bluuebunny/crossref_metadata_2025 huggingface dataset:
Student perceptions in online higher education toward faculty mentoring
Authors: AuCoin Dena J , Wright Lisa A
Published: June 2021

Student persistence is important for students, faculty, and universities and online faculty mentoring supports student persistence to graduation. The online learning environment is increasingly a choice for more undergraduate students, and it continues to grow in popularity as an attractive option for adults. It is crucial to find ways to increase persistence and graduation especially given the increased use of virtual learning during the COVID-19 pandemic. Attrition rates in online learning can be high for a variety of reasons, including persistence and engagement. Faculty mentors in the online environment can strengthen connections and relationships with undergraduate students, and it is important to ask for and evaluate these student perceptions. This mixed methods study surveyed and interviewed undergraduate students in an online university to understand both their experiences with faculty mentoring in the online environment and the potential of a faculty mentor program in a large online university. The purpose of this study was to explore the perceptions and experiences of four undergraduate student mentees with their faculty mentor at a large online university using mixed methods research design. In addition, survey data from one department are analyzed to guide future mentoring programs in online learning environments. Findings from the study indicate belief that mentoring and encouragement from faculty would enhance students’ scholarly experience. Students indicated they would like to participate in a faculty mentoring program, and it was clear that students welcome and appreciate the opportunity to further cement a professional relationship between themselves and faculty. This article makes a unique contribution to higher education research, providing a potential model for others seeking guidance in mentoring in online higher education. The data analysis and research indicate that a larger scale mentoring program might be more valuable for students.
Being Peer Gynt: How students collaboratively make meaning of a digital game about a literature classic
Authors: Sandberg Magnus H , Silseth Kenneth
Published: June 2021

Henrik Ibsen’s play Peer Gynt digs deep into the question of what it means to be oneself. An upcoming computer game version invites players to take on the role of Peer and thereby raises new questions about identity and identification. By recording dyads of students who play an early version of the game and analysing their interaction during gameplay, we examine how students collaboratively make meaning of the computer game. This study employs a sociocultural and dialogic approach to meaning making. In the analysis, we draw on Gee’s theory on multiple player identities and see the dyads playing together as two real-world selves negotiating on creating one virtual self through a co-authorship of situated meaning in what Gee calls the projective stance. To better understand their cooperation in this undertaking, we also apply Goffman’s term activity frames. The analysis shows how the dyads approach the game in different ways by establishing frames in which they interpret, impersonate or recreate Peer, in order to make meaning of their gameplay.
Analysing electrocardiographic traits and predicting cardiac risk in UK biobank
Authors: Ramírez Julia , Duijvenboden Stefan van , Young William J , Orini Michele , Jones Aled R , Lambiase Pier D , Munroe Patricia B , Tinker Andrew
Published: June 2021

The electrocardiogram (ECG) is a commonly used clinical tool that reflects cardiac excitability and disease. Many parameters are can be measured and with the improvement of methodology can now be quantified in an automated fashion, with accuracy and at scale. Furthermore, these measurements can be heritable and thus genome wide association studies inform the underpinning biological mechanisms. In this review we describe how we have used the resources in UK Biobank to undertake such work. In particular, we focus on a substudy uniquely describing the response to exercise performed at scale with accompanying genetic information.
An undiagnosed patient with skin rash, polyarthritis, and edema responding to low-dose colchicine: A case report
Authors: Maita Hiroki , Kobayashi Tadashi , Akimoto Takashi , Osawa Hiroshi , Hasui Keisuke , Kato Hiroyuki
Published: June 2021

A 54-year-old man was referred to our hospital with painful rashes on the extremities. He also developed polyarthritis and pitting pedal edema. Blood tests showed no specific autoantibodies and were negative for human leukocyte antigens B51, B15, and B27. Lower extremity venous ultrasonography and computed tomography angiography showed no vascular disorders. Skin biopsy showed no evidence of thrombosis or vasculitis. Direct fluorescence antibody analysis showed no antibody or complement deposition. Joint ultrasonography showed mild synovial thickening and/or synovial effusion in the extremities. Non-steroidal anti-inflammatory drugs and topical steroids were administered, followed by oral steroids. However, the signs and symptoms did not improve. Oral steroids were discontinued, and colchicine (0.5 mg/day) was administered. Thereafter, the symptoms of arthritis improved, and no skin rash developed. In potentially inflammatory conditions with skin rash, edema, and polyarthritis that are difficult to diagnose, low-dose colchicine administration may be considered for prompt relief of symptoms.
Factors Associated with Patients’ Connection to Referred Social Needs Resources at a Federally Qualified Health Center
Authors: Lian Tyler , Kutzer Kate , Gautam Diwas , Eisenson Howard , Crowder Jane C. , Esmaili Emily , Sandhu Sahil , Trachtman Lawrence , Prvu Bettger Janet , Drake Connor
Published: June 2021

Introduction:

In an effort to improve health outcomes and promote health equity, healthcare systems have increasingly begun to screen patients for unmet social needs and refer them to relevant social services and community-based organizations. This study aimed to identify factors associated with the successful connection (ie, services started) to social needs resources, as well as factors associated with an attempt to connect as a secondary, intermediate outcome.

Methods:

This retrospective cohort study included patients who had been screened, referred, and subsequently reached for follow-up navigation from March 2019 to December 2020, as part of a social needs intervention at a federally qualified health center (FQHC). Measures included demographic and social needs covariates collected during screening, as well as resource-related covariates that characterized the referred resources, including service domain (area of need addressed), service site (integration relative to the FQHC), and access modality (means of accessing services).

