bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative mitochondrial genomics of Shoveliteratura triangula (Orthoptera, Tettigoniidae, Meconematinae) and the first description of a female specimen
Authors: MAO SHAOLI , YUAN HAO , CHANG HUIHUI , SHI FUMING , ZHOU YAFU
Published: September 2022

This paper provides the first description of a female of Shoveliteratura triangula Shi, Bian & Change, 2011, as well as the complete mitogenome sequence using next-generation sequencing (NGS) technology. The length of the entire mitogenome was 16,152 bp and contained the typical gene arrangement, base composition, and codon usage found in other related species. The overall base composition exhibited a clear anti-G (10.8%) and AT bias (70.5%). The third codon positions in all protein-coding genes (PCGs) displayed high AT-content values (81.4%) in contrast to lower values of 64.2%/64.5% in the first/second positions. Two tandem repeats, 2.49 repeats of 112 bp and 3.65 repeats of 201 bp, contributed 1013 bp to the length of the S. triangula control region (CR). A T-stretch as a recognition sequence of the replication origin and more than one distinct tandem repeat in the CR were common in the Tettigoniidae mitogenomes. Both the maximum likelihood (ML) and Bayesian inference (BI) analyses supported each subfamily of the Tettigoniidae as a monophyletic group. The relationships of the subfamilies were as follows: (Lipotactinae (Hexacentrinae (Conocephalinae (Meconematinae (Bradyporinae, Tettigoniinae))))). The newly sequenced species S. triangula was most closely related to Pseudokuzicus pieli.
Revision of the Garra species of the Hajar Mountains in Oman and the United Arab Emirates with the description of two new species (Teleostei: Cyprinidae)
Authors: KIRCHNER SANDRA , KRUCKENHAUSER LUISE , PICHLER ARTHUR , BORKENHAGEN KAI , FREYHOF JÖRG
Published: September 2022

The Garra species inhabiting the Hajar Mountains are revised and five species are recognised, two of which are newly species described herein. Garra barreimiae, from the United Arab Emirates (UAE) and Northern Oman, is distinguished from other Garra species in the Hajar Mountains by a strongly mottled flank pattern with individual or series of midlateral orange scales, a white dorsal-fin tip, an orange spot at the upper operculum, and more gill rakers on the lower limb of the first gill arch. Garra barreimiae shawkahensis is a synonym of G. barreimiae. Garra gallagheri, from the Wadi Bani Khalid drainage in Oman, is distinguished by flank-scale margins the same colour or slightly darker than the centre of the scales. Garra longipinnis, from the interior wadis in the Central Hajar Mountains in Oman, is distinguished by flank-scale margins being clearly darker than the centre of scales. The original description of G. longipinnis was based on a few individuals with very large fins, which are here considered aberrant. Garra shamal, new species, from the coastal drainages around Muscat in Oman, is distinguished by a strongly mottled flank pattern usually without orange midlateral scales, a white dorsal-fin tip, no orange spot at the upper operculum, and middle caudal-fin rays and membranes the same colour or slightly darker than the rest of the fins in colouration. Garra sharq, new species, from the Wadi Kabbah drainage and a few interior springs in Oman, is distinguished by a strongly mottled flank pattern with individual or series of orange midlateral scales, no orange spot at the upper opercle, and dorsal-fin tip and membranes between central caudal-fin rays the same colour as the rest of the fins. All five species are well differentiated genetically and form distinct mitochondrial clades with between 2.1 and 9.2% differences (p-distances) in the mitochondrial COI.
Twenty-five new species of mining bees (Hymenoptera: Andrenidae: Andrena) from Israel and the Levant
Authors: PISANTY GIDEON , SCHEUCHL ERWIN , MARTIN TERESA , CARDINAL SOPHIE , WOOD THOMAS JAMES
Published: September 2022

Andrena is one of the most diverse bee genera, comprising about 1,600 described species of ground-nesting solitary bees. Many Andrena species are plant specialists, and several taxa have been indicated to be important pollinators of wild and/or crop plants. The Eastern Mediterranean Basin and Israel in particular are one of the main world diversity hotspots of Andrena. Based on extensive examination of museum specimens combined with DNA barcoding, we hereby describe twenty-five Levantine species of Andrena new to science: Andrena anathema Pisanty sp. nov., A. ardentia Pisanty sp. nov., A. asluji Pisanty sp. nov., A. curviocciput Pisanty & Wood sp. nov., A. dividicincta Pisanty sp. nov., A. dorchini Pisanty sp. nov., A. euphorbiae Pisanty sp. nov., A. gageae Wood & Pisanty sp. nov., A. herodesi Pisanty & Wood sp. nov., A. hulae Pisanty sp. nov., A. igraeca Pisanty & Wood sp. nov., A. inusitata Pisanty sp. nov., A. janthinoides Pisanty sp. nov., A. longistilus Pisanty & Wood sp. nov., A. lunaris Pisanty & Wood sp. nov., A. macula Pisanty & Wood sp. nov., A. obtusa Pisanty sp. nov., A. ornithogali Pisanty & Wood sp. nov., A. petrae Wood sp. nov., A. protuber Pisanty sp. nov., A. sulfurea Wood sp. nov., A. turmalina Pisanty & Wood sp. nov., A. veronicae Pisanty & Wood sp. nov., A. veterana Pisanty sp. nov., and A. xera Pisanty sp. nov. We synonymise Andrena edentula Wood with A. tadauchii Gusenleitner syn. nov., and recognise four infraspecific names as valid species: Andrena mediterranea Pisanty & Scheuchl stat. nov., A. mizorhina Warncke stat. nov., A. noacki Alfken sp. resurr. and A. ochraceohirta Alfken sp. resurr. We additionally describe the hitherto unknown sexes of four species, provide new records for fifteen species previously unknown from Israel, and list fourteen taxa whose previously reported presence in Israel is considered erroneous or questionable.
GPs’ and practice nurses’ views on their management of paediatric anxiety problems: an interview study
Authors: Koet Lukas B. M. , Bennenbroek Jessie J. M. , Bruggeman Annouk Y. S. , de Schepper Evelien I. T. , Bohnen Arthur M. , Bindels Patrick J. E. , Gerger Heike
Published: September 2022

