bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Merger and Acquisition on Financial Performance: Evidence from Construction and Real Estate Industry of India
Authors: Gupta Isha , Raman T. V. , Tripathy Naliniprava
Published: November 2021

This article aims to examine the impact of mergers and acquisitions (M&A) on the financial performance of the construction and real estate industry, using the broad spectrum of financial ratios. The period of study is from 2011 to 2020, and paired t-test methodology has been used. It is hypothesized that there is a significant difference in the pre-M&A period and post-M&A period. The study findings conclude that profitability ratio and liquidity ratio have improved significantly, whereas leverage ratio exhibits no change in performance. In the efficiency ratio, the fixed-assets turnover ratio substantially improves, but the total asset turnover ratio and current asset turnover ratio show a slight improvement. The study concludes that the Indian construction and real estate company’s financial performance has improved overall for the acquiring firms during the post-M&A period. The study implies that the construction sector supports the synergy hypothesis, stating that M&A will improve synergy during the post-M&A period because of the consolidation of two firms’ resources.
The Effect of Dentin Treated with Calcium Phosphate Desensitizer on Shear Bond Strength with Different Resin Cement: An In Vitro Study
Authors: Kavut İdris , Uğur Mehmet
Published: November 2021

Aim:

The aim of this study was to evaluate the effect of calcium phosphate based desensitizing agent on shear bond strength of self-etch/adhesive resin cements to dentin.

Materials and Methods:

Eighty dentin specimens were prepared from freshly extracted human third molar teeth and were classified, randomly ( n = 20). Half of groups were treated with calcium phosphate based Teethmate Desensitizer and then Panavia V5, RelyX Ultimate (containing self-etch primer), Panavia SA, and RelyX U200 self-adhesive resin cements were luted to all dentin surfaces. All specimens were stored in an incubator at 37°C for 24 h. Shear bond strength was tested by a universal test machine at a 0.5 mm/min crosshead speed. The data were analyzed with a statistical program. Two-way ANOVA was used for statistical differences ( P <.05). Dentin surfaces were examined with scanning electron microscopy (SEM) at x5000 and x10000 magnifications.

Results:

The higher shear bond values were observed in the groups with Teethmate Desensitizer applied and cemented with self-etch (16.05 ± 6.24 and 14.73 ± 4.75), whereas the lowest bonding values were observed in the groups with self-adhesive resin cement without Teethmate Desensitizer (3.73 ± 0.77 and 5.85 ± 4.19; P <.001). As the main effect of the treatment, the bond strength was 9.39 ± 6.04 in the control group, whereas it was 13.49 ± 5.44 in the Teethmate applied groups ( P <.05)

Conclusions:

Calcium phosphate desensitizer did not adversely effected shear bond strength of self-etch/adhesive resin cements to dentin. It even significantly increased the shear bond strength of self-adhesive resin cements.
Equitable Access to Higher Education: An Analysis of India’s National Education Policy (2020) in a Post-Pandemic World
Authors: DasGupta Paramita , Bhattacharya Saurya
Published: November 2021

Of the various less-than-comfortable narrative strands of the status quo that the COVID-19 pandemic has succeeded in showing up in stark relief—our rather troubling (if somewhat half-hearted) complacence about the systemic blind-spots that continue to colour the prevailing culture of a clearly inequitable higher education policy-framework—easily features among the most worrying, and thus, among those precise pulse-points that carry tremendous potential to help build the post-pandemic reset better, stronger and palpably fairer.1 In this piece, the authors endeavour to elaborate upon this and supplement the same with a brief analysis of India’s year-old National Education Policy, 20202—and how this nation (India) of more than 1.3 billion,3 supposedly poised on the cusp of a massive self-reinvention—is attempting to embark upon this journey.
Tamil Nadu Politics and Tamil Cinema: A Symbiotic Relationship?
Authors: Velayutham Selvaraj , Devadas Vijay
Published: November 2021

From the second-half of the twentieth century, a nascent Tamil cinema became increasingly influential in Tamil society and more prominent in political life. The Dravidar Kazhagam, founded by Periyar E. V. Ramasamy in 1944, morphed into the DMK and AIADMK, two dominant state political parties in Tamil Nadu. Through the medium of film, some of its leading lights, C. N. Annadurai, M. Karunanidhi, M. G. Ramachandran and Jayalalitha, cultivated cinema audiences and the voting public in the political ideologies of the Dravidian movement and subsequently became Chief Ministers of Tamil Nadu. The symbiotic relationship between politics and Tamil cinema has meant that political and social commentaries and the assertion of Tamil nationalistic ideas was commonplace in Tamil films. In recent years, Tamil cinema has become the vehicle for raising a wide range of concerns ranging from caste, class and gender and state/nation politics, marking a shift that focusses on everyday politics in the state. In this article, we present a critical survey of the role of Tamil cinema in disseminating particular realities and politics of identity that speak to an essentialised notion of Tamil cultural and linguistic identity, the concomitant disavowal of broader conceptions of Indian-ness or belonging to the Indian nation, as well as the use of cinema to address everyday politics in the State.
Oppressed Within the Oppressed: The Patriarchal Hegemonic Discourse of Colourism on Dalit Women in Shahjadpur, Sirajganj, Bangladesh
Authors: Rifat-Ur-Rahman Md. , Khatun Subeda , Piya Shahida Amin , Arefin Sadia , Imran Md. Masood
Published: November 2021

