bluuebunny/crossref_metadata_2025 huggingface dataset:
A systematic review of the research progress of traditional Chinese medicine against pulmonary fibrosis: from a pharmacological perspective
Authors: Qin Shanbo , Tan Peng , Xie Junjie , Zhou Yongfeng , Zhao Junning
Published: August 2023

Pulmonary fibrosis is a chronic progressive interstitial lung disease caused by a variety of etiologies. The disease can eventually lead to irreversible damage to the lung tissue structure, severely affecting respiratory function and posing a serious threat to human health. Currently, glucocorticoids and immunosuppressants are the main drugs used in the clinical treatment of pulmonary fibrosis, but their efficacy is limited and they can cause serious adverse effects. Traditional Chinese medicines have important research value and potential for clinical application in anti-pulmonary fibrosis. In recent years, more and more scientific researches have been conducted on the use of traditional Chinese medicine to improve or reduce pulmonary fibrosis, and some important breakthroughs have been made. This review paper systematically summarized the research progress of pharmacological mechanism of traditional Chinese medicines and their active compounds in improving or reducing pulmonary fibrosis. We conducted a systematic search in several main scientific databases, including PubMed, Web of Science, and Google Scholar, using keywords such as idiopathic pulmonary fibrosis, pulmonary fibrosis, interstitial pneumonia, natural products, herbal medicine, and therapeutic methods. Ultimately, 252 articles were included and systematically evaluated in this analysis. The anti-fibrotic mechanisms of these traditional Chinese medicine studies can be roughly categorized into 5 main aspects, including inhibition of epithelial-mesenchymal transition, anti-inflammatory and antioxidant effects, improvement of extracellular matrix deposition, mediation of apoptosis and autophagy, and inhibition of endoplasmic reticulum stress. The purpose of this article is to provide pharmaceutical researchers with information on the progress of scientific research on improving or reducing Pulmonary fibrosis with traditional Chinese medicine, and to provide reference for further pharmacological research.
Barriers to prophylactic treatment among patients with haemophilia A in Shandong Province, China: a qualitative study
Authors: Liu Ziyu , Feng Junchao , Fang Yunhai , Cheng Yan , Li Shunping
Published: August 2023

Background

Haemophilia A is a rare, hereditary haemorrhagic disease that manifests as induced spontaneous bleeding and leads to disability or premature death in severe cases. Prophylactic treatment is optimal for patients to prevent uncontrolled bleeding and reduce the severity of the injury. However, little is known about the use of prophylactic treatment among patients with haemophilia A in China, especially barriers that predispose them to low or non-adherence. In this study, we explore the barriers to the prophylactic treatment of patients with haemophilia A.

Method

We used personal interviews and focus groups to collect the data and analysed the data through thematic analysis. Purposive sampling was employed to recruit our participants. We continued recruiting participants until data saturation was reached from the thematic analysis. Ultimately, we obtained 37 participants, among whom 19 participated in personal interviews and 18 participated in focus groups (i.e., 3 focus groups with 6 participants each).

Results

Three themes and nine subthemes were identified from the thematic analysis. Nine subthemes (i.e., perceived barriers) emerged from the analysis, which were further clustered into three themes: (1) poor primary health care, (2) inadequate financial support, and (3) a lack of patient-centred care.

Conclusion

The findings presented in this descriptive qualitative study offer a unique view of Chinese patients with haemophilia A and their barriers to prophylactic treatment. Our findings not only provide an in-depth understanding of barriers to prophylactic treatment encountered by Chinese patients with haemophilia A but also address the urgent need to strengthen primary care, provide adequate financial support, and establish patient-centred care for these suffering patients.
How to START? Four pillars to optimally begin your orphan drug development
Authors: Jonker Anneliene Hechtelt , Batista Liliana , Gabaldo Michela , Hivert Virginie , Ardigo Diego ,   on behalf of the IRDiRC ODDG TF and IRDiRC TSC
Published: August 2023

Drug development is a complex, resource intensive and long process in any disease area, and developing medicines to treat rare diseases presents even more challenges due to the small patient populations, often limited disease knowledge, heterogeneous clinical manifestations, and disease progression. However, common to all drug development programs is the need to gather as much information as possible on both the disease and the patients’ needs ahead of the development path definition. Here, we propose a checklist named START, a tool that provides an overview of the key pillars to be considered when starting an orphan drug development: STakeholder mapping, Available information on the disease, Resources, and Target patient value profile. This tool helps to build solid foundations of a successful patient-centered medicines development program and guides different types of developers through a set of questions to ask for guidance through the starting phase of a rare disease therapeutic pathway.
Bispecific antibodies targeting BCMA, GPRC5D, and FcRH5 for multiple myeloma therapy: latest updates from ASCO 2023 Annual Meeting
Authors: Zhao Juanjuan , Ren Quan , Liu Xinyuan , Guo Xiangqian , Song Yongping
Published: August 2023

Several bispecific antibodies (bsAbs) targeting BCMA, GPRC5D, and FcRH5 are in clinical trials for heavily pretreated multiple myeloma (MM) patients. Teclistamab was approved for relapsed/refractory MM therapy in 2022, while elranatamab, linvoseltamab, F182112, talquetamab, and cevostamab are currently undergoing clinical trials. This study summarizes several latest reports on bsAbs for the treatment of MM from the ASCO 2023 Annual Meeting.
O-RADS combined with contrast-enhanced ultrasound in risk stratification of adnexal masses
Authors: Shi Yanyun , Li Huan , Wu Xiuhua , Li Xiaoqin , Yang Min
Published: August 2023

Background

Ovarian-Adnexal Reporting and Data System (O-RADS) for ultrasound is a lexicon and risk stratification system that includes all risk categories and relevant management recommendation. It has high sensitivity in diagnosing malignant adnexal tumors, but the specificity is lower.

