bluuebunny/crossref_metadata_2025 huggingface dataset:
Digital Health Literacy in Patients With Heart Failure in Times of Pandemic
Authors: Rodríguez Parrado Indira Yuselfy , Achury Saldaña Diana Marcela
Published: March 2022

This study sought to determine the effect of a digital health literacy program regarding knowledge and skills in the use of digital resources related to self-care and health empowerment for patients with heart failure. A cross-sectional pilot study was conducted before and after the program in patients (n = 28) with heart failure at a tertiary care center. Both a knowledge test and the Health Empowerment Scale were used with a Cronbach's α of 0.89. The information was processed using the statistical software Restudio, which allowed us to make a descriptive and inferential analysis. Seventy-five percent of the participants were men with an average age of 68 years, 60.7% had elementary schooling, 71.4% had preserved ejection fraction, and 57.6% had a family member as a caregiver. A statistically significant change (P < .005) was found in the level of empowerment and the knowledge and skills in the use of digital resources applied in health. The results showed that the digital health literacy program is a cost-effective intervention that nursing professionals must integrate into continuity of care, not only in pandemic times but also in a permanent and standardized manner. An empowered patient with knowledge and skills in the use of digital resources is a patient with the ability to decide, satisfy needs, and solve problems, with critical thinking and control over their health.
Content and Usability Validation of an Intelligent Virtual Conversation Assistant Used for Virtual Triage During the COVID-19 Pandemic in Brazil
Authors: de Campos Filho Amadeu Sá , Vasconcelos Cursino José Ricardo , do Nascimento José William Araújo , de Souza Rafael Roque , da Silva Lima Roque Geicianfran , de Souza Cavalcanti Andréia Roque
Published: March 2022

This study aimed to describe the development process, content validation, and usability of a COVID-19 screening system incorporated into a chatbot-type intelligent virtual assistant (CoronaBot). This is a methodological research carried out in three phases. The first corresponded to the development of the flowchart and content of the virtual assistant, the second phase consisted of the implementation of the content in chatbot, and the third phase consisted of content validation. Data analysis was performed by agreement rate, content validity index, and kappa statistical test. Finally, in the third phase, the chatbot's usability was analyzed using the System Usability Scale, by 10 users. The CoronaBot content presented domains with agreement rate above 87.5%, and its items referring to symptomatological scores and interface screens had values of content validity index with a mean of 0.96, kappa test with values from 0.70 to 0.76, and interspecialist agreement of 1.00, demonstrating excellence of prototype content. The global usability score was 80.1. The script developed and incorporated into the chatbot prototype achieved a satisfactory level of content validity. The usability of the chatbot was considered good, adding to the credibility of the device.
Data Quality of Automated Comorbidity Lists in Patients With Mental Health and Substance Use Disorders
Authors: Woersching Joanna , Van Cleave Janet H. , Egleston Brian , Ma Chenjuan , Haber Judith , Chyun Deborah
Published: March 2022

EHRs provide an opportunity to conduct research on underrepresented oncology populations with mental health and substance use disorders. However, a lack of data quality may introduce unintended bias into EHR data. The objective of this article is describe our analysis of data quality within automated comorbidity lists commonly found in EHRs. Investigators conducted a retrospective chart review of 395 oncology patients from a safety-net integrated healthcare system. Statistical analysis included κ coefficients and a condition logistic regression. Subjects were racially and ethnically diverse and predominantly used Medicaid insurance. Weak κ coefficients (κ = 0.2–0.39, P < .01) were noted for drug and alcohol use disorders indicating deficiencies in comorbidity documentation within the automated comorbidity list. Further, conditional logistic regression analyses revealed deficiencies in comorbidity documentation in patients with drug use disorders (odds ratio, 11.03; 95% confidence interval, 2.71–44.9; P = .01) and psychoses (odds ratio, 0.04; confidence interval, 0.02–0.10; P < .01). Findings suggest deficiencies in automatic comorbidity lists as compared with a review of provider narrative notes when identifying comorbidities. As healthcare systems increasingly use EHR data in clinical studies and decision making, the quality of healthcare delivery and clinical research may be affected by discrepancies in the documentation of comorbidities.
Circulating tumor cells and cell-free tumor DNA analyses in urothelial cancer using the LiquidBiopsy platform
Authors: Kobayashi Minoru , Abe Hideyuki , Arai Kyoko , Murakami Satoshi , Kamai Takao
Published: March 2022

Background:

Emerging data suggested that liquid biopsy such as detection of circulating tumor cells (CTCs) and cell-free tumor DNA analysis augments the management of patients with urothelial cancer (UC). We presented our pilot experience of liquid biopsy using the Ion Torrent platform to detect CTCs and genomic alterations in UC.

Materials and methods:

Blood or urine samples from 16 patients were subjected to CTC and plasma/urine cell-free tumor DNA isolation for next generation sequencing (NGS) using the Ion S5 system to detect mutations among 50 oncogenes on the Ion AmpliSeq Cancer Hotspot Panel.

Results:

The Ion Torrent platform detected a higher number of CTCs than those in previous studies using the CellSearchTM system. Overall, mutations were detected in 13/16 (81.3%) patients with a median number of 18 (range 12–25). NGS isolated 17 hotspot mutations from 11 genes and 41 novel genomic alterations from 24 genes, some of which are supposed to be clinically actionable.

