bluuebunny/crossref_metadata_2025 huggingface dataset:
An assessment of the vaccination of school-aged children in England against SARS-CoV-2
Authors: Keeling Matt J. , Moore Sam E.
Published: May 2022

Background

Children and young persons are known to have a high number of close interactions, often within the school environment, which can facilitate rapid spread of infection; yet for SARS-CoV-2, it is the elderly and vulnerable that suffer the greatest health burden. Vaccination, initially targeting the elderly and vulnerable before later expanding to the entire adult population, has been transformative in the control of SARS-CoV-2 in England. However, early concerns over adverse events and the lower risk associated with infection in younger individuals means that the expansion of the vaccine programme to those under 18 years of age needs to be rigorously and quantitatively assessed.

Methods

Here, using a bespoke mathematical model matched to case and hospital data for England, we consider the potential impact of vaccinating 12–17 and 5–11-year-olds. This analysis is reported from an early model (generated in June 2021) that formed part of the evidence base for the decisions in England, and a later model (from November 2021) that benefits from a richer understanding of vaccine efficacy, greater knowledge of the Delta variant wave and uses data on the rate of vaccine administration. For both models, we consider the population wide impact of childhood vaccination as well as the specific impact on the age groups targeted for vaccination.

Results

Projections from June suggested that an expansion of the vaccine programme to those 12–17 years old could generate substantial reductions in infection, hospital admission and deaths in the entire population, depending on population behaviour following the relaxation of control measures. The benefits within the 12–17-year-old cohort were less marked, saving between 660 and 1100 (95% PI (prediction interval) 280–2300) hospital admissions and between 22 and 38 (95% PI 9–91) deaths depending on assumed population behaviour. For the more recent model, the benefits within this age group are reduced, saving on average 630 (95% PI 300–1300) hospital admissions and 11 (95% PI 5–28) deaths for 80% vaccine uptake, while the benefits to the wider population represent a reduction of 8–10% in hospital admissions and deaths. The vaccination of 5–11-year-olds is projected to have a far smaller impact, in part due to the later roll-out of vaccines to this age group.

Conclusions

Vaccination of 12–170-year-olds and 5–11-year-olds is projected to generate a reduction in infection, hospital admission and deaths for both the age groups involved and the population in general. For any decision involving childhood vaccination, these benefits needs to be balanced against potential adverse events from the vaccine, the operational constraints on delivery and the potential for diverting resources from other public health campaigns.
Identification of the sesquiterpene synthase AcTPS1 and high production of (–)-germacrene D in metabolically engineered Saccharomyces cerevisiae
Authors: Liu Jiajia , Chen Chang , Wan Xiukun , Yao Ge , Bao Shaoheng , Wang Fuli , Wang Kang , Song Tianyu , Han Penggang , Jiang Hui
Published: May 2022

Background

The sesquiterpene germacrene D is a highly promising product due to its wide variety of insecticidal activities and ability to serve as a precursor for many other sesquiterpenes. Biosynthesis of high value compounds through genome mining for synthases and metabolic engineering of microbial factories, especially Saccharomyces cerevisiae, has been proven to be an effective strategy. However, there have been no studies on the de novo synthesis of germacrene D from carbon sources in microbes. Hence, the construction of the S. cerevisiae cell factory to achieve high production of germacrene D is highly desirable.

Results

We identified five putative sesquiterpene synthases (AcTPS1 to AcTPS5) from Acremonium chrysogenum and the major product of AcTPS1 characterized by in vivo, in vitro reaction and NMR detection was revealed to be (–)-germacrene D. After systematically comparing twenty-one germacrene D synthases, AcTPS1 was found to generate the highest amount of (–)-germacrene D and was integrated into the terpene precursor-enhancing yeast strain, achieving 376.2 mg/L of (–)-germacrene D. Iterative engineering was performed to improve the production of (–)-germacrene D, including increasing the copy numbers of AcTPS1, tHMG1 and ERG20, and downregulating or knocking out other inhibitory factors (such as erg9, rox1, dpp1). Finally, the optimal strain LSc81 achieved 1.94 g/L (–)-germacrene D in shake-flask fermentation and 7.9 g/L (–)-germacrene D in a 5-L bioreactor, which is the highest reported (–)-germacrene D titer achieved to date.

Conclusion

We successfully achieved high production of (–)-germacrene D in S. cerevisiae through terpene synthase mining and metabolic engineering, providing an impressive example of microbial overproduction of high-value compounds.
Protective effect of homogeneous polysaccharides of Wuguchong (HPW) on intestinal mucositis induced by 5-fluorouracil in mice
Authors: Shi Peng , Zhao Tianqi , Wang Wendong , Peng Fangli , Wang Ting , Jia Yong , Zou Linxuan , Wang Peng , Yang Simengge , Fan Yue , Zong Junwei , Qu Xueling , Wang Shouyu
Published: May 2022

Background

In hospitalized patients, drug side effects usually trigger intestinal mucositis (IM), which in turn damages intestinal absorption and reduces the efficacy of treatment. It has been discovered that natural polysaccharides can relieve IM. In this study, we extracted and purified homogenous polysaccharides of Wuguchong (HPW), a traditional Chinese medicine, and explored the protective effect of HPW on 5-fluorouracil (5-FU)-induced IM.

