bluuebunny/crossref_metadata_2025 huggingface dataset:
Nomogram Predicts Risk and Prognostic Factors for Bone Metastasis of Pancreatic Cancer: A Population-Based Analysis
Authors: Zhang Wei , Ji Lichen , Wang Xijun , Zhu Senbo , Luo Junchao , Zhang Yin , Tong Yu , Feng Fabo , Kang Yao , Bi Qing
Published: March 2022

Background

The overall survival (OS) of pancreatic cancer (PC) patients with bone metastasis (BM) is extremely low, and it is pretty hard to treat bone metastasis. However, there are currently no effective nomograms to predict the diagnosis and prognosis of pancreatic cancer with bone metastasis (PCBM). Therefore, it is of great significance to establish effective predictive models to guide clinical practice.

Methods

We screened patients from Surveillance Epidemiology and End Results (SEER) database between 2010 and 2016. The independent risk factors of PCBM were identified from univariable and multivariable logistic regression analyses, and univariate and multivariate Cox proportional hazards regression analyses were used to determine independent prognostic factors affecting the prognosis of PCBM. In addition, two nomograms were constructed to predict the risk and prognosis of PCBM. We used the area under the curve (AUC), C-index and calibration curve to determine the predictive accuracy and discriminability of nomograms. The decision curve analysis (DCA) and Kaplan-Meier(K-M) survival curves were employed to further confirm the clinical effectiveness of the nomogram.

Results

Multivariable logistic regression analyses revealed that risk factors of PCBM included age, primary site, histological subtype, N stage, radiotherapy, surgery, brain metastasis, lung metastasis, and liver metastasis. Using Cox regression analyses, we found that independent prognostic factors of PCBM were age, race, grade, histological subtype, surgery, chemotherapy, and lung metastasis. We utilized nomograms to visually express data analysis results. The C-index of training cohort was 0.795 (95%CI: 0.758-0.832), whereas that of internal validation cohort was 0.800 (95%CI: 0.739-0.862), and the external validation cohort was 0.787 (95%CI: 0.746-0.828). Based on AUC of receiver operating characteristic (ROC) analysis, calibration plots, and decision curve analysis (DCA), we concluded that the risk and prognosis model of PCBM exhibits excellent performance.

Conclusion

Nomogram is sufficiently accurate to predict the risk and prognostic factors of PCBM, allowing for individualized clinical decisions for future clinical work.
Identification of Major Organisms Involved in Nutritional Ecosystem in the Acidic Soil From Pennsylvania, USA
Authors: James Madison T. , Farrisi Sophia T. , Shah Shreya , Shah Vishal
Published: March 2022

Microorganisms play a critical role in the structure and functioning of soil ecosystems. Within acidic soil across the northeastern United States and Canada, we have little understanding of the microbial diversity present and its relationship to the biochemical cycles. The current study is aimed at understanding the taxonomical and functional diversities in the acidic soil obtained from near various types of trees, how the diversities change as a function of depth, and the linkage between taxonomical and functional diversities. From eight sampling locations, soil samples were collected from three horizons (depths). The three depths were 0–10 cm (A), 11–25 cm (B), and 26–40 cm (C). Results indicate that across all the samples analyzed, Bradyrhizobium and Candidatus Solibacter are the most abundant bacteria in the soil microbiome. The differences in the soil microbiome across the samples were attributed to the abundance of individual organism’s present in the soil and not to the presence or absence of individual organisms. Subsystem level analysis of the soil microbiome sequences indicate that there is higher level of abundance of genes attributed to regulation and cell signaling. A low level of sequences were detected for sulfur metabolism, potassium metabolism, iron acquisition and metabolism, and phosphorous metabolism. Structure-functional analysis indicate that Bradyrhizobium, Rhodopseudomonas, and Burkholderia are the major organisms involved in the nutritional ecosystem functioning within acidic soil. Based on the results, we propose utilizing a consortium of these organisms as an environmentally friendly alternative to the use of chemicals to maintain soil fertility and ecosystem functioning.
Constructed Wetlands for Reclamation and Reuse of Wastewater and Urban Stormwater: A Review
Authors: Biswal Basanta Kumar , Balasubramanian Rajasekhar
Published: March 2022

In recent years, increasing attention has been given for reclamation and reuse of water (wastewater and stormwater) in the context of augmenting water supplies. Constructed wetland (CW) systems make use of natural substrates, plants, and microbes for decontamination of wastewater and stormwater. These nature-based water treatment systems are cost-effective and sustainable. This review critically analyzes the recent advances on the application of CW systems for removal of total suspended solids (TSS), various chemical (nutrients including total nitrogen and total phosphorus, heavy metals, and organics) and microbial pollutants (Escherichia coli, enterococci, fecal coliforms, etc.) in wastewater and stormwater. Furthermore, the influence of key factors including CW configurations, substrates, vegetation, ambient temperature/seasonal changes, oxygen levels and hydraulic retention time on the performance of CW systems are discussed. Insights into various pollutant removal mechanisms, microbial diversity and modeling (kinetics, hydrological and mechanistic) are provided. CW systems show good performance for removal of diverse pollutants from wastewater and stormwater. The pollutant removal mechanisms include physical (sedimentation and filtration), chemical (sorption, complexation and precipitation) and biological (biodegradation, microbial transformation and microbial/plant assimilation) processes. The dominant microbial communities enriched in CW systems include nitrifiers, denitrifiers and organic biodegraders. The key knowledge gaps in the development of multifunctional CW systems are highlighted. We believe that this critical review would help urban planners, environmental engineers and managers with implementation of innovative strategies for wastewater and stormwater reclamation and reuse to alleviate water stress in urban areas and to contribute to environmental sustainability. Moreover, this review would help to optimize the performance of CW systems as well as to develop regulatory guidelines for installation, operation and maintenance of CW systems.
When Is It Appropriate to Take Off the Mask? Signaling Pathways That Regulate ß(1,3)-Glucan Exposure in Candida albicans
Authors: Chen Tian , Wagner Andrew S. , Reynolds Todd B.
Published: March 2022

