bluuebunny/crossref_metadata_2025 huggingface dataset:
What does it mean that all is aflame? Non-axial Buddhist inspiration for an Anthropocene ontology
Authors: Hannes Tom , Bombaerts Gunter
Published: February 2023

Bruno Latour’s “practical climatoscepticism” expresses our moral inhibition with respect to the climate crisis. In spite of Clive Hamilton’s claim that the Anthropocene condition requires us to be suspicious of all previous (i.e. Holocene) ontologies, we propose a threefold Anthropocene ontological structure inspired by non-axial Buddhist elements. In the ontological field, the overall domain in which meaning is searched for, the Buddhist relationalist view on existence can nurture post-humanist philosophies. For the ontological home, one’s specific position and responsibilities, the Buddhist concept “dharma-position” can feed into Hamilton’s “new anthropocentrism.” For the ontological path, the ideal qualities of our interactions, the Buddhist “brahmaviharas” can lend functional structure to the tensions between philosophies of radical acceptance and engaged action. We discuss how this threefold ontological structure provides partial answers to Latour’s “practical climatoscepticism” and Hamilton’s no-analogue world. We sketch avenues for investigation for various Anthropocene ontologies.
Measuring Economic Development and Carbon Dioxide Emissions Inefficiency
Authors: Wu Jih-Shong
Published: February 2023

Excessive emissions of greenhouse gases have exacerbated global climate change, and the use of fossil fuels is the main reason for the rapid rise of CO2 in the atmosphere. In this study, stochastic frontier analysis is employed to measure the causal relationship between GDP growth and fossil fuel use for CO2 inefficiency of APEC member economies. The empirical results revealed a significant positive correlation between them and found that member economies with a high per capita GDP, such as Singapore, effectively mitigate CO2 emissions. This result revealed that high income standards lead to emphasis on environmental protection. China and the United States are the top two CO2 emitters and should actively formulate carbon reduction strategies for economic development and energy utilization. This study calls for both developing and developed countries to gradually adopt and increase renewable energy and develop low-carbon technologies to reduce greenhouse gas emissions and jointly address the challenges of climate change.
Nurse Managers’ Involvement in Decision-Making and Associated Factors in Selected Government Hospitals, Addis Ababa, Ethiopia: A Cross-Sectional Study
Authors: Tazebew Chalie , Mulugeta Tefera , Boka Abdissa
Published: February 2023

Introduction

In the healthcare system, nurse managers’ participation in decision-making was invaluable in preserving cost-effective service and safe patient care. Despite the fact that nurse managers have the power to ensure optimal health care service, their involvement in decision-making has not been well studied.

Objectives

To assess nurse managers’ decision-making involvement and associated factors working in selected governmental hospitals in Addis Ababa, Ethiopia 2021.

Methods

A cross-sectional study was conducted among 176 nurse managers from government hospitals in Addis Ababa, with a response rate of 168 (95.5%). The total sample size is assigned in proportion. The technique of systematic random sampling was used. A structured, self-administered questionnaire was used to collect data, which was then checked, cleaned, entered into EPI Info version 7.2, and exported to SPSS software version 25 for analysis. In a binary logistic regression model analysis, a p-value < .25 was used as the cut-off point to consider variables as candidates for multivariable analysis. A p-value of .05 was used to determine the predictor variables with a 95% confidence interval.

Result

The mean age and standard deviation of the 168 respondents were 34.9 ± 4.1 years. More than half, 97 (57.7%), were excluded from general decision-making. Nurse managers in matron positions were 10 times more likely to participate in decision-making than head nurses (AOR = 10.00, 95% CI: 1.14–87.72, p = .038). Nurse managers who received managerial support were five times more likely to participate in good decision-making than nurse managers who did not receive managerial support (AOR = 5.29, 95% CI: 1.208–23.158, p = .027). Nurse managers who received feedback on their decision-making involvement had 7.7 times more good decision-making involvement than those who did not (AOR = 7.70, 95% CI: 2.482–23.911, p = .000).

Conclusion

According to the findings of the study, the majority of nurse managers were not involved in decision-making.
The Cost of Multimodal vs Opioid Postoperative Pain Regimens for the Foot & Ankle Surgical Patient
Authors: Kelly William D. , Jackson J. Benjamin , Bian Julia
Published: February 2023

Category:

Other; Other

Introduction/ Purpose:

Orthopedic surgeons are one of the highest prescribing specialties of opioids in medicine. To address the ongoing opioid crisis in the United States, many surgeons have adopted multimodal regimens for post-operative pain control to decrease the need for opioids. Recent studies have demonstrated the effectiveness of opioid-sparing multimodal pain management therapies when compared to opioid inclusive therapies. However, to date there are no published studies analyzing the cost of multimodal vs opioid postoperative pain regimens for the elective foot & ankle surgical post-surgical patient.

Methods:

A secondary analysis of data collected from two studies that evaluated pain control after elective forefoot surgery was analyzed. The index study examined the number of opioid pills consumed post-operatively. A follow-up then examined the clinical utility of the non-opioid pain regimen for pain control post-operatively. Medications in the non-opioid multimodal regimen included cyclobenzaprine, ketorolac, meloxicam, pregabalin, and acetaminophen. Using information collected during these two studies, deidentified patient profiles were constructed using the patient’s insurance carrier and preferred pharmacy to determine the cost of each patient’s post-operative regimen (narcotics vs multimodal). All patients, 40 patients from the multimodal pain pathway study and 59 from the opioid pain control study, were included in this analysis and their prescription costs were totaled and analyzed.