Methods and results

First, we identified the physical and chemical properties of the extracted homogeneous polysaccharides. The molecular weight of HPW was 616 kDa, and it was composed of 14 monosaccharides. Then, a model of small IM induced by 5-FU (50 mg/kg) was established in mice to explore the effect and mechanism of HPW. The results showed that HPW effectively increased histological indicators such as villus height, crypt depth and goblet cell count. Moreover, HPW relieved intestinal barrier indicators such as D-Lac and diamine oxidase (DAO). Subsequently, western blotting was used to measure the expression of Claudin-1, Occludin, proliferating cell nuclear antigen, and inflammatory proteins such as NF-κB (P65), tumour necrosis factor-α (TNF-α), and COX-2. The results also indicated that HPW could reduce inflammation and protect the barrier at the molecular level. Finally, we investigated the influence of HPW on the levels of short-chain fatty acids, a metabolite of intestinal flora, in the faeces of mice.

Conclusions

HPW, which is a bioactive polysaccharide derived from insects, has protective effects on the intestinal mucosa, can relieve intestinal inflammation caused by drug side effects, and deserves further development and research.
The impact of blastomere loss on pregnancy and neonatal outcomes of vitrified-warmed Day3 embryos in single embryo transfer cycles
Authors: Jiang Shutian , Jin Wei , Zhao Xinxi , Xi Qianwen , Chen Li , Gao Yining , Li Wenzhi , Kuang Yanping
Published: May 2022

Background

Blastomere loss is a common phenomenon that occurs following cryopreservation. To date, studies have drawn conflicting conclusions regarding the impact of blastomere loss on pregnancy outcomes. Besides, limited information is available concerning the neonatal safety of embryos with blastomere loss. In the present study, we aimed to investigate the impact of blastomere loss on pregnancy and neonatal outcomes of vitrified/warmed Day3 cleavage-stage embryos in single embryo transfer cycles.

Methods

This retrospective cohort study included all vitrified/warmed D3 cleavage-stage single frozen-thawed embryo transfer (FET) cycles between April 2015 and February 2021. We compared pregnancy and subsequent neonatal outcomes between the intact embryos group and the blastomere loss group in single FET cycles.

Results

A total of 6287 single FET cycles were included in the study, in which 5873 cycles were classified into the intact embryo group and 414 cycles were classified into the blastomere loss group. The outcomes of the blastomere loss group were significantly inferior to those of the intact embryo group, in terms of implantation/biochemical pregnancy/clinical pregnancy/ongoing pregnancy rate and live birth rate per embryo transfer cycle/per clinical pregnancy. Further binary logistic regression confirmed that blastomere loss was negatively associated with live birth. Moreover, the blastomere loss group presented with an elevated early miscarriage rate. The neonatal conditions were broadly similar between the two groups. Additionally, multiple binary logistic regression analysis demonstrated that primary infertility and intracytoplasmic sperm injection (ICSI) were common influencing factors of blastomere loss (aOR 1.447, 95% CI 1.038–2.019, P = 0.029; aOR: 1.388, 95% CI: 1.044–51.846, P = 0.024).

Conclusions

The transfer of vitrified/warmed D3 embryos with blastomere loss is related to impaired embryo developmental potentials and reduced probabilities of conception. Moreover, even if the embryos with blastomere loss have implanted and reached clinical pregnancies, they present with a lower possibility of developing to live birth owing to a higher early miscarriage rate. However, once the embryos with blastomere loss result in a live birth, no adverse neonatal outcomes are observed.

Primary infertility and ICSI were found to be risk factors for blastomere loss.
White matter microstructural and morphometric alterations in autism: implications for intellectual capabilities
Authors: Yeh Chun-Hung , Tseng Rung-Yu , Ni Hsing-Chang , Cocchi Luca , Chang Jung-Chi , Hsu Mei-Yun , Tu En-Nien , Wu Yu-Yu , Chou Tai-Li , Gau Susan Shur-Fen , Lin Hsiang-Yuan
Published: May 2022

Background

Neuroimage literature of autism spectrum disorder (ASD) has a moderate-to-high risk of bias, partially because those combined with intellectual impairment (II) and/or minimally verbal (MV) status are generally ignored. We aimed to provide more comprehensive insights into white matter alterations of ASD, inclusive of individuals with II (ASD-II-Only) or MV expression (ASD-MV).

Methods

Sixty-five participants with ASD (ASD-Whole; 16.6 ± 5.9 years; comprising 34 intellectually able youth, ASD-IA, and 31 intellectually impaired youth, ASD-II, including 24 ASD-II-Only plus 7 ASD-MV) and 38 demographic-matched typically developing controls (TDC; 17.3 ± 5.6 years) were scanned in accelerated diffusion-weighted MRI. Fixel-based analysis was undertaken to investigate the categorical differences in fiber density (FD), fiber cross section (FC), and a combined index (FDC), and brain symptom/cognition associations.

Results

ASD-Whole had reduced FD in the anterior and posterior corpus callosum and left cerebellum Crus I, and smaller FDC in right cerebellum Crus II, compared to TDC. ASD-IA, relative to TDC, had no significant discrepancies, while ASD-II showed almost identical alterations to those from ASD-Whole vs. TDC. ASD-II-Only had greater FD/FDC in the isthmus splenium of callosum than ASD-MV. Autistic severity negatively correlated with FC in right Crus I. Nonverbal full-scale IQ positively correlated with FC/FDC in cerebellum VI. FD/FDC of the right dorsolateral prefrontal cortex showed a diagnosis-by-executive function interaction.

Limitations

We could not preclude the potential effects of age and sex from the ASD cohort, although statistical tests suggested that these factors were not influential. Our results could be confounded by variable psychiatric comorbidities and psychotropic medication uses in our ASD participants recruited from outpatient clinics, which is nevertheless closer to a real-world presentation of ASD. The outcomes related to ASD-MV were considered preliminaries due to the small sample size within this subgroup. Finally, our study design did not include intellectual impairment-only participants without ASD to disentangle the mixture of autistic and intellectual symptoms.

