bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship of Axial Alignment and Patient-Reported Outcomes in Patients with Total Ankle Arthroplasty under Weightbearing CT Scan
Authors: Pellegrini Manuel J. , Escudero Mario I. , Avilés Espinoza Carolina , Varela Cristobal , Gana Eric G. , Herreros Diego , Carrasco Consuelo , Burckhardt Bravo Valentina P. , Carcuro Giovanni M.
Published: April 2022

Category:

Ankle Arthritis

Introduction/Purpose:

Axial alignment (rotation) in total ankle replacement has come to surgeons' attention in recent publications. Unfortunately, most of the previously published data present information from non weight-bearing computed tomography (WBCT) scans or lack a correlation with patient-reported outcomes (PROs). To the author's knowledge, axial alignment is not completely understood in its current form and its relation to PROs. Therefore, our objective is to propose a standardization in measurements of axial alignment in prosthesis components under weight-bearing CT examination and to correlate it with patient-reported outcomes.

Methods:

After obtaining IRB approval, our prospectively collected surgical database was queried for patients undergoing Total Ankle Arthroplasty (TAA). Patients were included if they had preoperative weight-bearing X-rays, non-WBCT scan, pain evaluation (VAS pain score), preoperative functional scales (SF-36, SFMA, FAAOS, and FAAM) and underwent TAA using an Infinity Prosthesis with standard instrumentation. Patients were excluded if they had less than a one-year postoperative period, had revision surgery, or declined to participate. Twenty five patients met the inclusion/exclusion criteria. All patients were brought back to the clinic for weight-bearing CT scan, pain evaluation, repeat functional scales, and to sign informed consent for the specific needs of this study. Three fellowship-trained musculoskeletal radiologists realized all measurements in two time-frames (coronal, sagittal and axial alignment), separated for one month each. Cohen's inter and intraclass coefficients were calculated to estimate the amount of agreement that occurred by chance.

Results:

Average age was 64.5 years, Average BMI was 28. Good to excellent intraobserver reliability (ICC 0.891 , 0.750, 0.902 respectively) and good interobserver reliability (ICC 0.822) were reported. Component malrotation was seen in five patients (20%), defined as a relative axial rotation between components of 5 degrees or greater. There was a statistically significant correlation between coronal, sagittal and axial alignment measurements and FAAM scale (p<0.05). There was a positive trend in the association between malrotation and PROs, but this was not statistically significant (p=0.09).

Conclusion:

This is the first study to correlate axial component alignment in total ankle replacement with patient-reported outcomes. Success in TAA is in direct relationship with achieving neutral alignment at the ankle and hindfoot. Axial alignment is statistically correlated with PROs. There was a positive trend in the association between malrotation and PROs, however this study didn't show a statistical correlation.
Traces of a prehistoric and potentially tsunamigenic mass movement in the sediments of Lake Thun (Switzerland)
Authors: Kremer Katrina , Fabbri Stefano C. , Evers Frederic M. , Schweizer Nora , Wirth Stefanie B.
Published: April 2022

Mass movements constitute major natural hazards in the Alpine realm. When triggered on slopes adjacent to lakes, these mass movements can generate tsunami-like waves that may cause additional damage along the shore. For hazard assessment, knowledge about the occurrence, the trigger and the geomechanical and hydrogeological mechanisms of these mass movements is necessary. For reconstructing mass movements that occurred in or adjacent to lakes, the lakes’s sedimentary record can be used as an archive. Here, we present a prehistorical mass-movement event, of which the traces were found in an alpine lake, Lake Thun, in central Switzerland. The mass movement is identified by large blocks on the bathymetric map, a chaotic to transparent facies on the reflection seismic profiles, and by a mixture of deformed lake sediments and sandy organic-rich layers in the sediment-core record. The event is dated at 2642–2407 cal year BP. With an estimated volume of ~ 20 × 106m3it might have generated a wave with an initial amplitude of > 30 m. In addition to this prehistorical event, two younger deposits were identified in the sedimentary record. One could be dated at 1523–1361 cal year BP and thus can be potentially related to an event in 598/599 AD documented in historical reports. The youngest deposit is dated at 304–151 cal year BP (1646–1799 AD) and is interpreted to be related to the artificial Kander river deviation into Lake Thun (1714 AD).
Optimization of production parameters of particle gluing on internal bonding strength of particleboards using machine learning technology
Authors: Zhang Beilong , Hua Jun , Cai Liping , Gao Yunbo , Li Yilin
Published: April 2022

The particleboard (PB) production is an extremely complex process, many operating parameters affecting panel quality. It is a big challenge to optimize the PB production parameters. The production parameters of particle gluing have an important influence on the internal bond (IB) strength of PB. In this study, using grey relation analysis (GRA) and support vector regression (SVR) algorithm, a prediction model was developed to accurately predict IB of PB through particle gluing processing parameters in a PB production line. GRA was used to analyze the grey relational grade between the particle gluing processing parameters and IB of PB, and the variables were screened. The SVR algorithm was used to train 724 groups of particle gluing sample data between six particle gluing processing parameters and IB. The SVR model was tested with 181 sets of experimental data. The SVR model was verified by 181 sets of experimental data, and the values of mean absolute error (MAE), mean relative error (MRE), root mean square error (RMSE), and Theil’s inequality coefficient (TIC) of the model were 0.008, 0.017, 0.013, and 0.014, respectively. The results showed that the prediction performance of the nonlinear regression prediction model based on GRA–SVR is superior, and the GRA–SVR prediction model can be used to real-time predict the IB in the PB production line.
Fremanezumab in the prevention of high-frequency episodic and chronic migraine: a 12-week, multicenter, real-life, cohort study (the FRIEND study)
Authors: Barbanti Piero , Egeo Gabriella , Aurilia Cinzia , d’Onofrio Florindo , Albanese Maria , Cetta Ilaria , Di Fiore Paola , Zucco Maurizio , Filippi Massimo , Bono Francesco , Altamura Claudia , Proietti Stefania , Bonassi Stefano , Vernieri Fabrizio ,   for the FRIEND-Study Group
Published: April 2022

