bluuebunny/crossref_metadata_2025 huggingface dataset:
Interactive Affection of Pre-Pregnancy Overweight or Obesity, Excessive Gestational Weight Gain and Glucose Tolerance Test Characteristics on Adverse Pregnancy Outcomes Among Women With Gestational Diabetes Mellitus
Authors: Lin Li-hua , Lin Juan , Yan Jian-ying
Published: July 2022

Purpose

To examine the combined effect of pre-pregnancy overweight or obesity, excessive gestational weight gain, and glucose tolerance status on the incidence of adverse pregnancy outcomes among women with gestational diabetes mellitus.

Methods

A observational study including 5529 gestational diabetes mellitus patients was performed. Logistic regression were used to assess the independent and multiplicative interactions of overweight or obese, excessive gestational weight gain, abnormal items of oral glucose tolerance test and adverse pregnancy outcomes. Additive interactions were calculated using an Excel sheet developed by Anderson to calculate relative excess risk.

Results

Overall 1076(19.46%) study subject were overweight or obese and 1858(33.60%) women gained weight above recommended. Based on IADPSG criteria, more than one-third women with two, or three abnormal glucose values. Preconception overweight or obesity, above recommended gestational weight gain, and two or more abnormal items of oral glucose tolerance test parameters significantly increased the risk of adverse pregnancy outcomes, separately. After accounting for confounders, each two of overweight or obesity, excessive gestational weight gain, two or more abnormal items of OGTT parameters, the pairwise interactions on adverse pregnancy outcomes appear to be multiplicative. Coexistence of preconception overweight or obesity, above recommended gestational weight gain and two or more abnormal items of oral glucose tolerance test parameters increased the highest risk for adverse pregnancy outcomes. No additive interaction was found.

Conclusions

Pre-pregnancy overweight or obesity, excessive gestational weight gain, two or more abnormal items of OGTT parameters contribute to adverse pregnancy outcomes independently among women with gestational diabetes mellitus. Additionally, the combined effect between these three factors and adverse pregnancy outcomes appear to be multiplicative. Interventions focus on maternal overweight or obesity and gestational weight gain should be offered to improve pregnancy outcomes.
Short-Term Forecasting and Uncertainty Analysis of Photovoltaic Power Based on the FCM-WOA-BILSTM Model
Authors: Cao Wensi , Zhou Junlong , Xu Qiang , Zhen Juan , Huang Xiaobo
Published: July 2022

Aiming to solve the problem that photovoltaic power generation is always accompanied by uncertainty and the short-term prediction accuracy of photovoltaic power (PV) is not high, this paper proposes a method for short-term photovoltaic power forecasting (PPF) and uncertainty analysis using the fuzzy-c-means (FCM), whale optimization algorithm (WOA), bi-directional long short-term memory (BILSTM), and no-parametric kernel density estimation (NPKDE). First, the principal component analysis (PCA) is used to reduce the dimensionality of the daily feature vector, and then the FCM is used to divide the weather into four categories: sunny, cloudy, rainy, and extreme weather. Second, the WOA algorithm is used to train the hyperparameters of BILSTM, and finally, the optimized hyperparameters were used to construct a WOA-BILSTM prediction model to train the four types of weather samples after FCM clustering. The NPKDE method was used to calculate the probability density distribution of PV prediction errors and confidence intervals for PPF. The RMSEs of the FCM-WOA-BILSTM model are 2.46%, 4.89%, and 1.14% for sunny, cloudy, and rainy weather types, respectively. The simulation results of the calculation example show that compared with the BP, LSTM, GRU, PSO-BILSTM, and FCM-PSO-BP models, the proposed FCM-WOA-BILSTM model has higher prediction accuracy under various weather types, which verifies the effectiveness of the method. Moreover, the NPKDE method can accurately describe the probability density distribution of forecast errors.
Polycentricity, Agglomeration, and Industrial Air Pollution in the Chinese City-Regions
Authors: Han Xu , Dou Jianmin , Tang Chenghui
Published: July 2022

With the rise of the city-regions development strategy, the impact of the spatial structure in city-regions on environmental pollution becomes an increasingly important issue related to sustainable regional development. Although previous studies have paid attention to spatial structure affecting environmental quality, there is a lack of analyzing the reduction effect of industrial pollution emission from the perspective of polycentricity and monocentricity. In order to provide the evidence from industrial production activities to test the relationship between spatial structure and industrial pollution, this study extends the production density model by treating industrial pollution emissions as non-expected output and introducing the spatial structure factor into the model, thus revealing the non-linear interactive effects of spatial structure and agglomeration on industrial pollution emissions, and exploring this emission reduction effect and its mechanisms using threshold regression model and mediation model. The empirical analysis shows that spatial structure matters and the results are as follows: Firstly, polycentricity is associated with lower industrial pollution emission intensity, but the emission reduction effect of polycentricity depends on regional agglomeration. Secondly, the higher the regional agglomeration, the greater the emission reduction effect. Thirdly, the heterogeneity test also indicates that the geographical compactness and unified administration of city-regions strengthen this emission reduction effect. Fourthly, the mediating effect test verifies the three mechanisms proposed in this study, among which energy utilization efficiency effect plays a major role. The governments are expected to promote the transformation of the spatial structure from a monocentricity to polycentricity based on the level of regional agglomeration to ensure that the expected emission reduction effect can be achieved.
Network Evolution and Influencing Factors of Global Trade Embodied Carbon Emission
Authors: Di Yuna , Cao Jinjin , Guo Zhichao , Khan Muhammad Kaleem
Published: July 2022