Results:

Of the 501 patients in the analytic sample, 32.7% had started services with 1 or more of their referred resources within 4 weeks of the initial referral, and 63.3% had at least attempted to contact 1 referred resource, whether or not they were able to start services. Receiving a referral to resources that patients could access via phone call or drop-in visit, as opposed to resources that required additional appointments or applications prior to accessing services, was associated with increased odds (aOR 1.95, 95% CI 1.05, 3.61) of connection success, after adjusting for age, sex, race, ethnicity, education, number of social needs, and resource-related characteristics. This study did not find statistically significant associations between connection attempt and any variable included in adjusted analyses.

Conclusion:

These findings suggest that referral pathways may influence the success of patients’ connection to social needs resources, highlighting opportunities for more accessible solutions to addressing patients’ unmet social needs.
An Exploratory Qualitative Study of Computer Screening to Support Decision-Making about Use of Palliative Care Registers in Primary Care: GP Think Aloud and Patient and Carer Interviews
Authors: Hubbard Gill , Broadfoot Kirsten , Carolan Clare , van Woerden Hugo C.
Published: June 2021

Objectives:

This study aimed to understand factors that influence general practitioner (GP) use of automated computer screening to identify patients for the palliative care register (PCR) and the experiences of palliative care and this emerging technology from patients’ and carers’ perspectives.

Methods:

A computer screening program electronically searches primary care records in routine clinical practice to identify patients with advanced illness who are not already on a PCR. Five GPs were asked to “think aloud” about adding patients identified by computer screening to the PCR. Key informant interviews with 6 patients on the PCR and 4 carers about their experiences of palliative care while on the PCR and their views of this technology. Data were analyzed thematically.

Results and Conclusions:

Using computer screening, 29% additional patients were added by GPs to the PCR. GP decision-making for the PCR was informed by clinical factors such as: if being treated with curative intent; having stable or unstable disease; end-stage disease, frailty; the likelihood of dying within the next 12 months; and psychosocial factors such as, age, personality, patient preference and social support. Six (60%) patients/carers did not know that they/their relative was on the PCR. From a patient/carer perspective, having a non-curative illness was not in and of itself sufficient reason for being on the PCR; other factors such as, unstable disease and avoiding pain and suffering were equally if not more, important. Patients and carers considered that computer screening should support but not replace, GP decision-making about the PCR. Computer screening merits ongoing development as a tool to aid clinical decision-making around entry to a PCR, but should not be used as a sole criterion. Care need, irrespective of diagnosis, disease trajectory or prognosis, should determine care.
A Reflection on Transactive Planning: Transfer of Planning Knowledge in Local Community-Level Deliberation
Authors: Taufiq Muhammad , Suhirman  , Kombaitan Benedictus
Published: June 2021

There is a limited understanding of how knowledge transfer in deliberative planning takes place, especially in a rural context. This article examines the metamorphosis of knowledge that occurs in deliberative rural planning dominated by the community. Deliberation facilitates the transactive process in development planning through knowledge transfer between the planner and the community to ensure that the achieved policies are appropriate for the local conditions. By combining the notion of transactive planning from John Friedmann, organizational knowledge creation from Nonaka, and the knowledge transfer–acquisition loop from Luna Khirfan, this article proposes a model of knowledge transfer based on a case study of deliberative planning practice for rural development in Teluk Aru, Indonesia. Fourteen respondents from various groups were interviewed, including village government officers, subdistrict officers, district agency officers, and community members. The deliberation process took place in four transactive stages: (a) public involvement, (b) knowledge enhancement, (c) concept dominance, and (d) policy improvement. The participants need to go through all these stages to ensure that the achieved policies conform to substantive needs and the community’s wishes. The proposed model shows that not all participants are in the same situation when taking part in the deliberation. Some of them can internalize the knowledge gained, while others are in a zone that is not covered by knowledge transfer. This explains why rural planning does not bring in inherent knowledge, although many attended the deliberation. Power, deliberative ability, and seriousness in participating affect the process of knowledge transfer.
Public Sector Employment, Quality of Government, and Well-Being: A Global Analysis
Authors: Davidson Robert , Pacek Alexander , Radcliff Benjamin
Published: June 2021

While a growing literature within the study of subjective well-being demonstrates the impact of socio-political factors on subjective well-being, scholars have conspicuously failed to consider the role of the size and scope of government as determinants of well-being. Where such studies exist, the focus is largely on the advanced industrial democracies of the Organization for Economic Co-Operation and Development. In this study, we examine the size of the public sector as a determinant of cross-national variation in life satisfaction across a worldwide sample. Our findings strongly suggest that as the public sector grows, subjective well-being increases as well, conditional on the extent of quality of government. Using cross-sectional data on 84 countries, we show this relationship has an independent and separable impact from other economic and political factors.
Hyperintense acute reperfusion marker associated with hemorrhagic transformation in the WAKE-UP trial
Authors: Wouters Anke , Scheldeman Lauranne , Dupont Patrick , Cheng Bastian , Ebinger Martin , Jensen Märit , Endres Matthias , Gerloff Christian , Muir Keith W , Nighoghossian Norbert , Pedraza Salvador , Simonsen Claus Z , Boutitie Florent , Thijs Vincent , Thomalla Götz , Fiebach Jochen , Lemmens Robin
Published: June 2021

Introduction

Hyperintense acute reperfusion marker (HARM) is an indicator of early disruption of the blood-brain-barrier. Our aim was to investigate the incidence of HARM in patients with a diffusion weighted imaging (DWI) - fluid attenuated inversion recovery (FLAIR) mismatch and determine the association between this marker and hemorrhagic complications as well as clinical outcome.

