bluuebunny/crossref_metadata_2025 huggingface dataset:
Bodies in Motion
Authors: Smith Tyler Jo
Published: April 2021

Drawing on the combined approaches of ancient Greek iconography, dance history, and the archaeology of ritual and religion, this paper examines dance gesture as a mechanism of ritual communication in ancient Greek vase-painting. After presenting the problems and limitations of matching art and text with regard to dance, as both Classical scholars and practitioners of modern dance have attempted, the paper expands on various ways of showing dance on vases. Special attention is given to komast dancers on black-figure vases and to other types of dance scenes and figures. A rethinking of the evidence for dance as ritual on Greek vases is proposed under the two categories of non-repetitive and repetitive gesture. It is posited that such a distinction anticipates the mood, participants, and occasions, and might indicate discrete areas of ritual activity. Dance, gesture, and ritual are also considered according to the gender and sexuality of performers, the presence of the divine, and the relationship between the shape, composition, and function of some vessels.
Alcyonium bursa Linnaeus, 1758 is not a sponge
Authors: VAN SOEST ROB W.M. , PLOTKIN ALEXANDER
Published: April 2021

In the 10th edition of the Systema Naturae (Linnaeus, 1758), which is the starting point of the Code for Zoological Nomenclature (ICZN Art. 3), Linnaeus named three species of the genus Alcyonium, A. arboreum, A. digitatum, and A. bursa. The genus name Alcyonium was based on the 16th and 17th century pre-Linnaean use for a diversity of marine organisms, including cnidarians, sponges, bryozoans, and algae. In the first valid presentation of the genus name, Linnaeus narrowed this down to comprise two clear cnidarians (A. arboreum, currently Paragorgia arborea, and A. digitatum, still accepted under this name and subsequently assigned as type species), but the pre-Linnaean diversity perhaps explains why the third species, A. bursa, was not recognized as a cnidarian. Linnaeus defined it as ‘Alcyonium acaule pulposum subglobosum. Habitat in O. Europaea.’ (translated as: Alcyonium without stalk, fleshy, semiglobular. From the European Ocean).’ Attempts to fix its identity among contemporary authors at the end of the 18th and beginning of the 19th century followed a checkered course, with opinions varying from algae to tunicates and sponges.
Early Eocene snakeflies (Raphidioptera) of western North America from the Okanagan Highlands and Green River Formation
Authors: ARCHIBALD S. BRUCE , MAKARKIN VLADIMIR N.
Published: April 2021

Four new species of Raphidiidae are described from the early Eocene of western North America: Megaraphidia antiquissima sp. nov. from McAbee, M. ootsa sp. nov. from Driftwood Canyon, M. hopkinsi sp. nov. from the Allenby Formation (all from British Columbia, Canada), M. klondika sp. nov. from Republic (Washington, United States of America). Archiinocellia Handlirsch, 1910, Archiinocellia oligoneura Handlirsch, 1910 from Horsefly River (British Columbia, Canada), and A. protomaculata (Engel, 2011), comb. nov., from the Green River Formation (Colorado, United States of America) are redescribed. Archiinocellia is assigned to Raphidiidae, sit. nov. The apparent absence of sclerotized gonocoxites 9 in the Archiinocellia protomaculata male is probably plesiomorphic at the family level. As some modern snakeflies do not require a cold interval to complete their development and Eocene Inocelliidae and Raphidiidae lived in regions of warm winters (especially A. protomaculata), adaptation to cold winters in many modern snakeflies is a post-Eocene phenomenon. Eocene Raphidiidae of Europe (Priabonian) differ greatly from those of North America (Ypresian and Priabonian). This pattern might reflect dispersal in either direction or ranges established prior to continental separation. Eocene Inocelliidae of Europe (Priabonian), however, are more similar to those of North America (Ypresian and Lutetian).
New arietellid copepods (Calanoida, Arietellidae) from anchialine caves in the Eastern Adriatic Sea
Authors: KRŠINIĆ FRANO , BOXSHALL GEOFF A.
Published: April 2021

Two new species of calanoid copepods are described; Metacalanus adriaticus sp. nov. from an anchialine cave on Vis Island, and Paramisophria tvrtkovici sp. nov. from Orljak Cave, located in the lower part of River Krka estuary, near the town of Šibenik (Croatia). This is the first report of arietellid copepods found in any anchialine cave along the coast of the Adriatic Sea. In M. adriaticus sp. nov. the antennules are asymmetrical in both sexes (the female left antennule is 18-segmented, right 20-segmented; male left 16-segmented and right 20-segmented); the uniramous fifth legs of the female are 2-segmented; the terminal segment of the fifth leg in both sexes is the longest; and in the male the fifth leg exopod is 2-segmented. In P. tvrtkovici sp. nov. the antennules of both sexes are asymmetrical with the left antennule longer than the right, the female antennule is 21-segmented on both sides; the male left antennule is 19-segmented, the right 21-segmented; the armature of the terminal exopod segment of leg 1 is II, 2 ,2; the male fifth legs have a rudimentary endopod on the left leg, the third exopodal segment is smallest and bears three unequal processes on its outer margin, and the terminal spine is completely separated from the segment. On the right leg the third segment carries two short, unequal processes on its outer distal margin, as well as a long sigmoidal spine which is fused to the segment. It is inferred that, after the last glaciation, these new Arietellids moved out from their southern Adriatic refuge, colonizing first the anchialine habitats of the outer eastern Adriatic islands and then spreading along the coast.
A new species of Doryctobracon Enderlein (Hymenoptera, Braconidae) parasitizing larvae of Anastrepha Schiner (Diptera, Tephritidae), with illustrated key to species of Doryctobracon that parasitize fruit-infesting tephritids in Brazil
Authors: MARINHO CLÁUDIA F. , DE SOUZA-FILHO MIGUEL F. , RAGA ADALTON , SANTOS WYRATAN DA S. , ZUCCHI ROBERTO A.
Published: April 2021

