bluuebunny/crossref_metadata_2025 huggingface dataset:
Sex and gender differences in depressive symptoms in older workers: the role of working conditions
Authors: de Breij Sascha , Huisman Martijn , Boot Cécile R. L. , Deeg Dorly J. H.
Published: May 2022

Background

Female older workers generally leave the work force earlier than men. Depressive symptoms are a risk factor of early work exit and are more common in women. To extend working lives, pathways leading to these sex inequalities need to be identified. The aim of this study was to investigate the association of sex and gender with depressive symptoms in older workers, and the role of working conditions in this association.

Methods

We used data from the Longitudinal Aging Study Amsterdam (2012–2013/2015–2016, n = 313). Our outcome was depressive symptoms, measured by the Center for Epidemiologic Studies Depression Scale. We included biological sex, a gender index ranging from masculine to feminine (consisting of six items measuring gender roles: working hours, income, occupation segregation, education, informal caregiving, time spent on household chores), and working conditions (physical demands, psychosocial demands, cognitive demands, autonomy, task variation, social support) in our models. We examined the differential vulnerability hypothesis, i.e., sex/gender moderates the association between working conditions and depressive symptoms, and the differential exposure hypothesis, i.e., working conditions mediate the association between sex/gender and depressive symptoms.

Results

Female sex and feminine gender were both associated with more depressive symptoms. The differential vulnerability hypothesis was not supported by our results. We did find that femininity was negatively associated with autonomy and task variation. In turn, these working conditions were associated with fewer depressive symptoms. Thus, autonomy and task variation partially mediated the association between gender and depressive symptoms, supporting the differential exposure hypothesis. Mediation effects for sex inequalities were not significant.

Conclusions

Older female workers and older feminine workers have more depressive symptoms than their male/masculine counterparts. Autonomy and task variation appeared to be important in – partially – explaining gender differences in depressive symptoms rather than sex differences. By improving these conditions, gender inequality in mental health among older workers can be reduced, so that both genders have similar chances to reach the retirement age in good mental health.
Living standard and access to tetanus toxoid immunization among women in Bangladesh
Authors: Islam Ummay Nayeema , Sen Kanchan Kumar , Bari Wasimul
Published: May 2022

Background

Although Bangladesh has an impressive track record in the reduction of maternal and child mortality, tetanus, a dreadful disease, impedes the way to achieve Sustainable Development Goal (SDG) in this respect. Sufficient doses of tetanus toxoid containing vaccine during pregnancy ensure immunity against tetanus to mothers as well as newborns. Since inequalities persist across vaccination programs globally, in this paper, an attempt has been made to examine whether tetanus toxoid immunization (TTI) status among the women of reproductive age in Bangladesh for their most recent live birth born preceding 2 years of the survey changes with their living standard index (LSI).

Methods

Five domains of deprivation such as energy use, improved sanitation, drinking water, housing and assets ownership were used to compute the LSI using a approach proposed by Alkire and Foster. The adjusted association between LSI and TTI was established by using logistic regression model. For the purpose of statistical analysis, a nationally representative cross-sectional data extracted from Bangladesh Multiple Indicator Cluster Survey (BMICS), 2019 have been used.

Result

The bivariate analysis revealed that 79.5% (95% CI 78.0–81.0) of women with low and 83.1% (95% CI 81.3–84.9) with moderate living standards had sufficient vaccination coverage for their most recent pregnancies while this percentage was higher for the women who belonged to high living standard (85.2, 95% CI = 84.2–86.2). A strong evidence for greater odds of sufficient immunization with TT among the women maintaining a high standard of living (AOR = 1.24, 95% CI = 1.08–1.42, p < 0.01) was found from regression analysis.

Conclusion

The results depict existing living standard disparity with respect to TT vaccination coverage among women in Bangladesh. Present research suggests that immunization campaigns need to be conducted especially for the disadvantaged people to improve their health care and immunization service utilization among women within the age bracket of 15 to 49. This study proposed a scientific way to enhance TT vaccination among Bangladeshi women, which could help Bangladesh attain a widespread tetanus protection and thus, meet the SDGs for maternal and child mortality reduction.
Osteoporosis in nontuberculous mycobacterial pulmonary disease: a cross-sectional study
Authors: Tanaka Hiromu , Asakura Takanori , Suzuki Shoji , Okamori Satoshi , Kusumoto Tatsuya , Ogawa Takunori , Uno Shunsuke , Morita Atsuho , Lee Ho , Namkoong Ho , Kamata Hirofumi , Sato Yasunori , Uwamino Yoshifumi , Nishimura Tomoyasu , Ishii Makoto , Fukunaga Koichi , Hasegawa Naoki
Published: May 2022

Background

Since nontuberculous mycobacterial pulmonary disease (NTM-PD) is common in middle-aged/elderly slender women at risk of osteoporosis, we hypothesized that NTM-PD could be associated with osteoporosis. The study aimed to evaluate the prevalence of osteoporosis in patients with NTM-PD compared with that in the general population and determine the factors associated with osteoporosis in the subjects, including the serum estradiol (E2) and 25-hydroxyvitamin D (25OHD) levels.

Methods

We have recruited 228 consecutive adult patients with NTM-PD from a prospective cohort study at the Keio University Hospital, who had no history of osteoporosis or osteoporosis-associated bone fracture but underwent dual-energy X-ray absorptiometry-based bone mineral density (BMD) evaluation from August 2017–September 2019. The E2 and 25OHD levels were measured in 165 patients with available stored serum samples. We performed multivariable logistic regression analyses for osteopenia and osteoporosis.