Background

Anxiety problems are common in both children and adolescents, and many affected children do not receive appropriate treatment. Understaffing of mental healthcare services and long waiting lists form major barriers. In the Netherlands, practice nurses have been introduced into general practice to support general practitioners (GPs) in the management of psychosocial problems. In this study we investigated the views of GPs and practice nurses on their management of paediatric anxiety problems.

Methods

We performed an exploratory study using semi-structured interviews with 13 GPs and 13 practice nurses in the greater Rotterdam area in 2021. Interviews were transcribed and coded into topics, which were categorized per research question.

Results

In their management of paediatric anxiety problems, both GPs and practice nurses try to explore the case and the needs of affected children and their parents. GPs rarely follow up affected children themselves. They often refer the child, preferably to their practice nurse. Practice nurses regularly initiate follow-up consultations with affected children themselves. Practice nurses reported using a variety of therapeutic techniques, including elements of cognitive behavioural therapy. In more severe cases, practice nurses refer the child to external mental healthcare services. GPs reported being satisfied with their collaboration with practice nurses. Both GPs and practice nurses experience significant barriers in the management of paediatric anxiety problems. Most importantly, long waiting lists for external mental health care were reported to be a major difficulty. Improving cooperation with external mental healthcare providers was reported to be an important facilitator.

Conclusions

In their management of paediatric anxiety problems, GPs and practice nurses experience major challenges in the cooperation with external mental healthcare providers and in the long waiting lists for these services. GPs and practice nurses believe that thanks to their shared approach more children with anxiety problems can remain treated in general practice. Future research is needed to evaluate the treatment outcomes of the shared efforts of GPs and practice nurses in their management of paediatric anxiety problems.
A nationwide cohort study suggests clarithromycin-based therapy for Helicobacter pylori eradication is safe in patients with stable coronary heart disease and subsequent peptic ulcer disease
Authors: Chen Yen-Chun , Li Yi-Da , Yu Ben-Hui , Chen Yi-Chun
Published: September 2022

Background

Clarithromycin-based therapy is important for Helicobacter pylori eradication treatment. However, clarithromycin may increase cardiovascular risk. Hence, we investigated the association between clarithromycin use and outcomes in adults with stable coronary heart disease (CHD) and subsequent peptic ulcer disease (PUD).

Methods

This nationwide cohort study used a national health insurance database to screen 298,417 Taiwanese residents who were diagnosed with coronary heart disease from 2001 to 2015 for eligibility in the study and to evaluate select eligible patients with CHD–PUD from 2004 to 2015. Data were obtained from new users of clarithromycin (n = 4183) and nonusers of clarithromycin (n = 24,752) during follow-up. A total of 4070 eligible clarithromycin users and 4070 nonusers were subject to final analysis by 1:1 propensity score matching. Participants were followed up after receiving clarithromycin or at the corresponding date until the occurrence of cardiovascular morbidity in the presence of competing mortality, overall mortality and cardiovascular mortality, or through the end of 2015. The incidence rates and risks of overall mortality and cardiovascular outcomes were evaluated. The associations between clarithromycin and arrhythmia risk, as well as its dose and duration and overall mortality and cardiovascular outcomes were also addressed.

Results

Clarithromycin users were associated with adjusted hazard ratios of 1.08 (95% confidence interval, 0.93–1.24; 21.5 compared with 21.2 per 1000 patient-years) for overall mortality, 0.95 (0.57–1.59; 1.5 compared with 1.8 per 1000 patient-years) for cardiovascular mortality, and 0.94 (0.89–1.09; 19.6 compared with 20.2 per 1000 patient-years) for cardiovascular morbidity in the presence of competing mortality, as compared with nonusers. We found no relationship between dose and duration of clarithromycin and overall mortality and cardiovascular outcomes and no increased risk of arrhythmia during follow-up period. After inclusion of arrhythmia events to re-estimate the risks of all study outcomes, the results remained insignificant.

Conclusion

Concerning overall mortality, cardiovascular mortality, and cardiovascular morbidity, our results suggest clarithromycin-based therapy for Helicobacter pylori eradication may be safe in patients with stable CHD and subsequent PUD.
The effects of a combination of 3D virtual reality and hands-on horticultural activities on mastery, achievement motives, self-esteem, isolation and depression: a quasi-experimental study
Authors: Fan Ching-Chih , Choy Cheuk-Sing , Huang Chiu-Mieh , Chih Po-Sheng , Lee Chia-Chiang , Lin Fen-He , Guo Jong-Long
Published: September 2022

Background

Aging societies are a public health concern worldwide. It is critical to develop strategies that harness technology to enhance older adults’ mastery, achievement motives, self-esteem, isolation and depression effectively.