Results:

A box plot was constructed to visualize data and identify outliers to be removed for data analysis. Prescriptions in the opioid group had an average cost of $8.92 (SD=$5.74) while the multimodal group had an average cost of $25.60 (SD=$10.49), p

Conclusion:

Patients whose post-operative pain was managed by an opioid-free multimodal regimen had statistically significant higher prescription costs than with opioid monotherapy regardless of health insurance type. However, the difference may not be clinically significant as on average it was $17. As more studies demonstrate the effectiveness of opioid-free post-operative pain management, it may be reassuring to surgeons that despite a greater number of medications with the multimodal protocol the average cost difference was only about $17. This information may allow surgeons to prescribe this regimen to all patients regardless of socioeconomic status and continue to decrease post-operative opioid prescriptions.
TAK-981, a SUMOylation inhibitor, suppresses AML growth immune-independently
Authors: Kim Han Sun , Kim Bo-Reum , Dao Thien T. P. , Kim Jin-Mo , Kim Yoon-Ju , Son Hyunsong , Jo Sihyang , Kim Doyeon , Kim Jiwoo , Suh Young Ju , Kim Hee-Je , Cho Byung-Sik , Park Sunghyouk
Published: February 2023

Acute myeloid leukemia (AML) generally has an unsatisfactory prognosis despite the recent introduction of new regimens, including targeted agents and antibodies. To find a new druggable pathway, we performed integrated bioinformatic pathway screening on large OHSU and MILE AML databases, discovered the SUMOylation pathway, and validated it independently with an external data set (totaling 2959 AML and 642 normal sample data). The clinical relevance of SUMOylation in AML was supported by its core gene expression which is correlated with patient survival, European LeukemiaNet 2017 risk classification, and AML-relevant mutations. TAK-981, a first-in-class SUMOylation inhibitor currently under clinical trials for solid tumors, showed antileukemic effects with apoptosis induction, cell-cycle arrest, and induction of differentiation marker expression in leukemic cells. It exhibited potent nanomolar activity, often stronger than that of cytarabine, which is part of the standard of care. TAK-981’s utility was further demonstrated in in vivo mouse and human leukemia models as well as patient-derived primary AML cells. Our results also indicate direct and cancer cell-inherent anti-AML effects by TAK-981, different from the type 1 interferon and immune-dependent mechanism in a previous solid tumor study. Overall, we provide a proof-of-concept for SUMOylation as a new targetable pathway in AML and propose TAK-981 as a promising direct anti-AML agent. Our data should prompt studies on optimal combination strategies and transitions to clinical trials in AML.
Patterns of human and porcine gammaherpesvirus-encoded BILF1 receptor endocytosis
Authors: Mavri Maša , Glišić Sanja , Senćanski Milan , Vrecl Milka , Rosenkilde Mette M. , Spiess Katja , Kubale Valentina
Published: February 2023

Background

The viral G-protein-coupled receptor (vGPCR) BILF1 encoded by the Epstein–Barr virus (EBV) is an oncogene and immunoevasin and can downregulate MHC-I molecules at the surface of infected cells. MHC-I downregulation, which presumably occurs through co-internalization with EBV-BILF1, is preserved among BILF1 receptors, including the three BILF1 orthologs encoded by porcine lymphotropic herpesviruses (PLHV BILFs). This study aimed to understand the detailed mechanisms of BILF1 receptor constitutive internalization, to explore the translational potential of PLHV BILFs compared with EBV-BILF1.

Methods

A novel real-time fluorescence resonance energy transfer (FRET)-based internalization assay combined with dominant-negative variants of dynamin-1 (Dyn K44A) and the chemical clathrin inhibitor Pitstop2 in HEK-293A cells was used to study the effect of specific endocytic proteins on BILF1 internalization. Bioluminescence resonance energy transfer (BRET)-saturation analysis was used to study BILF1 receptor interaction with β-arrestin2 and Rab7. In addition, a bioinformatics approach informational spectrum method (ISM) was used to investigate the interaction affinity of BILF1 receptors with β-arrestin2, AP-2, and caveolin-1.

Results

We identified dynamin-dependent, clathrin-mediated constitutive endocytosis for all BILF1 receptors. The observed interaction affinity between BILF1 receptors and caveolin-1 and the decreased internalization in the presence of a dominant-negative variant of caveolin-1 (Cav S80E) indicated the involvement of caveolin-1 in BILF1 trafficking. Furthermore, after BILF1 internalization from the plasma membrane, both the recycling and degradation pathways are proposed for BILF1 receptors.

Conclusions

The similarity in the internalization mechanisms observed for EBV-BILF1 and PLHV1-2 BILF1 provide a foundation for further studies exploring a possible translational potential for PLHVs, as proposed previously, and provides new information about receptor trafficking.

Graphical Abstract
Comparative transcriptome analysis reveals the regulatory mechanisms of two tropical water lilies in response to cold stress
Authors: Ma Xiangyu , Jin Qijiang , Wang Yanjie , Wang Xiaowen , Wang Xuelian , Yang Meihua , Ye Chunxiu , Yang Zhijuan , XU Yingchun
Published: February 2023

Background

Tropical water lily is an aquatic plant with high ornamental value, but it cannot overwinter naturally at high latitudes. The temperature drop has become a key factor restricting the development and promotion of the industry.

