bluuebunny/crossref_metadata_2025 huggingface dataset:
Sarcopenic obesity is associated with impaired physical function and mortality in older patients with heart failure: insight from FRAGILE-HF
Authors: Saito Hiroshi , Matsue Yuya , Kamiya Kentaro , Kagiyama Nobuyuki , Maeda Daichi , Endo Yoshiko , Ueno Hidenao , Yoshioka Kenji , Mizukami Akira , Saito Kazuya , Ogasahara Yuki , Maekawa Emi , Konishi Masaaki , Kitai Takeshi , Iwata Kentaro , Jujo Kentaro , Wada Hiroshi , Hiki Masaru , Dotare Taishi , Sunayama Tsutomu , Kasai Takatoshi , Nagamatsu Hirofumi , Ozawa Tetsuya , Izawa Katsuya , Yamamoto Shuhei , Aizawa Naoki , Wakaume Kazuki , Oka Kazuhiro , Momomura Shin-ichi , Minamino Tohru
Published: July 2022

Background

The purpose of this study was to clarify the prevalence, association with frailty and exercise capacity, and prognostic implication of sarcopenic obesity in patients with heart failure.

Methods

The present study included 779 older adults hospitalized with heart failure (median age: 81 years; 57.4% men). Sarcopenia was diagnosed based on the guidelines by the Asian Working Group for Sarcopenia. Obesity was defined as the percentage of body fat mass (FM) obtained by bioelectrical impedance analysis. The FM cut-off points for obesity were 38% for women and 27% for men. The primary endpoint was 1-year all-cause death. We assessed the associations of sarcopenic obesity occurrence with the short physical performance battery (SPPB) score and 6-minute walk distance (6MWD).

Results

The rates of sarcopenia and obesity were 19.3 and 26.2%, respectively. The patients were classified into the following groups: non-sarcopenia/non-obesity (58.5%), non-sarcopenia/obesity (22.2%), sarcopenia/non-obesity (15.3%), and sarcopenia/obesity (4.0%). The sarcopenia/obesity group had a lower SPPB score and shorter 6MWD, which was independent of age and sex (coefficient, − 0.120;t-value, − 3.74;P < 0.001 and coefficient, − 77.42;t-value, − 3.61;P < 0.001; respectively). Ninety-six patients died during the 1-year follow-up period. In a Cox proportional hazard analysis, sarcopenia and obesity together were an independent prognostic factor even after adjusting for a coexisting prognostic factor (non-sarcopenia/non-obesity vs. sarcopenia/obesity: hazard ratio, 2.48; 95% confidence interval, 1.22–5.04;P = 0.012).

Conclusion

Sarcopenic obesity is a risk factor for all-cause death and low physical function in older adults with heart failure.

Trial registration

University Hospital Information Network (UMIN-CTR:UMIN000023929).
Integrated analysis reveals the dysfunction of signaling pathways in uveal melanoma
Authors: Sun Songlin , Guo Boxia , Xu Liang , Shi Rui
Published: July 2022

Background

Uveal melanoma (UM) is the most common primary intraocular malignancy with a strong tendency to metastasize. The prognosis is poor once metastasis occurs. The treatment remains challenging for metastatic UM, even though our understanding of UM has advanced, mostly because the complexity of the genetic and immunologic background has not been fully explored.

Methods

Single-cell sequencing data were acquired from a healthy dataset and three UM datasets. The differentially expressed genes between primary and metastatic UM in The Cancer Genome Atlas (TCGA) data were attributed to specific cell types and explained with functional annotation. The analysis for cell–cell communication was conducted by “CellChat” to understand the cell crosstalk among the cell clusters and to delineate the dysfunctional signaling pathways in metastatic UM. CCK-8, EdU and transwell assays were performed to verify the function of the genes of interest.

Results

We revealed aberrant signaling pathways with distinct functional statuses between primary and metastatic UM by integrating multiple datasets. The crucial signals contributing most to outgoing or incoming signaling of metastasis were identified to uncover the potential targeting genes. The association of these genes with disease risk was estimated based on survival data from TCGA. The key genes associated with proliferation and metastasis were verified.

Conclusions

Conclusively, we discovered the potential key signals for occurrence and metastasis of UM and provided a theoretical basis for potential clinical application.
The stigma of patients with chronic insomnia: a clinical study
Authors: He Shuo , Ke Xue-Jia , Wu Yan , Kong Xiao-Yi , Wang Yun , Sun Hui-Qin , Xia Deng-Zhi , Chen Gui-Hai
Published: July 2022

Background

The objective of this study was to explore the stigma and related influencing factors in individuals with chronic insomnia disorder (CID).

Methods

A total of 70 CID patients and 70 healthy controls (CON) were enrolled in the study. All subjects completed the assessments of sleep, emotion, and cognition. Their stigma and life quality were measured using the Chronic Stigma Scale and the 36-Item Short-Form Health Survey (SF-36).

