bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of physical activity with sarcopenia evaluated based on muscle mass and strength in older adults: 2008–2011 and 2014 − 2018 Korea National Health and Nutrition Examination Surveys
Authors: Seo Je Hyun , Lee Young
Published: March 2022

Background

Adequate physical activity (PA) is essential for preventing sarcopenia in older adults. However, there are insufficient epidemiological data on the intensity of PA needed to prevent age-related sarcopenia. The purpose of this study was to investigate the association of PA intensity with skeletal muscle mass and muscle strength.

Methods

This was a population-based study with a cross-sectional design that was conducted using data from the 2008 − 2011 and 2014 − 2018 Korea National Health and Nutrition Examination Surveys, which included a total of 11,162 participants aged ≥ 60 years. PA was assessed using the results of a questionnaire and organized by intensity, frequency, and duration. The study population was divided into the following groups based on PA intensity: no exercise, walking only, moderate PA, and vigorous PA. To assess sarcopenia, skeletal muscle index (SMI) and hand grip strength (HGS) were measured as indicators of muscle mass and strength, respectively. Logistic regression analysis was used to explore the relationship between PA intensity and sarcopenia.

Results

SMI and HGS were significantly higher in men and women engaged in moderate to vigorous PA than in those who did not exercise. The odds ratios (ORs) for sarcopenia defined based on SMI and HGS were lowest in men engaged in vigorous PA (0.444, 95% confidence interval [CI]: 0.242 − 0.818 and 0.450, 95% CI: 0.228 − 0.890, respectively). In women, the OR for sarcopenia defined based on HGS was the lowest in the group engaged in vigorous PA (0.441, 95% CI: 0.199 − 0.975), while there was no risk reduction for sarcopenia defined based on SMI.

Conclusions

Moderate to vigorous PA was highly correlated with SMI and HGS in men and women. Intensive PA was positively correlated with sarcopenia prevention, which can be monitored using HGS.
Later-life transitions and changes in prescription medication use for pain and depression
Authors: Lam Jack , Vuolo Mike
Published: March 2022

Background

Over the past two decades, prescription medication use for pain and depression increased dramatically. Most studies consider the early life course, despite a similar increase among those in later life. In this paper, we examine whether and how later life transitions may relate to changes in medication use.

Methods

We draw on data from the Health and Retirement Study and fixed-effects models to examine whether work, family, and civic transitions in later life are related to changes in the usage of prescription pain and depression medication.

Results

Results show that individuals had higher odds of regularly using prescription pain and depression medications in periods when out of the labor market. Higher odds of depression medication use were also associated with periods of widowhood, and lower odds of use when frequently volunteering. Such relations persist adjusting for reported levels of pain and depression.

Conclusion

Our findings call attention to the importance of social ties and the presence of actors that may regulate health behaviors, as well as a change in social context, that may shape medication use in later life.
Endovascular thrombectomy for acute ischemic stroke in elderly patients with atrial fibrillation
Authors: Jiao Jincheng , Liu Sheng , Cui Chang , Cao Yuezhou , Jia Zhenyu , Liu Hailei , Wang Chendong , Hang Yu , Ni Heng , Chen Minglong , Li Mingfang , Shi Haibin
Published: March 2022

Background

To assess the clinical outcomes after endovascular thrombectomy (EVT) in elderly large vessel occlusion (LVO)-related acute ischemic stroke (AIS) patients with atrial fibrillation (AF).

Methods

Between January 2019 and December 2020, consecutive AF patients who received EVT due to anterior-circulation stroke were enrolled. The primary outcome was modified Rankin scale (mRS) score at 90 days. Secondary outcomes included all-cause mortality, the recanalization status after EVT (assessed using modified thrombolysis in cerebral infarction scale, mTICI) and any intracranial hemorrhage (ICH). A multivariate logistic regression model was performed to identify predictors of the functional outcome.

Results

A total of 148 eligible patients were finally enrolled. Among them, 42 were ≥ 80 years old. Compared to their younger counterparts, patients aged ≥80 years had lower likelihood of good functional outcome (mRS score 0–2) at 90 days (26.2% vs. 48.1%, P = 0.015), less satisfied recanalization (mTICI, 2b-3) (78.6% vs. 94.3%, P = 0.004) and higher all-cause mortality rate (35.7% vs. 14.2%, P = 0.003). A multivariable logistic regression analysis showed that age ≥ 80 years at baseline were the significant predictors for a poor functional outcome (OR: 3.72, 95% CI: 1.17–11.89, p = 0.027). Intravenous thrombolysis (IVT) prior to EVT and longer time intervals from onset of symptoms to EVT tended to be associated with poor functional outcome in patients ≥80 years old.

Conclusions

Age ≥ 80 years was a significant predictor of unfavorable outcomes after EVT for AIS patients with AF. An increased risk of adverse events must be balanced against the benefit from EVT in elderly patients with AF.
Peri-tumoural spatial distribution of lipid composition and tubule formation in breast cancer
Authors: Chan Kwok-Shing , Cheung Sai Man , Senn Nicholas , Husain Ehab , Masannat Yazan , Heys Steven , He Jiabao
Published: March 2022

Background

Response guided treatment in breast cancer is highly desirable, but the effectiveness is only established based on residual cellularity from histopathological analysis after surgery. Tubule formation, a key component of grading score, is directly associated with cellularity, with significant implications on prognosis. Peri-tumoural lipid composition, a potential marker, can be rapidly mapped across the entire breast using novel method of chemical shift-encoded imaging, enabling the quantification of spatial distribution. We hypothesise that peri-tumoural spatial distribution of lipid composition is sensitive to tumour cellular differentiation and proliferative activity.

