bluuebunny/crossref_metadata_2025 huggingface dataset:
Cardiovascular effects of exercise induced dynamic hyperinflation in COPD patients—Dynamically hyperinflated and non-hyperinflated subgroups
Authors: Lukacsovits Jozsef , Szollosi Gergo , Varga Janos T.
Published: January 2023

Introduction

An increase in respiratory rate and expiratory flow limitation can facilitate dynamic hyperinflation (DH), which may cause an element of the intrathoracic pressure in connection with the worsening of venous return, with negative effect on stroke volume (SV) and cardiac output (CO). It has been unclassified, whether poor circulatory adaptation to exercise can be attributed to DH or poor cardio-vascular performance itself in COPD. Only a subset of COPD patients exhibit dynamic hyperinflation during exercise.

Patients and methods

We designed a study to show how lung mechanical and cardiovascular parameters change in hyperinflated and non-hyperinflated COPD patients during exercise with a new experimental set-up. Thirty-three COPD patients with similar severity of COPD and left ventricular performance (20 men, 13 women, mean±SD age: 65,36±6,95 years) participated. We measured the cardiovascular parameters with a non-invasive device (Finometer-pro) including the left ventricular ejection time index (LVETi) and estimated the change of DH with inspiratory capacity (IC) manoeuvres during exercise.

Results

Twenty-one subjects exhibited DH (DH group) and 12 did not (non-DH group). The measurement results were given in mean ± SD and difference between the values measured during maximal load and rest also (ΔX = Xmax.load—Xrest). ΔSV and ΔCO were significantly higher in non-DH vs. DH patients (ΔSV: non-DH 9,7 ± 13,22 ml vs. DH -3,6 ± 14,34 ml, p = 0.0142; ΔCO: non-DH 2,26 ± 1,46 l/min vs. DH 0,88 ± 1,35 l/min, p = 0.0024). LVETi was not different between the two groups. Calculated oxygen delivery (DO2) during maximal load was significantly higher in non-DH group.

Conclusion

We concluded that worse cardiovascular adaptation to exercise of COPD patients can be associated with exercise-induced DH in a similar cardiovascular aged COPD group.
Dynamic stability of the financial monitoring system: Intellectual analysis
Authors: Kuzmenko Olha , Bilan Yuriy , Bondarenko Evgenia , Gavurova Beata , Yarovenko Hanna
Published: January 2023

Introduction

Although there is a growing number of scientific publications on financial monitoring, combating money laundering, the shadow economy, and the impact of corruption on economic development, further research needs to determine the stability of the national financial system in dynamics. The dynamic stability of the national financial monitoring system subjects will allow to adequately assess the effectiveness of the existing national financial monitoring system in each country and determine the influential factors.

Materials and methods

The article investigates an approach to identifying the dynamic stability of the national financial monitoring system subjects based on the calculation of the integrated indicator of the country’s financial system propensity to ALM, vector autoregression (VAR) model taking into account time lag. The proposed integrated indicator allowed to adequately assess the existing financial monitoring systems of the countries (15 countries of the European Union for 2000–2020: Austria, Belgium, Cyprus, Estonia, Finland, France, Greece, Ireland, Italy, Latvia, Malta, Netherlands, Portugal, Slovak Republic, Spain). In addition, vector autoregression models (VAR) of the dependence of the country’s financial system propensity to ALM on the regressors Government Integrity, Index of economic freedom, Monetary Sector credit to the private sector (% GDP), were built, taking into account time lags in general and for each studied country.

Results

According to the modeling results, the national financial monitoring systems in Austria, Belgium, Estonia, Finland, France, Ireland, Netherlands, Slovak Republic, Spain were resistant to money laundering. It is vice versa in Malta, Greece, Cyprus, Portugal, Italy, Latvia. These conclusions are also confirmed based on a binary approach. Such exogenous variables as Government Integrity (with a lag of 2 years) and the Index of economic freedom (taking into account the time delays of the regression reflection under the influence of this regressor for 1 and 2 years) have a statistically significant effect on the country’s financial system.

Conclusion

The general vector autoregression (VAR) model shows that the current value of the country’s financial system propensity to ALM by 92.78% is determined by its previous value. With an increase of Government Integrity by 1%, the country’s financial system’s propensity to ALM will decrease by 0.000616 units with a lag of two years. The nature of the impact made by the Index of economic freedom on the performance feature was specific—when this indicator increases by 1% for a lag delay in one year, the PFSALM value will decrease by 0.001997 units, and for a lag delay of two years it will change the trend and increase by 0.003076 units per unit, respectively.
Imbalanced weighting of proactive and reactive control as a marker of risk-taking propensity
Authors: Grisetto Fanny , Le Denmat Pierre , Delevoye-Turrell Yvonne N. , Vantrepotte Quentin , Davin Tanguy , Dinca Andreea , Ghoulti Isabelle Desenclos-El , Roger Clémence
Published: January 2023

