bluuebunny/crossref_metadata_2025 huggingface dataset:
JUSTIFICATION OF IMAGING IN DENTAL CLINICS: DOES RADIATION KNOWLEDGE PLAY A ROLE?
Authors: Alashban Yazeed , Alohaly Amani , Shubayr Nasser , Albeshan Salman
Published: February 2023

The study aims to investigate dentists’ knowledge and consideration of radiation in relation to their referral practices and use of referral guidelines for imaging in Saudi Arabia. A cross-sectional study was conducted among dentists in different occupational positions in Saudi Arabia. The analysis showed that 68% of the dentists knew of imaging referral guidelines to consult before ordering an imaging exam. However, more than a quarter of the sample did not use them. More than half of responders estimated the average effective dose correctly for intraoral radiography, 44.8% for panoramic radiography, 53.4% for cone beam dental computed tomography (CT) and 47.8% for a study of dental implants/jaws using CT. Limited radiation knowledge and lack of use of proper referral guidelines among dentists indicate that the imaging referral justification process must be improved. The study concluded that radiation knowledge plays a critical role regarding image justification in dental clinics.
Industry-Specific Profile of COVID-19–Related Workers' Compensation Claims in New York State
Authors: Laskaris Zoey , Markowitz Steven B.
Published: February 2023

Objective

This study aimed to characterize the distribution and award status of COVID-19–related workers' compensation (WC) claims in New York State (NYS) for 2020 and 2021.

Methods

Characteristics and filing rates of COVID-19 claims were described by industry, time of illness, and award status. Nursing care facilities' claims were compared with the recorded nursing home staff COVID-19 infections and deaths reported by the Centers for Medicare & Medicaid Services (CMS) during the same period.

Results

Of 29,814 COVID-19 claims, 21.9% were awarded benefits, although 86.8% of the claimants worked in essential industries. Of the 46,505 CMS-recorded COVID-19 infections, 1.4% resulted in a claim and 7.2% of the 111 CMS-recorded deaths received death benefits.

Conclusions

The NYS WC program has provided very modest support to essential workers for the likely work-related burden of the pandemic in NYS.
Incidence of stress among emergency nurses: A systematic review and meta-analysis
Authors: Jiaru Jiao , Yanxue Zheng , Wennv Hao
Published: February 2023

Background:

This study’s main purpose is to evaluate the stress level among emergency nurses systematically.

Methods:

Adhering to the preferred reporting items for systematic reviews and meta-analyses guidelines, nine databases, including PubMed, Cochrane, web of science, Scopus, ScienceDirect, Embase, China National Knowledge Infrastructure, Wanfang, and China biomedical literature service system, were searched to collect cross-sectional studies on emergency nurses. Two researchers independently screened the literature, extracted the data, and evaluated the risk of bias in the included studies.

Results:

From 2655 studies, 21 cross-sectional studies were included, including 4293 subjects. Meta-analysis showed that the incidence of low-level stress was 0.21% (95% CI [0.18–0.24]), the incidence of middle-level stress was 0.46% (95% CI [0.33–0.58]), and the incidence of high-level stress was 0.32% (95% CI [0.22–0.41]), which is mainly at the medium level.

Conclusion:

This review identified the stress level of emergency nurses mainly at the medium level. This result makes nursing administrators pay more attention to the mental health problems of emergency nurses and actively take measures to promote the physical and mental health of emergency nurses and further promote the development of the nursing profession.
Effect of nursing intervention based on continuity model on psychological stress state of patients with rheumatoid arthritis
Authors: Wang Li , Gao Dongmei , Guo Airu
Published: February 2023

To explore the effect of nursing intervention based on continuity model on psychological stress state of patients with rheumatoid arthritis (RA). A total of 128 patients with RA in our hospital from January 2015 to January 2017 were selected and divided into 2 groups by random number table method, 64 cases in each group. The control group received routine nursing, and the observation group received nursing intervention based on continuity model. The physiological function recovery, psychological stress, negative psychology, trait coping style and quality of life were compared between the 2 groups. Compared with the control group, the first time to get out of bed, the time to subside swelling of upper limb and the length of hospital stay in the experimental group were significantly shorter, the sleep time was significantly longer, and the visual analog scale score was significantly lower in the experimental group (all P < .05). After receiving nursing intervention, the psychological stress scores of somatizations, anxiety and depression of all patients were significantly lower than before nursing, and the above scores of the observation group were significantly lower than those of the control group (all P < .05). After nursing, the positive coping score, negative coping score and quality of life score of all patients were significantly higher than those before nursing, and the above scores of the observation group were significantly higher than those of the control group (all P < .05). Nursing intervention based on continuity model can promote the recovery of physical function, improve psychological stress and negative emotions, and improve the quality of life of patients with RA, which is worthy of clinical application.
Lung and bone metastases patterns in osteosarcoma: Chemotherapy improves overall survival
Authors: Tang Liyuan , Liu Binbin
Published: February 2023

