bluuebunny/crossref_metadata_2025 huggingface dataset:
Interactions between nutrient intake and comorbidities for quality of life in premenopausal and postmenopausal women
Authors: Nguyen Hai Duc
Published: October 2022

Objective

This study aimed to identify the associations between nutrient intake and health-related quality of life (HRQOL) in premenopausal and postmenopausal women.

Methods

Using data from Korean National Health and Nutrition Examination Surveys (2019‐2020), EQ-5D-3L, and multivariate logistic and linear regression models, we analyzed the association and interaction between nutrient intake, comorbidities, and HRQOL among 4,027 Korean women.

Results

Nutrient intake levels were lower in postmenopausal women than in premenopausal women. Interactions were observed between numerous nutrient intakes and comorbidities for HRQOL among premenopausal and postmenopausal women. Higher intakes of various nutrients (particularly, folic acid and vitamin A) were related to higher HRQOL scores in premenopausal women with comorbidities (log of inverse HRQOL scores, β = −0.31 [95% confidence interval [CI], −0.58 to −0.05] and β = −0.19 [95% CI, −0.37 to −0.001]) and postmenopausal women with comorbidities (log of inverse HRQOL scores, β = −0.34 [95% CI, −0.61 to −0.07] and β = −0.19 [95% CI, −0.38 to −0.01]), respectively. Regular exercise was associated with a lower risk of mobility problems (odds ratio [OR], 0.59; 95% CI, 0.44‐0.81), self-care problems (OR, 0.53; 95% CI, 0.28‐0.99), usual activity problems (OR, 0.42; 95% CI, 0.26‐0.67), and any problem (OR, 0.71; 95% CI, 0.56‐0.90), as well as an increase in HRQOL score (log of inverse HRQOL scores, β = −0.42; 95% CI, −0.68 to −0.16) in postmenopausal women. Smoking was related to a higher prevalence of depression and anxiety problems (OR, 2.51; 95% CI, 1.53‐4.13) and any problem (OR, 1.67; 95% CI, 1.11‐2.52), as well as a decrease in HRQOL scores (log of inverse HRQOL scores, β = 0.51; 95% CI, 0.14‐0.88) in premenopausal women.

Conclusions

Given the lower nutrient intake levels in postmenopausal women, it is critical to establish HRQOL-improving approaches for this population, including regular exercise, nutrient intake, and smoking cessation.
Effects of COVID-19 on Pediatric Cancer Care: A Multicenter Study of 11 Middle Eastern Countries
Authors: Elzembely Mahmoud M. , Al Rawas Abdulhakim , Al-Hebshi Abdulqader , Alhadi Abdulrahman , Ibrahim Ahmed K. , Zein Amal Ahmed , Ragab Iman , Alshamsi Eman Taryam , Dammag Enas , Gachi Fatiha , Zain Gamal Hussien , Mohammad Hadeel Saleh , Haddad Hisham , Boudiaf Houda , Alharbi Ibrahim , Sultan Iyad , Salami Khadra Hasan , Bayoumy Mohamed S. , Al-Mulla Naima Ali , Al Mashaikhi Nawal , Almajali Rami Mohammed , Farah Roula , Al Daama Saad A. , Ahmad Salah , Ragab Seham M. , Fadel Shady H. , Ahmed Soha , Al-Sweedan Suleimman , Abdelmabood Suzy , Kaleem Waleed Khaled , Madney Youssef
Published: October 2022

During the COVID-19 pandemic, major challenges are facing pediatric cancer centers regarding access to cancer centers, continuity of the anti-cancer therapy, hospital admission, and infection protection precautions. Pediatric oncologists actively treating children with cancer from 29 cancer centers at 11 countries were asked to answer a survey from May 2020 to August 2020 either directly or through the internet. COVID-19 pandemic affected the access to pediatric cancer care in the form of difficulty in reaching the center in 22 (75.9%) centers and affection of patients’ flow in 21 (72.4%) centers. Health care professionals (HCP) were infected with COVID-19 in 20 (69%) surveyed centers. Eighteen centers (62%) modified the treatment guidelines. Care of follow-up patients was provided in-hospital in 8(27.6%) centers, through telemedicine in 10 (34.5%) centers, and just delayed in 11 (38%) centers. Pediatric oncologists had different expectations about the future effects of COVID-19 on pediatric cancer care. Seventy-six percent of pediatric oncologists think the COVID-19 pandemic will increase the use of telemedicine. Fifty-five percent of pediatric oncologists think if the COVID-19 pandemic persists, we will need to change chemotherapy protocols to less myelosuppressive ones. Collaborative studies are required to prioritize pediatric cancer management during COVID-19 era.
InternalBrace for Intercarpal Ligament Reconstruction
Authors: Starr Brian W. , Ono Shimpei , Seyferth Anne , Chung Kevin C.
Published: October 2022