According to the dual mechanisms of control (DMC), reactive and proactive control are involved in adjusting behaviors when maladapted to the environment. However, both contextual and inter-individual factors increase the weight of one control mechanism over the other, by influencing their cognitive costs. According to one of the DMC postulates, limited reactive control capacities should be counterbalanced by greater proactive control to ensure control efficiency. Moreover, as the flexible weighting between reactive and proactive control is key for adaptive behaviors, we expected that maladaptive behaviors, such as risk-taking, would be characterized by an absence of such counterbalance. However, to our knowledge, no studies have yet investigated this postulate. In the current study, we analyzed the performances of 176 participants on two reaction time tasks (Simon and Stop Signal tasks) and a risk-taking assessment (Balloon Analog Risk Taking, BART). The post-error slowing in the Simon task was used to reflect the spontaneous individuals’ tendency to proactively adjust behaviors after an error. The Stop Signal Reaction Time was used to assess reactive inhibition capacities and the duration of the button press in the BART was used as an index of risk-taking propensity. Results showed that poorer reactive inhibition capacities predicted greater proactive adjustments after an error. Furthermore, the higher the risk-taking propensity, the less reactive inhibition capacities predicted proactive behavioral adjustments. The reported results suggest that higher risk-taking is associated with a smaller weighting of proactive control in response to limited reactive inhibition capacities. These findings highlight the importance of considering the imbalanced weighting of reactive and proactive control in the analysis of risk-taking, and in a broader sense, maladaptive behaviors.
On limitations of uniplex networks for modeling multiplex contagion
Authors: Landry Nicholas W. , adams jimi
Published: January 2023

Many network contagion processes are inherently multiplex in nature, yet are often reduced to processes on uniplex networks in analytic practice. We therefore examine how data modeling choices can affect the predictions of contagion processes. We demonstrate that multiplex contagion processes are not simply the union of contagion processes over their constituent uniplex networks. We use multiplex network data from two different contexts—(1) a behavioral network to represent their potential for infectious disease transmission using a “simple” epidemiological model, and (2) users from online social network sites to represent their potential for information spread using a threshold-based “complex” contagion process. Our results show that contagion on multiplex data is not captured accurately in models developed from the uniplex networks even when they are combined, and that the nature of the differences between the (combined) uniplex and multiplex results depends on the specific spreading process over these networks.
Impact of antiphospholipid antibodies on thrombotic events in ambulatory cancer patients
Authors: Kansuttiviwat Chalermkiat , Niprapan Piangrawee , Tantiworawit Adisak , Norasetthada Lalita , Rattarittamrong Ekarat , Rattanathammethee Thanawat , Hantrakool Sasinee , Piriyakhuntorn Pokpong , Punnachet Teerachat , Hantrakun Nonthakorn , Chai-adisaksopha Chatree
Published: January 2023

Background

Despite the conflicting data, the positivity of antiphospholipid antibodies (aPL) in cancer patients may be associated with an increased risk of thrombosis.

Objective

To identify the prevalence and impact of aPL on venous thromboembolic events (VTE) and arterial thrombosis (ATE) in ambulatory cancer patients

Methods

In this single-center, prospective cohort study, we enrolled newly diagnosed ambulatory cancer patients receiving chemotherapy. Non-cancer controls were age- and sex-matched. Participants were evaluated for aPL. Primary outcomes were the composite outcome of VTE or ATE and the prevalence of aPL positivity in cancer patients. Secondary outcomes included the risk of VTE and ATE in cancer patients and all-cause mortality at six-month follow-up duration.

Results

There were 137 cases and 137 controls with mean age of 56.0±12.3 and 55.5±12.1 years, respectively. Cancer patients were more likely to have positive aPL compared to controls, with the risk difference of 9.4% (95%CI 1.5 to 17.5). Composite of ATE or VTE occurred in 9 (6.6%) in cancer patients and 2 (1.5%) in controls. Cancer patients with aPL positivity were associated with higher risk of ATE or VTE (risk ratio [RR] 3.6, 95% CI 1.04–12.4). Positive LA in cancer patients were associated with higher risk of composites of ATE or VTE (RR 5.3 95%CI 1.3–21.0), whereas the anti-β2-GPI positivity were associated with increased risk of VTE (RR 4.7, 95%CI 1.1–19.2).

Conclusion

aPL was more prevalent in active cancer patients and positive aPL in cancer patients was associated with arterial or venous thrombosis.
Clinical characteristics and mortality risk among critically ill patients with COVID-19 owing to the B.1.617.2 (Delta) variant in Vietnam: A retrospective observational study
Authors: Do Thanh Van , Manabe Toshie , Vu Giap Van , Nong Vuong Minh , Fujikura Yuji , Phan Dung , Pham Thach The , Do Cuong Duy , Doan Tra Thu , Nguyen Nguyen Trung , Nguyen Thai Quoc , Dong Thanh Van , Luong Chinh Quoc , Manabe Hiroki , Kambayashi Dan , Hoang Anh Viet , Vu Nhan Van , Trinh Giang Kim , Do Son Ngoc , Kamiya Takeshi , Ohara Hirotaka , Nguyen Chi Van , Dang Tuan Quoc , Kudo Koichiro , Dao Co Xuan
Published: January 2023

Background

SARS-CoV-2 Delta variant caused a large number of COVID-19 cases in many countries, including Vietnam. Understanding mortality risk factors is crucial for the clinical management of severe COVID-19.

