bluuebunny/crossref_metadata_2025 huggingface dataset:
Age-related changes of human serum Sirtuin6 in adults
Authors: Zhao Ying , Bai Xiangli , Jia Xiong , Lu Yajing , Cheng Wenzhuo , Shu Meng , Zhu Yan , Zhu Lin , Wang Li , Shu Yan , Song Yi , Jin Si
Published: August 2021

Background

Aging is a natural life process and with an aging population, age-related diseases (e.g. type 2 diabetes mellitus (T2DM), atherosclerosis-based cardiovascular diseases) are the primary mortality cause in older adults. Telomerase is often used as an aging biomarker. Detection and characterization of novel biomarkers can help in a more specific and sensitive identification of a person’s aging status. Also, this could help in age-related diseases early prevent, ultimately prolonging the population’s life span. Sirtuin 6 (Sirt6) - a member of the Sirtuins NAD+-dependent histone deacetylases family - is mainly intracellularly expressed, and is reported to be involved in the regulation of aging and aging-related diseases. Whether serum Sirt6 is correlated with aging and could be used as an aging biomarker is unknown. In the present study, we aimed to investigate the age-related Sirt6 changes in the serum of human adults.

Methods

Participants were divided into three groups according to age: 20–30 years (Young); 45–55 years (Middle-aged); and ≥ 70 years (Old). The Sirt6 and telomerase serum concentrations were determined by ELISA. The Sirt6 and human telomerase reverse transcriptase (hTERT) expression in vessels from amputated human lower limbs were analyzed using real-time quantitative PCR (RT-qPCR) and immunohistochemical staining. The relationships between variables were evaluated by Pearson correlation analysis.

Results

The Sirt6 and telomerase serum levels reduced with an increase in age. A similar tendency was observed for Sirt6 and hTERT in the vessel. Serum levels of Sirt6 were higher in females compared with males. Pearson’s regression analysis revealed that the Sirt6 serum level positively correlated with telomerase (r = 0.5743) and both were significantly negatively correlated with age (r = − 0.5830 and r = − 0.5993, respectively).

Conclusions

We reported a negative correlation between serum Sirt6 concentration and aging in human beings. Therefore, the Sirt6 serum level is a potential sex-specific aging marker.
Epidemiological characteristics of hand, foot, and mouth disease in Yunnan Province, China, 2008–2019
Authors: Jiang Li , Jiang Hongchao , Tian Xin , Xia Xueshan , Huang Tian
Published: August 2021

Background

Since 2016, enterovirus 71 (EV71) vaccines have been approved for market entry, and little is known about how the epidemiology of hand, foot, and mouth disease (HFMD) has been affected by the introduction of the vaccines in Yunnan Province. The study describes the epidemiological characteristics of HFMD before and after the introduction of EV71 vaccination in Yunnan Province.

Methods

Surveillance data collected between 2008 and 2019 were analyzed to produce epidemiological distribution on cases, etiologic composition, and EV71 vaccination coverage, as well as to compare these characteristics before and after EV71 vaccination.

Results

A total of 1,653,533 children received EV71 vaccines from 2016 through 2019 in Yunnan. The annual EV71 vaccination coverage rate ranged from 5.53 to 15.01% among children ≤5 years old. After the introduction of EV71 vaccines, the overall incidence of HFMD increased and reached over 200 cases per 100,000 population-years in 2018 and 2019. However, the case severity and case fatality rate decreased and remained lower than 1 and 0.005% after 2016, respectively. EV71-associated mild, severe and fatal cases sharply decreased. The predominant viral serotype changed to non-EV71/non-CV-A16 enteroviruses which were detected across the whole province.

Conclusions

Non-EV71/non-CV-A16 enteroviruses became the predominant strain and led to a higher incidence in Yunnan. Expanding EV71 vaccination and strengthening laboratory-based surveillance could further decrease the burden of severe HFMD and detect and monitor emerging enteroviruses.
Analysis of the causes and influencing factors of fetal loss in advanced maternal age: a nested case-control study
Authors: Wang Xiaomei , Lin Yuan , Liu Zhaozhen , Huang Xinxin , Chen Rongxin , Huang Huihui
Published: August 2021

Background

The risk of fetal loss is higher among ≥35-year-olds than younger women. The present study aimed to explore the causes and factors influencing fetal loss in advanced maternal age (AMA).

Methods

AMA women with singleton fetuses (< 14 gestational weeks) who underwent their first prenatal examination in the Obstetrics Department of Fujian Maternity and Child Health Hospital from December 2018 to June 2020 were included in this cohort study. Those who terminated the pregnancy before 14 gestational weeks were excluded. A baseline survey was conducted, and follow-up was carried out until the termination of the pregnancy. Clinical data were extracted to analyse the causes of fetal loss among them. In the nested case-control study, the AMA women with fetal loss were enrolled as the case group, and women without fetal loss in the same period were enrolled as the control group, in a 1:2 ratio matched by age and gestational weeks. Logistic regression models were used to analyse the factors influencing fetal loss.