The biggest victims of colourism in Bangladesh are girls, who are victims of colour-based violence and suffer from a dark-black complexion. In general, Bangalee society is a dominating patriarchal society, which has been established through a hegemonic discourse. This study explores how and in what process this racist discourse has started in the society. Therefore, being born with only a black complexion, a family deals with long-term psychological problems. In addition to the so-called mainstream social system in Bangladesh, a detached and marginalized group living in Bangladesh is known as Dalits. They are primarily a neglected community, isolated from the mainstream. Among them, the condition of Dalit women is much more deplorable. Dark complexion women are experiencing the most exploitation, deprivation and neglect. The Dalit women are ‘Oppressed within the Oppressed’—they are forced to live a cursed life through a dark-black complexion from birth. This study focuses on how masculine authoritarian behaviours dominate the dark-black face of the Dalit girls in Bangladesh. A random sample-based interview has been conducted on Dalit people of Shahjadpur in the Sirajganj district to explore what kind of mechanism exploits the girls and how the literal meaning of ‘beauty’ is established in society.
Book review: Adam Auerbach, Demanding Development: The Politics of Public Goods Provision in India’s Urban Slums
Authors: Tumbe Chinmay
Published: November 2021

Adam Auerbach, Demanding Development: The Politics of Public Goods Provision in India’s Urban Slums. Cambridge: Cambridge University Press, 2020, 328pp., $34.99. ISBN: 1108491936 (hardcover). ISBN: 9781108741330 (paperback).
Book review: Amita Baviskar, Uncivil City: Ecology, Equity and the Commons in Delhi
Authors: Ajmal Khan A. T.
Published: November 2021

Amita Baviskar, Uncivil City: Ecology, Equity and the Commons in Delhi. SAGE Publications, 2020, 300 pp., ₹1,195. ISBN: 9789353289409.
Community Awareness and Understanding of the Origin of Swahili Archaeological Heritage and Ruins along Tanzania’s Swahili Coast: Conservation and Management Issues
Authors: Chami Maximilian F. , Albrecht Eike , Ryano Mandela Peter
Published: November 2021

The Tanzanian coast has many remains of medieval Swahili settlements dated between the twelfth and sixteenth centuries C.E. In the same region, Neolithic and Later Stone Age sites have also been reported, alongside evidence for Early Iron Working settlements. Swahili culture, and the ruins that can still be seen, have their origins in this rich cultural past. It appears, however, that the present communities along the Tanzanian Swahili coast, and the public, are unaware of this important heritage history. There is a popular belief among them that the origin and influence on the now ruined Swahili settlements came from the Middle East, and it is true that Arab and other travellers described Swahili civilization in their writings. In this article, we explore the communities and researchers’ different perspectives on the origin of the Swahili ruins, focusing on the conservation and management problems this raises. We also analyse the position and role of heritage management institutions in the country towards enhancing community awareness and proper conservation of the ruins. Finally, we propose ways of promoting community awareness of the origin of the Swahili ruins, influencing participation and actions towards their conservation and management.
Advances in the application of mesenchymal stem cells, exosomes, biomimetic materials, and 3D printing in osteoporosis treatment
Authors: He Xiao-Yu , Yu Hai-Ming , Lin Shu , Li Yi-Zhong
Published: November 2021

Owing to an increase in the aging population, osteoporosis has become a severe public health concern, with a high prevalence among the elderly and postmenopausal adults. Osteoporosis-related fracture is a major cause of morbidity and mortality in elderly and postmenopausal adults, posing a considerable socioeconomic burden. However, existing treatments can only slow down the process of osteoporosis, reduce the risk of fractures, and repair fractures locally. Therefore, emerging methods for treating osteoporosis, such as mesenchymal stem cell transplantation, exosome-driving drug delivery systems, biomimetic materials, and 3D printing technology, have received increasing research attention, with significant progress. Mesenchymal stem cells (MSCs) are pluripotent stem cells that can differentiate into different types of functional cells. Exosomes play a key role in regulating cell microenvironments through paracrine mechanisms. Bionic materials and 3D printed scaffolds are beneficial for the reconstruction and repair of osteoporotic bones and osteoporosis-related fractures. Stem cells, exosomes, and biomimetic materials represent emerging technologies for osteoporosis treatment. This review summarizes the latest developments in these three aspects.
Uncovering the Novel QTLs and Candidate Genes of Salt Tolerance in Rice with Linkage Mapping, RTM-GWAS, and RNA-seq
Authors: Kong Weilong , Zhang Chenhao , Zhang Shengcheng , Qiang Yalin , Zhang Yue , Zhong Hua , Li Yangsheng
Published: November 2021

