bluuebunny/crossref_metadata_2025 huggingface dataset:
Four French sheath-based transradial cerebral angiographies in the elderly: A single neurointerventionalist's experience
Authors: Choi Dae Han , Yoo Chan Jong , Park Cheol Wan , Kim Myeong Jin
Published: March 2022

Background

Catheter angiography via transradial access (TRA) is better at reducing access site complications and morbidity than via transfemoral access (TFA). The rate of periprocedural complications increases in elderly populations and using a smaller sheath can help reduce access site complications. The aim of this study was to assess the feasibility and safety of 4 F sheath-based TRA cerebral angiography in elderly patients (≥65 years) and compare it to TFA cerebral angiography.

Methods

The medical records of elderly patients undergoing diagnostic cerebral angiography with a single neurointerventionalist via TRA (57 cases, from July 2019 to December 2020) versus TFA (69 cases, from January 2018 to June 2019) were retrospectively reviewed. All TRA angiographies were performed via right radial artery access with a 4 F sheath and a 4 F Simmons 2 catheter.

Results

There were no significant differences (TRA vs. TFA) in age (71.1 ± 4.0 vs. 72.1 ± 4.6 years, p = 0.189), accessed vessels (3.9 ± 0.5 vs. 3.9 ± 0.6, p = 0.852), fluoroscopy time (7.1 ± 3.3 vs. 7.6 ± 3.5 min, p = 0.068), and radiation exposure (42.1 ± 15.8 vs. 47.0 ± 13.7 Gy-cm2, p = 0.067). However, the procedure duration was significantly shorter in the TRA group (17.2 ± 3.9 vs. 19.0 ± 6.0 min, p = 0.003). Painful groin hematoma occurred in 2 of the 69 cases (2.9%) in the TFA group. In the TRA group, access site complications were not occurred; however, catheter kinks occurred in 2 of 57 cases (3.5%).

Conclusions

The 4 F sheath-based TRA is a feasible option for diagnostic cerebral angiography in elderly patients. However, care should be taken during catheter manipulation.
Pseudopterosins and Seco-Pseudopterosins: Compilation and Revision of Conflicting NMR Data, Names, Numbering Systems and Structural Elucidation
Authors: Coll Toledano Josep
Published: March 2022

The present review is focussed on the structural elucidation of the bicyclic and tricyclic diterpenoid title compounds isolated from Pseudopterogorgia species, displaying a direct structural relationship with the biosynthetic precursor GGPP (regular isoprenoid skeletons). A compilation of 1H and 13C NMR spectroscopic data is presented grouped by similar spin systems. Apparent inconsistencies or potential missassignments are discussed, pointing out convenient revisions of data assignment to improve structure correlations. Some hemisynthetic intermediates in the structural elucidation process are included, as well as data of representative synthetic compounds.
Financial Hardship Impacts Depression and Anxiety Among U.S. Patients with Sinusitis
Authors: Pandrangi Vivek C. , Mace Jess C. , Detwiller Kara Y. , Smith Timothy L. , Geltzeiler Mathew
Published: March 2022

Background

Mental health conditions are common in the United States, and recent efforts have examined the development of mental health conditions among patients with sinusitis.

Objectives

The purpose of this study was to investigate the association between depression, anxiety, and financial hardship among patients with sinusitis.

Methods

Cross-sectional study using the 2018 National Health Interview Survey (NHIS). Data regarding demographics, perceived financial hardship, self-reported depression and anxiety, mental healthcare utilization, and treatment compliance were obtained.

Results

Among patients with sinusitis (N = 28 million adults), 9% reported depression and 24% reported anxiety. Sinusitis patients with depression and anxiety reported an increased severity of financial insecurity (p < 0.001). On multivariable logistic regression, worsening financial insecurity increased the odds of depression and anxiety. Patients reporting the highest financial insecurity severity had the highest odds of depression (OR = 3.88, 95% CI = 3.84–3.93, p < 0.001) and anxiety (OR = 2.09, 95% CI = 2.08–2.10, p < 0.001) among measures of financial stress. Specific financial stressors were independently associated with patient-reported depression and anxiety. Sinusitis patients with increased financial insecurity were more likely to require mental health services and treatment (p < 0.001), but were also more likely to report cost-related treatment noncompliance (p < 0.001) and reduced access to mental healthcare due to costs (p < 0.001).

Conclusion

Perceived financial hardship is associated with self-reported depression and anxiety among patients with sinusitis. Sinusitis patients with financial hardship also face challenges in accessing and maintaining mental health services and treatment due to costs. Understanding the burden of financial insecurity on mental health and access to treatment may improve quality of care through the development of screening tools and individualized treatment strategies.
Post-Concussive Orthostatic Tachycardia is Distinct from Postural Orthostatic Tachycardia Syndrome (POTS) in Children and Adolescents
Authors: Pearson Rachel , Sheridan Christopher A. , Kang Kaylee , Brown Anne , Baham Michael , Asarnow Robert , Giza Christopher C. , Choe Meeryo C.
Published: March 2022