As a global issue, climate warming has received extensive attention in recent years. Scientific identification of the network evolution, transfer path, and influencing factors of embodied carbon in trade is of great significance for the global joint response to climate change challenges. In this paper, based on the latest World Input-Output Database and carbon emissions data of 42 countries (the total carbon emissions of 42 countries account for about 80% of the world’s total carbon emissions), we use social network analysis to describe the global trade embodied carbon emission from 2000 to 2014, and explore the relevant factors that influence global embodied carbon emissions. From the overall network, a small number of countries produce more carbon emissions, of which China is gradually in the center of the global carbon emissions network, while the United States and the European Union are always in the center. The point entry degree of developed economies is larger, while the point out degree of developing countries is higher, indicating that part of carbon emissions from developed countries are transferred to developing countries through economic links. Through QAP analysis, it is found that factors such as population, energy structure, geographic distance, final consumption and trade agreements are the main factors of the evolution of the embodied carbon network, and these factors can explain 42.3% of the pattern of the implied carbon network in trade. Moreover, the decrease of the degree of proximity indicates that the path of carbon emission correlation between countries is shortening and it is necessary for the world to join hands to respond to climate change.
Agricultural Communities’ Risk Assessment and the Effects of Climate Change: A Pathway Toward Green Productivity and Sustainable Development
Authors: Sohail Muhammad Tayyab , Mustafa Sohaib , Ali Mazurina Mohd , Riaz Sidra
Published: July 2022

This study was carried out to assess agricultural communities’ understanding of climate change, the adaptation measures being undertaken against climate change, and industrial wastewater irrigation. It was considered important to check agricultural communities’ understanding of climate change, as the majority of the study area belongs to the farming and industry sector. This study was based on primary data collected through a survey in the study area. The results of present study showed that agricultural communities with sufficient resources and assets consider themselves to be safer and more capable of coping with the negative effects of climate change. Agricultural communities used different techniques to deal with the impacts of climate change in present study area. This study produced findings about agricultural households’ adaptation tactics that are unique and will aid policymakers in assisting agricultural communities in their day-to-day activities and farming practices, as well as in the implementation of proper monitoring and public policies to ensure integration and sustainability. This research is based on the sustainable livelihoods approach (SLA), which investigates how livelihood assets support agricultural communities by combining household adoption/adaptation strategies and livelihood outcomes.
Environmental Stress and the Primate Microbiome: Glucocorticoids Contribute to Structure Gut Bacterial Communities of Black Howler Monkeys in Anthropogenically Disturbed Forest Fragments
Authors: Martínez-Mota Rodolfo , Righini Nicoletta , Mallott Elizabeth K. , Palme Rupert , Amato Katherine R.
Published: July 2022

Animals living in anthropogenically disturbed habitats are exposed to environmental stressors which can trigger physiological reactions, such as chronic elevations of glucocorticoid hormones. Physiological responses to stressors may induce changes in the gut microbiome, most likely, facilitated by the gut–brain communication. Although these effects have been observed in humans and animal models, elucidating gut bacterial changes in wild animals under natural stressful conditions is still an ongoing task. Here we analyzed the association between physiological stress related to anthropogenic forest disturbance and changes in gut bacterial communities of black howler monkeys (Alouatta pigra) living in forest fragments in Mexico. We measured individuals’ fecal glucocorticoid metabolites (fGCMs) as an index of physiological stress and created inventories of fecal bacterial communities sequencing the 16S rRNA gene to assess gut microbiome change. We evaluated environmental stress by estimating differences in food availability – feeding tree diversity and biomass – in each group’s habitat. We found that both fGCMs and food availability indices were related to gut bacterial community shifts in black howler monkeys. Furthermore, using structural equation modeling, we found that a decrease in food availability, estimated through reductions in feeding tree basal area, increased fGCMs, which in turn induced increases in bacterial richness. Our findings show that the activation of the hypothalamic–pituitary–adrenal (HPA)-axis, which is a physiological response sensitive to environmental stressors such as the ecological disturbance of a habitat, contributes to structure the gut microbiome of arboreal primates in disturbed forests.
Human Occupation of the North American Colorado Plateau ∼37,000 Years Ago
Authors: Rowe Timothy B. , Stafford Thomas W. , Fisher Daniel C. , Enghild Jan J. , Quigg J. Michael , Ketcham Richard A. , Sagebiel J. Chris , Hanna Romy , Colbert Matthew W.
Published: July 2022

Calibrating human population dispersals across Earth’s surface is fundamental to assessing rates and timing of anthropogenic impacts and distinguishing ecological phenomena influenced by humans from those that were not. Here, we describe the Hartley mammoth locality, which dates to 38,900–36,250 cal BP by AMS 14C analysis of hydroxyproline from bone collagen. We accept the standard view that elaborate stone technology of the Eurasian Upper Paleolithic was introduced into the Americas by arrival of the Native American clade ∼16,000 cal BP. It follows that if older cultural sites exist in the Americas, they might only be diagnosed using nuanced taphonomic approaches. We employed computed tomography (CT and μCT) and other state-of-the-art methods that had not previously been applied to investigating ancient American sites. This revealed multiple lines of taphonomic evidence suggesting that two mammoths were butchered using expedient lithic and bone technology, along with evidence diagnostic of controlled (domestic) fire. That this may be an ancient cultural site is corroborated by independent genetic evidence of two founding populations for humans in the Americas, which has already raised the possibility of a dispersal into the Americas by people of East Asian ancestry that preceded the Native American clade by millennia. The Hartley mammoth locality thus provides a new deep point of chronologic reference for occupation of the Americas and the attainment by humans of a near-global distribution.
Potential Factors Canceling Interannual Cycles of Shoot Production in a Moso Bamboo (Phyllostachys pubescens) Stand
Authors: Lin Chuan-Ya , Miki Takeshi , Kume Tomonori
Published: July 2022

