-based system for ECS-aided EGC diagnosis.

Methods

We constructed a CNN based on a residual neural network with a training dataset comprising 906 images from 61 EGC cases and 717 images from 65 noncancerous gastric mucosa (NGM) cases. To evaluate diagnostic ability, we used an independent test dataset comprising 313 images from 39 EGC cases and 235 images from 33 NGM cases. The test dataset was further evaluated by three endoscopists, and their findings were compared with CNN-based results.

Results

The trained CNN required 7.0 s to analyze the test dataset. The area under the curve of the total ECS images was 0.93. The CNN produced 18 false positives from 7 NGM lesions and 74 false negatives from 28 EGC lesions. In the per-image analysis, the accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 83.2%, 76.4%, 92.3%, 93.0%, and 74.6%, respectively, with the CNN and 76.8%, 73.4%, 81.3%, 83.9%, and 69.6%, respectively, for the endoscopist-derived values. The CNN-based findings had significantly higher specificity than the findings determined by all endoscopists. In the per-lesion analysis, the accuracy, sensitivity, specificity, PPV, and NPV of the CNN-based findings were 86.1%, 82.1%, 90.9%, 91.4%, and 81.1%, respectively, and those of the results calculated by the endoscopists were 82.4%, 79.5%, 85.9%, 86.9%, and 78.0%, respectively.

Conclusions

Compared with three endoscopists, our CNN for ECS demonstrated higher specificity for EGC diagnosis. Using the CNN in ECS-based EGC diagnosis may improve the diagnostic performance of endoscopists.
Bartonella endocarditis and diffuse crescentic proliferative glomerulonephritis with a full-house pattern of immune complex deposition
Authors: Guo Shunhua , Pottanat Neha D. , Herrmann Jeremy L. , Schamberger Marcus S.
Published: May 2022

Background

Bartonella endocarditis is often a diagnostic challenge due to its variable clinical manifestations, especially when it is first presented with involvement of organs other than skin and lymph nodes, such as the kidney.

Case presentation

This was a 13-year-old girl presenting with fever, chest and abdominal pain, acute kidney injury, nephrotic-range proteinuria and low complement levels. Her kidney biopsy showed diffuse crescentic proliferative glomerulonephritis with a full-house pattern of immune complex deposition shown by immunofluorescence, which was initially considered consistent with systemic lupus erythematous-associated glomerulonephritis (lupus nephritis). After extensive workup, Bartonella endocarditis was diagnosed. Antibiotic treatment and valvular replacement surgery were undertaken with subsequent return of kidney function to normal range.

Conclusion

This case demonstrates the importance of considering the full clinical picture when interpreting clinical, laboratory and biopsy findings, because the treatment strategy for infective endocarditis versus lupus nephritis is drastically different.
Level IV neck dissection in cN0 HPV-negative oropharyngeal squamous cell carcinoma: a retrospective cohort study
Authors: Huo Zirong , Fu Shuiting , Ma Chunyue , Sheng Surui
Published: May 2022

Background

As opposed to observation of the neck, elective neck dissection has a survival benefit for cN0 oropharyngeal squamous cell carcinoma (OPSCC). However, there are limited date on level IV neck dissection in human papillomavirus (HPV)-negative OPSCC because most earlier studies did not stratify by P16 or HPV status. Thus, whether to exclude level IV from selective dissection (SND) of cN0 HPV-negative OPSCC remains controversial.

Methods

In this single-center retrospective cohort study, disease-free survival (DFS) was estimated as the primary endpoint for 124 cN0 HPV-negative OPSCC patients who received SND of levels I-III (Group A) and I-IV (Group B). Overall survival (OS) and disease-specific survival (DSS) were considered secondary endpoints.

Results

For the entire cohort, the 5-year DFS rates of Groups A and B were 55.0% and 60.1%, respectively. Five-year OS rates were 58.9% and 61.5%, and 5-year DSS rates were 74.0% and 64.8%, respectively. Group B did not show higher 5-year DFS, OS, or DSS than Group A.

