bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of Ischemic Steal Syndrome in a Patient With Aberrant Arterial Anatomy Following Dialysis Access Surgery
Authors: Nwaneri Nkemjika , Aziz Faizaan , Matchett Michael , Aziz Faisal , Radtka John
Published: October 2022

Symptomatic ischemic steal syndrome (ISS) is a complex complication that develops in a small number of patients who have undergone a dialysis access procedure. This report describes the case of a 44-year-old female with aberrant upper extremity arterial anatomy who developed ISS following a radio-cephalic fistula. Ultrasound evaluation revealed abnormal blood flow in the radial artery and identified a communication between the radial and ulnar arteries distal to the anastomosis of the arteriovenous fistula. These findings assisted with the development of a surgical plan to ligate the intervening radial artery which resulted in resolution of the ISS symptoms.
On the causation correlation of maritime accidents based on data mining techniques
Authors: Ma Xiaoxue , Lan He , Qiao Weiliang , Han Bing , He Heilong
Published: October 2022

A great deal of valuable information included in maritime accident reports needs to be excavated to contribute to accident prevention or risk defence. In the present study, data mining technologies are applied to explore the potential causation correlations among the risk factors associated with maritime accidents. A collection of 285 accident reports is subjected to database analysis by using text mining technology to extract keywords, and the critical factors are then determined with reference to objective reports. The FP-Growth (frequent pattern growth) algorithm is then applied to identify the association rules hidden in the causations leading accidents, and the strength level of the identified association rules is evaluated quantitatively. The results show that the data mining technologies are applicable for identifying correlations hidden among factors contributing to maritime accidents. In addition, single factors do not significantly lead to accidents, while the integration of factors can easily cause accidents even under the condition of a good navigation environment. Therefore, stakeholders involved in maritime activities are advised to systematically assess risk factors, and prevent maritime accidents by interrupting the correlations among the factors.
Progression-free survival as surrogate endpoint of overall survival in esophageal squamous cell carcinoma: a real-world data and literature-based analysis
Authors: Han Weiming , Wang Lan , Li Chen , Chen Junqiang , Zhang Wencheng , Wang Xin , Pang Qingsong , Zhao Yidian , Sun Xinchen , Zhang Kaixian , Li Gaofeng , Li Ling , Qiao Xueying , Liu Miaoling , Wang Yadi , Deng Lei , Wang Wenqing , Bi Nan , Zhang Tao , Deng Wei , Ni Wenjie , Chang Xiao , Zhou Zongmei , Liang Jun , Feng Qinfu , Wang Lvhua , Chen Dongfu , Lv Jima , Zhu Shuchai , Han Chun , Xiao Zefen
Published: October 2022

Background:

The surrogacy of progression-free survival (PFS) for overall survival (OS) in esophageal squamous cell carcinoma (ESCC) remains unelucidated. This study aimed to determine the validity of PFS as a surrogate endpoint for OS in ESCC patients treated with definitive radiotherapy or definitive chemoradiotherapy (dRT/dCRT), as well as characterize the prognostic factors and survival of such patients.

Methods:

A total of 3662 patients from 10 cancer centers were enrolled. One-, 2-, and 3-year PFS (PFS12, PFS24, and PSF36, respectively) were used as time points for analysis. At each time point, ESCC-specific mortality and OS were characterized using competing risk and conditional survival models, while correlation between PFS and OS was evaluated by linear regression.

Results:

At PFS12, PFS24, and PFS36, a progressive decrease in 5-year ESCC-specific mortality (35.2%–13.4%) and increase in 5-year OS (46.6%–62.9%) were observed. Regardless, the OS of patients remained markedly lower than those of the age- and sex-matched Chinese general population. TNM stage remained a significant prognostic factor at PFS36. Strong correlation was found between 3-year PFS and 5-year OS, which was further externally validated.

Conclusions:

Three-year PFS may act as a potential surrogate endpoint for 5-year OS. TNM stage was considered a significant prognostic factor for OS, and may represent the optimal prognostic tool to guide clinical decision-making and post-treatment follow-up.
Comorbidity between lung cancer and COVID-19 pneumonia: role of immunoregulatory gene transcripts in high ACE2-expressing normal lung
Authors: Lazar Vladimir , Raynaud Jacques , Magidi Shai , Bresson Catherine , Martini Jean-François , Galbraith Susan , Wunder Fanny , Onn Amir , Batist Gerald , Girard Nicolas , Lassen Ulrik , Pramesh C. S. , Al-Omari Amal , Ikeda Sadakatsu , Berchem Guy , Blay Jean-Yves , Solomon Benjamin , Felip Enriqueta , Tabernero Josep , Rubin Eitan , Philip Thierry , Porgador Angel , Berindan-Neagoe Ioana , Schilsky Richard L. , Kurzrock Razelle
Published: October 2022

Background:

SARS-CoV-2 (COVID-19) elicits a T-cell antigen-mediated immune response of variable efficacy. To understand this variability, we explored transcriptomic expression of angiotensin-converting enzyme 2 ( ACE2, the SARS-CoV-2 receptor) and of immunoregulatory genes in normal lung tissues from patients with non-small cell lung cancer (NSCLC).

Methods:

This study used the transcriptomic and the clinical data for NSCLC patients generated during the CHEMORES study [ n = 123 primary resected (early-stage) NSCLC] and the WINTHER clinical trial ( n = 32 metastatic NSCLC).