Background

Fremanezumab has demonstrated to be effective, safe, and tolerated in the prevention of episodic or chronic migraine (CM) in randomized, placebo-controlled trials (RCTs). Real-life studies are needed to explore drug effects in unselected patients in routine circumstances and to provide higher generalizability results. This study explores the effectiveness, safety, and tolerability of fremanezumab in a real-life population of individuals affected by high-frequency episodic (HFEM: 8–14 days/month) or CM.

Methods

This is a 12-week multicenter, prospective, cohort, real-life study. We considered all consecutive patients affected by HFEM or CM visited at 9 Italian headache centers from 28/07/2020 to 11/11/2020. Eligible patients were given subcutaneous fremanezumab at the doses of 225 mg monthly or 675 mg quarterly, according to their preference. Primary study endpoints were the change in monthly migraine days (MMDs) in HFEM and monthly headache days (MHDs) in CM patients at weeks 9–12 compared to baseline. Secondary endpoints encompassed variation in monthly analgesic intake (MAI), Numerical Rating Scale (NRS), HIT-6 and MIDAS scores, and ≥ 50%, ≥ 75% and 100% responder rates at the same time intervals.

Results

Sixty-seventh number migraine patients had received ≥ 1 subcutaneous fremanezumab dose and were considered for safety analysis, while 53 patients completed 12 weeks of treatment and were included also in the effectiveness analysis. Fremanezumab was effective in both HFEM and CM, inducing at week 12 a significant reduction in MMDs (-4.6,p < 0.05), MHDs (-9.4,p < 0.001), MAI (-5.7,p < 0.05; -11.1,p < 0.001), NRS (-3.1,p < 0.001; -2.5,p < 0.001), and MIDAS scores (-58.3,p < 0.05; -43.7;p < 0.001). HIT-6 was significantly reduced only in HFEM patients (-18.1,p < 0.001). Remission from CM to episodic migraine and from MO to no-MO occurred in 75% and 67.7% of the patients. The ≥ 50%, ≥ 75% and 100% responder rates at week 12 were 76.5%, 29.4% and 9.9% in HFEM and 58.3%, 25% and 0% in CM. Younger age emerged as a positive response predictor (OR = 0.91; 95% CI 0.85–0.98,p = 0.013). Treatment-emergent adverse events were uncommon (5.7%) and mild. No patient discontinued fremanezumab for any reason.

Conclusions

Fremanezumab seems more effective in real-life than in RCTs. Younger age emerges as a potential response predictor.
Towards a robust out-of-the-box neural network model for genomic data
Authors: Zhang Zhaoyi , Cheng Songyang , Solis-Lemus Claudia
Published: April 2022

Background

The accurate prediction of biological features from genomic data is paramount for precision medicine and sustainable agriculture. For decades, neural network models have been widely popular in fields like computer vision, astrophysics and targeted marketing given their prediction accuracy and their robust performance under big data settings. Yet neural network models have not made a successful transition into the medical and biological world due to the ubiquitous characteristics of biological data such as modest sample sizes, sparsity, and extreme heterogeneity.

Results

Here, we investigate the robustness, generalization potential and prediction accuracy of widely used convolutional neural network and natural language processing models with a variety of heterogeneous genomic datasets. Mainly, recurrent neural network models outperform convolutional neural network models in terms of prediction accuracy, overfitting and transferability across the datasets under study.

Conclusions

While the perspective of a robust out-of-the-box neural network model is out of reach, we identify certain model characteristics that translate well across datasets and could serve as a baseline model for translational researchers.
Significance of linkage disequilibrium and epistasis on genetic variances in noninbred and inbred populations
Authors: Viana José Marcelo Soriano , Garcia Antonio Augusto Franco
Published: April 2022

Background

The influence of linkage disequilibrium (LD), epistasis, and inbreeding on genotypic variance continues to be an important area of investigation in genetics and evolution. Although the current knowledge about biological pathways and gene networks indicates that epistasis is important in determining quantitative traits, the empirical evidence for a range of species and traits is that the genotypic variance is most additive. This has been confirmed by some recent theoretical studies. However, because these investigations assumed linkage equilibrium, considered only additive effects, or used simplified assumptions for two- and higher-order epistatic effects, the objective of this investigation was to provide additional information about the impact of LD and epistasis on genetic variances in noninbred and inbred populations, using a simulated dataset.

