bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact performance analysis of a novel rubber-composite combat helmet
Authors: Jităraşu Octavian , Lache Simona , Velea Marian Nicolae
Published: November 2022

Starting from the permanent need to ensure individual protection in case of impact with a projectile, this work presents a comparative analysis between the ballistic helmet used by the Romanian Armed Forces, made of steel and Kevlar, and a novel multilayer helmet proposed to be made of rubber and Kevlar fibers reinforced polyethylene. The impact behavior of the ballistic helmets is analyzed numerically, using the finite element method, from different perspectives, including the protective performance of the combat helmets and the kinetic energy of the projectile dissipated during the impact. The numerical model of the steel and Kevlar helmet is validated by ballistic tests, observing the projectile impact on the ballistic helmets. Results from the simulations and experiments show that the steel and Kevlar helmets are not able to resist a 7.62 mm bullet with a striking velocity of 690 m/s, while, according to the simulations, the novel multilayer helmet proposed is not penetrated by the projectile.
How to promote China's green economic development? The combination effects of consumption tax and carbon tax policies
Authors: Liu Weijiang , Liu Min , Li Yangyang , Liu Tingting
Published: November 2022

With massive greenhouse gas emissions causing global warming, emissions reduction and economic growth are essential objectives that must be balanced in sustainable development worldwide. The tax policy is an effective tool for environmental protection and economic regulation. Over the years, China has continuously adjusted tax policies, and the tax structure has tended to be optimized, but there is still no carbon tax. In this regard, based on the purpose of promoting the harmonious development of the environment and economy, this article builds a dynamic computable general equilibrium (CGE) model with five scenarios to assess the economic, energy, and environmental effects of the consumption tax, the carbon tax as well as their combination in China during 2022 to 2035. The results show that lowering the consumption tax on non-energy-intensive commodities boosts long-term economic growth but is not conducive to emissions reduction. Additionally, a separate carbon tax promotes a cleaner energy transition, reducing emissions while harming the economy. In contrast to the stand-alone policy treatment, the combination of lower consumption taxes on non-energy-intensive commodities with the medium carbon tax rate could have a “double dividend” effect, with long-term economic growth and consistently reduced pollution emissions. In the future, it will be essential to implement the appropriate policy combination to reduce fossil energy consumption and increase clean energy share. Thus, it would help to achieve China's 2030 peak carbon target and promote green economic development effectively.
Study of methylene blue dye elimination from water using polyaniline (PANI) and PANI/SiO2 composite
Authors: Bensedira Abderrahim , Haddaoui Nacerddine , Doufnoune Rachida , Meziane Ouahiba , Labidi Nouar Sofiane
Published: November 2022

Conducting polymeric composites have attracted great attention over the last years because of their potential uses in chemical, electronic and optical devices, and as catalysts as well as in adsorption processes. Chemical synthesis of polyaniline (PANI) and polyaniline-SiO2 composite and their adsorptive performance were reported in the present work. These materials were prepared and evaluated for their methylene blue (MB) dye adsorption characteristics from aqueous solution. Adsorption equilibrium kinetic and thermodynamic experiments of MB onto PANI and PANI/SiO2 were studied. The effects of initial dye concentration, contact time and temperature on the adsorption capacity of PANI/SiO2 for MB have been investigated. The pseudo-first order and pseudo-second order kinetic models were used to describe the kinetic data. It was found that adsorption kinetics followed the pseudo-second order at all of the studied temperatures. The Langmuir, Freundlich and Dubinin Raduschkevich adsorption models were used for the mathematical description and the HyperChem v8 software was exploited to propose a possible mechanism of the adsorption process.
Trajectories of Change in Career Decision Difficulties During a Manualized Individual Career Counseling Intervention: The Influence of Counselor Adherence, Working Alliance and Client Personality Traits
Authors: Milot-Lapointe Francis , Le Corff Yann
Published: November 2022

This study aimed to identify trajectories of change in client career decision difficulties during a manualized career counseling intervention and examine the role of counselor adherence, working alliance, and personality traits in predicting these trajectories. Participants were 257 individuals who received an average of 7.79 career counseling sessions at a university career services center. Using growth mixture modeling, four class-trajectories were identified. Clients in class 1 had a moderate level of decision difficulties at the beginning of counseling while clients in classes 2, 3 and 4 had moderate-salient initial levels of difficulties. Clients in classes 1 and 2 experienced a very large reduction of their decision difficulties during counseling and left the process with negligible levels of difficulties. Clients in class 3 saw a large reduction of their decision difficulties during counseling and left the process with moderate levels of difficulties. Clients in class 4 did not experience change and left the process with moderate-salient levels of difficulties. Counselor adherence to the intervention manual significantly contributed to discriminate between clients from class 4 and clients from classes 1, 2 and 3. Client level of neuroticism significantly contributed to distinguish clients belonging to class 4 from clients belonging to class 1.
A Modified Regimen of 21-day Nab-Paclitaxel Plus Gemcitabine in Locally Advanced or Metastatic Pancreatic Cancer: A Retrospective Real-World Study
Authors: Chang Chen , Meng Lingwei , Li Xiaofen , Cheng Ke , Yi Cheng , Peng Bing , Ma Ji , Cao Dan
Published: November 2022

Background

It is 1 of the standard treatment options for metastasis pancreatic cancer to receive nab-paclitaxel (125 mg/m2) plus gemcitabine (1000 mg/m2) on days 1, 8 and 15 every 28 days. Some patients showed intolerance and inconvenience to this therapeutic regimen. Thus, we conducted this retrospective real-world study to determine the efficacy and tolerability of a modified 21-day nab-paclitaxel plus gemcitabine (nab-P/Gem) regimen for the first-line treatment of locally advanced or metastatic pancreatic cancer.