Background: Orthostatic tachycardia (OT) affects some patients after concussion/mild traumatic brain injury (mTBI). In this study, we sought to identify the factors associated with increased risk for OT in patients with mTBI. Methods: We conducted a retrospective review of 268 patients (8-25 years) with mTBI/concussion to determine the prevalence of OT, defined as orthostatic heart rate change ≥40 bpm for those ≤19 years of age and ≥30 bpm on active standing test for those >19 years of age. Results: Among the study population, 7% (n = 19) exhibited post-concussive OT. The only significant difference between OT and non-OT groups was that history of prior concussion was more prevalent in the OT group. Conclusion: A substantial subset (7%) of concussion clinic patients exhibit OT. While POTS literature describes female and adolescent predominance, post-concussive OT had similar prevalence across age and gender groups in this study, suggesting that it may be distinct from POTS.
Quality of Antenatal Care Service and Factors Associated with Client Satisfaction at Public Health Facilities of Bele Gasgar District
Authors: Hussen Mustefa Adem , Worku Bekelu Teka
Published: March 2022

Background: Quality of service and client satisfaction are crucial to increase services utilization. However, there is a paucity of data in this study area. Consequently, this study aimed to assess “Quality of Antenatal Care (ANC) and client satisfaction in Public Health Facilities”. Method: Facility-based cross-sectional study was conducted from March 11 to April 19, 2019. Systematic random sampling was used to select 366 women. Data were collected through the exit interview, data extraction, and observation. Result: Quality of ANC was 30% (95% CI = 25–35). About 55% (95% CI = 50–60) of women were satisfied with the services. Iron/folic acid supplementation (AOR = 2.23, 95% CI;1.30–4.79), measuring weight (AOR = 3.61, 95% CI = 1.40–9.31), travel time >60 min (AOR = 4, 95% CI;2.3–8.16) and 60–120 min (AOR = 3.68, 95% CI = 1.61–8.38), and consultation time (AOR = 2.89, 95% CI = 1.14–7.31) were positively associated with client satisfaction, while health professional initiation to ask question never (AOR = 0.20, 95% CI = 0.08–0.43) and to ask sometimes (AOR = 0.32, 95% CI = 0.16–0.65) were negatively associated. Conclusion: Quality of ANC was low while clients’ satisfaction was moderately low. Therefore, improvement in the area of input, process, and output is recommended.
The TΑp63/BCL2 axis represents a novel mechanism of clinical aggressiveness in chronic lymphocytic leukemia
Authors: Laidou Stamatia , Grigoriadis Dionysios , Papanikolaou Sofia , Foutadakis Spyros , Ntoufa Stavroula , Tsagiopoulou Maria , Vatsellas Giannis , Anagnostopoulos Achilles , Kouvatsi Anastasia , Stavroyianni Niki , Psomopoulos Fotis , Makris Antonios M. , Agelopoulos Marios , Thanos Dimitris , Chatzidimitriou Anastasia , Papakonstantinou Nikos , Stamatopoulos Kostas
Published: March 2022

The TA-isoform of the p63 transcription factor (TAp63) has been reported to contribute to clinical aggressiveness in chronic lymphocytic leukemia (CLL) in a hitherto elusive way. Here, we sought to further understand and define the role of TAp63 in the pathophysiology of CLL. First, we found that elevated TAp63 expression levels are linked with adverse clinical outcomes, including disease relapse and shorter time-to-first treatment and overall survival. Next, prompted by the fact that TAp63 participates in an NF-κB/TAp63/BCL2 antiapoptotic axis in activated mature, normal B cells, we explored molecular links between TAp63 and BCL2 also in CLL. We documented a strong correlation at both the protein and the messenger RNA (mRNA) levels, alluding to the potential prosurvival role of TAp63. This claim was supported by inducible downregulation of TAp63 expression in the MEC1 CLL cell line using clustered regularly interspaced short palindromic repeats (CRISPR) system, which resulted in downregulation of BCL2 expression. Next, using chromatin immunoprecipitation (ChIP) sequencing, we examined whether BCL2 might constitute a transcriptional target of TAp63 and identified a significant binding profile of TAp63 in the BCL2 gene locus, across a genomic region previously characterized as a super enhancer in CLL. Moreover, we identified high-confidence TAp63 binding regions in genes mainly implicated in immune response and DNA-damage procedures. Finally, we found that upregulated TAp63 expression levels render CLL cells less responsive to apoptosis induction with the BCL2 inhibitor venetoclax. On these grounds, TAp63 appears to act as a positive modulator of BCL2, hence contributing to the antiapoptotic phenotype that underlies clinical aggressiveness and treatment resistance in CLL.
Antigen identification and avoidance on outcomes in fibrotic hypersensitivity pneumonitis
Authors: Petnak Tananchai , Thongprayoon Charat , Baqir Misbah , Ryu Jay H. , Moua Teng
Published: March 2022

Background

Suspected causative antigens may be unidentified in 30–50% of patients with fibrotic hypersensitivity pneumonitis (f-HP). It is unclear whether antigen identification and avoidance in this setting offer any additional clinical benefit. We hypothesised that antigen identification and avoidance may improve the clinical course of patients with fibrotic disease.

Methods

Patients meeting recent international practice guidance for f-HP diagnosis evaluated at Mayo Clinic Rochester from January 2005 to December 2018 were included. Causative antigen and antigen avoidance were specifically defined and ascertained through review of the medical records. Cox proportional-hazards regression was performed to assess antigen identification and avoidance as predictors of either all-cause mortality or lung transplantation.