Methods

This study aimed to explore the effects of a combination of three-dimensional virtual reality (VR) and hands-on horticultural activities on the psychological well-being of community-dwelling older adults. We used a quasi-experimental design. A total of 62 community-dwelling older adults were recruited and assigned to the experimental (n = 32) and comparison groups (n = 30). The members of the experimental group participated in an 8-week intervention program. Participants of both groups completed before-and-after intervention measurements for outcome variables that included perceived self-esteem, depression, isolation, and mastery and achievement motives, which were analyzed using the generalized estimating equation (GEE). A baseline score of depression was used as an adjustment for the GEE analyses to eliminate the effects of depression on outcomes.

Results

After controlling age and gender as confounders, GEE analyses indicated that the experimental group showed significant post-intervention improvements in scores for self-esteem (β = 2.18, P = .005) and mastery (β = 1.23, P = .039), compared to the control group.

Conclusions

This study supported a combination of three-dimensional VR and hands-on horticultural activities on community-dwelling older adults to improve self-esteem and mastery. The findings suggest that the future implementation of a similar program would be feasible and beneficial to community-dwelling older adults.

Trial registration

The study was posted on www.clinicaltrials.gov (NCT05087654) on 21/10/2021. It was approved by the Institutional Review Board of En Chu Kong Hospital and performed in accordance with the Declaration of Helsinki.
The impact of age on rectal cancer treatment, complications and survival
Authors: Høydahl Øystein , Edna Tom-Harald , Xanthoulis Athanasios , Lydersen Stian , Endreseth Birger Henning
Published: September 2022

Background

The number of older patients with rectal cancer is increasing. Treatment outcome discrepancies persist, despite similar treatment guidelines. To offer the oldest patients optimal individually adjusted care, further knowledge is needed regarding treatment strategy and outcome. The present study aimed to evaluate treatment, postoperative complications, and survival in older patients treated for rectal cancer.

Methods

This retrospective study included all 666 patients (n=255 females, n=411 males) treated for rectal cancer at Levanger Hospital during 1980-2016 (n=193 <65 years, n=329 65-79 years, n=144 ≥80 years). We performed logistic regression to analyse associations between complications, 90-day mortality, and explanatory variables. We performed a relative survival analysis to identify factors associated with short- and long-term survival.

Results

Despite a similar distribution of cancer stages across age-groups, patients aged ≥80 years were treated with a non-curative approach more frequently than younger age groups. Among patients aged ≥80 years, 42% underwent a non-curative treatment approach, compared to 25% of patients aged <65 years, and 25% of patients aged 65-79 years. The 90-day mortality was 15.3% among patients aged ≥80 years, compared to 5.7% among patients aged <65 years, and 9.4% among patients aged 65-79 years.

Among 431 (65%) patients treated with a major resection with curative intent, the 90-day mortality was 5.9% among patients aged ≥80 years (n=68), compared to 0.8% among patients aged <65 years (n=126), and 3.8% among patients aged 65-79 years (n=237). The rate of postoperative complications was 47.6%. Pneumonia was the only complication that occurred more frequently in the older patient group. The severity of complications increased with three factors: age, American Society of Anaesthesiologists score, and >400 ml perioperative blood loss. Among patients that survived the first 90 days, the relative long-term survival rates, five-year local recurrence rates, and metastases rates were independent of age.

Conclusion

Patients aged ≥80 years were less likely to undergo a major resection with curative intent and experienced more severe complications after surgery than patients aged <80 years. When patients aged ≥80 years were treated with a major resection with curative intent, the long-term survival rate was comparable to that of younger patients.
Modified geriatric nutritional risk index in patients with pancreatic cancer: a propensity score-matched analysis
Authors: Sakamoto Teruhisa , Sunaguchi Teppei , Goto Keisuke , Morimoto Masaki , Murakami Yuki , Miyatani Kozo , Hanaki Takehiko , Shishido Yuji , Kihara Kyoichi , Matsunaga Tomoyuki , Yamamoto Manabu , Tokuyasu Naruo , Fujiwara Yoshiyuki
Published: September 2022

Background

The modified nutritional geriatric risk index (mGNRI) was developed as a novel index and provides a more appropriate prognostic index than the original GNRI, which was reported to be a useful index for predicting prognoses for various malignancies. This study investigated the prognostic significance of the mGNRI compared with that of the GNRI in patients with pancreatic cancer and the association with psoas muscle volume (PMV) for survival outcomes.

Methods

This retrospective study included 137 patients who had undergone pancreatectomy for pancreatic cancer. The enrolled patients were grouped as high mGNRI (≥ 85.3) or low mGNRI (< 85.3), and high GNRI (≥ 92) or low GNRI (< 92) for prognostic analysis based on cutoff values. A propensity-matched analysis was performed in this study.

Results

The 5-year overall survival of patients in the high mGNRI group or high GNRI group was significantly longer than those in the low mGNRI group or low GNRI group. Statistically significant differences for the 5-year OS were observed in the three groups with respect to the combination of mGNRI and PMV. Patients with low mGNRI/low PMV had a worse 5-year OS rate compared with patients with high GNRI/high PMV or those with high GNRI or high PMV, but not both. The concordance index of the mGNRI to predict the 5-year overall survival was greater than that of the GNRI or the combination of the GNRI and PMV, but lower than that of the combination of the mGNRI and PMV. Multivariate analysis revealed that the mGNRI was an independent prognostic factor for patients with pancreatic cancer (P = 0.005).