Patients and Methods

We included patients from the Efficacy and Safety of MRI-Based Thrombolysis in Wake-Up Stroke (WAKE-UP) trial who underwent baseline perfusion weighted imaging (PWI). HARM was defined as a hyperintense signal in the cerebrospinal fluid space on FLAIR imaging at 24 h after baseline imaging. We compared baseline characteristics in patients with and without HARM and investigated the association between HARM and any hemorrhagic transformation (HT) and parenchymal hematoma (PH) in a multivariate logistic regression. We also explored HARM as an independent predictor of poor outcome, defined as a modified Rankin Scale of 3–6 at 90 days.

Results

HARM was present in 14 of 223 (6%) patients with a DWI-FLAIR mismatch and baseline characteristics were similar in patients with vs without HARM. HARM showed an independent relationship with any HT (OR 6.67; 95%CI 1.72–26.58) and any PH (OR 6.92; 95%CI 1.34–29.49). The rate of HARM was similar in patients with good and poor outcome (5%, p = 0.90).

Conclusion

In the WAKE-UP trial, the incidence of HARM was only 6% at 24 h. An association was present between HARM and hemorrhagic complications, but no relationship with functional outcome was observed.
Geographical variations and associated factors of defaulting from immunization among children aged 12 to 23 months in Ethiopia: using spatial and multilevel analysis of 2016 Ethiopian Demographic and Health Survey
Authors: Awol Mukemil , Alemu Zewdie Aderaw , Moges Nurilign Abebe , Jemal Kemal
Published: June 2021

Background

In Ethiopia, despite the considerable improvement in immunization coverage, the burden of defaulting from immunization among children is still high with marked variation among regions. However, the geographical variation and contextual factors of defaulting from immunization were poorly understood. Hence, this study aimed to identify the spatial pattern and associated factors of defaulting from immunization.

Methods

An in-depth analysis of the 2016 Ethiopian Demographic and Health Survey (EDHS 2016) data was used. A total of 1638 children nested in 552 enumeration areas (EAs) were included in the analysis. Global Moran’s I statistic and Bernoulli purely spatial scan statistics were employed to identify geographical patterns and detect spatial clusters of defaulting immunization, respectively. Multilevel logistic regression models were fitted to identify factors associated with defaulting immunization. A p value < 0.05 was used to identify significantly associated factors with defaulting of child immunization.

Results

A spatial heterogeneity of defaulting from immunization was observed (Global Moran’s I = 0.386379, p value < 0.001), and four significant SaTScan clusters of areas with high defaulting from immunization were detected. The most likely primary SaTScan cluster was seen in the Somali region, and secondary clusters were detected in (Afar, South Nation Nationality of people (SNNP), Oromiya, Amhara, and Gambella) regions. In the final model of the multilevel analysis, individual and community level factors accounted for 56.4% of the variance in the odds of defaulting immunization. Children from mothers who had no formal education (AOR = 4.23; 95% CI: 117, 15.78), and children living in Afar, Oromiya, Somali, SNNP, Gambella, and Harari regions had higher odds of having defaulted immunization from community level.

Conclusions

A clustered pattern of areas with high default of immunization was observed in Ethiopia. Both the individual and community-level characteristics were statistically significant factors of defaulting immunization. Therefore, the Federal Ethiopian Ministry of Health should prioritize the areas with defaulting of immunization and consider the identified factors for immunization interventions.
Predicting biological pathways of chemical compounds with a profile-inspired approach
Authors: Lopez-Ibañez Javier , Pazos Florencio , Chagoyen Monica
Published: June 2021

Background

Assignment of chemical compounds to biological pathways is a crucial step to understand the relationship between the chemical repertory of an organism and its biology. Protein sequence profiles are very successful in capturing the main structural and functional features of a protein family, and can be used to assign new members to it based on matching of their sequences against these profiles. In this work, we extend this idea to chemical compounds, constructing a profile-inspired model for a set of related metabolites (those in the same biological pathway), based on a fragment-based vectorial representation of their chemical structures.

Results

We use this representation to predict the biological pathway of a chemical compound with good overall accuracy (AUC 0.74–0.90 depending on the database tested), and analyzed some factors that affect performance. The approach, which is compared with equivalent methods, can in addition detect those molecular fragments characteristic of a pathway.

Conclusions

The method is available as a graphical interactive web server http://csbg.cnb.csic.es/iFragMent.
Complex II subunit SDHD is critical for cell growth and metabolism, which can be partially restored with a synthetic ubiquinone analog
Authors: Bandara Aloka B. , Drake Joshua C. , Brown David A.
Published: June 2021

Background

Succinate dehydrogenase (Complex II) plays a dual role in respiration by catalyzing the oxidation of succinate to fumarate in the mitochondrial Krebs cycle and transferring electrons from succinate to ubiquinone in the mitochondrial electron transport chain (ETC). Mutations in Complex II are associated with a number of pathologies. SDHD, one of the four subunits of Complex II, serves by anchoring the complex to the inner-membrane and transferring electrons from the complex to ubiquinone. Thus, modeling SDHD dysfunction could be a valuable tool for understanding its importance in metabolism and developing novel therapeutics, however no suitable models exist.

