bluuebunny/crossref_metadata_2025 huggingface dataset:
MO1042: Challenges of Diagnosing and Treating Urinary Tract Infection Throuh the Centuries
Authors: Tasic Danijela , Glogovac Stevan , Dimitrijevic Zorica , Radenkovic Sonja
Published: May 2022

BACKGROUND AND AIMS

Numerous epidemiological studies indicate the great importance of diagnosing and treating urinary tract infections. Whether they are treated by urology specialists as provided by international guides while clinical practice is provided, or they are treated by nephrologists as practiced in Serbia, the end result is bacterial resistance to antibiotics. Patients often request from doctors for “natural” nonpharmacological drugs, especially when it comes to treating uranium infection and calculosis. Therefore, the aim of our work is to investigate the ways of diagnosing and treating urinary tract infections, hematuria and calculosis in the past.

METHOD

Numerous resources, including MEDLINE, books, magazines, encyclopedias and data bases, were used to collect the information described in this paper.

RESULTS

The first written records made 6000 years ago about the visual observation of the color and appearance of urine by uroscopy date from Babylon. Painful urination and blood in the urine has been associated with Egyptians in the past, although they attached great importance to hygiene. Since ancient Egypt hematuria has been attributed to schistosoma hematobium today known as schistosomiasis. The eggs of this parasite were found in the urinary tract of a mummy dating from 1189 BC. Later Egyptian medical papers from 1550 BC describe calculosis, cystitis and urinary frequency in people who have been in contact with contaminated water. In 1798, French doctors from the time of Napoleon described Egypt as the only country in which men menstruate. Although only described about 86 plants belonging to 43 species in southeastern Serbia, there are few records on how to treat hematuria, urinary tract infections and calculosis. Herbal medicine in Serbia is recorded in the oldest document from the 14th century (The Hodoch Codex) and the 16th century (The Chilandar Medicinal Codex). The health book “Pelagic's Folk's Teacher” was published in 1879 by Vasa Pelagic. He published folk healing experiences for the first time on over 900 pages and thus gained great popularity. Most of the information was collected by University Professor Dr. Jovan Tucakov, who in his book “Herbal Therapy,” first published in 1973, described the use of herbs to treat various diseases, including urinary tract infections. Almost every family in Serbia owns these books and changes their therapy together with conventional medicines. However, little attention is paid to the side effects of such combinations and the importance of the consequences of the length of treatment.

CONCLUSION

Today, treating a urinary tract infection is a major challenge due to bacterial resistance to antibiotics. Knowledge that the culture and social habits of the people are one of the important contexts for improving health care and health education of people and not just the application of technological advances.
MO1044: Understanding Perception of Pregnancy Risk in Women with Chronic Kidney Disease
Authors: Ralston Elizabeth , Bramham Kate
Published: May 2022

BACKGROUND AND AIMS

Women with chronic kidney disease (CKD) are at increased risk of adverse pregnancy and renal outcomes, including preterm birth and progression of kidney disease. Women's risk perceptions of pregnancy impact behaviours and decisions including engagement with prenatal care, mode of delivery choices and adherence to medical advice, therefore, it is important that women perceive and understand their risk accurately. Pre-pregnancy counselling is recommended for all women with CKD, but it is unknown how women with CKD understand their pregnancy risk and if pre-pregnancy counselling affects women's perceptions. The aim of this study was to understand how a large cohort of diverse women with CKD perceive their pregnancy risk and compare differences in risk perceptions between those who have and have not received pre-pregnancy counselling.

METHOD

The ‘Perception of Pregnancy Risk Questionnaire’ (PPRQ;1) and ‘Desire to Avoid Pregnancy Questionnaire’ (2) were used to measure risk perception and pregnancy intention respectively. The PPRQ was adapted to assess risk perceptions in women with CKD including the severity of kidney disease. Content validity of the adapted PPRQ was confirmed by a panel of 21 experts including nephrologists, midwives, psychologists and obstetricians. Women aged between 18 and 50 years with CKD stages 1–5 were recruited from nine renal units in the United Kingdom and asked to complete an online survey (October 2020–December 2021). Clinical data were extracted from local databases. Data were analysed descriptively.

RESULTS

A total of 322 women completed the survey, mean age of 34.9 (SD 7.1) years. Women's obstetric history and pregnancy perspectives are described in the Table. Half of the respondents already had children (172/322; 54.1%) and three-quarters perceived pregnancy to be important or very important to themselves (241/322; 75.8%) and two-thirds (218/322; 66.7%) perceived pregnancy to be important or very important to their family. Only 109/321 (34%) of women with CKD had previously attended pre-pregnancy counselling, but those who had attended had a higher perception of pregnancy risk [51.4 (SD 21.4) versus 41.9 (SD 23.8); P < 0.0001] (0: not very severe to 100: extremely severe) and severity of kidney disease [51.3 (SD 24.9) versus 43.7 (SD 28.6); P = 0.014] compared to women who had not attended pre-pregnancy counselling.

CONCLUSION

This large multi-centre questionnaire study identified that risk perceptions of pregnancy for women with CKD appear to be higher than those of women with an uncomplicated pregnancy [PPRQ scores of 24.0 (SD 14.5)] [1]. However, women who had received pre-pregnancy counselling had a significantly higher perception of pregnancy risk and perceived severity of kidney disease. Limitations include a lack of measurement before and after attending a pre-pregnancy counselling clinic. Further assessment of the relationship between severity of kidney disease and perceived pregnancy risk and pregnancy intentions is needed.
MO1047: Patient Reported Outcomes in Glomerulonephritis
Authors: Yeo Fiona , Hui Ho Rou , Choo Jason , Zhuan Tan Hui , Mok Irene , Lim Cynthia
Published: May 2022

BACKGROUND AND AIMS

Glomerulonephritis and its treatment may be associated with disease or treatment-related complications causing significant symptom burden and hospitalizations affecting physical function and quality of life (QoL). Patient-centered care harnessing patient-reported outcome measures (PROMs) can guide physicians to optimize patients’ functional well-being. Few studies have described health-related QoL (HRQOL) in patients with glomerulonephritis. We aimed to describe the HRQOL and determinants of HRQOL among patients with active glomerulonephritis.