Results

Osteoporosis (T-score ≤  − 2.5) and osteopenia (T-score − 1 to − 2.5) were diagnosed in 35.1% and 36.8% of patients with NTM-PD, respectively. Compared with the general population, the proportion of osteoporosis was significantly higher in 50–59-, 60–69-, and 70–79-year-old women with NTM-PD. Multivariable analysis revealed that older age (adjusted odds ratio [aOR] for 1-year increase = 1.12; 95% confidence interval [CI] = 1.07–1.18), female sex (aOR = 36.3; 95% CI = 7.57–174), lower BMI (aOR for 1 kg/m2 decrease = 1.37; 95% CI = 1.14–1.65), and chronic Pseudomonas aeruginosa (PA) infection (aOR = 6.70; 95% CI = 1.07–41.8) were independently associated with osteoporosis. Additionally, multivariable analysis in 165 patients whose serum E2 and 25OHD levels were measured showed that both low E2 levels (< 10 pg/mL) and lower 25OHD levels were independently associated with osteoporosis.

Conclusions

Middle-aged/elderly women with NTM-PD have a higher prevalence of osteoporosis than the general population. BMD screening should be considered in NTM-PD, especially in older females with severe diseases such as chronic PA infection and lower BMI, and low serum E2 and 25OHD levels.
Papillary muscle avulsion following balloon mitral valvotomy evaluated with three-dimensional echocardiography
Authors: Bai Wenjuan , Deng Ling , Tang Hong
Published: May 2022

Background

Percutaneous balloon mitral valvotomy is a common therapeutic approach for rheumatic mitral stenosis. Avulsion of the papillary muscle is a rare but serious complication of balloon mitral valvotomy. The papillary muscles are derived from the trabecular layer of the developing ventricular walls. When subjected to a force, avulsion of papillary muscle from the trabecular layer may occur.

Case presentation

In this case report, we describe a patient with rheumatic mitral stenosis, who experienced avulsion of the mitral papillary muscle from the left ventricular wall after undergoing balloon mitral valvotomy. Papillary muscle alvusion resulted in severe mitral regurgitation, which was finally treated by mitral valve replacement.

Conclusion

We successfully diagnosed avulsion of the papillary muscle following balloon mitral valvotomy. Three-dimensional transthoracic echocardiography provides more information on mitral apparatus structure than two-dimensional transthoracic echocardiography.
Piloting ‘Virtual Ward’: a novel platform for delivering medical student education by residents
Authors: Kappel Coralea , Hijazi Waseem , Singhal Nishma
Published: May 2022

Background

Clinical experiences lie at the heart of undergraduate medical education (UGME). COVID-19 related disruptions in Medical Education impacted medical students substantially. As educators, efforts directed at developing new mediums to educate our medical students in the face of these new limitations were vital. The Virtual Ward (VW) pilot was an inaugural resident-driven, virtual educational opportunity aimed at supplement the learning of core internal medicine skills for undergraduate medical students.

Methods

Interested medical students were paired in groups of 5–6 with an internal medicine resident tutor. The McMaster University UGME core internal medicine topic list was provided to resident tutors to teach in an open, morning-report format in which students directed content selection. Following completion of the VW series, we distributed an online anonymous survey using a 5-point Likert scale to gauge the efficacy of the intervention and compare it to existing learning modalities offered by the UGME.

Results

In total, 166 medical students and 27 internal medicine resident tutors participated in the VW pilot. 46 (28%) medical students responded to the survey and 96% of survey respondents rated the sessions as being helpful to their learning. The majority rated VW superior to existing learning modalities and 94% thought VW should continue after COVID-related restrictions abate.

Conclusions

VW is a novel educational platform that was very well received by learners. We propose VW may have a continued supplemental role post-pandemic to help with translation of knowledge to clinical skills and provide an additional avenue of mentorship for students.
Identification of individuals benefiting from the kakaritsuke-yakuzaishi (family pharmacist) system in Japan: a retrospective cohort study using an employment-based health insurance claims database
Authors: Iketani Ryo , Konomura Keiko
Published: May 2022

Background

The kakaritsuke-yakuzaishi system (henceforth, the family pharmacist system) which provides more health services than those by general pharmaceutical practice, was implemented in Japan in April 2016. To distribute medical resources and medical care expenditures appropriately, identifying the possible major beneficiaries of this system is essential. By analyzing administrative claims data through this retrospective cohort study, we identified modifiers of the potential benefits of the system. Further, we integrated the identified modifiers into a scoring system that indicates the possible benefitting subpopulations.

Methods

We obtained data about individuals under 75 years old routinely using community pharmacies in Japan from the JMDC database. We classified the individuals as users or non-users. We used claims related to “choufukutouyaku-sougosayoutou-boushi-kasan (additional therapeutic duplication and drug interaction [TDDI] prevention fees)” filed between April 2018 and March 2020, which indicate that individuals’ prescriptions were modified to adjust leftover drugs or to avoid TDDI as indicators of potential benefit. We estimated adjusted absolute risk differences and 95% confidence intervals for product terms using multiple generalized linear regression models. We included the factors whose 95% confidence interval lower limits did not reach 0 in the multiple logistic regression models for developing a scoring system.