Candida spp. are an important source of systemic and mucosal infections in immune compromised populations. However, drug resistance or toxicity has put limits on the efficacy of current antifungals. The C. albicans cell wall is considered a good therapeutic target due to its roles in viability and fungal pathogenicity. One potential method for improving antifungal strategies could be to enhance the detection of fungal cell wall antigens by host immune cells. (1,3)-glucan, which is an important component of fungal cell walls, is a highly immunogenic epitope. Consequently, multiple host pattern recognition receptors, such as dectin-1, complement receptor 3 (CR3), and the ephrin type A receptor A (EphA2) are capable of recognizing exposed (unmasked) (1,3)-glucan moieties on the cell surface to initiate an anti-fungal immune response. However, (1,3)-glucan is normally covered (masked) by a layer of glycosylated proteins on the outer surface of the cell wall, hiding it from immune detection. In order to better understand possible mechanisms of unmasking (1,3)-glucan, we must develop a deeper comprehension of the pathways driving this phenotype. In this review, we describe the medical importance of (1,3)-glucan exposure in anti-fungal immunity, and highlight environmental stimuli and stressors encountered within the host that are capable of inducing changes in the levels of surface exposed (1,3)-glucan. Furthermore, particular focus is placed on how signal transduction cascades regulate changes in (1,3)-glucan exposure, as understanding the role that these pathways have in mediating this phenotype will be critical for future therapeutic development.
Lifestyle Modifies the Diabetes-Related Metabolic Risk, Conditional on Individual Genetic Differences
Authors: Shin Jisu , Zhou Xuan , Tan Joanne T. M. , Hyppönen Elina , Benyamin Beben , Lee S. Hong
Published: March 2022

Metabolic syndrome is a group of heritable metabolic traits that are highly associated with type 2 diabetes (T2DM). Classical interventions to T2DM include individual self-management of environmental risk factors, such as improving diet quality, increasing physical activity, and reducing smoking and alcohol consumption, which decreases the risk of developing metabolic syndrome. However, it is poorly understood how the phenotypes of diabetes-related metabolic traits change with respect to lifestyle modifications at the individual level. In the analysis, we used 12 diabetes-related metabolic traits and eight lifestyle covariates from the UK Biobank comprising 288,837 white British participants genotyped for 1,133,273 genome-wide single nucleotide polymorphisms. We found 16 GxE interactions. Modulation of genetic effects by physical activity was seen for four traits (glucose, HbA1c, C-reactive protein, systolic blood pressure) and by alcohol and smoking for three (BMI, glucose, waist–hip ratio and BMI and diastolic and systolic blood pressure, respectively). We also found a number of significant phenotypic modulations by the lifestyle covariates, which were not attributed to the genetic effects in the model. Overall, modulation in the metabolic risk in response to the level of lifestyle covariates was clearly observed, and its direction and magnitude were varied depending on individual differences. We also showed that the metabolic risk inferred by our model was notably higher in T2DM prospective cases than controls. Our findings highlight the importance of individual genetic differences in the prevention and management of diabetes and suggest that the one-size-fits-all approach may not benefit all.
Characterization of Somatic Mutations That Affect Neoantigens in Non-Small Cell Lung Cancer
Authors: Liang Hongge , Xu Yan , Chen Minjiang , Zhao Jing , Zhong Wei , Liu Xiaoyan , Gao Xiaoxing , Li Shanqing , Li Ji , Guo Chao , Jia He , Wang Mengzhao
Published: March 2022

Purpose

Immune checkpoint inhibitors (ICIs) have recently emerged as an important option for treating patients with advanced non-small cell lung cancer (NSCLC). Neoantigens are important biomarkers and potential immunotherapy targets that play important roles in the prognosis and treatment of patients with NSCLC. This study aimed to evaluate and characterize the relationships between somatic mutations and potential neoantigens in specimens from patients who underwent surgical treatment for NSCLC.

Patients and Methods

This prospective study evaluated specimens from patients with NSCLC who underwent surgical treatment at the Peking Union Medical College, China, from June 2019 to September 2019. Whole-exome sequencing was performed for tumor tissues and corresponding normal tissues. Candidate neoantigens were predicted using generative software, and the relationships between various mutation characteristics and number of neoantigens were evaluated.

Results

Neoantigen-related gene mutations were less frequent than mutations affecting the whole genome. Genes with high neoantigen burden had more types and higher frequencies of mutations. The number of candidate neoantigens was positively correlated with missense mutations, code shift insertions/deletions, split-site variations, and nonsense mutations. However, in the multiple linear regression analysis, only missense mutations were positively correlated with the number of neoantigens. The number of neoantigens was also positively correlated with base transversions (A>C/C>A, T>G/G>T, and C>G/G>C) and negatively correlated with base transitions (A>G/G>A and C>T/T>C).