Conclusions

ASD-associated white matter alterations appear driven by individuals with II and potentially further by MV. Results suggest that changes in the corpus callosum and cerebellum are key for psychopathology and cognition associated with ASD. Our work highlights an essential to include understudied subpopulations on the spectrum in research.
Endobronchial ultrasound-guided transbronchial needle aspiration facilitating diagnosis of sarcoidosis in a breast cancer patient with multiple lymphadenopathy: a case report
Authors: Oride Yuka , Koi Yumiko , Sasada Tatsunari , Kajitani Keiko , Ohara Masahiro , Kondo Tomohiro , Daimaru Yutaka , Kawamura Shingo
Published: May 2022

Background

Sarcoidosis is a benign systemic granulomatous disorder of unknown etiology. Cell-mediated immunity disorder is often found in sarcoidosis patients, and an association between malignant tumors and sarcoidosis has been suggested. Sarcoidosis and malignant disease can occur simultaneously or sequentially, leading to misdiagnosis and mistreatment. Sarcoidosis is diagnosed clinically, radiologically, and histologically. We report herein a case of sarcoidosis diagnosed by endobronchial ultrasound-guided transbronchial needle aspiration from the mediastinal lymph nodes of a breast cancer patient.

Case presentation

The patient was a 70-year-old Asian woman who presented with right breast tumor. A 20-mm movable mass was identified in the inferolateral quadrant of the right breast, and mammography revealed a spiculated mass with calcification. Ultrasonography revealed a mass with internal hypoechogenicity, and biopsy revealed estrogen receptor-positive, human epidermal growth factor receptor 2-positive invasive ductal carcinoma. Positron emission tomography/computed tomography showed multiple lymphadenopathy including mediastinal lymph nodes, with fluorodeoxyglucose accumulation in those nodes suggesting breast cancer metastases. Endobronchial ultrasound-guided transbronchial needle aspiration of a mediastinal lymph node revealed noncaseous epithelioid granuloma. Due to a history of uveitis and elevated soluble interleukin 2 receptor, lymphadenopathy due to sarcoidosis and stage IIA breast cancer were diagnosed. Right partial mastectomy and axillary lymph node dissection were performed after preoperative chemotherapy. No exacerbation of sarcoidosis symptoms has been observed during treatment.

Conclusion

We report a case of breast cancer in which sarcoidosis could be diagnosed based on endobronchial ultrasound-guided transbronchial needle aspiration, a history of uveitis, and elevated soluble interleukin 2 receptor despite fluorodeoxyglucose positron emission tomography/computed tomography suggesting multiple lymph node metastases. This report emphasizes the importance of differential diagnosis of lymph node involvements in cancer patients.
A typology of smallholder livestock production systems reflecting the impact of the development of a local milk collection industry: Case study of Fatick region, Senegal
Authors: Habanabakize Ernest , Ba Koki , Corniaux Christian , Cortbaoui Patrick , Vasseur Elsa
Published: May 2022

Senegal is a country where millions of livelihoods directly depend on smallholder livestock production activities. Unfortunately, these farmers now face the effects of a changing climate and associated societal responses. In addition, the lack of understanding of the specific farmers’ problems in their respective production systems by assuming homogeneity has led to inappropriate planning of interventions and inefficient utilization of resources. The variations in individual farming systems and local contexts require to understand each system separately to inform decision-makers and relevant stakeholders about specific entries of intervention for farmers based on customized needs. Using a Fatick region case study, different statistical clustering techniques were adopted to develop a livestock typology that reflects the above realities. This typology confirmed the co-existence of three livestock production cluster systems with differences and similarities in their production targets and quantities, market access, animal breeds, and the livestock management system of the animals. The studied region represented a new format of smallholder livestock development, where the implementation of a dairy processor and its milk collection centre created a new dynamic in production activities. Farmers confirmed that the extension services and a consistent market opportunity provided by the dairy processor increased local productivity and offered an alternative source of income but they have also reiterated concerns like the dairy processor’s low milk buying prices which need to be addressed. To harness the growth and the regional opportunities, there is a need to establish robust and continuous collaboration structures between the Government, agro-industries, and producers. These public-private partnerships will help producers lower the cost of inputs and services and increase productivity while boosting local dairy production.
Dietary methionine deficiency stunts growth and increases fat deposition via suppression of fatty acids transportation and hepatic catabolism in Pekin ducks
Authors: Wu Yongbao , Tang Jing , Wen Zhiguo , Zhang Bo , Cao Junting , Zhao Lulu , Guo Zhanbao , Xie Ming , Zhou Zhengkui , Hou Shuisheng
Published: May 2022

Background

Although methionine (Met), the first-limiting dietary amino acid, has crucial roles in growth and regulation of lipid metabolism in ducks, mechanisms underlying are not well understood. Therefore, the objective was to use dietary Met deficiency to investigate the involvement of Met in lipid metabolism and fat accumulation of Pekin ducks.

Methods

A total of 150 male Pekin ducks (15-d-old, 558.5 ± 4.4 g) were allocated into 5 groups (6 replicates with 5 birds each) and fed corn and soybean meal-based diets containing 0.28%, 0.35%, 0.43%, 0.50%, and 0.58% Met, respectively, for 4 weeks. Met-deficient (Met-D, 0.28% Met) and Met-adequate (Met-A, 0.43% Met) groups were selected for subsequent molecular studies. Serum, liver, and abdominal fat samples were collected to assess the genes and proteins involved in lipid metabolism of Pekin ducks and hepatocytes were cultured in vivo for verification.