Intercarpal ligament injuries such as scapholunate and lunotriquetral tears are common causes of wrist pain. There is no shortage of surgical techniques, nor in the volume of literature exploring this topic. However, research progress has not led to a consensus regarding the optimal management of subacute and chronic injuries without articular wear. The senior author (KCC) has performed the spectrum of reconstructive techniques, including dorsal and volar approaches, tendon weaves, ligament tenodesis procedures, reduction and association procedures, and bone-ligament-bone techniques.1,2 In the absence of convincing, consistent outcomes, we began investigating a novel all-dorsal reconstructive technique using the Arthrex InternalBrace system. The complexity and unpredictable outcomes associated with traditional ligament tenodesis procedures led us to adopt the all-dorsal InternalBrace technique as our primary reconstructive approach. We have performed over 20 procedures with this technique since 2019. In an average tourniquet time of under 60 minutes, we are able to achieve predictable carpal stabilization, pain relief, and restoration of motion. This is the preferred reconstructive approach of the senior author.
Titanium Internal Fixator Removal in Maxillofacial Surgery: Is It Necessary? A Systematic Review and Meta-Analysis
Authors: Piombino Pasquale , Sani Lorenzo , Sandu Giorgia , Carraturo Emanuele , De Riu Giacomo , Vaira Luigi A. , Maglitto Fabio , Califano Luigi
Published: October 2022

Titanium plates and screws are essential devices in maxillofacial surgery since late 1980s, but despite their wide use there is no consensus in titanium internal fixators removal after bone healing. A systematic literature review and meta-analysis were conducted on seventeen retrospective studies. Effect size and 95% confidence intervals were calculated for plate removal (per plate and per patient) and for removal causes (infection, pain, screws complications, exposition, palpability). Odds ratio, 95% confidence intervals, and χ2 test were measured for sex, smoking, and implant site. Heterogeneity was evaluated with Cochran and Inconstancy test. Obtained data were used to design Forest and Funnel plots. The aim of the study is to identify and clarify reasons and risk factors for plates and screws removal. Infection is the most frequent reason; the habit of tobacco usage and implant site (mandibula) are the main risk factors. The administration of antibiotic prophylaxis is essential, and patients must quit smoking before and after surgery. In conclusion there is no scientific evidence supporting the removal of internal devices as mandatory step of the postoperative procedure.
Free Fibula Flap for the Treatment of Agnathia in a 10-Year-Old With Severe Agnathia-Otocephaly Complex
Authors: Cohen Oriana , Morrison Kerry A. , Jacobson Adam , Levine Jamie , Staffenberg David A.
Published: October 2022

Agnathia-otocephaly complex (AOC), a first branchial arch defect, is characterized by mandibular hypoplasia or aplasia, ear abnormalities, microstomia, and macroglossia and is a rare and often fatal diagnosis. Herein, the technical considerations and details of mandibular reconstruction using virtual surgical planning (VSP) and a vascularized free fibula flap for further mandibular reconstruction in a 10-year-old boy are presented. The patient’s preoperative examination was consistent with agnathia (absence of mandibular symphysis, bilateral mandibular bodies, condyles, coronoids, rami, and temporomandibular joint), severe microstomia, and a Tessier # 30 cleft (maintained to allow oral access until later in treatment). Virtual surgical planning was utilized to plan a 3-segment fibula for the reconstruction of the mandibular symphysis and bilateral body segments, and bilateral costochondral grafts were planned for the rami. To the authors’ knowledge, this represents the first application of virtual surgical planning for mandibular reconstruction with a vascularized free fibula flap in a pediatric patient with severe agnathia-otocephaly complex.
Bone Morphogenetic Protein 2 Plus Leukocyte and Platelet-Rich Fibrin for the Treatment of MRONJ
Authors: Moraes-da-Silva Aneliza de Fatima , Maluf Gustavo , Rubira-Bullen Izabel Regina Fischer , Santos Paulo Sergio da Silva
Published: October 2022

Leukocyte and platelet-rich fibrin is known to contain high concentrations of growth factors and when associated with rhBMP-2, it may increase bone remodeling due to its osteoinductive property. The aim of this case is to report the outcome of surgical treatment of medication‐related osteonecrosis of the jaw with prototype plate installation and the use of leukocyte and platelet-rich fibrin in association with rhBMP-2 in a 78-year-old female patient under therapy with alendronate. The present Studies describes that the combination of this treatment presented complete healing of osteonecrosis and represents a promising treatment option to be used for medication‐related osteonecrosis of the jaw.
Stripes and loss of color in ball pythons (Python regius) are associated with variants affecting endothelin signaling
Authors: Dao Uyen M. , Lederer Izabella , Tabor Ray L. , Shahid Basmah ,   The BIO306W Consortium, Graves Chiron W. , Seidel Hannah S.
Published: October 2022

Color patterns in non-avian reptiles are beautifully diverse, but little is known about the genetics and development of these patterns. Here we investigated color patterning in pet ball pythons (Python regius), which have been bred to show color phenotypes that differ dramatically from the wildtype form. We report that several color phenotypes in pet animals are associated with putative loss-of-function variants in the gene encoding endothelin receptor EDNRB1: (i) frameshift variants inEDNRB1are associated with conversion of the normal mottled color pattern to skin that is almost fully white, (ii) missense variants affecting conserved sites of the EDNRB1 protein are associated with dorsal, longitudinal stripes, and (iii) substitutions atEDNRB1splice donors are associated with subtle changes in patterning compared to wildtype. We propose that these phenotypes are caused by loss of specialized color cells (chromatophores), with loss ranging from severe (fully white) to moderate (dorsal striping) to mild (subtle changes in patterning). Our study is the first to describe variants affecting endothelin signaling in a non-avian reptile and suggests that reductions in endothelin signaling in ball pythons can produce a variety of color phenotypes, depending on the degree of color cell loss.
Assessment of the influence of weave structure, wind speed and garment size on the ventilation of simulated garment
Authors: Sayanjali Fateme , Ezazshahabi Nazanin , Mousazadegan Fatemeh
Published: October 2022

Purpose

The aim of the present study is to investigate the effect of fabric weave structure on air permeability and its relation with the garment ventilation.

