bluuebunny/crossref_metadata_2025 huggingface dataset:
The collagen structure of C1q induces wound healing by engaging discoidin domain receptor 2
Authors: Hayuningtyas Ria Aryani , Han Myeonggil , Choi Seoyeon , Kwak Man Sup , Park In Ho , Lee Ji-Hyun , Choi Ji Eun , Kim Dae Ki , Son Myoungsun , Shin Jeon-Soo
Published: October 2021

Background

C1q has been reported to reveal complement-independent roles in immune and non-immune cells. C1q binds to its specific receptors to regulate distinct functions that rely on the environment and cell types. Discoidin domain receptor 2 (DDR2) is activated by collagen and functions in wound healing by controlling matrix metalloproteinase (MMP) expression. Since C1q exhibits a collagen-like structure, we hypothesized that C1q might engage DDR2 to regulate wound healing and extracellular matrix (ECM) remodeling.

Methods

Cell-based assay, proximity ligation assay, ELISA, and surface plasmon analysis were utilized to investigate DDR2 and C1q binding. We also investigate the C1q-mediated in vitro wound healing ability using the human fibrosarcoma cell line, HT1080.

Results

C1q induced the phosphorylation of DDR2, p38 kinase, and ERK1/2. C1q and DDR2 binding improved cell migration and induced MMP2 and MMP9 expression. DDR2-specific shRNA reduced C1q-mediated cell migration for wound healing.

Conclusions

C1q is a new DDR2 ligand that promotes wound healing. These findings have therapeutic implications in wound healing-related diseases.
Evaluation of candidate reference genes for quantitative real-time PCR analysis in a male rat model of dietary iron deficiency
Authors: Fiddler Joanna L. , Clarke Stephen L.
Published: October 2021

Background

Quantitative real-time polymerase chain reaction (qPCR) is a reliable and efficient method for quantitation of gene expression. Due to the increased use of qPCR in examining nutrient-gene interactions, it is important to examine, develop, and utilize standardized approaches for data analyses and interpretation. A common method used to normalize expression data involves the use of reference genes (RG) to determine relative mRNA abundance. When calculating the relative abundance, the selection of RG can influence experimental results and has the potential to skew data interpretation. Although common RG may be used for normalization, often little consideration is given to the suitability of RG selection for an experimental condition or between various tissue or cell types. In the current study, we examined the stability of gene expression using BestKeeper, comparative delta quantitation cycle, NormFinder, and RefFinder in a variety of tissues obtained from iron-deficient and pair-fed iron-replete rats to determine the optimal selection among ten candidate RG.

Results

Our results suggest that several commonly used RG (e.g., Actb and Gapdh) exhibit less stability compared to other candidate RG (e.g., Rpl19 and Rps29) in both iron-deficient and iron-replete pair-fed conditions. For all evaluated RG, Tfrc expression significantly increased in iron-deficient animal livers compared to the iron-replete pair-fed controls; however, the relative induction varied nearly 4-fold between the most suitable (Rpl19) and least suitable (Gapdh) RG.

Conclusion

These results indicate the selection and use of RG should be empirically determined and RG selection may vary across experimental conditions and biological tissues.
A laminar augmented cascading flexible neural forest model for classification of cancer subtypes based on gene expression data
Authors: Zhong Lianxin , Meng Qingfang , Chen Yuehui , Du Lei , Wu Peng
Published: October 2021

Background

Correctly classifying the subtypes of cancer is of great significance for the in-depth study of cancer pathogenesis and the realization of personalized treatment for cancer patients. In recent years, classification of cancer subtypes using deep neural networks and gene expression data has gradually become a research hotspot. However, most classifiers may face overfitting and low classification accuracy when dealing with small sample size and high-dimensional biology data.

Results

In this paper, a laminar augmented cascading flexible neural forest (LACFNForest) model was proposed to complete the classification of cancer subtypes. This model is a cascading flexible neural forest using deep flexible neural forest (DFNForest) as the base classifier. A hierarchical broadening ensemble method was proposed, which ensures the robustness of classification results and avoids the waste of model structure and function as much as possible. We also introduced an output judgment mechanism to each layer of the forest to reduce the computational complexity of the model. The deep neural forest was extended to the densely connected deep neural forest to improve the prediction results. The experiments on RNA-seq gene expression data showed that LACFNForest has better performance in the classification of cancer subtypes compared to the conventional methods.

Conclusion

The LACFNForest model effectively improves the accuracy of cancer subtype classification with good robustness. It provides a new approach for the ensemble learning of classifiers in terms of structural design.
SicknessMiner: a deep-learning-driven text-mining tool to abridge disease-disease associations
Authors: Rosário-Ferreira Nícia , Guimarães Victor , Costa Vítor S. , Moreira Irina S.
Published: October 2021

Background

Blood cancers (BCs) are responsible for over 720 K yearly deaths worldwide. Their prevalence and mortality-rate uphold the relevance of research related to BCs. Despite the availability of different resources establishing Disease-Disease Associations (DDAs), the knowledge is scattered and not accessible in a straightforward way to the scientific community. Here, we propose SicknessMiner, a biomedical Text-Mining (TM) approach towards the centralization of DDAs. Our methodology encompasses Named Entity Recognition (NER) and Named Entity Normalization (NEN) steps, and the DDAs retrieved were compared to the DisGeNET resource for qualitative and quantitative comparison.