Conclusion

The number of candidate neoantigens in NSCLC specimens was associated with mutation frequency, type of mutation, and type of base substitution.
GAD65 Antibody Epitopes and Genetic Background in Latent Autoimmune Diabetes in Youth (LADY)
Authors: Peng Yiman , Li Xia , Xiang Yufei , Yan Xiang , Zhou Houde , Tang Xiaohan , Cheng Jin , Niu Xiaohong , Liu Jing , Ji Qiuhe , Ji Linong , Huang Gan , Zhou Zhiguang
Published: March 2022

Epitope-specific GAD65Abs and HLA-DR-DQ gene assays help improve the value of risk stratification in autoimmune diabetes mellitus and protect islet function. Identification and early intervention are important for latent autoimmune diabetes in youth (LADY). The aims of this study were to investigate 1) the frequencies of the epitope-specific GAD65Abs and HLA-DR-DQ genes in LADY and 2) the association between HLA-DR-DQ genes and epitope-specific GAD65Abs. Higher frequencies of GAD65-CAb and multiepitope GAD65Abs were observed in young type 1 diabetes, LADY, and old type 1 diabetes subjects than those in latent autoimmune diabetes in adult (LADA) patients. The frequencies of the specific susceptible HLA haplotype DR3, total susceptible HLA haplotypes, and high-risk genotypes were higher in type 1 diabetes and LADY patients than those in LADA patients. In contrast, type 1 diabetes and LADY patients had lower frequencies of low/no genetic risk genotypes (DRX/X) than those of LADA patients. Logistic regression analysis suggested that the susceptible HLA haplotypes were risk factors for glutamic acid decarboxylase antibody (GADA) multiepitope positivity in autoimmune diabetes mellitus. LADY may be more severe than LADA, and LADY seemed to be a transitional type of type 1 diabetes and LADA. GADA epitope and HLA-DR-DQ gene assays are important for risk stratification in autoimmune diabetes mellitus and protection of islet function.
Functional and Immune Modulatory Characteristics of Bone Marrow Mesenchymal Stromal Cells in Patients With Aplastic Anemia: A Systematic Review
Authors: Atmar Khaled , Tulling Adam J. , Lankester Arjan C. , Bartels Marije , Smiers Frans J. , van der Burg Mirjam , Mohseny Alexander B.
Published: March 2022

Background

In most patients with aplastic anemia (AA), the diagnosis is limited to a description of the symptoms. Lack of understanding of the underlying pathophysiological mechanisms causing bone marrow failure (BMF), hampers tailored treatment. In these patients, auto-immune cell-mediated destruction of the bone marrow is often presumed to be the causative mechanism. The status of the bone marrow microenvironment, particularly the mesenchymal stromal cell (MSC) component, was recently suggested as a potential player in the pathophysiology of AA. Therefore, functional, and immune modulatory characteristics of bone marrow MSCs might represent important parameters for AA.

Objective

To conduct a systematic review to evaluate in vitro functional properties of MSCs derived from patients with AA compared to healthy controls.

Methods

According to PRISMA guidelines, a comprehensive search strategy was performed by using online databases (Pubmed, ISI Web of Science, Embase, and the Cochrane Library). Studies reporting on phenotypical characterization, proliferation potential, differentiation capacity, immunomodulatory potential, and ability to support hematopoiesis were identified and screened using the Rayyan software tool.

Results

23 articles were included in this systematic review, describing a total of 324 patients with AA and 285 controls. None of the studies identified a significant difference in expression of any MSC surface marker between both groups. However, AA-MSCs showed a decreased proliferation potential, an increased tendency to differentiate into the adipogenic lineage and decreased propensity towards osteogenic differentiation. Importantly, AA-MSCs show reduced capacity of immunosuppression and hematopoietic support in comparison to healthy controls.

Conclusion

We conclude that there are indications for a contribution of MSCs in the pathophysiology of AA. However, the current evidence is of poor quality and requires better defined study populations in addition to a more robust methodology to study MSC biology at a cellular and molecular level. Future studies on bone marrow microenvironment should aim at elucidating the interaction between MSCs, hematopoietic stem cells (HSCs) and immune cells to identify impairments associated with/causing BMF in patients with AA.
Photosynthetic Carbon Assimilation and Electron Transport Rates in Two Symbiont-Bearing Planktonic Foraminifera
Authors: Takagi Haruka , Kimoto Katsunori , Fujiki Tetsuichi
Published: March 2022