Conclusions:

The Ion Torrent platform efficiently detected CTCs compared with previous reports. NGS with the present system also allowed for detection of gene alterations which are likely to be therapeutic targets and provided an attractive tool to guide personalized therapy for patients with advanced UC.
Comparison of Vision-related Quality of Life Between Normal Tension Glaucoma and Primary Open-angle Glaucoma
Authors: Chun Yeoun Sook , Sung Kyung Rim , Park Chan Kee , Kim Hwang Ki , Yoo Chungkwon , Kim Yong Yeon , Park Ki Ho , Kim Chan Yun , Choi Kyu-Ryong , Lee Kyoo Won , Han Seungbong , Kim Chang-sik
Published: March 2022

Précis:

Although there was little difference in overall vision-related quality of life (VRQOL) between patients with normal tension glaucoma (NTG) and primary open-angle glaucoma (POAG) after controlling for confounding factors, POAG tended to have poorer VRQOL, especially in social functioning and dependency, than NTG.

Purpose:

The fundamental goal of treatment of patients with glaucoma is to preserve their VRQOL. The aim of this study was to compare VRQOL between patients with NTG and those with POAG.

Materials and Methods:

The self-reported National Eye Institute Visual Function Questionnaire (NEI VFQ-25) survey was performed, including clinical, demographic, and socioeconomic data from 506 Korean patients with NTG and 287 with POAG. The mean deviation of the integrated binocular visual field was calculated using the best location method. The NEI VFQ-25 results were evaluated by Rasch analysis to control item difficulty and variation in individual response ability. Propensity score matching was used to control for various confounding factors affecting VRQOL.

Results:

Although patients with POAG tended to have worse VRQOL than those with NTG, there was no statistically significant between-group difference in ocular pain, near and distance activities, mental health, role difficulties, ability to drive, and the overall composite score. However, the social functioning (P=0.016) and dependency (P=0.026) were significantly poorer in POAG patients.

Conclusions:

Overall VRQOL in patients with NTG and POAG was found to be similar. However, social functioning and dependency were significantly worse in those with POAG. These findings are relevant to supporting glaucoma patients.
Using Electroencephalogram Biosignal Changes for Delirium Detection in Intensive Care Units
Authors: Jin Taixian , Jin Huiying , Lee Sun-Mi
Published: March 2022

BACKGROUND: Biosignal data acquired during quantitative electroencephalography (QEEG) research may ultimately be used to develop algorithms for more accurate detection of delirium. This study investigates the biosignal changes during delirium states by using the QEEG data of patients in a medical intensive care unit. METHODS: This observational study was conducted between September 2018 and December 2019 at a tertiary hospital in South Korea. Delirium was measured using the Korean version of Confusion Assessment Method for the Intensive Care Unit in intensive care unit patients. Quantitative EEG measurements were recorded for 20 minutes in a natural state without external treatment or stimuli, and QEEG data measured in the centroparietal and parietal regions with eyes open were selected for analysis. Power spectrum analysis with a 5-minute epoch was conducted on the selected 65 cases. RESULTS: QEEG changes in the presence of delirium indicated that alpha, beta, gamma, and spectral edge frequency 50% waves showed significantly lower absolute power spectra than the corresponding findings in the absence of delirium. Brain-mapping results showed that these brain waves were inactivated in delirious states. CONCLUSION: QEEG assessments can potentially detect the changes in the centroparietal and parietal regions of delirium patients. QEEG changes, including lower power spectra of alpha, beta, and gamma waves, and spectral edge frequency 50%, can be successfully used to distinguish delirium from the absence of delirium.
Factors Associated With Hope and Quality of Life in Patients With Coronary Artery Disease
Authors: SOLEIMANI Mohammad Ali , ZARABADI-POUR Simin , HUAK CHAN Yiong , ALLEN Kelly-Ann , SHAMSIZADEH Morteza
Published: March 2022

Background

Psychological resources such as hope have been suggested to affect quality of life (QoL) positively in patients with heart disease. However, little information regarding the relationship between these two constructs is available.

Purpose

This work was aimed at examining the factors associated with hope and QoL in patients with coronary artery disease.

Methods

In this descriptive work, perceived QoL and hope were assessed in 500 patients with heart disease. The information was collected using the McGill QoL Questionnaire, demographic variables, and the Herth Hope Index. The Pearson correlation test and general linear model were used to examine correlations through SPSS Version 22.

Results

A considerable correlation was discovered between QoL and hope (r = .337, p < .001). Multivariate analyses with regression revealed that religious beliefs and social support both had significant and positive effects on the total perceived hope of patients and that patient age had a considerable negative impact on QoL (p < .05). None of these factors had a significant impact on hope (p < .05). In addition, the total QoL had a significant and positive effect on patient feelings and thoughts, whereas the physical problems component of QoL had a significant and negative effect on hope (p < .05). Participants with higher levels of education reported more hope.

Conclusions

QoL relates significantly to self-perceived hope in patients. Understanding QoL and hopefulness in patients with coronary artery disease has implications for nurses and other healthcare professionals.
Combined clinical and specific positron emission tomography/computed tomography-based radiomic features and machine-learning model in prediction of thymoma risk groups
Authors: Ozkan Elgin , Orhan Kaan , Soydal Cigdem , Kahya Yusuf , Seckin Tunc Servet , Celik Ozer , Dizbay Sak Serpil , Kayi Cangir Ayten
Published: March 2022

Objectives

In this single-center study, we aimed to propose a machine-learning model and assess its ability with clinical data to classify low- and high-risk thymoma on fluorine-18 (18F) fluorodeoxyglucose (FDG) (18F-FDG) PET/computed tomography (CT) images.