Results

377 patients were included. Of these, suspected causative antigen was identified in 225 (60%). Identification of a suspected antigen (adjusted hazard ratio (HR) 0.69, 95% CI 0.48–0.99; p=0.04) and subsequent antigen avoidance (adjusted HR 0.47, 95% CI 0.31–0.71; p<0.001) were associated with decreased all-cause mortality and transplantation. Both those with suspected antigen identification but nonavoidance and those with unidentifiable antigen had increased risk of all-cause mortality or transplantation (adjusted HR 2.22, 95% CI 1.34–3.69; p=0.002versusadjusted HR 2.09, 95% CI 1.34–3.26; p=0.001, respectively). Exposure to avian antigen was associated with better outcome compared to other antigen subtypes (adjusted HR 0.63, 95% CI 0.43–0.93; p=0.02).

Conclusion

Our findings suggest that antigen identification and antigen avoidance remain relevant even in patients with fibrotic disease, where both appear to be associated with improved outcomes.
Endoscopic follow-up of low-grade precancerous bronchial lesions in high-risk patients: long-term results of the SELEPREBB randomised multicentre trial
Authors: Guisier Florian , Deslee Gaëtan , Birembaut Philippe , Escarguel Bruno , Chapel Françoise , Bota Suzanna , Métayer Josette , Lachkar Samy , Capron Frédérique , Homasson Jean Paul , Taulelle Marc , Quintana Marie , Raspaud Christophe , Messelet Daniel , Benzaquen Jonathan , Hofman Paul , Baddredine Jamal , Paris Christophe , Cales Valérie , Laurent Philippe , Vignaud Jean-Michel , Ménard Olivier , Copin Marie-Christine , Ramon Philippe , Bouchindhomme Brigitte , Tavernier Jean-Yves , Quintin Isabelle , Quiot Jean-Jacques , Galateau-Sallé Françoise , Zalcman Gérard , Piton Nicolas , Thiberville Luc
Published: March 2022

Background

3–9% of low-grade preinvasive bronchial lesions progress to cancer. This study assessed the usefulness of an intensive bronchoscopy surveillance strategy in patients with bronchial lesions up to moderate squamous dysplasia.

Methods

SELEPREBB (ClinicalTrials.govNCT00213603) was a randomised study conducted in 17 French centres. After baseline lung computed tomography (CT) and autofluorescence bronchoscopy (AFB) to exclude lung cancer and bronchial severe squamous dysplasia or carcinomain situ(CIS), patients were assigned to standard surveillance (arm A) with CT and AFB at 36 months or to intensive surveillance (arm B) with AFB every 6 months. Further long-term data were obtained with a median follow-up of 4.7 years.

Results

364 patients were randomised (A: 180, B: 184). 27 patients developed invasive lung cancer and two developed persistent CIS during the study, with no difference between arms (OR 0.63, 95% CI 0.20–1.96, p=0.42). Mild or moderate dysplasia at baseline bronchoscopy was a significant lung cancer risk factor both at 3 years (8 of 74 patients, OR 6.9, 95% CI 2.5–18.9, p<0.001) and at maximum follow-up (16 of 74 patients, OR 5.9, 95% CI 2.9–12.0, p<0.001). Smoking cessation was significantly associated with clearance of bronchial dysplasia on follow-up (OR 0.12, 95% CI 0.01–0.66, p=0.005) and with a reduced risk of lung cancer at 5 years (OR 0.15, 95% CI 0.003–0.99, p=0.04).

Conclusion

Patients with mild or moderate dysplasia are at very high risk for lung cancer at 5 years, with smoking cessation significantly reducing the risk. Whereas intensive bronchoscopy surveillance does not improve patient outcomes, the identification of bronchial dysplasia using initial bronchoscopy maybe useful for risk stratification strategies in lung cancer screening programmes.
Inspiratory muscle training enhances recovery post-COVID-19: a randomised controlled trial
Authors: McNarry Melitta A. , Berg Ronan M.G. , Shelley James , Hudson Joanne , Saynor Zoe L. , Duckers Jamie , Lewis Keir , Davies Gwyneth A. , Mackintosh Kelly A.
Published: March 2022

Background

Many people recovering from coronavirus disease 2019 (COVID-19) experience prolonged symptoms, particularly breathlessness. We urgently need to identify safe and effective COVID-19 rehabilitative strategies. The aim of the current study was to investigate the potential rehabilitative role of inspiratory muscle training (IMT).

Methods

281 adults (age 46.6±12.2 years; 88% female) recovering from self-reported COVID-19 (9.0±4.2 months post-acute infection) were randomised 4:1 to an 8-week IMT or a “usual care” waitlist control arm. Health-related quality-of-life and breathlessness questionnaires (King's Brief Interstitial Lung Disease (K-BILD) and Transition Dyspnoea Index (TDI)), respiratory muscle strength, and fitness (Chester Step Test) were assessed pre- and post-intervention. The primary end-point was K-BILD total score, with the K-BILD domains and TDI being key secondary outcomes.

Results

According to intention to treat, there was no difference between groups in K-BILD total score post-intervention (control: 59.5±12.4; IMT: 58.2±12.3; p<0.05) but IMT elicited clinically meaningful improvements in the K-BILD domains for breathlessness (control: 59.8±12.6; IMT: 62.2±16.2; p<0.05) and chest symptoms (control: 59.2±18.7; IMT: 64.5±18.2; p<0.05), along with clinically meaningful improvements in breathlessness according to TDI (control: 0.9±1.7versus2.0±2.0; p<0.05). IMT also improved respiratory muscle strength and estimated aerobic fitness.