Results

Dietary Met deficiency caused growth depression and excess fat deposition that were ameliorated by feeding diets with adequate Met. Serum triglyceride and non-esterified fatty acid concentrations increased (P < 0.05), whereas serum concentrations of total cholesterol, low density lipoprotein cholesterol, total protein, and albumin decreased (P < 0.05) in Met-D ducks compared to those in Met-A ducks. Based on hepatic proteomics analyses, dietary Met deficiency suppressed expression of key proteins related to fatty acid transport, fatty acid oxidation, tricarboxylic acid cycle, glycolysis/gluconeogenesis, ketogenesis, and electron transport chain; selected key proteins had similar expression patterns verified by qRT-PCR and Western blotting, which indicated these processes were likely impaired. In vitro verification with hepatocyte models confirmed albumin expression was diminished by Met deficiency. Additionally, in abdominal fat, dietary Met deficiency increased adipocyte diameter and area (P < 0.05), and down-regulated (P < 0.05) of lipolytic genes and proteins, suggesting Met deficiency may suppress lipolysis in adipocyte.

Conclusion

Taken together, these data demonstrated that dietary Met deficiency in Pekin ducks resulted in stunted growth and excess fat deposition, which may be related to suppression of fatty acids transportation and hepatic catabolism.
Traffic and road conditions monitoring system using extracted information from Twitter
Authors: Putra Prabu Kresna , Mahendra Rahmad , Budi Indra
Published: May 2022

Congested roads and daily traffic jams cause traffic disturbances. A traffic monitoring system using closed-circuit television (CCTV) has been implemented, but the information gathered is still limited for public use. This research focuses on utilizing Twitter data to monitor traffic and road conditions. Traffic-related information is extracted from social media using text mining approach. The methods include Tweet classification for filtering relevant data, location information extraction, and geocoding in order to convert text-based location into coordinate information that can be deployed into Geographic Information System. We test several supervised classification algorithms in this study, i.e., Naïve Bayes, Random Forest, Logistic Regression, and Support Vector Machine. We experiment with Bag Of Words (BOW) and Term Frequency - Inverse Document Frequency (TF-IDF) as the feature representation. The location information is extracted using Named Entity Recognition (NER) and Part-Of-Speech (POS) Tagger. The geocoding is implemented using the ArcPy library. The best model for Tweet relevance classification is the Logistic Regression classifier with the feature combination of unigram and char n-gram, achieving an F1-score of 93%. The NER-based location extractor obtains an F1-score of 54% with a precision of 96%. The geocoding success rate for extracting the location information is 68%. In addition, a web-based visualization is also implemented in order to display traffic information using the spatial interface.
Health of Pug dogs in the UK: disorder predispositions and protections
Authors: O’Neill Dan G. , Sahota Jaya , Brodbelt Dave C. , Church David B. , Packer Rowena M.A. , Pegram Camilla
Published: May 2022

Background

Pugs are a brachycephalic dog breed that has become phenomenally popular over recent decades. However, there is growing concern about serious health and welfare issues in the breed. To augment the evidence-base on the comparative health of Pugs, this study aimed to compare the odds of common disorders between Pugs and all remaining dogs under primary veterinary care in the UK during 2016.

A cross-sectional study design of VetCompass clinical records was used to estimate the one-year (2016) period prevalence for the disorders most commonly diagnosed in Pugs and non-Pugs. Risk factor analysis applied multivariable logistic regression modelling methods to compare the odds of 40 common disorders between Pugs and non-Pugs.

Results

From a study population of 905,544 dogs, the analysis included random samples of 4308 Pugs and 21,835 non-Pugs. Pugs were younger (2.36 years, range 0.07–16.24 vs 4.44 years, range 0.01–20.46,p <  0.001) and lighter (8.95 kg, range 5.00–13.60 vs. 14.07 kg, range 1.41–85.00,p <  0.001) than non-Pugs. Pugs had 1.86 (95% confidence interval [CI] 1.72 to 2.01) times the adjusted odds of diagnosis with ≥1 disorder than non-Pugs. Pugs had significantly increased adjusted odds for 23/40 (57.5%) common disorders. These included: brachycephalic obstructive airway syndrome (odds ratio [OR] 53.92; 95% CI 36.22 to 80.28), stenotic nares (OR 51.25; 95% CI 24.93 to 105.37) and corneal ulceration (OR 13.01; 95% CI 10.50 to 16.11). Conversely, Pugs had significantly reduced adjusted odds of 7/40 (17.5%) common disorders compared to non-Pugs. These included: heart murmur (OR 0.23; 95% 0.13 to 0.14), lipoma (OR 0.24; 95% CI 0.11 to 0.55) and aggression (OR 0.31; 95% CI 0.21 to 0.47).

Conclusions

The current study highlights that predispositions outnumber protections between Pugs and non-Pugs for common disorders, suggesting some critical health welfare challenges to overcome for Pugs. Highly differing heath profiles between Pugs and other dogs in the UK suggest that the Pug has diverged substantially from mainstream dog breeds and can no longer be considered as a typical dog from a health perspective.
Stability analysis of multi-serial-link mechanism driven by antagonistic multiarticular artificial muscles
Authors: Ishikawa Yuta , Nabae Hiroyuki , Endo Gen , Suzumori Koichi
Published: May 2022