Results:

We identified patient subgroups with high and low ACE2 expression ( p = 1.55 × 10−19) in normal lung tissue, presumed to be at higher and lower risk, respectively, of developing severe COVID-19 should they become infected. ACE2 transcript expression in normal lung tissues (but not in tumor tissue) of patients with NSCLC was higher in individuals with more advanced disease. High- ACE2 expressors had significantly higher levels of CD8+ cytotoxic T lymphocytes and natural killer cells but with presumably impaired function by high Thymocyte Selection-Associated High Mobility Group Box Protein TOX ( TOX) expression. In addition, immune checkpoint-related molecules – PD-L1, CTLA-4, PD-1, and TIGIT – are more highly expressed in normal (but not tumor) lung tissues; these molecules might dampen immune response to either viruses or cancer. Importantly, however, high inducible T-cell co-stimulator ( ICOS), which can amplify immune and cytokine reactivity, significantly correlated with high ACE2 expression in univariable analysis of normal lung (but not lung tumor tissue).

Conclusions:

We report a normal lung immune-tolerant state that may explain a potential comorbidity risk between two diseases – NSCLC and susceptibility to COVID-19 pneumonia. Further, a NSCLC patient subgroup has normal lung tissue expressing high ACE2 and high ICOS transcripts, the latter potentially promoting a hyperimmune response, and possibly leading to severe COVID-19 pulmonary compromise.
Board Gender Diversity, Corporate Social Disclosures, and National Culture
Authors: Peng Xuhui , Qi Tian , Wang Gang
Published: October 2022

The impact of board gender diversity on corporate social responsibility has attracted considerable attention in recent years. However, the study of the relationship between board gender diversity, corporate social disclosures, and national culture has been scarce. Therefore, in this study, we measured the corporate social disclosures data of multinational corporations (MNCs) from China, Japan, the United Kingdom, and the United States using content analysis. Then, we investigated the relationship between board gender diversity and the corporate social disclosures of MNCs as well as the moderating effect of national culture on that relationship. The results show that (1) board gender diversity positively impacts the corporate social disclosures of MNCs and that (2) masculinity negatively moderates the relationship between board gender diversity and the corporate social disclosures of MNCs. The findings emphasize the importance of board gender diversity in the stakeholder management of the board of directors and how it could be affected by different national cultural environments from the stakeholder theory perspective. This study established a link between board gender diversity, corporate social disclosures, and national culture as well as promoted the development of corporate social responsibility (CSR) disclosure measurement methods. Additionally, our results provide suggestions to policymakers and MNCs in how to effectively adopt board gender diversity to promote CSR in specific national cultural environments.
Language Maintenance and Shift of a fangyan Group: The Case of Mid-Mountain Hakka in Hakka-Chaoshan Adjoining Areas
Authors: Qiu Chun-an , Qiu Zhouzan
Published: October 2022

Previous studies have discussed the impact of social context on language maintenance and shift of Chinese fangyan in metropolises, but not enough in rural areas. To explore the language maintenance and shift of the Hakka fangyan among Mid-mountain Hakka (MMH), a sub-branch of the Hakka people who live in Hakka-Chaoshan adjoining areas, this study examined the language proficiency, use, attitudes, and group identity of 200 residents in Jiexi County using quantitative and qualitative data. Through an analysis of survey- and interview-based self-reported data, our results revealed that although MMH seemed able to maintain the Hakka fangyan at a good level overall, there was still a sharp intergenerational decline in fangyan proficiency, use, attitudes, and awareness of Hakka identity and culture. Furthermore, there may have been a shift from the predominance of Hakka-Chaoshan bilinguals to the predominance of Hakka- Putonghua bilinguals across generations. We also constructed a model of the factors influencing language maintenance and shift of MMH. This study helps enhance our understanding of the role of group identity in language maintenance and shift, and has important implications for the practice of fangyan protection in rural areas of China.
How the Bronfenbrenner Bio-ecological System Theory Explains the Development of Students’ Sense of Belonging to School?
Authors: El Zaatari Wafaa , Maalouf Imad
Published: October 2022

The central concept of this review underscores the fact that the development of a feeling of belonging at school occurs because of different interactions between developing students and the school’s ecological environment over time. This review argues that Bronfenbrenner’s Bio-ecological Systems Theory can best explain the development of school belonging by highlighting the role of PPCT (Process, Person, Context, and Time). The process includes the interactions (proximal and distal) that occur between students and their school’s ecological systems. The person considers the active role of students in influencing their development. The context encompasses the school’s ecological systems. The time includes events and the chronological age of students. The review highlights the most important proximal practices and interactions that occur in school microsystems and play a significant role in enhancing students’ sense of belonging. Empirical, longitudinal research that focuses on the interactions of all the components of the PPCT model is recommended.
Thrombolysis after dabigatran reversal: A nation-wide Italian multicentre study, systematic review and meta-analysis
Authors: Romoli Michele , Matteo Eleonora , Migliaccio Ludovica , Gentile Mauro , Mosconi Maria Giulia , Scura Giuseppe Maria , Naccarato Marcello , Colangeli Enrico , Candelaresi Paolo , Andreone Vincenzo , Giammello Fabrizio , Fortunata Musolino Rosa , Dell’Aera Cristina , Sepe Federica Nicoletta , Pronello Edoardo , Barbarini Leonardo , Caggiula Marcella , Rizzo Federica , Petruzzellis Marco , Giorli Elisa , Zedde Maria Luisa , Anticoli Sabrina , Mangiardi Marilena , Muto Mario , Diana Francesco , De Angelis Maria Vittoria , Digiovanni Anna , Concari Letizia , La Gioia Sara , Sessa Maria , Biguzzi Sara , Cordici Francesco , Longoni Marco , Ruggiero Maria , Cenciarelli Silvia , Eusebi Paolo , Sacco Simona , Caso Valeria , Paciaroni Maurizio , Ricci Stefano , Zini Andrea , Toni Danilo , Giannandrea David
Published: October 2022