Results

The ratio of individuals with stigma was significantly different between CID and CON groups (C2 = 35.6, p < 0.001). Compared with the CON group, the CID group had higher scores for total stigma (U = 662.0, p < 0.001), internalized stigma (U = 593.0, p < 0.001), enacted stigma (U = 1568.0, p < 0.001), PSQI (U = 2485.0, p < 0.001) and HAMD-17 (U = 69.5, p < 0.001) as well as lower scores for MoCA-C (U = 3997.5, p < 0.001) and most items of SF-36. Partial correlation analysis showed that different items of the Chronic Stigma Scale were positively correlated with illness duration, PSQI and HAMD-17 scores, while negatively correlated with one or more items of the SF-36. Multivariate regression analysis showed that illness duration and the Mental Health domain of the SF-36 were independent risk factors for one or more items of stigma in CID patients.

Conclusion

Patients with CID have an increased risk of stigma. Moreover, illness duration and Mental Health may be primary factors related to stigma.
Social networks and internet emotional relationships on mental health and quality of life in students: structural equation modelling
Authors: Aliverdi Fatemeh , Farajidana Hoorvash , Tourzani Zahra Mehdizadeh , Salehi Leili , Qorbani Mostafa , Mohamadi Farima , Mahmoodi Zohreh
Published: July 2022

Background

Social networks and relationships create a sense of belonging and social identity; hence, can affect mental health and the quality of life, especially in young people. The present study was conducted to determine the predicting role of social networks and internet emotional relationships on students’ mental health and quality of life.

Methods

The present cross-sectional study was conducted in 2021 on 350 students at Alborz University of Medical Sciences selected by convenience sampling. Data were collected using five questionnaires: socioeconomic status, social networks, internet emotional relationships, stress, anxiety, depression scale (DASS-21), quality of life, and a checklist of demographic details. Data were analyzed in SPSS-25, PLS-3, and Lisrel-8.8.

Results

According to the path analysis, the DASS-21 score had the most significant positive causal association with internet emotional relationships in the direct path (B = 0.22) and the most negative association with socioeconomic status (B = − 0.09). Quality of life had the highest negative causal association with the DASS-21 score in the direct path (B = − 0.26) and the highest positive association with socioeconomic status in the indirect path (B = 0.02). The mean duration of using social networks (B ≈ − 0.07) and internet emotional relationships (B ≈ − 0.09) had the highest negative association with quality of life.

Conclusion

The use of the internet and virtual networks, internet emotional relationships, and unfavorable socioeconomic status were associated with higher DASS-21 scores and reduced quality of life in the students. Since students are the future of countries, it is necessary for policymakers to further address this group and their concerns.
Time-trends for eczema prevalences among children and adults from 1985 to 2015 in China: a systematic review
Authors: Liu Wei , Cai Jiao , Sun Chanjuan , Zou Zhijun , Zhang Jialing , Huang Chen
Published: July 2022

Background

Several studies have reported that childhood prevalence of eczema has been increasing worldwide. However, none study quantitatively evaluated prevalence trends of eczema among children and adults in the last 30 years in China.

Methods and Findings

Via a systematic review of literature databases in English and Chinese, we summarized all studies reporting eczema prevalences from 1985 to 2015 in China as well as diagramed prevalence and eczematous population trends against year for different age groups. A total of 93 studies and 17 studies (16 for children and one for adults) were selected for qualitative and quantitative synthesis, respectively. Childhood lifetime-ever eczema prevalences ranged from 10.0% to 30.0%. Prevalences among 3-12-year-olds children showed increasing trends in most specific cities, but national lifetime-ever eczema prevalences among 13-14-year-olds children decreased from 10.6% in 2001 to 8.6% in 2009 in mainland China. We estimated that about 1.5 million children aged 13-14-year-olds in 2009 and 15.5 million children aged 3-6-year-olds in 2012 had lifetime-ever eczema in mainland China. Similar studies were too few to ascertain time-trends of eczema prevalence among adults. About 39.4, 20.0, and 11.6 million adults aged 15-86-year-olds in 2010 had contact dermatitis, seborrheic dermatitis, and atopic dermatitis in the mainland China, respectively.

Conclusions

The burden of eczema became heavier in young children, whereas perhaps had been reduced in adolescent in China. More studies for eczema prevalence in adults are warranted.
Enhancing medication risk communication in developing countries: a cross-sectional survey among doctors and pharmacists in Malaysia
Authors: Panickar Rema , Aziz Zoriah , Kamarulzaman Adeeba
Published: July 2022

Background

Medication risk communication is essential to ensure the safe use of medicines. However, very few nations worldwide have established effective risk communication systems. To date, the effectiveness of risk communication among healthcare professionals in Malaysia has never been evaluated. Our study aimed to (i) evaluate doctors’ and pharmacists’ awareness of regulatory risk communication methods; (ii) identify factors predicting the usefulness of these methods; and (iii) compare respondents’ preferences for risk communication to outline suggestions for enhancement.

Methods

We conducted a nationwide cross-sectional survey covering four commonly used risk communications, namely a national drug bulletin, safety alerts, Direct Healthcare Professional Communication letters (DHPCs), and educational materials. Multiple logistic regression analysis was used to determine the association between independent variables and the usefulness of risk communication. We performed qualitative analysis of free-text responses to gain insights on respondents’ perspectives on risk communication.