Osteosarcoma (OS) is a malignant tumor originating from the mesenchymal tissue. Simultaneous reports of lung and bone metastases (BM) in OS are rare in the literature. A total of 353 new cases of lung metastases (LM), 93 new cases of BM, and 59 new cases of LM and BM were diagnosed in the Surveillance, Epidemiology and End Results (SEER) database from 2010 to 2019. Univariate and multivariate logistic regression analyses were used to identify risk factors for LM and/or BM, and Cox regression analyses were performed to identify the prognostic factors for LM and/or BM. Kaplan–Meier (K–M) curves and log-rank tests were used to analyze the overall survival of patients with LM and/or BM. LM was diagnosed in 353 patients. Female sex, tumor size >100 mm, telangiectatic OS type, central OS type, N1 stage, other locations, BM, surgical treatments, radiotherapy and chemotherapy were significantly correlated with LM. 93 patients were diagnosed with BM. 25 to 59 years old, T1 stage, presence of LM, liver metastases, radiotherapy, and surgical treatments were significantly correlated with the BM. 59 patients were diagnosed with LM and BM. The chondroblastic OS type, small cell OS type, T1 stage, N1 stage, other locations, liver metastases, radiotherapy, and surgical treatments were significantly correlated with LM and BM. Metastases, radiotherapy, and surgery at the primary site were significantly associated with LM and/or BM. Chemotherapy at the primary site has been shown to be effective in improving the survival rate of LM and/or BM. Of the OS patients with LM, 61.47% died, and older age, BM, no surgery, and no chemotherapy were harmful to survival. 72.04% of OS patients with BM died, and N1 stage, no surgery, and no chemotherapy were harmful for survival. 69.49% of OS patients with LM and BM died, and older age and no chemotherapy were harmful for survival.
Factors associated with hospital choice of Chinese patients: A meta-analysis
Authors: Che Xiaoming , Chen Weidong , Wu Xuehua , Lin Pengcheng
Published: February 2023

Introduction:

While China continues to optimize the tiered medical care system, the status quo of patients preferring higher-tier hospitals has not improved. Herein, we aimed to analyze the factors influencing patients’ healthcare choices in China and to provide an evidentiary basis for optimizing the tiered healthcare system.

Patient concerns:

Most patients are concerned that primary care services will not provide appropriate treatment or health advice. Also, patients consider medical technology, cost, experience, quality of service and convenience before seeking care.

Outcomes:

A total of 18 cross-sectional studies involving 10,348 samples were included. After combining the effect size, the factors affecting the choice of Chinese patients for medical treatment were medical technology and quality (49%), the convenience of medical treatment (37%), medical expenses (23%), hospital service quality (20%) medical insurance policy (16%), and acquaintance relationship (11%).

Conclusion:

The selection of medical treatment for Chinese residents is primarily influenced by medical technology and convenience. The medical insurance policy does not provide sufficient guidance. Furthermore, the tiered medical care system should be optimized to improve the usability of primary care services.
Diagnostic accuracy of shear wave elastography for endometrial cancer: A meta-analysis
Authors: Bian Jinyi , Li Jingnan , Liu Yangcheng
Published: February 2023

Background:

This meta-analysis aimed to identify the accuracy of shear wave elastography (SWE) in the diagnosis of endometrial cancer (EC).

Methods:

We searched the PubMed, Cochrane Library, and chinese biomedical literature database from inception to September 30, 2022. Meta-analysis was conducted using STATA version 14.0 and Meta-Disc version 1.4 software. We calculated summary statistics for sensitivity (Sen), specificity (Spe), positive and negative likelihood ratio (LR+/LR−), diagnostic odds ratio (DOR), and receiver operating characteristic (SROC) curves.

Results:

Eight studies that met all the inclusion criteria were included in this meta-analysis. A total of 432 patients with EC and 548 with benign endometrial lesions were assessed. All endometrial lesions were histologically confirmed by SWE. The pooled Sen was 0.91 (95% confidence interval [CI] = 0.83–0.95); the pooled Spe was 0.90 (95% CI = 0.86–0.93); the pooled LR+ was 9.10 (95% CI = 6.20–13.35); the pooled negative LR− was 0.10 (95% CI = 0.05–0.20); the pooled DOR of SWE in the diagnosis of EC was 90.73 (95% CI = 36.62–804.5). The area under the SROC curve was 0.95 (95% CI = 0.93–0.97). No evidence of publication bias was found (t = 0.98, P = .37).

Conclusion:

Our meta-analysis indicates that SWE may have high diagnostic accuracy in the differential diagnosis of benign and malignant endometrial lesions. Thus, SWE may be a useful tool for the diagnosis of EC.
3D-printed individualized navigation template versus the fluoroscopic guide to defining the femoral tunnel for medial patellofemoral ligament reconstruction: A retrospective study
Authors: Zhang Wenhao , Mou Limin , Zhang Shiping , Liu Wei , Remila Aimaiti , Han Mingzhan , Xiang Wenyuan , Fang Rui
Published: February 2023