Objective

To explore the value of O-RADS combined with contrast-enhanced ultrasound (CEUS) in risk stratification of adnexal masses.

Methods

A retrospective study was performed on 85 patients with 100 adnexal masses that preoperatively underwent conventional ultrasound as well as CEUS examination and obtained the postoperative pathological results. The masses were classified into O-RADS2, 3, 4, and 5 by conventional ultrasound. After contrast enhancement, the classification of O-RADS was adjusted according to CEUS imaging features. The O-RADS 2 and 3 lesions with suspected malignant features like irregular blood vessels or internal inhomogeneous hyperenhancement were upgraded to O-RADS 4, and the O-RADS 4 lesions with the above features were upgraded to O-RADS 5. The O-RADS 4 lesions with suspicious benign angiographic features like a regular vessel, interior hypoenhancement or non-enhancement were downgraded to O-RADS 3; the O-RADS 5 lesions with rim ring-enhancement and interior non-enhancement were downgraded to O-RADS 3. The sensitivity, specificity, accuracy, PPV, NPV, and AUC of the two methods were compared, taking pathological results as the gold standard.

Results

The sensitivity, specificity, accuracy, PPV, NPV, and AUC of O-RADS and O-RADS combined with CEUS in the diagnosis of malignant adnexal tumors were 96.6%, 66.2%, 75.0%, 53.8%, 97.9%, 0.910 and 96.6%, 91.5%, 93.0%, 82.4%, 98.5%, 0.962, respectively. The specificity, accuracy, PPV, and AUC of O-RADS combined with CEUS were considerably higher than those of O-RADS (P < 0.01). Furthermore, both methods had excellent sensitivity and NPV but there were no significant differences between them(P > 0.05).

Conclusion

Combination of O-RADS and CEUS can significantly improve the specificity and PPV in diagnosing malignant adnexal tumors. It seems promising in the clinical application of risk stratification of adnexal masses.
Study on self-management of real-time and individualized support in stroke patients based on resilience: a protocol for a randomized controlled trial
Authors: Jiang N. , Xv Y. , Sun X. , Feng L. , Wang Y. B. , Jiang X. L.
Published: August 2023

Background

The transitional period from hospital to home is vital for stroke patients, but it poses serious challenges. Good self-management ability can optimize disease outcomes. However, stroke patients in China have a low level of self-management ability during the transitional period, and a lack of effective support may be the reason. With the rapid development of technology, using wearable monitors to achieve real-time and individualized support may be the key to solving this problem. This study uses a randomized controlled trial design to assess the efficacy of using wearable technology to realize real-time and individualized self-management support in stroke patients’ self-management behavior during the transitional period following discharge from hospital.

Methods

This parallel-group randomized controlled trial will be conducted in two hospitals and patients’ homes. A total of 183 adult stroke patients will be enrolled in the study and randomly assigned to three groups in a 1:1:1 ratio. The smartwatch intervention group (n = 61) will receive Real-time and Individualized Self-management Support (RISS) program + routine care, the wristband group (n = 61) will wear a fitness tracker (self-monitoring) + routine care, and the control group (n = 61) will receive routine stroke care. The intervention will last for 6 months. The primary outcomes are neurological function status, self-management behavior, quality of life, biochemical indicators, recurrence rate, and unplanned readmission rate. Secondary outcomes are resilience, patient activation, psychological status, and caregiver assessments. The analysis is intention-to-treat. The intervention effect will be evaluated at baseline (T0), 2 months after discharge (T1), 3 months after discharge (T2), and 6 months after discharge (T3).

Discussion

The cloud platform designed in this study not only has the function of real-time recording but also can push timely solutions when patients have abnormal conditions, as well as early warnings or alarms. This study could also potentially help patients develop good self-management habits through resilience theory, wearable devices, and individualized problem–solution library of self-management which can lay the foundation for long-term maintenance and continuous improvement of good self-management behavior in the future.

Trial registration

The ethics approval has been granted by the Ethics Committee of West China Hospital, Sichuan University (2022–941). All patients will be informed of the study details and sign a written informed consent form before enrollment. The research results will be reported in conferences and peer-reviewed publications. The trial registration number is ChiCTR2300070384. Registered on 11 April 2023.
An observer-blinded, cluster randomised trial of a typhoid conjugate vaccine in an urban South Indian cohort
Authors: Sahai Nikhil , Arunachalam Dilesh Kumar , Morris Tim , Copas Andrew , Samuel Prasanna , Mohan Venkata Raghava , Abraham Vinod , Selwyn Joshua Anish , Kumar Praveen , Rose Winsley , Balaji Veeraraghavan , Kang Gagandeep , John Jacob
Published: August 2023

Background

Typhoid fever causes nearly 110,000 deaths among 9.24 million cases globally and disproportionately affects developing countries. As a control measure in such regions, typhoid conjugate vaccines (TCVs) are recommended by the World Health Organization (WHO). We present here the protocol of a cluster randomised vaccine trial to assess the impact of introducing TyphiBEV® vaccine to those between 1 and 30 years of age in a high-burden setting.