Results

Of the 1146 responses received, 650 were from pharmacists (56.7%). Among the four methods surveyed, 71.5% of respondents were aware of educational materials, while awareness of the other three methods ranged from 20.7 to 53.9%. Pharmacists had higher awareness of all four methods compared to doctors. Private sector respondents were more aware of DHPCs compared to those from the public sector. The strongest predictors for finding risk communication useful were being a pharmacist [odds ratio (OR) = 18.2; 95% CI: 10.98–30.07; p <  0.001], having ≥30 years’ work experience [OR = 4.9; 95% CI: 1.98–12.08; p <  0.001], and working in the pharmaceutical industry [OR = 4.6; 95% CI: 1.08–19.72; p = 0.039]. Both doctors and pharmacists preferred risk communication in the English-language and electronic format. However, other preferences differed between the professions and sectors. Analysis of free-text comments revealed five core themes to guide risk communication enhancement strategies.

Conclusions

Risk communication awareness differed between public and private sector doctors and pharmacists depending on communication source. Integrating our findings with the theory of effective communication, we provide suggestions for developing strategic plans on enhancing risk communication. Public-private sector collaboration is key in ensuring risk communication effectiveness.
Role of no table salt on hypertension and stroke based on large sample size from National Health and Nutrition Examination Survey database
Authors: Li Zongqin , Hu Lan , Rong Xiaoxia , Luo Jun , Xu Xuejie , Zhao Yonglong
Published: July 2022

Background

To assess the associations between no table salt and hypertension or stroke.

Methods

The data of 15,352 subjects were collected from National Health and Nutrition Examination Survey (NHANES) database. All subjects were divided into no hypertension or stroke group (n = 10,894), hypertension group (n = 5888), stroke group (n = 164) and hypertension and stroke group (n = 511). Univariate and multivariate logistic regression analysis was used to measure the associations of salt type used with hypertension and stroke and co-variables were respectively adjusted in different models.

Results

After adjusting age and gender, other salt intake was associated with 1.88-fold risk of hypertension (OR = 1.88, 95%CI: 1.44–2.46) and no table salt was associated with 1.30-fold risk of hypertension (OR = 1.30, 95%CI: 1.15–1.47). After adjusting age, gender, race, BMI, PIR, marital status, CVDs, whether doctors’ told them to reduce salt, and diabetes, the risk of hypertension was 1.23-fold increase in no table salt group (OR = 1.23, 95%CI: 1.04–1.46). After the adjustment of age and gender, the risk of hypertension and stroke was 3.33-fold increase (OR = 3.33, 95%CI: 2.12–5.32) in other salt intake group and 1.43-fold increase (OR = 1.43, 95%CI:1.17–1.74) in no table salt group.

Conclusion

Other salt intake or no table salt were associated with a higher risk of hypertension or hypertension and stroke.
Fatty infiltration in cervical extensor muscle: is there a relationship with cervical sagittal alignment after anterior cervical discectomy and fusion?
Authors: Wang Xing-jin , Huang Kang-kang , He Jun-bo , Wu Ting-kui , Rong Xin , Liu Hao
Published: July 2022

Purpose

To investigate the relationship between the preoperative paraspinal Goutalier grade of fatty infiltration and postoperative cervical sagittal alignment in patients undergoing anterior cervical discectomy and fusion (ACDF).

Methods

A total of 101 patients who underwent single-level ACDF with the Zero-profile implant system between March 2011 and April 2020 were included in this study. Cervical sagittal alignment parameters, including the C2-C7 Cobb angle, functional spinal unit (FSU) angle, cervical sagittal vertical axis (SVA), and T1 slope (T1S), were assessed. Preoperative magnetic resonance images were used to classify patients according to Goutalier grade. Clinical outcomes including Neck Disability Index (NDI) scores, Japanese Orthepaedic Association (JOA) scores and Visual Analogue Scale (VAS) scores were collected and analyzed.

Results

According to the Goutalier grade, 33 patients were classified as Goutalier 0–1 (Group A), 44 were classified as Goutalier 1.5–2 (Group B), and 24 were classified as Goutalier 2.5–4.0 (Group C). The mean age among the three groups showed significant differences (P = 0.007). At the last follow-up, the C2-C7 Cobb angle, FSU angle, and T1S improved after the surgery among the groups. Although there were varying degrees of loss of curvature among the different groups during the follow-up period, the postoperative cervical sagittal alignment parameters demonstrated no statistical differences among the three groups (P > 0.05). In addition, patients in all groups experienced significant relief of their symptoms, and the clinical scores were comparable among the groups (P > 0.05).

Conclusion

The complex nature of anterior cervical surgery requires surgical attention both in decompression and sagittal alignment. Our study demonstrates satisfactory postoperative cervical sagittal alignment of patients despite different grades of fatty infiltration of the multifidus muscle following single-level ACDF. Based on our results, the improvement and maintenance of cervical sagittal alignment after ACDF remains a complex problem that spine surgeons should consider before surgery.
Effects of the advanced mandibular spring on mandibular retrognathia treatment: a three-dimensional finite element study
Authors: Zhu Cheng , Li Ruomei , Yuan Lingjun , Zheng Yikan , Jin Yu , Li Hairui , Liu Chao , Xia Lunguo , Fang Bing
Published: July 2022

Background

The Advanced Mandibular Spring (AMS) was newly developed as a dentofacial orthopedic appliance in conjunctive use of clear aligners to treat Class II malocclusion with mandibular retrognathia in adolescents. This study aimed to launch a biomechanical assessment and evaluate whether the stress patterns generated by AMS promote mandibular growth.