Doryctobracon maculatus Marinho, a new species of Braconidae (Opiinae) collected in the municipalities of Piracicaba and São Roque, state of São Paulo, Brazil, is described and illustrated. This new species is placed in group of species with areolate propodeum, but is easily distinguished from other species of this group, and other members of the genus by the noticeable black to dark-brown spots on the head, mesosoma and metasoma. This new species was reared in larvae of Anastrepha pseudoparallela (Diptera, Tephritidae) in passion fruits, Passiflora alata Curtis (Passifloraceae). An illustrated key to species of Doryctobracon recorded in Brazil is presented.
Pacific Meridional Modes without Equatorial Pacific Influence
Authors: Zhang Yu , Yu Shiyun , Amaya Dillon J. , Kosaka Yu , Larson Sarah M. , Wang Xudong , Yang Jun-Chao , Stuecker Malte F. , Xie Shang-Ping , Miller Arthur J. , Lin Xiaopei
Published: April 2021

Investigating Pacific Meridional Modes (PMM) without the influence of tropical Pacific variability is technically difficult if based on observations or fully coupled model simulations due to their overlapping spatial structures. To confront this issue, the present study investigates both North (NPMM) and South PMM (SPMM) in terms of their associated atmospheric forcing and response processes based on a mechanically decoupled climate model simulation. In this experiment, the climatological wind stress is prescribed over the tropical Pacific, which effectively removes dynamically coupled tropical Pacific variability (e.g., the El Niño-Southern Oscillation). Interannual NPMM in this experiment is forced not only by the North Pacific Oscillation, but also by a North Pacific tripole (NPT) pattern of atmospheric internal variability, which primarily forces decadal NPMM variability. Interannual and decadal variability of the SPMM is partly forced by the South Pacific Oscillation. In turn, both interannual and decadal NPMM variability can excite atmospheric teleconnections over the Northern Hemisphere extratropics by influencing the meridional displacement of the climatological intertropical convergence zone throughout the whole year. Similarly, both interannual and decadal SPMM variability can also excite atmospheric teleconnections over the Southern Hemisphere extratropics by extending/shrinking the climatological South Pacific convergence zone in all seasons. Our results highlight a new poleward pathway by which both the NPMM and SPMM feed back to the extratropical climate, in addition to the equatorward influence on tropical Pacific variability.
Flash Drought in CMIP5 Models
Authors: Hoffmann David , Gallant Ailie J. E. , Hobbins Mike
Published: April 2021

‘Flash drought’ (FD) describes the rapid onset of drought on sub-seasonal times scales. It is of particular interest for agriculture as it can deplete soil moisture for crop growth in just a few weeks. To better understand the processes causing FD, we evaluate the importance of evaporative demand and precipitation by comparing three different drought indices that estimate this hazard using meteorological and hydrological parameters from the CMIP5 suite of models. We apply the Standardized Precipitation Index (SPI); the Evaporative Demand Drought Index (EDDI), derived from evaporative demand (E0); and the Evaporative Stress Index (ESI), which connects atmospheric and soil moisture conditions by measuring the ratio of actual and potential evaporation. The results show moderate-to-strong relationships (r2 > 0.5) between drought indices and upper level soil moisture on daily time scales, especially in drought-prone regions. We find that all indices are able to identify FD in the top 10-cm layer of soil moisture in a similar proportion to that in the models’ climatologies. However, there is significant inter-model spread in the characteristics of the FDs identified. This spread is mainly caused by an overestimation of E0, indicating stark differences in the land surface models and coupling in individual CMIP5 models. Of all indices, the SPI provides the highest skill in predicting FD prior to or at the time of onset in soil moisture, while both EDDI and ESI show significantly lower skill. The results highlight that the lack of precipitation is the main contributor to FDs in climate models, with E0 playing a secondary role.
Comparative wave measurements at a wave energy site with a recently developed low-cost wave buoy (Spotter), ADCP and pressure loggers
Authors: Lancaster Orrin , Cossu Remo , Boulay Sebastien , Hunter Scott , Baldock Tom E.
Published: April 2021

Wave measurements from a new, low-cost, real-time wave buoy (Spotter) are investigated in a comparative study as part of a site characterization study at a wave energy candidate site at King Island, Tasmania, Australia. Measurements from the Sofar Ocean Spotter buoy are compared with concurrent measurements from a Teledyne RD Instrument (RDI) 1200 kHz Work Horse ADCP and two RBRsolo3 D wave16 pressure loggers. The comparison period between 8th August – 12th October 2019 provides both the shallowest and longest continuous published comparison undertaken with the Spotter buoy.