Methods

The primary objective is to determine the relative and absolute rate reduction of symptomatic, blood-culture-confirmed S. Typhi infection among participants vaccinated with TyphiBEV® in vaccine clusters compared with the unvaccinated participants in non-vaccine clusters. The study population is residents of 30 wards of Vellore (a South Indian city) with participants between the ages of 1 and 30 years who provide informed consent. The wards will be divided into 60 contiguous clusters and 30 will be randomly selected for its participants to receive TyphiBEV® at the start of the study. No placebo/control is planned for the non-intervention clusters, which will receive the vaccine at the end of the trial. Participants will not be blinded to their intervention. Episodes of typhoid fever among participants will be captured via stimulated, passive fever surveillance in the area for 2 years after vaccination, which will include the most utilised healthcare facilities. Observers blinded to the participants’ intervention statuses will record illness details. Relative and absolute rate reductions will be calculated at the end of this surveillance and used to estimate vaccine effectiveness.

Discussion

The results from our trial will allow countries to make better-informed decisions regarding the TCV that they will roll-out and may improve the global supplies and affordability of the vaccines.

Trial registration

Clinical Trials Registry of India (CTRI) CTRI/2022/03/041314. Prospectively registered on 23 March 2022 (https://ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=62548&EncHid=&userName=vellore%20typhoid). CTRI collects the full WHO Trial Registration Data Set.
Role of inflammatory burden and treatment on joint space width in psoriatic arthritis—a high-resolution peripheral quantitative computed tomography study
Authors: Jin Yingzhao , Cheng Isaac T , So Ho , Wu Dongze , Griffith James F , Hung Vivian W , Qin Ling , Szeto Cheuk-Chun , Chan Agnes WS , Tam Lai-Shan
Published: August 2023

Background

To investigate the relationship between disease-related parameters and joint space width (JSW) on high-resolution peripheral quantitative computed tomography (HR-pQCT) in psoriatic arthritis (PsA) patients.

Methods

PsA patients who underwent HR-pQCT examination of the second to fourth metacarpophalangeal joint (MCPJ 2–4) were recruited in this cross-sectional study. The joint space metrics included joint space volume (JSV), mean, minimum, and maximum JSW, JSW asymmetry, and distribution. Correlation analysis and multivariable linear regression models were used to determine the association between disease-related variables and JSW.

Results

Sixty-seven patients [37 (55.2%) males; median (IQR) age: 57.0 (53.0, 63.0); median disease duration: 21 (16, 28) years] were included in this analysis. Multivariable linear regression analysis demonstrated that males had larger JSV (MCPJ 2–4), mean (MCPJ 4), and maximum JSW (MCPJ 3). Longer disease duration (MCPJ 2–3) and higher ESR values (MCPJ 3) were negatively associated with mean and maximum JSW, while higher damage joint count was negatively associated with mean and minimum JSW (MCPJ 2). Use of conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) was negatively associated with minimum JSW (MCPJ 3) while use of biologic DMARDs (bDMARDs) was positively associated with minimum JSW (MCPJ 2).

Conclusion

Higher inflammatory burden as reflected by longer disease duration, higher ESR levels, and damage joint count was negatively associated with mean, maximum, and minimum JSW, while suppression of inflammation using bDMARDs seems to limit the decline in JSW.
Lymphoscintigraphy findings in patients with chylothorax: influence of biochemical parameters
Authors: Zhang Li , Zhang Xiaoyue , Wen Zhe , Tong Guansheng , Hao Kun , Qiu Yongkang , Kang Lei
Published: August 2023

Background

Chylothorax is a condition that can be challenging to diagnose due to its nonspecific clinical presentation. Several biochemical parameters of chylous pleural effusion have been identified as important indicators for the diagnosis of chylothorax. Lymphoscintigraphy is utilized to assess chylothorax and determine the location of chyle leakage. The present study aimed to evaluate the correlation between the biochemical parameters of chylous pleural effusion and 99mTc-dextran (99mTc-DX) lymphoscintigraphy in diagnosing chylothorax.

Material and methods

A total of 120 patients were enrolled in the study, 83 of the patients with unilateral chylothorax, and 37 with bilateral chylothorax. All patients underwent both 99mTc-DX lymphoscintigraphy and pleural effusion laboratory analysis. The 99mTc-DX lymphoscintigraphy images were categorized as positive or negative groups based on the presence or absence of abnormal radioactive tracer accumulation in the thorax, respectively. The biochemical parameters of the two groups were subsequently compared.

Results

Among these patients, 101 (84.17%) had exudative effusions, while 19 (15.83%) had transudative effusions, as determined by the levels of pleural effusion protein, lactate dehydrogenase and cholesterol. Abnormal tracer accumulation in thorax was observed in 82 patients (68.33%). Our findings indicated that lymphoscintigraphy results were not associated with exudative and transudative chylothorax (P = 0.597). The lymphoscintigraphy positive group displayed significantly higher levels of pleural effusion triglyceride and pleural effusion triglyceride/serum triglyceride ratio in all biochemical parameters, compared to the negative group (P = 0.000 and P = 0.005). We identified cutoff values of 2.870 mmol/L for pleural effusion triglycerides and 4.625 for pleural effusion triglyceride/serum triglyceride ratio, respectively, which can facilitate differentiating the positive and negative cases on lymphoscintigraphy.