Methods

A three-dimensional finite element model was constructed using images of CBCT and spiral CT. The model consisted of craniomaxillofacial bones, articular discs, retrodiscal elastic stratum, masticatory muscle, teeth, periodontal ligament, aligner and AMS. Mechanical effects were analyzed in three types of models: mandibular postural position, mandibular advancement with AMS, and mandibular advancement with only muscular force.

Results

The stress generated by AMS was distributed to all teeth and periodontal ligament, pushing mandibular teeth forward and maxillary teeth backward. In the temporomandibular joint area, the pressure in the superior and posterior aspects of the condyle was reduced, which conformed to the stress pattern promoting condylar and mandibular growth. Stress distribution became even in the anterior aspect of the condyle and the articular disc. Significant tensile stress was generated in the posterior aspect of the glenoid fossa, which conformed to the stress pattern stimulating the remodeling of the fossa.

Conclusions

AMS created a favorable biomechanical environment for treating mandibular retrognathia in adolescents.
The trends of female sterilization in India: an age period cohort analysis approach
Authors: Bansal Anjali , Dwivedi Laxmi Kant , Ali Balhasan
Published: July 2022

In India, sterilisation is the most frequent method of modern contraception, and is primarily used by women. The contemporaneous assessment of sterilisation literature focuses only on trends and patterns that are limited to socioeconomic considerations, ignoring the cohort and period issues. No study has employed Age Period Cohort (APC) analysis to highlight the effect of APC on a particular outcome to yet. We have used maximum entropy method modelling to analyse the individual influence of APC on female sterilisation in India using the four rounds of the National Family Health Survey (NFHS). While the older group had higher sterilisation rates than the younger cohort, the age effects were found to have a standard inverted U-shaped curve, with women sterilising in their mid-30s as the might have completed their desire family size. The analysis found high rural-urban differentials in utilising female sterilisation, highlighting the relevance of education and empowerment in contraceptive decision-making among the educated one. Female sterilisation has become less common among Muslims in India over time, and among uneducated women, and it has shifted to later ages with each succeeding period. This was determined to be concerning in terms of India's future fertility. Since 1947, the government has implemented numerous policies to provide women with a variety of contraceptive options; however, the dominance of female sterilisation throughout all periods demonstrates that the government's efforts to provide temporary methods were futile.
Sex diversity within U.S. residencies: a cross-sectional study of trends from 2011 to 2019
Authors: Aguwa Ugochi T. , Menard Maylander , Srikumaran Divya , Prescott Christina , Canner Joseph , Woreta Fasika
Published: July 2022

Background

Despite females comprising 50.8% of the U.S. population, the percentage of females in the physician workforce is only 36.3%. Studies have examined sex trends within select specialties, however there is insufficient literature studying trends across all specialties. In this study, the authors examined trends in the proportion of female residents from 2011 to 2019 across all specialties, including both surgical and non-surgical. 

Methods

Data on the proportion of female residents from 2011 to 2019 in all specialties was extracted from the Accreditation Council for Graduate Medical Education (ACGME) Data Resource Books and analyzed with the chi-square test for trend.

Results

From 2011 to 2019, there was a statistically significant increase in the percentage of female residents in surgical specialties (p < 0.001) and no significant change in the percentage of female residents in non-surgical specialties. In the same time period, the specialty with the highest percentage of females was Obstetrics & Gynecology (81.3%), and the specialty with the lowest percentage of females was Orthopedic Surgery (13.8%).

Conclusions

Although there has been a positive overall trend in the percentage of females entering medical and surgical specialties, the percentage of females in medicine overall still lies below that of the entire population. Increased efforts are needed to increase female representation in medicine, especially in the U.S. in specialties where they are traditionally underrepresented.
Co-implementing vitamin A supplementation with seasonal malaria chemoprevention in Sokoto State, Nigeria: a feasibility and acceptability study
Authors: Oresanya Olusola , Phillips Abimbola , Okereke Ekechi , Ahmadu Abraham , Ibinaiye Taiwo , Marasciulo Madeleine , Ward Charlotte , Adesoro Olatunde , Mohammed Rilwanu , Nikau Jamilu , Isokpunwu Chris Osa , Inname Mohammad Ali , Counihan Helen , Baker Kevin , Maxwell Kolawole , Smith Helen
Published: July 2022

Background

Bi-annual high dose vitamin A supplements administered to children aged 6–59 months can significantly reduce child mortality, but vitamin A supplementation (VAS) coverage is low in Nigeria. The World Health Organization recommends that VAS be integrated into other public health programmes which are aimed at improving child survival. Seasonal malaria chemoprevention (SMC) provides a ready platform for VAS integration to improve health outcomes. This study explored the feasibility and acceptability of integrating VAS with SMC in one local government area in Sokoto State.

Methods

A concurrent QUAN-QUAL mixed methods study was used to assess the feasibility and acceptability of co-implementing VAS with SMC in one LGA of Sokoto state. Existing SMC implementation tools and job aids were revised and SMC and VAS were delivered using a door-to-door approach. VAS and SMC coverage were subsequently assessed using questionnaires administered to 188 and 197 households at baseline and endline respectively. The qualitative component involved key informant interviews and focus group discussions with policymakers, programme officials and technical partners to explore feasibility and acceptability. Thematic analysis was carried out on the qualitative data.