Moso bamboo (Phyllostachys pubescens) forests are utilized for food, building materials, and carbon fixation in East Asia. Hence, understanding the factors that influence productivity is important. Long-term records of managed Moso bamboo forests have provided evidence for 2-year cycles of new shoot production. A widely accepted explanatory hypothesis is that the 2-year leaf life span and unequal proportions of newer and older leaves in bamboo stands are the cause of the 2-year shoot production cycle. However, 2-year cycles are not observed in all circumstances. If the 2-year leaf life span causes the biennial production cycle, why are the 2-year cycles of new shoot production not observed in some periods? By constructing an age-structured population growth model that considered the Moso bamboo leaf life span, this study aimed to clarify the possible mechanisms that could suppress the 2-year cycle of new shoot production. The simulation demonstrated that the 2-year cycle may readily disappear because of the contribution of considerable carbohydrates originating from photosynthesis in old leaves and in new leaves of zero-year-old culms, and from belowground carbon storage in roots and rhizomes. The results suggested that the contribution of photosynthesis in old leaves and in new leaves of zero-year-old culms may be overlooked at the population scale, and that belowground carbon storage in Moso bamboo rhizome systems might act as buffer to stabilize the year-to-year variations in new shoot production.
Genome-Wide Characterization and Analysis of the bHLH Transcription Factor Family in Suaeda aralocaspica, an Annual Halophyte With Single-Cell C4 Anatomy
Authors: Wei Xiaowei , Cao Jing , Lan Haiyan
Published: July 2022

Basic helix-loop-helix (bHLH) transcription factors play important roles in plant growth, development, metabolism, hormone signaling pathways, and responses to abiotic stresses. However, comprehensive genomic and functional analyses ofbHLHgenes have not yet been reported in desert euhalophytes.Suaeda aralocaspica, an annual C4halophyte without Kranz anatomy, presents high photosynthetic efficiency in harsh natural habitats and is an ideal plant for identifying transcription factors involved in stress resistance. In this study, 83bHLHgenes inS. aralocaspicawere identified and categorized into 21 subfamilies based on conserved motifs, gene structures, and phylogenetic analysis. Functional annotation enrichment revealed that the majority of SabHLHs were enriched in Gene Ontology (GO) terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways involved in the response to stress conditions, as transcription factors. A number ofcis-acting elements related to plant hormones and stress responses were also predicted in the promoter regions ofSabHLHs, which were confirmed by expression analysis under various abiotic stress conditions (NaCl, mannitol, low temperature, ABA, GA3, MeJA, and SA); most were involved in tolerance to drought and salinity. SabHLH169 (076) protein localized in the nucleus was involved in transcriptional activity, and gene expression could be affected by different light qualities. This study is the first comprehensive analysis of thebHLHgene family inS. aralocaspica.These data will facilitate further characterization of their molecular functions in the adaptation of desert plants to abiotic stress.
Metabolic Reprogramming Induces Macrophage Polarization in the Tumor Microenvironment
Authors: Wang Shilin , Liu Guohong , Li Yirong , Pan Yunbao
Published: July 2022

Macrophages are one of the most important cells in the innate immune system, they are converted into two distinct subtypes with completely different molecular phenotypes and functional features under different stimuli of the microenvironment: M1 macrophages induced by IFN-γ/lipopolysaccharides(LPS) and M2 macrophages induced by IL-4/IL-10/IL-13. Tumor-associated macrophages (TAMs) differentiate from macrophages through various factors in the tumor microenvironment (TME). TAMs have the phenotype and function of M2 macrophages and are capable of secreting multiple cytokines to promote tumor progression. Both tumor cells and macrophages can meet the energy needs for rapid cell growth and proliferation through metabolic reprogramming, so a comprehensive understanding of pro-tumor and antitumor metabolic switches in TAM is essential to understanding immune escape mechanisms. This paper focuses on the functions of relevant signaling pathways and cytokines during macrophage polarization and metabolic reprogramming, and briefly discusses the effects of different microenvironments and macrophage pathogenicity, in addition to describing the research progress of inhibitory drugs for certain metabolic and polarized signaling pathways.
N-glycosylation of UNC93B1 at a Specific Asparagine Residue Is Required for TLR9 Signaling
Authors: Song Hyun-Sup , Park Soeun , Huh Ji-Won , Lee Yu-Ran , Jung Da-Jung , Yang Chorong , Kim So Hyun , Kim Ho Min , Kim You-Me
Published: July 2022