Introduction:

Recent anticoagulant intake represents a contraindication for thrombolysis in acute ischemic stroke. Idarucizumab reverses the anticoagulant effect of dabigatran, potentially allowing for thrombolysis. This nation-wide observational cohort study, systematic review, and meta-analysis evaluated the efficacy and safety of thrombolysis preceded by dabigatran-reversal in people with acute ischemic stroke.

Patients and methods:

We recruited people undergoing thrombolysis following dabigatran-reversal at 17 stroke centers in Italy (reversal-group), people on dabigatran treated with thrombolysis without reversal (no-reversal group), and age, sex, hypertension, stroke severity, and reperfusion treatment-matched controls in 1:7 ratio (control-group). We compared groups for symptomatic intracranial hemorrhage (sICH, main outcome), any brain hemorrhage, good functional outcome (mRS 0–2 at 3 months), and death. The systematic review followed a predefined protocol (CRD42017060274), and odds ratio (OR) meta-analysis was implemented to compare groups.

Results:

Thirty-nine patients in dabigatran-reversal group and 300 matched controls were included. Reversal was associated with a non-significant increase in sICH (10.3% vs 6%, aOR = 1.32, 95% CI = 0.39–4.52), death (17.9% vs 10%, aOR = 0.77, 95% CI = 0.12–4.93) and good functional outcome (64.1% vs 52.8%, aOR = 1.41, 95% CI = 0.63–3.19). No hemorrhagic events or deaths were registered in no-reversal group (n = 12). Pooling data from 3 studies after systematic review (n = 1879), reversal carried a non-significant trend for sICH (OR = 1.53, 95% CI = 0.67–3.50), death (OR = 1.53, 95% CI = 0.73–3.24) and good functional outcome (OR = 2.46, 95% CI = 0.85–7.16).

Discussion and conclusion:

People treated with reperfusion strategies after dabigatran reversal with idarucizumab seem to have a marginal increase in the risk of sICH but comparable functional recovery to matched patients with stroke. Further studies are needed to define treatment cost-effectiveness and potential thresholds in plasma dabigatran concentration for reversal.
Health-oriented leadership: Antecedents of leaders’ awareness regarding warning signals of emerging depression and burnout
Authors: Pischel Sarah , Felfe Jörg , Krick Annika
Published: October 2022

Due to growing demands, there is an increase in depression and burnout causing sickness absence and early retirement. Detecting depression and burnout at an early stage is a crucial task for leaders to allow for early support and prevent more severe illnesses. Within the health-oriented leadership concept, awareness is the ability to recognize followers’ warning signals as a potential health risk. Although it is widely accepted that awareness is a precondition to taking appropriate action, it is yet unclear to what extent leaders recognize the warning signals of followers and which factors facilitate or impede awareness. In an experimental study ( N = 54) and a survey study ( N = 215) we examined antecedents of awareness in followers and leaders: (a) clarity of displayed warning signals in followers, (b) leaders’ stressors, (c) leaders’ autonomy. Even under favorable conditions, only about half of the leaders recognized warning signals as a health risk. Leaders showed lower awareness during times of high stress and low autonomy and when followers displayed less clear warning signals. Autonomy moderated the effect of stress (workload) on awareness, but there was no buffering effect as expected. The findings deepen the theoretical understanding of awareness and suggest that leaders need to know how their awareness may be impeded. We provide practical recommendations for human resource management on how leaders’ awareness can be fostered.
Examination of Cinnamomum camphora interlocked grain adopting X-ray computed tomography combined with particle image velocimetry
Authors: Cipta Hairi , Kobayashi Kayoko , Chen Shuoye , Sugiyama Junji
Published: October 2022

Trees develop wood grain more or less parallel to the tree axis as they grow laterally. However, many tree species also develop interlocked grain that is expressed as a change in the wood grain orientation, periodically switching between left- and right-handed spirals over the years. Wood grain information is critical to determining the wood quality and is an important record of cellular events in a cambium. This study examined the wood grain of axial xylem cells in the semi-ring porous hardwood Cinnamomum camphora by first visualizing the three-dimensional structure using a conventional X-ray computed tomography instrument producing tomography images. We propose the use of particle image velocimetry (PIV) and the two-dimensional fast Fourier transform (2D-FFT) to analyze computed tomography images in obtaining grain angle (δ) information from the vessel deviation. We found undulation on the radial variation of the grain angle (δ) that indicates periodical changes in the wood grain orientation as left- and right-handed spirals ranging from − 25° to 16° and − 22° to 18° using the 2D-FFT and PIV, respectively. Furthermore, despite the major orientation of vessels inclining in the tangential direction, the PIV result revealed a minor deviation with vessels inclining in various orientations along the tree radius.
Toxicity of ZnO and Fe2O3 nano-agro-chemicals to soil microbial activities, nitrogen utilization, and associated human health risks
Authors: Shah Ghulam Mustafa , Amin Mubashara , Shahid Muhammad , Ahmad Iftikhar , Khalid Samina , Abbas Ghulam , Imran Muhammad , Naeem Muhammad Asif , Shahid Naeem
Published: October 2022