Salinity is a major abiotic stress that limits plant growth and crop productivity. Indica rice and japonica rice show significant differences in tolerance to abiotic stress, and it is considered a feasible method to breed progeny with stronger tolerance to abiotic stress by crossing indica and japonica rice. We herein developed a high-generation recombinant inbred lines (RILs) from Luohui 9 (indica) X RPY geng (japonica). Based on the high-density bin map of this RILs population, salt tolerance QTLs controlling final survival rates were analyzed by linkage mapping and RTM-GWAS methods. A total of seven QTLs were identified on chromosome 3, 4, 5, 6, and 8. qST-3.1, qST-5.1, qST-6.1, and qST-6.2 were novel salt tolerance QTLs in this study and their function were functionally verified by comparative analysis of parental genotype RILs. The gene aggregation result of these four new QTLs emphasized that the combination of the four QTL synergistic genotypes can significantly improve the salt stress tolerance of rice. By comparing the transcriptomes of the root tissues of the parents’ seedlings, at 3 days and 7 days after salt treatment, we then achieved fine mapping of QTLs based on differentially expressed genes (DEGs) identification and DEGs annotations, namely, LOC_Os06g01250 in qST-6.1, LOC_Os06g37300 in qST-6.2, LOC_Os05g14880 in qST-5.1. The homologous genes of these candidate genes were involved in abiotic stress tolerance in different plants. These results indicated that LOC_Os05g14880, LOC_Os06g01250, and LOC_Os06g37300 were the candidate genes of qST-5.1, qST-6.1, and qST-6.2. Our finding provided novel salt tolerance-related QTLs, candidate genes, and several RILs with better tolerance, which will facilitate breeding for improved salt tolerance of rice varieties and promote the exploration tolerance mechanisms of rice salt stress.
Analysis of transcriptomic data sets supports the role of IL-6 in NETosis and immunothrombosis in severe COVID-19
Authors: Mukhopadhyay Samanwoy , Sinha Subrata , Mohapatra Saroj Kant
Published: November 2021

Background

There is an urgent need to understand the key events driving pathogenesis of severe COVID-19 disease, so that precise treatment can be instituted. In this respect NETosis is gaining increased attention in the scientific community, as an important pathological process contributing to mortality. We sought to test if indeed there exists robust evidence of NETosis in multiple transcriptomic data sets from human subjects with severe COVID-19 disease. Gene set enrichment analysis was performed to test for up-regulation of gene set functional in NETosis in the blood of patients with COVID-19 illness.

Results

Blood gene expression functional in NETosis increased with severity of illness, showed negative correlation with blood oxygen saturation, and was validated in the lung of COVID-19 non-survivors. Temporal expression of IL-6 was compared between severe and moderate illness with COVID-19. Unsupervised clustering was performed to reveal co-expression of IL-6 with complement genes. In severe COVID-19 illness, there is transcriptional evidence of activation of NETosis, complement and coagulation cascade, and negative correlation between NETosis and respiratory function (oxygen saturation). An early spike in IL-6 is observed in severe COVID-19 illness that is correlated with complement activation.

Conclusions

Based on the transcriptional dynamics of IL-6 expression and its downstream effect on complement activation, we constructed a model that links early spike in IL-6 level with persistent and self-perpetuating complement activation, NETosis, immunothrombosis and respiratory dysfunction. Our model supports the early initiation of anti-IL6 therapy in severe COVID-19 disease before the life-threatening complications of the disease can perpetuate themselves autonomously.
Testing assembly strategies of Francisella tularensis genomes to infer an evolutionary conservation analysis of genomic structures
Authors: Neubert Kerstin , Zuchantke Eric , Leidenfrost Robert Maximilian , Wünschiers Röbbe , Grützke Josephine , Malorny Burkhard , Brendebach Holger , Al Dahouk Sascha , Homeier Timo , Hotzel Helmut , Reinert Knut , Tomaso Herbert , Busch Anne
Published: November 2021

Background

We benchmarked sequencing technology and assembly strategies for short-read, long-read, and hybrid assemblers in respect to correctness, contiguity, and completeness of assemblies in genomes of Francisella tularensis. Benchmarking allowed in-depth analyses of genomic structures of the Francisella pathogenicity islands and insertion sequences. Five major high-throughput sequencing technologies were applied, including next-generation “short-read” and third-generation “long-read” sequencing methods.

Results

We focused on short-read assemblers, hybrid assemblers, and analysis of the genomic structure with particular emphasis on insertion sequences and the Francisella pathogenicity island. The A5-miseq pipeline performed best for MiSeq data, Mira for Ion Torrent data, and ABySS for HiSeq data from eight short-read assembly methods. Two approaches were applied to benchmark long-read and hybrid assembly strategies: long-read-first assembly followed by correction with short reads (Canu/Pilon, Flye/Pilon) and short-read-first assembly along with scaffolding based on long reads (Unicyler, SPAdes). Hybrid assembly can resolve large repetitive regions best with a “long-read first” approach.

Conclusions

Genomic structures of the Francisella pathogenicity islands frequently showed misassembly. Insertion sequences (IS) could be used to perform an evolutionary conservation analysis. A phylogenetic structure of insertion sequences and the evolution within the clades elucidated the clade structure of the highly conservative F. tularensis.
Effects of electrical muscle stimulation on cerebral blood flow
Authors: Ando Soichi , Takagi Yoko , Watanabe Hikaru , Mochizuki Kodai , Sudo Mizuki , Fujibayashi Mami , Tsurugano Shinobu , Sato Kohei
Published: November 2021

Abstract

Background

Electrical muscle stimulation (EMS) induces involuntary muscle contraction. Several studies have suggested that EMS has the potential to be an alternative method of voluntary exercise; however, its effects on cerebral blood flow (CBF) when applied to large lower limb muscles are poorly understood. Thus, the purpose of this study was to examine the effects of EMS on CBF, focusing on whether the effects differ between the internal carotid (ICA) and vertebral (VA) arteries.

Methods

The participants performed the experiments under EMS and control (rest) conditions in a randomized crossover design. The ICA and VA blood flow were measured before and during EMS or control. Heart rate, blood pressure, minute ventilation, oxygen uptake, and end-tidal partial pressure of carbon dioxide (PETCO2) were monitored and measured as well.