Results

The responses of Nymphaea lotus and Nymphaea rubra to cold stress were analyzed from the perspective of physiology and transcriptomics. Under the cold stress, Nymphaea rubra had obvious leaf edge curling and chlorosis. The degree of peroxidation of its membrane was higher than that of Nymphaea lotus, and the content of photosynthetic pigments also decreased more than that of Nymphaea lotus. The soluble sugar content, SOD enzyme activity and CAT enzyme activity of Nymphaea lotus were higher than those of Nymphaea rubra. This indicated that there were significant differences in the cold sensitivity of the two varieties. GO enrichment and KEGG pathway analysis showed that many stress response genes and pathways were affected and enriched to varying degrees under the cold stress, especially plant hormone signal transduction, metabolic pathways and some transcription factor genes were from ZAT gene family or WKRY gene family. The key transcription factor ZAT12 protein in the cold stress response process has a C2H2 conserved domain, and the protein is localized in the nucleus. Under the cold stress, overexpression of the NlZAT12 gene in Arabidopsis thaliana increased the expression of some cold-responsive protein genes. The content of reactive oxygen species and MDA in transgenic Arabidopsis thaliana was lower, and the content of soluble sugar was higher, indicating that overexpression of NlZAT12 can improve the cold tolerance of Arabidopsis thaliana.

Conclusion

We demonstrate that ethylene signalling and reactive oxygen species signalling play critical roles in the response of the two cultivars to cold stress. The key gene NlZAT12 for improving cold tolerance was identified. Our study provides a theoretical basis for revealing the molecular mechanism of tropical water lily in response to cold stress.
Elevated atmospheric CO2 concentrations caused a shift of the metabolically active microbiome in vineyard soil
Authors: Rosado-Porto David , Ratering Stefan , Wohlfahrt Yvette , Schneider Bellinda , Glatt Andrea , Schnell Sylvia
Published: February 2023

Background

Elevated carbon dioxide concentrations (eCO2), one of the main causes of climate change, have several consequences for both vine and cover crops in vineyards and potentially also for the soil microbiome. Hence soil samples were taken from a vineyard free-air CO2enrichment (VineyardFACE) study in Geisenheim and examined for possible changes in the soil active bacterial composition (cDNA of 16S rRNA) using a metabarcoding approach. Soil samples were taken from the areas between the rows of vines with and without cover cropping from plots exposed to either eCO2or ambient CO2(aCO2).

Results

Diversity indices and redundancy analysis (RDA) demonstrated that eCO2changed the active soil bacterial diversity in grapevine soil with cover crops (p-value 0.007). In contrast, the bacterial composition in bare soil was unaffected. In addition, the microbial soil respiration (p-values 0.04—0.003) and the ammonium concentration (p-value 0.003) were significantly different in the samples where cover crops were present and exposed to eCO2. Moreover, under eCO2conditions, qPCR results showed a significant decrease in 16S rRNA copy numbers and transcripts for enzymes involved in N2fixation and NO2−reduction were observed using qPCR. Co-occurrence analysis revealed a shift in the number, strength, and patterns of microbial interactions under eCO2conditions, mainly represented by a reduction in the number of interacting ASVs and the number of interactions.

Conclusions

The results of this study demonstrate that eCO2concentrations changed the active soil bacterial composition, which could have future influence on both soil properties and wine quality.
Resilience and stability of the CF- intestinal and respiratory microbiome during nutritional and exercise intervention
Authors: Knoll Rebecca L. , Jarquín-Díaz Víctor Hugo , Klopp Jonas , Kemper Alissa , Hilbert Katja , Hillen Barlo , Pfirrmann Daniel , Simon Perikles , Bähner Viola , Nitsche Oliver , Gehring Stephan , Markó Lajos , Forslund Sofia K. , Poplawska Krystyna
Published: February 2023

Background

Impaired respiratory and intestinal microbiome composition is linked to cystic fibrosis lung disease severity. In people with cystic fibrosis (pwCF), regular exercise is recommended to delay disease progression and preserve a stable lung function. An optimal nutritional status is vital for best clinical outcomes. Our study investigated whether regular and monitored exercise and nutritional support promotes CF microbiome health.

Methods

A personalized nutrition and exercise program promoted nutritional intake and physical fitness in 18 pwCF for 12 months. Throughout the study, patients performed strength and endurance training monitored by a sports scientist via an internet platform. After three months, food supplementation with Lactobacillus rhamnosus LGG was introduced. Nutritional status and physical fitness were assessed before the study started, after three and nine months. Sputum and stool were collected, and microbial composition was analyzed by 16S rRNA gene sequencing.

Results

Sputum and stool microbiome composition remained stable and highly specific to each patient during the study period. Disease-associated pathogens dominated sputum composition. Lung disease severity and recent antibiotic treatment had the highest impact on taxonomic composition in stool and sputum microbiome. Strikingly, the long-term antibiotic treatment burden had only a minor influence.

Conclusion

Despite the exercise and nutritional intervention, respiratory and intestinal microbiomes proved to be resilient. Dominant pathogens drove the composition and functionality of the microbiome. Further studies are required to understand which therapy could destabilize the dominant disease-associated microbial composition of pwCF.
Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio as prognostic predictors for delirium in critically ill patients: a systematic review and meta-analysis
Authors: Sarejloo Shirin , Shojaei Niloofar , Lucke-Wold Brandon , Zelmanovich Rebecca , Khanzadeh Shokoufeh
Published: February 2023

Introduction

In this systematic review and meta-analysis, we aim to analyze the current literature to evaluate neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) values among critically ill patients who develop delirium as compared to those who do not.