Results

We obtained the DDAs via co-mention using our SicknessMiner or gene- or variant-disease similarity on DisGeNET. SicknessMiner was able to retrieve around 92% of the DisGeNET results and nearly 15% of the SicknessMiner results were specific to our pipeline.

Conclusions

SicknessMiner is a valuable tool to extract disease-disease relationship from RAW input corpus.
On the robustness of generalization of drug–drug interaction models
Authors: Kpanou Rogia , Osseni Mazid Abiodoun , Tossou Prudencio , Laviolette Francois , Corbeil Jacques
Published: October 2021

Background

Deep learning methods are a proven commodity in many fields and endeavors. One of these endeavors is predicting the presence of adverse drug–drug interactions (DDIs). The models generated can predict, with reasonable accuracy, the phenotypes arising from the drug interactions using their molecular structures. Nevertheless, this task requires improvement to be truly useful. Given the complexity of the predictive task, an extensive benchmarking on structure-based models for DDIs prediction was performed to evaluate their drawbacks and advantages.

Results

We rigorously tested various structure-based models that predict drug interactions using different splitting strategies to simulate different real-world scenarios. In addition to the effects of different training and testing setups on the robustness and generalizability of the models, we then explore the contribution of traditional approaches such as multitask learning and data augmentation.

Conclusion

Structure-based models tend to generalize poorly to unseen drugs despite their ability to identify new DDIs among drugs seen during training accurately. Indeed, they efficiently propagate information between known drugs and could be valuable for discovering new DDIs in a database. However, these models will most probably fail when exposed to unknown drugs. While multitask learning does not help in our case to solve the problem, the use of data augmentation does at least mitigate it. Therefore, researchers must be cautious of the bias of the random evaluation scheme, especially if their goal is to discover new DDIs.
Neurogenomic divergence during speciation by reinforcement of mating behaviors in chorus frogs (Pseudacris)
Authors: Ospina Oscar E. , Lemmon Alan R. , Dye Mysia , Zdyrski Christopher , Holland Sean , Stribling Daniel , Kortyna Michelle L. , Lemmon Emily Moriarty
Published: October 2021

Background

Species interactions can promote mating behavior divergence, particularly when these interactions are costly due to maladaptive hybridization. Selection against hybridization can indirectly cause evolution of reproductive isolation within species, a process termed cascade reinforcement. This process can drive incipient speciation by generating divergent selection pressures among populations that interact with different species assemblages. Theoretical and empirical studies indicate that divergent selection on gene expression networks has the potential to increase reproductive isolation among populations. After identifying candidate synaptic transmission genes derived from neurophysiological studies in anurans, we test for divergence of gene expression in a system undergoing cascade reinforcement, the Upland Chorus Frog (Pseudacris feriarum).

Results

Our analyses identified seven candidate synaptic transmission genes that have diverged between ancestral and reinforced populations ofP. feriarum, including five that encode synaptic vesicle proteins. Our gene correlation network analyses revealed four genetic modules that have diverged between these populations, two possessing a significant concentration of neurotransmission enrichment terms: one for synaptic membrane components and the other for metabolism of the neurotransmitter nitric oxide. We also ascertained that a greater number of genes have diverged in expression by geography than by sex. Moreover, we found that more genes have diverged within females as compared to males between populations. Conversely, we observed no difference in the number of differentially-expressed genes within the ancestral compared to the reinforced population between the sexes.

Conclusions

This work is consistent with the idea that divergent selection on mating behaviors via cascade reinforcement contributed to evolution of gene expression inP. feriarum. Although our study design does not allow us to fully rule out the influence of environment and demography, the fact that more genes diverged in females than males points to a role for cascade reinforcement. Our discoveries of divergent candidate genes and gene networks related to neurotransmission support the idea that neural mechanisms of acoustic mating behaviors have diverged between populations, and agree with previous neurophysiological studies in frogs. Increasing support for this hypothesis, however, will require additional experiments under common garden conditions. Our work points to the importance of future replicated and tissue-specific studies to elucidate the relative contribution of gene expression divergence to the evolution of reproductive isolation during incipient speciation.
Two target genes based multiple cross displacement amplification combined with a lateral flow biosensor for the detection of Mycobacterium tuberculosis complex
Authors: Huang Junfei , Xiao Ziyu , Yang Xinggui , Chen Xu , Wang Xiaojuan , Chen Yijiang , Zheng Wenlin , Chen Wei , Chen Huijuan , Li Shijun
Published: October 2021

Background

Tuberculosis (TB) is a serious chronic infectious disease caused by Mycobacterium tuberculosis complex (MTBC). Hence, the development of a novel, simple, rapid and sensitive method to detect MTBC is of great significance for the prevention and treatment of TB.