During medial patellofemoral ligament (MPFL) reconstruction, fluoroscopic determination of the femoral tunnel point is the most common method. However, there is a decrease in tunnel position accuracy due to rotation of the femur during fluoroscopy, as well as the damage to the operator from multiple fluoroscopies, whereas the 3D-printed individualized navigation template is not affected by this factor. This study focuses on the accuracy and early clinical efficacy of 2 different ways to determine the femoral tunnel (Schöttle point) for double-bundle isometric MPFL reconstruction. This is a retrospective study, conducted between 2016 and 2019, in which 60 patients with recurrent patellar dislocation were divided into 2 groups: 30 with MPFL reconstruction at the Schöttle point determined by 3D-printed individualized navigation template (group A) and 30 with MPFL reconstruction at the Schöttle point determined by fluoroscopic guidance (group B). The changes in patella congruence angle and patella tilt angle before and after surgery were assessed using computed tomography scans of the knee, knee function was assessed using the Kujala knee score and the international knee documentation committee (IKDC) score, and the 2 approaches were compared for the intraoperative establishment of the femoral tunnel position at a distance from Schöttle point. At a minimum of 3 years follow-up, patella tilt angle and patella congruence angle returned to normal levels and were statistically different from the preoperative range, with no significant differences between the 2 groups at the same period, and Kujala and IKDC scores of knee function were significantly improved in both groups after surgery. The mean Kujala and IKDC scores were statistically different between groups A and B at 3 and 6 months postoperatively. No statistically significant differences were seen between the 2 groups at the final follow-up. Both femoral tunnel localization approaches for double-bundle isometric MPFL reconstruction resulted in good knee function. At no < 3 years of follow-up, the use of a 3D-printed individualized navigation template did result in more accurate isometric points and higher knee function scores in the early postoperative period.
Risk factors for urinary incontinence during pregnancy among nulliparous women in the United Arab Emirates
Authors: Elbiss Hassan M , Osman Nawal , Abu-Zidan Fikri M.
Published: February 2023

Urinary incontinence (UI), which affects the quality of life, is associated with different risk factors during pregnancy. We aimed to study the risk factors related to UI during pregnancy among nulliparous women in the UAE. This is a prospective descriptive survey, which included all nulliparous women after the first 24 weeks’ gestation from 2012 to 2014 in a teaching hospital in the UAE. Participants were interviewed face-to-face, using a structured and pre-tested questionnaire and divided into 2 groups: those with UI and those without it. Factors which were statistically significant (P < .05) between the 2 groups were entered into an logistic regression backward logistic regression model to define the factors predicting UI. Five hundred one participants were interviewed. UI occurred in 106/501 (21.2%). The 2-sample comparison analysis showed that urinary tract infection (UTI) (47.2% vs 34.4%, P = .018) and its number of attacks (P = .007), chronic cough (28.3% vs 13.9%, P < .001) and chronic constipation (34.9% vs 19%, P < .001) were statistically significant between those who had UI and those who did not. The logistic regression backward logistic regression model showed that the risk factors which predicted UI were chronic constipation (P = .003), chronic cough (P = .008), and the number of UTI attacks (P = .036). UI affects one-fifth of nulliparous women in the UAE. Chronic cough, constipation, and repeated UTI infection, significantly increase the odds of UI during pregnancy. Addressing these risk factors may reduce the risk of UI.
Diagnostic value of pleural fluid SMRP, CA125, MMP-7, and MMP-9 in malignant pleural effusion
Authors: Han Gaohua , Li Jun , Liu Xinbo , Guo Ruyue
Published: February 2023

This study aimed to investigate the clinical value of mesothelin soluble related peptide (SMRP), cancer antigen 125 (CA125), matrix metalloproteinase-7 (MMP-7), and matrix metalloproteinase-9 (MMP-9) in benign and malignant pleural exudative effusion. A total of 105 adult patients with pleural exudative effusion admitted in our hospital from December 2019 to December 2020 were selected. Patients were divided into the benign group (n = 60) and the malignant group (n = 45) according to their condition. The levels of SMRP, CA125, MMP-7, and MMP-9 in the pleural effusion were determined by enzyme linked immunosorbent assay. Receiver operating characteristic curves were used to analyze the individual and combined predictive value of SMRP, MMP-7, MMP-9, and CA125 levels. In the malignant group, the SMRP, CA125, MMP-7, and MMP-9 levels were all significantly higher than those in benign group (P = .01). The detection efficiency of the 4 indicators in the combined diagnosis were higher than that of single index and combination of any 2 indices. There was a moderate positive correlation between SMRP and CA125 and MMP-7 in malignant pleural effusion. The correlation between MMP-7 and MMP-9 was moderately positive. The diagnostic efficacy of SMRP combined with CA125, MMP-7, and MMP-9 in pleural effusion for malignant pleural effusion and BPE are better than single index, which has certain clinical values for the selection of early intervention scheme for BPE patients.
Effects of electrical muscle stimulation on core muscle activation and physical performance in non-athletic adults: A randomized controlled trial
Authors: Yoo Hyun-Joon , Park Sangsoo , Oh Sejun , Kang Munjeong , Seo Yongha , Kim Byung Gon , Lee Sang-Heon
Published: February 2023

Background:

Electrical muscle stimulation (EMS) activates muscles through electrical currents, resulting in involuntary muscle contractions. This study aimed to evaluate the immediate clinical effects of superimposing EMS on strength training compared with conventional exercise in healthy non-athletic adults.