Artificial multiarticular musculoskeletal systems consisting of serially connected links driven by monoarticular and multiarticular muscles, which are often inspired by vertebrates, enable robots to elicit dynamic, elegant, and flexible movements. However, serial links driven by multiarticular muscles can cause unstable motion (e.g., buckling). The stability of musculoskeletal mechanisms driven by antagonistic multiarticular muscles depends on the muscle configuration, origin/insertion of muscles, spring constants of muscles, contracting force of muscles, and other factors. We analyze the stability of a multi-serial-link mechanism driven by antagonistic multiarticular muscles aiming to avoid buckling and other undesired motions. We theoretically derive the potential energy of the system and the stable condition at the target point, and validate the results through dynamic simulations and experiments. This paper presents the static stability criteria of serially linked robots, which are redundantly driven by monoarticular and multiarticular muscles, resulting in the design and control guidelines for those robots.
Acute necrotizing calculous cholecystitis after treatment with ceftriaxone in an elderly patient: a case report
Authors: Shigemori Tsunehiko , Imoto Ichiro , Inoue Yasuhiro , Nishiwaki Ryo , Sugimasa Natsuko , Hamaguchi Tetsuya , Noji Midori , Takeuchi Kenji , Ito Yoshiyuki , Yasuma Taro , Gabazza Esteban C. , Kato Toshio
Published: May 2022

Background

Ceftriaxone, a third-generation cephalosporin antibiotic with a long plasma half-life, is widely used to treat various infections. The use of ceftriaxone can sometimes induce biliary sludge or stone formation. Although most cases of ceftriaxone-induced pseudolithiasis are asymptomatic or mild and resolve with discontinuation of the drug, we experienced an elderly case of severe acute necrotizing calculous cholecystitis after administration of ceftriaxone.

Case presentation

A 72-year-old male patient was admitted to our hospital because of acute diverticulitis in ascending colon. Ceftriaxone was administered at a dose of 2 g/day for 6 days. Although he recovered after therapy, he was readmitted about 2 weeks later because of severe pain with rebound tenderness in the right upper quadrant. An abdominal imaging study revealed stones and sludge in the gallbladder that were not observed before starting ceftriaxone therapy. Therefore, antibiotic treatment with flomoxef 2 g/day was indicated. However, on the fifth day of readmission, the peritoneal irritation symptoms in the right upper quadrant worsened, and elevated inflammatory response and liver dysfunction were observed. Cholecystectomy was performed based on these findings. The resected inflamed gallbladder showed acute necrotizing cholecystitis with sand granular gallstones. A comparative analysis of the infrared spectroscopic pattern of the composition of gallstones collected during surgery with that of the ceftriaxone powder revealed that both have very similar infrared spectroscopic patterns.

Conclusions

Ceftriaxone-related pseudolithiasis is generally reversible and mainly observed in children. Here, we report a rare case of ceftriaxone-related acute necrotizing cholecystitis in an elderly patient. We confirmed that the stones in the gallbladder are composed of ceftriaxone. The older age, dehydration, fasting, and long-time bed rest during the administration of high-dose ceftriaxone were the potential risk factors for gallstone formation.
Study protocol: investigating the feasibility of a hybrid delivery of home-based cluster set resistance training for individuals previously treated for lung cancer
Authors: Fairman C. M. , Owens O. L. , Kendall K. L. , Steele J. , Latella C. , Jones M. T. , Marcotte L. , Peddle-McIntyre C. M. J. , McDonnell K. K.
Published: May 2022

Background

Symptom burden remains a critical concern for individuals with non-small cell lung cancer (NSCLC) following the completion of treatment. The most common symptom clusters, dyspnea (shortness of breath) and fatigue, can contribute to physical decline, reductions in quality of life, and a higher risk of comorbidities and mortality. Dyspnea is a primary limiter of exercise capacity in individuals with lung cancer, resulting in exercise avoidance and an accelerated physical decline. As such, designing resistance training with cluster sets to mitigate symptoms of dyspnea and fatigue may result in improved exercise tolerance. Thus, maintaining the exercise stimulus via cluster sets, combined with improved tolerance of the exercise, could result in the maintenance of physical function and quality of life. The purpose of this study is to investigate the feasibility and preliminary efficacy of a hybrid-delivery home-based cluster-set resistance training program in individuals with NSCLC.

Methods

Individuals with NSCLC (n = 15), within 12 months of completion of treatment, will be recruited to participate in this single-arm feasibility trial. Participants will complete 8 weeks of home-based resistance training designed to minimize dyspnea and fatigue. The hybrid delivery of the program will include supervised sessions in the participants’ home and virtual supervision via video conferencing. The primary outcome of feasibility will be quantified by recruitment rates, retention, acceptability, and intervention fidelity. Exploratory outcomes (dyspnea, fatigue, quality of life, physical function, and body composition) will be assessed pre- and post-intervention.

Discussion

This study will provide important data on the feasibility of delivering this intervention and inform procedures for a future randomized controlled trial.

Trial registration

Record not yet public
Atrial fibrillation in cancer patients who develop stroke
Authors: Khamis Alia , Shaban Ala Emad , Altamimi Tamer Salhab , Shkoukani Zakaria Walid , Hamam Ismail
Published: May 2022

Background

Acute ischemic stroke (Stroke) and transient ischemic attacks (TIA) are known complications in cancer patients and those with atrial fibrillation (AF). The role AF plays in Stroke/TIA in the setting of cancer is unclear. The purpose of this study was to assess the relationship between AF and Stroke/TIA in cancer patients.

Methods

We conducted a case-control study comparing all patients who developed Stroke/TIA from 2014 to 2019 following a cancer diagnosis at King Hussein Cancer Center (KHCC), matched to Stroke/TIA-free controls based on age, gender, and cancer site.

