bluuebunny/crossref_metadata_2025 huggingface dataset:
Diabetes mellitus und Demenz
Authors: Kopf Daniel
Published: October 2022

Diabetes mellitus und Demenz werden mit zunehmendem Lebensalter häufiger, sind wegen der demografischen Entwicklung in Deutschland auf dem Vormarsch und beeinträchtigen die Lebensqualität erheblich. Sie hängen auch in ihrer Krankheitsentstehung zusammen: Bei Demenz liegt eine Insulinresistenz des Gehirns vor. Das Zusammentreffen der beiden Störungen erschwert die Behandlung erheblich, sodass neue Therapieziele und Konzepte erforderlich sind.
Typ-2-Diabetes mellitus und gastrointestinale Krebsvorsorge
Authors: Scherübl Hans
Published: October 2022

In Deutschland sind mehr als 8 Millionen Menschen diabeteskrank. Patienten mit Typ-2-Diabetes mellitus (T2D) haben ein erhöhtes Risiko für gastrointestinale Adenokarzinome, sie erkranken z. T. früher und weisen i. d. R. ein ungünstigeres, tumorspezifisches 5-Jahres-Überleben auf als Stoffwechselgesunde. Krebs ist nun die Haupttodesursache von Menschen mit T2D. Die chronische Hyperglykämie und die Insulinresistenz können das Wachstum von gastrointestinalen Tumoren begünstigen. So kann T2D Adenokarzinome des Dickdarms, der Bauchspeicheldrüse, der Gallenblase, der Gallengänge, der Leber, des Magens und der Speiseröhre verursachen. Ein gesunder Lebensstil und die Teilnahme an Vorsorgeuntersuchungen sind wichtig und können das tumorbedingte Erkrankungs- und Sterberisiko von T2D-Patienten erheblich verringern.
Clinical value of alarm features for colorectal cancer: a meta-analysis
Authors: Frazzoni Leonardo , Laterza Liboria , La Marca Marina , Zagari Rocco Maurizio , Radaelli Franco , Hassan Cesare , Repici Alessandro , Facciorusso Antonio , Gkolfakis Paraskevas , Spada Cristiano , Triantafyllou Konstantinos , Bazzoli Franco , Dinis-Ribeiro Mario , Fuccio Lorenzo
Published: October 2022

Background Colorectal cancer (CRC) is a common neoplasm in Western countries. Prioritizing access to colonoscopy appears of critical relevance. Alarm features are considered to increase the likelihood of CRC. Our aim was to assess the diagnostic performance of alarm features for CRC diagnosis.

Methods We performed a systematic review and meta-analysis of studies reporting the diagnostic accuracy of alarm features (rectal bleeding, anemia, change in bowel habit, and weight loss) for CRC, published up to September 2021. Colonoscopy was required as the reference diagnostic test. Diagnostic accuracy measures were pooled by a bivariate mixed-effects regression model. The number needed to scope (NNS; i. e. the number of patients who need to undergo colonoscopy to diagnose one CRC) according to each alarm feature was calculated.

Results 31 studies with 45 100 patients (mean age 31–88 years; men 36 %–63 %) were included. The prevalence of CRC ranged from 0.2 % to 22 %. Sensitivity was suboptimal, ranging from 12.4 % for weight loss to 49 % for rectal bleeding, whereas specificity ranged from 69.8 % for rectal bleeding to 91.9 % for weight loss. Taken individually, rectal bleeding and anemia would be the only practical alarm features mandating colonoscopy (NNS 5.3 and 6.7, respectively).

Conclusions When considered independently, alarm features have variable accuracy for CRC, given the high heterogeneity of study populations reflected by wide variability in CRC prevalence. Rectal bleeding and anemia are the most practical to select patients for colonoscopy. Integration of alarm features in a comprehensive evaluation of patients should be considered.
Genetic and Functional Analyses of the Novel KLF11 Pro193Thr Variant
in a Three-Generation Family with MODY7
Authors: Guan Gaopeng , Qin Tiantian , Zhao Li-ling , Jin Ping
Published: October 2022

KLF11 regulates insulin gene expression through binding to the insulin promoter
and has been reported as a causative gene for maturity-onset diabetes of the
young 7 (MODY7). Here, we report a novel KLF11 variant associated with a
three-generation family with early childhood-onset diabetes and explore its
clinical and functional characteristics. The three-generational pedigree
contains five patients affected by diabetes. The pathogenic variant identified
by whole-exome sequencing was further confirmed by Sanger sequencing and
pedigree verification. Luciferase reporter assays and glucose-stimulated insulin
secretion were used to examine whether the KLF11 variant binds to the insulin
promoter and regulate insulin secretion in vitro. The proband, his son, and his
uncle exhibited hyperglycemia at ages 32, 13 and 71 years, respectively. All
three patients showed characteristics of metabolic syndrome (obesity,
dyslipidemia, and diabetes), but the insulin secretion of islet β-cells
was impaired. A novel heterozygous missense variant, c.577 C>A
(p.Pro193Thr) of the KLF11 gene was detected in all three patients. This variant
co-segregates with the diabetes phenotype, consistent with an autosomal dominant
disorder. The identified KLF11 p.Pro193Thr variant drastically decreased the
transcriptional activity of KLF11, as demonstrated by luciferase reporter assay.
Functional analyses revealed that the KLF11 Pro193Thr variant inhibited
glucose-stimulated insulin secretion. We identified a novel KLF11 Pro193Thr
variant in a three generation family with MODY7. These findings shed light on
the molecular mechanisms underlying the pathogenesis of MODY7 and expand the
genotype and clinical spectrum of MODY7.
Analysis of the Components of 236 Cases of Urinary Stones in Xinjiang Uyghur Children
Authors: Aierken Yeerfan , Ye Erdeng , Abudureyimu Abudusaimi , Li Shui-Xue , Kadier Abudushataer , Keyoumu Hanikezi , Liu Dong
Published: October 2022

Introduction The aim of the study is to explore the relationship between clinical characteristics and urinary calculus in Xinjiang Uyghur children, and to provide clinical basis for the prevention as well as treatment of urinary stone.