Strong agreement was evident between the Spotter buoy and RDI ADCP of key wave parameters including the significant wave height, peak wave period, and mean wave direction, with the mean values of those parameters across the full deployment period agreeing within 3%. Surface wave spectra and directional spectra are also analyzed with good agreement observed over the majority of the frequency domain, although the Spotter buoy records approximately 17% less energy within a narrow frequency band near the peak frequency when compared to the RDI ADCP. Measurements derived from the pressure loggers routinely underestimated the significant wave height and overestimated the mean wave period over the deployment period. The comparison highlights the suitability of the Spotter buoy for low-cost wave resource studies, with accurate measurements of key parameters and spectra observed.
Status and Prospects of Agricultural Growth Domestic Product in the Kingdom of Saudi Arabia
Authors: Emam Abda Abdalla , Abass Amal Saeed , Elmulthum Nagat Ahmed , Elrasheed Mutasim
Published: April 2021

The Kingdom of Saudi Arabia (KSA) has set Vision 2030 to reduce the total dependency of the country oil sectors, diversifying the economy and achieving sustainable food security. This necessitated conducting this study which aimed at estimating and analyzing the association and impact of selected agricultural subsectors (dates, honey, fish, chicken, and cattle) on Agricultural Growth Domestic Product (AGDP) of KSA, and identifying the leading subsector in the economy that might substantially affect AGDP and other subsectors. Unit root test, Johansen co-integration, vector error correction model (VECM), multiple regression techniques, and impulse test were used in analyzing the secondary data that covered the period from 1985 to 2017. Results revealed the presence of long-run co-integration between designated variables. Only the coefficient of adjustment parameter for dates (as dependent variable) is negative (−5.42) and significant (critical t value = −2.52 with p = .02), meaning that the model was able to correct its past-time disequilibrium. Furthermore, short-run causality was noticed between few variables. The regression analysis results indicated the existence of positive and significant relationships between the dependent (AGDP) and each of the independent variables: cattle (0.83; p = .00), honey (50.05; p = .06), and chicken (0.07; p = .00). On the contrary, results of the impulse tests showed that the cattle subsector is leading in the economy. Accordingly, cattle, honey, and chicken subsectors should be given high priority in the government investment policy.
Hate Speech and Authentic Personhood: Unveiling the Truth
Authors: Asogwa Nicholas Uchechukwu , Onwuama Michael Emeka
Published: April 2021

We often think that individuals should live their lives in ways they are convinced are most appropriate to their self-understanding and beliefs. However, we equally think that this idea of living according to one’s convictions and self-understanding does not mean endorsement of forms of speech that injure the person and dignity of others. So far, the debate on hate speech has revolved around the justification of its protection and prohibition. In this article, we examine the idea of hate speech through the lens of authentic personhood, the foundation upon which most arguments for and against speech restriction are based. The aim is to demonstrate that the state restricting speech may be as justified as the one protecting it, seeing that in reality, hate speech both violates and vindicates authentic personhood. Given the nature and structure of “autonomy” and “speech,” a balancing approach to free expression and equality is preferable to outright protection or prohibition of hate speech.
Betacellulin regulates peripheral nerve regeneration by affecting Schwann cell migration and axon elongation
Authors: Wang Yaxian , Zhang Fuchao , Zhang Yunsong , Shan Qi , Liu Wei , Zhang Fengyuan , Zhang Feiyu , Yi Sheng
Published: April 2021

Background

Growth factors execute essential biological functions and affect various physiological and pathological processes, including peripheral nerve repair and regeneration. Our previous sequencing data showed that the mRNA coding for betacellulin (Btc), an epidermal growth factor protein family member, was up-regulated in rat sciatic nerve segment after nerve injury, implying the potential involvement of Btc during peripheral nerve regeneration.

Methods

Expression of Btc was examined in Schwann cells by immunostaining. The function of Btc in regulating Schwann cells was investigated by transfecting cultured cells with siRNA segment against Btc or treating cells with Btc recombinant protein. The influence of Schwann cell-secreted Btc on neurons was determined using a co-culture assay. The in vivo effects of Btc on Schwann cell migration and axon elongation after rat sciatic nerve injury were further evaluated.

Results

Immunostaining images and ELISA outcomes indicated that Btc was present in and secreted by Schwann cells. Transwell migration and wound healing observations showed that transfection with siRNA against Btc impeded Schwann cell migration while application of exogenous Btc advanced Schwann cell migration. Besides the regulating effect on Schwann cell phenotype, Btc secreted by Schwann cells influenced neuron behavior and increased neurite length. In vivo evidence supported the promoting role of Btc in nerve regeneration after both rat sciatic nerve crush injury and transection injury.

Conclusion

Our findings demonstrate the essential roles of Btc on Schwann cell migration and axon elongation and imply the potential application of Btc as a regenerative strategy for treating peripheral nerve injury.
The role of the microbiome in ovarian cancer: mechanistic insights into oncobiosis and to bacterial metabolite signaling
Authors: Sipos Adrienn , Ujlaki Gyula , Mikó Edit , Maka Eszter , Szabó Judit , Uray Karen , Krasznai Zoárd , Bai Péter
Published: April 2021