Design/methodology/approach

For this purpose, five groups of cotton/polyester shirting fabrics with plain, T2/1, T2/2, T3/1 and T3/3 weave structures were studied. In order to evaluate ventilation, the garment samples were prepared in different sizes, so that the thickness of the air gap formed between the garment and the body simulator varies by zero, 1.5, 1.2 and 2.9 cm. The effect of wind and its speed (1, 2 and 3 m/s) on clothing ventilation has also been evaluated.

Findings

The results indicated that the rise of wind speed and air gap thickness, due to the increased convective heat transfer, would diminish the air gap temperature of clothing and improves its ventilation. In addition, the fabric weave pattern influences the air ability to pass through the fabric, thus affecting the ventilation capability of the garment.

Originality/value

Garments made of fabrics with higher structural firmness, such as the plain, not only have lower air permeability, but also has weaker ventilation capability.
A divide quantified—exploring the relationship between ICT infrastructure diffusion and income inequality
Authors: Kocsis David , Xiong Jason
Published: October 2022

Purpose

Information and communication technology (ICT) has the potential to address and reduce income inequality. However, since 1980, income inequality in the United States has caused concerns for researchers, policymakers and the public. Entrepreneurs and managers can take advantage of information technologies, while those in the middle and the bottom see fewer benefits. Meanwhile, countries such as Iceland are more capable of using ICT infrastructure to reduce income inequality, which contributes to the well-being of its citizens. This research study explores the relationship between infrastructure diffusion and income inequality through Rogers’s diffusion of innovations theory.

Design/methodology/approach

To answer the research questions, the author assessed the data through a series of regression analyses using SPSS. The authors used Power BI software to chart the relationships between ICT infrastructure diffusion and income inequality by country and in the United States by state and region.

Findings

The results show diffusion of innovations theory’s tenets do not necessarily hold, because a significant negative relationship exists between infrastructure diffusion and income inequality, especially in countries with emerging economies. In the United States, this relationship significantly differs by region.

Originality/value

This research contributes to research by expanding economic and sociology work to the IS domain, while providing conflicting evidence for diffusion of innovations theory. The research also provides suggestions for practice, such as more focused ICT infrastructure investments and regulations.
Supporting sustainable marketing programs: exploring relationships between cultural values, green attitudes and intent
Authors: Johnston Nick E. , Jai Tun-Min (Catherine) , Phelan Kelly Virginia , Velikova Natalia
Published: October 2022

Purpose

This study aims to explore antecedents of supporting local food branded by a sustainable state-operated agricultural marketing program (SOAMP). Cultural values and pro-environmental attitudes were examined as well as their effect on purchase and word-of-mouth intent.

Design/methodology/approach

The values, attitudes and behavior model served as the framework for testing the measurement and structural models and mediation effects. A total of 259 individuals participated in the online survey.

Findings

Structural model was a good fit to the data. The values of collectivism and long-term orientation were the strongest predictors of intent to purchase and spread word of mouth about SOAMP branded products. Green consumption attitudes mediate the relationship from collectivism value to intent to support products branded by a sustainability marketing program.

Originality/value

This study is original in that it challenges the notion that local food consumption is primarily driven by pro-green attitudes. To the best of the authors’ knowledge, it is also the first of its kind to approach local food and pro-green consumption from a cultural perspective by using Hofstede’s cultural values scale to explore how individuals’ values affect their support of products branded by a sustainability marketing program.
A case of palisaded neutrophilic and granulomatous dermatitis associated with systemic lupus erythematosus presenting with pustules
Authors: Tajima Aki , Yamazaki Fumikazu , Huynh Trang Nguyen Mai , Ueda‐Hayakawa Ikuko , Kishimoto Izumi , Itsukage Shizu , Kume Noriko , Tanizaki Hideaki
Published: October 2022

Palisaded neutrophilic and granulomatous dermatitis (PNGD) is a relatively rare skin disease that is characterized by a reactive granulomatous histopathological pattern and is often associated with systemic autoimmune diseases. We encountered a case of PNGD that presented with pustules, although the prototypical clinical presentation of PNGD is mainly erythema and papules. Here, this rare case of PNGD with pustules is presented and discussed in relation to the relevant literature.
Interspecific and intraspecific variation of tree branch, leaf and stomatal traits in relation to topography in an aseasonal Amazon forest
Authors: Zuleta Daniel , Muller‐Landau Helene C. , Duque Alvaro , Caro Natali , Cardenas Dairon , Castaño Nicolas , León‐Peláez Juan Diego , Feeley Kenneth J.
Published: October 2022

Tropical forest responses to variation in water availability, which are critical for understanding and predicting the effects of climate change, depend on trait variation among trees.

We quantified interspecific and intraspecific variation in 18 branch, leaf and stomatal traits for 19–72 dominant tree species along a local topographic gradient in an aseasonal Amazon terra firme forest, and tested trait relationships with tree size, elevation, and species' topographic associations. We further tested whether correlation and coordination of traits vary among trees, among species and/or among trees within species.

Intraspecific trait variation was substantial and exceeded interspecific variation in 10 of 18 traits. For leaf acquisition traits, intraspecific variation was mainly related to tree topographic elevation, while most of the variation in branch, leaf and stomatal traits was related to tree size. Interspecific variation showed no clear relationships with species' habitat association. Although trait correlations and coordinations were generally maintained among trees and among species, bivariate relationships varied among trees within species, across habitat association classes and across tree size classes.