Results

The ICA blood flow increased during EMS [Pre: 330 ± 69 mL min−1; EMS: 371 ± 81 mL min−1, P = 0.001, effect size (Cohen’s d) = 0.55]. In contrast, the VA blood flow did not change during EMS (Pre: 125 ± 47 mL min−1; EMS: 130 ± 45 mL min−1, P = 0.26, effect size = 0.12). In the EMS condition, there was a significant positive linear correlation between ΔPETCO2 and ΔICA blood flow (R = 0.74, P = 0.02). No relationships were observed between ΔPETCO2 and ΔVA blood flow (linear: R = − 0.17, P = 0.66; quadratic: R = 0.43, P = 0.55).

Conclusions

The present results indicate that EMS increased ICA blood flow but not VA blood flow, suggesting that the effects of EMS on cerebral perfusion differ between anterior and posterior cerebral circulation, primarily due to the differences in cerebrovascular response to CO2.
Predicting clinical events using Bayesian multivariate linear mixed models with application to scleroderma
Authors: Kim Ji Soo , Shah Ami A. , Hummers Laura K. , Zeger Scott L.
Published: November 2021

Background

Scleroderma is a serious chronic autoimmune disease in which a patient’s disease state manifests in several irregularly spaced longitudinal measures of lung, heart, skin, and other organ systems. Threshold crossings of pulmonary and cardiac measures indicate potentially life-threatening key clinical events including interstitial lung disease (ILD), cardiomyopathy, and pulmonary hypertension (PH). The statistical challenge is to accurately and precisely predict these events by using all of the clinical history for the patient at hand and for a reference population of patients.

Methods

We use a Bayesian mixed model approach to simultaneously characterize each individual’s future trajectories for several biomarkers. We estimate this model using a large population of patients from the Johns Hopkins Scleroderma Center Research Registry. The joint probabilities of critical lung and heart events are then calculated as a byproduct of the mixed model.

Results

The performance of this approach is substantially better than standard, more common alternatives. In order to predict an individual’s risks in a clinical setting, we also develop a cross-validated, sequential prediction (CVSP) algorithm. As additional data are observed during a patient’s visit, the algorithm sequentially produces updated predictions for the future longitudinal trajectories and for ILD, cardiomyopathy, and PH. The updated prediction distributions with little additional computing, for example within an electronic health record (EHR).

Conclusions

This method that generates real-time personalized risk estimates has been implemented within the electronic health record system for clinical testing. To our knowledge, this work represents the first approach to compute personalized risk estimates for multiple scleroderma complications.
Appraising clinical applicability of studies: mapping and synthesis of current frameworks, and proposal of the FrACAS framework and VICORT checklist
Authors: Nguyen Quoc Dinh , Moodie Erica M. , Desmarais Philippe , Goulden Robert , Forget Marie-France , Peters Eric , Saeed Sahar , Keezer Mark R. , Wolfson Christina
Published: November 2021

Background

Not all research findings are translated to clinical practice. Reasons for lack of applicability are varied, and multiple frameworks and criteria exist to appraise the general applicability of epidemiological and clinical research. In this two-part study, we identify, map, and synthesize frameworks and criteria; we develop a framework to assist clinicians to appraise applicability specifically from a clinical perspective.

Methods

We conducted a literature search in PubMed and Embase to identify frameworks appraising applicability of study results. Conceptual thematic analysis was used to synthesize frameworks and criteria. We carried out a framework development process integrating contemporary debates in epidemiology, findings from the literature search and synthesis, iterative pilot-testing, and brainstorming and consensus discussions to propose a concise framework to appraise clinical applicability.

Results

Of the 4622 references retrieved, we identified 26 unique frameworks featuring 21 criteria. Frameworks and criteria varied by scope and level of aggregation of the evidence appraised, target user, and specific area of applicability (internal validity, clinical applicability, external validity, and system applicability). Our proposed Framework Appraising the Clinical Applicability of Studies (FrACAS) classifies studies in three domains (research, practice informing, and practice changing) by examining six criteria sequentially: Validity, Indication-informativeness, Clinical relevance, Originality, Risk-benefit comprehensiveness, and Transposability (VICORT checklist).

Conclusions

Existing frameworks to applicability vary by scope, target user, and area of applicability. We introduce FrACAS to specifically assess applicability from a clinical perspective. Our framework can be used as a tool for the design, appraisal, and interpretation of epidemiological and clinical studies.
Cellular retinol binding protein-1 inhibits cancer stemness via upregulating WIF1 to suppress Wnt/β-catenin pathway in hepatocellular carcinoma
Authors: Liu Xiangye , Shan Wenhua , Li Tingting , Gao Xiaoge , Kong Fanyun , You Hongjuan , Kong Delong , Qiao Shuxi , Tang Renxian
Published: November 2021

Background

CRBP-1, a cytosolic chaperone of vitamin A, is identified in a serious number of cancers; however, its biological role in hepatocellular carcinoma (HCC) needs to be further explored. The aim of our present study is to explore the roles and mechanisms of CRBP-1 in regulating liver cancer by using in vitro and in vivo biology approaches.

Methods

The expression level of CRBP-1 was detected using immunohistochemistry in HCC and matching adjacent non-tumorous liver tissues. Following established stable CRBP-1 overexpressed HCC cell lines, the cell growth and tumorigenicity were investigated both in vitro and in vivo. Intracellular retinoic acid was quantified by ELISA. The relationship between CRBP-1 and WIF1 was validated by using dual luciferase and ChIP analyses.

