bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of serum IL-6 and TNF-α in coronavirus disease 2019 (COVID-19) associated renal impairment
Authors: Chen Li-Da , Hu Lan , Song Yang , Huang Ya-Ping , Yang Si-Jiu , Yang Juan , Zhang Xiao-bin
Published: September 2022

Objectives: Association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and kidney injury has been noted in previous studies. However, the mechanisms remain unknown. The present study aimed to explore the potential mechanisms of kidney injury in COVID-19.

Methods: Demographic characteristics, underlying diseases, signs, symptoms, and laboratory data of 100 COVID-19 patients were collected and analyzed in this retrospective study. Patients were divided into three groups: mild, moderate, and severe to critical group. Kidney injury was evaluated by markers including estimated glomerular filtration rate (eGFR), serum creatinine, blood urea nitrogen, and cystatin C.

Results: A total of 100 patients with 12 mild, 63 moderate, and 25 severe to critical COVID-19 were included in this study. The kidney injury markers including eGFR, serum creatinine, blood urea nitrogen, and cystatin C all worsened significantly with an increase in disease severity. The correlation test showed that cytokines IL-2R, IL-6, IL-8, and tumor necrosis factor (TNF)-α were statistically correlated with eGFR and cystatin C. In multivariate analysis, log IL-6 (β = −0.331, p = .001 for eGFR and β = 0.405, p < .001 for cystatin C) and log TNF-α (β = −0.316, p = .001 for eGFR and β = 0.534, p < .001 for cystatin C) were found to be the major independent predictors of kidney injury.

Conclusion: Serum IL-6 and TNF-α levels were the major independent predictors of kidney injury in COVID-19.
Drainage of infiltrated rainwater in wall assemblies: Test method, experimental quantification, and recommendations
Authors: Van Linden Stéphanie , Lacasse Michael , Van Den Bossche Nathan
Published: September 2022

Drainage reduces the amount of water able to infiltrate toward the interior of wall assemblies. However, a portion of the infiltrated water remains in the assembly after drainage has occurred. The degree to which this retained portion of water affects the durability of the wall assembly can be evaluated by means of hygrothermal simulations. However, the number of studies reporting information on the retention percentage that can be applied as input for hygrothermal simulations and on the drainage performance of wall assemblies is, in general, quite limited. Therefore, an experimental study was developed, to assess governing test methods to evaluate drainage characteristics and to quantify retention of water in wall test specimens having various cavity widths and incorporating different drainage materials. It was concluded that apart from the absolute amount of retained water, the lateral spreading of water in the cavity and the overall wetted area, should also be considered, thereby resulting in reporting the retained amount relative to the wetted area. The latter values provide more detailed information on the behavior of water in the cavity. Additionally, it was concluded that a clear cavity of 1 mm can drain water more efficiently than a cavity of 10 mm. As well, the surface texture of drainage materials affected the spreading and retention of water within the cavity and the use of a drainage mat in the cavity resulted in an increased relative retention but a reduced lateral spreading of the water.
Effect of the Shanghai Stroke Service System (4S) on the quality of stroke care and outcomes: A prospective quality improvement project
Authors: Xu Jiawen , Xie Yanan , Fang Kun , Wang Xin , Chen Shengdi , Liu Xueyuan , Zhao Yuwu , Guan Yangtai , Cai Dingfang , Li Gang , Liu Jianmin , Liu JianRen , Zhuang Jianhua , Xian Ying , Shen Haipeng , Li Hao , Wang David Z , Campbell Bruce CV , Parsons Mark W , Dong Yi , Dong Qiang
Published: September 2022

Background:

In China, disparities in the quality of stroke care still exist and implementing quality improvement is still a challenge.

Aim:

The aim of the study was to determine whether the intervention by Shanghai Stroke Service System (4S) has helped improve adherence to stroke care guidelines and patient outcome.

Methods:

The 4S is a regional stroke network with real-time data extraction among its 61 stroke centers in Shanghai. A total of 11 key performance indicators (KPIs) were evaluated. The primary outcomes were a composite measure and an all-or-none measure of adherence to 11 KPIs. The secondary outcomes were length of hospital stay and in-hospital mortality.

Results:

The study enrolled 92,395 patients (mean age 69.0 ± 12.5 years, 65.2% men) with acute ischemic stroke hospitalized within 7 days of onset in Shanghai from January 2015 to December 2020. More patients received guideline recommended care between 2018 and 2020 than those between 2015 and 2017 (composite measure 87.1% vs 83.6%; absolute difference 2.9%, 95% confidence interval (CI) = [2.7%, 3.2%], p < 0.001; all-or-none measure 49.2% vs 44.8% patients; absolute difference 3.5%, 95% CI = [2.7%, 4.2%], p < 0.001). Further analysis of individual KPIs showed an absolute increase in six KPIs ranging from 3.4% to 8.9% (p < 0.001 for all comparisons). Compared with 2015–2017, hospital length of stay was shorter (10.95 vs 11.90 days; absolute difference –1.08, 95% CI = [–1.18, –0.99], p < 0.001), and in-hospital mortality was significantly reduced (risk ratio (RR) = 0.88, 95% CI = [0.79, 0.98], p = 0.01) in 2018–2020.

Conclusion:

The 4S intervention was associated with increased adherence to the stroke care guidelines, which further translated to improved clinical outcomes.