Photosymbiosis is one of the key features characterizing planktonic foraminifera; the number of symbiont cells within a single host has been reported to be well over thousands, meaning that photosynthesis by photosymbiosis may be a “hot spot” for primary production, especially in oligotrophic oceans. As microenvironmental conditions around foraminifera are greatly affected by rapid biological activities—such as photosynthesis and respiration—information on the photosynthetic activities of symbionts is essential to interpret the geochemical proxies recorded in foraminiferal tests (e.g., δ13C and δ18O). Recently, active chlorophyll fluorometry has been increasingly employed as a useful tool for immediate estimation of photosynthesis. However, carbon assimilation rates are the only direct indicator of the photosynthetic carbon flux. Therefore, before utilizing active fluorescence methods to understand carbon dynamics in foraminiferal symbiosis, it is necessary to confirm the relationship between the fluorescence-based photosynthetic rate [electron transport rate (ETR)] and carbon assimilation rate (P). Here, these two rates were compared for two species, Trilobatus sacculifer and Globigerinella siphonifera Type II, using 14C-tracer experiments and active fluorometric measurements by fast repetition rate fluorometry. The results showed a significant positive correlation between the P and ETR of the two species, indicating that carbon assimilation can be estimated by the fluorometric method. However, the regression slopes, which represent the apparent electron requirement for carbon assimilation (e–/C), were significantly different in the two species, and were estimated at 26.2 for T. sacculifer and 96.5 for G. siphonifera. These are strikingly high, considering the theoretically and empirically realistic e–/C values. We hypothesized that the high e–/C observed may be due in part to the use of unlabeled respiratory carbon (underestimation of P). A simple mass balance calculation suggests that a significant amount of carbon should derive from the host’s respired CO2, whose contribution is higher in G. siphonifera than in T. sacculifer. Within the context of using test geochemical parameters, such as δ13C, as paleoceanographic proxies, it is important to note that the potential magnitude of the photosynthetic effect varies among species. This attempt to couple ETR and P could comprehensively reveal an interesting perspective on the intimate interactions existing within photosymbiotic systems.
Exploring Five Methods for Estimating Net Community Production on the Siberian Continental Shelf and Slope of the Arctic Ocean
Authors: Alkire M. B. , Polyakov I. , Macdonald R. W.
Published: March 2022

The loss of sea ice and changes to vertical stratification in the Arctic Ocean are altering the availability of light and nutrients, with significant consequences for net community production (NCP) and carbon export. However, a general lack of quality data, particular during winter months, inhibits our ability to quantify such change. As a result, two parameters necessary for calculating annual NCP, integration depth (Zint) and pre-bloom nitrate concentration (Npre), are often either assigned or estimated from summer measurements. Vertical profiles of temperature, salinity, nitrate, and dissolved oxygen were collected during three cruises conducted between August and October of 2013, 2015, and 2018 in a data-sparse region of the Arctic Ocean along the Siberian continental slope. Estimates of NCP were calculated from these data using five different methods that either assigned constant values for Zint and/or Npre or estimated these parameters from summer observations. The five methods returned similar mean values of Zint (44–54 m), Npre (5.4–5.7 mmol m–3), and NCP (12–16 g C m–2) across the study region; however, there was considerable variability among stations/profiles. It was determined that the NCP calculations were particularly sensitive to Npre. Despite this sensitivity, mean NCP estimates calculated along four transects re-occupied during the three cruises generally agreed across the five methods with two important exceptions. First, methods with pre-assigned Zint and/or Npre underestimated the NCP when the nitracline shoaled in the Laptev Sea and when high-nutrient shelf waters were advected northward from the East Siberian Sea shelf in 2015. In contrast, the methods that directly estimated both Zint and Npre did not suffer from this bias. These results suggest that assignment of Npre and/or Zint provides reasonable estimates of NCP, particularly averaged over larger spatial scales and/or longer time scales, but these approaches are not suitable for evaluating interannual variability in NCP, particularly in dynamic regions. Combining all methods across the three cruise years indicates NCP in the Laptev Sea and Lomonosov Ridge areas (10–11 g C m–2) was slightly lower than that north of Severnaya Zemlya (13 g C m–2) and in the East Siberian Sea (16 g C m–2).
Micro(nano)plastics Prevalence, Food Web Interactions, and Toxicity Assessment in Aquatic Organisms: A Review
Authors: Benson Nsikak U. , Agboola Omowumi D. , Fred-Ahmadu Omowunmi H. , De-la-Torre Gabriel Enrique , Oluwalana Ayodeji , Williams Akan B.
Published: March 2022

Plastic pollution is a fast-rising environmental catastrophe. Microplastics and nanoplastics (MNPs) are ubiquitous components of most aquatic environments, and their burgeoning prevalence is endangering aquatic organisms. Recent studies have documented the entanglement of marine and freshwater biota by plastic litters, particularly ghost fishing gear, resulting in suffocation, drowning, or starving to death. Numerous reports have shown that aquatic organisms readily ingest and accumulate these emerging contaminants in their digestive systems. Given experimental evidence that contaminants-laden MNPs can persist in the gastrointestinal tract for considerable durations, investigations have documented a high probability of lethal and sublethal toxicological effects associated with direct and indirect MNPs ingestions. These include chronic protein modulation, DNA damage, embryotoxicity, gastrointestinal toxicity, genotoxicity, growth inhibition toxicity, histopathotoxicity, liver toxicity, neurotoxicity, oxidative stress, reproductive toxicity, and tissue damage. Today, reports have proven the transfer of MNPs across the aquatic food web to humans. However, the mechanisms of multiple contaminants-laden MNPs-induced toxicities, size-dependent toxicity, and the comprehensive mode-of-action and alterations of digestive, reproductive, and neurological systems’ functionality in marine organisms are still unclear. Thus, this review mainly addresses the prevalence, food web interactions, and toxicity assessment of micro(nano) plastics in marine and freshwater organisms. It summarizes documented studies based on the following broad objectives: (1) the occurrence and prevalence of micro(nano) plastic particles in marine and freshwater environments; (2) the ingestion of MNPs by aquatic biota and the food web exposure routes and bioaccumulation of contaminated MNPs by higher trophic entities; (3) the adsorption and desorption of persistent organic pollutants, metals, and chemical additives on/from micro(nano)plastics; and (4) the probable ecotoxicological effects of micro(nano)plastics ingestion on aquatic biota.
The Lipid-Lowering Effect of Dietary Taurine in Orange-Spotted Groupers (Epinephelus coioides) Involves Both Bile Acids and Lipid Metabolism
Authors: Wang Xuexi , Bai Fakai , Niu Xingjian , Sun Yunzhang , Ye Jidan
Published: March 2022

