bluuebunny/crossref_metadata_2025 huggingface dataset:
Populism, Religion, and Social Media in Central America
Authors: Siles Ignacio , Guevara Erica , Tristán-Jiménez Larissa , Carazo Carolina
Published: July 2021

This paper analyzes how presidential candidates Fabricio Alvarado and Nayib Bukele used Facebook during the elections in Costa Rica (2018) and El Salvador (2019) respectively to develop a particular style of communication that blended populist elements and religious discourse. This style of communication extended traditional modes of populism that have prevailed in Latin America since the turn of the century (emphasizing the notion of the hero who comes to rescue “the people”) but expressed them in an explicitly religious way (stressing the role of a “messiah” who comes to alter the established political order). We conducted both content and multimodal discourse analyses of 838 posts made by these candidates on Facebook during their respective electoral campaigns. We argue that the study of these campaigns would be incomplete without accounting for the relationship between populism, religion, and social media. While populism gave political validity to religious discourse, a religious imaginary provided populism with charismatic and messianic authority. This populist/religious reason found an ideal expression in Facebook and, simultaneously, was resignified by this platform's affordances. In this way, we assess how fundamentalist Christianity has become a legitimating force of knowledge and politics in the context of epistemic tensions that shape contemporary Latin-American societies.
Irish Fiddle and Western Classical Violin: Listener Perceptions and Acoustical Differences
Authors: Geringer John M. , Bugaj Kasia , Geringer Katie A.
Published: July 2021

This report is a summary of two studies. In the first, we compared examples of Irish fiddle performances with Western classical violin performances. Acoustical analyses showed that both classical examples produced average spectral centroids higher in frequency, higher harmonic to noise ratios, more use of vibrato, more disjunct intervals, and less ornamentation. Expert listeners described the classical examples as resonant, ringing, and brighter. Tone in the Irish examples was characterized as varied, gritty, and full-bodied. In the second study, we asked 72 music majors to listen to different recordings and respond in two ways. The first section consisted of extremely brief examples of four different solo violin styles: classical, jazz, old-time fiddle, and Irish. The second section consisted of longer examples of either Irish or classical performances. The listeners were asked to describe salient features of each. They frequently identified the following characteristics of the Irish excerpts: grace notes, double stops, ornamentation, and dance-like. In contrast, classical extracts were described using the terms: vibrato, melody, intervals, and extended technique. Implications for music listening are discussed.
Gastrostomy Tube Placement in Neonates Undergoing Congenital Heart Surgery: A Novel Assessment for Improving Utilization and Timing of Placement
Authors: Beers Kevin M. , Bettenhausen Aaron , Prihoda Thomas J. , Calhoon John H. , Husain S. Adil
Published: July 2021

Background:

Neonates undergoing congenital heart defect repair require optimized nutritional support in the perioperative period. Utilization of a gastrostomy tube is not infrequent, yet optimal timing for placement is ill-defined. The objective of this study was to identify characteristics of patients whose postoperative course included gastrostomy tube placement to facilitate supplemental tube feeding following neonatal repair of congenital heart defects.

Methods:

A single-institution, retrospective chart review identified 64 consecutive neonates who underwent cardiac operations from 2012 to 2016. Perioperative variables were evaluated for significance in relation to gastrostomy tube placement.

Results:

A total of 27 (42%) underwent gastrostomy tube placement. Diagnosis of a genetic syndrome was associated with the likelihood of placement of gastrostomy tube ( P = .032), as were patients with single ventricle physiology ( P = .0013) compared to those felt to be amenable to eventual biventricular repair. Aortic arch reconstruction ( P = .029), as well as the need for delayed sternal closure ( P = .05), was associated with increased frequency of gastrostomy tube placement. Postoperative outcomes including the number of days intubated ( P = .0026) and the presence of significant dysphagia ( P = .0034) were associated with gastrostomy placement. Additionally, genetic syndrome ( P = .003), aortic arch reconstruction ( P = .01), and postoperative intubation duration ( P = .0024) correlated with increased length of stay, where increased length of stay was associated with gastrostomy tube placement ( P = .0004).

Discussion:

Patient characteristics that were associated with a high likelihood of eventual gastrostomy placement were identified in this study. Early recognition of such characteristics in future patients may allow for reduced time to gastrostomy tube placement, which in turn may improve perioperative growth and outcomes.
Outcome of Pulmonary Autograft After the Ross Procedure
Authors: Nakayama Yuki , Shinkawa Takeshi , Matsumura Goki , Hoki Ryogo , Kobayashi Kei , Yoshida Hisashi , Yamagishi Masaaki , Niinami Hiroshi
Published: July 2021

Background:

The purpose of this study was to assess autograft function after the Ross procedure and to review surgical outcomes associated with autograft reoperations.

Methods:

This is a retrospective study of patients undergoing the Ross procedure since 1993. Autograft function and autograft reoperation were studied. Autograft failure was defined as more than moderate autograft regurgitation or autograft dilatation to more than 50 mm diameter or z-score of more than +4 in children. One hospital death was excluded from analysis as were patients with unknown late autograft status.