Trial registration:

ClinicalTrials.gov identifier: NCT02735226.
The prognostic importance of the angiotensin II/angiotensin-(1–7) ratio in patients with SARS-CoV-2 infection
Authors: Amezcua-Guerra Luis M , del Valle Leonardo , González-Pacheco Héctor , Springall Rashidi , Márquez-Velasco Ricardo , Massó Felipe , Brianza-Padilla Malinalli , Manzur-Sandoval Daniel , González-Flores Julieta , García-Ávila Carlos , Juárez-Vicuña Yaneli , Sánchez-Muñoz Fausto , Ballinas-Verdugo Martha A , Basilio-Gálvez Edna , Paez-Arenas Araceli , Castillo-Salazar Mauricio , Cásares-Alvarado Sergio , Hernández-Diazcouder Adrián , Sánchez-Gloria José L , Tavera-Alonso Claudia , Gopar-Nieto Rodrigo , Sandoval Julio
Published: September 2022

Background:

Information about angiotensin II (Ang II), angiotensin-converting enzyme 2 (ACE2), and Ang-(1–7) levels in patients with COVID-19 is scarce.

Objective:

To characterize the Ang II–ACE2–Ang-(1–7) axis in patients with SARS-CoV-2 infection to understand its role in pathogenesis and prognosis.

Methods:

Patients greater than 18 years diagnosed with COVID-19, based on clinical findings and positive RT-PCR test, who required hospitalization and treatment were included. We compared Ang II, aldosterone, Ang-(1–7), and Ang-(1–9) concentrations and ACE2 concentration and activity between COVID-19 patients and historic controls. We compared baseline demographics, laboratory results (enzyme, peptide, and inflammatory marker levels), and outcome (patients who survived versus those who died).

Results:

Serum from 74 patients [age: 58 (48–67.2) years; 68% men] with moderate (20%) or severe (80%) COVID-19 were analyzed. During 13 (10–21) days of hospitalization, 25 patients died from COVID-19 and 49 patients survived. Compared with controls, Ang II concentration was higher and Ang-(1–7) concentration was lower, despite significantly higher ACE2 activity in patients. Ang II concentration was higher and Ang-(1–7) concentration was lower in patients who died. The Ang II/Ang-(1–7) ratio was significantly higher in patients who died. In multivariate analysis, Ang II/Ang-(1–7) ratio greater than 3.45 (OR = 5.87) and lymphocyte count ⩽0.65 × 103/µl (OR = 8.43) were independent predictors of mortality from COVID-19.

Conclusion:

In patients with severe SARS-CoV-2 infection, imbalance in the Ang II–ACE2–Ang-(1–7) axis may reflect deleterious effects of Ang II and may indicate a worse outcome.
Investigating the Potential Bioactive Components of Qing-Fei-Pai-Du Decoction Against COVID-19 in Diabetes/Diabetic Patients Based on Network Pharmacology and Molecular Docking
Authors: Liu Yang , Huang Huilian
Published: September 2022

The network pharmacological regulation mechanism has been studied in which Qing-Fei-Pai-Du Decoction (QFPDD) can be used for treating diabetic patients suffering from coronavirus disease 2019 (COVID-19). In this study, we retrieved the target genes of QFPDD along with its effective components from the Traditional Chinese medicine systems pharmacology database. The target genes of diabetes and COVID-19-associated diseases were searched based on the GeneCards database, and the co-target genes of QFPDD were obtained. The target genes were analyzed using the Gene Ontology and the Kyoto Encyclopedia of Genes and Genomes. Cytoscape software was used for constructing the “herb-ingredient-target” network. Then, the co-target genes were imported into the Metascape database to analyze protein–protein interaction. Based on the results of the analysis of the hub genes from each database, the key target genes and the active components of QFPDD effective for treating diabetic COVID-19 patients were obtained. The crystal structures of the key target genes were retrieved from the protein data bank database, and molecular docking (MD) was performed using the AutoDock Tool, PyMoL, Chen3D, and other software. In total, 305 active ingredients and 274 target genes were identified among 19 traditional Chinese medicines present in QFPDD. We found 4585 COVID-19 target genes, 16 660 diabetes target genes, and 60 drug-disease target genes. The results of the Gene ontology and Kyoto Encyclopedia of Genes and Genomes analyses showed that the main function of these co-target genes was immune regulation. Additionally, protein interaction analysis and cluster analysis were performed to obtain a protein interaction network, and 3 core proteins and 4 core active components were found. According to the results of MD, the main effective components (quercetin, kaempferol, and wogonin) present in QFPDD were found to bind strongly to the receptor. The main active components of QFPDD were effective in treating diabetes complicated with COVID-19 through their actions on multiple biological pathways.
Fungal infection of the central nervous system: Autopsy analysis of six cases
Authors: Khaba Moshawa Calvin , Ngale Tshepo Cletus , Makhado Ndivhuho Agnes
Published: September 2022

Fungal infections of the central nervous system are fatal and rare clinical entities observable in immunosuppressed patients from varying causes. They carry higher risks of morbidities and mortality as compared to viral, bacterial or parasitic central nervous system infections. This study describes clinicopathological description of the central nervous system fungal infections with antemortem diagnostic challenges. This is a 9-year retrospective study of six cases composed of three females and three males with a mean age of 29.3 years. All six decedents presented with signs of meningeal irritation. They all suffered from immunodeficiency of varying causes. The gross and microscopic features revealed cryptococcosis, candidiasis and mucormycosis as the cause of the central nervous system infection. Early diagnosis and appropriate medical treatment are of paramount importance in improving the overall survival of patients with central nervous system mycosis. A few autopsy cases with fungal infection of the central nervous system have been described; therefore, more autopsies studies are needed to re-enforce on the existing epidemiology of these fatal infections. Moreover, this will assist in further elucidating the varying gross features and tissue reaction patterns associated with them.
Electrodermal Activity and Heart Rate Variability During Exposure Fear Scripts Predict Trait-Level and Momentary Social Anxiety and Eating-Disorder Symptoms in an Analogue Sample
Authors: Christian Caroline , Cash Elizabeth , Cohen Dan A. , Trombley Christopher M. , Levinson Cheri A.
Published: September 2022