Results

At endline, the proportion of children who received at least one dose of VAS in the last six months increased significantly from 2 to 59% (p < 0.001). There were no adverse effects on the coverage of SMC delivery with 70% eligible children reached at baseline, increasing to 76% (p = 0.412) at endline. There was no significant change (p = 0.264) in the quality of SMC, measured by proportion of children receiving their first dose as directly observed treatment (DOT), at baseline (54%) compared to endline (68%). The qualitative findings are presented as two overarching themes relating to feasibility and acceptability of the integrated VAS-SMC strategy, and within each, a series of sub-themes describe study participants’ views of important considerations in implementing the strategy.

Conclusion

This study showed that it is feasible and acceptable to integrate VAS with SMC delivery in areas of high seasonal malaria transmission such as northern Nigeria, where SMC campaigns are implemented. SMC-VAS integrated campaigns can significantly increase vitamin A coverage but more research is required to demonstrate the feasibility of this integration in different settings and on a larger scale.
Conserved and lineage-specific hypothetical proteins may have played a central role in the rise and diversification of major archaeal groups
Authors: Méheust Raphaël , Castelle Cindy J. , Jaffe Alexander L. , Banfield Jillian F.
Published: July 2022

Background

Archaea play fundamental roles in the environment, for example by methane production and consumption, ammonia oxidation, protein degradation, carbon compound turnover, and sulfur compound transformations. Recent genomic analyses have profoundly reshaped our understanding of the distribution and functionalities of Archaea and their roles in eukaryotic evolution.

Results

Here, 1179 representative genomes were selected from 3197 archaeal genomes. The representative genomes clustered based on the content of 10,866 newly defined archaeal protein families (that will serve as a community resource) recapitulates archaeal phylogeny. We identified the co-occurring proteins that distinguish the major lineages. Those with metabolic roles were consistent with experimental data. However, two families specific to Asgard were determined to be new eukaryotic signature proteins. Overall, the blocks of lineage-specific families are dominated by proteins that lack functional predictions.

Conclusions

Given that these hypothetical proteins are near ubiquitous within major archaeal groups, we propose that they were important in the origin of most of the major archaeal lineages. Interestingly, although there were clearly phylum-specific co-occurring proteins, no such blocks of protein families were shared across superphyla, suggesting a burst-like origin of new lineages early in archaeal evolution.
Larva migrans in BALB/c mice experimentally infected with Toxocara cati ensured by PCR assay
Authors: Naderbandi Majid , Zibaei Mohammad , Haniloo Ali , Firoozeh Farzaneh , Hatami Zahra , Shokri Elham , Taira Kensuke
Published: July 2022

Background

Toxocara cati, the cat roundworm, is a parasitic nematode that known to cause toxocariasis in intermediate hosts and humans. In this study, we characterized the dynamics ofT. catilarvae migration in BALB/c mice after inoculation with eggs and ensured the migration detecting the larval DNA by a PCR. To evaluate the dynamics of larval migration and distribution, twenty-four BALB/c mice were orally inoculated with 2500 T. catiinfective eggs and the visceral organs of the infected animals were examined by pepsin digestion and microscopic parasite counts, followed by PCR at day 1 to 28 post-inoculation.

Results

The PCR assays were successfully used for detection ofT. catilarvae in tissue samples andT. catilarvae and the DNAs were found in the liver, lungs, heart, kidneys and the brain. We detectedT. catiin 92.2% of tissue samples by PCR, 30% higher than the conventional pepsin digestion technique.

Conclusion

Our findings demonstrated that the PCR assay is a sensitive and specific for the detection ofT. catilarvae. Therefore, it could become a useful tool for the investigation of the dynamics of larval migration andToxocarainfection in murine model.
Food-related quality of life in inflammatory bowel disease: measuring the validity and reliability of the Turkish version of FR-QOL-29
Authors: Aslan Çin Nazlı Nur , Whelan Kevin , Özçelik Ayşe Özfer
Published: July 2022

Purpose

Food-related quality of life is considerably impaired in patients with inflammatory bowel disease (IBD) and should be widely measured in research and clinical practice. This study aims to translate the FR-QoL-29 instrument to the Turkish language and evaluate its validity and reliability in Turkish patients with IBD.

Methods

The FR-QoL-29 was forwards and backwards translated into Turkish and the validity and reliability of the FR-QoL-29-Turkish measured at two tertiary hospitals in Ankara, Turkey. Participants completed four questionnaires regarding: sociodemographic; clinical (disease type and activity), and nutritional characteristics (MUST) together with FR-QoL-29-Turkish. In addition, 30 patients repeated the questionnaires after two weeks. collected. Pearson correlation coefficients and Cronbach α were used to assess reliability and validity (p < 0.05).

Results

A total of 180 participants with IBD (78 Crohn’s disease, 102 ulcerative colitis), with a mean age of 45.9 ± 12.5 years, were included. Bartlett's sphericity test was statistically significant (p < 0.001), meeting the prerequisite for factor analysis, and the adequacy of the sample size for factor analysis was confirmed by a high Kaiser–Meyer–Olkin (KMO = 0.92). Validity was confirmed by factor loadings ranging from 0.310 to 0.858. Item-total score correlations ranged from 0.258 to 0.837 and Cronbach’s α coefficient was 0.96 for the whole questionnaire indicating high internal consistency.