Methods

Twenty whole tumour specimens freshly excised from patients with invasive ductal carcinoma (9 Score 2 and 11 Score 3 in tubule formation) were scanned on a 3 T clinical scanner (Achieva TX, Philips Healthcare). Quantitative lipid composition maps were acquired for polyunsaturated, monounsaturated, and saturated fatty acids (PUFA, MUFA, SFA). The peri-tumoural spatial distribution (mean, skewness, entropy and kurtosis) of each lipid constituent were then computed. The proliferative activity marker Ki-67 and tumour-infiltrating lymphocytes (TILs) were assessed histologically.

Results

For MUFA, there were significant differences between groups in mean (p = 0.0119), skewness (p = 0.0116), entropy (p = 0.0223), kurtosis (p = 0.0381), and correlations against Ki-67 in mean (ρ = -0.5414), skewness (ρ = 0.6045) and entropy (ρ = 0.6677), and TILs in mean (ρ = -0.4621). For SFA, there were significant differences between groups in mean (p = 0.0329) and skewness (p = 0.0111), and correlation against Ki-67 in mean (ρ = 0.5910). For PUFA, there was no significant difference in mean, skewness, entropy or kurtosis between the groups.

Conclusions

There was an association between peri-tumoural spatial distribution of lipid composition with tumour cellular differentiation and proliferation. Peri-tumoural lipid composition imaging might have potential in non-invasive quantitative assessment of patients with breast cancer for treatment planning and monitoring.
Mapping disadvantage: identifying inequities in functional outcomes for prostate cancer survivors based on geography
Authors: Koo Kendrick , Papa Nathan , Evans Melanie , Jefford Michael , IJzerman Maarten , White Victoria , Evans Sue M. , Ristevski Eli , Emery Jon , Millar Jeremy
Published: March 2022

Background

Prostate cancer is the most common internal malignancy in Australian men, and although most patients have good survival outcomes, treatment toxicities can impair function, leading to diminished quality of life for prostate cancer survivors. Socioeconomic disadvantage and geographical remoteness have been shown to be related to worse oncologic outcomes, and it is expected that they would similarly influence functional outcomes in prostate cancer.

Methods

Using data from the Victorian Prostate Cancer Outcomes Registry (n = 10,924), we investigated functional outcomes as measured by the Expanded Prostate Cancer Index Composite-26 (EPIC-26) following prostate cancer treatment, focusing on associations with socioeconomic status and geographical remoteness and controlling for clinicopathologic characteristics. A single composite score was developed from the five separate EPIC-26 domains for use in geo-mapping.

Results

A total of 7690 patients had complete EPIC-26 data, allowing mapping hotspots of poor function using our composite score. These hotspots were observed to relate to areas of socioeconomic disadvantage. Significant heterogeneity in outcomes was seen in urban areas, with hotspots of good and poor function. Both socioeconomic disadvantage and geographical remoteness were found to predict for worse functional outcomes, although only the former is significant on multivariate analysis.

Conclusions

Geo-mapping of functional outcomes in prostate cancer has the potential to guide health care service provision and planning. A nuanced policy approach is required so as not to miss disadvantaged patients who live in urban areas. We have demonstrated the potential of geo-mapping to visualise population-level outcomes, potentially allowing targeted interventions to address inequities in quality of care.
Risk of hepatocellular carcinoma in antiviral treatment-naïve chronic hepatitis B patients treated with entecavir or tenofovir disoproxil fumarate: a network meta-analysis
Authors: Huang Ze-Hong , Lu Gui-Yang , Qiu Ling-Xian , Zhong Guo-Hua , Huang Yue , Yao Xing-Mei , Liu Xiao-Hui , Huang Shou-Jie , Wu Ting , Yuan Quan , Wang Ying-Bin , Su Ying-Ying , Zhang Jun , Xia Ning-Shao
Published: March 2022

Background

Long-term antiviral treatments are associated with a significantly lower hepatocellular carcinoma (HCC) incidence in chronic hepatitis B (CHB) patients by reducing HBV DNA concentrations. However, it is still controversial whether antiviral strategies affect HCC development in antiviral treatment-naïve CHB patients. This study aimed to estimate the incidence of HCC in antiviral treatment-naïve CHB patients who were treated with Entecavir (ETV) and Tenofovir Disoproxil Fumarate (TDF) and compare the efficacy of two treatment regimens in HCC reduction.

Methods

The PubMed, Embase, China National Knowledge Infrastructure, and Wanfang databases were systematically searched until June 24, 2021. The pooled incidence and 95% confidence interval of HCC were calculated by the Freeman-Tukey double arcsine transformation method. The efficacies of ETV and TDF treatments in HCC reduction were compared through a network meta-analysis.