Methods

Patients with locally advanced and metastatic pancreatic cancer treated with nab-paclitaxel (125 mg/m2) plus gemcitabine (1000 mg/m2) on days 1 and 8 every 21-day at West China Hospital and Shang Jin Hospital of Sichuan University from Mar 2018 to Dec 2021 were reviewed retrospectively. Clinical characteristics of patients were collected. The progression-free survival, overall survival, objective response rate, disease control rate, and toxicity were evaluated.

Results

A total of 113 patients who received the modified regimen of 21-day nab-P/Gem chemotherapy were included. The median overall survival was 9.3 months and the median progression-free survival was 4.4 months. The objective response rate and disease control rate were 18.6% and 56.7%, respectively. The median relative dose intensity for this modified regimen was 65%. The adverse events were mild to moderate, and the most common grade 3 or 4 treatment-related adverse events were neutropenia (21%) and leukopenia (16%).

Conclusions

Our study showed that this modified regimen of 21-day nab-P/Gem for locally advanced and metastatic pancreatic cancer had comparable efficacy and tolerable toxicity. This treatment may provide a considerable option for pancreatic cancer patients who desire a modified schedule. The modified regimen of 21-day nab-P/Gem is also an option worth considering during the coronavirus disease 2019 pandemic for minimizing the number of visits and limiting the risk of exposure.
A three-dimensional B-spline wavelet finite element method for structural vibration analysis
Authors: Sun Ze-xi , Jin Guo-yong , Ye Tian-gui , Song Kai-yao , Chen Yu-kun
Published: November 2022

In this study, a three-dimensional (3-D) B-spline wavelet finite element method (WFEM) is proposed by combining the wavelet theory and 3-D finite element method (FEM). Owing to the semi-orthogonality and multi-resolution analysis of spline wavelet over the solution domain, a cuboid with uniform distribution nodes is established for the 3-D B-spline wavelet on the interval (BSWI) element. The governing equations of vibration for the elastic structures are derived by introducing the 3-D B-spline wavelet theory into the displacement components of each node. A procedure for assembling the BSWI elements is presented by redefining the index element node functions. Numerical studies including the vibration analysis of solid and hollow beams and plates under different boundary conditions are performed to show the performance of the present method. A comprehensive comparison of the predicted vibration characteristics obtained by the present method, traditional FEM, and reference data is presented to verify the accuracy and efficiency of the 3-D B-spline WFEM. The core of the present method is involving the 3-D B-spline wavelet to replace the polynomial interpolation functions in the traditional FEM, which enhances computational accuracy during the vibration analysis of the elastic structures.
LGBTQ+ Youth-Generated Intervention Concepts for Reducing Teen Dating Violence Inequities
Authors: Coulter Robert W. S. , Gartner Rachel E.
Published: November 2022

Lesbian, gay, bisexual, transgender, queer, nonbinary, and other sexual and gender minority (LGBTQ+) youth are at substantially greater risk than cisgender heterosexual youth for experiencing teen dating violence (TDV) victimization, including emotional, physical, and sexual abuse within dating/romantic relationships. Despite these inequities, there are no evidence-based interventions designed specifically to address TDV among LGBTQ+ youth. To redress this dearth of interventions, we utilized a youth-centric approach, wherein 46 LGBTQ+ youth co-developed intervention concepts for reducing TDV. Participants engaged in a process of generating, prioritizing, and refining intervention concepts for reducing TDV inequities using human-centered design activities. LGBTQ+ youth generated eight intervention concepts, including the name, description, audience, problem focus, goals, and process for each. Their interventions focused on strategies for enhancing education, support systems, and advocacy. The intervention concepts had a wide variety of intended audiences, including LGBTQ+ and non-LGBTQ+ youth, teachers, school administrators, and policymakers. Overall, LGBTQ+ youth sought to improve education and skills pertaining to violence, sexual health, and healthy relationships; enhance support systems and resources for students’ basic, mental health, and safety needs; and build advocacy channels related to “outing” and LGBTQ+ students’ needs. These LGBTQ+ youth-generated programmatic and policy intervention concepts, in addition to our human-centered design approach, can be directly leveraged by health promotion practitioners and prevention experts into future intervention development, implementation, and evaluation efforts to improve LGBTQ+ youth health, well-being, resilience, and advocacy.
About the “Away Goals Rule” in Association Football. Does Scrapping the Rule Increase the Fairness of the Game?
Authors: Bahamonde-Birke Francisco J. , Bahamonde-Birke Ramón Andrés
Published: November 2022