Background

Various nano-enabled agrochemicals are being extensively used for soil remediation and to boost crop production by increasing the nutrient efficiency of fertilizers. However, understanding of their potential risks on the manure–soil–plant continuum is limited. These nano-agrochemicals can be potentially toxic to soil microbes and their associated functions, such as nitrogen (N) mineralization and decomposition of organic materials. Moreover, the accumulation of nanoparticles (NPs) in edible crops may reduce food quality, and can cause serious threats to human health. Accordingly, here we investigated how zinc (ZONPs) and iron oxide (IONPs) nanoparticles affect the soil microbial communities, their efficiency of decomposition and N mineralization, radish yield, and plant N recovery after soil application of poultry manure (PM). Furthermore, we studied the associated health risks (DIM, HRI) via dietary intake of radish.

Results

Soil application of ZONPs and IONPs significantly (P < 0.05) increased microbial biomass Zn/Fe indicating their microbial utilization. This decreased the colony-forming units (CFU) of bacteria and fungi. For example, the application of PM with ZONPs and IONPs decreased the CFU of bacteria by 32% and 19%, respectively. In case of fungi, the CFU reductions were slightly different (ZONPs: 28% and IONPs: 23%). Consequently, the N mineralization significantly decreased by 62% and 29% due to ZONPs and IONPs, respectively. Which ultimately resulted in the reduction of radish dry matter yield by 22% and 12%. The respective reductions of the apparent N recovery (ANR) were 65% and 39%. Health risk assessment indicated that DIM and HRI values from both the NPs lie under safe limits.

Conclusions

We conclude that both metal oxide nanoparticles (i.e., ZONPs and IONPs) can significantly affect the soil microbial community, their associated functions, and crop yield with the former being relatively more toxic. However, no evidence was found regarding the health risks to humans via dietary radish intake. These toxicological effects imply restricting the widespread production and use of NPs, and developing strategies for their safe disposal to avoid their contact with soil beneficial microorganisms.
Mutation of the MYH3 gene causes recessive cleft palate in Limousine cattle
Authors: Vaiman Anne , Fritz Sébastien , Beauvallet Christian , Boussaha Mekki , Grohs Cécile , Daniel-Carlier Nathalie , Relun Anne , Boichard Didier , Vilotte Jean-Luc , Duchesne Amandine
Published: October 2022

Background

The palate is a structure separating the oral and nasal cavities and its integrity is essential for feeding and breathing. The total or partial opening of the palate is called a cleft palate and is a common malformation in mammals with environmental or hereditary aetiologies. Generally, it compromises life expectancy in the absence of surgical repair. A new form of non-syndromic cleft palate arose recently in Limousine cattle, with animals referred to the French National Observatory of Bovine Abnormalities since 2012. Since the number of affected animals has increased steadily, this study was undertaken to identify the cause of this disease.

Results

Based on pedigree analysis, occurrence of cleft palate in Limousine cattle was concordant with an autosomal recessive mode of inheritance. Genotyping of 16 affected animals and homozygosity mapping led to the identification of a single disease-associated haplotype on Bos taurus chromosome (BTA)19. The genome of two affected animals was sequenced, and their sequences were compared to the ARS-UCD1.2 reference genome to identify variants. The likely causal variants were compared to the variant database of the 1000 bull genome project and two fully linked mutations in exon 24 of the MYH3 (myosin heavy chain) gene were detected: a 1-bp non-synonymous substitution (BTA19:g.29609623A>G) and a 11-bp frameshift deletion (BTA19:g.29609605-29609615del). These two mutations were specific to the Limousine breed, with an estimated allele frequency of 2.4% and are predicted to be deleterious. The frameshift leads to a premature termination codon. Accordingly, mRNA and protein analyses in muscles from wild-type and affected animals revealed a decrease in MYH3 expression in affected animals, probably due to mRNA decay, as well as an absence of the MYH3 protein in these animals. MYH3 is mostly expressed in muscles, including craniofacial muscles, during embryogenesis, and its absence may impair palate formation.

Conclusions

We describe a new form of hereditary cleft palate in Limousine cattle. We identified two fully linked and deleterious mutations, ultimately leading to the loss-of-function of the MYH3 protein. The mutations were included on the Illumina EuroG10k v8 and EuroGMD v1 SNP chips and are used to set up a reliable eradication strategy in the French Limousine breed.
Isolation of nontuberculous mycobacteria species from different water sources: a study of six hospitals in Tehran, Iran
Authors: Moghaddam Sina , Nojoomi Farshad , Dabbagh Moghaddam Arasb , Mohammadimehr Mojgan , Sakhaee Fatemeh , Masoumi Morteza , Siadat Seyed Davar , Fateh Abolfazl
Published: October 2022

Purpose

Nontuberculous mycobacteria (NTM) are ubiquitous bacteria that are naturally resistant to disinfectants and antibiotics and can colonize systems for supplying drinking water. Therefore, this study aimed to evaluate the prevalence of NTM in the drinking water of six hospitals in Tehran, Iran.