Results

Via CRISPR/Cas9, we mutated SDHD in HEK293 cells and investigated the in vitro role of SDHD in metabolism. Compared to the parent HEK293, the knockout mutant HEK293ΔSDHD produced significantly less number of cells in culture. The mutant cells predictably had suppressed Complex II-mediated mitochondrial respiration, but also Complex I-mediated respiration. SDHD mutation also adversely affected glycolytic capacity and ATP synthesis. Mutant cells were more apoptotic and susceptible to necrosis. Treatment with the mitochondrial therapeutic idebenone partially improved oxygen consumption and growth of mutant cells.

Conclusions

Overall, our results suggest that SDHD is vital for growth and metabolism of mammalian cells, and that respiratory and growth defects can be partially restored with treatment of a ubiquinone analog. This is the first report to use CRISPR/Cas9 approach to construct a knockout SDHD cell line and evaluate the efficacy of an established mitochondrial therapeutic candidate to improve bioenergetic capacity.
kataegis: an R package for identification and visualization of the genomic localized hypermutation regions using high-throughput sequencing
Authors: Lin Xue , Hua Yingying , Gu Shuanglin , Lv Li , Li Xingyu , Chen Pin , Dai Peng , Hu Yunyun , Liu Anna , Li Jian
Published: June 2021

Background

Genomic localized hypermutation regions were found in cancers, which were reported to be related to the prognosis of cancers. This genomic localized hypermutation is quite different from the usual somatic mutations in the frequency of occurrence and genomic density. It is like a mutations “violent storm”, which is just what the Greek word “kataegis” means.

Results

There are needs for a light-weighted and simple-to-use toolkit to identify and visualize the localized hypermutation regions in genome. Thus we developed the R package “kataegis” to meet these needs. The package used only three steps to identify the genomic hypermutation regions, i.e., i) read in the variation files in standard formats; ii) calculate the inter-mutational distances; iii) identify the hypermutation regions with appropriate parameters, and finally one step to visualize the nucleotide contents and spectra of both the foci and flanking regions, and the genomic landscape of these regions.

Conclusions

The kataegis package is available on Bionconductor/Github (https://github.com/flosalbizziae/kataegis), which provides a light-weighted and simple-to-use toolkit for quickly identifying and visualizing the genomic hypermuation regions.
Comprehensive identification and expression analysis of B-Box genes in cotton
Authors: Feng Zhen , Li Mengyu , Li Yi , Yang Xu , Wei Hengling , Fu Xiaokang , Ma Liang , Lu Jianhua , Wang Hantao , Yu Shuxun
Published: June 2021

Background

B-BOX (BBX) proteins are zinc-finger transcription factors with one or two BBX domains and sometimes a CCT domain. These proteins play an essential role in regulating plant growth and development, as well as in resisting abiotic stress. So far, the BBX gene family has been widely studied in other crops. However, no one has systematically studied the BBX gene in cotton.

Results

In the present study, 17, 18, 37 and 33 BBX genes were detected in Gossypium arboreum, G. raimondii, G. hirsutum and G. barbadense, respectively, via genome-wide identification. Phylogenetic analysis showed that all BBX genes were divided into 5 main categories. The protein motifs and exon/intron structures showed that each group of BBX genes was highly conserved. Collinearity analysis revealed that the amplification of BBX gene family in Gossypium spp. was mainly through segmental replication. Nonsynonymous (Ka)/ synonymous (Ks) substitution ratios indicated that the BBX gene family had undergone purification selection throughout the long-term natural selection process. Moreover, transcriptomic data showed that some GhBBX genes were highly expressed in floral organs. The qRT-PCR results showed that there were significant differences in GhBBX genes in leaves and shoot apexes between early-maturing materials and late-maturing materials at most periods. Yeast two-hybrid results showed that GhBBX5/GhBBX23 and GhBBX8/GhBBX26 might interact with GhFT. Transcriptome data analysis and qRT-PCR verification showed that different GhBBX genes had different biological functions in abiotic stress and phytohormone response.

Conclusions

Our comprehensive analysis of BBX in G. hirsutum provided a basis for further study on the molecular role of GhBBXs in regulating flowering and cotton resistance to abiotic stress.
Dietary phytochemical index associated with cardiovascular risk factor in patients with type 1 diabetes mellitus
Authors: Delshad Aghdam Saeideh , Siassi Fereydoun , Nasli Esfahani Ensieh , Qorbani Mostafa , Rajab Asadollah , Sajjadpour Zahra , Bashiri Anahita , Aghayan Maryam , Sotoudeh Gity
Published: June 2021

Background

Dietary phytochemical index (DPI) is useful and inexpensive method to identify the role of phytochemicals on cardiovascular disease (CVD) risk factors. This study aimed to assess the relationship between DPI and CVD risk factors in patients with type1 diabetes mellitus.

Methods

A total of 261 participants aged 18–35 years with T1DM were enrolled in this cross-sectional study to assess the relationship between DPI and CVD risk factors. Anthropometric measurements, blood lipids, glucose, and antioxidant level were measured. Food intakes were determined using a food frequency questionnaire to calculate DPI. Logistic regression was used.

Results

The mean age of participants was 25 years. After adjustment for potential confounders, participants in the highest tertile of DPI had 88 % lower chance of hyperglycemia (P for trend = 0.020), 81 % lower chance of low high-density lipoprotein cholesterol (HDL-C) (P for trend = 0.030) and 98 % lower chance of high low-density lipoprotein cholesterol to HDL-C ratio (P for tend = 0.040). There were no relationships between DPI and other CVD risk factors.