The present study analyzes all major international football tournaments organized by UEFA and CONMEBOL during a period of 30 years to assess the impact of the away goals rule (AGR). The study takes advantage of natural experiment given by the differentiated application of the AGR by both confederations, in order to assess the efficacy and the consequences of the rule in terms of both the total amount of goals being scored (the original intention of the rule) and the teams that progressed onto the next stages. The results show that the AGR seems to have failed to fulfill its original goal of increasing both scoring by teams playing away and scoring in general. The AGR is found to have a significant impact favoring the chances of the team starting the series at home. However, it still does not translate into a higher probability of progressing onto the next stage than the team closing the series at home. Closing the series at home has an intrinsic advantage, which is only countered, although not completely, by the impact of the AGR. Regarding tiebreakers, we observe that closing the series at home has a positive impact no matter whether overtimes with AGR or penalty shootouts are used as tiebreakers. However, playing an overtime, when no AGR is set in place has a determining influence favoring the team closing the series at home.
High antibacterial and antioxidant cotton fabric based on AgNPs@HTCS and hyaluronic acid via lay by lay self-assembly
Authors: Luo Yapei , Liu Zihan , Wang Lili , Zhao Xiaomin , Li Hao , Wu Minghua
Published: November 2022

The fabrics of health care function have drawn increasing attention. Herein, AgNO3 was in-situ reduced into nano silver (AgNPs) by aloe extract (AVE) as reducing agent to gain AgNPs@hinokitiol-grafted chitosan (AgNPs@HTCS). The antibacterial and antioxidant cotton fabric were fabricated by LBL method using AgNPs@HTCS as positive layer and hyaluronic acid as negative layer. The results showed that the optimum preparation conditions of AgNPs@HTCS were as follows: AgNO3 10 mmol/L, HTCS 40 v/v %, AVE 15 mL, 80 °C, 6 h. MIC values of AgNPs@HTCS against S. aureus and E. coli attained 1.7 μg/mL and 5.3 μg/mL, respectively. The antibacterial ratio of cotton fabric reached the maximum 99.9 % at very low concentration of AgNPs@HTCS 0.25 g/L. After 3 LBL layers, the antibacterial properties of functional cotton fabric could withstand the acid or alkali washing. After 25 washing cycles, the antibacterial rate of LBL fabric still maintained above 96 %. Compared with the untreated fabric, antioxidant capacity of LBL functional cotton fabric raised approximately two times. LBL functional cotton fabric still retained the wear performances of the original fabric.
Topical Zhiyang Pingfu Liquid for Moderate to Severe Skin Rash Associated With EGFRIs: A double-blinded randomized controlled trial
Authors: Zhang Jingyi , Lu Xingyu , Zhang Xu , Tan Kexin , Li Jia , Cui Huijuan
Published: November 2022

Background:

Skin rash is the most common adverse effect associated with epidermal growth factor receptor inhibitors (EGFRIs). The study has observed the efficacy and safety of Zhiyang Pingfu Liquid in the treatment of EGFRIs-related moderate and severe rash.

Methods:

Patients suffering from EGFRIs-related moderate to severe rash were enrolled and then randomly divided into the treatment group and the control group, receiving Zhiyang Pingfu Liquid and placebo liquid respectively combined with minocycline and methylprednisolone recommended by guideline for 14 days. Changes in rash grades were observed, as well as the dosage of minocycline. Blood routine examination and liver and kidney function were evaluated to observe the safety of Zhiyang Pingfu Liquid. The total response of rash included complete response (CR) and partial response (PR). And the effective rate of rash was the percentage of CR and PR in the total cases.

Results:

A total of 54 out of 58 patients finished the study with 27 patients in each group. The effective rates of rash among the treatment group and the control group were 81.48% and 55.56% after 14 days treatment ( P = .040). The treatment group had a lower dosage of minocycline compared with the control group. The median total dose of oral minocycline administration was 1000 mg in the treatment group and 1400 mg in the control group.

Conclusion:

Zhiyang Pingfu Liquid can effectively improve the moderate and severe EGFRIs-induced rash, and reduce the use of minocycline, as well as the side reactions brought by minocycline. However, larger randomized controlled trials are needed to verify these findings.

Clinical Trial Registration:

The trial was registered on the Chinese Clinical Trial Registry, the registration number is ChiCTR1800017053.
Guessing the sequence of multiple relinings with AFX and nitinol-based cuff: “A riddle, wrapped in a mystery, inside an enigma”
Authors: Georgakarakos Efstratios , Dimitriadis Konstantinos
Published: November 2022

Objective

Knowing the structural and technical features of both the older and newer aortic endografts is an essential tool to understand off-the-shelf combinations of different devices used to treat challenging abdominal aortic aneurysm (AAA) anatomies or failures of previous endovascular aneurysm repairs (EVAR).

Methods

We present a case of a 72-year-old male with history of AAA and evidence of multiple past EVAR interventions who presented with abdominal pain. With no reliable surgical history, we attempted to delineate the types of different endograft parts implanted and the sequence of relining procedure based on plain X-ray projections and combined computed tomography along with intraoperative angiography.