Results

A total of 239 women with fetal loss and 478 controls were enrolled. The causes of fetal loss were most often fetal factors, followed by maternal factors, umbilical cord factors, and placental factors. Multivariate logistic regression analysis indicated that junior high school education and below (adjusted odds ratio (aOR) = 5.13, 95% confidence interval (CI): 2.19–12.02), senior high school education (aOR = 4.91, 95% CI: 2.09–11.54), residence in a rural area (aOR = 2.85, 95% CI: 1.92–4.25), unemployment (aOR = 1.81, 95% CI: 1.20–2.71), spontaneous abortion history (aOR = 1.88, 95% CI: 1.26–2.80), preterm birth history (aOR = 11.08, 95% CI: 2.90–42.26), hypertensive disorders of pregnancy (aOR = 7.20, 95% CI: 2.24–23.12), and preterm premature rupture of membranes (aOR = 4.12, 95% CI: 1.53–11.11) were risk factors for fetal loss.

Conclusions

Low educational level, unemployment, abnormal pregnancy/labor history, and pregnancy complications were correlated with the incidence of fetal loss in AMA. Thus, early identification as well as a targeted intervention, should be conducted.
Integrating HECW1 expression into the clinical indicators exhibits high accuracy in assessing the prognosis of patients with clear cell renal cell carcinoma
Authors: Wang Chao , Dong Keqin , Wang Yuning , Peng Guang , Song Xu , Yu Yongwei , Shen Pei , Cui Xingang
Published: August 2021

Abstracts

Background

Although many intratumoral biomarkers have been reported to predict clear cell renal cell carcinoma (ccRCC) patient prognosis, combining intratumoral and clinical indicators could predict ccRCC prognosis more accurately than any of these markers alone. This study mainly examined the prognostic value of HECT, C2 and WW domain-containing E3 ubiquitin protein ligase 1 (HECW1) expression in ccRCC patients in combination with established clinical indicators.

Methods

The expression level of HECW1 was screened out by data-independent acquisition mass spectrometry (DIA-MS) and analyzed in ccRCC patients from the The Cancer Genome Atlas (TCGA) database and our cohort. A total of 300 ccRCC patients were stochastically divided into a training cohort and a validation cohort, and real-time PCR, immunohistochemistry (IHC) and statistical analyses were employed to examine the prognostic value of HECW1 in ccRCC patients.

Results

The expression level of HECW1 usually decreased in human ccRCC specimens relative to control specimens in TCGA (p < 0.001). DIA-MS, Real-time PCR, and IHC analyses also showed that the majority of ccRCCs harbored decreased HECW1 expression compared with that in normal adjacent tissues (p < 0.001). Additionally, HECW1 expression was reduced in ccRCC cell lines compared with the normal renal cell line HK-2 (p < 0.001). Moreover, lower HECW1 expression was found in ccRCC patients with a higher tumor node metastasis (TNM) stage, bone metastasis, or first-line targeted drug resistance (p < 0.001). Low HECW1 expression indicated higher TNM stage, SSIGN (Stage, Size, Grade, and Necrosis) score and WHO/ISUP grade and poor prognosis in ccRCC patients (p < 0.05). Even after multivariable adjustment, HECW1, TNM stage, and SSIGN score served as independent risk factors. The c-index analysis showed that integrating intratumoral HECW1 expression into TNM stage or SSIGN score resulted in a higher c-index value than these indicators alone for predicting ccRCC patient prognosis.

Conclusion

HECW1 is a novel prognostic biomarker and therapeutic target in ccRCC, and integrating intratumoral HECW1 expression with established clinical indicators yields higher accuracy in assessing the postoperative prognosis of ccRCC patients.
Digital learning in medical education: comparing experiences of Malaysian and Japanese students
Authors: Jun Xin L. , Ahmad Hathim A. A. , Jing Yi N. , Reiko A. , Noor Akmal Shareela I.
Published: August 2021

Background

Medical education has undergone a transformation from conventional to digital learning, enabling learning without any time and place restrictions. Nevertheless, the actual trends of usage and its impact on learning motivation among medical students between developed and developing nations are yet to be investigated. Hence, this study compares the effect of digital learning on learning motivation among Malaysian and Japanese medical students in Universiti Kebangsaan Malaysia (UKM) and Shiga University of Medical Science (SUMS) respectively.

Methods

A modified Students Motivation towards Science Learning (SMTSL) was used to assess the digital learning usage and learning motivation among 150 UKM and 147 SUMS medical students throughout Year 1 to 5.

Results

The frequency of digital learning usage and learning motivation among UKM medical students was significantly higher as compared to SUMS (p < 0.001). Electronic books (e-books) were the most preferred source of digital learning among UKM medical students as compared to SUMS medical students who used research articles, e-books, online courses and videos at similar frequencies. UKM medical students in the clinical phase exhibited a significantly higher learning motivation as compared to preclinical students (p < 0.05) but not among SUMS medical students.