Results

In this study, multiple cross displacement amplification (MCDA) combined with a nanoparticle-based lateral flow biosensor (LFB) was developed to simultaneously detect two target genes (IS6110 and mpb64) of MTBC (MCDA-LFB). One suite of specific MCDA primers designed for the IS6110 and mpb64 genes was validated using genomic DNA extracted from the reference strain H37Rv. The MCDA amplicons were analyzed using a real-time turbidimeter, colorimetric indicator (malachite green, MG) and LFBs. The optimal amplification temperature and time were confirmed, and the MCDA-LFB method established in the current report was evaluated by detecting various pathogens (i.e., reference strains, isolates and clinical sputum samples). The results showed that the two sets of MCDA primers targeting the IS6110 and mpb64 genes could effectively detect MTBC strains. The optimal reaction conditions for the MCDA assay were determined to be 67 °C for 35 min. The MCDA assay limit of detection (LoD) was 100 fg per reaction for pure genomic DNA. The specificity of the MCDA-LFB assay was 100%, and there were no cross-reactions for non-MTBC strains. For sputum samples and MTBC strain detection, the positive rate of MCDA-LFB for the detection of MTBC strains was consistent with seminested automatic real-time PCR (Xpert MTB/RIF) and higher than acid-fast staining (AFS) and culture assays when used for sputum samples. The MCDA-LFB assay was a rapid tool, and the whole procedure for MCDA-LFB, including DNA template preparation, MCDA reaction and amplification product analysis, was completed within 70 min.

Conclusion

The MCDA-LFB assay targeting the IS6110 and mpb64 genes is a simple, rapid, sensitive and reliable detection method, and it has potential significance for the prevention and treatment of TB.
Factors associated with hospital outcomes of patients with penetrating craniocerebral injuries in armed conflict areas of the Democratic Republic of the Congo: a retrospective series
Authors: Mudekereza Paterne Safari , Murhula Gauthier Bahizire , Kachungunu Charles , Mudekereza Amani , Cikomola Fabrice , Mubenga Leon-Emmanuel Mukengeshai , Balungwe Patrick Birindwa , Budema Paul Munguakonkwa , Molima Christian , Mugabo Erick Namegabe , Lekuya Hervé Monka
Published: October 2021

Introduction

Penetrating craniocerebral injuries (PCCI) are types of open head injuries caused by sharp objects or missiles, resulting in communication between the cranial cavity and the external environment. This condition is deemed to be more prevalent in armed conflict regions where both civilians and military are frequently assaulted on the head, but paradoxically their hospital outcomes are under-reported. We aimed to identify factors associated with poor hospital outcomes of patients with PCCI.

Methods

This was a retrospective series of patients admitted at the Regional Hospital of Bukavu, DRC, from 2010 to 2020. We retrieved medical records of patients with PCCI operated in the surgical departments. A multivariate logistic regression model was performed to find associations between patients’ admission clinico-radiological parameters and hospital outcomes. Poor outcome was defined as a Glasgow Outcomes Score below 4.

Results

The prevalence of PCCI was 9.1% (91/858 cases) among admitted TBI patients. More than one-third (36.2%) of patients were admitted with GCS < 13, and 40.6% of them were unstable hemodynamic. Hemiplegia was found in 23.1% on admission. Eight patients had an intracerebral hemorrhage. Among the 69 operated patients, complications, mainly infectious, occurred in half (50.7%) of patients. Poor hospital outcomes were observed in 30.4% and associated with an admission GCS < 13, hemodynamic instability, intracerebral hemorrhage, and hemiplegia (p < 0.05).

Conclusion

The hospital poor outcomes are observed when patients present with hemodynamic instability, an admission GCS < 13, intracerebral hemorrhage, and hemiplegia. There is a need for optimizing the initial care of patients with PCCI in armed conflict regions.
Sodium nitroprusside protects HFD induced gut dysfunction via activating AMPKα/SIRT1 signaling
Authors: Li Xiaomei , Li Chen , Li Yuanqi , Liu Cong , Liang Xue , Liu Ting , Liu Zhihua
Published: October 2021

Background

Activation of Adenosine 5′-monophosphate-activated protein kinase/Sirtuin1 (AMPK/SIRT1) exerts an effect in alleviating obesity and gut damage. Sodium nitroprusside (SNP), a nitric oxide (NO) donor, has been reported to activate AMPK. This study was to investigate the effect of SNP on HFD induced gut dysfunction and the mechanism.

Methods

SNP was applied on lipopolysaccharide (LPS) stimulated Caco-2 cell monolayers which mimicked intestinal epithelial barrier dysfunction and HFD-fed mice which were complicated by gut dysfunction. Then AMPKα/SIRT1 pathway and gut barrier indicators were investigated.

Results

SNP rescued the loss of tight junction proteins ZO-1 and occludin, the inhibition of AMPKα/SIRT1 in LPS stimulated Caco-2 cell monolayers, and the effects were not shown when AMPKa1 was knocked-down by siRNA. SNP also alleviated HFD induced obesity and gut dysfunction in mice, as indicated by the decreasing of intestinal permeability, the increasing expression of ZO-1 and occludin, the decreasing levels of pro-inflammatory cytokine IL-6, and the repairing of gut microbiota dysbiosis. These effects were complicated by the increased colonic NO content and the activated AMPKα/SIRT1 signaling.