Conclusions

IMT may represent an important home-based rehabilitation strategy for wider implementation as part of COVID-19 rehabilitative strategies. Given the diverse nature of long COVID, further research is warranted on the individual responses to rehabilitation; the withdrawal rate herein highlights that no one strategy is likely to be appropriate for all.
The LOX-1 receptor ectopically expressed in the liver alleviates atherosclerosis by clearing Ox-LDL from the circulation
Authors: Wang Zhiwen , Chen Juan , Zeng Zhuanglin , Zhang Qing , Du Gaohui , Guo Xiaopeng , Wei Yumiao
Published: March 2022

Objective

Oxidized Low-Density-Lipoprotein (Ox-LDL) is the core factor in the development of atherosclerosis. However, there are few therapies aimed at eliminating Ox-LDL. Here in this study, we investigate whether the ectopically expression of the lectin-like oxidized low density lipoprotein receptor (LOX-1) in the liver could lead to the elimination of circulating Ox-LDL and prevent the deposition in the vascular wall, thereby alleviating the progression of atherosclerosis.

Methods

Apolipoprotein E-deficient (ApoE−/−) mice were randomly divided into three groups, the control group, the AAV8-TBG-eGFP group (eGFP group) and AAV8-TBG-LOX-1 group (LOX-1 group). In the LOX-1 group, mice received an injection of virus dilution AAV8-TBG-LOX-1 (1.16 × 1011 virus genome (v.g)/animal/100 μl). The mice in the control group and eGFP group received the same amount of sterile saline and AAV8-TBG-eGFP virus dilution injections. The expression of LOX-1 in the liver was detected by immunofluorescent, western blot and immunohistochemistry. The safety of the virus was assessed by hematoxylin–eosin (H&E) staining, blood biochemical analyses and immunofluorescent. The function of LOX-1 in the liver was detected by the co-localization of LOX-1 and Dil-labeled Ox-LDL (Dil-Ox-LDL) under laser scanning confocal microscope. The extent of Ox-LDL in plasma was detected by ELISA. Changes in blood lipids were assessed through blood biochemical analysis. The progression of atherosclerotic lesions was detected by Oil red O staining. And the expression of Vascular Cell Adhesion Molecule-1 (VCAM-1) in endothelial cells and the extent and migration of macrophages in atherosclerotic plaque were detected by immunofluorescence staining. The protein expression in liver was assessed by qRT-PCR and western blot.

Results

The expression of LOX-1 was stable in liver within 4 weeks. Ectopically expressed LOX-1 in the liver phagocytosed and degraded Ox-LDL and reduced Ox-LDL from circulation but did not have a significant effect on blood lipid levels. After the expression of LOX-1 in liver, Ox-LDL can be cleared by the hepatocytes, thereby reducing VCAM-1 expression in vascular endothelium and the migration of macrophages in plaques, and eventually alleviating the progression of atherosclerosis. Functional expression of LOX-1 in hepatocytes may facilitate the metabolic clearance of Ox-LDL by upregulating the expression of ATP-binding cassette G5 and G8 (ABCG5/G8), which is the primary neutral sterol transporter in hepatobiliary and transintestinal cholesterol excretion.

Conclusion

Ectopic liver-specific expression of LOX-1 receptor alleviates the progression of atherosclerosis by clearing Ox-LDL from circulation.
Safety and efficacy of coronary angiography and percutaneous coronary intervention via distal transradial artery access in the anatomical snuffbox: a single-centre prospective cohort study using a propensity score method
Authors: Li Feng , Shi Gan-Wei , Yu Xiao-Long , Song Rui-Xiao , Xiao Jian-Qiang , Huang Hao-Min , Li La-Mei , Zhang Liu-Yan , Gong Chun , Cai Gao-Jun
Published: March 2022

Background

This study investigated the safety and efficacy of coronary angiography (CAG) and percutaneous coronary intervention (PCI) via distal transradial artery access (d-TRA).

Methods

For this single-centre prospective cohort study, a total of 1066 patients who underwent CAG or PCI procedures from September 2019 to November 2020 were included. Patients were divided into two groups: the d-TRA group (346) and the conventional transradial artery access (c-TRA) group (720) based on access site. A total of 342 pairs of patients were successfully matched using propensity score matching (PSM) for subsequent analysis.

Results

No significant differences in puncture success rate, procedural method, procedural time, sheath size, contrast dosage or fluoroscopy time were noted between the two groups. The puncture time in the d-TRA group was longer than that in the c-TRA group (P < 0.01), and the procedure success rate was lower than that in the c-TRA group (90.94% vs. 96.49%,P = 0.01). The haemostasis time in the d-TRA group was shorter than that in the c-TRA group (P < 0.01), and the visual analogue scale (VAS) was lower than that in the c-TRA group (P < 0.01). In addition, the prevalence of bleeding and haematoma in the d-TRA group was lower than that in the c-TRA group (1.75% vs. 7.31%,P < 0.01; 0.58% vs. 3.22%,P = 0.01, respectively). No significant difference in the incidence of numbness was noted between the two groups. No other complications were found in two groups.

Conclusion

d-TRA is as safe and effective as c-TRA for CAG and PCI. It has the advantages of improved comfort and fewer complications.