Conclusions

The mGNRI might be a more useful prognostic factor than the GNRI for patients with pancreatic cancer, and might predict prognostic outcomes more accurately when combined with PMV.
“You can’t swim well if there is a weight dragging you down”: cross-sectional study of intimate partner violence, sexual assault and child abuse prevalence against Australian nurses, midwives and carers
Authors: McLindon Elizabeth , Diemer Kristin , Kuruppu Jacqueline , Spiteri-Staines Anneliese , Hegarty Kelsey
Published: September 2022

Background

Domestic and family violence (DFV), including intimate partner violence (IPV), sexual assault and child abuse are prevalent health and social issues, often precipitating contact with health services. Nurses, midwives and carers are frontline responders to women and children who have experienced violence, with some research suggesting that health professionals themselves may report a higher incidence of IPV in their personal lives compared to the community. This paper reports the largest study of DFV against health professionals to date.

Method

An online descriptive, cross-sectional survey of 10,674 women and 772 men members of the Australian Nursing and Midwifery Federation (ANMF) (Victorian Branch). The primary outcome measures were 12-month and adult lifetime IPV prevalence (Composite Abuse Scale); secondary outcomes included sexual assault and child abuse (Australian Bureau of Statistics Personal Safety Survey) and prevalence of IPV perpetration (bespoke).

Results

Response rate was 15.2% of women/11.2% of men who were sent an invitation email, and 38.4% of women/28.3% of men who opened the email. In the last 12-months, 22.1% of women and 24.0% of men had experienced IPV, while across the adult lifetime, 45.1% of women and 35.0% of men had experienced IPV. These figures are higher than an Australian community sample. Non-partner sexual assault had been experienced by 18.6% of women and 7.1% of men, which was similar to national community sample. IPV survivors were 2-3 times more likely to have experienced physical, sexual or emotional abuse in childhood compared to those without a history of IPV (women OR 2.7, 95% CI 2.4 to 2.9; men OR 2.8, 95% CI 2.0 to 4.1). Since the age of sixteen, 11.7% of men and 1.7% of women had behaved in a way that had made a partner or ex-partner feel afraid of them.

Conclusions

The high prevalence of intimate partner violence and child abuse in this group of nurses, midwives and carers suggests the need for workplace support programs. The findings support the theory that childhood adversity may be related to entering the nursing profession and has implications for the training and support of this group.
Socioeconomic inequalities in teenage pregnancy in Nigeria: evidence from Demographic Health Survey
Authors: Okoli Chijioke Ifeanyi , Hajizadeh Mohammad , Rahman Mohammad Mafizur , Velayutham Eswaran , Khanam Rasheda
Published: September 2022

Background

Despite the high rate of teenage pregnancy in Nigeria and host of negative medical, social and economic consequences that are associated with the problem, relatively few studies have examined socioeconomic inequality in teenage pregnancy. Understanding the key factors associated with socioeconomic inequality in teenage pregnancy is essential in designing effective policies for teenage pregnancy reduction. This study focuses on measuring inequality and identifying factors explaining socioeconomic inequality in teenage pregnancy in Nigeria.

Methods

This is a cross sectional study using individual recode (data) file from the 2018 Nigeria Demographic Health Survey. The dataset comprises a representative sample of 8,423 women of reproductive age 15 – 19 years in Nigeria. The normalized Concentration index (Cn) was used to determine the magnitude of inequalities in teenage pregnancy. The Cn was decomposed to determine the contribution of explanatory factors to socioeconomic inequalities in teenage pregnancy in Nigeria.

Results

The negative value of the Cn (-0.354; 95% confidence interval [CI] = -0.400 to -0.308) suggests that pregnancy is more concentrated among the poor teenagers. The decomposition analysis identified marital status, wealth index of households, exposure to information and communication technology, and religion as the most important predictors contributing to observed concentration of teenage pregnancy in Nigeria.

Conclusion

There is a need for targeted intervention to reduce teenage pregnancy among low socioeconomic status women in Nigeria. The intervention should break the intergenerational cycle of low socioeconomic status that make teenagers’ susceptible to unintended pregnancy. Economic empowerment is recommended, as empowered girls are better prepared to handle reproductive health issues. Moreover, religious bodies, parents and schools should provide counselling, and guidance that will promote positive reproductive and sexual health behaviours to teenagers.
Is inpatient rehabilitation a predictor of a lower incidence of persistent knee pain 3-months following total knee replacement? A retrospective, observational study
Authors: Johns Nathan , Naylor Justine , McKenzie Dean , Brady Bernadette , Olver John
Published: September 2022

Background

Moderate to severe levels of persistent knee pain have been estimated to affect up to 25% of people 3-months or more after a total knee replacement. It is unknown whether the type of rehabilitation pathway is associated with persistent high pain after surgery. Using a prospectively followed Australian cohort who underwent total knee replacement for knee osteoarthritis, this study aimed to i) report the incidence of high-intensity knee pain (defined as a score ≤ 15 on the Oxford Knee Score pain subscale) across time and ii) identify whether referral to inpatient rehabilitation was one of the predictors of persistent pain at 3-months post-surgery.

Methods

A retrospective analysis of a large prospective study was conducted using the Oxford Knee Score pain subscale to determine if participants had high pain at 3-months, 12-months and 36-months post-surgery. Relative risks for high pain at 3-, 12- and 36-months between the type of rehabilitation pathway were determined using Poisson multivariable regression with robust standard errors. The same technique was also employed to determine potential predictors, including rehabilitation pathway, of high pain at 3 months.