Results

The eligible cohort included 162,340 individuals (1,214 users and 161,126 non-users). The leftover drugs adjustment significantly increased for individuals prescribed antidepressants. However, as only one modifier was identified, we did not develop a scoring system for the leftover drugs adjustment. For TDDI prevention, the following factors were included in the scoring system: being female, being prescribed ≥ 6 drug types, using ≥ 2 medical institutions, and being prescribed proton pump inhibitors, antibiotics, probiotics, or traditional Japanese herbal medicines. The developed scoring system for TDDI prevention scored “female” and “traditional Japanese herbal medicines prescription” factors higher than other factors.

Conclusions

Individuals who are female or prescribed traditional Japanese herbal medicines, or antidepressants may benefit significantly from the family pharmacist system.
APOBEC3 mutational signatures are associated with extensive and diverse genomic instability across multiple tumour types
Authors: Jakobsdottir G. Maria , Brewer Daniel S , Cooper Colin , Green Catherine , Wedge David C
Published: May 2022

Background

The APOBEC3 (apolipoprotein B mRNA editing enzyme catalytic polypeptide 3) family of cytidine deaminases is responsible for two mutational signatures (SBS2 and SBS13) found in cancer genomes. APOBEC3 enzymes are activated in response to viral infection, and have been associated with increased mutation burden and TP53 mutation. In addition to this, it has been suggested that APOBEC3 activity may be responsible for mutations that do not fall into the classical APOBEC3 signatures (SBS2 and SBS13), through generation of double strand breaks.Previous work has mainly focused on the effects of APOBEC3 within individual tumour types using exome sequencing data. Here, we use whole genome sequencing data from 2451 primary tumours from 39 different tumour types in the Pan-Cancer Analysis of Whole Genomes (PCAWG) data set to investigate the relationship between APOBEC3 and genomic instability (GI).

Results and conclusions

We found that the number of classical APOBEC3 signature mutations correlates with increased mutation burden across different tumour types. In addition, the number of APOBEC3 mutations is a significant predictor for six different measures of GI. Two GI measures (INDELs attributed to INDEL signatures ID6 and ID8) strongly suggest the occurrence and error prone repair of double strand breaks, and the relationship between APOBEC3 mutations and GI remains when SNVs attributed to kataegis are excluded.We provide evidence that supports a model of cancer genome evolution in which APOBEC3 acts as a causative factor in the development of diverse and widespread genomic instability through the generation of double strand breaks. This has important implications for treatment approaches for cancers that carry APOBEC3 mutations, and challenges the view that APOBECs only act opportunistically at sites of single stranded DNA.
Multiple metastases of androgen indifferent prostate cancer in the urinary tract: two case reports and a literature review
Authors: Masuda Tsukasa , Kosaka Takeo , Nakamura Kohei , Hongo Hiroshi , Yuge Kazuyuki , Nishihara Hiroshi , Oya Mototsugu
Published: May 2022

Background

Prostate cancer (PC) is mainly known to metastasize to bone, lung and liver, but isolated metastases of prostate cancer, including ductal carcinoma, in the urinary tract are very rare. We describe two patients with nodular masses in the urinary tract (the anterior urethra or the urinary bladder) that were found on cystoscopy during treatment of castration-resistant prostate cancer.

Case presentation

In both cases, the pathological diagnosis from transurethral tumor resection showed that they were androgen indifferent prostate cancer (AIPC), including aggressive variant prostate cancer (AVPC) in Case 1 and treatment-induced neuroendocrine differentiation prostate cancer (NEPC) in Case 2. In Case 1, Loss of genetic heterozygosity (LOH) of BRCA2 and gene amplification of KRAS was identified from the urethra polyps. In Case 2, homozygous deletion was observed in PTEN, and LOH without mutation was observed in RB1.

Conclusion

These are the first reports of two cases of urinary tract metastasis of AIPC.
Exome-wide analysis of copy number variation shows association of the human leukocyte antigen region with asthma in UK Biobank
Authors: Fawcett Katherine A. , Demidov German , Shrine Nick , Paynton Megan L. , Ossowski Stephan , Sayers Ian , Wain Louise V. , Hollox Edward J.
Published: May 2022

Background

The role of copy number variants (CNVs) in susceptibility to asthma is not well understood. This is, in part, due to the difficulty of accurately measuring CNVs in large enough sample sizes to detect associations. The recent availability of whole-exome sequencing (WES) in large biobank studies provides an unprecedented opportunity to study the role of CNVs in asthma.

Methods

We called common CNVs in 49,953 individuals in the first release of UK Biobank WES using ClinCNV software. CNVs were tested for association with asthma in a stage 1 analysis comprising 7098 asthma cases and 36,578 controls from the first release of sequencing data. Nominally-associated CNVs were then meta-analysed in stage 2 with an additional 17,280 asthma cases and 115,562 controls from the second release of UK Biobank exome sequencing, followed by validation and fine-mapping.

Results

Five of 189 CNVs were associated with asthma in stage 2, including a deletion overlapping the HLA-DQA1 and HLA-DQB1 genes, a duplication of CHROMR/PRKRA, deletions within MUC22 and TAP2, and a duplication in FBRSL1. The HLA-DQA1, HLA-DQB1, MUC22 and TAP2 genes all reside within the human leukocyte antigen (HLA) region on chromosome 6. In silico analyses demonstrated that the deletion overlapping HLA-DQA1 and HLA-DQB1 is likely to be an artefact arising from under-mapping of reads from non-reference HLA haplotypes, and that the CHROMR/PRKRA and FBRSL1 duplications represent presence/absence of pseudogenes within the HLA region. Bayesian fine-mapping of the HLA region suggested that there are two independent asthma association signals. The variants with the largest posterior inclusion probability in the two credible sets were an amino acid change in HLA-DQB1 (glutamine to histidine at residue 253) and a multi-allelic amino acid change in HLA-DRB1 (presence/absence of serine, glycine or leucine at residue 11).