Methods:

This study was a randomised, controlled, parallel-group trial conducted at a single centre. Forty-one healthy young volunteers were recruited and randomised into two groups: strengthening with superimposed EMS (S+E) and strengthening (S) groups. All participants underwent the 30 minutes of strength training program, three times a week for 8 weeks, consisting of core muscle exercises. Additionally, the S+E group received EMS during training, which stimulated the bilateral abdominal, gluteus, and hip adductor muscles. As the primary outcome measure, we evaluated the changes in muscle thickness, including the abdominal, gluteal, and hip adductor muscles, using ultrasound. Muscle thickness was measured in both resting and contracted states. For secondary outcomes, physical performance (Functional Movement System score, McGill’s core stability test, and hip muscle power) and body composition analysis were evaluated. All assessments were performed at the beginning and end of the intervention.

Results:

39 participants (S+E group = 20, S group = 19) completed the study. The clinical characteristics and baseline functional status of each group did not differ significantly between the groups. After completion of the training, the S+E group showed more efficient contraction in most of the evaluated muscles. The resting muscle thickness did not differ significantly between the groups; however, the contracted muscle thickness in the S+E group was higher than that in the S group (p < 0.05). Physical performance and body composition were not significantly different between the two groups. No intervention-related complications were reported during the study.

Conclusion:

EMS seems to be a safe and reasonable modality for improving physical fitness in healthy individuals.
Comparative study of the genomic landscape and tumor microenvironment among large cell carcinoma of the lung, large cell neuroendocrine of the lung, and small cell lung cancer
Authors: Li Fanghua , Yang Yue , Xu Ying , Li Ke , Song Linhong , Xue Yang , Dong Dandan
Published: February 2023

Deciphering the genomic profiles and tumor microenvironment (TME) in large cell carcinomas of the lung (LCC), large cell neuroendocrine of the lung (LCNEC), and small cell lung cancer (SCLC) might contribute to a better understanding of lung cancer and then improve outcomes. Ten LCC patients, 12 LCNEC patients, and 18 SCLC patients were enrolled. Targeted next-generation sequencing was used to investigate the genomic profiles of LCC, LCNEC, and SCLC. Tumor-infiltrating lymphocytes (TILs) within cancer cell nests and in cancer stroma were counted separately. Precise 60% of LCNEC patients harbored classical non-small cell lung cancer driver alterations, occurring in BRAF, KRAS, ROS1, and RET. More than 70% of SCLC patients harbored TP53-RB1 co-alterations. Moreover, 88.9%, 40%, and 77.8% of LCC, LCNEC, and SCLC cases had a high tumor mutation burden level with more than 7 mutations/Mb. Furthermore, high index of CD68+ CD163+ (TILs within cancer cell nests/ TILs within cancer cell nests and in cancer stroma, P = .041, 548 days vs not reached) and CD163+ TILs (P = .041, 548 days vs not reached) predicted a shorter OS in SCLC. Our findings revealed the distinct genomic profiles and TME contexture among LCC, LCNEC, and SCLC. Our findings suggest that stratifying LCNEC/SCLC patients based on TME contexture might help clinical disease management.
Development of de novo nonalcoholic fatty liver disease following pancreatectomy
Authors: Patel Vanisha , Shah Parth , Ludwig Daniel R. , Hammill Chet W. , Ashkar Motaz
Published: February 2023

De novo non-alcoholic fatty liver disease (NAFLD) after pancreatectomy is a recognized phenomenon; however, its pathophysiology is poorly understood. This study aimed to determine the incidence and identify peri-operative risk factors for the development of de novo NAFLD within various pancreatectomy groups. This single-center retrospective cohort study included patients who underwent pancreatectomy between 2000 and 2020. The incidence rate of de novo NAFLD and time to diagnosis were recorded across patients with malignant versus benign indications for pancreatectomy. The overall incidence of de novo NAFLD after pancreatectomy was 17.5% (24/136). Twenty-one percent (20/94) of patients with malignant indications for surgery developed NAFLD compared to 9.5% (4/42) with benign indications (P = .09). Time to development of hepatic steatosis in the malignant group was 26.4 months and was significantly shorter by an average of 6 months when compared to the benign group (32.8 months, P = .03). Higher pre-operative body mass index was associated with new-onset NAFLD (P = .03). Pre-operative body mass index is a significant predictor for de novo NAFLD and highlights a group that should be closely monitored post-operatively, especially after resections for pancreatic malignancy.
Predictive factors analysis of cesarean scar pregnancy treated by local injection of Lauromacrogol combined with curettage
Authors: Huang Jianxia , He Pei , Li Dingheng , Zhou Jianwei
Published: February 2023

To explore factors related to local injection of Lauromacrogol combined with curettage in the treatment of cesarean scar pregnancy. A total of 24 successful and 8 unsuccessful cases were included. The age, gravidity, parity, times of cesarean section, interval from the last cesarean section, preoperative human chorionic gonadotropin (HCG), HCG on the first day after operation, decreasing rate of HCG on the first day after operation, average diameter of gestational sac, and preoperative vaginal bleeding days were analyzed. There were no significant differences of age, gravidity, parity, previous cesarean section times between groups. The differences of preoperative HCG, HCG on the first day after operation, the decreasing rate of HCG, gestational sac diameter, preoperative vaginal bleeding days were statistically significant between groups. The interval from the last cesarean section and the decreasing rate of HCG were protective factors, while the mean diameter of gestational sac and period of vaginal bleeding before operation were risk factors for the success of the treatment. The mean diameter of gestational sac owned the best predictive value.
Dynamic coagulofibrinolytic responses under long-term VV-ECMO management without anticoagulation in a COVID-19-ARDS patient: A case report
Authors: Matsumoto Hironori , Kikuchi Satoshi , Murata Satoru , Ohshita Muneaki , Harima Yutaka , Annen Suguru , Mukai Naoki , Nakabayashi Yuki , Ogawa Shirou , Okita Mitsuo , Takeba Jun , Sato Norio
Published: February 2023