Methods

We conducted a retrospective study at an intensive care center in Ho Chi Minh City that urgently built by Bach Mai Hospital during the COVID-19 outbreak in Vietnam, when the Delta variant predominated. Participants were laboratory-confirmed patients with SARS-CoV-2 infection, admitted in August 2021. Data on patients’ demographic and clinical characteristics, radiographic and laboratory findings, treatment, and clinical time course were compared between survivors and non-survivors. Risk factors to mortality were assessed using logistic regression.

Results

Among 504 eligible COVID-19 patients, case fatality was 52.2%. Unvaccinated patients accounted for 61.2% of non-survivors and 43.6% of survivors (p < 0.001). The time from onset to hospital admission was 8 days in non-survivors and 7 days in survivors (p = 0.004). Among non-survivors, 90.2% developed acute respiratory distress syndrome (ARDS). Oxygen therapy was administered for all patients, but antiviral agent was given to 51.7% of non-survivors. 54.2% of non-survivors tested positive for the bacterial infection using blood culture. The risk factors for mortality were diabetes mellitus, respiration rate, oxygen saturation, vaccination status, time from onset to admission, and older age.

Conclusions

Critical patients with COVID-19 owing to the Delta variant in Vietnam had delayed hospital admission, leading to ARDS and death. Early availability of vaccines and preventing bacterial infections are crucial for reducing mortality of COVID-19, especially in low- and middle-income countries.
Executive functioning in adolescents and adults with Silver-Russell syndrome
Authors: Burgevin Mélissa , Lacroix Agnès , Ollivier Fanny , Bourdet Karine , Coutant Régis , Donadille Bruno , Faivre Laurence , Manouvrier-Hanu Sylvie , Petit Florence , Thauvin-Robinet Christel , Toutain Annick , Netchine Irène , Odent Sylvie
Published: January 2023

Silver-Russell syndrome (SRS) is a rare imprinting disorder characterized by prenatal and postnatal growth retardation. The two principal causes of SRS are loss of methylation on chromosome 11p15 (11p15 LOM) and maternal uniparental disomy of chromosome 7 (UPD(7)mat). Knowledge of the neuropsychological profile of SRS remains sparse and incomplete even if several difficulties related to attention and learning have been reported both in the literature and by patients with SRS. These difficulties could be the result of troubles in different cognitive domains, but also of executive dysfunction. Nevertheless, executive functioning has never been investigated, even though executive functions play an essential role in psychological development, and are extensively involved in daily life. The present study explored the executive functioning of individuals with SRS due to UPD(7)mat or 11p15 LOM. A battery of executive tasks assessing cognitive flexibility, inhibitory control, and working memory, together with a task assessing sustained attention, was administered to 19 individuals with SRS (13–39 years) and 19 healthy controls. The Behavior Rating Inventory of Executive Function was also completed by the participants’ families. The results showed that participants with SRS had similar performance (z-scores) to our controls, in a context of normal intellectual efficiency. Group comparisons with Bayesian statistics showed a single difference between the 11p15 LOM and control groups: the completion time for part A of the Trail Making Test appeared to be longer in the 11p15 LOM group than in the control group. However, at the clinical level, several participants with SRS had clinically significant scores on various measures of EFs. Thus, the cognitive phenotype of SRS did not appear to be characterized by executive dysfunction, but individuals with SRS could be at high risk of developing executive dysfunction or attention-deficit/hyperactivity disorder. These results provide new insights into the neuropsychological profile of individuals with SRS.
Utilizing quantitative dried blood spot analysis to objectively assess adherence to cardiovascular pharmacotherapy among patients at Kenyatta National Hospital, Nairobi, Kenya
Authors: Wata David , Ogwu John , Dunford Louise , Lawson Graham , Tanna Sangeeta
Published: January 2023

The burden of cardiovascular disease (CVD) is rising in Kenya and non-adherence to cardiovascular pharmacotherapy is a growing global public health issue that leads to treatment failure, an increased risk of cardiac events and poor clinical outcomes. This study assessed adherence to selected cardiovascular therapy medications among CVD patients attending outpatient clinics at Kenyatta National Hospital, Kenya by determining drug concentration(s) in patient dried blood spot (DBS) samples. Patients who had been taking one or more of the five commonly prescribed CVD medications (amlodipine, atenolol, atorvastatin, losartan, and valsartan) for at least six months were enrolled. Each patient completed a short questionnaire about their medication history and then provided a finger-prick blood spot sample from which drug concentrations were determined by liquid chromatography-high resolution mass spectrometry analysis. Two hundred and thirty-nine patients (62.3% female) participated in the study. The median number of medications used by patients was 2 (IQR 75%-25% is 3–1). Less than half (117; 49.0%) of patients were adherent to their prescribed CVD pharmacotherapy. Binary regression analysis revealed a significant correlation between non-adherence and the number of medications in the treatment regimen (Odds Ratio (OR) 1.583; 95%CI: 0.949–2.639; P-value = 0.039) and that gender was not an independent predictor of medication adherence (OR 1.233; 95%CI: 0.730–2.083; P-value = 0.216). Valuable information about adherence to each medication in the patient’s treatment regimen was obtained using quantitative DBS analysis showing that adherence to CVD medications was not uniform. DBS sampling, due its minimally invasive nature, convenience and ease of transport is a useful alternative matrix to monitor adherence to pharmacotherapies objectively, when combined with hyphenated mass spectrometry analytical techniques. This information can provide physicians with an evidence-based novel approach towards personalization and optimization of CVD pharmacotherapy and implementing interventions in the Kenyan population, thereby improving clinical outcomes.
Effects of telework on anxiety and depression across the United States during the covid-19 crisis
Authors: Islam Nazmul , Baun Kyle , Racette Rachel
Published: January 2023