Results

In general, the most important component of the genotypic variance was additive variance. Because of positive LD values, after 10 generations of random crosses there was generally a decrease in all genetic variances and covariances, especially the nonepistatic variances. Thus, the epistatic variance/genotypic variance ratio is inversely proportional to the LD level. Increasing inbreeding increased the magnitude of the additive, additive x additive, additive x dominance, and dominance x additive variances, and decreased the dominance and dominance x dominance variances. Except for duplicate epistasis with 100% interacting genes, the epistatic variance/genotypic variance ratio was proportional to the inbreeding level. In general, the additive x additive variance was the most important component of the epistatic variance. Concerning the genetic covariances, in general, they showed lower magnitudes relative to the genetic variances and positive and negative signs. The epistatic variance/genotypic variance ratio was maximized under duplicate and dominant epistasis and minimized assuming recessive and complementary epistasis. Increasing the percentage of epistatic genes from 30 to 100% increased the epistatic variance/genotypic variance ratio by a rate of 1.3 to 12.6, especially in inbred populations. The epistatic variance/genotypic variance ratio was maximized in the noninbred and inbred populations with intermediate LD and an average allelic frequency of the dominant genes of 0.3 and in the noninbred and inbred populations with low LD and an average allelic frequency of 0.5.

Conclusions

Additive variance is in general the most important component of genotypic variance. LD and inbreeding have a significant effect on the magnitude of the genetic variances and covariances. In general, the additive x additive variance is the most important component of epistatic variance. The maximization of the epistatic variance/genotypic variance ratio depends on the LD level, degree of inbreeding, epistasis type, percentage of interacting genes, and average allelic frequency.
Effects of reduced gag cleavage efficiency on HIV-1 Gag-Pol package
Authors: Lin Yi-Ru , Chu Shih-Ming , Yu Fu-Hsien , Huang Kuo-Jung , Wang Chin-Tien
Published: April 2022

Background

HIV-1 pol, which encodes enzymes required for virus replication, is initially translated as a Gag-Pol fusion protein. Gag-Pol is incorporated into virions via interactions with Gag precursor Pr55gag. Protease (PR) embedded in Gag-Pol mediates the proteolytic processing of both Pr55gag and Gag-Pol during or soon after virus particle release from cells. Since efficient Gag-Pol viral incorporation depends on interaction with Pr55gag via its N-terminal Gag domain, the prevention of premature Gag cleavage may alleviate Gag-Pol packaging deficiencies associated with cleavage enhancement from PR.

Results

We engineered PR cleavage-blocking Gag mutations with the potential to significantly reduce Gag processing efficiency. Such mutations may mitigate the negative effects of enhanced PR activation on virus assembly and Gag-Pol packaging due to an RT dimerization enhancer or leucine zipper dimerization motif. When co-expressed with Pr55gag, we noted that enhanced PR activation resulted in reduced Gag-Pol cis or trans incorporation into Pr55gag particles, regardless of whether or not Gag cleavage sites within Gag-Pol were blocked.

Conclusions

Our data suggest that the amount of HIV-1 Gag-Pol or Pol viral incorporation is largely dependent on virus particle production, and that cleavage blocking in the Gag-Pol N-terminal Gag domain does not exert significant impacts on Pol packaging.
Micronutrient content drives elementome variability amongst the Symbiodiniaceae
Authors: Camp Emma F. , Nitschke Matthew R. , Clases David , Gonzalez de Vega Raquel , Reich Hannah G. , Goyen Samantha , Suggett David J.
Published: April 2022

Background

Elements are the basis of life on Earth, whereby organisms are essentially evolved chemical substances that dynamically interact with each other and their environment. Determining species elemental quotas (their elementome) is a key indicator for their success across environments with different resource availabilities. Elementomes remain undescribed for functionally diverse dinoflagellates within the family Symbiodiniaceae that includes coral endosymbionts. We used dry combustion and ICP-MS to assess whether Symbiodiniaceae (ten isolates spanning five generaBreviolum, Cladocopium, Durusdinium, Effrenium, Symbiodinium) maintained under long-term nutrient replete conditions have unique elementomes (six key macronutrients and nine micronutrients) that would reflect evolutionarily conserved preferential elemental acquisition. For three isolates we assessed how elevated temperature impacted their elementomes. Further, we tested whether Symbiodiniaceae conform to common stoichiometric hypotheses (e.g., the growth rate hypothesis) documented in other marine algae. This study considers whether Symbiodiniaceae isolates possess unique elementomes reflective of their natural ecologies, evolutionary histories, and resistance to environmental change.

Results

Symbiodiniaceae isolates maintained under long-term luxury uptake conditions, all exhibited highly divergent elementomes from one another, driven primarily by differential content of micronutrients. All N:P and C:P ratios were below the Redfield ratio values, whereas C:N was close to the Redfield value. Elevated temperature resulted in a more homogenised elementome across isolates. The Family-level elementome was (C19.8N2.6P1.0S18.8K0.7Ca0.1) · 1000 (Fe55.7Mn5.6Sr2.3Zn0.8Ni0.5Se0.3Cu0.2Mo0.1V0.04) mmol Phosphorous-1versus (C25.4N3.1P1.0S23.1K0.9Ca0.4) · 1000 (Fe66.7Mn6.3Sr7.2Zn0.8Ni0.4Se0.2Cu0.2Mo0.2V0.05) mmol Phosphorous-1at 27.4 ± 0.4 °C and 30.7 ± 0.01 °C, respectively. Symbiodiniaceae isolates tested here conformed to some, but not all, stoichiometric principles.