Conclusions

Although higher intake of phytochemical-rich foods had a beneficial effect on some risk factors of CVD, more studies more studies are warranted to corroborate the present findings.
Alterations in MicroRNA gene expression profile in liver transplant patients with hepatocellular carcinoma
Authors: Afshari Afsoon , Yaghobi Ramin , Karimi Mohammad Hossein , Mowla Javad
Published: June 2021

Background

Hepatocellular carcinoma (HCC) can lead to liver failure which renders to liver transplant. miRNAs might be detected as biomarkers in subclinical stage of several hepatobiliary disorders like HCC. Therefore, in the present study, alterations in miRNAs as biomarkers were detected in LT patients with HCC.

Methods

Fourteen tissue samples composed of 5 rejected and 9 non-rejected ones were used for studying the miRNAs expression pattern using LNA-array probe assay and the result was evaluated by in house SYBR Green Real-time PCR protocols on 30 other tissue samples composed of 10 rejected and 20 non-rejected ones for the selected miRNAs. All samples were collected from liver transplanted patients with HCC.

Results

The study results revealed that in rejected patients compared to non-rejected ones, hsa-miR-3158-5p, -4449, -4511, and -4633-5p were up-regulated and hsa-miR-122-3p, -194-5p, 548as-3p, and -4284 were down-regulated. ROC curve analysis also confirmed that miR194-5p and -548as-3p in up-regulated and also, miR-3158-5p, -4449 in down-regulated microRNAs are significantly important molecules in rejection.

Conclusion

Finally, the tissue levels of specific miRNAs (especially hsa-miR-3158-5p, -4449, -194-5p and -548as-3p) significantly correlated with the development of HCC, which can be present as biomarkers after further completing studies.
Is insulin the preferred treatment in persons with type 2 diabetes and liver cirrhosis?
Authors: Yen Fu-Shun , Lai Jung-Nien , Wei James Cheng-Chung , Chiu Lu-Ting , Hsu Chih-Cheng , Hou Ming-Chih , Hwu Chii-Min
Published: June 2021

Background

Insulin is highly recommended for diabetes management in persons with liver cirrhosis. However, few studies have evaluated its long-term effects in these persons. We conducted this study to compare the risks of mortality, liver-related complications, and cardiovascular events in persons with type 2 diabetes mellitus (T2DM) and compensated liver cirrhosis.

Methods

From January 1, 2000, to December 31, 2012, we selected 2047 insulin users and 4094 propensity score-matched nonusers from Taiwan’s National Health Insurance Research Database. Cox proportional hazard models were used to assess the risks of outcomes.

Results

The mean follow-up time was 5.84 years. The death rate during the follow-up period was 5.28 and 4.07 per 100 person-years for insulin users and nonusers, respectively. In insulin users, the hazard ratios and 95% confidence intervals (CIs) of all-cause mortality, hepatocellular carcinoma, decompensated cirrhosis, hepatic failure, major cardiovascular events, and hypoglycemia were 1.31 (1.18–1.45), 1.18 (1.05–1.34), 1.53 (1.35–1.72), 1.26 (1.42–1.86), 1.41 (1.23–1.62), and 3.33 (2.45–4.53), respectively.

Conclusions

This retrospective cohort study indicated that among persons with T2DM and compensated liver cirrhosis, insulin users were associated with higher risks of death, liver-related complications, cardiovascular events, and hypoglycemia compared with insulin nonusers.
Serum pepsinogen levels in different regions of China and its influencing factors: a multicenter cross-sectional study
Authors: Tong Yuling , Wang Hongguang , Zhao Yi , He Xueqiang , Xu Hongwei , Li Hong , Shuai Ping , Gong Lirong , Wu Hongbo , Xu Hongzhi , Luo Yinhu , Wang Dong , Liu Shizhu , Song Zhenya
Published: June 2021

Background

The aim of this study is to investigate the difference of serum pepsinogen (PG) baseline levels in different regions of China and its influencing factors.

Methods

From October 2016 to October 2018, asymptomatic health checkup people who underwent nasal endoscopy in nine health management centers in different regions of China were collected. Lifestyle questionnaires were conducted, and serum PG and gastroscopy were performed. The differences in PG levels in baseline population (OLGA-0 grade) were studied according to geographical subregions of China. SPSS software was used for statistical analysis.

Results

1922 patients were included in the final analysis. Compared with the non-atrophy (OLGA-0) group, PGR levels in atrophy group (OLGA-I to IV) were significantly decreased with the atrophy degree (p < 0.05). A total of 1590 baseline people (OLGA-0) were included in the study, including 254 from South China, 574 from East China, 210 from Southwest China, 332 from Northeast China, and 220 from Central/Northern China. There were significant differences in baseline PGI levels among the five regions (p < 0.05). The PGII levels were also different among the five regions, except for Central/Northern versus Southern China. PGR (PGI/PGII ratio) levels in Southern China were higher than other four regions. Further studies were conducted on the related factors that might affect the baseline PG level, which was affected by nationality, dietary habits, smoking,Helicobacter pyloriinfection and other related factors.

Conclusion

Influenced by many factors, the baseline PG levels are different in different regions of China. In the follow-up studies of PG cut-off value, different PG cut-off value based on region may be more effective in the screening of gastric cancer and precancerous lesions in China.
Natural killer cell activity is a risk factor for the recurrence risk after curative treatment of hepatocellular carcinoma
Authors: Lee Han Ah , Goh Hyun Gil , Lee Young-Sun , Jung Young Kul , Kim Ji Hoon , Yim Hyung Joon , Lee Min-Goo , An Hyunggin , Jeen Yoon Tae , Yeon Jong Eun , Byun Kwan Soo , Seo Yeon Seok
Published: June 2021

Background

Natural killer (NK) cells have been known to contribute to surveillance and control of hepatocellular carcinoma (HCC). However, the association of NK cell activity with stage and recurrence risk of HCC have not been fully evaluated.