This study serves to provide evidence on how the increase in people working from home due to government induced social distancing measures is contributing to the frequency of individuals suffering from depression or anxiety. Using a compilation of datasets from the NHIS, Household Pulse Survey, and the Oxford Covid-19 Response Tracker, we find a general trend of increased rates of depression and anxiety in those who moved to a remote working format. However, while all regions have an increased frequency in anxiety for those who switched to telework, those in the Northeast and West (that also have implemented strict lockdown measures related to social distancing) have slightly higher rates of anxiety compared to those in the South and Midwest.
Serving organization goals by organizational information dissemination: An empirical study from the Communist Youth League of China
Authors: Zhou Xueqing , Jing Jielin , Yin Yushi , Liu Qing
Published: January 2023

From the perspective of news topic modeling, this paper investigated how the Communist Youth League of China (CYLC) uses organizational information communication to serve organizational goals—“Keep the Party Assured and the Youth Satisfied” (“让党放心, 让青年满意”). Using the Latent Dirichlet allocation (LDA) algorithm, we performed a topic analysis on 1898 news articles published on the CYLC website. We discovered that nearly all of the CYLC’s news centered on the achievement of its organizational goals, reflecting the characteristics of information dissemination that is highly supportive of organizational objectives. We discovered distinct differences in the dissemination of organizational information between the central, provincial, municipal, county, and school league committees through cluster analysis. The various league organizations have distinct positioning and distinguishing characteristics. In addition, correlation analysis reveals that higher-level league organizations prioritize the dissemination of “Keep the Party Assured” information. While lower-level organizations gradually implement “Keep the Youth Satisfied” initiatives. This paper fills a gap in research on mass organizations in the field of information dissemination and serves as a resource for other political organizations involved in public information dissemination.
Farnesol and phosphorylation of the transcriptional regulator Efg1 affect Candida albicans white-opaque switching rates
Authors: Brenes Lucas R. , Johnson Alexander D. , Lohse Matthew B.
Published: January 2023

Candida albicans is a normal member of the human microbiome and an opportunistic fungal pathogen. This species undergoes several morphological transitions, and here we consider white-opaque switching. In this switching program, C. albicans reversibly alternates between two cell types, named “white” and “opaque,” each of which is normally stable across thousands of cell divisions. Although switching under most conditions is stochastic and rare, certain environmental signals or genetic manipulations can dramatically increase the rate of switching. Here, we report the identification of two new inputs which affect white-to-opaque switching rates. The first, exposure to sub-micromolar concentrations of (E,E)-farnesol, reduces white-to-opaque switching by ten-fold or more. The second input, an inferred PKA phosphorylation of residue T208 on the transcriptional regulator Efg1, increases white-to-opaque switching ten-fold. Combining these and other environmental inputs results in a variety of different switching rates, indicating that a given rate represents the integration of multiple inputs.
Burnout and coping strategies among resident physicians at an Indonesian tertiary referral hospital during COVID-19 pandemic
Authors: Menaldi Sri Linuwih , Raharjanti Natalia Widiasih , Wahid Mardiastuti , Ramadianto Adhitya Sigit , Nugrahadi Nadia Rahmadiani , Adhiguna G. M. Yudi Prasetia , Kusumoningrum Dewi Anggraeni
Published: January 2023

Background

The COVID-19 pandemic has increased the burden on resident physicians. They may use different coping strategies to manage those burdens, which partly determine their mental health outcomes, including burnout syndrome. This study explores the relationship between coping strategies and burnout among resident physicians during the COVID-19 pandemic in an Indonesian tertiary referral hospital.

Methods

This online cross-sectional study was conducted from June to August 2020, involving nine residency programs in the Faculty of Medicine Universitas Indonesia–Cipto Mangunkusumo Hospital. Burnout syndrome was assessed using Maslach Burnout Inventory, while Brief COPE measured coping strategies.

Results

A total of 388 residents participated in this study. High emotional exhaustion (EE), depersonalization (DP), and low personal accomplishment (PA) were found in 15.5%, 5.2%, and 39.2%, respectively. Residents more often use adaptive than maladaptive coping strategies. Higher PA was correlated to residents using problem-focused (r = 0.299; p < 0.001) and emotion-focused (r = 0.397; p < 0.001). Meanwhile, dysfunctional coping strategies are moderately correlated with EE (r = 0,518; p <0,001) and DP (r = 0,507; p<0,001).