Results

A total of 27 studies were identified as eligible for this systematic review. The incidence densities in the ETV and TDF treatment groups were 2.78 (95% CI: 2.21-3.40) and 2.59 (95% CI: 1.51-3.96) per 100 persons-year among patients with preexisting cirrhosis and 0.49 (95% CI: 0.32-0.68) and 0.30 (95% CI: 0.06-0.70) per 100 persons-year among patients without preexisting cirrhosis. As the proportion of CHB patients with preexisting cirrhosis increased, the incidence density of HCC also increased gradually. Compared with other Nucleos(t)ide analogs (NAs) treatments, ETV and TDF treatments significantly lowered the risk of HCC, with hazard ratios (HRs) of 0.60 (95% CI: 0.40-0.90) and 0.56 (95% CI: 0.35-0.89), respectively. However, there was no difference in the incidence density of HCC between ETV and TDF treatments (HR = 0.92, 95% CI: 0.71-1.20) regardless of preexisting cirrhosis.

Conclusion

ETV and TDF treatments were associated with significantly lower risks of HCC than other NAs treatments. However, no difference was observed between ETV and TDF treatments in the risk of HCC development regardless of preexisting cirrhosis among treatment-naïve CHB patients.
Effect of anticoagulant/antiplatelet therapy on the development and progression of diabetic retinopathy
Authors: Jeng Chi-Juei , Hsieh Yi-Ting , Lin Cheng-Li , Wang I-Jong
Published: March 2022

Background

We investigated whether antiplatelet/anticoagulant (APAC) therapy can protect patients with type 2 diabetes mellitus (T2DM) from the development or progression of diabetic retinopathy (DR).

Methods

This is a retrospective cohort study using Longitudinal Health Insurance Database in Taiwan. A total of 73,964 type 2 diabetic patients older than 20 years old were included. Hazard ration (HR) of non-proliferative DR (NPDR), proliferative DR (PDR), and diabetic macular edema (DME) were analyzed with APAC usage as a time-dependent covariate. Age, sex, comorbidities, and medicines were further adjusted in a multi-variable model. Contributions of respective APAC was investigated with sensitivity analysis.

Results

Compared with nonusers, APAC users had a lower cumulative incidence of NPDR (P < 0.001), overall incidence of NPDR (10.7 per 1000 person-years), and risk of developing NPDR (adjusted HR = 0.78, 95% CI = 0.73–0.83). However, no significant differences were observed between APAC users and nonusers in the risks of PDR or DME. Hypertension, diabetic nephropathy and diabetic neuropathy were risk factors for NDPR development, while heart disease, cardiovascular disease, peripheral arterial occlusive disease, and statin usage were covariates decreasing NPDR development. Aspirin and Dipyridamole showed significant protection against NPDR development. Clopidogrel, Ticlopidine, and warfarin showed enhanced protection in combination with aspirin usage.

Conclusions

APAC medications have a protective effect against NPDR development. Diabetic patients benefit from single use of aspirin or dipyridamole on prevention of NPDR.
RETRACTED ARTICLE: Neonatal congenital mesoblastic nephroma that caused respiratory oncologic emergency early after birth: a case report
Authors: Kato Hirotaka , Mitani Yasuyuki , Goda Taro , Yamaue Hiroki
Published: March 2022

Background

Congenital mesoblastic nephromas mainly present as asymptomatic abdominal masses, but some present hematuria, hypertension or hypercalcemia. Neonatal dyspnea in an early-birth neonate due to rapid tumor growth is reported here for the first time.

Case presentation

A renal tumor and polyhydramnios were detected by ultrasonography of a male fetus at 32 weeks and 3 days of gestation. The mother had abdominal distension due to the polyhydramnios and signs of imminent premature birth. Amniocentesis was performed and the signs of imminent preterm birth subsided, but growth of the renal tumor was noted as a potential cause of respiratory dysfunction. Cesarean section was performed at 36 weeks and 2 days of gestation. His birthweight was 2638 g and his 1 and 5 min APGAR scores were 2 and 4 points, respectively. There was no spontaneous breathing at birth and he had remarkable abdominal distention. He underwent cardiopulmonary resuscitation. After circulation stabilized, emergency surgery was performed because of progressive hypoxemia and respiratory acidosis. Laparotomy revealed a huge tumor arising from the right kidney and right nephrectomy was performed. Histopathological examination led to diagnosis of congenital mesoblastic nephroma. The respiratory condition and circulatory dynamics stabilized after the pressure on the thorax from the tumor was relieved by surgery. The postoperative course was uneventful. No recurrence or complications have been observed in the 36 months since the surgery.

Conclusions

Congenital mesoblastic nephroma can rapidly increase in size from the fetal period and may cause respiratory oncologic emergency, although there is relatively good prognosis.
Risk factors associated with readmissions of patients with severe mental disorders under treatment with antipsychotics
Authors: Portela Ronaldo , Wainberg Milton Leonard , Castel Saulo , de Oliveira Helian Nunes , Ruas Cristina Mariano
Published: March 2022

Background

The aim of this study was to assess the risk of readmission in patients with severe mental disorders, compare it between patients using different types of antipsychotics and determine risk factors for psychiatric readmission.

Methods

Medical records of a non-concurrent cohort of 625 patients with severe mental disorders (such as psychoses and severe mood disorders) who were first discharged from January to December 2012 (entry into the cohort), with longitudinal follow-up until December 2017 constitute the sample. Descriptive statistical analysis of characteristics of study sample was performed. The risk factors for readmission were assessed using Cox regression.