Methods

Untreated patients with newly diagnosed HCC were prospectively enrolled. Peripheral blood mononuclear cells were isolated at the time of diagnosis. Patients who had undergone surgery or radiofrequency ablation were classified as the curative treatment group, and their blood samples were collected again at 1 month after treatment.

Results

A total of 80 patients with HCC were enrolled. The mean age was 62.5 years. At baseline, interferon (IFN)-γ producing NK cell proportion was significantly lower in patients with Barcelona clinic liver cancer (BCLC) stage B, C, or D than in those with BCLC stage 0 (42.9% vs. 56.8%,P = 0.045). Among all patients, 56 patients had undergone curative treatment, and 42 patients re-visited at 1 month after curative treatment. There was no significant change in total NK cell and IFN-γ producing NK cell proportion from baseline to 1 month after treatment (allP > 0.05). During a median follow-up of 12.4 months, HCC recurred in 14 patients (33.3%). When patients were classified according to the IFN-γ producing NK cell proportion (group 1, ≥ 45%; and group 2, < 45%), HCC recurrence rate did not differ according to the IFN-γ producing NK cell proportion at baseline (log-rank test,P = 0.835). However, patients with < 45% IFN-γ producing NK cell proportion at 1 month after treatment had a significantly higher HCC recurrence rate than patients with that of ≥ 45% (log-rank test,P < 0.001). Multivariate analysis revealed that BCLC stage B (hazard ratio [HR] = 3.412,P = 0.045) and < 45% IFN-γ producing NK cell proportion at 1 month after treatment (HR = 6.934,P = 0.001) independently predicted an increased risk of HCC recurrence.

Conclusions

Decreased NK cell activity is significantly associated with the advanced stage of HCC, and the increased recurrence risk of HCC after curative treatment.
Sofosbuvir/velpatasvir is an effective treatment for patients with hepatitis C and advanced fibrosis or cirrhosis in a real-world setting in Taiwan
Authors: Huang Yu-Ting , Hsieh Yung-Yu , Chen Wei-Ming , Tung Shui-Yi , Wei Kuo-Liang , Shen Chen-Heng , Chang Kao-Chi , Lu Chung-Kuang , Yen Chih-Wei , Lu Sheng-Nan , Hung Chao-Hung , Chang Te-Sheng
Published: June 2021

Introduction

Real-world data regarding the impact of hepatic fibrosis on the effectiveness of sofosbuvir/velpatasvir (SOF/VEL) treatment is limited in the Asian population.

Methods

We analyzed data for all 823 patients with hepatitis C virus treated with SOF/VEL from June 2019 to September 2020 at Chang Gung Memorial Hospital in Chiayi, Taiwan. The degree of fibrosis was determined using the fibrosis-4 (FIB-4) index, with advanced fibrosis or cirrhosis defined as a FIB-4 score of > 3.25. The primary treatment outcome was the rate of sustained virologic response 12 weeks after treatment cessation (SVR). Adverse events (AEs) were also evaluated.

Results

SVR rates did not significantly differ (p > 0.05) between patients with FIB-4 scores of ≤ 3.25 and those with scores of > 3.25. In the per protocol analysis, 99.2% (593/598) of the FIB-4 ≤ 3.25 group and 100% (172/172) of the FIB-4 > 3.25 group achieved SVR; in the evaluable population analysis, 93.4% (593/635) of the FIB-4 ≤ 3.25 group and 91.5% (172/188) of the FIB-4 > 3.25 group achieved SVR. Five patients with FIB-4 scores of ≤ 3.25 did not attain SVR: two relapsed and three had no response. The most common AEs were comparable (p > 0.05) for the FIB-4 ≤ 3.25 group and the FIB-4 > 3.25 group and included abdominal discomfort (4.4% vs. 5.9%), fatigue (4.1% vs. 5.9%), and skin itching (3.6% vs. 3.2%). Laboratory abnormalities were more common in the FIB-4 > 3.25 group (p < 0.001). Six patients with FIB-4 scores of > 3.25 had total bilirubin elevation > 3 × the upper normal limit (UNL). Alanine transaminase elevation > 5 × the UNL was observed in two patients with FIB-4 scores of ≤ 3.25 and one patient with a FIB-4 score of > 3.25. No AEs resulted in treatment discontinuation.

Conclusions

SOF/VEL treatment is well tolerated and achieves high SVR rates for patients of Taiwanese ethnicity with HCV, regardless of cirrhosis status.
Targeted imaging of esophageal adenocarcinoma with a near-infrared fluorescent peptide
Authors: Kang Xiaoyu , Li Meng , liu Lei , Liu Shaopeng , Hu Hao , Zhang Rui , Ning Siming , Tian Zuhong , Pan Yanglin , Guo Xuegang , Wu Kaichun
Published: June 2021

Background

Targeted optical imaging offers a noninvasive and accurate method for the early detection of gastrointestinal tumors, especially for flat appearances. In our previous study, a sequence of SNFYMPL (SNF) was identified as a specific peptide to bind to esophageal carcinoma using phage-display technology. This study aimed to evaluate the tumor-targeting efficacy of Cy5.5-conjugated SNF probe for imaging of esophageal carcinoma in vitro and in vivo.