Conclusion

Lymphoscintigraphy technique is a dependable diagnostic tool for the qualitative assessment of chylous pleural effusion. Higher pleural effusion triglyceride level and pleural effusion triglyceride/serum triglyceride ratio indicate a positive result in patients with chylothorax on lymphoscintigraphy, with the cutoff values of 2.870 mmol/L and 4.625 aiding in the diagnosis.
Microphone utility estimation in acoustic sensor networks using single-channel signal features
Authors: Günther Michael , Brendel Andreas , Kellermann Walter
Published: August 2023

In multichannel signal processing with distributed sensors, choosing the optimal subset of observed sensor signals to be exploited is crucial in order to maximize algorithmic performance and reduce computational load, ideally both at the same time. In the acoustic domain, signal cross-correlation is a natural choice to quantify the usefulness of microphone signals, i.e., microphone utility, for coherent array processing, but its estimation requires that the uncoded signals are synchronized and transmitted between nodes. In resource-constrained environments like acoustic sensor networks, low data transmission rates often make transmission of all observed signals to the centralized location infeasible, thus discouraging direct estimation of signal cross-correlation. Instead, we employ characteristic features of the recorded signals to estimate the usefulness of individual microphone signals using the Magnitude-Squared Coherence (MSC) between the source and respective microphone signal as ground-truth metric. In this contribution, we provide a comprehensive analysis of model-based microphone utility estimation approaches that use signal features and, as an alternative, also propose machine learning-based estimation methods that identify optimal sensor signal utility features. The performance of both approaches is validated experimentally using both simulated and recorded acoustic data, comprising a variety of realistic and practically relevant acoustic scenarios including moving and static sources.
Association of sarcopenia, pre-sarcopenia, and dynapenia with the onset and progression of locomotive syndrome in Japanese older adults: a cross-sectional study
Authors: Jung Hungu , Tanaka Shigeharu , Kataoka Shusei , Tanaka Ryo
Published: August 2023

Background

Sarcopenia commonly occurs in older adults with motor disorders requiring long-term care, and the clinical features of sarcopenia are associated with locomotive syndrome. Dynapenia is the age-related loss of muscle strength. However, the association of sarcopenia and dynapenia with the onset and progression of locomotive syndrome in older adults remains unknown. The current study aimed to determine the association of sarcopenia, pre-sarcopenia, and dynapenia with the onset and progression of locomotive syndrome in Japanese older adults.

Methods

This study included older females (n = 264, 73.9 ± 5.8 years) and males (n = 92, 76.3 ± 6.1 years). Sarcopenia was defined as low muscle function and mass; pre-sarcopenia was defined as low muscle mass with normal muscle function; and dynapenia was defined as low muscle function without low muscle mass. Locomotive syndrome (stage 0–2) severity was determined using the stand-up test, the two-step test, and the 25-question geriatric locomotive function scale. Logistic regression analysis was performed to determine the relationship between sarcopenia category and locomotive syndrome stages.

Results

Age (1.208, 95% confidence interval (CI) 1.124–1.298), sex (2.455, 95% CI 1.241–4.856), and BMI (1.211, 95% CI 1.077–1.361) were significant variables for determining locomotive syndrome stage ≥ 1, whereas pre-sarcopenia (0.543, 95% CI 0.331–0.891) and sarcopenia (1.664, 95% CI 1.005–2.755) were significant variables for determining locomotive syndrome stage 2.

Conclusions

Only sarcopenia was associated with locomotive syndrome progression, while low muscle mass or low muscle function was not associated with locomotive syndrome. Gaining muscle mass accompanied by an increased muscle function for older adults is warranted to prevent locomotive syndrome progression in the super-aged society.
Ginkgo biloba extract alleviates fatty liver hemorrhagic syndrome in laying hens via reshaping gut microbiota
Authors: Yang Xinyue , Li Depeng , Zhang Meihong , Feng Yuqing , Jin Xiaolu , Liu Dan , Guo Yuming , Hu Yongfei
Published: August 2023

Background

Ginkgo biloba extract (GBE) is evidenced to be effective in the prevention and alleviation of metabolic disorders, including obesity, diabetes and fatty liver disease. However, the role of GBE in alleviating fatty liver hemorrhagic syndrome (FLHS) in laying hens and the underlying mechanisms remain to be elucidated. Here, we investigated the effects of GBE on relieving FLHS with an emphasis on the modulatory role of GBE in chicken gut microbiota.