Methods

Totally, 198 water samples were collected. Each water sample was filtered via a membrane filter with a pore size of 0.45 µm and then decontaminated by 0.005% cetylpyridinium chloride. The membrane filters were incubated on two Lowenstein-Jensen media at 25 °C and 37 °C for 8 weeks. The positive cultures were identified with phenotypic tests, and then NTM species were detected according to the hsp65, rpoB, and 16S rDNA genes. Drug susceptibility testing (DST) was also carried out.

Results

Overall, 76 (40.4%) of the isolates were slowly growing mycobacteria (SGM) and 112 (59.6%) of the ones were rapidly growing mycobacteria (RGM). The most common NTM were Mycobacterium aurum, M. gordonae, M. phocaicum, M. mucogenicum, M. kansasii, M. simiae, M. gadium, M. lentiflavum, M. fortuitum, and M. porcinum. Among these 188 samples, NTM ranged from 1 to > 300 colony-forming unit (CFU) /500 mL, with a median of 182 CFU/500 mL. In the infectious department of all hospitals, the amount of CFU was higher than in other parts of the hospitals. The DST findings in this study indicated the diversity of resistance to different drugs. Among RGM, M. mucogenicum was the most susceptible isolate; however, M. fortuitum showed a different resistance pattern. Also, among SGM isolates, M. kansasii and M. simiae, the diversity of DST indicated.

Conclusions

The current study showed NTM strains could be an important component of hospital water supplies and a possible source of nosocomial infections according to the CFU reported in this study. The obtained findings also help clarify the dynamics of NTM variety and distribution in the water systems of hospitals in the research area.
Nutrient reallocation between stem and leaf drives grazed grassland degradation in inner Mongolia, China
Authors: Liu Jiayue , Lu Shuaizhi , Liu Changcheng , Hou Dongjie
Published: October 2022

Background

Decline in height and aboveground biomass of the plant community are critical indicators of grassland ecosystem degradation. Nutrient reallocation induced by grazing occurs among different organs, which balances the trade-off between growth and defense. However, it is not yet clear how nutrient reallocation strategies affect plant community structure and functions in grazed grasslands. A grazing experiment was conducted in a typical steppe in Inner Mongolia, China. We investigated plant community characteristics and measured plant functional traits of dominant species (Leymus chinensis and Cleistogenes squarrosa) at individual and population levels. Carbon (C), nitrogen (N), phosphorus (P), copper (Cu), iron (Fe), manganese (Mn), and zinc (Zn) concentrations of stem and leaf in the two species were also determined.

Results

N, P, Cu, Fe, Mn, and Zn concentrations in leaves and stems of L. chinensis and C. squarrosa significantly increased with grazing intensity, and microelements (Cu, Fe, Mn, and Zn) were more sensitive to grazing. The nutrient slopes of macro- and microelements in leaves were significantly higher than those in stems under grazing, indicating that nutrient resources were preferentially allocated to leaves and enhanced the compensatory growth of leaves in the grazed grassland. With increasing grazing intensity, the aboveground biomass of stems and leaves in the two species significantly decreased, but leaf to stem ratio increased at the individual level, indicating that plants preferentially allocated biomass to leaves under grazing. The increase in leaf to stem ratio due to nutrient reallocation between the two organs significantly reduced height and aboveground biomass at population and community levels, driving grassland ecosystem degradation.

Conclusion

Our study revealed the driving forces of community structure and function degradation in grazed grasslands from the perspective of nutrient resource allocation, and provided insights into plant adaptation strategies to grazing.
Comparison of the effect of double-lumen endotracheal tubes and bronchial blockers on lung collapse in video-assisted thoracoscopic surgery: a systematic review and meta-analysis
Authors: Xiang Ying-ying , Chen Qi , Tang Xi-xi , Cao Lei
Published: October 2022

Objective

This meta-analysis compared the quality of lung collapse and the resultant adverse reactions between the use of double-lumen endotracheal tubes (DLT) and bronchial blockers (BB) in minimally invasive thoracic surgery.

Methods

A search was performed in five bibliographic databases, namely PubMed, Springer, Medline, EMBASE, and Cochrane Library ignoring the original language, which identified five randomized controlled trials (RCTs) published on or before December 31, 2021. These studies were subsequently analyzed. All included studies compared the efficacy and safety of DLT and BB as a lung isolation technique in surgery. The methodological quality of each study was assessed by the Cochrane Collaboration’s risk of bias tool. The quality of lung collapse and the malposition rate were adopted as the main outcome indicators. Alternatively, the intubation time and the incidence of postoperative sore throat were adopted as secondary indicators.

Results

When either DLT or BB were utilized in minimally invasive thoracic surgery, no differences were observed in the quality of lung collapse (odds ratio [OR], 1.00; 95% confidence interval [CI], 0.63 to 1.58), the intubation time (mean difference [MD], 0.06; 95% CI, -1.02 to 1.14), or the malposition rate (OR, 0.88; 95% CI, 0.37 to 2.06). However, the incidence of postoperative sore throat among patients treated with BB was significantly lower than that among patients treated with DLT (OR, 5.25; 95% CI, 2.55 to 10.75).