Methods

PubMed, Web of Science, and Scopus were used to conduct a systematic search for relevant publications published before June 12, 2022. The Newcastle–Ottawa scale was used for quality assessment. Because a significant level of heterogeneity was found, we used the random-effects model to generate pooled effects.

Results

Twenty-four studies including 11,579 critically ill patients, of whom 2439 were diagnosed with delirium, were included in our meta-analysis. Compared with the non-delirious group, the delirious group's NLR levels were significantly higher (WMD = 2.14; CI 95% = 1.48–2.80, p < 0.01). In the subgroup analysis according to the type of critical condition, the NLR levels in patients of delirious group were significantly more than those of non-delirious group in studies on POD, PSD and PCD (WMD = 1.14, CI 95% = 0.38–1.91, p < 0.01, WMD = 1.38, CI 95% = 1.04–1.72, p < 0.001, and WMD = 4.22, CI 95% = 3.47–4.98, p < 0.001, respectively). However, compared with the non-delirious group, the delirious group's PLR levels were not significantly different (WMD = 1.74; CI 95% = -12.39–15.86, p = 0.80).

Conclusion

Our findings support NLR to be a promising biomarker that can be readily integrated into clinical settings to aid in the prediction and prevention of delirium.
Changes in emergency psychiatric consultations in time of COVID-19: a retrospective observational study in the Verona Academic Hospital over the two pandemic years 2020–2021
Authors: Bodini Luca , Bonetto Chiara , Maccagnani Antonio , Bonora Antonio , Polati Enrico , Ricci Giorgio , Paolillo Ciro , Amaddeo Francesco , Lasalvia Antonio
Published: February 2023

Background

During the first months of the COVID-19 pandemic, local health authorities in most Italian regions prescribed a reduction of ordinary outpatient and community mental health care. The aim of this study was to assess the impact of the COVID-19 pandemic on access to the emergency departments (ED) for psychiatric consultation in the pandemic years 2020 and 2021 compared to 2019.

Methods

This is a retrospective study conducted by using routinely collected administrative data of the two EDs of the Verona Academic Hospital Trust (Verona, Italy). All ED psychiatry consultations registered from 01.01.2020 to 31.12.2021 were compared with those registered in the pre-pandemic year (01.01.2019 to 31.12.2019). The association between each recorded characteristic and the year considered was estimated by chi-square or Fisher’s exact test.

Results

A significant reduction was observed between 2020 and 2019 (-23.3%) and between 2021 and 2019 (-16.3%). This reduction was most evident in the lockdown period of 2020 (-40.3%) and in the phase corresponding to the second and third pandemic waves (-36.1%). In 2021, young adults and people with diagnosis of psychosis showed an increase in requests for psychiatric consultation.

Conclusions

Fear of contagion may have been an important factor in the overall reduction in psychiatric consultations. However, psychiatric consultations for people with psychosis and for young adults increased. This finding underlines the need for mental health services to implement alternative outreach strategies aimed to support, in times of crisis, these vulnerable segments of the population.
Emergency department care experiences among members of equity-deserving groups: quantitative results from a cross-sectional mixed methods study
Authors: Bartels Susan A. , MacKenzie Meredith , Douglas Stuart L. , Collier Amanda , Pritchard Jodie , Purkey Eva , Messenger David , Walker Melanie
Published: February 2023

Background

Emergency departments (EDs) serve an integral role in healthcare, particularly for vulnerable populations. However, marginalized groups often report negative ED experiences, including stigmatizing attitudes and behaviours. We engaged with historically marginalized patients to better understand their ED care experiences.

Method

Participants were invited to complete an anonymous mixed-methods survey about a previous ED experience. We analysed quantitative data including controls and equity-deserving groups (EDGs) - those who self-identified as: (a) Indigenous; (b) having a disability; (c) experiencing mental health issues; (d) a person who uses substances; (e) a sexual and gender minority; (f) a visible minority; (g) experiencing violence; and/or (h) facing homelessness - to identify differences in their perspectives. Differences between EDGs and controls were calculated with chi squared tests, geometric means with confidence ellipses, and the Kruskal-Wallis H test.

Results

We collected a total of 2114 surveys from 1973 unique participants, 949 controls and 994 who identified as equity-deserving. Members of EDGs were more likely to attribute negative feelings to their ED experience (p < 0.001), to indicate that their identity impacted the care received (p < 0.001), and that they felt disrespected and/or judged while in the ED (p < 0.001). Members of EDGs were also more likely to indicate that they had little control over healthcare decisions (p < 0.001) and that it was more important to be treated with kindness/respect than to receive the best possible care (p < 0.001).

Conclusion

Members of EDGs were more likely to report negative ED care experiences. Equity-deserving individuals felt judged and disrespected by ED staff and felt disempowered to make decisions about their care. Next steps will include contextualizing findings using participants’ qualitative data and identifying how to improve ED care experiences among EDGs to make it more inclusive and better able to meet their healthcare needs.
Propensity score analysis with missing data using a multi-task neural network
Authors: Yang Shu , Du Peipei , Feng Xixi , He Daihai , Chen Yaolong , Zhong Linda L. D. , Yan Xiaodong , Luo Jiawei
Published: February 2023

Background

Propensity score analysis is increasingly used to control for confounding factors in observational studies. Unfortunately, unavoidable missing values make estimating propensity scores extremely challenging. We propose a new method for estimating propensity scores in data with missing values.