Our results demonstrate the magnitude and importance of intraspecific trait variation in tropical trees, especially as related to tree size. Furthermore, these results suggest that previous findings relating interspecific variation with topographic association in seasonal forests do not necessarily generalize to aseasonal forests.

Read the free Plain Language Summary for this article on the Journal blog.
Different ways to success: Plant community trajectories over time and a soil moisture gradient in restored wetlands
Authors: Mosanghini Davide , Oriolo Giuseppe , Boscutti Francesco
Published: October 2022

Ecological restoration is one of the most promising strategies to combat historical wetland losses caused by land use changes. Restored areas are ideal sites to study plant succession and changes in ecosystem functions over time. However, little is known about the influence of restoration on plant succession along environmental stress gradients. Knowing the processes and mechanisms driving the succession over time in contrasting abiotic conditions might provide new insight into the ultimate success of an ecological restoration.

Relying on long‐term vegetation monitoring, we studied the community succession of 4 plant communities along a restored waterlogging gradient in North‐East Italy (from high to low soil saturation level): (i) Cladium fens, (ii) low alkaline fens, (iii) Molina wet meadows and (iv) dry meadows. We monitored 23 permanent plots distributed along the gradient, spanning from 1 to 21 years since restoration, and 4 plots as target vegetation (natural habitats). We analysed the changes in plant communities in terms of functional traits, diversity and species composition.

We found that exotic and annual species decreased in mature stages of restoration while leaf dry matter content increased over time. Nutrient indicator value and leaf area showed opposite trends at the extreme points of the gradient. Across the successional stages, species richness decreased in Cladium fens and increased in alkaline fens and meadows. Species composition moved toward target vegetation showing contrasting dynamics between different restored habitats.

Synthesis and applications. During succession waterlogging stress acts as main abiotic filter, triggering contrasting trajectories of plant communities. This filter seems to be stronger at the extreme points of the gradient generating opposite but faster dynamics than at intermediate conditions. Time and waterlogging promoted a continuous selection of species consistent to target vegetation in terms of richness, functional traits and composition. The evidenced trajectories suggest the need to develop habitat‐specific protocols concerning the selection of restoration site and subsequent management decisions, with particular regard to plant communities at intermediate ecological conditions.
Beyond virtue and vice: A return to uncertainty
Authors: Kenklies Karsten , Michael Lewin David , Tonner Philip
Published: October 2022

Education is astonishingly simple. We have all been through it, whether as children or later in life—indeed, many of us are still going through it in some form or other; we all know what works; and we are all committed to realising its individual and social potential. Such a view of the matter might dispense with the need for philosophy of education altogether as the problems of education are seen as little more than puzzles to be solved. We know (or think that we know) what we want to achieve, the challenge is how to do so most efficiently. If only the virtues of education were that perspicuous, that simple. If only the vices were so easily identified and expunged. It turns out that education is astonishingly complex. The following chapters aspire to re-introduce a certain complexity that abstains from an all-too-easy understanding. They seek not to offer solutions, but complications, disruptions and dissensions. The authors assume positions against the usual associations and evaluations regarding certain words and phrases—a revaluation that turns the virtues to vices and the vices to virtues.
Obesity mediates the opposite association of education and diabetes in Chinese men and women: Results from the REACTION study
Authors: Zhu Yuanyue , Hu Chunyan , Lin Lin , Wang Shuangyuan , Lin Hong , Huo Yanan , Wan Qin , Qin Yingfen , Hu Ruying , Shi Lixin , Su Qing , Yu Xuefeng , Yan Li , Qin Guijun , Tang Xulei , Chen Gang , Xu Min , Xu Yu , Wang Tiange , Zhao Zhiyun , Gao Zhengnan , Wang Guixia , Shen Feixia , Luo Zuojie , Chen Li , Li Qiang , Ye Zhen , Zhang Yinfei , Liu Chao , Wang Youmin , Wu Shengli , Yang Tao , Deng Huacong , Chen Lulu , Zeng Tianshu , Zhao Jiajun , Mu Yiming , Wang Weiqing , Ning Guang , Bi Yufang , Chen Yuhong , Lu Jieli
Published: October 2022

Background

Evidence regarding the impact of education on diabetes risk is scarce in developing countries. We aimed to explore the association between education and diabetes within a large population in China and to identify the possible mediators between them.

Methods

Information on educational level and lifestyle factors was collected through questionnaires. Diabetes was diagnosed from self‐report and biochemical measurements. A structural equation model was constructed to quantify the mediation effect of each mediator.

Results

Compared with their least educated counterparts, men with college education had a higher risk of diabetes (odds ratio [OR] 1.19; 95% confidence interval [CI], 1.12–1.27), while college‐educated women were less likely to have diabetes (OR 0.77; 95% CI, 0.73–0.82). Obesity was the strongest mediator in both genders (proportion of mediation: 11.6% in men and 23.9% in women), and its association with education was positive in men (β[SE] 0.0387 [0.0037]) and negative in women (β[SE] −0.0824 [0.0030]). Taken together, all behavioral factors explained 12.4% of the excess risk of diabetes in men and 33.3% in women.