Conclusions

This retrospective cohort study validated that in cN0 HPV-negative OPSCC, SND including level IV does not have substantial benefits regarding DFS, OS or DSS.
Outcomes of 25-gauge pars plana vitrectomy alone with air tamponade for the management of rhegmatogenous retinal detachment with inferior breaks
Authors: Tang Yongping , Lin Bo , Chen Jing , Chen Daosen , Wu Ronghan
Published: May 2022

Background

This study was investigated the surgical outcomes of primary rhegmatogenous retinal detachment (RRD) with inferior retinal breaks (IRBs) that were repaired by 25-gauge pars plana vitrectomy (PPV) with air tamponade.

Methods

This retrospective review included 81 consecutive patients who had RRD with IRBs and underwent PPV with air tamponade in our hospital from January 2017 to January 2020. The main outcomes were single surgery anatomical success (SSAS) rate, postoperative best-corrected visual acuity (BCVA), and complications.

Results

The patient population consisted of 29 women and 52 men (mean age, 52.12 years); the mean follow-up interval was 8.88 months. The mean number of affected quadrants was 1.65 (range, 1–4 quadrants) and the mean number of breaks was 3.25. A single break was present in 20 cases (24.7%); two to 10 breaks were present in 61 (75.3%) cases. The SSAS rate was 91.36% (74/81) and the final anatomical success rate was 96.30% (78/81). More than half of the patients had BCVA < 0.3 logarithm of the minimum angle of resolution at the last follow-up. Axial length and patient age were candidate risk factors for redetachment (axial length, p = 0.03; age, p = 0.002). Postoperative complications included macular epiretinal membrane formation in one patient, lens opacity in three patients, and clinically significant macular edema in one patient.

Conclusions

PPV with air tamponade may be effective for the treatment of primary RRD with IRBs. Extensive preoperative discussion may be necessary for young patients and patients with particularly long axial length.
The influence of congenital and developmental cataract surgery on the ocular surface in a six-month follow-up prospective clinical study
Authors: Lin Xiaolei , Li Hongzhe , Zhou Xiyue , Liu Xin , Fan Fan , Yang Tianke , Luo Yi
Published: May 2022

Background

The purpose of this study was to identify changes in tear film function and meibomian gland function in children after congenital/developmental cataract surgery.

Methods

This study enrolled 16 eyes of 16 congenital/developmental cataract patients (mean age: 8.05 ± 1.43 years) who underwent cataract surgery and 16 eyes of 16 normal volunteers (mean age: 8.31 ± 2.18 years). Clinical assessments were conducted preoperatively and at 1 week, 1, 3 and 6 months postoperatively. Symptom questionnaires, non-invasive tear film break-up time, tear meniscus height, corneal fluorescein staining, lid margin abnormality, meibomian gland expressibility, and meibography were assessed.

Results

The ocular symptom score was significantly higher in congenital/developmental cataract patients compared to normal controls during the 5 visits (P = 0.009). And the average non-invasive tear film break-up time was significantly lower in congenital/developmental cataract patients compared to normal controls (P = 0.017). The first non-invasive tear film break-up time and average non-invasive tear film break-up time were lowest at 1 month postoperatively compared to baseline levels (P = 0.008 and P = 0.012, respectively). The lid margin score of the upper eyelid was significantly higher in congenital/developmental cataract patients compared to normal controls at 1 week postoperatively (P = 0.027). The meibum expressibility score decreased significantly during the 5 visits (P = 0.024). No significant difference was observed in meibomian gland tortuosity, meibomian gland width, meibomian gland area and meibomian gland length between the congenital/developmental group and normal controls preoperatively and at 6 months postoperatively (P > 0.05).

Conclusion

Tear film stability and meibomian gland function are worsened transiently after congenital/developmental cataract surgery without accompanying meibomian gland morphological changes.
Digital interventions for subjective and objective social isolation among individuals with mental health conditions: a scoping review
Authors: Toh Gigi , Pearce Eiluned , Vines John , Ikhtabi Sarah , Birken Mary , Pitman Alexandra , Johnson Sonia
Published: May 2022

Background

Social isolation encompasses subjective and objective concepts. Both are associated with negative health consequences and are more prevalent among people with mental health problems than among the general population. To alleviate social isolation, digital interventions have potential as accessible alternatives or adjuncts to face-to-face interventions. This scoping review aimed to describe the types of digital interventions evaluated for feasibility, acceptability and effectiveness in alleviating social isolation among individuals with mental health problems, and to present an overview of the quantitative evidence yielded to inform future intervention design.