Materials and methods

Both simulated and real-world datasets are used in our experiments. The simulated datasets were constructed under 2 scenarios, the presence (T = 1) and the absence (T = 0) of the true effect. The real-world dataset comes from LaLonde’s employment training program. We construct missing data with varying degrees of missing rates under three missing mechanisms: MAR, MCAR, and MNAR. Then we compare MTNN with 2 other traditional methods in different scenarios. The experiments in each scenario were repeated 20,000 times. Our code is publicly available athttps://github.com/ljwa2323/MTNN.

Results

Under the three missing mechanisms of MAR, MCAR and MNAR, the RMSE between the effect and the true effect estimated by our proposed method is the smallest in simulations and in real-world data. Furthermore, the standard deviation of the effect estimated by our method is the smallest. In situations where the missing rate is low, the estimation of our method is more accurate.

Conclusions

MTNN can perform propensity score estimation and missing value filling at the same time through shared hidden layers and joint learning, which solves the dilemma of traditional methods and is very suitable for estimating true effects in samples with missing values. The method is expected to be broadly generalized and applied to real-world observational studies.
Technology-enabled virtual ward for COVID management of the elderly and immunocompromised in Singapore: a descriptive cohort
Authors: Ko Stephanie Q. , Kumar Shoban Krishna , Jacob Jonathan , Hooi Benjamin M. Y. , Soo Michelle , Nashi Norshima , Cruz Maria Teresa D. , Wah Yeo Ai , Xin Wong Zhi , Smitasin Nares , Lum Lionel , Archuleta Sophia
Published: February 2023

Background

To address the hospital bed demand for Delta and Omicron surges in Singapore, the National University Health System (NUHS) developed a COVID Virtual Ward to relieve bed pressures on its three acute hospitals—National University Hospital, Ng Teng Fong General Hospital, Alexandra Hospital. To serve a multilingual population, the COVID Virtual Ward featuring protocolized teleconsultation of high-risk patients, use of a vital signs chatbot, supplemented by home visits where necessary. This study aims to evaluate the safety, outcomes and utilisation of the Virtual Ward as a scalable response to COVID-19 surges.

Methods

This is a retrospective cohort study of all patients admitted to the COVID Virtual Ward between 23 September to 9 November 2021. Patients were defined as “early discharge” if they were referred from inpatient COVID-19 wards and “admission avoidance” if they were referred directly from primary care or emergency services. Patient demographics, utilisation measures and clinical outcomes were extracted from the electronic health record system. The primary outcomes were escalation to hospital and mortality. Use of the vital signs chatbot was evaluated by examining compliance levels, need for automated reminders and alerts triggered. Patient experience was evaluated using data extracted from a quality improvement feedback form.

Results

238 patients were admitted to the COVID Virtual Ward from 23 September to 9 November, of whom 42% were male, 67.6% of Chinese ethnicity. 43.7% were over the age of 70, 20.5% were immunocompromised, and 36.6% were not fully vaccinated. 17.2% of patients were escalated to hospital and 2.1% of patients died. Patients who were escalated to hospital were more likely to be immunocompromised or to have a higher ISARIC 4C-Mortality Score. There were no missed deteriorations. All patients received teleconsults (median of 5 teleconsults per patient, IQR 3–7). 21.4% of patients received home visits. 77.7% of patients engaged with the vital signs chatbot, with a compliance rate of 84%. All patients would recommend the programme to others in their situation.

Conclusions

Virtual Wards are a scalable, safe and patient-centered strategy to care for high risk COVID-19 patients at home.

Trial Registration

NA.
Glycosylation spectral signatures for glioma grade discrimination using Raman spectroscopy
Authors: Quesnel Agathe , Coles Nathan , Angione Claudio , Dey Priyanka , Polvikoski Tuomo M. , Outeiro Tiago F. , Islam Meez , Khundakar Ahmad A. , Filippou Panagiota S.
Published: February 2023

Background

Gliomas are the most common brain tumours with the high-grade glioblastoma representing the most aggressive and lethal form. Currently, there is a lack of specific glioma biomarkers that would aid tumour subtyping and minimally invasive early diagnosis. Aberrant glycosylation is an important post-translational modification in cancer and is implicated in glioma progression. Raman spectroscopy (RS), a vibrational spectroscopic label-free technique, has already shown promise in cancer diagnostics.

Methods

RS was combined with machine learning to discriminate glioma grades. Raman spectral signatures of glycosylation patterns were used in serum samples and fixed tissue biopsy samples, as well as in single cells and spheroids.

Results

Glioma grades in fixed tissue patient samples and serum were discriminated with high accuracy. Discrimination between higher malignant glioma grades (III and IV) was achieved with high accuracy in tissue, serum, and cellular models using single cells and spheroids. Biomolecular changes were assigned to alterations in glycosylation corroborated by analysing glycan standards and other changes such as carotenoid antioxidant content.

Conclusion

RS combined with machine learning could pave the way for more objective and less invasive grading of glioma patients, serving as a useful tool to facilitate glioma diagnosis and delineate biomolecular glioma progression changes.
Distribution, dynamic evolution, and clinical outcomes of patients with advanced breast cancer according to HER2 expression
Authors: Shi Qin , Yu Jing , Liu Deyue , Ren Fang , Wu Jiayi , Shen Kunwei
Published: February 2023

Background

Novel antibody‒drug conjugates (ADC) have shown great efficacy in HER2-low advanced breast cancer. However, the clinical features of HER2-low disease still need to be clarified. The current study aims to evaluate the distribution and dynamic change in HER2 expression in patients with disease recurrence and the clinical outcome of those patients.