Toll-like receptors (TLRs) play critical roles in the first line of host defense against pathogens through recognition of pathogen-associated molecular patterns and initiation of the innate immune responses. The proper localization of TLRs in specific subcellular compartments is crucial for their ligand recognition and downstream signaling to ensure appropriate responses against pathogens while avoiding erroneous or excessive activation. Several TLRs, including TLR7 and TLR9 but not TLR4, depend on UNC93B1 for their proper intracellular localization and signaling. Accumulating evidence suggest that UNC93B1 differentially regulates its various client TLRs, but the specific mechanisms by which UNC93B1 controls individual TLRs are not well understood. Protein N-glycosylation is one of the most frequent and important post-translational modification that occurs in membrane-localized or secreted proteins. UNC93B1 was previously shown to be glycosylated at Asn251 and Asn272 residues. In this study, we investigated whether N-glycosylation of UNC93B1 affects its function by comparing wild type and glycosylation-defective mutant UNC93B1 proteins. It was found that glycosylation of Asn251 and Asn272 residues can occur independently of each other and mutation of neither N251Q or N272Q in UNC93B1 altered expression and localization of UNC93B1 and TLR9. In contrast, CpG DNA-stimulated TLR9 signaling was severely inhibited in cells expressing UNC93B1(N272Q), but not in cells with UNC93B1(N251Q). Further, it was found that glycosylation at Asn272 of UNC93B1 is essential for the recruitment of MyD88 to TLR9 and the subsequent downstream signaling. On the other hand, the defective glycosylation at Asn272 did not affect TLR7 signaling. Collectively, these data demonstrate that the glycosylation at a specific asparagine residue of UNC93B1 is required for TLR9 signaling and the glycosylation status of UNC93B1 differently affects activation of TLR7 and TLR9.
Development and Validation of a Nomogram for Predicting Generalization in Patients With Ocular Myasthenia Gravis
Authors: Ruan Zhe , Sun Chao , Lang Yanlin , Gao Feng , Guo Rongjing , Xu Quan , Yu Liping , Wu Songdi , Lei Tao , Liu Yu , Zhang Min , Li Huanhuan , Tang Yonglan , Gao Ting , Gao Yanwu , Lu Xiaodan , Li Zhuyi , Chang Ting
Published: July 2022

Background

This study aims to develop and validate a nomogram for predicting 1- and 2-year generalization probabilities in patients with ocular myasthenia gravis (OMG).

Methods

In total, 501 eligible patients with OMG treated at seven tertiary hospitals in China between January 2015 and May 2019 were included. The primary outcome measure was disease generalization. A nomogram for predicting 1- and 2-year generalization probabilities was constructed using a stepwise Cox regression model. Nomogram performance was quantified using C-indexes and calibration curves. Two-year cumulative generalization rates were analyzed using the Kaplan−Meier method for distinct nomogram-stratified risk groups. The clinical usefulness of the nomogram was evaluated using decision curve analysis (DCA).

Result

The eligible patients were randomly divided into a development cohort (n=351, 70%) and a validation cohort (n=150, 30%). The final model included five variables: sex, onset age, repetitive nerve stimulation findings, acetylcholine receptor antibody test results, and thymic status. The model demonstrated good discrimination (C-indexes of 0.733 and 0.788 in the development and validation cohorts, respectively) and calibration, with good agreement between actual and nomogram-estimated generalization probabilities. Kaplan−Meier curves revealed higher 2-year cumulative generalization rates in the high-risk group than that in the low-risk group. DCA demonstrated a higher net benefit of nomogram-assisted decisions compared to treatment of all patients or none.

Conclusion

The nomogram model can predict 1- and 2-year generalization probabilities in patients with OMG and stratified these patients into distinct generalization risk groups. The nomogram has potential to aid neurologists in selecting suitable patients for initiating immunotherapy and for enrolment in clinical trials of risk-modifying treatments.
Multiple Myeloma-Derived Extracellular Vesicles Modulate the Bone Marrow Immune Microenvironment
Authors: Lopes Raquel , Caetano Joana , Barahona Filipa , Pestana Carolina , Ferreira Bruna Velosa , Lourenço Diana , Queirós Ana C. , Bilreiro Carlos , Shemesh Noam , Beck Hans Christian , Carvalho Ana Sofia , Matthiesen Rune , Bogen Bjarne , Costa-Silva Bruno , Serre Karine , Carneiro Emilie Arnault , João Cristina
Published: July 2022

Multiple myeloma (MM), the third most frequent hematological cancer worldwide, is characterized by the proliferation of neoplastic plasma cells in the bone marrow (BM). One of the hallmarks of MM is a permissive BM microenvironment. Increasing evidence suggests that cell-to-cell communication between myeloma and immune cellsviatumor cell-derived extracellular vesicles (EV) plays a key role in the pathogenesis of MM. Hence, we aimed to explore BM immune alterations induced by MM-derived EV. For this, we inoculated immunocompetent BALB/cByJ mice with a myeloma cell line, MOPC315.BM, inducing a MM phenotype. Upon tumor establishment, characterization of the BM microenvironment revealed the expression of both activation and suppressive markers by lymphocytes, such as granzyme B and PD-1, respectively. In addition, conditioning of the animals with MOPC315.BM-derived EV, before transplantation of the MOPC315.BM tumor cells, did not anticipate the disease phenotype. However, it induced features of suppression in the BM milieu, such as an increase in PD-1 expression by CD4+ T cells. Overall, our findings reveal the involvement of MOPC315.BM-derived EV protein content as promoters of immune niche remodeling, strengthening the importance of assessing the mechanisms by which MM may impact the immune microenvironment.
Structural Features of Antibody-Peptide Recognition
Authors: Lee Jessica H. , Yin Rui , Ofek Gilad , Pierce Brian G.
Published: July 2022