Methods

We searched five electronic databases for quantitative and mixed methods studies published between January 2000 and July 2020. Studies were included if they evaluated digital interventions for individuals with mental health conditions, had subjective and/or objective social isolation as their primary outcome, or as one of their outcomes if no primary outcome was specified. Feasibility studies were included if feasibility outcomes were the primary outcomes and social isolation was among their secondary outcomes. A narrative synthesis was conducted to present our findings. The protocol was registered on Open Science Framework (doi:https://doi.org/10.17605/OSF.IO/CNX8A).

Results

Thirty-two studies were included for our review: 16 feasibility studies, seven single-group studies and nine effectiveness trials. There was great variation in the interventions, study designs and sample populations. Interventions included web-based programmes, phone-based programmes, blended interventions, socially assistive robots and virtual reality interventions. Many were feasibility studies, or otherwise not fully powered to detect an effect if one were present, thus preventing clear conclusions about clinical effectiveness. Satisfactory feasibility outcomes indicated potential for future trials to assess these interventions.

Conclusion

Our scoping review identified a range of digital approaches utilized to alleviate social isolation among individuals with mental health disorders. Conclusions regarding clinical effectiveness cannot be reached due to variability of approaches and lack of large-scale randomized controlled trials. To make clear recommendations for digital social isolation interventions, future research needs to be based on rigorous methods and larger samples. Future studies should also focus on utilizing theory-driven approaches and improving existing approaches to advance the field.
Prenatal healthcare after sentencing reform: heterogeneous effects for prenatal healthcare access and equity
Authors: Jahn Jaquelyn L. , Simes Jessica T.
Published: May 2022

Background

High rates of imprisonment in the U.S. have significant health, social, and economic consequences, particularly for marginalized communities. This study examines imprisonment as a contextual driver of receiving prenatal care by evaluating whether early and adequate prenatal care improved after Pennsylvania’s criminal sentencing reform reduced prison admissions.

Methods

We linked individual-level birth certificate microdata on births (n = 999,503) in Pennsylvania (2009–2015), to monthly county-level rates of prison admissions. We apply an interrupted time series approach that contrasts post-policy changes in early and adequate prenatal care across counties where prison admissions were effectively reduced or continued to rise. We then tested whether prenatal care improvements were stronger among Black birthing people and those with lower levels of educational attainment.

Results

In counties where prison admissions declined the most after the policy, early prenatal care increased from 69.0% to 73.2%, and inadequate prenatal care decreased from 18.1% to 15.9%. By comparison, improvements in early prenatal care were smaller in counties where prison admissions increased the most post-policy (73.5 to 76.4%) and there was no change to prenatal care inadequacy (14.4% pre and post). We find this pattern of improvements to be particularly strong among Black birthing people and those with lower levels of educational attainment.

Conclusions

Pennsylvania’s sentencing reforms were associated with small advancements in racial and socioeconomic equity in prenatal care.
Early prediction of moderate-to-severe condition of inhalation-induced acute respiratory distress syndrome via interpretable machine learning
Authors: Wu Junwei , Liu Chao , Xie Lixin , Li Xiang , Xiao Kun , Xie Guotong , Xie Fei
Published: May 2022

Background

Several studies have investigated the correlation between physiological parameters and the risk of acute respiratory distress syndrome (ARDS), in addition, etiology-associated heterogeneity in ARDS has become an emerging topic quite recently; however, the intersection between the two, which is early prediction of target conditions in etiology-specific ARDS, has not been well-studied. We aimed to develop and validate a machine-learning model for the early prediction of moderate-to-severe condition of inhalation-induced ARDS.

Methods

Clinical expertise was applied with data-driven analysis. Using data from electronic intensive care units (retrospective derivation cohort) and the three most accessible vital signs (i.e. heart rate, temperature, and respiratory rate) together with feature engineering, we applied a random forest approach during the time window of 90 h that ended 6 h prior to the onset of moderate-to-severe respiratory failure (the ratio of partial pressure of arterial oxygen to fraction of inspired oxygen ≤ 200 mmHg).