Methods

Twenty-seven patients (14 male, 13 female; mean age: 49.6 ± 10.2 years) who underwent PET/CT to evaluate the suspected anterior mediastinal mass and histopathologically diagnosed with thymoma were included. On 18F-FDG PET/CT images, the anterior mediastinal tumor was segmented. Standardized uptake value (SUV)max, SUVmean, SUVpeak, MTV and total lesion glycolysis of primary mediastinal lesions were calculated. For texture analysis first, second, and higher-order texture features were calculated. Clinical information includes gender, age, myasthenia gravis status; serum levels of lactate dehydrogenase (LDH), alkaline phosphatase, C-reactive protein, hemoglobin, white blood cell, lymphocyte and platelet counts were included in the analysis.

Results

Histopathologic examination was consistent with low risk and high-risk thymoma in 15 cases and 12 cases, respectively. The age and myasthenic syndrome were statistically significant in both groups (P = 0.039 and P = 0.05, respectively). The serum LDH level was also statistically significant in both groups (450.86 ± 487.07 vs. 204.82 ± 59.04; P < 0.001). The highest AUC has been achieved with MLP Classifier (ANN) machine learning method, with a range of 0.830 then the other learning classifiers. Three features were identified to differentiate low- and high-risk thymoma for the machine learning, namely; myasthenia gravis, LDH, SHAPE_Sphericity [only for 3D ROI (nz>1)].

Conclusions

This small dataset study has proposed a machine-learning model by MLP Classifier (ANN) analysis on 18F-FDG PET/CT images, which can predict low risk and high-risk thymoma. This study also demonstrated that the combination of clinical data and specific PET/CT-based radiomic features with image variables can predict thymoma risk groups. However, these results should be supported by studies with larger dataset.
Preventing Health Care–Associated Infections Through Implementation of an Interprofessional Visual Management Safety Tracker
Authors: Frist Avila Patricia , Twibell K. Renee , Demaree Heather
Published: March 2022

Background:

The management of health care associated infections (HAIs) challenges acute care facilities due to variability in practices. The purpose of this quality improvement project was to decrease central line–associated bloodstream infection, catheter-associated urinary tract infection, and Clostridioides difficile infection in a high acuity care environment using a visual management (VM) tool to address practice variations.

Local Problem:

An acute care unit experienced increasing HAIs.

Methods:

An interprofessional team used Lean methodology to implement a VM tool reflective of evidence-based HAI prevention practices that staff had frequently omitted.

Interventions:

A VM tool called the Safety Tracker was created.

Results:

In 12 months, HAIs decreased from 9 events to 1, with a corresponding reduction in indwelling urinary catheter utilization and central line utilization. More than $160 000 were avoided in health care costs.

Conclusions:

Creating an interprofessional VM Safety Tracker could significantly reduce HAIs.
Integration of the 5As Nicotine Cessation Framework in a Primary Care Clinic
Authors: Mangena Nomuhle , Dabney Beverly W. , Linton Mary
Published: March 2022

Background:

Nicotine causes significant morbidity and mortality. Many adults who want to quit using nicotine may not be receiving adequate support from their primary care providers. If used properly, the 5As nicotine cessation guidelines may help patients address their nicotine use.

Local Problem:

Smokers screened for tobacco use at a primary care clinic were not consistently offered evidence-based interventions using the 5As at each primary care encounter.

Methods:

The 5As framework was presented to providers via PowerPoint presentation and printed materials. Provider and patient behaviors were measured using data from pre- and postintervention chart reviews.

Results:

There was a statistically significant postintervention increase in the proportion of smokers who received the 5As components (P < .001). Patients' nicotine use decreased post-intervention.

Conclusion:

Results suggest that the intervention increased providers' knowledge and use of the 5As, which helped patients reduce their nicotine use.
Protection to Self and to One's Sexual Partner After Human Papillomavirus Vaccination: Preliminary Analysis From the Transmission Reduction And Prevention with HPV Vaccination Study
Authors: MacCosham Aaron , El-Zein Mariam , Burchell Ann N. , Tellier Pierre-Paul , Coutlée François , Franco Eduardo L. ,   for the TRAP-HPV study group
Published: March 2022

Background

It is unknown whether recently human papillomavirus (HPV)–vaccinated individuals confer protection against vaccine-preventable HPV types to their partners.

Methods

Participants 18 to 45 years old who were living in Montreal, Canada, and in a heterosexual relationship of 6 months or less were randomly assigned to receive the intervention HPV vaccine, Gardasil or Gardasil 9, or active control (AC), Avaxim, a hepatitis A vaccine. Couples attended a maximum of 6 clinic visits (baseline and at 2, 4, 6, 9, and 12 months) and provided genital samples for detection of 36 HPV genotypes. Participants were vaccinated at baseline and at 2 and 6 months. We used Cox proportional hazards regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between the administered vaccine and infections at the HPV episode level.