Methods

The SNF-Cy5.5 probe was synthesized and then identified using High Performance Liquid Chromatography (HPLC) and mass spectrometry (MS). Confocal fluorescence imaging and Flow cytometry analysis were performed to evaluate the binding specificity and the receptor binding affinity of SNF-Cy5.5 to OE33. In vivo imaging was performed to evaluate the targeting ability of SNF-Cy5.5 to esophageal carcinoma.

Results

The confocal imaging and flow cytometry analysis showed that SNF-Cy5.5 bound specifically to the plasma membrane of OE33 cells with a high affinity. In vivo, for non-block group, SNF-Cy5.5 probe exhibited rapid OE33 tumor targeting during 24 h p.i. and excellent tumor-to-background contrast at 2 h p.i. For the block group, SNF-Cy5.5 was not observed in the mice after 4 h p.i. Ex vivo imaging also revealed that a higher fluorescent signal intensity value of the tumors was clearly observed in the non-block group than that in the block group (2.6 ± 0.32 × 109 vs. 0.8 ± 0.08 × 109, p < 0.05).

Conclusions

SNF-Cy5.5 was synthesized and characterized with a high efficiency and purity. The higher affinity, specificity, and tumor targeting efficacy of SNF-Cy5.5 were confirmed by in vitro and in vivo tests. SNF-Cy5.5 is a promising optical probe for the imaging of esophageal adenocarcinoma.
Pancreaticopleural fistula in a child with chronic pancreatitis harboring compound SPINK1 variants
Authors: Kijmassuwan Teera , Aanpreung Prapun , Prachayakul Varayu , Tovichien Prakarn
Published: June 2021

Background

Pancreaticopleural fistula (PPF) is a rare complication of chronic pancreatitis (CP) that requires a high index of clinical suspicion in the patient who presents with a pleural effusion. Visualizing the fistula tract from the pancreatic duct to the pleural space by radiological imaging provides confirmation of this complication.

Case presentation

A 9-year-old boy who presented with massive right pleural effusion secondary to PPF, a complication of CP from a genetic mutation involving two mutations ofSPINK1. We successfully managed the case with by endoscopic pancreatic duct stent placement after failure of conservative treatment approaches.

Conclusions

PPF is a rare but serious complication of CP in all ages. The diagnosis of PPF in children requires a high index of clinical suspicion and should be considered in the differential diagnosis of massive pleural effusion where pancreatic pathology is present. A high level of pleural fluid amylase and the results from radiological imaging when the patients have symptoms play essential roles in the diagnosis of PPF. Currently, Magnetic resonance cholangiopancreatigraphy (MRCP) is the imaging modality of choice. Endoscopic therapy and surgery are treatment options for patients who do not respond to conservative therapy.
Structural equation model of affecting factors on elder abuse to patients under hemodialysis by family caregivers
Authors: Mahmoudian Amaneh , Shamsalinia Abbas , Alipour Atefeh , Fotoukian Zahra , Ghaffari Fatemeh
Published: June 2021

Background

The objectives of the present study were to determine the prevalence of older adults with hemodialysis (HD) abuse by family caregivers and the factors affecting it.

Method

This is a correlational-causal study, which is conducted in 2018 in Iran. The sample size was 367 in both groups (the older adults and their family caregivers). Data collection was done using an individual-social information questionnaire for the older adults under hemodialysis and their family caregivers, the questionnaire of elder abuse by family caregivers to the older people under hemodialysis, Zarit Burden Interview and the scale of instrumental activities of daily living (IADL). Data were analyzed by the structural equation model (SEM) method. The Fitness of proposed pattern was measured using the following indexes: chi-square/degree of freedom ratio (CMIN/DF), Normed Fit Index (NFI), comparative fit index (CFI), goodness of fit index (GFI), and standardized root mean squared residual (SRMR). The significant level in this study was considered p < 0.05.

Results

The results of the present study showed that more than 70 % of the older adults suffer from elder abuse by family caregivers on average. The highest median elder abuse was related to emotional misbehavior (21.46 ± 6.09) and financial misbehavior (19.07 ± 5.33), respectively. Moderate care burden was experienced by 63.2 % of caregivers. The percentage of older women and men, who needed help with daily activities was 81.4 and 80.5 %, respectively. The results showed that the caregivers’ level of education and care burden with standard beta coefficient of -0.251 and 0.200 and the educational level of older adults and IADL with the best beta coefficient of -0.299 and − 0.234, had the highest regression effect on elder abuse respectively. According to the results, the model-fit indices of the hypothesized model was meet the criteria, with the NFI = 0.951, GFI = 0.970, CFI = 0.967, and SRMR = 0.041. The outcome was suitable for the recommended level, so the hypothetical model appeared to fit the data.

Conclusions

The results of the present study showed that the prevalence of elder abuse by family caregivers among the older adults under hemodialysis is high. Providing psychological counseling can reduce the consequences of elder abuse.
Inflammation and microbial translocation measured prior to combination antiretroviral therapy (cART) and long-term probability of clinical progression in people living with HIV
Authors: Merlini Esther , Cozzi-lepri Alessandro , Castagna Antonella , Costantini Andrea , Caputo Sergio Lo , Carrara Stefania , Quiros-Roldan Eugenia , Ursitti Maria A. , Antinori Andrea , D’Arminio Monforte Antonella , Marchetti Giulia
Published: June 2021

Background

Despite the effectiveness of cART, people living with HIV still experience an increased risk of serious non-AIDS events, as compared to the HIV negative population. Whether pre-cART microbial translocation (MT) and systemic inflammation might predict morbidity/mortality during suppressive cART, independently of other known risk factors, is still unclear. Thus, we aimed to investigate the role of pre-cART inflammation and MT as predictors of clinical progression in HIV+ patients enrolled in the Icona Foundation Study Cohort.