Results

Males represented 51.5% of the cohort, and 75.6% of the patients had no partner. Most patients (89.9%) lived with relatives, and 64.7% did not complete elementary school. Only 17.1% used more than one antipsychotic, 34.2% did not adhere to the treatment, and 13.9% discontinued the medication due to unavailability in public pharmacies. There was a need to change the antipsychotic due to the lack of therapeutic response (11.2% of the patients) and adverse reactions to the antipsychotic (5.3% of the patients). Cox regression showed that the risk of readmission was increased by 25.0% (RR, 1.25; 95% CI, 1.03–1.52) when used typical antipsychotics, compared to those who used atypical ones, and by 92.0% (RR, 1.92; 95% CI, 1.63–2.27) when patients did not adhere to maintenance treatment compared to those who adhered.

Conclusions

Use of atypical antipsychotics and adherence to treatment were associated with a lower risk of psychiatric readmissions.
A descriptive analysis of food pantries in twelve American states: hours of operation, faith-based affiliation, and location
Authors: Riediger Natalie D. , Dahl Lindsey , Biradar Rajeshwari A. , Mudryj Adriana N. , Torabi Mahmoud
Published: March 2022

Background

Our objectives were to describe both the development, and content, of a charitable food dataset that includes geographic information for food pantries in 12 American states.

Methods

Food pantries were identified from the foodpantries.org website for 12 states, which were linked to state-, county-, and census-level demographic information. The publicly available 2015 Food Access Research Atlas and the 2010 US Census of Population and Housing were used to obtain demographic information of each study state. We conducted a descriptive analysis and chi-square tests were used to test for differences in patterns of food pantries according to various factors.

Results

We identified 3777 food pantries in 12 US states, providing an estimated 4.84 food pantries per 100,000 people, but ranged from 2.60 to 7.76 within individual states. The majority of counties (61.2%) had at least one food pantry. In contrast, only 15.7% of all census tracts in the study states had at least one food pantry. A higher proportion of urban census tracts had food pantries compared to rural tracts. We identified 2388 (63.2%) as being faith-based food pantries. More than a third (34.4%) of food pantries did not have information on their days of operation available. Among the food pantries displaying days of operation, 78.1% were open at least once per week. Only 13.6% of food pantries were open ≤1 day per month.

Conclusions

The dataset developed in this study may be linked to food access and food environment data to further examine associations between food pantries and other aspects of the consumer food system (e.g. food deserts) and population health from a systems perspective. Additional linkage with the U.S. Religion Census Data may be useful to examine associations between church communities and the spatial distribution of food pantries.
What is the impact of structural and cultural factors and interventions within educational settings on promoting positive mental health and preventing poor mental health: a systematic review
Authors: Troy David , Anderson Joanna , Jessiman Patricia E. , Albers Patricia N. , Williams Joanna G. , Sheard Seamus , Geijer-Simpson Emma , Spencer Liam , Kaner Eileen , Limmer Mark , Viner Russell , Kidger Judi
Published: March 2022

Mental health (MH) difficulties are on the increase among children and young people (CYP). Evidence has shown that educational settings contain both risk and protective factors for MH. This review investigated which structural and cultural factors and interventions within educational settings promote positive MH and prevent poor MH in 4–18 year olds. Searches were conducted in PsychINFO, Embase, ERIC, ASSIA and British Education Index, and reference lists from key studies and relevant systematic reviews were hand-searched. Intervention, cohort, and qualitative studies were included. Of the 62 included papers, 36 examined cultural factors (30 social/relational and six value-related) while 12 studies examined structural factors (eight organisational and four physical) and 14 studies examined multiple factors. There was strong evidence for the impact of positive classroom management techniques, access to physical activity, and peer mentoring on student MH. Studies examining the impact of positive school culture, teacher training in MH and parent involvement in school MH activities also found predominantly positive results for student MH, albeit the evidence was of lower quality or from a low number of studies. Few studies explicitly examined the impact of interventions on MH inequalities; those that did indicated limited if any reduction to inequalities. A very small number of studies suggested that interventions targeting those at risk of poor MH due to socioeconomic factors could successfully improve wellbeing and reduce depression, anxiety and behavioural problems. Studies exploring the effect of management and leadership strategies within schools, policies, and aspects of the physical environment other than green space were scarce or absent in the literature. This review highlights the need to consider the ways in which educational settings are organised, the culture that is created and the physical space in order to improve the MH of CYP.
Improving dementia care: insights from audit and feedback in interdisciplinary primary care sites
Authors: Arsenault-Lapierre Geneviève , Le Berre Mélanie , Rojas-Rozo Laura , McAiney Carrie , Ingram Jennifer , Lee Linda , Vedel Isabelle
Published: March 2022

Background

Many primary care sites have implemented models to improve detection, diagnosis, and management of dementia, as per Canadian guidelines. The aim of this study is to describe the responses of clinicians, managers, and staff of sites that have implemented these models when presented with audit results, their insights on the factors that explain their results, their proposed solutions for improvement and how these align to one another.

Methods

One audit and feedback cycle was carried out in eight purposefully sampled sites in Ontario, Canada, that had previously implemented dementia care models. Audit consisted of a) chart review to assess quality of dementia care indicators, b) questionnaire to assess the physicians’ knowledge, attitudes and practice toward dementia care, and c) semi-structured interviews to understand barriers and facilitators to implementing these models. Feedback was given to clinicians, managers, and staff in the form of graphic and oral presentations, followed by eight focus groups (one per site). Discussions revolved around: what audit results elicited more discussion from the participants, 2) their insights on the factors that explain their audit results, and 3) solutions they propose to improve dementia care. Deductive content and inductive thematic analyses, grounded in causal pathways models’ theory was performed.