Materials and Methods In total, 236 urinary tract stone samples were collected from pediatric patients from February 2017 to April 2019, and those samples were analyzed by infrared spectroscopy. Stone compositions were compared with demographic data.

Results Among the 236 cases, 166 cases were boys (70.34%) and 70 cases were girls (29.66%), with a male-to-female ratio of 2.37:1. A total of 21 kinds of calculi were detected, including 107 cases with six kinds of simple calculi and 129 cases with 15 kinds of mixed calculi. In this study, magnesium ammonium phosphate hexahydrate was only found in boys, and the difference was statistically significant (6.6 vs. 0.0%, p = 0.037). There were statistical differences in the age distribution of children with ammonium hydrogen urate, calcium oxalate, and other stone components (p < 0.05), while there were no statistical differences in the age distribution of children with apatite carbonate, magnesium ammonium phosphate hexahydrate, and anhydrous uric acid. The results showed that there was a significant difference in the localization of calculi between male and female children (upper urinary tract stones: 78.9 vs. 98.6%, p < 0.001).

Conclusion Uyghur pediatric patients with urolithiasis were young and the majority of stones was mixed, The main components of calculi were ammonium hydrogen urate, calcium oxalate and apatite carbonate, and there are differences in the localization of calculi between genders.
Comparação entre fixação de fio de Kirschner liso e de parafusos canulados em fraturas deslocadas do côndilo lateral do úmero em crianças
Authors: Vergara Alberto Daniel Navarro , Fretes Alberto Navarro
Published: October 2022

Objetivo Comparar o uso de parafusos canulados e de fios de Kirschner lisos em termos da redução da presença de calo exuberante e de complicações em fraturas pediátricas deslocadas do côndilo lateral do úmero.

Métodos Um estudo analítico transversal de casos consecutivos foi realizado de maio a outubro de 2021 com 30 crianças com fraturas deslocadas de côndilo umeral externo. Os resultados funcionais para dor e amplitude de movimento foram estratificados utilizando o sistema de classificação Dhillon.

Resultados Ao todo, 19 pacientes foram submetidos à fixação de fio Kirschner, e 11 à fixação de parafusos canulados. A fixação realizada foi fechada em 14 casos (47%) e aberta em 16 (53%). Dos casos incluídos, não houve perda no acompanhamento. A amostra continha 21 (70%) pacientes do sexo masculino, e a idade variou de 5 a 15 anos, com média de 6,96 anos. A causa mais frequente de fratura foi queda de altura (50%), e esteve relacionada ao maior deslocamento nas radiografias da linha de base. Complicações que não estavam relacionadas à abordagem de redução ou ao implante utilizado foram observadas em 12 (40%) casos.

Conclusão Este estudo não mostra benefícios em relação ao uso de pinos lisos ou de parafusos canulados para reduzir a presença de calo exuberante na consolidação da fratura. Vemos que as complicações que surgem estão relacionadas à gravidade da lesão, e não é possível identificar benefícios na escolha de um implante ou outro. Pudemos ver que a classificação de Weiss ajuda a definir o comportamento em favor da redução aberta ou fechada sem dar preferência ao pino liso ou ao parafuso canulado para a fixação da fratura.
Effect of stomach motility on food hydrolysis and gastric emptying: Insight from computational models
Authors: Kuhar Sharun , Lee Jae Ho , Seo Jung-Hee , Pasricha Pankaj J , Mittal Rajat
Published: October 2022

The peristaltic motion of stomach walls combines with the secretion of digestive enzymes to initiate the process that breaks down food. In this study, the mixing, breakdown, and emptying of a liquid meal containing protein is simulated in a model of a human stomach. In this model, pepsin, the gastric enzyme responsible for protein hydrolysis, is secreted from the proximal region of the stomach walls and allowed to react with the contents of the stomach. The velocities of the retropulsive jet induced by the peristaltic motion, the emptying rate, and the extent of hydrolysis are quantified for a control case as well as for three other cases with reduced motility of the stomach, which may result from conditions such as diabetes mellitus. This study quantifies the effect of stomach motility on the rate of food breakdown and its emptying into the duodenum and we correlate these observations with the mixing in the stomach induced by the wall motion.
Analytical model for predicting the length scale of shock/boundary layer interaction with curvature
Authors: Cheng Jianrui , Yang Kai , Zheng Xiaogang , Shi Chongguang , Zhu Chengxiang , You Yancheng
Published: October 2022

In practical aerodynamic problems, curved shock/boundary layer interaction (CSBLI) is more frequently encountered than the canonical shock/boundary layer interaction (SBLI). Owing to the topological complexity of the flow field brought about by shock curvature, accurate prediction of the interaction length scale of CSBLI is a challenging task. In this work, streamwise and spanwise curvatures are introduced, in turn, with the aim of establishing an analytical model for the interaction length scale of CSBLI based on conservation of mass. The validity and universality of the model are verified, which reveal the impact of the shock curvatures on the interaction, acting as the form of non-uniformity. As an example, the CSBLI with different curvatures is compared, demonstrating that a streamwise curvature of 0.071 will bring a reduction of about 16.5% of the interaction length. The proposed method can be regarded as providing a foundation for further research on CSBLI, opening new perspectives for the investigation of SBLI flow structures.
Retracted: Symbiotic Association Between Ants and Fungus
Authors: Riaz S , Farooq F , Manzoor F
Published: October 2022