Rationale:

Venovenous extracorporeal membrane oxygenation (ECMO) is recommended for the treatment of critically ill patients with acute respiratory distress syndrome due to coronavirus disease 2019 (COVID-19). However, ECMO management can cause both bleeding and thrombotic complications. There are insufficient coagulofibrinolytic data for appropriate ECMO management in patients with COVID-19.

Patient concerns:

A 48-year-old man with severe COVID-19-acute respiratory distress syndrome underwent long-term venovenous ECMO management for 48 days. Refractory oronasal bleeding developed on day 13, so the administration of unfractionated heparin was ceased for 29 days.

Diagnosis:

The patient showed dynamic coagulofibrinolytic responses associated with ECMO management, as shown by fibrin/fibrinogen degradation products, soluble fibrin, thrombin-antithrombin complex, and plasmin-α2-plasmin inhibitor complex elevations, suggesting the development of ECMO-induced coagulopathy.

Interventions:

We assessed coagulofibrinolytic markers to decide the appropriate timing for controlling excessive activation of coagulation by exchanging ECMO circuits. Moreover, viscoelastic hemostatic assays were used for adequate transfusion of blood products.

Outcomes:

Safe long-term ECMO management was completed, which was withdrawn on day 48. The patient was weaned off mechanical ventilation on day 57 and was transferred to another hospital for rehabilitation.

Lessons:

Monitoring the coagulofibrinolytic status using markers and viscoelastic hemostatic assays may be effective for safe long-term ECMO management even without anticoagulant therapy.
Intelligence as proxy phenotype providing insight into the heterogeneity of schizophrenia
Authors: Ren Hongyan , Yin Meiyu , Wang Qiang , Deng Wei , Ma Xiaohong , Zhao Liansheng , Li Xiaojing , Sham Pak , Li Ming , Li Shiwu , Li Tao
Published: February 2023

Schizophrenia is a mental disorder constituting different symptom clusters. Its high heterogeneity in both pathophysiology and clinical manifestations hampered effective prevention and treatment. It has long been recognized that one of the core features of schizophrenia is its intellectual decline. Using the proxy-phenotype method (PPM), we tried to identify core genes, the expression of which in the dorsal lateral prefrontal cortex (DLPFC) showed a genetic dependence between intelligence (IT) and schizophrenia (SCZ). The result revealed ten genes of genetic dependence in their genetic expression in DLPFC between IT and schizophrenia. Further, a clustering analysis using the expression matrix of these ten genes identified four biotypes in our patient group. Subsequent phenotypic profiling of these four biotypes indicated a significant difference in working memory capacity, the gray matter volume (GMV) of five brain regions (lLimbicA_TempPole_2, rLimbicA_TempPole_2 rLimbicB_OFC_1, rContA_IPS_1 and rContB_PFClv_1), structural network and psychopathology. An in-vitro investigation of the biological functions of these core genes indicated their potentially critical role in neuronal growth, especially in dendritic spines. Our current study employed a novel statistical approach to identify the core genes associated with IT and explore the possibility of using the expression knowledge of these core genes to reduce the heterogeneity of schizophrenia. The results pinpointed one biotype that exhibited significant deficits in working memory, GMV in limbic and prefrontal areas, and also showed psychopathology of core negative symptom and worse outcomes.
Integrative multi-ancestry genetic analysis of gene regulation in coronary arteries prioritizes disease risk loci
Authors: Hodonsky Chani J. , Turner Adam W. , Khan Mohammad Daud , Barrientos Nelson B. , Methorst Ruben , Ma Lijiang , Lopez Nicolas G. , Mosquera Jose Verdezoto , Auguste Gaëlle , Farber Emily , Ma Wei Feng , Wong Doris , Onengut-Gumuscu Suna , Kavousi Maryam , Peyser Patricia A. , van der Laan Sander W. , Leeper Nicholas J. , Kovacic Jason C. , Björkegren Johan L.M. , Miller Clint L.
Published: February 2023

Genome-wide association studies (GWAS) have identified hundreds of genetic risk loci for coronary artery disease (CAD). However, non-European populations are underrepresented in GWAS and the causal gene-regulatory mechanisms of these risk loci during atherosclerosis remain unclear. We incorporated local ancestry and haplotype information to identify quantitative trait loci (QTL) for gene expression and splicing in coronary arteries obtained from 138 ancestrally diverse Americans. Of 2,132 eQTL-associated genes (eGenes), 47% were previously unreported in coronary arteries and 19% exhibited cell-type-specific expression. Colocalization analysis with GWAS identified subgroups of eGenes unique to CAD and blood pressure. Fine-mapping highlighted additional eGenes of interest, includingTBX20andIL5. Splicing (s)QTLs for 1,690 genes were also identified, among whichTOR1AIP1andULK3sQTLs demonstrated the importance of evaluating splicing events to accurately identify disease-relevant gene expression. Our work provides the first human coronary artery eQTL resource from a patient sample and exemplifies the necessity of diverse study populations and multi-omic approaches to characterize gene regulation in critical disease processes.