Conclusions

At least two independent loci characterised by amino acid changes in the HLA-DQA1, HLA-DQB1 and HLA-DRB1 genes are likely to account for association of SNPs and CNVs in this region with asthma. The high divergence of haplotypes in the HLA can give rise to spurious CNVs, providing an important, cautionary tale for future large-scale analyses of sequencing data.
The autonomic balance of heart rhythm complexity after renal artery denervation: insight from entropy of entropy and average entropy analysis
Authors: Lin Po-Lin , Lin Ping-Yen , Huang Han-Ping , Vaezi Hamideh , Liu Lawrence Yu-Min , Lee Ying-Hsiang , Huang Chun-Che , Yang Ten-Fang , Hsu Long , Hsu Chang Francis
Published: May 2022

Background

The current method to evaluate the autonomic balance after renal denervation (RDN) relies on heart rate variability (HRV). However, parameters of HRV were not always predictive of response to RDN. Therefore, the complexity and disorder of heart rhythm, measured by entropy of entropy (EoE) and average entropy (AE), have been used to analyze autonomic dysfunction. This study evaluated the dynamic changes in autonomic status after RDN via EoE and AE analysis.

Methods

Five patients were prospectively enrolled in the Global SYMPLICITY Registry from 2020 to 2021. 24-h Holter and ambulatory blood pressure monitoring (ABPM) was performed at baseline and 3 months after RDN procedures. The autonomic status was analyzed using the entropy-based AE and EoE analysis and the conventional HRV-based low frequency (LF), high frequency (HF), and LF/HF.

Results

After RDN, the ABPM of all patients showed a significant reduction in blood pressure (BP) and heart rate. Only AE and HF values of all patients had consistent changes after RDN (p < 0.05). The spearman rank-order correlation coefficient of AE vs. HF was 0.86, but AE had a lower coefficient of variation than HF.

Conclusions

Monitoring the AE and EoE analysis could be an alternative to interpreting autonomic status. In addition, a relative change of autonomic tone, especially an increasing parasympathetic activity, could restore autonomic balance after RDN.
P-selectin glycoprotein ligand-1 (PSGL-1/CD162) is incorporated into clinical HIV-1 isolates and can mediate virus capture and subsequent transfer to permissive cells
Authors: Burnie Jonathan , Persaud Arvin Tejnarine , Thaya Laxshaginee , Liu Qingbo , Miao Huiyi , Grabinsky Stephen , Norouzi Vanessa , Lusso Paolo , Tang Vera A. , Guzzo Christina
Published: May 2022

Background

P-selectin glycoprotein ligand-1 (PSGL-1/CD162) has been studied extensively for its role in mediating leukocyte rolling through interactions with its cognate receptor, P-selectin. Recently, PSGL-1 was identified as a novel HIV-1 host restriction factor, particularly when expressed at high levels in the HIV envelope. Importantly, while the potent antiviral activity of PSGL-1 has been clearly demonstrated in various complementary model systems, the breadth of PSGL-1 incorporation across genetically diverse viral isolates and clinical isolates has yet to be described. Additionally, the biological activity of virion-incorporated PSGL-1 has also yet to be shown.

Results

Herein we assessed the levels of PSGL-1 on viruses produced through transfection with various amounts of PSGL-1 plasmid DNA (0–250 ng), compared to levels of PSGL-1 on viruses produced through infection of T cell lines and primary PBMC. We found that very low levels of PSGL-1 plasmid DNA (< 2.5 ng/well) were necessary to generate virus models that could closely mirror the phenotype of viruses produced via infection of T cells and PBMC. Unique to this study, we show that PSGL-1 is incorporated in a broad range of HIV-1 and SIV isolates and that virions with incorporated PSGL-1 are detectable in plasma from viremic HIV-1-infected individuals, corroborating the relevance of PSGL-1 in natural infection. Additionally, we show that PSGL-1 on viruses can bind its cognate selectin receptors, P-, E-, and L-selectins. Finally, we show viruses with endogenous levels of PSGL-1 can be captured by P-selectin and transferred to HIV-permissive bystander cells, highlighting a novel role for PSGL-1 in HIV-1 infection. Notably, viruses which contained high levels of PSGL-1 were noninfectious in our hands, in line with previous findings reporting the potent antiviral activity of PSGL-1.