Results

The trained random forest classifier was validated using two independent validation cohorts, with an area under the curve of 0.9127 (95% confidence interval 0.8713–0.9542) and 0.9026 (95% confidence interval 0.8075–1), respectively. A Stable and Interpretable RUle Set (SIRUS) was used to extract rules from the RF to provide guidelines for clinicians. We identified several predictive factors, including resp_96h_6h_min < 9, resp_96h_6h_mean ≥ 16.1, HR_96h_6h_mean ≥ 102, and temp_96h_6h_max > 100, that could be used for predicting inhalation-induced ARDS (moderate-to-severe condition) 6 h prior to onset in critical care units. (‘xxx_96h_6h_min/mean/max’: the minimum/mean/maximum values of the xxx vital sign collected during a 90 h time window beginning 96 h prior to the onset of ARDS and ending 6 h prior to the onset from every recorded blood gas test).

Conclusions

This newly established random forest‑based interpretable model shows good predictive ability for moderate-to-severe inhalation-induced ARDS and may assist clinicians in decision-making, as well as facilitate the enrolment of patients in prevention programmes to improve their outcomes.
Bridging the cervicothoracic junction during posterior cervical laminectomy and fusion for the treatment of multilevel cervical ossification of the posterior longitudinal ligament: a retrospective case series
Authors: Wu Dong-Zhao , Gu Zhen-Fang , Meng De-Jing , Hou Shu-Bing , Ren Liang , Sun Xian-Ze
Published: May 2022

Background

The purpose of this study was to investigate the surgical efficacy of crossing the cervicothoracic junction during posterior cervical laminectomy and fusion for the treatment of multilevel cervical ossification of the posterior longitudinal ligament (OPLL).

Methods

From October 2009 to October 2017, 46 consecutive patients with multilevel cervical OPLL underwent posterior cervical laminectomy and crossing the cervicothoracic junction fusion were obtained in the study. Their medical records were retrospectively collected. Cervical lordosis and cervical sagittal balance were used to assess radiographic outcomes. Japanese Orthopedic Association (JOA), axial symptom, C5 root palsy, blood loss, and operation time were used to assess clinical outcomes. The mean follow-up period was 20.7 ± 8.3 months.

Results

The operation time was 205.2 ± 39.8 min and the intraoperative blood loss was 352.2 ± 143.7 ml. Analysis of the final follow-up data showed significant differences in JOA score (P < 0.01), C2-C7 lordosis angle (P < 0.01), and C2-C7 SVA (P < 0.01). CT confirmed that grafted bone was completely fused in all patients and progression of OPLL was observed in two patients (4.3%) at final follow-up. No adjacent segment disease (ASD) or instrument failure occurred in any patients.

Conclusions

Cervical laminectomy and crossing the cervicothoracic junction fusion are effective and safe methods to treat multilevel cervical OPLL. Randomized controlled studies compared constructs ending at cervical vertebrae or thoracic vertebrae are needed to confirm these results.
Evidence for anti-inflammatory effects and modulation of neurotransmitter metabolism by Salvia officinalis L.
Authors: Margetts Gemma , Kleidonas Sotirios , Zaibi Nawel S. , Zaibi Mohamed S. , Edwards Kieron D.
Published: May 2022

Background

Cognitive health is of great interest to society, with neuroinflammation and systemic inflammation age-related risk factors that are linked to declines in cognitive performance. Several botanical ingredients have been suggested to have benefits in this area includingSalvia officinalis(sage), which has shown anti-inflammatory effects and exhibited promising cognitive improvements in multiple human studies. The current study demonstrates anti-inflammatory effects forS. officinalisacross a broad set of in vitro models in human cells, and adds further evidence to support modulation of acetylcholine and monoamine neurostransmitter levels as mechanisms that contribute towards the benefits of the herb on cognitive health.

Methods

The effect ofS. officinalisextract on release of multiple cytokines and chemokines was measured in human primary intestinal epithelial cells treated with or without LPS stimulation, and Blood Brain Barrier (BBB) cells in presence or absence of recombinant IL-17A and/or Human IL-17RA/IL-17R Antibody. Antioxidant effects were also assessed in BBB cells incubated with the extract and H2O2. The anti-inflammatory effects ofS. officinalisextract were further assessed based on clinically-relevant biomarker readouts across 12 human primary cell-based disease models of the BioMAP Diversity PLUS panel.