Trail registrationChinese Clinical Trial Registry, ChiCTR1900026519.
Impact of a procalcitonin-based algorithm on the quality of management of patients with uncomplicated adhesion-related small bowel obstruction assessed by a textbook outcome: a multicenter cluster-randomized open-label controlled trial
Authors: Sabbagh Charles , Mauvais Francois , Tuech Jean-Jacques , Tresallet Christophe , Ortega-Debalon Pablo , Mathonnet Muriel , Lefevre Jeremie H. , Lakkis Zaher , Fuks David , Muscari Fabrice , Dron Bernard , Couderc Philippe , Alves Arnaud , Regimbeau Jean-Marc
Published: March 2022

Background

Acute adhesion-related small bowel obstruction (ASBO) is a common digestive emergency, accounting for 1 to 3% of all digestive emergencies. The efficacy of conservative management in this setting is a subject of debate, as it may delay the decision to perform surgery and increase the frequency of bowel resection (e.g., in the presence of bowel necrosis) or, in contrast, prompt an excessive number of unnecessary laparotomies. Thus, the decision to perform surgery is difficult. We propose that the introduction of the procalcitonin (PCT)-based algorithm improves the quality of the management of patients with ASBO by aiding the decision of whether or not to perform surgery.

Methods

This is a 1:1 cluster-randomized clinical trial (use of algorithm: no algorithm) using an independent computer to ensure that investigators cannot interfere with the randomization. Each cluster will correspond to one investigating center. All patients in a center will be managed in the same way. Before randomization, each principal investigator will provide a commitment to participate in the study to avoid the risk of “empty clusters”. The patients included will constitute two parallel arms (use of algorithm versus no algorithm), with no expected crossover between arms. The inclusion criteria are being an adult with uncomplicated acute ASBO (i.e., absence of fever, abdominal pain and distension, nausea and/or vomiting, and the absence of gas and/or stool, in conjunction with a contrast-enhanced CT scan, for patients with previous abdominal surgery) who is able to express consent with a signed written informed consent form. Patients with complicated acute ASBO (strangulation or peritonitis) will be excluded.

Discussion

There is an ongoing debate on the management of uncomplicated ASBO. The main points are to avoid a surgery if it is unnecessary and to avoid delayed surgery if it is necessary. Currently, there are no robust criteria to objectively determine the failure of non-surgical treatment or to establish the indications for surgery in acute ASBO. Our team proposes the use of procalcitonin (PCT) to help distinguish patients for whom conservative management is likely to be successful from those for whom surgical management is required. The results from a randomized control trial could help in the selection of patients through clear inclusion and exclusion criteria and simplify or clarify the management algorithm. In conclusion, PCT may be useful in evaluating the proper strategy for ASBO.

Trial registration The trial is registered at clinical trials under the reference: NCT03905239
Natural killer cell-related gene signature predicts malignancy of glioma and the survival of patients
Authors: Li Chenglong , Liu Fangkun , Sun Lunquan , Liu Zhixiong , Zeng Yu
Published: March 2022

Background

Natural killer (NK) cells-based therapies are one of the most promising strategies against cancer. The aim of this study is to investigate the natural killer cell related genes and its prognostic value in glioma.

Methods

The Chinese Glioma Genome Atlas (CGGA) was used to develop the natural killer cell-related signature. Risk score was built by multivariate Cox proportional hazards model. A cohort of 326 glioma samples with whole transcriptome expression data from the CGGA database was included for discovery. The Cancer Genome Atlas (TCGA) datasets was used for validation. GO and KEGG were used to reveal the biological process and function associated with the natural killer cell-related signature. We also collected the clinical pathological features of patients with gliomas to analyze the association with tumor malignancy and patients’ survival.

Results

We screened for NK-related genes to build a prognostic signature, and identified the risk score based on the signature. We found that NK-related risk score was independent of various clinical factors. Nature-killer cell gene expression is correlated with clinicopathological features of gliomas. Innovatively, we demonstrated the tight relation between the risk score and immune checkpoints, and found NK-related risk score combined with PD1/PDL1 patients could predict the patient outcome.

Conclusion

Natural killer cell-related gene signature can predict malignancy of glioma and the survival of patients, these results might provide new view for the research of glioma malignancy and individual immunotherapy.
Combination of ferroptosis and pyroptosis to construct a prognostic classifier and predict immune landscape, chemotherapeutic efficacy and immunosuppressive molecules in hepatocellular carcinoma
Authors: Xu Lijun , Zheng Qing , Liu Wenwen
Published: March 2022

Background

The induction of ferroptosis and pyroptosis has been highlighted as a novel approach to decide cancer cell fate. However, few studies have systematically explored the role of combining these two novel cell death modalities in hepatocellular carcinoma  (HCC).

Methods

Ferroptosis-related genes (FRGs) and pyroptosis-related genes (PRGs) were retrieved and downloaded from FerrDb and GeneCards database, respectively. A prognostic classifier integrating with prognostic differentially expressed FRGs and PRGs was constructed by the least absolute shrinkage and selection operator (LASSO) algorithm in the TCGA-LIHC dataset and verified using the ICGC (LIRI-JP) dataset.

Results

A total of 194 differentially expressed FRGs and PRGs were identified and named as differentially expressed genes (DEGs) and, out of them 79 were found dramatically correlated with prognosis in HCC. Based on 13 key DEGs with prognostic value, a novel expression signature was constructed and used to stratify HCC patients into 2 groups. Kaplan–Meier analysis demonstrated that high-risk patients had a more dismal prognosis. Receiver operating characteristic curve (ROC) and multivariate Cox analysis confirmed its predictive power and independent characteristic. Immune profile analysis demonstrated that high-risk group had prominent upregulation of immunosuppressive cells, including macrophages, Th2_cells and Treg. The correlation analysis between this signature and immunosuppressive molecules, Immunophenoscore (IPS) and chemotherapeutic efficacy demonstrated that low-risk group had a higher  IC50 of cisplatin, mitomycin and doxorubicin and negatively related with CTLA4, HAVCR2, LAG3, PDCD1, TIGIT and ICIs treatment represented by CTLA4-/PD-1-, CTLA4 + /PD-1-, CTLA4-/PD-1 + .