Eating disorders (EDs) and social anxiety disorder (SAD) are characterized by high levels of fear and effectively treated with exposure therapy. Physiological markers of fear can elucidate how exposure influences psychophysiological processes underlying psychopathology. In the current study ( N = 109), we measured heart rate variability, heart rate, and electrodermal activity (EDA) with wearable sensors during ED fear, SAD fear, and neutral scripts. Bayesian ridge-regression models tested physiological features during these scripts as predictors of momentary and trait ED and SAD symptoms and determined which physiological features most strongly predicted symptoms. Across models, prediction error was low, which indicates high predictive accuracy. The most salient predictors were EDA features during the neutral script. These findings suggest physiological markers can accurately predict ED and SAD symptoms. This research highlights the utility of wearable sensor technology as a complement to exposure therapy and informs research, assessment, and treatment for anxiety-based disorders.
Understanding the Impact of COVID-19 Partial Lockdown in Tanzania: Grassroots Responses in Low-Income Communities in Dar es Salaam
Authors: Kombe Wilbard , Kyessi Alphonce G. , Limbumba Tatu Mtwangi , Osuteye Emmanuel
Published: September 2022

This article aims to understand grassroots responses to COVID-19 and how they impacted the well-being of low-income informal communities in Dar es Salaam. An exploratory qualitative research design, using semi-structured questionnaires, was adopted for use in Ubungo Kisiwani and Hanna Nassif settlements. Focus group discussions with select members of the community, including women’s groups, and mtaa (sub-ward) and ten-cell leaders, were held. The selection of respondents took into account the socio-economic and spatial characteristics of the two communities. Although Tanzania’s response to COVID-19 was based on a partial lockdown, these measures led to decline in income and loss of livelihoods among the poor. Likewise, several low-income persons, particularly those working in the hospitality industry, were temporarily retrenched owing to the poor business environment, severely undermining their ability to pay for basic services. The largely collective but limited social capital deployed by grassroots actors were crucial safety nets for the most vulnerable. These have to be acknowledged and coordinated. Mixed land use in informal settlements also proved useful in providing convenient access to the basic needs of households; reducing the need to travel outside one’s neighbourhood, thus enhancing the resilience of the communities.
“I’m concerned”: A multi-site assessment of emergency medicine resident speaking up behaviors
Authors: Feldman Nicola , Volz Nico , Snow Tim , Wong Lillian , Hock Sara M , Barnes David K , Bentley Suzanne
Published: September 2022

Introduction

According to the Institute of Medicine, 98,000 annual deaths are caused by preventable errors. Speaking up about patient safety or professionalism concerns when they arise allows medical staff to move from bystanders to active participants in the prevention of patient harm. This study assesses the current climate around speaking up for patient safety and unprofessional behavior by Emergency Medicine (EM) resident physicians and compares it to previously published data from other specialties.

Methods

A multi-site, descriptive, cross-sectional design was utilized based on previously published Speaking Up Climate Safety and Professionalism Scales. EM residents at 3 programs in the United States were surveyed, and their responses were compared to previously published responses from other specialties.

Results

102 residents from 3 EM residency programs responded to the survey, yielding a response rate of 54.3%. Responses on the survey fell close to the neutral response (3 on a 5-point Likert scale) on all measures, indicating opportunity for improvement. However, EM responses were significantly more favorable than responses from other specialties on several questions.

Conclusion

This assessment demonstrates room for improvement on speaking up behaviors among EM residents but also suggests that unique features of EM may contribute to a relatively more positive speaking up climate compared to other specialties, which may inform strategies to increase speaking up behaviors. For example, deliberate practice of situations requiring strong teamwork and strategies to reduce traditional hierarchies may help emulate the climate that tends to occur organically in EM.
For a Zemiology of Politics
Authors: Davis Howard , White Holly
Published: September 2022

A zemiology of politics is required in the face of disastrous historic, contemporary and future social harms. Focusing on state-led politics, the article charts some politically generated or mediated social harms: military; ecological and economic. These can generate justificatory narratives of zemiogenic deceit and ignorance. In a contemporary political moment of authoritarian populism, nativism and racism, each feature as part of wider processes towards the corruption and destruction of politics. The article then suggests some of the potentials of healthy politics and fundamental principles for a zemiology of politics including: subordination of crime-centric criminology to a historically grounded international zemiology, the incorporation of agnotological perspectives, and an orientation that is public, inclusive, reflexive and non-fundamentalist.
Collective intelligence as a public good
Authors: Leonard Naomi Ehrich , Levin Simon A
Published: September 2022