Findings

The audit and feedback process allowed the 63 participants to discuss many audit results and share their insights on a) organizational factors (lack of human resources, the importance of organized links with community services, clear roles and support from external memory clinics) and b) clinician factors (perceived competency practice and attitudes on dementia care), that could explain their audit results. Participants also provided solutions to improve dementia care in primary care (financial incentives, having clear pathways, adding tools to improve chart documentation, establish training on dementia care, and the possibility of benchmarking with other institutions). Proposed solutions were well aligned with their insights and further nuanced according to contextual details.

Conclusions

This study provides valuable information on solutions proposed by primary care clinicians, managers, and staff to improve dementia care in primary care. The solutions are grounded in clinical experience and will inform ongoing and future dementia strategies.
Adaptation and validation of the patient assessment of chronic illness care in United States community pharmacies
Authors: Adeoye-Olatunde Omolola A. , Pratt Naomi , Kim David D. , Schmidt Evan , Snyder Margie E.
Published: March 2022

Background

Roles for United States (US)-based community pharmacists in caring for persons with chronic conditions have greatly expanded. The Patient Assessment of Chronic Illness Care (PACIC) was developed to assess patients’ perspectives of care received. However, successful application of this instrument in community pharmacies is uncertain. The objective of this study was to adapt the PACIC for use in community pharmacies (CP-PACIC), assess validity of the CP-PACIC and examine CP-PACIC scale score differences relative to patient characteristics.

Methods

This cross-sectional study surveyed chronically ill adults in Indiana, US who receive care from pharmacists in community pharmacies. The modified CP-PACIC scale consisted of 20-items, which were rated on a 5-point Likert scale from 0 (none of the time) to 4 (always). The total possible score ranged from 0 – 80. An exploratory factor analysis (EFA) was conducted to assess performance and dimensionality. CP-PACIC validity, including face validity, construct validity (via exploratory factor analysis) and internal consistency were assessed. Relationships between patient characteristics and scale scores were evaluated using appropriate statistical tests.

Results

Five hundred forty-six respondents’ data were analyzed. EFA revealed a 2-factor solution (termed advanced pharmacy chronic illness care (AP) and traditional pharmacy chronic illness care (TP) subscales) accounting for 64.7% of variance; all 20 items were retained. The total 20-item CP-PACIC scale had a Cronbach’s alpha (internal consistency) of 0.96; with a 12-item AP subscale Cronbach’s alpha of 0.97 and 8-item TP subscale Cronbach’s alpha of 0.89. Median total score was 12.0 [interquartile range = 27.3]. Median CP-PACIC sores varied across many respondent demographics (i.e., survey administration type, age, sex, education, health condition, number of pharmacy services received, community pharmacy type) such as whether respondents participated in one or more pharmacy service or not (29 vs. 10; p < .001).

Conclusions

Unlike the original 5-subscale (patient activation, delivery system design, goal setting, problem solving, and follow-up/coordination) PACIC, analysis demonstrated a 2-factor (AP, TP) solution for the CP-PACIC scale with good internal consistency. As there are no standardized evaluation tools that exist, community pharmacies could find great value in using this CP-PACIC tool to benchmark performance and inform quality improvement strategies for patient care delivery.
HER2 expression, copy number variation and survival outcomes in HER2-low non-metastatic breast cancer: an international multicentre cohort study and TCGA-METABRIC analysis
Authors: Tan Ryan Shea Ying Cong , Ong Whee Sze , Lee Kyung-Hun , Lim Abner Herbert , Park Seri , Park Yeon Hee , Lin Ching-Hung , Lu Yen-Shen , Ono Makiko , Ueno Takayuki , Naito Yoichi , Onishi Tatsuya , Lim Geok-Hoon , Tan Su-Ming , Lee Han-Byoel , Ryu Han Suk , Han Wonshik , Tan Veronique Kiak Mien , Wong Fuh-Yong , Im Seock-Ah , Tan Puay Hoon , Chan Jason Yongsheng , Yap Yoon-Sim
Published: March 2022

Background

HER2-low breast cancer (BC) is currently an area of active interest. This study evaluated the impact of low expression of HER2 on survival outcomes in HER2-negative non-metastatic breast cancer (BC).

Methods

Patients with HER2-negative non-metastatic BC from 6 centres within the Asian Breast Cancer Cooperative Group (ABCCG) (n = 28,280) were analysed. HER2-low was defined as immunohistochemistry (IHC) 1+ or 2+ and in situ hybridization non-amplified (ISH−) and HER2-zero as IHC 0. Relapse-free survival (RFS) and overall survival (OS) by hormone receptor status and HER2 IHC 0, 1+ and 2+ ISH− status were the main outcomes. A combined TCGA-BRCA and METABRIC cohort (n = 1967) was also analysed to explore the association between HER2 expression, ERBB2 copy number variation (CNV) status and RFS.