Results

S. officinalisshowed significant attenuation of the release of most cytokines/chemokines into apical media in LPS-stimulated intestinal cells, but small increases in the release of markers including IL-6, IL-8 in basolateral media; where TNF-α was the only marker to be significantly reduced.S. officinalisattenuated the release of CRP and VCAM-1 from BBB cells under IL-17A induced conditions, and also decreased H2O2induced ROS overproduction in these cells. Phenotypic profiling with the BioMAP Diversity PLUS Panel identified additional anti-inflammatory mediators, and based on a similarity search analysis suggested potential mechanistic similarity to caffeic acid and drugs known to inhibit COMT and MAO activity to modulate monoamine metabolism. Subsequent in vitro assessment showed thatS. officinaliswas able to inhibit the activity of these same enzymes.

Conclusions

S. officinalisextract showed anti-inflammatory effects across multiple human cell lines, which could potentially reduce peripheral inflammation and support cognitive health.S. officinalisextract also showed the ability to inhibit enzymes related to the metabolism of monoamine neurotransmitters, suggesting possible dopaminergic and serotonergic effects acting alongside proposed cholinergic effects to mediate acute cognitive performance benefits previously demonstrated for the extract.
Community nurses’ perspectives on a novel blended training approach: a qualitative study
Authors: Yu Chou Chuen , Le Khanh M. , Low James A.
Published: May 2022

Background

Transiting into the community setting often presents novel difficulties for nurses because the role demands skills that might not have been obtained through usual clinical experience or training. The Ageing-in-Place Community Care Team (AIP-CCT) Community Nurse Basic Training programme was developed to address this learning gap. This training programme prepares nurses to lead in a multi-disciplinary team in delivering patient-centred care to patients with progressive or life-limiting conditions in the community setting. This study evaluated the inaugural training programme provided to a group of nurses from an acute hospital in Singapore.

Methods

Qualitative in-depth interviews were carried out with 13 participants from the training programme three-months after completion of the AIP-CCT Community Nurse Basic Training programme provided by an acute hospital to understand the programme’s impact on their knowledge, skills and clinical practice, as well as barriers and facilitators to learning.

Results

Overall, perception towards the training course was mixed. Course content was found to be relevant, and participants reported that training led to improvement in their practice. However, experienced nurses felt that the content of some modules were lacking in depth. This could have explained why only junior nurses tended to hold favourable attitudes and felt that the training led to increase in their confidence level. Although medical content was assessed favourably, the course was not able to address some of the constraints faced by community nurses such as managing expectations and handling difficult patients in the home care setting. For some modules, face-to-face training was preferred and e-learning components can be improved to increase communication and interaction.

Conclusion

This study provided insights into how a community nurse training programme could be developed to meet the needs of community nurses. The training was able to reinforce skills and knowledge, address knowledge gaps and provide new clinical care approaches and communication strategies. These incremental effects on experienced community nurses could be extrapolated to have greater benefits for inexperienced community nurses. Based on findings of the study, potential changes to the training programme were discussed to improve training outcomes.
Nutritional control regulates symbiont proliferation and life history in coral-dinoflagellate symbiosis
Authors: Cui Guoxin , Liew Yi Jin , Konciute Migle K. , Zhan Ye , Hung Shiou-Han , Thistle Jana , Gastoldi Lucia , Schmidt-Roach Sebastian , Dekker Job , Aranda Manuel
Published: May 2022

Background

The coral-Symbiodiniaceae symbiosis is fundamental for the coral reef ecosystem. Corals provide various inorganic nutrients to their algal symbionts in exchange for the photosynthates to meet their metabolic demands. When becoming symbionts, Symbiodiniaceae cells show a reduced proliferation rate and a different life history. While it is generally believed that the animal hosts play critical roles in regulating these processes, far less is known about the molecular underpinnings that allow the corals to induce the changes in their symbionts.

Results

We tested symbiont cell proliferation and life stage changes in vitro in response to different nutrient-limiting conditions to determine the key nutrients and to compare the respective symbiont transcriptomic profiles to cells in hospite. We then examined the effects of nutrient repletion on symbiont proliferation in coral hosts and quantified life stage transitions in vitro using time-lapse confocal imaging. Here, we show that symbionts in hospite share gene expression and pathway activation profiles with free-living cells under nitrogen-limited conditions, strongly suggesting that symbiont proliferation in symbiosis is limited by nitrogen availability.