Conclusion

A suitable learning environment should be developed to encourage digital learning usage among different levels of medical students to enhance its complementary role in medical education and augment the level of motivation among medical students in continuous lifelong learning.
Hospital nurses’ knowledge regarding older patients: a multicenter study
Authors: Derks Christel T. A. J. , Hutten - van den Elsen Marjo M. G. M. , Hakvoort Lysette J. , van Mersbergen Mariëlle P. J. ,   RENurse Consortium, Schuurmans Marieke J. , Dikken Jeroen
Published: August 2021

Background

Nursing care in hospitals increasingly involves older adults. A nursing workforce able to care for the ageing population is therefore critical for ensuring quality older adult care. Gaining insight in the knowledge and attitudes of nurses regarding older patients in the Netherlands is needed to develop and increase the impact of education- and quality improvement programs which can positively influence nurses’ knowledge and attitudes regarding older patients.

Methods

A cross-sectional multicenter study was performed. Data was collected in ten tertiary medical teaching hospitals well spread across the Netherlands (89 wards, 2902 nurses). Knowledge levels were measured using the Knowledge about Older Patient-Quiz (KOP-Q), consisting of 30 true-false questions. Knowledge levels of registered nurses are compared with knowledge levels known from literature of first year nursing students; last year nursing students; nurses; and nurse specialist. Potential associated factors considered were: age; sex; education; experience; opinions and preferences. Opinion and preferences regarding working with older patients were measured by three questions: 1) which patient group nurses preferred to work with; 2) how nurses feel about the increase of older patients in the hospital; and 3) whether nurses find it difficult to care for older patients.

Results

From all wards, a representative sample of 1743 registered hospital nurses working on all 89 wards participated. On all wards, a large range in knowledge levels is observed between nurses, with 37% of nurses presenting knowledge levels comparable with nursing student and 31% of nurses presenting knowledge levels comparable with nurse specialists. Knowledge is related to age (p < .001), work experiences (p < .001), preparatory secondary education (p < .001) and nurses education level (p = .012). A minority (12.5%) prefers working with older patients and most nurses do not find it difficult.

Conclusions

This study shows that there is a large diversity in knowledge levels of Dutch hospital nurses in every hospital, on every ward. A majority of nurses demonstrate negative opinions and preferences. This implies that older patients admitted can receive different levels of quality of care on the same day as nurses with different knowledge levels provide care during the various shifts. Findings demonstrate an urgent need for education programs with themes regarding essential care for older patients in the Netherlands.
Treating patients with opioid overdose at a primary care emergency outpatient clinic: a cost-minimization analysis
Authors: Vibeto Jon Hjellum , Vallersnes Odd Martin , Dobloug Andrea , Brekke Mette , Jacobsen Dag , Ekeberg Øivind , Wangen Knut Reidar
Published: August 2021

Background

Treating patients with acute poisoning by substances of abuse in a primary care emergency clinic has previously been shown to be a safe strategy. We conducted an economic evaluation of this strategy compared to hospital treatment, which is the usual strategy.

Methods

Assuming equal health outcomes, we conducted a cost-minimization analysis. We constructed a representative opioid overdose patient based on a cohort of 359 patients treated for opioid overdose at the Oslo Accident and Emergency Outpatient Clinic (OAEOC) from 1.10.2011 to 30.9.2012. Using a health care system perspective, we estimated the expected resources used on the representative patient in primary care based on data from the observed OAEOC cohort and on information from key informants at the OAEOC. A likely course of treatment of the same patient in a hospital setting was established from information from key informants on provider procedures at Drammen Hospital, as were estimates of hospital use of resources. We calculated expected costs for both settings. Given that the treatments usually last for less than one day, we used undiscounted cost values.

Results

The estimated per patient cost in primary care was 121 EUR (2018 EUR 1.00 = NOK 9.5962), comprising 97 EUR on personnel costs and 24 EUR on treatment costs. In the hospital setting, the corresponding cost was 612 EUR, comprising 186 EUR on personnel costs, 183 EUR on treatment costs, and 243 EUR associated with intensive care unit admission. The point estimate of the cost difference per patient was 491 EUR, with a low-difference scenario estimated at 264 EUR and a high-difference scenario at 771 EUR.

Conclusions

Compared to hospital treatment, treating patients with opioid overdose in a primary care setting costs substantially less. Our findings are probably generalizable to poisoning with other substances of abuse. Implementing elements of the OAEOC procedure in primary care emergency clinics and in hospital emergency departments could improve the use of health care resources.
Association between Veterans Aging Cohort Study (VACS) index and neurocognitive function among people living with HIV–a cross sectional study in coastal South India
Authors: Ganapathy Archana , Achappa Basavaprabhu , Kulkarni Vaman , Madi Deepak , Holla Ramesh , Bhaskaran Unnikrishnan , Rathi Priya , Mahalingam Soundarya , Dsouza Nikhil Victor
Published: August 2021

Background

HIV is an infectious disease affecting 36.7 million people worldwide. In recent times, Antiretroviral Therapy (ART) has become accessible to the majority of People Living with HIV (PLHIV) and this has transformed the course of infection to one that is chronic, characterized by fewer diseases pathognomonic of AIDS. In view of this, there is a pressing need for better markers, apart from the routine HIV indicators, to detect comorbidities such as Neurocognitive Impairment (NCI). The aim of this study was to find out the association between Veterans Aging Cohort Study (VACS) index and Neurocognitive function in HIV positive patients.