Ants are eusocial insects belong to family Formicidae and live in symbiotic association with different species of the fungus. Fungi serving them as food and others relationship between fungus and ants is fungi increase the durability of the nest ants living in carton nests in the trees. Our goal was to investigate through literature obvious interactions between ants and common fungi, protection of ants' colonies from pathogens and uses of fungal isolates in sustainable agriculture. Fungal bank in the ants colony is their source of food and colonies of ants (Hymenoptera: Formicidae) are attacked by numerous parasites, pathogens, and parasitoids that exploit entire colonies and their resources. Symbiotic fungi strains belonging to Penicillium found in ants nests are antibiotic producer. High frequency and high diversity of these colonies suggested that insects preferentially sustained this fungus for their survival. Fungal growing ants evolved a close mutualistic relationship with multiple species of Actinobacteria belonging to the genus Pseudonocardia for protection of colony from various diseases. Fungus-growing ants and Pseudonocardia symbionts are novel and significant source of antibiotic and antifungal agents and used as model system due to experimental tractability and well-studied ecology. Beauveria bassiana, Metarhizium anisopliae and Lecanicillium psalliotae are Entomopathogenic fungi found in mutualistic association with Attine ants used in a much smaller scale. Formulation of entomopathogenic fungi-based pesticides biosynthesis of fungal-based nanoparticles at industrial scale is useful in recent sustainable agriculture.
The impact of COVID-19 monoclonal antibodies on clinical outcomes: A retrospective cohort study
Authors: R. Nagler Arielle , Horwitz Leora I , Jones Simon , Petrilli Christopher M , Iturrate Eduardo , Lighter Jennifer L , Phillips Michael , Bosworth Brian P , Polsky Bruce , Volpicelli Frank M , Dapkins Isaac , Viswanathan Anand , François Fritz , Kalkut Gary
Published: October 2022

Purpose

Despite progress in the treatment of coronavirus disease 2019 (COVID-19), including the development of monoclonal antibodies (mAbs), more clinical data to support the use of mAbs in outpatients with COVID-19 is needed. This study is designed to determine the impact of bamlanivimab, bamlanivimab/etesevimab, or casirivimab/imdevimab on clinical outcomes within 30 days of COVID-19 diagnosis.

Methods

A retrospective cohort study was conducted at a single academic medical center with 3 campuses in Manhattan, Brooklyn, and Long Island, NY. Patients 12 years of age or older who tested positive for COVID-19 or were treated with a COVID-19–specific therapy, including COVID-19 mAb therapies, at the study site between November 24, 2020, and May 15, 2021, were included. The primary outcomes included rates of emergency department (ED) visit, inpatient admission, intensive care unit (ICU) admission, or death within 30 days from the date of COVID-19 diagnosis.

Results

A total of 1,344 mAb-treated patients were propensity matched to 1,344 patients with COVID-19 patients who were not treated with mAb therapy. Within 30 days of diagnosis, among the patients who received mAb therapy, 101 (7.5%) presented to the ED and 79 (5.9%) were admitted. Among the patients who did not receive mAb therapy, 165 (12.3%) presented to the ED and 156 (11.6%) were admitted (relative risk [RR], 0.61 [95% CI, 0.50-0.75] and 0.51 [95% CI, 0.40-0.64], respectively). Four mAb patients (0.3%) and 2.64 control patients (0.2%) were admitted to the ICU (RR, 01.51; 95% CI, 0.45-5.09). Six mAb-treated patients (0.4%) and 3.37 controls (0.3%) died and/or were admitted to hospice (RR, 1.61; 95% CI, 0.54-4.83). mAb therapy in ambulatory patients with COVID-19 decreases the risk of ED presentation and hospital admission within 30 days of diagnosis.
Burnt Out: Rate of Burnout in Neuropsychology Survey Respondents During the COVID-19 Pandemic, Brief Communication
Authors: Marra David E C , Simons Mary U , Schwartz Eben S , Marston Elizabeth A , Hoelzle James B
Published: October 2022

Objective

Due to the COVID-19 pandemic, burnout among healthcare workers has significantly increased. This study evaluated rates of burnout in neuropsychologists one year into the COVID-19 pandemic.

Method

A survey invitation was sent across five neuropsychology-related listservs in April 2021. Burnout was assessed with the Copenhagen Burnout Inventory (CBI; Kristensen, T. S., Borritz, M., Villadsen, E., & Christensen, K. B. (2005). The Copenhagen Burnout Inventory: A new tool for the assessment of burnout. Work & Stress, 19 (3), 192–207) and differences in Personal, Work, and Client burnout scores were evaluated across patient population and work setting.

Results

57.3% and 51.5% of respondents (N = 130) endorsed moderate-to-high levels of personal and work-related burnout, respectively. In the Personal domain, respondents working with pediatric patients had higher mean scores and a higher proportion of respondents endorsed moderate-to-high levels of burnout.