Conclusions

FR-QoL-29-Turkish is a valid and reliable measure of food-related quality of life in IBD patients with Turkish language. The FR-QoL-29-Turkish gives a comprehensive overview of the main aspects of food quality of life and can be used as a useful tool in both research and clinical practice.
Neural correlates of user learning during long-term BCI training for the Cybathlon competition
Authors: Tortora Stefano , Beraldo Gloria , Bettella Francesco , Formaggio Emanuela , Rubega Maria , Del Felice Alessandra , Masiero Stefano , Carli Ruggero , Petrone Nicola , Menegatti Emanuele , Tonin Luca
Published: July 2022

Background

Brain-computer interfaces (BCIs) are systems capable of translating human brain patterns, measured through electroencephalography (EEG), into commands for an external device. Despite the great advances in machine learning solutions to enhance the performance of BCI decoders, the translational impact of this technology remains elusive. The reliability of BCIs is often unsatisfactory for end-users, limiting their application outside a laboratory environment.

Methods

We present the analysis on the data acquired from an end-user during the preparation for two Cybathlon competitions, where our pilot won the gold medal twice in a row. These data are of particular interest given the mutual learning approach adopted during the longitudinal training phase (8 months), the long training break in between the two events (1 year) and the demanding evaluation scenario. A multifaceted perspective on long-term user learning is proposed: we enriched the information gathered through conventional metrics (e.g., accuracy, application performances) by investigating novel neural correlates of learning in different neural domains.

Results

First, we showed that by focusing the training on user learning, the pilot was capable of significantly improving his performance over time even with infrequent decoder re-calibrations. Second, we revealed that the analysis of the within-class modifications of the pilot’s neural patterns in the Riemannian domain is more effective in tracking the acquisition and the stabilization of BCI skills, especially after the 1-year break. These results further confirmed the key role of mutual learning in the acquisition of BCI skills, and particularly highlighted the importance of user learning as a key to enhance BCI reliability.

Conclusion

We firmly believe that our work may open new perspectives and fuel discussions in the BCI field to shift the focus of future research: not only to the machine learning of the decoder, but also in investigating novel training procedures to boost the user learning and the stability of the BCI skills in the long-term. To this end, the analyses and the metrics proposed could be used to monitor the user learning during training and provide a marker guiding the decoder re-calibration to maximize the mutual adaptation of the user to the BCI system.
Absolute quantitative lipidomics reveals lipids profiling in liver of mice with early-stage alcoholic liver disease
Authors: Zhao Fei , Chen Jun , Guo Rui , Zhu Jinyan , Gu Weijia , Li Songtao , Li Jiaomei
Published: July 2022

Background

Alcoholic liver disease (ALD) is one of the most prevalent chronic liver disease worldwide. Alcohol-induced alterations in hepatic lipids play an important role in ALD develpoment and progression. The present study aimed to thoroughly describe the changes of lipid profiling in liver of mice with early-stage alcoholic liver disease.

Methods

C57BL/6J male mice aged 7-week were randomized into alcohol-fed (AF) group and pair-fed control group (PF) (n = 10 per group). The early stage of ALD was induced with Lieber-DeCarli liquid diet. The lipids profiling was analyzed by absolute quantitative lipidomics with UHPLC-QTRAP-MS/MS.

Results

Alcohol intake significantly increased the levels of alanine aminotransferase (ALT) in plasma, and tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and triacylglycerols (TAG) levels in liver. Lipidomis analyses showed that 41 TAGs were up-regulated and 8 TAGs were down-regulated in response to alcohol intake. The 8 decreased TAGs were with more double bond, longer carbon chain length and mostly contained docosahexaenoic acid (C22:6n-3) and eicosapentaenoic acid (C20:5n-3), compared with the up-regulated TAGs. Furthermore, the down-regulated TAG(56:9)_FA20:5 was inversely associated with ALT and IL-6 levels. In addition, several altered lysophosphatidylcholines (LPC), lysophosphatidylethanolamines (LPE) and hexosylceramides (HCER) were all significantly decreased in response to alcohol consumption, especially HCer(18:1/22:0), with the top reduction among all the down-regulated lipids.

Conclusions

These findings suggest that not only the up-regulated lipids, alcohol-induced reduction in some specific lipids might also contribute to the ALD development, especially TAG(56:9)_FA20:5 and HCer(18:1/22:0). Their physiological functions and effects on ALD development warrants further investigation.
Paradoxical response to chest wall loading predicts a favorable mechanical response to reduction in tidal volume or PEEP
Authors: Selickman John , Tawfik Pierre , Crooke Philip S. , Dries David J. , Shelver Jonathan , Gattinoni Luciano , Marini John J.
Published: July 2022

Background

Chest wall loading has been shown to paradoxically improve respiratory system compliance (CRS) in patients with moderate to severe acute respiratory distress syndrome (ARDS). The most likely, albeit unconfirmed, mechanism is relief of end-tidal overdistension in ‘baby lungs’ of low-capacity. The purpose of this study was to define how small changes of tidal volume (VT) and positive end-expiratory pressure (PEEP) affect CRS(and its associated airway pressures) in patients with ARDS who demonstrate a paradoxical response to chest wall loading. We hypothesized that small reductions of VTor PEEP would alleviate overdistension and favorably affect CRSand conversely, that small increases of VTor PEEP would worsen CRS.