Antibody recognition of antigens is a critical element of adaptive immunity. One key class of antibody-antigen complexes is comprised of antibodies targeting linear epitopes of proteins, which in some cases are conserved elements of viruses and pathogens of relevance for vaccine design and immunotherapy. Here we report a detailed analysis of the structural and interface features of this class of complexes, based on a set of nearly 200 nonredundant high resolution antibody-peptide complex structures that were assembled from the Protein Data Bank. We found that antibody-bound peptides adopt a broad range of conformations, often displaying limited secondary structure, and that the same peptide sequence bound by different antibodies can in many cases exhibit varying conformations. Propensities of contacts with antibody loops and extent of antibody binding conformational changes were found to be broadly similar to those for antibodies in complex with larger protein antigens. However, antibody-peptide interfaces showed lower buried surface areas and fewer hydrogen bonds than antibody-protein antigen complexes, while calculated binding energy per buried interface area was found to be higher on average for antibody-peptide interfaces, likely due in part to a greater proportion of buried hydrophobic residues and higher shape complementarity. This dataset and these observations can be of use for future studies focused on this class of interactions, including predictive computational modeling efforts and the design of antibodies or epitope-based vaccine immunogens.
p53/sirtuin 1/NF-κB Signaling Axis in Chronic Inflammation and Maladaptive Kidney Repair After Cisplatin Nephrotoxicity
Authors: Fu Ying , Wang Ying , Liu Yuxue , Tang Chengyuan , Cai Juan , Chen Guochun , Dong Zheng
Published: July 2022

Chronic inflammation contributes to maladaptive kidney repair, but its regulation is unclear. Here, we report that sirtuin 1 (SIRT1) is downregulated after repeated low-dose cisplatin (RLDC) injury, and this downregulation leads to p65 acetylation and consequent NF-κB activation resulting in a persistent inflammatory response. RLDC induced the down-regulation of SIRT1 and activation of NF-κB, which were accompanied by chronic tubular damage, tubulointerstitial inflammation, and fibrosis in mice. Inhibition of NF-κB suppressed the production of pro-inflammatory cytokines and fibrotic phenotypes in RLDC-treated renal tubular cells. SIRT1 activation by its agonists markedly reduced the acetylation of p65 (a key component of NF-κB), resulting in the attenuation of the inflammatory and fibrotic responses. Conversely, knockdown of SIRT1 exacerbated these cellular changes. At the upstream, p53 was activated after RLDC treatment to repress SIRT1, resulting in p65 acetylation, NF-κB activation and transcription of inflammatory cytokines. In mice, SIRT1 agonists attenuated RLDC-induced chronic inflammation, tissue damage, and renal fibrosis. Together, these results unveil the p53/SIRT1/NF-κB signaling axis in maladaptive kidney repair following RLDC treatment, where p53 represses SIRT1 to increase p65 acetylation for NF-κB activation, leading to chronic renal inflammation.
Allogeneic Hematopoietic Cell Transplantation for Patients With Deficiency of Adenosine Deaminase 2 (DADA2): Approaches, Obstacles and Special Considerations
Authors: Hashem Hasan , Dimitrova Dimana , Meyts Isabelle
Published: July 2022

Deficiency of adenosine deaminase 2 (DADA2) is an inherited autosomal recessive disease characterized by autoinflammation (recurrent fever), vasculopathy (livedo racemosa, polyarteritis nodosa, lacunar ischemic strokes, and intracranial hemorrhages, end organ vasculitis), immunodeficiency, lymphoproliferation, immune cytopenias, and bone marrow failure. Allogeneic hematopoietic cell transplantation (HCT) is curative for DADA2 as it reverses the hematological, immune and vascular phenotype of DADA2. The primary goal of HCT in DADA2, like in other non-malignant diseases, is engraftment with the establishment of normal hematopoiesis and normal immune function. Strategies in selecting a preparative regimen should take into consideration the specific vulnerabilities to endothelial dysfunction and liver toxicity in DADA2 patients. Overcoming an increased risk of graft rejection while minimizing organ toxicity, graft-versus-host disease, and infections can be particularly challenging in DADA2 patients. This review will discuss approaches to HCT in DADA2 patients including disease-specific considerations, barriers to successful engraftment, post-HCT complications, and clinical outcomes of published patients with DADA2 who have undergone HCT to date.
Comparing Patterns in Antimicrobial Use During Global Point Prevalence Study at a Single Tertiary Hospital in Ghana: Implications for Antimicrobial Stewardship Programme
Authors: Enimil Anthony , Agbedinu Kwabena , Yeboah Michael , Pauwels Ines , Goossens Herman , Ansong Daniel , Mensah Nicholas , Vesporten Ann
Published: July 2022

Background

The Global Point Prevalence Study (PPS) provides a platform for institutions to register and add clinical information on antimicrobial usage and determine variables related to proper antimicrobial stewardship.

Objective

To assess the trends in antimicrobial usage and quality indicators in antimicrobial prescriptions at our hospital.

Method

We retrospectively compared data collected at Komfo Anokye Teaching Hospital (KATH) during the Global PPS in 2015 and 2019. Both surveys took place on a day in September of the respective year. Medical records of all in-patients on admission at 0800 hours on a specific day were reviewed for antimicrobial use in the survey. Data on antibiotic use, including indications for use and the presence of quality indicators, were recorded.