Conclusion

The use of dysfunctional coping strategies is linked to higher emotional exhaustion and depersonalization aspect of burnout. However, a higher sense of personal accomplishment is linked to problem-focused and emotion-focused strategies. Appropriate identification and intervention of residents with dysfunctional coping strategies may be beneficial in reducing burnout risk.
An SUI-based approach to explore visual search results cluster-graphs
Authors: Rashid Umer , Saddal Maha , Farooq Ghazanfar , Khan Muazzam Ali , Ahmad Naveed
Published: January 2023

Nowadays, exponential growth in online production and extensive perceptual power of visual contents (i.e., images) complicate the users’ information needs. The research has shown that users are interested in satisfying their visual information needs by accessing the image objects. However, the exploration of images via existing search engines is challenging. Mainly, existing search engines employ linear lists or grid layouts, sorted in descending order of relevancy to the user’s query to present the image results, which hinders image exploration via multiple information modalities associated with them. Furthermore, results at lower-ranking positions are cumbersome to reach. This research proposed a Search User Interface (SUI) approach to instantiate the non-linear reachability of the image results by enabling interactive exploration and visualization options. We represent the results in a cluster-graph data model, where the nodes represent images and the edges are multimodal similarity relationships. The results in clusters are reachable via multimodal similarity relationships. We instantiated the proposed approach over a real dataset of images and evaluated it via multiple types of usability tests and behavioral analysis techniques. The usability testing reveals good satisfaction (76.83%) and usability (83.73%) scores.
Ectodomain shedding of EGFR ligands serves as an activation readout for TRP channels
Authors: Tatsumi Manae , Kishi Takayuki , Ishida Satoru , Kawana Hiroki , Uwamizu Akiharu , Ono Yuki , Kawakami Kouki , Aoki Junken , Inoue Asuka
Published: January 2023

Transient receptor potential (TRP) channels are activated by various extracellular and intracellular stimuli and are involved in many physiological events. Because compounds that act on TRP channels are potential candidates for therapeutic agents, a simple method for evaluating TRP channel activation is needed. In this study, we demonstrated that a transforming growth factor alpha (TGFα) shedding assay, previously developed for detecting G-protein–coupled receptor (GPCR) activation, can also detect TRP channel activation. This assay is a low-cost, easily accessible method that requires only an absorbance microplate reader. Mechanistically, TRP-channel-triggered TGFα shedding is achieved by both of a disintegrin and metalloproteinase domain-containing protein 10 (ADAM10) and 17 (ADAM17), whereas the GPCR-induced TGFα shedding response depends solely on ADAM17. This difference may be the result of qualitative or quantitative differences in intracellular Ca2+ kinetics between TRP channels and GPCRs. Use of epidermal growth factor (EGF) and betacellulin (BTC), substrates of ADAM10, improved the specificity of the shedding assay by reducing background responses mediated by endogenously expressed GPCRs. This assay for TRP channel measurement will not only facilitate the high-throughput screening of TRP channel ligands but also contribute to understanding the roles played by TRP channels as regulators of membrane protein ectodomain shedding.
Left ventricle segmentation in transesophageal echocardiography images using a deep neural network
Authors: Kang Seungyoung , Kim Sun Ju , Ahn Hong Gi , Cha Kyoung-Chul , Yang Sejung
Published: January 2023

Purpose

There has been little progress in research on the best anatomical position for effective chest compressions and cardiac function during cardiopulmonary resuscitation (CPR). This study aimed to divide the left ventricle (LV) into segments to determine the best position for effective chest compressions using the LV systolic function seen during CPR.

Methods

We used transesophageal echocardiography images acquired during CPR. A deep neural network with an attention mechanism and a residual feature aggregation module were applied to the images to segment the LV. The results were compared between the proposed model and U-Net.

Results

The results of the proposed model showed higher performance in most metrics when compared to U-Net: dice coefficient (0.899±0.017 vs. 0.792±0.027, p<0.05); intersection of union (0.822±0.026 vs. 0.668±0.034, p<0.05); recall (0.904±0.023 vs. 0.757±0.037, p<0.05); precision (0.901±0.021 vs. 0.859±0.034, p>0.05). There was a significant difference between the proposed model and U-Net.

Conclusion

Compared to U-Net, the proposed model showed better performance for all metrics. This model would allow us to evaluate the systolic function of the heart during CPR in greater detail by segmenting the LV more accurately.
Increased Angiopoietin-1 and -2 levels in human vitreous are associated with proliferative diabetic retinopathy
Authors: Tsai Teresa , Alwees Mohannad , Asaad Mohammad Ali , Theile Janine , Kakkassery Vinodh , Dick H. Burkhard , Schultz Tim , Joachim Stephanie C.
Published: January 2023

Background

Diabetic retinopathy is a frequent complication of diabetes mellitus and a leading cause of blindness in adults. The objective of this study was to elucidate the diabetic retinopathy pathophysiology in more detail by comparing protein alterations in human vitreous of different diabetic retinopathy stages.

Methods

Vitreous samples were obtained from 116 patients undergoing pars plana vitrectomy. Quantitative immunoassays were performed of angiogenic factors (VEGF-A, PIGF, Angiopoietin-1, Angiopoietin-2, Galectin-1) as well as cytokines (IL-1β, IL-8, IFN-γ, TNF-α, CCL3) in samples from control patients (patients who don’t suffer from diabetes; n = 58) as well as diabetes mellitus patients without retinopathy (n = 25), non-proliferative diabetic retinopathy (n = 12), and proliferative diabetic retinopathy patients (n = 21). In addition, correlation analysis of protein levels in vitreous samples and fasting glucose values of these patients as well as correlation analyses of protein levels and VEGF-A were performed.