Results

A tubular endograft was presented with a distal fracture of its endoskeleton, and relined with the same type unibody bifurcate. The latter was extended proximally with an AFX extension of a characteristic radiopaque continuous rim. Angiographic findings intraoperatively excluded the latter as part of the initial procedure. Moreover, an extra nitinol-based cuff was identified centrally.

Conclusion

In diagnostic challenges involving multiple relining attempts of different endograft parts, careful analysis of the imaging findings, based on knowledge of the structural and technical features of both the older and newer endografts is necessary for proper diagnosis, identification of potential problems and complications and intervention planning, if needed.
Respiratory failure
Authors: Wallis Charles , Hendon-John Lewis
Published: November 2022

Respiratory failure is a leading cause of morbidity and mortality in the UK, and a significant burden on the NHS. It occurs when the lungs fail to provide adequate gas exchange leading to hypoxia and/or hypercapnia. Primary care clinicians will often encounter acute and chronic respiratory failure and have a key role in the management of patients. This review aims to provide a broad overview of the pathophysiology, causes, presentation, investigations and management relevant to primary care.
“Making the Past Serve the Present”: The Testimonial Tourist Gaze and Infrastructures of Memory in Xinjiang Uyghur Autonomous Region (XUAR), China
Authors: Brown Melissa Shani , O’Brien David
Published: November 2022

In this article, we explore how tourism in Xinjiang is politically weaponised. Commodifying Uyghur cultural heritage for tourism allows the Chinese Communist Party (CCP) to insist it is not committing cultural genocide, but actually “conserving” Uyghur culture. This directly bears on the CCP’s internment of Muslim minorities in “re-education” camps, ostensibly to target Islamic “extremism.” We explore how tourism to Xinjiang is presented as a “success” of the camps and conscripted into the “Sinicisation” of the region and the secularising of minorities’ cultures. Places and practices are deconstructed as cultural heritage, and reconstructed to provide tourists with “exotic” experiences of “wonderful Xinjiang.” This transforms the “tourist gaze” into a “testimonial” one: tourists to Xinjiang are made into witnesses that “Xinjiang is beautiful” and Uyghurs are “happy.” In this, touristic development and tourists themselves are key agents in the CCP’s territorialisation of Xinjiang, the sinicisation of Uyghur culture, and the legitimation of the violence of the camps.
Inhibitory Learning versus Habituation in an Experimental Exposure Intervention for People With Heightened Health Anxiety: Increase of Distress Tolerance as a Joint Mechanism of Change?
Authors: Sauer Karoline S. , Witthöft Michael
Published: November 2022

The Inhibitory Learning Theory (ILT; Craske et al., 2008) changed the focus of exposure-based treatment from erasing excitatory associations and fear reduction (habituation (HA)) to reinforcing inhibitory associations and fear toleration (inhibitory learning (IL)). Studies which directly compare both approaches, IL versus HA, are scarce. The present study aimed at implementing and comparing an IL-based ( n = 26; Age: M = 23.59, SD = 4.38) with a HA-based ( n = 28; Age: M = 25.46, SD = 6.22) experimental exposure approach (including in vivo, interoceptive, and in sensu exposure) in a sample of people with heightened health anxiety. A significant pre- to post-intervention reduction of state health anxiety ( p < .001), which was especially associated with an increase of distress tolerance (DT) pre- to post-exposure ( F (1, 50) = 12.2, p < .001, ηp2 = .20), was observed. A superiority of the IL-based over the HA-based exposure intervention was not detected in relation to major outcomes (e.g., state health anxiety), as well as in relation to a change of DT. The present study underlines the importance of strengthening DT (for heightened health anxiety) during an exposure-based intervention.
How accurate are radiography and computed tomography in the diagnosis of COVID-19?—A Bayesian approach
Authors: Canals Mauricio , Canals Andrea
Published: November 2022

Background

The role of radiology in patients with clinical suspicion of COVID-19 is evolving with scientific evidence, but there are differences in opinion on when and how the technique should be used for clinical diagnosis.

Purpose

To estimate the pre-test and post-test probability that a patient has COVID-19 in the event of a positive and/or negative result from chest X-ray and chest computed tomography (CT) radiological studies, comparing with those of real time polymerase chain reaction (RT-PCR) tests.

Methods

The literature on the sensitivity and specificity of the chest X-ray, chest CT, and RT-PCR was reviewed. Based on these reported data, the likelihood ratios (LR) were estimated and the pre-test probabilities were related to the post-test probabilities after positive or negative results.

Results

The chest X-ray has only a confirmatory value in cases of high suspicion. Chest CT analyses showed that when it is used as a general study, it has almost confirmatory value under high clinical suspicion. A chest CT classified with CO-RADS ≥ 4 has almost a diagnostic certainty of COVID-19 even with moderate or low clinical presumptions, and the CO-RADS 5 classification is almost pathognomonic before any clinical presumption. To rule out COVID-19 completely is only possible in very low clinical assumptions with negative RT-PCR and/or CT.