Conclusions

In a general Chinese population, the association between education level and diabetes was positive in men but negative in women. Obesity was the major mediator underlying the education disparities of diabetes risk, with a stronger mediation effect among women.
Rheumatoid arthritis and Hailey‐Hailey disease treated with methotrexate
Authors: Mestre Beatriz , Garcia Jorge , Madruga Dias João
Published: October 2022

We report a rare case of long‐standing Hailey‐Hailey disease in a Caucasian Portuguese 69‐year‐old woman, recently diagnosed with rheumatoid arthritis. The patient's skin lesions remained active and exudative despite topical and oral treatments with corticosteroids, tetracyclines, antifungals, and oral treatment with azathioprine. After introduction of methotrexate for rheumatoid arthritis treatment, the skin lesions regressed, with significant impact on the patient's quality of life. This case report supports the clinical evidence of methotrexate's potential role in Hailey‐Hailey disease treatment.
High‐fat diet‐induced obesity augments the deleterious effects of estrogen deficiency on bone: Evidence from ovariectomized mice
Authors: Ali Dalia , Figeac Florence , Caci Atenisa , Ditzel Nicholas , Schmal Clarissa , Kerckhofs Greet , Havelund Jesper , Færgeman Nils , Rauch Alexander , Tencerova Michaela , Kassem Moustapha
Published: October 2022

Several epidemiological studies have suggested that obesity complicated with insulin resistance and type 2 diabetes exerts deleterious effects on the skeleton. While obesity coexists with estrogen deficiency in postmenopausal women, their combined effects on the skeleton are poorly studied. Thus, we investigated the impact of high‐fat diet (HFD) on bone and metabolism of ovariectomized (OVX) female mice (C57BL/6J). OVX or sham operated mice were fed either HFD (60%fat) or normal diet (10%fat) for 12 weeks. HFD‐OVX group exhibited pronounced increase in body weight (~86% in HFD and ~122% in HFD‐OVX, p < 0.0005) and impaired glucose tolerance. Bone microCT‐scanning revealed a pronounced decrease in trabecular bone volume/total volume (BV/TV) (−15.6 ± 0.48% in HFD and −37.5 ± 0.235% in HFD‐OVX, p < 0.005) and expansion of bone marrow adipose tissue (BMAT; +60.7 ± 9.9% in HFD vs. +79.5 ± 5.86% in HFD‐OVX, p < 0.005). Mechanistically, HFD‐OVX treatment led to upregulation of genes markers of senescence, bone resorption, adipogenesis, inflammation, downregulation of gene markers of bone formation and bone development. Similarly, HFD‐OVX treatment resulted in significant changes in bone tissue levels of purine/pyrimidine and Glutamate metabolisms, known to play a regulatory role in bone metabolism. Obesity and estrogen deficiency exert combined deleterious effects on bone resulting in accelerated cellular senescence, expansion of BMAT and impaired bone formation leading to decreased bone mass. Our results suggest that obesity may increase bone fragility in postmenopausal women.
A longitudinal study of the association between pro‐inflammatory cytokines and mood symptoms in bipolar disorder
Authors: Huang Mao‐Hsuan , Chan Yee‐Lam E. , Chen Mu‐Hong , Hsu Ju‐Wei , Huang Kai‐Lin , Li Cheng‐Ta , Tsai Shih‐Jen , Su Tung‐Ping , Bai Ya‐Mei
Published: October 2022

Background

Because of a relative dearth of longitudinal studies, the directionality of the relationship between mood and inflammation among patients with bipolar disorder (BD) is still unclear. We aimed to investigate the longitudinal associations of pro‐inflammatory markers with mood symptom severity in BD.

Methods

Hundred and thirty‐two adult patients with BD were enrolled. At the baseline and 1‐year follow‐up visit, all participants received mood assessment with Montgomery Åsberg depression rating scale (MADRS) and Young mania rating scale, and underwent blood draws to quantify metabolic profile and serum levels of the pro‐inflammatory markers, including soluble interleukin‐6 receptor, soluble tumor necrosis factor‐α receptor type 1 (sTNF‐αR1), monocyte chemoattractant protein‐1, and C‐reactive protein. A four‐factor model of MADRS, consisting of sadness, negative thoughts, detachment, and neurovegetative symptoms, were applied.

Results

At baseline, 65 patients with BD were in depressed state, and 67 patients with BD were in euthymic state. Among patients in depressed state, baseline MADRS total score positively correlated with sTNF‐αR1 level at follow‐up. While baseline sTNF‐αR1 level positively predicted sadness symptom in euthymic patients with BD who later developed depression (n = 22), sadness in patients with bipolar depression predicted later increase in serum sTNF‐αR1 level even after remission (n = 17). Moreover, lithium had a stronger effect of lowering peripheral sTNF‐αR1 level as compared with other mood stabilizers.

Conclusion

Our results indicate the bidirectional inflammation‐depression relationship in BD.
What progress can the Australian Journal of Rural Health celebrate on its thirtieth anniversary?
Authors: Humphreys John S. , Wakerman John
Published: October 2022

Thirty years ago the first edition of the Australian Journal of Rural Health (AJRH) was published. Following reviews published in 2002 and 2012, it is again time to review what progress has been made in bringing about improved health outcomes for residents of rural and remote Australia over the past decade. Compounded by the Covid‐19 crisis that has affected the health and health care system throughout Australia, this review notes the significant lack of progress over the past decade in ameliorating ongoing problems of poor access to primary health care and associated avoidable hospitalisations, persistent poor health of Indigenous Australians, and the greater prevalence of a range of health risk factors. Following the findings of the recent New South Wales enquiry into rural health, this review highlights what is needed to implement the many recommendations that have emerged from the wealth of evidence‐based research published in journals such as the AJRH to improve health outcomes and increase the parity and equity in health between metropolitan and non‐metropolitan Australians.
Effect of intensive insulin therapy on inflammatory response after cardiac surgery using bedside artificial pancreas: A propensity score‐matched analysis
Authors: Fujii Tasuku , Hirai Takahiro , Tamura Takahiro , Suzuki Shogo , Nishiwaki Kimitoshi
Published: October 2022