Conclusions

We demonstrate that nitrogen limitation not only suppresses cell proliferation but also life stage transition to maintain symbionts in the immobile coccoid stage. Nutrient repletion experiments in corals further confirmed that nitrogen availability is the major factor limiting symbiont density in hospite. Our study emphasizes the importance of nitrogen in coral-algae interactions and, more importantly, sheds light on the crucial role of nitrogen in symbiont life history regulation.
Urchin-like magnetic microspheres for cancer therapy through synergistic effect of mechanical force, photothermal and photodynamic effects
Authors: Wu Kai , Mohsin Ali , Zaman Waqas Qamar , Zhang Zefei , Guan Wenyan , Chu Maoquan , Zhuang Yingping , Guo Meijin
Published: May 2022

Background

Magnetic materials mediated by mechanical forces to combat cancer cells are currently attracting attention. Firstly, the magnetic force penetrates deeper into tissues than the NIR laser alone to destroy tumours. Secondly, the synergistic effect of nano-magnetic-material characteristics results in a viable option for the targeted killing of cancer cells. Therefore, mechanical force (MF) produced by magnetic nanomaterials under low frequency dynamic magnetic field combined with laser technology is the most effective, safe and efficient tool for killing cancer cells and tumour growth.

Results

In this study, we synthesized novel urchin-like hollow magnetic microspheres (UHMMs) composed of superparamagnetic Fe3O4. We demonstrated the excellent performance of UHMMs for killing laryngocarcinoma cancer cells through mechanical force and photothermal effects under a vibrating magnetic field and near-infrared laser, respectively. The killing efficiency was further improved after loading the synthesised UHMMs with Chlorin e6 relative to unloaded UHMMs. Additionally, in animal experiments, laryngocarcinoma solid tumour growth was effectively inhibited by UHMMs@Ce6 through magneto-mechanic force, photothermal and photodynamic therapy.

Conclusions

The biocompatibility and high efficiency of multimodal integrated therapy with the UHMMs prepared in this work provide new insights for developing novel nano therapy and drug loading platforms for tumour treatment. In vivo experiments further demonstrated that UHMMs/Ce6 are excellent tools for strongly inhibiting tumour growth through the above-mentioned characteristic effects.

Graphical Abstract
Monitoring in vivo behavior of size-dependent fluorescent particles as a model fine dust
Authors: Son Taewoong , Cho Youn-Joo , Lee Hyunseung , Cho Mi Young , Goh Byeongwoo , Kim Hyun Min , Hoa Phan Thi Ngoc , Cho Sun-Hee , Park Young-Jun , Park Hye Sun , Hong Kwan Soo
Published: May 2022

Background

There has been growing concern regarding the impact of air pollution, especially fine dust, on human health. However, it is difficult to estimate the toxicity of fine dust on the human body because of its diverse effects depending on the composition and environmental factors.

Results

In this study, we focused on the difference in the biodistribution of fine dust according to the size distribution of particulate matter after inhalation into the body to predict its impact on human health. We synthesized Cy7-doped silica particulate matters (CSPMs) having different particle sizes and employed them as model fine dust, and studied their whole-body in vivo biodistribution in BALB/c nude mice. Image-tracking and quantitative and qualitative analyses were performed on the ex vivo organs and tissues. Additionally, flow cytometric analysis of single cells isolated from the lungs was performed. Smaller particles with a diameter of less than 100 nm (CSPM0.1) were observed to be removed relatively rapidly from the lungs upon initial inhalation. However, they were confirmed to accumulate continuously over 4 weeks of observation. In particular, smaller particles were found to spread rapidly to other organs during the early stages of inhalation.

Conclusions

The results show in vivo behavioral differences that arisen from particle size through mouse experimental model. Although these are far from the human inhalation studies, it provides information that can help predict the effect of fine dust on human health. This study might provide with insights on association between CSPM0.1 accumulation in several organs including the lungs and adverse effect to underlying diseases in the organs.

Graphical Abstract