Results:

Among 75 patients analyzed, preoperative diagnosis before the Ross procedure included aortic regurgitation in 26, aortic stenosis in 19, combined lesions in 28, and 2 mechanical valve malfunctions. Median age at the Ross procedure was 12.1 (0.4-43.6) years with 44 children less than 15 years old. Six patients had greater than mild autograft regurgitation at post-Ross hospital discharge. During median follow-up of 14.9 years, there were 23 autograft failures. Eighteen autograft reoperations were performed on 17 patients (13 children), including 12 aortic valve replacements, 5 aortic root replacements (including 1 valve-sparing root replacement), and 1 Konno procedure. Freedom from autograft failure and autograft reoperation at 20 years after the Ross procedure was 52.0% and 66.3%, respectively. Multivariate analysis identified greater than mild autograft regurgitation at hospital discharge from Ross procedure as a risk factor for autograft failure ( P < .01). All patients who underwent autograft reoperation survived and had good health status at a median of 6.9 years after the reoperation.

Conclusions:

The Ross procedure is effective in delaying prosthetic aortic valve replacement, although the time-related risk of autograft failure is a real consideration.
Transition to Ductal Stenting for Single Ventricle Patients Led to Improved Survival: An Institutional Case Series
Authors: Prabhu Neel K. , Zhu Alexander , Meza James M. , Hill Kevin D. , Fleming Gregory A. , Chamberlain Reid C. , Lodge Andrew J. , Turek Joseph W. , Andersen Nicholas D.
Published: July 2021

Background:

The use of systemic-to-pulmonary shunts (SPS) in neonates with single ventricle heart defects and ductal-dependent pulmonary blood flow (ddPBF) was historically associated with high morbidity and mortality at our center. As a result, we transitioned to the preferential use of ductus arteriosus stents (DS) when feasible. This report describes our initial results with this strategy.

Methods:

A single-center study of single ventricle patients that received DS or SPS from 2015 to 2019 was performed to assess whether DS was associated with decreased in-hospital morbidity and increased survival to stage II palliation.

Results:

A total of 34 patients were included (DS = 11; SPS = 23). Underlying cardiac anomalies were similar between groups and included pulmonary atresia, unbalanced atrioventricular septal defect, and tricuspid atresia. Procedure success was similar between groups (82% vs 83%). Two DS patients were converted to SPS, due to ductal vasospasm or pulmonary artery obstruction, and four SPS patients required surgical shunt revision. In DS patients, postprocedure mechanical ventilation duration was shorter (one vs three days, P = .009) and fewer required postprocedure extracorporeal membrane oxygenation (9% vs 39%, P = .11). A higher proportion of DS patients survived to stage II palliation (100% vs 64%, P = .035), and the probability of one-year survival was higher in DS patients (100% vs 61%, P = .02).

Conclusions:

At our center, patients with single ventricle heart defects and ddPBF that received DS experienced reduced in-hospital morbidity and increased survival to stage II palliation compared to SPS.
The Veil of Bureaucracy: How Officials Evade Partisan Politics in Participatory Settings
Authors: Stiman Meaghan
Published: July 2021

In theory, participatory democracies are thought to empower citizens in local decision-making processes. However, in practice, community voice is rarely representative, and even in cases of equal representation, citizens are often disempowered through bureaucratic processes. Drawing on the case of a firearm discharge debate from a rural county’s municipal meetings in Virginia, I extend research about how power operates in participatory settings. Partisan political ideology fueled the debate amongst constituents in expected ways, wherein citizens engaged collectivist and individualist frames to sway the county municipal board ( Celinska 2007 ). However, it was a third frame that ultimately explains the ordinance’s repeal: the bureaucratic frame, an ideological orientation to participatory processes that defers decision-making to disembodied abstract rules and procedures. This frame derives its power from its depoliticization potential, allowing bureaucrats to evade contentious political debates. Whoever is best able to wield this frame not only depoliticizes the debate to gain rationalized legitimacy but can do so in such a way to favor a partisan agenda. This study advances gun research and participatory democracy research by analyzing how the bureaucratic frame, which veils partisanship, offers an alternative political possibility for elected officials, community leaders, and citizens to adjudicate partisan debates.
Identifying patients with CKD risk at the time of nephrectomy: When to initiate nephrology consult
Authors: Yang Yihe , Kozel Zachary , Sharma Purva , Yaskiv Oksana , Torres Jose , Pandya Shashank , Jhaveri Kenar D. , Bhaskaran Madhu , Vira Manish , Bijol Vanesa
Published: July 2021

Introduction:

The prevalence of chronic kidney disease (CKD) is high among kidney neoplasm patients because of the overlapping risk factors. Our purpose is to identify kidney cancer survivors with higher CKD risk.

Methods:

We studied a retrospective cohort of 361 kidney tumor patients with partial or radical nephrectomy. Linear mixed model was performed.

Results:

Of patients with follow-up >3 months, 84% were identified retrospectively to fulfill criteria for CKD diagnosis, although CKD was documented in only 15%. Urinalysis was performed in 205 (57%) patients at the time of nephrectomy. Multivariate analysis showed interstitial fibrosis and tubular atrophy (IFTA) >25% ( p = 0.005), severe arteriolar sclerosis ( p = 0.013), female gender ( p = 0.024), older age ( p = 0.012), BMI ⩾ 25 kg/m2 ( p < 0.001), documented CKD ( p < 0.001), baseline eGFR ⩽ 60 ml/min/1.73 m2 ( p < 0.001), and radical nephrectomy ( p < 0.001) were independent risk factors of lower eGFR at baseline and during follow-up. Average eGFR decreased within 3 months post nephrectomy. However, patients with different risk levels showed different eGFR time trend pattern at longer follow-ups. Multivariate analysis of time × risk factor interaction showed BMI, radical nephrectomy and baseline eGFR had time-dependent impact. BMI ⩾ 25 kg/m2 and radical nephrectomy were associated with steeper eGFR decrease slope. In baseline eGFR > 90 ml/min/1.73 m2 group, eGFR rebounded to pre-nephrectomy levels during extended follow-up. In partial nephrectomy patients with baseline eGFR ⩾ 90 ml/min/1.73 m2 ( n = 61), proteinuria ( p < 0.001) and BMI ( p < 0.001) were independent risk factors of decreased eGFR during follow up.