Conclusions

Elementomes for Symbiodiniaceae diverge from those reported for other marine algae, primarily via lower C:N:P and different micronutrient expressions. Long-term maintenance of Symbiodiniaceae isolates in culture under common nutrient replete conditions suggests isolates have evolutionary conserved preferential uptake for certain elements that allows these unique elementomes to be identified. Micronutrient content (normalised to phosphorous) commonly increased in the Symbiodiniaceae isolates in response to elevated temperature, potentially indicating a common elemental signature to warming.
Morphological and pomological diversity of wild Prunus microcarpa Boiss. germplasm
Authors: Khadivi Ali , Mirheidari Farhad , Moradi Younes , Paryan Simin
Published: April 2022

Background

Prunus microcarpaBoiss. is usually found in dry calcareous and rocky mountain slopes and is well adapted to severe winter and dry-hot summer conditions. Morphological and pomological diversity among 81 accessions ofP. microcarpaspecies selected from natural habitats was assessed.

Results

The accessions investigated were significantly different from each other in terms of the traits recorded. Tree growth habit was highly variable, including weeping, spreading, open, semi-erect, and erect. Most of the accessions had very small leaves, a probable adaptation to the xerophytic conditions. Ripening date ranged from mid-June to early August. Fruit weight as the first character considering in domestication process ranged from 0.21 to 0.44 g. Principal component analysis (PCA) could describe the evaluated traits as the 11 main components that were able to justify 76.29% of total variance. Also, the accessions were clustered into two major clusters by the Ward dendrogram.

Conclusions

Significant diversity was revealed, regarding the morphological traits in the evaluatedP. microcarpagermplasm that reflected the necessity for the conservation of this germplasm, and it is expected that the results gained in this study will assist currentCerasusbreeding efforts and will maintain the genetic integrity ofP. microcarpa.
Prevalence of orthostatic hypertension and its association with cerebrovascular diagnoses in patients with suspected TIA and minor stroke
Authors: Barzkar Farzaneh , Myint Phyo K. , Kwok Chun Shing , Metcalf Anthony Kneale , Potter John F. , Baradaran Hamid Reza
Published: April 2022

Purpose

We aimed to compare the rate of stroke, transient ischemic attack, and cerebrovascular disease diagnoses across groups of patients based on their orthostatic blood pressure response in a transients ischemic attack clinic setting.

Materials and Methods

We retrospectively analysed prospectively collected data from 3201 patients referred to a transient ischemic attack (TIA)/minor stroke outpatients clinic. Trained nurses measured supine and standing blood pressure using an automated blood pressure device and the patients were categorized based on their orthostatic blood pressure change into four groups: no orthostatic blood pressure rise, systolic orthostatic hypertension, diastolic orthostatic hypertension, and combined orthostatic hypertension. Then, four stroke physicians, who were unaware of patients' orthostatic BP response, assessed the patients and made diagnoses based on clinical and imaging data. We compared the rate of stroke, TIA, and cerebrovascular disease (either stroke or TIA) diagnoses across the study groups using Pearson's χ2 test. The effect of confounders was adjusted using a multivariate logistic regression analysis.

Results

Cerebrovascular disease was significantly less common in patients with combined systolic and diastolic orthostatic hypertension compared to the "no rise" group [OR = 0.56 (95% CI 0.35–0.89]. The odds were even lower among the subgroups of patients with obesity [OR = 0.31 (0.12–0.80)], without history of smoking [OR 0.34 (0.15–0.80)], and without hypertension [OR = 0.42 (95% CI 0.19–0.92)]. We found no significant relationship between orthostatic blood pressure rise with the diagnosis of stroke. However, the odds of TIA were significantly lower in patients with diastolic [OR 0.82 (0.68–0.98)] and combined types of orthostatic hypertension [OR = 0.54 (0.32–0.93)]; especially in patients younger than 65 years [OR = 0.17 (0.04–0.73)] without a history of hypertension [OR = 0.34 (0.13–0.91)], and patients who did not take antihypertensive therapy [OR = 0.35 (0.14–0.86)].

Conclusion

Our data suggest that orthostatic hypertension may be a protective factor for TIA among younger and normotensive patients.
Ten-year atherosclerosis cardiovascular disease (ASCVD) risk score and its components among an Iranian population: a cohort-based cross-sectional study
Authors: Zibaeenejad Fatemeh , Mohammadi Seyyed Saeed , Sayadi Mehrab , Safari Fatemeh , Zibaeenezhad Mohammad Javad
Published: April 2022

Background

Atherosclerotic cardiovascular disease (ASCVD) continues to be the first cause of mortality globally. Effective preventive strategies require focused efforts to clarify ASCVD risk factors in different subgroups of a population. This study aimed to identify individuals at higher risk of ASCVD among Shiraz University employees to guide decision-making for primary prevention.

Methods

This cohort-based cross-sectional study was conducted on data of 1191 participants (25–70 years old) from Shiraz University employees selected by systematic random sampling. The 10-year ASCVD risk was calculated with an ASCVD risk score estimator developed by the American College of Cardiology/American Heart Association (ACC/AHA). To analyze the data, descriptive and chi-square tests were used. All statistical analyses were conducted using the SPSS version 16.0 software. The p-value < 0.05 was considered a significant level.