Results

We restricted analyses to 273 participants (intervention: n = 141, AC: n = 132) who had at least 2 visits with valid HPV data. The HR of becoming positive for a given vaccine-preventable HPV type in the intervention group among those who received at least 1 dose compared with AC was 0.47 (95% CI, 0.23–0.97). Comparing individuals with HPV-vaccinated versus AC-vaccinated partners, there was no difference in risk of becoming positive for a given vaccine-preventable HPV type among those whose partners received at least 1 (HR, 1.46; 95% CI, 0.73–2.94) or 2 (HR, 0.78; 95% CI, 0.31–1.96) doses.

Conclusions

Our study provides inconclusive evidence that individuals whose partner recently received an HPV vaccine are protected from vaccine-preventable types but demonstrates that vaccinated individuals are at a lower risk of incident infections.

Trial Registration Number: NCT01824537.
High Ubiquitin-Specific Protease 2a Expression Level Predicts Poor Prognosis in Upper Tract Urothelial Carcinoma
Authors: Ke Hung-Lung , Lee Yi-Chen , Li Wei-Ming , Wang Chien-Sheng , Hsu Wei-Chi , Lin Hui-Hui , Lee Yu-An , Jhan Jhen-Hao , Li Ching-Chia , Yeh Hsin-Chih , Wu Wen-Jeng , Huang A-Mei
Published: March 2022

Background:

Ubiquitin-mediated protein degradation has been reported to be involved in regulating the activity of oncoproteins and tumor suppressors. Dysfunction or dysregulation of the ubiquitin-proteasome system may induce tumorigenesis. Deubiquitinase ubiquitin-specific protease 2a (USP2a) has been reported to regulate cell growth or death and is involved in the pathogenesis of various diseases, including cancers. However, the role of USP2a in upper tract urothelial carcinoma (UTUC) has not been investigated yet. The goal of this study was to evaluate the clinical significance of USP2a expression in UTUC.

Materials and Methods:

A total of 110 UTUC cases were included in this study. USP2a expression level was evaluated through immunohistochemistry staining, and the correlation of USP2a expression level with both clinical and pathologic variables was analyzed.

Results:

High USP2a expression level was observed in 48 (43.6%) cancer specimens. USP2a expression level was significantly correlated with tumor stage (P=0.001), grade (P=0.033), and tumor recurrence (P=0.008). High USP2a expression level was correlated with poor disease-free survival (P=0.005) and cancer-specific survival (P<0.001). In addition, high USP2a expression level was an independent predictor of poor disease-free survival (hazard ratio=2.31; P=0.007) and cancer-specific survival (hazard ratio=5.49; P=0.009).

Conclusions:

This study indicated that USP2a protein expression level may be a potential biomarker for predicting UTUC patient survival. Further prospective studies are needed to investigate the role of USP2a in UTUC progression.
CD56 Expression in Papillary Thyroid Carcinoma Is Highly Dependent on the Histologic Subtype: A Potential Diagnostic Pitfall
Authors: Cho Uiju , Kim Yourha , Jeon Sora , Jung Chan Kwon
Published: March 2022

Loss of CD56 expression has been regarded as a diagnostic marker of papillary thyroid carcinoma (PTC). However, certain variants of PTC can aberrantly express CD56. Using a digital image analysis tool, we evaluated H-scores of CD56 immunostaining in 216 thyroid tumors. The H-score of the CD56 of all PTCs was lower than that of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) (P<0.001). The H-scores of CD56 were lower in classic PTC, the infiltrative follicular variant, and the diffuse sclerosing variant than in other PTC variants (P<0.001), whereas the H-scores were higher in tall cell variant, Warthin-like variant, and cribriform-morular variant than in classic PTC (P<0.001). The optimal cutoff value of H-scores for the CD56 expression was 180 for differentiating the NIFTP from the follicular adenoma and 30 for the differential diagnosis of NIFTP and infiltrative follicular variant PTC. CD56 expression is predominantly lost in classic and infiltrative follicular variants of PTCs and more preserved in the other histologic subtypes of PTC and NIFTP. CD56 is particularly useful for differentiating PTC from follicular-pattern thyroid neoplasms, but the aberrant expression in uncommon variants of PTC could be a diagnostic pitfall.
External Validation of the PediBIRN Screening Tool for Abusive Head Trauma in Pediatric Emergency Department Settings
Authors: Hymel Kent P. , Fingarson Amanda K. , Pierce Mary Clyde , Kaczor Kim , Makoroff Kathi L. , Wang Ming
Published: March 2022

Objective

The screening performance of the PediBIRN (Pediatric Brain Injury Research Network) abusive head trauma (AHT) 4-variable clinical decision rule (CDR) has been validated in the pediatric intensive care unit setting and in a broader setting of all hospitalized, acutely head-injured children. To further broaden the rule’s clinical applicability, we sought to validate its AHT screening performance in pediatric emergency department (ED) settings.

Methods

We conducted a retrospective, secondary analysis of an existing, deidentified, prospective data set captured to derive a bruising CDR. Subjects were patients under 3 years with bruising and confirmed acute head trauma. An expert medical panel had previously identified patients with AHT. Measures of the CDR’s AHT screening performance (sensitivity, specificity, likelihood ratios) were calculated with 95% confidence intervals (CIs).