Conclusions:

As have been suggested by others and confirmed by our study, proteinuria and CKD are greatly under-recognized. Although self-evident as a minimum workup for nephrectomy patients to include SCr, eGFR, urinalysis, and proteinuria, the need for uniform applications of this practice should be reinforced. Non-neoplastic histology evaluation is valuable and should include an estimate of global sclerosis% (GS) and IFTA%. Patients with any proteinuria and/or eGFR ⩽ 60 at the time of nephrectomy or in follow-up with urologists, and/or >25% GS or IFTA, should be referred for early nephrology consultation.
Investigating the relationships between the burden of multiple sensory hypersensitivity symptoms and headache-related disability in patents with migraine
Authors: Suzuki Keisuke , Suzuki Shiho , Shiina Tomohiko , Okamura Madoka , Haruyama Yasuo , Tatsumoto Muneto , Hirata Koichi
Published: July 2021

Objective

Sensory hypersensitivities such as photophobia, phonophobia, and osmophobia are common in patients with migraine. We investigated the burden of these multiple sensory hypersensitivities in migraine.

Methods

In this cross-sectional study, 187 consecutive patients with migraine (26 men/161 women; age, 45.9 ± 13.2 years) were included. Sensory hypersensitivity symptoms such as photo−/phono−/osmophobia and accompanying symptoms were determined by neurologists in interviews. The Migraine Disability Assessment (MIDAS) was used to assess headache-related disability. The Kessler Psychological Distress Scale (K6) was also administered.

Results

Photophobia, phonophobia and osmophobia were observed in 75.4%, 76.5% and 55.1% of the patients with migraine, respectively. A significant overlap in sensory hypersensitivities (photo−/phono−/osmophobia) was found; the proportions of patients with 2 and 3 coexisting sensory hypersensitivities were 33.2% and 41.7%, respectively. The MIDAS score was higher in those with 3 sensory hypersensitivity symptoms than in those with 0 to 2 sensory hypersensitivity symptoms. A generalized linear model with ordinal logistic regression analysis revealed that multiple sensory hypersensitivities, younger age, more migraine days per month, and a higher K6 score were significantly related to the higher MIDAS score.

Conclusion

Our study showed that sensory hypersensitivities commonly occur and overlap in patients with migraine and that multiple sensory hypersensitivity symptoms have a significant impact on headache-related disability.
Subsurface Deformation Mechanism in Nano-cutting of Gallium Arsenide Using Molecular Dynamics Simulation
Authors: Chen Chenghao , Lai Min , Fang Fengzhou
Published: July 2021

During the nano-cutting process, monocrystalline gallium arsenide is faced with various surface/subsurface deformations and damages that significantly influence the product’s performance. In this paper, molecular dynamics simulations of nano-cutting on gallium arsenide are conducted to investigate the surface and subsurface deformation mechanism. Dislocations are found in the machined subsurface. Phase transformation and amorphization are studied by means of coordination numbers. Results reveal the existence of an intermediate phase with a coordination number of five during the cutting process. Models with different cutting speeds are established to investigate the effects on the dislocation. The effect of crystal anisotropy on the dislocation type and density is studied via models with different cutting orientations. In addition, the subsurface stress is also analyzed.
Diagnostic delay of acute mitral regurgitation during the coronavirus disease 2019 pandemic: a case report
Authors: Kawabata Azumi , Funakoshi Hiraku , Ito Joji , Santanda Takushi , Norisue Yasuhiro , Watanabe Hiroyuki
Published: July 2021

Background

Diagnostic errors or delays can cause serious consequences for patient safety, especially in the emergency department. Anchoring bias is one of the major factors leading to diagnostic error. During the coronavirus disease 2019 (COVID-19) pandemic, the high probability of COVID-19 in febrile patients could be a major cause of anchoring bias leading to diagnostic error. In addition, certain evaluations such as auscultation are difficult to perform on a casual basis due to the increased risk of contact infection, which lead to inadequate assessment of the patients with valvular disease.

Acute mitral regurgitation (MR) could be a fatal disease in the emergency department, especially if there is a diagnostic error or delay in diagnosis. It is often reported that diagnosis can be difficult even though there is no treatment other than emergent surgery.

The diagnosis of acute MR has become more difficult because coronavirus disease 2019 (COVID-19) pandemic could affect our daily practice especially in febrile patients.

We report a case of a diagnostic delay of a febrile patient because of anchoring bias during the COVID-19 pandemic.

Case presentation

A 45-year-old man presented to the emergency department complaining of acute dyspnea and fever. Based on vital signs and computed tomography of the chest, acute pneumonia due to COVID-19 was suspected. Auscultation was avoided because of facility rule based on concern of contact infection. After admission to the intensive care unit, Doppler echocardiography revealed acute mitral regurgitation, and transesophageal echocardiography revealed mitral valve tendon rupture. After confirming the negative result for the polymerase chain reaction of severe acute respiratory syndrome coronavirus 2, mitral valvuloplasty was performed on the third day after admission. The patient was discharged 14 days after admission without complications.