Methods

In our study, we included 97 HIV positive patients and their Neurocognitive function was assessed using a combination of Montreal Cognitive Assessment and Grooved Pegboard Test, while VACS index was calculated using the most recent laboratory values. Binomial Logistics Regression analyses, adjusting for potential confounding variables, was performed to determine the association between VACS score and Neurocognitive Impairment.

Results

We found that a higher VACS Index was associated with global and domain-wise Neurocognitive impairment (p < 0.01), specifically in the domains of attention (p < 0.01) and fine motor skills (p = 0.01). Our study also showed that among all the VACS components, older age (p = 0.02) and lower hemoglobin (p < 0.01) values were associated with global NCI. After plotting an ROC curve, a VACS cut-off score of 11.00 was identified as it had good sensitivity (87.0%) and specificity (71.4%) in identifying Global NCI.

Conclusion

Our findings extend prior research on the use of VACS Index to predict global and domain-wise NCI in HIV-positive patients. However, further research with more comprehensive neurocognitive testing is required in our setting before VACS Index can be used as a tool to screen for neurocognitive dysfunction among PLHIV.
Noise constrains the evolution of call frequency contours in flowing water frogs: a comparative analysis in two clades
Authors: Zhao Longhui , Santos Juan C. , Wang Jichao , Ran Jianghong , Tang Yezhong , Cui Jianguo
Published: August 2021

Background

The acoustic adaptation hypothesis (AAH) states that signals should evolve towards an optimal transmission of the intended information from senders to intended receivers given the environmental constraints of the medium that they traverse. To date, most AAH studies have focused on the effect of stratified vegetation on signal propagation. These studies, based on the AAH, predict that acoustic signals should experience less attenuation and degradation where habitats are less acoustically complex. Here, we explored this effect by including an environmental noise dimension to test some AAH predictions in two clades of widespread amphibians (Bufonidae and Ranidae) that actively use acoustic signals for communication. By using data from 106 species in these clades, we focused on the characterization of the differences in dominant frequency (DF) and frequency contour (i.e., frequency modulation [FM] and harmonic performances) of mating calls and compared them between species that inhabit flowing-water or still-water environments.

Results

After including temperature, body size, habitat type and phylogenetic relationships, we found that DF differences among species were explained mostly by body size and habitat structure. We also showed that species living in lentic habitats tend to have advertisement calls characterized by well-defined FM and harmonics. Likewise, our results suggest that flowing-water habitats can constrain the evolutionary trajectories of the frequency-contour traits of advertisement calls in these anurans.

Conclusions

Our results may support AAH predictions in frogs that vocalize in noisy habitats because flowing-water environments often produce persistent ambient noise. For instance, these anurans tend to generate vocalizations with less well-defined FM and harmonic traits. These findings may help us understand how noise in the environment can influence natural selection as it shapes acoustic signals in affected species.
Validation of the Indonesian version of the foot and ankle score in patients with chronic lateral ankle instability
Authors: Adhitya I Putu Gde Surya , Yu Wen‐Yu , Saraswati Putu Ayu Sita , Winaya I Made Niko , Lin Mau‐Roung
Published: August 2021

Background

This study aimed to examine the psychometric performance of the Foot and Ankle Outcome Score (FAOS) used in Indonesian patients with chronic lateral ankle instability (CLAI).

Methods

The FAOS was translated into Indonesian through standardized procedures. Among 224 patients with unilateral CLAI recruited from 14 physical therapy clinics during a 1‐year period, reliabilities, construct validities, and responsiveness levels of the FAOS were examined. Active and passive range of motion of ankle dorsiflexion or plantiflexion, figure‐of‐eight, numeric pain rating scale (NPRS), and Short Form (SF)‐36 were used to test the construct validities.

Results

The five subscales indicated adequate internal consistency (Cronbach's alpha, 0.74 ~ 0.96) and interrater test‐retest reliabilities (interclass correlation coefficients, 0.80 ~ 0.94). Subscales of the FAOS moderately converged with those selected measures with similar constructs ( values, 0.32 ~ 0.53), with the exception of the correlation of pain with the NPRS (, ‐0.06). Results of the principal component analysis showed that the five‐factor structure of the FAOS was appropriate for the Indonesian data, although six items (four in the pain and two in the other symptoms (OSs) subscales) did not perfectly fit their original subscales. Guyatt's responsiveness index for the FAOS's subscales changed in the SF‐36's physical function over a 1‐month period and ranged 0.37 to 1.27.

Conclusions

The Indonesian version of the FAOS demonstrated acceptable reliabilities and responsiveness, and fair construct validities among CLAI patients, although certain items in the pain and OSs subscales may need to be further explored and improved.
A quantitative analysis of extension and distribution of lung injury in COVID-19: a prospective study based on chest computed tomography
Authors: Pellegrini Mariangela , Larina Aleksandra , Mourtos Evangelos , Frithiof Robert , Lipcsey Miklos , Hultström Michael , Segelsjö Monica , Hansen Tomas , Perchiazzi Gaetano
Published: August 2021

Background

Typical features differentiate COVID-19-associated lung injury from acute respiratory distress syndrome. The clinical role of chest computed tomography (CT) in describing the progression of COVID-19-associated lung injury remains to be clarified. We investigated in COVID-19 patients the regional distribution of lung injury and the influence of clinical and laboratory features on its progression.