Conclusions

Our results indicate that levels of PSGL-1 incorporation into virions can vary widely among model systems tested, and that careful tailoring of plasmid levels is required to recapitulate physiological systems when using pseudovirus models. Taken together, our data suggest that PSGL-1 may play diverse roles in the physiology of HIV-1 infection, particularly due to the functionally active state of PSGL-1 on virion surfaces and the breadth of PSGL-1 incorporation among a wide range of viral isolates.
Neutralizing antibody and T cell responses against SARS-CoV-2 variants of concern following ChAdOx-1 or BNT162b2 boosting in the elderly previously immunized with CoronaVac vaccine
Authors: Liwsrisakun Chalerm , Pata Supansa , Laopajon Witida , Takheaw Nuchjira , Chaiwong Warawut , Inchai Juthamas , Pothirat Chaicharn , Bumroongkit Chaiwat , Deesomchok Athavudh , Theerakittikul Theerakorn , Limsukon Atikun , Tajarernmuang Pattraporn , Niyatiwatchanchai Nutchanok , Trongtrakul Konlawij , Chuensirikulchai Kantinan , Kasinrerk Watchara
Published: May 2022

Background

The existence of SARS-CoV-2 variants of concern (VOCs) in association with evidence of breakthrough infections despite vaccination resulted in the need for vaccine boosting. In elderly individuals, information on the immunogenicity of booster vaccinations is limited. In countries where the CoronaVac inactivated vaccine is the primary vaccine, the appropriate boosting regimen is not clear. Immunologic studies of the effects of booster vaccination against VOCs, particularly Delta and Omicron, following CoronaVac in elderly individuals are helpful for policy makers. In this study, we determined the immune responses against VOCs following ChAdOx-1 or BNT162b2 boosting in elderly individuals previously immunized with CoronaVac.

Results

Before boosting, the median % inhibition of neutralizing antibodies (NAbs) against the wild-type (WT), Alpha, Beta, Delta and Omicron variants in the ChAdOx-1 and BNT162b2 groups was 52.8% vs. 53.4, 36.6% vs. 39.9, 5.2% vs. 13.7, 34.3% vs. 44.9, and 20.8% vs. 18.8%, respectively. After boosting with ChAdOx-1 or BNT162b2, the % inhibition of NAbs were increased to 97.3% vs. 97.4, 94.3% vs. 97.3%, 79.9 vs. 93.7, 95.5% vs. 97.5, and 26.9% vs. 31.9% for WT, Alpha, Beta, Delta and Omicron variants, respectively. Boosting with BNT162b2 induced significantly higher NAb levels than boosting with ChAdOx-1 against the Alpha, Beta and Delta variants but not the WT and Omicron variants. NAb levels against Omicron variant were not significantly different before and after boosting with ChAdOx-1 or BNT162b2. To evaluate T-cell responses, S peptides of the WT, Alpha, Beta and Delta variants were used to stimulate T cells. Upon stimulation, the expression of IL-17A in CD8 T cells was higher in the BNT162b2 group than in the ChAdOx-1 boosting group. However, IFN-γ production in CD4 and CD8 T cells did not significantly differ under all vaccination regimens. The expression of FasL in CD4 T cells, but not CD8 T cells, was higher in the BNT162b2-boosted group.

Conclusion

Boosting with either ChAdOx-1 or BNT162b2 in CoronaVac-primed healthy elderly individuals induced high NAb production against all examined VOCs except Omicron. BNT162b2 stimulated higher NAb and some T-cell responses than ChAdOx-1. Vaccine boosting is, therefore, recommended for elderly individuals previously immunized with CoronaVac.
Automated freezing of gait assessment with marker-based motion capture and multi-stage spatial-temporal graph convolutional neural networks
Authors: Filtjens Benjamin , Ginis Pieter , Nieuwboer Alice , Slaets Peter , Vanrumste Bart
Published: May 2022

Background

Freezing of gait (FOG) is a common and debilitating gait impairment in Parkinson’s disease. Further insight into this phenomenon is hampered by the difficulty to objectively assess FOG. To meet this clinical need, this paper proposes an automated motion-capture-based FOG assessment method driven by a novel deep neural network.

Methods

Automated FOG assessment can be formulated as an action segmentation problem, where temporal models are tasked to recognize and temporally localize the FOG segments in untrimmed motion capture trials. This paper takes a closer look at the performance of state-of-the-art action segmentation models when tasked to automatically assess FOG. Furthermore, a novel deep neural network architecture is proposed that aims to better capture the spatial and temporal dependencies than the state-of-the-art baselines. The proposed network, termed multi-stage spatial-temporal graph convolutional network (MS-GCN), combines the spatial-temporal graph convolutional network (ST-GCN) and the multi-stage temporal convolutional network (MS-TCN). The ST-GCN captures the hierarchical spatial-temporal motion among the joints inherent to motion capture, while the multi-stage component reduces over-segmentation errors by refining the predictions over multiple stages. The proposed model was validated on a dataset of fourteen freezers, fourteen non-freezers, and fourteen healthy control subjects.

Results

The experiments indicate that the proposed model outperforms four state-of-the-art baselines. Moreover, FOG outcomes derived from MS-GCN predictions had an excellent (r = 0.93 [0.87, 0.97]) and moderately strong (r = 0.75 [0.55, 0.87]) linear relationship with FOG outcomes derived from manual annotations.

Conclusions

The proposed MS-GCN may provide an automated and objective alternative to labor-intensive clinician-based FOG assessment. Future work is now possible that aims to assess the generalization of MS-GCN to a larger and more varied verification cohort.
Sex differences in the relationships between body composition, fat distribution, and mitochondrial energy metabolism: a pilot study
Authors: Bellissimo Moriah P. , Fleischer Candace C. , Reiter David A. , Goss Amy M. , Zhou Lei , Smith Matthew Ryan , Kohlmeier Jacob , Tirouvanziam Rabindra , Tran Phong H. , Hao Li , Crain Benjamin H. , Wells Greg D. , Jones Dean P. , Ziegler Thomas R. , Alvarez Jessica A.
Published: May 2022

Background

Adiposity and mitochondrial dysfunction are related factors contributing to metabolic disease development. This pilot study examined whether in vivo and ex vivo indices of mitochondrial metabolism were differentially associated with body composition in males and females.