Results

The incidence of high pain in all participants was 73% pre-surgery and 10, 5 and 6% at 3-, 12- and 36-months respectively following knee replacement. There was a significant interaction between time and rehabilitation pathway, suggesting that the effect of the rehabilitation pathway varied across time. The incidence of high pain at 3-months did not significantly differ between those who attended inpatient rehabilitation (11.6%) and those discharged directly home (9.5%). Multivariable Poisson regression analysis identified the pre-surgical presence of high pain, co-morbid low back pain or other lower limb problem, younger age and having a major complication within 3-months following surgery as significant predictors of persistent pain whilst discharge to inpatient rehabilitation was not.

Conclusion

A small but clinically significant minority of people continued to have high pain levels at 3-, 12- and 36-months following a primary total knee replacement for osteoarthritis. Participation in an inpatient rehabilitation program does not appear to be an important predictor of ongoing knee pain.

Trial registration

The data were collected in the Evidence-based Processes and Outcomes of Care (EPOC) study, ClinicalTrials.gov Identifier: NCT01899443
Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) for ovarian cancer in an Australian institution: lessons from 20 years’ experience
Authors: Farrell R. , Liauw W. S. , Morris D. L.
Published: September 2022

Objectives

We report the 20-year experience of the largest Australian unit performing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for ovarian cancer and reflect on learning opportunities.

Methods

A retrospective review of all cases of CRS for ovarian cancer at St George Peritonectomy Unit from Jan 1998 to Jan 2018 was performed. Prospectively collected data include age, stage, histology, disease extent (PCI), completeness of cytoreduction (CC score), HIPEC regime, 30-day surgical morbidity, disease recurrence, and death. Survival was computed using Kaplan–Meier method and analysed using log-rank tests and Cox-proportional hazards models.

Results

Forty-one women with advanced ovarian cancer (11 primary stage III/IV, 30 recurrent) underwent CRS, 29 (71%) with HIPEC. Most (68%) had high-volume disease (PCI > 15). In 98%, CC0/CC1 (residual < 2.5 mm) was achieved. Fourteen (34%) had grade 3/4 complications, 1 patient (2%) died within 30 days and 2 patients (5%) died within 90 days. Progression-free and median overall survival was 30.0 and 67.0 months for primary cancer, and 6.7 and 18.1 months for recurrent cancer. Survival was associated with platinum-sensitivity, PCI ≤ 15, and CC score 0, but not HIPEC.

Conclusion

This study reports outcomes for patients with advanced ovarian cancer patients treated in an Australian centre offering CRS and HIPEC. Whilst survival and morbidity outcomes were good for primary disease, they were poorer than predicted from the literature for cases of recurrent disease. The incorporation of evidence-based predictors of survival and multidisciplinary input are essential to achieve the best survival outcomes.
Impact of low health literacy on patients’ health outcomes: a multicenter cohort study
Authors: Shahid Rabia , Shoker Muhammad , Chu Luan Manh , Frehlick Ryan , Ward Heather , Pahwa Punam
Published: September 2022

Background

This study aims to assess the health literacy of medical patients admitted to hospitals and examine its correlation with patients’ emergency department visits, hospital readmissions, and durations of hospital stay.

Methods

This prospective cohort study recruited patients admitted to the general internal medicine units at the two urban tertiary care hospitals. Health literacy was measured using the full-length Test of Functional Health Literacy in Adults. Logistic regression analyses were performed to examine the correlation between health literacy and the desired outcomes. The primary outcome of interest of this study was to determine the correlation between health literacy and emergency department revisit within 90 days of discharge. The secondary outcomes of interest were to assess the correlation between health literacy and length of stay and hospital readmission within 90 days of discharge.

Results

We found that 50% had adequate health literacy, 32% had inadequate, and 18% of patients had marginal health literacy. Patients with inadequate health literacy were more likely to revisit the emergency department as compared to patients with adequate health literacy (odds ratio: 3.0; 95% Confidence Interval: 1.3–6.9,p = 0.01). In patients with inadequate health literacy, the mean predicted probability of emergency department revisits was 0.22 ± 0.11 if their education level was some high school or less and 0.57 ± 0.18 if they had completed college. No significant correlation was noted between health literacy and duration of hospital stay or readmission.

Conclusions

Only half of the patients admitted to the general internal medicine unit had adequate health literacy. Patients with low health literacy, but high education, had a higher probability of emergency department revisits.
Lung function and radiological findings 1 year after COVID-19: a prospective follow-up
Authors: Tarraso Julia , Safont Belen , Carbonell-Asins Juan A. , Fernandez-Fabrellas Estrella , Sancho-Chust José N. , Naval Elsa , Amat Beatriz , Herrera Susana , Ros José A. , Soler-Cataluña Juan J. , Rodriguez-Portal Jose A. , Andreu Ada L. , Marín Margarita , Rodriguez-Hermosa Juan L. , Gonzalez-Villaescusa Cruz , Soriano Joan B. , Signes-Costa Jaime ,   COVID-FIBROTIC study team, García Yolanda , Blasco Natividad , Herrera Antonio , Mulet Alba , Ballester Andrea , Fernandez Lucia , Quezada Antonio , Meneses Elsie Daviana , Carrión Noelia , Celis Carly , Cabanes Luis , Molina Virginia , Valentin Veronica , López Irene , Solana-Martínez Elena , Aparicio-Vicente Mario , López Celia , Cuenca Selene , Vargas Gianna
Published: September 2022

Background

The coronavirus disease (COVID-19) pandemic has already affected more than 400 million people, with increasing numbers of survivors. These data indicate that a myriad of people may be affected by pulmonary sequelae of the infection. The aim of this study was to evaluate pulmonary sequelae in patients with bilateral COVID-19 pneumonia according to severity 1 year after hospital discharge.