Methods

This was a prospective study. For each CT, twenty images, evenly spaced along the cranio-caudal axis, were selected. For regional analysis, each CT image was divided into three concentric subpleural regions of interest and four quadrants. Hyper-, normally, hypo- and non-inflated lung compartments were defined. Nonparametric tests were used for hypothesis testing (α = 0.05). Spearman correlation test was used to detect correlations between lung compartments and clinical features.

Results

Twenty-three out of 111 recruited patients were eligible for further analysis. Five hundred-sixty CT images were analyzed. Lung injury, composed by hypo- and non-inflated areas, was significantly more represented in subpleural than in core lung regions. A secondary, centripetal spread of lung injury was associated with exposure to mechanical ventilation (p < 0.04), longer spontaneous breathing (more than 14 days,p < 0.05) and non-protective tidal volume (p < 0.04). Positive fluid balance (p < 0.01), high plasma D-dimers (p < 0.01) and ferritin (p < 0.04) were associated with increased lung injury.

Conclusions

In a cohort of COVID-19 patients with severe respiratory failure, a predominant subpleural distribution of lung injury is observed. Prolonged spontaneous breathing and high tidal volumes, both causes of patient self-induced lung injury, are associated to an extensive involvement of more central regions. Positive fluid balance, inflammation and thrombosis are associated with lung injury.

Trial registrationStudy registered a priori the 20th of March, 2020. Clinical Trials ID NCT04316884.
Musculoskeletal practices for the preparticipation physical examination
Authors: Corrente Connor , Silvis Matthew , Murphy Joseph , Gallo Robert , Onks Cayce
Published: August 2021

Background

Little is known about the musculoskeletal (MSK) exam providers use during the Preparticipation Physical Examination (PPE). The primary aims of this study were to determine current practice with regards to the MSK screening exam, if goals are being met, and if there may be opportunities for improvement.

Methods

This cross-sectional survey-based study utilized a REDCap instrument that was distributed to members of the American Academy of Family Physicians (AAFP) and the American Medical Society for Sports Medicine (AMSSM). Questions focused on participant demographics and MSK exam practices for the PPE. Descriptive statistics were used.

Results

The study had a total of 616 participants with a response rate of 9 %. The majority of respondents (82 %) were familiar with the 4th Edition PPE Monograph and 80 % either moderately or strongly agreed that they use this as a guideline for their MSK screening exam. The 90 s MSK screening test was implemented by 52 % of the participants. The majority of participants use an orthopedic exam as part of their PPE (82 %). Ninety-two percent of participants felt satisfied that their MSK exam would screen for current injury, while only 42 % were satisfied that it effectively screened for future injury. 86 % of participants agree that the MSK exam should be performed, while 26 % said that they don’t perform a physical exam at all.

Discussion

There is a lack of understanding of the PPE Monograph as there is wide variability in MSK screening techniques providers use despite the majority of participants being familiar with the guidelines described in the monograph. Additionally, providers don’t believe that the MSK exam screens for future injury.

Conclusions

The goals of the MSK portion of the 4th Edition PPE monograph are not adequately being met and there is a need for further research to validate screening exams for the prevention of MSK injury.
A new stability result for a thermoelastic Bresse system with viscoelastic damping
Authors: Mukiawa Soh Edwin , Enyi Cyril Dennis , Apalara Tijani Abdulaziz
Published: August 2021

We investigate a thermoelastic Bresse system with viscoelastic damping acting on the shear force and heat conduction acting on the bending moment. We show that with weaker conditions on the relaxation function and physical parameters, the solution energy has general and optimal decay rates. Some examples are given to illustrate the findings.
Abortion care in a pandemic: an analysis of the number and social profile of people requesting and receiving abortion care during the first COVID-19 lockdown (March 16 to June 14, 2020) in Flanders, Belgium
Authors: De Kort Leen , Wood Jonas , Wouters Edwin , Van de Velde Sarah
Published: August 2021

Background

The COVID-19 pandemic and the national COVID-19 measures might have increased potential barriers to abortion care and created new ones, especially for vulnerable groups. This study documents the impact of the pandemic and the lockdown measures on the profile of people going through the abortion process.

Methods

Using anonymized patient records from a Belgian abortion centre, we first compared the number of abortion requests and procedures during the first COVID-19 lockdown with the same months in the five preceding years. Next, we analysed the social profile of people requesting an abortion in those two time periods and looked at the number of long-acting reversible contraceptive devices (LARC) placed after curettage.

Results

The abortion centre saw a drop in the number of abortion requests during the lockdown. This difference was more pronounced for people in paid employment and people using (modern) contraception. People were also more likely to request an abortion earlier in their pregnancy. The drop in abortion procedures and LARC’s placed after curettage was proportionate to the drop in abortion requests and did not differ according to clients’ characteristics.

Conclusion

Questions arose concerning the potential selectivity with which COVID-19 influenced the need for abortion care and accessibility to services. Although there was a general drop in abortion requests and procedures during the first COVID-19 lockdown in the studied abortion centre, our results suggest that the profile of people requesting and receiving an abortion did only slightly change during the lockdown, and did not affect vulnerable groups visibly harder.
The limits of clinical findings in similar phenotypes, from Carpenter to ATRX syndrome using a whole exome sequencing approach: a case review
Authors: Sáenz Samantha S. , Arias Benjamin , Hosomichi Kazuyoshi , Romero Vanessa I.
Published: August 2021

Background

The diagnostic process for uncommon disorders with similar manifestations is complicated and requires newer technology, like gene sequencing for a correct diagnosis.