METHOD

This was a cross-sectional study of adults with active glomerulonephritis recruited at the Singapore General Hospital Glomerulonephritis Disease Management Clinics between July 2020 and July 2021. HRQOL was assessed using the Short-Form Health Survey (SF-36) and Patient-Reported Outcome Measurement Informative System (PROMIS). Socio-demographic and clinical data were collected. Multivariate linear regression was used to determine predictors of HRQOL.

RESULTS

A total of 60 patients with glomerulonephritis (13 minimal change disease, 9 primary focal segmental glomerulosclerosis, 8 membranous nephropathy, 15 lupus nephritis, 8 IgA nephropathy and 7 other glomerulonephritis) with median age 44.5 years old (IQR 32–57) participated. Most (83%) had received immunosuppressants within 60 days of study enrolment. The scores for general health and energy were lower than other health domains of SF-36 such as physical functioning (Table 1). Health domain scores of those with nephrotic presentations (minimal change disease, FSGS and membranous nephropathy) and nephritic presentations (lupus nephritis and IgA nephropathy) were not significantly different. In the multivariable model accounting for age, gender, eGFR, ethnicity, hematuria, edema and immunosuppressant use (Table 2), age correlated positively with emotional role and social functioning while ethnicity influenced the pain scores. Hematuria was associated with lower physical role scores while eGFR correlated positively with social functioning. Calcineurin inhibitor use was associated with higher global physical health scores.

CONCLUSION

Sociodemographic, clinical and treatment may affect SF-36 and PROMIS HRQOL scores in patients with glomerulonephritis.
FC055: Effect of Atacicept on Renal Function in SLE Patients
Authors: Isenberg David , Lin Celia , Kao Amy , Aydemir Aida , Gordon Caroline
Published: May 2022

BACKGROUND AND AIMS

Atacicept is a dual BLyS/APRIL inhibitor. APRIL-SLE was a double-blind, placebo-controlled phase 2 study, which randomized moderate-to-severe systemic lupus erythematosus (SLE) patients to atacicept 75 mg, atacicept 150 mg or placebo. The primary endpoint was the proportion of subjects who experienced a new flare during the 52-week treatment period. In total, 111 patients in the placebo group, 112 patients in the atacicept 75 mg group and 62 patients in the atacicept 150 mg group completed 52 weeks of treatment. Patients with severe renal disease were excluded, while patients with proteinuria and mild–moderate chronic kidney disease, as assessed by KDIGO criteria, were eligible. The effect of atacicept on measures of renal function in these patients has not previously been reported.

METHOD

The study excluded moderate to severe glomerulonephritis, as defined by either of the following: urinary protein/creatinine ratio > 1 mg/mg and/or hematuria or a significant renal impairment as defined by glomerular filtration rate (GFR) < 50 mL/min/1.73 m2. Urine protein/creatinine ratio (UPCR) and GFR were measured at baseline, week 2, and then every 4 weeks until week 52.

RESULTS

In the APRIL-SLE study, the analysis for GFR and UPCR are of all patients (62–111 per group) with up to 15% of patients having a history of SLE-related renal disease. GFR time course showed stability for the atacicept groups compared to a 4.3% decline in the placebo group at week 52 from baseline (figure and table). Furthermore, reductions in UPCR from baseline at week 52 were observed in the atacicept groups compared to an increase in the placebo group.

CONCLUSION

In this phase 2 APRIL-SLE study, analysis of renal data suggests potential for improved renal function with atacicept treatment in SLE renal disease.
FC060: Malignancies in Patients With Anca-Associated Vasculitis Treated within the Euvas Trials
Authors: Sanchez Alamo Beatriz , Moi Laura , Mahr Alfred , Hrušková Zdenka , M. Bajema Ingeborg , Wallquist Carin , Jayne David , W.A. Westman Kerstin
Published: May 2022

BACKGROUND AND AIMS

Patients with ANCA-associated vasculitis (AAV) are known to have an increased risk for the development of malignancies, which has been largely attributed to immunodeficiency or side effects induced by immunosuppressive treatments. Because there is a considerable latency period for cancer development after exposure to immunosuppressive treatments, little data are available on the incidence of cancer for large cohort of patients with AAV and long follow-up. The aim of this study is to describe the cumulative incidence of cancer in patients with AAV who participated in the European Vasculitis Society (EUVAS) therapeutic clinical trials from 1995 to 2012.

METHOD

A total of 848 patients with AAV from 17 European countries were included in the present study. Information was retrieved from questionnaires sent to the principal investigators of the original RCTs (MEPEX, NORAM, CYCAZAREM, CYCLOPS, IMPROVE, RITUXVAS and MYCYC).