Methods

Prospective, multi-center physiologic study of seventeen patients with moderate to severe ARDS who demonstrated paradoxical responses to chest wall loading. All patients received mechanical ventilation in volume control mode and were passively ventilated. Airway pressures were measured before and after decreasing/increasing VTby 1 ml/kg predicted body weight and decreasing/increasing PEEP by 2.5 cmH2O.

Results

Decreasing either VTor PEEP improved CRSin all patients. Driving pressure (DP) decreased by a mean of 4.9 cmH2O (supine) and by 4.3 cmH2O (prone) after decreasing VT, and by a mean of 2.9 cmH2O (supine) and 2.2 cmH2O (prone) after decreasing PEEP. CRSincreased by a mean of 3.1 ml/cmH2O (supine) and by 2.5 ml/cmH2O (prone) after decreasing VT.CRSincreased by a mean of 5.2 ml/cmH2O (supine) and 3.6 ml/cmH2O (prone) after decreasing PEEP (P < 0.01 for all). Small increments of either VTor PEEP worsened CRSin the majority of patients.

Conclusion

Patients with a paradoxical response to chest wall loading demonstrate uniform improvement in both DP and CRSfollowing a reduction in either VTor PEEP, findings in keeping with prior evidence suggesting its presence is a sign of end-tidal overdistension. The presence of ‘paradox’ should prompt re-evaluation of modifiable determinants of end-tidal overdistension, including VT, PEEP, and body position.
The effects of polyunsaturated fatty acid (PUFA) administration on the microbiome-gut-brain axis in adolescents with anorexia nervosa (the MiGBAN study): study protocol for a longitudinal, double-blind, randomized, placebo-controlled trial
Authors: Keller Lara , Dempfle Astrid , Dahmen Brigitte , Schreiber Samira , Adan Roger A. H. , Andreani Nadia Andrea , Danner Unna N. , Eisert Albrecht , Fetissov Sergueï , Fischmeister Florian Ph. S. , Karwautz Andreas , Konrad Kerstin , Kooij Karlijn L. , Trinh Stefanie , van der Vijgh Benny , van Elburg Annemarie A. , Zeiler Michael , Baines John , Seitz Jochen , Herpertz-Dahlmann Beate
Published: July 2022

Background

Anorexia nervosa (AN) is a severe psychiatric disease that often takes a chronic course due to insufficient treatment options. Emerging evidence on the gut-brain axis offers the opportunity to find innovative treatments for patients with psychiatric disorders. The gut microbiome of patients with AN shows profound alterations that do not completely disappear after weight rehabilitation. In previous studies, the administration of polyunsaturated fatty acids (PUFA) resulted in effects that might be beneficial in the treatment of AN, affecting the microbiome, body weight and executive functions. Therefore, the MiGBAN study aims to examine the effects of a nutritional supplementation with PUFA on the gut microbiome and body mass index (BMI) in patients with AN.

Methods

This is a longitudinal, double-blind, randomized, placebo-controlled trial. Within 2 years, 60 adolescent patients aged 12 to 19 years with AN will receive either PUFA or placebo for 6 months additional to treatment as usual. After 1 year, the long-term effect of PUFA on the gut microbiome and consecutively on BMI will be determined. Secondary outcomes include improvement of gastrointestinal symptoms, eating disorder psychopathology, and comorbidities. Additionally, the interaction of the gut microbiome with the brain (microbiome-gut-brain axis) will be studied by conducting MRI measurements to assess functional and morphological changes and neuropsychological assessments to describe cognitive functioning. Anti-inflammatory effects of PUFA in AN will be examined via serum inflammation and gut permeability markers. Our hypothesis is that PUFA administration will have positive effects on the gut microbiota and thus the treatment of AN by leading to a faster weight gain and a reduction of gastrointestinal problems and eating disorder psychopathology.

Discussion

Due to previously heterogeneous results, a systematic and longitudinal investigation of the microbiome-gut-brain axis in AN is essential. The current trial aims to further analyse this promising research field to identify new, effective therapeutic tools that could help improve the treatment and quality of life of patients. If this trial is successful and PUFA supplementation contributes to beneficial microbiome changes and a better treatment outcome, their administration would be a readily applicable additional component of multimodal AN treatment.

Trial registration

German Clinical Trials Register DRKS00017130. Registered on 12 November 2019.
Clinical features and outcomes of patients with wheat-dependent exercise-induced anaphylaxis: a retrospective study
Authors: Du Zhirong , Gao Xiang , Li Junda , Li Lun , Liu Juan , Yin Jia
Published: July 2022

Background

Wheat-dependent exercise-induced anaphylaxis (WDEIA) is a serious and potentially life-threatening form of wheat allergy. Further episodes can only be prevented by avoiding wheat ingestion or avoiding exercise after wheat intake. Anaphylaxis may recur in some patients post-diagnosis. This study aimed to analyze the clinical features and management/outcomes of WDEIA in China.

Methods

We retrospectively analyzed the clinical characteristics, and laboratory testing of 197 patients with WDEIA. After diagnosis, the patients were followed up as outpatients to evaluate dietary/exercise choice and clinical outcomes.