We discuss measures of collective intelligence in evolved and designed self-organizing ensembles, defining collective intelligence in terms of the benefits to be gained through the exchange of information and other resources, as well as through coordination or cooperation, in the interests of a public good. These benefits can be numerous, from estimating a hard-to-observe cue to efficiently searching for resource. The measures should also account for costs to individuals, such as in attention or energy, and trade-offs for the ensemble, such as the flexibility to respond to an important change in the environment versus stability that is robust to unimportant variability. When there is a tension between the interests of the individual and those of the group, game-theoretic considerations may affect the level of collective intelligence that can be achieved. Models of individual rules that yield collective dynamics with multi-stable solutions provide a means to examine and shape collective intelligence in evolved and designed systems.
Detecting measurable residual disease beyond 10−4 by an IGHV leader-based NGS approach improves prognostic stratification in CLL
Authors: Hengeveld Paul J. , van der Klift Michèle Y. , Kolijn P. Martijn , Davi Frédéric , Kavelaars François G. , de Jonge Evert , Robrecht Sandra , Assmann Jorn L. J. C. , van der Straten Lina , Ritgen Matthias , Westerweel Peter E. , Fischer Kirsten , Goede Valentin , Hallek Michael , Levin Mark-David , Langerak Anton W.
Published: September 2022

The sensitivity of conventional techniques for reliable quantification of minimal/measurable residual disease (MRD) in chronic lymphocytic leukemia (CLL) is limited to MRD 10−4. Measuring MRD <10−4 could help to further distinguish between patients with CLL with durable remission and those at risk of early relapse. We herein present an academically developed immunoglobulin heavy-chain variable (IGHV) leader-based next-generation sequencing (NGS) assay for the quantification of MRD in CLL. We demonstrate, based on measurements in contrived MRD samples, that the linear range of detection and quantification of our assay reaches beyond MRD 10−5. If provided with sufficient DNA input, MRD can be detected down to MRD 10−6. There was high interassay concordance between measurements of the IGHV leader-based NGS assay and allele-specific oligonucleotide quantitative polymerase chain reaction (PCR) (r = 0.92 [95% confidence interval {CI}, 0.86-0.96]) and droplet digital PCR (r = 0.93 [95% CI, 0.88-0.96]) on contrived MRD samples. In a cohort of 67 patients from the CLL11 trial, using MRD 10−5 as a cutoff, undetectable MRD was associated with superior progression-free survival (PFS) and time to next treatment. More important, deeper MRD measurement allowed for additional stratification of patients with MRD <10−4 but ≥10−5. PFS of patients in this MRD range was significantly shorter, compared with patients with MRD <10−5 (hazard ratio [HR], 4.0 [95% CI, 1.6-10.3]; P = .004), but significantly longer, compared with patients with MRD ≥10−4 (HR, 0.44 [95% CI, 0.23-0.87]; P = .018). These results support the clinical utility of the IGHV leader-based NGS assay.
The prevalence of primary headache disorders in children and adolescents in Zambia: a schools-based study
Authors: Kawatu Nfwama , Wa Somwe Somwe , Ciccone Ornella , Mukanzu Misheck , Uluduz Derya , Şaşmaz Tayyar , Yalçın Bengü Nehir Buğdaycı , Wöber Christian , Steiner Timothy J.
Published: September 2022

Background

The Global Campaign against Headache collects data from children (6–11 years) and adolescents (12–17) to inform health and education policies and contribute to the Global Burden of Disease (GBD) study. This survey in Zambia, part of this global enquiry, was the second from sub-Saharan Africa (SSA).

Methods

Following the generic protocol, this was a schools-based cross-sectional survey. We used the child and adolescent versions of the structured Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire, self-completed by pupils within classes, in a total of nine schools in Lusaka (urban) and Copperbelt (semi-rural). These two of Zambia’s ten provinces were selected to represent the country’s urban/rural divide. Headache diagnostic questions were based on ICHD-3 except for undifferentiated headache (UdH).

Results

Of 2,759 potential participants, 2,089 (615 children [29.4%], 1,474 adolescents [70.6%]) completed questionnaires (participating proportion 75.7%). Children were therefore under-represented (mean age 13.1 ± 2.8 years), while gender distribution (1,128 [54.0%] male, 961 [46.0%] female) was close to expectation. Observed lifetime prevalence of headache was 97.5%. Gender- and age-adjusted 1-year prevalence estimates were 85.8% for all headache, 53.2% for migraine (definite 17.5%, probable 35.7%), 12.1% for tension-type headache (TTH), 14.8% for UdH, 3.3% for all headache on ≥ 15 days/month and 0.9% for probable medication-overuse headache. Headache durations were short: only 28.6% of participants with any headache, and only 10.5% of those diagnosed as probable migraine, reported usual durations of > 2 h (the threshold for definite migraine). Of the latter, 36.6% reported < 1 h, the duration criterion for UdH. There were weak associations of migraine (definite + probable) with female gender, and of TTH and headache on ≥ 15 days/month with adolescence. Headache yesterday was reported by 22.2% of the sample, 25.5% of those with headache.

Conclusions

Headache disorders among young people are prevalent in Zambia. Among them, migraine is the most common, with UdH also highly prevalent. In this study there were diagnostic uncertainties, which rested to a large extent on the distinction between migraine and UdH among the many participants reporting headache of < 2 h’ duration. Similar uncertainties occurred in the first study in SSA, in Ethiopia. Because of these, we conclude only that migraine affects at least 17.5% of these age groups in Zambia, which is still a large proportion, adult prevalence in an earlier study being 22.9%. Supplementary estimates of attributed burden are needed to inform public-health and educational policies in Zambia.
Analysis of protein kinase C (HcPKC) gene expression and single-nucleotide polymorphisms related to inner shell color traits in Hyriopsis cumingii
Authors: Zhang Mengying , Chen Xiajun , Zhang Jinpan , Guo Baiying , Li Jiale , Bai Zhiyi
Published: September 2022

Background

Protein kinase C (PKC) is a multifunctional serine and PKC can phosphorylate serine residues in the cytoplasmic domain of tyrosinase, thereby regulating the activity of tyrosinase. Activated PKC is bound to the melanosome membrane, and unactivated PKC is free in the cytoplasm of melanocytes. In this study, we study the role of PKC gene in the melanin synthesis pathway and its effect on the color of the nacre of H. cumingii.