Results

The total number of patients on admission in 2015 and 2019 were 386 and 630, respectively. The proportion of patients on at least one antimicrobial was 64% (247/386) and 58.4% (368/630) in 2015 and 2019, respectively. Pneumonia was the most common medical condition for which antimicrobial was prescribed for 2015, 30(16.9%) and 2019, 44(23.0%), respectively. There was a decrease in Hospital-acquired infections from 2015, 6.2% (24/386) to 4.8% (30/630) in 2019. The use of biomarkers increased from 4.9% (12/247) to 7.6% (28/368).

Conclusion

Over 50% of hospitalised patients were on antimicrobials for both years. The inauguration of the antimicrobial stewardship committee at KATH will improve these quality indicators.
Nuclear Factor-κB Plays a Positive Role in TNFα Expression in Golden Pompano, Trachinotus ovatus (Linnaeus 1758)
Authors: Zhu Ke-Cheng , Guo Hua-Yang , Guo Liang , Liu Bao-Suo , Zhang Nan , Jiang Shi-Gui , Zhang Dian-Chang
Published: July 2022

Tumour necrosis factor-α (TNFα) is a multifarious mediator of lymphoid tissue growth and antimicrobial defence mechanisms, and it acts as a pro-inflammatory regulator. The function of TNFα in parasite infection and the underlying mechanism through which nuclear factor-κB (NF-κB) regulates TNFα remain largely unclear in teleosts. In the present study, TNFα (ToTNFα) from golden pompano (Trachinotus ovatus) was identified, and its sequence features and expression levels were determined. The genomic DNA sequence is composed of 1,130 bp, consists of four exons and three introns, and encodes 341 amino acid polypeptides. The putative protein sequence shares 34.7%–61.9% identity with fish TNFα and possesses a TNF family signature and two conserved cysteine residues. Moreover, the expressions of ToNF-κB and ToTNFα are constitutively expressed in all examined tissues, with higher levels observed in the immune relevant tissues. Both ToNF-κB and ToTNFα transcription was increased in the local infection sites (skin and gill) and system immune tissues (liver, spleen and head kidney) after Cryptocaryon irritans stimulation. In addition, to investigate whether ToNF-κB is a regulator of ToTNFα, promoter analysis was performed. The region from -970 to +79 bp is known as the core promoter by different truncated mutants of ToTNFα. Subsequently, the activity of the ToTNFα-p2 promoter was dramatically reduced after targeted mutation of the M6-binding site. Additionally, an electrophoretic mobile shift assay (EMSA) verified that ToNF-κB interacted with the M6-binding site in the ToTNFα promoter region to control the expression of ToTNFα. In conclusion, the present study provides the positive regulation of TNFα transcription by NF-κB and contributes to a better understanding of the transcriptional mechanism of TNFα in fish.
Length-Weight Relationships and Otolith-Based Growth Curves for Brushtooth Lizardfish off Taiwan With Observations of Region and Aging–Material Effects on Global Growth Estimates
Authors: Chang Shui-Kai , Chou Yuan-Tian , Hoyle Simon D.
Published: July 2022

Establishing appropriate aging procedures and growth models are two important steps for estimating reliable growth curves and in developing proper stock assessments. Lizardfishes have a strong influence on the structures of epibenthic communities and are important to the trawl fisheries of many coastal countries. For brushtooth lizardfish,Saurida undosquamis, the major species in the lizardfish catches of Taiwan, three issues were investigated. First, we used generalized additive models to explore factors (e.g., sex, data source, season) affecting the length-weight relationship (LWR), and to estimate suitable parameters. Second, we identified suitable procedures for otolith preparation (sagittal or transverse sections), validated the periodicity of ring increments using marginal increment analysis (MIA) with discussions of the appropriateness of the analysis, and determined the “best-fit” growth modelviamulti-model inference. Lastly, we compared growth estimates from this study with those published globally and developed an overview of global variation and the main associated variables through hierarchical cluster analysis and random forest modeling. Results suggested the following. (1) A suitable LWR for the stock was BW = 6.269 × 10-3· FL3.144for females and BW = 6.439 × 10-3· FL3.144for males. The allometric coefficient varied among samples and data sources and through the season. (2) Aging precision may be higher using transverse sections rather than sagittal sections. MIA indicates that otolith ring marks are formed annually during the active spawning season at the end of winter and the beginning of spring (from February). The Von Bertalanffy Growth Model was selected and the parameters (L∞,K, andt0) were: 46.4 cm, 0.12 year-1, and -2.12 year for sex-combined; 38.6 cm, 0.15 year-1, -2.06 year for males; and, 42.0 cm, 0.16 year-1, -1.53 year for females. (3) Globally, 86 sets of growth parameters were compiled from the literature. Region and aging material were the most important sources of variation in global estimates, which indicates the importance of using reliable aging material.
Population Abundance and Density Estimates for Costa Rica’s Endemic Sea Snake, Hydrophis platurus xanthos
Authors: Bessesen Brooke L. , Oedekoven Cornelia S. , Galbreath Gary J. , González-Suárez Manuela
Published: July 2022