Main body

We described two brothers clinically diagnosed with Carpenter syndrome, which is a condition characterized by the premature fusion of certain skull bones (craniosynostosis), abnormalities of the fingers and toes, and other developmental problems, for which they underwent craniotomies. However, whole exome sequencing analysis concluded a novel pathological variation in the ATRX chromatin remodeler gene and protein remodeling demonstrated structural variations that decreased the function, giving a completely different diagnosis to these patients.

Conclusion

Our study focuses on the importance of using newer technologies, such as whole exome sequencing analysis, in patients with ambiguous phenotypes.
Metabolic and transcriptomic profiles of glioblastoma invasion revealed by comparisons between patients and corresponding orthotopic xenografts in mice
Authors: Cudalbu Cristina , Bady Pierre , Lai Marta , Xin Lijing , Gusyatiner Olga , Hamou Marie-France , Lepore Mario , Brouland Jean-Philippe , Daniel Roy T. , Hottinger Andreas F. , Hegi Monika E.
Published: August 2021

The invasive behavior of glioblastoma, the most aggressive primary brain tumor, is considered highly relevant for tumor recurrence. However, the invasion zone is difficult to visualize by Magnetic Resonance Imaging (MRI) and is protected by the blood brain barrier, posing a particular challenge for treatment. We report biological features of invasive growth accompanying tumor progression and invasion based on associated metabolic and transcriptomic changes observed in patient derived orthotopic xenografts (PDOX) in the mouse and the corresponding patients’ tumors. The evolution of metabolic changes, followed in vivo longitudinally by 1H Magnetic Resonance Spectroscopy (1H MRS) at ultra-high field, reflected growth and the invasive properties of the human glioblastoma transplanted into the brains of mice (PDOX). Comparison of MRS derived metabolite signatures, reflecting temporal changes of tumor development and invasion in PDOX, revealed high similarity to spatial metabolite signatures of combined multi-voxel MRS analyses sampled across different areas of the patients’ tumors. Pathway analyses of the transcriptome associated with the metabolite profiles of the PDOX, identified molecular signatures of invasion, comprising extracellular matrix degradation and reorganization, growth factor binding, and vascular remodeling. Specific analysis of expression signatures from the invaded mouse brain, revealed extent of invasion dependent induction of immune response, recapitulating respective signatures observed in glioblastoma. Integrating metabolic profiles and gene expression of highly invasive PDOX provided insights into progression and invasion associated mechanisms of extracellular matrix remodeling that is essential for cell–cell communication and regulation of cellular processes. Structural changes and biochemical properties of the extracellular matrix are of importance for the biological behavior of tumors and may be druggable. Ultra-high field MRS reveals to be suitable for in vivo monitoring of progression in the non-enhancing infiltration zone of glioblastoma.
Aortic root repair in a patient with acquired hemophilia A: case report
Authors: Gok Emre , Akay Mehmet H. , de Armas Ismael Salas , Klein Kimberly , Tint Hlaing , Allison Paul M. , Chen Alice J. , Akkanti Bindu , Kar Biswajit , Gregoric Igor D.
Published: August 2021

Background

Patients with acquired hemophilia A (AHA) who require open heart surgery have a life-threatening risk of hemorrhage. Limited data exist to guide perioperative management of these patients.

Case presentation

A 53-year-old female with rheumatoid arthritis, concomitant aortic valve endocarditis, and severe aortic regurgitation presented to our hospital. Bleeding and abnormal coagulation tests were noted during the initial workup, and she was diagnosed with AHA. The perioperative management plan included the use of pharmaceuticals, porcine recombinant factor VIII, and blood products. Extensive preoperative coagulation data were obtained, and factor VIII levels were continuously monitored to mitigate bleeding complications. The aortic valve replacement and root repair were uneventful.

Conclusion

Cardiac surgery in patients with AHA is possible as long as complex perioperative hemostatic and hematology management is used.
Successful limb salvage beyond the golden time following blunt traumatic open complete transection of the femoral artery and vein in a patient with cardiac arrest: a case report
Authors: Himura Hoshi , Uchida Kenichiro , Miyashita Masahiro , Mizobata Yasumitsu
Published: August 2021

Background

Open complete transection of the femoral artery and vein following blunt trauma is extremely rare. Furthermore, even if the patient has been successfully resuscitated, it is sometimes difficult in most patients to preserve the injured limb, especially after damage control resuscitation. We report a case of open complete transection of the femoral artery and vein secondary to high-energy blunt trauma and a successful limb preservation treatment strategy.