Results

The low expression of CRBP-1 was observed in HCC tissues compared to the normal liver tissues, while high CRBP-1 expression correlated with clinicopathological characteristics and increased overall survival in HCC patients. Overexpression of CRBP-1 significantly inhibited cell growth and tumorigenicity both in vitro and in vivo. Moreover, overexpression of CRBP-1 suppressed tumorsphere formation and cancer stemness related genes expression in HCC. Mechanically, CRBP-1 inhibited Wnt/β-catenin signaling pathway to suppress cancer cell stemness of HCC. Furthermore, our results revealed that CRBP-1 could increase the intracellular levels of retinoic acid, which induced the activation of RARs/RXRs leading to the transcriptional expression of WIF1, a secreted antagonist of the Wnt/β-catenin signaling pathway, by physically interacting with the region on WIF1 promoter.

Conclusion

Our findings reveal that CRBP-1 is a crucial player in the initiation and progression of HCC, which provide a novel independent prognostic biomarker and therapeutic target for the diagnosis and treatment of HCC.
Are wearable devices effective for preventing and detecting falls: an umbrella review (a review of systematic reviews)
Authors: Warrington Daniel Joseph , Shortis Elizabeth Jane , Whittaker Paula Jane
Published: November 2021

Background

Falls are a common and serious health issue facing the global population, causing an estimated 646,000 deaths per year globally. Wearable devices typically combine accelerometers, gyroscopes and even barometers; using the data collected and inputting this into an algorithm that decides whether a fall has occurred. The purpose of this umbrella review was to provide a comprehensive overview of the systematic reviews on the effectiveness of wearable electronic devices for falls detection in adults.

Methods

MEDLINE, Embase, Cochrane Database of Systematic Reviews (CDSR), and CINAHL, were searched from their inceptions until April 2019 for systematic reviews that assessed the accuracy of wearable technology in the detection of falls.

Results

Seven systematic reviews were included in this review. Due to heterogeneity between the included systematic reviews in their methods and their reporting of results, a meta-analysis could not be performed. Most devices tested used accelerometers, often in combination with gyroscopes. Three systematic reviews reported an average sensitivity of 93.1% or greater and an average specificity of 86.4% or greater for the detection of falls. Placing sensors on the trunk, foot or leg appears to provide the highest accuracy for falls detection, with multiple sensors increasing the accuracy, specificity, and sensitivity of these devices.

Conclusions

This review demonstrated that wearable device technology offers a low-cost and accurate way to effectively detect falls and summon for help. There are significant differences in the effectiveness of these devices depending on the type of device and its placement. Further high-quality research is needed to confirm the accuracy of these devices in frail older people in real-world settings.
Spatial epidemiologic analysis of the liver cancer and gallbladder cancer incidence and its determinants in South Korea
Authors: Jang Jieun , Yoo Dae-Sung , Chun Byung Chul
Published: November 2021

Background

There have been reports on regional variation in prevalence of hepatitis B and C, and Clonorchis sinensis (C. sinensis) infection, which indicates potential of spatial variation in liver cancer and gallbladder cancer incidence in Korea. Therefore, we aimed to assess the regional variation of liver and gallbladder cancer incidence and its determinants based on the regional distribution of risk factors, including hepatitis B infection in Korea.

Methods

This study used an ecological study design and district-level cancer incidence statistics generated by the National Cancer Center. Spatial clusters of liver and gallbladder cancer incidence were detected based on spatial scan statistics using SaTScan™ software. We set the size of maximum spatial scanning window of 25 and 35% of the population at risk for analyses of liver and gallbladder cancer, respectively. Significance level of 0.05 was used to reject the null hypothesis of no cluster. We fitted the Besag-York-Mollie model using integrated nested Laplace approximations to assess factors that influence the regional variation in cancer incidence.

Results

Spatial clusters with high liver cancer incidence rates were detected in the southwestern and southeastern regions of Korea. High gallbladder cancer incidence rates are clustered in the southeastern region. Regional liver cancer incidence can be accounted for the prevalence of high household income (coefficient, − 0.10; 95% credible interval [CI], − 0.18 to − 0.02), marital status (coefficient, − 0.14; 95% CI, − 0.25 to − 0.03), the incidence of hepatitis B (coefficient, 0.87; 95% CI, 0.29 to 1.44), and liver cancer screening (coefficient, 0.06; 95% CI, 0.00 to 0.12), while gallbladder cancer incidence was related to the prevalence of high household income (coefficient, − 0.03; 95% CI, − 0.05 to 0.00) and living close to a river with a high prevalence of liver fluke infection (coefficient, 0.55; 95% CI, 0.14 to 0.96).

Conclusions

This study demonstrated geographic variation in liver and gallbladder cancer incidence, which can be explained by determinants such as hepatitis B, income, marital status, and living near a river.
Solitary multicystic lesion lung cancer: two case reports and review of the literature
Authors: Tang Xi , Liu Gang , Tan Xianglan , Liu Chengjun , Xiang Jin , Jiang Yu
Published: November 2021

Background

Lung cancer associated with cystic airspaces, especially solitary multicystic lesion lung cancer, is a rare disease (a rare imaging performance of non-small cell lung cancer). It is difficult to diagnose owing to the lack of a clear definition; therefore, diagnosis of these neoplastic lesions remains challenging.

Case presentation

We outlined two cases of elderly Chinese men who were admitted to the hospital with a solitary multicystic lesion of the lung and subsequent surgical resection, confirming a diagnosis of adenocarcinoma.