Ovarian cancer is characterized by dysbiosis, referred to as oncobiosis in neoplastic diseases. In ovarian cancer, oncobiosis was identified in numerous compartments, including the tumor tissue itself, the upper and lower female genital tract, serum, peritoneum, and the intestines. Colonization was linked to Gram-negative bacteria with high inflammatory potential. Local inflammation probably participates in the initiation and continuation of carcinogenesis. Furthermore, local bacterial colonies in the peritoneum may facilitate metastasis formation in ovarian cancer. Vaginal infections (e.g.Neisseria gonorrhoeaeorChlamydia trachomatis) increase the risk of developing ovarian cancer. Bacterial metabolites, produced by the healthy eubiome or the oncobiome, may exert autocrine, paracrine, and hormone-like effects, as was evidenced in breast cancer or pancreas adenocarcinoma. We discuss the possible involvement of lipopolysaccharides, lysophosphatides and tryptophan metabolites, as well as, short-chain fatty acids, secondary bile acids and polyamines in the carcinogenesis of ovarian cancer. We discuss the applicability of nutrients, antibiotics, and probiotics to harness the microbiome and support ovarian cancer therapy. The oncobiome and the most likely bacterial metabolites play vital roles in mediating the effectiveness of chemotherapy. Finally, we discuss the potential of oncobiotic changes as biomarkers for the diagnosis of ovarian cancer and microbial metabolites as possible adjuvant agents in therapy.
Molecular characterisation of Mycobacterium avium subsp. paratuberculosis in Australia
Authors: Hodgeman Rachel , Mann Rachel , Savin Keith , Djitro Noel , Rochfort Simone , Rodoni Brendan
Published: April 2021

Background

Mycobacterium avium subsp. paratuberculosis (Map) causes Johne’s disease (JD), a chronic enteritis widespread in ruminants, resulting in substantial economic losses, especially to the dairy industry. Understanding the genetic diversity of Map in Australia will assist epidemiological studies for tracking disease transmission and identify subtype characteristics for use in development of improved diagnostic typing methods. Here we investigated the phylogenetic relationships of 351 Map isolates and compared different subtyping methods to assess their suitability for use in diagnostics and accuracy.

Results

SNP-based phylogenetic analysis of 228 Australian isolates and 123 publicly available international isolates grouped Type S and Type C strains into two distinct lineages. Type C strains were highly monomorphic with only 20 SNP differences separating them. Type S strains, when aligned separately to the Telford strain, fell into two distinct clades: The first clade contained seven international isolates while the second clade contained one international isolate from Scotland and all 59 Australian isolates. The Australian Type B strain clustered with US bison strains. IS1311 PCR and Restriction Enzyme Analysis (REA) intermittently generated incorrect results when compared to Long Sequence Polymorphism (LSP) analysis, whole genome SNP-based phylogenetic analysis, IS1311 sequence alignment and average nucleotide identity (ANI). These alternative methods generated consistent Map typing results. A published SNP based assay for genotyping Map was found to be unsuitable for differentiating between Australian and international strain types of Map.

Conclusion

This is the first phylogenetic analysis of Australian Map isolates. The Type C lineage was highly monomorphic, and the Type S lineage clustered all Australian isolates into one clade with a single Scottish sheep strain. The Australian isolate classified as Type B by IS1311 PCR and REA is likely to be descended from bison and most closely related to US bison strains. Limitations of the current typing methods were identified in this study.
Photosynthesis acclimation under severely fluctuating light conditions allows faster growth of diatoms compared with dinoflagellates
Authors: Zhou Lu , Wu Songcui , Gu Wenhui , Wang Lijun , Wang Jing , Gao Shan , Wang Guangce
Published: April 2021

Background

Diatoms contribute 20% of the global primary production and are adaptable in dynamic environments. Diatoms always bloom earlier in the annual phytoplankton succession instead of dinoflagellates. However, how diatoms acclimate to a dynamic environment, especially under changing light conditions, remains unclear.

Results

We compared the growth and photosynthesis under fluctuating light conditions of red tide diatom Skeletonema costatum, red tide dinoflagellate Amphidinium carterae, Prorocentrum donghaiense, Karenia mikimotoi, model diatom Phaeodactylum tricornutum, Thalassiosira pseudonana and model dinoflagellate Dinophycae Symbiodinium. Diatoms grew faster and maintained a consistently higher level of photosynthesis. Diatoms were sensitive to the specific inhibitor of Proton Gradient Regulation 5 (PGR5) depending photosynthetic electron flow, which is a crucial mechanism to protect their photosynthetic apparatus under fluctuating light. In contrast, the dinoflagellates were not sensitive to this inhibitor. Therefore, we investigate how PGR5 functions under light fluctuations in the model diatom P. tricornutum by knocking down and overexpressing PGR5. Overexpression of PGR5 reduced the photosystem I acceptor side limitation (Y (NA)) and increased growth rate under severely fluctuating light in contrast to the knockdown of PGR5.

Conclusion

Diatoms acclimatize to fluctuating light conditions better than dinoflagellates. PGR5 in diatoms can regulate their photosynthetic electron flow and accelerate their growth under severe light fluctuation, supporting fast biomass accumulation under dynamic environments in pioneer blooms.
Gastrointestinal symptoms as the first manifestation of antiphospholipid syndrome
Authors: Zou Xiaojuan , Fan Zhongqi , Zhao Ling , Xu Weiling , Zhang Jin , Jiang Zhenyu
Published: April 2021

Background

Antiphospholipid syndrome (APS) is an acquired pre-thrombotic autoimmune condition, which produces autoantibodies called antiphospholipid antibodies (APL) against phospholipid-binding plasma proteins. The diagnosis of APS requires at least one of Sapporo standard clinical manifestations and one laboratory criteria (persistently medium/high titer anticardiolipin antibodies, and/or medium/high titer anti-β2-glycoprotein I antibodies, and/or a positive lupus anticoagulant test). Gastrointestinal lesions are rarely reported in APS patients. APS cases with recurrent abdominal pain as the first clinical manifestation are even rarer.

Case presentation

This report describes an APS case with recurrent abdominal pain as the first clinical manifestation of antiphospholipid syndrome. The patient has a history of two miscarriages. Computed tomography of the abdomen confirmed mesenteric thrombosis and intestinal obstruction while laboratory tests for serum antiphospholipid and anti-β2-glycoprotein I antibodies were positive. This led to the diagnosis of APS.