Results

In this study, a HcPKC gene in H. cumingii was cloned and its effects on melanin synthesis and nacre color were studied. HcPKC was expressed in both purple and white mussels, and the level of mRNA expression was higher in the purple mussels than in white mussels. Strong and specific mRNA signals were detected in the dorsal epithelial cells of the mantle pallial layer, indicating that HcPKC may be involved in nacre formation. After SNP association with inner shell color related traits, according to the principle that 0.25 < PIC < 0.5 is medium polymorphism and PIC < 0.25 is low polymorphism, the A + 332G site on the HcPKC gene was a site of moderate polymorphism, and the other four sites were low polymorphism sex sites. There was strong linkage disequilibrium among the five loci. A haplotype was constructed and it was found that the frequency of T1 (AGGAA)in the white population was significantly higher than that in the purple population (P < 0.05).

Conclusion

The study found that HcPKC of H. cumingii can be used as a candidate gene related to inner shell color, and some of the SNP sites can be used for molecular-assisted breeding in the spinnaker mussel, providing a reference for cultivating high-quality freshwater pearls.
Unraveling metabolic patterns and molecular mechanisms underlying storability in sugar beet
Authors: Gippert Anna-Lena , Madritsch Silvia , Woryna Patrick , Otte Sandra , Mayrhofer Martina , Eigner Herbert , Garibay-Hernández Adriana , D’Auria John C. , Molin Eva M. , Mock Hans-Peter
Published: September 2022

Background

Sugar beet is an important crop for sugar production. Sugar beet roots are stored up to several weeks post-harvest waiting for processing in the sugar factories. During this time, sucrose loss and invert sugar accumulation decreases the final yield and processing quality. To improve storability, more information about post-harvest metabolism is required. We investigated primary and secondary metabolites of six sugar beet varieties during storage. Based on their variety-specific sucrose loss, three storage classes representing well, moderate, and bad storability were compared. Furthermore, metabolic data were visualized together with transcriptome data to identify potential mechanisms involved in the storage process.

Results

We found that sugar beet varieties that performed well during storage have higher pools of 15 free amino acids which were already observable at harvest. This storage class-specific feature is visible at harvest as well as after 13 weeks of storage. The profile of most of the detected organic acids and semi-polar metabolites changed during storage. Only pyroglutamic acid and two semi-polar metabolites, including ferulic acid, show higher levels in well storable varieties before and/or after 13 weeks of storage. The combinatorial OMICs approach revealed that well storable varieties had increased downregulation of genes involved in amino acid degradation before and after 13 weeks of storage. Furthermore, we found that most of the differentially genes involved in protein degradation were downregulated in well storable varieties at both timepoints, before and after 13 weeks of storage.

Conclusions

Our results indicate that increased levels of 15 free amino acids, pyroglutamic acid and two semi-polar compounds, including ferulic acid, were associated with a better storability of sugar beet taproots. Predictive metabolic patterns were already apparent at harvest. With respect to elongated storage, we highlighted the role of free amino acids in the taproot. Using complementary transcriptomic data, we could identify potential underlying mechanisms of sugar beet storability. These include the downregulation of genes for amino acid degradation and metabolism as well as a suppressed proteolysis in the well storable varieties.
Transcriptomic and alternative splicing analyses provide insights into the roles of exogenous salicylic acid ameliorating waxy maize seedling growth under heat stress
Authors: Guo Jian , Wang Zitao , Qu Lingling , Hu Yifan , Lu Dalei
Published: September 2022

Background

Salicylic acid (SA) is a phytohormone which works to regulate the abiotic stress response of plants. However, the molecular mechanism by which SA mediates heat tolerance in waxy maize (Zea maysL.sinsensisKulesh) remains unknown.

Results

Two varieties of waxy maize seedlings, heat-tolerant ‘Yunuo7’ (Y7) and heat-sensitive ‘Suyunuo5’ (S5), were pretreated with SA prior to heat stress (HTS). After treatment, physiological and transcriptomic changes were analyzed. Compared with HTS, the exogenous application of SA enhanced the shoot dry weight, the activities of antioxidant enzymes (e.g., SOD, POD, CAT and APX), and the concentration of endogenous phytohormones (e.g., SA, ABA, IAA, GA3), while decreased the MDA content. Transcriptome analysis showed that the number of differentially expressed genes (DEGs) identified in the control (CK) vs HTS and HTS vs HTS + SA comparisons were more in S5 than in Y7. HTS induced the downregulation of genes involved in photosynthesis and the upregulation of genes encoding heat shock transcription factors (HSFs) and heat shock proteins (HSPs). Compared with HTS, SA pretreatment reversed the expression of 5 photosynthesis-related genes, 26 phytohormone-related genes, and all genes encoding HSFs and HSPs in S5. Furthermore, the number of alternative splicing (AS) events increased under HTS treatment for both varieties, while decreased under SA pretreatment of S5. Differentially spliced genes (DSGs) showed little overlap with DEGs, and DEGs and DSGs differed significantly in functional enrichment.