Results

We detected up-regulated levels of VEGF-A (p = 0.001), PIGF (p<0.001), Angiopoietin-1 (p = 0.005), Angiopoietin-2 (p<0.001), IL-1β (p = 0.012), and IL-8 (p = 0.018) in proliferative diabetic retinopathy samples. Interestingly, we found a strong positive correlation between Angiopoietin-2 and VEGF-A levels as well as a positive correlation between Angiopoietin-1 and VEGF-A.

Conclusion

This indicated that further angiogenic factors, besides VEGF, but also pro-inflammatory cytokines are involved in disease progression and development of proliferative diabetic retinopathy. In contrast, factors other than angiogenic factors seem to play a crucial role in non-proliferative diabetic retinopathy development. A detailed breakdown of the pathophysiology contributes to future detection and treatment of the disease.
Behavioural activation for depressive symptoms in young people with emerging or early psychosis: A pilot study protocol
Authors: Byrne Mitchell K. , Easpaig Bróna Nic Giolla , Gray Richard , Creek Rebecca , Jones Martin , Brown Ellie , Mitchell David , Zhai Jianxia , Tan Jing-Yu , Denis Shaun , Bressington Daniel
Published: January 2023

Background

Theoretically, behavioural activation may have a valuable role to play in the treatment of depression among young people with emerging/early psychosis, however we lack trial evidence concerning its acceptability and feasibility. This study will establish the feasibility of clinician-delivered behavioural activation as an adjunct to standard care for this population. We aim to train and support clinicians in delivering behavioural activation to improve depressive symptoms in young people with early/emerging psychosis. Our objectives are to:

Establish the number of young people with early/emerging psychosis with clinically meaningful depression symptoms.

Establish the proportion of clinicians that complete the behavioural activation training and are deemed to be competent.

Determine the proportion of eligible participants approached who agree to consent to the research.

Determine the proportion of participants that complete baseline measures, complete behavioural activation treatment (attending for at least fifteen minutes in a minimum of eight sessions), and complete follow-up measures (immediately post-intervention and at 3 months follow-up).

Establish clinicians’ fidelity to treatment (by recording randomly selected treatment sessions and completing a fidelity checklist).

Calculate preliminary efficacy of behavioural activation against primary and secondary outcomes.

Explore participants’ experiences of facilitating behavioural activation (clinicians) and receiving behavioural activation (young people with emerging/early psychosis).

Method

This is a pilot controlled clinical trial with a two-arm parallel-group study. Approximately 60 young people with emerging/early psychosis will be randomly allocated to either behavioural activation treatment plus standard care or standard care alone. The primary outcome: depressive symptoms; and secondary outcomes: negative symptoms, overall psychiatric symptoms, medication side effects and functioning, will be assessed at baseline, post-intervention and at 3-months follow-up. The protocol is registered with the Australian New Zealand Clinical Trials Registry (reference number: ACTRN12622000756729).

Discussion

The findings will inform the design of a full-scale randomised controlled trial.
Calorie restriction alters the mechanisms of radiation-induced mouse thymic lymphomagenesis
Authors: Nakayama Takafumi , Sunaoshi Masaaki , Shang Yi , Takahashi Mizuki , Saito Takato , Blyth Benjamin J. , Amasaki Yoshiko , Daino Kazuhiro , Shimada Yoshiya , Tachibana Akira , Kakinuma Shizuko
Published: January 2023

Calorie restriction (CR) suppresses not only spontaneous but also chemical- and radiation-induced carcinogenesis. Our previous study revealed that the cancer-preventive effect of CR is tissue dependent and that CR does not effectively prevent the development of thymic lymphoma (TL). We investigated the association between CR and the genomic alterations of resulting TLs to clarify the underlying resistance mechanism. TLs were obtained from previous and new experiments, in which B6C3F1 mice were exposed to radiation at 1 week of age and fed with a CR or standard (non-CR) diet from 7 weeks throughout their lifetimes. All available TLs were used for analysis of genomic DNA. In contrast to the TLs of the non-CR group, those of the CR group displayed suppression of copy-neutral loss of heterozygosity (LOH) involving relevant tumor suppressor genes (Cdkn2a, Ikzf1, Trp53, Pten), an event regarded as cell division–associated. However, CR did not affect interstitial deletions of those genes, which were observed in both groups. In addition, CR affected the mechanism of Ikzf1 inactivation in TLs: the non-CR group exhibited copy-neutral LOH with duplicated inactive alleles, whereas the CR group showed expression of dominant-negative isoforms accompanying a point mutation or an intragenic deletion. These results suggest that, even though CR reduces cell division–related genomic rearrangements by suppressing cell proliferation, tumors arise via diverse carcinogenic pathways including inactivation of tumor suppressors via interstitial deletions and other mutations. These findings provide a molecular basis for improved prevention strategies that overcome the CR resistance of lymphomagenesis.
Long-term respiratory follow-up of ICU hospitalized COVID-19 patients: Prospective cohort study
Authors: Ribeiro Carvalho Carlos Roberto , Lamas Celina Almeida , Chate Rodrigo Caruso , Salge João Marcos , Sawamura Marcio Valente Yamada , de Albuquerque André L. P. , Toufen Junior Carlos , Lima Daniel Mario , Garcia Michelle Louvaes , Scudeller Paula Gobi , Nomura Cesar Higa , Gutierrez Marco Antonio , Baldi Bruno Guedes ,   HCFMUSP Covid-19 Study Group
Published: January 2023