Population abundance and density estimates provide key information for conservation assessment and prioritization of efforts and management. However, data are still largely unavailable for many taxa, including sea snakes, which appear to be facing global declines. Here, we present the first quantitative abundance and density estimates for the geographically isolated sea snakeHydrophis platurus xanthosendemic to the inner basin of Golfo Dulce, Costa Rica. Using systematic distance sampling methods, we obtained and analyzed 199 snake detections from 46 transect lines covering the entire known distribution (totaling nine days and 469 km of effort). Our modeling methods accounted for (i) the probability of detecting a snake given it was available to be detected (ii) the average availability of snakes at the water surface during a 24-hr cycle, and (iii) the by-hour variance in the taxon’s activity pattern. The best estimate of population abundance was 29781 individuals (95% CI=20104–44115) with an estimated density of 76 snakes/km2. Without historical abundance estimates or minimum viable population size, it is unknown whether this number represents a healthy population. However, with all individuals inhabiting a relatively small inlet increasingly exposed to anthropogenic impacts, the long-term persistence ofH. p. xanthosmay be threatened by ongoing impacts (boat propeller strikes, agricultural runoff, and climate change), as well as unforeseen events in the future.
A Structural Damage Identification Method Based on Arrangement of the Static Force Residual Vector
Authors: Shen Jibao , Li Zhike , Luo Shuai , Wang Wei
Published: July 2022

In order to effectively and conveniently identify the damage location and damage degree of structural members under static response, a structural damage identification method based on the force residual vector is proposed. The force residual vector is defined by using the static displacement data and the stiffness matrix of the finite element model structure. The structural element corresponding to the non-zero element of the permutation force residual vector is intelligently determined as the damage element. The damage degree of the damaged unit is calculated from the equilibrium equation, which is established by the global stiffness matrix with only the damaged unit. For example, the identification analysis of damage units of numerical models is carried out for a simply supported beam as a simple structure and a truss as a complex structure based on the proposed method. In El Centro seismic wave, the dynamic responses of the original model and truss damage model are simulated and compared by using state space theory to verify the necessity of damage identification.
P1245 Polymorphic Variants of HSD3B1 Gene Confer Different Outcome in Specific Subgroups of Patients Infected With SARS-CoV-2
Authors: Epistolio Samantha , Ramelli Giulia , Ottaviano Margaret , Crupi Emanuele , Marandino Laura , Biggiogero Maira , Maida Pier Andrea , Ruinelli Lorenzo , Vogl Ursula , Mangan Dylan , Pascale Mariarosa , Cantù Marco , Ceschi Alessandro , Bernasconi Enos , Mazzucchelli Luca , Catapano Carlo , Alimonti Andrea , Garzoni Christian , Gillessen Sommer Silke , Stefanini Federico Mattia , Franzetti-Pellanda Alessandra , Frattini Milo , Pereira Mestre Ricardo
Published: July 2022

Introduction: Severe respiratory syndrome coronavirus 2 (SARS-CoV-2) uses the androgen receptor (AR), through ACE2 receptor and TMPRSS2, to enter nasal and upper airways epithelial cells. Genetic analyses revealed that HSD3B1 P1245C polymorphic variant increases dihydrotestosterone production and upregulation of TMPRSS2 with respect to P1245A variant, thus possibly influencing SARS-CoV-2 infection. Our aim was to characterize the HSD3B1 polymorphism status and its potential association with clinical outcomes in hospitalized patients with COVID-19 in Southern Switzerland.

Materials and Methods: The cohort included 400 patients hospitalized for COVID-19 during the first wave between February and May 2020 in two different hospitals of Canton Ticino. Genomic DNA was extracted from formalin-fixed paraffin-embedded tissue blocks, and HSD3B1 gene polymorphism was evaluated by Sanger sequencing. Statistical associations were verified using different test.

Results:HSD3B1 polymorphic variants were not associated with a single classical factor related to worse clinical prognosis in hospitalized patients with SARS-CoV-2. However, in specific subgroups, HSD3B1 variants played a clinical role: intensive care unit admission was more probable in patients with P1245C diabetes compared with P1245A individuals without this comorbidity and death was more associated with hypertensive P1245A>C cases than patients with P1245A diabetes without hypertension.

Discussion: This is the first study showing that HSD3B1 gene status may influence the severity of SARS-CoV-2 infection. If confirmed, our results could lead to the introduction of HSD3B1 gene status analysis in patients infected with SARS-CoV-2 to predict clinical outcome.
Deep Learning Model for Predicting Intradialytic Hypotension Without Privacy Infringement: A Retrospective Two-Center Study
Authors: Kim Hyung Woo , Heo Seok-Jae , Kim Minseok , Lee Jakyung , Park Keun Hyung , Lee Gongmyung , Baeg Song In , Kwon Young Eun , Choi Hye Min , Oh Dong-Jin , Nam Chung-Mo , Kim Beom Seok
Published: July 2022

Objective

Previously developed Intradialytic hypotension (IDH) prediction models utilize clinical variables with potential privacy protection issues. We developed an IDH prediction model using minimal variables, without the risk of privacy infringement.

Methods

Unidentifiable data from 63,640 hemodialysis sessions (26,746 of 79 patients for internal validation, 36,894 of 255 patients for external validation) from two Korean hospital hemodialysis databases were finally analyzed, using three IDH definitions: (1) systolic blood pressure (SBP) nadir <90 mmHg (Nadir90); (2) SBP decrease ≥20 mmHg from baseline (Fall20); and (3) SBP decrease ≥20 mmHg and/or mean arterial pressure decrease ≥10 mmHg (Fall20/MAP10). The developed models use 30 min information to predict an IDH event in the following 10 min window. Area under the receiver operating characteristic curves (AUROCs) and precision-recall curves were used to compare machine learning and deep learning models by logistic regression, XGBoost, and convolutional neural networks.