Results

This study demonstrated that 75.3% of the participants had low risk scores, whereas 13.2% and 2.5% of them had intermediate and high risk scores, respectively. Additionally, it revealed that among women 93.7%, 2.7%, and 0.6% had low intermediate and had high risk scores, respectively, whereas among men, 61.5%, 21.1%, and 3.9% had low intermediate and high risk scores, respectively. Based on the results of the chi-square test, men were significantly more prone to ASCVD (38.5%) than women (6.3%) were. Interestingly, 40.9% of known cases of hypertension had uncontrolled blood pressure, and 62.5% of individuals without any history of hypertension, who were considered new cases of hypertension, had abnormal blood pressure. Furthermore, 38.5% of diabetic patients and 1.6% of people who did not have a history of diabetes had abnormal serum fasting blood sugar.

Conclusion

It was revealed that nearly 15.7% of participants were at intermediate and high risk of developing ASCVD in the next 10 years with greater risk in men. Considerably, some of hypertensive and diabetic participants had uncontrolled blood pressure and blood sugar levels, respectively. New cases of diabetes and hypertension were also recognized in our study. Therefore, to address the primary prevention of ASCVD in this population, it is necessary to have plans for targeted interventions, which can be effective in modifying their risk factors.
Rupture of sinus of Valsalva aneurysm: a case report in a child
Authors: Jiang Kunfeng , Chen Jingyu , Zhu Xu , Xiao Huan , Ran Tingting , Tang Yi , Ji Xiaojuan
Published: April 2022

Background

Sinus of Valsalva aneurysm (SVA) is a rare congenital disease that can cause severe clinical presentations when the aneurysm ruptures. Here, we report a rare case of a noncoronary sinus of Valsalva aneurysm with rupture into the right atrium.

Case presentation

A 14-year-old Chinese female patient presented viral myocarditis with acute heart failure at the local hospital, and she was finally diagnosed with a noncoronary sinus Valsalva aneurysm with rupture into the right atrium by digital subtraction angiography with cardiac catheterization angiography and echocardiography at our hospital (Children’s Hospital of Chongqing Medical University). Percutaneous closure intervention was performed shortly after her diagnosis, and the patient showed good functional recovery.

Conclusions

We report a case of ruptured sinus of Valsalva aneurysm successfully treated by percutaneous closure, which is an excellent alternative treatment.
Impact of different degrees of left ventricular strain on left atrial mechanics in heart failure with preserved ejection fraction
Authors: Songsangjinda Thammarak , Krittayaphong Rungroj
Published: April 2022

Background

Impairment of left atrial (LA) function is linked to left ventricle (LV) mechanics in patients with heart failure with preserved ejection fraction (HFpEF). In this study, we set forth to determine the difference in LA mechanics compared between HFpEF patients with different degrees of LV strains using the cardiac magnetic resonance feature tracking technique.

Methods

This retrospective study enrolled 79 patients with prior heart failure event and LV ejection fraction (LVEF) ≥ 50% (HFpEF group) together with 2:1 matched controls. LV global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS); LA emptying fraction (LAEF); and, LA strains consisting of reservoir phase strain (LASr), conduit phase strain (LAScd), and contraction phase strain (LASct) were derived from cine images. All LA parameters were compared between HFpEF subgroups (lower and higher LV strain stratified by the median of each LV strain value) and controls.

Results

A total of 237 subjects were included. HFpEF had a lower LAEF and LA strain values compared with controls. The mean GLS value was significantly different between HFpEF and controls (− 13.3 ± 3.4% vs. − 15.4 ± 2.2%, p < 0.001). HFpEF with lower GLS (value ≥  − 13.1%) had significantly impaired LA mechanical parameters compared with both HFpEF with higher GLS and controls independent of potential confounders, as follows: LAEF (38.8 ± 16.6% vs. 48.6 ± 15.7% and 54.2 ± 12.2%), LASr (14.6 ± 7.1% vs. 24.3 ± 9.6% and 26.7 ± 8.8%), and LAScd (− 6.6 ± 3.9% vs. − 12.9 ± 6.0% and − 14.7 ± 7.4%) (post hoc analysis of variance p < 0.05 for all comparisons). Similarly, HFpEF with lower GCS (value ≥  − 16.6%) or lower GRS (value < 27.9%) also had significant impairment of LASr and LAScd compared with the higher strain group and controls. Abnormal LAEF (< 50%) and abnormal LASr (< 23%) are independently associated with NYHA class ≥ II (Odds ratio [OR] 3.894 [95% CI 2.202–6.885] p < 0.001, adjusted OR 3.382 [1.791–6.389] p < 0.001 for abnormal LAEF; and OR 2.613 [1.497–4.562] p = 0.001, adjusted OR 2.064 [1.118–2.110] p = 0.021 for abnormal LASr).

Conclusions

Patients with HFpEF were found to have impaired LV and LA mechanics. Abnormal LA mechanics was highly prevalent in HFpEF patients with lower LV strain and significantly associated with the symptomatic status of the patients.
Real-world characteristics, treatment experiences and corticosteroid utilisation of patients treated with tofacitinib for moderate to severe ulcerative colitis
Authors: Chiorean Michael V. , Allegretti Jessica R. , Sharma Puza P. , Chastek Benjamin , Salese Leonardo , Bell Elizabeth J. , Peterson-Brandt Jesse , Cappelleri Joseph C. , Guo Xiang , Khan Nabeel
Published: April 2022

Background

Tofacitinib is an oral, small molecule JAK inhibitor for the treatment of UC. We aimed to describe the real-world treatment experience and corticosteroid utilisation of patients treated with tofacitinib in a US claims database.