Conclusions

This paper provides useful information on gastrointestinal manifestations and APS, also including a brief literature review about possible gastrointestinal symptoms of APS.
Evaluation of circulating cell-free DNA in cholestatic liver disease using liver-specific methylation markers
Authors: Punia Sohan , Juran Brian D. , Ali Ahmad H. , Schlicht Erik M. , Moore Raymond M. , Sun Zhifu , Lazaridis Konstantinos N.
Published: April 2021

Background

Quantification of circulating organ-specific cell-free DNA (cfDNA) provides a sensitive measure of ongoing cell death that could benefit evaluation of the cholestatic liver diseases primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC), which lack reliable non-invasive biomarkers. Our goal in this pilot study was to determine whether liver-specific cfDNA levels are increased in PBC and PSC patients relative to controls and in advanced versus early disease, to evaluate their potential as novel disease biomarkers.

Methods

Peripheral blood derived bisulfite-treated DNA was PCR amplified from patients with PBC (n = 48), PSC (n = 48) and controls (n = 96) to evaluate methylation status at 16 CpG sites reported to be specifically unmethylated in liver tissue near the genes IGF2R, ITIH4 and VTN. Amplicons were used to prepare paired end libraries which were sequenced on a MiSeq sequencer. Trimmed reads were aligned and used to determine unmethylation ratios and to calculate concentration of liver-specific cfDNA. Comparisons between groups were performed using the two-tailed Mann–Whitney Test and relationships between variables were evaluated using Pearson’s Correlation.

Results

Levels of liver-specific cfDNA, as measured at the 3 genetic loci, were increased in PBC and PSC patients relative to controls and in late-stage relative to early-stage patients. As well, cfDNA levels were correlated with levels of alkaline phosphatase, a commonly used biochemical test to evaluate disease severity in liver disease, in patients, but not in controls.

Conclusions

cfDNA offers promise as a non-invasive liquid-biopsy to evaluate liver-specific cell-death in patients with cholestatic liver diseases.
Activity of daily living upon admission is an independent predictor of in-hospital mortality in older patients with community-acquired pneumonia
Authors: Kang Yu , Fang Xiang-Yang , Wang Dong , Wang Xiao-Juan
Published: April 2021

Background

Older patients hospitalized with community-acquired pneumonia (CAP) are at high risk for short-term mortality. Activity of daily living (ADL) is associated with clinical outcomes in older patients. We aimed to investigate the prognostic value of ADL upon admission on the in-hospital mortality in older patients with CAP.

Methods

We conducted a retrospective cohort study involving patients aged ≥65 years admitted to Beijing Chao-Yang hospital due to CAP between June 2012 and June 2020. ADL evaluation upon admission was performed by Barthel Index (BI). Data from all patients were extracted from the electronic medical records.

Results

Four thousand eight hundred eighty patients were included, 131 patients (2.7%) died during their hospitalization. Median BI in the Deceased group was 45 (20–65), Deceased group had lower BI scores than Survivors group (p < 0.001). Low BI (< 60) was more frequent in patients who died in the hospital than in patients discharged alive (69.5% vs. 13%, p < 0.001). In-hospital mortality was higher among patients with worse ADL upon admission (BI< 60) compared to those BI≥60 (12.6% vs. 0.9%). The worse ADL upon admission (BI< 60) was associated with an increase in the risk of death during CAP hospitalization, worse ADL upon admission (BI< 60) showed an odds ratio (OR) for in-hospital mortality of 7.53 (95%CI: 2.77–20.48; P < 0.01). This association remained significant after adjustment for age, comorbid conditions, respiratory failure, pathogens and laboratory findings (OR, 3.74; 95%CI, 2.37–5.91; P < 0.01). Receiver operating characteristic (ROC) curve revealed that BI upon admission is a predictor related to in-hospital mortality in elderly patients, the area under the ROC curve of BI in predicting in-hospital mortality was 0.81 (with 95% confidence interval: 0.78–0.85). The predictive value of ADL upon admission was better than age in our study population.

Conclusion

Activity of daily living upon admission is an independent predictor of in-hospital mortality in older patients with community-acquired pneumonia.
Clinical factors associated with shorter durable response, and patterns of acquired resistance to first-line pembrolizumab monotherapy in PD-L1-positive non-small-cell lung cancer patients: a retrospective multicenter study
Authors: Hosoya Kazutaka , Fujimoto Daichi , Morimoto Takeshi , Kumagai Toru , Tamiya Akihiro , Taniguchi Yoshihiko , Yokoyama Toshihide , Ishida Tadashi , Matsumoto Hirotaka , Hirano Katsuya , Kominami Ryota , Tomii Keisuke , Suzuki Hidekazu , Hirashima Tomonori , Tanaka Satoshi , Uchida Junji , Morita Mitsunori , Kanazu Masaki , Mori Masahide , Nagata Kenji , Fukuda Ikue , Tamiya Motohiro
Published: April 2021

Background

Despite the wide-spread use of immune checkpoint inhibitors (ICIs) in cancer chemotherapy, reports on patients developing acquired resistance (AR) to ICI therapy are scarce. Therefore, we first investigated the characteristics associated with shorter durable responses of ICI treatment and revealed the clinical patterns of AR and prognosis of the patients involved.