Results

The results showed that GBE treatment ameliorated biochemical blood indicators in high-fat diet (HFD)-induced FLHS laying hen model by decreasing the levels of TG, TC, ALT and ALP. The lipid accumulation and pathological score of liver were also relieved after GBE treatment. Moreover, GBE treatment enhanced the antioxidant activity of liver and serum by increasing GSH, SOD, T-AOC, GSH-PX and reducing MDA, and downregulated the expression of genes related to lipid synthesis (FAS, LXRα, GPAT1, PPARγ and ChREBP1) and inflammatory cytokines (TNF-α, IL-6, TLR4 and NF-κB) in the liver. Microbial profiling analysis revealed that GBE treatment reshaped the HFD-perturbed gut microbiota, particularly elevated the abundance of Megasphaera in the cecum. Meanwhile, targeted metabolomic analysis of SCFAs revealed that GBE treatment significantly promoted the production of total SCFAs, acetate and propionate, which were positively correlated with the GBE-enriched gut microbiota. Finally, we confirmed that the GBE-altered gut microbiota was sufficient to alleviate FLHS by fecal microbiota transplantation (FMT).

Conclusions

We provided evidence that GBE alleviated FLHS in HFD-induced laying hens through reshaping the composition of gut microbiota. Our findings shed light on mechanism underlying the anti-FLHS efficacy of GBE and lay foundations for future use of GBE as additive to prevent and control FLHS in laying hen industry.
Examining the psychometric properties of the Norwegian version of the Social Aptitudes Scale in two clinical samples
Authors: Kaiser Sabine , Mathiassen Børge , Handegård Bjørn Helge , Arnesen Yngvild , Halvorsen Marianne Berg
Published: August 2023

Background

Few studies have examined the psychometric properties of the Social Aptitudes Scale (SAS). The study aims of the current paper were to examine the internal consistency and the validity of the Norwegian SAS.

Methods

Parents of children from a clinical neuropediatric sample (N = 257) and from a clinical sample from child and adolescent’s mental health services (N = 804) filled in the SAS.

Results

Internal consistency for the SAS were good in both samples and correlations between the SAS and different scales were in the expected directions. The results from the Confirmatory Factor Analyses indicated poor model fit.

Conclusions

Future validity studies should investigate whether SAS is suitable as a screening instrument for detecting autism spectrum disorder.
“I miss the normalness”: Mother and child perspectives of well-being and effective remote support from primary schools during Covid-19 school closures
Authors: Lacey Alison J. , Banerjee Robin , Dockalova Lucie , Lester Kathryn J.
Published: August 2023

Background

Covid-19 related school closures radically disrupted children’s access to social and educational opportunities and changed daily life for millions of families across the world. Emerging evidence indicates that, overall, closures were associated with a decline in children’s mental health and well-being, although individual experiences varied widely. The extent to which primary schools adapted remote well-being support is likely to have contributed to child and family adjustment, although this has not yet been fully explored in Covid related research.

Methods

This longitudinal qualitative study examines variability in remote well-being provision in primary schools during the pandemic, and following school reopening, from the perspective of mothers and children using a whole school approaches framework. Twenty-one primary school aged children and their mothers took part in a semi-structured interview at two time points: time one during the first UK national lockdown and time two approximately seven months later after most children had returned to school. A hybrid inductive-deductive thematic analysis approach identified key themes relating to trajectories of well-being and remote school approaches over this period.

Results

School closures were associated with a decline in well-being for most children. Disrupted contact with friends and teachers, and limited opportunities for enriched, meaningful activity were identified as key risk factors. Protective factors included family and child characteristics that mitigated against the loss of wider systems of support, including family socioeconomic status, parental availability, child temperament, and structured daily routines. Four key dimensions of effective remote well-being provision were identified (the 4Cs). The 4Cs - contact, content, creativity and community – provide an accessible framework for schools to foster children’s social relationships and sense of belonging during periods of closure. Analysis of pupil reintegration outcomes suggest that post-Covid support priorities should include extending social and play-based universal interventions in schools.

Conclusion

Remote well-being support for children during Covid-related school closures varied in quality with implications for children’s mental health and well-being. Findings from this study highlight the importance of ongoing social contact and enriched daily activities to protect children’s well-being and development and present a framework of effective remote wellbeing support for primary schools in the event of future closures or prolonged pupil absence.
Investigation and analysis of porcine epidemic diarrhea cases and evaluation of different immunization strategies in the large-scale swine farming system
Authors: Zhang Bingzhou , Qing Jie , Yan Zhong , Shi Yuntong , Wang Zewei , Chen Jing , Li Junxian , Li Shuangxi , Wu Weisheng , Hu Xiaofang , Li Yang , Zhang Xiaoyang , Wu Lili , Zhu Shouyue , Yan Zheng , Wang Yongquan , Guo Xiaoli , Yu Ligen , Li Xiaowen
Published: August 2023

Background

Porcine epidemic diarrhea (PED) is a contagious intestinal disease caused by porcine epidemic diarrhea virus (PEDV) characterized by vomiting, diarrhea, anorexia, and dehydration, which has caused huge economic losses around the world. However, it is very hard to find completely valid approaches to control the transmission of PEDV. At present, vaccine immunity remains the most effective method. To better control the spread of PED and evaluate the validity of different immunization strategies, 240 PED outbreak cases from 577 swine breeding farms were collected and analyzed. The objective of the present study was to analyze the epidemic regularity of PEDV and evaluate two kinds of different immunization strategies for controlling PED.