Case presentation

A 57-year-old Asian man was transferred to hospital after having fallen from the 15th floor of a condominium. The patient was in cardiac arrest at the scene, but was successfully resuscitated by emergency medical services staff. On arrival, the patient’s hemodynamics were completely collapsed with active external bleeding from the thigh, so we immediately started resuscitation including activation of massive transfusion protocol and temporarily ligated the transected proximal superficial femoral artery, deep femoral artery just distal after branching lateral femoral circumflex artery and the superficial femoral vein. Following radiological findings showing a potential pelvic fracture with active bleeding, we also performed retroperitoneal packing in the resuscitation room and moved the patient to the angiography room for transcatheter arterial embolization. The patient’s consciousness was preserved and perfusion of the injured limb was barely maintained after his hemodynamics were adequately stabilized. As we detected weak perfusion of the lower limb via a potential collateral flow from the lateral femoral circumflex artery branches from deep femoral artery by pulse doppler of the dorsal pedis artery, we decided to reconstruct superficial femoral artery and vein at 24 h after injury using great saphenous vein bypass grafts. The patient was transferred to a rehabilitation hospital with good neurological and limb outcome after hospitalization for 52 days.

Conclusion

We successfully preserved the patient’s lower limb after cardiac arrest and complete transection of the femoral artery and vein and achieved a good neurological outcome. Even if a femoral artery needs to be ligated temporarily, careful observation and assessment should be performed so as not to lose the chance to salvage the limb even during damage control resuscitation.
Inheritance and reflection: “re-study” of three anthropology fieldwork sites in China’s Yunnan Province
Authors: Wang Mingming
Published: August 2021

This article is a research report involving three anthropological studies conducted during the period of “Kuige” and their “re-studies.” By narrating the project, I set forth my views on the connections and differences between Chinese anthropological explorations from two historical periods. These anthropological explorations refer to the study of Lu Village conducted by Fei Xiaotong, that of “West Town” (Xizhou) by Francis L. K. Hsu, and that of “Pai-IPai” (Dai) villages by Tien Ju-Kang. They were all completed in the late 1930s and early 1940s. Each writer extracted a framework to analyze the land system, ancestor worship, and the relationship between humans and gods from the writer’s own field experience. Despite the difference in research methods, all three studies noticed the cultural differences between rural society and modernity. Since 2000, Peking University and Yunnan Minzu University have launched a “Province-university Cooperation Project.” During the project, a research team formed of several young scholars revisited Lu Village, “West Town” (Xizhou), and Namu Village. These writers’ works were based on the data acquired in their fieldwork and drew upon the opinions raised by global anthropologists on “re-study” in recent decades. Considering the dual effects of social change and shifts in academic concepts around “follow-up research,” the scholars put forward several points of view with their ethnographies, which all featured the characteristics of inheritance and reflection. Based on the results of the three “re-studies,” this article emphasizes the importance of the study of public rituals for the research of rural society. This article also attempts to re-examine the methodology of “human ecology,” which profoundly impacts Chinese anthropology and sociology.
Tracking the dissemination of Erwinia amylovora in the Eurasian continent using a PCR targeted on the duplication of a single CRISPR spacer
Authors: Kurz Mirjam , Carnal Simon , Dafny-Yelin Mery , Mairesse Orly , Gottsberger Richard A. , Ivanović Milan , Grahovac Mila , Lagonenko Alexander L. , Drenova Nataliya , Zharmukhamedova Galiya , Doolotkeldieva Tinatin , Smits Theo H. M. , Rezzonico Fabio
Published: August 2021

Fire blight is the most devastating disease affecting pome fruit production globally. The pathogen is native to North America and was imported to western Europe in the 1950s, progressively spreading over the continent in the ensuing decades. Previous phylogenetic studies have revealed the extreme genetic homogeneity of the pathogen outside its center of origin, which makes epidemiological studies difficult. These are generally only possible using hypervariable regions of the genome such as those represented by CRISPRs (Clustered Regularly Interspaced Short Palindromic Repeats), which are, however, not practical to sequence due to their size and variability. Here, we present a simple PCR assay targeting the duplication of a single CRISPR spacer in Erwinia amylovora that was found to be an important marker to discriminate between two main European populations of the pathogen. We implemented the assay on a total of 582 isolates to follow the spread of fire blight across the continent over several decades and, wherever possible, within single countries. The results obtained point to the occurrence of two major separate introduction events for E. amylovora in Europe that occurred approximately 20 years apart, and confirmed the existence of two principal distribution areas located in Northeastern Europe and the Eastern Mediterranean Basin from which the pathogen moved on to colonize the Eurasian continent.
Comparison of intrinsic exercise capacity and response to acute exercise in ICR (Institute of Cancer Research) mice derived from three different lineages
Authors: Hwang Dong-Joo , Kwon Ki-Chun , Choi Dong-Hun , Song Hyun-Keun , Kim Kil-Soo , Jung Young-Suk , Hwang Dae-Youn , Cho Joon-Yong
Published: August 2021

Background

As a laboratory animal resource, the ICR mouse is commonly used in a variety of research fields. However, information on differences in exercise-related characteristics in ICR mice derived from different lineages and the underlying mechanisms remains to be elucidated. In this study, we investigated the intrinsic exercise capacity and a magnitude of response to acute exercise, and sought to identify mechanisms contributing to difference in Korl:ICR (a novel ICR lineage recently established by the National Institute of Food and Drug Safety Evaluation, Korea) and two commercialized ICR lineages derived from different origins (viz., A:ICR mouse from Orient Bio Com, the United States, and B:ICR mouse from Japan SLC Inc., Japan).