Results

ABCCG cohort median follow-up was 6.6 years; there were 12,260 (43.4%) HER2-low BC and 16,020 (56.6%) HER2-zero BC. The outcomes were better in HER2-low BC than in HER2-zero BC (RFS: centre-adjusted hazard ratio (HR) 0.88, 95% CI 0.82–0.93, P < 0.001; OS: centre-adjusted HR 0.82, 95% CI 0.76–0.89, P < 0.001). On multivariable analysis, HER2-low status was prognostic (RFS: HR 0.90, 95% CI 0.85–0.96, P = 0.002; OS: HR 0.86, 95% CI 0.79–0.93, P < 0.001). These differences remained significant in hormone receptor-positive tumours and for OS in hormone receptor-negative tumours. Superior outcomes were observed for HER2 IHC1+ BC versus HER2-zero BC (RFS: HR 0.89, 95% CI 0.83–0.96, P = 0.001; OS: HR 0.85, 95% CI 0.78–0.93, P = 0.001). No significant differences were seen between HER2 IHC2+ ISH− and HER2-zero BCs. In the TCGA-BRCA and METABRIC cohorts, ERBB2 CNV status was an independent RFS prognostic factor (neutral versus non-neutral HR 0.71, 95% CI 0.59–0.86, P < 0.001); no differences in RFS by ERBB2 mRNA expression levels were found.

Conclusions

HER2-low BC had a superior prognosis compared to HER2-zero BC in the non-metastatic setting, though absolute differences were modest and driven by HER2 IHC 1+ BC. ERBB2 CNV merits further investigation in HER2-negative BC.
Intrathecal adenosine enhances the antinociception of Xylazine in goats
Authors: Abouelfetouh Mahmoud M. , Salah Eman , Liu Lingling , Ding Mingxing , Ding Yi
Published: March 2022

Background

The role of adenosine (AD) in neuromodulation of nociceptive signaling at the level of the spinal cord has been established in both preclinical and clinical models. Recently, the signaling pathway that involves adenosine 5-monophosphate activated protein kinase has been reported to mediate the antinociceptive effects of xylazine (XYL). The objective of this study was to investigate the antinociceptive, cardiorespiratory and hematological effects of intrathecal administration of combined XYL-AD in goats as compared to XYL alone. Six clinically healthy adult goats weighing 25 ± 2 kg were randomly assigned to one of three groups in a cross-over design. Goats were sedated with XYL (0.05 mg/kg, IM) in all groups. Ten min later, 0.9% saline solution [SAL group], XYL (0.05 mg/kg) [XYL group] or a combination of XYL (0.05 mg/kg) and AD (2000 µg) [XYL-AD group] was injected intrathecally. Antinociception scores and both cardiorespiratory and hematological parameters were measured before XYL sedation and intrathecal injection (baseline), and at 5, 10, 15, 30, 60, 90, 120 and 150 min thereafter.

Results

The XYL-AD group showed significantly earlier onset of antinociception [5 (5–7) min] than XYL [13 (12–14.25] min (P = 0.031). The duration of complete antinociception in goats that received XYL-AD was significantly longer (P = 0.031) than that received XYL alone [65 (58.75–66.25) and 47.5 (43.75–51.25) min, respectively]. In both XYL and XYL-AD groups, heart rate (HR), arterial blood pressure (SAP, MAP and DAP) were significantly decreased (P < 0.05) compared to the baseline. Compared to the SAL group, a statistically significant reduction in HR from 10 to 150 min (P < 0.05) was detected in the XYL group contrary to the XYL-AD group. Differences in the hematological parameters among different groups were insignificant.

Conclusions

AD injected intrathecally interacts synergistically with XYL to promote antinociception in goats. This discovery supports the use of AD in combination with XYL in clinical trials.
Spatio-temporal modelling of malaria mortality in India from 2004 to 2013 from the Million Death Study
Authors: Jana Sayantee , Fu Sze Hang , Gelband Hellen , Brown Patrick , Jha Prabhat
Published: March 2022

Background

India has a substantial burden of malaria, concentrated in specific areas and population groups. Spatio-temporal modelling of deaths due to malaria in India is a critical tool for identifying high-risk groups for effective resource allocation and disease control policy-making, and subsequently for the country’s progress towards United Nations 2030 Sustainable Development Goals.

Methods

In this study, a spatio-temporal model with the objective of understanding the spatial distribution of malaria mortality rates and the rate of temporal decline, across the country, has been constructed. A spatio-temporal “random slope” model was used, with malaria risk depending on a spatial relative risk surface and a linear time effect with a spatially-varying coefficient. The models were adjusted for urban/rural status (residence of the deceased) and Normalized Difference Vegetation Index (NDVI), using 2004–13 data from the Million Death Study (MDS) (the most recent data available), with nationwide geographic coverage. Previous studies based on MDS had focused only on aggregated analyses.

Results

The rural population had twice the risk of death due to malaria compared to the urban population. Malaria mortality in some of the highest-risk regions, namely the states of Odisha and Jharkhand, are declining faster than other areas; however, the rate of decline was not uniformly correlated with the level of risk. The overall decline was faster after 2010.

Conclusion

The results suggest a need for increased attention in high-risk rural populations, which already face challenges like inadequate infrastructure, inaccessibility to health care facilities, awareness, and education around malaria mortality and prevalence. It also points to the urgent need to restart the MDS to document changes since 2013, to develop appropriate malaria control measures.
Assessing the health estimation capacity of air pollution exposure prediction models
Authors: Krall Jenna R. , Keller Joshua P. , Peng Roger D.
Published: March 2022

Background

The era of big data has enabled sophisticated models to predict air pollution concentrations over space and time. Historically these models have been evaluated using overall metrics that measure how close predictions are to monitoring data. However, overall methods are not designed to distinguish error at timescales most relevant for epidemiologic studies, such as day-to-day errors that impact studies of short-term health associations.