Conclusion

More than half of the survey respondents endorsed elevated levels of personal and work-related burnout. This is concerning as burnout is associated with personal challenges and diminished patient care. Potential organizational interventions are discussed.
ICSDA: a multi-modal deep learning model to predict breast cancer recurrence and metastasis risk by integrating pathological, clinical and gene expression data
Authors: Yao Yuhua , Lv Yaping , Tong Ling , Liang Yuebin , Xi Shuxue , Ji Binbin , Zhang Guanglu , Li Ling , Tian Geng , Tang Min , Hu Xiyue , Li Shijun , Yang Jialiang
Published: October 2022

Breast cancer patients often have recurrence and metastasis after surgery. Predicting the risk of recurrence and metastasis for a breast cancer patient is essential for the development of precision treatment. In this study, we proposed a novel multi-modal deep learning prediction model by integrating hematoxylin & eosin (H&E)-stained histopathological images, clinical information and gene expression data. Specifically, we segmented tumor regions in H&E into image blocks (256 × 256 pixels) and encoded each image block into a 1D feature vector using a deep neural network. Then, the attention module scored each area of the H&E-stained images and combined image features with clinical and gene expression data to predict the risk of recurrence and metastasis for each patient. To test the model, we downloaded all 196 breast cancer samples from the Cancer Genome Atlas with clinical, gene expression and H&E information simultaneously available. The samples were then divided into the training and testing sets with a ratio of 7: 3, in which the distributions of the samples were kept between the two datasets by hierarchical sampling. The multi-modal model achieved an area-under-the-curve value of 0.75 on the testing set better than those based solely on H&E image, sequencing data and clinical data, respectively. This study might have clinical significance in identifying high-risk breast cancer patients, who may benefit from postoperative adjuvant treatment.
A systematic assessment of cell type deconvolution algorithms for DNA methylation data
Authors: Song Junyan , Kuan Pei-Fen
Published: October 2022

We performed systematic assessment of computational deconvolution methods that play an important role in the estimation of cell type proportions from bulk methylation data. The proposed framework methylDeConv (available as an R package) integrates several deconvolution methods for methylation profiles (Illumina HumanMethylation450 and MethylationEPIC arrays) and offers different cell-type-specific CpG selection to construct the extended reference library which incorporates the main immune cell subsets, epithelial cells and cell-free DNAs. We compared the performance of different deconvolution algorithms via simulations and benchmark datasets and further investigated the associations of the estimated cell type proportions to cancer therapy in breast cancer and subtypes in melanoma methylation case studies. Our results indicated that the deconvolution based on the extended reference library is critical to obtain accurate estimates of cell proportions in non-blood tissues.
A molecular phylogeny of the Persian Gulf and the Gulf of Oman oyster species
Authors: Ghaffari Hamze , Ahmadzadeh Faraham , Saberi-Pirooz Reihaneh , Abtahi Behrooz
Published: October 2022

The taxonomy of oysters along the northern coasts of the Persian Gulf and the Gulf of Oman is not well recognized. We present a phylogenetic analysis of oyster species in these regions. We combined morphological and molecular techniques to obtain the identity of oysters to the lowest taxonomic levels. Analysis of partial nucleotide sequences from mitochondrial cytochrome c oxidase subunit I (COI) was used for the phylogenetic evaluation. Based on our findings, Iranian samples nested within the genus Saccostrea and belonged to Saccostrea mordax and Saccostrea palmula clades. The shell morphology of the studied samples was variable, as in other rock oyster species. The examination of morphological features was in line with the molecular outcomes, but despite some similarities, Iranian S. palmula had well-developed and elongated chomata. The results also showed that S. mordax and S. palmula possessed significant relative abundance as dominant oysters in the Persian Gulf and the Gulf of Oman, respectively. Phylogenetic analysis revealed that Iranian samples of S. palmula formed a separate subclade from the Gulf of California and Panama samples, with large genetic distances (6–7%). Iranian specimens differed morphologically and genetically, suggesting that they could be a new species, although more research is needed.
The emergence of a cryptic lineage and cytonuclear discordance through past hybridization in the Japanese fire-bellied newt,Cynops pyrrhogaster(Amphibia: Urodela)
Authors: Tominaga Atsushi , Yoshikawa Natsuhiko , Matsui Masafumi , Nagata Nobuaki , Sato Yukuto
Published: October 2022

Discrepancies in geographic variation patterns between nuclear DNA and mitochondrial DNA (mtDNA) are the result of the complicated differentiation processes in organisms and are the key to understanding their true evolutionary processes. The genetic differentiation of the northern and Southern-Izu lineages of the Japanese newt, Cynops pyrrhogaster, was investigated through their single nucleotide polymorphism variations obtained via multiplexed ISSR genotyping by sequencing (MIG-seq). We found three genetic groups (Tohoku, N-Kanto and S-Kanto), that were not detected by mtDNA variations, in the northern lineage. N-Kanto has intermediate genetic characteristics between Tohoku and S-Kanto. The genetic groups are now moderately isolated from each other and have unique genetic characteristics. An estimation of the evolutionary history using the approximate Bayesian computation (ABC) approach suggested that Tohoku diverged from the common ancestor of S-Kanto and S-Izu. Then, S-Kanto and S-Izu split, and the recent hybridization between Tohoku and S-Kanto gave rise to N-Kanto. The origin of N-Kanto through the hybridization is relatively young and seems to be related to changes in the distributions of Tohoku and S-Kanto as a result of climatic oscillation in the Pleistocene. We conclude that the mitochondrial genome of S-Kanto was captured in Tohoku and that the original mitochondrial genome of Tohoku was entirely removed through hybridization.
Delineation of functionally essential protein regions for 242 neurodevelopmental genes
Authors: Iqbal Sumaiya , Brünger Tobias , Pérez-Palma Eduardo , Macnee Marie , Brunklaus Andreas , Daly Mark J , Campbell Arthur J , Hoksza David , May Patrick , Lal Dennis
Published: October 2022