Methods

We conducted a retrospective multi-center cohort study that included NSCLC patients with PD-L1 tumor proportion scores of ≥50% who received first-line pembrolizumab and showed response to the therapy. Among patients showing response, progression-free survival (PFS) was investigated based on different clinically relevant factors. AR was defined as disease progression after partial or complete response based on Response Evaluation Criteria in Solid Tumors. Among patients with AR, patterns of AR and post-progression survival (PPS) were investigated. Oligoprogression was defined as disease progression in up to 5 individual progressive lesions.

Results

Among 174 patients who received first-line pembrolizumab, 88 showed response and were included in the study. Among these patients, 46 (52%) developed AR. Patients with old age, poor performance status (PS), at least 3 metastatic organs, or bone metastasis showed significantly shorter PFS. Among 46 patients with AR, 32 (70%) developed AR as oligoprogression and showed significantly longer PPS than those with non-oligoprogressive AR.

Conclusions

Patients with old age, poor PS, at least 3 metastatic organs, or bone metastasis showed shorter durable responses to pembrolizumab monotherapy. Oligoprogressive AR was relatively common and associated with better prognosis. Further research is required to develop optimal approaches for the treatment of these patients.
Diagnostic measures for severe acute malnutrition in Indian infants under 6 months of age: a secondary data analysis
Authors: Chowdhury Ranadip , Nitika  , Choudhary Tarun Shankar , Taneja Sunita , Martines Jose , Bhandari Nita , Bahl Rajiv
Published: April 2021

Background

Weight for length z-score (WLZ) < − 3 is currently used to define severe acute malnutrition (SAM) among infants. However, this approach has important limitations for infants younger than 6 months of age as WLZ cannot be calculated using WHO growth standards if infant length is < 45 cm. Moreover, length for age z-score (LAZ) and weight for length z-score (WLZ) are least reliable measures, with high chances of variation, and less chances of detecting undernutrition in under 6 months infants. The objective of the current analysis was to compare WLZ with WAZ and LAZ in a cohort of Indian infants in predicting the deaths between 6 weeks and 6 months of age.

Methods

The data was from an individually randomized trial conducted in slums of Delhi, India in which infants’ weight and length were measured at 6 weeks of age (at the time of the first immunization visit). Vital status of the infants was documented from 6 weeks to 6 months of age. The sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios were calculated for WAZ < -3, WLZ < -3, and LAZ < -3 for deaths between 6 weeks and 6 months of age. The receiver operating characteristics curve was calculated for each of the above anthropometric indicators.

Results

For deaths occurring between 6 weeks to 6 months of age, the specificity ranged between 85.9–95.9% for all three anthropometric indicators. However, the sensitivity was considerably higher for WAZ; it was 64.6% for WAZ < -3, 39.1% for LAZ < -3, and 25.0% for WLZ < -3. WAZ < -3 had higher area under curve (0.75; 95% CI: 0.68, 0.82) and hence, better discriminated deaths between 6 weeks and 6 months of age than WLZ < -3. The adjusted relative risk (RR 10.6, 95% CI 5.9, 18.9) and the population attributable fraction (PAF 57.9, 95% CI 38.8, 71.0%) of mortality was highest for WAZ < -3.

Conclusions

We found WAZ < -3 at 6 weeks of age to be a better predictor of death in the 6 weeks to 6 months of life in comparison to WLZ < -3 and LAZ < -3 and propose that it should be considered to diagnose SAM in this age group.
Mental health of undocumented migrants and migrants undergoing regularization in Switzerland: a cross-sectional study
Authors: Fakhoury Julien , Burton-Jeangros Claudine , Consoli Liala , Duvoisin Aline , Courvoisier Delphine , Jackson Yves
Published: April 2021

Background

Undocumented migrants live and work in precarious conditions. Few studies have explored the mental health consequences of such environment. The objective of this study is to describe the mental health of migrants at different stages of a regularization program.

Methods

This cross-sectional study included migrants undocumented or in the process of regularization. We screened for symptoms of anxiety, depression and sleep disturbance using validated tools. We created a composite outcome of altered mental health including these components plus self-report of a recent diagnosis of mental health condition by a health professional.

Results

We enrolled 456 participants of whom 246 (53.9%) were undocumented. They were predominantly women (71.9%) with a median age of 43.3 (interquartile range: 15.5) years, from Latin America (63.6%) or Asia (20.2%) who had lived in Switzerland for 12 (IQR: 7) years. Overall, 57.2% presented symptoms of altered mental health. Prevalence of symptoms of anxiety, depression and sleep disturbance were 36% (95% confidence interval: 31.6–40.6%), 45.4% (95% CI: 40.8–50.1%) and 23% (95% CI: 19.2–27.2), respectively. Younger age (adjusted odd ratio: 0.7; 95% CI: 0.5–0.9 for each additional decade), social isolation (aOR: 2.4; 95% CI: 1.4–4.2), exposure to abuse (aOR: 1.9; 95% CI: 1.1–3.5), financial instability (aOR: 2.2; 95% CI: 1.4–3.7) and multi-morbidity (aOR: 3.2; 95% CI: 1.7–6.5) were associated with increased risk of having altered mental health while being in the early stages of the process of regularization had no effect (aOR: 1.3: 95% CI: 0.8–2.2).