Results

Expert medical panel members had classified 78 of 117 eligible patients (67%) as AHT, 38 (33%) as non-AHT, and 1 as indeterminate. Excluding the indeterminate case, the PediBIRN-4 demonstrated a sensitivity of 0.96 (95% CI, 0.88–0.99), specificity of 0.29 (95% CI, 0.16–0.46), positive likelihood ratio of 1.35 (95% CI, 1.10–1.67), and negative likelihood ratio of 0.13 (95% CI, 0.04–0.46). Close inspection of the data revealed that 1 of the CDR's predictor variables had lowered specificity without impacting sensitivity. Eliminating this variable would have increased specificity to 0.84 (95% CI, 0.68–0.93).

Conclusions

The PediBIRN 4-variable CDR demonstrated AHT screening sensitivity in the pediatric ED equivalent to pediatric intensive care unit and other inpatient settings, but lower specificity. Further study of a simplified 3-variable PediBIRN AHT screening tool for the ED setting is warranted.
Are Temporal Artery Biopsy Findings Related to PET/CT Findings in Giant Cell Arteritis?
Authors: Mestre-Torres Jaume , Martínez-Valle Fernando , Gabaldón Alejandra , Simó-Perdigó Marc , Salcedo-Allende M. Teresa , Navales-Mateu Ignacio , Solans-Laqué Roser
Published: March 2022

Background

Two clinical subsets of giant cell arteritis have been identified with different histological and CT findings. However, PET/CT findings have not been compared with temporal artery biopsy (TAB).

Objective

The aims of this study were to describe clinical and histological findings in patients with giant cell arteritis according to the presence or absence of aortitis in PET/CT at the disease diagnosis, and to identify independent factors related to aortic involvement.

Methods

Patients were included and followed prospectively. Clinical symptoms and TAB findings were recorded. PET/CT was performed in the first 10 days of steroid therapy. Aortitis was defined if a grade 3 uptake on visual analysis was present on arterial wall. Clinical and histological variables were compared according to the presence or absence of aortitis on PET/CT. Multivariate analysis was performed to identify independent factors related to the presence of aortitis.

Results

Twenty-seven patients (median age, 77.6 years) were included. PET/CT was performed with a median delay of 5.0 days. Aortitis was observed in 8 patients. Patients with aortitis were younger (69.9 vs 83.7 years, P = 0.04) and had less frequently ischemic manifestations (25.0% vs 84.2%, P = 0.006) than patients without aortitis. Giant multinucleated cells were more frequent on TAB from patients with aortitis (71.4% vs 16.7%), and its presence was an independent risk factor for the occurrence of aortic involvement on PET/CT (odds ratio, 12.2; P = 0.046).

Conclusions

Our study shows that giant cells on TAB are associated with the presence of aortitis on PET/CT. Patients with aortic involvement are younger and show less frequently ischemic manifestations.
PET/CT With 68Ga-PSMA and 18F-FDG in Metastatic Adenoid Cystic Carcinoma
Authors: Isgoren Serkan , Hekimsoy Turkay , Koroglu Erdem , Demir Hakan
Published: March 2022

Adenoid cystic carcinoma (ACC) is a rare and slow-growing tumor, originating from salivary glands. Locoregional recurrence and distant metastasis of ACC can be visualized not only with 18F-FDG but also with 68Ga-PSMA PET/CT due to its high prostate-specific membrane antigen (PSMA) expression. We report 2 cases of metastatic ACC who underwent first 18F-FDG and then 68Ga-PSMA for staging and restaging.
Is Delayed Image of 18F-FDG PET/CT Necessary for Mediastinal Lymph Node Staging in Non–Small Cell Lung Cancer Patients?
Authors: Lee Sang Woo , Kim Seong-Jang
Published: March 2022

Purpose

The purpose of this study was to evaluate the diagnostic accuracies of dual-time-point (DTP) 18F-FDG PET/CT for detection of mediastinal lymph node (LN) metastasis in non–small cell lung cancer (NSCLC) patients through a systematic review and meta-analysis.

Patients and Methods

The PubMed, Cochrane database, and EMBASE database, from the earliest available date of indexing through October 31, 2021, were searched for studies evaluating diagnostic performance of DTP 18F-FDG PET/CT for detection of metastatic mediastinal LN in NSCLC patients. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR−), and constructed summary receiver operating characteristic curves.

Results

Ten studies (758 patients) were included in the current study. In patient-based analysis, early image showed a sensitivity of 0.76 and a specificity of 0.75. Delayed image revealed a sensitivity of 0.84 and a specificity of 0.71. In LN-based analysis, early image showed a sensitivity of 0.80 and a specificity of 0.83. Delayed image revealed a sensitivity of 0.84 and a specificity of 0.87. Retention index or %ΔSUVmax is superior to early or delayed images of DTP 18F-FDG PET/CT for detection of mediastinal LN metastasis.