Conclusions

In this research, a novel expression signature was identified based on FRGs and PRGs in HCC, and this signature could be used to predict prognosis and select patients potentially benefiting from immunotherapies and chemotherapy.
A cross sectional assessment of basic needs insecurity prevalence and associated factors among college students enrolled at a large, public university in the Southeastern U.S
Authors: Robbins Mary Kate , Spence Marsha , Steeves Elizabeth Anderson
Published: March 2022

Background

There is increasing evidence of problematic rates of food insecurity among college students, yet few studies have gone beyond this to examine housing insecurity rates or rates of basic need insecurity (BNI), which is defined as having both food and housing insecurity, among the postsecondary population. BNI may have significant impacts on the mental and social health, and academic outcomes of college students, yet remains understudied. The researchers of this study are among the first to assess the prevalence of food insecurity, housing insecurity, and basic needs insecurity among college students enrolled at a large, public university in the Southeast and to identify factors associated with experiencing food, housing, and basic needs insecurity.

Methods

A cross-sectional online survey was conducted at a large, public university in the Southeast United States. All eligible, enrolled students (n = 23,444) were asked to complete an online survey, 2634 responded (11.2% response rate). Multivariate logistic regression models were used to assess relationships between demographic and financial factors and the outcomes of interest (food, housing, and basic needs insecurity).

Results

High rates of food insecurity (48.5%), housing insecurity (66.1%), and basic needs insecurity (37.1%) were identified. After controlling for confounders, factors that were significantly associated with increased odds of students having basic needs insecurity included previous food insecurity (p < 0.001; Odds Ratio (OR) = 3.36; Confidence Interval (CI) = 2.64–4.28), being employed (p < 0.001, OR = 1.70; CI = 1.34–2.17), not receiving family financial support (p < 0.001, OR = 1.61; CI = 1.30–2.00), and living off-campus (p < 0.001, OR = 1.67; CI = 1.25–2.22). Juniors (p < 0.001, OR = 1.78; CI = 1.31–2.42), seniors (p < 0.001, OR = 2.06; CI = 1.52–2.78), Masters (p = 0.004, OR = 1.68; CI = 1.18–2.40), and PhD or EdD (p = 0.029, OR = 1.55; CI = 1.05–2.31) students were significantly more likely to experience basic needs insecurity than sophomore students.

Conclusions

This research identifies high rates of food, housing, and basic needs insecurity among college students enrolled at a large, public university. Financial factors such as being food insecure prior to attending college, working during college, and not having familial financial support were all related to BNI in this sample. Students who were more advanced in their education experienced more BNI than less advanced students. Innovative interventions with enhanced BNI measures, for example, partnering with financial aid offices to screen and refer students to food resources, are likely needed to address this multi-faceted problem.
Longitudinal changes in COVID-19 vaccination intent among South African adults: evidence from the NIDS-CRAM panel survey, February to May 2021
Authors: Burger Ronelle , Köhler Timothy , Golos Aleksandra M. , Buttenheim Alison M. , English René , Tameris Michele , Maughan-Brown Brendan
Published: March 2022

Background

COVID-19 vaccine hesitancy has threatened the ability of many countries worldwide to contain the pandemic. Given the severe impact of the pandemic in South Africa and disruptions to the roll-out of the vaccine in early 2021, slower-than-expected uptake is a pressing public health challenge in the country. We examined longitudinal changes in COVID-19 vaccination intent among South African adults, as well as determinants of intent to receive a vaccine.

Methods

We used longitudinal data from Wave 4 (February/March 2021) and Wave 5 (April/May 2021) of the National Income Dynamics Study: Coronavirus Rapid Mobile Survey (NIDS-CRAM), a national and broadly representative panel survey of adults in South Africa. We conducted cross-sectional analyses on aggregate and between-group variation in vaccination intent, examined individual-level changes between waves, and modeled demographic predictors of intent.

Results

We analysed data for 5629 (Wave 4; 48% male, mean age 41.5 years) and 5862 (Wave 5; 48% male, mean age 41.6 years) respondents. Willingness to get a COVID-19 vaccine significantly increased from 70.8% (95% CI: 68.5–73.1) in Wave 4 to 76.1% (95% CI: 74.2–77.8) in Wave 5. Individual-level analyses indicated that only 6.6% of respondents remained strongly hesitant between survey waves. Although respondents aged 18–24 years were 8.5 percentage points more likely to report hesitancy, hesitant respondents in this group were 5.6 percentage points more likely to change their minds by Wave 5. Concerns about rushed testing and safety of the vaccines were frequent and strongly-held reasons for hesitancy.

Conclusions

Willingness to receive a COVID-19 vaccine has increased among adults in South Africa, and those who were entrenched in their reluctance make up a small proportion of the country’s population. Younger adults, those in formal housing, and those who trusted COVID-19 information on social media were more likely to be hesitant. Given that stated vaccination intent may not translate into behaviour, our finding that three-quarters of the population were willing to accept the vaccine may reflect an upper bound. Vaccination promotion campaigns should continue to frame vaccine acceptance as the norm and tailor strategies to different demographic groups.
Time trend analysis of leisure-time activity participation among young-old adults in China 2002–2018
Authors: Fong Joelle H. , Feng Qiushi , Zhang Wei , Chen Huashuai
Published: March 2022

Background

To examine the time trends of leisure activity engagement among young-old adults aged 65–74 in China over a 16-year period.