Neurodevelopmental disorders (NDDs), including severe paediatric epilepsy, autism and intellectual disabilities are heterogeneous conditions in which clinical genetic testing can often identify a pathogenic variant. For many of them, genetic therapies will be tested in this or the coming years in clinical trials. In contrast to first-generation symptomatic treatments, the new disease-modifying precision medicines require a genetic test-informed diagnosis before a patient can be enrolled in a clinical trial. However, even in 2022, most identified genetic variants in NDD genes are ‘variants of uncertain significance’. To safely enrol patients in precision medicine clinical trials, it is important to increase our knowledge about which regions in NDD-associated proteins can ‘tolerate’ missense variants and which ones are ‘essential’ and will cause a NDD when mutated. In addition, knowledge about functionally indispensable regions in the 3D structure context of proteins can also provide insights into the molecular mechanisms of disease variants.

We developed a novel consensus approach that overlays evolutionary, and population based genomic scores to identify 3D essential sites (Essential3D) on protein structures. After extensive benchmarking of AlphaFold predicted and experimentally solved protein structures, we generated the currently largest expert curated protein structure set for 242 NDDs and identified 14 377 Essential3D sites across 189 gene disorders associated proteins. We demonstrate that the consensus annotation of Essential3D sites improves prioritization of disease mutations over single annotations. The identified Essential3D sites were enriched for functional features such as intermembrane regions or active sites and discovered key inter-molecule interactions in protein complexes that were otherwise not annotated. Using the currently largest autism, developmental disorders, and epilepsies exome sequencing studies including >360 000 NDD patients and population controls, we found that missense variants at Essential3D sites are 8-fold enriched in patients.

In summary, we developed a comprehensive protein structure set for 242 NDDs and identified 14 377 Essential3D sites in these. All data are available at https://es-ndd.broadinstitute.org for interactive visual inspection to enhance variant interpretation and development of mechanistic hypotheses for 242 NDDs genes. The provided resources will enhance clinical variant interpretation and in silico drug target development for NDD-associated genes and encoded proteins.
Hepatitis B Virus (HBV) Replication During Tenofovir Therapy Is Frequent in Human Immunodeficiency Virus/HBV Coinfection
Authors: Hofmann Eveline , Surial Bernard , Boillat-Blanco Noémie , Günthard Huldrych F , Stöckle Marcel , Bernasconi Enos , Schmid Patrick , Calmy Alexandra , Suter-Riniker Franziska , Rauch Andri , Wandeler Gilles , Béguelin Charles ,   for the Swiss HIV Cohort Study, Abela I , Aebi-Popp K , Anagnostopoulos A , Battegay M , Bernasconi E , Braun DL , Bucher HC , Calmy A , Cavassini M , Ciuffi A , Dollenmaier G , Egger M , Elzi L , Fehr J , Fellay J , Furrer H , Fux CA , Günthard HF , Hachfeld A , Haerry D , Hasse B , Hirsch HH , Hoffmann M , Hösli I , Huber M , Kahlert CR , Kaiser L , Keiser O , Klimkait T , Kouyos RD , Kovari H , Kusejko K , Martinetti G , Martinez de Tejada B , Marzolini C , Metzner KJ , Müller N , Nemeth J , Nicca D , Paioni P , Pantaleo G , Perreau M , Rauch A , Schmid P , Speck R , Stöckle M , Tarr P , Trkola A , Wandeler G , Yerly S
Published: October 2022

In the Swiss HIV Cohort Study, 61 of 222 (27%) HIV–suppressed persons with chronic hepatitis B virus (HBV) infection had HBV replication after 2 years on tenofovir, of whom 77% were suppressed thereafter. Self-reported adherence to therapy and HBV viral load at tenofovir initiation were predictors of persistent replication.
When Civilisational Clashes Meet Power Shifts: Rethinking Global Disorder
Authors: Zhang Baohui
Published: October 2022

Samuel Huntington’s famous prediction in 1993 of “clashes of civilisations”, amid that decade’s rosy expectations of “liberal peace”, sparked wide criticism for its rebutting of the then-conventional wisdom of globalisation, global governance, and democratic peace that defined the so-called “liberal” international politics of the 1990s. However, events in recent decades have corroborated his stark prediction. In particular, conflicts between the West and non-Western rising powers have become a salient feature of international politics—an outcome shaped not only by differences in civilisational identity but also by power shifts that trigger civilisational clashes. In their quest to acquire influence better befitting their expanding material capabilities, rising powers seek to reorder the international system by shaping its rules and institutions according to their civilisational values and norms. This aspiration has generated conflict between non-Western rising powers and the West over ideational incompatibilities, global governance, and the reconfiguration of regional orders. The consequences of such civilisational conflict have led to escalating fragmentation, disorder, and instability in world politics.
CR Loss: Improving Biometric Using ClassRoom Learning Approach
Authors: Prasad Shitala , Chai Tingting , Li Jiahui , Zhang Zhaoxin
Published: October 2022