Methods

Patients with pathologically diagnosed relapsed breast cancer between 2009 and 2018 were included. Samples were considered HER2-zero when the immunohistochemistry (IHC) score was 0, HER2-low when the IHC score was 1 + or 2 + with negative fluorescence in situ hybridization (FISH) results, and HER2-positive when the IHC score was 3 + or the FISH results were positive. Breast cancer-specific survival (BCSS) was compared among the three HER2 groups. Changes in HER2 status were also evaluated.

Results

A total of 247 patients were included. Among recurrent tumors, 53 (21.5%) were HER2-zero, 127 (51.4%) were HER2-low, and 67 (27.1%) were HER2-positive. The HER2-low subtype represented 68.1% of the HR-positive breast cancer group and 31.3% of the HR-negative group (P < 0.001). This three-group classification of HER2 status was prognostic in advanced breast cancer (P = 0.0011), with HER2-positive patients having the best clinical outcome after disease recurrence (P = 0.024), while only marginal survival advantages were observed in HER2-low patients versus HER2-zero patients (P = 0.051). In the subgroup analysis, the survival difference was observed only in patients with HR-negative recurrent tumors (P = 0.0006) or with distant metastasis (P = 0.0037). The overall discordance rate of HER2 status between primary and recurrent tumors was 38.1%, with 25 (49.0%) primary HER2-zero patients and 19 (26.8%) HER2-positive patients shifting to HER2-low at recurrence.

Conclusion

Nearly half of the advanced breast cancer patients had HER2-low disease, which indicates a poorer prognosis than HER2-positive disease and marginally better outcomes than HER2-zero disease. During disease progression, one-fifth of tumors convert to HER2-low entities, and the corresponding patients may benefit from ADC treatment.
FOLFOX regimen after failure of fluorouracil and leucovorin plus nanoliposomal-irinotecan therapy for advanced pancreatic cancer: a retrospective observational study
Authors: Kobayashi Satoshi , Tezuka Shun , Yamachika Yui , Tsunoda Shotaro , Nagashima Shuhei , Tozuka Yuichiro , Fukushima Taito , Morimoto Manabu , Ueno Makoto , Furuse Junji , Maeda Shin
Published: February 2023

Background

Fluorouracil, leucovorin (5FU/LV), and nanoliposomal-irinotecan (nal-IRI) combination therapy has been established as the second-line treatment for advanced pancreatic ductal adenocarcinoma. Oxaliplatin with 5FU/LV (FOLFOX) is often used as a subsequent treatment, although its efficacy and safety are yet to be fully elucidated. We aimed to evaluate the efficacy and safety of FOLFOX as a third- or later-line treatment for patients with advanced pancreatic ductal adenocarcinoma.

Methods

We conducted a single-centre, retrospective study that enrolled 43 patients who received FOLFOX after failure of gemcitabine-based regimen followed by 5FU/LV + nal-IRI therapy between October 2020 and January 2022. FOLFOX therapy consisted of oxaliplatin (85 mg/m2), levo-leucovorin calcium (200 mg/m2) and 5-FU (2400 mg/m2) every 2 weeks per cycle. Overall survival, progression-free survival, objective response, and adverse events were evaluated.

Results

At the median follow-up time of 3.9 months in all patients, the median overall survival and progression-free survival were 3.9 months (95% confidence interval [CI], 3.1–4.8) and 1.3 months (95% CI, 1.0–1.5), respectively. Response and disease control rates were 0 and 25.6%, respectively. The most common adverse event was anaemia in all grades followed by anorexia; the incidence of anorexia and grades 3 and 4 was 21 and 4.7%, respectively. Notably, grades 3–4 peripheral sensory neuropathy was not observed. Multivariable analysis revealed that a C-reactive protein (CRP) level of > 1.0 mg/dL was a poor prognostic factor for both progression-free survival and overall survival: hazard ratios were 2.037 (95% CI, 1.010–4.107; p = 0.047) and 2.471 (95% CI, 1.063–5.745; p = 0.036), respectively.

Conclusion

FOLFOX as a subsequent treatment after failure of second-line treatment with 5FU/LV + nal-IRI is tolerable, although its efficacy is limited, particularly in patients with high CRP levels.
Effectiveness and safety of blonanserin in young and middle-aged female patients with schizophrenia: data from a post-marketing surveillance
Authors: Bo Qijing , Wang Xijin , Liu Xuejun , Sang Hong , Xun Zhiyuan , Zhang Ruiling , Yang Xiaodong , Deng Huaili , Li Keqing , Chen Jindong , Sun Meijuan , Zhao Guijun , Liu Xianglai , Cai Duanfang , Zhan Guilai , Li Juhong , Li Haiyun , Wang Gang
Published: February 2023

Background

A post-marketing surveillance of blonanserin has been ongoing since September 2018. The aim of this study was to assess the effectiveness and safety of oral blonanserin in Chinese young and middle-aged female patients with schizophrenia in real clinical settings, using the data from the post-marketing surveillance.

Methods

A 12-week, prospective, multi-center, open-label, post-marketing surveillance was conducted. Female patients aged 18–40 years were included in this analysis. The Brief Psychiatric Rating Scale (BPRS) was used to evaluate the effectiveness of blonanserin in improving psychiatric symptoms. The incidence of adverse drug reactions (ADRs) such as of extrapyramidal symptoms (EPS), prolactin elevation and the weight gain were used to evaluate the safety profile of blonanserin.