Results

Among 344,714 segments, 9,154 (2.7%), 134,988 (39.2%), and 149,674 (43.4%) IDH events occurred according to three different IDH definitions (Nadir90, Fall20, and Fall20/MAP10, respectively). Compared with models including logistic regression, random forest, and XGBoost, the deep learning model achieved the best performance in predicting IDH (AUROCs: Nadir90, 0.905; Fall20, 0.864; Fall20/MAP10, 0.863) only using measurements from hemodialysis machine during dialysis session.

Conclusions

The deep learning model performed well only using monitoring measurement of hemodialysis machine in predicting IDH without any personal information that could risk privacy infringement.
Self-Expandable Metal Stent in the Management of Malignant Airway Disorders
Authors: Bai Yang , Zhan Ke , Chi Jing , Jiang JinYue , Li Shuang , Yin Yuting , Li Yishi , Guo Shuliang
Published: July 2022

Background

Self-expanding metallic stent (SEMS) is a palliative therapy for patients with malignant central airway obstruction (CAO) or tracheoesophageal fistula (TEF). Despite this, many patients experience death shortly after SEMS placement.

Aims

We aimed to investigate the effect of SEMS on the palliative treatment between malignant CAO and malignant TEF patients and investigate the associated prognostic factors of the 3-month survival.

Methods

We performed a single-center, retrospective study of malignant CAO or TEF patients receiving SEMS placement. Clinical data were collected using the standardized data abstraction forms. Data were analyzed using SPSS 22.0. A two-sided P-value <0.05 was statistically significant.

Results

106 malignant patients (82 CAO and 24 TEF) receiving SEMS placement were included. The body mass index (BMI), hemoglobin levels, and albumin levels in the malignant TEF group were lower than in the malignant CAO group (all P < 0.05). The procalcitonin levels, C-reactive protein levels, and the proportion of inflammatory lesions were higher in the malignant TEF group than in the malignant CAO group (all P < 0.05). The proportion of symptomatic improvement after the SEMS placement was 97.6% in the malignant CAO group, whereas 50.0% in the malignant TEF group, with a significant difference (P = 0.000). Three months after SEMS placement, the survival rate at was 67.0%, significantly lower in the malignant TEF group than in the malignant CAO group (45.8% vs. 73.2%, P = 0.013). Multivariate analysis revealed that BMI [odds ratio (OR) = 1.841, 95% certificated interval (CI) (1.155-2.935), P = 0.010] and neutrophil percentage [OR = 0.936, 95% CI (0.883–0.993), P = 0.027] were the independent risk factors for patients who survived three months after SEMS placement.

Conclusions

We observed symptom improvement in malignant CAO and TEF patients after SEMS placement. The survival rate in malignant TEF patients after SEMS placement was low, probably due to aspiration pneumonitis and malnutrition. Therefore, we recommend more aggressive treatment modalities in patients with malignant TEF, such as strong antibiotics, nutrition support, and strategic ventilation. More studies are needed to investigate the prognostic factors in patients with malignant airway disorders receiving SEMS placement.
A Survey on Current Practices of Umbilical Cord Clamping in Malaysia
Authors: Pong Kwai Meng , Puasa Norezliani , Mahdy Zaleha Abdullah
Published: July 2022

Background

Delayed cord clamping (DCC) has been demonstrated to have significant benefits in reducing the incidence of intraventricular hemorrhage, blood transfusion and neonatal mortality in preterm neonates and improving hemodynamic and long-term neurodevelopment among term infants. There is no clear guideline on umbilical cord clamping (UCC) practices in Malaysia.

Objective

The aim of this survey was to assess the knowledge and practice of DCC among obstetric doctors and midwives in Malaysia, and pediatric colleagues who witness the delivery.

Method

This is a cross-sectional survey conducted in childbirth facilities in Malaysia from October 2020 to January 2021. A convenient snowball sampling was adopted. A validated questionnaire was disseminated to practicing obstetric and pediatric doctors and midwives electronically via email and WhatsApp using Google Form. The data were analyzed using descriptive and analytical statistics.

Results

A total of 327 respondents completed the questionnaires, comprising 206 obstetric doctors, 72 pediatric doctors and 49 midwives. The majority of respondents were specialists or higher in rank (53.2%). Only 29% reported the existence of guidelines on UCC in their place of work. Midwives (P = 0.003) and staff of lower ranks and level of education (P < 0.001) appeared to be more aware of the existence of a UCC guideline. Most respondents had positive knowledge of DCC for both term and preterm neonates. A large proportion (82%) of respondents agreed that DCC helped increase neonatal iron stores, and was good for both preterm (70.7%) and term (76.2%) neonates not requiring positive pressure ventilation. Doctors, specialists, those who are 40 years old and above, and those who have been in service for at least 10 years were found to have better knowledge regarding DCC (P < 0.05).

Conclusion

The awareness and practice of obstetric, pediatric and midwifery staff of guidelines on UCC were less than satisfactory. Even though most respondents have good knowledge and positive perception regarding benefits of DCC, these were not translated into their routine practice. Hence, a national guideline emphasizing the benefits of DCC should be made available in all childbirth facilities.