Methods

We included Icona patients with ≥2 vials of plasma stored within 6 months before cART initiation and at least one CD4 count after therapy available. Circulating biomarker: LPS, sCD14, EndoCab, hs-CRP. Kaplan-Meier curves and Cox regression models were used. We defined the endpoint of clinical progression as the occurrence of a new AIDS-defining condition, severe non-AIDS condition (SNAEs) or death whichever occurred first. Follow-up accrued from the data of starting cART and was censored at the time of last available clinical visit. Biomarkers were evaluated as both binary (above/below median) and continuous variables (logescale).

Results

We studied 486 patients with 125 clinical events: 39 (31%) AIDS, 66 (53%) SNAEs and 20 (16%) deaths. Among the analyzed MT and pro-inflammatory markers, hs-CRP seemed to be the only biomarker retaining some association with the endpoint of clinical progression (i.e. AIDS/SNAEs/death) after adjustment for confounders, both when the study population was stratified according to the median of the distribution (1.51 mg/L) and when the study population was stratified according to the 33% percentiles of the distribution (low 0.0–1.1 mg/L; intermediate 1.2–5.3 mg/L; high > 5.3 mg/L). In particular, the higher the hs-CRP values, the higher the risk of clinical progression (p = 0.056 for median-based model; p = 0.002 for 33% percentile-based model).

Conclusions

Our data carries evidence for an association between the risk of disease progression after cART initiation and circulating pre-cART hs-CRP levels but not with levels of MT. These results suggest that pre-therapy HIV-driven pro-inflammatory milieu might overweight MT and its downstream immune-activation.
Antimicrobial resistance and molecular epidemiological typing of Neisseria gonorrhoeae isolates from Kyrgyzstan in Central Asia, 2012 and 2017
Authors: Karymbaeva Saliya , Boiko Iryna , Jacobsson Susanne , Mamaeva Galina , Ibraeva Ainagul , Usupova Dilara , Golparian Daniel , Unemo Magnus
Published: June 2021

Background

Gonorrhoea and antimicrobial resistance (AMR) in Neisseria gonorrhoeae are significant public health concerns globally. Nearly no gonococcal AMR data are available from Central Asia, and no data from Kyrgyzstan has been published. We examined, for the first time, AMR and molecular epidemiology of N. gonorrhoeae isolates cultured in Kyrgyzstan in 2012 and 2017, in order to inform refinements of the Kyrgyz national gonorrhoea management guidelines.

Methods

N. gonorrhoeae isolates cultured in 2012 (n = 84) and 2017 (n = 72) in Kyrgyzstan were examined. MICs of nine antimicrobials were determined using Etest and, where available, clinical breakpoints from the EUCAST were applied. N. gonorrhoeae multiantigen sequence typing (NG-MAST) was also performed.

Results

The overall resistance levels were high to ciprofloxacin (88.5%), tetracycline (56.9%), benzylpenicillin (39.1%), and kanamycin (4.7%). Resistance to cefixime (0.6%, n = 1 isolate), azithromycin (0.6%, n = 1), and gentamicin (0.6%, n = 1) was rare. No resistance to ceftriaxone or spectinomycin was found. However, the proportion of isolates with decreased susceptibility (MIC = 0.125 mg/L) to ceftriaxone and cefixime was 12.8 and 11.5%, respectively. Gonococcal isolates were assigned 69 sequence types, of which 52 (75.4%) were new.

Conclusions

The gonococcal population in Kyrgyzstan in 2012 and 2017 showed a high genetic diversity. Ceftriaxone, 500–1000 mg, in combination with azithromycin 2 g or doxycycline, particularly when chlamydial infection has not been excluded, should be recommended as empiric first-line treatment. Spectinomycin 2 g could be an alternative treatment, and given with azithromycin 2 g if pharyngeal gonorrhoea has not been excluded. Fluoroquinolones, aminoglycosides, benzylpenicillin, or tetracyclines should not be used for empiric treatment of gonorrhoea in Kyrgyzstan. Timely updating and high compliance to national gonorrhoea treatment guidelines based on quality-assured AMR data is imperative. Expanded and improved gonococcal AMR surveillance in Kyrgyzstan is crucial.
Import and transmission of Mycobacterium orygis and Mycobacterium africanum, Norway
Authors: Eldholm Vegard , Rønning Janne O. , Mengshoel Anne Torunn , Arnesen Trude
Published: June 2021

Background

The aim of the current study was to improve our understanding of the origins and transmission of Mycobacterium africanum (MAF) in Norway.

Methods

Whole-genome sequences (WGS) were generated for all (n = 29) available clinical isolates received at the Norwegian National Reference Laboratory for Mycobacteria (NRL) and identified as MAF in Norway, in the period 2010–2020. Phylogenetic analyses were performed.

Results

The analyses indicated several imports of MAF lineage 6 from both East and West African countries, whereas MAF lineage 5 was restricted to patients with West African connections. We also find evidence for transmission of MAF in Norway. Finally, our analyses revealed that a group of isolates from patients originating in South Asia, identified as MAF by means of a commercial line-probe assay, in fact belonged to Mycobacterium orygis.

Conclusions

Most MAF cases in Norway are the result of import, but transmission is occurring within Norway.