Conclusions

Chest X-ray and especially CT are fast studies that have the capacity to report high probability of COVID-19, being a real contribution to the concept of “probable case” and allowing support to be installed in an early and timely manner.
A recent two-fold increase in medical adverse event deaths among US inpatients
Authors: Oura Petteri , Sajantila Antti
Published: November 2022

Inpatients have a particular risk of sustaining medical adverse events (MAEs). This analysis aimed to identify patterns of change in deaths due to MAEs among US inpatients. The analysis was based on nationwide cause-of-death data from 1999 to 2019. To adjust for secular trends in overall mortality, MAE deaths were examined proportional to total deaths. Statistical analysis was performed by means of joinpoint regression modeling. Over the analysis period, a total of 18,126,135 certified deaths occurred among inpatients. MAEs were used as the underlying cause of death in 43,899 cases (0.24%). MAE deaths showed a significant increase from mid-2010s onwards; the estimated increase in MAE deaths was up to 15.6% per year (95% confidence interval 11.3–20.1) from 2014 to 2019. Procedure-related events mainly drove the trend. As the present data are insufficient to substantiate and disentangle underlying factors, future analyses are warranted.
Antifungal Properties of Zataria multiflora on Candida species: A Systematic Review
Authors: Shafaroudi Ali Malekzadeh , Gorji Nadia Elyassi , Nasiri Pegah , Javidnia Javad , Saravi Mohammad Ebrahimi
Published: November 2022

Background and purpose

Candida infections have increased significantly in the antimicrobial resistance era, and synthetic antifungal drugs have limitations. The present work aimed to review the antifungal properties of Zataria multiflora ( Z. multiflora) as an herbal remedy.

Method

PubMed, Scopus, ScienceDirect, Web of Science, SID, Civilica, and Magiran databases were searched for the antifungal activity on in vitro, in vivo, dental biofilm, and clinical studies of Z. multiflora on Candida species.

Results

Overall, 33 articles evaluated the effect of Z. multiflora on Candida species and classified them into four groups, as follows in vitro (23), dental biofilm (6), in vivo (2), and clinical studies (3). All studies considered Z. multiflora effective in reducing or even inhibiting the growth of Candida species. NoMFC significant differences were seen in the effect of Z. multiflora on susceptible Candida compared to the resistant groups of Candida in the studies. It was also influential in inhibiting C. parapsilosis, C. glabrata, C. krusei, C. kefyer, and C. zeylanoides.

Conclusion

Considering the side effects and resistance of current antifungal drugs as well as the benefits of using herbal medicines, such as lower cost, less likely to develop drug resistance, the absence of side effects, and toxicity compared with chemical ones, it is possible as a powerful alternative to replace or combine with the current antifungal for Candida infection therapy along with other therapies.
An experimental study on laser ablation of Ultra-thin SiNx layer of PERC solar cell
Authors: Rana Pinal , Khatri Durga Prasad , Kottantharayil Anil , Marla Deepak
Published: November 2022

In this work, a nanosecond green laser (532 nm) is used to generate narrow openings by removing an ultra-thin (85 nm) SiN x layer that is coated on a silicon substrate for application in the fabrication of Passivated Emitter and Rear Contact (PERC) solar cells. An experimental analysis is presented to identify the optimal range of laser parameters for an efficient ablation with minimal damage to the silicon substrate. The ablated samples were characterized using a 3D profilometer to obtain the surface profiles and scanning electron microscope imaging to observe the surface quality. Further, energy-dispersive X-ray line analysis and atom probe tomography were performed to evaluate the nitrogen content on the surface and along the depth, respectively. The experimental results suggest that the SiN x layer starts to ablate only above a threshold laser fluence of 1.4 J/cm2, while the surface bulged out for laser fluence slightly below the ablation threshold. The central part of the ablated region was clean with a negligible nitrogen concentration at the surface, about ∼0.03% at a fluence of 2.4 J/cm2. Nitrogen concentration reduces continuously and almost becomes zero at 80 nm depth, suggesting complete ablation of the SiN x layer for establishing electrical contacts. The ablation width was close to the laser spot diameter only at lower values of the laser fluence. The lowest value of ablation depth was about 180 nm, suggesting that only about 95 nm layer of the silicon is ablated. The study demonstrates that nanosecond laser ablation is a potential technique for ablation of the SiN x layer of PERC solar cells but requires choosing the optimal parameters.
Optical genome mapping in acute myeloid leukemia: a multicenter evaluation
Authors: Levy Brynn , Baughn Linda B. , Akkari Yassmine , Chartrand Scott , LaBarge Brandon , Claxton David , Lennon P. Alan , Cujar Claudia , Kolhe Ravindra , Kroeger Kate , Pitel Beth , Sahajpal Nikhil , Sathanoori Malini , Vlad George , Zhang Lijun , Fang Min , Kanagal-Shamanna Rashmi , Broach James R.
Published: November 2022