An 8-week feeding trial was conducted to investigate how dietary taurine supplementation attenuates the lipid deposition induced by dietary high lipid in juvenile orange-spotted grouper (Epinephelus coioides). Three isonitrogenous (47% crude protein) semipurified diets were formulated to contain two levels of lipid and termed as 10% lipid diet, 15% lipid diet, and 15% lipid with 1% taurine (namely, diet 10L, diet 15L, and diet 15L + T, respectively). Groupers fed diet 15L + T showed higher weight gain and feed efficiency compared with diet 15L. Groupers fed diet 15L showed higher liver lipid contents, plasma total cholesterol (TC), and leptin contents vs. those fed diet 10L. Diet 15L + T decreased hepatosomatic index, liver lipid content, and plasma TC and adiponectin contents, and increased liver 3-hydroxy-3-methy1 glutary1 coenzyme A reductase content compared with diet 15L. Fish fed diet 15L had higher contents of chenodeoxycholic acid, deoxycholic acid, and lithocholic acid, and lower contents of glycodeoxycholic acid (GDCA), glycolithocholic acid, glycoursodeoxycholic acid, taurodeoxycholic acid (TDCA), and β-, γ-, and ω-muricholic acid (MCA) when compared with fish fed diet 10L. Diet 15L + T downregulated the contents of glycocholic acid, glycochenodeoxycholic acid, taurohyodeoxycholic acid, tauromuricholic acid, TDCA, ursodeoxycholic acid, GDCA, and β-MCA vs. diet 15L. Diet 15L upregulated expression of peroxisome proliferator-activated receptor α (pparα) gene but downregulated expression of acyl-CoA carboxylase (acc), fatty acid synthase (fas), and glucose-6-phosphate dehydrogenase (g6pd) genes in comparison with diet 10L. The gene expression level of fas and 6pgd was downregulated and the pparα gene expression level was upregulated in fish fed diet 15L + T compared with those in fish fed diet 15L. Overall, this study indicated that dietary taurine supplementation can attenuate the liver lipid deposition of groupers caused by feeding 15% lipid through accelerating lipid absorption of taurine-conjugated bile acids and fatty acid β-oxidation and inhibiting lipogenesis.
Nitrogen, Phosphorus, and Sulfur Tri-doped Carbon A Coated NiCo2Se4 Needle Arrays Grown on Carbon Cloth as Binder-free Anode for Potassium-Ion Batteries
Authors: Fan Jinchen , Zheng Yujun , Zhao Zhongshu , Guo Wenyao , Zhu Sheng
Published: March 2022

Bimetallic selenides are considered to be the promising high-capacity anode materials for potassium ion batteries (PIBs). However, the dramatic volume fluctuation of K+ ions and pulverization during cycling still limit their practical application in PIBs. Herein, the nitrogen, phosphorus, and sulfur tri-doped carbon (SPNC)-coated bimetallic NiCo2Se4 needle arrays grown on carbon cloth (NiCo2Se4⊂SPNC/CC) prepared as a binder-free anode for PIBs. The polyphosphazene (PSZ) was used as ingenious heteroatoms doping carbon source. The coated SPNC layer derived from the PSZ on the surfaces of NiCo2Se4 needle arrays not only effectively alleviate the volume expansion of NiCo2Se4 but also provide abundant active sites for the storage of K+ ions. As the PIB anode, the NiCo2Se4⊂SPNC/CC could deliver a high reversible capacity of 880.9 mA h g−1 at a current density of 0.1 A g−1. After 500 cycles, the NiCo2Se4⊂SPNC/CC anode still maintains a high reversible capacity of 268.1 mA h·g−1 at a current density of 0.5 A g−1.
Changing Epidemiology of TB in Shandong, China Driven by Demographic Changes
Authors: Lin Qianying , Shrestha Sourya , Zhao Shi , Chiu Alice P. Y. , Liu Yao , Yu Chunbao , Tao Ningning , Li Yifan , Shao Yang , He Daihai , Li Huaichen
Published: March 2022

Tuberculosis (TB) incidence has been in steady decline in China over the last few decades. However, ongoing demographic transition, fueled by aging, and massive internal migration could have important implications for TB control in the future. We collated data on TB notification, demography, and drug resistance between 2004 and 2017 across seven cities in Shandong, the second most populous province in China. Using these data, and age-period-cohort models, we (i) quantified heterogeneities in TB incidence across cities, by age, sex, resident status, and occupation and (ii) projected future trends in TB incidence, including drug-resistant TB (DR-TB). Between 2006 and 2017, we observed (i) substantial variability in the rates of annual change in TB incidence across cities, from -4.84 to 1.52%; (ii) heterogeneities in the increments in the proportion of patients over 60 among reported TB cases differs from 2 to 13%, and from 0 to 17% for women; (iii) huge differences across cities in the annual growths in TB notification rates among migrant population between 2007 and 2017, from 2.81 cases per 100K migrants per year in Jinan to 22.11 cases per 100K migrants per year in Liaocheng, with drastically increasing burden of TB cases from farmers; and (iv) moderate and stable increase in the notification rates of DR-TB in the province. All of these trends were projected to continue over the next decade, increasing heterogeneities in TB incidence across cities and between populations. To sustain declines in TB incidence and to prevent an increase in Multiple DR-TB (MDR-TB) in the future in China, future TB control strategies may (i) need to be tailored to local demography, (ii) prioritize key populations, such as elderly and internal migrants, and (iii) enhance DR-TB surveillance.
Risk Factors for Post-operative Planned Reintubation in Patients After General Anesthesia: A Systematic Review and Meta-Analysis
Authors: Xie Zhiqin , Liu Jiawen , Yang Zhen , Tang Liping , Wang Shuilian , Du Yunyu , Yang Lina
Published: March 2022

Background

The occurrence of postoperative reintubation (POR) in patients after general anesthesia (GA) is often synonymous with a poor prognosis in patients. This is the first review analyzing scientific literature to identify risk factors of POR after general anesthesia. The purpose of this study was to collect currently published studies to determine the most common and consistent risk factors associated with POR after GA.