Methods

We introduce frequency band model performance, which quantifies health estimation capacity of air quality prediction models for time series studies of air pollution and health. Frequency band model performance uses a discrete Fourier transform to evaluate prediction models at timescales of interest. We simulated fine particulate matter (PM2.5), with errors at timescales varying from acute to seasonal, and health time series data. To compare evaluation approaches, we use correlations and root mean squared error (RMSE). Additionally, we assess health estimation capacity through bias and RMSE in estimated health associations. We apply frequency band model performance to PM2.5 predictions at 17 monitors in 8 US cities.

Results

In simulations, frequency band model performance rates predictions better (lower RMSE, higher correlation) when there is no error at a particular timescale (e.g., acute) and worse when error is added to that timescale, compared to overall approaches. Further, frequency band model performance is more strongly associated (R2 = 0.95) with health association bias compared to overall approaches (R2 = 0.57). For PM2.5 predictions in Salt Lake City, UT, frequency band model performance better identifies acute error that may impact estimated short-term health associations.

Conclusions

For epidemiologic studies, frequency band model performance provides an improvement over existing approaches because it evaluates models at the timescale of interest and is more strongly associated with bias in estimated health associations. Evaluating prediction models at timescales relevant for health studies is critical to determining whether model error will impact estimated health associations.
Recent progress in advanced biomaterials for long-acting reversible contraception
Authors: Yan Mingzhe , Zhang Yanming , Wu Zhihang , Li Yifei , Dou Keke , Wang Banghui , Wang Yingruo , Zhou Qihui
Published: March 2022

Unintended pregnancy is a global issue with serious ramifications for women, their families, and society, including abortion, infertility, and maternal death. Although existing contraceptive strategies have been widely used in people's lives, there have not been satisfactory feedbacks due to low contraceptive efficacy and related side effects (e.g., decreased sexuality, menstrual cycle disorder, and even lifelong infertility). In recent years, biomaterials-based long-acting reversible contraception has received increasing attention from the viewpoint of fundamental research and practical applications mainly owing to improved delivery routes and controlled drug delivery. This review summarizes recent progress in advanced biomaterials for long-acting reversible contraception via various delivery routes, including subcutaneous implant, transdermal patch, oral administration, vaginal ring, intrauterine device, fallopian tube occlusion, vas deferens contraception, and Intravenous administration. In addition, biomaterials, especially nanomaterials, still need to be improved and prospects for the future in contraception are mentioned.

Graphical Abstract
Indigenous people in Aotearoa New Zealand are overrepresented in cannabis convictions
Authors: Rapana Wetini , Winter Taylor , Fox Ririwai , Riordan Benjamin C. , Kulkarni Rajas , Waitoki Waikaremoana , Scarf Damian
Published: March 2022

Background

Previous work has demonstrated that cannabis laws have had a disproportionate impact on Māori, the Indigenous people of Aotearoa New Zealand. In 2019, the New Zealand Government amended cannabis laws, providing police with the power to determine whether a therapeutic or health-centred approach would be more beneficial than a conviction. In the current study, we use population level data to assess whether this law change has ameliorated the bias in cannabis convictions for Māori.

Methods

Data were drawn from the Integrated Data Infrastructure (IDI), a large government database hosted by Aotearoa New Zealand’s national statistics office. In the IDI, we selected individuals who (1) were between 18 and 65, (2) were Māori or Pākehā (New Zealanders of European descent) and, (3) had any cannabis charges that proceeded to the courts.

Results

Māori ethnicity was a significant predictor of the odds of receiving a cannabis conviction for Māori males (Odds: 1.56), with a marginally significant effect for Māori females (Odds: 1.57). Further, for Māori, there was no reduction in the number of cannabis charges before vs. after the amendment to cannabis laws.

Conclusion

The current study demonstrates that the bias in cannabis convictions for Māori remain. Given this, the New Zealand Government must follow other countries around the world and move forward on cannabis law reform.
Wnt4, Wnt6 and β-catenin expression in human placental tissue – is there a link with first trimester miscarriage? Results from a pilot study
Authors: Chronopoulou Elpiniki , Koika Vasiliki , Tsiveriotis Konstantinos , Stefanidis Konstantinos , Kalogeropoulos Sotirios , Georgopoulos Neoklis , Adonakis George , Kaponis Apostolos
Published: March 2022

Background

Demystifying the events around early pregnancy is challenging. A wide network of mediators and signaling cascades orchestrate the processes of implantation and trophoblast proliferation. Dysregulation of these pathways could be implicated in early pregnancy loss. There is accumulating evidence around the role of Wnt pathway in implantation and early pregnancy. The purpose of this study was to explore alterations in the expression of Wnt4, Wnt6 and β-catenin in placental tissue obtained from human first trimester euploid miscarriages versus normally developing early pregnancies.

Methods

The study group consisted of first trimester miscarriages (early embryonic demises and incomplete miscarriages) and the control group of social terminations of pregnancy (TOPs). The placental mRNA expression of Wnt4, Wnt6 and β-catenin was studied using reverse transcription PCR and real time PCR. Only euploid conceptions were included in the analysis.

Results

Wnt4 expression was significantly increased in placental tissue from first trimester miscarriages versus controls (p = 0.003). No significant difference was documented in the expression of Wnt6 (p = 0.286) and β-catenin (p = 0.793). There was a 5.1fold increase in Wnt4 expression for early embryonic demises versus TOPs and a 7.6fold increase for incomplete miscarriages versus TOPs – no significant difference between the two subgroups of miscarriage (p = 0.533).