Results

Two hundred seventy-two patients were included (136 per group). The mean age was 63.95 ± 13.06 and 57% were females. The Stroke/TIA group had more AF at the time of event (14% vs. 4%, OR: 4.25, 95%-CI: 1.39 - 17.36) and had a larger proportion of death on study conclusion (OR: 9.4, 95%-CI: 3.74 - 23.64). On conditional logistic regression, patients in the Stroke/TIA group had higher odds of: AF (OR: 7.93, 95%-CI: 1.6 – 39.18), ischemic stroke before cancer diagnosis (OR: 9.18, 95%-CI: 2.66 – 31.74), being on active cancer treatment (OR: 3.11, 95%-CI: 1.46 – 6.62), dyslipidemia (OR: 3.78, 95%-CI: 1.32 – 10.82), and renal disease (OR: 4.25, 95%-CI: 1.55 – 11.63). On another conditional logistic regression model built to assess the role of the CHA2DS2-VASc score, a score of >=2 in males and >=3 in females significantly increased the risk of developing Stroke/TIA in cancer patients (OR: 2.45, 95%-CI: 1.08 - 5.58).

Conclusion

AF, previous ischemic stroke, active cancer treatment, dyslipidemia, and renal disease are independent risk factors for Stroke/TIA and a higher CHA2DS2-VASc score significantly increases the risk in cancer patients regardless of AF.
Association between intimate partner violence and nutritional status of married Nepalese women
Authors: Chaudhary Arun , Nakarmi Janet , Goodman Annekathryn
Published: May 2022

Background

Intimate partner violence (IPV) is physical, sexual, or psychological harm perpetrated by a spouse or an intimate partner. Its detrimental effects on women’s physical, mental, sexual, and reproductive health are well-documented. However, its impact on nutritional status is not well-studied, and previous studies have led to contradictory findings. This study aimed to explore the association between intimate partner violence and the nutritional status of married Nepalese women.

Methods

The study used the 2016 Nepal Demographic Health Survey data, which employed a modified version of the Conflict Tactics Scale to determine women’s exposure to IPV. Anemia and low body mass index (BMI) were used as proxies of nutritional status. Multinomial regression was used to analyze the relationship between BMI and IPV; multivariable logistic regression was used to analyze the association between anemia and IPV.

Results

The prevalence of underweight, overweight/obesity, and anemia were respectively 13.9%, 25.1%, and 38.7%. The prevalence of physical, sexual, and emotional IPVs experienced in the preceding year were respectively 9.8%, 4.6%, and 7.6%. Likewise, the prevalence of lifetime physical, sexual, emotional, and controlling behavior IPVs were respectively 21.8%, 7.4%, 12.3%, and 32.1%. The low intensity of emotional IPV (AOR 1.62; CI: 1.02–2.56) and moderate intensity of physical IPV (AOR 3.70; CI: 1.64–8.35) experienced in the preceding year, and low intensity of lifetime emotional IPV (AOR 1.69; CI: 1.11–2.58) were associated with an increased risk of overweight/obesity. Moderate intensity of sexual IPV (AOR 2.59; CI: 1.099–6.108) experienced in the preceding year was associated with an increased risk of underweight BMI. The low intensity of lifetime controlling behavior (AOR1.25; CI: 1.03–1.53) was associated with an increased risk of anemia.

Conclusions

Emotional and Physical IPVs are significantly associated with an increased risk of overweight/obesity. Sexual IPV is significantly associated with an increased risk of underweight BMI, and controlling behavior is significantly associated with an increased risk of anemia. Seeking help could offset the detrimental effects of IPV; therefore, IPV screening should be a part of regular healthcare assessment for married women, and appropriate rehabilitation should be offered to IPV survivors.
Hemifacial spasm caused by tortuous vertebrobasilar artery: a case report
Authors: Librata Pramitha Nayana , Sani Achmad Firdaus , Kurniawan Dedy , Hamdan Muhammad , Nugraha Priya
Published: May 2022

Background

Hemifacial spasm is a rare movement disorder. Prevalence estimates worldwide was 14.5 per 100,000 women and 7.4 per 100,000 men. Hemifacial spasm generally caused by compression of blood vessels at the root entry zone of the facial nerve in the brainstem, tortuous anteroinferior cerebellar artery (AICA) and posteroinferior cerebellar artery (PICA). Direct compression by vertebrobasilar dolichoectasia (VBD) with coincidence cavernoma is extremely rare.

Case report

A 50-year-old woman with right hemifacial spasm for 1 year, with a history of hypertension for 10 years, did not take medication regularly. MRI MRA was performed showing suspicious dolichoectasia in the vertebrobasilar artery and cavernoma in the left basal ganglia. Then digital subtraction angiography was performed, it was found that the tortuous vertebrobasilar junction artery with a curve to the right caused right hemifacial spasm.

Conclusion

Vascular imaging examination is important to do to find the cause of hemifacial spasm suspected to be due to vascular causes. The finding of two types of intracranial vascular malformations should be explored further. Therefore, the selection of therapy and management becomes more appropriate.
Evaluation of the risk of development of resistance to QoI fungicide ZJ0712 in Podosphaera xanthii under greenhouse conditions
Authors: Peng Qin , Fan Jieru , Wang Min , Liu Zeqi , Miao Jianqiang , Cai Meng , Huang Zhongqiao , Liu Xili
Published: May 2022