Conclusions

Physiological and transcriptional together indicated that HTS and SA pretreatment had a greater effect on S5 than Y7. Additionally, it appears that transcriptional regulation and AS work synergistically to enhance thermotolerance in heat-sensitive waxy maize. Our study revealed the regulatory effects and underlying molecular mechanisms of SA on waxy maize seedling under HTS.
Lithium-induced nephropathy; One medication with multiple side effects: a case report
Authors: Zhang Pingchuan , Gandhi Hardik , Kassis Nader
Published: September 2022

Background

Lithium carbonate is commonly used in the treatment of bipolar disorder. A spectrum of side effects is associated with lithium, including nephrogenic diabetes insipidus, renal tubular acidosis, chronic tubulointerstitial nephropathy, and minimal change disease. Although the former three adverse effects are well-known, minimal change disease is relatively rare.

Case presentation

We herein report a case of lithium therapy-induced minimal change disease with concurrent chronic tubulointerstitial nephropathy. A 66-year old man with bipolar disorder treated by lithium for 20 years, presented to the hospital with anasarca and decreased urine output for 4 weeks. The medical history also included hyperlipidemia, hypertension, and benign prostatic hyperplasia. Further laboratory investigation revealed elevated serum lithium (2.17 mmol/L), potassium (6.0 mmol/L), and creatinine levels (2.92 mg/dL), nephrotic range proteinuria, and hypoalbuminemia. Lithium was discontinued and the patient was treated with intravenous fluids. He underwent a kidney biopsy, which showed findings consistent with minimal change disease with concurrent acute tubular injury and chronic tubulointerstitial nephropathy. The patient was subsequently treated with steroids in an outpatient setting. He did not respond to the treatment, and hemodialysis was started.

Conclusion

Based on the previously reported cases and review of literature, occurrence of lithium-associated minimal change nephropathy is rare. Patients with lithium-associated minimal change disease and acute tubular injury usually respond to discontinuation of lithium therapy and/or steroid treatment. In this case, minimal change nephropathy was steroid-resistant and kidney function of the patient reported here did not recover after 6-month follow-up. We postulated the underlying cause to be minimal change disease with chronic tubulointerstitial nephropathy due to long-term lithium use. This case provides an example of a rare side effect of lithium-induced minimal change nephropathy with chronic tubulointerstitial nephropathy in addition to its well-known complication of interstitial nephritis or diabetes insipidus. In our opinion, these patients likely have much worse clinical outcome.
Prognostic factors for relapse-free survival in stage IB-IIIA primary lung adenocarcinoma by epidermal growth factor receptor mutation status
Authors: Isaka Tetsuya , Ito Hiroyuki , Yokose Tomoyuki , Saito Haruhiro , Adachi Hiroyuki , Murakami Kotaro , Miura Jun , Kikunishi Noritake , Rino Yasushi
Published: September 2022

Background

Pathological stage IB-IIIA lung adenocarcinoma with an epidermal growth factor receptor (EGFR) mutation (Mt) has a high recurrence rate even after complete resection. However, there have been few reports on the risk factors for Mt recurrence. This study aimed to analyze the clinicopathological factors related to the relapse-free survival (RFS) of patients with pathological stage IB-IIIA primary lung adenocarcinoma with and without an EGFR mutation.

Methods

Patients who underwent curative surgery for Mt (n = 208) harboring the EGFR exon 21 L858R point mutation or EGFR exon 19 deletion mutation and EGFR mutation wild-type lung adenocarcinoma (Wt, n = 358) between January 2010 and December 2020 were included. Patients who received adjuvant EGFR-tyrosine kinase inhibitors were excluded. The prognostic factors for RFS were analyzed using a multivariable Cox regression analysis.

Results

The 5-year RFS rates in the Mt and Wt groups were 43.5 and 52.3%, respectively (p = 0.907). Prognostic factors for RFS in the Mt group included smoking history (hazard ratio [HR], 1.49; p = 0.049), blood vessel invasion (HR, 1.84; p = 0.023), and lymph node metastasis (HR, 1.96; p = 0.005). However, adjuvant chemotherapy was not a prognostic factor (HR, 1.02; p = 0.906). In contrast, positron emission tomography (PET) max standardized uptake value (SUV) ≥ 6.0 (HR, 1.53; p = 0.042), lymphatic vessel invasion (HR, 1.54; p = 0.036), lymph node metastasis (HR, 1.79; p = 0.002), and adjuvant chemotherapy (HR, 0.60; p = 0.008) were prognostic factors for RFS in the Wt group.

Conclusions

Prognostic factors for RFS in stage IB-IIIA primary lung adenocarcinoma differ by epidermal growth factor receptor mutation status. The impact of adjuvant chemotherapy on RFS also differed by EGFR mutation status.
Impact of hemodynamic instability during cytoreductive surgery on survival in high-grade serous ovarian carcinoma
Authors: Kim Se Ik , Lee Hyung-Chul , Yoon Hyun-Kyu , Kim Hee Seung , Chung Hyun Hoon , Kim Jae-Weon , Park Noh Hyun , Song Yong-Sang , Lee Maria
Published: September 2022

Background

To evaluate the impact of intraoperative hypotension and hemodynamic instability on survival outcomes in patients with high-grade serous ovarian carcinoma (HGSOC).

Methods

We retrospectively identified patients with HGSOC, who underwent primary or interval debulking surgery between August 2013 and December 2019. We collected anesthesia-related variables, including the arterial blood pressure measurements (at 1-min intervals) during the surgery of patients. The cumulative duration of mean arterial blood pressure (MAP) readings under 65 mmHg and two performance measurements (median performance error [MDPE] and wobble) were calculated. We investigated associations between the factors indicating hemodynamic instability and prognosis.