Results

The results showed that the main reasons which led to the outbreak of PED were the movement of pig herds between different pig farms (41.7%) and delaying piglets from the normal production flow (15.8%). The prevalence of PEDV in the hot season (May to October) was obviously higher than that in the cold season (January to April, November to December). Results of different vaccine immunity cases showed that immunization with the highly virulent live vaccine (NH-TA2020 strain) and the commercial inactivated vaccine could significantly decrease the frequency of swine breeding farms (5.9%), the duration of PED epidemic (1.70 weeks), and the week batches of dead piglets (0.48 weeks weaned piglets), compared with immunization with commercial attenuated vaccines and inactivated vaccine of PED. Meanwhile, immunization with the highly virulent live vaccine and the commercial inactivated vaccine could bring us more cash flows of Y̶275,274 per year than immunization with commercial live attenuated vaccine and inactivated vaccine in one 3000 sow pig farm within one year.

Conclusion

Therefore, immunization with highly virulent live vaccine and inactivated vaccine of PED is more effective and economical in the prevention and control of PED in the large-scale swine farming system.
Integration policies and migrants' labour market outcomes: a local perspective based on different regional configurations in the EU
Authors: De Coninck David , Solano Giacomo
Published: August 2023

Migrants’ integration process and their labour market inclusion occur within distinct local contexts. However, the existing literature has paid little attention to the role of the local context and its relationship with national-level policy outcomes on migrant integration. This study addresses this gap by using new regional (NUTS-2) data from Eurostat and integration policy data from MIPEX, coupled with multivariate analyses. We investigate how national-level integration policies are related to the employment rate gap between migrants and country nationals, and how this relationship varies depending on the local context. Results show that migrant integration policies exhibit no association with this gap in low-competitive, culturally homogeneous and rural regions. Conversely, integration policies are associated with a larger gap in high-competitive and diverse urban regions. Notably, consistent with previous national-level literature, inclusive integration policies are associated with negative outcomes for migrants compared to country nationals. However, a shift toward more inclusive policies is found to reduce this gap, suggesting that inclusive policies may be a response to a widening divide between country nationals and migrants. This study offers valuable insights into the role of regional configurations and the impact of national-level integration policies on migrants' labor market outcomes, providing a local perspective that enhances our understanding of migrant integration processes.
Basal procalcitonin, C-reactive protein, interleukin-6, and presepsin for prediction of mortality in critically ill septic patients: a systematic review and meta-analysis
Authors: Molano-Franco Daniel , Arevalo-Rodriguez Ingrid , Muriel Alfonso , del Campo-Albendea Laura , Fernández-García Silvia , Alvarez-Méndez Ana , Simancas-Racines Daniel , Viteri Andres , Sanchez Guillermo , Fernandez-Felix Borja , Lopez-Alcalde Jesus , Solà Ivan , Osorio Dimelza , Khan Khalid Saeed , Nuvials Xavier , Ferrer Ricard , Zamora Javier ,   the SEPSIS-BIOMARKERS Collaborators, Estupiñan Alvaro , Franco Luis , Cardenas Jorge , Robayo Ivan , Villabon Mario , Gomez Mario , Stalling Elena , Alvarez Noelia
Published: August 2023

Background

Numerous biomarkers have been proposed for diagnosis, therapeutic, and prognosis in sepsis. Previous evaluations of the value of biomarkers for predicting mortality due to this life-threatening condition fail to address the complexity of this condition and the risk of bias associated with prognostic studies. We evaluate the predictive performance of four of these biomarkers in the prognosis of mortality through a methodologically sound evaluation.

Methods

We conducted a systematic review a systematic review and meta-analysis to determine, in critically ill adults with sepsis, whether procalcitonin (PCT), C-reactive protein (CRP), interleukin-6 (IL-6), and presepsin (sCD14) are independent prognostic factors for mortality. We searched MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials up to March 2023. Only Phase-2 confirmatory prognostic factor studies among critically ill septic adults were included. Random effects meta-analyses pooled the prognostic association estimates.

Results

We included 60 studies (15,681 patients) with 99 biomarker assessments. Quality of the statistical analysis and reporting domains using the QUIPS tool showed high risk of bias in > 60% assessments. The biomarker measurement as a continuous variable in models adjusted by key covariates (age and severity score) for predicting mortality at 28–30 days showed a null or near to null association for basal PCT (pooled OR = 0.99, 95% CI = 0.99–1.003), CRP (OR = 1.01, 95% CI = 0.87 to 1.17), and IL-6 (OR = 1.02, 95% CI = 1.01–1.03) and sCD14 (pooled HR = 1.003, 95% CI = 1.000 to 1.006). Additional meta-analyses accounting for other prognostic covariates had similarly null findings.

Conclusion

Baseline, isolated measurement of PCT, CRP, IL-6, and sCD14 has not been shown to help predict mortality in critically ill patients with sepsis. The role of these biomarkers should be evaluated in new studies where the patient selection would be standardized and the measurement of biomarker results.

Trial registration

PROSPERO (CRD42019128790).
Blastic plasmacytoid dendritic cell neoplasm: challenges in diagnosis and treatment with potential of venetoclax as an alternative to vincristine in high-risk patients—a case report
Authors: Syed Naveed , Jaber Waed Mohammad , Elkonaissi Islam Samir , Mirza Imran , Damlaj Moussab
Published: August 2023

Background

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and challenging cancer for diagnosis and treatment. Accurate diagnosis plays a crucial role guiding appropriate treatment, typically involving high-intensity lymphoblastic leukemia regimens which typically include vincristine. However, the use of vincristine may be particularly limited in patients with pre-existing neuropathy or individuals at high risk of developing it. Here, we present a case of BPDCN that was initially diagnosed as marginal zone lymphoma (MZL) and subsequently as non-specific T-cell lymphoma, thus highlights the importance of accurate diagnosis and modified treatment.