Methods

Patients with a UC diagnosis who initiated tofacitinib, vedolizumab or tumour necrosis factor inhibitor (TNFi) treatment between May 2018 and July 2019 were identified from the Optum Research Database. Demographic and clinical characteristics of patients who initiated tofacitinib, vedolizumab or TNFi were described. Oral corticosteroid use prior to and following tofacitinib initiation was evaluated. Tofacitinib adherence (proportion of days covered) and continuation was assessed for 6 months following initiation. Analyses were descriptive and stratified by prior biologic use (naïve, 1 or ≥ 2; minimum of 12 months prior to tofacitinib initiation).

Results

Among patients initiating tofacitinib (N = 225), mean age was 45.6 (SD 16.5) years and 50.2% were female. Of these, 43 (19.1%) patients were biologic-naïve and 182 (80.9%) had prior biologic use (92 [40.9%], 1 prior biologic; 90 [40.0%], ≥ 2 prior biologics). Among patients with 1 prior biologic, 82.6% were previously treated with a TNFi. Among patients with ≥ 2 prior biologics, 54.4% were previously treated with vedolizumab and a TNFi, 16.7% with two TNFi and 28.9% with ≥ 3 prior biologics. In the 6 months prior to tofacitinib initiation, 65.8% of patients had received oral corticosteroids (74.4%, 60.9% and 66.7% for biologic-naïve, 1 and ≥ 2 prior biologics, respectively). The proportion of patients with ongoing oral corticosteroid use 3–6 months after tofacitinib initiation decreased to 13.3% (9.3%, 18.5% and 10.0% for biologic-naïve, 1 and ≥ 2 prior biologics, respectively), and 19.6% of patients discontinued oral corticosteroid use during the 6 months after tofacitinib initiation. Overall, tofacitinib adherence, as determined by the mean proportion of days covered during the 6-month follow-up, was 0.7 (median 0.8). During the 6-month follow-up, 84.9% of patients continued tofacitinib.

Conclusions

Among patients with UC initiating tofacitinib, the majority had prior biologic use. Tofacitinib adherence was high, discontinuation was low and oral corticosteroid utilisation decreased irrespective of prior biologic use. Further research with longer follow-up and a larger sample size is required.
The role of faecal calprotectin in diagnosis and staging of colorectal neoplasia: a systematic review and meta-analysis
Authors: Ross Fiona A. , Park James H. , Mansouri David , Combet Emilie , Horgan Paul G. , McMillan Donald C. , Roxburgh Campbell S. D.
Published: April 2022

Introduction

The presence of inflammation is a key hallmark of cancer and, plays an important role in disease progression and survival in colorectal cancer (CRC). Calprotectin detected in the faeces is a sensitive measure of colonic inflammation. The role of FC as a diagnostic test that may categorise patients by risk of neoplasia is poorly defined. This systematic review and meta-analysis aims to characterise the relationship between elevations of FC and colorectal neoplasia.

Methods

A systematic review was performed using the keywords (MESH terms) and a statistical and meta-analysis was performed.

Results

A total of 35 studies are included in this review. CRC patients are more likely than controls to have an elevated FC OR 5.19, 95% CI 3.12–8.62,p < 0.001 with a heterogeneity (I2 = 27%). No tumour characteristics significantly correlated with FC, only stage of CRC shows signs that it may potentially correlate with FC.

Conclusion

FC levels are significantly higher in CRC, with high sensitivity. Its low specificity prevents it from being used to diagnose or screen for CRC.
A descriptive study of high resolution total colonic intracavitary manometry and colonic transit test in the diagnostic efficacy of functional constipation in Chinese patients
Authors: Wang Dan , Zhang Zhao , Li Mingsen , Liu Tingting , Chen Chao , Cong Jiying , Jiao Chenmeng , Li Yuwei
Published: April 2022

Background

This study was to observe the diagnostic efficacy of high resolution total colonic intracavitary manometry (HRCM) vs colonic transit test (CTT) in the assessment of functional constipation (FC) in Chinese patients.

Methods

Seventy-nine cases of patients with severe FC who were admitted and received colon resection between July 2016 and July 2019 at the Tianjin Union Medical Center were retrospectively reviewed. Before operation, all patients received CTT at outpatient service, followed by HRCM at ward. The resected tissues were subject to histological observation, which was used to determine the diagnostic efficacy of HRCM vs CTT.

Results

The accuracy of CTT for the FC diagnosis was 69.6% (55/79), and the false negative ratio was 30.4%. The accuracy of HRCM for the FC diagnosis was 81.0% (64/79), and the false negative ratio was 19.0% (15/79). Twelve patients showed normal characteristics after CTT but abnormal after HRCM. In contrast, only 4 showed normal after HRCM but abnormal after CTT. In addition, among the 79 patients 12 were detected normal by both CTT and HRCM.

Conclusion

HRCM can be more suitable to assess FC compared with CTT, while CTT is still indispensable for HRCM to diagnose FC.
Epidemiology and outcomes of gastrointestinal mucosal melanomas: a national database analysis
Authors: Shah Niraj James , Aloysius Mark M. , Bhanat Eldrin , Gupta Shweta , Aswath Ganesh , John Savio , Tang Shou-Jiang , Goyal Hemant
Published: April 2022

Aim

Gastrointestinal malignant melanoma is a rare mucosal melanoma (MM). Other MM include the respiratory and the genitourinary tract. All mucosal melanomas have a poor prognosis when compared to cutaneous melanomas. Ano-rectal melanomas are by far the most common and most studied gastrointestinal MM. Large-scale clinical data is lacking due to the rarity of the disease. We aim to analyze epidemiology and survival of the Gastrointestinal (G.I.) MM over 45 years using a national database.