Methods

Thirty-four participants including 19 females (mean 27 yr) and 15 males (mean 29 yr) had body composition assessed by dual energy x-ray absorptiometry and magnetic resonance (MR) imaging. Monocyte reserve capacity and maximal oxygen consumption rate (OCR) were determined ex vivo using extracellular flux analysis. In vivo quadriceps mitochondrial function was measured using 31P-MR spectroscopy based on post-exercise recovery kinetics (τPCr). The homeostatic model assessment of insulin resistance (HOMA-IR) was calculated from fasting glucose and insulin levels. Variables were log-transformed, and Pearson correlations and partial correlations were used for analyses.

Results

Mitochondrial metabolism was similar between sexes (p > 0.05). In males only, higher fat mass percent (FM%) was correlated with lower reserve capacity (r = − 0.73; p = 0.002) and reduced muscle mitochondrial function (r = 0.58, p = 0.02). Thigh subcutaneous adipose tissue was inversely related to reserve capacity in males (r = − 0.75, p = 0.001), but in females was correlated to higher maximal OCR (r = 0.48, p = 0.046), independent of FM. In females, lean mass was related to greater reserve capacity (r = 0.47, p = 0.04). In all participants, insulin (r = 0.35; p = 0.04) and HOMA-IR (r = 0.34; p = 0.05) were associated with a higher τPCr.

Conclusions

These novel findings demonstrate distinct sex-dependent associations between monocyte and skeletal muscle mitochondrial metabolism with body composition. With further study, increased understanding of these relationships may inform sex-specific interventions to improve mitochondrial function and metabolic health.
“Using information to shape perception”: tobacco industry documents study of the evolution of Corporate Affairs in the Miller Brewing Company
Authors: McCambridge Jim , Garry Jack , Kypri Kypros , Hastings Gerard
Published: May 2022

Background

The Miller Brewing Company (MBC) was wholly owned by Phillip Morris (PM), between 1970 and 2002. Tobacco industry document studies identify alliances between the alcohol and tobacco industries to counter U.S. policies in the 1980s and 1990s. This investigation sought to study in-depth inter-relationships between MBC and PM, with a particular focus on alcohol policy issues. We used the Truth Tobacco Industry Documents library to trace the evolution of corporate affairs and related alcohol policy orientated functions within and between MBC and PM.

Results

MBC was structured and led by PM senior executives from soon after takeover in 1970. Corporate Affairs sought to influence public perceptions of alcohol to align them with business interests. Alcohol education was specifically designed to prevent the adoption of policies inimical to those interests (e.g., raising excise taxes). Strategic consideration of alcohol policy issues was integrated within company-wide thinking, which sought to apply lessons from tobacco to alcohol and vice versa. PM directly led key alcohol industry organisations nationally and globally, which have successfully delayed the adoption and implementation of known effective policy measures in the U.S. and worldwide.

Conclusions

PM has been a key architect of alcohol industry political strategies. This study builds on earlier work on alcohol companies in the tobacco documents, and offers historical data on how tobacco companies have used commercial involvements in other sectors to influence wider public health policy. We are only beginning to appreciate how multi-sectoral companies internally develop political strategies across product categories. Global health and national governmental policy-making needs to be better protected from business interests that fundamentally conflict with public health goals.
Quantifying the reduction of respiratory motion by mechanical ventilation with MRI for radiotherapy
Authors: van Kesteren Z. , Veldman J. K. , Parkes M. J. , Stevens M. F. , Balasupramaniam P. , van den Aardweg J. G. , van Tienhoven G. , Bel A. , van Dijk I. W. E. M.
Published: May 2022

Background

Due to respiratory motion, accurate radiotherapy delivery to thoracic and abdominal tumors is challenging. We aimed to quantify the ability of mechanical ventilation to reduce respiratory motion, by measuring diaphragm motion magnitudes in the same volunteers during free breathing (FB), mechanically regularized breathing (RB) at 22 breaths per minute (brpm), variation in mean diaphragm position across multiple deep inspiration breath-holds (DIBH) and diaphragm drift during single prolonged breath-holds (PBH) in two MRI sessions.

Methods

In two sessions, MRIs were acquired from fifteen healthy volunteers who were trained to be mechanically ventilated non-invasively We measured diaphragm motion amplitudes during FB and RB, the inter-quartile range (IQR) of the variation in average diaphragm position from one measurement over five consecutive DIBHs, and diaphragm cranial drift velocities during single PBHs from inhalation (PIBH) and exhalation (PEBH) breath-holds.

Results

RB significantly reduced the respiratory motion amplitude by 39%, from median (range) 20.9 (10.6–41.9) mm during FB to 12.8 (6.2–23.8) mm. The median IQR for variation in average diaphragm position over multiple DIBHs was 4.2 (1.0–23.6) mm. During single PIBHs with a median duration of 7.1 (2.0–11.1) minutes, the median diaphragm cranial drift velocity was 3.0 (0.4–6.5) mm/minute. For PEBH, the median duration was 5.8 (1.8–10.2) minutes with 4.4 (1.8–15.1) mm/minute diaphragm drift velocity.

Conclusions

Regularized breathing at a frequency of 22 brpm resulted in significantly smaller diaphragm motion amplitudes compared to free breathing. This would enable smaller treatment volumes in radiotherapy. Furthermore, prolonged breath-holding from inhalation and exhalation with median durations of six to seven minutes are feasible.