Methods

COVID-FIBROTIC is a multicenter prospective observational cohort study for admitted patients with bilateral COVID-19 pneumonia. Pulmonary functional outcomes and chest computed tomography sequelae were analyzed 12 months after hospital discharge and we classified patients into three groups according to severity. A post hoc analysis model was designed to establish how functional test changed between groups and over time. A multivariable logistic regression model was created to study prognostic factors for lung diffusion impairment and radiological fibrotic-like changes at 12 months.

Results

Among 488 hospitalized patients with COVID-19 pneumonia, 284 patients had completed the entire evaluation at 12 months. Median age was 60.5 ± 11.9 and 55.3% were men. We found between-group differences in male sex, length of hospital stay, radiological involvement and inflammatory laboratory parameters. The functional evaluation of pulmonary sequelae showed that severe patients had statistically worse levels of lung diffusion at 2 months but no between group differences were found in subsequent controls. At 12-month follow up, however, we found impaired lung diffusion in 39.8% unrelated to severity. Radiological fibrotic-like changes at 12 months were reported in 22.7% of patients (102/448), only associated with radiological involvement at admission (OR: 1.55, 95% CI 1.06–2.38; p = 0.02) and LDH (OR: 0.99, 95% CI 0.98–0.99; p = 0.046).

Conclusion

Our data suggest that a significant percentage of individuals would develop pulmonary sequelae after COVID 19 pneumonia, regardless of severity of the acute process.

Trial registration clinicaltrials.gov NCT04409275 (June 1, 2020)
Myeloid liver kinase B1 contributes to lung inflammation induced by lipoteichoic acid but not by viable Streptococcus pneumoniae
Authors: Pereverzeva Liza , Otto Natasja A. , Roelofs Joris J. T. H. , de Vos Alex F. , van der Poll Tom
Published: September 2022

Background

Liver kinase B1 (Lkb1, gene name Stk11) functions as a tumor suppressor in cancer. Myeloid cell Lkb1 potentiates lung inflammation induced by the Gram-negative bacterial cell wall component lipopolysaccharide and in host defense during Gram-negative pneumonia. Here, we sought to investigate the role of myeloid Lkb1 in lung inflammation elicited by the Gram-positive bacterial cell wall component lipoteichoic acid (LTA) and during pneumonia caused by the Gram-positive respiratory pathogen Streptococcus pneumoniae (Spneu).

Methods

Alveolar and bone marrow derived macrophages (AMs, BMDMs) harvested from myeloid-specific Lkb1 deficient (Stk11-ΔM) and littermate control mice were stimulated with LTA or Spneu in vitro. Stk11-ΔM and control mice were challenged via the airways with LTA or infected with Spneu in vivo.

Results

Lkb1 deficient AMs and BMDMs produced less tumor necrosis factor (TNF)α upon activation by LTA or Spneu. During LTA-induced lung inflammation, Stk11-ΔM mice had reduced numbers of AMs in the lungs, as well as diminished cytokine release and neutrophil recruitment into the airways. During pneumonia induced by either encapsulated or non-encapsulated Spneu, Stk11-ΔM and control mice had comparable bacterial loads and inflammatory responses in the lung, with the exception of lower TNFα levels in Stk11-ΔM mice after infection with the non-encapsulated strain.

Conclusion

Myeloid Lkb1 contributes to LTA-induced lung inflammation, but is not important for host defense during pneumococcal pneumonia.
Small extracellular vesicles: from promoting pre-metastatic niche formation to therapeutic strategies in breast cancer
Authors: Chen Xiaoxiao , Feng Jiamei , Chen Weili , Shao Shijun , Chen Li , Wan Hua
Published: September 2022

Breast cancer is the most common cancer in females, and to date, the mortality rate of breast cancer metastasis cannot be ignored. The metastasis of breast cancer is a complex, staged process, and the pattern of metastatic spread is not random. The pre-metastatic niche, as an organ-specific home for metastasis, is a favourable environment for tumour cell colonization. As detection techniques improve, the role of the pre-metastatic niche in breast cancer metastasis is being uncovered. sEVs (small extracellular vesicles) can deliver cargo, which is vital for the formation of pre-metastatic niches. sEVs participate in multiple aspects of creating a distant microenvironment to promote tumour invasion, including the secretion of inflammatory molecules, immunosuppression, angiogenesis and enhancement of vascular permeability, as well as regulation of the stromal environment. Here, we discuss the multifaceted mechanisms through which breast cancer-derived sEVs contribute to pre-metastatic niches. In addition, sEVs as biomarkers and antimetastatic therapies are also discussed, particularly their use in transporting exosomal microRNAs. The study of sEVs may provide insight into immunotherapy and targeted therapies for breast cancer, and we also provide an overview of their potential role in antitumour metastasis.
Liquid biopsy: current technology and clinical applications
Authors: Nikanjam Mina , Kato Shumei , Kurzrock Razelle
Published: September 2022