Conclusions

The results may imply that SNP, as a NO donor, alleviates HFD induced gut dysfunction probably by activating the AMPKα/SIRT1 signaling pathway.
Genomic profiling of a patient with quadruple synchronous colorectal cancer: a case report
Authors: Jia Xiongjie , Peng Xinyu , Sun Junjie , Zhang Tao , Lin Hengxue , Bai Tianliang , Zhang Aimin
Published: October 2021

Background

Synchronous colorectal cancer (SCRC) is featured by the presence of multiple primary tumor lesions in a single patient at initial diagnosis. It is less common with the prevalence of approximately 3.5% among colorectal cancer (CRC). Some studies of SCRC have been performed in patients with two tumor lesions. However, SCRC cases with three or more tumor lesions were rare and remained to be investigated.

Case presentation

In this case report, we presented a 56-year-old male SCRC case with quadruple tumor lesions which is rarely seen in clinical practice. After laparoscopic radical resection of sigmoid carcinoma and partial rectum resection, the four tumor samples were subjected to pathological evaluation and next-generation sequencing (NGS) based genetic profiling. The four tumor lesions included two adenocarcinomas with moderate differentiation at sigmoid colon and rectum respectively, a grade 1 neuroendocrine tumor (NET) at rectum and a high-grade intraepithelial neoplasia at ascending colon. Each tumor exhibited distinct histology types and mutation profiles. After surgical resection, the patient remained disease-free after four cycles of chemotherapy with oxaliplatin and capecitabine (XELOX).

Conclusions

The tumor lesions in this case showed different pathological and genetic features which indicats the heterogeneity of SCRC. The genomic profilling might provide novel insights to understand SCRC at molecular level.
Outbreaks of mumps genotype G viruses in the Netherlands between October 2019 and March 2020: clusters associated with multiple introductions
Authors: Shah Anita A. , Bodewes Rogier , Reijnen Linda , Boelsums Timo , Weller Claudia M. , Fanoy Ewout B. , Veldhuijzen Irene K.
Published: October 2021

Background

From October 2019–March 2020, several clusters of mumps cases were identified in the Netherlands. Our objective was to describe cluster-associated mumps virus transmission using epidemiological and molecular information in order to help future mumps outbreak investigation and control efforts.

Methods

An epidemiological cluster includes ≥ 2 mumps cases with at least an epidemiological-link to a laboratory-confirmed mumps case. A molecular group includes ≥ 2 mumps cases with identical mumps virus sequences. Cases with symptom onset date between 1 October 2019 and 31 March 2020 reported through the National Notifiable Diseases Surveillance System were included. We described epidemiological and clinical characteristics of mumps cases. Sequence data was obtained from selected regions of mumps virus genomes (2270 nucleotides). Associations between epidemiological and molecular information were investigated.

Results

In total, 102 mumps cases were notified (90% laboratory-confirmed, 10% epidemiologically-linked). 71 out of 102 cases were identified as part of an epidemiological cluster and/or molecular group. Twenty-one (30%) of 71 cases were identified solely from epidemiological information, 25 (35%) solely from molecular surveillance, and 25 (35%) using both. Fourteen epidemiological clusters were identified containing a total of 46 (range: 2–12, median: 3) cases. Complete sequence data was obtained from 50 mumps genotype G viruses. Twelve molecular groups were identified containing 43 (range: 2–13) cases, dispersed geographically and timewise. Combined information grouped seven epidemiological clusters into two distinct molecular groups. The first lasting for 14 weeks, the other for 6. Additionally, one molecular group was detected, linked by geography and time but without an epidemiological-link.

Conclusions

Combined epidemiological and molecular information indicated ongoing mumps virus transmission from multiple introductions for extended time periods. Sequence analysis provided valuable insights into epidemiological clustering. If combined information is available in a timely manner, this would improve outbreak detection, generate further insight into mumps transmission, and guide necessary control measures.
Spatio-temporal analysis of bacillary dysentery in Sichuan province, China, 2011–2019
Authors: Zhang Yao , Zhang Mengyuan , Kang Dianju , Sun Wei , Yang Changhong , Wei Rongjie
Published: October 2021

Background

Bacillary dysentery (BD) is a common infectious disease in China and causes enormous economic burdens. The purpose of this study was to describe the epidemiological characteristics of BD and to identify its possible hot spots and potentially high-risk areas in Sichuan province of China.

Methods

In this study, we collected monthly BD incidence reports of 181 counties in Sichuan province, China, from January 2011 to December 2019. Descriptive statistics were used to evaluate the epidemic characteristics of BD. Moran’s I index was applied to investigate the yearly patterns of the spatial distribution. And spatio-temporal scanning statistics with the spatial unit set as county and the temporal unit set as month were used to investigate the possible high-risk region. Meanwhile, the circular moving windows were also employed in the spatio-temporal scanning to scan the study areas.