Results

In total, 338 patients were included. Based on the cumulative duration of MAP under 65 mmHg, we divided patients into two groups: ≥30 min and <30 min. The progression-free survival (PFS) was worse in the ≥30 min group (n = 107) than the <30 min group (n = 231) (median, 18.2 vs. 23.7 months; P = 0.014). In multivariate analysis adjusting for confounders, a duration of ≥30 min of MAP under 65 mmHg was identified as an independent poor prognostic factor for PFS (adjusted HR, 1.376; 95% CI, 1.035–1.830; P = 0.028). Shorter PFS was observed in the group with a MDPE <−4.0% (adjusted HR, 1.351; 95% CI, 1.024–1.783; P = 0.033) and a wobble ≥7.5% (adjusted HR, 1.445; 95% CI, 1.100–1.899; P = 0.008). However, no differences were observed in overall survival.

Conclusion

This study suggests that the three intraoperative variables for hemodynamic instability, cumulative duration of MAP <65 mmHg, MDPE, and wobble, might be novel prognostic biomarkers for disease recurrence in patients with HGSOC.
The reliability, validity and screening effect of the happiness index scale among inpatients in a general hospital
Authors: Shen Yizhong , Yuan Shuai , Liu Jingwen , Sun Bin , Chen Zilin , Zheng Lijiao , Chen Lihao , Chen Hanwei , Feng Huiqiang , He Hongbo
Published: September 2022

Background

The Happiness Index Scale (HIS) is a newly developed scale by our group to screen for common psychological illnesses among general hospital inpatients. This study aimed to analyze the reliability, validity and screening effect of the HIS and to explore its clinical application.

Methods

From April 1, 2021, to December 31, 2021, a total of 8405 continuous inpatients were enrolled from different departments of a large tertiary general hospital with 1385 inpatient beds in Guangzhou, Guangdong Province, China. Using a cross-sectional survey design, each participant was assessed with the Patient Health Questionnaire 9(PHQ-9), Generalized Anxiety Disorder 7 items(GAD-7), Athens Insomnia Scale (AIS), Columbia Suicide Severity Rating Scale (C-SSRS) and HIS within 24 h of admission. McDonald's ω coefficient, the Guttman split-half coefficient and the test–retest reliability coefficient were used to evaluate the reliability of the HIS and the construct validity and criterion validity of the validity tests. Scores on the PHQ-9, GAD-7, AIS, and C-SSRS were used as the gold standard tools to analyze the screening effect of the HIS.

Results

The HIS exhibited very good reliability, with a McDonald's ω coefficient of 0.825, a Guttman split-half coefficient of 0.920 and a test–retest reliability coefficient of 0.745 (P < 0.05). Confirmatory factor analysis showed a satisfactory model fitting index with a χ2/df = 2.602, a root mean squared error of approximation (RMSEA) of 0.014, a standardized root mean square residual (SRMR) of 0.010, a comparative fit index (CFI) of 0.992, and a Tucker–Lewis index (TLI) of 0.983. The correlation coefficient between the total score of each dimension of the scale and the corresponding criterion was 0.854 ~ 0.949 (P < 0.001). The HIS showed a very good distinguishing effect. The average HIS score of inpatients who screened positive for psychological problems was significantly higher than that of inpatients who screened negative for psychological problems (t = 3790.619, P < 0.001). The effect size was very large (Cohens d = 2.695, 95% CI = 2.630 ~ 2.761). Approximately 90.2% of the positive and negative screening results of the HIS were matched with the gold standard tools, with a kappa value of 0.747 (P < 0.001). The screening effect test showed a sensitivity (true positive rate) of 92.9% and a specificity (true negative rate) of 89.5%.

Conclusion

The HIS exhibited satisfactory reliability and validity and a clinically meaningful screening effect with a much shorter version compared to the commonly used screening scales. Thus, it could potentially be useful as the first screening step to rule out psychological conditions for inpatients in general hospitals or to remind medical teams of further psychological concerns.
The effects of cyberbullying victimization on depression and suicidal ideation among adolescents and young adults: a three year cohort study from India
Authors: Maurya Chanda , Muhammad T. , Dhillon Preeti , Maurya Priya
Published: September 2022

Background

Cyberbullying victimisation is considered a global public health issue concerning the psychological development of adolescents that oftentimes persists into adulthood. The current study explored the longitudinal relationship between cyberbullying victimisation and depression and suicidal ideation among adolescents and young adults, given the scarcity of such studies in poor-resource settings like India.

Methods

Data were drawn from the “Understanding the Lives of Adolescents and Young Adults” (UDAYA- 2015-16 and 2018–19) surveys conducted in two most-populated Indian states of Uttar Pradesh and Bihar. Bivariate and logistic regression analysis was conducted to fulfil the objectives of the study using a sample of 4428 and 11,864 adolescent (aged 10–19 years) male and female cohorts, respectively.

Results

The prevalence of cyberbullying victimization increased from 3.8% to 6.4% among female respondents and 1.9% to 5.6% among male respondents over three years. About 33% of females and 16.6% of males had depressive symptoms in their young adulthood. Nearly 7.5% females compared to 2.3% of males, reported that they have seriously considered attempting suicide in the past one year. Adolscents who experienced cyberbullying victimization were 2.07 times more likely to have depressive symptoms comapared to those who did not experience cyberbullying victimization. Similarly, adolescents who experienced cyberbullying victimization were 2.50 times more likely to have suicidal ideation than their counterparts with no experience of cyberbullying victimization.