Conclusions

In COVID-19 pandemic, anchoring bias suspecting COVID-19 among febrile patients becomes a strong heuristic factor. A thorough history and physical examination is still important in febrile patients presenting with dyspnea to ensure the correct diagnosis of acute mitral regurgitation.
Simultaneous giant adrenocortical and renal cell carcinoma associated with lead exposure from residual gun pellets after shotgun injury: case report
Authors: Mazuran Berislav , Hrkac Adelina
Published: July 2021

Background

A case of simultaneous adrenocortical and renal cell carcinoma due to long-term lead exposure from residual gun pellets is a rare and relatively unknown topic in the literature.

Case presentation

We present a 43-year-old male patient with a giant retroperitoneal tumor. Thirteen years before he had a shotgun injury of the left upper side of the abdomen and residual gun pellets are present in the abdominal wall. Extirpation of the tumor and the left kidney was performed. Histopathological examination described adrenocortical and renal cell carcinoma.

Conclusion

Continuous and long-term exposure to toxic lead effects from residual gun pellets and traumatic injury represent likely carcinogenic factors in the presented patient.
Comparative and functional genomics of the ABC transporter superfamily across arthropods
Authors: Denecke Shane , Rankić Ivan , Driva Olympia , Kalsi Megha , Luong Ngoc Bao Hang , Buer Benjamin , Nauen Ralf , Geibel Sven , Vontas John
Published: July 2021

Background

The ATP-binding cassette (ABC) transporter superfamily is comprised predominantly of proteins which directly utilize energy from ATP to move molecules across the plasma membrane. Although they have been the subject of frequent investigation across many taxa, arthropod ABCs have been less well studied. While the manual annotation of ABC transporters has been performed in many arthropods, there has so far been no systematic comparison of the superfamily within this order using the increasing number of sequenced genomes. Furthermore, functional work on these genes is limited.

Results

Here, we developed a standardized pipeline to annotate ABCs from predicted proteomes and used it to perform comparative genomics on ABC families across arthropod lineages. Using Kruskal-Wallis tests and the Computational Analysis of gene Family Evolution (CAFE), we were able to observe significant expansions of the ABC-B full transporters (P-glycoproteins) in Lepidoptera and the ABC-H transporters in Hemiptera. RNA-sequencing of epithelia tissues in the Lepidoptera Helicoverpa armigera showed that the 7 P-glycoprotein paralogues differ substantially in their tissue distribution, suggesting a spatial division of labor. It also seems that functional redundancy is a feature of these transporters as RNAi knockdown showed that most transporters are dispensable with the exception of the highly conserved gene Snu, which is probably due to its role in cuticular formation.

Conclusions

We have performed an annotation of the ABC superfamily across > 150 arthropod species for which good quality protein annotations exist. Our findings highlight specific expansions of ABC transporter families which suggest evolutionary adaptation. Future work will be able to use this analysis as a resource to provide a better understanding of the ABC superfamily in arthropods.
Histone deacetylase inhibitor panobinostat induces antitumor activity in epithelioid sarcoma and rhabdoid tumor by growth factor receptor modulation
Authors: Harttrampf Anne Catherine , da Costa Maria Eugenia Marques , Renoult Aline , Daudigeos-Dubus Estelle , Geoerger Birgit
Published: July 2021

Background

Epithelioid sarcomas and rhabdoid tumors are rare, aggressive malignancies with poor prognosis. Both are characterized by INI1 alterations and deregulation of growth factor receptors albeit their interaction has not been elucidated.

Methods

In this study, we investigated the activity of a panel of epigenetic modulators and receptor tyrosine kinase inhibitors in vitro on respective cell lines as well as on primary patient-derived epithelioid sarcoma cells, and in vivo on xenografted mice. Focusing on histone deacetylase (HDAC) inhibitors, we studied the mechanism of action of this class of agents, its effect on growth factor receptor regulation, and changes in epithelial-to-mesenchymal transition by using cell- and RT-qPCR-based assays.

Results

Pan-HDAC inhibitor panobinostat exhibited potent anti-proliferative activity at low nanomolar concentrations in A204 rhabdoid tumor, and VAESBJ/GRU1 epithelioid sarcoma cell lines, strongly induced apoptosis, and resulted in significant tumor growth inhibition in VAESBJ xenografts. It differentially regulated EGFR, FGFR1 and FGFR2, leading to downregulation of EGFR in epithelioid sarcoma and to mesenchymal-to-epithelial transition whereas in rhabdoid tumor cells, EGFR was strongly upregulated and reinforced the mesenchymal phenotype. All three cell lines were rendered more susceptible towards combination with EGFF inhibitor erlotinib, further enhancing apoptosis.

Conclusions

HDAC inhibitors exhibit significant anticancer activity due to their multifaceted actions on cytotoxicity, differentiation and drug sensitization. Our data suggest that the tailored, tissue-specific combination of HDAC inhibitors with therapeutics which target cellular salvage mechanisms might increase their therapeutic relevance.
Dietary habits among men and women in West Greenland: follow-up on the ACCEPT birth cohort
Authors: Wielsøe Maria , Berthelsen Dina , Mulvad Gert , Isidor Silvia , Long Manhai , Bonefeld-Jørgensen Eva Cecilie
Published: July 2021

Background

In the past decades, the diet in Greenland has been in transition resulting in a lower intake of traditional food and a higher intake of imported western food. This diet transition can affect public health negatively, and thus, continued monitoring of dietary habits is important. The present study aimed to follow up on the dietary habits of pregnant women included in the Greenlandic ACCEPT birth cohort (2013–2015) and the children’s father.