Study Design Overview
The association between proportion of night shifts and musculoskeletal pain and headaches in nurses: a cross-sectional study
Authors: Stavås Jon Are , Nilsen Kristian Bernhard , Matre Dagfinn
Published: February 2023

Objectives

To investigate whether a higher proportion of night shifts is associated with a higher occurrence of musculoskeletal pain and headaches. Furthermore, to investigate whether sleep duration can mediate this potential association.

Method

The study included 684 nurses in rotating shift work (day, evening, night) who responded to a daily questionnaire about working hours, sleep, and pain for 28 consecutive days. The data were treated as cross-sectional data.

Results

A negative binomial regression analysis adjusted for age and BMI revealed that working a higher proportion of night shifts is not associated with a higher occurrence of musculoskeletal pain and headaches. On the contrary, those working ≥ 50 % night shifts had a significantly lower occurrence of pain in the lower extremities than those who worked <25 % night shifts (IRR 0.69 95 % CI 0.51, 0.94). There was no indication of a mediation effect with total sleep time (TST).

Conclusion

The results of this study indicate that working a higher monthly proportion of night shifts is not associated with a higher occurrence of musculoskeletal pain and headaches.

What is already known on this topic?

A few studies have investigated the association between proportion of night shifts and musculoskeletal pain and headaches, but the findings are conflicting, and the studies are largely based on retrospective questionnaires.

What this study adds

This study gives further knowledge about the association between proportion of night shifts and musculoskeletal pain and headaches.

How this study might affect research, practice or policy

The results have implications for the design of future studies on the effect of shift work on musculoskeletal pain and headache. The negative effect of night shifts are not necessarily dose-dependent, and real-life studies must seek to account for the “healthy worker effect”.
Clonal Hematopoiesis of Indeterminate Potential Status is Associated with Left Main Artery Stenosis
Authors: Heimlich J. Brett , Raddatz Michael A. , Wells John , Vlasschaert Caitlyn , Olson Sydney , Threadcraft Marcus , Foster Kristoff , Boateng Emmanuel , Umbarger Kelsey , Su Yan Ru , Roden Dan M. , Barker Colin M. , Bick Alexander G.
Published: February 2023

Clonal hematopoiesis of indeterminate potential (CHIP) occurs as a result of acquired mutations in bone marrow progenitor cells. CHIP confers a twofold risk of atherosclerotic cardiovascular disease (ASCVD). However, there is limited data regarding specific cardiovascular phenotypes in this population. We recruited patients from the Vanderbilt University Medical Center cardiac catheterization laboratory and performed next generation sequencing to determine CHIP status. Multivariable logistic regression models and proportional odds models were used to assess the association between CHIP status and coronary angiography. We find nearly 1 in 5 patients undergoing coronary angiography have a CHIP mutation. Those with CHIP had a higher risk of having left main coronary artery disease compared to non-CHIP carriers. We additionally find that those with a specific CHIP mutation, ten eleven translocase 2(TET2)has a larger effect size on left main stenosis compared with other CHIP mutations. This is the first description of a specific atherosclerotic phenotype in CHIP and serves as a basis for understanding enhanced morbidity and mortality in CHIP.
The long COVID evidence gap: comparing self-reporting and clinical coding of long COVID using longitudinal study data linked to healthcare records
Authors: Knuppel Anika , Boyd Andy , Macleod John , Chaturvedi Nishi , Williams Dylan M
Published: February 2023

The term “long COVID” (LC) was coined in spring 2020 by individuals with ongoing symptoms following COVID-19, but it took until December 2020 for clinical codes to be created in order to record persistent post-COVID-19 illness and referrals within electronic health records (EHRs). Analysis of whole-population EHR databases have helped understand the epidemiology of LC; yet concerns exist about the completeness of accessible EHRs for LC. UK longitudinal population studies (LPS) collected self-reported data on COVID-19 and LC from early 2020 and deposited these data in the UK Longitudinal Linkage Collaboration (UK LLC) research database where they are systematically linked to the participants EHRs. Comparisons of LPS reported LC with recorded LC in the EHRs of the same individuals may be helpful in understanding the epidemiology of emerging conditions such as LC. We used data from 10 UK LPS in the UK LLC to investigate whether participants self-reporting LC had a LC diagnosis or referral code in their English EHR after 10 to 22 months of follow up. Of 6412 participants with COVID-19 symptom duration data and linkage to health records, 898 (14.0%) self-reported LC of any severity in LPS surveys. Among these, just 42 (4.7%; 95% CI: 3.5, 6.3) were identified with LC-related codes in EHRs. In individuals reporting debilitating LC, this proportion was only marginally higher (5.6%; 95% CI: 3.7, 8.3). Our data show a striking discrepancy between LC as perceived and reported by participants in LPS and evidence of LC recorded in their EHRs; and that this discrepancy was patterned by ethnicity and possibly by indicators of deprivation. Self-reported symptoms may not be reflected in coded EHRs due to factors including variations in individuals help seeking behaviours, clinician coding practices and the availability of appropriate codes. However, these considerations appear unlikely to provide a complete explanation for the substantial observed reporting discrepancy. These results may indicate substantial unmet clinical need, in keeping with patient reports of difficulties accessing healthcare and sub-optimal recognition of, and response to, their illness when they do. They may also indicate potential shortcomings of epidemiological research on LC based on EHR- or LPS-based ascertainment alone and illustrate the value of triangulation between LPS and EHR data where linked and made available through resources such as the UK LLC.
SpaDecon: cell-type deconvolution in spatial transcriptomics with semi-supervised learning
Authors: Coleman Kyle , Hu Jian , Schroeder Amelia , Lee Edward B. , Li Mingyao
Published: February 2023