Conclusion

The findings suggest that cyberbullying victims are at higher risk of depressive symptoms and suicidal thoughts and these adverse effects persist for longer period. Therefore, cyberbullying and related mental health problems need to be addressed with more efficient strategies such as increased awareness of nuances of online harassments among adolescent and young adult population.
Comparison of laparoscope-assisted single-needle laparoscopic percutaneous extraperitoneal closure versus open repair for pediatric inguinal hernia
Authors: Wu Shaofeng , Xing Xiaoyu , He Rong , Zhao Haiteng , Zhong Liang , Sun Jie
Published: September 2022

Background

Laparoscopic-assisted repairs for pediatric inguinal hernia have gained gradual acceptance over the past decade. However, consensus about the optimal management is still lacking. The aim of this study is to compare outcomes of a modified laparoscope-assisted single-needle laparoscopic percutaneous extraperitoneal closure (LPEC) versus open repair of pediatric hernias/hydrocele in a single institution.

Materials and methods

We retrospectively reviewed the medical data of children who underwent laparoscope-assisted single-needle LPEC and open repair (OR) for inguinal hernia from 2014 to 2019. Data collection included demographics, laterality of hernia, surgical time and time to follow-up. We also reviewed and analyzed the evidence of recurrence, the incidence of metachronous contralateral inguinal hernia (MCIH), and other complications.

Results

In our cohort, 961 patients in the OR group and 1098 patients in the LPEC group were analyzed retrospectively. Mean operative time was significantly shorter in the LPEC group (22.3 ± 3.5 min) than in the OR group (27.8 ± 5.9 min) for bilateral hernia repair (p < 0.001). Postoperative recurrence was 1.3% (13/1035) in the OR group and 0.5% (6/1182) in the LPEC group (p = 0.056). Iatrogenic cryptorchidism occurred statistically more frequently in the OR group than in the LPEC group (0.4% vs. 0%, p = 0.013). In addition, the incidence of MCIH was 3.7% (33/887) in the OR group and 0.3% (3/1014) in the LPEC group (p < 0.01).

Conclusion

Comparing to open technique, laparoscope-assisted single-needle LPEC provides a simple and effective option for pediatric inguinal hernia/hydrocele repair with excellent outcomes, a low incidence of recurrence, and reduced MCIH.
Dissection of transcriptome dysregulation and immune characterization in women with germline BRCA1 mutation at single-cell resolution
Authors: Yu Xuexin , Lin Wanrun , Spirtos Alexandra , Wang Yan , Chen Hao , Ye Jianfeng , Parker Jessica , Liu Ci Ci , Wang Yiying , Quinn Gabriella , Zhou Feng , Chambers Setsuko K. , Lewis Cheryl , Lea Jayanthi , Li Bo , Zheng Wenxin
Published: September 2022

Background

High-grade serous carcinoma (HGSC) is the most frequent and lethal type of ovarian cancer. It has been proposed that tubal secretory cells are the origin of ovarian HGSC in women with familial BRCA1/2 mutations. However, the molecular changes underlying malignant transformation remain unknown.

Method

We performed single-cell RNA and T cell receptor sequencing of tubal fimbriated ends from 3 BRCA1 germline mutation carriers (BRCA1 carriers) and 3 normal controls with no high-risk history (non-BRCA1 carriers).

Results

Exploring the transcriptomes of 19,008 cells, predominantly from BRCA1+ samples, we identified 5 major cell populations in the fallopian tubal mucosae. The secretory cells of BRCA1+ samples had differentially expressed genes involved in tumor growth and regulation, chemokine signaling, and antigen presentation compared to the wild-type BRCA1 controls. There are several novel findings in this study. First, a subset of the fallopian tubal secretory cells from one BRCA1 carrier exhibited an epithelial-to-mesenchymal transition (EMT) phenotype, which was also present in the mucosal fibroblasts. Second, we identified a previously unreported phenotypic split of the EMT secretory cells with distinct evolutionary endpoints. Third, we observed increased clonal expansion among the CD8+ T cell population from BRCA1+ carriers. Among those clonally expanded CD8+ T cells, PD-1 was significantly increased in tubal mucosae of BRCA1+ patients compared with that of normal controls, indicating that T cell exhaustion may occur before the development of any premalignant or malignant lesions.

Conclusion

These results indicate that EMT and immune evasion in normal-looking tubal mucosae may represent early events leading to the development of HGSC in women with BRCA1 germline mutation. Our findings provide a probable molecular mechanism explaining why some, but not all, women with BRCA1 germline mutation present with early development and rapid dissemination of HGSC.
A simulation study for geographic cluster detection analysis on population-based health survey data using spatial scan statistics
Authors: Moon Jisu , Jung Inkyung
Published: September 2022

Background

In public health and epidemiology, spatial scan statistics can be used to identify spatial cluster patterns of health-related outcomes from population-based health survey data. Although it is appropriate to consider the complex sample design and sampling weight when analyzing complex sample survey data, the observed survey responses without these considerations are often used in many studies related to spatial cluster detection.

Methods

We conducted a simulation study to investigate which data type from complex survey data is more suitable for use by comparing the spatial cluster detection results of three approaches: (1) individual-level data, (2) weighted individual-level data, and (3) aggregated data.

Results

The results of the spatial cluster detection varied depending on the data type. To compare the performance of spatial cluster detection, sensitivity and positive predictive value (PPV) were evaluated over 100 iterations. The average sensitivity was high for all three approaches, but the average PPV was higher when using aggregated data than when using individual-level data with or without sampling weights.

Conclusions

Through the simulation study, we found that use of aggregate-level data is more appropriate than other types of data, when searching for spatial clusters using spatial scan statistics on population-based health survey data.