Trial registration

Medical Ethics Committee protocol NL.64693.018.18.
The effect of corticosteroid injection in the treatment of greater trochanter pain syndrome: a systematic review and meta-analysis of randomized controlled trials
Authors: Wang Yule , Wang Kaijin , Qin Yiling , Wang Sanrong , Tan Botao , Jia Lang , Jia Gongwei , Niu Lingchuan
Published: May 2022

Background

corticosteroid injection (CSI) has been used to treat greater trochanter pain syndrome (GTPS) for many years. However, so far, the efficacy of CSI in the treatment of GTPS is still controversial. Therefore, the aim of this review is to evaluate the effectiveness of CSI in comparison with sham intervention, nature history, usual care, platelet-rich plasma (PRP), physiotherapy/exercise therapy, dry needling, or other nonsurgical treatment for improvements in pain and function in GTPS.

Methods

PubMed (Medline), Embase, Cochrane Library were searched from their inception until April 2021. Randomized controlled trails (RCTs) comparing CSI to nonsurgical treatment were included. Data on the effect of CSI on pain and function were extracted and checked by two review authors independently. The treatment effect was analyzed in the short term, medium term, and long term.

Results

Eight RCTs (764 patients) were included. This review suggests CSI may be superior to usual care and ‘wait and see,’ ESWT, but may not be superior to exercise, PRP, dry needling, and sham intervention in short-term pain or function improvement. In terms of medium-term pain or function improvement, CSI may be superior to usual care and ‘wait and see,’ but may not be superior to PRP. In terms of long-term pain or function improvement, CSI may be inferior to PRP and ESWT, but it may be superior to usual care and ‘wait and see’ at 12 months.

Conclusions

Due to the small sample size and lack of sufficient clinical studies, current evidence is equivocal regarding the efficacy of CSI in the treatment of GTPS. Considering the limitations, more large-sample and high-quality RCTs are needed to prove the therapeutic effect of CSI on GTPS.

Trial registration

PROSPERO registration number: CRD42021247991. Registered 09 May 2021.
Impact of gender differences on hemostasis in patients after coronary artery bypass grafts surgeries in the context of tranexamic acid administration
Authors: Wang Enshi , Wang Yang , Hu Shengshou , Yuan Su
Published: May 2022

Background

Sex differences present in the blood management of patients after coronary artery bypass grafts (CABG) surgeries. Tranexamic acid (TXA) performed well in maintaining hemostasis during and after surgeries. However, the impact of sex differences on blood control after CABG in patients who received TXA was not investigated.

Methods

Overall, 29,536 patients undergoing CABG with TXA administration from 2009 to 2019 in our hospital were included. Propensity score matching was performed. Finally, 6808 males and 6808 females were matched based on 23 covariates.

Results

Female patients had a 0.36-fold lower incidence of reoperations due to major hemorrhage or cardiac tamponade compared to males (1.3% vs. 2.0%, p = 0.001, OR = 0.64, 95%CI = 0.49–0.84). Females had a median of 100 ml less blood loss in 24 h (median 360 vs. 460 ml, p < 0.0001), 150 ml less in 48 h (median 580 vs. 730 ml, p < 0.0001), and 180 ml less in total (median 760 vs. 940 ml, p < 0.0001) than male patients. The red blood cell (RBC) transfusion rate in female was 1.53-fold higher than that in male (33.0% vs. 21.6%, OR = 1.53, 95% CI = 1.43–1.63, p < 0.0001). Females also had higher morbidities than males after CABGs.

Conclusions

Females had less blood loss than males after CABG with the TXA treatment. Females still had a higher RBC transfusion rate after surgery. Morbidities in women were also higher than that in men.
The effect of cognitive functional therapy for chronic nonspecific low back pain: a systematic review and meta-analysis
Authors: Miki Takahiro , Kondo Yu , Kurakata Hiroshi , Buzasi Eva , Takebayashi Tsuneo , Takasaki Hiroshi
Published: May 2022

Background

To apply the Bio-Psych-Social (BPS) model into clinical practice, it is important not to focus on psychosocial domains only since biomedical factors can also contribute to chronic pain conditions. The cognitive functional therapy (CFT) is the management system based on the BPS model for chronic nonspecific low back pain (CNSLBP).

Objectives

This study aimed to compare CFT with the other interventions for CNSLBP regarding pain, disability/functional status, QoL and psychological factors.

Design

This study was a systematic review and meta-analysis of a randomised controlled trial.

Method

Literature Search was conducted in electronic search engines. Enrolled participants included 1) CNSLBP and 2) primary, secondary, or tertiary care patients. CFT was the interventions included. Comparisons were any types of treatment.

Results

Three studies met the eligibility criteria. The total number of participants was 336. For pain intensity, MD [95% CIs] was -1.38 [-2.78 − 0.02] and -1.01 [-1.92 − -0.10] at intermediate and long term for two studies, respectively. About disability/functional status, SMD [95% CIs] was -0.76 [-1.46 − -0.07] at the intermediate for three studies and MD [95% CIs] was -8.48 [-11.47 − -5.49] at long term for two studies. About fear of physical activity, MD [95% CIs] was -3.01 [-5.14 − -0.88] and -3.56 [-6.43 − -0.68] at intermediate and long term for two studies, respectively. No studies reported scores associated with QOL. All the quality of the evidence was very low.