Methods

The follow-up food intake was assessed in 2019–2020 using food frequency questionnaires for 101 mothers and 76 fathers aged 24–55 years living in Nuuk, Sisimiut, and Ilulissat. Non-parametric statistical methods were used (Mann-Whitney U test/Spearman correlation) to assess the dietary pattern and influencing factors.

Results

The proportion of traditional and imported food was 14 and 86%, respectively. Intake frequency differed by gender (vegetables, fruits, fast food), the living town (terrestrial animals, vegetables, fruits), and age (fish, meat products, fruits, fast food). Socioeconomic and lifestyle factors significantly correlated with the intake frequency of several traditional and imported foods. Few changes in the mother’s dietary habits from inclusion (during pregnancy) to follow-up (3–5 years later) were found, showing less frequent intake of seabirds and fruits and more frequent meat intake.

Conclusion

We identified several factors that could affect dietary habits, and the results may be used to target future food recommendation for relevant population groups.
The functions and prognostic values of m6A RNA methylation regulators in thyroid carcinoma
Authors: Yu Zhi-Hao , Feng Shao-Ting , Zhang Di , Cao Xu-Chen , Yu Yue , Wang Xin
Published: July 2021

Background

N6-Methyladenosine (m6A) is the most common RNA modification and regulates RNA splicing, translation, translocation, and stability. Aberrant expression of m6A has been reported in various types of human cancers. m6A RNA modification is dynamically and reversibly mediated by different regulators, including methyltransferase, demethylases, and m6A binding proteins. However, the role of m6A RNA methylation regulators in thyroid cancer remains unknown. The aim of this study is to investigate the effect of the 13 main m6A RNA modification regulators in thyroid carcinoma.

Methods

We obtained clinical data and RNA sequencing data of 13 m6A RNA methylation regulators from The Cancer Genome Atlas (TCGA) THCA database. We performed consensus clustering to identify the clinical relevance of m6A RNA methylation regulators in thyroid carcinoma. Then we used LASSO Cox regression analysis to generate a prognostic signature based on m6A RNA modification regulator expression. Kyoto Encyclopedia of Genes and Genomes, Gene Ontology and Gene Set Enrichment Analyses were performed to explore differential cellular processes and signaling pathways between the two groups based on risk signature.

Results

We found that most of the m6A RNA modification regulators are down-regulated in 450 patients with thyroid carcinoma. We derived a three m6A RNA modification regulator genes-based risk signature (FTO, RBM15 and KIAA1429), that is an independent prognostic biomarker in patients with thyroid carcinoma. Moreover, we found that this risk signature could better predict outcome in male than female. Functional research in vitro demonstrated that the m6A RNA methylation regulators involved in the model acted significant role in the proliferation and migration of thyroid cancer cells.

Conclusions

Our study revealed the influence of m6A RNA methylation regulators on thyroid carcinoma through biological experiments and three-gene prognostic model.
The cumulation of ill health and low agency in socially excluded city dwellers in the Netherlands: how to better identify high-risk/high-need population segments with public health survey data
Authors: van Bergen Addi P. L. , van Loon Annelies , Hoff Stella J. M. , Wolf Judith R. L. M. , van Hemert Albert M.
Published: July 2021

Background

Population segmentation and risk stratification are important strategies for allocating resources in public health, health care and social care. Social exclusion, which is defined as the cumulation of disadvantages in social, economic, cultural and political domains, is associated with an increased risk of health problems, low agency, and as a consequence, a higher need for health and social care. The aim of this study is to test social exclusion against traditional social stratifiers to identify high-risk/high-need population segments.

Methods

We used data from 33,285 adults from the 2016 Public Health Monitor of four major cities in the Netherlands. To identify at-risk populations for cardiovascular risk, cancer, low self-rated health, anxiety and depression symptoms, and low personal control, we compared relative risks (RR) and population attributable fractions (PAF) for social exclusion, which was measured with the Social Exclusion Index for Health Surveys (SEI-HS), and four traditional social stratifiers, namely, education, income, labour market position and migration background.

Results

The analyses showed significant associations of social exclusion with all the health indicators and personal control. Particular strong RRs were found for anxiety and depression symptoms (7.95) and low personal control (6.36), with corresponding PAFs of 42 and 35%, respectively. Social exclusion was significantly better at identifying population segments with high anxiety and depression symptoms and low personal control than were the four traditional stratifiers, while the two approaches were similar at identifying other health problems. The combination of social exclusion with a low labour market position (19.5% of the adult population) captured 67% of the prevalence of anxiety and depression symptoms and 60% of the prevalence of low personal control, as well as substantial proportions of the other health indicators.