Results

A total of 392 patients were included both in the safety and full analysis sets, 311 patients completed the surveillance protocol. The BPRS total score was 48.8 ± 14.11 at the baseline, decreasing to 25.5 ± 7.56 at 12 weeks (P < 0.001, compared with baseline). EPS (20.2%) including akathisia, tremor, dystonia, and parkinsonism were found as the most frequent ADRs. The mean weight gain was 0.27 ± 2.5 kg at 12 weeks from the baseline. Four cases (1%) of prolactin elevation were observed during the period of surveillance.

Conclusion

Blonanserin significantly improved the symptoms of schizophrenia in female patients aged 18–40 years; the drug was well tolerated and had a low tendency to cause metabolic side effects, including prolactin elevation in these patients. Blonanserin might be a reasonable drug for the treatment of schizophrenia in young and middle-aged female patients.
Psychopathological network for early-onset post-stroke depression symptoms
Authors: Pan Chensheng , Li Guo , Sun Wenzhe , Miao Jinfeng , Wang Yanyan , Lan Yan , Qiu Xiuli , Zhao Xin , Wang He , Zhu Zhou , Zhu Suiqiang
Published: February 2023

Background

Post-stroke depression (PSD) can be conceptualized as a complex network where PSD symptoms (PSDS) interact with each other. The neural mechanism of PSD and interactions among PSDS remain to be elucidated. This study aimed to investigate the neuroanatomical substrates of, as well as the interactions between, individual PSDS to better understand the pathogenesis of early-onset PSD.

Methods

A total of 861 first-ever stroke patients admitted within 7 days poststroke were consecutively recruited from three independent hospitals in China. Sociodemographic, clinical and neuroimaging data were
collected upon admission. PSDS assessment with Hamilton Depression Rating Scale was performed at 2 weeks after stroke. Thirteen PSDS were included to develop a psychopathological network in which central symptoms (i.e. symptoms most strongly correlated with other PSDS) were identified. Voxel-based lesion-symptom mapping (VLSM) was performed to uncover the lesion locations associated with overall PSDS severity and severities of individual PSDS, in order to test the hypothesis that strategic lesion locations for central symptoms could significantly contribute to higher overall PSDS severity.

Results

Depressed mood, Psychiatric anxiety and Loss of interest in work and activities were identified as central PSDS at the early stage of stroke in our relatively stable PSDS network. Lesions in bilateral (especially the right) basal ganglia and capsular regions were found significantly associated with higher overall PSDS severity. Most of the above regions were also correlated with higher severities of 3 central PSDS. The other 10 PSDS could not be mapped to any certain brain region.

Conclusions

There are stable interactions among early-onset PSDS with Depressed mood, Psychiatric anxiety and Loss of interest as central symptoms. The strategic lesion locations for central symptoms may indirectly induce other PSDS via the symptom network, resulting in higher overall PSDS
severity.

Trial registration

URL: http://www.chictr.org.cn/enIndex.aspx; Unique identifier: ChiCTR-ROC-17013993.
A systematic review of the clustering and correlates of physical activity and sedentary behavior among boys and girls
Authors: Mello Gabrielli Thais de , Bertuol Cecília , Minatto Giseli , Barbosa Filho Valter Cordeiro , Oldenburg Brian , Leech Rebecca Maree , Silva Kelly Samara
Published: February 2023

Identifying the clustering and correlates of physical activity (PA) and sedentary behavior (SB) is very important for developing appropriate lifestyle interventions for children and adolescents. This systematic review (Prospero CRD42018094826) aimed to identify PA and SB cluster patterns and their correlates among boys and girls (0–19 years). The search was carried out in five electronic databases. Cluster characteristics were extracted in accordance with authors’ descriptions by two independent reviewers and a third resolved any disagreements. Seventeen studies met the inclusion criteria and the population age ranged from six to 18 years old. Nine, twelve, and ten cluster types were identified for mixed-sex samples, boys, and girls, respectively. While girls were in clusters characterized by “Low PA Low SB” and “Low PA High SB”, the majority of boys were in clusters defined by “High PA High SB” and “High PA Low SB”. Few associations were found between sociodemographic variables and all cluster types. Boys and girls in “High PA High SB” clusters had higher BMI and obesity in most of the tested associations. In contrast, those in the “High PA Low SB” clusters presented lower BMI, waist circumference, and overweight and obesity. Different cluster patterns of PA and SB were observed in boys and girls. However, in both sexes, a better adiposity profile was found among children and adolescents in “High PA Low SB” clusters. Our results suggest that it is not enough to increase PA to manage the adiposity correlates, it is also necessary to reduce SB in this population.
The impact of food insecurity on health outcomes: empirical evidence from sub-Saharan African countries
Authors: Beyene Sisay Demissew
Published: February 2023

Background

Food insecurity adversely affects human health, which means food security and nutrition are crucial to improving people’s health outcomes. Both food insecurity and health outcomes are the policy and agenda of the 2030 Sustainable Development Goals (SDGs). However, there is a lack of macro-level empirical studies (Macro-level study means studies at the broadest level using variables that represent a given country or the whole population of a country or economy as a whole. For example, if the urban population (% of the total population) of XYZ country is 30%, it is used as a proxy variable to represent represent country's urbanization level. Empirical study implies studies that employ the econometrics method, which is the application of math and statistics.) concerning the relationship between food insecurity and health outcomes in sub-Saharan African (SSA) countries though the region is highly affected by food insecurity and its related health problems. Therefore, this study aims to examine the impact of food insecurity on life expectancy and infant mortality in SSA countries.