Case presentation

A 49-year-old Arab man with a medical history of diabetes, peripheral neuropathy, hypertension, and depression presented with widespread, painless multiple skin lesions. After undergoing a biopsy at another institution, the patient was initially diagnosed with MZL, and received two cycles of bendamustine and rituximab. However, the disease relapsed and was later diagnosed with non-specific T-cell lymphoma, which proved refractory to a single cycle of CHOP chemotherapy. The patient was subsequently referred to our centre, where a comprehensive evaluation revealed BPDCN with a unique finding on bone marrow exam: signet ring plasmacytoid dendritic cells. Due to the patient's pre-existing neuropathy and previous treatment, we administered the Hyper-CVAD regimen with a 50% reduction in vincristine dosage, which resulted in an excellent response. During the second part of cycle one, when new skin lesions started appearing, venetoclax was added to the treatment regimen. Subsequently, we discontinued vincristine due to worsening neuropathic pain and neuropathy-related weakness. Venetoclax was continued in cycle two and led to a complete response. The patient achieved a disease-free state for the first time in disease course, maintaining it for a period of over six weeks before experiencing a relapse.

Conclusions

Accurate diagnosis is crucial for guiding appropriate treatment. Our case highlights the challenges associated with diagnosis and treatment, as well as the potential of venetoclax as an alternative to vincristine, particularly in patients with pre-existing neuropathy or those at a high risk of developing it. Further research is needed to evaluate the effectiveness of BCL2 inhibitors as a replacement for essential drugs and its potential as a bridging therapy until patients can undergo a stem cell transplant.
Mapping the course to recovery: a prospective study on the anatomic distribution of early postoperative pain after total knee arthroplasty
Authors: Mekkawy Kevin L. , Zhang Bo , Wenzel Alyssa , Harris Andrew B. , Khanuja Harpal S. , Sterling Robert S. , Hegde Vishal , Oni Julius K.
Published: August 2023

Introduction

Early postoperative pain following total knee arthroplasty significantly impacts outcomes and patient satisfaction. However, the characteristics and sources of early pain after total knee arthroplasty remain unclear. Therefore, the purpose of this study was to determine the anatomic distribution and course of postoperative pain in the acute and subacute period following total knee arthroplasty.

Methods

A prospective observational study of primary, elective unilateral total knee arthroplasty cases was conducted at our academic tertiary care medical center from January 2021 to September 2021. Preoperative variables were extracted from institutional electronic medical records. Postoperatively, patients utilized a knee pain map to identify the two locations with the most significant pain and rated it using the visual analog scale (VAS). The data were collected on day 0, at 2 weeks, 2 months, and 6 months after operation.

Results

This study included 112 patients, with 6% of patients having no pain at postoperative day 0, 22% at 2 weeks, 46% at 2 months, and 86% at 6 months after operation. In those who reported pain, the VAS score (mean ± standard deviation) was 5.8 ± 2.4 on postoperative day 0 and decreased at each follow-up time point (5.4 ± 2.3 at 2 weeks, 3.9 ± 2.2 at 2 months, and 3.8 ± 2.7 at 6 months). The majority of patients were able to identify distinct loci of pain. The most common early pain loci were patellae, thigh, and medial joint line, and this distribution dissipated by 6 months.

Conclusion

At 2 postoperative weeks, pain was primarily at the medial joint, and at 6 months postoperatively, pain was more likely to be at the lateral joint. No relationship was found between pain at six months and pain scores or location at postoperative day 0 or 2 weeks. Understanding the distribution and progression of knee pain following total knee arthroplasty may benefit patient education and targeted interventions.

Level of Evidence

Level II, prospective observational study
Survival of putative Lacticaseibacillus paracasei C1I12 after supplementation of marang (Artocarpus odoratissimus) juice
Authors: Calumba Kriza Faye A. , Demerey Carmina M. , Villame Rovi Gem E. , Palangga Zarryn D. , Tagubase Jackie Lou J.
Published: August 2023

The demand for non-dairy functional beverages is increasing. Marang (Artocarpus odoratissimus) is an underutilized fruit in the Philippines. This study aimed to assess the survival of putative Lacticaseibacillus paracasei C1I12 strain previously isolated from Nypa fruticans after supplementation of marang juice. At the end of 30 days of storage at 4 ºC, the viable cell count was significantly higher in the supplemented marang juice (8.17 log CFU/mL) compared to the raw marang juice (5.07 log CFU/mL) (P < 0.05). Cell counts in the juice with putative L. paracasei C1I12 were 7 log CFU/mL after 180 min in simulated gastric and intestinal fluids. Aerobic bacteria and coliforms were not detected in assessing the initial microbiological quality of the raw marang juice. The pH was 3.38 and 3.84 for the juice with putative L. paracasei C1I12 and the raw marang juice, respectively, while the total soluble solids reached 10.58°Brix and 14.00°Brix, respectively. This study shows that inoculation with the C1I12 strain ensured high cell counts in the marang juice after in vitro digestion. This is the first study demonstrating the potential of putative L. paracasei C1I12 in the production of a non-dairy marang beverage which can be further explored for functional food and probiotic applications.