RESULTS

Among the total of 848 patients (median follow-up: 8 years, IQR: 2.2–8.8), 149 patients were diagnosed with 181 malignancies. The 10-year cumulative incidence of cancer was estimated at 20.6%. The median duration of start of AAV therapy-to-time of cancer diagnosis was 4.96 years (IQR: 2.24-8.83). The most common cancer types were skin cancer (37.4%), out of which 6 were melanoma and 62 nonmelanoma skin cancer, followed by gastrointestinal cancer (12.6%) and prostatic cancer (9.9%). Patients who developed cancer were significantly older at randomization than those who did not (62 ± 12 versus 57 ± 14 years) (P < 0.001). Considering both remission-induction and remission-maintenance therapies, 94% of the patients received cyclophosphamide, 68.4% azathioprine, 28.2% mycophenolate, 11.4% methotrexate and 10.4% rituximab during the observation period. A total of 6 out of the 28 patients, who were treated with rituximab and two pulses of IV cyclophosphamide as induction therapy, developed cancer. Diagnosis of cancer significantly predicted shorter survival (log-rank = 9.2; P = 0.002).

CONCLUSION

Our findings, which were derived from a large number of patients with AAV enrolled in clinical trials over the past 25 years, estimate the 10-year cumulative incidence of malignancies following the start of AAV therapy at 20.6%. The development of cancer is tightly associated with decreased survival. Analyses of standardized incidence ratios, using the cancer incidence of the background populations as reference, are underway.
MO354: Selenium-Binding Protein 1 (Sepp1) as an Early Sensitive Biomarker of Acute Kidney Injury in Patients Undergoing Cardiopulmonary Bypass
Authors: Zicarelli Mariateresa , Pizzini Patrizia , Jeracitano Federica , Cutrupi Sebastiano , Spoto Belinda , Testa Alessandra , Serraino Filiberto , Mastroroberto Pasquale , Andreucci Michele , Coppolino Giuseppe , Bolignano Davide
Published: May 2022

BACKGROUND AND AIMS

Acute kidney injury (AKI) often occurs in patients undergoing major cardiac surgery with cardiopulmonary bypass (CPB). Despite renal ischemia remains the key trigger, sustained oxidative stress is now acknowledged as a significant contributor. Selenium-binding protein 1 (SEPP1) is an intracellular protein whose blood levels increase in response to systemic cardiovascular and oxidative stress, as well as in the course of chronic kidney injury.

METHOD

In this pilot prospective study, we measured circulating SEPP1 levels in a cohort of 45 patients undergoing cardiac surgery with CPB in order to test its possible role in predicting the following occurrence of AKI. Serum samples of SEPP1 were collected before CPB (baseline) and at 4, 8 and 12 h after the end of the procedure and measured with a commercially available ELISA kit.

RESULTS

In the whole cohort, there was a significant statistical trend in SEPP1 levels from baseline to 12 h after CPB [39 (10–45) versus 3263 (1886–5042) ng/mL; P < 0.0001]. Within 48 h from CPB end, 12/45 patients (27%) developed AKI, as defined as an increase in serum creatinine >0.3 mg/dL or an absolute 1.5-fold increase from baseline and/or a reduced urine output (<0.5 mL/kg/h). Circulating SEPP1 displayed an earlier and more prominent increase in AKI patients as compared with others [4 h SEPP1: 52 (39–233) versus 546 (260–1000) ng/mL; P < 0.001]. 8 h SEPP1: 638 (437–1254) versus 1959 (1055–5303) ng/mL; P < 0.001; difference between overall trends: P < 0.001 (Fig. 1). At ROC analyses, either 4 or 8 h circulating SEPP1 had a remarkable diagnostic capacity in identifying AKI patients (AUCs 0.854 and 0.790, both P < 0.001). The crude OR of AKI in patients with 4 and 8 h SEPP1 above the best ROC-derived cut-off values (178 and 1840 ng/mL, respectively) was 22 (95%CI 2.5–192.9) and 14.5 (95% CI 2.9–71.2), respectively. At multivariate analysis, such a risk was independent from potential confounders, including CPB duration, clamping time and age.

CONCLUSION

Increased SEPP1 levels in patients undergoing CPB may reflect a sustained response to systemic oxidative stress. Such a response becomes more prominent when renal damage is also occurring. Studies on larger and more heterogeneous cohorts are needed to confirm whether SEPP1 may be a candidate as an early and specific biomarker of AKI in this high-risk setting.
MO365: Single-Cell Profiling Analysis Reveals the Transcriptomic Landscape Of Kidneys in Patients With Acute Kidney Injury
Authors: Tang Rong
Published: May 2022

BACKGROUND AND AIMS

Acute kidney injury (AKI) is a common clinical syndrome associated with considerable mortality and healthcare costs. Up to now, the underlying pathological mechanisms of AKI are still unclear, and specific strategies for early diagnosis and treatment of AKI are lacking. In this research, single-cell RNA sequencing (scRNA-seq) was applied to kidney biopsies of patients with AKI to elucidate novel molecular mechanisms and intercellular communications.

METHOD

The transcriptomes of human kidney specimens obtained from subjects with AKI and renal transplant healthy living donors were defined by scRNA-seq technology. Differentially expressed genes (DEGs) and cell clusters of the kidney were determined. Gene ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were performed, and cell–cell crosstalk communication analysis among distince cell subtypes were conducted.

RESULTS

A total of 16 distinct cell clusters were determined in kidney from subjects of AKI and control. Proximal tubule cells of AKI had up-regulation of novel pro-apoptotic genes including USP47, RASSF4, EBAG9, IER3 and NUB1, which have not been reported previously. Further, proximal tubule cells highly expressed endoplasmic reticulum stress related genes (PDIA6, ATF6, HSPA5 and DNAJC3), autophagy related genes (S100A11, CLDN1, TMBIM6, RB1CC1 and VMP1) and genes enriched in RIG-1 signaling. PALM3 was overexpressed in proximal tubule cells of AKI at both mRNA and protein levels, which is involved in cell adhesion, TLR4 signaling and infammation response. DEGs overexpressed in other tubular cells were primarily enriched in NOD-like receptor signaling, estrogen signaling, interleukin-12-mediated signaling and IL-17 signaling. Glomerular cells such as EC upregulated DEGs participating in cell adhesion, apoptosis and chemotaxis. Overexpressed genes in kidney-resident immune cells including macrophages, NK-T cells, monocytes and dendritic cells suggested abnormal regulation related with leukocyte activation, chemotaxis, cell adhesion and complement activation. In addition, the ligand-receptor interactions analysis revealed cell–cell communication contributing to adhesion, recruitment and infiltration of inflammatory cells into the kidneys, and cytokine production in the process of AKI.