Conclusions

This is, to our knowledge, the first study demonstrating significant alteration of Wnt4 expression in human placental tissue, from failed early pregnancies compared to normal controls. Undoubtedly, a more profound study is needed to confirm these preliminary findings and explore Wnt mediators as potential targets for strategies to predict and prevent miscarriage.
Measuring xylem hydraulic vulnerability for long-vessel species: an improved methodology with the flow centrifugation technique
Authors: Burlett Régis , Parise Camille , Capdeville Gaëlle , Cochard Hervé , Lamarque Laurent J. , King Andrew , Delzon Sylvain
Published: March 2022

Context

Understanding plant resilience and adaptation to drought is a major challenge in crop and forest sciences. Several methods have been developed to assess the vulnerability to xylem embolism. The in situ flow centrifuge (or cavitron) is the fastest technique allowing to characterise this trait for plants having vessel lengths shorter than the rotor size.

Aims

We present (i) a series of changes to the earlier cavitron design, aimed at improving the accuracy and speed of measurement through automated operations, and (ii) a new development through the design of a large diameter rotor expanding the range of species that can be measured.

Methods

Both hardware and software modifications to the original design have been developed. In order to avoid artefacts caused by cut open vessels, a centrifuge with a large rotor (1 m) has been developed, and vulnerability curves obtained with this new device were compared with those obtained using reference methods.

Results

The new set-up expands the range of conductance measurable with a cavitron and enables it to accurately determine the absolute value of conductivity even for species having very low hydraulic conductivity. The large rotor cavitron shows good agreement with the reference techniques for conifers and diffuse-porous species but also for ring-porous species having long vessels.

Conclusion

The set-up described in this manuscript provides a faster, safer and more accurate method to construct vulnerability curves, compared to the original cavitron design, and extends the measurement capabilities to new species that are difficult to measure to date.

Key message

Recent improvements to cavitron setup enable to measure xylem vulnerability curves for an expanded number of plant species, with longer vessels or lower hydraulic conductivity.
Altitude is a better predictor of the habitat requirements of epixylic bryophytes and lichens than the presence of coarse woody debris in mountain forests: a study in Poland
Authors: Chmura Damian , Żarnowiec Jan , Staniaszek-Kik Monika
Published: March 2022

Key message

In order to preserve the continuity of epiphytic and epixylic cryptogamic flora, two things are essential: maintaining the near-natural character of a forest community in relation to the montane zonation and more sustainable forest management in relation to deadwood.

Context

Lichens and bryophytes are common species that inhabit dead wood. The relationship between their habitat requirements, which can be expressed by their Ellenberg indicator values and the characteristics of dead logs, are not yet known.

Aims

We formulated the hypothesis that altitude is positively correlated with the demands of species for higher light and lower temperature, while the decomposition stage of deadwood is positively correlated with species’ requirements for nutrients and moisture. Moreover, we assumed that there would be differences in the habitat requirements among specific groups of species, i.e., lichens, liverworts, and mosses.

Methods

A total of 629 logs that were colonized by bryophytes and lichens were analyzed in terms of their mean Ellenberg indicator values in order to determine whether there is a link between the location, decomposition of logs and the species’ environmental requirements.

Results

Altitude correlated with the moisture and nutrients in the habitats of liverworts and mosses and light and soil acidification only in mosses.

Conclusions

The obtained results demonstrate that the altitudinal distribution of epixylic species in a montane region is of greater importance than the deadwood properties like decomposition stage and moisture content.
Application of direct analysis in real-time mass spectrometry (DART-MS) in forensic science: a comprehensive review
Authors: Gupta Swati , Samal Nilimamayee
Published: March 2022

Background

As the rate of crime is constantly increasing, the workload on the forensic analyst also piles up. The availability of a limited number of seized samples makes it crucial to directly analyze the sample, thereby preventing wastage in the prior steps of sample preparation. Due to such needs, the forensic community is consistently working on broadening the usage of direct analysis in real-time mass spectrometry (DART-MS). DART-MS is a relatively new technique for rapid mass spectral analysis. Its use for chemical analysis credits its ability to analyze the sample at atmospheric pressure.

Main body

This article gives insight into the ionization mechanisms, data analysis tools, and the use of hyphenated techniques like thermal-desorption-DART-MS, infrared-thermal-desorption-DART-MS, Joule-heating thermal-desorption-DART-MS, etc. This review summarizes the applications of DART-MS in the field of Forensic Science reported from 2005 to 2021. The applications include analysis of drugs, warfare agents, gun-shot residues, ink differentiation, and other forensically relevant samples. The paper also presents the relation between the type of DART-MS technique and the ionization mode used for a particular class of compounds.

Conclusion

The review follows that the high-resolution mass-spectrometers or low-resolution mass-spectrometers systems in the positive or negative mode were highly dependent on the type of analyte under investigation. Drugs, inks, dyes, and paints were mainly analyzed using the positive ionization mode in the HRMS technique. The examinations of fire accelerants predominantly used the positive ionization mode in the LRMS technique. Moreover, the limit of detection values obtained from the qualitative screening of street drugs were of ppb level, indicating high sensitivity of DART-MS. Considering the work done in the past years, there are potential future research needs of this technology, especially in forensic science.

Graphical Abstract