Conclusions

For solitary pulmonary cystic airspaces (especially solitary multicystic lung lesions), it is important to properly recognise their imaging features. Due to the possibility of malignancies, timely surgery is an effective treatment strategy for early diagnosis.
Preliminary development of a questionnaire to measure the extra-pulmonary symptoms of severe asthma
Authors: de Felice Giulio , Hyland Michael E. , Lanario Joseph W. , Antonacci Yuri , Jones Rupert C. , Masoli Matthew
Published: November 2021

Background

Research into the effects of asthma treatments on the extra-pulmonary symptoms of severe asthma is limited by the absence of a suitable questionnaire. The aim was to create a questionnaire suitable for intervention studies by selecting symptoms that are statistically associated with asthma pathology and therefore may improve when pathology is reduced.

Methods

Patients attending a specialist asthma clinic completed the 65-item General Symptom Questionnaire (GSQ-65), a questionnaire validated for assessing symptoms of people with multiple medically unexplained symptoms. Lung function (FEV1%) and cumulative oral corticosteroids (OCS) calculated from maintenance dose plus exacerbations were obtained from clinic records. Pathology was represented by the two components of a principal component analysis (PCA) of FEV1% and OCS. LASSO regression was used to select symptoms that had high coefficients with these two principal components and occurred frequently in severe asthma.

Results

100 patients provided data. PCA revealed two components, one where FEV1% and OCS were inversely related and another where they were directly related. LASSO regression revealed 39 symptoms with non-zero coefficients on one or more of the two principal components from which 16 symptoms were selected for the GSQ-A on the basis of magnitude of coefficient and frequency. Asthma symptoms measured by asthma control questionnaires were excluded. The GSQ-A correlated 0.33 and − 0.34 (p = 0.001) with the two principal components.

Conclusion

The GSQ-A assesses the frequency of 16 heterogenous non-respiratory symptoms that are associated with asthma severity using the statistical combination of FEV1% and OCS.
Interstitial lung disease is a dominant feature in patients with circulating myositis-specific antibodies
Authors: Misra Abhinav K. , Wong Nathan L. , Healey Terrance T. , Lally Edward V. , Shea Barry S.
Published: November 2021

Background

Many patients with polymyositis (PM) or dermatomyositis (DM) have circulating myositis-specific antibodies (MSAs). Interstitial lung disease (ILD) is a common manifestation of PM/DM, and it can even precede the onset of characteristic muscle or skin manifestations. Furthermore, there appear to be some patients with ILD and circulating MSAs who do not develop muscle or skin disease even after prolonged follow-up. We sought to determine whether ILD is equally or more common than myositis or dermatitis at the time of initial detection of MSAs.

Methods

We identified all patients found to have circulating MSAs at our institution over a 4-year period and assessed for the presence of lung, muscle, and skin disease at the time of initial detection of MSAs. Among those found to have ILD, we compared demographic and clinical features, chest CT scan findings, and outcomes between those with PM/DM-associated ILD and those with ILD but no muscle or skin disease.

Results

A total of 3078 patients were tested for MSAs, and of these 40 were positive. Nine different MSAs were detected, with anti-histidyl tRNA synthetase (anti-Jo-1) being the most common (35% of MSAs). Among patients with positive MSAs, 86% were found to have ILD, compared to 39% and 28% with muscle and skin involvement, respectively (p < 0.001). Fifty percent of all MSA-positive patients had isolated ILD, with no evidence of muscle or skin disease. Those with isolated ILD were more likely to be older and have fibrotic changes on chest CT, less likely to receive immunomodulatory therapy, and had worse overall survival.

Conclusions

In this study we found that individuals with circulating MSAs were more likely to have ILD than classic muscle or skin manifestations of PM/DM at the time of initial detection of MSAs. Our findings suggest that the presence of ILD should be considered a disease-defining manifestation in the presence of MSAs and incorporated into classification criteria for PM/DM.
Modified high-flow nasal cannula oxygen therapy versus conventional oxygen therapy in patients undergoing bronchoscopy: a randomized clinical trial
Authors: Wang Rui , Li Hai-Chao , Li Xu-Yan , Tang Xiao , Chu Hui-Wen , Yuan Xue , Tong Zhao-Hui , Sun Bing
Published: November 2021

Background

Hypoxemia frequently occurs during bronchoscopy. High-flow nasal cannula (HFNC) oxygen therapy may be a feasible alternative to prevent the deterioration of gas exchange during bronchoscopy. With the convenience of clinical use in mind, we modified an HFNC using a single cannula. This clinical trial was designed to test the hypothesis that a modified HFNC would decrease the proportion of patients with a single moment of peripheral arterial oxygen saturation (SpO2) < 90% during bronchoscopy.

Methods

In this single-center, prospective randomized controlled trial, hospitalized patients in the respiratory department in need of diagnostic bronchoscopy were randomly assigned to a modified HFNC oxygen therapy group or a conventional oxygen therapy (COT) group. The primary outcome was the proportion of patients with a single moment of SpO2 < 90% during bronchoscopy.

Results

Eight hundred and twelve patients were randomized to the modified HFNC (n = 406) or COT (n = 406) group. Twenty-four patients were unable to cooperate or comply with bronchoscopy. Thus, 788 patients were included in the analysis. The proportion of patients with a single moment of SpO2 < 90% during bronchoscopy in the modified HFNC group was significantly lower than that in the COT group (12.5% vs. 28.8%, p < 0.001). There were no significant differences in the fraction of inspired oxygen between the two groups. The lowest SpO2 during bronchoscopy and 5 min after bronchoscopy in the modified HFNC group was significantly higher than that in the COT group. Multivariate analysis showed that a baseline forced vital capacity (FVC) < 2.7 L (OR, 0.276; 95% CI, 0.083–0.919, p = 0.036) and a volume of fluid instilled > 60 ml (OR, 1.034; 95% CI, 1.002–1.067, p = 0.036) were independent risk factors for hypoxemia during bronchoscopy in the modified HFNC group.