Liquid biopsies are increasingly used for cancer molecular profiling that enables a precision oncology approach. Circulating extracellular nucleic acids (cell-free DNA; cfDNA), circulating tumor DNA (ctDNA), and circulating tumor cells (CTCs) can be isolated from the blood and other body fluids. This review will focus on current technologies and clinical applications for liquid biopsies. ctDNA/cfDNA has been isolated and analyzed using many techniques, e.g., droplet digital polymerase chain reaction, beads, emulsion, amplification, and magnetics (BEAMing), tagged-amplicon deep sequencing (TAm-Seq), cancer personalized profiling by deep sequencing (CAPP-Seq), whole genome bisulfite sequencing (WGBS-Seq), whole exome sequencing (WES), and whole genome sequencing (WGS). CTCs have been isolated using biomarker-based cell capture, and positive or negative enrichment based on biophysical and other properties. ctDNA/cfDNA and CTCs are being exploited in a variety of clinical applications: differentiating unique immune checkpoint blockade response patterns using serial samples; predicting immune checkpoint blockade response based on baseline liquid biopsy characteristics; predicting response and resistance to targeted therapy and chemotherapy as well as immunotherapy, including CAR-T cells, based on serial sampling; assessing shed DNA from multiple metastatic sites; assessing potentially actionable alterations; analyzing prognosis and tumor burden, including after surgery; interrogating difficult-to biopsy tumors; and detecting cancer at early stages. The latter can be limited by the small amounts of tumor-derived components shed into the circulation; furthermore, cfDNA assessment in all cancers can be confounded by clonal hematopoeisis of indeterminate potential, especially in the elderly. CTCs can be technically more difficult to isolate that cfDNA, but permit functional assays, as well as evaluation of CTC-derived DNA, RNA and proteins, including single-cell analysis. Blood biopsies are less invasive than tissue biopsies and hence amenable to serial collection, which can provide critical molecular information in real time. In conclusion, liquid biopsy is a powerful tool, and remarkable advances in this technology have impacted multiple aspects of precision oncology, from early diagnosis to management of refractory metastatic disease. Future research may focus on fluids beyond blood, such as ascites, effusions, urine, and cerebrospinal fluid, as well as methylation patterns and elements such as exosomes.
PEEP-FiO2 table versus EIT to titrate PEEP in mechanically ventilated patients with COVID-19-related ARDS
Authors: Somhorst Peter , van der Zee Philip , Endeman Henrik , Gommers Diederik
Published: September 2022

Rationale

It is unknown how to titrate positive end-expiratory pressure (PEEP) in patients with COVID-19-related acute respiratory distress syndrome (ARDS). Guidelines recommend the one-size-fits-all PEEP-FiO2 table. In this retrospective cohort study, an electrical impedance tomography (EIT)-guided PEEP trial was used to titrate PEEP.

Objectives

To compare baseline PEEP according to the high PEEP-FiO2 table and personalized PEEP following an EIT-guided PEEP trial.

Methods

We performed an EIT-guided decremental PEEP trial in patients with moderate-to-severe COVID-19-related ARDS upon intensive care unit admission. PEEP was set at the lowest PEEP above the intersection of curves representing relative alveolar overdistention and collapse. Baseline PEEP was compared with PEEP set according to EIT. We identified patients in whom the EIT-guided PEEP trial resulted in a decrease or increase in PEEP of ≥ 2 cmH2O.

Measurements and main results

We performed a PEEP trial in 75 patients. In 23 (31%) patients, PEEP was decreased ≥ 2 cmH2O, and in 24 (32%) patients, PEEP was increased ≥ 2 cmH2O. Patients in whom PEEP was decreased had improved respiratory mechanics and more overdistention in the non-dependent lung region at higher PEEP levels. These patients also had a lower BMI, longer time between onset of symptoms and intubation, and higher incidence of pulmonary embolism. Oxygenation improved in patients in whom PEEP was increased.

Conclusions

An EIT-guided PEEP trial resulted in a relevant change in PEEP in 63% of patients. These results support the hypothesis that PEEP should be personalized in patients with ARDS.
Predicting conversion of brain β-amyloid positivity in amyloid-negative individuals
Authors: Park Chae Jung , Seo Younghoon , Choe Yeong Sim , Jang Hyemin , Lee Hyejoo , Kim Jun Pyo ,   for the Alzheimer’s Disease Neuroimaging Initiative
Published: September 2022

Background

Cortical deposition of β-amyloid (Aβ) plaque is one of the main hallmarks of Alzheimer’s disease (AD). While Aβ positivity has been the main concern so far, predicting whether Aβ (−) individuals will convert to Aβ (+) has become crucial in clinical and research aspects. In this study, we aimed to develop a classifier that predicts the conversion from Aβ (−) to Aβ (+) using artificial intelligence.

Methods

Data were obtained from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) cohort regarding patients who were initially Aβ (−). We developed an artificial neural network-based classifier with baseline age, gender, APOE ε4 genotype, and global and regional standardized uptake value ratios (SUVRs) from positron emission tomography. Ten times repeated 10-fold cross-validation was performed for model measurement, and the feature importance was assessed. To validate the prediction model, we recruited subjects at the Samsung Medical Center (SMC).

Results

A total of 229 participants (53 converters) from the ADNI dataset and a total of 40 subjects (10 converters) from the SMC dataset were included. The average area under the receiver operating characteristic values of three developed models are as follows: Model 1 (age, gender, APOE ε4) of 0.674, Model 2 (age, gender, APOE ε4, global SUVR) of 0.814, and Model 3 (age, gender, APOE ε4, global and regional SUVR) of 0.841. External validation result showed an AUROC of 0.900.