CONCLUSION

Together, this study reveals distinct cell-specific transcriptional landscapes of kidney in AKI patients, also altered signaling pathways and potential cell-cell crosstalk in development of AKI. These data may provide new insights into the pathogenesis and potential therapeutic strategies of AKI.
Retrospective analysis of the impact of severe obesity on kidney transplant outcomes
Authors: Tsapepas Demetra , Sandra Vanessa , Dale Leigh Ann , Drexler Yelena , King Kristen L , Yu Miko , Toma Katherine , Van Bever Jennifer , Sanichar Navin , Husain S Ali , Mohan Sumit
Published: May 2022

Background

The prevalence of obesity among kidney transplant recipients is rising. We sought to determine the association between recipient body mass index (BMI) and post-transplant complications.

Methods

Single-center, retrospective cohort study of all adult kidney transplant recipients from 2004 to 2020. Recipients were stratified into four BMI categories: normal-weight (BMI 18.5–24.9 kg/m2, n = 1020), overweight (BMI 25–29.9 kg/m2, n = 1002), moderately obese (BMI 30–34.9 kg/m2, n = 510) and severely-to-morbidly obese (BMI ≥35 kg/m2, n = 274). Logistic regression was used to estimate the association between BMI category and surgical site infections (SSIs).

Results

Recipients with BMI ≥35 kg/m2 had significantly higher rates of SSIs (P < .0001) compared with recipients in all other categories. On multivariable analysis, recipients with BMI ≥35 kg/m2 had increased odds of SSIs compared with normal-weight recipients [odds ratio (OR) 3.34, 95% confidence interval (CI) 1.55–7.22, P = .022). On multivariable and Kaplan–Meier analyses, no BMI groups demonstrated increased odds for death-censored graft failure.

Conclusion

Severe obesity in kidney transplant recipients is associated with increased SSIs, but not kidney allograft failure.
A fly’s eye view of quiescent neural stem cells
Authors: Gujar Mahekta R , Wang Hongyan
Published: May 2022

The balance between proliferation and quiescence of stem cells is crucial in maintaining tissue homeostasis. Neural stem cells (NSCs) in the brain have the ability to be reactivated from a reversible quiescent state to generate new neurons. However, how NSCs transit between quiescence and reactivation remains largely elusive. Drosophila larval brain NSCs, also known as neuroblasts, have emerged as an excellent in vivo model to study molecular mechanisms underlying NSC quiescence and reactivation. Here, we discuss our current understanding of the molecular mechanisms underlying the reactivation of quiescent NSCs in Drosophila. We review the most recent advances on epigenetic regulations and microtubule cytoskeleton in Drosophila quiescent NSCs and their cross-talk with signaling pathways that are required in regulating NSC reactivation.
Isolated rhinorrhea in the presentation of SARS-CoV-2 infection among preschool- versus school-aged children
Authors: Proulx Catherine , Autmizgine Julie , Drouin Olivier , Panetta Luc , Delisle Gaelle A , Luu Thuy Mai , Quach Caroline , Kakkar Fatima
Published: May 2022

Objectives

Rapid identification and isolation of SARS-CoV-2 cases are priorities in school and child care settings to prevent further outbreaks. The objective of this study was to compare the clinical presentation of SARS-CoV-2 infections among preschool (<5 years) versus school-aged (≥5 years) children diagnosed with SARS-CoV-2 infection, and, specifically, the probability of presenting with an isolated symptom, such rhinorrhea or sore throat.

Methods

Retrospective study of children (≤18 years of age) diagnosed with SARS-CoV-2 in the outpatient COVID-19 clinic or the Emergency Department at the Centre Hospitalier Universitaire Sainte-Justine (Montreal, Quebec, Canada) February through May 2020.

Results

Of 3,789 children tested, 105 (3%) were positive for SARS-CoV-2, and 104 included in the analysis (n=49 age <5 years and n=55 age ≥5 years). While fever was the most common presenting symptom across both age groups, in the absence of fever, the presence of a combination of two or more symptoms identified the majority (92%) of cases. Isolated single symptom presentations were uncommon (<5% of cases). Most importantly, not a single child in either age group presented with isolated rhinorrhea or sore throat.

Conclusions

While there are differences in the clinical manifestations of COVID-19 in preschool- versus school-aged children, in both age groups, isolated rhinorrhea was not a manifestation of SARS-CoV-2 infection. These results could help further guide testing criteria and exclusion criteria in child care and school settings.
Effector-triggered inhibition of nodulation: A rhizobial effector protease targets soybean kinase GmPBS1-1
Authors: Khan Asaf , Wadood Syed F , Chen Min , Wang Yan , Xie Zhi-Ping , Staehelin Christian
Published: May 2022