Detection of hallmark genomic aberrations in acute myeloid leukemia (AML) is essential for diagnostic subtyping, prognosis, and patient management. However, cytogenetic/cytogenomic techniques used to identify those aberrations, such as karyotyping, fluorescence in situ hybridization (FISH), or chromosomal microarray analysis (CMA), are limited by the need for skilled personnel as well as significant time, cost, and labor. Optical genome mapping (OGM) provides a single, cost-effective assay with a significantly higher resolution than karyotyping and with a comprehensive genome-wide analysis comparable with CMA and the added unique ability to detect balanced structural variants (SVs). Here, we report in a real-world setting the performance of OGM in a cohort of 100 AML cases that were previously characterized by karyotype alone or karyotype and FISH or CMA. OGM identified all clinically relevant SVs and copy number variants (CNVs) reported by these standard cytogenetic methods when representative clones were present in >5% allelic fraction. Importantly, OGM identified clinically relevant information in 13% of cases that had been missed by the routine methods. Three cases reported with normal karyotypes were shown to have cryptic translocations involving gene fusions. In 4% of cases, OGM findings would have altered recommended clinical management, and in an additional 8% of cases, OGM would have rendered the cases potentially eligible for clinical trials. The results from this multi-institutional study indicate that OGM effectively recovers clinically relevant SVs and CNVs found by standard-of-care methods and reveals additional SVs that are not reported. Furthermore, OGM minimizes the need for labor-intensive multiple cytogenetic tests while concomitantly maximizing diagnostic detection through a standardized workflow.
Accurate genome-wide phasing from IBD data
Authors: Noto Keith , Ruiz Luong
Published: November 2022

As genotype databases increase in size, so too do the number of detectable segments of identity by descent (IBD): segments of the genome where two individuals share an identical copy of one of their two parental haplotypes, due to shared ancestry. We show that given a large enough genotype database, these segments of IBD collectively overlap entire chromosomes, including instances of IBD that span multiple chromosomes, and can be used to accurately separate the alleles inherited from each parent across the entire genome. The resulting phase is not an improvement over state-of-the-art local phasing methods, but provides accurate long-range phasing that indicates which of two haplotypes in different regions of the genome, including different chromosomes, was inherited from the same parent. We are able to separate the DNA inherited from each parent completely, across the entire genome, with 98% median accuracy in a test set of 30,000 individuals. We estimate the IBD data requirements for accurate genome-wide phasing, and we propose a method for estimating confidence in the resulting phase. We show that our methods do not require the genotypes of close family, and that they are robust to genotype errors and missing data. In fact, our method can impute missing data accurately and correct genotype errors.
A novel SNP assay reveals increased genetic variability and abundance following translocations to a remnant Allegheny woodrat population
Authors: Muller-Girard Megan , Fowles Gretchen , Duchamp Joseph , Kouneski Samantha , Mollohan Cheryl , Smyser Timothy J. , Turner Gregory G. , Westrich Bradford , Doyle Jacqueline M.
Published: November 2022

Background

Allegheny woodrats (Neotoma magister) are found in metapopulations distributed throughout the Interior Highlands and Appalachia. Historically these metapopulations persisted as relatively fluid networks, enabling gene flow between subpopulations and recolonization of formerly extirpated regions. However, over the past 45 years, the abundance of Allegheny woodrats has declined throughout the species’ range due to a combination of habitat destruction, declining hard mast availability, and roundworm parasitism. In an effort to initiate genetic rescue of a small, genetically depauperate subpopulation in New Jersey, woodrats were translocated from a genetically robust population in Pennsylvania (PA) in 2015, 2016 and 2017. Herein, we assess the efficacy of these translocations to restore genetic diversity within the recipient population.

Results

We designed a novel 134 single nucleotide polymorphism panel, which was used to genotype the six woodrats translocated from PA and 82 individuals from the NJ population captured before and after the translocation events. These data indicated that a minimum of two translocated individuals successfully produced at least 13 offspring, who reproduced as well. Further, population-wide observed heterozygosity rose substantially following the first set of translocations, reached levels comparable to that of populations in Indiana and Ohio, and remained elevated over the subsequent years. Abundance also increased during the monitoring period, suggesting Pennsylvania translocations initiated genetic rescue of the New Jersey population.

Conclusions

Our results indicate, encouragingly, that very small numbers of translocated individuals can successfully restore the genetic diversity of a threatened population. Our work also highlights the challenges of managing very small populations, such as when translocated individuals have greater reproductive success relative to residents. Finally, we note that ongoing work with Allegheny woodrats may broadly shape our understanding of genetic rescue within metapopulations and across heterogeneous landscapes.
Bacteriomes in lesions of pulmonary tuberculosis and its association with status of Mycobacterium tuberculosis excretion
Authors: Du Weili , Zhao Yingli , Zhang Li , Che Jialu , Liu Zichen , Li Kun , Che Nanying
Published: November 2022

Background

Bacteria in lung play an important role in sustaining lung health. Understanding the characteristics of bacteriomes in lesions of pulmonary tuberculosis (TB) patients, who excrete Mycobacterium tuberculosis (MTB), is important for TB prevention and effective treatment. 

Methods

In this study, bacteriomes in lesions from TB patients excreting bacteria (TB-E) and those from TB patients not excreting bacteria (TB-NE) with matched normal lung tissues (NT) were compared by 16S rRNA sequencing. Bacterial MetaCyc functions in TB lesions were also predicted by PICRUSt2 tool.