One of the important factors in deep feature learning is their loss function design which highly influences the network performance. In this paper, we proposed a classroom (CR) learning approach along with arcface loss for contactless palmprint recognition to obtain high-level discriminative features without any extra load made to the network architecture. CR loss allows the network to learn the best possible feature representations for palmprint images. To validate our concept, we performed extensive experimental evaluations on various popular benchmark palmprint databases where our methods outperform the state-of-the-art methods. We also introduced a challenging contactless palmprint database called Harbin Institute of Technology-Network & Information Security Research Center contactless palmprint database version 1.0 (HIT-NIST-V1), as a new contribution to this domain. The result proves that the proposed CR loss consistently outperforms the SOTA methods for all the considered databases and especially for HIT-NIST-V1.
Health-related quality of life following neoadjuvant chemoradiotherapy versus perioperative chemotherapy and esophagectomy for esophageal cancer: a European multicenter study
Authors: Schuring N , Markar S R , Hagens E R C , Jezerskyte E , Sprangers M A G , Lagergren P , Johar A , Gisbertz S S , van Berge Henegouwen M I ,   the LASER study group
Published: October 2022

Curative treatment for locally advanced esophageal cancer consists of (neo)adjuvant treatment followed by esophagectomy. Both neoadjuvant chemoradiotherapy and perioperative chemotherapy improve the 5-year overall survival rate compared with surgery alone. However, it is unknown whether these treatment strategies are associated with differences in long-term health-related quality of life (HRQL). The aim of this study is to compare long-term HRQL in patients after esophagectomy treated with neoadjuvant chemoradiotherapy or perioperative chemotherapy. Disease-free cancer patients having undergone esophagectomy and (neo)adjuvant treatment in one of the participating lasting symptoms after esophageal resection (LASER) study centers between 2010 and 2016, were identified from the LASER study dataset. Included patients completed the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30), EORTC QLQ-OG25, and LASER questionnaires at least 1 year after the completion of treatment. Long-term HRQL was compared between patients treated with neoadjuvant chemoradiotherapy or perioperative chemotherapy, using univariable and multivariable regression and presented as differences in mean score. Among the 565 included patients, 349 (61.8%) received neoadjuvant chemoradiotherapy, and 216 (38.2%) perioperative chemotherapy. Patients treated with perioperative chemotherapy reported more symptomatology for diarrhea (difference in means 5.93), reflux (difference in means 7.40), and odynophagia (difference in means 4.66). The differences did not exceed the 10 points to be of clinical relevance. No significant differences for the LASER key symptoms were observed. The observed differences in long-term HRQL are in favor of patients treated with neoadjuvant chemoradiotherapy compared with patients treated with perioperative chemotherapy; however, the differences were small. Patients need to be informed about long-term HRQL when considering allocation of (neo)adjuvant treatment.
Association between severity of ischemia evaluated by stress CMR and Syntax score in patients with stable coronary artery disease
Authors: Igual Munoz B , Domemench Tort D D T , Maryemmezzitouny M M , Berenguer Jofesa A B J , Miro Palau V M P , Gradoli Palmero J G P , Ridocci Soriano F R S , Forner Giner J F G , Ontoria Oviedo I O O , Sepulveda Sanchez P S S , Montero Argudo A M A , Paya Serrano R P S
Published: October 2022

Dipiridamol stress cardiac magnetic resonance (CMR) had proved to be useful to evaluate the benefit of revascularization in stable coronary artery disease [1]. Nevertheless the association between stress CMR imaging parameters and coronary Syntax score has not yet be fully evaluated.

Objective

To analyze the association of the extent and transmurality of ischemia and necrosis analyzed by vasodilators stress CMR with the severity and prognosis of coronary artery disease assessed by the Syntax score.

Methods

A retrospective cohort study including consecutive patients with stable coronary artery disease with inducible ischaemia in vasodilators stress CMR who underwent post-study catheterization was performed. The CMR protocol includes a functional study with b-SSFP sequences, first-pass perfusion with b-SSFP sequences obtained after administration of 0.84mg/kg of dipyridamole and during administration of gadolinium chelates and also IR-FGE viability sequences. A post-stress perfusion (PSP) and viability (V) score was developed scoring each segment from 0 to 2 according to transmurality. The number of segments with induced wall motion abnormalities (NSIWA) were also analyzed. The Syntax I and II scores were calculated using data from coronary angiography and computerized medical records.

Results

208 patients were included, mean age 65±13 years, 44% women, 109 of them revascularized after stress CMR, 13 of them by surgery. Univariate analysis showed a significant correlation of the PSP, NSIWA and V scores with the Syntax I and Syntax 2. Using a multivariate regression models, NSIWA and V scores were independent predictors for Syntax I while NSIWA and PSP were independent predictors for Syntax 2.

Conclusions

– CMR stress test in patients with stable coronary artery disease allows an integrative assessment of V, PSP and PSWA and all of this parameters were associated with the severity of coronary artery disease and the prognosis after revascularization estimated by the Syntax I and 2.

– NSIWA and V independently predict the severity of coronary artery disease estimated using Syntax I.

– NSIWA and PSP independently predict prognosis after revascularization estimated for surgery using Syntax 2.

Funding Acknowledgement

Type of funding sources: None.
Feasibility and clinical outcomes of 48 mm drug eluting stents in management of patients with coronary artery disease
Authors: El Amrawy A , Loutfi M , El Tahan S , Wagdy S
Published: October 2022

Background

Long Coronary lesions represent a formidable challenge during percutaneous coronary intervention (PCI). Implantation of multiple contiguous stents may result in sections of overlapping stents or gaps of unstented segments and is an independent predictor of restenosis and major adverse cardiovascular events (MACEs).

Objectives

To assess the feasibility, and short-term clinical outcomes of implanting 48mm drug eluting stents (DES) in treatment of long lesions in patients with coronary artery disease (CAD).