Greenhouse-grown cucumbers were monitored over two successive growing seasons to investigate the effects of successive application of ZJ0712, a new quinone outside inhibitor (QoI) fungicide, on the development of resistance in cucumber powdery mildew (Podosphaera xanthii). Resistant P. xanthii isolates were detected after nine successive applications of ZJ0712, although the control efficacy of this fungicide against cucumber powdery mildew at that time was still higher than 80%. Seven ZJ0712-resistant P. xanthii isolates with resistance factor values greater than 180 were obtained, which exhibited a stable resistance to ZJ0712. These resistant P. xanthii isolates had similar pathogenicity to the wild-type isolate on cucumber plants. The ZJ0712 showed significant cross-resistance with azoxystrobin, enostrobilurin, or chlorothalonil, but not with the azole fungicide triadimefon. Furthermore, the most commonly reported G143A mutation in Cyt b associated with QoI resistance was found in five of the seven resistant isolates. These findings suggest that there is a high risk of resistance development associated with using ZJ0712 for controlling cucumber powdery mildew under greenhouse conditions, and the underlying resistance mechanisms in different P. xanthii isolates are not consistent and need to be further unraveled.
CT severity score in COVID-19 patients, assessment of performance in triage and outcome prediction: a comparative study of different methods
Authors: Almasi Nokiani Alireza , Shahnazari Razieh , Abbasi Mohammad Amin , Divsalar Farshad , Bayazidi Marzieh , Sadatnaseri Azadeh
Published: May 2022

Background

Lung involvement in COVID-19 can be quantified by chest CT scan with some triage and prognostication value. Optimizing initial triage of patients could help decrease adverse health impacts of the disease through better clinical management. At least 6 CT severity score (CTSS) systems have been proposed. We aimed to evaluate triage and prognostication performance of seven different CTSSs, including one proposed by ourselves, in hospitalized COVID-19 patients diagnosed by positive polymerase chain reaction (PCR).

Results

After exclusion of 14 heart failure and significant preexisting pulmonary disease patients, 96 COVID-19, PCR-positive patients were included into our retrospective study, admitted from February 20, 2020, to July 22. Their mean age was 63.6 ± 17.4 years (range 21–88, median 67). Fifty-seven (59.4%) were men, and 39 (40.6%) were women. All CTSSs showed good interrater reliability as calculated intraclass correlation coefficients (ICCs) between two radiologists were 0.764–0.837. Those CTSSs with more numerous segmentations showed the best ICCs. As judged by area under curve (AUC) for each receiver operator characteristic (ROC) curve, only three CTSSs showed acceptable AUCs (AUC = 0.7) for triage of severe/critical patients. All CTSSs showed acceptable AUCs for prognostication (AUCs = 0.76–0.79). Calculated AUCs for different CTSSs were not significantly different for triage and for prediction of severe/critical disease, but some difference was shown for prediction of critical disease.

Conclusions

Men are probably affected more frequently than women by COVID-19. Quantification of lung disease in COVID-19 is a readily available and easy tool to be used in triage and prognostication, but we do not advocate its use in heart failure or chronic respiratory disease patients. The scoring systems with more numerous segmentations are recommended if any future imaging for comparison is contemplated. CTSS performance in triage was much lower than earlier reports, and only three CTSSs showed acceptable AUCs in this regard. CTSS performed better for prognostic purposes than for triage as all 7 CTSSs showed acceptable AUCs in both types of prognostic ROC curves. There is not much difference among performance of different CTSSs.
Promising role of topical caffeine mesoporous gel in collagen resynthesis and UV protection through proline assessment
Authors: Seleem Mae , Abulfadl Y. S. , Hoffy NadaEl , Lotfy Nancy M. , Ewida Heba A.
Published: May 2022

Background

Caffeine, an alkaloid agent, has been globally used regularly in drinks, for the reduction in skin cancers and wrinkle formation. As a result of the previous, attempts have been carried out to use caffeine in cosmetology due to its antioxidant and UV ray protection effects. Our aim was to evaluate the effect of caffeine on collagen resynthesis via its effect on proline and prolidase biosynthesis on mice, orally and topically as mesoporous silica at three levels, and the influence on UV protection. In skin biopsies of orally and topically treated mice, the following was assessed using ELISA and Western blot techniques, the activity of prolidase, together with the concentrations of proline, beta integrin, insulin growth factor, protein kinases beta, and mitogen-activated protein kinase. Moreover, we loaded the caffeine on mesoporous silica and assessed the aforementioned parameters together with checkpoint kinase 1 and Rad3-related protein.

Results

Caffeine promoted collagen resynthesis in a dose-dependent manner. The mechanism of this process was found at the level of prolidase activity as caffeine significantly increased the enzyme activity. Caffeine also had a protective effect against UV exhibited by the over-expression of beta integrin, insulin growth factor together with the under-expression of protein kinases beta, mitogen-activated protein kinase, checkpoint kinase 1, and Rad3-related protein.

Conclusions

Our study revealed the superiority of SYL-C12 (mesoporous silica-loaded caffeine gel), compromising the high level of the three independent factors, in terms of the measured responses in mesoporous silica with caffeine. Moreover, caffeine promoted collagen resynthesis with significant protective effect against UV apoptotic damage.
External auditory canal obstruction due to tuberous sclerosis complex angiofibromas: a case report
Authors: İşlek Akif , Şimşek Sadullah
Published: May 2022

Background

Tuberous sclerosis complex (TSC), an autosomal dominant genetic disorder and auricula and external auditory canal (EAC) involvement, is rare. Surgical excision is rarely recommended for cutaneous lesions.

Case presentation

A 31-year-old male patient was admitted with a complaint of left fullness, discharge, and conductive hearing loss. Symmetrical nodular cutaneous lesions on the malar region, tragus, and lateral portion of the EAC bilaterally were noted. The patient had diagnosed with TSC during adolescence clinically and genetically. Surgery was planned to obtain a favorable, self-cleaning EAC rather than total excision of angiofibromas. Angiofibromas on the EAC and tragus were excised. The defect was repaired by sliding a fasciocutaneous island flap inferiorly created in the preauricular area. No EAC stenosis or angiofibroma recurrence was observed during follow-up.