Methods

We have retrieved all relevant research published before April 2021 from PubMed, Embase, Web of Science, and the Cochrane Library electronic databases. These studies were selected according to the inclusion and exclusion criteria. The Z test determined the combined odds ratio (OR) of risk factors. We used OR and its corresponding 95% confidence interval (CI) to identify significant differences in risk factors. The quality of the study was evaluated with the NOS scale, and meta-analysis was carried out with Cochrane Collaboration's Revman 5.0 software.

Results

A total of 10 studies were included, with a total of 7,789 recipients of POR. We identified 7 risk factors related to POR after GA: ASA ≥ 3 (OR = 3.58), COPD (OR = 2.09), thoracic surgery (OR = 17.09), airway surgery (OR = 9.93), head-and-neck surgery (OR = 3.49), sepsis (OR = 3.50), DVT (OR = 4.94).

Conclusion

Our meta-analysis showed that ASA ≥ 3, COPD, thoracic surgery, airway surgery, head-and-neck surgery, sepsis and DVT were associated with POR after GA.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/display_record.php?, Identifier: CRD42021252466.
Angiotensin System Autoantibodies Correlate With Routine Prognostic Indicators for COVID-19 Severity
Authors: Labandeira Carmen M. , Pedrosa Maria A. , Suarez-Quintanilla Juan A. , Cortes-Ayaso María , Labandeira-García José Luis , Rodríguez-Pérez Ana I.
Published: March 2022

Objective

We previously showed that angiotensin type-1 receptor and ACE2 autoantibodies (AT1-AA, ACE2-AA) are associated with COVID-19 severity. Our aim is to find correlations of these autoantibodies with routine biochemical parameters that allow an initial classification of patients.

Methods

In an initial cohort of 119 COVID-19 patients, serum AT1-AA and ACE2-AA concentrations were obtained within 24 h after diagnosis. In 50 patients with a complete set of routine biochemical parameters, clinical data and disease outcome information, a Random Forest algorithm was used to select prognostic indicators, and the Spearman coefficient was used to analyze correlations with AT1-AA, ACE2-AA.

Results

Hemoglobin, lactate dehydrogenase and procalcitonin were selected. A decrease in one unit of hemoglobin, an increase in 0.25 units of procalcitonin, or an increase in 100 units of lactate dehydrogenase increased the severity of the disease by 35.27, 69.25, and 3.2%, respectively. Our binary logistic regression model had a predictive capability to differentiate between mild and moderate/severe disease of 84%, and between mild/moderate and severe disease of 76%. Furthermore, the selected parameters showed strong correlations with AT1-AA or ACE2-AA, particularly in men.

Conclusion

Hemoglobin, lactate dehydrogenase and procalcitonin can be used for initial classification of COVID-19 patients in the admission day. Subsequent determination of more complex or late arrival biomarkers may provide further data on severity, mechanisms, and therapeutic options.
Multimodal In-training Examination in an Emergency Medicine Residency Training Program: A Longitudinal Observational Study
Authors: Liu Pin , Chen Shou-Yen , Chang Yu-Che , Ng Chip-Jin , Chaou Chung-Hsien
Published: March 2022

Background

In-training examination (ITE) has been widely adopted as an assessment tool to measure residents' competency. We incorporated different formats of assessments into the emergency medicine (EM) residency training program to form a multimodal, multistation ITE. This study was conducted to examine the cost and effectiveness of its different testing formats.

Methods

We conducted a longitudinal study in a tertiary teaching hospital in Taiwan. Nine EM residents were enrolled and followed for 4 years, and the biannual ITE scores were recorded and analyzed. Each ITE consisted of 8–10 stations and was categorized into four formats: multiple-choice question (MCQ), question and answer (QA), oral examination (OE), and high-fidelity simulation (HFS) formats. The learner satisfaction, validity, reliability, and costs were analyzed.

Results

486 station scores were recorded during the 4 years. The numbers of MCQ, OE, QA, and HFS stations were 45 (9.26%), 90 (18.5%), 198 (40.7%), and 135 (27.8%), respectively. The overall Cronbach's alpha reached 0.968, indicating good overall internal consistency. The correlation with EM board examination was highest for HFS (ρ = 0.657). The average costs of an MCQ station, an OE station, and an HFS station were ~3, 14, and 21 times that of a QA station.