Results

Among the 197 WDEIA patients (median age, 37 years), 53.8% were male and 28.4% had other allergic disorders. The median duration of anaphylaxis before diagnosis was 16 months. Significant delays in diagnosis (> 1 years) were recorded in 52.7% of the patients, which has not decreased by years (P = 0.064). Exercise (83.8%), alcohol (12.2%), and nonsteroidal anti-inflammatory drugs (7.1%) were the most common cofactors. The most common clinical features were urticaria (100%), loss of consciousness (82.7%), dyspnea (50.8%), and hypotension (47.2%). Of the 197 eligible patients, 155 responded (78.7%), and 124 (80.0%) of which had no anaphylaxis post-diagnosis. A wheat-free diet prevented future anaphylaxis in 91.7% of the patients, followed by the avoidance of wheat combined with exercise (87%) and reduced wheat intake combined with exercise avoidance (80.5%).

Conclusion

The diagnosis of WDEIA is frequently delayed. Therefore, when patients present with unexplained anaphylaxis, the possibility of WDEIA should be considered. A wheat-free diet or avoiding wheat combined with exercise or reduced wheat combined with exercise avoidance helps to significantly reduce the onset of future anaphylaxis. However, approximately one-fifth of patients continue to experience anaphylaxis post-diagnosis. Thus, these patients must always carry epinephrine autoinjectors.
The longitudinal bidirectional relationship between autistic traits and brain morphology from childhood to adolescence: a population-based cohort study
Authors: Durkut Melisa , Blok Elisabet , Suleri Anna , White Tonya
Published: July 2022

Objective

Autistic traits are associated with alterations in brain morphology. However, the anatomic location of these differences and their developmental trajectories are unclear. The primary objective of this longitudinal study was to explore the bidirectional relationship between autistic traits and brain morphology from childhood to adolescence.

Method

Participants were drawn from a population-based cohort. Cross-sectional and longitudinal analyses included 1950 (mean age 13.5) and 304 participants (mean ages 6.2 and 13.5), respectively. Autistic traits were measured with the Social Responsiveness Scale. Global brain measures and surface-based measures of gyrification, cortical thickness and surface area were obtained from T1-weighted MRI scans. Cross-sectional associations were assessed using linear regression analyses. Cross-lagged panel models were used to determine the longitudinal bidirectional relationship between autistic traits and brain morphology.

Results

Cross-sectionally, higher levels of autistic traits in adolescents are associated with lower gyrification in the pars opercularis, insula and superior temporal cortex; smaller surface area in the middle temporal and postcentral cortex; larger cortical thickness in the superior frontal cortex; and smaller cerebellum cortex volume. Longitudinally, both autistic traits and brain measures were quite stable, with neither brain measures predicting changes in autistic traits, nor vice-versa.

Limitations

Autistic traits were assessed at only two time points, and thus we could not distinguish within- versus between-person effects. Furthermore, two different MRI scanners were used between baseline and follow-up for imaging data acquisition.

Conclusions

Our findings point to early changes in brain morphology in children with autistic symptoms that remain quite stable over time. The observed relationship did not change substantially after excluding children with high levels of autistic traits, bolstering the evidence for the extension of the neurobiology of autistic traits to the general population.
Waardenburg syndrome type 4 coexisting with open-angle glaucoma: a case report
Authors: Zhang Li , Wan Yue , Wang Ningli
Published: July 2022

Background

Waardenburg syndrome is an autosomal dominant disorder with varying degrees of sensorineural hearing loss as well as abnormal pigmentation in hair, skin, and iris. There are four types of Waardenburg syndrome (1–4) with different characteristics. Mutations in six genes have been identified to be associated with the various types. Herein, we describe a case of Waardenburg syndrome type 4 combined with open-angle glaucoma.

Case presentation

A 43-year-old Han Chinese man had undergone trabeculectomy due to progression of visual field impairment and unstable intraocular pressure in both eyes. Slit-lamp examination revealed diffuse iris hypopigmentation in the left eye and hypopigmentation of part of the iris in the right eye. Fundus examination showed red, sunset-like fundus due to a lack of pigmentation in the retinal pigment epithelium layer, diffuse loss of the nerve fiber layer, and an excavated optic nerve head with advanced-stage glaucoma. Imaging was performed using anterior segment optical coherence tomography to detect the iris configuration. In the heterochromic iris portion, the normal part of the iris showed a clear hyperreflective signal of the anterior border layer, while atrophy of the pigmented anterior border layer showed a hyporeflective area of the anterior surface resulting in reduced light absorption. Two mutations of the endothelin receptor type B gene were recognized in this study. The first (c.1111G>A on exon 7) leads to an amino acid change from glycine to serine at codon 371. Sanger verification revealed that this mutation is inherited from the mother. The other mutation (c.553G>A) leads to an amino acid change from valine to methionine at codon 185. Sanger verification showed that this mutation was inherited from the father.

Conclusion

Waardenburg syndrome shows a remarkable diversity in clinical presentation and morphology. This disease can also present with open-angle glaucoma. Sequencing analysis revealed two heterozygous mutations in the EDNRB gene in this patient, inherited from his mother and father, respectively. These two sites constitute a compound heterozygous variation.