Background

Coronavirus disease (COVID-19) survivors exhibit multisystemic alterations after hospitalization. Little is known about long-term imaging and pulmonary function of hospitalized patients intensive care unit (ICU) who survive COVID-19. We aimed to investigate long-term consequences of COVID-19 on the respiratory system of patients discharged from hospital ICU and identify risk factors associated with chest computed tomography (CT) lesion severity.

Methods

A prospective cohort study of COVID-19 patients admitted to a tertiary hospital ICU in Brazil (March-August/2020), and followed-up six-twelve months after hospital admission. Initial assessment included: modified Medical Research Council dyspnea scale, SpO2 evaluation, forced vital capacity, and chest X-Ray. Patients with alterations in at least one of these examinations were eligible for CT and pulmonary function tests (PFTs) approximately 16 months after hospital admission. Primary outcome: CT lesion severity (fibrotic-like or non-fibrotic-like). Baseline clinical variables were used to build a machine learning model (ML) to predict the severity of CT lesion.

Results

In total, 326 patients (72%) were eligible for CT and PFTs. COVID-19 CT lesions were identified in 81.8% of patients, and half of them showed mild restrictive lung impairment and impaired lung diffusion capacity. Patients with COVID-19 CT findings were stratified into two categories of lesion severity: non-fibrotic-like (50.8%-ground-glass opacities/reticulations) and fibrotic-like (49.2%-traction bronchiectasis/architectural distortion). No association between CT feature severity and altered lung diffusion or functional restrictive/obstructive patterns was found. The ML detected that male sex, ICU and invasive mechanic ventilation (IMV) period, tracheostomy and vasoactive drug need during hospitalization were predictors of CT lesion severity(sensitivity,0.78±0.02;specificity,0.79±0.01;F1-score,0.78±0.02;positive predictive rate,0.78±0.02; accuracy,0.78±0.02; and area under the curve,0.83±0.01).

Conclusion

ICU hospitalization due to COVID-19 led to respiratory system alterations six-twelve months after hospital admission. Male sex and critical disease acute phase, characterized by a longer ICU and IMV period, and need for tracheostomy and vasoactive drugs, were risk factors for severe CT lesions six-twelve months after hospital admission.
The effect of damage to the white matter network and premorbid intellectual ability on postoperative verbal short-term memory and functional outcome in patients with brain lesions
Authors: Ebina Kota , Matsui Mie , Kinoshita Masashi , Saito Daisuke , Nakada Mitsutoshi
Published: January 2023

Cognitive reserve is the capacity to cope with cognitive decline due to brain damage caused by neurological diseases. Premorbid IQ has been investigated as a proxy for cognitive reserve. To date, no study has focused on the effects of premorbid IQ in patients with brain tumors, considering the damage to white matter tracts. We investigated whether a higher premorbid IQ has a beneficial impact on postoperative verbal short-term memory and functional outcomes in patients with brain tumors. A total of 65 patients with brain tumors (35 right and 30 left hemisphere lesions) and 65 healthy subjects participated in the study. We used multiple regression analysis to examine whether white matter tract damage and premorbid IQ affect postoperative verbal short-term memory, and the interaction effects of premorbid IQ with damage to white matter tract on postoperative verbal short-term memory. Path analysis was used to investigate the relationship between damage to the white matter tract and premorbid IQ on postoperative functional ability. Our results showed that damage to the left arcuate fasciculus affected postoperative functional ability through verbal short-term memory, working memory, and global cognition in patients with left hemisphere lesions. In the right hemisphere lesion group, high premorbid IQ had a positive effect on functional ability by mediating verbal short-term memory, verbal working memory, and global cognition. We found that damage to the eloquent pathway affected postoperative verbal short-term memory regardless of the premorbid IQ level. However, a higher premorbid IQ was associated with better postoperative verbal short-term memory and functional outcomes when the brain lesions were not located in a crucial pathway. Our findings suggest that premorbid IQ and damage to the white matter tracts should be considered predictors of postoperative functional outcomes.
Analysis of microbial contamination during use and reprocessing of surgical instruments and sterile packaging systems
Authors: Dreikausen Lena , Blender Bernd , Trifunovic-Koenig Milena , Salm Florian , Bushuven Stefan , Gerber Bianka , Henke Matthias
Published: January 2023