Results

The annual incidence of BD ranged between 16.13/100,000 and 6.17/100,000 person-years from 2011 to 2019 in Sichuan. The majority of the cases were children aged 5 years or younger. For the descriptive statistics, a peak from May to October was observed in temporal analysis, the epidemics were mainly concentrated in the northwest and southwest of Sichuan in spatial analysis. After 2016, the scope of BD significantly narrowed and severe epidemic areas were relatively stable. For the spatial autocorrelation analysis, a high global autocorrelation was observed at the county level, and the high–high clusters mainly distributed in the northwest and southwest of Sichuan. For the spatio-temporal scanning, the spatiotemporal clusters of BD occurred every year from 2011 to 2019. The most likely cluster areas mainly distributed in the southwest and northwest of Sichuan at the beginning, and then gradually concentrated in the southwest. The secondary cluster mainly concentrated in the northwest and its surrounding areas. Moreover, the 2nd secondary cluster was relatively small and mainly distributed in the central area. No clusters were noted in eastern Sichuan.

Conclusions

Based on our current analysis, BD is still a common challenge in Sichuan, especially for counties in the southwest and northwest in summer and autumn. More disease prevention and control measures should be taken in such higher-risk susceptible areas at a certain time to allocate the public health resources rationally, and finally reduce the spread of BD.
RSNA and BSTI grading systems of COVID-19 pneumonia: comparison of the diagnostic performance and interobserver agreement
Authors: Kavak Seyhmus , Duymus Recai
Published: October 2021

Background

This study aimed to compare the performance and interobservers agreement of cases with findings on chest CT based on the British Society of Thoracic Imaging (BSTI) guideline statement of COVID-19 and the Radiological Society of North America (RSNA) expert consensus statement.

Methods

In this study, 903 patients who had admitted to the emergency department with a pre-diagnosis of COVID-19 between 1 and 18 July 2020 and had chest CT. Two radiologists classified the chest CT findings according to the RSNA and BSTI consensus statements. The performance, sensitivity and specificity values of the two classification systems were calculated and the agreement between the observers was compared by using kappa analysis.

Results

Considering RT-PCR test result as a gold standard, the sensitivity, specificity and positive predictive values were significantly higher for the two observers according to the BSTI guidance statement and the RSNA expert consensus statement (83.3%, 89.7%, 89.0%; % 81.2,% 89.7,% 88.7, respectively). There was a good agreement in the PCR positive group (κ: 0.707; p < 0.001 for BSTI and κ: 0.716; p < 0.001 for RSNA), a good agreement in the PCR negative group (κ: 0.645; p < 0.001 for BSTI and κ: 0.743; p < 0.001 for RSNA) according to the BSTI and RSNA classification between the two radiologists.

Conclusion

As a result, RSNA and BSTI statement provided reasonable performance and interobservers agreement in reporting CT findings of COVID-19. However, the number of patients defined as false negative and indeterminate in both classification systems is at a level that cannot be neglected.
The reporting quality of natural language processing studies: systematic review of studies of radiology reports
Authors: Davidson Emma M. , Poon Michael T. C. , Casey Arlene , Grivas Andreas , Duma Daniel , Dong Hang , Suárez-Paniagua Víctor , Grover Claire , Tobin Richard , Whalley Heather , Wu Honghan , Alex Beatrice , Whiteley William
Published: October 2021

Background

Automated language analysis of radiology reports using natural language processing (NLP) can provide valuable information on patients’ health and disease. With its rapid development, NLP studies should have transparent methodology to allow comparison of approaches and reproducibility. This systematic review aims to summarise the characteristics and reporting quality of studies applying NLP to radiology reports.

Methods

We searched Google Scholar for studies published in English that applied NLP to radiology reports of any imaging modality between January 2015 and October 2019. At least two reviewers independently performed screening and completed data extraction. We specified 15 criteria relating to data source, datasets, ground truth, outcomes, and reproducibility for quality assessment. The primary NLP performance measures were precision, recall and F1 score.

Results

Of the 4,836 records retrieved, we included 164 studies that used NLP on radiology reports. The commonest clinical applications of NLP were disease information or classification (28%) and diagnostic surveillance (27.4%). Most studies used English radiology reports (86%). Reports from mixed imaging modalities were used in 28% of the studies. Oncology (24%) was the most frequent disease area. Most studies had dataset size > 200 (85.4%) but the proportion of studies that described their annotated, training, validation, and test set were 67.1%, 63.4%, 45.7%, and 67.7% respectively. About half of the studies reported precision (48.8%) and recall (53.7%). Few studies reported external validation performed (10.8%), data availability (8.5%) and code availability (9.1%). There was no pattern of performance associated with the overall reporting quality.

Conclusions

There is a range of potential clinical applications for NLP of radiology reports in health services and research. However, we found suboptimal reporting quality that precludes comparison, reproducibility, and replication. Our results support the need for development of reporting standards specific to clinical NLP studies.
An adaptive optimal viewing angle determination algorithm for TEVAR operation
Authors: Sun Weiya , Yang Guanyu , Chen Yang , Shu Huazhong
Published: October 2021

Background

The determination of the right x-ray angiography viewing angle is an important issue during the treatment of thoracic endovascular aortic repair (TEVAR). An inaccurate projection angle (manually determined today by the physicians according to their personal experience) may affect the placement of the stent and cause vascular occlusion or endoleak.

Methods

Based on the acquisition of a computed tomography angiography (CTA) image before TEVAR, an adaptive optimization algorithm is proposed to determine the optimal viewing angle of the angiogram automatically. This optimal view aims at avoiding any overlapping between the left common carotid artery and the left subclavian artery. Moreover, the proposed optimal procedure exploits the patient-specific morphology to adaptively reduce the potential foreshortening effect.