Conclusions

A modified HFNC could decrease the proportion of patients with a single moment of SpO2 < 90% during bronchoscopy. A lower baseline FVC and large-volume bronchoalveolar lavage may predict desaturation during bronchoscopy when using a modified HFNC.

Trial registration ClinicalTrials. Gov: NCT02606188. Registered 17 November 2015.
Obstructive sleep apnoea and 12-month weight loss in adults with class 3 obesity attending a multidisciplinary weight management program
Authors: Kobuch Sophie , Tsang Fiona , Chimoriya Ritesh , Gossayn Daniel , O’Brien Sarah , Jamal Javeria , Laks Leon , Tahrani Abd , Kormas Nic , Piya Milan K
Published: November 2021

Background

Although there is a strong association between obesity and obstructive sleep apnoea (OSA), the effects of OSA and CPAP therapy on weight loss are less well known. The aim of this study in adults with class 3 obesity attending a multidisciplinary weight management program was to assess the relationship between OSA and CPAP usage, and 12-month weight change.

Methods

A retrospective cohort study of all patients commencing an intensive multidisciplinary publicly funded weight management program in Sydney, Australia, between March 2018 and March 2019. OSA was diagnosed using laboratory overnight sleep studies. Demographic and clinical data, and use of CPAP therapy was collected at baseline and 12 months. CPAP use was confirmed if used ≥4 h on average per night on download.

Results

Of the 178 patients who joined the program, 111 (62.4 %) completed 12 months in the program. At baseline, 63.1 % (n=70) of patients had OSA, of whom 54.3 % (n=38) were using CPAP. The non-OSA group had more females compared to the OSA with CPAP group and OSA without CPAP group (90.2 % vs. 57.9 % and 62.5 %, respectively; p=0.003), but there were no significant baseline differences in BMI (50.4±9.3 vs. 52.1±8.7 and 50.3±9.5 kg/m2, respectively; p=0.636). There was significant weight loss across all three groups at 12 months. However, there were no statistically significant differences across groups in the percentage of body weight loss (OSA with CPAP: 6.3±5.6 %, OSA without CPAP: 6.8±6.9 %, non-OSA: 7.2±6.5 %; p=0.844), or the proportion of patients who achieved ≥5 % body weight loss (OSA with CPAP: 57.9 %, OSA without CPAP: 59.4 %, non-OSA: 65.9 %; p=0.743). In patients with T2DM, there was a significant reduction in HbA1c from baseline to 12 months (7.8±1.7 % to 7.3±1.4 %, p=0.03), with no difference between groups (p=0.997).

Conclusions

This multidisciplinary weight management program resulted in significant weight loss at 12 months, regardless of OSA diagnosis or CPAP use in adults with class 3 obesity. Larger studies are needed to further investigate the effects of severity of OSA status and CPAP use in weight management programs. Until completed, this study suggests that the focus should remain on implementing lifestyle changes and weight management regardless of OSA status.
Identification of de novo mutations for ARID1B haploinsufficiency associated with Coffin–Siris syndrome 1 in three Chinese families via array-CGH and whole exome sequencing
Authors: Lu Guanting , Peng Qiongling , Wu Lianying , Zhang Jian , Ma Liya
Published: November 2021

Background

Coffin–Siris syndrome (CSS) is a multiple malformation syndrome characterized by intellectual disability associated with coarse facial features, hirsutism, sparse scalp hair, and hypoplastic or absent fifth fingernails or toenails. CSS represents a small group of intellectual disability, and could be caused by at least twelve genes. The genetic background is quite heterogenous, making it difficult for clinicians and genetic consultors to pinpoint the exact disease types.

Methods

Array-Comparative Genomic Hybridization (array-CGH) and whole exome sequencing (WES) were applied for three trios affected with intellectual disability and clinical features similar with those of Coffin–Siris syndrome. Sanger sequencing was used to verify the detected single-nucleotide variants (SNVs).

Results

All of the three cases were female with normal karyotypes of 46, XX, born of healthy, non-consanguineous parents. A 6q25 microdeletion (arr[hg19]6q25.3(155,966,487–158,803,979) × 1) (2.84 Mb) (case 1) and two loss-of-function (LoF) mutations of ARID1B [c.2332 + 1G > A in case 2 and c.4741C > T (p.Q1581X) in case 3] were identified. All of the three pathogenic abnormalities were de novo, not inherited from their parents. After comparison of publicly available microdeletions containing ARID1B, four types of microdeletions leading to insufficient production of ARID1B were identified, namely deletions covering the whole region of ARID1B, deletions covering the promoter region, deletions covering the termination region or deletions covering enhancer regions.