Conclusion

We developed prediction models regarding Aβ positivity conversion. With the growing recognition of the need for earlier intervention in AD, the results of this study are expected to contribute to the screening of early treatment candidates.
Mouse models of SMA show divergent patterns of neuronal vulnerability and resilience
Authors: Woschitz Victoria , Mei Irene , Hedlund Eva , Murray Lyndsay M.
Published: September 2022

Background

Spinal muscular atrophy (SMA) is a form of motor neuron disease affecting primarily children characterised by the loss of lower motor neurons (MNs). Breakdown of the neuromuscular junctions (NMJs) is an early pathological event in SMA. However, not all motor neurons are equally vulnerable, with some populations being lost early in the disease while others remain intact at the disease end-stage. A thorough understanding of the basis of this selective vulnerability will give critical insight into the factors which prohibit pathology in certain motor neuron populations and consequently help identify novel neuroprotective strategies.

Methods

To retrieve a comprehensive understanding of motor neuron susceptibility in SMA, we mapped NMJ pathology in 20 muscles from the Smn2B/- SMA mouse model and cross-compared these data with published data from three other commonly used mouse models. To gain insight into the molecular mechanisms regulating selective resilience and vulnerability, we analysed published RNA sequencing data acquired from differentially vulnerable motor neurons from two different SMA mouse models.

Results

In the Smn2B/- mouse model of SMA, we identified substantial NMJ loss in the muscles from the core, neck, proximal hind limbs and proximal forelimbs, with a marked reduction in denervation in the distal limbs and head. Motor neuron cell body loss was greater at T5 and T11 compared with L5. We subsequently show that although widespread denervation is observed in each SMA mouse model (with the notable exception of the Taiwanese model), all models have a distinct pattern of selective vulnerability. A comparison of previously published data sets reveals novel transcripts upregulated with a disease in selectively resistant motor neurons, including genes involved in axonal transport, RNA processing and mitochondrial bioenergetics.

Conclusions

Our work demonstrates that the Smn2B/- mouse model shows a pattern of selective vulnerability which bears resemblance to the regional pathology observed in SMA patients. We found drastic differences in patterns of selective vulnerability across the four SMA mouse models, which is critical to consider during experimental design. We also identified transcript groups that potentially contribute to the protection of certain motor neurons in SMA mouse models.
Thermo-mechanical simulations of powder bed fusion processes: accuracy and efficiency
Authors: Burkhardt Christian , Steinmann Paul , Mergheim Julia
Published: September 2022

In this contribution, the accuracy and efficiency of various modeling assumptions and numerical settings in thermo-mechanical simulations of powder bed fusion (PBF) processes are analyzed. Thermo-mechanical simulations are used to develop a better understanding of the process and to determine residual stresses and distortions based on the temperature history. In these numerically very complex simulations, modeling assumptions are often made that reduce computational effort but lead to inaccuracies. These assumptions include the omission of the surrounding powder or the use of geometrically linearized material models. The numerical setting, in particular the temporal and spatial discretizations, can further lead to discretization errors. Here, a highly parallelized and adaptive finite element method based on the open source C++ library deal.II is validated and utilized, to investigate some of these modeling assumptions and to identify the required temporal and spatial discretizations for the simulation of PBF of Ti-6Al-4V. The insights initially gained on a simple wall-like geometry are transferred to a larger open rectangular profile where the results of a detailed simulation are compared with those of a more efficient one. The results for the efficient approach show a maximum deviation of $$\approx 8\%$$

≈
8
%

in the displacements and $$\approx 3.5\%$$

≈
3.5
%

in the residual stresses while significantly reducing the computational time.
Paper 2: a systematic review of narrative therapy treatment outcomes for eating disorders—bridging the divide between practice-based evidence and evidence-based practice
Authors: Conti Janet , Heywood Lauren , Hay Phillipa , Shrestha Rebecca Makaju , Perich Tania
Published: September 2022

Background

Narrative therapy has been proposed to have practice-based evidence however little is known about its research evidence-base in the treatment of eating disorders. The aim of this study was to conduct a systematic review of the outcome literature of narrative therapy for eating disorders.

Method

Treatment outcome data were extracted from 33 eligible included studies following systematic search of five data bases. The study is reported according to Preferred Reporting items for Systematic Reviews and Meta-Analyses guidelines.

Results

Of the identified 33 studies, 3 reported positive outcomes using psychometric instruments, albeit some were outdated. Otherwise, reported outcomes were based on therapy transcript material and therapist reports. The most commonly reported treatment outcome was in relation to shifts in identity narratives and improved personal agency with a trend towards under-reporting shifts in ED symptoms. Some improvements were reported in interpersonal and occupational engagement, reduced ED symptoms, and improved quality of life, however, there was an absence of standardized measures to support these reports.

Conclusions

This systematic review found limited support for narrative therapy in the treatment of eating disorders through practice-based evidence in clinician reports and transcripts of therapy sessions. Less is known about systematic treatment outcomes of narrative therapy. There is a need to fill this gap to understand the effectiveness of narrative therapy in the treatment of EDs through systematic (1) Deliveries of this intervention; and (2) Reporting of outcomes. In doing so, the research arm of narrative therapy evidence base will become more comprehensively known.