Results

Experimental results conducted on thirty-five patients demonstrate that the optimal angiographic viewing angle based on the proposed method has no significant difference when compared with the expert practice (p = 0.0678).

Conclusion

We propose a method that utilizes the CTA image acquired before TEVAR to automatically calculate the optimal C-arm angle. This method has the potential to assist surgeons during their interventional procedure by providing a shorter procedure time, less radiation exposure, and less contrast injection.
Longitudinal change in c-terminal fibroblast growth factor 23 and outcomes in patients with advanced chronic kidney disease
Authors: Alderson Helen V. , Chinnadurai Rajkumar , Ibrahim Sara T. , Asar Ozgur , Ritchie James P. , Middleton Rachel , Larsson Anders , Diggle Peter J. , Larsson Tobias E. , Kalra Philip A.
Published: October 2021

Background

Fibroblast growth factor23 (FGF23) is elevated in CKD and has been associated with outcomes such as death, cardiovascular (CV) events and progression to Renal Replacement therapy (RRT). The majority of studies have been unable to account for change in FGF23 over time and those which have demonstrate conflicting results. We performed a survival analysis looking at change in c-terminal FGF23 (cFGF23) over time to assess the relative contribution of cFGF23 to these outcomes.

Methods

We measured cFGF23 on plasma samples from 388 patients with CKD 3-5 who had serial measurements of cFGF23, with a mean of 4.2 samples per individual. We used linear regression analysis to assess the annual rate of change in cFGF23 and assessed the relationship between time-varying cFGF23 and the outcomes in a cox-regression analysis.

Results

Across our population, median baseline eGFR was 32.3mls/min/1.73m2, median baseline cFGF23 was 162 relative units/ml (RU/ml) (IQR 101-244 RU/mL). Over 70 months (IQR 53-97) median follow-up, 76 (19.6%) patients progressed to RRT, 86 (22.2%) died, and 52 (13.4%) suffered a major non-fatal CV event. On multivariate analysis, longitudinal change in cFGF23 was significantly associated with risk for death and progression to RRT but not non-fatal cardiovascular events.

Conclusion

In our study, increasing cFGF23 was significantly associated with risk for death and RRT.
Higher fasting C-peptide is associated with post-stroke depression: a multicenter prospective cohort study
Authors: Wang Yanyan , Sun Wenzhe , Miao Jinfeng , Qiu Xiuli , Lan Yan , Pan Chensheng , Li Guo , Zhao Xin , Zhu Zhou , Zhu Suiqiang
Published: October 2021

Background

Fasting C-peptide (FCP) has been shown to play an important role in the pathophysiology of mood disorders including depression and schizophrenia, but it is unknown whether it also predicts post-stroke depression (PSD). This study examined the association between FCP and PSD at 6 months after acute ischemic-stroke onset among Chinese subjects.

Methods

A total of 656 stroke patients were consecutively recruited from three hospitals of Wuhan city, Hubei province. Clinical and laboratory data were collected on admission. PSD status was evaluated by DSM-V criteria and 17-item Hamilton Rating Scale for Depression (HAMD-17) at 6 months after acute ischemic stroke. The χ2-test, Mann-Whitney U-test, and t-test were used to check for statistical significance. Multivariate logistic regression model was used to explore independent predictor of PSD.

Results

In the univariate analysis, significant differences were found between the PSD and non-PSD groups in terms of FCP level (p = 0.009). After multivariate adjustments, FCP remained a significant independent predictor of PSD, with an adjusted odds ratio of 1.179 (95%CI: 1.040–1.337, p = 0.010).

Conclusions

Higher FCP levels on admission were found to be associated with PSD at 6 months after acute ischemic-stroke onset. For stroke patients, doctors should pay attention to the baseline FCP for screening high-risk PSD in clinical practice.
The mediating/moderating role of cultural context factors on self-care practices among those living with diabetes in rural Appalachia
Authors: Smalls Brittany L. , Adegboyega Adebola , Combs Ellen , Rutledge Matthew , Westgate Philip M. , Azam Md. Tofial , De La Barra Felipe , Williams Lovoria B. , Schoenberg Nancy E.
Published: October 2021

Background

The aim of this study was to examine whether cultural factors, such as religiosity and social support, mediate/moderate the relationship between personal/psychosocial factors and T2DM self-care in a rural Appalachian community.

Methods

Regression models were utilized to assess for mediation and moderation. Multilevel linear mixed effects models and GEE-type logistic regression models were fit for continuous (social support, self-care) and binary (religiosity) outcomes, respectively.

Results

The results indicated that cultural context factors (religiosity and social support) can mediate/moderate the relationship between psychosocial factors and T2DM self-care. Specifically, after adjusting for demographic variables, the findings suggested that social support may moderate the effect of depressive symptoms and stress on self-care. Religiosity may moderate the effect of distress on self-care, and empowerment was a predictor of self-care but was not mediated/moderated by the assessed cultural context factors. When considering health status, religiosity was a moderately significant predictor of self-care and may mediate the relationship between perceived health status and T2DM self-care.