Conclusions

This study shows that the SEI-HS is a powerful tool for identifying high-risk/high-need population segments in which not only ill health is concentrated, as is the case with traditional social stratifiers, but also a high prevalence of anxiety and depression symptoms and low personal control are present, in addition to an accumulation of social problems. These findings have implications for health care practice, public health and social interventions in large cities.
Application of CRISPR/Cas9 technology in wild apple (Malus sieverii) for paired sites gene editing
Authors: Zhang Yan , Zhou Ping , Bozorov Tohir A. , Zhang Daoyuan
Published: July 2021

Background

Xinjiang wild apple is an important tree of the Tianshan Mountains, and in recent years, it has undergone destruction by many biotic and abiotic stress and human activities. It is necessary to use new technologies to research its genomic function and molecular improvement. The clustered regulatory interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein (Cas) system has been successfully applied to genetic improvement in many crops, but its editing capability varies depending on the different combinations of the synthetic guide RNA (sgRNA) and Cas9 protein expression devices.

Results

In this study, we used 2 systems of vectors with paired sgRNAs targeting to MsPDS. As expected, we successfully induced the albino phenotype of calli and buds in both systems.

Conclusions

We conclude that CRISPR/Cas9 is a powerful system for editing the wild apple genome and expands the range of plants available for gene editing.
Diffusion-weighted MRI and 18F-FDG PET/CT in assessing the response to neoadjuvant chemoradiotherapy in locally advanced esophageal squamous cell carcinoma
Authors: Xu Xin , Sun Zhi-Yong , Wu Hua-Wei , Zhang Chen-Peng , Hu Bin , Rong Ling , Chen Hai-Yan , Xie Hua-Ying , Wang Yu-Ming , Lin Hai-Ping , Bai Yong-Rui , Ye Qing , Ma Xiu-Mei
Published: July 2021

Background

Neoadjuvant chemoradiotherapy (nCRT) followed by surgery is a currently widely used strategy for locally advanced esophageal cancer (EC). However, the conventional imaging methods have certain deficiencies in the evaluation and prediction of the efficacy of nCRT. This study aimed to explore the value of functional imaging in predicting the response to neoadjuvant chemoradiotherapy (nCRT) in locally advanced esophageal squamous cell carcinoma (ESCC).

Methods

Fifty-four patients diagnosed with locally advanced ESCC from August 2017 to September 2019 and treated with nCRT were retrospectively analyzed. DW-MRI scanning was performed before nCRT, at 10–15 fractions of radiotherapy, and 4–6 weeks after the completion of nCRT. 18F-FDG PET/CT scans were performed before nCRT and 4–6 weeks after the completion of nCRT. These 18F-FDG PET/CT and DW-MRI parameters and relative changes were compared between patients with pathological complete response (pCR) and non-pCR.

Results

A total of 8 of 54 patients (14.8%) were evaluated as disease progression in the preoperative assessment. The remaining forty-six patients underwent operations, and the pathological assessments of the surgical resection specimens demonstrated pathological complete response (pCR) in 10 patients (21.7%) and complete response of primary tumor (pCR-T) in 16 patients (34.8%). The change of metabolic tumor volume (∆MTV) and change of total lesion glycolysis (∆TLG) were significantly different between patients with pCR and non-pCR. The SUVmax-Tpost, MTV-Tpost, and TLG-Tpost of esophageal tumors in 18F-FDG PET/CT scans after neoadjuvant chemoradiotherapy and the ∆ SUVmax-T and ∆MTV-T were significantly different between pCR-T versus non-pCR-T patients. The esophageal tumor apparent diffusion coefficient (ADC) increased after nCRT; the ADCduring, ADCpost and ∆ADCduring were significantly different between pCR-T and non-pCR-T groups. ROC analyses showed that the model that combined ADCduring with TLG-Tpost had the highest AUC (0.914) for pCR-T prediction, with 90.0% and 86.4% sensitivity and specificity, respectively.

Conclusion

18F-FDG PET/CT is useful for re-staging after nCRT and for surgical decision. Integrating parameters of 18F-FDG PET/CT and DW-MRI can identify pathological response of primary tumor to nCRT more accurately in ESCC.
Impact of the COVID-19 outbreak on severe trauma trends and healthcare system reassessment in Lombardia, Italy: an analysis from the regional trauma registry
Authors: Giudici Riccardo , Lancioni Armando , Gay Hedwige , Bassi Gabriele , Chiara Osvaldo , Mare Claudio , Latronico Nicola , Pesenti Antonio , Faccincani Roberto , Cabrini Luca , Fumagalli Roberto , Chieregato Arturo , Briani Laura , Sammartano Fabrizio , Sechi Giuseppe , Zoli Alberto , Pagliosa Andrea , Foti Giuseppe , Borotto Erika , Palo Alessandra , Valoti Oliviero , Botteri Marco , Carlucci Michele , Reitano Elisa , Bini Roberto
Published: July 2021

Backgrounds

The COVID-19 pandemic drastically strained the health systems worldwide, obligating the reassessment of how healthcare is delivered. In Lombardia, Italy, a Regional Emergency Committee (REC) was established and the regional health system reorganized, with only three hospitals designated as hubs for trauma care. The aim of this study was to evaluate the effects of this reorganization of regional care, comparing the distribution of patients before and during the COVID-19 outbreak and to describe changes in the epidemiology of severe trauma among the two periods.

Methods

A cohort study was conducted using retrospectively collected data from the Regional Trauma Registry of Lombardia (LTR). We compared the data of trauma patients admitted to three hub hospitals before the COVID-19 outbreak (September 1 to November 19, 2019) with those recorded during the pandemic (February 21 to May 10, 2020) in the same hospitals. Demographic data, level of pre-hospital care (Advanced Life Support-ALS, Basic Life Support-BLS), type of transportation, mechanism of injury (MOI), abbreviated injury score (AIS, 1998 version), injury severity score (ISS), revised trauma score (RTS), and ICU admission and survival outcome of all the patients admitted to the three trauma centers designed as hubs, were reviewed. Screening for COVID-19 was performed with nasopharyngeal swabs, chest ultrasound, and/or computed tomography.