Results

Alpha diversity of bacteria, including Chao 1 and Shannon indexes, for TB-E was significantly higher than those in TB-NE and NT; while for TB-NE group, Chao 1 index was higher than that in NT group. Predominant phyla in TB lesions and NT were Proteobacteria, Actinobacteria, Firmicutes, and Bacteroidetes, but analysis of similarity (ANOSIM, p < 0.001) revealed significantly different bacterial compositions among TB-E, TB-NE and NT samples. As for bacteriomes in TB lesions, a strong association (ANOSIM, p < 0.001) was observed with the status of MTB excretion. Indicator genera identified in TB-E and TB-NE demonstrated distinctive micro-ecological environments of TB lesions from patients with different clinical manifestations. Co-occurrence analysis revealed a densely-linked bacterial community in TB-NE compared to that in TB-E. MetaCyc functions responsible for menaquinone synthesis and chorismate metabolism that could potentially impact the persistent-state and nutrient metabolism of MTB were enriched in TB-E samples. While in TB-NE samples, enrichment of bacterial MetaCyc function responsible for heme b synthesis might contribute to TB pathology through ferroptosis.

Conclusion

Bacteriomes and their MetaCyc functions in TB lesions are elucidated, and they are associated with status of MTB excretion among pulmonary TB patients. These results serve as a basis for designing novel strategies for preventing and treating pulmonary TB disease.
High-risk diagnosis combinations in patients undergoing interhospital transfer: a retrospective observational study
Authors: Reimer Andrew P. , Schiltz Nicholas K. , Koroukian Siran M.
Published: November 2022

Background

There is limited research on individual patient characteristics, alone or in combination, that contribute to the higher levels of mortality in post-transfer patients. The purpose of this work is to identify significant combinations of diagnoses that identify subgroups of post-interhospital transfer patients experiencing the highest levels of mortality.

Methods

This was a retrospective cross-sectional study using structured electronic health record data from a regional health system between 2010–2017. We employed a machine learning approach, association rules mining using the Apriori algorithm to identify diagnosis combinations.

The study population includes all patients aged 21 and older that were transferred within our health system from a community hospital to one of three main receiving hospitals.

Results

Overall, 8893 patients were included in the analysis. Patients experiencing mortality post-transfer were on average older (70.5 vs 62.6 years) and on average had more diagnoses in 5 of the 6 diagnostic subcategories. Within the diagnostic subcategories, most diagnoses were comorbidities and active medical problems, with hypertension, atrial fibrillation, and acute respiratory failure being the most common. Several combinations of diagnoses identified patients that exceeded 50% post-interhospital transfer mortality.

Conclusions

Comorbid burden, in combination with active medical problems, were most predictive for those experiencing the highest rates of mortality. Further improving patient level prognostication can facilitate informed decision making between providers and patients to shift the paradigm from transferring all patients to higher level care to only transferring those who will benefit or desire continued care, and reduce futile transfers.
Association between variables measured in the ambulance and in-hospital mortality among adult patients with and without infection: a prospective cohort study
Authors: Wallgren Ulrika Margareta , Järnbert-Pettersson Hans , Sjölin Jan , Kurland Lisa
Published: November 2022

Background

Patients presenting with infection to the ambulance are common, but risk factors for poor outcome are not known. The primary aim of the current study was to study the association between variables measured in the ambulance and mortality among adult patients with and without infection. The secondary aim was to study the association between these variables and mortality in a subgroup of patients who developed sepsis within 36 h.

Methods

Prospective cohort study of 553 ambulance patients with, and 318 patients without infection, performed in Stockholm during 2017–2018. The association between 21 variables (8 keywords related to medical history, 6 vital signs, 4 blood tests, and age, gender, comorbidity) and in-hospital mortality was analysed using logistic regression.

Results

Among patients with infection, inability of the patient to answer questions relating to certain symptoms such as pain and gastrointestinal symptoms was significantly associated with mortality in univariable analysis, in addition to oxygen saturation < 94%, heart rate > 110 /min, Glasgow Coma Scale (GCS) < 15, soluble urokinase Plasminogen Activator Receptor (suPAR) 4.0–7.9 ng/mL, suPAR ≥ 8.0 ng/mL and a Charlson comorbidity score ≥ 5. suPAR ≥ 8.0 ng/mL remained significant in multivariable analysis (OR 25.4; 95% CI, 3.2–199.8). Among patients without infection, suPAR ≥ 8.0 ng/mL and a Charlson comorbidity score ≥ 5 were significantly associated with mortality in univariable analysis, while suPAR ≥ 8.0 ng/mL remained significant in multivariable analysis (OR 56.1; 95% CI, 4.5–700.0). Among patients who developed sepsis, inability to answer questions relating to pain remained significant in multivariable analysis (OR 13.2; 95% CI, 2.2–78.9), in addition to suPAR ≥ 8.0 ng/mL (OR 16.1; 95% CI, 2.0–128.6).

Conclusions

suPAR ≥ 8.0 ng/mL was associated with mortality in patients presenting to the ambulance both with and without infection and in those who developed sepsis. Furthermore, the inability of the ambulance patient with an infection to answer questions relating to specific symptoms was associated with a surprisingly high mortality. These results suggest that suPAR and medical history are valuable tools with which to identify patients at risk of poor outcome in the ambulance and could potentially signal the need of enhanced attention.