Spatially resolved transcriptomics (SRT) has advanced our understanding of the spatial patterns of gene expression, but the lack of single-cell resolution in spatial barcoding-based SRT hinders the inference of specific locations of individual cells. To determine the spatial distribution of cell types in SRT, we present SpaDecon, a semi-supervised learning approach that incorporates gene expression, spatial location, and histology information for cell-type deconvolution. SpaDecon was evaluated through analyses of four real SRT datasets using knowledge of the expected distributions of cell types. Quantitative evaluations were performed for four pseudo-SRT datasets constructed according to benchmark proportions. Using mean squared error and Jensen-Shannon divergence with the benchmark proportions as evaluation criteria, we show that SpaDecon performance surpasses that of published cell-type deconvolution methods. Given the accuracy and computational speed of SpaDecon, we anticipate it will be valuable for SRT data analysis and will facilitate the integration of genomics and digital pathology.
Proposed Methodology for Reducing Bias in Structural MRI Analysis in the Presence of Lesions: Data from a Pediatric Traumatic Brain Injury Cohort
Authors: Griffiths-King Daniel , Shephard Adam , Novak Jan , Catroppa Cathy , Anderson Vicki A. , Wood Amanda G.
Published: February 2023

Traumatic brain injury can lead to multiple pathologic features, including brain lesions, which are visible on magnetic resonance imaging (MRI). These resulting heterogenous lesions can present a difficulty for several standard approaches to neuroimaging, resulting in bias and error in subsequent quantitative measurements. Thus, cases presenting with lesions on MRI may be excluded from analyses, biasing samples across the research field. We outline a potential solution to this issue in the case of Freesurfer, a popular neuroimaging tool for surface-based segmentation of brain tissue from structural MRI. The proposed solution involves two-steps, a) Pre-processing: Enantiomorphic Lesion-Filling and b) Post-processing: Lesion Labelling. We applied this methodology to 14 pediatric TBI cases which presented with lesions on T1w MRI. Following qualitative inspection of these cases after implementation of the approach, 8 out of 14 cases were retained as being of sufficient quality. In brief, we have presented here an adapted pipeline for processing structural MRI (sMRI) of patients who have experienced a TBI using the Freesurfer software package. This approach aims to mitigate potential lesion-induced biases that exist beyond the locality of the pathological tissue, even in the contralesioned hemisphere.
Coupling allows robust redox circadian rhythms despite heterogeneity and noise
Authors: del Olmo Marta , Kalashnikov Anton , Schmal Christoph , Kramer Achim , Herzel Hanspeter
Published: February 2023

Circadian clocks are endogenous oscillators present in almost all cells that drive daily rhythms in physiology and behavior. There are two mechanisms that have been proposed to explain how circadian rhythms are generated in mammalian cells: through a transcription-translation feedback loop (TTFL) and based on oxidation/reduction reactions, both of which are intrinsically stochastic and heterogeneous at the single cell level. In order to explore the emerging properties of stochastic and heterogeneous redox oscillators, we simplify a recently developed kinetic model of redox oscillations to an amplitude-phase oscillator with ‘twist’ (period-amplitude correlation) and subject to Gaussian noise. We show that noise and heterogeneity alone lead to fast desynchronization, and that coupling between noisy oscillators can establish robust and synchronized rhythms with amplitude expansions and tuning of the period due to twist. Coupling a network of redox oscillators to a simple model of the TTFL also contributes to synchronization, large amplitudes and fine-tuning of the period for appropriate interaction strengths. These results provide insights into how the circadian clock compensates randomness from intracellular sources and highlight the importance of noise, heterogeneity and coupling in the context of circadian oscillators.
Two dimensions of chemical variation of the human microbiome across body sites and in COVID-19 patients
Authors: Dick Jeffrey M.
Published: February 2023