Results

During the COVID-19 pandemic, trauma patients admitted to the hubs increased (46.4% vs 28.3%, p < 0.001) with an increase in pre-hospital time (71.8 vs 61.3 min, p < 0.01), while observed in hospital mortality was unaffected. TRISS, ISS, AIS, and ICU admission were similar in both periods. During the COVID-19 outbreak, we observed substantial changes in MOI of severe trauma patients admitted to three hubs, with increases of unintentional (31.9% vs 18.5%, p < 0.05) and intentional falls (8.4% vs 1.2%, p < 0.05), whereas the pandemic restrictions reduced road- related injuries (35.6% vs 60%, p < 0.05). Deaths on scene were significantly increased (17.7% vs 6.8%, p < 0.001).

Conclusions

The COVID-19 outbreak affected the epidemiology of severe trauma patients. An increase in trauma patient admissions to a few designated facilities with high level of care obtained satisfactory results, while COVID-19 patients overwhelmed resources of most other hospitals.
Mini-transverse incision using a novel bush-hook versus conventional open incision for treatment of carpal tunnel syndrome: a prospective study
Authors: Ma Tianxiao , Wang Dongyue , Hu Yuqing , Zhao Xiaocui , Wang Wei , Song Lihua
Published: July 2021

Purpose

This study aimed to investigate the outcomes of a mini-transverse incision with a bush-hook versus a conventional open incision for carpal tunnel release (CTR).

Methods

This was a prospective study. The decision to receive either technique (mini-transverse incision with a bush-hook or conventional open incision) was primarily based on patients’ choice. Patients’ symptom severity, functional status, and symptomatic pain were measured at pre-operation, 1 month, and 3 and 6 months postoperatively, and any relevant complications were recorded. Kelly’s scale was used to evaluate the overall clinical efficacy.

Results

Eighty-nine patients were included in the open CTR group and 85 patients in the mini-transverse incision group. The mini-transverse incision group had a significantly smaller incision (4.4±0.6 vs 44.8±3.7 mm), shorter surgical time (7.8±1.9 vs 21.2±3.4 min), and shorter hospital stay (3.7±1.6 vs 5.9±2.0 days) than did the open CTR group. Both groups showed significant improvements from baseline levels (all P<0.001). At postoperative 1 month and 3 months, the transverse incision group showed a significantly better VAS, SSS, and FSS (all P<0.05), but the difference was non-significant at 6 months except for FSS (P=0.022). Also, mini-transverse incision showed a significantly reduced time to return to work and activities, trend to a higher rate of excellence, and good and fewer complications than did the open CTR.

Conclusions

The mini-transverse incision exhibited better performance in surgery-related measures, symptomatic remission, functional recovery, and postoperative morbidity, thus could be considered a promising technique alternative.
Meningitic Escherichia coli α-hemolysin aggravates blood–brain barrier disruption via targeting TGFβ1-triggered hedgehog signaling
Authors: Fu Jiyang , Li Liang , Huo Dong , Yang Ruicheng , Yang Bo , Xu Bojie , Yang Xiaopei , Dai Menghong , Tan Chen , Chen Huanchun , Wang Xiangru
Published: July 2021

Bacterial meningitis is a life-threatening infectious disease with severe neurological sequelae and a high mortality rate, in which Escherichia coli is one of the primary Gram-negative etiological bacteria. Meningitic E. coli infection is often accompanied by an elevated blood–brain barrier (BBB) permeability. BBB is the structural and functional barrier composed of brain microvascular endothelial cells (BMECs), astrocytes, and pericytes, and we have previously shown that astrocytes-derived TGFβ1 physiologically maintained the BBB permeability by triggering a non-canonical hedgehog signaling in brain microvascular endothelial cells (BMECs). Here, we subsequently demonstrated that meningitic E. coli infection could subvert this intercellular communication within BBB by attenuating TGFBRII/Gli2-mediated such signaling. By high-throughput screening, we identified E. coli α-hemolysin as the critical determinant responsible for this attenuation through Sp1-dependent TGFBRII reduction and triggering Ca2+ influx and protein kinase A activation, thus leading to Gli2 suppression. Additionally, the exogenous hedgehog agonist SAG exhibited promising protection against the infection-caused BBB dysfunction. Our work revealed a hedgehog-targeted pathogenic mechanism during meningitic E. coli-caused BBB disruption and suggested that activating hedgehog signaling within BBB could be a potential protective strategy for future therapy of bacterial meningitis.
Mutation of copper binding sites on cellular prion protein abolishes its inhibitory action on NMDA receptors in mouse hippocampal neurons
Authors: Huang Sun , Black Stefanie A. , Huang Junting , Stys Peter K. , Zamponi Gerald W.
Published: July 2021