Trial registration

ClinicalTrials.gov, NCT03249597. Registered 15 August 2017—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03249597.
Comprehensive analysis of the differences between left- and right-side colorectal cancer and respective prognostic prediction
Authors: Niu Mengye , Chen Chengyang , Gao Xian , Guo Yi , Zhang Bingzhou , Wang Xin , Chen Shihao , Niu Xupeng , Zhang Chao , Li Like , Li Zhongxin , Zhao Zengren , Jiang Xia
Published: November 2022

Background

Previous studies have reported that the tumor heterogeneity and complex oncogenic mechanisms of proximal and distal colon cancer (CRC) are divergent. Therefore, we aim to analyze the differences between left-sided CRC (L_cancer) and right-sided CRC (R_cancer), as well as constructing respective nomograms.

Methods

We enrolled 335 colon cancer patients (146 L_cancer patients and 189 R_cancer patients) from The Cancer Genome Atlas (TCGA) data sets, and 102 pairs of color cancer tissue and adjacent normal tissue (51 L_cancer patients and 51 R_cancer patients) from our hospital. Firstly, we analyzed the differences between the L_cancer patients and R_cancer patients, and then established the L_cancer and R_cancer prognostic models using LASSO Cox.

Results

R_cancer patients had lower survival than L_cancer patients. R_cancer patients had higher ESTIMATE and immune scores and lower tumor purity. These patterns of expression of immune checkpoint-related genes and TMB level were higher in R_cancer than in L_cancer patients. Finally, we using Lasso Cox regression analyses established a prognostic model for L_cancer patients and a prognostic model for R_cancer patients. The AUC values of the risk score for OS in L_cancer were 0.862 in the training set and 0.914 in the testing set, while those in R_cancer were 0.835 in the training set and 0.857 in the testing set. The AUC values in fivefold cross-validation were between 0.727 and 0.978, proving that the two prognostic models have great stability. The nomogram of L_cancer included prognostic genes, age, pathological M, pathological stage, and gender, the AUC values of which were 0.800 in the training set and 0.905 in the testing set. Meanwhile, the nomogram of R_cancer comprised prognostic genes, pathological N, pathological T, and age, the AUC values of which were 0.836 in the training set and 0.850 in the testing set. In the R_cancer patients, high-risk patients had a lower proportion of ‘B cells memory’, ‘Dendritic cells resting’, immune score, ESTIMATE score, immune checkpoint-related genes, and HLA-family genes, and a higher proportion of ‘T cells follicular helper’, ‘Dendritic cells activated’, and ‘Mast cells activated’.

Conclusions

We found significant differences between L_cancer and R_cancer patients and established a clinical predictive nomogram for L_cancer patients and a nomogram for R_cancer patients. Additionally, R_cancer patients in low-risk groups may be more beneficial from immunotherapy.
Association of serum klotho levels with different-staged vascular calcification status in patients with maintenance hemodialysis
Authors: Lin Yan , Huang Jiayuan , Zhou Meiyang , Pan Cuiping , Shan Aiqin , Zhou Canxin
Published: November 2022

Background

Vascular calcification (VC) is suggested to be associated with serum klotho levels in patients with maintenance hemodialysis (MHD), whereas there is a lack of reports on the associations of VC status in whole arteries with serum klotho contents.

Methods

One hundred forty eligible patients with MHD and a total of age-and gender-matched normal controls (NCs) were recruited. We analyzed the VC statuses of large arteries and peripheral muscular arteries by calculating the sum of scores from each artery. The levels of serum klotho were determined by ELISA. In addition, the relationship between serum klotho and VC status was evaluated using correlation analysis and regression analysis.

Results

The VC severity in MHD patients tended to be worse in comparison with NCs. Serum klotho level in patients with MHD was lower than that in the NC subjects (​P < 0.0001), which was correlated with VC scores as reflected by correlation analysis and regression analysis. Serum klotho concentrations exhibited a dynamic decline along with increased VC status stages. Subjects with higher levels of serum klotho had a higher prevalence of cardiovascular events.

Conclusion

Our study indicates serum klotho is strongly associated with VC status in a stage-dependent manner.
In the need of a digital cicerone in healthcare? – Guidance for parents
Authors: Bäckström C , Knez R , Fahlgren M , Synnergren M , Larsson V
Published: November 2022

Objective

To explore parents’ experiences using digital tools in relation to pregnancy, labor and birth, and the child’s first 18 months.

Background

Parents find relevant information using digital healthcare tools, material obtained from professionals, as well as personal opinions and experiences that vary in quality.

Method

Fifteen parents were interviewed and data were analyzed beginning with content analysis and followed by thematic analysis.

Results

The main theme was insecurity and responsibility for own choices and knowledge. Parents use digital tools to take responsibility for their insecurity and need for knowledge when entering parenthood.

Conclusion

The parents’ experiences highlighted that (1) insecurity can be both eased and enhanced using digital tools, (2) they took responsibility for feelings of insecurity and the search for knowledge, and (3) they needed knowledge to make the right choices and feel secure that these choices are made in the best interest of their new family.