Methods

The study was conducted for the whole population of 31 sampled SSA countries selected based on data availability. The study uses secondary data collected online from the databases of the United Nations Development Programme (UNDP), the Food and Agricultural Organization (FAO), and the World Bank (WB). The study uses yearly balanced data from 2001 to 2018. This study employs a multicountry panel data analysis and several estimation techniques; it employs Driscoll-Kraay standard errors (DKSE), a generalized method of momentum (GMM), fixed effects (FE), and the Granger causality test.

Results

A 1% increment in people’s prevalence for undernourishment reduces their life expectancy by 0.00348 percentage points (PPs). However, life expectancy rises by 0.00317 PPs with every 1% increase in average dietary energy supply. A 1% rise in the prevalence of undernourishment increases infant mortality by 0.0119 PPs. However, a 1% increment in average dietary energy supply reduces infant mortality by 0.0139 PPs.

Conclusions

Food insecurity harms the health status of SSA countries, but food security impacts in the reverse direction. This implies that to meet SDG 3.2, SSA should ensure food security.
Optimization of sniff nasal inspiratory pressure (SNIP) measurement methodology in healthy subjects
Authors: Wilding R. J. , Thynne M. , Subhan M. M. F.
Published: February 2023

Background

Maximal inspiratory pressure (MIP) is currently the most commonly used measure for respiratory muscle strength (RMS) estimation, however, requires significant effort. Falsely low values are therefore common, especially in fatigue-prone subjects, such as neuromuscular disorder patients. In contrast, sniff nasal inspiratory pressure (SNIP) requires a short, sharp sniff; this is a natural manoeuvre, decreasing required effort. Consequently, it has been suggested that use of SNIP could confirm the accuracy of MIP measurements. However, no recent guidelines regarding the optimal method of SNIP measurement exist, and varied approaches have been described.

Objectives

We compared SNIP values from three conditions, namely with 30, 60 or 90 s time intervals between repeats, the right (SNIPR) and left (SNIPL) nostril, and the contralateral nostril occluded (SNIPO) or non-occluded (SNIPNO). Additionally, we determined the optimal number of repeats for accurate SNIP measurement.

Method

52 healthy subjects (23 males) were recruited for this study, of which a subset of 10 subjects (5 males) completed tests comparing the time interval between repeats. SNIP was measured from functional residual capacity via a probe in one nostril, while MIP was measured from residual volume.

Results

There was no significant difference in SNIP depending on the interval between repeats (P = 0.98); subjects preferred the 30 s. SNIPO was significantly higher than SNIPNO (P < 0.00001) but SNIPL and SNIPR did not significantly differ (P =  0.60). There was an initial learning effect for the first SNIP test; SNIP did not decline during 80 repeats (P =  0.64).

Conclusions

We conclude that SNIPO is a more reliable RMS indicator than SNIPNO, as there is reduced risk of RMS underestimation. Allowing subjects to choose which nostril to use is appropriate, as this did not significantly affect SNIP, but may increase ease of performance. We suggest that twenty repeats is sufficient to overcome any learning effect and that fatigue is unlikely after this number of repeats. We believe these results are important in aiding the accurate collection of SNIP reference value data in the healthy population.
Association between hyperuricemia and chronic kidney disease: a cross-sectional study in Bangladeshi adults
Authors: Barman Zitu , Hasan Mahmudul , Miah Rakib , Mou Ananya Dutta , Hafsa Jaasia Momtahena , Trisha Aporajita Das , Mahmud Firoz , Ali Nurshad
Published: February 2023

Background and aims

Chronic kidney disease (CKD) is a public health concern worldwide and has been recognized as a significant risk factor for cardiovascular disease. The elevated level of uric acid (hyperuricemia) has been suggested to be associated with obesity, hypertension, cardiovascular disease and diabetes. However, there is limited information on the relationship between hyperuricemia and CKD. Therefore, this study aimed to estimate the prevalence of CKD and assess its relationship with hyperuricemia in Bangladeshi adults.

Methods

In this study, blood samples were collected from 545 participants (398 males and 147 females) aged ≥ 18 years. Biochemical parameters such as serum uric acid (SUA), lipid profile markers, glucose, creatinine and urea were measured by colorimetric methods. The estimated glomerular filtration rate (eGFR) and CKD were determined based on serum creatinine levels with existed formula. Multivariate logistic regression analysis was performed to evaluate the association between SUA and CKD.

Results

The overall prevalence of CKD was 5.9% with 6.1% in males and 5.2% in females. Hyperuricemia was prevalent in 18.7% of participants with 23.2% in males and 14.6% in females. An increasing trend of CKD prevalence was observed with increasing age in the groups. The mean eGFR level was significantly lower in male (95.1 ± 31.8 ml/min/1.73m2) than in female (109.3 ± 77.4 ml/min/1.73m2) subjects (p < 0.01). The mean level of SUA was significantly higher (p < 0.01) in participants having CKD (7.1 ± 1.9 mg/dL) than in participants without CKD (5.7 ± 1.6 mg/dL). A decreasing trend for eGFR concentration and an increasing trend for CKD prevalence was observed across the SUA quartiles (p < 0.001). In regression analysis, a significant positive association was found between hyperuricemia and CKD.

Conclusion

This study showed an independent association between hyperuricemia and CKD in Bangladeshi adults. Further mechanistic studies are needed to explore the potential link between hyperuricemia and CKD.