Conclusions

This study highlights the need for multi-pronged social and health interventions addressing the various domains of undocumented migrants living difficulties as complement to legal status regularization policies. Protection against unfair working conditions and abuse, access to adequate housing, promoting social integration and preventive interventions to tackle the early occurrence of chronic diseases may all contribute to reduce the burden of altered mental health in this group. More research is needed to assess the long-term impact of legal status regularization on mental health.
Noise sensitivity associated with nonrestorative sleep in Chinese adults: a cross-sectional study
Authors: Li Sha , Fong Daniel Yee Tak , Wong Janet Yuen Ha , McPherson Bradley , Lau Esther Yuet Ying , Huang Lixi , Ip Mary Sau Man
Published: April 2021

Background

Nonrestorative sleep is a common sleep disorder with a prevalence ranging from 1.4 to 35%, and is associated with various psychological and physical health issues. Noise exposure and noise sensitivity have been proposed to contribute to nonrestorative sleep. This study aimed to examine the relationships among noise, noise sensitivity, nonrestorative sleep, and physiological sleep parameters in Chinese adults.

Methods

A cross-sectional household survey was conducted with randomly selected Chinese adults based on a frame stratified by geographical districts and types of quarters in Hong Kong. We administered a battery of questionnaires, including the Nonrestorative Sleep Scale, the Weinstein Noise Sensitivity Scale, the ENRICHD Social Support Instrument, the Patient Health Questionnaire, and the Perceived Stress Scale to assess nonrestorative sleep, noise sensitivity, social support, somatic symptoms and stress, respectively. Anxiety and depression were evaluated by the Hospital Anxiety and Depression Scale while sociodemographic and lifestyle characteristics were assessed with an investigator-developed sheet. Nocturnal noise level and physiological sleep parameters were measured during nighttime for a week by noise dosimetry and actigraphy, respectively. A structured multiphase linear regression was conducted to estimate associations.

Results

A total of 500 adults (66.4% female) with an average age of 39 years completed this study. Bivariate regressions showed that age, marital status, occupation, family income, season, exercise, cola and soda consumption, social support, somatic symptoms, stress, depression, noise sensitivity, total sleep time, and awakenings were associated with nonrestorative sleep. In the multivariable analysis, family income, season, exercise, social support, somatic symptoms, stress, and depression remained associated with nonrestorative sleep. Specifically, a one-unit increase of noise sensitivity was associated with 0.08 increase in nonrestorative sleep (95% confidence interval [CI]: 0.01, 0.15, p = 0.023). Nocturnal noise was negatively associated with time in bed (b = − 1.65, 95% CI: − 2.77, − 0.52, p = 0.004), total sleep time (b = − 1.61, 95% CI: − 2.59, − 0.62, p = 0.001), and awakenings (b = − 0.16, 95% CI: − 0.30, − 0.03, p = 0.018), but was not associated with nonrestorative sleep.

Conclusions

Nonrestorative sleep was predicted by noise sensitivity in addition to family income, season, exercise, social support, somatic symptoms, stress, and depression.
Correction to: Self-reported suboptimal sleep and receipt of sleep assessment and treatment among persons with and without a mental health condition in Australia: a cross sectional
Authors: Metse Alexandra P. , Fehily Caitlin , Clinton-McHarg Tara , Wynne Olivia , Lawn Sharon , Wiggers John , Bowman Jenny A.
Published: April 2021

An amendment to this paper has been published and can be accessed via the original article.
Correlation between loss of Smad4 and clinical parameters of non-small cell lung cancer: an observational cohort study
Authors: Guo Xiangjun , Li Mengmeng , Wang Xin , Pan Yun , Li Jiashu
Published: April 2021

Background

SMAD4 has been found to be inactivated to varying degrees in many types of cancer; the purpose of this study was to investigate the correlation between SMAD4 expression in non-small cell lung cancer (NSCLC) and clinical pathological parameters.

Methods

The serum concentration of SMAD4 was measured by enzyme-linked immunosorbent assay and its histological expression was quantified by immunohistochemistry.

Results

The serum concentration of Smad4 in patients with NSCLC was lower than that in benign lung disease patients and healthy individuals (P < 0.001) and its concentration was related to the histological classification, pathological differentiation, lymphatic metastasis and clinical stage of NSCLC. The sensitivity and specificity of serum Smad4 were 91.56% and 61.56% for screening NSCLC from healthy individuals and 84.55% and 60.36% for screening NSCLC from patients with benign lung disease. Logistic regression analysis showed that the degree of cell differentiation (P < 0.001), lymph node metastasis (P < 0.001) and clinical stage of NSCLC (P = 0.007) affected the expression of Smad4, and had a strong correlation with the expression of Smad4. The expression of Smad4 in NSCLC tissues was lower than that in normal lung tissues (P = 0.009) and its expression was related to the degree of tissue differentiation, lymph node metastasis and clinical stage (P < 0.05).

Conclusions

The downregulation or deletion of Smad4 is related to the malignant biological behavior of NSCLC and serum Smad4 could be considered as a potential molecular indicator for diagnosis and evaluation of NSCLC.
The effect of atorvastatin on inflammatory markers in sulfur mustard gas induced bronchitis: a randomized double-blinded, placebo-control clinical trial
Authors: Momeni Behrooz , Nazer Saeed , Masoompour Seyed Masoom , Geramizadeh Bita , Sajadi Seyed Vahid
Published: April 2021

Background

This study was performed to evaluate the anti-inflammatory effect of atorvastatin in patients with chronic bronchitis, exposed to sulfur mustard gas.