Methods

A prospective study enrolling 300 patients, with a single CAD planned to undergo PCI with 48mm DES. Clinical data, procedural outcomes and follow-up to 6 months were obtained. MACEs were considered the combined study end point defined as cardiac death, non-fatal myocardial infarction, unstable angina and the need for target lesion revascularization (TLR).

Results

Among the 300 subjects enrolled, 80% were males, mean age was 60.8±8.6 years. Procedural success rate was 97.3%. Failure of crossing was encountered in 4 patients due to severe tortuosity. Six-month clinical outcome was compared between diabetic (DM) (n=90) and non-DM patients; 6-month cumulative MACEs were significantly lower in the non-DM than in DM group (2.9% in non-DM vs. 13.3% in DM, p=0.013). Clinically driven TLR was 4% and two cardiac deaths were reported. The independent predictors of repeat revascularization were insulin treated type 2 DM, and reference vessel diameter (RVD) ≤2.75 mm.

Conclusion

The use of 48mm DES is feasible, safe and cost effective in treatment of long coronary lesions. Independent predictors of repeat revascularization are type 2 diabetes mellitus, and RVD ≤2.75mm.

Funding Acknowledgement

Type of funding sources: None.
The long-term cardiac events after coronary bifurcation stenting with second-generation drug-eluting stents in elderly patients are comparable to those of younger patients
Authors: Kim J H , Franchin L , Hong S J , Cha J J , Lim S , Joo H J , Park J H , Yu C W , Ahn T H , Lim D S , Dascenzo F
Published: October 2022

Background

Elderly patients undergoing percutaneous coronary intervention (PCI) generally have a high risk of adverse clinical outcomes. We investigated the long-term clinical impact of PCI on coronary bifurcation disease in elderly patients in Korea and Italy.

Methods

From the BIFURCAT (comBined Insights from the Unified RAIN and COBIS bifurcAtion regisTries) data, we evaluated 5,537 patients who underwent PCI for coronary bifurcation disease. The primary outcome was major adverse cardiac events (MACEs), defined as the composite of target vessel myocardial infarction, target lesion revascularisation, and stent thrombosis. Kaplan–Meier estimates and Cox proportional hazard models were used to compare elderly patients (aged ≥75 years) and younger patients (aged <75 years).

Results

A total of 1,415 patients (26%) were aged ≥75 years. Elderly patients were more frequently female, had higher rates of hypertension and chronic kidney disease (CKD), and presented more frequently with left main (LM) disease. After a median follow-up of 2.1 years, MACEs were comparable between elderly and younger patients. In multivariable analysis, old age was not an independent predictor of MACEs (p=0.977). In elderly patients, CKD and LM disease were independent predictors of MACEs, whereas in younger patients, hypertension, diabetes, CKD, reduced left ventricular ejection fraction, LM disease, and two-stent strategy usage were independent predictors.

Conclusions

Elderly patients who underwent coronary bifurcation PCI with second-generation drug-eluting stents demonstrated similar clinical outcomes to those of younger patients. Both CKD and LM disease were independent predictors of MACEs, regardless of age after coronary bifurcation PCI.

Funding Acknowledgement

Type of funding sources: None.
In-hospital and long-term outcomes of percutaneous coronary interventions for chronic total occlusions in patients with contrast-associated acute kidney injury
Authors: Tajti P T , Ayoub A M , Behnes M B , Buettner H J B , Neumann F J N , Mashayekhi K M
Published: October 2022

Background

The prognostic impact on in-hospital and long-term outcomes of contrast-associated acute kidney injury (CA-AKI) in patients undergoing chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has been limitedly studied.

Methods

We examined 2707 consecutive procedures performed in a referral CTO center between 2015 and 2019. CA-AKI was defined as an increase in serum creatinine ≥0.3 mg/dl or ≥50% within 48 h post-PCI†. Primary endpoints were major adverse cardiac and cerebrovascular events (MACCE) in-hospital (composite of all-cause death, myocardial infarction [MI], target vessel revascularization [TVR], stroke) and at 1-year of follow-up.

Results

The overall incidence of CA-AKI was 11.5%, respectively. Patients with CA-AKI (n=312) had more severe comorbidities in comparison with patients without CA-AKI (n=2,395). Technical success was similar across the groups (87.2% vs. 90.5%, p=0.056), whereas procedural success was lower in the CA-AKI group (84.3% vs. 89.7%, p=0.004). In-hospital MACCE was 1.3%, respectively, and were comparable in patients with and without CA-AKI (1.6% vs. 1.3%, p=0.655), however, pericardial tamponade requiring pericardiocentesis occurred more commonly in patients with renal function impairment (2.2% vs. 0.5%, p=0.001). In multivariate analysis, CA-AKI was not associated with higher risk for in-hospital MACCE (adjusted odds ratio [OR] 1.34, confidence intervals [CI] 0.45–3.19, p=0.563). At median follow-up time of 14 months (interquartile range [IQR], 11 to 35 months), the cumulative incidence of 1-year MACCE was significantly higher in patients with versus without CA-AKI (20.8% vs. 12.8%, p<0.001), and CA-AKI was independently associated with an increased risk for 1-year MACCE (adjusted hazard ratio [HR] 1.52, CI 1.05–2.15, p=0.029) following CTO PCI. Patients with CA-AKI had inferior MACCE-free (log-rank p<0.001) survival on Kaplan-Meier analysis (Figure 1), mostly driven by higher rate of target vessel failure (log-rank p<0.001), mortality (log-rank p=0.001), and myocardial infarction (log-rank p=0.042) over time. MACCE-free survivals significantly differed both in successful (Figure 2, Panel A) versus failed (Figure 2, Panel B) CTO PCI, with less favourable outcomes in patients developing CA-AKI post-PCI.