Type III protein secretion systems of nitrogen-fixing rhizobia deliver effector proteins into leguminous host cells to promote or inhibit the nodule symbiosis. However, mechanisms underlying effector-triggered inhibition of nodulation remain largely unknown. Nodulation outer protein T (NopT) of Sinorhizobium sp. NGR234 is an effector protease related to the Pseudomonas effector Avirulence protein Pseudomonas phaseolicola B (AvrPphB). Here, we constructed NGR234 mutants producing different NopT variants and found that protease activity of NopT negatively affects nodulation of smooth crotalaria (Crotalaria pallida). NopT variants lacking residues required for autocleavage and subsequent lipidation showed reduced symbiotic effects and were not targeted to the plasma membrane. We further noticed that Sinorhizobium fredii strains possess a mutated nopT gene. Sinorhizobium fredii USDA257 expressing nopT of NGR234 induced considerably fewer nodules in soybean (Glycine max) cv. Nenfeng 15 but not in other cultivars. Effector perception was further examined in NopT-expressing leaves of Arabidopsis (Arabidopsis thaliana) and found to be dependent on the protein kinase Arabidopsis AvrPphB Susceptible 1 (AtPBS1) and the associated resistance protein Arabidopsis Resistance to Pseudomonas syringae 5 (AtRPS5). Experiments with Nicotiana benthamiana plants indicated that the soybean homolog GmPBS1-1 associated with AtRPS5 can perceive NopT. Further analysis showed that NopT cleaves AtPBS1 and GmPBS1-1 and thus can activate these target proteins. Insertion of a DKM motif at the cleavage site of GmPBS1-1 resulted in increased proteolysis. Nodulation tests with soybeans expressing an autoactive GmPBS1-1 variant indicated that activation of a GmPBS1-1-mediated resistance pathway impairs nodule formation in cv. Nenfeng 15. Our findings suggest that legumes face an evolutionary dilemma of either developing effector-triggered immunity against pathogenic bacteria or establishing symbiosis with suboptimally adapted rhizobia producing pathogen-like effectors.
COVID-19 among Amazonian indigenous in Peru: mortality, incidence, and clinical characteristics
Authors: Soto-Cabezas M Gabriela , Reyes Mary F , Soriano Anderson N , Rodríguez Jean Pierre Velásquez , Ibargüen Luis Ordoñez , Martel Kevin S , Jaime Noemi Flores , Munayco Cesar V
Published: May 2022

Background

Few studies have described the clinical characteristics of patients with COVID-19 from ethnic minority groups. Our objective was to evaluate the mortality and incidence rates, clinical characteristics and factors associated with mortality in cases with COVID-19 belonging to the Amazonian indigenous ethnic group in Peru.

Methods

We performed a retrospective cohort study including all cases from COVID-19 among Peruvian people identified as Amazonian indigenous from 07 March to 31 October 2020. We calculated the standardized mortality and incidence ratios using the indirect age-adjusted method to determine the differences between Amazonian Indigenous and the general population. In addition, we used multivariable logistic regression to determine the risk factors for death.

Results

A total of 19 018 laboratory confirmed COVID-19 cases were analyzed. Indigenous people had 3.18 (95% CI, 3.13–3.23) times the risk of infection and 0.34 (0.31–0.37) times the mortality risk of the general Peruvian population. Males had 1.29 (1.04–1.61) times the odds of death compared with females and for each year of age, the odds of mortality increased 1.03 (1.03–1.04) times. Cases with respiratory distress had 2.47 (1.96–3.10) times more likely to die. Having an immunodeficiency was 18.7 (6.12–57.00) times more likely to die.

Discussion

The Amazonian indigenous population in Peru was strongly affected by COVID-19 compared with the general Peruvian population.
Energy Flux in Thin Plates
Authors: Thompson Ian , Fazakerley Grace
Published: May 2022

A formula for energy flux due to vibrations in a thin plate modelled by Kirchhoff theory is derived by considering a Mindlin plate and taking the low frequency (or low thickness) limit. It is shown that a term that is usually neglected in Kirchhoff theory persists close to free edges. This term does not affect the transverse displacement, but it does affect the energy flux. The new flux formula conserves energy and evaluates to zero along fixed, free and simply supported edges. An example problem, in which edge waves are excited by a point source located in a semi-infinite plate, is considered. Numerical calculations show that the energy radiated into the far field matches the energy introduced by the source.
Obstructive sleep apnea, cerebrovascular disease, and amyloid in older adults with Down syndrome across the Alzheimer’s continuum
Authors: Lao Patrick , Zimmerman Molly E , Hartley Sigan L , Gutierrez José , Keator David , Igwe Kay C , Laing Krystal K , Cotton-Samuel Dejania , Sathishkumar Mithra , Moni Fahmida , Andrews Howard , Krinsky-McHale Sharon , Head Elizabeth , Lee Joseph H , Lai Florence , Yassa Michael A , Diana Rosas H , Silverman Wayne , Lott Ira T , Schupf Nicole , Brickman Adam M
Published: May 2022

We determined the extent to which obstructive sleep apnea (OSA) is associated with increased cerebrovascular disease and amyloid burden, and the relation of the two processes across clinical Alzheimer’s disease (AD) diagnostic groups in adults with Down syndrome (DS). Adults with DS from the Biomarkers of Alzheimer’s Disease in Down Syndrome (ADDS) study were included given available research MRI (n = 116; 50 ± 8 years; 42% women) and amyloid PET scans (n = 71; 50 ± 7 years; 39% women) at the time of analysis. Participants were characterized as cognitively stable (CS; 64%), with mild cognitive impairment-DS (MCI-DS; 23%), with possible AD dementia (5%), or with definite AD dementia (8%). OSA was determined via medical records and interviews. Models tested the effect of OSA on MRI-derived cerebrovascular biomarkers and PET-derived amyloid burden, and the moderating effect of OSA and AD diagnosis on biomarkers. OSA was reported in 39% of participants, which did not differ by clinical AD diagnostic group. OSA was not associated with cerebrovascular biomarkers but was associated with greater cortical amyloid burden. White matter hyperintensity (WMH) volume (primarily in the parietal lobe), enlarged perivascular spaces, and cortical and striatal amyloid burden were greater across clinical AD diagnostic groups (CS<MCI-DS<possible AD<definite AD). OSA increased the differences in WMH volumes across clinical AD diagnostic groups, primarily in the frontal and temporal lobes. Adults with DS and OSA had greater amyloid burden and greater cerebrovascular disease with AD. Importantly, OSA may be a modifiable risk factor that can be targeted for intervention in this population at risk for AD.
Uneven Access to Justice: Social Context and Eligibility for the Right to Counsel
Authors: Dahaghi Kevin
Published: May 2022