Conclusions

This study represents the first known research to examine cultural assets and diabetes self-care practices among a community-based sample of Appalachian adults. We echo calls to increase the evidence on social support and religiosity and other contextual factors among this highly affected population.

Trial registration

US National Library of Science identifier NCT03474731. Registered March 23, 2018, www.clinicaltrials.gov.
Governance structure affects transboundary disease management under alternative objectives
Authors: Blackwood Julie C. , Malakhov Mykhaylo M. , Duan Junyan , Pellett Jordan J. , Phadke Ishan S. , Lenhart Suzanne , Sims Charles , Shea Katriona
Published: October 2021

Background

The development of public health policy is inextricably linked with governance structure. In our increasingly globalized world, human migration and infectious diseases often span multiple administrative jurisdictions that might have different systems of government and divergent management objectives. However, few studies have considered how the allocation of regulatory authority among jurisdictions can affect disease management outcomes.

Methods

Here we evaluate the relative merits of decentralized and centralized management by developing and numerically analyzing a two-jurisdictionSIRSmodel that explicitly incorporates migration. In our model, managers choose between vaccination, isolation, medication, border closure, and a travel ban on infected individuals while aiming to minimize either the number of cases or the number of deaths.

Results

We consider a variety of scenarios and show how optimal strategies differ for decentralized and centralized management levels. We demonstrate that policies formed in the best interest of individual jurisdictions may not achieve global objectives, and identify situations where locally applied interventions can lead to an overall increase in the numbers of cases and deaths.

Conclusions

Our approach underscores the importance of tailoring disease management plans to existing regulatory structures as part of an evidence-based decision framework. Most importantly, we demonstrate that there needs to be a greater consideration of the degree to which governance structure impacts disease outcomes.
Early outcomes of the arthroscopic Latarjet procedure in a series of 37 patients with shoulder instability
Authors: Zeng Zheng , Liu Chuan , Liu Yang , Huang Yan
Published: October 2021

Background

Anterior shoulder dislocation remains a clinical challenge. This study aimed to assess the graft position and clinical outcomes of the arthroscopic Latarjet procedure and capsular repair for the treatment of recurrent anterior shoulder dislocation with significant glenoid bone loss in 37 patients.

Methods

Between 2017 and 2017, 37 patients underwent arthroscopic Latarjet plus capsular repair procedure for recurrent anterior shoulder dislocation combined with significant glenoid bone loss. In follow-up examinations, Walch-Duplay scores, subjective shoulder value (SSV) scores, Rowe scores, and active range of motion (AROM) were assessed. Three-dimensional computed tomography (CT) was used to evaluate coracoid graft position and bone resorption. A new method of evaluating the position of the coracoid bone block after Latarjet (H-Z method) was developed.

Results

Thirty-seven patients were included in this study. Follow-up ranged from 6 to 36 months postoperatively (with an average of 13 months). No recurrent dislocation occurred at the final follow-up, and there was no significant effect on the AROM (all p > 0.05). Rowe (from 42.2 ± 5.6 to 91.1 ± 3.3), Walch-Duplay (from 31.5 ± 8.0 to 92.6 ± 3.7), and SSV (from 63.9 ± 6.1 to 79.3% ± 5.0%) scores were improved significantly after surgery (all p < 0.001). CT showed that the 29 patients had varying degrees of bone resorption, and 23 recovered to the preinjury level of motional function within 6–12 months after surgery.

Conclusions

In active patients with recurrent anterior shoulder dislocations and significant glenoid bone loss, the arthroscopic Latarjet procedure plus capsular repair could restore shoulder stability satisfactory.
Evaluation of osteogenic potential of Cissus quadrangularis on mandibular alveolar ridge distraction
Authors: Altaweel Alaa Abdelqader , Baiomy Abdel Aziz Baiomy Abdullah , Shoshan Hazem Shawky , Abbas Hisham , Abdel-Hafiz Ahmed Abdel-Shakour , Gaber Abd El-Hamid , Zewail Amr Abdelfatah , Elshiekh Marwa A. M.
Published: October 2021

Background

This randomized clinical trial was designed to evaluate osteogenic potential of Cissus quadrangularis in alveolar distraction to facilitate implant installation.

Material and methods

Twenty patients with atrophic ridge were treated by alveolar distraction. After completing distractor activation, patients were randomly divided into two equal groups according to administered drug (placebo and Cissus quadrangularis group). After a consolidation period, distractors were removed and implants were inserted. Clinical evaluation was done to assess wound healing, and distractor and implant stability. Histological evaluation was performed at time of implant insertion. Radiographic evaluation was performed to assess bone volume and density after distraction, as well as, density and bone loss around implant.

Results

Radiographic and histological results showed that bone formation and maturation of study group were faster than that of control group. There was a significant increased bone density in distracted area and around implant in study group than control group. A significant bone loss at end of consolidation period, and around implant at end of the study was reported in control group than study group.

Conclusion

Cissus quadrangularis administration during the consolidation period is associated with increased osteogenic potential of distracted bone. The histological and radiographic findings of current study proved that Cissus quadrangularis not only enhances rate of new bone formation, but also bone density to withstand the biomechanical requirements of implant placement in a shorter time.