Background

Perioperative hyperglycemia leads to poor postoperative clinical outcomes, including compromised immune function, cardiovascular events, and mortality. The optimal perioperative blood glucose levels during cardiac surgery remain unclear. A closed‐loop glycemic control system (artificial pancreas, target blood glucose range:120–150 mg/dl) prevents postoperative inflammatory response more effectively than conventional insulin therapy (<200 mg/dl). However, the clinical effects of intensive insulin therapy with strict glycemic control (80–110 mg/dl) are controversial. This study aimed to determine whether intensive insulin therapy would further suppress postoperative inflammatory reactions.

Methods

This study analyzed 262 patients who underwent cardiovascular surgery with cardiopulmonary bypass. The patients were divided into two groups according to their target blood glucose range: 80–110 mg/dl and 120–150 mg/dl. The primary outcome was the difference in the C‐reactive protein levels between the two groups.

Results

Propensity score matching resulted in 95 patients in each group based on their covariates. There was no difference in the postoperative maximum C‐reactive protein levels between the two groups (14.81 ± 5.93 mg/dl vs. 14.34 ± 5.52 mg/dl; p = 0.571) following propensity score matching. Hypoglycemia did not occur during intensive insulin therapy.

Conclusions

Intensive insulin therapy following cardiac surgery with cardiopulmonary bypass did not demonstrate significant advantages in the suppression of postoperative inflammatory reactions compared to that with mild glycemic control. However, intensive insulin therapy using an artificial pancreas was found to be safe, with no hypoglycemic events.
Blood products transfusion and retinopathy of prematurity: A cohort study
Authors: Uberos Jose , Fernandez‐Marin Elisabeth , Campos‐Martínez Ana , Ruiz‐López Aida , García‐Serrano Jose Luis
Published: October 2022

Aim

The aim of the study was to assess the influence of blood product transfusions on the development and severity of retinopathy of prematurity (ROP).

Methods

A retrospective cohort study was conducted of very low birth weight (VLBW) newborns with less than 32 weeks gestational age (GA) admitted to the neonatal unit of a tertiary care hospital during the period from 1 January 2008 to 31 December 2021. Data on the degree of ROP and the transfusions received were obtained and analysed. Both univariate and multivariate analyses were performed, by logistic regression.

Results

A total of 565 VLBW newborns were recruited, of whom 263 received a red blood cell transfusion prior to 36 weeks corrected GA. The newborns with ROP received significantly more red blood cell transfusions than those not presenting this condition. After adjusting for oxygen therapy and GA, the risk of ROP was found to be 2.77 times higher (95% CI 1.31–5.88) after receiving three or more transfusions, with a 3.95 times higher risk (95% CI 1.40–11.1) of developing severe ROP. Having received the first red blood cell transfusion before 32 weeks corrected GA is associated with an increased risk of ROP (OR 2.18; 95% CI: 1.09–4.36).

Conclusion

In VLBW neonates, the number of red blood cell transfusions and their administration before 32 weeks corrected GA are important risk factors for ROP.
A first in man study to evaluate the safety, pharmacokinetics and pharmacodynamics of RP7214, a dihydroorotate dehydrogenase inhibitor in healthy subjects
Authors: Nair Ajit , Barde Prajak J. , Routhu Kasi V. , Viswanadha Srikant , Veeraraghavan Sridhar , Pak Samuel , Peterson Jeffrey A. , Vakkalanka Swaroop
Published: October 2022

Dihydroorotate dehydrogenase (DHODH) is a mitochondrial enzyme that is essential for pyrimidine de novo synthesis. Rapidly growing cancer cells and replicating viruses are dependent on host cell nucleotides, the precursors of which are provided by DHODH. Hence, DHODH becomes an ideal target for pharmacological intervention. RP7214 is a potent and selective inhibitor of human DHODH and has shown antiviral and antileukaemic activity in preclinical studies. This paper describes the phase I study that evaluated the safety and pharmacokinetics of single and multiple ascending doses (SAD and MAD) and the food effect of RP7214 in healthy volunteers (HVs). The study was a randomized, double‐blind, placebo‐controlled trial of single dose (100, 200 and 400 mg QD), multiple doses (200 and 400 mg BID for 7 days) and a food effect study at a single dose of 200 mg. A total of 18, 12 and 12 HVs were enrolled in the SAD, MAD and food effect parts of the study, respectively. RP7214 was well tolerated at all dose levels. There were 20 treatment‐emergent adverse events (TEAEs) reported, out of which most were mild to moderate in severity while three TEAEs were grade ≥3. RP7214 showed accumulation on multiple dosing. Steady‐state concentrations were reached within about 3‐6 days. The mean plasma half‐life at steady‐state was 12.8 hours (9.9‐15.3). Food did not impact the absorption of RP7214. Inhibition of DHODH, as evidenced by increased dihydroorotate levels, was observed, confirming target engagement. The high systemic exposure with a favourable safety profile shows potential for the development of RP7214 in SARS‐CoV‐2 and acute myeloid leukaemia (NCT04680429).
Associating Somatic Mutation with Clinical Outcomes Through Kernel Regression and Optimal Transport
Authors: Little Paul , Hsu Li , Sun Wei
Published: October 2022