The right to counsel is a cornerstone of due process. This article explores the legal construction of “indigency” in criminal county courts. I examine Texas’s Fair Defense Act (2001), a policy mandate that required all 254 counties to create formal criteria used for determining eligibility for access to counsel, as an empirical case for understanding local policy choices that shape access to justice. Drawing on novel data from court plans, I find significant variation in the stringency of eligibility criteria used to determine indigency. Results show that socioeconomic conditions, racial threat, interest group presence, and elements of judicial discretion are key determinants of restrictive eligibility criteria. These findings suggest racial threat can be tied to the institutional design of policies, rather than the enforcement or dormancy of criminal law. The variable institutionalization of eligibility criteria has implications for understanding the entrenchment of racial and class-based inequalities in access to legal institutions.
Efficient and iterative retron-mediated in vivo recombineering in Escherichia coli
Authors: Ellington Adam J , Reisch Christopher R
Published: May 2022

Recombineering is an important tool in gene editing, enabling fast, precise and highly specific in vivo modification of microbial genomes. Oligonucleotide-mediated recombineering via the in vivo production of single-stranded DNA can overcome the limitations of traditional recombineering methods that rely on the exogenous delivery of editing templates. By modifying a previously reported plasmid-based system for fully in vivo single-stranded DNA recombineering, we demonstrate iterative editing of independent loci by utilizing a temperature-sensitive origin of replication for easy curing of the editing plasmid from recombinant cells. Optimization of the promoters driving the expression of the system’s functional components, combined with targeted counterselection against unedited cells with Cas9 nuclease, enabled editing efficiencies of 90–100%. The addition of a dominant-negative mutL allele to the system allowed single-nucleotide edits that were otherwise unachievable due to mismatch repair. Finally, we tested alternative recombinases and found that efficiency significantly increased for some targets. Requiring only a single cloning step for retargeting, our system provides an easy-to-use method for rapid, efficient construction of desired mutants.

Graphical Abstract
The last of the large-sized tortoises of the Mediterranean islands
Authors: Valenti Pietro , Vlachos Evangelos , Kehlmaier Christian , Fritz Uwe , Georgalis Georgios L , Luján Àngel Hernández , Miccichè Roberto , Sineo Luca , Delfino Massimo
Published: May 2022

Archaeological investigations carried out in the cave Zubbio di Cozzo San Pietro, Bagheria, Sicily, revealed the presence of a few skeletal elements of a large-sized tortoise in a funerary area dating to the Copper/Bronze Age. The tortoise has been AMS-dated revealing an age of 12.5 ± 0.5 kyr BP and therefore it pre-dates the funerary activities. The morphology of the retrieved skeletal elements differs from that of the only native tortoise currently living in Sicily, Testudo hermanni. The tortoise’s size significantly exceeds the size range of extant Te. hermanni and all Testudo spp., as well as that of their known fossils, and suggests a shell length of 50–60 cm. Repeated efforts to obtain DNA sequences from the tortoise of Zubbio di Cozzo San Pietro failed, but the morphology of the femur is distinct enough to allow us to erect a new taxon, Solitudo sicula gen. et sp. nov., based on a parsimony analysis. It belongs to a hitherto unrecognized clade that includes other large-sized tortoises from Mediterranean islands, like Malta and Menorca. A review of the pertinent taxa indicates that the remains here described represent the geologically youngest large-sized tortoise of the Mediterranean area.
Origin and Phylogeography of Chinese Cereal Cyst Nematode Heterodera avenae Revealed by Mitochondrial COI Sequences
Authors: Shao Hudie , Xue Qin , Yao Ke , Cui Jiangkuan , Huang Wenkun , Kong Lingan , Li Chuanren , Li Hongmei , Peng Deliang , Smiley Richard W. , Peng Huan
Published: May 2022

Heterodera avenae, a globally distributed plant-parasitic nematode, is one of the most significant pests on cereal crops. In China, it is widely distributed in cereal-growing areas of 16 provinces and causes serious yield losses. In the present study, a total of 98 populations of H. avenae were collected from major wheat-growing regions in China and six other countries. The mitochondrial COI genes were amplified and analyzed. Forty-one mitochondrial COI haplotypes were identified, suggesting a high genetic diversity and endemism level of H. avenae in China. Phylogenetic analysis showed that H. avenae populations in China were divided into four clades. Significant evolutionary and genetic differences were found between Chinese (except Hubei) and foreign populations. Hap1, the most widely distributed haplotype, was considered to be a separate evolutionary origin in China. The gene flow of H. avenae from the northwestern region to the north China region and Huang-Huai-Hai region was significant, so as the direction between north China and Huang-Huai-Hai region. We speculate that water flowing from the Yellow River and mechanical harvesters promoted gene exchange among these groups. A distance-based redundancy analysis showed that genetic distances observed among H. avenae populations were explained foremost not only by geographic distance but also by temperature and precipitation. This study provides theoretical support for the origin and spread of H. avenae populations in China and elsewhere in the world.
Improving Resident Knowledge of Ergonomics Guidelines
Authors: Jeffries Erin L. , Hardesty Susan , Scott Nicole P.
Published: May 2022

OBJECTIVE:

To improve resident knowledge of ergonomics guidelines for surgery, vaginal deliveries and repairs, and documentation.