A surgical site infection (SSI) is one of the most common surgical complications. This study analyzed different sources of microorganisms in the air, on reusable surgical instruments, and the outer surface of sterile packaging systems during the use and reprocessing of sterile goods (from the operating room (OR) to the Central Sterile Supply Department (CSSD)). The microbial load in the air was analyzed via active air sampling and settle plates. Furthermore, the airborne particle load was measured by a particle counter. Contact agar plates were used to determine the microbial load on surgical instruments and sterile packaging systems. The highest average microbial and particle load was measured in the air of the OR (active air sampling: max. 56 CFU/m3; settle plates: max. 9 CFU; ≥0.3 μm particles in size: 1,958,403 no./m3). However, no microbial load (0 CFU) was detected on surgical instruments sampled in the OR. The outer surface of stored sterile packaging systems showed a maximal microbial load of 64 CFU. The most common identified pathogen was coagulase-negative staphylococci. Compared to properly reprocessed reusable surgical instruments and sterile packaging systems, the air still seems to be the primary potential source of microbial contamination, especially within the OR.
Access to medicines among the Brazilian population based on the 2019 National Health Survey
Authors: Leal Adriana Amorim de Farias , Rodrigues Galvão Maria Helena , Medeiros Arthur de Almeida , Roncalli Ângelo Giuseppe
Published: January 2023

Introduction

Access to medicines is a challenge, especially in developing countries, highlighting the need of population-based research to evaluate access and related factors.

Objective

This study aimed to assess access to medicines and identify associated factors using data from the 2019 Brazilian National Health Survey (PNS).

Methods

This population-based cross-sectional study used data from the 2019 PNS and considered access to prescription medicines as the primary outcome. The sample included 24,753 individuals aged 15 years or older who looked for medical care in the last 15 days and received a medicine prescription. Andersen’s behavioral model was used to select independent variables. After descriptive analysis, a multinomial logistic regression multilevel analysis was performed using the independent variables with a significance level lower than 0.20 in the bivariate analysis.

Results

The lowest chances of getting access to medicines were observed in individuals aged between 40 and 59 years, women, with complete middle and high school, with lower-income families, who attended public services, with worse self-assessed health, and those who looked for health care for disease prevention and health promotion.

Conclusions

Access to medicines among the Brazilian population is associated with social, economic, and health perception factors. Our findings may update and guide the development of public policies on medication and pharmaceutical care, facilitating medication purchases by the care user and promoting health equity.
A green-lipped mussel prevents rheumatoid arthritis via regulation of inflammatory response and osteoclastogenesis
Authors: Yang SeungCheon , Min Hong Ki , Park Jin-Sil , Na Hyun Sik , Cho Mi-La , Park Sung-Hwan
Published: January 2023

Rheumatoid arthritis (RA) is a chronic inflammatory disorder characterized by progressive joint destruction. Green-lipped mussel (GLM) has chondro-modulatory and anti-inflammatory properties, but the mechanism underlying the effect of GLM on RA is unclear. To investigate the roles of GLM on the pathogenesis of RA, we examined the effects of GLM in collagen-induced arthritis (CIA) mice and osteoclast differentiation. GLM was orally administrated CIA mice at 3 weeks after chicken type II collagen (CII) immunizations. GLM reduced arthritis severity and the histologic score of CIA mice compared to vehicle. The expression of proinflammatory cytokines (TNF-α, IL-1β, and IL-17) was decreased in the ankle joints of GLM-treated CIA mice. The expression of CD4+ IL-17+ cells decreased in ex vivo splenocytes and the spleens of GLM-treated CIA mice. Moreover, GLM inhibited TRAP+ multinucleated cells among mouse bone marrow-derived monocytes/macrophages (BMM), and the expression of osteoclast-related genes in mouse BMMs and human monocytes in vitro. These results suggest that GLM has potential as a therapeutic agent that can improve disease by controlling pathologic immune cells and osteoclastogenesis.
Biomechanical properties of porcine meniscus as determined via AFM: Effect of region, compartment and anisotropy
Authors: Orton Kevin , Batchelor Wyndham , Ziebarth Noel M. , Best Thomas M. , Travascio Francesco , Jackson Alicia R.
Published: January 2023

The meniscus is a fibrocartilaginous tissue that plays an essential role in load transmission, lubrication, and stabilization of the knee. Loss of meniscus function, through degeneration or trauma, can lead to osteoarthritis in the underlying articular cartilage. To perform its crucial function, the meniscus extracellular matrix has a particular organization, including collagen fiber bundles running circumferentially, allowing the tissue to withstand tensile hoop stresses developed during axial loading. Given its critical role in preserving the health of the knee, better understanding structure-function relations of the biomechanical properties of the meniscus is critical. The main objective of this study was to measure the compressive modulus of porcine meniscus using Atomic Force Microscopy (AFM); the effects of three key factors were investigated: direction (axial, circumferential), compartment (medial, lateral) and region (inner, outer). Porcine menisci were prepared in 8 groups (= 2 directions x 2 compartments x 2 regions) with n = 9 per group. A custom AFM was used to obtain force-indentation curves, which were then curve-fit with the Hertz model to determine the tissue’s compressive modulus. The compressive modulus ranged from 0.75 to 4.00 MPa across the 8 groups, with an averaged value of 2.04±0.86MPa. Only direction had a significant effect on meniscus compressive modulus (circumferential > axial, p = 0.024), in agreement with earlier studies demonstrating that mechanical properties in the tissue are anisotropic. This behavior is likely the result of the particular collagen fiber arrangement in the tissue and plays a key role in load transmission capability. This study provides important information on the micromechanical properties of the meniscus, which is crucial for understanding tissue pathophysiology, as well as for developing novel treatments for tissue repair.