Conclusion

Here we identified de novo ARID1B mutations in three Chinese trios. Four types of microdeletions covering ARID1B were identified. This study broadens current knowledge of ARID1B mutations for clinicians and genetic consultors.
Control of the expiratory flow in a lung model and in healthy volunteers with an adjustable flow regulator: a combined bench and randomized crossover study
Authors: Schmidt Johannes , Martin Anna , Wenzel Christin , Weber Jonas , Wirth Steffen , Schumann Stefan
Published: November 2021

Background

Pursed-lips breathing (PLB) is a technique to attenuate small airway collapse by regulating the expiratory flow. During mandatory ventilation, flow-controlled expiration (FLEX), which mimics the expiratory flow course of PLB utilizing a digital system for measurement and control, was shown to exert lung protective effects. However, PLB requires a patient’s participation and coordinated muscular effort and FLEX requires a complex technical setup. Here, we present an adjustable flow regulator to mimic PLB and FLEX, respectively, without the need of a patient’s participation, or a complex technical device.

Methods

Our study consisted of two parts: First, in a lung model which was ventilated with standard settings (tidal volume 500 ml, respiratory rate 12 min−1, positive end-expiratory pressure (PEEP) 5 cmH2O), the possible reduction of the maximal expiratory flow by utilizing the flow regulator was assessed. Second, with spontaneously breathing healthy volunteers, the short-term effects of medium and strong expiratory flow reduction on airway pressure, the change of end-expiratory lung volume (EELV), and breathing discomfort was investigated.

Results

In the lung model experiments, expiratory flow could be reduced from − 899 ± 9 ml·s−1 down to − 328 ± 25 ml·s−1. Thereby, inspiratory variables and PEEP were unaffected. In the volunteers, the maximal expiratory flow of − 574 ± 131 ml·s−1 under baseline conditions was reduced to − 395 ± 71 ml·s−1 for medium flow regulation and to − 266 ± 58 ml·s−1 for strong flow regulation, respectively (p < 0.001). Accordingly, mean airway pressure increased from 0.6 ± 0.1 cmH2O to 2.9 ± 0.4 cmH2O with medium flow regulation and to 5.4 ± 2.4 cmH2O with strong flow regulation, respectively (p < 0.001). The EELV increased from baseline by 31 ± 458 ml for medium flow regulation and 320 ± 681 ml for strong flow regulation (p = 0.033). The participants rated breathing with the flow regulator as moderately uncomfortable, but none rated breathing with the flow regulator as intolerable.

Conclusions

The flow regulator represents an adjustable device for application of a self-regulated expiratory resistive load, representing an alternative for PLB and FLEX. Future applications in spontaneously breathing patients and patients with mandatory ventilation alike may reveal potential benefits.

Trial registration: DRKS00015296, registered on 20th August, 2018; URL: https://www.drks.de/drks_web/setLocale_EN.do.
Sex differences in the non-linear association between BMI and LDL cholesterol in middle-aged and older adults: findings from two nationally representative surveys in China
Authors: Li Haibin , Ma Jiahui , Zheng Deqiang , Li Xia , Guo Xiuhua , Wang Jing , Su Pixiong
Published: November 2021

Background

The relationship between body mass index (BMI) and low-density lipoprotein cholesterol (LDL-C) has not been clearly elucidated in middle-aged and older adults. This study aimed to evaluate the non-linear dose-response relationship between BMI and LDL-C in males and females.

Methods

Data was obtained from two nationally representative surveys in China—the China Health and Nutrition Survey (CHNS, 2009) and China Health and Retirement Longitudinal Study (CHARLS, 2011–2012). To evaluate the sex differences in the association between BMI and LDL-C, the generalized additive models with a smooth function for continuous BMI and smooth-factor interaction for sexes with BMI were used. Segmented regressions were fitted to calculate the slopes with different estimated breakpoints among females and males.

Results

A total of 12,273 participants (47.1% male) aged 45 to 75 years were included. The generalized additive models revealed that a non-linear relationship between BMI and LDL-C level in both sexes after adjustment for age, residence, education levels, marital status, drinking, smoking status, and cohort (CHNS or CHARLS). Slopes of the association between BMI and LDL-C association changed at BMI 20.3 kg/m2 (95% CI: 18.8 to 21.8) in females and 27.1 kg/m2 (95% CI: 25. 8 to 28.4) in males. Below these BMI breakpoints, LDL-C levels increased 1.84 (95% CI: 1.45 to 2.31) in males and 3.49 (95% CI: 1.54 to 5.45) mg/dL per kg/m2 in females. However, LDL-C levels declined − 1.50 (95% CI: − 2.92 to − 0.09) mg/dL per kg/m2 above BMI of 27.1 kg/m2 in males. The non-linear association BMI and LDL-C in males and females was varied by cohort source, age groups, and the number of metabolic syndrome criteria.

Conclusions

In the Chinese middle aged and older adults, the BMI and LDL-C relationship was inverted U-shaped with a high level of LDL-C at a BMI of 27.1 kg/m2 in males, and an approximately linear association was observed in females.
How cancer cells remodel lipid metabolism: strategies targeting transcription factors
Authors: Jeong Do-Won , Lee Seulbee , Chun Yang-Sook
Published: November 2021

Reprogramming of lipid metabolism has received increasing recognition as a hallmark of cancer cells because lipid dysregulation and the alteration of related enzyme profiles are closely correlated with oncogenic signals and malignant phenotypes, such as metastasis and therapeutic resistance. In this review, we describe recent findings that support the importance of lipids, as well as the transcription factors involved in cancer lipid metabolism. With recent advances in transcription factor analysis, including computer-modeling techniques, transcription factors are emerging as central players in cancer biology. Considering the limited number and the crucial role of transcription factors associated with lipid rewiring in cancers, transcription factor targeting is a promising potential strategy for cancer therapy.