Conclusions

Dual-time-point 18F-FDG PET/CT showed a good diagnostic performances for detection of metastatic mediastinal LNs in NSCLC patients. Early and delayed images of DTP 18F-FDG PET/CT revealed similar diagnostic accuracies for LN metastasis. However, retention index or %ΔSUVmax is superior to early or delayed images of DTP 18F-FDG PET/CT for detection of mediastinal LN metastasis in NSCLC patients. Further large multicenter studies would be necessary to substantiate the diagnostic accuracy of DTP 18F-FDG PET/CT for mediastinal LN staging in NSCLC patients.
Macrophage Migration Inhibitory Factor Provides a Predictive Performance of Septic Acute Kidney Injury
Authors: Li Tianlong , Zhang Jiahao , Long Minghui , Jiang Xiaofang , Yang Cheng , Wang Fengqin , Su Lianjiu , Peng Zhiyong
Published: March 2022

Background:

Septic acute kidney injury (AKI) is a common condition in ICU with poor outcomes. Septic AKI patients have a progressively decreased urine output and increased serum creatinine. However, urine volume and serum creatinine showed poor sensitivity to early diagnosis of septic AKI. Searching for potential biomarkers to early detect AKI is crucial in day-to-day clinical practice. Macrophage migration inhibitory factor (MIF), primarily released by renal tubular epithelial cells, vascular endothelial cells, and immune cells, was found to be closely associated with the inflammatory response in sepsis. MIF may be used as a biomarker of septic AKI indicating aggravation of systemic inflammatory response.

Methods:

Our study included sepsis patients admitted to the ICU. The KDIGO guideline was used to confirm the diagnosis and staging of septic AKI. Blood samples were collected and tested, as well as clinical data were recorded. Independent risk factors were selected via logistic regression analysis. By drawing the receiver operating characteristic (ROC) curves, the area under the ROC curves (AUC) was computed. The relationship between serum MIF level and mortality of septic AKI was analyzed using Cox regression analysis.

Results:

With high serum MIF level at ICU admission, the patients were more likely to develop AKI. The AUC of serum MIF (MIFAUC = 0.797) was found to be a good predictor of septic AKI. In addition, higher serum MIF levels corresponded to more severe AKI as well as a higher mortality rate.

Conclusions:

Serum MIF might be a biomarker for predicting the occurrence, development, and outcomes of septic AKI. This conclusion will need to be confirmed by more robust investigations in the future.
Sodium-enriched floral nectar increases pollinator visitation rate and diversity
Authors: Finkelstein Carrie J. , CaraDonna Paul J. , Gruver Andrea , Welti Ellen A. R. , Kaspari Michael , Sanders Nathan J.
Published: March 2022

Plants have evolved a variety of approaches to attract pollinators, including enriching their nectar with essential nutrients. Because sodium is an essential nutrient for pollinators, and sodium concentration in nectar can vary both within and among species, we explored whether experimentally enriching floral nectar with sodium in five plant species would influence pollinator visitation and diversity. We found that the number of visits by pollinators increased on plants with sodium-enriched nectar, regardless of plant species, relative to plants receiving control nectar. Similarly, the number of species visiting plants with sodium-enriched nectar was twice that of controls. Our findings suggest that sodium in floral nectar may play an important but unappreciated role in the ecology and evolution of plant–pollinator mutualisms.
Evolution of reproductive strategies in incipient multicellularity
Authors: Gao Yuanxiao , Pichugin Yuriy , Gokhale Chaitanya S. , Traulsen Arne
Published: March 2022

Multicellular organisms potentially show a large degree of diversity in reproductive strategies, producing offspring with varying sizes and compositions compared to their unicellular ancestors. In reality, only a few of these reproductive strategies are prevalent. To understand why this could be the case, we develop a stage-structured population model to probe the evolutionary growth advantages of reproductive strategies in incipient multicellular organisms. The performance of reproductive strategies is evaluated by the growth rates of the corresponding populations. We identify the optimal reproductive strategy, leading to the largest growth rate for a population. Considering the effects of organism size and cellular interaction, we found that distinct reproductive strategies could perform uniquely or equally well under different conditions. If a single reproductive strategy is optimal, it is binary splitting, dividing into two parts. Our results show that organism size and cellular interaction can play crucial roles in shaping reproductive strategies in nascent multicellularity. Our model sheds light on understanding the mechanism driving the evolution of reproductive strategies in incipient multicellularity. Beyond multicellularity, our results imply that a crucial factor in the evolution of unicellular species’ reproductive strategies is organism size.
Virtual stick balancing: skill development in Newtonian and Aristotelian dynamics
Authors: Kovacs Balazs A. , Insperger Tamas
Published: March 2022

Human reaction delay significantly limits manual control of unstable systems. It is more difficult to balance a short stick on a fingertip than a long one, because a shorter stick falls faster and therefore requires faster reactions. In this study, a virtual stick balancing environment was developed where the reaction delay can be artificially modulated and the law of motion can be changed between second-order (Newtonian) and first-order (Aristotelian) dynamics. Twenty-four subjects were separated into two groups and asked to perform virtual stick balancing programmed according to either Newtonian or Aristotelian dynamics. The shortest stick length (critical length,
L

c

) was determined for different added delays in six sessions of balancing trials performed on different days. The observed relation between
L

c

and the overall reaction delay
τ
reflected the feature of the underlying mathematical models: (i) for the Newtonian dynamics
L

c

is proportional to
τ
2
; (ii) for the Aristotelian dynamics
L

c

is proportional to
τ
. Deviation of the measured
L

c

(
τ
) function from the theoretical one was larger for the Newtonian dynamics for all sessions, which suggests that, at least in virtually controlled tasks, it is more difficult to adopt second-order dynamics than first-order dynamics.
Head transcriptome profiling of glossiphoniid leech (
Helobdella austinensis
) reveals clues about proboscis development
Authors: Kwak Hee-Jin , Lee Sung-Gwon , Park Soon Cheol , Kim Jung-Hyeuk , Weisblat David A. , Park Chungoo , Cho Sung-Jin
Published: March 2022