Conclusions

Three studies were included and the quality of all the evidence was very low. Although the study found statistically significant differences in some measures, the effectiveness of the CFT will need to be re-evaluated in the future.

Trial registration

PROSPERO registration number CRD42020158182.
A multicentre evaluation exploring the impact of an integrated health and social care intervention for the caregivers of ICU survivors
Authors: McPeake Joanne , Henderson Philip , MacTavish Pamela , Devine Helen , Daniel Malcolm , Lucie Phil , Bollan Lynn , Hogg Lucy , MacMahon Mike , Mulhern Sharon , Murray Pauline , O’Neill Laura , Strachan Laura , Iwashyna Theodore J. , Shaw Martin , Quasim Tara
Published: May 2022

Background

Caregivers and family members of Intensive Care Unit (ICU) survivors can face emotional problems following patient discharge from hospital. We aimed to evaluate the impact of a multi-centre integrated health and social care intervention, on caregiver and family member outcomes.

Methods

This study evaluated the impact of the Intensive Care Syndrome: Promoting Independence and Return to Employment (InS:PIRE) programme across 9 sites in Scotland. InS:PIRE is an integrated health and social care intervention. We compared caregivers who attended this programme with a contemporary control group of ICU caregivers (usual care cohort), who did not attend.

Results

The primary outcome was anxiety measured via the Hospital Anxiety and Depression Scale at 12 months post-hospital discharge. Secondary outcome measures included depression, carer strain and clinical insomnia. A total of 170 caregivers had data available at 12 months for inclusion in this study; 81 caregivers attended the InS:PIRE intervention and completed outcome measures at 12 months post-hospital discharge. In the usual care cohort of caregivers, 89 completed measures. The two cohorts had similar baseline demographics. After adjustment, those caregivers who attended InS:PIRE demonstrated a significant improvement in symptoms of anxiety (OR: 0.42, 95% CI: 0.20–0.89, p = 0.02), carer strain (OR: 0.39; 95% CI: 0.16–0.98 p = 0.04) and clinical insomnia (OR: 0.40; 95% CI: 0.17–0.77 p < 0.001). There was no significant difference in symptoms of depression at 12 months.

Conclusions

This multicentre evaluation has shown that caregivers who attended an integrated health and social care intervention reported improved emotional health and less symptoms of insomnia, 12 months after the delivery of the intervention.
Interspecific hybridization in tomato influences endogenous viral sRNAs and alters gene expression
Authors: Lopez-Gomollon Sara , Müller Sebastian Y. , Baulcombe David C.
Published: May 2022

Background

Hybridization is associated with the activation of transposable elements and changes in the patterns of gene expression leading to phenotypic changes. However, the underlying mechanisms are not well understood.

Results

Here, we describe the changes to the gene expression in interspecificSolanumhybrids that are associated with small RNAs derived from endogenous (para)retroviruses (EPRV). There were prominent changes to sRNA profiles in these hybrids involving 22-nt species produced in the DCL2 biogenesis pathway, and the hybridization-induced changes to the gene expression were similar to those in adcl2mutant.

Conclusions

These findings indicate that hybridization leads to activation of EPRV, perturbation of small RNA profiles, and, consequently, changes in the gene expression. Such hybridization-induced variation in the gene expression could increase the natural phenotypic variation in natural evolution or in breeding for agriculture.
Effectiveness of multimodal exercises integrated with cognitive-behavioral therapy in working patients with chronic neck pain: protocol of a randomized controlled trial with 1-year follow-up
Authors: Monticone M. , Simone Vullo S. , Lecca L. I. , Meloni F. , Portoghese I. , Campagna M.
Published: May 2022

Background

The etiology of neck pain is multifactorial and includes personal and work-related factors such as age, sex, wrong postures, and repeated strains. Studies based on bio-psychosocial model also link chronic neck pain to psychological factors. Over time, the use of multidisciplinary interventions for chronic neck pain has grown in order to improve disability, pain, and adaptive cognitions and behaviors towards patients’ problems. The objective is to evaluate the effectiveness of an individual-based multidisciplinary rehabilitation program that integrates cognitive-behavioral therapy focused on kinesiophobia with specific exercises in the treatment of patients with chronic neck pain, employed in different working activities.

Methods

A randomized, parallel-group superiority-controlled trial will be conducted with 1-year follow-up. One hundred seventy patients engaged in several working activities (blue collar and white collar workers) will be randomly allocated to either the experimental (receiving a multidisciplinary rehabilitation program combining multimodal exercises with psychologist-lead cognitive-behavioral therapy sessions) or the control group (receiving general care physiotherapy). Both groups will follow individual-based programs once a week for 10 weeks. The main outcome measures will be the Neck Disability Index, the Tampa Scale for Kinesiophobia, the Pain Catastrophizing Scale, a pain numerical rating scale, the Short-Form Health Survey, and the Work Ability Index. Participants will be evaluated before, after training, and after 12 months.

Discussion

Findings may provide empirical evidence on the effectiveness of an individual-based multidisciplinary rehabilitation program on inducing clinically significant and long-term improvements in the disability, pain, psychological factors, and quality of life of workers with chronic neck pain and that these would be maintained in the long term. Hence, this trial might contribute towards refining guidelines for good clinical practice and might be used as a basis for health authorities’ recommendations.

Trial registration

ClinicalTrials.gov NCT04768790. Registered on 24 February 2021