Graphical Abstract
Preoperative CT-based radiomics for diagnosing muscle invasion of bladder cancer
Authors: Ren Jingyi , Gu Hongmei , Zhang Ni , Chen Wang
Published: August 2023

Background

The primary objective of the research was to develop a method using radiomics-based computed tomography (CT) to predict muscle invasion in bladder cancer (BCa) before surgery.

Methods

A total of 269 patients with bladder cancer were divided into two groups; training group (n = 188 cases) and validation group (n = 81 cases). Radiomics characteristics were determined by analyzing the CT images of each patient. The least absolute shrinkage and selection operator (LASSO) technique was used for developing a radiomics signature. Furthermore, logistic regression (LR), the support vector machine (SVM), decision tree (DT), and Artificial Neural Network (ANN) models were applied to differentiate between non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC). Their performance was determined using the area under the receiver operating characteristic curve (AUC-ROC). In addition, accuracy, specificity, and sensitivity evaluations were also conducted.

Results

The radiomics signature was found to be successful in its prediction. A total of 1036 radiomics features were found in the 269 patients, and out of those, 16 were selected as the best predictors of radiomics features. The results revealed that the ANN classifier had the best performance, with a validation set accuracy of 0.950.

Conclusions

The current work used machine learning and radiomics techniques to successfully construct a prediction model for muscle invasion in bladder cancer. The ANN model produced significant outcomes that may be used in clinical diagnosis or therapy.
Recurrent aneurysm 11 years after thoracoabdominal aortic replacement due to recanalization of intercostal arteries of the wrapping native aorta in Marfan syndrome: a case report
Authors: Tanaka Shun , Yamauchi Haruo , Minegishi Sachito , Ono Minoru
Published: August 2023

Background

Persistent blood flow is common in aortic aneurysms following endovascular repair. However, the recanalization of thrombosed intercostal arteries after open aortic repair is rare. We report a case of aortic aneurysm recurrence 11 years after thoracoabdominal aortic replacement resulting from recanalization of the intercostal arteries like a type II endoleak in a patient with Marfan syndrome.

Case presentation

A 50-year-old woman with Marfan syndrome presented with left-sided back pain after meals. She underwent abdominal aortic replacement at 35 years of age, distal aortic arch and thoracoabdominal aortic replacement for type B chronic aortic dissection at 38 years of age, and aortic root to the remnant arch replacement with a mechanical valve conduit for type A acute aortic dissection at 43 years of age, which resulted in complete replacement of the entire aorta with prosthetic grafts. The patient has been taking warfarin since then. The prothrombin time-international normalized ratio levels were controlled almost within the range of 1.5–2.5 during the follow-up period, but it was elevated up to 3.4 at 1 month before she felt back pain and kept high at 4.2 on admission. Enhanced computed tomography (CT) revealed an aneurysm between the descending graft and the remaining native aortic wall, compressing the esophagus. However, there were no abnormal findings on the CT performed 10 months prior to admission. Surgery revealed that the orifices of the intercostal arteries were patent with backflow. We closed the patent intercostal arteries using nonabsorbable sutures. The patient’s postoperative course was uneventful, and the CT performed 1 year later showed no aneurysmal recurrence.

Conclusions

Here, we describe a rare case of recurrent aortic aneurysm long term after graft replacement due to recanalization of the intercostal arteries of the remaining aortic wall. Our findings suggest that closing all orifices of the intercostal arteries during aortic repair, regardless of backflow, could prevent delayed reopening; systemic anticoagulation after aortic replacement may be a risk factor for recanalization, and that postoperative periodic CT follow-up is essential, especially in patients receiving anticoagulant therapy.
Combining unsupervised deep learning and Monte Carlo dropout for seismic data reconstruction and its uncertainty quantification
Authors: Chen Gui , Liu Yang
Published: August 2023

Many methods, such as multichannel singular spectrum analysis (MSSA) and deep seismic prior (DSP), have been developed for seismic data reconstruction, but they do not quantify the uncertainty of reconstructed traces, relying on the subjective visual inspection of results. Our goal is to quantify the reconstructed uncertainty while recovering missing traces. We develop a framework including an unsupervised deep-learning-based seismic data reconstruction method and the existing Monte Carlo dropout method to achieve this goal. The only information required by our framework is the original incomplete data. A convolutional neural network trained on the original nonmissing traces can simultaneously denoise and reconstruct seismic data. For uncertainty quantification, the Monte Carlo dropout method treats the well-known dropout technique as Bayesian variational inference. This refers to the fact that the dropout technique can be regarded as an approximation to the probabilistic Gaussian process and thus can be used to obtain an approximate distribution (Bernoulli variational distribution) of the posterior distribution. The reconstructed result and uncertainty of the trained model are yielded through multiple Monte Carlo dropout simulations. The analysis of the reconstructed uncertainty quantifies the confidence to use reconstructed traces. Tests on synthetic and field data illustrate that our framework outperforms the MSSA and DSP methods on reconstructed accuracy and quantifies the reconstructed uncertainty as an objective benchmark to guide decision making.