PROJECT SUMMARY:

We consulted with a licensed occupational therapist at our institution regarding our difficulties with maintaining proper ergonomics while operating, performing deliveries, and documenting. We conducted two separate sessions: one in the obstetrics workroom regarding techniques to improve the ergonomics of our documentation and one in the operating room and labor and delivery unit to address techniques to avoid injury and promote long-term wellness. The sessions were conducted during morning report at our institution, and the obstetrics and gynecology teams attended both sessions. The sessions were available by videoconference for the entire residency program. Handouts were created to present basic ergonomics guidelines and were provided at the conclusion of the sessions. The handouts summarized the information provided during the sessions and included recommendations for adjustments that could be made in the workroom, operating room, and delivery room. The sessions were conducted during ACOG Wellness Week.

OUTCOME:

Adjustments were made in the obstetric and gynecology team workrooms to improve ergonomic function. Sessions improved resident knowledge of ergonomics recommendations for vaginal deliveries. Recommendations included guidelines for arm and shoulder position, tucked chins, and appropriate bed height (sitting vs standing). Adjustments were made in the workroom to position the top of the monitor just below eye level and arm's length away, and chairs were adjusted so that the keyboard and mouse height were just below elbow height. Residents were encouraged to keep arms and wrists in a relaxed, neutral position and to sit all the way back in the chair with back supported and feet firmly on the floor. Residents improved their knowledge of ergonomics guidelines and increased awareness of posture and positioning both on the labor and delivery unit and in the operating room.

RELEVANCE TO WOMEN'S HEALTH OR PHYSICIANS IN PRACTICE:

Work-related musculoskeletal disorders are prevalent among surgeons and can have a significant effect on productivity and career longevity. If we are able to implement evidence-based guidelines developed by high-quality ergonomics research, we can potentially protect obstetricians and gynecologists from injury and improve overall wellness.
Prevalence, Impact, and Trajectories of Sleep Disturbance in Cardiac Rehabilitation
Authors: Tighe Caitlan A. , Buysse Daniel J. , Weiner Debra K. , Beehler Gregory P. , Forman Daniel E.
Published: May 2022

Objective:

The aim of this review was to summarize literature examining the prevalence, impact, and trajectories of sleep disturbance in cardiac rehabilitation (CR) patients and discuss how CR programs may incorporate targeted evaluation and interventions to promote sleep health.

Review Methods:

A narrative review of literature allowed for an examination of the prevalence of sleep disturbance in CR patients, the effects of sleep disturbance on CR outcomes, and trajectories of sleep disturbance in CR.

Sleep disturbance is prevalent in CR patient populations and is related to clinical and functional outcomes. Sleep may be an important biobehavioral process to target in CR to improve important patient outcomes and achieve secondary prevention goals.
PEELING AND INTERNAL LIMITING MEMBRANE REPOSITION (PAIR) FOR MYOPIC FOVEOSCHISIS
Authors: Chou Hung-Da , Teh Wee Min , Wu Wei-Chi , Hwang Yih-Shiou , Chen Kuan-Jen , Lai Chi-Chun
Published: May 2022

Purpose:

To report the outcomes of the Peeling and Internal Limiting Membrane Reposition (PAIR) technique in myopic foveoschisis.

Methods:

A retrospective case series of eyes with myopic foveoschisis that underwent vitrectomy and PAIR. Visual acuity, fundus photographs, and optical coherence tomography measurements were obtained and analyzed. Data are presented as medians (ranges).

Results:

A total of seven eyes underwent PAIR and were followed up for 339 days (188–436 days). No intraoperative complications were noted. One eye exhibited postoperative macular hole formation, but the hole was healed through fluid–gas exchange. At the last follow-up, the visual acuity had improved from 20/66 (20/332–20/40) to 20/40 (20/100–20/25), and the central foveal thickness had decreased from 576 µm to 269 µm. A repositioned internal limiting membrane (ILM) was observed in six of the eyes, and inner retinal dimples were noted in only two eyes. However, retinal wrinkles under the repositioned or perifoveal ILM were noted in five eyes.

Conclusion:

The PAIR technique relieved traction, restored the ILM, and achieved functional and morphological improvement in eyes with myopic foveoschisis. Limited occurrence of inner retinal dimples and retinal thinning was noted, but retinal wrinkles occurred, likely due to ILM contracture.
The clinical efficacy of integrated care in combination with vasopressin for cardiogenic shock induced by acute myocardial infarction
Authors: Xu Ling , Li Qunxing , Yin Delu , Song Guangyu , Wu Hongyan
Published: May 2022

Background:

Cardiogenic shock (CS) is the most serious complication of acute myocardial infarction (AMI) with high mortality, and the conventional nursing mode can not meet the clinical needs. Studies have shown that integrated care model has advantages for critical and chronic diseases. However, there is no clinical study to evaluate the clinical efficacy of this nursing model on cardiogenic shock induced by acute myocardial infarction (CS-AMI).

Methods:

This is a prospective randomized controlled trial to study the clinical efficacy of integrated care combined with vasopressin in the treatment of CS-AMI. Participants will be randomized in a 1:1 ratio to receive integrated care combined with vasopressin in the treatment group and conventional care combined with vasopressin in the control group. The patients will be followed up for 3 months after systematic treatment. Observation indicators include: length of hospital stay, quality of life score, blood pressure level, and nursing satisfaction score. Finally, SPASS 20.0 software will be used for statistical analysis of the data.