Methods

Data for a nationally representative sample of young-old adults was sourced from the 2002–2018 Chinese Longitudinal Healthy Longevity Survey (N = 9504). Generalized estimating equations regressions were implemented to assess temporal trends for 10 different leisure-time activities. We also evaluated time trends for solitary versus social leisure-time activities.

Results

Young-old adults were less likely to engage in any form of social activities (e.g. participate in social events) over time, controlling for other confounders such as age, sex, education, income, and health characteristics. Trends in outdoor activities participation and tourism also declined over 2002-2014, but reversed in 2018. In contrast, solitary leisure activities (e.g. watching TV) became more popular. There was a significant spike in the likelihood of keeping pets from 2011 onwards, especially among urbanites.

Conclusions

The future elderly in China have tended towards home-bound and solitary leisure activities over time, which warrants policy attention and public health interventions to reverse such trends.
Online consultation in an orthopedic trauma surgery outpatient clinic: is there a learning curve?
Authors: Hepp Pierre , Osterhoff Georg , Melcher Peter , Henkelmann Ralf , Theopold Jan
Published: March 2022

Background

In the context of the German contact restrictions due to the COVID-19 pandemic of March 2020, an online-based consultation system was established in our university orthopedic outpatient department to maintain patient care. As a basis for contact-minimizing communication, this was continued after the contact restrictions were lifted. The aim of this prospective pilot study was to assess the effectiveness, technical feasibility, and patient flow in this system under lockdown conditions and in the period afterwards.

Methods

The evaluation took place from the beginning of the first lockdown on March 13, 2020, until May 31, 2021. For each patient encounter, the quality of the sound and video connections was documented. The outcomes of the consultations were recorded. Four categories were distinguished: 1) no follow-up necessary, 2) follow-up via online consultation, 3) referral for surgical therapy, and 4) follow-up in the outpatient clinic for physical examination.

A comparison was made between an early cohort right after implementation of the online consultation and and a late cohort after establishment of the consultation.

Results

There were 408 patient encounters via online consultation. A total of 360 (88%) consultations were uninterrupted. Initial presentations accounted for 124 (30%) consultations. In 75 (18%) patients, no further follow-up was necessary. Follow-up via online consultation was scheduled in 82 (20%) patients, direct referral for surgery was made in 86 (21%) patients, and a follow-up for physical examination was arranged in 165 (40%) patients. When comparing the early and late cohort, there was no difference in the duration of the conversation (p = 0.23). A significant difference was found in the type of further treatment. In the late cohort, conservative therapy was used more often (p < 0.01), resulting in a lower number of follow-up visits for clinical examination (p < 0.01).

Conclusion

While a definite decision for further procedure was possible solely by online consultation in a large percentage of cases, 40% of patients still needed an additional in-person consultation for physical examination. A learning curve could be observed regarding the selection of patients suited for online consultation. Overall, online consultation is a useful measure to manage patient volume and to visibly support direct doctor-patient contact.
Functional comparison of pacifiers using finite element analysis
Authors: Tesini David A. , Hu Linda C. , Usui Brent H. , Lee Christopher L.
Published: March 2022

Background

Pacifiers have been shown to affect maxillary growth related to the anatomic structure of the palate and forces placed upon it during sucking. This study compares and evaluates the mechanical behavior of pacifiers of different design and size (i.e., fit), identified by brand and size, positioned in age-specific palatal models with respect to both contact area and force when subjected to peristaltic tongue function and intraoral pressure related to non-nutritive sucking.

Methods

Nonlinear finite element analyses were used to simulate dynamic mechanical interaction between the pacifiers and palates. Time-varying, external pressure loads were applied which represent intraoral pressure arising from non-nutritive sucking and peristaltic behavior of the tongue. The silicone rubber pacifier bulb was represented using a hyperelastic material model.

Results

Results from the finite element analyses include deformation, stress, strain, contact area, and contact force. Mechanical interaction was evaluated in terms of the spatial distribution of the contact area and force between the pacifier and the palate. The resulting palatal interaction profiles were quantitatively compared to assess how pacifier fit specifically affects the support provided to two areas of the palate, the palatal vault and the Tektal wall.

Conclusions

Pacifiers interact with the palate differently based on their fit (i.e., design and size) regardless of whether they are labeled conventional or orthodontic. Finite element analysis is an effective tool for evaluating how a pacifier’s design affects functional mechanics and for providing guidance on biometric sizing.
Machine learning based forecast for the prediction of inpatient bed demand
Authors: Tello Manuel , Reich Eric S. , Puckey Jason , Maff Rebecca , Garcia-Arce Andres , Bhattacharya Biplab Sudhin , Feijoo Felipe
Published: March 2022

Background

Overcrowding is a serious problem that impacts the ability to provide optimal level of care in a timely manner. High patient volume is known to increase the boarding time at the emergency department (ED), as well as at post-anesthesia care unit (PACU). Furthermore, the same high volume increases inpatient bed transfer times, which causes delays in elective surgeries, increases the probability of near misses, patient safety incidents, and adverse events.