Somatic mutations in cancer patients are inherently sparse and potentially high dimensional. Cancer patients may share the same set of deregulated biological processes perturbed by different sets of somatically mutated genes. Therefore, when assessing the associations between somatic mutations and clinical outcomes, gene-by-gene analysis is often under-powered because it does not capture the complex disease mechanisms shared across cancer patients. Rather than testing genes one by one, an intuitive approach is to aggregate somatic mutation data of multiple genes to assess their joint association with clinical outcomes. The challenge is how to aggregate such information. Building on the optimal transport method, we propose a principled approach to estimate the similarity of somatic mutation profiles of multiple genes between tumor samples, while accounting for gene–gene similarities defined by gene annotations or empirical mutational patterns. Using such similarities, we can assess the associations between somatic mutations and clinical outcomes by kernel regression. We have applied our method to analyze somatic mutation data of 17 cancer types and identified at least five cancer types, where somatic mutations are associated with overall survival, progression-free interval, or cytolytic activity.
An automatic knowledge graph construction approach to promoting collaborative knowledge building, group performance, social interaction and socially shared regulation in CSCL
Authors: Zheng Lanqin , Niu Jiayu , Long Miaolang , Fan Yunchao
Published: October 2022

Computer‐supported collaborative learning (CSCL) has been an effective pedagogy in the field of education. However, productive collaborative learning often does not occur spontaneously, and learners often have difficulties with collaborative knowledge building and socially shared regulation. To address this research gap, this study proposes an automatic knowledge graph construction approach based on deep neural network models. In total, 63 groups comprising 189 college students participated in this study and were assigned to three conditions, namely, the automatic activated and unactivated knowledge graph (AAUKG) condition, the automated activated knowledge graph (AAKG) condition, and the traditional online collaborative learning (TOCL) condition. The findings revealed that the AAUKG approach had more significant and positive impacts on collaborative knowledge building, group performance, social interaction, and socially shared regulation than the AAKG and TOCL approaches. This study provides substantial evidence of utilising both automatically activated and unactivated knowledge graphs to improve collaborative learning performance.

Practitioner notes

What is already known about this topic

Knowledge graphs have been widely used in many fields for searches, recommendations, analytics, and automation.

Researchers have explored how to construct knowledge graphs. However, few studies have automatically constructed knowledge graphs in the CSCL context.

What this paper adds

An automatic knowledge graph construction approach is proposed and validated in the CSCL context.

The findings indicate that the AAUKG approach has more significant and positive impacts on collaborative knowledge building, group performance, social interaction, and socially shared regulation than the AAKG and TOCL approaches.

Implications for practice and/or policy

The AAUKG approach is an effective method for improving knowledge building and group performance in the CSCL context.

Researchers and practitioners are encouraged to consider how knowledge graphs can be applied to facilitate collaborative learning efficiently.
Specific adolescent prodromal symptoms associated with onset of psychosis in the Northern Finland Birth Cohort 1986
Authors: Palomäki Johanna , Therman Sebastian , Kerkelä Martta , Järvelin Marjo‐Riitta , Jones Peter , Murray Graham K. , Nordström Tanja , Heinimaa Markus , Miettunen Jouko , Veijola Juha , Riekki Tiina
Published: October 2022

Background

Several psychological symptoms in adolescence associate with later development of psychosis. However, it is unclear which symptoms specifically predict psychotic disorders rather than psychiatric disorders in general. We conducted a prospective study comparing how specific adolescent psychotic‐like symptoms, predicted psychotic and non‐psychotic hospital‐treated psychiatric disorders in the population‐based Northern Finland Birth Cohort 1986 (NFBC1986).

Methods

At age 15–16 years, 6632 members of the NFBC1986 completed the PROD‐screen questionnaire. New hospital‐treated mental disorders of the NFBC1986 participants were detected between age 17 and 30 years from the Finnish Care Register for Health Care. Multiple covariates were used in the analysis.

Results

During the follow‐up, 1.1% of the participants developed a psychotic and 3.2% a non‐psychotic psychiatric disorder. Three symptoms were specifically associated with onset of psychosis compared to non‐psychotic psychiatric disorders: ‘Difficulty in controlling one's speech, behaviour or facial expression while communicating’ (adjusted OR 4.00; 95% CI 1.66–9.92), ‘Difficulties in understanding written text or heard speech’ (OR 2.25; 1.12–4.51), and ‘Difficulty or uncertainty in making contact with other people’ (OR 2.20; 1.03–4.67). Of these, the first one remained statistically significant after Bonferroni correction for multiple comparisons.