Discussion

Surgical excision for this clinical entity provides satisfactory management even if it was not routinely recommended for other skin lesions.
Relative Dose Intensity and Pathologic Response Rates in Patients With Breast Cancer and With and Without HIV Who Received Neoadjuvant Chemotherapy
Authors: Martei Yehoda M. , Narasimhamurthy Mohan , Setlhako Dipho I. , Ayane Gezahen , Ralefala Tlotlo , Chiyapo Sebathu , Gross Robert , Shulman Lawrence N. , Grover Surbhi , DeMichele Angela
Published: May 2022

PURPOSE

Patients who are HIV-positive and have breast cancer have worse overall survival (OS) compared with patients who are HIV-negative. Pathologic complete response (pCR) and relative dose intensity (RDI) of chemotherapy are associated with survival. We assessed whether pCR and RDI rates were lower for patients who are HIV-positive and received neoadjuvant chemotherapy (NACT).

METHODS

This was a prospective cohort analysis of patients initiating NACT in Botswana (February 2017 to September 2019). Primary outcomes were pCR and RDI; secondary outcomes were OS and toxicity. HIV status and zidovudine (ZDV) treatment were stratification factors. Multivariable analysis was used to control for confounding.

RESULTS

In total, 26 of 110 enrolled individuals were HIV-positive. In univariable analysis, HIV-positive (odds ratio [OR] = 0.2; P = .048) and RDI < 0.85 (OR = 0.30; P = .025) were associated with pCR. In multivariable analysis, the magnitude of association decreased for HIV-positive (OR = 0.28; P = .11), but RDI < 0.85 remained independently associated with pCR (OR = 0.32; P = .035). Patients who are HIV-positive had significantly lower mean RDI, and those on ZDV had significantly lower RDI. Ninety-one (83%) were stage III with 2-year OS significantly worse for patients who are HIV-positive (58% v 74%). Hazard ratio for all-cause mortality was 2.68 (95% CI, 1.17 to 6.13; P = .028) in patients who are HIV-positive compared with patients who are HIV-negative. Toxicity rates were similar despite patients who are HIV-positive receiving significantly lower dose intensity chemotherapy.

CONCLUSION

Patients who are HIV-positive and have breast cancer in Botswana have lower pCR rates and also receive lower dose intensity therapy, which may contribute to worse OS. Patients who are HIV-positive on ZDV-containing regimens received even lower dose intensity of NACT. Administering optimal dose intensity in patients who are HIV-positive remains a challenge, and targeted interventions that address modifiable risk factors are needed to improve therapy delivery and outcomes.
Clustered 8-Oxo-Guanine Mutations and Oncogenic Gene Fusions in Microsatellite-Unstable Colorectal Cancer
Authors: Madison Russell W. , Hu Xiaoju , Ramanan Vivek , Xu Zhuxuan , Huang Richard S.P. , Sokol Ethan S. , Frampton Garrett M. , Schrock Alexa B. , Ali Siraj M. , Ganesan Shridar , De Subhajyoti
Published: May 2022

PURPOSE

Colorectal carcinomas (CRCs) with microsatellite-instability (MSI) are enriched for oncogenic kinase fusions (KFs), including NTRK1, RET, and BRAF, but the mechanism underlying this finding is unclear.

METHODS

The genomic profiles of 32,218 advanced CRC tumor specimens were analyzed to assess the fusion breakpoints of oncogenic alterations including KFs in microsatellite-stable and microsatellite-unstable CRC. Genomic contexts of such alterations were analyzed to obtain mechanistic insights.

RESULTS

Genomic analysis demonstrated that oncogenic fusion breakpoints in MSI tumors do not preferentially involve repetitive or low-complexity sequences. Instead, their junction regions showed pronounced guanine and cytosine bias and elevated mutation frequency at G:C contexts. Elevated mutation frequency at G:C bases in relevant introns predicted prevalence of associated oncogenic fusions in MSI CRCs. CRCs harboring mismatch repair signatures had enrichment of butyrate-producing microbial species, reported to be associated with induction of 8-oxoguanine lesions in the intestine.

CONCLUSION

Detailed analysis of breakpoints in MSI-associated KFs support a model in which inefficient repair and/or processing of microbiome-induced clustered 8-oxoguanine damage in MSI CRC contributes to the increased incidence of specific oncogenic fusions.
Painting Bronze in Early China
Authors: Miller Allison R.
Published: May 2022

Scholars of Greek and Roman art have long recognized that many sculptures that today appear unpainted were originally covered in bright, polychrome paint. In contrast, the hallowed works of China's classical antiquity, the bronzes, are generally believed to have been monochrome works. In recent years, however, many varieties of bronzes have been unearthed with polychrome ornamentation including sacrificial vessels, figural sculptures, mirrors, lamps, weapons, and personal ornaments. This article summarizes and interprets the current evidence for painting on early Chinese bronze artifacts based on recent archaeological discoveries and on newer advances in technical analysis. In particular, I show that the practice of applying paint to bronzes goes far beyond embedding pigment into the intaglio channels of bronzes such as occurred during the Shang and Western Zhou eras. I also demonstrate that especially in the Warring States and early imperial periods, painted coloration on bronzes took off in diversely rich and compelling ways. This article highlights the various modes and techniques of painting bronze in early China, and offers several hypotheses as to why such polychrome ornamentation was desirable in early China, reconciling those motives with our quite different modern sensibilities.