Methods

The Surveillance, Epidemiology and End Results (SEER) database was queried to identify patients with biopsy-proven G.I. Melanomas. We selected tumor site, intervention, and survival information for oncology codes as per the international classification of diseases. Survival analysis was performed using the SPSS v 27 ® IBM software.

Results

Of the 1105 biopsy-proven confirmed cases of primary G.I. melanoma's, 191 (17.3%) received chemotherapy (C.T.), 202 (18.3%) received radiotherapy (R.T.), 63 (5.7%) received both C.T and R.T., while 684 (61.9%) of the population received surgery alone or combined with C.T. and/or R.T. Statistically significant improvement in survival was noted in all treatment strategies that utilized surgery and also when site-specific MM cohorts underwent a surgical approach with or without C.T and/or R.T.

Conclusion

This is the most extensive study reporting epidemiological and survival data of treatment strategy outcomes of primary G.I. mucosal melanoma elucidating best overall survival with a management strategy involving surgical intervention.
Changes of inequality in functional disability of older populations in China from 2008 to 2018: a decomposition analysis
Authors: Zhang Tao , Liu Chaojie , Lu Beiyin , Wang Xiaohe
Published: April 2022

Background

This study aims to determine the change of inequality in functional disability of older populations in China over the period from 2008 to 2018 and decompose the contribution of the personal and environmental predictors to the change.

Methods

Data were drawn from two waves (2008 and 2018) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Functional disability was assessed by the basic activities of daily living (ADL) and the instrumental activities of daily living (IADL). Concentration index (CI) was calculated to measure the socioeconomic inequality in ADL and IADL. A two-level linear regression model was established to identify the individual and care environmental predictors and their contribution to the inequality of ADL and IADL, respectively. The Oaxaca-type decomposition technique was adopted to estimate the contribution of these predictors to changes of the inequality in ADL and IADL over the period from 2008 to 2018.

Results

Socioeconomic inequality in functional disability of older adults increased over the period from 2008 to 2018, with the CI for ADL changing from − 0.0085 to − 0.0137 and the CI for IADL changing from − 0.0164 to − 0.0276, respectively. Self-rated economic status was the single most powerful predictor of changes in the inequality, although the growing and dominant rating of older persons with fare economic status could offset the detrimental effects of other (rich or poor) ratings on the changes. The enlarged inequality was also attributable to the increasing importance of regular exercise and its distributional changes, as well as the accumulative long-term effect of farming in earlier life. They outweighed the counteracting effects of rural residency, living with chronic conditions and in an institution.

Conclusions

Socioeconomic inequality in functional disability of older populations in China increased over the period from 2008 to 2018. Re-distribution of wealth remains to be a powerful instrument for addressing the inequality issue, but alone it is not enough. The detrimental accumulative effect of farming will not disappear any time soon. While rural residents are catching up with their urban counterparts, new challenges such as physical inactivity are emerging.
Using multiple imputation and intervention-based scenarios to project the mobility of older adults
Authors: Kontto Jukka , Paalanen Laura , Sund Reijo , Sainio Päivi , Koskinen Seppo , Demakakos Panayotes , Tolonen Hanna , Härkänen Tommi
Published: April 2022

Background

Projections of the development of mobility limitations of older adults are needed for evidence-based policy making. The aim of this study was to generate projections of mobility limitations among older people in the United States, England, and Finland.

Methods

We applied multiple imputation modelling with bootstrapping to generate projections of stair climbing and walking limitations until 2026. A physical activity intervention producing a beneficial effect on self-reported activities of daily living measures was identified in a comprehensive literature search and incorporated in the scenarios used in the projections. We utilised the harmonised longitudinal survey data from the Ageing Trajectories of Health – Longitudinal Opportunities and Synergies (ATHLOS) project (N = 24,982).

Results

Based on the scenarios from 2012 to 2026, the prevalence of walking limitations will decrease from 9.4 to 6.4%. A physical activity intervention would decrease the prevalence of stair climbing limitations compared with no intervention from 28.9 to 18.9% between 2012 and 2026.

Conclusions

A physical activity intervention implemented on older population seems to have a positive effect on maintaining mobility in the future. Our method provides an interesting option for generating projections by incorporating intervention-based scenarios.
Associations between community participation and types of places visited among persons living with and without dementia: risks perception and socio-demographic aspects
Authors: Margot-Cattin Isabel , Berchtold André , Gaber Sophie , Kuhne Nicolas , Nygård Louise , Malinowsky Camilla
Published: April 2022

Introduction

Increasingly, literature has focused on community participation in places visited by persons living with and without dementia. Earlier research indicates that multiple factors, including socio-demographic aspects and risk perception may influence community participation.

Aim and methods

This cross-sectional, explorative study aims to inquire into how places visited, socio-demographic aspects and risks perception are associated with self-rated community participation for persons living with and without dementia (n = 70) in Switzerland. Data was collected through face-to-face interviews with questionnaires (ACT-OUT, MoCA, sociodemographic). First, we investigated whether the number of places visited was correlated with self-rated participation; then we added socio-demographic and risks perception factors with a bivariate analysis; and searched for a model using multinomial logistic regressions.