Conclusions

Multi-dimensional assessment contributes to good reliability. HFS correlates best with the final training exam score but is also the most expensive format among ITEs. Increased testing domains with various formats improve ITE's overall reliability. Program directors must understand each test format's strengths and limitations to bring forth the best combination of exams under the local context.
Memory Foam Pillow as an Intervention in Obstructive Sleep Apnea Syndrome: A Preliminary Randomized Study
Authors: Stavrou Vasileios T. , Koutedakis Yiannis , Astara Kyriaki , Vavougios George D. , Papayianni Eirini , Stavrou Ilias T. , Bardaka Fotini , Pastaka Chaido , Gourgoulianis Konstantinos I.
Published: March 2022

Specific pillow use is a seldom studied or controlled factor in the setting of sleep disordered breathing. The aim of this study was to investigate the effect of different pillows [own pillow (OP), memory foam pillow (MFP), generic laboratory pillow (LP)] on polysomnography (PSG)-derived parameters in patients with Obstructive Sleep Apnea Syndrome (OSAS). Thirty-two consecutive patients with OSAS were randomly allocated into two groups with randomized pillow usage [Group A: 3 h with LP and 3 h with OP (Age: 53.8 ± 12.5 years, BMI: 32.1 ± 4.6 kg/m2); Group B: 3 h with LP and 3 h with MFP (Age: 52.0 ± 6.3 years, BMI: 30.6 ± 2.2 kg/m2)]. Statistically significant differences between pillow types were detected in desaturation index and heart rate. In Group B (with MFP), a statistically significant decrease of 47.0 ± 15.9% was observed in snoring events (p < 0.05) and 10.6 ± 6.7% in their duration (p < 0.05) compared to LP. On the other hand, group A with OP recorded a decrease of 29.1 ± 32.1% in snoring events and 32.5 ± 33.1% in duration, but these values were not statistically significant (p > 0.05) compared to LP. These findings indicate that pillow type and usage, often uncontrolled in OSAS studies (contribution to the field), may impact several PSG parameters and are related to a snoring subtype of the syndrome. Secondly, they indicate that a focus on the treatment of the snoring OSAS subtype warrants further dedicated investigation.
Relationship Between Plasma Vitamin C and COVID-19 Susceptibility and Severity: A Two-Sample Mendelian Randomization Study
Authors: Chen Song , Zheng Changhua , Chen Tianlai , Huang Dianhua , Pan Yuancheng , Chen Shunyou
Published: March 2022

Background

Considering the antioxidant function of Vitamin C, also called ascorbic acid, it is widely used against viral infections such as coronavirus disease (COVID-19) based on in vitro, observational, and ecological studies. Many confounding factors that can affect Vitamin C levels. Thus, the association described to date may not be causal. To determine the causal relationship between genetically predicted plasma Vitamin C and COVID-19 susceptibility and severity, we performed two-sample Mendelian randomization (MR) based on large samples.

Methods

The summary-level data for Vitamin C was obtained from a GWAS meta-analysis, which included 52,018 individuals from four studies of European ancestry. Data for COVID-19 HGI results were obtained from the meta-analysis of 35 GWASs with more than 1,000,000 subjects of European ancestry, including 32,494 cases with COVID-19 susceptibility and 1,316,207 controls, 9,986 cases with COVID-19 hospitalization and 1,877,672 controls, and 5,101 cases with COVID-19 severe disease and 1,383,241 controls. Mendelian randomization (MR) analysis was conducted to examine the effect of selected single nucleotide polymorphisms and COVID-19 susceptibility, hospitalization, disease severity. Several sensitivity analyses were performed with inverse-variance weighted (random-effect model), inverse variance weighted (fixed-effect model), weighted median, and maximum likelihood methods for estimating the causal effects.

Results

In this MR study, genetic predisposition to the levels of plasma Vitamin C was not associated with COVID-19 susceptibility (OR: 0.99, 95% CI: 0.84–1.17, P = 0.91), hospitalization (OR: 1.10, 95% CI: 0.71–1.71, P = 0.67) and severity (OR: 0.83, 95% CI: 0.43–1.59, P = 0.58). The association was consistent in complementary analyses. No potential heterogeneities and directional pleiotropies were observed for the analysis results.

Conclusion

According to our study, no correlation was observed between plasma Vitamin C levels and COVID-19 susceptibility and severity. Further studies in different ethnics are necessary to explore the potential role and mechanisms of circulating serum Vitamin C levels on COVID-19.
2% Ganciclovir Eye Drops Control Posner-Schlossman Syndrome Relapses With/Without Cytomegalovirus Intraocular Reactivation
Authors: Sheng Qilian , Zhai Ruyi , Fan Xintong , Kong Xiangmei
Published: March 2022

Background

To observe and compare the efficacy of 2% ganciclovir eye drops in the treatment of Posner-Schlossman Syndrome relapses with/without cytomegalovirus intraocular reactivation.

Methods

A prospective cohort study enrolling 101 patients diagnosed unilateral Posner-Schlossman Syndrome in Eye & ENT hospital, Fudan University, Shanghai, China. Thorough ophthalmic examinations were given. Aqueous humor sample was collected from the attacked eye of each patient and all pathogen immunoglobulins tests were performed. All patients were treated with appropriate corticosteroids and intraocular pressure-lowering drugs. 2% ganciclovir eye drops were given to patients whose cytomegalovirus antibody aqueous humor/serum correction ratio >0. Patients were followed up for 2 months. Ocular manifestations and cumulative drug dose were recorded.