Conclusion

When utilized in minimally invasive thoracic surgery, the quality of lung collapse with DLT was identical to that with BB. However, patients treated with the latter demonstrated a significantly lower incidence of postoperative sore throat.
DNA methylation alternation in Stanford- A acute aortic dissection
Authors: Chen Yufei , Xu Xu , Chen Zhaoran , Huang Bi , Wang Xiaojian , Fan Xiaohan
Published: October 2022

Background

Acute aortic dissection (AAD) is a life-threatening cardiovascular disease. Recent studies have shown that DNA methylation may be associated with the pathological mechanism of AAD, but the panorama of DNA methylation needs to be explored.

Methods

DNA methylation patterns were screened using Infinium Human Methylation 450 K BeadChip in the aortic tissues from 4 patients with Stanford-A AAD and 4 controls. Gene enrichment was analyzed by Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway and gene ontology (GO). DNA methylation levels of candidate genes were determined by pyrosequencing in the replication cohort including 16 patients with AAD and 7 controls. Protein expression level of candidate gene was assessed by Western blot.

Results

A total of 589 differentially methylated positions including 315 hypomethylated and 274 hypermethylated positions were found in AAD group. KEGG analysis demonstrated that differentially methylated position-associated genes were enriched in MAPK signaling pathway, TNF signaling pathway and apoptosis pathway, et al. GO analysis demonstrated that differentially methylated position-associated genes were enriched in protein binding, angiogenesis and heart development et al. The differential DNA methylation in five key genes, including Fas, ANGPT2, DUSP6, FARP1 and CARD6, was authenticated in the independent replication cohort. The protein expression level of the Fas was increased by 1.78 times, indicating the possible role of DNA methylation in regulation of gene expression.

Conclusion

DNA methylation was markedly changed in the aortic tissues of Stanford-A AAD and associated with gene dysregulation, involved in AAD progression.
Predictors and prognosis of PCI-related myocardial injury in chronic total occlusion
Authors: Kong Tianzhong , Dai Xintong , Luan Bo , Zhang Xiaojiao , Hou Aijie , Wang Yong
Published: October 2022

Background

Periprocedural myocardial injury (PMI) is associated with major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI). However, the incidence predictors and prognosis of PMI in chronic total occlusion (CTO) undergoing PCI remains unclear.

Method

To evaluate the predictors and prognostic impact of PMI following PCI in patients with CTO. We consecutively enrolled 132 individuals and 8 of whom with procedural failure were excluded in this study. Thus, a total of 124 CTO patients successfully received PCI were included in this study. And patients were divided into the PMI group (n = 42) and the non-PMI group (n = 82) according to their c-TnI levels measured after procedure. The baseline and angiographic characteristics of the two groups were compared. The predictors of PMI and the correlation between PMI and MACE were investigated.

Results

Overall, PMI occurred in 42 patients (33.9%). Comparing with control group, PMI group had more diabetes (54.8% vs. 31.7%,P = 0.013) and dyslipidemia (54.8% vs. 13.4%, P＜0.001). Also, there were significant differences between the two groups in left ventricular ejection fraction(43.2 ± 7.2 vs 47.2 ± 8.0, P = 0.027), prior myocardial infarction(54.8%vs43.1%, P = 0.020), prior PCI(57.1% vs 22.0%, P＜0.001) and prior CABG(14.3% vs 2.4%, P = 0.011). Also, patients with PMI had more calcified lesions (52.4% vs 24.4%, P = 0.002) and were more likely to have multivessel disease (71.4% vs 35.4%, P＜0.001). In addition, patients in the PMI group had higher J-CTO scores (3.3 ± 1.0 vs 1.9 ± 0.5, P＜0.001) and were more likely to have wire-crossing difficulties (64.3% vs 37.8%, P = 0.005), require more use of retrograde approach (38.1% vs 7.3%, P＜0.001) and have more procedural complications (19.0% vs 2.4%, P = 0.003). In the multivariate analysis, multivessel artery disease (odd ratio [OR], 4.347;95% confidence interval [CI], 1.601– 11.809;P  = 0.004), retrograde approach (OR, 4.036; 95%CI, 1.162– 14.020;P  = 0.028) and the presence of procedural complications (OR, 16.480;95%CI, 2.515-107.987;P = 0.003) were predictors of PMI.

Conclusion

The incidence of PMI in CTO patients after PCI was 33.9%. Multivessel artery disease, retrograde approach, and the presence of procedural complications were predictors of PMI after CTO-PCI. Patients who develop PMI tend to have a poorer clinical prognosis and more MACE than those who do not develop PMI.
Acute heart failure associated with toxic shock syndrome due to methicillin-susceptible Staphylococcus aureus during the postpartum period: case report and systematic literature review
Authors: Suzuki Takahiro , Matsuo Takahiro , Kijima Yasufumi , Hasegawa Ryo , Ishikawa Kazuhiro , Yamanaka Michiko , Kawai Fujimi , Komiyama Nobuyuki , Mori Nobuyoshi
Published: October 2022

Background

Toxic shock syndrome (TSS) caused by Staphylococcus aureus in the postpartum period is a rare but life-threatening disease. We present a case of acute heart failure as the initial presentation of TSS due to methicillin-susceptible Staphylococcus aureus (MSSA) and describe its clinical characteristics with a systematic literature review.