Trial registration

This study was retrospectively registered on www.ClinicalTrial.gov: NCT04669795-17\12\2020.
Neuroprotective potentials of selected natural edible oils using enzyme inhibitory, kinetic and simulation approaches
Authors: Mahnashi Mater H. , Alyami Bandar A. , Alqahtani Yahya S. , Alqarni Ali O. , Jan Muhammad Saeed , Ayaz Muhammad , Ullah Farhat , Shahid Muhammad , Rashid Umer , Sadiq Abdul
Published: October 2021

Background

Edible oils have proven health benefits in the prevention and treatment of various disorders since the establishment of human era. This study was aimed to appraise neuropharmacological studies on the commonly used edible oils including Cinnamomum verum (CV), Zingiber officinale (ZO) and Cuminum cyminum (CC).

Methods

The oils were analyzed via GC-MS for identifications of bioactive compounds. Anti-radicals capacity of the oils were evaluated via 2,2-diphenyl-1-picryl-hydrazyl-hydrate (DPPH) and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid (ABTS) radicals scavenging assays. The samples were also tested against two important acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) which are among the important drug targets in Alzheimer’s disease. Lineweaver-Burk plots were constructed for enzyme inhibition studies which correspond to velocity of enzymes (Vmax) against the reciprocal of substrate concentration (Km) in the presence of test samples and control drugs following Michaelis-Menten kinetics. Docking studies on AChE target were also carried out using Molecular Operating Environment (MOE 2016.0802) software.

Results

(Gas chromatography-mass spectrometry GC-MS) analysis revealed the presence of thirty-four compounds in Cinnamon oil (Cv.Eo), fourteen in ginger oil (Zo.Eo) and fifty-six in cumin oil (Cc.Eo). In the antioxidant assays, Cv.Eo, Zo.Eo and Cc.Eo exhibited IC50 values of 85, 121, 280 μg/ml sequentially against DPPH radicals. Whereas, in ABTS assay, Cv.Eo, Zo.Eo and Cc.Eo showed considerable anti-radicals potentials with IC50 values of 93, 77 and 271 μg/ml respectively. Furthermore, Cv.Eo was highly active against AChE enzyme with IC50 of 21 μg/ml. Zo.Eo and Cc.Eo exhibited considerable inhibitory activities against AChE with IC50 values of 88 and 198 μg/ml respectively. In BChE assay, Cv.Eo, Zo.Eo and Cc.Eo exhibited IC50 values of 106, 101 and 37 μg/ml respectively. Our results revealed that these oils possess considerable antioxidant and cholinesterase inhibitory potentials. As functional foods these oils can be effective remedy for the prevention and management of neurological disorders including AD. Synergistic effect of all the identified compounds was determined via binding energy values computed through docking simulations. Binding orientations showed that all the compounds interact with amino acid residues present in the peripheral anionic site (PAS) and catalytic anionic site (CAS) amino acid residues, oxyanion hole and acyl pocket via π-π stacking interactions and hydrogen bond interactions.
Conceptions of clinical learning among stakeholders involved in undergraduate nursing education: a phenomenographic study
Authors: Stoffels Malou , van der Burgt Stephanie M. E. , Stenfors Terese , Daelmans Hester E. M. , Peerdeman Saskia M. , Kusurkar Rashmi A.
Published: October 2021

Background

To prepare nursing students to become critical, autonomous members of the workforce, an agreement among stakeholders on how this can be achieved in the clinical setting is needed. However, a critical discussion of the clinical learning process in relation to actual and desirable outcomes is lacking in the nursing education literature. This study aimed to map conceptions of the desired process and outcomes of clinical learning among stakeholders involved in undergraduate clinical nursing education.

Methods

Twenty-five semi-structured interviews about their understanding of clinical learning were conducted with nursing students, supervisors, clinical educators and higher education institute professionals involved in clinical nursing education in a Dutch academic medical center. Data were analyzed using a phenomenographic approach.

Results

Four conceptions were identified: clinical learning as a process to 1) meet curricular demands, 2) learn to deliberately deliver patient care, 3) learn to deliver patient care within the larger (healthcare) context, and 4) become a continuously developing professional. Conceptions 3 and 4 represented a broader, more inclusive perspective on clinical learning than conception 1 and 2. Conceptions were distinguished by five dimensions: role of guidelines from the school; learning opportunities, focus of supervisor; focus of reflection; desirable outcomes of clinical learning.

Conclusions

Those directly involved in clinical learning in nursing may have qualitatively different understandings of its desired nature and outcomes. Two patterns across conceptions could be discerned: a) a shift in focus from learning as following standards, to following an individualized learning trajectory and b) a shift in focus from increasing patient load, to understanding oneself and the patient within the healthcare context. To prepare nursing students for the future workforce, a flexible, social form of self-regulated learning is warranted, as well as an understanding of one’s own role within the healthcare system and a critical attitude towards healthcare. Schools and hospitals should collaborate to integrate these values in the curriculum. The current study adds different ways of applying self-regulated learning as a relevant dimension in understanding clinical learning to the literature. Through the phenomenographic approach we identified conceptions that can be a basis for training and policy development.