Cephalization refers to the evolutionary trend towards the concentration of neural tissues, sensory organs, mouth and associated structures at the front end of bilaterian animals. Comprehensive studies on gene expression related to the anterior formation in invertebrate models are currently lacking. In this study, we performed
de novo
transcriptional profiling on a proboscis-bearing leech (
Helobdella austinensis
) to identify differentially expressed genes (DEGs) in the anterior versus other parts of the body, in particular to find clues as to the development of the proboscis. Between the head and the body, 132 head-specific DEGs were identified, of which we chose 11 to investigate their developmental function during embryogenesis. Analysis of the spatial expression of these genes using
in situ
hybridization showed that they were characteristically expressed in the anterior region of the developing embryo, including the proboscis. Our results provide information on the genes related to head formation and insights into the function of proboscis-related genes during organogenesis with the potential roles of genes not yet characterized.
Climate change and alpine-adapted insects: modelling environmental envelopes of a grasshopper radiation
Authors: Koot Emily M. , Morgan-Richards Mary , Trewick Steven A.
Published: March 2022

Mountains create steep environmental gradients that are sensitive barometers of climate change. We calibrated 10 statistical models to formulate ensemble ecological niche models for 12 predominantly alpine, flightless grasshopper species in
Aotearoa
New Zealand, using their current distributions and current conditions. Niche models were then projected for two future global climate scenarios: representative concentration pathway (RCP) 2.6 (1.0°C rise) and RCP8.5 (3.7°C rise). Results were species specific, with two-thirds of our models suggesting a reduction in potential range for nine species by 2070, but surprisingly, for six species, we predict an increase in potential suitable habitat under mild (+1.0°C) or severe global warming (+3.7°C). However, when the limited dispersal ability of these flightless grasshoppers is taken into account, all 12 species studied are predicted to suffer extreme reductions in range, with a quarter likely to go extinct due to a 96–100% reduction in suitable habitat. Habitat loss is associated with habitat fragmentation that is likely to escalate stochastic vulnerability of remaining populations. Here, we present the predicted outcomes for an endemic radiation of alpine taxa as an exemplar of the challenges that alpine species, both in New Zealand and internationally, are subject to by anthropogenic climate change.
The visual coupling between neighbours explains local interactions underlying human ‘flocking'
Authors: Dachner Gregory C. , Wirth Trenton D. , Richmond Emily , Warren William H.
Published: March 2022

Patterns of collective motion in bird flocks, fish schools and human crowds are believed to emerge from local interactions between individuals. Most ‘flocking' models attribute these local interactions to hypothetical rules or metaphorical forces and assume an omniscient third-person view of the positions and velocities of all individuals in space. We develop a
visual model
of collective motion in human crowds based on the visual coupling that governs pedestrian interactions from a first-person embedded viewpoint. Specifically, humans control their walking speed and direction by cancelling the average angular velocity and optical expansion/contraction of their neighbours, weighted by visibility (1 − occlusion). We test the model by simulating data from experiments with virtual crowds and real human ‘swarms'. The visual model outperforms our previous omniscient model and explains basic properties of interaction: ‘repulsion' forces reduce to cancelling optical expansion, ‘attraction' forces to cancelling optical contraction and ‘alignment' to cancelling the combination of expansion/contraction and angular velocity. Moreover, the neighbourhood of interaction follows from Euclid's Law of perspective and the geometry of occlusion. We conclude that the local interactions underlying human flocking are a natural consequence of the laws of optics. Similar perceptual principles may apply to collective motion in other species.
Cambrian edrioasteroid reveals new mechanism for secondary reduction of the skeleton in echinoderms
Authors: Zamora Samuel , Rahman Imran A. , Sumrall Colin D. , Gibson Adam P. , Thompson Jeffrey R.
Published: March 2022

Echinoderms are characterized by a distinctive high-magnesium calcite endoskeleton as adults, but elements of this have been drastically reduced in some groups. Herein, we describe a new pentaradial echinoderm,Yorkicystis haefnerin. gen. n. sp., which provides, to our knowledge, the oldest evidence of secondary non-mineralization of the echinoderm skeleton. This material was collected from the Cambrian Kinzers Formation in York (Pennsylvania, USA) and is dated asca510 Ma. Detailed morphological observations demonstrate that the ambulacra (i.e. axial region) are composed of flooring and cover plates, but the rest of the body (i.e. extraxial region) is preserved as a dark film and lacks any evidence of skeletal plating. Moreover, X-ray fluorescence analysis reveals that the axial region is elevated in iron. Based on our morphological and chemical data and on taphonomic comparisons with other fossils from the Kinzers Formation, we infer that the axial region was originally calcified, while the extraxial region was non-mineralized. Phylogenetic analyses recoverYorkicystisas an edrioasteroid, indicating that this partial absence of skeleton resulted from a secondary reduction. We hypothesize that skeletal reduction resulted from lack of expression of the skeletogenic gene regulatory network in the extraxial body wall during development. Secondary reduction of the skeleton inYorkicystismight have allowed for greater flexibility of the body wall.
A novel RORγt+ antigen presenting cell type instructs microbiota-dependent regulatory T cell differentiation and tolerance during early life
Authors: Akagbosu Blossom , Tayyebi Zakieh , Shibu Gayathri , Paucar Iza Yoselin A. , Deep Deeksha , Parisotto Yollanda Franco , Fisher Logan , Pasolli H. Amalia , Thevin Valentin , Elmentaite Rasa , Knott Maximilian , Hemmers Saskia , Jahn Lorenz , Friedrich Christin , Verter Jacob , Wang Zhong-Min , van den Brink Marcel , Gasteiger Georg , Grünewald Thomas G. P. , Marie Julien C. , Leslie Christina , Rudensky Alexander Y. , Brown Chrysothemis C.
Published: March 2022