Case presentation

A 34-year-old woman, 8 days after a normal vaginal delivery presented to our hospital with dyspnea and fever. She had jugular venous distension, bilateral leg edema, and erythema. Laboratory examinations revealed elevated NT-pro-BNP level of 3,233 pg/mL. Transthoracic echocardiography showed elevated tricuspid regurgitation peak gradient, with decreased respiratory variability of the inferior vena cava diameter and bilateral pleural effusions. The patient was hospitalized with suspicion of congestive heart failure. MSSA positive for toxic shock syndrome exotoxin-1 was detected in the culture of the perineal incision wound, and we diagnosed TSS caused by MSSA. Intravenous diuretics were administered, along with eventual cefazolin plus clindamycin. After 2 weeks of antimicrobial therapy, the patient showed improvement and was discharged. No recurrence was observed at the 24-month follow-up.

Conclusion

This is a rare case report of acute heart failure being the initial manifestation of TSS due to MSSA in the postpartum period. Clinicians should consider TSS as a possibility in postpartum patients with acute heart failure. This systematic review provides insights into its clinical features, treatment regimens, and prognosis of TSS by S. aureus in the postpartum period. TSS requires an appropriate, prompt diagnosis, because delayed treatment can be fatal.
Explanation of hand, foot, and mouth disease cases in Japan using Google Trends before and during the COVID-19: infodemiology study
Authors: Niu Qian , Liu Junyu , Zhao Zixi , Onishi Miyu , Kawaguchi Asuka , Bandara Anuradhi , Harada Keiko , Aoyama Tomoki , Nagai-Tanima Momoko
Published: October 2022

Background

Coronavirus Disease 2019 (COVID-19) pandemic affects common diseases, but its impact on hand, foot, and mouth disease (HFMD) is unclear. Google Trends data is beneficial for approximate real-time statistics and because of ease in access, is expected to be used for infection explanation from an information-seeking behavior perspective. We aimed to explain HFMD cases before and during COVID-19 using Google Trends.

Methods

HFMD cases were obtained from the National Institute of Infectious Diseases, and Google search data from 2009 to 2021 in Japan were downloaded from Google Trends. Pearson correlation coefficients were calculated between HFMD cases and the search topic “HFMD” from 2009 to 2021. Japanese tweets containing “HFMD” were retrieved to select search terms for further analysis. Search terms with counts larger than 1000 and belonging to ranges of infection sources, susceptible sites, susceptible populations, symptoms, treatment, preventive measures, and identified diseases were retained. Cross-correlation analyses were conducted to detect lag changes between HFMD cases and search terms before and during the COVID-19 pandemic. Multiple linear regressions with backward elimination processing were used to identify the most significant terms for HFMD explanation.

Results

HFMD cases and Google search volume peaked around July in most years, excluding 2020 and 2021. The search topic “HFMD” presented strong correlations with HFMD cases, except in 2020 when the COVID-19 outbreak occurred. In addition, the differences in lags for 73 (72.3%) search terms were negative, which might indicate increasing public awareness of HFMD infections during the COVID-19 pandemic. The results of multiple linear regression demonstrated that significant search terms contained the same meanings but expanded informative search content during the COVID-19 pandemic.

Conclusions

The significant terms for the explanation of HFMD cases before and during COVID-19 were different. Awareness of HFMD infections in Japan may have improved during the COVID-19 pandemic. Continuous monitoring is important to promote public health and prevent resurgence. The public interest reflected in information-seeking behavior can be helpful for public health surveillance.
Identification of the origin of tumor in vein: comparison between CEUS LI-RADS v2017 and v2016 for patients at high risk
Authors: Tong Wen-juan , Cheng Mei-qing , Lin Man-xia , Hu Hang-tong , Pan Jia-min , Huang Hui , Wang Ying , Xie Xiao-yan , Lu Ming-de , Kuang Ming , Huang Yang , Wang Wei
Published: October 2022

Objectives

To compare the diagnostic performance of the Contrast-Enhanced Ultrasound (CEUS) Liver Imaging Report and Data System (LI-RADS) v2016 and v2017 in identifying the origin of tumor in vein (TIV).

Methods

From April 2014 to December 2018, focal liver lesions (FLLs) accompanied by TIV formation in patients at high risk for hepatocellular carcinoma (HCC) were enrolled. Histologic evaluation or composite imaging reference standard were served as the reference standard. Each case was categorized according to the CEUS LI-RADS v2016 and v2017, respectively. Diagnostic performance of CEUS LI-RADS v2016 and v2017 in identifying the originated tumor of TIV was validated via sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value.

Results

A total of 273 FLLs with TIV were analyzed finally, including 266 HCCs and 7 non-HCCs. In v2016, when adopting all TIV as LR-5V, the accuracy and PPV in identifying the originated tumor were both 97.4%. In v2017, when assigning TIV according to contiguous FLLs CEUS LI-RADS category, the accuracy and PPV were 61.9% and 99.4% in subclass of LR-5 as the diagnostic criteria of HCC, and 64.1% and 99.4% in subclass of LR-4/5 as the criteria of HCC diagnosis. There were significant differences in diagnostic accuracy between CEUS LI-RADS v2016 and v2017 in identifying the originated tumor of TIV (p < 0.001).

Conclusions

CEUS LI-RADS v2016 could be better than v2017 in identifying the originated tumor of TIV.
Practice of general pediatrics in Saudi Arabia: current status, challenges, and opportunities
Authors: Alnasser Yossef S. , Alabdali Alhanouf F. , Alshabri Rahaf I. , Albatati Sawsan M.
Published: October 2022

Background

In Saudi Arabia, general pediatrics serves children until they are 14 years old. It has contributed to improving the health of Saudi children.