Results

Results showed that despite no significant difference in body weight and weight-proportioned tissue mass of heart and skeletal muscles among groups, the relatively low intrinsic exercise capacity and exaggerated response to acute exercise were identified in B:ICR comparted with Korl:ICR and A:ICR, as reflected by total work and lactate threshold (LT). Also, the mitochondrial efficiency expressed as the complex 1 and complex 1 + 2 respiratory control ratio (RCR) values for cardiac mitochondrial O2consumption in B:ICR was significantly lower than that in Korl:ICR with higher level of state 2 respiration by glutamate/malate and UCP3 expression in cardiac muscle.

Conclusions

Taken together, these results indicate that the intrinsic exercise capacity of ICR mouse varies according to lineages, suggesting the role of cardiac mitochondrial coupling efficiency as a possible mechanism that might contribute to differences in the intrinsic exercise capacity and magnitude of response to exercise.
Correlation between CT chest severity score (CT-SS) and ABO blood group system in Egyptian patients with COVID-19
Authors: Mansour Mohamed G. , Abdelrahman Ahmed S. , Abdeldayem Emad H.
Published: August 2021

Background

The 2019 coronavirus disease (COVID-19) has become a global health crisis. CT chest is considered as an important investigation for early diagnosis as well as assessment of severity of COVID-19 pneumonia. Several articles reported that there is a correlation between ABO blood group system and susceptibility as well as prognosis of the disease. In our study we correlated the CT severity score (CT-SS) and the ABO blood group in patients with COVID-19 infection. This study involved 547 symptomatic patients with pathologically proven COVID-19 infection (positive PCR); non contrast CT chest was done for all cases and CT severity score (CT-SS) was calculated followed by its correlation with the patients’ ABO blood group. Aim of the work was to evaluate the relation between CT-SS and the ABO blood groups in Egyptian patients with COVID-19 infection.

Results

The mean CT-SS in patients with blood group A patients (n = 153; 28%) was 13.7 (moderate severity), while in patients with blood group O (n = 227; 41.5%) the mean CT-SS was 6.7 (mild severity). In blood group B patients (n = 139; 25.4%) the mean CT-SS was 9.1 (mild to moderate severity) and in blood group AB patients (n = 28; 5.1%) the mean CT-SS was 9.7 (mild to moderate severity).

Conclusion

COVID-19 patients with blood group A are more prone to aggressive CT findings (higher CT-SS) and consequently may be susceptible to increased risk of mortality compared to the patients with other blood groups; however, patients with blood group O are suggested to have the least CT-SS and appear to be relatively protected.
Gravimetry and petrophysics for defining the intracratonic and rift basins of the Western-Central Africa zone
Authors: Maddaloni Francesca , Pivetta Tommaso , Braitenberg Carla
Published: August 2021

The global gravity field obtained from the observations of the satellite Gravity Field and Steady-State Ocean Circulation Explorer (GOCE) satellite offers new opportunities in defining density variations of earth’s crust and mantle, allowing new insights into the structure of specific geologic features. The Central African Rift is a key feature in understanding the dismemberment of Gondwana, and we contribute to defining the crustal density structure underlying the rift. The presence of a narrow and up to 12 km deep basin implies crustal stretching allowed the sediment to accumulate, but a key question is whether the stretching processes also affected the deeper layers of the crust or was limited to the upper crust. The study area includes a subbasin of the greater Chad sag basin, which extends over 1500 × 1500 km and occupies the center of North-Central Africa, shared between the countries of Chad, Sudan, Nigeria, Niger, Algeria, Libya, and Cameroon. We find that the rifting affected the lower crust of the West African Rift, and we evaluate evidence for a 1500 km long and several km thick magmatic crustal intrusion presumably associated with underplating and crustal thinning. We estimate that the stretching factor must be at least 1.5 and had affected the entire crust. To our knowledge, the identification of a continuous body of magmatic intrusions is new and has been only possible through the recent global gravity field. The magmatism has altered the thermal conditions from the time of emplacement on, and it is relevant for the maturation of hydrocarbons present in the sediments. The timing of the magmatism is presumably tied to two pulses of volcanism documented in the rift, associated with the first postrift phase from 96 to 88 Ma and the second postrift phase from 23 Ma up to the Quaternary.
Peripartum Diagnosis of Currarino Syndrome With Anterior Sacral Meningocele: A Case Report
Authors: Neumann Kaitlyn E. , Pappas Helen , McCrory Emery H.
Published: August 2021

Neurologic conditions without prenatal optimization can pose anesthetic and obstetrical challenges. We present a case of Currarino syndrome; an autosomal dominant triad of agenesis of the sacrum, anterior sacral meningocele (ASM) with sacral teratomas, and anorectal stenosis; diagnosed during pregnancy; and the subsequent anesthetic considerations. The location, size, and risk of rupture of the ASM can create obstacles to delivery. Eligibility for neuraxial anesthesia should be made on a case-by-case basis with risk-benefit analysis, and deficits should be documented allowing prompt identification and intervention should complications arise. Multidisciplinary team coordination is vital to help facilitate maternal safety.