Methods

In this randomized double-blinded clinical trial we recruited patients with chronic bronchitis after exposure to sulfur mustard gas. Ninety men 45–75 years old diagnosed with chronic bronchitis after exposure to mustard gas during the Iran-Iraq war, were randomly assigned to receive either atorvastatin (40 mg) or placebo once a day for 3 months. The interleukin 6 (IL-6), tumor necrosis factor α (TNF-α), procalcitonin, highly sensitive CRP and COPD assessment test (CAT) score was compared at baseline and after 12 weeks.

Results

After consuming atorvastatin for 12 weeks, IL-6 level (mean difference [95%CI]; 0.2 [− 0.05, 0.5]), TNF-α (mean difference [95%CI]; − 0.07 [− 0.2, 0.07]), high sensitive CRP (mean difference [95%CI] − 0.1 [− 1.2, 0.9]), and procalcitonin (mean difference [95%CI]; 0.003 [− 0.02, 0.03]) did not change significantly. However, in the placebo group, only IL-6 (mean difference [95%CI]; 0.6 [0.2, 1.05]) decreased significantly after 12 weeks, but levels of high sensitive CRP (mean difference [95%CI]; − 0.3 [− 1.4, 0.8]) TNF-α (mean difference [95%CI]; − 0.2 [− 0.34, − 0.06]) and procalcitonin (mean difference [95%CI]; 0.02 [− 0.001, 0.04]) did not change significantly. After 12 weeks, the mean differences in TNF- α, IL-6 level, high sensitive CRP, procalcitonin, and CAT score did not significantly differ between the two groups.

Conclusions

The administration of 40 mg atorvastatin for 3 months did not significantly change the inflammatory markers or the quality of life of patients exposed to mustard gas with chronic bronchitis.

Trial registration: IRCT, IRCT138904144312N1. Registered 16 August 2014,https://en.irct.ir/trial/4577.
Calcitriol-mediated hypercalcemia as an immune-related adverse event in a patient receiving nivolumab and ipilimumab for metastatic renal cell carcinoma, case report
Authors: Johnson Kai , Issa Majd , Parikh Anish , Monk Paul , Yin Ming , Mortazavi Amir , Yang Yuanquan
Published: April 2021

Background

Severe hypercalcemia is often associated with uncontrolled malignancy through several mechanisms. However, calcitriol-mediated hypercalcemia is a rare etiology for advanced solid tumors.

Case presentation

We report a case of calcitriol-mediated hypercalcemia secondary to immune checkpoint inhibition in a responder with metastatic clear cell renal cell carcinoma (ccRCC). In this case, a 68 year old male with metastatic ccRCC to the liver within 4 months of right radical nephrectomy went on to develop hypercalcemia (12.8 mg/dL) shortly following 2 cycles of nivolumab and ipilimumab. Additional testing showed an elevated calcitriol level (142 pg/mL), low parathyroid hormone (PTH) and parathyroid hormone-related protein (PTHrP) levels, and a normal 25-hydroxyvitamin D level. FDG-PET imaging showed hypermetabolic mediastinal, hilar, and intra-abdominal lymphadenopathy, however the subsequent lymph node biopsy only showed reactive lymphoid cells without malignancy or granuloma. The hypercalcemia was resistant to initial therapy with calcitonin, hydration, and zoledronic acid but quickly responded to high-dose prednisone (1 mg/kg), followed by normalization of calcitriol levels. The patient was rechallenged with nivolumab and ipilimumab which provided a partial response after 4 cycles. He was maintained on low dose prednisone (10 mg daily) leading to a sustained resolution of his hypercalcemia.

Conclusion

This case suggests calcitriol-mediated hypercalcemia as a novel immune-related adverse event.
Skin autofluorescence and the complexity of complications in patients with type 2 diabetes mellitus: a cross-sectional study
Authors: Wang Xian , Zhao Xingwang , Lian Tingting , Wei Juanjin , Yue Wanxu , Zhang Senwei , Chen Qiu
Published: April 2021

Background

The accumulation of advanced glycation end products (AGEs) occurring in skin tissues can be measured as skin autofluorescence (SAF). Here, we assessed the correlation between SAF values and the complexity and severity of type 2 diabetes mellitus (T2DM) complications.

Methods

The basic clinical information of 825 patients with T2DM was collected through an electronic system, and SAF was measured by adapting a DM-Scan, a non-invasive optical signal detector. Diabetic complications were diagnosed based on clinical criteria by experienced doctors. Linear regression analysis was used to evaluate the independent determinants of SAF, and multiple logistic regression analysis was performed to assess independent determinants that influence the severity of the complications.

Results

SAF was significantly associated with the complexity of T2DM complications. Similarly, independent relationships between SAF and age (β = 0.389, P <  0.001), sex (β = − 2.221, P = 0.004), 2-h C-peptide (β = − 0.182, P = 0.017), aminotransferase (ALT, β = − 0.158, P = 0.041), blood creatinine (BCr, β = 0.206, P = 0.009), and fatty liver (β = 0.161, P = 0.026) were observed. With the increasing number of complications, the SAF values increased significantly after adjusting for related risk factors. The SAF values correlated with diabetic retinopathy, diabetic kidney diseases, cardiovascular disease, and diabetic peripheral neuropathy when compared with patients without any T2DM-associated complications. Moreover, the AGE-based diabetic complication risk score for each complication demonstrated a relationship with the presence or absence of certain complications.

Conclusion

SAF is an independent marker for diabetic retinopathy, diabetic kidney diseases, cardiovascular disease, and diabetic peripheral neuropathy, and it is also a predictor of the complexity of T2DM complications. Moreover, the diabetic complication risk score is capable of predicting the risk of diabetic complications in patients with T2DM.