Objective

The purpose of this study is to develop a Machine Learning (ML) based strategy to predict weekly forecasts of the inpatient bed demand in order to assist the resource planning for the ED and PACU, resulting in a more efficient utilization.

Methods

The data utilized included all adult inpatient encounters at Geisinger Medical Center (GMC) for the last 5 years. The variables considered were class of inpatient encounter, observation, or surgical overnight recovery (SORU) at the time of their discharge. The ML based strategy is built using the K-means clustering method and the Support Vector Machine Regression technique (K-SVR).

Results

The performance obtained by the K-SVR strategy in the retrospective cohort amounts to a mean absolute percentage error (MAPE) that ranges between 0.49 and 4.10% based on the test period. Additionally, results present a reduced variability, which translates into more stable forecasting results.

Conclusions

The results from this study demonstrate the capacity of ML techniques to forecast inpatient bed demand, particularly using K-SVR. It is expected that the implementation of this model in the workflow of bed capacity management will create efficiencies, which will translate in a more reliable, inexpensive and timely care for patients.
Providing telenursing care for victims: a simulated study for introducing of possibility nursing interventions in disasters
Authors: Nejadshafiee Mahdiye , Nekoei-Moghadam Mahmoud , Bahaadinbeigy Kambiz , Khankeh Hamidreza , Sheikhbardsiri Hojjat
Published: March 2022

Introduction

Uncertainty occurrence of disasters requires special attention and a shortage of health care specialists is a challenge for health care systems; therefore, the use of telenursing care during a disaster is an appropriate way to provide care. This study aimed to investigate telenursing operational possibilities in disasters.

Methods

A cross-sectional study was performed by implementing a functional exercise (Drill) for the possibility of nursing interventions in the response phase to disasters at Kerman University of Medical Sciences in 2021. Two evaluators examined and scored the possibility of providing telenursing care using a researcher-made checklist and we surveyed Inter-rater agreement between two evaluators by Cohen's kappa coefficient. Data were analyzed using descriptive tests and SPSS 20 software.

Results

Findings showed that implementation of telenursing care would be helpful in future disasters. The scores received from assessment of the evaluation checklist for this simulated exercise program by the first evaluator was 83.25 and for the second evaluator was 72.00. The results of the study showed that the mean score of the possibility of telenursing in disasters was at a high level 77.50. Thus, the quality of the telenursing care in simulated conditions was satisfactory.

Conclusion

Today, disaster management is almost impossible without using new technologies. This study found that due to the lack of specialized nursing staff in the deprived areas affected by disasters, the most important way to provide health care for a large group of the population is to develop effective health services so that everyone can use these services equally and fairly.
Effects of repeated infections with non-typeable Haemophilus influenzae on lung in vitamin D deficient and smoking mice
Authors: Serré Jef , Tanjeko Ajime Tom , Mathyssen Carolien , Heigl Tobias , Sacreas Annelore , Cook Dana Paulina , Verbeken Erik , Maes Karen , Verhaegen Jan , Pilette Charles , Vanoirbeek Jeroen , Gysemans Conny , Mathieu Chantal , Vanaudenaerde Bart , Janssens Wim , Gayan-Ramirez Ghislaine
Published: March 2022

Background

In chronic obstructive pulmonary disease (COPD), exacerbations cause acute inflammatory flare-ups and increase the risk for hospitalization and mortality. Exacerbations are common in all disease stages and are often caused by bacterial infections e.g., non-typeable Heamophilus influenzae (NTHi). Accumulating evidence also associates vitamin D deficiency with the severity of COPD and exacerbation frequency. However, it is still unclear whether vitamin D deficiency when combined with cigarette smoking would worsen and prolong exacerbations caused by repeated infections with the same bacterial strain.

Methods

Vitamin D sufficient (VDS) and deficient (VDD) mice were exposed to nose-only cigarette smoke (CS) for 14 weeks and oropharyngeally instilled with NTHi at week 6, 10 and 14. Three days after the last instillation, mice were assessed for lung function, tissue remodeling, inflammation and immunity. The impact of VDD and CS on inflammatory cells and immunoglobulin (Ig) production was also assessed in non-infected animals while serum Ig production against NTHi and dsDNA was measured in COPD patients before and 1 year after supplementation with Vitamin D3.

Results

VDD enhanced NTHi eradication, independently of CS and complete eradication was reflected by decreased anti-NTHi Ig’s within the lung. In addition, VDD led to an increase in total lung capacity (TLC), lung compliance (Cchord), MMP12/TIMP1 ratio with a rise in serum Ig titers and anti-dsDNA Ig’s. Interestingly, in non-infected animals, VDD exacerbated the CS-induced anti-NTHi Ig’s, anti-dsDNA Ig’s and inflammatory cells within the lung. In COPD patients, serum Ig production was not affected by vitamin D status but anti-NTHi IgG increased after vitamin D3 supplementation in patients who were Vitamin D insufficient before treatment.

Conclusion

During repeated infections, VDD facilitated NTHi eradication and resolution of local lung inflammation through production of anti-NTHi Ig, independently of CS whilst it also promoted autoantibodies. In COPD patients, vitamin D supplementation could be protective against NTHi infections in vitamin D insufficient patients. Future research is needed to decipher the determinants of dual effects of VDD on adaptive immunity.

Trail registration

ClinicalTrials, NCT00666367. Registered 23 April 2008, https://www.clinicaltrials.gov/ct2/show/study/NCT00666367.