A better understanding of dysbiosis is a major goal of human microbiome studies, but more knowledge about chemical effects on microbial communities is needed. Oxidation-reduction and hydration-dehydration reactions are chemical processes that are important for physiological functions and, it is hypothesized here, may also influence the elemental composition of microbial proteins. Chemical metrics of biomolecules relevant to these processes are carbon oxidation state (ZC) and stoichiometric hydration state. I calculated these metrics for protein sequences derived from microbial genomes (multiplied by 16S rRNA-based taxonomic abundances to obtain community reference proteomes), shotgun metagenomes, and metaproteomes. Metaproteomes of gut communities are reduced (i.e., have lowerZC) compared to oral communities. In contrast, community reference proteomes have lowerin gut compared to nasal, skin, and oral communities, and metagenomes for gut and oral communities exhibit the same trend. The chemical differences for metaproteomes may be explained by physiological adjustment of protein expression levels to anaerobic, reducing conditions in the gut, whereas metagenomes and reference proteomes may reflect evolutionary adaptation to dehydrating conditions brought on by intestinal absorption of water. Community reference proteomes, metagenome-assembled genomes (MAGs), and metaproteomes compiled from various studies yield a common trend of more reduced proteins in gut communities of COVID-19 patients compared to controls. These chemical differences imply more reducing conditions in the guts of COVID-19 patients, a finding that contrasts with oxidative conditions that have been previously associated with dysbiosis in inflammatory bowel disease and HIV infection. These results reveal how the human microbiome is shaped by multiple chemical factors over a range of timescales and suggest a new strategy for using multi-omics data to infer changes in gut redox conditions in COVID-19 patients.
Divergent patterns of meiotic double strand breaks and synapsis initiation dynamics suggest an evolutionary shift in the meiosis program between American and Australian marsupials
Authors: Valero-Regalón F. Javier , Solé Mireia , López-Jiménez Pablo , Valerio-de Arana María , Martín-Ruiz Marta , de la Fuente Roberto , Marín-Gual Laia , Renfree Marilyn B. , Shaw Geoff , Berríos Soledad , Fernández-Donoso Raúl , Waters Paul D. , Ruiz-Herrera Aurora , Gómez Rocío , Page Jesús
Published: February 2023

In eutherian mammals, hundreds of programmed DNA double-strand breaks (DSBs) are generated at the onset of meiosis. The DNA damage response is then triggered. Although the dynamics of this response is well studied in eutherian mammals, recent findings have revealed different patterns of DNA damage signaling and repair in marsupial mammals. To better characterize these differences, here we analyzed synapsis and the chromosomal distribution of meiotic DSBs markers in three different marsupial species (Thylamys elegans, Dromiciops gliorides, andMacropus eugenii) that represent South American and Australian Orders. Our results revealed inter-specific differences in the chromosomal distribution of DNA damage and repair proteins, which were associated with differing synapsis patterns. In the American speciesT. elegansandD. gliroides, synapsis progressed exclusively from the chromosomal ends towards interstitial regions. This was accompanied by sparse H2AX phosphorylation, mainly accumulating at chromosomal ends, which appeared conspicuously polarized in abouquetconfiguration at early stages of prophase I. Accordingly, RAD51 and RPA were mainly localized at chromosomal ends throughout prophaseI in both American marsupials, likely resulting in reduced recombination rates at interstitial positions. In sharp contrast, synapsis initiated at both interstitial and distal chromosomal regions in the Australian representativeM. eugenii, γH2AX had a broad nuclear distribution, and RAD51 and RPA foci displayed an even chromosomal distribution. Given the basal evolutionary position ofT. elegans, it is likely that the meiotic features reported in this species represent an ancestral pattern in marsupials and that a shift in the meiotic program occurred after the split ofD. gliroidesand the Australian marsupial clade. Our results open intriguing questions about the regulation and homeostasis of meiotic DSBs in marsupials. The low recombination rates observed at the interstitial chromosomal regions in American marsupials can result in the formation of large linkage groups, thus having an impact in the evolution of their genomes.
Measuring chondrocyte viability of articular cartilage based on label-free two-photon microscopy and deep learning image analysis
Authors: Fan Hongming , Xu Pei , Chen Xun , Li Yang , Hsu Jennifer , Le Michael , Zhang Zhao , Ye Emily , Gao Bruce , Ye Tong
Published: February 2023

Objective

Chondrocyte viability (CV) is an important indicator of articular cartilage health. Two-photon excitation autofluorescence (TPAF) and second harmonic generation (SHG) microscopy provide a label-free method for imaging chondrocytes. In this study, we propose an automated assessment of CV using deep learning cell segmentation and counting based on acquired TPAF/SHG images.

Design

Label-free TPAF/SHG images of cartilage samples from rats and porcine were acquired using both commercial and home-built two-photon microscopes, respectively. TPAF/SHG images were merged to form RGB color images with red, green, and blue channels assigned to TPAF (two channels) and SHG signals, respectively. To make the training datasets for the deep learning networks, individual chondrocyte areas on the RGB color images were manually circled and live or dead chondrocytes were validated by using Calcein-AM and Ethidium homodimer-1 dye labeling. We first built a chondrocyte viability network (MCV-Net) using the Mask R-CNN architecture, which could provide individual segmented cellular areas with live or dead status. Wiener deconvolution preprocessing was added before the input of MCV-Net to improve the accuracy of the CV analysis, forming the Wiener deconvolution CV network (wMCV-Net).

Results

Training (300 images) and test (120 images) datasets were built for rats and porcine cartilage respectively. Wiener deconvolution could improve the Peak Signal-to-Noise Ratio (PSNR) for 30-40%. We demonstrated that both MCV-Net and wMCV-Net significantly improved the accuracy of the CV measurement.

Conclusion

A custom desktop TPAF/SHG microscope was used in collaboration with deep learning algorithm wMCV-Net based label-free method to assess the CV and get 95% accuracy with both rats and porcine samples.