Method

This study adopted a qualitative method and recruited pediatric physicians to investigate status, successes, challenges, and opportunities. Later, data were analyzed using thematic analysis and hermeneutic phenomenology.

Results

This study attracted 13 pediatric physicians for interviews. All participants appreciated the role of general pediatricians, but the trainees had a negative attitude regarding the general pediatrics specialty. They all agreed on providing primary care for all children and recommended that their first visit should occur earlier. Shortage of pediatricians, lack of community pediatricians, busy clinics, limited Arabic resources, and poor communication skills are significant barriers to children receiving adequate care. The majority of pediatricians favor extending the pediatric age to 18 years old. One pediatrician stated, “Youths between ages 14–18 years are lost, adults and we refuse to care for them…” Additionally, pediatricians have concerns about managing developmental delays and behavioral issues. They believe the current pediatric residency provides many opportunities for a brighter future.

Conclusion

General pediatrics is well established in Saudi Arabia. To continue thriving, we need to address some challenges that pediatricians face and attract more residency graduates. The current pediatric residency programs can provide opportunities to address deficit areas.
Neonatal hemochromatosis with εγδβ-thalassemia: a case report and analysis of serum iron regulators
Authors: Tsuge Mitsuru , Kodera Aya , Sumitomo Hiromi , Araki Tooru , Yoshida Ryuichi , Yasui Kazuya , Sato Hiroki , Washio Yosuke , Washio Kana , Shigehara Kenji , Yashiro Masato , Yagi Takahito , Tsukahara Hirokazu
Published: October 2022

Background

Neonatal hemochromatosis causes acute liver failure during the neonatal period, mostly due to gestational alloimmune liver disease (GALD). Thalassemia causes hemolytic anemia and ineffective erythropoiesis due to mutations in the globin gene. Although neonatal hemochromatosis and thalassemia have completely different causes, the coexistence of these diseases can synergistically exacerbate iron overload. We report that a newborn with εγδβ-thalassemia developed neonatal hemochromatosis, which did not respond to iron chelators and rapidly worsened, requiring living-donor liver transplantation.

Case presentation

A 1-day-old Japanese boy with hemolytic anemia and targeted red blood cells was diagnosed with εγδβ-thalassemia by genetic testing, and required frequent red blood cell transfusions. At 2 months after birth, exacerbation of jaundice, grayish-white stool, and high serum ferritin levels were observed, and liver biopsy showed iron deposition in hepatocytes and Kupffer cells. Magnetic resonance imaging scans showed findings suggestive of iron deposits in the liver, spleen, pancreas, and bone marrow. The total amount of red blood cell transfusions administered did not meet the criteria for post-transfusion iron overload. Administration of an iron-chelating agent was initiated, but iron overload rapidly progressed to liver failure without improvement in jaundice and liver damage. He underwent living-donor liver transplantation from his mother, after which iron overload disappeared, and no recurrence of iron overload was observed. Immunohistochemical staining for C5b-9 in the liver was positive. Serum hepcidin levels were low and serum growth differentiation factor-15 levels were high prior to living-donor liver transplantation.

Conclusions

We reported that an infant with εγδβ-thalassemia developed NH due to GALD, and that coexistence of ineffective erythropoiesis in addition to erythrocyte transfusions may have exacerbated iron overload. Low serum hepcidin levels, in this case, might have been caused by decreased hepcidin production arising from fetal liver damage due to neonatal hemochromatosis and increased hepcidin-inhibiting hematopoietic mediators due to the ineffective hematopoiesis observed in thalassemia.
Sleep duration and risk of high blood pressure in Thai adolescents: the Thai National Health Examination Survey V, 2014 (NHES-V)
Authors: Pirojsakul Kwanchai , Aekplakorn Wichai , Siwarom Sirinapa , Paksi Witchuri , Kessomboon Pattapong , Neelapaichit Nareemarn , Chariyalertsak Suwat , Assanangkornchai Savitree , Taneepanichskul Surasak
Published: October 2022

Background

Sleep duration has been proposed to be associated with high blood pressure. However, nationwide studies regarding this association in adolescents remain limited. This study aimed to explore the national prevalence of high blood pressure among Thai adolescents and to determine the association between sleep duration and high blood pressure.

Methods

Data from adolescents aged 10–19 years from the Thai National Health and Examination Survey V were included. We collected demographic data (including age and gender), height, weight, waist circumference, blood pressure, fasting blood chemistries and sleep duration data. Sleep durations were categorized as short, normal or long for each age group based on the United States National Sleep Foundation’s recommendations. High blood pressure was diagnosed using the 2017 guidelines of the American Academy of Pediatrics. Factors associated with high blood pressure were analyzed using multivariate logistic regression.

Results

A total of 3505 adolescents (1785 female) were included. The prevalence of high blood pressure was 9.4% (95% CI 8.5–10.4%). The high blood pressure group had higher BMI z-score, LDL-C, triglyceride and lower HDL-C than the normotensive group. In the multivariate analysis, BMI z-score, LDL-C and HDL-C were independently associated with high blood pressure. However, there was no association between sleep duration and high blood pressure.

Conclusions

High blood pressure risk was increased in adolescents with high BMI z-score. Neither short nor long sleep duration was associated with an increased risk of high blood pressure.