Establishing and maintaining tolerance to self- or innocuous foreign antigens is vital for preservation of organismal health. Within the thymus, medullary thymic epithelial cells (mTECs) expressing AutoImmune Regulator, Aire, play a critical role in self-tolerance through deletion of autoreactive T cells and promotion of thymic regulatory T (Treg) cell development. Within weeks of birth, a separate wave of Treg cell differentiation occurs in the periphery, upon exposure to dietary and commensal microbiota derived antigens, yet the cell types responsible for the generation of peripheral Treg (pTreg) cells are not known. Here we identified a new class of RORγt+ antigen-presenting cells (APC), dubbed Thetis cells (TCs), with transcriptional features of both mTECs and dendritic cells (DCs), comprising 4 major sub-groups (TC I-IV). We uncovered a developmental wave of TCs within intestinal lymph nodes during a critical early life window, coincident with the wave of pTreg cell differentiation. While TC I and III expressed the signature mTEC nuclear factor Aire, TC IV lacked Aire expression and were enriched for molecules required for pTreg generation, including the TGF-β activating integrin αvβ8. Loss of either MHCII or Itgb8 expression by TCs led to a profound impairment in intestinal pTreg differentiation, with onset of intestinal inflammation. In contrast, MHCII expression by RORγt+ group 3 innate lymphoid cells (ILC3) and classical DCs was neither sufficient nor required for pTreg generation, further implicating TCs as the tolerogenic RORγt+ APC with an essential early life function. Our studies reveal parallel pathways for establishment of tolerance to self and foreign antigen within the thymus and periphery, marked by involvement of shared cellular and transcriptional programs.
Single-cell RNA Sequencing of Pediatric Ependymoma Unravels Subclonal Heterogeneity Associated with Patient Survival
Authors: Wu Haoda , Fu Ruiqing , Zhang Yu-Hong , Liu Zhiming , Chen Zhenhua , Xu Jingkai , Tian Yongji , Jin Wenfei , Wong Samuel Zheng Hao , Wu Qing-Feng
Published: March 2022

Ependymoma (EPN) is a malignant glial tumor occurring throughout central nervous system which commonly presents in children. Although recent studies have characterized EPN samples at both the bulk and single-cell level, intra-tumoral heterogeneity across subclones remains a confounding factor which impedes understanding of EPN biology. In this study, we generated a high-resolution single-cell dataset of pediatric ependymoma with a particular focus on the comparison of subclone differences within tumors, and show upregulation of cilium-associated genes in more highly differentiated subclone populations. As a proxy to traditional pseudotime analysis, we applied a novel trajectory scoring method to reveal cellular compositions associated with poor survival outcomes across primary and relapsed patients. Furthermore, we identified putative cell-cell communication features between relapsed and primary samples and show upregulation of pathways associated with immune cell crosstalk. Our results reveal both inter- and intratumoral gene expression profiles and tumor differentiation and provide a framework for studying transcriptomic signatures of individual subclones in ependymoma at single-cell resolution.
Tissue-specific landscape of protein aggregation and quality control in an aging vertebrate
Authors: Chen Yiwen R. , Harel Itamar , Singh Param Priya , Ziv Inbal , Moses Eitan , Goshtchevsky Uri , Machado Ben E. , Brunet Anne , Jarosz Daniel F.
Published: March 2022

Protein aggregation is a hallmark of age-related neurodegeneration. Yet, aggregation during normal aging and in tissues other than the brain is poorly understood. Here we leverage the African turquoise killifish to systematically profile protein aggregates in seven tissues of an aging vertebrate. Age-dependent aggregation is strikingly tissue-specific, and not simply driven by protein expression differences. Experimental interrogation, combined with machine learning, indicates that this specificity is linked to both protein-autonomous biophysical features and tissue-selective alterations in protein quality control. Co-aggregation of protein quality control machinery during aging may further reduce proteostasis capacity, exacerbating aggregate burden. A segmental progeria model with accelerated aging in specific tissues exhibits selectively increased aggregation in these same tissues. Intriguingly, many age-related protein aggregates arise in wild-type proteins that, when mutated, drive human diseases. Our data chart a comprehensive landscape of protein aggregation during aging and reveal strong, tissue-specific associations with dysfunction and disease.

HIGHLIGHTS

Tissue-specific protein aggregation is prevalent during vertebrate aging

Both protein biophysical properties and tissue-specific protein homeostasis patterns impact aggregation

A segmental progeria model with accelerated aging exhibits selectively increased protein aggregation in affected tissues

Many aggregates that accumulate during physiological aging are linked to disease