Results

A cytomegalovirus ratio >0.40 was considered cytomegalovirus reactivation. The reactivation group (N = 46) had significantly higher percent of iris depigmentation (78.26%, P < 0.05) and endothelial cell loss rate (19.46%, P < 0.001) than the latent group (N = 55, 58.18% and 10.86%, respectively). The cumulative treatment time and 2% ganciclovir doses were 6.50 ± 4.67 weeks and 181.70 ± 130.95 drops for the reactivation group; 5.95 ± 4.11 weeks and 161.89 ± 110.66 drops for the latent group (P > 0.05). The median cumulative 2% ganciclovir estimated for inflammation control were 252.00 ± 50.71 and 224.00 ± 32.45 drops for the reactivation and latent group. The residual rate of uncontrolled cases was 0.19 ± 0.15 and 0.00, respectively (P < 0.05).

Conclusions

A treatment course of 8–9 weeks' 2% ganciclovir is recommended to relapses both with and without cytomegalovirus intraocular reactivation. Preventive ganciclovir application may benefit patients with historical cytomegalovirus infections.

Clinical Trial Registration

www.chictr.org.cn, identifier: ChiCTR1900022340, Date: 2019/04/06.
Tree Species Diversity and Forest Edge Density Jointly Shape the Gut Microbiota Composition in Juvenile Great Tits (Parus major)
Authors: Goossens Evy , Boonyarittichaikij Roschong , Dekeukeleire Daan , Hertzog Lionel , Van Praet Sarah , Pasmans Frank , Bonte Dries , Verheyen Kris , Lens Luc , Martel An , Verbrugghe Elin
Published: March 2022

Despite the microbiome’s key role in health and fitness, little is known about the environmental factors shaping the gut microbiome of wild birds. With habitat fragmentation being recognised as a major threat to biological diversity, we here determined how forest structure influences the bacterial species richness and diversity of wild great tit nestlings (Parus major). Using an Illumina metabarcoding approach which amplifies the 16S bacterial ribosomal RNA gene, we measured gut microbiota diversity and composition from 49 great tit nestlings, originating from 23 different nests that were located in 22 different study plots across a gradient of forest fragmentation and tree species diversity. Per nest, an average microbiome was determined on which the influence of tree species (composition and richness) and forest fragmentation (fragment area and edge density) was examined and whether this was linked to host characteristics (body condition and fledging success). We found an interaction effect of edge density with tree species richness or composition on both the microbial richness (alpha diversity: Chao1 and Shannon) and community structure (beta diversity: weighted and unweighted UniFrac). No significant short-term impact was observed of the overall faecal microbiome on host characteristics, but rather an adverse effect of specific bacterial genera on fledging success. These results highlight the influence of environmental factors on the microbial richness as well as the phylogenetic diversity during a life stage where the birds’ microbiota is shaped, which could lead to long-term consequences for host fitness.
The Ubiquitin Ligase RNF34 Participates in the Peripheral Quality Control of CFTR (RNF34 Role in CFTR PeriQC)
Authors: Taniguchi Shogo , Ito Yukiko , Kiritani Hibiki , Maruo Asuka , Sakai Ryohei , Ono Yuji , Fukuda Ryosuke , Okiyoneda Tsukasa
Published: March 2022

The peripheral protein quality control (periQC) system eliminates the conformationally defective cystic fibrosis transmembrane conductance regulator (CFTR), including ∆F508-CFTR, from the plasma membrane (PM) and limits the efficacy of pharmacological therapy for cystic fibrosis (CF). The ubiquitin (Ub) ligase RFFL is responsible for the chaperone-independent ubiquitination and lysosomal degradation of CFTR in the periQC. Here, we report that the Ub ligase RNF34 participates in the CFTR periQC in parallel to RFFL. An in vitro study reveals that RNF34 directly recognizes the CFTR NBD1 and selectively promotes the ubiquitination of unfolded proteins. RNF34 was localized in the cytoplasm and endosomes, where RFFL was equally colocalized. RNF34 ablation increased the PM density as well as the mature form of ∆F508-CFTR rescued at low temperatures. RFFL ablation, with the exception of RNF34 ablation, increased the functional PM expression of ∆F508-CFTR upon a triple combination of CFTR modulators (Trikafta) treatment by inhibiting the K63-linked polyubiquitination. Interestingly, simultaneous ablation of RNF34 and RFFL dramatically increased the functional PM ∆F508-CFTR by inhibiting the ubiquitination in the post-Golgi compartments. The CFTR-NLuc assay demonstrates that simultaneous ablation of RNF34 and RFFL dramatically inhibits the degradation of mature ∆F508-CFTR after Trikafta treatment. Therefore, these results suggest that RNF34 plays a crucial role in the CFTR periQC, especially when there is insufficient RFFL. We propose that simultaneous inhibition of RFFL and RNF34 may improve the efficacy of CFTR modulators.
Progress in Research on the Effect of Melatonin on Postoperative Cognitive Dysfunction in Older Patients
Authors: Wei Yuqing , Zhang Chunlu , Wang Danyang , Wang Chengping , Sun Lin , Chen Peng
Published: March 2022

Postoperative cognitive dysfunction (POCD) is a common complication of the central nervous system in elderly patients after operation. It will prolong the length of stay, reduce the independence and quality of daily life, and increase the risk of death. However, at present, there is a lack of safe and effective ideal drugs for the prevention and treatment of POCD. Melatonin is one of the hormones secreted by the pineal gland of the brain, which has the functions of regulating circadian rhythm, anti-inflammation, anti-oxidation, anti-apoptosis, and so on. Some recent studies have shown that MT can prevent and treat POCD by adjusting circadian rhythm, restoring cholinergic system function, neuroprotection, and so on. This article will introduce POCD, melatonin and the mechanism of melatonin on POCD, respectively, to provide a basis for clinical prevention and treatment of POCD in the elderly.