Results

For the group of participants living with dementia, risks of falling (p = .014) and of getting lost (p = .037) were significantly associated with self-rated participation. For the group of participants living without dementia, visiting places outside the home was significantly associated with self-rated participation, especially visiting places in domain D/places for recreational and physical activities (p = .005).

Discussion and conclusions

The results of exploring multiple factors and searching for a model highlights the complexity of community participation as a construct. Risks and visiting places for recreational and physical activities seem to play a role in self-rated participation. Mobile interviews might be better suited to gain in-depth understanding on community participation for persons living with dementia.
Association between self-reported body mass index and active life expectancy in a large community-dwelling sample of older U.S. adults
Authors: Jia Haomiao , Lubetkin Erica I.
Published: April 2022

Background

Obesity may have a protective effect (greater survival) in older adults, a finding known as the “obesity paradox.” This study examined the association between self-reported body mass index (BMI) and active life expectancy (ALE) among older U.S. adults.

Methods

Using the Medicare Health Outcomes Survey Cohort 15 (2012 baseline, 2014 follow-up), we estimated life expectancy and ALE by participants’ baseline BMI and age using multi-state models. A participant was classified as in an active state if this person reported having no difficulty for any of these six activities of daily living (ADLs).

Results

Small differences in life expectancy were noted among persons in normal weight (BMI 18.5–24.9 kg/m2), overweight (BMI 25–29.9 kg/m2), and obesity ranges (BMI 30 kg/m2 and higher). However, persons with obesity had a significantly lower ALE. ALE at age 65 was 11.1 (11.0–11.2) years for persons with obesity, 1.2 (1.1–1.3) years less than that for the normal weight and overweight persons (12.3 years for both, 12.2–12.4). Persons with class III obesity had a significantly lower life expectancy and ALE than normal weight persons. Although persons with class I or II obesity had a similar life expectancy as normal weight persons, they have a shorter ALE.

Conclusions

Although older adults with obesity have a similar life expectancy as normal weight persons, they have a significantly shorter ALE. Given the complex relationship of BMI and ALE, a “one size fits all” approach to weight management is not advisable.
Systemic antifungal strategies in allogeneic hematopoietic stem cell recipients hospitalized in french hematology units: a post-hoc analysis of the cross-sectional observational AFHEM study﻿
Authors: Michallet Mauricette , el Cheikh Jean , Herbrecht Raoul , Yakoub-Agha Ibrahim , Caillot Denis , Gangneux Jean-Pierre
Published: April 2022

Background

Invasive fungal diseases (IFD) remain a major complication of allogeneic hematopoietic stem cell transplantation (alloHSCT) and are associated with high mortality rates in patients receiving alloHSCT. Antifungal prophylaxis is increasingly being used in the management of IFDs in patients receiving alloHSCT.

Methods

A post-hoc analysis of the cross-sectional observational AFHEM study was carried out to describe the use of antifungal drugs in real-life clinical practice in alloHSCT recipients hospitalized in French hematological units.

Results

A total of 147 alloHSCT recipients were enrolled; most were adults (n = 135; 92%) and had received alloHSCT < 6 months prior to enrollment (n = 123; 84%). Overall, 119 (81%) patients received a systemic antifungal therapy; of these, 95 (80%) patients received antifungal prophylaxis. Rates of patients receiving systemic antifungal treatment were similar irrespective of transplant time, neutropenic, and graft-versus-host disease status. Among patients on systemic antifungal treatment, 83 (70%) received an azole, 22 (18%) received an echinocandin, and 16 (13%) received a polyene.

Conclusions

This work provides evidence of the antifungal strategies used in alloHSCT recipients hospitalized in French hematological units. Unlike earlier studies, the AFHEM study showed that prophylaxis appears to be the leading antifungal strategy used in alloHSCT recipients in France.
Surgical treatment of a patient with live intracranial sparganosis for 17 years
Authors: Hu Jialing , Liao Kaili , Feng Xiaojin , Jiang Danling , Liu Hailin , Zheng Qingcui , Qiu Hai , Hua Fuzhou , Xu Guohai , Xu Chunhua
Published: April 2022

Background

The incidence of sparganosis, especially intracranial live sparganosis is very low in China. Due to the lack of typical clinical manifestations, it is difficult to make a clear preoperative diagnosis of the disease, which often leads to delays the disease and serious consequences.

Case presentation

A 23-year-old man presented with a 17-year history of intermittent seizures and right extremity numbness and weakness. Magnetic resonance imaging (MRI) showed patchy, nodular and line-like enhancement. Enzyme-linked immunosorbent assay (ELISA) detected positive antibodies to Spirometra mansoni in peripheral blood and cerebrospinal fluid (CSF). In addition, during the operation, an ivory-colored live sparganosis was removed under the precise positioning of neuronavigation, and the patient was diagnosed with cerebral sparganosis. The patient began praziquantel and sodium valproate treatment after the operation, and was followed up for 3 months. There was no recurrence of epilepsy, and the weakness and numbness of the right limb improved.

Conclusion

Nonspecific clinical manifestations often make the diagnosis of cerebral sparganosis difficult, and a comprehensive diagnosis should be made based on epidemiological history, clinical manifestations, ELISA results and imaging findings. Surgery is the preferred method for the treatment of cerebral sparganosis, and more satisfactory results can be achieved under the precise positioning of neuronavigation.