Conclusions

Contrast-associated acute kidney injury commonly occurs in patients undergoing CTO PCI, that may lead to an increased risk for MACCE 1-year post-PCI, but not immediately after the procedure.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only.
Phosphomimetic endothelial nitric oxide synthase-loaded microbubbles-mediated cardiac shock wave transfection therapy for angiogenesis in the ischemic myocardium
Authors: Mehrad H
Published: October 2022

Background

Cardiac shock wave therapy is a potential and effective remedy to promote revascularization in the ischemic myocardium of patients with refractory coronary heart disease (CHD). Although gene therapy holds great promise as a treatment for coronary heart disease, current clinical application is hampered by the development of safe and efficient systems for local gene delivery to a specific tissue or organ.

Purpose

In this study, we developed an experimental pulsed- focused electrohydraulic shock wave therapy system and investigated its effectiveness on myocardial angiogenesis in the hypercholesterolemic rabbit accompanied by phosphomimetic endothelial nitric oxide synthase-loaded microbubbles administration, wherein a high resolution diagnostic ultrasound is adjuncted with the therapy system, with a goal of increased safety.

Methods

Briefly, New Zealand white rabbits underwent 2% cholesterol rich diet injury for sixteen weeks. Histopathology results showed the formation of foam cells-rich soft atherosclerotic plaques with severe stenosis in all of the rabbits' coronary arteries. Then treatment group underwent extracorporeal electrohydraulic pulsed-focused shock waves (25kV, 0.5Hz, 150 pulses) accompanied by phosphomimetic endothelial nitric oxide synthase-loaded PESDA (Perfluorocarbon Exposed Sonicated Dextrose Albumin) microbubbles (100 ml/kg, 2.5x105 bubbles/ml) administration.

Results

Results from ultrasonography and histopathology showed a significant increase in the mean value for myocardial neovessels density in the treatment group compared with the control group (p<0.05).

Conclusion

Enhanced angiogenesis and sonoporation effect of electrohydraulic shock wave therapy, induced by inertial collapsed microbubbles, accompanied by phosphomimetic endothelial nitric oxide synthase-mediated shock wave transfection therapy, can cause to enhance the nitric oxide synthesis and VEGF, interleukin8 (IL8), stromal cell- derived factor 1 (SDF1) and matrix metalloproteinase 9 (MMP9) secretion in the hypercholesterolemic rabbits' coronary arteries, resulting in the differentiation and recruitment of endothelial progenitor cells (EPCs), promotion of revascularization in the ischemic myocardium and improvement of the cardiac function.

Funding Acknowledgement

Type of funding sources: Public Institution(s). Main funding source(s): Mehrad Research Lab
End-of-trial inflammatory biomarkers, lipid levels, creatine kinase and markers of renal and liver function in the LoDoCo2 trial
Authors: Van Broekhoven A , Mohammadnia N , Silvis M J M , Los J , Fiolet A T L , Opstal T S J , Mosterd A , Eikelboom J W , Nidorf S M , Bax W A , Tijssen J G P , De Kleijn D P V , Thompson P L , El Messaoudi S , Cornel J H
Published: October 2022

Background

The Low-Dose Colchicine 2 (LoDoCo2) trial demonstrated that colchicine reduced major cardiovascular events in patients with chronic coronary artery disease (CAD). The effect of long-term colchicine treatment on inflammatory biomarkers and markers reflecting renal and liver function have not been investigated yet.

Purpose

This substudy examines levels of inflammatory biomarkers, lipid fractions, creatine kinase (CK) and markers of renal and liver function at close-out of the trial.

Methods

The LoDoCo2 trial randomly assigned patients with chronic CAD to colchicine 0.5 mg once daily or placebo. Blood samples were drawn during close-out visits after a median follow-up of 32.7 (interquartile range [IQR] 24.0–48.6) months.

Results

Assignment to colchicine was associated with lower levels of high-sensitivity C-Reactive Protein (0.94 mg/L [0.53–1.93] vs. 1.24 mg/L [0.73–2.55]; −24.2%; p<0.01) and interleukin-6 (2.70 ng/L [1.79–4.18] vs. 3.16 ng/L [2.07–4.95]; −14.9%; p<0.01), but was not associated with any differences in lipid fractions or markers of renal function. Although CK levels were higher after colchicine (123.0 U/L, [84.0–184.0] vs. 110.0 U/L, [77.0–164.0], p<0.01), the number of participants with marked elevations of CK (>5 times upper limit of normal [ULN]) was low and not different between treatment groups. Levels of alanine aminotransferase (ULN 40 U/L) and albumin (ULN 50 U/L) were higher (p<0.01) in the colchicine group compared to placebo (30.0 U/L [22.0–40.0] vs. 26.0 U/L [19.0–34.0] and 43.01 g/L±2.39 vs. 42.64 g/L±2.48, respectively). There were no differences in gamma-glutamyl transferase or bilirubin.

Conclusion

Long-term low-dose colchicine in patients with chronic CAD was associated with lower levels of hs-CRP and IL-6 but was not associated with clinically important differences in lipid fractions, CK, renal or liver function.

Funding Acknowledgement

Type of funding sources: Public Institution(s). Main funding source(s): The National Health Medical Research Council of AustraliaThe Netherlands Organization for Health Research and Development