Discussion:

This study will evaluate the clinical efficacy of integrated nursing combined with vasopressin in the treatment of CS-AMI. The results of this study will provide a reference for selecting appropriate nursing programs for CS-AMI patients.

Trial registration:

OSF Registration number: DOI 10.17605/OSF.IO/K8CN4
Design, synthesis, and biological evaluation of histone deacetylase inhibitor with novel salicylamide zinc binding group
Authors: Kim Ji Hyun , Ali Khan Hashim , Oh Yong Jin , Seo Young Ho
Published: May 2022

Introduction:

Histone deacetylases (HDACs) have emerged as important therapeutic targets for various diseases, such as cancer and neurological disorders. Although a majority of HDAC inhibitors use hydroxamic acids as zinc binding groups, hydroxamic acid zinc-binding groups suffer from poor bioavailability and nonspecific metal-binding properties, necessitating a new zinc-binding group. Salicylic acid and its derivatives, well-known for their therapeutic value, have also been reported to chelate zinc ions in a bidentate fashion. This drew our attention towards replacing hydroxamic acid with salicylamide as a zinc-binding group.

Methods:

In this study, for the first time, compound 5 possessing a novel salicylamide zinc-binding group was synthesized and evaluated biologically for its ability to inhibit various HDAC isoforms and induce acetylation upon α-tubulin and histone H3 among MDA-MB-231 cells.

Results:

Compound 5 exhibits selective inhibition against class I HDAC isoforms (HDAC1, 2, and 3) over class II and IV HDAC isoforms (HDAC4, 6, and 11). The exposure of MDA-MB-231 cells to compound 5 efficiently induced the acetylation of more histone H3 than α-tubulin, suggesting that compound 5 is a class I selective HDAC inhibitor. Moreover, the molecular docking study indicated that the salicylamide zinc-binding group of compound 5 coordinates the active zinc ion of class I HDAC2 in a bidentate fashion.

Conclusion:

Overall, salicylamide represents a novel zinc-binding group for the development of class I selective HDAC inhibitors.

Graphical abstract:

(http://links.lww.com/MD/G668)
Primary seminoma of prostate in a patient with Klinefelter syndrome
Authors: Shi Duncheng , Chen Changjian , Huang Huagang , Tian Jingyu , Zhou Jianfang , Jin Shihua
Published: May 2022

Rationale:

Klinefelter syndrome (KS) is a sex differentiation syndrome that occurs in men and is characterized by the 47XXY genotype. An association between KS and cancer has also been reported. The occurrence of seminoma of the prostate in KS has not been reported in the literature to date. Primary seminoma should be included in the differential diagnosis of prostate neoplasms in patients with KS.

Patient concerns:

A 39-year-old man presenting with urinary retention was admitted to our hospital. Physical examination revealed sparse pubic hairs, atrophic testes, and an underdeveloped penis. Hormonal examination revealed significantly lowered serum testosterone levels and markedly higher follicle-stimulating hormone levels. A chromosomal examination was performed. Computed tomography and magnetic resonance imaging imaging showed a neoplasm in the left lobe of the prostate, and immunohistochemical examination of a transrectal needle biopsy of the prostate was performed.

Diagnoses:

Chromosomal examination was exhibited a 47 XXY genotype. Histopathology and of Immunohistochemistry of the transrectal needle biopsy specimen confirmed a seminoma. No other neoplasm was found on systemic examination; therefore, the patient was diagnosed with primary prostate seminoma and Klinefelter syndrome.

Interventions:

The patient refused any treatment except catheterization because of religious reason.

Outcomes:

The patient died 2 years later.

Lessons:

Primary seminoma should be included in the differential diagnosis of neoplasms of the prostate in patients with KS. Transrectal ultrasound-guided prostate needle biopsy is essential for the diagnosis of prostate neoplasms, and cisplatin-based chemotherapy remains the primary treatment for seminoma.
Mesenteric panniculitis does not confer an increased risk for cancers
Authors: Hussain Ikram , Ishrat Saba , Aravamudan Veeraraghavan Meyyur , Khan Shahab R. , Mohan Babu P. , Lohan Rahul , Abid Muhammad Bilal , Ang Tiing Leong
Published: May 2022

Background:

Mesenteric panniculitis (MP) is a non-specific, localized inflammation at the mesentery of small intestines which often gets detected on computed tomography. An association with malignant neoplasms remains unclear. We performed a systematic review and meta-analysis to examine the association of malignancy with MP.

Methods:

MEDLINE, EMBASE, Web of Science, and Cochrane databases were searched for articles published from inception to 2020 that evaluated the association of malignant neoplasms with MP in comparison with control groups. Using random-effects method, a summary odds ratio (OR) estimate with 95% confidence intervals for malignant neoplasms in MP was estimated.

Results:

Four case-control studies reporting data on 415 MP patients against 1132 matched-controls met inclusion criteria and were analyzed. The pooled OR for finding a malignant neoplasm in patients with MP was 0.907 (95% CI: 0.688–1.196; P = .489). The heterogeneity was mild and non-significant. Also, there was no heightened risk of any specific type of malignancy with MP. Three more case-series with unmatched-control groups (MP: 282, unmatched-controls: 17,691) were included in a separate analysis where the pooled OR of finding a malignant neoplasm was 2.963 (95% CI: 1.434–6.121; P = .003). There was substantial heterogeneity in this group.

Conclusion:

This meta-analysis of matched controlled studies proves absence of any significant association of malignant neoplasms with MP. Our study also demonstrates that the putative association of malignancy with MP is mainly driven by uncontrolled studies or case-series.