We have previously reported that cellular prion protein (PrPC) can down-regulate NMDA receptor activity and in a copper dependent manner. Here, we employed AAV9 to introduce murine cellular prion protein into mouse hippocampal neurons in primary cultures from PrP null mice to determine the role of the six copper binding motifs located within the N-terminal domain of PrPC. The results demonstrate that viral expression of wild type PrPC lowers NMDAR activity in PrP null mouse hippocampal neurons by reducing the magnitude of non-desensitizing currents. Elimination of the last two copper binding sites alone, or in combination with the remaining four attenuates this protective effect. Thus our data suggest that copper ion interactions with specific binding sites on PrPC are critical for PrPC dependent modulation of NMDA receptor function.
RNA-seq co-expression network analysis reveals anxiolytic behavior of mice with Efnb2 knockout in parvalbumin+ neurons
Authors: Sun Ying , Ma Le , Chen Jianhua , Wang Weidi , Peng Shiyu , Cheng Ying , Zhang Yu , Chen Jinghong , Ju Peijun
Published: July 2021

Anxiety disorders are the most common psychiatric disorders, and the change in the activity of the prefrontal cortex (PFC) is considered as the underlying pathological mechanism. Parvalbumin-expressing (PV+) inhibition contributes to the overall activity of the PFC. However, the molecular mechanism underlying the excitation-inhibition imbalance of PV+ neurons in the PFC is unknown. Efnb2 is a membrane-bound molecule that plays an important role in the nervous system through binding the Eph receptor. To investigate whether the loss of Efnb2 in PV+ affects anxiety, we examined the behavior of wild type and Efnb2 in PV+ neurons knockout (KO) mice. We monitored the defensive responses to aversive stimuli of elevated plus maze (EPM) and found that KO mice exhibited obvious fearless and anxiolytic behaviors. To further investigate the underlying regulatory mechanism, we performed RNA sequencing, analyzed the differentially expressed genes (DEGs), and constructed the weighted gene co-expression network analysis (WGCNA). The WGCNA identified 12 characteristic modules. Among them, the MEgreen module showed the most significant correlation with KO mice of EPM stimuli. The Gene Ontology enrichment and the Kyoto Encyclopedia of Genes and Genomes enrichment analysis revealed that this was related to the distal axon, Ras signaling pathway and insulin signaling pathway. Furthermore, the whole-cell voltage clamp recordings also proved that Efnb2 gene knock-out could affect synaptic function. Together with the transcriptomic analysis of mice with Efnb2 knockout on PV+ neurons, our findings suggest that Efnb2 gene in the PV+ neuron of PFC may be a crucial factor for fear and anxiety, which provide an insight into anxiety pathophysiology.
The role m6A RNA methylation is CNS development and glioma pathogenesis
Authors: Pan Ting , Wu Fan , Li Liwen , Wu Shiyan , Zhou Fang , Zhang Ping , Sun Caixing , Xia Liang
Published: July 2021

Epigenetic abnormalities play a crucial role in many tumors, including glioma. RNA methylation occurs as an epigenetic modification similar to DNA methylation and histone modification. m6A methylation is the most common and most intensively studied RNA methylation, which can be found throughout the RNA life cycle and exert biological functions by affecting RNA metabolism. The m6A modification is primarily associated with three types of protease, which are encoded by the writer, eraser and reader genes, respectively. It has been shown that the m6A methylation has close connections with the occurrence and development of many tumors, including glioma. In this study, the concept and the research progress of m6A methylation are reviewed, especially the role of m6A methylation in glioma. Moreover, we will discuss how glioma is paving the way to the development of new therapeutic options based on the inhibition of m6A deposition.
Survivors of avalanche accidents: posttraumatic stress disorder symptoms and quality of life: a multicentre study
Authors: Léonard Charlotte , Charriau-Perret Anaëlle , Debaty Guillaume , Belle Loïc , Ricard Cécile , Sanchez Caroline , Dupré Pierre-Marie , Panoff Gregory , Bougerol Thierry , Viglino Damien , Blancher Marc ,   the Northern French-Alps Emergency Network (“RENAU”)
Published: July 2021

Background

As any traumatic event, avalanches could trigger psychological disorders on survivors. Our objectives were to determine the prevalence of post-traumatic stress disorder among avalanche survivors and to evaluate post-traumatic stress disorder risks factors as well as the impact on quality of life.

Methods

A multicentre study was conducted in victims included in the North Alpine Avalanche Registry from 2014 to 2018. Data were collected through a standard questionnaire during semi-directed phone interviews. The primary outcome was the total score on the Impact of Event Scale Revised. Secondary outcomes were the Mental Component Scale and the Physical Component Scale scores of the Short Form 12 questionnaire.

Results

During the study period, 132 of 211 victims survived. Among the 107 victims included, 55 (51.4%) phone interviews were obtained. Six patients (10.9, 95% CI 1.76–20.05) had an Impact of Event Scale Revised score ≥ 33 indicating a strong probability for post-traumatic stress disorder. Median Mental Component Scale score was 39.0 (IQR 30.5–46.3) for post-traumatic stress disorder patients and 40.1 (IQR 36.5–43.4) for non post-traumatic stress disorder (p = 0.76). Median Physical Component Scale score was 39.4 (37.2–44.3) for post-traumatic stress disorder patients and 44.2 (39.1–46.8) for non post-traumatic stress disorder (p = 0.39). No significant difference in the quality of life in both populations was observed, and no independent risk factors of post-traumatic stress disorder was identified.

Conclusion

Avalanche accidents may induce post-traumatic stress disorders among survivors in a comparable prevalence to the most traumatic event already studied. Early recognition and preventive measures should be set up in order to reduce the psychological burden in these victims.

Trial registration

NCT03936738.