Conclusion

To our knowledge, this is the first general‐population‐based prospective study exploring psychiatric symptoms predicting the onset of hospital‐treated first‐episode psychosis in comparison to non‐psychotic disorders. We found three symptoms related with difficulties in social interaction which predicted onset of psychosis. This is a novel finding and should be replicated.
Morphology, accumulation and survival of Desmanthus under different planting densities and harvest heights
Authors: Medeiros Aurielle S. , dos Santos Mércia V. F. , da Cunha Márcio V. , de Mello Alexandre C. L. , Simões Neto Djalma E. , de Oliveira Osniel F. , Muir James P. , Dubeux Jose C. B. , dos Santos André E.
Published: October 2022

The use of legumes is an important strategy for animal feeding, especially during the dry season. The aim was to evaluate the effect of planting densities (40,000; 15,625 and 10,000 plants ha−1) and harvest heights (20 and 40 cm) on the morphology, accumulation and survival of Desmanthus (Desmanthus pernambucanus [L.] Thellung), cultivated in subhumid tropical region, as well as to estimate the repeatability of the evaluated characteristics and the optimal number of measurements. The treatments were randomized in blocks, with subdivided plots and four replicates. Planting densities were evaluated in the plots and the harvest heights in the subplots. Eight harvests were carried out with an interval of 84 days. Morphological and productive characteristics and survival were evaluated. Cultivation under density of 40,000 plants ha−1 produced taller plants, with higher leaf area index (LAI = 0.98), light interception (LI = 49%), individual accumulations (18.8 g DM plant−1) and by area (576.5 kg DM ha−1 harvest−1), although resulting in reduced plant stand (66%). Harvest heights do not affect accumulation and survival. It is possible to reduce the number of measurements for stem diameter, number of leaflets per leaf (R2 = 95%), plant height, canopy diameter, LAI, LI, leaf length and width, number of leaves per branch, branch diameter and LBR (R2 = 90%), optimizing resources for future research. Desmanthus has potential for use in protein banks, being harvested in the rainy season, conserved and supplied in addition to animals, but plant growth is minimal during the dry season under rainfed conditions.
Loss of H3K27 trimethylation in a distinct group of de‐differentiated chordoma of the skull base
Authors: Makise Naohiro , Shimoi Tatsunori , Sunami Kuniko , Aoyagi Yasuko , Kobayashi Hiroshi , Tanaka Shota , Kawai Akira , Yonemori Kan , Ushiku Tetsuo , Yoshida Akihiko
Published: October 2022

De‐differentiated chordoma is defined as a high‐grade sarcoma lacking notochordal differentiation, which arises in association with conventional chordoma. The mechanism underlying de‐differentiation remains unclear. We immunohistochemically investigated trimethylation at lysine 27 of histone 3 (H3K27me3) in nine de‐differentiated chordomas. The tumours occurred at the skull base (n = 5) or the sacrum (n = 4) in four men and five women with a median age of 50 years. De‐differentiation occurred de novo in four cases and at recurrence/metastasis in five cases. Five tumours retained H3K27me3, whereas four showed complete loss of H3K27me3 only in the de‐differentiated component, while the conventional chordoma component retained H3K27me3. All the H3K27me3‐negative tumours showed co‐loss of dimethylation at H3K27 (H3K27me2), consistent with inactivation of polycomb repressive complex 2. Two genetically analysed H3K27me3‐negative tumours harboured EED homozygous deletions. All four H3K27me3‐negative de‐differentiated chordomas affected the skull base of young or middle‐aged women. Unlike dense proliferation of highly pleomorphic spindle or epithelioid cells in the H3K27me3‐positive de‐differentiated chordomas, all H3K27me3‐negative tumours displayed swirling fascicles of relatively uniform spindle cells with alternating cellularity and perivascular accentuation, resembling malignant peripheral nerve sheath tumour (MPNST). Rhabdomyoblastic differentiation was present in one H3K27me3‐negative tumour. We identified a novel group of de‐differentiated chordomas in the skull base that lost H3K27me3/me2 only in the de‐differentiated component, which was associated with EED homozygous deletion and MPNST‐like histology. Our data suggest a distinct ‘polycomb‐type’ de‐differentiation pathway in chordoma, similar to a recently described de‐differentiated chondrosarcoma with H3K27me3 loss.
AV‐node isolation as an alternative to AV‐node ablation in patients undergoing pace & ablate strategy
Authors: Lemke Lisa , El Hamriti Mustapha , Braun Martin , Baridwan Nafilah , Sciacca Vanessa , Fink Thomas , Khalaph Moneeb , Guckel Denise , Eitz Thomas , Sohns Christian , Sommer Philipp , Imnadze Guram
Published: October 2022

Introduction

Atrioventricular (AV)‐node ablation (AVNA) is a common therapy option for rate control strategy of permanent atrial fibrillation (AF). We hypothesized that isolation of the AV nodal isolation (AVNI) is associated with a more frequent preservation of an adequate escape rhythm compared to AVNA.

Methods

This retrospective study included 20 patients with therapy‐refractory AF being treated with AVNI and 40 historical AVNA‐controls. In AVNI the AV‐node region was mapped using a 3D mapping system. Ablation was performed around the previously mapped HIS‐cloud regions isolating the atrium from the AV‐node. In the AVNI group, ablation was performed with irrigated tip ablation catheter in all cases. The two approaches were compared regarding rate of escape rhythm, delta QRS, and procedural data.

Results

The number of patients with adequate escape rhythm in AVNI was significantly superior to AVNA immediately postoperative (90% vs. 40%, p < 0.01) and during follow‐up (77% vs. 36%, p < 0.05). The median change in QRS width was 0 ms in AVNI versus +26 ms in AVNA (p < 0.01). Thirty percent new bundle branch blocks in AVNA were observed compared to 0% in AVNI (p < 0.01). In the AVNI group, fluoroscopy time and total dose area product were significantly lower (p < 0.01).

Conclusion

The present study suggests that AV‐node isolation using 3D navigation mapping system is a feasible and effective alternative to conventional AVNA. The precise application of radiofrequency lesions preserves a stable AV‐junctional rhythm.